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HomeMy WebLinkAbout107-15 RESOLUTIONRESOLUTION NO. 107-15 A RESOLUTION TO AWARD BID #15-33 AND AUTHORIZE A CONTRACT WITH T&T GREEN, LLC OF FAYETTEVILLE, ARKANSAS FOR THE REPLACEMENT OF INSULATION AT THE CITY RECYCLING CENTER IN THE AMOUNT OF $38,000.00 BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1. That the City Council of the City of Fayetteville, Arkansas hereby awards Bid #15-33 and authorizes a contract with T&T Green, LLC of Fayetteville, Arkansas for the replacement of insulation at the City Recycling Center in the amount of $38,000.00. PASSED and APPROVED this 16`h day of June, 2015. ATTEST: By: /0 K SONDRA E. SMITH, City Clerk T er �.`� • G� Off. '. %. ff FAYETTEl/1LLE;� 'j9��•+ �i'1,S l�Y�•� ��h. 113 West Mountain Street City of Fayetteville, Arkansas Fayetteville, AR 72701 (479)575-8323 Text File �— - File Number: 2015-0266 Agenda Date: 6/1612015 Version: 1 Status: Agenda Ready In Control: City Council Meeting File Type: Resolution Agenda Number: A. 3 BID #15-33 T&T GREEN, LLC A RESOLUTION TO AWARD BID #15-33 AND AUTHORIZE A CONTRACT WITH T&T GREEN, LLC OF FAYETTEVILLE, ARKANSAS FOR THE REPLACEMENT OF INSULATION AT THE CITY RECYCLING CENTER IN THE AMOUNT OF $38,000.00 BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1. That the City Council of the City of Fayetteville, Arkansas hereby awards Bid #15-33 and authorizes a contract with T&T Green, LLC of Fayetteville, Arkansas for the replacement of insulation at the City Recycling Center in the amount of $38,000.00. City of Fayetteville, Arkansas Page 1 Printed on 6110/2015 City of Fayetteville Staff Review Form 2015-0266 Legistar File ID 6/16/2015 City Council Meeting Date - Agenda Item Only N/A for Non -Agenda Item Brian Pugh 5/29/2015 Recycling & Trash Collection / Transportation Services Department Submitted By Submitted Date Division / Department Action Recommendation: A Resolution to award bid # 15-33 to T&T Green, LLC for the application of spray foam insulation at the City Recycling Center for the amount of $38,000. Budget Impact: 5500.5080.5816.00 Recycling and Trash Account Number 07012.1 Project Number Fund Material Recovery Facility Insulation Replacement Project Title Budgeted Item? Yes Current Budget $ 71,276.00 Funds Obligated $ 38,000.00 Current Balance 33,2.011 Does item have a cost? Yes Item Cost Budget Adjustment Attached? No Budget Adjustment Remaining Budget 33,276>00 V20140710 Previous Ordinance or Resolution # Original Contract Number: Approval Date: Comments: Bid #15-33 Spray Foam insulation at City Recycling Center CITY OF 1U1 CITY COUNCIL AGENDA MEMO ARKAS MEETING OF JUNE 16"', 2015 TO: Mayor and City Council THRU: Jeff Coles, Recycling and Trash Collections Director FROM: Brian Pugh, Waste Reduction Coordinator DATE: May 28, 2015 SUBJECT: A RESOLUTION TO AWARD BID #15-33 TO T&T GREEN, LLC FOR THE APPLICATION OF SPRAY FOAM INSULATION AT THE CITY RECYCLING CENTER FOR THE AMOUNT OF $38,000 RECOMMENDATION: Approve a resolution to award bid #15-33 to T&T Green, LLC for the application of spray foam insulation at the City Recycling Center for the amount of $38,000. BACKGROUND: Bid 15-33 was issued and advertised on April 15th, 2015 and April 22, 2015 and closed on May 8'h, 2015. The bid requests services for the removal of old fiberglass insulation and application of new spray foam insulation inside the recycling center located at 1560 S. Happy Hollow Road adjacent to the Transfer Station. The bid was requested in order to replace insulation that has deteriorated and is needed to maintain the facility. DISCUSSION: There were 4 bids received for the service with T&T Green, LLC being the lowest responsible bibber for the project. T&T Green, LLC has met all requirements for the bid. BUDGETISTAFF IMPACT: The project was planned and budgeted for this year and there is money allocated in project 07012 sub project 1 to cover the project. Attachments: #15-33 Bid from T&T Green, LLC, #15-33 Bid tabulation, Contract for project with T&T Green, Purchase Order for Bid #15-33. Mailing Address: 113 W. Mountain Street www.fayetteville-ar.gov Fayetteville, AR 72701 City of Fayetteville Bid 15-33, Construction — Spray Foam Insulation Bid Form Contract Name: Bid 15-33, Construction — Spray Foam Insulation Bid Number 15-33 BID TO: Owner: The City of Fayetteville, Arkansas 113 West Mountain Street Fayetteville, Arkansas 72701 BID FROM: Bidder:4-1'ee 1-t- 3? iV. 1 FIeuII P. A._7I_rJI Section 1— Intent: 1. The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an agreement with the City of Fayetteville in the form included in the Contract Documents to perform and furnish all Work as specified or indicated in the Contract Documents for the Bid price and within the Bid time indicated in this Bid and in accordance with the other terms and conditions of the Contract Documents. Section 2 —Terms & Conditions: 2. Bidder accepts all of the terms and conditions of the Invitation to Bid and Instructions to Bidders, including without limitation those dealing with the disposition of Bid security. This Bid will remain subject to acceptance for 18O days after the day of Bid opening. Bidder will sign and deliver the required number of counterparts of the Agreement with the Bonds and other documents required by the Bidding Requirements within 15 days after the date of City's Notice of Award. Section 3 — Bidder's Representations: In submitting this Bid, Bidder represents, as more fully set forth in theAgreement that: A.) Bidder has examined and carefully studied the Bid Documents, and the following Addenda, receipt of all which is hereby acknowledged: Number Date B.) Bidder has visited the Site and become familiar with and is satisfied as to the general, local, and Site conditions that may affect cost, progress, performance, and furnishing of the Work. City of Fayetteville, AR Bid 15-33, Construction — Spray Foam Insulation Page 22 of 29 C.) Bidder is familiar with and is satisfied as to all federal, state, and local Laws and Regulations that may affect cost, progress, performance, and furnishing of the Work. D.) Bidder has carefully studied all: (1) reports of explorations and tests of subsurface conditions at or contiguous to the Site and all drawings of physical conditions in or relating to existing surface or subsurface structures at or contiguous to the Site; and (2) reports and drawings of a Hazardous Environmental Condition, if any, at the Site. Bidder acknowledges that such reports and drawings are not Contract Documents and may not be complete for Bidder's purposes. Bidder acknowledges that City and Engineer do not assume responsibility for the accuracy or completeness of information and data shown or indicated in the Bid Documents with respect to Underground Facilities at or contiguous to the Site. E.) Bidder has obtained and carefully studied (or assumes responsibility for having done so) all such additional or supplementary examinations, investigations, explorations, tests, studies, and data concerning conditions (surface, subsurface, and Underground Facilities) at or contiguous to the Site or otherwise which may affect cost, progress, performance, or furnishing of the Work or which relate to any aspect of the means, methods, techniques, sequences, and procedures of construction to be employed by Bidder and safety precautions and programs incident thereto. F.) Bidder does not consider that any additional examinations, investigations, explorations, tests, studies; or data are necessary for the determination of this Bid for performing and furnishing of the Work in accordance with the times, price, and other terms and conditions of the Contract Documents. G.) Bidder is aware of the general nature of work to be performed by City and others at the Site that relates to Work for which this Bid is submitted as indicated in the Contract Documents. H.) Bidder has correlated the information known to Bidder, information and observations obtained from visits to the Site, reports, and drawings identified in the Contract Documents, and all additional exam€nations, investigations, explorations, tests, studies, and data with the Contract Documents. I.) Bidder has given Engineer written notice of all conflicts, errors, ambiguities, or discrepancies that Bidder has discovered in the Contract Documents, and the written resolution thereof by Engineer is acceptable to Bidder. J.) The Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performing and furnishing the Work for which this Bid is submitted. K.) This Bid is genuine and not made in the interest of or on behalf of any undisclosed person, firm, or corporation and is not submitted in conformity with any agreement or rules of any group, association, organization, or corporation; Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham bid; Bidder has not solicited or induced any person, firm, or a corporation to refrain from bidding; and Bidder has not sought by collusion to obtain for himself any advantage over any other Bidder or over City. City of Fayetteville, AR Bid 15-33, Construction — Spray Foam Insulation Page 23 of 29 L.) Bidder will perform the Work in compliance with all applicable trench safety standards set forth in Occupational Safety and Health Administration (OSHA) Part 1926 —Subpart P— Excavations. M.) No Bid shall be based upon aggregate of Subcontractors performing more than 60 percent of the total Work. N.) The experience, past performance, and ability of each proposed Subcontractor will be considered in the evaluation of Bids. Any Subcontractor so requested shall be required to furnish experience statements prior to the Notice of Awards. Section 4 —Price: Total lump sum bid amount of for all work described in this bid package: $ J t/ pc:. o o section 5— lastin of Subcontractors: 1 7M e f } L -t 5 . I, the signed General Contractor, certify that proposals from the following subcontractors were used in the preparation of my proposal. I agree that if I am the successful bidder, and if the following subcontractors are approved by the City, I will not enter into contracts with others for thee divisions of the Work without written approval from the City. Section 6— Contract Times: A.) Bidder agrees that the Work will be substantially completed and ready for final payment within the number of calendar days indicated in the bid documents. B.) Bidder accepts the provisions of the Agreement referring to liquidated damages in the event of failure to complete the Work with the times specified in the bid document. Section 7— Debarment: A.) As A bidder on this project, you are required to provide debarment/suspension certification indicating that you are in compliance with the below Federal Executive Order. Certification can be done by completing and signing this form. a. Federal Executive Order (E.O.) 12549 "Debarment and Suspension" requires that all contractors receiving individual awards, using federal funds, and all sub -recipients certify that the organization and its principals are not debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or agency from doing business with the Federal Government. b. Your signature below certifies that neither you nor your principal is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. Section 8— Communications A.) Communications concerning this Bid shall be addressed to the Bidder as follows: City of Fayetteville, AR Bid 15-33, Construction —Spray Foam Insulation Page 24 of 29 Ti1e,t P. j*AJ A 4-ps. 7j;2b( Phone No. (^ ,,,(LV/toA W) at t G secon 9 —SIGNATURE: A.) This bid is being submitted in good ₹aith, according to the e tire bid package presented: SUBMITTEDonthis --Date of d tar :�—• Arkansas State Contractor License No. O2.. t I L If Bidder is: OPTION 1: An Individual Name (type or printed): By: (SEAL) (Individual's Signature) Doing business as: Business address: Phone No.: FAX No.: OPTION 2: A Partnersh Partnership Name: (SEAL) By: (Signature of general partner— attach evidence of authority to sign) Narne (type or printed): Business address: Phone No.. FAX No.: OPTION 3: A Corporation OR LI.C r Corporation Name: J 4T GtftA . L1 C (SEAL) T Date of Incorporation: j7J Type (General Business, Professional, Service, Umited Liability): City of Fayetteville, AR Bid 15-33, Construction —Spray Foam Insulation Page 25 of 29 By: (Signature — attach evidence of authority to sign} Name (type or printed): (CORPORATE SEAL) Business address: Phone No.: ____________________FAX c FAX N_____________________o.:f City of Fayetteville, AR Bid 15-33, Construction —Spray Foam Insulation Page 26 of 29 City of Fayetteville Bid 15-33, Construction — Spray Foam Insulation VPnrinr RPfprPnces The following information is required from all Bidders so all bids may be reviewed and properly evaluated. COMPANY NAME: BUSINESS ADDRES NUMBER OF YEARS IN BUSINESS: f HOW LONG IN PRESENT LOCATION: S £4/1C)br 1t 5' TOTAL NUMBER OF CURRENT EMPLOYEES: FULLTIME N PART TIME NUMBER OF EMPLOYEES YOU PLAN TO USE TO SERVICE THIS CONTRACT: S S FULLTIME PART TIME PLEASE LIST FOUR (4) LOCAL COMMERCIAL AND/OR GOVERNMENTAL REFERENCES THAT YOU HAVE PREVIOUSLY PERFORMED SIMILAR CONTRACT SERVICES FOR WITHIN THE PAST FIVE (S) YEARS (All fields must be completed). Contractors shall have valid experience. �a P . nG . . r I� _ �OJI nf COMPANY Y NAME COA 0(-C COMPANY NAME Lv�7 AA'1 5.sjd1JcX11 CITY, STATE, ZIP COT T PERSON TELEPHONE y Vc ` slc l rr /Z7.( DATE CPLE ED t?+r12CC . CDII1/► 3E-�IAILADDR S ! 3. fnc � r �1j 4 LC COMPANY NAME CITY, STATE, ZIP CONTACT PERSON TELEPHONE DA [E CO PLETED EJ41 f yi-4(4 E-MAIL ADDRESS City of Fayetteville, AR Bid 15-33, Construction - Spray Foam insulation Page 27 of 29 1'1i T 1-q Fl, CITY; STATE, ZIP M'.rith Qvbnn CONTACT PERSON TELEPHONE )jowi D TE C MPLETED A1`r A r M E-MAIL ADDRESS 4. G COMPANY NAME 1wV 6L (I Ut3 CITY, STATE, ZIP �1( CONTACT PERSON TELEPHONE 6r2r — LJ t ATE C M LETED �.�. E-MAItADDRESS BiD BOND (Percentage) Bond No. 62386152 KNOW ALL PERSONS BY THESE PRESENTS, That we T & T Green, LLC of 808 N. Highland Ave Fayetteville, AR 72701 , hereinafter referred to as the Principal, and WESTERN SURETY COMPANY as Surety, are held and firmly bound unto City of city of Fayetteville Xt , hereinafter referred to as the Obligee, in the amount of Five Percent of the Amount Bid ( 5% ), for the payment of which we bind ourselves, our legal representatives, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, Principal has submitted or is about to submit a proposal to Obligee on a contract for Bid 15-33, Construction- Spray Foam Insulation NOW, THEREFORE, if the said contract be awarded to Principal and Principal shall, within such time as may be specified, enter into the contract in writing and give such bond or bonds as may be specified in the bidding or contract documents with surety acceptable to Obligee; or if Principal shall fail to do so, pay to Obligee the damages which Obligee may suffer by reason of such failure not exceeding the penalty of this bond, then this obligation shall be void; otherwise to remain in full force and effect. SIGNED, SEALED AND DATED this 8th day of May 2015 Principal T & T G n L BY: Surety WESTERN SURETY COMPANY BY: O e Stuart , Attorney Terri Diann - in Fact Form F4595-8-2001 Western Surety Company POWER OF ATTORNEY - CERTIFIED COPY BondNo. 62386152 Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company"), does by these presents make, constitute and appoint Terri Dianne Stuart its true and lawful attorney(s)-in-fact, with full power and authority hereby conferred, to execute, acknowledge and deliver for and on its behalf as Surety, bonds for: Principal: T & T Green, LLC Obligee: City of City of Fayetteville Amount: $500,000.00 and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Senior Vice President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said attorney(s)-in-fact may do within the above stated limitations. Said appointment is made under and by authority of the following bylaw of Western Surety Company which remains in full force and effect. "Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." All authority hereby conferred shall expire and terminate, without notice, unless used before midnight of August 6th 2015 , but until such time shall be irrevocable and in full force and effect. In Witness Whereof, Western Surety Company has caused these presents to be signed by its Vice President, Paul T. Bruflat, and its corporate, ea to be affixed this Sth__ day of May 2015 �44Y` wsy SUR Y COMPANY Paul T ruflat, Vice President ti �Q 4 `ate A ss On this 8th day of Ma , in the year 2015 ,before me, a notary public, personally appeared Paul T. Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of WESTER �SbL F� �C�p1�I6PAN aandacknnTledged said instrument to be the voluntary act and deed said co tion- s S. PETRIK s r—� NOTARY PUBLICs a�SOUTH DAKOTA SEAL s Notary Public - South Dakota +e•eahyyhhy_.,b9v + My Commission Expires August' [1, 2016 I the undersigned officer of Western Surety Company, a stock corporation of the State of South Dakota, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as set forth in the Power of Attorney is now in force. In testimony whereof, I have hereunto set my hand and seal of Western Surety Company this 8th day of May , 2015 , Form F5306-8-2012 WES R SURE Y COMPANY Paul T ruflat, Vice President CITY OF a e e11�le ARKANAS Bid 15-33, Construction - Spray Foam Insulation BIDDER Revised 05119/2015 BID: 15-33 05!08115 2:00 PM CITY OF FAYETTEVILLE TOTAL BID PRICE 1 Arkansas Foam Insulation $ 39,412.00 2 Davis Construction $ 57,800.00 3 Ozark Foam LLC $ 41,195.00 4 T & T Green LLC $ 38,000.00 'NOTICE: Sid award is Contingent upon vendor meeting minimum sp*Oicaticns and formal authoriration by City Off ials. CERTIFIED: A. F en Iennie, Purchasing W 5 CITY OF City of Fayetteville, AR ny�irevflle CONTRACT Bid 15-33, Construction — Spray Foam Insulation AN (� n, Vendor: T&T Green, LLC, 808 N. Highland Ave, Fayetteville, AR 72701 This contract executed this I o day of _ , 2015, between the City of Fayetteville, Arkansas, and T&T Green, LLC In consideration of the mutual covenants contained herein, the parties agree as follows: T&T Green, LLC at its own cost and expense shall furnish all labor, materials, supplies, machinery, equipment, tools, supervision, bonds, insurance, tax permits, and all other accessories and services necessary to complete items bid per Bid 15-33 as stated in T&T Green, LLC bid proposal, and in accordance with specifications attached hereto and made a part hereof under Bid 15-33, all included herein as if spelled out word for word. The City of Fayetteville shall pay T&T Green, LLC based on their bid proposal in an amount not to exceed $38,0©0.00. Payments will be made after approval and acceptance of work and submission of invoice. Payments will be made approximately 30 days after receipt of invoice. 3. The Contract documents which comprise the contract between the City of Fayetteville and T&T Green, LLC consist of this Contract and the following documents attached hereto, and made a part hereof: A. Bid form identified as Invitation to Bid 15-33 with the specifications and conditions typed thereon. B. T&T Green, LLC bid proposal. C. The Notice to Prospective Bidders and the Bid Tabulation. 4. These Contract documents constitute the entire agreement between the City of Fayetteville and T&T Green, LLC and may be modified only by a duly executed written instrument signed by the City of Fayetteville and T&T Green, LLC. 5. T&TGreen, LLC shall not assign its duties under the terms of this agreement. 6. T&T Green, LLC agrees to hold the City of Fayetteville harmless and indemnify the City of Fayetteville, against any and all claims for property damage, personal injury or death, arising from T&T Green, LLC performance of this contract. This c€ause.shall not in any form or manner be construed to waive that tort immunity set forth under Arkansas Law. 7. T&T Green, LLC shall furnish a certificate of insurance addressed to the City of Fayetteville, showing that he carries the following insurance which shall €be maintained throughout the term of the Contract. Any work sublet, the contractor shall require the subcontractor similarly to provide worker's compensation insurance. in case any employee engaged in work on the project under this contract is not protected under Worker's Compensation Insurance, T&T Green.j,LC shall provide and shall cause each Subcontractor to provide adequate employer's liability insurance for the protection of such of his employees as are not otherwise protected. Workmen's Compensation Statutory Amount Comprehensive General & Automobile Insurance Bodily Injury Liability $500,000 for each person injured. $1,000,000 for each accident. City of Fayetteville, AR Bid 15-33, construction - Spray Foam Insulation Page 1 of 2 Property Damage Liability $1,000,000 aggregate. The premiums for all insurance and the bond required herein shall be paid by T&T Green, LLC. T&T Green, LLC to furnish proof of licensure as required by all local and state agencies. This contract may be terminated by the City of Fayetteville or T&TGreenn. LLC with 30 days written notice. 10. This project shall be completed within 60 calendar days from issue date of Notice to Proceed. 11. Liquidated Damages: N/A 12. Freedom of Information Act: City of Fayetteville contracts and documents prepared while performing city contractual work are subject to the Arkansas Freedom of Information Act. If a Freedom of Information Act request is presented to the City of Fayetteville, the contractor will do everything possible to provide the documents in a prompt and timely manner as prescribed in the Arkansas Freedom of Information Act (A.C_A. 25-19-101 et. Seq.). Only legally authorized photo -coping costs pursuant to the FOIA may be assessed for this compliance. 13. Changes in Scope or Price: Changes, modifications, or amendments in scope, price or fees to this contract shall not be allowed without a prior formal contract amendment approved by the Mayor and the City Council in advance of the change in scope, cost or fees. WITNESS OUR HANDS THIS DAY OF___________ T&T GREEN) LLC ti 5i to Printed Contractor Name & Title A EST (Signature) Company Secretary (Printed Name/ BusinessAddress Cit •, State�Code Date Signed: /z z /' S T&T Green, LLC 808 N. Highland Ave. Fayetteville, AR 72701 (479) 531-7658, jtucker )tar Ed green.corn City of Fayetteville, AR Bid 15-33. Construction —Spray Foarn Insulation Page 2 of 2 ATTEST: (Signature) .S . Sandra Smith, City Clerk �••�,\�`f Ore •.G� ° VAYETTEVIELE. Date Signed: 1 S City of Fayetteville, AR 113 W_ Mountain Fayetteville, AR 72701 equ nn o.: City Of Fayetteville 512812015 f b01 a Purcinye Gdery urrl r: xpected Ltu1wry Lieto: June 22 015 Vendor#: Vendor Name: Mall 25019 TAT Green LLC resp_ No:_xx_ Address: Fob Point: Taxable Quot Attached 908 N R' hlend AW tyv ex: City. State: Sfilp to code: Divison . Approv Fayetteville AR 72701 170 Requester: Requester's Employee #: Exten Glenda Eden 1701 497 ltei Description t3uanG unit of Issue Unit Cost Extended Cost Account Numbers PmjeoVSubprcjont# 1rw00104y# Fixed Asset # Remove and install MRF 1 Insulation I job 38,000A $38,000.00 55003000.5010.00 7012,1 2 15-33 $0.00 3 $0AD 4 00.00 5 $0.00 B $0.00 7 $0.00 9 $0.00 9 $0.00 10 $0,00 freight $0.00 dpec'al boErac3rte; subtotal: $39,000.00 Tax: $3,705.00 Total! $41,705.00 Approvals: Maya= _ Department Dheclor: Purchasing Manager: Finance A Internal Services Director. ___�_ Budget Manager: _ IT Manager. Dispatch Manager: utilities Manager: Other: CONseu W louu Bond 62386369 SUBCONTRACT PAYMENT BOND KNOW ALL BY THESE PRESENTS, That we, T & T Green, LLC 808 N. Highland Ave, Fayetteville, AR 72701 (Here insert the name and address, or legal title, of the Subcontractor) as Principal, herein called Principal, and WESTERN SURETY COMPANY , a corporation of the State of South Dakota , as Surety, herein called Surety, are held and firmly bound unto City of City of Fayetteville (Here insert the name and address, or legal title, of the General Contractor) as Obligee, herein called Obligee, for the use and benefit of claimants as herein defined, in the amount of Thirty Eight Thousand and 00/100 Dollars($ 38,000.00 ), 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_.., June 16th, 2015 entered into a subcontract with Obligee for Bid 15-33, Construction- Spray Foam Insulation which subcontract is by reference made a part hereof, and is referred to as subcontract. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, That, if the Principal shall promptly make payment to all Claimants as herein defined, for all labor and material used or reasonably required for use in the performance of the Subcontract, 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 for labor, material, or both, used or reasonably required for use in the performance of the contract. 2. The above -named Principal and Surety hereby jointly and severally agree with the Obligee 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 in the Claimant's own name for such sums as may be justly due Claimant. 3. No suit or action shall be commenced hereunder by any Claimant: (a) Unless Claimant shall have given written notice to any two of the following: The Principal, the Obligee, 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. (b) After the expiration of one (1) year following the date on which Principal ceased work on said Subcontract. (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. Signed and sealed this 19th day of June , 2015 In the presence of: T & T G LC (Seal) Principal 111111 111111 111 IIIHIIII1 11111 l IIIHHI 11111 11111 11111 1111 1111011III By Doc ID: 016313960003 Type: LIE Kind: PERFORMANCE BOND WESTERN SURETY COMPANY Recorded: 06/25/2015 at 02:23:29 PM F Fee Amt: $25.00 Page 1 of 3 , Surety Washington county. AR ` Kyle Sylvester Circuit Clerk FileB p ��O33-00000283 �� Qrr]] Terri Dianne Stu rt ttorney-�n-Fact Bond 62386369 SUBCONTRACT PERFORMANCE BOND KNOW ALL BY THESE PRESENTS, That we, T & T Green, LLC 808 N. Highland Ave Fayetteville, AR 72701 (Here insert the name and address, or legal title, of the Subcontractor) As Principal, herein called Principal, and WESTERN SURETY COMPANY , a corporation of the State of th Dakota ,as Surety, herein called Surety, are held and firmly bound unto City of City of Fayetteville (Here insert the name and address, or legal title, of the General Contractor) as Obligee, in the amount of Thirty Eight Thousand and 00/100 Dollars ($_38, 000 .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 June 16th, 2015 entered into a subcontract with Obligee for Bid 15-33, Construction- Spray Foam Insulation which subcontract is by reference made a part hereof, and is referred to as subcontract. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if the Principal shall promptly and faithfully perform said subcontract, then this obligation shall be null and void; otherwise to remain in full force and effect. The Surety hereby waives notice of any modification or amendment to the Subcontract made in accordance with the terms thereof, and any alteration or extension of time made by or through the General Contractor. Whenever Principal shall be, and be declared by Obligee to be in default under the subcontract, the Obligee having performed Obligee's obligations thereunder: (1) Surety may promptly remedy the default subject to the provisions of paragraph 3 herein, or; (2) Obligee after reasonable notice to Surety may, or Surety upon demand of Obligee, may arrange for the performance of Principal's obligation under the subcontract subject to the provisions of paragraph 3 herein; (3) The balance of the subcontract price, as defined below, shall be credited against the reasonable cost of completing performance of the subcontract. If completed by the Obligee, and the reasonable cost exceeds the balance of the subcontract price, the Surety shall pay to the Obligee such excess, but in no event shall the aggregate liability of the Surety exceed the amount of this bond. If the Surety arranges completion or remedies the default, that portion of the balance of the subcontract price as may be required to complete the subcontract or remedy the default and to reimburse the Surety for its outlays shall be paid to the Surety at the times and in the manner as said sums would have been, payable to Principal had there been no default under the subcontract. The term "balance of the subcontract price," as used in this paragraph, shall mean the total amount payable by Obligee to Principal under the subcontract and any amendments thereto, less the amounts heretofore properly paid by Obligee under the subcontract. Any suit under this bond must be instituted before the expiration of two years from date on which final payment under the subcontract falls due. No right of action shall accrue on this bond to or for the use of any person or corporation other than the Obligee named herein or the heirs, executors, administrators or successors of the Obligee. Signed and sealed this 19th day of In the presence of: June , 2015 T & T G een LL Seal Primcigal By WESTERN SURETY COMPANY n n A Surety Attorney -in -Fact Terri Dianne Stuart Western Surety Company POWER OF ATTORNEY - CERTIFIED COPY Bond No. 62 3 8 6 3 6 Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company"), does by these presents make, constitute and appoint Terri Dianne Stuart its true and lawful attorney(s)-in-fact, with full power and authority hereby conferred, to execute, acxnowreuge auu uouvoi .V. �.==u �u its behalf as Surety, bonds for: Principal: T & T Green, LLC Obligee: City of City of Fayetteville Amount: $500,000.00 and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Senior Vice President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said attorney(s)-in-fact may do within the above stated limitations. Said appointment is made under and by authority of the following bylaw of Western Surety Company which remains in full force and effect. "Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." All authority hereby conferred shall expire and terminate, without notice, unless used before midnight of November 13th 2015 , but until such time shall be irrevocable and in full force and effect. In Witness Whereof, Western Surety Company has caused these presents to be signed by its Vice President, Paul T. Bruflat, and itsoorporaWAml. 19th day June , 2015 tobeaffixedthis...of WEST SUR Y COMPANY i Paul T ruflat, Vice President •_Jq FSOUTI1FA ss to A On this 19th day of June , in the year 2015 , before me, a notary public, personally appeared Paul T. Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of WESTER�S4U41 E4 Y,a,C�( MP anda4ck4n%o vledged said instrument to be the voluntary act and deed o said core tion. S. PETRIK p fr- ` NOTARY PUBLIC f s'&r1SOUTH DAKOTA1.c/ Notary Public - South Dakota }444444ae4,4�"�a44�4444444oi4 + My Commission Expires August 11, 2016 I the undersigned officer of Western Surety Company, a stock corporation of the State of South Dakota, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as set forth in the Power of Attorney is now in force. In testimony whereof, I have hereunto set my hand and seal of Western Surety Company this 19th day of June , 2015 . Form F5306-6-2012 WESJ SURE)Y COMPANY Paul T ruflat, Vice President TTGRE-1 OP 1D: TS .acc�RL CERTIFICATE OF LIABILITY INSURANCE ��' DATE(MMIOD,YYYY) 06/23/2015 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 Rogers Insurance Agency 2809 W. Ajax, # 300 Rogers, AR 72758-6226 Brad Bridgers, CIC NAME: CT Brad Bridgers, CIC PHONE 479.636.4561 arc No): N No Ext A DRESS: BBrid ers Ro ers-Insurance.com INSURER(S) AFFORDING COVERAGE NAIL S INSURERA , EMCASCO Insurance Co, 21407 INSURED T&T Green, LLC Joe Tucker 808 North Highland Avenue Fayetteville, AR 72701 INSURER B : Employers Mutual Casualty Co. 21415 INSURER C : Accident Fund Ins Co. 10166 INSURER D : INSURER E INSURER F: e+�,r�o Ar-Ca rrw DTICIrATF h1I1MRFR- REVISION NUMULK: 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. ]NSR LTR TYPEOFINSURANCE ADDL UB POLICYNUMBERPM�IpYEFF POLICY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR D83276 07114/2014 0711412015 EACH OCCURRENCE $ 1,000,04 DAMAGE TO RENTED PREMISES(EaoccurreneL $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'LAGGREGATELIMIT APPLIES PER: POLICYTi Ti PRO- PRODUCTS - COMP/OP AGO $ 2,000,00 $ A .srrLOG AUTOMOBILE LIABILITY X ANY AUTO ALLOWNED SCHEDULED HIRED AUTOS II AUTOS ON -O NON -OWNED 4E83276 07/1412014 07/1412015 COMBINED SENGLELIMIT anti $ 1,000,00 BODILY INJURY (Par person) $ BODILY INJURY(Peraccident) $ PROPERTY DAMAGE PER ACC1DENT) $ $ B X UMBRELLALIAB EXCESS L1AB X OCCUR CLAIMS -MADE IJ83276 07114/2014 07/1412015 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 DED I X I RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVEY� OFFICERIMEMBEER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WCV6092666 07114/2014 07114/2015 AlWC STATU- OTH- TORY E.L.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE- EA EMPLOYE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONSI LOCATIONS IVEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) c-rf TIBIf�A r unr r, m CANr.Ft 1 ATI(TN V VI1111 CITFAYO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fayetteville THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 113 W. Mountain Fayetteville, AR 72701 AUTHORIZED REPRESENTATIVE -Eve Cv 1M5tl-LUIUM..VKU VVKr'VKAI lVIM. MU riy11(s [CbeIVCu. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Bond 62386369 SUBCONTRACT PAYMENT BOND KNOW ALL BY THESE PRESENTS, That we, T & T Green, LLC 808 N. Highland Ave, Fayetteville, AR 72701 (Here insert the name and address, or legal title, of the Subcontractor) as Principal, herein called Principal, and WESTERN SURETY COMPANY , a corporation of the State of South Dakota , as Surety, herein called Surety, are held and firmly bound unto City of City of Fayetteville (Here insert the name and address, or legal title, of the General Contractor) as Obligee, herein called Obligee, for the use and benefit of claimants as herein defined, in the amount of Thirty Eight Thousand and 00/100 Dollars($ 38 000.00 ), 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 June 16th, 2015 _ entered into a subcontract with Obligee for Bid 15-33, Construction- Spray Foam Insulation which subcontract is by reference made a part hereof, and is referred to as subcontract. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, That, if the Principal shall promptly make payment to all Claimants as herein defined, for all labor and material used or reasonably required for use in the performance of the Subcontract, 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 for labor, material, or both, used or reasonably required for use in the performance of the contract. 2. The above -named Principal and Surety hereby jointly and severally agree with the Obligee 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 in the Claimant's own name for such sums as may be justly due Claimant. 3. No suit or action shall be commenced hereunder by any Claimant: (a) Unless Claimant shall have given written notice to any two of the following: The Principal, the Obligee, 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. (b) After the expiration of one (1) year following the date on which Principal ceased work on said Subcontract. (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. Signed and sealed this 19th day of June , 2015 In the presence of Doc ID: 016313960003 Type: LIE Kind: PERFORMANCE BOND Recorded: 06/25/2015 at 02:23:29 PM /.. Fee Amt: $25.00 Page 1 of 3 i Washington County. AR Kyle Sylvester Circuit Clerk {' �1 FileBo33-00000283 ;.= T & T G e LC (Seal) Principal By WESTERN SURETY COMPANY Surety L.— ( ' ttorne in -F t Terri Dianne Stu rt Y Bond 62386369 SUBCONTRACT PERFORMANCE BOND KNOW ALL BY THESE PRESENTS, That we, T & T Green, LLC 808 N. Highland Ave, Fayetteville, AR 72701 (Here insert the name and address, or legal title, of the Subcontractor) As Principal, herein called Principal, and WESTERN SURETY COMPANY , a corporation of the State of South Dakota , as Surety, herein called Surety, are held and firmly bound unto City of City of Fayetteville r _ (Here insert the name and address, or legal title, of the General Contractor) as Obligee, in the amount of Thirt Eight Thousand and 00/100 Dollars ($ 38 , 000.00 ), 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 June 16th, 2015 entered into a subcontract with Obligee for Bid 15-33, Construction- Spy Foam Insulation which subcontract is by reference made a part hereof, and is referred to as subcontract. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if the Principal shall promptly and faithfully perform said subcontract, then this obligation shall be null and void; otherwise to remain in full force and effect. The Surety hereby waives notice of any modification or amendment to the Subcontract made in accordance with the terms thereof, and any alteration or extension of time made by or through the General Contractor. Whenever Principal shall be, and be declared by Obligee to be in default under the subcontract, the Obligee having performed Obligee's obligations thereunder: (1) Surety may promptly remedy the default subject to the provisions of paragraph 3 herein, or; (2) Obligee after reasonable notice to Surety may, or Surety upon demand of Obligee, may arrange for the performance of Principal's obligation under the subcontract subject to the provisions of paragraph 3 herein; (3) The balance of the subcontract price, as defined below, shall be credited against the reasonable cost of completing performance of the subcontract. If completed by the Obligee, and the reasonable cost exceeds the balance of the subcontract price, the Surety shall pay to the Obligee such excess, but in no event shall the aggregate liability of the Surety exceed the amount of this bond. If the Surety arranges completion or remedies the default, that portion of the balance of the subcontract price as may be required to complete the subcontract or remedy the default and to reimburse the Surety for its outlays shall be paid to the Surety at the times and in the manner as said sums would have been payable to Principal had there been no default under the subcontract. The term "balance of the subcontract price," as used in this paragraph, shall mean the total amount payable by Obligee to Principal under the subcontract and any amendments thereto, less the amounts heretofore properly paid by Obligee under the subcontract. Any suit under this bond must be instituted before the expiration of two years from date on which final payment under the subcontract falls due. No right of action shall accrue on this bond to or for the use of any person or corporation other than the Obligee named herein or the heirs, executors, administrators or successors of the Obligee. Signed and sealed this 19th day of June , 2015 In the presence of: . Form F5880 T & T G een LL Seal Principal By WESTERN SURETY COMPANY Surety torney-in- act Terri Dianne Stuart At Western Surety Company POWER OF ATTORNEY - CERTIFIED COPY BondNo. 62386369 Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company"), does by these presents make, constitute and appoint Terri Dianne Stuart its true and lawful attorney(s)-in•fact, with full power and authority hereby conferred, to execute, acknowledge and deliver for and on its behalf as Surety, bonds for: Principal: T & T Green, LLC Obligee: City of City of Fayetteville Amount: $500,000.00 and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Senior Vice President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said attorney(s)-in-fact may do within the above stated limitations. Said appointment is made under and by authority of the following bylaw of Western Surety Company which remains in full force and effect. "Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." All authority hereby conferred shall expire and terminate, without notice, unless used before midnight of November 13th 2015 , but until such time shall be irrevocable and in full force and effect. In Witness Whereof, Western Surety Company has caused these presents to be signed by its Vice President, Paul T. Bruflat, and its corporate.BCAl.to be affixed this 1 9th day of June 2015 aW`O cgs S1.$OUl IiA ss COi3NW4 •• W SUR Y COMPANY Paul T ruflat, Vice President On this 19th day of June , in the year 2015 , before me, a notary public, personally appeared Paul T. Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of eed o WESTER�5h[JaI T f OM` `yd` ckn ovledged said instrument to be the voluntary act and dsaid core tion, I S. PETRIK e EAL 13OTARY PUBLIC SEAL i Nota Public - South Dakota i�SOUTH DAKOTA r i '} +iti titi4M titititititiMgtitititi45tititi t My Commission Expires August 11, 2016 I the undersigned officer of Western Surety Company, a stock corporation of the State of South Dakota, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as set forth in the Power of Attorney is now in force. In testimony whereof, I have hereunto set my hand and seal of Western Surety Company this 19th day of June_,2 015. Form F5306-8-2012 WES4 SURE)Y COMPANY Paul T ruflat, Vice President TTGRE-1 OP ID: TS ACORO' ATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE D0612312015 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 Rogers Insurance Agency 2809 W. Ajax, # 300 Rogers, Ali 72758-6226 CONTACT Brad Bridgers, CIC PHONE FAX INC. Ho, E„1.479-636-4551 (AIC NO)! ADDRESS: BBrid ers Ro ers-Insurance.com Brad Bridgers, CIC INSURERISI AFFORDING COVERAGE NAIL a INSURER A: EMCASCO tnsumnco Co. 21407 INSURED T&T Green, LLC INSURER B : Employers Mutual Casualty Co. 21415 Joe Tucker 808 North Highland Avenue INSURERc:Accident Fund Ins Co. 10166 INSURER D: Fayetteville, AR 72701 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE A.1151 POLICY NUMBER POLICY EFF EXP IDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR 4D83276 0711412014 0711412015 EACH OCCURRENCE S 1,000,00 MTORENTED PREMISES Ea occurrence $ 100.00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000.00 GEL AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOG PRODUCTS. COMP/OP AGG $ 2,000,00 S A AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 4E83276 07/1412014 07/1412015 COSINGLE LIMIT COMBINED D $1,000,00 X BODILY INJURY (Per person} S BODILY INJURY(Paracddent) $ PROPERTY DAMAGE PERACCIDE B X UMBRELLALIAB EXCESSLIAB X OCCUR CLAIMS -MADE 4J83276 07/14/2014 07/14/2015 EACH OCCURRENCE S 1,000,00 AGGREGATE $ 1,000,00 DED X I RETENTIONS 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' I,.IABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) Iryes. doV400 under DESCRIPTION OF OPERATIONS below N 1 A CV6092666 07/1412014 0711412015 X WC STATU- OTH- E.L. EACH ACCIDENT S 1,000,00 E.L. DISEASE - EA EMPLOYEI S 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER CANCELLATION CITFAYO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fayetteville Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 113 W. Mountain Fayetteville, AR 72701 AUTHORIZEDREPRESENTATIVE / O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD