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PROOF OF INSURANCE (2017) CLOSED AC�. TTB DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 8002 2/22/2017 THIS CERTIFICATEIS 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(s). PRODUCER CONTACT NAME: PROFESSIONAL INS ASSOC INC/PHS (AC.No,E.0 (866) 467-8730 �pN ,Nc): (888) 443-6112 141078 P: (866) 467-8730 F: (888) 443-6112 q DRIESS: PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAIC# SAN ANTONIO TX 78265 INSURER A: Sentinel Ins Co LTD 11000 INSURED i INSURER B INSURER C SCDS CONSULTING DESIGN INSURER ............................. 2518 W 157TH ST INSURER GARDENA CA 90249 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,EXCLUS IONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OFINSURANCE ,111'DI. SWIM POLICYNUMRER POLILYEFF POLICYENP LIMITS ,.LrR INRR III." /M1/M17)1)1'YYY1) IM1fIM/OD/F'YYNI EACH OCCURRENCE „Z _ 000 000 COMMERCIAL GENERAL LIABILITY > r r CLAIMS-MADE �I ° I OCCUR DAMAGERENTED I`�, __ PREMISES S(R occurrence) $1, 000, 0 0 0 A X General Liab X I 57 SBA AT3451 09/23/2016 09/23/2017 MED EXP(Any one person) $10, 000 PERSONAL&ADV INJURY $2, 0 00, 000 GI`NIT,AGGREGAr'l-LIMIT APPLIES PER: �GENERAL AGGREGATE :a 4, 000, 0 0 0 h'OLtlC:;IY' PRO LOC PRODUCTS-COMP/OP AGG A, 000, 000 A JECT r OTHER: 'S I AUTOMOBILE LIABILITY G COMBINED SINGLE LIMIT {I (Ea accident) 'y ANY AUTO I BODILY INJURY(Per person) OWNED SCHEDULED .- AUTOS ONLY AUTOS I BODILY INJURY(Per accident) HIRED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY AUTOS ONLY I (Per accident) X UMBRELLA LIAB X OCCUR I EACH OCCURRENCE 1$ _ >3, 000, 000 A EXCESS LIAB CLAIMS-MADE X 57 SBA AT3451 09/23/2016 09/23/2017 AGGREGATE 3, 000, 000 DED ]RETENTION$Vl0,000 AND EMPLOYERS'LIARIOITY (STATUTE IFR H ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E L EACH ACCIDENT �y OFFICER/MEMBER EXCLUDED? ryry NIA (Mandatory in NH) I E L DISEASE-EA EMPLOYEE "S If yes,describe under VV XX E DISEASE-POLICY LIMIT I S DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Those usual to the Insured' s Operations . City of El Segundo is an additional insured per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of El Segundo AUTHORIZED REPRESENTATIVE 350 MAIN ST EL SEGUNDO, CA 90245 ..._....................... 1988.2015 ACORD CORPORATION,All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Tj-IE HARTFORD Select Customer Insurance Center 3600 WISEMAN BLVD. SAN ANTONIO TX 78251 Policyholder, please call us at: (866) 467-8730 Agent, please callus at: (866) 467-8730 SERVICE.TX @THEHARTFORD.COM INSURANCE ENDORSEMENT ATTACHED *** PLEASE REVIEW THE CHANGE *** Enclosed is an endorsement for your business insurance policy. Please review it at your convenience. If you have questions or need to make further changes: Policyholder, please call us at: (866) 467-8730 Agent, please call us at: (866) 467-8730 between 7 A.M. and 7 P.M. CST . The premium billing will be mailed to you separately. You can expect to receive it soon. Thank you for allowing us to service your business needs. PROFESSIONAL INS ASSOC INC/PHS THE HARTFORD SELECT CUSTOMER INSURANCE CENTER The Hartford Hartford Fire Insurance Company and its Affiliates One Hartford Plaza,Hartford,Connecticut 06155 it THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLICY CHANGE This endorsement changes the policy effective on the Inception Date of the policy unless another date is indicated below: Policy Number: 57 SBA AT3451 DX Named Insured and Mailing Address; SCDS CONSULTING DESIGN 2518 WEST 157TH STREET GARDENA CA 90249 Policy Change Effective Date: 02/22/17 Effective hour is the same as stated in the Declarations Page of the Policy. Policy Change Number: 002 Agent Name: PROFESSIONAL INS ASSOC INC/PHS Code: 141078 POLICY . SENTINEL INSURANCE COMPANY, LIMITED ANY CHANGES IN YOUR PREMIUM WILL BE REFLECTED IN YOUR NEXT BILLING STATEMENT.IF YOU ARE ENROLLED IN REPETITIVE EFT DRAWS FROM YOUR BANK ACCOUNT, CHANGES IN PREMIUM WILL CHANGE FUTURE DRAW AMOUNTS. THIS IS NOT A BILL. NO PREMIUM DUE AS OF POLICY CHANGE EFFECTIVE DATE BUSINESS LIABILITY OPTIONAL COVERAGES ARE REVISED ADDITIONAL INSURED(S) ARE ADDED THE FOLLOWING ARE ADDITIONAL INSURED FOR BUSINESS LIABILITY COVERAGE IN THIS POLICY. LOCATION 001 BUILDING 001 SEE FORM IH 12 00 PRO RATA FACTOR: 0.907 THIS ENDORSEMENT DOES NOT CHANGE THE POLICY EXCEPT AS SHOWN. Form SS 1211 0405 T Page 001 (CONTINUED ON NEXT PAGE) Process Date: 02/22/17 Policy Effective Date: 09/23/16 Policy Expiration Date: 09/23/17 POLICY CHANGE (Contiinued) Policy Number: 57 SEA AT3451 Policy Change Number: 002 ADDITIONAL INSURED 02 - OWNERS, LESSES OR CONTRACTORS IS ADDED FORM SG4171 NAME CITY OF EL SEGUNDO ADDRESS 350 MAIN ST. EL SEGUNDO CA 902451 FORM NUMBERS OF ENDORSEMENTS REVISED AT �NDORSEMENT ISSUE: SS 41 71 06 11 11+120101185 ADDITIONAL INSURED - PERSON-ORGANIZATION FORM NUMBERS OF ENDORSEMENTS REVISED AT ENDORSEMENT ISS1.0 111120011,85 Af.)DITIONAL INSURED - OWNER, LESSEES OR CONTRACTOR Form SS 12 1104 05 T Page 002 Process Date: 02/22/17 Policy Effective Date: 09/23/16 Policy Expiration Date: 09/23/17 POLICY NUMBER; 57 SBA AT3451 CHANGE NUMBER: 002 lk THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): CITY OF EL SEGUNDO Location And Description Of Completed Operations: 350 MAIN ST. EL SEGUNDO CA 90245 Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Section C. — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard". d Form SS 417'106'11 Page 1 of 1 Process Date: 02/22/17 Policy Expiration Date: 09/23/17 © 2011,The Hartford (Includes copyrighted material of Insurance Services Office, Inc., with its permission) POLICY NUMBER: 57 SBA AT3451 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - PERSON-ORGANIZATION GLENBOROUGH, LLC 650 EAST HOSPITALITY LANE 150 SAN BERNADINO, CA 92405 W.E. O'NEIL CONSTRUCTION CO. OF CALIFORNIA 909 N. SEPULVEDA BLVD. , SUITE 400 EL SEGUNDO, CA 90245 FAR WEST CONTRACTORS CORP 7070 PATTERSON DRIVE GARDEN GROVE, CA 92841 RE:350 EAST AVENUE M, PALMDALE CA & ONE SPACE PARK, REDONDO BEACH CA VERIZON COMMUNICATIONS INC. AND ITS SUBSIDIARIES AND AFFILIATES AND ITS VERIZON AFFILIATES, FIRECTORS, OFFICERS AND REPRESENTATIVES 2400 NORTH GLENVILLE DRIVE RICHARDSON, TX 75082 NORTHROP GRUMMAN SYSTEMS CORPORATION 2980 FAIRVIEW PARK FALL CHURCH, VA 22042 2H CONSTRUCTION 2653 WALNUT AVE SIGNAL HILL, CA 90755 CITY OF EL SEGUNDO 350 MAIN ST. EL SEGUNDO CA 90245 Form K 1 00,11 85T SEQ. NO. 001 Printed in U.S.A. Page 001 Process Date: 02/22/17 Expiration Date: 09/23/17 POLICY NUMBER: 57 SBA AT3451 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNER, LESSEES OR CONTRACTOR CITY OF EL SEGUNDO 350 MAIN ST. EL SEGUNDO CA 90245 Form IIH 1 1186 T SEQ. NO. 003 Printed in U.S.A. Page 001 Process Date: 02/22/17 Expiration Date: 09/23/17 DATE(MM/DD/YYYY) A4CC?R -> CERTIFICATE OF LIABILITY INSURANCE 2/312017 _ 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 M chael J Hall&Company PHONE such endorsement(s). Y W�F F Michael J..9::)aNN.. ...C.!�mp.any.,...L1. 0.1Y a 1107 445 W.. Ir)t ,a700 9r rt�,R_ 00_ 9 _�s' 1. -- �A/E Insurance Services E-MAIL 19660 10th Ave NE !� —s_ Ctify�t �J'll�l3tp�?Dyorlro IPoulsbo WA 98370 INx ............................................................... .....U.R.E,.R.ISI..AFFORDIN,OC,OVERAGE NAIC# I INSURER A:Lllaenrly Insurance Vn.defwrlter; Inc/ '16917 INSURED 11325 INSURER B: SCDS Consulting Design INSURERC: 2518 W 157th Street Gardena CA 90249 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1500145535 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 POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER POLICY (MM/DDIYYYK) ,. GENERAL LIABILITY EACH OCCURRENCE $ _-- DAMAGE 70-fEN"TED _COMMERCIAL GENERAL LIABILITY PRFMISES­(Ea occurrence) $ CLAIMS-MADE ��OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE I � MIT APPLIES S PER: ..PRODUCTS COMP/OP AGG POLICY P RO 1 LOC $ JFC7 11 AUTOMOBILE LI A BILITY ,UnOIW a C{it.t 901 Ea ac I ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPfR IlYDAMAGE $ HIRED AUTOS AUTOS (Pfy a[cidamnt) UMBRELLA LI AB OCCURRENCE OCCUR ,$ EXCESS LI AB HCLAIMS-MADE AGGREGATE $ DED I u $ RETENTION$ $ WORKERS COMPENSATION „1CC MIT-I,,,,,,,,I T AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE[:] N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E,L.DISEASE-EA EMPLOYEE_,_$ If yes,describe under DESCRIPTION OF OPERATIONS below E L.DISEASE'-POLICY LIMIT $ A Professional Liab Claims Made AEE1024040002 2126/2016 2/26/2018 $2,000,000 Per Claim $2,000,000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of EL Segundo THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 350 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. El Segundo CA 90245 AUTHORIZEDD REP% TIVE Vy I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD AC" VEHICLE OR EQUIPMENT CERTIFICATE OF INSURANCE DATE(MMIDDIYYYY) Fo;/27/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. This form Is used to report coverages provided to a single specific vehicle or equipment.Do not use this form to report liability coverage provided to multiple vehicles under a single policy.Use ACORD 25 for that purpose. PRODUCER CONTACT NAME: Judy 9e Agency, Iva{ F;x% .. Sfa eFa= Beth Belt r Insurance A en Inc. PHONE FAX 562-809-9559 A. r t laoo � 20220 State Road A AIL ud opp h'betiger.com t Cerritos,CA.90703 CUSTOMER ID o: INSURER(S)AFFORDING COVERAGE NAIC S _ INSURED INSURER A State Farm: ob. INSURERS .,.... Mutual Automobile Insurance Company 2517$ SANTA CRUZ,EDUARDO S SHANNON 2518 W 157TH ST INSURFRC: GARDENACA 90249-4627 INSURER D: INSURER E: DE'SCRIPTI'ON OF VEHICLE OR EQUIPMENT YEAR I MAKE I MANUFACTURER MODEL BODY TYPE VEHICLE MENTWICATION NUMBER 2^.......7. Toyota 0 ota Prerunner Pick-u p 5TEJU62N07Z413471 ......... ._. . ... 4-,....._.___...,...;...._. DESCRIPTION VEHICLEIEQUIPMENT VALUE SERIAL NUMBER - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER.: THIS IS TO CERTIFY THAT THE POLICY(IES)OF INSURANCE LISTED BELOW HASIHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD(S)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 POLICY(iES)DESCRIBED HEREIN IS/ARE SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICY(IES). IN SR!aW2a01 POLICY EFFECTIVE POLICY EXPIRATION ✓� LTR I I D TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYYYY) DATE MIDD/YYYY) LIMITS VEHICLE LIABILITY COMBINED SINGLE LIMIT S z,000,000 BormY INJURY(Per person) $ 139-8383-B18-75 02118!2017 08/18/2017 U BODILY INJURY(Per accident) S PROPERTY DAMAGE i GENERAL LIABILITY EACH OCCURENCE E OCCURRENCE GENERALAGGREGATE $ CLAIMS MADE S INSR Loss POLICY EFFECTIVE "POLICY EXPIRATION LTR PAYEE TYPE OF INSURANCE POLICY NUMBER DATE(MWDDIYYYY) DATE(MMIDDIYYYY) LIMITS I DEDUCTIBLE X VEH COLLISION LOSS 139-8383-B18-75 0211BQ01m 7— 06118/2017 []ACV E]AGREED AMT S LIMIT 0- []STATED AMT $500 DED I� S X VEH COMP VEH OTC I _ ACV AGREED AMT LIMIT m.. -.. _ .. 