Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Macco's Commercial Interiors & City/Grand Carpet Replacement
ORIGINAL CONTRACTOR AGREEMENT., GRAND OPERA HOUSE CARPET REPLACEMENT THIS AGREEMENT, made on the 23"' day of March, 2016, by and between the CITY OF- OSHKOSH, party of the first part, hereinafter referred to as CITY, and MACCO'S COMMERCIAL INTERIORS, INC., 680 S. WESTLAND DRIVE, APPLETON, WI 64914, hereinafter referred to as the CONTRACTOR, WITNESSETH: That the City and the Contractor, for the consideration hereinafter named, enter into the following agreement. The Contractor's proposal is attached hereto and reflects the agreement of the parties except where it conflicts with this agreement, in which case this agreement shall prevail. ARTICLE 1. PROJECT MANAGER A. Assignment of Project Manager. The Contractor shall assign the following individual to manage the project described in this contract: (Dale Schumerth, Macco's Commercial Interiors, Inc.) 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 11. CITY REPRESENTATIVE The City shall assign the following individual to manage the project described in this contract: (Jon Urben, General Services Manager) ARTICLE Ill. SCOPE OF WORK The Contractor shall provide the services described in the City's February 17, 2016, Invitation for Bid for the Project titled "CARPET REPLACEMENT GRAND OPERA HOUSE" and the contractor's bid form and bid bond for the project dated March 10, 2016 attached as Exhibit A. If anything in the Bid Form conflicts with the Bid Specifications, the provisions in the Bid Specifications shall govern. 1 The Contractor may provide additional products and/or services if such products/services are requested in writing by the Authorized Representative of the City. ARTICLE IV. CITY RESPONSIBLITIES The City shall furnish, at the Contractor's request, such information as is needed by the Contractor to aid in the progress of the project, providing it is reasonably obtainable from City records. To prevent any unreasonable delay in the Contractor'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 V, TIME OF COMPLETION The work to be performed under this contract shall be completed by no later than August 1 , 2016. ARTICLE III. PAYMENT A. The Contract Sum. The City shall pay to the Contractor for the performance of the contract the sum of $63,969, adjusted by any changes hereafter mutually agreed upon in writing by the parties hereto.. Fee schedules shall be firm for the duration of this Agreement. B. Method of Payment. The Contractor shall submit itemized monthly statements for services. The City shall pay the Contractor within 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 Contractor 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. ARTICLE IV. CONTRACTOR TO HOLD CITY HARMLESS The Contractor covenants and agrees to protect and hold the City of Oshkosh 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 2 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 Contractor shall provide insurance for this project that includes the City of Oshkosh as an additional insured. The contractor's certificate of insurance for this project is attached as Exhibit B. ARTICLE VI. TERMINATION A. For Cause. If the Contractor 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 Contractor. In this event, the Contractor shall be entitled to compensation for any satisfactory, usable work completed. B. For Convenience. The City may terminate this contract at any time by giving written notice to the Contractor no later than 10 calendar days before the termination date. If the City terminates under this paragraph, then the Contractor 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. 3 In the Presence of: CONTRACTOR /CONSULTANT 9 (Seal of Contractor (Specify Titley if a Corporation.) By: ' (Specify Titley r CITY OF OSHKOSH /`941, sy: rJQ�VJ(-Mark A. oh[off, City Manager itness) And: ._ k 0)1—) (Witne ) Pamela R. Ubrig, City Clerk APPROVED: I hereby certify that the necess- ary provisions have been made to pay the liability which will accrue under this contract. ity A orne mm &I Lan City Comptroller 4 CITY OF OSHKOSH 13ID PROPOSAL FORM Page 1 oft CARPET REPLACEMENT, GRAND OPERA HOUSE; From. vtQ 5_Co m1n e wj_ (bidder's company name) DID PROPOSAL D ADLIMEt FRIDAY, MARCH 11,2016 @ 10:00 A.M. CST Addenda: Recelpt of Addenda numbered I— - are hereby understood, acknowledged and Included In bidder's bid proposal form, If no addenda were Issued for this project please write`NIA"above, In compliance with the adverdsing for gids and having carefully examined the drawings and specification for the Work and the Site of the proposed work and having determined ali of the conditions of the work, the rules, regulations, laws, codes, ordinances, and other governing circumstances relating to this project, the undersigned proposes to furnish all labor, Materials and Equipment necessary to complete the work Indicated described In the project specifications to include all.described work completed to the Owners'sa.tlsfaction, By Submission of this Bid,each 13fdder certifies, and In the case of a joint:gad, each party thereto certifies as to its own organization, that this Bid fins been arrived at independently without consultation, communication,or agreement as to a matter relating to this aid and with any other gadder or with any competitor. We, the undersigned, propose to furnish all labor and materlols per the project specifications or noted deviations for the following amount(s): 111dfders may bid on BOTH or iwI` HER fristailatiott methods,belo%. BID l=OR INSTALLATION METHOD 1 (All carpet produced on stz�.ndard "actlanbg - no t c e pad back[nn Ins !fir will then double stick a senarata rpet� In oot tral ae sI l TOTTA+L.BID,METHOD 1 $ U 3 .00 (Bid Price--In Words �f�� ►nelu Qs ptJ ;14te 6AJ; de4uc;f 4 BID FOR INSTALLATION_METHOL?. 2_(�_ rpet foI stalrways4nly�produced on standard " onbac"-all other areas to h e attache ad backinay TOTAL 1310 METHOD 2 $ I (D ,00 -- (gad Price--In Words) Mrd 'r�etue�es ►rvna�tee t d,, edu��- '!s(�o�", Ac4- � Warranty Details:'; 6 , %,�J 2& - . , M. aka-Atu S _ CM fort�Cc, Q+1�C C`Ol,rti �. �cacJt�eG� � �' Contract Time; If this bid Is accepted,we will complete tho work by; kpa vs.4 2016, (c te) 20 f CITY OF OSHKOSH DID PROPOSAL(rORM Pago 2 of 2 CARPET REPLACEMENT, GRAND OPERA HOUSE: SIGNATURES Date; 04116 game of Company. r Submitted by, (ome/title) Address of Company; That I have examined and carefully prepared this Proposal from the Pians and Specifications and have checked the some in detail before submlttincd this Praposal; that I have full authority to make such statements and submit this Proposal In (its) (their) behalf, and that said statements are true a correct, slcgnatur Title — 2I O.—ATADocumont A310TM - 2010 Bid Bond CONTRACTOR; SURETY: r 1`r1rNr?.ll,+;trla'!ufl+�11+01 lrrlrlprrl'1 f.YplRt;Ic�dl.itrillrc rrrfr!!u'i/rr'rlinl�lt+c4 AMCCU,g CClMAWNIGb1L 1411:1{IOPR*INC. r>�htt+lnr.+til 232$Ifritum Road is:l?rlt:I1AN1;130NUN(I COMPAW(I/,1131JAL) Ginols nay,W1 34303 9701)MAID, s flotkway 111ra riac<ifn9nt 110E rritio+111on1 lagal 1Voal 17av M0nos,lA 110245 consequencos,CansVila[+arr w 111 1)4NNt:i•t; an aItolmy Is erlouluglia V4111 (-N''trrrrr',Ir;r?rtI51(rlrl.+'rlN 11111111t's,rr rna?9Cl to Ifs ctrr,KdCfi9rt of 011 Y OF 081IKQ,914 modiricallutl, Ally 2! Clitwai Avonuv,Osfwardi,W1 SAIIIJ•I13 Cont lfsOtj.:tif reLve l,Ov lu ('cnfra4tor.$r++ely,C3�'+IIeF of Ei()Hd 1;IAOI1NT, f'1yp PLACCIII nt"'Will uld, otim party tdw bi;cnasldoree of Amann]nkq tlrF,ratirtlora aryl�r.�fr�e pt;oJt:Ct; s,1/r7nto,Irrrxrtrurrurrl;lrfiz�.4a,rrrlrlE'rs+lt'rtttrunb{'r',tl'euml Slshxnslrtilrrr0flertllfif,lsr3.Ortie%fjFj Yet Nimillrr,Ifllriv: Thu 001111-Morand Suroly ON,IIo11l1"I t0 III,Ull'110r in 1110141nolnll so forth abovo,IOC rho 1w)-mew nru'iliclr the Cclntmetormid S[in=fs'himl 11lcnlse1w';,fllcir•llcir(t,oxo(nilors,ndillinisimici a,sliCccssursand f14S111ns.joiiii(yarid VVerilly,1s5 prt?ridcd,ItalVill.TIO C01Hhti0llS ui']his 1101111 at-0,11101 111111 it illo Owilcr:lum)fs the bid orlltt`coltllacfor st'itbill the time spedf vu ill t11G 11lcl Il(1C1motIt5,C+1'll'€llllll sildt little lvii0d im Int11'ba 11.qrCed to Il)1110 t wit rml(l C'ontrrrt4r,liptl 11w Cmllfttcbt r t,Iilter.l I)Cittcrc 11114 it 10111illcf 41'1111 I110 0t4'11or ill 110C(mltlli krill 010 ICun$of SUc:II bill,nitd giYCs surll Wild or bowjsS7I5 may tit 5peci1ie(l In IIS.h€ddiupinr Conlrnrl t)(aslnlit:nlf 11,41111 Slily milli] ed In Ak,jllristl€ctlon of 11w I1r0}trl Rod olhcneise accclliabJr to lllc ow1mr.(01.1110 A1€09111 perfoh;I wcc ofrach(A11tllllct .111d 141 Ills prompt p11CIlloill orlollt aixi Inji(Mal forllisWd Irl Ille€nnsccllai(sil AlorvolI or(3)pi),P In llrt 1)41111:1112 dirt's It nce,1101 to aacccd 111e nnsnnnl(if Ih1S 11010.betil c-li 1110 fl9h)Unf<)x:cifred in sft€d bid 110 stroll 1a11,el'11111ollm (orwhich the Os%'IlCr niag in xnod rlllllr conlriral with A11111 orpnn}v to peff{lrfn film uc(r �irk rrrvd by said bad.then 111is Obrinali4nshn!€bo:will runt sold,011111I1ylsc to nlitmin lit 11111 force 111ldoflect."I-1100 5tiri:ll 1101T43 4yaly s ally mithe 4f ill)ll}lllt I(! 111 b(`l14'i}('ll f]1('-{)ll'ttL'rllll[t 1'nlrtnlcloi 1110\fCifd AIC ili11411144'€Ilcll1ll( c)1t'lier nl�i)'owelil ltic lard.51'o-ti4 Qr or notit'r by'Ian'31111.1~'shall pot;Ipply to 11111'c.Nom Ston v.xAxcd1!{I';S€.\f1'(Goj rI;1)'$!lf(hc the time for wcepmrul nl'bkls 1)"16(4'.Ill Ilk lilt][lit( linv'1115.and[ticO1411ot 111111 Cl)I{Ilitl'I{)1'SIKIII vbNirl(IV�lll'4I4`s vollwill for 1111 oXn311SfP1l heyvllr)S11Y1'(fill)trin'a1 Ir IIli.S fiQ]I(l Is€4511011 Ill tOtlfieCEiml 44111111 511bcoll gldr's bad to it 1:`rndfrlefor,ilia Mill ConlitICICII'If,11115 tlnnd$h:111 be-&-eind Io tri`5(r1a�4111r7Y.lpf'11114 1111'wl'In 01vilmllall Ill.,(dela to leo Conlllictor, Whoo IBIS Mind lmbeen furid.01W lb CUlllply 11(ill 11 S11111nOr1'Urmiset,lentil w.quirtl114ill In dee 10coli(511 of 1114'.Prtllect, itn4'plovisloli ill IIIN Valid Colllliclirl;;wtlh S71d 5laltawy or ICgill shnll t1(!dwilml licicied llwriom Gild prol'Wotls conlllrlul[If1 10 Mich sGUntow of ofliel•loysll lquilvilleul&10111 lie tltelriCd hKoilatlml04 Isumill_Wilen sa f ltntshod.Ilk intern Is 1)litl Ellis 11ov(l Mmll ht`consln;rct;IS a mafulon,tlolld,i1:d 1101 Its II comut;)n Imp Imild. Sipled sttxl seld('11 1111s jolt) (likv ol, M001.2oro --!'�il�ri �,. ,_._� �4.�.(,�,{S'+•Irl! �• � 1 ctrl ... . J1CIICI IM11 WGN01P113 C�h IPhrf1 li?Il7Ul I] _ _ �, __��•.�-._..,. :..w__,..._.s n�crv) ` ! �j 11110 � r t'1'rllrrr flp�ulu113 Jn�ls�:l1,rlll'orucr fit T'r�ci AIA I]o(trM 1 Aa1o'd 1610.GuillvlQin i+196:1.1`;0141011}20 i(r!q 11M A?nfr'r`�p SM1:{4ula cr fiF�liile;ati ASl rk�hlt+oirrvSd.��- �� f MER-CHANTS )i_dW671-� C�3 C�O M i'A N Y, POWER OF AT'rORNrY . Know/dJ Rirsons Hy T'litma,F},e4nnls.that l,IEif2Cl IAN ra tib?•?fwm m..ip}iNY(,wuAi.)and hiMCHl1N T$W flJhr/d_BO IUING. 1t C..J)atlt L,05t t coir-lralio,ts of Ilvr Stole (Ilerefo o417aIvaly eotloff VHJ';Mrlynri o5}do hlv(;by mnko:C421>,alftu4u wid appo)nl, lnrkefdua5v. Bi'IRfa Krause; Chrislopl)er);Hovdf ),Joffroy R Moishpor. Kelly Cody; Roxanne Jensen; Trudy A S niewski a;G:rtrue anti 1R1YJll'r,ItuiisCJr(<l•lr1•F0':(.10111akn.Immolo.sr'ololUi rf,lrma rNl D9110 if of flip(.ndmplimus.aF$trroly,bonds.tilvIodaf rn�3 (mil ellhof r;aIllen f tiNjalxltta ill ihr;fialmo Isutilecl to IN Wifatsort Hint nny such In%tr amm mml)nr..J,Amw tlso afncmni t.& F11't'1;Pt MILLION(�JS.I)tlf).!?r10.f111)DUT,1.,11t,ti 'els pomrol-Allwowe is grenred nut rs alglx,tl tend SCal(id t)y facoillr.'0 wiyor and by tlulhoGly of the ia11ovony Hy-1A?vt adopto Ry ing J$�nfd,f 1?foCIC 5 all ijtt.(Chantr H011(141)Cwrspany 11:{ntu;tf)can APO]2:y..2011 mxr si}taplotr Ly tale 130flrrf or f74nthm of hlrrclJanl' linlUnf:l t:otgRog.Jet:.off Octo w 14.201 t 'Trte piftkiml,$r.;rplAry,Tleasul or.o ifip.sstetsrtl f forrclJm of=lily It4siSlatV$i Cf438ly 01 lur f'Vice I'1HSIvr lq altnfl IiUVd I Gavr ofitl oalhortly to fir=r1 to ntllliorira tlwrm to rluctllo nil lwh oil of(ho Company,dlld flllom Ilse z ?of Ihtt Company Iliorpfo,tmtic and mKIM00iijin,fOGrY,lllllhr^rss,cafitfucls of lil`Joil4ly and othorit+etrnys ofililtalory k1 ills ndll,rc iiw[aof,` 'Tn0 51fifui oro of orr/Ilifliviliod oflicer tiny?ale sant 01 140 C1tinp0my Jany 11a nrrind by rrlcshitlle ur ol+CUnrtin l4ni$0183fon to tlrly p01•rSJf Stl Allornoy vJ Cm 66caltnn the,nuf willionviliq tier v3[muhau 01W 1101very of any bold,w4cilfiking,fecapnfbr,nce.or ol)fof snrolyVllp ut=r.,J(,v n of Ilia f.-wtlmmly.arxt grreb st Jnitlufo Mild wal wtlen so omia shad Ilow)Ila snail=InrEu and Afoul Its 111vt411I Alanua'fy fried: Irl cNp,(,pGliofJ mllfI p0itf,pils fu favor of IN,?Infra NpriflollM o!r+nnarvJldlfau pals'.II?a ppreed 111el Ilia)tvtvr:r end stiola sly IImIty givon f011A tll;ofrLUy-in"pati irxfudos arty rind tilt oatSouls for Ino lolnaee)r rotam0d llzrccnlrlpos nr4l(rr Grsaf esl5nnlr:s on eitgflvmrf(v and' con,lrllWlalt clui{rttc�s retlu[rod riy trial Stale of Florida flalklrinlotll of T(anspor{ahcn.11 is lolly t,iWarstoad Thal cpJlsen3bsll to lite Stela tllF:vrid,t Uafrrillotenl of ra115f t1slnl:nn 1n:,f:ililt naylant of leo final askhiole to Illrf cofarnslur Jniflor its iSstfgnail,611"01111101 fef,esu fK%atrlely rbinppny ora.•tyef its flfxtgalrrons tirldor its bvfsd Ill v"..111 Ulftiltrolf3 m(0vor orlllo r.ntsl i(Ay Dupfirlitiom 7f Kl twmy�uf,[y,It fib 00((ep 1631 UK p{n5'9r lnt:f 00110,11y lrereby�ivY!It W liv,Alww0y.In-r•tict ciu,rinl do 11100%Cd 01 raVOW W11.0 I4KJ 4riillan pursan;,f ItoIIGG ed$Vol inlefll lies be@n alml IU li tp COIJ1455JDnel• 111"mil of i kgirways)l Rte t G rlfltoft. lilll I of Xt1et0e1,/alt l-Wt 1101(a0)dayg pilor to the IuNifimlion or lew:011fin. q,dvdnnss v`tittimaf,IIA Owlt.-nninr,Imv(t emi"od Mrs fnstnl+lte,sito to slgtlod and Sualad 11116 )411 (Illy of )(INImy fats 00(311{I qr"'/r� �Il Gt7 1.1 ld['fIGHANIS 13ONOING COMPANY(WIMAt-1 ti'axl��ry\Y4f(ti{. j% �,r�O` ... .... r h1&RCHAN'f3NA110NALi30)IDJ)40,INC. Im ••,.,Fre ''� d`' r=f�ff'•i{ e 5T/iff?Or Io:Nr% �o,.,uy)�,n,ial,�" .,�,r•, f,Oul:f y OF Vitim- Ss, Yrasfdnnr Qn 11)15 l,Ui M10! JGrretiwy 401(3 ,J&l(.ro 1rt(i Itirpooled Carr)f ilylor,to air,))olswal}!Ellmyll-1.flu t'roing la'/rite-sworn dW ley Phil Ire In fyfdt't(ent 0Ina MIER:tiMf.t1f;Nlllrlt}('OMPANY(MUIUAL)find 1dL'11CHAN),S NATIONAL t10fIr)Irq(3,rN[.:unJI(lnl Ilia setts rlfAx"d )o ilia for&-tioing V,slfurtlaul nfn Ilut Gnrlklrnto sisal:.or JhP Eornprtilks;And Viol Rte said fratitrment was,signed tlrlNJ:laoleil ill ft0WI of IN,, C1f:11gardes by n4lhuflEy of Ily)lr fCst%+ictiva tioslda'of DtMV4014 M.� �!y-�'�" 1'lEf,l)4'rY6GRYT (A-- f ""• I�ts'��. aif�irrlr,i��,,•FA�`r^= `•'�YYY'��� ` f ��-1N w lluhlryf rrb). .Jtr? GOunfy.knrh - (L•'rhifn Rtlrt r1 rl6l(✓y"$f.ltlT111115SfUll vectis rsal imeftlittrilu Ills Insi(ulnofn) I.�N.i>I'verq 4rfAn1,?f,,lr„Sdornray df !h@ IAi�RC,l3lifl 3:i t?0rJJ]Ih`n GOk�Pt1NY(lrllfltJllC)oral IAEfiC:lafitd TS N,i1'!()tffSL pO"JE)It•:Q,t)IG,. do Ivel)),CeOh(that We ui)of rind toreyoing rs a tn,n tlir:f MfUl copy or Ihn f/ry'Nf:f(,0F.; T0I1NF.Y exeG(110 by said Crfmn:ink4s, . ))Js DIPJ in full farm,9114 aifact afw Ilan Ilri Mnil(IMIX1o(t❑f t4 ONO I'}, l f 1t If}t tn(e55 1tVhCrohf,I hail hervulrla Sef I1ty liond;)i1U,11fixod thcr rdal of(110 Con;J(1n111s on IND clay of }�'��(" {r •,ytltif iF,, 4 03 4> ;'G3 ::�� ',. 1933 :• .t F'QA 0014(61/15) CERTIFICATE OF LIABILITY INSURANCEDATt(MWI)DIYYYY) -' 3/26/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES CIELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If tho cortiflcate holder 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 hold©r In lieu of such andorsoment(5). PRODUCER TACt NAME: Tiffanie Courtney.— M3 Insurance Solutions, Inc, PHONE F x 480 Pilgrim Way, Suite 1230Alc1Art oo Ell: 2Q �kQS�1b2�_.._ A�H?I- . Green Bay WI 52304 AnpREss; tiffanie.cou_rtneyft3in_s.com PRCbi)C"- CUSTOMER tDN•MACCF-? INSURER(S)AFFO WING COVERAGE NAIC# w INSVRERAiAmerisure Insurance Macco's Floor Covering Center Tric INSURER Macco's Commercial Interiors Trio --- _.__..— MCI Purchasing, LLC 2035 Larsen Road INSURERll; Green Say WI 54303 - INSURER E. INSURER E• _�..._.- -COVERAGES CERTIFICATE NLIMBER:1B6924633S 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 MAYBE ISSUED OR MAY PERTAIN,THE.INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,FXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, RISR ..~TYPE OFINSURANC£ D DR _.��._-.�.-__...-- POLCYEFF P IZ EXP --- LIRIITS----'- LTR N POLICY NUMBER hU DGNYYY MAUDDIYYYY A GENERALLIABILITY Y Y CPP20913750101 2/21/2616 2/27/201'1 EACH OCCURRENCE $1,000,000 X COMMFRCIAL GENERAL LIABILITY S D 31CaE-'raNTrS—W200,1100 — �fjEMkSES�Eaocwrrente]— ._--'•--'--- CLAIh&MADE 1 OCCUR MED EXP An im _Lsonj $10,000 PERSONALBADVINAW $1,000,000 ------- GENERAL AGGREGATE $2,000,000 GENLAGGREGATE LtmrrAPPiJE_SPER- PRODUCTS-COMRXIPAGG $2,000,000 _ POLICY x PRO. LOC - - A AUTOMOBILE LIABILITY y y CA20911740001 2/27/2016 2/27/2017 COMBINED SINGLELIMIr $1,000,$00 -1 We accident) X I ANYAUrO WDAY INJURY(Perpersan) $_-- ....... 1 - ALL O'IANEDAUTO$ _.r..._____ _........___ .�- SCNEOULEDAUCOS BCOILYRIluRY(Per accidbrg) S., ._ I---- PRCPERTY DAMAGE _ I11REDAUT09 (Per gtdde") $ NON-0"VVOAUTOS --- $ .—.---- - A % U140HELLALIAO X OCdIR M20913770002 2/27/2016 2/27/2017 EACHOCCURRENCE $10,000,000 EXCESS LIAB CLAIh1S•MADE AGGREGATE'---- $10,Ona,0110 �~ DEDUCTIBLE —_� —.._.._ $ x RETENTION $0 .... $ — A YIORKERS COMPENSATION WC2041376 12121/20-16 2/27/2017 X Y,CST TU- OTH- ANDEMPLOYERS'LtABILITY YiN 70RYLWM* R_ ANY PRDPRIETOWARTNERIEXECUTIVE EL.EACH ACCIDENT $1,00D,µ000 OFFICERIMEMBER EXCLUDE117 NIA IMandalory in NH) F.L.DISEASE-FA EkUILOYEt $1,00D,000 �. 11 yas da9tr18,m&r "-�-- 1) SM11P A"JOYOPERATIONSWw E.L.DISEASE-POLICY LIMIT tl 000,000 A i1netallation Floater CPP209117500012/27/2016 2/27/2017 At Any One Location 100,0VU DESCRIPTION OF OPERATIONS T LOCATIONS 1 VEIUCLES[Attach ACORD 101,Addillonal Ramarka Schedule,if mors$Paco is requlrad) The City of Oshkosh, its officers, council membars, agents, employees or authorized volunteers are included as Additional Insured on a primary & Non Contributory Basis on the General Liability and TJmbrella Liability and Additional Insured on the Automobile Liability. See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRI13ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Oshkosh - Attn City Clerk 215 Church Street PO Sox 1130 AUDIORVEDREPRESENTAPVE Oshkosh WI S4903-1130 .3�, � c01988.2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:MACCF-2 _ LOC!E: .....,.._._ „.-------- '�Q� ADDITIONAL. REMARKS SCHEDULE Fags 1 of i AGENCY NAMED INSURED 143 Insurance Solutions, .Inc. Macco's Floor Covering Center .Inc -- Macco's Commercial Interiors Inc POLICY NUMBER MCI Purchasing, LLC 2035 Larson Road ARRTCR 14AIC000F Green Bay W1 54303 €FFECTNE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 1-5 — FORM TITLE: CERTIFICATF. OF LIABILITY INSURANCE 30 day Notice of Cancellation, to the Certificate Holder, is included on the policy. j ACORD 101(2008101) Q 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANCES THE POLICY, PLEASE READ IT CAREFULLY. CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE FORM Policy Number Agency Number Policy Effective Date ClIP20913750201 4'L95904 p2/^7;?G16 Policy Expiration Datey� Dale Account Number 02/27/2U'17. 02/03/2416 24061.173 Famed Insured Agency Issuing Company 14ACCOS FLOOR COVERING CENTER M3 XNSUFANCU SOLUTIONS, AMERISURE INSUPPNCL INC. COMPAW 1, a, SECTION 11-WHO IS AN INSURED is amended to add as an insured any person or organization: (1) Whom you are required to add as an additional insured on this policy under a written contract or written agreement relating to your business, or (2) Who is named as an additional insured under this policy on a certificate of insurance, b, The written contract,written agreement,or certificate of insurance must: (1) Require additional insured status for a time period during the term of this policy;and (2) Be executed prior to the"bodily Injury","property damage",or"personal and advertising injury"leading to et claim under this policy, C, If,however. (1) "Your work"began under a letter of intentor work order,and (2) The letter of intent or work order led to a written contract or written agreement within 30 days of beginning such work,and (3) Your customer's customary contracts require persons or organizations to be named as additional insureds; we will provide additional insured status as specified in this endorsement. 2. SECTION 11-WHO IS AN INSURED is amended to add the foflowing If the additional insured is. a. An individual,their spouse is also an additional insured b. A partnership or joint venture,members, partners,and their spouses are also additional insureds c. A limited liability company.members and managers are also additional insureds. d. An organization other than a- (1)Partnership; (2)Joint venture;or (3)Limited liability company; executive officers and directors of the organization are also additional insureds. Stockholders are also additional insureds, but only with respect to their liability as stockholders. e. A trust,trustees are also insureds, but only wtth respect to their duties as trustees. Includes copyrighted material of Insurance Services Office, Inc. CG 70 48 Q9 13 Pages 1 of 3 3. The insurance provided under thus endorsement is limited as follows: a. That person or organization is an additional insured only with respect to liability ansing out of (1) Premises you (a)Own: (b)Rent; (c)Lease;or (d)Occupy, or (2) Ongoing operations performed byyou or on your behalf. If, however,the written contract,written agreement,or certificate of insurance also requires completed operations coverage,we will also provide completed operations coverage for that additional insured. b, remises, as respects paragraph 3.a.(1)above, include common or public areas about such premises if so required in the written contract or written agreement c. Additional insured status provided Linder paragraphs 3.a.(1)(b)or 3.a.(1)(c)above does not extend beyond the end of a premises lease or recital agreement d. Ongoing operations,as respects paragraph 3.a.(2)above,does not apply to"bodily injury"or"property damage"occurring after• (1) All work to be performed by you or on your behalf for the additional insured(s)at 1h site of the covered operations is complete,including related materials,parts or equtpment(other than service, maintenance or repair$):or (2) That portion of"your work"out of which the injury or damage arises is put to its intended use by any person or organization other than another contractor working for a principal as a part of the same project e. The limits of insurance that apply to the additional insured are the least of those specified in the. (1) Written contract, (2) Written agreement: (3) Certificate of insurance:or (4) Declarations of this policy_ The limits of insurance are inclusive of and not in addition to the limits of insurance shown in the Declarations. f, The insurance provided to the additional insured does not apply to"bodily injury","property darnage",or "personal and advertising injury"arising out of an architect's.engineer's,or surveyor's rendering of,or failure to render,any professional services, including but not limited to: (1) The preparing,approving,or failing to prepare or approve: (a)Maps, (b)Drawings, (c)opinions, (d) Reports; (a)Surveys, (f7 Change orders; (g)Design specifications;and (2) Supervisory,inspection,orengineering services Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 3 CG 70 48 0913 r g. SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS,paragraph 4.other Insurance is deleted and replaced with the following: 4, Other Insurance. Coverage provided by this endorsement is excess over any other valid and collectible insurance available to the additional insured whether; a. Primary; b.Excess, c.Contingent, or d,On any other basis; unless the written contract,written agreement,or certificate of insurance requires this insurance be primary. In that case,this insurance will be primary without contribution from such other insurance available to the additional insured, h. If the written contract,wntten agreement,or certificate of insurance as outlined above requires additional insured status by use of CG 20 10 11 85, then the terms of that endorsement, shown below,are incorporated into this endorsement to the extent such terms do not restrict coverage otherwise provided by this endorsement. ADDITIONAL INSURED,OWNERS, LESS=e5 0R CONTRACTORS(FORM B) is endorsement modifies insurance provided under the following- IT, GOMMERCIALL GENERAL LIABILITY COVERAGE BART, SCHEDULE Name of Person or Organization; Blanket Where Required by Written Contract, Agreement,or Certificate of Insurance that the terms of CC 201411 85 apply (€f no entry appears above,information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) WHO IS AN INSURED(Section 11)is amended to include as an insured the person or organization shown in the Schedule,but only with respect to liability arising out of "your work"for that insured by or for you. Copyright,Insurance Services Office, Inc, 1984 CG 2010 11 85 I. If the written contract,written agreement,or certificate of insurance as outlined above requires additional insured status by use of an Insurance Services Office (ISO)endorsement,then the coverage provided under this CG 74 48 endorsement does not apply. Additional insured status is limited to that provided by the 150 endorsement. Includes copyrighted material of Insurance Services Office, Inc CG 70 48 09 13 Pages 3 of 3 o. Rating Search: Sc,)Wt i »Advanced SearchPrint this pane Rating Services Home � Ratings Recent Rating ActWily Amerisure Insurance Company u a Search far d Rating AM.Best B:004032 NNC#;99468 FEIN$;383859912 RaglanahCeirters ,; Mailing Address View Additional Address lnformallon - - ---- Rating Process.&Definitions �,, P.O.Box 2050 Assfgnad to i ta�nct�at i urdefstand€rtg Beet's Ratngs Farmington Hills,MI 48333-2060 Insurance >rtr t a.Gutda to Best's Ratngs United Slates companies A qe_-taut a Ffnancla(Strength Rating Guidethat have, ,n Issuer:Credit Rating W49Weh:vrvwtamarisuro.wm to our opinion,an excellent abllfty n,Issue Rsling Guide?-- Phone:248.615-9000 to meet their ongoing Msurance a National State Rat ng Gwde Fax:248-426-7992 I chuations. A Country'Rlsklnrorm0on -- _----- 'a fAerket$egm nt Ou leak Based on A.M.Best's analysis,052538-Amerisure Mutual Holdings Inc Is the AMB Ultimate Parent and identifies the topmost entity Rat nu Methodology of the corporate structure.View a list of operating insurance entities in this structure, IndustryResearch; f industry&Market Centers •" a Financlal Strength Ra11nLView Ueflnlllon Best's Credit Rating Anal Caritact arr'Anatyst Rating; A(Excellent) Rating issued by:A.M,Best Rating Services,Inc, Conferences&Events;:M Afflflatton Code: p(Pooled) Senior Financlal Analyst:Gordon Mclean Awards&Recognitions Financial Size Category: XJ($750 Million to$1 Billion) Managing Senior Pinanclal Analyst:Jactialene Lentz,CPA Data Subnfsslon Canter a Outlook: Stable Regulatory'Infomtattoh?„ Action; Affirmed , _ , Effective Date: February 25,2015 Find a Iles!s Credit Rating Initial Rating Date: June 30,1959 View A.M.Best's at 0 s esu a Slate o ' _ ' Firkf a GrfnjNirq fl of Len,-Tent lssuer Credit Ratiri _View Dennit€an nAdvance-dSearch Long•Torn1: a Outlook: Stable A,M.$85t Rillirlg SOtVlces Action: Affirmed Contact Information m !ffaclive Date: February 25,2015 In€tlat Rating Date: June 18,2007 v OanoEegs lhde Bas's a In -TFy^g9.t A.M.Bost has provided ratings&analysis an this company since 1969. F211212014 Long-TarmissuerCredit ive Date Rating EfffiDRating 015 A2/2512015 a A 2/12/2014 a 1130!2013 A 1/30/2013 a 8115!2012 A 611 512 01 2 a 617/2011 A 6/7/2011 a 6/1712010 A 6!1712010 a r 4tI AMS Credit Report-includes Best's Financial Strength Rating and railonale along with comprehensive analytical commentary,detailed business overview and key financial data, Report Revision Date:3/1812015(represents the latest slgnlffcant change). ( { Hislodcal Reports are available in AMB Credit Report Archive Yip View additional news reports and products for this company. • : -� r.' �$r Data, �7Jtl� Jan 22,2010 /1.M.BestAssigns Rafts to Amedsure Partners insurance Company 1 of2