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HomeMy WebLinkAboutIntersect Technology Institute Inc DBA ITI Cabling Inc; 2025-07-14; ASD IT: ALGA NORTE BALL FIELDS Page 1 City Attorney Approved 6/5/2024 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT ALGA NORTE BALL FIELDS This contract is made on the ______________ day of _________________________, 2025 (“Contract”), by the City of Carlsbad, California, a municipal corporation ("City") and Intersect Technology Institute, Inc. d/b/a ITI Cabling, Inc., a California corporation whose principal place of business is 432 Venture St, Escondido, CA 92029 ("Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, as contained in the Standard Specifications for Public Works Construction “Greenbook,” latest edition and including all errata; Part 1 General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor’s proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carlsbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by Gary Hornby (City Project Manager). PAYMENT. Project payment shall not exceed $7,625.00. No other compensation will be allowed except for items covered by subsequent amendments (if any) to this Contract. The City shall withhold retention as required by Public Contract Code Section 9203. The Contractor will issue an invoice on a monthly basis for work completed during the preceding month. TIME OF PERFORMANCE. Contractor agrees to start within thirty (30) working days after receipt of Notice to Proceed. Contractor agrees to complete work within thirty (30) working days after receipt of Notice to Proceed. PREVAILING WAGE RATES. Any construction, alteration, demolition, repair, and maintenance work, including work performed during design and preconstruction such as inspection and land surveying work, cumulatively exceeding $1,000 and performed under this Contract constitute “public works” under Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 14th July ASD IT: ALGA NORTE BALL FIELDS Page 2 City Attorney Approved 6/5/2024 California Labor Code Section 1720 et seq., and are subject to state prevailing wage laws. The general prevailing rate of wages, for each craft or type of worker needed to execute the contract, shall be those as determined by the Director of Industrial Relations pursuant to the Sections 1770, 1773 and 1773.1 of the California Labor Code. Consistent with the requirement of Section 1773.2 of the California Labor code, a current copy of applicable wage rates may be obtained via the internet at: www.dir.ca.gov/dlsr/. Contractor shall not pay less than the said specified prevailing rates of wages to all such workers employed by him or her in the execution of the Contract. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Labor Code Section 1776. DIR REGISTRATION. California Labor Code Section 1725.5 requires the Contractor and any subcontractor or subconsultant performing any public work under this Contract to be currently registered with the California Department of Industrial Relations (‘DIR’), as specified in Labor Code Section 1725.5. Labor Code Section 1771.1 provides that a contractor or subcontractor/subconsultant shall not be qualified to engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Labor Code section 1725.5. Prior to the performance of public work by any subcontractor or subconsultant under this Contract, Contractor must furnish the City with the subcontractor or subconsultant's current DIR registration number. CALIFORNIA AIR RESOURCES BOARD (CARB) ADVANCED CLEAN FLEETS REGULATION. Contractor’s vehicles with a gross vehicle weight rating greater than 8,500 lbs. and light-duty package delivery vehicles operated in California may be subject to the California Air Resources Board (CARB) Advanced Clean Fleets regulations. Such vehicles may therefore be subject to requirements to reduce emissions of air pollutants. For more information, please visit the CARB Advanced Clean Fleets webpage at https://ww2.arb.ca.gov/our-work/programs/advanced-clean-fleets. CALIFORNIA AIR RESOURCES BOARD (CARB) IN-USE OFF-ROAD DIESEL FUELED FLEETS REGULATION. Contractors are required to comply with the requirements of the In-Use Off-Road Diesel-Fueled Fleet regulations, including, without limitation, compliance with Title 13 of the California Code of Regulations section 2449 et seq. throughout the term of the Project. More information about the requirements and Contractor’s required certification is provided in Exhibit C. CONSTRUCTION MANAGEMENT SOFTWARE. Procore Project Management and Collaboration System. This project may utilize the Owner’s Procore (www.procore.com) online project management and document control platform. The intent of utilizing Procore is to reduce cost and schedule risk, improve quality and safety, and maintain a healthy team dynamic by improving information flow, reducing non- productive activities, reducing rework and decreasing turnaround times. The Contractor is required to create a free web-based Procore user account(s) and utilize web-based training / tutorials (as needed) to become familiar with the system. Unless the Engineer approves otherwise, the Contractor shall process all project documents through Procore because this platform will be used to submit, track, distribute and collaborate on project. If unfamiliar or not otherwise trained with Procore, Contractor and applicable team members shall complete a free training certification course located at http://learn.procore.com/procore-certification-subcontractor. The Contractor is responsible for attaining their own Procore support, as needed, either through the online training or reaching out to the Procore Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 ASD IT: ALGA NORTE BALL FIELDS Page 3 City Attorney Approved 6/5/2024 support team. It will be the responsibility of the Contractor to regularly check Procore and review updated documents as they are added. There will be no cost to the Contractor for use of Procore. It is recommended that the Contractor provide mobile access for Windows, iOS located at https://apps.apple.com/us/app/procore-construction-management/id374930542 or Android devices located at https://play.google.com/store/apps/details?id=com.procore.activities with the Procore App installed to at least one on-site individual to provide real-time access to current posted drawings, specifications, RFIs, submittals, schedules, change orders, project documents, as well as any deficient observations or punch list items. Providing mobile access will improve communication, efficiency, and productivity for all parties. The use of Procore for project management does not relieve the contractor of any other requirements as may be specified in the contract documents. FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this Contract and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five (5) years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ___________________________________ Print Name: ___________________________________ REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers’ Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance. Insurance written on an “occurrence” basis, including personal & advertising injury, with limits no less than $2,000,000 per occurrence. If a general aggregate limit Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 Dan Hopkins ASD IT: ALGA NORTE BALL FIELDS Page 4 City Attorney Approved 6/5/2024 applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. Property Damage Insurance. Insurance in an amount of not less than $2,000,000. Automobile Liability Insurance. Insurance in the amount of $2,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non-scheduled. The automobile insurance certificate must state the coverage is for “any auto” and cannot be limited in any manner. Additional Insurance Terms. The above policies shall have non-cancellation clauses providing that 30 days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS’ COMPENSATION AND EMPLOYER’S LIABILITY. Workers’ Compensation limits as required by the California Labor Code. Workers’ Compensation will not be required if Contractor has no employees and provides, to City’s satisfaction, a declaration stating this. BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Carlsbad Business License for the duration of the contract. ACCOUNTING RECORDS. Contractor will maintain complete and accurate records with respect to costs incurred under this Contract. All records will be clearly identifiable. Contractor will allow a representative of City during normal business hours to examine, audit, and make transcripts or copies of records and any other documents created pursuant to this Contract. Contractor will allow inspection of all work, data, documents, proceedings, and activities related to the Contract for a period of three (3) years from the date of final payment under this Contract. INDEMNITY. Contractor agrees to defend (with counsel approved by the City), indemnify, and hold harmless the City and its officers, elected and appointed officials, employees and volunteers from and against all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys’ fees for litigation, arbitration, or other dispute resolution method. THIRD PARTY RIGHTS. Nothing in this Agreement should be construed to give any rights or benefits to any party other than the City and Contractor. JURISDICTION AND VENUE. This Agreement shall be interpreted in accordance with the laws of the State of California regardless of conflict of laws principles. The Contractor agrees and hereby stipulates that Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 ASD IT: ALGA NORTE BALL FIELDS Page 5 City Attorney Approved 6/5/2024 the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Contract is San Diego County, California. CONTRACTOR’S INFORMATION. Intersect Technology Institute, Inc. d/b/a ITI Cabling, Inc. 432 Venture St. (name of Contractor) 849343 (street address) Escondido, CA 92029 (Contractor’s license number) C-7 11/30/2026 (city/state/zip) 858.816.0686 (license class. and exp. date) 1000001685 6/30/2026 (telephone no.) Kharbridge@iticabling.com (DIR registration number/exp. date) (e-mail address) SUCCESSORS AND ASSIGNS. It is mutually understood and agreed that this Contract will be binding upon City and Contractor and their respective successors. Neither this Contract nor any part of it nor any monies due or to become due under it may be assigned by Contractor without the prior consent of City. AUTHORITY. The individuals executing this Contract and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Contract. [signatures on following page] Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 ASD IT: ALGA NORTE BALL FIELDS Page 6 City Attorney Approved 6/5/2024 CONTRACTOR CITY OF CARLSBAD, a municipal corporation of the State of California Intersect Technology Institute, Inc. d/b/a ITI Cabling Inc., a California corporation By: By: (sign here) IT Director (print name/title) ATTEST: By: SHERRY FREISINGER, City Clerk (sign here) By: Morgen Fry, Assistant City Clerk (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Contract must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, President, or Vice-President Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney BY: _____________________________ Deputy City Attorney Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 VP of OperationsDan Hopkins Chief Financial OfficerTessa Page ASD IT: ALGA NORTE BALL FIELDS Page 7 City Attorney Approved 6/5/2024 EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each subcontractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each subcontractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a subcontractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Type of Work to be Subcontracted Business Name and Address DIR Registration No. & Expiration Date License No., Classification & Expiration Date % of Total Contract None Total % Subcontracted: ____0%___________ The Contractor must perform no less than 50% of the work with its own forces. Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 ASD IT: ALGA NORTE BALL FIELDS Page 8 City Attorney Approved 6/5/2024 EXHIBIT B STATEMENT OF WORK ALGA NORTE BALL FIELDS ITI Quote #: 02F5832-IO-KH Date: 3/11/2025 Scope: Telecommunications City of Carlsbad: Alga Norte Ball Fields ● At five (5) locations Install a customer provided Wireless Access Point device at 15 feet up the Musco light pole. ● Install five (5) Category 6 extended distance cables for each Wireless device location. Install the Wireless Access Points at 15 feet up the Musco light pole. ● At the IDF side terminate the cables on the existing patch panel. ● At the station side, terminate the cables with RJ-45 mod connectors. ● Label & Test to industry standards. Scope Assumptions: ● Total price is good for 90 days from the bid date. ● Permits and Bonds are not included. ● ITI does not carry Pollution insurance and will not be required to provide additional insured coverage. ● The Project will commence and materials ordered ** upon receipt of a purchase order. ● When required by written contract or agreement, endorsements included with this certificate are issued on a Blanket basis. Any changes to the status of provided endorsements will be at the expense of the Contractor. ● Work outside of the above mentioned scope of work may be billed in addition to the given price. ● Hourly rate is based on State Prevailing Wages. ● Clear and unobstructed cable paths for all cable runs. ● Floor monuments and surface mounted raceway if needed to be provided and installed by others. ● All conduits, Telecommunication Boxes (Nema 4X, 3R etc) to be provided by others and to have pull rope in place. ● All Communication Outside Plant Manholes, Handholes, Manholes, Handholes & Hardware, Duct Bank Conduits all with pull rope in place to be provided and installed by others. ● Telecom Room Entrance or Exit Conduit Sleeves, Cores, penetrations, or power poles to be provided by others. ● Telecom Raceway, Cable Tray, Ladder Rack or Wire Basket Cable Tray outside of Telecommunication Rooms to be provided by others. ● Interconnections between all TGBs and the TMGB with the telecommunications backbone conductor, Bonding to each TGB and TMGB to Bond the equipment grounding busbar to the TGB with a No. 2 AWG bonding conductors and Bonding of each TGB and TMGB to Vertical steel of the building frame to be provided by others. ● Rigidly fixed, 3/4" void free, fire rated AC plywood to be provided by others. Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 ASD IT: ALGA NORTE BALL FIELDS Page 9 City Attorney Approved 6/5/2024 ● Fire stopping outside of Telecom Room installation to include materials and labor to be provided by others ● Network equipment provided, installed and configured by others ● WAP’s (Wireless Access Point), Cabling, Installation, Mounting Brackets, Network Switches, Device Patch Cords, programming or commissioning by others. Project Exclusions: ● BIM (Building Information Modeling) Services using Autodesk Revit or the like to include 3D Modeling ● Phone or Data Service (Cox, AT&T etc.) extensions into building(s) to include MPOE, MDF or IDF. ● No specialty permits included. Project Schedule: 2 Days Project Hours: 32 Total Project Price: $7,625.00 *** NOTE: Bonds are not included but if required a 1.5% adder will be charged. *** ITI Cabling Inc. EMR is .92 *** ITI Cabling Inc. is a certified Small Business Enterprise for the State Of California and the Federal Government. *** ITI Cabling Inc. is 100% Bondable. Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 ASD IT: ALGA NORTE BALL FIELDS Page 10 City Attorney Approved 6/5/2024 EXHIBIT C In-Use Off-Road Diesel-Fueled Fleet Regulation Requirements CARB implemented amendments to the In-Use Off-Road Diesel Fueled Fleets Regulations that apply broadly to all self-propelled off-road diesel vehicles 25 horsepower or greater and other forms of equipment used in California. More information about the requirements can be found at https://ww2.arb.ca.gov/our-work/programs/use-road-diesel-fueled-fleets-regulation Contractors are required to comply with the requirements of the In-Use Off-Road Diesel-Fueled Fleet regulations, including, without limitation, compliance with Title 13 of the California Code of Regulations section 2449 et seq. throughout the term of the Project. The City is a “Public Works Awarding Body,” as that term is defined under Title 13 California Code of Regulations Section 2449(c)(46). Accordingly, the Contractor must submit, with their pre-award contract documents, valid Certificates of Reported Compliance (CRC) for the Contractor’s fleet, and for the fleets of any listed subcontractors (including any applicable leased equipment or vehicles). Failure to provide a valid CRC, will limit the city’s ability to proceed with awarding this Contract. Contractor has an on-going obligation for term of this Agreement to provide copies of Contractor’s, as well as all listed subcontractors, most recent CRC issued by CARB. Throughout the Project, and for three (3) years thereafter, Contractor shall make available for inspection and copying any and all documents or information associated with Contractor’s and subcontractors’ fleet including, without limitation, CRC, fuel/refueling records, maintenance records, emissions records, and any other information the Contractor is required to produce, keep or maintain pursuant to the Regulation upon two (2) calendar days’ notice from the City. Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 ASD IT: ALGA NORTE BALL FIELDS Page 11 City Attorney Approved 6/5/2024 EXHIBIT C (CONT.) IN-USE OFF-ROAD DIESEL-FUELED FLEET REGULATION CERTIFICATION Contractor hereby acknowledges that they have reviewed the CARB’s policies, rules and regulations and are familiar with the requirements of In-Use Off-Road Diesel-Fueled Fleet Regulation. Contractor hereby certifies, subject to the penalty of perjury, that the option checked below relating to the Contractor’s fleet, and/or that of their subcontractor(s) (“Fleet”) is true and correct: ☐ The Fleet is subject to the requirements of the Regulation, and the appropriate Certificate(s) of Reported Compliance have been attached hereto. ☐ The Fleet is exempt from the Regulation under Section 2449.1(f)(2), and a signed description of the subject vehicles, and reasoning for exemption has been attached hereto. ☐ Contractor and/or their subcontractor is unable to procure R99 or R100 renewable diesel fuel as defined in the Regulation pursuant to Section 2449.1(f)(3). Contractor shall keep detailed records describing the normal refueling methods, their attempts to procure renewable diesel fuel and proof that shows they were not able to procure renewable diesel (i.e., third party correspondence or vendor bids). ☐ The Fleet is exempt from the requirements of the Regulation pursuant to Section 2449(i)(4) because this Project has been deemed an “emergency”, as that term is defined in Section 2449(c)(18). Contractor shall only operate the exempted vehicles in the emergency situation and records of the exempted vehicles must be maintained, pursuant to Section 2449(i)(4). ☐ The Fleet does not fall under the Regulation or are otherwise exempt and a detailed reasoning is attached to this certification. Name of Contractor: Signature: Name: Title: Date: Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 ITI Cabling Inc. 7/9/2025 Dan Hopkins VP of Operations X 09/18/2024 Paul Dole Insurance Agency 5130 Bonita Road, Suite A Mailing: P.O. Box 400 Bonita CA 91908 Ellen Lu (619) 475-5200 (619) 475-5258 ellen@doleandsons.com Intersect Technology Institute, Inc., DBA: ITI Cabling Inc 432 Venture Street Escondido CA 92029 West American Insurance Company 44393 Scottsdale Insruance Company 41297 Insurance Company of the West 27847 24-25GL,BA,EX,WC A BKW56688892 09/20/2024 09/20/2025 1,000,000 500,000 15,000 1,000,000 2,000,000 2,000,000 Deductible $1,000(PD) A BAW56688892 09/20/2024 09/20/2025 1,000,000 Liab Deductible $0 B XLS2005227 09/20/2024 09/20/2025 5,000,000 5,000,000 follow form GL/Auto/EL Deductible $0 C Y WSD 5067386 02 09/20/2024 09/20/2025 Deductible $0 1,000,000 1,000,000 1,000,000 Evidence of Insurance City of Carlsbad 1635 Faraday Ave Carlsbad CA 92008 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCEDAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7 Docusign Envelope ID: D5281F1C-CF13-43E7-A91F-4D225DBE55C7