Loading...
HomeMy WebLinkAboutH & H Industries & City/ Public Works Contract 16-19 CITY 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: H & H Industries, Inc. Date: March 23, 2016 2801 Syene Road Project: Water Filtration Equipment Madison WI 53713 Replacement From: Amber Heise, Admin. Assistant Attn: Re: Signed Agreement Please find: ® Attached ❑ Under Separate Cover . ❑ Copy of Letter ® Agreement ❑ Amendment ❑ Report ❑ Agenda ❑ Meeting Notes ❑ Photos ❑ Mylars ❑ Change Order ❑ Plans ❑ Specifications ❑ Estimates ❑ Diskette ❑ Zip Disk ❑ Other Quantity Description 1 Executed Agreement for the Water Filtration Plant equipment replacement, ' Public Works Contract 16-19 1 Executed Performance Bond 1 Certificate of Liability Insurance These are being transmitted as indicated below: ❑ For Approval ® For Your Use ❑ As Requested ❑ For Review& Comment Remarks• cc: City Clerk (original) Public Works (original) CONSTRUCTION CONTRACT THIS AGREEMENT, made on the 24th day of February, 2016, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and H & H INDUSTRIES, INC., 2801 SYENE ROAD, MADISON,WI 53713, 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. 16-19 for the Water Filtration Plant equipment replacement, for the Public Works Department, pursuant to Resolution 16-65 adopted by the Common Council of the City of Oshkosh on the 23RD day of February, 2016, 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 Il. TIME OF COMPLETION The work to be performed under this contract shall be commenced and the work completed within the time limits specified in the Special Conditions and/or CONTRACTOR's proposal. ARTICLE 111. PAYMENT (a) The Contract Sum. The CITY shall pay to the CONTRACTOR for the performance of the Contract the sum of Five-Hundred-Twenty-Three-Thousand-Four-Hundred-Twenty-Four Dollars and 00/100 ($523,424.00), 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 1 work covered by the Contract. (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 coverage 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 Jength 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 Pians 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. 2 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, 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. 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 the Presence of: CONTRACTOR H & H Ind(") �j / i4, By. J. Brady Farrell.President (Seal of Contractor (Specify Title) if a Corporation.) Martin J.Becker,Chief Financial Officer (Specify Title) CITY OF OSHKOSH � By, Mar A. Rohloff, City Manager Itness .. And; Pamela R. Ubrig, City Cl rk/ t} APPROVED; I hereby certify that the necessary provisions have been made to pay the liability which will accrue under this contract C4AAtrney City Comptroller 3 } CITY OF OSHKOSH - WATER FILTRATION PLANT EQUIPMENT REPLACEMENT PROJECT PERFORMANCE BOND FORM Any singular reference to Contractor,Surety,Owner,or other party shall be considered plural where applicable. CONTRACTOR SURETY (Nance and Address): (Name and Address of Principal Place of Business): H&H Industries, Inc. Travelers Casualty and Surety Company of America 2801 Syene Rd One Tower Square Madison,WI 53793 Hartford,CT 06183 OWNER(Name and Address): City of Oshkosh,Wisconsin City Hall,215 Church Avenue Oshkosh,WI 54901 CONTRACT Date: 2-24.2016 Amount: $523,424.00 Description(Name and Location),'Water Filtration Plant Equipment Replacement Project,City of Oshkosh Contract No. 16-19 BOND Bond Number; 106358408 Date(Not earlier than Contract Date): 3.1-206 Amount; $523,424.00 Modifications to this Bond Form: None Surety and Contractor,intending to be legally bound hereby,subject to the terms printed on the reverse side hereof, do each cause this Performance Bond to be duly executed on its behalf by its authorized officer,agent,or representative. CONTRACTOR AS PRINCIPAL, SURETY C6►1►party; ,H&H Ind Istries,Inc. Travelers Casualty and Surety Company of America Signature;' T ~` (Sea!) (Seal) Name alld Title Surety's Na►►te and CQr orate Seal Paei1 A. Christensen ( .. \ Ph ief Executive Officer Su By Signa ure an itle I lizabeth Mosoa,Attorney-in-Fact (Attach Power of Attorney) (Space is provided below for signatures of additional parties,if required.) "N'4 1, Attest: Signature and Titlo Broo a L. Parker,witness PW/DEN001/650630 PERFORMANCE BOND FORM JANUARY 4,2016 00 61 13,13 - I ©COPYRIGHT 2016 CH2M HILL 1- CITY OF OSHKOSH-WATER FILTRATION PLANT EQUIPMENT REPLACEMENT PROJECT CONTRACTOR AS PRINCIPAL SURETY Company: Signature: (Seal) (Seal) Name and Title Surety's Name and Corporate Seal By: Signature and Title (Attach Power of Attorney) Attest: Signature and Title PW/DEN001/650630 PERFORMANCE BOND DORM JANUARY 4,2016 00 61 13,13 -2 CCOPYRIGHT 2016 CH2M HILL 1 CITY OF OSHKOSH - WATER FILTRATION PLANT EQUIPMENT REPLACEMENT PROJECT 1, Contractor and Surety,jointly and severally,bind 4.3. Obtain bids or negotiated proposals from themselves,their heirs,executors,administrators, qualified contractors acceptable to Owner for a successors,and assigns to Owner for the performance contract for performance and completion of the of tite Contract,which is incorporated herein by Contract,arrange for a contract to be prepared for reference. execution by Owner and Contractor selected with Owner's concurrence,to be secured with 2, If Contractor performs tite Contract,Surety and performance and payment bonds executed by a Contractor have no obligation tinder this Bond, qualified surety equivalent to the bonds issued on except to participate in conferences as provided in the Contract,and pay to Owner the amount of Paragraph 3.1. damages as described in Paragraph 6 in excess of the Balance of the Contract Price incurred by 3. Ifthere is no Owner Default,Surety's obligation Owner resulting from Contractor Default;or tinder this Bond shall arise after: 4.4. Waive its right to perform and complete, 3,1. Owner has tiotiftetl Contractor and Surety,at arrange for completion,or obtain a new contractor the addresses described in Paragraph 10 below, and with reasonable promptness under the that Owner is considering declaring a Contractor circumstances: Default and has requested and attempted to arrange a conference with Contractor and Surety 1. After investigation,determine the to be held not later than 15 days after receipt of amount for which it may be liable to Owner such notice to discuss methods of performing the and,as soon as practicable after the amount Contract.ff Owner,Contractor and Surety agree, is determined,tender payment therefor to Contractor shall be allowed a reasonable time to Owner;or perform the Contract,but such an agreement shall not waive Owner's right,if any,subsequently to 2. Deny liability in whole or in part and declare a Contractor Default;and notify Owner citing reasons therefor. 3.2. Owner has declared a Contractor Default 5. If Surety does not proceed as provided in and formally terminated Contractor's right to Paragraph 4 with reasonable promptness,Surety shall complete the Contract.Such Contractor Default be deemed to be in default on this Bond 15 days after shall not be declared earlier than 20 days after receipt of an additional written notice from Owner to Contractor and Surety have received notice as Surety demanding that Surety perforin its obligations provided in Paragraph 3,1;and under this Bond,and Owner shall be entitled to enforce any remedy available to Owner,If Surety 3.3. Owner has agreed to pay the Balance of the proceeds as provided in Paragraph 4.4,and Owner Contract Price to: refuses the payment tendered or Surety has denied liability,in whole or in part,without further notice 1. Surety in accordance with the terms of Owner shall be entitled to enforce any remedy the Contract; available to Owner, 2, Another contractor selected pursuant to 6. After Owner has terminated Contractor's right to Paragraph 4.3 to perform the Contract. complete the Contract,and if Surety elects to act under Paragraph 4.1,4.2,or 4.3 above,then the 4. When Owner has satisfied Lite conditions of responsibilities of Surety to Owner sliall not be Paragraph 3,Surety shall promptly and at Surety's greater than those of Contractor under the Contract, expense take one of the following actions: and the responsibilities of Owner to Surety shall not be greater than those of Owner under the Contract. 4.1. Arrange for Contractor,with consent of To a limit of the amount of this Bond,but subject to Owner,to perform and complete the Contract;or commitment by Owner of tite Balance of the Contract Price to mitigation of costs and damages on the 4.2. Undertake to perform and complete the Contract,Surety is obligated without duplication for: Contract itself,through its agents or through independent contractors;or PW/DEN001/650630 PERFORMANCE BOND FORM JANUARY 4,2016 00 61 13.13 -3 ©COPYRIGHT 2016 CH2M HILL CITY OF OSHKOSH- WATER FILTRATION PLANT EQUIPMENT REPLACEMENT PROJECT 6,1. The responsibilities of Contractor for 10.Notice to Surety,Owner,or Contractor shall be correction of defective Work and completion of mailed or delivered to the address shown on the the Contract; signature page, 6.2. Additional legal,design professional,and 11.When this Bond has been furnished to comply delay costs resulting from Contractor's Default, with a statutory requirement in the location where the and resulting from the actions or failure to act of Contract was to be performed,any provision in this Surety under Paragraph 4;and Bond conflicting with said statutory requirement shall be deetned deleted herefrom and provisions 6.3. Liquidated damages,or if no liquidated conforming to such statutory requirement shall be damages are specified in the Contract,actual deemed incorporated herein.The intent is that this damages caused by delayed performance or non- Bond shall be construed as a statutory bond and not performance of Contractor, as a common law bond. 7. Surety shall not be liable to Owner or others for 12.Definitions, obligations of Contractor that are unrelated to the Contract,and the Balance of the Contract Price shall 12.1.Balance of the Contract Price:The total not be reduced or set off on account of any such amount payable by Owner to Contractor snider the unrelated obligations.No right of action shall accrue Contract after all proper adjustments have been on this Bond to any person or entity other than made,including allowance to Contractor of any Owner or its heirs,executors,administrators,or amounts received or to be received by Owner in successors. settlement of insurance or other Claims for damages to which Contractor is entitled,reduced 8. Surety hereby waives notice of any change, by all valid and proper payments made to or on including changes of time,to Contract or to related behalf of Contractor under the Contract. subcontracts,purchase orders,and other obligations. 12.2.Contract,The agreement between Owner 9. Any proceeding,legal or equitable,under this and Contractor identified on the signature page, Bond may be instituted in any court of competent including all Contract Documents and changes jurisdiction its the location in which the Work or part thereto, of the Work is located and shall be instituted within two years after Contractor Default or within two 12.3.Contractor Default;Failure of Contractor, years after Contractor ceased working or within two which has neither been remedied nor waived,to years after Surety refuses or fails to perform its perform or otherwise to comply with the terms of obligations under this Bond,whichever occurs first. the Contract. If the provisions of this paragraph are void or prohibited by law,the minimum period of limitation 12A.Owner Default:Failure of Owner,which has available to sureties as a defense in thejurisdiction of neither been remedled nor waived,to pay the suit shall be applicable. Contractor as required by the Contract or to perform and complete or comply with the other terms thereof. FOR INFORMATION ONLY--Name,Address and Telephone Surety Agency or Broker Hausmann-Johnson Ins;PO Box 259408,Madison,WI 53725-9408;648-252-9674 Owner's Representative(engineer or other party) END OF SECTION PW/DENOOI/650630 PERFORMANCE BOND FORM JANUARY 4,2016 00 6I 13.13 -4 CO COPYRIGHT 2016 CH2M HILL , CITY OF OSHKOSH - WATER FILTRATION PLANT EQUIPMENT REPLACEMENT PROJECT PAYMENT BOND FORM Any singular reference to Contractor,Surety,Owner,or otlier party shall be considered plural where applicable. CONTRACTOR SURETY (Name and Address): (Name and Address of Principal Place of Business); H &H Industries, Inc. Travelers Casualty and Surety Company of America 2809 Syene Rd One Tower Square Madison,Wl 53713 Hartford, CT 06183 OWNER(Namc and Address): City of Oshkosli,Wisconsin City Hall,2I5 Cliurcli Avenue Osltkosh,WI 54901 CONTRACT Date: 2-24-2016 Amount: $523,424.00 Description(Name and Location):Water Filtration Plant Equipment Replacement Project,City of Oshkosli Contract No, 16-19 BOND Bond Number; 106358408 Date(Not earlier than Contract Date): 3-1-2016 Amount: $523,424.00 Modifications to this Bond Form: None Surety and Contractor,intending to be legally bound hereby,subject to the terms printed on the reverse side lide6of;,do eaclr cause this Payment Bond to be duty executed on its behalf by its authorized officer,agent,or represoritat196', CdNTRA0FOR AS PRINCIPAL SURETY } 1l 0 C_ompanyy ,H'&H Incly4ries, Inc. Travelers Casualty and Surety Company of America Signat-tsie:'� __(Seal) (Seal) Name and Tit€e Surety's N e and oiorate Seal i:ul A. Christensen Chief Executive Officer By ���� Signature an itle Elizabeth Mosca,Attorney-in-f=act (Attach Power of Attorney) (Space is provided below for signatures of additional parties,if required.) Attest: Signature ooke L Parker,witness PW/DEN001/650630 PAYMENT BOND FORM JANUARY 4, 2016 00 61 13,16- I ©COPYRIGHT 2016 CH2M HILI, f CITY OF OSHKOSH - WATER FILTRATION PLANT EQUIPMENT REPLACEMENT PROJECT CONTRACTOR AS PRINCWAL SURETY Company: Signature: (Seal) (Seal) Name and Title Surety's Nance and Corporate Seal By: Signature and Title (Attach Power of Attorney) Attest: Signature and Title PW/DEN001/650630 PAYMENT BOND FORM JANUARY 4,2016 00 61 13.16-2 ©COPYRIGHT 2016 CI-12M HILL 1 � 1 CITY OF OSHKOSH - WATER FILTRATION PLANT EQUIPMENT REPLACEMENT PROJECT 1, Contractor and Surety,jointly and severally,bind were furnished or supplied,or for whom the themselves,their heirs,executors,administrators, labor was done or performed;and successors,and assigns to Owner to pay for.labor, materials,and equipment furnished by Claimants for 2. Have either received a rejection in use in the performance of the Contract,which is whole or in pail fi-om Contractor,or not incorporated herein by reference, received within 30 days of furnishing the above notice any communication from 2. With respect to Owner,this obligation shall be Contractor by which Contractor had null and void if Contractor: indicated the claim will be paid directly or indirectly;and 2.1. Promptly makes payment,directly or indirectly,for all sums due Claimants,and 3. Not having been paid within the above 30 days,]nave sent a written notice to Surety 2.2. Defends,indemnifies,and holds harmless and sent a copy,or notice thereof,to Owner, Owner from all claims,demands,liens,or suits stating that a claim is being made under this alleging non-payment by Contractor by any Bond and enclosing a copy of the previous person or entity who furnished labor,materials,or written notice furnished to Contractor. equipment for use in the performance of tine Contract,provided Owner has promptly notified 5. If a notice by a Claimant required by Paragraph 4 Contractor and Surety(at the addresses described is provided by Owner to Contractor or to Surety,that in Paragraph 12)of any claims,demands,liens,or is sufficient compliance. suits and tendered defense of such claims, demands,liens,or suits to Contractor and Surety, 6. When a Claimant has satisfied the conditions of and provided there is no Owner Default, Paragraph 4,the Surety shall promptly and at Surety's expense take the following actions, 3. With respect to Claimants,this obligation shall be null and void if Contractor promptly makes payment, 6.1. Send an answer to that Claimant,with a directly or indirectly,for all sums due. copy to Owner,within 45 clays after receipt of the claim,stating the amounts that are undisputed and 4, Surety shall have no obligation to Claimants tine basis for challenging any amounts that are under this Bond until: disputed. 4.1. Claimants who are employed by or have a 6.2, Pay or arrange for payment of any direct contract with Contractor have given notice undisputed amounts, to Surety(at the addresses described in Paragraph 12)and sent a copy,or notice thereof, 7. Surety's total obligation shall not exceed the to Owner,stating that a claim is being made under amount of this Bond,and the amount of this Bond this Bond and,with substantial accuracy,the shall be credited for any payments made in good faith amount of the claim. by Surety. 4.2. Claimants who do not have a direct contract & Amounts owed by Owner to Contractor under file with Contractor: Contract shall be used for the performance of the Contract and to satisfy claims,if any,under any 1. Have furnished written notice to performance bond.By Contractor furnishing and Contractor and sent a copy,or notice Owner accepting this Bond,they agree that all funds thereof,to Owner,within 90 days after earned by Contractor in the performance of the having last performed labor or last furnished Contract are dedicated to satisfy obligations of materials or equipment included in the claim Contractor and Surety lander this Bond,subject to stating,with substantial accuracy,the Owner's priority to use the funds for the completion amount of the claim and the name of tine of the Work. party to whom the materials or equipment PWIDEN001/650630 PAYMENT BOND FORM JANUARY 4,2016 00 61 13.16 -3 ©COPYRIGHT 2016 CH2M HILL CITY OF OSHKOSH- WATER FILTRATION PLANT EQUIPMENT REPLACEMENT PROJECT 9. Surety shall not be liable to Owner,Claimants,or conforming to such statutory requirement shall be others for obligations of Contractor that are unrelated deemed incorporated herein.The intent is that this to the Contract.Owner shall not be liable for Bond shall be construed as a statutory Bond and not payment of any costs or expenses of any Claimant as a common law bond. under this Bond,and shall have under this Bond no obligations to make payments to,give notices on 14.Upon request of any person or entity appearing to behalf of,or otherwise have obligations to Claimants be a potential beneficiary of this Bond,Contractor under this Bond. shall promptly furnish a copy of this Bond or shall permit a copy to be made. 10.Surety hereby waives notice of any change, including changes of time,to the Contract or to 15.Definitions: related Subcontracts,purchase orders and other obligations. 15.1.Claimant:An individual or entity having a direct contract with Contractor,or with a first-tier 11.No suitor action shall be commenced by a subcontractor of Contractor,to furnish labor, Claimant under this Bond other than in a court of materials,or equipment for use in the competent jurisdiction in the location in which the performance of the Contract.The intent of this Work or part of the Work is located or after the Bond shall be to include without limitation in the expiration of one year from the date(1)on which the terms"labor,materials or equipment"that part of Claimant gave the notice required by Paragraph 4.1 water,gas,power,light,heat,oil,gasoline, or Paragraph 4.2.3,or(2)on which the last labor or telephone service,or rental equipment used in the service was performed by anyone or the last materials Contract,architectural and engineering services or equipment were furnished by anyone under the required for performance of the Work of Construction Contract,whichever of(1)or(2)first Contractor and Contractor's Subcontractors,and occurs.If the provisions of this paragraph are void or all other items for which a mechanic's lien may be prohibited by law,the minimum period of limitation asserted in the jurisdiction where the labor, available to sureties as a defense in the jurisdiction of materials,or equipment were furnished, the suit shall be applicable. 15.2.Contract:The agreement between Owner 12,Notice to Surety,Owner,or Contractor shall be and Contractor identified on the signature page, malled or delivered to the addresses shown on the including all Contract Documents and changes signature page.Actual receipt of notice by Surety, thereto. Owner,or Contractor,however accomplished,shall be sufficient compliance as of the date received at the 15.3.Owner Default:Failure of Owner,which has address shown on the signature page, neither been remedied nor waived,to pay Contractor as required by the Contract or to 13.When this Bond has been furnished to comply perform and complete or comply with the other with a statutory requirement in the location where the terms thereof. Contract was to be performed,any provision in this Bond conflicting with said statutory requirement shall be deemed deleted herefronn and provisions FOR INFORMATION ONLY—Name,Address and Telephone Surety Agency or Broker: Hausmann-Johnson Ins; PO Box 259408, Madison,Wi 53725-9408;608252-9674 Owner's Representative(engineer or other party): END OF SECTION PW/DEN001/650630 PAYMENT BOND FORM JANUARY 4,2016 00 61 13.16-4 ©COPYRIGHT 2016 CH2M HILL r WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER i 'i POWER OF ATTORNEY TRAVELERSELERS Farmington Casualty Company St.Paul Mercury Insurance Company Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Ire. 'Travelers Casualty and Surety Company of America St.Paul Fire and 11larine Insurance Company United States Fidelity and Guaranty Company St.Paul Guardian Insurance Company Attorney-In Fact No. 229850 Certificate No. 006474489 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St, Paul Fire and Marine Insurance Company, St,Paul Guardian Insurance Company,St. Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company are corporations dally organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint '11111liausntttnn,Jeff l lautsinann,Judith A. Walker,Sheila Dickey,Brooke L. Parker,Patrick A.McKenna,and Elizabeth Mosca of the City of Mattison ,State of Wisconsin ,their true and lawful Attorney(s)-in-Fact, each in their separate Capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law, IN`j'ITNESS WHEREOF,the Companies have caused this instrurnenI to be signed arid their corporate seals to be heretoaffixed,this 26th day of Angus[ 2015 4` �\ Farmington Casualty Courinany ` St.Pau111lercury Insurance Company Fidelity and Guaranty,Irtsurance Connjiarry 'Travelers Casualty and Surety Company Fidelity and Guaranty Insurance Underwriters,Inc, Travelers Casualty and Surety Company of America St.Paul Fire and}Marine Insurance Company United States Fidelity and Guaranty Company St,Paul Guardian Insurance Company GASU,� "I" hK-,uhf 1'�NSU�ro L1Y Nr0 EZ Y t`tpF �$` • fin � � �' 4tft1 � Fs�s �r,`pneoagpEm b � � ti i 1 4 S 2A o 1977 $ ^ f " 1 g t ... o a tiARTfBRfI, 3 Fit s $AL,•t3 y� � L�Yncc 1$..v�� �s�'"•'fe of Fw' . '� X31 AtitSr_ State of Connecticut By: City of Hartford ss. Robert L.Raney,Knior Vire President On this the 26th da of August 2015 before me y personally appeared Robert L.Raney,who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,'Fravelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer, ,.TET In WitnessWhereof,I hereunto set my hated and official seal. TAH �Q� 0, • V My Commission expires the 3001 day of June,2016. * pU6L1�+ Marie C.Tetreault,Notary Public 58440-8-12 Printed in U.S.A. WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOU7THE RED BORDER This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surely Company of America,and United States Fidelity and Guaranty Company,which resolutions are now in full force and effect,reading as follows: RESOLVED,that the Chairman,the President,any Vice Chairman,any Execrative Vice President,any Senior Vice President,any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary;and it is FURTHER RESOLVED,that any bond,recognizance,contract of indemnity,or writing obligatory in the nature of a bond,recognizance,or conditional undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal,if required)by one or more Attomeys-in-Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice President, any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attomey or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate hearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I,Kevin E.Hughes,the undersigned,Assistant Secretary,of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which is in full force and effect and has not been revoked. i / IN TESTIMONY 111HEREOF,I have hereunto set my hand and affixed the seals of said Companies this.. I day of IV/I%l�fi� 20 f 6 Kevin E.Hughes,Assistant Secr tary I w. E p�su� [• Fees a {ti�p i s 'ixsv sr ny . O,{, l C'1 f•" 'o v.�.. G¢ yr 1 rp' Q.r y {ti,l 'l " 4 3� l 4� d b 9 e z o 1977 n i ! , �. n Harnro�m, s tam �o =y+.SEAIJ,�3° n To verify the authenticity of this Power of Attorney,call 1-800-421-3880 or contact us at www.travelersbond.conn.Please refer to the Attorney-In-Fact number,the above-named individuals and the details of the bond to which the power is attached. WARNING:THIS POWER OF ATTORNEY 1S INVALID WITHOUT THE RED BORDER HHIND-2 OP ID:MDC gCORn� CERTIFICATE OF LIABILITY INSURANCE DATE 0310 112 0 1 YY) 03!0112016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holler is an ADDITIONAL INSURED,the policy(les) 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 NONEACT Jeff Prey Hausmann-Johnson Insurance Inc PHONE 608-257-3735 uc No): 608-257 4324 700 Regent St.,PO Box 259408 ruc Nn Exl Madison,WI 53726.9408 E-MAIL Jeff Frey ADDRESS: INSURER($)AFFORDING COVERAGE NAIC N INSURER A:Cincinnati Insurance Company 10677 INSURED H&H Industries, Inc. INSURER B:Nautilus Insurance Company 2801 Syene Rd INSURER C: Madison,WI 53713 INSURER 0 INSURER E' INSURER F. COVERAGES CERTIFICATE NUMBER: 2016-2 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE APDL SUB POLICY EFF POLICY EXP LIMITS LTR YYYY POLICY NUMBER MWDDlf0WDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE 0 OCCUR X CPP0895582 01101/2016 01/01/2017 DPREISES AMAGE To REorcu encs $ 500,00 MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLI ES PER: GENERAL AGGREGATE $ 2,000,00 POLICY N JE° [::]LOC PRODUCTS-COMPIOPAGG $ 2,000,00 OTHER Elec Data $ 500,000 AUTOMOB[lELIABILlTY COEa accMBINEOSINGLELIMITident $ 1,000,000 A X ANY AUTO X CPA0895582 0110112016 01/0112017 BODiLYINJURY(Per person) $ ALL OWNEDSCHEDULED BODILY INJURY(Per acddenf) $ X AUTOS X OS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Peraccidenl $ X UMBRELLALV4B X OCCUR EACH OCCURRENCE $ 14,000,000 A EXCESS LIAR CLAIMS-M.ADE X CPP0895582 01/0112016 01/0112017 AGGREGATE S 14,000,00 DED X RETENTIONS 0 5 WORKERS COMPENSATION X I PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER RI A ANY PROPMETOR1PARTNEEXECUTIVE YIN 0192371006 01/01/2016 0110112017 E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? [N] NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEES 100,00 N es,describe under DESCRIPTION OF OPERATIONS Wan E.L.DISEASE-POLICY LIMIT S 540,00 B Professional& CCP201644110 11/24/2015 11/24/2016 Limit 2,000,00 Pollution Llab. Ded. 25,000 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) RE: Public Works Contract 16-19 -- Water Filtration Plant When required in a written contract, The City of Oshkosh, and its officers council members, agents, employees and authorized volunteers are listed as additional insured with respect to commercial general liability, auto, and umbrella on a primary & non contributory basis. 30 day notice (NEXT PAGE) CERTIFICATE HOLDER CANCELLATION CITYOSH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI of Oshkosh ACCORDANCE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 215 Church Ave PO Box 1130 AUTHORIZED REPRESENTATIVE Oshkosh,WI 54903-1130 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD NOTEPAD: HGLDERCODE CITYOSH HHIND-2 PAGE 2 INSUR£D'S FAME H&H Industries,Inc. OP ID: MDG Date 03/0112016 of cancellation a plies. Installation Flower = $650,000 #FCPP0895582 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL.LIABILITY COVERAGE PART A, Endorsement-Table of Contents: Coverage: Begins on Paae: 1. Employee Benefit Liability Coverage............................ ...2 2. Unintentional Failure to Disclose Hazards.......................................................................................... 7 3. Damage to Premises Rented to You........................................................................................ .......... 8 4. Supplementary Payments................................................................................................................—9 S. Medical Payments....-.......................................................................................................................... 9 6. Voluntary Property Damage (Coverage a.)and Care,Custody or Control Liability Coverage(Coverage b.).........................................................................................................9 7. 180 Day Coverage for Newly Formed or Acquired Organizations..................................................10 8. Waiver of Subrogation.............................................................................................. 9. Automatic Additional Insured -Specified Relationships: ................................................................10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions-Permits Relating to Premises; • State or Political Subdivisions-Permits;and • Contractors'Operations 10. Broadened Contractual Liability-Work Within 50'of Railroad Property.........................................14 11. Property Damage to Borrowed Equipment....................................................................................... 14 12. Employees as Insureds -Specified Health Care Services: ............................................................14 • Nurses; • Emergency Medical Technicians;and • Paramedics 13. Broadened Notice of Occurrence......................................................................................................14 S. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1, Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of. a. The Each Occurrence Limit shown in the Declarations;or b. $500,000 unless otherwise stated$ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 1 of 15 1 6. Voluntary Property Damage (Coverage a.)and Care,Custody or Control Liability Coverage (Coverage b.) Limits of Insurance(Each Occurrence) Coverage a.$1,000 Coverage b. $5,000 unless otherwise stated $ Deductibles(Each Occurrence) Coverage a.$250 Coverage b. $250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a Area (For Limits in Excess of (For Limits in Excess of (b Payroll $5,000) $5,000) (c) Gross Sales (d) Units e Other b. Care, Custody $ or Control TOTAL ANNUAL PREMIUM $ 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the ap- plicable limit of insur- 1. Employee Benefit Liability Coverage price in the payment of a. The following is added to SECTION I judgments or settle- - COVERAGES: Employee Benefit ments. Liability Coverage. No other obligation or liabil- (1) Insuring Agreement ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay- obligated to pay as dam- ments. ages caused by any act, er- ror or omission of the in- (b) This insurance applies to sured, or of any other per- damages only if the act, er- son for whose acts the in- ror or omission, Is negli- sured is legally liable, to gently committed in the which this insurance ap- "administration" of your plies. We will have the right employee benefit pro- and duty to defend the in- gram"; and sured against any "suit" 1) Occurs during the pol- seeking those damages. icy period;or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our discretion, investigate any a) you did not have report of an act, error or knowledge of a omission and settle any claim or "suit" on claim or "suit` that may re- or before the ef- sult. But: fective date of this endorsement. 1) The amount we will pay for damages is limited You will be as described in SEC- deemed to have TION 111 - LIMITS OF knowledge of a INSURANCE;and claim or "suit' when any 2) Our right and duty to "authorized repre- defend ends when we sentative"; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 2 of 15 I) Reports all, or formance,of investment any part, of the vehicles;or act, error or omission to us 3) Advice given to any or any other person with respect to insurer; that person's decision to participate or not to ii) Receives a participate in any plan written or ver- included in the "em- bal demand or ployee benefit pro- claim for dam- gram". ages because of the act, er- (f) Workers' Compensation ror or omis- and Similar Laws sion; and Any claim arising out of b) There is no other your failure to comply with applicable insur- the mandatory provisions of ante, any workers' compensation, unemployment compensa- (2) Exclusions tion insurance, social secu- rity or disability benefits law This insurance does not apply or any similar law. #o: (a) Bodily Injury, Property (g) ERISA Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of "Bodil injury", "property liability imposed on a fiduci- Y J rY p p Y ary by the Employee Re- damage" or "personal and tirement Income Security advertising injury". Act of 9974, as now or (b) Dishonest, Fraudulent, hereafter amended, or by Criminal or Malicious Act any similar federal, state or local laws. Damages arising out of any intentional, dishonest, (h) Available Benefits fraudulent, criminal or mali- Any claire for benefits to the cious act, error or omission, extent that such benefits committed by any insured, are available, with reason- including the willful or reck- able effort and cooperation less violation of any statute, of the insured, from the ap- (c) f=ailure to Perform a Con- plicablo funds accrued or tract other collectible insurance. Damages arising out of fail- (1) Taxes, Fines or Penalties ure of performance of con- Taxes, fines or penalties, tract by any insurer. including those imposed (d) Insufficiency of Funds under the Internal Revenue Code or any similar state or Damages arising out of an local law. insufficiency of funds to 0) Employment-Related meet any obligations under any plan included in the Practices "employee benefit pro- Any liability arising out of gram". any: (e) Inadequacy of Perform- (1) Refusal to employ; ante of Investment I Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, evaluation, reassign- 1) Failure of any invest- ment, discipline, defa- ment to perform; mation, harassment, 2) Errors in providing in- humiliation, discrimina- formation on past per- tion or other employ- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 3 of 15 ment-related practices, (e) A trust, you are an insured, acts or omissions;or Your trustees are also in- 4 Consequential liability in- sureds, but only with re- ( ) q y spect to their duties as as a result of(1), (2) or trustees. (3)above. (2) Each of the following is also an This exclusion applies insured: whether the insured may be held liable as an employer (a) Each of your "employees" or in any other capacity and who is or was authorized to to any obligation to share administer your "employee damages with or repay benefit program", someone else who must pay damages because of (b) Any persons, organizations the injury. or "employees" having proper temporary authori- (3) Supplementary Payments zation to administer your "employee benefit program" SECTION f - COVERAGES, if you die, but only until your SUPPLEMENTARY PAY- legal representative is ap- MENTS - COVERAGES A AND pointed B also apply to this Coverage. b. Who is an Insured (c) Your legal representative if you die, but only with re- As respects Employee Benefit Liabil- spect to duties as such. ity Coverage, SECTION 11 - WHO IS That representative will AN INSURED is deleted in its en- have all your rights and du- tirety and replaced by the following: ties under this Coverage Part. (1) If you are designated In the (3) Any organization you newly ac- Declarations as: quire or form, other than a part- (a) An individual, you and your nership, joint venture or limited spouse are insureds, but liability company, and over only with respect to the which you maintain ownership conduct of a business of or majority interest, will qualify which you are the sole as a Named Insured if no other owner. similar insurance applies to that organization. However, cover- (b) A partnership or joint ven- age under this provision: ture, you are an insured. Your members, your part- (a) Is afforded only until the ners, and their spouses are 180th day after you acquire also insureds but only with or form the organization or respect to the conduct of the end of the policy period, your business. whichever is earlier;and (c) A limited liability company, (b) Does not apply to any act, you are an insured. Your error or omission that was members are also insureds, committed before you ac- but only with respect to the quired or formed the or- conduct of your business. ganization. Your managers are in sureds, but only with re- c. Limits of Insurance spect to their duties as your As respects Employee Benefit Liabil- managers, ity Coverage, SECTION III - LIMITS (d) An organization other than OF INSURANCE is deleted in its en- a partnership, joint venture tirety and replaced by the following: or limited liability company, (1) The Limits of Insurance shown you are an insured. Your in Section B, Limits of Insur- "executive officers" and di- ance, 1. Employee Benefit Li- rectors are insureds, but ability Coverage and the rules only with respect to their below fix the most we will pay duties as your officers or di- regardless of the number of: rectors, Your stockholders are also insureds, but only (a) Insureds; with respect to their liability as stockholders. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 4 of 15 (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations applies to all damages (c) Persons or organizations sustained by any one "em- making claims or bringing ployee", including such ,suits"; "employee's" dependents (d) Acts,errors or omissions;or and beneficiaries, because of all acts, errors or omis- (e) Benefits included in your sions to which this insur- "employee benefit pro- ante applies. gram". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect Section B. Limits of Insurance, to: 1. Employee Benefit Liability 1 right to Coverage of this endorsement ) Our g ht and duty defend the insured is the most we will pay for all damages because of acts, er- against any "suits" seeking those dam- rors or omissions negligently committed in the "administra- tion" of your "employee benefit 2) Your duties and the program"• duties of any other in- (3) Subject to the limit described in volved insured, in the (2) above, the Each Employee event of an act, error or Limit shown in Section B. Limits omission,or claim, of Insurance, 1. Employee apply irrespective of the Benefit Liability Coverage of application of the deductible this endorsement is the most we amount. will pay for all damages sus- tained by any one "employee", (d) We may pay any part or all Including damages sustained by of the deductible amount to such "employee's" dependents effect settlement of any and beneficiaries,as a result of: claim or "suit" and, upon notification of the action (a) An act, error or omission;or taken, you shall promptly (b) A series of related acts, er- reimburse us for such part rors or omissions, regard- of the deductible amount as less of the amount of time we have paid. that lapses between such d. Additional Conditions acts,errors or omissions, As respects Employee Benefit Li- lnegligently committed in ' the ability Coverage, SECTION IV �- administration of your em- COMMERCIAL GENERAL LIABIL- ployee benefit program". 1TY CONDITIONS is amended as However, the amount paid un- follows: der this endorsement shall not (1) Item 2. Duties In the Event of exceed, and will be subject to Occurrence, Offense, Claim or the limits and restrictions that Suit is deleted in Its entirety and apply to the payment of benefits replaced by the following: in any plan included in the "em- ployee benefit program". 2. Duties in the Event of an Act, Error or (4) Deductible Amount Omission, or Claim or Suit a Our obligation to a dam- a• You must see to it that we are noti- ( ) g pay fied as soon as practicable of an act, ages on behalf of the in- error or omission which may result in sured applies only to the a claim. To the extent possible, no- amount of damages in ex- tice should include: cess of the deductible amount stated in the Decla- (1) What the act, error or omission rations as applicable to was and when it occurred;and Each Employee. The limits of insurance shall not be (2) The names and addresses of reduced by the amount of anyone who may suffer dam- this deductible. ages as a result of the act, error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 5 of 15 b. If a claim is made or"suit" is brought b. Method of Sharing against any insured,you must: If all of the other insur- (1) Immediately record the specifics ance permits contribu- of the claim or "suit" and the tion by equal shares, date received; and we will follow this method also. Under (2) Notify us as soon as practicable. this approach each in- You must see to it that we receive surer contributes equal written notice of the claim or"suit" as amounts until it has soon as practicable. paid its applicable limit of insurance or none of c. You and any other involved insured the loss remains, must: whichever comes first. (1) Immediately send us copies of If any of the other in- any demands, notices, sum- surance does not per- monses or legal papers re- mit contribution by ceived in connection with the equal shares, we will claim or"suit"; contribute by limits, Under this method, (2) Authorize us to obtain records each insurer's share is and other information; based on the ratio of its (3) Cooperate with us in the investi- applicable limit of in- gation or settlement of the claim surance to the total ap- or defense against the "suit"; plicable limits of insur- and ance of all insurers. (4) Assist us, upon our request, In c. No Coverage the enforcement of any right This insurance shall not against any person or organiza- cover any loss for tion which may be liable to the which the insured is insured because of an act, error entitled to recovery un- or omission to which this insur- der any other insur- ance may also apply. ance in force previous d. No insured will, except at that in- to the effective date of sured's own cost, voluntarily make a this Coverage Part. payment, assume any obligation, or e. Additional Definitions incur any expense without our con- sent. As respects Employee Benefit Li- ability Coverage, SECTION V - (2) Item 5. Other Insurance is de- DEFINITIONS Is amended as fol- leted in its entirety and replaced lows: by the following: 5. Other Insurance (1) The following definitions are added: If other valid and collectible 1. "Administration"means: insurance is available to the insured for a loss we cover a. Providing information to under this Coverage Part, "employees", including our obligations are limited their dependents and as follows: beneficiaries, with re- spect to eligibil€ty for or a. Primary Insurance scope of "employee This insurance is pri- benefit programs"; mary except when c. b. Interpreting the "em- below applies. If this ployee benefit pro- insurance is primary, grams"; our obligations are not affected unless any of c. Handling records in the other insurance is connection with the also primary. Then, we employee benefit pro- will share with all that grams"; or other insurance by the d. Effecting, continuing or method described in b. below, terminating any "em- ployee's" participation Includes copyrighted material of insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 6 of 15 in any benefit Included benefits, workers' com- in the "employee bene- pensation and disability fit program". benefits;and However, "administration" d. Vacation plans, includ- does not include: ing buy and sell pro- grams; leave of ab- a. Handling payroll de- sence programs, in- ductions;or cluding military, mater- b. The failure to effect or nity, family, and civil maintain any insurance leave; tuition assis- or adequate limits of tance plans; transpor- coverage of insurance, tation and health club including but not limited subsidies. to unemployment in- (2) The following definitions are surance, social security deleted in their entirety and re- benefits, workers' com- placed by the following: pensation and disability benefits. 21, "Suit" means a civil pro- 2. "Cafeteria plans" moans ceeding in which money damages because of an plan authorized by applica- act error or omission to ble law to allow "employ- which this insurance applies ees" to elect to pay for cer- are alleged. "Suit"includes: tain benefits with pre-tax dollars, a. An arbitration pro- ceeding in which such 3. "Employee benefit pro- damages are claimed grams" means a program and to which the in- providing some or all of the sured must submit or following benefits to "em- does submit with our ployees", whether provided consent; through a "cafeteria plan"or otherwise: b. Any other alternative dispute resolution pro- a. Group life insurance; ceeding in which such group accident or damages are claimed health insurance; den- and to which the In- tal, vision and hearing sured submits with our plans; and flexible consent;or spending accounts; provided that no one c. An appeal of a civil other than an "em- proceeding. ployee" may subscribe p a"oemeans g, "Employee" per- suchsuch benefits and p Y such benefits are made son actively employed, for- generally available to mercy employed, on leave those"employees"who of absence or disabled, or satisfy the plan's eligl- retired, "Employee" in- bility requirements; cludes a "leased worker „Employee" does not in- b. Profit sharing plans, clude a"temporary worker". employee savings plans, employee stock 2. Unintentional f=ailure to Disclose Haz- ownership plans, pen- ards sion plans and stock SECTION IV- COMMERCIAL GENERAL subscription plans, LIABILITY CONDITIONS, 7. Represen- provided that no one tations is hereby amended by the addi- other than an "em- tion of the following: ployee" may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to existing hazards, if generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eligible under the your policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on c. Unemployment insur- such failure. ance, social security Includes copyrighted material of Insurance GA 233 02 07 Services Office,Inc.,with its permission. Page 7 of 15 3. Damage to Premises Rented to You e) Settling, cracking, of Paragraph shrinking or ex- a. The last Subparagraph g p pansion; or 2. SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY f) Nesting or infesta- AND PROPERTY DAMAGE, 2, LI- tion, or discharge ABILITY Exclusions is hereby de- or release of leted and replaced by the following: waste products or secretions, by in- Exclusions c.through q.do not apply sects, birds, ro- to damage by fire, explosion, light- dents or other ning, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. rectly by any of the follow- b, The insurance provided under SEC- ing: TION I - COVERAGES, COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE LIABILITY applies any other earth move- to "property damage" arising out of ment; water damage to premises that are both rented to and occupied by you. 2) Water that backs up or overflows from a (1) As respects Water Damage Le- sewer,drain or sump; gal Liability, as provided in Paragraph 3.b.above: 3) Water under the ground surface press- The exclusions under SECTION ing on, or flowing or I - COVERAGES, COVERAGE seeping through: A. BODILY INJURY AND PROPERTY DAMAGE LIABIL. a) f=oundations, ITY, 2. Exclusions, other than I. walls, floors or War and the Nuclear Energy paved surfaces; Liability Exclusion, are deleted b) Basements, and the following are added: whether paved or This insurance does not apply not;or to: c) Doors,windows or (a) 'Property damage": other openings. 1) Assumed in any con- (c) Loss caused by or resulting tract;or from water that leaks or flows from plumbing, heat- 2) Loss caused by or ro- ing, air conditioning, or fire suiting from any of the protection systems caused following: by or resulting from freez- a) Wear and tear; ing, unless: b Rust, corrasion, 1) You did your best to maintain heat in the fungus, decay, building or structure;or deterioration, hid- den or latent de- 2) You drained the fect or any quality equipment and shut off in property that the water supply if the causes it to dam- heat was not main- age or destroy it- tained. self; (d) toss to or damage to: C) Smog; 1} Plumbing, heating, air d) Mechanical conditioning, fire pro- breakdown in- tection systems, or cluding rupture or other equipment or ap- bursting caused pliances;or by centrifugal force; 2) The interior of any building or structure, or to personal property in the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 8 of 15 caused by or resulting 5. Medical Payments from rain, snow, sleet or ice, whether driven The Medical Expense Limit of Any One by wind or not. Person as stated in the Declarations is amended to the limit shown in Section B. c. Limit of Insurance Limits of Insurance, 5. Medical Pay- The Damage to Premises Rented to ments of this endorsement. You Limit as shown in the Declara- 6. Voluntary Property Damage and Care, tions is amended as follows: Custody or Control Liability Coverage (2) Paragraph 6. of SECTION ill - a. Voluntary Property Damage Cov- LIMITS OF INSURANCE is erage hereby deleted and replaced by the following: We will pay for"property damage" to property of others arising out of op- 6. Subject to S. above, the erations incidental to the insured's Damage to Premises business when: Rented to You Limit is the most we will pay udder (9) Damage is caused by the in- COVERAGE A. BODILY sured; or INJURY AND PROPERTY (2) Damage occurs while in the in- DAMAGE LIABILITY, for sured's possession. damages because of "property damage" to With your consent, we will make premises while rented to these payments regardless of fault. you or temporarily occupied by you with permission of b. Care, Custody or Control Liability the owner, arising out of Coverage any one "occurrence" to SECTION I - COVERAGES, COV- which this insurance ap- ERAGE A. BODILY INJURY AND plies. PROPERTY DAMAGE LIABILITY, 2. (3) The amount we will pay is lim- Exclusions,j. Damage to Propertyy, ited as described in Section B. Subparagraphs (3), (4) and (5) da Limits of Insurance, 3. Dam• not apply to "property damage" to age to Premises Rented to the property of others described You of this endorsement. therein. 4. Supplementary Payments With respect to the insurance provided by this section of the endorsement, the fol- Under SECTION I - COVERAGE, SUP- lowing additional provisions apply: PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. The Limits of Insurance shown in the Declarations are replaced by the lim- a. Paragraph 2. Is replaced by the fol- its designated in Section B. Limits of lowing: Insurance, 6, Voluntary Property Up to the limit shown in Section B. Damage and Care, Custody or Limits of Insurance, 4.a. Bail Bonds Control Liability Coverage of this of this endorsement for cost of bail endorsement with respect to cover- bonds required because of accidents age provided by this endorsement. or traffic law violations arising out of These limits are inclusive of and not the use of any vehicle to which the in addition to the limits being re- Bodily Injury Liability Coverage ap- placed. The Limits of Insurance shown in Section B. Limits of Insur- hese bonds. do not have to furnish ance, 6. Voluntary Property Dam- thess, age and Care, Custody or Control b. Paragraph 4. is replaced by the fol- Liability Coverage of this endorse- lowing: ment fix the most we will pay in any one 'occurrence" regardless of the All reasonable expenses incurred by number of: the insured at our request to assist us in the investigation or defense of ( ) Insureds; the claim or "suit", including actual (2) Claims made or "suits" brought; loss of earnings up to the limit shown or in Section B. Limits of Insurance, 4.b. Loss of Earnings of this en- (3) Persons or organizations mak- dorsement per day because of time ing claims or bringing"suits". off from work. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 9 of 15 b. Deductible Clause 9. Automatic Additional Insured - Speci- (1) Our obligation to pay damages fied Relationships on your behalf applies only to a. The following is hereby added to the amount of damages for each SECTION II-WHO IS AN INSURED: "occurrence" which are in ex- cess of the deductible amount (1) Any person or organization de- stated in Section B. Limits of scribed in Paragraph 9.a.(2) Insurance, 6. Voluntary Prop- below (hereinafter referred to as erty Damage and Care, Cus- additional insured) whom you tody or Control Liability Cov- are required to add as an addi- erage of this endorsement, The tional insured under this Cover- limits of insurance will not be re- age Part by reason of: duced by the application of such (a) A written contract or deductible amount. agreement; or (2) Condition 2. Duties in the Event (b) An oral agreement or con- of Occurrence, Offense, Claim tract where a certificate of or Suit, applies to each claim or ninsurance showing that per- suit irrespective of the amour#, son or organization as an (3) We may pay any part or all of additional insured has been the deductible amount to effect issued, settlement of any claim or "suit" is an insured, provided: and, upon notification of the ac- tion taken, you shall promptly (a) The written or oral contract reimburse us for such part of the or agreement is: deductible amount as has been paid by us. 1) Currently in effect or becomes effective 7. 180 Day Coverage for Newly Formed or during the policy pe- Acquired Organizations riod;and SECTION Il - WHO IS AN INSURED is 2) Executed prior to an amended as follows: 'occurrence"or offense Subparagraph a, of Paragraph 4. is to which this insurance hereby deleted and replaced by the fol- would apply; and lowing: (b) They are not specifically a. Insurance under this provision is af- named as an additional in- forded only until the 980th day after sured under any other pro- you acquire or form the organization vision of, or endorsement or the end of the policy period, added to, this Coverage whichever is earlier; Part. 8. Waiver of Subrogation (2) Only the following persons or organizations are additional in- SECTION IV- COMMERCIAL GENERAL sureds under this endorsement, LIABILITY CONDITIONS, 9. Transfer of and insurance coverage pro- Rights of Recovery Against Others to vided to such additional in- Us is hereby amended by the addition of sureds is limited as provided the following: herein: We waive any right of recovery we may (a) The manager or lessor of a have because of payments we make for premises leased to you with injury or damage arising out of your on- whom you have agreed per going operations or"your work" done un- Paragraph 9.a,(1) above to der a written contract requiring such provide insurance, but only waiver with that person or organization with respect to liability aris- and included in the "products-completed ing out of the ownership, operations hazard". However, our rights maintenance or use of that may only be waived prior to the `occur- part of a premises leased to rence"giving rise to the injury or damage you, subject to the following for which we make payment under this additional exclusions: Coverage Part. The insured must do This insurance does not nothing after a loss to impair our rights. At our request,the insured will bring "suit" apply I to: or transfer those rights to us and help us 1) Any "occurrence" enforce those rights, which takes place after Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 10 of 15 you cease to be a ten- c) Any physical or ant in that premises. chemical change 2) Structural alterations, in the product new construction or made intentionally by the vendor; demolition operations performed by or on be- d) Repackaging, un- half of such additional less unpacked insured. solely for the pur- pose of inspection, (b) Any person or organization on, demonstrati from which you lease testing, ti e th equipment with whom you substitution e have agreed per Paragraph parts under 9.a.(1) above to provide in in- structions from the surance. Such person(s)or manufacturer, and organization(s)are insureds then repackaged soleIX with respect to their in the original liability arising out of the container; maintenance, operation or use by you of equipment e) Any failure to leased to you by such per- make such in- son(s) or organizations(s). spections, adjust- However, this insurance ments, tests or does not apply to any "oc- servicing as the currence"which takes place vendor has after the equipment lease agreed to make or expires. normally under- takes to make in (c) Any person or organization e usual course (referred to below as ven- the in dor) with whom you have of connection with agreed per Paragraph the distribution or 9.a.(1) above to provide in- sale of the prod- surance, but only with re- ucts; spect to "bodily injury" or "property damage" arising f) Demonstration, in- out of"your products"which stallation, servic- are distributed or sold in the ing or repair op- regular course of the ven- erations, except dor's business, subject to such operations the following additional ex- performed at the clusions: vendor's premises 1) The insurance afforded in connection withthe sale of the the vendor does not product; apply to: g) Products which, a) "Bodily injury„ " after distribution or property damage" for which the ven- sale by you, have ed or been label dor is obligated to relabeled el used pay damages by as a container, reason of the as- part or ingredient ity in on of lct or of any other thing ity in a contract s or substance by or agreement. This exclusion does not for the vendor, apply to liability for 2) This insurance does damages that the not apply to any in- vendor would sured person or or- have in the ab- ganization: sence of the con- tract or agree- a) From whom you ment; have acquired such products, or b) Any express war- any ingredient, ranty unauthorized part or container, by you; entering into, ac- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 11 of 15 companying or 2) This insurance does containing such not apply to "bodily in- products;or jury", "property dam- age" or "personal and cluded within the b} When liability hadvertising injury" aris- e ing out of operations products- performed for the state completed opera- tions hazard" has or political subdivision. been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1) spect to such above to provide insurance, products. but only with respect to li- abilit (d) Any state or political subdi- work` arising out of "your performed for that vision with which you have additional insured by you or agreed per Paragraph on your behalf. A person or 9.a.(1) above to provide In- organization's status as an surance, subject to the fol- insured under this provision lowing additional provision: of this endorsement contin- Thls insurance applies only ues for only the period of with respect to the following time required by the written hazards for which the state contract or agreement, but or political subdivision has in no event beyond the ex- issued a permit in connec- piration date of this Cover- tion with premises you own, age Part. If there is no rent or control and to which written contract or agree- this insurance applies: ment, or if no period of time is required by the written 1) The existence, mainte- contract or agreement, a nance, repair, con- person or organization's struction, erection, or status as an Insured under removal of advertising this endorsement ends signs, awnings, cano- when your operations for pies, cellar entrances, that insured are completed, coal holes, driveways, 3 An insurance provided to an manholes, marquees, ( ) Y hoist away openings, additional insured designated sidewalk vaults, street under Paragraph 9.a.(2): banners, or decora- (a) Subparagraphs (e) and (f) tions and similar expo- does not apply to "bodily sures;or injury"or"property damage" 2) The construction, erec- included within the "prod- tion, or removal of ele- acts-completed operations vators;or hazard'; 3) The ownership, main- (b) Subparagraphs (a), (b), (d), tenance, or use of any (e)and (f) does not apply to elevators covered by "bodily injury", "property this insurance, damage" or "personal and advertising injury" arising (e) Any state or political subdi- out of the sole negligence vision with which you have or willful misconduct of the agreed per Paragraph additional insured or their 9.a.(1) above to provide in- agents, "employees" or any surance, subject to the fol- other representative of the lowing provisions: additional insured;or 1) This insurance applies (c) Subparagraph (f) does not only with respect to op- apply to "bodily injury", erations performed by "property damage" or "per- you or on your behalf sonal and advertising injury" for which the state or arising out of: political subdivision has ) g Defects in design fur- issued a permit. 1 fur- nished by or on behalf Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 12 of 15 5 of the additional in- spects any other insurance sured;or policy issued to the addi- tional insured, and such 2) The rendering of, or other insurance policy shall failure to render, any be excess and / or noncon- professional architec- tributing, whichever applies, tural, engineering or with this insurance. surveying services, in- cluding: (b) Any insurance provided by a) The preparing, this endorsement shall be approving or fail, primary to other insurance approo prepare or available to the additional ing toinsured except: approve maps, shop drawings, 1) As otherwise provided opinions, reports, in SECTION IV - surveys, field or- COMMERCIAL GEN- ders, change or- ERAL LIABILITY ders or drawings CONDITIONS, 5. Other and specifications; Insurance, b. Excess and Insurance; or b) Supervisory, in- 2) For any other valid and spection, archi- collectible insurance tectural or engi- available to the addi- neering activities. tional insured as an 3) "Your work"for which a additional insured by consolidated (wrap-up) attachment of an en- dorsement to another insurance program has insurance policy that is been provided by the written on an excess primecontractor-project basis. In such case, manager or owner of the coverage provided the construction project under this endorse- in which you are in- ment shall also be ex- volved. cess. b. Only with regard to insurance pro- (2) Condition 11. Conformance to vided to an additional insured desig- Specific Written Contract or nated under Paragraph 9.a.(2) Sub- Agreement is hereby added: paragraph (f) above, SECTION HI - LIMITS OF INSURANCE is amended 11. Conformance to Specific to include: Written Contract or The limits applicable to the additional Agreement insured are those specified in the With respect to additional written contract or agreement or in insureds described in Para- the Declarations of this Coverage graph 9.a.(2)(9 above only: Part, whichever are less. If no limits are specified in the written contract If a written contract or or agreement, or if there is no written agreement between you contract or agreement, the limits ap- and the additional insured plicable to the additional insured are specifies that coverage for those specified in the Declarations of the additional insured: this Coverage Part. The limits of in- suranceBe are inclusive of and not in Be pre Serves Of- shown the In- addition to the limits of insurance five additional insured shown in the Declarations, form number CG 20 10 c. SECTION IV - COMMERCIAL GEN- or CG 20 37 (where ERAL LIABILITY CONDITIONS is edition specified);or hereby amended as follows: b. Include coverage for (1) Condition 5. Other Insurance is completed operations; amended to include: or (a) Where required by a written c. Include coverage for contract or agreement, this "your work"; insurance is primary and 1 and where the limits or cov- or noncontributory as re- erage provided to the add!- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 13 of 15 tional insured is more re- 11. of this endorsement fix the strictive than was specifi- most we will pay in any one "oc- cally required in that written currence" regardless of the contract or agreement, the number of: terms of Paragraphs 9.a.(3)(a), 9.a.(3)(b) or 9.b. (a) Insureds; above, or any combination (b) Claims made or "suits" thereof, shall be interpreted brought;or as providing the limits or coverage required by the (c) Persons or organizations terms of the written contract making claims or bring or agreement, but only to "suits". the extent that such limits or coverage is included within (2) Deductible Clause the terms of the Coverage a Our obligation to a d Part to which this endorse- ( ) ages olig our behalf am ment is attached. If, how- one to the amount of applies ever, the written contract or ages for each "occurrence- agreement specifies the In- which sare in excess of the surance Services Office Deductible amount stated in number additionalGG 20 10 but does al insured form Section B. Limits of Insur- ance 19. of this endorse- not specify which edition, or ance, The limits of endoinsurrse- specifies xi edition that mentance will not be reduced b does not exist, Paragraphs the application of such be 9.a.(3)(a) and 9.a.(3)(b) of pp De- this endorsement shall not ductible amount, apply and Paragraph 9.b. of (b) Condition 2, Duties in the this endorsement shall ap- Event of Occurrence, Of- ply. fense, Claim or Suit, ap- 10. Broadened Contractual Liability-Work plies to each claim or "suit" Within 50' of Railroad Property irrespective of the amount. It is hereby agreed that Paragraph f,(1) of (c) We may pay any part or all Definition 12. "Insured contract" (SEC- of the deductible amount to TION V-DEFINITIONS)is deleted. effect settlement of any claim or "suit" and, upon 11. Property Damage to Borrowed Equip- notification of the action ment taken, you shall promptly reimburse us for such part a. The following is hereby added to Ex- of the deductible amount as clusion j. Damage to Property of has been paid by us, Paragraph 2., Exclusions of SEC- TION I - COVERAGES, COVERAGE 12. Employees as Insureds - Specified A. BODILY INJURY AND PROP- Health Care Services ERTY DAMAGE LIABILITY: it is hereby agreed that Paragraph Paragraphs (3) and (4) of this exclu- 2.a.(1)(d) of SECTION II - WHO IS AN sion do not apply to tools or equip- INSURED, does not apply to your "em- ment loaned to you, provided they ptoyees"who provide professional health are not being used to perform opera- care services on your behalf as duly li- tions at the time of loss. censed: b. With respect to the insurance pro- a. Nurses; vided by this section of the en- b. Emergency Medical Technicians dorsement, the following additional 9 Y ,or provisions apply: c. Paramedics, (1) The Limits of insurance shown in the jurisdiction where an "occurrence" in the Declarations are replaced or offense to which this insurance applies by the limits designated in Sec- takes place. tion B. Limits of Insurance, 11. of this endorsement with respect 13. Broadened Notice of Occurrence to coverage provided by this Paragraph a. of Condition 2. Duties in endorsement, These limits are the Event of Occurrence, Offense thelimits inclusive of and not in addition a Claim or Suit SECTION IV- COMMER- the limits being replaced. The CIAL GENERAL LIABILITY CONDI- Limits of Insurance shown in Section B. Limits of Insurance, Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 14 of 15 TIONS) is hereby deleted and replaced (2) The names and addresses of by the following: any injured persons and wit- a. You must see to it that we are noti- nesses; and fed as soon as practicable of an (3) The nature and location of any "occurronco" or an offense which injury or damage arising out of may result in a claim. To the extent the"occurrence"or offense. possible, notice should include: This requirement applies only when (1) How, when and where the "oc- the "occurrence"or offense is known currence"or offense took place; to an"authorized representative". Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 15 of 15