HomeMy WebLinkAboutCH2M HILL 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: Ms. Linda Mohr Date: March 4, 2015
CH2M HILL Engineers Sub'ect: Executed Agreement
135 South 84 Street, Suite 400 Air Permit Assistance and Generators
Milwaukee, WI 53214 Review
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
Quantit Descri tion
1 Executed A reement
These are being transmitted as indicated below:
❑ For Approval � For Your Use ❑ As Requested ❑, For Review 8�Comment
Remarks:
Enclosed is a copy of the executed agreement for the air permit assistance and generators review
services. 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.
Steve Brand —Copy
City Attorney's O�ce—Copy
City Clerk's Office —Original
cc: _ File —Original Signed:
Tracy . Taylor
I:\EngineeringlTracy TaylorlSteve Brand Agreements\CH2M Hill LOT-Air Perm Assist&Generators Review Executed A ement 3-4-15.do
AGREEMENT
This AGREEMENT, made an #he � day of �' , 2015, by
and between the C1TY �F OSHKOSH, par#y of the first part, hereinafter referred to as
CITY, and CH2M H1LL ENGINEERS, INC., 135 Soufh 84�' Street, Suite 400,
Milwaukee, Wl 53214, party of the secand part, hereinafter referred to as the
CONSUL.TANT,
WITNESSETH:
That the CITY and the CONSULTANT, for the consideratian hereinafter named,
enter in#o the following AGREEMENT for AIR PERMIT ASSISTANCE AND
GENERATORS REVIEW.
ARTICLE I. PROJECT MANAGER
A. Assignment af Project Manager. The GONSULTANT shail assign the
following individual to manage the PROJECT described in this AGREEMENT:
Linda Mohr, P.E. —Senior Project Manager
B. Changes in Project Manager. The CITY shall have the right to approve or
disapprove of any proposed change from the individual named above as Project
Manager, The CITY shall be provided with a resume or other information far any
praposed substitute and shall be given the opportunity #o intervisw that person priar to
any praposed change.
ARTICL.E 1L CITY REPRESENTATIVE .
The CiTY shall assign the following individuai to manage the PR4JECT
described €n this AGREEMENT:
Stephan Brand —Public UUorks Utilities Bureau Manager
ARTICLE IEi. SCOPE OF WURK
The C4NSULTANT shall provide the services described fn the CONSULTANT's
Scope of Sarvices. CITY may make or approve changes within the general Scope of
Services in this AGREEMENT. !f such changes affect CONSUL.TANT's cost of or time
required for perFormance of the services, an equitable adjustment will be made through
an amendment#o this AGREEMENT.
All reports, drawings, specificafions, computer #iles, field data, notes, and other
documents and instruments prepared by the CONSULTANT as instruments of service
shail remam the property of the C(TY.
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ARTICLE IV. STANDARD OF CARE .
The standard of care applicable to C�NSULTANT's services wilf be the degree
of skill and dillgence norma[(y employed by professional consultants or consultants
performing the same or similar seruices at #he time said services are performed.
C4NSULTANT will re-perform any services not meeting this standard without additPonal
compensation.
ARTIC�E V. OPfNfONS OF COST. FINANC(AL. CONSIDERATlUNS, AND
SCHEDULES
In providing opinions of cost, financiai analyses, economic feasibility proJections,
and schedules for the PROJECT, C4NSUk.TANT has no control over cost or price of
labor and materia(s; unknown or latent condttions of existing equipmen# or structures
that may affect aperation or maintenance cos#s; competitive bidding procedures and
market conditions; time or quality of performance by operating personnel or third
parties; and other economic and operationa( factors that may materially affect the
ultimate project cost or schedule. Therefore, it is understood between the partiss that
the CONSULTANT makes no warranty that ths G�TY's ac#uaE praJect costs, financial
aspects, economic feasibility, or schedu(es will not vary from CONSULTANT's opinions,
analyses, proJections, or estimates.
ARTICLE VI. RECORD DRAWINGS
Record drawings, if requ(red, will be prepared, in part, on the basis of infarmation
compiled and furnished by others. CONSULTANT is nat respanslble for any errors or �
omissions in the information from athers that the CONSULTANT reasonably relied upon
and that are incarporated into the record drawings.
ARTICLE VIf. CITY RESP�NSIBILIT(ES
The CITY shall furnish, at the CONSULTANT's request, such information as is
needed by the CONSULTANT to aid in the pragress of the PROJECT, providing it is
reasonably obtainab(e from City records,
Ta prevent any unreasonable delay in the CONSULTANT's work, the C1TY will
examine all reports and other dacuments and will make any authorizatians necessary to
proceed with work within a reasonable time periad.
ARTIC�E VIII. ASBEST�S OR HAZARD4US SUBSTANCES
If asbestos or hazardaus substances )n any form are encountared or suspected,
CONSULTANT will stop its own work in the affected portians of the PROJECT to permit
#esting and evaluation.
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If asbestos is sus�ected, CONSULTANT will, if requested, rnanage the asbestos
remediation acfivities using a qualified subcontractor at an additional fee and contract
terms ta be negot(ated.
If hazardous substances other than as�estas are suspected, CONSULTANT wilf,
if requested, conduct tests fo determine the extent of the problem and wi(f pertarm the
necessary studies and recommend the necessary remedial maasures at an addi#ionai
fee and contract terms to be negatiated.
CfTY recognizes #hat C(JNSULTANT assumes no risk andlor liabili#y far a waste
or hazardous waste site originated by other than the CONSULTANT.
ARTiCLE IX. ClTY'S INSURANCE
CITY will mafntain property insurance on aH pre-existing physlcal facilities
associated ir� any way with #he PR�JECT.
CITY will provide (or have the constructian contractor(s) provide) a Builders Risk
All Risk insurance policy for the full replacement value of aIl project work inc)uding the
value of all ansite C1TY-furnished equipment and/or rnaterials associated with
C�NSULTANT's services. Upan request, CITY will provide C�NSULTANT a copy of
such palicy.
ARTICLE X. TIME OF C4MPLETI�N
The wark to be performed under this AGREEMENT shall be commenced and the �
work completed within the time limits as agreed upon in the C4NSULTANT's Scope of
Servlces.
The CONSULTANT shail perform the services under th3s AGREEMENT with
reasonable diligence and expediency cansistent with sound professional practices. The
CITY agrees tha# the CONSUI.TANT is not responsibie for damages arising directly or
indirectly from any delays for causes beyond the CONSUL.TANT's control. For the �
purpases of this AGREEMENT, such causes include, but are not limifed to, strikes ar
other iabor disputes, severe weather disru�tions ar other natural disasters, faiiure of
perFormance by the CfTY, or discovery of any hazardous substances or differing site
condi#ions. !f the delays resulting fram any such causes increase the time required by
the C�NSULTANT ta perform its services in an orderly and efflcient manner, the
CONSULTANT shall be entitled to an equitable ad)ustment in schedule.
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ARTICLE XI. COMPONENT PARTS �F THE AGREEMENT
This AGREEMENT consists of the following camponent parts, ali af which are as
fully a part of this AGREEMENT as if herein set out verbatim, or if not at#ached, as if
hereto attached:
1. This Instrument '
2. CONSUl.TANT's Scope oi Services dated February 13, 2015 and
attached hereto
in the event that any provision in any af the above component parts of this
AGREEMENT conflicts with any provision in any ather of� the component parts, #he
provision in the component part first enumerated above shafl govern over any ather
component part which follows (t numericaily except as may be otherwise specifica(ly
stated.
ARTICLE XlI. PAYMENT
A. The Agreemant Sum. The CITY shal! pay to the CONSUI.TANT far the
performancs o# the AGREEMENT fhe tatal sum as set forth below, adjusted by any
changes hereafter mutually agreed upon in writing by the par�ies hereto:
• Time and Materials Not ta Exceed $21,450 {Twenty-�ne Thousand Four
Hundred Fifty Dollars).
• Attached fee schedules shatf be firm for the duration of this AGREEMENT.
B. Method of Payment, The CONSUI.TANT shali submit itemized mon#hly
statements far services. The CITY shali pay the C4NSULTANT within thirty (30)
caiendar days after receipt of such statement. If any statement amount is dispu#ed, the
CITY, may withhold paymen# of such amount and shall provide to CONSUI-TANT a
statement as to #he reason(s)for withhalding payment.
C. Additianal Costs. Costs for additional services shaN be negotia#ed and set
forth in a wri#ten amendment to this AGREEMENT executed by both parties prior fo
praceeding with the work covered under the subject amendment.
ARTICLE XIII. HOLD HARMLESS
The C4NSULTANT covenants and agrees to protect and hold the City of
�shkosh harmiess against ali ac#ions, claims, and demands which may be to the
propartionate ex#ent caused by or result from the Intentianal or negfigent acts of the
CONSULTANT, his/her agents ar assigns, his/her emp(oyees, or his/her subcontrac#ors
related however remately to the perfarmance of thls AGREEMENT or be caused or
result from any violation of any law or administrative regulation, and shali indemnify or
refund to the CITY a(i 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
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� within thirty (30} days of the date of the CITY's written demand for indemnification ar
refund for those actions, claim, and demands caused by ar resulting from intentional or
negligent acts as specified in this paragraph. �
Subject to any limifations contained in Sec. 893.80 and any similar statu#e, of the
Wisconsin Statutes, the C1TY further agrees ta hold CONSUI.TANT harmless from any
and all liabitity, including claims, demands, losses, costs, damages, and expenses of
every klnd and description (incfuding death), or damages to person or property arising
out of re-use of the documents withouf cansent where such Ilability Es #ounded upon or
grows out of the acts or omission of any af#he officers, empiayees or agents of the City
of 4shkosh whiie acting within the scope of their employment.
ARTICLE XIV. INSURANCE
The CONSULTANT agrees to abide by the attached Cify of Oshkosh insurance
Requ�remenfs.
ARTICLE XV. TERMINATI4N
A. For Cause, If the CONSULTANT sha[I fai( to fuifll in time(y and proper
manner any of the obligations under fhis AGREEMENT, the CITY shall have the right to
terminate this AGREEMENT by written notice to the CONSUL.TANT.. In this event, the
C�NSULTANT shall be entitled to cornpensatlon for any satisfactory, usable work
completed.
B, �or Convenience. The CITY may terminate #his AGREEMENT at any time
by giving written natice to #he CONSULTANT na later than ten {10) calendar days
before the termination date. If the CITY terminates under this paragraph, then the
GONSULTANT shall be entitled to compensation for any satisfactory work perfarmed to
the date of termination.
This document and any specified attachments contain all te�ms and conditions of
the AGREEMENT and any alteration thereto shafl be invalid unless made in writing,
s�gned by both parties and incorparated as an arnendment to this AGREEMENT. �
ARTICI.� XVI. RE-USE C}F PROJECT DOCUMENTS
All reports, drawings, specifications, documents, and other deliverables of
C4NSULTANT, whether in hard capy�or in electronic farm, are instruments of service
for this PR�JECT, whether the PROJECT is campleted or nat. CITY agrees to
indemnify C4NSULTANT and CONSULTANT's off(cers, employees, subcontractors,
and affiliated corporations from all claims, damages, losses, and costs, including, but
not limited to, litigation expenses and attorney's fess arising out of or related to the
unautharized re-use, change, or alterafion of these project documents.
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ARTfC�E XVII. SUSPENSION DELAY OR tNTERRUPTION OF WC}RK
CITY may suspend, de[ay, ar interrupt the services of CONSULTANT for the
convenlence of CITY. In such event, C�NSULTANT's contract price and schedule shall
be equitably adjusted. .
ARTICLE XVlll. N�THIRD-PARTY BENEFICIARIES
This AGREEMENT gives no rights or benefits to anyone ather than CiTY and
C�NSULTANT and has no third-party bene�ciaries.
In the Presence af: CQNSULTANT
. By:
�1� �i��,s�w�F��i�
(Seal of Consultant (Specify Ti#le}
if a Corporation.)
By:
(specify Titls)
CITY OF OSHKOSH �
By: ���-�
{VVitness) Marlc A. Rohioff, City Manager
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. .- RECI:IVED --- -
SCOPE OF SERVICES
��� � `���J��
Air Permit Assistance and Generators �,+���s��r���;��s N�
Task 1 - Air Permit Assistance
Under the City af�shkosh(City}Type A Registration Permit Coverage Number 471005920-ROPA issued
by the Wisconsin Department of Naturai Resources(WDNR) in January 2014,the City is required to
perform an annual compliance audtt to determine compiiance status with each permi#requirement.
CH2M NILi.wll!conduct and document the annual campliance audit and review the City's recard
keeping plan.CH2M HILL will complete the annual campliance certification reports and monitoring
reports for submission to WDfVR by February 26, 2015.CH2M H1LL will respond#o WDNR review
comments on the submissian.
Task 2 -- Generators Review
CM2M H1LL will review the grounding pravisions for each portable emergency generator used at the
wastewater iift stations.CH2M HlLL wil)discuss wi#h wastewater treatment piant personnel ihe
operatian of the generators at the lift stations served to document potential lnconsistencies in
operation or passible safety issues. CH2M Hill will document in a dra#t technical memorandum its
review and recommendations for patential needed improvements by April 24,2015.CM2M HILL will
meet with the City to discuss the City's review comments on the draft memorandum.CH2M H1LL w11!
submit a final memorandum incorporating the City's camments to complete the wark by May 15,2015.
Task 3 -- Project management, quality assurance/quality contro[
Project management and quality assurance/quality cantroi activities include:
ProJect management.The praject scope of services wiil be managed through frequent team
communication vla meetings,telephone calls,and e-mail. ProJect casts w111 be controlled through
monthly reviews and reporting to the City. �
Quality Control/Quality Assurance(QA/QC).QA/QC reviewers wfll suppart technical staff and review
completed work prior to submission ta the City.
Leve! of Effort and Compensation '
7he estimated level of effort far the scope of services is 14�hour and proposed compensatfon, $21,450.
TABLE 1
Esttmated Isvel of effort and compensation
' 9.nar
ProJ�ot Q/VQC QAI4C proJact Proj�et ProJeet
.... _.
M:pa r R�vi�wrr �vl�w�r �r im�r CkrMd AccamiwM
rr�o r w� ua TatdLabor TotaiHours ToUI Toulby
iukDasc tfon Mohr BtpO�s Uok� Wood WaMr CiNrw T�ri 7ask b Ta�k Enptns� T��k
,Pk{,. . �L,��-
.411S��.Q4,'., i�`..> -: .., . �F-��._. �� �,...},�W�F�>. �.3�I{.�'s=� : � ; '��� `,�►� ��, . k�^•,`.**.,. *'r�ne �d^'�;��,rcE"�. ?;"w�a;. x "+r.:�� .';
vx�?....+.:r .a ��._�..
P ect M ent g � � 0 � „:D 20 i3.180 2! 3200 •i3a80
q�{ pgg�g�e/Q�� �rq 8 12 0 0 0 0 53,580 20 33,680
$ubtotel a a 12 6 0 0 20 ;8,T10 48 5200 SS,i10
,,�I;P��1��1�rs�`'f�,3, ".i;. .�rk..,.-, �1 a?IO�H1 y{. �` zs����x,.�,„, � 1�.?�� .��f � '�'�',+F ,� � .� m` �'�,�'*�'�'� <.,.,�,�'f -
NfPeqS�ftA33ilt&k9 4 0 4D � 0 37,f40 !'�B 37.140
ca��Tl��[!��'14Y[s ,:e�g � a� nt }ip`t�a 3 st"' ,�a � }� . a � z r` � {�,yy � f� a. �r y x�a "rP„,, � ,� v k.
��x s..°.'ay''a � a 7-�:�: ,�}t� ..��:f _,a a'!'R;�:; ,..Y t ..,r , :�.�+s�.,�t 4,r�' ..a�;;x
Gtx�eralots Re�laN 4 0 40 4 0 77.t�0 18 5230 57,370
Totif �� 6 S2 40 �{0 i 2d ;21,OY0 114 f430 321,�d0
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CERTfFIGATE �F LtABiLITY �NSURA�CE ����,
TFitS CERTlFtCATE IS 15SUED AS A A'iATTER OF INFORfJfATlON ONLYANp CONFERS NO RtGHI'S�II�;OM;�H . �IFtCQ7E HdLpER.TH(S
CERTIFICAT� QOES NOT AFFIRMATiVE�Y OR NEf3A71VEI.Y AMEND, EXTENp QR A[.7ER THE COVERAGE AFFORDED BY 7fiE POLICIES
BELOW. 7HIS C�R7[FICA7E OF INSURANGE DOES NOi' CONSTlTUS� A CONTRACT BET�1��•1�{�9�U��l�CIt�SU�R�S), AUTHORIZED
REPRESENTATIVE OR PRQQUCER,AND 7FtE CER7IFICATE HOLDER. . vY
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the ferms and condtflons of fhe pollcy,cerfafn polialss may requlre an endorsemenf. A statamenf on ihIs certlticate does not confer rtghfs to the
certittcata holder tn tleu of sucb endorsement(s. • '
PRODUCBR CONTACT
MARSH USA INC.P a��E:
t225 iTTN STREET,$UITE 130D1 P ONE = c o•
DENVER,CO 80202•5534 E•}dA1L '
. � StSSURER 3 AfFOR01f1O COVERAGE NAIC 0
161f4•42345•5EX2P•14116 025825 BK �NSUREaA:GreenvrichlnsuranceComFanY 22322
ItJSURED lNSURER B t�A WA
CH2M HILL ENGINEERS,U�tC,i �insurancepmeris���no, � 2d554
9127 SOUTH JAAIAICA STREEp � 1NSUaeR c;
Et�lOLEWOOD,CO BOS12 � ihsuRea�:2urkhAmeiican lnsurance Co 16535
fMSURER E:
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IiVDIGATED, NOTWITHSTANDING ANY RE4UIREtviENT,TERM OR CC)NOI710N OF ANY CONTRAC7 OR OTHER DOCUMEN7 WCfti RESPECT 70 WHICt!THl3
CER71FlCATE MAY BE ISSUEO OR H1AY FERTAtN,7NE 1NSURANCE AF�ORDED BY 7HE POLtCIES QESCRIBED HEREiN tS SU9JECT TO ALL 7HE TERMS,
EXCLUSIONS AND CONDfTlQNS OF SUCH POL(CiES.LIMITS SNOWN MAY NAVE BEEN REDUCED BY PAIp CLAIhA3.
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cITY OF osHKOSH,ANO ITS oFFICERS,CoUNCtI ME1d8ERS,AGENTS,EMPLOYEES AND AUTNoRizED VoLUNTEERS ARE iA'cLUDED AS AM ADDIit�NAl.INSUREO ON i}tE cErlEaAl LWBtLIiY
AND AUTOtAOBILE L(ABIIITY POLICIES AS REQUtREQ BY YlWTTEN CONTRACT ORAGREEAtENT:•FOR PAOPESSIOMAL LIABlU7Y COVERAGE,TNE AtiGREGA7E UMIT IS 7HE TO7AL 3NSURAAlCE �
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CERTiFfCATE H�LDER CANCEL4ATlON
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215 CNURCFi AVENUE,PO 84X 1130P '
OSNKOSH,Y!f 54903•1130 AUTFtOR11E0 REPRESENTATIYE ,
� o!tAarab USA lna.
SharonA.Nammer ���ti Q-�a^r+-��v
�9888•ZOiO AGORD CORPORATION. A1!rtghfs reserved.
ACORD 25(2010/05j� 7he ACORD name and fogo are registered marks of ACORD
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ENDORSEf�EhlT#041 -
This�endorsement,effecfive 12:01 a.m.,May01,2QS4, iorms apart af
PofioyNo.RG�6000�5503 by Green��foh lnsurarice Comparty
issuad to CH2M Hl LL COMPANlES, LTf�. .
7H15 ENRORSEMEN7 CNANOESTHE POLICY.PLEASE READ l7 CARE�ULLY
. AUTON1,47tCADDITfONAC.IhtSUR6D"S PR{NiARY CdYERAG� .
This endorsement madities lnsurance provided under tha tollowing:
CON6VlERCtAL GENERAL LlAB1LIiY GOVERAGE PART '
With respect to coverage prwided by this endorsement,the provfsions af the Coverage Part apply unless
. modliied by this endorsement. �
SCH EDU LE
Name Of Additional Ittsured Person s Or Or an3zafion Location s crt Covered O srations
Any entEfy,person or arganlzation.yau are requfred All Locafions
by any contract,permlt,aacess agreement, ,
exeouEed prlar to any lass to provide additional
insured stafus underfhis Polic .
� A. Section !I—V1fio 1s an fnsured is amended to lnelude.as an additlonal tnsured the person(s)or
Organlzation (s) sha�n In tha sohedufe and any ather persan(s) or organizatian(s} you are
requtred fo add as an additforial insured under the contract, perrnit or access'agreement
described ln the schedule bat only with respeot to liabllity for "bodily fnJury�' ar "property
demage"or"personal and advertlsing injury aaased,(n whols or in patt by: .
9, °Bodity InJur�,°property damage"or°personal and advertising injury"aaused by tha ya�r
operations on the additional lnsured's premises or
2, °Yourworlc"for the addifionaf lnsured and lncluded ln Ehe°products-completed operatians '
hazard°;ar
3. Your aots or omissians;or
4. The aots or omissions ofthose aottng on your behalf.
As reseots 2,3,artd 4 the folfowfng also applles fn the performance of your ongoing
operations for the addltional�nsured(s)at the location(sj designated above.
F(owever:
MANUS. 4 20id X.l..Ameriaa, Ino. Afl Rights Reserved.
� May not be copied without permfssion.
i,the insurance allorded fa sudt additlana!lnsured(s)onJy appties fo the extent permifted .
by law;and �
2. (f ooverage provided to the additfonaf Jnsured(s}fs requlred by a aonkract,permft or
acaess agreement,the insutance afforded to suctl additional Insured(s)�vil1 not be broader .
fhan ihat which yau are tequired hy ttte aontract,permit or access agreement Eo provide
for such aciditfonal insured(s)
' B. Only when requlred by a oontract,perm�or access agreemenk thls insurance appiies to:
i. (a)Afl work an the project(other than servtce,mafntenance or repafrs}fo be performed by
or on behaJf of the additional lnsured(s)at ft�e siEe o{the aovered operafions has been
oompleted;or(b)Thak portion oi your work ouE of�vhich the inJury or damage arlses has
been put to Its iatended use by any parson or orgarrization other than ar�other conEracEor
or subcontractor engaged in periorming operatlons tor a princfpal as part of the same
project,
2. "Bodily Injuty"or"Property Damage arfsing out of any act ar omission oi the additiona(
insured(s)or any oi their employees,other than the general supervislon of work
performed tortFie additior,al Insured(s)by you.
However: ' �
3.7Me insurance afforded to such additionaJ insured(s)only applfes to the extent permitted by laW and
4 If ooverage prov�ded to tt�e additional insured(s)is requlred by a oonfraof,permik or access
agreemenf,thelnsurance affarded to such addltlonal insured(s)tvfl)not be broadar than that whiot�you
are requfted by the oontract,permlt or acaess agreement to prov3de ior such'addltfonal insured(s).
C. Any enverage provided hereunder shal!be excess over any othe�valld and co�(ectibla lnsuranoe
availabie to the additional insured(sj whether prlmary,excess,aontfngent or on any other basJs unfess a _
cantract spe�cally�requfred that thfs insurance be primary,ar you request that it apply on a primary •
basfs.When th(s lnsuranoe applles on a primarybasis for ihe additiona(Insureds descrl6ed abtave,it sha(f
�apply anfy to"bodily injury','property damage` or "persanal and advertising Injury'oa�sed by your work
for that additlonal insured by ar for you.C3ther fnsuranca affordsd fo those addifianal insureds�v�ll appfy
as excess and not contribute as primary to the insuranae�allotded by this endnrsement. •
The limtts oi, Ensurance wi#h respect to each person,organizaf(on or.entiry shal(aot exceed the limits ,
of Nabfllty ai the namsd insared Al! insuring agreements, exclusions and conditions o!fhls polioy �
appfy, ln no event, shali the coveraga or limits ot tnsuranae!n this coveraga form tre increased by
such contract,permit ar acaess agreernent.
At!other terms and condltions rematn tFra same. . � �
' �,���`t rzusj
C�
� Authorfzed Re�resentative '
MANUS O 201d X.L.America,Ino. AU Rights Reserved.
May nat be copied vrithoat permissitm,
Signed for and in behalf of the City of Oshkosh
,— ___ � .
`\\ `,� M
� , i ,Z
Pamela R. Ubrig, City Cler
n orenson, A orney
�
.
�d.Y�(�U�Q,4'1�' �S�S?'� ��Q�� �1�-G�,
I hereby certify that the necessary provisions
have been made to pay the liability which will
accrue under this contract.
�.���e C��f I�,Q'')�
3 ���� �a� �U
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