RFP 26-09 Rehabilitation Inspection Services.pdf

Town of Groton

Request for Proposal

26-09

Rehabilitation Inspection Services Bid

February 2026

TOWN OF GROTON

RFP 26-09

REHABILITATION INSPECTION SERVICES

The Town of Groton requests proposals from qualified firms or individuals for professional and technical services related to Housing Rehabilitation required to provide administrative and technical support to implement activities including program income from March 19, 2026

– March 19, 2029.

The Town requires the program to be in direct compliance with all local, state and federal laws and policies including but not limited to: Affirmative Action, Section 3, Fair Housing, Equal

Opportunity, Davis-Bacon and State Prevailing Wage. The selected contractor shall be familiar and in compliance with the above referenced policies and laws as related to their specific tasks within the program.

The selected contractor agrees to indemnify, hold harmless and defend the Town from and against any and all liability for loss, damage or expense which the Town may suffer or for which the Town may be held liable by reason of injury, including death to any person or damage to any property arising out of or in any manner connected with the operations to be performed under an agreement with the Town, whether or not due in whole or in part of any act, omission or negligence of the Town or any of its representatives or employees.

The selected contractor agrees and warrants that in the performance of the contract pursuant to this solicitation that he or she will not discriminate or permit discrimination against any person or group of persons on the grounds of sex, race, color, religion, age, marital status, ancestry, national origin, past history of mental disorder, mental or physical disability, or any other basis in any manner prohibited by the laws of the United States, the State of Connecticut or the Town of

Groton.

The Town of Groton reserves the right to cancel any agreement at any time with thirty (30) days prior written notice to the consultant for the purpose of cause or convenience.

All Application Development and Submission and Citizen Participation activities necessary for the specific project submission must be included in the proposal.

Selection will be based on amount of Small Cities projects completed, experience of staff assigned, cost and any other factors deemed of benefit to the community.

Copies of this RFP are available on the Town’s website at www.groton-ct.gov .

http://www.groton-ct.gov/

Three copies of the proposal must be submitted to Karl Klein, Purchasing Agent, Town of

Groton, 45 Fort Hill Road, Groton, CT 06340 no later than 2:30 p.m. on Feb 20, 2026. Proposals must include the following information:

a. Proposed scope of work and project approach;

b. Detailed information of the firm’s background and experience in Federal/State funding, specific Small Cities CDBG Program experience is required;

c. Key staff assigned with resumes;

d. Proposed fee approach including a list of per diem rates by job category;

e. Each proposer must provide certification of insurance in the types and amounts specified by DECD Bulletin #94-003 within ten (10) days of selection by the

Town.

Additional information is available by contacting Karl Klein, Purchasing Agent, Town of

Groton, at KKlein@groton-ct.gov no later than 12:00 p.m. 7 days prior to proposal due date.

Evaluation of Proposals

The Town will evaluate the proposals based on the following scoring system:

Proposed scope of work and project approach 15 points

Detailed information of the firm’s background and experience in Federal/State funding, specific 20 points

Small Cities CDBG Program experience is required 25 points

Key staff assigned with resumes 10 points

Proposed fee approach including a list of per diem rates by job category 30 points

Total Possible Points 100

The Town of Groton reserves the right to accept or reject any proposals as deemed in the best interest of the Town. The Town of Groton reserves the right to waive any informalities or technicalities and to award the contract to a bidder other than the lowest bid and to negotiate and award a contract that it determines best meets their needs and to best serve the public interests of the Town of Groton.

The Town of Groton is an Equal Opportunity/Affirmative Action Employer and encourages small, minority, women owned and Section 3 firms to apply.

AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER

MBE’s, WBE’s and SBE’s ARE ENCOURAGED TO APPLY

INSURANCE REQUIREMENTS

Insurance shall be written with carriers approved in the State of Connecticut and with a minimum AM Best

Rating of "A-" V I I I . In addition, al l carriers are subject to approval by the Town of Groton and no coverage shall contain special limitations on the scope of protection afforded to the Town, its officers, officials, employees or volunteers. The Town of Groton shall be named as the certificate holder. The Town of Groton shall be named as an Additional Insured on a primary and non-contributory basis to all policies except Workers' Compensation and Professional Liability. A waiver of subrogation shall apply on all lines.

General Liability Each Occurrence

General Aggregate

Products/Completed operations Aggregate

- Policy must contain no exclusion for Explosion.

Collapse and Underground Hazard (XC & U)

- Contractor must notify the Town whenever claims

Reduce the General Aggregate below $1,000,000

- The Town should be notified if the Aggregate l imits

Include defense costs

Auto Liability Combined Single Limit

Each Accident $1,000,000

Umbrella (Excess

Liability)

Each Occurrence

Aggregate

$1,000,000

Workers' Compensation and

Employers' Liability

WC Statutory Limits EL

Each Accident EL Disease

Each Employee EL Disease

Policy Limit

$500,000

$500,000

$500,000

For Contractors:

(Should a Contractor be involved in operations requiring coverage under special State or Federal Acts. such as Maritime or Railroad, the Contractor must provide evidence of this coverage. Should a Contractor be exempt from the Workers' Compensation Laws of the State of Connecticut, or any other State or Federal requirements, evidence of such exemption must be provided and a "Hold-Harmless" agreement provided in language satisfactory to the Town, holding it harmless in the event of any claim for injury or damages.

Contractors based out-of-state must provide evidence that their Workers' Compensation policy will cover injuries/illnesses sustained while working in the State of Connecticut. The Contractor is responsible for ensuring that al l of its subcontractors carry Workers' Compensation Insurance, as described above.

(Minimum Limits)

$1,000,000

$3,000,000

If any policy is written on a "Claims Made" basis, the policy must be continually renewed for a minimum of three (3) years from the completion date of this contract. If the policy is replaced and/or the retroactive date is changed, then the expiring policy must be endorsed to extend the reporting period for claims for the policy in effect during the contract for three (3) years from the completion date. Original, completed

Certificates of Insurance must be presented to the Town of Groton Public Works prior to purchase order/contract issuance. Contractor agrees to provide replacement/renewal certificates at least 60 days prior to the expiration of any policy. Should any of the above described policies be cancelled before the expiration date, written notice must be made to the Town thirty (30) days prior to cancellation).

Certificates of Insurance should be sent to the Town of Groton Human Resources Department for review except ones that go thru Purchasing.

EXHIBIT A

HOUSING REHABILITATION SERVICES AGREEMENT

THIS AGREEMENT (the “Contract”) is effective as of this day, March 19, 2026 (“Effective

Date”), between the TOWN OF GROTON, a municipal corporation with an address of 45 Fort

Hill Road, Groton, Connecticut 06340 (the “TOWN”) and (INSERT NAME OF

FIRM/PERSON), located at (INSERT ADDRESS), Connecticut (the “CONTRACTOR”) (which are sometimes referred to in this Contract individually or collectively as a “Party” or the

“Parties”).

RECITALS

WHEREAS, the TOWN is a Charter Town duly organized and functioning in accordance with the laws of the State of Connecticut; and

WHEREAS, the CONTRACTOR is engaged in the business of providing housing rehabilitation services and possesses specialized knowledge and skill with regard to housing rehabilitation programs and management coordination; and

WHEREAS, the Town has procured the services through a public process; and

WHEREAS, the TOWN wishes to provide housing rehabilitation services to the residents of the

TOWN; and

NOW, THEREFORE, in consideration of the mutual benefits and promises each to the other made herein, the parties named above do hereby agree as follows:

SECTION I – RELATIONSHIP OF THE PARTIES

A. Independent Contractors. The TOWN and CONTRACTOR are independent contractors.

Nothing in this Contract shall be construed or be deemed to create a relationship between the

TOWN (and/or any officers, employees, boards, commissions, successors, agents, counsel and assigns thereof) and CONTRACTOR (and/or any officers, employees, successors, agents, counsel and assigns thereof) of employer and employee or principal and agent or any relationship other than that of independent parties contracting with each other solely for the purpose of carrying out the terms and conditions of this Contract.

B. No Express or Implied Authority. Neither Party shall have any express or implied right or authority to assume or create any obligation or responsibility on behalf of or in the name of the other Party, except as provided in this Contract.

C. Role of CONTRACTOR. The Parties agree that neither CONTRACTOR nor any officer, employee, successor, agent, counsel and/or assign of CONTRACTOR, and nothing in this

Agreement shall be construed to indicate that CONTRACTOR nor any officer, employee, successor, agent, counsel and/or assign of CONTRACTOR are, employees of the TOWN, and neither CONTRACTOR nor any officer, employee, successor, agent, counsel and/or assign of CONTRACTOR are eligible to participate in any benefit program provided by the

TOWN for its employees by reason of this Contract. CONTRACTOR shall be responsible for the provision of any benefits to any officer, employee, successor, agent, counsel and/or assign of CONTRACTOR and payment to, or on behalf of, them of any wages, salaries, taxes, withholding payments, penalties, fees, fringe benefits, contributions to insurance and pension or other deferred compensation plans (including, but not limited to, workers’ compensation and Social Security obligations), and licensing fees, and the filing of any necessary documents, forms and returns pertinent to any of the foregoing.

D. No Exercise of Control or Direction. It is understood that the TOWN and CONTRACTOR shall exercise no control over the activities and operations of each other. Nothing in this

Agreement is intended nor shall be construed to allow the TOWN to exercise any control or direction over the manner or method by which the services contemplated hereunder are performed by CONTRACTOR or any office, employee, agent, counsel and/or assign of

CONTRACTOR. The Parties shall each individually comply with and perform all the duties, responsibilities and obligations by this Agreement.

SECTION II – EXPRESS PROVISIONS

A. Definition of Housing Rehabilitation Services. “Housing Rehabilitation Services” shall mean the services provided by the CONTRACTOR in accordance with Section II-B that are necessary to effectively carry out a housing rehabilitation program for the TOWN.

B. Services to be provided by CONTRACTOR. The CONTRACTOR shall be responsible for housing rehabilitation inspection services for the TOWN. These services shall include property inspections to determine scopes of work within program guidelines, preparation of work specifications and cost estimates, project bidding, construction and payment authorization inspections, and all of the associated administrative duties. Work shall follow standard practices and guidelines detailed by the U.S. Department of Housing and Urban

Development. Representative tasks shall include, but shall not be limited to:

a. Scheduling and conducting an initial inspection to meet Section 8 Housing

Quality Standards;

b. Providing lead paint notifications to applicants and collecting a receipt notice;

c. Scheduling meetings with a lead inspector to complete a lead-based paint test to ensure such tests are coordinated with rehabilitation efforts;

d. Sending a referral letter to the State Historic Preservation Office when properties qualify for state review;

e. Developing preliminary scopes and budgets (cost estimates);

f. Reviewing scope and budget with applicant and obtaining applicant’s approval;

g. Developing work specifications and obtaining applicant’s approval;

h. Coordinating pre-bid and bid opening dates with applicants and the TOWN;

i. Advertising for bids;

j. Scheduling and attending pre-bid meetings;

k. Mailing bid addendums;

l. Reviewing bids for completeness;

m. Collecting construction contractors’ references, certificates of insurance, licenses, and, as necessary, Section 3 and civil rights information;

n. Verifying construction contractors’ status with consumer protection and state and federal debarred lists; the homeowner will check contractor-supplied references;

o. Collecting construction contractors’ applications;

p. Coordinating construction contractor selection with applicants and notifying the

TOWN of applicants’ decisions on contract award;

q. Conducting interim and final construction inspections and payment authorization inspections; and

r. Collecting lien waivers and lead paint clearance test results from construction contractors.

The TOWN or CONTRACTOR (dependent upon availability) shall be responsible for determining homeowner eligibility, contract execution, processing payments, file maintenance, and other general administrative duties. Representative tasks shall include, but shall not be limited to:

• Application intake, which includes: recruiting applicants; verifying income;

calculating loan-to-value ratios; verifying tax payments; conducting title searches;

collecting certificates of homeowner’s insurance and flood insurance; collecting assessors’ cards; completing environmental statutory checklists; collecting tenant information forms; and referring eligible properties to the CONTRACTOR;

• Encumbering funds from the State Department of Economic & Community

Development;

• Providing General Information Notices, regarding relocation, to applicants;

• Providing notice of rehabilitation work to tenants;

• Preparing mortgage documentation;

• Coordinating relocation necessitated by hazardous material abatement;

• Compiling lists of construction contractors and bid summaries;

• Reviewing bids with applicants;

• Preparing loan documents;

• Scheduling loan closings and contract signings;

• Recording loan documents in the Groton Land Records;

• Issuing Notices to Proceed to construction contractors;

• Issuing progress and final payments to construction contractors;

• Ensuring that Building Inspection makes a final inspection of the construction work;

• Providing letters of lead clearance to applicants;

• Collecting applicants’ approval of the completed construction work; and

• Preparing and filing mortgage modification agreements.

C. Place of Work. The CONTRACTOR shall perform the services required by this Agreement at any place or location and at such times as the CONTRACTOR shall determine.

The parties agree that the nature of some of the services to be performed by the

CONTRACTOR will necessitate that the services be performed on the TOWN’s premises.

The TOWN therefore agrees to provide its premises for use by the CONTRACTOR while performing these services. The CONTRACTOR agrees to perform the above described services on TOWN premises between 8:30 a.m. and 4:30 p.m.

D. Training and Certifications. The CONTRACTOR shall complete any training or maintain any certifications recommended or required by the U.S. Department of Housing and Urban

Development, the U.S. Environmental Protection Agency, the State of Connecticut or agency thereof for the duration of the Agreement. The CONTRACTOR further agrees that all personnel hired or subcontracted by the CONTRACTOR to perform work under this contract must also complete any training or maintain any certifications recommended or required by the U.S. Department of Housing and Urban Development, the U.S. Environmental Protection

Agency, the State of Connecticut or agency thereof for the duration of the Agreement.

SECTION III – COMPENSATION

For the services performed by the CONTRACTOR to rehabilitate housing units, the TOWN agrees to pay the CONTRACTOR the sum of not to exceed insert cost, as outlined in the proposal. The CONTRACTOR shall provide the TOWN with a summary of work items completed with billing. Billing shall be accepted on a monthly or less frequent basis. The

CONTRACTOR shall be responsible for all mileage and vehicle charges incurred as required under this Agreement. For services performed by the CONTRACTOR in excess of rehabilitation on fifteen (15) housing units, costs and scope will be mutually agreeable by the TOWN and

CONTRACTOR.

Unless specifically mentioned within this Agreement, the CONTRACTOR is responsible for all other expenses relative to the provision of services under this Agreement, including but not limited to all cost of equipment, all fees, fines, licenses, bonds or taxes required of or imposed against the CONTRACTOR and all other of the CONTRACTOR’s cost of doing business. The

TOWN shall not be responsible for any of these expenses incurred by the CONTRACTOR in performing services for the TOWN.

SECTION IV – INSURANCE REQUIREMENTS

CONTRACTOR, at its sole cost and expense, will provide, carry and maintain throughout the

Term of this Contract, adequate insurance as requested by the TOWN that will protect the

CONTRACTOR, as well as the TOWN, its officers, boards, commissions, successors, agents, employees, counsel, assigns and volunteers from any and all claims for loss, damage, injury or death which may arise from the operation of this Contract by the CONTRACTOR or anyone directly or indirectly employed by them. Policies shall be so written that the Office of Planning and Development Services will be notified of cancellation at least thirty (30) days prior to the effective date of such cancellation. Certificates showing that all of the CONTRACTOR’s operations are covered, and stating the coverage includes the TOWN as an additional insured, the limits of liability, expiration dates and exclusions, if any, will be filed with the Town of Groton

Department of Planning and Development before the Term of the Contract commences.

The CONTRACTOR shall provide the TOWN with certification by a properly qualified representative of the insurer that the CONTRACTOR’s insurance complies with this Section.

The TOWN, its officers, boards, commissions, successors, agents, employees, counsel, assigns and volunteers are to be covered as insured with respect to liability arising out of any acts or omissions by or on behalf of the CONTRACTOR; products and completed operations of the

CONTRACTOR; and, premises owned, occupied, or used by the CONTRACTOR. The coverage shall contain no special limitations on the scope of protection afforded to the TOWN, its officers, boards, commissions, successors, agents, employees, counsel, assigns and volunteers.

The CONTRACTOR’s insurance coverage shall be primary insurance with respect to the

TOWN, its officers, boards, commissions, successors, agents, employees, counsel, assigns and volunteers. Any insurance or self-insurance maintained by the TOWN, its officers, boards, commissions, successors, agents, employees, counsel, assigns and volunteers shall be excess of the CONTRACTOR’s insurance and shall not contribute with it.

Insurance shall be written with carriers approved in the State of Connecticut and with a minimum AM Best Rating of "A-" VIII. In addition, all carriers are subject to approval by the

Town of Groton and no coverage shall contain special limitations on the scope of protection afforded to the Town, its officers, officials, employees or volunteers. The Town of Groton shall be named as the certificate holder. The Town of Groton shall be named as an Additional Insured on a primary and non-contributory basis to all policies except Workers' Compensation and

Professional Liability. A waiver of subrogation shall apply on all lines.

General Liability Each Occurrence

General Aggregate

Products/Completed operations Aggregate

- Policy must contain no exclusion for Explosion.

Collapse and Underground Hazard (XC & U)

- Contractor must notify the Town whenever claims

Reduce the General Aggregate below $1,000,000

- The Town should be notified if the Aggregate l imits

Include defense costs

Auto Liability Combined Single Limit

Each Accident $1,000,000

Umbrella (Excess

Liability)

Each Occurrence

Aggregate

(Minimum Limits)

Workers' Compensation and

Employers' Liability

WC Statutory Limits EL

Each Accident EL Disease

Each Employee EL Disease

Policy Limit

$500,000

$500,000

$500,000

For Contractors:

(Should a Contractor be involved in operations requiring coverage under special State or Federal Acts.

such as Maritime or Railroad, the Contractor must provide evidence of this coverage. Should a

Contractor be exempt from the Workers' Compensation Laws of the State of Connecticut, or any other

State or Federal requirements, evidence of such exemption must be provided and a "Hold-Harmless" agreement provided in language satisfactory to the Town, holding it harmless in the event of any claim for injury or damages. Contractors based out-of-state must provide evidence that their Workers'

Compensation policy will cover injuries/illnesses sustained while working in the State of Connecticut.

The Contractor is responsible for ensuring that al l of its subcontractors carry Workers' Compensation

Insurance, as described above If any policy is written on a "Claims Made" basis, the policy must be continually renewed for a minimum of three (3) years from the completion date of this contract. If the policy is replaced and/or the retroactive date is changed, then the expiring policy must be endorsed to extend the reporting period for claims for the policy in effect during the contract for three (3) years from the completion date. Original, completed Certificates of Insurance must be presented to the Town of

Groton Public Works prior to purchase order/contract issuance. Contractor agrees to provide replacement/renewal certificates at least 60 days prior to the expiration of any policy. Should any of the above described policies be cancelled before the expiration date, written notice must be made to the Town thirty (30) days prior to cancellation).

Certificates of Insurance should be sent to the Town of Groton Human Resources Department for review except ones that go thru Purchasing.

INDEMNIFICATION. CONTRACTOR assumes liability for, and agrees to indemnify, defend, protect, save, keep and hold harmless TOWN, its officers, employees, boards, commissions, successors, agents, counsel and assigns from and against any and all liabilities, demands, settlements, obligations, losses, damages, fines, penalties, forfeitures, claims (including without limitation, claims involving strict or absolute liability in tort and/or claims involving any local, municipal, state, and/or federal law, statute, requirement, provision and/or regulation, including, without limitation, OSHA, admiralty, maritime, longshoreman, Coast Guard and/or environmental requirements, laws and/or regulations and any other provisions which may apply to the handling, transportation, storage, or disposal of sewage and/or the operation of any vessel), actions, suits, costs, expenses and disbursements (including, without limitation, reasonable legal fees and expenses) of any kind and nature whatsoever (“Claims”), regardless of whether such

Claims are known to the Parties during the Term of this Contract, arising out of or as a result of

CONTRACTOR’s negligence and/or willful, reckless and/or intentional act and/or omission during the Term hereof which may be imposed on, incurred by or asserted against

CONTRACTOR, the operation and/or possession of any vessel by CONTRACTOR, or the performance or enforcement of any of the terms hereof, or in any way relating to or arising out of the acceptance, rejection, delivery, lease, sublease, possession, use, operation, return and/or storage of the vessels as contemplated by this Contract and/or the Grant and/or the Bareboat

Lease Agreement and/or the termination of this Contract or any accident in connection with any vessels during the Term hereof.

THE INDEMNITIES IN THIS SECTION SHALL CONTINUE IN FULL FORCE AND

EFFECT NOTWITHSTANDING THE EXPIRATION OR OTHER TERMINATION OF THIS

AGREEMENT.

SECTION V – OBLIGATIONS AND RESPONSIBILITIES OF THE TOWN

The TOWN agrees to comply with all reasonable requests of the CONTRACTOR and provide access to all documents reasonably necessary to the performance of the CONTRACTOR’s duties under this Agreement.

SECTION VI – TERMINATION OF AGREEMENT

A. This Agreement shall expire on March 19, 2029, but may be terminated earlier upon thirty

(30) days prior written notice of termination from one party to the other for cause or convenience. This Agreement may also be extended for up to two terms of one year each, which the Town may exercise in its sole, absolute discretion.

B. This Agreement shall terminate automatically if the CONTRACTOR becomes bankrupt or insolvent during the term of the Agreement, or in the event of the sale of the business of the

CONTRACTOR, or in the event of the death of the CONTRACTOR.

C. Either party shall have cause to terminate this Agreement sooner than its normal expiration date in the event that either party defaults in any of its obligations under this Agreement and fails to cure such default within (10) days after written notice specifying the nature of the default.

D. Additionally, the TOWN shall have cause to terminate this Agreement in the event that the

CONTRACTOR fails to meet any of the reasonable deadlines established by the TOWN, destroys TOWN property, acts dishonestly, or steals from the TOWN. The CONTRACTOR shall have cause to terminate this Agreement in the event that the TOWN fails to pay the

CONTRACTOR all or any part of the compensation set forth in this Agreement on the date due if the failure is not remedied by the TOWN within thirty (30) days of the date the payment is due.

SECTION VII – MISCELLANEOUS

A. Severability. If for any reason, any provision of this Contract is held invalid, the other provisions of this Contract will remain in effect insofar as is consistent with law.

B. Headings. The Section captions used in this Contract are included solely for convenience and shall not in any way limit or be used to construe or interpret the terms and provisions of this Contract.

C. Notices. All notices, demands, consents or approvals required or provided for hereunder shall be given by certified or registered mail, return receipt requested, or by Federal Express or other overnight courier service addressed to the Parties at the addresses listed below:

If to the TOWN:

Office of Planning and Development Services

Town Hall Annex

134 Groton Long Point Road

Groton, CT 06340

If to the CONTRACTOR:

INSERT NAME

INSERT ADDRESS

D. Counterparts. This Contract may be executed in counterparts, each of which shall be an original, but all of which shall constitute one and the same document. Each of the Parties shall sign a sufficient number of counterparts, so that each Party will receive a fully executed original of this Contract.

E. Assignment and Successors. Neither Party shall assign this Contract, in whole or in part, or to any other company, organization, independent contractor, subcontractor, person, or entity without the prior written consent of the non-assigning party. Notwithstanding the foregoing limitations on assignment, this Contract shall be binding upon and shall inure to the benefit of the Parties hereto and their respective successors, heirs, executors and assigns.

F. Waiver of Breach of Contract. The waiver by any Party of a breach or violation of any provision of this Contract shall not operate as, nor be construed to be, a waiver of any subsequent breach of the same or any other provision.

G. Entire Agreement of the Parties. This Agreement supersedes any and all Agreements, either oral or written, between the parties hereto with respect to the rendering of services by the CONTRACTOR for the TOWN and contains all of the covenants and Agreements between the parties with respect to the rendering of such services. Each party to this

Agreement acknowledges that no representations, inducements, promises or Agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party which are not embodied herein, and that no other agreement, statement or promise not contained in this Agreement shall be valid or binding. Any modification of this Agreement will be effective only if it is in writing and is signed by the party to be charged.

Governing Law. This Agreement will be governed and construed and enforced in accordance with the laws of the State of Connecticut without regard to its conflict of law provision.

Entered into on the day of ________ 2026.

Signed, Sealed and Delivered

In the presence of: TOWN OF GROTON

______________________________ By _________________________________

John Burt

Town Manager

In the presence of:

By _________________________________

Delia Morrison

______________________________ Finance Director

In the presence of: TOWN OF GROTON

Jonathan Reiner, AICP

Director of Planning & Development

Services entered into on the day of ________ 2026.

In the presence of:

NAME OF FIRM

NAME OF PRINCIPAL

TITLE