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HomeMy WebLinkAbout17. 22-522DECEMBER 13, 2022 21-522 RESOLUTION (CARRIED______LOST______LAID OVER______WITHDRAWN______) PURPOSE: APPROVE ONE YEAR AGREEMENT WITH GREATER OSHKOSH HEALTHY NEIGHBORHOODS INCORPORATED (GO-HNI) ($100,000.00) INITIATED BY: DEPARTMENT OF COMMUNITY DEVELOPMENT WHEREAS, the Common Council of the City of Oshkosh has previously approved two 3-year agreements with Greater Oshkosh Healthy Neighborhoods Incorporated (GO-HNI), to serve as the structure for the next generation of neighborhoods programs, community building and engagement, and real estate development in Oshkosh on; and WHERAS, on November 9, 2021, the Common Council approved a one year extension to the existing 3-year agreement with GO-HNI through December 31, 2022; and WHEREAS, GO-HNI is now requesting a one year agreement through December 31, 2023 to further the overall goals of the ONE Oshkosh Initiative by facilitating neighborhood activities through interagency cooperation and services provided by GO- HNI to strengthen neighborhoods in Oshkosh. NOW, THEREFORE, BE IT RESOLVED by the Common Council of the City of Oshkosh that the attached one year agreement with Greater Oshkosh Healthy Neighborhoods Incorporated (GO-HNI), is hereby approved and the proper City officials are hereby authorized to execute and deliver said agreement in substantially the same form as attached hereto, any changes in the execution copy being deemed approved by their respective signatures, and said City officials are authorized and directed to take those steps necessary to implement the terms and conditions of the Agreement. Money for this purpose is hereby appropriated from Acct No. 0302-0740-6412 - Healthy Neighborhood Initiatives. City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 920.236.5000 http://www.ci.oshkosh.wi.us TO: Honorable Mayor and Members of the Common Council FROM: Kelly Nieforth, Community Development Director DATE: December 8, 2022 RE: Approve One Year Agreement with Greater Oshkosh Healthy Neighborhoods Incorporated (GO-HNI) ($100,000) BACKGROUND Greater Oshkosh Healthy Neighborhoods Incorporated (GO-HNI) was created in 2016 as a public-private partnership whose primary focus is to revitalize neighborhoods and engage neighborhood residents in the City of Oshkosh. The City’s Strategic Plan identifies neighborhood revitalization as a continuing goal and annually, GO-HNI fulfills many action items approved as part of the plan. Since 2016, GO-HNI has been an active participant in the ONE Oshkosh, Neighborhood Night Out, Rock the Block, and many neighborhood events throughout Oshkosh that support neighborhood development. On November 9, 2021, the Common Council approved a one year extension to the existing three year agreement with GO-HNI that was set to expire on December 31, 2021. This was done to give GO-HNI ample time to explore alternate funding sources and to finalize their strategic plan. GO-HNI is now requesting approval for a one-year agreement from January 1, 2023 through December 31, 2023 so they can continue to try to secure private funding for the organization. ANALYSIS Since 2016, GO-HNI has cultivated and provided assistance to the twenty-three neighborhood associations and regularly guides neighborhoods through the process to create their own association. There are multiple prospects for additional neighborhood associations over the next year and a goal of helping to facilitate the creation of one additional neighborhood association is included in the proposed agreement. In addition to neighborhood association development, another important aspect of GO-HNI’s initial strategic plan was real estate development through housing rehab projects. When GO- HNI was created, housing rehab investments were intended to serve as a means to generate additional income to grow GO-HNI’s capabilities and eventually decrease the city’s investment in the organization. However, since 2016, real estate redevelopment has been a challenge for the organization and GO-HNI has proposed to explore other activities that would assist in redeveloping neighborhoods, but not create a financial burden for the organization. In the City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 920.236.5000 http://www.ci.oshkosh.wi.us meantime, GO-HNI continues to offer grants and services that improve the appearance of homes in the neighborhood associations. FISCAL IMPACT The term of the agreement is for one year. The proposed city investment for 2023 is $100,000 which aligns with the previous agreement. City funding from this agreement is supported by TID funds collected during the one year affordable housing extension option allowed per state statute. Account No. 0302-0740-6412 – Healthy Neighborhoods Initiative will fund the contribution. There is no impact on the general fund. Since 2016, the City has invested over $900,000 of Healthy Neighborhood Initiative funds into the organization but projections show that the City will run out of the Healthy Neighborhood Initiative funds in less than five years if the current expenditures remain the same. RECOMMENDATIONS The Common Council approves the one year agreement with Greater Oshkosh Healthy Neighborhoods Incorporated for $100,000. Respectfully Submitted, Approved, Kelly Nieforth Mark A. Rohloff Community Development Director City Manager AGREEMENT This Agreement is between the City of Oshkosh, ("the City") and the Greater Oshkosh Healthy Neighborhoods Incorporated, ("GO-HNI") for one (1) year. In accordance with this Agreement, GO-HNI agrees to provide neighborhood development activities in the City, to coordinate this assistance with designated the City staff and City Council, and to implement the activities set forth herein. PURPOSE The purpose of the one (1) year Agreement is to further the overall goals of the ONE Oshkosh Initiative as set forth in EXHIBIT A by facilitating neighborhood development activities through services provided by GO-HNI to strengthen neighborhoods in the City of Oshkosh. AGREEMENT GO-HNI agrees to provide direct neighborhood development assistance in the City in accordance with EXHIBIT A and herein. GO-HNI will put forth its best efforts to promote neighborhood development services including community building & engagement and property development/enhancement activities within Oshkosh. The services to be provided by GO-HNI will consist of the following: Section I- Neighborhood Development 1. GO-HNI will conduct on-going neighborhood organizing.  Neighborhood organizing efforts will be done in coordination with the Neighborhood Association Recognition Policy in place with the City.  GO-HNI will support the organization of a minimum of one (1) new neighborhood association annually. GO-HNI will contact the appropriate City staff when new neighborhoods begin the organizing process. City staff will provide technical assistance to the neighborhood organization, as feasible, upon request by GO-HNI.  GO-HNI will be responsible for notifying recognized neighborhood associations and the City when a recognized neighborhood association meets or fails to meet the requirements set forth by the Neighborhood Association Recognition Policy in place with the City.  GO-HNI will also supply a list of one (1) neighborhood resident contacts from each recognized neighborhood association to the City annually. 2. GO-HNI will assist existing neighborhood associations upon direct contact or referral from the City Council and/or City staff and report findings and resolution to the City Council and/or City staff. 3. GO-HNI will engage with existing neighborhood associations that may be inactive or without neighborhood association leadership in order to restore the neighborhood association. 4. GO-HNI will organize and provide staff support for ten (10) Oshkosh Healthy Neighborhood Alliance (OHNA) meetings annually. GO-HNI will be responsible for maintaining a membership roster and a record of meeting agendas, materials, and minutes. 5. GO-HNI will organize, sponsor, and promote a minimum of three (3) educational opportunities annually for recognized neighborhood associations at OHNA meetings. 2 6. GO-HNI will be responsible for supporting, sponsoring, or organizing a minimum of one (1) event per recognized neighborhood association annually. 7. GO-HNI will organize, sponsor, and promote a minimum of one (1) neighborhood leadership training annually. Section II- Community Building and Engagement Program 8. GO-HNI will promote and administer a Community Building and Engagement (CB&E) program in the City as described below:  Each recognized neighborhood association that maintains an active status will be entitled to $1,000 of CB&E funds annually to assist with costs for neighborhood association development and engagement activities. GO-HNI will determine if the request for funds meet the guidelines of the program. 1. An “Active Neighborhood Association” is defined as: meeting the agreed upon terms in the GO-HNI and recognized neighborhood association Agreement which includes hosting an annual meeting, hosting an annual event, tracking volunteer hours, and providing contact information for association leadership to GO-HNI.  An active neighborhood association may request an additional $500 annually for CB&E purposes which requires approval from the City of Oshkosh Community Development Director or Designee. GO-HNI will submit the request of additional funds to the City for consideration.  GO-HNI may utilize up to $1,000 of CB&E funds annually to assist with the reengagement of an inactive recognized neighborhood association.  GO-HNI may utilize up to $1,000 of CB&E funds annually to provide services to all the recognized neighborhood associations to assist with development and engagement activities in the neighborhood association.  CB&E funds that are not spent each calendar year can be carried over to GO-HNI’s next calendar year budget and be used for CB&E activities as outlined above. 9. GO-HNI and the City will review the program to ensure it is achieving the outcomes and production targets established by the terms of this Agreement. The City will be recognized as a funder on all program promotional materials. 10. GO-HNI and the City will coordinate to collect, analyze and report on data that measures the impacts of Community Building and Engagement activities on resident confidence within an agreed upon geography by the Term of this Agreement. Section III- Property Development/Enhancement 11. GO-HNI will attract private capital investment to neighborhoods with the goal of creating $2 of private investment for every $1 of public funding spent during the Term of this Agreement. 12. GO-HNI will allocate a minimum of twenty (20) Good Neighbor Grants annually in recognized neighborhood associations. 13. GO-HNI will review opportunities to purchase and/or rehab homes when financially feasible. 3 14. GO-HNI will actively partner on neighborhood beautification efforts through public/private partnerships. 15. GO-HNI will provide in-kind support to NeighborWorks America for their efforts of advancing property development/enhancement programs in the City and may explore the option of creating an affiliation with NeighborWorks America. Section IV- Marketing Activities 16. GO-HNI will establish one (1) unique neighborhood brand as set forth by the ONE Oshkosh brand criteria established by the City and GO-HNI during the Term of this Agreement. 17. GO-HNI will work with residents to develop neighborhood-specific marketing materials that promote Oshkosh neighborhoods as places of choice as set forth by the ONE Oshkosh Initiative brand criteria established by the City and GO-HNI by the Term of this Agreement. 18. GO-HNI will develop targeted communication and outreach tools to reach stakeholders to garner on-going support for neighborhood development activities in Oshkosh. Activities, and frequency of such, will include: Annually:  Neighborhood Association Meetings and/or Appropriate Events  One (1) City-wide event annually to promote neighborhood development activities of GO- HNI and the City  City Council meeting presentation As Appropriate:  Social Media  Press Releases 19. GO-HNI will ensure that its website is both a reflection of a collaborative and high-quality organization and a client-centered resource containing quality information. 20. When meeting with local residents, investors, realtors, or lending institutions, GO-HNI will provide information and referrals on existing local, state and federal neighborhood assistance programs. These programs include, but are not limited to, housing loan and grant programs, neighborhood capital improvement programs and homebuyer assistance programs offered by the City. GO-HNI staff will also provide information and referrals to other organizations that can meet the needs of residents, investors, realtors, and lending institutions. Section V- Capacity Building 21. GO-HNI staff will meet bi-monthly and as needed with City staff to review neighborhood development needs and discuss implementation of appropriate community or location-specific tools, as well as to provide support for neighborhood development endeavors. 4 22. GO-HNI will build the capacity of the organization to proactively respond to neighborhood-based opportunities or concerns originated by residents with the assistance of the City if necessary. Section VI- Additional Support Activities 23. GO-HNI will provide written annual reports to the City Manager and Director of Community Development. This activity will include a summary of the activities conducted during the reporting period as they related to the identified production targets within this Agreement. 24. GO-HNI will track key measurements to garner an overall sense of how the greater Oshkosh area is doing. Such measurements may include, but are not limited to:  Number of resident volunteer hours invested by neighborhoods  Value (in dollars) of in-kind donations  Number of resident events held and/or sponsored  Private dollars leveraged as a result of the City’s investment TERM This Agreement shall commence on January 1, 2023 and shall terminate on December 31, 2023 unless terminated earlier by one of the parties as provided in this Agreement. TERMINATION This Agreement may be terminated by either party upon thirty (30) days written notice in the event of default by the other party of any material provision hereof which remains unremedied for thirty (30) days following written notice of such default. COMPENSATION The City shall pay to GO-HNI a lump sum in the amount of $100,000 in 2023 by February 15, 2023. The City has the ability to withhold funding should GO-HNI fail to meet annual production targets as indicated within this Agreement. Up to $30,000 of this amount can be used for CB&E activities identified within Section II of this Agreement. The remaining annual contract funds must be used for affordable housing activities identified within this Agreement which may include administrative costs. In the event this Agreement is terminated for any reason during the course of the year after payment has been made, GO-HNI will be entitled to retain payment for documented work completed, with the remainder of the lump sum returned to the City. 5 ADDITIONAL SERVICES FOR MANAGEMENT AND ADMINISTRATION OF NEIGHBORHOOD DEVELOPMENT ACTIVITIES At the City’s discretion the City may request additional marketing, sales, projects and other management and administrative tasks or services related to the City’s neighborhood development activities. If additional services are requested, the City and GO-HNI shall mutually determine a starting date for such assignment, goals and expectations, as well as additional compensation for such functions, if necessary. INDEPENDENT CONTRACTOR GO-HNI shall be an independent contractor of the City. Neither GO-HNI nor any of its officers, employees, or agents shall be considered to be an employee of the City as a result of the obligations undertaken pursuant to this agreement. The projects funded and undertaken shall not be considered to be joint ventures or indicative of any partnership, and both such relationships are disavowed. GO-HNI's officers, employees and agents shall make no commitments or representation on behalf of the City to third parties without prior approval of the City. In addition, GO-HNI hereby holds harmless the City and its departments, officers, employees and agents from and against all claims, demands and liability for damages to third persons of any type whatever arising out of the actions of GO-HNI under this agreement. CONFIDENTIALITY GO-HNI 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) open records requests, 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 GO-HNI is a named party and GO-HNI 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 GO-HNI’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 GO-HNI 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. GO-HNI shall not be entitled to additional compensation for employee services provided under this paragraph. 6 LIABILITY INSURANCE GO-HNI agrees to abide by the attached City of Oshkosh Insurance Requirements for Professional Services. NOTICES All communications or notices required or permitted by this Agreement shall be in writing and shall be deemed to have been given: (i) upon delivery to an officer or the person entitled to such notice, if hand delivered, or (ii) five business days following deposit in the United States Mail, postage prepaid, or with a nationally recognized overnight commercial carrier that will certify as to the date and time of delivery, air bill prepaid, or (iii) upon transmission if by facsimile or email, any such communication or notice shall be addressed as follows, unless and until any such party notifies the other in accordance with this section of any change of address: If to the City: City of Oshkosh Community Development Director 215 Church Avenue Post Office Box 1130 Oshkosh, WI, 54903-1130 knieforth@ci.oshkosh.wi.us If to GO-HNI: Greater Oshkosh Healthy Neighborhoods Incorporated 100 N. Main Street, Suite 103 Oshkosh, WI 54901 Attn: Chairman of the Board tfojtik@gohni.org 7 ASSIGNMENT GO-HNI agrees that it will not assign this Agreement or any portion thereof, or any of its responsibilities hereunder, to any other party without first obtaining the written permission of the City. IN WITNESS WHEREOF, the parties hereto have executed this agreement on the _____ day of _____________________, 2022. GREATER OSHKOSH HEALTHY NEIGHBORHOODS INCORPORATED ________________________________ JULIE KIEFER CHAIRPERSON OF THE BOARD CITY OF OSHKOSH ______________________________ Mark A. Rohloff CITY MANAGER ______________________________ Jessi Balcom CITY CLERK APPROVED AS TO FUNDING AVAILABILITY: APPROVED AS TO FORM: ______________________________ ______________________________ RUSS VAN GOMPEL, FINANCE DIRECTOR LYNN LORENSON, CITY ATTORNEY EXHIBIT A2023 OSHKOSH HEALTHY NEIGHBORHOODS PRODUCTION TARGETS GOALSPRODUCTION TARGETACTION STEPSSUCCESS MEASURES1. Neighborhood Development a. Provide support to all existing neighborhood associations b. Facilitate the creation of one (1) new neighborhood association through the term of the agreementc. Reach out and engage with one (1) inactive neighborhood association annuallya. Promote the benefits of a neighborhood association through a variety of public formatsb. Work with City staff to identify opportunities to engage with inactive neighborhood associations through city infrastructure projects or development projects. a. Number of neighborhood associations created annually b. Number of volunteer hours invested on behalf of neighborhoods annuallyc. Number of inactive neighborhood association outreaches2. Support the Oshkosh Healthy Neighborhood Alliance (OHNA)a. Hold ten (10) OHNA meetings annually b. Sponsor one (1) OHNA project or event annually c. Schedule a minimum of three (3) educational guest speakers for OHNA annually d. Grow OHNA membership a. Maintain regular communication with resident leaders to identify neighborhood needs that can be addressed at OHNA meetings b. Maintain an ongoing list of relevant guest speakers and topics of concern c. Promote OHNA and encourage new associations to appoint resident membersa. Number of meetings held b. Number of projects/events heldc. Number of guest presentations given GOALSPRODUCTION TARGETACTION STEPSSUCCESS MEASURES3. Community Engagementa. Support a minimum of five (5) outreach opportunities to engage the community annuallyb. Allocate funds for a minimum of twenty (20) Good Neighbor Grants annuallyc. Allocate funds to active Neighborhood Associations for Community Building and Engagement (CB&E) activitiesa. Promote and administer CB&E funding to support neighborhood association activities b. Provide organizational support to neighborhood associations as necessary c. Review program policies to ensure grants are being adequately utilized and awarded throughout all neighborhood associationsd. Solicit additional private investors to invest in the neighborhoods for specific projectsa. Number of community engagements b. Ratio of total investment by property owners and Oshkosh Healthy Neighborhoods though the Good Neighbor Grants annuallyc. Value (in $) of in-kind donations and volunteer hours invested d. Project / event photo documentation e. Annual CB&E Program Executive Summary4. Establish unique neighborhood brands and positive neighborhood identities. a. Partner with a minimum of one (1) neighborhood association annually to develop unique logos and marketing materialsb. Utilize GO-HNI website and social media platforms to promote the neighborhood associations a. Promote and administer available funding for neighborhood marketing b. Participate in marketing meetings as necessary to ensure consistency with brand parameters c. Assist with identifying impactful marketing methodsa. Number of neighborhood logos created GOALSPRODUCTION TARGETACTION STEPSSUCCESS MEASURES5. Provide resident leadership education a. Sponsor a minimum of one (1) neighborhood leadership training workshop annuallyb. Assist with identifying and recruiting residents for other education opportunitiesa. Recruit work group to organize and implement a workshop b. Refine workshop curriculuma. Number of residents trained b. Number of neighborhoods organized 6. Attract private capital investment to neighborhoods and GO-HNI organizationa. Annually, create $2 of private investment for every $1 of public funding spent in neighborhood projectsb. Increase the amount of private investment into the GOHNI organization by $15,000 a. Create and implement a resource development plan for GO-HNIb. Actively seek to grow and renew partnershipsa. Amount of private funding invested in GO-HNI compared to public fundingb. Amount of private funding invested in neighborhoods compared to public funding Insurance Requirements for the City of Oshkosh Revised: April 26, 2022 Revised: April 11, 20222 Revised: February 1, 2022 Revised: December 20, 2018 Revised: May 12, 2014 Revised: April 14, 2014 Revised: October 23, 2013 Revised: July 16, 2012 Revised: May 25, 2012 Revised: May 9, 2012 Revised: December 21, 2011 Revised: March 31, 2011 Original: January 14, 2011 4/26/22 City of Oshkosh Insurance Requirements INTRODUCTION The City’s Insurance Requirements describe the insurance required, some of which identify the risks to be covered and allow the Contractor and its Insurer some flexibility in covering those risks. The City will not be reviewing each and every detail of the Contractor’s policy, but expects that the required coverage exists. The City’s action, or inaction, of allowing the contract to proceed does not act as a waiver of any insurance requirement or an alteration of any required term of the contract. To the contrary, the City relies on the affirmations of the Contractor and to the extent that such affirmations are false, misleading, or in error, the City reserves the right to, in addition to enforcement of contract requirements, the ability to pursue any false, misleading, or erroneous affirmations. It is important that the City of Oshkosh is adequately protected from loss due to the negligence of others (contractors, suppliers, vendors, etc.) who are working for, with, or on behalf of the City of Oshkosh. To help achieve this goal, the City of Oshkosh requires that other parties carry a certain level of insurance that will protect, defend and indemnify the City from losses arising out of their activities or from their products. The following standards have been established to help provide direction and consistency for City of Oshkosh Departments. Until the appropriate certificate of insurance verifying the required coverage is obtained, the City of Oshkosh will NOT be issuing a license, permit or entering into a contract. Insurance requirements for jobs or activities such as asbestos abatement, pollution clean up, oil recycling, hazardous waste removal, or any new contract or activity where it is not clear what level of insurance should be required will be determined by the City Attorney and the Safety & Risk Management Officer. The City Attorney and/or the Safety & Risk Management Officer are responsible for the review of all certificates of insurance to determine if they meet the insurance requirements. There may be times when an organization or Contractor can not meet the insurance requirements. Any significant variance from the standards must be authorized by the City Attorney and/or the Safety & Risk Management Officer. 4/14/14 III - 1 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 project/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. 4/14/14 III - 2 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. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYY) 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 endorsement(s). PRODUCER CONTACT NAME: PHONE (A/C. No. Ext): FAX (A/C. No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: ABC Insurance Company NAIC # INSURED INSURER B: XYZ Insurance Company NAIC # INSURER C: LMN Insurance Company NAIC # INSURER D: 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYY) POLICY EXP (MM/DD/YYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 A CLAIMS-MADE OCCUR MED EXP (Any one person) $ 5,000 ISO FORM CG 20 37 OR EQUIVALENT PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN’L AGGREGATE LIMIT APPLIES PER: PRODUCTS – COMP/OP AGG $ 2,000,000 POLICY PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ANY AUTO BODILY INJURY (Per person) $ B ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION $10,000 $ C WORKERS COMPENSATION AND EMPLOYERS’ LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? Y / N (Mandatory in NH) N If yes, describe under DESCRIPTION OF OPERATIONS below WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE – EA EMPLOYEE $ 100,000 E.L. DISEASE – POLICY LIMIT $ 500,000 A PROFESSIONAL LIABILITY $1,000,000 EACH CLAIM $1,000,000 ANNUAL AGGREGATE DESCRIPTION OF OPERATIONS / 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’ prior written notice has been given to the City Clerk – City of Oshkosh. CERTIFICATE HOLDER CANCELLATION City of Oshkosh, Attn: City Clerk 215 Church Avenue PO Box 1130 Oshkosh, WI 54903-1130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE, THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Insurer(s) must have a minimum A.M. Best rating of A- and a Financial Performance Rating of VI or better. Policy effective and expiration date. Policy effective and expiration date. Policy effective and expiration date. Policy effective and expiration date. General Liability Policy Number Auto Liability Policy Number Professional Liability Policy Number Workers Compensation Policy Number Insurance Agent’s contact information. Insurance Agency contact information, including street address and PO Box if applicable. Insured’s contact information, including name, address and phone number. Insurance Standard III SAMPLE CERTIFICATE Please indicate somewhere on this certificate, the contract or project # this certificate is for. Umbrella Liability Policy Number Policy effective and expiration date. 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 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) design- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to “bodily injury” or “property damage” occurring after: 1. All work, including materials, parts or equip- ment 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 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. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 Insurance Standard III SAMPLE CERTIFICATE Please indicate somewhere on this certificate, the contract or project # this certificate is for. Policy # POLICY NUMBER: 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”. CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 Policy # Insurance Standard III SAMPLE CERTIFICATE Please indicate somewhere on this certificate, the contract or project # this certificate is for.