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HomeMy WebLinkAbout2024-346-E-Emergency Svc-HRTM Consulting, LLC-Implementation and TrainingRevised 01/24 1 [Departmental Use Only] TITLE TeleStaff Implementation FY 24 NORTH CAROLINA SERVICES AGREEMENT NO RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter “Agreement”), made and entered into this 10th day of June, 2024, (“Effective Date”) by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County") and HTRM Consulting, LLC, (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): Implementation services and training for UKG Telestaff scheduling system for Orange County, NC Emergency Services. 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 DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 Revised 01/24 2 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) Should any documents, exhibits, or addenda be attached to this Agreement, the terms of this Agreement shall have priority in any conflict with or among the terms of such referenced documents, exhibits. 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 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. DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 Revised 01/24 3 3. Basic Services a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows (fully describe services to be provided): Provision of mplementation services and training for UKG Telestaff scheduling system in accordance with the attached Statement of Work and in accordance with the terms and conditions therin. 4. Duration of Services a. Term. The term of this Agreement shall be from June 10, 2024 to June 30, 2025. 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 on or about two weeks from the date of execution of this contract as per the attached statement of work. 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 Twenty-One Thousand Six Hundred and 00/100 Dollars ($21,600.00). 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 a. Cooperation and Coordination. The County has designated (The Division Chief of Public Safety Communications and the Division Chief of Emergency Medical Services ) DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 Revised 01/24 4 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 N/A (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 terminate this Agreement upon notice to the other party that obligations pursuant to this DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 Revised 01/24 5 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. DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 Revised 01/24 6 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 Orange County 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 or 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 or 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. 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 DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 Revised 01/24 7 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:Lysa May HRTM Consulting, LLC P.O. Box 8181 100 West St. Hillsborough, NC 27278 Belle Meade, NJ 08502 [SIGNATURE PAGE TO FOLLOW] DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 Revised 01/24 8 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, County Manager By: __________________________________ Printed Name and Title DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 Sasha Wieand/ VP Client Engagement Sasha Wieand Revised 01/24 9 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: HRTM Consulting, LLC Vendor Contact Person: Sasha Weiand Phone: 732-5801-0784 Address: 100 West St. City Belle Meade State: NJ Zip: 08502 Department: Emergency Services Amount: $21,600 Purpose: Implementation and Training Budget Code(s): 10750020-630000 Vendor # 68541 Vendor Status with NCSOS: Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date 05/31/2024 End Date 06/30/2025 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmat ively state work on this project has not been initiated prio r to execution of the agreement. This agreement is approved as to technical form and content. Services related to this agreement have alread y begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services 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 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: Received for record retention: Office of the Clerk to the Board __________________________________________Date:________ DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 6/10/2024 6/13/2024 6/17/2024 6/17/2024 6/20/2024 Statement of Work Statement of Work SOW for Agreement to Perform Consulting Services to Client Date Services Performed By: Services Performed For: 5/10/2024 HRTM Consulting, LLC 100 West Street Belle Meade, NJ 08502 Emergency Services Orange County, NC 510 Meadowlands Drive Hillsborough, N.C. 27278 This SOW # (hereinafter called the “SOW”), effective as of 05/10/2024 is entered into by and between Contractor and Client, and is subject to the terms and conditions specified below. The Exhibit(s) to this SOW, if any, shall be deemed to be a part hereof. In the event of any inconsistencies between the terms of the body of this SOW and the terms of the Exhibit(s) hereto, the terms of the body of this SOW shall prevail. Period of Performance The Services shall commence on or about two weeks from signature date through 6 months (estimate of timeline). 1.0 Scope of Work This Statement of Work (also known as the "SOW") documents the agreement between HRTM Consulting LLC and Client concerning the services to be performed by HRTM, including the deliverables, the costs of the project, the responsibility of each party and how the project will be managed. 1.1 Project Overview and Assumptions I In Scope for Base Implementation • Security Management • 3 staffing authorities/roles per business unit (end user, staffer, administrator) • 3 login policies per business unit (end user, staffer, administrator) • Organization Management • One Business Unit each for EMS, Communications and Fire Marshal Scheduling Group DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 • Overtime Hiring practices are the same for all staff in the business unit • Time Off Requests practices are the same for all staff in the business unit • If exists, all employees are covered under the same union contract/MO • Define skills, specialty and/or certification at position, unit or area • Event Type and Extra Units for Special Deploy (1 Event type) • Examples: Deploy extra unit to the roster for a football game, parade, strike team, etc.. • Configure one Event Type and provide training so customers can create other Event Types • Shift Management • Ability to support up all shift patterns for each business unit (i.e., A/B/C, Admin) • Support of Kelly Days • Roster Management • Include multiple roster views • Roster Headcounts • Minimums Staffing (Leave Thresholds/Roster Counts/Alarms) • Implement up to 4 customer-defined minimum staffing requirements (i.e., weekday, weekend, Engine, Ambulance) • Leverage minimums to trigger alarms on the roster • Multi-day Schedule • Include multiple views • Code Management • Signup Process • Ability for user to make themselves available or not available for work • Ability for users to sign up for special event opportunities • Validate Dynamic/Static issues • Examples: • Rank, skill, certification, not currently working etc. • Accrual Code Management • Initial accrual code(s) balance(s) - manual or import • No cascading accrual process • Example – Vacation, then comp, then sick • Customer responsible for ongoing accrual code updates • Import required to be in UKG format. • Time Off Request – Various non-working codes (Vacation, Comp, Sick, etc.) • Ensure compliance with union rules, common business practice, ect. • Validate Dynamic/Static issues • Examples: • Sufficient bank of hours in accrual group • X hours before shift start • Minimum Staffing violations • With or without approval by code • With or without approvals – Workflows • Shift trades • One Way & Two Way DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 • Ensure compliance with union rules, common business practice, etc. • Validate Dynamic/Static issues • Examples • Rank, skill, certification, etc. • With or without approval by code - Workflows • Overtime/Special Event Hiring (Fill by Rule) • Multiple hiring/staffing list selections (2 Hiring Strategy) • Example – Day of Hiring, Week out Hiring, Special Event Hiring • Linked Hiring/Staffing Lists with sorting criteria for each list (3 Hiring Lists) • Example – Floaters, Signups, Overtime, Mandatory (each sub list with sorting criteria. OT – least number OT hours worked, Seniority. Mandatory – lease number of Mandatory worked, reverse seniority • Fatigue Rule (1 Fatigue Rule per business unit) • Leverage fatigue rules in generating hiring list. Exclude people from hiring list that would put them in a fatigue scenario. • Prevent or warn w/ approval user from signing up or make available to work if would put them in a fatigue situation • Outbound working opportunities via email or SMS (text) (Assist client to obtain a Twilio account) • Dynamic/Static Issues • To support Work Code management and Roster management (roster moves) • Workflow notifications • To support Work Code management • Notification Management • Email and or SMS (text) notifications, messages and working opportunities • Email Manager & SMS Manger • Report Management • Standard reports • Export Management • Standard payroll export configuration variable length flat file • Roster Type report export for downstream RMS and CAD systems • MFA Configuration • One production cutover upon successful user acceptance testing • One-time data import of customer supplied person data in UKG format • 8 hours remote consulting training session Out of Scope • Scheduling Management o Self-Fill o Assignment Templates o Preferences • Notification Management o IVR DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 • Import Management o On-going Person import from HCM Add on Services not included in Base implementation (additional costs on page 5) • WFM/HCM Integrations o Integration with UKG WFC • Bidding Management – o Vacation Bidding o Position Shift Bidding • Extra Duty Event Management • Custom Reports Timeline Client must obtain licenses from UKG and instance access to begin project and keep timeline. Once Cloud environment is established: one - two weeks to gather materials and kick off 90-120 days for build out and testing. 2.0 Project Guidelines 2.1 Change Control If the Scope of Services defined in this document changes at any time during this project, HRTM and Client will review and adjust the scope and budget of services through standard HRTM change control procedures. HRTM will provide a dedicated TeleStaff Solution Consultant to ensure continuity and knowledge of environment. A backup consultant would also be defined for situations where it is required. 2.2 Customer Approval of Deliverables As part of the project, service deliverables may be provided to Client for approval and/or acceptance. Delays in customer approval/acceptance of deliverables will result in an extension of the project timeline and may result in additional services being required. To avoid project delays and increased costs, Client should expect to approve/accept deliverables or provide written notification of errors to HRTM within five (5) business days after receipt of the deliverable. Following the receipt of a revised deliverable, Client will then have an additional five (5) business days to report that all errors have been resolved and provide deliverable acceptance. DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 3.0 Project Management 3.1 Project Planning and Management The HRTM Consultant and Client will work in conjunction to issue tasks, schedules and other work assignments to the joint project teams. Additional hours will be added to the contract to cover specific efforts that may arise outside the scope of general administration. An example of this would be changes to union contacts that require configuration changes. HRTM Consultant will provide feedback, suggestions and best practices as pertains to scope of work and how it relates to Client’s TeleStaff Environment. 4.0 Project Costs and Rate Schedules Role Quantity Rate Total Workforce Telestaff Implementation- Base Implementation Extra Duty Module Configuration Configuration for Shift Bid Configuration for Vacation Bid Integration to WFC Included 135 Hours $160 per Hour $21,600 TOTALS $21,600 Invoicing Process Client will be invoiced as follows: 50% at Contract signing 25% at start of testing DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 25% at Go Live IN WITNESS WHEREOF, the parties hereto have caused this SOW to be effective as of the day, month and year first written above. Emergency Services Orange County, NC HRTM Consulting, LLC By: By: Name: Name: Title: Title: DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS AUTOSAUTOSNON-OWNEDHIRED AUTOS SCHEDULEDALL OWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD MTTU Hiscox Inc. 5 Concourse Parkway Suite 2150 Atlanta GA, 30328 (888) 202-3007 contact@hiscox.com Hiscox Insurance Company Inc 10200 Human Resource Time Management 2737 Humphrey Street East Elmhurst, NY 11369 Orange County Po Box 8181 Hillsborough, NC 27278 Each Claim: $ 1,000,000 Aggregate: $ 1,000,000 Professional LiabilityA 07/16/202507/16/2024P103.001.237.7YY 06/07/2024 DocuSign Envelope ID: 85C88458-49A6-4204-9060-DEE5B09A64A1