HomeMy WebLinkAbout2020-644-E AMS-Bioclean Restoration fire Station 2 containmentRevised 07/20 1
[Departmental Use Only]
TITLE FIre Station #2
FY 2020/2021
NORTH CAROLINA
SERVICES AGREEMENT NO RFP/RFQ
ORANGE COUNTY
This Services Agreement (hereinafter “Agreement”), made and entered into this 24th day of
November, 2020, (“Effective Date”) by and between Orange County, North Carolina a political
subdivision of the State of North Carolina (hereinafter, the "County") and Bioclean Restoration,
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 Agreement is for services to be rendered by Provider to County with respect
to (insert type of project): Mold cleaning in the living/dining room, kitchen, left
rear office, and bay main doors based on the IIRC S520 standards. This includes
HEPA vacuuming, wiping with biocide, HEPA vacuuming, and final fogging.
Please see attached Quote #358 dated 10/29/2020.
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
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with applicable federal, state and local laws and regulations applicable to the
performance of these services. Provider is solely responsible for the professional
quality, accuracy and timely completion and 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 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.
vii) Should this Agreement involve project designs, the construction or creation of
which is to be bid out or fulfilled by other contractors, and bidding or negotiation
with contractors produce prices which, when added to the other elements of the
approved total project cost, produce a cost that is in excess of the approved total
project cost, the Provider shall participate with the County in negotiation and
design adjustments to the extent such are necessary to obtain prices within the
approved total project cost. All activity of the Provider with respect to these
matters shall constitute Basic Services and shall be performed by the Provider
without additional compensation. If negotiation and design adjustments fail to
bring costs within the total project cost the County may reject all bids and
Provider will redesign or reduce portions of the project in an effort to reduce the
bid prices to within the total project cost and rebid the project. One such redesign
is included within Basic Services. If this second letting for bids does not produce
bids that are within the approved total project cost initially or after negotiations
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with the contractor the cost is not reduced to an amount within the total project
cost, the Provider is not obligated to engage in further redesign.
3. Basic Services
a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows
(fully describe services to be provided): Mold Cleaning at Fire Station #2 at 5601 St.
Marys Rd, Hillsborough. See attached Quote.
4. Duration of Services
a. Term. The term of this Agreement shall be from 11/24/2020 to 05/24/2020.
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
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 11/24/2020.
5. Compensation
a. Compensation for Basic Services. Compensation for Basic Services shall include all
compensation due the Provider from the County for all services satisfactorily (as
determined by the County) performed pursuant to this Agreement. The maximum
amount payable for Basic Services shall not exceed Fifteen Thousand Four Hundred
Thirty Three Dollars and Fifty Eight Cents Dollars ($15,433.58). Payment for
satisfactorily performed 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.
c. 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
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a. Cooperation and Coordination. The County has designated (Paul Sorrell) to act as the
County's representative with respect to the Project who shall have the authority to render
decisions within guidelines established by the County Manager or the County Board of
Commissioners and who 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. Provider shall obtain, at its sole expense, Commercial General
Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any
additional insurance as may be required by County’s Risk Manager as such insurance
requirements are described in the Orange County Risk Transfer Policy and Orange
County Minimum Insurance Coverage Requirements (each document is incorporated
herein by reference and may be viewed at
http://www.orangecountync.gov/departments/purchasing_division/contracts.php). If
County’s Risk Manager determines additional insurance coverage is required such
additional insurance shall consist of NA (if no additional insurance required mark N/A
as being not applicable). Provider shall not commence work until such insurance is in
effect and certification thereof has been received by the County's Risk Manager.
8. Indemnity
a. Indemnity. To the extent authorized by North Carolina law 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. Either party may
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terminate this Agreement upon notice to the other party that obligations pursuant to this
Agreement are made impractical due to declarations of emergency by Orange County or
by North Carolina due to events directly impacting Orange County. Both parties shall
remain responsible for all payment and performance due up to the receipt of such notice,
but shall have no further obligation or responsibility beyond that date provided the
terminating party has taken all reasonable steps to complete the performance of its
obligations.
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. Upon request of the County, the Provider shall submit to County all
relevant documentation, including but not limited to, job cost records, to support
its claims for final compensation.
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.
e. 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
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.
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c. Non-Discrimination. 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 non-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.orangecountync.gov/departments/purchasing_division/contracts.php.) 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.
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.
e. 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.
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.
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In the event of a change in the County’s statutory authority, mandate or mandated
functions, by state 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.
i. 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 11A and Article 40 of North Carolina General Statute Chapter 66.
j. 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 Provider’s Name
Attention:Paul Sorrell Bioclean Restoration, Inc
P.O. Box 8181 PO Box 849
Hillsborough, NC 27278 Burlington, NC 27216
[SIGNATURE PAGE TO FOLLOW]
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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:
By: _________________________________
Bonnie Hammersley
By: __________________________________
Richard Stinson, Operations Manager
Printed Name and Title
DocuSign Envelope ID: BCEDBC03-3697-488E-8276-2F2F2CA43199
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ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Party/Vendor Name: Bioclean Restoration, Inc. Party/Vendor Contact Person: Richard Stinson
(biocleanrestorationnc@gmail.com) Contact Phone: 336-792-0037 Party/Vendor Address: PO Box 849 City
Burlington State: NC Zip: 27216 Department: AMS Amount: $15,433.58 Purpose: Mold Cleaning at Fire Station
#2 on St.Mary's Rd, Hillsborough Budget Code(s): 10240320-570000 Vendor # 66889 (N/A if new vendor)
Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment
Effective Date Approved by Board Yes No Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work
on this project has not been initiated prior to execution of the agreement:
Department Director’s Signature ________________________________________ Date: ________
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that
was addressed:
Information Technologies
(Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer___________________________________ Date: ________
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board __________________________________________Date:_________
DocuSign Envelope ID: BCEDBC03-3697-488E-8276-2F2F2CA43199
11/30/2020
12/1/2020
12/3/2020
12/3/2020
Revised 07/20 10
DocuSign Envelope ID: BCEDBC03-3697-488E-8276-2F2F2CA43199
RECIPIENT:
Orange County, NC
PO Box 8181
Hillsborough, NC 27278
Phone: 919-245-2631
SERVICE ADDRESS:
5601 St Mary’s Rd
Hillsborough, NC 27278
Quote #358
Sent on Oct 29, 2020
Total $15,433.58
PRODUCT / SERVICE DESCRIPTION UNIT COST TOTAL
Insulation Repair insulation as needed to to prevent attic air entry into
the living area of the building.
$350.00 $350.00
Ceiling Tiles We will remove, bag, and dispose of contaminated ceiling
tiles. These will be replaced with new tiles. ***Price quoted
here is per tile**** We wont know for sure how many until we
start. Some may have mold on the back side.
$12.32 $12.32
Mold Cleaning Per Protocol We will cleaning the living/dining room, kitchen, left rear
office, and bay man doors based on the IICRC S520
standards. This includes HEPA vacuuming, wiping with
biocide, HEPA vacuuming, and final fogging.
$3,000.00 $3,000.00*
Air Scrubber Air Scrubber Rental Per Day.
5 units for 4 days. 1 day during demo on negative air and 3
days after on recirculate to help clean the air
$95.00 $1,900.00
Sealing openings Seal along wall of ceiling grid throughout the living quarters
and the large gap at the ceiling in the engine bay. Add
weatherstripping to the man doors going the engine bay and
exterior
$318.00 $318.00
Recommendations We recommend having a HVAC contractor install UV filters
on both HVAC units to help prevent mold growth virus’, and
bacteria. We also recommend installing a dehumidifier on
each unit to help control the humidity.
We recommend adding insulation to the suspended ceiling
as an additional barrier to prevent a hot air/cold air situation
between the suspended ceiling and the attic insulation that
is currently installed.
We are happy to get these items priced and facilitate the
installation.
$0.00 $0.00
Clearance Testing Clearance testing provided by Pilot Environmental $1,600.00 $1,600.00
Air Scrubber Air Scrubber Rental Per Day
Additional units needed during cleaning
$95.00 $380.00
Dehumidifier - XLarge Per 24 hours period - no monitoring
These will be run during cleaning and for 4 days after to
regulate and maintain humidity 5 units for 4 days
$115.29 $2,305.80
1 of 2 pages
Bioclean Restoration, Inc.
PO Box 849 | Burlington, NC 27216
336-792-0037 | biocleanrestorationoffice@gmail.com | Bioclean-NC.com
DocuSign Envelope ID: BCEDBC03-3697-488E-8276-2F2F2CA43199
PRODUCT / SERVICE DESCRIPTION UNIT COST TOTAL
HMR Temporary
Containment Walls
Temporary plastic containment walls attached with duct or
poly tape
$250.00 $1,500.00
HVAC Cleaning Clean ducts and HVAC air handlers $1,600.00 $3,200.00
This quote is valid for the next 30 days, after which values may be subject to
change.
Subtotal $14,566.12
North Carolina
State (4.75%)
$549.39
Orange County
(2.75%)
$318.07
Total $15,433.58
2 of 2 pages
Bioclean Restoration, Inc.
PO Box 849 | Burlington, NC 27216
336-792-0037 | biocleanrestorationoffice@gmail.com | Bioclean-NC.com
DocuSign Envelope ID: BCEDBC03-3697-488E-8276-2F2F2CA43199
Standard mold remediation protocol
1. Pre remediation testing to determine scope of job when practical. (to include
air quality, asbestos and lead swabs)
2. Set containment with exit chamber. Minimum of one HEPA air scrubber
inside and one outside of containment. Seal any ac ductwork inside of the
containment.
3. Complete demolition with containment air scrubber on circulate, bag debris
and remove from property. Hepa vacuum the floor.
4. Perform knockdown fog and clean horizontal surfaces.
5. “Hepa sandwich” (hepa, then Shockwave wipe, then 2nd hepa) of all
exposed surfaces inside of the containment including the containment.
White rag test and repeat as necessary.
6. Perform final knockdown fog and clean horizontal surfaces.
7. Allow air scrubbers to circulate for three days after.
8. Perform post remediation testing.
Our Certifications
IOT Mold Remediator
MICRO Certified Mold Inspector
MICRO Certified Mold Removal Contractor
IICRC Advanced Microbial Remediator
EMSL Advanced Fungal Interpretation
EPA and NCDOH Lead Certified Firm
IICRC Master Water Damage Restorer
IICRC Master Textile Cleaner
IICRC Master Fire & Smoke Restorer
IICRC Trauma & Crime Scene Restorer
IICRC CCT, CRT, CRR, OCT,
HAZWOPER 40
VOB, Veteran Owned Business
DocuSign Envelope ID: BCEDBC03-3697-488E-8276-2F2F2CA43199
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
ACORif CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
11t23t2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDE:R, 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: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer riqhts to the certificate holder in lieu of such endorsement(s).
PRODUCER
MAST & GARRISON, INC.
PO BOX 340
BURLINGTON, N.C.27216
g9IIIICT MAST & GARRISON, INC
lllg\F^ --.,. 3362264474 lsl "^,. aSOZZO+i;gS
E.MAILlnhoEcc.
INSURER(S) AFFORDING COVERAGE NAIC #
tNsuRER A: ROCKWOOD CASUALTY
INSURED
BIOCLEAN RESTORATION, INC
PO BOX 849
BURLINGTON. N.C,27216 INSIJRER E :
INSIIRFR F
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 INSUMNCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THEi TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NSR
LTR TYPE OF INSURANCE NSn WN POLICY NUMBER
POLICY EFFIMM/nnrywl POLICY EXP
IMM/DN/VYYYT LIMITS
GOMMERCIAL GENERAL LIABILITY
l cLAil\,rs-MADE I l occuR
EACH OCCURRENCE $
UAMASE IUKtrNIEU
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MED EXP (Any one person)$
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER;GENERAL AGGREGATE $
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$
AU'OMOBILE LIABILITY
ANY AUTO
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AUTOS ONLY
HIRED
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SCHEDULED
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COMtsINED SINGLE LIMII
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BODILY INJURY (Per person)$
BODILY INJURY (Per accident)$
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PER I I OTH.STATIITF I I FR
E.L. EACH ACCIDENT s 1000000
E.L. DISEASE - EA EMPLOYET s 1000000
E.L. DISEASE - POLICY LIMIT $ 1000000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
ERTIFICATE HOLDER GANCELLATION
ORANGE COUNW ASSET MANAGEMENT COORDINATOR
PO BOX 8181
HILLSBOROUGH, N.C. 27278
SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE OELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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o't988-201s ACORD TtoN. Atl reserved.
ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD
rights
DocuSign Envelope ID: BCEDBC03-3697-488E-8276-2F2F2CA43199
DocuSign Envelope ID: BCEDBC03-3697-488E-8276-2F2F2CA43199
DocuSign Envelope ID: BCEDBC03-3697-488E-8276-2F2F2CA43199