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HomeMy WebLinkAboutMidwest Engineering/testing svs 12-08 CITY OF OSHKOSH DEPARTMENT OF PUBLIC WORKS 215 CHURCH AVENUE, P.O. BOX 1130, OSHKOSH, WI 54903-1130 PHONE: (920) 236-5065 FAX(920)236-5068 LETTER OF TRANSMITTAL To: Mr. Matthew Henderson Date: December 7, 2012 Midwest Engineering Services, Inc. Subject: Executed Agreement 821 Corporate Court, Suite 102 Construction Testing Services Waukesha, WI 53189-5010 James Road Area Detention Basin Contract 12-08 Please find: ® Attached ❑ Under Separate Cover ❑ Copy of Letter ® Contracts ❑ Amendment ❑ Report ❑ Agenda ❑ Meeting Notes ❑ Photos ❑ Mylars ❑ Change Order ❑ Plans ❑ Specifications ❑ Estimates ❑ Diskette ❑ Zip Disk ❑ Other Quantity Description 1 Executed Agreement These are being transmitted as indicated below: ❑ For Approval ® For Your Use ❑ As Requested ❑ For Review& Comment Remarks: Enclosed is a copy of the executed agreement for the construction testing services for the James Road Area Detention Basin. If you have any questions, please contact us. City Attorney's Office — Copy City Clerk's Office —Original cc: _ File—Original Signed: Tracyylor L\Engineering112-08 James Road Area Detention Basin\Project_Information\CorrespondencelLOTs1LOT-MES Executed Agreement-FDT 12-7-12.docx AGREEMENT THIS AGREEMENT, made on the Cr4 day of Qe, , 2012, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and MIDWEST ENGINEERING SERVICES, INC., 821 Corporate Court, Suite 102, Waukesha, WI 53189-5010, party of the second part, hereinafter referred to as the CONSULTANT, WITNESSETH: That the CITY and the CONSULTANT, for the consideration hereinafter named, enter into the following Agreement. The CONSULTANT's Proposal is attached hereto and reflects the agreement of the parties except where they conflict with this Agreement, in which case this Agreement shall prevail. ARTICLE I. PROJECT MANAGER A. Assignment of Project Manager. The CONSULTANT shall assign the following individual to manage the project described in this Agreement: Matthew Henderson —Vice President 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 II. CITY REPRESENTATIVE The CITY shall assign the following individual to manage the project described in this Agreement: James Rabe, P.E., CPESC — Civil Engineering Supervisor ARTICLE III. SCOPE OF WORK The CONSULTANT shall provide the services described in the CONSULTANT's Proposal. The CONSULTANT may provide additional products and/or services if such products/services are requested in writing by the Authorized Representative of the CITY. I:\Engineenng112-08 James Road Area Detention Basin\Project_Information\Contract Info112-08 Agreement-MES QA Testing_11-21-12.docx Page 1 of 4 All reports, drawings, specifications, computer files, field data, notes, and other documents and instruments prepared by the CONSULTANT as instruments of service shall remain the property of the CITY. ARTICLE IV. 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. ARTICLE V. TIME OF COMPLETION The work to be performed under this Agreement shall be commenced and the work completed in conjunction with the work performed by R. G. Huston, Inc. on the James Road Area Detention Basin. 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, 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. ARTICLE VI. 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 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. I\Engineering\12-08 James Road Area Detention Basin\Project_Information\Contract Info112-08 Agreement-MES QA Testing_11-21-12.docx Page 2 of 4 ARTICLE VII. 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: • Time and Materials Not to Exceed $23,090 (Twenty Three Thousand Ninety Dollars). • Fee schedules 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 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. ARTICLE VIII. CONSULTANT TO HOLD CITY HARMLESS The CONSULTANT covenants and agrees to protect and hold the City of Oshkosh harmless against all actions, claims, and demands of any kind or character whatsoever which may in any way be caused by or result from the intentional or negligent acts of the CONSULTANT, his agents or assigns, his employees, or his subcontractors related however remotely 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. ARTICLE IV. INSURANCE The CONSULTANT agrees to abide by the attached City of Oshkosh Insurance Requirements. ARTICLE X. 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. I:\Engineering\12-08 James Road Area Detention Basin\Project_Information\Contract Info\12-08 Agreement-MES QA Testing_11-21-12.docx Page 3 of 4 B. For Convenience. The CITY may terminate this Agreement at any time by giving written notice to the CONSULTANT no later than 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. In the Presence of: CONSULTANT A PA By: '! G%2 (Seal of Consultant (Specify Title) if a Corporation.) By: (Specify Title) CITY OF OSHKOSH 'd P4-1, By: _ (Witness) Mark A. Rohloff, City Manager 4�,- And: /LL w i ,d (Witness) - - -111r •t y Clerk Tabcd 1 APPOVED: I hereby certify that the necessary provisions have been made to pay the liability which which will accrue under this Agreement. ity Attorney" R/4414. (JA City Cotrnolltr I:\Engineering\12-08 James Road Area Detention Basin\Project_Information\Contract Info112-08 Agreement-MES QA Testing_11-21-12.docx Page 4 of 4 midwest engineering services, inc. [MCI geotechnical • environmental • materials engineers 821 Corporate Court Suite 102 Waukesha.WI 53189-5010 262-521-2125 FAX 262-521-2471 www.midwesteng.com November 13, 2012 - Mr. James Rabe, P.E. _. - _. Civil Engineering Supervisor - 215 Church Ave. Oshkosh, WI 54901 Subject: Proposal for Construction Testing Services James Road Area Detention Basin Oshkosh, Wisconsin MES Project No. 7-12309 Dear Mr. Rabe, Midwest Engineering Services, Inc. (MES) is pleased to submit this proposal for construction testing services for the above referenced project. A brief description of our understanding of the scope of work to be provided, as outlined in your November 7, 2012 e-mail, along with our method of performance and fees is included in the following paragraphs. Project Description and Scope of Services The testing services will be conducted for the construction of the proposed James Road Detention Basin. It is understood that the scope of work to be conducted by MES personnel will include the following: • Observe the stripping of the site and cutting to design grades to evaluate the suitability of the exposed subgrade soils; • Observe and monitor the preparation of subgrade soils prior to the placement of new fill; • Perform Field Density Testing utilizing a nuclear density gauge (ASTM D2922) on fill placement to assess the degree of compaction being achieved relative to the project specifications; • Perform laboratory moisture density relationship tests (ASTM D-1557, Modified Proctor) on representative samples of proposed fill materials and; CORPORATE OFFICE WAUKESHA.WI 262-970-0764 APPLETON,WI • RIPON,WI • GREEN BAY,WI • CHIPPEWA FALLS MES Project No. 7-12309 James Road Area Detention Basin Oshkosh, Wisconsin Page 2 • Assist City of Oshkosh personnel as needed to prepare field notes of work preformed. Method of Performance MES will assign a Senior Engineering Technician from the MES Ripon Branch, for the full time testing requested whose principal duties will be to assist in the field evaluation of subgrade preparation, and by observation and testing of fill placement, document compliance with the project specifications. In addition, a Senior Geotechnical Engineer will also review the planned work scope with the MES Senior Engineering Technician to identify technical objectives, and will periodically visit the jobsite for supervision of MES personnel and for engineering evaluations of the work performed. Fees Midwest Engineering Services, Inc. will provide the above referenced services on a unit charge basis in accordance with the attached Cost Estimate Worksheet and Standard Fee Schedule and pursuant to the General Conditions, both of which are enclosed herein and considered part of this agreement. As requested, a cost breakdown of the proposed services and fees has been included, using the number of days and lab tests specified in the November 7, 2012 e-mail. MES's fees will be determined by the actual time expended by our personnel for this project and the amount of laboratory testing performed, and therefore directly dependent on the actual construction period and extent of our involvement. We request that all field services be scheduled at least 24 hours in advance. Closing MES will proceed with the work on the basis of your verbal authorization. Please provide formal acknowledgement of receipt and acceptance of this agreement by having an appropriate party sign in the space below and return one copy for our files. Please be advised that return of only the signature page will indicate acceptance of the entire agreement document, including the attached fee schedule and general conditions. Thank you for the opportunity to offer our services on this project. If there are any questions regarding this proposal or other matters, please do not hesitate to call. Midwest Engineering looks forward to working with you on this project. MES Project No. 7-12309 James Road Area Detention Basin Oshkosh, Wisconsin Page 3 Very truly yours, MIDWEST ENGINING SERVICES, INC. Edward D. Zyga, P.E. Principal of Firm Accepted by: CITY OF OSHKOSH Signature: Name: (Typed or Printed) Title: Date: Enclosures: Cost Estimate Worksheet Standard Fee Schedule General Testing General Conditions MIDWEST ENGINEERING SERVICES COST ESTIMATE WORKSHEET Client Name: City of Oshkosh Date: 11/13/2012 Project Name: James Road Area Detention Basin MES Proposal No: 7-12309 Project Location: Oshkosh, WI Page 1 of 1 Quantity Unit Fee Rate Total SENIOR GEOTECHNICAL ENGINEER 24 Hours $95.00 $2,280.00 Senior Geotechnical Engineer for project setup, pre- construction meeting, MES personnel supervision, on- site observation (3 trips) and technical consultation. SENIOR ENGINEERING TECHNICIAN 40 Days $500.00 $20,000.00 Senior Engineering Technician for on-site observation and testing, assuming 8 hours per day including travel time and daily report preparation; includes nuclear density gauge, vehicle charge, and review of daily field reports by Project Manager. TESTS 6 Tests $135.00 $810.00 Moisture Density Relationship Testing ASTM D-1557, Modified Proctor TOTAL ESTIMATED FEE: $23,090.00 OTHER CHARGES, AS APPLICABLE Unit Fee Rate SENIOR ENGINEERING TECHNICIAN (Half-Day) Half-Day $300.00 4 hours or less, including travel time SENIOR ENGINEERING TECHNICIAN (Overtime) Hour $57.00 More than 8 hours per day; or Saturday, Sunday or holiday work NOTE It is anticipated that by coordination with the City and contractor reps, and with the shorter daylight during the fall season, an 8-hour day, including travel time from the Ripon office, should be sufficient on most days to accomplish the requested services. MIDWEST ENGINEERING SERVICES, INC. CONSTRUCTION TESTING AND ENGINEERING STANDARD FEE SCHEDULE ENGINEERING SERVICES Engineering services for on-site monitoring and evaluation, construction materials testing, job site meetings, report preparation and review, and consultation. Staff Engineer or Geologist $65.00/Hour Principal of Firm $110.00/Hour Project Engineer or Manager $80.00/Hour Drafting Services $40.00/Hour Principal Engineer $95.00/Hour Secretarial Services $35.00/Hour FIELD TESTING SERVICES Technical services for on-site monitoring and testing of materials for earthwork, foundations, concrete, masonry, structural steel, fireproofing, roofing, and pavement construction. Sample Pick Up $35.00/Hour Support Vehicle $50.00/Day Engineering Technician $37.50/Hour Nuclear Density Gauge $25.00/Day Engineering Technician II $40.00/Hour Floor Flatness Gauge $50.00/Day Senior Engineering Technician $45.00/Hour Windsor Probe $50.00/Day+Probe Special Inspections Technician $65.00/Hour Concrete Cylinder Molds $30.00/box(20) AWS Weld Inspector Upon Request Concrete Coring Equipment $100.00/Day+ Bit LABORATORY TESTING SERVICES Concrete Compression Test Moisture Content $5.00/Each Cylinder Cast by MES $12.00/Each Density with Moisture Content $25.00/Each Cylinder Cast by other $15.00/Each Organic Content(Loss on Ignition) $30.00/Each Trimming Charges $5.00/Each Percent Finer No.200 $35.00/Each Concrete Core Compression Test $30.00/Each Grain size- Mechanical $50.00/Each Mortar Cube Compression Test $15.00/Each Grain size-Hydrometer $75.00/Each Grout Prism Compression Test $15.00/Each Atterberg Limits $50.00/Each CMU Compression Test $50.00/Each Standard Proctor $125.00/Each Aggregate Sieve Analysis $50.00/Each Modified Proctor $150.00/Each Asphalt Core Density $25.00/Each California Bearing Ratio $175.00/Each MTSG Test $75.00/Each Permeability, Granular Soil $200.00/Each Asphalt Extraction/Gradation $150.00/Each Permeability, Cohesive Soil $250.00/Each Marshall Density Test $150.00/Each Sample Prep/Remolding $30.00/Each REMARKS - Personnel charges will be based on a portal-to-portal basis; a minimum charge of 3 hours will apply for all Field Testing Services. One (1) day advance scheduling is requested for all field testing services; same-day scheduling will be subject to a premium rate of 1.5 times the standard rate. Where a support vehicle is not needed, a transportation charge of $0.50 per mile will be added for travel to and from the site, and other job related travel. Project Engineer for contract administration, scheduling, report review and consultation will be charged to all reports at a minimum rate of one half hour per report. An overtime multiplier of 1.5 will be used for services performed on Saturday, Sunday or holidays; for work scheduled outside the hours of 7:30 a.m. to 5:00 p.m.; or for more than eight(8) hours per day. The above prices include up to four (4) copies of the report distributed as requested. Payment for invoices will be due within 15 days of receipt of invoice. Interest will be added at a rate of 1 1/2% per month of delinquency. Proposal estimates and verbal quotations will remain valid for 60 days, at which time they may be subject to change or withdrawal. ctfs 10 GENERAL CONDITIONS Midwest Engineering Services, Inc. General Testing Services Item 1.Scope of work.Midwest Engineering Services,Inc.(MES)shall perform services in property of MES,unless there are other contractual agreements.MES will retain final reports accordance with an"agreement"made with the"client".The agreement consists of MES's relating to the services performed for a period of 5 years following submission of the report proposal,Standard Fee Schedule,and these General Conditions.The"client"is defined as the Client agrees to return upon demand and will not use for any purpose whatsoever all reports person or entity requesting and/or authorizing the work,and in doing so,client represents and other work furnished to client or his agent which are not paid for. and warrants that he is duly authorized in this role,even if performed on behalf of another party or entity,in which case the other party or entity is also considered as the client.The Item 9.Confidentiality.MES shall hold confidential the business and technical information hiring of MES signifies the acceptance of this proposal and the terms of this agreement obtained or generated in performance of services under this agreement and identified in writing by the client as"confidential".MES shall not disclose such information except if such The fees for services rendered will be billed in accordance with the Standard Fee Schedule; disclosure is required by governmental statute,ordinance,or regulation;for compliance with unit rates for services not covered in the Fee Schedule or elsewhere in the agreement can be professional standards of conduct for public safety,health,and welfare concerns;or for pro- provided.Any cost estimates stated in this contract shall not be considered as a firm figure tection of MES against claims or liabilities arising from performance of its services. unless otherwise specifically stated in this contract.The standard prices proposed for the work are predicated upon the client's acceptance of the conditions and allocations of risks The technical and pricing information contained in any report or proposal submitted by MES and obligations described in the agreement.The client agrees to impart the terms of this is to be considered confidential and proprietary,and shall not be released or otherwise made agreement to any third party to whom client releases any part of MES's work.MES shall have available to any third party without the express written consent of MES. no obligations to any party other than those expressed in this agreement. Item 10.Standard of Care.MES will perform the services under this agreement in accor- Ile m 2.Site Access.The client will provide for the right-of-access to the work site.In the dance with generally accepted practice,in a manner consistent with that level of care and skill event the work site is not owned by the client,client represents to MES that all necessary ordinarily exercised by members of this profession under similar circumstances.No other permissions for MES to enter the site and conduct the work have been obtained.While MES warranties implied or expressed,in fact or by law,are made or intended in this agreement shall exercise reasonable care to minimize damage to the property,the client understands The client recognizes that subsurface soil,groundwater and other materials can vary between that some damage may occur during the normal course of work,that MES has not included in sampling and testing points and with time,and that the interpretation of data,and opinions its fee the cost of restoration of damage,and that client will pay for such restoration costs.. and recommendations made by MES are based solely on obtained data.Such limitations can result in a redirection of conclusions and interpretations where new or changed information Item 3.Personnel Responsibility.The presence of MES field representatives will be for the is obtained.MES will not be responsible for the interpretation by others.of data obtained by purpose of providing observation and field testing,and does not include supervision or direc- MES. Lion of the actual work of the contractor,his employees or agents.The contractor(s)for this project should be so advised.The contractor should also be informed that neither the pres- Item 11.Limitations of Liability.The client agrees to limit MES's liability to the client and all ence of,nor the observation and testing by MES personnel shall excuse the contractor in any parties claiming through the client or otherwise claiming reliance on MES's services,alleg- way for defects discovered in his work.It is understood that MES will not be responsible for edly arising from MES's professional acts or errors and omissions,to a sum not to exceed the job or site safety of the project.Job and site safety will be the sole responsibility of the lesser of MES's fees for the services performed on the project,or$25,000.00,provided that contractor unless contracted to others. such claims are not attributable to MES's gross negligence or intentional misconduct.In this latter event,the limit of liability will be increased to$25,000 less any applicable insurance Item 4. Observations and Tests.The term"observation"implies only that MES would ob- amount covering alleged damages ar claims.In no event shall MES or any other party to this serve the applicable portions of the work we have agreed to be involved with and perform agreement,including parties which may have or claim to have a direct or indirect reliance on tests,from which to develop an.opinion as to whether the work essentially complies with the MES's services,be liable to the other parties for incidental,indirect,or consequential dam- job requirements.Client shall cause all tests and observation of the site,materials and work ages arising from any cause. performed by MES or others to be timely and properly performed in accordance with the plans,specifications and contract documents,and MES's recommendations.No claims for Item 12. Insurance and Indemnity. MES represents that the company maintains general loss,damage or injury shall be brought against MES by client or any third party unless all liability and property damage insurance coverage considered adequate and comparable with tests and observations have been so performed and unless MES's recommendations have coverage maintained by other similar firms,and that MES's employees are covered by been followed. Workman's Compensation Insurance.Certificates of insurance can be provided to the client upon written request.MES shall not be responsible for any loss,damage,or liability beyond Item 5.Accuracy of Test Locations and Elevations.The accuracy and proximity of provided the insurance limits and conditions.MES agrees to indemnify the client from and save client survey control will affect the accuracy of in-situ test location and elevation determinations. harmless against any loss,damage,or liability stemming from acts of gross negligence by Unless otherwise noted,the accuracy of test locations and elevations will be commensurate MES.Except as expressly set forth in Item Nos.11 and 12,the client agrees to hold MES,its only with pacing and approximate measurements or estimates. officers,directors,agents,and employees,harmless from any claims,suits or liability includ- ing but not limited to attorney fees,costs of settlement and other incidental costs.tor per- Item 6.Degree of Certainly of Compliance.With any manufactured product,there are sta- sonal injury,death,illness,property damage or any other loss,allegedly arising from or re- tistical variations in its uniformity,and in the accuracy of tests used to measure its qualities. lated to MES's performance of work. As compared with other manufactured products,field construction usually has wider fluctua- tions in bath product and test results.Thus,even with very careful observations and testing, Item 13. Modifications.This agreement and all attachments pursuant to this agreement it cannot be said that all parts of the product comply with the job requirements.Our proposal represent the entire understanding between the parties,and neither the client nor MES may is for the Scope of Services requested by our client and as scheduled by the client or client's amend or modify any aspect of this contract unless such alterations are reduced to writing representative.The degree of certainty for compliance with project specifications is much and properly executed by the parties hereto.These terms and conditions shall supersede all greater with full-time observation and testing than it is with intermittent observation and prior or contemporaneous communications,representations,or agreements,and any provi- testing. skins expressed or implied in the request for proposal,purchase order,authorization to pro- ceed,or other contradictory provisions,whether written or oral. Item 7.Hazardous Materials and Conditions.Prior to the start of services,or at the earliest time such information is learned,it shall be the duty of the client,or other involved or con- Item 14.Termination.This agreement may be terminated by either party upon seven day's tatted parties, to advise MES of any known or suspected undocumented fills,hazardous prior written notice.In the event of termination,MES shall be compensated by the client for materials, by-products, or constituents, and any known environmental,geologic,and all services performed up to and including the termination date,including reimbursable ex- geotechnical conditions,which exist on or near any premises upon which work is to be per- penses,and for the completion of such services and records as are necessary to place MES's formed by MES employees or subcontractors or which in any other way may be pertinent to files in order and/or to protect its professional reputation. ME5's proposed services. Item 15.Payment.Invoices for performed work will be submitted monthly for services ren- The discovery of unanticipated hazardous materials,or suspected hazardous materials.may tiered the prior month and/or upon completion of said services,payable within 30 days of require that special and immediate measures by exercised to protect the health and safety of invoice date.The fees quoted are based upon an expected timely payment.An interest charge MES site personnel and/or the public.MES may at its option and on the basis of its judgment of 1.5% per month will be added to delinquent charges;however,MES at its option may and opinion,exercise such precautions to complete the project,or terminate further work on terminate its services due to clients failure to pay when due.In the event of termination of the project.In either case,the client will be notified as soon as practically possible,and the services prior to completion,client shall compensate MES for all services performed prior to client agrees to bear all reasonable and equitable cost adjustments,if any,associated with and for such termination. such measures taken. Item 16.Sample Disposal.Unless otherwise agreed,test specimens or samples will be Item 6.Reports and Ownership of Documents.ME$will furnish three copies of the report to disposed immediately upon completion of the test.All drilling samples or specimens will be the client.Additional copies will be furnished to the owner or others at the rate specified in the disposed of thirty(30)days after submission of MES's report. fee schedule.All reports,boring logs,field data,field notes,laboratory test data,calculations, estimates.and other documents prepared by MES as instruments of service,shall remain the 12/21/11 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 aqqreqate must apply separately to this project/location 3. BUSINESS AUTOMOBILE COVERAGE 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. III - 1 12/21/11 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 the General Liability and Business Automobile Liability coverage 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 include Products — Completed Operations equivalent to ISO form CG 20 37 for a minimum of 2 years after acceptance of the 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. 11 I - 2 C—`t DATE(MMlDDNYY) "° 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 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 Insurance Agency contact NAME: information,including street PHONE Insurance Agent's FAX address and PO Box if contact information. A/C.No): applicable. (AIC.No.Ext): .___... _.....___ ............... (....._._._._ ) ......__.. _..........__ __......... E-MAIL ADDRESS: INSURERS)AFFORDING COVERAGE NAIC# INSURER A ABC Insurance Company NAIC# INSURED Insured's contact information, including name,address and INSURER B: XYZ Insurance Company NAIC# phone number. INSURER C: LMN Insurance Com an NAIC# INSURER D: Insurer(s)must have a minimum A.M.Best rating ofA- -- - ---- - and a Financial Performance Rating of in 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;. ..._... __._. ................ -........._._ .ADDLSUBR .......... ._. .... POLICY EFF . POLICY EXP LTR TYPE OF INSURANCE INSR I WVD POLICY NUMBER I (MM/DD/YYY) (MM/DD/YYY) LIMITS :.GENERAL LIABILITY 'EACH OCCURRENCE $1,000,000 General Liability Policy Number Policy effective and expiration date :DAMAGE EMI TO( RENTED ®COMMERCIAL GENERAL LIABILITY ® '. ❑ I PREMISES(Ea occurrence) $50,000 A ; ❑CLAIMS-MADE:®'OCCUR MED EXP(Any one person) $5000 ®! ISO FORM CG 2037 OR EQUIVALENT PERSONAL 8 ADV INJURY $1,000,000 ❑ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG $2,000,000 ❑j POLICY(®;JECT❑LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ____...._. $1,000,000 .___.. ®',ANY AUTO ® ❑ I Auto Liability Policy Number I Policy effective and expiration date. BODILY INJURY(Per person) ; $ ALL OWNED SCHEDULED ,:t. AUTOS ❑ AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE ❑',HIRED AUTOS,❑ AUTOS (Per accdent) $ ID D ®'UMBRELLA LIAB OCCUR ® ',; ❑ EACH OCCURRENCE $2,000,000 CLAIMS MADE ` A ❑EXCESS LIAB El 'Umbrella Liability Policy Number I Policy effective and expiration date. 1AGGREGATE $2,000,000 ❑DED (®.RETENTION$$10,000 $ C ;WORKERS EMPLOYOERS'LIABILITY IILITY ❑ ❑ ®,TORY IMITS❑ OER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICE/MEMBER EXCLUDED? YIN Workers Compensation Policy Policy effective and expiration date. E L EACH ACCIDENT $100,000 I(Mandatory In NH) N Number ?If yes,describe under E L.DISEASE EA EMPLOYEE $100,000 - - - -- :DESCRIPTION OF OPERATIONS below i E.L.DISEASE—POLICY LIMIT $500,000 A PROFESSIONAL LIABILITY ® ❑ $1,000,000 EACH CLAIM Professional Liability Policy 'Policy effective and expiration date.I ',$1,000,000 ANNUAL AGGREGATE Number DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more apace is required) Additional Insureds on the Commercial General Liability and Automobile Liability arising out of project work shall be City of Oshkosh,and its officers,council members,agents,employees and authorized volunteers. 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 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