HomeMy WebLinkAboutResolution - 2010-R0190 - Construction Contract (No. 9508) W/ Pavement Restoration, Inc. For Asphalt Rej. - 04/19/2010Resolution No. 2010-RO190
April 19, 2010
Item No. 5.12
RESOLUTION
3E 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
iirected to execute for and on behalf of the City of Lubbock, Unit Price Construction
�ontract No. 9508 for an asphalt rejuvenation program, by and between the City of
Lubbock and Pavement Restoration, Inc. of Boerne, Texas, and related documents. Said
�ontract is attached hereto and incorporated in this resolution as if fully set forth herein
tnd shall be included in the minutes of the City Council.
'assed by the City Council on April 19, 2010
TOM 1ARTIN MAYOR
kTTEST:
Garza, City Secretary
'ED AS TO CONTENT:
Q.�1--
P.E., Chien Operations Officer
PROVED AS TO FORM:
Weaver, Assistant City Attorney
ocs?RES.Contract-Pavement Restoration, Inc.
31, 2010
Resolution No. 2010-RO190
Contract No. 9508
STATE OF TEXAS §
COUNTY OF LUBBOCK §
This contract, (the "Contract"), effective as of the 19th day of April, 2010, (the "Effective
Date"), is by and between the City of Lubbock, (the "City"), a Texas municipal corporation, and
Pavement Restoration Inc. ("CONTRACTOR") of Boerne, Texas.
WITNESSETH
WHEREAS, the City desires to obtain an Asphalt Reiuvenation Program in Lubbock,
Texas; and
WHEREAS, CONTRACTOR has a professional experienced staff and is qualified to
provide Asphalt Reiuvenation Program;
and
WHEREAS, the City desires to contract with CONTRACTOR to provide an Asphalt
Reiuvenation Program in Lubbock, Texas.
NOW THEREFORE, for and in consideration of the terms, covenants and conditions set
forth in this Contract, the City and CONTRACTOR hereby agree as follows:
ARTICLE I. TERM
The contract shall be for a term of three years, each term of this Contract commences on a
date to be specified for each year in a written "Notice to Proceed" of the Owner. The Contractor
is to substantially complete the project within 120 (ONE HUNDRED TWENTY) calendar days
and the liquidated damages amount is $500 (FIVE HUNDRED) each calendar day thereafter as
stipulated in the specifications and other contract documents.
ARTICLE II. COMPENSATION
CONTRACTOR shall be compensated by the City $0.95 (NINETY-FIVE CENTS) per
Square Yard for the first year, $1.00 (ONE DOLLAR) per Square Yard for the second year
and $1.05 (ONE DOLLAR & FIVE CENTS) per Square Yard for the third year. Estimated
quantity of Reclamite Preservative Seal to be applied under this contract per year is 515,780
Square Yards for a total contract price not to exceed $490,000 (FOUR HUNDRED & NINETY
THOUSAND AND 00/100) per year. Contractor shall submit a monthly request for payment to the
Owner's Representative for approval. The Owner shall pay the Contractor on or before the fifteenth
day of the current month the total amount of the Owner's Representative's Certificate of Partial
Payment, less 5% of the amount thereof, which 5% shall be retained until final payment, and
further, less all previous payments and all further sums that may be retained by Owner under the
terms of the contract documents.
ARTICLE III. TERMINATION
a. General. City may terminate this Contract, for any reason, upon thirty (30) days written
notice to CONTRACTOR.
b. Termination and Remedies. In the event CONTRACTOR breaches any term and/or
provision of this Contract the City shall be entitled to exercise any right or remedy available to it
at law or equity, including without limitation, termination of this Contract and assertion of action
for damages and/or injunctive relief. The exercise of any right or remedy shall not preclude the
concurrent or subsequent exercise of any other right or remedy and all other rights and remedies
shall be cumulative. City or CONTRACTOR may, in its sole discretion, terminate this
Agreement at any time, with or without cause upon thirty (30) days written notice.
ARTICLE IV. REPRESENTATIONS AND WARRANTIES
A. Existence. CONTRACTOR is a corporation duly organized, validly existing, and in
good standing under the laws of the State of Texas and is qualified to carry on its business in the
State of Texas.
B. Corporate Power. CONTRACTOR has the corporate power to enter into and perform
this Contract and all other activities contemplated hereby.
C. Authorization. Execution, delivery, and performance of this Contract and the activities
contemplated hereby have been duly and validly authorized by all the requisite corporate action
on the part of CONTRACTOR. This Contract constitutes legal, valid, and binding obligations of
the CONTRACTOR and is enforceable in accordance with the terms therof.
D. CONTRACTOR. CONTRACTOR maintains a professional staff and employs, as
needed, other qualified specialists experienced in providing Asphalt Rejuvenation Program,
and are familiar with all laws, rules, and regulations, both state and federal, including, without
limitation the applicable laws, regarding the activities contemplated hereby.
E. Performance. CONTRACTOR will and shall conduct all activities contemplated by
this Contract in a good and workmanlike manner, and comply with all laws, rules, and
regulations, both state and federal, relating to predictive maintenance services, as contemplated
hereby. If any of the activities of CONTRACTOR, or omissions of the activities required herein,
shall cause, in whole or in part, liability or loss on the part of the City, it shall be deemed that
CONTRACTOR did not perform said activities (or omitted the performance of said activities) in
a good and workmanlike manner.
F. Use of Copyrighted Material. CONTRACTOR warrants that any materials provided by
CONTRACTOR for use by City pursuant to this Contract shall not contain any proprietary
material owned by any other party that is protected under the Copyright Act or any other similar
law. CONTRACTOR shall be solely responsible for ensuring that any materials provided by
CONTRACTOR pursuant to this Contract satisfy this requirement and CONTRACTOR agrees
to hold City harmless from all liability or loss to which City is exposed on account of
CONTRACTOR's failure to perform this duty.
ARTICLE V. SCOPE OF WORK
CONTRACTOR shall accomplish the following:
The contractor shall furnish all labor, material, and equipment necessary to perform all
operations for the application of an asphalt rejuvenating agent to asphaltic surfaces at various
locations. All Traffic Control shall conform to the Texas Manual on Uniform Traffic Control
Devices in accordance with the City of Lubbock Public Works Engineering Standard Paving
Specifications, Section 10.1, BARRICADES. A map of streets selected for application is hereto
attached and incorporated by reference.
The contractor shall be responsible for sweeping and cleaning of the streets prior to, and after
treatment when required. Prior to treatment, the street will be cleaned of all debris (dirt, leaves,
foreign materials, etc.) This work shall be accomplished by brooming, power blowing, or other
approved methods. All sand used during the treatment must be removed no later than 48 hours
after treatment of the street. This shall be accomplished by mechanical sweeping. All turnouts,
cul-de-sacs, etc. must be cleaned of any material to the satisfaction of the Street Superintendent.
If the cleanup process falls behind or the cleanup is not satisfactory to the Street Superintendent
the application process will be halted until the sweeping crew has caught up, or until the street
and surrounding right of way has been cleaned. Street sweeping and clean up shall be included
in the price per square yard for the asphalt -rejuvenating agent.
The asphalt -rejuvenating agent shall be applied by a distributor truck at the temperature
recommended by the manufacturer and at the pressure required for the proper distribution. The
emulsion shall be applied so that uniform distribution is obtained at all points of the areas treated.
Areas inadvertently missed shall receive additional treatment. Application of asphalt
rejuvenating agent shall be on one-half width of the pavement at a time. When the second half of
the surface is treated, the distributor nozzle nearest the center of the road shall overlap the
previous application by at least one-half the width of the nozzle spray. In any event the
centerline construction joint of the pavement shall be treated in both application passes of the
distributor truck. The asphalt -rejuvenating agent shall be blended with water at the rate of two
(2) parts rejuvenating agent to one (1) part water, by volume or as specified by the manufacturer.
The combined mixture of asphalt rejuvenating agent and water shall be spread at the rate of 0.05
to 0.10 gallons per square yard, or as approved by the Street Superintendent following field
testing. After the street has been treated, the area within one foot of the curb line on both sides of
the road shall receive an additional treatment of the asphalt rejuvenating agent. The treatment
shall be uniformly applied by a method acceptable to the Street Superintendent. After the
rejuvenating agent has penetrated the surface, a coating of dry sand shall be applied to the surface
to protect the traveling public.
The asphalt -rejuvenating agent shall not be placed when the ambient temperature is below
40 degrees F as determined by the National Weather Service continuous broadcast, 748-1071
selection 2. The asphalt -rejuvenating agent shall be applied only when the existing surface to be
treated is thoroughly dry and when it is not threatening to rain.
ARTICLE VI. INDEPENDENT CONTRACTOR STATUS
CONTRACTOR and City agree that CONTRACTOR shall perform the duties under this
Contract as an independent contractor. CONTRACTOR has the sole discretion to determine the
manner in which the services are to be performed.
ARTICLE VII. INSURANCE
A. General. CONTRACTOR shall procure and carry, at its sole cost and expense through
the life of this Contract insurance protection hereinafter specified, in form and substance
satisfactory to the City. City must approve all policies prior to the commencement of any
activities whether performed by CONTRACTOR, subcontractor, agents, or third parties. The
insurance carrier must be an insurance company authorized to transact business in the State of
Texas and have a Best's Financial rating of "A" or better. A Certificate of Insurance specifying
each and all coverage shall be submitted to City prior to the execution of this Contract. All
insurance shall be prepared and executed by the insurance company or it's authorized agents and
shall contain an endorsement naming the City of Lubbock a primary additional insured, the
additional insured endorsement shall include products and completed operations. Written
notice of cancellation or any material change will be provided thirty (30) days in advance of
cancellation or change. All insurance, other than Workers' Compensation, shall provide a waiver
of subrogation in favor of the City of Lubbock, and shall contain cross liability and severability
clauses.
B. Required Coverage. CONTRACTOR shall obtain and maintain policies of insurance
throughout the Contract term in limits specified below.
1. Worker's Compensation. CONTRACTOR shall maintain Workers' Compensation and
Employer's Liability insurance coverage as required by statute: at a minimum FIVE HUNDRED
THOUSAND and no/100 DOLLARS ($500,000).
2. Commercial General Liability. CONTRACTOR shall maintain Commercial General
Liability coverage endorsed to include Products and Completed Operations AGG., Contractual
Liability, Personal & Advertising Injury and Heavy Equipment. The policy shall have a
minimum of ONE MILLION and no/100 Dollars ($1,000,000) combined single limit in the
aggregate and per occurrence.
3. Commercial Automobile Liability. CONTRACTOR shall maintain Commercial
Automobile Liability coverage with a minimum of FIVE HUNDRED THOUSAND and
no/100 Dollars ($500,000) combined single for Bodily injury and Property Damage and shall
include any auto or in the alternative, owned autos, non -owned autos and hired autos.
C. Subcontractors. CONTRACTOR shall require each subcontractor with whom it
contracts to provide activities as contemplated by this Contract, to obtain proof of insurance
coverage as set forth herein, and to provide to CONTRACTOR, prior to such person performing
any such activities, a Certificate of Insurance establishing such coverage.
ARTICLE VIII. EMPLOYMENT OF AGENTS
CONTRACTOR may employ or retain agents, consultants, contractors, or third parties, to
perform certain duties of CONTRACTOR under this Contract provided that CONTRACTOR is
in no event relieved of any obligation under this Contract. Any such agents, contractors, or third
parties retained and/or employed by CONTRACTOR shall be required to carry, for the protection
and benefit of the City and CONTRACTOR and naming said third parties as additional insureds,
insurance as described above in this Contract.
ARTICLE IX. CONFIDENTIALITY
CONTRACTOR shall retain all information received from or concerning the City and the
City's business in strictest confidence and shall not reveal such information to third parties
without prior written consent of the City, unless otherwise required by law.
ARTICLE X. INDEMNITY
CONTRACTOR shall indemnify and save harmless the City of Lubbock and its officers,
agents, and employees from all suits, actions, losses, damages, claims, or liability of any
character, type, or description, including without limiting the generality of the foregoing all
expenses of litigation, court costs, and attorney's fees for injury or death to any person, or injury
to any property, received or sustained by any person or persons or property, arising out of, or
occasioned by, the acts of CONTRACTOR, its agents or employees, in the execution of this
Contract.
ARTICLE XI. COMPLIANCE WITH APPLICABLE LAWS
CONTRACTOR shall comply with all applicable federal, state and local laws, statutes,
ordinances, rules and regulations relating, in any way, manner or form, to the activities under this
Contract, and any amendments thereto.
ARTICLE XII. NOTICE
A. General. Whenever notice from CONTRACTOR to City or City to CONTRACTOR
is required or permitted by this Contract and no other method of notice is provided, such notice
shall be given by (1) actual delivery of the written notice to the other party by hand. (2) facsimile,
or other reasonable means (in which case such notice shall be effective upon delivery). or (3) by
depositing the written notice in the United States mail, properly addressed to the other party at
the address provided in this article, registered or certified mail, return receipt requested, in which
case such notice shall be effective on the third business day after such notice is so deposited.
B. CONTRACTOR's Address. CONTRACTOR's address and numbers for the purposes
of notice are:
Pavement Restoration, Inc.
Attn: Robert Wiggins - President
P.O. Box 1532
Boerne, Texas 78006
Telephone: (813) 323-2710
Facsimile: (830) 336-3484
C. City's Address. The City's address and numbers for the purposes of notice are:
City of Lubbock
Attn: Kevin Lair — Street Superintendent
P. 0. Box 2000
Lubbock, Texas 79457
Telephone: (806) 775 - 2600
Facsimile: (806) 775 - 2744
D. Change of Address. Either party may change its address or numbers for purposes of
notice by giving written notice to the other party, referring specifically to this Contract, and
setting forth such new address or numbers. The address or numbers shall become effective on
the 15th day after such notice is effective.
ARTICLE XIII. MISCELLANEOUS
A. Captions. The captions for the articles and sections in this Contract are inserted in
this Contract strictly for the parties' convenience in identifying the provisions to this Contract and
shall not be given any effect in construing this Contract.
B. Audit. CONTRACTOR shall provide access to its corporate books and records to the
City. The City may audit, at its expense and during normal business hours, CONTRACTOR's
books and records with respect to this Contract between CONTRACTOR and City.
C. Records. CONTRACTOR shall maintain records that are necessary to substantiate
the services provided by CONTRACTOR
D. Assignability. CONTRACTOR may not assign this Contract without the prior written
approval of the City.
E. Successor and Assigns. This Contract binds and inures to the benefit of the City,
CONTRACTOR, and their respective successors, legal representatives, and assigns.
F. Construction and Venue. THIS CONTRACT SHALL BE GOVERNED BY AND
CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS. THE
PARTIES HERETO HEREBY IRREVOCABLY CONSENT TO THE EXCLUSIVE
JURISDICTION AND VENUE OF THE COURTS OF THE STATE OF TEXAS, COUNTY OF
LUBBOCK, FOR THE PURPOSES OF ALL LEGAL PROCEEDINGS ARISING OUT OF OR
RELATING TO THIS CONTRACT OR THE ACTIONS THAT ARE CONTEMPLATED
HEREBY.
G. Severability. If any provision of this Contract is ever held to be invalid or ineffective
by any court of competent Jurisdiction with respect to any person or circumstances, the
remainder of this Contract and the application of such provision to persons and/or circumstances
other than those with respect to which it is held invalid or ineffective shall not be affected
thereby.
H. Amendment. No amendment, modification, or alteration of the terms of this Contract
shall be binding unless such amendment, modification, or alteration is in writing, dated
subsequent to this Contract, and duly executed by CONTRACTOR and City.
I. Entire Agreement. This Contract contains the Entire Contract between the City and
CONTRACTOR, and there are no other written or oral promises, conditions, warranties, or
representations relating to or affecting the matters contemplated herein.
EXECUTED as of the Effective Date hereof.
CONTRACTOR:
(OWNER):
COMPLETE ADDRESS:
Company Y v % 4z5ToRAro(� Ih
Address t tl V Au" VvMou-
City, State, Zip a25A('% �- T 78Oo6
ATTEST:
CITY OF LUBBOCK, TEXAS
By: ---
AYOR
ATTEST:
I
City)secretary
APP D AS T ONTENT:
e
r-
Ow er's Representative
III/ 1 /� . I j- n V/' ,/ A
Director of Public Works
,Llz 1-4 APPROV AS T, FORM:
Corporate Secretary
City Attorney
Page Intentionally Left Blank
SUSPENSION AND DEBARMENT CERTIFICATION
Federal Law (A-102 Common Rule and OMB Circular A-110) prohibits non -Federal entities from
contracting with or making sub -awards under covered transactions to parties that are suspended or
debarred or whose principals are suspended or debarred. Covered transactions include procurement
contracts for goods or services equal to or in excess of $25,000 and all non -procurement transactions
(e.g., sub -awards to sub -recipients).
Contractors receiving individual awards of $25,000 or more and all sub -recipients must certify that their
organization and its principals are not suspended or debarred by a Federal agency.
Before an award of $25,000 or more can be made to your firm, you must certify that your organization
and its principals are not suspended or debarred by a Federal agency.
I, the undersigned agent for the firm named below, certify that neither this firm nor its principals
are suspended or debarred by a Federal agency.
CK07u 171101r/►I_3u I �A
FEDERAL TAX ID or SOCIAL
Signature of Company Official:
Printed name of company official
Date Signed: 3 1.3 i I 'aOtO
No. 19 3 4204
above: 108112_1 Wt%litI1J
Page Intentionally Left Blank
STATUTORY PAYMENT BOND PURSUANT TO SECTION 2253.021(a)
OF THE TEXAS GOVERNMENT CODE
(CONTRACTS MORE THAN $50,000)
KNOW ALL MEN BY THESE PRESENTS, that Pavement Restoration, Inc. (hereinafter called the Principal(s),
as Principal(s), and Nations Bonding Company
(hereinafter called the Surety(s), as Surety(s), are held and firmly bound unto the City of Lubbock (hereinafter
called the Obligee), in the amount of Four hundred ninety thousand and 00/100_ Dollars ($490,000) lawful
money of the United States for the payment whereof, the said Principal and Surety bind themselves, and their
heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the Principal has entered into a certain written contract with the Obligee, dated the 19th day of
April, 2010,to Asphalt Rejuvenation Program in Lubbock, Texas
and said Principal under the law is required before commencing the work provided for in said contract to execute
a bond in the amount of said contract which contract is hereby referred to and made a part hereof as fully and to
the same extent as if copied at length herein.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal
shall pay all claimants supplying labor and material to him or a subcontractor in the prosecution of the work
provided for in said contract, then, this obligation shall be void; otherwise to remain in full force and effect;
PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Section 2253.021(a)
of the Texas Government Code, and all liabilities on this bond shall be determined in accordance with the
provisions of said Article to the same extent as if it were copied at length herein.
IN WITNESS WHEREOF, the said Principal (s) and Surety (s) have signed and sealed this instrument
this 5th day of April 2010.
Nations Bonding Company
Sure .'
*By.
(Title) Douglas . King / Attorney In act
Pavement Restoration, Inc.
(Company Name)
By
(Printed Name)
(Signature)
(Title)
The undersigned surety company represents that it is duly qualified to do business in Texas, and hereby
designates Cory Bentley 1 Upshaw Insurance** an agent resident in Lubbock County to whom any requisite
notices may be delivered and on whom service of process may be had in matters arisingout of such suretyship.
(Title) Do
Approved as to form:
City of L k
B ��
By: ---
City ttorney
* Note: If signed by an officer of the Surety Company there must be on file a certified extract from the by-laws
showing that this person has authority to sign such obligation. If signed by an Attorney in Fact, we must have
copy of power of attorney for our files.
** Cory Bentley
Upshaw Insurance
801 South Fillmore Suite 300
Amarillo, TX 79105
MERCHANTS AT 10 N S
BONDING COMPANY BONDING COMPANY
POWER OF ATTORNEY Bond No. FLC65214
KNOW ALL PERSONS BY THESE PRESENTS: That MERCHANTS BONDING COMPANY (MUTUAL) is a corporation duly organized under the
laws of the State of Iowa, and that NATIONS BONDING COMPANY is a corporation duly organized under the laws of the State of Texas
(herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint
Douglas W. King
of Tampa and State of Florida their true and lawful Attorney -in -Fact, with full power
and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surety
any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject to the limitation that any
such instrument shall not exceed the amount of:
THREE MILLION ($3,000,000.00) DOLLARS
and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers
of the Companies, and all the acts of said Attorney -in -Fact, pursuant to the authority herein given, are hereby ratified and confirmed.
This Power -of -Attorney is made and executed pursuant to and by authority of the following bylaws adopted by the Board of Directors
of Merchants Bonding Company (Mutual) on November 16, 2002 and adopted by the Board of Directors of Nations Bonding
Company on April 19, 2003.
"The Chairman of the Board or President or any Vice President or Secretary shall have power and authority to appoint
Attomeys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto,
bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof.
The signature of any authorized officer and the Seal of the Company may be affixed by facsimile to any Power of Attorney or
Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship
obligations of the Company, and such signature and seal when so used shall have the same force and effect as though
manually fixed"
In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 22nd day of January , 2010.
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MERCHANTS BONDING COMPANY (MUTUAL)
NATIONS BONDING COMPANY
By 774—
President
On this22nd day of January , 2010, before me appeared Larry Taylor, tome personally known, who being by me duly swom did say that
he is President of MERCHANTS BONDING COMPANY (MUTUAL) and NATIONS BONDING COMPANY; and that the seals
affixed to the foregoing instrument are the corporate seals of the Companies; and that the said instrument was signed and sealed in
behalf of the Companies by authority of their respective Boards of Directors.
In Testimony Whereof, I have hereunto set my hand and affixed my Official Seal at the City of Des Moines, Iowa, the day and year first
above written.
CINDY SMYTH �.�17 �4�
*1001
Commission Number 173504
My Commission Expires
March 16,201 Z Notary Public, Polk County, Iowa
STATE OF IOWA
COUNTY OF POLK ss.
I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and NATIONS BONDING COMPANY, do hereby certify
that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is
still in full force and effect and has not been amended or revoked.
In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 5th day of April 1 2010
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STATUTORY PERFORMANCE BOND PURSUANT TO SECTION 2253.021(a)
OF THE TEXAS GOVERNMENT CODE
(CONTRACTS MORE THAN $100,000)
KNOW ALL MEN BY THESE PRESENTS, that Pavement Restoration, Inc (hereinafter called the
Principal(s), as Principal(s),and Nations Bonding Company
(hereinafter called the Surety(s), as Surety(s), are held and firmly bound unto the City of Lubbock (hereinafter
called the Obligee), in the amount of Four Hundred & Ninety Thousand and 001100 Dollars ($ 490,000) lawful
money of the United States for the payment whereof, the said Principal and Surety bind themselves, and their
heirs, administrators, executors, successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the Principal has entered into a certain written contract with the Obligee, dated the 19th
day of April, 2010, to Asphalt Rejuvenation Program in Lubbock, Texas
and said principal under the law is required before commencing the work provided for in said contract to
execute a bond in the amount of said contract which contract is hereby referred to and made a part hereof as
fully and to the same extent as if copied at length herein.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said
Principal shall faithfully perform the work in accordance with the plans, specifications and contract documents,
then this obligation shall be void; otherwise to remain in full force and effect.
PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Section 2253.021(a)
of the Texas Government Code, and all liabilities on this bond shall be determined in accordance with the
provisions of said article to the same extent as if it were copied at length herein.
IN WITNESS WHEREOF, the said Principal (s) and Surety (s) have signed and sealed this instrument
this 5' day of April, 2010.
Nati 1 Bonding Company
Surety
* By:
( itle) Dougla1r. King, Attorney In act
Pavement Restoration, Inc._
(Company Name)WI-111-5— ULJ
By: J4 l lI lS
(Printed Name)
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(Signature)
(Title)
The undersigned surety company represents that it is duly qualified to do business in Texas, and hereby
designates Cory Bentley/ Upshaw Insurance** an agent resident in Lubbock County to whom any requisite
notices may be delivered and on whom service of process may be had in matters arisingout of such suretyship.
Nations Bonding Company
Su ty
*By:
(Title) Douglas King! ttorney In act
Approved as to form:
City o=ZOA"6�2�
By:
City Attorney
* Note: If signed by an officer of the Surety Company there must be on file a certified extract from the by-laws
showing that this person has authority to sign such obligation. If signed by an Attorney in Fact, we must have
copy of power of attorney for our files.
** Cory Bentley
Upshaw Insurance
801 South Fillmore Suite 300
Amarillo, TX 79105
;.ER.CH.ANTS NAT 10 N S F
BONDING COMPANY BONDING COMPANY
POWER OF ATTORNEY Bond No. FLC65214
KNOW ALL PERSONS BY THESE PRESENTS: That MERCHANTS BONDING COMPANY (MUTUAL) is a corporation duly organized under the
laws of the State of Iowa, and that NATIONS BONDING COMPANY is a corporation duly organized under the laws of the State of Texas
(herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint
Douglas W. King
of Tampa and State of Florida their true and lawful Attorney -in -Fact, with full power
and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surety
any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject to the limitation that any
such instrument shall not exceed the amount of:
THREE MILLION ($3,000,000.00) DOLLARS
and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers
of the Companies, and all the acts of said Attorney -in -Fact, pursuant to the authority herein given, are hereby ratified and confirmed.
This Power -of -Attorney is made and executed pursuant to and by authority of the following bylaws adopted by the Board of Directors
of Merchants Bonding Company (Mutual) on November 16, 2002 and adopted by the Board of Directors of Nations Bonding
Company on April 19, 2003.
"The Chairman of the Board or President or any Vice President or Secretary shall have power and authority to appoint
Attomeys-in-Fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto,
bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof.
The signature of any authorized officer and the Seal of the Company may be affixed by facsimile to any Power of Attorney or
Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship
obligations of the Company, and such signature and seal when so used shall have the same force and effect as though
manually fixed."
In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 22nd day of January , 2010.
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MERCHANTS BONDING COMPANY (MUTUAL)
NATIONS BONDING COMPANY
By 774—
President
On this22nd day of January , 2010, before me appeared Larry Taylor, tome personally known, who being by me duly swom did say that
he is President of MERCHANTS BONDING COMPANY (MUTUAL) and NATIONS BONDING COMPANY; and that the seals
affixed to the foregoing instrument are the corporate seals of the Companies; and that the said instrument was signed and sealed in
behalf of the Companies by authority of their respective Boards of Directors.
In Testimony Whereof, I have hereunto set my hand and affixed my Official Seal at the City of Des Moines, Iowa, the day and year first
above written.
CINDY SMYTH �.
Commission Number 173504
w My Commission Expires
March 16, 2012 Notary Public, Polk County, Iowa
STATE OF IOWA
COUNTY OF POLK ss.
I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and NATIONS BONDING COMPANY, do hereby certify
that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is
still in full force and effect and has not been amended or revoked.
In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 5th day of April , 2010.
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Secretary
2010 Street Rejuvenator Project
Street
To
From
Width
Length
Area
Kent
Boston
University
18
1880
3760
Akron
Loyola
Kent
29
274
851
Loyola
University
CDS W of Akron
29
1387
4587
Loyola
Boston
CDS E of Boston
29
374
1293
Boston
Kent
Joint line N of Madision
29
850
2750
Akron
Madison
Loyola
29
300
1027
Madison
University
Boston
29
1874
6180
Akron
Madison
Joint line N of Madison
29
168
540
Brentwood
CDS South of Dartmout CDS N of Emory
33
1604
6390
Emory
Brentwood
E end of Pavement
33
162
625
Dartmouth
Brentwood
E end of Pavement
33
162
625
Dartmouth
Chicago
Brentwood
33
282
1085
Emory
Chicago
Brentwood
33
282
1085
Chicago
Erskine
Colgate
43
1705
8205
Emory
Chicago
Clinton
33
284
1097
Dartmouth
Chicago
Clinton
33
284
1097
Clinton
CDS N of Emory
CDS S of Dartmouth
33
1604
6385
Colgate
Dover
E end of Pavement
23
1120
2890
Bangor
CDS S of Grinnell
Marshall
29
2352
7720
Kemper
Belmont
Bangor
29
286
982
Kemper
Belmont
Bangor
29
286
982
Belmont
Erskine
End of Pavement N of Marsha
39
2537
11000
Marshall
Joint line W of Bangor
CDS W of Belmont
29
1142
4007
Lehigh
Belmont
CDS W of Belmont
29
630
2340
Kenper
Chicago
Belmont
29
1050
3385
Harvard
Chicago
Belmont
29
1050
3385
Jarvis
CDS W of Belmont
Belmont
29
654
2387
Grinnell
CDS W of Belmont
Belmont
29
341
1380
Fordham
Chicago
Belmont
29
848
2732
Brentwood
Fordham
CDS N Fordham
29
386
1525
Brentwood
Fordham
CDS S Fordham
29
521
1959
Beaufort
Fordham
CDS S Fordham
29
521
1959
Chicago
Fordham
Erskine
54
579
3500
Chicago
Fordham
End of Pavement N of Marsha.
23
1989
5083
Monticello
Ithasca
End of Pavement N of Itasca
29
240
803
Itasca
Milwaukee
CDS W of Monticello
29
1081
3660
Norwich
Itasca
Harvard
29
466
1560
Harvard
CDS E of Norwich
CDS W of Norwich
29
1041
3740
Street
To
From
Width
Length
Area
Aberdeen
19th
21st
29
708
2289
21st
Aberdeen
Joint line W of Aberdeen
29
349
1163
Aberdeen
21st
21st
29
164
530
21st
Slide Road
Aberdeen
29
550
1875
106th
Clinton
Frankford
43
2455
12045
Clinton
CDS S of 106th
106th
29
476
1565
Colton
CDS S of 106th
106th
29
476
1565
Dover
Joint Line S of 106th
106th
29
540
1765
Elkhart
Joint Line S of 106th
106th
33
530
1981
Elmwood
107th
106th
29
270
940
Evanston
107th
106th
29
270
940
107th
Elkhart
Frankford
29
1370
4415
Ave S
98th
100th
29
775
2570
99th
Ave S
Ave T
29
560
1835
Ave T
99th
98th
29
215
810
99th PL
Ave S
CDS W of Ave S
29
600
1970
100th
Ave U
End of Pavement E of Ave S
29
1700
5545
Ave U
End of Pavement N of
1 End of Pavement S of 100th
22
360
890
Ave T
100th
End of Pavement S of 100th
29
168
575
Savannah
98th
103rd
33
1925
7635
Toledo
99th
CDS N of 99th
29
400
1505
Topeka
99th
CDS N of 99th
29
455
1930
99th
Topeka
Savannah
29
590
1925
99th
CDS E of Salisbury
Savannah
29
645
2250
Salisbury
CDS N of 99th
99th
29
400
1505
100th
Savannah
Joint line W of Savannah
33
770
2845
101st
Savannah
CDS W of Toledo
29
900
3115
Toledo
101st
102nd
29
274
945
102nd
CDS W of Toledo
CDS E of Toledo
29
955
3360
103rd
Savannah
Joint Line W of Savannah
29
990
3190
Xenia
82nd
85th
40
1220
5350
84th
Xenia
CDS W of Xenia
29
610
2325
84th
Xenia
CDS E of Xenia
29
1005
3620
84th
Xenia
CDS E of Xenia
30
1005
3690
Winfeild
85th
End of Pavement S of 85th
29
145
515
Harvard
Knoxville
W End of Pavement
29
459
1510
Itasca
Knoxville
W End of Pavement
29
435
1430
Jarvis
Knoxville
W End of Pavement
29
435
1430
Kemper
Knoxville
W End of Pavement
29
435
1430
Street
To
From
Width
Length
Area
Lehigh
Knoxville
W End of Pavement
29
405
1325
Marshall
Knoxville
W End of Pavement
29
405
1325
Knoxville
Loop 289
Itasca
33
1598
5890
86th
Ave T
CDS W of Ave T
30
705
2490
87th
Ave T
Ave U
29
685
2290
88th
Ave T
Ave U
29
685
2290
Ave T
86th
90th
33
1265
4755
89th
Ave T
Sherman
30
430
1465
Sherman
89th
CDS S of 89th
29
360
1390
Temple
90th
CDS N of 90th
29
360
1390
Terrell
90th
CDS N of 90th
29
360
1390
Ave U
87th
90th
23
860
2205
90th
Ave U
Sherman
23
860
2205
Joliet
105th
106th
29
145
638
106th
Joliet
Memphis
29
1830
5897
Lynnhaven
105th
CDS N 105th
29
280
905
Lynnhaven PL
105th
104th
29
330
1180
104th
Lynnhaven PI
Memphis
29
330
1095
Kenosha
105th
110th
33
1450
5320
105th
Dover
Chicago
29
819
2640
Dover
105th
104th
29
170
757
Durham
104th
CDS S of 104th
29
270
1060
104th
Durham
Chicago
33
1360
4990
Dover
104th
103th
29
265
920
103rd
CDS E of Clinton
CDS W of Dover
29
1240
4420
Clinton
102nd
103rd
29
265
925
102nd
CDS W of Dover
Chicago
29
1275
4320
Chicago
102nd
105th
43
1195
5705
Detroit
108th
113th
29
1404
4590
111th
Detroit
Canton
39
397
1720
113th
Detroit
Canton
23
421
1075
Canton
112th
113th
21
391
921
112th
Akron
Boston
16
895
1625
Akron
110th
112th
29
425
1375
111th
Akron
Boston
29
887
2940
Canton
110th
112th
29
425
1375
Canton
108th
106th
29
528
2120
106th
Canton
Detroit
29
265
860
107th
Canton
Detroit
29
300
970
Street
To
From
Width
Length
Area
Detroit
106th
108th
29
570
1870
106th
Detroit
CDS W of Dixon
29
635
2225
Dixon
106th
108th
29
550
1835
107th
Dixon
CDS W of Dixon
29
495
1810
106th
Elkridge
Flint
29
245
850
107th
Elkridge
Flint
29
315
1150
Elkridge
106th
107th
29
296
1075
37th
Millwaukee
35th
36
1470
5880
37th
Pontiac
35th
33
265
1040
Norwich
37th
36th
33
265
1040
36th
35th
CDS E of Norwich
33
775
2950
Pontiac
Prentiss
S end of Pavement
33
600
2450
Prentiss
35th
S end of Pavement
33
700
2575
Primrose
35th
37th
33
615
2315
36th
CDS W of Primrose
CDS E of Primrose
33
220
1090
37th
Prentiss
Quincy
33
375
1550
35th
37th
Quincy
33
1902
7015
Quincy
34th
34th PI
52
264
3370
Quincy
37th
34th PI
25
875
2450
Quincy
37th
34th PI
25
875
2450
Pontiac
34th
35th
33
598
2200
34th PI
Pontiac
Oakridge
33
264
1050
Oakridge
CDS N of 34th PI
CDS S of 34th PI
33
620
2550
122nd
Quaker
Norfolk
26
1678
5020
Norfolk
122nd
124th
33
592
2175
Norwood
122nd
CCDS S of 122nd
33
235
1005
Orlando
122nd
CCDS S of 122nd
33
235
1005
Oxford
122nd
124th
33
592
2175
Peoria
122nd
125th
33
880
3315
123rd
Peoria
Norfolk
33
1275
4750
124th
Peoria
Norfolk
33
1305
4800
Norwood
124th
125th
33
250
917
125th
Quaker
Norfolk
33
1480
5325
125th
Quaker
Norfolk
33
1480
5325
Norfolk
125th
127th
33
585
2150
126th
Norfolk
CDS W of Norfolk
33
550
2160
127th
Norfolk
CDS W of Norfolk
33
550
2160
Toledo
109th
CDS N of 109th
33
650
2525
106th
109th
Toledo
33
830
3345
Street
To
From
Width
Length
Area
Topeka
109th
CDS N of 109th
33
220
950
109th Pi
109th
Troy
33
765
2805
109th Pi
Utica
Troy
33
285
1045
Utica
CDS N of 109th PL
CDS S of 109th PI
33
680
2775
109th
Troy
Utica
33
285
1045
Utica
106th
109th
33
380
1395
Vicksburg
106th
S end of Pavement
39
239
1050
Vinton
106th
CDS S of 106th
39
220
950
Wayne
106th
CDS S of 106th
33
220
950
Winston
106th
CDS S of 106th
33
220
950
York
106th
CDS S of 106th
33
220
950
106th
York
Vinton
33
1180
4350
Juneau
98th
100th
39
617
2675
100th
Juneau
Justice
33
495
1875
Justice
100th
CDS N of 100th
33
430
1720
Justice
100th
101st
33
275
1008
101st
Justice
CDS E of Justice
33
459
1850
Jarvis
Slide Road
CDS W odf Aberdeen
33
1345
5075
Aberdeer
Kemper
Jarvis
33
270
990
Kemper
Slide Road
Bangor
33
1565
5620
Albany
Lehigh
kemper
33
270
990
Albany
Lehigh
Marshall
33
270
990
Aberdeen
Lehigh
Kemper
33
270
990
Aberdeen
Lehigh
Marshall
33
270
990
Lehigh
CDS W of Albany
CDS E of Aberdeen
33
1640
6300
marshall
Bangor
CDS E of Aberdeen
33
1710
6420
Jarvis
Vinton
CDS W of York
33
1570
5910
York
Jarvis
Kemper
33
285
1045
Kemper
Slide Road
Vinton
33
1160
4285
Kemper
Marshall
Vinton
33
435
1620
Winston
Kemper
Lehigh
33
285
1045
Lehigh
CDS W of Winston
Marshall
33
880
3375
Marshall
Slide Road
Marshall
33
795
2920
Marshall
Marshall
Marshall
33
175
785
Marshall
Lehigh
Vale
33
675
2475
Vinton
Marshall
CDS N of Marshall
33
260
1095
Vale
Kemper
Marshall
39
870
3525
Kemper
Vale
Jarvis
39
580
2515
Vinton
Kemper
Vale
33
910
3340
Itasca
Jarvis
Vale
33
890
3265
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DIDDIYYYY)
03/313/31 /10
PRODUCER 1-813-229-8021
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
M. E. Wilson Co., Inc.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
OF INSURANCE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
300 W. Platt St.
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Ste 200
A
Tampa, FL 33606
INSURERS AFFORDING COVERAGE NAIC #
INSURED
Palmetto Prime of Tampa, Inc.; Pavement Restoration, Inc
INSURERA WESTFIELD INS CO 24112
INSURER B: AMERICAN INTERSTATE INS CO 31895
Will -Bea Leasing Inc
INSURER C:
5423 N. 59th- Street
INSURERD:
Tampa, FL 33610
INSURER E
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADOL
OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATIONM
LIMITS
A
-TYPE
GENERALLIABILITY
CYY4653719
01/01/10
01/01/11
EACHOCCURRENCE $1,000,000
UAMAUF TU RENTED
PREMISES eoccurence $150,000
MERCIALGENERALLIABILITY
MED EXP (Any one person) $10,000
17CLAIMS MADE ? X _- OCCUR
PERSONAL BADV INJURY $ 1,000,000
GENERAL AGGREGATE $2.000,000
PRODUCTS -COMP/OPAGG $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
POLICY Fx-1 PRO- LOC
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CMK4653719
01/01/10
01/01/11
COMBINED SINGLE LIMIT $1,000,000
(Eaaw M)
BODILY INJURY
(Perperson) $
ALLOWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY $
(Peraccident)
X
X
HIREDAUTOS
NON-OWNEDAUTOS
PROPERTYDAMAGE $
(Peraccident)
GARAGE LIABILITY
AUTO ONLY -EAACCIDENT $
OTHERTHAN EAACC $
ANYAUTO
AUTOONLY: AGG $
A
EXCESSNMBRELLALIABILITY
CKH4653719
01/01/10
01/01/11
EACH OCCURRENCE $ 1,000,000
X I OCCUR FICLAIMSMADE
AGGREGATE $1,000,000
$
$
DEDUCTIBLE
$
RETENTION $
B
WORKERS COMPENSATION AND
AVWCFLISS1492010
01/01/10
01/01/11
X WCSTATU- OTH-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
$500,000
E.LEACHACCIDENT $
E.LDISEASE -EAEMPLOYEE $500,000
OFRCER/MEMBEREXCLUDED?
If Yes, describe under
SPECIAL PROVISIONS bebw
EL DISEASE -POLICY LIMIT $500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
Certificate holder is additional insured with respects to the General Liability policy for both on-going and completed
operations per the attached CG2033 (7/04) and CG7087 (1/05). Waiver of Subrogation applies in favor of the certificate
holder, for both General Liability and Workers Comp employers liability policies referenced above per attached
CG2404 (10/93) and WC000313 (4-84). Such insurance shall be considered primary and non-contributory with
respects to the Additional Insureds.
CERTIFICATE HOLDER CANCELLATION
City of Lubbock
c/o City of Lubbock Public Works Contracting Office
1625 13th Street Suite 204
Lubbock, TX 79401
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) ML001 OACORD CORPORATION 1988
15024017
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.
ACORD 25 (2001/08)
POLICY NUMBER: CMM4653719 COMMERCIAL GENERAL LIABILITY
CG 24 0410 93
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization: City of Lubbock
c/o City of Lubbock Public Works Contracting Office
1625 13th Street Suite 204
Lubbock, TX 79401
USA
(If no entry appears above, information required to complete this endorsement will be shown in
the Declarations as applicable to this endorsement.)
The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section
IV — COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the
following:
We waive any right of recovery we may have against the person or organization shown in the
Schedule above because of payments we make for injury or damage arising out of your ongoing
operations or "your work" done under a contract with that person or organization and included in
the "products -completed operations hazard". This waiver applies only to the person or
organization shown in the Schedule above.
CG 24 0410 93 Copyright, Insurance Services Office, Inc., 1998
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not: enforce our
right against the person or organization named in the Schedule. (This agreement applies only to the extent that you
perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
City of Lubbock
C/o City of Lubbock Public Works Contracting Office
1625 13th Street Suite 204
Lubbock, TX 79401
USA
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy_)
Endorsement Effective 01/01/10 Policy No. AVWCFLISS1492010 Endorsement No.
Insured: Palmetto Prime of Tampa, Inc.; Pavement Restoration, Inc Premium $ 0.00
Company: AmmicAN nazRsTATa INS co Countersigned By
WC 00 03 13
(Ed. 4-84)
Copyright 198:1 National Council on Compensation Insurance. AGENT COPY
Resolution No. 2010-RO190
COMMERCIAL GENERAL
LIABILITY
CG 20 33 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS WHEN
REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization for
whom you are performing operations when you and such person or organization have agreed in writing in a
contract or agreement that such person or organization be added as an additional insured on your policy. Such
person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or
"personal and advertising -injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured.
A person's or organization's status as an additional insured under this endorsement ends when your
operations for that additional insured are completed.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to:
1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the
failure to render, any professional architectural, engineering or surveying services, including:
a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports,
surveys, field orders, change orders or drawings and specifications; or
b. Supervisory, inspection, architectural or engineering activities.
2. "Bodily injury" or "property damage" occurring after.
a. All work, including materials, parts or equipment furnished in connection with such work, on the project
(other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at
the location of the covered operations has been completed; or
b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by
any person or organization other than another contractor or subcontractor engaged in performing
operations for a principal as a part of the same project.
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR,
CONTRACTORS - AUTOMATIC STATUS WHEK
REQUIRED IN CONSTRUCTION AGREEMENT -
COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section 11- Who Is An Insured is amended to
include as an additional insured any person
or organization when you and such person
or organization have agreed in writing in a
contract or agreement that such person or
organization be added as an additional in-
sured on your policy. Such person or organ-
ization is an additional insured only with
respect to liability caused, in whole or in part,
by "your work" performed for that insured and
included in the 'products -completed oper-
ations" hazard.
The coverage afforded to the Additional In-
sured is solely limited to liability specifically
resulting from the conduct of the Named In-
sured, which may be imputed to the Addi-
tional Insured.
B. This endorsement provides no coverage to
the Additional Insured for liability caused, in
whole or in part, out of the claimed
negligence of the Additional Insured, other
than which may be imputed to the Additional
Insured by virtue of the conduct of the Named
Insured.
C. With respect to the Insurance afforded these
additional insureds, the following additional
exclusion applies:
This insurance does not apply to:
1. "Bodily injury", "property damage" or
"personal and advertising Injury" caused,
in whole or in part by the rendering of,
or the failure to render, any professional
architectural, engineering, or surveying
services, including:
a. The preparing, approving, or failing
to prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders, or
drawing and specifications; and
b. Supervisory, inspection, architec-
tural, or engineering activities.
2. Willful misconduct of, or for defects in
design furnished by, the additional in-
sured or its 'employees".
As a condition of coverage, the additional in-
sured shall be obligated to tender the defense
and indemnity of every claim or suit to all
other insurers that may provide coverage to
the additional insured, whether contingent,
excess or primary.
Includes Copyrighted Material of Insurance
Services owes, Inc.. with Its permission CG 70 87 0105