, the purposes · senior services covenants and agrees to fulfil its mission of providing a senior...

MEMORANDUM OF AGREEMENT BY AND BETWEEN

THE COUNTY OF BEAUFORT, SOUTH CAROLINA AND

BEAUFORT COUNTY COUNCIL ON AGING D/B/A SENIOR SERVICES OF BEAUFORT COUNTY

WHEREAS, THE BEAUFORT COUNTY COUNCIL ON AGING, INC., is a registered

domestic corporation incorporated under the laws of the State of South Carolina and at the time of this

Agreement is in good standing; and

WHEREAS, THE BEAUFORT C~UNTY COUNCIL ON AGING, INC is otherwise known

and, ordoing business as the SENIOR SERVICES OF BEAUFORT COUNTY, a charitable organization

registered with the South Carolina Secretary of State; and

WHEREAS, this Agreement pertains and applies to and binds both mE BEAUFORT COUNTY

COUNCIL ON AGING, INC and the SENIOR SERVICES OF BEAUFORT COUNTY whose principal

place of business located at 1408 Paris Avenue, Port Royal, South Carolina 29935 (hereinafter "Senior

Services"); and

WHEREAS, the COUNTY OF BEAUFORT, SOUTH CAROLINA (hereinafter "the County")

is a political subdivision ofthe State of South Carolina and whose primary business address is 100 Ribaut

Road, Beaufort, South Carolina, 29902; and

WHEREAS, Senior Services and the County desire to enter into this binding and contractual

agreement for the purposes of expending the Grant Funds specified herein for the purposes of constructing , a building to be used as a Senior Citizen Center (hereinafter the "Center").

NOW THEREFORE, in consideration of the mutual covenants and agreements provided herein,

and for other good and valuable consideration the sufficiency of which is acknowledged by the parties,

Senior Services and the County agree as follows.

ARTICLE 1.

PURPOSE OF THIS AGREEMENT

1.1. The purpose of this Agreement pertains to the Senior Service's receipt of Grant Funds from the

South Carolina Governor's Office, Division on Aging, in the amount of Three Hundred Sixty-Five

Thousand ($365,000) Dollars (hereinafter, the "grant funds") and provide for the restricted use of

the grant funds for the purpose of constructing a Center as provided herein.

1.2. The grant funds shall be expended solely and exclusively to design and construct the Center under

the terms, conditions, specifications, requirements and restrictions as provided in the Application

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for Grant and associated Grant Document copies of which are attached hereto in Exhibit A and

incorporated by reference herein as if set forth verbatim.

ARTICLE 2.

USE OF GRANT FUNDS

2.1. Senior Services covenants and agrees to comply with and confonn to each and every provision set

forth in the Grant Documents, Exhibit A, including, but not limited to, the restrictions on use of the

Grant Funds for the construction of the Center.

2.2. Senior Services covenants and agrees that it shall conduct or cause to be conducted all necessary and

appropriate action made necessary to assure complete and faithful performance of the requirements

set for in the Grant Documents (Exhibit A) including, but not limited to, faithful completion of the

construction of the Center in full and complete conformance with all applicable local, state and

federal laws, regulations and directives which are in effect now or in the future.

2.3. The Grant Funds shall be utilized solely and exclusively to design and construct the Center, the

dimensions of which shall not exceed thirty-six hundred (3,600) square feet, and which shall be

located at a site selected by the County, in the County's sole discretion, within the confines of the

Beaufort County Parks and Leisure Services Burton Wells Recreation Complex located at

Middleton Recreation Drive, Burton, South Carolina, 29906.

2.4. Senior Services covenants and agrees to fulfil its mission of providing a senior citizen center and

shall cooperate with the County to cause the construction of the Center and develop a comprehensive

and coordinated system of senior services to be provided by Senior Services at its sole and exclusive

costs.

2.5. This Agreement constitutes the entire agreement ofthe parties unless mutually amended in writing.

ARTICLE 3

RESPONSIBILITIES OF SENIOR SERVICES

3.1. It shall be the sole and exclusive responsibility for Senior Services to provide as follows: (A)

Workers' Compensation Insurance as required by the State of South Carolina with statutory limits

or employer liability insurance with respect to any person not covered under an endorsement for

workers' compensation insurance with a minimum limit of$1 00,000 I $300,000 per occurrence; (B)

General Tort Liability Coverage; (C) Personal Property Insurance Coverage; (D) Data Processing

Coverage; (E) Automobile Comprehensive and Collision Coverage; and Automobile Liability

insurance coverage as set forth in Exhibit B.

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The insurance policies provided in this, Section 3.1, shall be endorsed to provide that no policy shall

be cancelled, changed or reduced in coverage until after thirty (30) days prior written notice has been

delivered to the County by certified mail.

3.2. Senior Services shall be solely responsible for payment of all utilities, cleaning supplies and

custodial care of the Center upon completion.

3.3. Senior Services shall provide all necessary equipment and furniture for effective program operation

of the Center.

3.4. Senior Services shall be responsible for all Senior programs and services and will ensure there is

sufficient staffto supervise the Center and the senior services programs conducted at the Center.

3.5. Senior Services shall keep and maintain all necessary and appropriate hazard, personal property and

liability insurance insuring the Center's contents.

ARTICLE 4

EXPENDITURES AND REIMBURSEMENTS

4.1. The following expense reimbursement procedures shall be followed for the costs of the design and

construction of the Senior Citizens Facility:

4.1. A. The County shall submit an invoice each thirty (30) days to Senior Services of Beaufort

County, Attention: Executive Director at PO Box 1776, Beaufort, SC 29901 for incurred

costs and reimbursement for architectural, engineering, design and construction services.

4.1. B. Senior Services shall forward each invoice within ten (10) days of receipt to: Marvile

Thompson, Area Director, C/O LCOG at P.O. Box 98, Yemassee, SC 29945.

4.I.C. The LowCountry Council of Government's Area Agency on Aging shall, upon receipt of

each invoice, but not less than ten (10) days from the date of receipt, approve each invoice

and forward a request for payment / invoice to the South Carolina Lt. Governor's Office on

Aging at 1301 Gervais Street, Suite 200, Columbia, SC 29201.

4.1.0. Upon receipt of said invoice, the Office of Aging will cause a check in the amount of the

invoice to be made in favor of and mailed to the LowCounrty Council of Government' s Area

Agency on Aging at P.O. Box 98, Yemassee, SC 29945 within thirty (30) days of the

County's submission of invoice referenced in Section 4.I.A above.

4.I.E. Upon receipt of the payment referred to in Section 4.I.D, the LowCountry Council of

Government's Area Agency on Aging shall cause a check in the amount of the invoice to

be made in favor of and mailed to Thomas A. Henrikson, Beaufort County Controller at P.O.

Drawer 1228, Beaufort, SC 29901-1228, no later than thirty (30) days from the date of

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invoice referred to in Section 4.1.A.

ARTICLES

INDEMNIFICATION

5.1. Senior Services shall indemnify, defend, and hold County, its officers, employees, agents, and

volunteers hannless from and against any and all liability, claims, suits, actions, damages, and causes

of action arising during the tenn of this Agreement out of any personal injury, bodily injury, loss of

life, or damage to property, or any violation ofany federal, state, or local law or ordinance, or other

cause in connection with the negligent or intentional acts or omissions ofthe Council on Aging, its

employees, subcontractors, or agents, or on account of the performance or character of this work,

except for any such claim arising solely out of the active negligence, sole negligence, or willful

misconduct of the County, its officers, employees, agents, or volunteers.

ARTICLE 6

EQUIPMENT, LICENSES, PERMITS AND SUPPLIES

6.1. Senior Services shall be liable and shall provide and maintain and keep in repair all necessary

equipment and supplies necessary to operate the Senior Citizens Facility.

ARTICLE 7

APPLICABLE LAWS

7.1. Senior Services shall comply with and faithfully observe all municipal, county, state and federal

laws, ordinances andlor regulations now applicable, or which may hereafter be applicable pertaining

to the use of said facility.

ARTICLES

COUNTY RESPONSmILITIES

8.1. The County shall furnish in-kind staff support to assist with design and construction of the Senior

Citizens Facility including the procurement of architectural, engineering, and contracting services.

8.2. The County shall contribute towards the completion of the Senior Services Center, said contribution

to be made at such time and for such purpose as the County, in its sole discretion, deems fit.

8.3. The County will provide the necessary site and footprint needed for the construction of the Senior

Citizens Center.

8.4. The County shall own all right, title and interest to the Senior Citizens Center.

of 5

ARTICLE 9

TERM

9.1. The initial tenn of this Agreement shall be twenty (20) years. The County and Senior Services agree

that this Agreement shall be subject to review, renegotiation and possible renewal at the end of the

initial tenn of twenty (20) years and each fifth (Slh) year thereafter.

9.2. At the end of the initial term or at such time as this Agreement terminated for non-renewal, the

County shall own all right, title and interest to the Senior Citizens Center.

This Agreement shall take effect this 2.. , day of M~Y 2007.

IN WITNESS WHEREOF, the parties have executed this Memorandum of Agreement as of this

~dayof N~'1 ,2007.

WITNESS:

t~) j./f&M.A, BEA

By::~~~~~~~~ __ _ Gary Kubic Beaufort Cou mistrator Post Office Drawer 1228 Beaufort, SC 29901 (843) 470-2501

Executive Director Post Office Box 1776 Beaufort, SC 29901 (843) 524-1787

of 5

, t Exhibit A

Grant Documents

(Following on separate page)

TO:

VIA:

FROM:

SUB!:

DATE:

Councilman Herbert N Glaze, Chairman, Public Services Committee

Gary Kubic, County Administrator H. C. Boehm, Jr., Deputy Administrator

Bob Klink, County Engineer

SENIOR CENTER DESIGN FOR BURTON WELLS PARK

March 6, 2007

BACKGROUND. Beaufort County Council on Aging was awarded a $365,000 grant for the construction of a new Senior Center at Burton Wells Park. The grant comes from The SC Department of Health and Human Services. The tenos of th~ grant proposes that Beaufort County provide the requi.reQ .1and 8:Ud construction management services. The County will ma~' ta' wnership of the land and all improvements; however, the Council oli Aging will operate the facility undei! 29-year written agreement. Beaufort County. It is anticipated that the proposed 2,ooo.sqwb foot pluS Senior Center will have the following similar 11 es: Large multipurpose room, computer care room, kitchen, stOrage rooms, restrooms, large porches and outdoor seating areas, covered breeze-way connection to the existing Recreation Center facility, exterior design features will be compatible with the Recreation Center, and wheelchair accessibility throughout the facility.

The Engineering Division advertised for a .public solicitation to~&E firms requesting professional qualifications for the design of a S~~;or Center. On 9/19/06 five qualification packages were received from the followmg f1fJ1lS: • The FWA Group, Cunurungs &

C:~ lady, Inc., KRA, Inc., ~tewart, Cooper, Newell Architects and The PRAD Group. . '

A selection committee was assembled to evaluate and rank the qualification packages. This committee included the Director of Beaufort County Council on Aging, the Deputy Administrator for Community ServiCes, the Director of Northern Beaufort County PALS and the CIP Implementation Manager. The committee decided to interview 3 ~of"the. 5 firms based on the highest ranked evaluations. After the interviews. the committee selected the firm of Stewart, COOper and Newell'with offices in Columbia, SC.

Subsequently, the Engineering Division entered into fees negotiations with Stewart, Cooper and Newell for a full service design agreement including construction. administration services. An agreement was reached and a proposal received in the amount of $75,739.00. The selection committee reViewed the details of the negotiated proposal and found it to be fair and reasonable. The following is a list of proposed funding sources: . .

Proposed Funding Sources , State Grant FY2006 "Senior Center" CIP AcCount FY2C03 "General Contingency" CIP Account Total Budget

. Amount Current Balance S365,OOO $72,000 $72,000 SlOO,pOO $248,856 S537,000 ".

RECOMMENDATION. The Engineering Division recommends that The Public Services' Committee approve and recommend to County Council the acceptance of the design proposal from Stewart, Cooper and Newell for the Senior Center design a~d construction administration services at Burton Wells Parle in the amount of$75,739.00. f

REKlDHlmsd

cc: Selection Committee Members

J. ttacbments: Design Services Proposal

(._y -.lISrCtrDesignlpscapp

Senior Services of/Beaufort County (FormeI1y Beaufort Coun1y CoundI on Aging)

PO Box 1 n6· Beaufort. SC 29901 • Telephone: (843) 524-1787 • Fax: (843) 524-0532

March 28, 2007

Mr. Morris Campbell Director, Community of Services County Council of Beaufort County Beaufort, South Carolina 29901

Dear Mr. Campbell:

As requested, here are two sets of the Notification of Grant award (NGA) for the senior center construction at Burton Wells Park as issued by LCOG. The NGA serves as an agreement between the Lt. Governor's Office on Aging and the Lowcountry Council of Governments Area Agency on Aging. Please pass along the extra packet to Attorney Kelly Golden.

All references should be made to the "C" forms that are attached, as they will be our contract/agreement with the LCOG and the Office on Aging. (see. attached communications from Marvile Thompson, LCOG) • _.--. -. ·.eo •• _._, ..... ____ .~ __ •. __ • ___ .• ••• . . •

n is required, do not hesitate to contact me.

Enclosures: 2 sets (1) M. Campbell (2) K. Golden

A United Way Agency ~

LOWCOUNIRY COUNaL. OF GOVERNMENTS P.O. BOX 98 YEMASSEE, SC 29945-0098 omCEAT POINT SOlTI1i 0·95 EXIT 33 AT US HWY. 17)

PHONE (843) 726-5536 FAX (843) 72&5165 EMAIL: [email protected] LDWCOUNTRY REGIONAL DEVELOPMENT CORPORATION· LDWOOUNTRY AREA AGENCY ON AGING

l..DWCOUNIRYWORKFORCE INVFSTMENT AREA August 31, 2006

Ms. Jannette Wdliams, Exec. Director Sr. Services ofBeattort County P.O. Box 1776 Beaufort, SC 29901

Dear Ianoette:

Please find enclosed copy ofNGA for the Senior Center construction in Beaufort County which serves as an agreement between the Lt. Governor's Office on Aging and the LowcountJy Council of Governments Area Agency on Aging.

These funds are to be used for Senior Center Construction as per instructio~ outlined in the Senior Ceotec Manual and in the amounts listed in the "C" fOnDS.

In the process of construction and other issues regarding the building always refer back to the"C" forms as they are your c:ontractIagreemem with this office and the Office on Aging and to the Senior Center Manual.

If you have any questions, please let me know.

~f~~ Marvile J. Thompson Human Services Director

Mjt

Enclosed

Serving BEAUFORT • COllEfON • HAMPTON • JASPER Counties

.... RECEIVED AUG 8 2006

~rle nf ~nutq QIarnlina <00lte of <rIte 1rieutemmt (inlJernnr

Andre Bauer LicutCDaDt Governor

Office on Aging Cornelia D. Gibbons

Dircc10r

Mr. L. Chriswell Bickley, Jr. Lowcountry Council of Governments Post Office Box 98 Yemassee, South Carolina 29945-0098

Dear Mr. Bickley:

In reference to LGOA Grant PIP190:

August 7, 2006

The Lieutenant Govemor's Office on Aging has prepared and amendment to the Notification of Grant A ward for the Senior Center construction in Beaufort County. The amendment adds funding transferred to the Beaufort Project at some point in the past. The period of this award remains July 19,2006 through December 31, 2007. Conditions to the award on the reverse side of the NGA have not changed.

Two copies of the amended Notification of Grant Award are enclosed. Please sign both copies and return one to the Office on Aging to the attention of Joanne Metrick, Operations Manager. If you have any questions about this document please contact me at 803-734-9935 or bye-mail at [email protected]

We appreciate Janette for bringing the additional funds to our attention so you can enter into an agreement with Beaufort County Council on Aging for the full amount available from PIP for the construction of the Senior Center that will serve older adults in Beaufort County.

Sincerely,

~~.~ Joanne Metrick Operations Manager

Enclosures

1301 Gervais Street, Suite 200, Columbia, South Carolina 29201

... 'f-/ \

LIEUTENANT GOVERNOR'S OFFICE ON AGING

1301 Gervais Street, Suite 200 • Columbia, South Carolina 29201

NOTIFICA nON OF SENIOR CENTER (PIP) GRANT AWARD

Grantee Name

.0. Box 98

IY .. m'UL~_ SC 29945-0098

FISCAL " CODES

4B7tO

Federal Employer 10 Nuiriber

'-'. , 57..()5243~

BUDGET CATEGORY

Fund$ • ~truction

Gi-aritPeriod LGOA Grant Log Number

07119105·1213',07

"Construction 'x'

New Amendment (I 1 Revision (I

------ ---l====t===::::;::t--- -- .-.--.~.--.- p- - - " ._--- -.

signature certifies that the funds aw3rded are available to the for the activities ~lri the PIP Grant AppliCation -

-nrnhmilttM by Beaufort Ctlunt)'"C6imtSl on Aging to ooiiStNCt Uie senler the

signature certifies that the assurance and concfltions in aDll11'OV11!d PIP Application and on lheieYel'Se"$ide are

IllnrlMdntvl and accepted by the grantee as part of this award.

Director

8/16/06

"

LOWCOUNlRY COUNCIL OF GOVERNMENTS P.O. BOX 98 YEMASSfE, SC 29945-0098 OFRCEIJ POINT SOlJIH 0-95 EXIT 33 AT US HWY. 17)

PHONE (843) 726-5536 FAX (843) 726-5165 EMAIL: office@kMa>tint:rycog.org l..OWCOUNlRY REGIONAL DEVElOPMENT OORPORA'OON ·lOWOJUI'rJRY AREA AGENCY ON AGING

l..OWOOUNlRYWORKFORCE INVESTMENT AREA

January 28, 2006

Ms. Marsha Stepp, Senior Consultant S.C. Lt. Governor's Office on Aging 1301 Gervais St., Suite 200 Columbia, SC 29201

Dear Marsha:

Enclosed please find two copies of the completed C-Fonns for the Beaufort County Council on Aging PIP Senior Center Project. The Area Agency on Aging is requesting that the Lt. Govemor's Office on Aging initiate a grant agreement for this project.

If you have any questions or need additional information, please let me know.

Sincerely,

!~ lpoo~n' ·n.D/~ .. "Human Servi~r

Mjt

Enclosures

Serving BEAUFORr • COllETON • HAMPTON • JASPER Counties

Senior Services of 'Beaufort County (formerly Beaufort County Council on Aging)

PO Box 1776· Beaufort. SC 29901 • Telephone: (843) 524-1787 • Fax: (843) 524..Q532

January 23, 2006

Ms. Marvile Thompson Director Area Agency on Aging Lowcomrtryeouncitof-60vemments Post Office Box 98 Yemassee, SC 29945

Re: C- Forms for Senior Center PIP - Beaufort County

Dear Marvile:

As requested, enclosed you will find completed C Fonns #1 - 8. Please sign accordingly and forward to the LTGOA, as soon as possible. Also, we have included the County Council's confirmation letter for $50,000.00 in cash toward the project and the letter from the County's Building Inspection Department that will be responsible for all inspection services during the construction process.

Upon approval, by the LCOG MA and the L TGOA, Senior Services and County Council of Beaufort will be prepared to start the process for construction of the new Senior Center at Burton Wells Park.

I am forwarding minutes from our board meeting of November 8, 2005 that referenced County Council of Beaufort County agreement to serve as subcontractor for this project. The Memorandum of Agreement (MOA) is being finalized by County Council and will be submitted to LCOG as soon we receive it in our office.

As always, thanks for your support. As you know, time is of essence and we need to act immediately to ensure that we do not lose this grant.

If additional information and documentation are required, please give me a call.

Enclosures = 4 (C-fonns, County Confirm., County Inspection, Nov. 8th minutes).

o. A United Way Agency

'.

SENIOR CENTER PERMANENT IMPROVEMENT PROGRAM Project Plan (Form C-l)

Project Sponsor: Senior Services of Beaufort County

Address: PO Box 1776 Beaufort. SC 29901

E-mail address:[email protected]

Location of Proposed Project: Burton Wells County Park

Contact person: Jannette Williams

Phone: (843) 524-1787

Fax: (843) 524-0532

. ·R-equestedActiom _""Establishproject ....:X.;.: RtW-ise. scope of work. _x_ Revise budget

Estimated date that funds will be needed: /J{a.a), " -<pO ~ .

Project Description

This revised scope of work and revised budget will change our original PIP proposal for the expansion of our Senior Center in Port Royal to a project will use PIP funds to construct a new Senior Center at the recently opened Burton Wells County Park which is a facility owned and operated by Beaufort County and its Department of Parks and Leisure Services (PALS).

The Burton Wells County Park is a beautiful new facility that opened in April of 2004 and has more than 300 acres and includes new buildings, athletic facilities, and parks. Our revised plan intends to build a new 2,000 square foot Senior Center that will adjoin the new recreation building at the Burton Wells County Park complex.

We have forged a strong partnership for this effort that has the advantage of allowing us to share the new PALS facilities and services of this state of the art recreation area with amenities that include a fitness center, a large gymnasium, meeting and classroom space, adequate parking, access to extensive athletic fields, picnic areas, parks and gardens. Another advantage of our revised plan is additional support and resources from Beaufort County Council that adds

. additional funding ($50.000) and in-kind support_f!om the County's Planning and Engineering Department and Department of Parks and Leisure Services which .will assist in planning,· procurement and construction management. By adjoining our new Senior Center to Burton Wells we will also be better able to coordinate and collaborate more closely with the staff and programs offered by PALS.

Our plan is to build and furnish a 2,000 square foot Senior Center that will include the following: o A multi-purpose room of 1,350 square feet o A computer room of 100 square feet o A site manager's office of 120 square feet. o Two restrooms each of 75 square feet o Storage areas of 100 square feet. o Kitchen Area of 180 square feet

In implementing this plan Senior Services of Beaufort County will work closely with its Beaufort County officials and staff to assure this project complies with the specified Senior Center Standards.

SENIOR CENTER PERMANENT IMPROVEMENT PROGRAM Estimated Project Costs (Form C-2)

Project Sponsor: Senior Services of Beaufort County

Project Name: Beaufort County Senior Center

Is this a revision to an existing estimated cost form or part of a new project request? _x_ Existing New

$. _______ Land Purchase ----:... ____ Acres

$. ________ BuOdiug Purchase ....... _____ --GrOsS Square Feet

$ ____ 3_.' .... ,_..24 ..... 8 _____ Professional Service Fees

$ ________ ~uipment aucl/or Materials

$ ________ ,Site Development

$. ____ 3;:;.;6=5=,OOO .......... _____ New Construction ::::2,z.:O..:.,OO:...-___ Gross Square Feet

$. ________ Renovation5- Building Interior

S-______ -:Renovations- Building Exterior

S _______ ~Roormg

s _______ Other Permanent Improvements

S. _________ Landscaping

$. _______ Other Capital Outlay -111-------.. --------- -_ ______________________ __ __ _ _ _ _

S. _______ Labor Costs

$. __ .:.;l8::;.J;O.;:;.;O~O~ __ Otber. Furniture and Equipment

$. _______ Contingency

$. _______ Environmental Hazard Abatement

ffi420,24ijESTIMATED TOTAL PROJECT COST

Additional Comments:

I

I

SENIOR CENTER PERMANENT IMPROVEMENT PROGRAM Proposed Sources of Funding (Form C-3)

Project Sponsor: Senior Services of Beaufort Cotmty

Project Name: Beaufort-County Senior Center

Is this a revision to an existing Source of Funding form or part of a new project request? _x_ Existing New

-_._--------------------- ------ - - --------------------$_----::3:;,:5;;:.:O,=O=OO~ __ PIP Grant Funds

____ ~-Community Development Block Grant

__ =-= ___ Local Government: Beaufort County

_~ ____ ....;Rural Development Grant

,_-,~= __ Agency Local Funding: Senior Services of Beaufort County

, __ ==~ __ Otber: Previously Awarded PIP funds

-__ ~=~ __ Other: Beaufort Fund

______ ~hu

TOTAL PROPOSED FUNDING

Submitted by: Date: /-Z 3 ,tJ(P ~~~~~~~----

Approved bY:--.:~~~~~~~~:::.=::=-_____ Date:ri.~ 1- d.h

I

SENIOR CENTER PERMANENT IMPROVEMENT PROGRAM Proposed Sources of Funding (Form C-4)

Project Sponsor: Senior Services of Beaufort Comty

Project Name: Beaufort County Senior Center

Is this a revision to an existing Certification of Match form or pm of a new project request! _x_ Existing New

Inacconiancewith the Senior Ctmter J»~~nt .Improvement regulations, acceptable match for Permanent hnproveuient Grants must be provided by' iIie' proJect· sponsor 3iidcertiffed ol' the Area Agency on Aging.

Amount 550,000 517.000 5 5.000 525,000

515.000

5 3,948

5 5,800

$ 2,500

$124,248

I declare that the above Seni Center Pennanent

Source of Matching Funds Beaufort County. cash match Senior Services of Beaufort, County cash match Beaufort Fund. grant Beaufort County Engineering Dept., in-kind services in planning and project management Beaufort County, in-kind land at Burton Wells for project

Beaufort County Human Services Dept., in-kind services in planning and project management Beaufort County P ~ in-kind services in planning and project management The Praxis Network, in-kind services in planning and grant writing and grant management

TOTAL Matching Funds Available

ch is available and complies with the match requirements of the pc vement guidelines.

Date

certify that the above match is available to the grantee and complies with the match requirements of the Senior Center Permanent Improvement guidelines. I certify that the match specified above is correct and complies with the Senior Center Permanent Improvement guide' es accordin y interpretation of the manual.

~- -Dh Date

,)1 WESTON J. NEWTON CHAIRMAN

W .!L'snEr VON HA1llEN VICE CHAIRMAN

COUNQL MEMBEJ.S

fMNKB&A1NAN GEB.ALDDAWSON . MAUD. GENElV.U!S HElUIEllTN.GLAZE . MAIl.GAJtET Eo GBJFfIN STAlU.ETTA HAIRSTON 'l'EIEB. LAMB WILUAMLMCBlUDE

·lUaIAllDH.~AiT

COUNTY COUNCIL OF BEAUFORT COUNTY ADMINISTRATION BUILDING

100 RIBAUT ROAD POST omCE DRAWER 1228

BEAUFORT, SOUTH CAROLINA 29901-1228 TELEPHONE: (843) 470-2800

FAX: (843) 470-2751 www.bcgov.nct

December 16, 2005

Ms, Jarinette E. Williams, Executive Director Senior Services of BeaUfort County P.-O.Box 1776

. Beaufort, South Carolina 19901

RE: Funding for Senior Services Facility at Burton Wells

Dear Ms. Williams:

GAJ.TT. ruBle OOUNTT ADMlNlmAroa.

KElLY J. GOlDEN SfAfF ATTOI\NEY

SUZIINNE M. J.AINET Q.ElK TO OOUNm

Please accept this as confirmation of Beaufort County's commitment to contribute an additional . . Fifty-Thousand Dollars ($50,000) in cash toward the local match requirement for the Three

Hundred and Fifty Thousand Dollars ($350,000) Permanent Improvement Program Grant received by Senior Services of Beaufort for the development of a facility for our adult

O%tatlZe::tA

.' population.. .

1bis commitment toward the development of the project is an addition to the earlier commitment we made to provide the property for the facility and the "in-kind" services of managing the planning, design, and. development of the Four Hundred and Fifteen Thousand Dollars ($415,000) project.

·WtHlre-happy·to partner with.the Senior Services Board .and s.Rlff ~4 lQ9!c fQ~ to wo~g together to bring this project to fruition for the citizens of our county. .

Please let me know if we can be of any further assistance .

. GK:ch

cc: Monis C. Campbell, Director of Community Services

. Ji3AWU

H. C. Boehm, Director of Public ServiceslLand Management Susan Milne. Human Services PlannerlFacilitator

... 3:oo:'**,I;<~ .. Hm " ... l~.n~,)( . .)t..." ).weh .... w.,···"

Senior Services of Beaufort County November 8,2005

PRESENT: Jean Von Harten, Willie Faulkner, George S. Chenault, Joyce B. Major, Sue Kinniard, Cindy Mcintosh, John McGowan, Cecile Dickey, Sally Sauls, Nancy Davidson, Faye McGowan, Jim Neighbors and Jeanette Williams, Executive Director

Guest; Susan Milne

The meeting was called to order at 2:34 PM by President Joyce B. Major with the invocation by Willie Faulkner. The minutes of the October 11 th meeting were approved on a motion by Nancy Davidson; seconded by Cecile Dickey. The motion was unanimously approved

CHURCH CHALLENGE:

The Church Challenge stands at $11,450.00. We have received a check from St.Helena Episcopal Church for $1,000.00.

FUND RAISER UPDATE:

The Big Thursday Golf Tournament and auction sale will take place on Thursday, November 17, 2005. Rea!tors of Beaufort are support~ng our fund raiser. Some sponsors have not named their teams. Chad and John are meeting frequently to finalize plans.

Some funds donated to Ruby Lee Knight (birthday gift) have been turned over to our treasurer. The board agreed to earmark these dollars for our building fund.

BURTON WELLS UPDATE:

The Beaufort County Council -has agreed to serve as subcontracting agency for Senior Services of Beaufort County's building program; i.e., procurement, architectural services, engineering, bidding and contractors, etc. This agreement has been sanctioned by the Low Country Council of Governments and the State agency. We are requested to send a letter to the Beaufort County Council indicating this organization's 'concurrence with .

. \ !

!p. • -----------------:

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COUNTY COUNCIL OF BEAUFORT COUtfTYti U 1 \ L!:. :.:._ .•• :. __ 1..;) i i >

BEAUFORT COUNTY ENGINEERING DIVISIO P '\ \ ::,:.: J 11 . Building 3, 102 Industrial Village Road i U til . NOV 1 6 2005 eJ

Post Offi~e Drawer 1228, B~auf~rtl SC 29901-1~B L ___ ' __ '" ..... ~ Phone. (843) 470-2625 Fax. (843) 470-2630 BEAlill ~r-1T GO' .. itHY .

I. pF·.;r:jJ:;~::",pn c- ·3ERVICEsolV.

TO: Monis Campbell, Community Services Director

SUBJ: In-Kind Contribution - Senior Center

DATE: Novemger lS,~ii

In response to your request, ~ in-kind cost estimate for the approximate value for engineering services that will support the construction of the new Beaufort Senior Center is provided,

As you know, the $350,000 grant requires a 30% local match ofSl05,OOO. The match may be any combination of cash, land value and in-kind services. The attached estimate propoSes that our Engineering Divisio.n wiD be able to contn"bute approximately $25,000 of in-kind services providing design and construction administration support.

This is a rough order of magnitude estimate. Our actual contribution will depend on several project administration variables to include the amount of additional documentation required in support of

the~ REKlDHlpae

Attachments: Cost Estimate:· "Design and Construction J\dministration Support for the Senior Center' dated 11/08/05

cc: Paul Andres

__ . ...aIDM<-'c .. ____ ~._'~ L. .... ,

-

Cwnty Council of Beaufort County

11 5

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Camty Counc)J 'of Beaufort f;ounty

ESTIMATED BREAKOUT OF ENGINEERJNG SUPPORT HOURS

SENIOR CE~TER

.~,

. "I

Purchasing 1.("

20% CfP Project Manager

15% CIP ImpJementation Manager

Construction Manager

Admlnlstratfve AssIstant

•

• Morris C. Campbell Executive Director CollllD1lDity Services

Novem~ J~,_ 2Q9~

COUNTY COUNCIL OF BEAUFORT COUNTY Multi Government Center .. 100 Ribaut Road

Post Office Drawer 1228 Beaufort, South Carolina 29901-1228

Telephone (843) 470-2600 FAX (843) 470-4518

Ms. Jannette Williams, Executive Director Senior Services of Beaufort County P. O. Box 1776 Beaufort, South Carolina 29901

RE: Property value at Burton Wells

Dear Ms. Williams:

The attached is the appraised value of the property the County will donate toward the construction of the senior center. As you will note, the appraisal was done by the County Assessor's Office.

If you need additional information, please contact me. Thanks!

Imee

c: Gary Kubic, County Admjnistrator John Miller, Director, PALS

'<#

Value estimate for Burton Wells recreation/assembly building and ten (10.0) acres of land:

The property is located at "1 Middleton Drive, Burton SCn and is further identified as a portion of Beaufort County Parcel Identification Number R100-027-000-0004-0000.

The Total Estimated Value of the property described above is: $2.705.00Q

TWO MILLION SEVEN HUNDRED FIVE THOUSAND DOLLARS.

Property Description and Valuation Calculation: The property is located in ·-unincorporatet:t-aeaufort~nty;-Oistriet~Qgi-aAd-is--GUmmtl¥~jor..use as a public park. The building value being estimated is a multipurpose public building constructed in 2004. The principal type of frame is concrete block with steel truss roof covered with preformed, enameled metal sheets. The

. building consists of two (2) assembly rooms, fourteen (14) office/conference rooms, two (2) exercise rooms and a gymnasium. There are two (2) large

. restrooms (thirty fixtures total) and four (4) small restrooms (eight fixtures total.) Total occupancy for the building is rated at 1,391 people. Ingress and egress is asphaltic pavement with two-hundred, fifty (250) parking spaces. The value estimate is based on the cost approach plus estimated land value. Below is a breakdown of the cost estimate.*

Recreation/assembly building:

Conditioned space 20,644 SF x $109.85 = $2,267,743 Entry porch 720 SF x $ 21.97 = $ 15,818 MechanicaVstorage 540 SF x $ 43.94 = $ 23,727 Asphalt paving/parking: 12,400 cu. Yds (est) x $20.00 = $ 247,850 (including site prep., grading, drainage, engineering, etc.)

Total Cost Building & Paving = $2,555,138

Estimated Land Value: 10 acres x $15,000

Rounded to $2,555,000

=

':' Total.Estimated Property Value as of April 20, 2005 is:

$ 150,000

$2.705.000 ..

*Oue to the lack of comparable sales for this special use property and inapplicability of the income approach to value, 'ooly the cost approach was used for this estimate.

Robert,C. Reames ' I,nterim Beaufort County Assessor

. ' : . . ~;..~~/

SENIOR CENTER PERMANENT IMPROVEMENT PROGRAM Project Sponsor Certification of Assurances (Form C-5)

c-s

In regards to the _G_rea __ te_r_B_ea....,.....u.-fo~rt~A_rea ______ Senior CenterPennane.nt ImprOvement Project, PiOjo:t DUne

.I .I

CuIIentJ:y has or will have the reqUired matching fimds prior to the start ~ c:onstrUction.

Bas or will have sufficient fonds.or.other resomces to operate and maintain the senior center funded under this program in accordaDCe with the Senior Center Procedure Manual. Senior Center: S1andaIds. issaed by DHBB.

wm maim;'; co~t an:hitectura1 engineeting supervision and inspection at the constIuction si~ to insUre that . the compl~ed wo~ conformS with the approved plans. and specifications;· that it will fainish progress reports and other related inforination as the ~tate may require: .

Will commit to completing the project within the required timefJ:ame and infonn DHHS of any delays and potential problems.

Will comply with the State ReversicmaIy Interest in Mnlti-Pmpose Senio~ Centers. ..

Will comply with all federal, state. and local requirements and applicable cOdes. laws and regulations.

Will ensure that the facility is or will be readily accesslble to persons with disabilities and·will comply with the . .Americans Disabilities Act ~.AiJ.Y SfiiiCtiirlIl clWiges Willl5e made in lceotdam:e with 1:h.e Arcbitectural andB~ers M 42 U.S.C. 4151-4157. . .

... ~ .provide all seryices available under these funds iIi a non-discriminatoxy manner as required by Title VI of

1he Civil ;Rights Act of 1964 as amended.

Understands that the availability of these funds is time-limited and DHHS agrees to provide these funds only within 1he times frames as d . the Senior Center Permanent ImproVement Project Mannal. .

SENIOR CENTER PERMANENT lMPROvEl'v.IENT PROGRAM Area Agency ·on Aging ·Certification of Assurances (Fo·rm C~6)

Regarding the_...;;.G,..rea-.....,;t;.;;.e_r~B~ea~u ..... fo __ rt_A_rea __ S_e_n_io_r_C_·e_n_t_e_r ____ .,..-_PIP project, j Project uame J

~~GJ1lron~by· Seni~eOli~of Beau{QrJ_.~[I.t;I._ ...... __ ._._ . __ ......... , Project Spcmsar

_.;;;;Lo;;;.w;;,;.co,;::.;..:u:..:n..:..:try;:...!.....,....:A..:..r:..,.:ea:.::....A~ge:""'n .... c~y"--o_n_A--=g_in-=g~ ___ hereby agrees to and gives assurances to Area AypJ1:y OIl Aging

DHBSthat:

This appli~tion has been reviewed and meets the Senior Center Program Manual requirements.

It will provide oversight and assistance to the project sponsor to the extent necessary to ensure oomplia:nce with the Senior Center Program Manual guidelines.

C-6

It Will ensure ·adequate .control and timely release of funds to the project sponsor using gene~y ). accepted accou.nti.ng p~ocedures.· .

~-.-j'

It will comply with the State Reversionary Interest in Multi-Purpose Senio~ Centers.

It will monitor the project sponsor for compliance with the Senior Center ProWam Manual.

It will advise the DHHS Senior Center Coordinator of any significant problems encountered in the process of completing the project. .

AAARecommendation(s):~ _____________________ ---:..._

C61leviscd 8101.

DeCember 8, 2005

Ms. Marvile Thompson

COUNTY COUNCIL OF BEAUFORT COUNTY

BEAUFORT COUNTY JNSPECTION DEPARTMENT Multi Government Center. 100 Ribaut Road, Room 275

P.O. Drawer 1228, Beaufort, SC 29901-1228 Phone: (843) 470-2680. FAX: (843) 370-2686

Director of Area Aging Agencies Lowcountry Council c;.f Governments P.O. Box 98 Yemassee, SC 29945

RE: Beaufort County - Burton Wells Senior Facility Project

Dear Ms. Thompson:

The Beaufort County Building Inspection Department Will provide plan review and inspection services to ensure quality construction and compliance with applicable building codes in construction of the referenced facilitY.

Specifically, the department will provide any assistance required to ensure compliance wi1h the International Building Codes, National Electric Code, SC Energy Code, and ANSI Al17 .1-1998 requirements.

If I can be of any further assistance, please let me know.

Sincerely,

/2/.~. _ ~L~O

Director

cc: Gary Kubic, County Administrator Morris C. Campbell, ED, Community Services John Miller, Director, Parks and Leisure Services Jannette Williams, Executive Director, Beaufort County Senior Services

.. .. . . ... (.h.v.Q.Q .... H, (cwo;::; .•. (Mh%Z,tG : .. lhMdU.i. . ... PM M2r.:oo:'-.h.(w.',X.O.W'M.M,(U)(W.WWi %" ... ,,' : :H ,,3. ~ ..

Request for Taxpayer Identification Number and Certification

Give fonn to the requester. Do NOT send to the IRS.

individuals, IhIs Is yotI- social securfty runber (SSN).HaMwer,1f you In a resident aDen ~ a

Nota: If the fJCt:Ount Is tI mOl8 fllan one name. see the chBlf on page 2 for guidelines on whose

I ~tor-r IcIcmtItIaIlon numblf I m 1517+01$1 ?J;ISI510 t---=='------

SIgn Here

Purpose at form. A personwho Is ~ to file an Information retum with the IRS must get ycU' conect tDcpayer ldentlftcatlonnumber (11N) to report, for example, Income paid to you. real estate transac:llollS, mortgage Interest you paid, acqulsftlon or sbaI1donmenl of Sec:urad .pmpedy~cel1atio.!lQf ~tJ!' ~ . contributions you made to an IRA.

Use Form W-9, if you are a U.s. person (Including a resident aien). to give yOAZr correct l1N to the person requesting It (the requesler)and, when applicable, to:

1. CertIfy the lIN you are giving Is correct (or you are waiting far 8 number to be Issued),

2. Cettify you are not subject to backup withhoIcfllg, or

3. ClaIm exemption from backup withhoIdlng If you 818 an exempt payee.

If you are 8 foreign person. IRS prefers you use 8 Form W-8 (certificate of foreign status). Mer December 31, 2000, foreign persons must use an appropriate Form W-8. Nota: "8 tequestar gives you 8 form other than Fonn W-9to tequestyour T1N,you must use the requeste~s form If It Is substantially similar to this Fonn W-9.

~

What Is wlttlhokIng? Persc:ns making certain payments to you must wi1hhoId and pay to the RS 31% of such payments under certafn conditions. llis Is caRed ~ wtthhoIdIng.- payments that may be subject to backup wffflhofding Include Interest, dividends, broker and barter exchange transactions, rents, royalti_;-nonernployee pay, and certaln payments from fishing boat operators. Real estate transactions are not subject to backup wlthhoId"lIl9.

ono.~~Rive. ~~...E.. conectnd III" mal(8 the proper...:n II ............ S, a report aI you- taxable Interest and dividends on your tax return, payments you receive win not be subject to backup withholding. payments you recelYewiU be subjecl to backup withholding If

1. YC1I do not fumlsh you- lIN to the requester, or

2. YC1I do not certify you- TlN When required (see the Part III Instructions on page 2 for detals), or .

3. The IRS tells 1he requester that you furnished an Incorreet TIN, or

4. The IRS tells you that you are subject to backup wHhhoIding because you did not report aU )0.1' Interest and dividends on your tax return (for reportable Interest and dividends oriy), or

Cet. No. 10U1X

5. You do cetfifyto the requester that you are not subfed to backup withholding under 3 lIbove(fcr reportable interest and dividend accolris opened after 1983 only).

Certain payees and payments are exempt from backup wIttIhaIdIng. See the Part a instructions and the separate Instructlonsfor the Requestar of Fonn w-9.

Penalties FaDureto furnish TIN. If you fall to fumIsh )Qi" CXln'ect'TIN to a requester, you are stilJect to 8 penalty of $50 far each such failure unless yoc.r faIItn Is due to reasonabIecause and not to willful neglect. CIvIl penalty for false information with respec:tto wI1tIholcIng. If you make a false statamentwtth no reasonablebasis that results in no backup wItho'1oIcfing. you are subject to a $500 penalty. CrImInal penalty for falsifying infonnation. Wilfully falsifying certifications or a1ftnnatIons may subject you to aImlnaI penalties Including fines and/or imprisonmenl Misuse of TINs. If the requester cftsdoses or uses TINs In violation of Federal law, the requester may be~}ect to cMl and criminal penal6es.

Form W-9 (Rev. 11-99)

1

ExhibitB

Insurance Coverage

(Following on separate page)

... ' .. , .

CAROLINA.

. ." Beaufo~ ~oUnty CounciJ. qn Aging PO "Box 1776 Beaufqit; SC 29902

"Attn: Ms: Jeanette Wil1iam$

'Policy Nw;nber: 10-49366-3

Dear Policyholder: .

F.1JND:"--.. ";.~----.. -"".".--"-~~!:~~~}~~~~~ -~.-. " "

ThiS certifies that BeaUfort ~ty Council On Aging, of Beaufort; ~uthCarolina cqverS their employees for Wo~' QlmpensatiOn ~ance through ti)e ~ta~ Accident FlUld. .

Theirpre~t cOverag~ runs continuo:usly from January Olst,2906 lintil Jan~ 01st; 2007. This is to . ~ertifjr that Beaufort County Council On: Aging, of Beaufort, "South Caronna is in compliance wjth . Article 1, G"tapter"7, TitIe42 (wOrkers' compensation law) ofSout:h CarolfuaCodeofLaws .

. . ... Respectfuny, ~ .

t1;:tty, ~cr- . I

P.olicy Holder ServiCes . . [email protected]

PoliCy Number. Policy Period:

10-49366:-3 01/01/06 -01/01/07

.... - . .. .. " . '\.

P.O. BOX 1021-oot:bLUMBIA, SC 29221-5O(Xl" (803) 896-5856 ·1.~521--6576 . FAX: 803-612-2756

. [email protected]. "

10/31/.2006

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1 OF 1 EFFECTIVE 12:01 AM STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE.

NUMBER OF RATE PER PERSONS PERSON PREMIUM PERSONNEL CLASSIFICATION

19 324.00 6.156.00 - DIRECTORS. EXEC. MANAGERS 4 72.00 288.00 - CLERICAL PERSONNEL 1 72.00 72.00 - VOLUNTEERS 5 150.00 750.00 - OTHERS

7.266.00 - TOTAL PREMIUM

COVERAGE

LIMIt OF LIABILITY - $1.000,000 PER OCCURRENCE

PREPAID LEGAL DEFENSE COSTS COVERAGE BASIC 15,000.00 OPTIONAL .00 TOTAL 15,000.00

~."

1 OF 1 EFFECTIVE l2~01 AM STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE.

COVERED CAUSES OF lOSS: SPECIAL FORM'EARTHQUAKE FORM FLOOD INSURANCE

BOILER 'AND MACHINERY COVERAGE FORM: IN RETURN FOR THE PAYMENT OF PREMIUM AND SUBJECT TO ALL THE TERMS OF THIS POLICY. WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY WHILE THE OBJECT IS IN USE OR CONNECTED READY FOR USE AT ANY LOCATION.

LIMIT OF INSURANCE ................. $5,000.000 PER ACCIDENT PREMI UM ........... ~ . . . . . . . . . . . . . . .. INCLUDED

FORMS APPLICABLE TO BOILER AND"MACHINERY COVERAGE, PD-Ol; PD-09; PD-12

-RDINANCE AND LAW LIMIT OF INSURANCE .............. " ... $100,000

OPTIONAL COVERAGES APPLICABLE' ONLY WHEN ENTRIES ARE MADE IN THE BRACKETS BELOW: REPLACEMENT COST BUILDINGS ........... (X) REPLACEMENT COST PERSONAL PROPERTY ... (X)

DEDUCTIBLES: COVERED LOSS ......................... $250 EARTHQUAKE: SPECIAL 5% DEDUCTIBLE. THIS POLICY CONTAINS A SEPARATE

DEDUCTIBLE FOR EARTHQUAKE LOSSES.

COINSURANCE ............................ 80%

SEGMENT PROPERTY LIMIT OF NUMBER DESCRIPTION/LOCATION INSURANCE RATE

20 BLUEFTON CENTER BLDG 0 0.300 ULMER RD. CONT 4.694 0.238

30 SENIOR SVS BEAUFORT CO OFFICES BLDG 0 0.148 1408 PARIS AVE. CONT 30,000 0.130

40 ST HELENA CENTER BLDG 0 0.307 BALL PARK RD. CONT 7.907 0.242

TOTAL BUILDING PREMIUM -~. TOTAL CONTENTS PREMIUM

TOTAL PREMIUM

PREMIUM

.00 11.17

.00 39.00

.00 19.13

1 OF 1 EFFECTIVE 12:01 AMSTANDARfr TIME AT YOUR MAILING ADDRESS SHOWN ABOVE.

IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERM'S OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.

COINSURANCE: YOU MUST MAINTAIN A MINIMUM COVERAGE EQUAL TO lOot OF THE FULL REPLACEMENT VALUE OF ALL COVERED PROPERTY AT ALL INSURED'S P~EMISES.

DEDUCTIBLE: STANDARD DEDUCTIBLE ......................... $250 SPECIAL BREAKDOWN DEDUCTIBLE ................ $1,000

COVERAGE LIMITS: EQUIPMENT ................................... $ 15.000 DATA & MEDIA / EXTRA EXPENSE: a.·20% Cf EQUIPMENT LIMIT WITH $10,000 MINIMUM/$lOO.OOO MAXIMUM b. ADDITIONAL DATA & MEDIA/EXTRA EXPENSE $ 0

SEGMTI LOCATION LIMIT OF PROP NO. PROPERTY DESCRIPTION COVERAGE RATE PREMIUM

10 ALL LOCATIONS 1 DP EQUIp· 15.000 0.217 32.55

TOTALS 15.000 32.55

AMOUNT BILLED (MINIMUM) 35.00

1 OF 1 EFFECTIVE 12:01 AM STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE.

. COVERAGE - $200 DEDUCTIBLE COMPREHENSIVE $200 DEDUCTIBLE COllISlbN

VEHICLE MAKE/MODEL NUMBER YEAR SERIAL NUMBER

220 1999 DODGE VAN 503008

250 1994 FORD CROWN VICTORIA . 161723

260 2002 DODGE RAM VAN 124054

270 1995 FORD AEROSTAR VAN B73390

280 2000 DODGE WAGON i23645

290 1994 CHEVROLET ASTRO VAN B185749

VEHICLE COST RATES

30.099 COMP 0.14 COll 0.38

15.000 COMP 0.24 COll 0.61

19.078 COMP 0.14 COll 0.55

16.000 COMP 0.14 COll 0.38

23.000 COMP 0.14 COll 0.38

15.000 COMP 0.14 COll 0.38

TOTAL COMPREHENSIVE PREMIUM TOTAL COllISION PREMIUM TOTAL PREMIUM

PREMIUMS

42.14 . 114.38

36.00 91.50

26.71 104.93

22AO 60.80

32.20 87.40

21.00 57.00

180.45 516.01 696.46

EFFECTIVE 12:01 AM STANDARD TIME AT. YOUR MAILING- ADDRESS SHOWN ABOVE.

NUMBER OF VEHICLES

6

RATE PER VEHICLE

380.00

LIMIT OF LIABILITY

PREMIUM

2.280.00

COVERAGE

1.000.000 COMBINED SINGLE LIMIT EACH ACCIDENT

MEDICAL PAYMENTS 1.000 EACH PERSON

UNINSURED MOTORISTS COVERAGE 15.000 BODILY INJURY EACH PERSON 30,000 BODILY INJURY EACH AcCtDENT 10,000 PROPERTY DAMAGE EACH ACCIDENT

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