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HomeMy WebLinkAbout2017-355-E AMS - Cummins Atlantic, LLC - Generator Service Contract DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC [Departmental Use Only] TITLE Generator PM Service FY 2017-2018 ORANGE COUNTY CONTRACT UNDER $15,000.00 NORTH CAROLINA THIS AGREEMENT, made and entered into this 20th day of July, 2017, ("Effective Date")by and between Orange County, North Carolina, a political subdivision of the State of North Carolina, (the"County"), party of the first part; and Cummins Atlantic,LLC. (the"Provider"),party of the second part; WITNESSETH: For the purpose and subject to the terms and conditions hereinafter set forth, the County hereby contracts for the services of the Provider, and the Provider agrees to provide the following services to the County in accordance with the terms of this Agreement,time being of the essence: The services and/or materials (hereinafter referred to collectively as "Services") to be furnished under this Agreement are as follows: To provide preventive maintenance services to Orange County generators as outlined in the attached planned equipment maintenance agreement dated June 27th,2017. The term of this agreement rendered shall be from 8/1/2017 to 6/30/2018. Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions due to its acts or omissions, in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts, to the extent caused by Provider, at no additional cost to the County. Provider agrees that Provider shall not sub-contract any of the services to be provided in this Agreement, nor shall Provider assign any right or responsibility granted or required by this Agreement, without the prior written approval of the County. SPECIFIC TERMS 1. Payment: The County agrees to pay at the rates specified for Services satisfactorily performed in accord with this Agreement. The amount to be paid by the County shall not exceed ten thousand four hundred and eight one dollars and sixteen cents, ($10,481.16). Payment shall be made within thirty (30) days of an invoice properly submitted to County. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. 2. Non—waiver: Failure by County at any time to require the perfoiinance by Provider of any of the provisions hereof shall in no way waive or affect the County's right hereunder to enforce the same,nor shall any waiver by the County of any breach be held to be a waiver of any succeeding breach or a waiver of this Non-Waiver Clause. 3. Independent Contractor: The Provider shall operate as an independent contractor and the County shall not be responsible for any of the Provider's acts or omissions. The Provider shall not be treated as an employee with respect to the Services performed hereunder for federal or state tax, unemployment or workers' compensation purposes. The Provider understands that neither federal, nor state, nor payroll tax of any kind shall be withheld or paid by the County on behalf of the Provider or the employees of the Provider. 4. Insurance: Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may be 1 DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC required by County'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 County's Risk Manager determines additional insurance coverage is required due to Provider's insurance coverages falling short of Orange County's minimum coverage requirements, such additional insurance shall consist of (if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 5. Indemnity: The Provider agrees to defend, indemnify, and hold harmless Orange County from all losses, liabilities, claims, demands, suits, costs, damages or expenses (including reasonable attorney's fees) arising from bodily injury, including death, to any person or persons or damage to or destruction of any property to the extent caused by any negligent or intentional act or omission on the part of the Provider, its agents, or assigns directly or indirectly related to the Services to be performed pursuant to this Agreement on the part of the Provider. 6. Termination: This Agreement may be terminated at any time by mutual written agreement of the parties or by the County upon thirty (30) days' written notice to the Provider. County may suspend this Agreement upon reasonable notice to the Provider. 7. Entire Agreement and Signatures: The parties have read this Agreement and agree to be bound by all of its terms, and further agree that it constitutes the complete and exclusive statement of the Agreement between the parties unless and until modified in writing and signed by the parties. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. 8. Priority: In determining the basic services to be provided, should any documents be referenced in or attached to this Agreement, the terms of this Agreement shall have priority in any conflict between the terms of referenced documents and the terms of this Agreement. 9. Governing Law: Both parties agree that this Agreement shall be governed by the laws of the State of North Carolina. 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 state and federal anti-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.). 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. By executing this Agreement Provider affirms that Provider is and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider 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. 10. Dispute Resolution: Any and all suits or actions to enforce, interpret, or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. 2 DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC 11. Non Appropriation: Provider acknowledges that County 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. In the event that public funds are unavailable and not appropriated for the performance of County's obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability and non-appropriation of public funds. 12. Limitation of Liability Notwithstanding the foregoing, in no event shall either party be liable to the other for indirect, incidental, consequential, special, punitive, or liquidated damages; nor shall either party's total liability under this Agreement exceed three times (3x) the total contract price. The foregoing limitation shall not apply to the extent Claims are covered by insurance that Provider is required to carry under the terms of this Agreement. 13. Warranty: Parts and Services provided hereunder are accompanied by express, written manufacturer's warranty and Provider's limited service warranty. Except as provided herein. no other warranties exist. express or implied. including any warranties for merchantability and fitness for a particular purpose. [SIGNATURE PAGE TO FOLLOW] 3 DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC IN WITNESS WHEREOF, County and the Provider have signed this Agreement, effective as of the day first written above. ORANuE Signed y:COUNTY PR I Red by: ocu // By: �?OtA t It �' voit rstu By: D1:a- l� iin S ar.91Ntanager Title: WVWaPr 200 S. Cameron St. P.O. Box 8181 Hillsborough,NC 27278 4 DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC Sales and to Service 6/27/2017 Orange Co. Public Works P.O. Box 8181 Hillsborough, NC 27278 RE: Planned Maintenance Proposal Dear Mr. Allan Dorman, Cummins Sales and Service is a premier engine and power generation systems provider committed to delivering fast and proven solutions to our customers. We are pleased to offer you a Planned Maintenance Proposal for your review and approval. Due to the critical nature of your standby power system, this Agreement was developed based on your specific needs and equipment to ensure maximum performance and reliability. Benefits of Planned Maintenance • Improves system reliability. • Maintenance performed by certified technicians specifically trained in power generation. • PM customers receive preferred service for unscheduled emergency repairs. • Creation of a service record for customer equipment. • Additional maintenance recommendations documented at that time. • Scheduling managed by Cummins Sales and Service to ensure timely maintenance intervals. • Eliminates administrative burden, covers equipment from multiple vendors. Please sign, date and return the enclosed Agreement to our office along with any purchase documentation necessary so we can tend to your servicing needs. Planned Maintenance Agreements are "auto-renewed" annually prior to the end of your agreement. Should you have any questions or require additional information on this or any other subject relating to your equipment, please feel free to contact me. We look forward to the opportunity to earn your trust and business. Sincerely, .062.ytif Weglzei7 Doug McGrigor Service Sales Rep Office: (336) 275-4531 x301 Cell: (336) 362-9288 Email: stephen.mcgrigor @cummins.com DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC '" Sales and Cummins Atlantic LLC Service 512 Teague Street Greensboro, NC 27406 cso Phone: (336) 275-4531 Fax: (336) 275-8304 PLANNED EQUIPMENT MAINTENANCE AGREEMENT n:NaNY'P III ii °.i . a aw," ., a sn.II Il�� n�f tt u� Orange Co. Public Works Name: Mr. Allan Dorman Quote Date: 6/27/2017 P.O. Box 8181 Phone: (919) 619-8859 Quote Expires: 8/26/2017 Hillsborough, NC 27278 Cell: Quote ID: QT-804 Customer#: 5538 Fax: Quoted By: Doug McGrigor Payment Type: Pay As You Go E-mail: adorman @orangecountync.gov Quote Term: 1 Year Site Name:EMS Meadowlands / #7098 (510 Meadowlands Rd. Hillsborough NC 27278) Unit Name: EMS Meadowlands Month of Year Service Type Qty Sell Price Extended Price Make: Other 1st Service Model: TBD 1 Unknown Full Service 1 $615.83 $615.83 S/N: TBD 1 Unknown Loadbank (1.5 Hrs) 1 $565.38 $565.38 Size: 200kW Year 1 Total:$1,181.21 ATS Qty: 1 Notes: Site Name:Fuel Station 30kW (600 Hwy. 86 North Hillsborough NC 27278) Unit Name: Fuel Station 30kW Month of Year Service Type Qty Sell Price Extended Price Make: Other 1st Service Model: 30KOZI81 1 Unknown Full Service 1 $428.96 $428.96 S/N: TBD 1 Unknown Loadbank (1.5 Hrs) 1 $388.20 $388.20 Size: 30kW Year 1 Total:$817.16 ATS Qty: 1 Notes: Site Name:Hillsborough Commons / #7110 (113 Mayo St. Hillsborough NC 27278) Unit Name:Hillsborough Commons Month of Year Service Type Qty Sell Price Extended Price Make: Other 1st Service Model: TBD 1 Unknown Full Service 1 $341.93 $341.93 S/N: TBD Year 1 Total:$341.93 Size: 22kW ATS Qty: 1 Notes: Site Name:Jail 60kW (125 Court ST. Hillsborough NC 27278) Unit Name: Jail 60kW Month of Year Service Type Qty Sell Price Extended Price Make: Other 1st Service Model: TBD 1 Unknown Full Service 1 $402.29 $402.29 S/N: TBD Year 1 Total:$402.29 Size: 60kW ATS Qty: 1 DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC Notes: Site Name:Justice Bldg. / #7109 (106 East Margaret La. Hillsborough NC 27278) Unit Name: Justice - Sheriff 175kW Month of Year Service Type Qty Sell Price Extended Price Make: Cummins 1st Service Model: DSHAB 1 Unknown Full Service 1 $551.95 $551.95 S/N: 46875637 1 Unknown Loadbank (1.5 Hrs) 1 $513.90 $513.90 Size: 175kW Year 1 Total:$1,065.85 ATS Qty: 1 Notes: Site Name:Link Center (200 S. Cameron ST. Hillsborough NC 27278) Unit Name: Link Center Month of Year Service Type Qty Sell Price Extended Price Make: Other 1st Service Model: TBD 1 Unknown Full Service 1 $469.93 $469.93 S/N: TBD Year 1 Total:$469.93 Size: 124kW ATS Qty: 1 Notes: Site Name:Mountain 50kW (1000 Virgina Cates Rd. Hillsborough NC 27278) Unit Name: Mountain 50kW Month of Year Service Type Qty Sell Price Extended Price Make: Other 1st Service Model: 10.75050-G49 1 Unknown Full Service 1 $475.81 $475.81 S/N: P0611070001 1 Unknown Loadbank (1.5 Hrs) 1 $436.90 $436.90 Size: 50kW Year 1 Total:$912.71 ATS Qty: 1 Notes: Site Name:New Motor Pool 80kW (600 Hwy. 86 North Hillsborough NC 27596) Unit Name: New Motor Pool 80kW Month of Year Service Type Qty Sell Price Extended Price Make: Onan 1st Service Model: 80DGDA 1 Unknown Full Service 1 $467.11 $467.11 S/N: 45185264 1 Unknown Loadbank (1.5 Hrs) 1 $428.20 $428.20 Size: 80kW Year 1 Total:$895.31 ATS Qty: 1 Notes: Site Name:Seymour / #7152 (2551 Homestead Rd. Chapel Hill NC 27516) Unit Name: Seymour 250kW Month of Year Service Type Qty Sell Price Extended Price Make: Kohler 1st Service Model: 250 REOZIE 1 Unknown Full Service 1 $623.23 $623.23 S/N: TBD 1 Unknown Loadbank (1.5 Hrs) 1 $572.78 $572.78 Size: 250kW Year 1 Total:$1,196.01 ATS Qty: 1 Notes: DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC Site Name:Southern / #7089 (2501 Homestead Rd. Chapel Hill NC 27516) Unit Name: Southern 125 kW Month of Year Service Type Qty Sell Price Extended Price Make: Cummins 1st Service Model: D6FC 1 Unknown Full Service 1 $560.83 $560.83 S/N: 46468867 1 Unknown Loadbank (1.5 Hrs) 1 $522.78 $522.78 Size: 125kW Year 1 Total:$1,083.61 ATS Qty: 1 Notes: Site Name:WCOB / #7108 (131 West Margaret La. Hillsborough NC 27278) Unit Name: WCOB 250kW Month of Year Service Type Qty Sell Price Extended Price Make: Generac 1st Service Model: TBD 1 Unknown Full Service 1 $469.93 $469.93 S/N: TBD Year 1 Total:$469.93 Size: 250kW ATS Qty: 1 Notes: Site Name:WCOB-M / #7107 (131 West Margaret La. Hillsborough NC 27278) Unit Name: WCOB-M 250kW Month of Year Service Type Qty Sell Price Extended Price Make: Generac 1st Service Model: TBD 1 Unknown Full Service 1 $469.93 $469.93 S/N: TBD Year 1 Total:$469.93 Size: 250kW ATS Qty: 1 Notes: Site Name:Whitted Human Services / #7151 (300 W. Tryon St. Hillsborough NC 27278) Unit Name: Whitted 250kW Month of Year Service Type Qty Sell Price Extended Price Make: Kohler 1st Service Model: 250REOZJE 1 Unknown Full Service 1 $612.87 $612.87 S/N: TBD 1 Unknown Loadbank (1.5 Hrs) 1 $562.42 $562.42 Size: 250kW Year 1 Total:$1,175.29 ATS Qty: 1 Notes: .................................................................................................................................................................................................................................................................................... Total Agreement Amount:* $10,481.16 *Quote does not include applicable taxes DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC <` ales and Cummins Atlantic LLC 0)- Service 512 Teague Street Greensboro, NC 27406 Phone: (336) 275-4531 PLANNED EQUIPMENT MAINTENANCE AGREEMENT 'I /��i � :III. w � /� I I IIII dd III .piIII�wdl"w :IIIIIIIIIIII„ pnn ,. y,.,� a. �!) .. .,. .. .� . li"�uulY.., � w w .�'.Y.�.. .,.�a mi.I .w I aul��, m..I� Orange Co. Public Works Name: Mr. Allan Dorman Quote Date: 6/27/2017 P.O. Box 8181 Phone: (919) 619-8859 Quote Expires: 8/26/2017 Hillsborough, NC 27278 Cell: Quote ID: QT-804 Customer#: 5538 Fax: Quoted By: Doug McGrigor Payment Type: Pay As You Go E-mail: adorman @orangecountync.gov Quote Term: 1 Year Total Agreement Amount:* $10,481.16 *Quote does not include applicable taxes Comment: Total Agreement Amount Does Not Include Applicable Taxes. Please call 804-232-7428 or Email southpm @cummins.com for invoice total prior to sending payment. Planned Equipment Maintenance Agreements are designed with an automatic renewal provision. Details of this provision are listed in the "Planned Equipment Maintenance Agreement Terms and Conditions". If you do not wish to participate in the auto renew option, please check the box below to opt out. ❑ Opt out of Automatic Renewal. Selection Required for Load Bank Test Readings will be taken every 15 minutes, unless otherwise specified. *If no selection is made, we will perform this option by default ❑*Annual Load Bank Test, NFPA 110, 2010 Edition 8.4.2.3 The generator set will be loaded to a load factor of not less than 50% of the EPS kW nameplate rating for 30 minutes, load will then be increased to a load factor not less than 75% of the EPS kW nameplate rating for 60 minutes for a total run time of 1.5 continuous hours. ❑50% of the EPS nameplate kW rating for 30 minutes, followed by 75% of the EPS nameplate kW rating for 60 minutes, for a total of 1.5 continuous hours ❑80% of the EPS nameplate kW rating for 1.5 continuous hours ❑ Other— Please Specify Please return signed agreement to: Cummins Atlantic LLC Attn: PEM Administration Group 3900 Deepwater Terminal Road Richmond, VA 23234 Email: southpm @cummins.com Sellllelr hereby agrees to sellll to Buyer, and Buyer hereby agrees to buy from Selller, tlhe 9ioregoillmg products/services upon the terms and conditions set forth lilrn t.lre "Planned Equipment Maintenance Agreement I crlcrrrs anent Conditions" attached Iherete, wlhiimrh are hereby incorporated y reference. Ilm��lrm�lirm by " . m u w ;14''011,1111111111111111111111111F II plU p° 10141011 orau a o Signature: Signature: Date: Date: Please rel:.mrr, signature rep sleet only DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC This Agreement, when accepted by you and approved NO OTHER WARRANTIES APPLY, INCLUDING by a Cummins Atlantic LLC , LLC (the "Company") IMPLIED WARRANTIES OR MERCHANTABILITY OR authorized representative, will constitute the entire FITNESS FOR A PARTICULAR PURPOSE. IN NO exclusive agreement between us for the services to be. EVENT WILL THE COMPANY BE LIABLE FOR LOSS All prior oral or written understandings are superseded OF PROFITS OR INCIDENTAL, SPECIAL OR by this agreement. The parties hereto intend that the CONSEQUENTIAL DAMAGES CAUSED BY terms and conditions contained herein will exclusively PRODUCTS OR SERVICES THAT WE SUPPLY. govern the services to be provided. This Agreement may The Company is not responsible for any expenses for not be amended unless agreed to in writing by an damages, including materials or labor, to repair damage authorized representative of the Company. caused by abuse, accident, theft, acts of third party, Scope of Services operation of equipment in a manner outside of the The Company shall perform maintenance on the operations recommendation of the Company for such equipment listed on the front side of this Agreement. The equipment, or force of nature, or if repairs or servicing scope of these maintenance services is more fully are performed by a party other than the Company. The described in the "Scope of Services". No other work, Company shall not be responsible for failure to render materials or activities are included in this agreement service or repairs for causes beyond its control, including unless agreed to in supplemental documentation. strikes and labor disputes. Agreement Term -Automatic Renewal Provision Payment Terms If you elect the automatic renewal provision, this Payment terms are Net 30 from date of invoice. Agreement will automatically renew at the end of the General initial term for a period equal to the initial term (the 1. You represent that you own the equipment "Renewal Term"). In such event, cost increases for the subject tothis Agreement, or, if you are not the owner, Renewal Term will not exceed three (3%) percent per that you have the authority to enter into this Agreement. year. Either party has the right to terminate this Agreement with thirty (30) days prior written notice, 2. Any notice or other communication given unless the work has already been performed. hereunder shall be in writing and mailed to address shown on this Agreement. Any such notice shall be Maintenance Service deemed given when deposited in the United States mail. All services hereunder will be performed between 7:00 Any notices to be provided to the Company shall be a.m. and 5:00 p.m., Monday through Friday, excluding mailed to: holidays unless agreed to in writing by the Company prior to the execution of this Agreement. Cummins Atlantic LLC Coverage and Limitations Attn: PM Administration Group The Company warrants and agrees that all parts and 3900 Deepw Terminal 234 Ric hh mond, VA 233234 materials shall be suitable for the use intended. For any parts manufactured by Cummins Inc. (CMI) or its 3.This Agreement shall be binding upon and inure to the subsidiaries, the only warranty that applies is the written benefit of the parties and their respective successors Limited Warranty provided by CMI for that part. Limited and assigns. Warranties may apply for select parts provided by third party manufacturers only to the extent as defined in writing by the third party component manufacturer's Rev January 2014 warranty. The sole remedy is the repair or replacement of the affected part by Company's discretion. DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC Power Generation System Planned Maintenance • INSPECTION —C3 (MOfc1'°IIL°°IIIIIL...'"9il" QUART kY C _.._ 7'NIE C 'Y Eui!'II Y,'Jp Safety Engine & Lubrication System • Perform Lock Out Tag Out procedure (LOTO) • Inspect lubrication system for leaks&visually check oil level • Inspect crankcase ventilation system Battery& Battery Charger System • Inspect spark ignited ignition system • Check/record battery charger functions&charge rate • Inspect oil heater operation (if applicable) • Check connections,termination cleanliness and Intake/Exhaust System security Inspect air cleaner restriction indicator •• Check electrolyte level, vent caps and all cells in the Inspect air cleaner element and entire intake system •starting batteries Inspect entire exhaust system and rain cap •• Check specific gravity of batteries Inspect louver operations •• Test starting batteries with electronic analyzer Inspect spark arrestor •• Check starter connections and wiring • • Check starting voltage Empty condensate trap on silencer Fuel System Generator Controls & Power Connections • Inspect main tank/day tank fuel level &test transfer • Visually inspect all engine mounted wiring, senders and pump operation devices • Inspect tank vents&overflow piping • Visually inspect all control mounted components and wiring • Inspect gaseous fuel regulator vent(natural gas only) • Inspect generator heater operation • Inspect all fuel hoses, clamps, pipes,components, • Lamp test all lights and indicators vents and fittings • Visually inspect breaker and power connections • Inspect governor linkage and oil level (if applicable) • Manually operate generator main breaker(s)open and closed ** • Drain condensation from fuel/water separators • Obtain fuel sample& inspect for contamination NOTE:Will not exercise breakers or contactors on a paralleling device. • Optional—fuel sample for laboratory analysis* Generator Operations Engine Cooling System Start, observe, &record generator and equipment operation • Verify engine and generator safeties for proper operation • Inspect water pump, all hoses and clamps for leaks, • Inspect duct work, louver motors, controls&test as coolant level and condition appropriate • Inspect radiator condition System test with or without load • Observe coolant heater operations • Inspect drive belts, observe alignment and deflection Automatic Transfer Switch • Utilize SCA test strip to record coolant properties • Visually inspect all power and control wiring • Inspect radiator surfaces,shrouds and barriers for • Visually inspect switch mechanism and enclosure obstruction Visually inspect controls and time delays settings • Optional—coolant sample for laboratory analysis* • Verify function of exercise clock Housekeeping • General cleaning of enclosure interior, genset and ATS Lubrication Oil & Filtration Service • Change engine lubrication oil • Change primary lubrication and bypass filters • Change fuel and coolant filters • Post lube service operation of genset(unloaded)at rated temperature • Optional—oil sample for laboratory analysis* Operational & Functional Review of Generator Critical Components • Inspect engine cooling fan&fan drives for excessive wear or shaft wobble • Check all pulleys, belt tensioners,slack adjusters&idler pulleys for travel,wear&overall condition • Inspect/lubricate drive bearings, gear or belt drives *Additional Charge Additional Services and Repairs Quotes provided in accordance with customer requirements by service offerings. Any additional repairs,parts or services which are required will be brought to the attention of the owner. Repairs will only be made after proper authorization from the owner is given to Cummins Atlantic,LLC. Any additional repairs,maintenance or service performed by Cummins Atlantic,LLC for a Planned Equipment Maintenance Agreement holder will be at current Cummins Atlantic,LLC planned maintenance labor rates salesandservice.cummins.com Bulletin PM000001 Rev 05/16 ©2014 Cummins Atlantic DocuSign Envelope ID:B24B6EE8-440A-4618-BA1B-758A520A23BC AC?J CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ' 6/28/2017 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 have ADDITIONAL INSURED provisions or 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 Aon Risk Services Northeast, Inc. NAME:ACT A.I. King Insurance Agency,Inc. 1660 W. 2nd Street, Suite 650 PHONE FAX Cleveland, OH 44113 Ext): E-MAIL 317-841-6004 (A/C,No): 317-841-6006 E-MAIL L ADDRESS: richard@aikinginsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Old Republic Insurance Company 24147 INSURED INSURER B: Lexington Insurance Company 19437 Cummins Inc. 500 Jackson Street INSURER c: Ace American Insurance Company 22667 Mail Code 60805 INSURERD: Columbus IN 47201-6258 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 36405340 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A / COMMERCIAL GENERAL LIABILITY ✓ MWZY 302202-16 12/1/2016 12/1/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE ,/ OCCUR PREMISES(Ea occur ence ) $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 ✓ POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILELIABILITY MWTB 12/1/2016 12/1/2017 COMBINED SINGLE LIMIT $ ✓ (Ea accident) 2,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ ✓ AUTOS ONLY ✓ AUTOS ONLY (Per accident) ✓ Phy Damage $ Self Insured B 7 UMBRELLA LIAB / OCCUR 62785312 12/1/2016 12/1/2017 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ $ A WORKERS COMPENSATION / MWC 308551 00 12/1/2016 12/1/2017 ✓ O PERTUTE ETH AND EMPLOYERS'LIABILITY Y N ANYPR PRIETOREXCLUDEE ECUTIVE N N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Property FAZD38483018 8/1/2016 8/1/2017 Limit:$10,000,000 Special Form including Earthquake&Flood Leased/Rented Equipment FAZD38483018 8/1/2016 8/1/2017 Limit:$25,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Orange County NC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. 200 S. Cameron St. Hillsborough NC 27278 AUTHORIZED REPRESENTATIVE er / /c Richard Trakimas ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 36405340 1 16/17 GL AU OMB WC 16/17 PROP (Std-Merged Dist) I Kaleeda Jenkins 1 6/28/2017 1:18:20 PM (PDT) I Page 1 of 1