HomeMy WebLinkAboutPW CNT 15-01/James Peterson SonsCITY OF OSHKOSH
LEGAL DEPARTMENT
215 CHURCH AVENUE, P.O. BOX 1130, OSHKOSH, WI 54903-1130
PHONE: (920) 236-5115 FAX (920) 236-5106
LETTER OF TRANSMITTAL
To: James Peterson Sons, Inc.
PO Box 120
Medford, WI 54451
Attn: John T. Marshall
Please find:
❑ Copy of Letter
❑ Meeting Notes
❑ Specifications
� Attached
� Contracts
❑ Photos
❑ Estimates
❑ Under Separate Cover
❑ Amendment
❑ Mylars
❑ Diskette
❑ Report
❑ Change Order
❑ Zip Disk
❑ Agenda
❑ Plans
❑ Other
Quantit Description
1 Ori inal si ned contract for the 9& Washburn Area Detention Basin
Contract 15-01
These are being transmitted as indicated below:
❑ For Approval � For Your Use ❑ As Requested ❑ For Review & Comment
Remarks:
cc:
City Clerk (original)
Public Works, Engineering (original)
City Attorney (copy)
�
CONSTRUCTION CONTRACT
THIS AGREEMENT, made on the 15'h day of July, 2014, by and between the CITY
OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and JAMES
PETERSON SONS, INC., N2251 Gibson Drive, Medford, WI 54451, party of the second
part, hereinafter referred to as the CONTRACTOR,
WITNESSETH:
That the CITY and the CONTRACTOR, for the consideration hereinafter named,
agree as follows:
ARTICLE I. SCOPE OF WORK
The CONTRACTOR hereby agrees to furnish all of the materials and all of the
equipment and labor necessary, and to perform all of the work shown on the plans and
described in the specifications for the project entitled or described as follows:
Public Works Contract No. 15-01
for 9`" & Washburn Area Detention Basin, for the Public Works Department, pursuant to
Resolution 15-327 adopted by the Common Council of the City of Oshkosh on the 14th day
of July, 2015,
all in accordance and in strict compliance with the CONTRACTOR's Proposal and the other
Contract Documents referred to in ARTICLE V of this Contract.
ARTICLE II. TIME OF COMPLETION
The work to be performed under this contract shail be commenced and the work
completed within the time limits specified in the Special Conditions and/or
CONTRACTOR's proposal.
ARTICLE III. PAYMENT
(a) The Contract Sum.
The CITY shall pay to the CONTRACTOR for the performance of the Contract the sum of
$2,528,792.00, adjusted by any changes as provided in the Specifications, or any changes
hereafter mutually agreed upon in writing by the parties hereto, provided, however, in the
event the Proposal and Contract Documents are on a"Unit Price" basis, the above
mentioned figure is an estimated figure, and the CITY shall, in such cases, pay to the
CONTRACTOR for the perFormance of the Contract the amounts determined for the total
number of each of the units of work as set forth in the CONTRACTOR's proposal; the
number of units therein contained is approximate only, and the final payment shall be
made for the actual number of units that are incorporated in or made necessary by the
work covered by the Contract.
1
(b) Progress Payments.
In the event the time necessary to complete this Contract is such that progress payments
are required, they shall be made according to the provisions set forth in the Specifications.
ARTICLE IV. CONTRACTOR TO HOLD CITY HARMLESS
The CONTRACTOR covenants and agrees to protect and hold the CITY harmless
against all actions, claims and demands of any kind or character whatsoever which may in
any way be caused by or result from the intentional or negligent acts of the
CONTRACTOR, his agents or assigns, his employees or his subcontractors related
however remotely to the performance of this Contract or be caused or result from any
violation of any law or administrative regulation, and shall indemnify or refund to the CITY
all sums including court costs, attorney fees, and punitive damages which the CITY may be
obliged or adjudged to pay on any such claims or demands within thirty (30) days of the
date of the CITY's written demand for indemnification or refund.
ARTICLE V. INSURANCE
The Insurance required by the City of Oshkosh as specified in the CITY's
specifications, including addenda, or plans, or instructions, or advertisements, shall be
primary coveraqe and that any insurance or self insurance maintained by the City of
Oshkosh, its officers, council members, agents, employees or authorized volunteers will
not contribute to a loss. All insurance shall be based upon the occurrence of an event, and
not based on claims made. All insurance shall be in full force prior to commencing work
and remain in force until the entire job is completed and the length of time that is specified,
if any, in this Contract, the Specifications, whichever is longer.
ARTICLE VI. COMPONENT PARTS OF THE CONTRACT
This Contract consists of the following component parts, all of which are as fully a
part of this contract as if herein set out verbatim, or if not attached, as if hereto attached:
1. This Instrument
2. The City's Plans and Specifications, including all Addenda's
3. City of Oshkosh Standard Specifications
4. Instructions to Bidders
5. Advertisement for Bids
6. Contractor's Proposal
The Contract Documents are complementary; what is required by one is as binding
as if required by all. Before undertaking each part of the work, the CONTRACTOR shall
carefully study and compare the Contract Documents and check and verify all pertinent
figures and measurements required therein. CONTRACTOR shall promptly report in
writing to the Engineer any conflict, error, ambiguity or discrepancy which CONTRACTOR
may discover and shall obtain written clarification from the Engineer before proceeding with
any work affected thereby.
In the event that any provision in any of the above component parts of this Contract
conflicts with any provision in any other of the component parts, tne 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.
IT IS HEREBY DECLARED, UNDERSTOOD AND AGREED that the word
"CONTRACTOR" wherever used in this Contract means the party of the second part and
its/his/their legal representatives, successors, and assigns.
IN WITNESS WHEREOF, the City of Oshkosh, Wisconsin, has caused this contract
to be sealed with its corporate seal and to be subscribed to by its City Manager and City
Clerk and countersigned by the Comptroller of said City, and the party of the second part
hereunto set its, his or their hand and seal the day and year first above written.
In th��Presence of:
�; � i� ��`
(Seal of Contractor
if a Corporation.)
APPROVED:
CONTRACTOR
JAMES PETERSON SONS, INC.
; ` —
vP
(Spe � Title
By:
�
(Specif itle)
CITY OF OSHKOSH
By:
M rk A. Rohloff, City Manager
� )
And: � � � � �
Pamela R. Ubrig, City lerk
I hereby certify that the necessary
provisions have been made to pay
the liability which will accrue under
this contract
;���.,--�
City Comptroller
`�� � CERTIFICATE OF LIABILITY INSURANCE „i�,`2o�5"�"y'
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 INSUR4NCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE�
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holtler is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subjec[ [o
[he terms and contlitions of the policy, certain policies may require an entlorsement. A statement on this certificate does not confer rights [o the
certificate holder in lieu ot such endorsement(sl.
PRODUCER
M3, Eau Claire Hranch
3406 Oakwood Hills Parkway
Eau Claire WI 54701
INSlIREO
James Peterson Sons, Inc.
Peterson & Sons W LLC
Buteyn Peterson Construction Co Inc
PO Box 120
Nedford WI 54451-0120
E:
AFFORDMG COVERAGE
NAIC k
COVERAGES CERTIFICATE NUMBER:499580704 REVISION NUMBER:
THIS IS TO CERTIFV THAT THE POLIGES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIO� INDICATED. NOPMTHSTANDING ANV RE�UIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER �OCUMENT VJI7H RESPECT TO
WHICH THIS CERTIFICATE MAY BE ISSl1ED OR MAY PERTAIN, THE INSURANCE AFFOROED BV THE POLIGES DESCRIBED HEREIN IS SUBJECT
TO ALL THE TERMS, EXCLUSIONS AND CONDRIONS OF SUCH POLICIES LIMITS SHOVVN MAY HAVE BEEN REDUCED BY PAID CL41MS.
INSR ryPEOFINSURANCE A��LSUB0. POLICYEFF POLICYE%P
LTR INSR NNO POIICYNUMBER MMI�OIYYYY MMI00/WVY LIMITS
A GENERALLIABILITY DTWSC411925PHX15 1/1/2015 1/1/2016
EACH OCCURRENCE E1,000,000
A A N
X COMMERCIALGENERALLIA6ILITV PREMISES Eaoccunence 5300,000
CLAIMS-MADE � OCCUR MEp EXP (Any one person) 510, 000
PERSONALBADVINJURV 51,000,00�
GENERALAGGREGATE 52�000,000
GEN'LAGGREGATEIIMITAPPLIESPER: pRODUCTS-COMPIOPAGG 52�400,000
POLICV X PRO- �� _
A AUTOM091LELIABILITY DTB105C411925COF15 1/1/2015 1/1/2016 COMBINE�SINGLELIMIT E1,000,000
K ANYAUTO (Eaaccitlenl)
BODILYINJURY(Pe�person) S
AL� ONMEDAUTOS BO�ILY INJURV (Per auident) E
SCHEDULEDAUTOS PROPERTV �AMAGE
K HIREDAUTOS (Peracutlent) E
K NON-OwNE�AUTOS S
S
p X UMBRELLA LIA9 X OCCUR COPSC411925TIL 1/1/2015 1/1/2016 EqCH OCCURRENCE E10,000,000
EXCESSLIAB CLAIMS-MADE AGGREGATE E10,000,000
DEDUCTIBLE t
K RETENTION E10,000 j
p WORKERSCOMPENSATION DTDTBIIBSC43192A5 1/1/2015 1/1/2016 X �STATU- OTH-
ANO EMPLOYERS' LIABILITY Y� N
FNYPROPRIETOe/PARTNEPoEXECt1TNE E.L.EACHACCIDENT E50�,000
OFfICEWMEMBEREXCWOED? � N�A
(ManEatory in NH) EL. �ISEASE -
Ifyes,tlescnDeunder EAEMPLOYE E500,000
DESCRIPTIONOFOPERATIONSbelow ELDISEASE-POLICVLIMR 5500,000
A Leased\Rentetl Equipment QT6608A996B61PHX15 1/1/2015 1/1/2016 per iCem 500,000
Installation Floa[er 1,000,000
DESCRIPTION OF OPERATION51 LOCATIONS I VEHICLES (Attac� ACOR� 101. Atltlicianal Remarks ScM1atlule, il more apace is requlretl)
Public Works Contract No 15-01
City of Oshkosh and its officers, council members, agents, employees and authorized volunteers are
additional insureds with regard to General Liability.
CITY OF OSHKOSH
215 CHURCH AVENUE
OSHKOSH WI 54903-1130
ACORD 25 (2009/09)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
_ _ii� F ��,[, - � �iLA.' J=�
OO 1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
PAYMENT BOND
Contract Number 15-01
Date Bond Executed (Date of Contracl or Later) 07/17/2015
PRINCIPAUCONTRACTOR (Legal Name end Business Address)
James Peterson Sons, Inc. Utility
N2251 Gibson Dr
Medford, WI 54451
SURETY(IES) (Legal Name(s) and Business Address(es))
Liberty Mutual Insurance Company
175 Berkeley St
Boston. MA 02116
OWNER (Legal Name and Business Address)
CIIY OK OSHKOSH
215 Church Avenue
PO Box 1130
Oshkosh, Wisconsin 54903•1130
OBLIGATION
BOND #354-034-014
CITY OF OSHKOSH
Type of Organization
❑ Indivldual � Partnership
� Corporetlon
Stafe of Incaporefion
Wisconsin
Penal Sum of Bond
$2,528,792.00
The Contractor and Surety, Jolnt�y end severally, bind themselves, their heirs, executors, administrators, successors
and assigns to the Owner to pay for labor, materials and equipment furnlshed for use in the periormance of the
Contract identified above, which is incorporated hereln by reference, subject to the following terms.
If the Contractor promptly makes payment of all sums due to claimants, and defends, indemnifies and holds
harmless the Owner from all claims, demands, liens or suits by any person or entity seeking payment for labor,
materfals or equipment furnished for use in the pertortnance of the Contract, then tfie Surety and the Contractor
shall have no obligation under this Bond.
If there is no Ovmer Detault to pay the Contractor as required under the Contract for work performed or to perform
or complete any materlal term of the Contract, than the Surety(ies) obligation under this Bond shall arise a(ter the
Owner has promptly notifled the Contracfor and the Surety of claims, demands, liens or suits against lhe Owner or
the Owner's property by any person or antity seeking payment for labor, materials or equipment furnished for use In
the performance of the Contract and tendered defense of such clalms, demands, liens or suits to tha Contractor
and the Surety.
Amounts owed by the Owner to Contractor under the Contracl shall be used for performance of the Contract and to
satisfy claims, if any, under any Performance Bond. By the Conlractor furnishing and the Owner accepting this
Bond, they agree that all funds earned by the Contractor in the pertormance of ihe Contrect are dedicated to satisfy
obligations of the Contractor and Surety under this Bond, subJect to the Owner's priority to use the funds for the
completlon oi the work.
Upon notice and tendering of claims as specifled above, the Surety shall promptly and at Surely's expense defend,
indemnity and hold harmless the Owner against such claim, demand, lien or suit.
Surety shall answer claimanls, with a copy to Owner, withln sixty (60) days of the date of lhe claim, stating ihe
emount that are disputed and the specific basis for challeng(ng any amount that Is dlsputed or pay or arrange for
payment of any undisputed amount claimed.
Surely shalf not be obligated to the Owner, clafmants or others for obligations of the Contractor under this 8ond that
are unrelated to the Contract. The Ownar shall not be liable for the payment of any costs or expenses of any
clalmant under this Bond and shall have no obligation to make payments to, or give notice on behalf of claimants,
or otherwise have any obllgalfon to ctaimants under this Bond.
Notice to lhe Contractor or Surety shall be deemed to have been given: (i) upon delivery to an officer or person
entitled to such notice, if hand delivered; or (li) two (2) business days following deposit in the United Stales mail,
postage prepaid; (iii) upon delivery by a commercia! carrier fhat will certify Ihe date and tlme ot delivery; or (iv) upon
transmission if by facslmlfa, email or other form of electronic transmission. Notices shall be provided to lhe Owner,
Surety andlor Contractor at their address as specified on this Bond or to a facsimile, emall or other electronic
address that has been provided in writing to the other paAy to be usad for this purpose.
The laws of the State of Wlsconsin shall govern the interpretation and constructfon of this Bond. Winnebago
County shall be the venue for all disputes arising under this Bond. Any provision in ihis Bond thal may conflict with
stalutory or other legal requlrement shall be deemed deleted herefrom and p�ovlsions conforming to the statutory or
other legal requirement shall be deemed incorporated hereln.
James Peterson Sons, Inc. Utility Division
Name of Pdncipal/Contractor
r(' y
Titl �
Liberty Mutual Insurance Company
Name of Surety
Robert Downey,
PERFORMANCEBOND
Contrect Numher 15-01
Date Bond Executed (Date of Contract or Later) 07/17/2015
PRINCIPAUCONTRACTOR (Legal Name and Business Address)
James Peterson Sons, Inc. Utility Division
N2251 Gibson Dr
Medford, WI 54451
SURETY(IES) (Legal Name(s) and Businass Address(es))
Liberty Mutual Insurance Company
N2251 Gibson Dr
Medford, WI 54451
OWNER (Legal Name and 8usiness Address)
CITY OF OSHKOSH
215 Church Avenue
PO Box 1130
Oshkosh, Wfsconsin 54903-1 � 30
OBLIGATION
BOND #354-034-014
CITY OF OSHKOSH
Type of Organization
❑ lndividual � Partnersh/p
� Caporatlon
State of Incorporation
Wisconsin
Penal Sum of Bond
$2,528,792.00
The Contractor and Surety, Jointly and severally, bind themselves, their heirs, executo�s, administrators, successors
and ass(gns to lhe Owner for payment of the sum shown ebove or the performance of the Contracl identified
above, which is Incorporated herein by reference.
This Bond shall cover any work performed during initial construction and any warranty perlod required by the
Contracl,
If there Is no Owner Default to pay the Contractor as required under the Conlract for work performed or lo perform
or complete any material term of the Contract, lhen the Surety(ies} obligation under this Bond shall arise after:
1. The Owner provides notice to the Contractor and Surety that the Owner is considering declaring the
Contractor In default of the Contract. Within flve (5) business days of lhe Owners notice, either the
Contractor or the Surety may request a conference with the Owner to discuss such default and lhe
remedy therefor. If a conference is requested, the conference shall be scheduled lo take placa at
Owners principal place of busfness or another agreed upon location within five (5) business days of the
requast for conference. If ihe Owner, Contractor and Surety agree, lhe Contrsctor may be allowed a
reasonable lime to perform the Contract, but such agreament shall not waive the Owner's righl, If any,
to subsequently dedare the Contractor in default
2. The Owner declares the Contractor in default and notifles ihe Surety of the declaralion of default; and
3. The Owner agrees to pay lhe balance of the Contract price in accordance wilh the terms of Ihe
Contract to the Surety or to a qualif(ed Contractor selected to perform ihe Contract.
Failure of the Owner to comply with the notice requirement specified above shall not releasa the Surety from ils
obligations.
Upon notice irom the Owner as provided above, the Surety shall promptly and at Suretys expense take one of the
following actions:
1. Arrenge for the Contractor, with consent o( the Owner, to perform and complete lhe Coniract;
2. Undertake to perform and complete the Contract itseff, through qualified agents or fndependent
contractors;
3. Obtain bids or negotiated proposals trom qualified contractors acceptable to ihe Owner to enter Into a
contract with lhe Owner for performance and completion of the Contract, to be secured with
performance and payment bonds, and to pay to the Owner as damages any amount in excess of the
original contract amount for lhe completion of the Contract; any additional legal, design professional,
archltect, or consultant fees resulting from any delay in the completion of the Contrech, and any
applicable Ilquidated damages specified within the Contract resulting from any delay in the completion
of the Conlract.
4, Make payment to the Owner, as soon as praclicable after an amount is determined for completion of
the Contract; or
5. Deny liability in whole or in pari and notify the Owner, citing with specificity the reasons for such denial.
If the Surety does not proceed with reasonable promptness, Owner may give notice to the Surety and the Surety
shall be daemed In default on this Bond five (5) business days aNer notice by the Owner demanding the Surety
perfortn its obligations �nder this Bond. Owner shall be entilled to enforce any remedy available to Owner upon
default.
Except for default of tha Surely and Surety's eledion to perform or complete the Contract itse�f under Paragraph 2
above, Surety's liability shall be limited to the emount of this Bond.
Notice to the Conlractor or Surety shall be deemed to have been glven: (i) upon delivery to an officer or person
entitled to such notica, if hand delivered; or (ii) two (2) business days following deposit in lhe United States mail,
postage prepaid; (iii) upon delivery by a commercial carrier that will certify the date and time of delivery; or (iv) upon
transmisslon if by facsimile, email or other form of electronic transmission. Notices shall be provided to the Owner,
Surety and/or Contractor at their address as speclfied on this Bond or to a facsimile, email or other electronic
address that has been provided in writing to ihe other party to be used for thfs purpose.
The laws of the State of Wisconsin shall govem the interpretation and construction of fhis Bond. Winnebago
County shaA be the venue for all disputes arising under this Bond. Any provlslon In this Bond that may conflict with
statutory or other legal requirement shail be deemed deleted herefrom and provisions conforming to the statutory or
other legal requirement shall be deemed incorporated herein.
The above obliga(ion Is void if the Contractor performs and fulfdis all the lerms, conditions and agreements of the
Contract and any authorized modifications during tha term of the origlnal Contract and any extensions thereof.
Nolice to the Surety is waived for any modifications agreed upon by Owner and Contractor.
James Peterson Sons, Inc. Utility Division Liberty Mutual Insurance Company
Nama of Principal/Contractor Name of Surety
Title �f� «,/
�
THIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.
This Power of Attorney limits the acts ot ihose named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated.
CeRifcate No. sszsoso
American Fire and Casualty Company Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company WestAmerican Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: ThatAmerican Fire & Casualry Company and The Ohio Casualty Insurence Company are corporations duly organized under the laws of
ihe State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and WestAmerican Insurance Company
is a corporetion duly organized underthe laws of the State of Indiana (herein collectivety called the "Companies'�, pursuant to and by authority herein set forth, does hereby name, constiNte
and appoint, Chris SteinaqeP Christopher M. Kemp� Connie Smith� Michael J Douqlas Robert DowneV
a�� of the city of Hutlson , state of wl each individually if there be more �han one named, its irue and lawful attorney-io-fact to make, exeate, seal, acknowledge
and deliver, for and on its behal( as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pwsuance of Ihese presents and shall
be as binding upon the Companies as if Ihey have been duly signed by the president antl attested by the secretary of the Companies in their own proper persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authonzed oKcer or oKcial of the Companies and the corporate seals of the Companies have been affxed
the�2t0 thls 30th day of March � 2015
pN�C45L P��SqYINSL p�\NSUqq PNINSUqA��
y,4 `MOM 9(i CJ`NG]M�.O.L J�����~CF 'yQ�ay'Dt30.W�(�T
a, 1906 0 o t9t9 1912 � 7997 s
S
z. � i. m E o � o
° :� a
; �
��h�y��"H.Mr..�'`eaa �y+��,��NVSH �a� '�o .v <
� ssn�w��r`� mrnnx�
f 1 f � f ♦
STATE OF PENNSYLVANIA ss
COUNTY OFMONTGOMERY
American Fire and Casually Company
The Ohio Casualty Insurance Company
Liberty Mutual Insurance Company
West merican insurance Company
By:
David M. Care ; Assistant Secretary
On this 3oth day of March , 2015 , before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of American Pire antl
Casualty Company, Liberty Mutual Insurance Company, The Ohio Casualty Insurance Company, and West American Insurance Company, and that he, as such, being authorized so to do,
execute the foregoing instmment for the �urposes therein contained by signing on behalf of the corporations by himself as a duly authorized offcer.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affxed my notaiial seal at Plymouth Meeting, PennsyNania, on the day and year fvst above written.
5P pqST COMMONWEALTH OFPENNSYLVANW �
Q.F'�µoxW£ F!� NotanalSeal /, � , .��`�
� � ¢i 'y Teresa Pastelle, Notary Public �� gY; �C/�.(.Q-/CJ /Li
oF Plymouth Twp., Monigomery Counry Teresa Pastella, Nolary Public
�.�p My Commission Expires Mamh 28, 2017
v_ �,'F' MembeqPennsyNaniaASSOCia�ionofNOlanes
t'y'
This Power of Atlorney is made and exewted pursuant to and by authority of the following By-laws and AWhorizations of American Fire and Casualty Company, The Ohio Casualty Insurance
Company, Libedy Mutual Insurance Company, and West American Insurence Company which resolutions are now in full force antl effect reading as (ollows:
ARTICLE IV — OFFICERS — Section 12. Power of Attorney. Any officer or other offcial of the Corporation authorized for that purpose in writing by the Chairman or the Piesident, and subject
ro such limitation as the Chairman or the President may prescribe, shall appoint such attomeys-In-fact, as may be necessary to act in behalf ot the Corporation to make, execute, seal,
acknowledgeanddeliverassureiyanyandalluntlertakings,bonds,recognizancesandothersuretyobligations. Suchattorneys-in-fact,subjecttothelimitationssetfodhintheirrespective
powers of attorney, shall have full power to bind the Corporation by lheir signature and exeation of any such instruments and to attach thereto the seal of the Corporatian. When so
exeated, such insWments shall be as binding as if signed by ihe President and attested to by the Secretary. Any power or authority grantetl to any representative or ariomey-in-fact under
the provisions of ihis atlicle may be revoked at any time by ihe Board, the Chairman, the President or by the offcer or offcers granting such power or authority.
ARTICLE XIII — Execution of Contrects — SECTION 5. Surety Bonds and Undertakings. Any offcer of the Company authorized for that purpose in writing by the chaiiman or the president.
and subject to such limitations as the chalrman or the president may prescri6e, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, exeate,
seal, acknowledge and tleliver as surety any and all undedakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their
respective powers of attorney, shall have full power to bind the Company by Iheir signature and exeation of any such instruments and to attach thereto the seal of the Company. When so
exeated such insWments shall be as binding as if signed by the president and attested by the secretary
Cerlificate of Designation — 7he President of the Company, acting pursuant to the Bylaws of ihe Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys-in-
fact as may be necessary to act on behalf of ihe Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety
obligations.
Authorization — By unanimous consent of the Company's Board of Directors, the Company consents ihat facsimile or mechanically reproduced signature of any assistant secretary of the
Company, wherever appearing upon a certifed copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with
the same force and efiect as though manually aKxed.
I, Gregory W. Davenport, the undersigned, Assistant Secretary, of American Fire and Wsualty Company, The Ohio Casualty Insurance Company, Lihedy Mutual Insurance Company, and
West Ameriran Insurance Company do hereby certify that the original power of attomey of which the foreg �ng is a full, true and rtect copy of Ihe Power of Attorney exeated said
Companies, is in full force and effect and has not been revoked. �
IN TESTIMONY WHEREOF, I have hereunto set my hand and affxed the seals of said Companies this � day of , pp
PNDCAS� <tY�NS�� �iNSVR µiYSpq
o�aNr JP wo q9 JP pro2e qry �P o aN �i'L'�
2�'��' 69�a Qh �c' x°'� 2 F z�q '� r g 2�q"° 4°'� Tn
1906 0 0 1919 1972 ° 7997 i By: '��
3 Gregory W. Davenport, Assistant Secretary
6 ' ° 3 p'� d N t
"�y'°��emr���.'� .�y�`w��a,ns*�a� � EF'a 3
+ 1 � * �� TsAfHJS < �bII.N�
Z #
101 Oi 1000
�
��
��
��
o�
a=
o=
002532
COMMERCIAL GENERAL LIABI�ITY
THIS ENDORSEMENT CHANGES THE POLIGY. ALEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - AUTOMATIC STATUS
IF REQUIREQ BY WRITTEN CONTRACT
{CQNTRACTQRS)
This endorsement modifies insurance provided under the following:
CQMMERCIAI GENERAL LIABIUTY COVcRAGE PAR7
1. 7he following is added to SECTION II — WHO IS
AN IhlSURED'.
Any person or organization that:
a. You agree in a"written contracf requiring in-
surance" to inc(ude as an additianal insured
on this Coverage Part; and
b. Has not been added as an additional insured
for the same project by attachment of an en-
dorsement under this Goverage Part which
includes such person or organizatian in itte
endorsemenYs schedule;
is an insured, but:
a. Only with respect to Gability for "bodily in}ury",
"property damage" or "personal injury"; and
b. Only as deSCribed in Paragraph {1 �, (2) or (3)
below, whichever applies:
(1) if the "written contract �equiring insur-
ance" specifically requires you to provide
additional insured coverage to that per-
son or organization by the use of:
(a} The Additional Insured — Owners,
Lessees or Contractors — (Form BJ
endorsemeni CG 20 10 11 85; or
(6) Either or both of the following: the
Additional Insured — Owners, Les-
sees o� Contractors — Scheduled
Person Or Ofganization endorsement
CG 20 'I � 1 D D i, or the Additional in-
sured — Owners, Lessees or Contrac-
tors — Compieted Operations en-
dorsement CG 2D 37 10 Qt;
the person or organization is an additional
insured oniy if the in}ury or damage anses
ouf of "your work" to which the "w�itten
contract requiring insurance" applies;
(2) If the "written contract requiring insur-
ance" specificaily requires you to provide
additionat insured ooverage io that per-
son or organization by the us2 of:
(a) The Additional Insured — Owners,
Lessees or Gontractors — Scheduled
Person or Organization endorsement
CG 2D 10 07 44 or CG 20 10 04 13,
the Rdditional Insured — Owners,
Lessees or Contractors — Completed
�perations endorsement CG 20 37
07 04 or CG 2a 37 04 13, or both of
such endorsements with either ot
those edition dates; or
(b} Ether or both of the following: the
Additional Insured — Owners, Les-
sees nr ConVactors — Scheduled
Person Or Organization endorsement
CG 20 10, or the Additional Insured —
Ow�ers, Lessees or Contractors —
Completed Operations endorsement
CG 20 37, withaut an edition date ot
such endorsement specified;
the person or organization is an additional
insured only if the injury or damage is
caused, in whole or in part, by acts or
omissions af you or your subcantractor in
the pertormance of "your work" to whlch
the "written corrtract requiring insuranee"
applies; or
(3y If neither Paragraph {1) nor (2) above ap-
plies:
{a) The person o� organization is an ad-
ditional i�sured only if, and to the ex-
tent that, the injury or damage is
caused by acts or omissions of you or
your subcont�acto� in the perform-
ance of "your work" to which the "writ-
ten contcact requiri�ig insurance" ap-
plies; and
(b) The person or organizaiion does not
qualify as ao additional insured with
respect to the independent acts or
omissions of such person or organi-
zation.
CG D5 04 08 13 � 26t3 The Travelers I�demnity Company. Ali rights reserved.
Page 1 of 3
,
COMMERCIAL GENERAL LIABILITY
2. The insurance provided to the additional insured
by this endorsemeni is limited as follows:
a. If the Limits of Insurance of this Coverage
Part shown in the Declarations exceed the
minimum limits of liatrility required by the
"written contract requiring insurance", the in-
surance provided to the additional insured will
be limited to such minimum required limits of
liability. For the purposes of determining
whether this limitation appli2s, the minimum
limits of liability required by the "written con-
tract requinng insurance" wi�l be considered
to include the minfmum limits of liabiliiy of any
Umbrella or Ezcess liability cove�age �equired
for the additiona! insured by that "written con-
tract requiring insurance". This endorsement
will not increase the limits of insurance de-
scribed in Section III — Limits Of Insurance.
b. The insurance provided to the additional in-
sured does not apply to "bodily injury", "prop-
erty damage" or "personal injury" arising out
of the �endering of, or failure to render, any
professional architectural, engineering or sur-
veying services, induding:
(1) The preparing, approving, or failing to
prepare or approve, maps, shop draw-
ings, opinions, reports, surveys, field or-
ders or change orders, or ihe preparing,
approving, or failing to prepare or ap-
prove, drawings and specifications; and
{2) Supervisory, inspection, architectural or
engineering activities.
c. The insurance provided to the additionai in-
sured does not appiy to "bodily injury" or
"property damage" caused by "your work" and
included in the "produds-completed opera-
tions hazard" unless the "written contraci re-
quiring insurance" specificaliy requires you to
provide such coverage for thaF additional in-
sured during the policy period.
3. The insurance provided to the additional insured
by this endorsement is excess over any valid and
collectible other insurance, whether primary, ex-
cess, contingent or on any other basis, that is
available to the additional insured. However, if the
"written contract requiring insurance" specificalfy
requires that this insurance apply on a primary
basis or a primary and non-contn6utory basis, this
insurance is primary to other insurance available
to the additional insured under which that person
or organization qualifies as a named insured, and
we will not share with that other insurance, But
ihe insurance provided to the additional insured
by this endorsement stil3 is excess over any valid
and collectible other insurance, whether primary.
excess, contingent or on any other basis, that is
available to the additional insured when that per-
son or organization is an additional insured, or is
any other insured that does not qualify as a
named insured, under such other insurance.
4. As a condition of coverage provided to the addi-
tional insured by this endorsement:
a. The additional insured must give us written
notice as soon as practicabfe of an "occur-
rence" or an offense which may result in a
claim. To the extent possible, such notice
should include:
(1) How, when and where the "occurrence"
or offense took place;
(Zj The names and addresses of any injured
persons and witnesses; and
(3) The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
b. If a claim is made or °suiY' is brought against
the additional insured, the additional insured
must:
(1) fmmediately record the specifics cf the
claim or "suiP' and the date received; and
(2) Notify us as soon as practicabie.
The additional insured must see to it that we
receive written notice of the claim or "suit" as
soon as practicable.
c. The additional insured must immediately send
us copies of all legal papers received in con-
nection with the daim or "suii", cooperaie with
us in ihe investigation or settlement of the
claim or defense against ihe "suit", and oth-
erwise comply with all policy conditions.
d. The additional insured must tender the de-
fense and indemnity of any claim or "suit" to
any pravider of other insurance which would
cover fhe additional insured for a loss we
cover under this endorsement. However, this
condition does not affect whe[her the insur-
ance provided to the additional insured by this
endorsemeni is primary to other insurance
available to the additional insured which cov-
ers that person or orga�ization as a named
insured as described in Paragraph 3, above.
5. The following is added to the DEFINITIONS Seo-
tion:
"Written contract requiring insurance" means lhat
paR af any writtsn contract or agreement under
which you are required to include a person or or-
Page 2 of 3 O 2013 The Trevelers Indemnity Company All rights reserved. CG D6 04 0$ 13
ganization as an additional insured on this Cover-
age Part, provided that the "bodily injury" and
"property damage" occurs, and the "personal in-
jury" is caused by an offense committed, during
the policy period and:
��
o=
o=
o°
CG D6 04 08 13
0025JJ
COMMERCIAL GENERA� LfABILITY
a. After the signing and execution of the contract
or agreemerrt by you; and
b. While ihat part of the contract or agreement is
in effect.
�.2073 The Travelers Indemnity Company. OJI rights reserved.
Page 3 of 3