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HomeMy WebLinkAbout2018-069-E AMS - Tile Restoration Inc. Flooring ECCC-SHSCDocuSign Envelope ID: 1 1 591 086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 [Departmental Use Only] TITLE Flooring ECCC /SHSC FY 2018 NORTH CAROLINA SERVICES AGREEMENT UNDER $90,000.00 NO RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter "Agreement "), made and entered into this 2nd day of March, 2018, ( "Effective Date ") by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County ") and Tile Restoration Inc, (hereinafter, the "Provider "). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Agreement is for services to be rendered by Provider to County with respect to (insert type of project): Southern Human Services and Efland Cheeks Community Centers floor care. ii) By executing this Agreement, the 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. iii) Time is of the essence with respect to this Agreement. iv) The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. 2. Responsibilities of the Provider a. Services to be provided. The Provider shall provide the County with all services required in Section 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Provider is solely responsible for the professional Revised 10/17 DocuSign Envelope ID: 1 1 591 086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 quality, accuracy and timely completion and/or submission of all work related to the Basic Services. ii) Provider shall be responsible for all errors or omissions of its agents, contractors, employees, or assigns in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. iii) The Provider shall not, except as otherwise provided for in this Agreement, subcontract the performance of any work under this Agreement without prior written permission of the County. No permission for subcontracting shall create, between the County and the subcontractor, any contract or any other relationship. iv) Provider is an independent contractor of County. Any and all employees of the Provider engaged by the Provider in the performance of any work or services required of the Provider under this Agreement, shall be considered employees or agents of the Provider only and not of the County, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Provider. v) If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Provider 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. vi) In determining the basic services to be provided, should any documents be referenced in 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. Should a request for proposals and a proposal be referenced the terms of the request for proposals shall have priority over the terms of any proposal. 3. Basic Services a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows (fully describe services to be provided): labor and material to strip wax and apply Epic Urethane finish to all VCT surfaces as detailed in proposals dated February 14, 2018. Work to be performed at: Southern Human Services Center, located at 2501 Homestead Road; and Efland Cheeks Community Center, located at 117 Richmond Road, Efland. 4. Duration of Services a. Term. The term of this Agreement shall be from March 2, 2018 to April 30, 2018. b. Scheduling of Services. i) The Provider shall schedule and perform its activities in a timely manner. Revised 10/17 2 DocuSign Envelope ID: 1 1 591 086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 ii) Should the County determine that the Provider is behind schedule, it may require the Provider to expedite and accelerate its efforts, including providing additional resources and working overtime, as necessary, to perform its services in accordance with the approved project schedule at no additional cost to the County. iii) The Commencement Date for the Provider's Basic Services shall be March 2, 2018. 5. Compensation a. Compensation for Basic Services. Compensation for Basic Services shall include all compensation due the Provider from the County for all services under this Agreement. The maximum amount payable for Basic Services shall not exceed seventeen thousand one hundred seventy Dollars ($17,170). Payment for Basic Services shall become due and payable within thirty (30) days of Provider properly invoicing County. Payment shall be subject to provisions of Section 5(b). b. Disputes. In the event the amount stated on an invoice is disputed by the County, the County may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. 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. Additional Services. County shall not be responsible for costs related to any services in addition to the Basic Services performed by Provider unless County requests such additional services in writing and such additional services are evidenced by a written amendment to this Agreement. 6. Responsibilities of the County a. Cooperation and Coordination. The County has designated (Freddy Brooks) to act as the County's representative with respect to the Project and shall have the authority to render decisions within guidelines established by the County Manager and/or the County Board of Commissioners and shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance a. General Requirements. Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may be 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 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 Revised 10/17 3 DocuSign Envelope ID: 1 1 591 086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 in effect and certification thereof has been received by the County's Risk Manager. 8. Indemnity a. Indemnity. The Provider agrees, without limitation, to defend, indemnify and hold harmless the County from all loss, liability, claims or expense, including attorney's fees, arising out of or related to the Project and arising from property damage or bodily injury including death to any person or persons caused in whole or in part by the negligence or misconduct of the Provider except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 9. Amendments to the Agreement a. Changes in Basic Services. Changes in the Basic Services and entitlement to additional compensation or a change in duration of this Agreement shall be made by a written Amendment to this Agreement executed by the County and the Provider. The Provider shall proceed to perform the Services required by the Amendment only after receiving a fully executed Amendment from the County. 10. Termination a. Termination for Convenience of the County. This Agreement may be terminated without cause by the County and for its convenience upon seven (7) days' prior written notice to the Provider. b. Other Termination. The Provider may terminate this Agreement based upon the County's material breach of this Agreement; provided, the County has not taken all reasonable actions to remedy the breach. The Provider shall give the County seven (7) days' prior written notice of its intent to terminate this Agreement for cause. Compensation After Termination. i) In the event of termination, the Provider shall be paid that portion of the fees and expenses that it has earned to the date of termination, less any costs or expenses incurred or anticipated to be incurred by the County due to errors or omissions of the Provider. ii) Should this Agreement be terminated, the Provider shall deliver to the County within seven (7) days, at no additional cost, all deliverables including any electronic data or files relating to the Project. d. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. Revised 10/17 4 DocuSign Envelope ID: 1 1 591 086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 Suspension. County may suspend the Basic Services and this Agreement at any time for County's convenience and without penalty to County upon three (3) days' notice to Provider. Upon any suspension by County, Provider shall discontinue work on the Basic Services and shall not resume the Basic Services until notified to proceed by County. 11. Additional Provisions a. Limitation and Assignment. The County and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County nor the Provider shall assign or transfer its interest in this Agreement without the written consent of the other. b. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are 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 identified, on the list created by the State Treasurer pursuant to G.S. 147 - 86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147 - 86.81. Non - Discrimination. 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 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.oran ecountync. og v /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. d. 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. Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. Revised 10/17 5 DocuSign Envelope ID: 1 1 591 086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 f. Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the Parties. g. Ownership of Work Product. Should Provider's performance of this Agreement generate documents, items or things that are specific to this Project such documents, items or things shall become the property of the County and may be used on any other project without additional compensation to the Provider. The use of the documents, items or things by the County or by any person or entity for any purpose other than the Project as set forth in this Agreement shall be at the full risk of the County. h. 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. It is expressly agreed that County 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 County's statutory authority, mandate and/or mandated functions, by state and /or federal legislative or regulatory action, which adversely affects County's authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Provider of such limitation or change in County's legal authority. i. Si agn tures. 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 I IA and Article 40 of North Carolina General Statute Chapter 66. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Attention: Freddy Brooks P.O. Box 8181 Hillsborough, NC 27278 [SIGNATURE PAGE TO FOLLOW] Revised 10/17 6 Provider's Name Tile Restoration Inc 119 East Main Street Hookerton, NC 28538 DocuSign Envelope ID: 1 1 591 086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have hereunder set their hands and seal, all as of the day and year first above written. ORANGE COUNTY: Docu5igned by: �61n_Ak' h*l&wLrst" By. — 06379946755E477... County Manager Revised 10/17 7 PROVIDER: UocuSigned by: By. —1 87F03CAFABB9478... Brad Albritton, Vice President Printed Name and Title DocuSign Envelope ID: 1 1 591 086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 Freddy Brooks Orange County Public Works 600 Highway 86 North Hillsborough, NC 27278 4'" 'TR} I III 0A Your Flooring Sollttion HesoDrre `' Tile Restoration Inc 119 East Main St, Hookerton,Norlh Carolina 28538 Phone: 2527472821 Fax: 252-376-1452 Phone :919 - 245 -2636 Fax:919- 644 -3043 Email:fbrooks@orangecountync.gov Southern Human Services -All VCT Floors Units Process Description of Area Date: 02/14/2018 06 :55 AM Rep.: Brad Albritton Cell: 252 -916 -2045 Email: brads @tilerestorationinc.com 460 Epic Urcthanc Labor and Material to Strip Wax and apply Epic Urethane Finish to all VCT Surfaces Proposal Includes: Stripping of finish from VCT Flooring Application of Epic Urethane finish to VCT Flooring, Project can be separated into multiple mobilizations if needed. 50% of Proposal Due Before Work is Scheduled A fee of 2.5% w!11 be added for all all Credil Card lrarrsacllons Terms: Net 20 Days Please Remit All Contracts, PO's and Payments To; Tile Restoralion Inc. 119 East Main Si PO Box 160 Hookerton NC 28538 Price Per 5 13,295.00 Price $ 13,295,00 Sub Total $ 13,295.00 Deposit Due SUT $ 997.13 Total $ 14,292,13 Proposal Valid for 30 Days Delivery to Job, Sales Tax and Installation are included. All services gumaniccd as specified. All work to be complete in a workmanlike manner according to standard practices. Any allcration or deviation rrom this proposal involving extra costs will be executed only upon written orders, and will become an extra charge over and above the proposal. All agreements contingent upon strikes, accidents or delays beyond our control, Owner to carry fire, tornado and other necessary insurance, our workers are fully covered by Workman's Compensation Insurance. Evidence of insurance will be provided upon request. Any special requirements or endorsements may incur additional charges. We do not waive any rights of subrogation against contractor or owner For any loss covered by insurance of any type. All Tile Restoration services require a minimum of 72 of care time before they can be exposed to moishuie. Iflhis timeline is not adhered to the customer takes full responsibility for any damage or performmtce issues that may resuil.*Epoxies chalk and yellow with age, extruded exposure to UV and artificial lighling. [Ack o 'ventilation, incomplete mixing, miscatalyYalion or the use of heaters Ihat emit carbon dioxide and carbon monoxide during application and initial stages of curing may cause amine blush, possibly affecting adhesion orsubsequent topcoats. TRI marketing will send periodic email communication informing you of various service offerings. Al any time you wish to stop receiving this information you may opt out Pram within the email received or contact our office- ** Tile Restoration will lake all precaution to protect adjoining Flooring, walls, materials etcetera from exposure to water and/or chemicals. Any damage that may occur from contact from water and/or chemical is not the responsibility of Tile Restoration Inc. and its staff. Any changes or additional work required or requested by the owner, will be done at an additional charge and must be written, l hereby give Tile Restoration Inc. authorization to do the work specified and payment will be made as mrtlhued above DocuSign Envelope ID: 1 1 591 086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 Freddy Brooks Orange County Public Works 600 Highway 86 North Hillsborough, NC 27278 �j ■ Ec1 Your Flooring iA■ 5ohufion Resource'" Tile Restoration Inc 119 East Main St, Hookerton,North Carolina 28538 Phone: 2527472821 Fax: 252 -376 -1452 Phone:919 -245 -2636 Fax:919- 644 -30443 Email:fbrooks@orangecountync.gov Efland Community Center -Various Rooms Units Process 1 460 Epic Urethane Description of Area Date: 02/14/2018 07:08 AM Rep.: Brad Albritton Cell: 252 -916 -2045 Email: brada@tilerestora(loninc.com tiierestorationinc.com Price Per Price Labor and Material to Ship Wax and apply Epic Urethane $ 3,874.00 Finish to Multipurpose Room 112, Platform 120, Vestibule 105, Lounge 122, Kitchen 110, RR 1 112, RR3 114. Proposal Includes: Stripping of finish from VCT Flooring Application of Epic Urethane Finish to VCT Flooring 50% of Proposal Due Before Work is Scheduled A fee of 25% wlflbe added for aft all Credit Card !transactions Terms: Net 20 Days Please Remit All Contracts, PO's and payments To: Tile Restorni ion Inc. 119 East Main St PO [cox 1691Iookerton NC 28538 $ 3,875.00 Sufi Total $ 3,875.00 Deposit Due SUT $ 290.63 Total $ 4,165.63 proposal Valid for 30 Days Delivery to Job, Sales Tax and Installation are included. All services guaranteed as specified. All work to he complete in a workmanlike manner according to standard practices, Any alteration or deviation from Ibis proposal involving extra costs will he executed only upon written orders„ and will become an extra charge over and above the proposal. All agreements contingent upon strikes, accidents or delays beyond our control, Owner to carry tire, tornado and other necessary insurance. Our workers are fully covered by Work mans Compensation Insurance, Evidence of Insurance will be provided upon request. Any spacial requirements or endorsements may incur additional charges. We do not waive any rights ofsubrogation against contractor or owner for any loss covered by insurance ofany type, All Tile Restoration services require a minimum of 72 oreurc time before they can be exposed to moisture. if!his timeline is not adhered to the customer takes flrll responsibility for any damage or performance issues that may result. "Epoxies chalk and yellow with age, extended exposure to UV and artificial lighting. Lack orventilation, incomplete mixing, miscatalyxation or the use oflhcaters that emit carbon dioxide and carbon monoxide during application and initial stages of curing may cause amine blush, possibly affecling adhesion of subsequent topcoats. TRI marketing will send periodic email communication inratming you of various service offerings. At any time you wish to stop receiving this information you may opt out from within the email received or contact our o)rce. •• Tile Restoration will take all precaution to protect adjoining flooring, walls, materials etcetera from exposure to water andlor chemicals, Any damage that may occur from comact from water and/or chemical is not the responsibility of Tile Reslomtion Inc. and its staff; Any changes or additional work required or requested by the owner, will be done at an additional charge and must be written. I hereby give Tile Restoration Inc. aulhorization to do the work specified and payment will be made as outlined above DocuSign Envelope ID: 11591086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 CERTIFICATE OF LIABILITY INSURANCE PDA7TE(MMIDD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 02/21 /2018 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 CONTACT Sherry Whaley, AAI, CRIS NAME: Jake A Parrott Insurance Agency Inc PHONE (252)523 -1041 ac, (252)523 -0145 CC. Ext : No : E -MAIL swhaley @parrottins.com 2508 N HERRITAGE STREET ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # PO BOX 3547 INSURERA: EMPLOYERS MUTUAL CASUALTY CO 21415 KINSTON NC 28502 INSURED INSURER B: ACCIDENT FUND INS CO OF AMERICA 10166 INSURERC: $ 500,000 TILE RESTORATION INC INSURER D: $ 10,000 PO BOX 160 INSURER E: INSURER F: HOOKERTON NC 28538 -0160 COVERAGES CERTIFICATE NUMBER: 17 18 MASTER 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 LTR TYPE OF INSURANCE ADUL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD /YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE IX-1 OCCUR DAMAGE PREM SESO(Ea occurrence) RENTED $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 A Y Y 5D20546 11/07/2017 11/07/2018 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 1-1 —] ❑ LOC JECT PRODUCTS - COMP /OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS Y Y 5E20546 11/07/2017 11/07/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Medical payments $ 5,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE 5J20546 11/07/2017 11/07/2018 AGGREGATE $ 2,000,000 DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N /A Y WCV6152738 -0 11/07/2017 11/07/2018 X STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If Ves, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ORANGE COUNTY IS LISTED AS AN ADDITIONAL INSURED AS PERTAINS TO GENERAL LIABILITY, ON A PRIMARY BASIS INCLUDING PRODUCTS & COMPLETED OPERATIONS, VIAA WRITTEN CONTRACT IN PLACE WITH THIS REQUIREMENT INCLUDED. ORANGE COUNTY IS LISTED AS AN ADDITIONAL INSURED AS PERTAINS TO AUTO LIABILITY, VIAA WRITTEN CONTRACT IN PLACE WITH THIS REQUIREMENT INCLUDED. WAIVER OF SUBROGATION IN FAVOR OF ADDITIONAL INSURED APPLIES TO GENERALAND AUTO LIABILITYAND WORKER'S COMPENSATION, VIAA WRITTEN CONTRACT IN PLACE WITH THIS REQUIREMENT INCLUDED. EXCLUDED OFFICERS IN WORKER'S COMPENSATION COVERAGE: DAVID ALBRITTON & CHARLES ALBRITTON III. CERTIFICATE HOLDER CANCELLATION @ 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ORANGE COUNTY ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 8181 AUTHORIZED REPRESENTATIVE HILLSBOROUGH NC 27278 �fl) ji Oaw @ 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 11 591086-0989-4E2D-8A03-5E4CDBBE1 178 ADDITIONAL COVERAGES Ref # Description Uninsured motorist property damage Coverage Code UMPD Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount 100 Deductible Type Premium Ref # Description Uninsured motorist combined single limit Coverage Code UMCSL Form No. Edition Date Limit 1 1,000,000 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Underinsured motorist combined single limit Coverage Code UNCSL Form No. Edition Date Limit 1 1,000,000 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Personal & Advertising Injury Coverage Code PIADV Form No. Edition Date Limit 1 2,000,000 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Umbrella(C) Coverage Code CUMBR Form No. Edition Date Limit 1 2,000,000 Limit 2 2,000,000 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Adjst. to reconcile -exp mod. premium Coverage Code AREM Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium - $1,009.00 Ref # Description Premium discount Coverage Code PDIS Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium - $300.00 Ref # Description Schedule rate adjustment Coverage Code SRA Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium - $980.00 Ref # Description Schedule rate adjustment Coverage Code SRA Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$1,542.00 Ref # Description Premium discount Coverage Code PDIS Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium - $473.00 Ref # Description WC & Employer's liability Coverage Code WCEL Form No. Edition Date Limit 1 1,000,000 Limit 2 1,000,000 Limit 3 1,000,000 Deductible Amount Deductible Type Premium OFADTLCV Copyright 2001, AMS Services, Inc. DocuSign Envelope ID: 11 591086-0989-4E2D-8A03-5E4CDBBE1 178 ADDITIONAL COVERAGES Ref # Description WC & Employer's liability Coverage Code WCEL Form No. Edition Date Limit 1 1,000,000 Limit 2 1,000,000 Limit 3 1,000,000 Deductible Amount Deductible Type Premium Ref # Description Adjst. to reconcile -exp mod. premium Coverage Code AREM Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium -$1,588.00 Ref # Description Increased employer's liability Coverage Code INEL Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $100.00 Ref # Description Increased employer's liability Coverage Code INEL Form No. Edition Date Limit 1 --j Limit 2 Limit 3 Deductible Amount Deductible Type Premium $154.00 Ref # Description Waiver of Subrogation Coverage Code WVSUB Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $250.00 Ref # Description Expense constant Coverage Code EXCNT Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium $230.00 Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref # Description Coverage Code Form No. Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium rFADTLCv Copyright 2001, AMS Services, Inc. DocuSign Envelope ID: 11 591086-0989-4E2D-8A03-5E4CDBBE1 178 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION WHEN REQUIRED IN A WRITTEN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard ". CG7555(10 -13) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 1 of 1 DocuSign Envelope ID: 11 591086-0989-4E2D-8A03-5E4CDBBE1 178 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO ELITE AMENDMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The BUSINESS AUTO COVERAGE FORM is amended to include the following clarifications and extensions of coverage. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. TEMPORARY SUBSTITUTE AUTO PHYSICAL (1) Coverage under this provision is afforded DAMAGE only up to 180 days after you acquire or SECTION I — COVERED AUTOS paragraph C. form the organization, or to the end of the Certain Trailers, Mobile Equipment, and policy period, whichever is earlier. Temporary Substitute Autos is amended by (2) Any organization you acquire or form will adding the following: not be considered an "insured" if: If PHYSICAL DAMAGE COVERAGE is provided by this coverage form for an "auto" you own, the Physical Damage Coverages provided for that owned "auto" are extended to any "auto" you do not own while used with the permission of its owner as a temporary substitute for the covered "auto" you own that is out of service because of breakdown, repair, servicing, "loss" or destruction. The coverage provided is the same as the coverage provided for the vehicle being replaced. B. BLANKET ADDITIONAL INSURED SECTION II — LIABILITY COVERAGE, A.1. Who Is An Insured is amended by adding the following: Any person or organization who is a party to a written agreement or contract with you in which you agree to provide the type of insurance afforded under this Business Auto Coverage Form. This provision applies to claims for "bodily injury" or "property damage" which occur after the execution of any written agreement or contract. C. EMPLOYEES AS INSUREDS The following is added to the Section II — LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured Provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. D. NEWLY FORMED OR ACQUIRED ORGANIZATIONS (a) The organization is a partnership or a joint venture; or (b) That organization is covered under other similar insurance. (3) Coverage under this provision does not apply to any claim for "bodily injury" or "property damage" resulting from an "accident" that occurred before you formed or acquired the organization. E. SUBSIDIARIES AS INSUREDS SECTION II — LIABILITY COVERAGE, A.1. Who Is An Insured is amended by adding the following: Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of this policy. However, "insured" does not include any subsidiary that is an "insured" under any other automobile liability policy or was an "insured" under such a policy but for termination of that policy or the exhaustion of the policy's limits of liability. F. COVERAGE EXTENSIONS — SUPPLEMENTARY PAYMENTS SECTION II — LIABILITY COVERAGE, A.2.a. Coverage Extensions, Supplementary Payments (2) and (4) are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. SECTION II — LIABILITY COVERAGE, A.1. Who Is An Insured is amended by adding the following: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of Any organization which you acquire or form after earnings up to $500 a day because of time off the effective date of this policy in which you from work. maintain ownership or majority interest. However: CA7450(7 -14) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 1 of 4 DocuSign Envelope ID: 11 591086-0989-4E2D-8A03-5E4CDBBE1 178 G. FELLOW EMPLOYEE COVERAGE In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by workers compensation exclusivity rule, or similar protection. The following provision is added: Subparagraph 5. of paragraph B. Exclusions in SECTION II LIABILITY COVERAGE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. H. PHYSICAL DAMAGE — TOWING SECTION III — PHYSICAL DAMAGE COVERAGE, A.2. Towing is replaced with the following: We will pay for towing and labor costs incurred, subject to the following: a. Up to $100 each time a covered "auto" of the private passenger type is disabled; or b. Up to $500 each time a covered "auto" other than the private passenger type is disabled. However, the labor must be performed at the place of disablement. I. LOCKSMITH SERVICES SECTION III — PHYSICAL DAMAGE COVERAGE, AA. Coverage Extensions is amended by adding the following: We will pay up to $250 per occurrence for necessary locksmith services for keys locked inside a covered private passenger "auto ". The deductible is waived for these services. J. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions subparagraph a. Transportation Expenses is replaced by the following: (1) We will pay up to $75 per day to a maximum of $2,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Cause Of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expirations, when the covered "auto" is returned to use or we pay for its "loss ". (2) If the temporary transportation expenses you incur arise from your rental of an "auto" of the private passenger type, the most we will pay is the amount it costs to rent an "auto" of the private passenger type which is of the same like kind and quality as the stolen covered "auto." K. AUDIO, VISUAL, AND DATA ELECTRONIC EQUIPMENT COVERAGE In addition to the Each Accident Limit of Insurance and subject to the provisions of Paragraph C.2. of Section III Physical Damage of the coverage form, we will pay up to $5,000 for "loss" in any one "accident" to all electronic equipment that reproduces, receives, or transmits audio, visual or data signals. L. HIRED AUTO PHYSICAL DAMAGE SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss, or Collision coverage is provided for any "auto" you own, then the Physical Damage coverages provided are extended to "autos" you hire, subject to the following limit and deductible: (1) The most we will pay for loss to any hired "auto" is the lesser of Actual Cash Value or Cost of Repair, minus the deductible. (2) The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. (3) Subject to the above limit and deductible provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will pay up to $1,000, in addition to the limit above, for loss of use of a hired auto to a leasing or rental concern for a monetary loss sustained, provided it results from an "accident" for which you are legally liable. M. AUTO LOAN OR LEASE COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE paragraph A.4. Coverage Extensions is amended by the addition of the following: In the event of a total "loss" to a covered "auto" which is covered under this policy for Comprehensive, Specified Cause of Loss, or Collision coverage, we will pay any unpaid amount due, including up to a maximum of $500 for early termination fees or penalties, on the lease or loan for a covered "auto ", less: 1. The amount paid under the PHYSICAL DAMAGE COVERAGE SECTION of the policy; and 2. Any: a. Overdue lease /loan payments at the time of the "loss "; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage. c. Security deposits not returned by the lessor; CA7450(7 -14) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 2 of 4 DocuSign Envelope ID: 11 591086-0989-4E2D-8A03-5E4CDBBE1 178 d. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and e. Carry-over balances from previous loans or leases. Coverage does not apply to any unpaid amount due on a loan for which the covered "auto" is not the sole collateral. N. PERSONAL PROPERTY OF OTHERS SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: We will pay up to $500 for loss to personal property of others in or on your covered "auto." This coverage applies only in the event of "loss" to your covered "auto" caused by fire, lightning, explosion, theft, mischief or vandalism, the covered "auto's" collision with another object, or the covered "auto's" overturn. No deductibles apply to this coverage. O. PERSONAL EFFECTS COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: We will pay up to $500 for "loss" to your personal effects not otherwise covered in the policy or, if you are an individual, the personal effects of a family member, that is in the covered auto at the time of the "loss ". For the purposes of this extension personal effects means tangible property that is worn or carried by an insured including portable audio, visual, or electronic devices. Personal effects does not include tools, jewelry, guns, money and securities, or musical instruments P. EXTRA EXPENSE FOR STOLEN AUTO SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: We will pay up to $1,000 for the expense incurred returning a stolen covered "auto" to you because of the total theft of such covered "auto ". Coverage applies only to those covered "autos" for which you carry Comprehensive or Specified Causes Of Loss Coverage. Q. RENTAL REIMBURSEMENT SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: 1. This coverage applies only to a covered "auto" for which PHYSICAL DAMAGE COVERAGE is provided on this policy. 2. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto ". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto ". No deductibles apply to this coverage. 3. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days. a. The number of days reasonably required to repair or replace the covered "auto ". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you; or b. 30 days. 4. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses incurred; or b. $75 per day, subject to a $2,250 limit. 5. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 6. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Physical Damage — Transportation Expense Coverage Extension included in this endorsement. 7. Coverage provided by this extension is excess over any other collectible insurance and /or endorsement to this policy. R. AIRBAG COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE, B.3.a. Exclusions is amended by adding the following: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. S. NEW VEHICLE REPLACEMENT COST The following is added to Paragraph C. Limit of Insurance of SECTION III — PHYSICAL DAMAGE COVERAGE In the event of a total "loss" to your new covered auto of the private passenger type or vehicle having a gross vehicle weight of 20,000 pounds or less, to which this coverage applies, we will pay at your option: a. The verifiable new vehicle purchase price you paid for your damaged vehicle, not including any insurance or warranties. b. The purchase price, as negotiated by us, of a new vehicle of the same make, model, and equipment, or most similar model available, not including any furnishings, parts, or equipment not installed by the manufacturer or their dealership. CA7450(7 -14) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 3 of 4 DocuSign Envelope ID: 11 591086-0989-4E2D-8A03-5E4CDBBE1 178 c. The market value of your damaged vehicle, not including any furnishings, parts, or equipment not installed by the manufacturer or their dealership. We will not pay for initiation or set up costs associated with a loans or leases. For the purposes of this coverage extension a new covered auto is defined as an "auto" of which you are the original owner that has not been previously titled which you purchased less than 180 days prior to the date of loss. T. LOSS TO TWO OR MORE COVERED AUTOS FROM ONE ACCIDENT SECTION III — PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by adding the following: If a Comprehensive, Specified Causes of Loss or Collision Coverage "loss" from one "accident" involves two or more covered "autos ", only the highest deductible applicable to those coverages will be applied to the "accident ". This provision only applies if you carry Comprehensive, Collision or Specified Causes of Loss Coverage for those vehicles, and does not extend coverage to any covered "autos" for which you do not carry such coverage. U. WAIVER OF DEDUCTIBLE — GLASS REPAIR OR REPLACEMENT SECTION III — PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by adding the following: If a Comprehensive Coverage deductible is shown in the Declarations it does not apply to the cost of repairing or replacing damaged glass. V. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV — BUSINESS AUTO CONDITIONS, A.2. Duties in the Event of Accident, Claim, Suit or Loss is amended by adding the following: d. Your obligation to notify us promptly of an "accident ", claim, "suit" or "loss" is satisfied if you send us the required notice as soon as practicable after your Insurance Administrator or anyone else designated by you to be responsible for insurance matters is notified, or in any manner made aware, of an "accident', claim, "suit" or "loss ". W. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY Subparagraph 5. of paragraph A. Loss Conditions of SECTION IV BUSINESS AUTO CONDITIONS is deleted in its entirety and replaced with the following. 5. Transfer of Rights of Recovery Against Others to Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. However, we waive any right of recovery we may have against any person, or organization with whom you have a written contract, agreement or permit executed prior to the "loss" that requires a waiver of recovery for payments made for damages arising out of your operations done under contract with such person or organization. X. UNINTENTIONAL FAILURE TO DISCLOSE EXPOSURES SECTION IV — BUSINESS AUTO CONDITIONS, B.2. Concealment, Misrepresentation, or Fraud is amended by adding the following: If you unintentionally fail to disclose any exposures existing at the inception date of this policy, we will not deny coverage under this Coverage Part solely because of such failure to disclose. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non - renewal. Y. MENTAL ANGUISH SECTION V — DEFINITIONS, C. is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from bodily injury, sickness or disease. Z. LIBERALIZATION If we revise this endorsement to provide greater coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. CA7450(7 -14) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 4 of 4 DocuSign Envelope ID: 11591086 - 0989- 4E2D- 8A03- 5E4CDBBE1178 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4 -84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any person or organization that you perform work for that is liable for an injury, covered by this policy, that prior to the injury has written contract requiring a waiver of our right to recover from them. NORTH CAROLINA This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 11/4/2014 Policy No. 5H2O546 Endorsement No. 1 Insured TILE RESTORATION, INC. Premium $ Insurance Company EMASCO INSURANCE COMPANY Countersigned by &404 -; U t-4�� WC 00 03 13 (Ed. 4 -84) Copyright 1983 National Council on Compensation Insurance.