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HomeMy WebLinkAboutShort Elliott Hendrickson, Inc 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. Thomas Henning Date: June 2, 2014 Short Elliott Hendrickson Inc. Subject: Executed Agreement 809 North 8th Street, Suite 205 Risk Management Plan Updates for Sheboygan, WI 53081 the Water and Wastewater Treatment Plants 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 risk management plan updates. 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 `_______ X96,.71-----Steve Brand —C opy cc: File—Original Signed: �' � Trac L Taylor "- I:\Engineering\Tracy Taylor\Steve Brand Agreements\SEH LOT-Executed Agreemnt-RMP Updates 6-2-14.docx AGREEMENT THIS AGREEMENT, made on the 2.b day of 01/4j , 2014, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and SHORT ELLIOTT HENDRICKSON, INC., 808 North 8th Street, Sheboygan, WI 53081-4032, 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 RISK MANAGEMENT PLAN UPDATES FOR THE WATER AND WASTEWATER TREATMENT PLANTS. ARTICLE I. PROJECT MANAGER A. Assignment of Project Manager. The CONSULTANT shall assign the following individual to manage the PROJECT described in this AGREEMENT: Thomas A. Henning — Project Manager/Senior Professional Engineer 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. 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. I:\Engineering\Tracy Taylor\Steve Brand Agreements\SEH RMP Updates Agreemnt_4-8-14.docx Page 1 of 5 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. CITY RESPONSIBILITIES The CITY shall furnish, at the CONSULTANT's request, such information as is needed by the CONSULTANT to aid in the progress of the PROJECT, providing it is reasonably obtainable from City records. To prevent any unreasonable delay in the CONSULTANT's work, the CITY will examine all reports and other documents and will make any authorizations necessary to proceed with work within a reasonable time period. ARTICLE VI. 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. ARTICLE VII. 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 4, 2014 and attached hereto I:\Engineering\Tracy Taylor\Steve Brand Agreements\SEH RMP Updates Agreemnt_4-8-14.docx Page 2 of 5 • 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 VIII. 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: • Lump Sum Not to Exceed $12,300 (Twelve Thousand Three Hundred Dollars). 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 IX. 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 errors, omissions, 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 refund for those actions, claim, and demands caused by or resulting from the errors, omissions, 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. I:\Engineering\Tracy Taylor\Steve Brand Agreements\SEH RMP Updates Agreemnt_4-8-14.docx Page 3 of 5 ARTICLE X. INSURANCE The CONSULTANT agrees to abide by the attached City of Oshkosh Insurance Requirements. ARTICLE XI. 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 XII. 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. ARTICLE XIII. 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. I:\Engineering\Tracy Taylor\Steve Brand Agreements\SEH RMP Updates Agreemnt_4-8-14.docx Page 4 of 5 • ARTICLE XIV. 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 By: t>ii,e' `y t/ //6 /- (Seal of Consultant (Specify Title) if a Corporation.) By: (Specify Title) CITY OF OSHKOSH By: 4.4;: z 1 �. /. i (Witness) ,4,. . -o - '�7 . ,: -nager 155157-,4 And: i4 ILA 1Ict (Witness) Pamela R. Ubrig, City C -rk APPROVED: I hereby certify that the necessary provisions - 6 have been made to pay the liability which itst will accrue under this AGREEMENT. ' ity Attor City Comptroller I:\Engineering\Tracy Taylor\Steve Brand Agreements\SEH RMP Updates Agreemnt_4-8-14.docx Page 5 of 5 RECEIVED SEH APR ° 82014 DEPT. OF PUBLIC WORKS April 4,2014 OSHKOSH, WISCOf'N City of Oshkosh RMP Updates for the Water and Wastewater Treatment Plants Steve Brand Superintendent of Utilities City of Oshkosh 215 Church Avenue,P.O.Box 1130 Oshkosh,WI 54903-1130 Dear Mr. Brand: Short Elliott Hendrickson Inc. (SEW)appreciates the opportunity to provide the City of Oshkosh (hereinafter referred to as the"City")with this Agreement for Professional Services(Agreement)to update the Risk Management Plans(RMPs)for the City water and wastewater facilities located in Oshkosh,Wisconsin. The following paragraphs summarize several key issues pertaining to complying with the U.S. Environmental Protection Agency's(U.S. EPA's)RMP and Process Safety Management (PSM)program rules. The City of Oshkosh uses chlorine and ammonia to provide disinfection in the water at the water plant and chlorine for disinfection at the wastewater plant. These chemicals are stored in quantities that exceed the respective applicability thresholds. Therefore,the City of Oshkosh prepared an RMP in accordance with 40 CFR 68 for the plants. The plans are required to be updated every five years. The next update is required by July 1,2014. SEH proposes to assist the City with updating the plans in accordance with the rules and submitting the updated plans as required before the regulatory deadline. SCOPE OF SERVICES This proposal is prepared under the assumption that the chlorine and ammonia systems at the City water and wastewater plants are regulated as Program 3 under the RMP rules. Program 3 applies to facilities that are subject to PSM requirements under rules established by OSHA. Task 1-Kickoff Discussion and Collection of Information Key members of the City and SEH project team will discuss the project,project objectives,data needs, completion schedule, and project team communication protocol. The approach developed during the kickoff discussion will be followed throughout the project. Following the kickoff discussion,the project team will gather information specific to subject systems that have changed since the last plan update. SEH has both electronic and hard copies of the existing RMPs in our files.However, SEH may request copies of sections of the current plans as necessary. Task 2-Perform Hazard Assessment Task 2.1 -Identify Release Scenarios As part of the update, SEH will re-evaluate the worst-case release scenario for subject chemicals at both plants. The worst-case release scenario is defined as the release scenario that gives the greatest distance to Short Elliott Hendrickson Inc.,809 North 8th Street,Suite 205,Sheboygan,WI 53081-4032 SEH is an equal opportunity employer www.sehinc.com 920.452.6603 I 888.908.8166 fax Mr. Steve Brand April 4,2014 Page 2 the toxic endpoint.U.S.EPA defines the worst-case release scenario for chlorine and ammonia as a 10- minute release of the entire contents of the largest vessel.Alternative release scenarios will also be identified. The alternative release scenario is a scenario which is more likely to occur than the worst-case scenario. Task 2.2-Conduct Modeling SEH will estimate the distance to the toxic endpoints for the worst-case and alternative release scenarios with U.S.EPA lookup tables or from modeling results published by the AWWA. The toxic endpoint is the farthest distance at which a concentration of 0.0087 mg/L chlorine or 0.14 mg/L ammonia is predicted. Task 2.3 -Identify Public and Environmental Receptors SEH will purchase a current"EDR Offsite Receptor Report"to estimate the residential population within the distance to the toxic endpoints.Institutions,parks,recreational areas,forests,monuments,wildlife sanctuaries,preserves,wilderness areas,and major commercial,office, and industrial buildings within the distance to endpoint will be identified. Task 2.4-Five-Year Accident History SEH will document a summary of all accidental releases that have occurred over the past five years at these facilities that have caused deaths,injuries,significant property damage,or environmental damage. Task 3-Update Process Hazards Review SEH will conduct a Process Hazards Review update for the storage and use of chlorine and ammonia and will modify the Process Hazards section of the RMP to incorporate the new review. The update will consist of a What If Analysis, and the completion of the Hazard Review Checklist for Program 3 processes published in the AWWA Compliance Guidance and Model Risk Management Program for Water Treatment Plants. This step is considered the most important step in the development of the RMP. Task 4-Compile RMP and Prepare Summary for Submittal to EPA Based on the information gathered in Tasks 1 through 3, SEH will assemble updated RMPs for the facilities. SEH will use U.S.EPA's RMP*Submit software to prepare electronic submittals that meet U.S. EPA requirements. SEH will also provide the City with hard copies of the plans to be kept on-site and made available to regulatory agencies and local emergency response personnel. OPTIONAL Task 5—Modify RMP Format to SEH Standard The formats of the two current RMPs are somewhat cumbersome and the organization of the RMPs makes finding information in the document time consuming. At the request of the City, SEH will reformat the two RMP's into a format that SEH has used for RMP prepared for several other water and wastewater clients. The format is easier to work with and will save the City time in finding information in the plans, and updating the materials that need updating. COST ESTIMATE SEH will execute Tasks 1 through 4 for a lump sum fee of$9,800. SEH will complete Optional Task 5 for a lump sum fee of$2,500. Work outside the scope of this agreement will be completed on a time and materials basis and will not be completed without your formal authorization. Mr. Steve Brand April 4,2014 Page 3 SCHEDULE SEH is prepared to initiate this project upon receipt of written authorization. The site visit and walk- through will be conducted as soon as can be arranged with the facilities,but will be no later than early May 2014. SEH will provide draft RMP/PSM plans to the City by late May. This timing will allow the City sufficient time to review and comment on the draft RMPs before the July 1,2014 deadline. Key Assumptions, Terms, and Conditions This scope of work is developed using the following assumptions: • The RMP will be updated for chlorine and ammonia at the water treatment facility and for chlorine and ammonia at the wastewater treatment facility; • The worst-case and alternative release scenarios have not changed,therefore,additional dispersion modeling is not necessary,or modeling results published by AWWA can be used; • SEH will provide one copy of the draft RMP/PSM plan for each plant for the City's review and two copies of the final RMP/PSM plans including recommendations; and • The City will authorize SEH to proceed with the project before April 20,2014. We look forward to working with you on this project. If you have any questions regarding our proposal, please feel free to contact Tom Henning at 920.287.0677 (thenning @sehinc.com) or Gloria Chojnocki at 608.270.5368(gchojnacki @sehinc.com). Sincerely, SHORT ELLIOTT HENDRICKSON INC. , Thomas A.Henning,PE, CHMM Gloria G. Chojnacki, CHMM Project Manger/Senior Professional Engineer Senior Environmental Scientist tah/GGC p:Vcob\oshko\ommoo\rmp update proposal april 20141oshkosh nap update proposal 3-31-14.doc Accepted by the City of Oshkosh By Date: Authorized Client Signature . 73905 ACO® e DATE(MM/DD/Yl'YY) �- CERTIFICATE OF LIABILITY INSURAICEIVE 4/29/2014 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 COV % V D BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN T Vj StIiIiG RER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsedtt,� f$ IN0311brt IS'W 'JED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statementb th1s'.cg ifiatM6y€.1not c er rights to the certificate holder in lieu of such endorsement(s). OSHIC PRODUCER NAME:CT Dorothy Stabler Commercial Lines-(952)242-3100 PHONE 952-242-3058 FAX (A/C.No,Est): INC.No): Wells Fargo Insurance Services USA,Inc. ADDRESS: dorothy.stabler @wellsfargo.com 400 Highway 169 South,8th Floor INSURER(S)AFFORDING COVERAGE NAIL# St.Louis Park,MN 55426 INSURERA: Hartford Casualty Insurance Company 29424 INSURED INSURER B: Nationwide Mutual Insurance Company 23787 Short-Elliott-Hendrickson,Inc. INSURER C: Sentinel Insurance Co.Ltd 11000 3535 Vadnais Center Drive INSURER D: St.Paul,MN 55110 INSURERS: INSURER F: COVERAGES CERTIFICATE NUMBER: 7647277 REVISION NUMBER: See below 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 LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 41 UUNAQ5367 10/01/13 10/01/14 EACH OCCURRENCE _ $ 1,000,000 CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $ 1,000,000 — MED EXP(Any one person) _ $ 10,000 PERSONAL&ADVINJURY _ $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Combined Total Aggregate $ 10,000,000 B AUTOMOBILE LIABILITY ACP7181965099 10/01/13 10/01/14 CO accident)SINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) _ $ — $ A X UMBRELLA LIAB X OCCUR 41XHUAQ3364 10/01/13 10/01/14 EACH OCCURRENCE _ $ 7,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 7,000,000 DED X RETENTION$ 10,000 $ C WORKERS COMPENSATION OTH- 41 WEBS7536 10/01/13 10/01/14 X PER AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT 1,000,000 OFFICER/MEMBER EXCLUDED? N N/A $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) City of Oshkosh,and its officers,council members,agents,employees and authorized volunteers are Additional Insureds with regards to General Liability and Automobile Liability when required by written contract with the insured. Coverage under the General Liability and Auto Liability are primary and non-contributory when required by written contract with the insured. A 30 Day Notice of Cancellation applies to all policies shown,except 10 days for non-payment of premium. CERTIFICATE HOLDER CANCELLATION City of Oshkosh SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 215 Church Avenue PO Box 1130 AUTHORIZED REPRESENTATIVE Oshkosh,WI 54903-1130 /� /— I 7 .`��"f The ACORD name and logo are registered marks of ACORD ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) (This cert ificate replaces cer66cater 6691261 issued on 10/2/2013) ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) nu OS/28/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: H. Robert Anderson & Assocs., Inc. PHONE No,Ext): 952.893.1933 FAX No):952.893.1819 8201 Norman Center Drive E-MAIL Suite 220 ADDRESS: INSURER(S)AFFORDING CEI E IV E NAIC Bloomington, MN 55437 INSURER A: XL Special ty Insuranc e Co. INSURED Short-El l iott-Hendrickson, Incorporated INSURER B: MAY Q C) 0 ')014, 3535 Vadnais Center Drive INSURERC: G St. Paul, MN 55110 INSURERD: INSURERE: DEPT. OF FUWI CONOSIN INSURER F: OSHKOSH r COVERAGES CERTIFICATE NUMBER: 10/13-14 PL 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. ILNTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD//YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ UAMAG*I KtNIEU COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE I$ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY^ JECT LOC $ AUTOMOBILE LIABILITY CUMBINLU SINULt LIMI I (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS AUTOS '(ROPERI Y Per accident)DAMAGE NON-OWNED $ UMBRELLA LIAR _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION S $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIV Ni A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ DsC RdIeuN OnF d OP ERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability DPR971002210/01/2013 10/0112014 Each Claim/ $5,000,000 A Annual Aggregate $10,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) This certificate or memorandum of insurance does not affirmatively or negatively amend, extend, or alter the coverage afforded by the insurance policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Oshkosh Department of Public Works 215 Church Avenue -AUTHORIZED REPRESENTATIVE PO Box 1130 tV.,4e--- Osl-kosh, WI 54903-1130 ©1988 4010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD