2006-118
ORDINANCE NO. 2.0tXr II g
AN ORDINANCE ACCEPTING COMPETITIVE BIDS AND AWARDING A PUBLIC WORKS
CONTRACT FOR THE CONSTRUCTION OF THE PARVIN 15/21 " SANITARY SEWER LINE
PROJECT FOR THE CITY OF DENTON WATER/WASTEWATER UTILITIES DIVISION;
PROVIDING FOR THE EXPENDITURE OF FUNDS THEREFOR; AND PROVIDING AN
EFFECTIVE DATE (BID 3480-P ARVIN SANITARY SEWER LINE AWARDED TO WILSON
CONTRACTOR SERVICES, L.L.C. IN AN AMOUNT NOT TO EXCEED $238,479.60).
WHEREAS, the City has solicited, received and tabulated competitive bids for the
construction of public works or improvements in accordance with the procedures of State law and
City ordinances; and
WHEREAS, the City Manager, or a designated employee, has received and recommended
that the herein described bids are the lowest responsible bids for the construction of the public works
or improvements described in the bid invitation, bid proposals and plans and specifications therein;
NOW, THEREFORE,
THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS:
SECTION I. The following competitive bids for the construction of public works or
improvements, as described in the "Bid Invitations", "Bid Proposals" or plans and specifications on
file in the Office of the City's Purchasing Agent filed according to the bid number assigned hereto,
are hereby accepted and approved as being the lowest responsible bids:
BID
NUMBER
CONTRACTOR
AMOUNT
3480
Wilson Contractor Services, L.L.C.
$238,479.60
SECTION 2. The acceptance and approval of the above competitive bids shall not constitute
a contract between the City and the person submitting the bid for construction of such public works
or improvements herein accepted and approved, until such person shall comply with all requirements
specified in the Notice to Bidders including the timely execution of a written contract and furnishing
of performance and payment bonds, and insurance certificate after notification of the award of the
bid.
SECTION 3. The City Manager is hereby authorized to execute all necessary written
contracts for the performance of the construction ofthe public works or improvements in accordance
with the bids accepted and approved herein, provided that such contracts are made in accordance
with the Notice to Bidders and Bid Proposals, and documents relating thereto specifying the terms,
conditions, plans and specifications, standards, quantities and specified sums contained therein.
SECTION 4. Upon acceptance and approval ofthe above competitive bids and the execution
of contracts for the public works and improvements as authorized herein, the City Council hereby
authorizes the expenditure of funds in the manner and in the amount as specified in such approved
bids and authorized contracts executed pursuant thereto.
SECTION 5. This ordinance shall become effective immediately upon its passage and
approval.
PASSED AND APPROVED this the
/lcl
2 - dayof
Yl(~
C~ kcL
,2006.
EULINE BROCK, MAYOR
ATTEST:
JENNIFER WALTERS, CITY SECRETARY
APPROVED AS TO LEGAL FORM:
EDWIN M. S~[)ER;CITY ATTORNEY)
~- . ~/
BY: ___ .
3-0RD-Bid 3480
CONTRACT AGREEMENT
ST ATE OF TEXAS
S COUNTY OF DENTON S
THIS AGREEMENT, made and entered into this L day of May A.D., 2006, by and
between Citv of Denton of the County of Denton and State of Texas, acting through
Howard Martin thereunto duly authorized so to do,
hereinafter termed "OWNER," and
Wilson Contractor Services. L.L.C.
107 Bell Ave Suite 3
Denton. TX 76201
ofthe City of Denton, County of Denton and State of
"CONTRACTOR. "
Texas
, hereinafter termed
WITNESSETH: That for and in consideration of the payments and agreements hereinafter
mentioned, to be made and performed by OWNER, and under the conditions expressed in the bonds
attached hereto, CONTRACTOR hereby agrees with OWNER to commence and complete
performance of the work specified below:
Bid 3480- Parvin 15/21" Sanitarv Sewer Line
"
in the amount of $238.479.60 and all extra work in connection therewith, under the terms as stated
in the General Conditions of the agreement; and at his (or their) own proper cost and expense to
furnish all materials, supplies, machinery, equipment, tools, superintendence, labor, insurance, and
other accessories and services necessary to complete the work specified above, in accordance with
the conditions and prices stated in the Proposal and the Performance and Payment Bonds, attached
hereto, and in accordance with all the General Conditions of the Agreement, the Special Conditions,
the Notice to Bidders (Advertisement for Bids), and Instructions to Bidders, as referenced herein
and on file in the office of the Purchasing Agent, and in accordance with all local, state and federal
laws; and plans, which includes all maps, plats, blueprints, and other drawings and printed or
written explanatory matter thereof, and the Specifications therefore, as prepared by:
Citv of Denton Utilitv and CIP Engineering staff
all of which are referenced herein and made a part hereof and collectively evidence and constitute
the entire contract.
CA-l
Independent Status
It is mutually understood and agreed by and between City and Contractor that Contractor is
an independent contractor and shall not be deemed to be or considered an employee of the City of
Denton, Texas, for the purposes of income tax, withholding, social security taxes, vacation or sick
leave benefits, worker's compensation, or any other City employee benefit. City shall not have
supervision and control of Contractor or any employee of Contractor, and it is expressly understood
that Contractor shall perform the services hereunder according to the attached specifications at the
general direction of the City Manager of the City of Denton, Texas, or his designee under this
agreement.
Indemnification
Contractor covenants and agrees to and does hereby indemnify, hold harmless and defend, at
its own expense, Owner, its officers, servants and employees, from and against any and all claims or
suits for property loss or damage and/or personal injury, including death, to any and all persons, of
whatsoever kind or character, whether real or asserted, arising out of the Work and services to be
performed hereunder by Contractor, its officers, agents, employees, subcontractors, licensees or
invitees, whether or not caused, in whole or in part, by the alleged negligence of the officers,
servants, employees, of the Owner. Contractor likewise covenants and agrees to, and does hereby,
indemnify and hold harmless Owner during the performance of any of the terms and conditions of
this Contract, whether arising out of in whole or in part, any and all alleged acts or omissions of
officers, servants, or employees of Owner. The provisions of this paragraph are solely for the
benefit of the parties hereto and not intended to create or grant any rights, contractual or otherwise,
to any other person or entity.
Choice of Law and Venue
This agreement shall be governed by the law of the State of Texas and venue for its
construction and enforcement shaUlie in the courts of Denton County, Texas.
The CONTRACTOR hereby agrees to commence work on or after the date established for
the start of work as set forth in written notice to commence work and complete all work within the
time stated in the Proposal, subject to such extensions of time as are provided by the General and
Special Conditions.
The OWNER agrees to pay the CONTRACTOR in current funds the price or prices shown
in the Proposal, which forms a part of this contract, such payments to be subject to the General and
Special Conditions of the Contract.
CA-2
IN WITNESS WHEREOF, the parties of these presents have executed this agreement in the
year and day first above written.
ATTEST:
/)f: ~U ))~
~OFORM'
~~
CA-3
~~
City of Denton
BY~~~
(SEAL)
CONTRACTOR
,_______u__ _ ____~
, WILSON CONTRACTOR SERVICES, LLC
107 BELL A VE., SUITE 3
l. _ _ _ _ _ _ DENTON, TX 76201
_./
MAILING ADDRESS
7t/O ,'J r../ \ - I/':lt/
PHONE NUMBER
/
94 () q9~ -II =tS
FAX NUMBER
BY: -AJ'II~ (IV-/). fra-;.:J /~-~
TITL
AA-;H,4v~
PRINTED NAME -
(SEAL)
Bond No. 4351947
PERFORMANCE BOND
STATE OF TEXAS S
COUNTY OF DENTON S
KNOW ALL MEN BY THESE PRESENTS: That Wilson Contractor Services. L.L.C./
whose address is 107 Bell Ave. Suite 3. Denton. TX 76201 hereinafter called Principal, and
SureTec Insurance Company /' , a corporation organized and existing under the laws
of the State of Texas , and fully authorized to transact business in the State of
Texas, as Surety, are held and firmly bound unto the City of Denton, a municipal corporation
organized and existing under the laws of the State of Texas, hereinafter called Owner, in jhe penal
sum of Two Hundred Thirt Ei ht Thousand Four Hundred Sevent Nine and 60/100 "f5'OLLARS
238479.60 us ten percent of the stated penal sum as an additional sum of money representing
additional court expenses, attorneys' fees, and liquidated damages arising out of or connected with
the below identified Contract, in lawful money of the United States, to be paid in Denton County,
Texas, for the payment of which sum well and truly to be made, we hereby bind ourselves, our
heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these
presents. This Bond shall automatically be increased by the amount of any Change Order or
Supplemental Agreement, which increases the Contract price, but in no event shall a Change Order
or Supplemental Agreement, which reduces the Contract price, decrease the penal sum ofthis Bond.
THE OBLIGATION TO PAY SAME is conditioned as follows: Whereas, the Principal
entered into a certain Contract, identified by Ordinanc<;Number 2006: 118, with the City of Denton,
the Owner, dated the ~day of Mav A.D: 2006}-1'copy of whj.ch IS hereto attached and made a
part hereof, for Bid 3480.Parvin 15/21" Sanitarv Sewer Line. V
NOW, THEREFORE, if the Principal shall well, truly and faithfully perform and fulfill all
of the undertakings, covenants, terms, conditions and agreements of said Contract in accordance
with the Plans, Specifications and Contract Documents during the original term thereof and any
extension thereof which may be granted by the Owner, with or without notice to the Surety, and
during the life of any guaranty or warranty required under this Contract, and shall also well and
truly perform and fulfill all the undertakings, covenants, terms, conditions and agreements of any
and all duly authorized modifications of said Contract that may hereafter be made, notice of which
modifications to the Surety being hereby waived; and, if the Principal shall repair and/or replace all
defects due to faulty materials and workmanship that appear within a period of one (1) year from
the date of final completion and final acceptance of the Work by the Owner; and, if the Principal
shall fully indemnify and save harmless the Owner from all costs and damages which Owner may
suffer by reason of failure to so perform herein and shall fully reimburse and repay Owner all outlay
and expense which the Owner may incur in making good any default or deficiency, then this
obligation shall be void; otherwise, it shall remain in full force and effect.
PB -1
PROVIDED FURTHER, that if any legal action be filed upon this Bond, exclusive venue
shall lie in Denton County, State of Texas.
AND PROVIDED FURTHER, that the said Surety, for value received, hereby stipulates and
agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the
Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc., accompanying the
same, shall in anywise affect its obligation on this Bond, and it does hereby waive notice of any
such change, extension oftime, alteration or addition to the terms of the Contract, or to the Work to
be performed thereunder, or to the Plans, Specifications, Drawings, etc.
This Bond is given pursuant to the provisions of Chapter 2253 of the Texas Government
Code, as amended, and any other applicable statutes of the State of Texas.
The undersigned and designated agent is hereby designated by the Surety herein as the
Resident Agent in Denton County to whom any requisite notices may be delivered and on whom
service of process may be had in matters arising out of such suretyship, as provided by Article 7.19-
I of the Insurance Code, Vernon's Annotated Civil Statutes of the State of Texas.
IN WITNESS WHEREOF, this instrument is executed in 4 copies, each one of which shall
be deemed an original, this the ~ day of May , 2006 ~ .
ATTEST:
PRINClP AL
BY: W4nWi4MI
SECRETARY
Wilson Contractor Services, L.L.C.
BY: '7I.7i~7
~ PRESIDENT
ATTEST:
SURETY
BY: CPd.tf3A,.I'~
SureTec Insurance CO~~~
BY:'1~X~
ATTORNEY-IN-FACT
Pauline L. Lesch
The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the
process IS:
NAME:
Ramey King Insurance
STREET ADDRESS:
510 N. I35E, Denton, Texas
76205
(NOTE: Date of Performance Bond must be date of Contract. If Resident Agent is not a corporation, give a
person's name.)
PB - 2
ot~
<;\~~
Bond No. 4351947
PAYMENT BOND
STATE OF TEXAS 9
COUNTY OF DENTON 9
KNOW ALL MEN BY THESE PRESENTS: That Wilson Contractor Services. L.L.C~
whose address is 107 Bell Ave. Suite 3 Denton. TX 76201 , hereinafter called Principal, and
SureTec Insurance COffioanv./" , a corporation organized and existing under the laws of
the State of Texas , and fully authorized to transact business in the State of Texas, as
Surety, are held and firmly bound unto the City of Denton, a municipal corporation organized and
existing under the laws of the State of Texas, hereinafter called Owner, and unto all persons, firms,
and corporations who may furnish materials for, or perform labor upon, the building or
improvements hereinafter referred to, in the penal sum of Two Hu~ed Thirty Eight Thousand
Four Hundred Seventy Nine and 60/100 DOLLARS~38,479.60Yin lawful money of the United
States, to be paid in Denton, County, Texas, for the payment of which sum well and truly to be
made, we hereby bind ourselves, our heirs, executors, administrators, successors, and assigns,
jointly and severally, firmly by these presents. This Bond shall automatically be increased by the
amount of any Change Order or Supplemental Agreement which increases the Contract price, but in
no event shall a Change Order or Supplemental Agreement which reduces the Contract price
decrease the penal sum of this Bond.
THE OBLIGATION TO PAY SAME is conditioned as follows: Whereas, the Principal
entered into a certain Contract, identified by Ordinance Number 2006-118, with the City of Denton,
the Owner, dated the ~ day of May A.D. 2006/, a copy of which is hereto attached and
made a part hereof, for Bid 3480 Parvin 15121" Sanitary Sewer Line.~
NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its duties and
make prompt payment to all persons, firms, subcontractors, corporations and claimants supplying
labor and/or material in the prosecution of the Work provided for in said Contract and any and all
duly authorized modifications of said Contract that may hereafter be made, notice of which
modifications to the Surety being hereby expressly waived, then this obligation shall be void;
otherwise it shall remain in full force and effect.
PROVIDED FURTHER, that if any legal action be filed on this Bond, exclusive venue shall
lie in Denton County, Texas.
AND PROVIDED FURTHER, that the said Surety, for value received, hereby stipulates and
agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the
Work to be performed thereunder, or to the Plans, Specifications, Drawings, etc., accompanying the
same, shall in anywise affect its obligation on this Bond, and it does hereby waive notice of any
such change, extension of time, alteration or addition to the terms of the Contract, or to the Work to
be performed thereunder, or to the Plans, Specifications, Drawings, etc.
PB - 3
This Bond is given pursuant to the provisions of Chapter 2253 of the Texas Goverrunent
Code, as amended, and any other applicable statutes of the State of Texas.
The undersigned and designated agent is hereby designated by the Surety herein as the
Resident Agent in Denton County to whom any requisite notices may be delivered and on whom
service of process may be had in matters arising out of such surety, as provided by Article 7.19-1 of
the Insurance Code, Vernon's Annotated Civil Statutes of the State of Texas.
IN WITNESS WHEREOF, this instrument is executed in 4 copies, each one of which shall
be deemed an original, this the ~ day of May , 2006./'
ATTEST:
PRINCIPAL
BY: We14r, W.J.'-I
SECRETARY
B:."O";;J.;;~
.~ PRESIDENT
L.L.C.
ATTEST:
SURETY
BY: fk~~
SureTec Insurance CO~~
BY:'-f~X~
ATTORNEY-IN-FACT
Pauline L. Lesch
The Resident Agent of the Surety in Denton County, Texas for delivery of notice and service of the
process IS:
NAME:
Ramey King Insurance
STREET ADDRESS:
510 N. I35E, Denton, Texas
76205
(NOTE: Date of Payment Bond must be date of Contract. If Resident Agent is not a corporation,
give a person 's name.)
PB-4
Ck
~\~1
SureTec Insurance Company
THIS BOND RIDER CONTAINS IMPORTANT COVERAGE
INFORMATION
Statutory Complaint Notice
To obtain information or make a complaint: You may call the Surety's toll free telephone
number for information or to make a complaint at: 1-866-732-0099. You may also write
to the Surety at:
SureTec Insurance Company
9737 Great Hills Trail, Suite 320
Austin, TX 78759
You may contact the Texas Department of Insurance to obtain information on
companies, coverage, rights or complaints at 1-800-252-3439. You may write the Texas
Department of Insurance at
PO Box 149104
Austin, TX 78714-9104
Fax#: 512-475-1771
PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your
premium or about a claim, you should contact the Surety first. If the dispute is not
resolved, you may contact the Texas Department of Insurance.
----------------------------------------------------------------------------------------------------------------------
Terrorism Risks Exclusion
The Bond to which this Rider is attached does not provide coverage for, and the surety
shall not be liable for, losses caused by acts of terrorism, riot, civil insurrection, or acts
of war.
------------------------------------------------------------------------------------------------------------------
Exclusion of Liability for
Mold, Mycotoxins, Fungi & Environmental Hazards
The Bond to which this Rider is attached does not provide coverage for, and the surety
thereon shall not be liable for, molds, living or dead fungi, bacteria, allergens,
histamines, spores, hyphae, or mycotoxins, or their related products or parts, nor for
any environmental hazards, bio-hazards, hazardous materials, environmental spills,
contamination, or cleanup, nor the remediation thereof, nor the consequences to
persons, property, or the performance of the bonded obligations, of the occurrence,
existence, or appearance thereof.
Rev. 08/04
POA #, 4221029
SureTec Insurance Company
LIMITED POWER OF ATTORNEY
Know All Men by These Presents, That SURETEC INSURANCE COMP ANY~ "Company"), a corporation duly organized and
existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents
make, constitute and appoint .
Clem F. Lesch, Pauline L. Lesch~en W. Lewis, Barry Romito, Patrick C. Locke, Allen Sparks
of Dallas, Texas its true and lawful Attomey(s).in-fact, with full power and authority hereby conferred in its name, place and stead, to
execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to
include waivers to the conditions of contracts and consents of surety, providing the bond penalty does not exceed
Five Million and noli 00 Dollars ($5,000,000.00) /
and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the corporate
seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney(s)-in-Fact may do in the
premises, Said appointment shall continue in force until June 30. 2007 and is made under and by authority of the following
resolutions of the Board of Directors of the SureTec Insurance Company:
Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is
hereby vested with full power and authority to appoint anyone or more suitable persons as Attomey(s).in-Fact to represent and act for and on
behalf of the Company subject to the following provisions:
Attorney~jn-Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agrccmcnts or indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thcrcunder, and any such instruments so executed by any such
Attomey.in.Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolved. that lhe signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or
any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid
and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20U, of April,
1999)
III Witlless WilereoJ, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its corporate seal
to be hereto affixed this 20th day of June, A.D. 2005.
:RAN~
~c,...........,,~
'~~.. ..0
~/ -;.. '1\.~
to! w j~'
"'[/12:'
~\.J. 1"'('
.........M...~.....
*
.
On this 20th day of June, A.D. 2005 before me personally came Bill King, to me known, who, being by me duly sworn, did depose and say, that he
resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above
instrument; that he knows the seal of said Company;lthat the scal affixed to said instrument is such corporate seal; that it was so affixed by order of the
Board of Directors of said Company; and that he sign~d his name thereto by like order.
State of Texas
County of Harris
ss:
By:
M~I~N~
.My commission expires August 27, 2008
I
T, M. Brent Beaty, Assistant Secretary of SURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy
of a Power of Attorney, executed by said Company, ~hich is still in full force and effect; and furthermore, the resolutions of the Board of Dircctors, set
out in the Power of Attorney are in full force and effe4t.
I
Given under my hand and the seal of said Company at Houston, Texas this 2nd day of 06, A.D.
, -----
ry
i
Any instrument issued In excess of the penalty stated above is totally vllld and wlihout any validity.
For verification of the authority of this power you m'ay call (713) 812-0800 any business day between 8:00 am and 5:00 pm CST.
i
Ol:\
~..\o.
fJ<
CITY OF DENTON
INSURANCE REQUIREMENTS FOR CONTRACTORS
Bidder's attention is directed to the insurance requirements below. It is highly recommended that
bidders confer with their respective insurance carriers or brokers to determine in advance of Bid
submission the availability of insurance certificates and endorsements as prescribed and provided
herein. If an apparent low bidder fails to comply strictly with the insurance requirements, that
bidder may be disqualified from award of the contract. Upon bid award, all insurance
requirements shall become contractual obligations, which the successful bidder shall have a duty
to maintain throughout the course of this contract.
STANDARD PROVISIONS:
Without limiting any of the other obligations or liabilities of the Contractor, the Contractor shall
provide and maintain until the contracted work has been completed and accepted by the City of
Denton, Owner, the minimum insurance coverage as indicated hereinafter.
As soon as practicable after notification of bid award, Contractor shall file with the Purchasing
Department satisfactory certificates of insurance, containing the bid number and title of the project.
Contractor may, upon written request to the Purchasing Department, ask for clarification of any
insurance requirements at any time; however, Contractors are strongly advised to make such
requests prior to bid opening, since the insurance requirements may not be modified or waived after
bid opening unless a written exception has been submitted with the bid. Contractor shall not
commence any work or deliver any material until he or she receives notification that the contract
has been accepted, approved, and signed by the City of Denton.
All insurance policies proposed or obtained in satisfaction of these requirements shall comply with
the following general specifications, and shall be maintained in compliance with these general
specifications throughout the duration of the Contract, or longer, if so noted:
. Each policy shall be issued by a company authorized to do business in the State of
Texas with an AM. Best Company rating of at least A.
. Any deductibles or self-insured retentions shall be declared in the bid proposal. If
requested by the City, the insurer shall reduce or eliminate such deductibles or
self-insured retentions with respect to the City, its officials, agents, employees and
volunteers; or, the contractor shall procure a bond guaranteeing payment of losses and
related investigations, claim administration and defense expenses.
. Liability policies shall be endorsed to provide the following:
.. Name as additional insured the City of Denton, its Officials, Agents, Employees
and volunteers.
.. That such insurance is primary to any other insurance available to the additional
insured with respect to claims covered under the policy and that this insurance
applies separately to each insured against whom claim is made or suit is brought.
The inclusion of more than one insured shall not operate to increase the insurer's
limit ofliability.
. All policies shall be endorsed to read:
"SAID POLICY SHALL NOT BE CANCELLED, NONRENEWED OR
MATERIALLY CHANGE WITHOUT 30 DAYS ADVANCED WRITTEN NOTICE
BEING GIVEN TO THE OWNER (CITY) EXCEPT WHEN THE POLICY IS
BEING CANCELLED FOR NONPAYMENT OF PREMIUM IN WHICH CASE 10
DAYS ADVANCE WRITTEN NOTICE IS REQUIRED".
. Should any of the required insurance be provided under a claims-made form, Contractor
shall maintain such coverage continuously throughout the term of this contract and,
without lapse, for a period of three years beyond the contract expiration, such that
occurrences arising during the contract term which give rise to claims made after
expiration of the contract shall be covered.
. Should any of the required insurance be provided under a form of coverage that
includes a general annual aggregate limit providing for claims investigation or legal
defense costs to be included in the general annual aggregate limit, the Contractor shall
either double the occurrence limits or obtain Owners and Contractors Protective
Liability Insurance.
. Should any required insurance lapse during the contract term, requests for payments
originating after such lapse shall not be processed until the City receives satisfactory
evidence of reinstated coverage as required by this contract, effective as of the lapse
date. If insurance is not reinstated, City may, at its sole option, terminate this
agreement effective on the date ofthe lapse.
SPECIFIC ADDITIONAL INSURANCE REQUIREMENTS:
All insurance policies proposed or obtained in satisfaction of this Contract shall additionally
comply with the following marked specifications, and shall be maintained in compliance with these
additional specifications throughout the duration of the Contract, or longer, if so noted:
[X] A. General Liability Insurance:
General Liability insurance with combined single limits of not less than $1,000,000
shall be provided and maintained by the Contractor. The policy shall be written on an
occurrence basis either in a single policy or in a combination of underlying and
umbrella or excess policies.
Ifthe Commercial General Liability form (ISO Form CG 0001 current edition) is used:
. Coverage A shall include premises, operations, products, and completed
operations, independent contractors, contractual liability covering this contract
and broad form property damage coverage.
. Coverage B shall include personal injury.
. Coverage C, medical payments, is not required.
If the Comprehensive General Liability form (ISO Form GL 0002 Current Edition and
ISO Form GL 0404) is used, it shall include at least:
. Bodily injury and Property Damage Liability for premises, operations,
products and completed operations, independent contractors and property
damage resulting from explosion, collapse or underground (XCV) exposures.
. Broad form contractual liability (preferably by endorsement) covering this
contract, personal injury liability and broad form property damage liability.
[X] Automobile Liability Insurance:
Contractor shall provide Commercial Automobile Liability insurance with Combined Single
Limits (CSL) of not less than $500,000 either in a single policy or in a combination of
basic and umbrella or excess policies. The policy will include bodily injury and property
damage liability arising out of the operation, maintenance and use of all automobiles and
mobile equipment used in conjunction with this contract.
Satisfaction of the above requirement shall be in the form of a policy endorsement for:
.
any auto, or
all owned, hired and non-owned autos.
[X] Workers Compensation Insurance
Contractor shall purchase and maintain Worker's Compensation insurance which, in addition
to meeting the minimum statutory requirements for issuance of such insurance, has
Employer's Liability limits of at least $100,000 for each accident, $100,000 per each
employee, and a $500,000 policy limit for occupational disease. The City need not be
named as an "Additional Insured" but the insurer shall agree to waive all rights of
subrogation against the City, its officials, agents, employees and volunteers for any work
performed for the City by the Named Insured. For building or construction projects, the
Contractor shall comply with the provisions of Attachment 1 in accordance with 9406.096
of the Texas Labor Code and rule 28TAC 110.110 of the Texas Worker's Compensation
Commission (TWCC).
[ ] Owner's and Contractor's Protective Liability Insurance
The Contractor shall obtain, pay for and maintain at all times during the prosecution of the
work under this contract, an Owner's and Contractor's Protective Liability insurance policy
naming the City as insured for property damage and bodily injury which may arise in the
prosecution of the work or Contractor's operations under this contract. Coverage shall be on
an"occurrence" basis, and the policy shall be issued by the same insurance company that
carries the Contractor's liability insurance. Policy limits will be at least
combined bodily injury and property damage per occurrence with a aggregate.
[ ] Fire Damage Legal Liability Insurance
Coverage is required if Broad form General Liability is not provided or is unavailable to the
contractor or if a contractor leases or rents a portion of a City building. Limits of not less
than each occurrence are required.
[ ] Professional Liability Insurauce
Professional liability insurance with limits not less than per claim with respect to
negligent acts, errors or omissions in connection with professional services is required under
this Agreement.
[ ] Builders' Risk Insurance
Builders' Risk Insurance, on an All-Risk form for 100% of the completed value shall be
provided. Such policy shall include as "Named Insured" the City of Denton and all
subcontractors as their interests may appear.
[ ] Commercial Crime
Provides coverage for the theft or disappearance of cash or checks, robbery inside/outside
the premises, burglary of the premises, and employee fidelity. The employee fidelity
portion of this coverage should be written on a "blanket" basis to cover all employees,
including new hires. This type insurance should be required if the contractor has access to
City funds. Limits of not less than each occurrence are required.
[ ] Additional Iusurance
Other insurance may be required on an individual basis for extra hazardous contracts and
specific service agreements. If such additional insurance is required for a specific contract,
that requirement will be described in the "Specific Conditions" ofthe contract specifications.
ATTACHMENT 1
[X] Worker's Compensation Coverage for Building or Construction Projects for
Governmental Entities
A. Definitions:
Certificate of coverage ("certificate")-A copy of a certificate of insurance, a certificate
of authority to self-insure issued by the commission, or a coverage agreement (TWCC-
81, TWCC-82, TWCC-83, or TWCC-84), showing statutory workers' compensation
insurance coverage for the person's or entity's employees providing services on a
project, for the duration of the project.
Duration of the project - includes the time from the beginning of the work on the project
until the contractor's/person's work on the project has been completed and accepted by
the governmental entity.
Persons providing services on the project ("subcontractor" in 9406.096) - includes all
persons or entities performing all or part of the services the contractor has undertaken to
perform on the project, regardless of whether that person contracted directly with the
contractor and regardless of whether that person has employees. This includes, without
limitation, independent contractors, subcontractors, leasing companies, motor carriers,
owner-operators, employees of .any such entity, or employees of any entity which
furnishes persons to provide services on the project. "Services" include, without
limitation, providing, hauling, or delivering equipment or materials, or providing labor,
transportation, or other service related to a project. "Services" does not include
activities umelated to the project, such as food/beverage vendors, office supply
deliveries, and delivery of portable toilets.
B. The contractor shall provide coverage, based on proper reporting of classification codes
and payroll amounts and filing of any overage agreements, which meets the statutory
requirements of Texas Labor Code, Section 401.011(44) for all employees of the
Contractor providing services on the project, for the duration ofthe project.
C. The Contractor must provide a certificate of coverage to the governmental entity prior
to being awarded the contract.
D. If the coverage period shown on the contractor's current certificate of coverage ends
during the duration of the project, the contractor must, prior to the end of the coverage
period, file a new certificate of coverage with the governmental entity showing that
coverage has been extended.
E. The contractor shall obtain from each person providing services on a project, and
provide to the governmental entity:
(1) a certificate of coverage, prior to that person beginning work on the project, so the
governmental entity will have on file certificates of coverage showing coverage
for all persons providing services on the project; and
(2) no later than seven days after receipt by the contractor, a new certificate of
coverage showing extension of coverage, if the coverage period shown on the
current certificate of coverage ends during the duration of the project.
F. The contractor shall retain all required certificates of coverage for the duration of the
project and for one year thereafter.
G. The contractor shall notify the governmental entity in wntmg by certified mail or
personal delivery, within 10 days after the contractor knew or should have known, of
any change that materially affects the provision of coverage of any person providing
services on the project.
H. The contractor shall post on each proj ect site a notice, in the text, form and manner
prescribed by the Texas Workers' Compensation Commission, informing all persons
providing services on the project that they are required to be covered, and stating how a
person may verify coverage and report lack of coverage.
1. The contractor shall contractually require each person with whom it contracts to provide
services on a project, to:
(1) provide coverage, based on proper reporting of classification codes and payroll
amounts and filing of any coverage agreements, which meets the statutory
requirements of Texas Labor Code, Section 401.011(44) for all of its employees
providing services on the project, for the duration of the project;
(2) provide to the contractor, prior to that person beginning work on the project, a
certificate of coverage showing that coverage is being provided for all employees
of the person providing services on the project, for the duration of the project;
(3) provide the contractor, prior to the end of the coverage period, a new certificate of
coverage showing extension of coverage, if the coverage period shown on the
current certificate of coverage ends during the duration of the project;
(4) obtain from each other person with whom it contracts, and provide to the
contractor:
(a) a certificate of coverage, prior to the other person beginning work on the
project; and
(b) a new certificate of coverage showing extension of coverage, prior to the
end of the coverage period, if the coverage period shown on the current
certificate of coverage ends during the duration of the project;
(5) retain all required certificates of coverage on file for the duration of the project
and for one year thereafter;
(6) notify the governmental entity in writing by certified mail or personal delivery,
within 10 days after the person knew or should have known, of any change that
materially affects the provision of coverage of any person providing services on
the project; and
(7) contractually require each person with whom it contracts, to perform as required
by paragraphs (1) - (7), with the certificates of coverage to be provided to the
person for whom they are providing services.
J. By signing this contract or providing or causing to be provided a certificate of coverage,
the contractor is representing to the governmental entity that all employees of the
contractor who will provide services on the project will be covered by workers'
compensation coverage for the duration of the proj ect, that the coverage will be based
on proper reporting of classification codes and payroll amounts, and that all coverage
agreements will be filed with the appropriate insurance carrier or, in the case of a self-
insured, with the commission's Division of Self-Insurance Regulation. Providing false
or misleading information may subject the contractor to administrative penalties,
criminal penalties, civil penalties, or other civil actions.
K. The contractor's failure to comply with any of these provisions is a breach of contract
by the contractor which entitles the governmental entity to declare the contract void if
the contractor does not remedy the breach within ten days after receipt of notice of
breach from the governmental entity.
.: BIO'# 3480
ADDENDUM # 1
. Addendum #1 to be returned with Bid ProposaL'
The following are changes to the bid specifications:
,
1. Please see new quantities listed on P-3 & P-4.
NO OTHER CHANGES AT THIS TIME.
. Date:
This form shall b~ signed and returned with your bid.
. .(,j~\Jo",- W:\S"'"""
Name: t;J;ISo",,- &'^tro<:.tDI Sue-S.
~~\D~
. ;\~W\.- ~~-l5-r.~/~5
~1p""
I
Signature:
Company:
Title:
BID # 3480
ADDENDUM # 2
Addendum # 2 to be returned with Bid Proposal
The following are changes to the bid specifications:
NO OTHER CHANGES AT THIS TIME.
This form shall be signed and returned with your bid.
Name:
Signature:
Company:
Title:
Date:
-I~;jiJ~ .
---Il-il ~
_1 /'),'1<;"'/ t-i",~-4/ Yc
J/Td V4ed,"d.--. f--
f#(/o~
BID # 3480
ADDENDUM # 3
Addendum # 3 to be returned with Bid Proposal
The following are changes to the bid specifications:
NO OTHER CHANGES AT THIS TIME.
This form shall be signed and returned with your bid.
Title:
~Hf~
..-I~/. .....
I )):(<r,J ~/I'/_./.H~
~;qt",<;...r
it - a
Name:
Signature:
Company:
Date:
. Project Name
. . Parvin 15121" Sanitary Sewer I-ine
.BaseBid . .
o
aID T A8ULA TION SHEET
Work Days
. ...:Bid No.
P.O. No.
90
3480
""",'
Item.
Description
Contractors Warranties and Understandings
. UnitPri~ inWards ~ ~"""
Qnantity Unit Unit Price
Total
507-D
1
I LS $ '010cl.0
103.1
507-A 8" SDR-35 Sanitary Sewer Pipe
Unit Prt~ I~ Words ~
507-B
12" SDR-35 Sanitary Sewer Pipe
Unit Prt~ In Words
I r;p $1': I"'. 0
507-C
15" SDR-35 Sanitary Sewer Pipe
Unit Prtce.ln Words
o
~
21" ASTM F679 Sanitary Sewer Pipe
~
-
I r;p $ Y: J. <{O.O
Unit prtce In Words
507'E 18" ASTM 746 Ductile Iron Pipe for Sanitary Sewer
Unit prtce In Words
502.9
Unit prtce in Words
201
$ reo.DO
Unit prtce In Words.
202.~.4.2 Broadcast Seeding
Unit prtce In Words
Unitprtce In Words
502.1-A Concrete Manhole (5' I.D.)
Unit prtce In Words ~
Sewer 03 Remove Existing Manhole
lEA $
~O'. 0
Unit prtce In Words
~
502.1-B
$ S-3-70.0
Unit prtce in Words
Unit prtce In Words
4-:\<-
j
lEA
o
Sewer 02 Abandon Existing Manhole
Sewer 01
Sewer Une
I EA $ )000. 00
Unit prtce In Words
801
8arrtcades, Warning Signs and Detours
1
LS $ roO. 0 & LS $
c),OO
Unit prtce In Words
3/2012006
P-3
Project Name . ,
Parvin 15/21" Sanitary Sewer Line
"Base Bid '
"'. ~,
.'
Item
504.7
. 4023-C
BID TABULATION SHEET
Work Days
.BidNo.
'P.O.No.
.90
3480
Description
Qnantity Unit Unit Price
Total
Concrete Encasement of 18" DIP Sanita Sewer
.119
Lf $
Unit Price IriWords .
.00
Unit Price In Words
803.2 9" Gabion Mattress & Filter
Unit prtce In Words r.
107.19.3 Excavation Protection
107.20.
Unit Price In Words
402.3-A As hall Saw Cut
:75' ILf $ ~O.OO.
203.3
502.12.4 Break Into Existin Manhole 0
Unit Prjce In Words .[..
SUBTOTAL BASE BID 0
3/20/2006 P-4
"
(~~~
SURETE:C
.
BID BOND
KNOW ALL MEN BY THESE PRESENTS, that we WILSON CONTRACTOR SERVICES. L.L.C. as principal,
hereinafter called the Principal, and SURETEC INSURANCE COMPANY, 9737 Great Hills Traii, Suite 320, Austin,
TX 78759, as Surety, hereinafter called the Surety, are held and firmly bound unto Citv of Denton as Obligee,'
hereinafter called the Obligee, in the sum of Five Percent of the Greatest Amount Bid (5%) for the payment of
which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our heirs, executors,
administrators, successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the principal has submitted a bid for Parvin 15/21" Sanitarv Sewer Line.
NOW, THEREFORE, if the contract be timely awarded to the Principal and the Principal shall within such time as
specified in the bid, enter into a contract in writing or, in the event of the faiiure of the Principal to enter into such
Contract, if the Principal shall pay to the Obligee the difference not to exceed the penalty hereof between the
amount specified in said bid and such larger amount for which the Obligee may in good faith contract with another
party to perform the work covered by said bid, then this obligation shall be null and void, otherwise to remain in full
force and effect.
PROVIDED, HOWEVER, neither Principal nor Surety shall be bound hereunder unless Obligee prior to execution
of the final contract shall furnish evidence of financing in a manner and form acceptable to Principal and Surety that
financing has been firmly committed to cover the entire cost of the project.
SIGNED, sealed and dated this 6th day of Aprii, 2006.
WILSON CONTRACTOR SERVICES. L.L.C.
"""d"~_
By)j~
TI~LE: l 7i.' j
SureTec Insurance Company
BY:\-P~ ~~ J
Pauline L. Lesch, Attorney-in-Fact
SureTec Insurance Company
THIS BOND RIDER CONTAINS IMPORTANT COVERAGE INFORMATION
Statutory Complaint Notice
To obtain information or make a complaint: You may call the Surety's toll free telephone
number for information or to make a complaint at: 1-866-732-0099. You may also write to the
Surety at: .
SureTec Insurance Company
9737 Great Hills Trail, Suite 320
Austin, Tx 78759
You may contact the Texas Department of Insurance to obtain information on companies,
coverage; rights or complaints at 1-800-252-3439. You may write the Texas Department of
Insurance at .
PO Box 149104
Austin, TX 78714-9104
FaX#: 512-475-1771
PREMIUM OR CLAIM DISPUTES: Should you haye a dispute concerning your premium or
about a claim, you should contact the Surety first. If the dispute is not resolved, you may
contact the Texas Department of Insurance.
Terrorism Risks Exclusion
The Bond to which this Rider is attached does not provide coverage for, and the surety shall
not be liable for, losses caused by acts of terrorism, riot, civil insurrection, or acts of war.
c
Exclusion of Liability for.
Mold, Mycotoxins, Fungi & Environmental Hazards
The Bond to which this Rider is attached does not provide coverage for, and the surety
thereon shall not be liable for, molds, living or dead fungi, bacteria, allergens, histamines,
spores, hyphae, or mycotoxins, or their related products or parts, nor for any environmental
hazards, bio-hazards, hazardous materials, environmental spills, contamination, or cleanup,
nor the remediation thereof, nor the consequences to persons, property, or the performance
of the bonded obligations, of the occurrence, existence, or appearance thereof.
Texas Rider 010106
POA #, 4221029
SureTec Insurance Company
LIMITED POWER OF ATTORNEY
Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a cOIporation duly organized and
existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents
make, constitute and appoint
Clem F. Lesch, Pauline L. Lesch, Gary Matula, Steven W. Lewis, Barry Romito, Patrick C. Locke, Allen Sparks
of Dallas, Texas its true and lawful Attomey(s)-in~fact, with full power and authority hereby conferred in its name, place and stead, to
execute, acknowledge and deliver any and all bonds, recognizances, lUldertakings or other instruments or contracts of suretyship to
include waivers to the conditions of contracts and consents of surety, providing the. bond penalty does not exceed
Five Million and nol100 Dollars ($5,000,000.00)
and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the President, sealed with the cOIporate
seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attomey(s)-in-Fact may do in the
premises. Said appointment shall continue in force until June 30. 2007 and is made under and by authority of the following
resolutions ofllie Board of Directors of the SureTec Insurance Company:
Be it Resolved, that the President, any Vice-President, any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is
hereby vested with full power and authority to appoint anyone or more suitable persons as Attomey(s)-in-Fact to represent and act for and on
behalf of the Company subject to the following provisions:
Attorney-in-Fact may be given full power and authority for and in the name of and of behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or
any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid
and binding upon the Company with respect to any bond or undertaking to which it is attached. (Adopted at a meeting held on 20rA of April,
1999)
[II Witness Whereof, SURETEC INSURANCE COMPANY has caused these presents to be signed by its President, and its cOIporate seal
to be hereto affixed this 20th day of June, A.D. 2005.
By:
State of Texas
County of Harris
ss:
e' Mi==V
. . llIaleolTeXllS
!'>J, My CommIssIon Expires
'!'..~ August 27.2008
M~I~N~
My commission expires August 27,2008
T, M. Brent Bealy, Assistant Secretary ofSURETEC INSURANCE COMPANY, do hereby certify that the above and foregoing is a true and correct copy
ofa Power of Attorney, executed by said Company, which is still in full force and effect; and furthermore, the resolutions of the Board of Directors, set
out in the Power of Attorney are in full force and effect.
Given under my hand and the seal of said Company at Houston, Texas tins 6th
April
06
,20 ,A.D.
ry
Any instrument issued in excess of the penalty stated above is totally void and without any validity.
For verification of the authority of this power you may cali (713) 812-0800 any business day between 8:00 am and 5:00 pm CST.
PRODUCER (972)423-1010
The Roy Agency Inc.
801 East Plano Parkway
Suite 140
Plano, TX 75074-6774
INSURED Wi 1 son Contractor
107 Bell, Suite 3
Denton, TX 76201
FAX (972)423-5662
DATE (MMJDDNYYY)
04/19/2006
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.
I
ACORD
'"
CERTIFICATE OF LIABILITY INSURANCE
Services.
/
LLCv'
~~
~~'l
INSURERS AFFORDING COVERAGE
INSURER A: Bi tuminous Casual ty Company
INSURERB: Texas Mutual Insurance CO.
INSURER c:
INSURER D:
INSURER E:
NAIC#
20095
.
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
II~$': ~ri!l:~ TYPE OF INSURANCE POliCY NUMBER p~..L.~~~ EFFECTIVE P~k'CY EXPIRATION liMITS
.. I
GENERAL. liABIliTY V CLP3196770 -09/16/2005 09/16/2006' -EACH OCCURRENCE . 1,000,000
I. X COMMERCIAL GENERAL L1~BILllY DAMAGE T9",~ENTED -, I 100,000
I CLAIMS MADE [!] OCCUI\.. ~ BLANKET ADDITIONAL / MED EX? (Anyone person) I 10,000
A V INSURED PE~ PERSONAL & ADV INJURY I 1,000,000
)f Blkt Waiver/Subrol/ WRITTEN CONTRACT GENERAL AGGREGATE I 2,000,000 ..........
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMPIOP AGG I 2,000,000
I -nPRO- n /'
POLICY JECT LOC
AUTOMOBILE llABIUT'! V CAP3196764 09/16/2005 09/16/2006- COMBINED SINGLE LIMIT
-,.,- ..,/" . (Eaaccident) I
X ANY AUTO 1,000,000 )../
-
ALL OWNED AUTOS BODILY INJURY
- I
SCHEDULED A~ (Per person)
A X
HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS"""'--- (Per accident) I
X Blkt Addl. Insur~ /'
X PROPERTY DAMAGE .
Blkt Waiver/Subro. (Peraccidenl)
R":GE UABIUTY AUTO ONLY - EA ACCIDENT .
ANY AUTO OTHER THAN EAACC .
AUTO ONLY: AGG .
EXCESS/UMBRELLA LIABIlITY EACH OCCURRENCE . .
j -OCCUR D .CLAIMS MADE AGGREGATE .
.
=J ~EDUCTlBLE I
RETENTION I /' ~ I
WORKERS COMr~;T10N AND V TSFOOOll08679 08/30/2005 08/30/2006< -xjwc STAT~L.~t ---------------
EMPL.OYERS' L1A IlITY __ .IOBYJ.JM[ _. ....EB._
B ANY PROPRIETOm.RTNERlEXECUTIVE / E.L. EACH ACCIDENT . 500,000 f'J
QFFICERlMEMBE CLUDED? B LANKET WAIV~~ E.L. DISEASE. EA EMPLOYEE $ 500,000 t-
Ifyes,describeun~
SPECIAL PROVISI below OF SUBROGATION E.L. DISEASE - POLICY LIMIT I 500,000
OTHER CLP3196770 09/16/2005 09/16/2006 $350,000 Any One Item
ontractors Equipment:
Leased/Ren~/Borrowed $250,000 Max.
'" $1,000 Deductible
DESCRIPTION OF OPE=Sr/LOCATlONS I VEHICL.ES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
ertificate H r is named as Additional Insured on the General Liability Polic}~
'Said policy s~ll not be cancelled, non renewed or materially change without 30 days advanced
.ritten notice2tieing given to the owner (City) except when the policy is being cancelled for
onpayment of ~emium in which case 10 days advance written notice is required'.'.l.---'
C
City of Denton /
901-B Texas Street
Denton, TX 76209
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL.ED BEFORE THE
EXPIRATION ~fHEREOF, THE ISSUING INSURER WILL. ENDEAVOR TO MAlL
..J.L \.oAYs WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
C.J. Ro
V.P., CIC/CRR
~
'P~C'
ACORD 25 (2001/08)
@ACORD CORPORATION 1988