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HomeMy WebLinkAboutContract #: 1567 - From: 12-15-2022 To: 12-15-2023 - Bobrek Engineering & Construction - DPW AGREEMENT FOR PROFESSIONAL ENGINEERING SERVICES BETWEEN THE TOWN OF NORTH ANDOVER, MASSACHUSETTS AND BOBREK ENGINEERING & CONSTRUCTION,LLC. THIS AGREEMENT made this/ day of , 2022 between Bobrek Engineering & Construction, LLC., a Massachusetts corporation with a usual place of business at 100 Conifer Hill Drive, Suite 204, Danvers, MA 01923,hereinafter called the"ENGINEER," and the Town of North Andover, MA, acting by its Select Board, with a usual place of business at 120 Main Street,North Andover, MA 01845 hereinafter called the"TOWN". The ENGINEER and the TOWN, for the consideration hereinafter named, agree as follows: 1. Scope of Work The ENGINEER shall perform the work set forth in the Scope of Services attached hereto as Exhibit A. 2. Contract Price The TOWN shall pay the ENGINEER for services rendered in the performance of this Agreement a lump sum of$98,000.00. The amount to be paid to the ENGINEER shall not exceed $98,000.00 without the prior written consent of the TOWN. 3. Commencement and Completion of Work A. This Agreement shall commence on September 15, 2022 and shall expire on September 15, 2023, unless terminated sooner in accordance with this Agreement. B. Progress and Completion: ENGINEER shall commence work promptly upon execution of this Agreement and shall prosecute and complete the work regularly, diligently and uninterruptedly at such a rate of progress as will insure completion in a timely manner. 4. Performance of the Work The ENGINEER shall supervise and direct the Work, using his best skills and attention, which shall not be less than such state of skill and attention generally rendered by the engineering/design profession for projects similar to the Project in scope, difficulty and location. A. Responsibilily for the Work: (1) The ENGINEER shall be responsible to the TOWN for the acts and omissions of his employees, subcontractors and their agents and employees, and other persons performing any of the Work under a contract with the ENGINEER. Consistent with the standard of care referenced above, the ENGINEER shall be responsible for the professional and technical accuracy for all work or services furnished by him or his consultants and subcontractors. The ENGINEER shall perform his work under this Agreement in such a competent and professional manner that detail checking and reviewing by the TOWN shall not be necessary. (2) The ENGINEER shall not employ additional consultants,nor sublet, assign or transfer any part of his services or obligations under this Agreement without the prior approval and written consent of the TOWN. Such written consent shall not in any way relieve the ENGINEER from his responsibility for the professional and technical accuracy for the work or services furnished under this Agreement. (3) All consultants must be registered and licensed in their respective disciplines if registration and licensor are required under the applicable provisions of Massachusetts law. (4) The ENGINEER and all consultants and subcontractors shall conform their work and services to any guidelines, standards and regulations of any governmental authority applicable to the type of work or services covered by this Agreement. (5) The ENGINEER shall not be relieved from its obligations to perform the work in accordance with the requirements of this Agreement either by the activities or duties of the TOWN in its administration of the Agreement, or by inspections,tests or approvals required or performed by persons other than the ENGINEER. (6) Neither the TOWN's review, approval or acceptance of,nor payment for any of the work or services performed shall be construed to operate as a waiver of any rights under the Agreement or any cause of action arising out of the performance of the Agreement. B. Deliverables, Ownership of Documents: One (1) reproducible copy of all drawings, plans, specifications and other documents prepared by the ENGINEER shall become the property of the TOWN upon payment in full therefor to the ENGINEER. Ownership of stamped drawings and specifications shall not include the ENGINEER's certification or stamp. Any re-use of such documents without the ENGINEER's written verification of suitability for the specific purpose intended shall be without liability or legal exposure to the ENGINEER or to the ENGINEER's independent professional associates, subcontractors or 2 consultants. Distribution or submission to meet official regulatory requirements or for other purposes in connection with the Project is not to be construed as an act in derogation of the ENGINEER's rights under this Agreement. C. Compliance With Laws: In the performance of the Work, the ENGINEER shall comply with all applicable federal, state and local laws and regulations, including those relating to workplace and employee safety. 5. Site Information Not Guaranteed; Contractor's Investigation The TOWN shall famish to the ENGINEER available surveys, data and documents relating to the area which is the subject of the Scope of Work. All such information, including that relating to subsurface and other conditions,natural phenomena, existing pipes, and other structures is from the best sources at present available to the TOWN. All such information is famished only for the information and convenience of the ENGINEER and is not guaranteed. It is agreed and understood that the TOWN does not warrant or guarantee that the subsurface or other conditions, natural phenomena, existing pipes, or other structures will be the same as those indicated in the information famished, and the ENGINEER must satisfy himself as to the correctness of such information. If, in the opinion of the ENGINEER, such information is inadequate,the ENGINEER may request the TOWN's approval to verify such information through the use of consultants or additional exploration. In no case shall the ENGINEER commence such work without the TOATN's prior written consent. Such work shall be compensated as agreed upon by TOWN and ENGINEER. 6. Payments to the Contractor A. Cost incurred on this project shall be billed monthly on an hourly basis as outlined in the attached Scope of Services. Payment shall be due 30 days after receipt of an invoice by the TOWN. B. If there is a material change in the scope of work, the TOWN and the ENGINEER shall mutually agree to an adjustment in the Contract Price. C. If the TOWN authorizes the ENGINEER to perform additional services,the ENGINEER shall be compensated in an amount mutually agreed upon, in advance, in writing. Except in the case of an emergency,the ENGINEER shall not perform any additional services until such compensation has been so established. 7. Reimbursement Except as otherwise included in the Contract Price or otherwise provided for under this Agreement, the ENGINEER shall be reimbursed by the TOWN: (a) at 1.0 times the actual cost to the ENGINEER of consultants retained to obtain information pursuant to Article 5 hereof or otherwise. No such reimbursement shall be made unless the rates of compensation have been approved, in advance,by the TOWN; (b) at 1.0 times the actual cost of additional or specially authorized expense items, as approved by the TOWN. 3 8. Final Pavment,.Effect The acceptance of final payment by the ENGINEER shall constitute a waiver of all claims by the ENGINEER arising under the Agreement. 9. Terms Required By Law This Agreement shall be considered to include all terms required to be included in it by the Massachusetts General Laws, and all other laws, as though such terms were set forth in full herein. 10. Indemnification A. General Liability: The ENGINEER shall indemnify and hold harmless the TOWN from and against any and all claims,damages, losses, and expenses, including attorney's fees, to the extent arising out of the performance of this Agreement and to the extent the same relate to matters of general commercial liability,when such claims, damages,losses, and expenses are caused, in whole or in part,by the negligent or wrongful acts or omissions of the ENGINEER or his employees, agents, subcontractors or representatives. B. Professional Liability: The ENGINEER shall indemnify and hold harmless the TOWN from and against any and all claims, damages, losses, and expenses, including attorney's fees, arising out of the performance of this Agreement and to the extent the same relate to the professional competence of the ENGINEER's services,when such claims, damages, losses, and expenses are caused, in whole or in part,by the negligent acts,negligent errors or omissions of the ENGINEER or his employees,agents, subcontractors or representatives. 11. Insurance A. The ENGINEER shall at his own expense obtain and maintain a Professional Liability Insurance policy for errors, omissions or negligent acts arising out of the performance of this Agreement in a minimum amount of$1,000,000.00. B. The coverage shall be in force from the time of the agreement to the date when all construction work for the Project is completed and accepted by the TO". If, however,the policy is a claims made policy, it shall remain in force for a period of six(6)years after completion. Since this insurance is normally written on a year-to-year basis, the ENGINEER shall notify the TO" should coverage become unavailable. C. The ENGINEER shall, before commencing performance of this Agreement, provide by insurance for the payment of compensation and the furnishing of other benefits in accordance with M.G.L. c.152, as amended,to all its e*mployees and shall continue such insurance in full force and effect during the term of the Agreement. 4 D. The ENGINEER shall carry insurance in a sufficient amount to assure the restoration of any plans, drawings, computations, field notes or other similar data relating to the work covered by this Agreement in the event of loss or destruction until the final fee payment is made or all data are turned over to the TOWN. E. The ENGINEER shall also maintain public liability insurance, including property damage,bodily injury or death, and personal injury and motor vehicle liability insurance against claims for damages because of bodily injury or death of any person or damage to property. F. Evidence of insurance coverage and any and all renewals substantiating that required insurance coverage is in effect shall be filed with the Agreement. Any cancellation of insurance,whether by the insurers or by the insured, shall not be valid unless written notice thereof is given by the party proposing cancellation to the other party and to the TOWN at least fifteen days prior to the intended effective date thereof,which date shall be expressed in said notice. G. Upon request of the ENGINEER, the TOWN reserves the right to modify any conditions of this Article. 12. Notice All notices required to be given hereunder shall be in writing and delivered to, or mailed first class to,the parties'respective addresses stated above. In the event that immediate notice is required, it may be given by telephone or facsimile,but shall, to the extent possible,be followed by notice in writing in the manner set forth above. 13. Termination A. Each party shall have the right to terminate this Agreement in the event of a failure of the other party to comply with the terms of the Agreement. Such termination shall be effective upon seven days'notice to the party in default and the failure within that time of said party to cure its default. B. The TO" shall have the right to terminate the Agreement without cause,upon ten(10)days'written notice to the ENGINEER. In the event that the Agreement is terminated pursuant to this subparagraph, the ENGINEER shall be reimbursed in accordance with the Agreement for all work performed up to the termination date. 14. Miscellaneous A. AssigMent: The ENGINEER shall not assign or transfer any of its rights, duties or obligations under this Agreement without the written approval of the TOWN. B. Govemin2 Law: This Agreement shall be govemed by and construed in accordance with the law of the Commonwealth of Massachusetts. 5 IN WITNESS WHEREOF,the parties hereto have set their hands and seals,the TOWN by its authorized representative who,however,incurs no personal liability by reason of the execution hereof or of anything herein contained,as of the day and year first above written. THE TOWN THE CONTRACTOR Bobrek Engineering & Construction Divisio&Depifrtment Head Company Wne 08/31/22 Town Manager Date Si Rurc Date John Bobrek, President Print Name&Title APPROVED AS TO FORM: Town Counsel Date CERTIFICATION AS TO AVAILABILITY OF FUNDS: A 7/0Y Town AC40unia-nt Date 6 CERTIFICATIONS CERTIFICATE OF NON-COLLUSION The undersigned certifies under penalties of perjury that our bid or proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the word "person" shall mean natural person, business, partnership, corporation, committee, union, club or other organization, entity, or group of individuals. Signature Date 0 8/31/2 2 John B ek, President Bobrek Engineering & Construction Print Name & Title Company Name CERTIFICATE OF TAX COMPLIANCE Pursuant to Chapter 62C of the Massachusetts General Laws, Section 49A (b), I John Bobrek , authorized signatory for Bobrek Engineering & Construction Name of individual Name of contractor do hereby certify under the pains and penalties of perjury that said contractor has complied with all laws of the Commonwealth of Massachusetts, and the Town of North Andover, relating to taxes, permit or other fees, reporting of employees and contractors, and withholding and remitting child support. 08/31/22 Sign r Date 7 N/A Bobrek Engineering & Construction, LLC is a sole member LLC CERTIFICATE OF VOTE At a duly authorized meeting the Board of Directors of the held on it was VOTED, THAT (Name) (Officer) of be and hereby is authorized to execute contracts and bonds in the name and on behalf of said , and affix its corporate seal hereto; and such execution of any contract or obligation in the name of on its behalf by such officer under seal of ,shall be valid and binding upon I hereby certify that I am the clerk of the above named and that is the duly elected officer as above of said and that the above vote has not been amended or rescinded and remains in full force and effect as the date of this contract. (Date) (Clerk) 8 EXHIBIT A �. Enginering8Gonst1uctfon Bobrek Engineering& Construction, LLC O B R K 100 Conifer Hill Drive, Suite 204, Danvers, MA 01923 www.gobobrek.com 978-406-9619 August 31, 2022 Mr.John Borgesi, P.E. Town Engineer North Andover Department of Public Works 384 Osgood Street North Andover, MA 01845 RE: Engineering Services Proposal Town-Wide Culverts Assessment Dear Mr. Borgesi: Bobrek Engineering & Construction, LLC (BEC) is pleased to present the following proposal to provide engineering services for the assessment of Town of North Andover's (Town) culverts. According to the Town's Geographical Information Systems (GIS), approximately 200 culverts have been inventoried. This scope has been developed to complete an inspection of each culvert,asses surrounding conditions, and provide a ranking report for the Town-Wide assessment Project. Below please find the Project understanding, as well as BEC's proposed scope of services,schedule and fee for the Project. PROJECT UNDERSTANDING The Town intends to complete a culvert repair project as part of the Capital Improvement Plan (CIP) in the coming fiscal years. The Town has recently completed the GIS inventory of the Town owned culverts. The next step in the CIP process for repairing a culvert in the Town, is to complete an assessment of all Town owned culverts to determine the high priority areas. SCOPE OF SERVICES BEC will implement the following proposed tasks associated with the Project: Task 1—Data Collection & Review • BEC will establish points of contact with the Project Team with the Town. Project objectives will be reviewed and established with a kickoff meeting. • BEC will work with the Town to assemble a total number of potential culvert locations based on mapping, GIS and any Town records or historical knowledge. This will include a working meeting with the Towns staff to note culvert locations which may not be available through GIS. Town of North Andover, MA (P-2022) Pagel of 4 August 31, 2022 2022.08.31—North Andover Culverts Assessment Proposal.doc EngineeringaCansteuotion Bobrek Engineering& Construction, LLC BOBREK 100 Conifer Hill Drive,Suite 204, Danvers, MA 01923 www.gobobrek.com 978-406-9619 • BEC will drive all public roadways within the Town to verify location of culverts with a Town staff member. A final number of Town maintained culverts will be reviewed with the Town's staff. • BEC will create a Town-Wide map identifying all Town-maintained culverts to be included in this project utilizing the Town's provided GIS shapefiles. A culvert inventory and inspection sheet will be presented to the Town identifying the information to be collected at each location. Task 2—Culvert Inventory Survey&Assessment • BEC will perform a field inventory and baseline assessment of the Town's culverts with a Town staff member. It is anticipated that following data will be collected at each location: o General information such as roadway characteristics & materials, location, data, etc. o Structural information such as barrel shape, material, number of cells, length, etc. o Geometric dimensions such as diameter of sizes of opening(s), span, rise, etc. o Estimate height of cover from top of structure to roadway, approximate skew of angle, slope embankment, etc. o Type of end treatments identifying materials, thickness, shape, etc. o Identify safety features such as guardrail, railings, fences, etc. o Note items including general culvert conditions, structure failures, blockages, streambed materials, bankfull width upstream and downstream, etc. o Provide a rankings and general condition assessment, incorporating comment from the Town's staff(Adequate/Fair, Poor/Needs Improvement, or Hazard). o Recommend next steps or actions for those culverts noted in the 'Poor/Needs Improvement' category or lower. • BEC will format and scan our field notes for archiving. Photos will be taken to document the inlet, outlet, and any deficiencies of the structure. Documentation will be sent to the Town staff for their records. • BEC will update the Towns GIS with FieldMaps by ArcMap if the culvert general location is incorrect while at each culvert location. Task 3—Data Results & Reporting • BEC will meet with Town staff to present the raw data from the Town-wide culverts assessment. • BEC will provide an outline to the documentation report to Town staff to define the rankings structure for which culverts are classified as deficient. • BEC will develop the culvert assessment report and rankings for the culverts and submit to the Town. The report is assumed to include: Town of North Andover, MA(P-2022) Page 2 of 4 August 31, 2022 2022.08.31—North Andover Culverts Assessment Proposal.doc Engineering&Construction Bobrek Engineering&Construction, LLC 0 B R E K 100 Conifer Hill Drive,Suite 204, Danvers, MA 01923 www.gobobrek.com 978-406-9619 • The inventory of each Town-maintained culvert within the Town limits, as described above. • inventory/assessment for each culvert sheet containing the identified data in Task 2, • Provide the Town with an updated GIS shapefile for any updated culvert locations. • BEC will attend a report conclusion meeting as directed by the Town for the project, SCHEDULE: Bobrek Engineering&Construction will begin work within one month of an executed contract and purchase order. BEC assumes completing this report deliverable within six (6) months of an executed contract, anticipated over the winter of 2022-2023. FEE: BEC proposes to perform the work described within this proposal on a Time and Materials Basis, invoiced monthly based upon the work completed, Monthly invoices include a summary of services provided during the invoicing period. The fee for these services as follows: Phase Description Labor Labor Expense Fee Hours Fee Fee Summary 1 Data Collection & Review 40 $5,000 $500 $5,500 2 Culvert Inventory Survey 520 $65,000 $2,000 $67,000 &Assessment 3 Data Results & Reporting 200 $25,000 $500 $25,500 Total 760 $95,000 1 $3,000 $98,000 The budget will not be exceeded without prior written authorization by the client. EXCLUSIONS: Bobrek Engineering and Construction has not included the following services in the scope of work and budget; we can provide these additional services at your request under a contract amendment: 1. Engineering Design or Permitting of Repairs; 2. One round of updating is included in our budget for each deliverable; further updates are additional work; 3. Filing fees, advertising costs, and compensation fees associated with permit submittals and agency requests; 4. Environmental Soil Assessments and Testing; 5. Subcontractors will be utilized if necessary, at a standard markup of 10%; 6. Structural or Geotechnical Engineering Assessment Town of North Andover, MA(P-2022) Page 3 of 4 August 31, 2022 2022,08.31—North Andover Culverts Assessment Proposal.doc .......................- Engineer7Canstructlon Bobrek Engineering&Construction, LLC BOBREK 100 Conifer Hill Drive, Suite 204, Danvers, MA 01923 www.gobobrek.com 978-406-9619 7. Wetlands assessment; 8. BEC has permission to enter the properties where culverts are located; and 9. Design of dewatering systems. PROJECTTERMS Bobrek Engineering & Construction, LLC will complete this scope of services in accordance with the Town's Standard Terms and Conditions. If this proposal meets your expectations, please print and execute one copy of this proposal agreement, and our Terms & Conditions and return it to my attention. Please feel free to contact me should you have any questions at 978-406-9619 or jtP.rSoLik�rk.carn. We thank you for this opportunity and look forward to working with you! Sincerely, Bobrek Engineering& Construction, LLC John Bobrek, P.E. President Town of North Andover, Engineering Design Proposal —Town-Wide Culverts Assessment Project proposal execution is completed by the following signatures. Town of North Andover, MA: Bobrek Engineering& Construction, LLC: By: By: John Bobrek, P.E. Title: Title: President Date: Date: 08/31/2022 Town of North Andover, MA(P-2022) Page 4 of 4 August 31, 2022 2022.08.31—North Andover Culverts Assessment Proposal.doc BOBRENG-01 LCOTE ACORO' [:t8:31M�1222 M /YYYY) �� CERTIFICATE OF LIABILITY INSURANCE 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 have ADDITIONAL INSURED provisions or 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(O. PRODUCER CONTACT LOCI Cote DeSanctis Insurance Agency,Inc. NAME`___— .- 100 Unicom Parts Drive PHONE/CC N ,Extl:(781)569-0142 JAIC,No):-_........---........., Woburn,MA 01801 .......---- E-MAIL Icote m A®®�Es desanctisins.co @ ____----- .----.....__----.--..__ —_..........—......__ INSURR 5�j_AFF®RDING C®VERAGE _........_,_....... __�___ INSURER A:Berk1eySpeciajty Insurance Company ._.._- ___.. 31295 .-.._.__ INSURED -INSURER B.Safety_Indemnity Insurance Corn ap ny ..........__ 33618... _ Bobrek Engineering&Construction Co 100 Conifer Hill Drive INsugE�C e Hanford Accident and Indemnity Company_.. 22357_......._____ Suite 204 INSURER 0:Navigators Specialtvinsurance Cornoa�._..... 36056 Danvers,MA01923 INSURER E:_.......__...—........_ ... 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. 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY L=XPLTH LIMBS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 � _ _— _..... ____._......__..................._ — 100,000 CLAIMS-MADE _X!OCCUR CGL006012530 6/30/2022 6/30/2023 DAMAGE r®RENTED .... PREMISES tEa occurrsnr�e�__�..._..___._...__.....—_�...-- �D 1,000 PERSONAL&4PV INJURY $ 1,000,000 2,000,000 OE jNj°L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ._.......--_$—_.--... POLICY[XI JE® ��LOG _PR®DUCTS-Cf76hPi6P_AGG._$ f OTHER: B COMBINED SINGLE LIMIT 1,000,600 AUTOMOBILE LIABILITY 5_gaccident_......------._. ..$ ....—._..........—.. ANY AUTO COM5924215 3/4/2022 3/4/2023 BODILY INJURY�Perke song OWNED SCHEDULED AUTOS ONLY X AUTOS .BODILY INJURY iler accident X. Tos ONLY X NRTN6g N&D a�°a c a DAMAGE _..— .... ...__......_._........ _---.......------.. I Is A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE_ _$ _ —2,000,000 EXCESS LIAB CLAIMS-MADE CX010718524 6/30/2022 6/30/2023 2,000,000 __ __......,_--..__....__.._.�._-- AGGREGATE_ _._ - ._—.__._..._............._ DED RETENTION$ C WORKERS COMPENSATION X I PER OTH- AND EMPLOYERS'LIABILITY STATUTE ..._.... ER 08WECAL4JR4 6/6/2022 6/6/2023 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE YN pFFIGERlMEMBER EXCLUDED? NIA E.L�EACH ACCIDENT___........__. $ _ (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,006 _..._.�.v__..... ._.__._....... .._.....__..... If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT D Pro fessionalLiab CH22MPLX00341NC 3/27/2022 3/2712023 per Claim 2,000,000 D Professional Liab CH22MPLX00341NC 3/27/2022 3/27/2023 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORO 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 120 Main Street North Andover,MA 01845 AUTHORIZED REPRESENTATIVE_J6. ACORD 25(2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD