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HomeMy WebLinkAboutProfessional Services Agreement McMahon Associates Inc. - Safety Building Police Department Vav Boxes Replacement DocuSign Envelope ID:6E06D618-F440-4493-9B63-50E25F3E6CD1 13 9 E x'd City ORIGINAL of • RECEIVED Oshkosh JUL 01 2020 PROFESSIONAL SERVICES AGREEMENT CITY CLERK'S OFFICE CITY OF OSHKOSH SAFETY BUILDING POLICE DEPARTMENT VAV BOXES REPLACEMENT THIS AGREEMENT, made on the 18th day of June, 2020, by and between the CITY of OSHKOSH, hereinafter referred to as CITY, and MCMAHON ASSOCIATES INC, 1445 MCMAHON DRIVE, NEENAH,WI 54956, hereinafter referred to as the CONSULTANT. WITNESSETH: That the CITY and the CONSULTANT, for the consideration hereinafter named, enter into the following Agreement. • 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 Professional Services Proposal dated June 9,2020, and attached hereto. In the event that 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. CITY REPRESENTATIVE The CITY shall assign the following individual to manage this Agreement: Jon Urben, General Services Division SCOPE OF WORK The CONSULTANT shall provide the services described in the CONSULTANT's attached Professional Services Proposal. CITY may make or approve changes within the general Scope of Services contained within the Professional Services Proposal and in this AGREEMENT.If such changes affect CONSULTANT's cost or time required for performance of the services, an equitable adjustment will be made through an amendment to this AGREEMENT. City Hall,215 Church Avenue P.O.Box 1 130 Oshkosh,WI 54903-1 130 http://www.ci.oshkosh,wi.us _DocuSign.Envelope_ID:6E06D6.1.8_F_440 4493-9B63-50E25E3E6CD1 RECORDS AND INSTRUMENTS OF SERVICE The City acknowledges the CONSULTANT's reports, drawings, data, computer files, and other materials, documents prepared by the CONSULTANT as instruments of professional service. Nevertheless, the plans and specifications prepared under this Agreement shall become the property of the City upon completion of the work and payment in full of all monies due to the CONSULTANT. The City agrees, to the fullest extent permitted by law, that CONSULTANT does not warranty or guaranty its deliverables in the context of only reuse or modification of the instruments of service by the City or any person or entity for which the City is responsible. Any document related to this agreement,whether in electronic or paper form,is considered a public record and shall be provided to the City upon request. The CONSULTANT may provide the City with an explanation of why they believe any document should not be released to the public. The City shall make all final determinations regarding the release of any document related to this Agreement. TERM AND TERMINATION A. Term. This Agreement shall commence upon the date indicated above and shall terminate on December 31, 2020, unless terminated earlier by one of the parties as provided below, except that CITY may extend this Agreement,upon written notice to CONSULTANT. B. Termination. 1. For Cause. If either party shall fail to fulfill in timely and proper manner any of the obligations under this Agreement, the other party shall have the right to terminate this Agreement by written notice. In this event, the CONSULTANT shall be entitled to compensation to the date of delivery of the Notice. 2.For Convenience. The CITY may terminate this Agreement at any time by giving written notice to the CONSULTANT no later than 30 calendar days before the termination date. TIME OF COMPLETION The CONSULTANT shall perform the services under this Agreement with reasonable diligence and expediency consistent with sound professional practices. The CITY agrees that 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, or failure of performance by the CITY. 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. SUSPENSION, DELAY,OR INTERRUPTION OF WORK CITY may suspend, delay, or interrupt the Services of CONSULTANT for the convenience of CITY. In such event, CONSULTANT's contract price and schedule shall be equitably adjusted. DocuSign_Envelope_ID:_6E06D618-E44D-4493,9E63-50E25E3E6CD9_ • ASSIGNMENT Neither party to this Agreement shall transfer, sublet or assign any rights under or interest in this Agreement (including,but not limited to, monies that are due or monies that may be due) without the prior written consent of the other party. INDEPENDENT CONTRACTOR CONSULTANT is an independent contractor and is not an employee of the CITY. COOPERATION IN LITIGATION AND AUDITS CONSULTANT shall fully and completely cooperate with the City, the City's insurer, the City's attorneys, the City's Auditors or other representative of the City (collectively, the "City" for purposes of this Article) in connection with (a) any internal or governmental investigation or administrative, regulatory, arbitral or judicial proceeding (collectively "Litigation") or internal or governmental Audit, with respect to matters relating to this Agreement; other than a third party proceeding in which CONSULTANT is a named party and CONSULTANT and the City have not entered into a mutually acceptable joint defense agreement. Such cooperation may include, but shall not be limited to, responding to requests for documents and/or other records, and making CONSULTANT's employees available to the City (or their respective insurers, attorneys or auditors) upon reasonable notice for: (i) interviews, factual investigations, and providing declarations or affidavits that provide truthful information in connection with any Litigation or Audit; (ii) appearing at the request of the City to give testimony without requiring service of a subpoena or other legal process; (iii) volunteering to the City all pertinent information related to any Litigation or Audit; and (iv) providing information and legal representations to auditors in a form and within a timeframe requested. City shall reimburse CONSULTANT for reasonable direct expenses incurred in connection with providing documents and records required under this paragraph and may require, at the City's sole discretion, such expenses to be documented by receipts or other appropriate documentation. Reasonable direct expenses include costs, such as copying, postage and similar costs; but do not include wages, salaries,benefits and other employee compensation. CONSULTANT shall not be entitled to additional compensation for employee services provided under this paragraph. 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. 41 DocuSignEnYelop�ID:6E06D618-F440-4493=9663-50E25F3E6CD1 • 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. CONSULTANT may reasonably rely upon the accuracy,timeliness,and completeness of the information provided by CITY. 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. PAYMENT A. The Agreement Sum. The CITY shall pay to the CONSULTANT for the performance of the Agreement the total amount of $4,000.00 in the Cost portion of the Consultant's Professional Services Proposal. B.Method of Payment. The CONSULTANT shall submit itemized monthly statements for services. The CITY shall pay the CONSULTANT within 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. HOLD HARMLESS The CONSULTANT covenants and agrees to protect and hold the City of Oshkosh harmless against all actions, claims, and demands which may be to the proportionate extent caused by or result from the intentional or negligent acts of the CONSULTANT, its agents or assigns, its employees, or its SUBCONSULTANT related to the performance of this Agreement or be caused or result from any violation of any law or administrative regulation, and shall indemnify or refund to the CITY all sums including court costs, attorney fees, and punitive damages which the CITY may be obliged or adjudged to pay on any such claims or demands within thirty (30) days of the date of 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), which may be to the proportionate extent caused by or result from the intentional or negligent acts of the CITY, its agents or assigns, its employees, or its SUBCONSULTANTS related to the performance of this —DocuSJgn_Eoxelope_IO_6E06D618-F440-493-9663=50E25F3E6CD1 Agreement or be caused or result from any violation of any law or administrative regulation,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. It is the intention of the parties to this Agreement that each party shall be solely responsible for its own actions and activities and the actions and activities of its own officers,employees and agents while acting within the scope of their employment INSURANCE The CONSULTANT agrees to abide by the attached City of Oshkosh Insurance Requirements for Professional Services. WHOLE AGREEMENT/AMENDMENT 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. NO THIRD-PARTY BENEFICIARIES This AGREEMENT gives no rights or benefits to anyone other than CI l Y and CONSULTANT and has no third-party beneficiaries. AGREEMENT NOT TO BE CONSTRUED AGAINST ANY PARTY This Agreement is the product of negotiation between the parties hereto and no term, covenant or provision herein or the failure to include a term, covenant or provision shall be construed against any party hereto solely on the basis that one party or the other drafted this Agreement or any term,covenant or condition contained herein. NO WAIVER Failure of either party to insist upon the strict performance of terms and provisions of this agreement, or any of them, shall not constitute or be construed as a waiver or relinquishment of that party's right to thereafter enforce such term or provision, and that term of the provisions shall continue in full force and effect. NON-DISCRIMINATION The Operator agrees not to discriminate in its operations under this Agreement on the basis of race,color, creed, age, and gender, or as otherwise prohibited by law. A breach of this covenant may be regarded as a material breach of this Agreement DocuSign_EmielopeiDL6E06D_618E44044493-9B63_50E25F3 E6.CD 1• SEVERABILITY If any term, covenant, condition or provision of this agreement shall be invalid or enforceable, the remainder of this agreement shall not be affected thereby the remainder of the agreement shall be valid and enforceable to the fullest extent permitted by law. CHOICE OF LAW AND VENUE The laws of the State of Wisconsin shall govern the interpretation and construction of this Agreement. Winnebago County shall be the venue for all disputes arising under this Agreement. DocuSign Envelope ID:6E06D618-F44O-4493-9663-50E25F3E6CD1 • IN WITNESS WHEREOF, the City of Oshkosh, Wisconsin, has caused this contract to be sealed with its corporate seal and to be subscribed to by its City Manager and City Clerk and countersigned by the Comptroller of said City, and CONSULTANT hereunto set its hand and seal the day and year first above written. Il e Presente of: McMah s ciates nc. Artictlic L v (Seal of CONSULTANT (Specify Title) if a Corporation.) CITY OF OSHKOSH � By: Cam/ Mark A. Rohloff, City Manager ( ess) And: mess) Pamela R. Ubrig, City Clerk APPROVED: I hereby certify that the necessary provisions have been made to pay the liability which will accrue under this contract lek A 661"-6 - Ci y -,ttorney rd._ City Comptroller DocuSign Envelope ID:6E06D618-F440-4493-9B63-50E25F3E6CD1 McMAHON AGREEMENT Enmann ARCHITECTS For PROFESSIONAL SERVICES City of Oshkosh Date: June 9, 2020 Attn: Mr.Jon Urben Manager of General Services Division 215 Church Street Oshkosh, WI 54901 McM. No. M0032-9-20-0001.02/.06 PROJECT DESCRIPTION: The City of Oshkosh is replacing nine (9) pneumatic VAV boxes in the Police Administrative Office located in the Oshkosh Safety Building,with nine (9) new electronic VAV boxes. Additionally, the City of Oshkosh would like to replace twenty- four(24) pneumatic VAV boxes in the old Court Room area with new electronic VAV boxes as an Alternate Bid item (Alt- 1).As this project is considered to be equipment replacement in-kind, a DSPS submittal is not required. SCOPE OF SERVICES: McMahon Associates, Inc. (McMahon) agrees to provide the following professional engineering design services: A) Base Bid: Oshkosh Safety Building replacement of nine (9) existing two pipe VAV boxes in the Police Administration Office: a. Make (2) site visits to verify the type of replacement work that is required on the units. b. Coordinate with the Control Contractor(ECD)to verify the existing control cabinet capacity and the additional capacity required for the project. c. Layout schedule for VAV box replacement with box and duct sizes. d. Create an install plan for the Heating Contractor's Work and a second plan for the Controls Contractor's Work(ECD). e. Include Division 23 specifications on the drawings. f. Create an agenda for a contractor pre-bid walk through. g. Conduct a pre-bid walk through for HVAC contractors and subcontractors. h. Answer questions from contractors via addenda during Bid Phase. i. Attend bid opening. j. Provide written recommendation for Contract Award for Common Council approval. k. Conduct a Kickoff meeting with contractor after Award. I. Review Equipment Submittals. m. Make (1) site visit or attend (1) project meeting. n. Perform (1)final Walk Through at the end of project. B) Al.'"na `• Bid (Alt-1): - hkosh `:fety Building re•:./¢ce `';•nt of twenty-four(24)exi ;`g ``,o pipe VAV boxes in the old Cour Room 4 na . area: a. M1,ke (2) site vials to veri the type of replace .`l work th.`.; is required on the units. .' b. C.)rdinate wi ;' the Contri: Contractor (ECD) verify the exi ting control cabinet cap;,"ity and the ad itional ca city require for the project. .-' c. La:'out sche,..' le for VAV bi replacement <ith box and duct si=_es. d. C :•ate an i',r tall plan fort Heating Contractor's Work and a •;cond plan for the ontrols Contractor's irk ([Cr'. e. I lude )vision 23 specific tions o•f e drawings. f. Ceate,;`n agenda for a con , 'pre-bid walk through. % g. CLt-$ct a pre-bid walk through for HVAC contractors and subcon 11Page Do_cuagn Envelope_ID:6E06D618_F440_4493=9663=50E251_3_E6CD1 • SCOPE OF SERVICES: (continued) . Answer . esti ns from contractors via •. da during Bid Phase. • Attend >d ope ing. j Provid written ecommendation • r Contract ward for Com :n Council approval. Con.<`ct a Kicko' meeting with .ntractor aft: Award. I Re =w Equipme Submitta ke (1)site visit •r att 1) project meeting. erform (1) final Wa hrough at the end of proje The following are not included in McMahon Associates, Inc.Scope of Services: A) Submittal to DSPS for approval. B) Permit fees. C) Construction Management. D) Electrical Design,Generator Design, Fire Alarm or Voice Data Design. E) Plumbing Design. F) Energy Modeling or Energy Analysis. SPECIAL TERMS: (Refer Also To General Terms&Conditions-Attached) The City of Oshkosh agrees that the Project Description,Scope Of Services and Compensation sections contained in this Agreement, pertaining to this project or any addendum thereto, are considered confidential and proprietary, and shall not be released or otherwise made available to any third party, prior to the execution of this Agreement,without the expressed written consent of McMahon Associates Inc. COMPENSATION:(Does Not Include Permit Or Approval Fees) McMahon Associates, Inc. proposes to complete the above Scope of Services for the following lump sum fees: HVAC Design Services for Base Bid as described above for the following compensation: $4,000.00 • COMPLETION SCHEDULE: McMAHON agrees to complete this project as follows: ■ Schedule shall be coordinated once a PO has been issued for the work. [The rest of this page left blank intentionally.) 2 ' Page _-Rncsi$ign smelope ID:6E06D618-F440-4493-9B63-50E25F3E6CD1 • ACCEPTANCE: The General Terms & Conditions And The Scope Of Services(Defined In The Above Agreement) Are Accepted, and McMahon Associates, Inc. Is Hereby Authorized To Proceed With The Services. The Agreement Fee Is Firm For Acceptance Within Sixty(60)Days From Date Of This Agreement CITY OF OSHKOSH McMAHON ASSOCIATES, INC. Oshkosh,Wisconsin Neenah, Wisconsin By: By: (Authorized Signature) Thomas J. Ki t, P.E., B EES, CCS Title: Title: Associate/Project Manager Date: Date: ✓ Project Manager: J B. Clary, P.E. MBA CGD Project Engineer Plrn,r R,tuin One Cony fnr Our Ra..ards Street Address: 1445 McMAHON DRIVE-NEENAH,WI 54956 Mailing Address: P.O. Box 1025-NEENAH,WI 54957-1025 PH 920-751-4200 . FX 920-751-4284 • WWW.MCMGRP,COM W!:\WP\Agreements\SF-Agreements(McM)\2020\00005-03-10C.clacx(sdk) 3IPage __DocuSign Envelope ID:6E06D618-F440-4493-9B63-50E25F3E6CD1 _ Revised:_March_19,_2020___.._ McMAHON McMAHON ASSOCIATES, INC. EfgGiNEERS %Wt..fT C , " GENERAL TERMS & CONDITIONS 1, McMAHON ASSOCIATES, INC. (hereinafter referred to as'McMAHON')will bill the Owner monthly with net payment due in 30-days. Past due balances • shall be subject to a service charge at a rate of 1.0% per month. In addition, McMAHON may, after giving 48-hours notice, suspend service under any Agreement until the Owner has paid in full all amounts due for services rendered and expenses incurred. These expenses include service charges on past due invoices, collection agency fees and attorney fees Incurred by McMAHON to collect all monies due McMAHON. McMAHON and Owner hereby acknowledge that McMAHON has and may exercise lien rights on subject property. 2. The stated fees and Scope of Services constitute our best estimate of the fees and tasks required to perform the services as defined. This Agreement,upon execution by both parties hereto,can be amended only by written Instrument signed by both parties. For those projects involving conceptual or process development services, activities often cannot be fully defined during Initial planning. As the project progresses, facts uncovered may reveal a change in direction, which may alter the Scope. McMAHON will promptly inform the Owner in writing of such situations so changes in this Agreement can be negotiated,as required. • 3. The stipulated fee is firm for acceptance by the Owner for 60•days from date of Agreement publication. 4. Costs and schedule commitments shall be subject to re-negotiation for delays caused by the Owner's failure to provide specified facilities or information, or for delays caused by unpredictable occurrences, including without limitation,fires,floods,riots,strikes,unavailability of labor or materials, delays or defaults by suppliers of materials or services,process shutdowns,pandemics,acts of God or the public enemy,or acts or regulations of any governmental agency. Temporary delay of services caused by any of the above, which results in additional costs beyond those outlined, may require re-negotiation of this Agreement. 5. Reimbursable expenses Incurred by McMAHON in the interest of the project Including,but not limited to,equipment rental will be billed to the Owner at cost plus 10%and sub-consultants at cost plus 12%. When McMAHON,subsequent to execution of an Agreement, finds that specialized equipment must be purchased to provide special services,the cost of such equipment will be added to the agreed fee for professional services only after the Owner has been notified and agrees to these costs. 6. McMAHON will maintain insurance coverage in the following amounts: Worker's Compensation Statutory General Liability Bodily Injury-Per Incident/Annual Aggregate $1,000,000 I$2,000,000 Automobile Liability Bodily Injury $1,000,000 Property Damage $1,000,000 Professional Liability Coverage $2,000,000 If the Owner requires coverage or limits in addition to the above stated amounts, premiums for additional Insurance shall be paid by the Owner. McMAHON's liability to Owner for any indemnity commitments,reimbursement of legal fees,or for any damages arising In any way out of performance of our contract Is limited to ten(10)times McMAHON's fee not to exceed to$500,000. 7. The Owner agrees to provide such legal, accounting and insurance counseling services as may be required for the project for the Owner's purpose- All unresolved claims,disputes and other matters in question between the Owner and McMAHON shall be submitted to mediation,if an agreement cannot be reached by Owner and McMAHON. 8. Termination of this Agreement by the Owner or McMAHON shall be effective upon 7-days written notice to the other party. The written notice shall include the reasons and details for termination; payment is due as stated in paragraph 1. if the Owner defaults in any of the Agreements entered into between McMAHON and the Owner,or if the Owner falls to carry out any of the duties contained In these terms and conditions,McMAHON may,upon 7-days written notice, suspend Its services without further obligation or liability to the Owner unless,within such 7-day period, the Owner remedies such violation to the reasonable satisfaction of McMAHON. 9. Re-use of any documents or AutoCAD representations pertaining to this project by the Owner for extensions of this project or on any other project shall be at the Owner's risk and the Owner agrees to defend, Indemnify and hold harmless McMAHON from all claims, damages and expenses, Including attorneys' fees arising out of such re-use of the documents or AutoCAD representations by the Owner or by others acting through the Owner. 10, Purchase Orders-In the event the Owner issues a purchase order or other instrument related to the Engineer's services,it is understood and agreed that such document is for Owner's internal accounting purposes only and shall In no way modify, add to or delete any of the terms and conditions of this Agreement. If the Owner does issue a purchase order,or other similar instrument,it is understood and agreed that the Engineer shall indicate the purchase order number on the invaice(s)sent to the Owner. 11. McMAHON will provide all services in accordance with generally accepted professional practices. McMAHON will not provide or offer to provide services Inconsistent with or contrary to such practices nor make any other warranty or guarantee, expressed or Implied,nor to have any Agreement or contract for services subject to the provisions of any uniform commercial code. Similarly,McMAHON will not accept those terms and conditions offered by the Owner In its purchase order, requisition or notice of authorization to proceed,except as set forth herein or expressly accepted in writing. Written acknowledgment of receipt, or the actual performance of services subsequent to receipt, of any such purchase order, requisition or notice of authorization to proceed is specifically deemed not to constitute acceptance of any terms or conditions contrary to those set forth herein. 12, McMAHON intends to serve as the Owner's professional representative for those services, as defined in this Agreement, and to provide advice and consultation to the Owner as a professional. Any opinions of probable project costs, approvals and other decisions made by McMAHON for the Owner are rendered on the basis of experience and qualifications and represent our professional judgment. Nothing contained in this Agreement shall create a contractual relationship with,or a cause of action,in favor of a third party against either the Architect or McMAHON. 13, This Agreement shall not be construed as giving McMAHON the responsibility or authority to direct or supervise construction means,methods, techniques, sequence or procedures of construction selected by Contractors or Subcontractors, or the safety precautions and programs incident to the work of the Contractors or Subcontractors. 14. The Owner shall be responsible for maintenance of the structure, or portions of the structure,which have been completed and have been accepted for Its intended use by the Owner. All structures are subject to wear and tear,and environmental and man-made exposures. As a result, all structures require regular and frequent monitoring and maintenance to prevent damage and deterioration. Such monitoring and maintenance is the sole responsibility of the Owner. McMAHON shall have no responsibility for such issues or resulting damages. W:l McM.Inro 1 Proposal SOQ GTC's 1 GTC(McM-2020),docx Jao_au5ign=Ftivelope_ID 6.E0_6D6_18=F_4_40-4493-913_63=50E25F3E6CD1_ 4/14114 CITY OF OSHKOSH INSURANCE REQUIREMENTS III. PROFESSIONAL SERVICES LIABILITY INSURANCE REQUIREMENTS The Contractor shall not commence work on contract until proof of insurance required has been provided to the applicable City department before the contract or purchase order is considered for approval by the City. It is hereby agreed and understood that the insurance required by the City of Oshkosh is primary coverage and that any insurance or self insurance maintained by the City of Oshkosh, its officers, council members, agents, employees or authorized volunteers will not contribute to a loss. All insurance shall be in full force prior to commencing work and remain in force until the entire job is completed and the length of time that is specified, if any, in the contract or listed below whichever is longer. 1. PROFESSIONAL LIABILITY A. Limits (1) $1,000,000 each claim (2) $1,000,000 annual aggregate B. Must continue coverage for 2 years after final acceptance for service/job 2. GENERAL LIABILITY COVERAGE A. Commercial General Liability (1) $1,000,000 each occurrence limit (2) $1,000,000 personal liability and advertising injury (3) $2,000,000 general aggregate (4) $2,000,000 products—completed operations aggregate B. Claims made form of coverage is not acceptable. C. Insurance must include: (1) Premises and Operations Liability (2) Contractual Liability (3) Personal Injury (4) Explosion, collapse and underground coverage (5) Products/Completed Operations must be carried for 2 years after acceptance of completed work (6) The general aggregate must apply separately to this prolect/location 3. BUSINESS AUTOMOBILE COVERAGE— If this exposure shall exist: A. $1,000,000 combined single limit for Bodily Injury and Property Damage each accident B. Must cover liability for Symbol #1 - "Any Auto"— including Owned, Non-Owned and Hired Automobile Liability. Ill - 1 _Do_auSign_EmteloWta E96D6_1$-F440=4493=91365=50E25E3E6CDI _ 4/14/14 • 4. WORKERS COMPENSATION AND EMPLOYERS LIABILITY—"If" required by Wisconsin State Statute or any Workers Compensation Statutes of a different state. A. Must carry coverage for Statutory Workers Compensation and an Employers Liability limit of: (1) $100,000 Each Accident (2) $500,000 Disease Policy Limit (3) $100,000 Disease-- Each Employee 5. UMBRELLA LIABILITY - If exposure exists, provide coverage at least as broad as the underlying Commercial General Liability, Watercraft Liability (if required), Automobile Liability and Employers Liability, with a minimum limit of$2,000,000 each occurrence and $2,000,000 aggregate, and a maximum self-insured retention of$10,000. 6. ADDITIONAL PROVISIONS A. Acceptability of Insurers - Insurance is to be placed with insurers who have an A.M. Best rating of no less than A- and a Financial Size Category of no less than Class VI, and who are authorized as an admitted insurance company in the state of Wisconsin. B. Additional Insured Requirements — The following must be named as additional insureds on all Liability Policies for liability arising out of project work - City of Oshkosh, and its officers, council members, agents, employees and authorized volunteers. On the Commercial General Liability Policy, the additional insured coverage must be ISO form CG 20 10 07 04 or its equivalent and also include Products -- Completed Operations ISO form CG 20 37 07 04 or its equivalent for a minimum of 2 years after acceptance of work. This does not apply to Professional Liability, Workers Compensation and Employers Liability. C. Certificates of Insurance acceptable to the City of Oshkosh shall be submitted prior to commencement of the work to the applicable City department. These certificates shall contain a provision that coverage afforded under the policies will not be canceled or non renewed until at least 30 days' prior written notice has been given to the City Clerk —City of Oshkosh. III - 2 DocuSign_Envelope-lDIZE06DB18-E_44.0-4_4.9.3-9B63-50E25F_3.E5CD1_ /'� DATE(MWDDfYYY) • a p' CERTIFICATE OF LIABILITY INSURANCE . 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 pol)cy(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 endorsement(s). PRODUCER CONTACT Insurance Agency contact NAME: information,Including street Insurance Agent's �'f KA address and PO Box If (NCNNo Ext): contact in formation, IA1C No): applicable. E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC!! INSURER A: ABC Insurance Compaq _ NAIC# —__. INSURED insured's contact Information, INSURER B: XYZ Insurance Compaq NAIC# including name,address and _ phone number. INSURER c: LMN Insurance Company NAIC# INSURER 0: Insurer's)must have a minimum A.M.Best rating of A• ---- — end a Financial Performance Paling of Vl or better. —. 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 AMY 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 AD SUER POLICY EFF POLICY EXP LTR I DL TYPE OF INSURANCE INSR I WVO I POLICY NUMBER (MOD/WY) , (MMIODIYYY) I LIMITS GENERAL LIABILITY I 1 EACH OCCURRENCE $1,000,000 ® ® E I General Liability Policy Number! Policy affective and expiration dale. DAMAGE TO RENTED ) $ Oh4h1ERCIALCF.NERALUADILITY y y PREh1ISES(Eaoccurerce 50,000 A ❑CLAIMS-MADE®OCCUR MED EXP(Any one person) $5,000 ®j ISO FORM CG 20 37 OR EQUIVALENT PERSONAL&ADV INJURY $1,000,000 ❑! 1 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT( APPLIES PER: - PRODUCTS—COMP/OP AGG $2,000,000 E POLICY F moTi �LOC I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ®ZANY AUTO ® ❑ Auto liability Policy Number Policy e,yec;iveand expiration dale. BODILY INJURY(Per person) $ B ❑ALL OWNED ❑ AUTOS SCHEDULED BODILY INJURY(Per acddent) $ I AUTOS _ ,❑I HIRED AUTOS NON-OWNED PROPERTY DAMAGE 17 AUTOS (Per accident) $ El I_ $ w ®UMBRELLA LIAR OCCUR LSI 0 EACH OCCURRENCE $2,000,000 A ❑i EXCESS LIAR ❑ CLAIMS-MADE Umbrella Uability Policy Numberl Policy effective and expiration dale. AGGREGATE $2,000,000 DICED ®RETENTION S10,000 E 1 $ -- c AND EMPLOYERS'L A I rtTY ❑ ❑ I® WC TH- T RY LIMITS'STATU- ❑ OER ANY PROPRIETOR/PARTNER/EXECUTIVE • OFFICE/MEMBER EXCLUDED? Y(N Work e s Compensation Policy Policy effect/ia and expiration da(e.l EL,EACH ACCIDENT $100,000 (Mandatory In NH) N Number +=L DISEASE—EA EMPLOYEE; $100,000 If yes,descdbe under I"I.E.L. DESCRIPTION OF OPERATIONS below EE.L.DISEASE—POLICY OMIT I $500,000 A PROFESSIONAL LIABILITY ❑ 0 I I$1,000,000 EACH CLAIM Professional LlablliryPolicy Poky effective end enplralion dale. $1,000,000 ANNUAL AGGREGATE Number I DESCRIPTION OF OPERATIONS I LOCATIONS(VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Additional Insureds per attached endorsements. Certificates of Insurance acceptable to the City of Oshkosh shall be submitted prior to commencement of the work to the applicable City department. These certificates shall contain a provision that coverage afforded under the policies will not be canceled or non renewed until at least 30 days'prlorwritten notice has been given to the City Clerk—City of Oshkosh. CERTIFICATE HOLDER CANCELLATION City of Oshkosh,Attn:City Clerk Insurance Standard III SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 Church Avenue SAMPLE CERTIFICATE THE EXPIRATION DATE,THEREOF,NOTICE WILL BE DELIVERED IN PO Box 1130 ACCORDANCE WITH THE POLICY PROVISIONS. • Oshkosh,WI 54903.1130 Please Indicate somewhere on this certificate,the contract or project# AUTHORIZED REPRESENTATIVE this certificate is for. ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD __Docu_Sign=Eoxxelope ID:6E0_6D6_18-F440- 493=9B63=50E25F3E6CD1 _ • POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 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 Name Of Additional Insured Person(s) Or Organization(s): Location(s)Of Covered Operations As required by contract Any and all job sites Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to B. With respect-to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- organization(s) shown in the Schedule, but only sions apply: with respect to liability for "bodily injury', "property damage" or "personal and advertising injury" This insurance does not apply to "bodily injury" or caused, in whole or in part, by: "property damage"occurring after: 1. Your acts or omissions; or 1. All work, including materials, parts or equip- 2. The acts or omissions of those acting on your ment furnished in connection with such work, behalf; on the project(other than service, maintenance or repairs) to be performed by or on behalf of In the performance of your ongoing operations for the additional insured(s) at the location of the the additional insured(s) at the location(s) design- covered operations has been completed; or nated above, 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. Insurance Standard III SAMPLE CERTIFICATE Please Indicate somewhere on this certificate,the contract or project# this certificate Is for. CG 20 10 07 04 ©ISO Properties, Inc., 2004 Page 1 of 1 ❑ Docu_ ign Envelope ID:6E06D618-F440-4493-9B63-50E25F3E6CD1 POLICY NUMBER: I Policy# COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 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 SCHEDULE • • Name Of Additional Insured Person(s) Or Organization(s): Location And Description Of Completed Operations As required by contract Any and all job sites Information required to complete this Schedule, if not shown above,will be shown in the Declarations. 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 dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products-completed operations hazard°. Insurance Standard III SAMPLE CERTIFICATE Please Indicate somewhere on this certificate,the contract or project# this certificate Is for. CG 20 37 07 04 ©ISO Properties, Inc., 2064 Page 1 of 1 ❑