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HomeMy WebLinkAbout05048 - DOKKEN ENGINEERING VISTA CHINO WHITEWATER RIVER PRELIMINARY BRIDGE DESIGN HBRR GRANT PREPARATION Kathie Hart From: Tabitha Richards Sent: Tuesday,July 30, 2013 7:00 AM To: Kathie Hart; Carrie Rovney; Dave Barakian;Savat Khamphou Cc: JV"hempseR Subject: E:A5048-D kken Eng(Prelim bridge design &prepare HBRR Pkg $12,540.00) This can be closed Tabitha Richards 760-323-8253 ext 8750 From: Kathie Hart Sent: Monday, July 29, 2013 2:36 PM To: Tabitha Richards; Carrie Rovney; Dave Barakian; Savat Khamphou Cc: Jay Thompson Subject: A5048 - Dokken Eng (Prelim bridge design &prepare HBRR Pkg $12,540.00) This agreement expired in 2006. Has the work been completed? OK to Close this file? Kathie Hart, CAW Chief Deputy City Clerk City of Palm Springs 9(760)323-8206 3200 f. Tahquitz Canyon Way A (760)322-8332 Palm Springs; CA 92262 O9athie.Hart@Pahn,5priWCA.90 Please note that tarty Hall is open H a.m. to 6 p.m. Monday through Thursday,and closed on Fridays at this time. Q� r 1 Dokken Engineering Vista Chino @ Whitewater River Prelim Bridge Design AGREEMENT#5048 Cm signed, 3-4-05 CITY OF PALM SPRINGS CONTRACT SERVICES AGREEMENT FOR --------------------------------- VISTA CHINO AT WHITEWATER RIVER PRELIMINARY BRIDGE DESIGN AND ESTIMATE HBRR GRANT PREPARATION AND SUBMITTAL PACKAGE THIS CONTRACT SERVICES AGREEMENT (herein "Agreement") is made and entered into this day of "WA aLO6 by and between the CITY OF PALM SPRINGS,a munlclPa*01�1corporation(herein"City")and Dokken Engineering (herein"Contractor"). NOW, THEREFORE, the parties hereto agree as follows: 1.0 SERVICES OF CONTRACTOR 1.1 Scope of Services. In compliance with all of the terms and conditions of this Agreement, the Contractor shall perform the work or services set forth in the "Scope of Services" attached hereto as Exhibit"A" and incorporated herein by reference. Contractor warrants that all work and services set forth in the Scope of Services will be performed in a competent, professional and satisfactory manner. 1.2 Compliance With Law. All work and services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, and regulations of the City and any Federal, State or local governmental agency of competent jurisdiction. 1.3 Licenses, Permits, Fees and Assessments. Contractor shall obtain at its sole cost and expense such licenses, permits and approvals as may be required by law for the performance of the services required by this Agreement. 2.0 COMPENSATION 2.1 Contract Sum. For the services rendered pursuant to this Agreement, Contractor shall be compensated in accordance with the "Schedule of Compensation" attached hereto as Exhibit "B" and incorporated herein by this reference, but not exceeding the maximum contract amount of Twelve Thousand Five Hundred Forty and 001100 dollars ($12,540.00) ("Contract Sum"). 2.2 Method of Payment. Provided that Contractor is not in default under the terms of this Agreement, Contractor shall be paid as outlined in Exhibit "B" Schedule of Compensation. 3.0 COORDINATION OF WORK 3.1 Representative of Contractor. Don Bloodworth is hereby designated as being the principal and representative of Contractor authorized to act in its behalf with respect to the work and services specified herein and make all decisions in connection therewith. 3.2 Contract Officer. Marcus Fuller is hereby designated as being the representative the City authorized to act in its behalf with respect to the work and services specified herein and make all decisions in connection therewith ("Contract Officer"). The City Manager of City shall have the right to designate another Contract Officer by providing written notice to Contractor. 3.3 Prohibition Against Subcontractinq or Assiqnment. Contractor shall not contract with any entity to perform in whole or in part the work or services required hereunder ORIGINAL BID MWOR AGREEMENT y�. .`��`� . , . �h,,, :�Yr`-. without the express written approval of the City. Neither this Agreement nor any interest herein may be assigned or transferred, voluntarily or by operation of law,withoutthe priorwritten approval of City. Any such prohibited assignment or transfer shall be void. 3.4 Independent Contractor. Neither the City nor any of its employees shall have any control over the manner, mode or means by which Contractor, its agents or employees, perform the services required herein, except as otherwise set forth. Contractor shall perform all services required herein as an independent contractor of City and shall remain under only such obligations as are consistent with that role. Contractor shall not at any time or in any manner represent that it, or any of its agents or employees, are agents or employees of City. 4.0 INSURANCE, INDEMNIFICATION AND BONDS 4.1 Insurance. The Contractor shall procure and maintain,at its sole cost and expense, in a form and content satisfactory to City, during the entire term of this Agreement including any extension thereof, the following policies of insurance: (a) Commercial General Liability Insurance. A policy of commercial general liability insurance written on a per occurrence basis with a combined single limit of at least $1,000,000 bodily injury and property damage including coverages for contractual liability, personal injury, independent contractors, broad form property damage, products and completed operations.The Commercial General Liability Policy shall name the City of Palm Springs as an additional insured in accordance with standard ISO additional insured endorsement form CG2010(1185) or equivalent language. (b) Worker's Compensation Insurance. A policy of worker's compensation insurance in an amount which fully complies with the statutory requirements of the State of California and which includes $1,000,000 employer's liability. (c) Business Automobile Insurance. A policy of business automobile liability insurance written on a per occurrence basis with a single limit liability in the amount of $1,000,000 bodily injury and property damage. Said policy shall include coverage for owned, non-owned, leased and hired cars. (d) Additional Insurance. Additional limits and coverages, which may include professional liability insurance, will be specified in Exhibit B. All of the above policies of insurance shall be primary insurance. (Reference Section 4.4 regarding sufficiency.) The insurershall waive all rights of subrogation and contribution it may have against the City, its officers, employees and agents, and their respective insurers. In the event any of said policies of insurance are canceled, the Contractor shall, prior to the cancellation date, submit new evidence of insurance in conformance with this Section 4.1 to the Contract Officer. No work or services under this Agreement shall commence until the Contractor has provided the City with Certificates of Insurance, endorsements or appropriate insurance binders evidencing the above insurance coverages and said Certificates of Insurance, endorsements, or binders are approved by the City. The contractor agrees that the provisions of this Section 4.1 shall not be construed as limiting in any way the extent to which the Contractor may be held responsible for the payment of damages to any persons or property resulting from the Contractor's activities or the activities of any person or persons for which the Contractor is otherwise responsible. In the event the Contractor subcontracts any portion of the work in compliance with Section 3.3 of this Agreement the contract between the Contractor and such subcontractor shall require the subcontractor to maintain the same polices of insurance that the Contractor is required to maintain pursuant to this Section. -2- 4.2 Indemnification. Contractor agrees to indemnify the City, its officers, agents and employees against, and will hold and save them and each of them harmless from, any and all actions, suits, claims,damages to persons or property, losses, costs, penalties, obligations, errors, omissions or liabilities, (herein"claims or liabilities")that may be asserted or claimed by any person, firm or entity arising out of or in connection with the negligent performance of the work, operations or activities of Contractor, its agents, employees, subcontractors, or invitees, provided for herein, or arising from the negligent acts oromissions of Contractor hereunder,or arising from Contractor's negligent performance of or failure to perform any term, provision, covenant or condition of this Agreement, whether or not there is concurrent passive or active negligence on the part of the City, its officers, agents or employees but excluding such claims or liabilities arising from the sole negligence or willful misconduct of the City, its officers, agents or employees, who are directly responsible to the City, and in connection therewith: (a) Contractor will defend any action or actions filed in connection with any of said claims or liabilities and will pay all costs and expenses, including legal costs and attorneys' fees incurred in connection therewith; (b) Contractorwill promptly pay anyjudgment rendered against the City, its officers, agents or employees for any such claims or liabilities arising out of or in connection with the negligent performance of or failure to perform such work, operations or activities of Contractor hereunder; and Contractor agrees to save and hold the City, its officers, agents, and employees harmless therefrom; (c) In the event the City, its officers,agents or employees is made a party to any action or proceeding filed or prosecuted against Contractor for such damages or other claims arising out of or in connection with the negligent performance of or failure to perform the work, operation or activities of Contractor hereunder, Contractor agrees to pay to the City, its officers, agents or employees, any and all costs and expenses incurred by the City, its officers, agents or employees in such action or proceeding, including but not limited to, legal costs and attorneys' fees. 4.3 Performance Bond. Concurrently with execution of this Agreement, Contractor shall deliver to City a performance bond in the sum of the amount of this Agreement, in the form provided by the City, which secures the faithful performance of this Agreement, unless such requirement is waived by the Contract Officer. The bond shall contain the original notarized signature of an authorized officer of the surety and affixed thereto shall be a certified and current copy of his power of attorney. The bond shall be unconditional and remain in force during the entire term of the Agreement and shall be null and void only if the Contractor promptly and faithfully performs all terms and conditions of this Agreement. 4.4 Sufficiency of Insurer or Suretv. Insurance or bonds required by this Agreement shall be satisfactory only if issued by companies qualified to do business in California, rated "A"or better in the most recent edition of Best's Key Rating Guide or in the Federal Register, unless such requirements are waived by the City Manager or designee of the City Manager due to unique circumstances. In the event the City Manager determines that the work or services to be performed under this Agreement creates an increased or decreased risk of loss to the City, the Contractor agrees that the minimum limits of the insurance policies and the performance bond required by this Section 4 may be changed accordingly upon receipt of written notice from the City Manager or designee; provided that the Contractor shall have the right to appeal a determination of increased coverage by the City Manager to the City Council of City within ten(10)days of receipt of notice from the City Manager. 5.0 TERM 5.1 Term. Unless earlier terminated in accordance with Section 5.2 below, this Agreement shall continue in full force until December 31, 2005. -3- 5.2 Termination Prior to Expiration of Term. Either party may terminate this Agreement at anytime,with orwithout cause, upon thirty(30)days written notice to the other party. Upon receipt of the notice of termination, the Contractor shall immediately cease all work or services hereunder except as may be specifically approved by the Contract Officer. In the event of termination by the City, Contractor shall be entitled to compensation for all services rendered prior to the effectiveness of the notice of termination and for such additional services specifically authorized by the Contract Officer and City shall be entitled to reimbursement for any compensation paid in excess of the services rendered. 6,0 MISCELLANEOUS 6.1 Covenant Aqainst Discrimination. Contractor covenants that, by and for itself, its heirs, executors, assigns and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, or ancestry in the performance of this Agreement. Contractor shall take affirmative action to ensure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin or ancestry. 6.2 Non-liability of City Officers and Employees. No officer or employee of the City shall be personally liable to the Contractor, or any successor in interest, in the event of any default or breach by the City or for any amount which may become due to the Contractor or to its successor, or for breach of any obligation of the terms of this Agreement. 6.3 Conflict of Interest. No officer or employee of the City shall have any financial interest, direct or indirect, in this Agreement nor shall any such officer or employee participate in any decision relating to the Agreement which effects his financial interest or the financial interest of any corporation, partnership or association in which he is, directly or indirectly interested, in violation of any State statute or regulation. The Contractor warrants that it has not paid or given and will not pay or give any third party any money or other consideration for obtaining this Agreement. 6.4 Notice. Any notice, demand, request, document, consent, approval, or communication either party desires or is required to give to the other party or any other person shall be in writing and either served personally or sent by prepaid,first-class mail, in the case of the City, to the City Manager and to the attention of the Contract Officer, CITY OF PALM SPRINGS, P.O. Box 2743, Palm Springs, California 92263, and in the case of the Contractor, to the person at the address designated on the execution page of this Agreement. 6.5 Interpretation. The terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of this Agreement or any other rule of construction which might otherwise apply. 6.6 Integration;Amendment. It is understood that there are no oral agreements between the parties hereto affecting this Agreement and this Agreement supersedes and cancels any and all previous negotiations, arrangements, agreements and understandings, if any, between the parties, and none shall be used to interpret this Agreement. This Agreement may be amended at any time by the mutual consent of the parties by an instrument in writing. 6.7 SeverabilftV. In the event that part of this Agreement shall be declared invalid or unenforceable by a valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining portions of this Agreement which are hereby declared as severable and shall be interpreted to carry out the intent of the parties hereunder unless the invalid provision is so material that its invalidity deprives either party of the basic benefit of their bargain or renders this Agreement meaningless. -4- 6.8 Waiver. No delay or omission in the exercise of any right or remedy by a nondefaulting party on any default shall impair such right or remedy or be construed as a waiver. A party's consent to or approval of any act by the other party requiring the party's consent or approval shall not be deemed to waive or render unnecessary the other party's consent to or approval of any subsequent act. Any waiver by either party of any default must be in writing and shall not be a waiver of any other default concerning the same or any other provision of this Agreement. 6.9 Attorneys' Fees. If either party to this Agreement is required to initiate or defend or made a party to any action or proceeding in anyway connected with this Agreement, the prevailing party in such action or proceeding, in addition to any other relief which may be granted, whether legal orequitable, shall be entitled to reasonable attorney's fees,whetheror notthe matter proceeds to judgment. 6.10 Corporate Authority. The persons executing this Agreement on behalf of the parties hereto warrant that(i)such party is duly organized and existing, (ii)they are duly authorized to execute and deliver this Agreement on behalf of said party, (iii)by so executing this Agreement, such party is formally bound to the provisions of this Agreement, and (iv) the entering into this Agreement does not violate any provision of any other Agreement to which said party is bound. SIGNATURES ON NEXT PAGE -5- IN WITNESS WHEREOF, the parties have executed and entered into this Agreement as of the date first written above CITY OF PALM SPRINGS ATTEST: a municipal corporation City Clerk City Mara er, � / Approved by the City Manager on: ' -' -IDh � \a4�4V y� DOKKEN ENGINEERING CONTRgpA,CCTO,R: Check one:_�Individual_Partnership""Corporraattiy.,n By: Signature(notari2eq!y Si� '5e(notarized) Name: Name: Title: Title: (This Agreement must be signed in the above space by one of This Agreement must be signed in the above space by one of the following: Chairman of the Board,President or any Vice the following. Secretary,Chief Financial Officer or any President) Assistant Treasurer) Stateof (^.9eiFoR^i a,ry I State I County of e..,{R4mt�%U Iss County of5A64Y 41�d++Ta Iss On 2- •p" before me, fpv �• ✓Tt Q�3L OnZ'/•/-&c — befoieme, personally appeared ,Rg�;A,icI1Ut T. �iAf'-'C.K personally appeared C4-jyg- «/'J1 personally known to me(or proved to me on the basis of satisfactory personally known to me(or proved to me on the basis of satisfactory evidence) to be the person(s)whose mallets) is/arc subscribed to the evidence)to be the persons)whose name(s)is/are subscribed to the within mstrumentand acknowledged tome that he/she/they exeoutedthe within mstrunientand ackaowledgedto me that he/she/they executed the same in his/her/their authorized capacity(ies),and that by his/her/their sane in his/her/their authorized capaeity(ies),and that by his/her/their signalure(s)on the instrument the person(s),or the entity upon behalf of signature(s)on the insrment the person(s),or the entity upon behalf of which the person(s)acted,executed the instrument. which the person(s)acted,executed the instrument. WITNESS my hand and official seal._ WITNESS my hand and official seal. Notary Signahne /;���, ,fi'I ! Notary Signatur Notary SC&I / Notary Sea f?unvl �P 9.3b0e 9'a Ca 'a '1114hi Sf'iC0679 his :g ' y Ptl iu¢o.. h 7119i'dDPd'19a 'd ,:y .3 i; lip r l; -r iJ 2006 „r $25,0H �c*rua:�,�'s:d 2tnr^ �L_�t4-ovsd �y �'.-nctta-�caa�alt 'c �.�®alta-rcha�a� -6- �C � J e &-s EXHIBIT "A" SCOPE OF WORK The following scope of work shall provide the City with professional civil engineering services necessary to provide preliminary estimates and conceptual plans for a future bridge across the Whitewater River at Vista Chino, in accordancewith the Bridge Design Study prepared by Berryman &Henigar in 1997; and to prepare all necessaryforms for application to Caltrans for Highway Bridge Rehabilitation and Replacement (HBRR) Program funding for construction of a new bridge at the low water crossing on Vista Chino at the Whitewater River. Submittal of the HBRR package to Caltrans and all associated coordination to be performed by City. TASK 1.0 - RECORD RESEARCH/PRELIMINARY ENGINEERING Contractorshall conductthorough record research to determine existing conditions.Contractorshall research roadway and utility as-builts, Riverside County Flood Control information, and right of way APN documents to determine property lines. Contractor shall use information collected to create a Bridge Plan that includes plan view, profile view, and typical section.A cost estimate shall be shown on the Bridge Plan. The cost estimate shall include: cost to construct new bridge, costs for temporary detour roadway including any necessary easements, costs for environmental clearance, costs to perform hydrological studies, costs for preliminary design, costs for final plans, specifications, and estimates, cost for right of way engineering, and cost for construction administration/inspection. The cost estimate will include a 25% contingency. TASK 2.0 - PREPARE GRANT APPLICATION Contractor shall prepare necessaryforms and paperwork to complete the PIES Form and the HBRR Grant Application. Contractor shall submit documents to City for review and approval, an shall response to review comments, and resubmit to City for final approval. City shall be responsible for submitting HBRR Grant Application to Caltrans for review and approval, and all associated coordination related to receiving Caltrans approval of the grant and authorization to proceed. -7- EXHIBIT "A-V SPECIAL REQUIREMENTS lormance Bond" is waived. -a- EXHIBIT "B" SCHEDULE OF COMPENSATION Tasks listed below are identical to tasks identified in Exhibit A of this Agreement. Payments to Contractor shall be made no more frequently than monthly, and shall be based on lump sum units of work as indicated herein. Lump sum payments shall be made to Contractor based upon completion of tasks, or pro-rata portions thereof noted below,to a maximum of 75%of the lump sum task item fee until completion of such task item. Each request for payment shall contain Contractor's statement of the work or tasks completed or portion performed, with supporting documentation. The determination of payment due shall be made based upon the reasonable judgement of the Contract Officer. Task Total Lump Sum Task 1, Record Research/Preliminary Engineering $8,800.00 Task 2, Prepare Grant Application $3,740.00 Total not to exceed contract amount $12,540.00 -9- M E M O R A N D U M TO: Mari Lynn Boswell Procurement Department FROM: Kathie Hart Chief Deputy City Clerk DATE: March 9, 2005 SUBJECT: Dokken Engineering A5048 cc: Jay Thompson, City Clerk File Attached are three (3) duplicate originals of the above referenced agreement. We have retained the original our files. Please feel free to contact me if there are any questions, ext. 8206. /kdh attach. CONTRACT ABSTRACT Contract Company Name: Dokken Engineering Company Contact: Don Bloodworth Summary of Services: Preliminary Bridge Design&Prepare fIBRR Package Contract Price: $12,540 Funding Source: 134-4498-50120 Contract Term: December 31, 2005 Contract Administration Lead Department: Public Works & Engineering Contract Administrator: David Barakian/Marcus Fuller Contract Approvals Council/Community Redevelopment Agency Approval Date: Under $25,000 Minute Order/Resolution Number: N/A Agreement Number: To be assigned �hlA% Contract Compliance Exhibits: Attached Signatures: Complete Insurance: Attached Bonds: N/A Contract prepared by: Public works & Engineering Submitted on: 3/1/05 By: Mari Lynn Boswell Client#: 654 DOKKEENGI A j0RD„, CERTIFICATE OF LIABILITY INSURANCE 211 712 00 5 Y) 02/17/2005 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey, Renton &Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 12675 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oakland, CA 94604-2675 510 465-3090 INSURERS AFFORDING COVERAGE INSURED INSURERA United States Fidelity&Guaranty Dokken Engineering Inc INSURER B. American Automobile Ins. Co. 11171 Sun Center Drive, Suite 250 INsuRERc Hudson Insurance Company Rancho Cordova, CA 95670 — — — INSURER D INSURER E COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS —_IN­SR POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OFINSURANCE POLICY NUMBER DATE(MM/DDNY) DATE(MM/DDNY) LIMITS A GENERAL LIABILITY BKO1804219 05/12/04 05/12/05 EACH OCCURRENCE _$1,0001000 _ x COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) S1,000,000 CLAIMS MADE J OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE _ $2,000,000 GEN'L AGGREGATE LIM ITAPPLIES PER. PRODUCTS -COMPUDPAGG $2,000,000 � PRO- h l JECT $ LOC A AUTOMOBILE LIABILITY BA01805289 05/12/04 05/12/05 COMBINED SINGLE LIMIT x IANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY - - SCHEDULED AUTOS I (Per poison) S HIRED AUTOS BODILY INJuav NON-OWNED AUTOS (Per accident) $ - PROPERTY DAMAGE (Per.moonl) $ GARAGE LIABILITY (AUTO ONLY-EA ACCIDENT $ ANY AUTO AOUTO ONLVN EA AGG $ A EXCESSLIABILITV BK01804219 05/12/04 05/12/05 EACHOCCURRENCF $4,000,000 X OCCUR CLAIMS MADE AGGREGATE $4,000,000 DEDUCTIBLE _ $ RETENTION $10000 $ WC STATU- OTH- B WORKERS COMPENSATION AND WZP80923454 107/01/04 07/01/05 X TORV UMIrs$ER -- -EMPLOYERS'LIABILUY - - - _-- - ff - - - --I_- —_-- - - - - _ E L.EACH ACCIDENT $1,000,000 EL DISEASE-EA EMPLOYEE $1,000,000 E.L.DISEASE-POLICY LIMIT $1,000,000 C OTHER Professional AEE7114400 03/13/05 03/13/06 $1,000,000 per claim Liability $3,000,000 annl aggr. �I DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS General Liability excludes claims arising from professional services. Certificate holder is included as additional insured for general liability per policy. Re: Indian Canyon Road Widening (DE-1309) CERTIFICATE HOLDER ADDIRONALINSURED;INSURERLETTER CANCELLATION SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Palm Springs 2 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O—DAYS WRITTEN Dept. of Public Works NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT,BUTFAILURE TO DOSOSHALL Attn: Mary Lynn IM POSE NO OBLIGATION OR LIABILITYOF ANYKIND UPON THE INSURER,ITS AGENTS OR P.O. Box 2743 REPRESENTATIVES. Palm Springs, CA 92263-2743 AUTHORIZED REPRESENTATIVE ACORD 25-5(7/97)1 of 1 #M120889 J � � �'`/_��MNN 0ACORD CORPORATION 1988