HomeMy WebLinkAboutSTEPHANIE MILESCity of Santa Ana
Clerk of the Council
AGREEMENT TERMINATION FORM
Please complete this form in its entirety when the attached agreement and all
amendments (if any) are no longer in effect.
Note: If your agreement is grant related, please ensure that all grant retention requirements
have been satisfied prior to signing the termination form.
Is the agreement(s) a permanent record? Yes No
Return form to the Clerk of the Council Office (M-30).
Call 647-1520 if you have any questions.
The agreement with
N-2021-005
No. was completed on
(List aff amendments. Use space below if needed.)
i.lagreementsWormWcrm - agreement termination form—goldenrod.doc
COTC Office Use Only
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and final payment has been made.
Department: CAA I Nfi5 3 11yt
Phone/Ext.: !,3gc5 0� 5355
Signature: G�Ckrl y�
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N-2021-005
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Utility Box
ARTIST &AGREEMENT
0%c La (TYaAiLt)FA
This agreement Is made and entered into as of November 21, 2020, by and between
the City of Santa Ana, a charter city and municipal corporation (hereinafter "City"), and
,gn\Aen6;t, (hereinafter "Artist") selected to participate in the
Utility Box Art°Program.
In consideration of the promises contained herein, the receipt and adequacy of which is
hereby acknowledged, the parties hereto agree as follows:
A. Preparation
1. The Artist shall view a pre-recorded video by the City regarding painting
guidelines and safety prior to starting work. In the video City staff will Identify any
electronics, equipment, and other facilities on the exterior of the utility box which
shall not be painted, including:
a. Official plaques, stickers, or identification numbers
b. Meter clocks
c. Keyholes or keyhole covers
d. Vents or viewports
e. Handles on doors and hinges
2. The boxes will be power washed by the City before painting starts; however, the
Artist will have the responsibility for any additional cleaning, prepping, and
priming prior to painting.
B. Materials
I. Artist will use paint type and paint products recommended by the City which are
the following:
a. Paint Type: Premium high solids 100% acrylic latex waterbome exterior
wail and trim paint; low sheen, eggshell or satin finish; minimum 1.5 mil
dry thickness per coat.
b. Paint Products (in recommended order):
I. Nova Color (available in wholesale at: www.novacolorpaint.com)
ii. Sherwin Williams: Accolade Exterior Acrylic Latex, Satin
iii. Frazee #126 Mirro Glide Low Sheen Acrylic Latex
iv. Pratt and Lambert: Accolade Exterior Acrylic Latex, Eggshell
2. Artist will purchase the needed paint and supplies, Including paintbrushes, paint
rollers, rolling pans, drop cloth, masking tape, latex gloves, and cups for
blending/mixing paint. Artist must provide their own additional supplies if
needed.
3. Artist will submit a list of paint products used for project, including brand name
(ex: Sherwin Williams), paint type (ex: acrylic latex), sheen (ex: satin), and color
number (ex: #126).
C. Project
1. Artist will paint the utility box assigned to them by the City, and nothing more.
Painting of the box must be completed by January 31 2021. Painting may only
occyr during the hours of 7 a.m. to 7 p.m. A minimum sidewalk clearance of four
(4) feet must be adhered to at all times.
2. Artist utility box is located on I 14UI i rl -c w u( 'A kod re'>a fr). 1. M i_ ;:'. 1411r)
Title of artwork: (� --e �`n b I � D�e_ 'u
3. Artist shall inform City staff the days and hours they are planning on v�orking on
the box so that staff will communicate with appropriate city agencies such as
Public Works and Santa Ana Police Department.
4. Artwork must Include all visible sides of the utility box including the top.
5. The Artist shall provide for City maintenance, operations, and emergency access
to their respective utility box at all times.
6. Artist recognition via signature on the utility box may be no larger than 3" x 5",
7. Artwork may not contain advertising, religious art, sexual content, negative or
violent imagery, convey political partisanship or include any hidden, subliminal or
camouflaged messages or statements of any kind or nature.
8. Artwork may not include any breach of intellectual property, trademarks, brands,
Images of illegal activity or involve the attachment of any objects to the box.
9. The Artist shall ensure that any areas utilized for the project are maintained and
restored to a well -maintained, safe, sanitary, and clean condition, and kept free
of any hazardous waste at all times. All equipment associated with the
installation of the artwork, trash and debris shall be removed and cleaned up on
a daily basis. Artist shall place a drop cloth or similar barrier on the ground below
the artwork while installation is underway, which barrier shall be removed each
day upon completion of an installation session.
D. Property Rights
1. The Artist hereby waives any legal rights under Federal, State, local, and/or
Administrative law to maintain the artwork upon City property. The completed
work will be the property of the City, which retains the sole and absolute right and
discretion to remove, modify, or replace the utility box, components of the utility
box, or the artwork if necessary without compensation or notice to the artist.
2. The Artist grants the City the right to use any images, photographs or video of
the artwork and the installation process for publicity or promotional purposes and
agree that the results of such activity shall remain the sole property of the City,
E. Payment
City agrees to pay, and Artist agrees to accept as an amount not -to -exceed $400
during the term of this Agreement. Compensation shall be divided into two (2)
separate payments. The first amount in $300 shall be Issued after final execution
of the Agreement. The final payment of $100 shall be issued upon the
completion of the project.
2. Payment by City shall be made within forty-five (45) days following receipt of
proper invoice evidencing work performed, subject to City accounting
procedures, and five (5) photographs documenting the completion of artwork on
all five sides of the assigned utility box. Payment need not be made for work
which fails to meet the standards of performance set forth in the Recitals which
may reasonably be expected by City.
F. Indemnity and Release of Liability
1, Artist shall defend, indemnify, protect and hold harmless the City, or their elected
and appointed officers, employees, members or agents from and again all claims
for damages, liability, cost and expense (including without limitation attorney's
fees) arising out of or alleged by third parties to the by the result of the negligent
acts, errors or omissions or the willful misconduct of tl e Artist, and Artist's
employees, subcontractors or other persons, agencies or firms for whom Artist is
legally responsible in connection with the execution of the work covered by this
agreement. Artist shall have no duty to indemnify or hold harmless the City if
claims, damages, liability, costs, expenses (including without limitation, attorney's
fees) arise from the sole negligence or sole willful misconduct of the City
subsequent declaration by the Artist. Artist's obligations shall survive the
termination of this Agreement.
2, Artist agrees to hereby fully release and forever discharge the City from any and
all claims, demands, damages, losses, and liabilities (hereinafter collectively
referred to as "claims"), which are or may be related to or in any way connected
with the negligence or willful misconduct of its officers, officials, employees, or
agents in connection with the creation, painting or installation of the artwork.
3. To protect the City, Artist shall execute a Release of Liability before participating
in the Utility Box Art Program, A true and correct copy of the Release of Liability
form is attached hereto as Exhibit A and incorporated herein by this reference.
All terms and requirements of the Release of Liability shall be enforceable in
addition to all terms and requirements of this Agreement.
ELM
If any component of the City's traffic signal system is damaged as a result of the
artists' work, the artist shall arrange for a licensed contractor to repair the
damage at the artists' sole expense.
2. The artist has the first option to repair artwork if damaged. When vandalism to
the artwork is reported or touch-up to the artwork is needed, the City will contact
the artist for first refusal, and the artist will be given 30 days to respond. if there is
no response within that timeframe or if the artist declines, the City reserves the
right to repair, remove, or modify damaged artwork as it sees fit.
3. it is the responsibility of the artist to update the City with their current contact
information so that staff can contact them should repairs be necessary.
H. Termination
The City may terminate this Agreement at any time for any reason. If the
Agreement is terminated by the City after the painting of a utility box has
commenced, Artists shall be entitled to reasonable compensation for work
performed to date, minus any offset representing the City's damages should
termination result from Artist's breach of contract. Artist hereby expressly waives
any and all claims for damages or compensation arising under this Agreement
except as set forth herein.
1. General Terms
t. Artist is not and any of the Artist's agents, employees or representatives are, for
all purposes under this agreement, an Independent contractor and shall not be
deemed to be an employee of the City, and none of them shall be entitled to any
benefits to which City employees are entitled including but not limited to,
overtime, retirement benefits, work's compensation benefits, injury leave or other
leave benefits.
2, Neither party shall assign any rights or obligations under this Agreement.
0
3. Each party covenants that it presently has no interests and shall not have
Interests, direct or Indirect, which would conflict in any manner with performance
of services specified under this Agreement.
4. Each party warrants that they have executed this Agreement knowingly, freely
and voluntarily and with full knowledge of its legal consequences. All parties
involved warrant and represent that, prior to executing this Agreement, each
party has had the opportunity to review and consider this matter with legal
counsel, and that the terms of this Agreement, and its consequences, are fully
understood by each party.
5. This Agreement represents the entire agreement and understanding between the
parties, and supersedes any and all prior agreements and understandings
'between the parties, whether oral or written.
6. Each undersigned represents and warrants that its signature herein below has
the power, authority and right to bind their respective parties to each of the terms
of this Agreement, and shall indemnify City fully, including reasonable costs and
attorney's fees, for any injuries or damages to City in the event that such
authority or power Is not, in fact, held by the signatory or is withdrawn.
N-2021-005
IN WITNESS WHEREOF, the parties hereto have executed this Agreement thg date
and year first above written.
,ATTEST:
paisy Gomez
-LGierk of the Council
VoRovep AS TO FORN4:
SONIA R, CARVALHO
City Attorney
i
l' r
By:
Ryan O. Hodge,
Assistant City Attorney
R€COIYIMEND~ D FOR APPROVAL:
Steven Mendoza
Executive Director
Community Development Agency
CITY OF SANTA ANA
Kristine Ridge
City Manager
ARTIST:
Print Name:
Address: i `� t �, C �� ��� le '� {
Utility Box Art Program
RELEASE FROM LIABILITY
Personal Information (Please print)
Pull Name:
Address:
City: Ln A a,,i State: r= Zip:
Emergency Contact: Van �C'I -7�t l i 1 'ty
Social Security(individual'Fax Payer ID (MIN) #: (2' ( 32 - 56 °<
Waiver and Liability Release
I have read and understand the Artists Agreement and will adhere to the rules and regulations set
forth wherein and act in a respectful manner while representing the City of Santa Ana. I assume
the responsibility of mental and physical fitness to participate in the assignment, and agree to abide
by all rules and requirements of the program. I also understand that failure to abide by the above
may lead to my termination from the program.
I understanl that I am not considered an employee of the City of Santa Ana for purposes of
Workers' Compensation, but that the City provides volunteer accident insurance in expess of any
other medical insurance I may have. I agree to comply with the City's policy regarding any Injuries I
Incur while under the City's supervision.
I agree to hold harmless the City of Santa Ana, its officers, employees and volunteers from and
against any and all liability arising out of or in any way connected with my participation in the
program. This release shall apply even though liability may arise out of negligence or carelessness
on the part of those discharged including their employees, agents and volunteers.
This waiver and liability release shall apply to myself, as well as any of my heirs, executors or
administrators,
I am of lawful age and legally competent to sign this agreement. I understand the terms and have
signed this document as my own free act.
I have fully informed myself of the contents of this release by reading it before I signed it. I realize
that by signing this document I am giving up legal rights to which I may be entitled.
pnitial) I have watched and understand the instructional and safety video for
pa sting my artwork on the city -owned utility box assigned to me,
located an
Title of artwork:
Signature L----- Print d Name
Date
Burns &
Wilcox
Digitally signed by
Francine R.
Francine R. Villareal
Date: 2020.12.17
Villareal
15:13:48-08'00'
101 California Street, Suite 975, San Francisco, CA 94111
Phone: (415) 421-4244 OR (800) 759-4855 Fax: (415) 421-0620
DATE:11/19/2020 INSURANCE BINDER Pagel of
THIS BINDER ISATEMPORARY INSURANCE CONTRACT, SUBJECTTO THE CONDITIONS SHOWN BELOW,
INSURED: City of Santa Ana B&W PRODUCER: Richard L Goblet
AGENT: MERRIWETHER & WILLIAMS INS
20 Civic Center Plaza 550 Montgomery St Ste 550
Santa Ana, CA 92701 San Francisco, CA 94111
LOCATION(S) OF RISK:
1. Main/Chesnut - SW Corner, Santa Ana, CA 92701
2. Main/Civic Center, Santa Ana, CA 92701
3. Main/McFadden - SW Corner, Santa Ana, CA 92701
4. Main/Bishop (SIGNAL), Santa Ana, CA 92701
5. Main/Cubbon - NW Corner, Santa Ana, CA 92701
6. Main/Russell - NW Corner, Santa Ana, CA 92701
7. Main/Borchard NW Corner, Santa Ana, CA 92701
8. Main/Edinger SW Corner, Santa Ana, CA 92701
9. Main/Pomona SE Corner, Santa Ana, CA 92701
10. Main/St. Andrew - NE Corner, Santa Ana, CA 92701
11. Main/St Gertude SE Corner, Santa Ana, CA 92701
12. Bristol/Santa Clara, Santa Ana, CA 92701
13. Bristol/Washington, Santa Ana, CA 92701
14. Bristol/19th St, Santa Ana, CA 92701
15. Bristol/Civic Center Drive, Santa Ana, CA 92701
16. Bristol/Bishop or Willits, Santa Ana, CA 92701
17. Bristol/McFadden, Santa Ana, CA 92701
18. Bristol/Wilshire, Santa Ana, CA 92701
19. Bristol/Edinger (Signal Box), Santa Ana, CA 92701
20, Bristol/Edinger (HUB), Santa Ana, CA 92701
21. 1st Street/Main St, Santa Ana, CA 92701
22. 3rd Street and Main, Santa Ana, CA 92701
23, 4th Street and Main, Santa Ana, CA 92701
24, 3rd Street and Broadway, Santa Ana, CA 92701
25. 1st Street/Downtown Plaza, Santa Ana, CA 92701
26. Main St. and Washington, Santa Ana, CA 92701
27, Raitt Street and MacArthur Blvd., Santa Ana, CA 92701
28. Greenville and Alton, Santa Ana, CA 92701
29. Flower St. and Washington, Santa Ana, CA 92701
30. Flower St. and Bishop, Santa Ana, CA 92701
31. Flower St. and Alton, Santa Ana, CA 92701
POLICY EFFECTIVE FROM: 11/09/2020 AT 12:01 AM TO 01/31/2021 AT 12:01 AM STD TIME AT RISK LOCATION,
FORM OF COVERAGE: COMMERCIAL GENERAL LIABILITY OCCURRENCE
POLICY NO: CIP423084
INSURER(S):
Risk Management Division
3 < REAI D&APPR.o�vFm BYs:
�Risk PJanagement Analyst
Burns&
Wilcox
101 California Street, Suite 975, San Francisco, CA 94111
Phone: (415) 421-4244 OR (800) 759-4855 Fax: (415) 421-0620
DATE: 11/1912020 INSURANCE BINDER Page 3 of 4
"ENDORSEMENTS & EXCLUSIONS:
UNLPFD1 - COMMON POLICY DECLARATIONS.
AF001772 -CLAIM REPORTING INFORMATION.
AF100 - POLICY JACKET.
AF3380 - FRAUD & MISREPRESENTATION ENDORSEMENT.
AF3550 - MINIMUM EARNED PREMIUM & CANCELLATION CLAUSE.
AF900 - SERVICE OF SUIT.
IL0017 - COMMON POLICY CONDITIONS.
SOFAE - SCHEDULE OF FORMS & ENDORSEMENTS.
AF000839 -INJURY TO EMPLOYEES, SUBCONTRACTORS, INDEPENDENT CONTRACTORS, TEMPORARY WORKERS,
LEASED WORKERS OR VOLUNTEERS EXCLUSION.
AF001007 - COMBINED COVERAGE & EXCLUSION ENDORSEMENT: ASBESTOS EXCLUSION; LEAD EXCLUSION;
CONTRACTOR'S SPECIAL CONDITIONS; EMPLOYMENT RELATED PRACTICES EXCLUSION; NUCLEAR ENERGY LIABILITY
EXCLUSION; PROFESSIONAL SERVICES AND MALPRACTICE EXCLUSION; SEXUAL / PHYSICAL ABUSE EXCLUSION;
TOTAL POLLUTION EXCLUSION WITH HOSTILE FIRE EXCEPTION; ASSAULT & BATTERY EXCLUSION; ANTI -STACKING
AND NONDUPLICATION OF LIMITS OF INSURANCE, TENDERING OF APPLICABLE LIMIT OF INSURANCE.
AF001396 -INFRINGEMENT, MISAPPROPRIATION AND UNFAIR COMPETITION EXCLUSION.
AF001707 -AMENDMENT OF NONPAYMENT CANCELLATION CONDITION.
AF001729 -CONDITIONAL EXCLUSION OF LIABILITY/CLAIMS IN THE STATE OF MISSOURI -ONLY APPLIES IF MISSOURI
IS PRINCIPLE PLACE OF BUSINESS OR RISK CONDUCTS MORE THAN 10% OF OPERATIONS IN MISSOURI.
AF001752 -AMERICANS WITH DISABILITIES ACT AND DISCRIMINATION EXCLUSION.
AF3378 - AMENDATORY ENDORSEMENTS: CANCELLATION, CANCELLATION OF FINANCED POLICY, AUDIT
CONDITIONS.
AF3400 - SILICAOR SILICARELATED DUST EXCLUSION.
UNLPFSD1L -COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS.
AF001788 -TOTAL CANNABIS AND RELATED PRODUCTS EXCLUSION.
CG0001 - COMMERCIAL GENERAL LIABILITY COVERAGE FORM - CG0001 04-13,
CG2107 -ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION AND DATA -RELATED LIABILITY
EXCLUSION.
CG2167 -FUNGI OR BACTERIA EXCLUSION ((DOES NOT APPLY TO GOODS OR PRODUCTS INTENDED FOR BODILY
CONSUMPTION).
CG2426 - AMENDMENT OF INSURED CONTRACT DEFINITION.
AF001401 -DAMAGE TO PREMISES RENTED TO YOU LIMITATION -FIRE LEGAL LIABILITY COVERAGE.
AF000873 -KNOWN INJURY OR DAMAGE EXCLUSION FOR PERSONAL & ADVERTISING INJURY.
AFOOD899 -CLARIFICATION AMENDMENT TO POLICY AIRCRAFT, AUTO OR WATERCRAFT EXCLUSION.
D2 -CALIFORNIA SURPLUS LINES NOTICE.
CAPRNOTICE -CALIFORNIA PREMIUM REFUNDS NOTICE -POLICIES CANCELED BY INSURED MAY INCUR A 10%
SHORT RATE PENALTY.
CG3234-CACHANGES.
AF001740 -DESIGNATED OPERATIONS -STATE OF NEW YORK EXCLUSION.
AF001741 - DESIGNATED OPERATIONS -STATE OF WASHINGTON EXCLUSION.
AF33509 - ASSAULT & BATTERY EXCLUSION REMOVAL (ENDORSEMENT TO REMOVE A&B EXCLUSION).
AF33510 - CLASSIFICATION LIMITATION.
AF33515A -NEW RESIDENTIAL CONSTRUCTION EXCLUSION.
AF33530 - SUBSIDENCE EXCLUSION.
AF3397 - EIFS EXCLUSION & DRYWALL EMISSION EXCLUSION.
CG0300 - DEDUCTIBLE LIABILITY.
CG2144 - LIMITATION OF COVERAGE TO A DESIGNATED PREMISES f PROJECT.
TYPIST: IN THE PROJECT BOX, TYPE THE FOLLOWING "ELECTRICAL / UTILITY BOX PAINTING FOR CITY OF SANTA ANA "
CG2154 - OCIPANRAP-UP EXCLUSION,
GLS 261s - ADDITIONAL INSURED - INDPENDENT CONTRACTOR (SCOTTSDALE FORM - SEE NEXT PAGE)
CONDITIONS:
Risk Manegonmi Dhtkm
REAEWEc&E0BY:,Risk lvlanageAnalyt
24p� d
F f.
03
LIM
i
101 California Street, Suite 975, San Francisco, CA 94111
Phone: (415) 421-4244 OR (800) 759-4855 Fax: (415) 421-0620
DATE:11/19/2020 INSURANCE BINDER Page 4of4
QUOTE BASED ON ONE MULTI BOX PROJECT AT FLAT RATE
MINIMUM PREMIUM APPLIES
NO A/l'S INCLUDED.
PLEASE REVIEW THIS BINDER CAREFULLYAS IT MAY DIFFER FROM COVERAGES AND LIMITS REQUESTED,
THIS COMPANY BINDS THE KIND(S) OF INSURANCE STIPULATED HEREIN. THE ABOVE COVERAGES ARE THE ONLY COVERAGES BOUND.
ANY COVERAGE REQUESTED IN THEAPPLICATION THAT DIFFERS FROM THE ABOVE IS NOT INCLUDED. THE INSURANCE IS SUBJECT TO
THE TERMS, CONDITIONS, LIMITATIONS, AND FORMS OF THE POLICY(S) IN CURRENT USE BY THE COMPANY. THIS BINDER IS
CANCELLED SIXTY (60) DAYS FROM THE EFFECTIVE DATE OR WHEN REPLACED BY A POLICY, WHICHEVER COMES FIRST.
THE AGENT MUST READ THIS CERTIFICATE AND IF NOT CORRECT RETURN IT IMMEDIATELY TO BURNS & WILCOX, LTD.
BY: Harvey Goldenberg, Authorized Representative (CA INS LIC # 0828615)
Risk ManeganmtDW[on
�� n� REVIEWED&j}APPPf'R'1 VED BY,
—"=2"' Ri5k1M.anagement Analyst
GENERAL CHANGE ENDORSEMENT
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below:
Name of Insurance Company(ies)
Atain Specialty Insurance Company Atain Spec Insurance Company 100.0% GenLiab
Inception Date Expiration Date
11/9/2020 1/31/2021
Endorsement Effective Policy Number Endorsement #
11/9/2020 1 CIP423084 1
Named Insured
City of Santa Ana N(VW#
Countersigned By
(Authorized Representative)
IN CONSIDERATION OF TIM PREMIUM PREVIOUSLY CI-IARGED, IT IS HEREBY UNDERSTOOD AND AGREED
THAT TIi}3 POLICY IS AMENDED AS FOLLOWS:
THE SCHEDULE OF LOCATIONS IS HEREBY AMENDED TO READ FOR. NO FURTHER CHARGE:
LOCATION#1: 1 ST STREET/MAIN ST., SANTA ANA, CA 92701
LOCATION#2: 31? D STREET/ MAINST. SANTAANA, CA 92701
LOCATION43: 4TH STREET LOCATIONk /MAIN ST. SANTA AAA, CA 92701
LOCATION44: 3RD STREET/BROAD WAY, SANTA ANA, CA 92701
LOCATION#5: 4THSTREET/BROADiPA1; SANTAANA, CA 92701
LOCATION#6: 57'HSTREET/BROADiPAI; SANTA ANA, CA 92701
LOCATION47: 47II STREET/BUSH, SANTA ANA, CA 92701
LOCATION#8: 1ST STREET/BRISTOLSTREET, SANTA AAA, CA 92701
LOCATION0. 17TH STREET/BRISTOL STREET, SANTA AM, CA 92701
LOCATION#10: MACARTHUR BLVD/BRISTOL STREET, SANTAANA, CA 92701
LOC4TION411: AVINSTREET/MCF.4DDENAVE., SANTAANA, CA 92701
LOCATION412: HARBOR BLVD/MCFADDENAVE., SAIM ANA, CA 92701
LOCATION#13: GRAND/DYER, SANTA AAA, CA 92701
LOCATION#14: 17TH STREET/CENTRE ON 17TH, SANTA ANA, CA 92701
LOCATION015: 1ST STREET/DOWNTOWNPLAZA, SANTAANA, CA 92701
LOCATION416: MAIN/WASHINGTOA, SANTAAAA, CA 92701
LOCATION#17: RAITT/MACARTHUR BI,VD., SANTA ANA, CA 92701
LOCATION418: GREENVILLE✓ALTON, SANTA ANA, CA 92701
LOCATION#19: MATNS7RET"P/YVARNERAVE., SANTAANA, CA 92701
LOCATION920: FLOkTIERSTREET/BISHOP, SANTA AAA, CA 92701
All other terms and conditions remain unchanged.
knhom 12/4/2020
Risk Mansgmed Dhisfon
� } REAEWEo&pAPPR APPROVED
BY:
M
Ruk ManaBemenC nnalyst