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Building Permit #582-11 - 98 MIFFLIN DRIVE 3/2/2011
TOWN OF NORTH ANDOVER �� Z PPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: -Z — IMPORTANT:Applicant must complete all items on this page LOCATIONrmt O PROPERTY OWNER T 117Ot l�s A661SC171 Print MAP NO: _PARCEL: S ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 2 ne family ❑Addition ❑Two or more family ❑ Industrial O'�Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other TSeptic [7 yVe11 f7 Floodplain ❑ Wetlands . tshediDistnct OW, DESCRIPTION OF WORK TO BE PERFORMED: /1/0 STi2Uc Tyi}L Identification Please Type or Print Clearly) T/47� OWNER: Name: 0/s?{�.S /`�G-�!/�S`C7�{ Phone: Address: 96P 1771. r��Z/'1211,�� 121, CONTRACTOR Name: .�y��/�� /�l�T/ Phone: Address:S7V /YET yeeW&I �/ �l�Gr/ �n/��i � ��g�3 Supervisor's Construction License: �JExp. Date: /cam /-?/0?0 Home Improvement License: ZOrQ9 Exp. Date: © ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ /J. 7- D, FEE: Check No.: Receipt No.: NOTE: Persofs contracting with unregistered contractors do not have access to the guaranty fund Signature_of�Agent/Owner r Signatufe of.contractor Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit .n all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals hat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording oust be submitted with the building application Doe: Doe.Building Permit Revised 2008mi Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑. Stamped Paans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Swimming Pools .Q Tanning/Massage/Body Art ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U'FORM ^ DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: ,, - Located 384 Osgood S+eet FIRE DEPARTMENT -'Te'mp Dumpster on site yes no r/ Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— For department use Notified for pickup - Date Doc:.Building Permit Revised 2008 Location �C/ �/ No. '2' Date NORTH TOWN OF NORTH ANDOVER L a y Certificate of Occupancy $ J4�N�5 Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # food 2 51 --y Building Inspector OR Town of Andover No. = AK o dover, Mass., COCHICHEWICK V�. 7� ADRATED PP� y `S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System I _ W. BUILDING INSPECTOR THIS CERTIFIES THAT....�.... o. .......... ..... C.U.S G` ......................................... ............. Foundation has permission to erect..... buildings on .A& Rough ........ ............................................ ......v..- to be occupied as 1-�r/4T.!'1ro.4!l..........� o � ..... Chimney ............ ........ ................................................................................................. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRtJCTIO TS ELECTRICAL INSPECTOR Rough ................... ......................................... ..... .... ..... .. Service .. .. .... .......... .... .... ....... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. CONTRACTORS COPY i SID►E1;iTIAi,CONTRACTING AGREEMENT R s a emtwand-make sure yvu gnd�rstand it be ore signing it.This Agreement has legal eec�bads dose who sign it. e provenHai general contractors and subcontractors engaged in home improvement ctutg fly ecempt£rota registration by provisions of Chapter442;i c�f.. e Aft"laws;nk be registered with the Commonwealth a€hiassachuse is Int}oiries Gb it tray aad status std be made the hector,Dome lmiprovement Contract Registraticm, .. : . t s top,Puce,Rook 131€1 l osto�1vtA 0210$. . Dent ed g�sttant's Name Rog&L Raft',Inc. $440 ji's-Name Joseph R Raft' Rett`Number: 100294 Licewe N mbex:U15Q04 s .j eixt nseon February 2$,20I 1 between Roger J.Rahe',Inc. 3 # 7oseph Rahe',Inc:0€340 Mt.Vernon Street F awrenc6;MA 01843 Ph.(978499 8839 he et itattYet called`°Contractor"arid.Tom Reusch of 98 Mifflin Drive North Andover,I�A 1345 I�`h t9�8}j6$2-027 here�na8er called"owner".. I DET LE 3 DESCIZIP'IT6i�T Ol �VOItk- TO Bl PERFORMEI3 tractor agrees`to`perform m a good and workmanlike:manner all work detatlec Gelb Such wore: silts bf the foliowittg Remodel liathroorit as peF.attached specific ions antl allowattces: 13ET' LEA DESCktPTTf1N OFMA_ RL&LS T(3 EE USED 14afer' sci be `in perorinmg Hie ave destn"bed work consist of the following: As per aec1 specificatioins aricl allowaIIces: II PRIG$ Gbdtaetor:a�grees.to.do described in S€coon I for the total price of:$13,750.00 Tmrtethptsancf seven hundred fifty dollars: ITII7lN CONDITIONS kIVI)NECESSARY ADT3ITIONAL WORK ITf eons or addttonal work may require adJustmenit to tla overall pace for th$necessary weTato tlxs : lash casee Contactor s m€orin the homeowner ofd coittore formes and wTiere necessa#y a wriften amendt�ant bfthis C,�ntract will 6e megtntated ate execby the_Parties:_Additonalveak b-—on the scope oI rias contract witlbe billed at an lio>ir�y rate of5�f0 peX man hour for earpent +acrd$85 00 penman hour forplrmg Ac arial'mateiisl and subcoatract:woi will be.Iiilled at aurcet phis a 25%General Contracting€ee (978) 68:8-8831 10 Maui Street,Suite #2 North.Andover,MA 01845 Fax (978) 688-7476 III. PAYMENT Payment will be made as follows: $ 3,000.00 Deposit with signed contract $ 5,000.00 Completion of rough inspections $ 3,000.00 Completion of interior trim. $ 2,750.00 Completion of job as per specifications. Payments as provided above shall be made when due.Any payments that are delayed shall be subject to a finance charge of 1.5%per month. Notice: No agreement for home improvement contracting work shall require a down payment (advance deposit)of more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must make,in advance,to order and/or otherwise obtain delivery of special order materials and equipment,whichever amount is greater. IV. COMMENCEMENT AND COMPLETION OF WORK Contractor will not begin the work or order the materials before the third day following the signing of this Agreement,unless specified here in writing. Contractor will begin the work on or about March 4,2011. Barring delay caused by circumstances beyond Contractor's control,the work will be completed on or about March 25,2011. The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered as violations of this Agreement. V. NO ACCELERATION OF PAYMENTS BUT ESCROWING ALLOWED The Contractor may not require payments to be made in advance of the time specified in Section III(Payment)above for the reason that he deems himself or the payments to be insecure. Ii;however,he deems himself to be insecure,he may require, as a prerequisite to continuing the work described herein,that the balance of the payments under this contract that are in the control of the Owner,shall be placed in a joint escrow account that requires the signature of both the Contractor and the Owner for withdrawal. VI. INSURANCE Contractor will be responsible to Owner or any third party for any property damage or bodily injury caused by himself,his employees or his subcontractors in the performance of,or as a result of,the work under this Agreement. Contractor agrees to carry insurance to cover such damage or injury. VII SUBCONTRACTING Contractor agrees that,notwithstanding any agreement for materials and/or labor between Contractor and a third party,Contractor is responsible to Owner for completion of all work described in a timely and workmanlike manner. VIII CONSTRUCTION-RELATED PERMITS The following construction related permits will be necessary in order to complete the scope of work included in this contract and are the responsibility of the Contractor: (mark X where applicable) Building X Demolition Plumbing X Electrical X The Contractor under provisions of Chapter 142A of the General Laws is required to apply for and obtain all construction related permits.Home improvement work(i.e..additions,garages,porches, etc.)may require otherapermits including but not limited to Variances and Special Permits under Zoning by-laws through the Board of Appeals,Board of Health Permits for expansion of sewage disposal systems,Conservation Commission for an Order of Conditions,etc. Such permits which may require non-construction related,engineering,technical or legal representation of the Homeowner,shall be the responsibility of the Homeowner. Notice: If the homeowner obtains his own construction-related permits for the work described under this agreement,the homeowner is hereby advised that in the event of a dispute,judgment and nonpayment of the Contractor,the homeowner will not be entitled to make a claim to or collect from the guarantee fund established by Chapter 142A,M.G.L. IX. MODIFICATION This Agreement,including the provisions relating to price and payment schedule cannot be changed except by a written statement signed by both Contractor and Owner. However, cancellation by Owner is allowed in accordance with the Notice of Cancellation(annexed). X. WARRANTIES The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of one year following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials,or damage caused by Contractor,his subcontractors,employees or agents,is discovered within one year after completion of any job,including cleanup,the Contractor shall,at his own expense,forthwith remedy,repair,correct,replace,or cause to be remedied,repaired,or replaced,such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. All warranties for equipment supplied by the Contractor under this Agreement shall be those given by the manufacturers of such equipment,which shall be and are hereby passed through directly to the Owner. Under such manufacturers'warranties, the Owner may be required to register or mail in a warranty card or other evidence of ownership and use of such equipment in order to activate such warranties. The Owner's failure to mail in or register such documentation, which failure voids the manufacturer's warranty,shall not create any responsibility for the Contractor to warranty such equipment. XI. COMPLETENESS OF AGREEMENT FOR EXECUTION The Owner is hereby advised that he should not sign this Agreement unless and until all blank sections have been filled in or marked as void,deleted or not applicable,and until all exhibits and related or referenced documents that are incorporated herein are attached hereto. XII. COPY OF AGREEMENT TO BE GIVEN TO OWNER This Agreement is governed by the Laws of Massachusetts. It must be executed in duplicate,and an original signed copy hereof given to the Owner at the time of execution. No work under the Agreement shall begin prior to the signing of the Agreement and transmittal to the owner of a copy thereof. RIGHTS TO CANCEL The owner may cancel this agreement if it has been signed by the owner at a place other than an address of the contractor which may be his.main office or branch thereof,provided that the owner notifies the contractor in writing at his main office or branch by ordinary mail posted by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See attached Notice of Cancellation. HOMEOWNER DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. !;' (/eesSigaature Date Signed Contractor's Signature D to Signed Tom Reusch 98 Mifflin Drive North Andover,MA 01845 August 10,2010 FIRST FLOOR BATHROOM RENOVATION PRELIMINARY: Submit specifications and obtain all necessary permits. DEMOLITION: Remove all existing plumbing fixtures,cabinets,interior trim,plaster,wall tile, floor tile, and underlayment. Dispose of all debris. (Complete gut) FRAMING: Repair any framing cut or disturbed by previous plumbing installations. Provide internal blocking for installation of miscellaneous wall hardware. PLUMBING/FIXTURES: Replace sink and toilet shut offs.Install new shower valve,fiberglass tub/shower unit,sink,faucet,and toilet as selected by owner. Allowance for fixtures: $1,200.00 ELECTRICAL: Install recessed light in tub area,wall sconce over vanity,new exhaust fan, GFI receptacle,and all associated switches. Wall sconce provided by owner. INSULATION: After all necessary inspections repair insulation as needed. PLASTER: Install 1/2"blueboard to all wall and ceiling surfaces. Tape all seams and apply 1/8"skim coat plaster and trowel to a smooth finish. HEATING: Replace existing forced hot water baseboard with new unit. CABINETS/COUNTERTOPS: Install cabinet and countertop/sink as selected by owner. Allowance for cabinets and countertop: $250.00 INTERIOR TRIM: Install new recessed shelf unit in old window opening and new trim on existing door. Install new baseboard as needed. All interior trim shall match existing as close as possible. TILE: Install 1/2"underlayment over subfloor and secure as needed. Install ceramic tile to main floor as selected by owner. Allowance for tile,cement,grout,and installation: $600.00. PAINTING: Prime all new woodwork,walls,and ceiling.Apply two finish coats of Benjamin Moore paint as selected by owner. ACCESSORIES: Install towel bars and accessory hardware as provided by owner. Complete clean up and removal of all debris. Total cost as described above: $13,750.00 We are licensed,registered,and fully insured. License#015004 Registration#100294 Respectfully submitted, R.Joseph Ratte,Inc�`� Joseph R.Ratte,Pres. . : dlyl/l�20421l1 Office of sumer Affairs �Sluess Reg�ation HOME IMPROVEMENT CONTRACTOR Registration: :'1.00294 Type: Expiration: : 12012 Private Corporatio ?° J RO ER J. RATTE, Joseph Ratte r` Z 340 Mt. Vernon St Lawrence, MA 01843 t Undersecretary Massachusetts - Department of Public Safety Board of BuildingRegulations and Standards Construction Supervisor License Licenser CS 15004 Restricted to: 00 JOSEPH R RATTE 340 MT VERNON ST LAWRENCE, MA 01843 --�- �` - Expiration: 8/27/2011 ('ununisiuner Tr#: 20364 z The Commonwealth of Massachuselts Depardnent of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 IF www massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/omnization/individuat):,�7rCJ /� ,� W1 7T�- v z-- Address: S T City/State/Zip: �g�iz,9f 0e J' Phone#: q 7�� % L Are yo n employer?Check the appropriate box: Type of project(required): 1.LrI am a employer with ez?' 4. ❑I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- lamed on the attached sheet 7. ❑Remodeling ship and have no employees 'These subcontractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance required.] 5. ❑ We are a corporation and its 10.n Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roofrepairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Anyapplicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: r7 Policy#or Self-ins.Lic.#: 40W,' Expiration Date: a� Job Site Address: � City/State/Zip,/V dqgelZ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the.Office of Investigations of the DIA for insurance coverage verification. I do here-by eerti nder the 'u in ormadon provided above is true and correct. Si attne: -' L -- ---- - - Phone#: f ` Official use only. Do not write in this area,to be completed by city or town qff1cial City or Town: Per # Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M co CERTIFICATE OF LIABILITY INSURANCE OPID JY FDATE(MMIDDnYYY) RATTE-1 12/30/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Michaud, Rope And Ruscak Ins. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O. Box 188 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Andover MA 01845 Phone: 978 688 8829 Fax:978 557 2130 INSURERS AFFORDING COVERAGE. NAIC# INSURED INSURER A: Preferred mutual Insurance-Co. 15024 INSURER 8: Safety Insurance Company 12808 Roge J. Ratte, Inc. INSURER C: Guard Insurance Group 340 Mt. Vernon Street INSURER D: Lawrence MA 01843 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I POLICY EFFECTIVE POLICY EX LTRINSRO TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $1000000 COMMERCIAL GENERAL LIABILITY CPP0110594188 PREMISES Eaoccurence) $50000 CLAIMS MADE X❑OCCUR MED EXP(Any one person) $5000 A X Business Owners 03/28/10 03/28/11 PERSONAL BADV INJURY $1000000 GENERAL AGGREGATE $2000000 GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $2000000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT B ANY AUTO 1500030 01/16/11 01/16/12 (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $250000 X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $500000 X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $100000 (Per accident) GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F-I CLAIMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X TORY LIMITS ER AND EMPLOYERS'LIABILITY C ANY PROPRIETORIPARTNERIEXECUTIVEM RONC125464 04/23/10 04/23/11 E.L.EACH ACCIDENT $100000 OFFICERIMEMBER EXCLUDED? L1 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATKINS/LOCATIONS!VEHICLES/EXCLUSK)NS.ADDED BY ENDORSEMENT/SPECIAL PROVISIONS. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO1 - —-- DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL ----- -- — IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR - _ - REPRESENTATIVES. AUTHORQ REPRESEZA ACORD 25(2009/01) RISICURPMAMON. All rights reserved. The ACORD name and logo are registered marks of ACORD