Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
McKinnis-Police
0 I �� TM l �A A DocumentA101 Standard Form of Agreement B etween Owner and Contractor where the basis of payment is a Stipulated Sum AGREEMENT made as of the Zq day of September in the year 2014 (In words, indicate day, month and year.) ADDITIONS AND DELETIONS: The author of this document has BETWEEN the Owner :: added information needed for its (Name, legal status, address and other information) completion. The author may also have revised the text of the original City of Blair AIA standard form. An Additions and 218 So. 16th 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. City of Blair Hail Damage Emergency Package Location #28 - Police Headquarters Items included in the work: Ac T)FRC.RTRF.n TN`ADDENDUM No. 1 REVISED BID PROPOSAL NO.9 The Owner and Contractor agree as follows. 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 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 documentwas produced byAIA software at 16:25:29 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. (1363892049) User Notes: TABLE OF ARTICLES 1 2.. 3 4: 5 6 7 TERMINATION 01 8 MISCELLANE( 9 ENUMERATIO1 ol A IRIQI IRAmr F ARTICLE 1 THE The Contract Docur Onnrlitinncl T)rnvAT j its to be DOCUMENTS DOCUMENTS : of this Agreement, Conditions of the Contract (General, Supplementary and other �tions, Addenda issued prior to execution of this Agreement, other documents listed ions issued after execution of this Agreement, all of which form the Contract, and are if attached to this Agreement or repeated herein. The Contract represents the entire n the parties hereto and supersedes prior negotiations, representations or agreements, ration of the Contract Documents, other than a Modification, appears in Article 9. THIS. CONTRACT ate the Work described in the Contract Documents, except as specifically indicated in he recnnnsibility 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 § 32 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 Forty -Five ( 45 ) 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.) THE CONTRACT DOCUMENTS THE WORK OF THIS CONTRACT DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION CONTRACT SUM PAYMENTS AIA Document All 01 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 byAIA software at 16:25:29 on 09/1712014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. (1363892049) User Notes: Portion of Work Substantial Completion Date I 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 § 41 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 Nine Thousand Three Hundred Fifty Dollars ($69,350.00 ), 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 an' d 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) Add °Wall Scupper EA $1,500.00 Remove and Replace Roof Sheathing LF $1.75 Remove and Replace Damaged Roof LF $3.95 Insulation § 4A 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) 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 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 maximum extent possible under the law. This document was produced byAIA software at 16:25:29 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. User Notes: (1363892049) § 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. § 51.5 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 at 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 .4 l § 5.1.7 The pro following circ ;ate of previous payments made by the Owner; and if any, for which the Architect has withheld or nullified a Certificate for Payment as n 9.5 of AIA Document A201-2007. avment amount determined in accordance with Section 5.1.6 shall be further modified under the .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. &5 6fAI4 Document A201-200 7 requires release of applicable retainage upon Substantial Completion of Work with consent of surety, if any) .2 Add, if final 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 5.1.62 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. § 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: Init. AIA Document A101TM' — 2007. Copyright ©1915, 1918, 1925, 1937, 1951, 1958, 1961, 1963, 1967, 1974, 1977, 1987, 1991, 1997 and 200/ oy i ne 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 document was produced byAIA software at 16:25:29 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. (1363892049) User Notes: 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 (Sped)_ 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 A201 -2007. he 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, at the 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 inform. ation) 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, 199t and zuut Dy i ne 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 under the law. This document was produced by AIA software at 16:25:29 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. (1363692049) User Notes: i § 8.4 The Contractor's representative: (Name, address and other information) McKinnis Roofing & Sheet Metal, Inc. 164 S. 1' Street, P.O. Box 37 Blair Nebraska 68008 § ,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 Al01 2007, Standard Form of Agreement Between Owner and Contractor. § 9.1.2 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 I Package, City of Blair, Nebraska § 9.1.4 The Specifications: (Either list the Speccations here or refer to an exhibit attached to this Agreement.) Section Title Date Pages I All Sections Volumes 1 and 2 August, 2014 Inclusive Project Manual for Hail Damage Emergency Package, City of Blair, Nebraska § 9.1.5 The Drawings: (Either list the Drawings here or refer to an exhibit attached to this Agreement.) Number Title Date ADD. NO. 1 REVISED BID PROPOSAL Volume 2 Project Manual August, 2014 NO. 9' for Hail Damage Emergency Package, City of Blair, Nebraska § 9.1.6' The Addenda, if any: Number Date Pages Addendum No. 1 September 12, 2014 52 Addendum No. 2 September 15, 2014 1 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 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 maximum extent possible under the law. This document was produced byAIA software at 16:25:29 on 09/17/2014 under Order No.4669103762_1 which expires on 07/16/2015, and is not for resale. (1363892049) User Notes: 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 E201TM2007, Digital Data Protocol Exhibit, if completed by the parties, or the following: Not Applicable .2 Other documents, if any, listed below: (List here arty additional documents that are intended to form part of the Contract Documents, AIA Document A201 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. LQtnta hn"dina ronviromavitc if anv and limits nfliahility fnr insurance reauired in Article 11 of AIA Document 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 Ale 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 documentwas produced by AIA software at 16:25:29 on 09/17/2014 under Order No.4669103762_1 which expires on 07/1612015, and is not for resale. User Notes: (1363892049) 0 CEDAR RAPIDS, IOWA (A Stock Company) PERFORMANCE BOND Approved by The American Institute of Architects, A.I.A. Document No. A -311 February 1970 Edition Bond No. 54- 202150 Know All By These Presents, that McKinnis Roofing & Sheet Metal, Inc., P.O. Box 37, Blair, NE 68008 (Here insert the name and address or legal title of the Contractor) as Principal, hereinafter called Contractor, and UNITED FIRE & CASUALTY COMPANY, a corporation organized under the laws of the State of Iowa, as Surety, hereinafter called Surety, are held and firmly bound unto The City of Blair, 218 S. 16 Blair, NE 68008 (Here insert the name and address or legal title of the Uwner) as Obligee, hereinafter called Owner, in the amount of Sixty -nine Thousand Three Hundred Fifty and 00 /100---------------- - - - - -- Dollars ($ 69,350.00 ), for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors and assigns jointly and severally, firmly by these presents. WHEREAS, Contractor has by written agreement dated entered into a contract with Owner for City of Blair Hail Damage Emergency Package — Location #28 — Police accordance with drawings and specifications prepared by in HGM Associates, Inc., 640 Fifth Avenue, Council Bluffs, IA 51501 (Here insert full name, title and address) which contract is by reference made a part hereof, and is hereinafter referred to as the Contract. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if Contractor shall promptly and faithfully perform said contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect. The Surety hereby waives notice of any alteration or extension of time made by the Owner. Whenever Contractor shall be, and declared by Owner to be in default under the Contract, the Owner having performed Owner's obligations thereunder, the Surety may promptly remedy the default, or shall promptly 1) Complete the Contract in accordance with its terms and conditions, or 2) Obtain a bid or bids for completing the Contract in accordance with its terms and conditions, and upon determination by Surety of the lowest responsible bidder, or, if the Owner elects, upon determination by the Owner and the Surety jointly of the lowest responsible bidder, arrange Signed and sealed this In the presence of: Witness for a contract between such bidder and Owner, and make available as work progresses (even though there should be a default or a succession of defaults under the contract or contracts of completion at under this paragraph) sufficient funds to pay the cost of completion less the balance of the contract price; but not exceeding, including other costs and damages for which the Surety may be liable hereunder, the amount set forth in the first paragraph hereof. The term "balance of the contract price," as used in this paragraph, shall mean the total amount payable to the Owner to Contractor under the Contract and any amendments, thereto, less the amount properly paid by Owner to Contractor. Any suit under this bond must be instituted before the expiration of two (2) years from the date on which final payment under the contract falls due. No right of action shall accrue on this bond to or for the use of any person or corporation other than the Owner named herein or the heirs, executors, administrators or successors of Owner. 19th day of September A.D. 2014 itndss f UND -2090b (5 -91) McKinn' ofing & Sheet et 1, Inc. (Seal) By United Fire & asualty Company (Seal) ttorney -in -Fact • CEDAR RAPIDS, IOWA (A Stock Company) LABOR AND MATERIAL PAYMENT BOND Approved by The American Institute of Architects Bond No. 54- 202150 THIS BOND IS ISSUED SIMULTANEOUSLY WITH PERFORMANCE BOND IN FAVOR OF THE OWNER CONDITIONED ON THE FULL AND FAITHFUL PERFORMANCE OF THE CONTRACT AIA DOC. A311 FEB. 1970 ED. Know All By These Presents: That McKinnis Roofing & Sheet Metal, Inc., P.O. Box 37, Blair, NE 68008 , (Here insert the name and address or legal title of the Contractor) as Principal, hereinafter called Principal, and UNITED FIRE & CASUALTY COMPANY, a corporation organized under the laws of the State of Iowa, as Surety, hereinafter called Surety, are held and firmly bound unto The City of Blair 218 S. 16 ", Blair, NE 68008 (Here insert the name and address or legal title of Owner) as Obligee, hereinafter called Owner, for the use and benefit of claimants as hereinbelow defined, in the amount of Sixty -nine Thousand Three Hundred Fifty and 00/ 100----------------------------------- --- ---- --- ----- Dollars ($ 69,350.00 ) for the payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, Principal has by written agreement dated entered into a contract with Owner for City of Blair Hail Damage Emergency Package — Location 428 - Police Headquarters in accordance with drawings and specifications prepared by HGM Associates, Inc., 640 Fifth Avenue, Council Bluffs, IA 51501 (Here insert full name, title and address) which contract is by reference made a part hereof, and is hereinafter referred to as the Contract. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION, is such that if the Principal shall promptly make payment to all claimants as hereinafter defined, for all labor and material used or reasonably required for use in the performance of the Contract, then this obligation shall be void; otherwise it shall remain in full force and effect, subject, however, to the following conditions: 1. A claimant is defined as one having a direct contract with the Principal or with a subcontractor of the Principal for labor, material, or both, used or reasonably required for use in the performance of the contract, labor and material being UND -2091b (11 -90) construed to include that part of water, gas, power, light, heat, oil, gasoline, telephone service or rental of equipment directly applicable to the Contract. 2. The above named Principal and Surety hereby jointly and severally agree with the Owner that every claimant as herein defined, who has not been paid in full before the expiration of a period of ninety (90) days after the date on which the last of such claimant's work or labor was done or performed, or materials were furnished by such claimant, may sue on this bond for the use of such claimant, prosecute the suit to final judgment for such sum or sums as may be justly due claimant, and have execution thereon. The Owner shall not be liable for the payment of any costs or expenses of any such suit. 3. No suit or action shall be commenced hereunder by any claimant, (a) Unless claimant, other than one having a direct contract with the Principal, shall have given written notice to any two of the following: The Principal, the Owner, or the Surety above named, within ninety (90) days after such claimant did or performed the last of the work or labor, or furnished the last of the materials for which said claim is made, stating with substantial accuracy the amount claimed and the name of the party to whom the materials were furnished, or for whom the work or labor was done or performed. Such notice shall be served by mailing the same by registered mail or certified mail, postage prepaid, in an envelope addressed to the Principal, Owner or Surety, at any place where an office regularly maintained for the transaction of business, or served in any manner in which legal process may be served in the state of which the aforesaid project is located, save that such service need not be made by a public officer. (b) After the expiration of one (1) year following the date on which Principal ceased work on said Contract, it being understood, however, that if any limitation embodied in this bond is prohibited by any law controlling the construction hereof such limitation shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by such law. (c) Other than in a state court of competent jurisdiction in and for the county or other political subdivision of the state in which the project, or any part thereof, is situated, or in the United States District Court for the district in which the project, or any part thereof, is situated, and not elsewhere. 4. The amount of this bond shall be reduced by and to the extent of any payment or payments made in good faith hereunder, inclusive of the payment by Surety of mechanics' liens which may be filed of record against said improvement, whether or not claim for the amount of such lien be presented under and against this bond. Signed and sealed this 19th day of September A.D. 2014 McKinnis Roofing & Sheet Metal, Inc. (Seal) (Princi a By/ (title) In the presence o£ C�U�_Aw 0 (Witness) United Fire & Casualty Company By (Attorney -in -Fact) UNITED F UNITED F FMANCD (origi DOMINT;A'NI ;. 0R MAU12 :OMPAN' , CEDAR RAl?IIlS IA Inquiries . Surety Department COMPANY, GAINIF, TON, 118 Second s e SE NICE COMPANY; ROCIN, CA Cedar Rapids, IA 524U1 J:POWR.Cyp ATTORNEY ice of Company - See Certification) Ai L Q1` : UIVIAHA Nk i V3. VL111 L11.' 1 "LLW W �...L1U V1 - 'lLl 1 v.+Vlv11 L'lly 1 � Vl'�11 LL 111W W 11vLLlv11 v111 �vivil 1Y "Article VI — Surety Bonds and Undertakings" ACCOR" I I I ILIT IN U D ATE 09 /18 /DD/Y 09/18/2014 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 1- 866 - 220 -4625 Holmes Murphy and Associates - Omaha CONTACT NAME: PHONE FAX A/C No Ext : (AIC, No): E -MAIL ADDRESS: 2637 South 158th Plaza Suite 200 Omaha, NE 68130 INSURERS AFFORDING COVERAGE NAIC # INSURERA: EMPLOYERS MUTUAL CASUALTY COMPANY 21415 03 /01 /15 INSURED INSURER B: Mc&innis Roofing & Sheet Metal Inc. INSURERC: INSURER D: 164 S. 1st St. INSURER E: $ 100,000 Blair, NE 68008 $ 3.0,000 CLAIMS -MADE F-i-I OCCUR INSURER F: COVERAGES CERTIFICATE NUMBER: 41480292 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 SUBR POLICY NUMBER POLICY EFF MM /DDNYYY POLICY E MM /DD/YY W LIMITS • GENERAL LIABILITY 3D67857 05 /01 /1 03 /01 /15 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 3.0,000 CLAIMS -MADE F-i-I OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2.000,000 $ ] SECT POLICY X PRO- X LOC • AUTOMOBILE LIABILITY 31367857 05/01/14 05/01/15 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ • X UMBRELLA LIAB X OCCUR 3J67857 05/01/1 05/01/15 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 10, 000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER /MEMBER EXCLUDED? (Mandatory in NH) NIA 3H67857 05/01/1 05/01/15 X TORSL OT ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Any and All Projects City of Blair is an Additional Insured on the General Liability, if required by contract, with respect to the Operation of the Named Insured. 60 day notice of cancellation except for non - payment GtK I II-1;A I E FIULUEIZ UANUrLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Blair THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 218 So. 16th St. AUTHORIZED REPRESENTATIVE Blair, NE 68008 i USA ACORD 25 (2010/05) kworkmanne 41480292 ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD