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HomeMy WebLinkAbout2018-005-E AMS - Civil Consultants Feasibility Investigation for Cornelius StreetDocuSign Envelope ID: 016A45OF- 8FDD- 426F- 8A39- DOOA9115F413 [Departmental Use Only] TITLE Feasibility Invest FY 2017/18 NORTH CAROLINA SERVICES AGREEMENT UNDER $90,000.00 NO RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter "Agreement "), made and entered into this 29th day of December, 2017, ( "Effective Date ") by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County ") and Civil Consultants, (hereinafter, the "Provider "). That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Agreement is for services to be rendered by Provider to County with respect to (insert type ofproject): Feasibility Investigation Cornelius Street Properties ii) By executing this Agreement, the Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner. iii) Time is of the essence with respect to this Agreement. iv) The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. 2. Responsibilities of the Provider a. Services to be provided. The Provider shall provide the County with all services required in Section 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Provider is solely responsible for the professional Revised 10/17 DocuSign Envelope ID: 016A45OF- 8FDD- 426F- 8A39- DOOA9115F413 quality, accuracy and timely completion and/or submission of all work related to the Basic Services. ii) Provider shall be responsible for all errors or omissions of its agents, contractors, employees, or assigns in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. iii) The Provider shall not, except as otherwise provided for in this Agreement, subcontract the performance of any work under this Agreement without prior written permission of the County. No permission for subcontracting shall create, between the County and the subcontractor, any contract or any other relationship. iv) Provider is an independent contractor of County. Any and all employees of the Provider engaged by the Provider in the performance of any work or services required of the Provider under this Agreement, shall be considered employees or agents of the Provider only and not of the County, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Provider. v) If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Provider represents that it and/or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. vi) In determining the basic services to be provided, should any documents be referenced in this Agreement, the terms of this Agreement shall have priority in any conflict between the terms of referenced documents and the terms of this Agreement. Should a request for proposals and a proposal be referenced the terms of the request for proposals shall have priority over the terms of any proposal. 3. Basic Services a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows (fully describe services to be provided): Provide Feasibiliy Investigation for Cornelius Street Properties per proposal #24032 dated December 8, 2017. 4. Duration of Services a. Term. The term of this Agreement shall be from December 29, 2017 to June 30, 2018. b. Scheduling of Services. i) The Provider shall schedule and perform its activities in a timely manner. ii) Should the County determine that the Provider is behind schedule, it may require the Provider to expedite and accelerate its efforts, including providing additional Revised 10/17 2 DocuSign Envelope ID: 016A45OF- 8FDD- 426F- 8A39- DOOA9115F413 resources and working overtime, as necessary, to perform its services in accordance with the approved project schedule at no additional cost to the County. iii) The Commencement Date for the Provider's Basic Services shall be December 29, 2017. 5. Compensation a. Compensation for Basic Services. Compensation for Basic Services shall include all compensation due the Provider from the County for all services under this Agreement. The maximum amount payable for Basic Services shall not exceed Seven Thousand Five Hundred Dollars ($7,500.00). Payment for Basic Services shall become due and payable within thirty (30) days of Provider properly invoicing County. Payment shall be subject to provisions of Section 5(b). b. Disputes. In the event the amount stated on an invoice is disputed by the County, the County may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. Additional Services. County shall not be responsible for costs related to any services in addition to the Basic Services performed by Provider unless County requests such additional services in writing and such additional services are evidenced by a written amendment to this Agreement. 6. Responsibilities of the County a. Cooperation and Coordination. The County has designated (Jeff Thompson) to act as the County's representative with respect to the Project and shall have the authority to render decisions within guidelines established by the County Manager and/or the County Board of Commissioners and shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance Revised 10/17 3 DocuSign Envelope ID: 016A450E- 8FDD- 426F- 8A39- DOOA9115F413 8. Indemnity a. Indemnity. The Provider agrees, without limitation, to defend, indemnify and hold harmless the County from all loss, liability, claims or expense, including attorney's fees, arising out of or related to the Project and arising from property damage or bodily injury including death to any person or persons caused in whole or in part by the negligence or misconduct of the Provider except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 9. Amendments to the Agreement a. Changes in Basic Services. Changes in the Basic Services and entitlement to additional compensation or a change in duration of this Agreement shall be made by a written Amendment to this Agreement executed by the County and the Provider. The Provider shall proceed to perform the Services required by the Amendment only after receiving a fully executed Amendment from the County. 10. Termination a. Termination for Convenience of the County. This Agreement may be terminated without cause by the County and for its convenience upon seven (7) days' prior written notice to the Provider. b. Other Termination. The Provider may terminate this Agreement based upon the County's material breach of this Agreement; provided, the County has not taken all reasonable actions to remedy the breach. The Provider shall give the County seven (7) days' prior written notice of its intent to terminate this Agreement for cause. Compensation After Termination. i) In the event of termination, the Provider shall be paid that portion of the fees and expenses that it has earned to the date of termination, less any costs or expenses incurred or anticipated to be incurred by the County due to errors or omissions of the Provider. ii) Should this Agreement be terminated, the Provider shall deliver to the County within seven (7) days, at no additional cost, all deliverables including any electronic data or files relating to the Project. d. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. Suspension. County may suspend the Basic Services and this Agreement at any time for County's convenience and without penalty to County upon three (3) days' notice to Revised 10/17 4 DocuSign Envelope ID: 016A450E- 8FDD- 426F- 8A39- DOOA9115F413 Provider. Upon any suspension by County, Provider shall discontinue work on the Basic Services and shall not resume the Basic Services until notified to proceed by County. 11. Additional Provisions a. Limitation and Assignment. The County and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County nor the Provider shall assign or transfer its interest in this Agreement without the written consent of the other. b. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147 - 86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G. S. 147 - 86.81. d. Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non - performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. f. Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the Parties. Revised 10/17 5 DocuSign Envelope ID: 016A45OF- 8FDD- 426F- 8A39- DOOA9115F413 g. Ownership of Work Product. Should Provider's performance of this Agreement generate documents, items or things that are specific to this Project such documents, items or things shall become the property of the County and may be used on any other project without additional compensation to the Provider. The use of the documents, items or things by the County or by any person or entity for any purpose other than the Project as set forth in this Agreement shall be at the full risk of the County. h. 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. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the Parties to comply with Article I IA and Article 40 of North Carolina General Statute Chapter 66. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Attention:Jeff Thompson P.O. Box 8181 Hillsborough, NC 27278 [SIGNATURE PAGE TO FOLLOW] Revised 10/17 6 Provider's Name Civil Consultants 3708 Lyckan Parkway St 201 Durham, NC 27707 DocuSign Envelope ID: 016A450E- 8FDD- 426F- 8A39- DOOA9115F413 IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have hereunder set their hands and seal, all as of the day and year first above written. ORANGE COUNTY: PROVIDER: sgrcn By' � cey: � By' �LS.Ll ' RAA'4'kt 1/2/2018 ��— County Manager Tony M. Whitaker, PE, President Printed Name and Title Revised 10/17 7 12/21/2017 DocuSign Envelope ID: 016A45OF- 8FDD- 426F- 8A39- DOOA9115F413 0 consultants LAND DEVELOPMENT CONSULTANTS # 24032 PROPOSAL FOR CONSULTING ENGINEERING SERVICES Project: Feasibility Investigation Cornelius Street Properties Parcels 9864392344, 9864398253, and 9864397758 Orange County, NC Date: December 8, 2017 Client: Orange County Attn: Mr. Jeff Thompson PO Box 8181 Hillsborough, NC 27278 Engineer: Civil Consultants, Inc. 3708 Lyckan Parkway Suite 201 Durham, NC 27707 General Description of Protect Work: The project scope of work will be as follows: 1. Review of zoning and related criteria, physical site conditions, and regulatory issues pertaining to property usage and re- development for various governmental support services. 2. Assessment of development potential considering zoning, stormwater management regulations, and physical conditions; 3. "High - level" feasibility and capacity study for public water and sewer service and associated extensions /connections, prepare preliminary estimate of associated construction value, identify any unusual permitting requirements, etc. 4. Consideration of vehicular access issues, sight distance limitations, driveway access options, and probable issues concerning roadway improvements; 5. Prepare bubble sketches showing conceptual property usage options composed of various service facilities under consideration, with combinations of uses utilizing shared infrastructure such as driveway and parking areas, etc. as practical. 6. Attend a maximum of two meetings to discuss and present recommendations. LAND PLANNERS + CIVIL ENGINEERS 3708 LYCKAN PARKWAY, SUITE 201 DURHAM, NC 27707, PHONE: 919.490.1645 WWW.CIVIL- CONSULTANTS.COM LIC. C -1030 DocuSign Envelope ID: 016A450E- 8FDD- 426F- 8A39- DOOA9115F413 Orange County will provide for Engineer's use CAD -based mapping from GIS or other sources showing the following information for the parcel and extending at least 500 feet all around the parcel: • Property boundaries • Planimetric and terrain data including buildings, roadways, streams, stream buffers, water features, floodplain, pavement limits, etc. • Topography with 2' vertical intervals • Base zoning and any zoning overlay districts • Town of Hillsborough ETJ or limit of Utility Service Area • Locations of existing public water and sewer lines • Aerial imagery Compensation: Client shall compensate Engineer for project work performed on an hourly basis, at the hourly rates listed below. This agreement authorizes up to $7,500.00 for the general scope of work described. Tony M. Whitaker, PE President Schedule of Billing Rates Classification Hourly Rate Principal Engineer $160.00 Senior Designer $125.00 Designer Technician $95.00 Administrator $75.00 DocuSign Envelope ID: 016A45OF- 8FDD- 426F- 8A39- DOOA9115F413 AoC"R DFI CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 10/13/2017 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 have ADDITIONAL INSURED provisions or 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: Insurance Management Consultants, Inc. PHONE (704)799 -1600 (FZ (704)799 -2955 A/C No Ext : A/C, No): P.O. Box 2490 E -MAIL cert @imcipls.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Davidson NC 28036 INSURERA: Continental Casualty Company 20443 INSURED INSURER B: Civil Consultants, Inc. INSURER C: 3708 Lyckan Parkway INSURER D: Suite 201 INSURER E: CLAIMS -MADE D OCCUR Durham NC 27707 INSURER F: COVERAGES CERTIFICATE NUMBER. 5/14/17 Renewal 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 INSD WVD POLICY NUMBER MMIDDY EFF MOM/LDI D EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS -MADE D OCCUR PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ POLICY EI JECT LOC PRODUCTS - COMP /OPAGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER /EXECUTIVE El OFFICER /MEMBER EXCLUDED? N/A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ Per Claim $1,000,000 A Professional Liability AEH113816083 05/14/2017 05/14/2018 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Asset Management Services ACCORDANCE WITH THE POLICY PROVISIONS. 131 West Margaret Lane AUTHORIZED REPRESENTATIVE Hillsborough NC 27278 /� Ui /-=lv ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 016A45OF- 8FDD- 426F- 8A39- DOOA9115F413 71011312017 E (MMIDDIYYYY) AC" CERTIFICATE CERTIFICATE OF LIABILITY INSURANCE �� 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 INSURERS), 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: IPHONE FAX Andrew F. Jones , 'E; ReSs: 729 W NC HIGHWAY 54 INSURER(S) AFFORDING COVERAGE NAIC # DURHAM NC 27713 INSURERA: NATIONWIDE PROPERTY AND CASUALTY INSUF 37877 INSURED INSURER 8 INSURER C : _ CIVIL CONSULTANTS, INC INSURER D: 3708 LYCKAN PKWY STE 201 INSURER E: DURHAM NC 27707 -2586 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. ACCORDANCE WITH THE POLICY PROVISIONS. Orange County Asset Management Services INSR ADD LSUBR POLICY EFF POLICY EXP AUTHORIZED REPRESENTATIVE 131 West Margaret Lane LTR TYPE OF INSURANCE "SD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYY LIMITS L Jam„ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1.000,000 _ CLAIMS -MADE X OCCUR . DAMAGE TO RENTED PREMISES (Ea occurrence) S 30000 ME EXP [Any one person} $ 5,000 A ACP BPOK 3036630835 04/24/2017 04/24/2018 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER- GENERALAGGREGATE $ 2,000,000 POLICY PRO X LOG . JECT PRODUCTS- GOMPIOPAGG , S 2,000,000 OTHER,$ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) 5 ALL OWNED SCHEDULED BODILY INJURY [Per accident] $ AUTOS AUTOS NON -OWNED PROPERTYDAMAGE $ HIRED AUTOS AUTOS _ (Per accident) S UMBRELLA LIAB OCCUR _ EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION S S WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANYPROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT $ OFFICERJMEMBER EXCLUDE D? ❑NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE S If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 901, Additional Remarks Schedule, may be attachad if more space is required) [d=11:ill9 [011e] =1 Cy:14W_r9[a]61 ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Orange County Asset Management Services AUTHORIZED REPRESENTATIVE 131 West Margaret Lane Diane M Burgess Hillsborough NC 27278 L Jam„ ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD