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Demolition Contract-Wally Schmid Exc. & Oshkosh
�Z, DEMOLITION CONTRACT THIS AGREEMENT, is entered into on the 17th day of NOVEMBER 2016 by and between the CITY OF OSHKOSH, (CITY), and WALLY SCHMID EXCAVATING INC (name) 7821 SWISS ROAD, OSHKOSH WI 54902 (address), an entity formed pursuant to the laws of the State of Wisconsin, (CONTRACTOR). Based upon the promises and consideration described in this document, the parties' agreement is 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: Demolition Quotation No. 2016-10/25 for 670 GRAND STREET, OSHKOSH WI 54901 and appurtenant work,for the City of Oshkosh, all in accordance and in strict compliance with the City's request for quotations and the other documents referred to in ARTICLE V of this contract and which are fully incorporated into this contract as if fully restated. ARTICLE 1I. TIME OF COMPLETION The work to be performed under this contract shall commence be completed within the time limits specified in the General Conditions. ARTICLE Ill. PAYMENT (a) The City shall pay to the Contractor for the performance of the contract the total sum of$15,800.00 adjusted as allowed in the General Conditions or as allowed by law, or any changes hereafter mutually agreed upon in writing by the parties. (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 General Conditions. ARTICLE IV. CONTRACTOR TO INDEMNIFY AND 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 Demolition Contract - 1 remotely to the performance of this Contract or be caused or result from any violation of any law or administrative regulation. The contractor shall indemnify the City for all sums including court costs, attorney fees, damages, 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. ARTICLE V. INSURANCE The Insurance required by the City of Oshkosh as specified in the City's General Conditions, Supplemental Conditions, and 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 length of time that is specified, if any, in this contract, the specifications, whichever is longer. ARTICLE VI. COMPONENT PARTS OF THE CONTRACT This contract between the City and the Contractor consists of the following component parts, all of which are as fully a part of this contract as if herein set out verba- tim, or if not attached, as if hereto attached. ; 1. This Document 2, The City's General and any Supplemental Conditions 3. Specifications, including any addenda 4. City of Oshkosh Standard Specifications 5. Invitation for Quotations 6. Advertisement for Quotations 7. Contractor's Proposal The contract documents are complementary; what is required by one is as binding as if required by all. Before undertaking each part of the work, the Contractor shall carefully study and compare the Contract Documents and check and verify all pertinent figures and measurements required therein. Contractor shall promptly report in writing to the Engineer any conflict, error, ambiguity or discrepancy which Contractor may discover and shall obtain written clarification from the Engineer before proceeding with any work affected thereby. In the event that any provision in any of the above component parts of this contract conflicts with any provision in any other of the component parts, the provision in the Demolition Contract - 2 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 undersigned contractor and 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 By: ►� L (Seal of Contractor (Specify Title) if a Corporation.) By: (Specify Title) CITY OF OSHKOSH Mark A. Rohloff, City Mana er (Witness) (Witness) Pamela R. Ubrig, Cit Clerk APPROVED: I hereby certify that the necessary provisions have been made to pay the liability which will accrue under this contract. City Attorney j r !va City Comptroller Demolition Contract - 3 ATTACHMENT A City of Oshkosh, Wisconsin C_ City of Oshkosh Invitation for Quotation For RAZE AND REMOVAL, OF STRUCTURE 670 GRAND ST, OSHKOSH WI 54901 October 28, 2016 QUOTES ARE DUE TO PURCHASING NO LATER THAN: 10:00 AM MONDAY NOVEMBER 14, 2016 City of Oshkosh P.O. Box 1130 Oshkosh, Wisconsin 54903-1130 www-doshkosh.wi.us REQUEST FOR PRICE QUOTATIONS RAZING AND REMOVAL OF STRUCTURES Demolition Quotation Number: 2016-10125 Date: October 28, 2016 I. The City of Oshkosh is inviting sealed quotations from interested contractors for a project involving the demolition and removal of buildings and structure(s) from property within the municipal boundaries. Quotes must include all costs required to fully complete this project. Costs required to complete this project include, but may not necessarily be limited to, all labor, materials, equipment, supplies, transportation, permits, and approvals necessary to perform all work related to the demolition, removal, and proper disposal of material and debris located on the property. The City will be responsible for a very limited number of tasks and costs, with the contractor being responsible for all tasks and costs except where specifically noted. II. Sealed quotations must be submitted on the form provided by the City, which is attached to this Request as Exhibit A. The City's form contains the minimum information required to be considered a valid quote. Quotations that are submitted may include any additional relevant information the contractor believes may be helpful to the City. Sealed quotations must be received by the Director of General Services, located at the Oshkosh City Hall, 215 Church Avenue, Room 302, Oshkosh, Wisconsin 54901, by 10:00 a.m. on, MONDAY NOVEMBER 14, 2016. III. The successful completion of this project will be based upon the following: A. Complete removal of buildings and structures that that have been determined to be dangerous, unsafe, unsanitary, and/or otherwise unfit for human habitation from a property, with the "complete removal including the removal of basements, footings, and foundations; and, B. Restoring the property to a dust free and erosion free condition; and, C. Protecting neighboring properties, including private property and City right of way, from damage; and, . D. Minimize adverse impacts of the demolition and removal on the neighborhood; and, E. Compliance with all applicable local, state, and federal rules, whether or not they are specifically identified in this Request for Quotations; and, F. Compliance with all terms of any agreement with the City relating to this project. IV. All of the General Conditions identified in this Request for Price Quotations will apply to this project, except where they have been deleted, modified, or expanded by Supplemental Conditions. V. Supplemental Conditions may apply to this project. if "yes" is checked below, then Supplemental Conditions do apply to this project and should be attached to these General Conditions. If Supplemental Conditions apply, but are not attached, then you must contact Jon G. Urben, Director of General Services at (920) 236-5100, and request a copy. General Conditions - 1 A. Yes B. No X VI. Property: A. Property Address: 670 Grand Street, Oshkosh WI 54901 B. Structures to be Razed: 1. X House (with or without an attached garage) 2. Detached Garage 3. Other(s) C. The structures identified will be razed for the following reason: 1. X The City of Oshkosh owns the property and has chosen to remove the structures; or, 2. The property is privately owned and the City of Oshkosh is using its municipal authority along with judicial authorization to raze and remove the identified structures from the property. After the structures and debris are razed and removed, the property will continue to be privately owned. In certain circumstances, Wisconsin law and/or any applicable Court Order may give the property owner the opportunity to raze and remove the structures themselves. Due to these circumstances, all offers of work from the City, and/or signed contracts, related to private property may be revoked, modified, or otherwise voided at the sole discretion of the City. D. [Reserved for Supplemental Conditions related to this project] VII. Notice Regarding Quotation Process: The City expects that the total cost for this project will be less than $25,000.00. Therefore, this sealed quotation process will be followed instead of the formal bidding requirements described in the Wisconsin Statutes. If, after the initial request for quotation is circulated, the total cost for this project will be, or is expected to be, greater than $25,000.00, then all quotations will be rejected and the City will place this project within the formal bid process for all projects greater than $25,000.00. The City's conclusions regarding the value of the project may be the result of initial quotations or the result of further evaluation of the project. Quotations will be closely reviewed to ensure that change orders increasing the total contract value to the $25,000.00 level will not be necessary. Vlll. Sealed Quotations and Process: A. All costs related to the project must be included within the quoted price. Anticipated costs related to the project include, but are not limited to, labor, materials, supplies, permits, licenses, approvals, insurance, bonds, and disposal costs. The City is responsible only for asbestos abatement and the removal of any personal property having appreciable value. No compensation or change orders for additional costs or General Conditions - 2 expenses will be allowed based upon conditions which should have been known or were reasonably discoverable prior to the deadline for submitting quotations. B. State law limits the City's authority when it is removing, or hiring a contractor to remove, dilapidated and/or unsafe buildings located on private property. The City will remove all known personal property or fixtures with appreciable value before the successful contractor begins demolition activities, Any personal property or fixtures discovered on the property during the demolition process that has appreciable value does not become the property of the contractor and must be reported and given to the City for disposal or sale. The Contractor does not have to report the final value received for the salvage or recycling of materials removed from the property, except to the extent that estimates must be provided on the quotation form. The contractor must keep records related to the demolition and removal, including records of materials and objects and the prices obtained and provide copies of these records to the City upon request, C. The City of Oshkosh makes no warranties, express or implied, and assumes no responsibility for the condition of the structures to be razed, or for condition of the property on which the structures are located. The City is unable to ensure that the condition of the structures and property will not change between the date a contractor's quotation is provided and the date of demolition on private property,. D. Questions about the Project must be submitted to the City's Director of General Services in writing. "Writing" includes emails and faxes. The City will only respond to written questions. The City is not obligated to make questions and responses about the Project generally available except as required by Wisconsin Open Records laws. E. The City will award the contract for this project based upon the lowest quoted price commensurate with the quality, service, and ability to successfully complete the project within the expectations of the City of Oshkosh. The City reserves the right to place significant weight on an analysis of a contractor's anticipated quality, service, and ability to successfully complete the project. The City's Director of General Services shall have the sole discretion to review and approve a contractor's quotation within the requirements of the Municipal Code. Quotations will be opened after the submission deadline. There will be no formal "opening" meeting or event. The contractor selected will be notified of the next steps in the process. Those providing quotes that are not selected will be notified of that fact. F. In addition to all other criteria identified in this document and as allowed by law, the City reserves, without limitation, the following rights: 1. The right to reject any or all quotations received for any reason; 2. The right to request any additional information it believes is necessary to evaluate an interested contractor's ability to successfully complete the work desired. This may include references from other clients; 3. The right to reject a quotation for failure to comply with the quotation requirements, or any reasonable request by the City. G. A contract in.a form substantially similar to the agreement attached as Exhibit B will be required. General Conditions - 3 H. Contractors must comply with City insurance requirements before any contract will be approved. A copy of the City's insurance requirements is attached as Exhibit C. The City of Oshkosh shall be identified as an additional insured on the contractor's insurance policy for this project. Specifically, the additional insured must include the following: "City of Oshkosh, and its officers, council members, agents, employees and authorized volunteers. This does not apply to Workers Compensation Policies". 1X. Site Inspection / Contractor Risk. A. Contractors are solely responsible for reviewing, understanding, and evaluating the property and the structures on the property. No one shall enter the property for an inspection at any time without the permission of a representative from the City of Oshkosh. Persons interested in inspecting the property must contact the Inspections Division to set up an appointment. B. Contractors are solely responsible for reviewing and being aware of the contents of all available public records related to the property. City records are available for review upon request. The City will respond to questions regarding known conditions at the site and City codes that are applicable to the project. The City will not offer or provide opinions, analysis, or recommendations related to the project, except as they may relate to City codes and other requirements, The City has no duty to initiate the disclosure of any information in its possession relating to the property and/or structures on the property. The City is not responsible for verifying dimensions, elevations, site conditions, working conditions, transportation, storage, or any other relevant information related to the project. C. Contractors shall assume all liability and be responsible for all claims and damage related to the work they perform on this project. Contractor responsibility includes claims and damages related to their subcontractors, suppliers, and agents. Contractor responsibility begins on the date of any action at the site, including simply entering the property, after the City's contract has been signed and does not end until the expiration of any applicable limitations period as set forth in the Wisconsin Statutes. D. Contractors will hold the City harmless from claims, damages, and liabilities resulting from their work related to this project. "Their work" includes work and material provided by the contractor, and their subcontractors, suppliers, and agents. Contractors will fully and completely indemnify the City for all costs, fees, claims, and damages resulting from their work related to this project, and also the work performed by their subcontractors, suppliers, and agents. E. The condition of all aspects of the property and structures should be documented via photographs and/or video before starting any demolition actions, and again after the project is complete. At the completion of the project, the City shall be notified of all property and structure documentation in the contractor's possession. This documentation shall be made available to the City, at its request, for copying. The City shall be responsible for the reasonable costs of copying. Before the destruction of any records, the contractor shall notify the City in writing of its intention to destroy General Conditions - 4 records, and shall allow the City a minimum of sixty (60) days to request that the records, or copies of the records, be transferred to the City. X. COMMENCEMENT OF PROJECT: A. Contractors shall obtain, at their expense, all necessary permits, approvals, and licenses required for the razing and removal of the structures and debris from the property. Contractors should be aware that for certain projects they must obtain local, state, and federal authorizations. This includes, but is not limited to, demolition and right-of-way obstruction permits from the City of Oshkosh. The following are requirements of the Inspections Division before a demolition permit will be issued: 1. All permits necessary to disconnect utilities have been obtained; and, Z An erosion control plan approved by the City's Department of Public Works. The minimum requirements of this plan are: a) a type "D" covering of the two closest downstream inlets; and, b) a silt fence as needed; and, 3. All laws and regulations of any governmental authority having jurisdiction over the work or the property are being complied with, at least up to the point that the permit is issued; and, 4. All permits, certificates, and licenses required by the City of Oshkosh have been obtained. B. Demolition activities must commence not later than 10 days from the date of the contract and must be completed no later than 30 days after the contract is signed, This schedule may be altered by written agreement of the parties. The City may adjust the project schedule for any delays resulting from the following: asbestos removal issues; legal disputes between the City and the Property owner; circumstances requested by, or caused by, the City; or, due to circumstances not reasonably anticipated by one or both parties. Delays not approved by the City may result in the termination of the contract and/or the deduction from amounts owed to the Contractor for the costs of such delays. XI. UTILITIES A. All utilities serving any structure on the property shall be disconnected according to the requirements and regulations of the governmental entity or utility responsible for the service. B. Water service shall be terminated at the property line. An inspection of capped water lines by the City Water Distribution Division is required before the pipe is covered. C. Sanitary sewer laterals and storm sewer pipes shall be removed to the property line and shall be capped pursuant to applicable codes. An inspection of the capped sanitary sewer lateral and storm sewer pipe by the City Plumbing inspector is required before any pipe is covered. General Conditions - 5 D. Storm sewer laterals shall be removed to the property line and shall be capped pursuant to applicable codes. The only exception to this requirement will be if the property contains an outdoor yard drain which will remain after the buildings and structures are removed from the property, E. Electrical and gas service shall be terminated at a location and in a manner acceptable to the electrical or other utility and the City's electrical or other inspector, XII. GENERAL REQUIREMENTS: A. All above and below-ground buildings and structures, and any portion of buildings and structures which are the subject of the City's statutory razing authority shall be removed from the property. This includes all basements (including floors), footings, and foundations. Unless specifically requested to do so in writing by the City, the following shall NOT be removed: concrete or other material slabs that are not part of a building; parking areas; sidewalks; driveways; driveway apron; boundary fences; vegetation; or trees. It is the Contractors responsibility to notify the City in advance of any obstruction present that would unreasonably hinder the demolition project. B. All work shall be performed in a safe manner and suitable protection shall be provided for neighboring properties, including private property, City property, and the public. The current City of Oshkosh Building code requirements for demolition, protection of the public, protection of existing buildings and protection of adjoining properties provides minimum requirements. The best industry practices for demolition work will be used. All reasonable and advisable safety precautions will be taken, even if such precautions are above and beyond the minimum required by law. C. All temporary sidewalks, barricades, covers, and other temporary safety devices and facilities which are required or advisable for safety purposes shall be properly installed and diligently maintained, All temporary safety devices and facilities shall be removed upon the completion of the work under contract. D. An employee or agent with full authority to make all decisions for the contractor related to the project shall be on the property at all times during the demolition and removal process. E. All obstructions of a public right of way must be approved by the City Department of Public Works. Approval may also be required from Winnebago County or the Wisconsin Department of Transportation, depending upon the jurisdiction of the adjoining street, F. Demolition and removal shall be completely self-contained on the property. Any building or structure within ten (10) feet of any private property line, or a public street, alley, or sidewalk, shall be carefully and completely removed story after story, commencing with the top floor thereof. No debris, materials, or parts of such building shall be placed or allowed to fall upon any adjoining private property, or upon a public street, alley, or sidewalk, or to fall so near the same as to endanger persons or property thereon. All demolition materials and debris shall be removed from the private property, or the public street or sidewalk, each day, and more often throughout each day if the debris, materials, or weather require. General Conditions - 6 G. The property shall remain in a reasonably dust-free condition during and at the conclusion of the project. The demolition material and debris to be removed shall be wet down when necessary before being transported. Any use of water at the site requires the prior written approval of the City of Oshkosh Water Distribution Department. The City of Oshkosh does not allow the use of hydrants as a water supply. Potential water usage charges must be included in quotations. H. Explosives or explosive devices shall not be used on the project. Hazardous or toxic chemicals shall not be used on the project. I. Construction material and/or debris shall not be sold, burned, buried, or otherwise disposed of at or on the property, unless the material is being recycled with the prior approval of the City. All demolition material and debris are to be disposed of at a licensed landfill or at a recycling facility. No salvage, demolition material, or part of the structure(s) being demolished shall be sold without the express written consent of the City. J. The City will remove personal property with any appreciable value. Personal property with appreciable value on or in the property cannot be removed by the contractor except with the permission of the City. Personal property openly remaining in any building or structure, or upon the property, on the date demolition commences shall be considered abandoned or without appreciable monetary value and its disposal shall be the responsibility of the contractor. However, any personal property of appreciable value that was not obvious or was otherwise hidden but discovered during the demolition project shall be made immediately available for the City to retrieve. K. The contractor shall be responsible for all damage to neighboring private and public structures and properties, public sidewalks; curb and gutter; or gutter and street which are related to the demolition activities at the property. L. All debris, rubbish, and waste shall be removed from the property. X111. PROJECT COMPLETION: A. Ground openings, holes, and basement excavations shall be filled to an elevation and slope consistent with the remainder of the subject property and with the surrounding properties. "Fill' material shall be compacted between layers, or lifts, which shall not exceed eighteen inches (18"). The entire property shall be left in a level, dust and erosion free, neat, safe and sanitary condition. Material used for filling and grading includes soil, sand, gravel, and 4-Inch or smaller crushed stone capable of compaction for sub-grade which is acceptable to the City. Recycling of concrete or rock debris, basement walls or floors, foundation walls, and footings is encouraged. The City must receive advanced notice of recycling plans. The recycling process shall not occur on or near the property unless it is located in a zoning district in which this is an allowed activity. B. The property must be left with a minimum of 4" of black topsoil and a smooth grade. Topsoil shall mean loam, sandy loam, silt loam, silty clay loam, or clay loam humus bearing soils adapted to sustain plant life with a minimum organic content of 5% and General Conditions - 7 a pH between 6.0 and 7.0. Topsoil shall be pulverized and contain no clods larger than one inch (1") in diameter and be free of lumps, stones, sticks or any other foreign material. Vegetation must be established using seed and fertilizer with a covering approved by Wisconsin Department of Natural Resources. Approved coverings include mulch and Class 1 urban matting with biodegradable stakes, provided they are installed according to manufacturer and/or WDNR requirements. C. Completion of the project. 1. The project will be complete when vegetation is re-established on 70% of the disturbed surface using mulch in accordance with WDNR standards, or when the area is seeded with a Class 1 urban mat with biodegradable stakes installed in accordance with its manufacturer specifications. Upon completion of the project, all equipment, tools, and materials shall be removed and the premises left in a clean, neat and orderly condition. 2. The City must certify that the project is complete prior to full disbursements of the contract amount. Licensed landfill scale receipts for project demolition debris are required as part of all payment requests. The City may withhold a.portion or all of any payment otherwise due if the disposal of demolition debris, or the sale of any salvage or material, cannot be accounted for or verified. In the event that the contractor fails or refuses to leave the property the condition required by the agreement with the City, the City shall be authorized to deduct and set off from any payment to the successful contractor the City's reasonable estimate of the cost of completing the project or for remedying any property condition contrary to the City's requirements. 3. If the property is seeded using an approved Class 1 urban mat product, then the project is eligible to be considered complete upon the proper installation of the mat. If mulch or other methods are used, then 70% of the remaining amount due for the project can be disbursed upon the completion of the seeding, fertilizing, and mulching, with the final 30% due only when the grass has been reestablished on 70% of the disturbed surface. The City may make adjustments for amounts otherwise due to reflect change orders, deductions for work not completed, deductions for necessary repairs, deductions for any set-offs, deductions for liquidated or other damages. XIV. ASBESTOS AND HAZARDOUS CHEMICALS/WASTE: A. The City is responsible for asbestos testing and abatement related to the structures to be razed. No demolition work shall begin until the City notifies the contractor in writing that all asbestos abatement is complete. All work at the project shall stop immediately upon the discovery of what is, or what may be, additional asbestos at the site. Work shall not resume until the City provides written authorization to continue demolition work. B. Underground storage tanks and hazardous waste or hazardous waste containers shall be removed by legally qualified persons. The City shall be provided with the identification of persons removing storage tanks and/oi hazardous materials or waste who have been verified by the City. General Conditions - 8 C. The City is not responsible for the actual removal and cost of removal for property conditions that are known to exist or could reasonably be discovered, except asbestos. Underground storage tanks and/or hazardous waste shall be removed and disposed of in accordance with all applicable State and Federal regulations, as well as City of Oshkosh Fire Department regulations. D. Work on the project must stop immediately upon the discovery of underground storage tanks, or potential hazardous material or waste on the property. The successful contractor must retain a qualified consultant to assist with testing, removal, and disposal, and paperwork for Federal, State, and Local permits & documentation must be completed by a qualified persons. A State certified contractor must conduct the cleaning and tank removal. E. The City will adjust the project schedule accordingly in the event that additional or undiscovered asbestos, underground storage tanks, hazardous chemicals or containers, or similar substances are located during the demolition. The City shall not be responsible or liable to the contractor for idle time, additional costs, lost profits, or other costs associated with any delays with the projects. XV. MISCELLANEOUS: A. Parties are entitled to written notice of their default of any requirement and have seven (7) calendar days to remedy the problem. However, if the default is related to the actual, or potential, damage to any neighboring property or the public right of way, then the problem must be remedied immediately upon receipt of notice of default. If the defaulting contractor fails or refuses to remedy the issue requiring an immediate remedy, then the City may remedy the problem at the Contractors expense. The City may elect to deduct these expenses from the contract amount. B. The City may elect to terminate the contract and seek a replacement contractor to finish the project If the contractor remains in default of any written agreement related to this project after the time for remedying default has expired. The City is allowed to automatically set-off any amounts otherwise owed to the contractor against any amounts paid to the replacement contractor to complete the project. C. Time is of the essence in this project. The failure to complete the project within the allowed timeframe, subject to any extensions agreed to in writing in advance by the parties, shall result in liquidated damages payable to the City in the amount of $200.00 each day for each calendar day that the completion of the project is delayed beyond the stated completion date. In the event of a delay, the Contractor shall be liable for liquidated damages accruing from the original completion date until such time as the contractor completes the project, or until the date the project is completed by a replacement contractor in the event City obtains performance of similar services from others. Liquidated damages shall be in addition to other damages that the City may claim pursuant to any agreement or as allowed by law. D. Nothing in this Agreement is intended as a waiver of the municipality's right or opportunity to rely upon the municipal limitations and immunities contained within Wisconsin law. Municipal immunities and limitations include, but are not limited to, Sections 345.05, 893.80, and 893.53, Wisconsin Statutes. Such damage limits, caps and immunities are intended to be preserved and are incorporated into this General Conditions - 9 agreement and shall govern all disputes, contractual or otherwise, as they apply to the municipality and its agents, officers, and employees. E. Records related to this project may be considered public records pursuant to Wisconsin Statutes and, therefore, may be subject to the Wisconsin Open Records laws. The contractor will be notified of any open records requests received by the City that may involve records retained by the contractor. The contractor shall turn over all records requested by the City pursuant to an open records request, regardless of whether or not the contractor agrees that any particular record is a public record. The contractor will be notified of the results of the City's review and may institute legal action to prevent the disclosure of any document. The contractor accepts that the City's overriding interest is to comply with state Open Records laws. F. The terms identified in this Request shall be incorporated into the demolition permit(s) obtained related to this demolition project. The identification of one or more of these terms on the demolition permit will not act as a waiver of other terms not specifically identified on the demolition permit. G. For further information, contractors should call Jon G. Urben, Director of General Services at (920) 236-5100 XVI. ,[Reserved for Supplemental Conditions related to this project] General Conditions - 10 EXHIBIT A DEMOLITION QUOTATION FORM EXHIBIT A QUOTATION FOR: CITY OF OSHKOSH, WISCONSIN DUE: 10:00 AM MONDAY NOVEMBER 14 2016 Price Quote On: Demolition and Removal at: Address: 670 Grand Street Oshkosh WI 54901 Gross Cost of Project: $ Less Salvage Value**: $ QUOTED PRICE $ Quote for removing sanitary sewer lateral from property line to the City's main in the right of way if necessary: $ ** Describe: a) the objects and/or demolition materials expected to be sold for salvage; b) the value anticipated to be received; and, c) to whom the objects/material is expected to be sold: Demolition materials and debris will be disposed of at (the City must be notified of any changes): Name of Landfill: Address of Landfill Operator of Landfill: Operator Address: Telephone number: If contaminated/hazardous tanks, soil, or other materials are known to be present, attach a separate page with disposal information for hazardous material. I agree to complete the razing, removal, disposal, and site restoration of the above described property according to the requirements of the City's Request for Price Quotations. I will not start work until all permits, licenses, and approvals have been obtained, and I have been notified that all asbestos has been removed and the paperwork has been completed relative to any asbestos work that may treed to be done. Based upon my experience, I assert that any salvage values identified in this Quote represent the highest NET value which could be obtained for these materials in the local area. Demolition Quotation Form - 1 EXHIBIT A Initial here if you have reviewed Supplemental Conditions for this project, which are attached to the General Conditions as Exhibit,D, This price quotation shall be valid for thirty (30) days from the City's due date for price quotations. Name of Person, Firm, or Corporation Authorized Signature and Title Print Name and Title Address of Person, Firm, or Corporation City State Zip Code Telephone Number Demolition Quotation Form - 2 EXHIBIT B SAMPLE OF CITY OF OSHKOSH DEMOLITION CONTRACT SAMPLE DEMOLITION CONTRACT THIS AGREEMENT, is entered into on the day of , 2011, by and between the CITY OF OSHKOSH, (CITY), and (name) (address), an entity formed pursuant to the laws of the State of Wisconsin, (CONTRACTOR). Based upon the promises and consideration described in this document, the parties` agreement is as follows: ARTICLE [. 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: Demolition Quotation No. for and appurtenant work, for the City of Oshkosh, all in accordance and in strict compliance with the City's request for quotations and the other documents referred to in ARTICLE V of this contract and which are fully incorporated into this contract as if fully restated. ARTICLE 11. TIME OF COMPLETION The work to be performed under this contract shall commence be completed within the time limits specified in the General Conditions. ARTICLE Ill. PAYMENT (a) The City shall pay to the Contractor for the performance of the contract the total sum of$ , adjusted as allowed in the General Conditions or as allowed by law, or any changes hereafter mutually agreed upon in writing by the parties. (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 General Conditions. ARTICLE IV. CONTRACTOR TO INDEMNIFY AND HOLD CITY HARMLESS The Contractor covenants and agrees to protect and hold the City of Oshkosh harmless against ail 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. The contractor shall indemnify the City for all sums including court costs, attorney fees, damages, 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. Demolition Contract - 1 ARTICLE V. INSURANCE The Insurance required by the City of Oshkosh as specified in the City's General Conditions, Supplemental Conditions, and 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. Alf insurance shall be based upon the occurrence of an event, and not based on claims made. All insurance shall be in full force prior to commencing work and remain in force until the entire job is completed and the length of time that is specified, if any, in this contract, the specifications, whichever is longer. ARTICLE VI. COMPONENT PARTS OF THE CONTRACT This contract between the City and the Contractor consists of the following component parts, all of which are as fully a part of this contract as if herein set out verba- tim, or if not attached, as if hereto attached. 1 . This Document 2. The City's General and any Supplemental Conditions 3. Specifications, including any addenda 4. City of Oshkosh Standard Specifications 5. Invitation for Quotations 6. Advertisement for Quotations 7, Contractor's Proposal The contract documents are complementary; what is required by one is as binding as if required by all. Before undertaking each part of the work, the Contractor shall carefully study and compare the Contract Documents and check and verify all pertinent figures and measurements required therein. Contractor shall promptly report in writing to the Engineer any conflict, error, ambiguity or discrepancy which Contractor may discover and shall obtain written clarification from the Engineer before proceeding with any work affected thereby. In the event that any provision in any of the above component parts of this contract conflicts with any provision in any other of the component parts, 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 undersigned contractor and 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 Demolition Contract e 2 By: (Seal of Contractor (Specify Title) if a Corporation.) By: (Specify Title) CITY OF OSHKOSH By: Mark A. Rohloff, City Manager (Witness) And: (Witness) 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. City Attorney City Comptroller Demolition Contract - 3 EXHIBIT C SAMPLE OF CITY OF OSHKOSH INSURANCE REQUIREMENTS 4114/14 CITY OF OSHKOSH INSURANCE REQUIREMENTS VIII. RAZING AND REMOVAL OF BUILDINGS AND MATERIAL INSURANCE- REQUIREMENTS The Contractor shall not commence work on contract until proof of insurance required has been provided to the applicable City department before the contract or purchase order is considered for approval by the City. It is hereby agreed and understood that the Insurance required by the City of Oshkosh is pdMa coverage and that any insurance or self insurance maintained by the City of Oshkosh, ifs officers, council members, agents, employees or authorized volunteers will not contribute to a foss. All insurance shall be In full force prior to commencing work and remain in force until the entire job is completed and the length of time that is specified, if any, In the contract or listed below whichever is longer. 1. INSURANCE REQUIREMENTS FOR CONTRACTOR—LIABILITY A. Commercial General Llability coverage at least as broad as Insurance Services Office Commercial General Liability Form, Including coverage for Products Liability, Completed Operations, Contractual liability, and Explosion, Collapse, Underground coverage with the following minimum limits and coverage: 1. Each Occurrence limit $1,000,000 2. Personal and Advertising injury limit $1,000,000 3. General aggregate limit(other than Products-Completed Operations)per project $2,000,000 4. Products-Completed Operations aggregate $2,000,000 5. Fire Damage limit�-any one fire $60,000 6. Medical Expense limit any one person $5,000 7. Watercraft Liability, (Protection & Indemnity coverage)"If" the project work includes the use of, or operation of any watercraft, then Watercraft Liability Insurance must be In force with a limit of$1,000,000 per occurrence for Bodily Injury and Property Damage. 8. Products--Completed Operations coverage must be carried for two years after acceptance of work, B. Automobile Liability coverage at least as broad as Insurance Services Office Business Automobile Form, with minimum limits of $1,000,000 combined single limit per accident for Bodily Injury and Property.Damage, provided on a Symbol#1-"Any Auto" basis. C. Workers'Compensation as required by the State of Wisconsin,and Employers liability Insurance with sufficient limits to meet underlying Umbrella Liability insurance requirements, if applicable for the work coverage must include Maritime(Jones Act)or Longshoremen's and Harbor Workers Act coverage. D. Umbrella LlabU&providing coverage at least as broad as the underlying Commercial General Liability, Watercraft Liability (if required), Automobile Liability and Employers Liability, with a minimum limit of $2,000,000 each occurrence and $2,000,000 aggregate, and a maximum self-insured retention of$10,000. VIII - I 4/14114 E. Aircraft,Liability., "if" the project work includes the use of, or operation of any aircraft or helicopter, then Aircraft Liability Insurance must be In force with a limit of$3,000,000 per occurrence for Bodily Injury and Property Damage Including Passenger liability and Including liability for any slung cargo. F. Builder's Risk / installation Floater I Contractor's Eauloment or Property - The contractor Is responsible for loss and coverage for these exposures. City of Oshkosh will D-0-t assume responsibility for loss, including loss of use, for damage to property, materials, tools, equipment, and Items of a similar nature which are being either used In the work being performed by the contractor or Its subcontractors or are to be built, installed, or erected by the contractor or its subcontractors. G. Also, see requirements under Section 3. 2. INSURANCE REQUIREMENTS FOR SUBCONTRACTOR All subcontractors shall be required to obtain Commercial General Liability (if applicable Watercraft liability), Automobile Liability, Workers' Compensation and Employers Liability, (if applicable Aircraft liability) insurance. This Insurance shall be as broad and with the same limits as those required per Contractor requirements, excluding Umbrella Liability, contained In Section I above. 3. APPLICABLE~TO CONTRACTORS 1 SUBCONTRACTORS I SUB-SUB CONTRACTORS A. Acceotablilty of Insurers - insurance is to be placed with insurers who have an A.M. Bost rating of no less than A-and a Financial Size Category of no less than Class VI, and who are authorized as an admitted insurance company in the state of Wisconsin. S. Additional insured Reauirements — The following must be named as additional Insureds on all Liability policies for liability arising out of project work - City of Oshkosh, and Its officers, council members, agents, employees and authorized volunteers, On the Commercial General Liability Policy, the additional insured coverage must be ISO form CG 20 10 07 04 or its equivalent and also include Products — Completed Operations 180 form CG 20 37 07 04 or Its equivalent for a minimum of 2 years after acceptance of work. This does not apply to Workers Compensation Policies. C, Cert€f€cater of Insurance acceptable to the City of Oshkosh shall be submitted prior to commencement of the work to the applicable City department. These certificates shall contain a provision that coverage afforded under the policies will not be canceled or non renewed until at least 30 days'prior written notice has been given to the City Clerk --City of Oshkosh. Vill -2 CERTIFICATE of LIABILITY INSURANCE THIS FI_RTtEiCATE IS ISSUED AS A trtATTER OF 1NFORMATlON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT PFFD ASTiVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOK THiS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SJ,AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. I6IPORTANT: if the certificate holder Is an ADDITIONAL-INSURED,the pollcy(les) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditlorls of the Polley,certain policies may require an endorsement, A statement on this certificate does not confer rights to tile certificate holder In lieu of such endorsements. PRODUCER FD1 rnsuranceAgeneYeonfaef rnlamla flan,lnefudlag affect Insurance Agent's address and POBOXH confacrrnfarmavon. (aC.No): appllrable. URERIS)APFORDINOCOVERAOE NAI0I.-- ----- ---.--._.-...._._-_ _IrISUREAA, ABC Insurance Company _ MAIC# INSURED tnrvred'cconfacrrnlornravan, - h0vorlagnmie,sddrersand WSURERB__XYZ Insurance Company NA1C# phone number, ENSURER c. LMN InsufanCe teem an V NAtC# INSURER D: lnrurer(s)murlhaveaminfmumA.Ff.Ber[ravngorA• endo Finenrfa)Pedormance Ravng o1VlarbrNer. INSURER Er _ INSUHER F: — COVERAGES CERTIFICATE NUMBER: 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 INDIOATED. N01WITHSTANDiN3 ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE AMY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN iS SUBJECT TO ALL THE TERMS, _EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LNSR ADPL SUER — POLICYEFFPOLICY£XP LTR 7TSURAINSR WVb POLIOYHUMBER IJMMD M1 VDD LIMITS GENERAL LIABILITY lCiTY .1 EACH OCCURRENCE $1000.000 �COMMERCMGENEMLiABILITY ® ElGeneral LfaD"tyPakyhumber PO.•S'oh'ucthvandaxptrationdal9. DAMAGE TO RENTED -- PREMISEStEaocxnrer") $50,000 _ AaCLAIMS•MADE©OCCUR TdEOEXP(Anyonepefran) $5,000 ® 1SOFORMCG2037OREQUIVALENT PERSONALSADV]NdURY $1,000,000 ❑ --•-••------ GENERALAGGREOAT£. $2,000,000 GEITL AGGREGATELIMITAPPUESPER: PRODUCTS-COMPIOPAGO 2000,000 ❑iPOLICY �JJg O-11 LOC, ---� AUTOMOBILE LIABILITY COMBINED SINGLE:LIMIT $ tea ec�Gam} $1 DO0 000_ ArTYAlJTO ❑ AufalJabTQyPafcyfumber ParsyarleclFreBMaxprafondate. t* 11. iNJURY(PEfpartm) $ B ❑ALL AUTOS ED ❑ SCPE LED BODILYINJURY(Par aWdent) $ ❑HIREDAVTOS❑ AUTOS!lNED ROPE T-Y AI,W e $ 01 ❑ $ 10UM13RELLALiAIr ®'OCCUR Z ❑ EACHCCCURRENCE $2,000,OOD A ❑EXCESSLiAR ❑: CLAiM&MADEtlmbreraWblypoLyy&mbsr pokyelfedh,aanf/erpYaLbndafe, AG_ORE13ATE $2,000,000 T. DEO ®RETENrtaN510,000 — $ WORKERS COMPENSATION C' AND EMPLOYERS'LIAUILITY ❑ ❑ TORY LIM U- F1 £R ANY PROPRI ETORMARTN ERIEXECUTiVE O andalodPIABFIR yinnI,I) UDEO7 N SVorl:ersCOmpe4uUmPdiy ParcyeNed&Vand expmlandafa, E,L.IACHACCIDENT $100,000 (MandrloryinNH) N Number "' Iryas,descr�evndar E.L.DISEASE-EA EMPLOYEE_$100,000 DESCRIPTION OF OPERATIONS belCA --- E.L DISEA8E-POLICYLIU11- $500,000 DESCRIPTI OF OPERATIONS I LOCATIONS r VEHICLES tAtlech AGORD 101,Addldond Remarkr Schedule,ff mote Spice Is requ[red) Additional Insureds per attached endorsements, Certificates of Insurance acceptable to the 01ty of 0shkosh shall be submitted prior to eommoncernent of the work to the appficab]0 City department, Those certificates shall contain a provision that Covorano afforded under the pollalos will not be canceled or non renewed until at least 30 days'priorwrltten notice has boon given to the City Clerk—City of Oshkosh. CERTIFICATE HOLl7t;R CANCELLATION City of 0ehkosh,Attn:01(y Clork Insurance Standard V111 SHOULD ANY OF THE ABOVE;DESCRIBED POLICIES BE CANCELLED BEFORB 248 Church Avenue THE EXPIRATION DATE,THEREOF,NOTICE WILL BE oRLIVEREO IN PC Box 1130 SAMPLE CERTiFICATE ACCORDANCE WITH THEPOLiCYPROViSIONS, 0shkosh,VVI 84903.1130 Please Indicate somewhere on thls cortificate,the contract or projeot# AUTHORRED REPRESENTATIVE this carlificate is for. ©9888-2010 ACORD CORPORATION, All rights reserved. ACORD 25(2090108) Tlio ACORD name and logo are registered marks of ACORD POLICYNUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS r- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Or anization s : Locations Of Covered operations As required by contract Any and all job sites information re uired to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II -- Who Is An Insured is amended to B. With respect to the Insurance afforded to these Include as an additional Insured the person(s) or additional insureds,the following additional exclu- organization(s) shown In the Schedule, but only sions apply: with respect to liability for'bodily Injury", "property damage" or 'personal and advertising Injury" This Insurance does not apply to "bodily Injury" or caused,In whole or in part,by: "property damage°occurring after; I. Your acts or omissions;or 1. All work, Including materials, parts or equip- 2. The acts or omissions of those acting on your ment furnished in connection with such work, behalf; on the project(other than service, maintenance or airs) to of In the performance of your ongoing operations for there addtonal bnsur d(s) at the Io atione erformed bor oneofithe the additional insured(s) at the location(s) design- covered operations has been completed;or nated above. 2. That portion of °your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged In performing operations for a principal as a part of the same project, Elnsurancei,lStanndard VIIIERTIP'ICATrEomewhere on this ntract or project# talo s r CG 20 10 07 04 ©ISO Properties,Inc,,2004 Page 1 of 1 [I POLICY NUMBER; P°rrorr COMMERCIAL GENERAL LIABILITY 0020370704 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ Izations : Location And Description Of Completed Operations As required by contract Any and all job sites Information required to complete this Schedule, If not shown above,will be shown In the Declarations. Section 11 — Who Is An Insured Is amended to include as an additional insured the person(s) or organizatlon(s) shown In the Schedule, but only with respect to liability for 'bodily Injury", °property dam- age' caused, In whole or In part, by "your work" at the location designated and described In the sched- ule of this endorsement performed for that additional Insured and Included In the "products-completed operations hazard. Insurance Standard V"' SAMPLE CERTIFICATE Pleaso indicate somewhere on this certificate,the contract or project# this certificate Is for 0020370704 0 ISO Properties, Inc.,2004 Page 4 of 7 ❑ EXHIBIT A QUOTATION FOR: CITY OF OSHKOSH WISCONSIN DUE: 10:00 AM MONDAY NOVEMBER 14 2076 Price Quote On: Demolition and Removal at: Address: 670 Grand Street Oshkosh Wl 54909 Gross Cost of Project: $ , {�1--q- Less Salvage Value*: $ - QUOTED PRICE $ Quote for removing sanitary sewer lateral from property line to the City's main in the right of way if necessary: $ '30. ;- oC,c0 Describe: a) the objects and/or demolition materials expected to be sold for salvage; b) the value anticipated to be received; and, c) to whom the objects/material is expected to be sold: Demolition materials and debris will be disposed of at (the City must be notified of any changes): r Name of Landfill: 11 A441 c�� crtc.>�; � I� �S/�i,�c :` ����fo CYV Address of Landfill: P t Operator of Landfill: '�f�Sar,r A(-1 s w3 iz i Operator Address: Telephone number: '� , L - ; I ' - 1:� 2- t_yLu If contaminated/hazardous tanks, soil, or other materials are known to be present, attach a separate page with disposal information for hazardous material, I agree to complete the razing, removal, disposal, and site restoration of the above described property according to the requirements of the City's Request for Price Quotations. 1 will not start work until all permits, ,licenses, and approvals have been obtained, and l have been notified that all asbestos has been removed and the paperwork has been completed relative to any asbestos work that may need to be done. Based upon my experience, 1 assert that any salvage values identified in this Quote represent the highest NET value which could be obtained for these materials in the local area. Demolition Quotation Form - 9 EXHIBIT A V,; � 'Initial here if you have reviewed Supplemental Conditions for this , whi attached to the General Conditions as Exhibit D. p ch are This price quotation shall be valid for thirty (30) days from the City's due date for price quotations. WN C LY S(-1 hocne 0 t--Y' NC Name of Person, Firm, or Corporation A -'��/U�"";q uthorized Signature and Title 1, U i e-!Z S C Ff to r d Print Name and Title Address of Person, Firm, or Corporation d ( �L/( SC( � 0 z_ City State Zip Code Rt (0 YO Telephone Number [ Demolition Quotation Form - 2 f I /11C SCHM102 OP ID: DL CERTIFICATE OF LIABILITY INSURANCE OATE(MMlDDmrn THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLD ER14 Il 6124 16 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE= AFFORDED BY THE POLfC17EH5ES 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 holder is an ADDITIONAL INSURED, the policy(tes) must be endorsed, if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certaln policies may require an endorsement. A statement on this certiticate does not Confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER ADEMINO&ASSOCIATES INC NAME: DAVID VAN BOOGARD DAVID ADEMINO PxoNE 1001 TRUMAN P O BOX 99C No Ext:920-734-3110 FAX No): 920-734-6027 KIMBERLY, Wi 54136.0099 AQDRESB ;dVenbOO and ademino,Com DAVID VAN BOOGARD INSURER{S)AFFORDING COVERAGE NNC* INSURED WALLY SCHMID EXCAVATING INC WSURERA:ACUITY INSURANCE 94184 7821 SWISS RD INSURERB: OSHKOSH,WI 54902 INSURER C: INSURER D: INSURER E: COVERAG E5ENSURER F CERTIFICATE NUMBER: 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 OTHE=R DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPEOFINSURANCE INSD POLICYNUTABER 0 EPO C E P A X COMMERCIAL GENERAL LIABILITY MIDD I` LIMITS cwrnS-MADEXoccuR EACH OCC"ENCE $ 1,000,00 X X40178 04/14/2016 0411 2017R o R PREMISES Ea occurrence $ 100,00 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE UMITAPPLIES PER: POLICY 'Ro-- 0 LOC GENERAJ_AGGREGATE $ 2,000,00 OTHER; PRODUCTS-COPAP/OPRGG $ 2,000,00 AUT0140BILE LIABILITY $ A pp�Y AUTO COMBINED eBccPde°ntSINGLE LIMB $ X X40178 1,000,00 ALLOWh1=D OS )( SCFDULED 04H412016 0411412017 t30D1LYlNJURY(Per person) $ X AOWNEp BOpILY INJURY{Per acddent} $ HIRED AUTOS X AUTOS PROPER accIderdD RAGE $ X UMBRELLA LIAB X $ OCCUR A EXCESSLWB CLAIfvIS-trIA,DE X 40178 EACH OCCURRENCE $ 2,000,00 11115/2016 04H4/2017 AGGREGATE $ 2,000,00 DED X RETENTION $ Q VIORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY YIN X PER ATUTE R A ANY OFFl,EERR1,'E 3EREXCLUDED?ARTNERIEXFCUFIVE ❑NIA X40178 04/1412016 04/1412017 E.L.EACH ACCIDENT (MandotoryInNH) $ 100,00 If es,dosTcjn a under E.L.DISEASE EA EMPLOYEE $ 100 00 DESCRIPTION OF OPERATIONS bebw E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Addlllonal Remarks Schedule,may be attached It more space is required) RE:670 GRAND ST, OSHKOSH WI 54901 CITY OF AUTHORIZED VOLONTEERTS SIARE LISTED COUNCIL ADDITIONAL INSURED PER FORMS CB7332& C87245 CERTIFICATE HOLDER CANCELLATION OSC7jAU OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF OSHKOSH E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 CHURCH ST CORDANCE WITH THE POLICY PROVISIONS. OSHKOSH,W154901 ORIZE°REPRESENTATIVE DAVID VAN BOOGARD O 1980-2014 ACORD CORPORATION: All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 1711612016 10:47 Ademino &Associates (FAX)920 734 6027 P.0071013 : :':':':':':':':':':':':':':':':':':•:•:':':':':':':':.: . �:-:-- .:.: .:.:.:.:.:.: .:.:.: .:.:.:.:.:.: .:•::_:: �:---:. :r. r,� .:y�, :,dry,. .f •`: ,;.. 7), {'• G Y \� _ - v "i? :- :ti `}! •r ( r-:"�$i :'r�. 's i{;' <' :•l. ,^Cr',:. A.,3.` �, a.',., i3-rf3, L. .?a?.: r,�.{•. #:�',�-.. kr:' >y..k:��.tJ.ti•:• tt.# 1, •k� :} kl.�.t- ..y :>x�s: :t _]!!.'diS i3 `"ci Yd'ti :rf;1:'Ju' :i-:-`*,"E:iii - -• U' {r: .; )a,:;: iS _ o:. l.0 3' }. via t.-Sr�. . . .. . :ft:l.•:,: 3,r..3C : :' "r N- . >;{ �r;' }' 1, ' ;' }A�, , h,..•t " !; ' ..rr..� fl,y.1,.S FS' b..rA.. _4 tit;i'/.?;.-,?+:�.,f4:i '.f f{5 <:�.1 .li.�. '.--- v�,..1�.: _ .i. 4: ..!.. ryy„ft:::c:' -"c:/.'fh' ,.�ti.'• y'Sti''hr•:-,;)ri1'; d, f 1�x :ti. 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