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Item E8 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: APRIL 20, 2000 Division: TDC Bulk Item: Yes XXX No Department: N/A AGENDA ITEM WORDING: Approval of an Agreement with Prange & O'Hearn's Insights, Inc. to provide Visitor Information Survey Reports in an amount not to exceed $57,350.00 per year. ITEM BACKGROUND: TDC approved same at their meeting of March 14, 2000. PREVIOUS RELEVANT BOCC ACTION: BOCC approved FY 2000 budget at their meeting of September 22, 1999. STAFF RECOMMENDATION: Approval TOTAL COST:$57,350 per year BUDGETED: YES X COST TO COUNTY: $57,350 per year./TOURIST PAY APPROVED BY: County Attorney l$.. OMB/Purchasing~ Risk Management X DIVISION APPROVAL: ~/..P Lynda M. Stuart (Type/print name) To Follow: DOCUMENTATION: Included: X Not Required Agenda Item #~ MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Prange & O'Hearn's Insights, Inc. Effective Date: 4/20/2000 Contract Purpose/Description: Approval of an Agreement with Prange & O'Hearn's Insights, Inc. to provide Visitor Information Survey Reports in an amount not to exceed $57,350.00 per year. Contract Manager: Maxine Pacini (Name) X3523 . (Ext) Tourist Development Council (Department) For BOCC meeting on 4/20/2000 Agenda Deadline:4/5/2000 Contract Costs ~ Total Dollar Values of Contract: $57,350 Current Year Portion: $ .3 0/ 2- 3 if- 3 ~ Budgeted? Yes ~ No Account Codes: 116-76065-530340-T06G-250 X Grant: $ County Match: $ Estimated Ongoing Costs: $ (not included in dollar value above) ADDITIONAL COSTS /yr. For: (e.g. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW DATE IN CHANGES NEEDED? Yes No REVIEWER DATE OUT C~ Attor~~ O.M.B./Pur~sing -S/ (SlOb v / (/"/ 3 ~?Jv Division Director b_ttlv"V Risk Management :iJ~/ ()O (\, l~~r- ~~-t,~u~~ S. Hutton .3 /2..8"1 OG --- .s 7J::1lo0 _ / caV-ma;~ (Final reviewer should return contfact to originator) S /.J.!LI cfV 31:;;?-71tJU Comments: VISITOR PROFILE SURVEY AGREEMENT THIS AGREEMENT is entered into this day of , 2000, by and between the BOARD OF COUNTY COMMISSIONERS, Monroe County, Florida, hereinafter referred to as the COUNTY and PRANGE & O'HEARN'S INSIGHTS, INC. MARKETING AND RESEARCH GROUP, hereinafter referred to as FIRM; WITNESSETH WHEREAS, FIRM is qualified to provide services, and; WHEREAS, the Monroe County Tourist Development Council (TDC) has recommended this contract be entered into provide services, and; WHEREAS, the COUNTY wishes to enter into this Agreement for services with the FIRM, 1. TERM: The term of this Agreement is for a period of twenty-four (24) months commencing June 1, 2000 and terminating May 31, 2002 subject to Section 10 herein. 2. SERVICES: In consideration of the base monthly contractual amount, the FIRM shall provide the following services on behalf of the Florida Keys & Key West: A. Survey Design -- Develop survey instrument, restricting the number of questions so that the interview can be completed in a 3-5 minute time frame. Pretest questionnaire to ensure validity of response and timing requirements. B. Field Set-Up -- Identify key locations for interview sites. Develop a rotation plan for the locations selected, to provide alternates to unproductive sites as well as to broaden the reach of the field interviewing crew. Recruit interviewers from local labor pool from various locations in the Keys. Instruct interviewers in respondent selection techniques to be used, qualification criteria, and survey instrument administration. Supervise interviewers in the field. C. Data Collection -- Develop project schedule to provide a guide for interview completion. Conduct intercept interviews with visitors at selected locations throughout the five regions of Monroe County (Key Largo, Islamorada, Marathon, Lower Keys, and Key West). Achieve a quota of 250 completed interviews (approximately 50 per month) in each region during each season, for a total interview base of 3,000 per year. Rotate schedule so that days of the week are covered and a variety of visitor~ are interviewed. 1 D. Data Cleaning and Input -- Review each questionnaire for completeness and legibility. Input survey responses and deliver to TDC monthly survey data on diskette, in a format compatible with TOC's computer software. 3. REPORTS: The FIRM shall provide to TOC Administrative Office (1201 White Street, Suite 102, Key West, FL 33040) reports and documentation of results of services. Reports shall show, at a minimum: Monthly survey data on diskette, in a format compatible with TOC's computer software. All completed questionnaires and other hard copy from field work. 4. COMPENSATION: The FIRM's annual fee shall be $53,750, with an additional amount of no more than $3,600 per year for approved expenses. Miscellaneous expenses may include travel, lodging, printing, mailing, couriers, postage, respondent incentives (if required), etc. Miscellaneous expenses must be approved in advance and billed separately. Monroe County's performance and obligation to pay under this contract is contingent upon an annual appropriation by the BOCC. 5. BILLINGS: The FIRM shall submit to the TOC Administrative Office an initial billing for 25% ($13,437.50) each contract year, due upon receipt of the project design document and survey instrument, followed by 12 equal monthly billings of $3,359.37 for contract services, and up to $300 per month for all other approved charges incurred during the previous month for which payment is due from the COUNTY as authorized under this Agreement. The COUNTY shall be responsible for payment of all authorized fees and costs due the FIRM while this Agreement is in force which fees and costs are described and limited in paragraph 4. Said payments shall be sent by mail by COUNTY directly to Prange & O'Hearn's Insights, Inc., 43 East Ocean Boulevard, Stuart, FL 34994. 6. LICENSES AND QUALIFICATION: The FIRM warrants that it is qualified to perform the services under this agreement and holds any licenses necessary for same. 2 7. INDEMNIFICATION AND HOLD HARMLESS: The Contractor covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners 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 services provided by the Contractor or any of its Subcontractor(s) in any tier, occasioned by the negligence, errors, or other wrongful act or omission of the Contractor or its Subcontractors in any tier, their employees, or agents. In the event the completion of the project (to include the work of others) is delayed or suspended as a result of the Contractor's failure to purchase or maintain the required insurance, the Contractor shall indemnify the County from any and all increased expenses resulting from such delay. The first ten dollars ($10.00) of remuneration paid to the Contractor is for the indemnification provided for above. The extent of liability is in no way limited to, reduced, or lessened by the insurance requirements contained elsewhere within this agreement. 8. INSURANCE: Insurance requirements are in Exhibit A, attached hereto and incorporated herein by reference. 9. APPROVALS AND CHANGES OF SPECIFICATIONS OF SERVICES: The TOC shall have the sole and exclusive right to approve, modify, reject, or cancel any and all plans, proposals, submissions and other work in process, in which event the TOC's directions shall be immediately implemented. However, nothing in this Agreement shall be construed as requiring the FIRM to violate any contractual commitments to vendors contracted on TOC's behalf. All contractual commitments to contracted vendors require the TOC's prior written approval. The COUNTY shall only be liable for charges approved in writing prior to the FIRM's entering into such contractual commitment. If any modifications to the specifications become substantial, the FIRM may elect to re-negotiate the cost of deliverables under the revised specifications. The performance of all services between FIRM as described and otherwise provided under this Agreement will be in full cooperation with and under the direct supervision of the TOC. Whenever approval is required from the TOC, said approval shall be in writing from the TOC Administrative Director or a designee, according to TOC policy. 3 1 O. TERMINATION; RENEWAL: Either party shall have the right to cancel this Agreement at its sole discretion upon sixty (60) days written notice to the other party. FIRM shall deliver to TOC and COUNTY all papers and other materials related to the work performed under this Agreement upon termination thereof. County shall pay FIRM only for such reimbursable expenses authorized prior to termination. If, for any reason, funds are not appropriated in any fiscal year, FIRM will be given fifteen (15) days notice of termination, and FIRM will not be required to continue services or produce deliverables after the termination date. The COUNTY shall have the option of renewing this agreement for an additional one (1) year under the same terms and conditions subject to negotiation of monetary terms and provided the COUNTY provides FIRM prior written notice of its election of this option no later than thirty days before this agreement expires. 11. DISCLOSURE OF FINANCIAL INTERESTS: The FIRM agrees to disclose any existing financial interest in its business by its suppliers or providers utilized in fulfillment of this Agreement and shall disclose said interests as they may arise from time to time. 12. APPLICABLE LAW; VENUE: This Agreement shall be governed by and construed according to the laws of the State of Florida and all actions brought under or pursuant to this Agreement shall be brought in a court of competent jurisdiction in Monroe County, Florida. 13. ENTIRE AGREEMENT AMENDMENT: This writing embodies the entire Agreement and understanding between the parties hereto, and there are no other agreements or understandings, oral or written, with reference to the subject matter hereof that are not merged herein and superseded hereby. Any amendment to this Agreement shall be in writing and signed by both the COUNTY and FIRM. 14. LAWS AND REGULATIONS: It shall be understood and agreed that any and all services, materials and equipment shall comply fully with all Local, State and Federal laws and regulations. 15. TAXES: The Board of County Commissioners and TOC are exempt from Federal Excise and State of Florida Sales Tax. State Sales Tax and Use Tax Certificate Number is 03000 210354. 4 16. FINANCE CHARGES: The COUNTY and TOC, shall not be responsible for any finance charges. 17. ASSIGNMENT: The FIRM shall not assign, transfer, convey, sublet or otherwise dispose of this Agreement, or of any or all of its right, title or interest therein, of his or its power to execute such contract to any person, company or corporation without prior consent of the COUNTY. 18. OWNERSHIP: All work performed under the Agreement shall be the property of the TOC and COUNTY, for whatever use and/or disposition the TOC and COUNTY may deem appropriate. Such property shall include: a) all plans, documents and recommendations; b) All manuscripts, copy, graphics, and videotapes. The TOC and COUNTY shall have the full right to reproduce and/or use any products derived from the contractor's work under the Agreement without payment of any royalties, or fees. No reproduction of said property shall be made by FIRM or any other entity for purposes of resale. 19. COMPLIANCE WITH LAWS - NONDISCRIMINATION: The firm 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 or 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. 20 NOTICE: Whenever notice is required by this Agreement to be give to either party, said notice shall be delivered to: For County: Ms. Lynda Stuart Monroe County TOC 1201 White Street, Suite 102 Key West, FL 33040 For FIRM: Jack O'Hearn, President Prange & O'Hearn's Insights, Inc. 43 East Ocean Boulevard Stuart, FL 34994 21. SEVERABILITY: If any provision of this Agreement shall be held by a Court of competent jurisdiction to be invalid or unenforceable, the remainder of this Agreement, or the application of such provision other than those as to which it is invalid or unenforceable, shall not be affected thereby; and each provision of this Agreement shall be valid and enforceable to the fullest extent permitted by law. 22. The FIRM agrees to furnish the TOC with copies of bids of sub~ontractors. 5 23. ETHICS CLAUSE: The FIRM warrants that no person has been employed or retained to solicit or secure this contract upon an Agreement or understanding for a commission, percentage, brokerage, or contingent fee and that no member of the Monroe County government or the TDC has any interest, financially or otherwise, in the FIRM or its subcontractors. IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed in their names, and seals impressed hereon, by their proper officials, all as of the day and year first above written. (SEAL) Attest: Danny L. Kolhage, Clerk Board of County Commissioners of Monroe County Deputy Clerk Mayor/Chairman (CORPORATE SEAL) Attest: Prange & O'Hearn's Insights, Inc. Marketing and Research Group By By President Secretary OR Witness " 6 EX:-iIBIT , A RlSK lvl~NAGEMEm POLICY AND PROCEDURES CO NTRA.CT AD M:I:N1STRA TI 0 N MA.L"{U AL 1996 SiiUcn Gener.ll Insur.lnce Requirements for Other Contractors and Subcontractors As a pre-requisite of the work governed, Of the goods supplied under this contract (includincr the pre-~cring ofpersonnd and material), the Contractor shall obtain., at hislher own expense, ::J in.surance as specified in any attached schedules, which are made oart of this contract.. Tne Contractor v.ill e:J.SUre that the inSu.l-ance obtained Mll e..xtend protection to all Subcontractors engaged by the Contractor. ..\.5 an alternative, the Comractor may require all Subcontractors to obtain insurance consistent v.ith the attached schedules. Tae Contractor will not be permitted to commence work gove..~ed by this contract (including pre-staging of personnel and material) until satisfactory evidence of the required insurance has b~n furnished to the County as specified below. Delays in the commencement of work. resulting from the failure of the Contractor to provide satisfactory evidence of the required insurance, shall not extend deadlines specified in this contraCt and any penalties and failure to perform assessments shall be imposed as if the work commenced on the specified date and time, except for the Contractor's failure to provide satisfactory evidence. Tne Contractor shall maintain the required insurance throughout the entire term of this contract and any extensions specified in the attached schedules. Failure to comply v.ith this pro"ision may result in the immediate suspension of all work until the required insurance has been reinstated or reolaced. Delays in the comoletion of work resulting from the failure of the Contractor to maintain the ~quired insurailce shall not extend deadlines specified in this contract and any penalties and failure to perform assessments shall be imposed as if-the work had not been suspended, except for the Contractor's failure to maintain the required insurance. Tne Contractor shall pro\ide, to the County, as satisfactory evidence of the requ.ired insurance, ei mer: . Certificate of Insurance or. . A Certified copy of the actual insurance policy. Tne County, at Lts sole option, has the right to request a ce..T'\:ified copy of any or all insurance policies required by this contract. 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. Tne acceptance and/or approval of the ContractorS insurance shall not be constrUed as relieving the Contractor from any liability or obligation assumed under this contract or imposed by law. Adminimtion Instrudon ~4709.:!. 14. The Monroe County Board of County Commissioners, its employees and officials will be included as "Additional Insured" on all policies, except for Workers' Compensation. AnY deviations from these General Insurance Requirements must be requested in writing on the County prepared form entitled "Request for Waiyer of Insur.mce Requirements" and approved by Monroe County Risk Management. " " t5 Adminisu-mon lrutr'Jdon ;;~ 709 ,2 1996 ;:uluon GENERAL LIABILITY li"{SURANCE REQUlRE1\1ENTS FOR CONTRACT BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work governed by this contrac~ the Contractor shall obtain General Liability In.surance. Coverage shall be maintained throughout the life of the contract and include, as a minimum: .:' . Premises Operations . ProductS and Completed Operations . Blanket Contracrual Liability . Personal Injury Liability . . Expanded Definition of Property Damage The minimum limits acceptable shall be: 5300,000 Combined Single Limit (CSL) If split limits are pro....idecL the minimum limits acceptable shall be: 5100,000 per Person 5300,000 per Occurrence 5 50,000 Property Damage An Occurrence Form policy is preferred. If coverage is pro\-ided 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 for a minimum of t'Ndve (12) months follo\\ing the acceptance of work. by the County. Tne Monroe Countv' Board. of County Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. GLl Administntion [nstrJc:tion #4709.2 53 , ' .' l"'f"'f"O c.ul........ VEmCLE LIA.BILITY INSURANCE REQUIREMENTS FOR CONTRACf BETWEEN MONROE COUNTY, FLORIDA AND Recognizing that the work governed by this co.ntract requires the use of vehicles, the Contractor, orior to the commencement of wor~ shall obtain Vehicle Liability insurance. Coverage shall be maintained throughout the life of the contract and include, as a minimum, liability coverag:e for. . Ov.ned. Non-O,-^l1ed.., and Hired Vehicles The minimum limits acceptable shall be: 5100,000 Combined Single Limit (CSL) If split limits are pro\ided.., the minimum limits acceptable shall be: 5 50,000 per Person S 1 00,000 per Occurrence 5 25,000 Proper!)' Damage The Monroe Counrv Board ofCounry Commissioners shall be named as Additional Insured on all policies issued to satisfy the above requirements. VLl .' Adminis=tion [nstr'.lction 1:4709.1 30 " 1996 Edjt.i011 WORKERS' COMPENSATION INSURA.i~CE REQUIREMENTS FOR CON'TRAcr BETWEEN MONROE COUNTY, FLORIDA AND Prior to the commencement of work governl:d by this contract, the Contractor shall obtain Workers' Compensation Insurance with liniits sufficient to respond to Florida Statute 440. In addition, the Contractor shall obtain Employers' Liability I.n.sura.nc: with limits of not less than: 5100,000 Bodily Injury by Accident 5500,000 Bodily Injury by Diseas~ policy limits 5100,000 Bodily Injury by Disease, each employee Coverage shall be maintained throughout the entire term of the contract.. Coverage shall be provided by a company or companies authorized to tranSact business in the stare of Florida. If the Contractor has been approved by the Florida's Department of Labor, as an authorized self- insurer, the County shall recognize and honor the Contractor's statUS. The Contractor may be required to submit a Lener of Authorization issued by the Department of Labor and a Certificate of Insurance, providing details on the Contractor's Excess insurance Program. lfthe Contractor omicioates in a self-insurance fund, a Certificate oflnsurance Vliil be required. In addition, the C'ontractor may be required to submit upd.a:ted financial statements from the fund upon request from the County. ~,~;' wel .' Administr.U.ion Instruction #4709.1 87 SWOR.'f STATEMENT PURSUANT TO SECUON 287.lJJ(J)(a), nORIDA STATUTFS, ON PUBUC EmTrY CRIMES TEIS FOR..\{ MUST BE SIGNED AND SWORN TO IN THE PR.ESENCE OF A NOTARY PlJ""'BUC OR OTHER. o mCIAL AUTHORIZED TO ADMINISTER. OATHS. . 1. Thi3 sworn statement i.s ~mitted to [print name oC the pubUc entity} by [print lnd1v1du.al's lWI1e and title] (or [print name o( c:at1ty submitting swom statement] ~hose ousmess address is and (if appliClble) its Feder:U Employer Identification Number (FEIN) is (If the entity has no FElN, indude the " Social Secnrity Number of the incUvidn.al signing this sworn statement: .) 2. I understand that a 'public entity crime' as defined in Paragraph 2S7.1.33(1)(g), Florida Statutes. means a violation of any state or fcdaal. Law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of 3Irf other state or of the United. States, including, but not limited to, 3Irf bid or contract for goods or services to be provided. to 3Irf public entity or an agency or politic:1l subdivision of 3Irf other state or of the United States and involving antitrUSt. fraud, theft, bncery, co!.lI1Sion, racketeering, conspiracy, or yt];ul":!'j<J1 misrepresentation. 3. r understand that 'conviC1ed" or 'conviction' as defined in Paragr.aph 281.1.33(1)(b), Florida Stntntes. means a finding of guilt or a conv:iction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial coun of record. relating. to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict. nonjury trial.. or entry of a plea of guilty or nolo contendere. 4. I understand that an 'affiliate" as defined in Paragraph 287.l33(1)(a), Florida Statntes. means: ,. ...... 1. A prede~or or suo::essor of a person convicted of a public entity crime; or 2. An entity under the amtrol of 3Irf natnr:1l person who is a.ctiYe in the Ill3.Ilagement of the entity and who has been convicted of a. public entity crime. The_term ~te" includes those officers, directors, 'executives, panners, shareholde~ employees, members, and agents who are active in the "management of" an. ~te. '~"~e.ownership by on~.person of shares constituting a c::'ntrolling intere:st in another person, .- or a pooling of equipment or income among per30ns when not for fair market value under an arm's length agre...-ment, sball be a prima facie case that one person controls another person. A person who knowingly enters into a joint 'Ventl1re with a. person who has been convicted of a. public entity crime in Florida during the preceding 36 months shaD. be considered. an aff:i1.iate. 5. r understand that a 'pet:SOn" 3$ defined in Paragraph 287.1.33(1)(e), Florida Statnte:s. m~ any" natural person or entity organized tlJlder the Laws of any state or of the United. States with the legal power to enter into a binding contract and which bids or applies to bid on contr:1CI3 for the provision of goods or servic::s let by a public entity, or which otl1erwise transacu or applies to transact business with a public enu!'!. The term 'person" includes those officers, directot3, aecutive:s, partI1l:::n, shareb.olders, employe.e:s, members, and agents who are active in m.an.agemc:nt of an entity. .. 'J.. =:.:.:;-" ,~ ;~"~~"'C"" '~1 OCIIC" ''"- s(..::c----C ?laic" r Cwvc a:::u!c:d I.._ICW :s ~.- I., '-!...:luo '.... .,,_ __"_ ;uo;:',;;g ~~-:~~ -;-' :!~n~ [~djC1--;:'Wd:1 3~~ment lItI'PUes 'u -~~ - ,,- n .u -- ---'f - ~cicbc~~c cntir; submirting tbi:l SWOr::t, SLlCcmcnc. ClCC ury O( to omc.=rs, di.r~C:Cr:;. CX"...:.a"lc::::. P3rc;:C:-S. sb.:lrc:.oidc:::-s, employcc. mcmbC::;j, or Jgcnt'3 ?lao arc Jeti-.re in the m.:tn.:lgemc::ut of illc e:HiC:,: ::Or my JCili.:w:: or" c..Jc encirJ Ius b<:::c.l c.J::JJ'ged. with :lllU convic:ed o( 1 public entie'! c--'..rne subscQue:lC co July 1. '1989. . - Tae e:Hirj sUbmitting this swam SLlteme:lt, or one or more of its offic.=rs, dir::c:ors, c:ec.uives, panncrs, slurctoidcrs, employee, mc:nbers, or agent:! wllo are active in the r.n.an.agement of the e:lCit:'j, or an affil..iJ.ce of cl1c entirJ tw been ch.a!5ed with J.Uu convicted ot l public entity cim.e subsequent to July 1, 1989. - Tac e::tirl SUbmitting thi3 sworn sucement. or one or more of it:! offic.=rs, directors, e:::ec..ltives, pann ers , slurelloLders, empLoyee3, members, or agent:! who are %Clive In the !IL:lnagement of the entity, or an .llflliaee of the entity Ius been cl1.a.rged. with J.Uu convicted al a public entity crime subsequent co July 1. 1989. Howe'/er, there has been a. subsequent pro~g before a H~.ng Officer of the SUte of Florida. Division of AdministrJ.tive He:uings a:ld the FI1lJ.l Order entered. by tl:.e H~.ng OEficer deten"'li...ed. tl:.at it was not in the public interest to pia<=:: the'cntiey submitting this sworn sutement on the conviC:ed vendor llit. [attad:1 a copy o{ the final order] _ r ffi'ilJERSTAND THAT THE SUBMISSION OF THIS FOR...\! TO TIlE CONTRACTING OFFICER FOR THE PUBUC EXITTY ID~ lillliD IN PARAGRAPH 1 (ONE) ABOVE IS lOR THAT PUBUC ENTIrY ONLY A.'fD, TH.-\T THIS FOR-\! IS VALID THROUGH DECEM:BER 31 OF THE CAlENDAR YEAR IN 'WHICH IT IS FII.ED. r ALSO UNDERSt...\....'ill THAT I.A.\f REQUIRED TO t.'fFORM THE PUBUC ENTITY PRIOR TO E'ITERlNG INTO A C01'i"TRAcr 1.'( EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECIlON 237.011, nORIDA ST.-\TUTES FOR CATEGORY mo OF A..'fY CH...\....'fGE IN THE INFOR...\ofATION CONTAlNED IN THIS FOR.'\i. [signature 1 Sworn eo and subscribed before me this day of .19_. Person:illy DOwn OR Prcdu~ ic.':::l.ti..Gcarioil Notary Public - State of (Type of identification) My commission expires (printed typ<::d. or Stamped commi:ssioned. name of notarf public) Farm ?tJR JeW (Re-/. C6/11/9'2)