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HomeMy WebLinkAboutLee, Christopher; 2022-11-10; PSALCA-23032CAPSALCA-23032CA City Attorney Approved Version 6/12/18 1 AGREEMENT FOR LOAN OF ARTWORK & ARTIST SERVICES AT THE CARLSBAD SCULPTURE GARDEN CHRISTOPHER LEE THIS AGREEMENT is made and entered into as of the ______________ day of ___________________, 2022, by and between the CITY OF CARLSBAD, a municipal corporation, ("City"), and Christopher Lee, a Sole Proprietorship, ("Contractor”/”Lender”/”Artist”) (collectively, the “Parties”.) RECITALS City requires the professional services of an artist to loan artwork to the City for public display in the City of Carlsbad Sculpture Garden, 2955 Elmwood Street, Carlsbad, CA, 92008. Contractor has the ability to loan the Artwork and is available for various speaking engagements and/or instructional and outreach events, has submitted a proposal to City and has affirmed its willingness and ability to share their artwork and their artwork knowledge. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the “Services”) that are defined in Exhibit “A” and loan of Artwork as specified in “Exhibit B”, attached and incorporated by this reference in accordance with the terms and conditions set forth in this Agreement. 2. TERM This Agreement will be effective for a period of no more than twenty-four (24) months from the date first above written. 3. COMPENSATION The total fee payable for the Services to be performed will be five thousand dollars ($5,000). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. 4.STATUS OF CONTRACTOR Contractor will perform the Services as an independent contractor and in pursuit of Contractor’s independent calling, and not as an employee of City. Contractor will be under the control of City only as to the results to be accomplished. 5. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D November 10th PSALCA-23032CA City Attorney Approved Version 6/12/18 2 6. INSURANCE Contractor will obtain and maintain policies of commercial general liability insurance, automobile liability insurance, a combined policy of workers' compensation, employers liability insurance, and professional liability insurance from an insurance company authorized to transact the business of insurance in the State of California which has a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non- admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report, in an amount of not less than one million dollars ($1,000,000) each, unless otherwise authorized and approved by the Risk Manager or the City Manager. Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims- made coverage. The insurance will be in force during the life of this Agreement and will not be canceled without thirty (30) days prior written notice to the City by certified mail. City will be named as an additional insured on General Liability which shall provide primary coverage to the City. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Contractor will furnish certificates of insurance to the Contract Department, with endorsements to City prior to City’s execution of this Agreement. 7.NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement. For City For Contractor Name Richard Schultz Name Christopher Lee Title Cultural Arts Manager Title Contractor/Artist/Lender Department Library & Cultural Arts Address 11072 Puebla Drive La Mesa, CA 91941 Address City of Carlsbad 1775 Dove Lane Phone No. 619-840-5351 Carlsbad, CA 92011 Email Turchin551@cox.net Phone No. 442-339-2086 Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 8.CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests in all categories. Yes No 9.COMPLIANCE WITH LAWS Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment and will obtain and maintain a City of Carlsbad Business License for the term of this Agreement. DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D □ ■ PSALCA-23032CA City Attorney Approved Version 6/12/18 3 10. TERMINATION City may terminate this Agreement at any time after a discussion, and written notice to the Contractor. Contractor may terminate this Agreement any time before the artwork is placed for exhibition, after a discussion, and written notice to the City. City will pay Contractor's costs for services delivered up to the time of termination, if the services have been delivered in accordance with the Agreement. 11.CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees it may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, Government Code sections 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seq. Contractor further acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to terminate this Agreement. 12.JURISDICTIONS AND VENUE Contractor agrees and stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Agreement is the State Superior Court, San Diego County, California. 13. ASSIGNMENT Contractor may assign neither this Agreement nor any part of it, nor any monies due or to become due under it, without the prior written consent of City. 14.AMENDMENTS This Agreement may be amended by mutual consent of City and Contractor. Any amendment will be in writing, signed by both parties, with a statement of estimated changes in charges or time schedule. \\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ \\\ DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D PSALCA-23032CA City Attorney Approved Version 6/12/18 4 15. AUTHORITY The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR CITY OF CARLSBAD, a municipal corporation of the State of California By:By: (sign here) SUZANNE SMITHSON Library & Cultural Arts Director As Authorized by City Manager CHRISTOPHER LEE, Artist (print name/title) ATTEST: By: (sign here) For FAVIOLA MEDINA City Clerk Services Manager (print name/title) If required by City, proper notarial acknowledgment of execution by contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A. Group B. Chairman,Secretary, President,or Assistant Secretary, Vice-President CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: For CINDIE K. MCMAHON, City Attorney By: Deputy / Assistant City Attorney DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D PSALCA-23032CA City Attorney Approved Version 6/12/18 5 EXHIBIT “A” SCOPE OF SERVICES Lender will loan artwork to the City to be exhibited in the outdoor City of Carlsbad Sculpture Garden, 2955 Elmwood Street, Carlsbad, CA, 92008 and provide additional services as described below. 1.CITY’S CONTACT INFORMATION Cultural Arts Manager, Richard Schultz, 442-339-2086, richard.schultz@carlsbadca.gov Community Arts Coordinator, Tonya Rodzach, 442-245-0502, tonya.rodzach@carlsbadca.gov Cultural Arts General Phone, 442-339-2090 *Email may be the initial preferred method of reaching staff. 2. EXHIBIT LOCATION City of Carlsbad Sculpture Garden, 2955 Elmwood Street, Carlsbad, CA, 92008 3. ARTWORK LOAN PERIODS Artwork loan period: Jan. 23, 2023 to Sept. 12, 2024 Sculpture Garden exhibit period: Feb. 7, 2023 to Aug. 30, 2024 Lender agrees to loan the Artwork specified on the checklist attached as Exhibit "B." The Artwork will remain in the City’s possession during the loan period but may be withdrawn from the exhibition at the City’s sole discretion. City will notify Lender when any Artwork is withdrawn from the exhibit. City and Lender may agree in writing to extend the duration of this Agreement. Acceptance of the Artwork does not imply that the Artwork will be placed or maintained on public display for the Agreement's exhibit duration. Lender agrees to loan the Artwork specified on the checklist attached as Exhibit "B" of this Agreement to City. 4. TRANSPORTATION AND PACKING Lender will transport and deliver Artwork for installation at the City's Sculpture Garden and provide details as to any special requirements for display or installation. City will select and arrange for the artwork installer for the project. Lender certifies that the work to be loaned to the City under the terms and conditions of this Agreement is in good condition and meets the loan image submitted to the City. The City shall inspect the Artwork and complete and sign the opening condition report for each piece of Artwork, which will constitute the property's condition at the time of the receipt of the Artwork loan. Any discrepancies, losses, or evidence of damage to the Artwork noted at the time of inspection or at any time while in the City's custody will be reported immediately to the Lender. Lender will deliver Artwork to the City’s Sculpture Garden by loan start date, as described above. At the end of the exhibition, Lender will be responsible for picking up Artwork within a predetermined date that is agreed upon by both parties and within ten (10) business days after the close of the exhibition, no later than the date described above, unless other written DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D City Attorney Approved Version 6/12/18 6 PSALCA-23032CA arrangements are made between City and Lender. All drop-off and pickup deliveries shall be coordinated with the City's Cultural Arts Manager or Designee. 5. LENDER CITY reserves the right to audio and/or video record and to reproduce and distribute any lecture, reading or speaking engagement, and musical concert or musical Performance performed under this Agreement as virtual programming. City may retain the recording in its files, may replay the recordings for its employees and the public, including the right to post, replay, or broadcast the recordings on the City’s YouTube channel, the City’s cable channel, the City’s Library Facebook Live account, and other similar City internet-based platforms, and may make the recording available for non-circulation use at its library facilities. City shall not sell the recording. City shall provide a copy of the recording to the Artist, upon the Artist’s request. Press Kit Upon execution of Agreement, the Lender agrees to provide a high-resolution image of self (headshot preferred) and written biography (up to 300 words) as well as four (4) to five (5) high- resolution images of Artwork. Images shall be delivered to the City's Cultural Arts Manager or Designee in electronic form immediately upon the Agreement's execution. Warranty of Title Lender warrants that Lender is either the owner of the Artwork or the authorized agent of the lawful owner or artist of the Artwork and has the authority to enter into this Agreement and to grant the rights to City as set forth in this Agreement. Lender also warrants that the Artwork(s) is not now or will be subjected to claims of ownership, lien, encumbrance, copyright infringement, or trademark infringement under any state or federal law. Lender shall indemnify the City, its officers, and employees for all damages related to a claim asserting a violation or claim of violation of this Warranty of Title, including reasonable attorney fees and costs. Artwork Withdrawals Lender agrees once Artwork is placed for exhibition, it cannot be withdrawn from an exhibition by the Lender for any reason. Model Release For valuable consideration, receipt of which is hereby acknowledged, I hereby assign all rights to my portrait, picture, videotape and sound recording (collectively “Images”) of me or in which I may be included intact or in part, composite or distorted in character or form, without restriction, to the City of Carlsbad, a municipal corporation, and I hereby authorize the reproduction, copyright, exhibition, broadcast, cablecast, Internet posting, and/or distribution through any and all media now or hereafter known of said Images without limitation for purpose of this use. I waive the right to any fees, royalties or control, now or in the future, and I grant full permission for the use of my Image including, without limitations, name, likeness, performance, voice and biography, for the purpose of publicizing, advertising or promoting any City of Carlsbad matter or program. I hereby relinquish any right that I may have to examine or approve the completed product or products or the advertising copy or printed matter that may be used in conjunction therewith or the use to which it may be applied. ___________(Artist’s Initials) DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D u PSALCA-23032CA City Attorney Approved Version 6/12/18 7 6.CITY Artwork Installation City shall install and exhibit the Artwork. City reserves the right to make the final decision on which items will be included in the exhibition, and the arrangement of the exhibit. City shall take reasonable steps to preserve the exhibited Artwork against adverse environmental conditions, deterioration, damage or theft. Artwork Inspection Artwork will be visually inspected upon receipt, and any noticeable damage will be documented on the shipping receipt. Evidence of damage to Artwork while in the City’s custody will be reported immediately to the Lender. Artwork can be installed into a concrete pad or other identified surface with two to four points of connection. City may elect to display damaged Artwork if, in City’s sole determination, the displaying of the damaged Artwork will not exacerbate the preexisting damage. 7.REPRODUCTION RIGHTS, PUBLICITY AND PHOTOGRAPHY Except as limited by this Agreement, Lender retains any or all copyright, licensing, and/or ownership rights to the Artwork available to him/her under state or federal law. In accordance with Section 5 of the Scope of Work, Lender grants City the right to photograph, telecast, video production, social media coverage or make similar visual reproductions of the Artwork covered by this Agreement for publicity and advertising purposes and other educational purposes and in catalogues or posters that it distributes. City agrees to acknowledge the artist on all related print matter, exhibition announcements, publicity releases, invitations, posters, signs, or other promotional or educational materials relating to the Artwork. 8. HEALTH & SAFETY During the COVID-19 health-related pandemic or other related circumstance, all activities occurring at City facilities, all Parties must adhere to the guidance from the state, county, and local authorities on health and safety protocols. City staff will inform Lender what the current guidelines are prior to their arrival and entering any City facility. Safety protocols may include, but are not limited to, hand washing, temperature testing, requiring face covering, maintaining physical distancing of six (6) feet. The safety protocols may be modified at any time due to changing rules, regulations or circumstances. 9. CONTRACTOR FEE / INVOICING Fee. The total fee payable for the Services to be performed will be five thousand dollars ($5,000) in two payment installments. Payment Schedule - 1st Payment $4,000 Upon Artwork delivery and completion of installation 2nd Payment $1,000 Upon de-installation and pick-up of Artwork Invoicing & Payment. Contractor will be responsible for submitting invoices for Payment to the City of Carlsbad's Cultural Arts Manager or Designee, as designated on the schedule above. All invoices shall be detailed to include related activities. Final invoices approval will be completed by the Library & Cultural Arts Director or Designee. DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D Carlsbad Sculpture Garden Loan Detail Artist Name Christopher Lee Address 11072 Puebla Drive La Mesa, CA 91941 Phone number 619-840-5351 Email turchin551@cox.net Title of Artwork Breaking the Sound Barrier Media Machined aluminum, gold leafed cone, laminated blue glass sphere, polished fuschia glass disc, verde oxidized copper column cap, burnished aluminum flutes, red powder coated and painted steel column, suspended stainless steel rings, black powder coated steel support base Description “Breaking the Sound Barrier” is a suggestion about social and political discourse that has recently and increasingly been pervasive in our daily lives and has two meanings. The first is, of course, the abstract representation of images we have all seen of aircraft and/or rockets breaking the sound barrier creating intense booming sounds and visually of contrails or rings of condensation around the aircraft at that very instant. The rings are suspended burnished stainless steel around the column. The second meaning addresses the proliferation of loud and often vitriolic language in many public and private settings that tend to annoy and grate, “breaking” many of our social mores, often without consideration for others. Food for thought. Year Made 2022 Credit Line, lent by Christopher Lee (artist) Insurance Value $12,000 Size, Dimensions 9’ height x 3’ diameter Overall Weight 400 lbs +/- Handling Requirements (including, but not limited to pick points if hoisting is required to mount to attachment point) The piece will be delivered unassembled in parts, to be assembled on site with artist assistance/guidance. All hand built with no individual piece weighing more than 150lbs. Installation Details: Desired anchorage and attachment specs (i.e. wedge anchors, pins or epoxy) Black base attached o concrete pedestal with 4 wedge, drop-in, or stud anchors… ½”-13. EXHIBIT “B” CITY OF CARLSBAD SCULPTURE GARDEN ARTWORK LOAN PSALCA-23032CA City Attorney Approved Version 6/12/18 8 DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D ( City of Carlsbad PSALCA-23032CA City Attorney Approved Version 6/12/18 9 *Proposed design concept.*Final artwork will be viewed by Cultural Arts staff by the end of December, 2022 to confirm that the sculpture meets the requirements and imagery above. Christopher Lee Selected Artwork DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D WAIVER REQUEST FORM FACTORS IN SUPPORT OF REQUEST TO MODIFY INSURANCE REQUIREMENT(S) Generally, a modification to the coverage requirement will be accepting a lower limit of coverage or waiving the requirement(s). Requested by: Tonya Rodzach, Community Coordinator, Library & Cultural Arts Dept. November 3, 2022 (Name and Department) (Date) Proposed modification(s) to the General Liability requirement(s) for ARTIST (Type of insurance) (Name of contract) Reduce coverage to the amount of: $ . Waive coverage Other: FACTOR(S) IN SUPPORT OF MODIFICATION(S) (check those that apply) Significance of Contractor: Contractor has previous experience with the City that is important to the efficiency of completing the scope of work and the quality of the work-product. [explain] Significance of Contractor: Contractor has unique skills and there are few if any alternatives. [explain: include number of candidates RFP sent to and number responded if applicable] Contract Amount/Term of Contract: $ . Work will be completed over a period of . Professional Liability coverage is not available to this contractor or would increase the cost of the contract by $ [explain]. Other (e.g. explain why exposures are minimal, how exposures are covered in another policy, exposure control mechanisms, and any other information pertinent to your request): All onsite interviews on this Agreement are speaking engagement and/or instructional outreach events taking place at the Carlsbad Sculpture Garden, located at 2955 Elmwood Street, Carlsbad, 92008. Each event would have no audience and adherence to Health and Safety requirements provided by the city. Approved by Risk Manager for this contract only: (Signature) (Date) H:\WORD\Insurance\Admin Order #68.doc 06/15/2006 27 DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D 11/10/2022 □ ■---­□ □ □ DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D Renewal auto policy declarations Your policy effective date is November 26, 2022 Total Amount Due for the Policy Period Page 1 of 4 Information as of October 5, 2022 Please review your insured vehicles and verify their VINs are correct. Summary Vehicles covered ldenf ication Number (VIN) Premium Named lnsured(s) ..c...==.=.cc==..-=-=-..c-=--c'-"'-----------===--c-=-=~~~'---'-'---'--'-'-'-=--- 2001 Ford Truck F150 1FTRX17L 11NA76372 Christopher Lee, Arlene Lee 2016 Chevrolet Malibu 1G11CSSA4GF122987 Mailing address -------- Ca Ii fo rn i a Fraud Assessment Fee 11072 Puebla Dr Total* San Diego CA 91941-7100 * Your bill will be mailed separately. Before making a payment, please refer to your latest bill, which Includes payment options and installment fee information. If you do not pay in full, you will be charged an installment fee(s). See the Important payment and coverage information section for details about installment fees. Discounts (included in your total premium) Anti-theft $2.70 Good Driver (20%) Multiple Policy $14.30 Distinguished Driver ( Total discounts - ._, ------- Discounts per vehicle ( ..... 2-:..00_1 _Fo'--r_d_T_ru_c_k_F_15_0 ____________ ~===--"'- Anti-theft $0.70 Multiple Policy $5.00 ( 2016 Chevrolet Malibu Anti-theft $2.00 Multiple Policy $9.30 Listed drivers on your policy Christopher Lee Arlene Lee Excluded drivers from your policy None Good Driver (20%) Distinguished Driver Good Driver (20%) Distinguished Driver Polic number 699812 83 Your policy provided by Allstate Northbrook Indemnity Company Policy period Beginning November 26, 2022 through May 16, 2023 at 12:01 a.m. standard time Your Allstate agency is La Habra Ins Agy 2013 E La Habra Blvd LA Habra CA 90631-4203 (562) 691-9175 CHADLUITWIELER@allstate.com Some or all of the Information on your Polley Declarations Is used in the rating of your policy or It could affect your ellglblllty for certain coverages. Please notify us Immediately if you believe that any Information on your Policy Declarations Is incorrect. We will make corrections once you have notified us, and any resulting rate adjustments, will be made only for the current policy period or for future policy periods. Please also notify us immediately if you believe any coverages are not listed or are inaccurately listed. DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D Renewal auto policy declarations Policy number: !699812 838! Policy effective date: November 26, 2022 Coverage detail for 2001 Ford Truck F150 Coverage Automobile Liability Insurance • Bodily Injury Limits $100,000 each person $300,000 each occurrence • Property Damage $100,000 each occurrence Auto Collision Insurance Not purchased* Page 2 of 4 Deductible Premium Not applicable - _A_u_to_C_o_m_p:_r_e_h_en_s_iv_e_l_ns_u_r_a_nc_e ____ A_ct_u_al_c_a_s_h_v_al_u_e ________ _;$_2_5_0 _________ -1_ Rental Reimbursement Not purchased* Towing and labor Costs Not purchased* Uninsured Motorists Insurance • Bodily Injury • Property Damage Automobile Medical Payments $15,000 each person $30,000 each accident $3,500 each accident Not purchased* Coordinated Medical Protection Not purchased* Sound System Not purchased* Tape Not purchased* Not applicable - (._T_ot_a_l'-pr_e_m_iu_m_fo_r_2_0_0_1_F_o_rd_T_r_u_ck_F1_50 ________________________ --'W * This coverage can provide you with valuable protection. To help you stay current with your insurance needs, contact your Allstate agent to discuss coxerage options and other products and services that can help protect you. VIN 1FTRX17l 11NA76372 Rating information Your premium is determined based on certain information, including the following: • This vehicle is driven for business use, married person licensed 53 years. Allstate uses mileage information as one factor to help determine your premium amount. Important Note: The annual mileage figure applicable to this vehicle for the expiring policy period was: 6,000 • 6,499, The annual mileage figure applicable to this vehicle for the current policy period is: 6,000 • 6,499. The required odometer information to calculate your annual mileage for the current policy period was not provided, was illegible, could not be obtained or the most recent odometer reading we received was less than a previous reading. If any of the information shown above is Incorrect, missing or changes in the future, please contact your Allstate representative. Please keep In mind that a change in any of the information may result in an adjustment to your premium. 0 00 "' 9 5 DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D Renewal auto policy declarations Policy number: I 699 812 838 i Policy effective date: November 26, 2022 Page 3 of 4 ~ Allstate . Coverage detail for 2016 Chevrolet Malibu Coverage Limits Deductible Premium ----=----------------------------------------Auto mob i I e Liability Insurance Not applicable • Bodily Injury • Property Damage Auto Collision Insurance Waiver of deductible applies Auto Comprehensive Insurance Rental Reimbursement Towing and Labor Costs Uninsured Motorists Insurance for Bodily Injury Automobile Medical Payments Coordinated Medical Protection Sound System $100,000 each person $300,000 each occurrence $100,000 each occurrence Actual cash value Actual cash value Not purchased* Not purchased* $15,000 each person • $30,000 each accident Not purchased* Not purchased* Not purchased* Tape Not purchased* (Total premium for 2016 Chevrolet Malibu * This coverage can provide you with valuable protection. To help you stay current with your insurance needs, contact your Allstate agent to discuss coverage options and other products and services that can help protect you. $500 $250 Not applicable VIN 1G11C5SA4GF122987 Rating information --- - Your premium is determined based on certain informati9n, including the following: • This vehicle is driven 3-9 miles to work/school, married person licensed 52 years. Allstate uses mileage information as one factor to help determine your premium amount. Important Note: The annual mileage figure applicable to this vehicle for the expiring policy period was: 12,000 -12,499. The annual mileage figure applicable to this vehicle for the current policy period is: 12,000 -12,499. The required odometer information to calculate your annual mileage for the current policy period was not provided, was illegible, could not be obtained or the most recent odometer reading we received was less than a previous reading. If any of the information shown above is incorrect, missing or changes in the future, please contact your Allstate representative. Please keep in mind that a change in any of the information may result in an adjustment to your premium. Additional coverages Automobile Death Indemnity Insurance Not purchased* Automobile Disability Income Protection Not purchased* (continued) 0 co ex 0 5 i5 DocuSign Envelope ID: 502C2435-B7A7-425F-9953-4EB3D18D655D Renewal auto policy declarations Policy number: !699 812 838! Policy effective date: November 26, 2022 Identity Theft Expenses Not purchase1:I* * This coverage can provide you with valuable protection. To help you stay current with your insurance needs, contact your Allstate t1gent to discuss coverage options and other products and services that call help protect you. Your policy documents Page4of4 Your automobile policy consists of this Policy Declarations and the documents in the following list. Please keep these together. • Allstate Automobile Policy -AU104-3 • California Amendatory Endorsement -AU14629-3 • Amendment of Policy Provisions -AU14626-1 • California Paperless Disclosure -AU14943 Important payment and coverage information Here is some additional, helpful information related to your coverage and paying your bill: ►Your rate is lower because you are insuring multiple cars. ►Your bill will be sent to you in a separate mailing and will list any payment option(s) available to you. If you are eligible to pay your premium in installments, your first bill will reflect your available payment options, including the option to pay in full or to pay in monthly installments. Please note that any amounts payable for the first renewal bill will not include an installment fee (unless you have an unpaid balance from a previous policy period, in which case the Minimum Amount Due will include an installment fee, or unless you are participating in the Allstate Easy Pay Plan). The following applies t o installment payments made after your first renewal bill. l{you decide to pay your premium in installments, there will be a $3.50 installment fee charge for each paymen~ due. If you make 6 installment payments during the policy period, and do not change your payment plan method, then the total amount of installment fees during the policy period will be $21.00. If you are on the Allstate® Easy Pay Plan, there will be a $1.00 installment fee charge for each payment due. If you make 6 installment payments during the policy period, and remain on the Allstate® Easy Pay Plan, then the total amount of installment fees during the policy period will be $6.00. If you change payment plan methods or make additional payments, your installment fee charge for each payment due and the total amount of installment fees during the policy period may change or even increase. Please note that the Allstate® Easy Pay Plan allows you to have your insurance payments automatically deducted from your checking or savings account. · Allstate Northbrook Indemnity Company's Secretary and President have signed this policy with legal authority at Northbrook, Illinois. Phil Telgenhoff President Susan L. Lees Secretary 0 a:, a: 0 ~