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HomeMy WebLinkAbout2015-151-E AMS - Owens Roofing, Inc. for Skills Development Center-Sector A Roof Replacement $99,209 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 [Departmental Use Only] TITLE Skills Development Roof FY 2015 NORTH CAROLINA CONSTRUCTION AGREEMENT UNDER$250,000.00 ORANGE COUNTY THIS CONSTRUCTION AGREEMENT (hereinafter called "Agreement"), made as of the 23rd day of February, 2015, by and between Owens Roofing, Inc., (hereinafter called the "Contractor"), and Orange County, a body politic and a political subdivision of the State of North Carolina, (hereinafter called the "Owner"). WITNESSETH: That the Contractor and the Owner, for the consideration herein named, agree as follows: 1. CONTRACT DOCUMENTS; PRIORITY The Contract Documents consist of this Agreement, the Request for Proposals, Proposal, Construction Drawings and Written Specifications. The Contract Documents form the Contract. In the event of any inconsistency between or among the Contract Documents the Contract Documents shall be interpreted in the following order of priority: a. This Agreement. b. Designer Approved Bulletins and/or Field Orders. c. Request for Proposals and addenda thereto. d. Proposal. 2. SCOPE OF WORK The Contractor shall furnish and deliver all of the materials, and perform all of the work required by this Agreement within the time period stipulated in a written Notice-to-Proceed to be executed by the Contractor and Owner and in accordance with the following enumerated documents, which are made a part hereof as if fully contained herein: a. Construction Drawings prepared by 5th Wall Diagnostics Consultants (Sheet 1.01 through 1.04 dated October, 2014) b. Written specifications prepared by the project engineer. c. Owens Roofing, Inc proposal dated December 22, 2014, and bid analysis with recommendation provided by 5th Wall Building Diagnostics Consultants dated December 23, 2014, which fully describes the work to be performed, such work (hereinafter called the "Work"). d. Related documents listed under Section 1 above. Revised 10/14 1 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 3. TERM AND SCHEDULING a. The Contractor agrees to commence work pursuant to the written Notice-to Proceed. b. The Contractor agrees to complete substantially all Work included by April 28, 2015. c. Time is of the essence with respect to all dates specified in the Contract Documents as Completion Dates. d. The Contractor shall perform the Work in the time, manner and form required by the Contract Documents and as stipulated in a written Notice-to-Proceed to be executed by the Contractor and Owner. e. It is expressly understood that the Owner will employ other contractors to perform work as a part of the Project whose work will be performed simultaneously and sequentially with the performance of the Work by the Contractor. It shall be necessary for the Contractor to coordinate its activities with such other contractors, particularly with respect to access to work areas, storage of materials and other common facilities. f. Should the Owner determine that the Contractor is behind schedule Owner may require, at no additional cost to the Owner, the Contractor to expedite and accelerate its efforts, including providing additional resources and working overtime, as necessary, to perform the Work in accordance with the approved project schedule. 4. STANDARD OF CARE a. The Contractor shall exercise reasonable care and diligence in performing the Work in accordance with the highest generally accepted standards of this type of Contractor practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Contractor is solely responsible for the professional quality, accuracy and timely completion and/or submission of all work. b. The Contractor shall not load or permit any part of the Work to be loaded with a weight that will endanger its safety, intended performance or configuration. c. Contractor shall be responsible for all errors or omissions caused by its employees, agents, contractors, or assigns in the performance of the Agreement. Contractor shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the Owner. d. Contractor is an independent contractor of Owner. Any and all employees of the Contractor engaged by the Contractor in the performance of any work or services required of the Contractor under this Agreement, shall be considered employees or agents of the Contractor only and not of the Owner, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Contractor. r Revised 10/14 2 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 e. Contractor agrees that Contractor, its employees, agents and its subcontractors, if any, shall be required to comply with all federal, state and local antidiscrimination laws, regulations and policies that relate to the performance of Contractor's services under this Agreement. f. If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Contractor represents that it and/or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. 5. PAYMENT & TAXES a. The Owner hereby agrees to pay to the Contractor for the faithful performance of this Agreement, and the Contractor hereby agrees to perform all of the Work for a sum not-to- exceed ninety nine thousand two hundred nine dollars Dollars ($99,209). Not later than the fifth (5th) day of each calendar month the Contractor shall submit to the Owner's Representative, generally the architect if an architect is retained on the Work, a Request for Payment for work done during the previous calendar month. i. The Request for Payment shall be in form of a standardized invoice or AIA Document G702-703 appropriately addressed to Owner's Representative at Orange County, Attention Jeff Thompson, PO Box 8181, Hillsborough, NC 27278 and shall show substantially the value of work done during the previous calendar month. ii. The amount due for payment shall be ninety-five percent (95%) of the value of work completed since the last Request for Payment and this amount shall be paid by the Owner on or before the last business day of the month. Owner shall retain five percent (5%). 1. Upon Owner's Representative's certification that ninety percent (90%) of the Work has been satisfactorily completed retainage may be discontinued. Retainage may be discontinued, at Owner's Discretion, so long as work continues to be completed satisfactorily and on schedule. iii. Final payment shall not be due to the Contractor until thirty (30) days after one hundred percent (100%) of the Work, including punch list work, has been satisfactorily completed and an appropriate affidavit as required in Section 7(c) below has been received by Owner. b. Should Owner reasonably determine that Contractor has failed to perform the Work related to a Request for Payment, Owner, at its discretion may provide the Contractor ten (10) days to cure the breach. Owner may withhold the accompanying payment without penalty until such time as Contractor cures the breach. i. Should Contractor or its representatives fail to cure the breach within ten (10) days, or fail to reasonably agree to such modified schedule, Owner may immediately terminate this Agreement in writing, without penalty or incurring further obligation to Contractor. ii. This section shall not be interpreted to limit the definition of breach to the failure to perform the Work related to a Request for Payment. c. The Contractor has included in the Contract Price and shall pay all taxes assessed by any authority on the Work or the labor and materials used therein. It shall be the Contractor's Revised 10/14 3 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 responsibility to furnish the Owner documentary evidence showing the materials used and sales and use tax paid by the Contractor and each of its subcontractors. 6. INSURANCE AND BONDS a. Minimum requirements — Contractor shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may be required by Owner's Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http://oran ecountync.goy/purchasing/contracts.asp). If Owner's Risk Manager determines additional insurance coverage is required such additional insurance shall be designated here (if no additional insurance required mark N/A as being not applicable). Contractor shall not commence construction work until such insurance is in effect and certification thereof has been received by the Owner's Risk Manager. b. Performance Bonds — Contractor shall furnish bonds covering the faithful performance of the Contract and payment of all obligations arising under any of the Contract Documents or related in any way to the Work. Contractor shall immediately furnish a copy of such bonds to any requesting person who appears to be a potential beneficiary of bonds covering payment obligations arising under any of the Contract Documents. This subsection 6(b) applies only to Contracts of fifty thousand dollars ($50,000.00) or more where the total cost for the project is three hundred thousand dollars ($300,000.00) or more. 7. INDEMNITY a. The Contractor shall indemnify and hold harmless to the extent permitted by law the Owner and its agents and employees from and against any and all claims, damages, losses and expenses, including attorney's fees, arising out of or resulting from the performance or nonperformance of the Work, provided that any such claim, damages, loss or expense (A) is attributable to bodily injury, sickness, disease or death or injury to, or destruction of, property, including the loss of use resulting therefrom; and (B) is caused in whole or in part by any breach of any provision of the Agreement or by any negligent or wrongful act or omission of the Contractor, any Subcontractor, or supplier of the Contractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The indemnification obligation under this paragraph shall not be limited in any way by any limitation of the amount or type of damages, compensation or benefits payable by or for the Contractor or any subcontractor under workers' compensation acts, disability benefits acts or other employee benefit acts. b. The Contractor shall indemnify and hold harmless Owner from any lien of whatever type through the purchase of appropriate bonds and insurance as designated in Section 6 above. In the event any such lien is filed against Owner's property Contractor shall, through such bonds and insurance or at Contractors expense, defend Owner against all such claims of lien. i c. Upon completion of the Work the Contractor shall execute an affidavit stating there are no unpaid debts for any work that has been done or materials that have been furnished to the Project prior to and as of the date of substantial completion and further stating that Revised 10/14 4 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 Contractor shall indemnify, save and protect Owner and Owner's lender, if any, harmless from and against any and all claims, liabilities, losses, damages, causes of action, and expenses (including court costs and reasonable attorney's fees related thereto) arising out of, in connection with, or resulting from any such debts and liens. Such indemnification shall be in a form and substance acceptable to Owner. d. By executing this Agreement Contractor agrees to abide by and be bound by the indemnification provisions herein and of Section 7(c) specifically. 8. DISPUTE RESOLUTION AND GOVERNING LAW a. Owner and Contractor agree that should a dispute arise as to the terms of the Contract Documents the architect shall serve as the initial decision-maker, unless there is no architect retrained on the project related to the Work. Owner and Contractor further agree as follows: i. If there is no architect retained for the Work, Owner and Contractor agree, prior to the initiation of any civil litigation, to submit to mediation by agreeing on an individual to serve as mediator to mediate the dispute. ii. Should the Owner and Contractor fail to mutually agree on an individual to serve as mediator Owner may select a mediator to mediate the dispute. iii. Any mediator selected under this section shall be an attorney licensed to practice law in the State of North Carolina and shall be generally recognized as having experience in mediating construction disputes. iv. Owner and Contractor agree to equally share in the cost of a mediator selected under this section. b. The laws of the State of North Carolina shall apply to the interpretation and enforcement of this Agreement. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or nonperformance of, this Agreement or the Contract shall be brought in the General Court of Justice of North Carolina sitting in Orange County,North Carolina and it is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all anti-discrimination laws. c. Notice of any claim by Owner or Contractor must be initiated by written notice to the other Party within thirty (30) days of the occurrence of the event giving rise to the claim or within thirty (30) days of the discovery of the event or condition giving rise to the claim, whichever is later. i. Should any claim be made, regardless of whether such claim is made by Owner or Contractor, Contractor shall continue to faithfully and diligently perform the Work in such a manner as to meet all scheduled timelines. Any failure to faithfully and diligently perform the Work may be deemed, by the Owner, a breach of the Contract. ii. If a claim is made such claim shall be made to the initial decision maker, if applicable, who may request more supporting data, reject the claim in whole or in part, approve the claim in whole or in part or advise the parties the claim is unable to be resolved. iii. If a claim is made by the Owner the Owner may, but is not obligated to, notify the surety. Revised 10/14 5 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 9. NON—APPROPRIATION a. Contractor acknowledges that Owner is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. b. In the event that public funds are unavailable and not appropriated for the performance of Owner's obligations under this Agreement, then this Agreement shall automatically expire without penalty to Owner immediately upon written notice to Contractor of the unavailability and non-appropriation of public funds. It is expressly agreed that Owner shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement, but only as an emergency fiscal measure during a substantial fiscal crisis. c. In the event of a change in the Owner's statutory authority, mandate and/or mandated functions, by state and/or federal legislative or regulatory action, which adversely affects Owner's authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to Owner upon written notice to Contractor of such limitation or change in Owner's legal authority. 10. NOTICES Any notice required by this Agreement shall be in writing and delivered by certified or registered mail,return receipt requested to the following: Owner: Contractor: Orange County Owens Roofing, Inc. Attn: Jeff Thompson Attn: Bert Owens,President/Treasurer P.O. Box 8181 301 W Cabarrus Street Hillsborough,NC 27278 Raleigh,NC 27601 11. MISCELLANEOUS a. Duties and Obligations imposed by the Contract Documents shall be in addition to any Duties and Obligations imposed by state, federal or local law, rules, regulations and ordinances. b. No act or failure to act by the Owner or Contractor shall constitute a waiver of any right or duty granted them under the Contract Documents, nor shall any act or failure to act constitute any approval except as specifically agreed in writing. c. The Work shall be tested and inspected as required by the Contract Documents and as required by law. Unless prohibited by law the costs of all such tests and inspections related to state and federal codes such as ADA, Administrative, Electrical, Plumbing, Mechanical and Building Codes shall be borne by the Contractor. The costs for material and structural testing shall be conducted by an independent third party at the expense of the Owner. Delays related to any of the aforementioned tests and inspections shall not be grounds for delaying the completion of the work. If any such tests and inspections reveal deficiencies in the Work such that the Work does not comply with terms or requirements of the Contract Documents and/or the requirements of any code or law the Contractor is solely responsible for the cost of bringing such deficiencies into compliance with the terms Revised 10/14 6 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 of the Contract Documents and/or any code or law. d. Should the Architect, if an architect is retained for the project involving the Work, or Owner reject any portion of the Work for failing to comply with the Contract Documents Contractor shall immediately, at Contractor's expense, correct the Work. Any such rejection may be made before or after substantial completion. If applicable, any additional expense borne by the Architect under this section shall be paid at Contractor's expense. e. The Contractor shall not assign any portion of this Agreement nor subcontract the Work in its entirety without the prior written consent of the Owner. f. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11 A and Article 40 of North Carolina General Statute Chapter 66. 12. CONSEQUENTIAL AND LIQUIDATED DAMAGES a. Owner and Contractor mutually waive any claim against each other for consequential damages. Consequential Damages include: i. Damages incurred by Owner for loss of use, income, financing, or business. ii. Damages incurred by Contractor for office expenses, including personnel, loss of financing, profit, income, business, damage to reputation, or any other non-direct damages. b. Liquidated damages shall be in accord with the Contract Documents. 13. TERMINATION OR SUSPENSION a. The Owner may, without cause, order the Contractor to terminate, suspend, delay or interrupt the Work in whole or in part for such period of time as the Owner may determine. In the event of termination by the Owner under this Agreement, the Contractor shall be entitled to receive its reasonable and documented direct costs prior to termination, including the cost of materials purchased for the Work which purchases cannot be canceled or which material cannot reasonably be used by the Contractor on other work, and the cost of closing down the work in a safe and efficient manner. i. If Owner orders a delay, suspension or interruption of the Work, and such order is not due to or as a result of any fault on the part of the Contractor, the Contractor may recover a per diem amount at a rate calculated by$200 per day. ii. If Contractor elects to accept the amount listed in the General Conditions provision of the Construction Documents Contractor waives any right to further claims for payment of damages sustained as a result of Owner's order to delay, suspend or interrupt the Work. b. Contractor may terminate the Contract if, at the Owner's written direction, the Work is stopped for thirty (30) consecutive days through no act or fault of the Contractor, their agents or employees, or a subcontractor or their agents or employees or any other person performing work pursuant to the Contract Documents. Contractor may terminate the Revised 10/14 7 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 Contract if a Court or other Public authority having jurisdiction enters a lawful order that requires all work to be stopped and such stoppage lasts for thirty (30) consecutive days. 14. ENTIRE AGREEMENT All of the documents listed, referenced or described in this Agreement, the written Notice-to- Proceed, together with Modifications made or issued in accordance herewith are the Contract Documents, and the work, labor, materials and completed construction required by the Contract Documents and all parts thereof is the Work. The Contract Documents constitute the entire agreement between Owner and Contractor. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. If any provision of the Agreement shall be declared invalid or unenforceable,the remainder of the Agreement shall continue in full force and effect. [SIGNATURE PAGE TO FOLLOW] Revised 10/14 8 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 IN WITNESS WHEREOF, the Parties hereto have executed this Agreement as of the day and date first above written wholly or in a number of counterparts each of which shall, without proof or accounting for other counterparts, be deemed an original contract. ORANGE COUNTY CONTRACTOR DocuSigned by: DocuSigned by: i�ov�,�is �auxw�e V sl t i� f;tyf 0-wu's �vti si /fi'►rc asu�c v Signature f1gW&- 36462... County Manager Bert owens, president Printed Name and Title i i Revised 10/14 9 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 Orange County Asset Management Roof Replacement—Sector A-Shills Development Center, Chapel Hill,NC PROPOSAL FORM Proposal of Owens Roofing,Inc. (herein after called Bidder)a Corporation organized and existing under the Laws of the State of NC _ Insert corporation,partnership or individual as applicable To: Orange County Asset Management(herein after called Owner). Gentlemen: r The Bidder, in compliance with the bid for Roof Replacement — Sector A-Skills Development Center, Chapel Hill, North Carolina, having examined the Contract Documents prepared of the work by SthWall Building Diagnostics Consultants,dated October 2014, and addenda,and the site of the proposed work, and being familiar with all of the conditions surrounding the construction of the proposed project including the availability of materials, and supplies, agrees to construct the project in accordance with the Contract Documents, within the time set forth therein, and the prices stated below. These prices .are to cover all expenses incun•ed in performing the work required under the Contract Documents, of which this proposal is a part. Bidder further agrees that the amounts and quantities of materials be furnished and work to be done, as stated in the Instructions to Bidders,the General Conditions; Supplementary Conditions, and the Technical Specifications and Drawings, are recognized by it to be a full and complete indication of the work in its fullest and most complete sense, and that it is satisfied with such Notice etc., in determining the prices for the several classes of work as_specified, and will not at any time dispute or complain that there is any misunderstanding in regard to the nature or amount of materials to be furnished and work to be done. i Bidder hereby agrees to commence work under the contract on or before a date to be specified in writing known as "Notice to Proceed" and to fully complete the project within 30 consecutive calendar days thereafter as stipulated. B.)rider further agrees to pay liquidated damages in the amount of$200 per day, per building,for each and every day the project remains incomplete beyond the scheduled completion date. Bidder acknowledges receipts of the following addenda: Number I Date: 12.15. 4 Number Date: Number Date: Number Date: i Page l DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 Orange County Asset Management Roof Replacement—Sector A-Skills Development Center,Chapel Hill,NC PROPOSAL FORM General Items A. Insurance Lump Sum &S.) $1,9g0.00 B. Mobilization L.S. $ 2,970.00 C. Warranty L.S. $ 1,000.00 Subtotal--General Items L.S. $ 5,950.00 Work Items A. Remove and dispose of existing roof system L.S. $ 20,000.00 B. Remove and replace damaged or deteriorated wood Allowance L.S. $___500 $ /Bd.Ft. C. Furnish and install new wood blocking L.S. $ 759.00 D. Furnish and install new board insulation system L.S. $ 27,500.00 E. Furnish and install new polymer modified L.S. $ 339660.00 Bituminous membrane roof system to include all flashings and related accessories F. Furnish and install new shect metal flashing L.S. $ 8000.00 G. Furnish and install new skylight L.S. $ 1,600.00 H. Furnish and install other items not specifically included or listed herein L.S. $ 1,240.00 Subtotal—Work Items L.S. $ 93,259.00 Total Bid Price—(General Items and Work Items) L.S. $ 99.209.00 TOTAL BID PRICE: Bidder agrees to perform.all of the work described in the specifications and shown on the plans for the sum of Ninety Nine Thousand Two Hundred Nine&00/100------Dollars (99 209.00 ) (Amount shall be shown in both words and figures.) In the case of a discrepancy in the pricing, unit prices will control; if there is no unit price, the lump sum price will control; totals shall be corrected to be consistent with the unit prices and lump sum prices. The total base bid price shall be the sum of all unit cost extensions and line items listed. Should the actual quantities be increased or decreased relative to the estimated quantities included in the Proposal, the Unit Prices shown will be used to adjust the contract price in accordance with the contract documents throughout the life of the contract. Page 2 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 Orange County Asset Management Roof Replacement—Sector A-Skills Development Center,Chapel Hill,NC The Schedule of Values which will be used in the contractor's application for payment shall be the items, units,unit prices and total prices all as shown herein. Bidder understands that the Owner reserves the right to reject any or all bids and to waive any informalities in the bidding. The Bidder agrees that this bid shall be good and may not be withdrawn for a period of 60 calendar days after the scheduled closing time for receiving bids. Bidder ftnrther certifies that no or employee of Orange County has any interest, direct or indirect, in this Corporation or Partnership,or in this contract. Bidder further certifies that the foregoing statements made by it are true and that if any of the foregoing statements made are willfully false it is subject to punishment. Proposal forms will not be accepted unless signed by the Owner or authorized corporate officer. The following items must be submitted with the Proposal Form: 1. Proposal Guarantee 2. Contractor's License Number as issued by the State of North Carolina (Must be valid at time of bid opening) 3. Tabulation of Subcontractors and other persons and organizations required to be identified in this Proposal. Upon receipt of notice ofthe acceptance of this Proposal,Bidder will execute a formal contract. Date 12.22.14 NAME OF BIDDER: (Seal if bid is by a corporation) 0 fi 7 on, H o Corpor 'on BY: ?,0O,l~ Signature LE: P sesrden r n ss: tic: Alf';"secretnt-V CORPORATE SEAL I End of Proposal Form I Page 3 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 FORM OF BID BOND KNOW ALL MEN BY THESE PRESENTS THAT Owens Roofing Inc. as principal, and Western Surety Company as surety, who is duly licensed to act as surety in North Carolina, are held and firmly bound unto Orange County ^_ as obligee, in the penal SUM of Five Percent of Amount Bid ( 5% ) DOLLARS, lawful money of the United States of America, for the payment of which, well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. Signed, sealed and dated this 23rd day of December 2014 WHEREAS, the said principal is herewith submitting proposal for Roof Replacement Sector A Skills Development Center and the principal desires to file this bid bond in lieu of making the cash deposit as required by G,S. 143-129, NOW, THEREFORE, THE CONDITION OF THE ABOVE OBLIGATION is such, that if the principal shall be awarded the contract for which the bid is submitted and shall execute the contract and give bond for the faithful performance thereof within ten days after the award of same to the principal, then this obligation shall be null and void; but if the principal flails to so execute such contract and give performance bond as required by G.S. 143-129, the surety shall, upon demand, forthwith pay to the obligee the amount in the first paragraph hereof, Provided further, that the bid may be withdrawn by G.S. 143.129.1 Owens Roofing Inc. By, (SEAL) PAL � . Yea Western Surety Company _ _...___ (SEAL) t/!{1111!{11F+" °-'7' L-j Bobbi D. Pendleton Aftorney-in-Fact DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 Western r y Comp-%any PC➢WER Or ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-INTACT Know All Meu By These Presents,T7nrt WEST'FiRN SURETY COMPANY,a South Dakota corporation,is a duty organized and existing corporation having its principal office in the City of Sioux F'alls,and State of South Dakota,and that it does by Virtue of the signature and seal herein affixed hereby snake,constitute and appoint Dobbi D. Pendleton ,-Individually oh Durham NC its true and lawful Aitomey(s)-in-fact with full power and authority hereby conferred to sign,seal and execute for and on its behalf bonds,undertakings and other obligatory instruments of similar nature -In Unlimited Amounts - Surety Bond No.: Bid Bond principal: Owens Roofing Inc, Obligee: Orange County and to bind it thereby as Fully and to the same extent as if such instruments were signed by a duly authorized officer of the corporation and all the acts ofsaid Attorney,pursuant to the authority hereby given,are hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By-Law printed on the reverse hereof,duty adopted,as indicated,by the shareholders of the corporation. In Witness Whereof,NVESTEsRN SURI,TY COMPANY has caused these presents to be siglned by its Vice President and its corporate seal to be hereto affixed on this 100h day of August,2012. �,�onErr � WESTERN SURETY COMPANY A% 14 q °.SQL SA o1:s w TH t1Pµo+"� Saul T'.Bruflru,Vice]'resident State of South Dakota S& County of Minnehaha On this IOth day ofAugust,2012,before me personally came Paul T,Bruflat,to me known,who,being by me duly sworn,did depose and say: that he reside::in the City oi'Sioux Palls,Stato or South Dakota;that he is the Vice President of WE STERN SURETY COMPANY described in and which executed the above instrument;that he knows the seal of said corporation;that the seat affixed to the said instrument is such corporate seal;that it\vas so affixed pursurant to authority given by the Board of Directors of stud corporation and that he sighed his 'line thereto pursuant to like authority,and acknowledges same to be the act and deed of said corpoi atiou. My commission expires JhStia Mth h w eN 4 ¢ J,AtOHR June 23,2015 enr. VOTARY PUBLIC seas s s SOUTH DAKOTA J,Mohr,Notary Public t:�:lrrfl?t�:A�fr 1, 1,.'Nelson,Assistant Secretary of WF?S'1't;RN SUR1.1'Y COMPANY do hereby certify that the Power of Attorney hereinabove set forth is still in force,and luril?er cvrti ty(hat the 133Y-1-1\y or the corporation prinkNI oil the reverse hereof is still in force, to testimony whereof 1 have hereunto subscribed '" 23rd ;lay of December 2014 ;ny name and af'tSzed the s_;d oftl:e sofa eorijgrrttu�?3ntr WE S T 13 RN ;' URETY COMPANY po _wfGiY ��s^tn¢ C. rc,n„r.,zsa':-'oiz L.Ntasotr,assiraart Secretary DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 Authorizing By-Law ADOPTED BY THE SHAREHOLDERS OF WESTERN SURETY COMPANY This Power of Attorney is made and executed pursuant to and by authority of the following.-By-Latin duly adopted by the shareholders of the Company. 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, and 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. Tlrc corporate seal is not necessary for the validity of any bonds,policies,undertakings,Powers of Attorney or other obligations of the corporation. The signature ofany such officer and the corporate seal may be printed by facsimile. DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 APPENDIX B OR D MUST BE SUBMITTED WITH BID APPENDIX D CERTIFICATION REGARDING SUBCONTRACTING PRACTICES We, Owens Roofing,Inc. hereby certify that it is (Name of Bidder) our intent to perform 100%of the work required for the Roof Replacement-Sector A Skills Development Center contract. (Name of Project) In making this certification,the Bidder states the following: I. That the Bidder does not customarily subcontract elements of this type project,and normally performs and has the capability to perform and will perform all elements of the work on this project with his/her own current work forces;and 2. That the Bidder agrees to submit the following information after bid and before the award of the contract: * List the scope of services involved in this project. * List previous projects of this type that Bidder has performed with his/her forces. Payrolls from the above-mentioned jobs which illustrate Bidder's employees'job classifications needed to perform the elements of the work on the Project or a breakdown of Bidder's entire work force which illustrates the number of employees in each job classification. Name and phone number of the Field Supervisors for these jobs. List of equipment Bidder's firm owns that has been used on previous projects. Copies of lease agreement for equipment that was leased. The Bidder agrees to provide any additional information requested for the statement contained in paragraph number I above. The undersigned hereby certifies that he or she has read this certification and is authorized to bind the Bidder to the commitments herein contained. Date: 12.22.14 Bert Owens (Name o uthori j Officer) Signature: 1 _ Title: President Docu Sign-Envelope rID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 OWENS-1 OP ID:TL TE CERTIFICATE OF LIABILITY INSURANCE F DA 02/20/22015 015(MM/ ,f' 02 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Senn Dunn-Raleigh PHONE Tammy Coolidge FAX 4700 Falls of Neuse Rd,St 190 AIC No Ext:919-791-9861 A/c No; 919-372-3716 Raleigh,NC 27609-2521 E-MAIL s:tcoolidge@senndunn.com Benjamin T.Singleton,AAI INSURERS AFFORDING COVERAGE NAIC# INSURERA:Builders Premier Insurance Co. 13036 INSURED Owens Roofing,Inc. INSURER B:Builders Mutual Ins.Co. 10844 Owens-Hart, LLC 301 W. Cabarrus Street INSURER C Raleigh, NC 27601 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY PCP000244003 05/01/2014 05/01/2015 DAMAGE TO RENTED 100 00 PREMISES Ea occurrence $ s CLAIMS-MADE Fx—1 OCCUR MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ A X ANY AUTO PCA000733702 05101/2014 05/01/2015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS PER ACCIDENT X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,00 B EXCESS LIAB CLAIMS-MADE UMB002114402 05/01/2014 05/01/2015 AGGREGATE $ 4,000,00 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION X WC YS OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER B ANY PROPRIETOWPARTNER/EXECUTIVE Y/N WCP102219702 01/0112015 01101/2016 E.L.EACH ACCIDENT $ 1,000,00 OFFICERWEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 A Intallation Cov. PCP000244003 05/01/2014 05/13/2015 Job Site 1,050,00 Max Loss 3,150,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Orange County is included as an additional insured with regards to general liability as stated in the policy language with written contract prior to any loss. CERTIFICATE HOLDER CANCELLATION ORAN818 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Contractor's Blanket Additional Insured Endorsement Products - Completed Operations-A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II —WHO IS AN INSURED is amended to include as an additional insured any person or organization when you and such person or organization have agreed in a written contract or written agreement that such person or organization be added to your policy, but only with respect to liability for "bodily injury"or"property damage" caused by "your work" performed for that additional insured and included in the "products-completed operations hazard". When the named insured is required to add an additional insured on this policy, the written contract or written agreement must be: 1_ Currently in effect or becoming effective during the term of this policy; 2. Executed prior to a "bodily injury" "occurrence" or"property damage" "occurrence"to which this insurance would apply; and 3. Between a Named Insured and the additional insured B. The insurance provided to the additional insured is subject to the following provisions: 1. That person or organization is an additional insured only for liability caused by your negligence specifically resulting from "your work"for the additional insured as detailed in the written contract or written agreement. 2_ The Limits of Insurance (Section III) is amended to include: The limits applicable to the additional insured are the lesser of those specified in the written contract or agreement executed between you and the additional insured or in the Declaration of this Coverage Part,whichever is less. These Limits of Insurance are inclusive of, and are not in addition to, the Limits of Insurance shown in the Declarations and defined in Section III — Limits of Insurance. 3. The insurance provided to the additional insured does not apply to "bodily injury" or"property damage" arising out of the rendering of, or the failure to render any professional services by you or on your behalf, but only with respect to the following operations: a. Providing engineering, architectural or surveying services to others in your capacity as an engineer, architect or surveyor; and b. Providing, or hiring independent professional firms to provide, engineering, architectural or surveying services in connection with construction work you perform. Professional services include: c. The preparing, approving,failing to prepare, approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and d. Supervisor or inspection activities performed as part of any related architectural or engineering activities. e. However, professional services do not include services within construction means, methods,techniques, sequences and procedures employed by you in connection with your operations in your capacity as a construction contractor. i CG 70 24 03 09 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 2 Copyright, Insurance Services Office, Inc., 1997 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 4_ The following replaces Exclusion I under 2. Exclusions of Section I-COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY I. Damage to Your Work This insurance does not apply to "property damage" to"your work" arising out of it or any part of it and included in the "products-completed operations hazard". 5. When a written contractor written agreement requires coverage to be provided for"bodily injury" or"property damage" within the "products-completed operations hazard", coverage will not apply to "bodily injury"or"property damage"which occurs after: a. The period of time required by the written contract or written agreement; or b. Five years from the completion of"your work" on the project that is the subject of the written contract or written agreement. 6_ Any coverage provided to the additional insured by this endorsement shall be excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis, unless the written contract or written agreement in effect during this policy period and executed by you prior to an "occurrence" specifically requires that the insurance be provided on either a primary or on a primary and noncontributory basis. 7_ The insurance provided in this endorsement does not apply to "bodily injury", or"property damage"arising out of"your work"for which a consolidated (wrap-up) insurance program has been provided by the prime contractor, project manager or owner of a construction project in which you are involved. 8_ The following is added to SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit: e. An additional insured under this endorsement must comply with all provisions of this section_ f. The company may audit or require a copy of the contract. CG 70 24 03 09 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 2 of 2 Copyright,Insurance Services Office, Inc., 1997 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUILDERS BEST ELITE ENDORSEMENT - B This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART AND DECLARATION PAGE INDEX 1. FIRE, LIGHTNING, EXPLOSION AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT 2. WATERCRAFT COVERAGE ENHANCEMENT 3. SUPPLEMENTARY PAYMENTS (BAIL BONDS) ENHANCEMENT 4. PERSONAL AND ADVERTISING INJURY -ELECTRONIC PUBLICATION EXTENSION 5. VOLUNTARY PROPERTY DAMAGE COVERAGE 6. OFF PREMISES CARE, CUSTODY OR CONTROL COVERAGE 7. NEWLY FORMED OR ACQUIRED ORGANIZATIONS 8. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS 9. MEDICAL PAYMENTS 10.LIBERALIZATION CLAUSE 11.DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE,CLAIM OR SUIT 12.BODILY INJURY(MENTAL ANGUISH) 13.BROADENED MOBILE EQUIPMENT 14.NON-OWNED AIRCRAFT 15.FIRE DAMAGE 16.UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS CG 70 44 10 10 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 1. Fire, Lightning, Explosion And Sprinkler Leakage Damage To Premises You Rent If damage by fire, lightning, "explosion" or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner under Coverage A is not otherwise excluded from this insurance, the following applies: A. The last paragraph of Coverage A(Section I)— Paragraph 2. Exclusions—is replaced by the following: Exclusions c.through n. do not apply to damage by fire, lightning, "explosion" or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. B. Paragraph 6. of Section III - Limits of Insurance—is replaced by the following; 6. Subject to paragraph 5. above, the Damage To Premises Rented To You Limit shown in the declarations for Fire Damage Limit is the most we will pay under Coverage A for damages because of"property damage"to any one premises while rented to you, or in the case of damage by fire, lightning, "explosion", or sprinkler leakage, while rented to you or temporarily occupied by you with the permission of the owner. C. Sub-paragraph b.(1)(b) of Condition 4. Other Insurance(Section IV -Commercial General Liability Conditions).is replaced by the following: (1) That is Fire, Lightning, "Explosion" or Sprinkler Leakage insurance for premises rented to you or temporarily occupied by you with the permission of the owner, D. Paragraph 9.a. of the definition of"insured contract' in Section V-Definitions is replaced by the following: 9. "Insured Contract' means: a. A contract for the lease of premises. However,that portion of the contract for the lease of premises that indemnifies any person or organization for damages by fire, lightning, "explosion" or sprinkler leakage to premises while rented to you or temporarily occupied by you with the permission of the owner is not an "insured contract'; E. The following definition is added to Section V—Definitions: 23."Explosion" means a sudden release of expanding pressure accompanied by a noise, a bursting forth of material and evidence of the scattering of debris to locations further than would have resulted by gravity alone. a. "Explosion" does not include any of the following: Artificially generated electrical current including electrical arcing that disturbs electrical devices, appliances or wires; b. Rupture or bursting of water pipes; c. "Explosion" of steam boilers, steam pipes, steam engines or steam turbines owned or leased by you, or operated under your control; or d. Rupture or bursting caused by centrifugal force. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1997 CG 70 44 10 10 page 2 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 2. Watercraft Coverage Enhancement Sub-paragraph (2)of paragraph g.Aircraft,Auto Or Watercraft of paragraph 2. Exclusions of Section I - Coverage A are replaced by the following: g. Aircraft,Auto Or Watercraft (2) A watercraft you do not own that is: (a) Less than 51feet long; and (b) Not being used to carry persons or property for a charge; 3. Supplementary Payments (Bail Bonds) Enhancement Sub-paragraph b. of paragraph 1. of SUPPLEMENTARY PAYMENTS-COVERAGES A And B(of SECTION 1) is replaced by the following: b. Up to $5,000 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. 4. Personal and Advertising Injury-Electronic Publication Extension A. Sub-paragraphs b., d.,and a of paragraph 14. "Personal and Advertising Injury" (of SECTION V-DEFINITIONS) are replaced by the following: b. Malicious prosecution or abuse of process; d. Oral,written,televised, videotaped or electronic publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products or services; e. Oral, written, televised, videotaped or electronic publication of material that violates a person's right of privacy; B. The following offense (h.) is added under the list of offenses under paragraph 14. "Personal and Advertising Injury" (of SECTION V- DEFINITIONS): h. Discrimination or humiliation that results in injury to the reputation of a natural person, but only if such discrimination or humiliation is: (1) Not done intentionally by or at the direction of: (a) An insured; or (b) Any "executive officer" director, stockholder, partner or member of the insured; and (2) Not directly or indirectly related to the employment, prospective employment or termination of employment of any person or persons by any insured. C. Subparagraphs b. Material Published With Knowledge Of Falsity and c. Material Published Prior To Policy Period of 2. Exclusions of SECTION I-COVERAGES.COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY is replaced by the following: b. Material Published With Knowledge Of Falsity "Personal and advertising injury" arising out of oral, written, televised, videotaped or electronic publication of material, if done by or at the direction of the insured with knowledge of its falsity. c. Material Published Prior To Policy Period "Personal and advertising injury" arising out of oral, written,televised, videotaped or electronic publication of material whose first utterance, publication, or broadcast took place before the beginning of the policy period. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 CG 70 44 10 10 page 3 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 5. Voluntary Property Damage Coverage The following coverage is added: At your request, we will pay for"loss"to tangible property of others arising out of your business operations. The most we will pay for this coverage is $500 for each "occurrence"with a $2,500 aggregate limit during the policy period. The "loss" must occur during the policy period and in the "coverage territory." "Loss" means unintended damage or destruction. "Loss" does not mean disappearance, abstraction,theft or voluntary parting with property as a result of trick, scheme or false pretense. Voluntary Property Damage Coverage does not apply to: A. Damage arising out of the ownership, maintenance, use or entrustment of any "auto"; B. Property you own, occupy, rent or lease from others, or C. Property on your premises for sale, service, repair or storage. If the policy to which this endorsement is attached is written with a property damage liability deductible,the deductible shall apply to this Voluntary Property Damage Coverage. The limits of coverage stated above shall not be reduced by the amount of this deductible. 6. Off Premises Care, Custody Or Control Coverage The following coverage is added: A. We will pay those sums that you become legally obligated to pay as damages because of"property damage"to personal property of others while in your or your"employees" care, custody or control or real property of others over which you or your"employees" are exercising physical control if the "property damage" arises out of your business operations. This insurance applies to"property damage" only if: 1. The"property damage" is caused by an "occurrence"that takes place in the"coverage territory"; 2. The "property damage" occurs during the policy period. This Coverage is also subject to the provisions of paragraphs B., C., D., and E. below. B. Exclusions The insurance provided by this Off Premises Care, Custody or Control Coverage shall not apply to: 1. "Property damage"to: a. real property or premises owned, rented, operated, used or leased by you; b. personal property while such property was located at real property or premises described in a. above; c. any "auto" owned or operated by or leased to or rented by or loaned to: (1) your"employees", (2) your subcontractors (3) your subcontractors'employees (4) anyone performing work for or on behalf of your sub-contractors while such sub-contractor is performing work on your behalf d. arising of the ownership, maintenance, use or entrustment of any "auto", Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1997 CG 70 44 10 10 page 4 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 e. "mobile equipment" leased or rented to you, or someone performing work on your behalf, under a short-term or long-term rental or lease agreement. f. property while it is being transported on, in, or upon any"auto", "mobile equipment", watercraft, railcar or aircraft, including during 'loading or unloading." g. premises you (sell) sold, gave (give)away or abandoned (abandon), if the "property damage" arises out of any part of those premises. h. "your work" arising out of it or any part of it whether or not"your work"was performed by you or performed on your behalf by a sub-contractor; 1. that particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. j. "your product"; or k. tools, "mobile equipment or any other equipment or machinery used in the construction trades that are: (1) owned by, . (2) rented by, or (3) leased to, or (4) borrowed by any of your"employees", your sub-contractors or any person employed or hired by your sub-contractors for or while performing work on your behalf.. 2. Any claim or"suit"for"property damage" under this Off Premises Care, Custody Or Control Coverage that is also a claim for"loss" under Section 5. Voluntary Property Damage Coverage provided by this endorsement. 3. "Property damage" included in the"products-completed operations hazard". 4. Any claim or"suit" arising out of the same "occurrence"where we also paid damages for"property damage"that an insured was legally obligated to pay under Coverage A (of Section 1) 5. The cost of repairing or replacing: (a) Any of your work defectively or incorrectly done by you or by others on your behalf: or (b) Any product manufactured, sold or supplied by you, unless the "property damage" is caused directly by you after taking delivery of the product or completion of the work and resulting from a subsequent undertaking. C. Limits Of Insurance —The most we will pay for"property damage" under this Off Premises Care,Custody Or Control Coverage is$25,000 for each "occurrence". The maximum amount we will pay for the sum of all damages covered under this Off Premises Care,Custody Or Control Coverage because of"property damage" during the policy period is an annual aggregate of$25,000 D. Deductible— We will not pay for"property damage"for any one "occurrence" until the amount of"property damage" exceeds $250. If a "property damage" deductible applies to any potential claim or"suit"for an "occurrence" under Coverage A (of SECTION 1), that deductible shall apply if it is greater than $250. E. Your Obligations Under this Off Premises Care, Custody or Control Coverage In the event of"property damage" covered by this Off Premises Care, Custody or Control Coverage you shall, if requested by us, replace the property or furnish the labor and materials necessary for repairs thereto at your actual cost, excluding profit or overhead charges Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1997 CG 70 44 10 10 page 5 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 7. Newly Formed Or Acquired Organizations Paragraph 3. and subparagraphs a., b. and c. (of SECTION II -WHO IS AN INSURED)are changed as follows: 3. Any organization you newly acquire or form, other than a partnership,joint venture or limited liability company, 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 until the expiration of the policy period in which the organization was acquired, incorporated or organized 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. 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. 8. Waiver of Transfer of Rights of Recovery Against Others Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us (of SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS)The following is added: 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 any person or organization for whom you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the agreement. 9. Medical Payments If COVERAGE C MEDICAL PAYMENTS OF SECTION I -COVERAGES C is not otherwise excluded under this insurance,the Medical Expense Limit shown in the Declarations shall be the greater of: a. $10,000; or b. The amount shown in the Declarations 10.Liberalization Clause If after the effective date of this Commercial General Liability Elite Endorsement but before the end of the policy period,we file and receive approval from the appropriate insurance regulatory authorities to use a revised Commercial General Liability Elite Endorsement,then any provision of this revised endorsement that provides increased or broader coverage for an insured without an additional premium charge,we will automatically provide such increased or broader coverage under this endorsement as of the day the revision is effective in your state(s) shown in the Declarations Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 CG 70 44 10 10 page 6 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 11. Duties in the Event of Occurrence, Offense,Claim or Suit Paragraph 2.a., SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, The following is added to a. Knowledge of an "occurrence", claim or "suit' by the agent, servant or"employee"of any insured shall not in itself constitute knowledge of the insured unless; You, if you are an individual; A partner, if you are a partnership; A member or manager, if you are a limited liability company; An executive officer or designee, if you are a corporation; A trustee, if you are a trust; or A designee, if you are any other type of organization. shall have received notice from its agent, servant or"employee". Paragraph 2.b., SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS,The following is added to b. Knowledge of an "occurrence", claim or "suit' by the agent, servant or"employee"of any insured shall not in itself constitute knowledge of the insured unless; You, if you are an individual; A partner, if you are a partnership; A member or manager, if you are a limited liability company; An executive officer or designee, if you are a corporation; A trustee, if you are a trust; or A designee, if you are any other type of organization. shall have received notice from its agent, servant or"employee". 12.Bodily Injury(Mental Anguish) SECTION V—DEFINITIONS Paragraph 3. "Bodily injury" is replaced by the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these at any time. 13.Broadened Mobile Equipment Paragraph 12.f. (1) of SECTION V—DEFINITIONS is replaced by the following: (1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not for construction or resurfacing; or (c) Street cleaning provided that vehicles have a Gross Vehicle Weight of 1,000 pounds or greater 14.Non-Owned Aircraft The following is added to Subparagraph g. of 2. Exclusions of SECTION I—COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: (6) An aircraft with a paid crew, that is hired, chartered or loaned but is not owned by the insured. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1997 CG 70 44 10 10 page 7 DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 15.Fire Damage Limit,Any One Fire The following is added to SECTION III- LIMITS OF INSURANCE 8. The Fire Damage Limit shown in the Declarations shall be the greater of: a. $300,000; or b. The amount shown on the Declaration. 16.Unintentional Failure to Disclose Hazards The following is added to 6. Representations of SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS: Based on our dependence upon your representations as to existing hazards, if unintentionally you should fail to disclose all such hazards at the inception date of your policy, we will not reject coverage under this Coverage Part solely on such failure. I I C r Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 CG 70 44 10 10 page 8 WORKERS COMPENSATION&EMPLOYERS LIABILITY DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 Post Office Box 150005 Policy Number: WCP 1022197 02 Raleigh, North Carolina 27624-0005 Named Insured: OWENS ROOFING INC Agent: SENN DUNN INS,A MMA AGENCY 0000385 EXTENSION OF INFORMATION PAGE ENDORSEMENT SCHEDULE - ITEM 3.D. State Form Nbr. Ed. Date Description US WC000000C (1/15) POLICY PAGE ENDORSEMENT US WC000414 (7/90) NOTE OF CHG IN OWNERSHIP END US WC000419 (1/01) PREMIUM DUE DATE ENDORSEMENT GA WC000114 (1/14) TRIPRA PENDING LAW CHANGE GA WC000403 (4/84) EXP RATING MOD FACTOR END GA WC000404 (4/84) PENDING RATE CHG ENDORSEMENT GA WC000421 C (9/08) DOM TERR, EQUAKE, IND ACC END GA WC000422A (9/08) TRIPRA DISCLOSURE ENDT GA WC100402 (1/13) GA NON-COOP W/PREM AUDIT END GA WC100601 B (7/14) GA CANCEL/NONRENEWAL/CHG END NC WC000114 (1/14) TRIPRA PENDING LAW CHANGE NC WC000310 (4/84) SPROP/PARTNER/OTH CVG END NC WC000313 (4/84) WAIVER OF SUBROGATION NC WC000403 (4/84) EXP RATING MOD FACTOR END NC WC000404 (4/84) PENDING RATE CHG ENDORSEMENT NC WC000406A (7/95) PREMIUM DISCOUNT ENDORSEMENT NC WC000421 C (9/08) DOM TERR, EQUAKE, IND ACC END NC WC000422A (9/08) TRIPRA DISCLOSURE ENDT NC WC320301 C (1/14) NC AMENDED COVERAGE ENDORSE Sc WC000114 (1/14) TRIPRA PENDING LAW CHANGE SC WC000403 (4/84) EXP RATING MOD FACTOR END SC WC000404 (4/84) PENDING RATE CHG ENDORSEMENT Sc WC000421 C (9/08) DOM TERR, EQUAKE, IND ACC END Sc WC000422A (9/08) TRIPRA DISCLOSURE ENDT VA WC000114 (1/14) TRIPRA PENDING LAW CHANGE VA WC000403 (4/84) EXP RATING MOD FACTOR END VA WC000404 (4/84) PENDING RATE CHG ENDORSEMENT VA WC000412 (1/90) CONTNGT EXP RTG MOD FACT END VA WC000422A (9/08) TRIPRA DISCLOSURE ENDT VA WC450602 (7/93) VA AMENDATORY ENDORSEMENT VA WC450604 (1/97) VA-CCPAP ADJUSTMENT END. i i Issued Date: 12/05/2014 We000001A INSURED COPY DocuSign Envelope ID: F8FCAFA8-FBB2-47AF-964F-11 E53C70E4A1 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 perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule BLANKET WAIVER ANY PERSON OR ORGANIZATION AS REQUIRED BY WRITTEN CONTRACT 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$ I i Insurance Company Countersigned by WC 00 03 13 (Ed. 4-84) Copyright 1983 National Council on Compensation Insurance.