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HomeMy WebLinkAboutAgreement for Janitorial Services with Clean and Fresh Carpets for PD CITY OF MERIDIAN-MERIDIAN POLICE DEPARTMENT JANITORIAL SERVICES JANITORIAL AGREEMENT This AGREEMENT made between the City of Meridian-Meridian Police Department, a political subdivision of the State of Idaho, and CLEAN &FRESH CARPETS, hereinafter called JANITOR. The CITY OF MERIDIAN-MERIDIAN POLICE DEPARTMENT and JANITOR, in consideration of the mutual covenants hereinafter set forth, agree as follows: WORK The JANITOR is to perform janitorial services as set forth hereafter, in the buildings and at the frequency set forth in the Specifications, which are attached hereto and by this reference incorporated herein ^ Vacuum all carpets and dust all furniture, lockers, and surface areas. ^ Carpet extraction. ^ Mop all tiled floors with a cleaner. ^ Strip and wax all tiled floors, including polishing of floors with a mechanical polisher. ^ Empty all trash containers and discard all materials specified by POLICE DEPARTMENT. ^ Wash all windows with a window cleaner, inside and outside. ^ Clean all bathrooms, including toilet and lavatory bowls and refill all paper towel and toilet paper dispensers. ^ Change burned out light bulbs as needed with the exception of high lights in the lobby area. ^ Clean light fixtures. ^ Clean heating and cold air vents. ^ Wash walls and door moldings to remove markings. 2. COMPENSATION. The CITY OF MERIDIAN shall pay the JANITOR the sum of $2,259 per month for the services described herein and in the Specifications. Generally, payment will be sent to the JANITOR by the 15`" day of the month following POLICE DEPARTMENT's receipt of the JANITOR's invoice. In addition, the CITY OF MERIDIAN will compensate the JANITOR for any additional services as agreed to in Writing between POLICE DEPARTMENT and JANITOR. 3. MATERIALS AND EQUIPMENT JANITOR agrees to provide all materials and equipment necessary to perform all listed services as a part of the compensation listed above. POLICE DEPARTMENT will provide a storage area. *The POLICE DEPARTMENT will supply the paper products, liners and hand soap as needed by the JANITOR 4. EMPLOYEES. JANITOR agrees to provide POLICE DEPARTMENT with a list of names, dates of birth, social security numbers and addresses of all employees who will be performing the janitorial services. JANITOR agrees not to use any person in the performance of this contract until such person has been cleared by the POLICE DEPARTMENT. (Approval / Rejection will normally be completed within one week.) If POLICE DEPARTMENT disapproves of any such employee(s), in writing, JANITOR agrees not to use such employee(s) in the work. JANITOR further agrees to use care in selecting trustworthy employees and in supervising them. Procedure for implementing this section: 1. JANITOR will submit name, date of birth, social security number, and addresses for all employees JANITOR wishes to provide service under this contract to Jean Moore, Administrative Secretary, Meridian Police Department, 1401 E. Watertower St., Meridian, ID 83642. Information may also be faxed to Ms. Moore at 846-7372. 2. POLICE DEPARTMENT will provide a response to JANITOR, normally within one week, depending on extent of background check required. 3. Approved employees will make an appointment with Ms. Moore during regular business hours to obtain an identification card which will allow work within the Meridian Police building. Employees may begin work only after obtaining this identification card. 4. JANITOR's employees will wear the approved identification card at all times while within the Meridian Police building. JANITOR employee IDs will be subject to random checks by police personnel. 5. Failure to wear the approved identification within Meridian Police building shall result in the ejection of the employee and possible denial of future access to the building. 6. Any JANITOR employee who gains access to the Meridian Police building using an identification card issued to another person shall be ejected from the building and all future access shall be denied. Additionally, the access privileges of the person to whom the identification card is issued shall be withdrawn permanently. 7. Upon separation of service of any employee who has been granted access to the Meridian Police building, JANITOR agrees to notify Ms. Moore at 846-7370 on the same day as the separation occurs, or if such separation occurs at other than regular business hours, the next following business day prior to 9:00 am. JANITOR is also responsible for retrieving any Meridian Police issued identification card from such employee and returning said card to Ms. Moore. ADDENDUM: Implementation procedure and requirements for display of identification 5. INDEMNIFICATION. JANITOR agrees to indemnify, defend, and hold harmless THE CITY OF MERIDIAN-POLICE DEPARTMENT, and its officers, agents and employees, from and against any and all claims, losses, actions, or judgments for damages or injury to persons or property arising out of or in connection with the acts and/or any performances or activities or JANITOR, JANITOR's agents, employees, or representatives under this Agreement. 6. INSURANCE. JANITOR agrees to obtain and keep in force during its acts under this Agreement insurance in amounts and types as specified in the Specifications. Certificates of Insurance for all required insurances shall be submitted to the CITY OF MERIDIAN prior to CITY OF MERIDIAN signature to this Agreement. 7. COMPLIANCE WITH LAWS. JANITOR agrees to comply with all federal, state, city, and local laws, rules and regulations. ACCESS CARD ~'.¢e/~ ~'m vc.vyP~ q POLICE DEPARTMENT will give ewe magnetic access card to JANITOR for access to the premises, and JANITOR must obtain the approval of POLICE DEPARTMENT as to any employee who is given access to the card. JANITOR shall immediately report the loss or compromise of the card to the POLICE DEPARTMENT Administrative office 9. INDEPENDENT CONTRACTOR. The parties agree that JANITOR and all its employees are independent contractors for POLICE DEPARTMENT and in no way employees or agents of POLICE DEPARTMENT and are not entitled to workers compensation or any benefit of employment with the POLICE DEPARTMENT. POLICE DEPARTMENT shall have no control over the performance of the Agreement by JANITOR, except to specify the time and place of performance and the results to be achieved. JANITOR shall be responsible for the payment of any and all taxes due for the compensation received under this contract. 10. TERMINATION This Agreement may be terminated immediately by CITY OF MERIDIAN- POLICE DEPARTMENT for breach of this Agreement by JANITOR and either party may terminate this Agreement by 30 days written notice to termination to the other party. 11. DISPOSAL OF TOXIC SUBSTANCES JANITOR agrees to dispose of any and all toxic substances used in the premises in accordance with federal, state and local statutes and regulations and further agrees to indemnify POLICE DEPARTMENT from any liability resulting there from. 12. ATTORNEY FEES Reasonable attorney fees shall be awarded to the prevailing party in any action to enforce this Agreement or to declare termination or forfeiture of this Agreement. 13. AGREEMENT TIME PERIOD The work under this Agreement shall begin July 15, 2002 and, unless sooner terminated pursuant to Section 10 above, end September 30, 2003, unless otherwise specified by amendment 14. MISCELLANEOUS a. No assignment by a party hereto of any rights under or interest in the Agreement Documents will be binding on another party hereto without the written consent of the party sought to be bound; and specifically but without limitation moneys that may become due and moneys that are due may not be assigned without such consent (except to the extent that the effect of this restriction may be limited by law), and unless specifically stated to the contrary in any written consent to an assignment no assignment will release or discharge the assignor from any duty or responsibility under the Agreement Documents. b. THE CITY OF MERIDIAN and JANITOR each binds itself, its partners, successors, assigns and legal representatives to the other party hereto, its partners, successors, assigns and legal representatives in respect of all covenants and obligations contained in the Agreement Documents. 15. OTHER PROVISIONS IN WITNESS WHEREOF, THE CITY OF MERIDIAN and JANITOR have signed this Agreement in triplicate. One counterpart each has been delivered to CITY OF MERIDIAN and JANITOR. All portions of the Agreement Documents have been signed or identified by CITY OF MERIDIAN and JANITOR on their behalf. The Agreement will be effective on July 15, 2002. CITY OF DIAN By: Name: Robert D. Corrie Ma or Approved A 2-O ~ Janitor ~IV ~ ~J~/~,~~ By; * Name: ~O RATE S~A ] ~= SEAL WilPf~,~~~$~'g', J~v ~* erk Attest Address for giving notices 1401 E. Watertower St. Meridian, ID 83642 [CORPORATE SEAL] Address for giving notices *(JANITOR is a corporation; attach evidence of authority to sign if other than President signing. CITY OF MERIDIAN-MERIDIAN POLICE DEPARTMENT JANITORIAL SERVICES SPECIFICATIONS Description of Work The work contemplated under this Agreement consists of providing janitorial services to a City owned building: Meridian Police Department - 1401 E. Watertower - 846-7370 Contact person -Jean Moore, Administrative Secretary to the Chief It is the intent of the specifications that the JANITOR furnishes all necessary labor, equipment and cleaning materials and shall perform all cleaning operations and frequency thereof as shown on the following schedule. SCHEDULE OF JANITORIAL SERVICE CLEANING FUNCTION AND FREQUENCY BUILDING IS APPROXIMATELY 30,000 SQ. FT. FUNCTION Vacuum/Dust 5 per wk High Dusting 1 per mo Carpet Shampoo 2 per yr (Extraction) Floor Mopping 1 per wk Stripping/Floor Waxing 4 per yr Floor Buffing 1 per wk Empty Trash 5 per wk Wash Windows: Outside 4 per yr Inside 2 per yr Clean Bathrooms 5 per wk Change Light Bulbs As needed Clean Light Fixtures as needed Clean Air Vents 2 per yr Wash Walls/Molding as needed Scrub Tile Floor 4 per yr Clean Holding Cells 1 per wk Cost per hour for requested extra services $12.00 per hour Schedule of Com letion All janitorial services to the second floor of the building and evidence offices must be completed by 5:00 pm on regular business days. No access will be allowed to the second floor after regular business hours, except with authorized escort. All janitorial services to the Records Room must be completed by 7:00 pm on regular business days. No access will be allowed to the Records Room after 7:00 pm on business days, except with authorized escort. Janitorial services to the remainder of the building must be completed by 10:00 pm and all janitorial staff must vacate the building by that time. Conditions of Work The JANITOR has informed himself/herself of the conditions relating to the work and it is assumed that he/she has inspected the site at which the work is to be done and has made himself/herself familiar with the required cleaning functions and frequency at the site as shown. in the previously listed Schedule of Janitorial Service. Insurance The JANITOR shall not commence work under this Agreement until he/she has furnished the CITY OF MERIDIAN with satisfactory proof of the carriage of insurance as specified herein. A. Workmen's Compensation Insurance• The JANITOR shall maintain, during the life of this Agreement, Workmen's Compensation Insurance for all employees employed on this work. 1. State -Statutory 2. Employers Liability -Statutory 3. Applicable Federal -Statutory B. Comprehensive General Liability' The Janitor shall maintain this insurance against death or injury to persons or damage to property during this life of this contract in such form as it will protect the JANITOR and CITY OF MERIDIAN from all as above provided in the amounts: Bodily Injury $500,000. Each Occurrence and Annual Aggregate Property Damage Personal Injury $500,000. Each Occurrence and Annual Aggregate $500,000. Annual Aggregate The City of Meridian shall be explicitly named as an additional insured and POLICE DEPARTMENTS and Contractors Protective included. Special Provisions Emplo ees -All employees who will be working in the listed building are required to undergo a background investigation as conducted by the Meridian Police Department. Only employees with a satisfactory background check shall be allowed to access the work areas. Employees shall wear a Meridian Police issued identification card at all times while present within the building. JUL-15-2002 MON 12 50 PM 1D STATE INSURANCE FUND FAX N0. 2083343254 P, O1/Ol 0 s r STATE INSCJRANCE FUND 121 S W. S"rA"rP. ST • P.O, IIOX 83720 • llOISE, IllAHO 83720•W44 PHONP, (208) 332-2100- (eUU) 33a-2370 [[vdNSON Uwl)SR CIG%It'1'11+ICATIL IIOLD)t:,R: Rcv, S/:D00 MERIDIAN POLICE DEPT 201 E IDAHO ST MERIDIAN ID 83692 CERTIhICATF, OF WORKERS COMPL+'NSATION INSUYtANCE The Slate Insurance Fund hereby ecrlifies that tha insurance policy hereunder described is in full force and effect on the data of this certificate and that it remains in full force and effect until cancelled. POLICY NUM11CIt: 569724 1NSU1t1=D; CLEAN & FRL'+SI~ CARPETS 1107 N 9TH ST AOISL Ill 83702 ORiCiINAL EFFFCTIVL+ llA7'E; Novembar 16, 1999 Policy in force from Nuvcn)ber 16, 1999 12:01 a.m, at the mailing addresa of the lnsttred shown above or the jt~b sits in Idaho, PART 'l'WO: EMPLOYERS LIABILITY 1NSt1RANC'I? LIMITS Bodily Injury by Accident $100,000 each accident Dodily Injury by Disease $500,000 policy limit Bodily Injury by Discasc 5100,000 each employee The insurance coveraga applies to employees of the nbove•mentioned company anywhere in the state of Idaho and also to any employees living in Idaho but working temporarily in a neighboring state, In addition to the required coverage, the following elected coverage also applies; 13ra~ C; Wrobel ElCCted Sole PropricWt This ccrtil'icate is valid f~)r t)ne year from data of certificate. In the event of cancellation of said p~)licy, the State Insuranco T~'und will endeavor to notify the party to whom this certificate is issued by providing ten (10) days ndvanco notice, but the State Insurance Pond shall not be liable in any way for failure to give notice, Uatcd at Doise, Idaho on Jttly 15, 2002. Krishna Mc Donell Undcrwriler Capitol Indemnity Corporation P.O. Box 5900, Madison, WI 53705 COMMON POLICY DECLARATIONS RENEWAL OF NUMBER: NEW POLICY NUMBER POLICY PERIOD AGENCY BP00170211 11/26/2001 11/26/2002 08095 NAMED INSURED AND ADDRESS AGENT CLEAN AND FRESH NORTHEAST AGENCIES INC BRAD WROBEL DBA 2495 MAIN ST STE 209 1107 N 9TH ST BUFFALO, NY 14214 BOISE, ID 83702 POLICY PERIOD: 11/26/2001 - 11/26/2002 12:01 A.M. Standard Time at the address of the insured stated herein BUSINESS DESCRIPTION: JANITORIAL AND CARPET CLEANING IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. Commercial Property Coverage Part Commercial General Liability Coverage Commercial Crime Coverage Part Commercial Inland Marine Coverage Part Umbrella Coverage Part Liquor Liability Coverage Part Businessowners NOT Part NOT NOT NOT NOT NOT COVERED COVERED COVERED COVERED COVERED COVERED 520 TOTAL ADVANCE PREMIUM $ 520 Premium shown is payable: $ 520 104.00 AT INCEPTION * THE LIABILITY PREMIUM BASIS OF THIS POLICY IS SUBJECT TO AN AUDIT. ADDITIONAL OR RETURN PREMIUMS MAY BE DUE. Forms applicable to all Coverage parts: SEE ATTACHED COMMERCIAL POLICY FORM SCHEDULE # CICG 179 COUNTERSIGNED 12/27/2001 By Authorized Representative CICG 174 (06-98) AGENT COPY V2 Capitol Indemnity Corporation P.O. Box 5900 Madison, WI 53705 IMPORTANT NOTICE Please review the following endorsement(s) which has been attached to your renewal policy and will be attached to all future renewals of the policy. The endorsement(s) may change or delete coverage on your renewal policy. Endorsements: N/A CGE 002 (02-96) Capitol Indemnity Corporation P.O. Box 5900, Madison, W 153705 COMMERCIAL POLICY COVERAGE PART FORM SCHEDULE POLICY NUMBER POLICY PERIOD AGENCY BP00170211 11/26/2001 11/26/2002 08095 NAMED INSURED AND ADDRESS AGENT CLEAN AND FRESH BRAD WROBEL DBA NORTHEAST AGENCIES INC 1107 N 9TH ST BOISE, ID 83702 Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: FORMS APPLICABLE TO ALL PREMISES AND COVERAGES Form Edition Description BJP190 10 94 CICG 174 06 98 CGE 002 02 96 CGE 030 12 98 CGE 112 04 96 CGE 215 04 96 CGE 278 04 96 CICG 176 10 93 CICG 258 11 93 IL 00 17 11 98 IL 02 04 04 98 IL 0935 08 98 CGE 348 12 99 COMMERCIAL LINES POLICY JACKET COMMON POLICY DEC IMPORTANT .NOTICE POLICYHOLDERS NOTICE - YEAR 2000 COMPUTER PROBLEMS IMPORTANT NOTICE! IMPORTANT NOTICE - NON PAYMENT O F PREMIUM POLICYHOLDER AUDIT INFORMATION LOCATION SCHEDULE SINGLE DEDUCTIBLE COMMON POLICY CONDITIONS IDAHO CHANGES - CANCELLATION & NONRENEWAL EXCLUSION OF CERTAIN COMPUTER - RELATED LOSSES INSTALLMENT PAYMENT SCHEDULE-DIRECT BILL POLICY CICG 179 (10-93) AGENT COPY Capitol Indemnity Corporation P.O. Box 5900, Madison, WI 53705 LOCATIONS SCHEDULE POLICY NUMBER POLICY PERIOD AGENCY BP00170211 11/26/2001 11/26/2002 08095 NAMED INSURED AND ADDRESS AGENT CLEAN AND FRESH BRAD WROBEL DBA NORTHEAST AGENCIES INC 1107 N 9TH ST BOISE, ID 83702 Prems. No. Street 001 1107 N 9TH ST City BOISE St Zip ID 83702 CICG 176 (10-93) AGENT COPY Capitol Indemnity Corporation P.O. Box 5900, Madison, WI 53705 Insured's Name and Mailing Address CLEAN AND FRESH BRAD WROBEL DBA 1107 N 9TH ST BOISE, ID 83702 Business Description: BUSINESSOWNERS POLICY DECLARATION: Policy No. BP00170211 INCEPTION (Mo. Day Yr.)(12:01 AM Standard Time at your mailing address) 11/26/2001 EXPIRATION (Mo. Day Yr.) 'X' IF SUPPLEMENTAL. DECLARATION 11 / 2 6/ 2 0 0 2 ®SUPPLEMENTAL DECLARATIC RENEWAL OR REWRITE OF NO. NEW Form of Business JANITORIAL AND CARPET CLEANING I ® Individual ^ Partnership ^ Other ^ Corporation ^ Joint Venture In return for the payment of the premium and subject to all the terms of this policy, we agree with you to provide the insurance as stated ii this policy. DESCRIBED PREMISES Forms Applicable: ^ standard ®Special Premises No. Bldg. No. Location Mortgage Holder Name and Address SEE ATTACHED SUPPLEMENTAL DECLARATIONS SEE ATTACHED SCHEDULE PROPERTY PREM. NO. BLDG. NO. PREM. NO BLDG. NO. PREM. NO. BLDG. N0. SEE ATTACHED SUPPLEMENTAL DECLARATIONS Deductible $ SEE ATTACHED SUPPLEMENTAL DECLARATIONS OPTIONAL COVERAGES SEE ATTACHED SUPPLEMENTAL DECLARATIONS LIABILITY AND MEDICAL PAYMENTS Except for Fire Legal Liability, each paid claim for the following coverages reduces the amount of insurance we provide during the applicable annual period. Please refer to paragraph D.4. of the Businessowners Liability Coverage Form. Limits of Insurance Liability and Medical Expenses Medical Expenses Fire Legal Liability $ 500,000 $ 5 , 0 0 0 per person $ 10 0 , 0 0 0 any one fire or explosion TOTAL PREMIUM $ 5 2 0 payable $ FORMS AND ENDORSEMENTS: SEE ATTACHED SCHEDULE During the past three years no insurer has canceled any insurance issued to the named insured, similar to that afforded hereunder, unless otherwise stated herein. COUNTERSIGNATURE DATE AGENCY AT AGENT AND NUMBER NORTHEAST AGENCIES INC 12/27/2001 BUFFALO, NY 14214 2495 MAIN ST STE 209 08095 THESE DECLARATIONS, TOGETHER WITH THE COVERAGE FORM(S), COMMON POLICY CONDITIONS AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. CBP 001 (Ot-98) Includes copyrighted material of Insurance Services Ollice, Inc., with its permission. Copyright, Insurance Services Ollice, Inc., 1984, 1985 AGENT COPY Capitol Indemnity Corporation P.O. Box 5900, Madison, WI 53705 BUSINESSOWNERS SUPPLEMENTAL DECLARATIONS Policy Number: B P 0 017 0 211 Named Insured: CLEAN AND FRESH, BRAD WROBEL DBA Policy Effective Date: 11 / 2 6 / 2 0 01 DESCRIPTION OF PREMISES -ADDRESSES Prems. Bldg. No. No. Address 001 001 1107 N 9TH ST BOISE, ID 83702 DESCRIPTION OF PREMISES -OCCUPANCY Prems. Bldg. No. No. Occupancy 001 001 JANITORIAL SERVICES COVERAGES PROVIDED Prems. Bldg. No. No. Coverage 001 001 YOUR BUS. PERS. PROP. Construction FRAME Protecti 03 Limit of Automatic Increase Insurance in Insurance Deductible ACV/R $ 1,000 $ 250 RC OPTIONAL COVERAGES Prems. Bldg. No. No. Coverage Limits BUSINESS INCOME ACTUAL LOSS SUSTAINED Deducti~ MORTGAGE HOLDERS -NONE 12/27/2001 SLJ* AGENT COPY CBP 002 (O1-9t3) Capitol Indemnity Corporation P.O. Box 5900, Madison, WI 53705 COMMERCIAL BOP COVERAGE PART FORM SCHEDULE POLICY NUMBER POLICY PERIOD AGENCY BP00170211 11/26/2001 11/26/2002 08095 NAMED INSURED AND ADDRESS AGENT CLEAN AND FRESH BRAD WROBEL DBA NORTHEAST AGENCIES INC 1107 N 9TH ST BOISE, ID 83702 Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: FORMS APPLICABLE TO ALL PREMISES AND COVERAGES Form Edition Description CBP 001 O1 98 BOP DECLARATIONS CBP 002 01 98 BOP SCHEDULE CBP 005 Ol 98 BOP FORM SCHEDULE CBP 010 Ol 98 BOP LIABILITY SCHEDULE BP 00 06 01 97 BUSINESSOWNERS LIABILITY COVERAG E FORM BP 00 09 Ol 97 BUSINESSOWNERS COMMON POLICY CONDITIONS BP 04 17 Ol 96 EMPLOYMENT-RELATED PRACTICES EXCLUSION BP 04 18 06 89 AMENDMENT - LIQUOR LIABILITY EXCLUSION BP 04 54 O1 97 NEWLY ACQUIRED ORGANIZATIONS BP 10 04 04 98 EXCLUSION OF CERTAIN COMPUTER RELATED LOBBED ENDORSE CBP 004 12 00 EXCLUSION - PUNITIVE OR STATUTORY DAMAGES CBP 020 O1 99 BUSINESSOWNERS SPECIAL PROPERTY COVERAGE FORM CBP 111 12 00 EXCLUSION-DISCRIMINATION NO DUTY TO DEFEND OR INDEMNI CBP 135 12 00 EXCLUSION - LEAD LIABILITY BP 07 O1 O1 97 AMENDMENT OF POLICY PROVISIONS - CONTRACTORS BP 07 04 Ol 97 BUSINESS LIABILITY COVERAGE-PROPERTY DAMAGE LIABILIT CBP 012 10 97 CONTRACTUAL LIABILITY LIMITATION CBP 123 11 98 DAMAGE TO PROPERTY OF OTHERS CBP 005 (O1-98) AGENT COPY ,Capitol Indemnity Corporation P.O, Box 5900, Madison, W 153705 BUSINESSOWNERS SUPPLEMENTAL DECLARATIONS Policy Number: BPO 017 0211 Named Insured: CLEAN AND FRESH Policy Effective Date: 11 / 2 6 ~ 2 O 0 Premium AdY~n~E Classifications Code No. Baslg Rated Pf~-I1~Mf1 DAMAGE TO PROPERTY OF OTHER 00034 21,000 3,56 JANITORIAL SERVICES 96816, PRODUCTS-COMPLETED OPERATIONS ARE SUBJECT TO THE GENERAL AGGREGATE LIMIT CONTRACTORS LIABILITY 21 OOO PAYROLL 21~QOQ TOTAL PREMIUIYJ * THE LIABILITY PREMIUM BASIS OF THIS POLICY IS SUBJECT TO AID AUDIT. ADDITIONAL OR RETURN PREMIUMS MAY BE DUE. DATE -12/27/2001 NEW BUSINESS SLJ* CBP 010 (01-98) AGENT COPY POLICY NUMBER: BP00170211 BUSINESSOWN~RS ~P o7 A4 Al ~7 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFU~.~.Y, BUSINESS LIABILITY COVERAGE -PROPERTY I~,AM~ LIABILITY DEDUCTIBLE (PER OCCURRENCE ~~QS~~) This endorsement modifies insurance provided under the following: BUSINESSOWNERS POLICY SC~IEDULE* Amount Of Deductible Per Occurrence $ 250 *Information required to complete this Schedule, if not shown on this endorsement, will be shown In the Declarations. A. Our obligation under Section A. Coverages in the Businessowners Liability Coverage Form to pay damages on your behalf because of "property damage" applies only to the amount of damages in excels of the deductible amount shown in the Schedule. B. The deductible amount shown in the Schedule applies to the total of all damages because of "property damage" as the result of any one "oc- currence", regardless of the number of persons or organizations who sustain "property damage" because of that "occurrence". C. The terms of this insurance, including those With respect to: 1. Our right and duty to defend the inSUrpd against any "suits" seeking those ~ama9e~; and 2. Your duties in the event of an "occurrence", claim, or "suit" .apply irrespective of the application of thg deductible amount. D. We may pay any part or all of the deductible amount to effect settlement of any clalrrl or "SUIt" and, upon notification of the action taken, you shall promptly reimburse u$ for such part of the deductible amount as has been paid by u$. iBP 07 04 01 97 Copyright, Insurance Services Offlce, Inc., 1997 Pa~~ ~ p(1 ~ (~ Capitol Indemnity Corporation P.O. Box 5900 Madison, WI 53705 POLICYHOLDER NOTICE -YEAR 2000 COMPUTER PROBLEMS Please review your policy as it may contain one or more of the following year 2000 exclusions. Optional coverage endorsements that provide limited coverage for the year 2000 exposure may be available for an additional premium. An alternate endorsement may be used to provide coverage as the underwriter deems appropriate based on information provided by the insured regarding the specific exposures presented. Please have your agent contact a Home Office Underwriter for potential coverage. All requests will be individually underwritten by a Home Office Underwriter for coverage and premium determination. The intent of this Notice is to clarify the following exclusion Endorsements: 1. IL 09 35 -Exclusion of Certain Computer-Related Losses for the following coverages: Commercial Property, Commercial Inland Marine, Commercial Crime and Boiler and Machinery 2. CP 10 62 -Exclusion of Certain Computer-Related Losses -Virginia for Commercial Fire Policies 3. CR 01 37 -Exclusion of Certain Computer-Related Losses -Virginia for Crime Policies 4. CM 01 24 -Exclusion of Certain Computer-Related Losses -Virginia for Commercial Inland Marine Policies 5. BP 10 04 -Exclusion of Certain Computer-Related Losses for the Businessowners Policy An exclusion has been added to your policy to explicitly state that coverage is not provided for loss caused by a computer's inability, or that of computerized or other electronic equipment, to properly recognize a particular date or time. An example of this is a loss caused by the inability of the computer to recognize the year 2000. However, coverage is provided under certain circumstances: if the computer's inability to recognize a date or time results in a covered cause of loss -for example, fire -the loss resulting from that fire would be covered. The intent of this Notice is to clarify the following exclusion Endorsements: CG 21 60 -Exclusion Year 2000 Computer-Related and Other Electronic Problems for Commercial General Liability Coverage BP 10 05 -Exclusion Year 2000 Computer-Related and Other Electronic Problems for the Businessowners Policy 3• CCU 229 -Exclusion Year 2000 Computer-Related and Other Electronic Problems for the Umbrella Policy Because this endorsement is attached to your policy, you do not have coverage for liability arising out of any injury or damage related to any computer or other electronic equipment's inability to correctly recognize, process, distinguish, interpret or accept the year 2000 and beyond. This exclusion will apply regardless of whether the computer or other electronic product or devise (including computer chips) belongs to you or to others, or has been incorporated into your products or the products of others. THIS NOTICE HAS BEEN PREPARED IN CONJUNCTION WITH THE IMPLEMENTATION OF CHANGES TO YOUR POLICY. THIS NOTICE PROVIDES INFORMATION CONCERNING YOUR INSURANCE COVERAGE FOR BODILY INJURY, PROPERTY DAMAGE, AND PERSONAL AND ADVERTISING INJURY RESULTING FROM COMPUTER- RELATED OR OTHER ELECTRONIC PRODUCTS FAILURE TO RECOGNIZE THE CHANGE TO THE YEAR 2000. CGE 030 (12-98) Capitol Indemnity Corporation P.O. Box 5900 Madison, WI 53705 IMPORTANT NOTICE! This policy lists the first named insured on the declaration page. This part has specific rights and duties which are outlined in the common policy conditions. Please make certain that the first named insured, as listed, is correct. Advise us immediately if there is any change necessary. Please read this policy as there may be a difference in coverages, rules and conditions from other insurance policies CG E 112 (04-96) Capitol Indemnity Corporation P.O. Box 5900 Madison, WI 53705 IMPORTANT NOTICE -NON PAYMENT OF PREMIUM Reinstatement of coverage after cancellation for non-payment of premium is at our option and may be denied. Absolutely no policy will be reinstated after a second cancellation for non-payment of premium. CGE 215 (04-96) Capitol Indemnity Corporation P.O. Box 5900 Madison, WI 53705 POLICYHOLDER AUDIT INFORMATION Your commercial insurance policy may be audited. Your policy explains your rights and duties regarding an audit and this notice answers some common questions. WHY WOULD YOUR POLICY BY AUDITED? The premium charged when your policy was issued was an estimate based on the nature of your business and your exposures (payroll, sales, etc.) for the policy period. A review of your records at the end of the policy period allows us to adjust your premium based on actual operations during that time. HOW AND WHEN WILL AN AUDIT BE DONE? A premium auditor may either review your records in person or will send you a letter asking you to mail us the needed audit information. We will try to visit your business or contact you by mail as soon as we can after the end of our policy period. WHAT RECORDS ARE NEEDED FOR THE AUDIT? We will need to review your ledgers, journals, vouchers, contracts, tax reports, profit and loss statements and payroll and disbursement records. If you use subcontractors, we will need to see a Certificate of Insurance for each. Our premium auditor will let you know which of these items are specifically needed for your audit. WILL KEEPING DETAILED RECORDS HELP ME SAVE MONEY? You may be able to lower your final premium cost by keeping detailed records. A variety of insurance classifications may apply to your business, each having a different insurance rate. Detailed records should give us accurate payroll, sales and subcontracted costs allowing us to apply the appropriate classification to these exposures. DO I NEED A CERTIFICATE OF INSURANCE FOR EACH SUBCONTRACTOR I USE? You should always keep current Certificates of Insurance for all subcontractor you hire. Without these certificates, you may be charged as though the subcontractors' workers were your own employees -increasing your premium charge. WHY SHOULD I MAKE SURE THE PREMIUM BASIS (SUCH AS SALES OR PAYROLL) ARE REALISTIC ESTIMATES? Your initial policy premium is based on an estimate of your business operations for the policy period. The final policy premium is not determined until after your insurance audit. If your estimates are low, your deposit premium will be low and you will have to pay an additional premium after the audit. Likewise, overestimating your operations for the coming year will cause your deposit premium to be high, tying up your money until after the audit. Please contact your agent if you need more information or clarification on insurance premium audits. CG E 278 (04-96) In Witness Whereof, we have caused this policy to be executed and attested, and, if required by state law, this policy shall not be valid unless countersigned by our authorized representative. .ti~~~~~w;~~~ l'rr.i~l~~r.~