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HomeMy WebLinkAboutAvery Associates tia AGREEMENT THIS AGREEMENT is made and entered into on the 26th day of August, 2014 by and between the TOWN OF LOS ALTOS HILLS (hereinafter referred to as "TOWN") and Avery Associates, 3 1/2 N. Santa Cruz Ave., Suite A Los Gatos, CA 95030 (hereinafter referred to as "CONTRACTOR"). In consideration of their mutual covenants, the parties hereto agree as follows: 1. CONTRACTOR. Shall provide or furnish the following specified services and/or materials: Professional executive recruiting services for Town of Los Altos Hills Planning Director 2. EXHIBITS. The following attached exhibits are hereby incorporated into and made a part of this Agreement: Proposal from CONTRACTOR dated July 23, 2014 Scope of Work from Contractor: Attachment "A" 3. TERMS. The services and/or materials furnished under this Agreement shall commence August 25, 2014 and shall be completed by December 8, 2014, unless terminated pursuant to Section 5(f). 4. COMPENSATION. For the full performance of this Agreement: a. TOWN shall pay CONTRACTOR a consulting fee in an amount not to exceed sixteen thousand, four hundred dollars and zero cents ($16,400.00) within thirty (30) days following receipt of invoice and completion/delivery of services/goods as detailed in Sections 1, 2, and 3 of this Agreement and only upon satisfactory delivery/completion of goods/services in a manner consistent with professional/industry standards for the area in which CONTRACTOR operates. TOWN is not responsible for paying for any work done by CONTRACTOR or any subcontractor above and beyond the not to exceed amount. b. Town shall reimburse for CONTRACTOR's normal and direct costs or expenses to deliver any services/goods in a not-to-exceed amount of $3,000 and only with the prior written express consent of the Town. Town shall not be responsible for any interest or late charges on any payments from Town to CONTRACTOR. c. CONTRACTOR is responsible for monitoring its own forces/employees/agents/ subcontractors to ensure delivery of goods/services within the terms of this Agreement. TOWN will not accept or compensate CONTRACTOR for incomplete goods/services. Town of Los Altos Hills Page 1 of 4 Sheet form Updated 423MG v 5. GENERAL TERMS AND CONDITIONS. a. HOLD HARMLESS. CONTRACTOR agrees to indemnify, defend and hold harmless the TOWN, its officers, agents and employees from any and all demands, claims or liability of personal injury (including death) and property damage of any nature, caused by or arising out of the performance of CONTRACTOR under this Agreement. With regard to CONTRACTOR'S work product, CONTRACTOR agrees to indemnify, defend and hold harmless the TOWN, its officers, agents and employees from any and all demands, claims or liability of any nature to the extent caused by the negligent performance of CONTRACTOR under this Agreement. b. INSURANCE. CONTRACTOR shall file with the TOWN a certificate of insurance before commencing any services under this Agreement as follows: i. WORKERS COMPENSATION INSURANCE: Minimum statutory limits. ii. COMMERCIAL GENERAL LIABILITY AND PROPERTY DAMAGE INSURANCE: General Liability and Property Damage Combined. $1,000,000.00 per occurrence including comprehensive form, personal injury, broad form personal damage, contractual and premises/operation, all on an occurrence basis. If an aggregate limit exists, it shall apply separately or be no less than two (2) times the occurrence limit. iii. AUTOMOBILE INSURANCE: $1,000,000.00 per occurrence. iv. ERRORS AND OMISSIONS INSURANCE: $1,000,000.00 aggregate. v. NOTICE OF CANCELLATION: The City requires 30 days written notice of cancellation. Additionally, the notice statement on the certificate should not include the wording "endeavor to" or "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives." vi. CERTIFICATE OF INSURANCE: Prior to commencement of services, evidence of insurance coverage must be shown by a properly executed certificate of insurance and it shall name "The Town of Los Altos Hills, its elective and appointed officers, employees, and volunteers" as additional insureds. vii. To prevent delay and ensure compliance with this Agreement, the insurance certificates and endorsements must be submitted to: Town of Los Altos Hills 26379 Fremont Road Los Altos Hills, CA 94022 Town of Los Altos Hills Page 2 of 4 Short norm Updated 4/231+0 V 1110 c. NON-DISCRIMINATION. No discrimination shall be made in the employment of persons under this Agreement because of the race, color, national origin, age, ancestry, religion or sex of such person. d. INTEREST OF CONTRACTOR. It is understood and agreed that this Agreement is not a contract of employment and does not create an employer-employee relationship between the TOWN and CONTRACTOR. At all times CONTRACTOR shall be an independent contractor and CONTRACTOR is not authorized to bind the TOWN to any contracts or other obligations without the express written consent of the TOWN. In executing this Agreement, CONTRACTOR certifies that no one who has or will have any financial interest under this Agreement is an officer or employee of TOWN. e. CHANGES. This Agreement shall not be assigned or transferred without advance written consent of the TOWN. No changes or variations of any kind are authorized without the written consent of the City Manager. This Agreement may only be amended by a written instrument signed by both parties. f. TERMINATION. This Agreement may be terminated by TOWN upon seven (7) days written notice to CONTRACTOR. Monies owed for work satisfactorily completed shall be paid to CONTRACTOR within 14 days of termination. g. RECORDS. All reports, data, maps, models, charts, studies, surveys, calculations, photographs, memoranda, plans, studies, specifications, records, files, or any other documents or materials, in electronic or any other form, that are prepared or obtained pursuant to this Agreement and that relate to the matters covered hereunder shall be the property of the TOWN. CONTRACTOR hereby agrees to deliver those documents to the TOWN at any time upon demand of the TOWN. It is understood and agreed that the documents and other materials, including but not limited to those described above, prepared pursuant to this Agreement are prepared specifically for the TOWN and are not necessarily suitable for any future or other use. Failure by CONTRACTOR to deliver these documents to the TOWN within a reasonable time period or as specified by the TOWN shall be a material breach of this Agreement. TOWN and CONTRACTOR agree that until final approval by TOWN, all data, plans, specifications, reports and other documents are preliminary drafts not kept by the TOWN in the ordinary course of business and will not be disclosed to third parties without prior written consent of both parties. All work products submitted to the TOWN pursuant to this Agreement shall be deemed a "work for hire." Upon submission of any work for hire pursuant to this Agreement, and acceptance by the TOWN as complete, non-exclusive title to copyright of said work for hire shall transfer to the TOWN. The compensation recited in Section 4 shall be deemed to be sufficient consideration for said transfer of copyright. CONTRACTOR retains the right to use any project records, documents and materials for marketing of their professional services. Town of Los Altos Hills Page 3 of 4 Shod form Updated 4/23/+0 V h. ENTIRE AGREEMENT. This Agreement represents the entire agreement between the Parties. Any ambiguities or disputed terms between this Agreement and any attached Exhibits shall be interpreted according to the language in this Agreement and not the Exhibits. 6. INVOICING. Send all invoices to the contract coordinator at the address below. This Agreement shall become effective upon its approval and execution by TOWN. In witness whereof, the parties have executed this Agreement the day and year first written above. CONTRACT COORDINATOR and representative for TOWN: CONTRACTOR: Carl Cahill City Manager ���� !� Town of Los Altos Hills By: t J u/y 26379 Fremont Road S ature Date Los Altos Hills, CA 94022 /' KtI nlCiPAt- Print name, Title TOWN OF LOS ALTOSnHILLS:IL By: S onV enLa �Iq Carl Cahill, City Manager Dat Town of Los Altos Hills Page 4 of 4 Short form Updated 0/33/10 Attachment A AVERY I sits Los Gatos ♦ San Luis Obispo July 23, 2014 Carl Cahill Town of Los Altos Hills 26379 Fremont Road Los Altos Hills, CA 94022 Dear Mr. Cahill: Thank you for the opportunity to be considered for the recruitment of your new Planning Director for the Town of Los Altos Hills. We value our past working relationship with the Town and would look forward to working with you and the Town again in this assignment. Our firm is well qualified to support you in this assignment based on our extensive public sector experience and relevant expertise in Planning and Community Development related recruitments. Currently, we are conducting searches for a Community Development Director for the City of Paso Robles, a Economic/Community Development Director and Chief Building Official for the City of South San Francisco. We also recently completed a Planning Director search for Calaveras County and an Assistant Community Development Director search for Camarillo. Additionally, during the past 18 months, we completed Community Development Director recruitments for the cities of Santa Clarita, West Hollywood and Stockton. In the past several years we also completed the following assignments: CDD for the cities of Redwood City(2011), San Mateo (2009), Oakland (Deputy Director of Community Development/Housing, 2009) and the Town of Los Gatos (2009). These collective assignments have provided us with an extensive and current database of candidates and statewide personnel, which would be of great benefit to your city in this assignment. Following your review of this proposal, it is our hope that our recruitment expertise, our positive history with the Town, and our commitment to quality and service will provide the basis for positive consideration of our firm. Enclosed you will find the following information: The enclosed proposal contains the following information: • Company Profile • Firm Qualifications • Recruitment Team • Recruitment Plan William Avery&Associates,Inc. Labor Relations/Executive Search 3-1/2 N.Santa Cruz Ave.,Suite A Los Gatos,CA 95030 408 399.4424 Fax:408.399.4423 www.averyassoc.net • Client References • Consulting Fee • Guarantees& Ethics • Profiles on Principals of the Firm • Recruitment Timeline Once again, thank you for the opportunity to submit a proposal to assist with your recruitment. If you have any questions,please do not hesitate to call me at 408-399-4424. Sincerely, Paul Kimura PK:jmc V PROPOSAL FOR THE TOWN OF LOS ALTOS HILLS FOR THE PLANNING DIRECTOR William Avery& Associates, Inc. — Our Profile William Avery & Associates, Inc. (Avery Associates) is a successful and service focused Management Consulting firm based in Los Gatos, California. Incorporated in 1982, the firm specializes in Executive Search, Labor Relations and Human Resources/Management Consulting. The firm currently includes two Principals and several key consultants. Bill Avery, the founder of Avery Associates, heads the firm. He oversees the Labor Relations practice and also leads key searches. Paul Kimura is the Principal who oversees the Executive Search and Recruitment practice. Key staff members include Cris Piasecki, who supports the search practice and the firm's administrative staff includes Anne Matteini, the Finance/Contracts Administrator, and Jackie Collins and Jessica Towner. Temporary staff as needed augments the team. Mr. Avery, having served in the past as a City Manager, provides the firm with direct experience and knowledge of city administration. Mr. Kimura's expertise in executive, technical and business recruitment, which he gained during his nineteen years of high technology experience, provides the basis for many of the recruitment strategies and tactics utilized by the firm. Collectively and combined, the firms Principals offer exceptional expertise in the area of public sector recruitment and consulting. Their professional profiles are enclosed as part of this proposal. Firm Qualifications — What Differentiates Avery Associates Exceptional service delivery and a very high quality work product provide excellent results for our clients. This begins with the initial client meetings, which lead to detailed timelines for deliverables followed by weekly recruitment status updates following initiation of the search. Our candidate outreach efforts are professionally and confidentially conducted. The evaluation materials we provide clients are routinely characterized as accurate, comprehensive and of very high quality. We believe more so than any other public sector recruitment firm. This is largely based on our interview system utilizing behavioral interview techniques. This leads to a quality product with excellent end results for our clients. The service element is based on two factors: The first is the collective service philosophy from all of our organizational team members. They are each dedicated to providing service and support to clients. The second factor is based on the high level of engagement and participation from the firm Principals in every search assignment. This hands-on involvement includes client interface, identifying and developing the ideal candidate profile and position specification, development of the search strategy, candidate outreach, interviewing and assessment, completion 1 V of reference interviews, candidate presentation, final interview facilitation and when desired, negotiation of employment terms with the successful candidate. Recruitment Team for the Town of Los Altos Hills Paul Kimura will serve as the Principal in charge of this project and will be support by Cris Piasecki. Mr. Kimura will be personally involved in client interface, development of search strategy, outreach, interview and assessment of candidates and will be available throughout the search process to provide other related consulting services. Recruitment Plan and Services Provided I. Position Profile and Organizational Assessment The initial assessment phase is a critical component of the search process. Mr. Kimura will meet with the key decision makers to discuss the organizational needs and position requirements. Our goal for this aspect of the recruitment process is to: • Understand the Town and departmental priorities for this position. • Develop a clear understanding and consensus on the expertise, experience, education, performance attributes, interpersonal skills and operational style of the ideal candidate. • Discuss the goals, objectives,deliverables, and challenges related to this position. • Gain insight of the various organizational dynamics and departmental issues that exist within the organization. • Identify the compelling aspects to this opportunity. We would welcome the opportunity to have other discussions with various key staff as appropriate. Based on these discussions, a candidate profile and a final recruitment strategy will be presented for final approval. The ideal candidate profile would be incorporated into the formal position announcement. The candidate profile is also utilized in various other means as a marketing tool, an advertising copy, and for other announcements. II. Development of the Search Strategy and Advertising The search strategy is developed in conjunction with the organizational assessment. The final approach is based on your input and considerations during the assessment activity. !a 2 V (11.0 For this assignment, we feel it is critical to develop a high level of visibility with a comprehensive outreach program supplemented by a focused targeted recruitment approach. We would incorporate the following elements into this search: • Development of a targeted candidate list based on our current and extensive contacts in the development services field from our recruitment database. This list will expand through the course of outreach through phone contacts, referrals and recommendations from key sources and other current and former planning and/or building personnel who have extensive contacts and networks in this area. • Contacting current Chief Building Officials, Community Development Directors and Planning executives in comparable agencies that may be interested or aware of potential candidates. This effort will mainly be geared toward identifying individuals who meet the profile of the ideal candidate but are not actively seeking other employment. • Internet job postings on state or national public sector employment bulletin boards including CALBO, APA, CALAPA and possibly Planning and Building associations in specific and/or selected western states. It will also be posted on our company website(www.averyassoc.net). • Distribution of the comprehensive position announcement to various city, county, and state departments, as well as agencies throughout the state and country. • Print advertising in Western City(if timing permits) and Jobs Available. III. Candidate Assessment Our assessment process involves several "tiers" of evaluation. All candidates responding to this position will initially, be evaluated based on their resume and if appropriate, an extensive phone "screening" by a firm Consultant. Candidates who pass the initial "qualifying"criteria are then scheduled for a formal interview with the Principal in charge of the project. These extended personal interviews typically take one hour and a thorough discussion of their experience, accomplishments, management philosophy and interpersonal style takes place. In interviewing candidates, we utilize a methodology based on "behavioral" interview techniques. Fundamentally, this approach explores a candidate's past accomplishments and experiences. The philosophy here is that the best indicator of future performance is assessing past behavior. This methodology allows the firm to "project" how a candidate would approach and address challenges in the new position. 3 4 Those individuals who best fit the position requirements will have a Candidate Assessment Report developed by the Principal who conducted the interview. Additionally, two initial reference interviews are performed on these candidates. The reference interviews provide our clients with additional insights on the candidate's "behavior" and style. IV. Candidate Presentation Upon completion of formal interviews and initial reference interviews, a selection of candidates for presentation is made. Typically, the number of final candidates requested by our clients range from five to seven. We feel our extensive screening, interview, and reference process; combined with the knowledge gained during our initial assessment period, enable our client to proceed with fewer rather than more finalists. The final candidates are presented in our candidate presentation "book." Each finalist will have a file consisting of a candidate summary sheet, a resume, the Candidate Assessment Report(based on the formal interview), and candidate reference reports. V. Selection Process Once the final candidate interview group is identified, we will assist in the structuring of the interview process and coordinate the interview scheduling activity. Our firm will also provide candidates with guidance related to travel planning, hotel accommodations, as well as other interview planning issues. Upon request, our firm will also arrange for summary background evaluations on the Town's final one or two candidates. A copy of these confidential reports can be provided for you. VI Recruitment Closure and Follow-Up Based on the firm's experience in human resource management and executive search, we are able to assist our clients in the formulation of appropriate compensation and other employment arrangements. We will be available throughout our retention to assist in this process. As a matter of policy, Avery Associates monitors the transition and progress of any executive we place with a client. Within the first three to six months after the Town has hired the individual, we will speak with that individual to ensure that an effective transition has occurred. During the same period, we will also review the individual's status with your office. 4 References I. City of Culver City Serena Wright, Personnel Director; 310.253.5640 II. City of Santa Clarita Ken Striplin, City Manager; 661.255.4905 III. Town of Los Gatos Joe Pirzynski, Council Member; 408.356.3024 Greg Larson,Town Manager;408.354.6837 IV. City of Redwood City Bill Ekem,Assistant City Manager; 650.780.7380 Consulting Fee Based on the services described in our proposal, the professional services consulting fee for this recruitment will be$16,400. If awarded the search, we would request an initial retainer of$6,400 at the outset of the search. A second invoice of$5,000 would be submitted upon the Clients acceptance of a finalist candidate group. The final balance of$5,000 would be invoiced upon acceptance of a job offer constituting completion of the search. Our invoicing models ensures the fine will remain totally committed to the Town throughout the duration of the search as the final invoice is not submitted until the Town has an accepted candidate. The consulting fee will be inclusive of all services defined within this proposal unless otherwise stated. In addition to the Professional Services Fee,normal and direct out-of-pocket expenses associated with the search are charged back to the client. Expenses for this assignment would be a not-to-exceed amount of $3,000 without the express consent of the Town. These expenses include: advertising, clerical time, supplies,printing, telephone,postage, summary background evaluations, and consultant travel for client discussions,meetings and local or out-of-area candidate interviews.All expense items will be detailed and billed on a monthly basis. Guarantees and Ethics Whenever William Avery & Associates, Inc. is retained; we make several guarantees and commitments to a client. Due to our experience, knowledge and success within the management consulting field, we assure a client that we will only present candidates who meet a substantial majority of the ideal qualifications that you have outlined. We are also committed to continue our search efforts until a successful candidate is employed. It is also our practice to replace a candidate who may voluntarily resign during the first year of his/her employment. This same commitment applies if the client finds it necessary to terminate 5 or to request the resignation of the selected individual in the first year for any reason. In either case, we invoice a client only for out-of-pocket expenses incurred in identifying a replacement. 6 CPO• Avery Profile William Avery William Avery founded his successful management consulting firm in 1981. He has directed William Avery & Associates in service as a Labor Relations and Executive Search consultancy, serving personally as a chief negotiator, trainer, and representative in grievance and disciplinary matters. A specialist and widely recognized expert in employer-employee relations, he has served as a City Manager (Los Gatos) and Assistant City Manager. While City Manager, he was President of the Santa Clara County City Manager's Association and Chair of the County Employee Relations Service. Bill has lectured at De Anza College, San Jose State University, and Stanford University, and regularly makes presentations for the League of California Cities, CALPELRA, and other public sector organizations. Building on his personal track record of success, he expanded the firm's focus to include increased emphasis on public and private sector search. He added proven industry professionals with expertise in these areas. The result has been to create an exceptionally strong management consulting firm, now known as Avery Associates, with the expertise to provide the full range of services required for successful public or private sector executive search. A key measure of the firm's success has been the many long-term relationships that he and his staff have established with clients. Bill holds B.A. in Political Science and an MPA from San Jose State University, where he was graduated with highest honors. 7 S Avery Profile Paul Kimura Paul Kimura brings a unique combination of recruitment and business experience to Avery clients. Paul is involved in leading Avery's public sector professional searches. He has been both a corporate recruitment director and HR director for a number of high technology companies, ranging from Fortune 500 firms such as Novell and National Semiconductor to a Silicon Valley start-up. His proven recruitment and HR generalist skills help him bring forward the best available candidates and properly assess their skills and"fit"with client organizations. Indeed, many of the recruitment strategies and tactics incorporated into the Avery search process are a direct result of Paul's extensive recruitment experience in the high technology industry. Paul has been a successful HR consultant, guiding clients through all aspects of Human Resources functions — compensation & benefits, employee and management training, performance management, and termination issues. He is skilled in areas such as strategic planning, executive coaching, separation negotiation, and organizational assessment and design. It's another service that Avery Associates is able to offer its clients because of the unique background of its principals — and Paul's extended skill set in Human Resources underscores the fact that Avery professionals "have been there" and understand your needs from a personal perspective. Paul holds a B.S. degree in Business Administration from San Jose State University. He is active in professional HR organizations and in the community, where he has worked with a number of education, youth service, civic, business, and cultural organizations. "Just as Avery looks to form long-lasting relationships with its clients, I believe in making the same commitments within my community." 8 40 IS el 00 \ 2 yo — 4 = 4.4 H -) \ \ ) N N 5 \ ,--i/ \ CN 0 e _ 'C O H i , C.—.) / / / eel ) \ o g \ •— § <0 0.0k _ 3 ) \ ± , ) ! ) ` f \ � , \ E tj ) ) \ f ; I ` ] § { i ® { 0 ; ( kN \ u ° / t \ \ { ) ) - , ~ / } j ) ] . , ) ; ! ] I rx o ° / 2 4 Q ACOREP CERTIFICATE OF LIABILITY INSURANCE p09/1812014n 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 policylies)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). PRGOUCER JOE FRANGIEH CONTACT ME Camille Cowley 120 W CAMPBELL AVE STE A vvcNENo Ew 409 T93 8303 _... _Svc Noll4018793-8304 MAIL 5tateFarm CAMPBELL,CA 95008 ADDRESS.coni Ile.cOWley ks a@statefar con, _f �j IxSU 1 IAFFORDING.COVERAGE _ NIAIC CINSURER A Slab Farm Gl Ince Cpany _-. 25151 INSURE° WILLIAM AVERY&ASSOCIATES INC INSURERO.• . 3 1/2 N SANTA CRUZ AVE INSURER C. LOS GATOS CA 95030-5964 INSURER p-. _ INSURER F' INSURER F; COVERAGES CERTIFICATE NUMBER: 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. 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PRODUCTS P AGG 5 _ 4,000,000 I—/ I—PRO- T Business Property 3 141,200 POLICY !L¢ lEa Los cL AUTOMOBILE LIABILITY L JIr, 2426983-A01-CSG 07/01I2014 01/0112015 3 1.000,000 X ANY AUTO r • Juror INJURY(Po Pomn '5 ALL OWNED AUTOS enl5 NOD PROPERTYDAMAGE 'ENDO AUTOSAUTOS s l _ — • UMBRELLA UAB OCCUR II II " EACH OCCURRENCE 5 • EXCESS LIAR CLAIMS-MADE AGGREGATE E _ RETENTIONS $ NDE OMP'LSP TR-: W U. A EMPLOYERS' ARTN R ! '_. E RACCID _ER.. I OFYCE/MEMBER EXCLUDED-, ��'x A EL EACHACCIDENT 5 OFFICE/MEMBER In NR E%CW OED/ $ II yes, In NH) • EL DISEASE-EP EMPLOYEEIMIT $ _ orlfRIPTInNOE OPPRATINS nrnw EL DISEASE POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101.Additional Remade Schedule,If mare specs Is required) Description Of Operations:Recruitment Services CERTIFICATE HOLDER CANCELLATION City of Los Altos Hills SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 26379 Fremont Road ACCORDANCE WITH THE POLICY PROVISIONS. Los Altos Hills,CA 94022 AUTHORISED REPRESENTATIVE nOIYs.911.11 W oamlllo�Lwy Camille Cowley am o,.INh,le=:zt gym:='''. I ©1980-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1001486 132849.8 01-23-2013