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ElARI Ax • <br /> CARFAXFORPOL10E.COM — <br /> ENROLLMENT FORM FOR LAW ENFORCEMENT <br /> Official Agency Name(must provide FULL name)("Agency"): City of Everett Police Department <br /> Agency ORI Number:WA:0310300 <br /> Name of Chief of Police: Dan Templeman Number of Sworn Officers: 206 <br /> Address: 3002 Wetmore City: Everett <br /> County:Snohomish State:Washington Zip: 98201 <br /> Estimated number of motor vehicle accident reports per year: 2937 <br /> Enrollment in the CARFAX For Police Program allows Agency to subscribe, in exchange for motor vehicle accident reports data created'or <br /> collected by Agency, to the CARFAX investigative tools ("Investigative Tools"), the CARFAX E-Commerce Service, and such other tools and <br /> services that CARFAX may offer participants of the CARFAX For Police Program. <br /> Agency wishes to subscribe to: <br /> Investigative Tools Yes ❑ No <br /> CARFAX E-Commerce Service ❑Yes ® No(If Yes,please provide the additional infon-nation requested below) <br /> Additional information required for the CARFAX E-Commerce Service: <br /> Does applicable state or local law or regulation require that motor vehicle accident reports can only be provided to specific interested parties <br /> • (as defined by such law or regulation)? ❑Yes ® No <br /> • <br /> Amount to be reimbursed to Agency for each accident report sold through the CARFAX E-Commerce Service: $NA <br /> By signing below, I represent that I am duly authorized to execute this Enrollment Form on behalf of Agency and bind Agency to the CARFAX <br /> For Police Program Terms and Conditions: <br /> Signature: <br /> Title: Mayor Printed Name: Mayor Ray Stephenson <br /> • <br /> Date: <br /> Send completed form to: Chris Marchetti <br /> EMAIL: ChrisMarchetti@carfax.com I FAX: 800-790-8563 <br /> 1 3 0 PCA Enrollment Forrn—02/77 <br />