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HomeMy WebLinkAbout2020-160-E AMS - National Power generators DocuSign Envelope ID:81A8F7FF-A308-48A7-BD11-B27A2662836B nn°5 [Departmental Use Only] TITLE REPLACE GEN BAT FY 2020 ORANGE COUNTY CONTRACT UNDER$5,000.00 NORTH CAROLINA THIS AGREEMENT,made and entered into this 2nd day of February,2020, ("Effective Date")by and between Orange County, North Carolina, a body politic and corporate organized under the laws of the State of North Carolina, (the "County"), party of the first part; and National Power Corporation (the "Provider"),party of the second part; WITNESSETH: For the purpose and subject to the terms and conditions hereinafter set forth, the County hereby contracts for the services of the Provider, and the Provider agrees to provide the following services to the County in accordance with the terms of this Agreement,time being of the essence: The services and/or materials and/or construction (hereinafter referred to collectively as "Services") to be furnished under this Agreement are as follows: Replace generator batteries at RENA Community Center, EMS 510 Meadowlands Drive, Orange County Jail 125 Court Street, Southern 2501 Homestead Rd, Whitted 300 West Tryon St,Cedar Grove Community Center The term of this agreement rendered shall be from 02/02/2020 to 04/02/2020. Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions, 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. Provider agrees that Provider shall not sub-contract any of the services to be provided in this Agreement, nor shall Provider assign any right or responsibility granted or required by this Agreement,without the prior written approval of the County. SPECIFIC TERMS I. Payment: The County agrees to pay at the rates specified for Services satisfactorily (as determined by the County) performed in accord with this Agreement. The amount to be paid by the County shall not exceed Two Thousand Six Hundred and Thirty One Dollars and Ten Cent, ($2631.10). Payment shall be made within thirty (30) days of an invoice properly submitted to County. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. 2. Non—waiver: Failure by County at any time to require the performance by Provider of any of the provisions hereof shall in no way waive or affect the County's right hereunder to enforce the same,nor shall any waiver by the County of any breach be held to be a waiver of any succeeding breach or a waiver of this Non-Waiver Clause. 3. Independent Contractor: The Provider shall operate as an independent contractor, and the County shall not be responsible for any of the Provider's acts or omissions. The Provider shall not be treated as an employee with respect to the Services performed hereunder for federal or state tax, unemployment or workers' compensation purposes. The Provider understands that neither federal, nor state, nor payroll tax of any kind shall be withheld or paid by the County on behalf of the Provider or the employees of the Provider. 4. Insurance: Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may Revised 11/19 1 DocuSign Envelope ID:81A8F7FF-A308-48A7-BD11-B27A2662836B 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 be designated here NA (if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 5. Indemni : To the extent authorized by North Carolina law the Provider agrees, without limitation, to defend, indemnify, and hold harmless Orange County from all losses, liabilities, claims, demands, suits, costs, damages or expenses (including reasonable attorney's fees) arising from bodily injury, including death, to any person or persons or damage to or destruction of any property caused in whole or in part by any negligent or intentional act or omission on the part of the Provider in carrying out Provider's duties and obligations related to the Services to be provided in this Agreement. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 6. Termination: This Agreement may be terminated at any time by mutual written agreement of the parties or by the County upon written notice to the Provider. County may suspend this Agreement upon reasonable notice to Provider. 7. Entire Agreement and Signatures: The parties have read this Agreement and agree to be bound by all of its terms, and further agree that it constitutes the complete and exclusive statement of the Agreement between the parties unless and until modified in writing and signed by the parties. Modifications may be evidenced by telefacsimile signature. 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. 8. Governing Law and Priority: Both parties agree that this Agreement shall be governed by the laws of the State of North Carolina and Orange County. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal anti-discrimination laws, policies, rules, and regulations and the Orange County Non- Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.oran etync. og v/departments/purchasing division/contracts.php.). Any violation of this requirement is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. By executing this Agreement Provider 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. By executing this Agreement Provider affirms Provider is and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. In determining the basic services to be provided, should any documents be referenced in or attached to this Agreement, the terms herein shall have priority in any conflict between the terms of referenced documents and the terms of this Agreement. 9. Dispute Resolution: Neither party may initiate binding arbitration. Any disputes shall be resolved by nonbinding mediation. If such mediation fails either party may initiate litigation to resolve the dispute. Should either party initiate litigation to settle any dispute involving the terms of this Agreement Revised 11/19 2 DocuSign Envelope ID:81A8F7FF-A308-48A7-BD11-B27A2662836B such litigation shall be initiated in the General Court of Justice of North Carolina seated in Orange County, North Carolina. 10. 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. IN WITNESS WHEREOF, Orange County and the Provider have signed this Agreement, effective as of the day first written above. ORANGE COUNTY PROVIDER D Signed by: DocuSigned by: O 2c9 6681844C5... rector Cf656E4MEDU44CC... 200 S. Cameron St. Brandon Rice P.O. Box 8181 National Power Corporation Hillsborough,NC 27278 4541 Preslyn Dr. Raleigh,NC 27616 Revised 11/19 3 DocuSign Envelope ID:81A8F7FF-A308-48A7-BD11-B27A2662836B Brandon Rice NATIONAL Service Safes,Rentals&Repairs f_. POWER 919,861.6928 Smarter, nonstop power brand on.rlce o@natpow,com RENA COMMUNITY CENTER 101 EDGAR STREET CHAPEL HILL, NC 27516 Re:Quote#0000208033 Quote to replace generator battery.Work to be performed during next PM visit. If work is requested at another time other than the next PM additional labor and trip charges will apply. Item uant!t Cost SERVICE LABOR-TAXABLE 77.63 BATTERY GRP 31 1.00 185,00 Price Estimate Total: $262.63 i V 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 http://natpow.comlpplicies or may be obtained from your National Power sales representative. We accept payment by check,VISA.MasterCard,and American Express. Signature: Please remit payment to: National Power Corporation Name: 4641 Preslyn Drive Raleigh, NC 27616 Date: Phone: Email: PO# f r U z V3Z L s'-�p0av DocuSign Envelope ID:81A8F7FF-A308-48A7-BD11-B27A2662836B Brandon Rice NATIONAL Service Sales,Rentals&Repairs POWER 919.861.6928 Smarter, nonstop power brandon.rioe@natpow.com ' ORANGE COUNTYAMS 510 MEADOWLANDS DRIVE HILLSBOROUGH, NC 27278 Re:Quote#0000208031 Quote to replace generator battery. Work to be performed during next PM visit. If work is requested at another time other than the next PM additional labor and trip charges will apply. Item Quantity Cost SERVICE LABOR-TAXABLE 77.63 BATTERY GRP 31 1.00 185.00 Price Estimate Total: $262.63 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 http://natpow.com/policies or may be obtained from your National Power sales representative. We accept payment by check,VISA, MasterCard,and American Express. Signature: Please remit payment to: National Power Corporation Name: 4541 Preslyn Drive Raleigh,NC 27616 Date: Phone: Email: PO# I'. I. I I ]�-btioszo^ 570a DocuSign Envelope ID:81A8F7FF-A308-48A7-BD11-B27A2662836B Brandon Rice NATIONAL Service Sales,Rentals&Repairs 40: POWER 919.861.6928 Smarter,nonstop power bra ndon.rice a@natpow.com ORANGE COUNTY AMS 125 COURT STREET HILLSBOROUGH, NO 27278 Re: Quote#0000208025 Quote to replace generator battery.Work to be performed during next PM visit. If work is requested at another time other than the next PM additional labor and trip charges will apply. Item Quantity Cost SERVICE LABOR-TAXABLE 77.63 BATTERY GRP 31 1.00 185.00 Price Estimate Total: $262.63 Contract Acceptance Prices are valid far 30 days and based on the equipment and sevice information fisted 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 http://natpow.com/policies or may be obtained from your National Power sales representative, We accept payment by check,VISA, MasterCard,and American Express. Signature: Please remit payment to: National Power Corporation Name: 4541 Preslyn Drive Raleigh,NO 27616 Cate: Phone: Email: PO# to 0 DocuSign Envelope ID:81A8F7FF-A308-48A7-BD11-B27A2662836B Brandon Rice NATIONAL Service Sales,Rentals&Repairs POWER 919.861.6928 Smarter, nonstop power brandon,rice@natpow.com ORANGE COUNTYAMS 2501 HOMESTEAD RD CHAPEL HILL, NC 27516 Re:Quote#0000208037 Quote to replace block heater, heater hose,and refill coolant. Includes normal business hours work, if work needed outside of business hours overtime rates would apply. Item Quantity Cost SERVICE LABOR-TAXABLE 362.25 TRUCK FEE-TAXABLE 115.00 BLOCK HEATER 1.00 380.95 HEATER HOSES 314" 5.00 100.00 COOLANT/GAL 4.00 88.00 SHIPPING AND HANDLING 1.00 35.00 Price Estimate Total: $1,081.20 Contract Acce tanee 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 avai(able at httr)://natpow.com/policies or may be obtained from your National Power sales representative. We accept payment by check,VISA,MasterCard,and American Express. Signature: Please remit payment to: National Power Corporation Name: 4541 Preslyn Drive Raleigh, NC 27616 Date: Phone: Email: PO# DocuSign Envelope ID:81A8F7FF-A308-48A7-BD11-B27A2662836B Brandon Rice NATIONAL Service Sales, Rentals&Repairs POWER 919.861.6928 .................._... Smarter, nonstop power brandon.rice@natpow,com ORANGE COUNTYAMS 300 WEST"TRYON ST HIL.LSBOR000H, NC 27278 Re:Quote#0000208029 Quot6 to replace generator batteries. Work to be performed during next PM visit. If work is requested at another time other than the next PM additional labor and trip charges will apply. Item Quantity Cost SERVICE LABOR-TAXABLE 129,38 BATTERY GRP 31 2.00 370.00 Price Estimate Total: $499.38 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 http://natr)ow.comlpolicies or may be obtained from your National Power sales representative. We accept payment by check,VISA, MasterCard,and American Express. Signature: Please remit payment to: National Power Corporation Name: 4541 Preslyn Drive Raleigh, NC 27616 Date: Phone: Email: PO# 10'?,cje3Za — r7°cry DocuSign Envelope ID:81A8F7FF-A308-48A7-BD11-B27A2662836B Brandon Rice NATIONAL Service Sales,Rentals&Repairs POWER 919.861.6928 Smarter, nonstop power brandon.rice@natpow.com CEDAR GROVE COMMUNITY CENTER 5860 HWY 86N HILLSBOROUGH, NC 27278 Re:Quote#0000208035 Quote to replace generator battery. Work to be performed during next PM visit. If work is requested at another time other than the next PM additional labor and trip charges will apply. Item Quantity Cost SERVICE LABOR-TAXABLE 77.63 BATTERY GRP 31 1.00 185.00 Price Estimate Total: $262.63 Contract Accentance Prices are valid for 30 days and based on the equipment and sevice information listed above. Taxes are not included. Nationai 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 http://natpow.comlpolicies or may be obtained from your National Power sales representative. We acoept payment by check,VISA, MasterCard,and American Express. Signature: Please remit payment to: National Power Corporation Name: 4541 Preslyn Drive Raleigh, NC 27616 Date: Phone: Email: PO# l E DocuSign Envelope ID:81 A8F7FF-A308-48A7-BD1 1-B27A2662836B DEAPR-PARKS FACILITY MAINTENANCE CHECK LIST-BLACKWOOD FARM PARK Description: Monthly Facility Check Date Scheduled: 2/24/2020 Status: open: ❑ Completed: ® Requested By: Scheduled Monthly Inspector: Keith Barnhardt Asset ID: 4215 NC 86 S Date Completed: 2/24/2020 Asset Description: Blackwood Farm Task ID: FEXT-012565 - Task Desc: Mth-Fire Ext-Construction Trailer On Wall Details: Tag Date OK: Yes: ® No: ❑ Pressure OK Per Guage: Yes: M No: ❑ Any Damage: Yes: ❑ No: ® Repairs needed: ' Task ID: FEXT-012566 Task Desc: Mth-Fire Ext-House Main Floor Kitchen ' Details: Tag Date OK: Yes: ❑ No: ❑ Pressure OK Per Guage: Yes: ❑ No: ❑ Any Damage: Yes: ❑ No: ❑ Repairs needed: Office Building Not Used Since 11/2018 Task ID: FEXT-012567 Task Desc: Mth-Fire Ext-House Upstairs Hallway Details: Tag Date OK: Yes: ❑ No: ❑ Pressure OK Per Guage: Yes: ❑ No: ❑ Any Damage: Yes: ❑ No: ❑ Repairs needed: Office Building Not Used Since 11/2018 Task ID: FF-XT-012568 Task Desc: Mth-Fire Ext-Barn Details: Tag OK: Yes: ® No: ❑ Pressure OK Per Guage: Yes: ® Na: ❑ Any Damage: Yes: ❑ No: M Repairs needed: Click here to enter text. 1 Task ID: REST-012569 Task Desc: Mth-House Restrm-Upstairs r Details: Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ❑ No: ❑ i Repairs needed: Office Building Not Used Since 11/2018 Task ID: REST-012570 Task Desc: Mth-House Restrm-Main Floor I' I Details: Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ❑ No: ❑ Repairs needed: Office Building Not Used Since 11/2018 , Task ID: HWH-012571 Task Desc: Mth-Hot Water Heater-House Kitchen Annex Details: Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ❑ No: ❑ i Leaks Detected: Yes: ❑ No: ❑ Service Needed: Yes: ❑ No: ❑ DocuSign Envelope ID:81 A8F7FF-A308-48A7-BD1 1-B27A2662836B DEAPR-PARKS FACILITY MAINTENANCE CHECK LIST-SOCCER.COM Description: Monthly Facility Check Date Scheduled: 2/24/2020 Status: Open: ❑ Completed: ® Requested By: Scheduled Monthly Inspector: Patrick Nelson Asset ID: 4701 West Ten Road Date Completed: 2/24/2020 Asset Description: Soccer.com Center Task ID: ELGHT-012580 Task Desc: Mth-Emergency Lights-Right and Left-Men's Restroom Details: Emergency Light Function: Yes: N No: ❑ Repairs needed: Click here to enter text. Task ID: ELGHT-012581 Task Desc: Mth-Emergency Lights-Right and Left-Women's Restroom Details: Emergency Light Function: Yes: N No: ❑ Repairs needed: Click here to enter text. Task ID: ELGHT-012582 Task Desc: Mth-Emergency Lights-Right and Left-Team Room Details: Emergency Light Function: Yes: N No: ❑ Repairs needed: Click here to enter text. Task ID: ELGHT-012583 Task Desc: Mth-Emergency Lights-Right and Left-Concession Stand Details: Emergency Light Function: Yes: N No: ❑ Repairs needed: Click here to enter text. Task ID: FEXT-012584 Task Desc: Mth-Fire Ext-Concession Stand Details: Tag Date CK: Yes: N No: ❑ Pressure OK Per Guage: Yes: N No: ❑ Any Damage: Yes: ❑ No: N Repairs needed: Click here to enter text. Task ID: FEXT-012585 Task Desc: Mth-Fire Ext-Men's Restroom Details: Tag Date OK: Yes: N No: ❑ Pressure OK Per Guage: Yes: N No: ❑ Any Damage: Yes: ❑ No: N Repairs needed: Click here to enter text. Task ID: FEXT-012586 Task Desc: Mth-Fire Ext-Women's Restroom Details: Tag Date OK: Yes: ® No: ❑ Pressure OK Per Guage: Yes: N No: ❑ Any Damage: Yes: ❑ No: N Repairs needed: Click here to enter text. Task ID: FEXT-012587 Task Desc: Mth-Fire Ext-Shop Details: Tag Date OK: Yes: N No: ❑ Pressure OK Per Guage: Yes: N No: ❑ Any Damage: Yes: ❑ No: ® Repairs needed: Click here to enter text. DocuSign Envelope ID:81 A8F7FF-A308-48A7-BD1 1-B27A2662836B Task ID: FEXT-012588 Task Desc: Mth-Fire Ext-Shop Details: Tag Date OK: Yes: ® No: ❑ Pressure OK Per Guage: Yes: ® No: ❑ Any Damage: Yes: ❑ No: ® Repairs needed: Click here to enter text. Task ID: FEXT-012589 Task Desc: Mth-Fire Ext-Mechanical Room Details: Tag Date OK: Yes: ® No: ❑ Pressure OK Per Guage: Yes: M No: ❑ Any Damage: Yes: ❑ No: ® Repairs needed: Click here to enter text. Task ID: REST-012590 Task Desc: Mth-Restrm-Men's Details: Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ® No: ❑ Repairs needed: Click here to enter text. Task ID: REST-012591 Task Desc: Mth-Restrm-Women's Details: Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ® No: ❑ Repairs needed: Click here to enter text. Task ID: EWSH-012592 Task Desc: Mth-Eyewash and Shower Station-Shop Details: Perform Visual Inspection of Water Flow at Eyewash Heads: Yes: ® No: ❑ Perform Visual Inspection of Water Flow at Shower Head: Yes: ® No: ❑ Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ® No: ❑ Repairs needed: Click here to enter text. Task ID: HWH-012593 Task Desc: Mth-Not Water Heater-Plumbing Chase Room I Details: Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ® No: ❑ Leaks Detected: Yes: ❑ No: ® Service Needed: Yes: ❑ No: Repairs needed: Click here to enter text. , Task ID:ELGHT-012594 Task Desc: Mth-Emergency Lights-Right and Left-Mechanical Room Details: Emergency Light Function: Yes: ® No: ❑ Repairs needed: Click here to enter text. P F DocuSign Envelope ID:81 A8F7FF-A308-48A7-BD1 1-B27A2662836B DEAPR-PARKS FACILITY MAINTENANCE CHECK LIST-PARKS OPERATIONS BASE u i Description: Monthly Facility Check Date Scheduled: 2/1/2020 Status: Open: ❑ Completed: ® Requested By: Scheduled Monthly Inspector: David Golombisky Asset ID: 6823 Millhouse Road Date Completed: 2/20/2020 Asset Description: Parks Operations Base Task ID: EX-Sign-012552 Task Desc: Mth-Exit Signs-Office Front Door Details: Test Battery: Yes: ❑ No: ❑ Sign Working: Yes: ❑ No: ❑ Repairs needed: Yes: ❑ No: ❑ Office Building Not Used Since 11/2018 Task ID: ELGHT-012553 Task Desc: Mth-Exit Signs-Office Back Door Details: Test Batter Yes: ❑ No: ❑ Sign Working: Yes: ❑ No: ❑ y• � Repairs needed: Yes: ❑ No: ❑ Office Building Not Used Since 11/2018 Task ID: FEXT-012554 Task Desc: Mth-Fire Ext-Office Main Floor Hallway at Restroom Details: Tag Date OK: Yes: ❑ No: ❑ Pressure OK Per Guage: Yes: ❑ No: ❑ Any Damage: Yes: ❑ No: ❑ Repairs needed: Office Building Not Used Since 11/2018 Task ID: FEXT-012555 Task Desc: Mth-Fire Ext-Office Main Floor Back Door Details: Tag Date OK: Yes: ❑ No: ❑ Pressure OK Per Guage: Yes: ❑ No: ❑ Any Damage: Yes: ❑ No: ❑ Repairs needed: Office Building Not Used Since 11/2019 Task ID: FEXT-012555 Task Desc: Mth-Fire Ext-Shop Wall Beside Entry Door Details: Tag Date OK: Yes: M No: ❑ Pressure OK Per Guage: Yes: ® No: ❑ Any Damage: Yes: ❑ No: ® Repairs needed: None Task ID: FEXT-012557 Task Desc: Mth-Fire Ext-Shop Wall Beside Second Bay Door Details: Tag Date OK: Yes: ® No: ❑ Pressure OK Per Guage: Yes: M No: ❑ Any Damage: Yes: ❑ No: ® Repairs needed: None Task ID: REST-0125558 Task Desc: Mth-Restroom-Office-Upstairs Details: Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ❑ No: ❑ Repairs needed: Office Building Not Used Since 11/2018 l i DocuSign Envelope ID:81 A8F7FF-A308-48A7-BD1 1-B27A2662836B kl 3 Task ID: REST-012559 Task Desc: Mth-Restroom-Office-Main Floor Details: Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ❑ No: ❑ Repairs needed: Office Building Not Used Since 11/2078 Task ID: EWSH-012560 Task Desc: Mth-Eyewash Station-Shop Between Bay Doors-Interior Details: Perform Visual Inspection of Water Flow at Eyewash Heads: Yes: ® No: ❑ Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ® No: ❑ Repairs needed: None Task ID: ESWR-012561 Task Desc: Mth-Shower Station-Shop Between Bay Doors-Exterior Details: Perform Visual Inspection of Water Flow at Shower Head: Yes: ® No: ❑ Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: M No: ❑ Repairs needed: None Task ID: HWH-012562 Task Desc: Mth-Hat Water Heater-Office Basement Details: Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: ❑ No: ❑ Leaks Detected: Yes: ❑ No: ❑ Service Needed: Yes: ❑ No: ❑ Repairs needed: Office Building Not Used Since 11/2018 Task ID: FEXT-012563 Task Desc: Mth-Fire Ext-Construction Trailer Wall By First Door Details: Tag Date OK: Yes: ® No: ❑ Pressure OK Per Guage: Yes: ® No: ❑ Any Damage: Yes: ❑ No: ® Repairs needed: None p l V DocuSign Envelope ID:81 A8F7FF-A308-48A7-BD1 1-B27A2662836B DEAPR-PARKS FACILITY MAINTENANCE CHECK LIST-CEDAR GROVE SHOP AND PICNIC AREAS (Monthly Inspection Does Not include Community Center) Description: Monthly Facility Check Date Scheduled: 2/24/2020 Status: Open: ❑ Completed: ® Requested By: Scheduled Monthly Inspector: R.R. Asset ID: 5800 NC 86 N Date Completed: 2/24/2020 Asset Description: Cedar Grove Park Task ID: FEXT-012573 Task Desc: Mth-Fire Ext-Shop Inside Near Entry Door Details: Tag Date OK: Yes: ® No: ❑ Pressure OK Per Guage: Yes: ® No: ❑ Any Damage: Yes: ❑ No: N Repairs needed: Click here to enter text. Task ID: Rest-012574 Task Desc: Mth-Picnic Shelter Men's Restroom Details: Perform Visual Inspection of Plumbing Fixtures/Valves Yes: N No: ❑ Repairs needed: Click here to enter text. Task ID: Rest-GM75 Task Desc: Mth-Picnic Shelter Women's Restroom Details: Perform Visual Inspection of Plumbing Fixtures/Valves Yes: M No: ❑ Repairs needed: Click here to enter text. Task ID: EWSH-012576 Task Desc: Mth-Eyewash and Shower Station-Shop Details: Perform Visual Inspection of Water Flow at Eyewash Heads: Yes: N No: ❑ Perform Visual Inspection of Water Flow at Shower Head: Yes: N No: ❑ Perform Visual Inspection of Plumbing Fixtures/Valves: Yes: N No: ❑ Repairs needed: Click here to enter text. i l l i ti N k H DocuSign Envelope ID:81 A8F7FF-A308-48A7-BD1 1-B27A2662836B NATIO-3 �►co�ros CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) ` 07/01/2019 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 endorsements. PRODUCER 910-892-2121 NAME CT Amy M. Hartley SNIPES INSURANCE SERVICE, INC PHONE 910-892-2121 FAX 910-892-5228 PO BOX 1166 (A/C,No,Ext): (A/C,No DUNN, NC 28335 E-MAIL amy@snipesins.com ADDRESS: DAL SNIPES INSURERS AFFORDING COVERAGE NAIC# INSURER A:CINCINNATI INSURANCE CO 10677 INSURED National Power, LLC & NatPow INSURER B: Holdings, LLC & National Power Corporation INSURER C: 4641 PRESLYN DRIVE INSURERD: RALEIGH,NC 27616 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR EPP 039 26 42 07/01/2019 07/01/2020 DAMAGE TO RENTED 50 000 Y PREMISES Ea occurrence $ X Per Proj Aggre 5,000 MED EXP(Anyone person) $ X XCU Included PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY P - L-!!%Lj JJECT 171 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO Y EBA 0392642 07/01/2019 07/01/2020 BODILY INJURY Perperson) $ OWNED SCHEDULED X AUTOS ONLY X AUTOS BODILY INJURY Per accident $ X HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ A X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LAB CLAIMS-MADE EPP 039 26 42 07/01/2019 07/01/2020 AGGREGATE $ 5,000,000 DED X RETENTION$ 0 *follow F $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A E&O =EPP 92642 07/01/2019 07/01/2020 Occ/Aggre 1mm/lmm A Cargo/Transit 9 26 42 07/01/2019 07/01/2020 Any One 130,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ORANGE COUNTY IS AN ADDITIONAL INSURED FOR BOTH GENERAL LIABILITY AND AUTO LIABILITY AS REQUIRED BY WRITTEN CONTRACT PER CARRIER FORMS GA233 0207 AND AA4171 1105 CERTIFICATE HOLDER CANCELLATION ORANG-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ORANGE COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 8181 HILLSBOROUGH, NC 27278 AUTHORIZED REPRESENTATIVE aloll� ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD