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HomeMy WebLinkAboutContract 47893 C'•ECENE© CIT SECRETAW CONTRACT NO. jL* 172016 _EASEMENT ENCROACHMENT LICENSE AGREEMENT CJ J OF FORT Guy SECRETARY C��nrnrerci�rl THIS AGREEMENT is made and entered into by and between THE CITY OF FORT WORTH, a home rule municipal corporation of Tarrant County, Texas ("City"), acting by and through its duly authorized Planning and Development Director, and FW Rivercrest Bend, LLC, hereinafter referred to as "Licensee", owner of the property located at Athenia Drive and Scott Road, Fort Worth, Texas. ("Property"). RECITALS WHEREAS, Licensee is the owner of certain real property described as BEING A 131.98 SQUARE FOOT WROUGHT IRON FENCE ENCROACHMENT AREA LOCATED IN THE NATHEN H. CARROLL SURVEY, ABSTRACT No. 264, TARRANT COUNTY, TEXAS AND BEING A PART OF THAT FINAL PLAT FINAL PLAT OF LOTS 1-13, IX, 2X, 3X, 13X, BLOCK 100; LOTS 1-27, IX, 2X, 21X, 27X, BLOCK 101; LOTS 1-27, IX, 22X, BLOCK 102 AS RECORDED UNDER COUNTY CLERK'S FILE No. D215277282 OF THE RIVERCREST ADDITION TO THE CITY OF FT. WORTH AS RECORDED AS BEING A REPLAT OF BLOCKS 100-102, RIVERCREST ADDITION, VOLUME 310, PG. 91, PLAT RECORDS, TARRANT COUNTY, TX an addition to the City of Fort Worth, Tarrant County, Texas. (See Exhibit A); and WHEREAS, the City has a 60 foot wide sanitary sewer easement, Vol. 2049, Pg. 575, D.R.T.C.T. (the "Easement") in the property as shown on the map attached to this Agreement as Exhibit `B" and incorporated herein; and WHEREAS, Licensee desires to construct/place and maintain wrought iron fencing which will provide perimeter fencing (the "Encroachment") and which will encroach onto the City's Easement as shown on the attached survey and only to the extent shown thereon; and WHEREAS, to accommodate the needs of the Licensee, the City will allow the Encroachment under the terms and conditions as set forth in this Agreement. NOW, THEREFORE, the City and Licensee agree as follows: AGREEMENT 1. The City, in consideration of the payment by the Licensee of the fee set out below and covenants and agreements hereinafter contain ���?I be kCIAL RECORD formed by the 2014 Easement Encroachment Agreement-Commercial CITY SECRETARY Page 1 of 9 FT. WORTN, TX Licensee, hereby grants permission to the Licensee to encroach upon and occupy a portion of the City's Easement as described in and at the location shown Exhibit B for the purpose of constructing wrought iron perimeter fencing for the Rivercrest Bend community (the "Encroachment"). Upon completion of the Encroachment, Licensee agrees to be responsible for maintaining any and all structures and buildings within and above the Easement. Licensee shall not expand or otherwise cause the Encroachment to further infringe in or on the City's Easement beyond what is specifically described in the exhibit(s) attached hereto. 2. All construction, maintenance and operation in connection with such Encroachment, use and occupancy shall comply and be performed in strict compliance with the Charter, Ordinance and Codes of the City and in accordance with the directions of the Director of the Transportation and Public Works Department or the Director of the Water Department of City, or his duly authorized representative. Prior to the construction of the Encroachment, Licensee shall submit all plans and specifications to the applicable Director or his duly authorized representative. Licensee shall not commence construction of the Encroachment until such approval shall be indicated in writing by the Director. However, such approval shall not relieve Licensee of responsibility and liability for concept, design and computation in the preparation of such plans and specifications. 3. Licensee agrees that City may enter and utilize the referenced areas at any time for the purpose of installing, repairing, replacing or maintaining improvements to its public facilities or utilities necessary for the health, safety and welfare of the public for any other public purpose. City shall bear no responsibility or liability for any damage or disruption or other adverse consequences resulting from the Encroachment installed by Licensee, but City will make reasonable efforts to minimize such damage. In the event that any 2014 Easement Encroachment Agreement-Commercial Page 2 of 9 installation, reinstallation, relocation or repair of any existing or future utility or improvements owned by, constructed by or on behalf of the public or at public expense is made more costly by virtue of the construction, maintenance or existence of the Encroachment and use, Licensee shall pay to City an additional amount equal to such additional cost as reasonably determined by the Director of Transportation and Public Works or the Director of the Water Department of the City, or his duly authorized representative. 4. In order to defray all costs of inspection and supervision which City has incurred or will incur as a result of the construction, maintenance, inspection or management of the encroachments and uses provided for by this Agreement, Licensee agrees to pay to City at the time this Agreement is requested an application fee in the sum of Three Hundred and Twenty Five Dollars ($325.00). 5. The term of this Agreement shall be for thirty (30) years, commencing on the date this Agreement is executed by the City of Fort Worth. Provided however, this Agreement shall terminate upon the non-compliance of any of the terms of this Agreement by the Licensee. City shall notify Licensee of the non-compliance and if not cured within thirty days this Agreement shall be deemed terminated. 6. It is further understood and agreed upon between the parties hereto that the easements to be used and encroached upon as described herein, are held by City as trustee for the public; that City exercises such powers over the easement as have been delegated to it by the Constitution of the State of Texas or by the Legislature; and that City cannot contract away its duty and its legislative power to control the easement for the use and benefit of the public. It is accordingly agreed that if the governing body of City may at any time during the term hereof determine in its sole discretion to use or cause or permit the right of way to be used for any other public purpose, that does not preclude the use of the Encroachment on the Property for a office building or activities related thereto, 2014 Easement Encroachment Agreement-Commercial Page 3 of 9 including but not being limited to underground, surface of overhead communication, drainage, sanitary sewerage, transmission of natural or electricity, or any other public purpose, whether presently contemplated or not, that the parties agree to negotiate in good faith in order to accommodate the Encroachment and the public purpose. 7. LICENSEE COVENANTS AND AGREES TO INDEMNIFY, AND DOES HEREBY INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES AND ELECTED OFFICIALS FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR PROPERTY DAMAGE OR LOSS AND/OR PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR CHARACTER, ARISING OUT OF OR IN CONNECTION WITH, THE CONSTRUCTION, MAINTENANCE, OCCUPANCY, USE, EXISTENCE OR LOCATION OF SAID ENCROACHMENTS AND USES GRANTED HEREUNDER, WHETHER OR NOT CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE OF OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, LICENSEES, ELECTED OFFICIALS OR INVITEES OF THE CITY; AND LICENSEE HEREBY ASSUMES ALL LIABILITY AND RESPONSIBILITY FOR SUCH CLAIMS OR SUITS. LICENSEE SHALL LIKEWISE ASSUME ALL LIABILITY AND RESPONSIBILITY AND SHALL INDEMNIFY CITY FOR ANY AND ALL INJURY OR DAMAGE TO CITY PROPERTY ARISING OUT OF OR IN CONNECTION WITH THE ENCROACHMENTS AND ANY AND ALL ACTS OR OMISSIONS OF LICENSEE, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS,SUBCONTRACTORS, LICENSEES, OR INVITEES. 8. While this Agreement is in effect, Licensee agrees to furnish City with a Certificate of Insurance, naming City as certificate holder, as proof that it has secured and paid for a policy of public liability insurance covering all public risks related to the proposed use and occupancy of public property as located and described in Exhibit "A". The amounts of such insurance shall be not less than the following: $1,000,000 Commercial General Liability 2014 Easement Encroachment Agreement-Commercial Page 4 of 9 16. Licensee covenants and agrees that it will not assign all or any of its rights, privileges or duties under this contract without the written approval of City Planning and Development Director, and any attempted assignment without such written approval should be void. 17. Any cause of action for breach of this Agreement shall be brought in Tarrant County, Texas. This Agreement shall be governed by the laws of the State of Texas. 18. This agreement shall be binding upon the parties hereto, their successors and assigns. EXECUTED th' day of 20 City Licensee: City of Fort Worth FW Rivercrest Bend, LLC By: By: ( l RZ4andleH wood, Director Name: Michael Dike evelopment Title: Manager ATTEST: Approved As To Form and Legality VORI e City Secretapy tant City Attorney ex "'Pap-� OFFICIAL RECORD 2014 Easement Encroachment Ag ' elor�2Yerci Page 7 of 9 CITY SECRETARY FT. WORTHTX STATE OF TEXAS COUNTY OF TARRANT BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Randle Harwood, known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of the City of Fort Worth, and in the capacity therein stated. /PL-- IVEN UNDER MY HAND AND SEAL OF OFFICE this � Y da of 20 ,,,.�,, '`�„aY Po''. CASSANDRA F. FOREMAN Notary Public,State of texas ,• - My Commission Expires April 26, 2017 Notary Public in and for the State of Texas 2014 Easement Encroachment Agreement-Commercial Page 8 of 9 STATE OF TEXAS § COUNTY OF TARRANT § BEFORE ME, the undersigned authority, a Notary Public in and for the State of Texas, on this day personally appeared Michael Dike, Manager known to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, as the act and deed of FW Rivercrest Bend, LLC, and in the capacity therein stated. GIVEN UNDER MY HAND AND SEAL OF OFFICE this J� day of —, 201(0 . """" JANE EViIN BOUIWARE S`�pY ov'''' =_` °`�,s Notory PUViC,State of Texas N,:G�r, Comm. ExCifEls 10 17.2019 "�''fof'`,�� Notary .v t:�a7�t ete otary Public in and for the State of Texas 2014 Easement Encroachment Agreement-Commercial Page 9 of 9 EXHIBIT "P," WROUGHT IRON FENCE ENCROACHMENT AREA II FIELD NOTES BEING A 131.98 SQUARE FOOT WROUGHT IRON FENCE ENCROACHMENT AREA LOCATED IN THE NATHEN H. CARROLL SURVEY, ABSTRACT No. 264, TARRANT COUNTY, TEXAS AND BEING A PART OF THAT FINAL PLAT FINAL PLAT OF LOTS 1-13, 1X, 2X, 3X, 13X, BLOCK 100; LOTS 1-27, 1X, 2X, 21X, 27X, BLOCK 101; LOTS 1-27, 1X, 22X, BLOCK 102 AS RECORDED UNDER COUNTY CLERK'S FILE No. D215277282 OF THE RIVERCREST ADDITION TO THE CITY OF FT. WORTH AS RECORDED AS BEING A REPLAT OF BLOCKS 100-102, RIVERCREST ADDITION, VOLUME 310, PG. 91, PLAT RECORDS, TARRANT