HomeMy WebLinkAboutRES.3043.12-05-2016 -7
BILL NO. 16-214 RESOLUTION NO.
A RESOLUTION AUTHORIZING THE CITY MANAGER TO
EXECUTE AN AGREEMENT FOR PROFESSIONAL
SERVICES WITH LEWELLYN TECHNOLOGY OF
DELAW:�RE LLC, IN THE CITY OF CAPE GIR.AR '�AU,
MISSOURI
BE IT RESOLVED BY THE COUNCIL OF `iHE CITY OF CAPE
GIRARDEAU, MISSOURI, AS FOLLOWS :
ARTICLE l. The City Manager, for and on behalf of the
City of Cape Girardeau, Missouri, is hereby authorized to
execute an agreement for professional services with Lewellyn
Technology of Delaware LLC, for perForming a Dust Hazard
Assessment and evaluating Flammable Vapors at the City of Cape
Girardeau Wastewater Treatment Plant. The Agreement shall be in
substantially the form attached hereto as Exhibit A, which
document is hereby approved by the City Council, and
incorporated herein by reference, with such changes therein as
shall be approved by the officers of the City executing the
same .
,-
PASSED AND ADOPTED THIS � DAY OF � , 016.
Harry E. Rediger, Mayor
ATTEST:
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Bruce Taylor, Deputy City Clerk i/ " \.�
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, CITY Of CAPE GIRARDEAU
DEVELOPMENT SERVICES
CONTRACT
For
City Facilities
CONSULTANT NAME: Lewellvn Technologv of Delaware,LLC
THIS CONTRACT is between the City of Cape Girardeau, Missouri, hereinafter referred to as the
"City", and Lewellyn Technology of Delaware, LLC, 6210 Technology Center Drive, Suite 200,
Indianapolis, Indiana 46278, hereinafter referred to as the "Consultant".
INASMZICH as funds have been made available by the City through various funding sources, the City
intends to complete projects at City facilities and requires professional services. The Consultant,
upon the City's request through written Task Orders, will provide the City with any and all
professional services hereinafter detailed for the assessment/evaluation and inspection of the desired
improvements and the City will pay the Consultant as provided in this contract and subsequent Task
Orders. It is mutually agreed as follows:
ARTICLE I - SCOPE OF SERVICES
A. ASSESSMENT/EVALUATION PHASE—if requested by the City, the Consultant will
perform analyses of the processes, operations, and practices at City facilities relating to the
safe and proper operation of the specified facility.
B. INSPECTION SERVICES PHASE — if requested by the City, the Consultant will inspect
improvements necessary for the safe and proper operation of the City's facilities. The
furnishing of such project representation will not make Consultant responsible for the
construction methods and procedures used by the Contractor or for the Contractor's failure to
perform work in accordance with the contract documents.
ARTICLE II -ADDITIONAL SERVICES
The City reserves the right to request additional work; changed or unforeseen conditions may require
changes and work beyond the scope of this contract. In this event, a supplement to this agreement
shall be executed and submitted for the approval of the City prior to performing the additional or
changed work or incurring any additional cost thereof. Any change in compensation will be covered
in the supplement.
ARTICLE III - RESPONSIBILITIES OF CITY
The City will cooperate fully with the Consultant in the development of the project, including the
following:
A. make available all information pertaining to the project which may be in the possession of the
City;
B. provide the Consultant with the City's requirements for the project;
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.
C. make provisions for the Consultant to enter upon property at the project site for the
performance of his duties;
D. examine all studies and layouts developed by the Consultant and render decisions thereon in a
prompt manner so as not to delay the Consultant;
E. designate a City employee to act as City's representative under this contract, such person shall
have authority to transmit instructions, interpret the City's policies and render decisions with
respect to matters covered by this agreement;
ARTICLE IV- PERIOD OF SERVICE
The Consultant will commence work within two weeks after receiving signed a Task Order and
notice to proceed from the City. The phases of work shall be completed in accordance with the
associated Task Order.
The times are exclusive of review time by other agencies. The City will grant time extensions for
unavoidable delays beyond the control of the Consultant. Requests for extensions of time should be
requested in writing by the Consultant, stating fully the reasons for the request.
ARTICLE V—STANDARDS
The Consultant shall be responsible for working with the City in determining the appropriate
parameters and specifications for the project using sound judgment based on the specific site
conditions, City needs, and guidance provided by the Occupational Safety and Health Administration
(OSHA) and National Fire Protection Association(NFPA).
ARTICLE VI - COMPENSATION
For services provided under this contract, the City will compensate the Consultant as determined in
the Task Order based on Consultant's Charge Out Rates as determined below:
l. Charge Out rates shall include all direct payroll, general and administrative overhead,
specialized equipment costs, payroll ta�ces, holiday and vacation pay, sick leave pay,
insurance benefits, retirement and incentive pay.
2. Additional work incurred by others on a subcontract basis, said costs are to be passed through
the Consultant on the basis of reasonable and actual cost as invoiced by the subcontractors,
only if required and approved by the City.
METHOD OF PAYMENT — Unless otherwise stated in the Task Order, partial payments will be
made to the Consultant for work satisfactorily completed upon receipt of itemized invoices by the
City.
1. Invoices will be submitted monthly. Invoices submitted on or before the 20th
day of any month shall become due and payable on the lOth day of the
following month. Invoices for each Task Order shall be submitted separately.
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2. Cit��s Righi to Wilhhold Pa��ment. In the event the City becomes informed
that any representations of the Consultant provided in its monthly billing, are
wholly or partially inaccurate, City may withhold payment of sums then or in
the future otherwise due to the Consultant until the inaccuracy and the cause
thereof, is corrected to the City's reasonable satisfaction. 'The Consultant shall
correct or revise any enors or deficiencies without additional compensation
when due solely to Consultant's negligent acts,errors, or omissions.
PROPERTY ACCOUNTABILITY—If it becomes necessary to acquire any specialized equipment
for the performance of this contract, appropnate credit will be given for any residual value of said
equipment after completion of usage of the equipment.
ARTICLE VII-COVENANT AGAINST CONTINGENT FEES
The Consultant warrants that he has not employed or retained any company or person, other than a
bona fide employee working for the Consultant, to solicit or secure this agreernent, and that he has
not paid or agreed to pay any company or person, other than a bona fide employee, any fee,
commission, percentage, brokerage fee, gifts, or any other consideration,contingent upon or resulting
from the award or making of this contract. For breach or violation of this warranty, the City shall
have the right to annul this agreement without liabilitv, or in its discretion to deduct from the contract
price or consideration, or otherwise recover, the full amount of such fee, commission, percentage,
brokerage fee,gift,or contingent fee,plus reasonable attomey's fees.
ARTICLE VIII-SUBLETTING,ASSIGNMENT OR TRANSFER
No portion of the work covered by this contract, the contract itself, or any Task Order, except as
provided herein, shall be assigned, sublet or transferred without the written consent of the City. The
subletting of the work sha11 not relieve the Consultant of his primary responsibility for the quality and
performance of the work. The Consultant may engage subconVactors for the purposes of: foundation
bonngs and tests, abstracts of title, archaeological studies, and environmental studies, if required and
approved by the City.
ARTICLE IX-PROFESSIONAL ENDORSEMENT
All documents sha11 be endorsed by the Consultant and shall rellect the name and credentials of the
employee endorsing the work. Any review or approval by the City of any documents prepared by the
Consultant and/or its subconsultants shall be solely for the purpose of determining whether such
documents are consistent with City's intent and shall not be construed as approval of same by City.
No review of such documents shall relieve Consultant of its responsibility for the accuracy,
adequacy, fitness,suitabilin�, and coordination of its work product.
Consultant shall assign only qualified personnel to perform any service conceming the Project. At
the time of execution of the Task Order, the parties will agree on the Project Manager for the Task.
This person shall be the primary contact with the City's Project Manager and shall have authority to
bind Consultant.
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ARTICLE X-RETENTION OF RECORDS
The Consultant shall maintain all records, documents, cost and accountin�records, and other records
pertaining to this contract and to the project covered by this contract, for a period of not less than
three yeazs following final payment by City. Said records shall be made available for inspection by
authorized representatives of the City during regular working hours at the Consultant's place of
business.
ARTICLE XI-OWNERSHIP OF DOCUMENTS
Documents prepared under this contract shall be delivered to and become the property of the City
upon termination or completion of work. Basic notes, computations, and other data prepared under
this contract shall be made available to the City upon request. All such information produced under
this contract shall be available for use by the City withoui restriction or limitation on its use. If the
City incorporates any poriion of the �vork into a project other than that for which it was performed,
the City shall save the Consultant harmless from any claims and liabilities resulting from such use.
ARTICLE XII- TERMINATION
The City may terminate the contract ai any time by giving written notice. If the contract is terminated
because the project is abandoned or postponed by the City,the Consultant�vill be paid for actual time
and covered expenses incurred up to the date of termination, plus a pro-rated portion of any fixed fee.
ICthe contract is terminated due to the Consultant's services being unsatisfactory in the judgment of
the City, or if the Consultant fails to prosecute the work with due diligence, the City may procure
completion of the work in such manner as it deems to be in the best interest of the City. A Notice of
Terminaiion will be sent to the Consultant and the Consultant shall have a period of ten (10) days to
remedy the cause for termination. The Consultant will be responsible for any excess cost in addition
to that provided for in this contract or any damages the City may sustain by reason of the termination
of this contract due to unsatisfactory performances or prosecution. When Consultant services have
been so terminated, such temvnation shall not affect any rights or remedies of the City against the
Consultant then existing or which may later accrue. Similazly, any retention or payment of monies
due the Consultant shall not release the Consultant from liabilitv.
ARTICLE XIII-DECISIONS UNDER THIS CONTRACT
The City will determine the acceptability of work perfortned under this contract, and will decide a11
questions which may anse concerning the project. The City's decision shall be final and conclusive.
ARTICLE XIV-SUCCESSORS AND ASSIGNS
Subject to the restrictions on assignments in Article VIII above, the City and the Consultant agree
that this contract and all contracts entered into under the provisions of this contract shall be binding
upon the parties hereto and their successors and assigns.
ARTICLE XV-COMPLIANCE WITH LAWS
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The Consultant shall comply with all federal, state, and local laws, ordinances, and regulations
applicable to the work, including Title Vi of the Civil Rights Act of 1964 and non-discrimination
clauses incorporated herein,and shall procure all licenses and permits necessary for the fulfillment of
obligations under this contract. Consultant shall further comply with the following state law
reqwrements:
Work Authorization Program. If the Contract is for services expected to cost more than $5,000.00,
the Consultant shall comply with of Section 285.530 RSMo., pertaining to enrollment and
participation in a federal work authonzation program (as detined therein) and shall provide
verification through an affidavit (attached as Attachment C) that the Consultant (I) does not
knowingly employ any person who is an unauthorized alien in connection with the Contract and(2)is
enrolled in a federal work authorization program and provide docwnentary proof thereof. The
affidavit shall conta.in the notari-r.ed signature of the registered agent, legal representative, or
corporate officer of the Consultant including but not limited to the human resources director or their
equivalent.
Proof of Lawf'u! Yresence. Section 208.009 RSMo., requires that all applicants at the time of
application for any contract provided by a local govemment provide "�rmative proof that the
applicant is a citizen or a permanent resident of the United States or is lawfully present in the United
States." Consultant's affirmative proof must be established through (1) a Missouri driver's license,
(2) any "documentary evidence recognized by the department of revenue when processing an
application for a driver's license," or (2) "any document issued by the federal govemmenl that
confirms an alien's lawful presence in the United States." §208.009.3
ARTICLE XVI-RESPONSiBILITY FOR CLAIMS AND LIABILITY
The Consultant agrees to save harmless the City from all claims and liability due to his negligent acts
or the negligent acts of his employees, agents, or subcontractors. The City shall be entitled to recover
its actual attomeys' fees from Consultant for the City's enforcement of this A�neement.
ARTICLE XVI[- INSURANCE
The Consultant shall maintain commercial general liability, automobile liabiliry, and ���orker's
compensation and employer's liability insur�nce in full force and effect to protect the Consultant
from claims under Worker's Compensation Acts, claims for damages for personal injury or death,
and for damages to property arising &om the negligent acts, errors, or omissions of the Consultant
and its employees, agents and subconsultants in the performance of the services covered by this
Agreement, including, without limitation, risks insured against in commercial general liability
policies.
The Consultant shall also maintain professional liability insurance to protect the City against the
negligent acts, errors, or omissions, of the Consultant and those for whom it is legally responsible,
arising out of the performance of professional services under this Agreement.
Unless another amount is agreed to by the City based on the circumstances, the Consultant and his
subconsultants shall procwe and maintain during the life of this A�reement insurance of the types
and minimum amounts as follows:
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Insurance T�•nr Am n
Worker's Compensation: In full compliancc with statutory rcquirements of
Federal and State of Missouri
Comprehensive General and Professional Liability,
including: Comprehensive Automobile Liability, �411,000 each person
Employer Liabilit}�, City's Protective Bodily Injur}� $2,740,000 each occurrence
Including Death, and City's Protective Property
Damage:
The City's Protective policy shall name the City as the Insured. Certificates evidencing such
insurance shall be fumished to the City prior to the Consultant commencing the work on this project.
The ceriificates must state, "The CITY OF CAPE GIRARDEAU is an additional insured". The City
reserves the right to adjust the limit coverage reqwrements in accordance with changes in the
statutory sovereign immunity limits over the life of this contract to re�lect any changes in the limits as
published by the Missouri Department of insurance in the state register pursuant to RSMo. §537.610.
The Consultant sha11, upon request at any tirne, provide the City with certificates of insurance
evidencing the Consultant's commercial general or professional liability policies and evidencing that
they and all other required insurance is in effect, as to the services under this Contract.
Any insurance policy required as specified in this Article shall be written by a company that is
incorporated in the United States of America or is based in the United States of America. Each
insurance policy must by issued by a company authorized to issue such insurance in the State of
Missouri.
ARTICLE XVIII- FINDINGS CONFIDENTIAL
To the fullest extent permitted by law, all reporis, information, data, etc. prepared or assembled by
the Consultant under this contract are confidential, and the Consultant a�nees they shall not be made
available to any individual or organirarion without the prior written approval of the City.
ARTICLE XIX-NONDISCRIMINATION
The Consultant, with regard to the work performed by it after award and prior to completion of the
contract work, will not discriminate on the ground of race, color or national origin in the selection
and retention of subcontractors. The Consultant will comply with Title VI of the Civil Rights Act of
1964, as amended. In all solicitations either by competitive bidding or negotiation made by the
Consultant for work to be performed under a subcontract, including procurements of materials or
equipment, each potential subcontractor or supplier shall be norified by the Consultant's obligations
under this contract and the regulations relative to non-discrimination on the ground of color, race or
national ongin.
ARTICLE XIX-PERIOD OF SERVICE
This contract shall remain in effeci for five yeazs &om the date accepted by the City of Cape
Girardeau City Council.
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ARTICLE XX-ATTACHMENTS
The following e�chibits are aztached hereto�d are hereby made part of this contract:
Attachcnent A- Charge out rates for 2016, 2017 20l 8, 2019,2020, and 2021
Attactunent B- Certification Regarding Debarinent,Suspensio�, and Otf�er
Responsibility Matters - Pnmazy Covered Transactions
Attachment C - Affidavit of Participation in Fe�exal Woric Authorization Program
►.
Execut�d by tfie Ca�su(tant tt�is��day of �vY��v,b�r- . 20�,
Exoculed by the City this��of �e.,c�n-.-,�e.r . ao l(�
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FOR:CITY�'��E GIRARDEAU
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BY: i -
' cott Mey , Cily � anager
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ATTEST '
Bnice Tay or� Ciiy Clerk
FOR; LEWELLYN TECHNOL4�Y.[.LC
BY: �
ignature
NAME: 17 f B S � /�► �ir.:S
Wntt�Name
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ATTACHMENT B
CERTIFICATION REGARDING DEBARMENT,
SUSPENSION,AND OTHER RESPONSIBILITY MATTERS-
PRIMARY COVERED TRANSACTIONS
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this proposal, the prospective primary participant is providing the
certification set out below.
2. The inability of a person to provide the certification required below will not necessarily result
in denial of participation in this covered transaction. The prospective participant shall submit
an explanation of why it cannot provide the certification set out below. The certification or
explanation will be considered in connection with the department or agency's determination
whether to enter into this transaction. However, failure of the prospective primary participant
to furnish a certification or an explanation sha11 disqualify such person from participation in
this transaction.
3. The certification in this clause is a material representation of fact upon which reliance was
placed when the department or agency determined to enter into this transaction. If it is iater
determined that the prospective primary participant knowingly rendered an erroneous
certification in addition to other remedies available to the Federal Government, the
department or agency may terminate this transaction for cause of default.
4. The prospective primary participant shall provide immediate written notice to the department
or agency to whom this proposal is submitted if at any time the prospective primary
participant leams that its certification was erroneous when submitted or has become erroneous
by reason of changed circumstances.
5. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal,"
and "voluntarily excluded," "proposal" and °voluntarily excluded," as used in this clause,
have the meanings set out in the Definitions and Coverage sections of the rules implementing
Executive Order 12549. You may contact the department or agency to which this proposal is
being submitted for assistance in obtaining a copy of those regulations.
6. The prospective primary participant agees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter into any lower tier
covered transaction with a person who is debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction, unless authorized by the
department or agency entering into this transaction.
7. The prospective primary participant further agrees by submitting this proposal that it will
include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion--Lower Tier Covered Transaction" provided by the department or
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agency entering into this covered transaction, without modification, in all lower tier covered
transactions and in a11 solicitations for lower tier covered transactions.
8. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or
voluntarily excluded from the covered transaction, unless it knows that the certification is
erroneous. A participant may decide the method and frequency by which it determines the
eligibility of its principals. Each participant may, but is not required to check the
Nonprocurement List at the Excluded Parties List System.
https://www.epls.gov/epls/search.do?page=A&status=current&agency=69#A.
9. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The
knowledge and information of a participant is not required to exceed that which is normally
possessed by a prudent person in the ordinary course of business dealings.
10. Except for transactions authorized under paragraph 6 of these instructions, if a participant in a
covered transacrion knowingly enters into a lower tier covered transaction with a person who
is suspended, debarred, ineligible, or voluntarily excluded from participation in this
transaction, in addition to other remedies available to the Federal Government,the department
or agency may ternvnate this transaction for cause or default.
Certification Regarding Debarment, Suspension, and Other Responsibility Matters -Primary
Covered Transactions
1. The prospective primary participant certifies to the best of its knowledge and belief, that it
and its principals:
a. Are not presently debaned, suspended,proposed for debarment,declared ineligible, or
voluntarily excluded from covered transactions by any Federal department or agency;
b. Have not within a three-year period preceding this proposal been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain or performing a public (Federal, State
or local) transaction or contract under a public transaction; violation of Federal or
State antitrust statutes or commission of embezzlement, theft, forgery, bribery,
falsification or destruction of records, making false statements, or receiving stolen
property;
c. Are not presently indicted for or otherwise criminally or civilly chazged by a
governmental entity (Federal, State or local) with commission of any of the offenses
enumerated in pazagraph(1)(b)of this certification;and
d. Have not within a three-year period preceding this application/proposal had one or
more public transactions(Federal, State or local)terminated for cause or default.
2. Where the prospective primary participant is unable to certify to a.ny of the statements in this
certif cation, such prospective participant shall attach an explanation to this proposal.
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ATTACHMENT C
AFFIDAVIT OF PARTICIPATION IN
FEDERAL WORK AUTHORIZATION PROGRAM
Comes now Darla Harmon (name]as Human Resources Manager
(office he]d)first being duly sworn,on my oa[h,affirm Lewellyn Technology,LLC
(Company Name) "Consultanr' is enrolled and will conhnue to participate in a federal work
authorization program in respect to employees that wi11 work in connection with the contracted services
related to City Facilities and any incidental items associated with this work for the duration of the
contract,if awarded,in accordance with Section 285,530.2, Revised Statutes of Missouri. ( also affirm
that the Consultant does not and wi11 not knowingly employ a person who is an unauthorized alien in
connection with the contracted services for the duration of the contract, if awarded. Attached to this
affidavit is documentarion of the Consultant's participataon in a federal work authori2ation program.
(ATTACH DOCUMENTATION SHOWING THAT COMPANY PARTICIAPTES iN FEDERAL WORK
AUTHUR[ZATION PROGRAM. ALSO ATTACH PROOF OF I.AWFUL PRESENCE,AS PROVIDED IN THE
GENERAL COND[TIONS)
In Ajfirmation thereof, the facts stated a6ove are true and correct (The undersigned
understands that false statements made rn thfs filing ar•e subject to the penaltles provEded under
Sectfon 575.040,RSMo).
�._
C ���,/r.��_t��_<_�`��. _ Darla Harmon
Signature(person with authority) Printed Name
Human Resources Manager 17/15/2016
Title D ate
state of NFissouri�'ytiQ,{Q►icz, )
` ) ss.
County of �C� A A,CYIti+ )
Subscribed and sworn to before me this�_�day of i ,C�P_f'VI bp� .20�
C_
My commission expires: otary Public
� 1 � aa � ►�
���•'"'•. HEATHER tESTER
; o Notery Public. State of indixna 11
' Merion Counry
: Comm�ss�on M 622543
My Commiasion Explres
Novomber 22, 2018
Aco O� CERTIFICATE OF LIABILITY INSURANCE DATE(MANDDfVYY1�
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THIS CERTIFlCATE IS ISSUED AS A MATTEF OF INFORAAATION ONLY AND CONFER3 NO FlIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PO�ICIES
BELOW. THIS CERTIFICATE OF INSUHANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CEHTIFICATE HOLDER.
IMPORTANT: If the certificate holder fs an ADDITIONAL INSURED,the policy(i�)muet be endorsed. If SUBROGATION IS WAIYED,aubjact to
the terma and conditione of the policy,c�rtdn policiQs may requfn en�ndoreement. A atatement on this certificate does not confer righte to the
cerdficate holdar in Ileu of such endoreement e�.
PRODUCER C�A�MEACT D8N6 Bryant-Smith
. . . .... _. __. .
Bhepherd Insuraacc, LLC P�NQ�. �317�H4G-SSSQ {AIC,No):�317)BG6-544�
lil Congressional Boulevard �pp�E�dsmitheshepherdias.aom
SISSt9 100 INSURER(S�AFFORdNGCOVERAOE . F.. N4�C•
Carwel ZN 46032 n�suaeqnCoatinental Casualty Company 20443
iNsuaeo iNsuReaB_The Continental Insurance Co. •35269
Lotaellyn Technoloqy, LLC INSURERO:Va11G For e Iasurance C
_—_ Y 4 �panY .20508
6210 Technoloqy Center Drive, Suite 200 iNsuaean'�ransportation Iasuraace Cwnpaay ,20494
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u+su�a E:Lloyds of London
___ _ --*_
Indianapolis IN 46278 IN9URERF:
COVERAGES CERTIFICATE NUMBERCL168947298 REVISION NUMBER:
THIS S TO CERTIFY THAT THE POLtCIES OF INSURANCE LISTED BE�OW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PCLICY PER�OD
��NDICATE'� NOTWITHSTANCiNG ANv REQUIREMENT, TERM OR CONDITION OF ANY CON'RACT OR O�THER DOCUMENT WiTH RESPECT TC WHICH THIS
CERTIFICATE MAY BE ISSUED 'JR MAY PERTAIN, TNc WSURANCE ArFORDED 9Y THE PCI_ICIES DESCRIBED HEREIN IS SUBJECT -0 ALL THE TE�RMS,
EXCLUSIONS AND CONDIT'ONS QF SUCH�OLICIES L'MITS SHOWN IdAY HAVE 9EEN REDUCED BY�AID CLAIMS
INSR. ... `ADDL'SUBA� . ..i--PO..I V EFF � POLICY EXP I ........ .
L7R I TYPE OF IN9URANCE I � POLICV NUM9ER I VYV ' LIMIT8
� $ COMMERCIAL GENERAI LIABIUTY � � � �' .. �EACH OCCURRENCE ,E 1,000,000
,_.._
A . I CtAIMSMADE ( Y .OCCUR �,,. �� PRE_MS�S�a_occ_ur ence) �'S ... 300.000
i
�. ! ��CNP6043075276 �: 8/13/4016 �' 8/13/2017 ',MEDFJ(P(Anyoneperson) ;$ � 10,000
. . , , �.i � t . ._._ .._...
_ . .._.._.. �� � I PERSONAL 8 ADV INJURY I$ 1�000�000
�GEN'L AGGREGA'F��_IMIT APPLIES PER ' ��� � �1 GENERAL AGGREGATE •; 2�000�000
X POLICY x .jEa �LOC; :� , . . . . _.._.....
. . , PRODUCTS COMPlOPAGG-S 2,000,000
, . . .._____-._.r..
:OTNER ', � , I _.. _ b . .
'AUTONp&LE LIA8ILITY CAMBiN SINGLE LIMIT
` I 1 I ;tEa.acSt�kntl __� 1.000,000
H � x ,ANY AUTO i ��. i BODII.Y INJURv(Per person) �$ _
� ALLOWNED SCHEDULED guA6042895939 8/13/2016 ' 8/13/2017 BODILYINJURY Peramitlert' $ �
, .AUTOS ... (AUTOS I.._ ( l l
X Hi.REDAU"QS ��., R I NON-OWNED . �PRqF'EqTYpAMAGE ' . .
._ .... , ,nu7os ��,. , �,(Pet xcitlent] !S
' i � , ., , ' ..'. �,'8
Y -'UMBRELLA LIAB � x ��CJR . '�. ' �
. � . . . ,.. E,CHOCCURREWCE �.b 10�000r000
H , ,EXCESSLIAB ,_ GLA�MSMADE:, � ; �AGGREGATE . :S 10�000�000
!D D . x �REiEN7iON$ 10 000 '�'CVL6042896007 { 8/13/2016 !/13/Y017 j �� �g
C IWORKER9COMPENSATION . �IfC6042895987 �� 6/13/2016 . 8/13/2017 - x ; H- �
ANDEMPLOYERS'L�ABILITV Y�N', ��, , _ ,STATUTE �;_._ _ER : .
ANY PROPRIETOR/PARTNER�EXECUTIVE '. �.. ,, E L EACH ACCICENT � �.$ 1�000 J 000
D D��CRPTION80FOPERADONSbelow N/A � 8/13/2017 � ��
( orylnNH) � INC60{2895990 (CA) ' 8/13/2016 I .EL DiSEASE-EAEMPLOVE�$ 1�000 000
�I it yes,aescnbe unUer I �� � . ./
E ��.. i I E�. p��nse-�ouCvuMir�;s 1 000 000
i
S Errors & Omis�ions I Psr07110060 9/12/Y016 ' 8/13/2017 Limit(S25KDeauctibie) $5,000�000
A !Inlaad ifallae '� .� '�,.CtiP6043 07 517 6 �, 0/1!/2016 6/13/2017 leasedlRenteAEquipment �300�000
DESCRIP710N OF OPERATIONS/LOCATONB/VENICLE6(ACORD 101,AAOltlonel Fiemarks Sehetlul0.may bs Htachetl li moro�paq M requlred)
Automatio additional iasured status is provided with respect to gen�ral liability & auto liability oa a
primary & non-contributory basie per attnched policy lorms SH146968A & CNA63359 subjeat to policy terms,
conditions & exclusiona. J►utomatic w�iv�r of subroqation applies with respect to general liability, auto
liability b work�rs compensation p�r attsched respective policy forms SH146968A, CNA63359 & WC000313
subj�ct to policy terms, conditions & exclusioas. Umbrelle coverage is Follow Form except as r�apects
the Other Insurance provision.
CERTIFICATE HOLOER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
The Clt]► Of Cape G1i8rde8LL THE EXPIRATION OATE THEREOF, NOTICE WILL BE DEIIVERED IN
401 Independeace Street ACCORDANCE WITH THE POLICY PROVISIONS.
Cape Girardesu, MO 63703
AUTMOR2ED PEPREBENTATIVE
D Bryant-Smith/AREITH ^��'•"' '•`�'^�-¢�•�-�'�""''�a
m 198&2014 ACORD CORPORATION. All Hghts ressrvsd.
ACORD 25(2014fi1) The ACORD name and logo are registered marks of ACORD
1 N SQ25 no,ao i i
' WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you
pertorm work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefd anyone not named in the Schedule.
Schedule
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective Policy No. Endorsement No.
Insured Premium$
Insurance Company Countersigned by
WC000313
(Ed. 4-84) Copyright 1983 National Council on Compensation Insurance.
SB-146968-A
�� (Ed. 01/06)
IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE
ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT.
SEE PARAGRAPH C., OF THIS ENDORSEMENT FOR THESE DUTIES.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED ENDORSEMENT
WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE
&
BLANKET WAIVER OF SUBROGATION
Architects, Engtneers and Surveyors
This endorsement modifies insurance provided under the following:
BUSINESSOWNERS LIABILITY COVERAGE FORM
BUSINESSOWNERS COMMON POLICY CONDITIONS
A. WHO IS AN INSURED (Section C.) of the 4. The insurance provided to the additional
Businessowners Liability Coverage Form is insured does not apply to "bodily injury,"
amended to include as an insured any person or "property damage," "personal and advertising
organization whom you are required to add as an injury" arising out of an architect's, engineer's,
additional insured on this policy under a written or surveyor's rendering of or failure to render
contract or written agreement; but the written any professional services including:
contract or written agreement must be: a. The preparing, approving, or failing to
1. Currently in effect or becoming effective during prepare or approve maps, shop drawings,
the term of this policy;and opinions, reports, surveys, field orders,
2. Executed prior to the "bodily injury," "property change orders or drawings and
damage,"or"personal and advertising injury." specifications by any architect, engineer or
surveyor performing services on a project of
B. The insurance provided to the additional insured is which you serve as construction manager;
limited as follows: or
1. That person or organization is an additional b. Inspection, supervision, quality control,
insured solely for liability due to your negligence engineering or architectural services done
specifically resulting irom "your work" for the by you on a project of which you serve as
additional insured which is the subject of ihe construction manager.
written contract or written agreement. No 5. This insurance does not apply to "bodily injury,"
coverage applies to liability resulting from the "property damage,"or"personal and advertising
sole negligence of the additional insured. injury"arising out oi:
2. The Limits of Insurance applicable to the a. The construction or demolition work while
additional insured are those specified in the you are acting as a construction or
written contract or written agreement or in the demolition contractor. This exclusion does
Declarations of this policy, whichever is less. not apply to work done for or by you at your
These Limits of Insurance are inclusive of, and premises.
not in addition to,the Limits of Insurance shown
in the Declarations. C. BUSINESSOWNERS GENERAL LIABILITY
3. The coverage provided to the additional insured CONDITIONS — Duties In The Event of
within this endorsement and section titled Occurrence, Offense, Claim or Suit (Section
LIABILITY AND MEDICAL EXPENSE E•2•) of the Businessowners Liability Coverage
DEFINITIONS — "Insured CoMract" (Section Form is amended to add the following:
F.9.) within the Businessowners Liability An additional insured under this endorsement will
Coverage Form, does not apply to "bodily as soon as practicable:
injury" or "property damage" arising out of the �, Give written notice of an occurrence or an
"products-completed operations hazard" unless offense to us which may result in a claim or
required by the written contract or written "suit"under this insurance;
agreement.
SB-146968-A Page 1 of 2
(Ed.01106)
1 , SB-146968-A
c�a (Ed.01/06)
2. Tender the defense and indemnity of any claim insured against that "suit" If no other insurer
or "suit" to us for a loss we cover under this defends, we will undertake to do so, but we will
Coverage Part; be entitled to the additional insured's rights
3. Tender the defense and indemnity of any claim against all those other insurers.
or "suit" to any other insurer which also has When this insurance is excess over other
insurance for a loss we cover under this insurance, we will pay only our share of the
Coverage Part; and amount of the loss, if any, that exceeds the sum
4. Agree to make available any other insurance of:
which the additional insured has for a loss we (a) The total amount that all such other
cover under this Coverage Part. insurance would pay for the loss in the
We have no duty to defend or indemnify an absence of this insurance;and
additional insured under this endorsement until we (b) The total of all deductible and self-insured
receive written notice of a claim or "suiY' from the amounts under all that other insurance.
additional insured. We will share the remaining loss, if any, with
D. OTHER INSURANCE (Section H. 2. & 3.) of the any other insurance that is not described in this
Businessowners Common Policy Conditions are Excess Insurance provision and was not boughi
deleted and replaced with the following: specifically to apply in excess of the Limits of
2. This insurance is excess over any other Insurance shown in the Declarations of this
insurance naming the additional insured as an Coverage Part.
insured whether primary, excess, contingent or E. TRANSFER OF RIGHTS OF RECOVERY
on any other basis unless a written contract or AGAINST OTHERS TO US (Seetion K.2.) of the
written agreement specifically requires that this Businessowners Common Policy Conditions is
insurance be either primary or primary and deleted and replaced with the following:
noncontributing to the additional insured's own 2 We waive any right of recovery we may have
coverage. This insurance is excess over any against any person or organization against whom
other insurance to which the additional insured you have agreed to waive such right of recovery in a
has been added as an additional insured by Written contract or agreement because of payments
endorsement.
we make for injury or damage arising out of your
3. When this insurance is excess, we will have no ongoing operations or "your work" done under a
duty under Coverages A or B to defend the contract with that person or organization and
additional insured against any "suit" if any other included within the "products-completed operations
insurer has a duty to defend the additional hazard."
SB-146968-A Page 2 of 2
(Ed. 01/06)
CNA63359XX I
c�a (Ed. 04/12)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS EXTENDED COVERAGE ENDORSEMENT
- BUSINESS AUTO PLUS -
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
I. LIABILITY COVERAGE 4. An "employee" of yours is an "insured"
A. Who Is An Insured while operating an "auto" hired or rented
under a contract or agreement in that
The following is added to Section tl, Paragraph "employee's" name, with your permission,
A.1.,Who Is An Insured: while performing duties related to the
conduct of your business.
1. a. Any incorporated entity of which the
Named Insured owns a majority of the "Policy,"as used in this provision A. Who Is An
voting stock on the date of inception oi Insured, includes those policies that were in
this Coverage Form;provided that, force on the inception date of this Coverage
b. The insurance afforded by this Form but:
provision A.1. does not apply to any 1. Which are no longer in force;or
such entity that is an "insured" under
any other liability "policy" providing 2• Whose limits have been exhausted.
"auto"coverage. B. Bail Bonds and Loss of Earnings
2. Any organization you newly acquire or form, Section It, Paragraphs A.2. (2) and A.2. (4)
other than a limited liability company, are revised as follows:
partnership or joint venture, and over which �, In a.(2), the limit for the cost of bail bonds is
you maintain majority ownership interest. changed from$2,000 to$5,000; and
The insurance afforded by this provision 2. In a.(4), the limit for the loss of eamings is
A'2" changed from$250 to$500 a day.
a. Is effective on the acquisition or
formation date, and is afforded only C. Fellow Employee
until the end of the policy period of this Section II, Paragraph B.5 does not apply.
Coverage Form, or the next anniversary
of its inception date, whichever is Such coverage as is afforded by this provision
earlier. C. is excess ove� any other collectible
insurance.
b. Does not apply to: II. PHYSICAL DAMAGE COVERAGE
(1) "Bodily injury"or "property damage" A. Glass Breaka e—Hittin A Bird Or Animal—
caused by an accident that g 9
occurred before you acquired or Falling Objects Or Missiles
formed the organization;or The following is added to Section III,
(2) Any such organization that is an Paragraph A.3.:
insured" under any other liability Wiih res ect to an covered "auto," an
"policy"providing"auto"coverage. deductible shown in the Declarations will not
3. Any person or organization that you are apply to glass breakage if such glass is
required by a written contract to name as an repaired, in a manner acceptable to us, rather
additional insured is an 'insured" but only than replaced.
with respect to their legal liability for acts or B. Transportation Expenses
omissions of a person, who qualifies as an
"insured" under Section II — Who Is An Section III, Paragraph A.4.a. is revised, with
Insured and for whom Liability Coverage is respect to transportation expense incurred by
afforded under this policy. If required by You, to provide:
written contract, this insurance will be a. $60 per day, in lieu of$20;subject to
primary and non-contributory to insurance
on which the additional insured is a Named b• $1,800 maximum, in lieu of$600.
Insured.
CNA63359XX Copyright,crvA cor�ora�ion,2000. Page 1 of 3
(Ed. 04/12) Includes copyrighted maierial of the Insurance Services Office used with�s permission.
V � J
Tf�
C�� CNA63359XX
(Ed.04/12)
C. Loss of Use Expenses Section III, Paragraphs B.4.c and B.4.d. are
Section III, Paragraph A.4.b. is revised, with deleted and replaced by the following:
respect to loss of use expenses incurred by c. Physical Damage Coverage on a covered
you,to provide: "auto" also applies to "loss" to any
a. $1,000 maximum, in lieu of$600. permanently installed electronic equipment
including its antennas and other
D. Hired "Autos" accessories.
The following is added to Section III. d. A$100 per occurrence deductible applies to
Paragraph A.: the coverage provided by this provision.
5. Hired "Autos" G. Diminution In Value
If Physical Damage coverage is provided under The following is added to Section 111,
this policy, and such coverage does not extend Paragraph B.6.:
to Hired Autos,then Physical Damage coverage Subject to the following, the "diminution in
is extended to: value"exclusion does not apply to:
a. Any covered "auto" you lease, hire, rent a. Any covered "auto" of the private
or borrow without a driver; and
passenger type you lease, hire, rent or
b. Any covered "auto" hired or rented by borrow, without a driver for a period of
your "employee"without a driver, under 30 days or less, while performing duties
a contract in that individual related to the conduct of your business;
"employee's" name, with your and
permission, while performing duties b. Any covered "auto" of the private
related to the conduct of your business.
passenger type hired or rented by your
c. The most we will pay for any one "employee" without a driver for a period
"accident" or "loss" is the actual cash of 30 days or less, under a contract in
value, cost of repair, cost of that individual "employee's" name, with
replacement or $75,000, whichever is your permission, while performing
less, minus a $500 deductible for each duties related to the conduct of your
covered auto. No deductible applies to business.
"loss"caused by fire or lightning. c. Such coverage as is provided by this
d. The physical damage coverage as is provision is limited to a "diminution in
provided by this provision is equal to value" loss arising directly out of
the physical damage coverage(s} accidental damage and not as a result
provided on your owned "autos." of the failure to make repairs; faulty or
incomplete maintenance or repairs; or
e. Such physical damage coverage for
the installation of substandard parts.
hired"autos"will: d. The most we will pay for "loss" to a
covered "auto" in any one accident is
(1) Include loss of use, provided it is the lesser of:
the consequence of an "accidenY'
for which the Named Insured is (1) $5,000;or
legally iiable, and as a result of (2) 20% of the "auto's" actual cash
which a monetary loss is sustained . value(ACV).
by the leasing or rental concern.
(2) Such coverage as is provided by III. Drive Other Car Coverage—Executive Officers
this provision will be subject to a The following is added to Sections II and III:
limit of$750 per"accident." 1, An "auto" '
y you don t own, hire or borrow is a
E. Airbag Coverage covered "auto" for Liability Coverage while
The following is added to Section III, being used by, and for Physical Damage
Paragraph B.3.: Coverage while in the care, custody or control
of, any of your"executive officers,"except:
The accidental discharge of an airbag shall not a. An "auto" owned by that "executive officer"
be considered mechanical breakdown. or a member of that person's household;or
F. Electronic Equipment
CNA63359XX Copyright,CNA Corporatio�,z000 Page 2 of 3
(Ed. 04/12) InGudes copyrighted material of the Insurance Services Offlce used with its permission.
-4^
C�� CNA63359XX
(Ed. 04/12)
b. An "auto" used by that "executive officer" The following is added to Section IV,
while working in a business of selling, Paragraph A.5. Transfer Of Rights Of
servicing, repairing or parking "autos." Recovery Ageinst Others To Us:
Such �iability and/or Physical Damage We waive any right of recovery we may have,
Coverage as is afforded by this provision. because of payments we make for injury or
(1) Equal to the greatest of those damage, against any person or organization for
coverages afforded any covered "auto"; Whom or which you are required by written
and contract or agreement to obtain this waiver from
us.
(2) Excess over any other collectible This injury or damage must arise out of your
insurance. activities under a contract with that person or
2. For purposes of this provision, "executive organization.
officer" means a person holding any of the
officer positions created by your charter, �You must�agree to�that requirement prior to an
constitution, by-laws or any other similar accident or loss.
governing document, and, while a resident of C. Concealment, Misrepresentatio�or Fraud
the same household, includes that person's The following is added to Section IV,
spouse. Paragraph B.2.:
Such "executive officers" are "insureds" while Your failure to disclose all hazards existin on the
using a covered "auto" described in this date of inception of this Coverage Form shall not
provision. prejudice you with respect to the coverage afforded
IV. BUSINESS AUTO CONDITIONS provided such failure or omission is not intentional.
A. Duties In The Event Of Accident, Claim, Suit D. Other Insurance
Or Loss The following is added to Section IV,
The following is added to Section IV, Paragraph B.5.:
Paragraph A.2.a.: Regardless of the provisions of Paragraphs 5.a.
(4) Your "employees" may know of an and 5.d. above, the coverage provided by this
"accident" or "loss." This will not mean policy shall be on a primary non-contributory
that you have such knowledge, unless basis. This provision is applicable only when
such "accident" or "loss" is known to required by a written contract. That written
you or if you are not an individual, to contract must have been entered into prior to
any of your executive officers or "AccidenY'or"Loss."
partners or your insurance manager. E. Policy Period,Coverage Territory
The following is added to Section IV, Section IV, Paragraph B. 7.(5).(a). is revised
Paragraph A.2.b.: to provide:
(6) Your "employees" may know of
documents received concerning a claim 8• 45 days of coverage in lieu of 30 days.
or "suit." This will not mean that you V. DEFINITIONS
have such knowledge, unless receipt of
such documents is known to you or if Section V. Paragraph C. is deleted and replaced
you are not an individual, to any of your by the following:
executive officers or partners or your "Bodily injury" means bodily injury, sickness or
insurance manager. disease sustained by a person, including mental
B. Transfer Of Rights Of Recovery Against anguish, mental injury or death resulting from any of
Others To Us these.
CNA63359XX Copyright,crw corpora�ion,2000 Page 3 oi 3
(Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission.
� •
's' �
Brunke, Casey L.
From: Greg Thomas <gthomas@lewellyn.com>
Sent: Tuesday, November 22, 2016 10:12 AM
To: Brunke, Casey L.
Cc: Jason Reason
Subject: Lewellyn Technology E Verify ID#
Casey,
It was very nice speaking with you this morning. Per our conversation, I have provided our E-Verify# from our
HR Manager. Please let me know if you need any additional information.
I look forward to speaking with you soon regarding scheduling the on-site portion of the project for early 2017.
We can begin the document review immediately, upon issuance of a Purchase order.
We have the Federal Work Authorization,we are enrolled in E-Verify,verify all employees through this
and we are a federal contractor with FAR E-Verify Clause. Our ID number is 681759. We are good to
sign the affidavit, attachment C.
Darla Harmon
HR Manager
���BM1��
E:dhazmon(a�lewellyn com W:www.Leweilvn com
T:317-610-0028 C:812-699-1212
Best regards,
Greg Thomas
Lewellyn Technology� Director of Sa/es-Combustible Dust
Direct:317-610-0046� Mobile:317-749-7088� Email:gthomas(a�lewell n.y com
�� �
www.Lewell n.y com
Arc Flash Risk Assessment�Combustib/e Dust Services�Onsite&Online Training
Why Test your Dust?c(ick on this link.
httn://www.l ewel lyn.com/resources/dust-testin g-how-to-determ ine-if-your-dust-i s-combustible
1