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HomeMy WebLinkAbout2023-194 PO 20240191- J B Steel Holding Co. LLC IOWA. , 111 Purchase Order ,a CITY RECORDER Fiscal Year 2024 Page: 1 of: 1 :THIS PONUMBERMUSTAPPEAR=ON ALL.=--_ INVOFCES_ AND-;AND DUMENTS B City of Ashland - -'.- -'-'--------JT---------:'= _-- I ATTN: Accounts Payable L 20 E. Main PurchaseL 20240191 Ashland, OR 97520 Order# T Phone: 541/552-2010 O Email: payable@ashland.or.us V H C/O Public Works Department EJ B STEEL HOLDING COMPANY, LLC I 51 Winburn Way N PO BOX 4460 p Ashland, OR 97520 O MEDFORD, OR 97501 Phone: 541/488-5347 R T Fax: 541/488-6006 O Veit of Phone Num-ber Vendor-Fax Number BequisifionNum6er =___ Dehvery'Refererrce Scott Fleury Date Ordered_ Vendor Number =Date R equ►red= _= Frelifiti lefhod/Terms- _ PDeparfinenf/Locafion = = __ 11/08/2023 8147 FOB ASHLAND OR/NET30 City Accounts Payable Item#_i- == 07-e ptfor/Par N1a _ ._5 - _=_= TW: zoom_ UrntRr ce __Exten_ded Prlce Assessment of Talent BPS 1 Assessment of Talent PBS 1.0 $1,787.00 $1,787.00 Personal Services Agreement(Less than $35,000) Completion date: 06/30/2024 Project Account: E-202113-999 *************** GL SUMMARY*************** 081800-704200 V $1,787.00 / • • • By: Date: 11 `- I '� —_--- Authorl SignatureRO T ita1= _—_ $1,787.00 e---Cf. FORM #3 vel CITY of A request fora Purchase rir eir ASHLAND REQUISITION 7- # '"�0 (g r Date of request: 11/07/2023 Required date for delivery: Vendor Name JB Steel Address,City,State,Zip PO BOX 4460 Medford,OR 97501 Contact Name&Telephone Number Marla Hassell Email address SOURCING METHOD ❑ Exempt from Competitive Bidding 0 Invitation to Bid 0 Emergency O Reason for exemption: Date approved by Council:_ 0 Form#13,Written findings and Authorization ❑ AMC 2.50 _(Attach copy of council communication) 0 Written quote or proposal attached ❑ Written quote or proposal attached _(If council approval required,attach copy of CC) ❑ Small Procurement 0 Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: 0 State of Oregon © Direct Award _(Attach copy of council communication) Contract# ❑ Verbal/Written bid(s)or proposal(s) 0 Request for Qualifications(Public Works) 0 State of Washington Date approved by Council: Contract# Attach col of council communication 0 Other government agency contract Intermediate Procurement 0 Sole Source Agency GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) Contract# Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written bids&solicitation attached ❑ Form#4,Personal Services$5K to$75K Agency PERSONAL SERVICES Date approved by Council: 0 Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 Valid until: _ _(Date) Agreement approved by Legal and approved/signed by ❑ Less than$35,000,by direct appointment 0 Special Procurement City Administrator.AMC 2.50.070(4) O (3)Written proposals&solicitation attached 0 Form#9,Request for Approval 0 Annual cost to City exceeds$25,000,Council O Form#4,Personal Services$5K to$75K 0 Written quote or proposal attached approval required.(Attach copy of council communication) Date approved by Council: Valid until:_ _ (Date) Description of SERVICES Assessment of Talent BPS TOTAL COST $ 1,78.7.00 Item # Quantity Unit Description of MATERIALS Unit Price Total Cost El Per attached quotelproposal TOTAL COST Project Number 2 0 2 1 1 3- b Account Number 0 8 1 8 0 0. 7 0 4 2 0 0 Account Number - Account Number - *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this equisition form,I certify that the City's public contracting requirements have been satisfied. NAe Employee: Department Head: _�4 11.7-2 t//* T al to: • eater than$5,000) Department Manager/Supervisor: City Manager: r -- -.-__ .• 35,000) Funds appropriated for current fiscal year: YES / Finance Director-(Equal to or greater than$5,000) Date Comments: Form#3-Requisition PERSONAL SERVICES AGREEMENT (LESS THAN $35,000) J.B. Steel, LLC CONSULTANT: J13 Steel Construction CITY OF CONTACT: Marla Hassell, Estimator ASH LAN D 20 East Main Street ADDRESS: PO Box 4460 Ashland, Oregon 97520 Medford, OR 97501 Telephone: 541/488-5587 Fax: 541/488-6006 TELEPHONE: 541-773-8325 EMAIL: marlah@jbsteelconstruction.com cc: Iaurie@jbsteelconstruction.com This Personal Services Agreement (hereinafter "Agreement") is entere to b a c b_etween the > . tell City of Ashland, an Oregon municipal corporation (hereinafter "City") and �tcc onstruction (a domestic) ("hereinafter"Consultant"), for assessment and report of the Talent Booster Pump Station. NOW THEREFORE, in consideration of the mutual covenants contained herein, the City and Consultant hereby agree as follows: 1. Effective Date and Duration: This Agreement shall become effective on the date of execution on behalf of the City, as set forth below (the "Effective Date"), and unless sooner terminated as specifically provided herein, shall terminate upon the City's affirmative acceptance of Consultant's Work as complete and Consultant's acceptance of the City's final payment therefore, but not later than June 30, 2024. 2. Scope of Work: Consultant will provide assessment and report of the Talent Booster Pump Station as more fully set forth in the Consultant's Proposal dated October 16, 2023, which is attached hereto as "Exhibit A" and incorporated herein by this reference. Consultant's services are collectively referred to herein as the "Work." 3. Supporting Documents/Exhibits; Conflicting Provisions: This Agreement and any exhibits or other supporting documents shall be construed to be mutually complementary and supplementary wherever possible. In the event of a conflict which cannot be so resolved, the provisions of this Agreement itself shall control over any conflicting provisions in any of the exhibits or supporting documents. 4. All Costs Borne by Consultant: Consultant shall, at its own risk, perform the Work described above and, unless otherwise specified in this Agreement, furnish all labor, equipment, and materials required for the proper performance of such Work. 5. Qualified Work: Consultant has represented, and by entering into this Agreement now J.B.Steel,LLC Page 1 of 8: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND JB STEEL CONSTRUCTION represents, that all personnel assigned to the Work to be performed under this Agreement are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are so registered, licensed and bonded. 6. Compensation: City shall pay Consultant the sum of$1,787.00 as full compensation for Consultant's performance of all Work under this Agreement. In no event shall Consultant's total of all compensation and reimbursement under this Agreement exceed the sum of$1,787.00 (one thousand seven hundred eighty-seven U.S. dollars) without the express, written approval from the City official whose signature appears below, or such official's successor in office. Payments shall be made within thirty (30) days of the date of receipt by the City of Consultant's invoice. Should this Agreement be terminated prior to completion of all Work, payments will be made for any phase of the Work completed and accepted as of the date of termination. 7. Ownership of Work/Documents: All Work, work product, or other documents produced in furtherance of this Agreement belong to the City, and any copyright,patent, trademark proprietary or any other protected intellectual property right shall vest in and is hereby assigned to the City. 8. Statutory Requirements: The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220, 279B.230 and 279B.235. 9. Living Wage Requirements: If the amount of this Agreement is $25,335.05 or more, Consultant is required to comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage, as defined in that chapter, to all employees performing Work under this Agreement and to any Subcontractor who performs 50% or more of the Work under this Agreement. Consultant is also required to post the notice attached hereto as "Exhibit B"predominantly in areas where it will be seen by all employees. 10. Indemnification: Consultant hereby agrees to defend, indemnify, save, and hold City, its officers, employees, and agents harmless from any and all losses, claims, actions, costs, expenses, judgments, or other damages resulting from injury to any person (including injury resulting in death), or damage (including loss or destruction)to property, of whatsoever nature arising out of or incident to the performance of this Agreement by Consultant(including but not limited to, Consultant's employees, agents, and others designated by Consultant to perform Work or services attendant to this Agreement). However, Consultant shall not be held responsible for any losses, expenses, actions, costs, or other damages, caused solely by the gross negligence of City. 11. Termination: a. Mutual Consent. This Agreement may be terminated at any time by the mutual consent of both parties. b. City's Convenience. This Agreement may be terminated by City at any time upon not less than thirty (30) days' prior written notice delivered by certified mail or in person. c. For Cause. City may terminate or modify this Agreement, in whole or in part, effective J.B.Steel, LLC Page 2 of 8: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND JB STEEL CONSTRUCTION upon delivery of written notice to Consultant, or at such later date as may be established by City under any of the following conditions: i. If City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way that the services are no longer allowable or appropriate for purchase under this Agreement or are no longer eligible for the funding proposed for payments authorized by this Agreement; or iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this Agreement is for any reason denied, revoked, suspended, or not renewed. d. For Default or Breach. i. Either City or Consultant may terminate this Agreement in the event of a breach of the Agreement by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and its intent to terminate. If the party committing the breach has not entirely cured the breach within fifteen (15) days of the date of the notice, or within such other period as the party giving the notice may authorize in writing, then the Agreement may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Consultant's performance of each and every obligation and duty under this Agreement. City, by written notice to Consultant of default or breach, may at any time terminate the whole or any part of this Agreement if Consultant fails to provide the Work called for by this Agreement within the time specified herein or within any extension thereof iii. The rights and remedies of City provided in this subsection(d) are not exclusive and are in addition to any other rights and remedies provided by law or under this Agreement. 12. Independent Contractor Status: Consultant is an independent contractor and not an employee of the City for any purpose. 13. Assignment: Consultant shall not assign this Agreement or subcontract any portion of the Work without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be void. 14. Default. The Consultant shall be in default of this Agreement if Consultant: commits any material breach or default of any covenant, warranty, certification, or obligation under the Agreement; institutes an action for relief in bankruptcy or has instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing business on a regular basis of the type identified in its obligations under the Agreement; or attempts to assign rights in, or delegate duties under, this Agreement. J.B.Steel,LLC Page 3 of 8: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND JB STEEL CONSTRUCTION 15. Insurance. Consultant shall, at its own expense, maintain the following insurance: a. Workers' Compensation. Consultant shall obtain and maintain Workers' Compensation insurance in compliance with ORS 656.017, which requires subject employers to provide Oregon Workers' Compensation coverage for its subject workers, unless such employers are exempt under ORS 656.126. If exempt under ORS 656.126, Consultant shall certify such exemption to the City. b. Professional Liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence. This is to cover any damages caused by error, omission or negligent acts related to the Work to be provided under this Agreement. c. General Liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury, Death, and Property Damage. d. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000 (one million dollars) for each accident for Bodily Injury and Property Damage, including coverage for owned, hired or non-owned vehicles, as applicable. e. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or intent not to renew the insurance coverage(s)without thirty (30) days' prior written notice from the Consultant or its insurer(s) to the City. f. Additional Insured/Certificates of Insurance. Consultant shall name the City of Ashland, Oregon, and its elected officials, officers and employees as Additional Insureds on any insurance policies, excluding Professional Liability and Workers' Compensation, required herein, but only with respect to Consultant's services to be provided under this Agreement. The consultant's insurance is primary and non-contributory. As evidence of the insurance coverages required by this Agreement, the Consultant shall furnish acceptable insurance certificates and endorsements prior to commencing the Work under this Agreement. 16. Nondiscrimination: Consultant agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership,national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of any Work under this Agreement when employed by Consultant. Consultant agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Consultant agrees not to discriminate against a disadvantaged business enterprise, minority-owned business, woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055, in awarding subcontracts as required by ORS 279A.110. 17. Consultant's Compliance With Tax Laws: 17.1 Consultant represents and warrants to the City that: 17.1.1 Consultant shall, throughout the term of this Agreement, including any extensions hereof, comply with: J.B.Steel,LLC Page 4 of 8: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND JB STEEL CONSTRUCTION (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS Chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Consultant; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 17.1.2 Consultant, for a period of no fewer than six (6) calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS Chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Consultant; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 18. Governing Law; Jurisdiction: This Agreement shall be governed and construed in accordance with the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to maintain an action under this Agreement in any other venue. 19. Notice. Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery,by sending via a reputable commercial overnight courier, by mailing using registered or certified United States mail,return receipt requested, postage prepaid, or by electronically confirmed at the address or facsimile number set forth below: If to the City: Public Works Department Attn: Jason Strait 20 East Main Street Ashland, Oregon 97520 Telephone: 541-488-5587 With a copy to: City of Ashland - Legal Department 20 East Main Street Ashland, Oregon 97520 Telephone: 541-488-5350 J.B.Steel,LLC Page 5 of 8: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND JB STEEL CONSTRUCTION If to Consultant: Attn: Marla Hassell JB Stccl Construction J.B. Steel, LLC PO Box 4460 Medford, OR 97501 20. Amendments. This Agreement may be amended only by written instrument executed by both parties with the same formalities as this Agreement. 21. THIS AGREEMENT AND THE ATTACHED EXHIBITS CONSTITUTE THE ENTIRE UNDERSTANDING BETWEEN THE PARTIES. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR REPRESENTATIONS, EITHER ORAL OR WRITTEN,NOT SPECIFIED HEREIN REGARDING THIS AGREEMENT. CONSULTANT, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT HE/SHE HAS READ THIS AGREEMENT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND CONDITIONS. 22. Certification. Consultant shall execute the certification attached hereto as "Exhibit C" and incorporated herein by this reference. IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. J.B. Steel, LLC CITY OF ASHLAND: (CONSULTANT : By: Adow BY `._ atu - ignature a6ct'- 0t- William Joseph Batzer Printed Name Printed Name V 3� w2� OtYt-�tatl Vice President Title Title �t • •27., November 2, 2023 Date Date D �o ' ?/ Purchase Order No. N/A (W-9 is to be submitted with this signed Agreement) J.B.Steel,LLC Page 6 of 8: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND JB STEEL CONSTRUCTION JB 45MEL ------- L Mwvb= • COMMERCIAL & INDUSTRIAL October 16, 2023 Attn:Shannon Emerick RH2 Engineering, Inc. 3553 Arrowhead Drive,Suite 200 Medford, OR 97504 semerick@rh2.com RE:Talent Booster Pump Station/Public Works Shop Assessment Shannon: J.B.Steel, LLC is pleased to provide our proposal for the assessment and report of the Talent Booster Pump Station/Public Works Shop at Google Earth coordinates 42.2497, -122.7836. Our proposal is based on an email from Shannon Emerick dated October 5, 2023. Our proposal includes the following scope of work: JB Steel (JBS) will assess the condition of the metal building at the above address. Our assessment will include the following: o General condition of the building. • o Visible issues of corrosion or damage to the coatings that will need repair. o Assessing if the building has reasonable supports, details, members, and connectors. o A report detailing what repairs or improvements should be completed. We value the above work at: ONE THOUSAND SEVEN HUNDRED EIGHTY-SEVEN DOLLARS($1,787.00). Price good for 30 days. Clarifications and Exclusions: 1. JBS is not liable for any concealed conditions on the site. 2. The report issued is a recommendation only and JBS does not take responsibility for the overall condition of the building. 3. Work to be performed on a mutually agreeable schedule. 4. Permits,governmental fees, system development charges (SDC), utility charges or fees of any kind are not included. 5. No Architecture or Engineering fees are included. 6. Prevailing Wage rates have been considered and is deemed not to be necessary as a salaried employee will be conducting the assessment. 7. Cost of special inspections and testing, if required, is by Owner. 8. Any scopes of work not specifically mentioned above are not included. Thank you for the opportunity to quote this project. We look forward to working with you. Sincerely, J.B.Steel, LLC I ' Marla Hassell Estimator Accepted by: Date: 23228 Talent Booster Pump Station Proposal Mil/lag I, I . • ;I. . • i ''I f, 1 • i;. l , I..• ' it .\a. ;I„tr h ,, i Lit i ;ry Qar • EXHIBIT B CITY OF ASHLAND, OREGON City of Ashland LIVING ALL employers desaibed WAG E below must comply with City of Ashland laws regulating payment of a living wage. $18.1.2 per hour, effective June 30, 2023. AlThe Living Wage is adjusted annually every June 30 by the Consumer Price Index. Employees must be paid a portion of the business of of health care,retirement living wage: their employer,if the 401K,and IRS eligible employer has ten or more cafeteria plans(including employees,and has received childcare)benefits to the For all hours worked under a financial assistance for the employee's amount of wages. service contract between their proje or business from the employer and the City of City of Ashland over i Note: For temporary and Ashland if the contract $25,335.05; part-time employees,the exceeds$25,335.05 or more. Living Wage does not apply If their employer is the City of to the first 1040 hours worked For a0 hours worked in a Ashland,including the Parks in any calendar year. For month,lithe employee and Recreation Department more details,please see spends 50%a more of the Ashland Municipal Code employee's time in that month In calculating the living wage, Section 3.92.020. working on a project or employers may add the value For additional information: Call the Ashland City Manager's office at 541-488-6002 or write to the City Manager, City Hall,20 East Main Street,Ashland,OR 97520,or visit the City's website at www.ashland.or.us. Notice to Employers: This notice must be posted in areas where it can be seen by all employees. CITY or ASHLAND J.B.Steel,LLC Page 7 of 8: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND JB STEEL CONSTRUCTION EXHIBIT C CERTIFICATIONS/REPRESENTATIONS: Consultant, by and through its authorized representative, under penalty of perjury, certifies that(a) the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and (b) Consultant is not subject to backup withholding because: (i) it is exempt from backup withholding, or(ii) it has not been notified by the Internal Revenue Service (IRS) that it is subject to backup withholding as a result of a failure to report all interest or dividends, or(iii) the IRS has notified it that it is no longer subject to backup withholding. Consultant further represents and warrants to City that: (a) it has the power and authority to enter into this Agreement and perform the Work, (b) the Agreement, when executed and delivered, shall be a valid and binding obligation of Consultant enforceable in accordance with its terms, (c) the work under the Agreement shall be performed in accordance with the highest professional standards, and (d) Consultant is qualified,professionally competent, and duly licensed (if applicable)to perform the Work. Consultant also certifies under penalty of perjury that its business is not in violation of any Oregon tax laws, it is an independent contractor as defined in the Agreement, it is authorized to do business in the State of Oregon, and Consultant has checked four or more of the following criteria that apply to its business. X (1) Consultant carries out the work or services at a location separate from a private residence or is in a specific portion of a private residence, set aside as the location of the business. X (2) Commercial advertising or business cards or a trade association membership are purchased for the business. X (3)Telephone listing is used for the business separate from the personal residence listing. X (4) Labor or services are performed only pursuant to written contracts. (5) Labor or services are performed for two or more different persons within a period of one year. (6) Consultant assumes financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, warranties, errors and omission (professional liability) insurance or liability insurance relating to the Work or services to be provided. k 1410 Co su ant's sig nature William J. Batzer, VP November 2, 2023 Date J.B.Steel.LLC Page 8 of 8: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND JB STEEL CONSTRUCTION ARPA/SLFRF Required Contract Clauses Purpose: The purpose of this reference is to assist ARPA grant award recipients by summarizing required contract clauses consistent with the federal Uniform Guidance requirements that are applicable to the State and Local Fiscal Recovery Funds (SLFRF) program as part of the American Rescue Plan Act(ARPA). As described in this document a"recipient"is a recipient of an APRA funded grant award from Business Oregon. The SLFRF awards are generally subject to the requirements set forth in the The Office of Management and Budget's (OMB)Uniform Administrative Requirements.Cost Principles. and Audit Requirements for Federal Awards (commonly called "Uniform Guidance"). The "Uniform Guidance"is the set of federal rules(administrative requirements, cost principles,and audit guidelines)that apply to federal money. This includes requirements such as the treatment of eligible uses of funds,procurement,and reporting requirements. Please see the SLFRF Compliance and Reporting Guidance page 12 for full Award terms and conditions. It is the recipient's responsibility to ensure all SLFRF award funds are used in compliance with these requirements. In addition,recipients should be mindful of any additional compliance obligations that may apply —for example, additional restrictions imposed upon other sources of funds used in conjunction with SLFRF award funds,or statutes and regulations that may independently apply to water and sewer infrastructure projects. Contract Clause Checklist Directions: Appendix II of 2 CFR 200 (The Uniform Guidance) outlines the contract provisions that you must place in contracts with your contractors,and in contracts with subrecipients (if any). The checklist below contains these standard clauses for inclusion in contracts needed to utilize ARPA funds. Clauses for All Contracts: Creating a contract that complies with ARPA requirements must include the below sections as verbatim: x❑ Contractor must be registered in SAM.gov. - The Contractor shall register in the System for Award Management(SAM),which is the primary registrant database for the U.S. Federal Government and shall update the information at least annually after the initial registration and maintain its status in the SAM through the Term of this Agreement. Information regarding the process to register in the SAM can be obtained at Sam.gov O Whistleblower- Contractor receiving ARPA funds shall under or through this contract post notice of the rights and remedies provided to whistleblowers under No Fear Act Pub. L. 107-174. 29 CFR § 1614.703 (d). ® Inspections;Information - Contractor shall permit,and cause its subcontractors to allow the State of Oregon,the federal government and any party designated by them to: • Examine,visit and inspect, at any and all reasonable times,the property,if any, constituting the Project. • Inspect and make copies of any accounts,books and records,including,without limitation,its records regarding receipts, disbursement,contracts, and any other matters relating to the Project, and to its financial standing, and shall supply such reports and information as reasonably requested. • Interview any officer or employee of the Contractor,or its subcontractors, regarding the Project. CI Equal Opportunity- Contractor shall comply with Executive Order 11246 of September 24, 1965,entitled "Equal Employment Opportunity,"as amended by Executive Order 11375 of October 13, 1967,and as supplemented in Department of Labor regulations (41 CFR chapter 60). Ex Copeland"Anti-Kickback"Act - Contractor shall comply with the Copeland"Anti- Kickback"Act (40 U.S.C. 3145),as supplemented by Department of Labor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States"). The Act provides that each contractor or subrecipient must be prohibited from inducing,by any means, any person employed in the construction, completion, or repair of public work,to give up any part of the compensation to which he or she is otherwise entitled. The non-Federal entity must report all suspected or reported violations to the Federal awarding agency. ❑x Debarment and Suspension(Executive Orders 12549 and 12689) - A contract award (see 2 CFR 180.220) must not be made to parties listed on the governmentwide exclusions in the System for Award Management(SAM),in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp.,p. 189) and 12689 (3 CFR part 1989 Comp.,p. 235), "Debarment and Suspension." SAM Exclusions contains the names of parties debarred, suspended,or otherwise excluded by agencies,as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. x❑ Prohibition on purchasing telecommunications or surveillance equipment, services,or systems.As required by 2 CFR 200.216,federal grant or loan recipients and subrecipients are prohibited from obligating or expending loan or grant funds to procure or obtain; extend or renew a contract to procure or obtain;or enter into a contract (or extend or renew a contract)to procure or obtain equipment, services, or systems that use covered telecommunications equipment,video surveillance services or services as a substantial or essential component of any system,or as critical technology as part of any system. As described in Public Law 115-232,section 889,covered telecommunications equipment is telecommunications equipment produced by Huawei Technologies Company or ZTE Corporation (or any subsidiary or affiliate of such entities). Prohibitions extend to the use of Federal funds by recipients and subrecipients to enter into a contract with an entity that"uses any equipment, system,or service that uses covered telecommunications equipment or services"as a substantial or essential component of any system,or as critical technology as part of any system. Certain equipment,systems, or services, including equipment, systems, or services produced or provided by entities subject to the prohibition are recorded in the System for Award Management exclusion list. El Preference to United States made goods. - As appropriate and to the extent consistent with law,the contractor should,to the greatest extent practicable under a Federal award, provide a preference for the purchase,acquisition, or use of goods,products, or materials produced in the United States (including but not limited to iron,aluminum, steel, cement, and other manufactured products). The requirements of this section must be included in all subawards including all contracts and purchase orders for work or products under this award. For purposes of this section: (1) "Produced in the United States"means,for iron and steel products,that all manufacturing processes,from the initial melting stage through the application of coatings,occurred in the United States. (2) "Manufactured products"means items and construction materials composed in whole or in part of non-ferrous metals such as aluminum;plastics and polymer-based products such as polyvinyl chloride pipe; aggregates such as concrete;glass,including optical fiber; and lumber. Additional Clauses for Contracts Over$10,000: Creating a contract over$10,000 that complies with ARPA requirements must include the additional below sections as verbatim: El Procurement of recovered materials over$10,000. - The Contractor must comply with section 6002 of the Solid Waste Disposal Act,as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247 that contain the highest percentage of recovered materials practicable,consistent with maintaining a satisfactory level of competition,where the purchase price of the item exceeds $10,000 or the value of the quantity acquired during the preceding fiscal year exceeded$10,000;procuring solid waste management services in a manner that maximizes energy and resource recovery;and establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. x❑ Termination for cause and for convenience - Contractor shall address termination for cause and for convenience,including the manner by which it will be affected and the basis for settlement. The Contract Owner shall have the option,in its sole discretion,to terminate this Agreement, at any time during the term hereof,for convenience and without cause. The Contract Owner shall exercise this option by giving Contractor written notice of termination. The notice shall specify the date on which termination shall become effective. Additional Clauses for Contracts Over$100,000: Creating a contract over $100,000 that complies with ARPA requirements must include the additional below section(s) as verbatim: ❑ Certification form located in Appendix I. Byrd Anti-Lobbying Amendment(31 U.S.C. 1352) - Contractors that apply or bid for an award exceeding$100,000 must file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract,grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the non-Federal award. ❑ Note:Only include for contracts that involve the employment of mechanics or laborers. The Contract Work Hours and Safety Standards Act requires all contractors— prime and sub—to pay laborers and mechanics performing on a federal service contract and federal and federally assisted construction contract over$100,000, 1.5 times their basic rate of pay for all hours worked over 40 in a workweek. Employers are liable to employees for these unpaid wages. The failure of a contractor to comply with this Act may also result in liability under the False Claims Act. Employees who are due unpaid wages under the Contract Work Hours and Safety Standards Act may file a complaint with the Wage and Hour Division within the U.S. Department of Labor. The DOL may then enforce the provisions of the Act against violators. Additional Clauses for Contracts Over$150,000: Creating a contract over$150.000 that complies with ARPA requirements must include the additional below section(s) as verbatim: El Contractor shall comply with all applicable standards,orders,or requirements issued under section 306 of the Clean Air Act (42 U.S.C. 1857(h)), section 508 of the Clean Water Act(33 U.S.C. 1368),Executive Order 11738,and Environmental Protection Agency regulations (40 CFR part 15). Additional Clauses for Contracts Over$250,000 (the simplified acquisition threshold as of 2022): Creating a contract over$250.000 that complies with ARPA requirements must include the additional below section(s) as verbatim: ❑ Contracts for more than the simplified acquisition threshold, which is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council(Councils) as authorized by 41 U.S.C. 1908,must address administrative, contractual, or legal remedies in instances where contractors violate or breach contract terms,and provide for such sanctions and penalties as appropriate. Upon any breach of this Agreement by Contractor,the Contract Owner shall have all remedies available to it both in equity and/or at law. Appendix I Certification Regarding Lobbying (Awards to Contractors and Subcontractors in Excess of $100,000) The undersigned certifies,to the best of his or her knowledge and belief,that: (1) No Federal appropriated funds have been paid or will be paid,by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement,and the extension,continuation,renewal, amendment,or modification of any Federal contract,grant,loan or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with this Federal contract, grant,loan,or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying,"in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants,loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352,title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less y,► •. i. .i i s 0 and not more than$100,000 for each such failure. Signed: /__ Date:_LL= 1)2__x?o DATE(MM/DD/YYYY) A j GP CERTIFICATE OF LIABILITY INSURANCE 11/3/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF'INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Anchor Insurance and Surety, Inc PHONE Taylor Kornell FAX PO Box 2808 (A/c.No.Ext);503-224-2500 (A/C,No):503-224-9830 Portland OR 97208 ADDRESS: certificates@anchorias.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Middlesex Insurance Company 23434 INSURED JBSTEEL-02 INSURER B:Indian Harbor Insurance Co. 36940 J.B.Steel, LLC PO Box 4460 INSURER C: Medford OR 97501 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:25042015 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y A0171498002 5/1/2023 5/1/2024 EACH OCCURRENCE $1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(Ea occu ence) $500,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY X JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: • $ __ A AUTOMOBILE LIABILITY A0171498001 5/1/2023 5/1/2024 COMBIaaccideNEDnt)SINGLELIMIT $1,000,000 (E X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) .- _ A UMBRELLA LIAB X OCCUR A0171498003 5/1/2023 5/1/2024 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$1n nnn $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-E4 EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-.POLICY LIMIT $ B Professional Liability PEC005902302 5/1/2023 5/1/2024 Each Claim 1,000,000 Pollution Aggregate limit 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Certificate holder and all other specified entities are additional insured when required by written contract.The following attached endorsements apply:Blanket additional insured endorsement CG 2010 04/13 Automatic Additional Insured,CG 2037 04/13 Completed Operations,CG 2001 04/13 Primary Non-contributory, CG 2503 Per Project Aggregate,CG 2404 Waiver of Subrogation Umbrella follows form General Liability,Auto Liability and Employers Liability(Stop Gap) All Operations of the Named Insured Subject to Policy Terms and Conditions CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland 20 E Main Street AUTHORIZED REPRESENTATIVE Ashland OR 97520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • POLICY NUMBER: A0171498001 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: J.B. Steel, LLC Endorsement Effective Date: 5/1/2023-5/1/2024 SCHEDULE Name(s) Of Person(s)Or Organization(s): Any person or organization you are required to add as an additional insured under a written contract or written agreement in effect prior to any loss or damage Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 A0171498 05/10/2023 Middlesex Insurance Company 1 00001 0000000000 23130 0 N 7d388126-dfba-4907-b518-0475b1cc1a31 POLICY NUMBER: A0171498001 COMMERCIAL AUTO CA 76 01 0615 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - PRIMARY AND NONCONTRIBUTORY - COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s)or organization(s)who are"insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated. Named Insured: J.B. Steel, LLC Endorsement Effective Date: 5/1/2023-5/1/2024 SCHEDULE Name Of Person(s) Or Organization(s): Any person or organization you are required to add as an additional insured under a written contract or written agreement in effect prior to any loss or damage Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Each person or organization shown in the B. Primary And Noncontributory Insurance Schedule is an "insured" for Covered Autos This insurance is primary to and will not seek Liability Coverage, but only to the extent that contribution from any other auto insurance issued person or organization qualifies as an "insured" to the person or organization in the schedule under the Who Is An Insured provision contained under your policy provided that: in: (1) Paragraph A.1. of Section II -Covered Autos (1) The person or organization is a Named Insured Liability Coverage in the Business Auto and under such other insurance; and Motor Carrier Coverage Forms; or (2) Prior to the "accident" you have agreed in (2) Paragraph D.2. of Section I - Covered Autos writing in a contract or agreement that this Coverages of the Auto Dealers Coverage insurance would be primary and would not seek contribution from any other insurance Form. available to the person or organization. CA 76 01 06 15 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 A0171498 with its permission. 05/10/2023 Middlesex Insurance Company 1 00001 0000000000 23130 0 N 52a5891b-33de-449e-9673-10c9c3a00232 A0171498002 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2)You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the This insurance is primary to and will not seek additional insured. contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 1 A0166924 02/12/2021 Middlesex 1 00001 0000000000 21043 0 N 58e54a4c-433a-40c0-90b44644b1c1f2ff POLICY NUMBER: A0171498002 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations Any person or organization you are required to add as Jobsites as described in written contracts with the an named insured. additional insured under a written contract or written Description: agreement in effect prior to any loss or damage All Operations with written contract with the named insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", This insurance does not apply to "bodily injury" or "property damage" or "personal and advertising "property damage" occurring after: injury"caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs)to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed; or However: 2. That portion of "your work" out of which the 1. The insurance afforded to such additional injury or damage arises has been put to its intended use by any person or organization insured only applies to the extent permitted by other than another contractor or law; and subcontractor engaged in performing 2. If coverage provided to the additional insured operations for a principal as a part of the same is required by a contract or agreement, the project. insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 2 A0166924 02/12/2021 Middlesex 1 00001 0000000000 21043 0 N 1886c3ef-2da3-4fce-b883-7137a63b3613 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III -Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 0413 A0166924 02/12/2021 Middlesex POLICY NUMBER: A0171498002 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Or Organization(s) Operations Any person or organization you are required to add as Jobsites and Operations as described in written an contracts with the named insured. additional insured under a written contract or written agreement in effect prior to any loss or damage Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III -Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations hazard". 1. Required by the contract or agreement; or However: 2. Available under the applicable Limits of 1. The insurance afforded to such additional Insurance shown in the Declarations; insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the 2. If coverage provided to the additional insured applicable Limits of Insurance shown in the is required by a contract or agreement, the Declarations. insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 1 A0166924 02/12/2021 Middlesex 1 00001 0000000000 21043 0 N 3a6f1a2e-7975-47d3-b26445e0e716da29 POLICY NUMBER: A0171498002 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Any person or organization you are required to add as an additional insured under a written contract or written agreement in effect prior to any loss or damage Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV-Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard".This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1 A0152870 06/01/2020 Sentry Insurance a Mutual Company 1 00001 0000000000 20153 0 N 10c6f74b-b579-4845-b177-bb83acda814f POLICY NUMBER: A0171498002 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): All construction projects away from premises owned by or rented to the Insured Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally 3. Any payments made under Coverage A for obligated to pay as damages caused by damages or under Coverage C for medical "occurrences" under Section I- Coverage A, and expenses shall reduce the Designated for all medical expenses caused by accidents Construction Project General Aggregate Limit under Section I - Coverage C, which can be for that designated construction project. Such attributed only to ongoing operations at a single payments shall not reduce the General designated construction project shown in the Aggregate Limit shown in the Declarations nor Schedule above: shall they reduce any other Designated 1. A separate Designated Construction Project Construction Project General Aggregate Limit General Aggregate Limit applies to each for any other designated construction project designated construction project, and that limit shown in the Schedule above. is equal to the amount of the General 4. The limits shown in the Declarations for Each Aggregate Limit shown in the Declarations. Occurrence, Damage To Premises Rented To 2. The Designated Construction Project General You and Medical Expense continue to apply. Aggregate Limit is the most we will pay for the However, instead of being subject to the sum of all damages under Coverage A, except General Aggregate Limit shown in the damages because of "bodily injury" or Declarations, such limits will be subject to the "property damage" included in the applicable Designated Construction Project "products-completed operations hazard", and General Aggregate Limit. for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing"suits". CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 A0171498 06/01/2021 Middlesex 1 00001 0000000000 21152 0 N 75ef6abO-daf0-4ef4-8b51-1b84a6a6d3a8 B. For all sums which the insured becomes legally C. When coverage for liability arising out of the obligated to pay as damages caused by "products-completed operations hazard" is "occurrences" under Section I -Coverage A, and provided, any payments for damages because of for all medical expenses caused by accidents "bodily injury" or "property damage" included in under Section I - Coverage C, which cannot be the "products-completed operations hazard" will attributed only to ongoing operations at a single reduce the Products-completed Operations designated construction project shown in the Aggregate Limit, and not reduce the General Schedule above: Aggregate Limit nor the Designated Construction 1. Any payments made under Coverage A for Project General Aggregate Limit. damages or under Coverage C for medical D. If the applicable designated construction project expenses shall reduce the amount available has been abandoned, delayed, or abandoned and under the General Aggregate Limit or the then restarted, or if the authorized contracting Products-completed Operations Aggregate parties deviate from plans, blueprints, designs, Limit, whichever is applicable; and specifications or timetables, the project will still be 2. Such payments shall not reduce any deemed to be the same construction project. Designated Construction Project General E. The provisions of Section III - Limits Of Insurance Aggregate Limit. not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 ©Insurance Services Office, Inc., 2008 CG 25 03 05 09 A0171498 06/01/2021 Middlesex