HomeMy WebLinkAboutDixon Engineering-agreement for inspection of water storage tanks (2014) CITY OF OSHKOSH
DEPARTMENT OF PUBLIC WORKS
215 CHURCH AVENUE, P.O. BOX 1130, OSHKOSH, WI 54903-1130
PHONE: (920)236-5065 FAX(920)236-5068
LETTER OF TRANSMITTAL
To: Mr. Joseph T. Hoban Date: May 5, 2014
Dixon Engineering, Inc. Subject: Executed Agreement
9415 West Forest Home Avenue Engineering & Inspection Services for
Suite 208 Water Storage Tank
Hales Corner, WI 53130
Please find: ® Attached ❑ Under Separate Cover
❑ Copy of Letter ® Contracts ❑ Amendment ❑ Report ❑ Agenda
❑ Meeting Notes ❑ Photos ❑ Mylars ❑ Change Order ❑ Plans
❑ Specifications ❑ Estimates ❑ Diskette ❑ Zip Disk ❑ Other
Quantity Description
1 Executed Agreement
These are being transmitted as indicated below:
❑ For Approval ® For Your Use ❑ As Requested ❑ For Review&Comment
Remarks:
Enclosed is a copy of the executed agreement for the engineering and inspection services for the
water storage tank. A copy of a City of Oshkosh Purchase Order will follow shortly. Please reference
this Purchase Order number on all of your invoices.
If you have any questions, please contact us.
City Attorney's Office— Copy
City Clerk's Office—Original
Steve Brand —Copy ,
cc: _ File —Original Signed:
TracATaylor
I:\Engineering\Tracy Taylor,Steve Brand Agreements Dixon Eng LOT-Executed Agreemnt-Eng&Insp Serv-Wtr Storage -nk_5-5-14.docx
AGREEMENT
THIS AGREEMENT, made on the 30 day of APRIL— , 2014, by
and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as
CITY, and DIXON ENGINEERING, INC., 9415 West Forest Home Avenue, Suite 208,
Hales Corners, WI 53130, party of the second part, hereinafter referred to as the
CONSULTANT,
WITNESSETH:
That the CITY and the CONSULTANT, for the consideration hereinafter named,
enter into the following AGREEMENT for ENGINEERING AND INSPECTION
SERVICES FOR WATER STORAGE TANK.
ARTICLE I. PROJECT MANAGER
A. Assignment of Project Manager. The CONSULTANT shall assign the
following individual to manage the PROJECT described in this AGREEMENT:
Joseph T. Hoban, P.E.
B. Changes in Project Manager. The CITY shall have the right to approve or
disapprove of any proposed change from the individual named above as Project
Manager. The CITY shall be provided with a resume or other information for any
proposed substitute and shall be given the opportunity to interview that person prior to
any proposed change.
ARTICLE II. CITY REPRESENTATIVE
The CITY shall assign the following individual to manage the PROJECT
described in this AGREEMENT:
Stephan M. Brand—Public Works Utility Bureau Manager
ARTICLE III. SCOPE OF WORK
The CONSULTANT shall provide the services described in the CONSULTANT's
Proposal. CITY may make or approve changes within the general Scope of Services in
this AGREEMENT. If such changes affect CONSULTANT's cost of or time required for
performance of the services, an equitable adjustment will be made through an
amendment to this AGREEMENT.
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All reports, drawings, specifications, computer files, field data, notes, and other
documents and instruments prepared by the CONSULTANT as instruments of service
shall remain the property of the CITY.
ARTICLE IV. STANDARD OF CARE
The standard of care applicable to CONSULTANT's services will be the degree
of skill and diligence normally employed by professional consultants or consultants
performing the same or similar services at the time said services are performed.
CONSULTANT will re-perform any services not meeting this standard without additional
compensation.
ARTICLE V. OPINIONS OF COST, FINANCIAL CONSIDERATIONS, AND
SCHEDULES
In providing opinions of cost, financial analyses, economic feasibility projections,
and schedules for the PROJECT, CONSULTANT has no control over cost or price of
labor and materials; unknown or latent conditions of existing equipment or structures
that may affect operation or maintenance costs; competitive bidding procedures and
market conditions; time or quality of performance by operating personnel or third
parties; and other economic and operational factors that may materially affect the
ultimate project cost or schedule. Therefore, it is understood between the parties that
the CONSULTANT makes no warranty that the CITY's actual project costs, financial
aspects, economic feasibility, or schedules will not vary from CONSULTANT's opinions,
analyses, projections, or estimates.
ARTICLE VI. RECORD DRAWINGS
Record drawings, if required, will be prepared, in part, on the basis of information
compiled and furnished by others. CONSULTANT is not responsible for any errors or
omissions in the information from others that the CONSULTANT reasonably relied upon
and that are incorporated into the record drawings.
ARTICLE VII. CITY RESPONSIBILITIES
The CITY shall furnish, at the CONSULTANT's request, such information as is
needed by the CONSULTANT to aid in the progress of the PROJECT, providing it is
reasonably obtainable from City records.
To prevent any unreasonable delay in the CONSULTANT's work, the CITY will
examine all reports and other documents and will make any authorizations necessary to
proceed with work within a reasonable time period.
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ARTICLE VIII. ASBESTOS OR HAZARDOUS SUBSTANCES
If asbestos or hazardous substances in any form are encountered or suspected,
CONSULTANT will stop its own work in the affected portions of the PROJECT to permit
testing and evaluation.
If asbestos is suspected, CONSULTANT will, if requested, manage the asbestos
remediation activities using a qualified subcontractor at an additional fee and contract
terms to be negotiated.
If hazardous substances other than asbestos are suspected, CONSULTANT will,
if requested, conduct tests to determine the extent of the problem and will perform the
necessary studies and recommend the necessary remedial measures at an additional
fee and contract terms to be negotiated.
CITY recognizes that CONSULTANT assumes no risk and/or liability for a waste
or hazardous waste site originated by other than the CONSULTANT.
ARTICLE IX. CITY'S INSURANCE
CITY will maintain property insurance on all pre-existing physical facilities
associated in any way with the PROJECT.
CITY will provide (or have the construction contractor(s) provide) a Builders Risk
All Risk insurance policy for the full replacement value of all project work including the
value of all onsite CITY-furnished equipment and/or materials associated with
CONSULTANT's services. Upon request, CITY will provide CONSULTANT a copy of
such policy.
ARTICLE X. TIME OF COMPLETION
The work to be performed under this AGREEMENT shall be commenced and the
work completed within the time limits as agreed upon in the CONSULTANT's Proposal.
The CONSULTANT shall perform the services under this AGREEMENT with
reasonable diligence and expediency consistent with sound professional practices. The
CITY agrees that the CONSULTANT is not responsible for damages arising directly or
indirectly from any delays for causes beyond the CONSULTANT's control. For the
purposes of this AGREEMENT, such causes include, but are not limited to, strikes or
other labor disputes, severe weather disruptions or other natural disasters, failure of
performance by the CITY, or discovery of any hazardous substances or differing site
conditions. If the delays resulting from any such causes increase the time required by
the CONSULTANT to perform its services in an orderly and efficient manner, the
CONSULTANT shall be entitled to an equitable adjustment in schedule.
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ARTICLE XI. COMPONENT PARTS OF THE AGREEMENT
This AGREEMENT consists of the following component parts, all of which are as
fully a part of this AGREEMENT as if herein set out verbatim, or if not attached, as if
hereto attached:
1. This Instrument
2. CONSULTANT's Proposal dated April 19, 2014 and attached hereto
In the event that any provision in any of the above component parts of this
AGREEMENT conflicts with any provision in any other of the component parts, the
provision in the component part first enumerated above shall govern over any other
component part which follows it numerically except as may be otherwise specifically
stated.
ARTICLE XII. PAYMENT
A. The Agreement Sum. The CITY shall pay to the CONSULTANT for the
performance of the AGREEMENT the total sum as set forth below, adjusted by any
changes hereafter mutually agreed upon in writing by the parties hereto:
• Time and Materials Not to Exceed $16,606 (Sixteen Thousand Six
Hundred Six Dollars).
• Attached fee schedules shall be firm for the duration of this AGREEMENT.
B. Method of Payment. The CONSULTANT shall submit itemized monthly
statements for services. The CITY shall pay the CONSULTANT within thirty (30)
calendar days after receipt of such statement. If any statement amount is disputed, the
CITY may withhold payment of such amount and shall provide to CONSULTANT a
statement as to the reason(s)for withholding payment.
C. Additional Costs. Costs for additional services shall be negotiated and set
forth in a written amendment to this AGREEMENT executed by both parties prior to
proceeding with the work covered under the subject amendment.
ARTICLE XIII. HOLD HARMLESS
The CONSULTANT covenants and agrees to protect and hold the City of
Oshkosh harmless against all actions, claims, and demands which may be to the
proportionate extent caused by or result from the intentional or negligent acts of the
CONSULTANT, his/her agents or assigns, his/her employees, or his/her subcontractors
related however remotely to the performance of this AGREEMENT or be caused or
result from any violation of any law or administrative regulation, and shall indemnify or
refund to the CITY all sums including court costs, attorney fees, and punitive damages
which the CITY may be obliged or adjudged to pay on any such claims or demands
within thirty (30) days of the date of the CITY's written demand for indemnification or
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refund for those actions, claim, and demands caused by or resulting from intentional or
negligent acts as specified in this paragraph.
Subject to any limitations contained in Sec. 893.80 and any similar statute, of the
Wisconsin Statutes, the CITY further agrees to hold CONSULTANT harmless from any
and all liability, including claims, demands, losses, costs, damages, and expenses of
every kind and description (including death), or damages to person or property arising
out of re-use of the documents without consent where such liability is founded upon or
grows out of the acts or omission of any of the officers, employees or agents of the City
of Oshkosh while acting within the scope of their employment.
ARTICLE XIV. INSURANCE
The CONSULTANT agrees to abide by the attached City of Oshkosh Insurance
Requirements.
ARTICLE XV. TERMINATION
A. For Cause. if the CONSULTANT shall fail to fulfill in timely and proper
manner any of the obligations under this AGREEMENT, the CITY shall have the right to
terminate this AGREEMENT by written notice to the CONSULTANT. In this event, the
CONSULTANT shall be entitled to compensation for any satisfactory, usable work
completed.
B. For Convenience. The CITY may terminate this AGREEMENT at any time
by giving written notice to the CONSULTANT no later than ten (10) calendar days
before the termination date. If the CITY terminates under this paragraph, then the
CONSULTANT shall be entitled to compensation for any satisfactory work performed to
the date of termination.
This document and any specified attachments contain all terms and conditions of
the AGREEMENT and any alteration thereto shall be invalid unless made in writing,
signed by both parties and incorporated as an amendment to this AGREEMENT.
ARTICLE XVI. RE-USE OF PROJECT DOCUMENTS
All reports, drawings, specifications, documents, and other deliverables of
CONSULTANT, whether in hard copy or in electronic form, are instruments of service
for this PROJECT, whether the PROJECT is completed or not. CITY agrees to
indemnify CONSULTANT and CONSULTANT's officers, employees, subcontractors,
and affiliated corporations from all claims, damages, losses, and costs, including, but
not limited to, litigation expenses and attorney's fees arising out of or related to the
unauthorized re-use, change, or alteration of these project documents.
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ARTICLE XVII. SUSPENSION, DELAY, OR INTERRUPTION OF WORK
CITY may suspend, delay, or interrupt the services of CONSULTANT for the
convenience of CITY. In such event, CONSULTANT's contract price and schedule shall
be equitably adjusted.
ARTICLE XVIII. NO THIRD-PARTY BENEFICIARIES
This AGREEMENT gives no rights or benefits to anyone other than CITY and
CONSULTANT and has no third-party beneficiaries.
In the Presence of: CONSULTANT
VLC167)-6 (/ A By:
Vice Pr'5 S e,,-1 t
(Seal of Consultant (Specify Title)
if a Corporation.)
By:
(Specify Title)
CITY OF OSHKOSH
By: �--�
(Witness) Mark A. Rohloff, City Manag:r
And: J L
(Witness) Pamela R. brig, City er
APPROVED: I hereby certify that the necessary provisions
have been made to pay the liability which
` . _,.',.. ,(sisv will accrue under this AGREEMENT.
jt)pA/14, -
City Attorney
City 1-1(—\ty Comptroller
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DIXON•
IP-2 9415 West Forest Home
Suits 208
Hales Corners,WI 53130
ENGINEERING & INSPECTION SERVICES Telephone:(414)529-1859
FOR THE COATING INDUSTRY Fax:(414)529-3120
April 24,2014 RECEIVED
APR 24 2014
Mr. Steve Brand,Superintendent of Utilities DEPT. OF PUBLIC WORKS
City of Oshkosh
OSHKOSH, WISCONSIN
215 Church Street
Oshkosh,WI 54093
Re: Engineering and Inspections for the 750,000 Gallon Fluted Column Water Storage Tank
Dear Mr.Brand:
Enclosed is the engineering and inspection proposal for the 750,000 gallon fluted column water storage
tank.
Our proposal is divided into a Cover Page,Schedule A, Schedule B,Schedule C,and General
Provisions. The Cover Page proposes a not-to-exceed fee. Schedule A details the services provided by
our firm and services to be provided by your personnel. Schedule B explains the fees for providing the
services outlined in Schedule A. Schedule C is engineering fees for additional work, if necessary.
We appreciate the opportunity to submit this proposal. If I can be of any further service to you or
answer questions,please feel free to call me at(920)470-0957.
FOR DIXON ENGINEERING, INC.,
("1/h 1 '%/? --
Joseph T.Hoban,P.E.
Senior Project Engineer
Enclosure
Members: Society of Protective Coatings•American Water Works Association
Consulting Engineers Council
•
Re.c �� 9415 West Forest Home
D IXO � 01 Hales Corners,WI 53130
ENGINEERING & INSPECTION SERVICES Wos Telephone:(414)529-1859
FOR THE COATING INDUSTRY t"0504,05"'ar pU wiSCO�siN Fax:(414)529-3120
Proposal Water Storage Tank
750,000 Gallon Fluted Column, (Southwest Tank), #49-71-06-03
The Proposal is between Dixon Engineering,Inc. (DIXON)and the City of Oshkosh,Wisconsin
(Owner)to contract with DIXON for technical services for the 750,000 Gallon Fluted Column
(Project).
1.01 Payment
DIXON shall provide,or cause to be provided, services detailed in Scope of Services and
Owner agrees to pay DIXON as compensation for their services the fee/lump sum of Sixteen
Thousand,Six Hundred,and Six dollars($16,606.00). Terms of charges and payments per
details in Schedule B. (Prices quoted are subject to change ninety(90)days after proposal date,
if not contracted.)
2.01 SCOPE OF SERVICES
Preparation of Technical Specifications and Contract Documents,Project Administration,Pre-
Construction Meeting,Weld Inspection,and Paint Inspection Services per Schedule A
3.01 SIGNATURES
Joseph T.Hoban,P.E,Senior Project Engineer April 24,2014
PROPOSED by DIXON(Not a contract until approved by an officer) PROPOSAL DATE
CONTRACT APPROVED by OWNER POSITION DATE
CO SIGNATURE(if required) POSITION DATE
CONTRACT APPROVED by DIXON OFFICER POSITION EFFECTIVE CONTRACT DATE
Members:Society of Protective Coatings•American Water Works Association
Consulting Engineers Council
Page 1 of 7
SCOPE OF SERVICES-SCHEDULE A
750,000 Gallon Fluted Column, (Southwest Tank), #49-71-06-03
Oshkosh, Wisconsin
I. Technical Specifications
A. Owner agrees:
1. Use,unaltered,the Technical Specifications provided by Dixon when entering into an
agreement with the Contractor. Dixon will not unreasonably withhold a request to alter
the document. This clause is essential to protect Dixon's interest in regards to
Contractor pays for default clauses. This provision in no way creates any contractual
obligation, including those of third party beneficiary status, or relationship between
DIXON and Contractor.
2. Pay all advertising costs.The method of advertising is to be determined by the Owner.
3. Provide a place for the bid opening.
4. Open the bids received.
5. Review Payment and Performance Bonds,and insurance certificates of selected
Contractor. These should be reviewed by the Owner's insurance consultant and
attorney.
6. Sign and forward to the Contractor the notice to proceed. This Notice to Proceed will
be supplied to Owner by Dixon.
B. DIXON agrees:
1. Preparation of Technical Specifications:
a. Prepare Technical Specifications for project to include,but not limited to,the
following:
1) Detailed specifications
2) Inspection Form
b. Address all questions,written or verbal response,concerning the project that are
submitted to DIXON. (Dixon will not be held to any non-written statement.)
c. Direct mail advertisements to Contractors who have been prior approved as capable
and conscientious by DIXON.
d. Send specifications to selected,appropriate Builders Exchanges and Dodge Reports.
e. Review the bids submitted to the Owner and recommend award based on lowest
responsible and responsive bidder.
II. DIXON Shall Perform Project Administration:
1. Project administration for the purpose of coordinating the inspection program, local
inspector assistance,secretarial services,shop drawing review, and project finalization.
2. Review Contractor's Schedule of Values and work schedule.
3. Review shop drawings for compliance with technical specifications.
4. DIXON shall record a written record of all Project meetings with the Owner. Meeting
minutes shall be submitted to the Owner not more than ten(10)days after the meeting.
5. Perform services expected of Engineer and detailed in the EJCUC General Conditions.
Page 2 of 7
•
III. DIXON Shall Attend Pre-construction Meeting:
1. Attend a pre-construction meeting, and distribute minutes to major participants. Topics of
discussion will include Contractor's:
a. emergency response plan,
b. responsibilities to the Owner,
c. responsibilities to her/his workers,
d. responsibilities to the public
e. inspection start time
f. inspection schedule
g. liquidated damages
2. Contractor will have submittals which are to be submitted ten(1 d)days prior to the pre-
construction meeting. Some of these include: Contractor's schedule,ventilation,fall
prevention, confined space, waste hauler certifications,welder certifications, etc. These
will be reviewed prior to meeting and only deficiencies discussed.
IV. DIXON Shall Perform Critical Phase Inspections:
A. Weld Inspection:
1. One(1)visit(s)to inspect repair/installation work for specification compliance. All
weld repairs will be visually inspected for surface defects(i.e. undercut,negative
reinforcement,non-fusion, etc.).
B. Wet Interior—Painting:
1. Two(2)visit(s)to inspect the interior primer coat for uniformity, coverage,and dry film
thickness,prior to application of the succeeding paint coat.
2. Two (2)visit(s)to inspect the interior intermediate coating uniformity,coverage,dry
film thickness, and holiday detection,prior to application of the succeeding paint coat.
3. One(1)visit(s)to inspect the interior stripe coat for uniformity,coverage, and
thoroughness.
4. Two(2)visit(s)to inspect the interior topcoat for uniformity,coverage,performance,
and dry film thickness for compliance with specifications. Examine the overall project
for possible damage caused by equipment removal. Inspect the application of top
coats/installation of screens, light bulbs,etc.
Collection of samples will be taken during regularly scheduled visits. If additional sampling is
requested that cannot be completed during a regular visit,it shall be considered an additional service.
V. DIXON Shall Perform Inspection Services:
1. Review Contractor's crew size and equipment for ability to meet specification requirements
and time constraints.
2. Review abrasive and coating materials for approved manufacturers.
3. Inspect compressed air at blast nozzle for cleanliness(i.e. oil,moisture),
Page 3 of 7
4. Measure surface profile created by abrasive blast cleaning by compressive tape or surface
comparator.
5. Inspect abrasive blast cleanliness for specification requirements using SSPC Visual
Standards,latest edition thereof.
6. Review coating mixing,thinning, and manufacturer's application requirements.
7. Monitor environmental conditions prior to and during coating application(i.e. ambient
temperature,surface temperature,relative humidity,and dew point).
8. Inspect applied coating for dry film thickness,coverage,uniformity, and cure.
9. Collect appropriate samples for pre-disposal laboratory testing.
10. Prepare daily inspection report detailing above mentioned items and daily progress.
Page 4 of 7
SCHEDULE B
750,000 Gallon Fluted Column, (Southwest Tank), #49-71-06-03
Oshkosh, Wisconsin
1. Payment for Scope of Services,Schedule A—Technical Specifications, is the lump sum fee of
$3,200.00.
2. Compensation for Schedule A—Project Administration,shall be the time and material fee of
$1,500.00. Payment due as project progresses.
3. Compensation for participation at the pre-construction meeting shall be the lump sum fee of
$650.00,and will include preparation and travel time.
4. Compensation for weld inspection, Schedule A—Critical Phase Inspections is$650.00 based
on a$650.00 per visit fee with one visit(s)recommended.
5. Compensation for paint inspections, Schedule A---Critical Phase Inspections is $4,550.00
based on a$650.00 per visit fee with seven visit(s)recommended. DIXON reserves the
right to send the level of inspector they feel necessary based on the Contractor,project scope
and project progress.
6. DIXON will provide daily inspection services as outlined in Schedule A---Inspection Services.
Compensation for these services is$6,056.00,estimated using an average of five in hours on-
site daily. This time frame will vary based on Contractor speed, Contractor activity,
complexity of individual inspection,and environmental or neighbor concerns. DIXON
reserves the right to send the level of inspector they feel necessary based on the Contractor,
project scope,and project progress. All fees are time and material per Schedule C. DIXON
will notify the Owner bi-weekly of the"ESTIMATED"remaining budget,and will advise if a
change in fees or Scope of Services is necessary. The fee and Scope of Services are negotiable
between DIXON and the Owner.
Typical inspection schedule and associated rates:
Daily Inspection:
Travel time 3 hrs.@$75.00/hr. _ $225.00
Inspection time 5 hrs.@$75.00/hr. = 375.00
Mileage 180 miles @$0.60/mile = 108.00
Secretarial 0.5 hrs.@$48.00/hr. = 24.00
Contract Administration 0.25 hrs.@$100.00/hr. = 25.00
Total Estimated Daily Fee: _ $757.00
Estimated Daily Fee $757.00
Project Length x 8 days
Total Inspection Fee $6,056.00
7. DIXON reserves the right to adjust individual inspection line items as necessary based on the
Contractor's performance and pace of work. The total fees for Schedule B will not be
exceeded without prior approval from the Owner.
Page 5 of 7
8. Invoices will be compiled after the 201h of the month and shall include from the 20"'of the
preceding month to the 20't'of the invoiced month.
9. All DIXON service invoices which are paid within ten(10)days of date of issue shall be
discounted(Owner's favor)one percent(1%).
10.All DIXON service invoices which are outstanding more than sixty(60)days from date of
issue shall be assessed(DIXON's favor) one and one half percent(1'A%)per month interest
from date thirty(30)days after date of issue.
11.Delay in completing the work which is the responsibility of the Owner and which extends the
amount of time required for DIXON to complete their work shall be considered an additional
service,and DIXON shall be compensated for this delay under the provisions of Schedule C of
the Agreement.
12. Failure by the Contractor to notify DIXON of the necessity to change inspection dates more
than twenty-four(24)hours in advance and which results in unnecessary travel and/or expense
to DIXON shall cause this travel and expense to be considered an additional service, and
DIXON shall be compensated for travel and/or expense under the provisions of Schedule C of
the Agreement. This obligation will be included in the agreement between the City and the
Contractor.
13. Requests for attending council meetings shall be forthcoming from the Owner in writing unless
other arrangements are made between the Owner and DIXON. Attendance of council meetings
shall be considered an additional service and DIXON shall be compensated under the
provisions of Schedule C of the Agreement.
Page 6 of 7
SCHEDULE C
Engineering Services Fees
Labor Class Per Hour *Overtime Rate
Principal $175.00
Expert Witness(Office,Travel &Court) $185.00
Project Manager $100.00
Registered Professional Engineer $100.00
Certified NACE Inspector $90.00
Assistant Project Manager $80.00
Staff Engineer--Level III $72.00 to$85.00
Staff Engineer—Level H . $67.00 to$80.00
Staff Engineer—Level I $62.00 to$75.00
CAD Supervisor $65.00 to$75.00
CAWI or CWI Welding Inspector $67.00 to$85.00
Inspector—Level III $63.00 to$80.00
Inspector--Level II . $60.00 to$75.00
Inspector—Level I $55.00 to$70.00
CAD Technician $60.00 to$70.00
Secretarial Services . $48.00&expenses
Bookkeeping Services . $44.00
Project Status Meetings w/Project Engineers and Council or
Board Meetings Time and Expenses,
Including Preparation Time
*A11 Saturday, Sunday,and holiday inspections are overtime rate. Overtime rate is 1 %2 time the hourly
rate. Overtime rate does not apply to Principal.
Expenses:
Metropolitan Non—Metropolitan
Mileage $0.70/mile(including tolls)$0.60/mile
Meals &Lodging, $135 per diem $125 per diem
(may be increased based on location)
Without Lodging $35/day $30/day
Air Travel Business fare from Grand Rapids,
Chicago O'Hare,or Milwaukee,plus full size
car rental
Material(gaskets,cathodic protection caps,etc.) Negotiated
FEES EFFECTIVE THROUGH JUNE 30,2014
Revised 08/12
Page 7 of 7
��....N DIXONEI OP ID: LB
AL °" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDI0YYY)
02/1 312 01 4
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 poltcy(les)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:231-775-3416 NAME■CT
Bllck Dillon Insurance Fax:231-775-0817 �0� FAX
123 N Mitchell St P.O.B.389 IC N%o,Ext): I(AIC•No):
Padillac,MI ki � Cf °� ADDRESS:
Pete Sumin skl
INSURER(S)AFFORDING COVERAGE NAT°t
INSURER A:Auto Owners insurance Company 18988
INURED Dixon Engineering Inc +o 9 iQ INSURER B:Travelers Insurance Company
William Dixon A IN ttERC:US Specialty Insurance Company
La 4 3RD Ave B1-)6°C Lake Odessa,MI 48849.1191 ,
00-c, p5 , ,,15„— N RER s. -
05NK 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 LCLAIMS.
iTR TYPE OF INSURANCE ARSa MAW
WI POLICY NUMBER (MMID Y ) (MMIDLWYYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A r X COMMERCIAL GENERAL LIABILITY X 33007656 11/0112013 11101/2014 PREMISES SES(Ea commence)t $ 300,000
ICLAIMS-MADE I X OCCUR MED EXP(Any one person) 5 10,000
X XCU PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE f 2,000,000
GENT_AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000
—I POLICY n gel n 100 $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
(Ea accident) $
A X ANY AUTO X 9536751602 07/01/2013 07101/2014 BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
X HIRED AUTOS X MIX NED PROPERTY ident) AGE _
(Pe(accident)
$
X UMBRELLA MB X OCCUR EACH OCCURRENCE $ 5,000,000
A EXCESSLIAB CLAIMS-MADE 9536751603 11/0112013 1110112014 AGGREGATE s
DED I X I RETENTIONS WAIVED r0 wcsrATU- oTH• s
WORKERS COMPENSATION X I TORY LIMITS I X I ER
AND EMPLOYERS'LIABILITY IN
B ANY PROPRIETOWPARTNERIEXECUDVE Yr—i NfA 6JUB5B53814-2-13 10113/2013 10/1312014 E.L.EACH ACCIDENT s 500,000
OFFICER/MEMBER EXCLUDED? l
(Mandalory InN-1) E.L.DISEASE-EA EMPLOYEE $ 500,000
If qes descnbe under
DESCRIPTION OF OPERATIONS Debw E.L.DISEASE-POLICY MT $ 500,000
C Professional Liab USS1324111 07/0112013 07/01/2014 Ea Claim 1,0110,000
$25,000 DEDUCTIBLE Aggregate 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more apace le required)
When required by contract or written agreement, certificate holder and its
officers, council members, agents, employees and authorized volunteers
are included as Additional Insured by endorsement.
CERTIFICATE HOLDER CANCELLATION
CIOS001
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Oskosh THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Y ACCORDANCE WITH THE POLICY PROVISIONS.
215 Church Ave.
P.O.Box 1130 AUTHORIZED REPRESENTATIVE /�
Oshkosh,WI 54903-5100 7 4-r—P1-d, �
O1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD