Certificate of Insurance Electronic Tracking Agreement

1) Electronic Agreement Initiation:
This Certificate of Insurance Tracking Agreement (this "Agreement") is made and entered into as of this 04th day of September, 2010 by and between Hamilton Brewart Insurance Agency LLC, a California limited liability company doing business in Upland California, herein called "Company" and the below listed Client located in the below listed Location, herein called "Client." Company and Client agree that Company will provide Client services in accordance with the terms and subject to the conditions of this Agreement and applicable law.

2) Services Provided:
Company hereby agrees to provide Client services that will provide the tracking of certificates of insurance for Client's tenants, vendors, and sub-contractors at no cost to Client, contingent upon the continuance of the business relationship between Company and Client. Client agrees to allow Company full access to the tenants', vendors' and sub-contractors' certificates of insurance currently on file that will include the names and phone numbers of contact persons.

Client will allow Company to contact and solicit each tenant, vendor or sub-contractor, for the purpose of providing insurance quotations from Company. Client represents and warrants to Company that Client's execution, delivery and performance by Client of this Agreement does not violate any provision of any law or regulation, or result in a breach of or constitute a default under any contract or other obligation to which Client is a party or by which Client may be bound.

The following information will be required from the client, for the purpose of entering the data and the tracking of certificates of insurance:
A. Copies of certificates of insurance on file at this time
B. Contact information including name and phone numbers
C. Section of contract that references the insurance requirements for the tenant, vendors and/or sub-contractors.

Company will enter the information into a proprietary software program (CertifiTrac+) that will track and monitor the expiration of certificates of insurance.

3) Required Limits of Insurance:
The following are the minimum Limits of Insurance that we require from our vendors, tenants and sub-contractors.

General Liability *



Auto Liability *



Workers Compensation *



Excess / Umbrella Liability *







Any Special Requirements:


4) Client and Company Rights and Obligations:
Company agrees to provide timely tracking and monitoring of all certificates of insurance issued to Client. In turn, Client agrees to comply with Company procedures and guidelines in relation to Company's electronic commerce programs. Client understands and acknowledges that Company websites are owned and operated by Company. Client understands that any software available or provided on Company websites is proprietary to Company.

Upon commencement of this Agreement, Company shall provide Client a password to enable Client access to the CertifiTrac+ program. Client shall disclose such password only to those persons within Client's office that may be accessing Company websites on behalf of Client.

5) Confidentiality and Indemnification:
Company and Client both mutually agree that the information provided to each other will be held in the strictest confidence, and will not be re-sold or used for any other purpose other than set forth in 2) above. Company and Client further agree to hold each other harmless regarding any potential liability, errors or omissions that may arise from the use and monitoring or failure to monitor the certificates of insurance.

6) Term and Termination:
This agreement shall be effective on the date first above written and shall continue in force until terminated in writing by either party with 10 business days' notice to the other party. In addition, upon termination of this Agreement, the ability to access Company's websites by means of Company's revocation of Client's password, will also take place immediately.

7) Costs:
Company shall not be liable for any cost pertaining to hardware either owned or leased by Client, or whether used by Client in whole or in part in relation to Company's website. Any required electronic commerce system training shall be provided by Company to Client at Company's convenience and at no charge to Client, as long as this Agreement is in force.

8) Governing Law and Venue:
The laws of the State of California shall govern the validity, construction and effect of this Agreement. In the event of litigation, the parties agree that all proceedings shall be conducted in the state or federal court in Los Angeles, California. Further, the parties waive the right to assert that such court is located in an inconvenient forum.

By submitting this Agreement electronically, Client acknowledges and agrees to the terms and conditions above.

*Denotes Required Fields

CLIENT:


Company Name *
(If corporation, authorized officer must agree)


Contact Name *


Title *


Phone *


Email *		  


Address *


Address2


City *


State *


ZIP *

How did you hear about this program? *



Name of Referrer *

HAMILTON BREWART INSURANCE AGENCY, LLC:

1282 W. Arrow Highway
Upland, California 91786

Derek Brewart
President

CA Brokers License #0D69219
Phone (909) 981-5210
Facsimile (909) 985-3448

September 04th, 2010