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CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name: The Eastman Company
Vendor Number:
JD Edwards Number
Contract Number: V\/fc''3 •- 3-
This is assigned, by City Clerk's Office
Project Name: 224`h/228eh East Leg Rd Construction
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract
❑ Other: e,'VQ_pS rf'fu"n Fid-
Contract Effective Date: 9/18/15 Termination Date: 12/31/15
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Ingrid Willms-Dixon Department: Engineering
Contract Amount: $3,600.00
Approval Authority: (CIRCLE ONE 'Department Director' Mayor City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
Provide appraisal services for the property at Hytek Wetlands.
As of: 08/27/14
K EN* T
PROFESSIONAL SERVICES AGREEMENT
between the City of Kent and
The Eastman Company
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and The Eastman Company organized under the laws of the State of Washington,
located and doing business at 6206 35th Avenue NE, Seattle, WA 98115, Phone: (206) 856-9242, Contact:
Don Melton (hereinafter the "Contractor").
I. DESCRIPTION OF WORK.
Contractor shall perform the following services for the City:
Contractor shall provide appraisal services for the property at Hytek Wetlands
(APN - 38300-0030, 0055, and 0070), Kent, WA.
For a description, see the Contractor's Scope of Work which Is attached as
Exhibit A and incorporated by this reference.
Contractor further represents that the services furnished under this Agreement will be performed in
accordance with generally accepted professional practices within the Puget Sound region In effect at the
time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon the effective date of this Agreement, and Contractor shall complete the
work by December 31, 2015.
III. COMPENSATION. The City shall pay Contractor a total amount not to exceed Three
Thousand Six Hundred Dollars ($3,600.00) for the services described in this Agreement. The Contractor
shall invoice the City monthly based on time and materials incurred during the preceding month. The
hourly rates charged for Contractor's services shall be as delineated in the attached and incorporated
Exhibit A. All hourly rates charged shall remain locked at the negotiated rates throughout the term of this
Agreement. _
IV. INDEPENDENT CONTRACTOR. The parties Intend that an Independent Contractor-
Employer Relationship'w(ll be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08'RCW, the parties make the following representations:
A. The Contractor has the ability to control and direct the performance and details of Its
work, the City being interested only in the results obtained under this Agreement.
B. The Contractor maintains and pays for Its own place of business from which
Contractor's services under this Agreement will be performed.
C. The Contractor has an established and Independent business that is eligible for a
business deduction for federal income tax purposes that existed before the City
retained Contractor's services, or the Contractor is engaged in an independently
established trade, occupation, profession, or business of the same nature as that
involved under this Agreement.
PROFESSIONAL SERVICES AGREEMENT- 1
($20,000 or Less)
D. The Contractor is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, Including the Internal
Revenue Service and the state Department of Revenue.
E. The Contractor has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by Contractor's
business, and has obtained a Unified Business Identifier (UBI) number from the
State of Washington.
F. The Contractor maintains a set of books dedicated to the expenses and earnings of
Its business.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party seven (7) calendar days written notice at its address set forth on the signature
block of this Agreement.
VI. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any subcontract, the Contractor, Its subcontractors, or any person acting on behalf of the
Contractor or subcontractor shall not discrlminate against any person who is qualified and available to
perform the work to which the employment relates as provided for by the City of Kent's Equal
Employment Opportunity Policy. Contractor shall execute the attached City of Kent Equal Employment
Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the
contract work, file the attached Compliance Statement.
VII. INDEMNIFICATION. Contractor shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, Injuries, damages, losses or
suits, including all legal costs and attorney fees, arising out of or In connection with the Contractor's
performance of this Agreement, except for that portion of the Injuries and damages caused by the City's
negligence. The City's Inspection or acceptance of any of Contractor's work when completed shall not be
grounds to avoid any of these covenants of indemnification. The provisions of this section shall survive
the expiration or termination of this Agreement.
In the event Contractor refuses tender of defense in any suit or any claim, if that tender was made
pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having
jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Contractor's part, then
Contractor shall pay all the City's costs for defense, including all reasonable expert witness fees and
reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful
refusal on the Contractor's part.
VIII. INSURANCE. The Contractor shall procure and maintain for the duration of the
Agreement, Insurance of the types and In the amounts described in Exhibit B attached and incorporated by
this reference.
IX. CONTRACTOR'S WORK AND RISK. The Contractor agrees to comply with all federal,
state, and municipal laws, rules, and regulations that are now effective or in the future become applicable
to Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or
accruing out of the performance of those services. All work shall be done at Contractor's own risk, and
Contractor shall be responsible for any loss of or damage to materials, tools, or other articles used or held
for use in connection with the work.
X. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3,80 of the Kent City Code, the City requires Its
contractors and consultants to use recycled and recyclable products whenever practicable. A price
preference may be available for any designated recycled product.
B. Non-Waiver of Breach, The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this
i
PROFESSIONAL SERVICES AGREEMENT - 2
($20,000 or Less)
i
Agreement in one or more Instances shall not be construed to be a waiver or relinquishment of those
covenants, agreements or options, and the same shall be and remain in full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any
dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all Its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; .provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section VII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at
the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written
notice hereunder shall become effective three (3) business days after the date of mailing by registered or
certified mail, and shall be deemed sufficiently given If sent to the addressee at the address stated In this
Agreement or such other address as may be hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void.
F. Modification.. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of the City
and Contractor.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering Into or forming a part
of or altering In any manner this Agreement. Should any language in any of the exhibits to this
Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall
prevail.
H. Public Records Act. The Contractor acknowledges that the City is a public agency subject to
the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents,
notes, emails, and other records prepared or gathered by the Contractor in its performance of this
Agreement may be subject to public review and disclosure, even If those records are not produced to or
possessed by the City of Kent. As such, the Contractor agrees to cooperate fully with the City In satisfying
the City's duties and obligations under the Public Records Act.
I. City Business License Required. Prior to commencing the tasks described In Section I,
Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of
the Kent City Code.
PROFESSIONAL SERVICES AGREEMENT - 3
($20,000 or Less)
I
I
J. Counterparts and Signatures by Fax or Email, This Agreement may be executed In any
number of counterparts, each of which shall constitute an original, and all of which will together constitute
this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page
to the other by fax or email and that signature shall have the same force and effect as If the Agreement
bearing the original signature was received in person.
IN WITNESS, the parties below execute this Agreement, which shall become effective on
the last date entered below.
CONTRACTOR: CITY OF KENT:
By: By:---{�
(s nature) • (s gnat
Print Name: Print Name: Mark Howlett
Its: Pp�sIr1 why -7f`t'trUk o-- Its: Design Engineering Manager
DATE: 3 DATE:
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONTRACTOR: CITY OF KENT:
Don Melton Timothy J. LaPorte, P.E.
The Eastman Company City of Kent
6206 35th Avenue NE 220 Fourth Avenue South
Seattle, WA 98115 Kent, WA 98032
(206) 856-9242 (telephone) (253) 856-5500 (telephone)
N/A (facsimile) (253) 856-6500 (facsimile)
i
I
PROFESSIONAL SERVICES AGREEMENT- 4
($20,000 or Less)
I
l
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors Indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed, by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this day of � ladm L— 20 15
.
By:
For: Ill e �4w �� Ca<vrc ny
Title: PreS;dend
Date:
EEO COMPLIANCE DOCUMENTS - 1
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2 .
EXHIBIT A
The Eastman Company
Real Estate App olsers/Ahoh^ats/Coruofonts Phone 1206)063-6611
6206—WAvenue NE don@Vcavolue.com
Seattle,WA 98115
September,1;2015
Ms.Ingrid Wilkins-Dixon,project Analyst
Design Engineering•.Publio Works Department
City of Kent
220 rourlh avenue Soutlt
Kent,WA 08052
Re: Appraisal Bid-I-lytek Wetlands(APN—34300-0030,0055,and 0670), �
Kent,Washingl6n
Dear Ingrid:
Tlrunk you for lho opportunity to bid on.lhe above-referenced assignment. We pre interested In
providing appraisal services for the above rererenced property, ']'here air,two appraisal reporting.
options.The first Is a"Restricted Appraisal report"and the other is the"Appraisal Report."Our '..
apprtisal fee for abrief or summary format,USPAP compliant,appraisal report will not exceed
Three Thousand Six Hundred.Dollars($3,600).
The speolflo compietion date depends on When the assignment is actually awarded,and when all
necessary Information is provided to us (legal description, maps,wetland studies, and contract
information for the owner's representative), We can have the assignment completed in 30 days
after receiving written notification to proceed. rryou have any questions about this bid,please
contact Carl Bolstad (206473-9626 or emnit: gu'Lrdivn nlilycu�i). Thank you for the '...
opportunity to bid on this assignment.
Sincerely,
C.
Donald K.Mellon
The Easunnn Company
I
I
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EXHIBIT B
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEMENTS
Insurance
The Consultant shall procure and malntaln for the duration of the Agreement,
Insurance against claims for Injuries to persons or damage to property which
may arise from or In connection with the performance of the work hereunder
by the Consultant, their agents, representatives, employees or
subcontractors,
A. Minimum scope of Insurance
Consultant shall obtain insurance of the types described below:
1, Automobile Llability insurance covering all owned, non-owned,
hired and leased vehicles, Coverage shall be written on Insurance
Services Office (ISO) form CA 00 01 or a substitute form providing
equivalent liability coverage, If necessary, the policy shall be
endorsed to provide contractual liability coverage.
2, Commercial General Llability Insurances a e written on ISO
occurrence form CG 00 01 and shall cover liability arising from
premises, operations independent contractors, products-completed
operations, personal iWury and advertising injury, and liability.
assumed under an Insured contract. The City shall be named as an
Insured under the Consultant's Commercial General Liability
Insurance policy with respect to the work performed for the City
using ISO additional Insured endorsement CG 20 10 1165 or a
substitute endorsement providing equivalent coverage,
3, Workers'Compensation coverage as required by the Industrial
Insurance laws of the state of Washington,
4, Professlonal Liability Insurance appropriate to the Consultants
profession.
B. Minimum Amounts of Insurance
Consultant shall maintain the following Insurance limits:
1. Automobile Liability insurance with a minimum combined single
limit for bodily Injury and property damage of$1,000,000 per
accident.
2. CommeNlal generalLlab lity.insurance shall be written with limits
no less then $1,000,000 each occurrence, $2,000,000 general
aggregate and a $1,000,000 products-completed operations.
aggregate limit,
EXHIBIT B (Continued)
3. Professional Llabtllty Insurance shall be written with limits no less
than $1,000,000 per claim and $1,000,000 policy aggregate limit.
C. other Insurance Provisions
The Insurance polices are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
Insurance:
1. The Consultant's Insurance coverage shall be primary Insurance as
respect the City. Any Insurance, self-Insurance, or Insurance pool
coverage maintained by the City shall be excess of the Consultant's
Insurance and shall not contribute with It.
2, The Consultant's Insurance shall be endorsed to state that coverage
shall not be cancelled by either party, except after thirty (30) days
prlor written notice by certified mall, return receipt requested, has
been given to the city.
3. The City of Kent shall be named as an additional Insured on all
policies'(except Professional Liability) as respects work performed
by or on behalf of the Consultant and a copy of the endorsement
naming the City as additional Insured shall be attached to the
Certificate of Insurance. The City reserves the right to receive a
certified copy of all required Insurance policies. The Consultant's
Commercial General Liability Insurance shall also contain a clause
stating that coverage shall apply separately to each Insured against
whom claim is made or suit Is brought, except with respects to the
limits of the Insurer's liability.
D. Acceptability of Insurers
Insurance Is to be placed with Insurers with a current AX Best rating of not
less than ANIL
E. Verification of Coverage
Consultant shall furnish the City with original certificates and a copy of the
,amendatory endorsements, including but not necessarily limited to the
additional Insured endorsement, evidencing the Insurance requirements of
the Contractor before commencement of the work.
F. Subcontractors
Consultant shall include all subcontractors as Insureds under Its policies or -
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same Insurance
requirements as stated herein for the Consultant.
oRn® CERTIFICATE OF LIABILITY INSURANCE DAYS(MMIOOIYYYI)
6/12/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the polisy(les)must be endorsed.. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the-policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
Certificate holder In Ifeu of Bush endorsements,
PRODUCER c T Shari Lo£quist
C Don Viler Agency 0 (206)545-4800 F r .(206Isd6-4ed9
4201 Roosevelt Play NE D L slofgciet8filerinsurance.cout
INSU89R(S)AFFORDING COVERAGE HAIG0
Seattle WA 98105-6608 ISU a A:Travelers Caa Ina of America 19046
INSURED 'INSURER 02
02mz LLC dice The Eastman Company INSURER 01
6206 35th Ave RE INSURER DI
INSURER E 1
Seattle WA 98115 INSURER
COVERAGES CERTIFICATE NUMBERklaster OL 2015-16 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
q EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
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AUTOMOBILE LIABILITY COMBINED SINGLE LIMR ! 2,000,000
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Certificate holder is hereby named additional insured,
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BB CANCELLED BEFORE
City of Kent, Dept, of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Engineering ACCORDANCE WITH THE POLICY PROVISIONS.
Attni Nancy Yoshitake
220 4th Ave B AUTHORIZED REPRESENTATIVE
Kent, WA 98032-3994 .[ j
Shari Lofquist/SHARI
01088.2014 ACORD CORPORATION. All rights reserved.
ACORD 26(2014104) The ACORD name and logo are registered marks of ACORD
INS025 pmAop
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Policy H 680-7E721300-15-42 COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY,
BLANKET ADDITIONAL INSURED -- OWNERS, LESSEES
OR CONTRACTORS
This endorsement modifies Insurance provided under the following;
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PROVISIONS:
L WHO IS AN INSURED(SECTION II)Is emended In a written contract for this Insurance to
to Include as an Insured any person or organize• apply on a primary or contributory basis.
lion (called hereafter "additional Insured")whom 9, This Insurance does not apply;
you have agreed In a written contract, executed a. on any basis to any person or organization
prior to loss, to Hama as arllonal Insured, but for whom you have purchased an Owners
only with respect to liability
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work" or your ongoing operations for that addl• and Contractors Protective policy.
tlonal Insured performed by you or for you, b. to "bodlly Injury," "property damage," "per•
2. With respect to the Insurance afforded to Addl• sonal Injury," Or "advertising Injury" arising
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liability apply; 1, The preparing, approving or falling to
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or opinions, reports, surveys, change or•
2. The limits shown on the declarations, ders,designs or specifics Ions;and
whichever Is less, 2, supervisory, Inspection or engineering
b. This Insurance Is excess over any valid and services,
collectible Insurance unless you have agreed
C6 0105 04 94 Includes Copyrighted Materiel from Insurance Services Office,Inc. Page 1 of 1
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' ® DATE IM A
V CERTIFICATE OF LIABILITY INSURANCE 1z/31/2014
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING iNSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsoment(s).
PRODUCER cAANE.OT Shari Lofquist
C Don Filer Agency PHONE (206)545-A800 �� Na.ltos)545-404a
4201 Roosevelt Way NE EoonEss:slofquist@filerinsurance.com
INGURIERIBi AFFORDING COVERAGE NAIC0
Seattle WA 98105-6608 INSURER A.Continental Casualty Com an r
INSURED INSURER B:
G2MZ LLC, DBA: The Eastman Company INSURER C: _
6206 35th Ave NE INSURER D:
' INSURER E
Seattle WA 98115 INSURER F:
COVERAGES CERTIFICATE NUMBERiProfessional 2015 REVISIONNUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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A Professional Liability H'8-1332C108e-15 /1/2015 /1/2o1E iLDDD,DoaSI,DOD,00O
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DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,umore space he roquhad)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Evidence of Insurance
AUTHORIZED REPRESENTATIVE
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ACORD 25(2010/05) 01088.2010 ACORD CORPORATION. All rights reserved.
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