139-8383-BIB-75 02/16!2017 08/18/2017 © []STATED AMT S 500 DED _ .,. EQUIPMENT ❑ACV E]AGREED AMT $ LIMIT BASIC BROAD C]RC E]STATED AMT $ DED SPECIAL El 6 i REMARKS(INCLUDtNO SPECIAL CONDITIONS I OTHER COVERAGES)(Attach ACORO 101,Add@lorsel Remarks Sebed A%It mom apace Is required) 100%Replacement Cost up to the policy limits I Request for Additional Irlswed has been added and will be mailed out from our regional Office ADDITIONAL INTEREST CANCELLATION Sheet one of the following: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The add clonal intouodt dowbad bakm huts Won added to the pelity(ioo)Wed herein by poTicy nunnber(s). BEFORE THE EXPIRATION DATE THEREOF,NOTICE W11-1.BE A vmzwut has been subrlAlod to add Lie eooWnao lnleaoat deeoobud below to ft poNCY(ies) DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. listed lht»rel,iby_rot Ruan ba a. (LEASED VEHICLE I EQUIPMENT INTEREST: LEASED 'FINANCED DESCRIPTION OF THE ADDITIONAL INTEREST - a.. _. .w NAME AND ADDRESS OFAODn DO ZINTEREST ADDITIONAL INSURED LOSS PAYEE - City of El Segundo,it's Officials and Employees LENDER°S Loss PAYEE 350 Main Street LOAN I LEASE NUMBER El Segundo,CA.90278 THORVEO REP EN' T 01997.2015 ACORD CORPORAT fights reserved. ACORD 23(2016103) The ACORD name and logo are regls'te d marks of ACORD 1004:i61 142987.3 01-28-2818 CITY OF EL SEGUNDO WORKERS' COMPENSATION DECLARATION .......................................................................................... .........................................................................................................a...................................................................................................................................................................... ............................................................................................. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SUBJECTS AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN LABOR CODE § 3706, INTEREST, AND ATTORNEY'S FEES. affirm under penalty of perjury under the laws of California one of the following declarations: (_) I have and will maintain a certificate of consent of self-insure for workers'compensation, issued by the Director of Industrial Relations as provided for by Labor Code§3700 for the performance of the work set forth the agreement with the City of El Segundo. Policy No. (_)I have and will maintain workers'compensation insurance as required by Labor Code§3700 for the performance of the work for which the agreement with the City of El Segundo is executed. My workers' compensation insurance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone# (IL) I certify that, in the performance of the work set forth in the agreement with the City of El Segundo, I will not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Labor Code § 3700 1 must rent will automatically become void. 02/16/17 immediate) comply with those roves +DWI Date Y PY P ouo�e ¢ I'i N Signature of Applicant ] ,. Agreement for: -1 Dated: Reviewed by: 1