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HomeMy WebLinkAboutResolution - 2016-R0378 - Professional Service Contract - Signature Automation - 10/27/2016Resolution No. 2016-RO378 Item No. 6.15 October 27, 2016 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute for and on behalf of the City of Lubbock, a Professional Service Contract for Improvements to the North Water Treatment Plant, by and between the City of Lubbock and Signature Automation, and related documents. Said Contract is attached hereto and incorporated in this resolution as if fully set forth herein and shall be included in the minutes of the City Council. Passed by the City Council on October 27, 2016 4-1- - DANIEL M. POPE, MAYOR ATTEST: AQ# 4"o AZ--) Re cca Garza, City Secret VED AS TO Wood�Frq;Ain, P.E., Director of Public Works APPROVED AS TO FORM: RES.PS Contract, North Water Treatment Plant -Signature Automation 9.3 0.16 Resolution No. 2016-RO378 PROFESSIONAL SERVICES CONTRACT 13069 STATE OF TEXAS § COUNTY OF LUBBOCK § 27th October This Contract, (the "Contract" or "Agreement"), effective as of the _ day of 2016 (the "Effective Date"), is by and between the City of Lubbock, (the "CITY"), a Texas home rule municipal corporation, and Signature Automation, LLC., ("ENGINEER") a Texas limited liability company authorized to conduct business in Texas. WITNESSETH WHEREAS, the CITY desires to obtain professional engineering services related to the applications engineering services for the Improvements to the North and South Water Treatment Plants (the "Activities"); WHEREAS, ENGINEER has a professional staff experienced and is qualified to provide professional engineering services related to the Activities, and will provide the Services, as defined below, for the price provided herein, said price stipulated by CITY and ENGINEER to be a fair and reasonable price; and WHEREAS, the CITY desires to contract with ENGINEER to provide professional engineering services related to the Activities and ENGINEER desires to provide the Services related to same. NOW THEREFORE, for and in consideration of the terms, covenants and conditions set forth in this Contract, the CITY and ENGINEER hereby agree as follows: ARTICLE I. TERM The term of this Contract commences on the Effective Date and continues without interruption for a term of 800 days. If the ENGINEER determines that additional time is required to complete the Services, the City Engineer, may in his discretion, but is not obligated to, execute an agreement to grant up to an additional six (6) months of time to complete the Services so long as the amount of the monetary consideration does not increase. An amendment to this Agreement resulting in an increase in the amount of the monetary consideration must be approved by the CITY acting through its governing body. ARTICLE II. SERVICES AND COMPENSATION A. ENGINEER shall conduct all activities and within such timeframes as set forth on Exhibit attached hereto (the "Services"). B. ENGINEER shall receive as consideration to be paid for the performance of the Services set forth in the Basic Services, and if directed by CITY, the Additional Services and/or Special Services, based on hourly rates, not to exceed $199,000, per Exhibit "A" and Exhibit "B". ARTICLE III. TERMINATION A. General. CITY may terminate this Contract, for any reason or convenience, upon thirty (30) days written notice to ENGINEER. In the event this Agreement is so terminated, the CITY shall only pay ENGINEER for services actually performed by ENGINEER up to the date ENGINEER is deemed to have received notice of termination as provided herein. B. Termination and Remedies. In the event ENGINEER breaches any term and/or provision of this Contract, the CITY shall be entitled to exercise any right or remedy available to it by this Contract, at law, equity, or otherwise, including without limitation, termination of this Contract and assertion of an action for damages and/or injunctive relief. The exercise of any right or remedy shall not preclude the concurrent or subsequent exercise of any right or remedy and all rights and remedies shall be cumulative. ARTICLE IV. NON -ARBITRATION The CITY reserves the right to exercise any right or remedy available to it by law, contract, equity, or otherwise, including without limitation, the right to seek any and all forms of relief in a court of competent jurisdiction. Further, the CITY shall not be subject to any arbitration process prior to exercising its unrestricted right to seek judicial remedy. The remedies set forth herein are cumulative and not exclusive, and may be exercised concurrently. To the extent of any conflict between this provision and another provision in, or related to, this document, this provision shall control. ARTICLE V. REPRESENTATIONS AND WARRANTIES A. Existence. ENGINEER 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. ENGINEER 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 ENGINEER. This Contract constitutes legal, valid, and binding obligations of the ENGINEER and is enforceable in accordance with the terms thereof. D. Engineer. ENGINEER maintains a professional staff and employs, as needed, other qualified specialists experienced in providing the Services, 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. ENGINEER will and shall conduct all activities contemplated by this Contract in accordance with the standard of care, skill and diligence normally provided by a professional person in performance of similar professional engineering services, and comply with all applicable laws, rules, and regulations, both state and federal, relating to professional engineering services, as contemplated hereby. F. Use of Copyrighted Material. ENGINEER warrants that any materials provided by ENGINEER 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 law, statute, rule, order, regulation, ordinance or contractual obligation relating to the use or reproduction of materials. ENGINEER shall be solely responsible for ensuring that any materials provided by ENGINEER pursuant to this Contract satisfy this requirement and ENGINEER agrees to indemnify and hold CITY harmless from all liability or loss caused to CITY or to which CITY is exposed on account of ENGINEER's failure to perform this duty. ARTICLE VI. SCOPE OF SERVICES ENGINEER shall accomplish the following: Professional Engineering Services related to the application engineering services for the Improvements to the North and South Water Treatment Plants, as defined and provided in Exhibit "A," "Scope of Services." ARTICLE VII. INDEPENDENT CONTRACTOR STATUS ENGINEER and CITY agree that ENGINEER shall perform the duties under this Contract as an independent contractor and shall be considered as independent contractor under this Agreement and/or in its activities hereunder for all purposes. ENGINEER has the sole discretion to determine the manner in which the services are to be performed. During the performance of the Services under this Agreement, ENGINEER and ENGINEER's employees and/or subconsultants, will not be considered, for any purpose, employees or agents of the CITY within the meaning or the application of any federal, state, or local law or regulation, including without limitation, laws, rules or regulations regarding or related to unemployment insurance, old age benefits, workers compensation, labor, personal injury or taxes of any kind. ARTICLE VIII. INSURANCE ENGINEER shall procure and carry, at its sole cost and expense through the life of this Agreement, except as otherwise provided herein, insurance protection as hereinafter specified, in form and substance satisfactory to CITY, carried with an insurance company authorized to transact business in the state of Texas, covering all aspects and risks of loss of all operations in connection with this Agreement, including without limitation, the indemnity obligations set forth herein. ENGINEER shall obtain and maintain in full force and effect during the term of this Agreement, and shall cause each approved subcontractor or subconsultant of ENGINEER to obtain and maintain in full force and effect during the term of this Agreement, commercial general liability, professional liability, and automobile liability coverage for non -owned and hired vehicles with insurance carriers admitted to do business in the state of Texas. The insurance companies must carry a Best's Rating of A -VII or better. All policies will be written on per occurrence basis, subject to the following minimum limits of liability: Commercial General Liability: Per Occurrence Single Limit: $1,000,000 General Aggregate Limit: $2,000,000 Professional Liability: Combined Single Limit: $1,000,000 Automobile Liability: Combined Single Limit for any auto: $1,000,000 Per Occurrence Employer's Liability $1,000,000 Per Occurrence ENGINEER shall further cause any approved subcontractor or subconsultant to procure and carry, during the term of this Agreement, insurance coverage, as specified above for ENGINEER, including without limitation protecting CITY against direct losses caused by the professional negligence of the ., approved subcontractor or subconsultant. The CITY shall be listed as a primary and noncontributory additional insured with respect to the Automobile Liability and Commercial General Liability and shall be granted a waiver of subrogation under those policies. ENGINEER shall provide a Certificate of Insurance to the CITY as evidence of coverage. The Certificate shall provide 30 days' notice of cancellation. A copy of the additional insured endorsement and waiver of subrogation attached to the policy will be included in the Certificate. ENGINEER shall elect to obtain worker's compensation coverage pursuant to Section 406.002 of the Texas Labor Code. Further, ENGINEER shall maintain said coverage throughout the term of this Agreement and shall comply with all provisions of Title 5 of the Texas Labor Code to ensure that the ENGINEER maintains said coverage. The ENGINEER may maintain Occupational Accident and Disability Insurance in lieu of Worker's Compensation. In either event, the policy must be endorsed to include a waiver of subrogation in favor of the CITY. If at any time during the life of the Agreement or any extension hereof, ENGINEER fails to maintain the required insurance in full force and effect, ENGINEER shall be in breach hereof and all work under the Agreement shall be discontinued immediately. Notwithstanding anything contained herein to the contrary, the professional liability policy shall be maintained, at ENGINEER's sole cost and expense. The retroactive date shall be no later than the commencement of the performance of this Contract and the discovery period (possibly through tail coverage) shall be no less than ten (10) years after the completion of work specified in this Contract. The provisions of this Article VII I shall survive the termination or expiration of this Agreement. ARTICLE IX. EMPLOYMENT OF AGENTS/RETAINING OF CONSULTANTS ENGINEER may employ or retain consultants, contractors, or third parties (any of which are referred to herein as "Subconsultant"), to perform certain duties of ENGINEER, as set forth on Exhibit attached hereto, under this Contract, provided that the CITY approves the retaining of Subconsultants. ENGINEER is at all times responsible to CITY to perform the Services as provided in this Agreement and ENGINEER is in no event relieved of any obligation under this Contract upon retainage of any approved Subconsultant. Any agent and/or Subconsultant retained and/or employed by ENGINEER shall be required by ENGINEER to carry, for the protection and benefit of the CITY and ENGINEER and naming said third parties as additional insureds, insurance as required of ENGINEER, as described above in this Contract. ENGINEER represents that such services are either under applicable value thresholds or are otherwise exempt from notice and/or bid requirements under Texas Law. ARTICLE X. CONFIDENTIALITY ENGINEER 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 XI. INDEMNITY ENGINEER SHALL INDEMNIFY AND SAVE HARMLESS THE CITY OF LUBBOCK AND ITS ELECTED OFFICIALS, OFFICERS, AGENTS, AND EMPLOYEES FROM ALL SUITS, ACTIONS, LOSSES, DAMAGES, CLAIMS, OR LIABILITY OF ANY KIND, 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, TO THE EXTENT ARISING OUT OF, RELATED TO, OR OCCASIONED BY, THE NEGLIGENT ACTS OF ENGINEER, ITS AGENTS, EMPLOYEES, AND/OR SUBCONSULTANTS, RELATED TO THE PERFORMANCE, OPERATIONS OR OMISSIONS UNDER THIS CONTRACT AND/OR THE USE OF OCCUPATION OF CITY OWNED PROPERTY. THE INDEMNITY OBLIGATION PROVIDED HEREIN SHALL SURVIVE THE EXPIRATION OR TERMINATION OF THIS AGREEMENT. ARTICLE XII. COMPLIANCE WITH APPLICABLE LAWS ENGINEER 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 XIII. NOTICE A. General. Whenever notice from ENGINEER to CITY or CITY to ENGINEER 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 (in which case such notice shall be effective upon delivery); (2) facsimile (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. ENGINEER's Address. ENGINEER's address and numbers for the purposes of notice are: Signature Automation, LLC. Attn: Henry J. Hidalgo, P.E. 14679 Midway Rd, Suite 205 Addison, Texas 75001 Telephone: (469) 619-1241 Facsimile: (469) 619-1242 C. CITY's Address. The CITY's address and numbers for the purposes of notice are: City of Lubbock Attn: John Turpin, P.E. P. O. Box 2000 1625 13th Street Lubbock, Texas 79457 Telephone: (806) 775-2342 Facsimile: (806) 775-3344 D. Change of Address. Either party may change its address or numbers for purposes of notice by giving written notice to the other party as provided herein, 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 XIV. CITY -PROVIDED DATA CITY shall furnish ENGINEER non -confidential studies, reports, and other available data in the possession of the CITY pertinent to ENGINEER's Services, so long as CITY is entitled to rely on such studies, reports, and other data for the performance of ENGINEER's Services under this Contract (the "Provided Data"). ENGINEER shall be entitled to use and rely, so long as such reliance is reasonable, upon all such Provided Data. ARTICLE XV. 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. ENGINEER shall provide access to its corporate books and records to the CITY. The CITY may audit, at its expense and during normal business hours, ENGINEER's books and records with respect to this Contract between ENGINEER and CITY. C. Records. ENGINEER shall maintain records that are necessary to substantiate the Services provided by ENGINEER. D. Assignability. ENGINEER 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 and ENGINEER, and in the case of CITY, its respective successors, legal representatives, and assigns, and in the case of ENGINEER, its permitted successors and assigns. F. Construction and Venue. THIS CONTRACT SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS. THIS CONTRACT IS PERFORMABLE IN LUBBOCK COUNTY, TEXAS. THE PARTIES HERETO HEREBY IRREVOCABLY CONSENT TO THE SOLE AND EXCLUSIVE JURISDICTION AND VENUE OF THE COURTS OF COMPETENT JURISDICTION 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 authorized and executed by ENGINEER and CITY. I. Entire Agreement. This Contract, including Exhibits "A" and "B" attached hereto, contains the entire agreement between the CITY and ENGINEER, and there are no other written or oral promises, conditions, warranties, or representations relating to or affecting the matters contemplated herein. J. No Joint Enterprise. Nothing contained herein shall be construed to imply a joint venture, joint enterprise, partnership or principal — agent relationship between ENGINEER and the CITY. K. Documents Owned by CITY. Any and all documents, drawings and specifications prepared by ENGINEER as part of the Services hereunder, shall become the property of the CITY when ENGINEER has been compensated as set forth in Article ll, above. The ENGINEER shall make copies of any and all work products for its files. L. Notice of Waiver. A waiver by either CITY or ENGINEER of a breach of this Agreement must be in writing and duly authorized to be effective. In the event either party shall execute and deliver such waiver, such waiver shall not affect the waiving party's rights with respect to any other or subsequent breach. M. Third Party Activities. Nothing in this Agreement shall be construed to provide any rights or benefits whatsoever to any party other than CITY and ENGINEER. N. Appropriation. All funds for payment by the CITY under this contract are subject to the availability of an annual appropriation for this purpose by the CITY. In the event of non -appropriation of funds by the CITY Council of the CITY of Lubbock for the goods or services provided under this Contract, the CITY will terminate the Contract, without termination charge or other liability, on the last day of the then current fiscal year or when the appropriation made for the then -current year for the services covered by this Contract is spent, whichever event occurs first (the "Non -Appropriation Date"). If at any time funds are not appropriated for the continuance of this Contract, cancellation shall be accepted by the Seller on thirty (30) days prior written notice, but failure to give such notice shall be of no effect and the CITY shall not be obligated under this Contract beyond the Non -Appropriation Date. EXECUTED as of the Effective Date hereof. CITY OF LUBBOCK Daniel M. Pope, Mayor ATTEST: -400 pj'o-�� Reb I ca Garza, City Secretary APPROVED AS TO CONTENT: Michael G. Keenum, P.E., City Engineer J n E. Turpin, P. ,E ief Water Utilities Engineer APPROVED AS TO FORM: SIGNATURE AUTOMATION, LLC. By: I� �.� Name: HenryJ idalgo, P.E. Title: Presi ent EXHIBIT A Scope of Services Applications Engineering Scope of Services Signature Automation, LLC will provide Applications Engineering Services (AES) to the City of Lubbock (City) at the North and South Water Treatment Plants within the bounds of the Phase 2 Improvements to the North and South Water Treatment Plants Project construction. The AES work for the North and South Water Treatment Plants will be executed as separate tasks according to the scope breakdown included herein and the cost breakdown included in EXHIBIT B of this contract. The scope of work included herein details our approach in executing the programming portion of the projects in conjunction with the City, Instrumentation and Control System Integrator (CSI) and General Contractor. General In general, Signature Automation's services include the following scope of work for this project: 1. Submittals 2. Creation and modifications to process graphics displays on the existing HMI system. 3. Memory map coordination to support the graphics integration with vendor control systems. 4. Modification of existing plant PLC programming and provision of new PLC programming for the control system as shown on the Drawings and Specifications. 5. Final documentation 6. System testing 7. User training 8. Project management 9. Clerical 10. Other direct costs related to the execution of this work. Task 1- North Water Treatment Plant AES Task 1.1— Project Management This task consists of clerical, accounting, coordination and supervision of the project team, and overall quality management so that the project milestones and deliverables meet schedule and budgetary constraints. To keep all parties apprised of our work on the project, all invoices shall include a progress report detailing work completed during the previous reporting period, anticipated work during the next reporting period, and a list of any outstanding items that are awaiting resolution. The initial invoice will include the costs to cover the preparatory planning, coordination, scheduling and accounting required to initiate the work. Exhibit A Page 1 EXHIBIT A Scope of Services DELIVERABLES ■ Monthly Progress Reports and Invoicing Task 1.2 — HMI Graphics and PLC Programming Signature Automation will program the new plant PLCs and vendor systems within this project into the Wonderware System Platform based SCADA system in accordance with the Specification requirements. Initially, Signature Automation will obtain copies of the existing Wonderware HMI programs for use as the basis for developing the new HMI programming. Signature Automation will also obtain a copy of the existing PLC program(s) for use as the basis for adding new I/O and functionality. Signature Automation will develop the new PLC programs and modified PLC programs in accordance with the Specification requirements. Coordination Meetings and Workshops To assist in the coordination of efforts of the various parties, Signature Automation anticipates attendance and participation at the following meetings: ■ KICKOFF MEETING (onsite '/2 -day meeting with CSI for the North Water Treatment Plant project) ■ PROGRESS MEETINGS, as Needed (no onsite meetings, up to (6) six 1 -hour meetings via conference call) Submittals /Shop Drawings Signature Automation will provide submittals related to the PLC and HMI programming effort throughout the duration of the project to the ENGINEER for review and concurrence that the work is progressing as intended. The submittals listed below will be provided. ■ AES PROGRAMMING SUBMITTAL - The programming submittal will include a PLC input/output list, control descriptions, and HMI graphic screen shots. Programming Within 180 days of notice to proceed, the control system integrator (CSI) shall deliver an early development system (EDS) to the Signature Automation's offices in Addison, Texas. The EDS shall include all necessary hardware and software to facilitate the applications software programming and testing by the AES. The CSI shall set up the EDS at the staging site and demonstrate to the AES that the EDS that it is functional and ready for programming. The PLC/RIO system setups shall be mounted on 19" vertical racks. The racks shall be mobile. Racks maximum height shall be 7'. All power supplies, network Exhibit A Page 2 EXHIBIT A Scope of Services communication equipment, and PLC/RIO appurtenances shall be mounted on the rack assemblies. The CSI shall be responsible for unloading the EDS and removing all EDS shipping cartons. When the EDS is ready for pickup by the CSI, the CSI shall furnish all packing cartons and materials necessary for the shipment of the EDS. The AES shall retain the EDS for a period of 6 months after the system has been received and set up at the AES's staging facility. The EDS shall include all necessary hardware and software to facilitate the PLC/RTU based system programming and testing. The system shall include as a minimum a fully functional GE RX3i PLC complete with chassis rack, power supply, CPU, network module(s), and one of each type of I/O card. The PLC system shall be as specified in Section 17300. During this time period, Signature Automation shall provide all programming, inclusive of HMI and PLC programming, based on the control narratives developed during the control narratives workshop. After the programming period has expired, the AES shall notify the CSI that they may retrieve the EDS for preparation for the unwitnessed factory test. All costs associated with shipping the EDS to/from the AES provider's staging facility shall be borne by the CSI. System Testing and Commissioning Signature Automation shall develop test procedures and forms for use as the basis for documenting acceptance testing of the applications throughout the various testing phases noted herein. Per specification section 17000-3.4-A.5.a, Signature Automation shall perform a Witnessed Factory Test at their facility to demonstrate the control schemes. The WFT defined in this Section shall be coordinated by the AES directly with the Owner. This test will be for the North Water Treatment Plant project. Before scheduling this Witnessed Factory Test, the AES must determine through its own quality assurance program that the equipment is ready for shipment. The purpose of the test shall be to verify the functionality, performance, and stability of the software developed by the AES. Successful completion of this test shall be the basis for approval of the system to be returned to the CSI for staging in preparation for the FAT referenced within Section 17000. Once the system is shipped and installed in the field, Signature Automation will provide onsite support for the I/O Point Checkout and a Functional Acceptance Exhibit A Page 3 EXHIBIT A Scope of Services Test (Specification Section 17000-3.4-A.5.a). The purpose of this test will be to confirm the I/O signals and applications programming are properly configured. All of the aforementioned application testing will be performed in accordance with Specification Section 17000. At the completion of each phase of the application testing, Signature Automation will provide electronic copies in PDF format of the signed off test procedures for the testing performed by Signature Automation to serve as record documents of the acceptance and approvals by the Owner and/or Engineer. DELIVERABLES ■ (1) one 1 -day trip for the project Kickoff Meeting ■ AES Programming Submittal ■ Up to (4) four 3 -day trips for field commissioning ■ Up to (3) four 2 -day trips for field testing ■ Copies of Witnessed Factory Test - Application Programming Sign Off Sheets ■ Copies of Functional Acceptance Test - Application Programming Sign Off Sheets Task 1.3 — Historical and Reports Programming Signature Automation will update the Wonderware Historian database and configure new PLC and RIO I/O points added within this project. Signature Automation will also create or modify up to three (3) single -page reports each containing up to a total of 25 Historian tags. DELIVERABLES Up to (3) three single -page reports Task 1.4 — Final Documentation and Warranty Signature Automation will assemble final documentation associated with the HMI and PLC application programming efforts in accordance with the requirements of the Specifications. It is anticipated that the CSI will use this as a section of their overall documentation package. Signature Automation will provide a warranty support service for the term designated by the construction contract and has included phone support, remote SCADA programming support, and up to (2) one one -day trips to the facility for warranty work. Warranty support is provided for only the systems associated with the work included within this task item. Warranty work will be documented within standard field trip/support forms and submitted to the Engineer and Owner for their records. Exhibit A Page 4 EXHIBIT A Scope of Services DELIVERABLES ■ AES Final Documentation — At the conclusion of the project, Signature Automation will provide documentation to include the final I/O list and memory mapping, graphics printouts and copies of the PLC programs developed by Signature Automation. Backup files of all HMI and PLC programming will also be included in electronic format. ■ Up to (2) one 1 -day trips for onsite warranty support work ■ Warranty Work Documentation Reports Task 1.5 — Training Signature Automation will conduct Training within the South WTP AES project task. Task 1 - Assumptions For the purposes of developing the costs associated with this effort, Signature Automation has assumed the following: 1. For budgetary purposes, Signature Automation has estimated twelve month duration for our efforts although the overall construction project duration may be longer. Should the duration of Signature Automation's efforts exceed this, additional costs will be billed to cover project management support of the contract and any other incurred costs. 2. All tasks include costs for project management, clerical, accounting, quality control, coordination and other associated work to execute each task. 3. Signature Automation is not responsible for delays due to negligence, non- performance, unanticipated slippage of delivery dates caused by others. 4. Signature Automation is not responsible for problems associated with any third - party software (HMI, OIT, PLC, drivers, operating system, etc.) 5. Signature Automation is not procuring any hardware or software for this assignment 6. Signature Automation to be provided electronic backup files of requested, existing HMI and PLC systems. 7. Signature Automation is not procuring any bonding for this project. 8. Signature Automation is not providing a services support contract. Signature Automation can supplement as requested for this using our standard billing rates. 9. The CSI will deliver an Early Development System to Signature Automation within 180 days of contract award, for a programming development period of 6 months, and within the conditions listed in the Programming section above. 10. AES work for the South WTP Improvements work is split into a separate tasks however, some items such as meetings, workshops and submittals will be combined for both AES tasks as noted herein. All AES training, the Historical Reports Workshop and submittal, and the Programming Workshop are provided within the South WTP Improvements AES task. Exhibit A Page 5 EXHIBIT A Scope of Services Task 2 - South Water Treatment Plant AES Task 2.1— Project Management This task consists of clerical, accounting, coordination and supervision of the project team, and overall quality management so that the project milestones and deliverables meet schedule and budgetary constraints. To keep all parties apprised of our work on the project, all invoices shall include a progress report detailing work completed during the previous reporting period, anticipated work during the next reporting period, and a list of any outstanding items that are awaiting resolution. The initial invoice will include the costs to cover the preparatory planning, coordination, scheduling and accounting required to initiate the work. DELIVERABLES ■ Monthly Progress Reports and Invoicing Task 2.2 — HMI Graphics and PLC Programming Signature Automation will program the new plant PLCs and vendor systems within this AES task into the Wonderware System Platform based SCADA system in accordance with the Specification requirements. Initially, Signature Automation will obtain copies of the existing Wonderware HMI programs for use as the basis for developing the new HMI programming. Signature Automation will also obtain a copy of the existing PLC program(s) for use as the basis for adding new I/O and functionality. Signature Automation will develop the new PLC programs and modified PLC programs in accordance with the Specification requirements. Coordination Meetings and Workshops To assist in the coordination of efforts of the various parties, Signature Automation anticipates attendance and participation at the following meetings: KICKOFF MEETING (onsite '/z -day meeting with CSI for the South Water Treatment Plant project) ■ PROGRESS MEETINGS, as Needed (no onsite meetings, up to (4) four 1 -hour meetings via conference call) PROGRAMMING WORKSHOP (joint meeting for both North and South Water Treatment Plant Projects) - Signature Automation will conduct and lead a Programming Workshop with the Design Engineer and the Owner at the Owner's facility. The purpose of this workshop is to gain input from the Design Engineer and Owner prior to submitting database, trends, graphics, and control strategies. The information gained in this workshop will be utilized to initiate the applications development efforts. Exhibit A Page 6 EXHIBIT A Scope of Services Submittals /Shop Drawings Signature Automation will provide submittals related to the PLC and HMI programming effort throughout the duration of the AES task to the ENGINEER for review and concurrence that the work is progressing as intended. The submittals listed below will be provided. ■ AES PROJECT PLAN - (joint submittal for both North and South Water Treatment Plant projects) A project plan documenting Signature Automation's methodologies for executing the work be provided 30 days after contract award. A project schedule will be provided for coordination with and inclusion in the General Contractor's overall construction schedule. ■ AES PROGRAMMING SUBMITTAL - The programming submittal will include a PLC input/output list, control descriptions, and HMI graphic screen shots. ■ AES HISTORICAL DATA MANAGEMENT SUBMITTAL - The historical data management submittal will be provided after the Historical Reports Workshop and include the historical reports that will be provided for the project. Programming Signature Automation will utilize the early development system (EDS) provided by the CSI for the North WTP Project to perform applications development at Signature Automation's offices in Addison, Texas. During this time period, Signature Automation shall provide all programming, inclusive of HMI and PLC programming, based on the control narratives developed during the control narratives workshop. System Testing and Commissioning Signature Automation shall develop test procedures and forms for use as the basis for documenting acceptance testing of the applications throughout the various testing phases noted herein. Per specification section 17000-3.4-A.5.a, Signature Automation shall perform a Witnessed Factory Test at their facility to demonstrate the control schemes. The WFT defined in this Section shall be coordinated by the AES directly with the Owner. This test will be for the South Water Treatment Plant project. Before scheduling this Witnessed Factory Test, the AES must determine through its own quality assurance program that the equipment is ready for shipment. The purpose of the test shall be to verify the functionality, performance, and stability of the software developed by the AES. Successful completion of this test shall be the Exhibit A Page 7 EXHIBIT A Scope of Services basis for approval of the system to be returned to the CSI for staging in preparation for the FAT referenced within Section 17000. Once the system is shipped and installed in the field, Signature Automation will provide onsite support for the I/O Point Checkout and a Functional Acceptance Test (Specification Section 17000-3.4-A.5.a). The purpose of this test will be to confirm the I/O signals and applications programming are properly configured. All of the aforementioned application testing will be performed in accordance with Specification Section 17000. At the completion of each phase of the application testing, Signature Automation will provide electronic copies in PDF format of the signed off test procedures for the testing performed by Signature Automation to serve as record documents of the acceptance and approvals by the Owner and/or Engineer. DELIVERABLES ■ (1) one 1 -day trip for the project Kickoff Meeting ■ (1) one 1 -day trip for the Programming Workshop ■ AES Project Plan Submittal ■ AES Programming Submittal ■ AES Historical Data Management Submittal ■ Up to (4) four 1 -day trips for field testing and commissioning ■ Copies of Witnessed Factory Test - Application Programming Sign Off Sheets ■ Copies of Functional Acceptance Test - Application Programming Sign Off Sheets Task 2.3 — Historical and Reports Programming Signature Automation will update the Wonderware Historian database and configure new and modified PLC I/O points added within this AES task. Signature Automation will also create or modify up to one (1) single -page report containing up to a total of 25 Historian tags. Coordination Meetings and Workshops To assist in the coordination of efforts of the various parties, Signature Automation anticipates attendance and participation at the following meetings: REPORTS WORKSHOP - (joint meeting for both North and South Water Treatment Plant projects) After commissioning of the system and a time period where the City can operate and become proficient with the new Wonderware system, but no later than 3 months after commissioning, Signature Automation will conduct and lead a Reports Workshop with the Design Engineer and Owner at the Owner's Facility. The purpose of this Exhibit A Page 8 EXHIBIT A Scope of Services workshop is to develop the criteria for the types of reports to be provided within this project. DELIVERABLES (1) one 1 -day trip for the Reports Workshop Up to (1) one single -page report Task 2.4 — Final Documentation and Warranty Signature Automation will assemble final documentation associated with the HMI and PLC application programming efforts in accordance with the requirements of the Specifications. It is anticipated that the CSI will use this as a section of their overall documentation package. Signature Automation will provide a warranty support service for the term designated by the construction contract and has included phone support, remote SCADA programming support, and up to (1) one one -day trip to the facility for warranty work. Warranty support is provided for only the systems associated with the work included within this task item. Warranty work will be documented within standard field trip/support forms and submitted to the Engineer and Owner for their records. DELIVERABLES AES Final Documentation — At the conclusion of the project, Signature Automation will provide documentation to include the final I/O list and memory mapping, graphics printouts and copies of the PLC programs developed by Signature Automation. Backup files of all HMI and PLC programming will also be included in electronic format. Up to (1) one 1 -day trip for onsite warranty support work Warranty Work Documentation Reports Task 2.5 — Training Signature Automation will conduct Training in accordance with the Specification requirement as listed below and provide training specific to HMI and PLC programming implementation and support the CSI in conducting operator -overview training. This training will cover both the North and South Water Treatment Plant Projects. Category Description Duration Sessions Students Training Class Operations Training 4 hours l 4 Training Class Operations Follow up Training 4 hours 2 4 Exhibit A Page 9 EXHIBIT A Scope of Services DELIVERABLES ■ AES TRAINING PLAN - The Training Plan Submittal shall be provided to detail the training that is to be provided by the AES. This submittal will include preliminary agendas and a proposed schedule for each training session. ■ Training Manuals - 4 training manuals for each training class listed. Task 2 - Assumptions For the purposes of developing the costs associated with this effort, Signature Automation has assumed the following: 1. For budgetary purposes, Signature Automation has estimated six month duration for our efforts although the overall construction project duration may be longer. It is assumed that the schedule for South WTP AES and construction work will be concurrent and within the duration of the North WTP project construction schedule. Should the duration of Signature Automation's efforts exceed this, additional costs will be billed to cover project management support of the contract and any other incurred costs. 2. All tasks include costs for project management, clerical, accounting, quality control, coordination and other associated work to execute each task. 3. Signature Automation is not responsible for delays due to negligence, non- performance, unanticipated slippage of delivery dates caused by others. 4. Signature Automation is not responsible for problems associated with any third - party software (HMI, OIT, PLC, drivers, operating system, etc.) 5. Signature Automation is not procuring any hardware or software for this assignment 6. Signature Automation to be provided electronic backup files of requested, existing HMI and PLC systems. 7. Signature Automation is not procuring any bonding for this project. 8. Signature Automation is not providing a services support contract. Signature Automation can supplement as requested for this using our standard billing rates. 9. Signature Automation will utilize the Early Development System provided by the CSI for the North WTP to develop programming for the South WTP project. 10. AES work for the North WTP Improvements work is split into a separate task however, some items such as meetings, workshops and submittals will be combined for both projects as noted herein. All AES training, the Historical Reports Workshop and submittal, and the Programming Workshop are provided within this South WTP Improvements AES task. Exhibit A Page 10 EXHIBIT B Fee Structure Applications Engineering Fee Structure Task 1- North WTP AES Cost Breakdown Signature Automation will complete North Water Treatment Plant AES Task Iwork for the Phase 2 Improvements to North and South Water Treatment Plants Project on a lump sum basis for a fee of $149,500. The breakdown of this cost for each work subtask is as follows: 1. Task 1.1 — Project Management 2. Task 1.2 — HMI Graphics and PLC Programming a. AES Meetings and Workshops $ 4,250 b. AES Submittals $ 5,950 c. HMI Graphics Programming $ 23,400 d. PLC Programming $ 35,600 e. Testing and Commissioning $ 47,000 3. Task 1.3 — Historical and Reports Programming 4. Task 1.4 — Final Documentation and Warranty Task 2 - South WTP AES Cost Breakdown $ 13,950 $116,200 (Total) $ 7,850 $ 11,500 Signature Automation will complete South Water Treatment Plant AES Task Iwork for the Phase 2 Improvements to North and South Water Treatment Plants Project on a lump sum basis for a fee of $49,500. The breakdown of this cost for each work subtask is as follows: 1. Task 2.1 — Project Management 2. Task 2.2 — HMI Graphics and PLC Programming a. AES Meetings and Workshops $ 9,050 b. AES Submittals $ 5,600 c. HMI Graphics Programming $ 3,700 d. PLC Programming $ 3,700 e. Testing and Commissioning $ 8,050 3. Task 2.3 — Historical and Reports Programming 4. Task 2.4 — Final Documentation and Warranty 5. Task 2.5 — AES Training $ 2,150 $ 30,100 (Total) $ 4,900 $ 2,450 $ 9,900 Exhibit B Page 1 EXHIBIT B Fee Structure Total Project AES Cost Signature Automation will perform the above scope of work in accordance with mutually acceptable terms and conditions. These task items are for AES work and consists of all supervision, labor, testing, incidentals, and related items required to program the specified Programmable Logic Controllers and Wonderware process control software in accordance with the Engineer's Specifications Sections, complete in place. Progress invoices will be made on a monthly basis throughout the duration of the contract and will total the lump sum task and overall prices set forth in the contract. The total project cost for both Task 1 and Task 2 AES work will be provided on a lump sum basis fee of $199,000. Additional work beyond the scope of this project will be billed on a Time and Materials basis at Signature Automation's standard billing rates and direct costs of reimbursable travel expenses plus a ten -percent administrative fee. Exhibit B Page 2 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-117090 Signature Automation, LLC Addison, TX United States Date Filed: 09/27/2016 2 Name of governmental entity or state agency that is a party to the contract for which theo- m is being filed. City of Lubbock Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identity the contract, and provide a description of the services, goods, or other property to be provided under the contract. 12766 Improvements to the North and South Water Treatment Plants Engineer-of-Record Construction Phase Services 4 Name of Interested Parry City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Hidalgo, Henry Addison, TX United States X Patel, Kevin Addison, TX United States X Whitaker, Brett Addison, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. RACHEL CALHOUN I Notary Public, State of Texas Comm. Expires 03-29.2020 fill ,,.�� Notary ID 126771654 Signature of authorized a c tracting business entity AFFIX NOTARY STAMP / SEAL ABOVE JI Swo n to and subscribed before me, by the said V this the 20, to certify which, witness my hand and seal of offi 27 day of Signature of officer administering oath Printed name of officer administering oath Titl f officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (M07/22/16 ] PRODUCER THIS CERTIFICATE ISSUED AS A MATTER OF INFORMATION ONLY POLICY NUMBER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. Drawbridge Insurance Services, LLC P.O. Box 42 - 5788 York Rd THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE Buckingham, PA 18931 INSURED INSURER A: Lloyd's of London SIGNATURE AUTOMATION LLC 14679 MIDWAY RD INSURER B: INSURER C: INSURER D: STE 205 ADDISON, TX 75001 INSURER E: COVERAGES THE POLICES 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. INS LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXP DATE MM/DD/YY LIMITS CITY OF LUBBOCK, TX 79457 GENERAL LIABILITY ❑ COMMERCIAL GENERAL LIABILITY [--]CLAIMS MADE ❑ OCCUR ❑ AUTHORIZED REPRESENTATIVE MLokcid Kdhm EACH OCCURRENCE GENERAL AGGREGATE PRODUCTS COMPLETED OPS PREMISES DAMAGE LIMIT ❑ MEDICAL EXPENSES LIMIT GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ PROJECT ❑ LOC AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS [—]SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS ❑ ❑ COMBINED SINGLE LIMIT (Ea Accident) BODILY INJURY (per person) BODILY INJURY (per accident) PROPERTY DAMAGE (Per accident) 8 PROFESSIONAL LIABILITY/ TECHNOLOGY ERRORS & OMISSIONS ❑ OCCUR ® CLAIMS MADE ® DEDUCTIBLE: $7,500 ❑ RETENTION ESE03165533 01/04/16 01/04/17 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATUTORY LIMITS E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS: THE LLOYD'S POLICY HAS BLANKET ADDITIONAL ISURED STATUS. THE CITY OF LUBBOCK IS AN ADDITIONAL INSURED. CERTIFICATE HOLDER IN] ADDITIONAL INSURED. INSURER LETTER _0 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE THE CITY OF LUBBOCK EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL PO BOX 2000 1625 13TH STREET —_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINDUPON THE INSURER, ITS AGENTS OR REPRESENTATIVES CITY OF LUBBOCK, TX 79457 AUTHORIZED REPRESENTATIVE MLokcid Kdhm A � b® CERTIFICATE OF LIABILITY INSURANCE DATE 09/27/201/YYYY) 09/27/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER INSURETRUST COM LLC PO BOX 920398 NORCROSS, GA 300100398 (888) 661-3938 CONTACT a/CNNo Ext): aee 661 .3938 AIC No : 686 872.8921 ADDRESS: Serviee.cente ravelers.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA INSURED SIGNATURE AUTOMATION LLC 14679 MIDWAY RD STE 205 ADDISON, TX 75001 INSURER B: THE TRAVELERS INDEMNITY COMPANY INSURER C: THE STANDARD FIRE INSURANCE COMPANY INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 897682214361172 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X 680-7C319065-16 01/04/2016 01/04/2017 EACH OCCURRENCE $1 000000 DAMAGE TO RFNTE Ljs300,OOO CLAIMS -MADE OCCUR MED EXP (Any one arson $5,000 X HIRED AUTO PERSONAL 8 ADV INJURY $1,000,000 X NON OWNED AUTO GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT LOC GENERAL AGGREGATE $2000000 PRODUCTS - COMP/OP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS BODILY INJURY Per acddent) $ ( HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Peraccident) $ B X UMBRELLA LIAB X OCCUR CUP -7C319378-16 01/04/2016 01/04/2017 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $4,000,000 DEDI X I RETENTION $5,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N N/A X UB -8D221946-15 11/25/2015 11/25/2016 p X STATUTE ERH E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 ,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Addlaonal Remarks Schedule, may be attached H more space Is required) AS RESPECTS TO GENERAL LIABILITY, CERTIFICATE HOLDER IS ADDITIONAL INSURED - OWNERS/LESSEES/CONTR CG D1 05 BUT ONLY AS RESPECTS TO WORK PERFORMED BY THE INSURED FOR CONTRACT #12766. AS RESPECTS TO GENERAL LIABILITY, SUBROGATION AGAINST CERTIFICATE HOLDER HAS BEEN WAIVED PER TECHNOLOGY XTEND ENDORSEMENT, CG D4 17. AS RESPECTS TO WORKERS COMPENSATION COVERAGE, WC 42 03 04 - TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT HAS BEEN ATTACHED TO THE POLICY. THE CITY OF LUBBOCK IS LISTED IN THE ENDORSEMENT SCHEDULE AS A DESIGNATED PERSON OR ORGANIZATION. CITY OF LUBBOCK PO BOX 2000 1625 13TH STREET LUBBOCK, TX 79457 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 (,' I � • ���, ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD iiR A"el C�C��a WORKERS COMPENSATION I�1/GLG S7 AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 42 03 04 ( B) — 008 POLICY NUMBER: (ICUB-BD22194-6-15) TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A, of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ® Specific Waiver Name of person or organization CITY OF LUBBOCK CONTRACT #12766 ❑ Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: COMPUTER PROGRAMMING 3. Premium: The premium charge for this endorsement shall be 5 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: SEE SCHEDULE 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 Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 09-27-16 ST ASSIGN: Page 1 of 1 0 Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: 1. WHO IS AN INSURED (SECTION II) is amended to include as an insured any person or organiza- tion (called hereafter "additional insured") whom you have agreed in a written contract, executed prior to loss, to name as additional insured, but only with respect to liability arising out of "your work" or your ongoing operations for that addi- tional insured performed by you or for you. 2. With respect to the insurance afforded to Addi- tional Insureds the following conditions apply: a. Limits of Insurance — The following limits of liability apply: 1. The limits which you agreed to provide; or 2. The limits shown on the declarations, whichever is less. b. This insurance is excess over any valid and collectible insurance unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. 3. This insurance does not apply: a. on any basis to any person or organization for whom you have purchased an Owners and Contractors Protective policy. b. to "bodily injury," "property damage," "per- sonal injury," or "advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, in- cluding: 1. The preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, change or- ders, designs or specifications; and 2. Supervisory, inspection or engineering services. CG D1 05 04 94 Copyright, The Travelers Indemnity Company, 1994. Page 1 of 1 Includes Copyrighted Material from Insurance Services Office, Inc. POLICY NUMBER: COMMERCIAL GENERAL LIABILITY ISSUE DATE: - - THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON(S) OR ORGANIZATION(S): PROJECT/LOCATION OF COVERED OPERATIONS: 1. WHO IS AN INSURED - (Section II) is amended b) The insurance provided to the additional in- to include the person or organization shown in the sured does not apply to "bodily injury", "prop - Schedule above, but: erty damage" or "personal injury" arising out a) Only with respect to liability for "bodily injury", of the rendering of, or failure to render, any "property damage" or "personal injury"; and professional architectural, engineering or sur- veying services, including: b) If, and only to the extent that, the injury or damage is caused by acts or omissions of i. The preparing, approving, or failing to you or your subcontractor in the performance prepare or approve, maps, shop draw - of "your work" on or for the project, or at the ings, opinions, reports, surveys, field or - location, shown in the Schedule. The person ders or change orders, or the preparing, or organization does not qualify as an addi- approving, or failing to prepare or ap- tional insured with respect to the independent prove, drawings and specifications; and acts or omissions of such person or organiza- ii. Supervisory, inspection, architectural or tion. engineering activities. 2. The insurance provided to the additional insured c) The insurance provided to the additional in - by this endorsement is limited as follows: sured does not apply to "bodily injury" or a) In the event that the Limits of Insurance of "property damage" caused by "your work" this Coverage Part shown in the Declarations and included in the "products -completed op - exceed the limits of liability required by a erations hazard" unless a "written contract "written contract requiring insurance" for that requiring insurance" specifically requires you additional insured, the insurance provided to to provide such coverage for that additional the additional insured shall be limited to the insured, and then the insurance provided to limits of liability required by that "written con- the additional insured applies only to such tract requiring insurance". This endorsement "bodily injury" or "property damage" that oc- shall not increase the limits of insurance de- curs before the end of the period of time for scribed in Section III - Limits Of Insurance. which the "written contract requiring insur- ance" requires you to provide such coverage CG D2 47 08 06 0 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible 'other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if a "written contract requiring insurance" for that ad- ditional insured specifically requires that this in- surance apply on a primary basis or a primary and non-contributory basis, this insurance is pri- mary to 'other insurance" available to the addi- tional insured which covers that person or organi- zation as a named insured for such loss, and we will not share with that 'other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible 'other insurance", whether pri- mary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional in- sured under such 'other insurance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: 1. How, when and where the 'occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit' is brought against the additional insured, the additional insured must: L Immediately record the specifics of the claim or "suit' and the date received; and fl. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit' to any provider of 'other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to 'other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 0 2005 The St. Paul Travelers Companies, Inc. CG D2 47 08 05 CERTIFICATE OF INTERESTED PARTIES FORM 1295 10f1 Complete Nos.1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-117090 Signature Automation, LLC Addison, TX United States Date Filed: 09/27/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock Date Acknowledged: 10/13/2016 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 12766 Improvements to the North and South Water Treatment Plants Engineer -of -Record Construction Phase Services 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Hidalgo, Henry Addison, TX United States X Patel, Kevin Addison, TX United States X Whitaker, Brett Addison, TX United States X 5 Check only if there is NO Interested Party. 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said this the day of 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 loll Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-117090 Signature Automation, LLC Addison, TX United States Date Filed: 09/27/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 12766 Improvements to the North and South Water Treatment Plants Engineer-of-Record Construction Phase Services Nature of interest 4 Name of Interested Party City, State, Country (place of business) {check applicable) Controlling Intermediary Hidalgo, Henry Addison, TX United States X Patel, Kevin Addison, TX United States X Whitaker, Brett Addison, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. r�tjir►�'10 RACHEL CAlHOUN r�� f ~`` - Notary Public, State of Texas , �� N.�` 4' Comm. Expires 03-29-2020 ....• Notary ID 126771654 Signature of authorized a c tracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn before by the this the 2?� day to and subscribed me, said, of 20V, to certify which, witness my hand and seal of ofti f, twx�--- - - Signature of officer administering oath Printed name of officer administering oath Titl f officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277