HomeMy WebLinkAboutRes 2018-09-472 ILA Police Dispatch Services Executed AgreementCOURT ORDER NO. 2018- -10-01
THE STATE OF TEXAS
COUNTY OF COLLIN
Subject: Interlocal Agreement, Dispatch Services, City of Anna — Sheriff
On October 1, 2018, the Commissioners Court of Collin County, Texas, met in regular
session with the following members present and participating, to wit:
Keith Self Not Present
County Judge, Presiding
Susan Fletcher
Commissioner, Precinct 1
Cheryl Williams
Commissioner, Precinct 2
John D. Thomas
Commissioner, Precinct 3
Duncan Webb
Commissioner, Precinct 4
During such session the court considered a request for approval of an Interlocal Agreement
with the City of Anna.
Thereupon, a motion was made, seconded and carried with a majority vote of the court for
approval of an Interlocal Agreement with the City of Anna for Dispatch Services effective
October 1, 2018 through and including September 30, 2019. Same is hereby approved as per
the attached documentation.
Not Present
Keith Self, County Judge
V i
ATTEST:
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Commissioners Court
Collin County, T E X A S
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CITY OF ANNA, TEXAS
RESOLUTION NO.�2'
A RESOLUTION OF THE CITY OF ANNA, TEXAS APPROVING AN INTERLOCAL
DISPATCH SERVICES AGREEMENT WITH COLLIN COUNTY, TEXAS
WHEREAS, the City Council of the City of Anna Texas (the "City Council") finds that
renewal of the agreement for Dispatch Services with Collin County is vital to support the
City of Anna Police department's mission to preserve and protect the public health and
safety of the City's residents;
NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY
OF ANNA, TEXAS, THAT:
Whereas, Recitals Incorporated
The recitals set forth above areincorporated herein for all purposes as if set forth in full.
Section 1.. Approval of lnterlocal Dispatch Services Agreement
The City Council hereby approves the lnterlocal Dispatch Services Agreement attached
hereto as EXHIBIT 1, and authorizes, ratifies and approves the City Manager's
execution of same. The City Manager is hereby authorized to execute all documents and
to take all other actions necessary to finalize, act under, and enforce the Agreement that
shall remain in force until October 1, 2019.
PASSED AND APPROVED by the City Council of the City of Anna, Texas on this
11"' day of September, 2018.
ATTEST:
OF A/y
Carrie Smith, City Secretary =
APPROVW-
ike, Mayor
INTERLOCAL DISPATCH SERVICES AGREEMENT
This agreement is entered into on the 1 day of October
2018, by and between the City of Anna (the "City") and Collin County, a political
subdivision of the State of Texas (the "County").
RECITALS
1. The County, through the Sheriff's Office, owns and operates communication
facilities used in dispatching its law enforcement and emergency service personnel.
2. The City desires to obtain certain dispatch services from the County. Therefore,
under the authority of Texas Government Code, Title 7, Interlocal Cooperation Act,
Section 791 et seq., the parties agree as follows:
SECTION 1. DEFINITIONS
DISPATCH. SERVICES. The term "Dispatch Services" means all services
necessary for the Collin County Sheriff's Office to receive calls for law enforcement
service within the City's jurisdiction and to dispatch the City's law enforcement
personnel in response to such calls.
HOSTING SERVICES. The term "Hosting Services" means the County will
store the City's data as it relates to dispatch services.
SECTION 2. TERM
2.01 TERM. The term of this agreement shall commence on October 1, 2018,
and shall continue in full force and effect through September 30, 2019.
2.02 TERMINATION. Either party may terminate this agreement by giving
ninety (90) days written notice to the other party.
SECTION 3. SERVICES
3.01 The County agrees to provide dispatch services through the Sheriff's
Office to the City in the same manner and under the same work schedule as such services
1
are provided in the operation of the County's law enforcement personnel.
3.02 Hosting Services. The County agrees to provide Hosting Services to the
City and that it will provide 95% uptime availability of the service as covered herein.
3.03 Scheduled Maintenance: The City hereby acknowledges that the County
may, from time to time, perform maintenance service on the County network, with or
without notice to the City, which may result in the unavailability of the County network.
Emergency maintenance and maintenance for which the County has not given the City
notice in accordance with this Agreement shall not be deemed scheduled maintenance for
purposes of this Agreement. The County will make every effort to notify the City prior to
scheduled maintenance. Notice may be given in various forms including but not limited
to email notice and/or phone call.
3.04 Hosted Data Ownership. The City shall have sole ownership of the
City's hosted data and the County shall make no claim to ownership of City's hosted
data.
3.05 Hosted Data Back Up. The County will back up the City's hosted data
on a daily basis. All data backups will meet Criminal Justice Information Systems (CJIS)
requirements. Every effort is made to ensure the reliability of the backed up data in the
event that it would be necessary to restore a database. The County, however, makes no
guaranties that the backed up database will be error free. Upon request, the County will
provide to the City a current database backup that can be restored to an alternate location
to verify the contents and confirm the quality of the backup. All services required to
provide the City's data and/or verify data will be provided in accordance with the
County's current rates.
7
3.06 Remote Access Agreement. For each user the City is required to
complete and return Attachment (A), Connection Policy and Agreement Form for
remote access and return to County to the address in 9.02 item (C). No access will be
given to user unless County has received a Remote Access Agreement.
SECTION 4. NONEXCLUSIVITY OF SERVICE PROVISION
The parties agree that the County may contract to perform services similar or
identical to those specified in this agreement for such additional governmental or public
entities as the County, in its sole discretion, sees fit.
SECTION 5. COMPENSATION
5.01 The dispatch service charges for FY2019 in the amount of $90,117.00
shall be paid by the City in quarterly installments of $22,529.25 during the term hereof.
The fees will be based on the fee schedule formulas adopted by Commissioners' Court on
August 6, 2018 (Court Order No. 2018-628-08-06). In addition to the fee schedule, each
radio registered on the system will be assessed an annual connection fee by Plano, Allen,
Wylie, Murphy (PAWM) operators for access to their system. In FY2019, the fee will be
$108 per radio and may be updated annually by PAWM.
5.02 PAYMENT UPON EARLY TERMINATION. If this agreement is
terminated prior to the conclusion of a three-month period for which a payment has been
made pursuant to Section 5.01 of this agreement, the entire amount paid shall belong to
the County without prorating, as liquidated damages to cover the County's anticipated
costs for staffing and equipment to provide services hereunder.
5.03 SOURCE OF PAYMENT. The City agrees that payments that it is
required to make under this agreement shall be made out of the City's current revenues.
SECTION 6. CIVIL LIABILITY
3
6.01 Any civil liability relating to the furnishing of services under this
agreement shall be the responsibility of the City. The parties agree that the County shall
be acting as agent for the City in performing the services contemplated by this agreement.
6.02 The City shall hold the County free and harmless from any obligation,
costs, claims, judgments, attorney's fees, attachments, and other such Iiabilities arising
from or growing out of the services rendered to the City pursuant to the terms of this
agreement or in any way connected with the rendering of said services, except when the
same shall arise because of the willful misconduct or culpable negligence of the County,
and the County is adjudged to be guilty of willful misconduct or culpable negligence by a
court of competent jurisdiction.
SECTION 7. AMENDMENT
This agreement shall not be amended or modified other than in a written
agreement signed by the parties.
SECTION 8. CONTROLLING LAW
This agreement shall be deemed to be made under, governed by, and construed in
accordance with the laws of the State of Texas.
SECTION 9. NOTICES
9.01 FORM OF NOTICE. Unless otherwise specified, all communications
provided for in this agreement shall be in writing and shall be deemed delivered, whether
actually received or not, forty-eight (48) hours after deposit in the United States mail,
first class, registered or certified, return receipt requested, with proper postage prepaid or
immediately when delivered in person.
9.02 ADDRESSES. All communications provided for in this agreement shall
be addressed as follows:
4
(A) Collin County, to:
Purchasing Department
2300 Bloomdale #3160
McKinney, Texas 75071
(B) If to the City, to:
rAMi
J
(C) Collin County, Remote Access to:
Information Technology Department
2300 Bloomdale #3198
McKinney, Texas 75071
Or to such person at such address as may from time to time be specified in a notice
given as provided in this Section 9. In addition, notice of termination of this agreement
by the City shall be provided by the City to the County Judge of Collin County as
follows:
The Honorable Keith Self
Collin County Judge
Collin County Administration Building
2300 Bloomdale Rd. Suite 4192
McKinney, Texas 75071
SECTION 10. CAPTIONS
The headings to the various sections of this agreement have been inserted for the
convenient reference only and shall not modify, define, limit or expand the express
provision of this agreement.
SECTION 11. COUNTERPARTS
This agreement may be executed in counterparts, each of which, when taken
separately, shall be deemed an original.
SECTION 12. OBLIGATIONS OF CONDITION
All obligations of each party under this agreement are conditions to further
performance of the other party's continued performance of its obligation under the
agreement.
SECTION 13. EXCLUSIVE RIGHT TO ENFORCE THIS AGREEMENT
The County and the City have the exclusive right to bring suit to enforce this
Agreement, and no party may bring suit, as a third -party beneficiary or otherwise, to
enforce this agreement.
SECTION 14. PRIOR AGREEMENTS SUPERSEDED
This agreement constitutes the sole and only agreement of the parties hereto and
supersedes any prior understanding or written oral agreements between the parties
respecting the services to be provided under this agreement.
IN WITNESS WHEREOF, THE PARTIES HERETO HAVE EXECUTED THIS
AGREEMENT AS OF THE DAY AND YEAR FIRST ABOVE WRITTEN.
"COUNTY"
TITLE:
DATE:
W
ANNA PD
VPN
AGGREMENTS
TOTAL OF 15
Attachment "A"
Law Enforcement Officers Remote Connectivity Policy and Agreement Form
Remote Access Agreement
1.0 Purpose
The purpose of this document is to provide the framework for granting REMOTE ACCESS to Collin
County services/equipment through REMOTE ACCESS so that an Authorized Party of a law enforcement
agency (Agency) may access its data hosted on Collin County's network.
2.0 Scope
This policy applies to all Law Enforcement Officers utilizing REMOTE ACCESS to access the Collin County
network (such persons referred to herein as "Authorized Parties"). This policy applies to all Collin County
REMOTE ACCESS implementations.
3.0 Policy
Authorized parties may utilize the benefits of REMOTE ACCESS, which are a "user managed" service. "This
means that the Authorized party is responsible for selecting an Internet Service Provider (ISP), coordinating
installation, installing any required software, and paying associated fees as may be required to access the
REMOTE ACCESS.
Additionally,
1. It is the responsibility of the Authorized Party to ensure that unauthorized users are not allowed access to Collin
County internal networks. User accounts and passwords are NOT to be shared with anyone.
2. Authorized Parties and the Collin County employees sponsoring the request for REMOTE ACCESS are
responsible for defining what services/equipment/software the Authorized Parties need access to. Access will
be restricted to only those defined objects. Attempting to connector access any service/device not defined will
be considered a violation of the Collin County REMOTE ACCESS policy and will be reported to the Authorized
Party's agency
3. The Authorized Parties and the Collin. County employees sponsoring the REMOTE ACCESS request are also
responsible for defining the time scope that the REMOTE ACCESS account will be active. All accounts are
setup with an expiration date not to exceed 6 months, unless otherwise authorized to be a longer timeframe or
permanent by the County.
4. REMOTE ACCESS use is to be controlled using either a one-time password authentication such as a token
device or a public/private key system with a strong pass phrase.
5. When actively connected to the county network, the REMOTE ACCESS will force all traffic to and from the
remote PC over the REMOTE ACCESS tunnel; all other traffic will be dropped.
6. Dual (split) tunneling is NOT permitted; only one network connection is allowed.
7. REMOTE ACCESS gateways will be established and managed by Collin County Information Technology
Department.
8. All computers connected to Collin County internal networks via REMOTE ACCESS or any other technology
must use the most up-to-date anti -virus software from a reputable IT agency; this includes personal computers.
9. All Authorized Parties connecting to the Collin County internal networks via REMOTE ACCESS or any other
technology must keep their systems up to date with the latest security patches for their operating system and
applications installed on their connecting systems. All systems using REMOTE ACCESS connections to Collin
County must comply with Microsoft's Product Lifecycle chart and use only currently supporting and fully
patched operating systems.
10. Authorized Parties may be automatically disconnected from Collin County's network after sixty minutes of
inactivity. The user must then logon again to reconnect to the network.
11. Authorized Parties that are not Collin County owned equipment must comply with the Collin County acceptable
use policy when accessing the Internet while connected through the REMOTE ACCESS.
12. Only approved REMOTE ACCESS clients may be used.
13. Upon termination of a contract from Collin County, or at the request of the Collin County staff, the Authorized
Party must uninstall the REMOTE ACCESS connection from the Authorized Parry's computer.
14. Agency expressly agrees to notify the County of staffing changes involving an Authorized Party with access to
the County's network within 24 hours or next business day.
15. After six months of expired inactivity, Active Directory and REMOTE ACCESS accounts of an Authorized
Party will be permanently deleted, unless otherwise approved by the County.
16. Accounts will be locked out after a certain number of failed attempts.
17. Authorized Parties who have lost their password will have to contact their sponsoring agency to request a
password reset. The sponsoring agency will then contact Collin County IT to reset the password for the
REMOTE ACCESS user. The sponsoring agency is the Sheriff's Office.
18. It is the responsibility of the Authorized Party to install, configure, setup and support any issues with their
systems to connect to Collin County based on the information provided to them.
19. Authorized Parties connect at their own risk and Collin County is not responsible for any damages that they
may incur fi-om connecting through the REMOTE ACCESS to Collin County
20. Prior to acquiring REMOTE ACCESS all Authorized Parties will be required to pass a background check unless
otherwise approved by the County.
21. If the County migrates to a new network connection technology it is the responsibility of the Agency to budget
and obtain any required technology upgrade in order to maintain their network connection to the County. The
Agency will be provided advance notification for this change.
22. The Authorized Party must notify Collin County IT immediately upon learning of any compromise occurring
through an anti -virus, malware, or other form of unauthorized access. Collin County will also inform the
Authorized Parties of any breach or suspected breach occurring on the county network. REMOTE ACCESS
may be restricted during such an event while corrective actions are undertaken.
4.0 Granting Access
To obtain access via REMOTE ACCESS, the Agency and Authorized Party must be sponsored by a party
currently employed at Collin County and IT must agree this access is needed for the Collin County information
systems. The Agency and Authorized Party must sign this form agreeing to protect the security of the Collin
County network. For external Authorized Parties, the Request for REMOTE ACCESS Hurst be signed and
approved by the Manager who is responsible for the external Authorized Parry's use. REMOTE ACCESS
expiration will be based on the contract Iength unless further time is requested by Collin County Management.
The initial setup and testing will be performed during normal operating hours, Monday — Friday, 8 am — 5 pm,
and requires a minimal of two weeks' notice to schedule.
5.0 Enforcement
Collin County Information Technology Department may actively monitor the REMOTE ACCESS concentrator
for any suspicious and inappropriate activity. Any Authorized Party found to have violated any part of this policy
may have their REMOTE ACCESS terminated immediately.
6.0 Liability
Agency expressly agrees that they shall be liable for any and all damages, including but not limited to actual,
consequential, or incidental damages, for disruptions caused by their negligence or intentional misconduct,
including that caused by their Authorized Parties, to the County's services/equipment resulting from or related to
Agency's connection to the County's networks.
Unauthorized access or use is prohibited and will be prosecuted to the fullest extent. Anyone using this system
expressly consents to monitoring and is advised that if such monitoring reveals possible evidence of criminal
activity system personnel may provide the evidence of such monitoring to law enforcement officials. Anyone using
the system connects at their own risk and assumes all responsibilities for any possible damage to their own
equipment.
7.0 Definitions
Term
REMOTE
ACCESS
REMOTE
ACCESS
Concentrator
REMOTE
ACCESS Client
Agency
Management
Definition
An extension of Collin County's internal private network.
Physical device that manages REMOTE ACCESS connections.
Remote computer with REMOTE ACCESS software utilizing REMOTE
ACCESS services.
Person in Agency company that can take responsibility for the liability clause
of this document.
Dual (split) When utilizing REMOTE ACCESS, a connection (tunnel) is created to Collin
tunneling County's network
utilizing the Internet. Dual split tunneling allows for this connection as well as
a secondary connection to another source. This technology is NOT supported
when utilizing Collin County's REMOTE ACCESS.
User Employee, Agency, contractor, consultant, temporaries, customers,
government agencies, etc.
Sponsoring Party Collin County employee requesting access for a non -employee user to have
access to Collin County services/equipment through the REMOTE ACCESS.
The employee may be someone in IT.
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Signature:
Phone: Date:
Remote Access Users Signature
Printed Name: `ei Signature:
E-Mail Address: �ys',�d7o-„�„��-¢,�s �, a� Phone: Date: --oq-t
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone:
Date:
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Remote Access Users Signature
Signature:
Phone:
Printed Name: Z o r!,f ooA7 a h Signature:
E-Mail Address:c�
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Date:
Phone: Date: 1- e1 -I ,f
Signature:
Phone:
Date:
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Remote Access Users Signature
Signature:
Phone:
Printed Name: vq & o Orc�a Signature:
Date:
E-Mail Address: Gyr��ran ahnG Erxas, r,� Phone: JIq 1 If l Date:
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone:
Date:
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Signature:
Phone:
Date:
Remote Access Users Signature
Printed Name: �� �. 3u,7-1_ e Signature: �� 7
E-Mail Address: 0 b U j&teX _54wPhone: 7 aa90 Date: /'
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone:
Date:
Agency Management's Signature (if applicable)
Printed Name: _ Signature:
E-Mail Address:
Phone: Date:
Remote Access Users Signature
Printed Name: rc, 5+e-r Signature:
E-Mail Address:4L5,4 r „- Phone: 0 3- Date:/Cog
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone: Date:
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Signature:
Phone:
Date:
Remote Access Users Signature l
42J3;i��
Printed Name: RUSk �M� -1 '^ Signature:
E-Mail Address: ) C,n AA t-C) �Phone:9'72. -9�2 / -o2F9'?Date: at - q
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone:
Date:
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Signature:
Phone:
Remote Access Users Signature
Printed Name: u )DC) j S 0 A Signature:
Date:
E-Mail Address: Phone: 72- 92y 294Date: 9 4/%S_
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone:
Date:
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Signature:
Phone:
Remote Access Users Signature
Printed Name: Bra:RA®cti 6rra_�r Signatur -
Date:
E-Mail Address: bhl6ej Phone: qO3- %- C� a Date: 0`1i-04 15
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone:
Date:
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Signature:
Phone: Date:
Remote Access Users Signature
Printed Name: Signature:
E-Mail Address: 'y�•//a.�,,� Phone: Date: OIPA
10, VAT
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone: Date:
Agency Person in Agency company that can take responsibility for the liability
Management clause of this document.
Dual (split)
When utilizing REMOTE ACCESS, a connection (tunnel) is created to
tunneling
Collin County's network
utilizing the Internet. Dual split tunneling allows for this connection as
well as
a secondary connection to another source. This technology is NOT
supported
when utilizing Collin County's REMOTE ACCESS.
User
Employee, Agency, contractor, consultant, temporaries, customers,
government agencies, etc.
Sponsoring Party
Collin County employee requesting access for a non -employee user to
have access to Collin County services/equipment through the REMOTE
ACCESS. The employee may be someone in IT.
Agency Management's Signature (if applicable)
Printed Name: Signature:
E-Mail Address:
Phone: Date:
Remote Access Users Signature
Printed U dNY^ M 0-�e k_17Yt1kS _ Signature:
E-Mail Address4k rrxo S I" a /, A,4p4j S �JOLPhone: % -2 �1 � tI � Date:
i (_
Sponsoring Parry's Signature
Printed Name: ___ Signature:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale 93198
McKinney, Texas 75071
Phone: Date:
Agency Person in Agency company that can take responsibility for the liability
Management clause of this document.
Dual (split) When utilizing REMOTE ACCESS, a connection (tunnel) is created to
tunneling Collin County's network
utilizing the Internet. Dual split tunneling allows for this connection as
well as
a secondary connection to another source. This technology is NOT
supported
when utilizing Collin County's REMOTE ACCESS.
User Employee. Agency, contractor, consultant, temporaries, customers,
government agencies, etc.
Sponsoring Party Collin County employee requesting access for a non -employee user to
have access to Collin County services/equipment through the REMOTE
ACCESS. The employee may be someone in IT.
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Signature:
Phone:
Remote Access Users Signature
Printed Name: Gt� i reU1 140AZSignature:
Date:
Jt/ �
Mail Address: i—�tlnR t�eZ Anr `l eJC4F.Nhone: ��� q� y`� Date:
-w-cg
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale 93198
McKinney, 'Texas 75071
Signature:
Phone:
Date:
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Remote Access Users Signature
Signature:
Phone: Date:
Printed Name: + a lP Signature: --�
E-Mail Address: A `, Phone:< —at � 7.q �- ge,t4 0 Date: 0� ��19
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone:
Date:
Agency Management's Signature (if applicable)
Printed Name:
Signature:
E-Mail Address: Phone: Date:
Remote Access Users Signature NhwhioPrinted Name: haL f Signature:("
E-Mail Address: (&Sh01'I'f eo "jj4AW.jPW Phon . g7Z-qzq- -$' Date:
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale 43198
McKinney, Texas 75071
Signature:
Phone: Date:
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Remote Access Users Signature
Printed Name: beVo f-c
Signature:
Phone:
Signature:��-
Date:
E-Mail Address: '-e Plone: q'I Vq, aegf Date: ZIL
&a
U
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone:
Date:
Agency Management's Signature (if applicable)
Printed Name:
E-Mail Address:
Signature:
Phone: Date:
Remote Access Us
ers Signature
Printed Name: ye,_5 -IAi ���e Kignature:
E-Mail Address: cw,;encc ,i Phone: - y)kQVate:
Sponsoring Party's Signature
Printed Name:
E-Mail Address:
Return form to:
Caren Skipworth
2300 Bloomdale #3198
McKinney, Texas 75071
Signature:
Phone:
Date: