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HomeMy WebLinkAboutCONTRACT BETWEEN AUGUSTA, GA AND BLANCHARD & CALHOUN INSURANCE AGENCY, INC. FOR INSURANCE BROKERAGE SERVICES FOR THE AUGUSTA AVIATION COMMISSION AUGUSTA REGIONAL AIRPORT CONTRACT FOR INSURANCE BROKERAGE SERVICES FOR THE AUGUSTA AVIATION COMMISSION AUGUSTA REGIONAL AIRPORT AND B LANCHARD &CALHOUN INSURANCE AGENCY, INC. TABLE OF CONTENTS Page Article I Scope of Work 3 Article II Data Security and Software 6 Article III Staffing 6 Article IV Standards and Practices 7 Article V Compensation 7 Article VI Contract Term 7 Article VII Insurance Requirements 7 Article VIII Indemnification 9 Article IX Broker as Independent Consultant 9 Article X Assignment 9 Article XI Nondiscrimination 9 Article XII Default and Termination 10 Article XIII Miscellaneous Provisions 11 Exhibit A Required Submittals Exhibit B Specified Portions of Broker's Proposal Exhibit C Broker's Cost Proposal Contract for Insurance Brokerage Services Page 2 of 57 This Contract for Insurance Brokerage Services for the Augusta Regional Airport is entered into this 30 day of V\kayr _ , 2017, by and between Augusta, Georgia, a political and legal subdivision of the State of Georgia for the Augusta Aviation Commission (hereinafter referred to as "Airport") and Blanchard & Calhoun Insurance Agency, Inc., (hereinafter referred to as "Broker"), a Georgia domestic profit corporation whose principal place of business is located at 245 Davis Road,Augusta, Georgia. WITNESSETH: WHEREAS, the Augusta Aviation Commission requires a qualified firm to provide insurance brokerage services; and WHEREAS, the Airport issued a Request For Proposal (RFP), RFP 17-141 Airport Insurance Brokerage Services, requesting proposals from qualified brokers to provide Insurance Brokerage Services and act as the Airport's Agent/Broker of Record for various insurance policies; and WHEREAS, Broker responded to the RFP and represented that it is a qualified Broker that possesses the necessary expertise, knowledge, training and skills; and has the capability to perform all requirements and tasks set forth in this Contract; and WHEREAS, the Airport desires to enter into a Contract the Broker. NOW THEREFORE, in consideration of the promises and the mutual covenants contained in this Contract, the sufficiency and receipt of which is hereby acknowledged together, the Parties agree as follows: ARTICLE I SCOPE OF WORK BACKGROUND The Airport is located in Augusta, Georgia and is operated by the Augusta Aviation Commission for the City of Augusta. The Airport is a full-service commercial airport, as well as, a Fixed Based Operator and general aviation facility. The commercial side of the Airport consists of a new main passenger terminal that was completed and occupied within the last nine (9) years. The Augusta Air Trade Area has a population of over 550,000 and is the second largest city in Georgia. The Airport is served by two airlines: Delta Air Lines and American Eagle (d/b/a American Airlines). The Airport had twenty-four scheduled arrivals and departures per day as of December 2016. The Airport served 552,774 passengers in 2015 and projects 552,000 passengers in 2016.Augusta Regional Airport is a non-smoking facility. Total Annual Passengers: 2011 —541,843 2012—551,953 2013 —535,810 2014—534,204 2015—552,774 Contract for Insurance Brokerage Services Page 3 of 57 2016—552,000 1.0 SERVICES 1.1 The Broker shall review the Airport's existing coverages and contracts and make recommendations to make suggestions for new services and products to include: Aviation Commercial General Liability Business Auto—Pilot Courtesy Cars Business Auto—Fleet Commercial Inland Marine(Equipment and Fine Arts) Directors and Officers' Liability Pollution Liability 1.2 The Broker shall maintain full and accurate records with respect to all matters and services provided on behalf of the Airport's benefit plans and programs. 1.3 Broker shall, as directed by the Airport, negotiate with providers on various topics including, but not limited to, premium rates, benefits levels, performance standards and guarantees, contractual terms and conditions, quality assurance standards, utilization and performance reports, statistical and/or financial reports. 1.4 Serve as the Augusta Regional Airport Aviation Commission's Agent/Broker of Record for various lines of insurance. 1.5 Solicit and analyze proposals received from various insurance companies, negotiate changes for the benefit of the Augusta Regional Airport Aviation Commission and verify the reasonableness of the coverage terms and pricing. 1.6 Represent the Augusta Regional Airport Aviation Commission in all negotiations with insurers, underwriters, and other parties with regard to the Airport's insurance program. 1.7 Provide summaries of the various insurance programs and options, including but not limited to, limits, coverage, retention levels, terms, conditions, payment options,pricing, and insurer quality. 1.8 Make recommendations to the Augusta Regional Airport Aviation Commission of the most advantageous insurance programs providing the highest level of coverage at the best possible price to meet the Airport's needs and objectives. 1.9 Provide analysis and recommendations as to the most cost effective means for addressing the Augusta Regional Airport Aviation Commission's exposures. Contract for Insurance Brokerage Services Page 4 of 57 1.10 Review all policy and contract documents, including binders, issued to ensure that the insurance policies and contracts conform to the proposals offered by the insurers and those accepted and approved by the Augusta Regional Airport Aviation Commission. 1.11 Administer the placement of coverage and provide original binders, policies, and endorsements as requested and required in the timetable specified by the Augusta Regional Airport Aviation Commission. 1.12 Ensure that insurance policies are placed with reputable and financially responsible insurers (based on insurance rating among other criteria) including keeping the Augusta Regional Airport Aviation Commission informed of any changes in rating of the insurers and making recommendations should ratings change during policy term. 1.13 Assist the Augusta Regional Airport Aviation Commission with the review and design of insurance requirements to be used in contracts and leases. 1.14 Act as liaison between the Augusta Regional Airport Aviation Commission and the insurers and service companies in assisting with claims and providing certificates of insurance as necessary. 1.15 Review loss runs and provide copies of loss runs and summaries to the Augusta Regional Airport Aviation Commission annually. 1.16 Provide the Augusta Regional Airport Aviation Commission with aviation market trends annually. 1.17 Attend meetings related to the insurance program as requested. 1.18 Perform administrative and clerical services relative to account management, including but not limited to, changes to policies, premium adjustments, verification of accuracy of bills,and audits. 1.19 Submit all payments/premiums to carriers and other parties. All payments/premiums will be made to the selected brokerage Broker. 1.20 Assign account manager to the Augusta Regional Airport Aviation Commission who will be responsible for communication with the Airport and who, along with any other team members assigned, must be available on a 24 hour/7 day a week basis for advice and consultation on insurance program related issues and concerns. 1.21 Prepare and deliver necessary reports,including an annual report which contains a summary of the insurance program in force, coverage provisions, and any insurance claims. Contract for Insurance Brokerage Services Page 5 of 57 1.22 Assist in the management of claims asserted by passengers and patrons. 1.23 Ensure that the insurance policies provided are in effect continuously without a break in service. ARTICLE II DATA SECURITY AND SOFTWARE 2.1 Broker shall ensure that all personal and medical data provided by the Airport related to its employees or its patrons shall be maintained in a secure environment and protected from unauthorized access. 2.2 Individually identifiable information about the Airport's patrons or employee's past, present, or future health or condition, the provision of health care or payment for the health care is considered "Protected Health Information" ("PHI"). Broker shall comply with all HIPPA regulations. 2.3 Security Measures. Broker warrants that it has security measures to protect data from unauthorized access both in transmission and while housed. Users access Broker's systems only with a valid Username and Password combination transported over an encrypted SSL protocol. (Description of Security system to be provided by Broker) 2.4 Security Testing Procedures. Broker warrants that its security testing procedures shall protect the Airport's data. (To be provided by Broker) 2.5 Physical Security Measures. Broker utilizes physical security measures to protect server environment where data is housed. (To be provided by Broker) 2.6 Broker acknowledges that the Airport and City are subject to the Georgia Open Records Act. Broker shall immediately notify the Airport's Executive Director or his designee regarding any Open Records Requests received. 2.13 Upon the termination of the contract Broker shall return all data provided by the Airport during the term of the contract. ARTICLE III STAFFING 3.1 Broker shall provide adequate staffing for the Contract. 3.2 Broker shall utilize the persons listed in its proposal as Key Personnel. Any changes or substitutions in the Broker's personnel providing services shall be disclosed in writing to the Airport's representative. Any substitute personnel shall be qualified in accordance with requirements of this Contract. Contract for Insurance Brokerage Services Page 6 of 57 3.3 Broker's Key Personnel list is attached hereto as part of Exhibit B. ARTICLE IV STANDARDS AND PRACTICES Broker must conform to the highest standards of practices for the insurance brokerage industry. ARTICLE V COMPENSATION 5.1 Broker shall be compensated at the commission rates on Exhibit C attached hereto. 5.2 Invoices shall be submitted to: Ms. Risa Bingham, Finance Director 1501 Aviation Way Augusta, GA 30901 5.3 PAYMENT: Payment shall be tendered to the Broker upon acceptance and approval by the Airport for satisfactory compliance with the general terms, conditions and specifications of the Contract, completed services; verification of delivery of products; assurance that the product/service performs as specified and warranted; and receipt of a valid invoice. ARTICLE VI CONTRACT TERM The initial contract term shall be two years. By mutual agreement between the Broker and the Airport, the contract may be renewable for three (3) additional one (1) year periods. In accordance with Georgia law regarding multi-year contracts, the effective date of the contract shall continue through December 31 of the date of execution. The contract shall: (i) terminate absolutely and without further obligation on the part of Augusta each and every December 31st, as required by O.C.G.A. § 3b-b0-13, as amended, unless terminated earlier in accordance with the termination provisions in this Article of this Agreement: (ii) automatically renew on each January 1st, unless terminated in accordance with the termination provisions of this Agreement; and (iii) terminate absolutely, with no further renewals, on December 31, 2022, unless extended by written amendment. The Contract Time may be extended only by written renewal approved by the Augusta Aviation Commission, Augusta, Georgia Board of Commissioners and executed by the Augusta, Georgia Mayor and the Contractor in accordance with the terms of this Contract. ARTICLE VII INSURANCE REOUIREMENTS Contract for Insurance Brokerage Services Page 7 of 57 7.1 Broker shall procure and maintain until all of its obligations have been discharged, including any warranty periods under this Contract, are satisfied, insurance against claims for injury to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Broker, his agents, representatives, employees or sub-Brokers. The insurance requirements herein are minimum requirements for this Contract and in no way, limits the indemnity covenants contained in this Contract. The Airport in no way warrants that the minimum limits contained herein are sufficient to protect the Broker from liabilities that might arise out of the performance of the work under this Contract by the Broker, its agents, representatives, employees or sub- Brokers, and Broker is free to purchase additional insurance. 7.2 MINIMUM SCOPE AND LIMITS OF INSURANCE. Broker shall provide Professional (Errors and Omissions) Liability Insurance. For Professional Services with limits of liability of not less than$1,000,000 per occurrence or claim/$2,000,000 policy aggregate. Such coverage shall insure damage, injury and loss caused by error, omission or negligent acts, including all prior acts without limitation, related to the professional services to be provided under the resulting Contract. The definition of Contractual Liability shall be amended to state that liability under a contract of professional services is covered. Further, coverage shall be afforded for personal injury, reg tory actions, wrongful acts, and contractual liability. The Broker shall ensure that coverage under this Policy continues for a period of thirty-six(36)months after completion of services. 7.3 The policy shall be endorsed to include the following additional insured language: "City of Augusta, the Augusta Aviation Commission, their appointed and elected Officials, departments, agencies, boards, commissions, and its officers, officials, agents, and employees shall be named as additional insured" with respect to liability arising out of the activities performed by or on behalf of the Broker. 7.4 Policy shall contain a waiver of subrogation against the "City of Augusta, the Augusta Aviation Commission, their appointed and elected Officials, departments, agencies, boards, commissions, and its officers, officials, agents, and employees"for losses arising from work performed by or on behalf of the Broker. 7.5 In the event that the professional liability insurance required by this Contract is written on a claims-made basis, Broker warrants that any retroactive date under the policy shall precede the effective date of this Contract; and that either continuous coverage will be maintained or an extended discovery period will be exercised for a period of two (2) years beginning at the time work under this Contract is completed. The policy shall cover professional misconduct or lack of ordinary skill for those positions defined in the Scope of Work of this contract. This coverage shall be written with all Enviromnental/Pollution exclusions deleted. 7.6 Verification of Coverage: Broker shall furnish the Airport with certificates of insurance as required by this Contract. The certificates for each insurance policy are to be signed Contract for Insurance Brokerage Services Page 8 of 57 by a person authorized by that insurer to bind coverage on its behalf All certificates and endorsements are to be received and approved by the Airport before work commences. Each insurance policy required by this Contract must be in effect at or prior to commencement of work under this contract and remain in effect for the duration of the project. Failure to maintain the insurance policies as required by this Contract, or to provide evidence of renewal, is a material breach of contract. 7.7 Sub-Brokers: It is the sole responsibility of the Broker to ensure that all sub-Brokers are covered under its policies of insurance or to ensure all sub Brokers have separately procured any and all types and limits of insurance that is required under any and all pertinent state, federal and local laws, ordinances or resolutions that is suitable for asbestos testing and inspection. ARTICLE VIII INDEMNIFICATION The Broker shall indemnify, defend and save harmless the City and the Aviation Commission and their employees and agents from all claims, losses, suits or demands for bodily injury and property damage suffered by the City, the Aviation Commission, their employees, agents, contractors, customers, invitees or other third parties arising out of the negligence, willful misconduct of the Broker or the Broker's failure to perform its obligations under this Agreement. The Airport shall give the Broker timely notice on any claim coming under the scope of this paragraph. The Broker shall be entitled to control the defense in such actions and make all decisions with respect to settlement or compromise and appeal. ARTICLE IX BROKER AS INDEPENDENT CONSULTANT In conducting its business hereunder, Broker acts as an independent consultant or contractors and not as an employee or agent of Airport. The selection, retention, assignment, direction and payment of Broker's employees shall be the sole responsibility of Broker. ARTICLE X ASSIGNMENT This Contract shall not be sold, assigned or transferred by Broker by process or operation of law or in any other manner whatsoever, including intra-corporate transfers or reorganizations between or among a subsidiary of Broker, or with a business entity which is merged or consolidated with Broker or which purchases a majority or controlling interest in the ownership or assets of Broker without the prior written consent of the Airport. ARTICLE XI NONDISCRIMINATION Contract for Insurance Brokerage Services Page 9 of 57 Notwithstanding any other provision of this Contract, during the performance of this Contract Broker, for itself, its heirs, personal representatives, successors in interest and assigns, as part of the consideration of this Contract does hereby covenant and agree, that: 11.1 no person on the grounds of race, creed, color, sex, age, handicap or national origin shall be excluded from participation in, denied the benefits of, or be otherwise subjected to discrimination in the use of the Premises; 11.2 in the construction of any improvements on, over, or under the Premises and the furnishing of services thereon, no person on the grounds of race, creed, color, sex, age, handicap or national origin shall be excluded from participation in, denied the benefits of, or be otherwise subjected to discrimination; and 11.3 The Broker shall use the Premises in compliance with all other requirements imposed by or pursuant to 14 CFR Part 152 and Title VI of the Civil Rights Act of 1964 and 49 CFR, Subtitle A, Part 21,Nondiscrimination in Federally'Assisted Programs of the Department of Transportation, and as such Title and Regulations may be amended. ARTICLE XII DEFAULT AND TERMINATION Termination by Aim' . This Contract shall be subject to termination by the Airport time in the opinion of the Airport the Broker fails to carry out the Contract provisions any one or more of the following events: 12.1 The default by Broker in the performance of any of the terms, covenants or conditions of the Contract, and/or the failure of Broker to remedy, or undertake to remedy with sufficient forces and to the Airport's reasonable satisfaction. The Airport shall provide the Broker with notice of any conditions which violate or endanger the performance of the Contract. If after such notice the Broker fails to remedy such conditions within thirty(30) days to the satisfaction of the Airport, the Airport may exercise its option in writing to terminate the Contract without further notice to the Broker and order the Broker to stop providing services immediately and vacate the premises; and to cancel ordered products with no expense to the Airport. 12.2 Broker files a voluntary petition in bankruptcy, including a reorganization plan, makes a general or other assignment for the benefit of creditors, is adjudicated as bankrupt or if a receiver is appointed for the benefit of creditors, is adjudicated as bankrupt or if a receiver is appointed for the property or affairs of Broker and such receivership is not vacated within thirty (30) days after the appointment of such receiver. 12.3 Broker's failure to provide services according to the specifications contained herein. 12.4 Broker's failure to keep, perform, or observe any other term or condition of this Contract. Contract for Insurance Brokerage Services Page 10 of 57 12.5 Broker's performance of the Contract is unreasonably delayed. 12.6 The Airport reserves the right to terminate this Contract if the services provided under this Contract do not meet or exceed existing industry standards. The Airport reserves the right to make the final determination as to the quality of services. ARTICLE XIII MISCELLANEOUS PROVISIONS 13.1 Entire Agreement, This Contract constitutes the entire agreement between the parties, and as of its effective date supersedes all prior or independent contracts between the parties covering the subject matter hereof for the services to be provided, and all representations, warranties, inducements, promises or contracts, oral or otherwise, between the parties not embodied in this Contract shall be of no force or effect. 13.2 The Airport hereby engages the Broker and Broker hereby agrees, to perform the services hereinafter set forth in accordance with this Contract, consisting of the following documents: 13.2.1 Any amendments as mutually agreed and signed by both parties; 13.2.2 Any subsequent Change Orders as mutually agreed to and approved by Airport; 13.2.3 Broker's insurance certificates; 13.2.4 Broker's licenses and permits; 13.2.5 Specified portions of Broker's RFP; and 13.2.6 Broker's Required Submittals. 13.3 The Airport and Broker hereby agree no modifications or amendment to this Contract shall not be binding upon the parties unless the same is in writing, conforms to the Airport's policies and procedures governing change orders, is signed by the Airport's and the Broker's duly authorized representatives in the same manner as this Contract is executed. 13.4 Severability. If a provision or term hereof shall be finally declared void or illegal by any court or administrative agency having jurisdiction, the entire Contract shall not be void, but the remaining provisions shall continue in effect as nearly as possible in accordance with the original intent of the parties. 13.5 Notice. Any notice given by one party to the other in connection with this Contract shall be in writing and shall be sent by certified mail,return receipt requested with postage and fees prepaid to: The Airport: Augusta Aviation Commission Attention:Airport Executive Director 1501 Aviation Way Contract for Insurance Brokerage Services Page 11 of 57 Augusta, GA 30906 With a Copy to: City of Augusta General Counsel Augusta Law Department 535 Telfair Street, Suite 3000 Augusta, Georgia 30901-2374 706-842-5550 If to Broker, addressed to: Blanchard & Calhoun Insurance Agency, Inc. Attention: Preston Moss 245 Davis Road Augusta, GA 30907 Notices shall be deemed to have been received on the date of receipt as shown on the return receipt. 13.6 Headings. The headings used in this Contract are intended for convenience and reference only and do not define or limit the scope or meaning of any provision of this Contract. 13.7 Force Majeure. Neither party shall be held to be in breach of this Contract because of any failure to perform any of its obligations hereunder if said failure is due to any act of God, fire, flood, accident, strike, riot, insurrection, war, or any other cause over which that party has no control. Such party shall give notice and full particulars of such Force Majeure in writing to the other party within a reasonable time after occurrence of the event and the obligation of the party giving such notice shall endeavor to remove or overcome such inability with all reasonable dispatch. 13.8 Waiver. The waiver of any breach, violation or default in or with respect to the performance or observance of the covenants and conditions contained herein shall not be taken to constitute a waiver of any subsequent breach, violation or default in or with respect to the same or any other covenant or condition hereof. 13.9 Controlling Law and Venue. All claims, disputes and other matters in question between the City and the Broker arising out of or relating to the Agreement, or the breach thereof shall be decided in the Superior Court of Richmond County, Georgia. The Broker, by executing this Agreement, specifically consents to venue in Richmond County and waives any right to contest the venue in the Superior Court of Richmond County, Georgia. 13.10 Dispute. Any disputes regarding the terms or conditions or performance under this Contract shall be amicably resolved if possible. If efforts by both parties to resolve the disputes are unsuccessful, all disputes shall be resolved through non-binding arbitration or mediation. Contract for Insurance Brokerage Services Page 12 of 57 13.11 Broker Affidavit and Compliance. Pursuant to the Georgia Security and Immigration Compliance Act of 2006, the Broker understands and agrees that compliance with the requirements of O.C.G.A. § 13-10-91 and Georgia Department of Labor Rule 300-10-.02 are conditions of this Contract. The Broker further agrees that such compliance shall be attested by the Broker through execution of the Broker affidavit required by Georgia Department of Labor Rule 300-10-1-.07, or a substantially similar Broker affidavit. The Broker's fully executed affidavit is attached hereto and is incorporated into this Contract by reference. 13.12 Successors and Assigns. This Contract shall be binding on the parties hereto, their successors and assigns, the Broker agrees and understands that it may not transfer or assign this Contract or any of its right or obligations hereunder without written permission of the City. 13.13 Broker's Representations: The Broker represents and warrants to the Airport that this Contract and the Broker's obligation hereunder do not violate any applicable federal, state or local law, rule or regulation and that in the event any approvals of any governmental entity are required for the performance of any Broker's obligations hereunder, all such approvals shall be obtained by the Broker at its sole costs and expense in a timely manner. The Broker represents and warrants to the Airport that no such approvals of any governmental entity involved in the regulation of banking activities are required to be obtained by the Broker in connection with the performance by the Broker of any of its obligations hereunder or the exercise of any of its rights hereunder, or as a result of the performance by the Broker of any of its obligations hereunder. The Broker further warrants that it is a validly existing Georgia corporation and that it has all the necessary licensing and permits to provide the services herein. 13.14 Existence and Powers. The Broker is duly organized and validly existing under the laws of Georgia and is duly qualified to do business in the State of Georgia, with full power, authority and legal right to enter into and perform its obligations under this Contract. 13.15 Due Authorization and Binding Obligation. This Contract has been duly authorized, executed and delivered by the Broker and constitutes a legal, valid and binding obligation of the Broker , enforceable against the Broker in accordance with its terms, except to the extent its enforceability may be limited by (i) applicable bankruptcy, reorganization, moratorium or similar laws affecting enforcement of creditors' rights or remedies generally, (ii) general equitable principles concerning remedies, and (iii) limitations on the enforceability of rights to indemnification by federal or State laws or regulations or public policy. 13.16. No Conflict. To its knowledge, neither the execution nor delivery of this Contract by the Broker , nor the performance by the Broker of its obligations hereunder (i) conflicts with, violates or results in a material breach of any law or governmental regulation applicable to the Broker, (ii) conflicts with, violates or results in a material breach of any term or condition of any order, judgment or decree, or any contract, Contract or Contract for Insurance Brokerage Services Page 13 of 57 instrument, to which Broker is a party or by which Broker or any of its properties or assets are bound, or constitutes a material default under any of the foregoing, or (iii) constitutes a default under or results in the creation of, any lien, charge, encumbrance or security interest upon any assets of the Broker under any Contract or instrument to which the Broker is a party or by which the Broker or its assets may be bound or affected. 13.17 No Approvals Required. No approval, authorization, order or consent of, or declaration, registration or filing with, any Governmental Authority is required for the valid execution and delivery of this Contract by the Broker or the performance of its obligations hereunder, except such as have been duly obtained or made. 13.18 Financial Condition. There has been no material adverse change in the financial condition of the Broker that would impair the ability of the Broker to perform its obligations under this Contract. 13.19 No Collusion.The Broker's proposal is genuine and not collusive or a sham. The Broker has not colluded, conspired, connived or agreed, directly or indirectly, with any other person, to put in a sham proposal, or to refrain from proposing, and has not in any manner, directly or indirectly, sought, by Contract, collusion, communication or conference with any person, to fix the prices of the Broker's proposal or the proposals of any other Person or to secure any advantage against any Person interested in this Contract. 13.20 Information Supplied By Broker. The information supplied and representations and warranties made by the Broker are true, correct and complete in all material respects. The Broker 's proposal does not contain, and shall not contain, any untrue statement of a material fact or omit to state a material fact required to be stated therein, or necessary in order to make the statements therein not misleading. 13.21 Ethics, Gratuities and Kickbacks. Neither the Broker, any subsidiary, or any agent or other representative of the Broker has given or agreed to give, any employee or former employee of the City or Airport or any other person, a gratuity or an offer of employment in connection with any decision, approval, disapproval, recommendation, preparation or any part of a procurement requirement or a purchase request, influencing the content of any specification or procurement standard, rendering of advice,investigation, auditing, or in any other advisory capacity in any proceeding or application, request for ruling, determination, claim or controversy, or other particular matter pertaining to any procurement requirement or a contract or subcontract, or to any solicitation or proposal for a contract or subcontract. Notwithstanding any other provision hereof, for the breach or violation of this representation and warranty and upon a finding after notice and hearing, the City may terminate this Contract. 13.22 Contingent Fees. The Broker has not employed or retained any Broker or person, other than a bona fide employee working for the Broker, to solicit or secure this Contract; and the Broker has not paid or agreed to pay any Broker, association, corporation, firm or Contract for Insurance Brokerage Services Page 14 of 57 person, other than a bona fide employee working for the Broker, any fee, commission, percentage, gift or any other consideration contingent upon or resulting from the award or making of this Contract. For the breach or violation of this representation and warranty and upon a finding after notice and hearing,the Airport may terminate this Contract and, at its discretion,may deduct from fees or otherwise recover, the full amount of any such fee,commission,percentage,gift or consideration. 13.23 Compliance With Laws. The Broker shall promptly observe and comply with applicable provisions of all published federal, state, and local laws, rules and regulations which govern or apply to the services rendered by the Broker herein,or to the wages paid by the Broker to its employees. 13.24 Permits and Licensing. The Broker will procure and keep in force during the term of this Contract all necessary licenses, registrations, certificates, permits, and other authorizations as are required herein and/or by Georgia and federal laws. 13.25 Entire Contract. This Contract constitutes the entire agreement between the parties hereto and no other representation, warranties or contracts, whether written or oral, shall be binding on either of the parties. This Contract may not be modified except by an instrument in writing signed by both parties. 13.26 The Airport's contact for this Contract shall be Durinda Davis. 13.27 Broker's contact for this Contract shall be Preston Moss. IN WITNESS WHEREOF, the parties hereto have executed this Contract, the day and year first written above. AUGUSTA, A,V., 'N COMMISSION BLANCHARD& CALHOUN By: ,y Ran+y .ss Aviation Co i-.ion Chair President I , , (SEAL) (16 YO ATTEST Witness: Contract for Insurance Brokerage Services Page 15 of 57 AUGUSTA, GEORGIA „Jell, ,, ,, 7/ iardi- Davis, Jr.,As ;•‘,. Mayor • - pop e ' 5 - 4 ' i*''''''':;?!A;KY' : - 0 1 1 J a P✓ i S%a? .00 a% .4.O000 weeik..Ole e 4 l ✓d'I) Contract for Insurance Brokerage Services Page 16 of 57 EXHIBIT A REQUIRED SUBMITTALS Contract for Insurance Brokerage Services Page 17 of 57 ' 1-7:1-4— r. k 0 k J ) A Attacbrnent 6 tet,trivet taarr�Into arae Nfturn Inc 1 ose0kal flit iirneris thilii You-Svttmnta, frottttntnt vial. it Volo-ued Augusta.Georgia Augusta Procurement Department ATTN:procurement Director 535 Teifair Street,Suite 605 Atagusta,Georgia 30901 wame dim Proponent. •Blancher)!c Ca)hatn Insurance Agency,Inc. 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Company,anran DI oDdtrHHe>and weal to tale aAamaurt)nc�,P a ppr{/e fain conpanata with**an ors irdan Company has brim That this',monde sd non.ip110 tniaatgn as made and tel forth hwein Han ha tori N Mlanapttw4 mry bola re and slat remain m hdt fats and a11M rnhaq Than Ht prmntl el Magor ornamMa,as MOD*and M1/M1,heron stall be and ora herabs earned ata mod.as$4 of art'Ottorgotated 1l,Martina oto ant 000.010 00 porhan Odreedtrnn)Huy Tallowy y nay booed Tun obtain and: Thal Mt laltat ad aha iArapany To It afTheTalOY)•{than(arty of oke/ronin el mmosen nuylean Imade try tel fors Mram that camtbate a nateral eolach of men'1000001 Mrl.rte Genrbo Is talar*the tomrael In debut lad IC ittdat ON and all applicable nfhb rem/edtm Idoodl boo rpt Mored p tareladon of tics tonlran.terinian0ibn of me{Madan,saapwlaan And debe•n.,nt leo^,lour,tomenta.,a/ptetannos and ed 1 rid or brim,cur tompeasaoon doe and oway ono ton t rack llak--Coyabned/rima heDanatd M atrbmirmin of a ptepasai 11.t vend..torah's.us*:orally of pawn'.that to int bust 01 as knawkiaa and Midi la)TM prnn in the praptiat hart beer artr.ed at neentl roe eltboot.at to)0t'fiwdu a.yedspt r mloa000,5 a.-th haw (unman:. to+nmaDnatmm 0,atrtvmtnz M tat pu-ppw to to tlrttna ,tj Scu a.th rages w)h an,Nh[I rladDr p wah am UxnpadlIX 10)UN.n stint.:.,rtq.itut bi 11,1,ehr rowel whirn haw been gagged on The atopou'Mwr nal been Inowi nAnntlr,to any Othr nada,0.a any atrn ateblro r,tly drtlpaea Or ant really;p•ior Is spine{.do«Us a. 011.0 avlamps has brim mode,an to h►ie,by she wen'ar le moors any'that petal-aannn.Did t•lappnboo b lobo.,to NM to sabot a worm.'lot 1$ 1foursomeIpr mill atm,pnieor COMomnf nR hard or Palma,VW/nation shah ho reported to the Alb of Grarltll Anima,Genera:.4 Thy Unird Stat., Ofd 11 141 Anpon an5P,aac Imola rage.berates RIF Due Thwadap relo oary a 1PST IT 11:90.m Pale 6 of le • Contract for Insurance Brokerage Services Page 18 of 57 by Iubmrtlon of r propos01,111*resptna.ri Grin erfdfes.ender yt•»hl of perky,that Is the best at to irwwitdgt and better 7 no obrump+nces two whit It roust;Cents((of lot*,tit in perlono6K the senates tequned by this SOP.and 2 aha:twtorp split DrttwC0e*Iy.nor net member itefe*rotary publfr;Penny or Short affected by this nee,has en.petenay mtam I An ihr buiirwu of»a tespOndint tum et NI tubdtvrwtamit)bas any Interest that would conflict in any manner to dome written performance related 10 its Sip By submiubn lila Orwell.the vendor tender under maks Of berpuy,that to the best of et krone**and boar!: Is the ernes in the propene/have hem amwed at rndemndently wntltex retn/Mot Competition,u to ern natter relate*to ouch woes;nth any other vendor lir two any com,eoaomumcaliorts,o•agrrent*1,for the purpose of minim atherwht rttpdred by law,the poet oho hove any competitor &Mt*or ioebretify,loony other vendor Co comeeiltor boon coined in the(►;Pott!haws nen krpwingly been disclosed by the vendor prior ID spar.no t)M*attempt has baa made.o,will be made,by the vendor to induce any other perste,Mrmersivp or coopP-algn to wbrnt ot rpt to tubnis 5 propota. ID,the a0ep0i9 o1 mauk;Inj campai 1Dn Por any breach to wenn**of tests prosIion,the County shalt Rave the pari to Iermbyie any Metes tontine!o, agreement without Itabnity end at int dntttliat to dedun from The tea,.sr athetwne meow:,the aul tms.Jnt of such leo immq:bit,.,pertesnelle,Brit. payment or eonvideraPon Camtatter AIWA end*mermen! By tatuwiag tort tlrdavrt,the tinders ansa tOniracia verdin Oa tomplrnu oath Al G A S 134041,itatwt eYr mattvaly that dee mpom.ral,turn,of corporation which if rDmrauing worth Av9uata,Georgia Board of tamaisilatty bat ve*tend aith and It panreipanng in s federal wort a,ahordattem preonm"tory of the ritntonu w,doanon of work aetilansetten pro1rtt t operated by lb*Unoted Mints Deputment 01 nomet*M Security lir any equivantnt Seders,w*it author Yahoo program Operated by tM tinted States Depann$m on Norriand aecurky Os very rnlormaten ei mewl(/bet employees,pursuant b the InuntoratIon kion;and Control AO oh 198E BACA),et 98-6031.a atuadrntt with the aPfatceleibte Prrebnaat and dead/nos estybtIIDed lo 0 C 6.A 03.1041 the emkisiened further arreef Ihat should r'NOV O•contrast styli any auMm.traeeonit)to sonnettba wen the physical pedomtpce of services pvrsuanl to this LOntraa with Meow Georgia atwe or CDmmiwonevs.tow?ctrr t,•01 scares ow,lath auboonowty rlsl sfmller verification o1 morpheme wstn 0 C.G.A 413.1097 on the Subcontnrna Mhda,id provlyrd In hue 300.3$-O3.dM era oubitamelly smaiar loan Contractor Anther moot to intoner,records of;soh compliance and provost a copy of eat%such veribiepon to the Auguda,Stow;Bawd of CommiWaerri at the time the tubcorurattagtl if retained to perform such;tame Goargfe taw rgtttnd year torepany to hove an EAreelfyhben identification Number ttonyarry d n.)on or akar Orly 1,2009. For adrbtioeal wbrmatrot of to rnroh yon rrnrdcny,volt the Mute of*throe website ..'rik' X,•!s.if�s Lr.'t eirft eneJor"i l*;.^_.6t:1.0: 5vsrt..t4...I/3,EA If 1 . 1:1'' 9 a[-Verify'User Identification/cumber iGtompany I.D.I 581722 5011 I 551to*Mi 40500MA,10h NuvellfCOVt Ah.111 It3u)7 of 1.50,01151 -"-. 13,I4ABDItiDA T+ft OO( NfbDtifaAMatpvi Y,M%'1121 A100510 70 taes%Ot a((5PI Ci MOVIILAND tet Jan,l lifa9Onoocvm.Or UNDI*S!*Ml.ro t►rowl The undersigned further agrees to submit a notarized copy of Attachment B and any required documentation noted as part of the Augusta,Georgia Board of Commissions specifications which govern this process. in addition, the undersigned agrees to submit all required forms for any subcontrictorfs)as requested and or required f further understand that my 9ubmtttai will be deemed non comp)iant N any part of this process is violated. Blanchard&Calhoun Insurance Agency,Inc. Company Name �y 8Y: iFer-af.�ryfT—' iContrqctor Signature) President Title of Authorised°fitter or Agent of Contractor Preston A Moss.Ptepidenti. ► Printed Name of Authorized Officer w Agent 3`SCfi78FD AND SWORN B ORf ME ON Tai 13 THE DAY Of 'fit' r I ' NO?car+•,���t+f tf I . X-�`, NOTARY a G; 'de, ti ^s s Nary•ublit (((Jff y CO. mission Expires:1(J t- -2f) 44%\,,......../-, f ttte,eut,..o�d Is..Wait ton..plen-.141431;.E,ti,f 7 yagtS o1 RttarTry*fit k....,les tDa,S..bm,tua:_keyrmcnl N;utt bt KeteI , Atv.!flip/>p1a Oft 31.1!7 Avppri Muyyatt 6ra►erist Stoma" Mr Oat Thassday,trbrw,y 5,7017 rF 13 00 a on Psgr 7 el to Contract for Insurance Brokerage Services Page 19 of 57 bt•!tt �;%` .. ,° i;I OJ I 1 INSillt 1NOE, I)EPARJM1:S I ' PSI " ''111 �!i)I? 1 X3::111:1 l i'A 3113+)..l.,:‘ 1-iemsrn muss oaifj•Air Maur:met I nrnJ ent nt an L.- t aJdcacs charge within 3F days nf9m nxwe. t:tt .:1"'' ihe vain mown produce%ohmic ulna the ugrui i. Ia1+poirlCd with thcetwna. BLANC(1ARI)&CAI H OUN INSURANCE AGENCY INC PO»Ox 212359 AUGUSTA CA 309 0.2359 :t11./t... .r.`4,-.. .trzaTt. :ar. c=°%cam- .r,THIS IS YOUR GEORGIA INSURANCE LICENSE J BLANCHARD&CALIHOUN INSURANCE AGENCY INC I. License Numbcr: 7O59b NPN:8264602 , LJcrnsrd hinmIP.d Aran:,-tttsi,hrw; Expiration daft 12•31-21114Qualified int Pm Aly•AcridmikSirkn m f, Pm Ary-Cawmly Pm Ayy.Uri: i ) Pm Ary-Pw(.iny 1 A . u 5 f1 .i i F I. :, Ralph 7 Hudgens ti e; ,;Y.EMM5WV3.a=�Tx�:.a..:=a>%.�:t� ,21�.•.�,.•= c t'iXlunr.�ilgtcr of 11o�nl:sif:� 'a GEORGIA INSURANCE UCENSE tii.A1<71ARb A CALtirtiit,IA'1UHAN(3:AGENCY In( Ne ORM moll Lerma NuINn1, JJ....n1 a4,,NAbfilII N. 1P>•,,axtwt lung'+ 1 ..�..M41•y laNv,yiwn Mit en ti, 114 ny.,.. I2.11.2n1t Contract for Insurance Brokerage Services Page 20 of 57 ttir, Resident Agent Agent-Accident and Sickness,Agent-Casualty,Agent-Life, Agent-Property PRESTON ASHMORE MOSS PO BOX 212359 AUGUSTA.GA 30917-2359 is authorized to transact business as described above lleenStNo 203642 brae Dalt 03.24 t881 ElpistioniDtke O6•302018 C.u.N.•it.Mcr.72,02117` II 42ra[OrittlK.n:2W 7071u3ryC7009iY3;E aGeorgts Department IN.Ct0.4.1Ce IC'NE UUC044 OF10e.71oH lrice' 6'ION'H�FifWt m lF70C{D4p17+3+ RtsldentA.e+nt I Apert•Ac 9.ni♦nd Siu,nesi. PRE5Tpr;ASI;MORE MOSS Agent-Caw "3.Agent,tile,Aoenl. •:ow 1,4.1.,,,..Vi,CO) '17!94 .Plope+iy I UI 0,1 n.nPk •M 2•` }.ati _�_._ su.DH S]N 1i!• 3�I�.r Dr,M 3:10•! - .��.. Contract for Insurance Brokerage Services Page 21 of 57 et UTICA NATIONAL INSURANCE GROUP INSURANCE AGENTS AND BROKERS tS$UED 6Y ERRORS AND OMISSIONS LIABILITY POLICY Utiau National Insurercc Grsop Republic Franklin InsurancInsurance Cc naen7 CLAIMS-MADE BASICS P.G.Bax 5M.(Nu New York 13503 DECLARATIONS Renewal Teiephorte:03151736-200D NAMED INSURED AND MAILING ADDRESS LOCATION ADDRESS Btanrhard&Calhoun Instance Agency Inc 245 Davis Rd AugusPO box te?GA 3t>817 9 j Augusta,GA 30.407 iAT 12:01 A.M. STANDARD TIME AT THE ADDRESS OF THE INSURED AS STATED HEREIN. IN RETURN FOR PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATEQ IN THIS POLICY ,�...�. 'Ater $. 4375390 EO V01-01-2017 ✓ 01-01-2015 4375399 E0 BASIC POLICY COVERAGE LIMITS OF LIABILITY LEGAL LIABILITY $ 5,0D0,000 EACH LOSS 6,000,000/AGGREGATE INSURED'S DEDUCTIBLE AMOUNT $ 10,000 viACH LOSS DEDUCTIBLE APPLIES TO: $ . ,P00 A GGREGATE Xi LOSS ONLY PREMIUMSLOSS AND LITIGATION EXPENSE BASIC POLICY PREMIUM S 42,831 REAL ESTATE AGENTS AND BROKERS PREMIUM 5 x d MUTUAL FUND AND VARIABLE ANNUITY PREMIUM - Mee attached endorsementdadaist, S _ 0 Mee attached endorsement eelaAs; EMPLOYMENT-RELATED PRACTICES PREMIUM S OTHER 0 (See attached andoran+oerol lotdetails) TOTAL POLICY PREMIUM S 42,831.00 I RETROACTIVE DATE i This insurance does not apply 10 loss,whenever occurring.from"wrongful acts`which took place before the Retroactive Date,if any,shown 01-0-2011 ✓ Enter Date ce`None'dna Retroactive Date apples OPTIONAL EXTENDED REPORTING PERIOD PREMIUM In Section VII-EXTENDED REPORTING PERIODS,we agree to provide an Optional Extended Reporting Period under certain conditions The premium for such an Optional Extended Reporting Period is determined as shown In 1 paragraph 5.of Section VY. FORMS AND ENDORSEMENTS APPLYING TO AND MADE PARI OF THIS POLICY AT TIME OF ISSUE' BY �� ' COUNTERSIGNED AT: UTICA,NY COMPANY OFFICER DATE: December 27,2016 SHANNON PECK THESE DECLARATIONS AND THE COVERAGE FORMS)AND ENDORSEMENTS,IF ANY,ISSUED TO FORM A PART THEREOF,COMPLETE THE ABOVE NUMBERED POLICY. 14-0-EOA Ed.09.2012 SEE OVER FOR IMPORTANT CLAIMS-MADE COVERAGE NOTICE - _ Page 1012 BILLING NO 100844836 PREMIUM AMOUNT TO BE REFI.ECTED ON NEXT BILLING NOTICE Agent ti E0012 Contract for Insurance Brokerage Services Page 22 of 57 Fern " ` I Request for Taxpayer Alva Fonn 10 1hr On Ilaoe'rlbn'2efa1 b.n Doett nit 2D1s)a, Identification Number and Certification Mater'ala nor Moot Ammo Saves tend to the SRS. I Nemo pa shown an yew lrcoae On Murry'Nene s ra wked ao this line do not Item iris lot honk Blanchard&Calhoun Insurance Agency,Inc. k 2 Lninnea mom owabaraed Nowa name,r rioloown thorn eoa _ tr irr--6��wok a PPratviBM Om In.kale 1000 eliashestbr-.tMsk aril ono o!Inc krtbwine Innen tune- y In 0Ind.riC.elrsciepmpnehe b+ t,,igtioms rapes noblyW$O IE . ae:pA.membw Lot i�C torpo-ahoy r�$CarVo>mio` (� Pa'p.�vn 0 TrusUeatafa eery n rntlkes.ret Inrevefun cum 1i. 0innllep4birty amMtt•i nu rt tax casuie:alm O0V0CIW+a• we 8) ic-c DrDIRIdn s e rmeporpem,,➢,tamtaa'rmj a [ben'pt parte ea00 I t any)__ No».Fa a aMple-ara•rpgr LLC USN h.,d.arrpstase.aro nm inti ti C;check Pe appro}nate bo>.r.the i•e above foe (E , r irq+�MICA icreuiioe T Via tart tieselfeatrr al the a+npl0•mrobe.own/. ainstrument:* Dodo Or 4,,iOther few y i ao0n»lwrmbr,shalt,arw set Pt Suit not cask..ro.ra.r e.a r.r war ro PS n g 245 Davis Rd.;PO BOX 21235@ 7 Aeayseles none ane a litres tire) --- p •C+{y.srrta:rrld HP coot '"•.... "'— It Augusta,GA 30517.2355 1 Itot lases or ninnsen l ten tobarts'j •. . . - Part f` Taxpayer. Idenllfhcation Number(TIN) Enter yon,TiW in 14 appropriate box.The TIM provided mold mason it, name oven on Ins 1 to avoid "Salle backup waMwlotng For tnr)Yiduals,this le generate you.social claw redraw "MN,' �-� 'Ut�ant Mien,ante proprietor.or diereparded entity.site tow Part I Inaiouclrp., 01 pee .For oth,dor a 1 -1 J l entities,II Is your employe.ice•,pbcallon mmbor DEIN)H u do not have p 9.For pe - a�� Tay or pops 8 you a number,bag Floe Jo ped. Hole M tru account a in mote than cm r OF e came,see Rue insbuchons for low 1 and plc that on page 4 10, i+ 44,iason,neminn melba' 1 1 ) gtrdaknea on wheat nrrrtbFy W ender. 5 j @� ..,2�3 1 21 q 1 1!3 18 R:.r,II Certification i ) 1 11 that genomes o,perjury,I eerily rill: ___ 1.The mpnbe,ahoen or Udo toIn k my correct taxpayer idelndreataor number for Ion waling fora number to be issued so mei.and 2 I am not subject to backup MnlrlboWF.g because:tat I ern taerr t from S.ryas TORS)Mat I ems f backup withhsport ei nt or fa)r have n not born)e by Pa InternalmeMuRevenue no loiger subject to baolwp wrthhoidr g and withholding as a refute d a failure is rano',op Interpol or dividends,a Ic)the IRS teas naked me Mn I am 3 I am a 1-1.6 cioxan or other U.S pe'aon fdefrm®C below).aid c Ins FATCA code;a)enteree on ants form it any;indicating atop 1 Ian a%empl from FATCA rail Ciulthcation bstructloa s.You m AIRS M is ou On because you hove fades .re ul I tees out Siem 2 above Y you have been Forotared by the IRS boat you aw ra2 Obey a bfead to backup wahhnioir F >ai N, pori of Interest one Modena on your tax raison. real trials aransaakor's,tram 2 Cosa not apply. W acquisition or abandonment of secured property,ranceilahor o1 o.abI,eonln'bulons lean Irdmduo/retirement aven Fgemenmor dm 1IRwppi.rue genera6y,payments cane.than O11ytoral and Chtdmde,you Me sol moulted to aipn Noe sapiicetron.but your must provide your cornet TM See Nu oaslraliona cm come 9. Sign ��lpp��� ����- Herd u.a.poison I�K.�i/L•(.A- li>1!F 1/1 1/2017 Sign • Pao►• General Instructions •Jrar ,t19f Panna as t9aoa.ate.aa.tops F pvsani Miners kW irrveeely_to%-1 SKI.Mtn Women,are is the'nw+'+M he.enere Cops urres otherwise-,otea Flora arwia2oloots le!omaawn show 4rabynw'n ahaGm9 farm W-a floe' •FontRam; tn99,Cis ow Mal a9 kgt1ncr..nett o ahs the'dons 40 a 01 nwa.te p0oJM9 •Fnrn�tODp•A is ow or sbanporme^t d are:rat➢'o2a•If, PorPOge of FormDAs Form w-8 o'+ry a yp,*0I li 6 Penon I ud,nr,a rssioent ateN..to oto»oa ue r cosset TIN. An Ineenu01 r retry form W.a>eeiaeltq vino re Named le tee a•tr►x>natip era,00 not at rn boon W-9 tc yy, nerum*00..0491S Nam obtain yo.p synod lotmew Idanhtollion rumbas Mew- Ai9ueaow Ob0r p Thy.ya.m gnr be a'+jyl=r wube.arae be emir gait'wcuiry ftrreer 015N).rnooidwa'UM lcw .I gI a>arva Mo Sae'm,y e bdwo wtirrfprdrya tr gags 2 turner(ii.M.0000000 faparr.idamartacen euml>er{ATaA. karrilawmsr at wino' tea YMy out term,yox daelaadera eumIee fro li.to repo*pn n',tomato*talon the**mum poo lo 1 C4,101-aha!1M TM sou a't ptir+a k somck yo./.a other Ino.,$reponse*o-r•.nkumaiion thou*Comp*.d rarnaon" It ba awed b.yo.WC wtlmF W a'verse Mims mncleds.tot 000 nal omit..+lo.ant loHawr.F- 2 Carla)Dna!het Ito set •Faro let +NT ynletsfr armed a PRO aamap wye,u 0e1I U.S-sommpt peter r are ! •Form 10991099-tee, .Cla ..s/rmelrm:hem beraue*onetime n you a pSriOe'rna udrn*afl Peet*svr:lochs sr me+lua:lu'rds: app OOP ye.i aka alb o0epnp t^ai as 0U 9.Peron,yarn akapleie s me ee •}ohm 7�a MISC Iraaw lyre:0'norm.rim.awa'os x• arr Part-unpin eeme flare a U e boo or ono.*r M,acu,ad k Iht •Form 1099-a Om*ei moo:1...cV Yon .rimm^.omho.I' nes shim 11001 wassakset aa,on oisiecr,Ia'han*PT W aaatln+ll in)) int tee,arc bowitin; 0, 4.Canal toot!MCA DoOrynJ►rgarao on Ne tom ld try)Md,eal iter •Fern'1ppt-S cooing+herr trot MICA mowing.a intrad See Mink a FATCer �pp.plr o• et twosomes Mar.res.mien l•araeu o'11 WN 9 W awrria rrtarrrfal,pl+ •Four 1009 it(irnaohaM tare and terry prey eyelet"loosebox) tea enc 102,1% fain W-V few+12 2C'.; Contract for Insurance Brokerage Services Page 23 of 57 Secretary of State i4t, Li7C «CN7RCL MMER : Corporations Division DATE :DC/AUTEVriLrn- :4/U7/199-, YOR:SEIC730,: (EO.QIA 315 West Tower LATF #2 Martin Luther King, Jr. Dr. FT.RM 1.11:KLEF Atlanta, Georgia 30334-1530 BLACARD & cl,LBCIAI :NS. THOMAS M. DLANCHARD :45 kk AOG1E7A, GA :nCE:kri, CERTIFIED COPY rA7hy the Secretary cS:a:L ci tht EtiAc c Ctcizi ,, herecy ceA-LIty under Lte EtB: VI my c.tf_ce tha._ the attchCd dculient 11::e and cnr col:ien of dct:Jr,€f:t filed na.ne of BLANCHARD 6 CALHOUN INSURANCE AGENCY, INC. A DOMESTIC PROFIT CORPORATION SEId ent:11, WIS f:-;rr:.ed In :_nc z;r:. foil !) ;1hcvt- f:Jeti ti:t Off:cc Sectutazy of Stott (..n the dNte t:et :zt rerl :f .caln of : :1:..;1.ed pantnereh.p, :nccrperat :ion, .rt,.c cl +:4[)(1(.7 c: cryani2azon e appl:c.at :cn foz- rell :f:c%rr of antl..nrjey to rannact ninvtn: :n Th:s rert-ificate le ;.1 :n1-6 putriAant to lat :u 14 c: :he Li ;a: Code r.;! Geortna Annotid at:6 :F fac:e ev:dence cf :he ex:Etenrn- ncneziElenre c! tLe e:i_tted ; 0 ;1..! tilyr1 k I • tzy vox J77t Vi trta!'ii S:ait Contract for Insurance Brokerage Services Page 24 of 57 ra C r 0. ti 2 < C Ln x. � tit • w a v X q g▪ Y d & at7(5 w Li. ce V e.us 5. 0 ry ti) w ac in 0 ,+ w v Y Q V r4 c .0 Q R 4 0. g Id A U T O c m z N .� o v ,� v' 1m '� i0 C iii CC ea i M C g '+' M V m Q tr. M a ry• m Q c I: c • •r at to "o„'75 wt oh to( y 19 0 1¢ It ai Vi .0rnv a ki fft -. d M Qn D co is ^ V z O = V A, tp • Ca�y I m p O ^ oDo "�,. Q V ii 'Q r� re .'' L .T. u y _J F Z � in 2 � e +-. d p 2 d w Q O C :: 't.r _ Z F- A b m fi .- .m.. Q < c a� d E z w 0 — oe 2 c y r v k N A 0 C O •7 m C O O 0 < vrt ge 0. P m 2 on _ a 2• , �^ v �.+ V �i. v :: LA /I: Gam' of p C rn Le; s�a++ Z ° n Si 2 to '4.1.:''. M In w l? W111 d "' t:�:s L2 vi T F-- r 1 • ? t m m U 11♦ ij O Contract for Insurance Brokerage Services Page 25 of 57 r. % r- 9 Q SAO // st IL 4.. CO ƒ Of / Q K k ƒ � ( / = . - # ƒ G111 / k i i 9 $ ¥ 2 m A � 2 / ƒ $ #r f § K 2 « %$ # } & � $ § dce cc iii 'n'no) ` i k f t $ / ; � 2 re } -- a - r / + 7§ / � 2 \/ \ e, fes £ 2 ± �f k , k § [ ƒ ft -,5° . _ — / 1 u } ti k © . e - 0 ; , § P E re < < < \ cr � k Li \ / re ri § / k ± 0 Z 3 ( COit / Contract for Insurance Brokerage Services Page 26 of 57 THIS CERTIFICATE IS TO BE POSTED IN A CONSPICUOUS PLACE IN THE BUSINESS HEREIN DESCRIBED. BUSINESS 1, CERTIFICATE • A . - uGuSTA MAILING ADDRESS INFORMATION StANCHARD&CALHOUN INS AGENCY INC P 0 BOX 212350 AUGUSTA,GA 30817 THIS CERTIFICATE EXPIRES _ .." , .-•- - —-- ... BUS1N,---S LICENS -#, LCB1109001901 .. ' ' ._, _:11. 4..:-;=:,-,:c,.--...::-.L,.-r 4_...• CERTIFICATE IS,, 1, •N THE. T... ,..„04t4,0&,,w Jots A . Ne.....t„,.. . pro CLAS,SIFICAT)DNIS): 6 4til.t. , 52421-INStAIANCE AGENCIES Atii;:"--,,, '-• GES(5). BUSINESS TYPE: BUSINESS BUSINESS LOCATION: 745 Davis Rd,Augusts,GA 30907 CERTIFICATE HOLDER INFORMATION: SLANCHARD&CALHOUN INS AGENCY TXJII OCCUPATIONAL TAX CERTIFICATES VA=FOR CALENDAR YEAR ENDIMO 12111*PIT AXE IS SUBJECT TO RENEWAL EY 113i2aiS.THE MANNINO AND PEVELOPIA ENT PEPAXINENT MALL NAYS THE RICHT TO SUSPEND MiY cewrvicAlt IFTHE swims VIOLATER ANY LAW OR ORMAN&OF THE UNTIED guns,THE STATE OF .. , WWWWIA;OR AuxuaTA,osoncax it I ' •• . - 4001111111"*"...swor NAI,*Mork DINkstor PIannIng And DewdoPRIRm DePaltBsIB Contract for Insurance Brokerage Services Page 27 of 57 0 F. U R 41 1 A Systematic Mien YlerifJcatian for Entitlements(SAVE)Program Affidavit Verifying Status for Augusta,Georgia Benefit Application By executing this affidavit under oath,as an applicant for an Augusta,Georgia Business License or Occupation Tax Certificate,Alcohol License,Taxi Permit,Contract or other public benefit as reference in O.C.GA.Section 50.364,I am stating the following with respect to my proposal for an Augusta,Georgia contract for RFP 17 141 Airport!neurone.Brokerage Bombes I*FP Peeledti0w.bend Pa ten Wed Preston A.Moss.President Piou/reso chemo ifsoling Olson OWN es betiacaft diginie4 anginal,carsovothm,Pe►desstdst.mynas psalto may) Blanchard 5 Calhoun Insurance Agency,Inc. IdidattiYort Mew of hotness,terd anise,parAiership.er.Iertsdres,enokvl 1.) X I em a citizen of the United States. OR 2.) I am a legal permanent resident 18 years of age or older. OR 3.)_ I am an otherwise qualified alien(8 6 USC 1641)or nonimmigrant under the Federal Immigration and Nationality Act(8 USC 1101 et seq.)18 years of age or older and lawfully present in the United States. ' in making the above representation under oath,I understand that any person who knowingly and willfully snakes a false,fictitious,w fraudulent statement or re pntsentation in an affdovit shall be piety of a violation of Code Section 16-10.20 of the Official Code of Georgia. Praemn w emcee Passident Printed Name Aeon Registration Number for Mon-Chlzant SUBSCRIBED AND SWORN BEFOREMEME ON THIS THE ip DAY OF t lr]fr,r..•u 20 1, f1 ,yac�s�ait 6 _ -YY1 ... _ - g iSET `fit My 0lie `. Iiu fey E°-,go a \'4.7c- . , ,,...„Expires: 1 t ie.,4- t', NOT 'P v% ®°� .< :r-1 Ue ,fi�6zi-Fr,, t-' .0',fi. i t, _ +i,°rFfit ,-41 '�cry a Ski 014 I�'y RN,7haholl S,�8_ N. JC �,.�e' ° dr WfP i) tc tratersae len,Kd WS iss Um . prr9.OUP hoe Pip aof'te Contract for Insurance Brokerage Services Page 28 of 57 c.7-44—'1,, K 0 1 STATE OF GEORGIA•COUNTY OF RICHMOND Bumpppq/R 11-141 SUBCONTRACTOR AFFIDAVIT By executing this affidavit,the undersigned subcontractor verifies its compliant*with 0.C.OA 13- 10-91,staling affirmatively that the individual,firm,or corporation which Is engaged in the physical performance of services under a contract with Blanchard end Caholm insurance on behalf of Augusta Richmond County Board of Commissioners has registered with and is participating in a federal work authori:atiarl program' [any of the electronic verification of work authorization programs operated by the United Slates Department of Homeland Security or any equivalent federal work authorization program operated by the United Steles Department of Homeland Security to verify Information of newly hired employees,pursuant to the Immigration Reform and Control Act of 1984 ([RCA), P.t,. 99 03), in accordance with the applfcabiRy provisions and deeding;established in O.C.G.A 13-10.91. 651722 E-Verity'User IdeMf'icaton Number 1 Blanchard and Calhoun Insurance i Company Name M {Contactor Signature) President/Agent Tele of Authorized Meer or Agent of Contractor OsuijIs Law requires your company to hove an Preston A ■ 1E- a.teUser I tlasatlan Monter on or sew July Printed ofAuthodxed Officer or Agent For additional information: Statue of Georgia Nitagrmw.dastrucoa.usisduruter000101.pdf SUBSCRIBED AND SWORNt "BEFORE ME ON THIS THE 01112 l�pai!vaicrJ rcpt , _ DAY OF I [l.f , ,20iLl w,11% kitty mission Expires: I i 1, ‘ t L ?'4 2t ZC.a mii�cc €.,'is 2 .E esr ;� ra r 3,vr<a„ 1, $ su=,;arias t,„rzr., keg,§5 h) 1i, I taiCAt y► 9P 2,114, fla t'tta tsa - (,r rn -s et,,r r:r iv;rs 0r i a.tsa c1 R4 co InantMiro- talor'3 1 irr ill 6 ,;,V fig ('.<xc t4:4-4,1, 04, TG£,z”44tt"f'fr,,-) an.7/22/2a3n WP Item 017/441 Avon loware Brokerage/smote Pop rgf Contract for Insurance Brokerage Services Page 29 of 57 0 Y t) It cr I A In aordance the Laws orGeorgia,the foSor inp Madam ie required by ell vandal* NON-COLLUSION AFFIDAVIT OF SUBCONTRACTOR I Preston A.mos certify that *tie bid Or proposal la made tin out prior understanding,agreement or connection with any corporation,titre or person submlttirg a bid for the same work, labor or service to be done or the suppies,materials or equipment 10 be furnished and is to al respects fair and without colusion or fraud.I understand cotluelve bidding is a violation of state and federal law and can result in fines,prison sentences and ohtl damages awards.I agree to abide by all conditions of this bid or proposal and ear*that I am authorized to sign this bid or proposal for the bidder. Allam further states teal t pursuant to=AA.A.Seolon 38.91.21(d)and(a), elanchsadendl sIhnuq Insurance has not, by Itself or with Others, directly or indfrectly, prevented or attempted to prevent competition In such bidding or proposals by any means whatsoever.Affiant further states that(s)he Ices not prevented Or endeavored to prevent anyone from making a bid or offer on the project by any means whatever,nor has Af tent caused or induced another to withdraw a bid or offer for the work. Afflant further stales the,the said offer of Is bone fide.and that no one has gone to any suppler and attempted to get such person or company to furnish the materials to the bidder only,or If furnished to any other bidder,that the material shaft be at a higher price. Signature of Authorized Company Representative PresidenuAgsnt Title ,s� t�.� Swam to and rub:abed befc me this aC day of i r V2 f r'k ,201.-1 S . /__ _ Note, •Ic: s'"1�,( f t( I k piw �`~~ f j {Print Nems) 90 4 County: t ' 1 ti,. r� r NO % % to '4 41. Commission Expire : [ + Y-Z • NOT at `s, '�.� 5 ¢ip� eL)C r r tyc UUNT'i, -4' Pott- Ttit §re-z.attfa�#,naso:*r t=aP t;t-•rreih c.<,. s-.acs._ d�:a n. .tr°, fir t-.t`, tir.,t•+nt aa... B.t$:; Vail Ike-t t, ct,�-�� ;l3' art,€rriii Phe "1 t�rz. :Y; Htg„r,ts:, era ,tGe"r,a„°'jl'rtrr o,,,,, 6v .,r„. e¢:c%":rn;r r,€r t „ rtprYt: ttz a-t: < rag-,+it'ttt} 5k,'.7/lf25al RFP hem 517441 Airporl*Kuranae ereeuree Swim Pus,I Sit Contract for Insurance Brokerage Services Page 30 of 57 i :-Veri1y • t Company ID Number:501722 I THE E-VERIFY MEMORANDUM OF UNDERSTANDING FOR EMPLOYERS ARTICLE 1 PURPOSE AND AUTHORITY The parties to this agreement are the Department of Homeland Security(OHS)and the Blanchard A Calhoun Insurance Agency,Inc.(Employer). The purpose of this agreement is to set forth terms and conditions which the Employer wit blow while participating in E-Verify. E-Verify is a program that electronically confirms an employee's eligibility to work in the United States after completion of Form 1-9,Empbyment Eligibility Verification(Form 1-9).This Memorandum of Understanding(MOU)explains certain features of the E-Verify program and dewing specific responsibilities of the Employer,the Social Security Administration(SBA),end DHS. Authority for the E-Verify program is found b Title IV,Slue A.of the Illegal Immigration Reform and Immigrant Responsibility Act of 1998(iIRIRA),Pub.L.104-208,110 Stat.3009,as amended(8 U.S.C. §1324a note).The Federal Acquisition Regulation(FAR)Subpart 22.18,'Employment Eligiblity Verification'and Executive Order 12989,as amended,provide authority for Federal contractors and subcontractors(Federal contractor)to use E-Verify to verily the employment eligibility of certain employees working on Federal contracts. ARTICLE I1 RESPONSIBILITIES A.RESPONSIBILITIES OF THE EMPLOYER 1. The Employer agrees to display the following notices supplied by DHS in a prominent piece that Is clearly visible to prospective employees and al employees who are to be verified through the system: a. Notice of E Verify Participation b. Notice of Right to Work 2. The Employer agrees to provide to the SSA and OHS the names,titles,addresses,and telephone numbers of the Employer representatives to be contacted about E-Verity. The Employer also agrees to keep such information current by providing updated Information to SSA and DHS whenever the representatives'contact information changes. 3. The Employer agrees to grant E-Verify access only to current employees who need E-Verify access. Employers must promptly terminate an employee's E-Verify access lithe employer is separated from the company or no longer needs access to E-Verify. Paps 1 0111 E-VWy MOU br bbillirribb I Reviean Dab o6/s1r13 Contract for Insurance Brokerage Services Page 31 of 57 company H)Number:581722 4. The Employer agrees to become farnitlar with and comply with the most recent version of the E-Verify User Manual. 5. The Employer agrees that any Employer Representative who will create E-Verify cases MI complete the E-Verify Tutorial before that individual creates any cases. a. The Employer agrees that all Employer representatives will take the refresher tutorials when prompted by E-Veriy in order to continue using E-Verify. Failure to complete a refresher tutorial MI prevent the Employer Representative from continued use of E-Verily. 8,The Employer agrees to comply with current Form 1-9 procedures,with hvo exceptions: a. If an employee presents a'List B"identity document,the Employer agrees to only accept"List B"documents that contain a photo.(List B documents Identified in 8 C.F.R.§274a.2(bX 1X8))can be presented during the Form 1-9 process to establish Identity.)Nan employee objects to the photo requirement for religious reasons,the Employer should contact E-Verity at 888-464-4218. b. If an employee presents a DHS Form 1-651 (Permanent Resident Card),Form 1-766 (Employment Authorization Document),or U.S.Passport or Passport Card to complete Form 1-9, the Employer agrees to make a photocopy of the document and to retail the photocopy with the employee's Form 1-9.The Employer will use the photocopy to verify the photo and to assist OHS with lie review of photo mismatches that employees contest. OHS may in the future designate other documents that activate the photo screening tool. Note:Subject only to the exceptions noted previously In this paragraph,employees still retain the right to present any List A,or List B and List C,document(s)to complete the Form 1-9. 7. The Employer agrees to record the case verification number on the employee's Form 1-9 or to print the screen containing the case verification number and attach it to the employee's Form 1-9. 8. The Employer agrees that,although it participates in E Verify,the Employer has a responsibility to Complete,retain,and make available for inspection Forms 1-9 that relate to its employees,or from other requirements of applicable regulations or laws,including the obligation to comply with the antidiscrimination requirements of section 2748 of the INA with respect to Form 1-9 procedures. a. The Mowing modified requirements are the only exceptions to an Employer's obligation to not employ unauthorized workers and comply with the antidiscrimination provision of the INA(1)List B identity documents must have photos,as described in paragraph 6 above;(2)When an Employer confirms the identity and employment eligibility of newly hired employee using E-Verify procedures, the Employer establishes a rebuttable presumption that it has not violated section 274A(aX1)(A)of the immigration and Nationality Act(INA)with respect to the hiring of that employee;(3)11 the Employer receives a final nonconfirmalion for an employee,but continues to employ that person, the Employer must notify DHS and the Employer is subject to a civil money penalty between$550 and$1,100 for each failure to notify DHS of continued employment following a final nonoonfkmatinn;(4)If the Employer continues to employ an employee after receiving a final nonconikmatbn,then the Employer is subject to a rebuttable presumption that It has knowingly Page 2 of 1 t E•Verly MOU for Employers I Revision Dole O5WD1r13 Contract for Insurance Brokerage Services Page 32 of 57 Veri y Company ID Number;551722 employed an unauthorized alien in violation of section 274A(ax1)(A);and(5)no E-Verify participant is civilly or criminally liable under any law for any action taken in good faith based on info matison provided through the E-Verify. b. DHS reserves the right to conduct Form 1-9 compliance inspections,as well as any other enforcement or compliance activity authorized by law,including site visits,to ensure proper use of E-Verify. 9. The Employer is strictly prohibited from creating an E-Verily case before the employee hes been htef,meaning that a firm offer of employment was extended and accepted and Form P.O was completed. The Employer agrees to create an E Verfy case for new employees within three Employer business days after each employee has been hired(after both Sections 1 and 2 of Form 1.9 have been completed),and to complete as many steps of the E-Verify process as ere necessary according to the E-Verify User Manual. If E-Verify is temporarily unavailable,the three-day time period will be extended until It is again operational In order to accommodate the Employers attempting.In good faith,to make inquiries during the period of unavailability. 10. The Employer agrees not to use E-Verify for pre-employment screening of job applcants.In support of any unlawful employment pradace,or for any other use that this MOU or the E-Varify User Manuel does not authorize. 11.The Employer must use E-Verify for all new employees. The Employer will not verity selectively and will not verify employees heed before the effective date of this MOU. Employers who are Federal contractors may qualify for exceptions to this requirement as described In Article 11.6 of this Mali. 92. The Employer agrees to follow appropriate procedures(see Miele Ill below)regarding tentative noncorlilrmations. The Employer must promptly notify employees In private of the finding and provide them with the notice and letter containing information specific to the employee's E-Verity case. The Employer agrees to provide both the English and the translated notice and letter for employees with limited English proficiency to employees. The Employer agrees to provide written referral instructions to employees and instruct affected employees to bring the English copy of the letter to the SSA. The Employer must allow employees to contest the finding,and not take adverse action against employees if they choose to contest the finding,while their case is still pending.Further,when employees contest a tentative nonconfirmation based upon a photo mismatch,the Employer must take additional steps (see Article 111.8.below)to contact DHS with information necessary to resolve the challenge. 13. The Employer agrees not to take any adverse action against an employee based upon the employee's perceived employment eligibility status While SSA or OHS is processing the verification request unless the Employer obtains knowledge(as defined in 8 C.F.R.§274a.1(1))that the employee is not work authorized.The Employer understands that an Initial arability of the SSA or DHS automated verification system to verify work audxxization,a tentative nonconfernation,a case in continuance (Indicating the need for additional time for the government to resolve a case),or the finding of a photo mismatch,does not establish,and shouid not be interpreted as,evidence that the employee is not work authorized.in any of such cases,the employee must be provided a full and fair opportunity to contest the finding,and if he or she does so,the employee may not be terminated or suffer any adverse employment consequences based upon the employee's perceived employment eligibility status Pepe 5 c1 17 E-Verity MOU ler Employers I Revision Date 06109.113 Contract for Insurance Brokerage Services Page 33 of 57 Vern _______ ,. Comport'ID Number 651722 (including denying,reducing,or extending work hours,delaying or preventing training,requiring en employee to work in poorer conditions,withholding pay,refusing to assign the employee b a Federal contract or other assignment,or otherwise assuming that he or she is unauthorized to work)until and unless secondary verification by SSA or OHS has been completed end a final nonconfirmation has been issued.If the employee does not choose to contest a tentative no confirmation or a photo mismatch or If a secondary verification is completed and a final nonconflrmation Is Issued.then the Employer can find the employee Is not work authorized and terminate the employee's employment. Employers or employees with questions about a final nonconfrmation may cell E-Verity al 1-888.464- 4218(customer service)or 1-8864397-7781(meter hollne). 14. The Employer agrees b comply with Title VII of the OW Rights Ada 11164 and section 2740 of the INA as applicable by not discriminating unlawfully against any individual In hiring.firing. employment eligibility verification,or recruitment or referral practices because of his or her national origin or citizenship status,or by committing discriminatory documentary practices.The Employer understands that such Illegal practices can include selective verification or use of E-Verify except as provided in part D below,or discharging or refusing to hire employees because they appear or sound "foreign"or have received tentative nonoonfIrmatbna.The Employer further understands that any violation of the inxnigratkrn.related unfair employment practices provisions in section 2748 of the INA could subject the Employer to dvil penalties,bad(pay awards,and other sanctions,and violations of Title VII could subject the Employer to back pay awards,compensatory and punitive damages. Violations of either section 2740 of the INA or Title VII may also lead to the termination of Its participation in E-Verify.If the Employer has any questions relating to the and-disarimination provision, it should contact OSC at 1400.255.8155 or 1-800-237-2515(TDD). 15. The Employer agrees that it wig use the information it receives from E-Veerify only to confirm the employment eligibility of employees as authorized by this MOU.The Employer agrees that it wil safeguard this Information,and means of access to it(such as PiNS end passwords),to ensure that It is not used for any other purpose and as necessary to protect is confidentiality.Including ensuring that it is not disseminated to any person other than employees of the Employer who are authorized to perform the Employer's responslbiNies under this MOU.except for such dissemination as may be authorized In advance by SSA or DHS for legitimate purposes. 16. The Employer agrees to notify DHS knmediately in the event of a breach of personal Information. Breaches are defined as loss of control or unauthorized access to E-Verify personal data. All suspected or confirmed breeches should be reported by calling 1-888-464-4218 or via email at E-Verlfveldhs.00v_ Please use Privacy Incident—Password'in the subject line of your'mai when sending a breach report to E Verify. 17. The Employer acknowledges that the information it receives from SSA is governed by the Privacy Act(5 U.S.C.§552a(i)(1)and(3))and the Social Security Act(42 U.S.C.1306(a)).Any person who obtains this information under false pretenses or uses II for any purpose other than as provided for in this MOU may be subject to c rin*ral penalties. 18. The Employer agrees to cooperate with DHS and SSA in their compliance monitoring and evaluation of E-Verify,which includes permitting OHS.SSA,their contractors and other agents,upon mage 4 c 17 E•Verry MOU for Enpirverg 1 Prawn cele D0001113 Contract for Insurance Brokerage Services Page 34 of 57 E -VeriIy ,� Company ID Number:5e1122 reasonable notice,to review Fomes 1-9 and other employment records and to interview it end its employees regarding the Employer's use of E-Very,and to respond in a prompt and accurate roamer to DNS requests for information relating to their participation in E-Verity. 19. The Employer shall not make any false or unauthorized claims or references about ha participation in E-Verify on its webelte,in advertising materials,or other media. The Employer shall not describe Its services as federally approved,federally-certified,or federally-recognized,or use language with a Order intent on its website or other materials provided to the public. Entering into this MOU does not mean that E-Verify endorses or authorizes your E-Verify services and any damn to that effect is false. 20. The Employer shall not state in its webslte or other public documents that any language used therein has been provided or approved by OHS.USCIS or the Verification Division,without first obtaining the prior written consent of DHS. 21. The Employer agrees that E-Verity trademarks and logos may be used only under license by DHS/USCIS(see MI-T95(Web))and.other than pursuant to the specific terms of such Cxense,may not be used in any manner that might Imply that the Employer's services,products,websites,or publications are sponsored by,endorsed by,licensed by,or affiliated with OHS,USCIS,or E-Verify. 22. The Employer understands that If it uses E Verify procedures for any authorized by this MOU,the Employer may be subject to appropriate legal laaction and termination of its participation in E-Verify according to this MOU. a.RESPONSIBILITIES OF FEDERAL CONTRACTORS 1. If the Employer is a Federal contractor with the FAR E-Verify clause subject to the employment verification tones In Subpart 22.18 of the FAR,it will become fartrNiar with and comply with the most current version of the E-Verify User Manual for Federal Contractors as well as the E-Verify Supplemental Guide for Federal Contractors. 2. In addition to the responsibilities of every employer outlined in this MOU,the Employer understands that If It is a Federal contractor subject to the employment verification terms in Subpart 22.18 of the FAR it must verify the employment eligibility of any"employee assigned to the contract'(as defined in FAR 22.1801).Once an employee has been verified through E-Verify by the Employer,the Employer may not create a second case for the employee through E-Verify. a. An Employer that Is not enrolled in[-Verify es a Federal contractor at the time of a contract award must enroll as a Federal contractor In the E-Veriy program within 30 calendar days of contract award and,within 90 days of enrollment,begin to verify employment eligibility of new hires using E-Verify. The Employer must verily those employees who are working in the Untied States, whether or not they are assigned to the contract.Once the Employer begins verifying new Was, such verification of new hires must be Initiated within three business days after the hire date.Once enrolled in E-Verify as a Federal contractor,the Employer must begin verification 01 employees assigned to the contract within 00 calendar days alter the date of enrollment or within 30 days of an employee's assignment to the contract,whichever date is later. Page S di?E.Vedny MOU for Empbyera I Auction Dela 06001d13 Contract for Insurance Brokerage Services Page 35 of 57 i -Veri1y company ID Nurnbrr.581722 kflO :fr4r4k4..; b. Employers enrolled in E-Verify as a Federal contractor for 90 days or more at the time of a contract award must use E-Verify to begin verification of employment elgibiity for new hires of the Employer who are working In the United States,whether or not assigned to the contra,within three business days after the date of hire.lithe Employer is enrolled in E-Verity as a Federal contractor for 90 calendar days or less at the lime of contract award,the Employer must.within 90 days of enrolment,begin to use E-Verify to initiate verification of new hires of the contractor who are working in the United States,whether or not assigned to the contract.Such verification of new hires must be Initiated within three business days after the date of lira.An Employer enroled as a Federal contractor in E-Verify must begin verification of each employee assigned to the contract with n 90 calendar days after date of contract award or within 30 days after assignment to the contract,whichever is later. c. Federal contractors that are institutions of higher educalon(as defined at 20 U.S.C.1001(e)), state or local governments,governments of Federally recognized Indian tribes,or sureties performing under a takeover agreement entered into with a Federal agency under a performance bond may choose to only verify new and existing employees assigned to the Federal contract Such Federal contractors may,however,elect to verify ell new hires,anrilor all existing employees hired after November 6, 1900. Employers in this category must begin verification of employees assigned to the contract within 90 calendar days after the date of enrollment or within 30 days of an employee's assignment to the contract,whichever date le later. d. Upon enrollment,Employers who are Federal contractors may elect to verify employment eligibUlty of all existing employees working in the United States who were hired after November 6, 1986,Instead of verifying only those employees assigned to a covered Federal contract After enrolment.Employers must elect to verify existing staff following DHS procedures and begin E-Verify verification of all existing employees within 180 days alter the election. a. The Employer may use a previously completed Form 1-9 as the basis for creating an E-Verify case for an employee assigned to a contract as long as: L That Form 1-9 is complete(Including the SSN)end complies with Article II.A.6, li. The employee's work authorization has not expired,and Iii. The Employer has reviewed the Form 1-9 information either In person or in communications with the employee to ensure that the employee's Section 1,Form 1-9 attestation has not changed(inducing,but not limited to,a lawful permanent resident alien having become a naturalized U.S.citizen). 1. The Employer shall complete a new Form 1-9 consistent with Article IIA6 or update the previous Form 1-9 to provide the necessary Information if: I. The Employer cannot determine that Form 1-9 complies with Article II.A.6, ii. The employee's bests for work authorization as attested in Section 1 has expired or changed,or HI. The Form 1-9 contains no SSN or is otherwise incomplete. Note: If Section 1 of Form 1-9 is otherwise veld end up-to-date and the form otherwise complies with Pape 6 or'?E-versy MOO ler cmployaa I Revision pale Oe 1113 Contract for Insurance Brokerage Services Page 36 of 57 [ Verily Company ID Number:581722 Article II.C.S,but reflects documentation(such as a U.S.passport or Form 1-551)that expired alter completing Form 1-0,the Employer shall not require the production of additional documentation,or use the photo screening tool described In Article IIA.5,subject to any additional or superseding Instructions that may be provided on this subject in the E-Verify user Manual. g. The Employer agrees not to require a second verification using E-Verify of any assigned employee who has previously been verified as a newly hired employee under this MOU or to authorize verification of any existing employee by any Employer that is not a Federal contractor based on this Article. 3. The Employer understands that If It is a Federal contractor,Its compliance with this MOU is a performance requirement under the terms of the Federal contract or subcontract,and the Employer consents to the release of information relating to cambric*with its verification responsibilities under this MOU to contracting officers or other officials authorized to review the Employer's compliance with Federal contracting requirements. C.RESPONSIBIUTIES OF SSA 1. SSA agrees to allow OHS to compare date provided by the Employer against SSA's database. SSA sends DI-IS confirmation that the data sent either matches or does not match the information in SSA's database. 2. SSA agrees to safeguard the Information the Employer provides through E-Verify procedures. SSA also agrees to irnit access to such inkemetion,as is appropriate by Lew,to Individuals responsible for the verification of Social Security numbers or responsible for evaluation of E-Verify or such other persons or entities who may be authorized by SSA as governed by the Privacy Act(6 U.S.C.§5528), the Social Security Act(42 U.S.C.1306(a)),and SSA regulations(20 CFR Pert 401). 3. SSA agrees to provide case results from Its database within three Federal Government work days of the initial inquiry. E-Verify provides the information to the Employer. 4. SSA agrees to update SSA records as necessary It the employee who contests the SSA tentative nonconfirmation visits an SSA field office and provides the required evidence. If the employee visits an SSA field office within the eight Federal Government work days from the date of referral to SSA,SSA agrees to update SSA records,if appropriate,within the eight-day period unless SM determines that more than eight days may be necessary. In such cases.SSA will provide additional instructions to the employee. If the employee does not visit SSA in the time allowed,E-Verly may provide a final nonconflrmation to the employer. Note:If an Employer experiences technical problems,or hes a policy question,the employer should contact E-Verify at 1-688464-421& D.RESPONSIBIUTIES OF DHS 1. OHS agrees to provide the Employer with selected date from OHS databases to enable the Employer to conduct,to the extent authorized by this MOU: a. Automated verification checks on alien employees by electronic means,and Pees 1 of 17 e.vsnry MDU for Employers I novi$ion Data 00J01n3 Contract for Insurance Brokerage Services Page 37 of 57 r . :-V: Merl Company ID Number; 501722 1 b. Photo vertication checks(when available)on employees. 2. DHS agrees to assist the Employer with operational problems associated with the Employer's participation in E-Verify.DHS agrees to provide the Employer names,titles,addresses,and telephone numbers of OHS representatives to be contacted during the E-Verify process. 3. DHS agrees to provide to the Employer with access to E-Verily training materials as well as an E-Verify User Manual that contain instructions on E-Verify policies,procedures,and requirements for both SSA and DHS,inducting restrkdions on the use of&Verify. 4. DHS agrees to train Employers on all important changes made to E-Verify through the use of mandatory refresher tutorials and updates to the E-Verify User Manual.Even without changes to E-Verify,DHS reserves the right to require employers to take mandatory refresher tutorials. 5. OHS agrees to provide to the Employer a notice,which Indicates the Ernpbyer's participation In E-Verify.DHS also agrees to provide to the Employer anti-discrimination notices issued by the Office of Special Counsel for Immigration-Related Unfair Employment Practices(OSC),Civil Rights Division. U.S.Department of Justice. 6. DHS agrees to Issue each of the Employer's E-Verify users a unique user identification number and password that permits them to log In to E-Verify. 7, DHS agrees to safeguard the inforrrratlon the Employer provides,and to limit access to such information to Individuals reapor>sibiefor the verification process,for evaluation of E-Verify,or to such other persons or entities as may be authorized by applicable law.Information will be used only to verify the accuracy of Sootiest Security numbers and employment eiglbiiy,to enforce the INA and Federal criminal laws,and to administer Federal contracting requirements. 8. OHS agrees to provide a means of automated verification that provides(in conjunction with SSA verification procedures)confirmation or tentative none onfirmation of employees'employment eiigibiity within three Federal Government work days of the initial inquiry. 9. DHS agrees to provide a means of secondary verification(including updating OHS records)for employees who contest OHS tentative nonconfrnadons and photo mismatch tentative nonconfirmations.This provides final confirmation or none onfirmation of the employees'employment eligibility within 10 Federal Government work days of the date of referral to DHS,unless OHS determines that more than 10 days may be necessary.In such cases,DHS will provide additional verification instructions. ARTICLE III REFERRAL OP INDIVIDUALS TO SSA AND OHS A. REFERRAL TO SSA 1. If the Employer receives a tentative nonoonfirmation issued by SSA.the Employer must print the notice as directed by E-Verify. The Employer must promptly notify employees in private of the finding and provide them with the notice and letter containing information specific to the employee's E-Verlfy Pape 80(1,E. arty MOU 1x Employbu I Revision Woe 08l09na Contract for Insurance Brokerage Services Page 38 of 57 -Verify Conmpimy ID Mumbai 581722 t case. The Employer also agrees to provide both the English end the translated notice and letter for employees with limited English proficiency to employees. The Employer agrees to provide written referral instructions to employees and instruct affected employees to bring the English copy of the letter to the SSA. The Employer must allow employees to contest the finding,and not take adverse action against employees If they choose to contest the ending,while their case is stil pending. 2. The Employer agrees to obtain the employees response about whether he or she will contest the tentative nonconfrmation as soon as possible after the Employer receives the tentative nonconllrrnation. Only the employee may determine whether he or she will contest the tentative nonccnfirmation. 3. After a tentative nonconflrmation,the Employer wil refer employees to SSA field offices only as directed by E-Verity. The Employer must record the case verification number,review the employee information submitted to E-Verify to Identify any errors,and find out whether the employee contests the tentative nonoorniirmetion.The Employer will transmit the Social Security number,or any other corrected employee information that SSA requests,to SM for verification again if this review indicates a need to do so. 4. The Employer will instruct the employee to visit an SSA office within eight Federal Government work days.SSA will electronically transmit the result of the referral to the Employer within 10 Federal Government work days of the referral unless it determines that mom than 10 days is necessary. 5. While wafting for case results,the Employer agrees to check the E-Verify system regularly for case updates. 6, The Employer agrees not to ask the employee to obtain a printout from the Social Security Administration number database(the Ntxmident)or other written verification of the SSN from the SSA. B.REFERRAL TO DHS 1. If the Employer receives a tentative noncorrfrmatbn issued by DHS.the Employer must promptly notify employees in private of the finding and provide them with the notice and letter containing Information specific to the employee's E-Verify case. The Employer also agrees to provide both the English and the translated notice and letter for employees with limited English proficiency to employees.The Employer must allow employees to contest the finding,and not take adverse action against employees if they choose to contest the finding,while their case is seal pending. 2. The Employer agrees to obtain the employee's response about whether he or she will contest the tentative nonconfirmatlon as soon as possible after the Employer receives the tentative nornronfrnnation. Only the employee may determine whether he or she will contest the tentative nonoonfirmatlon. 3. The Employer agrees to refer individuals to OHS only when the employee chooses to contest a tentative noncontrmation. 4. lithe employee contests a tentative nonoonfirinatlon issued by DHS,the Employer will instruct the Page 6 of 17 E.Vmuy MDJJ lar Employers I Re+irlon Data 0601113 Contract for Insurance Brokerage Services Page 39 of 57 I - _ -Veri ... .. Company lb slumber 581722 employee to contact OHS through its toll-free hotline{as found on the referral letter)within eight Federal Government work days. 5. If the Employer finds a photo mismatch,the Employer must provide the photo mismatch tentative nonc onflrmation notice and follow the instructions outaned in paragraph 1 of this section for tentative nonconfirmations,generally. 6. The Employer agrees that If an employee contests a tentative nanc onflmretion based upon a photo mismatch,the Employer will send a copy of the employee's Form 1-551,Form 1-766,U.S.Passport,or passport card to DHS for review by: a, Scanning and uploading the document,or b. Sending a photocopy of the document by express mail(furnished and paid for by the employer). 7. The Employer understands that If ll cannot determine whether there is a photo match/mismatch.the Employer must forward the employee's documentation to OHS as described in the preceding paragraph. The Employer agrees to resolve the case as speeded by the DHS representative who will determine the photo match or mismatch, S. DHS wE electronically transmitthe resufi of the referral to the Employer within 10 Federal Government work days of the referral unless It determines that more than 10 days Is necessary. 9. While waiting for case results,the Employer agrees to check the E-Verify system regularly for case updates. ARTICLE IV SERVICE PROVISIONS A. NO SERVICE FEES 1. SSA and DHS will not charge the Employer for verification services performed under this MOU.The Employer is responsible for providing equipment needed to make Inqufles.To access E-Verity,an Employer will need a personal computer with Internet access. ARTICLE V MODIFICATION AND TERMINATION A MODIFICATION 1. This MOU is effective upon the signature of all parties and shall continue in effect for as long as the SSA and OHS operates the E-Verify program unless modified in writing by the mutual consent of all parties. 2. Any and all E-Verify system enhancements by OHS or SSA,including but not limited to E-Verify cheddng against additional data sources and Instituting new verification policies or procedures,will be covered under this MOU and will not cause the need for a supplemental MOU thet outlines these changes. Pape roe 11 E•Vedly MOU for Elnpbyots Morisco Dale OgOV13 Contract for Insurance Brokerage Services Page 40 of 57 Veril Company D Number:551722 B. TERMINATION 1. The Employer may terminate this MOU and is participation in E-Verity at any time upon 30 days prior written notice to the other parties. 2. Notwithstanding Article V,part A of this MOU,OHS may terminate this MOU,and thereby the Employer's participation In E-Verky,with or without notice at any time if deemed necessary because of the requirements of law or policy,or upon a determination by SSA or OHS that there has been a breach of system Nttegrtty or security by the Employer,or a failure on the part of the Employer to comply with established E-Verity procedures andlor legal requirements.The Employer understands that int le a Federal contractor,termination of this MOU by any party for any reason may negatively affect the performance of its contractual responsibilities. Similarly,the Employer understands that If It Is in a state where E.-Verify is mandatory,termination of this by any party MOU may negatively affect the Employer's business. 3. An Employer that Is a Federal contractor may terminate this MOU when the Federal contract that requires he participation in E-Verify is terminated or completed.In such cases,the Federal contractor must provide written notice to OHS.If an Employer that le a Federal contractor fake to provide such notice,then that Employer will remain en E-Verity participant,wet remain bound by the terms of this MOU that apply to non-Federal contractor participants,and veli be required to use the E Verify procedures to verify the employment eligibility of aN newly hired employees. 4.The Employer agrees that E-Verify Is not Noble for any losses,financial or otherwise,lithe Employer is terminated from E-Verity. ARTICLE VI PARTIES A Some or all SSA and OHS responsibNittes under this MOU may be performed by contractor(s),and SSA and DHS may adjust verification responsibilities between each other as necessary.By separate agreement with OHS,SSA has agreed to perform its responsibilities as described in this MOU. B. Nothing in this MOU is Intended,or should be construed,to create any right or benefit,substantive or procedural,enforceable at law by any third party against the United States,Its agencies,officers,or employees,or against the Employer,its agents,officers,or employees. C.The Employer may not assign,tiredly or Indirectly,whether by operation of law,change of control or merger,aN or any part of its rights or obligations wider this MDU without the prior written consent of OHS,which consent shall not be unreasonably withheld or delayed. Any attempt to sublicense,assign, or transfer any of the rights,duties,or obligations herein is void. D.Each party shall be solely responsible for defending any claim or action against it arising out of or related to E-Verify or this MOU,whether civil or criminal,end for any liability wherefrom,Including(but not limited to)any dispute between the Employer and any other person or entity regarding the applicability of Section 403(d)of IIRIRA to any action taken or alegedly taken by the Employer. E.The Employer understands that its participation in E-Verify is not confidential information end may be dsclosed as authorized or required by law and OHS or SSA policy,including but not limited to, Pegs 11 o11/&Verify MOU sat Emfloyen I ROMeon Dam ONO Ina Contract for Insurance Brokerage Services Page 41 of 57 eri Company ID Plumber:561722 Congressional oversight,E-Verify publicity and media Inquiries,determinations of compliance with Federal contractual requirements,and responses to inquiries under the Freedom of Information Act (FOIA). F. The individuals whose signatures appear below represent that they are authorized to enter into this MOU on behalf of the Employer end DHS respectively.The Employer understands that any inaccurate statement,representation.data or other information provided to OHS may subject the Employer,its suboontrectors.its employees,or Its representatives to:(1)prosecution for false statements pursuant to 18 U.S.C.1001 and/or;(2)irmtediate termination of is MOU and/or;(3)possible debarment or suspension. G.The foregoing constitutes the full agreement on this subject between OHS and the Employer. To be accepted is an E Varify participant,you should only sign the Employer's Section of the signature page.If you have any questions,contact E•Vedfy at 1-888.464.4218. Page 12 d 17 E-Yenfy MOU for EmWIMP%I Rs won Data 05701/13 Contract for Insurance Brokerage Services Page 42 of 57 . . ..,: E1:TVeriFy �.. ...... Company m Plumber:5E1722 Approved by: Employer 6lancnerd a Calhoun Insurance Andy,Fix. Name(Please Type or Print) 'Title Thomas M mrd Jr Signature Mate E1ricnly Signed 0711612012 Department of Homeland Security-Verification Division Name(Please Type or Print] 'nue uscls Verification Smarm Signatures EleotronlceNy Signed 07/16/2012 Pa®613 of 1 i E-Verily hhOU for Employers I aeriepn Dale 0Wo1r13 Contract for Insurance Brokerage Services Page 43 of 57 kk, Verify04, Company ID Ntan6*r: 681722 Information Required for the E•Verify Program information relating is your Cr�rnpariy: Blanchard 8 Calhoun Insurance Apency,Inc. Company Name 245 Davis Road Augusts„GA 301107 Company Facility Address P.O.sop 212359 Av9usla,GA 3D917-2359 Company Alternate Address County or Parish RIChstONt1 Ervlpbyer Identification Number 592324138 North American Industry 624 Classification Systems Code Parent Company Number of Employees 20 to 99 Number of Sites Verified for 1 Pape 14 ii 17 E•Yen y MDI)Ior Employers I Revision Date 0501113 Contract for Insurance Brokerage Services Page 44 of 57 Co.p.,ID Number. 5$1722 Are you verifying for more than 1 site?If yes,please provide the number makes verified for In each State: GEORGIA 1 sitc(a) Pape 18 eV E-Vedy L1OU tar Employs=(Revision Dela 061D1/13 Contract for Insurance Brokerage Services Page 45 of 57 1 -2,,,,,,:-. -. Veri Company ID Number:561F22 information relating to the Program Administrator(s)for your Company on policy question or operational problems: Name Mem B Rrpdon Phone Number (706)656-8544 Fax Number Email Address brigdonabienduerdand oun.00m Pa6616 o917 E'ud r NW br Ehployr ra I ltration Date aamll13 Contract for Insurance Brokerage Services Page 46 of 57 Wnr ID Nursibsn 581722 Page in#entIonally left blank Yeas 17 or 17 E-+srry NOl1lar En1*ysn I Revision Ds 06pV1s Contract for Insurance Brokerage Services Page 47 of 57 EXHIBIT B BROKER'S PROPOSAL Contract for Insurance Brokerage Services Page 48 of 57 -; a. � yv R 11 1 A NOTICE TO ALL VENDORS (PLEASE READ CAREFU}ty) ADHERE TO THE BELOW INSTRUCTIONS AND 111D N4T SUBSTfTUTE FORMS ('LEASE READCA ULLY: Attachment)a is a consoBdated document consisting of: 1. Business License Humber Regtareanent(must be provided) 2. Acknowledgement of Addenda(must be acknowledged,if any) 3. Statement of Non-Discrimination 4. Non-Collusion Affidavit of Prime Proponent/Offeror 5. Conflict of Merest 6. Contractor Affidavit and Agreement(E-Verify User ID Writhe,must be provided) Attachment B Must kg Noun sed$it z P; s midg Fettarned Budnass l.kcr.+;�ae.. •h Inv": mitts!-No Exceptions.u►arnent:Proponent must be licensed in the Governmental entity for where they do the majority of their business. Your company's businlss license number must be provided on Pate 1 of Attachment 8. If your Governmental entity(State or Local)does not require a business license,your company will be required to obtain a Richmond County business license If awarded a contract. For further information contact the license and Inspection Department Q 706 312-5050. mop, a Ad ; You Must acknOwledge MI Addenda. See Page 1 of Attachment B. f-Verify*Uper Identification Number(Company IA.) The recommended awarded vendor will be required to provide a copy of Homeland Security's Memorandum Of Understanding(MOU) Affidavit Verifying Status for Augusta Benefit Application(S.A.Vf_Presaramt f Mast Be Returned With Yaur Subm3tt� Retool Pr ty If A ble: 1. The Exception Sheet(if applicable) 2. Local Vendor Registration(if applicable) The successful proponent will submit the following forms to the Procurement Department no later than five(5)days after receiving the'better of Recommendation* (Vendor's letter will denote the date forms are to be received 1• Georgia Security and immigration Subcontractor Affidavit 2. Non-Collusion Affidavit of Sub-Contractor ARNlNG: Please review -game to Propnoon' ar ^eg Augusta Georgia's !neat Small Business Opportunity Program PrWronens �9:�nerxti. Vtation are DepeM ruot sed that acquisition al proposal docurnerm through Any source other then the office of the Procurement receiving Incomplete lar eaascurs enation upon Acquisition of al documee wbci to bast his qualificathorked ions course Flares the propose.as, the rtrk of 9 dent. ProPasali ere'rebirth opened- rt le your celcirrtmeatspriosulenktIng a proposairsPonsebmry to ensure that your company hatnes Inc spsNicauohs and Licenser lieu.!/6/gois NIP 17.1411u upon 1nshrtv+se Brokerage SR-vicai PM Out TNuraday,itbruary 5 1(117 gt 13:0G a in Pare Sof ill Contract for Insurance Brokerage Services Page 49 of 57 Augusta Regional Airport RFP For Airport Insurance Brokerage Services Blanchard&Calhoun insurance Agency,Inc.has been in business since 2919.We are the oldest and largest locally owned agency in Augusta,I serve as its President and have been with the agency for thirty seven years since September 1,1980.We have served Augusta Regional Airport for its Aviation and affiliate coverages for over three decades.We are located In Richmond County at 195 Davis Rd,Augusta, GA 30907. We are fully licensed and have a staff of thirty seven.We have an assigned team handling Augusta Regional Airport's insurance Including Janet Rockefeller as an account manager with 33 years' experience,Claudia Davis with 15 years'experience and Genf DuBois with 19 years'experience as service representatives.We also have a dedicated claims manager,Bonnie Mims with 8 years' experience,who is assigned to the Airport's account. All of our staff are licensed and have been with our agency many years.1 have the CAWC accreditation, Certified Authority on Workers Compensation and have served as the President of the Independent Insurance Agents of Augusta and also on the Board of Directors of the Independent Agents of Georgia.I have also served as Chairman of Georgia Agency Partners,a consolidation of sixteen agencies across Georgia representing over$425,000,000 in annual premium.I also have served as President and board member of many Aloe-Profit Organizations within Augusta. We represent every aviation carrier and have marketed Augusta Regional Airports insurance each year and have provided a successful reduction in cost each year.(Ten year premium history attached). We provide Claims Management and customer service seven days a week and on any and all holidays. Augusta Regional Airport's personnel have immediate access to me and our support staff as well. We have,each year,consistently provided all services stated in this RFP's scope of services under tie inclusive of all under 4.1 through 4,18 and will continue to do so if chosen to continue to represent the airport. Our agency prides Itself in the highest standard of service with immediate response.I am available to meet and discuss our service anytime requested.Thank you for giving us the opportunity to continue to provide Augusta Regional Airport excellent service. Sincerely, Preston .o President Contract for Insurance Brokerage Services Page 50 of 57 References Jefferson County Board of Education-Renee Weeks 078)625-7626 Macuch Steel Products-Bill Macuch(706)339-810© Augusta Iron&Steel-Bo Bovard{706)860.7739 Ambio Holdings,Inc-Steve Kiel(216)$33-5249 The Tryon Group,Inc-Eric Tryon{770(475-0004 Contract for Insurance Brokerage Services Page 51 of 57 P, O C fr 4n J vi pa H 4 o n W op R * P a -4 g �,. B to /ryy ra tch� 2 n n o 0 1a c ro ro iu o p g w K n IN if.) U 2 3 = n Da C` a 3 n S M ;o 2 bo rp 5 m .# ,. s d -, t'r. p .0 "` ti is C .-, ow t` LA W N R 3 M - g ' n n 0 V tH l~N I. y ~ N N ©N N 10 y't AI 1V 4,3 PO W VI �.D. A W W ►+ AO, C3 tpj W .fF1 N A IIh CC �0 tjcc TJ tn cc ¢W� I. �4pf jp. .4`tO VI 0 !a WE W DQ L! 46 DO W W N N A 41 W N OS N b1 W A V a' W pp V N N ON 0 O O N {y VI no p rD 0 10 CO O 0 0 0 N O A y1... n N yagW AM9.iAu YN UIAN :Ig §V `�� D .v 4 t3 iWA QO O µ a WANi!' OtO Si ;.1 in N ft4 1-.. A os O .is 1,1 vs to :is w iv N ii:, O N A W A w 40 M V 01 A O 40 A N V1 A Pr to {/� W Co 7t a H tei n cgro tv V P° o _1a Dr wm 3ri4 z Eaa ,g0 &32, y, n 1 a �c n A 3 c �, 4 0 M N Ib in to W tD co ID C+ N +{Vi {p►p� N T. W 00 'al N Vi go 0, V LI SI N cn 1.4 NJ tA�pl 4 CO N 4y Vf CO Ch O A UNn CA'a O # 0, Vf W '.0 u CO A in NJ V VN9 OA V VI O C: N in Q N X co. 4 X' n Contract for Insurance Brokerage Services Page 52 of 57 & g © � : . f_ 22 2 \�\ � �B tr \!i1!t' \ 4.4 411 =• 2 g ■. * 2 g 't _ :_ _ \ K $ gT \ \ _ __. A t \ Ari \ 3X g 0 2 2 K #-2 � . off _ 46 _ ,@ § 4.4401 I _ - ,r rt it /a® . _ } $ 114 ® fa r IF 0 e � . 72 . 6e o kk £ /37 2 Contract for!nsuranceB Brokerage Services Page 53 of 57 I Iso; , cliA a- ,.! . - I AND . ,, (4LiciouN jK i if N t' CENC INC . 4.1,% , t , ,\ Risk li v.,,, Management Center , Comprehensive Risk Management, , Employee Safety and Compliance :� :. t Platform ftxf x v fii714,,yr.'' y�s' # f: Help protect your "` ; ' . company with the Risk ,, �x fes. x Management ' g,,. _ 9 nt Center,a unique web-ba = s to of safety and risk management r• + „ t x a to empower your organizration'srisk t ,t ; 7',7`;:. .'11i ! `; ,n efforts. >� �.i;iii x z The Risk Management Ce alit t risk and enable employee safetyda r, i,t� . t i `� effective mitigation bY` t - �€ ,� . risk gah Programs, It= , , , ' aces andand provides a cast1..4,k44„, `'' 2 ` 'f '04'. use, t d ` t- , kt #y P fl reduction and safety center for youra � K � ' part *::444k,„,,,,,-4 7.,;.,,,,,,,.:, ,,,,l' 0 organization across all{fie � t �, ,.� � � �� � `.. �: t.. EffiCI.erlt, C'Ci t-Effertiv, and Tim{ -Savira Solution,--, T`1,_!i: s( r,;;;111:19.,11! t1 '71'` t 111111 : � 1� ,; -t "-rx-�`�lr' ,,�.;!]� 1_4a t _`; i J :u � ,11111 r:. liifr�r:�i '�t_1( '..e.0 i :.1tyC. Vh':1 1 `,' ',-i'4,1�'1I u 1 'K!_ I., a ' IL 1~• r Oa �S"t"n1131i I ttjfil. 1 �1. L 1 or-,r., dI I ' a �Ie-,Li...,i i-1 1r , i t— t f l w' �.t t t 1`litlt r f i1f s � �� •o-; r .rrfl „1,�'sll �..iy1..,} _ t: �° �t .�Ir9 i � �1�.1' ?y. ,, orninJnif,01[,►t?yut L€t �''�-�� CY-1? t' t z s • I at1' c:i '`1111 I,_ ,i pica da- •`Lori.t., 111.. y1. - t 1.9:.: t 1 1. 111 ,:E,i�,'-�11�• Tr lli rnk lup'Q.':ii#i i . f (ALL..., i -.13d,...-:.:14.,1,,, l,.il3� {I,i�9 't r 9 tl'il`ir i411Jk'il� o,?..,i e .ti!'�l,tJ��y lifCd t� l`�'Y 3 t r'4' "a "fti f�i hilt_ }l,:-0 .n_. e' .1".4,- oT, ! /.11 ii ( To learn more, or to sign up for a no-obligation webinar, contact Preston Moss at 706.650.6000 or pmoss blanchardoalhounins,cow,. Contract for Insurance Brokerage Services Page 54 of 57 Benefits Glance t,n1('#101 111,,' C1O4'3 i,�� , t } !t t - ! � yY t 1 . �. zf i '4 tl i,uj', 1.=,°!#1):;‘-'.;1 P 6' u'�EI 1 �r4 Ift�,.�1�1�� p . 114 4 Cw,i c4' ,4' I 'S YI .yt 1{e41 If11- '1�11ti #4�� i!hieLt 'r5 4 i � '. �,l is�r ' ld ,c-c,..61.401:4. r` In a4'k��IC j-1�11�$� �'�..,1 .- -;K;4 1; fe.'itt n4s4Id4 .•II4xI a.4-ti:�f��li„iEt, �eF i4 ;ilL a i', ti a ,rrJt-i 14..u1tC,'€3 A Holistic So/inion to Manage Risk Control loss, anti Improve Co aid;an item below to view mom information ln�Cr /ial�t i..--L74,1M�aeeTof ra ningaJ p }, ts brary pow and -a. Certificate of Insurance Management Training Shorts ! oJ liability your COJs to rrablllky end risk HR&Benefits Database Behevbr-Based Safety Resources and handbooks for aa SO states wim Build behavior-based safety progrants amm s withob hazard analyses 7 • ((tf Ind rrt Tradcingfrrenc ng and Claims rt=; t Job Description Tracking 'r fi�fii. Reporting r;J. i!c Access a Pne-landed JI Trend inaidents,repot dakrts,print OSHA Lpgs ; description s;create Modem�assigranents b • Safety Data Sheet Management ,, Be compliant with OSHA hazardous material Employee Training n Miming using standards and the new GJobaN Harm SystemAute schedutir�and repot g using our Y Harmonized '; online training Succeed Services at Havceee o r risk and oornpliance program managed by mana Client Tes a talkl - y talks about how the Risk Sucs l h Jennifer MasManagement Center has helped her organization **SU p k n h Jc s ..: >- � � .. �.. ._ Contract for Insurance Brokerage Services Page 55 of 57 EXHIBIT C BROKER'S COST PROPOSAL Contract for Insurance Brokerage Services Page 56 of 57 Augusta Regional Airport RFP 201b Fee Schedule Blanchard&Calhoun's fee schedule encompasses all Services Rendered inclusive of the Succeed Program(description attached)Succeed charges up to$11,000 annually when purchased direct from the vendor.We provide it no additional charge to Augusta Regional Airport.Our fees are based on Industry standards and also what the carriers that we provide pay us. Business Auto(Pilot Vehicles) - 1O% Directors&Officers liability 35.5% Auto Fleet Scheduled Art 15.5% Pollution liability 10% Aviation General liability 15% Our fees include all customer service transactions,claims handling,loss control visits and consultation, and any and all telephone consults.There are no additional fees charged.We offer multiple billing options to include annual,semi annual,quarterly or monthly. Contract for Insurance Brokerage Services Page 57 of 57