COUNTY, TX AND BEING MORE PARTICULARLY DESCRIBED BY METES AND BOUNDS DESCRIPTION AS FOLLOWS: COMMENCING AT A 1/2" IRON ROD FOUND WITH A YELLOW CAP, SAID IRON ROD BEING IN THE EAST LINE OF REPLAT OF SAID RIVERCREST ADDITION; THENCE N 89'58'51" E A DISTANCE OF 10.17 FEET TO THE POINT OF BEGINNING OF THE HEREIN DESCRIBED WROUGHT IRON FENCE ENCROACHMENT AREA; THENCE N 89'58'51" E A DISTANCE OF 11.87 FEET TO A POINT; THENCE S 32'37'17" E A DISTANCE OF 10.00 FEET TO A POINT; THENCE S 57022'43" W A DISTANCE OF 10.00 FEET TO A POINT; THENCE N 32'37'16" W A DISTANCE OF 16.40 FEET TO THE POINT OF BEGINNING AND HAVING AN AREA OF 131.98 SQUARE FEET, MORE OR LESS. OF T� �P.��G 1� RFO'•.9iP w«rwwwwwww...w-.w.L... CHRISTOPHER K.BRADLEY < ' 0 5251 Y 9 •'9�F �P�•� �,O'••..�SS�O•: �O SURA x . � 1 7 6 5 4 I 3 2 t BER ®v.. pLOCK B BDR 8CR8EIR a:�18:Ti 7'41.37 Au SCALE 1"=200' \ \ 13 12 r 11 10 9 e 7 85 • 3 �` \ L SEE DETAIL FOR ___� 1100` .m AREA II l ., :. - - _. - COTT ROAD -�- Ac T.C.W.C.A I.D.NUT !- I ,^ Y t LINE TABLE VOL.IOM,FO.6% 1 27 t I y� AREA x DT.c.T. 27 26 25 24 23 ' - fLINE BEARING DISTANCE 2 L1 N 22'09'25'W 42.83' RIVERCREST ADDITION , a , L2 s5W2f942•E 243.87 COUNTY CLERK'S FILE No.D215277282 3 L3 N 74.43'15'W 105.45 ,L4 N 56'13'08'W 108.27 _ W 101 ' AN ADDITION TO CRY OF FORT WORTH, 2t I r3"'7 r a i TARRANT COUNTY,TEXAS � � _4 I r r LINE TABLE 5AREA II DETAIL a�� + 1n I LINE BEi4RING DISTANCE AREA II Nc HorR L1 N89'S6'S1'E 10.1r L2 N 89.58'51'E 11.87'POINT OF N.T.S. to 00 6 L3 s 3237-17-E low COMMENCING L4 s5rz2'a3^w 110.01Y AREA II _ 1 7- 7 L5 N 32.37-16•W 113-AVj V'IRON ROD W/ I� 1 18 a tz 4 YELLOW CAP,/' � �1B II t 15 6 �p L1 14 13 4: POINT OF \ •131.98$Q.FT. 17 t0 BEGINNING y + Y T.C.W.C.a LD.No,1 16 �- VOL.4031.PG 294 D.F-T.C.T. 15 NATHAN H -F XL URK ABSTRAC'N° +61 _ t� 13 12 11 901 POINT OF 0.1 13ACRES BEGINNING AREA I •J 1Ce2ae w e"°61 Sig'IRON ROD DA.T.C.T. s �• '-Ip WROUGHT MON FENCE, WROUGHT MOM AREAE ENCROACHMENT AREA R ENCROACHMENT AREA I '" T,C.W.C.a I.D.11 VOL 4039.M l70 A FIEND MOTES FIELD NOTES DA.T.C.T..T. BEING A0.113 ACRE WROUGHT MON FENCE ENCROACHMENTAREA LOCATED IN THE BRITTON O. BEING A131.98 SQUARE FOOT WROUGHT IRON FENCE ENCROACHMENT AREA LOCATED IN ALFORD SURVEY ABSTRACT No 37 AND THE NATHRN H.CARROLL SURVEY,ABSTRACT No.261, THE BRITTON D.ALFORD SURVEY ABSTRACT No.37 AND THE NATHEN H.CARROLL SURVEY, TARRANT COUNTY,TEXAS AND BEING A PMR T OF THAT FINAL AT HIM KAT OLOTS 1 13,lA, ABSTRACT Mo.261,TARRANT COUNTY,TEXAS AND BEING A PMT O K THAT FINAL AT A 3X,13X,NODAL IOD.LOS 1.27,IX.ZX,Z1;27X,NOCK 101;LOTS 1-27,1X,22X.NOU 102 FINAL PUT O LOTS 1.13.IX.2K,3X,1310 NOCK IDD;LOTS 1.27,IX,ZX,21X,2M BLOCK AS RECORDED UNDER COUNTY CLEWS FILE No.D215277282 OF THE RNEEICRFST ADDITION TO 101;LOTS 1-27.IX,22X.NOCK 102 AS RECORDED UNDER COUNTY CLERKS FILE No, THE CRT O R.WORTH/SRECORDED AS N9W A REPLAY OF N006100.102,MVIERCREST 021S277292OTHERIVERCRESTAD01TK7NTOTHEOTYOFT WORTH AS RECORDED AS ADDITION,VOLUME 310,PG,91,PUT RECORDS,TARRANT COUNTY,U AND BEING MORE BEING A REPLAT OF 81000 IM 102,RNU ERCREST ADDITION,VOLUME 310.PG.91.PT PARTICULARLY OESCRIBED BY METES AND BOUNDS DESCRIPTION AS FOLLOWS: RECORDS,TARRANT COUNTY.TX AND OEM MORE PARTICULARLY DESCRIBED BY METES AND BOUNDS DESCRIPTION AS FOLLOWS. BEGINNING AT A S/r BION ROO FOUND,SAID IRON ROD BEING THE SOUTHEAST CORNER O COMMENDING AT A l/2'IRON ROD FOUND MTN A YELLOW CMID,SAIRON ROD BEING N REPLAY OF SAID RIVE�4ST ADOTION; THE EAST LINE DE REPLAY OF SMD NVECREST ADDITION; THE NCE N 22T29'2V W A DISTANCE O/2.53 FEET TO A PONT; THENCE NKTSI'E A DISTANCE O 10.17 FEET TO THE POW O BEGINNING O THE EXHIBIT IEBFE HEREIN DESCRIBED WROUGHT NOW FENCE ENCROACHMENT AREA; THENDE S Si 7P12'E A DISTANCE O 243-M FEET TO A PONT; THENCE N"*59'51"E A DISTANCE O 11.87 FEET TO A PONT; THENCE N 7/43'IS'W A DISTANCE O 105.48 FEET TO A POINT; THENCE 5379717'EA DISTANCEOI0.00 FEET TOA101NT; EXHIBIT SHOWING TWO THENot N 56'S3'Or W A DISTANCE O 108.22 FEET TO THE POO NT BEGINNING AND CONTAINING 0.113 ACRES DE LAND,MORE OR LESS. THENCE S 57.22'43'W A DISTANCE OF 10.00 FEET TO A POINT; THENCE N 37'3716'W ADISTANCE O 16.10 FEET TO THE PONT OF BEGINNING AMO WROUGHT IRON FENCE HAVING AN MEAD 131.98 SQUARE FEET,MON OR LESS I hereby state that Oils survey was made on the ground of the property legally described hereon. ENCROACHMENT AREAS I & 11 end is to the beet of my knowledge correct,and that there are no discrepancies,conflicts,shortages In area. LOCATED I N T H E boundary line conflicts,encroachments,overlapping of improveme s,easements or hta of way,except as shown hereon.Surveyed Apd,2016. (� „O F B R ITTO N D. ALFORD 1 �P:••''�srE,�• 9 , �, ;eL` o'•. N SURVEY A-37 & THE CMPoaTOPMER KelIY IIRADLEYRPLS 85251 ••••••••.••••••••••••••••••••••••••••••••••N•••••••• NATHAN H. CARROLL REFERENCE DATUM CHRISTOPHER KI NNY BRADLEY ............................P:....�... SURVEY A-264 1.Baerase Dile of TNM Coordinates a nt Mown hereon 91e referaced n III to Qa Telae Coadnet9 Sy9Wn d 1963.Noah Central Zane OrlO and based on Ut9 North AlMrken DeOUR d 1983. 5251 �: 9tia•�FSS>�•'�0 0�f/�"/v SUR14 FORT WORTH SURVEYING 107 E.COLLEGE AVE ALVARADO TEXAS76009 ,817-790-5900 JOB## 2013119 DATE: 04-15-16 DRAWN: CGH CHECKED: CKB FIRM NO.100784-00 c e® v® CERTIFICATE OF LIABILITY INSURANCE °A' °"'"'I' 12/188 12010014 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. rf 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 CONTACT NAME: Legacy Texas Insurance Services PHONE -- — - — FAX - 707 E.Arapaho Rd. lac.No Exu:972-461-7300 _ Arc Suite 200 ADDREssi I ne �nklc � Richardson TX 75081 INSURE S AFFORDING COVERAGE NAICtr __—_-- IHSURERA: 'f�_,ontlnent_GSsLO �j'IijZDy _ 23418._._ INSURED JAMESO4 INSURER a-Texas Mutual Insurance GoMp James R.Harris Partners, LLC INSURER C: INSURER D: 2929 W. 5th Street, Ste.A Fort Worth TX 76107 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:320519040 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 I TYPE OF INSURANCE POLICYNUMBER PMOLICYEFF POLaEXP LTR rI LVMTS A GENERALLIABILITY 4G�901346511412014 114/2015 EACHOCCURRENCE $1000,000 x COMMERCIAL GENERA._UAB,LITY PREMISES ce� ;100,000 CLAIMS-6IADE T1 OCCUR MEDEXP(Arty oneperson) $Excluded PERSONAL 6 ADV INJURY $1 ODO 000 GENERAL AGGREGATE $2 000 ODO GENT AGGREGATE LIMIT APPUES PER PRODUCTS-COMPIOP AGE; $2,000 ODO POCKY x I PRO- LCC 3 AUTOMOBILE UABILITY Ea aorident S ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per socldent) $ r AUTOS AUTOS NON4YAMD PROPERTY DAMAGE HIRED AUTOS ALITOS Per $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION S B WORKERS COMPENSATION 8P0001187756 /25/2014 125!2015 WC STATU- I OTH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORA'ARTNER/EXECUTIVE F'� NIA E,L.EACH ACCIDENT $500,000 OFFICERIMEMSER EXCLUOE07 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes descrDe OF O' DESG�RIPiION OPERATIONS below � E.L DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,AddVJonal Remarks Schedu)A,If more apace Is required) Certificate holder is listed as additional insured in re:FW Rivercrest Bend and on FW Rivercrest Bluffs. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Fort Worth ACCORDANCE WITH THE POLICY PROVISIONS. 1000 Trockmorton St Fort Worth TX 76102 AUWOFNZEO REPRESIMITATIVE EAwfi,Q`,c✓L� ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD