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Language Training Center/CFDLanguage Training Center Fire Dept - 2002 Spanish Language Classes for Firefighters Appropriation #570-03; P.O.#9661 Contract Not To Exceed $3,600.00 APPROVED, AS TO AGREEMENT FOR PROFESSIONAL SERVICESFo~i THIS AGREEMENT FOR PROFESSIONAL SERVICES ("Agreement"), is hereby made and entered into by and between the City of Carmel, Indiana, acting by and through its Board of Public Works and Safety (hereinafter "City"), and Language Training Center (hereinafter "Professional"). RECITALS WHEREAS, City owns and is responsible for its public works, which responsibility includes, but is not limited to, the planning, design, construction, operation and maintenance of it's infrastructure system; and WHEREAS, from time to time, City needs professional services to assist it in fulfilling its foregoing responsibilities; and WHEREAS, Professional is experienced in providing such professional services as are covered by this Agreement; and WHEREAS, City desires to engage Professional as an independent contractor for the purpose of providing to City, on a non-exclusive basis, the professional services referenced herein; and WHEREAS, Professional is qualified and desires to provide City with such professional services. NOW, THEREFORE, in consideration of the foregoing recitals and the covenants and conditions set forth herein, City and Professional mutually agree as follows: SECTION 1. INCORPORATION OF RECITALS The foregoing recitals are hereby incorporated into this Agreement and made a part hereof. SECTION 2. SCOPE OF SERVICES 2.1 City desires to engage Professional as an independent contractor for the professional services ("Services") set forth in attached Exhibit A, which is incorporated herein by this reference. Professional desires to provide the Services to City. 2.2 Professional acknowledges that it has read and understands this Agreement, and that Professional's execution of same constitutes its acceptance of all Agreement terms and conditions. 2.3 Professional understands and agrees that City may, from time to time, request Professional, on a non-exclusive basis, to provide additional professional services, the scope of which shall be as Language Training Center Fire Dept - 2002 Spanish Language Classes for Firefighters Appropriation #570-03; P.O.#9661 Contract Not To Exceed $3,600.00 requested and defined by the Mayor or his duly authorized representative. When City desires additional services from Professional, the Mayor or his duly authorized representative shall notify Professional and set forth the scope of ~uch additional services desired, as well as the time frame in which such services are to be rendered. Professional shall then provide, at no cost to City, a time and cost estimate for such additional services. Only after City has approved Professional's time and cost estimate shall Professional be authorized to commence such additional services, the description of which shall be set forth in documents which shall be numbered and attached hereto in the order approved. 2.4 Professional understands and agrees that City reserves the right, at any time, to direct Professional to make changes in the Services and/or additional services provided, or to otherwise change the scope of the work covered by this Agreement, and Professional agrees to promptly make such changes. Any difference in price or time of performance resulting from such changes shall be equitably adjusted by City and Professional after receipt of documentation from Professional in such form and detail as City may require. 2.5 Professional expressly warrants that all Services and/or additional services covered by this Agreement will conform to the specifications, samples, instructions, and/or descriptions furnished to City by Professional or by Professional to and accepted by City, and that such Services and/or additional services will be performed in a timely manner, in a good and workmanlike manner and free from defects. 2.6 Professional acknowledges and agrees that it knows of City's intended use and expressly warrants that all Services and/or additional services provided pursuant to this Agreement will be fit and sufficient for the particular purposes intended by City. 2.7 Time is of the essence of this Agreement. SECTION 3. CITY'S RESPONSIBILITIES 3.1 City shall provide such criteria and information as are reasonably necessary for Professional to understand the Services and/or additional services requested and to provide a time and cost estimate thereon. 3.2 Once City has accepted Professional's time and cost estimate for the Services and/or additional services, City shall: 3.2.1 Furnish to Professional, upon request, such studies, reports and other available data in City's possession as City considers reasonably pertinent to the Services and/or additional services to be provided; and 3.2.2 Arrange for Professional to enter upon public and private property as reasonably required for Professional to perform the Services and/or additional services; and Language Training Center Fire Dept - 2002 Spanish Language Classes for Firefighters Appropriation #570-03; P.O.#9661 Contract Not To Exceed $3,600.00 3.2.3 Make reasonably available to Professional for consultation, as needed, such individuals as are necessary for Professional to provide the Services and/or additional services to City. 3.2.4 Designate payment of the Services and/or additional services from City budget appropriation number 570-03 funds. 3.3 City shall designate the Mayor or his duly authorized representative to act on City's behalf on all matters regarding the Services and/or additional services. SECTION 4. PROFESSIONAL'S RESPONSIBILITIES 4.1 Professional shall provide to City, within five (5) business days after City requests same, a written time and cost estimate for the Services and/or additional services requested by City to be performed by Professional. 4.2 Once City has accepted Professional's time and cost estimate for Services and/or additional services, they shall be performed pursuant to the terms of this Agreement, within such time and cost estimate, and pursuant to any other terms and conditions set forth or referenced herein. 4.3 Professional shall coordinate its performance with the Mayor or his duly authorized representative pursuant to a mutually agreeable schedule and/or as circumstances dictate. 4.4 Professional shall provide the Services and/or additional services by following and applying at all times the highest professional and technical standards. SECTION 5. COMPENSATION 5.1 As full and complete compensation for the Services performed by Professional hereunder, and subject to the terms and conditions contained in this Agreement, City shall pay Professional as set forth in attached Exhibit A. 5.2 Professional estimates that the total price for the Services to be provided to City hereunder shall be no more than $3,600.00. Professional shall submit an invoice to City no more than once every thirty (30) days for Services and/or additional services provided City during the time period encompassed by such invoice. Invoices shall be submitted on a form containing the same information as that contained on the Professional Services Invoice attached hereto as Exhibit B, which is incorporated herein by this reference. City shall pay Professional for all undisputed Services and/or additional services rendered and stated on such invoice within sixty (60) days after the date of City's receipt of same. If the undisputed portion of an invoice amount is not timely paid, then a late charge in a sum equal to one percent (1%) of such unpaid and undisputed invoice amount shall accrue and be due and payable by City to Professional as a separate debt for each month same remains unpaid. 5.3 Professional agrees to provide City, in writing, and within fifteen (15) days of City's request for same, with Professional's estimate ("Estimate") of the total cost for the Services and/or additional Language Training Center Fire Dept - 2002 Spanish Language Classes for Firefighters Appropriation #570-03; P.O.#9661 Contract Not To Exceed $3,600.00 Services to be provided by Professional to City under this Agreement during the time period requested. Professional agrees not to provide any Services and/or additional Services to City during the time period covered by an Estimate that would cause the total cost of the Services and/or additional Services provided by Professional to City hereunder during such time period to exceed the Estimate, unless City has previously agreed, in writing, to pay an amount in excess thereof. 5.4 City, in its sole discretion, may agree to pre-pay all or any portion of the compensation to be paid Professional as a result of its provision of the Services and/or additional services hereunder, which pre-payment shall be expressly contingent upon and subject to an accounting and reconciliation by and between the parties at such time as such Services and/or additional services are fully performed, this Agreement is terminated and/or upon City's request. Professional agrees to immediately disgorge to City any prepayment amount it has received from City for Services and/or additional services that are disputed by City and/or which constitutes an overpayment for same. 5.5 If additional professional services are required and Professional wishes to hire an outside source for the performance of same, Professional shall so notify City, in advance of the engagement of such outside source, with an explanation of the need and qualifications of same. If City consents to such outside source, which consent shall not be unreasonably withheld, City shall reimburse Professional for the actual cost of same, which reimbursement sum shall be subtracted from the amount of compensation due Professional from City hereunder. Professional understands and agrees that any and all outside sources so hired shall be employees or contractors of Professional only. Professional warrants and indemnifies City for and from any and all costs, fees, expenses and/or damages incurred by City as a direct or indirect result of the use by Professional of an outside source. This indemnification obligation shall survive the termination of this Agreement. SECTION 6. TERM Subject to the termination provisions set forth in Section 7.1 hereinbelow, this Agreement shall be in effect from the Effective Date through December 31, 2002, and shall thereafter, on the first day of January in each subsequent year, automatically renew for a period of one (1) year. SECTION 7. MISCELLANEOUS 7.1 Termination. 7.1.1 The obligation to provide all or any portion of the Services and/or additional services under this Agreement may be terminated by City or Professional without cause upon thirty (30) days' notice to the other party. 7. l.2 The obligation to provide all or any portion of the Services and/or additional services under this Agreement may be terminated by City for cause, or upon City's failure to appropriate monies sufficient to pay for same, immediately upon Professional's receipt of City's "Notice To Cease Services." Language Training Center Fire Dept - 2002 Spanish Language Classes for Firefighters Appropriation #570-03; P.O.#9661 Contract Not To Exceed $3,600.00 7.1.3 In the event of full or partial Agreement termination, and as full and complete compensation hereunder, Professional shall be paid for all such Services and/or additional services rendered and expenses incurred as of the date of termination of same that are not in dispute, except that such payment amount shall not exceed the Estimate amount in effect at the time of termination, unless the parties have previously agreed in writing to a greater amount. Disputed compensation amounts shall be resolved as allowed by law. 7.2 Binding Effect. City and Professional, and their respective officers, officials, agents, parmers, successors, executors, administrators, assigns and legal representatives are bound to the other and to its officers, agents, partners, successors, executors, administrators, assigns and legal representatives, in all respects as to all covenants, agreements and obligations of this Agreement. 7.3 No Third Part,/Beneficiaries. Nothing contained herein shall be construed to give any rights or benefits hereunder to anyone other than City and/or Professional. 7.4 Relationship. The relationship of the parties hereto shall be as provided for in this Agreement, and neither Professional nor any of its agents, employees, contractors, subcontractors or outside sources are or shall become employees of City. Furthermore, Professional shall have the sole responsibility to pay to or for its agents, employees, contractors, subcontractors and outside sources all statutory, contractual and other benefits and/or obligations as they become due, and City shall not be responsible for same. Rather, the compensation to be paid hereunder by City to Professional shall be the full and maximum amount of compensation and monies required of City to be paid to Professional hereunder. Professional hereby warrants and indemnifies City for and from any and all costs, fees, expenses and/or damages incurred by City as a direct or indirect result of any statutory, contractual or other claim for wages, benefits or otherwise by any agent, employee, outside source, contractor or subcontractor of Professional regarding or related to the subject matter of this Agreement. This indemnification obligation shall survive the termination of this Agreement. 7.5 Insurance. Professional shall procure and maintain, with an insurer licensed to do business in the State of Indiana and reasonably acceptable to City, such insurance as is necessary for the protection of City and Professional from all claims under workers' compensation, occupational disease and/or unemployment compensation acts, because of errors and omissions, because of bodily injury, including, but not limited to, the personal injury, sickness, disease or death of any of Professional's employees, agents, contractors, subcontractors or outside sources, and/or because of injury to or destruction of property, including, but not limited to, any loss of use resulting therefrom. The coverage amounts shall be no less than those amounts set forth on attached Language Training Center Fire Dept - 2002 Spanish Language Classes for Firefighters Appropriation #570-03; P.O.#9661 Contract Not To Exceed $3,600.00 Exhibit C. Professional shall cause its insurers to name City as an additional insured on all such insurance policies (except on its Professional Responsibility Insurance policy), shall, upon request, provide City with copies of all such policies, and shall provide that such policies will not be canceled without thirty (30) days prior notice to City. 7.6 Liens. Professional shall not cause or permit the filing of any lien on any of City's property. In the event such a lien is filed of record and Professional fails to remove it within ten (10) days after the date of filing thereof, by payment or bonding, City shall have the right to pay such lien or obtain such bond, all at Professional's sole cost and expense. Professional shall indemnify and hold harmless City from and against any and all liabilities, losses, claims, costs, attorney fees, expenses and/or damages incurred by City in connection with any such lien or the removal thereof. This indemnification obligation shall survive the termination of this Agreement. 7.7 Default. In the event Professional: (a) repudiates, breaches or defaults under any of the terms or conditions of this Agreement, including Professional's warranties; (b) fails to perform the Services and/or additional services as specified; (c) fails to make progress so as to endanger timely and proper completion of the Services and/or additional services and does not correct such failure or breach within five (5) business days (or such shorter period of time as is commercially reasonable under the cimumstances) after receipt of notice from City specifying such failure or breach; or (d) becomes insolvent, files, or has filed against it, a petition for receivership, makes a general assignment for the benefit of creditors or dissolves, each such event constituting an event of default hereunder, City shall have the right to, among other things: (1) terminate all or any part of this Agreement, without liability to Professional; (2) perform or obtain, upon such terms and in such manner as it deems appropriate in its sole discretion, the Services and/or additional services which were to be provided by Professional and Professional shall be liable to City for any excess costs to City in performing or obtaining same; and/or (3) exercise any other right or remedy available to City at law or in equity. 7.8 Government Compliance. Professional agrees to comply with all present and future federal, state and local laws, executive orders, rules, regulations, codes and ordinances which may be applicable to Professional's performance of its obligations under this Agreement, and all relevant provisions thereof are incorporated herein by this reference. Professional agrees to indemnify and hold harmless City from any and all losses, damages, costs, attorney fees and/or liabilities resulting from any violation of such law, order, rule, regulation, code or ordinance. This indemnification obligation shall survive the termination of this Agreement. Language Training Center Fire Dept - 2002 Spanish Language Classes for Firefighters Appropriation #570-03; P.O.#9661 Contract Not To Exceed $3,600.00 7.9 Indemnification. Professional shall indemnify and hold harmless City and its officers, officials, employees, agents, assigns and legal representatives from any and all losses, liabilities, claims, judgments and liens, including, but not limited to, all damages, costs, expenses and attorney fees arising out of any intentional or negligent act or omission of Professional and/or any of its employees, agents, outside sources, contractors or subcontractors in the performance of this Agreement, or otherwise. The failure to do so shall constitute a material breach of this Agreement. This indemnification obligation shall survive the termination of this Agreement. 7.10 Discrimination Prohibition. Professional represents and warrants that it and each of its employees, agents, contractors, subcontractors and outside sources shall comply with all existing and futura laws of the United States, the State of Indiana and City prohibiting discrimination against any employee, applicant for employment and/or other person in the subcontracting of work and/or in the performance of any Services and/or additional services contemplated by this Agreement with respect to hire, tenure, terms, conditions or privileges of employment or any matter directly or indirectly related to employment, subcontracting or work performance hereunder because of race, religion, color, sex, handicap, national origin, ancestry, age, disabled veteran status or Vietnam era veteran status. City reserves the right to collect a penalty as provided in IC 5-16-6-1 for any person so discriminated against. This indemnification obligation shall survive the termination of this Agreement. 7.11 Severability. If any provision or portion of this Agreement is held to be invalid, illegal or unenforceable by a court of competent jurisdiction, that provision or portion thereof shall be stricken, and all other provisions of this Agreement which can operate independently of such stricken provision shall continue in full force and effect. 7.12 Notice. Any notice, invoice, order or other correspondence required or allowed to be sent pursuant to this Agreement shall be written and either hand-delivered or sent by prepaid U.S. certified mail, return receipt requested, addressed to the parties as follows: CITY: City of Carmel One Civic Square Carmel, IN 46032 ATTN:Mike Hollibaugh (with a copy to the City Attorney, Department of Law, same address) PROFESSIONAL: Language Training Center 7002 N. Graham Road, Ste. 220 Indianapolis, IN 46220 ATTN: Martin George Language Training Center Fire Dept - 2002 Spanish Language Classes for Firefighters Appropriation #570-03; P.O.#9661 Contract Not To Exceed $3,600.00 Notwithstanding the above, City may orally provide to Professional any notice required or permitted by this Agreement, provided that such notice shall also then be sent as required by this paragraph within ten (10) business days from the date of such oral notice. 7.13 Effective Date. The effective date ("Effective Date") of this Agreement shall be the date on which the last of the parties hereto executes same. 7.14 Governing Law; Lawsuits. This Agreement shall be governed by and construed in accordance with the laws of the State of Indiana, except for its conflict of laws provisions, as well as by all ordinances and codes of the City of Carmel, Indiana. The parties agree that, in the event a lawsuit is filed hereunder, they waive any rights to a jury trial they may have, agree to file any such lawsuit in an appropriate court in Hamilton County, Indiana only, and agree that such court is the appropriate venue for and has jurisdiction over same. 7.15 Waiver. Any delay or inaction on the part of either party in exercising or pursuing its rights and/or remedies hereunder or under law shall not operate to waive any such rights and/or remedies nor in any way affect the rights of such party to require such performance at any time thereafter. 7.16 Non-Assignment. Professional shall not assign or pledge this Agreement, whether as collateral for a loan or otherwise, and shall not delegate its obligations under this Agreement, without City's prior consent. 7. ! 7 Entire Agreement. This Agreement contains the entire agreement of and between the parties hereto with respect to the subject matter hereof, and no prior agreement, understanding or representation pertaining to such subject matter, written or oral, shall be effective for any purpose. No provision of this Agreement may be amended, added to or subtracted from except by an agreement in writing signed by both parties hereto and/or their respective successors in interest. To the extent any provision contained in this Agreement conflicts with any provision contained in any exhibit attached hereto, the provision contained in this Agreement shall prevail. 7.18 Representation and Warranties. Each party hereto represents and warrants that it is authorized to enter into this Agreement and that any person or entity executing this Agreement on behalf of such party has the authority to bind such party or the party which they represent, as the case may be. Language Traixfing Center Fire Dept - 2002 Spanish Language Classes for Firefighters Appropriation #570-03; P.O.#9661 Contract Not To Exceed $3,600.00 7.19 Headings. All headings and sections of this Agreement are inserted for convenience only and do not form a part of this Agreement nor limit, expand or otherwise alter the meaning of any provision hereof. 7.20 Advice of Counsel. The parties warrant that they have read this Agreement and understand it, have had an opportunity to obtain the advice and assistance of counsel throughout the negotiation of this Agreement, and enter into same freely, voluntarily, and without any duress, undue influence or coercion. IN WITNESS WHEREOF, the parties hereto have made and executed this Agreement as follows: CITY OF CARMEL, INDIANA by and through its Board of Public Works and Safety BY: Jam~es Braina~d, PresidingCV6fflcer Date: ,'~ ~ ~'- tS>~ M a~y A~ ~ur~e, M~ber Date: D ~ ~ ~ Billy ~alker, Member Date: ~fl' ~ ~ ~ LANGUAGE TRAINING CENTER BY: Authorized Signature Printed Name: ~ ~,~:VI to Title: FID/SSN: Date: ATTEST: Diana C o rdr a~, qAtX-,~ ,'°C 1 erk-_:]~r ~ ~-s~tr :r Date: A Spanish Language Instruction proposal developed for: Carmel Fire Department 916101 Language Training Center 7002 N. Graham Rd. Suite 220 indianapolis, IN 46220 Phone: (317) 578-4577 Fax: (317) 578-1673 Email: info@languagetrainingcenter.com Language Training Center The Language Training Center has provided language instruction for companies and individuals since 1992. The director, Martin George, has 18 years of experience developing and coordinating language programs. Through research, staff development, and experience, LTC has grown into a well-respected, highly reputable language institute. Drawing from our extensive experience and knowledge, the Language Training Center can tailor a language program to meet diverse needs. Offering instruction that adapts to the ever-changing requirements of language, The Language Training Center is dedicated to being flexible in accommodating students' instructional hours and individual learning styles and requirements. LTC prides itself on success through instruction for all age groups. With its core instructional materials, LTC is successful in applying various methods of instruction with student-specific goals. Educational Philosophy The Language Training Center has an experienced, degreed, and professional staff, Our instructors utilize a variety of language methodology to increase the effectiveness and efficiency of the language learning process. Understanding that second language learning needs to be much more than conjugating verbs, memorizing phrases, and learning about holidays, our programs are designed to involve the learner in an interactive manner. With the recent discoveries about language learning, we know that language needs to be taught in an authentic way. This allows students the opportunity to immediately apply what has been taught. The Language Training Center also understands current methodology, material, and classroom practices that allow students to make the greatest degree of progress in the shortest amount of time. To this end, classes are not taught using the traditional grammar translation or audio-lingual methodology, but utilizing the communicative competence model to help students acquire a new language. This model, unlike others, is taught using an eclectic approach that incorporates elements such as real-life situations, role-play and short dialogues, guided speaking activities and small group discussion. This allows the student to acquire a new language in a much more efficient manner. Finally, because language is developed through literacy activities, students will gain confidence through reading and writing assignments. LTC believes that students need to be viewed as life- learners. Students need to be encouraged to develop a means of comprehending what they see and hear. Authentic materials should again be utilized to help students develop critical thinking, active listening and guided speaking skills. Students should be asked to respond to "live" and "taped" discourse. Moreover, students should be taught how to anticipate, prepare for and respond to native speakers. The learner needs to develop schemata for what others will be discussing. Language activities revolve around commonly used words, phrases, and topics. Students at an advanced level have already had success at language learning. Advanced level students need to be taught how to more "effectively and efficiently" use language. Again using authentic materials as a model, students should begin to see how native speakers pose questions and engage in dialogue. Also, the material used at this level will encourage students to; learn new vocabulary and idiomatic expressions, leam workplace vocabulary, sharpen listening skills, and improve pronunciation. Classroom activities that require the students to be actively involved in the learning process are utilized to a greater degree. An Instructional Overview Language learning is not restricted to the school or university classroom. It is now commonly discussed in businesses across America. As the workforce in the U.S. has changed, so has the need for companies to be actively involved in language training. To meet the needs of a business setting, classes must be tailored to the specific tasks and daily work activities of the students. Contained within this proposal are specific examples of how LTC has met the language needs of various companies. Our instruction is customized to each specific learning environment. Within each of these environments, LTC experiences a variety of leaming styles and needs that allow instructors to continually extend the parameters of current language practices. With this in mind, LTC believes that language instruction cannot be completely standardized. The selection of core instructional materials addresses what is relevant, meaningful, and authentic for each class. This adaptation of core materials to each student's or group's specific needs is crucial to the overall success of LTC's programs. The course material revolves around helping students communicate effectively in well-defined settings. The personalization of language courses to meet individual needs is the key to a successful program. Quality Assurance LTC utilizes a system of checks and balances to ensure quality instruction. The process that each student or groups of students will follow includes: needs analysis, orientation, pre-assessment, material selection, class preparation, instructional development, course evaluation, post- assessment, and future recommendation. This process allows for constant monitoring and feedback of programs offered. First, a specific curriculum and syllabus will be developed for each course based upon the students' specific level of competency. Second, the director of LTC will observe one class per course, as appropriate, in order to give feedback to the instructor. Finally, the students themselves will have an opportunity to provide a written evaluation of the instructor and the learning process. All feedback is immediately integrated into the language programs to assure the highest quality and effectiveness of instruction. A Brief Overview of the Proposed Spanish Pro,qram The Language Training Center will provide Spanish language instruction for the Carmel Fire Department. Instruction will take place one time a week ( 3 classes) for 90 minutes each class. There will be 8-12 students in each class. Classes will be divided according to work shifts. This will be a twelve-week program with one additional week for orientation at the beginning of the program. The Carmel Fire Department will compensate the Language Training Center $100 per student. Below you will find general statements as to what will be taught in each class. Specific tasks and the sequence of material being covered will depend on the students' ability to grasp and assimilate information. Spanish for Specific Purposes This class is an introduction to conversational Spanish language with an emphasis on usage in the field of firefightJng. Basic communication necessary for everyday life and emergency situations will be used as a base for curriculum development. We understand that the students' need is to learn Spanish well enough to work with the Spanish-speaking community. In order to do that effectively, they will need to understand vocabulary, grammar, and basic language conventions in Spanish. This course will target those areas and will provide the students a language base on which to build toward attaining their long-term goal. Students at this level will focus on workplace language, both spoken and written, in order to effectively reach out and communicate with Spanish speaking persons. Authentic situations and activities that occur in on the job will serve as the instructional models for the course. Using this work-specific curriculum will give the students a comfortable knowledge base from which they can construct a basic understanding of the Spanish language. Instruction, classroom interaction, and assignments will be geared toward providing the proper schema that will enable firefighters to be successful in their language application. References Pearlette Mitchell Relocation Assistant Eli Lilly and Company Lilly Corporate Center Indianapolis, iN 46285 317.433.1743 Marsha Hammonds Human Resources Consultant International and Domestic Relocation Roche Diagnostics 9115 Hague Rd Indianapolis, IN 46250 317.845.7007 Estrella (Star) Velez Brightpoint University Trainer Brightpoint North America 501 Airtech Parkway Plainfield, IN 46168 800.952.2355 ex.2008 Karen Horseman Councillor, At Large City of Indianapolis, Marion County 1116 W. St. Clair Indianapolis, IN 46202 317.262.0657 Attorney Barnes and Thornburg 11 S. Meridian St. Indianapolis, iN 46204 317.231.7463 EXHIBIT B Invoice Name of Company: Address & Zip: Telephone No.: Fax No.: Date: Project Name: Invoice No: Person Providing Goods/Services Date Good. s/ Service Provided Goods/Serviees Provided (Describe each good/service separately and in detail) Goods Cost Per Item Services I~ourly Rate/ Hours Worked Total GRAND TOTAL Signature Printed Name EXHIBIT C INSURANCE COVERAGES Worker's Compensation & Disability Statutory Limits Employer's Liability: Bodily Injury by Accident/Disease: Bodily Injury by Accident/Disease: Bodily Injury by Accident/Disease: $100,000 each employee $250,000 each accident $500,000 policy limit Property damage, contractuaI liability, products-completed operations: General Aggregate Limit (other than Products/Completed Operations): Products/Completed Operations: $500,000 $500,000 Personal & Advertising Injury Policy Limit: Each Occurrence Limit: Fire Damage (any one fire): Medical Expense Limit (any one person): $500,000 $250,000 $250,000 $ 50,000 Comprehensive Auto Liability (owned, hired and non-owned) Bodily Single Limit: Injury and property damage: Policy Limit: $500,000 each accident $500,000 each accident $500,000 Umbrella Excess Liability Each occurrence and aggregate: $500,000 Maximum deductible: $ 10,000