HomeMy WebLinkAboutCAG2022-207 - Original - HWA GeoSciences Inc. - Police Services: Flagging & Traffic Control - 05/05/2022ApprovalOriginator:Department:
Date Sent:Date Required:
Authorized to Sign:
Director or Designee
Date of Council Approval:
Grant? Yes No
Type:Review/Signatures/RoutingComments:
Date Routed to the City Clerk’s Office:Agreement InformationVendor Name:Category:
Vendor Number:Sub-Category:
Project Name:
Project Details:
Agreement Amount:
Start Date:
Basis for Selection of Contractor:
Termination Date:
Local Business? Yes No*
Business License Verification: Yes In-Process Exempt (KCC 5.01.045)
If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace.
Notice required prior to disclosure?
Yes No
Contract Number:
Agreement Routing Form
For Approvals, Signatures and Records Management
This form combines & replaces the Request for Mayor’s Signature and Contract Cover
Sheet forms.
Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20
Budget Account Number:
Budget? Yes No
Dir Asst:
Sup/Mgr:
Dir/Dep:
rev. 20210513
FOR CITY OF KENT OFFICIAL USE ONLY
(Optional)
* Memo to Mayor must be attached
KENT POLICE SERVICES AGREEM ENT
WASHINcION
THIS AGREEMENT is made between the city of Kent, a washington municipal corporation
(hereinafter "Kent"), and ,-+.,J h CrAc Si./.E"J,(B tdL- , organized under the laws of
the State of Wasnington t ala,tz 3D De S E 807'ils;q-- LiA-
(hereinafter the "cont-ractor"). - qfiaz-\
I. TERM *AGREEMENT- FURTHER DEFINED - INCORPORATION OF ATTACHMENTS
AND INSURANCE EXHIBIT. The term "Agreement" as Used throughout this document shall
mean this document, and any and atl Scope of Seruices Attachments (hereinafter
'.Attachments,,) which describe the scope of services to be performed. The Attachments are
hereby incorporated into this Agreement by this reference. It is recognized that the Contractor
ruy 1.Lqu"st police services on several occasions, and therefore, while this main Agreement will
only be signed one time, there may be multiple Attachments to this Agreement. This Agreement
shall be enforceable with regard to each instance of work performed pursuant to each
Attachment. In the event or a conflict between the terms of this Agreement and any
Attachment, the terms of this Agreement shall prevail'
The Insurance exhibit as required by Section IX of this Agreement shall also be incorporated into
this Agreement as if set forth herein in full.
II. SCOPE OF SERVICES. Contractor desires to utilize the services of a commissioned Kent
police officer who will be dedicated to performing the services described in the Attachment(s) to
this Agreement.
police officers shall only be permitted to provide police-related services during the perf_ormance
of the work called for- herein, and Contractor shall not ask or solicit such police officers to
perform work that is not police-related.
III. COST OF SERVICES AND PAYMENT
A. Hourly Rate, Contractor shall pay to the Kent Police Department a sum for each
hour of worked performed by a commissioned police officer. The Chief of Police or his or her
designee shall have the aut-hority to determine the hourly rate that will be specified in the
Attachment.
B. Four Hour Minimum Payment Requirement. There shall be a four (4) hour
minimum payment required for each inltance that a police officer performs services under this
Agreemeni. 'therefore, Contractor shall be required to pay to Kent the greater sum of four (4)
hours of work or the actual number of hours worked during each instance that a police officer
performs services. For example, if Contractor needs two (2) police officers to work on the same
day and at the same time for two (2) hours of work each, Contractor will be required to pay Kent
for four (4) hours for each police officer, for a total of eight (8) hours. If Contractor needs two
(2) police bfficers for six (6) hours each, Contractor shall pay for six (6) hours for each police
officer for a total of twelve (12) hours.
C. Holiday Shifts and Shifts in Excess of Ten Hours. Shifts performed on holidays
shall be subject to an increased hourly rate that will be specified in the Attachment. Shifts that
POLICE SERVICES AGREEMENT - 1 (Form Version: u2o76)
=
last in excess of ten (10) hours will be subject to a higher hourly rate for all work performed inexcess of ten (10) hours. The hourly rate for work performed in excess of ten lffi) hours maynot be specified in the Attachment, but will be approximately at a rate of one anO one-nalf (1.5j
times the regular hourly rate charged on that day. The Contractor will be billed and shali paythe rate for work over ten (10) hours even if not specified in the Attachment.
D. Method and Time of Payment. Kent shall, within a reasonable time, submit a billto Contractor for amounts owing for services performed. Contractor shall, within fourteen (14)
calendar days of receipt of such bill, pay the amount owing to Kent. All payments shall be madeto the "City of Kent" and shall be delivered to:
City of Kent
Attn : Customer Services
220 Fourth Avenue South
Kent, WA 98032
E. Late Payment Penalties. If Contractor fails or neglects to pay any invoice withinthirty (30) calendar days from the date shown on the invoice Js tne "invoice date," a servicecharge of one percent (LVo) of the amount of the unpaid balance on the account or two dollars($2.00), whichever sum is greater, will be imposed one (1) month from the date payment wasdue, and at the end of each succeeding monthly period,-until att past due amounis are paid infull.
Any invoice or service charge due under this Agreement and unpaid shall constitute a debtowed to Kent. Kent may, pursuant to Chapter 3.10 of the Kent City Code and Chapter 19.16 ofthe Revised Code of Washington, use a collection agency to collect outstanding debts, or it mayseek collection by court proceedings, which remedies shall be in addition to all otner remedies.
At the discretion of the Chief of Police or his or her designee, services may not beprovided to Contractors who have delinquent payments.
IV. EMERGENCY INTERRUPTIONS IN SERVICE. Police officers performing services calledfor in this Agreement shall at all times be subject to the rules, regulaiions, and-policies of Kentand its Police Depaftment, and shall be required to follow thl orders of supervisors andcommand staff. Contractor understands that police officers performing services pursuant to thisAgreement may, from time to time, be required to perform traditional police duties for thebenefit of the greater public. Therefore, from time to time, police officers performing servicesfor Contractor may be required to respond to emergencies and abandon the services being calledfor under this Agreement. In the event of this oclurrence, Contractor shall not be relieved ofproviding full payment; provided, that in the event the interruption lasts longer that one half ofone hour (i.e., more than thirty (30) continuous minutes), Kent and Contraclor will agree to anamount of a reduction in the costs of services to account for the police officerC time notperforming services under this Agreement.
V, INDEMNIFICATION.
A. General. Contractor shall defend, indemnify, and hold Kent, 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 Kent,sperformance of this Agreement, except for that portion oflne injuries and damages caused bythe sole negligence of Kent or its officers or employees.
POLICE SERVICES AGREEMENT - 2 (Form Version: L/2Ot6)
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONTRACTOR'S WAIVER OF
IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF
THIS INDEMNIFTCNTTOIV. TNC PNNTTTS FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
N EGOTIATED THIS WAIVER.
B. Indemnification and the public Duty Doctrine. Contractor understands that'
pursuant to the legal doctrine in Washington called the "public duty doctrine," Kent, its Police
bepanment, and iti officers and employels of the Kent Police Department, owe a general duty
to the public and not a specific duty of protection or care to the Contractor. Contractor
understands that by entering into this Agreement, the Police Department's and the police
officer,s duties remain to the bublic in general, and neither Kent, its Police Department, nor any
of its officers or employees have a specific duty of protection or care to the Contractor, its
employees, subcontractors, and agents, or any ol its guests, or other people on the premises of
the Contractor. Moreover, neither Kent, its Police Department, nor any officer or emp.loyee of
Kent guarantees, in any way, the safety of any person or property as a result of the work
perfoimed under this Agreement. In the event of injury to any person or property, Contractor
shall not assert that Ke-nt, its police Department, or its police officer owed any special duty to
protect persons or property or provide care for such persons or property or had any special
relationship with the owner or any other person to protect persons or property. This Agreement
shall in no way create a duty for kent, its Police Department, or any of its officers or employees
where none previously existed. In the event Kent is sued, and a court determines that the
public duty doctrine does not apply, or an exception to the public duty doctrine exists with
relation to an injury to the person or property of any employee, subcontractor, guest, or other
person on the piemises of Contractor,
'Contractor shall specifically indemnify, hold harmless, and
defend Kent, its police Department, and each and every officer and employee thereof to the full
extent permitted by law.
C. Survival. The provisions of this Section V shall survive the expiration or
termination of this Agreement and the obligations contained therein will continue to apply
beyond the provision of services called for in any Attachment.
vL PARTIES ARE INDEPENDENT. The parties agree that neither shall be considered an
employee or agent of the other.
vrr. TERMTNATTON, ALTERATTON, OR RESCHEDULING. In the event Kent is unable to
obtain the services of a Kent Police Officer to perform the services called for in the Agreement,
Kent will contact Contractor, and advise Contractor that Kent is unable to perform the services
called for herein. Notice by way of telephone, email, writing, or in-person shall b-e_adequate
notice of such cancellation of services, and Kent shall not be liable for the cost of Contractor
obtaining replacement services.
In the event Contractor must cancel, alter, or reschedule the services called for by this
Agreement, Contractor must provide at least ten and one-half (10.5) hours advance notice to
the police Department by contacting its on-duty sergeant line at (25-3) 856-5840. A failure to
cancel, alter, or reschedule at leastien and one-half (10.5) hours before the services are called
for shall result in the Contractor paying the minimum four (4) hours of service provided for in
Section IILB. above, regardless oh *netn"r such services are provided at a later or rescheduled
date and time.
vIII. coNTRAcToR sHALL ABIDE BY LAws AND sHALL NOT DISCRIMINATE. At AII
times during Kent's performance of this Agreement, Contractor shall abide by all laws and
POLICE SERVICES AGREEMENT - 3 (Form version: u2o76)
1
I
regulations applicable to Contractor's business. Moreover, Contractor shall not, by reason ofrace, religion, color, sex, age, sexual orientation, national origin, or the presence of ahy sensory,mental, or physical disability, discriminate against any person in violation of any laws of theState of Washington or the United States.
IX. INSURANCE. Contractor shall at all times during Kent's performance of the servicescalled for in this Agreement procure and maintain insurance of the types and in the amountsdescribed in Exhibit A attached and incorporated by this reference.
X' CONTRACTOR'S BUSINESS PERFORMED AT ITS OWN RISK. Contractor shall take allnecessary precautions and shall be responsible for the safety of its employees, agents, guests,and all persons on Contractor's property and invitees at all times wfren a'po-|i." officer isperforming services pursuant to this Agreement.
XI. MISCELLANEOUSPROVISIONS.
A. Non-Waiver of Breach. The failure of Kent to insist upon strict performance ofany of the covenants and agreements contained in this Agreement, or to exercise any optionconferred by this Agreement in one or more instances shall not be construed to be a waiver orrelinquishment of those covenants, agreements, or options, and the same shall be and remain infull force and effect.
B. Resolution of Disputes and Governing Law. This Agreement shall be governedby and construed in accordance with the laws of the State of Washington. If the pirties areunable to settle any dispute, difference, or claim arising from the part-ies' performance of thisAgreement, the exclusive means of resolving that disputl, difference, or claim, shall only be byfiling suit exclusively under the venue, rules, and jurisdiction of the King County Superior Coun,King County, Washington, unless the parties agree in writing to an alternative dispuie resolutionprocess. In any claim or lawsuit for damages arising from the parties' performance of thisAgreement, each party shall pay all its legal costs and attorney's fees incurred in defending orbringing such claim or lawsuit, including all appeals, in addition to any other recovery or awardprovided by law; provided, however, nothing in this paragraph shall be construed to limit theKent's right to indemnification under section V.B. of this Agreement.
C. Written Notice. All communications regarding this Agreement shall be sent to theparties at the addresses listed on the signature page of th1 ngreement, unless notified to thecontrary. Any written notice hereunder shall become effective three (3) business days after thedate of mailing by registered or certified mail, and shall be deemed iufficientty given if sent tothe addressee at the address stated in this Agreement or such other addrels as may behereafter specified in writing.
D. Assignment. Any assignment of this Agreement by either party without thewritten consent of the non-assigning party shall be void. If the non-assigning party gives itsconsent to any assignment, the terms of this Agreement shall continue in full force an-d effectand no further assignment shall be made without additional written consent.
E. Modification. No waiver, alteration, or modification of any of the provisions of thisAgreement shall be binding unless in writing and signed by a duly autlrorized representative ofKent and Contractor.
F. Entire Agreement. The written provisions and terms of this Agreement, togetherwith any Exhibits or Attachments attached hereto or referenced herein, shall-supersede al'i prior
POLICE SERVICES AGREEMENT - 4 (Form version: t/2o16)
verbal statements of any officer or other representative of Kent, 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. All of the above documents are hereby made a part of this Agreemen_t' However,
sliould any language in any of the Exhibits or Attachments to this Agreement conflict with any
language containeJ' in this Agreement, the terms of this Agreement shall prevail. Further, the
,"p-r"r"ntative signing this Agreement on behalf of Contractor swears and affirms that he or she
is authorized to entei into th-is Agreement on behalf of Contractor and that action is binding on
the Contractor.
G. Compliance with Laws. 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 peformance of those operations.
H. Counterpalts, This Agreement may be executed in any number of counterpafts,
each of which shall constitute an original, and all of which will together constitute this one
Agreement.
IN WITNESS, the pafties below execute this Agreement, which shall become
effective on the last date entered below.
CONTRACTOR:
/\ -'.1 s"
By
(signature)
PTint NaMC: AHMED MAHMOUD
Its Geotech nical Enqineer
DATE:
(tiile)
51512022
KENT:
By:
(signature)
Print Name:Ra Padilla-
DATE:
NOTICES TO BE SENT TO:
CONTRACTOR:
Attn:AHMED MAHMOUD
ffi,Bothell,wAg8o21
208-506-8621 lephone)
(facsimile)
NOTICES TO BE SENT TO:
CITY OF KENT:
Sgt. Mike Schanbacher
City of Kent
22O Fourth Avenue South
Kent, WA 98032
(253) 856- 5841 (telePhone)
(253) 856-6802 (facsimile)
t:EiilSl6PD@ !il6u 3t4hlieof-h9&!ilE.Su€ Mdq het Arr*bat tu OfihV Wo*&cr
POLICE SERVICES AGREEMENT - 5 (Form Version: ll2OL6)
KENT SCOPE OF SERVICES ATTACHMENT
To Police Services Agreement9
This Scope of Services Attachment shall be incorporated into the Police Services Agregment signed
by v) 4 GEO <c;tErJ(/e< (,rtC - (hereinafter "contractor") on tfi*n s ' u7-7-
I DESCRIPTION OF SERVICES. Contractor requests the Services of a commissioned police
officer who will be dedicated to performing the following services (check box that applies):
.d Flagging/Traffic Control
n Security for Entertainment Venue or Event
n Security for Retail Establishment
n Guarding of Property, Buildings, Possessions, or Equipment
n other
II.
police officers shall only be permitted to provide police-related services during the
peformance of the work called for herein, and Contractor shall not ask or solicit such police
officers to perform work that is not police-related.
HOURLY RATE & NUMBER OF OFFICERS REQUIRED. The work called for herein shall be
paid by Contractor at the following hourly rates and the Contractor requests the following
number of officers:
Extra-Duty Work: Officer
Up to $80 per hour.x
Number of Officers Required:1
Extra-Duty Work: SuPervisor
Up to $100 per hour.*Number of Supervisors Requiredn
A
x Note: Hourly rates are quoted "up to" a specified amount. Officers are paid different rates
based on factors such as time in service, assignment, education, etc. The rate quoted is the
maximum rate that will be billed subject to overtime holiday rates specified below.
Contractor's rate may be lower.
Four Hour Minimum. There shall be a four (4) hour minimum payment required for
each instance that J police officer peforms services under the Agreement. Therefore,
Contractor shall be required to pay to Kent the greater sum of four (4) hours of work
or the actual number of hours worked during each instance that a police officer
performs services. For example, if Contractor needs two (2) officers to work on the
same day and at the same time for two (2) hours of work each, Contractor will be
required to pay Kent for four (4) hours for each police officer, for a total of eight (8)
hours. If Contractor needs two (2) officers for six (6) hours each, Contractor shall pay
for six (6) hours for each police officer for a total of twelve (12) hours.
SCOPE OF SERVICES ATTACHMENT TO POLICE SERVICES AGREEMENT
Page 1 of 2 (Form Version: 7212017
III.
IV
B Overtime Rate. Contractor shall be required to pay the rate of one and one half (1.5)
times the rate specified above for any time worked by a police officer in excess of ten(10) hours in a shift. Therefore, if a police officer works ten (10) hours, he or she
shall be paid at the rate specified above. If the officer works twelve (12) hours, he or
she shall be paid at the rate specified above for the first ten (10) hours, and at a rateof one'and one half (1.5) times the rate specified above fo. tn" remiining two (2)
hours.
c Holidav Rate. The following holidays are observed by Kent police officers: New year's
Day, Martin Luther King Day, President's Day, Memorial Day, Independence Day,
Labor Day, Veteran's Day, Thanksgiving Day, Day after Thanksgiving, and christmas.
Except as otherwise provided in this section, all hours worked during an obserued
holiday, or during 15:00 hours to 23:59 hours on Christmas Eve or New year,s Eve,will be billed at one and a half (1.5) times the rate specified above. All hours worked
on Thanksgiving Day or Christmas Day will be billed at a rate of two (2.0) times the
rate specified above.
D Contractor's Termination, Alteration or Rescheduling of Senrices. Cancellation,
alteration, or rescheduling of police officer services by the Contractor for a specific
date must be made at least ten and a one-half (10.5) hours prior to the scheduledstart time for that date. If Contractor fails to provide ten and one-half (10.5) hours
advance notice from the scheduled start time, Contractor will be billed foi a minimumpayment of four (4) hours per officer scheduled for that date in accordance with
Section II.A. above, Cancellation, alteration, or rescheduling notification can be made
by phone or email.
LOCATION OF SERVICES. The services called for herein shall be pedormed at the followinglocation: The work is located at the NE corner of pacific
Highway S and S 272nd St.(ARCO Gas station)
A police officer will arrive at the above location on the date and time specified below
612022 _,20_to 2 arr./pln
Print Name
Address: 21312 30th Dr SE, Bothell, WA 98021
Address
SCOPE OF SERVICES ATTACHMENT TO POLICE SERVICES AGREEMENT
Page 2 of 2
requests a Kent police offi
612022
cer provide services
_,20-.5t1
Approved by:
Kent ce Department Date
DATE AND TIME
from 8:30 arh/om
FOR SERVICES. Contractor
By signing below, I understand that I am entering a contract to hire police officers to perform thework described above, I agree to the terms of this Scope of Services Attachment and all of the termscontained within the Police Services Agreement referenced herein, and finally if I am signing this
Scope of Services Attachment on behalf of an organization, I swear and affirm that I am authJrizedto do so sn lehalf nf.the nrganization and that action is binding on the Contractor./^, Aat'r=-":/"' t'
5 tsr2o22
Signature Date
AHMED MAHMOUD
(Form Version: L2/2OL7)
CERTIFICATE OF LIABILITY INSURANCE
DATE (I'T'DD/YYYN
0510512022
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
ONLY
ALTERNEGATIVELY
THISHOLDER.THE CERTIFICATERIGHTSNOPONUINFORMATIONANDCONFERSrssuEDtsAASOFMATTERlsTHCERTIFICATETHEBY POLtCIESAFFORDEDCOVERAGEOREXTENDTHEORNOTDOESAFFIRMATIVELYAMEND,CERTIF]CATE AUTI.IORIZEDTHEISSUINGBETWEENArNsuRER(S),CONTRACT
boolanpolthetf onAendorsement.statementantheofcertainrequiresutotermstheconditionsandpolicy,maypoliciesSUBROGATIONlftsWAIVED,bJect
this cortificate does not confer hts to the certificate holder in lieu of such
Orion lnsurance / Ralph TaYlor
(425) 6734427(425)771-s197
rtaylor@orioninsgroup.com
NAIC #COVERAGE
361ATravelersnsurance Company
PRODUCER
Orion lnsurance Group
10634 E. Riverside Dr.
Suite #300
Bothell wA 98011
Kinsale lnsurance Company
INSURER C
INSURER
INSURER E
HWA GeoSciences lnc.
21312301h Drive SE, Suite 110
wA 98021-7010
INSUREO
Bothell
REVISION NUMBER:CERTIFTCATENUMBERT C11911
PERIODABOVENAMEDPOLICYFORTHETOISSUEDINSUREDTHEBELOWLISTEDBEENHAVETHETHATESPOLtCtINSURANCEOFlsTHISCERTIFYTOWHTOTHIStcHEROTHENTDOCUMRESPECTWITHANYOFORCONTRACTANYIREMORTERMCONDITIONNOTWITHSTANDINGREQUENT,INDICATED.THEtsHEREINTOSUBJECTALL TERMS,THBY POLtCtESE DESCRIBEDTHENAFFORDEDINSURANCEBEMAYORISSUEDPERTAIMAYCERTIFICATE
PAIDBY CLAIMS.MAYSHOWN BEENHAVE REDUCEDSUCHOFLIMPOLICIES.tTsANDEXCLUSIONSCONDITIONS
LIMITSNUMBERTYPE OF INSURANCE
1,000,000
1,000,000
10,000
1,000,000INJURY
2,000,000
2,000,000AGG
I
't2101120221210112021680-{09N931138-19 47
COHilERCIAL GENERAL LIABILITY
CLA|MS-MADE lX o""r*
!F8; l-1'-o"POLICY
A
$ 1,000,000
$BODILY INJURY (Per Pemn)
IBODILY INJURY (P€r aeident)
$
$
121011202212101t2021BA-3P900632-1 9-GRP
ANYAUTO
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
SCHEDULED
AUTOS
NON-OWNED
AUTOS ONLY
AUTOMOBILE LIABILITY
A
5,000,000EACH
5,000,000
UIBRELLA LIAB
EXCESS LIAB
OCCUR
12t01t202212t0112021cuP-003P901 597-1 9-47
RETENTION
A
,000,000E.L. EACH
1,000,000E.L. DISEASE - EA
1,000,000E.L. DISEASE
't210112021 12t0112022680-O09N931138 STOP GAPN/AA
AND EITPLOYERS' LIABILITY
ANY PROPRIETOFVPARTNEFVEXECUTIVE
OFFICER/MEMBER EXCLUDEO?
(ilandetory in NH)
YI
tf describ€ under
WORKERS
,000
Deductible
Each Claim
$3,000,000 Aggregate121011202112t011202201 001 71 1 87-0B
Professional Liability Claims Made
lncluding Pollution Liability
All projects including proiect number :2021-112-21. Full prior acts for 3mi3m limits. Excess Professional Liability limits of 2ml2m limits over primary
professional liability policy - reto date 121112020lhrough
Navigators, Policy# CE21 MPLZ07'16410.
All required parties including the city of Kent are listed as additional insureds with primary non-contributory wording except with respect to professional
liability and worker,s compensation. 3o-days notice of cancellation modification applies to certificate holder. A blanket waiver of subrogation applies in favor
of additional insureds
DESCRIPTION OF OPER IIIONS , LOCATIONS / VEHICLES (ACORD 101, Additionsl Romarkc Schodulo, may bs .ttachod if more spae i3 requiEd)
I{OLDER
@ 1988-2015ACORD CORPORATION. All rights
Development Engineering Gity of Kent
220 4th Avenue South
Kent wA 98032
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS'
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016103)The ACORD name and logo are rogistered marks of AGORD
rasewed.