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Home My WebLink AboutLetter of Transmittal: Dixon Engineering, Inc CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS 215 CHURCH AVENUE,P.O. BOX 1130,OSHKOSH,WI 54903-1.130 PHONE,': (920)236-5065 FAX(920)236-5068 LETTER OF TRANSMITTAL To: j oseph Hoban Date: October 17, 2018 Engineering, Inc. Executed Agreement for Consultin _ 5307 South 92nd Street, Suite 125 Services for T-Mobile Antenna Hales Corners, WI 53130 Installation on Marion Road Water Tower ------------------I Z-=-- Please find: Z Attached F] Under Separate Cover ❑ Copy of Letter Z Contracts ❑ Amendment ❑ Report ❑ Agenda ❑ Meeting Notes ❑ Photos ❑ Mylars ❑ Change Order ❑ Plans ❑ Specifications ❑ Estimates ❑ Diskette ❑ Zip Disk El Other Quantity 1 Executed L!A&�eem(Mt___ These are being transmitted as indicated below: R For Approval Z For Your Use ❑ As Requested E] For Review&Comment Remarks: Enclosed is a copy of the executed agreement for the consulting services for the T-Mobile antenna installation on the Marion Road Water Tower. A City of Oshkosh Purchase Order will follow shortly. Please reference this Purchase Order number on,all of your invoices. If you have any questions, please contact us. Steve Brand—Copy City Clerk's Office—Original cc: File—Original Signed: Tray -Tayll() 1:\Engineering\TracyTaylor\Steve Brand Agreements\Dixon Eng\Des Dfawings&St ruct Calc ReviewA'-Mobile Antenna-Marion Rd Tivr\DixonLor-Executed Agreelnent,..10-17- 18.docx AGREEMENT This AGREEMENT, made on the day of 2018, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and DIXON ENGINEERING, INC., 5307 South 92nd Street, Suite 125, Hales corners, W1 53130, party of the second part,hereinafter referred to as the CONSULTANT, WITNESSETH: The CITY and the CONSULTANT, for the consideration hereinafter named, enter into the following AGREEMENT for CONSULTING SERVICES FOR T-MOBILE ANTENNA INSTALLATION ON MARION ROAD WATER TOWER. ARTICLE 1. PROJECT MANAGER A. Assignment of Project Manager. The CONSULTANT shall assign the following individual to manage the PROJECT described in this AGREEMENT: Joseph T.Hoban, P.E.—Senior Project Engineer B. Changes in Project Manager. The CITY shall have the right to approve or disapprove of any proposed change from the individual named above as Project Manager. The CITY shall be provided with a resume or other information for any proposed substitute and shall be given the opportunity to interview that person prior to any proposed change. ARTICLE 11. CITY REPRESENTATIVE The CITY shall assign the following individual to manage the PROJECT described in this AGREEMENT: Stephan M. Brand—Public Works Utility Bureau Manager ARTICLE 111. SCOPE OF WORK The CONSULTANT shall provide the services described in the CONSULTANT's Proposal. The CITY may make or approve changes within the general Scope of Services in this AGREEMENT. If such changes affect CONSULTANT's cost of or time required for performance of the services, an equitable adjustment will be made through an amendment to this AGREEMENT. ]:\l;nginecriiig\'T'rac),'raylar\Steve Brand Agreements\Dixon Eng\Des DrAwings&Struct Cale Revievv- Page 1 of 6 'r-Mobile A idenna-Marion Rd Tvvr\Dixoo Agreement-.10-4-18.docx All reports, drawings, specifications, computer files, field data, notes, and other documents and instruments prepared by the CONSULTANT as instruments of service shall become property of the CITY upon payment for those documents by the CITY to the CONSULTANT, and shall remain the property of the CITY. ARTICLE IV. STANDARD OF CARE The standard of care applicable to CONSULTANT's services will be the degree of skill and diligence normally employed by professional consultants or consultants performing the same or similar services at the time said services are performed. CONSULTANT will re-perform any services not meeting this standard without additional compensation. ARTICLE V. OPINIONS OF COST,FINANCIAL CONSIDERATIONS, AND SCHEDULE In providing opinions of cost, financial analyses, economic feasibility projections, and schedules for the PROJECT, CONSULTANT has no control over cost or price of labor and materials; unknown or latent conditions of existing equipment or structures that may affect operation or maintenance costs; competitive bidding procedures and market conditions;time or quality of performance by operating personnel or third parties; and other economic and operational factors that may materially affect the ultimate project cost or schedule. Therefore,it is understood between the parties the CONSULTANT makes no warranty the CITY's actual project costs, financial aspects, economic feasibility, or schedules will not vary from CONSULTANT's opinions, analyses,projections,or estimates. ARTICLE VI. RECORD DRAWINGS Record drawings, if required, will be prepared, in part, on the basis of information compiled and furnished by others. CONSULTANT is not responsible for any errors or omissions in the information from others the CONSULTANT reasonably relied upon and are incorporated into the record drawings. ARTICLE VTl. CITY RESPONSIBILITIES The CITY shall furnish, at the CONSULTANT's request, such information as is needed by the CONSULTANT to aid in the progress of the PROJECT, providing it is reasonably obtainable from City records. To prevent any unreasonable delay in the CONSULTANT's work, the CITY will examine all reports and other documents and will make any authorizations necessary to proceed with work within a reasonable time period. I:\Engineering\Tracy Taylor\Steve Brand Agrecmvnts\DixonEng,\Des Drawings&Struct Cate Review- Page 2 of 6 T-Mobile Antenna-Marion Rd T%vr\Dixofi Agreement-104-18.docx ARTICLE Vffl. ASBESTOS OR HAZARDOUS SUBSTANCES If asbestos or hazardous substances in any form are encountered or suspected, CONSULTANT will stop its own work in the affected portions of the PROJECT to permit testing and evaluation. If asbestos is suspected, CONSULTANT will, if requested, manage the asbestos remediation activities using a qualified subcontractor at an additional fee and contract terms to be negotiated. If hazardous substances other than asbestos are suspected, CONSULTANT will, if requested, conduct tests to determine the extent of the problem and will perform the necessary studies and recommend the necessary remedial measures at an additional fee and contract terms to be negotiated. The CITY recognizes CONSULTANT assumes no risk and/or liability for a waste or hazardous waste site originated by other than the CONSULTANT. ARTICLE IX CITYS INSURANCE The CITY will maintain property insurance on all pre-existing physical facilities associated in any way with the PROJECT. The CITY will provide (or have the construction contractor(s) provide) a Builders Risk All Risk insurance policy for the full replacement value of all project work including the value of all onsite CITY-furnished equipment and/or materials associated with CONSULTANT's services. Upon request, the CITY will provide CONSULTANT a copy of such policy. ARTICLE X. TIME OF COMPLETION The work to be performed under this AGREEMENT shall be commenced and the work completed within the time limits as agreed upon in the CONSULTANT's Proposal. The CONSULTANT shall perform the services under this AGREEMENT with reasonable diligence and expediency consistent with sound professional practices. The CITY agrees the CONSULTANT is not responsible for damages arising directly or indirectly from any delays for causes beyond the CONSULTANT's control. For the purposes of this AGREEMENT, such causes include, but are not limited to, strikes or other labor disputes, severe weather disruptions or other natural disasters, failure of performance by the CITY, or discovery of any hazardous substances or differing site conditions. If the delays resulting from any such causes increase the time required by the CONSULTANT to perform its services in an orderly and efficient manner,the CONSULTANT shall be entitled to an equitable adjustment in schedule. l:\Engineering\Tracy Taylor\Steve Brand Agrcernents\Dixon Eng\Des Drawings&Struct talc Review- Page 3 of 6 T-Mobile Antenna-Marion Rd T%vr\Dixon Agreernent-10-4-18.docx ARTICLE XI. COMPONENT PARTS OF THE AGREEMENT This AGREEMENT consists of the following component parts, all of which are as fully a part of this AGREEMENT as if herein set out verbatim,or if not attached,as if hereto attached: 1. This Instrument 2. CONSULTANT'S Proposal dated July 21,2018 and attached hereto In the event any provision in any of the above component parts of this AGREEMENT conflicts with any provision in any other of the component parts, the provision in the component part first enumerated above shall govern over any other component part which follows it numerically except as may be otherwise specifically stated. ARTICLE XII. PAYMENT A. The Agreement Sum. The CITY shall pay to the CONSULTANT for the performance of the AGREEMENT the total sum as set forth below, adjusted by any changes hereafter mutually agreed upon in writing by the parties hereto: • Unit Prices Not to Exceed$5,650(Five Thousand Six Hundred Fifty Dollars). • Attached fee schedule shall be firm for the duration of this AGREEMENT. B. Method of Payment. The CONSULTANT shall submit itemized monthly statements for services. The CITY shall pay the CONSULTANT within thirty (30) calendar days after receipt of such statement. If any statement amount is disputed, the CITY may withhold payment of such amount and shall provide to CONSULTANT a statement as to the reason(s) for withholding payment. C. Additional Costs. Costs for additional services shall be negotiated and set forth in a written amendment to this AGREEMENT executed by both parties prior to proceeding with the work covered under the subject amendment. D. Indirect Costs. Indirect costs such as computer time, printing, copying, cell phone charges,telephone charges, and equipment rental shall be considered overhead and shall not be invoiced separately to the PROJECT. E. Expenses. Expenses may be billed with up to a maximum of 10% mark-up. All invoices with expenses shall include supporting documentation of the expense. Failure to include the supporting documentation will result irt the reduction of payments by the amount of those expense(s)not including documentation, 1:\Ftigincering\Tracy'raylor\Steve Brand Apreernents\Dixon Eng\Deg Drawings&Struct Calc Review- Page 4 of 6 T-Mobile Antenna•Marion Rd TAvr\Dixon Agreement_OA-18.docx ARTICLE XIII. HOLD HARMLESS The CONSULTANT covenants and agrees to protect and hold the City of Oshkosh harmless against all actions, claims, and demands to the proportionate extent caused by or resulting from the intentionally wrongful or negligent acts of the CONSULTANT, his/her agents or assigns, his/her employees, or his/her subcontractors related to the performance of this AGREEMENT or be caused or result from any violation of any law or administrative regulation, and shall indemnify the CITY for all sums including court costs, attorney fees, and damages of any kind which the CITY may be obliged or adjudged to pay on any such claims or demands upon the CITY's written demand for indemnification or refund for those actions, claim, and demands caused by or resulting from intentional or negligent acts as specified in this paragraph. Subject to any limitations contained in Sec. 893.80 and any similar statute of the Wisconsin Statutes, the CITY further agrees to hold CONSULTANT harmless from any and all liability, including claims, demands, losses, costs, damages, and expenses of every kind and description (including death), or damages to person or property arising out of re-use of the documents without consent where such liability is founded upon or grows out of the acts or omission of any of the officers, employees or agents of the City of Oshkosh while acting within the scope of their employment. ARTICLE XIV. INSURANCE The CONSULTANT agrees to abide by the attached City of Oshkosh Insurance Requireinents, ARTICLE XV. TERMINATION A. For Cause, If the CONSULTANT shall fail to fulfill in timely and proper manner any of the obligations under this AGREEMENT, the CITY shall have the right to terminate this AGREEMENT by written notice to the CONSULTANT. In this event, the CONSULTANT shall be entitled to compensation for any satisfactory,usable work completed. B. For Convenience. The CITY may terminate this AGREEMENT at any time by giving written notice to the CONSULTANT no later than ten (10) calendar days before the termination date. If the CITY terminates under this paragraph, then the CONSULTANT shall be entitled to compensation for any satisfactory work performed to the date of termination. This document and any specified attachments contain all terms and conditions of the AGREEMENT and any alteration thereto shall be invalid unless made in writing, signed by both parties and incorporated as an amendment to this AGREEMENT. 1:\Engineering\Tricy'rayi0r\Steve Brand Agreements\Dixon Png\Des Drawings&Struct Cale Review- T-Mobile Antenna-Marion Rd Tivr\Dixon Agreemerit_104-18.docx Page 5 of 6 ARTICLE XVI. RE-USE OF PROJECT DOCUMENTS All reports, drawings, specifications, documents, and other deliverables of CONSULTANT, whether in hard copy or in electronic form, are instruments of service for this PROJECT, whether the PROJECT is completed or not. The CITY agrees to indemnify CONSULTANT and CONSULTANT's officers, employees, subcontractors, and affiliated corporations from all claims, damages, losses, and costs, including,but not limited to,litigation expenses and attorney's fees arising out of or related to the unauthorized re-use, change, or alteration of these project documents. ARTICLE XVII. SUSPENSION, DELAY, OR INTERRUPTION OF WORK The CITY may suspend, delay, or interrupt the services of CONSULTANT for the convenience of the CITY. In such event, CONSULTANT's contract price and schedule shall be equitably adjusted. ARTICLE XVII.I. NO THIRD-PARTY BENEFICIARIES This AGREEMENT gives no rights or benefits to anyone other than the CITY and CONSULTANT and has no third-party beneficiaries. In the Presence of: CONSULTANT By: -7 gt�K2 (Seal of Consultant & ;�!v if a Corporation) (Specify Title) By: (Specify Title) CITY OF OSHKO5H-----,> By: —'w (Witness) mes abeTP.E., CPESC, Director of Public Works 1:\Engineering\Tracy'ray1or\Steve Brand Agreernerns\Dixon Eng\Dvs Drawings&Struct CaIr Review- T-Mobile Antenna-Marion Rd TNvr\Dixtin Agreexnent_10-4-18.docx Page 6 of 6 D IXON 5307 South 92nd Street Suite 126 Hales Corners,WI 53130 ENGINEERING & INSPECTION SERVICES Telephone: (414)529-1859 FOR THE COATING INDUSTRY RIEft l(#l-V529-3120 Proposal for Antennas SEP 26 M8 City of Oshkosh/T-Mobile(ML94443B)Project DEPT OF PUBLIC WORKS Mat-ion Tank 49-71-06-06 OSHKOSH, WISCONSIN The Proposal is between Dixon Engineering, Inc. (DIXON) and City of Oshkosh,Wisconsin (OWNER)to contract with DIXON for technical services for T-Mobile (CONTRACTOR). 1.01 Payment DIXON shall provide, or cause to be provided, services detailed in Scope of Services and OWNER agrees to pay DIXON as compensation for their services the (not to exceed/lump sum) fee of Five Thousand Six Hundred Fifty dollars $5,650. Terms of charges and payments per details in Schedule B. (Prices quoted are subject to change 90 days after proposal date, if not contracted.) 2.01 SCOPE OF SERVICES Desip,n Review, Attend a Precon Meeting, and Installation Inspections 3.01 SIGNATURES Joseph T. Hoban _July 21, 2018 PROPOSED by DIXON(Not a contract until approved by an officer) PROPOSAL DATE CONTRACT APPROVED by OWNER POSITION DATE CO SIGNATURE(if required) POSITION DATE CONTRACT APPROVED by DIXON OFFICER EFFECTIVE CONTRACT DATE Members: Society of Protective Coatings•American Water Works Association - Consulting Engineers Council SCHEDULE A City of Oshkosh/T-Mobile(ML94443B)Project Marion Tank 49-71-06-06 I, Design Drawings and Structural Calculations Review: a. Staff Engineer to review designs created by others. No calculations or Professional Engineering seal are included, Initial Site Inspection— Site Walk is a prerequisite to Design Drawings and Structural. Calculations Review. II. Site Work for: a. Attend and participate in a Preconstruction Meeting. b. Perform Installation inspections as the project progresses and a final post inspection to compare with design criteria. These inspections include letter report and photographs, III E 2 i SCHEDULE City of Oshkosh/T-Mobile(ML94443B)Project Marion Tank 49-71-06-06 I. PAYMENT a. When service is rendered Owner shall pay DIXON the following line item prices: i. Schedule A, Item 1, Design Drawings and Structural Calculations Review, the lump sum of$1,450. b. Owner shall pay DIXON the following line items times the number of units used: i. Schedule A, Item 11 1. (1) Preconstruction Meeting $1,050 per meeting 2. (3) Installation Inspections $1,050 per inspection INVOICES a. Invoices will be compiled monthly. b. All DIXON services that are outstanding more than thirty (30) days from date of issue shall be assessed (DIXON's favor) one and a half percent (1.5%)per month interest starting from 30 days after date of issue. 3 ' ' SCHEDULE C Antennas and Northern Wisconsin Einployee Labor Class Per Hour Overtime Rate* Principal......... ............................. ........ —.--......—...$250.0U Expert Witness (Offico, Travel & Coort).......... .............. ...............$250.O0 Associate................................................ ----------$l8l.00 ----.-----.$27O.O0 Project Munager......................'.............. ----------$l55.00 ..............................$233.U0 Assistant Project Manager........................... ..............................$l04.00 --..----.—.$158.0O Registered Professional Engineer.................. ...----.---.$l55.0O .--.--.—......$233.00 Structural Engineer...:................................ ----------$l55.0O ----------$233.00 Staff Engineer.......................................... ..............................$l29 OU ----------$l95.50 C/\WI ozCWI Welding Inspector.................. ----------$l29.0O ----------$l95.50 Certifim1NACE Tnmpect0r.......................... ...—............—$l2g.00 ..... ........................$l95.5O , Inspector —Level III.................................. ................................$98.00 ----------$l50.5O Inspector—Level 3I................................—. ----------..$@8.00 ----------$135.50 Inspector—Leve} }............................,..,.... —.............................$78.OA ----------$l2O.5O Contract Support Staff................................ ---..—......—$}V4.0] ..............................$I58.O0 Project or Board Meetings.......................... ......liznw &Expenses—Including Preparation Time** . *&D Saturday, Sunday, and holiday inspections, plus anytime over 40 hours per week are at overtime rate. Overtime rate is l 1/2times the hourly rate. Overtime rate does not apply to Principal. "All meetings held on Saturday, Sunday, or holidays are considered overtime for invoicing purposes. Expenses Metropolitan Out-State Mileage.................................................. ..........S8.7O/ uilm +tol[m ...................$0.60/nz{m Meals & L0dgin8...................................... ...........$l55.00 per them ...........$l45.00per diem (may beincreased based omlocation) Without Lodging....................................... ............$40.00 per them ............$35.AO per them Air Travel.............................................. ......Business fare from Chicago O'Hare urMilwaukee f full size car rental Material (gaskets, cathodic caps, light bulbs, vent screens, etc.) ..... ..........Labor & Material+3O96 FEES EFFECTIVE THROUGH: T)aoonzbor3l, 2018 DIXONE1 OP ID: LB DATE(MMIDD/YYYY) CERTIFICATE 4F LIABILITY INSURANCE 10/05/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s). PRODUCER CONTANAME: Pete Suminski Blick Dillon Insurance - PHONE "_. FAX 123 N Mitchell St P.O.B.389 _ �aG,tlo,E�t�231 775 3416 c,_No1 231 775 0817 E-MAIL _ ._... .....__...-- Cadillac,MI 49601 � YV � ADDRESS: I: Pete Suminski " INSURERS AFFORDING COVERAGE NAIC# A:Auto Owners Insurance Company.---..-..---..----?$g$$ Engineering INSURED Dixon En ti� --�- g g Inc (� INSURER B:EMC Insurance Companies 21415 William Dixon [4S ---- ----_---- --- -- 1104 3RD Ave PUB1 IC V1U INSURER U.S.Specialty insurance Co� 29599 Lake Odessa,MI 48849-11 pSHK�SII,W ISCONSIN INSURERD: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. —- -- INSR — TYPE OF INSURANCE _._,_.._...._..__._. �S.U, POLIGY EFF LIMITS LTR I D POLICY NUMBER MMIDD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE [K OCCUR X X 33007666 11/01/2017 11l01/2018 PREA E TO RENTED MISES{Ea_occurrence)._....._$._................__._,.-_300,00 X XCU MED EXP(Any one person) $ 10,00 PERSONAL BADVINJURY $ 1,000,00 GEN`L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JE 0 X]LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A X ANY AUTO X X 9636761602 07/01/2018 07/0112019 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ _ AUTOS AUTOS i MAGE_ 5k6PER7Y D A NON-OWNED $ HIRED AUTOS _.. AUTOS Peraccident __..........................._.._._....,.,. X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 9,000,000' A EXCESS LIAR CLAIMS-MADE X 9536751603 02/23/2018 11/01/2018 AGGREGATE $ 9,000,000* DED I X I RETENTION$ WAIVED $ WORKERS COMPENSATION PER TH- AND EMPLOYERS'LIABILITY Y X STATUTE X ER B ANY PROPRIETORIPARTNERIEXECUTIVE i; i N/A 5H7377018 10/1312017 10/13/2018 E.L EACH ACCIDENT $ W 1,000,000- OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 C Professional Llab USS1828843 07/01/2018 07/01/2019 Ea.Claim 2,000,00 $30,000 DEDUCTIBLE Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) When required by contract or written agreement,City of Oshkosh,and its officers,council members,agents,employees and authorized volunteers are included as Additional Insureds on the Commercial General Liability,Auto Liability and Excess Liability policies.30 Day cancellation notice is included. CERTIFICATE HOLDER CANCELLATION CIOS001 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Oskosh ACCORDANCE WITH THE POLICY PROVISIONS. Attn: City Clerk 215 Church Ave. AUTHORIZED REPRESENTATIVE P.O. Box 1130 Oshkosh,WI 54903-5100 / , �/rn�n�dit,•+ 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD DIXONE1 PAGE 2 NOTEPAD INSURED'S NAME Dixon Engineering Inc OP ID: LB Date 10/05/2018 ........... **Umbrella Liability Limits 11/01/17 to 02/22/18 = $5,000,000 Agency Code 01-0053-00 Policy Number 014601-33007656 Auto-Owners Insurance Company COMMERCIAL GENERAL LIABILITY 55373 (1-07)Z THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM. A. Under SECTION 11-WHO IS AN INSURED, the This insurance is primary for the Additional following is added: Insured, but only with respect to liability arising out of"your work"for that Additional Insured by A person or organization is an Additional Insured, or for you. Other insurance available to the only with respect to liability arising out of"your work" Additional Insured will apply as excess insur- for that Additional Insured by or for you: ance and not contribute as primary insurance to the insurance provided by this endorsement. 1. If required in a written contract or agreement; or 2. The following provision is added: 2. If required by an oral contract or agreement only if a Certificate of Insurance was issued prior to Other Additional Insured Coverage Issued By the loss indicating that the person or organiza- Us tion was an Additional Insured. If this policy provides coverage for the same B. Under SECTION III - LIMITS OF INSURANCE, the loss to any Additional Insured specifically shown following is added: as an Additional Insured in another endorsement to this policy, our maximum limit of insurance The limits of liability for the Additional Insured are under this endorsement and any other endorse- those specified in the written contract or agreement ment shall not exceed the limit of insurance in between the insured and the owner, lessee or the written contract or agreement between the contractor or those specified in the Certificate of insured and the owner, lessee or contractor, or Insurance, if an oral contract or agreement, not to the limits provided in this policy,whichever is exceed the limits provided in this policy. These less. Our maximum limit of insurance arising limits are inclusive of and not in addition to the limits out of an 'occurrence", shall not exceed the limit of insurance shown in the Declarations. of insurance shown in the Declarations, regard- less of the number of insureds or Additional C. SECTION IV- COMMERCIAL GENERAL Insureds. LIABILITY CONDITIONS, is amended as follows: All other policy terms and conditions apply. 1. The following provision is added to 4. Other Insurance: Includes copyrighted material of Insurance Services Office, Inc.,with its permission. 55373 (1-07)Z Copyright Insurance Services Office, Inc., 1984, 2003. Page 1 of 1