HomeMy Public PortalAboutORD11509 {Y,,. '�\ y}4 t '� ! t Y l�ti .1' .j1 F 4- j:t'"t' ,;•S 7!"
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. ,f BILL NO. 90- 122
. r SPONSORED BY COUNCILMAN SCHEULEN
ORDINANCE NO. 11 5b2
AN ORDINANCE OF THE CITY OF JEFFERSON, MISSOURI, AUTHORIZING THE
Sa
MAYOR AND CITY CLERK TO EXECUTE AN AGREEMENT FOR THE CONSTRUCTION
t OF FIRE STATION 5.
eh
is BE Ii ENACTED BY THE COUNCIL OF THE CITY OF JEFFERSON, MISSOURI,
AS FOLLOWS:
'a
Section 1. The Mayor and City Clerk are hereby authorized
. and directed to execute an agreement with Wisch and Vaughan
Construction Company for the construction of Fire Station 5 at
1005 Fairgrounds Road. The amount of the contract shall not
exceed $259,700. 00.
^' Section 2. The agreement shall be substantially the same in
} form and content as that agreement attached hereto as Exhibit A.
' - Section 3. This Ordinance shall be in full force and effect
from and after the date of its passage and approval.
Yi
Passed 1990 Approved /750
;`.
siding Officer Ma
ATTEST:
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City Clerk
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FIRE DEPARTMENT
320 East McCarty Street
Jefferson City, Missouri 65101
Y Change Order No. 1 Job No. 26773 Date January 29, 1991,
it,.... L.
g= Job: Construction of Fire Station #5, 1005 Fairground Rd.
Contractor Wisch & Vaughan Construction Co.
It is hereby mutually agreed that when this change order has been
.1fi�4
signed by the contracting parties, the following described changes
in the work required by the contract shall be executed by the
contractor without changing the terms of the contract except as
g g p ;.
;. herein stipulated and agreed.
Description of Changes: SEE ATTACHED
CONTRACTORS PROPOSAL FOR THE ABOVE DESCRIBED CHANGES; ,
tt I/We hereby agree to the modifications of the contract as described
<iv above and agree to furnish all materials and labor and perform all
work in connection therewith in accordance with the requirements
for similar work in existing contract except as otherwise
stipulated herein, for the following considerations:
Contract Amount - Add to (X) Deduct from ( ) the sum of:
�rt,zr .ry;7j.
One thousand one hundred and ninety-two DOLLARS ($1, 192 .00)
CONTRACTOR Ma UV,11A A.)
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SIGNATURE DATE
g•
' Recommended by:
Signature DATE c1
'"�
' ___________________________________________=_________
Accepted by:
a!4 Owner CITY OF 4EFFERSON, MISSOURI
' Signature DATE
rr STATEMENT OF CONTRACT ;WQ&�T:
i=
Original Contract Amount. . . . . . . . . . . . . . . $ 259,700.00
^} Previous Additions. . . . . . . . . . . . . . . . . . . . . $ 00. 00
TOTAL $ 259,700.00
Previous Deductions . . . . . . . . . . . . . . . . . . . $ 00. 00
r Net Prior to this Change . . . . . . . . . . . . . . $ 259.700.00
Amount of this Change X Add Deduct. $ 1, 192. 00
CONTRACT AMOUNT TO DATE . . . . . . . . . . . . . . . $ 260,892.,00
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CONSTRUCTION CONTRACT
THIS CONTRACT, made and entered into this day of Y`
1990, by and between Wisch & Vaughn Constructions k
Company hereinafter called "Contractor" , and the City of Jefferson, .
Missouri, a municipal corporation, hereinafter called "City" ,
WITNESSETH: That Whereas, the Contractor has become the lowest ,
responsible bidder for furnishing the supervision, labor, tools,
f' equipment, materials and supplies and for constructing the
following City improvements: TIRE STATION NO. 5
NOW THEREFORE, the parties to this contract agree to the following:
1. Manner and time for Completion. The Contractor agrees
with the City to furnish all supervision, labor, tools, equipment,
materials and supplies necessary to perform, and to perform, said
t
own ex
work at Contractor' s expense in accordance with the contract
;
I documents and any applicable City ordinances and state and federal 'F$tus, ,,: ,
1 laws, within One Hundred Fifty consectuive calendar from the date
!k>ts
Contractor is ordered to proceed, which order shall be issued by ' �> `;:
u the Fire Chief within ten (10) days after the date of this r
' contract.
2. Prevailing Wages. All labor utilized in the construction
of the aforementioned improvements shall be paid a wage of no less k
than the "prevailing hourly rate of wages" for work of a similar
t'
character in this locality, as established by Department of Labor
Q and Industrial Relations of the State of Missouri, and as
established by the Federal Employment Standards of the Department
' of Labor. Contractor acknowledges that Contractor knows the
prevailing hourly rate of wages for this project because Contractor
has obtained the prevailing hourly rate of wages from the contents x�
of Special Wage Determination No. 91-026-0006 in which the rate of
wages is set forth. The Contractor further agrees that Contractor
" will keep an accurate record showing the names and occupations of
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all workmen employed in connection with the work to be performed
t under the terms of this contract. The record shall show the actual
wages paid to the workmen in connection with the work to be
performed under the terms of this contract. A copy of the record
shall be delivered to the Fire Chief each week. In accordance with
Section 290.250 RSMo, Contractor shall forfeit to the City Ten
Dollars ($10. 00) for each workman employed, for each calendar day
or portion thereof that the workman is paid less than the
stipulated rates for any work done under this contract, by the
°h Contractor or any subcontractor under the Contractor.
3 . Insurance. Contractor shall procure and maintain at its
own expense during the life of this contract:
(a) Workmen's Compensation Insurance for all of its employees
to be engaged in work under this contract.
(b) Contractor's Public Liability Insurance in an amount not
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less than ?
$1, 000, 000 for all claims arising out of a single •
occurrence and $100, 000 for any one person in a single accident or
occurrence, except for those claims governed by the provisions of * , s{
the Missouri Workmen' s Compensation Law, Chapter 287, RSMo. , andY'
Contractor's Property Damage Insurance in an amount not less than`+, `
$1, 000, 000 for all claims arising out of a single accident or3t
occurrence and $100, 000 for any one person in a single accident or
r.°
occurrence.
(c) Automobile Liability Insurance in an amount not less than
$1, 000,000 for all claims arising out of a single accident or
4; occurrence and $100,000 for an y one person in a single id
occurrence.
accent or
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(d) Owner's Protective Liability Insurance - The Contractor3'
shall also obtain at its own expense and deliver to the City an
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Owner's Protective Liability Insurance Policy naming the City of
Jefferson as the insured, in an amount not less than $1 000 000 for
all claims arising out of a single accident or occurrence and ,6
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$100, 000 for an one .{1
y person in a single accident or occurrence,
except for those claims governed b the
g y provisions of the Missouri
Workmen's Compensation Law, Chapter 287, RSMo. No policy will be ``” ,r t`•.'ti
.l accepted which excludes liability for damage to underground
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structures or by reason of blasting, explosion or collapse. a` s''`
I (e) Subcontracts - In case any or all of this work is sublet,
the Contractor shall require the Subcontractor to procure and �� • 'r �
maintain all insurance required in Subparagraphs (a) , (b) , and (c)
hereof and in like amounts .
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a (f) Scone of Insurance and Special Hazard. The insurance 'a.
t required under Sub-paragraphs (b) and (c) hereof shall provide `
j, adequate protection for the Contractor and its subcontractors, '
respectively, against damage claims which may arise from operations
under this contract, whether such operations be by the insured or
by anyone directly or indirectly employed by it, and also against
any special hazards which may be encountered in the performance of
this contract,
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NOTE Paragraph (f) is construed to require the procurement of
Contractor's protective insurance (or contingent public liability
and contingent property damage policies) by a general contractor
whose subcontractor has employees working n the
the general public liability nd g project, unless
y property damage policy (or rider '
attached thereto) of the general contractor provides adequate
protection against claims arising from operations by anyone
directly or indirectly employed by the Contractor.
i
4. Contractor's Responsibility for Subcontractors. It is
further agreed that Contractor shall be as fully responsible to the
City for the acts and omissions of its subcontractors, and of
persons either directly or indirectly employed by them, as
Nr Contractor is for the acts and omissions of persons it directly
employs. Contractor shall cause appropriate provisions to be
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inserted in all subcontracts relating to this work, to bind all
all the terms herein setforth,
subcontractors to Contractor by
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insofar as applicable to the work of subcontractors and to give
Contractor the same power re a
rding termination of any subcontract ;
yx e
f . as the City may exercise over Contractor under any provisions of
this contract. Nothing contained in this contract shall create anyz ;Ft' '
contractual relations between any subcontractor and the City or
between any subcontractors ,
5. Liggida.ted Damages. The Fire Chief may, at his
discretion, deduct $150. 000 from any amount otherwise due under
this contract for every day Contractor fails or refuses to ci f e
prosecute the work, or any separable part thereof, with such "M
diligence
diligence as will insure the completion by the time aboveF�+fim+,��
specified, or any extension thereof, or fails to complete the work
y' by such time, as long as the City does not terminate the right of
Contractor to proceed. It is further provided that Contractor
shall not be charged with liquidated damages because of delays in
t the completion of the work due to unforeseeable causes beyond ?'
Ott•`�"'��t'r,„`••.�
'. Contractor' s control and without fault or negligence on t::;. r,•`;,,.�r`,;
Contractor' s part or the part of its agents.
6. Termination. The City reserves the right to terminate
this contract by giving at least five (5) days prior written notice
to the Contractor, without prejudice to any other rights or
remedies of the City should the Contractor be adjudged a bankrupt,
`. ;.' or if Contractor should make a general assignment for the benefit ,,
”: of its creditors, or if a receiver should be appointed for x : �
Contractor or for any of its property, or if Contractor should
persistently or repeatedly refuse or fail to supply enough properly
0
;F skilled workmen or proper material, or if Contractor should refuse
or fail to make prompt payment to any person supplying labor or
materials for the work under the contract, or persistently
? '? disregard instructions of the City or fail to observe or perform
any provisions of the contract.
.;; 7. Cityls Right to Proceed. In the event this contract is
terminated pursuant to Paragraph 6, then the City may take over the
work and prosecute the same to completion, by contract or
otherwise, and Contractor and its sureties shall be liable to the
City for any costs over the amount of this contract thereby
occasioned by the City. In any such case the City may take a
possession of, and utilize in completing the work, such materials,
61
i:. appliances and structures as may be on the work site and are
tr necessary for completion of the work. The foregoing provisions are
in addition to, and not in limitation of, the rights of the City
under any other provisions of the contract, city ordinances, and
state and federal laws.
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8. Indemnity. The Contractor agrees to defend, indemnify,
and save the City harmless from and against all claims, suits and
actions of every description, brought against the City and from all '
damage and costs by reason or on account of any injuries or damages j
received or sustained by any person or persons, or their property,
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#S}�{q `�L�,�:pk $kr'�i�a1'�Y, t��y� I7 i7')( ff �.� Z. !} 35. s. ' ,t r .1 t ,•. 11 1 s .1. i rst`3 S�3'a
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by Contractor, its servants, agents or subcontractors in the
construction of said work, or by any negligence or carelessness in
the performance of the same, or on account of any act or omission
of Contractor, its servants, agents, or subcontractors, or arising
out of the award of this contract to Contractor.,
n' 9. Pavpnent for Labor and Materials. The Contractor agrees
and binds itself to pay for all labor done, and for all the
u[ materials used in the construction of the work to be completedry
pursuant to this contract. Contractor shall furnish to the City a
) bond to insure the payment of all materials and labor used in the
k.`P
; performance of this contract.
10. Eayment. The City hereby agrees to pay the Contractor alb s '
� the work done
r>° pursuant to this contract according to the payment
?'. schedule set forth in the Contract Documents upon acceptance of
said work by the Fire Chief and in accordance with the rates and/or 4= rya'•=`°k'` >
amounts stated in the bid of Contractor dated October 16, 1990
which are by reference made a part hereof. No artialyyd
p payment to ;�,���x;,,•�} �f,
the Contractor shall operate as approval or acceptance of work done
or materials furnished hereunder. The total amount of thisL ,r;:^
I contract shall not exceed Two Hundred Fifty-nine gib
y-nine Thousand, Seven
Hundred Dollars ($259,700. 00) .
11.
Contract Documents. The contract documents shall consist
ti
of the following:
a. This Contract f. General Provisions
b. Addenda
g. Special Provisions
c. Information for Bidders h. Technical Specifications
d. Notice to Bidders i. Drawings and/or sketches
e. Signed Copy of Bid
This contract and the other documents enumerated in this
paragraph, form the Contract between the parties. These documents
are as fully a part of the contract as if attached hereto or
repeated herein.
12. Nondiscrimination. The Contractor agrees in the "
performance of this contract not to discriminate on the ground or
because of race, creed, color, national origin or ancestry, sex,religion, handicap, age, or political opinion
or affiliation,
against any employee of Contractor or applicant for employment and
shall include a similar provision in all subcontracts let or
awarded hereunder.
13. Notices. All notices required to be in writing may be
given by first class mail addressed to the City of Jefferson, 320
East McCarty, Jefferson City, Missouri 65101, and Contractor at
1909 S. Country Club Drive. The date of delivery of any notice
shall be the second full day after the day of its mailing.
14. Jurisdiction. This agreement and ever
hereunder shall be interpreted according to the laws sand nstatutes
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Wausau
Any correspondence in relation to this
Insurance bond should b e directed d r K `7
i to:
d ,�^ Wausau Insurance Companies ( '
r• 'Companies Bond Department k '
2000 Westwood Drive
01 THIS BOND IS ISSUED SIMULTANEOUSLY WITH PERFORMANCE Box 8017 }' '
BOND IN FAVOR OF THE OWNER CONDITIONED ON THE Wausau,Wisconsin 54402.8012 .
FULL AND FAITHFUL PERFORMANCE OF THE CONTRACT Bond Number 0750-62-050053—C F
LABOR & MATERIAL PAYMENT BOND
,. KNOW ALL MEN BY THESE PRESENTS: a,
That Wisch and Vaughan Construction Company, Tnc. �.
(Here insert full name and address or legal title of Contractor)
P. 0. Box 104388, Jefferson City, Missouri 65110-4388 kh'
-° as Principal, hereinafter called Principal, and _ Employers Insurance of Wausau A Mutual Companyd
!' (Here insert(oil name and address at legal tine of Surety) s
2000 Westwood Drive, Wausau, Wisconsin 54401
as Surety,hereinafter called Surety,are held and firmly bound unto
Citv of Jefferson
=* 320 E. McCarty Street Jefferson City, Missouri 65101
.a,q�.
(Here insert full name and address or legal tine of Oenerl
as Obligee, hereinafter called Owner, for the use and benefit of claimants as hereinbelow defined, in the amount of
'lion NnnrlrPrT Fi f t.r-Nine Thousand, Semen Hundred and no/1_00--- Dollars(5259.700.00*
(mere insert a sum equal to at least one-half of the contract pace)
' for the payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, successors and assigns,jointly and
severally,firmly by these presents.
s .r
November 29 `:t'` `
WHEREAS, Principal has by written agreement dated )g 90
entered into a contract with Owner for Constructing Fire Station No. 5
(Here insert full name,address and description of project) r ti�`'1�':��•;I;;�r�?•
in accordance with Drawings and Specifications prepared by
r
I ). .
i l+� ' d F i
{ (Here insert full name and addressor legal title of Architect)
(3vhich contract is by reference made a part hereof,and is hereinafter referred to as the Contract.
1 THEREFORE.THE CONDITION OF THIS OBLIGATION is such that,if Principal shall promptly make payment to all claimants as hereinafter defined,for all labor and
material used or reasonably required for use in the performance of the Contract,then this obligation shall be void:otherwise it shall remain in full force and effect,subject,however,to the
following conditiont: ?,
f: 1. A claimant is defined as one having a direct contract with the Principal or with a Subcontractor of the Principal for labor,material,or both,used or reasonably required for use in the ?•
performance of the Contract,labor and material being construed to include that part of water,gas,power,light,heat,oil,gasoline,telephone service or rental of equipment directly
applicable to the Contract. a `
2. The above named Principal and Surety hereby jointly and severally agree with the Owner that every claimant as herein defined,who has not been paid in full before theexpiration of a
period of ninety(90)days after the date on which the last of such claimant's work or labor was done or performed,or materials were furnished by such claimant,maysue on this bond for
t..
the use of such claimant,prosecute the suit to final judgment for such sum or sums as may be justly due claimant,and have execution thereon.The Owner shall not be liable for the "+
payment of any costs or expenses of any such suit.
3. No suitor action shall be commenced hereunder by any claimant: t f
a) Unless claimant.other than one havinga direct contract with the Principal.shall have given written notice to any two of the following:The Principal.the Owner.or the Surety above
named,within ninety(90)days after such claimant did or performed the last of the work or labor,or furnished the last of the materials for which said claim is made,stating with substantial ` -
> accuracy the amount claimed and the name of the party to whom the materials were furnished,or for whom the work or labor was done or performed.Such notice shall be served by
mailing the same by registered mail or certified mail,postage prepaid,in an envelope addressed to the Principal.Owner or Surety,at any place where an office is regularly maintained for f
the transaction of business,or served in any manner in which legal process maybe served in the state in which the aforesaid project is located,save that such sea ice nce I not be made by a h:
public officer.
b) After the expiration of one(1)year following the date on which Principal ceased Work on said Contract or after the expiration of one(1)year following the date of Substantial ;r
Completion of the Project,whichever is later,it being understood,however,that if any limitation embodied in this bond is prohibited by any law controlling the construction hereof such
limitation shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by such law.
c) Other than in a statecourt of competent jurisdiction in and for the county or other political subdivision of the state in which the Project,or any part thereof,is situated,or in the
! United States District Court for the district in which the Project,or any part thereof,is situated,and not elsewhere.
' 4. The amount of this bond shall be reduced by and to the extent of any payment or payments made in good faith hereunder,inclusive of the payment by Surety of mechanics'liens which
(' may be filed of record against said improvement,whether or not claim for the amount of such lien be presented under and against this bond.
t
30th November
Signed and sealed this day of _, 19—,90 _
Wisch and Vaughan Construction Com_pany, Inc.
(Principal) (Seal)
r.
(Witness) / pp
By l�T/L P'P✓S_
(Tide)
Employers Insurance of Wausau A Mutual. Company
1 (Surety) (Seal)
fitness)
Paula L. Ross B
„. y
(Att rney-in-Fact) Christine M. Flavin
ti.
i (P)815^4244 488 PRTD. USA
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( No. 207-065-01477
' EMPLOYERS INSURANCE WAUSAU A Mutual Company
POWER OF ATTORNEY
KNo W Ai,I,Ml,N 1i}' I'iIFS1,,I)lll,, •:NTS:
/^1
That the EMI'I,OYEI?S iNSURAN('h.O11 WAUSAIi AM utualI Compnnv,n c�orpnriitiun Orly orgaifi•r.od:rid existi fig trader
l the lanes of the Stacie of,Wisconsin, and having its prineipnl office in the Cif N, of Wausau, County of Marathon, Slnte� of
Wisconsin, has made, constituted;111(1 appointed,and does by these presents make,constitute and appoint _.._
CHRISTI.NE M. FLAVIN ___--
its true and lawful attorney-in•fact, with full power and authority herehy conferred in its mote, place alnd stead,to execute,
seal, acknowledge and deliver ANY OR AIA, BONDS, LINDERTA1<I1V0, , 1 a ,z,
t, ti 1;;6:('UCNI%AN('I?S OR O'I'1II;I2 WRIT"I'F,N
OBIAGATiONS IN THF, NATURE TIIERi OF INCLUDING CONSENTS OF SURETY AND WAIVERS TO
THE CONDITIONS OF CONTRACTS. NOT TO EXCEED THE PENAL SUM OF TEN MILLION
z DOLLARS ($10,000,000). a
at^r
p and to hind the corporation thcreby as fully icn(I to the saute extent as if such ponds were signed by the I'resicl ell t,sealed with t '
W the corporate seal of the corporation and duly attested by its secretary hereby ratifying and confirming all that the said
attorney-in-fact may do in the premises. ;,,r•
Z 'I'll is power ofattorneyisgrantedpursuant to tit efollowiit gresoliftion ado Ili c•dby t11v Board ofl)ir•ectn ors,of said('.out tnyat11
p ;u frrd
meeting duly called and held on the 18th day of May, 1973,which resolution is still in effect: t�•Z' .:�. a}t,
> "RESOi,VEI),that the President lend any Vice President—elective or appointive—of EMI'L,OYEI?S INSURANCE OF
tZ WAUSAU A Mutual Company he,and that each of them hereby is,authorized to execute powers of'attorney qualifying
)
Q (lie attorney named in the given power of attorney to execute on hehalfof I;MI 1,01'1;1%S INSl11{ANCE O1'WAUSAU A
H Mutual Company honds, undertakings and all contracts of'suretyship:alnd that an} secretary or assistant secretary be,
and that each or any of them herehy is, authorized to attest the execution ol'any such imwer of attornc;v,and to attach
z thereto the seal of EMPLOYERS INSURANCE OF WAIISAU A Mutual Company."
,r
"FU RT II Eli RESOI,VEA),that the signatures ofsuchofficersand thesealofEMi'I,OY}?RSINSt1RANCF,O1 WAL)SAL1
?4: LU A Mutual Company may be affixed to any such uneer of attorney an•In any certificate relating thereto by facsimile,and
00 any such power of attorney ur certificate heau•in{,such facsimile signatn•es lout facsimile seal shall be valid and hindin{, •;,(.: ,,,r=r�i`�k'.a.
upon the EMi i3OYERS I NSURANCE OF WAUSAU A Mutual Colnpiuty when so affixed and in the future with respect
F— to any bond, undertaking or contract of suretyship to which it is •cttached:'
' z
LLJ iN WITNESS WHEREOF,EMPLOYERS iNSURANCi?OF WAUSALi A Mutual('om p my has caused these presents to be
,1'
s
signed Ined h the senior vice resident and attested by its assistant secretary, 1ST "'' �G
W b Y p y,and its corporate seal to be hereto affixed this da 1""' r 4 'fi'
r, I Y
Hof MAY 19
z U) "'°°' f:MI'I..OYERS INSURANCE OF WAUSAU A Mutual Company
= SEAL i,� /o/�/ •'';.
„ 13y
{
L ' R.C. Retterath Senior Vice President
i 1 } AUest: - };
a ;
z / 1'
.I 0 R.J. B steman Assistant Secretary
I STATE OF WISCONSIN )
< )ss.
• <ir•
0 COUNTY OF MARATHON ) N
On this 7 ST day of MAY 19--R-6. before me personally came
tL R. C. Retterath to me known, who being by me duly sworn,did depose ,
and say that hi:is a senior vice president of the EM PLOY FRS INSURANCE OF WAUSAU A Mutual Company,the corporation described in r
(L
and which executed the above instrument;that he knows the seal of said corporation:that the seal i flixed to said instrument is such corporate
seal and that it was so affixed by order of the Board of Directors of said corporation and that he signed his name thereto by like order.
IN WITNESS WHEREOF,I have hereunto set my hand and affixed my official seal the day and year herein first above written.
YO_
Z1//A ✓l 1 Y
C/) Patricia A. Kleman is'otary Public
)` NOTARY PUBLIC t
f STATE OF WISCONSIN
MY COMMISSION EXPIRES JUNE 8, 1986
STATE. OF WISCONSIN ) CERTIFIC:ATE
t. CITY OF WAUSAU
COUNTY OF MARATHON > '.
1, the undersigned, assistant secretary of EMPLOYi:RS INSURANCE, OF WAUSAU A Mutual Company, if Wisconsin
f;) corporation, do hereby certify that the foregoing and attached power of attorney, WHICH MUST CONTAIN A
VALIDATING STATi?MENT PRINTED IN THE MARGIN THEREOF IN RED INK,remains in full force and has
not been revoked:and furthermore that the resolution of the Board of I)irec•tor:s set forth in the powerof attorney isstill in force.
Signed and settled in the City of Wausau,Marathon County,State of Wisconsin, this 30th day
`Y
of November — {g 90,
:3
s i``•• ,��t` an r R. I. lestcm
Assistant Secretary ,
t
3•
NOTE: iF .YO11 i1AVE ANY QUESTIONS R1IGARDING '1'111; VAIADITY Olt WORDING OF 'PHIS POWER OF
ATTORNEY,CALL TOI,1,FREE,(800)826.1661.(iN \%IIS('ONSIN,('AI,L,(ti(1( )•17'2.01611),
i
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.it: �9;, F�..Ja'--.' ,. 1 '; i.,���i(.i !* �t: p t.✓t r ',},t Xt t it sh:`�, 7�:, '
;. 'i4.,i. fi f .tr,`; t.�n t,(• �' t'>YZ .:�,�.�fti'i �.. �^. .�1 L t t ,u �! Y.P 1:rtt h`t+w ���t, � h•
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tC,�, ;�..,. r. i. a.•i..'.r.,,.,i r. `' -€r ,.��.{�r,�''"��6� ;(��4�� 1�"'tt �?�";<R i a �„� � L�g.>
rr�ti
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ausav 3 i
Any correspondence in relation to this '
bond should be directed to: �'
�In5u nc-el Wausau Insurance Companies
Bond Department
m an'es 2000 Westwood Drive ...........
ctsv fyy'+ 5
tk�•' � � BOX 8017
PERFORMANCE BOND Wausau, Wisconsin 54402-8017
>: KNOW ALL MEN BY THESE PRESENTS: Bond Number 0750-62-050053–C
That Wisch and Vaughan Construction Company, Inc. :}, `
(Here insert full name and address or legal title of Contractor)
P. 0. Box 104388 Jefferson City, Missouri 65110-4388 'at ?
Em to ers Insurance of Wausau A Mutual Company
as Principal, hereinafter called Contractor, and^—L. y
C (Here insert full name and address or legal title of Surety)
g
2000 Westwood Drive, Wausau,
WT 54401 , as Surety, hereinafter called Surety, are held and firmly bound unto
` 320 E. McCarty
;r rty Street Jefferson City Missouri 65101
(Here insert full name and address or legal title of Owner)
} as Obligee, hereinafter called Owner, in the amount ofR r
7tao Hundrgd Fifty–nine Thousand. Sp-v nElincired and no/100----- Dollars($-259.700-00
a,
for the payment whereof Contractor and Surety bind themselves,their heirs,executors,administrators,successors and assigns, t
jointly and severally, firmly by these presents.
WHEREAS, Contractor has by written agreement dated November 29 1990
entered into a contract with Owner for Constructing Fire Station No. 5 t�rrt'
., (Here insert full name,address and description of project) R
in accordance with Drawings and Specifications prepared byw; ,j(;, ;:;:.
(Here insert full name and address or legal title of Architect)
�Jwhich contract is by reference made a part hereof, and is hereinafter referred to as the Contract.
I i NOW,THEREFORE,THE CONDITION OFTHIS OBLIGATION is such that,if Contractor shall promptly and faithfully perform said Contract,then this
! obligation shall be null and void;otherwise it shall remain in full force and effect.
f`
The Surety hereby waives notice of any alteration or extension of time made by the Owner.
Whenever Contractor shall be,and declared by Owner to be in default under the Contract,the Owner having performed Owner's obligations thereunder,the
Surety may promptly remedy the default,or shall promptly '
1) Complete the Contract in accordance with its terms and conditions,or 1 �;
2) Obtain a bid or bids for completing the Contract in accordance with its terms and conditions,and upon determination by Surety of the lowest responsible �"v f,
}' bidder,or,if the Owner elects,upon determination by theOwnerand the Suretyjointly of the lowest responsible bidder,arrange fora contract between such bidder
and Owner+and makeavailabie as Work progresses(cven though there should be a default or a succession of defaults under the contract orcontracts of completion
arranged under this paragraph)sufficient funds to pay the cost of completion less the balance of the contract price;but not exceeding,including other costs and v
damages for which the Surety may be liable hereunder,the amount set forth in the first paragraph hereof.The term"balance of the contract price,"as used in this
paragraph,shall mean the total amount payable by Owner to Contractor under the Contract and any amendments thereto,less the amount properly paid by owner
to Contractor.
.a
Any suit underthis bond must be instituted before the expiration of two(2)years from the date on which final payment under the Contract falls due or before the ;
expiration of one(1)year from the Date of Substantial Completion of the Project,whichever is later. "=
No right of action shall accrue on this bond to or for the use of any person or corporation other than the Owner named herein or the heirs,executors,administrators
a or successors of the Owner.
Signed and sealed this 30th day of November t9 90`
Wisch and Vaughan Construction Company, Inc.
144 ? (Principal) (Seal)
(Witness) y J0 Lre-s
5� (Title)
1
Employers Insurance of Wausau A Mutual Company
rety) (Seal)
Paula L. Ross (W. ,
By "
(Attorney-in-Fact) ristine M. Flavin
(P)8134238 787 PRTD. USA
t
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No. 207-065-0 14 7 6
EMPLOYERS INSURANCE OF WAUSAU A Mutual Company
I?! POWER OI'' ATTORNEY
KN()W Al,l,MEN BY TIIESE,PRESENTS:
That the i?MPI,OYi,ItS INSURANCE,OF WALiSALJ A Mutual Company,a c•rn•porcttiun duly organized and existing under ,
the laws of the State of Wisconsin, and having its principal office in the('ity of Wausau, County of Marathon, State of
y � riza-
Wisconsin,has made,constituted and appointed,and does by these prestnts antler,constitute and appoint
_-._.CHRISTINE-_M. FLAVIN.,_ ._.
its true and lawful attorne0li-fact, with 1'1111 power and authority hereby conferred in its name, place loin stead,to execute, -,
seal, acknowledge and deliver ANY Olt Al,l, BONUS, LJNDER'I'AIiINGS, RECOC7Ni%ANCh;S OR O'I'Hi:It WitI'I"ITN c �`
0131,1GATIONS IN THE NATURE THERE,Oi' INCLUDING CONSENTS OF SURETY AND WAIVERS TO
THE CONDITIONS OF CONTRACTS. NOT TO EXCEED THE PENAL SUM OF TEN MILLION .: : 'r,<<
Z DOLLARS ($10,000,000).
q p and to hind the corporation thereby as fully and to the same extent as i1'suc•h hands were signed by the President,sealed with ±�
W the corporate seal of the corporation and duly attested by its secretary hereby rat irying and confirming till that the said
attorney-in-f tee,may do in the premises.
Z This power of attorney is granted pursuant to the following resolul ion adapted by the Board off)ircc•tors of said Company at 11
p� meeting duly called and Field on the 18th day of May, 197;i,which resolution is still in effect: ,
"RESOLVED,that the President and any Vice President—elective or appointive—of 1,MPLOYI';ItS INSURANCE Oh '.
W
WAUSAU A Mutual Company be,and that each of'them hereby is,authorized to execute powers of attorney qualifying
tl the attorney named in the given power of attorney to execute on behalf of h,Mi'LOl'I';}tS iNSLiRANCE Oh WAL1SAl1 A
' t
G Q Mutual Company bonds,undertakings and all contracts of suretyship;and that ally socretai;v cn assistant secretary be, .; }P
O and that each or any of them hereby is, authorized to attest the execution of any such power of attorney,and to attach d��tys{
f thereto the seal of EMPLOYERS iNSURANCE OF WALiSALI A Mutual Company:'=�:
-FURTHFRRESOI,Vi D,that tile signatures ofsuc•hofl'iversand till,scalofEM1 LOYi RSiNSURANCEOFWAUSAt1
W A Mutual Company inay be affixed to any such power of attorney or to any certificate relating thereto by facsimile,and ;.:.; •f,���•
O any such power of attorney or certificate bearing such facsitile signatures and facsimile seal shall lie valid and binding
tr, 0 upon the FMI#LOYERS INSURANCi•;OF WAUSAU A Mutual Company when so affixed and in the future with respect
F— to any bond, undertaking or contract of suretyship to which it is attac•heW,
Z IN WITNESS WIIFREOE,EMPLOYERS INSURANCE OE WAUSALi A Mutual Company has caused these presents to be 4sr'
W 1ST a• ' "°'i
W signed by the senior vice president and attested by its assistant secretary,and its corporate seal to be hereto affixed this _day
y V Q of MAY
At lr .
z co
EMPLOYERS INSURANCE OF WAUSAU A Mutual Company P „�
;v? _ !-,,SEA L B y
t
e#; >` ~ ter' R.C.Retterath Senior Vice President
+u- W
' } Attest:
Z
t, R.J. B steman Assistant Secretary
STATE OF WISCONSIN )
r,
a' Q )ss.
O COUNTY OF MARATHON )
cc On this 1ST day of MAY 19 86.before me personally came
.n
( W it.C. Retterath to me known,who being by me duly sworn,did depose
t
O and say that hcisa senior vice president oft lieEMPLOYERSINSURANCEOFWAUSAUAMutuul Company,the corporation described in
and which executed the above instrument:that he knows the seal of said corporation;that the seal affixed to said instrument is such corporate
f. CL seal and that it was so affixed by order of the Board of Directors of said corporation and that he signed his name thereto by like order.
QIN WITNESS WHEREOF, 1 have hereunto set my hand and affixed lily official seal the day and year herein first above written.
N. > s
o !
{
;.
Patricia A. Kleman Notary Public
NOTARY PUBLIC
U) STATE OF WISCONSIN
MY COMMISSION EXPIRES JUNE 8, 1986
r STATE Oh WISCONSIN ) CERTIFICATE.
` CiTY OF WAUSAU )ss.
COUNTY OF MARATI-ION )
I, the undersigned, assistant secretary of EMPLOYERS iNSURANCE, OE WAUSAU A Mutual Company, a Wisconsin
corporation, do hereby certify that the foregoing and attached power of attorney, WHICH MUST CONTAIN A {,
VAIAI)ATING STATEMENT PRINTED IN THE MARGIN THEREOF iN REI)INK,remains in full force and has
not been revoked;and furthermore that the resolution of the Board of Directors set forth in the power of,ttorney is still in force.
Signed and settled in the City of Wausau,Marathon County,State of Wisconsin, this 30th day
of November` 19 90
It --
(601,
R,J, Besteman Assistant Secretary
NOTE: ih YOII HAVE ANY (QUESTIONS REGARDING TllF' VAI,IDITY OR WORDING OF THIS POWER OF
. ATTORNEY,CA1,1,TO1,1,FREE(800)826.1661.(iN WiS('ONSIN,('AI,I,(81111)4T,-(1(611).
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ACORD CERTIFICATE OF INSURANCE ISSUE DATE (MM/DD/YY) a . .
12/21/90
w ,
------------------------------------------------------------------------------------------------------------------------------
RODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
] NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Winter-Dent & Company ------------------------------------------------------------------------------
101 East McCarty St. --- COMPANIES AFFORDING COVERAGE ---------------- ,.� .;;
P.O. Box 1046 ---------- ------------ ----..----------------- z ..
Jefferson City, MO 65102 COMPANYr ;y
314-634-2122 LETTER A TRAVELERS INDEMNITY COMPANY
_ a+uYS' t
----------------------------------------------------------------------
COMPANY �'d
.............................................. LETTER B fix:
INSURED ----------------------------------------------------------------------------- , ;
COMPANY r ;
WISCII & VAUGHAN CONSTRUCTION LETTER C
---- ----------------- --------------------------- r rF :
----------------
c. CO, INC. - - -
P.O. BOX 104388 COMPANY
JEFFERSON CITY MO LETTER D lit
, �
65110-4388 ----------------------------------------------------------------------------- atftY;.::
COMPANY
LETTER E
-------------------------------------------------------------------------------------------------------------------
COVERAGES
----------------------------------------------------------------------------- -----------------------------
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABODE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ,r,>;r•,.?.,i�,. '
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.
-------------------------------
�. CO POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE I POLICY NUMBER I DATE (MM/DD/YY)I DATE (NM/DD/YY2 I ALL LIMITS IN THOUSANDS
-------------------------------------+------------------+----------------+--------•---------+----------------------------------
A GENERAL LIABILITY 660208G7857IND90 12-31-90 12-31-91 GENERAL AGGREGATE $1,000,
IX] COMMERCIAL GENERAL LIABILITY PROD COMP/OPS AGGR $1,000, �;;;-�'�„thq;'•'i a
IX]I ] CLAIMS MADE IX] OCCURRENCE PERSONAL & ADV INJURY $ 500,
I I OWNER'S & CONTRACTORS PROTECT EACH OCCURRENCE $ 500,
f
FIRE DAMAGE(ONE FIRE) $ 50,
I ] MEDICAL EXP(1 PERSON) $ 5, rA'zta;
---+------'---------------------------+------------ +----------------+-----------------+--------------------------------- nt, t
AUTOMOBILE LIABILITY 660208G7857IND90- 12-31-90 12-31-91 CSL '}•,t ��r.
IX] ANY AUTO $500, u
IX] ALL OWNED AUTOS BODILY INJURY �F. ' ?'
IX] SCHEDULED AUTOS (PER PERSON) $
IX] HIRED AUTOS BODILY INJURY
IX] NON-OWNED AUTOS
I ] GARAGE LIABILITY PROPERTY
CIDENT) $
i I ] DAMAGE $
--------•---------------------- }.
! EXCESS LIABILITY EACH OCCURRENCE AGGREGATE
I ] OTHER THAN UMBRELLA FORM I I I I $ I$
---+---------------------------------+------------------+----------------+-----------------+--------------------------------- �€t
Ei STATUTORY
” A WORKERS' COMPENSATION KUB715G965090 12-31-90 12-31-91 $100, (EACH ACCIDENT)
AND $500, (DISEASE POL)
EMPLOYERS' LIABILITY $100, (DISEASE EACH EMP) +,
--------------------------------- ;
A OTHER m`
,
BUILDERS' RISK 66020BG7857IND90 12-31-90 12-31-91 $259,700.
c.
$500. DEDUCTIBLE Stiff
---------------------------------------------------
"' DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
-;; JOB: FIRE STATION NO. 5
ter`' 1F ANY POLICY DESCRIBED HEREIN IS CANCELLED 0 �
t•;���; R THE COVERAGE AFFORDED BY IT IS REDUCED, THE INSUROR WILL NOTIFY THE
>,. CERTIFICATE HOLDER IN WRITING, TEN DAYS BEFORE EFFECTIVE DATE OF SUCH CANCELLATION OR CHANGE.
CERTIFICATE-HOLDER------------------------------------------ CANCELLATION------------------------------------------------- ;
f _ -+--------------------------------------------------------------- ,,Jw
(SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR
CITY OF JEFFERSON TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED
320 EAST MCCARTY TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS
AGENTS OR REPRESENTATIVES.
?ACORD FFERSON CITY, MO 65101 AUTHO ED RE ESENTATIV 25-S (11/85)
-----------------------•---------------------•----------------------...... - - --------------------•
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�3
11/30/90 ;
". --------------------------------
--------------------------------------------------------
- ----------------------------------
-^
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS1w j
PRODUCER NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
[ ] EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
-------------------------------------------------
Winter-Dent & Company - C014PANIES AFFORDING COVERAGE
01 East McCarty St. .................................
------- ---------...----....------------------------------------------------- J~
z; .0. Box 1046 i;
COMPANY °'��`�•'� ' -�
Jefferson City, MO 65102 LETTER A TRAVELERS INDEMNITY COMPANY '''
314-634-2122 ----------------------------------------------------------------•--•---_... ; x ,
_ _ :
COMPANY 4F
------------------------------------ LETTER B ----------- ------ ----------------
----------------------------------- }„
INSURED COMPANY Y `'
WITCH & VAUGHAN CONSTRUCTION LETTER C - `
CO, INC.
P.O. BOX 104388 COMPANY
`( JEFFERSON CITY, MO LETTER D --------- ,
----------------------------- --- ------ r{ £,, t YIS
65110-4388 COMPANY _ „
.i y SSA t
LETTER E ------
-------. ---
------------------------------------------
COVERAGES _
THIS IS TO CERTIFY THAT-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
f` 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. -
-----
------------------------------
------------------------ ---------
CO I POLICY EFFECTIVE POLICY EXPIRATION . r i
POLICY NUMBER I DATE (MM/DD/YY)I DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS
LTRI TYPE OF INSURANCE --------------- 't
-+---------•------+---------- -+--------- - --
---+---------------------------------+-------------------------------------------------
------------ . .r i .
A GENERAL LIABILITY 66020BG7857IND89 12-31-89 12-31-90 GENERAL AGGREGATE 51,000,
PROD COMP/OPS AGGR $1,000,
[X] COMMERCIAL GENERAL LIABILITY PERSONAL & ADV INJURY S 500, ;.,,-•;,.•: :.
[X][ ] CLAIMS MADE [X] OCCURRENCE EACH OCCURRENCE S 500,
[ ] OWNER'S & CONTRACTORS PROTECT FIRE DAMAGE(ONE FIRE) S 50,
[ ]
;a MEDICAL EXPO PERSON) $ -5,----
g E
-----------+------------------+------- ---
----+-----------------+--------------------------
A AUTOMOBILE LIABILITY 66020BG7857IND89 12-31-89 12-31-90 CSL $500,
' [X] ANY AUTO BODILY INJURY ^t:t• i
[X] ALL OWNED AUTOS (PER PERSON) $
[X] SCHEDULED AUTOS BODILY INJURY ;4:f7rr?4-
[X] HIRED AUTOS (PER ACCIDENT) S u`'`"'``''`•
a, [X] NON-OWNED AUTOS PROPERTY
[ ] GARAGE LIABILITY DAMAGE $ (r '
[ ] -------------- --------------- -------------------------------- or1:;
-----+------------------+- - - --
A EXCESS LIABILITY SMCUP208G787089 I 12-31-89 I
12-31-90 EACH OCCURRENCE AGGREGATE
I $ 2,000, 52,000, ,'t£f '`
r: [X] '
[ ] OTHER THAN UMBRELLA FORM ----------------------------------------------------- Y�.
---+-- --------------------------------- {' rw
STATUTORY
A WORKERS' COMPENSATION KUB715G965089 12-31-89 12-31-90 5500, (DISEASGCPOL)T) rfi
AND
$100, (DISEASE-EACH-EMP) ";
EMPLOYERS' LIABILITY -----------------------
+------------------+----------------+- .
x4 ,
A OTHER
66020BG7857IND89 12-31-89 12-31-90 $259,700. Ga '
BUILDERS' RISK i
l. ----------------------- .-.-".-.--
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS �ti'
RE: FIRE STATION N0. 5
IF ANY POLICY DESCRIBED HERIN IS CANCELLED OR THE COVERAGE AFFORDED BY IT IS REDUCED, THE INSUROR WILL NOTIFY THE A
CERTIFICATE HOLDER IN WRITING, TEN DAYS BEFORE EFFECTIVE DATE OF SUCH CANCELLATION OR
..............CHANGE---------------------------------
r :} --------------------------- - ------------------------------------
CANCELLATION
CERTIFICATE HOLDER
aw. --------------------------------------------- +---------- -
---'� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
,;• THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR f
� ,.
Y•'t;°�t TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED
CITY OF JEFFERSON
r'z.. TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO
320 EAST MCCARTY
OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS /
AGENTS OR REPRESENTATIVES. ---------
------------ ------------• r----__-_-
JEFFERSON CITY, MO 65101
AUTNO D REPR ENTATIV
iv
:: ;> CORD-25_S-(11/85)--------------------------------------------------- ---------------------- j
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ISSUE DATE (MM/DD/YY) ' '.
ACORD INSURANCE BINDER 11/30/90
n
-
------------------------
4 e
THIS D]NDER IS A TEMPORARY INSURANCE-CONTRACT__SUBJECT-TO-THE•CONDITIONS-SHOUN_ON-TIIE-REVERSE-SIDE•OF-THIS-FORMw--.----.-- ,
--•------------- -------•-- BINDER NO
--- COMPANY TRAVELERS INSURANCE: COMPANY
. [ J --
PRODUCER ----------
a F i
EFFECTIVE I EXPIRATION
Winter-Dent & Company DATE TIME
1p�"` DATE TIME
101 East McCarty St. °
-----12:01-----[X] AM +-------------------------------------
--90----- f ..
P.O. Box 1046 [X] 12:01 AM
Jefferson City, MO 65102 11/29/ I---------"-"""""""" 11/29/91 .................
;,• 314-634-2122 L' J PM [ ) Noon
;! . ------------ - -----------
COD
E SUB-CODE ------
:.: I THIS BINDER I5 ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED
COMPANY PER EXPIRING POLICY NO.: _IV
<,... •--------------------------------------------- _ _
INSURED yt
DESCRIPTION OF OPERATION/VEHICLES/PROPERTY (INCLUDING LOCATION)
CITY OF JEFFERSON
OWNERS PROTECTIVE LIABILITY
"± 320 EAST MCCARTHY AWyr
JEFFERSON CITY, MO 65101
f: krL%iw
t ALL LIABILITY LIMITS IN THOUSANDS
s - --------------------------------
COVERAGES - -----------------
------------------
-----
----------
--__ _---------------------- COVERAGES/FORMS AMOUNT DEDUCTIBLE COINSURANCE
TYPE OF INSURANCE
PROPERTY CAUSES OF LOSS
[ ] BASIC [ J BROAD [ ] SPECIAL
[ ]
s
- }_----- $1,000,._._ _ -_-- GENERAL AGGREGATE
GENERAL LIABILITY
[ ] COMMERCIAL GENERAL LIABILITY PERSONAS-COMP. IN AGG. $ rF'
PERSONAL & AD. INJURY $
s ''• [ ][ ] CLAIMS MADE [ ] OCCURRENCE R
EACH OCCURRENCE 51,000,
[X] OWNERS & CONTRACTORS PROTECT. FIRE DAMAGE(ANY ONE FIRE) $
[ ] MEDICAL EXP(ANY ONE PER.) $
RETRO DATE FOR CLAIMS MADE: r
CSL------------------------------------------
--- --- --- ------
' UTOMOBILE [ ] ALL VEHICLES [ ] SCHEDULED VEHICLES gI PERS/ACC1D $ + k.
) LIABILITY PD $
] NON/OWNED MED. PAY $
] HIRED PIP $
[ ] GARAGE UM $
AUTO PHYSICAL DAMAGE [ ] ALL VEHICLES [ ] SCHEDULED VEHICLES [ ] ACV
I [ ] STATED AMOUNT $ }
[ ] COLLISION DED: I 3
;.. [ J OTHER
[ ] OTC DED:
------------------------ ---- ------
EACH AGGREGATE SELF-INSURE
R. EXCESS LIABILITY I OCCURRENCE I RETENTION
[ ] UMBRELLA FORM
•''
ec [ ] OTHER THAN UMBRELLA FORM RETRO DAYE FOR CLAIMS MADE: -----_ ________________________
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STATUTORY
WORKERS' C014PENSATION $ (EACH ACCIDENT) k'
$ (DISEASE POLICY LIMIT)
AND $ (DISEASE EACH EMPL.)
EMPLOYERS' LIABILITY -------------------------
-
------
SPECIAL CONDITIONS/RESTRICTIONS/OTHER COVERAGES
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WISCH & VAUGHAN CONSTRUCTION CO., INC., P.O. BOX 104388, JEFFERSON LITY, MO 65110-4388 IS RESPONSIBLE FOR PREMIUM AND
f r AUDIT.
FIRE STATION NO. 5 ---------
' ? RE: ---------------------------------------------------------------------------------------------
NAME & ADDRESS
-------------------------------------
-------------------------------j -[-] MORTGAGEE [ ] ADDITIONAL INSURED .,
]-LOSS-PAYEE----------------[------------------------------
{�;,,,•M�;t,. LOAN # „
�;. AUTHORIZED REPRESENTATIV
¢y :; CORD 75-S (11/85) -------------------------------- ----=
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CONDITIONS
COMPANY THIS 1 / OF 1 ON
SIDE.REVERSE y TO THE TERMS,
CONDITIONS AND LIMITATIONS OF POLICY(IES) IN CURRENT USE
BY THE COMPANY.
THIS BINDER 1 BY THE INSURED BY SURRENDER OF
THIS BINDER OR BY WRITTEN NOTICE TO THE COMPANY
CANCELLATION r r
COMPANY BY THE • TO THE INSURED IN ACCORDANCE
: THE POLICY CONDITIONS. / r WHEN Aft
REPLACED BY POLICY. BINDER • REPLACED
BINDER POLICY, THE COMPANY IS ENTITLED TO CHARGE A PREMIUM FOR THE
• 1 TO THE RULES AND RATES IN USE BY THE
COMPANY.
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