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HomeMy WebLinkAbout2018-103-E County Mgr - Ergonomics Center of NC program developmentDocuSign Envelope ID: 77AEB69E- 2B0D- 4BF3- AB64- 91 FD11A920E3 [Departmental Use Only] TITLE FY NORTH CAROLINA CONSULTING SERVICES AGREEMENT UNDER $90,000 ORANGE COUNTY This Agreement, made and entered into this 15th day of March, 2018, ( "Effective Date ") by and between Orange County, North Carolina a body politic and corporate of the State of North Carolina (hereinafter, the "County ") and The Ergonomics Center of North Carolina, (hereinafter, the "Consultant "). WITNESSETH: That the County and Consultant, for the consideration herein named, do hereby agree as follows: ARTICLE 1 SCOPE OF WORK 1.1 Scope of Work 1.1.1 This Services Agreement ( "Agreement ") is for professional consulting services to be rendered by Consultant to County with respect to (insert type of project)Ergonomic Program development, Gap Analysis and Resources per attached Proposal Summary 1.1.2 By executing this Agreement, the Consultant represents and agrees that Consultant 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. 1.1.3 Time is of the essence with respect to this Agreement. 1.1.4 The services to be performed under this Agreement consist of Basic Services, as described and designated in Article 3 hereof. Compensation to the Consultant for Basic Services under this Agreement shall be as set forth herein. ARTICLE 2 RESPONSIBILITIES OF THE CONSULTANT 2.1 Services to be Provided. The Consultant shall provide the County with all services required in Article 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. 2.2. Standard of Care 2.2.1 The Consultant shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Consultant practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Consultant is solely responsible for the professional quality, accuracy and timely completion and submission Revised 10/17 DocuSign Envelope ID: 77AEB69E- 2B0D- 4BF3- AB64- 91 FD11A920E3 of all reports, drawings, specifications, plans, documents and services (hereinafter "Deliverables ") related to the Basic Services. 2.2.2 The Consultant shall be responsible for all errors or omissions, in the deliverables prepared by the Consultant. 2.2.3 The Consultant shall correct at no additional cost to the County any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts in any Deliverables prepared by the Consultant. 2.2.4 The Consultant shall assure that all Deliverables prepared by it hereunder are in accordance with applicable laws, statutes, and that any necessary or appropriate applications for approvals are submitted to federal, state and local governments or agencies in a timely manner so as not to delay the Project. 2.2.5 The Consultant 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. 2.2.6 Any and all employees of the Consultant engaged by the Consultant in the performance of any work or services required of the Consultant under this Agreement, shall be considered employees or agents of the Consultant 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 Consultant. 2.2.7 If activities related to the performance of this agreement require specific licenses, certifications, or related credentials Consultant 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. ARTICLE 3 BASIC SERVICES 3.1 Basic Services 3.1.1 The Consultant shall perform as Basic Services the work and services described herein and as described in Exhibit "Proposal For Ergonomics Services (TED- 2017 - 024)" . ARTICLE 4 DURATION OF SERVICES 4.1 Scheduling of Services 4.1.1 The Consultant shall schedule and perform its activities in a timely manner. 4.1.2 Should the County determine that the Consultant is behind the agreed upon schedule, it may require the Consultant to expedite and accelerate his efforts, including providing Revised 10/17 2 DocuSign Envelope ID: 77AEB69E- 2B0D- 4BF3- AB64- 91 FD11A920E3 additional resources and working overtime, as necessary, to perform his services in accordance with the approved project schedule at no additional cost to the County. 4.1.3 The Commencement Date for the Consultant's Basic Services shall be March 15, 2018. ARTICLE 5 COMPENSATION 5.1 Compensation for Basic Services 5.1.1 Compensation for Basic Services shall include all compensation due the Consultant from the County for all services under this Agreement except for any authorized Reimbursable Expenses which are defined herein. The maximum amount payable for Basic Services is four thousand two hundred eighty -five and .05 Dollars ($4,285.05). Payment for Basic Services shall become due and payable in direct proportion to satisfactory services performed and work accomplished. ARTICLE 6 RESPONSIBILITIES OF THE COUNTY 6.1 Cooperation and Coordination 6.1.1 The County has designated Alisa Cornetto 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 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. 6.1.2 The County shall be solely responsible for determining whether Consultant as satisfactorily completed Tasks. It is agreed that County shall not unreasonably withhold its determination of satisfactory completion of any Task. In the event the amount of an invoice is disputed County may withhold payment until the dispute is resolved by the parties. County may also withhold payment on an invoice until the satisfactory completion of a Task by Consultant. ARTICLE 7 INSURANCE AND INDEMNITY 7.1 General Requirements 7.1.1 Consultant shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, Professional Liability 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.orangecountVnc.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). Consultant shall not commence work until such insurance is in effect and certification thereof has been received by the Owner's Risk Manager. Revised 10/17 3 DocuSign Envelope ID: 77AEB69E- 2B0D- 4BF3- AB64- 91 FD11A920E3 7.2 Indemnity 7.2.1 The Consultant agrees, without limitation, to 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 Consultant 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 Consultant to indemnify the County to the fullest extent permitted under North Carolina law. ARTICLE 8 AMENDMENTS TO THE AGREEMENT 8.1 Changes in Basic Services 8.1.1 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 Consultant. The Consultant shall proceed to perform the Services required by the Amendment only after receiving a fully executed Amendment from the County. ARTICLE 9 TERMINATION 9.1 Termination for Convenience of the County 9.1.1 This Agreement may be terminated without cause by the County and for its convenience upon seven (7) days prior written notice to the Consultant. 9.2 Other Termination 9.2.1 The Consultant 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 Consultant shall give the County seven (7) days' prior written notice of its intent to terminate this Agreement for cause. 9.3 Compensation After Termination 9.3.1 In the event of termination, the Consultant 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 Consultant. 9.3.2 Should this Agreement be terminated, the Consultant 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. 9.4 Waiver 9.4.1 The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Consultant 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 Revised 10/17 4 DocuSign Envelope ID: 77AEB69E- 2B0D- 4BF3- AB64- 91 FD11A920E3 for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. 9.5 Suspension 9.5.1 County may suspend the work at any time for County's convenience and without penalty to County upon three (3) days' notice to Consultant. Upon any suspension by County, Consultant shall discontinue the work and shall not resume the work until notified to proceed by County. ARTICLE 10 ADDITIONAL PROVISIONS 10.1 Relationship of Parties 10.1.1 Consultant is an independent contractor of the County. Neither Consultant nor any employee of the Consultant shall be deemed an officer, employee or agent of the County. Consultant's personnel shall not be employees of, or have any contractual relationship with, the County. 10.2 Limitation and Assignment 10.2.1 The County and the Consultant each bind themselves, their successors, assigns, and legal representatives to the terms of this Agreement. Neither the County nor the Consultant shall assign or transfer its interest in this Agreement without the written consent of the other. 10.3 Governing Law 10.3.1 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. Consultant 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 the definition of breach to discrimination. By executing this Agreement Consultant affirms that Consultant and any subcontractors of Consultant are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. Where applicable, failure to maintain compliance with the requirements of Article 2 of Chapter 64 of the General Statutes constitutes Consultant's breach of this Agreement. By executing this Agreement Consultant affirms Consultant is in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement, Consultant certifies that Consultant has not been identified, and has not utilized the services of any agent or subcontractor, on the Iran divestment list created by the State Treasurer pursuant to G.S. 147- 86.58 and the Israel boycott list created pursuant to G.S. 147 - 86.81. 10.4 Dispute Resolution Revised 10/17 5 DocuSign Envelope ID: 77AEB69E-2BOD-4BF3-AB64-91 FD1 1A920E3 10.4.1 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 and it is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. The Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. Under no circumstances shall any dispute be addressed through binding arbitration. 10.5 Extent of Agreement 10.5.1 This Agreement, together with the Request for Proposals together with attachments distributed by the County and the Consultant's submitted Proposal, all of which constitute the Contract Documents, represents the entire and integrated agreement between the County and the Consultant and supersedes all prior negotiations, representations or agreements, either written or oral. In the event of a conflict among the terms of the Contract Documents, the priority of documents shall be This Agreement, the County's Request for Proposals, attachments to the County's Request for Proposals, the Consultant's Proposal. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. 10.6 Severability 10.6.1 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. 10.7 Ownership of Deliverables 10.7.1 All Deliverables, together with all supporting materials, source documentation, data collected, field notes, and working drafts, developed in the performance of this Agreement shall become the property of the County and may be used on any other project without additional compensation to the Consultant. The use of the Deliverables 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. 10.8 Non - Appropriation 10.8.1 Consultant 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 Consultant 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 Revised 10/17 6 DocuSign Envelope ID: 77AEB69E- 2B0D- 4BF3- AB64- 91 FD11A920E3 authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Consultant of such limitation or change in County's legal authority. 10.9 Notices and Signatures 10.9.1 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. 10.9.2 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: Risk Management P.O. Box 8181 Hillsborough, NC 27278 [SIGNATURE PAGE TO FOLLOW] Revised 10/17 7 Consultant's Name & Address NC Ergonomics Center 3701 Neil Street Raleigh, NC 27607 DocuSign Envelope ID: 77AEB69E-2BOD-4BF3-AB64-91 FD1 1A920E3 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. COUNTY: Orange County DocuSigned by: County 06379946755E477... Revised 10/17 8 CONSULTANT: NC Ergonomics Center �ocu5igned by: Tim McGI 94665960EA2426. -. director Printed Name and Title Envelope ID: 77AEB69E-2B0D-4l3F3-AB64-91 FD1 1A920E3 VIA E -mail: ACornetto @orangecountync.aov November 20, 2017 Ms. Alisa Cornetto Risk Manager Orange County Finance and Administrative Services PO Box 8181 200 South Cameron Street Hillsborough, NC 27278 (919) 245 -2155 Dear Alisa: Thank you for your interest in continuing your partnership with the Ergonomics Center of North Carolina (ECNC). Per your request and based on discussions with Heather White, the proposal contains a summary description of professional services, estimated time and costs. Please note that travel expenses are billed as incurred. This proposal does include 40% pricing discounts per a North Carolina Governament Partnership. Please do not hesitate to contact me once you have had a chance to review or should you have any questions or concerns. On behalf of the ECNC, we look forward to the opportunity of partnering with you! Sincerely, Heather S. White, MIE, CPE Senior Ergonomist The Ergonomics Center of North Carolina DocuSign Envelope ID: 77AEB69E-2BOD-4BF3-AB64-91 FD1 1A920E3 Proposal: Ergonomics Process Development (TEC- 2017 -024) Prepared for ORANGE COUNTY NORTH CAROLINA Orange County Finance and Administrative Services Hillborough, NC November 20, 2017 THE ERG ❑N❑MICSCENTER C7 F N O R T H C A R C7 L I N A www.TheErgonomicsCenter.com DocuSign Envelope ID: 77AEB69E-2BOD-4BF3-AB64-91 FD1 1A920E3 THE ERGONOMICS CENTER OF NORTH CAROLINA NORTH CAROLINA STATE UNIVERSITY SERVICE AGREEMENT November 20, 2017 This Agreement entered into by and between the Ergonomics Center of North Carolina, housed within the North Carolina State University (hereinafter referred to as 'UNIVERSITY'), Raleigh, North Carolina, and Orange County Finance and Administrative Services, with a principal place of business in Hillsborough, NC, hereafter referred to as 'SPONSOR'. The project contemplated by this AGREEMENT is of mutual interest and benefit to the UNIVERSITY and the SPONSOR, and will further the instructional, research, and public service objectives of the UNIVERSITY in a manner consistent, with its status as a public educational institution; and the SPONSOR desires to provide funding in support of the project; the parties hereto agrees follows: (1.) SCOPE OF PROJECT - The UNIVERSITY will use its best efforts to perform activities as described in its proposal entitled: "STATEMENT OF ERGONOMIC SERVICES ", which is attached hereto and hereby made a part of this AGREEMENT, and hereafter referred to as 'PROJECT'. (2.) PERIOD OF PERFORMANCE - The activities of this project shall be conducted within a mutually agreed upon period based upon consultant availability and the scheduling demands of the SPONSOR. No work will begin without a signed agreement and /or purchase order. (This period may be modified by mutual written agreement of the parties hereto.) (3.) PAYMENT OF COSTS - In consideration of the UNIVERSITY'S performance hereunder, SPONSOR agrees to support the UNIVERSITY'S costs incurred conducting the activities of this project, in the amount as summarized in the attached "STATEMENT OF ERGONOMIC SERVICES ". Should the project involve less time and /or materials than proposed, actual hours worked and materials used will be billed. Travel expenses associated with this project are billed as incurred with the exception of meals and mileage. Meals and mileage are billed at State of North Carolina per diem rates as set corresponding with the date of the expense. Current rate schedules and policy details are available through the North Carolina State University Policies, Regulations and Rules website: http: / /www.ncsu.edu /policies /finance /. Unless this AGREEMENT is executed, the pricing is subject to change in sixty (60) days for the AGREEMENT issuance date. The Check should be payable to or the Purchase Order should be sent to NCSU /The Ergonomics Center of North Carolina. The SPONSOR shall make payment in full within 30 days of completion of the project. (4.) SPECIAL TERMS AND CONDITIONS: a. RIGHTS IN DEVELOPMENTS - Subject to the rights of the Federal Government, if any, neither party transfers by operation of this Agreement any intellectual property rights that either party now owns or hereafter acquires in the performance of the work. Should any invention potential arise out of this project, the parties to this agreement will enter into a sponsored research agreement to address that issue. b. LIABILITY - The liability of the UNIVERSITY, as an agency of the State of North Carolina, for bodily injury, property damage, infringement of proprietary rights and patents, and other items are limited by state law. CONSULTING - The UNIVERSITY consultant, and /or the SPONSOR shall not seek a consulting arrangement with each other on the subject of this study during the period covered by this AGREEMENT, according to the Conflict of Interest Policies of the University. d. REPORTS - UNIVERSITY shall deliver to the SPONSOR reports showing the results of the activity performed as described in the attached "STATEMENT OF ERGONOMIC SERVICES ". Submitted by The Ergonomics Center of North Carolina ' 11/20/17 2 DocuSign Envelope ID: 77AEB69E-2BOD-4BF3-AB64-91 FD1 1A920E3 e. PUBLICATIONS - UNIVERSITY shall have the right to publish the results obtained from this project, however, the SPONSOR shall review and edit a draft of the written text to prevent publication of any sponsor -owned proprietary information. f. HAZARDOUS MATERIALS - No Hazardous material is associated with this Project. g. TERMINATION - Performance under this AGREEMENT may be terminated by either party upon thirty (30) days written notice. Upon termination by either party, UNIVERSITY will be reimbursed for all costs and non - cancelable commitments incurred in performance of the project prior to the date of termination in an amount not to exceed the total commitment. h. GOVERNING LAW - This Agreement shall be governed and construed in accordance with the laws of the United States and North Carolina, without regard for conflict of laws provisions. (5.) AGREEMENT CHANGES - All amendments or changes to this AGREEMENT including, changes in the activities of the program, total estimated cost, and period of performance, shall be effective when made in writing and signed by authorized representatives of both parties. Any modification to the agreed upon date of performance (date of training or on -site consultation) requested by the client with less than 15 business days' notice to the date of performance will be subject to a $1,200 penalty fee. The parties hereto have executed this AGREEMENT effective as of the date below. SPONSOR The Ergonomics Center of North Carolina (UNIVERSITY) QocuSigned by: By 17FDCF0176800498 US& (,6Wt.t,{1�6 (Signed) . .. Date 3/24/2018 Name: Alisa Cornetto Title: Risk Manager Orange County Finance and Administrative Services Hillsborough, NC �ocuSigned by: By Tom►. )`?cGP.:.p. (Sign 9407B5960EA2426... Date 3/24/2018 Executive Director The Ergonomics Center of North Carolina Raleigh, NC 27607 Note: Return a copy of the executed AGREEMENT to the ECNC (FAX: 919 - 515 - 8156), or send a purchase order directly. Upon receipt of a signed quote or purchase order, project timing and ECNC resource assignments will be confirmed. Submitted by The Ergonomics Center of North Carolina 11/20/17 L-04-1 DocuSign Envelope ID: 77AEB69E-2BOD-4BF3-AB64-91 FD1 1A920E3 PROPOSAL FOR ERGONOMICS SERVICES (TEC- 2017 -024) Orange County Finance and Administrative Services Hillsborough, NC November 20, 2017 PROPOSAL SUMMARY In an effort to assist Orange County Finance and Administrative Services in effectively managing and executing the ergonomics efforts, a proposal for ergonomic professional services is presented. Should the project involve less time than proposed, actual hours will be billed. A detailed description of professional services followed by a cost breakdown estimate per service is included based upon conversations with Alisa Cornetto. Upon receipt of a signed quote or purchase order, project timing and ECNC resource assignments will be confirmed. DETAILED DESCRIPTION OF ERGONOMICS SERVICES 1. NC Government Partnership NC Government Partnerships are free to participating agencies and municipalities. The benefits are as follows: • Unlimited Center Membership Web Portal access • 40% discount on consulting services • Center workshops (delivered in Raleigh, NC) discounted 40% (unlimited attendees) /I. Develop Customized Ergonomics Program Standard Operating Procedure (SOP) and Program Gap Analysis The development of an Ergonomics Program Standard Operating Procedure (SOP) is specific to the company structure and processes. This document becomes the guiding framework for the implementation process and defines roles, responsibilities, and processes that support the ergonomics program. Such a deliverable would include meeting with the company personnel to gain a more thorough understanding of existing ergonomics, health and safety, engineering, training, and corrective action systems, processes, and protocols in an effort to maximize the integration of ergonomics into existing systems, processes, and tracking metrics. Understanding existing company infrastructure also helps ECNC complete a "gap analysis" on additional improvement opportunities relevant to the newly developed ergonomics program /process. The model drafted would follow the eight (8) major elements of any successful ergonomics process, namely: 1. Musculoskeletal Disorder (MSD) Management 2. Education & Training 3. Program, Compliance & Audits 4. Management Leadership 5. Employee Involvement & Accountability 6. Ergonomics Team(s) 7. Prioritization & Analysis 8. Hazard Reduction & Control In additional to a written policy, deliverables would include a group auditing form to assist with the regular systematic review of the functioning of the ergonomics process within the company infrastructure. Ill. Develop Customized Equipment Standards and Ergonomics Resources Development of equipment standards and employee resource documents should be completed during the final implementation of the SOP. These resources hinge upon the findings of the gap analysis and process defined in the SOP. Time and pricing estimation can be completed after the completion of Part II (listed above), and will be priced based on the Government Partnership Membership hourly rate of $90 /hour. Submitted by The Ergonomics Center of North Carolinas' 11/20/17 4 DocuSign Envelope ID: 77AEB69E- 2B0D- 4BF3- AB64- 91 FD11A920E3 PRICING SUMMARY Single Trip, 2 Days On -Site, Hillsborough, NC Proposal & Fee Structure (INCLUDING GOVERNMENT PARTNERSHIP MEMBERSHIP credit and discounts): Membership: Government Partnership Free Ergonomic Professional Services $ 3,600.00 Customized Ergonomics Program SOP and Gap Analysis 2 -Day Visit and SOP Development: 40 hours @ $90 /hour Travel Time $ 180.00 4 hrs @ $45 / hour Estimated Travel Expenses (travel from Concord, NC) $ 505.05 Includes hotel, mileage, per diem, etc. TOTAL ESTIMA TED FEES $ 4,285.05 Submitted by The Ergonomics Center of North Carolina 11/20/17 DocuSign Envelope ID: 77AEB69E-2B0D-4l3F3-AB64-91 FD1 1A920E3 (A OSFM- NC DEPARTMENT OF INSURANCE RISK MANAGEMENT Tel 919.647.0000 Fax 919.715.0067 MIKE CAUSEY, INSURANCE COMMISSIONER & STATE FIRE MARSHAL BRIAN TAYLOR, ASSISTANT STATE FIRE MARSHAL CERTIFICATE OF COVERAGE Certificate Holder: To Whom It May Concern Insurer: State of North Carolina Authorization: Public Officers & Employee Liability Insurance Commission of North Carolina and the General Statutes of North Carolina, Chapter 143, Articles 31 to 31 D, Sections §143 -291 to §143 -300. Period: July 1, 2017 until June 30, 2018 Coverage: A) Tort Claims against Departments, Agencies, and Employees B) Excess Liability for State Employees Lexington Insurance Company - Policy # 01- 559 -22 -82 C) Workers' Compensation Limits A) $1,000,000 for Tort claims against the State B) $10,000,000 for claims against state employees C) Statutory Limits for Workers' Compensation Description: North Carolina State University and its employees, officers, agents, as covered by the Defense of State Employees as per NCGS § 143 300.2. Administrator: Department Insurance - Risk Management Division Public Officers & Employees Liability Insurance Commission 1202 Mail Service Center, Raleigh, NC 27699 -1202 Note: Verified By: This Certificate is for informational purposes only and does not alter any provision of the Tort Claims or Defense of State Employees General Statutes of the State. Margie Boyd Risk Manager OFFICE OF STATE FIRE MARSHAL NCSU (2017 -18) 1202 MAIL SERVICE CENTER J RALEIGH, NC 27699 -1202 1 WWW.NCDOI.COM /OSFM DocuSign Envelope ID: 77AEB69E-2B0D-4l3F3-AB64-91 FD1 1A920E3 (A OSFM- NC DEPARTMENT OF INSURANCE July 6, 2017 Ms. Sherrie Settle Director of Sponsored Programs Research Administration /SPARCS North Carolina State University Campus Box 7514 Administrative Services Building I Raleigh, NC 27695 -7514 Dear Ms. Settle: RISK MANAGEMENT Tel 919.647.0000 Fax 919.715.0067 MIKE CAUSEY, INSURANCE COMMISSIONER & STATE FIRE MARSHAL BRIAN TAYLOR, ASSISTANT STATE FIRE MARSHAL The purpose of this letter is to provide certification of various insurance coverages for North Carolina State University. Property insurance is provided on a replacement cost basis by the State Property Fire Insurance Fund, a State self- insurance fund. This coverage is provided on a continuous basis and renews on July 1 of each year. We do not use policy numbers. Instead, we refer to the University's department /division number, which is 60005003. In regard to general liability, the State of North Carolina claims sovereign immunity and therefore cannot be sued without its permission. However, by statute (Chapter 143, Article 31), the State has waived its sovereign immunity against suits for negligence of its employees or agents resulting from bodily injury or property damage. The State has waived its immunity up to a limit of $1,000,000 per claim. The North Carolina Industrial Commission is constituted a court for the purpose of hearing and passing upon tort claims against departments, institutions or agencies. Excess liability coverage is provided for State employees, through a private insurance company, for losses resulting in bodily injury and property damage in the performance of their jobs. The limit of liability is $10,000,000 per occurrence. Coverage is provided by AIG policy number 01- 559- 22 -82. The State maintains a boiler and machinery policy written through the Hartford Steam Boiler Inspection and Insurance Company. The renewal date for this policy is January 12 and the limit of coverage is $50,000,000 for each accident with a $5,000 deductible (certain equipment may carry a higher deductible). Automobile liability insurance for state -owned vehicles is provided by Travelers. The bodily injury and property damage limits for this coverage is $1,000,000 per person and $10,000,000 per occurrence. This policy renewal date is July 1. OFFICE OF STATE FIRE MARSHAL 1202 MAIL SERVICE CENTER J RALEIGH, NC 27699 -1202 1 WWW.NCDOI.COM /OSFM DocuSign Envelope ID: 77AEB69E- 2BOD- 4l3F3- AB64- 91 FD11A920E3 Page Two Ms. Sherrie Settle North Carolina State University Public Employee Dishonesty coverage is written through Fidelity and Deposit Company of Maryland with a $1,000,000 limit. The policy renews on January 6. The State of North Carolina is self- insured for the payment of Workers Compensation claims. Sincerely, Bryan Heckle, CIC, CPCU, CRM Director of Risk Management DocuSign Envelope ID: 77AEB69E- 2BOD- 4BF3- AB64- 91 FD11A920E3 IF MAST002 A�OA CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) 06/30/2017 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 919- 828 -4371 NC Assoc. of Ins. Agents, Inc. P. O. Box 1165 CONTACT Barbra M. Abrahams NAMEa PHONE 919 - 828 -4371 FAx 919 - 821 -3172 A/C, No, Ext : AIC, No): E -MAIL babrahams @iianc.com ADDRESSm Cary, NC 27512 Barbra M. Abrahams INSURERS AFFORDING COVERAGE NAIC # INSURERA:Travelers Property 8r Casualty $ INSURED State of North Carolina INSURER B: INSURER C: Attn: Bryan Heckle /NC DOI 1202 Mail Service Center DAMAGE TO RENTED PREMISES Ea occurrence Raleigh, NC 27699 -1202 INSURER D: MED EXP (Any one person) $ 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS Raleigh, NC 27699 -1202 AUTHORIZED REPRESENTATIVE COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- JECT F7 LOC PRODUCTS - COMP /OPAGG $ $ OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ X BODILY INJURY Per person) $ 1,000,000 ANY AUTO TRJCAP104T6800TIL 07/01/2017 07/01/2018 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident INCL ABOVE $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BI /PD PER ACC $ 10,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR /PARTNER/EXECUTIVE ❑ OFFICER /MEMBER EXCLUDED? N/A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A HIRED PHYSICAL TRJCAP449J9525TIL 07/01/2017 07/01/2018 DAMAGE IilCeglY�ySlCal Uama "geLLIrr11LSSAV6V,CCOSTO r °epalydorW IR'Gtrl2dc1tgbddbdnaybQ 7Cf hedifmorespaceisrequired) Uco�vUeUr1agbeUounUlUy exceeds 10,000 Ibs.), whichever is less. Comp /Collision apply for 30 days from the date the rental contract becomes valid. If the value of the vehicle is higher than the Hired Physical Damage Limits and /or days of rental > 30 days than the vehicle must be scheduled in the Auto Web. CERTIFICATE HOLDER CANCELLATION NCDEPTO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NC Dept. Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p Of ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Margie Boyd 1202 Mail Service Center Raleigh, NC 27699 -1202 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) @ 1988 -2015 ACORD CORPORATION. All rights reserved. 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