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HomeMy WebLinkAbout2015-125-E ES - Law Enforcement Services, Inc. (LESI) for online personal history questionaire and post offer psychological evaluations DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 SERVICES & LICENSE AGREEMENT for Pre-employment Assessment with onlinePHQ°and Post-Offer Comprehensive Psycholoizical Evaluations THIS SERVICES AND LICENSE AGREEMENT is made and entered into as of January 1 , 2015 (the "Effective Date"), by and between LAW ENFORCEMENT SERVICES, INC. ("LESI"), located at 3409-A West Wendover Ave., Greensboro, NC, and ORANGE COUNTY, a local political subdivision of the State of North Carolina by and through its' Emergency Services Department (CLIENT), an County located at 510 Meadowlands Drive, Hillsborough,North Carolina,27278. RECITALS WHEREAS, LESI is the owner of certain computer software programs and systems designed to allow companies and agencies in law enforcement and related fields (including emergency services and public safety) to make pre-employment screening and evaluation more efficient; and WHEREAS, LESI desires to provides these programs, systems and services to Client on the terms and subject to the conditions set forth herein; and WHEREAS, Client desires to obtain access to use such software and services on the terms and subject to the conditions set forth herein in order for the Orange County to perform its pre-employment screening and evaluation of applicants for employment; NOW THEREFORE, in consideration of the mutual promises set forth herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged by the parties,the parties, intending to be legally bound, agree as follows: 1. Definitions 1.1 "Agreement" includes this agreement and all Exhibits, Attachments and Riders at the time of execution. 1.2 "Applicant" means an applicant for employment with Client, or an existing employee of Client, for whom Client wishes to use the onlinePHQ°system and the post-offer Comprehensive Psychological Evaluation. 1.3 "Certified Computer" means the client computer equipment and software operating system approved by LESI and for which the appropriate internet browser certificate has been issued by LESI. 1.4 "Client" means the person or entity signing this Agreement as Client, and includes the Orange County Emergency Services. WCSR 33289183v5 WCSR 33289183v5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 1.5 "License" means the license granted by LESI to Client to use onlinePHQ®, the Reports, Data and all related functionality of the onlinePHQ® system, in accordance with the terms and conditions of this Agreement. 1.6 "OnlinePHQ®" system means LESI's patented and proprietary software and system which collects data from applicants, analyzes data and generates reports to Client based on biodata from applicant information. 1.7 "Agency Administration Interface" means that portion of the onlinePHQ® system under which Client may open user accounts, generate passwords and instruction letters, track Applicants' progress, and download Reports. 1.8 "Reports"means LESI's proprietary reports provided to Client as listed on Exhibit B. 2. Scope of Work. The scope of services being provided under this Agreement is described generally below, and more specifically identified on Exhibit A attached hereto. The parties agree that LESI's services and products to be provided pursuant to this Agreement are as expressly set forth on Exhibit A. Any additional services requested by Client are subject to LESI's customary rates and will be billed as an additional charge. 2.1 onlinePHQ®. The scope of services includes Client's use of LESI's onlinePHQ®for pre-offer screening of Applicants by Client. Such use shall be in accordance with the terms and conditions of this Agreement and with applicable laws,rules, and regulations. 2.2 Comprehensive Psychological Evaluation. The scope of services also includes performance of a post-offer, pre-employment Comprehensive Psychological Evaluation of Applicants, upon request by Client. Only Applicants to whom Client has made offers of employment will be candidates for the Comprehensive Psychological Evaluation. 3. License. Subject to the terms and conditions of this Agreement, LESI grants Client a non-exclusive, non-transferable, limited License to use onlinePHQ®, and all published documentation related thereto and provided to Client by LESI solely for its internal operations on the Certified Computers. 4. Implementation. LESI shall use its commercially reasonable efforts to make the onlinePHQ° system available on Client's Certified Computers within thirty (30) days after execution of this Agreement. Client is responsible for providing all necessary computer hardware, software for accessing the internet, high speed data connection and support to access onlinePHQ® and download onlinePHQ® reports via the internet. LESI will issue the browser certificates based on the pricing listed on Exhibit C. Client acknowledges that LESI will not issue any onlinePHQ® Reports unless and until an Applicant has completed the onlinePHQ® questionnaire, and for the Comprehensive Psychological Evaluation, has completed post offer testing and face-to-face interview with an LESI-provided psychologist. 5. Term and Termination 5.1 Term. This Agreement shall commence on the Effective Date and continue for an initial period (the "Initial Term") of one (1) year unless earlier terminated as provided below. Upon 2 WCSR 33289183v5 WCSR 33289183v5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 expiration of the Initial Term and any Renewal Term (as defined below), this Agreement may be renewed for up to two, separate one (1)year renewal periods (each such one-year renewal period being a"Renewal Term") upon mutual agreement of the parties to each such Renewal Term, and on such terms and conditions for each such Renewal Term as the parties may agree. The Initial Term and all Renewal Terms are, collectively,the "Term." 5.2 Termination. (a) By LESI. LESI may terminate this Agreement, without prejudice to any other remedy LESI may have, immediately without further obligation to Client, in the event of(1) any material breach by Client of its obligations under this Agreement which cannot be remedied within thirty (30) days of LESI's notice to Client of the breach and LESI's intent to terminate the Agreement; or (2) Client's making an assignment for the benefit of its creditors, the filing under any voluntary bankruptcy or insolvency law, under the reorganization or arrangement provisions of the United States Bankruptcy Code, or under the provisions of any law of like import in connection with Client, or the appointment of a trustee or receiver for Client or its property. (b) By Client. Client may terminate the License, without prejudice to any other remedy Client may have, in the event of (1) any material breach by LESI of its obligations under this Agreement which is not remedied within thirty (30) days of Client's notice to LESI of the breach and Client's intent to terminate the Agreement; or (2) LESI's malting an assignment for the benefit of its creditors, the filing under any voluntary bankruptcy or insolvency law, under the reorganization or arrangement provisions of the United States Bankruptcy Code, or under the provisions of any law of like import in connection with LESI, or the appointment of a trustee or receiver for LESI or its property. Termination shall not relieve Client's obligation to pay all amounts which are due and payable as of the effective date of such termination. (c) Non-Appropriation. Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable and not appropriated for the performance of County's obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability and non-appropriation of public funds. It is expressly agreed that County shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement, but only as an emergency fiscal measure during a substantial fiscal crisis. In the event of a change in the County's statutory authority, mandate and/or mandated functions, by state and/or federal legislative or regulatory action,which adversely affects County's authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Provider of such limitation or change in County's legal authority. 3 WCSR 33289183v5 WCSR 33289183x5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 5.3 Effect of Termination. The expiration or termination of this Agreement (for any reason) shall not relieve either party of any obligation for liabilities accruing prior to the effective date of such expiration or termination (including, without limitation, liability for money owed). Upon the expiration or termination of this Agreement for any reason, Client shall immediately cease all use of the onlinePHQ®system. 6. Price and Payment 6.1 Fees. Client shall pay the service fees listed on Exhibit C for specified services rendered during the Initial Term For any additional term thereafter, LESI may adjust all or any part of the pricing on Exhibit C for that term upon thirty (30) days' prior notice to Client. LESI will provide timely invoices for all services under this Agreement. Service fees listed, other than reimbursable expenses, are Basic Service fees. The maximum amount payable for Basic Services shall not exceed Four Thousand Five Hundred Dollars ($4,500.00). 6.2 Additional Services or Data. Requests for any additional work beyond the scope of services on Exhibit A and any requests for additional data (including but not limited to older reports, information for validation, fitness for duty letters and underlying information, expert witness, etc.), may be accepted by LESI in its discretion and be charged separately to Client on a timely basis at LESI then-current rates. 6.3 Pae. Client will pay all accrued fees and costs within thirty (30) days of receipt of a properly submitted invoice. In the event the amount stated on an invoice is disputed by the Client, the Client may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. Should LESI fail to perform its duties under the terms of this Agreement, Client may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. 6.4 Expenses. Reimbursable expenses are in addition to the fees for Basic Services and are for the following expenditures to the extent reasonable and actually incurred by LESI with respect to the Project: (a) The Provider shall not be entitled to any marls-up on actual expenses incurred. (b) Reimbursable expenses shall be compensated by the Client along with invoices for Basic Services provided by LESI. Payment of Reimbursable Expenses shall be subject to LESI's timely submission of valid receipts for any such expenses and approval by the Client. Any additional charges not specified herein, must be mutually agreed upon in advance by both Parties and documented in writing with a letter signed by authorized representatives for each Party, subject to budgeted funds. 7. Proprietary Rights. 7.1 Client acknowledges and agrees that the copyrights, patents and any patent applications, trademarks and service marks,trade secrets, and all other intellectual property rights of whatever nature in onlinePHQ°,the Reports, data,test booklets, questionnaires, and related documentation and any underlying data and information are and shall remain the sole and exclusive property of 4 WCSR 33289183v5 WCSR 33289183x5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 LESI, and nothing in this Agreement should or will be construed as transferring any aspects of such rights to Client (other than the License on the terms of the Agreement) or any third party. Client will take no action inconsistent with LESI's ownership rights as stated above. 7.2 Distribution. Except as otherwise expressly provided herein, Client shall not: (1) make available or distribute all or part of any onlinePHQ®, LESI forms or test booklets, or other LESI material to any third party by assignment, sublicense or by any other means; (2) copy, adapt, reverse engineer, decompile, disassemble, or modify, in whole or in part, any of onlinePHQ 8; (3) use onlinePHQO to operate in or as a time-sharing service venture, or in any way allow third party access to onlinePHQ®; or (4) copy or distribute all or any part of any Report or any Applicant data except in accordance with applicable local, state and federal law and any applicable policies or procedures of Client. 8. Client Responsibility 8.1 Administration of onlinePHQO and post-offer Comprehensive Psychological Evaluation. Client will notify LESI of any Applicant(s) for whom Client wishes LESI to conduct a Comprehensive Psychological Evaluation. Any such Applicant(s) shall have been offered employment by Client on such terms as Client may determine in its sole discretion. LESI shall have no involvement in any offer or employment decision by Client. LESI will be responsible for the administration of the post-offer Comprehensive Psychological Evaluation, and all such Comprehensive Psychological Evaluations will be conducted at LESI's facility. Any test booklets that might be received by Client shall be returned to LESI, and Client shall not copy (in any media or format) any test booklet or any other testing materials. Client acknowledges that it is solely responsible for verifying Applicant identification. Client acknowledges that LESI cannot provide any onlinePHQO reports unless and until Applicant has completed the onlinePHQO questionnaire and completed any online or written verifications of information to LESI. Client acknowledges that LESI cannot provide any reports for the Comprehensive Psychological Evaluation until Applicant has completed post-offer testing and face-to-face interview with an LESI-provided psychologist. 8.2 Security of Certified Computers & Passwords. Client hereby acknowledges and agrees that it will provide security and control over the Certified Computers and passwords to ensure that (a) no unauthorized access is permitted to the Reports or related data, and (b)that all transfer and storage of the Reports and related data is maintained in a secure environment with access granted only to authorized persons. Client will immediately notify LESI by telephone, with written notice to follow, in the event that any Certified Computer or password is lost, stolen, replaced or damaged (if such damage is reasonably believed to compromise the security of the computer), or if Client has reason to believe that secure access to the onlinePHQO or any of the Reports or data, or any Certified Computer has been compromised. Upon receiving such notice, LESI will promptly take action to terminate access to the affected Certified Computer. 8.3 Client Responsibility for Hiring; Decisions. Client acknowledges and agrees that it retains sole and exclusive responsibility and liability for any and all decisions regarding any Applicant, including without limitation, all decisions to evaluate, process, hire or not hire, and retain any Applicant, and all fitness for duty evaluations and aptitude determinations of any Applicant for any position with Client. By providing the Services, data, Reports and other 5 WCSR 332891830 WCSR 332891830 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 services or information contemplated by this Agreement (including, without limitation, the psychological assessment described on Exhibit A), LESI makes no representation or warranty of any kind regarding, and assumes no liability for, any Applicant's fitness for duty with Client, aptitude for any employment with Client, past or future performance of any job with Client, or the outcome of any employment decision, act or omission of or by Client. Client acknowledges that LESI's services hereunder are not designed or intended to be an exclusive or exhaustive set of information on or assessments of any Applicant, and that Client should utilize all available resources in making any determination of any Applicant's fitness or aptitude for employment with Client, particularly for positions involving public contact and safety, and Client is solely responsible for such determination. 9. Indemnity; Limitation of Liability 9.1 Indemnity. Client shall to the extent provided by North Carolina law protect, defend, indemnify and hold LESI, its affiliates and their respective directors, officers, employees, and agents, and their respective successors and permitted assigns, harmless from any and all claims, actions, causes of action, liabilities, losses, damages, costs or expenses, including reasonable attorneys' fees, which result from any claim based upon or arising from (i) a material breach by Client of any of its express representations, warranties, covenants, agreements or obligations under the Agreement; (ii) any act or omission of Client in the interview, evaluation, employment decision or hiring/termination process related to any Applicant; and (iii) any act or omission of any Applicant (including, without limitation, claims arising under any theory of employer vicarious liability or r•esponcleat superior). 9.2 Limitation of Liability. LESI EXPRESSLY DISCLAIMS, AND CLIENT HEREBY EXPRESSLY WAIVES, ALL WARRANTIES EXPRESS OR IMPLIED RELATED TO THE SERVICES PROVIDED BY LESI UNDER THIS AGREEMENT. NEITHER LESI NOR ITS SHAREHOLDERS, DIRECTORS, OFFICERS, AGENTS OR REPRESENTATIVES SHALL HAVE ANY LIABILITY UNDER THIS AGREEMENT OR OTHERWISE FOR CONSEQUENTIAL, EXEMPLARY, SPECIAL, INCIDENTAL OR PUNITIVE DAMAGES, EVEN IF IT HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. IN ANY EVENT, THE LIABILITY OF LESI TO CLIENT FOR ANY REASON AND UPON ANY CAUSE OF ACTION SHALL BE LIMITED TO THE AMOUNTS PAID TO LESI BY CLIENT UNDER THIS AGREEMENT. THE FEES HEREIN REFLECT, AND ARE SET IN RELIANCE UPON, THIS ALLOCATION OF RISK AND THE EXCLUSION OF CONSEQUENTIAL DAMAGES SET FORTH IN THIS AGREEMENT. 10. Force Majeure. Neither party shall be under any liability for any loss or for any failure to perform any obligation hereunder due to causes beyond its control including without limitation industrial disputes of whatever nature, power loss, telecommunications failure, acts of God, acts of terrorism, or any other cause beyond its reasonable control. 11. General 11.1 Validity. If any part of this Agreement is held to be illegal or unenforceable, the validity or enforceability of the remainder of this Agreement shall not be affected. 6 WCSR 33289183x5 WCSR 33289183v5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 11.2 Binding Agreement. This Agreement will be binding upon and inure to the benefit of the parties hereto, their respective successors and assigns. Client may not assign its rights or obligations under this Agreement without the prior written consent of LESI. 11.3 No Waiver. The failure of a party to exercise any right or option given to it by, or to insist upon strict adherence to, the terms of this Agreement shall not constitute a waiver of any terms or conditions contained herein with respect to any such breach or any other or subsequent breach. 11.4 Solicitation. Client shall not solicit the employment of any LESI personnel who has been directly involved in the development, sale, installation, or support of onlinePHQ® during the term of this Agreement and for a period of two (2) years from the termination of this Agreement. 11.5 Notice. All notices hereunder shall be in writing and shall be deemed to have been duly given (i) when delivered personally, (ii) two (2) business days after delivery to a nationally recognized overnight delivery service, charges prepaid, (iii) three (3) days after being sent by registered or certified mail,postage prepaid, or (iv) when receipt is confirmed, if by facsimile or other telegraphic means, to the addresses below (such addresses may be altered by written notice given in accordance with this Section): If to LESI: If to Client: Law Enforcement Services,Inc. Orange County Emergency Services 3409-A West Wendover Avenue 510 Meadowlands Drive Greensboro,NC 27407 Hillsborough,NC 27278 Ellen Cuttler,President Jeryl Anderson, OCES Representative Facsimile: 336-299-0110 Facsimile: 919-732-8137 11.6 Relationship of Parties. In providing the services hereunder, LESI is acting as and shall be considered to be an independent contractor of Client. Nothing in this Agreement shall be deemed or construed by any party, or any other person, as creating the relationship of partnership,joint employers, or joint venture between the parties hereto. 11.7 Entire Agreement; Amendments. This Agreement, and any attachments to this Agreement, comprise the entire agreement between the parties regarding the subject matter hereof and supersedes and merges all prior proposals, understandings and all other agreements, oral and written, between the parties relating to the subject matter hereof. No amendment, change, or modification of this Agreement shall be valid unless the same be in writing and signed by the parties hereto. 11.8 No Third-Party Beneficiaries. No Applicant or any third party is entitled to rely on any provision of this Agreement nor is this Agreement intended to confer upon any person other than the direct parties hereto and their successors and permitted assigns any rights or remedies hereunder. The parties to this Agreement assume no liability to any third party because of any reliance on any provision of this Agreement. 7 WCSR 33289183v5 WCSR 33289183v5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 11.9 Counterparts. The parties may execute this Agreement in multiple counterparts, each of which constitutes an original, and all of which, collectively, constitute one and the same agreement. The signatures of all of the parties need not appear on the same counterpart, and delivery of an executed counterpart signature page by facsimile is as effective as executing and delivering this Agreement in the presence of the other parties to this Agreement. 11.10 Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 1 IA and Article 40 of North Carolina General Statute Chapter 66. [Remainder of p(rge intentionally left blank,Signature page follows] 8 WCSR 33289183x5 WCSR 33289183v5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their duly authorized officers as of the date first above written. LAW ENFORCEMENT SERVICES,INC. By: LDDof cu ISAigned by: C WtIX �ODA4A0 Ellen Cuttler President ORANGE COUNTY EMERGENCY SERVICES E66379949755-7 ocuSigned by: o�nd k NMIAAt V'bl By: .. Name: Bonnie Hammersley Title: County Manager Attached Exhibits Exhibit A—Scope of Work Exhibit B—Reports Exhibit C—Pricing WCSR 33289183v5 WCSR 33289183v5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 EXHIBIT A Scope of Work LESI will provide Client with access to the onlinePHQ° system, a patented, online application for collecting, analyzing and reporting background information. LESI will provide Client access to the LESI Agency Administrative Interface, allowing the Department to create onlinePHQ® passwords, track applicant progress in completing onlinePHQ®and download NMS and onlinePHQa reports. LESI will provide Client with post-offer, pre-employment Comprehensive Psychological Evaluations for each Applicant that Client specifies. LESI will provide Client with a Comprehensive Psychological Assessment Report for each Applicant (a) for whom Client has requested a Comprehensive Psychological Evaluation and (b) who has presented at LESI's facility and participated fully in the Comprehensive Psychological Evaluation. Such Applications will include sworn or non-sworn position employment candidates, including but not limited to, telecommunication employment candidates as may from time to time be referred by Client for said assessment. Such assessment shall include evaluation of both written testing and an oral interview of each candidate. Written testing shall include a review and evaluation of intellectual ability, educational achievement, emotional characteristics and overall psychological adjustment. WCSR 33289183v5 WCSR 33289183v5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 EXHIBIT B Reports The onlinePHQ O provides the following reports containing personal history, background information, and biodata: (1) Bio-data Summary Report. Summary report of bio-data indices of critical items derived from information submitted by applicant. (2) Critical Items Report. This report contains two types of information: a. Critical Items: Are items, which have been linked, through proprietary research, to specific negative job outcomes in law enforcement. This report does not guarantee any specific outcome of any Applicant, but serves as one indicator to Client that additional evaluation and/or investigation of these areas should be conducted. b. Negative indicators: Are items, which although linked to negative outcome have not, as yet, been empirically validated (they are not used to calculate the biodata indices) used to make assessments. Nonetheless, they are identified as items that Client should follow up on through additional evaluation and/or investigation. (3) The Background Investigators' Report. This is the comprehensive compilation of the applicants' responses to all relevant questions in the onlinePHQ®. This is the primary document to which Client's background investigators should refer to obtain detail about items noted on all the other reports. (4) The Life Events Report. This is a summarization of the information submitted by the applicant. The pertinent data is organized into "life events. "Life event data, includes a "begin and end date" for the event(s) in question as well as the frequency of these events (if applicable). Background investigators may use this report to review a "snapshot" of the applicant's background, and/or identify pertinent issues. (5) Discrepancy Report (if applicable). Current applicant data is compared to previously submitted applicant data and compared. Discrepancies in critical items and negative indicators are identified and reported. Post Offer, Comprehensive Psycholol4ical Evaluation The LESI assessment process generates a post offer, Comprehensive Psychological Evaluation Report based on a battery of tests, social history, and applicant interview with the LESI-provided psychologist. Topics covered in the assessment report include: -Background data -Personal impression and presence -Educational Achievement -Emotional characteristics -Specific areas of concern WCSR 33289183v5 WCSR 33289183x5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 -Overall assessment of suitability for employment WCSR 33289183v5 WCSR 33289183v5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 EXHIBIT C Pricin:s The cost for services will be as follows: 1. onlinePHQ Reports $ 50.00 per password utilized 2. Comprehensive Report: $300.00 per candidate 3. Administrative fee Comprehensive Psychological: $75.00 per Applicant (charged if Applicant fails to appear for face-to-face interview) 4. Agency Administrative Interface Initial Certification: $250.0,0 per workstation - (Initial access fee per Certified Computer station) 5. Agency Administrative Interface Yearly Renewal Fee: $125.00 per workstation (for Certified Computer station each year after the Initial Certification expires) 6. Reimbursable Expenses: Approved expenses billed on an actual out-of pocket basis Additional or other services requested by Client in addition to those listed in Exhibit A will be billed at LESI's customary rates. WCSR 33289183v5 WCSR 33289183v5 DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 2, DATE Y)AC® � / CERTIFICATE OF LIABILITY INSURANCE 02/02!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 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 endorsement(s). PRODUCER CONTACT NAME: Gladwell Insurance Agency Inc PHONE A No,Ext: 336 299-5185 FaAic No):(336)852-3676 5709 W.Friendly Ave.,27410 E-MAIL PO Box 8070 ADDRESS:staffing ladwell insurance.com Greensboro,NC 27419 PRODUCER CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: Erie Exchange Law Enforcement Services Inc 3409-A West Wendover Ave INSURER B: Greensboro,NC 27407 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSR WVDR POLICY NUMBER MM/DID�Y MM DDIYYYY LIMITS A GENERAL LIABILITY Q421690087 6/16/2014 6/16/2015 EACH OCCURRENCE $ 2000000 X COMMERCIAL GENERAL LIABILITY DAMAGERENTED PREMISES S(Ea occurrence) $ _ 2000000 CLAIMS-MADE X❑OCCUR MED EXP(Any one person) $ 5000 PERSONAL&ADV INJURY $ 2000000 GENERAL AGGREGATE $ 4000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4000000 X POLICY PE� LOC $ A AUTOMOBILE LIABILITY Q061630192 6/16/2014 6/16/2015 COMBINED SINGLE LIMIT (Ea accident) $ X ANY AUTO BODILY INJURY(Per person) $ 250000 ALL OWNED AUTOS BODILY INJURY(Per accident) $ 500000 SCHEDULEDAUTOS PROPERTY DAMAGE $ 100000 HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A AND EMPLOYERS'COMPEN A TIOI N YIN Q922400462 8/24/2014 8/24/2015 X WC S LAMTIUS of H- ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 100000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION ORANGE COUNTY EMERGENCY SERVICES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 510 MEADOWLANDS DR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HILLSBOROUGH NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. ATTN DINAH JEFFRIES djeffries @orangecountync.gov AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD 1 ® DATE(MMIDDNM) A4C"R CERTIFICATE OF LIABILITY INSURANCE 08/13/2014 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, subjectto 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 endorsement(s). PRODUCER CONTACT NAME:Trust Risk Management Services,Inc PHONE FAX Trust;Risk Management Services,Inc,doing business in NC as Potomac a1C,No,Ext:877.637.9700 LAIC,No)-.877.251.6111 Risk Management Services,Inc. EMAIL 1791 Paysphere Circle ADDRESS:in INSURER 5 AFFORDING COVERAGE NAIG4 Chicago,IL 60674 INSURER A.ACE American Insurance Company 22667 INSURED INSURER B: MICHAEL J CLITTLER INSURER C: 3409 W Wendover Ave Ste A INSURER D: Greensboro,NC 27407 1579 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR - ADDL SUB POLICY EFF POLICY EXP LTR TYPEOFINSURANCE INSR tNVD POLICYNUMBER (MMIDD/YVYY) (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL ABILITY EACH OCCURRENCE $ DAMAGE To RENTED $ CLAIMS MADE OCCUR PREMISES(Ea occurrence) MED EXP(Any one person) PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ C LOC POLICY �JET ❑ PRODUCTS-COMPiOP AGO $ OTHER: AUTOMOBILE LIABILITY (Ea SINGLE LIMIT IT Ea accident ANYAUTO BODILY INJURY(Per Person) $ ALL OWNED SCHEDULED $ AUTOS AUTOS BODILY INJURY(Per acdden HIRED AUTOS AUTp6ED PROPERTY DAMAGE $ (Per dent) $ UMBRELLA LUIB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE DED RETENTION$ $ WORKERS COMPENSATION IPER OTH $ AND EMPLOYERS LIABILITY YIN LITE I ER ANY PROPRIETORIPARTNERIEXECUTIVE N/A E.LEACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑ $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE Ifyes,describe under F.L.DISEASE�POLICY LIMIT $ DESCRIPTION OF OPERATIONS below Psychologist's Professional 78622104160 10/01/2014 10/01/2015 Each Incident $2,000,000 A Liability Annual $4,000,000 Retroactive Date:10/01/1991 Aggregate DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required): 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. AUTHORIZED REPRESENTATIVE ACORD 25(2014101) ©1988-2014 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD