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6106- Original Agreement
GOODS AND SERVICES AGREEMENT THIS AGREEMENT, is entered into between the City of Bremerton, a Washington Municipal Corporation ("City"), and Merchant Patrol Security Services, Inc. ("Vendor"), Whose mailing address is: PO Box 964, Olalla, WA 98359_ The parties agree as follows: I. VENDOR SERVICES. The Vendor shall provide the following goods and materials and/or perform the following services for the City: Security Services and Patrols. SCOPE: The Vendor agrees to perform the services more specifically described in the scope of work and duties, including any attachments thereto, attached hereto as Exhibit "A", which is incorporated by reference herein. II. TIME OF COMPLETION. Vendor shall complete the work and provide all goods, materials and services within 730 calendar days (2 year term) from the date all parties have signed this agreement. An additional negotiated two (2) year term extension shall be available if mutually agreed upon by both parties and, in the best interest of either / both party to extend with rates adjusted to compensate for increases / decreases to the State Prevailing Wages and cost of living rates. A Letter of Extension will be signed by the City and Vendor, and will be filed and become an amendment to this Goods and Services Agreement. III. COMPENSATION. The City shall pay the Vendor in an amount per hour as shown on Exhibit `B", including applicable Washington State Sales Tax, for the goods, materials and services contemplated in this Agreement. The City shall pay the Vendor the following amounts according to the following schedule: Unarmed Security Guard $ 18.70 per hour Vehicle Security Patrols $ 22.40 per hour A. Defective or Unauthorized Work. The City reserves its right to withhold payment from Vendor for any defective or unauthorized goods, materials or services. If Vendor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services on its own or from a third party, and Vendor 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 Agreement price specified above. The City further reserves its right to deduct the cost to complete this Agreement, including any Additional Costs, from any and all amounts due or to become due the Vendor. IV. INDEPENDENT CONTRACTOR. Vendor is and shall be at all times acting as an independent contractor and not as an employee of the City. The Vendor 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 Goods and Services Agreement Vendor, officer, agents, employees and subcontractors. The Vendor shall also secure all applicable business licenses, if required, in connection with the contract services, including all required licenses for Vendor's officers, agents, employees and sub -contractors. V. 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 Vendor's refusal or failure to supply a sufficient number of properly skilled workers or proper materials for completion of this Agreement. B. The Vendor's failure to complete this Agreement within the time specified in this Agreement. C. The Vendor's failure to make full and prompt payment to subcontractors or for material or labor. D. The Vendor's failure to comply with federal, state or local laws, rules or regulations. E. The Vendor's filing for bankruptcy or becoming adjudged bankrupt. If the City terminates this Agreement for good cause, the Vendor shall not receive any further monies due under this Agreement until the goods, materials, and services required by this Agreement are completed and fully performed by the City or a third party of the City's choosing. In addition; the City or Vendor may terminate this Agreement within 60 days of written notice, sent by Certified Mail, for any mutual termination reason. VI. CHANGES. The City may issue a written change order for any change in the goods, materials or services to be provided during the performance of this Agreement. If the Vendor determines, for any reason, that a change order is necessary, Vendor must submit a written change order request to an authorized agent of the City within fourteen (14) calendar days of the date Vendor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Vendor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the change order work upon receiving either a written change order from the City or an oral order from the City before actually receiving the written change order. If the Vendor fails to require a change order within the time allowed, the Vendor waives its right to make any claim or submit subsequent change order requests for that portion of the contract work. If the Vendor disagrees with the equitable adjustment the Vendor must complete the change order work; however, the Vendor may elect to protest the adjustment as provided below: A. Procedure and Protest by the Vendor. If the Vendor disagrees with anything required by a change order, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Vendor shall: 1. Immediately give a signed written notice of protest to the City; Goods and Services Agreement 2. Supplement the written protest within fourteen (14) calendar days with a written statement that provides the following information: a. The date of the Vendor'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 Vendor is asserting a schedule change or disruption. 3. The Vendor 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 Vendor's records needed for evaluating the protest. The City will evaluate all protests, provided the procedures in this section are followed. If the City determines that a protest is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. B. Vendor's Duty to Complete Protested Work. In spite of any protest, the Vendor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. C. Vendor's Acceptance of Changes. The Vendor 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 Vendor 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 Vendor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Vendor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). VII. CLAIMS. The Vendor shall give written notice to the City of all claims other than change orders within fourteen (14) calendar days of the occurrence of the events giving rise to 3 Goods and Services Agreement the claims. Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Vendor 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 Vendor knew, or should have known, of the facts giving rise to the claim. At a minimum, a Vendor's written claim must include the information set forth regarding protests in Section VI(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. Vendor 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. XIII. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers, 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. Vendor's obligation to indemnify shall not extend to that portion of damages caused by the City's sole negligence. The City's inspection or acceptance of any of Vendor's 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 Vendor and the City, its officers, officials, employees, agents and volunteers, the Vendor's liability hereunder shall be only to the extent of the Vendor's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THIS INDEMNIFICATION CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES 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. IX. INSURANCE. The Vendor shall procure and maintain for the duration of this Agreement, insurance against claims for injuries to persons or damage to property that may arise from or in connection with the performance of the contract work by the Vendor, its agents, representatives, employees or subcontractors. n Goods and Services Agreement Before beginning work on the project described in this Agreement, the Vendor shall provide a Certificate of Insurance evidencing: A. Automobile Liability insurance with limits no less than $500,000 combined single limit per accident for bodily injury and property damage; and B. Commercial General Liability insurance written on an occurrence basis with limits no less than $1,000,000 combined single limit per occurrence and $2,000,000 aggregate for personal injury, bodily injury and property damage. Coverage shall include but not be limited to: blanket contractual; products/completed operations/broad form property damage; and employer's liability. C. Excess Liability insurance with limits not less than $1,000,000 limit per occurrence and aggregate. t_;i:+., ftsufaf_ ,t,,, $i nnn nnn i; ;+ per- E. Workers Compensation insurance as statutorily required by the Industrial Insurance Act of the State of Washington, Title 51, Revised Code of Washington and employer's liability with limits not less than $1,000,000. Any payment of deductible or self -insured retention shall be the sole responsibility of the Vendor. All required policies shall be provided on an "occurrence" basis except professional liability insurance (if required), which shall be provided on a "claims -made" basis. The City shall be named as an additional insured on the Commercial General Liability insurance policy, as respects work performed by or on behalf of the Vendor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all the required insurance policies. The Vendor's Commercial General Liability insurance shall contain a clause stating that coverage shall apply 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 Vendor's insurance shall be primary and non-contributory insurance as respects the City and shall contain a waiver of subrogation against the City for claims arising out of any operations, liabilities and obligations to which coverage applies. It shall be an affirmative obligation upon Vendor to advise the City's Risk Manager by fax at (360) 473-5161, or by certified mail, return receipt requested to City of Bremerton, Attn: Risk Management, 345 6t' Street, Suite 100, 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 also reserves its unqualified right to require at any time and for any reason, proof of coverage in the form of a duplicate of the insurance policy with all endorsements as evidence of coverage. Goods and Services Agreement X. MISCELLANEOUS. A. Licenses and Taxes. Vendor shall possess a current Bremerton Business License and any regulatory license required to fulfill Vendor's obligations under this Agreement. B&O taxes shall be paid when due, and Vendor, by this agreement, assigns any payments due under this contract to the City Clerk for payment of such taxes which have been declared delinquent. B. Conflict and Precedence. In the event of a conflict between the contract documents, the document which rates higher on the following list shall take precedence: 1. Amendments / Change Orders to Goods and Services Agreement 2. Goods and Services Agreement 3. Scope of Work & Duties (Exhibit A) 4. Terms and Conditions 5. Vendor's Proposal (Exhibit B) C. Documents Incorporated by Reference. The following documents are incorporated by reference, to include, but not be limited to: 1. Terms and Conditions, 2. Scope of Work & Duties (Exhibit A) 3. Bid Proposal (Exhibit B), and 4. Non -Collusion Affidavit. D. Use of Photographs and Images. Vendor shall not use or distribute photographs or images depicting City officials, personnel, property, or equipment whether prepared by Vendor or provided by City without prior written consent of the City. The City will not unreasonably withhold its consent. E. Nondiscrimination. In the hiring of employees for the performance of work under this Agreement the Vendor, its subcontractors, or any person acting on behalf of Vendor shall not, by reason of race, religion, color, sex, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. F. Compliance with Laws. Vendor shall comply with all federal, state and local laws, rules and regulations throughout every aspect in the performance of this Agreement. G. Prevailiniz Wages. Vendor shall file a "Statement of Intent to Pay Prevailing Wages" with the State of Washington Department of Labor & Industries prior to commencing the contract work. Vendor shall pay prevailing wages and comply with Chapter 39.12 of the Revised Code of Washington, as well as any other applicable prevailing wage rate provisions. The latest prevailing wage rate 6 Goods and Services Agreement revision issued by the Department of Labor and Industries is attached. H. Work Performed at Vendor's Risk. Vendor 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 Vendor's own risk, and Vendor 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. I. Governing Law. This Agreement shall be governed and construed in accordance with the laws of the State of Washington. If any dispute arises between the City and Vendor under any of the provisions of this Agreement, resolution of that dispute shall be available exclusively under the jurisdiction, venue and rules of the Kitsap County Superior Court, Kitsap County, Washington. J. Attorney's Fees. 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 IX of this Agreement. K. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed below, 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 in this Agreement. Notices to be sent to: Notices to be sent to: CITY: VENDOR: Attn: Chris Mottner Attn: Dan Larson City of Bremerton Merchant Patrol Security Services 345 6 h Street, Suite 100 PO Box 964 Bremerton, WA 98337 Olalla, WA 98359 L. Assignment. Any assignment of this Agreement by the Vendor without the written consent of the City shall be void. M. 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 Vendor. N. 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 of the remaining portion of this Agreement and the remainder shall remain in full force and effect. Goods and Services Agreement O. Entire Agreement. The written provisions and terms of this Agreement, together with any attached Exhibits, supersede all prior verbal statements by any representative of the City, and those statements shall not be construed as forming a part of or altering in any manner this Agreement. This Agreement and any attached Exhibits contain the entire Agreement between the parties. Should any language in any Exhibit to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. IN WITNESS WHEREOF, the parties below have executed this Agreement. CITY: VENDOR: City of Bremerton By: Wo_ Print Na f e `�)ee er- Its:_ M(,,+ac:r Date: S f 4o k Zo-ZQ APPROVED AS TO FORM: By: ROGER . LUBO ICH, Bremerton City Attorney By:4- Print Name: a L-•.r-S o Its: �4�^�•�c�' __ Date: �1 r Ld Zd ATTEST: By: A')Oam�vu ANGELA 1 O VER, City Clerk Goods and Services Agreement Exhibit A SCOPE OF WORK AND DUTIES FOR Security Services and Patrols The contractor shall: A. Provide the required amount of security services per day, seven (7) days a week, times as specified. B. Vary times of vehicle and foot patrols during the required hours to be most effective. C. Provide vehicle patrol through city facilities and around properties as specified. D. Have all security personnel wear uniform apparel for identification and to maintain a professional appearance when on duty and to enhance authority. E. Have all security personnel successfully pass employment background checks, reference checks driver's record checks, drug screening and provide evidence of such if requested by city representatives. F. Have all security personnel be "unarmed", no exceptions allowed. G. Possess professional liability insurance of $1,000,000.00, automobile liability insurance of $500,000.00 and provide certificates of continued coverage. City of Bremerton to be named on all certificates of insurance to ensure validity. H. Provide the city representatives with phone number and instructions for contacting supervisor staff to report misconduct, non-performance, or un-kept appearance of assigned security personnel. Locations: A. Downtown Parking Facility, 405 Washington Avenue. B. Harborside Parking Facility, 100 Washington Avenue. C. Bremerton Library, 612 Fifth Street. D. Municipal Courts Building, 550 Park Avenue. E. Conference Center, 100 Washington Avenue. F. Naval Museum Facility, 251 First Street. G. Park Avenue Plaza Garage, 300 Park Avenue. H. Jarstad Park, Storage Buildings, 4320 W. Belfair Valley Road. I. Pump Station #17, Pipe Yard, Forestry Storage Buildings, 4398 W. Belfair Valley Road. Basic Duties• 1. Patrol on foot and inspect all levels of the facility, elevator, stairwells and the outer perimeter, as applicable. 2. Patrol and inspect buildings and grounds to detect and prevent fire, theft, illegal activity and property damage. Examine doors and windows to ensure security. 3. Patrol in security marked vehicles, through parking facilities and outer perimeter of facilities, as applicable. 4. Report and log all incidents of theft, vandalism, accidents and other disturbances. Place calls to city representative's voicemail day or night of any serious situations or conditions. 5. Assist contracted parking services with related tasks associated with vehicles and during scheduled events and activities, as applicable. 6. Inspection of fire suppression system daily, as instructed, and record data as required. 7. Give verbal warnings of "no trespassing" to persons loitering, or have no reason to be on city property, maintain an activity log of incidents to be given to the city on a monthly schedule or as requested. Supervisory Duties/Requirements: 1. Have contact with security services patrolman two (2) times per week to discuss any current issues and changes for quality control purposes and for evaluation of employee performance. 2. Physically inspect service locations one (1) time per month to see if service, procedures, or facility operations require changes or additional coverage. 3. Provide security recommendations to the city representatives that may enhance safety and security at city properties. 4. Access and review, for accuracy, the daily security service logs and check for proper security coverage for each location, per scope of work. Vehicle Security Patrols 1. Vehicle security patrols will be required at the City of Bremerton parking facilities to enhance presence and for coverage of parking levels and areas. 2. Vehicle security patrols will be provided around city facilities and properties as applicable. Patrol building perimeter, to enhance presence. 3. Vehicle security patrol shall be with the contractor's company owned vehicle when patrolling on and in city owned property and insured as such. Service Re uirements: The following locations require a total of four 4 hours of securitY Dresence per day, seven (7) days per week, and two 2 hours of vehicle patrol per day, seven (7) days per week, random work hours for a 6 hour shift. • Downtown Parking Facility • Harborside Parking Facility • Park Avenue Plaza Garage Hours of coverage to be 10:00 PM — 4:00 AM Each of the following locations requires half (1/2) hour of security presence per day, seven (7) days per week for a total of three (3) hours of security per day, random work hours for a 3 hour vehicle patrol shift. • Bremerton Library • Municipal Courts Building • Conference Center • Naval Museum Facility • Jarstad Park/Storage Buildings • Pump Station #17/Forestry Buildings Hours of coverage to be 10:00 PM — 4:00 AM City Contact List: A. Chris Mottner, Inventory/Facilities Supervisor Phone: (360) 473-2316 Email: Chris. Mottner ci.bremerton.wa.us B. Joe Stansbery, Lead Facilities Service Specialist Phone: (360) 473-5335 Email: Joe.Stansbe ci.bremerton.wa.us C. Customer Response Dispatcher (24-hour message phone) Phone: (360) 473-5920 Term: A. Services will be for a two (2) year period, beginning upon formal award of contract B. An additional two (2) year optional term may be negotiated by both parties, with rates adjusted to compensate for increases to cost of living rates. C. The City of Bremerton has the option to add hours of security services for the locations listed, if required, and will be billed at the same hourly rate as bid. D. The City of Bremerton has the option to change hours of security coverage based on site conditions, problems or any other associated issues. Exhibit B BID PROPOSAL Security Services and Patrol .City of Bremerton 1. Unarmed Security Guard $18.70 Per Hour. 2. Vehicle Security Patrols $ 22.40 Per Hour. (* if additional to item #1) Note: All supervisory and security work shall be included in the hourly rate shown. Total of six (6) hours security guard and three (3) hours of vehicle security patrols per day = (9) hours/day. Contractor: MPSS, inc./Merchant Patrol Security Services, Inc. Firm Name: Dan Larson Address: 5610 Kitsap Way Suite 380 Bremerton, WA. 98312 Telephone Number: 360-377-8500 Fax: 253-853-4185 Employer's Identification Number: 91-2184501 Washington Industrial Insurance Number: 5574800 Washington State Excise Tax Registration Number (UBI): 602 291798 Washington State Contractors Registration Number: 201 Washington State Contractors Registration Expiration Date: 6/2020 City of Bremerton Business License Number: 24012 12/30/2020 Page 1 of 2 Exhibit B BID PROPOSAL Security Services and Patrol City of Bremerton *Narrative: Please provide information regarding contacts, cooperation, experiences with local law enforcement officials, officers and departments that will be beneficia► to the provision of security services and patrols for the City of Bremerton; As a locally owned and operated security guard services in Bremerton, Merchant Patrol Security Services (MPSS) brings the most relevant kind of experience. MPSS has been providing security services for three (3) generations and currently operates security services to 36 commercial sites in Kitsap County. Our long history, community involvement, and established trust provides us with the relationships, understanding and appreciation for this community we call home. MPSS is proud of the partnerships we have built over 41 the years with our clients. MPSS currently has clients that have used our services for over 25 years. We believe that our ability to retain our clients for so long is based on developing a client into a partner. This is done over time, building trust and assuring confidence through performance. Additionally, our professional manner, use of sound judgement and tact has resulted in a trusted relationship with local law enforcement agencies, Kitsap County Jail, Department of Corrections, Kitsap Mental Health Services, Outreach Organizations (Coffee Oasis, Stand up4 Kids, Salvation Army), City Facilities Division and local downtown businesses. This also includes the Bremerton Police Department (BPD). MPSS regularly has contact with BPD Patrol Officers providing information and working together to detect and prevent, theft, fire, illegal activities and property damage to city property. Please review the Security Services and Patrols Proposal we have included. We believe it will provide you with additional information on MPSS ability, experience, history, management team, employment, training and mission. We are committed to strengthening our community; improve the security guard and patrol service industry, by setting a standard of quality, professionalism and integrity. MPSS will partner with our community, clients and Law Enforcement utilizing all available resources to identify, prevent, and resolve problems of crime/disorder, through the use of our security guards, and patrol services. *To be reviewed and rated by a city evaluation panel. Please attach to this proposal the bidding company's recent work experience, past performance and references from the local region for similar services. Page 2 of 2 03/25/2021 Nicholson & Associates Ins LLC 1802 Black Lake Blvd SW #301 Olympia, WA 98512 Amanda King (360)352-8444 (360)943-9712 amandak@nichinsure.com 00002284-329786 13 Merchant Patrol Security Services, Inc PO Box 964 Olalla, WA 98359 Mt Hawley Insurance Company A Y Y PGA0003853 05/23/2020 05/23/2021X X X 1,000,000 50,000 5,000 1,000,000 2,000,000 2,000,000 Progressive Companies 11770 B 00744122-2 05/23/2020 11/23/2020 X 1,000,000 Mt Hawley Insurance Company A XGA0001635 05/23/2020 05/23/2021 XX 1,000,000 1,000,000 Mt Hawley Insurance Company A PGA0003853 05/23/2020 05/23/2021 X Stop Gap 1,000,000 1,000,000 1,000,000 City of Bremerton is included as additional insured when required by written contract. Waiver of Subrogation applies. City of Bremerton 345 6th Street Suite 600 Bremerton, WA 98337 (NAK) Printed by NAK on March 25, 2021 at 09:33AM ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS (FORM B) Policy Number: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. b.Supervisory, inspection, architectural or engi- neering activities. 2."Bodily injury" or "property damage" occurring after: a.All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, mainte- nance or repairs) to be performed by or on behalf of the additional insured(s) at the lo- cation of the covered operations has been completed; or b.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a prin- cipal as a part of the same project. C. With respect to the insurance afforded to these addi- tional insureds, the following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the additional in- sured is: 1.The minimum amount required by any contract or agreement you have entered into to provide addi- tional insured coverage; or 2.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. D. Definitions "Ongoing operations" means operations not included in the "products-completed operations hazard." A. Section II – Who Is An Insured is amended to include as an additional insured any person or organ- ization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an addi- tional insured only with respect to liability for "bodily injury," "property damage" or "personal and adver- tising injury" caused, in whole or in part, by: 1.Your negligence; or 2.The negligence of those acting on your behalf; in the performance of your "ongoing operations" for the additional insured. A person's or organization's status as an additional insured under this endorsement ends when your oper- ations for that additional insured are completed. To the extent required under contract, this policy will apply as primary insurance to additional insureds and other insurance which may be available to such addi- tional insureds will be non-contributory. B.With respect to the insurance afforded to these ad- ditional insureds, the following additional exclusions apply: This insurance does not apply to: 1."Bodily injury," "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional archi- tectural, engineering or surveying services, including: a.The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or CGL 215 (06/16)Page 1 of 1Contains copyrighted material of ISO Properties, Inc. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. Mt. Hawley Insurance CompanyPGA0003853 Insured