CITY-STATE-ZIP: Cb^QnCv^rq^h £U331 - City of Ormond …

City of Ormond Beach22 South Beach Street

Ormond Beach, Florida 32174Telephone (386) 676-3223

Fax (386) 676-3374

REQUEST FOR PROPOSALSPROPOSER ACKNOWLEDGEMENT FORM

THIS FORM MUSTBE COMPLETED AND RETURNED WITH YOUR PROPOSAL

RFP TITLE: Temporary Personnel Staffing Services

RFP NUMBER: 2012-16

RFP OPENING DATE & TIME: 4/23/2012 2 p.m.

RFP OPENING LOCATION: 2nd Floor City Hall

PRE-SUBMITTAL MEETING: NA

Submittals Received After The Above Date And Time Will Not Be Accepted.

PROPOSER'S NAME: 1WV^dlA W^*uQ{yH Ulfillj/PROPOSER'S MAILING ADDRESS: llMQVVVcfl^ Q*XaOpU ff\"CITY-STATE-ZIP: Cb^QnCv^rq^h £U331 \̂ \F.E.I.N.: UQ~ UbjyJL)?)PHONE NUMBER: 3%jrufe~ 7fl&\ FAX NUMBER: 3^tg~ tjltWoHQIf returning as a "No Submittal", please state reason (s):

I certify that this Proposal is made without prior understanding,agreement, or connection with any corporation, firm, or personsubmitting a Proposal for the same materials, services, supplies, orequipment, and is in all respects fair and made without collusion orfraud. I agree to abide by all conditions of this RFP and certify that Iam authorized to sign this RFP for the Proposer. In submitting a RFPto the City of Ormond Beach, the Proposer offers and agrees that if theProposal is accepted, the Proposer will convey, assign or transfer to theCity of Ormond Beach all rights, title, and interest in and to all causesof action it may now or hereafter acquire under the Antitrust laws ofthe United States and the State of Florida for price fixing relating tothe particular commodities or services purchased or acquired by theCity of Ormond Beach. At the City's discretion, such assignment shallbe made and become effective at the time the City tenders finalpayment to the Proposer.

IGNATURE (MANUAL)

iQiAnovoCTrHjiSJ NAME (TYPED)

(J TITLE (^

DATED

Page 1 of35

a. Yes, the City of Ormond Beach will require evidence of the servicebond at the same time the Certificate of Insurance is provided, atthe time of the award.

In all other respects, except as specifically stated herein, the subject RFP remainsunchanged.

THIS ADDEDNDUM MUST BE ACKNOWLEDGED AND

RETURNED WITH YOUR RFP

COMPANY NAME

SIGNATURE:

The foregoing changes are hereby incorporated into the Request for ProposalsRequirements andContract Documents for Temporary Personnel StaffingServices, RFP 2012-16, for the City ofOrmondBeach.

City ofOrmond Beach, FloridaCounty of Volusia

END OF ADDENDUM NO. 1

Table of Contents

1. Title Page2. Acknowledgment to Addendum No. 13. Table ofContents

4. Transmittal Letter

5. Remedy Intelligent Staffing Profile Sheet6. Detailed Technical Proposal (Pages numbered 1-12)

Cover Sheet

Independence and Conflict of Interest StatementSimilar Client Base

Recruitment StrategyRemedy's QualificationsResponsibilities ofRemedyRemedy X-Ray ScreeningKnowledge BankAssociate Retention

Sole Provider AdvantagesAdditional Services Offered

Why RemedyNumber of Job Classifications, Positions and Rates

7. Attachment A - Price Sheet

8. Conflict, Non-Conflict of Interest, Litigation Statement9. Drug Free Workplace Certification10. RFP Response Form Page 111. RFP Response Form Page 212. Current City of Ormond Beach Business License13. Current Volusia County Business License14. Current City ofDaytona Beach Business License15. Service Bond, labeled "Certificate ofProperty Insurance"16. Copy of Current Insurance Policy

Remedyintelligent staffing

Phone: 386.615.8859

Fax: 386.615.6412

1140 Pelican Bay • Daytona Beach, FL 32119A Franchise of Remedy IntelligentStaffing, Inc.

Transmittal Letter

April 20, 2012

To Whom It May Concern:

We appreciate the opportunity to submit our bid for temporary employment servicesfor the City of Ormond Beach. Listed below are some of the qualifications whichadvocate us a responsive and responsible service provider. These items will be ineffect for the duration of the contract with the City.

• We have two full time offices located in Daytona and Deland for VolusiaCounty.

• We have been in business in Volusia County for fourteen years.

• Social security verification checks are ran on every new hire.

• We offer national background checks and the results are usually available in

less than 24 hours.

• Our drug tests are six panel and the results are available immediately.

• All paychecks are printed in our office which enables us to do payroll

adjustments without delay.

• After only eight hours of work we offer our temporary employees medical

insurance, dental insurance, short term disability and long term disability.

• Before applicants are given our application we have them take an advanced

technology screening called Insight. This is a hand held computerized

test which identifies and screens out workers who are prone to theft, violence

or substance abuse. Remedy has a patent on this technology.

• Our automated call system named MegaBlast enables us to reach hundreds of

qualified temporary associates within minutes, delivering a recorded personal

message about your job opportunity, shift changes or to make policy

announcements.

• Remedy is a full service staffing company which means we can help you fill

your hourly positions as well as your salary positions.

Respectful

rawnya Titus,Regional Manager

www.remedystaff.com

Remedyintelligent staffing

Remedy Profile Page

Phone: 386.615.8859

Fax:386.615.6412

1140 Pelican Bay • Daytona Beach, FL 32119A Franchise of Remedy IntelligentStaffing, Inc.

Who we are nationally:Remedy is national and part of The Select Family of Staffing Companies.Top 10 US Staffing Companies.Founded in 1965, merged with Select Personnel Services in 2006.Over 400 branches nationwide.

Employ 240,000 temporaries on assignment at 24,000 companies.More than $1.7 billion in revenues.Operate multiple offices to service specific client needs.All offices linked by one database. We all work together.

Who we are locally:• Local franchise owned and operated by Brian Rose since 1993.• 2 fully staffed offices in Volusia County - Daytona Beach and Deland.• Strong local involvement and accountability.• Experienced local team to better staff you

• Cheryl Ratcliff - Director of Business Development - 8 years tenure• Tawnya Titus - Regional Manager - 8 years tenure• Michael Messina - Recruiter- 2 years tenure• Tia Rainey - Senior Staffing Supervisor- 5 years tenure• Lisa Strickland - Staffing Supervisor - 6 years tenure• Carey Currie - Staffing Supervisor- 1year tenure• Carrie Pillblad - Staffingassistant - 1 year tenure• Enrico Paredes - On-Site Supervisor - 3 years tenure• Leslie Snyder - On-Site Supervisor - 2 years tenure

www.remedystaff.com

The City ofOrmondBeach,Florida

Independence and Conflict ofInterest Statements

This is an affirmative statement thatRemedy Intelligent Staffing has nointerest and shall not acquire anyinterest, direct or indirect, financial orotherwise, which would conflict in anymanner with the performance orservices provided. In the performanceof this contract, no subcontractor orperson having such an interest shall beemployed. We recognize and agree thatthe employees and contractors shall atall times be considered our employeesand not employed by the City of OrmondBeach, FL.

Remedy Intelligent Staffing or the firm'semployees have no relationships -professional, financial or otherwise withthe City or Ormond Beach or it'sofficials, employees or it's agencies.

Similar Client Base

City of Port Orange, FL - Heather Carrizales -386.506.5561 various positions filled - clerical, janitorial,Parks and Recreation summer program, etc. *Staffingsince 2012

County of Volusia, FL - Becky Bishop - 386.822.5764various positions filled - clerical, janitorial, maintenance,graphic designers, accounting, equipment operators, etc.*Staffing since 2009

APCO International - Ricky Marshall - 386.944.2481clerical, customer service and accounting positions*Staffing since 2006

Palm Coast Data - Deb McLaughlin - 386.447.2461clerical, janitorial, machine operators, sorters, accounting,etc. *Staffing since 2007

U.S. Foodservice - Susan Neff - 386.763.6183 various

positions filled - clerical, accounting clerks, equipmentoperators, packagers, inventory *Staffing since 2005

4/20/2012

Recruitment Strategy*Remedy is an Equal Opportunity Employer*

Job Fairs

Aggressive Advertising• Newspapers

• Internet Websites - Careerbuiler, Craigslist, Hot Jobs, LocalNewspaper SitesMagazines

• Welcome Packages

Local Job Postings• Colleges• Churches

• One Stop Career Center

Flyers. YMCA

• Laundromats

• Apartments

Associate Referral Bonuses

Client Referrals/ NetworkingOn-line application via website www.remedvstaff.comCrossover Placement

Mega, Blast (Our Automated call system which enables us to reach hundreds ofqualiTied candidates within minutes)

4/23/2012

Remedy's Qualifications

Who we are locally:Local franchise owned and operated by Brian Rose2 fully staffed offices in Volusia County - DaytonaBeach and Deland

Strong local involvement and accountabilityExperienced local team to better staff you- Cheryl Ratcliff - Director of Business Development -

8 years tenure- Tawnya Titus - Regional Manager - 8 years tenure- Michael Messina - Recruiter - 2 years tenure- Tia Rainey - Senior Staffing Supervisor - 5 years

tenure

- Lisa Strickland - Staffing Supervisor - 6 years tenure- Carey Currie - Staffing Supervisor - 1 year tenure- Carrie Pillblad - Staffing assistant - 1 year tenure- Enrico Paredes - On-Site Supervisor - 3 years

tenure

- Leslie Snyder - On-Site Supervisor - 2 years tenure

4/20/2012

esponsibilities ofRemedy

\ome oj our services will include:

• Recruiting, screening, placement and retention

• Tracking associate attendance and production standards

• Handling terminations upon The City of Ormond Beach'ssupervisor's request

• Helping The City of Ormond Beach maintain safety and securityprocedures

• Arrival checks

• Conducting orientations, safety video and evaluations

• Payroll

• Paycheck delivery

• One accurate invoice for billing

• Providing management reporting

• Developing a continuous improvement plan

4/20/2012

Screening-RemedyX-Ray»

Remedy X-Ray reveals answers to critical integrity questions.Nothing puts your company at risk more than a worker who is prone to theft,violence or substance

abuse. That's why we have initiated a powerful new self-screening system calledRemedy X-Ray thatquickly identifies and screens out undesirable job candidates who have integrityproblems.

Positive Work Environment - By screening out high-risk candidates, Remedy X-Ray helps build amore positive environment where workers are more dependable, more focused andproductive.

Avoid Trouble - Remedy X-Ray identifies applicants predisposed to costly anddangerous behaviorsuch as theft, violence or drug use - so we can quickly eliminate them fromconsideration.

No Costly Surprises - What does it cost to have the wrong person on-site?•Employee theft is the cause of 70% of total inventory shrinkage.•One-third of all retail, health care and manufacturing employees admitted stealingfrom employers.

Remedy X-Ray Works! - A substantial percentage of 500,000candidates participating in integrity screening acknowledgedproblems:•10.4% admitted to illegal drug use•5.9% admitted to theft

•2.8% admitted to violence

4/23/2012

Knowledge Bank

Computer assessments tailoredspecifically to your industry

Over 2,000 assessments tochoose from

Conveniently accessible web-based system, workingcandidates can complete theirtesting at home, at night andover the weekend

Accurate detailed results

including how long eachapplicant took to answer eachquestion 4/20/2012

Associate Retention

Associate benefitsinclude:

Medical Insurance

Dental Insurance

Prescription DrugDiscounts

Vision Care Insurance

Term Life Insurance

401 (k) Plan

Performance Bonus

Longevity Bonus

Referral Bonuses

Free Software Training

Employee of The MonthAwards

Optional associate retention activities:

- Perfect Attendance Bonuses

- Productivity Bonuses

- Safety Bonuses

- Employee of the Month Recognition

4/20/2012

4/20/2012

Additional Service We

Offer

Payroll New Direct Hires- Advantages:

• Reduces hiring and firing cost -unemployment claims etc.

• Remedy's Thorough Screening -Knowledge Bank and Insightcompleted on all new hires

• Being able to get to know anemployee's work ethic before making ahiring commitment

4/20/2012

Why Remedy

2 offices with full staff to support your hiring needsRecruiting is our biggest investmentSocial security verification checks are ran on everynew hire

Drug test are administered in our office to ensureaccuracy and obtain immediate results as to notdelay the hiring processAll paychecks are printed in our office whichenables us to do payroll adjustments immediately.We bill one accurate invoice

Successful retention plan: medical and dentalinsurance offered after only eight hours work,longevity bonuses and safety bonusesWe are a full service staffing company whichmeans we can help you fill your hourly positions aswell as your salary positions.Track record for "doing what we say will do"

4/20/2012

Position Title PAY RATE BILL RATE MARK UP

Accounting Clerk $ 10.00 $ 12.90 29.00%

Accounting Clerk II $ 11.00 $ 14.19 29.00%

Mechanic II $ 11.00 $ 14.19 29.00%

Maintenance Worker 1 $ 8.50 $ 10.97 29.00%

Maintenance Worker II $ 9.50 $ 12.26 29.00%

Office Assistant 1 $ 9.00 $ 11.61 29.00%

Office Assistant II $ 9.50 $ 12.26 29.00%

Office Assistant III $ 10.00 $ 12.90 29.00%

Tradesworker $ 11.00 $ 14.19 29.00%

City of Ormond BeachTemporary Personnel Staffing Services

RFP 2012-16

Attachment "A"- Price Sheet

The purpose of this RFP is to establish firm fixed prices on an hourly rate for thefollowing job classifications. The proposer is not required to be able to supply all ofthe positions listed in order to be considered responsive and responsible. Please alsoprovide any additional job classification you wish to be considered for.

JOB CLASSIFICATION BILLING RATE PER HOUR

Accounting Clerk MagoMechanic II

sftJfiLMaintenance Worker I SI

S3Maintenance Worker II

Office Assistant M\.(MTradesworker

(flfcs ft

)m.tt

(Vfecfcfte

mn»*a.3fe*/330

Page 26 of 35

presentations. All expenses, including travel expenses for interviews shall be borne by theproposer.


RFP 2012-16

CITY OF ORMOND BEACH, FLORIDA

CONFLICT. NON-CONFLICT OF INTEREST STATEMENTLITIGATION STATEMENT

P<f Tothe best of ourknowledge, the undersigned firm has nopotential conflicts of interest dueto any other clients or contracts for this project.

[ ] The undersigned firm, by attachment to this form, submits information which may be apotential conflict of interest due to otherclients or contracts for thisproject.

[ ] Theundersigned firm has had no litigation on anyproject in the last five (5) years.

[ ] The undersigned firm, by attachment to this form, submits a summary and disposition ofindividual cases of litigation during the past five (5) years.

XOMPANYNAMEA/] Q A

AUTHORIZED SIGNATURE

riTLE (J (j

DATE

Page 14 of 35


RFP 2012-16DRUG-FREE WORKPLACE CERTIFICATION

IDENTICAL OR "TIE" SUBMITTALS: Preference shall be given to businesses with drug-freeworkplace programs. Whenever two or more proposals which are equal in respect to price, quality, andservice are received by the State or by any political subdivision for the procurement of commodities orcontractual services, a bid received from a business that certifies that it has implemented a drug-freeworkplace program shall be givenpreference in the award process. Established procedures for processingtie bids will be followed if none of the tied vendors have a drug-free workplace program. In order to havea drug-free workplace program, a business shall:

1) Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing,possession, or use of a controlled substance is prohibited in the workplace and specifying the actionsthat will be taken against employees for violations of such prohibition.

2) Inform employees about the dangers of drug abuse in the workplace, the business's policy ofmaintaining a drug-free workplace, any available drug counseling, rehabilitation, and employeeassistance programs, and the penalties that may be imposed upon employees for drug abuse violation.

3) Give each employee that engages in providing the commodities or contractual services that are underbid a copy of the statement specified in subsection (1).

4) In the statement specified in subsection (1), notify the employees that, as a condition of working on thecommodities or contractual services that are under bid, the employee will abide by the terms of thestatement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to,any violation of Chapter 893 or of any controlled substance law of the United States or any state, for aviolation occurring in the workplace no later than five (5 ) calendar days after such conviction.

5) Impose sanctions on, or require the satisfactory participation in a drug abuse assistance orrehabilitation program if such is available in the employee's community, by any employee who is soconvicted.

6) Make a good faith effort to continue to maintain a drug-free workplace through implementation of thissection. (j » V -\_.li< _ _\ ^L A/-.

Company NamcQ i>**!*~~\jcr^pr^—^

Authorjzfid-SignatureL—h

Print Nan^^^^

Page 15 of 35


RFP 2012-16

RFP RESPONSE FORM

THIS RESPONSE IS SUBMITTED TO:

Purchasing CoordinatorCity of Ormond Beach22 S. Beach Street

Ormond Beach, Florida 32174

The undersigned SUBMITTER proposes and agrees, if this Submittal is accepted, to enter intoa Contract with the CITY that is substantially in the form of this Request for Proposal (RFP)and to provide all services, as specified or indicated in the RFP Documents, in full accordancewith the terms and conditions set forth in therein.

SUBMITTER accepts all of the terms and conditions of the General Conditions.SUBMITTER will sign the Contract and submit the Contract security (when applicable) andother documents required by the Contract Documents within ten (10) days after the date ofCITY'S Notice ofAward.

In submitting this information, SUBMITTER represents, as more fully set forth in theAgreement, that:

SUBMITTER has examined copies of all the RFP Documents and of the followingAddenda:

Addendum Date Addendum Number

Receipt ofall ofwhich is hereby acknowledged.

This Submittal is genuine and not made in the interest of or on behalf of any undisclosedperson, firm or corporation and is not submitted in conformity with any agreement or rulesof any group, association, organization or corporation; SUBMITTER has not directly orindirectly induced or solicited any other Submitter to submit a false or sham Submittal;SUBMITTER has not solicited or induced any person, firm or a corporation to refrain frombidding; and SUBMITTER has not sought by collusion to obtain for himself any advantageover any other Bidder or over the CITY.

Page 16 of 35

THIS RESPONSE IS SUBMITTED BY:

^CTOR LICENSrNUMBER: _ 0.3ftliCon PlQ..CV

COMPANY NAME

VENDOR/CONTRACTOR LICENS_

ADDRESS: I<4 0 ffllCOTI So..

PHONE NO.: Q%S. 'Lsi\ J ^iT^Pj FAX NO.: 3%(j) -(jpl5 ^M)Q.

SUBMITTER'S NAME:

0(Typedor PriiJ(Typed or Printed in Ink)Uc^ _ . \ \rv\ ~

TITLE:

AUTHORIZED SIGNATURE: I, KV-^iy^ \u\1^s hereby(Origi^l signature required ineach document)

declare that I have read and fully understand the RFP Documents and, including the GeneralConditions and the Scope of Work, and that I am duly authorized to sign and submit thisSubmittal.

TheCITY reserves the rightto reject any and all Submittals, to waive informalities, and to acceptany Submittal or parts thereof as the CITY, in its sole discretion, determines to be in the bestinterest of the CITY.

PROPOSER: PLEASE ENSURE THAT YOU HAVE SIGNED THE RFP RESPONSEFORM OF THIS REQUEST FOR PROPOSAL. OMISSION OF A SIGNATURE ONTHAT PAGE WILL RESULT IN REJECTION OF YOUR PROPOSAL.

Page 17 of 35

2011/2012

Volusia County Business Tax ReceiptIssued pursuant to F.S. 205 and Volusia County Code ofOrdinances Chapter 114-1 by

Volusia County Revenue Division - 123 W Indiana Ave, Room 103, DeLand, FL 32720 - 386-736-5938

Receipt # 200907130001 Expires: September 30, 2012Business Location: 1140 PELICAN BAY DR

Business Name:

Owner Name:

Volusia County Maiu»gAddressFLORIDA J

REMEDY INTELLIGENT STAFFINGSMARTSTAFF INCP O BOX 19067

JACKSONVILLE, FL 32245

BUSINESS TYPE

Business Service

CODE COUNT

471

TAX

$22.00

This receipt indicates payment ofatax, which is levied for the privilege ofdoing the type(s) of business listedabove within Volusia County. This receipt is non-regulatory in nature and is not meant to be acertification ofthe holder's ability to perform the service for which he is registered. This receipt also does not indicate thatthe business is legal or that it is in compliance with State or local laws and regulations.

The business must meet all County and/or Municipality planning and zoning requirements or this Business TaxReceipt may be revoked and all taxes paid would be forfeited.

The information contained on this Business Tax Receipt must be kept up to date. Contact the Volusia CountyRevenue Division for instructions on making changes to youraccount

TfflS PORTION OF THE BUSINESS TAX RECEIPT MUST BEPOSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS

Volusia County Business Tax ReceiptRevenue Division - 123 W Indiana Ave, Room 103, DeLand, FL 32720 - 386-736-5938

DATE PAID: 09/22/2011

PAYMENT 113-10-00001915RECEIPT #:

TOTAL TAX: 22.00

PENALTY: 0.00TOTAL PAID: 22.00

Business Name: REMEDY INTELLIGENT STAFFINGOwner Name: SMARTSTAFF INCMailing Address: P O BOX 19067

JACKSONVILLE, FL 32245

Receipt # 200907130001 Expires: September 30, 2012Business Location: 1140 PELICAN BAY DR

PLEASE DETACH THIS PORTION OF THE BUSINESS TAX RECEIPT FOR YOUR RECORDS

THE CITY OF DAYTONA BEACHBUSINESS TAX # BT-68764

THE CITY OF DAYTONA BEACH301 S. RIDGEWOOD

DAYTONA BEACH, FL 32114

REMEDY INTELLIGENT STAFFING

1140 PELICAN BAY DREMPLOYMENT AGENCY

DEVELOPMENT SERVICES DEPARTMENTPERMITS LICENSING DIVISION

BT-68764 TAX RECEIPT NO.

68764 ACCOUNT NO.

06/25/2009 VALID FROM

09/30/2012 VALID TO

10/28/2011 DATE PAID

$90.00 AMOUNT PAID

0505 Employment Agency

BRIAN S ROSE


PQ BOX 19067JACKSONVILLE, FL 32245

DISPLAY AT PLACE OF BUSINESS FOR PUBLIC INSPECTION

THE CITY DOES NOT CERTIFY OR IMPLY COMPETENCE OF BUSINESS. TAX RECEIPT

THE CITY OF DAYTONA BEACHReceipt #BL44875


1140 PELICAN BAY DR

0505

PEN10

08/12/2011

10/12/2011

Employment AgencyPenalty10%

BUSINESS TAX # BT-68764

Date Paid:

Pay Method:

Collected By:

October 28, 2011

CASH xxx

SLB

THE CITY OF DAYTONA BEACH301 S. RIDGEWOOD

DAYTONA BEACH. FL 32114

Fees Paid:

Paid By: BRIANS ROSE

90.00

9.00

99.00

TAX RECEIPT

ACORCf CERTIFICATE OF PROPERTY INSURANCEDATE (MM/DD/YYYY)

7/29/2011

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

Ifthis certificate is being prepared for a partywho has an insurable interest in the property, do not use this form. Use ACORD 27 or ACORD 28.CONTACT NAME:PRODUCER

Beecher Carlson Insurance Services21700 Oxnard Street, Suite 1800Woodland Hills, CA 91367

www.beechercarison.com

INSURED

Koosharem, LLC and SubsidiariesIncl. Select Staffing, SelectRemedy, RemedyTemp,RemX, Select Personnel Svcs., Ablest, Tandem et al3820 State StreetSanta Barbara CA 93105

COVERAGES CERTIFICATE NUMBER: 10784452

818-598-4200FAX

E-MAIL ADDRESS:

PRODUCER CUSTOMER ID:

INSURER(S) AFFORDING COVERAGE

Westchester Fire Insurance Company

INSURER C

INSURER D

INSURER E

INSURER F

818-598-5800

REVISION NUMBER:LOCATION OF PREMISES / DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Remarks Schedule, IfmorespaceIsrequired)

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMSEXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVEBEEN REDUCED BY PAID CLAIMS.

INSRLTR

TYPE OF INSURANCE POLICY NUMBERPOLICY EFFECTIVE

DATE (MM/DD/YYYY)POLICY EXPIRATION

DATE (MM/DD/YYYY) COVERED PROPERTY LIMITS

PROPERTY

DEDUCTIBLES

BUILDING

PERSONAL PROPERTY

BUSINESS INCOME

EXTRA EXPENSE

RENTAL VALUE

BLANKET BUILDING

BLANKET PERS PROP

BLANKET BLDG & PP

$CAUSES OF LOSS

$BASIC

BUILDING

$BROAD

$CONTENTS

SPECIAL$

EARTHQUAKE$

WIND$

FLOOD$

$

$

INLAND MARINE TYPE OF POLICY$

CAUSES OF LOSS

$POLICY NUMBER

$

$NAMED PERILS

$

$

A / CRIME DON G23657569 005 7/31/2011 7/31/2012 / Employee Theft $ 1,000,000TYPE OF POLICY $

$I BOILER & MACHINERY/1EQUIPMENT BREAKDOWN $

$

$

$

$TPECIAL CONDITIONS /OTHER COVERAGES (Attach ACORD 101, Additional Remarks Schedule, Ifmore space Isrequired)

CEFtTIFICATE HOLDER CANCELLATION

Evidence of Insurance

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

(WDHLS) Kim Wyles 0CERT NO.: 10784452 (WDHLS)

ACORD 24 (2009/09)Schwartz 7/29/20H io;47:oo am page i of i <s> 1995-2009 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

ACORCf CERTIFICATE OF LIABILITY INSURANCEDATE (MM/DD/YYYY)

3/30/701?

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject tothe terms and conditions of the policy,certain policies may requirean endorsement A statement on this certificatedoes not confer rights to thecertificate holder in lieuof such endorsements).

producer Beecher Carlson Insurance Services21700 Oxnard Street, Suite 1800Woodland Hills, CA 91367

www.beechercarlson.com

INSURED

Koosharem, LLC and SubsidiariesIncl. Select Staffing, SelectRemedy, RemedyTemp,RemX, Select Personnel Svcs., Ablest, Tandem et al3820 State StreetSanta Barbara CA 93105

COVERAGES

CONTACT NAME:

PHONE (A/C. No. EM): 818-598-4200 FAXIA/C.No): 818-598-5800

E-MAIL ADDRESS:

INSURE R(S) AFFORDING COVERAGE

insurer a : ACE American Insurance Co 22667

Illinois Union Insurance Co 27960

INSURER E

INSURER F

REVISION NUMBER:CERTIFICATE NUMBER: 12737877THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

INSRLTR TYPE OF INSURANCE

GENERAL LIABILITY

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE | / | OCCUR

GENL AGGREGATE LIMIT APPLIES PER:

PROJECT./ POLICY / LOC

AUTOMOBILE LIABILITY

ANY AUTO

ALL OWNEDAUTOS

HIRED AUTOS

SCHEDULEDAUTOSNON-OWNEDAUTOS

UMBRELLA LIAB

EXCESS LIAB

OCCUR

CLAIMS-MADE

DED RETENTIONS

WORKERS COMPENSATIONAND EMPLOYERS'LIABILITY y / NANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?(Mandatory In NH)If yes, describe underDESCRIPTION OF OPERATIONS below

PROFESSIONAL LIABILITY

;B

ADDLJNSB.

SUBRHUB. POLICY NUMBER

HDO G25533549

ISA H08693249

WLR C4677226A (All statesexcept ND,OH,WA,WI,WY)

SCF C46772271 (Wl)

G21683772 005

POLICY EFF(MM/DD/YYYY)

9/30/2011

9/30/2011

9/30/2011

9/30/2011

7/31/2011

POLICY EXP(MM/DD/YYYY)

4/30/2012

4/30/2012

4/30/2012

4/30/2012

7/31/2012

LIMITS

EACH OCCURRENCE

DAMAGE TO RENTEDPREMISES (Ea occurrence)

MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

COMBINED SINGLE LIMIT(Ea accident)

BODILYINJURY(Per person)

BODILY INJURY (Per accident)

PROPERTY DAMAGE(Per accident)

EACH OCCURRENCE

AGGREGATE

WC STATU-TORY LIMITS

E.L EACH ACCIDENT

w

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

EVENT/AGGREGATE

1,000,000

500,000

5,000

1,000,000

5,000,000

1,000,000

1,000,000

1,000,000

1.000.000

1,000,000

$1,000,000

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)

CERTIFICATE HOLDER

Evidence of insurance

CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE

\%r*-' u^s

(WDHLS) Kim Wyles

© 1988-2010 ACORD CORPORATION. All rights reserved.

ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD

CERT NO.: 12737877 (WDHLS) Robert Schwartz 3/30/2012 3:29:19 PM Page 1 of 1

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