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Home My WebLink AboutStructurewerks Convention Center Parking Ramp RepairsOshkosh CONTRACTOR AGREEMENT: CONVENTION CENTER PARKING RAMP REPAIRS THIS AGREEMENT, made on the 29th day of AUGUST, 2017, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and STRUCTUREWERKS, 12600 ROBIN LANE, BROOKFIELD WI 53005 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 I. COMPONENT PARTS OF THE CONTRACT This contract consists of the following component parts, all of which are as fully a part of this contract as if herein set out verbatim, or if not attached, as if hereto attached: 1. Proposal Solicitation 2. This Instrument 3. Contractor's Proposal 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. ARTICLE II. PROJECT MANAGER A. Assignment of Project Manager. The Contractor shall assign the following individual to manage the project described in this contract: (MATTHEW BUELOW, STRUCTUREWERKS, DIRECTOR OF SPECIAL PROJECTS) 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. City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1 130 http://www.ci.oshkosh.wi.us ARTICLE III. CITY REPRESENTATIVE The City shall assign the following individual to manage the project described in this contract: (JON URBEN, CITY OF OSHKOSH, GENERAL SERVICES MANAGER) ARTICLE IV. SCOPE OF WORK The Contractor shall provide the services described in the City's Invitation for Bid for the Project titled CITY CENTER PARKING STRUCTURE 2017 REPAIRS and the contractor's bid form and materials attached as Exhibit A. If anything in the Bid Form conflicts with the Bid Specifications, the provisions in the Bid Specifications shall govern. 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 V. 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 VI. TIME OF COMPLETION The work to be performed under this contract shall be completed by no later than DECEMBER 31, 2017 ARTICLE VII. PAYMENT A. The Contract Sum. The City shall pay to the Contractor for the performance of the contract the sum of $46,522.00 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 VIII. 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 City all sums including court costs, attorney fees and punitive damages which the City may be obliged or ad- judged 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 IX. 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 X. 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. In the Presence of: CONTRACTOR /CONSULTANT V� 4 (Seal of Contrato if a Corporation.) Ne-> Cc,('f By: w.. (Specify Ti" By: c, ^-iso\lir (Specify Title) CITY OF OSHKOSH Mark A. Rohloff, City Manager And: L 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. 4Q+orney City Comptroller Ev-K ►t CITY OF OSHKOSH BID PROPOSAL FORM CITY CENTER PARKING STRUCTURE 2017 REPAIRS Page 1 of 2 From:'��-�`L��-1��' kS (bidder's company name) BID PROPOSAL DEADLINE: Thursday, 8/10/17 @ 10:00 A.M. Date: (9 - 9 - 201 Addenda: Receipt of Addenda numbered � of �_ are hereby understood, acknowledged and included in bidder's bid proposal form. If no addenda were issued for this project please write "N/A" above. In compliance with the advertising for Bids and having carefully examined the drawings and specification for the Work and the Site of the proposed work and having determined all 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 construction indicated on the drawings and described in the project manual to include all described work completed to the Owners' satisfaction. By Submission of this Bid, each Bidder certifies, and in the case of a joint Bid, each party thereto certifies as to its own organization, that this Bid has been arrived at independently without consultation, communication, or agreement as to a matter relating to this Bid and with any other Bidder or with any competitor. We, the undersigned, propose to furnish all labor and materials per the project specifications or noted deviations for the following amount(s): BASE BID: TOTAL BASE BID: (Base liid Price - in Words) Warranty Details: S -i n,-' crj ovw- SIGNATURES Date: b'' `�- /7 Name of Company: .57'1?yC7'0A KS Submitted by: (name/title) / / /i[(44 -ems TS -'ZJ"Email: Address of Company: i zr oy � ,.1 �� , t3rcx� +�*� 1�9 6)1Phone: Zc- z-- -7 PW CITY OF OSHKOSH BID PROPOSAL FORM CITY CENTER PARKING STRUCTURE 2017 REPAIRS Page 2 of 2 Company Representative that will be named Project Manager for this project, if awarded the bid: That I have examined and carefully prepared this Proposal from the Plans and Specifications and have checked the same in detail before submitting this Proposal; that I have full authority to make such statements and submit this Proposal in (its) (their) behalf, and that said statements are true and correct. Signatoro.� Title 27 CITY CENTER PARKING STRUCTURE 2017 REPAIRS JULY 2017 BASE BID Work Item Reference Unit Quantity Unit Cost Total Estimated Cost General Conditions G1. Contractor Mobilization IDiv. t Specs. I L.S. I 1 I G2. controctor Generol Conditions IDIv. 1 Specs. I L.S. I 1 Work items STRUCTURAL ITEMS SI, Slab Spall Repair (Underside) 7 / SK -7 S.F. 20 r' S2. Speed Ramp Repairs 4,5 / SK -6 S.F. 150 7n $ (;5 - S3. Column Delamination Repair 6 / SK -7 S.F. 20 I (� • "" $ oG S4. Top of Wall Repair 2 / SK -5 L.F. 10 $ I I S5. Face of Wall Repair 3 / SK -5 S.F. 25 $ WATERPROOFING ITEMS WI. Rout and Seal Slab Cracks 12A / SK I O L.F. 100 $ /-//E,. W2. Joint and Cove Sealant Replacement 12A, 12B / SKI L.F. 260 17•�P $ f,4�"DG. - W3. On -Grade Sealant at Stair 12D / SK -10 L.F. 40 l .q4) $ q -7 0.'Y' - W4. Rout and Seal Floor Drain 12C / SK -10 EA. 8 Z9 -Sc, $ MISCELLANEOUS ITEMS 1,11. Asphalt Replacement at Island with Sealant 8,9 / SK -8 S.F. 1,350 $ cam_ �O - M2. Signage Re -anchoring EA. 1 z $ 36 �V - M3. Asphalt Replacement at Conduit with Sealant 9/SK-8,10/SK-9 S.F. 170 n , �- $ 104. Conduit Replacement 10/SK-9 L.S. 1 t Q $- IA5. Grind Slab Edge L.F. 8 t / /n , c _:� $ 3 S y-, - M6. Seal Drain Pipe/Body Connection EA. 3 a F % $ 59 C, . `= N17. Restriping Parking Garage L.F. 1 f -776.- $ •-n-Ta`-`c Base Bid Total (Numbers) S4( Base Bid Total Words o r -r -H `.-.�x tir,� c _4 rr , ,� �l r �}, y-, _ 1, 1e, r5 . 9 91 Base Bid Summary a. BIDDER will complete the Work for the following price: `�-\ 50c DOLLARS (useords) $ 46� << (figures) 8. Alternate Bids CARL WALKER, INC. BID FORMS PROJECT NO. R1-2011-483 004100-4 CITY CENTER PARKING STRUCTURE 2017 REPAIRS JULY 2017 a. Contractor shall provide unit cost for items listed below. These items are not part of the current construction package, but shall be considered as alternate work to be performed at the Owner's option at the cost given. Contract period will not be extended if alternates are accepted. b. Unit Prices: Work Item Total Estimated Reference Unit Quantity Unit Cost Cost E1. Supplemental Drain Replacement 1 1 / SK -9 EA. 3 Enhancement Bid Total (Numbers) Enhancement Bid Total Words i �� t t . `< -t t.,r�✓_ irt�rr�r rxJ �, 1 �H r„ l i /„> V 9. Description of Abbreviations: a. L.F. = Lineal Feet b. EA. = Each C. S.F. = Square Feet d. L.S. = Lump Sum e. LBS. = Pounds f. N.A. =Not Applicable 10. The quantities appearing in the preceding Schedule (paragraph G.6.c) are approximate only and are prepared for comparison of bids. Payment to the Contractor will be made only for the actual quantities of Work performed and accepted in accordance with the contract unit prices. Any item and/or section within the Work may be deleted by the Owner. a. Refer to Drawings and Specifications for other Work required as part of this Contract but not listed in the above schedule (paragraph G.6). 11. The terms used in this Bid which are defined in the General Conditions of the Contract included as part of the Contract Documents have the meanings assigned to them in the General Conditions. a. The quantities appearing in the preceding Schedule have been measured or estimated by the Engineer. Contractor may rely upon these quantities in preparation of the base Bid. b. Note that the items provided in the above list do not represent all of the General Requirement Work required by this Contractor. 12. The Bidder, by its officers and its agents or representatives present at the time of filing this Bid, being duly sworn on their oaths, say that neither they nor any of them have in any way directly or indirectly entered into any arrangement or agreement with any other Bidder, or with any officer of the City of Oshkosh, or Carl Walker, Inc. whereby such affiant or affiants has paid or is to pay such other Bidder or officer any sum of money, or has given is to give to such other Bidder or officer anything of value whatever; that such affiant or affiants has not directly or indirectly, entered into any arrangement or agreement with any other free competition in the letting of the Contract sought for by the attached Bids; that no inducement of any form or character other than that which appears on the face of the Bid will be suggested, offered, paid or delivered to any person whomsoever to influence the acceptance of the Bid or awarding of the Contract; that this Bidder has no agreement or understanding of any kind whatsoever, with any person whomsoever to pay, deliver to, or share with any other person in any way or manner, any of the proceeds of the Contract sought by this bid. CARL WALKER, INC. BID FORMS PROJECT NO. R1-2011-483 004100-5 E",_ �) 1'0 )� 6 CWRSnI IR -n9 OPInPJTFK T ACORO" CERTIFICATE OF LIABILITY INSURANCE E (MMID D/YWY) F0DATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Johnson Insurance Milwaukee 555 Main Street Ste 291 Racine, WI 53403 CONTACT Tammle Arbuckle PHONEFAX (A/c, No, Ext): (608) 203-3872 (A/c, No):(877) 254-8586 AEi%A,1Lss: tarbuckle@johnsonins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Cincinnati Insurance Company 10677 12/31/2017 INSURED INSURER B: Accident Fund Insurance Company of America 10166 INSURER C: Structurewerks, Inc. INSURER D: 12600 W Robin Ln Ste 100 Brookfield, WI 53005 INSURER E INSURER F: $ rnvGDKnI=Q CERTIFICATE NII IMRFR• REVISION NUMBER' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL I D SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X EPP 0065928 12/31/2016 12/31/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 500,000 Eoccurrence $ PREMI E a MED EXP (Any oneperson) $ 10,000 PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a jE Q F]LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY(CEO, X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY ATOS ONLY X EBA 0065928 12/31/2016 12/31/2017 acclid.n SINGLE LIMIT $ 1,000,000 BODILY INJURY Per person)$ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EUP 0066000 12/31/2016 12/31/2017 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ DED I X I RETENTION $ 0 Aggregate $ 5,000,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIMB R/PCLUD /EXECUTIVE Y OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WCV 8010391 07/27/2017 07/27/2016 PEARE T T FORTH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 1,000,000 E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Oshkosh is additional insured with respect to General Liability and Automobile Liability when agreed In written contract subject to the Policy terms, conditions and exclusions. Umbrella Liability follows form. City of Oshkosh Attn: City Clerk 215 Church Avenue PO Box 1130 Oshkosh, WI 54903 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indi- cated below. Endorsement Effective: Policy Number: 08-10-2016 IEBA 006 59 28 Named Insured: CWS SOURCE INC DBA STRUCTUREWERKS HANNA INVESTMENTS LLC, STRUCTUREWERKS INC Countersigned by: Repr With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SECTION II - LIABILITY COVERAGE, A. Cover- age, I. Who is an Insured is amended to include as an insured any person or organization with which you have agreed in a valid written contract to provide insurance as is afforded by this policy. This provision is limited to the scope of the valid written contract. This provision does not apply unless the valid written contract has been executed prior to the "bodily injury" or "property damage". AA 4171 11 05 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement - Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage.................................................................................................. 2 7 2. Unintentional Failure to Disclose Hazards.......................................................................................... 3. Damage to Premises Rented to You................................................................................................... 8 9 4. Supplementary Payments................................................................................................................... 9 5. 6. Medical Payments................................................................................................................................ Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.)......................................................................................................... 9 7. 180 Day Coverage for Newly Formed or Acquired Organizations.................................................. 10 8. Waiver of Subrogation....................................................................................................................... 10 10 9. Automatic Additional Insured - Specified Relationships: ................................................................ • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions - Permits Relating to Premises; • State or Political Subdivisions - Permits; and 10. • Contractors' Operations Broadened Contractual Liability - Work Within 50' of Railroad Property ......................................... 14 11. Property Damage to Borrowed Equipment.......................................................................................14 14 12. Employees as Insureds - Specified Health Care Services: ............................................................ • Nurses; • Emergency Medical Technicians; and • Paramedics 14 13. Broadened Notice of Occurrence...................................................................................................... B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 1 of 15 6. Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a. $1,000 Coverage b. $5,000 unless otherwise stated $ Deductibles (Each Occurrence) Coverage a. $250 Coverage b. $250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM have used up the ap- p- (a) Area (For Limits in Excess of (For Limits in Excess of 1. Employee Benefit LiabilityCoverage (b) Payroll $5,000) $5,000) judgments or settle- ments. (c) Gross Sales Liability Coverage. (d) Units (1) Insuring Agreement ity to pay sums or perform acts or services is covered e Other unless explicitly provided for b. Care, Custody under Supplementary Pay - $ or Control ages caused by any act, er- of the in- (b) This insurance applies to TOTAL ANNUAL PREMIUM damages only if the act, er- 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the ap- p- limit in plicable 1. Employee Benefit LiabilityCoverage t ane in the payment of a. The following is added to SECTION I judgments or settle- ments. -COVERAGES: Employee Benefit Liability Coverage. No other obligation or liabil- (1) Insuring Agreement ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay - obligated to pay as dam- ments. ages caused by any act, er- of the in- (b) This insurance applies to ror or omission sured, or of any other per- damages only if the act, er- son for whose acts the in- ror or omission, is negli- ently committed in the sured is legally liable, to ag administration" of your which this insurance ap- plies. We will have the right "employee benefit pro - and duty to defend the in- sured against any "suit" 1) Occurs during the pol- seeking those damages. icy period; or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our discretion, investigate any a) You did not have report of an act, error or knowledge of a claim or "suit" on omission and settle any claim or "suit" that may re- or before the ef- sult. But: fective date of this endorsement. 1) The amount we will pay You will be for damages is limited deemed to have as described in SEC- TION III - LIMITS OF knowledge of a INSURANCE; and claim or suit" when any 2) Our right and duty to "authorized repre- defend ends when we sentative"; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 2 of 15 i) Reports all, or any part, of the act, error or omission to us or any other insurer; iii) Receives a written or ver- bal demand or claim for dam- ages because of the act, er- ror or omis- sion; and b) There is no other applicable insur- ance. (2) Exclusions This insurance does not apply to: (a) Bodily Injury, Property Damage or Personal and Advertising Injury "Bodily injury", "property damage" or 'personal and advertising injury". (b) Dishonest, Fraudulent, Criminal or Malicious Act Damages arising out of any intentional, dishonest, fraudulent, criminal or mali- cious act, error or omission, committed by any insured, including the willful or reck- less violation of any statute. (c) Failure to Perform a Con- tract Damages arising out of fail- ure of performance of con- tract by any insurer. (d) Insufficiency of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit pro- gram". (e) Inadequacy of Perform- ance of Investment / Ad- vice Given With Respect to Participation Any claim based upon: 1) f=ailure of any invest- ment to perform; 2) Errors in providing in- formation on past per- formance of investment vehicles; or 3) Advice given to any person with respect to that person's decision to participate or not to participate in any plan included in the "em- ployee benefit pro- gram". (f) Workers' Compensation and Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers' compensation, unemployment compensa- tion insurance, social secu- rity or disability benefits law or any similar law. (g) ERISA Damages for which any in- sured is liable because of liability imposed on a fiduci- ary by the Employee Re- tirement Income Security Act of 1974, as now or hereafter amended, or by any similar federal, state or local laws. (h) Available Benefits a) Any claim for benefits to the extent that such benefits are available, with reason- able effort and cooperation of the insured, from the ap- plicable funds accrued or other collectible insurance. Taxes, Fines or Penalties Taxes, fines or penalties, including those imposed under the Internal Revenue Code or any similar state or local law. Employment -Related Practices Any liability arising out of any: (1) Refusal to employ; (2) Termination of em- ployment; (3) Coercion, demotion, evaluation, reassign- ment, discipline, defa- mation, harassment, humiliation, discrimina- tion or other employ - Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 3 of 15 ment-related practices, acts or omissions; or (4) Consequential liability as a result of (1), (2) or (3) above. This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. (3) Supplementary Payments SECTION I - COVERAGES, SUPPLEMENTARY PAY- MENTS - COVERAGES A AND B also apply to this Coverage. b. Who is an insured As respects Employee Benefit Liabil- ity Coverage, SECTION II - WHO IS AN INSURED is deleted in its en- tirety and replaced by the following: (1) If you are designated in the Declarations as: (a) An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. (b) A partnership or joint ven- ture, you are an insured. Your members, your part- ners, and their spouses are also insureds but only with respect to the conduct of your business. (c) A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are in- sureds, but only with re- spect to their duties as your managers. (d) An organization other than a partnership, joint venture or limited liability company, xou are an insured. Your executive officers" and di- rectors are insureds, but only with respect to their duties as your officers or di- rectors. Your stockholders are also insureds, but only with respect to their liability as stockholders. (e) A trust, you are an insured. Your trustees are also in- sureds, but only with re- spect to their duties as trustees. (2) Each of the following is also an insured; (a) Each of your "employees" who is or was authorized to administer your "employee benefit program". (b) Any persons, organizations or "employees" having proper temporary authori- zation to administer your "employee benefit program" if you die, but only until your legal representative is ap- pointed. (c) Your legal representative if you die, but only with re- spect to duties as such. That representative will have all your rights and du- ties under this Coverage Part. (3) Any organization you newly ac- quire or form, other than a part- nership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if no other similar insurance applies to that organization. However, cover- age under this provision: (a) Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and (b) Does not apply to any act, error or omission that was committed before you ac- quired or formed the or- ganization. c. Limits of Insurance As respects Employee Benefit Liabil- ity Coverage, SECTION III - LIMITS OF INSURANCE is deleted in its en- tirety and replaced by the following: (1) The Limits of Insurance shown in Section B. Limits of Insur- ance, 1. Employee Benefit Li- ability Coverage and the rules below fix the most we will pay regardless of the number of. (a) Insureds; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 4 of 15 (b) Claims made or "suits" brought; (c) Persons or organizations making claims or bringing "suits"; (d) Acts, errors or omissions, or (e) Benefits included in your "employee benefit pro- gram". (2) The Aggregate Limit shown in Section B. Limits of Insurance, 1. Employee Benefit Liability Coverage of this endorsement is the most we will pay for all damages because of acts, er- rors or omissions negligently committed in the "administra- tion" of your "employee benefit program". (3) Subject to the limit described in (2) above, the Each Employee Limit shown in Section B. Limits of Insurance, 1. Employee Benefit Liability Coverage of this endorsement is the most we will pay for all damages sus- tained by any one "employee", including damages sustained by such "employee's" dependents and beneficiaries, as a result of: (a) An act, error or omission; or (b) A series of related acts, er- rors or omissions, regard- less of the amount of time that lapses between such d acts, errors or omissions, negligently committed in the "administration" of your "em- ployee benefit program". However, the amount paid un- der this endorsement shall not exceed, and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the "em- ployee benefit program". (4) Deductible Amount (a) Our obligation to pay dam- ages on behalf of the in- sured applies only to the amount of damages in ex- cess of the deductible amount stated in the Decla- rations as applicable to Each Employee. The limits of insurance shall not be reduced by the amount of this deductible. (b) The deductible amount stated in the Declarations applies to all damages sustained by any one "em- ployee", including such "employee's" dependents and beneficiaries, because of all acts, errors or omis- sions to which this insur- ance applies. (c) The terms of this insurance, including those with respect to: 1) Our right and duty to defend the insured against any "suits" seeking those dam- ages; and 2) Your duties, and the duties of any other in- volved insured, in the event of an act, error or omission, or claim, apply irrespective of the application of the deductible amount. (d) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as we have paid. Additional Conditions As respects Employee Benefit Li- ability Coverage, SECTION IV - COMMERCIAL GENERAL LIABIL- ITY CONDITIONS is amended as follows: (1) Item 2. Duties in the Event of Occurrence, Offense, Claim or Suit is deleted in its entirety and replaced by the following: 2. Duties in the Event of an Act, Error or Omission, or Claim or Suit a. You must see to it that we are noti- fied as soon as practicable of an act, error or omission which may result in a claim. To the extent possible, no- tice should include: (1) What the act, error or omission was and when it occurred; and (2) The names and addresses of anyone who may suffer dam- ages as a result of the act, error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 5 of 15 b. If a claim is made or "suit" is brought against any insured, you must: (1) Immediately record the specifics of the claim or "suit" and the date received; and (2) Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. c. You and any other involved insured must: (1) Immediately send us copies of any demands, notices, sum- monses or legal papers re- ceived in connection with the claim or "suit"; (2) Authorize us to obtain records and other information; (3) Cooperate with us in the investi- gation or settlement of the claim or defense against the "suit"; and (4) Assist us, upon our request, in the enforcement of any right against any person or organiza- tion which may be liable to the insured because of an act, error or omission to which this insur- ance may also apply. d. No insured will, except at that in- sured's own cost, voluntarily make a Payment, assume any obligation, or incur any expense without our con- sent. (2) item 5. Other Insurance is de- leted in its entirety and replaced by the following: 5. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is pri- mary except when c. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in b. below. b. Method of Sharing If all of the other insur- ance permits contribu- tion by equal shares, we will follow this method also. Under this approach each in- surer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other in- surance does not per- mit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of in- surance to the total ap- plicable limits of insur- ance of all insurers. c. No Coverage This insurance shall not cover any loss for which the insured is entitled to recovery un- der any other insur- ance in force previous to the effective date of this Coverage Part. e. Additional Definitions As respects Employee Benefit Li- ability Coverage, SECTION V - DEFINITIONS is amended as fol- lows: (1) The following definitions are added: 1. "Administration" means: a. Providing information to "employees", including their dependents and beneficiaries, with re- spect to eligibility for or scope of "employee benefit programs"; b. Interpreting the "em- ployee benefit pro- grams"; c. Handling records in connection with the "employee benefit pro- grams"; or d. Effecting, continuing or terminating any "em- ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 6 of 15 GA 233 02 07 in any benefit included benefits, workers' com- in the "employee bene-pensation and disability fit program". benefits; and However, "administration" d. Vacation plans, includ- does not include: ing buy and sell pro- leave of ab - grams; a. Handling payroll de- sence programs, in- ductions; or cluding military, mater - nity, family, and civil b. The failure to effect or leave; tuition assis- maintain any insurance tante plans; or- or adequate limits of health club talion and heaalth c coverage of insurance, subsidies. including but not limited to unemployment in- (2) The following definitions are surance, social security deleted in their entirety and re - benefits, workers' com- placed by the following: pensation and disability benefits. 21. "Suit" means a civil pro- ceeding in which money 2. "Cafeteria plans" means damages because of an plan authorized by applica- act, error or omission to ble law to allow "employ- which this insurance applies ees" to elect to pay for cer- are alleged. "Suit" includes: tain benefits with pre-tax dollars. a. An arbitration pro- ceeding in which such 3. "Employee benefit pro- damages are claimed grams" means a program and to which the in - providing some or all of the sured must submit or following benefits to "em- does submit with our ployees", whether provided consent, through a "cafeteria plan" or otherwise: b. Any other alternative dispute resolution pro - a. Group life insurance; ceeding in which such group accident or damages are claimed health insurance; den- and to which the In- tal, vision and hearing sured submits with our plans; and flexible consent,, or spending accounts, provided that no one c. An appeal of a civil other than an "em- proceeding. ployee" may subscribe to such benefits and g, "Employee" means a per - son actively employed, for - such benefits are made merly employed, on leave generally available to of absence or disabled, or those "employees" who retired. "Employee" in - satisfy the plan's eligi- cludes a "leased worker". bility requirements; "Employee" does not in - b. Profit sharing plans, clude a "temporary worker". employee savings 2, Unintentional Failure to Disclose Haz- plans, employee stock ards ownership plans, pen- sion plans and stock SECTION IV - COMMERCIAL GENERAL subscription plans, LIABILITY CONDITIONS, 7. Represen- provided that no one tations is hereby amended by the addi- other than an "em- tion of the following: ployee" may subscribe to such benefits and Based on our dependence upon your such benefits are made representations as to existing hazards, if generally available to unintentionally you should fail to disclose all "employees" who all such hazards at the inception date of are eligible under the your policy, we will not reject coverage plan for such benefits; under this Coverage Part based solely on such failure. c. Unemployment insur- ance, social security Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 15 3. Damage to Premises Rented to You e) Settling, cracking, a. The last Subparagraph of Paragraph shrinking or ex - pansion; or 2. SECTION I - COVERAGES, COVERAGE A. - BODILY INJURY f) Nesting or infesta- AND PROPERTY DAMAGE, 2. LI- tion, or discharge ABILITY Exclusions is hereby de- or release of leted and replaced by the following: waste products or Exclusions c. through q. do not apply secretions, by in - sects, birds, ro- to damage by fire, explosion, light- dents or other ning, smoke or soot to premises animals. while rented to you or temporarily occupied by you with permission of (b) Loss caused directly or indi- the owner. rectly by any of the follow - b. The insurance provided under SEC- ing: TION 1 - COVERAGES, COVERAGE 1) Earthquake, volcanic A. BODILY INJURY AND PROP- eruption, landslide or ERTY DAMAGE LIABILITY applies any other earth move - to "property damage" arising out of ment; water damage to premises that are both rented to and occupied by you. 2) Water that backs up or overflows from a (1) As respects Water Damage Le- sewer, drain or sump; gal Liability, as provided in Paragraph 3.b. above: 3) Water under the ground surface press - The exclusions under SECTION ing on, or flowing or I- COVERAGES, COVERAGE seeping through: A. BODILY INJURY AND PROPERTY DAMAGE LIABIL- a) Foundations, ITY, 2. Exclusions, other than I. walls, floors or War and the Nuclear Energy paved surfaces; Liability Exclusion, are deleted b) Basements, and the following are added: whether paved or This insurance does not apply not; or to: c) Doors, windows or (a) "Property damage": other openings, 1) Assumed in any con- (c) Loss caused by or resulting tract, or from water that leaks or flows from plumbing, heat - 2) Loss caused by or re- ing, air conditioning, or fire sulting from any of the protection systems caused following: by or resulting from freez- ing, unless: a) Wear and tear; b) Rust, corrosion, 1) You did your best to maintain heat in the fungus, decay, building or structure; or deterioration, hid- den or latent de- 2) You drained the fect or any quality equipment and shut off in property that the water supply if the causes it to dam- heat was not main - age or destroy it- tained. self; (d) Loss to or damage to: C) Smog; 1) Plumbing, heating, air d) Mechanical conditioning, fire pro - breakdown in- tection systems, or cluding rupture or other equipment or ap- bursting caused pliances; or by centrifugal force; 2) The interior of any building or structure, or to personal property in the building or structure Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 8 of 15 caused by or resulting from rain, snow, sleet or ice, whether driven by wind or not. c. Limit of Insurance The Damage to Premises Rented to You Limit as shown in the Declara- tions is amended as follows: (2) Paragraph 6, of SECTION 111 - LIMITS OF INSURANCE is hereby deleted and replaced by the following: 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, for damages because of "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner, arising out of any one "occurrence" to which this insurance ap- plies. (3) The amount we will pay is lim- ited as described in Section B. Limits of Insurance, 3. Dam- age to Premises Rented to You of this endorsement. 4. Supplementary Payments Under SECTION I - COVERAGE, SUP- PLEMENTARY PAYMENTS - COVER- AGES A AND B: a. Paragraph 2. is replaced by the fol- lowing: Up to the limit shown in Section B. Limits of Insurance, 4.a. Bail Bonds of this endorsement for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies. We do not have to furnish these bonds. b. Paragraph 4. is replaced by the fol- lowing: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to the limit shown in Section B. Limits of Insurance, 4.b. Loss of Earnings of this en- dorsement per day because of time off from work. 5. Medical Payments The Medical Expense Limit of Any One Person as stated in the Declarations is amended to the limit shown in Section B. Limits of Insurance, 5. Medical Pay- ments of this endorsement. 6. Voluntary Property Damage and Care, Custody or Control Liability Coverage a. Voluntary Property Damage Cov- erage We will pay for "property damage" to property of others arising out of op- erations incidental to the insured's business when: (1) Damage is caused by the in- sured; or (2) Damage occurs while in the in- sured's possession. With your consent, we will make these payments regardless of fault. b. Care, Custody or Control Liability Coverage SECTION I - COVERAGES, COW ERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, i. Damage to Property, Subparagraphs (3), (4) and (5) do not apply to "property damage" to the property of others described therein. With respect to the insurance provided by this section of the endorsement, the fol- lowing additional provisions apply: a. The Limits of Insurance shown in the Declarations are replaced by the lim- its designated in Section B. Limits of Insurance, 6. Voluntary Property Damage and Care, Custody or Control Liability Coverage of this endorsement with respect to cover- age provided by this endorsement. These limits are inclusive of and not in addition to the limits being re- placed. The Limits of Insurance shown in Section B. Limits of Insur- ance, 6. Voluntary Property Dam- age and Care, Custody or Control Liability Coverage of this endorse- ment fix the most we will pay in any one "occurrence" regardless of the number of: (1) Insureds; (2) Claims made or "suits" brought; or (3) Persons or organizations mak- ing claims or bringing "suits". Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 9 of 15 7 8. b. Deductible Clause (1) Our obligation to pay damages on your behalf applies only to the amount of damages for each "occurrence" which are in ex- cess of the deductible amount stated in Section B. Limits of Insurance, 6. Voluntary Prop- erty Damage and Care, Cus- tody or Control Liability Cov- erage of this endorsement. The limits of insurance will not be re- duced by the application of such deductible amount. (2) Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit, applies to each claim or "suit" irrespective of the amount. (3) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the ac- tion taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 180 Day Coverage for Newly Formed or Acquired Organizations SECTION II - WHO IS AN INSURED is amended as follows: Subparagraph a. of Paragraph 4. is hereby deleted and replaced by the fol- lowing: a. Insurance under this provision is af- forded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 9. Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following: We waive any right of recovery we may have because of payments we make for injury or damage arising out of your on- going operations or "your work" done un- der a written contract requiring such waiver with that person or organization and included in the "products -completed operations hazard". However, our rights may only be waived prior to the "occur- rence" giving rise to the injury or damage for which we make payment under this Coverage Part. The insured must do nothing after a loss to impair our rights. At our request, the insured will bring "suit' or transfer those rights to us and help us enforce those rights. 9. Automatic Additional Insured - Speci- fied Relationships a. The following is hereby added to SECTION II - WHO IS AN INSURED_ (1) Any person or organization de- scribed in Paragraph 9.a.(2) below (hereinafter referred to as additional insured) whom you are required to add as an addi- tional insured under this Cover- age Part by reason of: (a) A written contract or agreement; or (b) An oral agreement or con- tract where a certificate of insurance showing that per- son or organization as an additional insured has been issued, is an insured, provided: (a) The written or oral contract or agreement is: 1) Currently in effect or becomes effective during the policy pe- riod; and 2) Executed prior to an "occurrence" or offense to which this insurance would apply; and (b) They are not specifically named as an additional in- sured under any other pro- vision of, or endorsement added to, this Coverage Part. (2) Only the following persons or organizations are additional in- sureds under this endorsement, and insurance coverage pro- vided to such additional in- sureds is limited as provided herein: (a) The manager or lessor of a premises leased to you with whom you have agreed per Paragraph 9.a.(1) above to provide insurance, but only with respect to liability aris- ing out of the ownership, maintenance or use of that part of a premises leased to you, subject to the following additional exclusions: This insurance does not apply to: 1) Any "occurrence" which takes place after Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 10 of 15 you cease to be a ten- c) Any physical or ant in that premises. chemical change in the product 2) Structural alterations, made intentionally new construction or by the vendor; demolition operations performed by or on be- d) Repackaging, un - half of such additional less unpacked insured. solely for the pur- pose of inspection, (b) Any person or organization demonstration, from which you lease - testing, or the equipment with whom you substitution of have agreed per Paragraph parts under in - 9.a.(1) above to provide in- structions from the surance, Such person(s) or manufacturer, and organization(s) are insureds then repackaged solely with respect to their in the original liability arising out of the container; maintenance, operation or use by you of equipment e) Any failure to leased to you by such per- make such in- spections, adjust - son(s) or organizations (s). However, this insurance ments, tests or does not apply to any "oc- servicing as the vendor has currence" which takes place after the equipment lease agreed to make or expires. normally under- takes to make in (c) Any person or organization the usual course (referred to below as ven- of business, in dor) with whom you have connection with agreed per Paragraph the distribution or 9.a.(1) above to provide in- sale of the prod- surance, but only with re- ucts; spect to "bodily injury" or "property damage" arising f) Demonstration, in - out of "your products" which stallabon, servic- are distributed or sold in the ing or repair op - orations, except regular course of the ven- dor's business, subject to such operations the following additional ex- performed at the clusions: vendor's premises in connection with 1) The insurance afforded the sale of the the vendor does not product; apply to: g} Products which, a) "Bodily injury" or after distribution or "property damage" sale by you, have for which the ven- been labeled or dor is obligated to relabeled or used pay damages by as a container, reason of the as- part or ingredient sumption of liabil- of any other thing ity in a contract or or substance by or agreement. This for the vendor. exclusion does not apply to liability for 2) This insurance does damages that the not apply to any in - vendor would sured person or or - have in the ab- ganization: sence of the con- a) From whom You tract or agree- have acquired menta such products, or b) Any express war- ranty unauthorized any ingredient, part or container, by you; entering into, ac - Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 11 of 15 GA 233 02 07 companying or 2) This insurance does containing such not apply to "bodily in- products; or jury", "property Jam- b} When liability in- h age" or "personal and advertising injury" aris- cl ed within the ing out of operations "products- performed-for the state completed opera- or political subdivision. tions hazard" has been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1) spect to such above to provide insurance, products. but only with respect to li- (d) Any state or political subdi- ability arising out of "your work" performed for that vision with which you have additional insured by you or agreed per Paragraph on your behalf. A person or 9.a.(1) above to provide in- organization's status as an surance, subject to the fol- insured under this provision lowing additional provision: of this endorsement contin- This insurance applies only ues for only the period of with respect to the following time required by the written hazards for which the state contract or agreement, but or political subdivision has in no event beyond the ex- issued a permit in connec- piration date of this Cover- tion with premises you own, age Part. If there is no written contract or agree- rent or control and to which this insurance applies: pent, or if no period of time is required by the written 1) The existence, mainte- contract or agreement, a nance, repair, con- person or organization's struction, erection, or status as an insured under removal of advertising this endorsement ends signs, awnings, cano- when your operations for pies, cellar entrances, that insured are completed. coal holes, driveways, manholes, marquees, (3) Any insurance provided to an hoist away openings, additional insured designated under Paragraph 9.a.(2): sidewalk vaults, street banners, or decora- (a) Subparagraphs (e) and (f) tions and similar expo- does not apply to "bodily sures; or injury" or "property damage" 2) The construction, erec- included within the "prod- tion, or removal of ele- ucts-completed operations vators; or hazard"; 3) The ownership, main- (b) Subparagraphs (a), (b), (d), or use of any (e) and (f) does not apply to "bodily "property elevators covered by elevat injury", damage" or "personal and this insurance. advertising injury" arising (e) Any state or political subdi- out of the sole negligence vision with which you have or willful misconduct of the agreed per Paragraph additional insured or their 9.a.(1) above to provide in- agents, "employees" or any surance, subject to the fol- other representative of the lowing provisions: additional insured; or 1) This insurance applies (c) Subparagraph (f) does not only with respect to op- apply to "bodily injury", erations performed by "property damage" or "per - you or on your behalf sonal and advertising injury" for which the state or arising out of: political subdivision has 1) Defects in design fur - issued a permit. nished by or on behalf Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 12 of 15 of the additional in- spects any other insurance sured; or policy issued to the addi- tional insured, and such 2) The rendering of, or other insurance policy shall failure to render, any be excess and / or noncon- professional architec- tributing, whichever applies, tural, engineering or with this insurance. surveying services, in- cluding: (b) Any insurance provided by this endorsement shall be a) The preparing, primary to other insurance approving or fail- available to the additional ing to prepare or insured except: approve maps, shop drawings, 1) As otherwise provided opinions, reports, field in SECTION IV - COMMERCIAL GEN- surveys, or- ders, change or- ERAL LIABILITY ders or drawings CONDITIONS, 5. Other and specifications; Insurance, b. Excess and Insurance; or b) Supervisory, in- 2) For any other valid and spection, archi- collectible insurance tectural or engi- available to the addi- neering activities. tional insured as an additional insured by 3) "Your work" for which a attachment of an en - consolidated (wrap-up) dorsement to another insurance program has insurance policy that is been provided by the written on an excess primecontractor-project basis. In such case, manager or owner of the coverage provided the construction project under this endorse - in which you are in- ment shall also be ex - volved. cess. b. Only with regard to insurance pro- (2) Condition 11. Conformance to vided to an additional insured desig- Specific Written Contract or nated under Paragraph 9.a.(2) Sub- Agreement is hereby added: paragraph (f) above, SECTION III - LIMITS OF INSURANCE is amended 11. Conformance to Specific to include: Written Contract or Agreement The limits applicable to the additional insured are those specified in the With respect to additional written contract or agreement or in insureds described in Para - the Declarations of this Coverage graph 9.a.(2)(f) above only: Part, whichever are less. If no limits If a written contract or are specified in the written contract agreement between you or agreement, or if there is no written and the additional insured contract or agreement, the limits ap- specifies that coverage for plicable to the additional insured are the additional insured: those specified in the Declarations of this Coverage Part. The limits of in- a. Be provided by the In- surance are inclusive of and not in surance Services Of - addition to the limits of insurance fice additional insured shown in the Declarations. form number CG 20 10 c. SECTION IV - COMMERCIAL GEN- or CG 20 37 (where edition specified); or ERAL LIABILITY CONDITIONS is hereby amended as follows: b. Include coverage for (1) Condition 5. Other Insurance is completed operations; amended to include: or (a) Where required by a written c. Include coverage for your work"; contract or agreement, this insurance is primary and / and where the limits or cov- or noncontributory as re- erage provided to the addi- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 13 of 15 tonal insured is more re- strictive than was specifi- cally required in that written contract or agreement, the terms of Paragraphs 9.a.(3)(a), 9.a.(3)(b) or 9.b. above, or any combination thereof, shall be interpreted as providing the limits or coverage required by the terms of the written contract or agreement, but only to the extent that such limits or coverage is included within the terms of the Coverage Part to which this endorse- ment is attached. If, how- ever, the written contract or agreement specifies the In- surance Services Office additional insured form number CG 20 10 but does not specify which edition, or specifies an edition that does not exist, Paragraphs 9.a.(3)(a) and 9.a.(3)(b) of this endorsement shall not apply and Paragraph 9.1% of this endorsement shall ap- ply. 10. Broadened Contractual Liability - Work Within 50' of Railroad Property It is hereby agreed that Paragraph f.(1) of Definition 12. "Insured contract" (SEC- TION V - DEFINITIONS) is deleted. 11. Property Damage to Borrowed Equip- ment a. The following is hereby added to Ex- clusion j. Damage to Property of Paragraph 2., Exclusions of SEC- TION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY: Paragraphs (3) and (4) of this exclu- sion do not apply to tools or equip- ment loaned to you, provided they are not being used to perform opera- tions at the time of loss. b. With respect to the insurance pro- vided by this section of the en- dorsement, the following additional provisions apply: (1) The Limits of insurance shown in the Declarations are replaced by the limits designated in Sec- tion B. Limits of Insurance, 11. of this endorsement with respect to coverage provided by this endorsement. These limits are inclusive of and not in addition to the limits being replaced. The Limits of Insurance shown in Section B. Limits of Insurance, 11. of this endorsement fix the most we will pay in any one "oc- currence" regardless of the number of: (a) Insureds,- (b) nsureds;(b) Claims made or "suits" brought; or (c) Persons or organizations making claims or bring "suits". (2) Deductible Clause (a) Our obligation to pay dam- ages on your behalf applies only to the amount of dam- ages for each "occurrence" which are in excess of the Deductible amount stated in Section B. Limits of Insur- ance, 11, of this endorse- ment. The limits of insur- ance will not be reduced by the application of such De- ductible amount. (b) Condition 2. Duties in the Event of Occurrence, Of- fense, Claim or Suit, ap- plies to each claim or "suit" irrespective of the amount. (c) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 12. Employees as Insureds - Specified Health Care Services It is hereby agreed that Paragraph 2.a.(1)(d) of SECTION II - WHO IS AN INSURED, does not apply to your "em- ployees" who provide professional health care services on your behalf as duly li- censed: a. Nurses,- b. urses; b. Emergency Medical Technicians; or c. Paramedics, in the jurisdiction where an "occurrence" or offense to which this insurance applies takes place. 13. Broadened Notice of Occurrence Paragraph a. of Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit (SECTION IV - COMMER- CIAL GENERAL LIABILITY CONDI- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 14 of 15 TIONS) is hereby deleted and replaced by the following: a. You must see to it that we are noti- fied as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1) How, when and where the "oc- currence" or offense took place; (2) The names and addresses of any injured persons and wit- nesses;and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. This requirement applies only when the "occurrence" or offense is known to an "authorized representative". Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 15 of 15 L WISCONSIN SOCIETY OF ARCHITECTS THE AMERICAN INSTITUTE OF ARCHITECTS WIS. AIA DOCUMENT JULY 1980 ED. WIS. A312 PUBLIC IMPROVEMENT PERFORMANCEILABOR AND MATERIAL PAYMENT BOND THIS BOND IS TO BE USED ON PUBLIC IMPROVEMENT CONTRACTS PURSUANT TO SECTION 779.14 WISCONSIN STATUTES. Bond No. HGMW101990380 KNOW ALL MEN BY THESE PRESENTS: that (Here insert name and address or legal title of the Contractor, referred to in Sec. 779.14 Wisconsin Statutes as the prime contractor) STRUCTUREWERKS, INC. 12600 Robin Lane Brookfield WI 53005 as Principal, hereinafter called Principal, and, (Ilere insert the legal tide and address of Surety) HUDSON INSURANCE COMPANY 100 William Street 5th Floor New York NY 10038 duly authorized and licensed to do business in the State of Wisconsin, as Surety, hereinafter called Surety, are held and firmly bound unto (Name and address or legal tide of Owner) CITY OF OSHKOSH 215 Church Avenue Oshkosh WI 54903-1130 as Obligee, hereinafter called Owner, for the use and benefit of claimants as hereinafter provided in the amount of Forty Six Thousand Five Hundred Twenty Two and 00/100Dollan ($ 46,522.00 ), (Here insert a sum at !wt equal to the contract price) for the payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, suc- cessors and assigns, jointly and severally, firmly by these preser%ts. WHEREAS, STRUCTUREWERKS, INC. Principal has by written agreement dated 8/29/2017 , entered into a contract with Owner for City Center Parking Structure 2017 Repairs, City of Oshkosh, WI in accordance with drawings and specifications prepared by (Here insert full acme, title and address) which contract is by reference made a part hereof and is required by Section 779.14, Wisconsin Statutes., The said written agreement, drawings, specifications and amendments are hereinafter referred to as the Contract. PUBLIC IMPROVEMENT PERFORMANCE/LABOR-MATERIAL BOND TWO PAGES WIS. AIA DOC. WIS. A312AUGUST. 1989ED. PAGE I Copr. 1969 Wisconsin Society of Architects/AIA 321 S. Hamilton St. Madison, Wis. 53703 N NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION, as required by Section 779.14, Wisconsin Statutes, is such that, if the' Principal shall faithfully perform the said contract and pay every person entitled thereto for all the claims for labor performed and materials furnished under the Contract, to be used or consumed in making the public improvement or performing the public work as provided in the Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect, subject, however, to the following conditions: 1) No assignment, modification or change of the Contract, or change in the work covered thereby, or any extension of time for the completion of the Con- tract shall release the sureties on the bond. 2) Not later than one year after the completion of work under the Contract, any party in interest may maintain an action in his own name against the Principal and the Surety upon this bond for the recovery of any damages he may have sustained by reason of the failure of the Principal to comply with the Contract or with the Contract between the Prin- cipal and his subcontractors. If the amount realized on this bond is insufficient to satisfy all claims of the parties in full, it shall be distributed among the parties pro rata. Signed and sealed this 7th day of September 2017 IN THE PRESENCE OF: STRUCTUREWERKS INC. /J (Seal) ItneY .�: I/ /CZ` 40' IN THE PRESENCE OF: witne HUDSON INSURANCE COMPANY Name of Swett' BY: e� —`-1'Seal ) c Title: Roxanne L. Jensen Attorney -in -Fact APPROVED BY* HT: Title: Owner (Seal) *This bond shall be approved in the case of the state by the state official authorized to enter into such con- tract, of a county by its district attorney, of a city by its mayor, of a village by its president, of a town by its chairman, of a school district by the director or president and of any other public board or body by the presiding officer thereof. PUBLIC IMPROVEMENT PERFORMANCE/ LABOR -MATERIAL BOND TWO PAGES WIS. AIA DOC. WIS. A312 AUGUST 1989 ED. PAGE 2 f 1• i 1� I HGMW-10-199-0380 IJS0N �t II GUTA, 11X14J=YaY$]-qk a j KNOW ALL MEN BY THESE PRESENTS: That HUDSON INSURANCE COMPANY, a corporation of the State of Delaware, with offices at 100 William Street, New York, New York, 10038, has made, constituted and appointed, and by these presents, does make, constitute and appoint Kelly L. Cody, Roxanne I., ,lensen, Christopher Knowlton Ilovden of the State of Wisconsin its true and lawfiil Atlorncy(s)-in-Pact, at New York, New York, each of them alone to have full power to act without the other or others, to make, execute and deliver on its behalf, as Surety, bonds and undertakings given for any and all purposes, also to execute and deliver on its behalf as aforesaid renewals, extensions, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, that no single bond or undertaking shall obligate said Company for any portion of the penal sum thereof in excess of the sum of Ten Million Dollars ($10,000,000.00). Such bonds and undertakings when duly executed by said Attomey(s)-in-Fact, shall be binding upon said Company as fully and to the same extent as if signed by the President of said Company under its corporate seal attested by its Secretary. In Witness Whereof, HUDSON INSURANCE COMPANY has caused these presents to be of its Senior Vice President thereunto duly authorized, on this 2211d day of June 20 16 at New York, New York. •ur•n• wt°rdi' HUDSON INSURANCE COMPANY S L`; A9... '.� By ...........!.... ...��.. .•.......................... Dina alakis Michael P. Gleeson Corporate Secretary Senior Vice President STATE OF NEW YORK COUNTY OI' NEW YORK. SS. On the 22nd day of June 20 IG belbre me personally came Mijscal, hl P Glceson to me known, who being by me duly sworn did depose and say that he is a Senior Vice President of IIUDSON INSURANCE COMPANY, the cdescribed herein and which executed the above instrument, that he knows the seal of said Corporation, that the seal affixed to said instrument is such corporatit w s so flixed by order of the Board of Directors of said Corporation, and that he signed his name thereto by like order. \\\`��\\11111111 (Notarial Seal) ��Qw ••Q�FES •• M. IN URI IIY .••i��i Notary ubl c, State w York 2p17 • : No. 01MU6067 aS : O .� 2 �tGS- Qualified m assau unty Commission ' es December 10, 2017 •mom P43, •`'� CERTIFICATION STATE OF NEW YORK COUNTY OF NEW YORK////�& �;II1p;�P; \xx`\\\` The undersigned Dina Daskalakis hereby certifies: That the original resolution, of which the following is a true and correct copy, was duly adopted by unanimous written consent of the Board of Directors of Hudson Insurance Company dated July 27", 2007, and has not since been revoked, amended or modified: "RESOLVED, that the President, the Executive Vice Presidents. the Senior Vice Presidents and the Vice Presidents shall have the authority and discretion, to appoint such agent or agents, or attorney or attorneys -in -fact, for the purpose of carrying on this Company's surety business, and to empower such agent or agents, or attorney or attonncys-in-fact, to execute and deliver, under this Company's seal or otherwise, bonds obligations, and recognizances, whether made by this Company as surety thereon or otherwise, indemnity contracts, contracts and certificates, and any and all other contracts and undertakings made in the course of this Company's surety business, and renewals, extensions, agreements, waivers, consents or stipulations regarding undertakings so made; and FURTHER RESOVLED, that the signature of any such Officer of the Company and the Company's seal may be affixed by facsimile to any power of attomey or certification given for the execution of any bond, undertaking, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, such signature and seal when so used whether heretofore or hereafter, being hereby adopted by the Company as the original signature oi'such otTicer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed." THAT the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and of the whole of the original and that the said Power of Attorney is still in full force and effect and has not been revoked, and furthermore that the Resolution of the Board of Directors, set forth in the said Power of Attorney is now in force. ss the hand of the undersigned and the seal of said Corporation this _ day ol•_ Q.(20�. •• �bt:►CN�r cod r ghew� Bv... ................ Zj.............. Dina Daskalakis, Corporate Secretary Form PerfA 10 8 2010 (v2) WISCONSIN SOCIETY OF ARCHITECTS THE AMERICAN INSTITUTE OF ARCHITECTS WIS. AIA DOCUMENT JULY 19W ED. WIS. A312 PUBLIC IMPROVEMENT PERFORMANCEILABOR AND MATERIAL PAYMENT BOND THIS BOND IS TO BE USED ON PUBLIC IMPROVEMENT CONTRACTS PURSUANT TO SECTION 779.14 WISCONSIN STATUTES. Bond No. HGMW101990380 KNOW ALL MEN BY THESE PRESENTS: that (Here insert name and address or legal title of the Contractor, referred to in Sec. 779.14 Wisconsin Statutes as the prime contractor) STRUCTUREWERKS, INC. 12600 Robin Lane Brookfield WI 53005 as Principal, hereinafter called Principal, and, (Here insert the legal title and address of Surety) HUDSON INSURANCE COMPANY 100 William Street 5th Floor New York NY 10038 duly authorized and licensed to do business in the State of Wisconsin, as Surety, hereinafter called Surety, are held and firmly bound unto (Name and address or legal title of Owner) CITY OF OSHKOSH 215 Church Avenue Oshkosh WI 54903-1130 as Obligee, hereinafter called Owner, for the use and benefit of claimants as hereinafter provided in the amount of Forty Six Thousand Five Hundred Twenty Two and 00/100Dollar8 ($ 46,522.00 ), (Here insert a sum at least equal to the contract price) for the payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, suc- cessors and assigns, jointly and severally, firmly by these presents. WHEREAS, STRUCTUREWERKS, INC. Principal has by written agreement dated 8/29/2017 entered into a contract with Owner for City Center Parking Structure 2017 Repairs, City of Oshkosh, WI in accordance with drawings and specifications prepared by (Here insert full name, title and address) which contract is by reference made a part hereof and is required by Section 779.14, Wisconsin Statutes, The said written agreement, drawings, specifications and amendments are hereinafter referred to as the Contract. PUBLIC IMPROVEMENT G PERFORMANCE/LABOR-MATERIAL BOND TWO PAGES WIS. AIA DOC. WIS. A312AUGUST. 1989ED. PAGE 1 m - IV Copr. 1969 Wisconsin Society of Architects/AIA 321 S. Hamilton St. Madison, Wis. 53703 NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION, as required by Section 779.14, Wisconsin Statutes, is such that, if the' Principal shall faithfully perform the said contract and pay every person entitled thereto for all the claims for labor performed and materials furnished under the Contract, to be used or consumed in making the public improvement or performing the public work as provided in the Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect, subject, however, to the following conditions: 1) No assignment, modification or change of the Contract, or change in the work covered thereby, or any extension of time for the completion of the Con- tract shall release the sureties on the bond. 2) Not later than one year after the completion of work under the Contract, any party in interest may maintain an action in his own name against the Signed and sealed this IN THE PRESENCE OF: wiuwm IN THE PRESENCE OF: witnea 7th Principal and the Surety upon this bond for the recovery of any damages he may have sustained by reason of the failure of the Principal to comply with the Contract or with the Contract between the Prin- cipal and his subcontractors. If the amount realized on this bond is insufficient to satisfy all claims of the parties in full, it shall be distributed among the parties pro rata. day of September ) 2017 STRUCTUREWERKS, INC. Principal Off+ HUDSON INSURANCE COMPANY Name of Surety (Seal) By: Qf y— �—e_ (seal) Tide: Roxanne L. Jensen Attorney -in -Fact APPROVED BY* B7: Title: Owner (Seal) *This bond shall be approved in the case of the state by the state official authorized to enter into such con- tract, of a county by its district attorney, of a city by its mayor, of a village by its president, of a town by its chairman, of a school district by the director or president and of any other public board or body by the presiding officer thereof. PUBLIC IMPROVEMENT PERFORMANCE/LABOR-MATERIAL BOND TWO PAGES WIS. AIA DOC. WIS. A312 AUGUST 1989 ED. PAGE 2 HGMW-10-199-0380 DSON POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That HUDSON INSURANCE COMPANY, a corporation of the State of Delaware, with offices at 100 William Street, New York, New York, 10038, has made, constituted and appointed, and by these presents, does make, constitute and appoint Kelly L. Cody, Roxanne L. Jensen, Christopher Knowlton Ilovden of the State of Wisconsin its true and lawful Attorney(s)-fn-Fact, at New York, New York, each of them alone to have full power to act without the other or others, to make, execute and deliver on its behalf, as Surety, bonds and undertakings given for any and all purposes, also to execute and deliver on its behalf as aforesaid renewals, extensions, agreements, waivers, consents or stipulations relating to such bonds or undertakings provided, however, that no single bond or undertaking shall obligate said Company for any portion of the penal sum thereof in excess of the sunt of Ten Million Dollars ($10,000,000.00). Such bonds and undertakings when duty executed by said Attorney(s)-in-Fact, shall be binding upon said Company as fully and to the same extent as if signed by the President of said Company under its corporate seal attested by its Secretary. in Witness Whereof, HUDSON INSURANCE COMPANY has caused these presents to be of its Senior Vice President thereunto duly authorized, on this 22nd day of June 20 16 at New York, New York. o�,rra°p' HUDSON INSURANCE COMPANY '� ' A :: A <:i: � .Lr (<C BY .:z • ... . `n`: _............................. Dina alakis Michael P. Gleeson Corporate Secretary Senior Vice President STATE OF NEW YORK COUNTY OFNEW YORK. SS. On the 22nd day of June -.20 16 before me personally came Michael P Glecson to me known, who being by me duly sworn did depose and say that he is a Senior Vice President of HUDSON INSURANCE COMPANY, the corponti described herein and which executed the above instrument, that he knuws the seal of said Corporation, that the seal affixed to said instrument is such corporate seal, t t it w s so ff ixed by order of the Board of Directors of said Corporation, and that he signed his name thereto by like order, \\\\\111111111tfI/1/j�� (Notarial Seal) ��y •.• ...... Ei'•j Notary ry Publ cState w York aQ; ��?017 I �i No. 01 MUGOG7 �• �� , Z Qualified in assau unty �;�� •�' Commission ' es December 10. 2017 �� • mud° :p� CERTIFICATION STATE OF NEW \\ COUNTY OF NEW YORK ////*S. t „P`1\x'��'�\ oil The undersigned Dina Daskalakis hereby certifies: That the original resolution, of which the fallowing is a true and correct copy, was duly adopted by unanimous written consent of the Board of Directors of I Judson Insurance Company dated July 27th, 2007, and has not since been revoked, amended or modified: "RESOLVE[), that the President, the pxccutivc Vice Presidents, the Senior Vice Presidents and the Vice Presidents shall have the authority and discretion, to appoint such agent or agents, or attorney or attorneys -in -fact, for the purpose of carrying on this Company's surely business, and to empower such agent or agents, or attorney or ationtcys-in-fact, to execute and deliver, under this Company's seal or otherwise, bonds obligations, and recognizances, whether made by this Company as surety thereon or otherwise, indemnity contracts, contracts and certificates, and any and all other contracts and undertakings made in the course of this Company's surety business, and renewals, extensions, agreements, waivers, consents or stipulations regarding undertakings so made; and FURTI IER RF.SOVLED, that the signature of any such Officer of the Company and the Company's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond, undertaking, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, such signature and seal when so used whether heretofore or hereafter, being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed." THAT the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and of the whole of the original and that the said Power of Attorney is still in full force and effect and has not been revoked, and furthermore that the Resolution of the Board of Directors, set forth in the said Powcr of Attorney is now in force y l 20 )7. ss the hand of the undersigned and the seal of said C'ororatiopn this �I oda o_ JL._ ep•4b�,�Oq� A oft / , (Co 11 ) o r; 918 gRtw'fi' Dina Daskalakis, Corporate Secretary Form PerfA 10 8 2010 (v3) ` I Document A31 0 TM -2010 CONTRACTOR: (.Name, legal status and address) STRUCTUREWERKS, INC. 12600 Robin Lane Brookfield, WI 53005 OWNER: (?ame, legal status and address) CITY OF OSHKOSH SURETY: (Name, legal status and principal place of business) HUDSON INSURANCE COMPANY 100 William Street 5th Floor New York, NY 10038 This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. 215 Church Avenue, Oshkosh, WI 54903-1130 Any singular reference to Contractor, Surety, Owner or BOND AMOUNT: Five percent of amount bid. other party shall be considered (5% of Amount Bid) plural where applicable. PROJECT: (Name, location or address, and Project number, if any) City Center Parking Structure Repairs 2017, City of Oshkosh, Wisconsin. Project Number, if any: The Contractor and Surety are bound to the Owner in the amount set forth above, for the payment of which the Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, as provided herein. The conditions of this Bond are such that if the Owner accepts the bid of the Contractor within the time specified in the bid documents, or within such time period as may be agreed to by the Owner and Contractor, and the Contractor either (1) enters into a contract with the Owner in accordance with the terms of such bid, and gives such bond or bonds as may be specified in the bidding or Contract Documents, with a surety admitted in the jurisdiction of the Project and otherwise acceptable to the Owner, for the faithful performance of such Contract and for the prompt payment of labor and material furnished in the prosecution thereof., or (2) pays to the Owner the difference, not to exceed the amount of this Bond, between the amount specified in said bid and such larger amount for which the Owner may in good faith contract with another party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full force and effect. The Surety hereby waives any notice of an agreement between the Owner and Contractor to extend the time in which the Owner may accept the bid. Waiver of notice by the Surety shall not apply to any extension exceeding sixty (60) days in the aggregate beyond the time for acceptance of bids specified in the bid documents, and the Owner and Contractor shall obtain the Surety's consent for an extension beyond sixty (60) days. If this Bond is issued in connection with a subcontractor's bid to a Contractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the tern Owner shall be deemed to be Contractor. When this Bond has been furnished to comply with a statutory or other legal requirement in the location of the Project, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. Signed and seal 10th day of August, 2017 STRUCTUREWERKS, INC. (Print' — (Seal) ('Title) ArL-$A 0.4 — HUDSON INSURANCE COMPANY (Surety) ,` (Seal) (Witness) (Title) i Kelly . Cody, Attorney in Fact AIA Document A310'" — 2010. Copyright O 1963, 1970 and 2010 by The American Institute of Architects. All rights reserved. HUDSON .r. BID BOND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That HUDSON INSURANCE COMPANY, a corporation of the State of Delaware, with offices at 100 William Street, New York, New York, 10038, has made, constituted and appointed, and by these presents, does make, constitute and appoint Kelly L. Cody, Roxanne L. Jensen, Christopher Knowlton Hovden of the State of Wisconsin its true and lawful Attorney(s)-in-Fact, at New York City in the State of New York, each of them alone to have full power to act without the other or others, to make, execute and deliver on its behalf, as Surety, bid bonds for any and all purposes. Such bid bonds, when duly executed by said Attomey(s)-in-Fact, shall be binding upon said Company as fully and to the same extent as if signed by the President of said Company under its corporate seal attested by its Secretary. In Witness Whereof, HUDSON INSURANCE COMPANY has caused these presents to be of its Senior Vice President thereunto duly on this 22nd day of June , 20 16 at New York, New York. a 1 HUDSON INSURANCE COMPANY _. 1918 • esl:':. . . ........��".. �.... y .... ...... ........... .................................... Dina a kalakis, Corporate Secretary Michael P. Gleeson, Senior Vice President STATE OF NEW YORK COUNTY OF NEW YORK SS. On the 22nd day of June 20 16 before me personally came Michael P. Gleeson to me known, who being by me duly sworn did depose and say that he is a Senior Vice President of HUDSON INSURANCE COMPANY, the Co any described herein and which executed the above instrument, that he knows the seal of said Company, that the seal affixed to said instrument is the corporate seal I f s.iCompany, that it was so affixed by order of the Board of Directors of said Company, and that he signed his name thereto by like order. Q (Notarial Seal) STATE OF NEW YORI COUNTY OF NEW YO The undersig ;s: ....... 113W—P .,.. ,,,..................................... ANN M. MURP Notary Public, S1 to of Ne York No. 01 MU6067 - Qualified in Nassau County Commission Expires December 10, 2017 CERTIFICATION THAT the original resolution, of which the following is a true and correct copy, was duly adopted by unanimous written consent of the Board of Directors of Hudson Insurance Company dated July 27, 2007, and has not since been revoked, amended or modified: "RESOLVED, that the President, the Executive Vice Presidents, the Senior Vice Presidents and the Vice Presidents shall have the authority and discretion, to appoint such agent or agents, or attorney or attomcys-in-fact, for the purpose of carrying on this Company's surety business, and to empower such agent or agents, or attorney or attorneys -in -fact, to execute and deliver, tinder this Company's seal or otherwise, bonds obligations, and recognizances, whether made by this Company as surety thereon or otherwise, indemnity contracts, contracts and certificates, and any and all other contracts and undertaking made in the course of this Company's surety business, and renewals, extensions, agreements, waivers, consents or stipulations regarding undertakings so made; and FURTHER RESOVLED, that the signature of any such Officer of the Company and the Company's seal may be affixed by facsimile to any power of attorney or certification given for the execution of any bond, undertaking, recognizance, contract of indemnity or other written obligation in the nature thereof or related thereto, such signature and seal when so used whether heretofore or hereafter, being hereby adopted by the Company as the original signature of such officer and the original seal of the Company, to be valid and binding upon the Company with the same force and effect as though manually affixed." THAT the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and of the whole of the original and that the said Power of Attorney is still in full force and effect and has not been revoked, and furthermore that the Resolution of the Board of Directors, set forth in the said Power of Attorney is now in force. �� aurae / 7 p $ ° the hand of the undersigned and the seal of said Company this day of 20 /�• o� 1�8 By... /. ..........I ' Dina skalakis, Corporate Secretary/ Form Bid 8 2010 (v2)