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2 <br />BASIC PROVISIONS <br />Service Provider Insurance Contact Information <br />Sandi Broughton <br />425-275-0560 <br />slbroughton@acrisure.coma <br />State Retirement Systems (must answer both questions) <br />Does Service Provider have 25 or more employees? <br /> <br />Answer: Yes <br /> <br />If Service Provider has less than 25 employees, did any Service Provider <br />Personnel who will work under this Professional Services Agreement retire <br />under a DRS retirement system? <br /> <br />Answer: N/A - Service Provider has 25 or more employees <br /> <br />“DRS retirement system” refers to any of the following Public Employers’ <br />Retirement System (PERS), School Employees’ Retirement System (SERS), <br />Teachers’ Retirement System (TRS), and Law Enforcement Officers and <br />Fire Fighters plan (LEOFF). <br /> <br />“Service Provider Personnel” includes Service Provider employees and <br />owners (such as shareholders, partners or members). If Service Provider is <br />a sole proprietor, then “Service Provider Personnel” refers to the sole <br />proprietor. <br /> <br />END OF BASIC PROVISIONS <br />