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Home My WebLink AboutDixon Engineering/water storage tanksCITY 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 TRANSMfTTAL To: Mr. Joseph T. Hoban, P.E. Dixon Engineering, Inc. 9415 West Forest Home Avenue Suite 208 Hales Corners, WI 53130 Date: October 9, 2015 Sub�ect: Executed Agreement Maintenance Inspection Services for Four Efevaied Water Stora e Tanks 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 These are being transmitted as indicated below: ❑ For Approval � For Your Use ❑ As Requested ❑ For Review & Comment Remarks: Enclosed is a copy of the executed agreement for the maintenance inspection services for four elevated water storage tanks. 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 Clerk's Office — Original cc: ` File — Original Signed: Trac . Taylor I:\Engineering\Tracy Taylor\Steve Brand Agreements\Dixon EnglMaint Insp-4 Elevated Wtr Storage Tanks\LOT-Executed Agreement 10-9-15.docx AGREEMENT THIS AGREEMENT, made on the � day of , 2015, by and between the CfTY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and DIXON ENGINEERING, INC., 9415 West Forest Home Avenue, Suite 208, Hales Corners, WI 53130, party of the second part, hereinafter referred to as the CONSULTANT, WITNESSETH: That the CITY and the CONSULTANT, for the consideration hereinafter named, enter into the following AGREEMENT for MAINTENANCE INSPECTION SERVICES FOR FOUR ELEVATED WATER STORAGE TANKS. ARTICLE I. PROJECT MANAGER A. Assignment of Project Manager. The CONSULTANT shall assign the following individual to manage the PROJECT described in this AGREEMENT: Joseph T. Hoban, P.E. B. Changes in Project Manager. The CITY shall have the right to approve or disapprove of any proposed change from the individual named above as Project Manager. The CITY shall be provided with a resume or other information for any proposed substitute and shall be given the opportunity to interview that person prior to any proposed change. ARTICLE II. CITY REPRESENTATIVE The CITY shall assign the following individual to manage the PROJECT described in this AGREEMENT: Stephan M. Brand — Public Works Utility Bureau Manager ARTICLE III. SCOPE OF WORK The CONSULTANT shall provide the services described in the CONSULTANT's Proposal. CITY may make or approve changes within the general Scope of Services in this AGREEMENT. If such changes affect CONSULTANT's cost of or time required for performance of the services, an equitable adjustment will be made through an amendment to this AGREEMENT. All reports, drawings, specifications, computer files, �eld data, notes, and other documents and instruments prepared by the CONSULTANT as instruments of service shall remain the property of the CITY. ARTICLE IV. STANDARD OF CARE The standard of care applicable to CONSULTANT's services will be the degree of skill and diligence normally employed by professional consultants or consultants performing the same or similar services at the time said services are performed. CONSULTANT will re-perform any services not meeting this standard without additional compensation. I:�Engirreering\Traq Taylor�Steve BrarM AgreementslDixon EnglMaint Insp.4 Elevated +Mr Srorage TanksWgreement 9-2S15.doc�c Page 1 of 5 ARTICLE V. OPINIONS OF COST FINANCIAL CONSIDERATIONS AND SCHEDULES In providing opinions of cost, financial analyses, economic feasibility projections, and schedules for the PROJECT, CONSULTANT has no control over cost or price of labor and materials; unknown or latent conditions of existing equipment or structures that may affect operation or maintenance costs; competitive bidding procedures and market conditions; time or quality of performance by operating personnel or third parties; and other economic and operational factors that may materially affect the ultimate project cost or schedule. Therefore, it is understood befinreen the parties that the CONSULTANT makes no warranty that the CITY's actual project costs, financial aspects, economic feasibility, or schedules will not vary from CONSULTANT's opinions, analyses, projections, or estimates. ARTICLE VI. RECORD DRAWINGS Record drawings, if required, will be prepared, in part, on the basis of information compiled and furnished by others. CONSULTANT is not responsible for any errors or omissions in the information from others that the CONSULTANT reasonably relied upon and that are incorporated into the record drawings. ARTICLE VII. CITY RESPONSIBILITIES The CITY shall furnish, at the CONSULTANT's request, such information as is needed by the CONSULTANT to aid in the progress of the PROJECT, providing it is reasonably obtainable from City records. To prevent any unreasonable delay in the CONSULTANT's work, the CITY will examine all reports and other documents and will make any authorizations necessary to proceed with work within a reasonable time period. ARTICLE VI11. ASBESTOS OR HAZARDOUS SUBSTANCES tf asbestos or hazardous substances in any form are encountered or suspected, CONSULTANT will stop its own work in the affected portions of the PROJECT to permit testing and evaluation. If asbestos is suspected, CONSULTANT will, if requested, manage the asbestos remediation activities using a qualified subcontractor at an additional fee and contract terms to be negotiated. If hazardous substances other than asbestos are suspected, CONSULTANT will, if requested, conduct tests to determine the extent of the problem and will perform the necessary studies and recommend the necessary remedial measures at an additional fee and contract terms to be negotiated. CITY recognizes that CONSULTANT assumes no risk and/or liability for a waste or hazardous waste site originated by other than the CONSU�TANT. ARTICLE IX. CITY'S INSURANCE CITY will maintain property insurance on all pre-existing physical facilities associated in any way with the PROJECT. I:�Engineering\Tracy Taylor�Steve Brand AgreementslDixon Eng\Maint Insp-4 Elevated Wtr Storage TanksWgreement_9-2S15.docx Page 2 of 5 CITY will provide (or have the construction contractor(s) provide) a Builders Risk All Risk insurance policy for the full replacement value of all project work including the value of all onsite CITY-furnished equipment and/or materials associated with CONSULTANT's services. Upon request, CITY will provide CONSULTANT a copy of such policy. ARTICLE X. TIME OF COMPLETION The work to be performed under this AGREEMENT shall be commenced and the work completed within the time limits as agreed upon in the CONSULTANT's Proposal. The CONSULTANT shall perform the services under this AGREEMENT with reasonable diligence and expediency consistent with sound professional practices. The CITY agrees that the CONSULTANT is not responsible for damages arising directly or indirectly from any delays for causes beyond the CONSULTANT's control. For the purposes of this AGREEMENT, such causes include, but are not limited to, strikes or other labor disputes, severe weather disruptions or other natural disasters, failure of performance by the CITY, or discovery of any hazardous substances or differing site conditions. If the delays resulting from any such causes increase the time required by the CONSULTANT to perform its services in an orderly and efficient manner, the CONSULTANT shall be entitled to an equitable adjustment in schedule. ARTICLE XI. COMPONENT PARTS OF THE AGREEMENT This AGREEMENT consists of the following component parts, all of which are as fully a part of this AGREEMENT as if herein set out verbatim, or if not attached, as if hereto attached: 1. This Instrument 2. CONSULTANT's Proposa! dated September 17, 2015 and attached hereto In the event that any provision in any of the above component parts of this AGREEMENT conflicts with any provision in any other of the component parts, the provision in the component part first enumerated above shall govern over any other component part which follows it numerically except as may be otherwise specifically stated. ARTICLE XII. PAYMENT A. The Agreement Sum. The CITY shall pay to the CONSULTANT for the performance of the AGREEMENT the total sum as set forth below, adjusted by any changes hereafter mutually agreed upon in writing by the parties hereto: • Lump Sum Not to Exceed $9,000 (Nine Thousand Dollars). • Attached fee schedule shall be firm for the duration of this AGREEMENT. B. Method of Payment. The CONSULTANT shall submit itemized monthly statements for services. The CITY shall pay the CONSULTANT within thirty (30) calendar days after receipt of such statement. If any statement amount is disputed, the CITY may withhold payment of such amount and shall provide to CONSULTANT a statement as to the reason(s) for withholding payment. C. Additional Costs. Costs for additional services shall be negotiated and set forth in a written amendment to this AGREEMENT executed by both parties prior to proceeding with the work covered under the subject amendment. 1:1EngineeringlTracy TayloASteve BrarW AgreementslDi�ron Eng�AAaint Insp-4 Elevated W[r Storage TanksWgreement 9-2S15.docx Page 3 of 5 ARTICLE XIII. HOLD HARMLESS The CONSULTANT covenants and agrees to protect and hold the City of Oshkosh harmless against all actions, claims, and demands which may be to the proportionate extent caused by or result from the intentional or negligent acts of the CONSULTANT, his/her agents or assigns, his/her employees, or his/her subcontractors related however remotely to the performance of this AGREEMENT or be caused or result from any violation of any law or administrative regulation, and shall indemnify or refund to the CITY all sums including court costs, attorney fees, and punitive damages which the CITY may be obliged or adjudged to pay on any such claims or demands within thirty (30) days of the date of the CITY's written demand for indemnification or refund for those actions, claim, and demands caused by or resulting from intentional or negligent acts as specified in this paragraph. Subject to any limitations contained in Sec. 893.80 and any similar statute, of the Wisconsin Statutes, the CITY further agrees to hold CONSULTANT harmless from any and all liability, including claims, demands, losses, costs, damages, and expenses of every kind and description (including death), or damages to person or property arising out of re-use of the documents without consent where such liability is founded upon or grows out of the acts or omission of any of the officers, employees or agents of the City of Oshkosh while acting within the scope of their employment. ARTICLE XIV. INSURANCE The CONSULTANT agrees to abide by the attached City of Oshkosh Insurance Requirements. ARTICLE XV. TERMINATION A. For Cause. If the CONSULTANT shall fail to fulfill in timely and proper manner any of the obligations under this AGREEMENT, the CITY shall have the right to terminate this AGREEMENT by written notice to the CONSULTANT. In this event, the CONSULTANT shall be entitled to compensation for any satisfactory, usable work completed. B. For Convenience. The CITY may terminate this AGREEMENT at any time by giving written notice to the CONSULTANT no later than ten (10) calendar days before the termination date. If the CITY terminates under this paragraph, then the CONSULTANT shall be entitled to compensation for any satisfactory work performed to the date of termination. This document and any specified attachments contain all terms and conditions of the AGREEMENT and any alteration thereto shall be invalid unless made in writing, signed by both parties and incorporated as an amendment to this AGREEMENT. ARTICLE XVI. RE-USE OF PROJECT DOCUMENTS All reports, drawings, specifications, documents, and other deliverables of CONSULTANT, whether in hard copy or in electronic form, are instruments of service for this PROJECT, whether the PROJECT is completed or not. CITY agrees to indemnify CONSULTANT and CONSULTANT's officers, employees, subcontractors, and affiliated corporations from all claims, damages, losses, and costs, including, but not limited to, litigation expenses and attorney's fees arising out of or related to the unauthorized re-use, change, or alteration of these project documents. I:�Engineering\Tracy Taylor�Steve Brand Agreements�Dixon Eng\Maint Insp-4 Elevated Wtr Storage TanksWgreement_9-2615.docu Page 4 of 5 ARTICLE XVII. SUSPENSION DELAY OR INTERRUPTION OF WORK CITY may suspend, delay, or interrupt the services of CONSULTANT for the convenience of CITY. In such event, CONSULTANT's contract price and schedule shall be equitably adjusted. ARTICLE XVIII. NO THIRD-PARTY BENEFICIARIES This AGREEMENT gives no rights or benefits to anyone other than CITY and CONSULTANT and has no third-party beneficiaries. In the Presence of: (Seal of Consultant, if a Corporation (Witness) (Witness) �- -• � � � �, i . ��c , . , �`r., , .ir l . . - �' - - CONSULTANT By: � n��v (Specify Title) By: (Specify Title) CITY OF OSHKOSH /� , ro, By: a--�,� �f�l Ma c A. Rohloff, City M � _�• Pamela R. Ubrig, City C er 0 9�Z6 /�� I hereby certify that the necessary provisions have been made to pay the liability which will accrue under this AGREEMENT. ��'��;�� f�jr�.,� nr� City Comptroller 1:1Engineering\Tracy Taylor�Steve Brand Agreements�Dixon Eng\Maint Insp4 Elevated WV Storage TanksWgreement 9-25-15.docz Page 5 of 5 �'�� _�u � —�3f�7 South 92nd Street R�CECVED Sutfe 125 -- Hales Corners, W153130 ENGINEERING & INSPECTION SERVICES ��P 1$ 2Qi5 Telephone: {414) 529-�859 FOR THE COATING INDUSTRY � Fax: t4�a� szs��2o I?EP"C'�t� i'tJ[3LIC «�ORKS OSHKOS(1, W{SC4NSIN Proposal for WRter Storage Tank 1,250,000 Gallon Hyclro Pillar, (9t/r - Wrc.slrbicf�fi), #49-71-116-01 _ __ ___ __ _ __ _ _ _ _ ___ _ _ __ _ _ _ ___ ___ __. 750,004 Double Ellipse, (Marion), #99-7I-Ob-D2 750,000 Flutetl Colutn�t, (Soccthwest), #49-71-06-D3 I,S00,000 Fluted Colut�ur, (Ferrteau Ave), #�9-71-6-(14 The Proposal is between Dixvn Engineering, Inc. (DIXOl� and the Citv of Oshkosl�, Wisconsin (Owner) to contract with DIXON for technical sei�vices for the Four Elevated Water Stora�e Tanks (Project). 1.41 PAYMENT DIXON shall provide, or cause to be provided, services detailed in Scope of Services and Owner agrees to pay DIXON as compensaiion for their services the fee/lump sun� of Nine Tl►ousand dollars ($9 Q, 00•QO). Terms of charges and payments per details in SCHEDULE B. (Prices quoted are subject to change ninety (90) days after proposal da#e, if noi conf�•acted.) 2.01 SCOPE OF SERVICES 1V�aintenance Inspeciion Sei•vices (Drained) ner SCHEDULE A 3.OI SIGNATURES Joseph T. Hoban, Senior Project Engineer _ September 17, 2Q15 PROPOSED by DIXON (Piot a coniract until approvcd by an ot3icer} PROPOSAL, DATE CONTRACT Ai'PROVED by OWNER POSITION DATE CO SIGNATURE (if required} POSITION DATE CONTRACT APPROVED by DIXQN OFFICER POSITION EFFECTIVE CONTRACT DATE SCHEDULE A Maintenance Inspection 1,250,000 Gcrllon Hyrtro-Pillnr, j9ilr - Washbur•n), #49-71-06-01 750,000 Double Ellrpse, {Mtrrion}, #49-71-06-02 750,000 Flrated Colccyrzn, (Sorctl:westj, #49-71-06-03 I,500,000 Fla�tetl Cohcrnrz, (Fef•raeatt Ave), #49-71-6-04 _ __ ___ ___ _ _ _ _ Osltkosfi;_Wisconsin _ . __ _ ___ _ _ _ __ A. Scope of Services Perfor�ned by �wner {Drained): 1. The Owner is not required to provide personnel to climb the tank; however, he is welcome to do so. A hard hat is required on this empIoyee and any employee on the ground. DIXON does ca�ry addi#ional safery h�nesses which can be used by the Owner's persoiulel; however, if the tank caniains a fall prevention device, that device shouid be used. DIXON persannel carry tl�eir own personal safety equipment for thAt purpose. DIXON will assist the Owner's persoru2el iii inspecting the exterior of the tank on the balcony and roo£ If there is a bottom manhole into the wet interior of a sphere, hydropillar, or composite, or a ladder from the roof manhole, the Owner's personnel wili be directed in. If DIXON is'required to rig the tank using their own rope ladder ancUor set of block and tackle for descent #�uough the riser, the Owner's personnel will not be allawed access. 2. By signing tl�is contract, i# is understaod the Owner's personnel is covered by the Owner's insurance and is not a i•esponsibility of DIXON's insurance. 3. Perform bacterioiogical tesdng after completion of the inspections. TwQ (2) consecutive samples are recom�nended at 24 hour inteivals per AW WA C-652-07 Chlorination Method No. 3. 4. Qperate the systen� without the tanks in-seivica. This includes operation and cnonitoring of p�essure relief valves, if necessaiy. 5. Drain the water storage tauks (hereinafter referred to as tank) prior to ihe arrival of DIXON. (Arrival time to be inutually agreed upon by the Owner and DIXON.) B. Scope of 5ervice� Performed by DIXUN (Drained): 1. Inspect the tanks' interior coating for remaining intactness and anticipated life. Review all interiar girders and appurtenances for possible structural damage from icing or corrosion. 2. Review all uiterior surfaces for corrosion and/or damage, and quantify damage for - -- -- -- repairs� AII repairs are to be quantified by extrapolation of a-measured area: - All - - -- quantities are estimates (usually high) because corrosion will continue between inspection and repair. 3. Inspect the exterior coating and perform ASTM adhesion tests where coating adhesion is quesiionabte. If it is evident that repainting is not necessasy for several years, no desti�uctive adhesion tests witl be performed. 4. Review all exterior appurtenances for damage due to corrosion. 5. Review tlie exterior of the exposed fou�idations. � 6. Review all safety requireineiits for ladders, cages, etc, 7. Review ail health aspects of the tank, including screening vf the vent, overflow pipe, aud other possible contamination sources. � 8. Provide a filled in DNR Form 3300-248 (Water Storage Faciliry Inspection Report) for each tank with the reports. 9. Prepare reports.documenting all items found and recommendatians for repair, including budgetary items. The engineering repoi�ts are to include: Conciusions and recommendarions, base report, and digital pho#ographs wi#h descriptions. SCH�DULE B Maintenance Inspection �,250,000 Gallon Hy�lro-Pillar, (9th - Wirshburn}, #49-71-116-tIX 750,000 Douhle Ellipse, (Mrr►�ion), #49-7I-06-02 750,000 Flrrted Colritm:, {Soutltwest), #49-71-06-03 ' 1,500,000 Flulerl Colum�r, (FernetruAve), #49-71-6-D4 � _ __ _ _ _ __ _ _ __ _ ___ _ _ _ _ _ Oshkosft, Wrsco�tsrrt 1. Coinpensation for Items 1 tluough 8, na�el time, and preparation of report as outlined in Schedule A—Scope of Services Performed by DIXON is a fixed fee of $2,250.00 per tank for 4 tanks. ($9 000.00 , 2. All DIXON service invoices which are outstanding mare than thirty (30) days from date of issue shall be assessed (DIXON's favor) one and one half percent (1 %2%) per month interest fiom date thirty days after date of issue. SCH�DUL� C Engineering Services Fees Labor Class Per Hour *�vertime Rate _ _ Princi al:::::�:. _ ___ _ _ _ __ $175.0� 'p ......... .................. ........ ........................... Expei�t Witness {Office, Travel & Court) ...................... $185.00 Project Manager ................................................... $100.00 Registered Professional Engineer ... . . . . . . . . . . .. . . . . . . . . . . .. .... $100.00 Certified NACE Inspector ................. ... .. . . . . ............. $90.00 Assistant Project Manager ....................................... $80.00 Staff Engineer — Level III . .. . .. . . . . . . .. . . . . .. . .. . . . . .. . .. . . . . . . .. $72.00 to $85.00 Staff Engineer — Level II . ..... ... . . . . . . .. . ... .. . .. . ... . . . .. . . . ... $b7.00 to $80.Q0 Staff Engineer — Level T . . . . . . . . . ..... . . . . . . . ... ... . .. ... ......... $62.00 to $75.00 CAD Supervisor ... . . . . . . .. . ... ....... .. . . .. .................... $65.00 to $?5.00 CA'WI or CWI Welding Inspector .............................. $67.00 to $85.00 Inspector -- Levei III ............ ......... ... ... ... .... ............ $b3.00 to $80.00 Inspector — Level II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. $60.�0 to $75.00 Inspectar — Level I ............ ......... ... .............. . .. .. .. ... $55.00 to $70.00 CAD Technician ................................................... $60.00 to $70:00 Secretarial Services . . ............. :.. . . . . . . .. . .. . .. . .. . . . . . . . . . ... $48.00 & expenses Bookkeepin� Services ..:......................................... $44.00 Project Status Meetings w/Project Engineers and Council or Boa2•d Meetings ....... ............................................ Time and Expenses, Including Preparation Time *All Saiurday, Sunday, and holiday inspections are ovei�ime rate. Overtime rate is 1 lh time the hourly rate. Ovei�time rate does not apply #o Principal. Expenses: Mileage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Meals & Lodging, ...... ....:..................................... WithoutLodging . . . . .. ......... . . . . . . . .. . . . . . . .. . . . . .. . . .. .. . . . .. AirTravel . . . .. . . .. . . . . . . ............ . . . . . . ......... .... .. ... ... ... Metropolitan Non--Metropolitan $0.70Im'tIe {inc�udingtof�s) $0.60/mite $I45 per diem $125 per diem (nta}y be increasecl based on location) $35/day $34/day Busii�ess fare from Grand Rapids, Chicaga O'Hare, or Mit�vauicee, plus full size car rental Material (gaskets, cathadic protection caps, etc.)............ Negotiated FEES EFFECTIVE THROUGN DECEMBER 31, 2015 ,r-�� DIKONE1 OP ID: LB '`��,...�,,.�1R°� CERTtFICATE OF L,lABiLITY INSURANCE pATE(MMtDUIYYYY) 09116f2Q15 � THIS CER'TIFICATE IS 13SUED AS A MATTER OF lNFOiiMAT14N ONLY AND CONFERS NO RIGHTS UPON THE CERTiFICATQ HOI.DE#i. THIS CERIIFICATE DOES NOT AFFIRMATiVELY OR iVEt3AT1VEi.Y AMEND, EXTEND OR ALT�R THE COVERAGE AFFORDED 8Y THH POUCIES ' BELOW. THiS CERTiF1CATE �F IN3URANCE DOES NOT CONS117U7E A COAITRAC7 BETWEEN 7HE iSSUINO IN3URER(S), AUTHORlZED REPRESENTATIVf OR PRODUCER, AND THECEttTIFICATE HOLD�R. the eRms and condltionsfof he ;ilcyicerf�r��dli�i'a5'�ay eyuEs,a�heiPdor e�mentmA statem nt o this c rt�IfRlcOa eAdoes not,conieE�rlghts,to the certlficate holder In Ileu of such e'dorsement s. PROOUC&R ,�,�° �"�T Pete Suminski Blick Dlllon Insurance �j�.Q 1 $ ��5 �o� 123 NMltcheil St P.O.B.389 �231-775-3416 r�a:231-775-0897 Cadlllac, MI 49601 . . � A RL Pate SUminskl _ ___ _.. .... .]��P�-p�.PU �iSCONS N • _ USkIKc3St-t, INSURED Dixon Englnee�ing Inc Wi!(iam Dixon 1104 3ftD Ave Lake Odessa, MI48849-1191 INSUR�R Sy AFFOROING COVERAOE NAIC / n:Auto Owners Insur�nce Com an 18988 s: Travelers c: US Specialty Ins Coropanv GOVERAGBS CERTIFICA7E NUMBER: REVISION NUMBER: THIS 1S TO CEitTIFY THAT 7HE POLICIES OF INSURANCE LISTED BELOYI HAVE BEEN ISSUED TO TNE INSURED NAMED ABOVE FOR THE POLfCY PERIOD INDfCA7ED. NO'FWITHSTAlVDINti ANY REQIJIREMENT, 7ERM OR CONDtftON OF ANY CONTRACT OR OT+iER DOCUMENT WfiH RESPECT TO WHICH 1}iIS CERTIFICA7E MAY BE ISSUED OR MAY PERTAS�l, THE IMSURANCE AF�ORDED BY THE PDLiGIES DESCRI6ED tiEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANQ COND(TfONS OF SUCH AOLICIES. LIMITS StfOWN MAYHAVE BEEN REDUCED BY PA10 CLAIMS. �� TYPB OF INSURANCE pOLICYNUMBER h3A410 Y[XYYYY MtQii�1DI YYYPY LIMRS CENERAlLU16}U7y EAq10CCLRRENGE s 1,040,000 A i� COMMERqAL3ENERpLLfABIUtt X X 33007655 71I01/209d 19/01/2015 p��MSES EaauRence 4 3fl�r�� CLIfMSMADE ❑X occuR hSEDFJW(Myonep9�son) s f0,000 X XCU PERSONAI&ADVINJUFY S i�OOO�OOO GF1dE�Al AGGRE6A7E S Z�OOO�OOO GEN'L f.GGREGATELI�A7APPLESPER: Pt20WCTS- COMP/OPACaG $ 2�000,000 PO11CY X PRO- LOC S AUTOMOBILE LIABIIITY 'I ODO 000 Ea BCCIdCnt f � r A ANY AUTO X X 9536754fi02 0TJ0112015 07l01/201 B BODILY INJURY (Pat person) s ALLOWNED x SCHEDUEEO BODILYINJURY�Paratc4i�q $ AUTOS AUiOS X HiREDAJTOS X NON-OWNED � Y RMAr,E $ AUTOS PER ,lCql1=N7 Y )( UNBRELLALUH X OCCUR EAGHOCCI,RREnCE = S�OOO,OOO A EXCESSLIAB q,A1MS-MADE 536759603 11/0't/1014 i�/0'�/Z�i�J A6GREGATE t rJ��00�� oEO X R�rEr�rroN s �NAIVED ' f WORKERSCOMPEHSATION x 1VCSTATT- X R- pND EhfPLOYER3' LUt81LfTY . B xvr r�raor�ziErorzfPnR�ewo�curi�� Y iN 6Jt185B53814-2-1d 10/93/2014 'IUH 312015 �.L. EACH ACCtDEN7 $ 500,000 CFFICERlMEMBET�DCCUAED'� � N)A (Msndatorylnt� • E.L.qSEASE.EAEMPLOYEE S �J�D,OQO If yes descnbe under CESL'RP7lOP10FOPERATIONSbeav EL.pISEASE-POUCYLMJT S �JOO�OOO C Proiesslonal Llab USS1525836 OT/01/2015 07/01/2016 Ea Claim 2,000,000 S25,OU0 DEDUCTIBLE Aggregafe 2,000,00 DESCRIPAON OF OPERATIOFi31lOCAT10NSlYEHCCBS (AttzchACOR0101, Addifian�i Rem,uke Sch�dule, if more spacs is requlre� en rec�uired b�r contraot or wri.tten agreement, City of Oshkosh, and its offiaars, council members, agents, empZoyses and au�hori.zed volunteers are inoluded as Additional Insureds on the Commeroial General LiabiI.ity, Auta Liability and Exaess LiabiJ.i.ty polioiss. 30 Day cancellation notioe is afforded under the Commercial Genera]. Liability policy. City of Oskosh 215 Church Ave. P.O. 8�x 1930 Oshkosh, W[ 549Q3�100 ACORD 25 (2010/05) CIOS001 SNOULD ANY OF TH� ABOVB DEBCR��D POUCIES B� CANCELtEO BEFdRE THE EXPIRATION DATE THERkOF, N�i10E WILL BE DEtIVERED IN ACCORDANCE WiTN 1HE POLICY PROVISIONB. AUTFIOF2IZED R�+itESENTATIYE �.�i .!��G�/7TG.�7�lU� • O 9986-2090 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Auto-Owners Insurance Company COMMERCIAL GENERAL LIABfLITY 55373 (1-07)Z THIS ENDfJRSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED _ ___ _ ___ __ __ This endorsement modifies insurance provided under the following; COMMERClAI. GEI�lERAI. L.IABIL.ITY COVERAGE FORM. A. Under SECTIDN il - WHO 1S AN INSURED, the following is added: A person ar organization is an Additional Insured, only with respect to liability arising out of "your work" for that Additionaf Insured by or for you: 1. ff requi►�ed in a written co�itract or agreement; or Z. If required by an oral contract or agreement onEy if a Certficate ofi Insurance was issued prior io the loss indicating that the person or organization was an Additional Insured, B. Under SEC710N III - LlMI7S OF 1NSURANCE, the fo[(owing is added: The limits of liability for the Additional lnsured are those specified in the wriiten contracf or agreement hefween the insured and the owner, lessee or contractor or those specified in tl�e Certificate of Insurance, if an orat cantract or agreement, t�ot to exceed the fimits provided in ihis policy. These limits are inclusive of and not in addition to the limits of insurance shown in ihe Declarations. C, SECTION IV - COMMERCIAL GENERAI. LiAB1LITY CONDITiONS, is amended as follows: t. The following provision is added to 4. Other Insurance: This insurance is primary for the Additional Insured, but only with respect to liability arising out of "your work" for that Additional Insured by or for you. Other insurance avaiiable to the Additional Insured will apply as excess insurance and not contribute as primary insurance to the insurance p�ovided by this endorsement. 2. The following provision is added: Other Additiona{ fnsured Coverage Issued By Us � If this policy provides coverage for the same loss to ariy Additional Insured specifically shown as an Addiiional Insured in another endorsement #o this �olicy, our maximum limit of insurance under this endorsement at}d any other endorsement shall not exceed the limit of insurai�ce in the writken caniract or agreement between the insured and the owner, lessee or contractor, or the lirnits provided in this policy, whichever is less. Our maximum limit of insurance arising out of an "occurrence", shall not exceed the limit of insurance shown in the Declarations, regardfess of the number of insureds or Additional Insureds. Alt other policy terms and conditions apply. Includes copyrighted material of lnsurance Services Office, Inc., with its permission. 55373 (1-07)Z Copyright Insurance Services O�ce, lnc., 1984, Z003. Page 7 of 1