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HomeMy WebLinkAboutAgenda 8-f - Emergency Debris Removal and Processing Services AgreementORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: September 20, 2018 Action Agenda Item No. 8 -f SUBJECT: Amendment to Emergency Debris Removal and Processing Services Agreement DEPARTMENT: Solid Waste ATTACHMENT(S): 1. Contract Amendment #1 2. Original Contract INFORMATION CONTACT: Robert Williams, 919 - 918 -4904 Cheryl Young, 919 - 918 -4914 1 PURPOSE: To approve an amendment extending an agreement between Orange County and Ceres Environmental Services, Inc. through October 1, 2019 for the purpose of providing a resource for Emergency Storm Debris Removal and Processing Services. BACKGROUND: Ceres Environmental Services, Inc. has acted as the County's secondary contractor for Emergency Storm Debris Removal. As the result of changes to Federal Emergency Management Agency (FEMA) regulations, the County's rip mart' Emergency Storm Debris Removal and Processing Services Contractor elected not to renew the current Contract. The Solid Waste Department is working collectively with the towns of Chapel Hill, Hillsborough and Carrboro to issue a new request for proposals (RFP) to secure Emergency Storm Debris Removal and Processing Services. Ceres Environmental agreed to extend the current Contract to insure the County has services available if needed while the RFP is developed and a new Contractor secured. FINANCIAL IMPACT: The primary purpose of the agreement is to ensure that adequate staffing and equipment resources are available in the event of a severe storm event to effectively manage large quantities of debris that would likely be generated. There are no expenses anticipated related to this agreement without an emergency declaration by the Chair of the Board of Commissioners. SOCIAL JUSTICE IMPACT: The following Orange County Social Justice goal is applicable to this item: • GOAL: ESTABLISH SUSTAINABLE AND EQUITABLE LAND -USE AND ENVIRONMENTAL POLICIES The fair treatment and meaningful involvement of people of all races, cultures, incomes and educational levels with respect to the development and enforcement of environmental laws, regulations, policies, and decisions. Fair treatment means that no group of people should bear a disproportionate share of the negative environmental consequences resulting from industrial, governmental and commercial operations or policies. RECOMMENDATION(S): The Manager recommends that the Board approve the amendment for the Contract extension and authorize the Manager to sign the Amendment. �i Attachment 1 NORTH CAROLINA ORANGE COUNTY CONTRACT AMENDMENT #1 THIS CONTRACT AMENDMENT ( "Amendment ") is made and entered into this day of September_ 2018 by and between ORANGE COUNTY (hereinafter referred to as "County ") and Ceres Environmental Services, Inc. (hereinafter referred to as "Provider "). WITNESSETH: THAT WHEREAS, the County and Provider entered into a contract dated October 1, 2013 with respect to the Removal, Reduction, Recycling and /or Disposal of Debris services to the C o u n t y (hereinafter the "Agreement "); and WHEREAS, the County and Provider desire to extend the Agreement while keeping in effect all terms and conditions of the Agreement not inconsistent with the terms and conditions set forth below. NOW THEREFORE, for and in consideration for the mutual covenants and agreements made in the Original Agreement and herein, the parties agree to amend the Original Agreement as follows: 1. The Term ofthe Agreement is hereby extended through October 1, 2019. 2. Subsection 1 Lb. Governing Law be replaced with the following: "Subsection 11. 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. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal anti - discrimination laws, policies, rules, and regulations and the Orange County Non - Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http: / /www.oran_ec�ountync. og v /departments /purchasing division/contracts.ph p.). Any violation of the Orange County Non - Discrimination Policy is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. 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 3 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, on the list created by the State Treasurer pursuant to G. S. 147- 86.81. Except for the changes made herein, the Agreement shall remain in full force and effect to the extent it is not inconsistent with this Amendment. IN TESTIMONY WHEREOF, this Amendment has been executed by the parties hereto, as of the date first above written. [0 1"M i d94 [oil LW4 County Manager 11391T b Title C! [Departmental Use Only] TITLE FY SERVICES AGREEMENT OVER $90,000.00 RFP —WITH REIMBURSABLE EXPENSES ORANGE COUNTY This Services Agreement (hereinafter "Agreement'), made and entered into this 1st day of October, 2013, ( "Effective Date ") by and between Orange County, North Carolina a body politic and corporate of the State of North Carolina (hereinafter, the "County ") and Ceres Environmental Services, Inc. (hereinafter, the "Provider "). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Services Agreement ( "Agreement ") is for professional services to be rendered by Provider to County with respect to (insert type of project): Removal, Reduction, Recycling and /or Disposal of Debris 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 Revised July 2010 5 performance of these services. Provider is solely responsible for the professional 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, 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) Provider agrees that Provider, its employees, agents and its subcontractors, if any, shall be required to comply with all federal, state and local antidiscrimination laws, regulations and policies that relate to the performance of Provider's services under this Agreement. vi) 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 Iicenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. 3. Basic Services a. Basic Services. i) The Provider shall perform as Basic Services the work and services described herein and as specified in the County's Request for Proposals (the "RFP ") "RFP Number 5193 for "Removal, Reduction, Recycling and/or Disposal of FEMA Eligible Debris" issued May 3, 2013, and the Provider's proposal, which are fully incorporated and integrated herein by reference together with Attachments Addendum 41 (designate all attachments). In the event a term or condition in any document or attachment conflicts with a term or condition of this Agreement the term or condition in this Agreement shall control. Should such conflict arise the priority of documents shall be as follows: This Agreement, the County's RFP together with attachments, Provider's Proposal together with attachments. ii) The Basic Services will be performed by the Provider in accordance with the following schedule: (Insert task list and milestone dates) Revised July 2010 2 L Task Milestone Date 1. n/a iii) Should County reasonably determine that Provider has not met the Milestone Dates established in Section 3(a)(ii), County shall notify Provider of the failure to meet the Milestone Date. The County, at its discretion may provide the Provider seven (7) days to cure the breach. County may withhold the accompanying payment without penalty until such time as Provider cures the breach. In the alternative, upon Provider's failure to meet any Milestone Date the County may modify the Milestone Date schedule, Should Provider or its representatives fail to cure the breach within seven (7) days, or fail to reasonably agree to such modified schedule, County may immediately terminate this Agreement in writing, without penalty or incurring further obligation to Provider. This section shall not be interpreted to limit the definition of breach to the failure to meet Milestone Dates. 4. Duration of Services a. Term. The term of this Agreement shall be from October 1, 2013 to September 30, 2018. b. Scheduling of Services i) The Provider shall schedule and perform his activities in a timely manner so as to meet the Milestone Dates listed in Section 3. ii) Should the County determine that the Provider is behind schedule, it may require the Provider to expedite and accelerate his efforts, including providing additional resources and working overtime, as necessary, to perform his services in accordance with the approved project schedule at no additional cost to the County. iii) Upon written agreement of the parties his Agreement may be renewed for one additional five -year term. iv) The Commencement Date for the Provider's Basic Services shall be October 1, 2013. 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 except reimbursable expenses as specified in section 5(c), below. Subject to the unit and services costs shown in Provider's Proposal the maximum amount payable for Basic Services is six million Dollars ($6,000,000.00). 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. Payment for Basic Services shall become due and payable in direct proportion to satisfactory services performed and work accomplished. Payments will be made as percentages of the whole as Project milestones as set out in Section 3(a)(ii) are achieved. (For example, if there Revised July 2010 3 rA are 10 Project Tasks with Milestone Dates then Provider may invoice for the first 10% of the whole upon County's acknowledgement of the satisfactory completion of Task one. Upon the County's acknowledgement that the second Task has been satisfactorily completed Provider may invoice for the next 10% of the whole.) b. 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. c. Reimbursable 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 the Provider with respect to the Project: i) Actual expenditures for postage, reproductions, photography, and long distance telephone charges directly attributable to this Project. ii) The actual cost of reproduction of reports, plans and specifications excluding documents for exclusive use by the Provider. iii) The Provider shall not be entitled to any mark -up on actual expenses incurred. iv) Reimbursable expenses shall be compensated by the County along with invoices for Basic Services provided by Provider. Payment of Reimbursable Expenses shall be subject to Provider's timely submission of valid receipts for any such expenses and approval by the County. Any additional charges not specified herein, must be mutually agreed to in advance by County and Provider and documented in writing with a letter signed by authorized representatives for County and Provider and, subject to budgeted funds. 6. Responsibilities of the County a. Cooperation and Coordination. The County has designated the (Solid Waste Management Director Gayle Wilson) 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 a. General Requirements. The Provider shall purchase and maintain and shall cause each of his subcontractors to purchase and maintain, during the period of performance of this Agreement: i) Worker's Compensation Insurance for protection fiom claims under workers' or workmen's compensation acts; ii) Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any Revised July 2010 4 of the Provider's employees or any other person and to real and personal property including loss of use resulting thereof, iii) Comprehensive Automobile Liability Insurance, including hired and non -owned vehicles, if any, covering personal injury or death, and property damage; and iv) Professional Liability Insurance, covering personal injury, bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Provider or his agents, Providers and employees. b. Insurance Rating. The minimum insurance rating for any company insuring the Provider shall be Best's A. If the Provider does not meet the 'insurance requirements the County's Risk Manager must be consulted prior to finalizing this Agreement. C. Limits of Coverage. Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A - Statutory State of N.C. Coverage B - Employers Liability $500,000 each accident and policy limit and disease each employee • Commercial General Liability $1,000,000 Each Occurrence; $2,000,000 Aggregate. • Automobile Liability Combined Single Limit $500,000 • Professional Liability NOTE Insert coverage limits required by . Risk Manages if applicable: d. Additional Insured. All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party. Evidence of such insurance shall be furnished to the County, together with evidence that each policy provides the County with not less than thirty (30) days prior written notice of any cancellation, non - renewal or reduction of coverage. S. Indemnity a. Indemnity. The Provider agrees 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 bodily injury including death or property damage 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 Revised July 2010 5 9 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. c. 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. 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. c. 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 Revised July 2010 6 irt, jurisdiction or venue with respect to such suits or actions. The Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. d. Entire Agreement. This Agreement, together with the RFP and its attachments and the Proposal and its attachments, 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. e. 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. f, 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. g. 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. h. 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: Gayle Wilson P.O. Box 8181 Hillsborough, NC 27278 Revised July 2010 Provider's Name & Address Ceres Environmental Services, Inc. Attention: David Preus 6960 Professional Parkway Sarasota, FL 34240 11 [SIGNATURE PAGE TO FOLLOW1 Revised July 2010 12 IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have hereunder set their hands and seat, all as of the day and year first above written, ORANGE COUNTY: PROVIDER: Oran Attest: [SEAL By:_Ceres Environmental Services, Inc. By David A. Preus, Vice President Printed Name and Title This instrument has been approved as to technical content. Coal Gayle Wilson/Alepartment Director This instrument has been pre - audited in the manner required by the Local Government Budget and Fiscal Control Act. a�;411zl_ �_� ji, Office of the Finance Director This instrument has een approved as to form and legal sufficiency. office of the County Attorney Revised July 2010 9 13 A�QRL]0 DATE (MMIDDIYYYY) � CERTIFICATE OF LIABILITY INSURANCE 10/29/2013 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(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 lieu of such endorsement(s). PRODUCER Christensen Group Insurance 11100 Hren Road West Minnetonka MN 55343 CONTACT Kell Preston NAME: y PHONE (952) 653-1000 FA No: (952)553 -11.01 ED➢AIE .kpreston @christensengroup.com INSURERS AFFORDING COVERAGE NAIC 9 WSURERA:Zurich American Ins. Co. POLICY EXP (MMIDDIYYYYI INSURED CERES ENVIRONMENTAL SERVICES, INC. 3825 85th Ave North Minneapolis MN 55443 INSURER 13 'Markel Int r 1 Ins. Co. Ltd GENERAL LIABILITY INSURFRC:Star Indemnity and Liability Tyler Simmons /KP INSURER D: INSURER E: EACH OCCURRENCE INSURER F: COVERAGES CERTIFICATE NUMBER:13 -14 - MASTER - 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 I LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EPP JMM1DDrTYYY1 POLICY EXP (MMIDDIYYYYI LIMITS Hillsborough, NC 27278 GENERAL LIABILITY Tyler Simmons /KP EACH OCCURRENCE $ 1,000,000 X COMMERCIAL. GENFRAL LIABILITY DAMAGE REMISES Ea occurrence) $ 300,000 A CLAIMS -MADE F—x] CCCUR X X L05911870 -01 8/18/2013 8/18/2014 MEDEXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMPIOPAGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY CO acc dED SINGLE LIMIT 2,000,000 $ BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X X AP9313049 -02 8/18/2013 8/18/2014 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS INCLUDES COVERAGE FOR $ ORIDA C X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAR CLAIMS -MADE 1000020303 8/18/2013 8/18/2414 DE❑ I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y J N ANY PROPRIETOWPARTNERIEXECUTIVE❑ X I WG SLATU- OE H- E.L. EACH ACCIDENT $ 1. 000 000 Mandatory InNH)EXCLUDED? NIA C9313050-02 8/18/2013 8/18/2014 E.L. DISEASE -EA EMPLOYE $ 1,000,000 "yes, describe under DESCRIPTION OF OPERATIONS below }{ INCLUDES MARYLAND E.L. DISEASE - POLICY LIMIT $ 1,000,000 13 Contractors Pollution X X 13CPLOMW40040 8/18/2013 8/18/2014 Each Condilton &Claim: $5,000,000 Claims Made Policy DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES {Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Certificate Holder is included as an Additional Insured under all policies excluding Workers Compensation when required by written contract. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010105) INS026 (201005).01 O 1988 -2010 ACORD CORPORATION. All rights reserved. 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 North Carolina RFP# 5193 AUTHORIZED REPRESENTATIVE 200 S Cameron Street Hillsborough, NC 27278 Tyler Simmons /KP ACORD 25 (2010105) INS026 (201005).01 O 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD