HomeMy Public PortalAbout037-2016 - Fire - Hastings Air Control - Exhaust SystemAGREEMENT
THIS AGREEMENT made and entered into this 6� day of r , 2016, and referred to as
li
Contract No. 37-2016, by and between the City of Richmond, I diana, a municipal corporation acting
by and through its Board of Public Works and Safety (hereinafter referred to as the "City") and Hastings
Air Energy Control, Inc., 5555 South Westridge Drive, New Berlin, WI 531-7900 (hereinafter referred to
as the "Contractor").
SECTION I. STATEMENT AND SUBJECT OF WORK
City hereby retains Contractor to provide services in connection with the upgrade and installation of the
magnetic exhaust system for the Richmond Fire Department (Station No. 3), which system upgrade
(hereinafter referred to as "the Project") shall include a 20 foot SBTA, 5 inch Upper Howe Assembly, 5
inch lower hose MG with 5 inch conical as further described on Exhibit A.
Requests for Quotes were made November 4, 2015. Responses to said request are on file in the office of
the Richmond Fire Department. The response of Contractor dated February 24, 2016, to said request is
attached hereto as "Exhibit A" which response consists of five (5) pages, and is hereby incorporated by
reference and made a part of this Agreement. Contractor agrees to abide by the same.
Should any provisions, terms, or conditions contained in any of the documents attached hereto as
Exhibits, or in any of the documents incorporated by reference herein, conflict with any of the provisions,
terms, or conditions of this Agreement, this Agreement shall be controlling.
Contractor shall furnish all labor, material, equipment, and services necessary for the proper completion
of all work specified.
No performance of services shall commence until the following has been met:
1. The City is in receipt of any required certificates of insurance;
2. The City is in receipt of any required affidavit signed by Contractor in accordance
with Indiana Code 22-5-1.7-11(a)(2); and
3. A purchase order has been issued by the Purchasing Department.
SECTION II. STATUS OF CONTRACTOR
Contractor shall be deemed to be an independent contractor and is not an employee or agent of the City of
Richmond. The Contractor shall provide, at its own expense, competent supervision of the work.
SECTION III. COMPENSATION
City shall pay Contractor a total amount not to exceed Nine Thousand Eight Hundred Seventy-
three Dollars and Forty-six Cents ($9,873.46) for the satisfactory completion of the Project.
SECTION IV. TERM OF AGREEMENT
This Agreement shall become effective when signed by all parties and shall continue in effect until
satisfactory completion of the Project.
Contract No. 37-2016
Page 1 of 5
f
Notwithstanding the term of this Agreement, City may terminate this Agreement in whole or in part, for
cause, at any time by giving at least five (5) working days written notice specifying the effective date and
the reasons for termination which shall include but not be limited to the following:
a. failure, for any reason of the Contractor to fulfill in a timely manner
its obligations under this Agreement;
b. submission of a report, other work product, or advice, whether oral or written, by the
Contractor to the City that is incorrect, incomplete, or does not meet reasonable
professional standards in any material respect;
c. ineffective or improper use of funds provided under this Agreement;
d. suspension or termination of the grant funding to the City under which this Agreement
is made; or
e. unavailability of sufficient funds to make payment on this Agreement.
In the event of such termination, the City shall be required to make payment for all work performed prior
to the date this Agreement is terminated, but shall be relieved of any other responsibility herein.
This Agreement may also be terminated, in whole or in part, by mutual Agreement of the parties by
setting forth the reasons for such termination, the effective date, and in the case of partial termination, the
portion to be terminated.
SECTION V. INDEMNIFICATION AND INSURANCE
Contractor agrees to obtain insurance and to indemnify the City for any damage or injury to person or
property or any other claims which may arise from the Contractor's conduct or performance of this
Agreement, either intentionally or negligently; provided, however, that nothing contained in this
Agreement shall be construed as rendering the Contractor liable for acts of the City, its officers, agents, or
employees. Contractor shall as a prerequisite to this Agreement, purchase and thereafter maintain such
insurance as will protect it from the claims set forth below which may arise out of or result from the
Contractor's operations under this Agreement, whether such operations by the Contractor or by any sub-
contractors or by anyone directly or indirectly employed by any of them, or by anyone for whose acts the
Contractor may be held responsible.
Coverage
A. Worker's Compensation &
Disability Requirements
B. Employer's Liability
C. Comprehensive General Liability
Section 1. Bodily Injury
Section 2. Property Damage
D. Comprehensive Auto Liability
Section 1. Bodily Injury
Limits
Statutory
$100,000
$1,000,000 each occurrence
$2,000,000 aggregate
$1,000,000 each occurrence
$1,000,000 each person
$1,000,000 each occurrence
Page 2 of 5
Section 2. Property Damage $1,000,000 each occurrence
E. Comprehensive Umbrella Liability $1,000,000 each occurrence
$2,000,000 each aggregate
SECTION VI. COMPLIANCE WITH WORKER'S COMPENSATION LAW
Contractor shall comply with all provisions of the Indiana Worker's Compensation law, and shall, before
commencing work under this Agreement, provide the City a certificate of insurance, or a certificate from
the industrial board showing that the Contractor has complied with Indiana Code Sections 22-3-2-5, 22-3-
5-1 and 22-3-5-2. If Contractor is an out of state employer and therefore subject to another state's
worker's compensation law, Contractor may choose to comply with all provisions of its home state's
worker's compensation law and provide the City proof of such compliance in lieu of complying with the
provisions of the Indiana Worker's Compensation Law.
SECTION VII. PROHIBITION AGAINST DISCRIMINATION
A. Pursuant to Indiana Code 22-9-1-10, Contractor, any sub -contractor, or any person acting on
behalf of Contractor or any sub -contractor shall not discriminate against any employee or
applicant for employment to be employed in the performance of this Agreement, with respect to
hire, tenure, terms, conditions or privileges of employment or any matter directly or indirectly
related to employment, because of race, religion, color, sex, disability, national origin, or
ancestry.
B. Pursuant to Indiana Code 5-16-6-1, the Contractor agrees:
That in the hiring of employees for the performance of work under this Agreement of any
subcontract hereunder, Contractor, any subcontractor, or any person acting on behalf of
Contractor or any sub -contractor, shall not discriminate by reason of race, religion, color,
sex, national origin or ancestry against any citizen of the State of Indiana who is qualified
and available to perform the work to which the employment relates;
2. That Contractor, any sub -contractor, or any person action on behalf of Contractor or any
sub -contractor shall in no manner discriminate against or intimidate any employee hired
for the performance of work under this Agreement on account of race, religion, color,
sex, national origin or ancestry;
That there may be deducted from the amount payable to Contractor by the City under this
Agreement, a penalty of five dollars ($5.00) for each person for each calendar day during
which such person was discriminated against or intimidated in violation of the provisions
of the Agreement; and
4. That this Agreement may be canceled or terminated by the City and all money due or to
become due hereunder may be forfeited, for a second or any subsequent violation of the
terms or conditions of this section of the Agreement.
C. Violation of the terms or conditions of this Agreement relating to discrimination or intimidation
shall be considered a material breach of this Agreement.
SECTION VHI. COMPLIANCE WITH INDIANA E-VERIFY PROGRAM REQUIREMENTS
Pursuant to Indiana Code 22-5-1.7, Contractor is required to enroll in and verify the work eligibility status
of all newly hired employees of the contractor through the Indiana E-Verify program. Contractor is not
required to verify the work eligibility status of all newly hired employees of the contractor through the
Page 3 of 5
Indiana E-Verify program if the Indiana E-Verify program no longer exists. Prior to the performance of
this Agreement, Contractor shall provide to the City its signed Affidavit affirming that Contractor does
not knowingly employ an unauthorized alien in accordance with IC 22-5-1.7-11 (a) (2). In the event
Contractor violates IC 22-5-1.7 the Contractor shall be required to remedy the violation not later than
thirty (30) days after the City notifies the Contractor of the violation. If Contractor fails to remedy the
violation within the thirty (30) day period provided above, the City shall consider the Contractor to be in
breach of this Agreement and this Agreement will be terminated. If the City determines that terminating
this Agreement would be detrimental to the public interest or public property, the City may allow this
Agreement to remain in effect until the City procures a new contractor. If this Agreement is terminated
under this section, then pursuant to IC 22-5-1.7-13 (c) the Contractor will remain liable to the City for
actual damages.
SECTION IX. IRAN INVESTMENT ACTIVITIES
Pursuant to Indiana Code (IC) 5-22-16.5, Contractor certifies that Contractor is not engaged in investment
activities in Iran. In the event City determines during the course of this Agreement that this certification
is no longer valid, City shall notify Contractor in writing of said determination and shall give contractor
ninety (90) days within which to respond to the written notice. In the event Contractor fails to
demonstrate to the City that the Contractor has ceased investment activities in Iran within ninety (90) days
after the written notice is given to the Contractor, the City may proceed with any remedies it may have
pursuant to IC 5-22-16.5. In the event the City determines during the course of this Agreement that this
certification is no longer valid and said determination is not refuted by Contractor in the manner set forth
in IC 5-22-16.5, the City reserves the right to consider the Contractor to be in breach of this Agreement
and terminate the agreement upon the expiration of the ninety (90) day period set forth above.
SECTION X. RELEASE OF LIABILITY
Contractor hereby agrees to release and hold harmless the City and all officers, employees, or agents of
the same from all liability which may arise in the course of Contractor's performance of its obligations
pursuant to this Agreement.
SECTION XI. MISCELLANEOUS
This Agreement is personal to the parties hereto and neither party may assign or delegate any of its rights
or obligations hereunder without the prior written consent of the other party. Any such delegation or
assignment, without the prior written consent of the other party, shall be null and void. This Agreement
shall be controlled by and interpreted according to Indiana law and shall be binding upon the parties, their
successors and assigns. This document constitutes the entire Agreement between the parties, although it
may be altered or amended in whole or in part at any time by filing with the Agreement a written
instrument setting forth such changes signed by both parties. By executing this Agreement the parties
agree that this document supersedes any previous discussion, negotiation, or conversation relating to the
subject matter contained herein.
This Agreement may be simultaneously executed in several counterparts, each of which shall be an
original and all of which shall constitute but one and the same instrument.
The parties hereto submit to jurisdiction of the courts of Wayne County, Indiana, and any suit arising out
of this Contract must be filed in said courts. The parties specifically agree that no arbitration or mediation
shall be required prior to the commencement of legal proceedings in said Courts. By executing this
Agreement, Contractor is estopped from bringing suit or any other action in any alternative forum, venue,
or in front of any other tribunal, court, or administrative body other than the Circuit or Superior Courts of
Wayne County, Indiana, regardless of any right Contractor may have to bring such suit in front of other
tribunals or in other venues.
Page 4 of 5
Any person executing this Contract in a representative capacity hereby warrants that he/she has been duly
authorized by his or her principal to execute this Contract.
In the event of any breach of this Agreement by Contractor, and in addition to any other damages or
remedies, Contractor shall be liable for all costs incurred by City in its efforts to enforce this Agreement,
including but not limited to, City's reasonable attorney's fees.
In the event that an ambiguity, question of intent, or a need for interpretation of this Agreement arises,
this Agreement shall be construed as if drafted jointly by the parties, and no presumption or burden of
proof shall arise favoring or disfavoring any party by virtue of the authorship of any of the provisions of
this Agreement.
IN WITNESS WHEREOF, the parties have executed this Agreement at Richmond, Indiana, as of the day
and year first written above, although signatures may be affixed on different dates.
"CITY"
THE CITY OF RICHMOND,
INDIANA by and through its
Board of Public Works and Safety
By: L
Vicki Robinson, President
"CONTRACTOR"
HASTINGS AIR ENERGY, INC.
5555 South Westridge Drive
New Berlin, WI 53151-7900
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Printed: M' A G le
Title:
it Date: Y4 Date:
APPROVED: (
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Date:
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Page 5 of 5
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air energy control, inc.
Page 2 of 3
P: 800.236.8450 / 262.364.0500
F. 800.260.9199 / 262,364.0550
www.hasbngsair.com
Regionally Serving Illinois I Indiana I Iowa I Kentucky I Michigan I Minnesota I North and South Dakota I Ohio I Wisconsin
Tim Brown
Richmond Fire Department #3
101 S. 51h Street
Shb To,
Richmond Fire Department #3
4300 Woodside Drive
Richmond IN Richmond IN
Description
P
rVE-SBTA-MG-LH
SBTA-20 Track pads. Induces: Tracy ends)
5
5" Magnetic Grabber - 5" Lower hose assem
Magnetic Grabber®, S" Conical Tailpipe Ada
VE-SB7rA-MG-UH2O5
SBTA-MG-Upper hose pack 20' x S". Indude
SEN-002
Engine Pressure Sensor Assembly w/ear dip;
VE-LEG-LP1
Sq Alumn Leg Tube, 1.2" Sq. X 19' Long, Ext
VE-LEG-MKF
Vertical Leg Mount IGt
SADL-013
S" 90 deg Black Elbow Metal Saddle
INST-M
install a complete system to include 20lt S81
Sin conical at St#3 for grass rig, additional Lc
PD
Per Diem
LIFT
Lift Usage Charges
FIT
Freight
NOTE: Shipping and Tax are NOT INCLUDED.
I have read the terms page, a single, separate page from the pricing,
and I ak and ditions of this quotation.
Signed:; E.;w`il�'[7 I�con�CE t i
Name: Tide:
Terms:
Prepay - 3% Discount:
Net 30 Days from Shipment
Visa/Mastercard/Discover
Purchase Order #
Date: 2/24/2016
Sales Person: Matthew Johnson
Quote #: QUO-20233-F212P9
Expires: 7/30/2016 11:00:00 PM
ops, splices, Joiner Plates, Security Boits, Tape, Labels
Qty
1.00
)ly. Ind ides: Safety Disconnect, 2' Hose, Reducer,
)ter
2.00
s: Hose, Saddle, Trolley, Balancer, Riser Bracket
1.00
2.00
vded Alumn, Feld Cut To Req'D Length
2.00
2.00
A, Sin Upper Hose Assembly, Sin Lower hose MG with
wer Section for other drop Sin MG
muo
1.00
1.00
$9,873.46
-2zl 41-tq'r1--P
RECEIVED
FEB 24 2016
Richmond Fire Dept,
Please remit tw:
Thank you for considering Hastings. 55a
5 sis Air- idg pri , n"'
New Berlin, WX 53151-7900
E7"IFIT
F -:A PAGE --L-0-
Page 1 of 3
H A S T I G S P: 800.236.8450 / 262.364.0500
air energy C o n t-r o l, Inc. F: 800.260.9199 / 262.364.0550
www.hasbngsair.com
Regionally Serving Illinois i Indiana i Iowa I Kentucky I Michigan I Minnesota I North and South Dakota I Ohio I Wisconsin
Tim Brown ShiQ To
Richmond Fire Department #3 4300 Woodside Drive Date: 2/24/2016
101 S. Sth Street Richmond IN Sales Person: Matthew Johnson
Richmond IN
Quote #: QU0-20233-F272P9
Expires: 7/30/201611:00:00 PM
Quote Per Request
install a complete system to include 20ft SBTA , Sin Upper Hose Assembly, Sin Lower hose MG with Sin conical at St #3
for grass rig. additional Lower Section for other drop Sin MG
Page 3 of 3
�J
■ ASTINGS
air energy conL�rol, inc.
P: 800.236.8450 1262.364.0500
F_ 800.260.9199 / 262.364.0550
www.hastingsair.com
Regionally Serving Illinois I Indiana I Iowa I Kentucky I Michigan I Minnesota I North and South Dakota I Ohio I Wisconsin
TERMS:
Freight for equipment is FOB destination. Hastings will deliver with our truck. Future parts or filter orders
will ship prepaid and add.
Normal delivery is 3 to 4 weeks after receipt of confirming purchase order or prepayment check.
Warranty is per manufacturer specifications. Contact representative for more details.
Payment terms are 3% discount for prepayment with order, or net 30 from date of start up. Payment terms
discount (3%) does not apply if the payment is made with a credit card. A 1 %2 % per month finance charge
will be assessed on all invoice balances outstanding past 30 days.
Price does not include sales tax. Please provide municipality's tax exemption certificate.
! PAGE -�_01�
PLYM VVENT°
clean air at work
WARRANTY
Statement of Limited Warranty
Seller warrants to the Buyer of all new products that it will be free of manufactured
defects in workmanship and material.
This warranty is void if Seller finds that the product has been subjected to improper
installation, improper care, service and maintenance or abnormal operations.
Warranty Period
All standard warranty periods start from the date of shipping to the original Buyer or
third party in which invoice and/or sales order number must be provided. Standard
warranty period applies unless otherwise stated in a written agreement between
Buyer and Seller at time of sale. Warranty periods are as follows:
Standard Product
10 Year Conditional Warranty: Aluminum Rail Extrusions Only
10 Year Conditional Warranty will be granted on standard Aluminum
Extrusion(s) only by Seller in accordance with following: Seller
receives completed Warranty Card from Buyer, that material received
is in good condition, within 30 business days of material receipt.
Warranty applies to Aluminum Rail Extrusion product only.
If completed Warranty Card is not received by Plymovent within 30
business days of material receipt, Plymovent's 5 Year Warranty on
Standard Product will apply.
For Warranty Card, please contact Plymovent's Customer Service
and/or Sales or go online to www.olvmovent.com under "contact us".
5 Year Conditional Warranty: Standard Fire Systems Only
5 Year Conditional Warranty will be granted by Seller in accordance
with the following: Seller receives a completed Warranty Card from
the Buyer, that material received is in good condition, within 30
business days of material receipt. Warranty applies to Fire product
only and includes Exhaust Hoses used within Fire Systems only.
If completed Warranty Card is not received by Plymovent within 30
business days of material receipt, Plymovent's 3 Year Warranty on
Standard Product will apply.
For Warranty Card, please contact Plymovent's Customer Service
and/or Sales or go online to www.12lymovent.com under "contact us".
EQUIPMENT LIMITED WARRANTY
CS)
Hastings Air -Energy Control, Inc. shall warranty all materials and equipment
for a period of (Five 5-Years Part and Labor) from final acceptance and start -
up. Defects shall be made good at the dealer's expense with no cost or
H A S T [ N G S
obligation to the owner. Hastings Air -Energy Control, Inc, shall not be
air energy con'; ol, inc.
responsible for system misuse, abuse, improper or insufficient maintenance,
natural disasters, components not operated properly under normal industry use,
5555 South':4+es'ritlae Grive
components that have been repaired, altered or modified. If any failure should
yetvv Berlin. v:+ 53151-790
occur, Hastings Air -Energy Control, Inc. shall repair or replace (with new or
p: 800.236.8450
remanufactured parts), at their option, the product without cost. All repairs shall
f: 800.260.9199
be completed at the original installation site of the product however Hastings
-- --- - ---- --
Air -Energy Control, Inc. reserves the right, at his cost, to remove and return the
Illinois Office
product to the plant where the product can be inspected, repaired or replaced and
m: 847.362.9660
`: 847.362.9661
then returned and reinstalled. Dealer shall be responsible for all labor costs and
P
Michigan Office
transportation costs, including, freight and insurance, in connection with
m: 248.888.9911
completing a warranty work call.
f: 248.478.9911
Minnesota Office
m: 952.8.12,8450
No warranty is made regarding the suitability or compatibility of any Hastings
': 3oc2sn.91e
Air -Energy Control, Inc product for a particular application or purpose. The
customer and dealer are responsible for the final selection and or proper
application as it applies to the intended use.
The enforceability of this warranty is limited to the original purchaser and is not
transferable to, or enforceable by, any subsequent owner.
There are no other express warranties covering the system other than those set
forth in this warranty. All implied warranties are limited to the (Five 5-Years
Parts and Labor) period of this warranty and no warranties expressed or
implied extend beyond this (Five 5-Years Parts and Labor) period.
Hastings Air -Energy Control, Inc will in no event be liable for any
consequential, incidental, indirect or special damages (including but not limited
to, lost profits, individual traveling costs, labor or other charges for adjustment)
arising out of or in connection with the use, misuse, or function of the system.
creatino a cleaner workplace
d l�7is J OF
f
Affidavit of Employment Eligibility Verification
The Contractor, -445T(krp 4, itf r Grt ,-G affirms under the penalties of perjury that
Contractor does not knowingly employ aA unauthorized alien. If Contractor is self-employed
and does not employ any employees, Contractor verifies he or she is a United States citizen
or qualified alien.
The Contractor has not knowingly employed or contracted with an unauthorized alien and
shall not retain an employee or contract with a person that the Contractor subsequently learns
is an unauthorized alien. Pursuant to Indiana Code 22-5-1.7, Contractor has enrolled in and
verified the work eligibility status of all newly hired employees of the contractor through the
Indiana E-Verify program.
The Contractor has required Contractor's subcontractors to certify to the Contractor that the
subcontractor does not knowingly employ or contract with an unauthorized alien and that the
subcontractor has enrolled and is participating in the E-Verify program. The Contractor will
maintain this certification throughout the duration of the term of a contract with a
subcontractor.
I hereby verify under the penalty of perjury that the foregoing statement is true.
Dated this %D "'day of Yy` �--� , 2016.
W di
(signature)
(printed name)
HASTAIR-01 NKAMKE
ACORO- CERTIFICATE OF LIABILITY INSURANCE
DATD/YYYY)
5/10/210/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
Robertson Ryan - Waukesha
20975 Swenson Drive, Suite 175
Waukesha, WI 53186
CONTACT
NAME:
PHONE 414 271-3575 FAX
A/C No Ext : ( ) A/C, No : (262) 717-9434
ADDRIESS:
INSURER(S) AFFORDING COVERAGE
NAIC N
INSURER A: The Cincinnati Insurance Company
10677
INSURED
INSURER B :
INSURER C :
Hastings Air Energy Control Inc
INSURER D :
5555 S Westridge Dr
New Berlin, WI 53151-7900
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCEADDLISUBRI
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DDrfM
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE TOCCUR
EPP 0223726
01/01/2016
01/01/2017
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence
$ 500,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY � X I JECT LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
A
AUTOMOBILE LIABILITY
X ANY AUTO
ALLOWNED SCHEDULED
X AUTOS AUTOS
X NON -OWNED
rHIRED AUTOS AUTOSIF
EBA0223726
01/01/2016
01/01/2017
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PR P.E ICAMAGE
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
EPP 0223726
01/01/2016
01/01/2017
EACH OCCURRENCE
$ 6,000,000
AGGREGATE
$ 6,000,000
DIED I X I RETENTION $ 0
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE Fig]
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
C 2136927
01/01/2016
01/01/2017
X STATUTE ERH
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Contract #37-2016 Fire Station #3, Richmond Fire Department
CERTIFICATE
City of Richmond
Fire Department
101 South Fifth St
Richmond, IN 47374
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
W 19SS-1U14 AGU11L1 GUKI'UKA I IUN. An ngnis reservea.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD