HomeMy Public PortalAbout007-2018 - Sanitation - Wisenhunt Construction - Rehabilitation workORIGINAL
AGREEMENT
THIS AGREEMENT made and entered into this day of January, 2018, by and between the
City of Richmond, Indiana, a municipal corporation acting by and through its Board of Sanitary
Commissioners, with its office at 50 North 5' Street, Richmond, Indiana, 47374 (hereinafter
referred to as "City") (referred to as the "City"), and Whisenhunt Construction, Inc., 645 Indiana
Avenue, Richmond, IN 47374 (hereinafter referred to as the "Contractor").5
SECTION I. STATEMENT AND SUBJECT OF WORK
City hereby retains Contractor for rehabilitation work associated with the MRF Restroom, with
those services being specifically set forth within the "scope -of -work" contained within Exhibit "A".
A Request for Quotes has been made available for inspection by Contractor, is on file in the office
of the Department of Sanitation for the City of Richmond, consisting of three (3) typewritten pages,
which is attached hereto and incorporated by reference herein as Exhibit "A", with said Exhibit
including the "scope -of -work" referenced above, as well as Addendum #1.
The response of Contractor to said Request for Quotes is attached hereto and incorporated by
reference herein as Exhibit `B", consisting of two (2) typewritten pages.
Should any provisions, terms, or conditions contained in any of the documents attached hereto and
incorporated by reference herein as Exhibits, conflict with any of the provisions, terms, or
conditions of this Agreement, this Agreement shall be controlling.
The Contractor shall furnish all labor, material, equipment, and services necessary for the proper
completion of all work specified. Contractor shall submit statements or bills monthly.
No performance of services shall commence until the following has been met:
1. The City is in receipt of any required certificates of insurance and/or warranties;
2. The City is in receipt of any required affidavit(s) signed by Contractor in accordance with
I.C. § 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 M. COMPENSATION
City shall pay Contractor at the rates indicated in Exhibit "A" in an amount not to exceed the sum
of Fourteen Thousand Five Hundred dollars and 00/100 ($14,500.00) for complete and satisfactory
performance of the work required hereunder. .
SECTION W. TERM OF AGREEMENT
This Agreement shall become effective upon execution by the parties and shall continue in effect
Contract No. 7-2018
1 1 Page
until completion of the terms set forth therein, but by no later than March 31, 2018, unless
extended in writing by City. 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 thirty (30) 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.
This Agreement may also be terminated by either the City or the Contractor, in whole or in part,
by mutual Agreement setting forth the reasons for such termination, the effective date, and in the
case of partial termination, the portion to be terminated.
This Agreement may also be terminated by either the City or the Contractor, without cause, by
giving at least thirty (30) days written notice to the other party.
In the event of termination of this Agreement, 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.
SECTION V. INDEMhIIFICATION 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 Limits
A. Worker's Compensation & Statutory
Disability Requirements
B. Employer's Liability $100,000
C. Comprehensive General Liability
2 1 Page
Section 1. Bodily Injury
Section 2. Property Damage
D. Comprehensive Auto Liability
Section 1. Bodily Injury
Section 2. Property Damage
E. Comprehensive Umbrella Liability
$1,000,000 each occurrence
$2,000,000 aggregate
$1,000,000 each occurrence
$1,000,000 each person
$1,000,000 each occurrence
$1,000,000 each occurrence
$1,000,000 each occurrence
$1,000,000 aggregate
F. Malpractice/Errors & Omissions Insurance $1,000,000 each occurrence
$2,000,000 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. 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 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 VM. 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 Board determines during the course
3 1 Page
of this Agreement that this certification is no longer valid, Board 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 Board
that the Contractor has ceased investment activities in Iran within ninety (90) days after
the written notice is given to the Contractor, the Board may proceed with any remedies it
may have pursuant to IC 5-22-16.5. In the event the Board 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 Board 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 IX. 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;
3. 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 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.
4 1 Page
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.
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.
Any person executing this Contract in a representative capacity hereby warrants that he or she has
been duly authorized by his or her principal to execute this Contract.
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.
5 1 Page
"CITY"
"CONTRACTOR"
The City of Richmond, Indiana, by and through
its Board of Sanitary Commissioners
Sue Miller, President
Dated:
Y. i0
APPROVED:
Wm-SWow, Ma
Dated: 0I 1 rz, I I t
Whisenhunt Construction, Inc.
(Printed): . r L tvs a ee-
Title:
Dated:
6 1 Page
Affidavit of Employment Eligibility Verification
The Contractor, s affirms
under the penalties of perjury that Contractor does not knowingly employ an 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.
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 z'7- day of J!+� , 2018.
(signature)
ZVI
(printed name)
The Richmond Sanitary District is requesting quotes
for rehabilitation of the MRF restroom.
Scope of Work:
1. Remove all fixtures, base cabinet sink and sink top. Remove urinals and toilets. Remove toilet
stalls and paint to be reused once restroom is finished.
2. Remove all old drywall.
3. Install the proper underlayment on all of the walls.
4. Tile all walls from floor up five feet then paint to ceiling high throughout restroom.
5. After grout has been applied and cured, seal all grout joints.
6. Install new sink base cabinet and new double sink top and new sink fixtures.
7. Urinals to be cleaned and reinstalled.
8. New partition to be furnished and installed between the two urinals.
9. New toilets and toilets seats to be installed.
10. Toilet stalls to be painted and reinstalled.
11. Restroom door to be replaced with new 36" heavy duty steel door.
12. Drop ceiling in restroom to be removed and new drop ceiling installed including new grids.
• Color of paint will be a light tan (Pony Tail).
• Paint Spec: Primer: B79W08810 — ProBlock Interior Oil -Based Primer White; Finish:
K45W00151— Pro Industrial PreCtatalyzed Waterbased Epoxy
• Base cabinet will be 72" wide x 21" deep x 34-1/2 high. 4 — door, 4 — drawer Oak Mink Finish
• Sink top will be 73" wide x 22" deep double bowl. Giallo Fioritto Granite Top. Walden
(rectangle) Style Bowl White. Bowl placement in vanity top is attached. Faucets will be Pfister
Oil Rubbed Bronze Finish with 4" centers. High Profile.
• Tile will be Florim USA Afrika Porcelain Nairobi 6" x 6" the capped off with 3" x 12" bull nose
tile. Grout color will be (ALMOND)
• Attached is layout of the restroom as it is right now.
• All items called out will be this or equal to.
COST OF Project:
Time to complete project:
NAME OF CONTRACTOR
ADDRESS
CITY/STATE
• CERTINCATE OF INSURANCE INCLUDED ( must meet the City of Richmond, IN requirements)
YES NO
• E-VERIFICATION FORM FILLED OUT: YES NO
• LOCAL PREFERENCE CLAIM: YES NO
• MAN INVESTMENT: YES NO
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CITY OF RICHMOND
DEPARTMENT OF SANITATION
2380 L MMTY AVENUE-MaNOND, WDLWA 47374
PHONE (765) 983-7450•FAX (765) 962 2669
Date:
October 19, 2017
To:
All Bidders
From:
Jeff Lohmoeller
RE:
Rehabilitation of the MRF Restroom
DAVE SNOW
Mayor
ERYAN ERVIN
Director
ADDENDUM #l.
This is "Addendum #1". This addendum is in reference to the above -mentioned services.
Please mark Addendum #1 on outside of envelope when returning quote.
Item #9: The toilets that you remove will be reused. We will not be purchasing new
toilets.
PRICE REQUEST
V G
f ^ T
CITY 0MU MOND
DEPARTMENT OF SMUAMN
2380 LIDERTYA.VENUE.RICHDQOND, MIANA47374
PI•IONB (765) 9$3-7450.FAX(765) 962-2669
THIS IS NOT AN ORDER
VENDOR
INSTRUCTIONS
This is a request for a price for the services of mat vials
described below. Any additional specifications may be'
attached hereto. This is NOT an order and the City reserves
Whisenhunt Construction Inc.
the right to accept all or part, or decline the entire proposal.
Please complete your full name and phone number below
645 Indiana Avenue
with signature; itemize all prices and charges where
Richmond, IN 47374
requested; and attach any explanation for any substitution to
specifications altered. Return in a sealed envelope, in care of
Richmond Sanitary District Board of Commissioners to
the administration building at the address above by the
specified date and time to be considered.
DATE:
REPLY MUST BE IN BY:
PAYMENT TERMS:
DELIVERY REQUIRED:
October 13, 2017
October 24, 2017 by I O:OOAM
UPON RECEIPT OF INVOICE
DELIVERED
DESCRIPTION
This is a request for quotes for rehabilitation of the MRF restroom. Please see attached specifications. All E-
Verify requirements will apply to this quote. Please include a Certificate of insurance, which must include
Worker's Compensation, and Warranty Information with quote.
Return the quote in a sealed envelope addressed to: Richmond Sanitary District
Denise Johnson, Customer Svc Mgr
2380 Liberty Avenue
Richmond, IN 47374
ATTN: MRF Restroom
If you have any questions please call Jeff Lohmoeller at 765-983-7464 or 765-993 2670.
Pre -Quote meeting will be held on October 18th at 10:OOAM, Richmond Sanitary District Board Room, 2380 Liberty
Avenue, Richmond, Indiana.
Total Cost :A ) 4 , s-vy
Time of Completion: -7-1 Days Quote Valid Until: Z-' Z4" ` V7
SIATE TAX EXEMPTION # 003121909-001
Rich rriondEGhtary District
11^IVII-- yr FIFMVI h.euv i 1114..j.
Lj
AUTHORIZED BY SIGNATURE
eCvS� �`
TITLE
• �¢� r1 �� s. 4 4d , 1p42-r
DATE PHONE NUMBER
�xh)b;) 8 1�eZ-
The Richmond Sanitary District is requesting quotes
for rehabilitation of the MRr restroom.
Scope of Work:
I. Remove all fixtures, base cabinet sink and sink top. Remove urinals and toilets. Remove toilet
stalls andpaint to be reused once restroom is finished.
2. Remove all old drywall.
3. Install the proper underlayment on all of the walls.
4. Tile all wails from floor up five feet then paint to ceiling high throughout restroom.
5. After grout has been applied and cured, seal all grout joints.
6. Install new sink base cabinet and new double sink top and new sink fixtures.
7. Urinals to be cleaned and reinstalled.
8. New partition to be famished and installed between the two urinals.
9. New toilets and toilets seats to be installed.
10. Toilet stalls to be painted and reinstalled.
11. Restroom door to be replaced with new 36" heavy duty steel door.
12. Drop ceiling in restroom to' be removed and new drop ceiling installed including new grids.
• Color of paint will be a light tan (Pony Tail).
• Paint Spec: Primer: B79WO8810 - ProBlock Interior Oil -Based Primer White; Finish:
K45W00151- Pro Industrial PreCtatalyzed Waterbased Epoxy
• Base cabinet will be 72" wide x 21" deep x 34-1/2 high. 4 - door, 4 - drawer Oak Mink Finish
• Sink top will be 73" wide x 22" deep double bowl. Giallo Fioritto Granite Top. Walden
(rectangle) Style Bowl White. Bowl placement in vanity top is attached. Faucets will be Pfister
Oil Rubbed Bronze Finish with 4" centers. High Profile.
• Tile willbe Florim USA Afrika Porcelain Nairobi 6" x 6" the capped off with 3" x 12" bull nose
tile. Grout color will be (ALMOND)
• Attached is layout of the restroom as it is right now.
• All items called out will be this or equal to.
COST OF Project: t. I + t '—fl 14411L At 1
Time to complete project: 3 w eAj%& .S
NAME OF CONTRACTOR "t,.J \^.X 3Cw16A -+
ADDRESS 4 S :rAA L � aw--c-
CITY/STATE Glti n^,aa^ j ! .r-O 4 7 3 7+
• CERTIFICATE OF INSURANCE INCLUDED ( must meet the City of Richmond, IN requirements)
YES NO
• E-VERMCATIONFORMFILLED OUT: YES NO
LOCAL FRF ERENCECLAIM: YES NO
• ]RAN INVESTMENT: YES NO
G a -CZ,
ACCPRV CERTIFICATE OF LIABILITY INSURANCE
DATE
01rzv2018 Y)
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).
PRODUCER
CONTACT Marcia Stroud
Indiana-VanVleet
1 Glen Miller Parkway
PHONE (765)935-5655 Arc No): (765)935 6164
EAJADDRESS: marcias@vanvleetinsurance.com
INSURER(S)AFFORDING COVERAGE
NAIC #
INSURERA: Erie Insurance Group
Richmond IN 47374
INSURED
INSURER B
INSURER C :
Whisenhunt Construction Inc, BCR Inc DBA
INSURER D
PO Box 233
645 Indiana Ave
I NSURER E :
INSURER F
Richmond IN 47375
COVERAGES CERTIFICATE NUMBER: RFVISION Nt1MRFR'
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
TYPE OF INSURANCE
POLICY NUMBER
POLICY
M ODNYYY
EXP
MM/DDDIYYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
Q423051479
6/30/2017
6/3012018
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Anyone person)
$ 5,000
PERSONAL& ADV INJURY
$ 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
POLICY I JEST LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OPAGG
$ 2,000,000
$
A
I
LIABILITY
ANY AUTO
SCHEDULED
AUTOS
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Q06 3040201
6/30/2017
6/3012018
CEa accidOM,..d nt SINGLE LIMB
BINAUTOMOBILE
en
$ 1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTYDAMAGE
Peraccident
$
S
A
X
UMBRELLA LIAB
EXCESSSUAB
X
OCCUR
CLAIMS -MADE
Q303070615
6/30/2017
6/3012018
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
DED 1X1 RETENTION 0
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PRO PRIETOR/PARTNERIEXECUTIVE YIN
OFFICEWMEMBER EXCLUDED? ❑N
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
Q90 3001064
6/30/2017
6/30/2018
X STA LITEORH
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 I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Richmond
ACCORDANCE WITH THE POLICY PROVISIONS.
Sanitation Department
AUTHORIZEDREPRESENTATIVE
2380 Liberty Ave
Richmond IN 47374
Fax: Email:
ACORD 26 (2016/03)
m 1988-2016 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
'ACORbr CERTIFICATE OF LIABILITY INSURANCE
k._''_
DATE(MM/DDIYYYY)
1 01/22/2018
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).
PRODUCER
CONTACT
NAME: Marcia Stroud
Indiana-VanVleet
1 Glen Miller Parkway
PHONE (765)935-5655 FAX.
No: (765)935-6164
AIL
ADDRESS: marcias@vanvleefinsurance.com
INSURER(S)AFFORDING COVERAGE
NAIC #
Richmond IN 47374
INSURERA: Erie Insurance Group
INSURED
INSURER B :
Whisenhunt Construction Inc, BCR Inc DBA
INSURERC:
PO Box 233
INSURER D :
645 Indiana Ave
INSURER E :
Richmond IN 47375
INSURERF:
COVERAGES CERTIFICATE NUMBER' RFVI-QIQu ru IItARGP•
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,
INS
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EF
MWDDIYYYY
POLICY EXP
MWDDIYYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FRIOCCUR
Q42 3061479
6/30/2017
6/30/2018
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTE
PREMISES (Ea occurrence)
$ 1,000,000
GEN'L
MED EXP (Any one person)
$ 5,000
PERSONAL&ADV INJURY
$ 1,000,000
AGGREGATE LIMIT APPLIES PER:
POLICY I JECT LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMPIOP AGG
$ 2,000,000
$
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Q06 3040201
6/30/2017
6/30/2018
COMBINED SINGLE LIMIT
Ea accident)
$
1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTYDAMAGE
Peraccident
$
$
A
X
UMBRELLA UAB
EXCESS UAB
XI
OCCUR
CLAIMS -MADE
Q303070615
6/30/2017
6/30/2018
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
DED I X I RETENTION $ O
$
A
WORK ERSCOMPENSATION
AND EMPLOYERS' LABILITY YIN
ANY PROPRIETORIPARTNEWEXECUTIVE
OFFICERIMEMBER EXCLUDED? ❑N
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
Q90 3001064
6/30/2017
6/30/2018
X STATUTE ERH
E.L.EACH ACCIDENT
$ 1,000,000
E.LDISEASE -EAEMPLOYEE
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
v"INt if rvnrr nvwr=ram IiAIVIrCLLA I IUIV
City of Richmond
Sanitation Department
2380 Liberty Ave
Fax:
47374
Email
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
to 1QRR-9ni;; Ar r1R1-1 Rr1RPr1RATIfyN All rinhfc -.—A
ACORD 25 (2016103)
The ACORD name and logo are registered marks of ACORD