Firm Details The following information is requested regarding the law firm: Firm Name Firm Contact Address City, State and Zip Tax ID Number Contact Phone Number Contact Fax Number Contact E-mail Address Firm Website Address Is the law firm HUB certified? Yes or No % of Total Attorneys that are Minority Attorneys % of Total Attorneys that are Women Attorneys Outside Counsel maintains malpractice insurance in an amount of not less than $___________. (Outside Counsel agrees to maintain at least this amount of insurance coverage during this OCC Term) List the hourly rate range per hour (not to exceed $525*) for each group of billing personnel listed below with the exception of paralegals (not to exceed a maximum of $225 per hour): Partners ________ to ________ Of Counsel ________ to ________ Associates ________ to ________ Paralegal ________ to ________ Other (describe) ________ to __________ *$525/hr is the maximum rate allowed by the Attorney General.