Loading...
HomeMy WebLinkAbout2018-174-E AMS - National Power WCOB generatorDocuSign Envelope ID: 674796AD -70F3- 4709- B017 -1 E5E84D83DBC [Departmental Use Only] TITLE WCOB Generator 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 14th day of May, 2018, ( "Effective Date ") by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County ") and National Power, (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): repair generator at 131 W Margaret Lane, Hillsborough, NC 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: 674796AD -70F3- 4709- B017 -1 E5E84D83DBC 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, parts and materials to replace oil pan, gasket, bolts, and refill with oil asset 7108, located at 131 W Margaret Lane, Hillsborough, NC, as detailed in provided quote 0000176997. 4. Duration of Services a. Term. The term of this Agreement shall be from May 14, 2018 to June 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: 674796AD -70F3- 4709- B017 -1 E5E84D83DBC 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 May 14, 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 four thousand eight hundred ninety five dollars and ninety five cents Dollars ($4,895.95). 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 (Alan Dorman) 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: 674796AD -70F3- 4709- B017 -1 E5E84D83DBC 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: 674796AD -70F3- 4709- B017 -1 E5E84D83DBC e. 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. c. 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. e. 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: 674796AD -70F3- 4709- B017 -1 E5E84D83DBC 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. Signatures. _ _ 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 11 A and Article 40 of North Carolina General Statute Chapter 66. j. 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: Alan Dorman P.O. Box 8181 Hillsborough, NC 27278 [SIGNATURE PAGE TO FOLLOW] Revised 10/17 6 Provider's Name National Power 4541 Preslyn Drive Raleigh, NC 27616 DocuSign Envelope ID: 674796AD -70F3- 4709- B017 -1 E5E84D83DBC 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: DocuSigned by: By. f76K'Vk �'KALYS� 0637y 994B755E477... CLYu>«Llviaiiagci Revised 10/17 7 PROVIDER: OoeuSigned by: By. 666t& B 31 E 09 EA83CM C 1... Brent Horton, CFO Printed Name and Title DocuSign Envelope ID: 674796AD -70F3- 4709- B017- 1E5E84D83DBC NATIONAL POWER 04/19/18 ORANGE COUNTY AMS 131 WEST MARGARET LANE HILLSBOROUGH, NC 27278 ALAN DORMAN, Re: Quote # 0000176997 National Power Corporation 4541 Presiyn Dr Rateigh NO 27616 Phone: (919) 790 -1672 Fax: (919) 790 -9714 We appreciate the opportunity to present this proposal. If you have any questions regarding our services, please do not hesitate to contact me. Regards, Generator Service Quoted by BRICE DocuSign Envelope ID: 674796AD -70F3- 4709- B017- 1E5E84D83DBC NATIONAL POWER smarter, nonstop power ORANGE COUNTY AMS 131 WEST MARGARET LANE HILLSBOROUGH, NC 27278 Re: Quote # 0000176997 Brandon Rice Service Sales, Rentals & Repairs 919.861.6928 brandon.rice @natpow.com Quote to replace oil pan, gasket, bolts, and refill with oil. Includes normal business hours work, if work needed outside of business hours overtime rates would apply. Item SERVICE LABOR - TAXABLE SERVICE LABOR - TAXABLE OIL PAN OIL PAN GASKET PLUG BOLTS O I LIGAL GENERATOR SERVICE MILEAGE _ TAXABLE Quantitu Cost 1,242.00 828.00 1.00 1,976.97 1.00 276.66 2.00 26.88 38.00 185.44 8.00 160.00 160.00 200.00 Price Estimate Total: $4,895.95 Contract Acceptance Prices are valid for 30 days and based on the equipment and sevice information listed above. Taxes are not included. National Power Corp. Terms and Conditions of Service apply to any order based on this offer and are incorporated by reference herein. A copy of these terms is available at httr):Nnatpow.com /policies or may be obtained from your National Power sales representative. We accept payment by check, VISA, MasterCard, and American Express. Signature: I n Please remit payment to: Name: Date: Phone: Email: PO# U -- '\ l o k1] �J . 0 Igo I2c,� 0I )7LI National Power Corporation 4541 Preslyn Drive Raleigh, NC 27616 w &x - -eA e (g n c_,n � -6 oc. C-,o v --I kO46 DocuSign Envelope ID: 674796AD -70F3- 4709- B017- 1E5E84D83DBC OP ID: AH 14AL7°' LY CERTIFICATE OF LIABILITY INSURANCE 7,T"212712017 E(MMIDDIY 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 he 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 SNIPES INSURANCE SERVICE, INC NAME: Amy_ G. Hartle PO BOX 1165 IMC..No, e,,1:910-892-2121 FAX . No): 910 -892 -5228 DtJNN, NC 28336 _A DBEs: alny @snipesins.com DAL SNIPES PRODUCER rusrnMFR In re NATIO -3 INSURED NATIONAL POWER CORPORATION 4541 PRESLYN DRIVE RALEIGH, NC 27616 CINCINNATI INSURANCE COMPANY 410677 CINCINNATI CASUALTY 128665 COVERAGES CERTIFICATE NUMBER- REVISION NLJMRFR: 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 I TYPE OF INSURANCE AD R SUER POLICY NUMBER MMIDDIYY F hMIDO;YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000. • X COMMERCIAL GENERAL LIABILITY X EPP 039 26 42 07101/2017 07101!2018 PREMISES Ea occurrence $ 100,00 CLAIMS -MADE � OCCUR MED EXP (Anyone person) $ 5,00 PERSONAL&ADV INJURY S 1,000,00 X PER PROJ AGGRE X XCU INCLUDED GENERAL AGGREGATE $ 2,000:00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY PRO- X LOC $ • AUTOMOBILE LIABILITY ANY AUTO x EBA 039 26 42 0710112017 071011201$ COMBINED SINGLE LIMIT (Ea accident} BODILY INJURY (Per person) $ 1,000,000 $ X. ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (PER ACCIDENT) $ X X $ NON -OWNED AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,00 A EXCESS LIAB CLAIMS -MADE EPP 039 26 42 07101/2017 07101/2018 DEDUCTIBLE *FOLLOW F $ X $ RETENTION S 0 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE WC STRTU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ® NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ "yes, describe under "j-SCRIPTION OF OPERATIONS below S E.L. DISEASE • POLICY LIMIT A ERROR & OMISSIONS EPP 039 26 42 07/01/2017 0710112018 OCCIAGGR 1 mm/1 mm A jCargolTransit EPP 039 26 42 07/0112017 0710112018 Any One 130,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES Attach ACORD 101, Additional Remarks Schedule, iF mare s ce is required ORANGE COUNTY IS AN ADDITIONAL INSURED FOR BOTH GENERAL LIABILITY AND AU O LIABILITY AS REQUIRED BY WRITTEN CONTRACT PER CARRIER FORMS GA233 0207 AND AA4171 1105 CFRTIFICATF HOI RFR C:AN('FI I ATION ORANG -1 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 8118 HILLSBOROUGH, NC 27278 AUTHORIZED REPRESENTATIVE 0 1985 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: 674796AD -70F3- 4709- B017- 1E5E84D83DBC ACOPRbr CERTIFICATE OF LIABILITY INSURANCE DATE 1(2/21/17 7 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon Risk Services, Inc of Florida CONTACT Aon Risk Services, Inc of Florida NAME: PHONE FAX A/C, No, Ext : 800 - 743 -8130 A/C, No): 800- 522 -7514 1001 Brickell Bay Drive, Suite #1100 Miami, FL 33131 -4937 EMAIL ADDRESS: ADP.COI.Center@Aon.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: New Hampshire Ins Cc 23841 INSURED ADP TotalSource FL XVI, Inc. INSURER B: INSURER C : $ 10200 Sunset Drive Miami, FL 33173 PERSONAL & ADV INJURY $ L /C /F INSURER D: $ INSURER E: $ National Power Corporation 4541 Preslyn Dr INSURER F: Raleigh, NC 27616 COVERAGES CERTIFICATE NUMBER: 1747663 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. LIMITS SHOWN ARE AS REQUESTED. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD /YYYY LIMITS oa &sk i5e evi "C ''s,, ''2.aa o Rohde COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR EACH OCCURRENCE $ DAMAGE PREM SESOE. olccur ence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY FI PROJECT FI LOC OTHER GENERAL AGGREGATE $ PRODUCTS - COMP /OPAGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Ea aBc deDtSINGLE LIMIT $ BODILY INJURY Per person $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ DEC I I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A X WC 026167977 INC 07/01/17 07/01/18 X PER ISTA TUTE OTH- ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) All worksite employees working for NATIONAL POWER CORPORATION, paid under ADP TOTALSOURCE, INC's payroll, are covered under the above stated policy. WAIVER OF SUBROGATION IN FAVOR OF CERTIFICATE HOLDER AS RESPECTS OF JOB PERFORMED BY NATIONAL POWER CORPORATION AS REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 8118 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hillsborough, NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE oa &sk i5e evi "C ''s,, ''2.aa o Rohde © 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD