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HomeMy WebLinkAbout2017-526-E ES - Gonzalez Painters & Contractors, Inc. for painting services at Emergency Operations Center DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 NORTH CAROLINA CONSTRUCTION SERVICES AGREEMENT UNDER $50,000 ORANGE COUNTY THIS CONSTRUCTION AGREEMENT (hereinafter"Agreement"), is made and entered into this 22th day of September, 2017 by and between Orange County, North Carolina (hereinafter the "Owner") party of the first part; and Gonzalez Painters & Contractors, Inc (hereinafter the "Contractor"),party of the second part; WITNESSETH: For the purpose and subject to the terms and conditions hereinafter set forth, the Owner hereby contracts for the construction services of the Contractor, and the Contractor agrees to provide the construction services to the Owner in accordance with the terms of this Agreement. 1. TERM AND MAXIMUM AMOUNT PAYABLE Beginning and ending dates of contract: September 22, 2017 through September 30, 2017. The Project Commencement Date shall be September 22, 2017. Dollar Amount Not to Exceed: Three Thousand Dollars ($3,000.00) 2. SERVICES Contractor agrees to provide the following construction services (the "Work"): Interior painting for Emergency Services, Emergency Operations Center per estimate # 18804 dated 8/16/17. Contract including paint (1) accent wall in the Emergency Services Lobby. Contractor shall not sub-contract all or any part of the construction services provided for in this Agreement without prior written approval of the Owner. Contractor shall be responsible for all errors or omissions, in the performance of the Agreement. Contractor shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to Owner. 3. PAYMENT Contractor shall submit an invoice for construction services provided. The invoice shall contain Contractor's name and federal tax identification number and shall be signed and dated by an officer of Contractor. It shall detail all construction services provided in payment requests. The Owner will make payments to Contractor within thirty (30) days after receipt of and approval of the invoice by the contracting department. In the event the amount stated on an invoice is disputed by Owner, then Owner may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. In addition, should Contractor fail to perform its duties under the terms of this Agreement, Owner may, without fault or penalty, withhold any payment associated with the Work to be performed until such time as said work is completed. 4. RELATIONSHIP OF PARTIES Contractor is an independent contractor of the Owner. Contractor represents that it has or will secure, at its own expense, all personnel required in performing the construction services under this Agreement. Such personnel shall not be employees of or have any contractual relationship Revised 2/17 1 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 with the Owner. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized or permitted under state and local law to perform such construction services. It is further agreed that Contractor will obey all State and Federal statutes, rules and regulations which are applicable to provisions of the construction services called for herein. Neither Contractor nor any employee of the Contractor shall be deemed an officer, employee or agent of the Owner. 5. SUSPENSION AND TERMINATION This Agreement may be terminated by Contractor upon thirty (30) days' written notice to the Owner, and the Owner may terminate this Agreement upon thirty (30) days' written notice to Contractor. Owner may suspend the Work at any time for Owner's convenience and without penalty to Owner upon three (3) days' notice to Contractor. Upon any suspension by Owner Contractor shall discontinue the Work and shall not resume the Work until notified to proceed by Owner. The notice required by this section or any other notice shall be delivered via certified mail, return receipt requested to the parties at the addresses as shown on the signature page to this Agreement. Such notice is deemed given upon its delivery to, or deposit in a receptacle of, the United States Post Office. 6. INSURANCE 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. 7. INDEMNIFICATION Contractor agrees to defend, indemnify, save, and protect Owner and Owner's lender, if any, harmless from and against any and all claims, liens, 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 negligence, act or failure to act by the Contractor, the Contractor's agents, assigns or employees resulting in property damage or personal injury, including death, or other loss related to the Work. Contractor is responsible for all errors or omissions caused by its agents, contractors, employees, or assigns in the performance of this Agreement. It is the intent of this section to require Contractor to indemnify the Owner to the full extent permitted under North Carolina law. 8. NON-ASSIGNMENT Contractor shall not assign all or any part of this Agreement, including rights to payments, to any other party without the prior written consent of the Owner. 9. NON—APPROPRIATION Revised 2/17 2 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 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. 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. 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. DISPUTE RESOLUTION 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. The policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing division/contracts.php). 11. ENTIRE AGREEMENT The parties have read this Agreement and agree to be bound by all of its terms, and further agree that it, together with specifically referenced documents, constitutes the complete and exclusive statement of the Agreement between the parties unless and until modified by a written amendment to this Agreement signed by the parties. Modifications may be evidenced by telefacsimile signatures. Should any conflict arise in the terms of any documents referenced herein and this Agreement the terms of this Agreement shall be given priority and shall control over all other such documents. Should a request for proposals and a proposal be referenced the terms of the request for proposals shall have priority over the terms of the proposal. 12. COMPLIANCE WITH LAW/GOVERNING LAW Both parties agree that this Agreement shall be governed by the laws of the State of North Carolina and any action brought under this Agreement shall be brought in the General Court of Justice of the State of North Carolina in Orange County. 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 non-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 the Orange County Non-Discrimination Policy 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 Contractor affirms that Contractor and any subcontractors of Contractor are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Contractor certifies that Contractor has not been Revised 2/17 3 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 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. 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 intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. [SIGNATURE PAGE TO FOLLOW] Revised 2/17 4 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 IN WITNESS WHEREOF Orange County and the Contractor have signed this agreement, effective as of the day and date first above written. ORANGE COUNTY CONTRACTOR UocuS g y g y' By &WAA kt41L Al 9/26/2017 By � o' 9/19/2017 � County Manager Gonzalez Painters & Contractors, Inc 200 S. Cameron St. 4301 Bennett Memorial Rd P.O. Box 8181 Durham NC 27708 Hillsborough, NC 27278 Revised 2/17 5 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 GONZALEZ PAINTERS & F frotPrs a CDrstrcctors, INC CONTRACTORS, INC 4301 Bennett Memorial Rd Durham NC 27705 ESTI MATE 919-477-6058 _ _ _,,,,,, ,,,, ,,,,,, ,,,,,,Bill to: Date. Estimate#_.___, 8/16/2017 18804 Angel Barnes Asset Management Services 919-201-6829 Description: Amount: INTERIORPAINT........................................................................................................................................................................................................................................................................................................................................................................................................................................1...80000........ Emergency Services. Paint two conference rooms Paint walls and trim Apply two coats of paint Use Sherwin Williams Paint Repair drywall as needed NOTES Sand and prime wall board(remove wood frame and do not put it back) Remove other wall boards and paint behind(re install) Protect work areas to avoid damage to furniture and fixtures Remove all job-related debris and materials and leave in broom-clean condition MATERIALS AND LABOR IS INCLUDED Thank you for the opportunity to quote your job Total Page 1 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 GONZALEZ PAINTERS & F Inters a CDntrccfors, INC CONTRACTORS, INC 4301 Bennett Memorial Rd Durham NC 27705 ESTI MATE 919-477-6058 Bill to: Date: Estimate#: 18804 Angel Barnes Asset Management Services 919-201-6829 Description: Amount: INSURANCE.... .... .... .... .... .... .... .... .... .... -Liability insurance and worker's compensation are carried through CMA Insurance,certificate of insurance is available upon request LIMITED WARRANTY -Gonzalez Painters and contractors,INC hereby guarantees that all work executed under this contract will be free of defects in materials and workmanship for a period of one(1)years from the date of final acceptance.All defects occurring within that period shall be replaced or repaired at no cost to the owner. This warranty is in lieu of all other warranties,expressed or implied.Our responsibility is limited to correct the condition as indicated above. -This warranty excludes and in no event will Gonzalez Painters and contractors,INC be responsible for consequential or incidental damages caused by accident or abuse,temperature changes,settlement or moisture, i.e.cracks caused by expansion and/or contraction.Cracks will be properly prepared as indicated at time of job, but will not be covered under this warranty. WORK STANDARD -All work is to be completed in a manner according to standard practices.Worker(s)will remain on job premised until completion of project.Work site will be cleaned daily and upon project completion.All agreements are contingent upon strikes,accidents,or delayed beyond our control. -The painting contractor will produce a"properly painted surface".A"properly painted surface is one that is uniform in color and sheen.It is one that is free of foreign material,lumps,skin sags,holidays,misses, strike-through,or insufficient coverage.It is a surface that is free of drips,splatters,spills,or over-spray which the contractors'workforce causes.Compliance to meeting the criteria of the"properly painted surface"shall be determined when viewing without magnification at a distance of five feet or more under normal lighting conditions and from a normal viewing position. -Any prior drips or poor workmanship prior to this painting may or may not be able to be corrected and will be determined at the time of the estimate. CUSTOMER RESPONSIBILITY -Please take specific note of job description -Color must be chosen one(1)week prior to start date.An Additional cost will be charged for color changes made after the commencement of work. -Alarms must be turned off while work is in progress Thank you for the opportunity to quote your job Total Page 2 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 Ti GONZALEZ PAINTERS & F Inters a CDntrccfors, INC CONTRACTORS, INC 4301 Bennett Memorial Rd Durham NC 27705 ESTI MATE 919-477-6058 _ _ _ Bill to: Date: Estimate#_.___, 8/16/2017 18804 Angel Barnes Asset Management Services 919-201-6829 Description: Amount: CHANGE i only a proposal and your acceptance is subject to our approval in order to make this-This is �s contract binding. -If after you agree to this work,you desire any change of additional work,please contact us,as the cost of all revisions must be agreed upon in writing.Workers are instructed not to undertake additional work without authorization. -Starting date is to be agreed verbally or through e-mail conversation.Change may require additional charge. -You will be notified of all needed carpentry or plaster repairs before they are done.If additional carpentry is found after project starts,will be an additional cost,and must be discussed by supervisor -It is essential that the work area be available to us,free from other trades.As a result of trade interference, Gonzalez Painters and contractors,INC,may leave the job and additional charges may be incurred. COST -We propose to furnish material and labor or labor only complete and in accordance with above specifications for the sum of all as stated above.Individual tasks,if selected,may require additional pricing.Price is valid for 90 days,unless otherwise noted. PAYMENT -The balance is to be paid on the last day of the job. -Progress payments may be requested throughout the course of the job if the job lasts longer than three(3) weeks. -Acceptable forms of payment are cash,check,money order,or credit card. ACCEPTANCE OF PROPOSAL -Please indicate your acceptance of this proposal by signing this copy and returning to us. -We must have your signed copy in order to secure a start date. -By signing this contract,I acknowledge that I have read and understood the terms and conditions of this proposal. SIGN DATE (Upon your approval,please print this last page,sign and return) Thank you for the opportunity to quote your job Total $1,800.00 Page 3 rct., 1 tit LJ co,Z Jo'e:t1.1.e 44:zn 24-Aua-281? 10:24 MetCarrier Tplernm SpanDSP FOX Watt p.3 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-0513F8E64A105 - AC11Z ° CERTIFICATE OF LIABILITY INSURANCE DAT!IMMODNYYY1 08/24(2017 TLM , 40■41...-.*--' 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 SY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED aPPOPIRPNTATIVII nR PROIIII(:PR AND TIM Ns RTIVI(ATI MOP DPIR IMPORTANT! If the aertificate holder is en ADDITIONAL INSURED,the pollicAles)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms end conditions of the policy.certain policies may require en endorsement, A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemenfis). pvcieocut -..k:',64'4UVI' AHOUNL) I hi L;UNNkN IN ALitNI...:Y INL, tokroAt• STRICKLAND INSURANCE BROKERS INC Prime IAIZ.ND,wit', 919-2H-9500 l V.No, 919-286-9501 .100 COMMERCE COURT iLANAIL GOLDSBORO.NC 27534 ADOMAS: ,I r IMSLIRS,Rffl)AFFORDING covratans NAACO UNSIJI■MH A:ATLANTIC CASUALTY INSURANCE COMPANY 11413URe0 INall114104 U CONZALL-2 rAlt.ITETIS 8,CONTDACTODD INC ittsw4$14c 4301 BENNETT MEMORIAL RD ,INauptioc u CHAPFI HII I NC 27514 IPIfilJ14104 I. II:MIJITelty 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 coniorrioN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CLI-IIII-ICAIL MAY UL iSSuLU OH MAY PLI41 AIN, I I IL IN,SURANCL AI-1-04-wL,L3 UY i FL loOLICALS uLSCPILILU I ILHLIN I tii,.111.1I_C I 10 ALL II IL I Lialt4, LXCLUSIONS ANU CONL)I I IONS OF SUCI I POLICILS,LIMI I S SI IOWN MAY I IAVL ULLN NLOuCLOUY HAIL)CLAIMS. Nr o ni.t i.L r insurtri ' VOLIGV MUM kIlt14 AMMIP,.4M111111111111.111111111111er X COhiMrRCIA4-Or-WAAL I-Mtn L001039496-1 ,03/17/2017 1 03/17/2018 ro 1 calm:8140r s 1.000.000 L. je .....0.... , l LIAMAct IQ 11041 l., ° CAI NMI war ...... LA: mi ' , 5 100 000 MU sw(Any°rot:mum) •5,000 A PrRrIONAI A ArAt rfouRY $1.000,000 crN1 AricArriA-rr I MIT APPI irri PrR: CrNrRN NconrcATT: 1$2000000 I' ' ___'II_ X 1.tucy _ jr41" , LLK; 1 imuuci b.CLIMI401•Act: ; 1,000,000 $ ,AwdeAuoTeosne uoksitav IN 7AIII:rYcAlunwANI-10anns :jairo:4 CD ,ILL7UiltLYY:117(7'.647 teatIlmr5711 $$ •I AIITOn NON OWNrf) MI , 1 I ,PROPrRTY nNmAnr , 104;11/U1M $ $ UM* 1LA LIAI mcmp :t ACH L.x.:CLIPOttNL't EXCE$3 LIA5 ' o Amin Linnr nrn RrTrNTION' 1 . ;AGGRrtiATI- 1111111 1 ^ IF , '07.::::::::::::Nuto? (111161c0PLOYIDE,"RS'LIABILITY my rpormETontrwtTHLortItXECLITIVE 1411 NI A YgPrrtivroNn Iloknv I r I rAn I AOCIITNT i LI LlibtAbt-tA WI'WY , t L UiStAbt MACY LAC I Dt$CRITTION Or OPERATIONS I LOCATIONS I VEHICLES IACONO 11)1,AilUAIvtial IR11110A IP$00114414,limy Dv a4taidivd if mono ow,ii moinno PER POLICY CERTIFICATE HOLDER CANCELLATION ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO DOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, HILLSBOROUGH NC 27278 AUTHORIZED IMPROleNTATRIE (d)i!'■.7:4014 ACORD CORPORATION. All rights reserved, ACORD 25(2014101) The ACORD name and logo aro registered marks of ACORD DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 C � DATE(MM/DD/YYYY) 08/11/2017 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 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 NAME: AROUND THE CORNER INS PHONE FAX 1431 BROAD ST (AIC,No,Ext): I (AIC,No): E-MAIL ADDRESS: DURHAM NC 27705 767HB INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA INSURED INSURER B: GONZALEZ PAINTERS AND INSURER C: CONTRACTORS INC 4301 BENNETT MEMORIAL RD INSURER D: DURHAM NC 27705 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence $ (CLAIMS-MADE n OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS–COMP/OP AGG o POLICY'GA I PROJECT n LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO AUTODULED BODILY INJURY(Per person) $ —ALL OWNED NON-OWNED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ UMBRELLA LIAB _J OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDI (RETENTION $ $ WORKERS COMPENSATION IWCSTATU- I IOTH- A AND EMPLOYERS'LIABILITY (6JUB-9F5658 1–2–1 7) 03-18-17 03-18–18 X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y/N E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) C N/A E.L.DISEASE–EA EMPLOYEE$ 1 ,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE–POLICY LIMIT $ 1 ,000,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREFO,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ORANGE COUNTY AUTHORIZED REPRESENTATIVE HO BOX 8181 HILLSBOROUGH NC 27278 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 BUSINESS AUTO 80518 DECLARATIONS NATIONWIDE INSURANCE ',CO OF AMERICA ONE NATIONWIDE PLAZA COLUMBUS, '',OH 43215-2220 Policy Number: ACP BAFB 2264894216 Item One Policy Period From 05/07/2017 To 05/07/2018 12:01 AM Standard Time at the mailing address below I Named Insured: GONZALEZ PAINTERS & CONTRACTORS INC Mailing Address: 4301 BENNETT MEMORIAL RD DURHAM, NC 27705-2305 Agency Name: All About Insurance 32 80518-022 000 35 Agency Address: CHAPEL HILL NC 27514-6110 (919)933-4000 Form of Business CORPORATION + In return for the payment of the premium, and subject to the terms of this policy, we agree with you to ovide the insurance stated in this policy. Item Two Schedule of Coverages and Covered Autos This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the COVERED AUTOS section of the Business Auto or Motor Carrier Coverage Form next to the name of the coverage. Coverage Covered Autos Limit and Deductible-the most we Premium will pay for any one accident or loss LIABILITY 7 See CA9927 3,$54.00 LIABILITY PROPERTY DAMAGE 7 See CA9927 3,374.00 MEDICAL PAYMENTS 7 See State Schedule 1,306.00 UNINSURED MOTORISTS 7 See State Schedule 92.00 - BODILY INJURY UNINSURED/UNDERINSURED MOTORISTS No Coverage - BODILY INJURY UNINSURED MOTORISTS 7 See State Schedule - PROPERTY DAMAGE Estimated Basic Premium $ 8,626.00 Estimated Assessments and Surcharges $ Estimated Total Premium $ 8,626.00 Estimated Total Commission: $ 1 1,293.90 PVDECPI (09-13) 00 DIRECT BILL EAH067 L734 2017067 AGENT COPY ACP BAF82264894216 981501132 35 0008576 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 BUSINESS AUTO SCHEDULE(S) NATIONWIDE INSURANCE CO OF AMERICA ONE NATIONWIDE PLAZA COLUMBUS,'OH 43215-2220 The following schedule(s) is/are a continuation of the declarations. Number: ACP BAFB 2264894216 Effective from 05/07/2017 to 05/Oyi/2018 Named Insured: GONZALEZ PAINTERS & CONTRACTORS INC Agency Name: All About Insurance SCHEDULE OF FORMS AND ENDORSEMENTS Form No. Date Title Premium AC9954 (04/05) AMENDMENT OF COVERED AUTO SYMBOL 7 CA0001 (0 3/1 0) BUSINESS AUTO COVERAGE FORM CA0126 (07/10) NORTH CAROLINA CHANGES CA2018 (1 2/9 3) PROFESSIONAL SERVICES NOT COVERED CA2107 (12/93) SPLIT UNINSURED MOTORISTS COVERAGE LIMITS CA2116 (04/1 0) NORTH CAROLINA UNINSURED MOTORISTS COVERAGE CA2301 (1 2/9 3) EXPLOSIVES CA2304 (1 0/01) ROLLING STORES CA2384 (01/0 6) EXCLUSION OF TERRORISM CA2394 (03/06) SILICA OR SILICA -RELATED DUST EXCL FOR COV AUTOS EXPOSURE CA9903 (03/06) AUTO MEDICAL PAYMENTS COVERAGE CA9927A (01/87) SPLIT LIABILITY LIMITS IL0003 (09/08) CALCULATION OF PREMIUM IL0017 (11/98) COMMON POLICY CONDITIONS IL0021 (09/08) NUCLEAR ENERGY LIABILITY EXCLUSION SCHEDULE OF IMPORTANT NOTICES Form No. Date T i t l e IN5017FB (03/11) IMPORTANT NOTICE FOR RENEWAL POLICIES IN5246 (03/11) NORTH CAROLINA REINSURANCE FACILITY IN5247 (03/11) NOTICE OF RIGHT TO PURCHASE HIGHER LIMITS OF UM/UIM IN5278 (12/13) IMPORTANT NOTICE FAIR CREDIT REPORTING ACT PHSCHED (01-97) DIRECT BILL EAH067 L734 2017067 AGENT COPY ACP BAFB2264894216 981503132 35 0008577 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 Policy Number: ACP BAFB 22-6-4894216 Item Two (Continued) —Schedule of Coverages and Covered Autos Schedule of Coverages - NORTH CAROLINA LIMIT OF COVERAGE INSURANCE DEDUCTIBLE PREMIUM MEDICAL PAYMENTS 2,000 UNINSURED MOTORISTS See CA2107 92.00 - BODILY INJURY UNINSURED MOTORISTS See CA2107 - PROPERTY DAMAGE PVDECST 11-10 00 DIRECT BILL L734 2017067 AGENT COPY ACP BAFB2264894216 981503132 35 0008578 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 II Policy Number: ACP BAFB 22-6-4894216 Item Three —Schedule of Covered Autos You Own Vehicle Description VIN Number Class Code Original' Cost New 002 1995 FORD 1FBJS31H8SHA99633 0148900 23,98 SUPER CLUB Garaging Location Premises ID Territory 4301 BENNETT MEMORIAL RD DURHAM, NC 27705-2305 001'3 Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 276.00 LIABILITY PROPERTY DAMAGE See CA9927 240.00 MEDICAL PAYMENTS See Item Two 114.00 UNINSURED MOTORISTS See CA2107 Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ 630.00 Vehicle Description VIN Number Class Code Original', Cost New 003 2006 CHEVROLET 1GCGG29V161244702 0148900 25,000 EXPRESS Garaging Location Premises ID Territory 4301 BENNETT MEMORIAL RD DURHAM, NC 27705-2305 001) Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 276.00 LIABILITY PROPERTY DAMAGE See CA9927 240.00 MEDICAL PAYMENTS See Item Two 114.00 UNINSURED MOTORISTS See CA2107 Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ 630.00 Vehicle Description VIN Number Class Code 008 1999 FORD 3FENF80C7XMA19608 3347900 F800 DUMP TRUCK Garaging Location Premises ID Territ ry 4301 BENNETT MEMORIAL RD DURHAM, NC 27705-2305 00113 Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 393.00 LIABILITY PROPERTY DAMAGE See CA9927 341.00 MEDICAL PAYMENTS See Item Two 114.00 UNINSURED MOTORISTS See CA2107 Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ 1 848.00 R PVDECVS 11-10 00 DIRECT BILL L734 2017067 AGENT COPY ACP BAFB2264894216 981503132 35 0008579 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 Policy Number: ACP BAFB 22-6-4894216 Item Three —Schedule of Covered Autos You Own Vehicle Description VIN Number Class Code 010 2001 CHEVROLET 1GCHG35R811142406 0148900 EXPRESS VAN Garaging Location Premises ID Territory 1503 AUTUMN RIDGE DR DURHAM, NC 27712-2682 0013 Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 276.00 LIABILITY PROPERTY DAMAGE See CA9927 240.00 MEDICAL PAYMENTS See Item Two 1 14.0 0 UNINSURED MOTORISTS See C/2107 Included - PROPERTY DAMAGE ff Estimated Vehicle Premium (Commission 15.00%) $ 630.00 Vehicle Description VIN Number Class Code 011 2010 FORD 1FBSS3BL2ADA70173 0148900 ECONOLINE E350 Garaging Location Premises ID Territory 1503 AUTUMN RIDGE DR DURHAM, NC 27712-2682 0013 Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 276.00 LIABILITY PROPERTY DAMAGE See CA9927 240.00 MEDICAL PAYMENTS See Item Two 114.00 UNINSURED MOTORISTS See CA2107 Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ 630.00 Vehicle Description VIN Number Class Code 013 2015 CHEVROLET 1G1PC5SB5F7171370 7398100 4 DOOR SEDAN Garaging Location Premises ID Territory 1503 AUTUMN RIDGE DR DURHAM, NC 27712-2682 001.3 Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 160.00 LIABILITY PROPERTY DAMAGE See CA9927 152.00 MEDICAL PAYMENTS See Item Two 26.00 UNINSURED MOTORISTS See CA2107 i Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ I 338.00 PVDECVS 11-10 00 DIRECT BILL L734 2017067 AGENT COPY ACP BAFB2264894216 981503132 35 0008580 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 Policy Number: ACP BAFB 22-6-4894216 Item Three —Schedule of Covered Autos You Own Vehicle Description VIN Number Class Code 014 2007 CHEVROLET 1GCFG15X871187283 0148900 EXPRESS VAN Garaging Location Premises ID Territ ry 1503 AUTUMN RIDGE DR DURHAM, NC 27712-2682 00114 Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 276.00 LIABILITY PROPERTY DAMAGE See CA9927 1 240.00 MEDICAL PAYMENTS See Item Two 114.00 UNINSURED MOTORISTS See CA2107 Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ 1 630.00 Vehicle Description VIN Number Class Code 015 2010 CHEVROLET 1GCZGFAA6A1115842 0148900 EXPRESS Garaging Location Premises ID Territ 1 ry 4301 BENNETT MEMORIAL RD DURHAM, NC 27705-2305 001'; Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 276.00 LIABILITY PROPERTY DAMAGE See CA9927 240.00 MEDICAL PAYMENTS See Item Two 114.00 UNINSURED MOTORISTS See CA2107 Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ 630.00 Vehicle Description VIN Number Class Code 016 2015 CHEVROLET 1GNSKCKC7FR665839 0348900 TAHOE Garaging Location Premises ID Territ ry 1503 AUTUMN RIDGE DR DURHAM, NC 27712-2682 001 s Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 364.00 LIABILITY PROPERTY DAMAGE See CA9927 316.00 MEDICAL PAYMENTS See Item Two 114.00 UNINSURED MOTORISTS See CA2107 Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ 794.00 II PVDECVS 11-1000 DIRECT BILL L734 2017067 AGENT COPY ACP BAFB2264894216 981503132 35 0008581 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 Policy Number: ACP BAFB 22-6-4894216 Item Three —Schedule of Covered Autos You Own Vehicle Description VIN Number Class Code 017 2009 CHEVROLET 1GCCS199X98100670 0348900 COLORADO TRUCK Garaging Location Premises ID Territory 4301 BENNETT MEMORIAL RD DURHAM, NC 27705-2305 001$ i• Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 364.00 LIABILITY PROPERTY DAMAGE See CA9927 316.00 MEDICAL PAYMENTS See Item Two 114.00 UNINSURED MOTORISTS See CA2107 Included - PROPERTY DAMAGE I Estimated Vehicle Premium (Commission 15.00%) $ 794.00 Vehicle Description VIN Number Class Code 019 2016 FORD 1FDUF5GT1GEA30243 2348900 550 Garaging Location Premises ID Territory 4301 BENNETT MEMORIAL RD DURHAM, NC 27705-2305 0013 , Coverage Limit of Insurance Deductible Premium LIABILITY See Cf9927 393.00 LIABILITY PROPERTY DAMAGE See CA9927 341.00 MEDICAL PAYMENTS See Item Two I 114.00 UNINSURED MOTORISTS See CA2107 ! Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ 848.00 Vehicle Description VIN Number Class Code 020 2004 CHEVROLET 1GCGG25U641134254 0348900 VAN Garaging Location Premises ID Territory 1503 AUTUMN RIDGE DR DURHAM, NC 27712-2682 001$ Coverage Limit of Insurance Deductible Premium LIABILITY See CA9927 364.00 LIABILITY PROPERTY DAMAGE See CF 9927 316.00 MEDICAL PAYMENTS See I t c m Two 114.00 UNINSURED MOTORISTS See CA2107 Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ 794.00 I C PVDECVS 11-10 I 00 DIRECT BILL L734 2017067 AGENT COPY I,CP BAFB2264894216 981503132 35 0008582 I DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 Policy Number: ACP BAFB 22-6-4894216 Item Three —Schedule of Covered Autos You Own Vehicle Description VIN Number Class Code 021 2017 BMW 5UXKR0C37H0V72732 7398100 351 Garaging Location Premises ID Territory 1503 AUTUMN RIDGE DR DURHAM, NC 27712-2682 0013 Coverage Limit of Insurance Deductible Premium LIABILITY See Cf 9927 160.00 LIABILITY PROPERTY DAMAGE See CA9927 152.00 MEDICAL PAYMENTS See Item Two 26.00 UNINSURED MOTORISTS See CA2107 Included - PROPERTY DAMAGE Estimated Vehicle Premium (Commission 15.00%) $ 338.00 II PVDECVS 11-10 00 DIRECT BILL L734 2017067 AGENT COPY ACP BAFB2264894216 981503132 35 0008583 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 BUSINES AUTO CA 21 0712 93 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPLIT UNINSURED MOTORISTS COVERAGE LIMITS This endorsement modifies insurance provided under the following: UNINSURED MOTORISTS COVERAGE SCHEDULE "Bodily Injury" $ 30,000 Each Person $ 60,000 Each"Accident" "Property Damage" $ 25,000 Each"Accident" (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Paragraph 1. of LIMIT OF INSURANCE is replaced by the following: 1. Regardless of the number of covered"autos", "insureds", premiums paid, claims made or vehicles involved in the"accident",the limit of insurance is as follows: a. The most we will pay for all damages resulting from "bodily injury" to any one person caused by any one "accident", including all damages claimed by any person or organization for care, loss ot services or death resulting from the "bodily injury", is the limit of"Bodily Injury" shown in the Schedule for each person. b. Subject to the limit for each person, the most we will pay for all damages resulting from "bodily injury" caused by any one"accident"is the limit of"Bodily Injury"shown in the Schedule for each"accident". c. If coverage for "property damage" is provided by this insure nce, the most we will pay for all damages resulting from"property damage"caused by any one"accide it"is the limit of"Property Dama e"shown in the Schedule for each "accident". All terms and conditions of this policy apply unless modified by this endorsement.11 CA 21 07 12 93 Includes copyrighted material of Insurance Services Office, Inc.2002,with its permission. Pa e 1 of 1 P L734 1 7 067 8584 AGENT COPY ACP BAFB22-6.4894216 100 35 DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 80518 CHANGE OF DECLARATIONS ENDORSEMENT- PLEASE READ CAREFULLY NATIONWIDE INSURANCE 0 OF AMERICA COLUMBUS, 0H 43215-2220 Policy Number: ACP BAFB 2264894216 Policy Effective From 05/07/2017 To 05/07/2018 12:01 A.M. Standard Time Transaction Effective 08/18/2017 12:01 A.M. Standard Time Named GONZALEZ PAINTERS & CONTRACTORS INC Insured: Mailing 4301 BENNETT MEMORIAL RD Premiu Address: ADDITIONAL $ 574.00 DURHAM, NC 27705-2305 Agency: All About Insurance 32 80518-022 000 1289 N FORDHAM BLVD 35 Total: $ 574.00 STE D1 (919)933-4000 COMMSN COM $ 86.1 0 CHAPEL HILL NC 27514-6110 COMMSN PER $ 0.00 'remium ADDED VEHICLE 3 $ 574.00 AUTO NO DESCRIPTION 23 2015 CHEVROLET SILVERADO 2500 VIN OCN STATED-AMOUNT 1 GC2CUEG2FZ530746 RADIUS USE TERRITORY CLASS C 0013 0348900 COVERAGE LIMIT/CODE DEDUCTIBLE PREMIUM LIABILITY SEE ENDORSEMENT CA9927 364.00 LIABILITY PD 25,000 NO 316.00 MED PAY 2,000 114.00 UM BI SEE ENDORSEMENT CA2107 6 .00 UM PD 25,000 COMMISSION PERCENT COMMISSION ADJUSTMENT 15.00 $86. 10 II ** THIS IS NOT A BILL - SEE YOUR BILLING STATEMENT. * * PH AMEND 1(01-97)00 DIRECT BILL EC0032 L7F0 2017233 AGENT COPY ACP BAFB2264894216 98150 132 35 0015192