Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Res.2828.07-07-2014
BILL NO. 14-106 RESOLUTION NO. A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE A CONTRACT AGREEMENT WITH GILMORE CONSTRUCTION, LLC, TO REMOVE AND REPAINT TAXIWAY CENTERLINES AND HOLD LINES AT THE CAPE GIRARDEAU REGIONAL AIRPORT BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF CAPE GIRARDEAU, MISSOURI, AS FOLLOWS: ARTICLE 1. The City Manager, for and on behalf of the City of Cape Girardeau, Missouri, is hereby authorized to execute a Contract Agreement with Gilmore Construction, LLC, to remove and repaint taxiway centerlines and hold lines at the Cape Girardeau Regional Airport, (Project No. 14-077A-1), in the City of Cape Girardeau, Missouri. A copy of said Agreement is attached to this Resolution and made a part hereof. PASSED AND ADOPTED THIS DAY OF 2014. H ry E. ediger, Mayor ATTEST: Gayle Conrad City Clerk FORM OF CONTRACT AGREEMENT (SPONSOR NAME) State Block Grant Project No. (rMoDOT PROJECT NUMBER} THIS AGREEMENT, made as of this day of 120, is BY AND BETWEEN the OWNER: Name: THE CITY OF CAPE GIRARDEAU, MISSOURI Address: 210 WEST WASHINGTON STREET City/State/Zip Code: CAPE GIRARDEAU, MISSOURI 63703 And the CONTRACTOR: Name: /T.TrTm City/State/Zip Code: WITNESSETH: WHEREAS it is the intent of the Owner to make improvements at THE CAPE GIRARDEAU REGIONAL AIRPORT generally described as follows; (BRIEF AND CONCISE DESCRIPTION OF PROJECT}. hereinafter referred to as the Project. NOW THEREFORE in consideration of the mutual covenants hereinafter set forth, OWNER and CONTRACTOR agree as follows: Article i —Work It is hereby mutually agreed that for and in consideration of the payments as provided for herein to the CONTRACTOR by the OWNER, CONTRACTOR shall faithfully furnish all necessary labor, equipment, and material and shall fully perform all necessary work to complete the Project in strict accordance with this Contract Agreement and the Contract Documents. Article 2 — Contract Documents CONTRACTOR agrees that the Contract Documents consist of the following: this Agreement, General Provisions, Supplementary Provisions, Specifications, Drawings, all issued addenda, Notice -to -Bidders, Instructions -to -Bidders, Proposal and associated attachments, Performance Bond, Payment Bond, Wage Rate Determinations, Insurance certificates, documents incorporated by reference, documents incorporated by attachment, and all OWNER authorized change orders issued subsequent to the date of this agreement All documents comprising the Contract Documents are complementary to one another and together establish the complete terms, conditions and obligations of the CONTRACTOR. All said Contract Documents are incorporated by reference into the Contract Agreement as if fully rewritten herein or attached thereto. Article 3 —Contract Price In consideration of the faithful performance and completion of the Work by the CONTRACTOR in accordance with the Contract Documents, OWNER shall pay the CONTRACTOR an amount equal to: subject to the following; (Amount in Written Words) (Amount in Numerals) 144 Rev. 11&05/12 (Ftinw) I a. Said amount is based on the schedule of prices and estimated quantities stated in CONTRACTOR'S Bid Proposal, which is attached to and made a part of this Agreement; b. Said amount is the aggregate sum of the result of the CONTRACTOR'S stated unit prices multiplied by the associated estimated quantities; c. CONTRACTOR and OWNER agree that said estimated quantities are not guaranteed and that the determination of actual quantities is to be made by the OWNER'S ENGINEER; d. Said amount is subject to modification for additions and deductions as provided for within the Contract General Provisions. Article 4 — Payment Upon the completion of the work and its acceptance by the OWNER, all sums due the CONTRACTOR by reason of faithful performance of the work, taking into consideration additions to or deductions from the Contract price by reason of alterations or modifications of the original Contract or by reason of "Extra Work" authorized under this Contract, will be paid to the CONTRACTOR by the OWNER after said completion and acceptance. The acceptance of final payment by the CONTRACTOR shall be considered as a release in full of all claims against the OWNER, arising out of, or by reason of, the work completed and materials furnished under this Contract. OWNER shall make progress payments to the CONTRACTOR in accordance with the terms set forth in the General Provisions. Progress payments shall be based on estimates prepared by the ENGINEER for the value of work performed and materials completed in place in accordance with the Contract Drawings and Specifications. Progress.payments are subject to retainage requirements as set forth in the General Provisions, Article 5 — Contract Time The CONTRACTOR agrees to commence work within ten (10) calendar days of the date specified in the OWNER'S Notice -to -Proceed. CONTRACTOR further agrees to complete said work within (NUMBER OF DAYS) of the commencement date stated within the Notice -to -Proceed. It is expressly understood and agreed that the stated Contract Time is reasonable for the completion of the Work, taking all factors into consideration. Furthermore, extensions of the Contract Time may only be permitted by execution of a formal modification to this Contract Agreement in accordance with the General Provisions and as approved by the OWNER_ Article 6 — Liquidated Damages The CONTRACTOR and OWNER understand and agree that time is of essence for completion of the Work and that the OWNER will suffer additional expense and financial loss if said Work is not completed within the authorized Contract Time. Furthermore, the CONTRACTOR and OWNER recognize and understand the difficulty, delay, and expense in establishing the exact amount of actual financial loss and additional expense. Accordingly, in place of requiring such proof, the CONTRACTOR expressly agrees to pay the OWNER as liquidated damages the non -penal sum of ${DOLLAR AMOUNT) per day for each calendar day required in excess of the authorized Contract Time. Furthermore, the CONTRACTOR understands and agrees that; a. the OWNER has the right to deduct from any moneys due the CONTRACTOR, the amount of said liquidated damages; b. the OWNER has the right to recover the amount of said liquidated damages from the CONTRACTOR, SURETY or both. Article 7— CONTRACTOR'S Representations The CONTRACTOR understands and agrees that all representations made by the CONTRACTOR within the Proposal Form shall apply under this Agreement as if fully rewritten herein. Article 8 — CONTRACTOR'S Certifications 145 Rm 06/05/12 (Minor) f rM. i The CONTRACTOR understands and agrees that all certifications made by the CONTRACTOR within the Proposal shall apply under this Agreement as if fully rewritten herein. The CONTRACTOR further certifies the following; a. Certification ofElinibility (29 CFR Part 5.5) i. By Entering into this contract, the CONTRACTOR certifies that neither he or she nor any person or firm who has an interest in the CONTRACTOR'S firm is a person or firm ineligible to be awarded Government contracts by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1); H. No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(axl ); iii. The penalty for making false statements is prescribed in the U.S. Criminal Code 18 U.S.C. b. Certification of NonSe reoated Facilities (41 CFR Part 60-1.8) The federally -assisted construction CONTRACTOR, certifies that a does not maintain or provide, for its employees, any segregated facilities at any of its establishments and that it does not permit its employees to Perform their services at any location, under its control, where segregated facilities are maintained. The BIDDER certifies that it 35411 not maintain or provide, for its employees, segregated facilities at any of its establishments and that it will not permit its employees to perform their services at any location under its control where segregated facilities are maintained. The Bidder agrees that a breach of this certification is a violation of the Equal Opportunity Clause, which is to be incorporated in the contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms, and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated on the basis of race, color, religion, or national origin because of habit, local custom, or any other reason. The Bidder agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause and that it will retain such certifications in its files. Article 9—Miscellaneous a. CONTRACTOR understands that it shall be solely responsible for the means, methods, techniques, sequences and procedures of construction in connection with completion of the Work; b. CONTRACTOR understands and agrees that it shall not accomplish any work or furnish any materials that are not covered or authorized by the Contract Documents unless authorized in writing by the OWNER or ENGINEER; c. The rights of each party under this Agreement shall not be assigned or transferred to any other person, entity, firm or corporation without prior written consent of both parties; d. OWNER and CONTRACTOR each bind itself, their partners, successors, assigns and legal representatives to the other party in respect to all covenants, agreements, and obligations contained in the Contract Documents. Article 10 — OWNER'S Representative The OWNER'S Representative, herein referred to as ENGINEER, is defined as follows: CRAWFORD, MURPHY & TILLY, LNC. _ ONE MEMORIAL DRIVE, SUITE 500 ST. LOUIS, MISSOURI 63102 Said ENGINEER will act as the OWNER'S representative and shall assume all rights and authority assigned to the ENGINEER as stated within the Contract Documents in connection with the completion of the Project Work. IN WITNESS WHEREOF, OWNER and CONTRACTOR have executed five (5) copies of this Agreement on the day and year first noted herein 146 Rcv. 06/05/12 (Minor) OWNER Name: _ Address: By: Signature Title of Representative ATTEST: By: Signature Title 1 147 Rev, 06/05/12 (Minor) t� m:�ewwe� CONTRACTOR Name: Address: By: Signature Title of Representative ATTEST By: Signature Title 147 Rev, 06/05/12 (Minor) t� m:�ewwe� PROPOSAL FORM THE CITY OF CAPE GIRARDEAU, MLSSOURI State Block Gram Project No. 14-077A-1 TO: City Cletr(Enginer The undersigned, in compliance with the request for bids for construction of the following Project REMOVE AND REAMRK TAXIWAY CENTERLINES, HOLD LINES, NON -MOVEMENT BOUNDARIES AND TArrr.an E EDGE MAR]M GS hereby proposes to furnish all labor, Permits, material, machinery, tools, supplies and equipment to faithfully perform all work required for construction of the Project in accordance with the project menosl, project drawings and issued Addenda within the specified time of performance for the following prices: BASE BID APPROX. BID FAA or ITEM DESCRIPTION QUANT IY U\TT PRICE EXTENSION ITEM MoDOT AND SPEC. UNITS DOLLARS CCS DOLLARS CCS 1 MO -100 Mobilization 1 $Lump 6r S6 6r$Cl{ Co sum 2 MO -620 Airport TaxiwayPavement 1,1 } t S . f Q G S ,no 1 3 MO -620 Airfield Paves Marking 35, # 1 is #yDt 9'iD =° 4 M"20 Airport Pavement Marking 50,470 SF#zS 1� opo Removal 15D 2 3S TOTAL BID (Base Bid) *121-727 E0 r" 'ts J r}.r ' 61. lav : a. By submittal of a proposal, the BIDDER acknowledges and accepts that the quantities established by the OWNER are an approximate estimate of the quantities required to fully complete the Project and that the estimated quantities are principally intended to serve as a basis for evaluation of bids. The BIDDER further acknowledges and accepts that payment under this contract will be made only for actual quantities and that quantities will vary in accordance with the General Provisions.subsection entitled "Alteration of Work and Quantities". b. The BIDDER w1mowledges and accepts that the Bid Documents are comprised of the docurttema identified within the General Provisions. The BIDDER father acknowledges that each the individual docmneata that comprise the Bid Docurnzats are complementary to one another and together establishes the Mete terms, conditions and obligations of the successful BIDDER e. As evidence of good faith in submitting this proposal, the undersigned encloses a bid guaranty in the form of a certified chock, cashier's check or bid bond in the amount of 5% of the bid price. The BIDDER acknowledges and accepts that refusal or failure to accept award and execute a contract within the terms and 144 aur. 06osn2 (ossa) conditions established herein will result in forfeiture of the bid guaranty to the owner as a liquidated damage. d. The BIDDER acknowledges and accepts the OWNER'S right to reject any or all bids e. The BIDDER acknowledges and accepts the OWNER'S right to hold all Proposals for purposes of review and evaluation and not issue a notice -0f --award for a period not to exceed sixty (60) calendar days from the stated date for receipt of bids. L The undersigned agrees that upon written notice of award of contract, he or she will execute the connect within thirty (30) days of the notice -of -award, and furthermore, and provide executed payment and performance bonds within fifteen (15) days from the date of contract execution. The undersigned accepts that failure to execute the contract and provide the required bonds within the stated timeframe shall result in forfeiture of the bid guaranty to the owner as a liquidated damage. g. Time of Performance: By submittal of this proposal, the tmdersigned acknowledges and agrees to commence work within.ten (10) calendar days of the date specified in the written "Notice -to -Proceed" as issued by the OWNER The undersigned further agrees to complete the Project within twelve (12) Calendar days from the commencement date specified in the Notice-to-Proceed- h. otice-to-Proceedh. The undersigned acknowledges and accepts that for each and every Calendar day the project remains incomplete beyond the contract time of performance, the Contractor shall pay the non-pcnal amok of 5750.00 (Seven Hundred Fifty Dollars) per Calendar day as a liquidated damage to the OWNER L The undersigned prime contractor, if not a MoDOT certified DBE, hereby assures that they will subcontract a minimum of zero (0) percent of the dollar value of the prime contract to DBE forms or make good faith efforts to meet the DBE contract goal. In addition, the prime contractor will include the DBE clauses (see Supplementary Provision No. 6 of the Federal and State Provisions) required by the DBE Program adapted by MoDOT and the city in all contracts and subcontracts relating to this project The undersigned will complete the DHE Participation information included herein, when a DBE goal has been established, including a demonstration of good faith efforts if the DBE goal is not met If the undersigned prime contractor is a MoDOT certified DBE Ron, then the prime contractor must perform at least thirty percent (30"/0) of the total contract vale work with its own fomes, and will receive DBE credit for all work which the prime contractor and any other McDOT certified DBE firm performs directly. J. The BIDDER, by submission of a proposal, acknowledges that award of this contract is subject to the provisions of the David Bacon Act mad the Missouri Prevailing Wage law. The BIDDER accepts the rcquirearient to pay prevailing wages for each classification and type of worker as established in the attached wage rate determinations as issued by the United Statea Department of labor and the Missouri Division of Labor Standards. The BIDDER further acknowledges and accepts their requitement to incorporate the provision to pay the established prevailing wages in every subcontract agreement entered into by the Bidder tinder this project The highest rate between the two (Federal and State) for each job classification shall be considered the prevailing wage. k. Compliance Reports (41 CYR Part 60-1.7): Within 30 days ad= award of this conrrmct, the Conttactor/Subcontractor shall file a compliance report (Standard Form 100) if s/he has not submitted a complete compliance report within 12 months proceeding the date of award This report is required if the Contractor/Subcontractor meets all of the following conditions: 1. Conractots/Sabcoanacwn are not exempt based on 41 CFR 60.1,5. 2. Has 50 or more employees 3. Is a prime contractor or first tier subcontractor. 4. There is a contract, subcontract, or purchase order amounting to $50,000 or more L The undersigned acknowledges receipt of the following mddmda: 145 Rev. 06101M (K=) Addendum No. #V%� . dated Date Received Addendum No. . dated Date Received Addendum No. dated Date Received Addendum No. dated Date Received Addendum No. . dared Date Received By submittal of a proposal (bid), the BIDDER represents the following. a. The BIDDER has read and thoroughly examined the bid documents including all authorized addenda. b. The BIDDER has a complete understanding of the terms and conditions required for the satisfactory performance of project work. c. The BIDDER has fully informed themselves of the project site, the project site conditions and the surrounding area. d. The BIDDER has familiarized themselves of the requirements of worldng on an operating airport and understands the conditions that may in any manner affect coat, progress or performance of the work e. The BIDDER has correlated their observations with that of the project documents. L The BIDDER has found no errors, conflicts, ambiguities or omissions in the project documents, except as previously submitted in writing to the owner that would affed cost; progress or performance of the work. g. The BIDDER is familiar with all applicable Federal, State and local laws, rules and regulations pertaining to execution of the contract and the project work h. The BIDDER has complied with all rcquirsments of these instructions and the associated project documents. CERTIFICATIONS BY BIDDER s` The undersigned hereby declares and certifies that the only parties interested in this proposal are named herein and that this proposal is made without collusion with any other person, firm or corporation. The undersigned further certifies that no member, officer or agent of OWNER'S has direct or indirect financial interest in this proposal. b. Certification of Non -Segregated Facilities (41 CFR Part 60-1.8) The BIDDER, as a potential federally -assisted construction eomractor, certifies that it does not maintain or provide, for its employees, any segregated facilities at any of its establishments and that it does not permit is employers to perform their services at any location, under its control, where segregated facilities are maintained. The BIDDER certifies that it will not maintain or provide, for its employees, segregated facilities at any of is establishment and that it will not permit its employers to perform their services at any location under its control where segregated facilities are maintained The Bidder agrees that a breach of this certification is s violation of the Equal opportunity Clause, which is to be incorporated in the contract. As used in this certification, the term "segregated facilities" means any weiRng rooms, work areas, resttooms, and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, parking lot, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated on the basis of race, color, religion, or national origin bemuse of habit, local custom, or any other reason. The Bidder agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding 510,000 which are not exempt from the provisions of the Equal Opportunity Glasse and that it will retain Stich certifications in its files. c. Trade Restriction Certification (49 CFR Part 30) 146 lues. O6MI12 Qa=) The Bidder, by submission of an offer certifies that it 1. is not owned or controlled by one or more citizens of a foreign country included in the list of countries that discriminate against U.S. firms published by the Office of the United States Trade Representative (USTR); 2. has not knowingly entered into any contact or subcontract for this project with a person that is a citizen or national of a foreign country on said list, or is owned or controlled directly or indirectly by one or more citizens or nationals of a foreiga country on said list; 3. has not procured any product nor subcontracted for the supply of any product for use on the project that is produced in a foreign country on said list d. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion (49 CFR Part 29) The Bidder certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. It further agrees by submitting this proposal that it will include this clause without modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts. Where the Bidder or any lower tier participant is unable to certify to this statement, it shall attach an explanation to this solicitation/proposal. e. Buy American Certification: (Title 49 U.S.C. Chapter 501) As a condition of bid responsiveness, the bidder must certify its compliance with the Buy American preferences established under Title 49 U.S.C. Section 50101. Bidders must complete the Buy American certification as follows: Buy American Certification (Title 49 U.S.C. Section 50101) U.S.C. Section 50101- Buying goods produced in the United States (a) Preference. - The Secretary of Transportation may obligate an amount that may be appropriated to cavy out section 106(k), 44502(a)(2), or 44509, subchapter I of chapter 471 (except section 47127), or chapter 481 (except sections 48102(e), 48106, 48107, and 48110) of this title for a project only if steel and manufactured goods used m the project are produced in the United States. (b) Waiver. - The Secretary may waive subsection (a) of this section if the Secretary finds that - (1) Applying subsection (a) would be inconsistent with the public interest (2) The steel and goods produced in the United States are not produced in a sufficient and reasonably available amount or are not of a satisfactory quality, (3) When procuring a facility or equipment under section 44502(ax2) or 44509, subchapter I of chapter 471 (except section 47127), or chapter 481 (except sections 48102(e), 48106, 48107, and 48110) of this title - (A) The cost of components and subcomponents produced in the United States is more than 60 percent of the cost of all components of the facility or equipment; and (B) Final assembly of the facility or equipment has occurred in the United Status; or (4) Including domestic material will increase the cost of the overall project by more than 25 percent 147 Rev. 0645/12 (MroQ) (c) Labor Costs. - In this section, labor costa involved in final assembly are not included in calculating the cost of componemts. The Bidder must select the appropriate certification for its proposal from one of the following statements: dThe bidder hereby certifies that they will comply with Title 49 US.0 Section 50101 by only inrtaDing steel and manufactured products produced In the United States of America. ❑ The bidder hereby certifies that they cannot fully comply with the Buy American preferences of Title 49 U.S.0 Section 50101(x) and therefore requests a waiver per Title 49 U.S.0 Section 50101(b) for the items lixted below. Component/ Item Country of Origin Total Component Cort in Project Total All Components in Project NOTES: 1) All requested information must be submitted for each individual product item waiver request 2) All steel used in this project must be produced in'the USA. Regional waivers will not be issued for steel not produced in the USA 3) All products, equipment, things requumg assembly must be assembled in the USA Regional waivers will not be issued for products, equipment, etc. not final assembled in the USA 4) The Owner will submit any requested waiver by the apparent low bidder to the FAA for a determination of AIP eligibility. Bidders are hereby advised there is no implied or expressed guarantee that a requested waiver will be approved by the Owner or the Federal Aviation Administration. £ Compliance with the Work Authorisation Law (as required by Section 285930, Revised Statues of Missouri) For all contracts where the total bid amount is in excess of 5100,000 (local match in excess of $5,000), the Bidder, by submission of an offer and by signing the Worker Eligibility Verification Affidavit for All Contract Agreements in Excess of S 100,000, certifies that it 1. does not knowingly employ any person who is an umamhorized alien in connection with the contracted services; 2. has enrolled and actively participates in a federal work authorization program; 148 Re+. 06/5/12 (hfm ) A general contractor or subcontractor of any tier shall not be liable under sections 295.525 to 285.550 when such general contractor or subcontractor contracts with its direct subcontractor who violates subsection 1 of this section, if the contract binding the contractor and subcontractor affirmatively states that the direct subcontractor is not knowingly in violation of subsection ] of this section and shall not henceforth be in such violation and the contractor or subcontractor receives a swom affidavit under the penalty of petjury attesting to the fact that the direct subcontractor's employees are lawfully present in the United States. 149 Rev. 06/05/12 (Minor) Mo�OT Missouri Department of Transportation — Domestic Material Compliance Certification Aviation Section Subject FAA Airport Improvement Program Buy American Preference Requirements `pMV AnpQrt _ MoDOT Project ALP. Project The Buy American Preferences under 49 U.S.C. § 50101 require that all steel and mamrfactraed goods used in Airport Improvement Program (AIP) funded pmj ects be produced in the United States. We, hereby ccrt that the following listed items used on any portion of the above referenced AIP-funded project are produced in the United States and are of 100 percent U.S. materials: *SAMPLE FORM* Signed: Title Company Address Renta.' 527,12014 S== AER 2.5 (227113) i 150 Rev. 06D5112 (Minor) WORICE:R ELIGIBILITY VERIFICATION AFFIDAVIT FOR ALL CONTRACT AGREEMENTS IN EXCESS OF $100P000 (Local match in excess of $5,000) (farjoint ventures, a separate affidavit is required for each business entity) STATEOF WS5eW1 ) )u COUN-fY OF S"'t) ) Ou this )%+h day of `�yAe- 20 �before me appeared 4. h% 4rlin2re , personally known to me or proved to me on the basis of satisfactory evidence to be a person whose name is subscnoed to this affidavit, who being by me duly sworn, deposed as follows: My name is and I am of sound mind, capable of making this affidavit, and personally certify the facts herein stated, as required by Section 285.530, RSMo, to enter into any contract agreement with the state or any of its political subdivisions mperform any job, task, employment, labor, personal services, or any other activity for which compensation is provided, expected, or due, including but not limited to all activities conducted by business entities: `` 1 I am the Pt s, de of G YwK e "" "'st �� and I am duly authorized, directed, and/or empowered to act officially and properly on behalf of this business entity. I hereby affrm and warrant that the aforementioned business entity is enrolled in a federal work authorization program operated by the United States Department of Homeland Security, and the aforementioned business e¢tity shall participate in said program to verify information (employment eligibility) of newly hired employees working in connection to wmic under the within contract agreement I have attached documentation to this affidavit to evidence enrollment/participation by the aforementioned business entity in a federal work authorization program, as required by Section 285.530, RSMo. In addition, I hereby affirm and warrant that the aforementioned business entity does not and shall not knowingly employ, in connection to work under the within contact agreement, any alien who does not have the legal right or authorization under federal law to work in the United States, as defnad in 8 U.S.C. § 1324a(hx3). I am aware and recognize that, unless certain contract and affidavit conditions are satisfied pursuant to Section 285.530, RSMo, the aforementioned business entity maybe held liable wader Sections 285.525 though 285.550, RSMo, for subcontractors that knowingly employ or continue to employ any unauthorized alien to work within the state of Missouri. I acknowledge that I am signing this affidavit as a free an f theafo /(o.�ned business entity and not under duress. L 1 wan swornm efare me this l-;�8y c Ilctmy Prise - Noty Md stats of ldsto!A Canty d Sloddnd Camn'"M #12409139 / W Catanktioo EVfts 1 WZ=f My commission expires: 1.4 -.4;7 (o ocurne itatwri n enrolliieea a hjn a acceptable. enroMit6d an para.gpd2ionVdoe{imerii 'N -Z fylKemordndum a f;:ZTndersiaading m A yob' `' and A valid co o sh¢:_s' busrnesrenid�-_ (Z) _ PY f .. entry, lheSoeial SeeirrityILA dmtnutra6my-and ilia Dr�isFori��. 151 (Affiant Signature) f ja'nC- 20 /7 Rev. 06135/12 (Minor) DISADVANTAGED BUSINESS ENTERPRISE (DBE) PARTICIPATION The information shown in this section est be completed when a DBE contact goal has been established. The percentage must equal or exceed the DBE contract goal. If the peroentage is below the contact goal, then the bidder must submit complete written documentation of good faith efforts taken to meet the DBE contract goal. a. Tee undersigned submits the following list of DBE's to be used in accomplishing the work of this contact The work, supplies or services, applicable value and percent of total federal contact each DBE is to perform or furnish is as follows: b. Joint venture with a DBE. The undersigned submits the following list of bid items the DBE prime is responsible for and any items that will be subcontracted out ate noted with an aster a or a stiml notation The work, applicable value and percentage of total federal contract the DBE prime is responsible for are as follows: DBE Name and Address Bid Item r Tu s) work Performed $ Value of DBE Work % of *"iVahre Applicable to DBE Goal S Ammmt Applicable to DBE Goal % of Total Federal Contract TOTAL DBE PARTICIPATION $ % *'Carnot exceed contact amount for given item of work. (Please reproduce the above sheet if additional space is needed.) 152 tic. 06/05/12 (216-) THIS EXECUTED PROPOSAL FORM MUST BE SUBMITTED IN THE ORIGINAL BOUND PROJECT MANUAL. SIGNATURE OF BIDDER The tmdetsgned states that the correct LEGAL NAME AND ADDRESS of (1) the individual bidder, (2) each partner or joint venturer (whether individuals or corporations, and whether doing business under a fictitious name), or (3) the corporation (with the state in which it is incorporated) are shown below; that (if not signing with the intention to bind themselves to become responsible and sole bidder) they are the agent of and they are signing and executing this (as indicated in the proper spaces below) as the bid of a D4 sole individual ( ) partnership ( ) joint verdure ( ) corporation, incorporated under the laws of state of t� Executed by bidder this I � t4 . day of J iJ� r- 20 Name of individual, all parmers orjointventurers: dG.L). /G� "Iftx-e t{r1.! l�iNere doing business tinder the name of Grimm Ce„J�4', u -c (If using a fictitious name, show this name above in addition to legal names) (If a corporation, show its name above) A ST: (Si e) Secretary ea�5, L. �keR Please prii mme Address of each: gt3 W �'ns A,' ,..� MD Sl3 W 3tn��s . 14..ce /k6 Addrew of principal place of business in Mrssmr± 'ZcrD Tnjs>Aei> I I)r AJvonce MO 63730 e) critic) G.O. G lege Please print name NOTE: If bidder is doing business under a fictitious name, the bid shall be executed in the legal name of the individual partners, joint ventures, or corporation, with the legal address shown, and registration of fictitious name filed with the secretary of state, as required by sections 427200 to 417.230 RSMo. If the bidder is a corporation not organized under the laws of 11Sissou rri it shall procure a certificate of authority to do business in Missouri, as required by section 351.572 et seq RSMo. 153 R�. 06AMU (nfm ) Everify-,61, Company ID Number. 560775 THE E -VERIFY PROGRAM FOR EMPLOYMENT VERIFICATION MEMORANDUM OF UNDERSTANDING ARTICLE I PURPOSE AND AUTHORITY This Memorandum of Understanding (MOI) sets forth the points of agreement between the Department_ of Homeland Security (DHS) and Gilmore Construction, 1JC (Employer) regarding the Employers participation In the Employment Eligibility Verification Program (E -Verify). This MOU explains certain features of the E -Verify program and enumerates specific responsibilities of DHS, the Social Security Administration (SSA), and the Employer. E -Verify is a program that electronically confirms an employee's eligibility to work in the United States after completion of the Employment Eligibility Vertfication Form (Form 1-9). For covered government contractors, E - Verify is used to verify the employment eligibility of all newly hired employees and all existing employees assigned to Federal contracts or to verify the entire workforce if the contractor so chooses. Authority for the E -Verify program is found in Title IV, Subtitle A, of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA), Pub. L 104208, 110 Stat 3009, as amended (8 U.S.C. § 1324a note). Authority for use of the E -Verity program by Federal contractors and subcontractors covered by the terms of Subpart 22.18, "Employment Eligibility Verification', of the Federal Acquisition Regulation (FAR) (hereinafter referred to In this MOU as a "Federal contractor with the FAR E -Verify clauses to verity the employment eligibility of certain employees working on Federal contracts is also found in Subpart 22.18 and in Executive Order 12989, as amended. ARTICLE II FUNCTIONS TO BE PERFORMED A. RESPONSIBILITIES OF SSA 1. SSA agrees to provide the Employer with available information that allows the Employer to confirm the accuracy of Social Security Numbers provided by all employees verified under this MOU and the employment authorbmton of U.S. citizens. 2. SSA agrees to provide to the Employer appropriate assistance with operational problems that may arise during the Employer's participation in the E -Verify program. SSA agrees to provide the Employer with names, titles, addresses, and telephone numbers of SSA representatives to be contacted during the E -Verify process. 3. SSA agrees to safeguard the information provided by the Employer through the E -Verify program procedures, and to limit access to such information, as is appropriate by law, to individuals responsible for the verification of Social Security Numbers and for evaluation of the E -Verify program or such other persons or entities who may be authorized by SSA as governed Page 1 of 13 1 E Verify MOU nor Employer I Rmislw Date OW01IN www.dhs.gov1E-Verify E-Veri . Company ID Number. 560775 To be accepted as a participant in E Verify, you should only sign the Employers Section of the signature page. If you have any questions, contact E -Verify at 888-464-4218. Construction, w ent of Homeland Security—Verification Division Verification for the E -Verify Program Ca LLC West Jenkins sheet Mo 93730 Company Aftemate Employer Identification Page 12 of 13 1 E -Verify MOU for Employer I ReYWw Date 0910110.9 www.dhs.gov/F-Verify NDV Western Surety Company BID BOND (Percentage) Bond Number 71554206 KNOW ALL PERSONS BY THESE PRESENTS, That we r_+tmore co^struction. LLC Of 813 W Jenkins St Advance MO 63730 hereinafter referred to as the Principal, and Western Surety company as Surety, are held and firmly bound unto City of rjrardeau of 401 Zndeoendence St., Cape Girardeau, MO 63701-6244 , hereinafter referred to as the Obligee, in the sum of Five —(-5--%) percent of the greatest amount bid, for the payment of which we bind ourselves, our legal representatives, successors and assigns, jointly and severally, finny by these presents. WHEREAS, Principal has submitted or is about to submit a proposal to Obligee on a contract for Removing 5 Remarking Airport Taxi Wav - NOW, THEREFORE, if the said contract be awarded to Principal and Principal shall, within such fime as may be specified, enter into the contract in writing and gine such bond or bonds as may be specified in the bidding or contract documents with surety acceptable to Obligee; or if Principal shall fall 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 17th day of June 2014 . Gilmore construction, LLC gy ��° (Spall Fpm FW78 ACKNOWLEDGMENT OF SURETY STATE OF Missouri 1 (Attorney -in -Fact) Bond No. 71554206 COUNTY OF /,, Scott ) 2'On this & A day of V u/�tP "� , before me, a notary public in and for said County, personally appeared JUSTTN D BRADLEY to me personally known and being by me duly sworn, did say, that he/she is the Attomey-in-Fact of WESTERN SURETY COMPANY, a corporation of Sioux Falls, South Dakota, created, organized and existing under and by virtue of the laws of the State of South Dakota, that the said instrument was executed on behalf of the said corporation by authority of its Board of Directors and that the said JUSTIN D BRADLEY acknowledges said instrument to be the free sat and dead of said corporation and that he/she has authority to sign said instrument without affixing the corporate seal of said corporation. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed n;y official seal at Sikeston Missouri , the day and year last above written. My r � axion exp -� Notary Public Fm 10682015 MM 0. GPJ= AryCaueI I Eq*M eMO 4 2016 scatc=dy C^.nndssbn @ 1129st59 Western Surety Company POWER OF ATTORNEY- CERTIFIED COPY Bond No. 71554206 Runs, All Eden By These Presents, that WESTERN SUE= COMPANY, a corporation duly orgarmad and exuting under the laws of the State of South Dakota, and having its psmripal ofbca in $ons Fans, South Dakota (ths'Compary"), doe by tbee premia make, oun.t:tut-and appoint TJSTIN n BRADLEY its true and lawful attorneys}{n-fact, with full power and mthardy hereby coaiicr ed, to wrote, admoaledea and deliver for and on its behalf as Surety, bonds fm: Principal: Gilmore Construction, LLC Obligee: City of Cape Girardeau Amount $500,000.00 and to bind the C oar any thereby as filly and m the sane extent as if such bonds were dgeed by the Senior Vice Precedent, sear with the corporate seal of the Company and duly attested by its Secretary, barely, ratifying and ,.mwr,g an that the said attornsy(s)-in-Sect may do within the above stated limitations. Said appointments made under and lay authority of the fdlawing bylaw of Western Screfy Campony which remains in fun force and entad 'Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporatioa shall be executed in the corporate name of the Company by the Prsadent, secretary, any Assistant Secretary, Treasurer, or any Pure Preidcut or by such utba offiras as the Board ofDire urs may mAhorize. The President, any V' President, Secretary, my Assistant Secretary, or the Treasurer may appoint Aitocoeys in Fact or agents who shall have arthartty to issue bonds, policies, or undertalcmgs in the neap of the Company. The corporate said is ort ne snary for the validity of any bands, policies, tmdart=�es, Powers of Attorney or other obligatims of the corporation. The signature of any sucb mS and the corporate seal may be printed by hwaimilp' All anthocity bereby .conferred shall expire and terminate withoat notice, unless Asad bef see midnightof September 17 2014 , but until such time shall be ixravocabla and Silll farce and effect. In Witness Where.£ Western Surety Company be, cared these preens to be sigmd by its Vice, President, Paul T. BnrBat, end its 17th d yof June 1 2014 WEST eR d SURE '4 COMPANY Pad T. rt, Vire Prrmden w� IA COL On this 17th day of June , in the year 2 014 , before me, .notary public, personally appeared Pail T. Br/ato8 , who being to me duly sworn, ackvnvdedged that he signed the above Power of Attorney as the afoxeaid officar of WESTERN S'URE'TY COMPANY amt acknowledged send in3trmnmt to be the volvatmy act and de� said Aa 'oa /M\\MNM\MYWY\\MYN S. PETRIK SL SEAL 7 SOUTH 110U= r. y otary Public. South Dak.ta My Corm tssim Eypires Acgmt 11, 2016 I the mdmigned officar of Wafem Surety Company, a stark curporatim of the State of South Dakota, do baeby cetiity that the ata...o._i Power of Attorney is is fail fors and effect and L irrevocable, and furthermore, that Section 7 of the bylaws of the Comps as eat froth in the Power of Attorney is now in fate. -- In testnoany whae4I have hmeomo set ray hand and seal of We3ttm Surety Company this 17th de, of June 2014 WEST R SURE COMPANY Peal T. Aflat, Pae President Form F6306&2012 y q s,q TY 1-6Oa371-6353 f�b&�° Fez 1-601335-3357 wxw.==ety.wm eo so. ran soiaFN. w slur-ran uwseMas�cnasucry.rom DATE: June 16, 2014 AGENT CODE: 24-17961 ATTENTION: Justin Number of Pages: RE: Bond 71554206 -Gilmore Construction, LLC Removing 6 Remarking Airport Taxi Way 5% Contract Amount: $90,000.00 Company Cole: 601 - Western Surety Company Thank you for placing this business with CNA Surety. Please execute the requested bond(s) by using the documents sent with this faxlemail. Sign the bond(s) and attach a gold colored seal from your Western Surety Company lit to each bond issued. We ask that you assign the above bond number. If the obligee has their own bond form that we have reviewed, you will only receive a Power of Attorney and an Acknowledgment of Surety, unless you request otherwise, Please send us a copy of the completed bond(s) for our file. ""Please advise us of the bid results as soon as they are available. Please complete and faxlemail us the following: Contract Price:, Contract Date: - Next two lowest Was the principal the low bidder? ❑ Yes ❑ No Do you need approval for the Performance and Payment bond at this 'tima? ❑ Yes ❑ No Premium: $0-.00 Commission Percentage 30.1 Effective: June 17, 2014 Please check your supply of gold seals periodically to ensure you have an adequate amount. To reorder gold seals, simply visit cnamwetv.com and click on the "Order Supplies Here' icon under the Broker/Agent Services section. "IMPORTANT NOTICE AND REMINDER: Approval of the requested Bid Bond is -NOT an approval of any final or other bonds that may be requested by this principal. Further, the Bid Bond approval is limited to the contract amount approved by the underwriter. If the anticipated bid exceeds this amount, you must contact the underwriter at 800.881.6053 to inquire about specific approval before filing the bid. Failurs to receive approval could result in declination of any subsequent performance and payment bond(s) requested. Furthermore, we reserve the right to decline any bond for any reason per the terms of the General Indemnity Agreement, and shall not be liable to the principal or any person or entity for such declination. Business Services PO SM sd.. Pok W 57117-S Thanks for placing this Fast Track Bond with CNA Surety! 1-000331-053 Fax 14605335-0357 �.C1195Ve1)'.c If you were pleased with the level of service received on this request, we would appreciate the opportunity to provide that same level of service on your next commercial bond request. When you deliver this bond, ask your customer if they need other bonds such as local license and permit, state contractor, employee dishonesty, notary or pension trust. A short conversation could result in additional business and a more committed client! If you have any questions, remember our bond experts are standing by at 1.800-331-6053. Thanks again fox considering CMA Surety. Sincerely, Brian L. Sittig Underwriting Manager PS: We're committed to providing the best service in the industry. If the service on this request fell short of your expectations, please let us know by contacting us at 1-800.331.6053. PERFORMANCE BOND BOND NUMBER PRINCIPAL (Legal Name and Business Address) SURETY (Legal Name and Business Address) STATE OF INCORPORATION PENAL SUM OF BOND (Expressed in words and numerals) CONTRACT DATE OBLIGATION KNOW ALL PERSONS BY THESE PRESENTS, that the above named PRINCIPAL, hereinafter referred to and called CONTRACTOR, and the above named SURETY hereby bind themselves unto The City of Cape Girardeau, Missouri, 401 Independence Street, Cape Girardeau, Missouri 63703, as OBLIGEE, hereinafter referred to and called OWNER, in the penal sum stated above, in lawful money of the United States of America to be paid to OWNER. For payment of the penal sum, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firrrdy by these presents. WHEREAS, CONTRACTOR has entered into the written contract agreement identified hereinabove with the OWNER for the following project: REMOVE AND REMARK TAXIWAY CENTERLINES, HOLD LINES, NON -MOVEMENT BOUNDARIES AND TAXILANE EDGE MARKINGS, CAPE GIRARDEAU REGIONAL AIRPORT, CAPE GIRARDEAU, MISSOURI which said contract and associated contract documents, including any present or future amendment thereto, is incorporated herein by reference and is hereinafter referred to as the Contract. CONDITION NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if CONTRACTOR shall promptly and faithfully perform all undertakings, covenants, terms, conditions and agreements of the Contract during the original term of the Contract and any extensions thereof that are granted by the OWNER, with or without notice to the SURETY, and during the period of any guarantee or warranties required under the Contract, and if CONTRACTOR shall perform and fulfill all undertakings, covenants, terms, conditions and agreements of any and all duly authorized modifications of the Contract that hereafter are made, then this obligation shall be void; otherwise it shall remain in full force and effect subject to the following additional conditions: 1. SURETY, for value received, hereby stipulates and agrees that no change, extension of time, modification, omission, addition or change in or to the Contract, or the work performed thereunder or the specifications accompanying the same, shall in any way affect the SURETY'S obligation on this bond; and SURETY hereby agrees to waive notice of any and all such extensions, modifications, omissions, alterations, and additions to the terms of the Contract, work or specifications. 2. Whenever CONTRACTOR shall be and declared by the OWNER to be in default under the Contract, the Surety shall promptly and at the SURETY'S expense remedy the default by implementing one or more of the following actions: a. Arrange for the CONTRACTOR, with consent of the OWNER, to perform and complete the Contract; or b. Undertake to perform and complete the Contract itself, through its agents or through independent contractors; or 154 Rev. 06/15/12 (Minor) c. Obtain bids or negotiated proposals from qualified contractors acceptable to the OWNER for a contract for performance and completion of the Contract; arrange for a contract to be prepared for execution by the OWNER and the contractor selected with the OWNER'S concurrence, to be secured with performance and payment bonds executed by a qualified surety equivalent to the Bonds issued on the Contract; and make available as work progresses (even though there should be a default or a succession of defaults under the contract or contracts of completion arranged under this paragraph) sufficient funds to pay the cost of completion less the balance of the contract price; but not exceeding, including other costs and damages for which the Surety may be liable hereunder, the penal sum of the bond. The term "balance of the contract price", as used in this paragraph, shall mean the total amount payable by OWNER to CONTRACTOR under the Contract and any amendments thereto, disbursed at the rate provided in the original contract, less the amount properly paid by OWNER to CONTRACTOR. d. With written consent of the OWNER, SURETY may waive its right to perform and complete, arrange for completion or obtain a new contractor and with reasonable promptness, investigate and determine the amount the SURETY is liable to the OWNER and tender payment therefor to the OWNER. 3. CONTRACTOR and SURETY agree that if in connection with the enforcement of this Bond, the OWNER is required to engage the services of an attorney, that reasonable attorney fees incurred by the OWNER, with or without suit, are in addition to the balance of the contract price. 4. No right of action shall accrue on this bond to or for the use of any person or corporation other than the OWNER named herein or the successors or assigns of the OWNER. WITNESS In witness whereof, this instrument is executed this the day of 20_ INDIVIDUAL PRINCIPAL: Company Name: Signature: Name and Title: CORPORATE PRINCIPAL: ATTEST: Corporate Name: Signature: Signature: Name and Title: Name and Title: (Affix Corporate Seal) SURETY: ATTEST: Surety Name: Signature: Signature: Name and Title: Name and Title: (Affix Seal) (Attach Power of Attorney) OWNER ACCEPTANCE: The OWNER approves the form of this Performance Bond. ATTEST: Date: Signature: Signature: Name and Title: Name and Title: (Affix Seal) 155 Rev. 06/95/12 (Minor) PAYMENT BOND BOND NUMBER PRINCIPAL (Legal Name and Business Address) SURETY (Legal A'ame and Business Address) STATE OF INCORPORATION PENAL SUM OF BOND (Expressed in words and numerals) CONTRACT DATE OBLIGATION KNOW ALL PERSONS BY THESE PRESENTS, that the above named PRINCIPAL, hereinafter referred to and called CONTRACTOR, and the above named SURETY hereby bind themselves unto The City of Cape Girardeau, Missouri, 401 Independence Street, Cape Girardeau, Missouri 63703, as OBLIGEE, hereinafter referred to and called OWNER, in the penal sum stated above, in lawful money of the United States of America to be paid to OWNER. For payment of the penal sum we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. ATEREAS, CONTRACTOR has entered mw the written contract agreement identified hereinabove with the OWNER for the following pmjem REMOVE AND REMARK TAXIWAY CENTERLINES, HOLD LINES, NON -MOVEMENT BOUNDARIES AND TAXILANE EDGE MARKINGS, CAPE GIRARDEAU REGIONAL AIRPORT, CAPE GIRARDEAU, MISSOURI which said contract and associated contract documents, including any present or future amendment thereto, is incorporated herein by reference and is hereinafter referred to as the Contract CONDITION NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if CONTRACTOR shall promptly make payment to all employees, persons, funis or corporations for all incurred indebtedness and just claims for labor, supplies, materials and services furnished for or used in connection with the performance of the Contract, then this obligation shall be void; otherwise it shall remain in full force and effect subject to the following additional conditions: 1. CONTRACTOR and SURETY indemnify and hold hamdess the OWNER for all claims, demands, liens or suits that arise from performance of the Contract 2. SURETY, for value received, hereby stipulates and agrees that no change, extension of time, modification, omission, addition or change in or to the Contract, or the work performed thereunder or the specifications accompanying the same, shall in any way affect the SURETY'S obligation on this bond; and SURETY hereby agrees to waive notice of any and all such extensions, modifications, omissions, alterations, and additions to the terms of the Contract, work or specifications. 3. No final settlement between the 0a7vTER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied 4. The amount of this bond shall be reduced by and to the extent of any payments made in good faith hereunder. 5. Amounts owed by the OWNER to the CONTRACTOR under the Contract shall be used for the performance of the Contract and to satisfy claims, if any, under any Performance Bond. By the CONTRACTOR furnishing and the OWNER accepting this Bond, they agree that all funds earned by the CONTRACTOR in the performance of 156 Rev. 06/05/12 (Minor) the Contract are dedicated to satisfy obligations of the CONTRACTOR and the SURETY under this Bond, subject to the OWNER'S priority to use the funds for the completion of the project. WITNESS In witness whereof, this instrument is executed this the day of 20_ INDIVIDUAL PRINCIPAL: Company Name: Signature: Name and Title: CORPORATE PRINCIPAL: ATTEST: Corporate Name: Signature: Signature: Name and Title: Name and Title: (Affix Corporate Seal) SURETY: ATTEST: Surety Name: Signature: Signature: Name and Title: Name and Title: (Affix Seal) (Attach Power of Attorney) OWNER ACCEPTANCE: The OWNER approves the form of this Payment Bond. ATTEST: R� Date: Signature: �•"� Signature: ' Name and Title: /e d SCR Name and Title: �G3 (Affix Seal 157 Ro . 06/05/12 (Minor) GILMC01 OP ID: AE 44coizo CERTIFICATE OF LIABILITY INSURANCE D07/25ATE /2014 ) o7/zs/zola 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) mustbe 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 endomement(s). PRODUCER SOUTH BROADVIEW CONTACT Drew Sherman NAME117 PRONri Est :573-335-3307I FAx A/C Nn:573-335-5844 EMAILs: dshennan ewalker.com P 0 BOX 733 CAPE GIRARDEAU, MO 63702-0733 07/28/2014 Drew Sherman INSURERIS) AFFORDING COVERAGE NAIL 6 INSURER A: AMERICA FIRST INSURANCE MED EXP (Any one Person) I 5 15,00 INSURED Gilmore Construction, LLC INSURER B: MISSOURI EMPLOYERS MUTUAL INS George Gilmore PO BOX 549 INSURER C: PRODUCTS - COMPIOP ADD S 2,000,00 Advance, MO 63730 INSURER D: TOMOBILE LIABILITY ANY AUTO ALL OWNEDX SCHEDULED AUTOS AUTOS NON-0wNED X HIRED AUTOS X AUTOS INSURER E INSURER F 07/28/2014 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. INSRI R TYPE OF INSURANCE IN I POLICY NUMBER MMIDCDl1'YYY Y EFF POLICY UP LIMITS A GENERAL LIABILITY XCOMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1XI OCCUR X CAPE GIRARDEAU, MO 63702-0617 BKS56143526 07/28/2014 07/28/2015 EACH OCCURRENCE IS 1,000,00 PREMISESEREoR' rrc s 1,000,00 MED EXP (Any one Person) I 5 15,00 PERSONAL S ADV INJURY S 1,000,00 GENERAL AGGREGATE S 2,000,00 GENL AGGREG�ATE LUMIT APPLIES PER: POLICYFPRO n LOC FrT PRODUCTS - COMPIOP ADD S 2,000,00 I S A TOMOBILE LIABILITY ANY AUTO ALL OWNEDX SCHEDULED AUTOS AUTOS NON-0wNED X HIRED AUTOS X AUTOS BAS56143526 07/28/2014 07/28/2015 COMBINED LIMIT .�IS 1,000,00 BODILY INJURY (Per Person) $ BODILY INJURY (Per amdeot) 5 PROPERTY DAMAGE 5 PER ACCIDEN 5 A X UMBRELLA DAB EXCESS UAB X OCCUR CLAIMSJMADE US056143526 07/2812014 07/28/2015 EACH OCCURRENCE 15 2,000,00 AGGREGATEIS 2,000,00 DED RETENTION E I S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y OFFICERIMEMBER EXCLUDED? (Mandatory in NH) R yes, wsmbe vnder DESCRIPTION OF OPERATIONS below N I A 2010367 11/16/2013 11/16/2014 WC STATU- OTH-I E.L. EACH ACCIDENT IS 1,000,00 E.L. DISEASE - EA EMPLOYEE]S 1,000,00 EL DISEASE -POLICY LIMIT I S 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 1D1, Addidonal Remarks Schedule, N more space la r ulred) SEE ATTACHED FORM# CG8810 04/13 6 CG0224 10/93 CANCELLATION CERTIFICATE IFICATE HOLDER ' CITYCAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF CAPE GIRARDEAU ACCORDANCE WITH THE POLICY PROVISIONS. 401 INDEPENDENCE CAPE GIRARDEAU, MO 63702-0617 AUTHORRED REPRESENTATIVE -------------- Cv i986 -201V ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD uvrtr�rv+nvl�. nu Ilya rcam .r; �. GILMC01 OP ID: AE 44cofzo CERTIFICATE OF LIABILITY INSURANCE O07/25/2014ATE Y) 07/25/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER W. E. WALKER-LAKENANPHO 117 SOUTH BROADVIEW CONTACT NAME, Drew Sherman tW.No E.1:573-335-3307 Fac No: 573-335-5844 P O BOX 733 E Aaess: dsherman@wewalker.com CAPE GIRARDEAU, MO 63702-0733 07/28/20151 Drew Sherman INSURER(Sl AFFORDING COVERAGE MAIC a INSURERA:AMERICA FIRST INSURANCE 1 PERSONAL 8 ADV INJURY $ INSURED Gilmore Construction, LLC George Gilmore PO BOX 549 INSURER B: INSURER C PRODUCTS - COMPIOP AGG I $ Advance, MO 63730 INSURER D 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. INSRI I -TR TYPE OF INSURANCE I D POLICY NUMBER MWDDSUBYEFF MMIDDY EXP LIMITS A GENERAL LIABILITY15 CONJnERCIAL GENERAL LIABILITY CLAIMS -0 DE ❑ OCCUR X OCP X BLOS6227371 07/28/2014 07/28/20151 EACHOCCURRENCE 1,000,08 P6 til AL"A t REMISES Ea occurrence S MED EXP (Any one Person) I S PERSONAL 8 ADV INJURY $ GENERA AGGREGATE S 2,000,88 GE I L AGGREIGATE I LIMIT APPLIES PER: JFCT I� LOC PRODUCTS - COMPIOP AGG I $ I AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS HIRED AUTOS AUT-0WNEO I��l COMBINED SINGLE LIMIT Ea accident)Per S BODILY INJURY ( person) S BODILY INJURY (Per ) PRO ACCIDDAMAGEarcidantAUTOS 5 15 UMBRELLA DAB EXCESS LJAB OCCUR CLAIMS) DE EACH OCCURRENCE 15 AGGREGATE S DED I I RETENTIONS Is WORKERS COMPENSATION AND EMPLOYERS' LIASILJTY YIN ANY PROPRIETORIPARTN=RfEXECUTVE❑ OFFICEt MNH) (Mandatory in ER EXCLUDED? ff DESCRIPTION Orbs OPERATIONS oei. NIA WC STATU.OTH-1 T ER E. L. EACH ACCIDIS EMPLOYEEI SENT E.L DISEASE - EA E.L. DISEASE - POLICY LIMIT I $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddlUonal Remarks Schedule, U mom space Is required) SEE ATTACHED FORM# CG8810 0413 S CG0224 1093 CITYCAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF CAPE GIRARDEAU ACCORDANCE WITH THE POLICY PROVISIONS. 401 INDEPENDENCE - CAPE GIRARDEAU, MO 63702-0617 AUTHORQED REPRESENTATIVE Drew Sherman W IVOO-LV IV M1 wmn ------ ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BLO56227371 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Number of Days' Notice 30 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. CG 02 24 10 93 Copyright Insurance Services Office, Inc., 1992 COMMERCIAL GENERAL LIABILITY CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON -OWNED AIRCRAFT 2 NON -OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY — ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS —COVERAGES A AND B 3 ADDITIONAL INSUREDS — BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY —ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS — EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 6 WHO IS AN INSURED — INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED — 6 FELLOW EMPLOYEE EXTENSION —MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7 LIBERALIZATION CLAUSE T BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US — 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I — Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I — Coverage A — Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY — ELEVATORS Under Paragraph 2. Exclusions of Section I — Coverage A — Bodily Injury And Property Damage Liability, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage' results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV — Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days, or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III — Limits of Insurance. ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limits Of Insurance. 2. Paragraph 6. under Section III — Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection systems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I — Coverage C — Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS — COVERAGES A AND B Under Supplementary Payments — Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or `suit", including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT Paragraph 2. under Section II Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury' caused in whole or in partby: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or C. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization, or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and advertising injury/' arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However: The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed, or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have retumed such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV — Commercial General Liability Conditions. 6 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance services Office. Inc., with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. C. "Bodily injury', "property damage" or "personal and advertising injury' arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. "Bodily injury" or "property damage" occurring after (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS endorsement issued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and noncontributory, this insurance is excess over any other insurance for which the additional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit' under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured, and C. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III — Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS / MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II - Who Is An Insured is replaced with the following: (1) "Bodily injury' or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing professional health care personnel to others, or if coverage for providing professional health care services is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. 9 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 8 Paragraphs (a) and (b) above do not apply to "bodily injury or "personal and advertising injury' caused by an .employee' who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the .employee's" job responsibilities assigned by you, includes the direct supervision of other 'employees' of yours. However, none of these "employees" are insureds for "bodily injury' or "personal and advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury or "personal and advertising injury, or caused in whole or in part by their intoxication by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II - Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury' or "property damage" that occurred before you acquired or formed the organization; and C. Coverage B does not apply to "personal and advertising injury' arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV — Commercial General Liability Conditions, the following is added to Condition 6. Representations: Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV — Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an 'occurrence", offense, claim or 'suit' by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II — Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or .employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V — Definitions, Definition 3. is replaced by the following: "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease. ® 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury' or "property damage' resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US — WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV — Commercial General Liability Conditions, the following is added to Condition 8. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard" provided: You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agreement. 0 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8 POLICY NUMBER: BKS56143526 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Number of Days' Notice 30 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. CG 02 24 10 93 Copyright Insurance Services Office, Inc., 1992 1 Western Surety Company PERFORMANCE BOND Bond Number: 71565767 KNOW ALL PERSONS BY THESE PRESENTS, That we Gilmore Construction, LLC of 813 W Jenkins St, Advance, MO 63730 ,hereinafter referred to as the Principal, and Western Surety Company as Surety, are held and firmly bound unto City of Cape Girardeau of 401 Independence St., Cape referred to as the Obligee, in the sum of _, hereinafter even and Dollars (S 92, 727. 60 ), for the payment of which we bind ourselves, our legal representatives, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, Principal has entered into a contract with Obligee, dated the day of NOW, THEREFORE, if the Principal shall faithfully perform such contract or shall indemnify and save harmless the Obligee from all cost and damage by reason of Principal's failure so to do, then this obligation shall be null and void. otherwise it shall remain in full force and effect. ANY PROCEEDING, legal or equitable, under this Bond may be instituted in any court of competent jurisdiction in the location in which the work or part of the work is located and shall be instituted within two years after Contractor Default or within two years after the Contractor ceased working or within two years after the Surety refuses or fails to perform its obligations under this Bond, whichever occurs first. If the provisions of this Paragraph are void or prohibited by law, the minimum period of limitation available to sureties as a defense in the jurisdiction of the suit shall be applicable. 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, SEALED AND DATED this 14th day of Julv 2014 . Gilmore Co =truction LLC rpal) Forth F4597 Western Surety Company PAYMENT BOND Bond Number: 71565767 KNOW ALL PERSONS BY THESE PRESENTS, That we Gilmore Construction, LLC of 813 w Jenkins St, Advance, MO 63730 ,hereinafter referred to as the Principal, and western surety Company as Surety, are held and firmly bound unto City of Cape Girardeau of referred to as the Obligee, in the sum of 637 01-624 4 , hereinafter sand Seven Hundred Twenty -Seven and Dollars (S 92, 727. 60 ), for the payment of which we bind ourselves, our legal representatives, successors and assigns, jointly and severalty, firmly by these presents. WHEREAS, Principal has entered into a contract with Obligee, dated day of • -u• �• - •• .. copy of which contract is by reference made a part hereof. NOW, THEREFORE, if Principal shall, in accordance with applicable Statutes, promptly make payment to all persons supplying labor and material in the prosecution of the work provided for in said contract, and any and all duly authorized modifications of said contract that may hereafter be made, notice of which modifications to Surety being waived, then this obligation to be void, otherwise to remain in full force and effect. No suit or action shall be commenced hereunder (a) After the expiration of one (1) year following the date on which Principal ceased work on said contract it being understood, however, that if any limitation embodied in this bond is prohibited by any law controlling the construction hereof such limitation shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by such law. (b) 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. The amount of this bond shall be reduced by and to the extent of any payment or payments made in good faith hereunder. SIGNED, SEALED AND DATED this 14th day of July 2014 . Gilmore C `-uction LLC Pry al BY t ` , T" JUST_TN D ACKNONVLEDGDIENT OF SURETY STATE OF Missouri l (Attorney -in -Fact) Bond No. 71565767 COUNTY OF <3 y��Scott Jy ss On this t� day of J fd, before me, a notary public in and for said County, personally appeared Jl1STTN RRADT,Fy to me personally known and being by me duly sworn, did say, that he/she is the Attorney -in -Fact of WESTERN SURETY COMPANY, a corporation of Sioux Falls, South Dakota, created, organized and existing under and by virtue of the laws of the State of South Dakota, that the said instrument was executed on behalf of the said corporation by authority of its Board of Directors and that the said JUSTIN D BRADLEY acknowledges said instrument to be the free act and deed of said corporation and that he/she has authority to sign said instrument without affixing the corporate seal of said corporation. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my official seal at Sikeston Missouri , the day and year last above written. My co r expire, Z Form 10642013 MARK D. (S My CamiWdm EON s%ftTkw4.2D15 swtt CM* mento` Cnmdsft A 1123` 9 Western Surety Company PONVER OF ATTORNEY - CERTIFIED COPY Bond No. 71565767 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 JUSTIN D BRADLEY its true and lawful attomey(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: Gilmore Construction, LLC Obligee: City of Cane Girardeau 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 ratibang and confirming all that the said attorney(s)dn-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 13 2014 , 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 seaj:Slp}_ affixed this 14th day of July 2014 WEST R// SURE COMPANY Paul T. Aruflat, Vice President v. v t STiFfQ^UTId'I41'TA COUT"Pitf}��'isidAEIA JJII On this 14th day of July , in the year 2014 , 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 WESTERN SURETY COMPANY and acknowledged said instrument to be the voluntary act and dIsaid co a 'en� S. PETRIK �/�'� HOGRY ��� Notary Public - South Dakota IaSOUTH DA A " i 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 - 4th day of July 2014 WEST R SURE COMPANY Paul T. at, Vice President Fonn F5306-8-2012 FORM OF CONTRACT AGREEMENT CITY OF CAPE GIRARDEAU, MISSOURI State Block Grant Project No. 14-077A-1 THIS AGREEMENT, made as of this day of 2014, is BY AND BETWEEN the OWNER: Name: THE CITY OF CA GH2ARDEAU, MISSOURI Address: 401 INDEPENDENCE STREET City/State/Zip Code: CAPE GIRARDEAU, MISSOURI 63703 And the CONTRACTOR: Name: GILMORE CONSTRUCTION, LLC. Address: 813 WEST JEN'KINS STREET City/State/Zip Code: ADVANCE, MISSOURI 63730 WITNESSETH: WHEREAS it is the intent of the Owner to make improvements at THE CAPE GIRARDEAU REGIONAL AIRPORT generally described as follows; REMOVE AND REMARK TAXIWAY CENTERLINES, HOLD LINES, NON -MOVEMENT BOUNDARIES AND TAXH.ANE EDGE MARKINGS, hereinafter referred to as the Project. NOW THEREFORE in consideration of the mutual covenants hereinafter set forth, OWNER and CONTRACTOR agree as follows: Article 1 — Work It is hereby mutually agreed that for and in consideration of the payments as provided for herein to the CONTRACTOR by the OWNER, CONTRACTOR shall faithfully fumish all necessary labor, equipment, and material and shall fully perform all necessary work to complete the Project in strict accordance with this Contract Agreement and the Contract Documents. Article 2 — Contract Documents CONTRACTOR agrees that the Contract Documents consist of the following: this Agreement, General Provisions, Supplementary Provisions, Specifications, Drawings, all issued addenda, Notice -to -Bidders, Instructions -to -Bidders, Proposal and associated attachments, Performance Bond, Payment Bond, Wage Rate Determinations, Insurance certificates, documents incorporated by reference, documents incorporated by attachment, and all OWNER authorized change orders issued subsequent to the date of this agreement. All documents comprising the Contract Documents are complementary to one another and together establish the complete terms, conditions and obligations of the CONTRACTOR. All said Contract Documents are incorporated by reference into the Contract Agreement as if fully rewritten herein or attached thereto. Article 3 — Contract Price In consideration of the faithful performance and completion of the Work by the CONTRACTOR in accordance with the Contract Documents, OWNER shall pay the CONTRACTOR an amount equal to: Ninety -Two Thousand, Seven Hundred Twenty Seven Dollars and Six" Cents ($92 727.60 (Amount in Written Words) (Amount in Numerals) 158 Rev. 06/05/12 (Minor) subject to the following; a. Said amount is based on the schedule of prices and estimated quantities stated in CON'TRACTOR'S Bid Proposal, which is attached to and made a part of this Agreement; b. Said amount is the aggregate sum of the result of the CONTRACTOR'S stated unit prices multiplied by the associated estimated quantities; c. CONTRACTOR and OWNER agree that said estimated quantities are not guaranteed and that the determination of actual quantities is to be made by the OWNER'S ENGINEER; d. Said amount is subject to modification for additions and deductions as provided for within the Contract General Provisions. Article 4 — Payment Upon the completion of the work and its acceptance by the OWNER, all sums due the CONTRACTOR by reason of faithful performance of the work, taking into consideration additions to or deductions from the Contract price by reason of alterations or modifications of the original Contract or by reason of "Extra Work" authorized under this Contract, will be paid to the CONTRACTOR by the OWNER after said completion and acceptance. The acceptance of final payment by the CONTRACTOR shall be considered as a release in full of all claims against the O WNTER, arising out of, or by reason of the work completed and materials furnished under this Contract. OWNER shall make progress payments to the CONTRACTOR in accordance with the terms set forth in the General Provisions. Progress payments shall be based on estimates prepared by the ENGINEER for the value of work performed and materials completed in place in accordance with the Contract Drawings and Specifications. Progress payments are subject to retainage requirements as set forth in the General Provisions. Article 5 — Contract Time The CONTRACTOR agrees to commence work within ten (10) calendar days of the date specified in the OWNER'S Notice -to -Proceed. CONTRACTOR further agrees to complete said work within twelve (12) calendar days of the commencement date stated within the Notice -to -Proceed. It is expressly understood and agreed that the stated Contract Time is reasonable for the completion of the Work, taking all factors into consideration. Furthermore, extensions of the Contract Time may only be permitted by execution of a formal modification to this Contract Agreement in accordance with the General Provisions and as approved by the OWNER- Article WNER Article 6— Liquidated Damages The CONTRACTOR and OWNER understand and agree that time is of essence for completion of the Work and that the OWNER will suffer additional expense and financial loss if said Work is not completed within the authorized Contract Time. Furthermore, the CONTRACTOR and OWNER recognize and understand the difficulty, delay, and expense in establishing the exact amount of actual financial loss and additional expense. Accordingly, in place of requiring such proof; the CONTRACTOR expressly agrees to pay the OWNER as liquidated damages the non -penal sum of $750.00 (Seven Hundred Fifty Dollars) per day for each calendar day required in excess of the authorized Contract Time. Furthermore, the CONTRACTOR understands and agrees that; a. the OWNER has the right to deduct from any moneys due the CONTRACTOR, the amount of said liquidated damages; b. the OWNER has the right to recover the amount of said liquidated damages from the CONTRACTOR, SURETY or both. Article 7 — CONTRACTOR'S Representations The CONTRACTOR understands and agrees that all representations made by the CONTRACTOR within the Proposal Form shall apply under this Agreement as if fully rewritten herein. 159 R". 06M5/12 (Minor) Article 8 — CONTRACTOR'S Certifications The CONTRACTOR understands and agrees that all certifications made by the CONTRACTOR within the Proposal shall apply under this Agreement as if frilly rewritten herein. The CONTRACTOR further certifies the following; a. Certification of Eligibility (29 CFR Part5.5) i. By Entering into this contract, the CONTRACTOR certifies that neither he or she nor any person or firm who has an interest in the CONTRACTOR'S firm is a person or firm ineligible to be awarded Government contracts by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1); ii. No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(x)(1); iii. The penalty for making false statements is prescribed in the U.S. Criminal Code 18 U.S.C. b. Certification of Non -Segregated Facilities (41 CFR Part 60.1.8) The federally -assisted construction CONTRACTOR, certifies that it does not maintain or provide, for its employees, any segregated facilities at any of its establishments and that it does not permit its employees to perform their services at any location, under its control, where segregated facilities are maintained. The BIDDER certifies that it will not maintain or provide, for its employees, segregated facilities at any of its establishments and that it will not permit its employees to perforrn thew services at any location under its control where segregated facilities are maintained. The Bidder agrees that a breach of this certification is a violation of the Equal Opportunity Clause, which is to be incorporated in the contract As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms, and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated on the basis of race, color, religion, or national origin because of habit, local custom, or any other reason. The Bidder agrees that (On ftficm ained identical certifications from proposed subcontractors for specific lime pen'l certifications from proposed subcontractors prior to the award of subcontracts'are not exempt from the provisions of the Equal Opportunity Clause and that it; .its files. Article 9 — Miscellaneous a. CONITRACTOR understands that it shall be solely responsibl and procedures of construction in connection with completion sequences b. CONTRACTOR understands and agrees that it shall not accoml?:I ar • • er�� materials that are not covered or authorized by the Contract Documents unless b OWNER or ENGINEER; c. The rights of each party under this Agreement shall not be assigned or transferred.uS any other person, entity, firm or corporation without prior written consent of both parties; d. OWNER and CONTRACTOR each bind itself, their partners, successors, assigns and legal representatives to the other party in respect to all covenants, agreements, and obligations contained in the Contract Documents. Article 10 — OWNER'S Representative The OWNER'S Representative, herein referred to as ENGINEER, is defined as follows: CRAWFORD, MURPHY & TILLY, INC. ONE MEMORIAL DRIVE, SUITE 500 ST. LOUIS, MISSOURI 63102 Said ENGINEER will act as the OR'?.TER'S representative and shall assume all rights and authority assigned to the ENGINEER as stated within the Contract Documents in connection with the completion of the Project Work. 160 Rm 0@05/12 (Minor) IN WITNESS VJIIEREOF, OWNER and CONTRACTOR have executed five (5) copies of this Agreement on the day and year first noted herein. OWNER CONTRACTOR Name: THE CITY OF CAPE GIRARDEAU, MISSOURI Name: GILMORE CONSTRUCTION, LLC Address: 401 INDEPENDENCE STREET Address: 813 WEST JENIQNS STREET M CAPE GIRARDEAU, MISSOURI 63703 ADVANCE, MISSOURI 63730 By: � a . Signature Pl`61Dr)e.1 Title of Representative ATTEST:/�� ,f� ATTEST By: > ., &/16 By: Signator Signa (iT.t CPt.�IL Terf I— Title Title 161 Rw. 06/05/12 (Minor) BILL NO. 14-106 RESOLUTION NO. A RESOLUTION AUTHORIZING THE CITY MANAGER TO EXECUTE A CONTRACT AGREEMENT WITH GILMORE CONSTRUCTION, LLC, TO REMOVE AND REPAINT TAXIWAY CENTERLINES AND HOLD LINES AT THE CAPE GIRARDEAU REGIONAL AIRPORT BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF CAPE GIRARDEAU, MISSOURI, AS FOLLOWS: ARTICLE 1. The City Manager, for and on behalf of the City of Cape Girardeau, Missouri, is hereby authorized to execute a Contract Agreement with Gilmore Construction, LLC, to remove and repaint taxiway centerlines and hold lines at the Cape Girardeau Regional Airport, (Project No. 14-077A-1), in the City of Cape Girardeau, Missouri. A copy of said Agreement is attached to this Resolution and made a part hereof. PASSED AND ADOPTED THIS DAY OF 2014. H ry E. ediger, Mayor ATTEST: Gayle Conrad City Clerk FORM OF CONTRACT AGREEMENT (SPONSOR NAME) State Block Grant Project No. (rMoDOT PROJECT NUMBER} THIS AGREEMENT, made as of this day of 120, is BY AND BETWEEN the OWNER: Name: THE CITY OF CAPE GIRARDEAU, MISSOURI Address: 210 WEST WASHINGTON STREET City/State/Zip Code: CAPE GIRARDEAU, MISSOURI 63703 And the CONTRACTOR: Name: /T.TrTm City/State/Zip Code: WITNESSETH: WHEREAS it is the intent of the Owner to make improvements at THE CAPE GIRARDEAU REGIONAL AIRPORT generally described as follows; (BRIEF AND CONCISE DESCRIPTION OF PROJECT}. hereinafter referred to as the Project. NOW THEREFORE in consideration of the mutual covenants hereinafter set forth, OWNER and CONTRACTOR agree as follows: Article i —Work It is hereby mutually agreed that for and in consideration of the payments as provided for herein to the CONTRACTOR by the OWNER, CONTRACTOR shall faithfully furnish all necessary labor, equipment, and material and shall fully perform all necessary work to complete the Project in strict accordance with this Contract Agreement and the Contract Documents. Article 2 — Contract Documents CONTRACTOR agrees that the Contract Documents consist of the following: this Agreement, General Provisions, Supplementary Provisions, Specifications, Drawings, all issued addenda, Notice -to -Bidders, Instructions -to -Bidders, Proposal and associated attachments, Performance Bond, Payment Bond, Wage Rate Determinations, Insurance certificates, documents incorporated by reference, documents incorporated by attachment, and all OWNER authorized change orders issued subsequent to the date of this agreement All documents comprising the Contract Documents are complementary to one another and together establish the complete terms, conditions and obligations of the CONTRACTOR. All said Contract Documents are incorporated by reference into the Contract Agreement as if fully rewritten herein or attached thereto. Article 3 —Contract Price In consideration of the faithful performance and completion of the Work by the CONTRACTOR in accordance with the Contract Documents, OWNER shall pay the CONTRACTOR an amount equal to: subject to the following; (Amount in Written Words) (Amount in Numerals) 144 Rev. 11&05/12 (Ftinw) I a. Said amount is based on the schedule of prices and estimated quantities stated in CONTRACTOR'S Bid Proposal, which is attached to and made a part of this Agreement; b. Said amount is the aggregate sum of the result of the CONTRACTOR'S stated unit prices multiplied by the associated estimated quantities; c. CONTRACTOR and OWNER agree that said estimated quantities are not guaranteed and that the determination of actual quantities is to be made by the OWNER'S ENGINEER; d. Said amount is subject to modification for additions and deductions as provided for within the Contract General Provisions. Article 4 — Payment Upon the completion of the work and its acceptance by the OWNER, all sums due the CONTRACTOR by reason of faithful performance of the work, taking into consideration additions to or deductions from the Contract price by reason of alterations or modifications of the original Contract or by reason of "Extra Work" authorized under this Contract, will be paid to the CONTRACTOR by the OWNER after said completion and acceptance. The acceptance of final payment by the CONTRACTOR shall be considered as a release in full of all claims against the OWNER, arising out of, or by reason of, the work completed and materials furnished under this Contract. OWNER shall make progress payments to the CONTRACTOR in accordance with the terms set forth in the General Provisions. Progress payments shall be based on estimates prepared by the ENGINEER for the value of work performed and materials completed in place in accordance with the Contract Drawings and Specifications. Progress.payments are subject to retainage requirements as set forth in the General Provisions, Article 5 — Contract Time The CONTRACTOR agrees to commence work within ten (10) calendar days of the date specified in the OWNER'S Notice -to -Proceed. CONTRACTOR further agrees to complete said work within (NUMBER OF DAYS) of the commencement date stated within the Notice -to -Proceed. It is expressly understood and agreed that the stated Contract Time is reasonable for the completion of the Work, taking all factors into consideration. Furthermore, extensions of the Contract Time may only be permitted by execution of a formal modification to this Contract Agreement in accordance with the General Provisions and as approved by the OWNER_ Article 6 — Liquidated Damages The CONTRACTOR and OWNER understand and agree that time is of essence for completion of the Work and that the OWNER will suffer additional expense and financial loss if said Work is not completed within the authorized Contract Time. Furthermore, the CONTRACTOR and OWNER recognize and understand the difficulty, delay, and expense in establishing the exact amount of actual financial loss and additional expense. Accordingly, in place of requiring such proof, the CONTRACTOR expressly agrees to pay the OWNER as liquidated damages the non -penal sum of ${DOLLAR AMOUNT) per day for each calendar day required in excess of the authorized Contract Time. Furthermore, the CONTRACTOR understands and agrees that; a. the OWNER has the right to deduct from any moneys due the CONTRACTOR, the amount of said liquidated damages; b. the OWNER has the right to recover the amount of said liquidated damages from the CONTRACTOR, SURETY or both. Article 7— CONTRACTOR'S Representations The CONTRACTOR understands and agrees that all representations made by the CONTRACTOR within the Proposal Form shall apply under this Agreement as if fully rewritten herein. Article 8 — CONTRACTOR'S Certifications 145 Rm 06/05/12 (Minor) f rM. i The CONTRACTOR understands and agrees that all certifications made by the CONTRACTOR within the Proposal shall apply under this Agreement as if fully rewritten herein. The CONTRACTOR further certifies the following; a. Certification ofElinibility (29 CFR Part 5.5) i. By Entering into this contract, the CONTRACTOR certifies that neither he or she nor any person or firm who has an interest in the CONTRACTOR'S firm is a person or firm ineligible to be awarded Government contracts by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(a)(1); H. No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of Section 3(a) of the Davis -Bacon Act or 29 CFR 5.12(axl ); iii. The penalty for making false statements is prescribed in the U.S. Criminal Code 18 U.S.C. b. Certification of NonSe reoated Facilities (41 CFR Part 60-1.8) The federally -assisted construction CONTRACTOR, certifies that a does not maintain or provide, for its employees, any segregated facilities at any of its establishments and that it does not permit its employees to Perform their services at any location, under its control, where segregated facilities are maintained. The BIDDER certifies that it 35411 not maintain or provide, for its employees, segregated facilities at any of its establishments and that it will not permit its employees to perform their services at any location under its control where segregated facilities are maintained. The Bidder agrees that a breach of this certification is a violation of the Equal Opportunity Clause, which is to be incorporated in the contract. As used in this certification, the term "segregated facilities" means any waiting rooms, work areas, restrooms, and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, parking lots, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated on the basis of race, color, religion, or national origin because of habit, local custom, or any other reason. The Bidder agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause and that it will retain such certifications in its files. Article 9—Miscellaneous a. CONTRACTOR understands that it shall be solely responsible for the means, methods, techniques, sequences and procedures of construction in connection with completion of the Work; b. CONTRACTOR understands and agrees that it shall not accomplish any work or furnish any materials that are not covered or authorized by the Contract Documents unless authorized in writing by the OWNER or ENGINEER; c. The rights of each party under this Agreement shall not be assigned or transferred to any other person, entity, firm or corporation without prior written consent of both parties; d. OWNER and CONTRACTOR each bind itself, their partners, successors, assigns and legal representatives to the other party in respect to all covenants, agreements, and obligations contained in the Contract Documents. Article 10 — OWNER'S Representative The OWNER'S Representative, herein referred to as ENGINEER, is defined as follows: CRAWFORD, MURPHY & TILLY, LNC. _ ONE MEMORIAL DRIVE, SUITE 500 ST. LOUIS, MISSOURI 63102 Said ENGINEER will act as the OWNER'S representative and shall assume all rights and authority assigned to the ENGINEER as stated within the Contract Documents in connection with the completion of the Project Work. IN WITNESS WHEREOF, OWNER and CONTRACTOR have executed five (5) copies of this Agreement on the day and year first noted herein 146 Rcv. 06/05/12 (Minor) OWNER Name: _ Address: By: Signature Title of Representative ATTEST: By: Signature Title 1 147 Rev, 06/05/12 (Minor) t� m:�ewwe� CONTRACTOR Name: Address: By: Signature Title of Representative ATTEST By: Signature Title 147 Rev, 06/05/12 (Minor) t� m:�ewwe� PROPOSAL FORM THE CITY OF CAPE GIRARDEAU, MLSSOURI State Block Gram Project No. 14-077A-1 TO: City Cletr(Enginer The undersigned, in compliance with the request for bids for construction of the following Project REMOVE AND REAMRK TAXIWAY CENTERLINES, HOLD LINES, NON -MOVEMENT BOUNDARIES AND TArrr.an E EDGE MAR]M GS hereby proposes to furnish all labor, Permits, material, machinery, tools, supplies and equipment to faithfully perform all work required for construction of the Project in accordance with the project menosl, project drawings and issued Addenda within the specified time of performance for the following prices: BASE BID APPROX. BID FAA or ITEM DESCRIPTION QUANT IY U\TT PRICE EXTENSION ITEM MoDOT AND SPEC. UNITS DOLLARS CCS DOLLARS CCS 1 MO -100 Mobilization 1 $Lump 6r S6 6r$Cl{ Co sum 2 MO -620 Airport TaxiwayPavement 1,1 } t S . f Q G S ,no 1 3 MO -620 Airfield Paves Marking 35, # 1 is #yDt 9'iD =° 4 M"20 Airport Pavement Marking 50,470 SF#zS 1� opo Removal 15D 2 3S TOTAL BID (Base Bid) *121-727 E0 r" 'ts J r}.r ' 61. lav : a. By submittal of a proposal, the BIDDER acknowledges and accepts that the quantities established by the OWNER are an approximate estimate of the quantities required to fully complete the Project and that the estimated quantities are principally intended to serve as a basis for evaluation of bids. The BIDDER further acknowledges and accepts that payment under this contract will be made only for actual quantities and that quantities will vary in accordance with the General Provisions.subsection entitled "Alteration of Work and Quantities". b. The BIDDER w1mowledges and accepts that the Bid Documents are comprised of the docurttema identified within the General Provisions. The BIDDER father acknowledges that each the individual docmneata that comprise the Bid Docurnzats are complementary to one another and together establishes the Mete terms, conditions and obligations of the successful BIDDER e. As evidence of good faith in submitting this proposal, the undersigned encloses a bid guaranty in the form of a certified chock, cashier's check or bid bond in the amount of 5% of the bid price. The BIDDER acknowledges and accepts that refusal or failure to accept award and execute a contract within the terms and 144 aur. 06osn2 (ossa) conditions established herein will result in forfeiture of the bid guaranty to the owner as a liquidated damage. d. The BIDDER acknowledges and accepts the OWNER'S right to reject any or all bids e. The BIDDER acknowledges and accepts the OWNER'S right to hold all Proposals for purposes of review and evaluation and not issue a notice -0f --award for a period not to exceed sixty (60) calendar days from the stated date for receipt of bids. L The undersigned agrees that upon written notice of award of contract, he or she will execute the connect within thirty (30) days of the notice -of -award, and furthermore, and provide executed payment and performance bonds within fifteen (15) days from the date of contract execution. The undersigned accepts that failure to execute the contract and provide the required bonds within the stated timeframe shall result in forfeiture of the bid guaranty to the owner as a liquidated damage. g. Time of Performance: By submittal of this proposal, the tmdersigned acknowledges and agrees to commence work within.ten (10) calendar days of the date specified in the written "Notice -to -Proceed" as issued by the OWNER The undersigned further agrees to complete the Project within twelve (12) Calendar days from the commencement date specified in the Notice-to-Proceed- h. otice-to-Proceedh. The undersigned acknowledges and accepts that for each and every Calendar day the project remains incomplete beyond the contract time of performance, the Contractor shall pay the non-pcnal amok of 5750.00 (Seven Hundred Fifty Dollars) per Calendar day as a liquidated damage to the OWNER L The undersigned prime contractor, if not a MoDOT certified DBE, hereby assures that they will subcontract a minimum of zero (0) percent of the dollar value of the prime contract to DBE forms or make good faith efforts to meet the DBE contract goal. In addition, the prime contractor will include the DBE clauses (see Supplementary Provision No. 6 of the Federal and State Provisions) required by the DBE Program adapted by MoDOT and the city in all contracts and subcontracts relating to this project The undersigned will complete the DHE Participation information included herein, when a DBE goal has been established, including a demonstration of good faith efforts if the DBE goal is not met If the undersigned prime contractor is a MoDOT certified DBE Ron, then the prime contractor must perform at least thirty percent (30"/0) of the total contract vale work with its own fomes, and will receive DBE credit for all work which the prime contractor and any other McDOT certified DBE firm performs directly. J. The BIDDER, by submission of a proposal, acknowledges that award of this contract is subject to the provisions of the David Bacon Act mad the Missouri Prevailing Wage law. The BIDDER accepts the rcquirearient to pay prevailing wages for each classification and type of worker as established in the attached wage rate determinations as issued by the United Statea Department of labor and the Missouri Division of Labor Standards. The BIDDER further acknowledges and accepts their requitement to incorporate the provision to pay the established prevailing wages in every subcontract agreement entered into by the Bidder tinder this project The highest rate between the two (Federal and State) for each job classification shall be considered the prevailing wage. k. Compliance Reports (41 CYR Part 60-1.7): Within 30 days ad= award of this conrrmct, the Conttactor/Subcontractor shall file a compliance report (Standard Form 100) if s/he has not submitted a complete compliance report within 12 months proceeding the date of award This report is required if the Contractor/Subcontractor meets all of the following conditions: 1. Conractots/Sabcoanacwn are not exempt based on 41 CFR 60.1,5. 2. Has 50 or more employees 3. Is a prime contractor or first tier subcontractor. 4. There is a contract, subcontract, or purchase order amounting to $50,000 or more L The undersigned acknowledges receipt of the following mddmda: 145 Rev. 06101M (K=) Addendum No. #V%� . dated Date Received Addendum No. . dated Date Received Addendum No. dated Date Received Addendum No. dated Date Received Addendum No. . dared Date Received By submittal of a proposal (bid), the BIDDER represents the following. a. The BIDDER has read and thoroughly examined the bid documents including all authorized addenda. b. The BIDDER has a complete understanding of the terms and conditions required for the satisfactory performance of project work. c. The BIDDER has fully informed themselves of the project site, the project site conditions and the surrounding area. d. The BIDDER has familiarized themselves of the requirements of worldng on an operating airport and understands the conditions that may in any manner affect coat, progress or performance of the work e. The BIDDER has correlated their observations with that of the project documents. L The BIDDER has found no errors, conflicts, ambiguities or omissions in the project documents, except as previously submitted in writing to the owner that would affed cost; progress or performance of the work. g. The BIDDER is familiar with all applicable Federal, State and local laws, rules and regulations pertaining to execution of the contract and the project work h. The BIDDER has complied with all rcquirsments of these instructions and the associated project documents. CERTIFICATIONS BY BIDDER s` The undersigned hereby declares and certifies that the only parties interested in this proposal are named herein and that this proposal is made without collusion with any other person, firm or corporation. The undersigned further certifies that no member, officer or agent of OWNER'S has direct or indirect financial interest in this proposal. b. Certification of Non -Segregated Facilities (41 CFR Part 60-1.8) The BIDDER, as a potential federally -assisted construction eomractor, certifies that it does not maintain or provide, for its employees, any segregated facilities at any of its establishments and that it does not permit is employers to perform their services at any location, under its control, where segregated facilities are maintained. The BIDDER certifies that it will not maintain or provide, for its employees, segregated facilities at any of is establishment and that it will not permit its employers to perform their services at any location under its control where segregated facilities are maintained The Bidder agrees that a breach of this certification is s violation of the Equal opportunity Clause, which is to be incorporated in the contract. As used in this certification, the term "segregated facilities" means any weiRng rooms, work areas, resttooms, and washrooms, restaurants and other eating areas, timeclocks, locker rooms and other storage or dressing areas, parking lot, drinking fountains, recreation or entertainment areas, transportation, and housing facilities provided for employees which are segregated on the basis of race, color, religion, or national origin bemuse of habit, local custom, or any other reason. The Bidder agrees that (except where it has obtained identical certifications from proposed subcontractors for specific time periods) it will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding 510,000 which are not exempt from the provisions of the Equal Opportunity Glasse and that it will retain Stich certifications in its files. c. Trade Restriction Certification (49 CFR Part 30) 146 lues. O6MI12 Qa=) The Bidder, by submission of an offer certifies that it 1. is not owned or controlled by one or more citizens of a foreign country included in the list of countries that discriminate against U.S. firms published by the Office of the United States Trade Representative (USTR); 2. has not knowingly entered into any contact or subcontract for this project with a person that is a citizen or national of a foreign country on said list, or is owned or controlled directly or indirectly by one or more citizens or nationals of a foreiga country on said list; 3. has not procured any product nor subcontracted for the supply of any product for use on the project that is produced in a foreign country on said list d. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion (49 CFR Part 29) The Bidder certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. It further agrees by submitting this proposal that it will include this clause without modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts. Where the Bidder or any lower tier participant is unable to certify to this statement, it shall attach an explanation to this solicitation/proposal. e. Buy American Certification: (Title 49 U.S.C. Chapter 501) As a condition of bid responsiveness, the bidder must certify its compliance with the Buy American preferences established under Title 49 U.S.C. Section 50101. Bidders must complete the Buy American certification as follows: Buy American Certification (Title 49 U.S.C. Section 50101) U.S.C. Section 50101- Buying goods produced in the United States (a) Preference. - The Secretary of Transportation may obligate an amount that may be appropriated to cavy out section 106(k), 44502(a)(2), or 44509, subchapter I of chapter 471 (except section 47127), or chapter 481 (except sections 48102(e), 48106, 48107, and 48110) of this title for a project only if steel and manufactured goods used m the project are produced in the United States. (b) Waiver. - The Secretary may waive subsection (a) of this section if the Secretary finds that - (1) Applying subsection (a) would be inconsistent with the public interest (2) The steel and goods produced in the United States are not produced in a sufficient and reasonably available amount or are not of a satisfactory quality, (3) When procuring a facility or equipment under section 44502(ax2) or 44509, subchapter I of chapter 471 (except section 47127), or chapter 481 (except sections 48102(e), 48106, 48107, and 48110) of this title - (A) The cost of components and subcomponents produced in the United States is more than 60 percent of the cost of all components of the facility or equipment; and (B) Final assembly of the facility or equipment has occurred in the United Status; or (4) Including domestic material will increase the cost of the overall project by more than 25 percent 147 Rev. 0645/12 (MroQ) (c) Labor Costs. - In this section, labor costa involved in final assembly are not included in calculating the cost of componemts. The Bidder must select the appropriate certification for its proposal from one of the following statements: dThe bidder hereby certifies that they will comply with Title 49 US.0 Section 50101 by only inrtaDing steel and manufactured products produced In the United States of America. ❑ The bidder hereby certifies that they cannot fully comply with the Buy American preferences of Title 49 U.S.0 Section 50101(x) and therefore requests a waiver per Title 49 U.S.0 Section 50101(b) for the items lixted below. Component/ Item Country of Origin Total Component Cort in Project Total All Components in Project NOTES: 1) All requested information must be submitted for each individual product item waiver request 2) All steel used in this project must be produced in'the USA. Regional waivers will not be issued for steel not produced in the USA 3) All products, equipment, things requumg assembly must be assembled in the USA Regional waivers will not be issued for products, equipment, etc. not final assembled in the USA 4) The Owner will submit any requested waiver by the apparent low bidder to the FAA for a determination of AIP eligibility. Bidders are hereby advised there is no implied or expressed guarantee that a requested waiver will be approved by the Owner or the Federal Aviation Administration. £ Compliance with the Work Authorisation Law (as required by Section 285930, Revised Statues of Missouri) For all contracts where the total bid amount is in excess of 5100,000 (local match in excess of $5,000), the Bidder, by submission of an offer and by signing the Worker Eligibility Verification Affidavit for All Contract Agreements in Excess of S 100,000, certifies that it 1. does not knowingly employ any person who is an umamhorized alien in connection with the contracted services; 2. has enrolled and actively participates in a federal work authorization program; 148 Re+. 06/5/12 (hfm ) A general contractor or subcontractor of any tier shall not be liable under sections 295.525 to 285.550 when such general contractor or subcontractor contracts with its direct subcontractor who violates subsection 1 of this section, if the contract binding the contractor and subcontractor affirmatively states that the direct subcontractor is not knowingly in violation of subsection ] of this section and shall not henceforth be in such violation and the contractor or subcontractor receives a swom affidavit under the penalty of petjury attesting to the fact that the direct subcontractor's employees are lawfully present in the United States. 149 Rev. 06/05/12 (Minor)