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August Winter & Sons/City Hall Boiler Repair
CONTRACTOR AGREEMENT- CITY HALL. BOILER REPAIR FEBRUARY, 2073 THIS AGREEMENT, made on the 14th day of February, 2013, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and August Winter & Sons, Inc., 2323 N. Roemer Road, Appleton, WI 54911 hereinafter referred to as the CONTRACTOR, WITNESSETH: That the City and the Contractor, for the consideration hereinafter named, enter into the following Agreement. The CITY'S Bid Specifications and Insurance requirements are attached hereto and incorporated into this Agreement. The Contractor's proposal is also attached hereto and reflects the agreement of the parties except where it conflicts with the CITY'S terms within this agreement, in which case the CITY'S Bid Specifications, Insurance requirements, and other terms of this agreement shall prevail. ARTICLE I. PROJECT MANAGER A. Assignment of Project Manager. The Contractor shall assign the following individual to manage the project described in this contract: (Mark Hill, Service Manager) 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 contract: (Jon Urben, General Services Manager) ARTICLE III. SCOPE OF WORK The Contractor shall provide services described in the CITY'S Bid Specifications dated January 25, 2013, attached hereto as Exhibit A, and the Contractor's Quote Form dated February 12, 2013, attached hereto as Exhibit B. Both Exhibit A and B are incorporated into this Agreement. If anything in the Contractor's proposal conflicts with the 1 CITY'S Bid Specifications or with this agreement, the CITY'S Bid Specifications and the provisions in this agreement shall govern. The Contractor may provide additional products and/or services if such products /services are requested in writing by the Authorized Representative of the City. ARTICLE IV, CITY RESPONSIBILITIES The City shall furnish, at the Contractor's request, such information as is needed by the Contractor to aid in the progress of the project, providing it is reasonably obtainable from City records. To prevent any unreasonable delay in the Contractor'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 contract shall be commenced and the work completed by March 31, 2013. ARTICLE Vl. PAYMENT A. The Contract Sum. The City shall pay to the Contractor for the performance of the contract the sum of $10,857, adjusted by any changes hereafter mutually agreed upon in writing by the parties hereto, Fee schedules shall be firm for the duration of this Agreement. B. Method of Payment. The Contractor shall submit itemized monthly statements for services. The City shall pay the Contractor 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 Contractor a statement as to the reason(s) for withholding payment. C. Additional Costs. Costs for additional services to 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 VII. CONTRACTOR TO HOLD CITY HARMLESS The Contractor covenants and agrees to protect and hold the City of Oshkosh harmless against all actions, claims and demands of any kind or character whatsoever 2 which may in any way be caused by or result from the intentional or negligent acts of the Contractor, his agents or assigns, his employees or his subcontractors related however remotely to the performance of this Contract 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. I. i 11[ 4 1 R M� 1 I l l lIIIIIIII HM3 1 1,Y _ I L11 8 19 The Contractor shall provide insurance for this project that includes the City of Oshkosh as an additional insured. The specific coverage required for this project is identified in the CITY'S Invitation for Quotation dated January 25, 2013, attached hereto as Exhibit A and fully incorporated into this Agreement. The Contractor is responsible for meeting all insurance requirements. The CITY does not waive this requirement due to its inaction or delayed action in the event that the Contractor's actual insurance coverage varies from the Insurance required. ARTICLE IX. TERMINATION A. For Cause. If the Contractor 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 Contractor. In this event, the Contractor shall be entitled to compensation for any satisfactory, usable work completed. B. For Convenience. The City may terminate this contract at any time by giving written notice to the Contractor no later than 10 calendar days before the termination date. If the City terminates under this paragraph, then the Contractor 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 (Seal of Contractor CONTRACTOR /CONSULTANT (Specify Title) 1� �w 141#gƒ ]g R, Zr! \ M e 6«« 2 �� �_ � ���2�� ■� �9� K' ./ _�� f/� 4 A City of Oshkosh, Wisconsin Invitation for Quotation For City Hail Boiler Repair January 25, 2013 City of Oshkosh P.O. Box 1130 Oshkosh, Wisconsin 54903 -1130 www.ci.oshkosh.wi.us REQUEST FOR QUOTATION We are submitting herewith for your consideration a request to quote: CITY HALL BOILER REPAIR All quotes must be addressed to the City of Oshkosh Purchasing Department, P.O. Box 1130, Oshkosh, Wisconsin, 54903 -1130, The outside of the envelope must be plainly marked in the lower left hand corner: "CITY HALL BOILER REPAIR" Envelope shall also show name of bidder. M' faxed to the Purchasing Department at 920 -236 -5186. The fax must be clearly marked: "ATTN: PURCHASING DEPARTMENT -"CITY HALL BOILER REPAIR" Quotes must be on file in the office of the Purchasing Department no later than 10:00 A.M., TUESDAY FEBRUARY 12, 2013 The City reserves the right to reject any and all quotations and to waive any informality in bidding. For specifications and further information concerning this request for quotation, contact Jon G Urben, General Services Manager, Room 101, City Hall, or telephone (920) 236 -5100. Mark A Rohloff City Manager PUBLISH: JANUARY 30, 2013 City of Oshkosh Standard Terms And Conditions (Request For Bids /Proposals) 1) Specifications: The specifications in this request are the minimum acceptable. When specific manufacturer and model numbers are used, they are to establish a design, type of construction, quality, functional capability and/or performance level desired. When alternates are bid /proposed, they must be identified by manufacturer, stock number, and such other information necessary to establish equivalency. The City of Oshkosh shall be the sole judge of equivalency. Bidders /proposers are cautioned to avoid bidding alternates to the specifications which may result in rejection of their bid /proposal. All prices shall exclude any Federal Excise Tax or State of Wisconsin Sales Taxes as the City of Oshkosh is exempt from such taxes and will furnish an exemption certificate, if requested by the successful bidder. 2) Deviations And Exceptions: Deviations and exceptions from original text, terms, conditions, or specifications shall be described fully, on the bidder's /proposer's letterhead, signed, and attached to the request. In the absence of such statement, the bid /proposal shall be accepted as in strict compliance with all terms, conditions, and specifications and the bidders /proposers shall be held liable. Only proposals which are made out on the regular proposal form attached hereto will be considered. 3) Quantities: The quantities shown on this request are based on estimated needs. The city reserves the right to increase or decrease quantities to meet actual needs. 4) Delivery: Deliveries shall be F.O.B. destination freight prepaid and included unless otherwise specified. 5) Acceptance - Rejection: The City of Oshkosh reserves the right to accept or reject any or all bids /proposals, to waive any technicality in any bid /proposal submitted, and to accept any part of a bid /proposal as deemed to be in the best interests of the city. 6) Ordering: Purchase orders or releases via purchasing cards shall be placed directly to the contractor by an authorized agency. No other purchase orders are authorized. 7) Guaranteed Delivery: Failure of the contractor to adhere to delivery schedules as specified or to promptly replace rejected materials shall render the contractor liable for all costs in excess of the contract price when alternate procurement is necessary. Excess costs shall include the administrative costs. 8) Entire Agreement: These Standard Terms and Conditions shall apply to any contract or order awarded as a result of this request except where special requirements are stated elsewhere in the request; in such cases, the special requirements shall apply. Further, the written contract and /or order with referenced parts and attachments shall constitute the entire agreement and no other terms and conditions in any document, acceptance, or acknowledgment shall be effective or binding unless expressly agreed to in writing by the contracting authority. 9) Applicable Law: This Contract shall be governed under the laws of the State of Wisconsin. The contractor shall at all times comply with and observe all federal and state laws, local laws, ordinances, and regulations which are in effect during the period of this contract and which in any manner affect the work or its conduct. The City of Oshkosh reserves the right to cancel any contract with a federally debarred contractor or a contractor which is presently identified on the list of parties excluded from federal procurement and non - procurement contracts. 10) Safety Requirements: All materials, equipment, and supplies provided to the City of Oshkosh must comply fully with all safety requirements as set forth by the Wisconsin Administrative Code, the Rules of the Industrial Commission of Safety, and all applicable OSHA Standards. 11) Material Safety Data Sheet: If any item(s) on an order(s) resulting from this award(s) is a hazardous chemical, as defined under 29CFR 1910.1200, provide one (1) copy of a Material Safety Data Sheet for each item with the shipped container(s) and one (1) copy with the invoice(s). 11110 GENERAL INFORMATION The City of Oshkosh is requesting quotations from interested firms for City Hall Boiler Repair located in City Hall, 215 Church Avenue, Oshkosh WI 54901. QUOTATION SPECIFICATIONS The specifications listed in this quotation are the minimum acceptable. The specifications are intended as non - restrictive. When not bidding on all particulars as specified, the bidder may offer that product to be an approved equal. Any submittals for equals must be fully supported with technical data, test results, or other pertinent information as evidence that the substitute offered is a sufficient alternate to the specification requirement. Failure to provide product information will result in disqualification of such requests. Quotation shall include all materials and labor to provide scopes of work identified on the attached prints: H-1 H-2 H -3 INSURANCE REQUIREMENTS Attached are insurance requirements for the City of Oshkosh. Firms must submit a certificate of insurance when submitting their quote form. CONTRACTOR QUALIFICATION FORM Attached is the City of Oshkosh Contractor Qualification Form that bidders must submit with their quote form. Bidders DO NOT need to submit this form with their quote if they have submitted this form to the City of Oshkosh in the last 12 months and all information is current and updated. In this case bidders must still contact the Purchasing Office (236 -5100) to verify their Contractor Qualification Form is on file and updated. SAMPLE CONTRACTOR AGREEMENT Attached is a sample contractor agreement that will be drawn up with the successful bidder. Bidders DO NOT need to submit this agreement when submitting their quote form. SITE REVIEW INSTRUCTIONS All site reviews for this project should be coordinated by calling City of Oshkosh Facility Maintenance Coordinator Terry Smith at (920) 379 -2262 or (920) 236 -5100. Site reviews may be coordinated between normal business hours. CITY OF OSHKOSH CONTRACTOR/BIDDER QUALIFICATION FORM Company Information Company Name: Complete Address: Phone: Fax: State Contractor's License #: State Public Works Contractor's License #: Other Applicable Licenses: Union Affiliation: Work Trades Performed: Type of Company: [ ] Corporation [ ] Partnership [ ] Sole Proprietorship Federal Tax ID#: Company Contact: Email Address: Date Formed: Number of Employees: Salaried: Hourly: Bank Reference Lenders Name and Address Lending Officers Name and Phone Number Completed Projects List four (4) representative projects completed in the last five (5) years Project Name Contracting Company Contact Name /Phone # Contract Amount Current Projects List four (4) representative projects currently under constriction Project Name Contracting Company Contact Name/Plione # Contract Amount Trade References List three (3) of your subcontractors or suppliers Company Name Address Phone # Contact Name Client References List three (3) clients Company Name Address Phone # Contact Name Other Information In the past five years has your company failed to complete a contract or had a contract terminated? []Yes []No In the past five years, has your company had any liens filed against it by any subcontractors or suppliers? []Yes []No Has your company ever had liquidated damages assessed against it? [ ] Yes [ ] No Has your company or any of its employees been involved in a lawsuit related to a project? [ ] Yes [ ] No Has your company been investigated for any violations of local, state, or federal laws? [ ] Yes [ ] No Has your company or any of its employee's been investigated for violation of ally labor laws? []Yes []No Provide a detailed description of the circumstances behind any "yes" answers given above below; 7116112 CITY OF OSHKOSH INSURANCE REQUIREMENTS CONTRACTOR'S INSURANCE WITH PROPERTY 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 rip mare 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. INSURANCE REQUIREMENTS FOR CONTRACTOR — LIABILITY, BONDS & PROPERTY A. Commercial General Liability coverage at least as broad as Insurance Services Office Commercial General Liability Form, including coverage for Products Liability, Completed Operations, Contractual Liability, and Explosion, Collapse, Underground coverage with the following minimum limits and coverage: 1. Each Occurrence limit $1,000,000 2. Personal and Advertising Injury limit $1,000,000 3. General aggregate limit (other than Products – Completed Operations) per project $2,000,000 4. Products – Completed Operations aggregate $2,000,000 5. Fire Damage limit -- any one fire $50,000 6. Medical Expense limit -- any one person $5,000 7. Watercraft Liability, (Protection & Indemnity coverage) "if" the project work includes the use of, or operation of any watercraft, then Watercraft Liability insurance must be in force with a limit of $1,000,000 per occurrence for Bodily Injury and Property Damage. 8. Products – Completed Operations coverage must be carried for two years after acceptance of completed work. B. Automobile Liability coverage at least as broad as Insurance Services Office Business Automobile Form, with minimum limits of $1,000,000 combined single limit per accident for Bodily Injury and Property Damage, provided on a Symbol #1– "Any Auto" basis. C. Workers' Compensation as required by the State of Wisconsin, and Employers Liability insurance with sufficient limits to meet underlying Umbrella Liability insurance requirements. If applicable for the work coverage must include Maritime (Jones Act) or Longshoremen's and Harbor Workers Act coverage. D. Umbrella Liability providing 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. 1.1 7116112 E. Aircraft Liability, "if" the project work includes the use of, or operation of any aircraft or helicopter, then Aircraft Liability insurance must be in force with a limit of $3,000,000 per occurrence for Bodily Injury and Property Damage including Passenger liability and including liability for any slung cargo. F, Property Insurance Coverage (Builders Risk/installation Floater) to be provided by the contractor, if the exposure exists. 1. The "property' insurance amount must be at least equal to the bid amount, plus or minus any change orders. It must also include value of Engineering or Architect fees relating to the property. 2. Covered property will include property on the project work sites, property in transit, and property stored off the project work sites. 3. Coverage will be on a Replacement Cost basis. 4. The City of Oshkosh, City of Oshkosh Consultants, architects, architect consultants, engineers, engineer consultants, contractors, and subcontractors will be added as named insureds to the policy. 5. Coverage must be written on a "special perils" or "all risk" perils basis. Coverage to include collapse. 6. Coverage must include coverage for Water Damage (including but not limited to flood, surface water, hydrostatic pressure) and Earth movement. 7. Coverage must be included for Testing and Start up. 8. If the exposure exists, coverage must include Boiler & Machinery coverage. 9. Coverage must include coverage for Engineers and Architects fees. 10. Coverage must include Building Ordinance or Law coverage with a limit of at least 5% of the contract amount. 11. The policy must cover /allow Partial Utilization by owner. 12. Coverage must include a 'waiver of subrogation" against any named insureds or additional insureds. 13. Contractor will be responsible for all deductibles and coinsurance penalties. G. Builder's Risk / Installation Floater / Contractor's Equipment or Property - The contractor is responsible for loss and coverage for these exposures. City of Oshkosh will not assume responsibility for loss, including loss of use, for damage to property, materials, tools, equipment, and items of a similar nature which are being either used in the work being performed by the contractor or its subcontractors or are to be built, installed, or erected by the contractor or its subcontractors. H. Also, see requirements under Section 3. IIM 7116112 1. Bond Requirements Bid Bond. Bids that are $25,000 or greater will require the contractor to provide to the owner a Bid Bond, which will accompany the bid for the project. The Bid Bond shall be equal to 5 percent of the contract bid. The City may, at its discretion, require bonds for certain contracts with amounts less than $25,000. 2. Payment and Performance Bond. If awarded the contract, bids that are $25,000 or greater will require the contractor to provide to the owner a Payment and Performance Bond in the amount of the contract price, covering faithful performance of the contract and payment of obligations arising thereunder, as stipulated in bidding requirements, or specifically required in the contract documents on the date of the contract's execution. The City may, at its discretion, require bonds for certain contracts with amounts less than $25,000. 3. Acceptability of Bonding Company. The Bid, Payment and Performance Bonds shall be placed with a bonding company with an A.M. Best rating of no less than A- and a Financial Size Category of no less than Class VI. INSURANCE REQUIREMENTS FOR SUBCONTRACTOR All subcontractors shall be required to obtain Commercial General Liability (if applicable Watercraft liability), Automobile Liability, Workers' Compensation and Employers Liability, (if applicable Aircraft liability) insurance. This insurance shall be as broad and with the same limits as those required per Contractor requirements, excluding Umbrella Liability, contained in Section 1 above. 3. APPLICABLE TO CONTRACTORS 1 SUBCONTRACTORS 1 SUB -SUB CONTRACTORS 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 include Products — Completed Operations equivalent to ISO form CG 20 37 for a minimum of 2 years after acceptance of work. This does not apply to Workers Compensation Policies. 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. 1 -3 DATE (MMIDDIYYI') "� " °` 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 Insurance Agency contact informatien, including street addressandPOBoxif appfkable. CONTACT NAME: PHONE Insurance Agent's contactinrormatlon. °AC No): _.._...,._.. E-MAIL Please indicate somewhere on this ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # EACH OCCURRENCE _ INSURERA: AB_C_Insurance Comp__ _ _ NAIC # ® INSURED Insured's contact Wormalion, fwtudhW name, address and INSURER B: XYZ Insurance Company I -NAIC # — INSURERC: LMN Insurance Company NAIC# phonenumber. INS URER D: Insurer(s) must have a minimum A.M. Bestrafing of A• and a Financial Petfomtance Rating of N orbetter. —!{ MEG EXP (Any one perscn) INSURER E: ENSURER F: j $ 1,400,404 I® ISO FORM CG 24 37 OR EQUIVALENT 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-- .-_-.-"--.-_ -- .___...- I--�ADDL LTR TYPEOFINSURANCE INSR SUBR' WVD POLICYNUMBER POLICYEFF POLICYEXP MMM MWE) LIMITS GENERAL LIABILITY Please indicate somewhere on this AUTHORIZED REPRESENTATIVE certificate, the contract or project # EACH OCCURRENCE � $ 1,444,444 ®: COMMERCIAL GENERAL LIABILITY A 'CLAIMS- MABEMOCCUR ® ❑ General Liddy Policy Number Poiicyeffactrre aril exp:ration date. DAMAGE TO TTO RENTED PREMISES (Ea o=m- rerKm) € $ 50,044 —!{ MEG EXP (Any one perscn) f $5,444 PERSONAL & ADV INJURY j $ 1,400,404 I® ISO FORM CG 24 37 OR EQUIVALENT ❑I GENERAL AGGREGATE $ 2,444,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO'. ; ❑:POLICY 10JECTI ❑;LOG PRODUCTS - COMP/OP AGG € $ 2,000,004 _.__... .� $ (AUTOMOBILE LIABILITY (� COMBINED SINGLE LIMIT EEaaaeGaent) € $ 1,Uo0,0oo i® ANY AlJTO B ALLOWNED SCHEDULED I ❑ AUTOS ❑ AUTOS ~ NON OhTJEO El. HIRED AUTOS II❑ AUTOS I❑ ❑ ® ❑ Auto Liab3ityPk .,1tyNumber poicyeffectrve and expiration date. BODILY INJURY (Per person) $ BODILY INJURY (Per accident) PROPERTY 6AMA6E (Per accident) $ _ $ $ — ®UMBRELLA LIAB ®:OCCUR ® ❑ EACH OCCURRENCE $ 2,044,004 A i❑ EXCESSLIAt3 ❑ CLAIMS -PAADE � ' RETENTION $1 0,000 i ❑: DED I ®' AGGREGATE - ° - -^ $ 2,444,400 Umbrera 1Ja0 Hlf' Number �l' xY Pod' effective aodex ration date. 'cy P+ WORKERS COMPENSATION C AND EMPLOYERS' LIABILITY ANY PROPRIBTORIPARTNERIEXECUTIVE OFFICEIMEMBER EXCLUDED? YIN (Mandatory In NH) N If yes, describe under DESCRIPTION OF OPERATIONS ceIn+v E] ®j C SSA IT- OT I - - -`- E -L. EACH ACCIDENT j $ 1 oo,44o ; Workeis Compansabi;n Policy Number EE effect- and expiration date. E.L. DISEASE- EA EMPLOYEE( $ 144,400 E.L. DISEASE - POLICY LIMIT - $544,440 i❑❑1 DESCRIPTION of OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Additional Insureds on all Liability Policies 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 bo 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 l SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 Church Avenue SAMPLE CERTIFICATE THE EXPIRATION DATE, THEREOF, NOTICE WILLBE DELIVERED IN PO Box 1130 ACCORDANCE WITH THE POLICY PROVISIONS. Oshkosh, WI 54903 -1130 Please indicate somewhere on this AUTHORIZED REPRESENTATIVE certificate, the contract or project # this certificate is for. ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF PROPERTY INSURANCE I DATE(MIA/)D1YYf) 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. COVERED PROPERTY LIMITS If this certificate is being prepared fora party who has an Insurable interest in the property, do not use this form. Use ACORD 27 or ACORD 28. PRODUCER Insurance Agency contact Information, including street addrass and PO Box if applicable, CONTACT NAME; PHONE /UC. No. Ex1L folnsuraneaAgen[s FAX contact lnrmalion. LAIC, Ho };- E -MAIL BUSiNESS INCOME _ — - EXTRAEXPENSE -` — BROAD 0. ADDRESS: - - - - -.. RENTAL VALUE S INSURER(S) AFFORDING COVERAGE $ ❑WND FLOOD jj INSURER A: ABC Insurance Company _NAIC# NAIC # S _ INSURED � —� lnsured's contact Information, Intruding nam0 address and INSURER B: XYZ Insurance Company NAIC # _ INSURERC: 'CAUSES ❑iINLAND MARINE OF LOSS ]❑ NAMED PERILS phonenumber, INSURER D: ❑ _� Insurer(s) nest have a minimum A.M. Best rating of A- and a financial Performance Rating of VI or better. mm $ INSURER E. ❑;CRIME TYPE OF POLICY INSURER F: $ $ $ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: LOCATION OF PREMISES 1 DESCRIPTION OF PROPERTY (Attach ACORD 101, AMtonal Remarks Schedule, if more space is required) THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR' LTR I TYPE OF INSURANCE POLICYNUMBER POLICYEFFECTIVE POLICY EXPIRATION DATE MWDO DATE (M&MDffM COVERED PROPERTY LIMITS A INPROPERTY lICC�]Ii CAUSES OF LOSS _ BASIC DEDUCTIBLES _ BUILDING �nlrador's responsible torAtL $ deduCLbks - CONTENTS $ $ $ PropedyPafcyNumber $ One ortheofher..dependson ® typeofpbbeLvobi;e. - -- _ ❑ BUiLDIt,G $See #Ian - CORD 101 farm cn rolirrrng page — S PERSONAL PROPERTY BUSiNESS INCOME _ — - EXTRAEXPENSE -` — BROAD 0. SPECIAL - EARTHQUAKE - - - - -.. RENTAL VALUE S BLANKET BUILDING $ ❑WND FLOOD jj poficyeffwlma rid erpGationdate. BLANKET PERS PROP S BLANKET BLDG & PP $ 'CAUSES ❑iINLAND MARINE OF LOSS ]❑ NAMED PERILS TYPE OF POLICY POLICY NUMBER ❑ $ $ ❑;CRIME TYPE OF POLICY E I i ❑-' $ $ $ P ®BOILER &MACHINERYI EQUIPMENT BREAKDOWN lfexposure exists Po:cyeffediveandexpvaliondale. ❑' $ BoFer 8 Machinery Potky Number $ ❑ $ SPECIAL CONDITIONS I OTHER COVERAGES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) SeeaftaeWACORD 101 form CERTIFICATE HOLDER CANCELLATION City of Oshkosh, Attn: City Clerk Insurance Standard I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 Church Avenue 21 SAMPLE CERTIFICATE THE EXPIRATION DATE, THEREOF, NOTICE WILL BE DELIVERED IN PO 3 BOX 1130 ACCORDANCE WITH THE POLICY PROVISIONS. Please indicate somewhere on this Oshkosh, 54903 -i i30 certificate, the contract or project # AUTHORIZED REPRESENTATIVE this certificate is for. ©1995 -2009 ACORD CORPORATION. All rights reserved. ACORD 24 (2009105) The ACORD name and logo are registered marks of ACORD ACC7140' IN.�' AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NA1AEDINSURED Ham oflnsuranceAgency Manse oflasured, lnchding address POLICY NUMBER CARRIER NA1C CODE EFFECTIVE DATE: AUDI i IUNAL RLMAKKS FORM NUMBER: 24 FORM TITLE: CERTIFICATE OF PROPERTY INSURANCE 1. The "property' insurance amount is at least equal to the bid amount, plus or minus any change orders. It also includes value of Engineering or Architect fees relating to the property. 2. Covered property includes property on the project work sites, property in transit, and property stored off the project work sites. 3. Coverage is on a Replacement Cost basis. 4. The City of Oshkosh, City of Oshkosh Consultants, architects, architect consultants, engineers, engineer consultants, contractors, and subcontractors are added as named insureds to the policy. 5. Coverage is written on a "special perils" or "all risk" perils basis. Coverage includes collapse. 6. Coverage includes coverage for Water Damage (including but not limited to flood, surface water, hydrostatic pressure) and Earth movement. 7. Coverage is included for Testing and Start up. 8. If the exposure exists, coverage includes Boiler & Machinery coverage. 9. Coverage includes coverage for Engineers and Architects fees. 10. Coverage includes Building Ordinance or Law coverage with a limit of at least 5% of the contract amount. 11. The policy covers /allows Partial Utilization by owner. 12. Coverage includes a "waiver of subrogation" against any named insureds or additional insureds. 13. Contractor is responsible for all deductibles and coinsurance penalties. ACORD 101 (2008104) Insurance Standard I SAMPLE CERTIFICATE Please Indicate somewhere on this certificate, the contract or project # this ce is for. 2008 The ACORD name and logo are registered marks of ACORD CONTRACTOR AGREEMENT- SAMPLE THIS AGREEMENT, made on the th day of , 20_, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and Contractor Name., address hereinafter referred to as the CONTRACTOR, WITNESSETH: That the City and the Contractor, for the consideration hereinafter named, enter into the following Agreement. The CITY'S Bid Specifications and Insurance requirements are attached hereto and incorporated into this Agreement. The Contractor's proposal is also attached hereto and reflects the agreement of the parties except where it conflicts with the CITY'S terms within this agreement, in which case the CITY'S Bid Specifications, Insurance requirements, and other terms of this agreement shall prevail. ARTICLE I. PROJECT MANAGER A. Assignment of Project Manager. The Contractor shall assign the following individual to manage the project described in this contract: (Contractor Project Manager Name & Title) 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 contract: (City Project Manager Name & Title) ARTICLE lll. SCOPE OF WORK The Contractor shall provide services described in the CITY'S Bid Specifications dated , attached hereto as Exhibit A, and the Contractor's "Project Bid Proposal Form" dated , attached hereto as Exhibit B. Both Exhibit A and B are incorporated into this Agreement. If anything in the Contractor's proposal conflicts with the CITY'S Bid Specifications or with this agreement, the CITY'S Bid Specifications and the provisions in this agreement shall govern. The Contractor may provide additional products and/or services if such products /services are requested in writing by the Authorized Representative of the City. ARTICLE IV. CITY RESPONSIBLITIES The City shall furnish, at the Contractor's request, such information as is needed by the Contractor to aid in the progress of the project, providing it is reasonably obtainable from City records. To prevent any unreasonable delay in the Contractor'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 contract shall be commenced and the work completed by A. The Contract Sum. The City shall pay to the Contractor for the performance of the contract the sum of $ , adjusted by any changes hereafter mutually agreed upon in writing by the parties hereto. Fee schedules shall be firm for the duration of this Agreement. B. Method of Payment. The Contractor shall submit itemized monthly statements for services. The City shall pay the Contractor 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 Contractor a statement as to the reason(s) for withholding payment. C. Additional Costs. Costs for additional services to 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 VII. CONTRACTOR TO HOLD CITY HARMLESS The Contractor 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 Contractor, his agents or assigns, his employees or his subcontractors related however remotely to the performance of this Contract 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 VIII. INSURAN The Contractor shall provide insurance for this project that includes the City of Oshkosh as an additional insured. The specific coverage required for this project is identified in the CITY'S Bid Specifications dated , attached hereto as Exhibit A and fully incorporated into this Agreement. The Contractor is responsible for meeting all insurance requirements. The CITY does not waive this requirement due to its inaction or delayed action in the event that the Contractor's actual insurance coverage varies from the Insurance required. ARTICLE IX. TERMINATION A. For Cause. If the Contractor 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 Contractor. In this event, the Contractor shall be entitled to compensation for any satisfactory, usable work completed. B. For Convenience. The City may terminate this contract at any time by giving written notice to the Contractor no later than 10 calendar days before the termination date. If the City terminates under this paragraph, then the Contractor 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: CONTRACTOR /CONSULTANT (Seal of Contractor (Specify Title) if a Corporation.) (Witness) (Witness) NO (Specify Title) By: Mark A. Rohloff, City Manager And: Pamela R. Ubrig, City Clerk APPROVED: I hereby certify that the necess- ary provisions have been made to pay the liability which will accrue under this contract. 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Z > N ° CITY OF OSHKOSH N o� n` m n 4 o N Q -i 0 VS "VA" AVE. W Z 0SHKOH. MISCONSIN CITY OF OSHKOSH CITY HALL Oshkosh, Wisconsin BOILER REPAIR OWNER REPRESENTATIVE City Hall -- Administration Building 215 Church Avenue Oshkosh, Wisconsin, 54903 -1130 (920) 236 -5100 Attention; Jon Urben {urben2ei.oshkosh.w_i,us HVAC ENGINEER Summit Design LLC W6744 Rogersville Road Fond du Lac, Wisconsin, 54937 (920) 979 -5452 Joel Clary PE suinmitdesign�charter.net SECTION -- QUOTE FORM PART 1 — GENERAL 1.1 QUOTE DUE: 10:00 A.M., Tuesday, February 12, 2013 1.2 AT: Purchasing Division Room 101 City Hall 215 Church Avenue Oshkosh, Wisconsin 54903 -1130 Phone (920) 236 -5100 1.3 PROJECT City Hall Boiler Replacement 215 Church Avenue Oshkosh, WI 54901 1.4 QUOTE PROPOSAL: We: Of: Street City state ,Zip Code Telephone: Fax Number: Submit our proposal for performing the Work for the above Project. 1. In compliance with the advertising for quotes and having carefully examined the drawings and specification for the Work and the Site of the proposed work and having determined all of the conditions of the work, the rules, regulations, laws, codes, ordinances, and other governing circumstances relating to this project, the undersigned proposes to furnish all Labor, Materials and Equipment necessary to complete the construction indicated on the drawings and described in the project manual to include all described work completed to the Owners' satisfaction. 2. By Submission of this quote, each bidder certifies, and in the case of a joint quote, each party thereto certifies as to its own organization, that this quote has been arrived at independently without consultation, communication, or agreement as to a matter relating to this quote and with any other bidder or with any competitor. All quotes exclude Wisconsin sales tax. Quote Form 1.5 BASE QUOTE I Replace the first 7 leaking Boiler Gasket Assemblies (Kits) for Boiler (B-2). This work will include reusing the existing cast iron plates with the replacement of water jacket nipples and combustion seals for the first 7 sections of the Boiler. This work will require the disassembling and then reassembling of the existing boiler. This boiler repair will reuse the existing temperature control system. Coordinate repair time frame with City Oshkosh Maintenance Coordinator. For The Sum Of: (Dollars) S 1.6 BASE QUOTE 1B Repair and Replace the Defective Boiler Flame Controller Assembly for Boiler (B -2). This will require the replacement of the existing burner control box and the reuse of the existing control panel base. Coordinate repair time frame with City Oshkosh Maintenance Coordinator. For The Sum Of: (Dollars ) $ 1.7 ALTERNATE QUOTE 2A Replace the Remaining 6 Boiler Gaskets Assemblies (Kits) for Boiler (B -2), This work will require reusing the existing cast iron plates with the replacement of water jacker nipples and combustion seals for the remaining 6 boiler sections. Coordinate repair time frame with City Oshkosh Maintenance Coordinator. For The Sum Of: (Dollars) $ 1.8 PROPOSED SUBCONRACTOR LIST ELECTRICAL: MECHANICAL: INSULATOR: OTHER: ADDENDUM ACKNOWLEDGEMENT We herby acknowledge receipt of and have thoroughly examined the written addenda(s) issued prior to the RFQ Date in association with this Project. These Addenda are numbered through , inclusive. We further understand that failure to fully list the numbers of all published Addenda may cause the Owner to reject this quote. 1.9 Submittals will be reviewed for general compliance with design concept and contract documents only. Full compliance with contract documents, Code requirements, dimensions, fit finishes, and interface with the existing Control System is the Prime contractor's responsibility. Within 7 days after award of contract, provide required submittals for approval to the HVAC Engineer. Contractor shall promptly respond to requests for additional information so that delivery and installation schedules are not delayed. 1.10 QUALITY ASSURANCE —REGULATORY REQUIREMENTS A. All work shall comply with the applicable code requirements in effect. Including by not limited to ASME, Division of Safety & Buildings Administrative Codes and other applicable Building or local codes in effect as of the contract date. B. The Contractor shall be fully responsible for obtaining all required approvals, permits licenses, inspections and certificates for this installation. The Contractor shall pay all permit fees, inspection fees, certificate fees, and licensing fees. 1.11 INSURANCE AND CONTRACTOR/BIDDER QUALIFICATION FORM All bidders should review and be familiar with the Attached City of Oshkosh insurance requirements. Bidders are required to provide a copy of a certificate of insurance when submitting Bid. In addition all bidders should complete and submit the attached contractor/bidder qualification form when submitting bid (SEE GENERAL INFORMATION). 1.12 SAFETY AND HAZARDOUS MATERIALS A. Contractor shall be solely responsible for initiating, maintaining, and supervising all safety programs and precautions and shall comply with applicable safety laws, good industry standards or practices, and take all reasonable precautions for the safety of their workers, City property, the Public, or City of Oshkosh employees, guest, or vendors. B. The City of Oshkosh retains the authority to approve all chemicals and lubricants prior to Contractor bringing them on site. The Contractor shall furnish a Material Safety Data Sheet and proper labeling for each hazardous chemical to be brought into the premises in compliance with OSHA Hazard Communication Standards, and track usage for EPA reporting purposes. 1.13 WARRANTY The installed equipment shall be warranted by the manufacturer for 1 year on the workings of the equipment. The contractor shall warrant the contractor's installation work for 1 year from defects in workmanship. The warranty date shall start on the date of the final acceptance of the system by the City of Oshkosh. 1.14 PREVAILING WAGE Is Not Required On This Job! 1.15 SCHEDULE A. Work shall be pursued during regular working hours until complete. This work must be specifically authorized by Jon Urben or other authorized representative of the City of Oshkosh. B. All work schedules shall be submitted and coordinated in advance to the designated City of Oshkosh representative and Consultant. 1.16 INSTALLATION A. Contractor shall patch and reassemble the Boiler (B -2) to the satisfaction of the City of Oshkosh. 1.17 PRODUCT DELIVERY, SITE ORGANIZATION AND CLEANUP A. Contractor shall keep work areas orderly and free from debris during the course of installation and clean up on a daily basis. If areas are not kept clean, the City of Oshkosh may demand immediate cleanup or clean those areas and deduct cost from contract. B. Contractor shall regularly remove trash, materials, cartons, etc. generated by their work from the premises. C. Clean outside surface of Repaired Boiler (B -2) and adjacent areas of grease, dirt and other construction debris at the time of Substantial Completion. 1.18 TIME OF COMPLETION We, the undersigned, acknowledge a Substantial Completion date of April 1, 2013 as indicated above for Base Quote as set forth in the Contract Documents providing the Owner issues a Notice to proceed within Five (5) Calendar days fiom Quote Date. 1.19 SIGNATURES Name: Address; Legal Entity: By: Title: (state weather a Corporation, Partnersbip, If Corporation, give state of incorporation and affix Corporate Seal) Hereunto Duly Authorized Date: End of Sid Form Corporate Seal 920- 739 -2230 (4/19) 02/12/2013 08;58:42 AM -0600 Quote Form 1.5 BASE QUQTE 1A Replace the first 7 leaking Boiler Gasket Assemblies (Kits) for Boiler (B -2). This work will include reusing the existing cast iron plates with the replacement of water jacket nipples and combustion seals for the first 7 sections of the Boiler. This work will require the disassembling and then reassembling of the 0.Xisting boiler. This boiler repair will reuse the existing temperature control system. Coordinate repair time flame with City Oshkosh Maintenance Coordinator. For The Sum Of; 3,738 Three Thousand r usand Seven:Huned Thirt . Ei ht..(Dollars) $ . 1A BASE QUOTE 1B Repair and Replace the Defective Boiler Flame Controller Assembly for Boiler (B-2). This will require the replacement of the existing burner control box and the reuse of the existing control panel Base. Coordinate repair time frame with City Oshkosh Maintenance Coordinator. For The Sum Of; 3,736 Three-Thousand -Seven. H undred.Th i rt Six (Dollars)$. 1.7 ALTERNATE MOTE 2A Replace the Remaining 6 Boiler Gaskets Assemblies (Kits) for Boiler (B -2). This work will require reusing the existing cast iron plates with the replacement of water• jacker nipples and combustion seals for the remaining 6 boiler sections. Coordinate repair time flame with City Oshkosh Maintenance Coordinator. For The Sum Of: 3,383 Three Thousand Three Hundred ' ..:(Dollars) '..,.zT 1.8 PROPOSED SUBCONRACTOR LIST 920- 739 -2230 (5/19) 02/12/2013 08:59:09 AM -0600 ADDENDUM ACKNOWLEDGEMENT We herby acknowledge receipt of and have thoroughly examined the written addenda(s) issued prior to the RFQ Date in association with this Project. These Addenda are numbered N/A through _ N/A , inclusive, Wo fbilher understand that failure to fully list the numbers of all published Addenda may cause the Owner to reject this quote. 1.9 Submittals will be reviewed for general compliance with design concept and contract documents only. Full compliance with contract documents, Code requirements, dimensions, ft finishes, and interface with the existing Control System is the Prime contractor's responsibility. Within 7 days after award of contract, provide required submittals for approval to the HVAC Engineer. Contractor shall promptly respond to requests for additional information so that delivery and installation schedules are not delayed, 1, l 0 QUALITY ASSURANCE -- REGULATORY REQUIREMENTS A. All work shall comply with the applicable code requirements in offeot: Including by not limited to ASME, Division of Safety & Buildings Administrative Codes and other applicable Building or local codes in effect as of the contract date, B, The Contractor shall be fully responsible for obtaining all required approvals, permits licenses, inspections and certificates for this installation, The Contractor shall pay all peinait fees, inspection fees, certificate fees, and licensing fees, 1,11 INSURANCE AND CONTRACTOR/BIDDER QUALIFICATION FORM All bidders should review and be familiar with the Attached City of Oshkosh insurance requirements, Bidders are required to provide a copy of a certificate of insurance when submitting Bid. In addition all bidders should complete and submit the attached contractor/bidder qualification form when submitting bid (SEE GENERAL INFORMATION. 1.12 SAFETY AND HAZARDOUS MATERIALS A. Contractor shall be solely responsible for initiating, maintaining, and supervising all safety programs and precautions and shall comply with applicable safety laws, good industry standards or practices, and take all reasonable precautions for the safety of their workers, Cityproperty, the Public, or City of Oshkosh employees, guest, or vendors. B. The City of Oshkosh retains the authority to approve all chemicals and lubricants prior to Contractor bringing them on si te. The Contractor shall furnish a Materia l Safety Data Sheet and proper labeling for each hazardous chemical to be brought into the premises in compliance with OSHA Hazard Communication Standards, and track usage for EPA reporting purposes, 1. 13 WARRANTY The installed equipment shall be warranted by the manufacturer for 1 year on the workings of the equipment, The contractor shall warrant the contractor's installation 920- 739 -2230 (6/19) 02/12/2013 08:59;50 AM —0600 work for i year front defects in workmanship. The warranty date shall start on the date of the final acceptance of the system by the City of Oshkosh. 1.14 PREVAILING WAGE Is Not required On This Job! 1.15 SCHEDULE A, Work shall be pursued during regular working hours until complete. Tbis work must be, speoificaliy authorized by Jon Urben or other authorized representative of the City of Oshkosh. B. All work schedules shall be submitted and coordinated in advance to the designated City of Oshkosh representative and Consultant. 1.16 INSTALLATION A. Contractor shall patch and reassemble the Boiler (B -2) to the satisfaction of the City of Oshkosh. 1.17 PRODUCT DELIVERY, SITE ORGANIZATION AND CLEANUP A. Contractor shall keep work areas orderly and free from debris during the course of installation and clean up on a daily basis. If areas aro not kept clean, the City of Oshkosh may demand immediate cleanup or clean those areas and deduct cost from contract. B. Contractor shall regularly remove trash, materials, cartons, etc, generated by their work from the premises. C, Clean outside surface of Repaired Boiler (B -2) and adjacent areas of grease, dirt and other construction debris at the time of Substantial Completion, 1,18 TRYM OF COMPLETION We, the undersigned, acknowledge a Substantial Completion date of April 1, 2013 as indicated above for Base Quote as set forth in the Contract Documents providing the Owner issues a Notice to proceed within Five (5) Calendar days from Quote Date, 1.19 SIGNATURES Name; August Winter & Sons, Inc. Address; 2323 N. Roemer Rd. Appletop � -1111 549 Legal Entity:. Corporation _ .... .... (,cafe west] C Tali ,Partnership, if Coq)oratioa, give stale of incoiporallon and aMX Corporate Seal) By; Title; Gene Ketterhagen, Vice President Hereunto Duly Authorized Dates - 2112/13 End of 131d Form Corporate Seal 920-739-2230 (7/19) 02/12/2013 09:00:19 AM -0600 CITY OF OSHICOSH CONTRACTOR/BIDDER QUALIFICATION FORM COMPFIDY1001-1110011 Company Name, August Winter& Sons, Inc... Complete Addross,,,.2323 N. Roerner_Road,:Ap0 iaton,ffl 54911 Phone, Fax.,-- (920) 739-2230 :State Contractor's License M, -:120264. State Ptiblic, Works Contractor's License, At;'�� Other Applioable Liconaos— Licensed in several othergatoa Union Affiliatiow. -400 and -434 (Plurnoers and Stearnfitt rik 10 1 1 Bor A Work Trados Performed ; e0 K - U� 603M. Contractor License : Engineering!] Master Plumber License 22717, Metal Typo of Company: Pq Cbro.-OW-64-f-J -FAMOW0 I".1" Company Contact: Gene Ketterhagen LrnAll gketterhage Data Formed: 1928 Number ofErnployces, Salaried: 30 Hourly; _150+ -! Z 7=�� Incorporated 4127/1953 (Wisconsin) Bank Reference BMO Harris Lenders Narna anti Address See Attached ...... - t ndina dfhc" Name and PhO16 Nitb0r Completed Projects List •fbur (4) I-Oproselitatlye projects completed In the Inst five (5) years Pr*jcct Nano Contracting Company Contact Namepl►ono # Contract Amouilt $4,710,000 Bush Brothers WWTP 715-841:7,4Q 4877, hk, 543 725,000 4845 Several 8 1 old I t Cofistru"OtIon-Eric Swanlund -920-739-6321 Current ProJects List four (4) representative Projects currently under construction Project Nanio Contrauthig C011APD11Y Collitirg Ngi-nciTholle Contract Amos 50212 51012, 51.1 5.212 Several I $650,557 74,500 920-739-2230 (8/19) 02/12/2013 09:01:03 AM —0600 Trade Referenees List throo (3) Of your subcontractors or suppliers ConipanyName Address Phone . ......... Cheat Referefiee$ List diroo (3) clients Company Npinu Address Phone # Conloot Namo . . . . . . . . . . . . . . . . . . . . . . . Other Inforination lies your company In the post five years lies to complete a contract or had a coMrsol termiiiated? [] Yes W No In the past five years, has your coMpally had oily Ifens filed against it by oily subcontractors or suppliers? [ ) Yes 14 No Has your conlpaviy ever had liquidated damages assessed against It? [] Yes W No Has your Company OF ally Of Its employees beep Involved In a Inws"It related to a project? 13 Yes W No . An Insurance claim Is pending regarding boiler malfunction. The result of the claim is not know at this time. Has your company been hive3tigated for ally Violallolis Of local, state, or federal laws? [ ] Yes [k] No Has your company or any of its employee's been Investigated for violation of finy labor laws? Yes V) No Provide fl. detailed dosed0on of the CiYOUnistances: behind any "yes" answers given above below: N/A 920 -739 -2230 (9/19) 02/12/2013 09:01:28 AM -0600 CERTIFIED COPY OF RESOMYFION OT BOARD OF DIRECTORS Or AUGUST WINTER & SONS, INC,. 1, Gerald J. Hietpas, hereby certifying that I a duly elected a��d tqualified Secretary of August Winter & Sons, Inc;. and keeper records Corporate Seal and that the fol lowing is a true and correct copy of a Resolution duly adopted at a special meeting of the Board of Directors of said August Winter & Sons, Inc. duly convened in accordance with the lay -Laws of said Corporation at its office at Appleton, Wisconsin, on the i" day of November, 2007 RESOLVED, that Gerald J: Hietpas, President, Secretary and Treasurer and Mark M. Eimmerman, Vice- President and Gene B. Ketterhagen, Vice - President and Thomas A. Winter, Director and Robert H. Winter, Director, and each of them is hereby authorized to execrate all contracts and all other papers necessary in the transaction of the Corporation's business and to bind the Corporation by such execution without any other signature of any other Officer: IN WITNESS WHEREOF, I have hereunto affixed my name as Secretary and have caused this Corporate Seal of said Corporation to be hereto affixed this I" day of November, 2007,. Gerald J. Hier ,' Secr. .'try -- (COR.eC)I ?.ATE SEAL) 1, Thoinas A. Winter, a Director of said Corporation do hereby certify that the foregoing is a correct copy of a Resolution passed as therein set forth. Thomas A. Winter, Director 920- 739 -2230 MAR 0 1 2014 (10/19) 02/12/2013 09:01:55 AM —0600 GERALD J HI£TPAS AUGUST WINTER & SONS INIAUS (, WNTT R & SONS, INCA 2323 N ROEMER RD PO BOX :1896 APPLETON W1 54912 -1896 Credential Unit Safety and Buildings Division 201 W Washington Ave, 4th floor PO Box 7082 Madison WT 53707 -7082 Phone: (608) 261 -8467 TDD: (608) 264 -8777 Fax: (608) 267 -0592 mad isoncred @commerce, state mi.us This is your new ,Certification, License, or Registration Card. ID: 920264 AUGUST WINTER 0: Cer Weetion, --LIO , or Registration 6 ;,- Expires F VAC Contractor - gistratlon 02/94114 Wisconsin D parkment of Commerce signature: C * ** Please check your credentials to see if they require'contlnuing education prior to your next renewal. * ** Peel the credential card from the letter. Sign the card! Show the card to whomever requests proof that you hold a credential administered by the Safety and Buildings Division. This card should indicate other Department of Commerce certifications, licenses, or registrations you currently hold. Destroy all previous cards that have a credential category which also appears on this card. Please review the information on the card. if errors or discrepancies are found, contact the S&B Credential Unit, 608- 261 -8467. You can also send an email to S &B, madisoncred @commerce,state.wi.us. Be prepared to give the S &B staff person the TD number printed on the card. S &B should also be notified of changes in addresses as they occur. Notification of address changes is the responsibility of the credential holder. A renewal notice will be sent to the address on file with S &B about 30 days before the expiration date of each credential indicated-on the card. Renewals are contingent upon compliance with the requirements specified in Comm 5, Wisconsin Administrative Code. The Department of Conuherce is an equal opportunity service provider and fimployer. If you need assistance to access services or need material in an alternate format, please contact the department at ar TDD 608- 264 -8777. 608- 261 -8467 SBD -10183 (R.01 /09) 920- 739 -2230 (11/19) 02/12/2013 09;02:23 AM -0600 DECEIVED FEB 2 5 2010 AUGUST W NTEA $mil$, Wi TODD GROTH 2323 N 2323 N ROEMER RD RD PO BOX 1896 APPLETON 911 54912-1896 Credential Unit Safety and Buildings Division 201 W Washington Ave, 4th floor PO Box 7082 Madison WI 53707 -7082 Phone: (608) 261 -8467 TDD: (608) 2648777 Fax: (608) 267 -0592 inadisoncred @commerce.state.wi.us This is your new Certification, License, or Registration Card. ID: 678806 TODD GROTH Certltlratton, I HVAC Qualifier or ReListration n Wisconsin Depa stgaAtm: Expires 04/03/14 Commerce * ** Please check your credentials to see if they require continuing education prior to your next renewal. * ** Peel the credential card from the letter. Sign the cards Show the card to whomever requests proof that you hold a credential administered by the Safety and Buildings Division. This card should indicate other Department of Commerce certifications, licenses, or registrations you currently hold. Destroy all previous cards that have a credential category which also appears on this card. Please review the information on the card. If errors or discrepancies are found, contact the S &B Credential Unit, 608 -261 -8467. You can also send an email to S &B, madisoncred @commerce.state.wi.us. Be prepared to give the S &B staff person the 1D number printed on the card. S &B should also be notified of changes in addresses as they occur. Notification of address changes is the responsibility of the credential holder. A renewal notice will be sent to the address on file with S &B about 30 days before the expiration date of each credential indicated on the card. Renewals are contingent upon compliance with the requirements specified in Comm 5, Wisconsin Administrative Code. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at ar TDD 608 -264 -8777. - 608 -261 -8467 SBD -10183 (8,01/09) 920 -739 -2230 (12/19) 02/12/2013 09:02 :51 AM -0600 Wisconsin Department of Safety and Professional Services; Homepage Page 1 of 1 Search for Individual or Company. by..Credential ID here: Specific Credential I© ;227170 ;I 1 record(s) were returned by your search, http: / /apps2.commerce.wi. gov /SB_ Credential/ SB— CredentialApp /ScarchByld ?ored�-id= 227... 3/2/2012 Credential ID Name CIty,State,Zip Type Expiration_ 227170 Ar 1" li< ° °_ GR—E— V LL IN.1.64942 -87a9 Mast rP:.fumi er.,. 0.313'if ..` http: / /apps2.commerce.wi. gov /SB_ Credential/ SB— CredentialApp /ScarchByld ?ored�-id= 227... 3/2/2012 920- 739 -2230 (13/19) 02/12/2013 09;03:13 AM -0600 BMO 10 Harris Biink 721 Wtst COP.ge Av+: Applelon, Vii -54911 A part of OMO Fipan6al Group t ,2,; 92073a•3800 Fax! 9..�9 13a4?15 October 17, 2012 'To Whom It May Concern:: RE: August W rater & Sans, laic P.O. Box 1896 2323 N Roemer Road Appleton, W154912 This correspondence will confirm that the above captioned company has a $1,600,000 line of credit wiih BMO Harris Bank, N.A. This line of credit is available in whole or in part until February 28, 2014. Management of this company is well known by bVr institution and respected for their integrity and business acumen. Should you have any questions or need additional information regarding; August Winter & Sons, Inc, please fe9l free to coiitaot me at any time. Y �1 _itX�_ti1 R.'Hilt PresYdeht MRH'rmv )A0 n�.aVjqk 920-739-2230 (14/19) 02/12/2013 09:03:33 AM -0600 AUGUST WINTER :& SONS, IN-C. MECHANICAL CONTRACTORS 2323 NORTH ROEMER ROAD APPLETON, WJ 54911 PO BOX 1896 APPLETON, Wl 54912 PHONE: 920/739-8881 * FAX: 9201739-2230 References . .......... Contractors ------------- -0-9 z i 0- ims. —am muma I mmm rm I Lo 0 1. 4 010 1 m - ilgq!T, Tim'Kip enhah .... ...... . ..... 2 969-7000 920 969 =7000 MMM.mz f9204751-8150 Miron Constructilon $.tpjQtlon Pat Loughrin (920) 739-4409 ... CR Meyer Construction Sob .Mqyqr, 920)135-3350" '(920) 235 - 3419......_ MA Mort enson y- O§tebfid - !1-(262),879-25.00 22621-879-2510 Sub-c"ontrac"'fors'"' MEMBER- ml m ims. —am muma I mmm rm I Lo 0 1. MAPPA10 (9201430-1644 JNeenah Papbr- Jiffi, We 'n-'d'r'lc'ks"' (920) 488-2717"' " (920) 488-2719- L&S Insulation Mark. Borchart-" _,(1�14) 476 -4940 (414).476--5175 '0 13prinkman tnsulation .......... Brian MoLees--.-..' (414)462-7750 " (41 1 4) -.462-77 :5'.:::1 Industrial - -- ..... . ........... ........ ... 01 Rtocter'&-Gahible (9201430-1644 JNeenah Papbr- Jiffi, We 'n-'d'r'lc'ks"' 94) 721-1040 lCoatlibg Excellence Ratio yPearce . .......... (9.20) 996 -1900 j(920)9086206 !I P, 6 6' d Service ... .... ... Nestla PIZZ.a .... ...... ........... Ems 12m 1 I I � Harlex Greeno.. 0-1, 0 11191 WIN Sara Lee Fdods Hau D . a .. 020)-98z-`l33.1;!! ........ 920)982-1247 Sara Lee Fdods (920) 982-7126 Packerland pgai;5 7- 4(920)_4061238. 920 . 40 .-1 6- -2f8 Bosar Consultants .... 1(92 0)497-8266 920- 739 -2230 (15/19) 02/12/2013 09 :04;25 AM -0600 AUGUST WINTER & SONS, INC. MECHANICAL CONTRACTORS 2323 NORTH ROEMER ROAD APPLETON WI 54911 PO BOX 1896 APPLETON Wl 64912 PHONE: 920- 739 -8881 FAX: 920 - 739 -2230 RE: CREDIT REFERENCES FOR: AUGUST WINTER & SONS, INC. 2323 North Roemer Road, Appleton, WI 54911 PO Box 1896, Appleton, WI 54912 -1896 PHONE: (920) 739 -8881 FAX: (920) 739 -2230 BUSINESS ACTIVITY: Mechanical Contractor DATE ESTABLISHED: April 27, 1953 ACCOUNTING FAX: (920) 739 -4993 D & B Rating, 3A1 SIC Code: 1711 OFFICERS OF AUGUST WINTER & SONS, INC. Gerald J. Hietpas, President Gene Ketterhagen, Vice President Mark Eimmerman, Vice President TRADE REFERENCES: Ferguson Attn: Linda 2300 North Sandra St. Appleton, WI 54911 Phone: (920) 830 -8000 Fax: (920) 830 -8010 Joseph T. Ryerson & Son, Inc. Please email request to: credreff.midwe st@Eyerso n. com FED ID # 39- 0855115 A/P Contact: Barb Schaefer Columbia Pipe & Supply Attn Credit Department Fax: (815) 744 -1504 Gustave A. Larson Co. Attn: Rob Berger Fax: (262) 542 -1400 PIease direct any questions and/or responses to Sharon Bons (920) 560 -2232. Thank you.' 920- 739 -2230 (16/19) 02/12/2013 09:04:49 AM -0600 W Brian D. Carpenter Senior Vice President Willis of Minnesota, Inc. 1600 Utica Ave south, Suite boo Minneapolis MN 55416 Direct: 763,302.7162 f�ri�n,�arpenterCuiWillls.com RE=; AUGUST WINTER & SONS, INC. 2323 Roemer Road, Appleton, WI 54911 To Whom It May Concern: Willis of Minnesota, Inc, (Willis) and its predecessor companies has served as the surety agent for August Winter & Sons, Inc. since 1980. The August Winter & Sons, Inc. account is a highly valued account of both Willis and their surety, Ohio f=armers Insurance Company (a subsidiary of Westfield Group, Westfield Center, Ohio). During the tenure of our relationship, a claim demand has never been presented for payment not paid by any surety who has written bonds for August Winter & Sons, Inc. Bond credit has been approved for August Winter & Sons, Inc, up to approximately $15,000,000 single contract/$ 25,000, 000 aggregate uncompleted backlog (bonded and unbonded). These amounts do not constitute a maximum limit for future requests, but are an indication of prior approvals. Each large bond request is underwritten based on the risk factors, contract terms, and financial condition /backlog amount of August Winter & Sons, Inc. at the time. If a project to be bonded is requested for approval by August Winter & Sons, Inc., and.is one they feel qualified to perform, it is unlikely that such a request would be declined, as their current surety and the prior surety have not declined any such requests since 1980. No restrictions have been placed on the August Winter & Sons, Inc. surety account, and bonds of any type needed would be provided. In the past, bid, performance, tabor and material payment, licenselpermit, and warranty bonds have been provided. We can recommend August Winter & Sons, Inc. to you without reseviations. They enjoy an excellent reputation, based on their proven track record of contract performance, financial results, and credit history. Sincerely, Brian D. Carpenter Willis of Minnesota, Inc. Senior Vice President 920 -739 -2230 (17/19) 02/12/2013 09:05:22 AM -0600 Willis office: (920) 739.7711 Taff Free: (800) 235 -3311 fax: (930) 739.1543 Webslte: www.wA1%.com October 2, 2012 Gary Winter August Winter & Sans, Inc. P0 Box 1896 Appleton WI 54912 -1886 Dear Gary: As requested, following are the Experience Modification Factors for August Winter & Sons, lnc: 10/01/2012 .88 10101/2011 .85 10101/2010 .86 10101/2009 .69 10/01/2008 .68 Gary, please let me know if any additional information is needed,. Sincerely, milis of Wisconsin, Inc. Debra A. Stolzman, OC,-AA AIM Willis of WISCOnS)n, Int 12Z 5. College Awe. City Centy Fast Sulte 29 Appleton, WI 54911 STDE 'AIlkm { CERTIFICATE OF PROPERTY INSURANCE 72/12/2013 T DIYYYY) 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. If this certificate Is being prepared for a parry who has an Insurable interest In the property, do not use this form. Use ACORD 27 or ACORD 28. PRODUCER (920) 739 -7711 Willis of Wisconsin, Inc.- Appleton 1221 =. College Avenue City Center East, 2nd Floor Appleton, WI 54911 NAMME: Customer Support aVc° No Ext :920- 739 -7711 arc No): 920 -739 -1543 a DRESS: certreg uests.ds willls.Com CUSTOMERID:AUGUWIN -02 INSURER(S) AFFORDING COVERAGE NAEC9 INSURED August Winter & Sons, Inc. P 0 Box 1896 Appleton, Wl 54912 -1896 INSURER A: Phoenix Insurance Company INSURER B. INSURERC: $ INSURER D: $ INSURER E : BASIC INSURER F., $ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: LOCATION OF PREMISES I DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Remarks Schedule, If more space Is required), THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMJDDNYYY) POLICY EXPIRATION DATE (MhVDDNYYY) COVERED PROPERTY LIMITS PROPERTY CAUSES OF LOSS DEDUCTIBLES BUILDING PERSONAL PROPERTY BUSANESS INCOME EXTRA EXPENSE RENTAL VALUE BLANKET BUILDING BLANKET PERS PROP BLANKET BLDG & PP $ $ BASIC BUILDING $ BROAD g CONTENTS SPECIAL $ EARTHQUAKE $ WIND $ FLOOD 5 s s A }( INLAND MARINE NAMEDPERILS Special TYPE OF POLICY Installation Floater 1011/2012 10/1/2013 X Basic Limit Temporary Storage Limit Transit Limit Maximum Payment 5 1,000,00 CAUSESOFLOSS X 5 1,000,00 POLICY NUMBER QT- 660 - 07860408 - PHX -12 X 3 1,000,00 X X 5 1,000,00 CRIME TYPE OF POLICY g S S BOILER & MACHINERY/ EQUIPMENT BREAKDOWN 5 S A Installation Floater QT- 660- 0786C408 - PHX -12 10/112012 10/1/2013 Deductible 5 1,00 s SPECIAL CONDITIONS l OTHER COVERAGES (Attach ACORD 10t, Additional Remarks Schedule, If more space Is required) Re: AWS ,lob #380026, City Hall Boiler Replacement (0212013) Bid Amount: $10,957 L:tKI IFIL:A l t HULUtK Oshkosh, City of Attn: City Clerk P0 Box 1130 Oshkosh, W154903 -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 Q 7° a- ©1995 -2009 ACORD CORPORATION. All rights reserved. ACORD 24 (2009109) The ACORD name and logo are registered marks of ACORD Best's Credit Rating Center - Company Information for Phoenix Insurance Company Page 1 of 2 For ratings and product access Login I Sign-up IR Print this page CD Phoenix Insurance Company A.M.Best 6:002515 NAIC 1:25623 FEIN ti:065303275 Assigned to l9rweii RatYUy' Address:One Tower Square companies Hartford,CT 06183 i that have,in Are a prior United States our opinion, Web:www.travelers.com a superior ability to mtheir Phone:860-277-7002-277-7-0111 ongoing insurance obligations. meet ett Fax:860-277-7002 Based on A.M.Best's analysis,058470-Travelers Companies,Inc.is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure.View a list of operating insurance entities in this structure. Best's Credit Ratings View all of the companies assigned this rating as a part of an AMB Rating Unit. Best's Credit Rating Analyst Office:A.M.Best Company,Oldwick NJ Financial Strength Rating View Definition i Rating: A+(Superior) Senior Financial Analyst:Michael W.Russo Financial Size Category: XV($2 Billion or greater) Assistant Vice President:Michael J.Lagomarsino,CFA Outlook: Stable Action: Affirmed Effective Date: May 10,2012 u Denotes Under Review Best's Rating Issuer Credit Rating View Definition Long-Term: as Outlook: Stable Action: Affirmed Date: May 10,2012 - -- - -- I Reports and News Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M.Best Group. AMB Credit Report-Insurance Professional-includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, h detailed business overview and key financial data. Report Revision Date:5/22/2012(represents the latest significant change). Historical Reports are available in AMB Credit Report-Insurance Professional Archive. Best's Executive Summary Reports(Financial Overview)-available in three versions,these presentation style reports feature balance sheet,income tom°( statement,key financial performance tests including profitability,liquidity and reserve analysis. Data Status:2012 Best's Statement File-P/C,US Contains data compiled as of 1/28/2013 Quality cross checked. • Single Company-five years of financial data specifically on this company. • Comparison -side-by-side financial analysis of this company with a peer group of up to five other companies you select. • Composite -evaluate this company's financials against a peer group composite.Report displays both the average and total composite of your selected peer group. el Best's Key Rating Guide Presentation Report-includes Best's Financial Strength Rating and financial data as provided in the most current edition of Best's Key Rating Guide products.(Quality cross Checked). ELT AMB Credit Report-Business Professional-provides three years of key financial data presented with colorful charts and tables.Each report also features the latest Best's Ratings,Rating Rationale and an excerpt from our Business Review commentary. Data Status:Contains data compiled as of 1/28/2013 Quality cross checked. Financial and Analytical Products Best's Key Rating Guide-P/C,US&Canada Best's Statement File-P/C.US Best's Statement File-Global Best's Insurance Reports-P/C.US&Canada Best's State Line-P/C,US Best's Executive Summary Report-Comparison-Property/Casualty Best's Executive Summary Report-Composite-Property/Casualty Best's Regulatory Center Best's Insurance Expense Exhibit(IEE)-P/C,US Best's Schedule F(Reinsurance)-P/C.US Best's Schedule D(Municipal Bonds)-US Best's Schedule D(Common Stocks)-US Best's Schedule D(Preferred Stocks)-US Best's Corporate Changes and Retirements-P/C,US/CN Best's Regulatory Center Market Share Reports Best's Schedule P(Loss Reserves)-P/C,US Best's Schedule 3-Hybrid-P/C&L/H.US Best's Schedule D(Corporate Bonds)-US http://www3.ambe st.com/ratings/entities/CompanyProfile.aspx?ambnum=2518&URatingl... 2/12/2013 AUGUWIN -02 STDB CERTIFICATE OF LIABILITY INSURANCE F DAT DfYYYY} 2!/12!21212013 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 mquiro an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements . PRODUCER (920) 739 -7711 Willis of Wisconsin, Inc.- Appleton 122 E. College Avenue City Center East, 2nd Floor Appleton, WI 54911 CONTACT NAME: Customer Support FAX A c No): 920- 739 -1543 EMAIL ADDRESS: certrequests.ds@willls.com INSURERS AFFORDING COVERAGE NAIC k INSURER A: Phoenix insurance Company 25623 INSURED August Winter & Sons, Inc. Attn: Sharon Bons P 0 Box 1896 Appleton, WI 54912 -1896 INSURER e.-Travelers Property Casualty_Company of Am 25674 INSURERC - Cincinnati Insurance Company 10677 INSURERD:Travelers Indemnity Company of America 25666 INSURER E:Charter Oak Fire Insurance Co 25615 INSURER F : 5 300,08 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. , TYPE OF INSURANCE AOOL BR VIVO POLICY NUMBER POLICY MWD POLICY IDYYYLTR LIMITS _.INSR GENERAL LIABILITY EACH OCCURRENCE $ 2,000,08 PREMISES Eaocaxrence 5 300,08 A X COMMERCIAL GENERAL LIABILITY X DT- CO- 6934C377- PHX -12 10/112012 10/1/2013 CLAIMS -MADE 1�1 OCCUR MED EXP (" one person) $ 10,00 PERSONAL BADVINJURY S 2,000,00 X Contractual Liability GENERAL AGGREGATE S 4,000,00 GEN1 AGGREGATE Li MIT APPLIES PER: PRODUCTS- COMPIOPAGG S 4,000,00 POLICY X PRO- LOC S AUTOMOBILE LIABILITY CEO.aBIa�DI SINGLE LIAIIT $ 1,000,08 BODILY I NJURY (Per person) $ B X ANY AUTO DT- 810- 323D2093- TiL -12 101112012 101112013 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROP£RTYDAMAGE PeracadeM $ 5 UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 20,000,08 F AGGREGATE $ 20,000,00 C X EXCESS LIAB CLAIMS -MADE EXS0102952 10/1/2012 10/112013 DED I X I RETENTIONS $0 $ D WORKERS COMPENSATION AND EMPLOYERS` LIABILITY ANY PROPRIETORIPARTNERlEXECUTIVE YIN Mandatory HHj CLUDE fYr N!A DTDTBHUB- 6934C37 -7 -12 10/1/2012 1011/2013 X WC STATU- OTH- TOR LIMITS HER E.L- EACH ACCIDENT $ 100,00 E-L DISEASE - EA EMPLOYEE $ 100,08 Min describe under RIPTION OF OPERATIONS Wow E.L- DISEASE - POLICY LIMIT $ 500,08 E Workers Compensation DTOUB- 558OL00 -2 -12 10/1/2012 10/112013 Employers Liability $1100150011100,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Re: AWS Job #380025 - City Hall Boiler Replacement (02/2013) The City of Oshkosh, and Its officers, council members, agents, employees and authorized volunteers are named as additional insureds to the Comm'/ General Liability per attached Endorsement #CGT808 - Blanket Additional Insured (Contractors) (equivalent to CG2010 07 -04 and CG2037 07 -04) for acts caused by AWS in the performance of their work to which the written contract requiring insurance applies. A specific 30 -day notice of cancellation, except 10 days for non- payment of premium, will be provided under the Comm'I General Liability, Automobile Liability and Workers Compensation Policies per the attached endorsements. CERTIFICATE HOLDER CANCELLATION Oshkosh, City of Attn: City Clerk P0 Box 1130 Oshkosh, WI 54903 -1130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD MEE! ; n� u.— POLICY NUMBER., DT- CO- 8934C377- PHX -12 COMMERCIAL GENERAL LIASILITY GIMERAL PURPOSE ENDORSEMENT THIS ENDORSEMENT CHANGES THIE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING; COMMERCIAL GENERAL I.IA$ILXTY COVERAGE PART PROVISIONS i. WHO IS AN INSURED - (SECTION II) IS AMENDtD TO INCLUDE ANY PERSON OR ORGANIZATION THAT. a) YOU AGREE IN A "WRITTEN CONTRACT REQUIRING INSURANCE" TO INCLUDE AS AN ADDITIONAL INSURED ON THIS COVERAGE PART, ' HOWEVER, THE PERSON OR ORGANIZATION IS AN ADDITIONAL INSURED: a) ONLY Wr TH RESPECT TO LIABILITY FOR "BODILY INJURY", " PROPERTY DAMAGE" OR "PERSONAL INJURY "; AND M� m b� o o rf " b) IF, AND ONLY TO THE EXTENT THAT, THE INJURY OR DAMAGE IS CAUSED BY ACTS OR OMISSIONS OF YOU OR YOUR SUBCONTRACTOR IN THE PERFORMANCE OF "YQUR WORK" TO WHICH THE "WRITTEN CONTRACT REQUIRING INSURANCE" APPLIES. THE PERSON OR ORGANIZATION DOES NOT QUALIFY AS AN ADDITIONAL INSURED WITH RESPECT TO THE INDEPENDENT ACTS OR {OMISSIONS OF SUCH PERSON OR ORGANIZATION, 2, THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT IS LIMITED AS FOLLOWS: a) IN THE EVENT THAT THE LIMITS OF INSURANCE OF 7HIS COVERAGE PART SHOWN IN THE DECLARATIONS EXCEED THE LIMITS OF LIABILITY REQUIRED BY THE "WRITTEN CONTRACT REQUIRING INSURANCE", THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED SHALL BE LIMITED TO THE LIMITS OF LIABILITY REQUIRED BY THAT "WRITTEN CONTRACT REQUIRING INSURANCE ". THIS ENDORSEMENT SHALL NOT INCREASE THE LIMITS OF INSURANCE DESCRIBED IN'SECTION III -- LIMITS OF INSURANCE. b) THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED DOES NOT APPLY TO 930DILY INJURY ", "PROPERTY DAMAGE" OR "PERSONA€. INJURY" ARISING OUT OF THE RENDERING OF, OR FAILURE TO RENDER, ANY PROFESSIONAL ARCHITECTURAL, ENGINEERING OR SURVEYING SERVICES, INCLUDING; I. THE PREPARING, APPROVING, OR FAILINQ TO PREPARE OR APPROVE, MAPS, SHOP DRAWINGS, OPINIONS, REPORTS, SURVEYS, FIELD ORDERS OR CHANGE ORDERS, OR THE PREPARING, APPROVING, OR FAILING TO PREPARE OR APPROVE, DRAWINGS AND SPECIFICATIONS; AND II.SUPERVISORY, INSPECTION, ARCHITECTURAL OR ENGINtEERING ACTIVITIES, co T8 08 Page 1 waaaa COMMERCIAL GENERAL LIABILITY POLICY NUMBER; DT -CO- 69340377- PHX -92 GENERAL PURPOSE ENDORSEMENT C) THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED DOES NOT APPLY TO 'BODILY INJURY" OR "PROPERTY DAMAGE" CAUSED BY "YOUR WORK" AND INCLUDED xN THE PPRODUCTS--COMPLETED OPERATIONS HAZARD° UNLESS THE "WRITTEN CONTRACT REQUIRING INSURANCE" SPECIFICALLY REQUIRES YOU TO PROVIDE SUCH COVERAGE FOR THAT ADDITIONAL INSURED, AND THEN THE INSURANCE PROVIDED 1.0 THE ADDITIONAL INSURED APPLIES ONLY TO SUCH "BODILY INJURY" OR "PROPERTY DAMAGE" THAT OCCURS BEFORE THE END OF THE PERIOD OF TIME FOR WHICH THE "WRITTEN CONTRACT REQUIRING INSURANCE" REQUIRES YOU TO PROVIDE SUCH COVERAGE OR THE END OF THE POLICY PERIOD, WHICHEVER IS EARLXER, 3. THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT IS EXCESS OVER ANY VALID AND COLLECTIBLE "OTHER INSURANCE ", 14HETHER PRIMARY, EXCESS, CONTINGENT OR ON AMY OTHER BASIS, THAT IS AVAILABLE TO THE ADDITIONAL INSURED FOR A LOSS WE COVER UNDER THIS ENDORSEMENT. HOWEVER, IF THE "WRITTEN CONTRACT REQUIRING INSURANCE" SPECIFICALLY REQUIRES THAT THIS 9NSURANCE APPLY ON A PRIMARY BASIS OR A PRIMARY AND NON- CONTRIBUTORY BASIS, THIS INSURANCE IS PRIMARY TO POTHER INSURANCE" AVAILABLE TO THE ADDITIONAL INSURED WHICH COVERS THAT PERSON OR ORGANIZATION AS A NAMED INSURED FOR SUCH LOSS, AND WE WILL NOT SHARE WITH THAT "OTHER INSURANCE ". BUT THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSEMENT STILL IS EXCESS OVER ANY VALID Am COLLECTIBLE "OTHER INSURANCE', WHETHER PRIMARY, EXCESS, CONTINGENT OR ONANY OTHER BASIS, THAT IS AVAILABLE TO THE ADDITIONAL INSURED WHEN THAT PERSONOR ORGANIZATION IS AN ADDITIONAL INSURED UNDER SUCH "OTHER INSURANCE ". 4. AS A CONDITION OF COVERAGE PROVIDED TO THE ADDITIONAL INSURED BY THIS ENDORSE61ENT $) THE ADDITIONAL INSURED MUST GIVE US WRITTEN NOTICE AS SOON AS PRACTICABLE OF AN "OCCURRENCE" OR AN OFFENSE WHICH MAY RESULT IN A CLAIM, TO THE EXTENT POSSIBLE, SUCH NOTICE SHOULD INCLUDE: I. HOW, WHEN AND WHERE THE "OCCURRENCE" OR OFFENSE TOOK PLACE; II.THE NAMES AND ADDRESSES OF ANY INJURED PERSONS AND WITNESSES; AND III.THE NATURE AND LOCATION OF ANY INJURY OR DAMMGE ARISING OUT OF THE "OCCURRENCE" OR OFFENSE. b) IF A CLAIM IS MADE OR "SUIT" IS BROUGHT AGAINST THE ADDITIONAL INSURED, THE ADDITIONAL INSURED MUST: I. IMMEDIATELY RECORD THE SPECIFICS OF THE CLAIM OR "SUITP AND THE DATE RECEIVED; AND II.NOTIFY US AS SOON AS PRACTICABLE. THE ADDITIONAL INSURED 14UST SEE TO IT THAT WE RECEIVE WRITTEN NOTICE OF THE CLAIM OR "SUIT" AS SOON AS PRACTICABLE, c) THE ADDITIONAL INSURED MUST IMMEDIATELY SEND US COPIES OF ALL LEGAL PAPERS RECEIVED IN CONNECTION WITH THE CLAIM OR 'SUIT ", COOPERATE WITH US IN THE INVESTIGATION OR SETTLEMENT OF THE CLAIM OR DEFENSE AGAINST THE OSUITP, AND OTHERWISE COMPLY WITH ALL POLICY CONDITIONS, CG T8 08 Page 2 COMMERCIAL GENERAL LIABILITY POLICY NUMBER: DT- CO- 6934C377- PHX -12 GENERAL PURPOSE ENDORSEMENT d) THE ADDITIONAL INSURED MUST TENDER THE DEFENSE AND INDEMNITY OF ANY CLAIM ON "SUXT" TO ANY PROVIDER OF "OTHER INSURANCE" WHICH WOULD COVER THE ADDITIONAL INSURED FOR A LOSS WE COVER UNDER THIS ENDORSEMENT, HOWEVER, THIS CONDITION DOES NOT AFFECT WHETHER THE INSURANCE PROVIDED TO THE ADDITIONAL INSURED 13Y THIS ENDORSEMENT IS PRT14ARY TO "OTHER INSURANCE" AVAILABLE TO THE ADDITIONAL INSURED WHICH COVERS THAT PERSON OR ORGANIZATION AS A NAM81D INSURED AS DESCRIBED IN PARAGRAPH 3. ABOVE. 5, THE'FOLLOWING DEFINITION IS ADDED TO SECTION V. - DEFINITIONS: "WRITTEN CONTRACT REQUIRING INSURANCE" MEANS THAT PART OF ANY WRITTEN CONTRACT OR AGREEMENT UNDER WHICH YOU ARE REQUIRED TO INCLUDE A PERSON OR ORGANIZATION AS AN ADDITIONAL INSURED ON THIS COVERAGE PART, PROVIDED THAT THE 'BODILY INJURY" AND "PROPERTY DA14AGEO OCCURS AND THE "PERSONAL INJURY" IS CAUSED BY AN OFFENSE COMMITTED: a. AFTFR THE EXECUTION OF THE CONTRACT OR AGREEMENT BY YOU; b. WHILE THAT PART OF THE CONTRACT OR AGREEMENT IS IN EFFECT; AND d. 8EFORE THE ENO OF THE POLICY PERIOD, a� a N rte_ r� a^ a� i= U� ca T8 08 page 3 o0sal POLICY NUMBER DT- CO- 6934C377- PHX -12 ISSUE DATE: 10/01/12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY -- NOTICE OF CANCELL.ATIONINONRENEWAL PROVIDED BY US This endorsement modliles Insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION, Number of Days Notice of Cancellation: 30 NONRENEWAL. Numbarof Days Notice of Nonrenawal: PERSON OR ORGANIZATION: ANy PERSON OR ORGANIZATION To WHOM YOU HAV$ AGREED IN A WRITTIEN CONTRACT THAT NOTICE OF CANCELLATION OR MATERIAL LIMITATXON9 OF THXS POLICY wILL BR GIVEN, BUT ONLY TF: 1. YOU $HND US A WRITTEN -REQUEST TO PROVIDE SUCH NOTICE, INCLUDINd THE NAME AND ADDRESS OF SUCH PERSON OR ORC4ANIZhTXOI7, AFTER THE FIRST NAMED INSURRD RECEIVES NOTICE FROM US OF THE CANCELLATZ011 OR MATERIAL LIMITATION OF THIS POLICYr AND 2. WE RRCgxV9 SUCH 34RITTEM X942U &S7 AT LEAST 14 DAYS BEFORE THE BEGINNING OF 7HE APPLICABLE 1RMER OF DAYS SHOWN IN THIS SCHEDULE ADDRESS: THE ADDRESS POP THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WR11TSN REQURST FROM YOU TO US. PROVISIONS: k If we cancel this policy for any statutorily permit- ted reason other than nonpayment of premium, and a number of days Is shown for cancellation In the schedule above, we will mall notice of cancel- lation to the person or organization shown in the schedule above. We will mall such notice to the address shown in the schedule above at least the number of days shown for cancellation In the schedule above beforo the effective date of can- cellation. B. if vie decide to not renews this policy for any slatu- torily permitted reason, and a number of days is shown for nonrenewal In the schedule above, we will mail notice of the nonrenewal to the person or organization shoem in the schedule obovo. We will mall such notice to the address shown In the schedulo above at least . the number of days shovm for nonrenewal In the schedule above be- fore the expiration date. IL T4 0012 09 0 2009 The Travelers Indemnity Company Page 1 of 1 POLICYNUMBER: DT- 810 - 3231)2093- TIL -12 ISSUE DATE: 10/01/12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - NOTICE OF CANCELLATIONINONRENEWAL PROVIDED BY US This endorsement modifies Insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCH DULEA CANCELLATION; Number of Days Notice of Cancellation: 30 NONRENEWAL: Number of bays Notice of Nonrenewa1; PERSON OR ORGANIZATION: °ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICH OF CANCELLATION OR MATERIAL LIMITATIONS OF THIS POLICY WILL BE GIVEN, BUx ONLY IF: 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THU NAME AND ADDRESS OF SUCH PFiRSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED MCRIVES NOTICE FROM US OF THE CANCELLATION OR MrRRIAL LIMITATION OF THIS POLTCYj AND 2. WE RECRIVO SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THU APPLICABLE NMER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS., THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US." PROVISIONS; A. If we cancel this policy for any statutorily permit- ted reason other than nonpayment of premium, and a number of days Is shown for cancellation In the schedule above, the will mall notice of cancel- lation to the parson or organization shown In the schedule above. We will mail such natics to the address shown in tha schedule above at least the number of days shown for cancellation In the schedule above before the effaclNe date of can- cellation. IL T4 0012 09 13, if we decide to not renew this policy for any statu- torily permitted reason, and a number of days Is shown for nonrenewal In the schedule above, via will mail notice of the nonrenevwal to the person or organization shown in the schedule above. We will mall such notice to the address shown In the schedule above at least the number of days shown for nonrenewal In the schedule above be- fore the explratlon date. G 2009 Ths T €avetars Indemnity Company Page 1 of 1 TRAV�LE1�5 AW WORKERS COMPENSATION AND 01M 7MR sQnan EMPLOYERS LIABILITY POLICY HnTrcRn, Cr 06183 ENDORSEMENT WC 99 0611(A) POLICY NUMBER: DTDTCHUB.6934C37 -7 -12 NOTICE OF CANCELLATION Except for non - payment of premium by you, we agree that no onncellation or Iimitation of this peitcy shall become affective until the number of day's written notice specified In Item 2 of the Schedule has been mailed to you and to the person or organization designated In Item 1 of the Schedule at the address Indicated. SCHEDULE 1. Name; ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTRU CONTRACT THAT NOTICE OF CANCELLATION OR MATERIAL LIMITATIONS OF THIS POLICY WILL B)3 GIVEN, BUT ONLY IFi I.YOU SEND US A WRITTEN RIZOURST TO PROVIDE SUCH NOTICE, INCLUDING THE NAM2 AND ADDRESS OR SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US Or THE CANCELLATIOX OR MATERIAL LIMITATION OF THIS POLICY) AND 2.WS RECEIVE BUCK WRITTEN REQUEST AT LEAST 14 DAYS SEVORe THE BROINNI110 OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE Address: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH 14RIT'TRN REQUEST FROM YOU TO US. 2. Number of Days Written Notice: 30 Addltlonai lays This endorsement changes the policy to Which It Is attached and is effective on the date issued unless otherYnse stated. (The Information below Is required only when this endorsement Is Issued subsequent to preparation of the policy_) Endorsement Effective Poky No. Endorsement No. Insured Premium $ Insurance Company Countersigned by DATE OF ISSUE: 90109/12 ST ASSIGN: Pago 9 of 1 T'R�l�'��fRS WORKERS COMPENSATION AND flue TVBR sQdARB EMPLOYERS LIABILITY POLICY HARTFORD, C1 061$3 ENDORSEMENT WC 99 0611 (A) POLICY NUMBER: DTOUS- 5WI- 00 -2 -12 NOTICE OF CANCELLATION Except for non - paymont of premlum by you, we agree that no cancellation or ]imitation of this policy shall become efreol €ve until the number of day's written notice speciftad In Item 2 of the Schedule has been mailed to you and to the person or organization designated in item 1 of the Schedule at the address Indicated. SCHEDULE 1. Name: ANY PERSON OR ORGANIZATION TO WHOM YOU HAV% AGREED IN A WRITTEN CONTRACT WHAT NOTICE Ole CANCELLATION OR MATERIAL LIMITATIONS OF THIS POLICY WILL BE GIVEN, BUT ONLY IF1 1. YOU SEND US A WRITTEN REQUEST To PROVIDE SUCH NOTICE, INCLUDIN07 THE NADfE ADD ADDRESS OF SUCH PERSON OR OROaANIZATION, AF'T'ER THE FIRST NAKED INSURED RECEIVES NOTICE FROM US OF THE CAtiCELLA'TION OR MATERIAL LXMITATION OP THIS POLICY; AND 2. WE RRCEIVS SUCH WR17M REQUEST AT LEAST 14 DAYS B61?ORH THE ] ZGXNNING OF THE APPLICABLE DUMPR OF DAYS SHOWN IN THIS SCHEDULE. Address: THB ADDRESS FOR THAT PERSON OR ORUANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. 2. Number (if pays Wdifen Notice: 30 Additional Days This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective Policy No, Endorsement No. Insured Premium b Insurance Company Countersigned by BATE OF ISSUE: 10101112 STASSICN: page 1 of 1 Best's Credit Rating Center- Company Information for Phoenix Insurance Company Page 1 of 2 itif For ratings and product access Login I Sign-up 03 Print this page 0 Phoenix Insurance Company A.M.Best ti:002518 NAIC 8:25623 FEIN 6:060303275 Assigned to Address:One Tower Square companies ' Hartford,CT 06183 that have,in Ai;=i United States our opinion, a superior ability to meet their Web:www.tr277-0 s.com ongoing insurance obligations. Phone::8 -2777002 s Fax:860-277-7002 Based on A.M.Bests analysis,058470-Travelers Companies,Inc.is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure.View a list of operating insurance entities in this structure. ( sdB • R ......_...._............_.__...__.__....__.._..-----_...___.._____.._..__._.__.__.__.._....._..--_--, + _ets Creit atings Best's Credit Rating Analyst __ View all of the companies assigned this rating as a part of an AMB Rating Unit. [ Financial Strength Rating View Definition ......_.._., Office:A.M.Best Company,Oldwick NJ A+(Superior) . Senior Financial Analyst:Michael W.Russo Rating: A+ Vice President:Michael J.Lagomarsino, Financial Size Category: XV($2 Billion or greater) CFA Outlook: Stable 1 Action: Affirmed Effective Date: May 10,2012 u Denotes Under Review Best's Rating Issuer Credit Rating View Definition __....___.__.____; . Long-Term: as Outlook: Stable Action:' Affirmed Date: May 10,2012 • Reports and News Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M.Best Group. AMB Credit Report-Insurance Professional-includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, N detailed business overview and key financial data. Report Revision Date:5/22/2012(represents the latest significant change). a Historical Reports are available in AMB Credit Report-Insurance Professional Archive. 12,-• Best's Executive Summary Reports(Financial Overview)-available in three versions,these presentation style reports feature balance sheet,income i "fl statement,key financial performance tests including profitability,liquidity and reserve analysis. Data Status:2012 Best's Statement File-P/C,US Contains data compiled as of 1/28/2013 Quality Cross Checked. • Single Company-five years of financial data specifically on this company. • Comparison -side-by-side financial analysis of this company with a peer group of up to five other companies you select. • Composite -evaluate this company's financials against a peer group composite.Report displays both the average and total composite of your selected peer group. iill Best's Key Rating Guide Presentation Report-includes Best's Financial Strength Rating and financial data as provided in the most current edition of r{,Best's Key Rating Guide products.(Quality Cross Checked). ` 1"° AMB Credit Report-Business Professional-provides three years of key financial data presented with colorful charts and tables.Each report also features , the latest Best's Ratings,Rating Rationale and an excerpt from our Business Review commentary. Data Status:Contains data compiled as of 1/28/2013 Quality Cross Checked. !Financial and Analytical Products Best's Key Rating Guide-P/C,US&Canada Best's Statement File-P/C.US Best's Statement File-Global Best's Insurance Reports-P/C.US&Canada Best's State Line-P/C.US Best's Executive Summary Report-Comparison-Property/Casualty Bests Executive Summary Report-Composite-Property/Casualty Best's Regulatory Center Best's Insurance Expense Exhibit(IEE)-P/C,US Best's Schedule F(Reinsurance)-P/C.US Best's Schedule D(Municipal Bonds)-US Best's Schedule D(Common Stocks)-US Best's Schedule D(Preferred Stocks)-US Bests Corporate Changes and Retirements-P/C,US/CN Best's Regulatory Center Market Share Reports Best's Schedule P(Loss Reserves)-P/C,US Best's Schedule D-Hybrid-P/C&L/H,US Best's Schedule D(Corporate Bonds)-US http://www3.ambest.com/ratings/entities/CompanyProfile.aspx?ambnum=2 518&URatingl... 2/12/2013 Best's Credit Rating Center- Company Information for Travelers Property Casualty Co of... Page 1 of 2 For ratings and product access Login I Sign-up Print this page (2) Travelers Property Casualty Co of Amer A.M.Best t:004461 NAIC a:25674 FEIN 6:362719165 Assigned to Rr Address:One Tower Square companies �4.tL'MIt Hartford,CT 06183 that have,in As; or United States our opinion, a our opinion, ability to meet their Web:Phone:860 277-0111 ongoing t ability obligations. heir x:80- 77-7-0111 insurance- Fax:860-277-7002 Based on A.M.Best's analysis,058470-Travelers Companies,Inc.is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure.View a list of operating insurance entities in this structure. 1 l Best's Credit Ratings "" " ' View all of the companies assigned this rating as a part of an AMB Rating Unit. �B_eat's Credit Rating Analyst Financial Str en_gth RatIng,View Definition ___._....................._...___. Office:A.M.Best Company,Oldwick NJ Rating: A+(Superior) Senior Financial Analyst:Michael W.Russo Financial Size Category: XV($2 Billion or greater) Assistant Vice President:Michael J.Lagomarsino, I Stable CFA _ f Outlook: Stab L_..._.__.._........_.___.______..................__._._._____._._..._.._._. Action: Affirmed Effective Date: May 10,2012 u Denotes Under Review Best's Rating ....... ... • Issuer Credit Rating Definitioq___..__,,..__.,__...-_..._..._._.._..._.__.__; Long-Term: as Outlook: Stable • • Action: Affirmed • Date: May 10,2012 • • I Reports and News - Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M.Best Group. `�'�' AMB Credit Report-Insurance Professional-includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, V k detailed business overview and key financial data. Report Revision Date:5/23/2012(represents the latest significant change). Historical Reports are available in AMB Credit Report-Insurance Professional Archive. Best's Executive Summary Reports(Financial Overview)-available in three versions,these presentation style reports feature balance sheet,income statement,key financial performance tests including profitability,liquidity and reserve analysis. Data Status:2012 Bests Statement File-P/C,US Contains data compiled as of 1/28/2013 Quality Cross Checked. • Single Company-five years of financial data specifically on this company. • Comparison -side-by-side financial analysis of this company with a peer group of up to five other companies you select. • Composite -evaluate this company's financials against a peer group composite.Report displays both the average and total composite of your selected peer group. Best's Key Rating Guide Presentation Report-includes Best's Financial Strength Rating and financial data as provided in the most current edition of ¥ Best's Key Rating Guide products.(Quality Cross Checked). AMB Credit Report-Business Professional-provides three years of key financial data presented with colorful charts and tables.Each report also features <r the latest Bests Ratings,Rating Rationale and an excerpt from our Business Review commentary. Data Status:Contains data compiled as of 1/28/2013 Quality cross Checked. it Financial and Analytical Products Best's Key Rating Guide-P/C,US&Canada Best's Statement File-P/C,US Best's Statement File-Global Best's Insurance Reports-P/C.US&Canada Best's State Line-P/C,US Best's Executive Summary Report-Comparison-Property/Casualty Best's Executive Summary Report-Composite-Property/Casualty Best's Regulatory Center Best's Insurance Expense Exhibit(IEE)-P/C,US Best's Schedule F(Reinsurance)-P/C,US Best's Schedule D(Municipal Bonds)-US Best's Schedule D(Common Stocks)-US Best's Corporate Changes and Retirements-P/C,US/CN Best's Regulatory Center Market Share Reports Best's Schedule P(Loss Reserves)-P/C,US Best's Schedule D(Corporate Bonds)-US Bests Insurance Reports-Online-P/C,US&Canada Best's Schedule BA(Other Long Term Investments)-P/C&LUH.US http://www3.ambest•com/ratings/entities/SearchResults•aspx?URatingId=2227864&b1=0&... 2/12/2013 Best's Credit Rating Center - Company Information for Cincinnati Insurance Company Page 1 of 2 For ratings and product access Login I Sign-up IR Print this page CI) Cincinnati Insurance Company Assigned to 1 A.M.Best*:000258 NAIC#:10677 FEIN ft:310542366 �ii.+� Address:P.O.Box 145496 companies Cincinnati,OH 45250-5496 that have in. A4. rt'. United States our opinion, a r opinion, ability to meet their Phone::513-870-2000 ..ongoing it ability meet obligations. Fax:513- 70-066 insurance Fax:513-870-2066 Based on A.M.Bests analysis,058704-Cincinnati Financial Corporation is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure.View a list of operating insurance entities in this structure. [13.st s Credit Ratings Best's Credit Rating Analyst View all of the companies assigned this rating as a part of an AMA Rating Unit. Financial Strength Rating Vlew Dom_...__...._....._.._._._..__._. ' Office:A.M.Best Company,Oldwick NJ t A+(Superior) ' j Senior Financial Analyst:Gordon McLean Rating: Mans in Senior Financial Analyst:Jennifer Financial Size Category: XV($2 Billion or greater) Marshall,CPCU,ARM Outlook: Stable Action: Affirmed • Effective Date: December 19,2012 u Denotes Under Review Best's Rating Issuer Credit Rating Definition___.._....._.__.._.__._____.._.___.. Long-Term: aa- Outlook: Stable Action: Affirmed Date: December 19,2012 .......................: Related Financial and Analytical Data The following links provide access to related data records that A.M.Best utilizes to provide financial and analytical data on a consolidated or branc asis. 019571 Cincinnati Insurance Companies Represents the"as filed"Company Consolidated financials for the Property/Casualty business of this legal entity. 004294 Cincinnati Insurance Companies Represents the A.M.Best Consolidated financials for the Property/Casualty business of this legal entity. J Reports and News — — —� Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M.Best Group. AMB Credit Report-Insurance Professional-includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, ,,_ detailed business overview and key financial data. Report Revision Date:1/11/2013(represents the latest significant change). t=- Historical Reports are available in AMB Credit Report-Insurance Professional Archive. i "' . Best's Executive Summary Reports(Financial Oveview)-available in three reserve versions, analysis.se presentation style reports feature balance sheet,income '?•: - statement,key financial performance tests including profitability, i9 b Data Status:2012 Best's Statement File-P/C,US Contains data compiled as of 1/28/2013 Quality Cross Checked. • Single Company-five years of financial data specifically on this company. • Comparison -side-by-side financial analysis of this company with a peer group of up to five other companies you select. • Composite -evaluate this company's financials against a peer group composite.Report displays both the average and total composite of your selected peer group. 0 xBest's Key Retina Guide Presentation Report-includes Best's Financial Strength Rating and financial data as provided in the most current edition of Best's Key Rating Guide products.(Quality cross Checked). AMB Credit Report-Business Professional-provides three years of key financial data presented with colorful charts and tables.Each report also features the latest Best's Ratings,Rating Rationale and an excerpt from our Business Review commentary. Data Status:Contains data compiled as of 1/28/2013 Quality Cross Checked. _._.._ [Financial and Analytical Products 1 Best's Kev Rating Guide-P/C.US&Canada Best's Statement File-P/C.US Best's Statement File-Global Best's Insurance Reports-P/C,US&Canada Best's State Line-P/C.US Best's Executive Summary Report-Comparison-Property/Casualty Best's Executive Summary Report-Compositt-Property/Casualty Best's Regulatory Center Best's Insurance Expense Exhibit(IEE)-P/C,US Best's Schedule F(Reinsurance)-P/C,US Best's Schedule D(Municipal Bonds)-US Best's Schedule D(Common Stocks)-US Best's Schedule D(Preferred Stocks)-US http://www3.ambest.com/ratings/entities/SearchResults-aspx?URatingld=2227864&b1=0&... 2/12/2013 Best's Credit Rating Center - Company Information for Travelers Indemnity Co of America Page 1 of 2 For ratings and product access Login I Sign-up A Print this page (7) Travelers Indemnity Co of America .........._......._._................ ......:. A.M.Best C:004003 NAIC 5:25666 FEIN 5:586020487 Assigned to R Address:One Tower Square companies '` Hartford,CT 06183 that have in Ao or United States our opinion, a r opinion, ability to meet their Web: 860-277-0111 ongoing insurance ability meet their Phone:x:80- 77-7-0111 Fax:860-277-7002 Based on A.M.Best's analysis,058470-Travelers Companies,Inc.is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure.View a list of operating insurance entities in this structure. 1 Best's Credit Ratings -.-....___.....___..___...._......_..._._----...--- View all of the companies assigned this rating as a part of an AMB Rating Unit. Best's Credit Rating Analyst ! �.—. Office:A.M.Best Company,Oldwick NJ Financial Strength Rating View Definition _._ Rating: A+(Superior) • • Senior Financial Analyst:Michael W.Russo g j Assistant Vice President:Michael J.Lagomarsino, Financial Size Category: XV($2 Billion or greater) CFA Outlook: Stable L_..__...._.__..___._.___..-_..._....._.___.__._..._...___....... Action: Affirmed Effective Date: May 10,2012 u Denotes Under Review Best's Rating • issuer Credit Rating View Definition__- Long-Term: as Outlook: Stable Action: Affirmed • • Date: May 10,2012 • IReports and News Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M.Best Group. AMB Credit Report-Insurance Professional-includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, l. detailed business overview and key financial data. Report Revision Date:5/22/2012(represents the latest significant change). 04– Historical Reports are available in AMB Credit Report-Insurance Professional Archive. S";?- Best's Executive Summary Reports(Financial Overview)-available in three versions,these presentation style reports feature balance sheet,income tom' statement,key financial performance tests including profitability,liquidity and reserve analysis. Data Status:2012 Best's Statement File-P/C,US Contains data compiled as of 1/28/2013 Quality Cross Checked. • Single Company-five years of financial data specifically on this company. • Comparison -side-by-side financial analysis of this company with a peer group of up to five other companies you select. • Composite -evaluate this company's financials against a peer group composite.Report displays both the average and total composite of your selected peer group. igBest's Key Rating Guide Presentation Report-includes Best's Financial Strength Rating and financial data as provided in the most current edition of r i- Best's Key Rating Guide products.(Quality Cross Checked). R... AMB Credit Report-Business Professional-provides three years of key financial data presented with colorful charts and tables.Each report also features jd the latest Bests Ratings,Rating Rationale and an excerpt from our Business Review commentary. Data Status:Contains data compiled as of 1/28/2013 Quality Cross Checked. J 1 Financial and Analytical Products Best's Key Rating Guide-P/C.US&Canada Best's Statement File-P/C.US Best's Statement File-Global Best's Insurance Reports-P/C,US&Canada Best's State Line-P/C,US Best's Executive Summary Report-Comparison-Property/Casualty Best's Executive Summary Report-Composite-Property/Casualty Best's Regulatory Center Best's Insurance Expense Exhibit(IEE)-P/C,US Best's Schedule F(Reinsurance)-P/C,US Best's Schedule D(Municipal Bonds)-US Best's Corporate Changes and Retirements-P/C,US/CN Best's Regulatory Center Market Share Reports Best's Schedule P(Loss Reserves)-P/C,US Best's Schedule D(Corporate Bonds)-US Best's Insurance Reports-Online-P/C.US&Canada Best's Schedule BA(Other Long Term Investments)-P/C&UH.US http://www3.ambest.com/ratings/entities/SearchResults.aspx?URatingld=2227864&b1=0&... 2/12/2013 Best's Credit Rating Center - Company Information for Charter Oak Fire Insurance Comp... Page 1 of 2 a/For ratings and product access Login I Sign-up iR Print this pane (7) Charter Oak Fire Insurance Company A.M.Best*:002516 NAIC 5:25615 FEIN ft:060291290 Assigned to !Vomit" .,,�__ Address:One Tower Square companies { Hartford,CT 06183 that have in A* or , United States our opinion, a superior ability to meet their Web:Rhone:860-2_ 7�-0111 a superi t ab obligations. heir x 86 2 777-0111 insurance.. _ Fax:860-277-7002 Based on A.M.Bests analysis,056470 Travelers Companies Inc.is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure.View a list of operating insurance entities in this structure. (Best's Credit Ratings -. - _.._........__.__.___..___.__._.._..Best's Credit Rating Anal t --s View all of the companies assigned this rating as a part of an AMB Rating Unit. _ Old k NJ Financial Strength.Rating View D ._._. I Office:A.M.Best Company, wic II Rating: A+(Superior) I Senior Financial Analyst:Michael W.Russo Financial Size Category: XV($2 Billion or greater) Assistant Vice President:Michael J.Lagomarsino, i 9 ry: Outlook: Stable Action: Affirmed . Effective Date: May 10,2012 • u Denotes Under Review Best's c Ratin Issuer Credit Rating De_„ ,,,Willa^...__......__......_._.._..__...___.___._.__ Long-Term: as Outlook: Stable Action: Affirmed Date: May 10,2012 Reports and News — - Visit Best's News and Analysis site for the latest news and press releases for this company and its A.M.Best Group. AMB Credit Insurance Professional-includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, N-1- detailed business overview and key financial data. Report Revision Date:5/23/2012(represents the latest significant change). = 920 -- 739- -2230 (19/19) 02/12/2013 09:07:04 AM -0600 r N (D (`7 M k- +i 0 co N V- C> P M O F O O O O :._ C6 C4 17 cd c(i? � tg � �* �w N N Cf? cV h ti r r: (73 r � r- fR to m N U � N u c (0 CC N 01 C U) W O O O t U r-.• U Q� co 0 c y OQ+N' N W2 P � � X$ cam) -`0V crow 2 m in 740 +- � acn v 0) N n.c Q = � �`�o(,�W oa ti c U 8= a _ L �� � �Vd¢m *r m O '6U Q 0 w° o U H J FO- U3 F�- M LO (D Q t7 0 il- N Ln ' Q co w fp (0) S �' r �' 0) GIB (� S' 00 (a o to (q" Ln Y QO 00 (ii (0 0) T•v�}• (O (O O 43 (0 I� 0) h� Qw co co ti of m' Mr N (D ti r ti N e•- �= �- V3 z z _ cq o U) v N O G ' U7� v} •� (°a � to 9 W M w O NZo rn v O :• • 0- 0 Z fl C E cl. U -6 0 3 0E CL mU v CL cc 0 N q� v W O c � c Q W N 0 c N rn cr 0 c ,0 N w N GS N c .0 — 8 x N c� �. v ..+ v G t�5 02 •- � 2 U ro fC � �� o 'Q� ° cc��m co o �� v Q.UJ �U UU) 0 w v °- a z o �- r N (D (`7 M k- +i 0 co N V- C> ( 1/19) 02/ 12/2013 08 : 57 : 38 AM -0600 -739-2230 AUGUST WINTER & SONS, INC. WINTER MECHANICAL CONTRACTORS 1 2323 NORTH ROEMER ROAD*APPLETON,WI 54911 PO BOX 1896*APPLETON,WI 54912 PHONE:9201739-8881*FAX:920/739-2230 PURCHASING DIVLC ON To: A'T-I'N: Punchasing Departmert From: Mark Hill FEB 12 2013 Company:City of Oshkosh Purchasing Pages: QSj4KOSH, WISCONSIN Faic 920-236-5186 Date: 2112113 Re: City Hall Boiler Repair CM •Comments: Our proposal follows. Please call if you have any questions. Thank you. PLEASE NOTE: • Proposals are based on prices now in effect The material portion is protected for 2 business clays and may need to be adjusted due to the volatiity of the market The labor portion is protected for 30 days. • Proposals are subject to the August Winter&Sons Conditions of Proposal,a copy of which is available upon request. • Proposal may be subject to approval of credit by August Winter&Sons,Inc. VISIT OUR WEB SITE AT hap://www.augusmintencom Branch Office:5613 Schofield Avenue, Schofield, WI 54476 PH:(715)355-7555, F)C(715)355-9048 I NAC•PLUMBING*TANK FABRICATION'PROCESS PPING'IND.SH TMETAL SPECIALTY METAL�;V4ASCQ�NSINLIC9dSEDMASSTERPLI�IABER CODE S�LICEAISENl81ABER221170 ENGINEERING 920 --739 -2230 (2/19) 02/12/2013 08:57:59 AM -0600 CITY OF OSHKOSH CITY HALL Oshkosh, Wisconsin BOILER REPAIR OWNCR.REMSENTATZVB City Hall -- Administration Building 215 Church Avenue Oshkosh, Wisconsin, 54903 -1130 (920) 235 -5100 Attention: Jon Urben ji1rben@qi,oshkosh.wi.us H.VAC�N��NEi�R Summit Design LLC W6744 Rogersville Road Fond du Lac, Wisconsin, 54937 (920) 979 -5452 reel Clary PE summ-nitdesi n oharter.net 920 --739 -2230 SECTION -- QUOTE FORM PART"I — GENERAL (3/19) 02/12/2013 08:58:17 AM -0600 1.1 QUOTE DUE: 10:00 A.M, Tuesday, February 12, 2013 1.2 AT: Purchasing Division Room 101 City Hall 215 Church Avenue Oshkosh, Wisconsin 54903 -1130 Phone (920) 236 -5100 1.3 PROJECT City Hall Boiler Replacement 215 Church Avenue Oshkosh, W15 3901 1.4 QUOTE PROPOSAL: We-- - -.... August Winter - &Sons, Inc. r - . .., - ---� -� Of: 2323 N. Roemer Rd. Appleton W1 - - - - - 54911, stFCCt aty stele zip Cade Telephone, 920- 739 -8881 Fax Number: 920- 739 -2230 Submit our proposal for performing the Work for the above Project, 1., in compliance with the advertising for quotes and having carefiilly examined the drawings and specification for the Work and the Site of the proposed work and having determined all of the conditions of tho work, the rules, regulations, laws, codes, ordinances, and other governing circumstances relating to this project, the undersigned proposes to famish all Labor, Materials and Equipnimt necessary to complete the construction indicated on the drawings and described in the project manual to include all described work completed to the Owners' satisfaction, 2. By Submission of this quote, each bidder certifies, and in the case of 1 joint quote, each party thereto certifies as to its own organization, that this quote has been arrived at independently without consultation, commimication, or agreement as to a matter relating to this quote and with any other bidder or with any competitor. 3. All quotes exclude Wisconsin sales tax.