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HomeMy Public PortalAbout169-2018 - Sanitation - Commercial Printing - Paper documentsAGREEMENT ORIGINAL THIS AGREEMENT made and entered into this 13_1d day of 2018, by and referred to as Contract No. 169-2018, 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 5t' Street, Richmond, Indiana, 47374 (hereinafter referred to as the "City"), and Commercial Printing Services, 815 N. Central Avenue, Connersville, Indiana 47331 (hereinafter referred to as the "Contractor"). SECTION I. STATEMENT AND SUBJECT OF WORK City hereby retains Contractor to provide printing for the Richmond Sanitary District's (hereinafter referred to as "District") billing stationary needs, which shall include, but not be limited to, statement paper, billing envelopes, return envelopes and non -permit envelopes. City sent a Request for Quotes to several vendors and contractors and the specifications therein are attached hereto and incorporated herein as Exhibit "A". The response of Contractor to the City's Request for Quotes is attached hereto and incorporated by reference herein as Exhibit `B", consisting of six (6) typewritten pages. Contractor is providing City, among other things, stationary for statement paper, billing envelopes, return envelopes and non -permit envelopes for assistant in the District's billing system for collecting District bills. This work is for the period beginning January 1, 2019 and concluding December 31, 2021. The price quotes set forth in Exhibit `B" are monthly and yearly estimates. City will not exceed the total paperwork and envelopes for the price amount quoted but may not use the total paperwork and envelopes for price amount quoted. 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 III. COMPENSATION City shall pay Contractor in an amount not to exceed Three Thousand Four Hundred Thirty -Nine Dollars and 00/100 ($3,439.00) per month, or in an amount not to exceed Forty -One Thousand Contract No. 169-2018 1 I Page jpz 1) Two Hundred Sixty -Eight Dollars and 00/100 ($41,268) per year, beginning January 1, 2019 and continuing at the same price per month and year through and including December 31, 2021 as set forth in Exhibit "A", for a three (3) year total not to exceed the amount of One Hundred Twenty - Three Thousand Eight Hundred Four Dollars and 00/100 ($123,804.00). SECTION IV. TERM OF AGREEMENT This Agreement shall become effective January 1, 2019 and shall continue in effect until December 31, 2021 at the same rates each year of this Agreement. 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 ninety (90) 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. 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. City agrees to indemnify Contractor for any damage or injury to person or property or any other claims which may arise from the City'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 City liable for acts of 2 1 Page the Contractor, 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 Section 1. Bodily Injury $1,000,000 each occurrence $2,000,000 aggregate Section 2. Property Damage $1,000,000 each occurrence D. Comprehensive Auto Liability Section 1. Bodily Injury $1,000,000 each person $1,000,000 each occurrence Section 2. Property Damage $1,000,000 each occurrence E. Comprehensive Umbrella Liability $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 3 1 Page 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 VIII. 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 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: 1. 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 4 1 Page 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. 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/she has been duly authorized by his or her principal to execute this Contract and that such authorization has not been revoked or rescinded. 5 1 Page 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 tary Commissioners Miller, President "CONTRACTOR" Commercial Printine Services (Pri s i ice rest ent Title: �,� , / Q F1 Dated: Stiens, Member Dated: l�r 1 ✓" �� APPROVED: 6 1 Page ICE REQUEST 0 n u o ' OF WvA.1M41'.l'VD 230LII3WNUF- R1CWA0ND INDYiNA47374 THIS IS NOT AN ORDER PHONE (765) 983 7450-rAX(765) 962 2669 VENDOR I INSTRUCTIONS This Is a iequest for a price for fhe'services of materials described below. Any additional specifications may be Commercial Printing Services attached hereto. This is NOT an order and the City reserves g the right to accept all or part, or decline the entire proposal. 815 N. Central Avenue Please complete your full name and phone number below with . signature; itemize all prices and charges where Connelrsvzlle, IN 47331 requested; and attach any explanation for any substitution to specifications altered. Return in a seated 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: September 24, 2016 10:OOAM on October 9, 2016 UPON RECEIPT OF INVOICE DELIVERED DESCRIPTION This is a request for quotes for printing for Richmond Sanitary District. Please see attached specifications. The company that is awarded the quote will need to have items printed and stored at their facility to be ready on hand for monthly deliveries. Quantities quoted are monthly estimates, RSD will order a week ahead of time with specific counts for each month. Please return this sheet by the above due date, in a sealed envelope to : Richmond Sanitaxy District Denise Johnson 2380 Liberty Avenue Richmond, IN 47374. A Certificate of Insurance must be included, alonq with a completed i~ Verify form. Prices Quoted must be honored from January 1, 2019 through December 31, 2021. STATE TAX EXEMPTION # 003121909.001 Richmond Sanitary District NAME OF FIRM QUOTING:' BY: AUTHORIZED 13Y SIGNATURE DATE PHONE NUMBER TITLE IEIKEUXT "A" f of 2 SPECIFICATIONS FOR. BILLING SUPPLIES The company that is* awarded the quote will need to have items printed and stored at their facility to be ready on hand for monthly deliveries. Quantities quoted below are monthly estimates, RSD will order a weep ahead of tone with specific counts for each month. Specifications for Statement Paper $ e 25,000 — 8'/a x 11 peaforated paper with additional color and 2 sided Specifications for Billing i l nvclope $ o 25,000 - #10 white window envelope with black ink with preprinted bully mail permit information, cross seamed Specifications for Return-E, nyelopes $ 25,000 - #9 white regular envelope with black ink Specifications for Non Permit Envelope $ ® 7,000 - #10 white window envelope with black ink and cross seamed Total Cost Quoted $, (total cost to include delivery) This quote/pricing is to be valid for the time period from when awarded through December 31, 2021.Three year contract beginning January 1, 2019. A Certificate of Insurance must be included, along with a completed F Verify form. Please return this sheet by the above due date, in a sealed envelope to: Richmond Sanitary District Demise Johnson 2380 Liberty Avenue Richmond, IN 47374. S`E1ilHMIT I 66X7 2 0l PRICE REQUEST 0 �o u a r n C[W Or MCIMOND DEPARTMENT OF SAI U.TATTON 2380 LIBERTY AVNNUEeRICHMONI) INDIANA 47374 PHOI`IS (765) 983 7450.FAX (765) 962-2669 '&'1FT%S IS N07C AN OYd17EIt VENDOR INSTRUCTIONS This is a request for a price for the services of materials described below. Any additional specifications may be COi]illlerGlal Printing Services attached hereto. This is NOT an order and the City reserves is the right to accept all or part, or decline the entire proposal. 815 N. Central Avenue Please complete your full name and phone number below with signature; itemize all prices end charges where Connersville, IN 47331 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: September 24, 2018 10:00AM an October 9, 2018 UPON RECEIPT OF INVOICE DELIVERS DESCRIPTION This is a request for quotes for printing for Richmond Sanitary District. Please see attached specifications. The company that is awarded the quote will need to have items printed and stored at their facility to be ready on hand for monthly deliveries. Quantities quoted are monthly estimates, RSD will order a week ahead of time with specific counts for each month. Please return this sheet by the above due date, in a sealed envelope to : Richmond Sanitary District Denise Johnson 2380 Liberty Avenue Richmond, Ili 47374. A Certificate of Insurance trust be Included along with a completed EVerifV form. Prices Quoted must be honored from January 1, 2019 through December 31, 2021. STATE TAX EXEMPTION # 003121909-001 Richmond Sanitary District NAME OF FIRM QUOTING: M l C. DATE AUTHO RAP BYSIGNkURV �j Tn'LE i I PHONE NUMBER EYMBI'I' "B" I ;of 6 ' 1 LFECIFICATIONS FOR ]BILLING SIII'PLIE The company that is'awarded the quote will needto nave items piinted and stored at their facility to be ready on hand for monthly delivciics. Quantities quoted below are mou bly estimates, RSD will Bider a week ahead of time with specific counts for each month. Specifications for Statement Paper �'� � x u 25,000 — 3 Yz x 11 perforated paper with additional color and 2 sided Specifications for.BilIiuxg nyelope, o 25,000 - 910 white window envelope with black ink with preprinted built mail penult information, cross seamed . _Spee3ifiicaiions for Return: ]Envelopes 25,000 - 49 white regular envelope with black Wx P P rt� Specifications for Pion Permit Envelope 7,000 #10 white window envelope with black ink and cross seamed P L�� r r Total Cost QYrOted- (total- cost: to include delivery) This quotelpricing is to be valid for the time period from 'when awarded through December 31, 2021. Three year contract, beginning January 1, 2019. 'y() Cerffiy(c�at)e� of Insurance must 1/bY�et included, along f�v{cith a completed eterIti P.�-Verify form. 1`r i cl Please return this sheet by the above due date, in a sealed envelope to: Mch mond Sanitary District Denise Johnson 2350 Liberty Avenue Richmond, IN 47374. EXHIBIT `B" 2 of 6 commerdel Hrinting erices October5, 2018 Richmond Sanitary District Denise Johnson 2380 Liberty Avenue Richmond, IN 47374 Dear Denise, Toll Free: 800-888-2164 765-825-2164 Fax:765-825-4229 815 N. Central Ave. P.O. Box 719 Connersville, IN 47331 www.Gpsprints.com Thank You for the opportunity to again provide Quotes for the printing of your Billing Stationery needs. All quotes provided are duplicating the current products delivered, except Non Permit Envelope, (previously printed on a Side Seam Envelope) which will be changed to the Diagonal Seam, insertable window envelopes, the same as the #10 Window, Billing Envelope. This change will ensure there are potential problems with inserting the bills. Also, the statement paper has again been quoted on the 704 Husky Text weight paper, with the long grain stock, to ensure the maintenance of the integrity of the perforations and to eliminate potential paper jams. We greatly value our printing relationship Denise and hope to agaln be able to supply your Billing Supply needs for the next 3 years! Please let me know if there are additional questions or information needed. We will'be anxious to hear your Partner Selection! Sincerely, Kay Parlor Sales Consultant EXMI 6 B" 3 of 6 :I E Verify Requirements: Def nitions: E-Verify Program —A electronic verification of work authorization program of the Illegal Immigration Reform. and Immigration Responsibility Act -of 1996 (['.L. 104 208), Division C, Tide IV,s.403 (a), as amended., operated by the United States Depaitnent of Homeland Security or successor work authorization program designated by the United States De t of Homeland Sectulty or other federal agency authorized to verify te work 'authorization status of newly hued employees under the Immigration Reform and. control Act of 1986 (P.L. 99-603). 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. U a am a an a Doan a PJ a a a A A a D a am Dana a A N a a an a A Sunman A an A a A Una" U Si A an U N a U A "a a axon "aaUaa al a ASS U A a an COMPLIANCE WITH 1101ANA E VERITY PROGRAM REQUCftE, NMI ITS Pursuant to Indiana Code 22.5.1,7, Contractor is required to enroll in and verify the wo& eligibility status of all newly hued employees of the contractor through the Indiana E-Verify program. Contractor is not rocEuired io verify the work eligibility status of allnewly hired employees of the contractor through the Indiana- E Vexify program if the Indiana EVerify program no longer exists. Prior to the pe:iformau.ce of the, 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 (a) (2). In the event Contractor violates IC 22-5-1.7 the Contractor shall be required to remedy the violation no later than thirty (30) days after the City notifies the Contractor of the violation.. 1f the 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. 1L'11)1d1J BI Jl "B'- 4 of 6 Affidavit of Employment Eligibility Verifcation The Contractor, �i��1 kv i i 1v !' ` '\tC���rms under the penalties ofperjuiy that Contractor does not know' gly employ 4 unauthorized alien. If Contractor is self-employed and does not employ any employees, Contractor vexffies he or she is a United States citizen or qualified alien. The Contractor has not Imowiugly employed or contracted with an unauthorized alien mid 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 thxoughthe Indiana E- Velifyprograrn. The Contractor has required Contractor's subcontractors to ceztify to the Contractor that the subcontractor does not Imowingly employ or contract with an unauthorized alien and that the subcontractor has enrolled and is participating in the E-Verify program. The Contractor will maintainthis cep tifxcation throughoutthe duration ofthe team of a contract with a subcontractor. I hereby verify under the penalty of pezjiuy that the foregoing statement is ti-ae. Dated this r; day of .S Qj �f c- (szgua (FrI tee name) t EXHIBIT "B" 5 of 6 IIZAN JNVi1STMCNT ACTIVITIES Ptusuant to Indiana Code (IC) 22-16.5, Contractor certifies that Contractor is not engaged in invesixuent activities in Iran. In the event City deteimiues during the course of this Agreement that this certi-fication is no longer valid, City shah notify Contractor in writing of said deten,n ation 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- deterauines during the course of this Agreement that this certification is no longer valid and said determination is not refitted by Contractor in the manner set i'orth 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. d:+X.m BI JL 66B99 6 of 6 I EIr '4� CERTIFICATE OF LIABILITY INSURANCE DAT11/262018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must 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 endorsements . PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONT NAME: CT CLIENT CONTACT CENTER PHOE A CNNo Ext : 888-333-4949 A/C No): 507-446-4664 ADDRESS: CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL.INSURANCE COMPANY 13935 INSURED 361-762-8 INSURER B: TATMAN INC PO BOX 719 INSURER C: INSURER D: CONNERSVILLE, IN 47331-0719 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 2 REVISION NUMBER: 0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF. INSURANCE DL IN SUBR POLICY NUMBER POLICY EFF MMIDDI Y POLICY EXP MIDDY Y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR N N 6078606 _ 07/21/2018 07/21/2019 EACH OCCURRENCE $1,000,000 ENTED nce PREMISES Ea R $100,000 MED EXP (Any one person) EXCLUDED GEN'L %� PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: RO- POLICY 1:1jECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS -COMP/OP AGO $2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON -OWNED AUTOS ONLY N N 6078606 07/21/2018 07/21/2019 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per cc.dno A X 1 UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE N N 6078607 07/21/2018 07/21/2019 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 DED I I RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA N 6078608 07/21/2018 07/21/2019 X PER STATUTE OER E.L. EACH ACCIDENT $500,000 E.L DISEASE - EA EMPLOYEE $500,000 E.L DISEASE -POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) P_FRTIGICATF NAi t1FR CANCELLATION 361-762-8 20 CITY OF RICHMOND INDIANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 50 N 5TH ST THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RICHMOND, IN 47374-4247 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Affidavit of Employment Eligibility Verification The Contractor, C RM&k5fflrms?under the penalties of perjury that Contractor does not knowingly employ a r 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 q day ofA \ UA JlJ , 20A 1 (signature� G'(� (printed name) 6fid� 6\�«I1Y Jwt David M. Snow Mayor Bryan Ervin Director CITY OF RICHMOND DEPARTMENT OF SANITATION 2380 LIBERTY AVENUE•RICHMOND, INDIANA 47374 PHONE (765) 983-74509FAX (765) 962-2669 TO: Commercial Printing Services FROM: Jeff Lohmoeller RE: Signature for Agreement DATE: November 21, 2018 Enclosed for your further handling, please find two (2) originals of the contract between your company and the City of Richmond, Indiana. Please sign and return to my attention at the letterhead address, the other original is for your records. If you have any questions, please feel free to contact me at 765-983-7450. Thank you.