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BLDE-23-000656 Plans
• SCOPE OF WORK GENERAL NOTES LEGEND AND ABBREVIATIONS TABLE OF CONTENTS PAGE# 1 DESCRIPTION •SYSTEM SIZE 4080W DC,3840W AC •ALL WORK SHALL COMPLY WITH MA 9th } •MODULES (12)JA SOLAR'JAM60S10-340/MR Ed.CMR 780(2015 IRC/IBC/IEBC),MUNICIPAL CODE,AND ALL MANUFACTURERS' SE SERVICE ENTRANCE t-� SOLAR MODULES PV-1.0 COVER SHEET •INVERTERS.(1)DELTA ELECTRONICS.E4-TL-US LISTINGS AND INSTALLATION INSTRUCTIONS, - F__-- -"; --- --- -`0 PV-2.0 SITE PLAN •RACKING:RL UNIVERSAL,SPEEDSEAL TRACK ON •PHOTOVOLTAIC SYSTEM WILL COMPLY WITH NEC 2020. ! ` I COMP,SEE DETAIL SNR-DC-00436 MP MAIN PANEL ®-+-------ter---_-----q PV-3.0 I LAYOUT } •ELECTRICAL SYSTEM GROUNDING WILL COMPLY WITH NEC 2020. 4 •RAPID SHUTDOWN.(12)APSMART RSD-S-PLC ROOFTOP ; _��j_ ,� ' PV-4.0 ELECTRICAL -.(1), p-� u.-..__- 1_. MODULE LEVEL RAPID SHUTDOWN DEVICE I'----SNR MOUNT ! •NEW 100 AMP MAIN BREAKER DISCONNECT WITH 100 AMP •PHOTOVOLTAIC SYSTEM IS UNGROUNDED,NO CONDUCTORS ARE SOLIDLY SP SUB-PANEL [--- SNR MOUNT&SKIRT PV-5.0 SIGNAGE MAIN ENCLOSURE TO BE INSTALLED. GROUNDED IN THE INVERTER.SYSTEM COMPLIES WITH 630.35. •SERVICE ENTRANCE CONDUCTORS TO BE REPLACED. •MODULES CONFORM TO AND ARE LISTED UNDER UL 1703. LC PV LOAD CENTER •MAIN PANEL REPLACEMENT.EXISTING 100 AMP MAIN PANEL f171 CHIMNEY WITH 100 AMP MAIN BREAKER TO BE REPLACED WITH NEW •INVERTER CONFORMS TO AND IS LISTED UNDER UL 1741. 125 AMP MAIN PANEL WITH 100 AMP MAIN BREAKER. SM SUNRUN METER •RACKING CONFORMS TO AND IS LISTED UNDER UL 2703. .1 ATTIC VENT •SNAPNRACK RACKING SYSTEMS.IN COMBINATION WITH TYPE I,OR TYPE II PM) DEDICATED PV METER [__j FLUSH ATTIC VENT MODULES,ARE CLASS A FIRE RATED. = PVC PIPE VENT •RAPID SHUTDOWN REQUIREMENTS MET WHEN INVERTERS AND ALL INV INVERTER(S) METAL PIPE VENT CONDUCTORS ARE WITHIN ARRAY BOUNDARIES PER NEC 690.12(1). .- T-VENT •CONSTRUCTION FOREMAN TO PLACE CONDUIT RUN PER 690.31(G). fAC I AC DISCONNECT(S) SATELLITE DISH •ARRAY DC CONDUCTORS ARE SIZED FOR DERATED CURRENT. DC-1 DISCONNECT(S) � DCI ' j FIRE SETBACKS •10.46 AMPS MODULE SHORT CIRCUIT CURRENT. /_�.., •16.34 AMPS DERATED SHORT CIRCUIT CURRENT[690.8(a)8 690.8(b)]. CB IQ COMBINER BOX •. HARDSCAPE •PV INSTALLATION COMPLIES WITH THE NEC 2017 ARTICLE 690.12(B) , (2).CONTROLLED CONDUCTORS LOCATED INSIDE THE ARRAY BOUNDARY ARE INTERIOR EQUIPMENT —PL— PROPERTY LINE LIMITED TO 80 VOLTS WITHIN 30 SECOND OF A RAPID SHUTDOWN INITIATION L_ SHOWN AS DASHED SCALE:NTS A AMPERE sunrun AC ALTERNATING CURRENT AFCI ARC FAULT CIRCUIT INTERRUPTER AZIM AZIMUTH VICINITY MAP COMP COMPOSITION #180120 DC DIRECT CURRENT ‘, L • ' .a RW, • (E) EXISTING ESS ENERGY STORAGE SYSTEM EXT EXTERIOR - •Blue Rock Golf CourseINT INTERIOR CUSTOMER RESIDENCE: MAG MAGNETIC ALAN COPITHORNE MSP MAIN SERVICE PANEL 28 VINE BROOK RD: (N) NEW YARMOUTH,MA.02664 NTS NOT TO SCALE OC ON CENTER TEL (508)394-0556 28 VIne rook Rd, kt. PRE-FAB PRE-FABRICATED APN:YAR M-000078-000157 South Yarmouth,MA:, PSF POUNDS PER SQUARE FOOT PROJECT NUMBER PV PHOTOVOLTAIC 223R-028COPI ,,,,, :' 134 RSD RAPID SHUTDOWN DEVICE TL TRANSFORMERLESS 415 580-6920 ex3 TYP TYPICAL DESIGNER. ( ) V VOLTS AMAN SONI SQUT, . W WATTS L AAL1ht.: .,,, .. SHEET ", REV[ NAME DATE COMMENTS COVER SHEET j REV:A 7/14/2022 • 8J - PAGE PV-1.0 ARRAY TRUE MAG PV AREA SITE PLAN-SCALE=1/16"=1' PITCH AZIM AZIM (SQFT) IV/\ i AR-01 37' 224° 238° 217.3 r / \ (N)ARRAY AR-01— \,/ -(E)RESIDENCE (E)GATE— \ 4 e \ e N / \ ,,'' / /e _ ille ,„,... sunrun \ M ., „ e \ . ..-, #180120 .., .....,,:.....,...."-,.. ., ... ,. ,, .: ,, . „.,.. q' \ CUSTOMER RESIDENCE: \� ---(E)FENCE ALAN COPITHORNE \\„/ -.. . , . -... - �\ 28 VINE BROOK RD, YARMOUTH,MA.02664 e,,,\\ TEL (508j394-0556 e`_ \ AC , PM APN:YARM-000078-000157 `1:gym\J L'4. \ PROJECT NUMBER: 6,10 223R-028COPI 04_,c \ DESIGNER (415)580-6920 ex3 AMAN SONI SHEET • SITE PLAN REV.A 7/14/2022 NOTE:ROOFTOP MODULE LEVEL RAPID SHUTDOWN DEVICE INSTALLED ON EACH MODULE PER NEC 690.12 PAGE PV-2.0 • ROOF INFO FRAMING INFO ATTACHMENT INFORMATION _DESIGN CRITERIA .._..._.............------ -T p p -it _-a..__.o- ---- .__..._._...\MAX R 30 PSL P__... Max OC ` Max Landsca a Max Landscape Max Portrait Max Portrait MAX DISTRIBUTED LOAD:3 PSF Name Type Height Type Detail Configuration Span Spacing I OC Spacing I OverhangOC Spacing Overhang1 ' RL UNIVERSAL,SPEEDSEAL TRACK ON WIND SPEED: AR-01 COMP SHINGLE-RLU 1-Story 2X6 RAFTERS 13'-6' 16" COMP,SEE DETAIL SNR-DC-00436 STAGGERED 140 MPH 3-SEC GUST. 1 • I_ S,S.LAG SCREWS: D1-AR-01-SCALE:3/16"=1.-0" 5/16"2.5"MIN EMBEDMENT STRUCTURAL NOTES: AZIM:224` • INSTALLERS SHALL NOTIFY PITCH:37° ENGINEER OF ANY POTENTIAL STRUCTURAL ISSUES I OBSERVED PRIOR TO PROCEEDING W/ INSTALLATION. • IF ARRAY(EXCLUDING SKIRT)I IS WITHIN 12"BOUNDARY REGION OF ANY ROOF PLANE EDGES(EXCEPT VALLEYS). THEN ATTACHMENTS NEED TO BE ADDED AND OVERHANG REDUCED WITHIN THE 12" BOUNDARY REGION ONLY AS r I-10" FOLLOWS: y k___- ___._ ._...._._ ...__. --_._33-T ___. ___.____ _.___ ._____. _...__...{--3'_1"-_y •.ALLOWABLE ATTACHMENT --- SPACING INDICATED ON , PLANS TO BE REDUCED BY 2'-6" 50% I +.—f — 0 ❑ 0 ❑ ❑ ❑ ❑ i ••ALLOWABLE OVERHANG I I INDICATED ON PLANS TO BE r-5'-4"TYP—i 1/5TH OF ALLOWABLE ATTACHMENT SPACING 6'-7" i 0 0 0 fl G 0 0 0 •- --_ % INDICATED ON PLANS • sunrun 8'-10" ' #180120 .,'SIF:E ..�i... ....... i..JF.L I SSTLUCT . (� CUSTOMER RESIDENCE FM4S 4 ALAN COPITHORNE 0�1HO , So ' c.1.;., . 28 VINE BROOK RD: o 4 VINCENT y'T YARMOUTH,MA.02664 g MWUMVANEZA CIVIL TEL.(508)394-0556 N•, " /EAE- <!2 APN:YARM-000078-000157 • Ar. tx• PROJECT NUMBER: ONAIEN 223 R-028COPI DESIGNER. (4t5)580-6920 ex3 AMAN SONI SHEET LAYOUT REV:A 7/14/2022 SEE SITE PLAN FOR NORTH ARROW PAGE PV-3.0 120/240 VAC SINGLE PHASE SERVICE /'� METER#: (nq j EVERSOURCE 2370916 NOTE:TOTAL PV BACKFEED=20A UTILITY ��� USED FOR INTERCONNECTION GRID CALCULATIONS NEW 100A MAIN BREAKER DISCONNECT WITH 100 AMP MAIN ENCLOSURE —LOAD SIDE TAP \1 NEW 100A MAIN (N)LOCKABLE BLADE TYPE (N)MA SMART BREAKER • FUSED AC UTILITY DELTA ELECTRONICS-. I DISCONNECT REVENUE E4-TL-US I 3840 WATT INVERTER JUNCTION BOX ___ METER _ PV MODULES �-� (3 C3 3 lZ OR EQUIVALENT JA SOLAR:JAM60S10-340/MR NEW 125A MAIN - / PANEL (/M� ✓` F, // (12)MODULES �.` '�• ; `ti. �� _ I 1 / (1)STRING OF(6)MODULES FACILITY 20A FUSES ~ J (1)STRING OF(6)MODULES INIIII LOADS _=,'.; SQUARED 240V METER SOCKET LOAD RATED DC (12)APSMART RSD-S-PLC MODULE D221NRB 100A CONTINUOUS DISCONNECT WITH AFCI, LEVEL RAPID SHUTDOWN DEVICES 3R.30A UTILITY SIDE OF CIRCUIT APSMART TRANSMITTER 120/240VAC CONNECTS TO TOP LOGS- (LINE AT TOP LOAD AT BOTTOMI CONDUIT SCHEDULE I s u n r u n # CONDUIT CONDUCTOR NEUTRAL GROUND 1 NONE (4)10 AWG PV WIRE NONE (1)10 AWG BARE COPPER 2 3/4"EMT OR EQUIV. (4)10 AWG THHN/THWN-2 NONE (1)10 AWG THHN/THWN-2 #180120 3 3/4"EMT OR EQUIV. (2)10 AWG THHWTHWN-2 (1)10 AWG THHN/THWN-2 (1)8 AWG THHN/THWN-.2 fl.iONE CI sy' `• "` """'" __.... vnr.o . CUSTOMER RESIDENCE ALAN COPITHORNE 28 VINE BROOK RD, YARMOUTH,MA.02664 MODULE CHARACTERISTICS JA SOLAR:JAM60S10-340/MR: 340 W TEL.(508)394-0556 OPEN CIRCUIT VOLTAGE: 41.55 V APN:YARM-000078-000157 MAX POWER VOLTAGE: 34.73 V • PROJECT NUMBER. SHORT CIRCUIT CURRENT: 10.46 A 223R-028COPI SYSTEM CHARACTERISTICS-INVERTER1 DESIGNER: (415)580-6920 ex3 SYSTEM SIZE. 4080 W AMAN SONI SYSTEM OPEN CIRCUIT VOLTAGE: 278 V SYSTEM OPERATING VOLTAGE: 208 V SHEET MAX ALLOWABLE DC VOLTAGE 480 V ELECTRICAL SYSTEM OPERATING CURRENT, 19.58 A SYSTEM SHORT CIRCUIT CURRENT: 26.15 A REV:A 7/14/2022 PAGE PV-4.0 INVERTER i sF l I .';.. NOTES AND SPECIFICATIONS: 1-Mi -. •SIGNS AND LABELS SHALL MEET THE REQUIREMENTS OF THE NEC 2020 ARTICLE ELECTRICAL SHOCK HAZARD PHOTOVOLTAIC DC DISCONNECT 110.21(B),UNLESS SPECIFIC INSTRUCTIONS ARE REQUIRED BY SECTION 690.OR IF REQUESTED BY THE LOCAL AHJ. MAXIMUM SYSTEM VOLTAGE. 480 VDC •SIGNS AND LABELS SHALL ADEQUATELY WARN OF HAZARDS USING EFFECTIVE TERMINALS ON LINE AND LOAD WORDS.COLORS AND SYMBOLS.•LABELS SHALL BE PERMANENTLY AFFIXED TO THE EQUIPMENT OR WIRING SIDES MAY BE ENERGIZED IN LABEL LOCATION METHOD AND SHALL NOT BE HAND WRITTEN. THE OPEN POSITION INVERTER(S),DC DISCONNECT(S). •LABEL SHALL BE OF SUFFICIENT DURABILITY TO WITHSTAND THE ENVIRONMENT PER CODE(S).NEC 2020:690.53 INVOLVED. LABEL LOCATION: •SIGNS AND LABELS SHALL COMPLY WITH ANSI 5535.4-2011,PRODUCT SAFETY INVERTER(S),AC/DC DISCONNECT(S), SIGNS AND LABELS,UNLESS OTHERWISE SPECIFIED. AC COMBINER PANEL(IF APPLICABLE). •DO NOT COVER EXISTING MANUFACTURER LABELS. PER CODE(S):NEC 2020 690.13(B) WARNING: PHOTOVOLTAIC A POWER SOURCE _._. LABEL LOCATION. DUAL POWER SUPPLY INTERIOR AND EXTERIOR DC CONDUIT EVERY 10 FT. SOURCES:UTILITY GRID AT EACH TURN,ABOVE AND BELOW PENETRATIONS, ON EVERY JB/PULL BOX CONTAINING DC CIRCUITS. _.____.___........_........._..._......_ .._____.._.__ _....._................— .._-......_..........._-........_............_... AND PV SOLAR ELECTRIC PER CODE(S)'NEC 2020.690.31(D)(2).IFC 2012. • SYSTEM s05.iL1 a CAUTION LABEL LOCATION. UTILITY SERVICE METER AND MAIN II, SERVICE PANEL. PER CODE(S):NEC 2620.705.12(°) MULTIPLE SOURCES OF POWER RAPID SHUTDOWN SWITCH FOR SOLAR PV SYSTEM SOLAR PANELS ON ROOF INVERTER (EXT) POWER SOURCE OUTPUT CONNECTION '�� DO NOT RELOCATE THIS 11140 OVERCURRENT DEVICE LABEL LOCATION: INSTALLED WITHIN 3'OF RAPID SHUT DOWN LABEL LOCATION: SWITCH PER CODE(S).NEC 2020'690.56(0)(2),IFC , s u n r u n ADJACENT TO PV BREAKER AND ESS 2012:605.11.1;IFC 2018:1204.5.3 a OCPD(IF APPLICABLE). PER CODE(S)NEC 2020: 4 _.5 , 705.12(6)(3)(2) �. ,: 1:414,".,t- . .` MAIN PANEL--• #190120 IIIIII PHOTOVOLTAIC SYSTEM `- '' t„s ^� '" -- COMBINER PANEL ,r v �' '`"`- • il • • DO NOT ADD LOADS - - CUSTOMER RESIDENCE: LABEL LOCATION AC DISCONNECT ALAN COPITHORNE PHOTOVOLTAIC AC COMBINER(IF 0 • 28 VINE BROOK RD. APPLICABLE). 3,� ruRNRAPIosHUTDOWN SERVICE ENTRANCE 1 YARMOUTH,MA.02664 PER CODE(S)'NEC 2020.705.12(D)(2)(3)(c) SWITCH TO THE"OFF— 0,4204 PRODUCTION 1 TEL.(508)394-0556 POSITION TO SHUT DOWN PV.SYSTEM AND REDUCE METER APN.YARM-000078-000157 PV SYSTEM DISCONNECT ...... PROJECT NUMBER: • MAXIMUM AC OPERATING CURRENT.16.00 AMPS SHOCK HAZARD IN THE 10 ARRAY. -----1 223R-028CCPI NOMINAL OPERATING AC VOLTAGE 240 VAC -------- DESIGNER. (415)580-6920 ex3 LABEL LOCATION 28 VINE BROOK RD, YARMOUTH, MA, 02664 AMANSONI AC DISCONNECT(S),PHOTOVOLTAIC SYSTEM POINT OF INTERCONNECTION. SHEET PER CODE(S)'NEC 2020:690.54 LABEL LOCATION: ON OR NO MORE THAT 1 M(3 FT)FROM THE SERVICE PER CODECS)'NEC 2020:705.10,710.10 SIGNAGE DISCONNECTING MEANS TO WHICH THE PV SYSTEMS ARE CONNECTED. REV A 7/14/2022 PER CODE(S):NEC 2020:690.56(C) PAGE PV-5.0 DIVISION QF OCCUPATIONAL LICENSURE 7 -,,,,,,:,,i45,,;:&.,,,,,, , c fes ./ /' i� Y�I�1 fA �� / �.r'/` / 7' _4,4.44 • � {` �� 'f •4•.,•-,;:44-.. ,-,•%••iiit LA0v0I4-4.....# : : 3 i, / w ,Tia ' .;• :P• • r.4 W { �- ,(,fit t, �/5,1� �,�, / y�/i 4 ,/r iii - LICENSE NUMBER EXPIRATION DATE '> + +e :k' , DIVISION ;OF CCCUPA�z.geN � - ..0%.: ,,'�y��� fir' ��". a 4' + !C "eS y i•4//p ,,4•4,„;•,•,,•4,4 ,4 j- :44#,.,,,,,oie...,„,44'41'04::''''''. ' '''' / -:-'-'•-"-:--i.,-;,:-.A ,,,,-*:,,,:::44,,f,-g.:4§4a.,..4 .*:-;.;44.„.,....„,,,,,-:, A �_ r . .RA ION DATE SERIAL ',1 D18 s . � 4'''';.''' .:-.;:4:-.".;, T i � �/ ;,;4:444•D � '�� � � �.4 �df�;���•w�1�4��"�' Nom. 6 7 / a. "']: ,'k rs//ptiD://s"�,r,;.`'al, _,' a, ��...IN BEACO-3 • OP ID: DE ACORE` CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDJYYYY) `..— 08/03/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 508-673-5808 CONTACT Jason Rua,LIA,CIC,AAI Rua-Dumont-Audet Ins.Agcy.In ;(AHONE -FAz......_......_...._..._. 508-673 5808 508-677-4828 155 North Main Street (Arc,No,Ext) IA/C,No! Fall River,MA 02722 1 EMAIL Jason M.Rua,LIA,CIC,AAI ADDRESS: INSURER(S)AFFORDING COVERAGE '; NAIL# INSURER A MAPFRE Insurance 34754 _INSURED INSURERS Nautilus Insurance Company 17370 eacon Solar Construction Inc. — — 2 Sha lee Lane INSURER c HISCOx Pro Lak@Ville,MA 02346 — INSURER D • ,INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE 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. INSR ADDL SUER; POLICY EFF POLICY EXP LTR TYPE OF INSURANCE IINSD'WVD: POLICY NUMBER (MMIDD/YYYY1 IIMMIDD/YYYYI ; • LIMITS B X ;COMMERCIAL GENERAL LIABILITY1,000,000 EACH OCCURRENCE__. 5___._..- DAMAGE TO RENTED 900,000 CLAIMS-MADE X OCCUR NN1295010 08/03/2022 08/03/2023,pREMiSE$..(Ea occurrences ,$• i , MED EXP(Anyone person)_ $ -- 5'000 '', ;PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: ,GENERAL AGGREGATE ,$ -..... 2,000,000 PRO 2,000,000 X POLICY[ JE T LOC PRODUCTS-COMP/OP_AGG $ ._..._ OTHER' I$ COMBINED SINGLE LIMIT 11,000,000 A AUTOMOBILE LIABILITY $ ANY AUTO I BQZ650 02/13/2022102/13/2023 BODILY INJURY(Perperson) .$ OWNEDSCHEDULED AUTOS ONLY X i AUTOS „BODILY INJURY Per accident);$ HIRED NON-AWNED PROPERTY DAMAGE X AUTOS ONLY I X._ AUTOS ONLY : ,(Per accident) $ $ B X' ', UMBRELLA LIAB OCCUR '.,EACH OCCURRENCE $ 3,000,000 ' AN1244595 0$/03/2022;08/03/2023 AGGREGATE $ 3,000,000 EXCESS LIAB CLAIMS MADE, DED . RETENTION$ ', $ WORKERS COMPENSATION i ' AND EMPLOYERS'LIABILITY Y/N �',STATUTE_, ER A• NY PROPRIETOR/PARTNER/EXECUTIVE [E L EACH ACCIDENT ,$ OFFICER/MEMBER EXCLUDED? jN/A ----- -_-_ .---._....._. .............. (Mandatory in NH) ,E .DISEASE-EA EMPLOYEE;S............... If yes:describe under _...... ....._... .........YEEI DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT '$ C professional ANE470779122 08/03/2022i08/03/2023'occur 1,000,000 aggregate 3,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) - Solar Heating System Installation Subject to actual policies'terms,conditions,definitions,coverages& exclusions. • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE c9a Y— ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. 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