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HomeMy WebLinkAboutJohnston Pile Driving LLC/Men Dock Rest CONTRACTOR AGREEMENT: PILE DRIVING SERVICES FOR MENOMINEE PARK CRUISER DOCK RESTORATION FEBRUARY, 2013 THIS AGREEMENT, made on the 20th day of February, 2013, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and Johnston Pile Driving, LLC, N2591 37th Avenue, Omro, WI 54963, 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: (Brady Johnston, Owner) 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: (Chad Dallman, Parks Operations Manager) ARTICLE III. SCOPE OF WORK The Contractor shall provide services described in the CITY'S Bid Specifications dated February 5, 2013, attached hereto as Exhibit A, and the Contractor's Quote Form dated February 6, 2013, attached hereto as Exhibit B. Both Exhibit A and B are 1 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 March 31 , 2013. ARTICLE VI. PAYMENT A. The Contract Sum. The City shall pay to the Contractor for the performance of the contract the sum of $11,200, 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 2 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. INSURANCE 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: CONTRACTOR /CONSULTANT 1111 _ILA ' �•' 1111 By: CV '"h 01/45TNO 3 (Seal of Contractor (Specify Title) if a Corporation.) By: (Specify Title) CITY OF OSHKOSH / 1 ) _ By: - /Ci�� /7 /?L r (z ri/// r_ 4 Mark A.- -ohloff, City Manager (Witness) 4 4 1 1) ', 7'( ( 2-e. And: OIL r (Witness) Pamela R. Ubrig, City Clerk / f J APPROVED: I hereby certify that the necess- I ary provisions have been made to pay the liability which will accrue �r under this contract. ■��i. � � 111��1�� ity Att. - i D ,_14,, ,a- cYCO-1--g - Clity 4 3(rn'5 rr A City of Oshkosh,Wisconsin Invitation for Quotation For PILE DRIVING SERVICES FOR THE MENOMINEE PARK CRUISER DOCK RESTORATION: CITY OF OSHKOSH PARKS DEPARTMENT February 5, 2013 City of Oshkosh P.O. Box 1130 Oshkosh, Wisconsin 54903-1130 www.ci.oshkosh.wi.us 1 CITY OF OSHKOSH - PURCHASING 215 Church Avenue, PO Box 1130 Oshkosh Wisconsin 54903-1130 (920) 236-5100 FAX (920) 236-5186 REQUEST FOR QUOTATION THIS IS NOT AN ORDER DATE: FEBRUARY 5, 2013 CONTACT: HOLLY MAGRADY Please furnish quotations on the commodities or services described below in accordance with terms set forth herein. All quotations must be F.O.B. DESTINATION and include cost of handling and freight to delivery point: QUANTITY DESCRIPTION UNIT TOTAL PRICE PRICE MENOMINEE PARK CRUISE DOCK RESTORATION: PILE DRIVING SERVICES PLEASE SEE ATTACHED SPECIFICATION AND QUOTE PROPOSAL PAGE Quotations must be in by 11:00 AM ON FRIDAY FEBRUARY 15, 2013 TERMS days. Delivery in days after receipt of order. The General Services Manager reserves the right to reject any or all quotations or to accept separate items in the quotation unless greater price advantage is available by purchasing the entire quantity from one bidder. IF QUOTATION IS QUALIFIED, PLEASE SPECIFY IN WHAT RESPECT. Quotations should not include Federal Excise or Wisconsin Sales taxes, as the City Oshkosh is exempt from the payment of such taxes. 2 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. 3 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). 11/10 4 QUOTE SPECIFICATIONS MENOMINEE PARK CRUISER DOCK RESTORATION: PILE DRIVING SERVICES CITY OF OSHKOSH PARKS DEPARTMENT SPECIFICATIONS The Menominee Park Cruiser Dock is in need of restoring 16 piles, more or less. We are requesting quotations for pile driving services for this project. This service will include all labor, materials, mobilization, and demobilization. The piles need to be a minimum 9" in diameter x 20' in length all in treated lumber. Work needs to be completed no later than March 15, 2013. To arrange a site visit and/or to discuss the scope of this project please contact Chad Dallman at 920-232-5313. Attached is City of Oshkosh Insurance Requirements for this project. The required Certificate of Insurance must accompany this quotation. Also attached is a sample of Agreement that will be used between the successful contractor and the city. Contractors must be qualified to submit a quote for this project. This shall be done on forms furnished by the City of Oshkosh, Wisconsin, and must be filled out in proper manner and then submitted to the General Services Manager for consideration no later than February 11,2013. The General Services Manager's decision as to qualifications will be final. Copies of this form may be obtained by contacting Purchasing at 920-236- 5100. 5 QUOTE We, the undersigned, propose to furnish and install 16 piles, more or less for the City of Oshkosh, Parks Department, FOB Oshkosh, Wisconsin, , as per specifications. We understand the work must be completed by March 15, 2013. Pile Driving per specifications $ QUOTATION [ ] Certificate of Insurance Attached [ ] Prequalification Attached* Terms NAME OF COMPANY SUBMITTED BY: NAME & TITLE OF PERSON SUBMITTING QUOTE 2013 DATE ADDRESS OF COMPANY • CITY STATE ZIP ) TELEPHONE NUMBER * If your firm has already completed a City of Oshkosh Prequalification, please contact the Purchasing Office at 920-236-5100 6 7/16/12 CITY OF OSHKOSH INSURANCE REQUIREMENTS I. 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 primary coverage and that any insurance or self insurance maintained by the City of Oshkosh, its officers, council members, agents, employees or authorized volunteers will not contribute to a loss. All insurance shall be in full force prior to commencing work and remain in force until the entire job is completed and the length of time that is specified, if any, in the contract or listed below whichever is longer. 1. 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. I - 1 7/16/12 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. I - 2 7/16/12 I. Bond Requirements 1. 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. 2. 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/SUBCONTRACTORS/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. I - 3 DATE(MM/DD/YY'y) `' CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Insurance Agency contact NAME: information,including street PHONE Insurance Agent's FAX address and PO Box if contact information. E-MAIL ....._._..._..._............. IA/C.No): applicable. E-MAIL ADDRESS: { INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: ABC Insurance Company NAIC# INSURED Insured's contact information, including name,address and INSURER B: XYZ Insurance Company NAIC# phone number. INSURER C. LMN Insurance Compan NAIL,# INSURER D: Insurer(s)must have a minimum A.M.Best rating of A- and a Financial Performance Rating of VI or better. INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE AMY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR- ADDL SUBR POLICY EFF POLICY EXP €t LTR> TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYY) (MM/DDIYYY) : LIMITS GENERAL LIABILITY I I !EACH OCCURRENCE $1,000,000 { General Liability Polic Number Policy effective and expiration date. E DAMAGE TO RENTED ®:COMMERCIAL GENERAL LIABILITY ® ❑ ry y ( I PREMISES(Ea occurrence) $50,000 A ' ❑:CLAIMS-MADE®OCCUR j !MED EXP(Any one person) $5,000 ® ISO FORM CG 20 37 OR EQUIVALENT `PERSONAL&ADV INJURY L$1,000,000 ❑ { ;GENERAL AGGREGATE !`$2,000,000 GET_AGGREGATE LIMIT APPLIES PER: [PRODUCTS—COMP/OP AGG $2,000,000 in POLICY iPRO- `LOC i 1 !AUTOMOBILE LIABILITY i [COMBINED SINGLE LIMIT I_ I !,(Ea accident) $1,000,000 ___ . I,IZIANY AUTO Auto Liability Policy Number Policy effective and expiration date. BODILY INJURY(Per person) $ B W ALL ONED , SCHEDULED I I Eli ❑: AUTOS ? I ! ;BODILY INJURY(Peraccident) $ NON- WNED ....... .......... ._.__..... ........... ._._._._...._...._.. I [PROPERTY DAMAGE ❑HIRED AUTOS O� ;❑- AUTOS { ,(Per accident) $ ❑ 1E11 1 I $ UMBRELLA LIAB OCCUR I ( !EACH OCCURRENCE $2,000 000 A CLAIMS-MADE i s Umbrella Liability Policy Number{ Policy effective and expiration date .I EXCESS LIAR ❑ I I !AGGREGATE 1 $2,000,000 I❑DED j®RETENTION S1 0,000 1 € i $ 'WORKERS COMPENSATION WC STATU- OTH- �' [AND EMPLOYERS'LIABILITY ❑ ❑ j ,1 TORY LIMITS❑{ ER ANY PROPRIETOR/PARTNER/EXECUTIVE ; i ` --- -I i ,OFFICElMEMBER EXCLUDED? YIN Workers Compensation Policy Policy effective and expiration date. E L.EACH ACCIDENT $100 000 !(Mandatory in NH) N 1 Number If yes,describe under 3 [E_L.DISEASE—EA EMPLOYEE $100,000 3 DESCRIPTION OF OPERATIONS below j IE.L.DISEASE—POLICY LIMIT l $500,000 ❑ ❑ DESCRIPTION OF OPERATIONS I LOCATIONS/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 be submitted prior to commencement of the work to the applicable City department These certificates shall contain a provision that coverage afforded under the policies will not be canceled or non renewed until at least 30 days'prior written notice has been given to the City Clerk—City of Oshkosh. CERTIFICATE HOLDER CANCELLATION City of Oshkosh,Attn:City Clerk Insurance Standard I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 Church Avenue THE EXPIRATION DATE,THEREOF,NOTICE WILL BE DELIVERED IN PO Box 1130 SAMPLE CERTIFICATE ACCORDANCE WITH THE POLICY PROVISIONS. Oshkosh,WI 54903-1130 Please indicate somewhere on this certificate,the contract or project# AUTHORIZED REPRESENTATIVE this certificate Is for. ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYY) ACG CERTIFICATE OF PROPERTY 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. If this certificate is being prepared for a party who has an insurable interest in the property,do not use this form. Use ACORD 27 or ACORD 28. PRODUCER CONTACT Insurance Agency contact NAME: information,including street PHONE Insurance Agent's FAX - _- address and PO Box if contact information. A/C.Na: A/C.No.Est): 1 applicable. E-MAIL ADDRESS: INSURERS)AFFORDING COVERAGE NAIC# INSURER A: ABC Insurance Company NAIL:# INSURED Insured's contact information, including name,address and INSURER B: XYZ Insurance Company NAIL# phone number. INSURER C: _! _ INSURER D: Insurer(s)must have a minimum A.M.Best rating of A- _...__..._..............._._.._...._...._....__. and a Financial Performance Rating of VI or better. INSURER E: • INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: LOCATION OF PREMISES/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. INSR1 POLICY NUMBER ' POLICY EFFECTIVE POLICY EXPIRATION €t' COVERED PROPERTY LIMITS LTR i TYPE OF INSURANCE DATE(MMIDD/YYY)DATE(MMIDDIYYY) [ ® PROPERTY One or the ather.depends on Zi BUILDING $ See#1 on type of job being done. 4---.. -1---— ... ACORD 101 'CAUSES OF LOSS DEDUCTIBLES ; form on I� j ' PERSONAL PROPERTY i $ following page BUILDING f A BASIC Contractor's responsible for ALL I �i. BUSINESS INCOME $ ' i - $ deductibles _.._._. OROAD (CONTENTS D EXTRA EXPENSE $ SPECIAL $ ;I RENTAL VALUE $ ®EARTHQUAKE $ € € BLANKET BUILDING $ Property Policy Number Policy effective and expiration date. ?MNO $ ( I BLANKET PERS PROP , $ ®FLOOD , $ BLANKET BLDG&PP $ 0 $ _ ' El' , $ p: $ ❑ $ INLAND MARINE TYPE OF POLICY '. 111I i $ ;CAUSES OF LOSS I ; $ NAMED PERILS POLICY NUMBER mm . $ Eli 1 0j i $ U CRIME j ;TYPE OF POLICY 0Y. $ B BOILER ti MACHINERY I 1—EQUIPMENT BREAKDOWN i Boiler&Machinery Policy Number Policy effective and expiration date. If exposure exists I $ U $ $ SPECIAL CONDITIONS I OTHER COVERAGES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) See attached ACORD 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 SAMPLE CERTIFICATE THE EXPIRATION DATE,THEREOF,NOTICE WILL BE DELIVERED IN PO Box 1130 ACCORDANCE WITH THE POLICY PROVISIONS. Oshkosh,WI 54903-1130 Please indicate somewhere on this certificate,the contract or project# AUTHORIZED REPRESENTATIVE this certificate is for. ©1995-2009 ACORD CORPORATION. All rights reserved. ACORD 24(2009/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: Ac= E1 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Name of Insurance Agency NAMED INSURED Name of Insured, including address POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, 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. Insurance Standard I SAMPLE CERTIFICATE Please Indicate somewhere on this certificate,the contract or project# this certificate is for. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ) 1fi3 QUOTE We,the undersigned,propose to furnish and install 16 piles,more or less for the City of Oshkosh,Parks Department,FOB Oshkosh,Wisconsin, ,as per specifications.We understand the work must be completed by March 15,2013. Pile Driving per specifications $ 11,200.00 QUOTATION (x I Certificate of Insurance Attached [ J Prequalification Attached* _ Terms Company Terms are 50% Due At Start of Project Balance Due Upon Completion Johnston Pile Driving, LLC NAME OF COMPANY SUBMITTED BY: Brady Johnston-Owner NAME&TITLE OF PERSON SUBMITTING QUOTE February 6, 2013 N2591 37th Avenue DATE ADDRESS OF COMPANY Omra, WI 54963 CITY STATE ZIP (920)685-5648 TELEPHONE NUMBER If your firm has already completed a City of Oshkosh Prequalification,please contact the Purchasing Office at 920-236-5100 6 �_„...,.... JOHNS-A OP ID: PV .4 CC)R Cr' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DO/YYYY) ‘..../--- 02/19/2013 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 Phone:920-722-7531 CONTACT Patti VandenBosch Ansay&Associates,LLC Fax:920-722-9011 PHONE 920-722-7531 FAX 201 East Bell Street (A/c,No.Ext): (alc,No):920-722-9011 Neenah,WI 54956 E-MAIL atti.vandenbosch fv.ansa com Chad M Messner ADDRESS:p y INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Insurance Co 10677 INSURED Johnston Pile Driving LLC INSURER B:Cincinnati Specialty Und. N2591 37th Ave. Omro,WI 54963 INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSR yNVD POLICY NUMBER (MM/DDIYYYY) (MM/DDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 B X COMMERCIAL GENERAL LIABILITY X CSU 0039230 07/01/2012 07/01/2013 DAMAGE TO RENTED 100,000 PREMISES{Ea ocarrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) $ Excluded PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 7 POLICY X PECr LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ A ANY AUTO X ENP 0150015 07/01/2012 07/01/2013 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X In:AWNED PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X ORY LIM TS OER AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y!N WC 2121903 07/01/2012 07/01/2013 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? y N/A (Mandatory In NH) E.L.DISEASE-BA EMPLOYE9$ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) City of Oshkosh, and its officers, council members, agents, employees and authorized volunteers are additional insured on Auto Liability by Endorsemnt #AA4004 with a 30 day NOC by #IA4087, and on General Liability including Completed Operations by Endorsements #CSIA405-A and #CSIA405-B and a 30 Day Notification by Endorsement #CSIA405-C. Copies of endorsements attached. CERTIFICATE HOLDER CANCELLATION CIOSOSI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Oshkosh THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY ACCORDANCE WITH THE POLICY PROVISIONS. Attn: City Clerk PO Box 1130 AUTHORIZED REPRESENTATIVE Oshkosh,WI 54903-1130 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD . Best's Credit Rating Center-Company Information for Cincinnati Insurance Company Page 1 of 2 'ier For ratings and product access Login I Sian-us Cincinnati Insurance Company r'Printthis pane C) A.M.Best Or 000258 NAIC Or 10677 FEIN r:310542366 Address:P.O.Box 145496 Assigned to t9iieisala ,h' Cincinnati,OH 45250-5496 companies United Slates that have in• iw.Yptor _e. Web:www.unfin.ccm our opinion, Phone:513-870-2000 a superior ability to meet their Fax:513-870-2066 ongoing insurance obligations. Based on A.M.Best's 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. Best's Credit Ratings View all of the assigned this rating as a part of an AMB Rating Unit. ............. . ._.,..___ Best's Credit Rating Analyst Financial Strength Rating View.Definition ..... ............... _. _. ................. .', . Office:A.M.Best Company,Oldwick NJ Rating: A+(Superior) I Senior Financial Analyst:Gordon McLean Financial Size Category: XV($2 Billion or greater) I Managing Senior Financial Analyst:Jennifer Outlook: Stable Marshall,CPCU,ARM Action: Affirmed Effective Date: December 19,2012 u Denotes Under Review Best's Rating Issuer Credit Rating View Definition Long-Term: aa- Outlook: Stable • Action: Affirmed '.. I 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 branch basis. 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 finandals for the Property/Casualty business of this legal entity. • :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-indudes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, 4 detailed business overview and key financial data. Report Revision Date:1/11/2013(represents the latest significant change). 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Page 1 of 2 410,For ratings and product access Loam I Sian-up Cincinnati Specialty Underwriters Ins Co EgaPrint this pate (2) A.M.Best 4:013843 NAIC C:13037 FEIN 4:651316588 Address:P.O.Box 145496 Assigned to t4rwoos9 ' Betln��. Cincinnati,OH 45250-5496 companies United States that have in !. A. Web:wwst.tinfin.com our opinion, Phone:513-870-2000 an excellent ability to meet their Fax:513-603-5500 ongoing insurance obligations. Based on A.M.Best's analysis,058704-Cincinnati Financial Corporation is the AMB Ultimate Parent and identities the topmost entity of the corporate structure.View a list of gperahna insurance entities in this structure. Best's Credit Ratings Financial Strength Rating View Definition Best's Credit Rating Analyst • Rating: A(Excellent) ' Office:A.M.Best Company,Oldwick NJ • Financial Size VIII($100 Million to$250 Senior Financial Analyst:Gordon McLean '..• Category: Million) Managing Senior Financial Analyst:Jennifer i Outlook: Stable Marshall,CPCU,ARM Action: Affirmed • __... ........ _...._ _._..... ..__.; Effective Date: December 19,2012 • • • u Denotes Under Review Bests Rating Issuer Credit Rating View Definition • • Long-Term: a • Outlook: Stable • Action: Affirmed • • Date: December 19,2012 '.. 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, t;4.t detailed business overview and key financial data. Report Revision Date:1/24/2013(represents the latest significant change). iI==fit Historical Reports are available in AM...?Credit Report-Insurance Professional Archive, Best's Kev Ratinct Guide Presentation Report-includes Best's Financial Strength Rating and financial data as provided in the most current edition of vii:Best's Key Rating Guide products.(Quality Cross Checked). 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