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Eriksen-Various Locations/Tornado Sirensviyvir TM ,?.,AIA DocumentA101 Standard Form of Agreement Between Owner and Contractor where the basis of payment is a Stipulated Sum AGREEMENT made as of the 30 day of September in the year 2014 (In words, indicate day, month and year.) ADDITIONS AND DELETIONS: BETWEEN the Owner: (Name, legal status, address and other information) City of Blair 218 So. 16th Blair, Nebraska 68008 Telephone Number: -(402) 426 -4191 Fax Number: (402)426 -4195 and the Contractor: (Name, legal status, address and other information) Eriksen Construction Company, Inc. 2546 South Hwy 30 Blair, Nebraska 68008 -0610 for the following Project: (Name, location and detailed description) City of Blair Hail Damage Emergency Package Location 429 — Various Locations / Tornado Sirens Items included in the work: AS DESCRIBED IN ADDENDUM NO. 1 REVISED BID PROPOSAL NO. 10 The Architect: (Name, legal status, address and other information) HGM Associates Inc. 640 Fifth Avenue Council Bluffs, Iowa ' 51501 -6427 Telephone Number: 712 - 323 -0.530 Fax Number: 712 -323 -0779 The Owner and Contractor agree as follows. The author of this document has added information needed for its completion. The author may also have revised the text of the original AIA standard form. An Additions and Deletions Report that notes added information as well as revisions to the standard form text is available from the author and should be reviewed. A vertical line in the left margin of this document indicates where the author has added necessary information and where the author has added to or deleted from the original AIA text. This document has important legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. AIA Document A201 Tm -2007, General Conditions of the Contract for Construction, is adopted in this document by reference. Do not use With other general conditions unless this document is modified. AIA Document A101 TM — 2007. Copyright ©1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991, 1997 and 2007 by The American [nit. Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the / maximum extent possible under the law. This document was produced byAIA software at 16:08:19 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. User Notes: (1634822995) TABLE OF ARTICLES THE CONTRACT DOCUMENTS THE WORK OF THIS CONTRACT DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION 4 CONTRACT SUM 5 PAYMENTS 6 DISPUTE RESOLUTION 7 TERMINATION' OR SUSPENSION 8 MISCELLANEOUS PROVISIONS 9 ENUMERATION OF CONTRACT DOCUMENTS 10 INSURANCE AND BONDS ARTICLE I THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement, Conditions of the Contract (General, Supplementary and other Conditions), Drawings, Specifications, Addenda issued prior to execution of this Agreement, other documents listed in this Agreement and Modifications issued after execution of this Agreement, all of which form the Contract, and are as fully a part of the Contract as if attached to this Agreement or repeated herein. The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations, representations or agreements, either written or oral. An enumeration of the Contract Documents, other than a Modification, appears in Article 9. ARTICLE 2 THE WORK OF THIS CONTRACT The Contractor shall fully execute the Work described in the Contract Documents, except as specifically indicated in the Contract Documents to be the responsibility of others. ARTICLE 3 DATE. OF COMMENCEMENT AND SUBSTANTIAL COMPLETION § 3.1 The date of commencement of the Work shall be the date of this Agreement unless a different date is stated below or provision is made for the date to be fixed in a notice to proceed issued by the Owner. (Insert the date of commencement if it differs from the date of this Agreement or, if applicable, state that the date will be fixed in a notice to proceed.) Not Applicable If, prior to the commencement of the Work, the Owner requires time to file mortgages and other security interests, the Owner's time requirement shall be as follows: Not Applicable § 3.2 The Contract Time shall be measured from the date of commencement. I § 3.3 The Contractor shall achieve Substantial Completion of the entire Work not later than Eighty ( 80 ) days from the date of commencement, or as follows: (Insert number of calendar days. Alternatively, a calendar date may be used when coordinated with the date of commencement. If appropriate, insert requirements for earlier Substantial Completion of certain portions of the Work.) AIA Document A101 TM — 2007. Copyright ©1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991, 1997 and 2007 by The American Init. Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized 2 reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the t maximum extent possible under the law. This document was produced by AIA software at 16:08:19 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. User Notes: (1634822995) Portion of Work Substantial Completion Date Substantial Completion of all work unless December 1, 2014 extended by approved change order subject to adjustments of this Contract Time as provided in the Contract Documents. (Insert provisions, if any, for liquidated damages relating to failure to achieve Substantial Completion on time or for bonus payments for early completion of the Work.) Not Applicable ARTICLE 4 CONTRACT SUM § .4.1 The Owner shall pay the Contractor the Contract Sum in current funds for the Contractor's performance of the Contract. The Contract Sum shall be Sixty Seven Thousand Nine Hundred Eighty ($67,980.00)), subject to additions and deductions. as provided in the Contract Documents. § '4.2 The Contract Sum is based upon the following alternates, if any, which are described in the Contract Documents and are hereby accepted by the 'Owner: (State the numbers, or other identification of accepted alternates. If the bidding or proposal documents permit the Owner to accept other alternates subsequent to the execution of this Agreement, attach a schedule of such other alternates showing the amount for each and the date when that amount expires) Not Applicable § 4.3 Unit prices, if any: (Identify and state the unit price; state quantity limitations, if any, to which the unit price will be applicable) Item Units and Limitations Price Per Unit ($0.00) Not Applicable § 4.4 Allowances included in the Contract Sum, if any: (Identify allowance and state exclusions, if any, from the allowance price) Item Price Not Applicable ARTICLE 5 PAYMENTS , § 5.1 PROGRESS PAYMENTS § 5.1.1 Based upon Applications for Payment submitted to the Architect by the Contractor and Certificates for Payment issued by the Architect, the Owner shall make progress payments on account of the Contract Sum to the Contractor as provided below and elsewhere in the Contract Documents. § 5.1.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month, or as follows: Provided that an Application for Payment is received by the Architect no later than a week prior to the last working day of the month, the Owner will make payment of the certified amount to the Contractor which will be ready by the Wednesday following the second Tuesday of the month. Blair City Council only approves claims at their first meeting each month. § 5.1.3 If an Application for Payment is received by the Architect after the application date fixed above, payment shall be made by the Owner not later than Forth Five ( 45 ) days after the Architect receives the Application for Payment. (Federal, state or local laws may require payment within a certain period of time.) Init. AIA Document A101 TM —2007. Copyright ©1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991, 1997 and 2007 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized 3 reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the t maximum extent possible under the law. This document was produced by AIA software at 16:08:19 on 09/17/2014 under Order No.4669103762_1 which expires on 07/1612015, and is not for resale. User Notes: (1634822995) § 5.1.4 Each Application for Payment shall be based on the most recent schedule of values submitted by the Contractor in accordance with the Contract Documents. The schedule of values shall allocate the entire Contract Sum among the various portions of the Work. The schedule of values shall be prepared in such form and supported by such data to substantiate its accuracy as the Architect may require. This schedule, unless objected to by the Architect, shall be used as a basis for reviewing the Contractor's Applications for Payment. § 5.1.5 Applications for Payment shall show the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. § 5.1.6 Subject to other provisions of the Contract Documents, the amount of each progress payment shall be computed as follows: .1 Take that portion of the Contract Sum properly allocable to completed Work as determined by multiplying the percentage completion of each portion of the Work by the share of the Contract Sum allocated to that portion of the Work in the schedule of values, less retainage of Five percent ( 5 %). Pending final determination of cost to the Owner of changes in the Work, amounts not in dispute shall be included as provided in Section 7.3.9 of AIA Document A201TM -2007, General Conditions of the Contract for Construction; .2 Add that portion of the Contract Sum properly allocable to materials and equipment delivered and suitably stored of the site for subsequent incorporation in the completed construction (or, if approved in advance by the Owner, suitably stored off the site at a location agreed upon in writing), less retainage of Five percent ( 5 %); .3 Subtract the aggregate of previous payments made by the Owner; and .4 Subtract amounts, if any, for which the Architect has withheld or nullified a Certificate for Payment as provided in Section 9.5 of AIA Document A201-2007. § 5.1.7 The progress payment amount determined in accordance with Section 5.1.6 shall be further modified under the following circumstances: .1 Add, upon Substantial Completion of the Work, a sum sufficient to increase the total payments to the full amount of the Contract Sum, less such amounts as the Architect shall determine for incomplete Work, retainage applicable to such work and unsettled claims; and (Section 9.8.5 ofAL4 Document A201 2007 requires release of applicable retainage upon Substantial Completion of Work - with consent of surety, if any) 2 Add, iffinal completion of the Work is thereafter materially delayed through no fault of the Contractor, any additional amounts payable in accordance with Section 9.10.3 of AIA Document A201 -2007. § 5.1.8 Reduction or limitation of retainage, if any, shall be as follows: (If it is intended, prior to Substantial Completion of the entire Work, to reduce or limit the retainage resulting from the percentages inserted in Sections 5.1.6.1 and 5.1.6.2 above, and this is not explained elsewhere in the Contract Documents, insert here provisions for such reduction or limitation.) NONE § 5.1.9 Except with the Owner's prior approval, the Contractor shall not make advance payments to suppliers for materials or equipment which have not been delivered and stored at the site. § 5.2 FINAL PAYMENT § 5.2.1 Final payment, constituting the entire unpaid balance of the Contract Sum, shall be made by the Owner to the Contractor when .1 the Contractor has fully performed the Contract except for the Contractor's responsibility to correct Work as provided in Section 12.2.2 of AIA Document A201 2007, and to satisfy other requirements, if any, which extend beyond final payment; and .2 a final Certificate for Payment has been issued by the Architect. Init. AIA Document A101 Tm — 2007. Copyright ©1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991, 1997 and 2007 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized 4 reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the t maximum extent possible under the law. This documentwas produced byAIA software at 16:08:19 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. User Notes: (1634822995) § 5.2.2 The Owner's final payment to the Contractor shall be made no later than 30 days after the issuance of the Architect's final Certificate for Payment, or as follows: Not Applicable ARTICLE 6 DISPUTE RESOLUTION § 6.1 INITIAL DECISION MAKER The Architect will serve as Initial Decision Maker pursuant to Section 15.2 of AIA Document A201 2007, unless the parties appoint below another individual, not a party to this Agreement, to serve as Initial Decision Maker. (If the parties mutually agree, insert the name, address and other contact information of the Initial Decision Maker, if other than the Architect.); § 6.2 BINDING DISPUTE RESOLUTION For any Claim subject to, but not resolved by, mediation pursuant to Section 15.3 of AIA Document A201 2007, the method of binding dispute resolution shall be as follows: (Check the appropriate box. if the Owner and Contractor do not select a method of binding dispute resolution below, or do not subsequently agree in writing to a binding dispute resolution method other than litigation, Claims will be resolved by litigation in a court of competent jurisdiction) [ X ] Arbitration pursuant to Section 15.4 of AIA Document A201-2007 [ ] Litigation in a court of competent jurisdiction [ ] Other (Spec6) ARTICLE '7 TERMINATION OR SUSPENSION § 7.1 The Contract may be terminated by the Owner or the Contractor as provided in Article 14 of AIA Document A2 § 7.2 The Work may be suspended by the Owner as provided in Article 14 of AIA Document A201 -2007. ARTICLE 8 MISCELLANEOUS PROVISIONS § 8.1 Where reference is made in this, Agreement to a provision of AIA Document A201-2007 or another Contract Document, the reference refers to that provision as amended or supplemented by other provisions of the Contract Documents. ` § 8.2 Payments due and unpaid under the Contract shall bear interest from the date payment is due at the rate stated below, or in the absence thereof, atthe legal rate prevailing from time to time at the place where the Project is located. (Insert rate of interest agreed upon, if any) 0 % § 8.3 The Owner's representative: (Name, address and other information) Al Shoemaker City of Blair 218 So. 16th Blair, Nebraska 68008 Init. AIA Document A101 Tm —2007. Copyright ©1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977,1987, 1991, 1997 and 2007 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized 5 reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible underthe law. This document was produced by AIA software at 16:08:19 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. User Notes: (1634822995) i § 8.4 The Contractor's representative: (Name, address and other information) Eriksen Construction Company, Inc. 2546 South Hwy 30 Blair, Nebraska 68008 -0610 § 8.5 Neither the Owner's nor the Contractor's representative shall be changed without ten days written notice to the other party. § 8.6 Other provisions: NONE ARTICLE 9 ENUMERATION OF CONTRACT DOCUMENTS § 9.1 The Contract Documents, except for Modifications issued after execution of this Agreement, are enumerated in the sections below. § 9.1.1 The Agreement is this executed AIA Document A101 2007, Standard Form of Agreement Between Owner and Contractor. § 91.2 The General Conditions are AIA Document A201 2007, General Conditions of the Contract for Construction. § 9.1.3 The Supplementary and other Conditions of the Contract: Document Title Date Pages I All Sections Volumes 1 and 2 August, 2014 Inclusive Project Manual for Hail Damage Emergency Package, City of Blair, Nebraska § 9.1.4 The Specifications: (Either list the Specifications here or refer to an exhibit attached to this Agreement.) Section Title Date Pages All Sections Volumes 1 and 2 August, 2014 Inclusive Project Manual for Hail Damage Emergency Package, City of Blair, Nebraska § 9.1.5 The Drawings: (Either list the Drawings here or refer to an exhibit attached to this Agreement.) Number ADD. NO. 1 REVISED BID PROPOSAL NO. 10 Title Date Volume 2 August, 2014 Project Manual for Hail Damage Emergency Package, City of Blair, Nebraska § 9.1.6 The Addenda, if any: Number Addendum No. 1 Addendum No. 2 Date Pages September 12, 2014 52 September 15, 2014 1 Init. AIA Document Al 01 TM — 2007. Copyright ©1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991, 1997 and 2007 by The American Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties, Unauthorized 6 reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the t maximum extent possible under the law. This document was produced byAIA software at 16:08:19 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. User Notes: (1634822995) Portions of Addenda relating to bidding requirements are not part of the Contract Documents unless the bidding requirements are also enumerated in this Article 9. § 9.1.7 Additional documents, if any, forming part of the Contract Documents: .1 AIA Document E201TM 2007, Digital Data Protocol Exhibit, if completed by the parties, or the following: Not Applicable .2 Other documents, if any, listed below: (List here any additional documents that are intended to form part of the Contract Documents. ALA DocumentA201 2007 provides that bidding requirements such as advertisement or invitation to bid, Instructions to Bidders, sample forms and the Contractor's bid are not part of the Contract Documents unless enumerated in this Agreement. They should be listed here only if intended to be part of the Contract Documents.) Not Applicable ARTICLE 10 INSURANCE AND BONDS The Contractor shall purchase and maintain insurance and provide bonds as set forth in Article 11 of AIA Document A201 2007. (State bonding requirements, if any, and limits of liability for insurance required in Article 11 ofALA Document A201 2007.) Type of insurance or bond Limit of liability or bond amount ($0.00) I Performance Bond 100% Payment Bond 100% 1h1: City (Prin eement entered into as of the day, and year first written above. ve- ignature) CONTRA CTOR (Signature) Blair, Nebraska Eriksen Construction Company, Inc. i name and title) (Printed name and title) es +i f ho V I 7P rts,-j tA+ AIA Document A101" — 2007. Copyright ©1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991, 1997 and 2007 by The American Init. Institute of Architects. All rights reserved. WARNING: This AIA Document is protected by U.S. Copyright Law and International Treaties. Unauthorized 7 reproduction or distribution of this AIA Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA software at 16:08:19 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. User Notes: (1634822995) TM D ocu me nt Perforinote Bond No. 106119616 CONTRACTOR: SURETY: (Name, legal.status and address) (Nance, legal statrrs and principal_place Eriksen Construction Co., Inc. of business) P.O. Box 610 Travelers Casualty and Surety Company Blair, NE 68008 of America OWNER. (Name, legal siams. and address). The City of Blair 218 S. 16th Blair, NE 68008 CONSTRUCTION CONTRACT Date: One Tower Square Hartford, CT 06183 Amount: $67,980.00 Descrilstion:. (Wglne an4locatioif) City of Blair Hail Damage Emergency Package Location #29 - Various Locations /Tornado Sirens BOND Date: September 23, 2014 (Not earlier than Construction Contract Date) Ahlount: $67,980.00 Modifications to this Bored: M Noise 0 See Section 16 CONTRACTOR AS PRINCIPAL Conili "arty: (Corporate Seal) Eriksen Construction Co., ILDC. Sggatw•e: Name Otof) i P'jorh ho rS+ and'i~itle: V I Gem Dre51 dt 0+ (Ally additional:stgnatztres.appear on the la This docu.rrieit has importanttegal consequences. Consultation.with an attoiney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. AIA Document A3*z2010 combines two.separate bonds, a Performance Bond and a Payment Bond, into one form. This is not a single combined Performance and Payment Bond. SURETY Company: (Corporate Seal) Travelers C�sualty and Surety Comp of America Sig tore:C auSe J qu ne L. Drey and Title: Attorney -in -Fact vtpage of this Perform ance Bond) (POR IIVVORMATIOAf ONLY— iVame, address and telephone) AGENT or BROKER: OWNER'S REPRESENTATIVE: (Architect; Engineer 'or other Constructors Bonding, Inc. HGM Associates, Inc. 14010 FNB Pkwy, Suite 300 640 Fifth Avenue Omaha, NE 68154 Council Bluffs, IA 51501 AIA Document AMM — 2010: The American Institute of Architects, oet to unit. § $'Tile Contractor and Surety, jointly and severally hind thetnseives, their heirs, executors, administrators, successors and assigns to the Owner for the perdorinduce of the Construction Contract, which is incorporated herein by reference: § 2 If the Contractor performs. the Construction Contract, the Surety and the Contractor shall have no obligation tinder this Bond, except when applicable to participate in a confereiiee as p•ov d- d. n Section 3: § 3 If there is no Owner Default under the Construction Contract, the Surety's obligation under this Bond.shalI arise after ,'F the Owner first provides notice to the Contractor and tire. S rrety that the Owner is considering declaring A Contractor Default. Such notice shall indicate whether the Owner is requesting a conference among tire. Owner; Contractor and Surety to- discuss the Contractor's performance. If the Owner does not request a.conference, the Surety Wray, within five (5) business days after receipt of the Owner's notice, request such a conference. If the Surety timely requests a conference, the Owner shall attend. Unless the Owner agrees . otherwise; any conference requested tinder this Section 3 ] shall be held wrthiti ten (10) business days of tie Surety's receipt of the Owner's notice. If the Owner, the Contractor and the Surety agree, fire Contractor shall be: allowed . a reasonable time to perform the Construction Contract; but such an agreement shall not waive the. Owner's right, if any, subsequently to declare a Contracto Deault; .2 the f Owner declares a Contractor Default, terminates the Construction Contract and notifies the Surety; and .3 the ONyner'l as agreed to pay the Balance of the Contract Price in, accordance with the terms of the Construction Contract to the Surety or to a contractor selected to perform. the Constriction Contract. § 4 Failure on the part of the Owner to comply with the notice requirement in Section 3.1 shall not constitute a failure to comply with a condition precedent to the Surety's obi'i_gations, or release'tiie Surety front its obligations, except to the extent the. Surety demonstrates actual prejudice. § 5 Wien the Owner has satisfied the conditions of Section 3, the Surety shall promptly and at the Surety's expense take one of the following' § 5,1 Arrange for the Contractor, with the, consent of the Owner to per•forni and complete the Construction Contract; § 5.2lindertake to perform and complete the Construction Contract itself, through its agents or independent contractors; 5 5.3 Obtain bids or negotiated proposals from qualified contractors acceptable to the Owner for a contract for perforinatce and completion of the Construction Contract, arrange fora contract to be prepared for execution by the Owner and a contractor selected with the Owner's concturence, to lie secured with perforriratce addlayrnent bonds executed by a qualified surety equivalent to the Bonds issued on the Construed 11 Contract, and pay to the Owner the amount of damages as described in Sectioi 7 iii-excess of the Balance of the Contract Price incurred by the Owner as o result of the Contractor Default; or § 5.4 Waive its right to perform; and complete, arrange for completion; or obtain a new contractor and with.reasonable promptness under the circumstances: .1 After investigation, determine "the a tiountfor which it may be liable to the Owner and; as soon as practicable after the amount is deferririned, make payment to. the Owner; or .2 Deny liability in whole or in part and notify the Owner, citing the reasons for' denial; § 6 If..the, Surety does not ptoeeed as provided iii Section $with reasonable promptness, the Surety shall be deemed to be in default " this this Bond severs days after receipt.of an additional written notice from the Owner to the Surety demanding that the Surety perform its obligations under this Bond, and the Owner shall he entitled to enforce any reinedy available to the. Owner. If the Surety proceeds as in Section 5A, and the Owner refuses the payment or tiie Surety has denied liability, to whole or in part, without further notice the Owner shall be entitled to enforce any reinedy available to the Owner. ttiit. AIA Document A31:2'm — 2010. The American Institute of Architects. 7 If the Surety elects to act under Section 5.1, 5.2 or 5.3, therithe responsibilities of the Surety to the Owner shall not be greaten than those of the Contractor under the Construction Contract, and the responsibilities of the Owner to the Surety shalt not he greater than those of the Owner under the Construction Contract. Subject to the commitment by the Owner to pay the Balance of the Contract Price,.the Surety is obligated, without duplication, for .1 the responsibilities of the Contractor for correction of defective work and completion of the Construction Contract; .2 additional legal, design professional: and delay costs resulting front the Contractor's Default, and resulting from the actions or failure to act of the Surety under Section 5; and .3 liquidated m daages, of if no liquidated damages are specified lo tile. C6ni t notion Contract, actual damages caused by delayed performance or non - performance of the Contractor. §'8 If the Surety elects to act under Section 5.1, 5.3 or 5.4, the Surety's liability is limited to, the amount of this Bond. 9 The Surety shall not be liable to the Owiter or. others foe obligations of the; Contractor that are unrelated to the Construction Contract, and the Balance of the Contract Price shall not be reduced or set o on account . of any such unrelated obligations. No right of action shall accrue on this Bond to any person or entity y other than the Owner or its heirs, executors, administrators; successors and assigns. §.10 The hereby waives notice of any change, including changes of tune, to, the Construction Contract or to related subcontracts, purchase orders and other obligatioin. 11 Any proceeding, legal or equitable, under this Bond may be instituted in any court of competent jurisdiction in the location in which the work or part of the work is located and shall be instituted within two years after a declaration of Contractor Default.or within two years after the Contractor ceased working or within two years after the Surety refuses.or falls to perform its obligations under this Bond, whichever occurs first. If the provisions of this Paragraph are voidor prohibited iiy law, the ntinilnunt period of lint }tatlon available to sureties, as a defense in the jorisdietioit, of the suit shall be applicable. 12 Notice to the Surety, the Owner or the Contractor shall be mailed or delivered to.the address shown on the page on which.their signature appears. 13 When this Bond has been furnished 'to comply with a 'statutory or other legal requiremeit in the location where the construction was to be perforined, any provision in.this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein, When so furnished, the intent is that this Bond shall be construed as.a statutory bond and not as a common law bold. 14 Definitions. 14.1 Balance of the Contract Price. The total amount payable by the Owner to the Contractor under the Construction Contract after all proper: adjustments leave been made, including allowance to the Contractor of any amounts.received or to be received by the Owner in settlement of insurance or other claims for damages to which the Contractor is entitled, reduced by all valid and proper payments made to or on behalf of the Contractor under the Construction Contract. 14.2 Construction Contract. The.agreement between the Owner and Contractor identified on the cover page, including all Contract Documents and changes made to the agreement and the Contract Documents. § 14.3 Contractor Default. Failure of the Contractor, which has not been remedied or waived, to perforiu or otherwise to comply with.a material term of the Construct }ot Contract. § 14;4 Owner Default. Failure of the Owner, which has not been remedied or waived, to pay tie Contractor as lenuired under the Construction.Contract or to perform and complete or comply with the other material terms of the Construction Contract. § 14.5 Contract Documents. All the documents that comprise the agreement between the Owner and Contractor. § 15 If this Band is issued for au agreement between a Contractor and subcontractor, the terns Contractor in this Bond shall be deernedto be Subcontractor and the term Owner shall be deemed to be Contractor. Init. AIA Document A312 -fm i 2010. The American Institute of ko itects. § 16 Modifications to this bond Are as follows: (Space. is pr•ovtded heloti for aclditonal signalureg of added parties, other than those appearing on the cover page) CONTRACTOR AS PRINCIPAL SURETY Company:, (Corporate Seal) Company: (CoiporateSel) Signature: Name and Title:. Address Signature: Name Arid Title: Address CAutidNi You should sign an original AIA Contract Document, on which this text appears in RED. An original assures that changes will not be obscured. Init. AIA DocumentA312 - 2010: The American institute of Architects: 4 -fiTa 1A Document A312 - 2010 Payment Bond No. 106119616 CONTRACTOR: (Narrre legal status and address) Eriksen Construction Co., Inc. P.O. Box 610 Blair, NE 68008 OWNER: (blame, legal slams and address) The City of Blair 218 S. 16th Blair, NE 68008 CONSTRUCTION CONTRACT Dater Amount: $67,980.00 SURETY: (Aranfe, legal status and principal place of business) Travelers Casualty and Surety Company of America One Tower Square Hartford, CT 06183 Description: (1Van?e and loca(ion) City of Blair Hail Damage Emergency Package Location #29 - Various Locations /Tornado Sirens BOND Date; September 23, 2014 (Vol earlier than Construction Contract Date) Amount: $67,980.00 Modifications to this Bond: IN Nolte El See Section 1$ This document has important legal consequences. Gonsultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surely, Owner or other party shall be considered plural where applicable. AIA- Document AM 2010 combines two separate bonds, a Performance Bond and a Payment Bond, Into one form. This is not a single combined Performance 9nd ie. nt Bond. CONTRACTOR AS PRINCIPAL SURETY C6 1 P any (Corporate .Seal) Goinpar y: (Corporate Seal) Eriksen Construction Co., Inc. Travelers Casualty and Surety Confa y of America S 9natu . k A - k ) , ��. Signature: Name !1 { Fir prlt hors } Name Pcc 'ne L Drey and Title: U 1 ei✓ PrtsidQ, + and Title: y -in - Fact (Any additional sigrralit res appeal• on the last page of this Payment Bond) (FOR MFORAIAT10N ONLY— Arame, address and telephone) AGENT or BROKER: OWNER'S REPRESENTATIVE: (Architect, Lnguieer or other party) Constructors Bonding, Inc. HGM Associates, Inc. 14010 FNB Pkwy, Suite 300 640 Fifth Avenue Omaha, NE 68154 Council Bluffs, IA 51501 Init. AIA 06cum6nt A312W — 2010. The American institute of Architects, 061100 5 1 Tlie Con tcactorand Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns io tite Owner to pay for jailor; materials:and equipment furnished for use in the performance of the Construction Contract, which is incorporated Herein by reference, subject to the following terms. 2 If the Contractor promptly makes payment of all sums due to Claimants, and defends, indemnifies and holds l armless tiie Owiiti from claims demands, liens or suits by any person or entity seeking payniept for labor, materials or equipinetit.furnislred for• use in the performance of the Construction Contract then tiie Surety and the Contractor shall have no obligation under this Bond. § 3 If theme is no Owner Default under (fie Construction Contract the Surety's obligation to the Owner under this Bond shall arise after the Owner has pronptly notified the Contractor and the Surety (at the address described in Section 13) of claims, demands, liens or suits against the Owner or the Owner's property by any person or entity seeking payment for labor, materials or equipment fiitnislhed for use in the , performance of the Construction Contract and tendered defense of such claims, demands liens or shits to the Contractor and: the Surety... § 4 When the Owner has satisfied the conditions in Secdon.3, the Surety shall promptly and at the Surety's expense defend. ,indemnify and hoed harmless (lie Owner against a duly tendered claim, demand, lien or suit. § 5 The Surety's obligations to a Claimant under this Bond shall arise after the following: § 5.1- Claimants, who. do not have a direct contract with the Contractor, ,1 Have furnished a written notice of non - payment to the Contractor, stating with substantial accuracy the amount cl aimed ; and the nanie of the party to whom the materials were, or equipment.was, furnished or supplied or for whom the Tabor was done or performed, within ninety (90) days :after having last perforated labor or last furnished materials or equipment included in. the Claim, and .2 have sent a Claim to the Surety (at. tiie address described in Section 13), § 5:2 Claimants, 'who are employed by or have a direct contract with the Contractor, have sent a Claim to the Surety (at the address described in,Section 13). § 6 If a notice of:tion- payment required by Section 5.1 .1 is given by tie Owner to the- Contractor, that is sufficient to satisfy a Claunant's obligation to furbish a written notice of lion- payment unifier Section 5.1.1. § 7 When a Claimant has satisfied the conditions of Sections 5.1 or 5.2, whichever is applicable, the Surety shall promptly and at (lie Surety's expense take the following actions: § 7.1 Selid ati answer to the Clainiant, with a copy to the Owner, within sixty (60) days After receipt of the Claim, stating the amounts ihatAre undisputed and the basis for chal'leng'ing any amounts that are. disputed; and § 7.2 Pay or arrange for payment of any undisputed amounts. § 7.3 The Surety's failure to discharge its obligations under Section 7.1 or Section 7.2 shall -not be deemed to constitute a waiver of defenses the Surety or Contractor may have or acquire as to a Claiin except as to undisputed amounts for wl icli the Surety and Claimant haver ached agreement, If, However, the Surety fails to discharge its obligations under Section 7.f or Section 7.2, the Srtioety shall indemnify the. Clainiarit for tie reasonable attorney's fees the Claimant incurs thereafter to recover any sums found to be due and owing to the Claimant. § 8 The Surety's total obligation shall not exceed the amount of this Bond,.plus the amount of reasonable attorney's fees provided under Section 7:3, and the amount of this Bond shall be credited for any payments made ju good: faith by the Suety. 9 Amounts owed by the Owner to the Contractor under the Construction Contract shall be used for the performance of the Construction Contract, and to satisfy claims, if any, under any construction performance bond. By the - Contractor furnishing and the Owner accepting this Bond, they agree that all funds earned by the Contractor in the performance of the Construction Contract are dedicated to satisfy obligations of the Contractor and Surety under this Bond; subject to the Owner's priority to usethe funds for the completion of the -Vvork. AA Document AiWm - 20t0: The American Institute of Architects. Init. § 10 The Surety shall not be liable to the Owner, Claimants or others.for obligations of the Contractor that are unrelated to the Constructtion. Contract. The Owner shall not be liable for the payment of any costs. or expenses of any Claim, ant under this Borid, .and shall have under this Bond no obligation to make payments to, or give notice on behalf of, Claimants or otherwise. have any obligations to Claimants under this Bond. 11 The Surety hereby waives notice of any change, including changes of tune, to the Construction Contract or to related subcontracts, purchase orders and other obligations. § 12 No suit or action shall be commenced by a Claimant under this Bond ottner than un a courtofcompetent jurisdiction in the state in which the project that isalie. subject of the Construction Contract is located or after the expiration of one year from the. date (1) on which the Claimant sent a Claim to the Suety l urs „uant to Section:5.1,2 or 5.2, or:(2),on .which the last labor or service was performed by anyone or the last materials or equipment were this Paragraph are furnisled. by anyone under• the Construction Contract, whichever of (1) or {2) first occurs, if the provisions of void or prohibited b y law the nifi innun period of lion tatiori Rvailable to sureties as a defense in the jurisdiction of the suit shalt .be applicable. § 13 Notice and Claims to the Surety, the Owner or the Contractor shall be mailed or delivered to the address shown on the page on which, their signattue appears. Actual receipt of notice or Clams, however aceomplished, shall be sufficient compliance as of the date received.. § 14 When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction was to be perfgrnted, any provision in this: Bond conflicting with said statutory or legal requiremen shall be deemed med deleted hereonz and pr fiovisions conforming to such statutory . r other - at ,be deemed incorporated herein. When so furbished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. § 15 Upon request by any person.or• entity appearing to be a potential beneficiary of this Bond, the Contractor and Owner shall promptly fiirrish a copy of this Bond or shall permit a copy to be made. § 16 bofinition.s § 16.1 Claim.. A written statement by the Claimant including at a minimum: .1 the name of the Claimant .2 the name of the person for whom the labor was done, or materials or equipment furnished; ,3 a copy of-the agreement or purchase order pursuant to which labor, materials or equipment was furnisledfor use in the performance of the Construction. Contract; 4 a Brief description of the labor, materials or equipment furnished; .5 the date on which ttie Claimant last performed labor or last furnished material's or equipment for use in the performance of the Construction Contract; ,6 the total amount earned by the Claimant for .labor, materials or equipment: furnished: as of the date of the Claim; j the total amount of previous payments received by the Claimant; and .8 the total amount due and unpaid to the Claimant for labor, materials or equipment furnished as of the date of the Claim., § 16.2. Claimant, An individual or entity lfaving a direct contract with the Contractor or with a subcontractor of the Contractor to furnish labor, materials or. equipment for .usein the performance of the Construction Contract. The term Claimantalso includes any individual or entity that has rightfully asserted a claim under au applicable mechanic's. lien or similarstatute_against the real property upon whicli the. Proleot is located. The intent of this Bond sliall be to include without limitation in the teams "Tabor, materials of equiprirettt” that part of water, gas power, light, heat, oil, gasoline, telephone service or rental equipment used in the Construction Contract, arcliitectmal and engineering services required for performance of the work of the Contractor and the Contractor's subcontractors, and all other items for which a mechanic's Tien may be asserted in the jurisdiction where the labor, materials or equipment were furnished. § 16.3 Construction Contract. The agreement between the Owner and Contractor identified on the cover page including all Contract Documents and all changes madeto the agreement.and the Conttact.Docunnents, Init. AIA Document A312TM - 2010. The American Inttifute of Architects. 7 § 18.4 Owner Default. Failure of the Owner, which has not been remedied or waived to pay the Contractor as required under the Constriction Contract or to perform and complete or comply With the other material terms of the Construction Contract. § 16.5 Contract Documents. All the documents that comprise the agreement between the Owner and Contractor. §17 If this Bond is issued for an agreement between. a Contractor and subcontractor, the terns Contractor in this Bond shall be deemed to be Subcontractor and the terra Owner shall be deemed to be Contractor. 18 Modifications to this bond are as follows (Space is provided cfed beloi for additional signatures of gelded pai ties, other that; those appearing on the covet, page) CONTRACTOR AS PRINCIPAL SURETY Company; (C.otporaie Seal) Company: (Cotporate Seat) Signature; Signattim: Name an. d Title: Natne and Title: Address Address CAUTION; Yoq siould'sign on original AIA Contract Document; on which this toxt appears In RED. An original assuros that changes will not he obscured. Init. AIA Document A312 —2010. The American Institute of Architects. WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUTTHE RED BORDER POWER OF ATTORNEY Farmington Casualty Company Fidelity and Guaranty Insurance Company Fidelity and Guaranty Insurance Underwriters, Inc. St. Paul Fire and Marine Insurance Company St. Paul Guardian Insurance Company Attorney -In Fact No 226055 St. Paul Mercury Insurance Company Travelers Casualty and Surety Company Travelers Casualty and Surety Company of America United States Fidelity and Guaranty Company Certificate No 005975331 KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the laws of the State of Wisconsin (herein collectively called the "Companies "), and that the Companies do hereby make, constitute and appoint Sharon K. Murray, David A. Dominiani, Maura P. Kelly, Joan Leu, Ronald R. Allison, Jacqueline L. Drey, and Kevin J. Stenger of the City of Omaha , State of Nebraska , their true and lawful Attorney(s) -in -Fact, each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their.) usiness of, guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or per{nEted m anyracY f TOns or- p3oceedings allowed by law. 4 ` 8th IN WITNESS WHEREOF, the Companies have caused this instrgment to be signed and thervorporate seals to be hereto affixed, this day of July 2014 X11 St. Paul Mercu Insurance Co Farmington Casualty Company 2 , Y P Y '' Travelers Casualty and Surety Company Fidelity and Guaranty:Insurancc,Gompauy�asy; Y Y P Y Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company St. Paul Guardian Insurance Company JP �'(Y AV, pASU,F �yJ•' ,�� tU• •y�. ��,- ...... pP .......... "0 5 G y�•� q q Q `V <CORPORAT'S ?• O•c 4 M1, �' Y° yi 2 oproq,�rj, v ` ° °wa°,, G n° °r� c > ��"� .'l. •. e 9 1896 l:poaeoRATF o= H FORD, ART < 5 HAR rA j e ~ X 19 8 2�' O 1977 WC(A9PgWTEO n _ X ' o ° CONN. n , CCNH. / g Wllp z o x i 1951 i�'•SEA)a ....... i o, '- o tSEAL:'aF '� Y "rvE J r �31 6 0cr " ..A- vr... .•:aD vb y a k 1 •.. v� � � ti� �f 1� v/ • H ��,�o a, Js . 7,Ny,; '+, ,Sy...... • r?,f bi �a � AtN� State of Connecticut City of Hartford ss. By: Robert L. Raney, enior Vice President On this the 8th day, of July 2014 , before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. 0 *) 4 In Witness Whereof, I hereunto set my hand and official seal. e My Commission expires the 30th day of June, 2016. Marie C. Tetreault, Notary Public 58440 -8 -12 Printed in U.S.A. OF BORDER This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof is filed in the office of the Secretary; and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary, of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and Unite&6S tes Fidelity Guaranty Company do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Compames,�which is in4611 force and has not been revoked. IN TESTIMONY WHEREOF, Ihave hereunto set my hand and affixed the seas of said4t)iuVanies this 23rd day of September 20 14 1 Kevin E. Hughes, Assistant Sec tary �5U Q,,'.•N FiftE 1 "; INSU P IlY A )", ty IXA \pWl A'YO 3� 4 G' ot u S :- iHL7epgpnp E A H4itTa A reiOl J 0, N. CON 1896 t ;oSElf?. D o o,, •.. 1�p S� �°awix'iianaese�' i 5�..�.a++ '•45...•«.. ha bl DtF �� To verify the authenticity of this Power of Attorney, call 1- 800 - 421 -3880 or contact us at www.travelersbond.com. Please refer to the Attorney -In -Fact number, the above -named individuals and the details of the bond to which the power is attached. WARNING: THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER ERIKS -1 OP ID: LO Ac ®R ®` CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 09/22/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marcotte Insurance Agency, Inc 11422 Miracle Hills Drive #100 CONTACT Lori Men8-9009 PHONE FAx 402- 398 -9009 ,c No , 402 - 398 -0917 EMAIL Imenichetti @marcotteins.com ADDRESS: Omaha, NE 68154.4420 Gregory Paulsen CPCU, ARM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Insurance 24775 A INSURED Eriksen Construction Co, Inc. Attn: Tim Shaw INSURERS: X DTC07331 PO90 04/01/2014 2546 S Hwy 30 INSURERC: 300 00 $ s INSURER D : CLAIMS -MADE FXI OCCUR Blair, NE 68008 -0610 INSURER E : INSURER F : MED EXP (Any one person) $ 5,00 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD I POLICY NUMBER POLICY EFF MMIDD POLICYEXP MMIDD /YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X X DTC07331 PO90 04/01/2014 04/01/2015 DAMAGE TO RENTED PREMISES Ea occurrence 300 00 $ s CLAIMS -MADE FXI OCCUR MED EXP (Any one person) $ 5,00 PERSONAL BADVINJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY -X] PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,00 0,00 0 BODILY INJURY (Per person) $ A X ANY AUTO DT8107331P090 04/0112014 04/01/2015 ALL OWNED SCHEDULED AUTOS AUTOS X HIREDAUTOS X AUTOS NED BODILY INJURY (Per accident) $ PERACCDI DAMAGE $ $ X UMBRELLA L1AB X OCCUR EACH OCCURRENCE $ 10,000,00 AGGREGATE $ 10,000,00 A EXCESS LIAB CLAIMS -MADE DTSMCUP7331PO90 04/01/2014 04/01/2015 DED I X I RETENTION$ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE /N OFFICER/MEMBER EXCLUDED? F_N1 (Mandatory in NH) N / A X DTNUB7331PO90 04101/2014 04/01/2015 WCSTATU OTH- X TORY LIMITS E E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE $ 500,00 If es, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 A Builders Risk QT6602882C871 04/01/2014 04/01/2015 Projects 6,000,00 Deduct 1,00 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Blair (Owner) and HGM Associates Inc (Engineer) are named as an additional insured on a primary & non contributory basis with respect to general liability for work performed under contract by the named insured on the following project: City of Blair Hail Damage Emergency Pckg -Loc #29 - Various Locations / Tornado Sirens. A waiver of subrogation in favor Lh3i111.i1y_1IP City of Blair 218 South 16th Blair, NE 68008 BLAIR01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD No 1 �� q f� ® HOLDER CODE BLAIR01 ERIKS -1 PAGE 2 INSURED'S NAME Eriksen Construction Co, Inc. OP ID: LO Date 09/22/2014 of the additional insureds applies to the General Liability and Workers ty applies to Employers Liability Limit