BEAUMONT INDEPENDENT SCHOOL DISTRICT

Beaumont, Texas
EXHIBIT"M"
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TO Dr. Carrol A. Thomas, ..Ir.
Superintendent of Schools
FROM: Robert Zingelmann ,Ii;
Chief Business Officer
DATE: September 15, 2011
SUBJECT: Consider and, if Appropriate, Take Action to Approve the Contracting
of Scott M. Favre Public Adjuster LLC., to Evaluate and Pursue
Possible Financial Damages to Beaumont ISD as a Result of the
British Petroleum Oil Spill or Related Events
Compensation will be based on collected funds. The percentage due
upon collection to Scott Favre is 20%.
Administration recommends approval of the contracting of Scott M.
Favre Public Adjuster LLC.
AGENDA
September 15, 2011
; Required BP Claim Information
Name of Individual: $P Claim #: _
o Current Address and Mailing Address
____________--, Mailing Address: _
If Different
o Office Phone #: L-J__- _
o Cell Phone#: L-J__- _
o Home Phone #: (--1 __- __
o Fax #: (---Y _ - __
o Email Address: ....;..
Required Documentation for Personal Claim
o Claims Presentation Agreement and Advice of Representation 0 Faxed
o Copy of Driver's License
o All W-2, 1099 and Income Tax Returns for 2008 .
o All W-2, 1099 and Income Tax Returns for 2009
o All W-2, 1099 and Income Tax Returns for 2010
o Pay Stubsor Monthly Statements for 2011
o Detailed Description of Causation
o Unemployment Compensation Benefits/Information (If Applicable)
o Replacement Income (Severance Pay) Information (If Appi,icable)
o Documentation Regarding Personal Property or Real Property Loss (If Applicable)
o Documentation Describing Removal and Clean Up (If Applicable)'
o Emergency Advance Payment Documentation (IfApplicable)
Required Documentation for Business or Government Entity
o Claims Presentation Agreement and Advice of Representation 0 Faxed
o Monthly Profit and Loss Statement: 1/2008 - 3/2011
-0 Sales Tax Return: 1/2010 - 4/2011
o Income Tax Returns w\Attachments and Schedules for 2008
- 0 Income Tax Returns w\Attachments and Schedules for 2009
o !ncome Tax Returns w\Attachments and Schedules for 2010
o petailed Description of Causation
o Letters Loss of Business or Increase of Expenses
o Private Insurance Compensation Information (if Applicqble)
- 0 Documentation Regarding Personal Property or Real Property Loss (If Applicable)
o Documentation Describing Removal-and Clean Up (If Applicable)
. 0 -Emergency Advance Payment Documentation (If Applicable)
EXHIBIT "M"
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ADVICE OF REPRESENTATION AND CO-PAYMENT NOTICE
Date:
------------------
Date of Loss: April 20. 2010
Claimant(FUll Name): _
Type of Loss: Economic Loss
Claim #
----------------
Last FoUl' # of SSNIEINlI1N(circle one) :, _
Gulf Coast Claims Facility COCCF):
Please be advised that I have retained Scott M. Favre PA, LLC as a business representative to
assist, prepare, quantify and present the econoDric loss as a result ofBritish Petroleum (BP) Deep
Water Horizon Disaster.
Also, with this, I request that GCCF, its agents and adjusters communicate directly with Scott
M. Favre PA, LLC, in all matters relating to this claim. This should include, but is not limited
.to, communications, correspondence, estimates or loss assessments with reference to this loss.
From the date you receive this Advice of Representation and Co-Payment Notice, I request
the GCCF Company to name Scott M. Favre PA, LLC as well as myself as an endorser on any
and all disbursements, drafts or checks issued for this claim.
Respectfully,
Claimant Signature: .Date: _
Address Filed Under:
PLEASE FORWARD ALL CORRESPONDENCE TO:
Scott M. Favre Public Adjustment LLC
7044 Stennis Airport Rd.
Kiln, MS 39556
Office: 228-466-5644
Fax: 228-466-5645
EXHIBIT "M"
Page 3 of 6
70,14 Stennis Airport Rd., Kiln, MS 39556 Office: 228-466-5644 Fax: 228-466-5645
www.favrepa.com
CLAIMS PRESENTATION AGREEMENT
THIS AGREEMENT ("Agreement") is made on September 15,2011 between Beaumont
Independent School District hereinafter referred to as "Client" and Scott M. Favre
Public Adjuster, LLC of Hancock County, Mississippi, hereinafter, "Scott M. Favre."
In consideration of the mutual promises herein contained, the parties hereto agree as
follows:
I. PURPOSE OF REPRESENTATION
1.01 Client hereby retains and employs S90tt M. Favre to assist and advise Client with
his/her claim against any responsible party relating to the BP Deep Water Horizon oil
spill disaster. Scott M. Favre shall prepare and present the claim to the Gulf Coast
Claims Facility and generally undertake to obtain the highest and best compensation on
Client's claim.
n. ASSIGNMENT OF INTEREST AND COMPENSATION
2.01 In consideration of Scott M. Favre's services, Client hereby sells, conveys and
assigns to Scott M. Favre twenty percent undivided interest in Client's claims against all
responsible parties for loss or damage incurred by Client as a result of the BP Deep Water
Horizon oil spill disaster, including all rights to make, litigate, negotiate, settle,
compromise, release or waive the claim. Client understands and agrees that this
assignment entitles Scott M. Favre to receive twenty percent of all money or other
compensation resulting from Client's BP Deep Water Horizon oil spill claim. Client
understands and agrees that this assignment entitles Scott M. Favre to be a payee on any
check payable to Client which constitutes a recovery on the BP Deep Water Horizon oil
spill claim. Client understands and agrees that this assignment requires Client to pay to
Scott M. Favre twenty percent (20%) of all monies paid by the Gulf Coast Claims
Facility after the execution ofthis contract in cOIDlection with Client's claim. Client
l.mderstands and agrees that Scott M. Favre is entitled to a lien on all recovery on the
claim to the extent ofh1s interest in the claim. If Scott M. Favre exhausts all avenues to
settle said claim pre litigation and claim must be litigated, Scott M. Favre agrees to lower
its fees to 10% and allow client to seek outside counsel as they wish to litigate said matter
_---..,..__ Initial
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Ill. AUTHORITY GRANTED TO SCOTT M. FAVRE
3.01 Client authorizes Scott M. Favre to prepare and submit documents to the Gulf Coast
Claims Facility regarding the claim; discuss Client's claim with representatives of the
Gulf Coast Claims Facility; and negotiate the claim with the Gulf Coast Claims Facility.
Scott M. Favre shall negotiate the claim as a whole, and shall not negotiate his assigned
portion ofthe claim separately. .
3.02 Scott M. Favre shall not make a settlement or compromise of Client's claim
without complete approval of Client.
IV. REPRESENTATIONS
4.01 It is expressly agreed and understood that no promises or guarantees as to the
outcome of the claim have been made to Client by Scott M. Favre. Scott M. Favre has
not represented to Client that Client will recover all or any of the funds so desired. It is
further expressly understood and agreed that no other representations have been made to
Client, except for those set out in this Agreement.
V. COOPERATION OF CLIENT
5.01 Client shall keep Scott M. Favre advised of Client's whereabouts at
all times, and provide Scott M. Favre with any changes of address, phone number or
business affiliation during the time period which Scott M. Favre's services are rendered,
and shall comply with all reasonable request of Scott M. Favre in connection with the
preparation and presentation of the aforesaid representation.
VI. TEXAS LAW TO APPLY
6.01 This agreement shall be construed under and in accordance with the laws of
Texas. All lawsuits arising out of this contract, ifany, shall be filed in Beaumont, Texas.
VII. PARTIES BOUND
7.01 This Agreement shall be binding upon and inure to the benefit of the parties
hereto and their respective heirs, executors, administrators, legal representations,
successors and assigns where pemlitted by this Agreement.
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Initial
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VIII. LEGAL CONSTRUCTION
8.01 In this case anyone or more ofthe provisions contained in this Agreement
shall. for any reason. be held to be invalid. illegal or unenforceable in any respect, such
invalidity, illegality, or unenforceability shall not affect any other provision thereof and
this Agreement shall be construed as ifsuch invalid, illegal, or unenforceable provision
had never been contained therein.
IX. PRIOR AGREEMENTS SUPERSEDED
9.01 TIlis agreement constitutes the sole and only Agreement of the parties
and supersedes any prior understandings or written or oral agreements between the
parties respecting the within subject matter.
x. CONFIDENTIALITY CLAUSE
Any and all names. personal infonnation and/or documents provided to Scott M. Favre
for the purpose of this claim shall remain confidential within the staff of Scott M. Favre.
TIlis staff may include, but is not limited to. office staff. claim preparers and outside
experts such as Certified Public Accountants. There is a strict confidentiality clause in
place within the Scott M. Favre staff.
I certify and acknowledge that I have had the opportunity to read this Agreement. I
further state that I , voluntarily enter into this
Agreement fully aware of its terms and conditions.
Beawnont Independent School District S c ~ t t M. Favre PA LLC
Signed on this __ day of__, 20_. Signed on this _ day of__, 20_.
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EXHIBIT "M"
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