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Copier - Kyrocera TA-3551ciLease Agreement Number: _ Lease Agreement This Lease Agreement (the "Lease ") contains the terms of your agreement with us. Please read it carefully and ask us any questions you may have. The words you, your and lessee mean you, our customer. The words we, us, our and the lessor, mean CIT Finance LLC. Equipment Dlescription Quantity Description Equipment Address 1 Kyocera M3550idn 55 SE Third Ave For additional equipment 45ind accessories, attach addendum. Equipment Supplier; Name, Address and Phone: End of Lease Purchase Option If no box is checked or if more than one box is checked, the Fair Market Value Purchase Option will apply. ® Fair Market Value ❑ $1.00 Purchase Option ❑ Other Term and Lease Lease Payment $ 118.49 (plus taxes, if applicable) Term (Months) 60 Payment Frequency Monthly Variable Payment Schedule if applicable: (Attach "Payment Schedule Addendum" if necessary) payments @ ; followed by payments © _ followed by payments ; followed by _ payments @ Payments are due in Advance The following additional payments are due on the date you sign this agreement: One -time Documentation Fee $75.00 Payable with First Invoice Advanced Payment $ due at Lease signing (including taxes, if applicable) If more than one Lease Payment is required in advance, the additional amount Will be applied at the end of the initial or any renewal term. IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person wh opens an account. What this means for you: When you open an account, we will ask or (i) if you are a legal entity, your name, address, and other information that will all us to identify you; (ii) If you are an individual, your name, address, and date of birth We may also ask to see your driver's license or other identifying documents. LESSOR: CIT Finance LLC 10201 Centurion Parkway N. #100 Jacksonville, FL 32256 Authorized Signature Date Signed Printed Name Print Title Lessee Okeechobee City Of DBA Okeechobee Fire Department Lessee Legal Name Lessee "Doing Business As" Name 55 SE Third Ave Billing Street Address Okeechobee Fl 34974 Billing City, State, Zip Billing Contact Name & Phone No. 863 - 767 -1586 Lessee Phone Number (if different from above) TERMS AND CONDITIONS BY SIGNING THIS LEASE: (i) You acknowledge that you have read and understand the terms and conditions of this Lease including those on page 2 of this Lease; (ii) You agree that this Lease is a net lease that you cannot terminate or cancel, you have an unconditional obligation to make all payments due under this Lease, and you cannot withhold, set off or reduce such payments for any reason; (iii) You will use the Equipment only for business purposes; and (iv) You agree that by providing a telephone number to a cellular or other wireless device, you are expressly consenting to receiving communications from us, our affiliates and agents (for non - marketing purposes) at that number, including, but not limited to, prerecorded and artificial voice messages, text messages, and calls from automated telephone dialing systems; these calls may incur fees from your cellular provider; and this consent applies to each such telephone number you provide to us now or in the future. ELECTRONIC TRANSMISSION AND COUNTERPARTS. A fax or electronically transmitted signed version of this Lease, when received by us, shall be binding on you for all purposes as if originally signed. This Lease is not binding on us until we sign it. We may accept this Lease by signing, either manually or electronically. You agree that the only version of this Lease that is the original for all purposes is the version containing your fax or scanned signature and our signature. This Lease may be signed in counterparts each of which will be considered an original and all counterparts will be considered and constitute one and the same Lease. This Lease may be retained electronically and you agree that any such electronic version shall be fully enforceable without the need to produce an original; however we may request an original signature document. LESSEE SIGNATURE Okeechobee City Of dba Okeechobee Fire Department Lessee Legal Name X , X 370.3/4,e5-- Authorized Sig, .tur- ti L Date S d X r i &n Lt' rht�l 2hriL) Print Signer's Name i d n; s!r r Print Signer's TI e Federal Tax ID Number Lebse Agreement Number: _ Lease Agreement This Lease Agreement (the "Lease ") contains the terms of your agreement with us. Please read it carefully and ask us any questions you may have. The words you, your and lessee mean you, our customer. The words we, us, our and the lessor, mean CIT Finance LLC. Equipment Description Quantity Description 1 KYOCERA M3550idn 1 STAND For additional equipment Equipment Supplie End of Lease P If no box is checke Market Value Purc ® Fair Market Va ❑ $1.00 Purchas Term and Leas Lease Payment $ $114.00 (plus taxes, if applicable) Term (Months) Payment Frequency Monthly and accessories, attach addendum. Name, Address and Phone: rchase Option or if more than one box is checked, the Fair ase Option will apply. ue Option ❑ Other _ Variable Payment Schedule if applicable: (Attach "Payment Schedule Addendum" if necessary) payments @ followed by payments @ ; followed by payments @ payments @ ; followed by Payments are due in Advance The following additional payments are due on the date you sign this agreement: One -time Documentation Fee $75.00 Payable with First Invoice Advanced Payment $_ due at Lease signing (including taxes, if applicable) If more than one Lepse Payment is required in advance, the additional amount vviWI be applied at the end of the initial or any renewal term. IMPORTANT INFORMATIO ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government figh the funding of terrorism and money laundering activities, Federal law requires all fin ndal institutions to obtain, verify and record Information that Identifies each person who opens an account. What this means for you: When you open an account, we will ask fot (1) if you are a legal entity, your name, address, and other information that will allow us to identify you; (II) if you are an individual, your name, address, and date of birt@. We may also ask to see your driver's license or other identifying documents. LESSOR: CIT Finance LLC 10201 Centurion Parkway N. #100 Jacksonville, FL 32256 Authorized Signature Date Signed Printed Name Print Title Equipment Address 55 S.E. THIRD AVE Lessee OKEECHOBEE CITY OF DBA OKEECHOBEE FIRE DEPARTMENT Lessee Legal Name Lessee "Doing Business As" Name Billing Street Address 55 S.E.THIRD AVE Billing City, State, Zip OKEECHOBEE, FL., 34974 Billing Contact Name & Phone No. 863 - 467 -1586 Lessee Phone Number (if different from above) TERMS AND CONDITIONS BY SIGNING THIS LEASE: (i) You acknowledge that you have read and understand the terms and conditions of this Lease including those on page 2 of this Lease; (ii) You agree that this Lease is a net lease that you cannot terminate or cancel, you have an unconditional obligation to make all payments due under this Lease, and you cannot withhold, set off or reduce such payments for any reason; (iii) You will use the Equipment only for business purposes; and (iv) You agree that by providing a telephone number to a cellular or other wireless device, you are expressly consenting to receiving communications from us, our affiliates and agents (for non - marketing purposes) at that number, including, but not limited to, prerecorded and artificial voice messages, text messages, and calls from automated telephone dialing systems; these calls may incur fees from your cellular provider; and this consent applies to each such telephone number you provide to us now or in the future. ELECTRONIC TRANSMISSION AND COUNTERPARTS. A fax or electronically transmitted signed version of this Lease, when received by us, shall be binding on you for all purposes as if originally signed. This Lease is not binding on us until we sign iL We may accept this Lease by signing, either manually or electronically. You agree that the only version of this Lease that is the original for all purposes is the version containing your fax or scanned signature and our signature. This Lease may be signed in counterparts each of which will be considered an original and all counterparts will be considered and constitute one and the same Lease. This Lease may be retained electronically and you agree that any such electronic version shall be fully enforceable without the need to produce an original; however we may request an original signature document. LESSEE SIGNATURE Okeechobee City of dba Oke'echebee Fire Dept Lessee Legal Name Authorized S X Prin Pr( n( Sgne Title Federal Tax ID Number CiP Lease Agreement Addendum (Florida) CUSTOMER INFORMATION Lessee Name Okeechobee City of dba Okeechobee Fire Department Lease # Annual Rate of Interest Billing Street Address /City/State /Zip 55 S.E. Third Ave, Okeechobee, Fl., 34974 This Addendum supplements the provisions of the Lease Agreement identified by the Lease Number specified above ( "Lease "). You and we make this Addendum an integral part of the Lease. Capitalized terms used in this Addendum that are not defined will have the meanings specified in the Lease. If there is any conflict between the Lease and this Addendum, then this Addend will control and prevail. 1. Title. We '11 hold title to the Equipment. If (a) you have not terming ed this Lease in accordance with Section 3 of this Addend and (b) no Default exists, then upon your payment to us of all Lease Payments and other amounts due under this Lease, at the end of the term of this Lease, you will be entitled to our interest in the Equipment, "AS IS, WHERE IS," without any warranty or representation from us, express or implied, other than the absence of any liens by, through or under us. This S ction 1 replaces the first four (4) sentences of Section 7 of this Lease entitled "Title; Recording ". 2. Funding Indent. You reasonably believe that funds can be obtained sufficient to make all Lease Payments and other payments during the term of this Lease. You agree that your chief executive or administrative officer (or your administrative office that has the responsibility of preparing the budget submitted to your governing body, as applicable) will provide for funding for such payments in your annual budget request submitted to your governing body. If your governing body chooses not to appropriate funds for such payments, you agree that your governing body will evidence such non - appropriation by omitting funds for such payments due during the a plicable fiscal period from the budget that it adopts. You d we agree that your obligation to make Lease Payments under this Lease will be your current expense and will not be interpreted to be a debt in violation of applicable law or constitutional limitations or requirements. If a Default occurs, any judgment obtained against you will be enforceable solely against revenues allocated by youit governing body for such purpose. Nothing contained in this 1.,ease will be interpreted a pledge of your obee F Lessee: orize dbee City of ate: Fire Department int e & T tie Date general tax revenues, funds or moneys. Regardless of any other provisions of this Lease, no ad valorem taxes are pledged to the payment of any amount due under this Lease. Also, all amounts due under this Lease will be paid only from funds arising from sources other than ad valorem taxation unless one of the following conditions is satisfied: (i) you are a county and the term of this Lease is sixty (60) months or less; (ii) you are a school district and the term of this Lease is twelve (12) months or less; or (iii) you are a municipality and if you are a home rule city, your charter does not prohibit the payment of amounts due under this Lease from ad valorem taxation revenues. This Section 2 is added as a new Section 18 of this Lease entitled "Funding Intent". 3. Non - appropriation of Funds. If (a) sufficient funds are not appropriated and budgeted by your governing body in any fiscal period for Lease Payments or other payments due under this Lease, and (b) you have exhausted all funds legally available for such payments, then you will give us written notice and this Lease will terminate as of the last day of your fiscal period for which funds for Lease Payments are available. Such termination is without any expense or penalty, except for the portions of the Lease Payments and those expenses associated with your return of the Equipment in accordance with Section 3 of this Lease for which funds have been budgeted and appropriated or are otherwise legally available. Upon such termination, all of your rights and interests in the Equipment will vest in us. This Section 3 is added as a new Section 19 of this Lease entitled "Non- appropriation of Funds ". 4. Choice of Law. Regardless of any conflicting provisions in this Lease, THIS LEASE WILL BE GOVERNED BY THE LAWS OF THE STATE OF FLORIDA. This Section 4 replaces subsection (a) "Choice of Law" under Section 17 of this Lease. Lessor CIT Finance LLC Authorized Signature Print Name & Title Date The Document Imaging People Customer Support Agreement for Block Contracts Customer #l: Date: Name: CITY OF OKEECHOBEE FIRE DEPT Addressi: 55 SE 3rd AVE Phone: 863467 -1586 Cityl: OKEECHOBEE Zip: 37974 Block contrac comes first. ts: Invoiced on meter cycles. Each cycle is good for a specified number of copies or period of time, whichever PRI E SCHEDULER ... PRICE SCHEDULE B Blo k Contract (Time or Usage) Block Contract (Time or Usage) Black Copies/Prints Black Copies/Prints copies per Cycle: 24,000 Copies per Cycle: st per Cycle: $240.00 Cost per Cycle: Months per Cycle: Mon hs per Cycle: -12 Platinum Upgrade By upgrading to Our Platinum Coverage, you authorize EGP to add a one -time charge, per system. In exchange, EGP will install a state -of- the -art surge suppressor /ener filter and will cover print systems, fax options, scan boards and hard drives excluded in the Customer Support Agreement. This surge suppressor /energ' filter must be installed by a qualified EGP Technician and remain locked to the system. Removal of the surge suppressor /energy filter from the system will void the Platinum coverage. I agree to purchase the Platinum Upgrade and understand all the terms and conditions as outlined ❑ I am declinin* to purchase t latinum Upgrade and unde.. (and all the terms and conditions as outlined 3 /9 /S- Signature: Network Service$ Time -Based Contract EGP offers our ci stomers Network Service Tim this Customer Sujort Agreement. ❑ I agree to purchase the Network Services Time Based Contract Date: ased contracts for Help Desk and On -Site Network Tech Support for Network Services not covered under I am declining to purc Signature: Network Servi Contract Date: 3/9 //, EGP Customer Service 1- 800 -451 -9407 Oblieations of GP: EGP, Inc. ("EGP") shall furnish all service, parts, labor, drums, toner and developer to produce a Published Guaranteed Yield Copies are base on 8 % x 11 sheet of bond paper or one linear foot of photocopying on "wide format" equipment. The scope of EGP 's service shall not include provision of paper, staples, optional print systems, facsimile options, hard drives or any optional items related to the Customer's digital system or any network support, including without limitations any maintenance required after installation ofsof ware by the Customer, after software updates or after any changes to operating systems have been made. Network support will be billed at EGP's current labor rate. The scope of EGP's service shall not include repairs necessitated by accident, misuse, abuse, theft, vandalism, electrical power failure, water, acts of God, or other causality or to repairs made necessary by service performed by personnel other than EGP. EGP shall only be obligated to provide service and support under this Agreement during Service Hours, Monday through Friday, 8am to Spm excluding EGP recognized holidays. The service and support provided by EGP under this Agreement does not include p: service, repairs or replacement of parts necessitated by the Customer exceeding a manufacturer's recommended volume limitations: b) service, repairs Or replacement ofparts necessitated by the malfunction of non-original manufacturer's equipment, parts, supplies, or attachments which have not been authorized by EGP in writing; c) services, repair or replacement of parts necessitated by the improper installation of toner, developer or foreign agents by the Customer; d) the cost of exterior and add-on copy counting or monitoring devices; or e) the cost of the equipment movements or relocations. The costs and expenses incurred for items not included in this Agreement and for supplies consumed as a result of abuse or misuse of equipment are the sole responsibility of the Customer. Oblieations o be in good mec shall provide sus charge a fee for The Customer s will be added fo and adjust the eq Recommended that do not met requirements by minimum require stomer: The Customer shall pay for the services and support provided by EGP in accordance with this Agreement. The equipment shall nical condition on the date of commencement of this Agreement, as determined by EGP, Inc. and its' service technicians. The Customer able electrical service and maintain proper environmental conditions, e.g. power filter and surge protection. EGP reserves the right to cessive toner use when manufacturer's published yield is not achieved Customer is responsible for shipping cost for toner and supplies. II provide EGP with meter readings as needed and accept estimated meter readings based upon service history. A meter collection fee equipment not remotely monitored The Customer shall pay for special servicing required to prepare equipment for movement or reinstall ipment after a movement. uter Re ' uirements: The Customer understands that the digital equipment may not function properly on computer systems or networks e specified minimum requirements. Any expenses incurred while satisfying the network and/or computer system hardware or software he Customer, EGP or any third party shall be the sole responsibility of the Customer. No refunds of installation fees will be given if all ems are not satisfied ment and Disclosure: The Customer hereby authorizes EGP and its representatives to operate the computer systems for purposes of (ding and inspection and the Customer hereby accepts full responsibilityfor any adverse consequencesfrom EGP's operation of such and the Customer hereby releases EGP from any responsibility or liability for EGP's operation of Customer's computer systems. EGP essary materials (both hardware and software) into such computer equipment. EGP shall not be held liable for any expenses or damages installation or use of any hardware or software by EGP, the Customer or any third party. The Customer hereby releases EGPfrom all ability for any loss or damage due to fire, theft, accident, or by any other cause. The Customer acknowledges that an integral part of this ure and normal operation of a computer system is the performance of regular back -ups. EGP will not perform a back -up of the and the Customer hereby releases EGP from any liability regarding lost data on arty fired or removable drives. Upon request, EGP rk support to insure a successful installation for an additional fee based upon its current hourly rate. al and Termination: The Term of this Agreement shall automatically renew for an additional term unless either party provides written ion of this Agreement to the other party, by certified mail or by email, more than thirty (30) days prior to expiration of the then - current just the pricing for service and support within its sole discretion, at the beginning of each new term. If certain equipment services under e sold to a third party or moved out of EGP's geographic service area, this Agreement shall be terminated as to that equipment. EGP er obligation to service or support terminated equipment and the Customer shall pay Liquidated Damages to EGP for that equipment, as Early Termination. In the event this Agreement is terminated prior to the expiration of the Agreement term by the Customer or as a result of a breach by Customer shall pay liquidated damages, but not as a penalty, in an amount equal to the total average monthly charge, charged to the twelve months prior to termination, times the number of months or metered cycles remaining under the term of this Agreement not to Customer and EGP hereby stipulate that damages flowing from or consequent to a breach of this Agreement are not readily ascertainable Lion of this Agreement and the liquated damages to be paid are not unreasonable or disproportionate. agreement is not assignable or otherwise transferable by either party in whole or in part without prior written consent of the other parry. fer or assignment by a party without the other party's prior written consent is void. hie remed : Customer's exclusive remedy against EGP and EGP's sole obligation in contract, tort, or otherwise, shall be for EGP to repairs to the Equipment and to keep the Equipment in good operating condition. In no event .shall EGP be liable for any indirect, ential damages arisingfrom the Agreement or the use of the Equipment or any service provided under this Agreement. Installation A testing, troublesh computer syste may install the n incurred during responsibility or installation proc Customer's syste can provide nehv Automatic Ren notice of cancel! term. EGP may this Agreement a shall have no furl defined in Sectio Earl Terminatio the Customer, th Customer for the exceed 6 months. at the time of exe Assienment: Th Any attempted tra Customer's exclu make all necessa special or conseq Le: al Proceedinl : This Agreement shall be governed by, and interpreted and enforced in accordance with the laws of the State of Florida without regard to its choice of 1 v rules. Jurisdiction and venue shall lie in the County and Circuit Courts in Orange County, Florida. If any legal action or other proceeding or acdon is brought forth for the enforcement of this Agreement, or because of an alleged dispute, breach, default, or misrepresentation in connection with any provision of the Agreement, the successful or prevailing party or parties shall be entitled to recover reasonable attorney's fees, court costs, and all of r expenses, even if not taxable court costs (including without limitation, all such fees, costs and expenses incident to trial appellate, bankruptcy, and st judgment proceedings), incurred in that action or proceeding or any appeal, in addition to any other relief to which the party or parries may be entitled. Furthermore, the Customer agrees to pay all costs of collection including reasonable attorneys fees whether suit be brought or not, incurred by EGP i collecting any past due balances or recovering any equipment. Entire Am-emend This Agreement contains the entire understanding, Agreement and contract between EGP and the Customer and each agrees that no representation, warranty or covenant was made by or on behalf of the other that is not contained in this Agreement and that in entering into this Agreement neither party reli d upon any representation, warranty or covenant not herein contained. Handwritten and/or typewritten provisions inserted into this Agreement initiale by both parties and approved by an EGP Authorized Officer shall control over the typewritten provisions in conflict therewith. By signing, you a ree that you have read understand and will comply with all terms, conditions and statements listed This Agreement st be approved by an EGP Authorized Officer before binding on EGP, Inc. Customer: Name: Signature: Title: EGP Inc. By- Date Signature: Title: rlltl..E, WE 1V1c.1Y1' Machine Type KYOCERA Model#: M3550idn Serial# Start Meter Black Ship To Address SAME Color Total ID # City State %Platinum Coverage Protector Serial# Phone# Zip Machine Type Model #: Serial# Start Meter Black Color Total ID # Ship To Address Phone# City State Zip ❑ Platinum Coverage Protector Serial# Machine Type Start Me Ship To Addn City r Black Model#: Serial# Color Total . ID # ss Phone# ❑ Platinum Cov rage Protector Serial# State Zip Machine Type Model #: Serial# Start Meier Black Color Total ID # Ship To Address Phone# City ❑ Platinum Coverage Protector Serial# State Zip Machine Type Model #: Serial# Start Meier Black Color Total ID # Ship To Address Phone# City State Zip ❑ Platinum Coverage otector Serial# Initial: ❑ Additional Equipment (See Schedule A) Version: 10/10/2014 ACCORD CERTIFICATE OF PROPERTY INSURANCE DATE (MM/DD/YYYY) 1/30/2015 THIS CERTIFICATE NS 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. If this certificate is being prepared for a party who has an insurable interest in the property, do not use this form. Use ACORD 27 or ACORD 28. PRODUCER World Risk Management, LLC 20 North Orange Avenue Ste 500 Orlando FL 32801 CONTACT P Diane Crispin NAME: PHONE (A/C No. Exit (407) 445 -2414 ADDRESS: diane crispin @wrmllc.com FAX (407)445 -2868 (NC, No): PRODUCER 00000047 CUSTOMER ID: INSURER(S) AFFORDING COVERAGE NAIC # INSURED City of Okeechobee 55 S.E. 3rd Avenue Okeechobee FL 34974 INSURER A: Public Risk Management of Florida INSURER B : INSURER C: INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER P1132500140 REVISION NUMBER: LOCATION OF PREMISES / DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Remarks Schedule, if more space is required) THIS IS TO CERTIFY INDICATED. NOTWITHSTANDING CERTIFICATE MAY BE EXCLUSIONS AND CONDITIONS -HAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (M&VDD/YYYY) POLICY EXPIRATION DATE (MWDD/YYYY) COVERED PROPERTY LIMITS A X I PROPERTY CAUSES OF LOSS I EDUCTIBLES 014 -001 10/1/2014 10/1/2015 — _ X — BUILDING PERSONAL PROPERTY BUSINESS INCOME EXTRA EXPENSE RENTAL VALUE BLANKET BUILDING BLANKET PERS PROP BLANKET BLDG 8 PP $ $ BASIC UILDING S BROAD $ +.0111-Ears X SPECIAL $ EARTHQUAKE - $ WIND $ FLOOD $ 2 , 500 , 000 $ $ CAUSES INLAND MARINE ' OF LOSS ,,. NAMED PERILS TYPE OF POLICY — $ $ POLICY NUMBER $ $ A X TYPE CRIME OF POLICY PRM 014 -001 10/1/2014 10/1/2015 — _ $ 500,000 $ 500,000 $ 500,000 I BOILER 8 MACHINERY EQUIPMENT BREAKDOWN / — $ $ — $ $ SPECIAL CONDITIONS 1 OTHER With respects written lease L8H4301725. CIM COVERAGES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) to the listed coverages held by the named insured, as evidence of insurance per agreement on contract #1219324 for New Kyocera copier model # TA- 3551ci serial # Financial is listed as Loss Payee. CERTIFICATE HOLDER CANCELLATION CIT Financial Customer Service 10201 Centurion Pkwy N #100 Jacksonville, FL 32256 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 Andrew Cooper /PATTI ACORD 24 (2009/09)' INS024 (200909) © 1995-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD