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HomeMy Public PortalAbout075-2021 - Mendenhall and Associates - wage scale compliance I � 3 AGREEMENT 04f 4 . THIS AGREEMENT made and entered into this day of 'TV 4� ,2021,and referred to as Contract No.75-2021 by and between the City of Richmond,Indiana,a municipal corporation acting by and through its Board of Sanitary Commissioners (referred to as the "City"), and Mendenhall & Associates, LLC, PO Box 428, Arcadia, IN 46030 (hereinafter referred to as the "Contractor"). SECTION I. STATEMENT AND SUBJECT OF WORK City hereby retains Contractor for the work described on Exhibit "A" attached hereto and incorporated by reference herein, which is Contractor's proposal to the work described herein, consisting of twenty-six (26) pages, with such work being responsive to the City's Request for Proposal,attached hereto and incorporated by reference herein as Exhibit"B". Said work generally relates to the need of a Labor Standards Administrator being responsible for all aspects of Davis- Bacon wage scale compliance for the City as required by the Indiana Finance Authority SRF Program and/or the Federal Government, as the same pertains to the "West Side Interceptor Improvements Project—Division A",which project has been awarded to Brackney,Inc. 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 the total sum of Six Thousand Dollars and 00/100 ($6,000.00) for the work described herein, and as set forth in the attached exhibits. SECTION IV. TERM OF AGREEMENT This Agreement shall become effective when signed by all of the parties hereto. 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 are not be limited to the following: a. failure,for any reason of the Contractor to fulfill in a timely manner 1 I Page 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. 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 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 2 I Page $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 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 - 3 I Page 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 calendar day during which such person was discriminated against or intimidated in violation of the provisions of the Agreement; and 4. That this Agreement maybe 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. 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 - 4 I Page 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. 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" "CONTRACTOR" The City of hmond,Indiana,by and through Mendenhall&Associates,LLC its Board o Sanitary Commissioners By: a'7.6r7s) dr4-74.ar9,---) Sue M]1 , re dent J ,. W(Printed): // r1 a er7 /'S.e4 an Bakshi,Vice President Title: /fir e S%( t'f, f '�' 4—9 01- Dated: e6/ /%'dam f r, t :tiens,Member Dated: to 'g APPROVED: k. e now,Ma Dated: 0 d q 7-1 5 I Page ' 1 1 Mendenhall& ` - ' Associates, LLc DBE/WBE CERTIFIED April 2, 2021 Elijah W. Welch, P.E. District Engineer Richmond Sanitary District 2380 Liberty Avenue Richmond, Indiana 47374 RE: Labor Standards Administration, West Side Interceptor Imprvements Project— Division A Dear Mr. Elijah Welch: Mendenhall &Associates, L.L.C. appreciates the recent request for proposal for labor standards administrative services pertaining to the wastewater improvement project for West Side Interceptor Improvement Project—Division. Our firm has been established for twenty-two years and with our team's.experience and our staff of knowledgeable professionals that have interest and insight of com- munities throughout Indiana, we are confident that we can carry out the require- ments of this SRF project. Attached to this letter is our proposal for your review. While you are reviewing our proposal, please contact us at (317) 984-8639 if you have any questions. Sincerely, Tina Mendenhall Henderson President P.O. Box 428-Arcadia, IN 46030•PH:317-984-8639•FX:317-984-74gHIBIT'A'-Page 1 of 26 ,I Mendenhall&if Associates, LLC (- -` , Name: DBE/WEE CERTIFIED Mendenhall &Associates, L.L.C. DBE/WBE Certified since 2019 Address: Brief description of the firm: P.O. Box 428 Mendenhall & Associates has the pleasure Arcadia, Indiana 46030 of helping communities write and adminis- ter private, state, and federal funds for in- frastructure projects. Primarily our grant administration services are provided to communities throughout Central Indiana. Key Personnel: Tina Henderson—Project Manager Wage Decision Selection Pre-Construction Meeting Labor Standards Compliance Weekly Payroll Review Interviews Close Out Colleen Freeman—Administrative Coordinator Labor Standards Compliance Weekly Payroll Review Interviews Close Out Somer Stephens=Labor Standards Specialist Wage Decision Selection Pre-Construction Meeting Weekly Payrolls Davis Bacon Wage Compliance Interviews Close Out P.O. Box 428.Arcadia, IN 46030•PH:317-984-8639•FX:317-984-74HIBIT'A'-Page 2 of 26 Mendenhall & Associates, LLC DBE/WBE CERTIFIED THREE MOST RECENT INDIANA FINANCE 4:,UTHO /STATE RE- Tt LVIN G LOAN is'D O)ECTS 2020: DiqIndv Labor Administrator; Mendenhall and Associates is currently the Labor Administrator for the Dig Indy Tunnel Project. Our contract is with Citizen Energy Group. City of Richmond Labor Administrator: Labor Administrator for the William E Ross Wastewater Treatment Plant Phase I project. Our contract is with the Richmond Sanitary District. City of Tipton: Labor Administrator for the LTCP Phase III Inceptor Pro- ject. Our +contract is with the Tipton Municipal Utilities. Indiana Finance Authority/ State Revolving Loan Fund Brownfield Labor Administrator. Mendenhall an�c Associates is the labor adminis- trator for Indiana Brownfields Program which is under the State Revolving Loan Fund organization. Our contract is with the Indiana Finance AuthorI ty. P.O. Box 428'Arcadia, IN 46030•PH:317-984-8639•FX:317-984-74WHBIT'A'-Page 3 of 26 Mendenhall&/ Associates, LLc DBE/V EE CERTIFIED SCOPE OF WORK Detailed Description of Anticipated Work Items West Side Interceptor Project Labor Standards Administration Fee: $6,000.00 Mendenhall and Associates will ensure the projects are compliant with federal regula- tions concerning all aspects of Labor Standards requirements to meet the State,Re- volving Loan Fund. We have based our fee on the total SRF Loan of $5,301,62.0.00 for this wastewater improvement project. Scope of Work: • Determine/ Review type of Wage Decision • Review of the current Wage Decision issued • Request Conformance Rates from US Department of Labor, when Applicable. • Assist with the Pre-Construction Conference • Obtain all forms related to Davis Bacon and help contractors and subcontrac- tors to stay in compliance. • Obtain and review all necessary State and Federal Forms from the Prime Con- tractor and all Subcontractors throughout the project. • Distribute applicable job site posters to the prime contractor (Davis-Bacon poster, EEO poster, IOSFJA poster, etc). • Validate all Prime/Sub-Contractors through www.Sams.gov to confirm that they are eligible to work on federally funded projects, • Verify Fringe Benefit Funds of all contractors, • Monitor weekly Contractor and Sub-Contractor Payrolls. • Resolve unsatisfactory payroll findings and report violations to Owner and SRF. • verify all apprentice on jobsite • Conduct on-site employee interviews with at least 10% of each worker classi- fication from,each contractor/subcontractor. • Frequent updates to the Owners. • Copy/supply all files at the end of the project to the owner. • Attend any Audits/Inspections performed by State or Federal Agencies that may benefit from our attendance. • Provide any documents requested through the Freedom of Information Act if requested by owner or funding agency. *Total contract time is 485 calendar days *DBE/WBE Certification Attached *Insurance Policy Attached HiBIT'A'-Page 4 of 26 P.O. Box 428•Arcadia, iN 46030•PH:317-984-8639•FX:317-984-74 Mendenhall & Associates, Li-c :'-'il--1: ` DBE/WBE CERTIFIED WBE/DBE CERTIFICATION P.O.Box 428-Arcadia, IN 46030•PH:317-984-8639•FX:317-984-74gHIBIT'A'-Page 5 of 26 • • 1 ' ! E C o 2(13 i O en 04) am-+ O A j 65 2 -t Clio 20 C.-:?:.! CD N m (!) 112 O i o V .-E U a) N 03 _-1 cli H • m 'a (6 "' m g. '= W cv OCi) o CO Cr) - -0 o a vz r-o co ° Oa, ° a � i. O co a) 0 o w O O O' �C• - a) .0 - - Q -C 0 RS C r C It O O ii N0 ca. 01 co N c7:3 C.) ❑ O 11..] -tc CuC CO03 co a) U3 t En a. C:t. CIS --8. 4 Et 0 G _rn a)LL m U O y > N q 0 Q .T. 2 0 13) O 0 o 4- 0 12 Ct N U a.) 1 CO r — . o - c) co 4 tliti V W 0 CC. e Q N V I i D W W EXHIBIT'A'-Page 6 of 26 is f STATE OF INDIANA DEPARTMENT OF ADMINISTRATION Division of Supplier Diversity Eric J. Holcomb, Governor Indiana Government Center South 402 West Washington Street, Room W459 Indianapolis, IN 46204 (317) 232-3061 April 24,2019 Ms. Tina Henderson Ms. Cohen Kay Freeman Mendenhall&Associates.LLC 113 East Main Street P.O:Box 428 Arcadia,IN 46030 Subject:Application for WBE Certification Dear Ms.Henderson &Ms.Freeman: Congratulations!The Indiana Department of Administration,Division of Supplier Diversity is pleased to inform you that Mendenhall &Associates,LLC, is hereby certified as a Women's Business Enterprise (WBE). Your company provides a commercially useful function in the areas listed below.Only work performed in these areas will be counted towards Women's Business Enterprise participation: UNSPSC CODE(S) Code Description 80171906 Government relations consultation and engagement 93151602 Government budgeting services 94131503 Technical assistance non governmental services 84121803 Government bonds 93121608 Non governmental liaison services 93141902 Rural investment services 93142006 Urban development control or regulations services 80101603 Economic or financial evaluation of projects 82111500 Technical writing 93141812 Labor inspection services 86132201 Training and Facilitation service 93141800 Employment 93141900 Rural development 93142000 Urban development 93142001 Urban development planning services 93142009 Urban project or program administration or management services 80101508 Business intelligence consulting services On September 13,2010.the Governor's Commission on Minority and Women's Business Enterprises EXHIBIT'A'-Page 7 of 26 I Reference.Mendenhall&Associates.LLC approved the departments effort to streamline its recertification process. Instead of conducting an onsite visit to each company seeking recertification,the department now has the discretion to waive the visit after a thorough review of the company's file and recertification documents.We have approved your certification and it is valid through April 30, 2022. Please note that DOA continues to reserve the right to conduct a site visit or phone interview at any rime to certified companies. Although your certification is valid for a three-year period,you are required to submit an annual.Affidavit of Continued Eligibility (ACE) form, located at wwlA in.iov/idea%mWhe!files.ACE Form.pdi. Please remember you must notify us immediately if any changes occur.Failure to notify us of changes or to provide an ACE form annually will result in revocation of your certification. Changes include, but are not limited to, changes in location, contact information, ownership and control. We encourage you to visit DOA's procurement website..ww73.in.govlidoa(_464.ittin, and update your Business Registration Profile. It is important that you review and update your profile regularly, because state purchasing agents and prime contractors may use this information to contact you for business opportunities. For questions regarding your registration profile. you may contact our office at 317-232- 3061. While this letter serves as notification of certification,it does not serve to prove continued eligibility.Please visit www.in.uov/idoa/mwbe/2743.htm to verify certification status.Please contact our office at(317)232- 3061 if you have any other questions. We ask that you please contact Amy L. Wolf,Deputy Director of Certification, at(317) 232-3061 or awolf atidoa.in.gov if you have any questions or concerns about your letter. Sincerely, „Q, 00, ; Amy L. Wolf.Deputy irector of Certification Indiana Department of Administration Division of Supplier Diversity ALW:cl EXHIBIT'A'-Page 8 of 26 Mendenhall& {` p,' Associates, LLC DBE/WBE CERTIFIED INSURANCE POLICY H�B�T'a'-Page 9 of 26 P.O.Box 428•Arcadia, IN 46030•PH:317-984-8639•FX:317-984-74 DATE(MMIDD!YYYY) �� '�� CERTIFICATE OF LIABILITY INSURANCE 4/1/2021 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 CON i NAME:AC Amanda Kline Dan Shields Insurance Agency WC,No,Exq: (317)984 3628 FAX No): (317)984-2304 616 Marion Ave P.O.Box 501 ADDRESS: Amanda@danshieldsinsurance.com INSURERS)AFFORDING COVERAGE NAIC# Arcadia IN 46030 INSURER A: Selective Insurance CO Of SC 19259 INSURED INSURER B: Selective Insurance CO of Amer 12572 MENDENHALL&ASSOCIATES LLC INSURER C: Starstone Specialty Insurance Company 44776 PO BOX 428 INSURER D: INSURER E: ARCADIA IN 46030 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, INbit ,AUUL4UBR PULIt.Y thF POLICY LAY LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 2,000,000 CLAIMS-MADE K OCCUR PRE 1t ISES Ea occurrence) S 500,000 • — MED EXP(Any one person) 5 15,000 A S2349324 09/20/2020 09/20/2021 PERSONAL&ADV INJURY 5 2,000,000 GENT_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4,000,000 I POLICY K JEe L I LOC PRODUCTS-COMP/OP AGG 5 4,000,000 OTHER: S AUTOMOBILE LIABILITY LUMUINEU SINLd.b LIMI I S 1,DOO,DOD _ (En accident)- - ' ' ANY AUTO BODILY INJURY(Per person) 5 " A -AWNED y SCHEDULED AUTOS ONLY /, AUTOS S2349324 09/20/2020 09/20/2021 BODILY INJURY(Per accident) S HIRED NON-OWNED PHUF'tHI1 UAMAUb 5 X AUTOS ONLY �AUTOS ONLY (Per acddenl) 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE 5 EXCESS LIAB CLAIMS-MADE AGGREGATE 5 _ DED RETENTION 5 S WORKERS COMPENSATION v AND EMPLOYERS'LIABILITY /��STAME ERIH Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ' E.L.EACH ACCIDENT S 1,000,000 B OFFICER/MEMBER EXCLUDED? N NIA WC 9055890 09/20/2020 09/20/2021 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 Oyes,describe under OESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT 5 1,000,000 Environmental and Energy En-ors and Errors&Omissions 5.000,000 C Omissions Liability 18512519IAEM 09/20/2020 09/20/2021 Aggregate DESCRIPTION OF OPERATIONS!LOCATIONS/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 The City of Richmond ACCORDANCE WITH THE POLICY PROVISIONS. Department of Sanitation AUTHORIZED REPRESENTATIVE 2380 Liberty Avenue Ae-o..d I<ti.A4, 1 Richmond,Indiana 47374 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD EXHIBIT'A'-Page 10 of 26 ElitePace General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG73000119 SUMMARY OF COVERAGES (including index) This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. Refer to the actual endorsement(Pages 3-through-9) for changes affecting your insurance protection. DESCRIPTION PAGE FOUND Additional Insureds-Primary and Non-Contributory Provision Page 8 Blanket Additional Insureds-As Required By Contract Page 5 • Owners, Lessees or Contractors(includes Architects, Engineers or Surveyors • Lessors of Leased Equipment • Managers or Lessors of Premises • Mortgagees,Assignees and Receivers • Any Other person or organization other than a joint venture • Grantors of Permits Broad Form Vendors Coverage Page 7 Damage To Premises Rented To You(Including Fire, Lightning or Explosion) Page 3 Electronic Data Liability($100,000) Page 4 Employee Definition Amended Page 9 Employees As Insureds Modified Page 5 Employer's Liability Exclusion Amended(Not applicable in New York) Page 3 Incidental Malpractice Exclusion modified Page 7 Knowledge of Occurrence, Claim, Suit or Loss Page 7 Liberalization Clause Page 8 Mental Anguish Amendment(Not applicable to New York) Page 9 Newly Formed or Acquired Organizations Page 5 Non-Owned Aircraft Page 3 Non-Owned Watercraft (under 60 feet) Page 3 Not-for-profit Members-as additional insureds Page 5 Personal And Advertising Injury-Discrimination Amendment(Not applicable in New York) Page 8 Products Amendment(Medical Payments) Page 4 Supplementary Payments Amended-Bail Bonds($5,000)and Loss of Earnings ($1,000) Page 4 Two or More Coverage Parts or Policies Issued By Us Page 8 Unintentional Failure to Disclose Hazards Page 8 Waiver of Transfer of Rights of Recovery(subrogation) Page 8 When Two or More Coverage Parts of this Policy Apply to a Loss Page 3 Copyright,2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 9 INSURED S COPY EXHIBIT'A'-Page 11 of 26 THIS PAGE IS INTENTIONALLY LEFT BLANK. Copyright,2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 2 of 9 INSURED'S COPY EXHIBIT'A'-Page 12 of 26 ElitePace. General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 00 01 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. However, if(a)two or more Coverage Parts of this policy, or(b) two or more forms or endorsements within the same Coverage Part apply to a loss, coverage provision(s) with the broadest language will apply, unless specifically stated otherwise within the particular amendment covering that loss. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. COVERAGES-Amendments B. The following is added to Exclusion g. Aircraft, SECTION I - COVERAGE A BODILY INJURY AND Auto Or Watercraft under COVERAGE A BODILY PROPERTY DAMAGE LIABILITY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions: EXCLUSIONS Employer's Liability Amendment This exclusion does not apply to: (6) Any aircraft, not owned or operated by any (This provision is not applicable in the State of New insured, which is hired, chartered or loaned with York). a paid crew. However, if the insured has any The following is added to Exclusion e. Employer's other valid and collectible insurance for "bodily Liability under COVERAGE A BODILY INJURY AND injury" or "property damage" that would be PROPERTY DAMAGE LIABILITY,2. Exclusions: covered under this provision, or on any other This exclusion also does not apply to any "temporary basis, this coverage is then excess, and subject worker". to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV- COMMERCIAL Non-Owned Aircraft,Auto or Watercraft GENERAL LIABILITY CONDITIONS. A. Paragraph (2) of Exclusion g. Aircraft, Auto Or Damage To Premises Rented to You Watercraft under COVERAGE A BODILY INJURY A. The last paragraph of Paragraph 2. Exclusions AND PROPERTY DAMAGE LIABILITY, 2. Exclus- under COVERAGE A BODILY INJURY AND ions is deleted in its entirety and replaced with the PROPERTY DAMAGE is deleted in its entirety and following: replaced with the following: (2) A watercraft you do not own that is: Exclusions c.through n. do not apply to damage by (a) Less than 26 feet long and not being used to fire, lightning or explosion to premises rented to you carry persons or property for a charge;or or temporarily occupied by you with the permission (b) At least 26 feet, but less than 60 feet long, of the owner. A separate limit of insurance applies to and not being used to carry persons or this coverage as described in SECTION III - LIMITS property for a charge. Any person is an OF INSURANCE. insured who uses or is responsible for the use of such watercraft with your expressed or implied consent. However, if the insured has any other valid and collectible insurance for "bodily injury" or"property damage" that would be covered under this provision, or on any other basis, this coverage is then excess, and subject to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS. Copyright,2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 9 INSURED'S COPY EXHIBIT'A'-Page 13 of 26 B. Paragraph 6. under SECTION III - LIMITS OF This exclusion applies even if damages are INSURANCE is deleted in its entirety and replaced claimed for notification costs, credit monitoring with the following: expenses, forensic expenses, public relations 6. Subject to Paragraph 5. above, the most we will expenses or any other loss, cost or expense pay under COVERAGE A for damages because incurred by you or others arising out of that of"property damage"to any one premises, while which is described in Paragraph (1) or (2) rented to you, or in the case of damage caused above. by fire, lightning or explosion,while rented to you B. The following paragraph is added to SECTION III - or temporarily occupied by you with permission LIMITS OF INSURANCE: of the owner, for all such damage caused by fire, Subject to 5. above, the most we will pay under lightning or explosion proximately caused by the COVERAGE A for"property damage" because of all same event, whether such damage results from loss of "electronic data" arising out of any one fire, lightning or explosion or any combination of "occurrence" is a sub-limit of$100,000. the three, is the amount shown in the Declara- tions for the Damage To Premises Rented To You Limit. EXCLUSIONS C. Paragraph a. of Definition 9."Insured contract" under Any Insured Amendment SECTION V-DEFINITIONS is deleted in its entirety Exclusion a. Any Insured under COVERAGE C and replaced with the following: MEDICAL PAYMENTS, 2. Exclusions is deleted in its a. A contract for a lease of premises. However,that entirety and replaced with the following: portion of the contract for a lease of premises a. Any Insured that indemnifies any person or organization for damage by fire, lightning or explosion to To any insured. premises while rented to you or temporarily This exclusion does not apply to: occupied by you with the permission of the (1) "Not-for-profit members"; owner is not an"insured contract"; Electronic Data Liability (2) "Golfing facility" members who are not paid a fee, salary, or other compensation; or A. Exclusion p.Access or Disclosure Of Confidential (3) "Volunteer workers". Or Personal Information And Data-related Liability under COVERAGE A BODILY INJURY This exclusion exception does not apply if COVERAGE AND PROPERTY DAMAGE LIABILITY, 2. C MEDICAL PAYMENTS is excluded by another Exclusions is deleted in its entirety and replaced by endorsement to this Coverage Part. the following: Product Amendment p. Access or Disclosure Of Confidential Or Exclusion f. Products-Completed Operations Hazard Personal Information And Data-related under COVERAGE C MEDICAL PAYMENTS, 2. Liability Exclusions is deleted in its entirety and replaced with Damages arising out of: the following: (1) Any access to or disclosure of any person's f. Products-Completed Operations Hazard or organization's confidential or personal Included within the "products-completed operations information, including patents, trade secrets, hazard". processing methods, customer lists, financial information, credit card information This exclusion does not apply to"your products"sold or any other type of nonpublic information; for use or consumption on your premises,while such or products are still on your premises. (2) The loss of, loss of use of, damage to, This exclusion exception, does not apply if COVERAGE corruption of, inability to access, or inability C MEDICAL PAYMENTS is excluded by another to manipulate"electronic data"that does not endorsement to this Coverage Part. result from physical injury to tangible SECTION I - SUPPLEMENTARY PAYMENTS- property. COVERAGES A AND B Expenses For Bail Bonds And Loss Of Earnings A. Subparagraph 1.b. under SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is deleted in its entirety and replaced with the following: b. Up to $5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. Copyright,2018 Selective Insurance Company of America.All rights reserved. CG 73 00 0119 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 4 of 9 INSURED'S COPY EXHIBIT'A'-Page 14 of 26 B. Subparagraph 1.d. under SUPPLEMENTARY a. Coverage under this provision is afforded only PAYMENTS - COVERAGES A AND B is deleted in until the 180th day after you acquire or form the its entirety and replaced with the following: organization or the end of the policy period, d. All reasonable expenses incurred by the insured whichever is earlier. However, COVERAGE A at our request to assist us in the investigation or does not apply to "bodily injury" or "property defense of the claim or "suit", including actual damage" that occurred before you acquired or loss of earnings up to $1,000 a day because of formed the organization. time off from work. B. The following paragraph is added to SECTION II SECTION II -WHO IS AN INSURED-Amendments -WHO IS AN INSURED, Paragraph 3: Not-for-Profit Organization Members If you are engaged in the business of con- struction of dwellings three stories or less in The following paragraph is added to SECTION II -WHO height, or other buildings three stories or less in IS AN INSURED: height and less than 25,000 square feet in area, If you are an organization other than a partnership,joint you will also be an insured with respect to "your venture, or a limited liability company, and you are a not- work" only, for the period of time described for-profit organization, the following are included as above, for your liability arising out of the conduct additional insureds: of any partnership or joint venture of which you 1. Your officials; are or were a member, even if that partnership or joint venture is not shown as a Named 2. Your trustees; Insured. However, this provision only applies if 3. Your members; you maintain or maintained an interest of at least 4. Your board members; fifty percent in that partnership or joint venture for the period of that partnership or joint venture. 5. Your commission members; This provision does not apply pp y to any partnership or joint 6. Your agency members; venture that has been dissolved or otherwise ceased to 7. Your insurance managers; function for more than thirty-six months. 8. Your elective or appointed officers;and With respect to the insurance provided by this provision, Newly Formed or Acquired Organizations, the 9. Your"not-for-profit members". following is added to SECTION IV - COMMERCIAL However only with respect to their liability for your GENERAL LIABILITY, Paragraph 4. Other Insurance, activities or activities they perform on your behalf. Subparagraph b. Excess Insurance: Employees As Insureds Modified The insurance provided by this provision, Newly Formed A. Subparagraph 2.a.(1)(a) under SECTION II - WHO or Acquired Organizations, is excess over any other insurance available to the insured, whether primary, IS AN INSURED does not apply to "bodily injury"to excess, contingent or on any other basis. a "temporary worker" caused by a co-"employee" who is not a"temporary worker". (All other provisions of this section remain unchanged) B. Subparagraph 2.a.(2) under SECTION II - WHO IS Blanket Additional Insureds - As Required By AN INSURED does not apply to "property damage" Contract to the property of a "temporary worker" or"volunteer Subject to the Primary and Non-Contributory provision worker" caused by a co-'employee" who is not a set forth in this endorsement, SECTION II -WHO IS AN "temporary worker"or"volunteer worker". INSURED is amended to include as an additional C. Subparagraph 2.a.(1)(d) under SECTION II - WHO insured: IS AN INSURED does not apply to "bodily injury" A. Owners, Lessees or Contractors/Architects, caused by cardio-pulmonary resuscitation or first aid Engineers and Surveyors services administered by a co-"employee". With respect to this provision only, Subparagraph (1) of 1. Any person or organization for whom you are perorming operations when you and such Exclusion 2. e. Employer's Liability under SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND person or organization have agreed ina written contract, pe written agreement or writtene permit that PROPERTY DAMAGE LIABILITY does not apply. such person or organization be added as an Newly Formed Or Acquired Organizations additional insured on your commercial general A. Subparagraph 3.a. under SECTION II -WHO IS AN liability policy; and INSURED is deleted in its entirety and replaced with the following: Copyright,2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 5 of 9 INSURED'S COPY EXHIBIT'A'-Page 15 of 26 2. Any other person or organization, including any With respect to the insurance afforded to these architects, engineers or surveyors not engaged additional insureds, this insurance does not by you, whom you are required to add as an apply to any "occurrence" which takes place additional insured under your policy in the after the equipment lease expires. contract or agreement in Paragraph 1.above: 2. Managers or Lessors of Premises Such person or organization is an additional insured Any person or organization from whom you only with respect to liability for "bodily injury", lease premises, but only with respect to liability "property damage" or "personal and advertising arising out of the ownership, maintenance or use injury"caused, in whole or in part, by: of that part of the premises leased to you. a. Your acts or omissions; or This insurance does not apply pp y to any "occur- b. The acts of omissions of those acting on rence"which takes place after you cease to be a your behalf; tenant of that premises. in the performance of your ongoing operations 3. Mortgagees, Assignees or Receivers performed for the additional insured in Paragraph 1., Any person or organization with respect to their above. liability as mortgagee, assignee or receiver and However,this insurance does not apply to: arising out of the ownership, maintenance or use "Bodily injury", "property damage" or "personal and of your premises. advertising injury" arising out of the rendering of, or This insurance does not apply to any the failure to render, any professional architectural, "occurrence" which takes place after the engineering or surveying services by or for you, mortgage is satisfied, or the assignment or including: receivership ends. a. The preparing, approving, or failing to 4. Any Person or Organization Other Than A prepare or approve, maps, shop drawings, Joint Venture opinions, reports, surveys, field orders, Any person or organization (other than a joint change orders or drawings and specifi- venture of which you are a member), but only cations; and with respect to liability for "bodily injury", b. Supervisory, inspection, architectural or "property damage" or "personal and advertising engineering activities. injury" caused, in whole or in part, by your acts Professional services do not include services within or omissions or the acts of omissions of those construction means, methods, techniques, acting on your behalf in the performance of your sequences and procedures employed by you in ongoing operations or in connection with connection with your operations in your capacity as property owned by you. a construction contractor. 5. State or Governmental Agency or Political A person or organization's status as an additional Subdivision-Permits or Authorizations insured under this endorsement ends when your Any state or governmental agency or subdivision operations for the person or organization described or political subdivision,but only with respect to: in Paragraph 1.above are completed. a. Operations performed by you or on your B. Other Additional Insureds behalf for which the state or governmental Any of the following persons or organizations with agency or subdivision or political subdivision whom you have agreed in a written contract, written has issued a permit or authorization; or agreement or written permit that such persons or b. The following hazards for which the state or organizations be added as an additional insured on governmental agency or subdivision or your commercial general liability policy: political subdivision has issued a permit or 1. Lessors of Leased Equipment authorization in connection with premises you own, rent or control and to which this Any person or organization from whom you insurance applies: lease equipment, but only with respect to liability for "bodily injury", "property damage" or "per- sonal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. Copyright,2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 6 of 9 INSIIRED'S COPY EXHIBIT'A'-Page 16 of 26 (1) The existence, maintenance, repair, c. Any physical or chemical change in the product construction, erection or removal of made intentionally by the vendor; advertising signs, awnings, canopies, d. Repackaging, unless unpacked solely for the cellar entrances, coal holes, driveways, purpose of inspection, demonstration, testing, or manholes, marquees, hoist away the substitution of parts under instructions from openings, sidewalk vaults, street the manufacturer, and then repackaged in the banners or decorations and similar original container; exposures; (2) The construction, erection or removal of e. Any failure to make such inspections, adjustments, tests or servicing as the vendor elevators; or has agreed to make or normally undertakes to (3) The ownership, maintenance or use of make in the usual course of business in any elevators covered by this insurance. connection with the sale of the product; or This insurance does not apply to: f. Products which, after distribution or sale by you, "Bodily injury" or"property dama e" have been labeled or re-labeled or used as a (a) y g container, part of ingredient of any other thing or arising out of operations performed substance by or for the vendor; however this for the federal government, state or insurance does not apply to any insured person municipality;or or organization, from who you have acquired (b) "Bodily injury" or "property damage" such products, or any ingredient, part or included within the "products- container, entering into, accompanying or con- completed operations hazard". taining such products. With respect to Paragraphs 2. through 4., this The provisions of this coverage extension do not apply insurance does not apply to structural unless the written contract or written agreement has alterations, new construction or demolition been signed by the Named Insured prior to the "bodily operations performed by or on behalf of such injury"or"property damage". person or organization. Incidental Malpractice The provisions of this coverage extension do not apply Subparagraph 2.a.(1)(d) under SECTION II - WHO IS unless the written contract or written agreement has AN INSURED is deleted in its entirety and replaced with been signed by the Named Insured or written permit the following: issued prior to the'bodily injury" or"property damage"or (d) Arising out of his or her providing or failing to provide "personal and advertising injury". Broad Form Vendors Coverage professional health care services. Subject to the Primaryand Non-ContributoryThis does not apply to nurses, emergency medical provision technicians or paramedics if you are not in the set forth in this endorsement, SECTION II-WHO IS AN business or occupation of providing any such INSURED is amended to include as an additional professional services. insured any person or organization (referred to below as This also does not apply to "bodily injury" caused by vendor) for whom you have agreed in a written contract or written agreement to provide coverage as an cardio-pulmonary resuscitation or first aid services additional insured under your policy. Such person or administered by a co-"employee". organization is an additional insured only with respect to This provision does not apply if you are a Social Service "bodily injury" or "property damage" arising out of "your or Senior Living risk. products" which are distributed or sold in the regular SECTION IV - COMMERCIAL GENERAL LIABILITY course of the vendor's business. However, the insurance CONDITIONS-Amendments afforded the vendor does not apply to: Knowledge Of Occurrence, Claim, Suit Or Loss a. "Bodily injury"or"property damage"for which the The following is added to Paragraph 2. Duties in the vendor is obligated to pay damages by reason of the assumption of liability in a contract or Event of Occurrence, Offense, Claim or Suit under agreement; however this exclusion does not SECTION IV - COMMERCIAL GENERAL LIABILITY apply to liability for damages that the vendor CONDITIONS: would have in the absence of the contract or The requirements under this paragraph do not apply until agreement; after the"occurrence"or offense is known to: b. Any express warranty unauthorized by you; 1. You, if you are an individual; 2. A partner, if you are a partnership; Copyright, 2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 7 of 9 INSURED'S COPY EXHIBIT'A'-Page 17 of 26 3. An "executive officer" or insurance manager, if you 3. You have assumed the liability of that person or are a corporation; organization in that same contract, and it is an 4. Your members, managers or insurance manager, if "insured contract". you are a limited liability company; or The section above only applies to that person or 5. Your elected or appointed officials, officers, organization identified above, and only if the "bodily members, trustees, board members, commission injury" or "property damage" occurs subsequent to the members, agency members, or your administrator or execution of the written contract or written agreement. your insurance manager if you are an organization Liberalization other than a partnership, joint venture, or limited The following condition is added to SECTION IV- liability company. COMMERCIAL GENERAL LIABILITY CONDITIONS: Primary and Non-Contributory Provision If we revise this Coverage Part to provide more coverage The following is added to Paragraph 4. Other Insur- without additional premium charge, subject to our filed ance, b. Excess Insurance under SECTION IV- company rules, your policy will automatically provide the COMMERCIAL GENERAL LIABILITY CONDITIONS: additional coverage as of the day the revision is effective This insurance is primary to and we will not seek in your state. contribution from any other insurance available to an Two or More Coverage Parts or Policies Issued By additional insured under this policy provided that: Us (1) The additional insured is a Named Insured under (This provision is not Applicable in the state of New York such other insurance; and or Wisconsin). (2) You have agreed in a written contract, written The following condition is added to SECTION IV - agreement or written permit that this insurance COMMERCIAL GENERAL LIABILITY CONDITIONS: would be primary and would not seek contribution It is our intention that the various coverage parts or from any other insurance available to the additional policies issued to you by us, or any company affiliated insured. with us, do not provide any duplication or overlap of Unintentional Failure To Disclose Hazards coverage. We have exercised diligence to draft our The following is added to Paragraph 6.Representations coverage parts and policies to reflect this intention. under SECTION IV - COMMERCIAL GENERAL However, if the facts and circumstances that will respond LIABILITY CONDITIONS: to any claim or "suit" give rise to actual or claimed duplication or overlap of coverage between the various However, if you should unintentionally fail to disclose any coverage parts or policies issued to you by us or any existing hazards in your representations to us at the company affiliated with us, the limit of insurance under inception date of the policy, or during the policy period in all such coverage parts or policies combined shall not connection with any additional hazards, we shall not exceed the highest applicable limit under this coverage, deny coverage under this Coverage Part based upon or any one of the other coverage forms or policies. such failure to disclose hazards. This condition does not apply to any Excess or Umbrella Waiver Of Transfer Of Rights Of Recovery policy issued by us specifically to apply as excess The following is added to Paragraph 8. Transfer of insurance over this coverage part or policy to which this Rights Of Recovery Against Others To Us under coverage part is attached. SECTION IV - COMMERCIAL GENERAL LIABILITY SECTION V-DEFINITIONS CONDITIONS: We will waive any right of recovery we may have against Discrimination a person or organization because of payments we make (This provision does not apply in New York). for"bodily injury" or"property damage"arising out of your A. The following is added to Definition 14. "Personal ongoing operations or "your work" done under a written and advertising injury": contract or written agreement and included in the "Personal and advertising injury" also means "products-completed operations hazard", if: "discrimination"that results in injury to the feelings or 1. You have agreed to waive any right of recovery reputation of a natural person, however only if such against that person or organization in a written "discrimination"or humiliation is: contract or written agreement; 1. Not done by or at the direction of: 2. Such person or organization is an additional insured a. The insured; or on your policy; or Copyright, 2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 9 INSURED'S COPY EXHIBIT'A'-Page 18 of 26 , . b. Anyone considered an insured under b. Loss of, loss of use of, damage to, corruption of, SECTION II-WHO IS AN INSURED; inability to access, or inability to properly 2. Not done intentionally to cause harm to another manipulate "electronic data", resulting from person. physical injury to tangible property. All such loss of"electronic data" shall be deemed to occur at 3. Not directly or indirectly related to the em- the time of the"occurrence"that caused it. ployment, prospective employment or termi- nationFor the purpose of the Electronic Data Liability coverage by any inn employment of any person or personssured. provided by this endorsement, "electronic data" is not tangible property. 4. Not arising out of any "advertisement" by the insured. ploy Employee Amendment B. The following definition is added to SECTION V- Definition 5. "Employee" under SECTION V- DEFINI- DEFINITIONS: TIONS is deleted in its entirety and replaced by the following: "Discrimination"means: 5. "Employee" includes a "leased worker", or a a. Any act or conduct that would be considered "temporary worker". If you are a School, "Employee" discrimination under any applicable federal, also includes a student teacher. state, or local statute, ordinance or law; Golfing Facility b. Any act or conduct that results in disparate The following definition is added to SECTION V - treatment of, or has disparate impact on, a DEFINITIONS: person, because of that person's race, religion, gender, sexual orientation, age, disability or "Golfing facility" means a golf course, golf club, driving physical impairment;or range, or miniature golf course. c. Any act or conduct characterized or interpreted Mental Anguish Amendment as discrimination by a person based on that (This provision does not apply in New York). person's race, religion, gender, sexual orients- Definition 3. "Bodily injury" under SECTION V- tion,age, disability or physical impairment. DEFINITIONS is deleted in its entirety and replaced with It does not include acts or conduct characterized or the following: interpreted as sexual intimidation or sexual harass- 3. "Bodily injury" means bodily injury, sickness or ment, or intimidation or harassment based on a disease sustained by a person, including death person's gender. resulting from any of these at any time.This includes Electronic Data mental anguish resulting from any bodily injury, The following definition is added to SECTION V- sickness or disease sustained by a person. (In New DEFINITIONS: York, mental anguish has been determined to be "Electronic data" means information, facts or programs "bodily injury"). stored as or on, created or used on, or transmitted to or Not-for-profit Member from computer software, including systems and The following definition is added to SECTION V- applications software, hard or floppy disks, CD-ROMS, DEFINITIONS: tapes, drives, cell, data processing devices or any other "Not-for-profit member" means a person who is a media which are used with electronically controlled member of a not-for-profit organization, including clubs equipment. For the purpose of the Electronic Data and churches, who receives no financial or other Liability coverage provided by this endorsement, compensation. Definition 17. "Property damage" is deleted in its entirety and replaced by the following: 17. "Property damage"means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or Copyright,2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 9 of 9 EXHIBIT'A'-Page 19 of 26 INSURED'S COPY STARSTONE .7.14, [NIP On.. Named Insured: Mendenhall &Associates LLC Policy No: 185125202AEM Endorsement No: 4 Effective Date: September 20, 2020 Premium: Included THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ENVIRONMENTAL & ENERGY LIABILITY INSURANCE ADDITIONAL INSURED ENDORSEMENT— OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: Any person or organization that is: 1. An owner of real or personal property on which you are performing operations pursuant to a written contract or written agreement, but only when specifically required written contract or written agreement, only the extent required by the written contract or written agreement,and only if: a. The written contract or written agreement is executed prior to the date of loss; and b. A Certificate of Insurance evidencing that request has been issued by an insurance professional prior to the date of loss. 2. A contractor on whose behalf you are performing operations pursuant to a written contract or agreement, but only when required by that written contract or agreement, only the extent required by the written contract or agreement, and only if: a. The written contract or written agreement is executed prior to the date of loss;and b. A Certificate of Insurance evidencing that request has been issued by an insurance professional prior to the date of loss. (If no entry appears above, information required to complete this endorsement will be shown in the Environmental&Energy Liability Insurance Package Policy Declarations as applicable to this endorsement) SECTION II—WHO IS AN INSURED is amended to include: A) SECTION II—WHO IS AN INSURED is amended to include as an additional insured the person or organization shown in the schedule above, but only with respect to liability arising out of your ongoing operations performed for the additional insureds, or in connection with premises owned by or rented to you. B) With respect to the insurance afforded to these additional insureds,the following exclusion is added: 1. Exclusions This insurance does not apply to"bodily injury"or"property damage"occurring after: SSI-EE-COM-84 03/16 Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 2 EXHIBIT'A'-Page 20 of 26 `y STARSTQNE Named Insured: Mendenhall &Associates LLC Policy No: I85125202AEM Endorsement No: 2 Effective Date: September 20, 2020 Premium: Included THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY., ENVIRONMENTAL & ENERGY LIABILITY INSURANCE WAIVER OF SUBROGATION - Blanket This endorsement modifies insurance provided under each coverage part and supersedes any conflicting provision in any coverage part, including any provision addressing the transfer of rights of recovery against others to us: We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement because of payments we make for injury or damage arising out of your ongoing operations or"your work"done under a contract with that person or organization and included in the"products-completed operations hazard". ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS REMAIN UNCHANGED. j:/ President Secretary SSI-EE-COM-05 03/16 Includes copyrighted material of Insurance Services Office Inc.with its permission Page 1 of 1 EXHIBIT'A'-Page 21 of 26 ElitePac® Commercial Automobile Extension COMMERCIAL AUTO CA 78 09 11 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Business Auto Coverage Form apply unless modified by the endorsement. AMENDMENTS TO SECTION II - LIABILITY COVER- EMPLOYEE INDEMNIFICATION AND EMPLOY- AGE ER'S LIABILITY AMENDMENT A. If this policy provides Auto Liability coverage for The following is added to SECTION II, B.4. - Owned Autos, the following extensions are applica- Exclusions: ble accordingly: This exclusion does not apply to a "volunteer work- NEWLY ACQUIRED OR FORMED ORGANIZA- er" who is not entitled to workers compensation, TIONS disability or unemployment compensation benefits. The following is added to SECTION II, A.1. -Who Is FELLOW EMPLOYEE COVERAGE An Insured: The Fellow Employee Exclusion, SECTION II, Any organization you newly acquire or form, other B.5.-is deleted in its entirety. than a partnership, joint venture or limited liability CARE, CUSTODY OR CONTROL AMENDMENT company over which you maintain ownership or majority interest, will qualify as a Named Insured if The following is added to SECTION II, B.6. - there is no similar insurance available to that organi- Exclusions: zation. However: This exclusion does not apply to property owned by 1. Coverage under this provision is afforded only anyone other than an"insured",subject to the follow- until the 180th day after you acquire or form the ing: organization or the end of the policy period, 1. The most we will pay under this exception for whichever is earlier; any one"accident" is the Limit of Insurance stet- 2. Coverage does not apply to "bodily injury" or ed in the ElitePac Schedule;and "property damage" resulting from an "accident" 2. A per "accident" deductible as stated in the that occurred before you acquired or formed the ElitePac Schedule applies to this exception. organization. B. If this policy provides Auto Liability coverage for No person or organization is an "insured" with re- Owned Autos or Non-Owned Autos, the following spect to the conduct of any current or past partner- extension is applicable accordingly: ship,joint venture or limited liability company that is LIMITED LIABILITY COMPANIES not shown as a Named Insured in the Declarations. EXPENSES FOR BAIL BONDS AND LOSS OF The following is added to SECTION II,A.1. -Who Is EARNINGS An Insured: Paragraphs (2) and (4) of SECTION II, A.2.a. - If you are a limited liability company, your members Supplementary t are e in their and managers are "insureds" while using a covered ple and repl Paymentsed with the following:redeleted "auto" you don't own, hire or borrow during the entircourse of their duties for you. (2) Up to the Limit of Insurance shown on the BLANKET ADDITIONAL INSUREDS - As ElitePac Schedule for the cost of bail bonds (in- Required By Contract cluding bonds for related traffic law violations) required because of an"accident"covered under The following is added to SECTION II, A.1.-Who Is this policy. We do not have to furnish these An Insured: bonds. (4) All reasonable expenses incurred by the "insured" at our request. This includes actual loss of earnings because of time off from work, which we will pay up to the Limit of Insurance shown on the ElitePac Schedule. Copyright,2017 Selective Insurance Company of America.All rights reserved. CA 78 09 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5 EXHIBIT'A'-Page 2 of 26 INSURED'S COPY Any person or organization whom you have agreed For labor charges to be eligible for reimbursement the in a written contract, written agreement or written labor must be performed at the place of disablement. permit that such person or organization be added as This coverage extension does not apply to Emergency an additional "insured" on your policy. Such person Services Organizations and Governmental Entities. or organization is an additional "insured" only with respect to liability for "bodily injury" or "property GLASS BREAKAGE DEDUCTIBLE damage"caused, in whole or in part, by your owner- The following is added to SECTION III, A.3. - Glass ship, maintenance or use of a covered "auto". This Breakage-Hitting A Bird Or Animal-Falling Objects coverage shall be primary and non-contributory with or Missiles: respect to the additional "insured". This provision If damaged glass is repaired rather than replaced, no only applies if: deductible will apply for such repair. This extension does 1. It is required in the written contract, written not apply to Emergency Services Organizations and agreement or written permit identified in this sec- Governmental Entities. tion; ADDITIONAL TRANSPORTATION EXPENSES SEC- 2. It is permitted by law; and TION III, A.4.a. - Transportation Expenses is deleted 3. The written contract or written agreement has in its entirety and replaced with the following: been executed (executed means signed by a We will pay up to the maximum Limit of Insurance shown named insured) or written permit issued prior to on the ElitePac Schedule for temporary transportation the"bodily injury"or"property damage". expenses that you incur because of any"loss" to a cov- C. If this policy provides Auto Liability coverage for Non- ered "auto", but only if the covered "auto" carries the Owned Autos, the following extension is applicable coverages and meets the requirements described in 1. accordingly: or 2. below: EMPLOYEES AS INSUREDS 1. We will pay temporary transportation expenses for If this policy provides Auto Liability coverage total theft of a covered "auto". We will only pay for Non-Owned Autos, the following is added forto such expenses incurred during the period beginning SECTION II,A.1.-Who Is An Insured: 24 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is re- Any"employee" of yours is an "insured" while using turned to use or we pay for its"loss". a covered "auto" you don't own, hire or borrow in 2. For "loss" other than total theft of a covered "auto" your business or your personal affairs. under Comprehensive or Specified Causes of Loss An "employee" of yours is an "insured"while operat- Coverage, or for any"loss"under Collision Coverage ing an "auto" hired or rented under a contract or to a covered "auto", we will only pay for those tern- agreement in that"employee's" name with your per- porary transportation expenses incurred during the mission, while performing duties related to the con- policy period beginning 24 hours after the "loss" and duct of your business. ending, regardless of the policy's expiration, with the AMENDMENTS TO SECTION 111 - PHYSICAL lesser of the number of days reasonably required to DAMAGE COVERAGE repair or replace the covered"auto"or 30 days. If this policy provides Comprehensive, Specified Causes Paragraph 2. of this extension does not apply while of Loss or Collision coverage, the following extensions there are spare or reserve "autos" available to you are applicable for those "autos" for which Comprehen- for your operations. sive, Specified Causes of Loss or Collision coverage is This coverage extension does not apply to Emergency purchased: Services Organizations and Governmental Entities. TOWING AND LABOR HIRED AUTO PHYSICAL DAMAGE COVERAGE SECTION III, A.2. -Towing is deleted in its entirety and The following is added to SECTION III, A.4. -Coverage replaced with the following: Extensions: We will pay all reasonable towing and labor costs up to Physical Damage coverage is hereby extended to apply the maximum Limit of Insurance shown on the ElitePac to Physical Damage"loss" to "autos" leased, hired, rent- Schedule per tow each time a covered "Private Passen- ed or borrowed without a driver. We will provide cover- ger Auto", "Social Service Van or Bus"or"Light Truck" is age equal to the broadest coverage available to any disabled and up to the maximum Limit of Insurance per covered "auto" shown in the Declarations. But, the most tow each time a covered"Medium Truck", "Heavy Truck" we will pay for"loss"to each "auto" under this coverage or"Extra Heavy Truck" is disabled. extension is the lesser of: Copyright,2017 Selective Insurance Company of America.All rights reserved. CA 78 09 11 17 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 2 of 5 EXHIBIT'A'-Page of 26 INSURED'S COPY 1. The Limit of Insurance stated in the ElitePac Sched- AUTO LOAN/LEASE GAP COVERAGE (Not Applica- ule;or ble in New York) 2. The actual cash value of the damaged or stolen The following is added to SECTION III, A.4. -Coverage property as of the time of the"loss'; or Extensions: 3. The actual cost of repairing or replacing the dam- In the event of a total "loss" to a covered "auto" we will aged or stolen property with other property of like pay any unpaid amount due on the lease or loan for a kind and quality. A part is of like kind and quality covered"auto",less: when it is of equal or better condition than the pre- 1. The amount paid under the Physical Damage Cover- accident part. We will use the original equipment age Section of the policy; and from the manufacturer when: (a) The operational safety of the vehicle might 2. Any: otherwise be impaired; a. Overdue lease/loan payments at the time of (b) Reasonable and diligent efforts to locate the "loss"; appropriate rebuilt, aftermarket or used part b. Financial penalties imposed under a lease for have been unsuccessful; or excessive use, abnormal wear and tear, high (c) A new original equipment part of like kind mileage or similar charges; and quality is available and will result in the c. Security deposits not refunded by the lessor or lowest overall repair cost. financial institution; For each leased, hired, rented or borrowed "auto" our d. Costs for extended warranties, credit life, health, obligation to pay"losses"will be reduced by a deductible accident, or disability insurance purchased with equal to the highest deductible applicable to any owned the loan or lease; and "auto"for that coverage. No deductible will be applied to e. Carry-over balances from previous leases or "losses"caused by fire or lightning. loans. SECTION IV, B.5. Other Insurance Condition, Para- You are responsible for the deductible applicable to the graph 5.b. is deleted in its entirety and replaced by the "loss"for the covered"auto". following: PERSONAL EFFECTS For Hired Auto Physical Damage Coverage, the follow- The following is added to SECTION III,A.4. -Coverage ing are deemed to be covered"autos"you own: Extensions: 1. Any covered "auto" you lease, hire, rent, or borrow; If this policy provides Comprehensive Coverage for a and covered "auto" you own and that covered "auto" is 2. Any covered "auto" hired or rented by your "em- stolen,we will pay up to the Limit of Insurance shown on ployee" under a contract or agreement in that the ElitePac Schedule, without application of a deducti- "employee's" name, with your permission, while ble, for lost personal effects that were in the covered performing duties related to the conduct of your "auto"at the time of theft. Personal effects do not include business. jewelry, tools, money, or securities. This coverage is However, any "auto" that is leased, hired, rented or excess over any other collectible insurance. borrowed with a driver is not a covered"auto", AIRBAG COVERAGE This coverage extension does not apply to Emergency The following is added to SECTION III, B.3.a. - Exclu- Services Organizations and Governmental Entities. sions: HIRED AUTO LOSS OF USE COVERAGE Mechanical breakdown does not include the accidental The following is added to SECTION III, A.4. -Coverage discharge of an airbag. Extensions: This coverage extension does not apply to Emergency We will pay expenses for which you are legally responsi- Services Organizations and Governmental Entities. ble to pay up to the Limit of Insurance shown on the EXPANDED AUDIO, VISUAL, AND DATA ELEC- ElitePac Schedule per "accident" for loss of use of a TRONIC EQUIPMENT COVERAGE leased, hired, rented or borrowed "auto" if it results from SECTION III, B.4.-Exclusions an"accident". This coverage extension does not apply to Emergency This exclusion does not apply to the following: Services Organizations, Governmental Entities, and 1. Global positioning systems; Schools. 2. "Telematic devices"; or 3. Electronic equipment that reproduces, receives or transmits visual or data signals and accessories used with such equipment, provided such equipment is: Copyright, 2017 Selective Insurance Company of America.All rights reserved. CA 78 09 11 17 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 3 of 5 INSURED'S COPY EXHIBIT'A'-Page 24 of 26 a. Permanently installed in or upon the covered 3. An executive officer or insurance manager, if you "auto"at the time of the"loss"; are a corporation; b. Removable from a housing unit that is perma- 4. Your members, managers or insurance manager, if nently installed in the covered "auto" at the time you are a limited liability company; of the"loss"; 5. Your elected or appointed officials, trustees, board c. Designed to be solely operated by use of power members or your insurance manager, if you are an from the"auto's"electrical system;or organization other than a partnership, joint venture d. Designed to be used solely in or upon the or limited liability company. covered"auto". But, this section does not amend the provisions relating For each covered "loss"to such equipment, a deductible to notification of police or protection or examination of of$50 shall apply, unless the deductible otherwise appli- the property that was subject to the"loss". cable to such equipment is less than $50, at which point WAIVER OF SUBROGATION the lower deductible, if any,will apply. SECTION IV, A.5. - Transfer Of Rights Of Recovery COMPREHENSIVE DEDUCTIBLE - LOCATION Against Others To Us is deleted in its entirety and TRACKING DEVICE replaced with the following: The following is added to SECTION III,D.-Deductible: We waive any right of recovery we may have against Any Comprehensive Coverage Deductible shown in the any person or organization because of payments we Declarations will be reduced by 50% for any "loss" make for "bodily injury" or "property damage" resulting caused by theft if the covered "auto" is equipped with a from the ownership, maintenance or use of a covered location tracking device and that device was the sole "auto" but only when you have assumed liability for such method used to recover the"auto". "bodily injury" or "property damage" in an "insured con- tract". In all other circumstances, if a person or organiza- PHYSICAL DAMAGE LIMIT OF INSURANCE tion to or for whom we make payment under this Cover- SECTION III, C. - Limit Of Insurance is deleted in its age Form has rights to recover damages from another, entirety and replaced with the following: those rights are transferred to us. The most we will pay for a "loss"in any one"accident"is MULTIPLE DEDUCTIBLES the lesser of: The following is added to SECTION IV, A. - Loss 1. The actual cash value of the damaged or stolen Conditions: property as of the time of the"loss"; or If a "loss" from one event involves two or more covered 2. The cost of repairing or replacing the damaged or "autos"and coverage under Comprehensive or Specified stolen property with other property of like kind and Causes of Loss applies, only the highest applicable quality. deductible will be applied. This coverage extension does not apply to Emergency CONCEALMENT, MISREPRESENTATION OR FRAUD Services Organizations and Governmental Entities. The following is added to SECTION IV, B.2. - Conceal- AMENDMENTS TO SECTION IV - BUSINESS AUTO ment,Misrepresentation Or Fraud: CONDITIONS If you should unintentionally fail to disclose any existing DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT hazards in your representations to us prior to the incep- OR LOSS tion date of the policy or during the policy period in The following is added to SECTION IV, A.2.a. - Duties connection with any newly discovered hazards, we will In The Event Of Accident, Claim,Suit Or Loss: not deny coverage under this Coverage Form based upon such failure. The notice requirements for reporting "accident" claim, POLICY PERIOD, COVERAGE TERRITORY "suit" or "loss" information to us, including provisions related to the subsequent investigation of such "acci- SECTION IV, B.7. - Policy Period, Coverage Territory dent", claim, "suit" or "loss" do not apply until the is deleted in its entirety and replaced with the following: "accident", claim,"suit"or"loss"is known to: Under this Coverage Form, we cover "accidents" and 1. You, if you are an individual; "losses"occurring: 2. A partner, if you are a partnership; a. During the policy period shown in the Declarations; and b. Within the"Coverage Territory". Copyright,2017 Selective Insurance Company of America.All rights reserved. CA 78 09 11 17 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 4 of 5 EXHIBIT'A'-Page 25 of 26 INSURED'S COPY We also cover "loss" to or "accidents" involving a coy- EXTRA HEAVY TRUCK ered "auto" while being transported between any of "Extra Heavy Truck" means a truck with a gross vehicle these places. weight rating of 45,001 pounds or more. TWO OR MORE COVERAGE FORMS OR POLICIES HEAVY TRUCK ISSUED BY US-DEDUCTIBLES The following is added to SECTION IV, B.8. - Two Or "Heavy Truck"means a truck with a gross vehicle weight More Coverage Forms Or Policies Issued By Us: rating of 20,001 pounds to 45,000 pounds. If a "loss" covered under this Coverage Form also in- LIGHT TRUCK volves a "loss"to other property resulting from the same "Light Truck" means a truck with a gross vehicle weight "accident" that is covered under this policy or another rating of 10,000 pounds or less. policy issued by us or any member company of ours, MEDIUM TRUCK only the highest applicable deductible will be applied. "Medium Truck" means a truck with a gross vehicle AMENDMENTS TO SECTION V-DEFINITIONS weight rating of 10,001 pounds to 20,000 pounds. BODILY INJURY INCLUDING MENTAL ANGUISH (Not PRIVATE PASSENGER AUTO Applicable in New York) "Private Passenger Auto" means a four-wheel "auto" of The definition of bodily injury is deleted in its entirety and the private passenger or station wagon type. A pickup, replaced by the following: panel truck or van not used for business is included "Bodily injury" means bodily injury, sickness, or disease within the definition of a"private passenger auto". sustained by a person, including death resulting from SOCIAL SERVICE VAN OR BUS any of these. "Bodily injury" includes mental anguish "Social Service Van or Bus"means a van or bus used by resulting from bodily injury, sickness or disease sus- a government entity, civic, charitable or social service tained by a person. organization to provide transportation to clients inci- ADDITIONS TO SECTION V-DEFINITIONS dental to the social services sponsored by the organiza- COVERAGE TERRITORY tion, including special trips and outings. "Coverage Territory"means: TELEMATIC DEVICE 1. The United States of America (including its territories "Telematic Device" includes devices designed for the and possessions), Canada and Puerto Rico; and collection and dissemination of data for the purpose of Anywhere in the world, except for countrymonitoring vehicle and/or driver performance. This in- 2. Yw any or cludes Global Positioning System technology, wireless jurisdiction that is subject to trade or other economic safety communications and automatic driving assistance sanction or embargo by the United States of systems, all integrated with computers and mobile corn- America, if a covered "auto" is leased, hired, rented, munications technology in automotive navigation sys- or borrowed without a driver for a period of 30 days tems. or less, and the insured's responsibility to pay"dam- ages" is determined in a "suit" on the merits in and VOLUNTEER WORKER under the substantive law of the United States of "Volunteer worker" means a person who performs busi- America (including its territories and possessions), ness duties for you, for no financial or other compensa- Puerto Rico, or Canada, or in a settlement we agree tion. to. If we are prevented by law, or otherwise, from defending the"insured"in a"suit" brought in a location described in Paragraph 2. above, the insured will conduct a defense of that"suit".We will reimburse the "insured"for the rea- sonable and necessary expenses incurred for the de- fense of any such "suit" seeking damages to which this insurance applies, and that we would have paid had we been able to exercise our right and duty to defend. Copyright,2017 Selective Insurance Company of America. All rights reserved. CA 78 09 11 17 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 5 of 5 EXHIBIT'A'-Page of 26 INSURED COPY March 30,2021 Mendenhall&Associates Attn:Tina Henderson PO BOX 428 Arcadia,IN 46030 Re: Request for Proposals West Side Interceptor Improvements Project—Division A Davis-Bacon Wage Scale Compliance Review and Certification The Richmond Sanitary District is seeking the assistance of a professional labor standards administrator to provide all Davis-Bacon wage scale compliance reviews and certifications for the West Side Interceptor Improvements Project—Division A as required by the State of Indiana Finance Authority SRF Program and/or Federal Government. Please review the attached RFP and,if interested in this work,please present a proposal as outlined. Thanks, Elijah W.Welch,P.E. District Engineer Richmond Sanitary District EXHIBIT'B'-Page 1 of 16 Richmond Sanitary District Request for Proposal West Side Interceptor Improvements Project—Division A Davis-Bacon Wage Scale Compliance Review and Certification The Richmond Sanitary District is seeking the assistance of a professional labor standards administrator (Herein after referred to as LSA) to provide all Davis-Bacon wage scale compliance reviews and certifications for the West Side Interceptor Improvements Project—Division A as required by the State of Indiana Finance Authority SRF Program and/or Federal Government. Part l: Project Information The Richmond Sanitary District (RSD) is in the process of awarding the West Side Interceptor Improvements Project—Division A to Brackney,Inc.of Brookville,IN. The project is being funded by the Indiana Finance Authority SRF loan program and requires Davis-Bacon Wage scale to be used. The below is a general summary of project information: Contractor: Brackney,Inc. 2145 State Road 1 Brookville,IN 47012 Construction Contract Amount:$5,301,620.00(see attached bid schedule) Subcontractor's listed on Form 96 as submitted by contractor at time of bid: 8(see attached) Time allowed per contract documents for completion of project: Substantial Completion:485 days Final Completion:60 days from Substantial Completion Project Description: The construction of approximately 4,624 linear feet of sanitary sewer ranging from twelve(12)to fifty-four (54) inches in diameter installed using a combination of open-cut and trenchless methods. An earth retention system comprised of sheet piling and soil nails will be required for the open cut construction under the Richmond Avenue Bridge. The project also includes the construction of approximately 390 linear feet of dual-barrel sanitary siphon piping,ten(10)and twenty-four(24)inches in diameter,to be installed using open cut methods,which includes temporary cofferdams across the Whitewater River. Improvements also include the construction of new manhole structures as required for a complete and functioning wastewater collection system. All ancillary work such as pipe rehabilitation using cured-in-place pipe (CIPP), pipe abandonment,site demolition,and site restoration shall be provided as required by the Contract Documents. Project Start Date:May 2019(estimated) Part 2: Proposed Scope of Work The LSA will be responsible for all aspects of Davis-Bacon wage scale compliance as required for the owner (City of Richmond/Richmond Sanitary District) by the State of Indiana Finance Authority SRF Program and/or Federal Government. The attached documents show a brief overview of information as related to the Davis-Bacon wage scale compliance requirements. Part 3: Deliverables All records associated with compliance review and certifications shall be provided as obtained during the project as well as in aggregate at the end of construction and final compliance review. Part 4—Content of Proposal(Response to RFP) EXHIBIT'B'-Page 2 of 16 Respondents to this RFP shall submit a proposal which shall include information as follows: 1. Proposed Scope of Services 2. Fee Tabulation for all work associated with this project 3. List of 3 recent IFA SRF projects showing history of work with this agency and ability to complete this specific type of work 4. Appropriate insurance will be required prior to approval of contract but is not required at time of submittal 5. Affidavit of E-verify will be required prior to approval of contract but is not required at time of submittal Part 5—Submittal Requirements The proposal shall be submitted to the Richmond Sanitary District no later than 12:00pm Friday,April 9, 2021. Proposals shall be delivered by email to Elijah Welch,District Engineer at ewelch4richmondindiana.gov. Appropriate insurance will be required prior to approval of contract. Questions shall be directed to Elijah Welch at ewelch@richmondindiana.gov or 765-983-7483. The Richmond Sanitary District reserves the right to reject any parts of and/or your entire proposal. EXHIBIT'Br-Page 3 of 16 Part of State Form 52414(R2/2-13)/Form 96(Revised 2013) BID OF BRACKNEY, INC. (Contractor) 2145 STATE ROAD 1 (Address) BROOKVILLE,IN 47012 FOR . . _ . PUBLIC WORKS PROJECTS OF E's l S's,ic ..LAJ C, ptoR /14(1 E/MU I S 4f2/z="c9-7 "' Filetl - • Action taken • EXHIBIT'B'-Page 4 of 16 { JJ 11 " CONTRACTOR'S BID FOR PUBLIC WORK o FORM 96 [t State Form 52414(R2/2-13)/Form 96(Revised 2013) _'•5;7:, Prescribed by State Board of Accounts rate PART I (To be completed for all bids. Please type or print) Date(month, day,year): 021 1. Governmental Unit(Owner): 0.71y .71 VP at/if/2040 2. County: /il/�fyitfF ` 3. Bidder(Firm): BRACKNEY, INC Address: 2145 STATE ROAD 1 CitylState/ZlPcode: BROOKVILLE, IN 47012 4. Telephone Number: 765-647-6551 5. Agent of Bidder(if applicable): Pursuant to notices given,the�r undersigned offers to furnish labor and/or mater4eT/)/u/ /JJ al necessary to complete the public works project ofGUESTJ%Dg',144C§/i/OR -,�/YI/ROf1F_MesTh A (Governmental Unit)in accordance" with plans and specifications prepared by G/7iir1&VeY1EAi7�� Aar C, and dated /2—/S-27/9 for the sum of g/D $ ,SZFE O The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply,the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the governmental unit. If the bid is to be awarded on a unit basis,the itemization of the units shall be shown on a separate attachment. The contractor and his subcontractors, If any, shall not discriminate against or intimidate any employee, or applicant for employment, to be employed in the performance of this contract, with respect to any matter directly or indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this covenant may be regarded as a material breach of the contract. CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS Of applicable) I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory obligation to use steel products made in the United States (I.C. 5-16-8-2). I hereby certify that I and all subcontractors employed by me for this project will use U.S. steel products on this project if awarded. I understand that violations hereunder may result in forfeiture of contractual payments. EXHIBIT'B'-Page 5 of 16 ACCEPTANCE The above bid is accepted this day of , ,subject to the following conditions: Contracting Authority Members: PART II (For projects of$150,000 or more—IC 36-1-12-4) Governmental Unit: Cam' 1 / ,h744JL Bidder(Firm) BRACKNEY, INC Date(month, day,year): 3- 9- 202/ These statements to be submitted under oath by each bidder with and as a part of his bid. Attach additional pages for each section as needed. SECTION I EXPERIENCE QUESTIONNAIRE 1. What public works projects has your organization completed for the period of one (1)year prior to the date of the current bid? Completion Contract Amount Class of Work Date Name and Address of Owner 10,731,236.00 SEWER 1/29/20 CITY OF RICHMOND, IN 2,926,749.00 SEWER 8/17/19 BUTLER CO.BRD OF COMMISSIONERS 3,195,175.00 SEWER 7/1/19 MONTGOMERY COUNTY ENVIRONMENTAL SRVS 2,290,242.00 SEWER 11/1/19 CITY OF RICHMOND, IN 2. What public works projects are now in process of construction by your organization? Expected Contract Amount Class of Work Completion Name and Address of Owner Date 9,024,524.55 WATER 06/01/20 CITY OF BATESVILLE, IN 3,117,134.00 SEWER 12/01/20 CITY OF BERNE, IN 704,822.00 SEWER 12/01/20 CITY OF CONNERSVILLE,IN(MEMORIAL DRIVE) 1,127,750.00 SEWER 04/01/20 CITY OF CONNERSVILLE,IN(7TH STREET) EXHIBIT'B'-Page 6 of 16 3. Have you ever failed to complete any work awarded to you? O If so,where and why? 4. List references from private firms for which you have performed work. /u i0 tv/6 a., �°AL� .0 G � / � — —2),e)ucLf-acrrc Ath.��o E at, LLC. c7-- t:o 7 7 /lee/54 SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE 1. Explain your plan or layout for performing proposed work. (Examples could include a narrative of when you could begin work, complete the project, number of workers, etc. and any other information which you believe would enable the governmental unit to consider your bid.) ACeJ13/,Jc7t. /l�N S'RASA 61;',4- ;�esA/.aas 2. Please list the names and addresses of all subcontractors (i.e.persons or firms outside your own firm who have performed part of the work)that you have used on public works projects during the past five(5) years along with a brief description of the work done by each subcontractor. SEE ATTACHED LIST EXHIBIT'B'-Page 7 of 16 3. If you intend to sublet any portion of the work,state the name and address of each subcontractor, equipment to be used by the subcontractor, and whether you will require a bond. However,if you are unable to currently provide a listing, please understand a listing must be provided prior to contract approval. Until the completion of the proposed project,you are under a continuing obligation to immediately notify the governmental unit in the event that you subsequently determine that you will use a subcontractor on the proposed project. Atz)EST'f o/ j ii i i kbraRn7 GOO STAp,tizR7'o al AJ7 NA?owa 1o8piCd, 356 Al /3OgTozeThe1Dl1�g7',URigc gg75 ,- 7V 1lEcu' i� GPENuTte% .j, q,/yo _Z,u4iflalApo / 1� VS291 Co mmeRCEC. A/ C.O� 84620 ,f0,eg 9a4'//OA,`6.AJC>' N/moo• /71/�DAh9 A) 180'J D 4. What equipment do you have available to use for the proposed project? Any equipment to be used by subcontractors may also be required to be listed by the governmental unit. ��1= �aN104I RF-fiDkr- 5. Have you entered into contracts or received offers for all materials which substantiate the prices used in preparing your proposal? If not, please explain the rationale used which would corroborate the prices listed. )Ie .� SECTION III CONTRACTOR'S FINANCIAL STATEMENT Attachment of bidder's financial statement is mandatory. Any bid submitted without said financial statement as required by statute shall thereby be rendered invalid. The financial statement provided hereunder to the governing body awarding the contract must be specific enough in detail so that said governing body can make a proper determination of the bidder's capability for completing the project if awarded. EXHIBIT'B'-Page 8 of 16 . i J' I SECTION IV CONTRACTOR'S NON—COLLUSION AFFIDAVIT The undersigned bidder or agent, being duly sworn on oath, says that he has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to include anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person In reference to such bidding. He further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly,any rebate,fee,gift, commission or thing of value on account of such sale. SECTION V OATH AND AFFIRMATION I HEREBY AFFIRM UNDER THE PENALTIES FOR PERJURY THAT THE FACTS AND INFORMATION CONTAINED IN THE FOREGOING BID FOR PUBLIC WORKS ARE TRUE AND CORRECT. Dated at FRANKLIN COUNTY this 9' day of R/9RCl-1 ;Pd 2/ BRACKNEY, INC (Name of Organization) PRE (DENT (Title of Person Signing) ACKNOWLEDGEMENT STATE OF INDIANA )ss COUNTY OF FRANKLIN Before me,a Notary Public, personally appeared the above-named KEVIN BRACKNEY and swore that the statements contained in the foregoing document are true and correct. Subscribed and sworn to before me this 9 day of ili��G��7 ,24.24. o9i/e;ublic My Commission Expires: ..)4 �7 r�0, County of Residence: FRANKLIN EXHIBIT'B'-Page 9 of 16 1 u • t t. . Subcontract List Work Description Midwest Mole, Inc. Boring 2460 N.Graham Ave. Indianapolis, IN 46218 Kelley Dewatering&Construction Co. Dewatering 5175 Clay Ave.SW Wyoming, MI 49548 Sub-surface of Indiana, Inc. Directional Bore 7225 W700S Morgantown, IN 46160 ABC,Asphalt, Block Concrete,Inc. Sawing 5230 Commerce Circle Drive Indianapolis, IN 46237 Ludwig Contracting, Inc. Electrical P.O.Box 128 Cedar Grove, IN 47016 ITT Water&Wastewater Indiana, LLC Dewatering 7615 West New York Street Indianapolis, IN 46214 Gillespie Surveying Construction Engineering 7110 Holland Rd. Brookville, IN 47012 Turn-key Tunneling, Inc. Boring 1247 Stimmel Rd. Columbus,OH 43223 EXHIBIT'B'-Page 10 of 16 91.10 1.1.abed-,8.1I81HX3 i. II- m o o 0 0 O o 0 0 0 0 0 0 0 0 a` o o 0I 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 o ui Oo 0 0 0o 0 0 o O o 0 co LE) st O CO to to O O o - 1. O W NW O Oj N N o O M i N En N O5 M Ef3 69 6N9 6N9 FA 6699 69 69 69 69 69 I 69 69 EFT Efl u :I o 4 o O O O O i 0 O d g - O O co O o O O 0 O O O O u'�. 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