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HomeMy WebLinkAboutC19-259 Community Language CooperativeAGREEMENT FOR PROFESSIONAL SERVICES BETWEEN EAGLE COUNTY, COLORADO AND Community Language Cooperative THIS AGREEMENT (“Agreement”) is effective as of 07/22/2019, by and between Community Language Cooperative (hereinafter “Contractor”) and Eagle County, Colorado, a body corporate and politic (hereinafter “County”). RECITALS WHEREAS, Community Language Cooperative will provide awareness training to staff, translation services and interpretation services (the “Project”); and where the services are to occur, offsite and at the county building located at 500 Broadway, Eagle, Colorado (the “Property”); and WHEREAS, Contractor is authorized to do business in the State of Colorado and has the time, skill, expertise, and experience necessary to provide the Services as defined below in paragraph 1 hereof; and WHEREAS, this Agreement shall govern the relationship between Contractor and County in connection with the Services. AGREEMENT NOW, THEREFORE, in consideration of the foregoing and the following promises Contractor and County agree as follows: 1. Services. Contractor agrees to diligently provide all services, labor, personnel and materials necessary to perform and complete the services described in Exhibit A (“Services”) which is attached hereto and incorporated herein by reference. The Services shall be performed in accordance with the provisions and conditions of this Agreement. a. Contractor agrees to furnish the Services in accordance with the schedule established in Exhibit A. If no completion date is specified in Exhibit A, then Contractor agrees to furnish the Services in a timely and expeditious manner consistent with the applicable standard of care. By signing below Contractor represents that it has the expertise and personnel necessary to properly and timely perform the Services. b. In the event of any conflict or inconsistency between the terms and conditions set forth in Exhibit A and the terms and conditions set forth in this Agreement, the terms and conditions set forth in this Agreement shall prevail. 2. County’s Representative. Administration Department’s ’s designee shall be Contractor’s contact with respect to this Agreement and performance of the Services. DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 2 Eagle County Prof Services Final 5/14 3. Term of the Agreement. This Agreement shall commence upon the date first written above, and subject to the provisions of paragraph 11 hereof, shall continue in full force and effect through the 31st_day of December, 2019. 4. Extension or Modification. This Agreement may not be amended or supplemented, nor may any obligations hereunder be waived, except by agreement signed by both parties. No additional services or work performed by Contractor shall be the basis for additional compensation unless and until Contractor has obtained written authorization and acknowledgement by County for such additional services in accordance with County’s internal policies. Accordingly, no course of conduct or dealings between the parties, nor verbal change orders, express or implied acceptance of alterations or additions to the Services, and no claim that County has been unjustly enriched by any additional services, whether or not there is in fact any such unjust enrichment, shall be the basis of any increase in the compensation payable hereunder. In the event that written authorization and acknowledgment by County for such additional services is not timely executed and issued in strict accordance with this Agreement, Contractor’s rights with respect to such additional services shall be deemed waived and such failure shall result in non-payment for such additional services or work performed. 5. Compensation. County shall compensate Contractor for the performance of the Services in a sum computed and payable as set forth in Exhibit A. The performance of the Services under this Agreement shall not exceed $ 10,000. Contractor shall not be entitled to bill at overtime and/or double time rates for work done outside of normal business hours unless specifically authorized in writing by County. a. Payment will be made for Services satisfactorily performed within thirty (30) days of receipt of a proper and accurate invoice from Contractor. All invoices shall include detail regarding the hours spent, tasks performed, who performed each task and such other detail as County may request. b. Any out-of-pocket expenses to be incurred by Contractor and reimbursed by County shall be identified on Exhibit A. Out-of-pocket expenses will be reimbursed without any additional mark-up thereon and are included in the not to exceed contract amount set forth above. Out-of-pocket expenses shall not include any payment of salaries, bonuses or other compensation to personnel of Contractor. Contractor shall not be reimbursed for expenses that are not set forth on Exhibit A unless specifically approved in writing by County. c. If, at any time during the term or after termination or expiration of this Agreement, County reasonably determines that any payment made by County to Contractor was improper because the Services for which payment was made were not performed as set forth in this Agreement, then upon written notice of such determination and request for reimbursement from County, Contractor shall forthwith return such payment(s) to County. Upon termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall forthwith be returned to County. d. County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made pursuant to the terms of this Agreement. DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 3 Eagle County Prof Services Final 5/14 e. Notwithstanding anything to the contrary contained in this Agreement, County shall have no obligations under this Agreement after, nor shall any payments be made to Contractor in respect of any period after December 31 of any year, without an appropriation therefor by County in accordance with a budget adopted by the Board of County Commissioners in compliance with Article 25, title 30 of the Colorado Revised Statutes, the Local Government Budget Law (C.R.S. 29-1-101 et. seq.) and the TABOR Amendment (Colorado Constitution, Article X, Sec. 20). 6. Sub-Contractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the particular reputation and expertise of Contractor. Contractor shall not enter into any sub-Contractor agreements for the performance of any of the Services or additional services without County’s prior written consent, which may be withheld in County’s sole discretion. County shall have the right in its reasonable discretion to approve all personnel assigned to the subject Project during the performance of this Agreement and no personnel to whom County has an objection, in its reasonable discretion, shall be assigned to the Project. Contractor shall require each sub-Contractor, as approved by County and to the extent of the Services to be performed by the sub-Contractor, to be bound to Contractor by the terms of this Agreement, and to assume toward Contractor all the obligations and responsibilities which Contractor, by this Agreement, assumes toward County. County shall have the right (but not the obligation) to enforce the provisions of this Agreement against any sub-Contractor hired by Contractor and Contractor shall cooperate in such process. The Contractor shall be responsible for the acts and omissions of its agents, employees and sub-Contractors or sub-contractors. 7. Insurance. Contractor agrees to provide and maintain at Contractor’s sole cost and expense, the following insurance coverage with limits of liability not less than those stated below: a. Types of Insurance. i. Workers’ Compensation insurance as required by law. ii. Auto coverage with limits of liability not less than $1,000,000 each accident combined bodily injury and property damage liability insurance, including coverage for owned, hired, and non-owned vehicles. iii. Commercial General Liability coverage to include premises and operations, personal/advertising injury, products/completed operations, broad form property damage with limits of liability not less than $1,000,000 per occurrence and $1,000,0000 aggregate limits. b. Other Requirements. i. The automobile and commercial general liability coverage shall be endorsed to include Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and volunteers as additional insureds. A certificate of insurance consistent with the foregoing requirement is attached hereto as Exhibit B. DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 4 Eagle County Prof Services Final 5/14 ii. Contractor’s certificates of insurance shall include sub-Contractors as additional insureds under its policies or Contractor shall furnish to County separate certificates and endorsements for each sub-Contractor. iii. The insurance provisions of this Agreement shall survive expiration or termination hereof. iv. The parties hereto understand and agree that the County is relying on, and does not waive or intend to waive by any provision of this Agreement, the monetary limitations or rights, immunities and protections provided by the Colorado Governmental Immunity Act, as from time to time amended, or otherwise available to County, its affiliated entities, successors or assigns, its elected officials, employees, agents and volunteers. v. Contractor is not entitled to workers’ compensation benefits except as provided by the Contractor, nor to unemployment insurance benefits unless unemployment compensation coverage is provided by Contractor or some other entity. The Contractor is obligated to pay all federal and state income tax on any moneys paid pursuant to this Agreement. 8. Indemnification. The Contractor shall indemnify and hold harmless County, and any of its officers, agents and employees against any losses, claims, damages or liabilities for which County may become subject to insofar as any such losses, claims, damages or liabilities arise out of, directly or indirectly, this Agreement, or are based upon any performance or nonperformance by Contractor or any of its sub-Contractors hereunder; and Contractor shall reimburse County for reasonable attorney fees and costs, legal and other expenses incurred by County in connection with investigating or defending any such loss, claim, damage, liability or action. This indemnification shall not apply to claims by third parties against the County to the extent that County is liable to such third party for such claims without regard to the involvement of the Contractor. This paragraph shall survive expiration or termination hereof. 9. Ownership of Documents. All documents (including electronic files) and materials obtained during, purchased or prepared in the performance of the Services shall remain the property of the County and are to be delivered to the County before any final payment is made to the Contractor or upon earlier termination of this Agreement. 10. Notice. Any notice required by this Agreement shall be deemed properly delivered when (i) personally delivered, or (ii) when mailed in the United States mail, first class postage prepaid, or (iii) when delivered by FedEx or other comparable courier service, charges prepaid, to the parties at their respective addresses listed below, or (iv) when sent via facsimile so long as the sending party can provide facsimile machine or other confirmation showing the date, time and receiving facsimile number for the transmission, or (v) when transmitted via e-mail with confirmation of receipt. Either party may change its address for purposes of this paragraph by giving five (5) days prior written notice of such change to the other party. DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 5 Eagle County Prof Services Final 5/14 COUNTY: Eagle County, Colorado Attention: Angelo Fernandez 500 Broadway Post Office Box 850 Eagle, CO 81631 Telephone: 970-328-8796 Facsimile: 970-328-8799 E-Mail: angelo.fernandez@eaglecounty.us With a copy to: Eagle County Attorney 500 Broadway Post Office Box 850 Eagle, Co 81631 Telephone: 970-328-8685 Facsimile: 970-328-8699 E-Mail: atty@eaglecounty.us CONTRACTOR: Community Language Cooperative 4193 S. Decatur Street Sheridan, CO 80110 indira@communitylanguagecoop.com 11. Termination. County may terminate this Agreement, in whole or in part, at any time and for any reason, with or without cause, and without penalty therefore with seven (7) calendar days’ prior written notice to the Contractor. Upon termination of this Agreement, Contractor shall immediately provide County with all documents as defined in paragraph 9 hereof, in such format as County shall direct and shall return all County owned materials and documents. County shall pay Contractor for Services satisfactorily performed to the date of termination. 12. Venue, Jurisdiction and Applicable Law. Any and all claims, disputes or controversies related to this Agreement, or breach thereof, shall be litigated in the District Court for Eagle County, Colorado, which shall be the sole and exclusive forum for such litigation. This Agreement shall be construed and interpreted under and shall be governed by the laws of the State of Colorado. 13. Execution by Counterparts; Electronic Signatures. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same instrument. The parties approve the use of electronic signatures for execution of this Agreement. Only the following two forms of electronic signatures shall be permitted to bind the parties to this Agreement: (i) Electronic or facsimile delivery of a fully executed copy of the signature page; (ii) the DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 6 Eagle County Prof Services Final 5/14 image of the signature of an authorized signer inserted onto PDF format documents. All documents must be properly notarized, if applicable. All use of electronic signatures shall be governed by the Uniform Electronic Transactions Act, C.R.S. 24-71.3-101 to 121. 14. Other Contract Requirements. a. Contractor has familiarized itself with the nature and extent of the Services to be provided hereunder and the Property or Properties, and with all local conditions, federal, state and local laws, ordinances, rules and regulations that in any manner affect cost, progress, or performance of the Services. b. Contractor will make, or cause to be made, examinations, investigations, and tests as he deems necessary for the performance of the Services. c. To the extent possible, Contractor has correlated the results of such observations, examinations, investigations, tests, reports, and data with the terms and conditions of this Agreement. d. To the extent possible, Contractor has given County written notice of all conflicts, errors, or discrepancies. e. Contractor shall be responsible for the completeness and accuracy of the Services, including all supporting data or other documents prepared or compiled in performance of the Services, and shall correct, at its sole expense, all significant errors and omissions therein. The fact that the County has accepted or approved the Services shall not relieve Contractor of any of its responsibilities. Contractor shall perform the Services in a skillful, professional and competent manner and in accordance with the standard of care, skill and diligence applicable to Contractors performing similar services. Contractor represents and warrants that it has the expertise and personnel necessary to properly perform the Services and covenants that its professional personnel are duly licensed to perform the Services within Colorado. This paragraph shall survive termination of this Agreement. f. Contractor agrees to work in an expeditious manner, within the sound exercise of its judgment and professional standards, in the performance of this Agreement. Time is of the essence with respect to this Agreement. g. This Agreement constitutes an agreement for performance of the Services by Contractor as an independent contractor and not as an employee of County. Nothing contained in this Agreement shall be deemed to create a relationship of employer-employee, master- servant, partnership, joint venture or any other relationship between County and Contractor except that of independent contractor. Contractor shall have no authority to bind County. DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 7 Eagle County Prof Services Final 5/14 h. Contractor represents and warrants that at all times in the performance of the Services, Contractor shall comply with any and all applicable laws, codes, rules and regulations. i. This Agreement contains the entire agreement between the parties with respect to the subject matter hereof and supersedes all other agreements or understanding between the parties with respect thereto. j. Contractor shall not assign any portion of this Agreement without the prior written consent of the County. Any attempt to assign this Agreement without such consent shall be void. k. This Agreement shall be binding upon and shall inure to the benefit of the parties hereto and their respective permitted assigns and successors in interest. Enforcement of this Agreement and all rights and obligations hereunder are reserved solely for the parties, and not to any third party. l. No failure or delay by either party in the exercise of any right hereunder shall constitute a waiver thereof. No waiver of any breach shall be deemed a waiver of any preceding or succeeding breach. m. The invalidity, illegality or unenforceability of any provision of this Agreement shall not affect the validity or enforceability of any other provision hereof. n. The signatories to this Agreement aver to their knowledge, no employee of the County has any personal or beneficial interest whatsoever in the Services or Property described in this Agreement. The Contractor has no beneficial interest, direct or indirect, that would conflict in any manner or degree with the performance of the Services and Contractor shall not employ any person having such known interests. o. The Contractor, if a natural person eighteen (18) years of age or older, hereby swears and affirms under penalty of perjury that he or she (i) is a citizen or otherwise lawfully present in the United States pursuant to federal law, (ii) to the extent applicable shall comply with C.R.S. 24-76.5-103 prior to the effective date of this Agreement. 15. Prohibitions on Government Contracts. As used in this Section 16, the term undocumented individual will refer to those individuals from foreign countries not legally within the United States as set forth in C.R.S. 8-17.5-101, et. seq. If Contractor has any employees or subcontractors, Contractor shall comply with C.R.S. 8-17.5-101, et. seq., and this Agreement. By execution of this Agreement, Contractor certifies that it does not knowingly employ or contract with an undocumented individual who will perform under this Agreement and that Contractor will participate in the E-verify Program or other Department of Labor and Employment program (“Department Program”) in order to confirm the eligibility of all employees who are newly hired for employment to perform Services under this Agreement. DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 8 Eagle County Prof Services Final 5/14 a. Contractor shall not: i. Knowingly employ or contract with an undocumented individual to perform Services under this Agreement; or ii. Enter into a subcontract that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an undocumented individual to perform work under the public contract for services. b. Contractor has confirmed the employment eligibility of all employees who are newly hired for employment to perform Services under this Agreement through participation in the E-Verify Program or Department Program, as administered by the United States Department of Homeland Security. Information on applying for the E-verify program can be found at: https://www.uscis.gov/e-verify c. Contractor shall not use either the E-verify program or other Department Program procedures to undertake pre-employment screening of job applicants while the public contract for services is being performed. d. If Contractor obtains actual knowledge that a subcontractor performing work under the public contract for services knowingly employs or contracts with an undocumented individual, Contractor shall be required to: i. Notify the subcontractor and County within three (3) days that Contractor has actual knowledge that the subcontractor is employing or contracting with an undocumented individual; and ii. Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to subparagraph (i) of the paragraph (d) the subcontractor does not stop employing or contracting with the undocumented individual; except that Contractor shall not terminate the contract with the subcontractor if during such three (3) days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an undocumented individual. e. Contractor shall comply with any reasonable request by the Department of Labor and Employment made in the course of an investigation that the department is undertaking pursuant to its authority established in C.R.S. 8-17.5-102(5). f. If Contractor violates these prohibitions, County may terminate the Agreement for breach of contract. If the Agreement is so terminated specifically for breach of this provision of this Agreement, Contractor shall be liable for actual and consequential damages to County as required by law. g. County will notify the Colorado Secretary of State if Contractor violates this provision of this Agreement and County terminates the Agreement for such breach. [REST OF PAGE INTENTIONALLY LEFT BLANK] DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 9 Eagle County Prof Services Final 5/14 IN WITNESS WHEREOF, the parties have executed this Agreement the day and year first set forth above. COUNTY OF EAGLE, STATE OF COLORADO, By and Through Its COUNTY MANAGER By: ______________________________ Jeff Shroll, County Manager CONTRACTOR: By:________________________________ Print Name: _________________________ Title: ______________________________ DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 Director Indira Guzman 10 Eagle County Prof Services Final 5/14 EXHIBIT A SCOPE OF SERVICES, SCHEDULE, FEES About the Community Language Cooperative The Community Language Cooperative (CLC) provides interpretation services, public involvement plans, focus groups, and inclusivity and diversity trainings to make community, academic and governmental events and meetings more inclusive and accessible to all stakeholders, but especially those that are not always present when decisions affecting their communities are made because of language barriers. The Cooperative provides services that broaden opportunities for participation and increased community engagement by non-English speakers. CLC’s services make it possible for organizations and government agencies to remove all language and cultural barriers as a standard component of important meetings, focus groups, and events that impact communities. Interpretation Services ● Hourly rate per interpreter for Spanish is $75 per hour and $95 per hour for any other language. A two-hour minimum is always charged. ● For any event longer than 2 hours, we will send a team of 2 interpreters to take turns and provide a clear and accurate interpretation. ● Equipment (headsets for simultaneous interpretation) is included with the fee. Each interpreter is equipped with 30 headsets. ● Last minutes requests - $25 scheduling fee will be added for anything less than 48 hr. notice ● Cancellation policy - If any assignment is cancelled with less than 48 hours’ notice, CLC will invoice for the entire scheduled block of time. If a request is cancelled on an untimely basis, the interpreter loses the opportunity to make up that revenue elsewhere. Translation Services ● Translation for Spanish will be $.15-.17 cents per word depending on technicality of the language used. The word count is done in the departure language. ● Translation for any other language is $.18 - .21 cents per word. ● For documents on Adobe, the CLC will charge an additional 10% translation fee. ● 10% surcharge for last minute request (less than 48 hours). Payment and Late Payments ● The CLC will send an invoice after services are rendered ● Late payments: If we have not received your payment in our office within thirty days of the invoice due date, we will send you an email reminder. If we have not received your payment within forty-five days, we will require a fifty percent down payment on future work. Also, we will add a 2% late payment fee to your next monthly invoice. The minimum late payment fee is $20.00. Travel DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 11 Eagle County Prof Services Final 5/14 For meetings outside of the Denver metro area, the CLC will charge $.53 cents per mile and $35 per hour for travel time, per interpreter. All food and lodging will be covered by the client requesting services. Food and lodging will be submitted with receipts for reimbursement. Languages Available Spanish Vietnamese, French, Burmese, Arabic, Somali, Amharic, Arabic, Nepali, Contact Information Indira S Guzman indira@communitylanguagecoop.com 303.564.5649 DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 12 Eagle County Prof Services Final 5/14 Language Justice and Community Interpreting Training Proposal Eagle County Purpose Eagle County Colorado has an opportunity to expand their network and community reach efforts through the practice of language justice and effective community interpretation. Language Justice allows for groups to take steps in creating true inclusive spaces. The Community Language Cooperative has a history of serving as liaisons between nonprofits and community and serving the role of cultural brokers and navigators in communities. They work with a network of nonprofits and government agencies and understand the challenges that come with working with community. The Community Language Cooperative will provide guidance on the best practices for conducting inclusive meetings in a multilingual setting and the best practices for community interpreting in addition to training community interpreters on fluid and effective interpretation, as well as the power dynamics within interpreting. Indira Guzman- Professional Profile Indira Guzman, a co-founder and lead interpreter at the Community Language Cooperative, has over 25 years of experience in providing real time interpretation services. After her Chicano Studies at Metro State University, Indira has acted as a liaison for the Spanish speaking community throughout Denver. She currently works as a community organizer with the Colorado Trust in Sheridan Colorado. As a worker-owner of the CLC, Indira provides coaching and training development with new interpreters and service providers on the best practices for breaking down language barriers. Indira currently sits as a board member for the Roots Family Resource Center and Sanctuary Christian Fellowship. She is also a member of the Economic Opportunity Committee with the Denver Foundation and a Governance Committee with the Arc of Colorado. Deliverables Facilitator and Interested Stakeholder Training (6 hours) Topics covered during this training will be: ● What is Language Justice ● History of Language Oppression ● Language Tree ● Preparing for a multilingual meeting ● Traps and language to avoid (jargon, acronyms, euphemisms) ● Assumptions and challenges that arise with language justice ● Using interpretation equipment ● Training is available for up to 25 stakeholders/partners Community Interpreter Training 101 (8 hours) Topics covered during this training will be: ● Role of the community interpreter and how to effectively navigate a multilingual space ● Identifying the role- learning when to advocate and when to interpret ● Ethics of the community interpreter ● Different types of interpretation (simultaneous and consecutive) ● Communication between the interpreter, facilitator, and community ● Troubleshooting any headset technical issues DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 13 Eagle County Prof Services Final 5/14 ● Mock Meeting and simultaneous interpretation practice Budget Preparation time for facilitators CLC facilitators will prepare interactive learning activities for LJ Presentation 2.5 hours $125/hour per facilitator $625.00 Language Justice Training 6 hours and 2 facilitators $125/hour per facilitator $1500.00 Community Interpreting 101 8 hours and 2 facilitators $125/hour per facilitator $2000.00 Materials and Printing Work packet and handouts $100.00 Travel ● ($35 per hour) ● miles round trip x $.585 per mile ● Lodging accomodation at cost $ Total Cost $ Interpretation Equipment is available for purchase for $1200.00 per case. Each case includes a charging case, 30 receivers/earphones, 2 transmitters/ microphones and a 90-day warranty. Contact Information Indira S Guzman-Sais indira@communitylanguagecoop.com 303-564-5649 DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 14 Eagle County Prof Services Final 5/14 EXHIBIT B Insurance Certificate DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 07/29/2019 Security First Insurance Agency 7851 S Elati St Suite 100 Littleton CO 80120 David Renner (303) 730-2327 (303) 730-2930 drenner@securityfirstia.com Community Language Cooperative 4200 Morrison Rd Unit 3 Denver CO 80219 Sentinel Insurance Company, Ltd 11000 CL194917798 A Y 34SBMPR5276 05/26/2019 05/26/2020 1,000,000 1,000,000 10,000 1,000,000 2,000,000 2,000,000 Add'l for policy minimum premium A 10,000 34SBMPR5276 05/26/2019 05/26/2020 1,000,000 1,000,000 Eagle County Government PO Box 850 500 Broadway St Eagle CO 81631 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 ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED 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 HIRED AUTOS ONLY DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83 DocuSign Envelope ID: 41FBB90C-D547-4568-BB71-5A9E94A20F83