FY2013 11/20/2012DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE: December 5, 2012
TO: Lynda Stuart, Office Manager
Tourist Development Council
ATTN. Maxine Pacini
Administrative Assistant
FROM: Pamela G. Hanc ck . C.
At the November 20, 2012, Board of County Commissioners meeting, the Board granted
approval and authorized execution of the following "G Items":
1. Agreement with Key Largo Chamber of Commerce, Inc. covering Bogart Film Festival in
May, 2013 in an amount not to exceed $50,000, DAC V, FY 2013 Event Resources.
2. Agreement with BW Promotions, Inc. covering Hemingway 5K Sunset Run &
Paddleboard Race in July, 2013 in an amount not to exceed $10,000, DAC I, FY 2013
Event Resources.
3. Agreement with Mad Dog Mandich Fishing Classic, LLC covering Publix Mad Dog
Mandich Fishing Classic in October, 2013 in an amount not to exceed $10,000, DAC IV
FY 2013 Event Resources.
4. Agreement with Lower Keys Chamber of Commerce, Inc. covering Big Pine & Lower
Keys Island Art Festival in December, 2013 in an amount not to exceed $15,000, DAC II,
FY 2013 Event Resources.
5. Agreement with Florida Keys Community College and the Letters "FKCC" covering
FKCC Swim Around Key West, Open Water Swims, and Swim Meets between June and
September, 2013 in an amount not to exceed $10,000, DAC I, FY 2013 Event Resources.
6. Agreement with Islamorada Chamber of Commerce, Inc. covering Florida Keys Island
Fest, 22"d Annual in April, 2013 in an amount not to exceed $20,000, DAC IV, FY 2013
Event Resources.
7. Agreement with Key Largo Baptist Church, Inc. covering Key Largo Bridge Run in
November, 2013 in an amount not to exceed $20,000, DAC V, FY 2013 Event
Resources.
8. Agreement with Stand Up For Education, Inc. covering Race Around the Rock in April,
2013 in an amount not to exceed $10,000, DAC I, FY 2013 Event Resources.
9. Agreement with super Boat International Productions, Inc. covering Key West World
Championship Race in November, 2013 in an amount not to exceed $120,000, DAC I,
FY 2013 Event Resources.
10. Agreement with Keys Area Interdenominational Resources, Inc. covering Sombrero
Beach Run in March, 2013 in an amount not to exceed $10,000, DAC III, FY 2013 Event
Resources.
11. Agreement with Greater Marathon Chamber of Commerce, Inc. covering Original
Marathon Seafood Festival in March, 2013 in an amount not to exceed $50,000, DAC III,
FY 2013 Event Resources.
12. Agreement with University of Florida Alumni Association, Inc., Key West Gator Club
covering Key West Marathon in October, 2013 in an amount not to exceed $27,500 (TDC
District I Funding Allocation = $25,000; TDC District II Funding Allocation = $2,500),
FY 2013 Event Resources.
13. Agreement with Phil Peterson's Key West Poker run, LLC covering Phil Peterson's 41"
Key West Poker Run in September, 2013 in an amount not to exceed $95,000 (District I =
$75,000; District II = $10,000; District IV = $10,000 Funding Allocation) FY 2013 Event
Resources.
14. Agreement with Key West Business Guild, Inc. covering Womenfest Key West 2013 in
September, 2013 in an amount not to exceed $50,000, DAC I, FY 2013 Event Resources.
15. Agreement with Upper Keys Community Pool, Inc. covering Orange Bowl Winter
Training and Swim Classic between December, 2013 and January, 2014 in an amount not
to exceed $50,000, DAC V, FY 2013 Event Resources.
16. Agreement with BH/NV Hawk's Cay Property Holdings, LLC, dba Hawk's Cay Resort
covering Christmas in the Keys Celebration in December, 2013 in an amount not to
exceed $40,000, DAC III, FY 2013 Event Resources.
17. Agreement with BH/NV Hawk's Cay Property Holdings, LLC, dba Hawk's Cay Resort
covering Heroes Welcome Tribute Weekend in August and September, 2013 in an
amount not to exceed $50,000, DAC III, FY 2013 Event Resources.
18. Agreement with New Orleans House of Key West, Inc. covering New Year's Eve Shoe
Drop on December 31, 2013 in an amount not to exceed $17,000, DAC I, FY 2013 Event
Resources.
19. Agreement with Rotary Club of Key Largo Charitable Events, Inc. covering Brew on the
Bay in April, 2013 in an amount not to exceed $10,000, DAC V, FY 2013 Event
Resources.
20. Agreement with Key West Innkeepers Association, Inc. covering Holiday Historic Inn
Tour in December, 2013 in an amount not to exceed $17,000, DAC I, FY 2013 Event
Resources.
21. Agreement with Naval Air Station Key West covering NAS Key West 2013
Southernmost Air Spectacular in March, 2013 in an amount not to exceed $60,000.
22. Agreement with Key West Bight Preservation Association, Inc. covering The Key West
Bight Before Christmas Holiday Celebration between November and December, 2013 in
an amount not to exceed $10,000, DAC I, FY 2013 Event Resources.
23. Agreement with Sunrise Rotary Foundation of Key West, Inc. covering Key West
Brewfest in August/September 2013 in an amount not to exceed $17,000, DAC I, FY
2013 Event Resources.
25. Agreement with Key West Tourist Development Association, Inc. covering Fantasy Fest
in October, 2013 in an amount not to exceed $150,000, FY 2013 Event Resources.
26. Agreement with Bauer Restaurant, Inc. covering Key West Songwriters Festival May
2013 in an amount not to exceed $100,000, DAC I, FY 2013 Event Resources.
27. Amendment to Agreement with Prange & O'Hearn, Inc. (d/b/a: Insights, Inc.) to amend
name of corporation to JDO Insights, Inc. (d/b/a: Insights, Inc.) and to make the change
retroactive to June 1, 2012 to allow for payment of invoices in new corporation name.
28. Agreement with Conch Foundation of the Upper Keys, Inc. covering Conch Scramble "on
the water" Charity Golf Tournament in September 2013 in an amount not to exceed
$20,000, DAC IV, FY 2013 Event Resources.
29. Agreement with Key West Half Marathon LLC for the Key West Half Marathon in
January, 2013 in an amount not to exceed $35,000, DAC 1, FY 2013 Event Resources.
Enclosed is the electronic copies of the above -mentioned. Should you have any
questions, please feel free to contact me.
cc: County Attorney w/o documents
Finance hard copy
File
Turn Key Events Agreement
THIS AGREEMENT (Agreement) is entered into this 20-d— day of�4r,2012,
by and between MONROE COUNTY, a political subdivision of the state of Florida (County)
and Bauer Restaurant, Inc. a for Profit organized under the laws of the state of Florida (Event
Sponsor).
WITNESSETH:
In consideration of the mutual covenants contained herein the parties agree as follows:
1. Payment: The COUNTY agrees to pay $100,000 (One Hundred Thousand
Dollars — TDC District I Funding Allocation) for: Key West Songwriters Festival in May 2013
from tourist development tax funds provided Event Sponsor meets all of its obligations under
this agreement.
2. Scope of Services: The Event Sponsor agrees to provide the County with an
event as specified in the Scope of Services below (Event):
a). Opening Party for Songwriters
b). Six (6) paid concerts at various locations in Key West
c). Twenty (20) free shows at various locations in Key West
d). Closing show
e). National TV Coverage
3. Payment: Upon receipt from Event Sponsor of documentation, reviewed and
verified by the Tourist Development Council (TDC) Administrative Office, proving that event
has been produced and promoted through marketing literature, advertising program/publication
ads, television coverage, publicity and on -site advertising, and that the required insurance was
obtained no less than twenty days prior to the event, COUNTY shall pay the sum in Paragraph
1.
Monroe County's performance and obligation to pay under this contract is contingent
upon an annual appropriation by the COUNTY.
4. Accounting: Financial records of Sponsor pertaining to this project shall be kept
according to generally recognized accounting principles and shall be available to the COUNTY
or to an authorized representative for audit. Records shall be retained a minimum of three
years after contract has been performed.
Key West Songwriters Festival
Tumkey Funding
FY 2013
ID #: 1103
1
5. Modification: Any changes to this contract may be made only by written mutual
agreement, recommended by the TDC and approved by the COUNTY.
6. Termination: This Agreement terminates on September 30, 2013. All invoices
must be submitted prior to September 30, 2013.
7. Non Occurrence of Event: The Event Sponsor shall give written notice to the
Monroe County Tourist Development Council if it is found necessary to cancel an event. The
notice shall contain the following specifics: 1) reason for cancellation, 2) documentation of the
reason for cancellation and 3) person authorized to cancel including title and stated affiliation.
8. Indemnification and Hold Harmless: The Event Sponsor covenants and agrees
to indemnify and hold harmless and defend Monroe County, its officers, employees and agents
including the Tourist Development Council and Visit Florida Keys from any and all claims for
bodily injury (including death), personal injury, and property damage (including property owned
by Monroe County) and any other losses, damages, and expenses (including attorney's fees)
which arise out of, in connection with, or by reason of the services provided, event sponsored,
or other activities and funding associated with this agreement, except those losses or damages
caused by COUNTY or its agents.
9. Insurance Requirements: Event sponsor as a pre -requisite of the Special Event
governed by this Agreement, shall obtain, at its own expense, insurance as specified in this
section.
Event sponsor shall furnish the County with a certificate evidencing the insurance
required by this paragraph not later than twenty (20) days prior to the event.
Please have your insurance agency e-mail your certificates of insurance directly to Maria
Slavik in the Monroe County Risk Management Department. Slavik-Maria(cD-MonroeCounty-
FL.Gov — The e-mail must state that this is a certificate for a TDC event (state name of
event as written within your contract) and should be forwarded to Maxine Pacini at the
TDC administrative office. Your certificate must state that the Monroe County Board of
County Commissioners is a "Certificate Holder" and that Monroe County, its employees
and officials will be included as "additional insured". If you or your insurance agency
need to speak with Maria regarding the insurance requirements, she can be contact by
telephone at (305) 295-3178, or by e-mail at the address stated above.
It is the event sponsor's responsibility to confirm that your insurance has been received and
approved. You can do this by contacting Maxine Pacini at AdminAsst(a_fla-keys.com or by
calling (305) 296-1552.
Event sponsor will not be permitted to commence work associated with the Event (including
pre -staging of personnel and material) until satisfactory evidence of the required insurance has
Key West Songwriters Festival
Tumkey Funding
FY 2013
ID #: 1103
2
been furnished to the county as specified below. Event sponsor shall maintain the required
insurance throughout the entire duration of the Special Event and any extensions specified in
any attached schedules. Failure to comply with this provision may result in the immediate
suspension of the Event until the required insurance has been reinstated or replaced. Event
sponsor shall provide, to the County, as satisfactory evidence of the required insurance, either:
Original certificate of Insurance
or
Certified copy of the actual insurance policy
A certified copy of any or all insurance policies required by this contract shall be filed with the
Clerk of the COUNTY prior to the Event.
All insurance policies must specify that they are not subject to cancellation, non -
renewal, material change or reduction in coverage unless a minimum of thirty (30) days prior
notification is given to the County by the insurer.
Acceptance and/or approval of event sponsors insurance shall not be construed as
relieving event sponsor from any liability or obligation assumed under this contract or imposed
by law.
Any deviations from these General Insurance Requirements must be requested in
writing on the County form titled "Request for Waiver of Insurance Requirements" and must be
approved by Monroe County Risk Management.
Prior to commencement of work governed by this contract, event sponsor shall obtain
General Liability Insurance. Coverage shall be maintained through out the life of the contract
and include, as a minimum:
Premises Operations
Products and Completed Operations
Blanket contractual Liability
Personal Injury Liability
Expanded Definition of Property Damage
The minimum limits acceptable shall be:
$1,000,000.00 combined Single Limit (CSL)
If split limits are provided, the minimum limits acceptable shall be:
$500,000.00 per person
$1,000,000.00 per Occurrence
$100,000.00 Property Damage
An Occurrence Form policy is preferred. If coverage is provided on a Claims
Made policy, its provisions should include coverage for claims filed on or after the effective
date of this contract. In addition, the period for which claims may be reported should extend
Key West Songwriters Festival
Tumkey Funding
FY 2013
ID #: 1103
3
for a minimum of twelve (12) months following the acceptance of work by the County.
Recognizing that the work governed by this contract involves the sales and/or distribution of
alcoholic beverages, the Contractor's General Liability Insurance policy shall include Liquor
Liability with limits equal to those of the basic coverage.
A separate Liquor Liability policy is acceptable if the coverage is not more restrictive
than the contractor's General Liability policy.
A Workers Compensation insurance is required by Florida Statutes.
10. Permits: The Event Sponsor will secure all required permits and licenses and
shall pay all appropriate business taxes.
11. Laws and Regulations: Any and all services, materials and equipment shall
comply fully with all Local, State and Federal laws and regulations.
12. Taxes: The COUNTY and TDC are exempt from Federal Excise and State of
Florida Sales Tax.
13. Finance Charges: The COUNTY and TDC will not be responsible for any
finance charges.
14. Relation of COUNTY/TDC: It is the intent of the parties hereto that the Event
Sponsor shall be legally considered as an independent contractor and that neither it nor its
employees shall, under any circumstances, be considered servants or agents of the COUNTY
and TDC, and the COUNTY and TDC shall at no time be legally responsible for any
negligence on the part of said Event Sponsor, its employees or agents, resulting in either
bodily or personal injury or property damage to any individual, firm, or corporation.
15. Disclosure: The Event Sponsor shall be required to list any or all potential
conflicts or interest, as defined by Florida Statutes Chapter 112 and Monroe County Code.
The Event Sponsor shall disclose to the COUNTY and TDC all actual or proposed conflicts of
interest, financial or otherwise, direct or indirect, involving any client's interest which may
conflict with the interest of the COUNTY and TDC.
16. Assignment: The Event Sponsor shall not assign, transfer, convey, sublet or
otherwise dispose of this agreement, or of any or all of its right, title or interest therein, or his or
its power to execute such agreement to any person, company or corporation without prior
consent of the TDC and COUNTY.
17. Compliance with laws - Nondiscrimination: The Event Sponsor, shall comply
with all federal, state and local laws and ordinances applicable to the work or payment for work
thereof, and shall not discriminate on the grounds of race, color, religion, sex, age, or national
origin in the performance of work under this Agreement. This Agreement shall be subject to
all federal, state, and local laws and ordinances.
Key West Songwriters Festival
Turnkey Funding
FY 2013
ID #: 1103
4
18. Security Protection: The Event Sponsor agrees to provide adequate security
for the event.
19. Ethics Clause: The Event Sponsor warrants that it has not employed, retained
or other wise had act on its behalf, any former County office or employee in violation of Section
2 or Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of
Ordinance No. 10-1990. For breach or violation of the provision the County may, at its
discretion terminate this agreement without liability and may also, at its discretion, deduct from
the agreement or purchase price, or otherwise recover, the full amount of any fee, commission,
percentage, gift, or consideration paid to the former or present County officer or employee.
20. Media rights: The TDC shall have the right to broadcast, rebroadcast, use,
reproduce, or transmit for any purpose whatsoever, radio, television, pictures, sound, film and
tape motion pictures and still photographs paid for by the COUNTY and TDC under this
agreement.
21. Logo: All promotional literature and display advertising with the exception
of generic advertising must display the "Key West — Close to Perfect - Far From Normal"
logo/trade mark (as per attached logo sample — Exhibit A). This logo/trade mark was
adopted by the TDC and County in April 2010.
22. Severability: If any provision of this Agreement shall be held by a Court of
competent jurisdiction to be invalid or unenforceable, all remaining provisions shall not be
affected thereby; and each provision of this Agreement shall be valid and enforceable to the
fullest extent permitted by law.
23. Authority: Each of the signatories for the sponsor below certifies and warrants
that:
a) The Sponsor's name in the agreement is the full name as designated in its corporate
charter, and b) they are empowered to act and execute the agreement for the Sponsor and c)
this Agreement has been approved by the Sponsor's Governing Board.
24. Public Entity Crimes: "A person or affiliate who has been placed on the
convicted vendor list following a conviction for public entity crime may not submit a proposal on
a contract to provide any goods or services to a public entity, may not submit a proposal on a
contract with a public entity for the construction or repair of a public building or public work,
may not submit proposals on leases of real property to public entity, may not be awarded or
perform work as a contractor, supplier, subcontractor, or consultant under a contract with any
public entity, and may not transact business with any public entity in excess of the threshold
amount provided in Section 287.017, Florida Statutes, for CATEGORY TWO for a period of 36
Key West Songwriters Festival
Tumkey Funding
FY 2013
ID #: 1103
5
months from the date of being placed on the convicted vendor list". By execution of this
Agreement, Sponsor warrants that it is in compliance with this requirement.
25. Governing LawNenue: This Agreement shall be governed by and construed in
accordance with the laws of the State of Florida applicable to contracts made and to be
performed entirely in the State. In the event that any cause of action or administrative
proceeding is instituted for the enforcement or interpretation of the agreement, the County and
Sponsor agree that venue shall lie in the appropriate court or before the appropriate
administrative body in Monroe County, Florida. This Agreement shall not be subject to
arbitration.
26. Notice: Any notice required or permitted under this agreement shall be in writing
and had delivered or mailed, postage prepaid, to the other party by certified mail, returned
receipt requested to the following:
For Grantee: Charles Bauer
4 Charles Street
Key West, FL 33040
For Grantor: Lynda Stuart
Monroe County Tourist Development Council
1201 White Street, Suite 102
Key West, FL 33040
And
Cynthia Hall, Asst. County Attorney
P.O. Box 1026
Key West, FL 33041-1026
27. Entire Agreement: The parties agree that the Agreement above constitutes the
entire agreement between the COUNTY and Event Sponsor.
Key West Songwriters Festival
Tumkey Funding
FY 2013
ID #: 1103
N.
IN WITNESS WHEREOF, the parties hereto have executed this agreement the day and
year first above written.
(SEAL)A4,y j4eav,'1,-,, Clc„K 44 Board of County Commissioners
Attest: of Monroe County
Deputy Clerk
(CORPORATE SEAL)
Attest:
By.
Secretary
Print Name
Date:
OR TWO WITNESSES
(1)
Print Name:
Date:
Key West SongWO12 Festiva/
Tumby Funding
FY 2013
ID * 1103
how, if,
ayor/Cha rman
Bauer Restaurant, Inc.
By
President
Q2!j2=t,,S5
Print Name
Date: 10 _ 9 — 1 -1-�;�
T'
(2)
Print Name:
Date:
7
MON OE COUNTY ATTORNEY
A O D, TOF R
—QYNTHIA L. MALL
ASSIST NT COUNTY ATTORNEY
Date.____Q' 2-6 — "I a
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EXHIBIT A
In -County Logo
The below logo that includes the "Monroe County Tourist Development Council" designation is
to be utilized in all approved in -county print newspaper ads, magazine ads, street banners,
posters and other approved signage efforts. Radio commercials should include "Brought to
you by The Monroe County Tourist Development Council". To seek approval, clarification
and/or logo in electronic format (eps or jpg file), contact Jessica Taylor -Smith or John
Underwood with Tinsley Advertising at 305-856-6060.
Key\Vest
Close to Perfect -Far From Nommal
MONROE COUNTY TOURIST DEVELOPMENT COUNCIL
Out -of -County Logo
The below logo that does NOT include the "Monroe County Tourist Development Council"
designation is to be utilized in all other efforts including any approved out -of -county print
newspaper ads, magazine ads, television commercials, internet advertising (banners, buttons,
e-mail blasts), direct mail promotions (brochures and pamphlets) and any approved
promotional items including programs, T-shirts, hats, jackets and koozie cups. Radio
commercials should include "Brought to you by The Monroe County Tourist Development
Council". To seek approval, clarification and/or logo in electronic format (eps or jpg file),
contact Jessica Taylor -Smith or John Underwood at Tinsley Advertising at 305-856-6060.
Key'Vest
Close to Perfect -Far From Normal
Key West Songwriters Festival
Tumkey Funding
FY 2013
ID #: 1103
V J
I CERTIFICATE OF LIABILITY INSURANCE
DATE (MWDD/YYYY)
1/23/2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER
FRANCIS L. DEAN & ASSOCIATES, LLC
S. NAPERVILLE ROAD, BLDG-B
CONTACT
NAME:
PHON1776
(A/C, No Ext : 800-745-2409 ac No): 630-665-7294
E-MAIL ADDRESS: info@fdean.com
P.O. BOX 4200
WHEATON, IL 60189
www.fdoan.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA: Riverport Insurance Company
36684
(800)745-2409
INSURED SPORTS AND RECREATION PROVIDERS ASSOCIATION (PURCHASING GROUP) AND
ITS PARTICIPATING MEMBERS:
INSURER B :
INSURERC :
Bauer Restaurants, Inc. dba The Key West Songwriters Fest
412 White Street
INSURERD:
INSURERE:
Key West, FL 33040
INSURER F :
COVERAGES CERTIFICATE NUMBER: S0164362-00 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSR
SUBR
N/VD
POLICY NUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
MMIDDIYYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
X
I$
FLDG180313
5/1/2013
5/6/2013
GENERAL AGGREGATE
$2,000,000.00
PRODUCTS - COMP/OP AGG
$2,000,000.00
PERSONAL & ADV INJURY
$1,000,000.00
EACH OCCURRENCE
$1,000,000.00
FIRE DAMAGE (Any one fire)
$300,000.00
GENL AGGREGATE LIMIT APPLIES PER:
�X7 POLICY PEa LOC
MED EXP (Any One person)
$5,000.00
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTos
HHIRED AUTO NON -OWNED
AUTOS
Ea acc dent nt�SINGLE LIMIT
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per acddent
$
RXCESS
UMBRELLA LIAR
LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
ED RETENTION $
$
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
The certificate holder is named as additional insured with respect to liability arising out of the operations of the named insured during the policy period.
Festival Activities
CERTIFICATE HOLDER CANCELLATION
Monroe County Board of County Commissioners
Risk Management-1100 Simonton Street
Key West, FL 33040
c 6lNAWu=
SHO LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACC RDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
Francis L. Dean
@ 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD