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HomeMy WebLinkAbout2016-540-E AMS - Triangle Landscaping, Inc. for Homestead Road Sidewalk DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 [Departmental Use Only] TITLE Homestead Sidewalk FY FY2016-17 NORTH CAROLINA CONSTRUCTION AGREEMENT UNDER$250,000.00 ORANGE COUNTY THIS CONSTRUCTION AGREEMENT (hereinafter called "Agreement"), made as of the 26th day of September, 20 16, by and between Triangle Landscaping, 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 CRA Associates Incorporated entitled "Sidewalk Extension for Southern Human Services Campus (Sheet #s C0.0 - C5.0 as indexed on attached sheet C0.0 and specifications listed within the bid solicitation dated August 15, 2016) b. Written specifications prepared by the project engineer. c. Attached "Sidewalk Extension for Southern Human Services Campus on Homestead Road" proposal dated August 30th, 2016 which fully describes the work to be performed. Such work will hereafter be called the "Work". Revised 6/16 1 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 d. Related documents listed under Section 1 above. 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 by December 31St, 2016, or no later than 90 calendar days after the Notice To Proceed, should the Notice To Proceed date fall on or later than September 30th, 2016. 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 Revised 6/16 2 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 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. e. 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 Eighty Six Thousand Eight Hundred Fifty Dollars ($86,850). 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, attn: Asset Management Services, 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 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. Revised 6/16 3 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 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://www.orangecountync.gov/departments/purchasing division/contracts.php). If Owner's Risk Manager determines additional insurance coverage is required such additional insurance shall be designated here N/A (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. 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 Contractor shall indemnify, save and protect Owner and Owner's lender, if any, harmless Revised 6/16 4 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 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. Any dispute with respect to any provision of, or the performance or non-performance of, this Agreement shall be subject to the Dispute Resolution Rules and Procedures for Orange County Design, Building Construction, Renovation, and Repair Projects which rules and procedures are incorporated herein. 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. 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. 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. Revised 6/16 5 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 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 Triangle Landscaping, Inc. Attn: Jeff Thompson Attn: Brad Lewis P.O. Box 8181 PO Box 144 Hillsborough,NC 27278 Stem,NC 27581 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 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. By executing this Agreement Contractor affirms that Contractor and any subcontractors of Contractor are and shall remain in compliance with Article 2 of Chapter 64 of the North Revised 6/16 6 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 Carolina General Statutes. g. By executing this Agreement Contractor certifies that Contractor has not been identified, and has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer pursuant to G.S. 147-86.58. h. Contractor shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal anti- discrimination laws, policies, rules, and regulations and the Orange County Anti Discrimination Policy. Any violation of this requirement is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. i. 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 11A 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 N/A. 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 Revised 6/16 7 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 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 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 6/16 8 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 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 /—OOCUSignetl byyy: Docu Signed by 7 : `---3U(./UUKSF//1419 Signature Signature County Manager Brad Lewis President Printed Name and Title Revised 6/16 9 SIDEWALK EXTENSION FOR SOUTHERN III • HUMAN SERVICES CAMPUS chop.hill,nc 2]514 919.401.8586 HOMESTEAD ROAD CHAPEL HILL, NORTH CAROLINA CONSTRUCTION BID SET 08/15/16 ... `, �ll•Il SHEET LISTING C 0.0 COVER SHEET C 1.0 OVERALL EXISTING CONDITIONS PLAN C 1.1 ENLARGED EXISTING CONDITIONS 1 c OWNERS C 1.2 ENLARGED EXISTING CONDITIONS 2 E C 1.3 ENLARGED EXISTING CONDITIONS 3 ORANGE COUNTY C 2.0 OVERALL SITE PLAN c °' DB 1009 PG 437 C 2.1 ENLARGED SITE PLAN 1 W C 2.2 ENLARGED SITE PLAN 2 g w N PB 59 PG 96 PB 78 PG 88 con ` C 2.3 ENLARGED SITE PLAN 3 d 9 L w PB 80 PG 179 PB 102 PG 99 C 3.0 OVERALL GRADING AND STORMWATER PLAN w z z U PIN 9880-00-8527 m a C 3.1 ENLARGED GRADING AND STORMWATER PLAN 1 C 3.2 ENLARGED GRADING AND STORMWATER PLAN 2 e °' C 3.3 ENLARGED GRADING AND STORMWATER PLAN 3 W) " z" ui N STATE OF NORTH CAROLINA C 4.0 OVERALL EROSION AND SEDIMENT CONTROL PLAN h;ono a DB 1031 PG 144 C 4.1 ENLARGED EROSION AND SEDIMENT CONTROL PLAN 1 w PB 46 PG 152 C 4.2 ENLARGED EROSION AND SEDIMENT CONTROL PLAN 2 PIN 9880-00-0680 C 4.3 ENLARGED SEDIMENT AND EROSION CONTROL PLAN 3 rn C 5.0 DETAILS rn N SITE COORDINATES: 352 57' 05.53"N d 799 03' 59.58"W sn COVER 0 N C0.0 CL � of ;ono; w „o ✓� mN9TAumoNbwseT U O O DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 FORM OF PROPOSAL (Addendum #1) Project: Sidewalk Extention for Southern Human Services Campus on Homestead Road Contract: Single Prime General Construction Institution: Orange County,North Carolina Bidder: �i��c\e L+Rt/00..Sc-,go„u0A Date: S- 30- ( The undersigned, as bidder, hereby declares that the only person or persons interested in this proposal as principal or principals is or are named herein and that no other person than herein mentioned has any interest in this proposal or in the contract to be entered into;that this proposal is made without connection with any other person,company or parties making a bid or proposal;and that it is in all respects fair and in good faith without collusion or fraud. The bidder further declares that he has examined the site of the work and the contract documents relative thereto,and has read all special provisions furnished prior to the opening of bids;that he has satisfied himself relative to the work to be performed. The Bidder proposes and agrees if this proposal is accepted to contract with Orange County, North Carolina,in the form of contract specified below, to furnish all necessary materials, equipment, machinery, tools, apparatus, means of transportation and labor necessary to complete the construction of the new sidewalk extension along Homestead Road, Chapel Hill ,North Carolina, in full in complete accordance with the plans, specifications and contract documents, to the full and entire satisfaction of Orange County, and CRA Associates, Inc., with a definite understanding that no money will be allowed for extra work except as set forth in the General Conditions and the contract documents,for the sum of: SINGLE PRIME CONTRACT: Base Bid:Total Dollars($) `13(O S50-0° Base Bid for the project broken into the following Areas: Station 0+00 to 0+75 Dollars($) t2 2.61' ° Station 0+75 to 5+31 and all remaining work areas Dollars($) 91) 2'6 0� GS 143-128(d)requires all single prime bidders to identify their subcontractors for the above subdivisions of work. A contractor whose bid is accepted shall not substitute any person as subcontractor in the place of the subcontractor listed in the original hid,except(i)if the listed subcontractor's bid is later determined by the contractor to be non-responsible or non-responsive or the listed subcontractor refuses to enter into a contract for the complete performance of the bid work,or(ii)with the approval of the awarding authority for good cause shown by the contractor. Form of Proposal 1 of 3 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 AI,TERNATES: Should any of the alternates as described in the contract documents be accepted,the amount written below shall be the amount to be "added to" or "deducted from" the base bid. (Strike out "Add" or "Deduct" as appropriate.) Deduct Alternate G-1: 5' wide Concrete Paving in lieu of 10' for the length of sidewalk extention Dollars($) 9,"1 s,12— UNIT PRICES: Unit Price No. 1: Replacement of Unsuitable Material with Off-site Fill $ (0.Ob /cy Unit Price No. 2: Concrete Sidewalk per Detail 5/C2.1 $ 4.15 /sf 1 Form of Proposal 2 of 3 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 Proposal Signature Page The undersigned further agrees that in the case of failure on his part to execute the said contract and the bonds within ten(10) consecutive calendar days after being given written notice of the award of contract, the certified check, cash or bid bond accompanying this bid shall be paid into the funds of the owner's account set aside for the project,as liquidated damages for such failure;otherwise the certified check,cash or bid bond accompanying this proposal shall be returned to the undersigned. Respectfully submitted this day of ° 30 ��(L (Name of firm or corporation making bid) WITNESS: By: Signature Name: 2)1,4 \ 3 (Proprietorship or Partnership) Print or type Title ltP ; (Owner/Partner/Pres./V.Pres) Address PO i.tra ATTEST: STE in (09L 21S i By: License No. C.L Title: Federal I.D.No. �� " 2-13 in`&0 (Corp.Sec.or Asst.Sec.only) Email Address: —CIy PI,Ju1n e.\ -s M� 1 (too\ (CORPORATE SEAL) Addendum received and used in computing bid: Addendum No. 1 Addendum No.3 Addendum No. 5 Addendum No. 2 Addendum No. 4 Addendum No. 6 Form of Proposal 3 of 3 DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 STATE OF NORTH CAROLINA E-VERIFY AFFIDAVIT ORANGE COUNTY ************************** I, d,rA—()°- (the individual attesting below), being duly authorized by and on behalf of L 432`12-41i),)))) (the entity bidding on project hereinafter"Employer")after first being duly sworn hereby swears or affirms as follows: 1. Employer understands that E-Verify is the federal E-Verify program operated by the United States Department of Homeland Security and other federal agencies,or any successor or equivalent program used to verify the work authorization of newly hired employees pursuant to federal law in accordance with NCGS§64-25(5). 2. Employer understands that Employers Must Use E-Verifv. Each employer, after hiring an employee to work in the United States,shall verify the work authorization of the employee through E-Verify in accordance with NCGS§64-26(a). 3. Employer is a person, business entity,or other organization that transacts business in this State and that employs 25 or more employees in this State. (mark Yes or No) a. YES , or b. NO X 4. Employer's subcontractors comply with E-Verify,and if Employer is the winning bidder on this project Employer will ensure compliance with E-Verify by any subcontractors subsequently hired by Employer. This day of , 2013. Signature of Affiant Print or Type Name: Q iy —¢0'3 State of North Carolina Orange County Signed and sworn to(or affirmed) before me,this the day of ,2013. n' My Commission Expires: DJ V Notary Public °�' DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 **#*Contractor,Vendor or Bidder-Return This Form WithAH Other Required Documentation***** IRAN DIVESTMENT ACT CERTIFICATION REQUIRED BY N.C.G.S. 143C-6A-5(a) �rs�Sctl ?;I)) .t.NL, Name of Contractor,Vendor or Bidder: i{,AN� ,p, As of the date listed below,the contractor, vendor or bidder listed above,and all subcontractors utilized by the contractor, vendor or bidder listed above, is not listed on the Final Divestment List created by the State Treasurer pursuant to N.C.G.S. l43-6A-4. The undersigned hereby certifies that he or she is authorized by the contractor,vendor or bidder listed above to make the foregoing statement. SZ36- 1U S ignature Date Wf86, \-:Z-LS 1 resie\ejV Printed Name Title Notes to persons signing this faire. N.C.G.S. 143C-6A-5(a)requires this certification for bids or contracts with the State of North Carolina,a North Carolina local government,or any other political subdivision of the State of North Carolina.The certification is required at the following times: ❑When a bid is submitted ❑W hen a contract is entered into(if the certification was not already made when the vendor made its bid) When a contract is renewed or assigned N.C.G.S, 143C-6A-5(b)requires that contractors with the State,a North Carolina local government,or any other political subdivision of the State of North Carolina must not utilize any subcontractor found on(he State Treasurer's Final Divestment List.The State Treasurer's Final Divestment List can be found on the State Treasurer's website at the address -www.nctreasurer.comllrtl1 and will be updated every 180 days. *** *Contractor,Vendor or Bidder-Return This Form With All Other Required.Documentation***** • DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 OP ID: DR AC RE) CERTIFICATE F LIABILITY INSURANCE DATE(MM/DD/YYYY) 04/18/2016 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 Phone: 919-682-4814 NAMEACT Christine Barnett The Sorgi Insurance Agency 16 919-682-4906 PHONE xtl:919-682-4814 FAX 919-682-4906 16 Consultant Place Suite 102 IA/C,No,E (A/C,No): Durham,NC 27707 E-MAIL chrisnsor iinsurance.com ADDRESS:James E.Sorgi,CIC PRODUCER V g CUSTOMER ID a:TRIALAN INSURER(S)AFFORDING COVERAGE NAIC S INSURED Triangle Landscaping Inc. INSURER A:Erie Insurance Exchange 26271 Brad Lewis dba 3582 Fletchers Way INSURERS: Stem,NC 27581 INSURER C: INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR L TYPE OF INSURANCE ADD SUBR POLICY EFF POLICY EXP W LIMITS LTR INSR VD POLICY NUMBER (MM/DD/YYYYI IMM/DD/YYYYI GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY Q2726204479 03/26/2016 03/26/2017 DAMAGE TO RENTED PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) $ PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY JEC7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 750,000 (Ea accident) A ANY AUTO Q032630379 03/26/2016 03/26/2017 BODILY INJURY(Per person) $ ALLOWNEDAUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS °N - AND ANY PROPRIETOR/PARTNER/EXECUTIVE Q872600559 03/26/2016 03/26/2017 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT_$ 500,000 A Contractor's equip Q272620479 03/26/2015 03/26/2017 Equipment 122,875 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE a THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County g ty ACCORDANCE WITH THE POLICY PROVISIONS. PO Box8181 Hillsborough,NC 27278 AUTHORIZED REPRESElNT�ATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD