HomeMy WebLinkAboutMinnesota Elevevator ♦
ELEVATOR MAINTENANCE SPECIFICATIONS &AGREEMENT
COMPLETE MAiNTENANCE
ELEVATOR MAINTENANCE AGREEMENT
Purchaser; �levator Service Provider:
City of Oshkosh Minnesota Elevator, Inc.
215 Church Avenus 19336 607t"Avenue
PO Box 1130 Mankato, MN 56001
OshEcosh,Wisconsin 54903-1130
Purchaser is procuring Elevator Service Provider's professional expertise to perform proactive Complete
Maintenance elevator service. This service is intended to promote safe operation, minirr�ize shutdowns
and the disruption of service, and to maximize equipment life and usage of this equipment through a
systematic Complete Maintenance elevator service program.
The Eievator Service Provider sf�aEl provide Complete Maintenance elevator service for the Purchaser on
the elevator equipment(herein called conveyances)at the locations referenced below in Oshkosh,WI.
k ..BUJLDI,{�G ' . ° ;. - LOCATION DRIVE TYPE , STAT��10 , �UIIN FREGj
City Center Hote1 Parking 1 N. Main Sf. Direct Hydraulic 19159 Monthiy
City Nall 215 Church Ave. Traction 16870 Manthly ,
Grand Opera Mousa#1 lift 100 High Ave. Screw HL00734 Quarterly
Grand Opera Mouse#2 pass 100 High Ave. Direct Hydraulic 27002 Quarterly
Public Safety Bldg#1 public 420 Jackson St, Direct Hydraulic 97286 Bimonthly
Public Safety Bldg#2 old jail 420 Jackson St, Direct Hydraulic 17287 Bimonthly
Park Plaza Convention Ctr 2 N. Main St. Direct Hydrauf�c 18825 Quarterly
EX7EN7 OF COVERAGE
This Agreement consists of a proactive and schedulad examination, cleaning, lubrication, adjustment, and
repair service at the intervals specified above. The Elevator Service Provider shall also repair or replace
worn or defective components on these conveyances due to ordinary wear and shall provide original
equipment manufacturer(OEM}parts or equivalent qualify.
A partial listing of covered component groups is found below. Nowever efevafors contain hundreds of
parts and components, all of which are not listed. Components are covered unless excluded in the
Exclusions from Agreement section:
• Controllers, including all components including printed circuif boards, software, drives, and
emergency lowering systems.
• Signal fixtures, including relamping on regularfy scheduled visiYs and emergency lighting.
• Power units, pumps, motors, control valves, exposed piping, shutoff valves, overspeed valves,
belts, bearings, seals, mufflers, etc, plungers, and packings.
• Car and hoistway doar operating devices and doar protection equipment.
• Car, car frames, platforms, guide shoes, limit switches, Eanding positioning systems, traveling
cables, fans, and other car or hoistway devices.
7he Elevator Senrice Prvvider shall immediafely make repairs needed to correct existing malfunctions or
potential malfunctions that can be determined by reasonable examination methods, and to be on call to
make such repairs if and when malfunction or failure shouEd occur. Repair work shall be pursued during
regular working hours without interruption until complete, unless over#ime is s�ecifically authorized by
Purchaser,
7he Elevator Service Provider shall furnish all trained personnel, tools and equipment, diagnostic and
troubleshooting software and hardware, and supplies to perform Comp(ete Maintenance elevator service.
MINIMUM INSPECTI�N FREQUENCY
Maintenance services shall be performed a minimum of 12 times per year on each of the conveyances
specified above as monfhly at approximately 30 day inte�vals befween inspections, a minimum of 6 times
per ysar on each of the conveyances specified above as bimonfhly at approxima#ely 61 day intervais, and
a minimum of 4 times per year on each of the conveyances specified above as quarterly at approximately
91 day intervals.
TERM OF AGREEMENT
This Agreement is effective April 1, 2095, and shall be for a 7HFtE� year term until March 31. 2018
unless cancelled by Purchaser for non-performance. The City of Oshkosh will have up to two options for
one year renewals at their sole discre#ion. There shall be no automatic renewal of this agreement,
however, it is subject to renewal if agreed fo by both parties in writing. See price escalation in
AGREEMENT PRICE section for years 4-5.
In the event a building, or area therein, is vacant, unaccupied, sold, underutiiized, or elevators removed
from public service for modernization, or for any other reason, Purchaser may suspend maintenance
service on all or a portion of the conveyances. The total billing shall be reduced proportionally to
compensate Purchaser for the periad of suspended service.
Equipment additions and dele#fons and the subsequent price adjustments to the Agreement shall be
made by means of the Maintenance Agreement Addendum, found at the iast page of this Agreement. In
fhe event of conflic#ing terms with Elevator Service Provider's proposal(s), the terms contained in this
Agreement shall govern.
AGREEMENT PRICE
7he price for the service as described in this Agreement shail be $10,524 (Ten fhousand five hundred
twent,y four dollars), payable an, nually in advance upon receipt of the invoice. Bid price shall reflect an
annual prepayment discount.
The Agreement Price shall be fixed at the bid price for the initial three vear term. If one or more of the
one year renewal options are exercised by the City of Oshkosh, the Agreement Price may be adjusted
annually on the April 1 effective date of this agreement, beglnning on Apri! 1, 2018, based on the
percentage increase or decrease in the Local 15 (or iYs successor) straight time hourly labor cost,
including benefits for iUEC �levator Constructors, which include but are not limited to, pensions, group
life insurance, sickness and accident insurance, and hospitalization insurance. However the maximum
annual price increase in years 4-5 (if one or more of the one year renewal options are exercised by the
City of Oshkosh) shall not exceed 4%. The straight hvurly labor cost applicable to this Agreement is
$73.235, of which $28.685 constitutes benefits plus vacations and paid holidays. See also OTHER
PRICING section foradditional pricing.
For payments 30 days past due, a delinquent payment charge calcu(ated at a maximum 1-1/2% per
month may be applied to delinquent payments, unless the Elevator Service Provider's invoice has been
disputed in writing by Purchaser.
HOURS OF SERVICE
Afl work will be performed during regular working hours of regular working days of the elevator trade,
unfess specifically authorized by Purchaser. The Elevator Service Provider shall respond to callbacks
during regular working hours at no extra charge to Purchaser as part of the Complete Maintenance
agreement.
Emergency callback service shall be provided promptly upon request from authorized representatives of
Purchaser, at any hour of any day o#the week requested. Authorized callback service outside of regular
working hours will be provided in addition to the Agreement price, at the difference between the
applicable overtime and regular tirrze rates provided in this Agreement.
MINIMUM MAINTENANCE TIME
The Elevator Service Provider's minimum quantity of hours on site per inspection performing Complete
Maintenance elevator service shall be sntered on the Bid Form. Failure to .fcalfill the minimum
maintenance hours shall be construed as failure to perform the services required by this Agreement.
WARRANTY
Elevator Service Provider's (Contractar's) warranty is limited to the repair or replacement, of defective
materiais and fhe correction of defective workmanship within a reasonahle time for defects that are
reported to them during the term of this contract. However, Elevator Service Provider shall make any and
a(I repairs or replacements to equipment damaged by Service Provider's improper repairs, adjustments,
negligent acts or omissions, or willful misconduct without additional cost to Purchaser. This warranty
excludes damage due to external causes such as fire,water and weather, improper use, misuse, or work
by others. THIS WARRANTY!S GIVEN IN LIEU OF ALL OTHER WARRANTIES, EITHER EXPRESSED
OR IMPLIED, INCI.UDING ANY WARRANTY OF MERCHANTABILITY OR FITNESS F'OR A
F'ARTICULAR PURPOSE.
PURCHASER'S RESPONSIBILITI�S
At all titnes, Purchaser shall retain exclusive possession and control of the equipment as owner, lessee,
possessor, or custodian. Purchassr agrees to provide unrestricted access to the equipment and a safe
warkplace for the Elevator Service Provider's employees, and to kesp the machine rooms free from
stored materials, and pit areas free from water.
CONDi710NS OF SERVICE
Maintenance service shall be performed by skilled and trained employees of the Elevator Contractor and
shall not be subcontrac#ed. Services provided shall include ail labor, trained personnei, transportation,
tools and equipment, replacemenf parts, repair service, diagnostic and troubleshooting equipment and
technical product manuals for servica provider's use; lubricants, cleaning fluids and cleaning supplies;
employee safety equipment and training, supervision, applicabie taxes, and other work or material
required to perform work under this Complete Maintenance Agreement, whether or not expressly stated.
The Elevator Service Provider agrees to indemnify and hald harmless Purchaser (and their agents and
employees) from alI claims or losses occasioned by personal injury or property damage to the exkent
caused by Elevator 5enrice Provider's (or their agents or employees} negligent acts or omissions during
pertormance of work, but not to the extent caused by others. Elevator Service Provider's indemnification
shall include reasonable attorney's Fees, court costs, etc. Elevator Service Provider shall also indemnify
Purchaser for Elevator Service f'rovlder's utilization of electronic diagnostic tools during the perFormance
of Complete Maintenance elevator service under this Agreement. fn no event shall either party be liable
for special, indirect, or consequential damages of any kind.
Under no circumstances shall either par#y be liable for any loss, damage or delay due to any cause
beyond either party's reasonable control (except for ordinary wear and tear}, including, but not limited to,
acts of governmenf, fire, explosion, theft,weather damage, floods, water, earthquake, or acts of God.
The Elevator Senrice Provider shall not be liable for any Ioss or damage caused by strikes, lockouts, or
other cause which is beyond their reasonable control. However, fn the event of a strike or Iockout,
Purchaser may suspend payment or proportionally reduce payment to compensate for a reduction in
maintenance services received, such as, but not limited to, less maintenance time than required by this
Agreement, or if temporary services are provided by personnel substituted for the licensed, trained IUEC
work force.
If any provlsion or portion of this Agreement is declared or held to be invalid, unenforceable, or prohibited
under applicable law, the validity or applicability of the remainder of this Agreement shall be valid and
binding.
Neither this Agreement nor any obligation to be performed under this Agreement may be assigned by
Elevator Serv+ce Provider without the prior written consent of Purchaser.
.� .
Subcontracting shali not be permitted for Complete Maintenance elevator maintenance without the written
approval of Purchaser, except for repairs to pumps, valves, and motors at an electrical or machine shop
facility.
AH information, opinions, recommendations, reports, or other information are ta be treated as confidentiai
by Elevator Service Provider, who shall not disclose either directly or indirectly to any third party without
Purchaser's written consent, except as required by Elevator Code or law. However Purchaser is a public
entity, subject to open records laws. According to such laws, the Purchaser's records that are held by the
Elevator Service Provider may be subject to public records laws. The Elevator Service Provider agrees to
fully cooperate with all public open records requests upon notification by the Purchaser.
Elevator 5ervice Provlder's personnel musf be trained in the construction, maintenance, repair,
inspection, and testing of the equipment on which they wii! be working, and their work force shall be
equipped with the skills, tools and equipment, supp(ies, documentation, ongoing product training, and
equipment to properly troubleshoot and repair the conveyances as contemplated by this Agreemanf, all at
no additional cost to Purchaser. No Temporary Mechanic (hereafter TM) shall be assigned maintenance
work under this Agreement unless appraved by Purchaser. However, a TM may be assigned repair work
required by this Agreement.
The Elevator Service Provider shall be solely responsible for initiating, maintaining, and supervising all
safety precautions and prograrris; for providing ali safety #raining to their employees in compliance with
applicable State, Federal, and local requirements; and shaEl be in conformance with good industry
standards and practices, and take all reasonable precautions for the safety of property, employees, and •
the general public.
Alf work shall be performed promptly, compfetely free of defects, and in conformance with good industry
standards and practices, and the original manufacturer's specifications.
Elevator Service Provider shall comply with Purchaser's reasonable sign-in and sign-out procedures.
The Elevator Service Provider acknowledges that it has inspected and Is famiiiar with the scheduled
equipment, agrees to accept the equipment in its existing condition and assumes all responsibility for
�epairs and maintenance of the equipment.All work shall comply with the Elevator Code requirements in
effect, currently the Wiscansin Administrative Code Chapter SPS 318 (revision effective 9/1/2014}, and
ASME A17.1-2013(incorporated by reference into SPS 318), and their successor codes when adopted in
Wisconsin during the term of this contracf.
ON-SITE DOCUMENTATION AND MAINTENANCE RECORDS
The Elevator 5ervice Provider is 5olely responsibfe for all A17.1 8.6.1 General Maintenance
Requirements, inciuding a written Maintenance Control Program, On-Site Documentation, and On-Site
Maintenance Records. A record of work performed shalf be documented in writing at the time vf each
visit, and must be kepf in the elevator equipment room
The Eleva#or Service Provider shalf be responsible for the quarterly testing and written record of
Firefighters' Emergency Operation, including Phase I recall and minimum one-floor operation on Phase I I.
The Elevator Service Provider is required to keep a written record documenting the quantity of hydraulic
fluid added to the system and emptied from Ieakage colfectlon containers and pans. The written record
shall be kept in each machine room, anct oil level recorded on a quarterly basis at a minimum. When the
quantity of hydrau(ic fiuid loss cannot be accounted for, additional testing as required by Elevator Code
shall be conducted at no additional cost to Purchaser.
Maintenance record format is subject to appraval by Purchaser and hard copy records shall be archived
in the machine room and are to be considered property of the Purchaser. The maintenance record must
remain in Purchaser's possession after termination of this agreement and shall include the following:
1. On-Site Documentation
2. Mainfenance Control Program Records
3. Repair and Replacement Records
4. Other Records, including a written documentation of hydraulic oil level on at ieast a quarterly
basis, quarterly testing and written record of Firefighters' Emergency Opera#ion, and records of all
Periodic Tests.
5. Documentation for testing of emergency systems, including alarm, emergency light and alarm,
car telephone, and door restrictor on at least a quarterly interval.
Failure to keep and retained the required records shall be construed as failure to perform the services
required by this Agreement.
EXCLUSIONS FROM AGREEMENT
7he Efevator Service Provider is not responsible or liable for the cost of adjustments, repairs, or
replacements necessitated by vandalism, or by negligence or misuse of the equipmen# by anyone other
than the Elevator Service Provider.
Other work specifically excluded from the Agreement includes:
• The repalr,refinishing,or replacement of cer and hotstway door panels,car door sllls,car gates,or hoistway
entrance frames and sills. However,Elevator Service Provider shall repair damage fo car and hoistway
door(s)and gates,entrance frame,sills,or enclosure finish when caused by improper adjustment or
maintenance of the associated equipment.
• Car enclosure panels and finishes,hancirails,ceilings,permanent car enclosure lighiing and lamps for car
iliumination,car finish flooring,and cleaning thereof.
• Hoistway and machine room enclosures,Ilghiing,heating,veniilation,pit ladders,and sprinklers in
hoistways and machine rooms.
• Mainline and emergency power disconnec#switches and associated fuses,and feeders to terminals on each
elevator controller.
• Underground hydraulic cylinders and buried piping or conduit.
• Fire alarm initiating devices in elevator lobbies,machine rooms,and hoistways.
• Pit or machine room sump pumps.
• Telephone service to terminals on elevator controller.
• Obsolescence of the elevator equipment. 1f original equipment manufacturer pafts are no longer available,
fhe Elevator Service Provider shall provide a reasonable substitute#or the original OEM parts of equal
quality. However,for major components,obsolescence shall be defined as the unavailability of required
new replacement pa�ts from both the manufacturer and third party market sources. Such obsolescence
shall brought to Purchaser's attention,who upon authorizing repiacements or upgrades,shall be respansible
for associated expenses,conslstent with the fabor and parts rates provided in this Agrearrtent.
For example,it is stipulated thaf Dover(-2 and Maxtan UC-1 and UC-4 control valves are covered under this
agreement,since replacement parts and new valves are currently availabte.
OTHER PRICING
All invoices for non-covered costs, including aufhorized overtime, etc. must identify the Purchaser's
building and elevator on which the work was performed. Such invoices shall detail a complete breakdown
of labor hours, labor rates, and individual parts prices, and will be invoiced at the appropriate billing rates,
as shown below. Purchaser wilf not be responsible for paying any ganeral charges, inciuding but not
limited to`sundries', 'miscellaneous disposable parts', or'fuel surcharge',
WORK CLASSIFICATION REGULAR TIM� OVHRTIME CALLBACKS OVERTlME REPAIRS
1.7xIU�Ct�,7� 2.OxlUECw4r�
MECHANEC $207.00 $325.00 $366.00
lUEC Lacnt 15
APPR�NTICE $'{76.00 N/A $3'12.00
IUEC LoCAL 15
7he hourly callback and repair rates provided above shall also apply to other services, such as periodic
maintenance, callbacks, #esting, or repairs requested on conveyances subsequently purchased or not
presently covered under this elevator maintenance agreement, .
,
The annuai percentage increase or decrease (as defined AGREEM�NT PR10E section), shall also be
applied to the hourly callback and repair rates shown above.
The rate for vehicle mileage reimbursement bilfed ta Purchaser for ove�time callbacks, for the term of this
Agreement shall be 0.60.
� .
The Elevator Service Provider's markup to Purchaser for material or replacement parts not included by
this Agreement shali be defined as 15 %. The applicable transpo�#ation, freight, delivery, or shipping
charges for material or replacement parts not included by this Agreement may be invoiced to Purchaser
at the following rate At na markup.
SPECIAL. PROVISIONS
Purchaser reserves the right to solicit bids and hire other Elevator Service Providers to perform work on
the conveyances that is not covered under this Agreement, such as, but not limited to: modernization,
upgrades, repairs, or non-covered replacement parts.
The Elevator Service provider is required to carry and maintain the Purchaser's (nsurance Requirements
attached to this document. A certificate of insurance, cauntersigned by an insurer licensed to do
business in Wisconsin, and covering the period of the contact shall be provided by Elevator Service
provider and approved by Purchaser prior to beginning any work on site.
All waste items including, but not limited to, cleaning compaunds or fluids, was#e cloths or wipers,
lubricants, old parts, containers, oil absorbents, and waste oil must be disposed of offsite by Elevator
Service Provider at their expense in full compiiance with OSHA and EPA guidelines or regulations. The
Elevator Service Provider shall furnish a Material Safety Data Sheet and proper labeling for each
hazardous chemica! used in Purchaser's facilities in compliance with OSHA Hazard Communication
Standards,
The Purchaser will initially make wiring diagrams available to Elevator Service Provider, who shall
maintain up-to-date wiring diagrams detai(ing circui#s of electrical protective devices and critical operating
circults in the machine room. All new electrical changes or modifications shall be incorporated into the
wiring diagrams, and following the modifications, Elevator Service Provider shall provide a second set of
reproducible wiring diagrams containing a(I changes or modifications to Purchaser without charge. All
wiring diagrams for each elevator are the property of Purchaser and shall not be removed from the
premises. Elevator Service Provider shall copy or replace as their condifion warrants.
PERIODIC TESTS
The �levator Service Provider shall conduct the applicable Category 1 and Catagary 5 Periodic Tests as
required by the SPS 318 and ASM� A17.1-2013 Codes at a minimum, and additional testing as shown
below, without additional compensation:
Hydraulic Elevators—Category One relief valve and cylinder tests per ASME A17.1-2013 Requirements
8.6.5.14.1 and 8.6.5.14.2 shall be performed annualfy on Al.t. hydraulic elevators.
Elevator Service provider shall perform tests on a timely basis and shall furnish suitabie test weight
material as required without additional cost, Test reports shall be provided to Purchaser, to the Authority
Having Jurisdiction (AHJ), and to any authorized representative, consultant, or insurance carrier
designated by Purchaser. �levator Service Provider is not responsible or liable for persona! injury
(including death) or properry damage because of the action or faiture of any part of the conveyances
during testing, unless caused by a failure to properly perform the test(s).
ANNtJAL PERFORMANCE MEETING
The Elevator Service Provider Maintenance Supervisor and Sales Representative shall meet with
Purchaser and their designated representatives on an annual basis at a minimum, to review performance.
Elevator Service Provider shall present a malntenance summary and analysis, including callback
analysis, hours worked, preventive maintenance performed, and sha!! identify performance trends,
promote feedback on performance or other issues, and review any outstanding recommendations or
proposals. The format and content of this report shall be approved by Purchaser. Recommendations
made by Elevator Service Provider shall be followed up with written proposals where appropriate, and
submitted on a time�y basis. It is Elevator Service Provider's obligation to schedule tfie annual meeting.
PERFORMANCE
Purchaser shall have full access to inspect Elevator Service Provider's services at any time, and may
periodically check the elevator performance by utftizing employees, inspectors, consultants, or insurance
carriers, at Purchaser's expense, to insure that the Elevator Service Provider is performing in accordance
with the terms of this Agreement. Such empfoyees, inspectors, consultants, or insurance carriers may
utilize generally accepted elevator industry maintenance guidelines when evaluating maintenance
performance, including, but not limited to thase published in the Building Transportat'ron Skandards and
Guidelines by the National Elevator Industry, Inc.
Maintain the elevator machine room, hoistway, car top, pit, and equipment in these areas in clean
condition throughout and at the end of the five year maintenance term.
Purchaser shall have the final determination of aA reasonable performance standards, and rrtay terminate
this Agreement with wriften nofice if it determines the level of service is inadequate, if recurring problems
exist, or if the Elevator Service Provider fails to compfy with the requirements of these specifications or
Elevator Code.
Written notice shall first be given the Elevator Service Provider to correct all deficiencies, to the
satisfaction of Purchaser, and to restore performance to the required lavel within thirty(30)days.
This agreement when signed by Purchaser and the Elevator Service Provider, shall constitute exclusively the
contract between the parties, and all prior representations or agreements not incorporated herein are
superseded.
Signed and Accepted by Purchaser Signed and Accepted by
Purchaser Citv of Oshkosh Minnesota Elevator, Inc. '"�
Signature /��---/'�• 1�-�"�'�'� Signature � �/ `
Name/Title NamelTitle (�Q,c�1` EGk: ��r.,ocd��F'�
C//5� �'lI.OA/ CGT/�/I :i/�
Date Date .3-//- 2rD t S
_ : �� �� ��,�
s,���rc..�-E _ �
N�o,�c��?�?�.�.�
cr1� G[.Erut
��-�� � � , '��� ��--
���������
1-
c�TV :r a}'
c�aKa��+,�isc�r����
Urben, Jon
From: Jeanne Fortino [jfortino@Hayscompanies.com]
Sent: Friday, March 13, 2015 10:58 AM
To: Urben, Jon
Cc: Tegan Sobocinski; 'Gary Eck'
Subject: City of Oshkosh
Attachments: 0343220498.pdf
..- - . . .
Jon,
After further review please see the below comments regarding the changes to your certificates.
Because the attached contract is requiring only a $2,000,000 umbrella limit, but we are providing a $10,000,000
umbrella limit-we do not need to provide a per project general liability limit. If the GL coverage was triggered,we are
providing$8 million more,worth of coverage than requested.
Also,we have included the Blanket additional insured endorsement.
If you have further questions please let me know.
Thanks,
Jeanne Fortino � Account Administrator
P&C
Email: ifortino@Havscompanies.com
Direct: (414j 290-35&Q � Fax: (414) 259-8448
Hays Companies of Wisconsin
1200 N. Mayfair Road, Suite 100 � Milwaul<ee � WI ( 53226
■�� �� �
�
All:Tk�oEher,C�est:at�.
This communication is intended only for the recipient(s)named above;may be confidential and/or legally privileged;and,must be treated as such in accordance
with state and federal laws.If you are not the intended recipient,you are hereby notified that any use of this communication,or any of its contents,is prohibited.If
you have received this communication in error,please return it to the sender and delete the message from your computer system.
-------------------------------------------------------------------------
This message was secured by ZixCor �R�.
1
,d►co°� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YWY)
��- 03/06/2015
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 certifcate 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 1-414-443-0000 CONTACT
NAME:
Haye Companiee of Wieconain, Inc. PHONE FAX
N A/C No:
1200 North Mayfair Road, Suite 100 pooRESS: .
Milwaukee, WI 53226 INSURERS AFFORDINGCOVERAGE NAIC#
INSURERA: pHOENIX INS CO 25623
INSURED INSURERB: CHARTER OAR FIRB INS CO 25615
Minneaota Elevator, Inc. LEXINGTON INS CO 19437
INSURER C:
19336 607th Avenue INSURERD: TRAVELERS IND CO 25658
Mankato, 2+III 56001 INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 4322o49s 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 TypE OF INSURANCE �DL SUBR pOLICY NUMBER MM%DDY� MM/DD� LIMITS
LTR
A GENERALLIABILI7Y X 630-867K9454-PHX-14 07/O1/1 07/O1/15 EpCHOCCURRENCE $1,000,000
DAMAGE TO RENTED
X COMMERCIALGENERALLIABILI7Y PREMISES Eaoccurrence $300,000
CLAIMS-MADE �OCCUR MED EXP(An one parson) $10,000
PERSONAL&ADVINJURY $1,000,000
GENERALAGGREGATE $2,000,000
GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
X POLICY PRa LOC $
S AUTOMOBILELIABILm' 7C 810-98776355-COF-14 07/O1/1 07/O1/15 COMBINEDSINGLELIMIT
Ea acadent 1,0 0 0,0 0 0
X ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
NON-OWNED PROPERN DAMAGE $
HIRED AUTOS AUTOS Per accident
$
C X UMBRELLALIAB x OCCUR X 015374861 07/O1/1 07/O1/15 EACHOCCURRENCE $ 10,000,000
EXCESSLIAB CLAIMS-MADE AGGREGATE $ 10,000,000
DED RETENTION$ $
D WORKERSCOMPENSATION YR-IIB-SE36206-3-14 07/O1/1 07/O1/15 X "`/CSTATU- OTH-
AND EMPLOYERS'LIABILITY
ANYPROPRIETOR/PARTNER/EXECUTIVE� N�A E.L.EACHACCIDENT $ 500,000
OFFICER/MEMBER EXCLUDED7
(Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000
Ifyes,describe under 500,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(Attach ACORD 107,AddlUonal Remarks Schedule,If more space Is requlred)
City of Oahkoeh, and ita officera, council membera, agente, employeee and authorized volunteera are included ae
additional inaured where required by written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Oehkoah THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: City Clerk
216 Church Avenue AUTHORIZED REPRESENTATIVE
P.O. Sox 1130
Oahkoah, WI 54 903-113 0 �..�� Q��.
IISA �����
O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/OS) The ACORD name and logo are registered marks of ACORD
jeannefortino
43220498
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
BLANKET ADDITIONAL INSURED
(CONTRACTORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. WHO IS AN INSURED—(Section II) is amended c) The insurance provided to the additional in-
to include any person or organization that you sured does not apply to "bodily injury" or
agree in a "written contract requiring insurance" "property damage" caused by "your work"
to include as an additional insured on this Cover- and included in the "products-completed op-
age Part, but: erations hazard" unless the "written contract
a) Only with respect to liability for"bodily injury", to9prov densuchncove ageflforll h tQadditio al
"property damage"or"personal injury'; and
insured, and then the insurance provided to
b) If, and only to the extent that, the injury or the additional insured applies only to such
damage is caused by acts or omissions of "bodily injury" or "property damage" that oc-
you or your subcontractor in the perFormance curs before the end of the period of time for
of "your work" to which the "written contract which the "written contract requiring insur-
requiring insurance" applies. The person or ance" requires you to provide such coverage
organization does not qualify as an additional or the end of the policy period, whichever is
insured with respect to the independent acts earlier.
or omissions of such person or organization.
3. The insurance provided to the additional insured
2. The insurance provided to the additional insured by this endorsement is excess over any valid and
by this endorsement is limited as follows: collectible "other insurance", whether primary,
a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is
this Coverage Part shown in the Declarations available to the additional insured for a loss we
exceed the limits of liability required by the cover under this endorsement. However, if the
"written contract requiring insurance", the in- "written contract requiring insurance" specifically
surance provided to the additional insured requires that this insurance apply on a primary
shall be limited to the limits of liability re- basis or a primary and non-contributory basis,
quired by that "written contract requiring in- this insurance is primary to "other insurance"
surance". This endorsement shall not in- available to the additional insured which covers
crease the limits of insurance described in that person or organization as a named insured
Section III—Limits Of Insurance. for such loss, and we will not share with that
b) The insurance provided to the additional in- "other insurance". But the insurance provided to
„ „ „ the additional insured by this endorsement still is
sured does not apply to bodily injury , prop- excess over any valid and collectible "other in-
erty damage" or "personal injury" arising out surance", whether rima
of the rendering of, or failure to render, any P ry, excess, contingent or
on any other basis, that is available to the addi-
professional architectural, engineering or sur- tional insured when that person or organization is
veying services, including: an additional insured under such "other insur-
i. The preparing, approving, or failing to ance".
prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the
ings, opinions, reports, surveys, field or- additional insured by this endorsement:
ders or change orders, or the preparing,
approving, or failing to prepare or ap- a) The additional insured must give us written
prove, drawings and specifications; and notice as soon as practicable of an "occur-
ii. Supervisory, inspection, architectural or rence" or an offense which may result in a
engineering activities. claim. To the extent possible, such notice
should include:
CG D2 46 08 05 0 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2
COMMERCIAL GENERAL LIABILITY
i. How, when and where the "occurrence" any provider of"other insurance"which would
or offense took place; cover the additional insured for a loss we
ii. The names and addresses of any injured cover under this endorsement. However, this
persons and witnesses; and condition does not affect whether the insur-
ance provided to the additional insured by
iii. The nature and location of any injury or this endorsement is primary to "other insur-
damage arising out of the"occurrence"or ance" available to the additional insured
offense. which covers that person or organization as a
b) If a claim is made or"suit" is brought against named insured as described in paragraph 3.
the additional insured, the additional insured above.
must: 5. The following definition is added to SECTION V.
i. Immediately record the specifics of the —DEFINITIONS:
claim or"suiY' and the date received; and "Written contract requiring insurance" means
ii. Notify us as soon as practicable. that part of any written contract or agreement
under which you are required to include a
The additional insured must see to it�that�we person or organization as an additional in-
receive written notice of the claim or suit as sured on this Coverage Part, provided that
soon as practicable. the "bodily injury" and "property damage" oc-
c) The additional insured must immediately curs and the "personal injury" is caused by an
send us copies of all legal papers received in offense committed:
connection with the claim or "suit", cooperate a. After the signing and execution of the
with us in the investigation or settlement of contract or agreement by you;
the claim or defense against the suit , and
otherwise comply with all policy conditions. b. While that part of the contract or
d) The additional insured must tender the de- agreement is in effect; and
fense and indemnity of any claim or "suiY' to c. Before the end of the policy period.
Page 2 of 2 �O 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05