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HomeMy WebLinkAboutContract 2012 2454 � a CRACK SEALING J " 2012 St Maint Materials Refer JPA - Contracts 1828 oo'c� and 1910 R.,APIDS Minnesota AGREEMENT THIS AGREMENT,made this 3rd day of April, 2012,by and between the City of Coon Rapids,a Minnesota municipal corporation(hereinafter called"Owner")and American Pavement Solutions,a Wisconsin Incorporation(hereinafter called"Contractor")whose business address is 1455 Gruber Rd, Green Bay,WI 554307-3007. WITNESSETH: The Contractor will commence and complete the construction of Improvement Project 12-05, 2012 Street Maintenance Materials: Crack Sealing. The Contractor will furnish all of the materials, supplies,tools,equipment,labor and other services necessary for the construction and completion of the project described herein. The Contractor will commence the work required by the Contract Documents within ten calendar days after the date of Notice to Proceed unless the period for completion is extended otherwise by the Contract Documents. The Contractor agrees to perform all of the work described in the Contract Documents for the sum of $124,768.56. The term"Contract Documents means and includes the following: • Advertisement for Bids « Information for Bidders • Bid • Bid Bond • Agreement • General Conditions • Modification of General Conditions • Performance Bond • Payment Bond • Notice of Award • Notice to Proceed • Change Order(s) + Drawings prepared or issued by Owner • Specifications prepared or issued by Owner • Addenda. The Owner will pay to the Contractor in the manner and at such time as set forth in the General Conditions such amounts as required by the Contract Documents. 0 While Contractor performs services for Owner,in consideration for the contract,the Contractor, subcontractors,agents employees, an assigns agree not to have a firearm in possession while at a worksite,traveling in Owner's equipment,or otherwise performing acts on behalf of Owner. This Agreement shall be binding upon all parties hereto and their respective heirs, executors, administrators, successors, and assigns. IN WITNESS WHEREOF,the parties hereto have executed, or caused to be executed by their duly authorized officials,this written Agreement in duplicate each of which shall be deemed an original on the date first above written. CITY OF COON RAPIDS Approved as to form: 1 By: vio r im Howe,Mayor - • _y dov, '/Jr-eli, .44/;' , 6;144-7 By M tthew S. ulton, City Manager American Pavement Solutions, Inc. By: Timothy D. Helstad Its: President AGENT FOR BONDING COMPANY HNI Risk Services, Inc. (Name) 16805 w. Cleveland Ave. (Address) New Berlin, WI 531 51-01 87 800-236-4464 (Telephone) * * * ** • * ( �'' * PAYMENT BOND Bond# 2115291 * The American Institute of Architects,AIA Document No.A312 *,*, * ** (December, 1984 Edition).Any singular reference to Contractor,Surety, Owner or other party shall be considered plural where applicable. CONTRACTOR(Name and Address): SURETY(Name and Principal Place of Business): American Pavement Solutions,Inc. Old Republic Insurance Company PO Box 13007 Green Bay,WI 54307-3007 400 N.Executive Drive,Suite 306, Brookfield,WI 53005 OWNER(Name and Address): City of Coon Rapids 1115 Robinson Drive Coon Rapids,MN 55433 CONSTRUCTION CONTRACT Date: 04/03/2012 Amount: $124,768.56 Description(Name and Location): Project 12-5,2012 North Metro Street Maintenance Program BOND Date(Not earlier than Construction Contract Date):04/10/2012 Amount:$124,768.56 Modifications to this Bond: El None ❑ See Page 2 CONTRACTOR AS PRINCIPAL SURETY 44ea.o,yA,,,,, Company: (Corporate Seal) Company: (I _f I) American Pavement Solutions, Inc. Old Republic Insurance Company `-� 11 Signature: 4�rc • b� Signature: Name and Title: Roger Myers, Sec/Trews Name and Title: Amy Sue aver/Attorney-in-Fact (Any additional signatures appear on page 2.) (FOR INFORMATION ONLY—Name,Address and Telephone) OWNER'S REPRESENTATIVE(Architect, Engineer or other AGENT or BROKER:HNI Risk Services,Inc.16805 W.Cleveland Ave., party): New Berlin,WI 53151 262/782-3940 1 The Contractor and the Surety,jointly and severally,bind them- 4.1 Claimants who are employed by or have a direct contract with the selves,their heirs,executors,administrators,successors and assigns Contractor have given notice to the Surety(at the address described to the Owner to pay for labor,materials and equipment furnished for in Paragraph 12)and sent a copy,or notice thereof,to the Owner, use in the performance of the Construction Contract,which is incor- stating that a claim is being made under this Bond and,with sub- porated herein by reference. stantial accuracy,the amount of the claim. 2 With respect to the Owner,this obligation shall be null and void if 4.2 Claimants who do not have a direct contract with the Contractor: the Contractor: .1 Have furnished written notice to the Contractor and sent a copy, , 2.1 Promptly makes payment,directly or indirectly,for all sums due or notice thereof,to the Owner,within 90 days after having last Claimants,and performed labor or last furnished materials or equipment included 2.2 Defends, indemnifies and holds harmless the Owner from in the claim stating,with substantial accuracy,the amount of the claims,demands, liens or suits by any person or entity whose claim and the name of the party to whom the materials were fur- claim,demand,lien or suit is for the payment for labor,materials nished or supplied or for whom the labor was done or performed; or equipment furnished for use in the performance of the Construc- and tion Contract,provided the Owner has promptly notified the Con- .2 Have either received a rejection In whole or in part from the Con- tractor and the Surety(at the address described in Paragraph 12) tractor,or riot received within 30 days of fumishirg the above notice of any claims;demands, liens or suits and tendered defense of any communication from the Contractor by which the Contractor such claims, demands, liens or suits to the Contractor and the has indicated the claim will be paid directly or indirectly;and Surety,and provided there is no Owner Default. .3 Not having been paid within the above 30 days,have sent a 3 With respect to Claimants,this obligation shall be null and void if written notice to the Surety(at the address described in Paragraph the Contractor promptly makes payment,directly or indirectly,for all 12)and sent a copy,or notice thereof,to the Owner,stating that sums due. a claim is being made under this Bond and enclosing a copy of 4 The Surety shall have no obligation to Claimants under this Bond until: the previous written notice furnished to the Contractor. ORlc 22114(7.93) Page 1 of 2 '5 If a notice required by Paragraph 4 is given by the Owner to the Con- Paragraph are void or prohibited by law,the minimum period of limi- tractor or to the Surety,that is sufficient compliance. tation available to sureties as a defense in the jurisdiction of the suit 6 When the Claimant has satisfied the conditions of Paragraph 4,the shall be applicable. Surety shall promptly and at the Surety's expense take the following 12 Notice to the Surety,the Owner or the Contractor shall be mailed actions: or delivered to the address shown on the signature page.Actual 6.1 Send an answer to the Claimant,with a copy to the Owner, receipt of notice by Surety,the Owner or the Contractor,however within 45 days after receipt of the claim,stating the amounts that accomplished,shall be sufficient compliance as of the date received are undisputed and the basis for challenging any amounts that are at the address shown on the signature page. disputed. 13 When this Bond has been furnished to comply with a statutory or 6.2 Pay or arrange for payment of any undisputed amounts. other legal requirement in the location where the construction was 7 The Surety's total obligation shall not exceed the amount of this to be performed,any provision in this Bond conflicting with said statu- Bond,and the amount of this Bond shall be credited for any payments tory or legal requirement shall be deemed deleted herefrom and made in good faith by the Surety. provisions conforming to such statutory or other legal requirement 8 Amounts owed by the Owner to the Contractor under the Construc- shall be deemed incorporated herein.The intent is that this Bond shall tion Contract shall be used for the performance of the Construction be construed as a statutory bond and not as a common law bond. Contract and to satisfy claims,if any, under any Construction Perfor- 14 Upon request by any person or entity appearing to be a potential mance Bond. By the Contractor furnishing and the Owner accepting beneficiary of this Bond,the Contractor shall promptly furnish a copy this Bond,they agree that all funds earned by the Contractor in the of this Bond or shall permit a copy to be made. performance of the Construction Contract are dedicated to satisfy obli- 15 DEFINITIONS gations of the Contractor and the Surety under this Bond,subject to 15.1 Claimant:An individual or entity having a direct contract with the Owner's priority to use the funds for the completion of the work, the Contractor or with a subcontractor of the Contractor to furnish 9 The Surety shall not be liable to the Owner,Claimants or others for labor, materials or equipment for use in the performance of the obligations of the Contractor that are unrelated to the Construction Contract.The intent of this Bond shall be to include without limi- Contract.The Owner shall not be liable for payment of any costs or tation in the terms"labor, materials or equipment"that part of expenses of any Claimant under this Bond,and shall have under this water,gas,power,light,heat,oil,gasoline,telephone service or Bond no obligation to make payments to,give notices on behalf of, rental equipment used in the Construction Contract,architectural or otherwise have obligations to Claimants under this Bond. and engineering services required for performance of the work of 10 The Surety hereby waives notice of any change,including changes the Contractor and the Contractor's subcontractors,and all other of time,to the Construction Contract or to related subcontracts,pur- items for which a mechanic's lien may be asserted in the jurisdic- chase orders and other obligations. non where the labor,materials or equipment were furnished. 11 No suit or action shall be commenced by a Claimant under this 15.2 Construction Contract:The agreement between the Owner Bond other than in a court of competent jurisdiction in the location and the Contractor identified on the signature page,including all in which the work or part of the work is located or after the expiration Contract Documents and changes thereto. of one year from the date(1)on which the Claimant gave the notice required by Subparagraph 4.1 or Clause 4.2.3,or(2)on which the last 15.3 Owner Default;Failure of the Owner,which has neither been labor or service was performed by anyone or the last materials or remedied nor waived,to pay the Contractor as required by the Con- equipment were furnished by anyone under the Construction Con- struction Contract or to perform and complete or comply with the tract,whichever of(1)or(2)first occurs. If the provisions of this other terms thereof. MODIFICATIONS TO THIS BOND ARE AS FOLLOWS: (Space is provided below for additional signatures of added parties,other than those appearing on the cover page.) (Corporate Seal) CONTRACTOR AS PRINCIPAL SURETY Old Republic Insurance Company Company: (Corporate Seal) Company: Signature: Signature: Name and Title: Name and Title: Address: Address: Page 2 of 2 • * * *. Bond#2115291 * iht * PERFORMANCE BOND * * The American Institute of Architects, * AIA Document No.A312(December,1984 Edition) * * * Any singular reference to Contractor,Surety,Owner or other party shall be considered plural where applicable. CONTRACTOR(Name and Address): OWNER(Name and Address): American Pavement Solutions, Inc. City of Coon Rapids PO Box 13007 1115 Robinson Drive Green Bay,WI 54307-3007 Coon Rapids,MN 55433 CONSTRUCTION CONTRACT SURETY(Name and Principal Place of Business): Old Republic Insurance Company Date: 04/03/2012 400 N.Executive Drive,Suite 306 Amount: $124,768.56 Brookfield,WI 53005 Description(Name and Location): Project 12-5,2012 North Metro Street Maintenance Program BOND Date(Not earlier than Construction Contract Date):04/10/2012 Amount$124,768.56 Modifications to this Bond: ® None 0 See Page 2 CONTRACTOR AS PRINCIPAL SURETY er,, Company: (Corporate Seal) Company: (i (, < I) American Pavement Solutions,Inc. Old Republic Insurance Company ,fib aW�`rc "ou nog Signature: ..' �` — - •na tire: *1 Name and Title: Roger Myers, .-c/Trea s Name and Title: Amy Sue S ver/Attorney-in-Fact (Any additional signatures appear on page 2.) (FOR INFORMATION Only-Name,Address and Telephone) OWNER'S REPRESENTATIVE(Architect,Engineer or other AGENT or BROKER: Agent party): Engineer 1 The Contractor and the Surety,jointly and severally,bind them- 3.3 The Owner has agreed to pay the Balance of the Contract Price selves,their heirs,executors,administrators,successors and assigns to the Surety in accordance with the terms of the Construction to the Owner for the performance of the Construction Contract,which Contract or to a contractor selected to perform the Construction is incorporated herein by reference, Contract in accordance with the terms of the contract with the 2 If the Contractor performs the Construction Contract,the Surety and Owner. the Contractor shall have no obligation under this Bond,except to par- 4 When the Owner has satisfied the conditions of Paragraph 3,the ticipate in conferences as provided in Subparagraph 3.1. Surety shall promptly and at the Surety's expense take one of the 3 If there is no Owner Defauitt the Surety's obligation under this Bond following actions: shall arise after: 3.1 The Owner has notified the Contractor and the Surety at its 4.1 Arrange for the Contractor with consent of the Owner,to address described in Paragraph 10 below that the Owner is con- perform and complete the Construction Contract;or sidering declaring a Contractor Default and has requested and 4.2 Undertake to perform and complete the Construction Contract attempted to arrange a conference with the Contractor and the Surety to be held not later than fifteen days after receipt of such itself,through Its agents or through independent contractors;or notice to discuss methods of performing the Construction Contract. 4.3 Obtain bids or negotiated proposals from qualified contractors If the Owner,the Contractor and the Surety agree,the Contractor acceptable to the Owner for a contract for performance and corn- shall be allowed a reasonable time to perform the Construction Con- pletion of the Construction Contract,arrange for a contract to be tract,but such an agreement shall not waive the Owner's right,if prepared for execution by the Owner and the contractor selected any,subsequently to declare a Contractor Default;and with the Owner's concurrence,to be secured with performance 3.2 The Owner has declared a Contractor Default and formally and payment bonds executed by a qualified surety equivalent to terminated the Contractor's right to complete the contract.Such the bonds issued on the Construction Contract,and pay to the Contractor Default shall not be declared earlier than twenty days Owner the amount of damages as described in Paragraph 6 in after the Contractor and Surety have received notice as provided excess of the Balance of the Contract Price incurred by the Owner in Subparagraph 3.1;and resulting from the Contractor's default;or ORSC 22119(10.93) Page 1 of 2 4.4 Waive its right to perform and complete, arrange for completion, accrue on this Bond to any person or entity other than the Owner or Or obtain a new contractor and with reasonable promptness under Its heirs,executors, administrators or successors. the circumstances: 8 The Surety hereby waives notice of any change,including changes .1 After investigation,determine the amount for which it may of time, to the Construction Contract or to related subcontracts, be liable to the Owner and, as soon as practicable after purchase orders and other obligations. the amount is determined,tender payment therefor to the 9 Any proceeding, legal or equitable,under this Bond may be Owner;or instituted in any court of competent jurisdiction in the location in which .2 Deny liability in whole or in part and notify the Owner citing the work or part of the work is located and shall be instituted within reasons therefor. two years after Contractor Default or within two years after the Con- tractor If the Surety does not proceed as provided in Paragraph 4 with tractor ceased working or within two years after the Surety refuses 5 If the Surety does no the proceed shall be deemed Paragraph to ra in default or fails to perform its obligations under this Bond,whichever occurs first. If the provisions of this Paragraph are void or prohibited by law, on this Bond fifteen days after receipt of an additional written notice the minimum period of limitation available to sureties as a defense from the Owner to the Surety demanding that the Surety perform its Obligations under this Bond,and the Owner shall be entitled to enforce in the jurisdiction of the suit shall be applicable. any remedy available to the Owner. If the Surety proceeds as provided 10 Notice to the Surety,the Owner or the Contractor shall be mailed in Subparagraph 4.4,and the Owner refuses the payment tendered or delivered to the address shown on the signature page. or the Surety has denied liability,in whole or in part,without further 11 When this Bond has been furnished to comply with a statutory or notice the Owner shall be entitled to enforce any remedy available other legal requirement in the location where the construction was to the Owner. to be performed,any provision in this Bond conflicting with said statu- 6 After the Owner has terminated the Contractor's right to complete tort' or legal requirement shall be deemed deleted herefrom and the Construction Contract, and if the Surety elects to act under provisions conforming to such statutory or other legal requirement Subparagraph 4.1,4.2, or 4.3 above,then the responsibilities of the shall be deemed incorporated herein.The intent is that this Bond shall Surety to the Owner shall not be greater than those of the Contractor be construed as a statutory bond and not as a common law bond. under the Construction Contract,and the responsibilities of the Owner 12 DEFINITIONS to the Surety shall not be greater than those of the Owner under the 12.1 Balance of the Contract Price The total amount payable by Construction Contract.To the limit of the amount of this Bond, but the Owner to the Contractor under the Construction Contract after subject to commitment by the Owner of the Balance of the Contract all proper adjustments have been made, including allowance to Price to mitigation of costs and damages on the Construction the Contractor of any amounts received or to be received by the Contract,the Surety is obligated without duplication for: Owner in settlement of insurance or other claims for damages to 6.1 The responsibilities of the Contractor for correction of defec which the Contractor is entitled, reduced by all valid and proper tive work and completion of the Construction Contract; payments made to or on behalf of the Contractor under the Construction Contract. 6.2 Additional legal design professional and delay costs resulting 12.2 Construction Contract:The agreement between the Owner from the Contractor's Default,and resulting from the actions or and the Contractor identified on the signature page, including all failure to act of the Surety under Paragraph 4;and Contract Documents and changes thereto. 6.3 Liquidated damages,or if no liquidated damages are speci- 12.3 Contractor Default:Failure of the Contractor,which has neither fled In the Construction Contract. actual damages caused by been remedied nor waived,to perform or otherwise to comply with delayed performance or non-performance of the Contractor, the terms of the Construction Contract. 7 The Surety shall not be liable to the Owner or others for obligations 12.4 Owner Default:Failure of the Owner,which has neither been of the Contractor that are unrelated to the Construction Contract and remedied nor waived,to pay the Contractor as required by the the Balance of the Contract Price shall not be reduced or set off on Construction Contract or to perform and complete or comply with account of any such unrelated obligations. No right of action shall the other terms thereof. MODIFICATIONS TO THIS BOND ARE AS FOLLOWS: (Space is provided below for additional signatures of added parties other than those appearing on the cover page.) CONTRACTOR AS PRINCIPAL (Corporate Seal) SURETY (Corporate Seal) Company: Company:Old Republic Insurance Company Address: Address: Name and Title: Name and Title: Signature: Signature: ORSC 22119(10-93) Page 2 Of 2 * INSURANCE 't?l'4 ANY *~fir POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That OLD REPUBLIC INSURANCE COMPANY,a Pennsylvania stock insurance corporation,does make,constitute and appoint: JAMES NATALIZIO, BARBARA J. MARSCBER, -DENISE M. BANKS, APRIL M. WEAATEERSTON, FRANCES G. CLAWSON,e CAROL J PRAZMA, .AMY SUE SHAVER, OF NEW BERLIN, WI its true and lawful Attorney(s)-in-Fact,with full power and authority,not exceeding$20,000,000,for and on behalf of the Company as surety,to execute and deliver and affix the seal of the Company thereto(if a seal is required),bonds,undertakings,recognizances or other written obligations in the nature thereof, (other than self-insurance workers compensation bonds guaranteeing payment of benefits,asbestos abatement contract bonds,waste manage- ment bonds,hazardous waste remediation bonds or black lung bonds),as follows: ALL WRITTEN INSTRUMENTS IN AN AMOUNT NOT TO EXCEED AN AGGREGATE OF ONE MILLION DOLLARS($1,000,000)-------'-----....--«.- ---- FOR ANY SINGLE OBLIGATION,'REGARDLESS OF TEE NUMBER OF INSTRUMENTS ISSUED FOR TEE OBLIGATION. and to.bind OLD REPUBLIC INSURANCE COMPANY thereby,and all of the acts of said Attorneys-In-Fact,pursuant to these presents,are ratified and Confirmed, This document is not valid unless printed on colored background and is multi-colored. This appointment is made under and by authority of the board of directors at a meeting held on May 12,2010. This Power of Attorney i$signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the OLD REPUBLIC INSURANCE COMPANY on May1 2,2010. RESOLVED FURTHER,that the chairman,president or any vice president of the Company's surety division,in conjunction with the secretary or any assistant secretary of the Company,be and hereby are authorized and directed to execute and deliver,to such persons as such officers of the Company may deem appropriate,Powers of Attorney in the form presented to and attached to the minutes of this meeting,authorizing such persons to execute and deliver and affix the seal of the Company to bonds,undertakings,recognizances,and suretyship obligations of all kinds, other than bail bonds,bank depository bonds,mortgage deficiency bonds,mortgage guaranty bonds,guarantees of installment paper and note guaranty bonds, The said officers may revoke any Power of Attorney previously granted to any such person. The authority of any Power of Attorney granted by any such officer of the Company as aforesaid shall not exceed twenty million dollars($20,000,000.00),except(a)bonds required to be filed as open penalty bonds,and(b)bonds filed with any court or governmental authority requiring an unlimited penalty in bonds filed in that court. RESOLVED FURTHER,that any bond,undertaking,recognizance,or suretyship obligation shall be valid and binding upon the Company (r)when signed by the chairman,president or any vice president of the Company's surety division and attested and sealed(if a seal be required)by any,secretary or assistant secretary;or (ii)when signed by duly authorized Attorney-in-Fact and sealed with the seal of the Company(if a seal be required). RESOLVED FURTHER,that the signature of any officer designated above,and the seal of the Company,may be affixed by facsimile to any Power of Attorney or certification thereof authorizing the execution and delivery of any bond,undertaking,recognizance,or other suretyship obligations of the Company,and such signature and seal when so used shall have the same force and effect as though manually affixed. IN WITNESS WHEREOF,OLD REPUBLIC INSURANCE COMPANY has caused these presents to be signed by its proper officer,and Its corporate seal to be affixed this 28TH day of. FEBRUARY, 2012. OLD REPUBLIC INSURANCE COMPANY ,s „,,eaeary n s/ r 'a{SEAL s ,i 450 Ass = t Secretary 4� r€ ,ice President STATE OF WISCONSIN,COUNTY OF YVAUKESHA-SS On this 28TH . day of. FEBRUARY, 2012 personally came before me, GERALD C.LEACH and PHYLLIS M.JOHNSON to me known to be the individuals and officers of the OLD.REPUBLIC INSURANCE COMPANY who executed the above instrument,and they each acknowledged the execution of the same,and being by me duly swom,did severally.depose and say;that they are said officers of the corporation aforesaid,and that the seal affixed to the above instrument is the seat of the corporation,and that said corporate seat and their signatures as such officers were duty affixed and subscribed to the said instrument by the authority of the board of directors of said organization. '• N09ry Pub4c '' My commission expires: 12/02/2012 CERTIFICATE I,the undersigned,assistant secretary of the OLD REPUBLIC INSURANCE COMPANY,a Pennsylvania corporation,CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked;and furthermore,that the Resolutions of the board of directors set forth in the Power of Attorney,are now in force. 24-1597 mow,+r,y '�`�"0 ... "'t'{,, Signed and sealed at the City of Brookfield,WI this �� day of - hR(.SEAL}; S e,,,,s .. 11. HNI RISK SEA CE ` ' +`rOT ORSC#22851 11005-R(5-10). r ' 1 AC Ro?J CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 441....----- 41... 4/9/2012 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 -CONTACT HNI Risk Services NAME` PO Box 510187 nico,Nn o,Ext): 262-782-3940 FAX No): 262-782-4198 E-MAIL ADDRESS: certsl hni.COm New Berlin WI 53151 INSURER(S)AFFORDING COVERAGE NAIC# 1 INSURER A: Cincinnati Insurance Companies A+ INSURED American Pavement Solutions Inc. INSURER B: West Bend Mutual Insurance Company THSMA,Inc. INSURER C: Daffinson Transport, LLC INSURER O: PO Box 13007 INSURER E: Green Bay WI 54307-3007 _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- ADDL SUBR POLICY EFF POUCY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS GENERAL UABILITY EACH A UAMAOtCUN NnitU $1,000,i}00 X I COMMERCIAL GENERAL LIABILITY CPP3656485 04/08/12 04/08/13 __ PREMISES(Ea occurrence) $500,000 CLAIMS-MADE I OCCUR MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENt AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 1 POLICY X PRO- JECT LOC $ AUTOMOBILE LIABILITY CPA3656485 04/08/12 04/08/13 COMBINED SINGLE LIMI I A (Ea acc den ent) $1.000,000 X ANY AUTO - BODILY INJURY(Per person) $ ■ ALLOS OWNED ■A TOSULED BODILY INJURY(Per accident) $ X HIRED AUTOS © NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ A UMBRELLA LIAB X OCCUR CPP3656485 04/08/12 04/08/13 EACH OCCURRENCE $ 9,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 9,000,000 DED RETENTION$ $ WORKERS COMPENSATION W'CSIAIIJ• 0111- B AND EMPLOYERS'UABILITY Y/N AAV 17272440 04/08/12 04/08/13 X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICE/MEMBER EXCLUDED? N/A 300,000 (Mandatory in NH) E.L,DISEASE-EA EMPLOYEE $500,000 If yes,describe under nFn/"PIPTInN OF nFFRATInnIR t,wirnv E.L.DISEASE-POLICY LIMIT $500,000 A Equipment Floater CPP3656485 04/08/12 04/08/13 Hired/Leased Equip 75,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Automatic Additional Insureds for owners,lessees and contractors as respects • all work performed by the Named Insured including ongoing and completed operations. Primary and non-contributory wording applies. Coon Rapid,Anoka,Columbia Heights,East Bethel,and Mahtomedi are included as additional insureds on General liabiltiy with respect to liability CERTIFICATE HOLDER CANCELLATION City of Coon Rapids SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Kris Linguist THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1155 Robinson Drive AUTHORIZED REPRESENTATIVE Coon Rapids MN 55433 . I _ ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD A' HOLDER NAME: City of Goon Rapids PAGE 2 INSURED'S NAME: American Pavement Solutions Inc. DATE:4/9/2012 work performed by the named insured.