#12-5845 (BASF Corporation)A G R E E M E N T 12-5845
for
Countywide Chemicals
THIS AGREEMENT, made and entered into on this�j, day of U--i " i-- 2012 by and
between BASF Corporation, authorized to do business in the State of Florida, whose business
address is 2371 Wilroy Road, Suffolk, Virginia 23434, hereinafter called the "Vendor" and
Collier County, a political subdivision of the State of Florida, Collier County, Naples,
hereinafter called the "County ":
WITNESSETH:
1. COMMENCEMENT. The contract shall be for a one (1) year period, commencing on
Oc.f a3� 2-a C)-_, and terminating on C c4- z 2 F 20 k 3 .
The County may, at its discretion and with the consent of the Vendor, renew the
Agreement under all of the terms and conditions contained in this Agreement for three
(3) additional one (1) year periods. The County shall give the Vendor written notice of
the County's intention to extend the Agreement term not less than ten (10) days prior to
the end of the Agreement term then in effect.
2. STATEMENT OF WORK. The Vendor shall provide the awarded chemical(s) on a
Primary/ Secondary basis as identified in Schedule A, attached herein and incorporated
by reference. Chemicals will be provided in accordance with the terms and conditions
of ITB 12 -5845 and the Vendor's submittal referred to herein and made an integral part
of this agreement.
This Agreement contains the entire understanding between the parties and any
modifications to this Agreement shall be mutually agreed upon in writing by the
Vendor and the County Project or Contract Manager or his designee, in compliance
with the County Purchasing Policy and Administrative Procedures in effect at the time
such services are authorized.
3. COMPENSATION. The County shall pay the Vendor for the performance of this
Agreement the aggregate of the units actually ordered and furnished at the unit price.
The contract shall be fixed pricing for a six (6) month period of time for each chemical
awarded. The County reserves the right to establish a longer fixed schedule (greater
than 6 months) with the awarded supplier(s). Surcharges will not be accepted in
conjunction with this contract, and such charges should be incorporated into the pricing
structure.
Page 1 of 9
Any county agency may purchase products and services under this contract, provided
sufficient funds are included in their budget(s). Payment will be made upon receipt of a
proper invoice and upon approval by the Project Manager or his designee, and in
compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government
Prompt Payment Act ".
Payments will be made for services furnished, delivered, and accepted, upon receipt
and approval of invoices submitted on the date of services or within six (6) months after
completion of contract. Any untimely submission of invoices beyond the specified
deadline period is subject to non - payment under the legal doctrine of "laches" as
untimely submitted. Time shall be deemed of the essence with respect to the timely
submission of invoices under this agreement.
4. SALES TAX. Vendor shall pay all sales, consumer, use and other similar taxes
associated with the Work or portions thereof, which are applicable during the
performance of the Work.
5. NOTICES. All notices from the County to the Vendor shall be deemed duly served if
mailed or faxed to the Vendor at the following Address:
BASF Corporation
2371 Wilroy Road
Suffolk, VA 23434
Telephone: (757) 538 -3700; Fax: (864) 964 -5475
E -mail: Jeanne.taylor@basf.com
Attention: Charles Wright
All Notices from the Vendor to the County shall be deemed duly served if mailed or
faxed to the County to:
Collier County Government Center
Purchasing Department
3327 Tamiami Trail, East
Naples, Florida 34112
Attention: Purchasing & General Services Director
Telephone: 239 - 252 -8975
Facsimile: 239 - 252 -6480
The Vendor and the County may change the above mailing address at any time upon
giving the other party written notification. All notices under this Agreement must be in
writing.
Page 2 of 9
6. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating
a partnership between the County and the Vendor or to constitute the Vendor as an
agent of the County.
7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits
necessary for the prosecution of the Work shall be obtained by the Vendor. Payment for
all such permits issued by the County shall be processed internally by the County. All
non - County permits necessary for the prosecution of the Work shall be procured and
paid for by the Vendor. The Vendor shall also be solely responsible for payment of any
and all taxes levied on the Vendor. In addition, the Vendor shall comply with all rules,
regulations and laws of Collier County, the State of Florida, or the U. S. Government
now in force or hereafter adopted. The Vendor agrees to comply with all laws
governing the responsibility of an employer with respect to persons employed by the
Vendor.
8. NO IMPROPER USE. The Vendor will not use, nor suffer or permit any person to use
in any manner whatsoever, County facilities for any improper, immoral or offensive
purpose, or for any purpose in violation of any federal, state, county or municipal
ordinance, rule, order or regulation, or of any governmental rule or regulation now in
effect or hereafter enacted or adopted. In the event of such violation by the Vendor or if
the County or its authorized representative shall deem any conduct on the part of the
Vendor to be objectionable or improper, the County shall have the right to suspend the
contract of the Vendor. Should the Vendor fail to correct any such violation, conduct, or
practice to the satisfaction of the County within twenty -four (24) hours after receiving
notice of such violation, conduct, or practice, such suspension to continue until the
violation is cured. The Vendor further agrees not to commence operation during the
suspension period until the violation has been corrected to the satisfaction of the
County.
9. TERMINATION. Should the Vendor be found to have failed to perform his services in
a manner satisfactory to the County as per this Agreement, the County may terminate
said agreement for cause; further the County may terminate this Agreement for
convenience with a thirty (30) day written notice. The County shall be sole judge of
non - performance.
10. NO DISCRIMINATION. The Vendor agrees that there shall be no discrimination as to
race, sex, color, creed or national origin.
11. INSURANCE. The Vendor shall provide insurance as follows:
A. Commercial General Liability: Coverage shall have minimum limits of $2,000,000
Per Occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage
Liability. This shall include Premises and Operations; Independent Vendors; Products
and Completed Operations and Contractual Liability.
Page 3 of 9
B. Business Auto Liability: Coverage shall have minimum limits of $1,000,000 Per
Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage
Liability. This shall include: Owned Vehicles, Hired and Non -Owned Vehicles and
Employee Non - Ownership.
C. Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
The coverage must include Employers' Liability with a minimum limit of $1,000,000 for
each accident.
D. Pollution Liability: Coverage shall have minimum limits of $1,000,000 Per
Occurrence for Bodily Injury Liability and Property Damage Liability.
Special Requirements: Collier County Government shall be listed as the Certificate
Holder and included as an Additional Insured on the Comprehensive General Liability
Policy.
Current, valid insurance policies meeting the requirement herein identified shall be
maintained by Vendor during the duration of this Agreement. Renewal certificates shall
be sent to the County ten (10) days prior to any expiration date. There shall be a thirty
(30) day notification to the County in the event of cancellation or modification of any
stipulated insurance coverage.
12. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Vendor
shall indemnify and hold harmless Collier County, its officers and employees from any
and all liabilities, damages, losses and costs, including, but not limited to, reasonable
attorneys' fees and paralegals' fees, to the extent caused by the negligence, recklessness,
or intentionally wrongful conduct of the Vendor or anyone employed or utilized by the
Vendor in the performance of this Agreement. This indemnification obligation shall not
be construed to negate, abridge or reduce any other rights or remedies which otherwise
may be available to an indemnified party or person described in this paragraph.
This section does not pertain to any incident arising from the sole negligence of Collier
County.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf of
the County by the Division of Public Utilities Water and Wastewater departments, in
conjunction with the Division of Public Services Parks and Recreation department.
14. CONFLICT OF INTEREST: Vendor represents that it presently has no interest and
shall acquire no interest, either direct or indirect, which would conflict in any manner
with the performance of services required hereunder. Vendor further represents that no
persons having any such interest shall be employed to perform those services.
Page 4 of 9
15. COMPONENT PARTS OF THIS CONTRACT. This Contract consists of the following
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Vendor's Submittal, Insurance Certificate, ITB #12 -5845 Specifications/ Scope
of Services, two (2) Addenda, and Schedule A.
16. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between
the parties herein that this agreement is subject to appropriation by the Board of County
Commissioners.
17. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or
individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee,
service or other item of value to any County employee, as set forth in Chapter 112, Part
III, Florida Statutes, Collier County Ethics Ordinance No. 2004 -05, and County
Administrative Procedure 5311. Violation of this provision may result in one or more of
the following consequences: a. Prohibition by the individual, firm, and/or any
employee of the firm from contact with County staff for a specified period of time; b.
Prohibition by the individual and /or firm from doing business with the County for a
specified period of time, including but not limited to: submitting bids, RFP, and/or
quotes; and, c. immediate termination of any contract held by the individual and/or
firm for cause.
18. IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Vendor is formally acknowledging without exception or stipulation that it is fully
responsible for complying with the provisions of the Immigration Reform and Control
Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either
may be amended. Failure by the Vendor to comply with the laws referenced herein shall
constitute a breach of this agreement and the County shall have the discretion to
unilaterally terminate this agreement immediately.
19. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County
encourages and agrees to the successful proposer extending the pricing, terms and
conditions of this solicitation or resultant contract to other governmental entities at the
discretion of the successful proposer.
20. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or
otherwise unenforceable, in whole or in part, the remaining portion of this Agreement
shall remain in effect.
21. ADDITIONAL ITEMS /SERVICES. Additional items and /or services may be added to
this contract in compliance with the Purchasing Policy.
22. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted
by this Agreement to resolve disputes between the parties, the parties shall make a good
faith effort to resolve any such disputes by negotiation. The negotiation shall be
attended by representatives of Vendor with full decision - making authority and by
County's staff person who would make the presentation of any settlement reached
Page 5 of 9
during negotiations to County for approval. Failing resolution, and prior to the
commencement of depositions in any litigation between the parties arising out of this
Agreement, the parties shall attempt to resolve the dispute through Mediation before an
agreed -upon Circuit Court Mediator certified by the State of Florida. The mediation
shall be attended by representatives of Vendor with full decision - making authority and
by County's staff person who would make the presentation of any settlement reached at
mediation to County's board for approval. Should either party fail to submit to
mediation as required hereunder, the other party may obtain a court order requiring
mediation under section 44.102, Fla. Stat.
Any suit or action brought by either party to this Agreement against the other party
relating to or arising out of this Agreement must be brought in the appropriate federal
or state courts in Collier County, Florida, which courts have sole and exclusive
jurisdiction on all such matters.
23. PERSONNEL: The Vendor's personnel and management to be utilized for this contract
shall be knowledgeable in their areas of expertise. The County reserves the right to
perform investigations as may be deemed necessary to insure that competent persons
will be utilized in the performance of the contract. The Vendor shall employ people who
are neat, clean, well - groomed and courteous. Subject to the American with Disabilities
Act, Vendor shall supply competent employees who are physically capable of
performing their employment duties. The County may require the Vendor to remove an
employee it deems careless, incompetent, insubordinate or otherwise objectionable and
whose continued employment on this County contract is not in the best interest of the
County.
24. ORDER OF PRECEDENCE: In the event of any conflict between or among the terms of
any of the Contract Documents, the terms of the Agreement shall take precedence over
the terms of all other Contract Documents except the terms of any Supplemental
Conditions shall take precedence over the Agreement. To the extent any conflict in the
terms of the Contract Documents cannot be resolved by application of the Supplemental
Conditions, if any, or the Agreement, the conflict shall be resolved by imposing the
more strict or costly obligation under the Contract Documents upon the Vendor at
Owner's discretion.
25. ASSIGNMENT: Vendor shall not assign this Agreement, or any part thereof, without
the prior consent in writing of the County. Any attempt to assign or otherwise transfer
this Agreement or any part herein, without the County's consent, shall be void. If
Vendor does, with approval, assign this Agreement or any part thereof, it shall require
that its assignee be bound to it and to assume toward Vendor all of the obligations and
responsibilities that Vendor has assumed toward the County.
Page 6 of 9
IN WITNESS WHEREOF, the Vendor and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first
above written.
ATTEST:
Dwight E. Brock,.Clerk of Courts
:A
By: �.
Dated: L
�t9 woo.
First Witness
Jeanne M. Taylor
TType/ print witness nameT
Q2iLl f "CA;;)
Second Witness
Rebecca Duman
TType/ print witness nameT
Approved as to form and
legal sufficiency:
Assistant County Attorney
Em'( I v K - Peps V1
Priht Name
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
I
BASF Corporation
Vendor
By: / �a z
Signature
Page 7 of 9
Linda A. Muroski, Director of Water Solutions
Typed signature and title
Schedule A
Bid Tabulation 12 -5845 Countywide Chemicals
1
Tanner Industries, Inc.
W -1
Ammonia
lbs
$0.6500
Primary
A'icgas Specialty Products,
1
W -1
Ammonia
lbs
$0.6900
Secondary
2
j Airgas Carbonic
W -2
Carbon Dioxide
ton
$215.0000
Primary
3
Allied Universal Corp
W -3
Chlorine
lbs
$0.1935
Primary
4
American Water
W -4
Corrosion` Inhibitor
lbs
$0.4100
Primary
Chemicals, Inca
(ortho - polyphosphate)
4
F2 Industries, LLC
W -4
Corrosion Inhibitor
Ibs
$0.4300
Secondary
(ortho - polyphosphate)
4
Carus Corporation
W -4
Corrosion Inhibitor
lbs
$0.4300
Secondary
(ortho - polyphosphate)
Thatcher Chemical of
Fluoride (Sodium
5
Florida
W -5
Fluorsilicate)
lbs
$0.4500
Primary
5
The Dumont Company, Inc.
W -5
Fluoride (Sodium
lbs
$0.4900
Secondary
Fluorsilicate)
6
Lhoist North America
W -6
Lime
lbs
$0.1400
Primary
6
Carmeuse
W -6
Lime
lbs
$0.1500
Secondary
7
The Dumont Company, Inc.
W -7
Liquid PO4
lbs
$0.5300
Primary
7
Carus Corporation
W -7
Liquid PO4
lbs
$0.5500
Secondary
8
The Dumont Company, Inc.
W -8
Muriatic Acid
lbs
$0.3100
Primary
8
Harcros Chemicals, Inc
W -8
Muriatic Acid
lbs
$0.3200
Secondary
American Water
9
Chemicals, Inc.
W -9
Scale Inhibitor
lbs
$0.6900
Primary
10
Polydyne
W -10
Sludge Polymer
lbs
$1.4000
Primary
10
BASF Corporation
W -10
Sludge Polymer
lbs
$2.2300
Secondary
11
Key Chemical
W -11
50% Sodium Hydroxide
lbs
$0.1500
Primary
11
Harcros Chemicals, Inc
W -11
50% Sodium Hydroxide
lbs
$0.1800
Secondary
Sulfuric Acid Trading
12
Company, Inc.
W -12
Sulfuric Acid
lbs
$0.0630
Primary
Page 8 of 9
Schedule A
Bid Tabulation 12 -5845 Countvwide Chemicals,
12
Key Chemical
W' -12
Sulfuric Acid
Ibs
$0.1500
Secondary
13
Polydyne
W -13
Polymer
Ibs
$1.4000
Primary
13
BASF Corporation
W -13
Polymer
Ibs
$2.2300
Secondary
14
Polydyne
WW -1
Emulsion Polymer
Ibs
$1.0500
Primary
14
BASF Corporation
WW -1
Emulsion Polymer
Ibs
$1.1500
Secondary
15
Harcros Chemicals, Inc
WW -2
Phosphoric Acid
gal
$12.7500
Primary
15
Shannon Chemical
Corporation
WW -2
Acid Phosphoric
p
g al
$13.2700
Secondary
'Harcros
Chemicals, Inc
WW -3
25 %. Sodium Hydroxide
Solution
gal
$1.3300 `
Primary
17
F2 Industries, LLC
W /WW -1
Calcium Hypochlorite
Ibs
$1.1600
Primary
17
Thatcher Chemical of
Florida
W / WW -1
Calcium H ypochlorite
Ibs
$1.2100
Secondary
18
Odyssey Manufacturing
Company
W /WW -2
Sodium Hypochlorite
gal
$0.6400
Primary
19
Davis Supply, Inc.
PR -1
Chlorine
gal
$1.1000
Primary
19
The Dumont Company, Inc.
PR -1
Chlorine
gal
$1.1500
Secondary
20
Harcros Chemicals, Inc
PR' -2
Sodium Bicarbonate
Ibs
$0.3500
Primary
20
The Dumont Company, Inc.
PR -2
Sodium Bicarbonate
Ibs `
$0.3600
Secondary
21
Harcros Chemicals, Inc
PR -3
Muriatic Acid
gal
$2.9000
Primary
22
Airgas National
Cabonation'
PR -4
COZ
Ibs
$0:2300
Primary
23
Thatcher Chemical of
Florida
PR -5
Calcium Chloride
Ibs
$0.3300
Primary
23
Harcros Chemicals, Inc
PR -5
Calcium Chloride
Ibs
$0.3700
Secondary
24
Chemrite
PR -6
Cal -Hypo (100% '
Chlorine)
Ibs
$1:2200
Primary
24
The Dumont Company, Inc.
PR -6
Cal; Hypo (100%
Chlorine)
Ibs
$1.4000
Secondary
25
The Dumont Company, Inc.
WW -5
Soybean Oil Degreaser
gal
$10.9500
Primary
25
Fog Free Technologies
WW -5
Soybean Oil Degreaser
gal
$15.7500
Secondary
Page 9 of 9
AC40ROr CERTIFICATE OF LIABILITY INSURANCE
°"YYY)
INSR
LTR
[DATE 302012
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. 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).
PRODUCER
MARSH USA, INC.
445 SOUTH STREET
MORRISTOWN, NJ 07960 -6454
Attn: Morristown .certrequest @Marsh.com /Fax: 212 - 948-0979
CONTACT
NAME:
PHONE Fax
A/ N Ext : A/C No):
E -MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
100973- ALL - CAS -12 -13
INSURER A: ACE American Insurance Company
22667
INSURED BASF CORPORATION
INSURER B: Indemnity Ins Co Of North America
43575
INSURER C:
ATTN: LESLIE FOWLER
100 PARK AVENUE
FLORHAM PARK, NJ 07932
INSURER D :
INSURER E
INSURER F:
$ 5,000,000
MED EXP (Any one person)
COVERAGES CERTIFICATE NUMBER: NYC - 0064111874 -01 RFVIQIr11J NIIMRC0•'1
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
LTR
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
GENERAL LIABILITY
HDC G2 7010301
06/01 /2012
06/01/2013
EACH OCCURRENCE
$ 5,000,000
COMMERCIAL GENERAL LIABILITY
X CLAIMS -MADE F—I OCCUR
PREMISES SES (Ea occurrence)
re
$ 5,000,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 5,000,000
GENERAL AGGREGATE
$ 5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY F7 PRO LOC
PRODUCTS - COMP /OP AGG
$ 5,000,000
$
A
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ISA HO 8708873 (AOS)
CAL HO 8708897 (Hired I Non - Owned)
06/0112012
06/01/2012
06/0112013
06/01/2013
COEa aMBINED SINGLE LIMIT ccident
51000,000
BODILY INJURY (Per person)
$
A
ALL OWNED SCHEDULED
AUTOS AUTOS
CAL HO 8708885 (Classic Car)
06/01/2012
06101/2013
BODILY INJURY Per accident)
$
X
HIRED AUTOS X NON -OWNED
AUTOS
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAB
H,LcAc,
OUR
EACH OCCURRENCE
$
EXCESS LIAR
MS-MADE
AGGREGATE
$
DED RETENTION$
$
B
A
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N
OFFICER/MEMBER EXCLUDED? �
(Mandatory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
WLR C4 6786701 (Deductible)
SCFC4678666A(Retro)
WLR C4 6786622 (AZ, CA, MA)
0610112012
06101/2012
06/0112012
06101/2013
06/01/2013
06/0112013
X WC STATU- OTH-
TORY LIMITS I P.
E.L. EACH ACCIDENT
1,000,000
$
E.L. DISEASE - FA EMPLOYE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
RE: CONTRACTIAGREEMENT # 12 -5845 "COUNTYWIDE CHEMICALS"
COLLIER COUNTY IS INCLUDED AS AN ADDITIONAL INSURED FOR GENERAL LIABILITY, AS THEIR INTERESTS MAY APPEAR IN A SIGNED, WRITTEN AGREEMENT WITH THE INSURED, GENERAL
LIABILITY COVERAGE INCLUDES POLLUTION COVERAGE.
COLLIER COUNTY
ADMINISTRATIVE SERVICES DIVISION
PURCHASING DEPARTMENT
3327 TAMIAMI TRAIL EAST
NAPLES, FL 34112 -4901
l.A1V V CLLR I I V N
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
ManashiMukherjeeLd�aot+it�ru ,L
U 1988 -2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD