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HomeMy WebLinkAbout5730AGENDA BILL CITY OF BREMERTON 7D CITY COUNCIL i SUBJECT: Public Works Agreement with Study Session Date: July 26, 2017 MacDonald -Miller Facility Solutions of COUNCIL MEETING Date: August 2, 2017 Tacoma, WA for the Replacement of the Department: PW & U HVAC 50 -ton Bitzer Compact Screw Presenter: _Wayne Hamilton Compressor for Kitsap Conference Center Phone: (360) 473-5207 SUMMARY: Request for proposals were prepared and solicited through the City's MRSC Small Works Roster program to four (4) large commercial HVAC contractors, and received in accordance with City Bid procedures. One (1) Bid was received. The low bidder is MacDonald -Miller Facility Solutions of Tacoma, Washington. This company is the original HVAC equipment installation contractor for the Conference Center/Harbor side Facility. ATTACHMENTS: 1) Bid Proposal from MacDonald -Miller Facility Solutions 2) Public Works Agreement FISCAL IMPACTS (Include Budgeted Amount): 2017 Conference Center Capital Improvements - $45,000.00. HVAC Unit Compressor Replacement. Project cost = $42,903.49 STUDY SESSION AGENDA: N No Presentation ❑ Full Presentation STUDY SESSION ACTION: © Consent Agenda ❑ General Business ❑ Public Hearing, RECOMMENDED MOTION: Move to approve the low bid of MacDonald -Miller Facility Solutions in the amount of $42,903.49; and authorize the Mayor to finalize and execute the agreement with substantially the same terms and conditions as presented. COUNCIL ACTION: Form Updated 01/07/15 [Approve ❑ Deny ❑ Table ❑ Continue ❑ No Action f DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C PUBLIC WORKS AGREEMENT THIS AGREEMENT, is entered into between the City of Bremerton, a Washington Municipal Corporation ("City"), and MacDonald — Miller Facility Solutions. ("Contractor"), whose mailing address is 2500 S. Holgate Street, Tacoma, WA 98402. The parties agree as follows: 1. CONTRACTOR SERVICES. The Contractor shall perform the following services for the City: Replacement of faulty HVAC 50 -ton Bitzer Compact Screw Compressor and all associated work to provide a completed project and warranty, per City project specifications and Contractor Proposal # 17022R1 MP. To the extent that the terms of Contractor's Proposal #17022R1 MP conflict with this Agreement, this Agreement shall control. 2. TIME OF COMPLETION. Contractor shall complete the work within 60 calendar days from the date of issuance of the City's Notice to Proceed. 3. COMPENSATION. The City shall pay the Contractor the total amount of $ 25,217.00, plus any applicable Washington State Sales Tax, for the work and services rp contemplated in this agreement. The Contractor shall invoice the City monthly. The City will pay for the portion of the work described in the invoice that ;has been completed by the Contractor and approved by the City. The City payment shall not constitute a waiver of the City's right to final inspection and acceptance of the project. A. :Performance Bond. Pursuant to Chapter 39.08 RCW, the Contractor, shall provide the City a performance bond for the full contract amount to be in effect until sixty (60) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue and the State Department of Labor and Industries and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. B. Retainage. The City shall hold back a retainage in the amount of five percent (5%) of any and all payments made. to contractor for a period of sixty (60) days after the date of final acceptance, or until receipt of all necessary releases from the State Department of Revenue and the State Department of Labor & Industries and until settlement of any liens filed under Chapter 60.28 RCW, whichever is later. C. Defective or Unauthorized Work. The City reserves its right to withhold payment from Contractor for any defective or unauthorized work. Defective or unauthorized work includes, without limitation: work and materials that do not conform to the requirements of this agreement; and extra work and materials fizrnished without the City's written approval. If PUBLIC WORKS AGREEMENT —Page 1 of 10 (between City of Bremerton and _MacDonald - MillerJ DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C Contractor is unable, for any reason, to satisfactorily complete any portion of the work, the City may complete the work �by contract or otherwise, and Contractor shall be liable to the City for any, additional costs' incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Contract price specified above. The City further reserves its right to deduct the cost to complete the Contract work, including any Additional Costs, from any and all amounts due or to become due the Contractor. D. Final Payment: Waiver of Claims. PAYMENT (EXCLUDING WITHHI CONSTITUTE A WAIVER OF ( PREVIOUSLY AND PROPERLY M) CONTRACTOR AS UNSETTLED AT FINAL PAYMENT IS MADE. MAKING OF FINAL RETAINAGE) SHALL AS, EXCEPT THOSE AND IDENTIFIED BY TIME REQUEST FOR 4. INDEPENDENT CONTRACTOR Contractor is and shall be at all times acting as an independent contractor and not as an employee of the City. The Contractor shall secure at its expense, and shall be responsible for all payments of income tax, social security, state disability insurance compensation, unemployment compensation, and all other payroll deductions for the Contractor, officer, agents, employees and subs -contractors. The Contractor shall also secure all applicable business licenses, if required, in connection with the contract services, including all required licenses for Contractor's officers,) agents, employees and sub- contractors. 5. TERMINATION. The City may terminate this agreement for good cause. "Good cause" shall include, without limitation, any one or more of the following events: A. The Contractor's refusal or failure to properly skilled workers or proper r Contract work. B. The Contractor's failure to complete the this agreement. C. The Contractor's failure to make subcontractors or for material or labor. D. The Contractor's persistent disregard,of or regulations. E. The Contractor's filing for bankruptcy or a sufficient number of for completion of the within the time specified in and prompt payment to state or local laws, rules adjudged bankrupt. If the City terminates this agreement for good cause, the Contractor shall not receive any further monies due under this agreement until the Contract work is ;completed. PUBLIC WORKS AGREEMENT — Page 2 of 10 (between City of Bremerton and _MacDonald - Miller j DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C 6. PREVAILING WAGES. Contractor shall file a Prevailing Wages," with the State of Washington Department of commencing the Contract work. Contractor shall pay prevailing wa 39.12 of the Revised Code of Washington, as well as any other ap provisions. The latest prevailing wage rate revision issued by tl Industries is attached. 7. CHANGES. The City may issue a written work chz in the Contract work during the performance of this agreement. If f any reason, that a change order is necessary, Contractor must su request to the City's project manager within two (2) business da} knew or should have known of the facts and events giving rise to City determines that the change increases or decreases the Co performance, the City will make an equitable adjustment. The City reach agreement with the Contractor on all equitable adjustments. unable to agree, the City will determine the equitable adjustment , Contractor shall proceed with the change order work upon recei directive or change order from the City. If the Contractor fails to r the time allowed, the Contractor waives its right to make any claim order requests for that portion of the contract work. If the G equitable adjustment the Contractor must complete the change Contractor may elect to protest the adjustment as provided below: tatement of Intent to Pay ibor & Industries prior to s and comply with Chapter cable prevailing wage rate Department of Labor and ge directive for any change Contractor determines, for mit a written change order of the date the Contractor ie requested change. If the tractor's costs or time for rill attempt, in good faith, to However, if the parties are it deems appropriate. The ing a written work change quire a change order within r submit subsequent change itractor disagrees with the order work; however, the A. ,'Procedure and Protest by the Contractor. If the Contractor disagrees with anything required by a work change directive or change order, including any direction, instruction, interpretation, or determination by the City, the Contractor shall: 1. Immediately give a signed written notice of protest to the City; 2. Supplement the written protest within fourteen (14) calendar days with a written statement that provides the following information: a. The date of the Contract's protest. b. The nature and circumstances that caused the protest. C. The provisions in this agreement that support the protest. d. The estimated dollar cost, if any, of the protested work and how that estimate was determined. e. An analysis of the progress schedule showing the schedule change or disruption if the Contractor is asserting a schedule change or disruptions. The Contractor shall keep complete records of extra costs and time incurred as a result of the protested work. The City shall have access to any of the Contractor's records needed for evaluating the protest. PUBLIC WORKS AGREEMENT — Page 3 of 10 (between City of Bremerton and MacDonald - Millerj DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C 3. The City will evaluate all protests, section are followed. If the City d the City will adjust payment for adjustment. No adjustment will be ided the procedures in this lines that a protest is valid, or time by an equitable for an invalid protest. B. .Contractor's Duty to CompleteProtested Work. In spite of any protest, the Contractor shall proceed promptly with the work as the City has ordered. C. Contractor's Acceptance of Changes. The Contractor accepts all requirements of a change order by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. A change order that is accepted by Contractor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Contractor also waives any, additional entitlement and accepts from the City any written order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Contractor completely waives any claims for protested work and accepts form the City any written order (including directions, instructions, interpretations, and d'etermination). 8. CLAIMS. The Contractor shall give written notice ito the City of all claims other than change orders within fourteen (14) calendar days of the occurrence of the events giving rise to the claims. Any claim for damages, additional payment for any reason, or extension of time, whether under this agreement or otherwise, shall be conclusively adeemed to have been waived by the Contractor unless a timely written claim is made in strict accordance with the applicable provisions of this agreement; or, if (and only if) no such provision is applicable, unless that claim is set forth in detail in writing and received by the City within seven (7) calendar days from the date Contractor knew, or should have known, of the facts giving rise to the claim. At a minimum, a Contractor's written claim must include the information set forth regarding protests in Section 7.A.2.a.-e. FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. Contractor must, in any event, file any claim or bring any ;suit arising from or connected with this agreement within 120 calendar days from the date the contract work is complete. PUBLIC WORKS AGREEMENT — Page 4 of 10 (between City of Bremerton and _MacDonald - MillerJ DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C 9. WARRANTY. The Contractor shall correct all defects in workmanship and materials within one year from the date of the City's acceptance of the Contract work. When defects are corrected, the warranty for that portion of the work shall extend for one year form the date such correction is completed and accepted by the City. The Contractor shall begin to correct any defects within seven (7) calendar days of its receipt o i notice from the City of the defect. If the Contractor does not accomplish the corrections within a reasonable time, the City may complete the corrections and the Contractor shall pay all costs incurred by the City in order to accomplish the correction. 10. INDEMNIFICATION. Contractor shall defend, indemnify and hold the City, its officer, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits including all legal costs and attorney fees, arising out of or in connection with the performance of this agreement, except for injuries and damages caused by the City's sole negligence. The City's inspection or acceptance of any of Contractor'sl work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Contractor and the City, its officials, employees, agents and volunteers, the Contractor's liability hereunder shall be only to the extent of the Contractor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THIS INDEMNIFICATION CONSTITUTES THE CONTRACTOR'S I WAIVER OF IMMUNITY UNDER .INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSE OF THIS INDEMNIFICATION. THE PARTIES ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. The provisions of this section shall survive the expiration or termination of this agreement. 11. INSURANCE. The Contractor shall procure and maintain for the duration of this agreement insurance of the types and in the amounts described below against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work by the Contractor, its agents, representative, employees, subconsultants or subcontractors. Before beginning work on the project described in this agreement, the Contractor shall provide a Certificate of Insurance evidencing: PUBLIC WORKS AGREEMENT — Page 5 of 10 (between City of Bremerton and MacDonald - Millerj DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C 1. Automobile Liability insurance with limits Ino less than $1,000,000 combined single limit per accident for bodily injury and property damage; and 2. Commercial General Liability insurance wi with limits no less than $1,000,000 combine and $2,000,000 general aggregate for perso property damage. Coverage shall include b contractual; products/completed operationsA explosion, collapse and underground (XCU); en on an occurrence basis single limit per occurrence .l injury, bodily injury and not be limited to: blanket gad form property damage; id employer's liability. 3. Excess Liability insurance with limits note less than $1,000,000 per occurrence and aggregate. Any payment of deductible or self insured retention shallbe the sole responsibility of the Contractor. The City, its officials, employees, agents and volunteers shall be named as an additional insured on the insurance policy, as respects work performed by or on behalf of the Contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The Contractor's insurance shall contain a clause stati I that coverage shall apply Ig g ppY separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. The Consultant's insurance shall be primary and non-contributory insurance as respects the City and shall contain a waiver of subrogation against the Cityl for claims arising out of any operations, liabilities and obligations to which coverage applies! It shall be an affirmative obligation upon Consultant to advise the City's Risk Manager by fax at (360) 473-5161, or by certified mail, return receipt requested to City of Bremerton, attri: Risk Management, 345 6`h Street, Suite 600, Bremerton, WA 98337 within two days of the cancellation, suspension or substantive change of any insurance policy set out herein, and failure to do so shall be construed to be a breach of this Agreement. The City reserves the right to receive a certified copy policies. 12. MISCELLANEOUS. all the required insurance A. Nondiscrimination. In the hiring of employees for the performance of work under this Agreement or any sub -contract hereunder, the Contractor, its sub -contractors, or any person acting on behalf of such Contractor or sub -contractor shall not, by reason of race, religion, color, sex, national origin, or the presence of any sensory,' mental, physical disability, or PUBLIC WORKS AGREEMENT — Page 6 of 10 (between City of Bremerton and _MacDonald - Millerj DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C sexual orientation discriminate against any person who is qualified and available to perform the work to which the employment relates. B. Compliance with Laws. Contractor shall comply with all federal, state and local laws, rules and regulations throughout every aspect in the performance of this agreement. C. Work Performed at Contractor's Risk. lContractor shall take all precautions necessary and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of this agreement. All work shall 'be done at Contractor's own risk, and Contractor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. D. Nonwaiver of Breach. The failure of the! City to insist upon strict performance of any of the terms and rights contained herein, or to exercise any option herein . conferred in one or more instances, shall not be constructed to be a waiver or relinquishment of those terms and rights and they shall remain in full force and effect E. Governing Law. This agreement shall be Igoverned and construed in accordance with the laws of the State of Washington. If any dispute arises between the City and Contractor under any of the provisions of this agreement, resolutIion of that dispute shall be available only through the jurisdiction, venue and rules of the Kitsap County Superior Court, Kitsap County, Washington. F. Attorney's Fees. To the extent not inconsistent with RCW 39.04.240, in any claim or lawsuit for damages arising from the parties' performance of this agreement, each party shall be responsible for payment of its own legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit; however, nothing in this subsection shall limit the City's right to indemnification under Section 10 of this agreement. G. Written Notice. All communications regarding this agreement shall be sent to the parties at the addresses listed on the signature page of this agreement, unless otherwise notified. Any written notice shall become effective upon delivery, but in any event three (3) calendar days after the date of mailing by registered or, certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated on this agreement. H. Assilmment. Any assignment of this agreement by the Contractor without the written consent of the City shall be void. I. Modification. No waiver, alteration, or modification of any of the provisions of this agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Contractor. J. Severability. If any one or more sections, ;sub -sections, or sentences of this agreement are held to be unconstitutional or invalid, that decision shall not affect the validity PUBLIC WORKS AGREEMENT — Page 7 of 10 (between City of Bremerton and MacDonald - MillerJ DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C of the remaining portion of this agreement and the remainder effect. K. Entire Agreement. The written provisions together with any attached Exhibits, supersede all prior verbal stat of the City, and those statements shall not be construed as formin manner this agreement. This agreement and any attached Exhibits between the parties. Should any language in any Exhibit to this language contained in this agreement, the terms of this agreement sl IN WITNESS WHEREOF, the parties below have executed CONTRACTOR G�mob: UJ� Stephanie Gebhardt Print Name: Title: CFO DATE 8/23/2017 Notices to be sent to: CONTRACTOR: MacDonald -Miller Facility Solutions, Inc. 7717 Detroit Ave SW Seattle, WA 98106 R:\LEGAL\Contracts\FORMS\ShortForm.PW.Agr.doe PUBLIC WORKS AGREEMENT — Page 8 of 10 (between City of Bremerton and _MacDonald - Millerj THE remain in full force and d terms of this agreement, rents by any representative a part of or altering in any Dntain the entire agreement ;reement conflict with any J prevail. agreement. OF BREMERTON Print Name• 2-Zr Title: D I le DATE Notices to be sent to: CITY OF BREMERTON: L+L4Ion 8rerner4pn loo 0 +cam r 6U_u Ave N Bremerton, WA � 6317- (360) 0 3 - 231 (;� (360)4-,'1'3 - 531.0 (facsimile) APPROVED AS TO FORM: W ty DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C May 23, 2017 Chris Mottner City of Bremerton Facilities Division Bremerton, WA 98337 Address: Kitsap Conference Center 100 Washington Ave Bremerton, WA Subject: Kitsap Conference Center Mammoth Unit 60 -ton Dear Name Chris, MacDonald -Miller Facility Solutions is pleased to provide you with the follo existing 50 ton BITZER Compressor. During survey of the compressor it v refrigeration was burnt due to possible compressor winding failure. This p Core assembly to assist in cleaning up the existing refrigeration. The cost per pound to MacDonald -Miller and your existing Mammoth VCUBE unit h in the system. MacDonald -Miller will perform several acid washes and dry the existing refrigeration. This process will impact the time needed to repl the longevity of a new compressor. This proposal will include alternative p Bremerton purchasing the BITZER 50 -ton Compressor and handling the C INCLUSIONS • Safe Off/Lock Out/Tag Out electrical connections and refrigeration • Vacuum/remove refrigeration for compressor change out. • Demo/remove existing BITZER 50 -ton compressor, and prepare fc reimbursement. • Provide/install (1) BITZER Compressor o Model CSH6553-50-4PU o Compact Screw Compressor • Provide/install rigging/chain fall for removal/install of existing/new • Provide/install (1) ball valve for future filter/compressor change oui • Provide/install (1) Suction Filter Kit Assembly. • Provide several acid washes of core refrigeration system for clean • Provide/install dryer filters changes during acid washing of refriger • Provide/include system neutralizers for refrigeration system. • Provide/include acid testing kits. • Provide/install oil changes for new compressor. • Provide/install new contactor for new compressor. • Provide start-up of new compressor. macmillercom 1.800.962-5979 WASHINGTON & OREGON MacDonald -Miller 1AAAAXFAciLrrY SOUMONSe We make buildings work better. Proposal # 17022R1 MP 98337 Replacement ig proposal to replace detected that the existing losal will add a Suction Filter R22 refrigeration is at $70 180 gallons of refrigeration filter change out to clean up the compressor and ensure ing showing the City of RE change out. Mammoth Unit. shipping to BITZER for core of refrigeration. DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C %MacDonaI&Mlller V= FACILITY SOWTIONSf, We make buildings work better. Proposal # 17022R1 MP Page 2 INCLUSIONS CONTINUED • Trade Supervision, Project Management, and site clean-up. 1 Year Warranty Alternate Pricing Inclusions Above listed inclusions except purchase of BITZER Compressor o Compressor purchase handled by City of Bremerton o Warranty for Compressor handled by City of Bremerton ASSUMPTIONS/CLARIFICATIONS • It is expected that a clear schedule will be laid out and agreed on based on the owner's expectations. • It is assumed that all work will be performed during normal business hours (regular shift). • It is assumed that existing refrigeration will be cleaned up and reused. This proposal does not include a complete system replacement of R22 refrigeration. • To clarify if City of Bremerton decides to purchase the BITZER Compressor, MacDonald - Miller will not warranty the new compressor. • It is noted that the cause of the compressor burn out might have belen caused by short cycling of the unit. MacDonald -Miller recommends that a controls review takes place to review current set points for the Mammoth unit. EXCLUSIONS • Washington State Sales Tax • Structural upgrades, if necessary. • After hours or weekend work — overtime labor rates • New R-22 Refrigeration for complete system of AHU-2 • Mechanical Engineering -Permits • Structural Review • All fire sprinkler, smoke control and fire alarm scope. • Engineering for existing system evaluation & redesign. • Repair or replacement of all other equipment or systems not mE • Warranty, upgrade or repairs to existing Mechanical system or in this proposal • Building modifications that may be required by local officials for • Any scope not referenced above PRICING Total base price per above scope description .................. med in this proposal. pment not specifically outlined compliance or upgrades. ................................$25,217.00Ea0 Alternate pricing City of Bremerton purchasing BITZER Compressor price per above scope description......................................................................................................:...................................$14,144.00 macmillercom 1-800-962-5979 WASHINGTON & OREGON DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C tTR�MacDoillald-Mlller ''��++I�+i'� FACIUTY SOLLMON5t We make buildings work better. Proposal # 170221R1 MP Page 3 Thank you again for the opportunity to provide you with this proposal. If you should have any questions or should require further information, please don't hesitate to contact me @ (253) 680-3166. Thank you, Mitch Powell Account Manager Anticipated starting date: Based on Approval Upon which this proposal is based. This proposal does not include, unless so stated, any applicable state or federal taxes. This proposal is subject to acceptance by purchaser within 30 days and subject to the terms and conditions stated on the following Acceptance: I agree to the terms Purchaser By and completion date: Based on Approval MACDONALD-MILLER FACILITY SOLUTIONS, INC. Submitted by:y Mitch acceptance of this agreement. macmillercom 1400-962-5979 WASHINGTON & OREGON Date n,wui a rvial laud t DocuSign Envelope ID: B2C642DC-BCF2-4FAC-A555-7E696126132C wptr.,errepresErt9th3tithis a 4;4rity*entering(^isAgreevrent.Ownerwarra ntathat b the test :fits te,:ge :'e ria are noa-aa a xrzOaris orh3:ard.:-As rrateriats r avbst3r}3 ir,or, arourd or affecting trieares wtiEa CE rc rS is b be performed. i This Agreement shall be governed by be laws of the State w'h ere the work was done. In the event anyparlyshall bring suit or action against Mie other for reiiefarissgout ofthis Agreement. ore preyailing partyshat have and reooveragain st Mie other partyalloourt costs, disbursements, and a reasonable atbrneysle. Customerwrisentstoandagreesb jurisdiction and venue of anyproeeedieg in the Distriilo r Superior Court of the State of Washing tin .for King Countyat Ma3Donald4iller FaGhrySolutions, In ds ek?aon. [laking a final payment shall -:Oradutes waivet of s3yms bytrle ti.,'rer'sxoepttr.::,se sn :;g from dams bythird parties arising out ofthecontract fsi;retfIhaworkb:*,r y ;thther=:s're?e^G oft^i3::nvii:tormart ulactwer•warranties passed on to the Owner by Con tractor. T Th a Ownera nd Contactor sha II oommenoe all oWims and causes of action against the other whether in contract tort. breach warran lyor otie rwise arising outof or related to th is contractwithin 385 days bllowing Contracbrs completion of the work Anynotiee required bytltsAgreementshali be deemed received, person, o r by laosimile o r sent bymae. TERMS AND CONDITIONSICONSTRUCTION SERMCES Acoep6nce Sysut-:tivng MacDo:ait•A'glia- rFs: tySolut vis, Inc. toC.rya a Me oohs Uction services donpmplaied by this AgreerE't Customer 3 e..ee3 to tla tef'-s an]-xrl ibn5 core t•. 3taLd. Scopeof0blgations MacDovald-MIterFacdRySotutgns.Inashall pro meconstruction service NihencontraciedV. ,pursuanttotheatts0ea proposal, purchase order or estimate ofwhtdt these terms and co rd Mons a6 a part ObligatonsofCustomer Cuslomer Oa11e)Wd all reasonabis000perstion requested in terms of personnel; aocess to premiseswherework is to be perfonred; promptly providing information requested bycontracbr, and shall promptly nolifyMa[DonaIC-Miller Faeilty Solutions, Inc upon observation ofanyunusual or unsafe condition. Servioe A* debility MacDonald-tl assr Food"lubons, Inc agree-. to protide constuct on servoe during normal bus ness hours. .e..8:DJam b 5:30 pm, Mondaytr:'.o^ r :a'y, k,4:sys e S e t . aria: upon baa zs afe 3t re^: riy;Me and terms. including veh deair ,gas Of 3Ceo413asserre:U. tear. i- = a:l iy f3:D:Wald Afil e:IF;a ty8: utt•rs ts:. Charges and Terms Payment is duewlhm 30 days of the m,oFp date. Anybalarcedue ager W days shall bear intere tat the maximum legal rate permitted tom theimoide date. Taxes Th ere willbeadded ballhargestheamount ofanypresentandfuture tatesoranyothergotiermental obargesroti.or hereafter imposed byexisting or Ju life lem with respect b anysemoes reI ndered or materials supplied. UmRato r o f Liabili ty MA CDONALD-M ILLE R FAC ILITY SOLUTIONS. INC. SHAL L NOT BE LIABLE TO CUSTOM ER FOR ANY INDIRECT, INCIDENTAL, CONSECLIE NTAL OR PUNITIVE DAMAGES, INC LU DIN G 'LOSS OF PROFIT O R GOO DWI ILL. AS A RESULT OF ANY M ATTER ARI S IN 0 OUT OF OR RELATING TO THE CONSTRUCTION SERVICES PROVIDED LINDER THIS AG FIE EME NT ANDOR ITS SUBJECT MATTER WHETHER SUCH LIAS LITY IS ASSERTED ON THE BASIS OF CONTRACT, TORT OR OTHERWISE, EVEN IF ADVISED 0FTHE POSSIBILITY OF SUCH DAMAGES. Tne ust mere re-a.tratVs C nsk- ltta r cert} ° t :. L lyt-ltyth d;:r brd3sage sall, not ex:ee: Document A312 TM -12010 Conforms with The American Institute of Architects AIA Document 312 Performance Bond CONTRACTOR: (Name, legal status and address) MacDonald -Miller Facility Solutions, Inc. 2500 S. Holgate Street Tacoma, WA 98402 OWNER: (frame, legal status and address) City of Bremerton CONSTRUCTION CONTRACT Date: Amount: S $27,486.53 Bond No: 023039664 SURETY: (Name, legal status and principal place of husiness) Liberty Mutual Insurance Company 175 Berkeley Street Boston, MA 02116 Description: Replacement of faulty HVAC 50 -ton Bitzer Compact Screw Compressor, (Name turd location) BOND Date: I rot earlier than Construdtion Contract Date) Am01Jit:$27,486.53 Modifications to this Bond: Q None See Section 16 CONTRACTOR AS PRINCIPAL SURETY Company: (Corporate Seal) Company. (Corporate Seal) MacDonald -Miller Facility Solutions, Inc. Liberty Mutual Insurance Company Signature: ` , l r, P Signa Name C,j pn r � V� j Name o n ach and Title: C� and Title: Attorney -in -Fact i (4ny additional signatures appear on the lastpage of this Perfoimance.Bond) (FOR LVFORAMT10AT OIVT Y — Narne, address and telephone) AGENT or BROKER: OWNER'S REPRESENTATIVE: (4rchitect, Engineer or other party:) I Parker I Smith I Feek 2233 112th Ave. N. E. Bellevue, WA 98004 (425) 709-3600 S-1852IAS 8110 Page 1 of 4 This documenthas important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. Proposal # 17022R1 MP § 1 The Contractor and Surety, jointly and severally, bind themselves, their heirs, executors, admin I trators, successors and assigns to the Owner for the performance of the Construction Contract, which is incorporated herein by reference. § 2 If the Contractor performs the Construction Contract; the Surety and the Contractor shall have no obligation under.this Bond, except when applicable to participate in a.conference as provided in Section 3. § 3 If there is no. Owner Default under the. Construction Contract, the Surety's obligation under this Bond shall arise after the Owner first provides notice to the Contractor and the Surety that the Owner is considering declaring a Contractor Default. Such notice shall Indicate whether the Owner is requesting a conference among .the Owner, Contractor and Surety to discuss the Contractor's performance. If the Owner does not request a conference, the Surety may, within five (5) business days after receipt of the Owner's notice, request such a conference. If the Surety timely requests a conference, the Owner shall attend. Unless the Owner agrees otherwise; any conference requested under this Section 3.1 shall be held within ten (10) business days of the Surety's receipt ofthe Owner's notice. If the Owner, the Contractor and the Surety agree, the Contractor shall be allowed a reasonable time to perform the Construction Contract, but such an agreement shall not waive the Owner's right, if any, subsequently to declare a Contractor Default; the Owner declares a Contractor Default, terminates the Construction Contract andinotifies the Surety; and the Owner has agreed to pay the Balance of the Contract Price in accordance with the terms of the Construction Contract to the Surety or to a contractor selected to perform the Construction Contract. I § 4 Failure on the part of the Owner to comply with the notice requirement in Section 3.1 shall not constitute a failure to comply with a condition precedent to the Surety's obligations, or release the Surety from its obligations,. except to the extent the Surety demonstrates actual prejudice. § 5 When the Owner has satisfied the conditions of Section 3, the Surety shall promptly and at the. SIurety's expense take one of the following actions: § 5.1 Arrange for the Contractor, with the consent of the Owner, to perform and complete the Construction Contract; § 5.2 Undertake to perform and complete the Construction Contract itself, through its agents or independent contractors; § 5.3 Obtain bids or negotiated proposals from qualifiedcontractors acceptable to the Owner fora contract for performance and completion of the Construction Contract, arrange for a contract to be prepared for execution by the Owner and a contractor selected with the Owner's concurrence, to be secured with performance and payment bonds executed by a qualified surety equivalent to the bonds issued on the Construction Contract, and pay to the Owner the amount of damages as described in Section 7 in excess of the Balance of the Contract Price incurred by the Owner as a result of the Contractor Default; or § 5.4 Waive its right to perform and complete, arrange for completion, or obtain a new contractor aird with reasonable .promptness under the circumstances: I After investigation, determine the amount for which it may be liable to the Owner and, as soon as practicable after the amount is determined, make payment to the Owner; or Deny liability in whole or in part and notify the Owner, citing the.reasons for denial. § B If the Surety does not proceed as provided in Section 5 with reasonable promptness, the Surety shall be deemed to be in default on this Bond seven days after receipt of.an additional written notice from the Owner to the Surety demanding that the Surety perform its obligations under this Bond, and the Owner shall be entitledto enforce any remedy available to the Owner. If the Surety proceeds as provided in Section 5.4, and the Owner refuses the payment or the Surety has denied liability, in whole or in part, without further notice the Owner shall be entitled to enforce any remedy available to the Owner. S-1852/AS 8/10 Page 2 of 4 §.7 If the Surety elects to act under Section 5.1, 5.2 or 5.3, then the responsibilities of the Surety tothe Owner shall not be greater than those of the Contractor under the Construction Contract, and the responsibilities of the Owner to the Surety shall1not be greater than those of the Owner under the Construction Contract. Subject to the commitment by the Owner to pay the Balance of the Contract Price, the Surety is obligated, without duplication, for .1 the responsibilities of the Contractor for correction of defective work and comple .2 additional legal, design professional and delay costs resulting from the Contracts failure to act of the Surety under Section 5; and .3 liquidated damages, or if no liquidated damages are specified in the Construction performance or non-performance of the Contractor. § 8 If the Surety elects to act under Section 5.1, 5.3 or 5.4, the Surety's liability is limited to the § 9 The Surety shall not be liable to the Owner or others for obligations of the Contractor that are u Balance of the Contract Price. shall not be reduced or set off on account of any such unrelated oblig,' Bond to any person or entity other than the Owner or its heirs, executors, administrators, successors § 10 The Surety hereby waives notice of any change, including changes of time, to the orders and other obligations. § 11 Any _proceeding, legal or equitable, under this Bond may be instituted in any court of bompete part of the work is located and shall be instituted within two years after: a declaration of Contractor ceased working or within two years after the Surety refuses or fails to perform its obligations under provisions of this Paragraph are void or prohibited by law, the minimum period of limitation availal the suit shall be applicable. § 12 Notice'to the Surety, the Owner or the Contractor shall be mailed or delivered to the address appears. § 13 When this Bond has been fumished to comply with a statutory or other legal requirement in performed, any provision in this Bond conflicting with said statutory or legal requirement shall be cbnforrning to.such statutory or other legal requirement shall be deemed incorporated herein. Whe construed as a statutory bond and not as a common law bond § 14 Definitions § 14.1 Balance of the Contract Price. The total amount payable by the Owner to the Contrac adjustments have been made, including allowance to the Contractor of any amounts received or to insurance or other claims for damages to which the Contractor is entitled, reduced by all valid and Contractor under the Construction Contract. § 14.2 Construction Contract. The agreement between the Owner and Contractor identified and changes made to the agreement and the Contract Documents. n of the Construction Contract; Default, and resulting from the actions or actual damages caused by delayed of this Bond. ted to the Construction Contract, and the ;.No right of action shall accrue on this assigns. Contract or to related subcontracts, purchase jurisdiction in the location in which the work or fault or within two years after the Contractor is Bond, whichever occurs first. If the to sureties as a defense in the jurisdiction of on the page on which their signature location where the construction was to be !med deleted herefrom and provisions furnished, the intent is that this Bbnd.shall be under the Construction Contract after all proper received by the Owner in settlement of )per payments made to or on behalf of the cover page, including all Contract Documents §.14.3 Contractor Defau It. Failure of the Contractor, which has not been remedied or waived,, to perform or otherwise to comply with a material term of the Construction Contract i § 14.4 Owner Default. Failure of the Owner, which has not been remedied or waived, to pay the Contractor as required under the Construction Contract or to perform and complete or comply withthe other material terms of the Construction Contract. § 14.5 Contract Documents. All the documents that comprise the agreement between the Owner and Contractor. § 15 If this Bond is issued for an agreement between a Contractor and subcontractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. I i I S-1852/AS 8/10 Page 3 of 4 § 16 Modifications to this bond are as follows: (Space is provided helow for aclditional sig),zatures of added parties, other than those at CONTRACTOR AS PRINCIPAL SURETY Company. (Corporate Seali Company. Signature: Signature: Name and Title:>(��� Name and 7 Address �1�f: ' 19,�t Address S-1 852/AS 811.0 Page 4 of 4 Document A312TM _ Conforms with The American Institute of Architects AIA Payment Bond CONTRACTOR: SURETY: ,Name, legal status and address) !Name., legal status arzd pr irzcipal plane c MacDonald -Miller Facility Solutions, Inc. Liberty Mutual Insurance Company 2500 S. Holgate Street 175 Berkeley Street Tacoma, WA 98402 Boston, MA 02116 OWNER: (Name, legal status and address) City of Bremerton CONSTRUCTION CONTRACT Date: Amowit: $27,486.53 Description: Replacement of faulty HVAC 50 -ton Bitzer Compact Screw Compressor, (Name and location). BOND Date: (Not earlier than Construction Contract nate) Amount: S $27,486.53 Moditications to this Bond: ® None ❑ See Section 18 CONTRACTOR AS PRINCIPAL SURETY Company: (Corporate Seal) Company.- ,Corp MacDonald -Miller Facility Solutions, Inc. Liberty Mutual Insurance Company Sign .atrire: Signature NameS LIV p ��, ,1 Name Roger Kaltenbac andTifle: � V �"`�"`"� and Title: Attorney -in -Fact (An), additional signanires appear on the last page pf thisPayment Bond.) TFOR LV'F0R1.MT10N01VLY —,Vane, address and telephone) AGENT or BROKER: OWNER'S REPRESENTATIVE: (4rchiteet,' Engineer or other party) Parker I Smith I Feek 2233 112th Ave. N. E. Bellevue, WA, 98004 (425) 709-3658 (425) 709-3600 S-2149/AS 8/10 010 ment 312 Bond No: 023039664 (hushes ) Seal' This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. Proposal # 17022R1 MP § 1 The Contractor and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to the Owner to pay for labor, materials and equipment famished for use in the performance of the Construction Contract, which is incorporated herein by reference, subject to the following terms. § 2 If the Contractor promptly makes payment of all sums due to Claimants, and defends, indemnifies and holds harmless the Owner from claims, demands, liens or suits by any person or entity seeking payment for labor, materials or equipment furnished for use in the performance of the Construction Contract, then the Surety and the. Contractor shall have no obligation under this Bond. 3 If there is no Owner Default under the Construction Contract, the Surety's ty s obligation to the Owner under this Bond shall arise after the Ovtmer has promptly notified the Contractor -and the Surety (at the address described in Section 13) of claims, demands, liens or suits against the Owner or the Owner's property -by any person or entity seeking payment for labor, materials or equipment furnished for use in the performance of the Construction Contract and tendered defense of such claims, demands, liens or suits to the Contractor and the Surety. § 4 Wluen the Owi-ier has satisfied the conditions iru Section 3, the Surety shall promptly and at the Surety s expense defend, indemnify and hold harmless the Owner against a duly tendered claim, demand, li en or suit. § 5 Th. Surety's obligations to a Claimant under this Bond shall arise after the following: § 5.1 Claimants, who do not have a direct contract with the Contractor .1 have furnished a written notice of non-payment to the Contractor, stating with substantial accuracy the amount claimed and the name of the party to whom the materials were, or equipment was, furnished or supplied or for whom the laborwas done or performed, within ninety (90) days after having last performed labor or last furnished materials or equipment included in the Claim; and 2 have sent a Claim to the. Surety (at the address described in Section 13). § 5.2 Claimants. who are employed by or have a direct_contract with the Contractor, have sent. a Section 13). § 6 If a notice of non-payment required by Section 5. 1.1 is given by -the Owner to the Contractor, to furnish a written notice of.non-payment under Section 5.1.1. § 7 When a Claimant has satisfied the eenditions of Sections 5.1 or 5.2, whichever is applicable, expense take the following actions: § 7.1 Send an answer to.the Claimant; with a copy to the Owner, within sixty (60) days after undisputed and the basis for challenging any amounts that are disputed; and § 7.2 Pay or arrange for payment of any undisputed amounts, to the Surety (at the address described in is sufficient to satisfy a Claimant's obligation Surety shall promptly and at the Suretyrs of the Claire, stating the amounts that are § 7.3 The Surety's failure to discharge.its obligations under. Section 7.1 'or Section 7.2 shall.not be deemed to constitute a waiver of defenses the - Surety or Contractor may have or acquire as to a Claim, except as to undisputed amounts for which1the Surety and Claimant have reached agreement. if, however, the Surety fails to discharge its obligations under Section 7.1 or Section 7.2, the Surety, shall indemnify the Claimant for the reasonable. attorney's fees the Claimant incurs thereafter to recover any sums found to be due .and owing to the ;Claimant. i § 8 the Surety's total obligation shall not exceed the amount of this Bond, plus the amount of reasonable attorney's fes provided under Section 7.3, and the amount of this Bond shall be credited for any payments made in good faith by the Surety. § 9 mounts owed by the Owner to the Contractor ruder the Construction Contract shall be used for the.performance of the Construction Contract and to satisfy ciairrus, if any, under any construction performance bond. By the Contractor furnishing. and the Owner accepting this Bond, they agree that all fiords earned by the Contractor in.the performance of the Construction Contract are dedicated to satisfy obligations of the Contractor and Surety under this Bond, subject to the Owner's priority to use the funds for the completion of the work. S-2149/AS 8/10 § 10 The Surety shall not be liable to the Owner,, Claimants or others for obligations of the Contractor that are unrelated to the Construction Contract. The Owner shall not be liable for the payment of any costs or expenses of any Claimant under this Bond, and shall have under this Bond no obligation to make payments to, or give notice on behalf of Claimants or otherwise have any obligations to Claimants under this Bond. § 11 The Surety hereby waives notice of any change, including changes of time, to the ConstructionliContract or to related subcontracts, purchase orders and other obligations. § 12 No suit or action shall be comrnenced.by a Claimant under this Bond other than in a court of competent jurisdiction in the state in which the project that is the subject of the Constriction Contractis located or after the expiration.of one year from the date (1) on which the Claimant sent a Claim to the Surety pursuant to Section 5.1.2 or 5.2, or (2) onwhich the last labor or service was per by anyone or the last materials or equipment -were. furnished by anyone under the Construction Contract, whichever of (1) or C) fust occurs. If the provisions of this Paragraph are void or prohibited by law, the minimum period of limitation. available to sureties as a defense in the jurisdiction of the suit shall be.applicable. §-13 Notice and Claims to the Surety, the Owner or the Contractor shall be mailed or delivered to tire. address shown on the page on which their signature appears. Actual receipt of notice or Claims, however,accomplished, shall be sufficient compliance. as of the date received § 14 When this Bond has been firrnished to complywith a statutory or other legal requirement in thz location where the construction wvas to be performed, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond § 1.5 Upon request by any person or entity appearing to.be a potential beneficiary of this Bond, the Contractor. and Owner shall promptly furnish a copy of this Bond or shall permit a copy to be made.. 16 Definitions 1.6.1 Claim. A written statement by the Claimant; including at a minimum: 1 the name of the Claimant; .2 the name of the person for whom the labor was done, or materials or equipment furnished; 3 a copy of the agreement or purchase order pursuant to which labor, materials or egwpmeritwas furnished for use in the performance of the Construction Contract .4 a brief description of the labor, materials or equipment firrnished; .5 the date on which the Claimant last.performed labor or last furnished materials or I quipment for use in the performance of the Construction Contract; .6 the total amount earned by the Claimant for labor, materials or equipment furnished as of the date of the Claim; .7 the total amount of previous payments received by the Claimant; and .8 the. total amount. clue and unpaid to the Claimant for labor, materials or equipment furnished as of the date of the Claim. § 16.2 Claim ant.. An individual or entity having a direct contract with the Contractor or with. a subcontractor of the Contractor to fiunish labor, materials or equipment for use in the performance of the Construction Contract.. The term Claimant also includes any individual or entity that has rightfully asserted a claim under an applicable mechanic's heir or si;nular statute against the real property upon which the Project is located, The intent of this Bond shall be to include without limitation in the terms "labor, materials or equipment" that part of water, gas, power, light, heat, oil, gasoline, telephone service or rental equipment used in the Construction Contract, architectural and eng neering services required for performance of the work of the Contractor and the Contracts subcontractors, and all other items for which a mechanic's lien may be.asserted in the jurisdiction where the labor, materials or equipment were furnished. § 16.3 Construction. Contract. The agreement between the Owner and Contractor identified on the cover page, including all Contract Documents and all changes made to the agreement and the Contract Documents. S-2149/AS 8/10 § 16.4 Own er Default. Failure of the Owner; which has not been remedied or waived, to pay the Contractor as required under the Construction Contract or to perform and complete or comply with the other material terms of the Construction Contract. § 16.5 Contract Documents. All the documents that comprise the agreement between the Ovmwr and Contractor. § 17 If this Bond is issued for an agreement between a Contractor and subcontractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. § 18 Modifications to this bond are as follows: (Space is provided helow for additional sigmwres of added pm•ties, other than those appearing on CONTRACTOR AS PRINCIPAL SURETY Company: , orpo,-ate S(?al) Company: Signature: V" Signature: _ Name and Title: ��; Q'_` \Tame and Title: Address C�'"fes' '`O 61�� ('�� C Address 5-2149/AS 8/10 co ver page.) ,/Corporate Seal) . � I I - - ,.:-- --�,_'�--�:-1,7::���-�-"::�I Z;;��. _--,- - � - � .­_ ::.- - .- -, - , - . . . , - - � --- `_� - : - .� ­_ _ - _.. , GROUND 'RED BACK'GROqND_-...--,­-­ " - - - - - - -:,�: " -. -, THIS POWER-_OF_-`ATT.ORNEY IS NOT VALID: UNCE S. T'IS:PRINTEU--ON. -__ - : § 'I - , . ­ -,-.,*- - - - 1..7 - z: I - ­ ­ -authorityJ - - - " - �. 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I __ _ , , - ,.. .. .: I �- . , .. _ -:;7, -:,- ':�_ -:�� -"-;::�- �"-�a�­--- � :�� ,7: -�m , , --. �2 - --� ..... .. ___. _ . - . .. .-,.- -- -: .��.---� - - �.. , - - August 6§t - - : _. 7-- -,: -, _.. ..... . . _ ..,.. - --:::- :� � - _... ... -_':::.:"�- -­-­�: -*� ---. � .'. - _ - - - * - -. - .1 .. - - , _.. - .- ...--.. � .:.� - ­­­ .. - �m 7- - ."�� _-�--:_,-- ,_-. - - __:7, -- "' - - . , � - - - - - -i&� - -- �� - ­­ � I I - __ - , �, __�.7 , ­;��7 .,7- --,, �, ::�,-- -_,.�� , _��! -- - 7�,- - � - 7�,� �hi� ,:'I,-- - _. - - __ - - - - __ - . - �] :_'_ N -61 ,(;�sualty--.1�surEinoe:Company�:::- ­ ' : (A ,.-- - ­ - - - _. - __ - Ii. 17�1,_�_ - - - -:�- : - - ­­ - - � _ 1-1. _0 - - - . ` :� _1 ­;-, - -, - --.,-,:.(A � - - - - - - - - - - - ­ - _. _. 7 - -_,�� '_ - - - ­ - Liberty Mbt'ua; nsurqnqe,:.kqmp ,. - �� - -:, __ , _ : - , _- ­_ - - - - - ,:: __ -1 Company - -,. - - � .-.-7 1 0 .� I f - �; -I �� .- -,. , , - - - - �!. -:.,:: ,�---L --f- . , , _pny.�� - �- _,�.�: ,z --w - . : .- - , . 991� ��. _�-* __ ��_ i_--;:, ::� �� . ��, - - - -1 - , .�'_ � :- --. ,'7 -_�-::, -., - . . . � il�" _,".__ _:16__:�-__,�-_'_­--_, .:' ,�_ -_-,,�F-_:_�_�- ,:. � -r- -' :� :- � -,;::� �_ �­ ��, - * ­ - - . � �7 1 -I' - - - - :�-;:�, 7�.,=� -_;,-Z� - - -' ' ��_- =�Nes -, American nsuranm Company - - . - -: - - :��,;E :�:_ � _-� . 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Zl,;-- .� Pi - an- .`,-T�e- * , _ _ _ _ - . - I - .pqrpq�es >1 - � --=, ��.­`: - - �. qn - - - ­ � - .-? 5 - - --, - ` �' �_ _�� _;,�Z - ,� - __Co`�� - �, 6 _'�6i ­ corporations - _;� 7 �� .� . Z:,::� __ - _:� .- - ___ - , - � _c. , , ' (D- . therein n -d ( signing-onjbehalf�of the Wdijl�:�uthorized:officef -f -:7 --� �:- . _?� , - . 0- - ) - - or -, - I * ------ - '--' . --- -:_� 'Z� ­ I - -, - - - - -, Z_ �= - -A u' _'_ - -,-.:-:-,-;�, �__ 1�� � , _E - 'W.- >-- IN WITNESS WHEREOF have hereunto `s_6bsc�rib6d`m y'_na6r_Fe a_nd_:affiWd mynotarial seal at King�,of.Prussia-,- yl�ania, 6n-,i�e,:'d�y-,d-nd--y&-ai*fir�t:aboVe,�vritt6-n� 7��.a _� __ _��,-_Z-�-�-:� '0� L. I , , - - -� . 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A.- -:,- S.W I � ,-_,�_ :�--- _,_, :,:" :1 - , - � __ , - - I— , . - - .- :�- � :�':­ L_ - ­ -_-- _.- 7:; - , , --- . _ _W Commission E)4)1Fes:Wrch'2 ­.- , ,. _: :� -3:--m , - - P� _. . , - .- _. : __ -­ -, - _ - . , , _ _ �:: 6-0. �7 � - :.'- �1 -: -_ � .� -.,�-�-_ -_�., 7� --"- ­ - ­ ... -_�' ,I-' - :, -, -.-�z - Z_",::- L ­�� -:,. ­ - - _. .- . _. _ _ _._ - - -�-!:� - - - , . _ - _ --- ­ _0 - - . I - . _­ - - - -P --- �� -�� - - _­ - . - � � �- Wrfiber. . Lnnsylvanb Association'of Notands ._� _�, F -��, -.7- � ,�--:7.. . I .11 jj' -E , - - _­ - , I -following- .-��§�-alty--"15'su(ai�cb;:C-oro.:n� lber�lly,�Kdtdal­ -,'O-' r . pursuant -to by-authqrit��qf.'ni: - - - m -'This�-Power- of,Atto�n6�*.LIS�"thaa6::�na.-exe6dted"p , �f. the :and'AUthbrizaticr of,T�W�bh�,6�c -I '0 . - - . . - - - ­ ". �_. - . L, - , ---.�-- L- - - - � .-, �. Insurance 6s. � _. 1 Company - � , 1. _ - ..� ,�.-`:.� - :, --:: :w_:,::. - - - - ­�;:_ _:��7_ - =, � QTP�ny,'�� :.. T . - - Company resolutions arenowi 0 jj_4,. . , urance d_w, st.American Insurance C �nfulffO�ce-and-effect�reading.as-follbws,.,.,, �:� :��-,� - �: _�-,, .. __ , - ­- --- - ..---,- __ _ _ I:- ZL - -, - __ __�7: ---'-- - . - : - - , - - -, ­­: '7';: -'-: �:: L7:�*::: �:;'5:: --"'::' --:: 7;�7­�­ _" ' --'.- __ _: L �: -It?'Z m -W , �% : - -',. - . - - __­ __ - - - , . " - ,::. . w � �:- �_, - - - - - * - �: . :. . _6j ,'.'�� . -- - -;� : .;: --,':-� 3.�: , ��7Z-:7�'; � .�:: � ��.�� _ � 6 , JARTI'd '_ i ' - ' jtk��' IS .Z.11 �M- Q) LE IV OFFICERS -- S ed on -1'�:-P_6 �r6f-�it6��ey:--A�iy6iii�e��(6t�6'�offi�i�I th'e�b�pofatioo:ajth'oriied�fbtth-jt-.-puro,i3�,�ii�wr�tio--gt�.tl�eCffbirrh-a-ndrtl�ejPre-�ide--nt,'a'n-'d'sUb'j'e-ct� ,zr_ . C6 --s- - . - . ,--. -_-�-- 'Section -12: . other - - -1 � authorized - -, -.� writing I -� - - - - Lm - such 0- ' ' ' * officer , - - , - - - - _ ­ _ ­ _ _ ,­ - -,--_ - - - - -- _:-_ - , _e� - - -41 -V � to �u IiMitatidn-as r:the P'Feiid6nt i� 'i5h��&ibi�.-shafrap . . 11 , - . ' necessary _e 4_� _p6int,suc afforneys-in-fa6t,'-as iia� be y -to-, actin -behalf of th -coi�6�afio��.t(�'��a�-e�exWd'jt , ;,QI;_ ,,> W " -, 7n- - - ,-.-- _ _- _ - - - -0:7S 'I- - � ,;-. - - - , :_:,-­ _ _ :7�­ - � , , - -, execute .W:4) , , , .. acknbwl6d�o�'6nd.d6liv6rL-as�surety any -and 6II,uhde'rtjkih6'!�'L ' '5s� - 6s�.�S06 aft6rri6��rin7fabt, subjectj(�tff�lirni6tibns�661: f6rffi ifi�,thei��.�sp��66_- ';0--z!-g . -attorney , bonds', recognizances:a4dihe? urety�6b�ijEti6 - - - - -1 _ ._ _ .� I '. _ . - , ,., , - �­ . - - _­_ - --.-- - - -_-'�,7­�� " ' I any s-- � R ,�:attach-ttf6rdto- -,"b - �C ---'Wih�n��:- '�tl) ,E-' '- , ---'- It ­ ­ - Wqlllha­�;641i� 06��ert�--66d-the- Corodrition-- by tfi�ei�j�at6i� andTe --' execution succi instruments A and , � (D. powers g.'a orney. - I XP9 ns rumen s --� - thereto the fLJ6�e 6rporation M - - - - 1i rari65 I - - -.,- - _M ' ­ -signed-- ­ _X�y power authority t-.aLly representative-or:attomey- n4act'under-, .> - .�� -executed- -_�_. " � . President ­ , and _ _ , ­_ When , . . . _- -f ' - - - - ' � - asi ,- a6d �ife'st�d-t6'6�-ih6'�e-c�eti�y-- .6_r�a * 8_ca. '-�dch,iii�iruime6t& 1�611:be-_6slbin in f by Presiderit. -6i , ..,_, -1 ­�. ­­ V_g . _­�­-1 - -, ., .. -, __ " _ . �� -"-. j�� - - - - -1�._ ::� �:_ _� __ - , -:� -,= - -- , - * - . 4i'ti 7 6y.timi.bV.-JI�e B66rd the - - - - ­ - - - T- . q_.- 4) 0 _ ' - . ` Chairman -6 - ' ff; ' ­_ 1-�'O'�ti,p6weror.authbrity,---�z __ - __ _ � .0 _ Jhe�provisi6n§-o , f this c16:ffiay-15e revoked any ;: C�airm the or by tFe, ffi6er or. o icers,orantinc . = >; 1� --- ,1�­ � �f - , -:,-: - �__�- '-_-,.,, -'-- ,:.- - .- - - - . z_ -_�:.l *:- �7. - - --"- _­.:_._ , granting - ';: __�.7 __��,__ ­;­ _ - _- ­ ­­ _'- _ - 0, ' - - __ . - 7%,:_ - -: , :-' -':- ,.- . - :��_ :�_ �� � _ - _ - , ­ - ' 'L -- , - . .: _-,. �� - .i... 117,41 - - _7 r-, . ARTICLEXIII'_� IExe�ufiqh 6f.Cbnira6t!�' SECTION 5� Surety Undertakings of author th'at-pufFoi-e-,�n,v�riti'ng�-b-�-'Ili-�'Chai-�rh"an�or,�the:-�.�esidE�nt-,-- ` Co CC . . .1 . - I .- - I , - ­ r - - - . - -1 -- - - I .- �, - �, - - .,--- .­_ , __._�. -�_ :, -E �- ', . _ .6 .. L�l . '_ - _ _­ ­- ­- .. . .,��_ - - " * '_ I --- � ri e, sha I appoint's(f&h_jtt6rrfe!*h f- tq- 1� .. - I- :>-:0) 'and subject_toisuch�li nitations -��th�-c6iii��'�.'6rtt4.���si66�t i:�6 -presc' ' ' ' 1.�'N ,i..,�:" , - __ - _ � ­ - -,- - - --- -��- -. . , , Zd66�S s � 7 ��t: as may be:nec6�sky_to�act in:behalf dfAhe Comp��y't�,maKej.e -, Z: = M - L,_ � ­ ­ . - -,-.. ­ . . , ­ - , _� - .a�d - .- I - __ - - - _. . - , - _ _ _ �ec�L - =. --Seal: .acknowledcie afn - ver 't any andw-all-uridertakings-, bonds�-recogn _. urety-.'6bligations-. �Sbch-'dtto�6iays-;iff-fa-tt�tubj6-dt to.'the_.Iiifiitati6-ns-�6t:fdrtF in their:: Ir o, - , d delj�7 '-:as sure Y'L ' . _0,�EW -.00 . . - I - '_ . - . - . - -1 I - - attorneys , " - - - - - - z , 'attorney ; - - - ,_ _1_ C&ffipahjb�_t��ii�:ii ­ ­' - ­ d."' . �. of any I �such.instrurn6nts an'd"to-att-a-c6fheret6 tlh�,ieq_ h e -':Co rp' - - - - :..I ,ave. ull.pbWbr.to!bind.the�execution-P J _ -,Wh - -so .-Q �D 9- 'respectiveli�i h f, * - _. .---_� - - L ­ - _* , - - _­gnature and- - . .. - " , '" " , ­ , ­ - - - ­ - , r _t - - �aoyj. ­ When -so - . T_ ' f _, _ ,I ' ' - ::::- , - , - . - , ­_ ­_ ;v . - .-: - .- -executed such insVurfients��h,all be 6-sibin.rding' as -if signed by--th6'presidenland'd te�t6d-b��fh&-�.�,j�r6t�f�.*::7'::-.-.."-�� * .. .. :: .--��-..�:�:-�:�_,,�---�----:,:-:�--�"-- �-��- ,�_-.�_- -_-,::-_ -�:_�:::-* ."-,:-��,::,;,_ - . � . _. '. - I � . -- , , , - , .. _ . *: - -� '- - - -, �_`,- - _--]:W .. I - , ­:­­ - - : - _. - - . �; � '.::':: .- ,. . . ., ..: - .. ; 1. I :_ - _.::.-L.-.j._.. --�',,__ , . " ::�: :,-, .-. - .. , ­.'.-_'-.�:*-.-._-�::�-.­:. , ..:.--. .- ... -.::.-.-, --. . . �. .- : -_ -*: -.--:.-:-- :�---.-_ __ __ �: :�-;;_ - I f" Designation , ' .. ': s__ , . - -, - - ,- - - - ..-.. - - �:_ - - .-.b:.::.. - ­ - _- - *Secretary- - - , - - vm 1. -. I ­­ ­­. " ­ ' " C .' - I..... .,. � :.... ..: ...... . ......... . :.. - L .: _:i: __ -- -1 �q o -' . -I *th-,, y aLWS_, L d'� � 6 ,-��siisia�i - .Ceftifi6at �T iant: o . 6 d i �f.� .- he -President. -of the Company pp�q, , jhq�qpmpaq.y; authorizes David - Eirey.. ..to .suc�ti�ine�.§;in--_ -, - - --7,- -The - - - ' ,-_ , ._ * - .i - _ _ .--_­ -� -, - .' - I., � -.:fact: as may be recdss�Ir . - .�an - -6 i. , xecodffiafices�n�fofh U cev. - __ - 1 . 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I I DocuSign Envelope ID: DD515A81-6ACC-46B1-A14F-671A316FE6E2 Certification of Compliance with Wage Payment Statutes The bidder hereby certifies that, within the three-year period immediately) preceding the bid solicitation date (05/15/17), the bidder is not a "willful" violator, a�s defined in RCW 49.48.082, of any provision of chapters 49.46, 49.48, or 49.52 RCW, as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdictio I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. MacDonald -Miller Facility solutions, Inc. Bidder's Business Name gnature of Authorized Official* Stephanie Gebhardt Printed Name CFO Title 9/22/2017 Seattle Date City Check One: Sole Proprietorship ❑ Partnership ❑ Joint Venture ❑ Corporation Q State of Incorporation, or if not a corporation, State where business entity was formed: If a co -partnership, give firm name under which business is transa * If a corporation, proposal must be executed in the corporate name by the president or vice-president (or any other corporate officer accompanied by evidence of authority to sign). If a co -partnership, proposal must be executed by a partner. MACDFAC-01 AMICHEL A`COR�� A..�� CERTIFICATE OF LIABILITY INSURI ANCE T E (MM/DD/YYYY) DA08/23/2017 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. E IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Hub International Northwest LLC 12100 NE 195th Street, Suite 200 Bothell, WA 98011 CONTACT NAME: PHONE FAX (A/C, No, Ext): (425) 489-4500 (A/c Ne):(425) 485-8489 E DRIL S. now.info@hubinternational.com i INSURERS AFFORDING COVERAGE NAIC # ' N ERA: Liberty Mutual Fire Insurance Company 23035 INSURED IN RB:Libe Insurance Corporation 42404 MacDonald -Miller Facility Solutions, Inc. /�, P.O Box 47983(t\/ Seattle; WA 98146 INSURER C: Berkley Assurance Company 39462 INSURER D: Travelers Casualty & Surety Company of America 31194 INSURER E INSURER F: X COVERAGES CERTIFICATE NUMBER: I 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. ILTR NSR TYPE OF INSURANCE ADDLSUBR D IVSD WVD VD POLICY NUMBER MMPOLICY EFF ID/DO POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCURTB2-Z61-066178-036 X X 12/31/2016 12/31/2017 DAMAGE TO RENTED 500,000 PREMISES a occurrence $ X WA STOP GAP MED EXP (Any oneperson) $ 5,000 - PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY F-1LOC PRODUCTS - COMP/OP AGG $ 4,000,000 JET OTHER: A AUTOMOBILE LIABILITY O aBINEDtSINGLE LIMIT 2,000,000 fE,X $ ANY AUTO X X AS2-Z61-066178-026 12/31/2016 1213112017 BODILY INJURY Perperson) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS � HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS -MADE X X TH7-Z61-066178-056 12/31/2016 12/31/2017 AGGREGATE $ 1'000,000 DED I X I RETENTION$ 10,000 $ A WORKERS COMPENSATION I PER X OTH- STATUE ER AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE TB2-Z61-066178-036 12/31/2016 12/31/2017 OFFICER/MEMBER EXCLUDED? (Mandatory in NIA E.L. DISEASE- EA EMPLOYE $ 1,000,000 If yes, describe ander under RIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 F*/POLL PCADB-5001463-1216 12/31/2016 12/3;1/2017 OCC/AGG: 1,000,000 D PARTY CRIME T 105542647 12/31/2016 12/311/2017 LIMIT: 1,000,000 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more spade is required) RE: MM JOB #73176650; KCLS BOTHEL'L HVAC EQUIP REPL ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT: THE CITY OF BREMERTON, ITS OFFICIALS, EMPLOYEES, AGENTS AND VOLUNTEERS; COVERAGE IS PRIMARY AND NON-CONTRIBUTORY. WAIVER OF SUBROGATION AND PER PROJECT AGGREGATE APPLIES. SEE ATTACHED ENDORSEMENT(S). *N/A TO ADDITIONAL INSURED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF BREMERTON THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: RISK MANAGEMENT 345 6TH STREET, SUITE 600 Bremerton, WA 98337 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD J V V V D of C N w C L J m N mom m»a mmo 2' va`l a`ly a E -2 � Q � a � m E °. 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( . - } §o. e_ _ §f { {Lu co /(cLo = Ee- ƒkkw k\§ g - {{�)\ _§ \ r� z |,2 ` /� | o {/ ■ . / kk) | #«! 2 at t[' 7( . + ( |k wm {\; \!t = `)/ \§�f�b t 15 ¥) &. o«( 2 ■]�t� y y \- _! = k {\` r \ r \)g, { } 7 ] - \ / f\) )ƒ\M § [ ! 2 §a{{ t _ ) (\ § k [ §ot - ! /) f 3/ ; ] E {\ §\f \® { f[ #&) \\� § . v- # { A ; a� !|� , /($ �: Imm \E - / z = ¥ ( ± 5�! {$N ,c\ �§\\ ƒ E a § Policy Number TB2-Z61-066178-036 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT OR DESIGNATED LOCATION COMBINED AGGREGATE LIMITS — WITH TOTAL AGGREGATE LIMIT FOR ALL PROJECTS AND LOCATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Designated Construction Project(s) or Designated Location(s): All " at which you're performing ongoing operations I Aggregate Limit for all Projects and Locations: $ 20,000,000 A. For all sums which the insured becomes legally obligated to pay as da Section I — Coverage A, and for all medical expenses caused by ac( which can be attributed only to ongoing operations at a single desig designated "location": 1.. A separate Designated General Aggregate Limit applies to each i each designated "location", and that limit is equal to the amount of the Declarations. 2. The Designated General Aggregate Limit is the most we will pad Section I - Coverage A, except damages because of "bodily injury" "products -completed operations hazard", and for medical expen: regardless of the number of: 4 a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". and All Construction Projects caused by "occurrences" under under Section I - Coverage C, construction project or a single Inated construction project and to General Aggregate Limit shown in for the sum of all damages under )r "property damage" included in the as under Section I - Coverage C Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated General Aggregate Limit for that designated construction project or designated "location". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated General Aggregate Limit for any other designated construction project or designated "location". The limits shown in the Declarations for Each Occurrence, Damage to Premises Rented to You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated General Aggregate Limit and the Total Aggregate Limit for all Projects and Locations. LC 25 19 01 15 © 2014 Liberty Mutual InsuranceI Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc.i, with its permission. The Total Aggregate Limit for all Projects and Locations shown in the Schedule of this endorsement is the most we will pay for the sum of all damages caused by "occurrences" under Section I — Coverage A and all medical expenses caused by accidents under Section I — Coverage C which can be attributed only to ongoing operations at a designated construction project or designated "location" shown in the Schedule of this endorsement, regardless of the number of construction projects, "locations", "occurrences" or accidents. I 6. Each Designated General Aggregate Limit is subject to the Total Aggregate Limit for all Projects and Locations shown in the Schedule of this endorsement. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project or single designated "location": 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and 2. Such.payments shall not reduce any Designated General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed .Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated General Aggregate Limit. D. If the applicable construction project has been abandoned, delayed, or'abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. For the purposes of this endorsement, the Definitions Section is amended by the addition of the following definition: t "Location" means any premises that you occupy for permanent operations as part of your business, but does not include any premises at which you are performing operations as part of a construction project. All premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "location". F. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. LC 25 19 01 15 © 2014 Liberty Mutual Insurance`. Page 2 of 2 Includes copyrighted material of Insurance Services Office, Incl, with its permission. Policy #AS2-Z61-066178-026 Issued by: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - NONCONTRIBUTING This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIERS COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies. person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage form. Schedule Name of Person(s) or Organizations(s): Any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either the scope of.coverage or the limits of insurance provided bylthe policy. Regarding Designated Contract or Project: Each person or organization shown in the Schedule of this endorsement is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section 11 of the Coverage Form. The following is added to the Other Insurance Condition: If you have agreed in a written agreement that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations, and the agreement was executed prior to the "bodily injury" or "property damage", then this insurance will be primary and we will not seek contribution from such insurance. { i i AC 84 23 08 11 © 2010, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER: AS2-Z61-066178-026 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respectto coverage provided by this endorsement, the provisions of the by the endorsement. SCHEDULE Name(s) Of Person(s) Or Organization(s): 4ny person or organization for whom you perform work under a written ,ontract if the contract requires you to obtain this agreement from us, but mly if the contract is executed prior to the injury or damage occurring. Premium: $ Form apply unless modified Information required to complete this Schedule, if not shown above, will by shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the 'loss" under a contract,with that person or organization. , CA 04 4410 13 © Insurance Services Office„ Inc., 2011 Page 1 of 1