HomeMy WebLinkAboutResolution - 2008-R0042 - Agreement - HVJ Associates Inc.- Pavement Evaluation System Engineering Services - 01_24_2008Resolution No. 2008-R0042
January 24, 2008
Item No. 4.24
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock BE and is hereby authorized and
directed to execute for and on behalf of the City of Lubbock an Agreement for
Engineering Services for a pavement evaluation system to be entered into by and between
said City and HVJ Associates, Inc. attached hereto and incorporated in this Resolution as
if fully set forth herein and shall be included in the minutes of the Council
Passed by the City Council this 24th day of January 12008.
DAVID A. MILLER, MAYOR
ATTEST:
City Secretary
APP QED AS TO CONTENT:
r r
K in Lair, trees Superintendent
7zlo-=
RM:
had Weaver, Assistant City Attorney
vw; City Att/Chad/REs-HVJ Associates Inc.
1/16/08
Resolution No. 2008—R0042
CONTRACT FOR ENGINEERING SERVICES FOR
PAVEMENT EVALUATION SYSTEM
AGREEMENT BETWEEN
CITY OF LUBBOCK, TEXAS AND HNJ ASSOCIATES, INC.
HvJ Associates, Inc. (" Subcontractor') hereby agrees to provide engineering services for a pavement evaluation system to the City of
Lubbock, Texas ('Client'} in accordance with the terms and conditions of this Agreement and the RFQ. The project scope and schedule
(Attachment A) and fees (Attachment B) for Subcontractor's services have been negotiated and are attached. No work shall be considered
authorized nor shall occur until both parties have signed this contract document.
Client shall compensate the Subcontractor for the services described in Attachment A with a not to exceed amount of $310,252. Invoices
for services performed shall be rendered monthly and shall itemize expenditures by Work Task and shall indicate the cumulative billings.
Payment to the Subcontractor by Client for services rendered will be made after receipt of an itemized invoice supported by appropriate
data and backup information and within 30 days after Client receipt of invoice. Subcontractor shall discharge at once all liens or
attachments which are tiled in connection with this Agreement, and shall indemnify and hold harmless Client, Clients' Clients, and the
owners of the premises on which the services are performed from any costs resulting from such liens or attachments.
This Agreement may be terminated by either party upon seven (7) days written notice to the other, and in the event of such termination,
the Subcontractor shall be paid only the compensation for services performed and expenses incurred to the date of termination.
Subcontractor will maintain Commercial General Liability, Automotive Inability, Workers Compensation and Employers' Liability, and
Professional Liability insurance to protect both Subcontractor and the Client. Subcontractor shall provide certification of insurance stating
the limits of such insurance for approval by Client within ten (10) days after execution of this agreement. Client will be named as additional
insureds with respect to the insurance coverages discussed except Workers Compensation and Professional Liability. The Subcontractor
hereby releases, discharges and shall fully indemnify and hold harmless the Client from and against any and all liabilities, expenses and costs
(including attorney's fees) incurred in connection with any claim against the Client and/or Subcontractor by action in court or otherwise, by
reason of any negligent act on or in connection with the work.
It is understood and agreed that Subcontractor is not an agent or employee of the Client but instead is an independent Subcontractor with
full control over all methods, manner and details of work undertaken by the Subcontractor. Subcontractor shall place priority on health
and safety and shall maintain a safe working environment during performance of services under this Contract. Subcontractor assumes all
risk of loss, loss of use, or damage to equipment and tools provided by Subcontractor used in performing services under this Contract.
All information obtained by Subcontractor in connection with this Contract shall be strictly confidential. Subcontractor agrees not to
disclose such information to any party, unless required by law.
Subcontractor binds himself, his partners, successors, assigns and legal representatives to the Client with respect to all covenants of this
Contract. Subcontractor may assign, sublet, or transfer his interest in the Contract with the written consent of the Client; however, no such
assignment, subletting or transfer shall relieve Subcontractor from the duty and responsibility for the performance of the covenants and
obligations granted in this Contract.
This Contract represents the entire agreement between the Client and the Subcontractor and may be amended only by a written instrument
signed by both parties. A waiver by either party of any breach of this agreement will not be binding unless prepared in writing, and any
such waiver will not affect rights regarding other breaches. If any part of this Contract is held invalid or unenforceable, the other
provisions will continue to be valid and binding. This Contract shall be governed by the laws of the State of Texas.
IN WITNESS' WHEREOF, the }p'artier hereto have caused this Contract to be executed the day and year first below written.
Executed in triplicate. Effective the 2`+eb day of January , 2008.
CITY OF LUBB CONTRACTOR — HVJ ASSOCIA S, INC.
00$��
David A. Miller, A av,r Authorized epresentative, Bobby Atteb
4201 Freidrich bane, Suite 110
A"ITEST: q Address
j Austin, TX 78744-1045
rheeea Can. City Sccrctan•
I _
APPR AS TO F RM: APP AS TO 'ONTENT:
C
W'
Chad Weaver, Assistant City Attorney Kevin [stir
Street Superintendent
G:\AUSTIN\CIVIL\Propusais\2007\AP-117-19960 City of Lubbock IMMP\Contract.DOC
Resolution No. 2008—R0042
ATTACHMENT A WORKPLAN AND SCHEDULE
Proposed Methods
The Infrastructure Maintenance Management Program (IMMP) system has been developed
and implemented for local governments by HVJ Associates, Inc. Recently in 2007 a work
order system module was added to allow tracking of street maintenance work tasks and
accounting for materials, labor and equipment expenditures. The primary focus of the
IMMP software is the Network Level development of pavement Maintenance, Rehabilitation
and Reconstruction (MR&R) plans for both Capital Improvement Programs (CIP) and
Street Maintenance Programs (SMP). The system is based a visual condition survey rating
procedures which are supported by a pavement condition survey manual with standard
definitions and a Pavement Rating Application (PRA). City staff will be trained in the use of
all these tools.
The primary focus of the software is at the Network Level and the software includes, MR&R
Plan Development, Logging of MR&R Work Accomplished, and a Mapping Module. The
system will:
• Process condition data collected by windshield pavement condition surveys,
• Calculate a Pavement Condition Rating (PCR) condition score for every street,
• Predict MR&R needs to select candidate projects using the survey data,
• Calculate network priority rankings based on a benefit/cost model,
• Generate multi -year MR&R plans,
• Predict the future performance of each pavement section,
• Generate summary and detailed reports and presentation graphs,
• Display database attributes in ArcView to create, view, and query the pavement
management data in a GIS environment,
• Include a Work Order Management System, and
• Include inventory ratings for other assets such as sidewalks, street drainage and
pavement markings.
Based on discussions with City of Lubbock staff and HVJ's current knowledge, the
proposed IMMP system is compatible with and can use the following City of Lubbock
requirements:
• Windows Server Environment
• GIS data from Geomedia
• Relational database technology
• Caches data from remote entry
A-i
Work Plan
The project work plan for completing the Pavement Evaluation System to meet the desired
goals of The City of Lubbock pavement evaluation and management program is described in
Ns section.
Project Objectives
A complete Pavement Evaluation System will be implemented based on a windshield
condition survey of all City streets. The objectives of this project are to provide the
following pavement evaluation services:
1. Update the City's Street Inventory database,
2. Conduct Pavement Visual Condition Surveys on all City accepted streets, including
unpaved gravel streets,
3. Produce final deliverables in the required format including cost estimates and street
analysis documents using the prescribed IMMP software, and
4. Provide training in the use of the IMMP and associated software tools and in the
collection of pavement condition surveys.
The following tasks have been developed based on the original RFQ, HVJ experience and
meetings held with City of Lubbock staff on Monday January 7`s, 2008
Task 1 Project Planning and Coordination
mid
The objective of this task is to finalize the field data collection methods, plans, and schedules
to be used for collecting pavement condition surveys. Another objective is to collect existing
City data.
Work Plan
A meeting with the City staff will be held to plan field data collection activities. The content
and layout of PRA data collection screens will be discussed. City of Lubbock will provide
HVJ existing historical street network databases and GIS shapefiles, so that a final list of
streets (inventory) can be updated and prepared for the field work. The database shall
include street name, from street, to street, length, width, additional area, and functional class
for each street segment. HVJ will develop an initial street inventory database, based on the
City provided GIS information and street listings.
HVJ will also review current MR&R practices used by the City and collect recent
construction unit price data provided by City staff. HVJ and City staff will also discuss the
timing (at what PCR score each MR&R action is triggered) and effectiveness (resulting PCR
score after MR&R action) of each treatment
A-2
Deliverables
Tbis task will result in a list of streets to be surveyed to be used in Task 3 for the field data
collection. Field data collection items and protocols will be finalized. HVJ will develop an
electronic survey form for the collection of street data during the survey process. The screen
captures below show the Pavement Rating Application (PRA) developed by HVJ for the
collection of street pavement data.
Task 2 Develop Computerized Street Inventory
The objective of this task will be to develop and deploy data collection software for use on
laptop computers for use in gathering field data. In addition, the application will be capable
of transferring the collected field survey data into the IMMP database on a computer server.
The PRA application will also be capable of receiving section information from the IMMP
database in Microsoft Access database file format.
HVJ will develop a computerized street inventory and condition data collection software for
all data items listed for collection in the RFQ. The data collection software will be developed
in a Microsoft Operating System environment based on Microsoft Access database
technology.
HVJ will design and develop all necessary software, including installation routines, for the
completion of this task. The software will be tested by HV3 staff prior to deployment.
Exhibits A and 8 show screen captures from the Pavement Rating Application (PRA).
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Deliverables
All survey data will be provided to the City of Lubbock in a Microsoft Access database.
Task 3 Dr& Software to City GIS System
The objective of this Task will be completed as early in the project as practical. The
development of the data collection plans in Tasks 1 and 2 and the actual field data collection
in Task 4 will require the development of this link since it aids the survey efficiency greatly
to have this link established prior to the surveys. In this manner the field crews will have
good and complete maps for organizing and conducting the surveys.
Wh& Plan
HVJ will provide a software system that can be linked to the City's Geographical
Information System (GIS). It is understood that the City of Lubbock Geomedia software
can export an Arcview format shape file which HVJ can use. A unique Segment_ID value
will allow the linking of the IMMP SQL database. This will allow the user to see S key
attributes graphically for each segment; 1) Pavement Condition Rating, 2) Pavement Surface
Type, 3) Street Functional Class, 4) Recommended Rehabilitation Treatment, and 5) Priority
Score. This task specifically will develop a relationship between the pavement management
system street segment ID and the GIS Segment_11) values.
T) liverablPs
This task will develop and deliver a table which links IMMP segment Ms to the City
prepared Segment ID data for each street segment. This will allow various attributes
calculated by the IMMP program and available in the UVM P database to be displayed in
graphical form.
A-4
Task 4 Collect Field Pavement Condition Survey Data
Obe1 iectives
The objective of this task is to conduct visual condition surveys of the total paved and
unpaved City street network using the IMMP methodology, inventory developed in Task 2,
and GIS Link developed in Task 3, using the PRA application.
W_"A Plan
HV) will conduct a "windshield" visual pavement condition survey which collects pavement
distress data. Based on available GIS data and discussions with City staff, we are assuming a
total of 1100 centerline miles of streets. These streets are primarily asphalt concrete, but the
system will also allow for collection of PCC, Gravel, and Brick streets as reviewed during a
recent visit to the City.
Distress data will be collected as part of a visual condition survey and will be gathered by
trained technicians. A Pavement Condition Rating (PCR) value ranging from 0 to 100 will
based on the distress deduct values associated with the severity and extent ratings for each
type of pavement distress.
First Arterial and Collector streets (approximately 444 centerline miles or 1150 lane miles)
will be surveyed. For Arterial and Collector streets both directions will be rated separately.
Thus the total of miles to survey is approximately 888 centerline miles or 2300 lane miles for
Arterial and Collector streets.
Second currently maintained local streets (approximately 656 centerline miles or 1700 lane
miles) will be surveyed. Both directions will be rated at the same time. An additional 50
centerline miles of local is also included for any additional streets, which are annexed during
the coming year.
Flexible Pavement Distress (Asphalt Streets) shall include alligator cracking, joint reflection
cracking, longitudinal and transverse cracking, patching, potholes, rutting, shoving, swell,
weathering, base failures, and raveling.
Rigid Pavement Distress (Concrete Streets) shall include buckling, linear cracking, joint
damage, patching, spalling (corner and joint), joint seal damage, scaling, and comer breaks.
Brick Street distresses shall include buckling, rutting, bumps, sags, patching, pop -outs,
scaling, corrugation, and faulting. All work will be supervised by a Professional Engineer
licensed in the State of Texas as required.
Drd verab a
Electronic files as prescribed in the RFQ and to the format needed by City and hard copy
outputs of reports on street pavement condition levels will be prepared and also available
electronically in the GIS mapping such as shown in Exhibit C.
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Exhibit C. Color Coded Street Repair Recommendations
Task 5 Collect Historical Data
Obiecdves
The purpose of this task will be to collect historical data on MR&R strategies, costs, and
effectiveness to be able to develop an estimate of the value of each City street segment and
its needs
Work Plan
Define the types of street maintenance treatments and unit costs based on City historical
records and experience. Collect existing traffic data records. The City will provide the street
repair budgets and unit costs for treatments based on recent City and/or TxDOT bid
tabulation records.
Using City supplied unit cost rates for reconstruction and overlay activities, HVJ will develop
network level inputs for the IMMP Pavement Investment Module (PIA).
Other historical data related to traffic levels, neighborhoods, and street functional
classification will also be collected to allow IMMP outputs to be summarized by political,
functional classification, and pavement surface.
Del_iyerablec
Input information will be summarized and developed for input into the IMMP system for
analysis in Task 6. An estimate of pavement NfR&R costs is needed for all sections and
projects. Arterial and Collector street segments are groups into linear projects (one half mile
in length) and Local street segments are grouped into "area" projects based on
neighborhoods. This information will be a part of the final report of this study.
A-6
Task 6 Produce Network Level Analysis
Objectives
This objective of this task is to execute the IMMP software to generate a 10 year plan for
MR&R work on City streets. It is planned to be accomplished in two parts. First solutions
will be run and an interim report prepared for Arterial and Collector streets (approximately
444 centerline miles or 1150 lane miles), since these streets are to be surveyed first. Second
IMMP solutions will be run and reports generated for Local streets (approximately 656
centerline miles or 1700 lane miles) which will take longer to survey. The planned solutions
will be both constrained based on the projected City budgets provided by the City and
unconstrained to estimate total current needs.
Work Plan
HVJ will collect all data and develop the inputs for the IMMP software. The system will be
executed in a constrained mode based on City Budgets. Street Maintenance and Capital
Improvement Program budgets can be separately provided. The work can be grouped by
neighborhood or maintenance subdivision to make the resulting work plans for effective and
efficient from a construction standpoint. Once a draft of the analysis has been prepared it
will be reviewed with City staff. Corrections will be made an a final solution generated using
the software. A formal presentation of these results will be presented to elected officials in a
working meeting.
An interim and final report will be prepared and delivered.
Task 7Implement Work Order Management System
O 'ect7ves
The purpose of this task will be to deliver the Work Order Module software including
documentation based on City of Lubbock requirements and user input/output requirements.
HVJ will deliver a final Work Order Management System. This will be based on a review of
the current Work Order System and a goal to reduce paper work. The system shall be
tailored to fit City of Lubbock Labor Categories and Staff, Equipment Types, and Materials
Types and the cost of each component as well as the total cost for various crews.
A Work Order Management System Module will be prepared and delivered.
Task 8 Alley Ra dings
ohirttv c
The objective of this task is to conduct visual condition surveys of all City maintained alleys
using the IMMP methodology, inventory developed in Task 2, and GIS Link developed in
Task 3, using the PRA application.
A-7
Work Plan
HVJ will conduct a "windshield" visual pavement condition survey which collects alley
surfacing conditions. Some alleys have pavements but many are gravel or earth.
Distress data will be collected as part of a visual condition survey and will be gathered by
trained technicians. City staff will also be trained. A Pavement Condition Rating (PCR) value
ranging from 0 to 100 will based on the distress deduct values associated with the severity
and extent ratings for each type of pavement distress.
The City has an estimated 700 centerline miles of alleys which are City maintained. The
estimate is based on this mileage. A unique Segment ID will also be assigned to these alleys,
so that they can he analyzed separately.
Electronic files as prescribed in the RFQ and to the format needed by City and hard copy
outputs of reports on alley surfacing conditions will be prepared and also available
electronically in the GIS mapping such as shown in Exhibit C.
Task 9 Deliver Database and Software with Documentation and Provide Training
MkCd=
The purpose of this task will be to deliver all final software packages, supporting
documentation, and a final report presenting the results of the analyses prepared in Task 6.
Work Plan
HVJ will deliver a final IMMP database and analysis software with complete documentation.
HVJ will provide two full days of training for City staff on use of the analysis software and
field data collection software. Software should include any tools used to collect and upload
condition surveys, pavement management client application to also include Pavement
Investment Module (PIK a multiyear budget module, Pavement Rating Application (PRA)
for field data collection, and a street maintenance Work Order Management (WOK system
that integrated into the pavement management system and the pavement management
database loaded with all the first year network data. The main database will be loaded on a
City designated server and a software install will provided for installation on multiple City
computers. The HVJ license allows the City to place the software on as many workstations
as required and the workstations access the applications using TCP/IP protocol, so any
management applications can easily be introduced to the City network. The City is provided
the source code for the software.
All software will be installed and documentation will be delivered. This will include a final
report which will be prepared documenting the results of the Task 6 reports. All documents
will be delivered with one hard copy and electronically on a compact disk (CD). The planned
documentation will include a final report and three user's manuals which together form an
Instructor's Manual:
1. Final Report on Lubbock Conditions and Network Recommendations
2, IMMP Users Manual including section of Pavement Investment Module (PIM) use
3. Condition Survey Manual including instructions for Pavement Rating Application
(PRA) use
4. Work Order Management System Users Manual
A-8
Based on the information collected and analyzed, HVJ will predict roadway maintenance,
rehabilitation and reconstruction (MR&R) needs for all sections in the network on a block
by block basis. The analyses described here will recommend the required maintenance and
rehabilitation treatments, and provide an estimate of the cost for the activities.
HVJ will also provide training on the field data survey and rating collection procedures,
engineering methods, and system analyses that can be performed with the IMMP software.
This comprehensive training will include discussions of the engineering parameters selected
on the project and how these may be modified or enhanced in the future to meet changing
conditions. Training will also involve discussions regarding the results presented by HVJ in
the final report. Training will include the basis upon which the engineering
recommendations were made and how the IMMP software predicts street maintenance and
rehabilitation priorities. Training will consist of:
1. '/z-day classroom executive overview for all City staff involved
2. '/z-day classroom computer analysis for engineers/managers
3. 1/2-day classroom session for data collection personnel
4. '/z-day field session for data collection personnel
S. 1-day classroom session for the Work Order System
Data collection training should be scheduled to correspond with the beginning of the data
collection activities.
Planned Work Schedule
A proposed project time schedule is shown on the following page. The task durations can
be discussed at the kick-off meeting and modified as needed to meet City of Lubbock goals.
A-9
PROPOSED TIME SCHEDULE FOR DEVELOPMENT OF PAVEMENT EVALUATION SYSTEM
ID
Task Name Duration
_
__ M1 M2 M3 _M4 IM5 N16 M_ 7 NIB M97M10JM11 M12,
1
Task 1 - Project Purring and Coordlrmlon 2 wks
2
Task 2 - Develop Computerized Street Inventory 8 wks
3
k - Link MIMP Software to GIS 2 mons4dTas3
Task 4 - Collect Pavement Condition Data 100 days
5
Arterial Streets 3 mons
6
Local Streets 2 mons
7
Task 5 - Collect Histoncal Data 1 mon:
Task 6 - Produce Network Level Analysis 60 days
Arterial Streets 1 mon-
I
8
9
10
Local Streets t moni
T ask 7 - Develop Work Order Management System 6 mons
Task 8 - Alley Ratings 3 mans
Task 9 - Deliver RAMP Software and Provide Training 2 mons it
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Resolution No. 2008-R0042
ACORD. CERTIFICATE OF LIABILITY INSURANCE 1° E' o�NYM
PRODUCER Phone: 713-490-4600 Fax: 71- 490-4700 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
USI Southwest ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
840 Lessner Suite 600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Three Memorial City ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Houston TX 77024
INSURERS AFFORDING COVERAGE NAIC
INSURED INSURERA,Hudson Insurance Company 9 9
H V J Associates Inc. INSURER& Hart ford Underwriters Insuran 30104
6120 S. Dairy Ashford
wc:
Houston TX 77072 suRERHartford Accident& Indemnity2 7
wsuRERD:Hartfnrd Casualtv Insurance C 9424
rAVF0ArIFC
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
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TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
D'L
CIFINSURANCE
POLICY NUMBER
POLICY EFFECTIVE
12/15/2007
POLICY EXPIRATION
12/15/2008
LIMITS
$
GENERALLIABILITr
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PERSONAL &ADV INJURY
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GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OPAGG
$2 QO 000
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X
BODILY INJURY
(ForaoOldent)
;
HIRED AUTOS
NON-OWNEDAUT05
X
PROPERTYDAIMAGE
(Perealdent)
S
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
$
OTHER THAN EA ACC
S
ANY AUTO
S
AUTO ONLY: AGG
D
EXCESSIUMBRELLALIABILITY
61X14UIT0937
12/15/2007
12/15/2008
EACHOCCURRENCE
$10 O 0,000
X OCCUR 71 CLAIMS MADE
AGGREGATE
$1 O 0
S
S
DEDUCTIBLE
$
X RETENTION $1 0
E
WORKERS COMPENSATION AND
61WBI00124
12/15/2007
12/15/2008
-
WCSTATU- OUR
X I
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICEHlMEMBEREXCLUDED?
E.L EACH ACCIDENT
$ 00
E.L. DISEASE - EA EMPLOYEE
S 1 Q Q 0 000
If yyes, describe under
SPECIALPROVISIONSbelow
E.L. DISEASE -POLICY LIMIT
S 1 Q 0 0 00
A
OTHERAEE7204000
Professional
Liability
4/6/2007
4/6/2008
Per Claim $1,000,000
Annual Aggregate $1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Blanket Waiver of Subrogation fall policies) and Blanket Additional Insured (all policies except Workers Compensation, &
Professional Liability) is issued in favor of the Certificate Holder as required by written contract, but limited to
he operations of the Named Insured. This insurance is primary and non-contributory to the insurance available to the
dditional Insured as required by written contract.
%P0719860 Pavement E�raluation System
ULK 1 11-IUA I t MULL ILK GANGCLL.A I IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
City of Lubbock WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
PO Box 2000 CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
Lubbock TX 79457 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY [FIND UPON
THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001108) p ACORD CORPORATION 1985
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
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