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HomeMy WebLinkAboutArbon Equipment Corporation; 2023-09-05; PWM24-2269FACPWM24-2269FAC Fire Station No. 6 Back Overhead Door Repairs Page 1 of 9 City Attorney Approved 6/30/2023 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT FIRE STATION NO. 6 BACK OVERHEAD DOOR REPAIRS This agreement is made on the ______________ day of _________________________, 2023, by the City of Carlsbad, California, a municipal corporation (hereinafter called "City") and Arbon Equipment Corporation, a Wisconsin corporation, whose principal place of business is 200 South Rite-Hite Way, Milwaukee, Wisconsin 53204-1195 (hereinafter called "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 Daniel Smith (City Project Manager). PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. WAGE RATES. 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 Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5. DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 5th September PWM24-2269FAC Fire Station No. 6 Back Overhead Door Repairs Page 2 of 9 City Attorney Approved 6/30/2023 The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. 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 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 agreement 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. DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 PWM24-2269FAC Fire Station No. 6 Back Overhead Door Repairs Page 3 of 9 City Attorney Approved 6/30/2023 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: ___________Joseph C. Ramaker_________ 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 of Injuries including accidental death, to any one person in an amount not less than……..$1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ….…$1,000,000 Property damage insurance in an amount of not less than……..$1,000,000 Automobile Liability Insurance in the amount of $1,000,000 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. 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. DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 PWM24-2269FAC Fire Station No. 6 Back Overhead Door Repairs Page 4 of 9 City Attorney Approved 6/30/2023 INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from 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. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within thirty (30) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within sixty (60) working days after receipt of Notice to Proceed. CONTRACTOR’S INFORMATION. Arbon Equipment Corporation 200 S. Rite-Hite Way (name of Contractor) 997264 (street address) Milwaukee, WI 53204-1195 (Contractor’s license number) C61, D21, D28 10/31/2024 (city/state/zip) 858-880-5510 (license class. and exp. date) 1000023968 6/30/2024 (telephone no.) kkorb@ritehite.com (DIR registration number and exp. date) (e-mail address) [signatures on following page] DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 PWM24-2269FAC Fire Station No. 6 Back Overhead Door Repairs Page 5 of 9 City Attorney Approved 6/30/2023 AUTHORITY. The individuals executing this Agreement 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 Agreement. CONTRACTOR ARBON EQUIPMENT CORP, a Wisconsin corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Joseph C. Ramaker, Chief Financial Officer Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager (print name/title) By: (sign here) Gerald F. Timms, President (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Agreement 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: F80E59EB-212B-4A45-A158-9309FF662215 PWM24-2269FAC Fire Station No. 6 Back Overhead Door Repairs Page 6 of 9 City Attorney Approved 6/30/2023 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. License No., Classification & Expiration Date % of Total Contract Total % Subcontracted: _______________ The Contractor must perform no less than 50% of the work with its own forces. DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 N/AN/A 0 N/A N/AN/A PWM24-2269FAC Fire Station No. 6 Back Overhead Door Repairs Page 7 of 9 City Attorney Approved 6/30/2023 EXHIBIT B Fire Station No. 6 Back Overhead Door Repairs Contractor to provide all tools, materials, equipment, and labor to perform repairs on two overhead doors at Fire Station No. 6, 7201 Rancho Santa Fe Rd, Carlsbad, California 92009. Repairs to be performed are as follows: Door No. 3 - Remove and replace worn center shaft coupler, frayed cables, and damaged cable drums. - Balance door after installation of new components. Door No. 4 - Remove and replace worn center shaft coupler and cables. - Balance door after installation of new components. Jobsite is to be left in a clean and professional manner each day. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Replace worn components of two overhead doors at rear entrance of Fire Station No. 6 appartatus bay $10,329.11 TOTAL* $10,329.11 *Includes taxes, fees, expenses, prevailing wage rates and all other costs. DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 Quote is valid for 45 days. Thank you for your business! Kevin Korb Field Service Sales Rep kkorb@ritehite.com 858-880-5510 arbon.ritehite.com Quote Description: C/O 2 - Door Repairs - Fire Station 6 PREPARED FOR: City Of Carlsbad 7201 Rancho Santa Fe Road Carlsbad,CA 92009 , US Dan Smith SEND PURCHASE ORDER TO: Arbon Equipment Corporation - West 13230 Evening Creek Dr S, Suite 210 San Diego, CA 92128 United States 253-796-5593 LINE PRODUCT DESCRIPTION QTY UNIT PRICE EXTENDED PRICE 1 Cable Drums -Pair 2 Included Included 2 Shaft Coupler 2 Included Included 3 Labor 1 Included Included Quote Summary: Position 3 ·Center shaft coupler is worn and missing keyway, door isn't balanced, cables frayed and cable drums damaged ·Remove and replace with new center shaft coupler, cables, cable drums and balance door Position 4 ·Center shaft coupler is damaged, cable drums are damaged and door isn't balanced ·Remove and replace with new center shaft coupler, cable drums and balance door ·Arbon provides scissor lift ·Cables aren't quoted on a line item since those were on the original order and don't need to be ordered again ·Only one center shaft coupler is listed on quote since original order included a center shaft couple for door 4 Freight and Handling Included Tax (Sales Tax)Included TOTAL $ 10,329.11 QUOTE: QT-213201 08/03/2023 PWM24-2269FAC; Exhibit "B" (cont.) DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215.. ______ _ #"'IHDUIV EQUIPMENT CORPORATION A RITE-HITE"COMPANY Quote is valid for 45 days. Thank you for your business! Kevin Korb Field Service Sales Rep kkorb@ritehite.com 858-880-5510 arbon.ritehite.com Quote Description: C/O 2 - Door Repairs - Fire Station 6 ·During initial repairs of doors 1 thru 4: o Found the cable drums were frozen on door 1 and had to be cut off. Drums that were going to be used on door 3 had to be used for door 1 o Found center shaft coupler on door 3 is worn and keyway is missing so this part should be replaced o Found cable drums are frozen on door 4 and will have to be cut off when replacing other parts so a new pair of cable drums will be required at door 4 PWM24-2269FAC; Exhibit "B" (cont.) DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215.. ______ _ #"'IHDUIV EQUIPMENT CORPORATION A RITE-HITE"COMPANY 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 THISCERTIFICATE 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 OCCURRENCE DAMAGE 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 5/9/2023 Robertson Ryan & Associates, Inc330 E Kilbourn Ave # 850Milwaukee WI 53202 Shari M. Smith 414-221-0362 RHCerts@robertsonryan.com SENTRY INSURANCE COMPANY 24988 RITEH-1 Sentry Casualty Insurance 28460Arbon Equipment CorporationRite-Hite Company, LLCDuctSox Inc./Caljan America195 S. Rite-Hite WayMilwaukee WI 53204 Ace American Insurance Company 22667 Great American Excess & Surplus Insurance 37532 Federal Insurance Company 20281 1947975837 A X 2,000,000 X 1,000,000 X Contractual Liab 10,000 2,000,000 2,000,000 X Y 9003074001 10/1/2022 10/1/2023 0 A 2,000,000 X X X X Comp $0 Ded X Coll $0 Ded 9003074002 10/1/2022 10/1/2023 CD X X 5,000,000 X G72542216002XSE77065201 10/1/202210/1/2022 Y 10/1/202310/1/2023 5,000,000 X 10,000 Excess Umbrella 5,000,000 BA X N Y 90030740039003074004 WI-NV, MD 10/1/202210/1/2022 10/1/202310/1/2023 1,000,000 1,000,000 1,000,000 EC Blanket PropertyProducts-Comp/OP NY N 35900947G71174682005 10/1/202210/1/2022 10/1/202310/1/2023 PropertyOcc & Aggregate 160,731,4782,000,000 Additional Insured: The City of Carlsbad. Waiver of subrogation applies to the work comp. Umbrella follows form. Insurance forms are attached. City of Carlsbad/CMWDc/o EXIGIS Insurance Compliance ServicesP.O. Box 947Murrieta CA 92564United States DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 ACORD® I ~ I f--□ □ f-- f-- Fl □ □ f-- f--~ f--f-- f--f-- f--H I I I I I □ I Additional Coverage 10/1/2022 to 10/1/2023 Arbon Equipment Corporation Rite-Hite Company, LLC -Products/Completed Operations policy is shown separately on the certificate of insurance -Blanket Waiver of Subrogation for General Liability CG2404/1219 -Blanket Waiver of Subrogation for Products/Completed Ops. CG2404/1219 -Blanket Waiver of Subrogation for Automobile Liability CA7616/0618 -Blanket Waiver of Subrogation for Workers' Compensation WC000313/0484 -Blanket Waiver of Subrogation for Umbrella -Blanket Additional Insured for General Liability CG2010/1219 -Blanket Additional Insured for Products/Completed Operations CG2037/1219 -Blanket Additional Insured for Automobile Liability CA8007/0618 -Blanket Additional Insured for Umbrella -Primary & Non-Contributory under the General Liability CG2001/1219 -Primary & Non-Contributory Products/Completed Operations CG2001/1219 -General Liability excluding Products/Completed Operations has no deductible -Products/Completed Operations Deductible $500,000 -Chubb Insurance includes Contractors Equipment/$700,000 with a $10,000 deductible with Replacement Cost. -Installation Floater & Transit limit $250,000 with a $10,000 deductible. -Crime: Employee Dishonesty $1,000,000/$25,000 Retention and Employee Theft of Clients Property $500,000/$25,000 Deductible. Travelers. Insurance Company, Policy 105842758. 10/1/22 to 10/1/23. -Excess Umbrella: $5,000,000 Occurrence and Aggregate limit the same-Harleysville Insurance Company of New York, EMR0000004000 -Excess Umbrella: $5,000,000 Occurrence and Aggregate limit the same-RSUI-NHA099238 -Umbrella follows form over and above the General Liability, Products Liability, Auto Liability and the Workers Compensation. -Property is replacement cost with no exclusion for height or a non-commercial building/structure If you received this certificate by mail and would like it emailed to you in the future, please email us your email address at RHCerts@robertsonryan.com; Attach a copy of the front page of the certificate when doing this. DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 POLICY NUMBER:G71174682 005 COMMERCIAL GENERAL LIABILITY CG 20 371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations As required by written contract signed by both As required by written contract signed by both parties prior to loss. parties prior to loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. CG 20 371219 © Insurance Services Office, Inc., 2018 Page 1 of 1 Change effective 10/01/2022 Page 1 of 2CG 20 10 12 19 09/20/20229003074 Sentry Insurance Company © Insurance Services Office, Inc., 2018 POLICY NUMBER:COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE CG 20 10 12 19 Name Of Additional Insured Person(s) Or Organization(s)Location(s) Of Covered Operations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1.Your acts or omissions; or 2.The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All locations Description: All jobs Where required by written & signed agreement 9003074001 00001 0000000000 22263 0 N1 669a952b-eb5f-40df-9140-fce82452c95f669a952b-eb5f-40df-9140-fce82452c95f DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 C.With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement; or 2.Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. © Insurance Services Office, Inc., 2018 Change effective 10/01/2022 CG 20 10 12 19Page 2 of 2 09/20/20229003074 Sentry Insurance Company DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 IL 00 17 11 98 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or de- livering to us advance written notice of can- cellation. 2. We may cancel this policy by mailing or deliv- ering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of pre- mium; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named lnsured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declara- tions is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and re- cords as they relate to this policy at any time dur- ing the policy period and up to three years after- ward. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recom- mendations we may make relative to certifica- tion, under state or municipal statutes, ordi- nances or regulations, of boilers, pressure ves- sels or elevators. E. Premiums The first Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named in- sured. If you die, your rights and duties will be trans- ferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary cus- tody of your property will have your rights and du- ties but only with respect to that property. IL 001711 98 9003074 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 09/06/2022 Sentry Insurance Company 1 00001 0000000000 22249 0 N 5e84d943,11Oa-4cf7-b6e1-3953c12cfc87 DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 IL 001711 98 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or de- livering to us advance written notice of can- cellation. 2. We may cancel this policy by mailing or deliv- ering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of pre- mium; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mall or deliver our notice to the first Named lnsured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suffi- cient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declara- tions is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and re- cords as they relate to this policy at any time dur- ing the policy period and up to three years after- ward. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not undertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recom- mendations we may make relative to certifica- tion, under state or municipal statutes, ordi- nances or regulations, of boilers, pressure ves- sels or elevators. E. Premiums The first Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named in- sured. If you die, your rights and duties will be trans- ferred to your legal representative but only while acting within the scope of duties as your legal representative. Until your legal representative is appointed, anyone having proper temporary cus- tody of your property will have your rights and du- ties but only with respect to that property. IL 001711 98 9003074 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 09/06/2022 Sentry Insurance Company 1 00001 0000000000 22249 0 N 67eedb02-cd69-41f5.Ba39-410e64ff9a39 DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 IL 00 1711 98 COMMON POLICY CONDITIONS All Coverage Parts included in this policy are subject to the following conditions. A. Cancellation 1. The first Named Insured shown in the Declara- tions may cancel this policy by mailing or de- livering to us advance written notice of cancel- lation. 2. We may cancel this policy by mailing or deliv- ering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancel- lation if we cancel for nonpayment of pre- mium; or b. 30 days before the effective date of cancel- lation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named lnsured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be ef- fective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be suf- ficient proof of notice. B. Changes This policy contains all the agreements between you and us concerning the insurance afforded. The first Named Insured shown in the Declarations is authorized to make changes in the terms of this policy with our consent. This policy's terms can be amended or waived only by endorsement issued by us and made a part of this policy. C. Examination Of Your Books And Records We may examine and audit your books and rec- ords as they relate to this policy at any time during the policy period and up to three years afterward. D. Inspections And Surveys 1. We have the right to: a. Make inspections and surveys at any time; b. Give you reports on the conditions we find; and c. Recommend changes. 2. We are not obligated to make any inspections, surveys, reports or recommendations and any such actions we do undertake relate only to in- surability and the premiums to be charged. We do not make safety inspections. We do not un- dertake to perform the duty of any person or organization to provide for the health or safety of workers or the public. And we do not warrant that conditions: a. Are safe or healthful; or b. Comply with laws, regulations, codes or standards. 3. Paragraphs 1. and 2. of this condition apply not only to us, but also to any rating, advisory, rate service or similar organization which makes insurance inspections, surveys, reports or recommendations. 4. Paragraph 2. of this condition does not apply to any inspections, surveys, reports or recom- mendations we may make relative to certifica- tion, under state or municipal statutes, ordi- nances or regulations, of boilers, pressure ves- sels or elevators. E. Premiums The first Named Insured shown in the Declara- tions: 1. Is responsible for the payment of all premiums; and 2. Will be the payee for any return premiums we pay. F. Transfer Of Your Rights And Duties Under This Policy Your rights and duties under this policy may not be transferred without our written consent except in the case of death of an individual named insured. If you die, your rights and duties will be trans- ferred to your legal representative but only while acting within the scope of duties as your legal rep- resentative. Until your legal representative is ap- pointed, anyone having proper temporary custody of your property will have your rights and duties but only with respect to that property. IL 00 17 11 98 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 □ DocuSign Envelope ID: F80E59EB-212B-4A45-A158-9309FF662215 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Name: Address: AL, AZ, CO, CT, FL, GA, IA, ID, IL, KS, LA, ME, Ml, MN, MO, MS, NC, NM, NY, OR, PA,SC,TN,VA,VT,WV Description of Waiver: Any person or organization for whom the Named Insured has agreed by written contract executed prior to loss. JoblD: This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below is required only when this endorsement Is issued subsequent to preparation of the policy.} Endorsement Effective Insured Insurance Company Change effective 10/01/2022 WC 00 0313 (Ed. 4-84} © 1983 Natlonal Council on Compensation Insurance. 9003074003 Policy No. Endorsement No. Premium Countersigned by ________________ _ Page 1 of 1 09/21/2022 Sentry Casualty Company 1 00002 0000000000 22264 0 N 794ce 1B9-e9b8-440b-8501-2a9e264252of