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HomeMy WebLinkAbout2021-278-AMS-Bar Roofing and Maintenance-Construction Contract Allowance ReconcilationRevised 07/20 ORANGE COUNTY CHANGE ORDER REQUEST NORTH CAROLINA ______________________________________________________________________________________________________________ Date: May 15, 2021 Project: Orange County Sportsplex Roof Replacement Change Order No. 1 Department: AMS/Sportsplex Department Address: 300 West Tryon Street / 101 Meadowlands Drive, Hillsborough NC 27278 Project: Orange County Sportsplex Roof Replacement (54540030 880000) Contractor: Bar Roofing and Maintenance Contractor Address: 2237 Bethel Church Road, Kernersville, NC 27284 Effective date of original contract: December 28, 2020 This change order increases decreases the contract time by days. Check here if no impact to contract time . Will this change order impact the date of substantial completion? Yes No. If yes, the amended date of substantial completion is: _______________________________________________________________________________________________________________ Full Description of Change: Construction Contract Allowance Reconcilation. Reason for Change: Reconcile construction allowances see attachment A Change Order Request Tracking log. _______________________________________________________________________________________________________________ Original contract sum: $ 429,050.00 Contract sum prior to this change order: $ 429,050.00 Amount of this change order: $ -17,863.25 Total sum of the contract including this change order: $ 411,186.75 _______________________________________________________________________________________________________________ This change order is executed to amend the contract time or contract sum. It shall not be construed to impact the original contract, project, services, or work in any other manner. All other terms of the Original Contract remain in effect. Approved and executed this 15th day of May, 2021. _______________________________ _____________________________ _____________________________ Contractor Owner Architect (when retained) By:____________________________ By:___________________________ By:___________________________ DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 5/7/2021 Principal Engineer, Atlas Engineering 5/10/2021 Owner 5/18/2021 County Manager Revised 07/20 DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 Revised 07/20 ORANGE COUNTY—DEPARTMENT USE ONLY _____________________________________________________________________________________________________ Party/Vendor Name: Bar Roofing and Maintenance Party/Vendor Contact Person: Nathan Darrah (nathan.barrfg@gmail.com) Contact Phone: 336.782.7108 Party/Vendor Address: 2237 Bethel Church Road City Kernersville State: NC Zip: 27284 Department: AMS/Sportsplex Amount: Credit of -$17,863.25 Purpose: Construction Contract Allowance Reco ncilation Budget Code(s): 54540030 880000 Vendor # 66791 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date Approved by Board Yes No Agenda Date: This agreement is approved as to technical form and content and I as Department Director affi rmatively state work on this project has not been initiated prior to execution of the agreement: Department Director’s Signature ________________________________________ Date: ________ Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: N/A Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 5/10/2021 5/10/2021 5/17/2021 5/17/2021 Orange County Sportsplex Roof Replacement Change Order Request Tracking COR #Scope Cost Atlas Review Comments Status 1 Add for 106 Sq.Ft. tapered ISO at NW corner of roof against wall $660.00 Atlas Approves Approved by Orange County, to be incorporated into Change Order 1 2-R1 Deduct for missing HD ISO over crickets & saddles: Revision R1 was submitted to include the 5% OH/P. $(666.75)Atlas Approves Approved by Orange County, to be incorporated into Change Order 1 3 Use of Unit Rates: Metal Deck Replacement, 10’x5’; Metal Deck Restoration, 20’x20’; 5/8” Gypsum Replacement, 450 sqft $2,387.50 COR pricing matches updated Unit Pricing provided by BAR Roofing on Oct. 29, 2020 Withdrawn by BAR Roofing. Quantities of Unit Rate work approved and incorporated in to Allowance Reconciliation in COR 6 4 Deduct for damaged ice skates from leak $(1,550.00)Atlas Approves, matches pricing provided by O.C. for skates Withdrawn by BAR Roofing. BAR Roofing to pay OC Sportsplex directly, Sportsplex to invoice BAR Roofing & provide skates 5 Use of Unit Rates: Metal Deck Restoration, 25sqft; 5/8" Gypsum Replacement, 210 sqft $402.50 COR pricing matches updated Unit Pricing provided by BAR Roofing on Oct. 29, 2020 Withdrawn by BAR Roofing. Quantities of Unit Rate work approved and incorporated in to Allowance Reconciliation in COR 6 6 Allowance Item Reconciliation $(17,856.50) Atlas Approves. Allowance Quantities listed matches documented quantities used. COR pricing matches updated Unit Pricing provided by BAR Roofing on Oct. 29, 2020 Final COR to be incorporated into Change Order 1 Original Contract Sum:$429,050.00 Change Order 1:$(17,863.25)(Total of COR's 1, 2-R1, & 6) Final Contract Sum:$411,186.75 DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 Orange County Sportsplex Roof Replacement Allowance Tracking Bid Allowance Allowance Used To-Date Allowance Returned in COR 6 Allowance Quantities Used #Item Unit Unit Cost from COR 3 from COR 5 COR 6 Qty Cost Qty Cost Qty Cost Qty Cost Qty Cost Qty Cost 1 Metal Deck Restoration sq.ft.$3.50 1,000 $3,500.00 425 $1,487.50 575 $2,012.50 400 $1,400.00 25 $87.50 2 Metal Deck Replacement sq.ft.$6.25 50 $312.50 50 $312.50 -$-50 $312.50 0 3 Metal Deck Repair sq.ft.$6.00 100 $600.00 -$-100 $600.00 0 0 4 Wood Blocking Replacement bd.ft.$3.75 200 $750.00 -$-200 $750.00 0 0 5 Plywood Replacement sq.ft.$4.75 600 $2,850.00 -$-600 $2,850.00 0 0 6 5/8" Gypsum Board Replacementsq.ft.$1.50 1,000 $1,500.00 660 $990.00 340 $510.00 450 $675.00 210 $315.00 7 Additional Walk Tread ln.ft.$8.00 500 $4,000.00 -$-500 $4,000.00 0 0 8 Rubber Paver ea.$33.00 100 $3,300.00 2 $66.00 98 $3,234.00 0 0 2 $66.00 9 Tapered Insulation bd.ft.$1.30 3,000 $3,900.00 -$-3,000 $3,900.00 0 0 Total:$20,712.50 Total:$2,856.00 Total:$17,856.50 COR 3 $2,387.50 COR 5 $402.50 COR 6 $66.00 DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 BAR Roofing & Maintenance / 1313 S. Park Dr., Kernersville, NC 27284 / P: 336.391.1670 CHANGE ORDER PROPOSAL PROJECT NAME: ORANGE COUNTY SPORTSPLEX PROJECT ADDRESS: 101 MEADOWLANDS DR, HILLSBOROUGH, NC 27278 CHANGE ORDER #: 1 RE: ADD TAPERED CRICKET TO: ATLAS ENGINEERING ATTN: ROB TATUM This Change Order Proposal is to reflect the change in cost, associated with the additional labor, material, equipment, etc. needed to complete the scope below. DETAILED SCOPE ADJUSTMENT:  Provide and install, approx. 106 sqft of tapered ISO to promote positive drainage out of the area. ½” per foot tapered ISO will be utilized in this area to keep water from ponding.  Please see the attached roof plan for size and location of the proposed cricket. CHANGE ORDER COST BREAKDOWN: ½” per foot tapered ISO cricket…………………………………………………………..$ 450.00 (1/2” per foot tapered ISO, 2” ISO fill, adhesive, ISO tapered edge strip, freight) Labor to install the new cricket…………………………………………………………...$ 150.00 Overhead & Profit at 10%...................................................................................................$ 60.00 CHANGE ORDER TOTAL…………………………………...$ 660.00 Signature of Acceptance: DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 BAR Roofing & Maintenance / 1313 S. Park Dr., Kernersville, NC 27284 / P: 336.391.1670 CHANGE ORDER PROPOSAL PROJECT NAME: ORANGE COUNTY SPORTSPLEX PROJECT ADDRESS: 101 MEADOWLANDS DR, HILLSBOROUGH, NC 27278 CHANGE ORDER #: 2 RE: DELETION OF ½” HD ISO OVER CRICKETS TO: ATLAS ENGINEERING ATTN: ROB TATUM This Deductive Change Order Proposal is to reflect the change in cost, associated with the labor, material, equipment, etc. no longer needed to complete the scope below. DETAILED SCOPE ADJUSTMENT:  Although it was purchased and delivered to the sight, the installation of the ½” HD ISO over the crickets/saddles, was not completed in the field. This deductive change order includes approx. 885 sqft of materials and labor not used to install the HD ISO. CHANGE ORDER COST BREAKDOWN: ½” HD ISO……………………………………………………………………………… - $ 354.00 Polyset Board-Max…………...…………………………………………………………. - $ 177.00 Labor…………………….................................................................................................. - $ 104.00 5% OH/P………………………………………………………………………………… - $ 31.75 CHANGE ORDER TOTAL…………………………………. - $ 666.75 Signature of Acceptance: DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 BAR Roofing & Maintenance / 1313 S. Park Dr., Kernersville, NC 27284 / P: 336.391.1670 CHANGE ORDER PROPOSAL PROJECT NAME: ORANGE COUNTY SPORTSPLEX PROJECT ADDRESS: 101 MEADOWLANDS DR, HILLSBOROUGH, NC 27278 CHANGE ORDER #: 3 RE: METAL DECK REPAIRS OVER ICE SKATE STORAGE TO: ATLAS ENGINEERING ATTN: ROB TATUM This Change Order Proposal is to reflect the change in cost, associated with the labor, material, equipment, etc. needed to complete the scope below. DETAILED SCOPE ADJUSTMENT:  During the removal of the existing roof system it was discovered, that an area of Gyp Board needed replacement due to deterioration. It was then discovered that the decking in the area needed replacement and restoration as well. See the attached roof plan for location of the repair and photos before and after. CHANGE ORDER COST BREAKDOWN: Metal Deck Replacement 10’ x 5’ area…………………………………………………..$ 312.50 Metal Deck Restoration 20’ x 20’ area…………………………………………………..$1,400.00 5/8” Gysum Board Replacement 450 sqft……………………………………………….$ 675.00 CHANGE ORDER TOTAL…………………………………..$2,387.50 Signature of Acceptance: DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 N.I.C. N.I.C. ROOF AREA A ROOF AREA B 1 1 1 1 1 1 2 33 3 1 1 ROOF AREA B 11'-3" 28'-3"35'-7" 61' 51' 31'-8" 14' 4' 25'-6" 40'-4" 119'-3" 53'-5" 30' 36'-9" 40'-2" 38'-2" 5'-4" 4'-6" 105'-5" RL RL RL RL V V V V V V V V V V V 5 5 5 5 4 4 6 6 6 1 7 13 13 10 10 8 12 12 12 9 V 24'-5" 54'-9" 123' 48'-10" 32'-8" 115'-7" 2.0 3 2.0 4 2.0 2 3.0 12 2.0 2 11 2.0 4 2.0 5 2.0 5 3.0 10 2.0 5 3.0 13 TYP. 2.0 5 3.0 11 TYP. 3.0 19 2.0 1 3.0 17 3.0 14 2.0 6 3.0 7 3.0 7 3.0 9 SIM. TYP. 2.0 1 3.0 10 TYP. 2.0 5 SIM. 3.0 19 3.0 8 3.0 18 3.0 17 2.0 1 2.0 5 2.0 1 4.0 22 4.0 21 4.0 21 4.0 21 3.0 15 4.0 21 2.0 2 2.0 2 N.I.C. 9 PARAPET WALL IN-WALL EXPANSION JOINT GRAVEL-STOP EDGE SCUPPER DRAIN MECHANICAL EQUIPMENT CURB RAIL CURB ROUND PENETRATION LEGEND # ## SATELLITE DETAIL CUT NOTE WALKPAD SLOPE DIRECTION RIDGE VALLEY STRUCTURAL RIDGE STRUCTURAL VALLEY RL V 1 REMOVE ABANDONED CURB/PENETRATION 2 RE-PIPE OVERFLOW DRAIN 3 INSTALL NEW 8"X16" OVERFLOW SCUPPER 4 WIDEN EXISTING SCUPPER TO 16" WIDE 5 REPLACE OVERFLOW CLAMPING RING WITH 6" 6 RAISE GAS PIPE TRAP 7 RAISE WATER/GAS PIPE 8 INSTALL ROOF HATCH RAIL 9 PAINT UNDERSIDE OF THE DECK OF ROOF AREA B 10 INSTALL NEW FALL PROTECTION ANCHOR 11 INSTALL NON-PENETRATING HANDRAIL 12 PAINT EQUIPMENT SUPPORT (ALTERNATE BID 1) 13 REPLACE PIPE INSULATION (ALTERNATE BID 2) NOTES KEYED TO DETAIL CUT PLAN: 1.THESE DRAWINGS ACCOMPANY A PROJECT MANUAL BY ATLAS ENGINEERING DATED AUGUST 2020. THE DRAWINGS ARE PROVIDED TO COMMUNICATE EXISTING CONDITIONS, DESIGN INTENT, AND GENERAL REFERENCE. CONTRACTOR SHALL FIELD VERIFY DIMENSIONS, DRAWING SCALES, ROOF CONSTRUCTIONS, AND ALL OTHER CONDITIONS THAT WILL AFFECT THE ROOF REPLACEMENT AND STAGING AND STORAGE SHOWN ON THIS PLAN AND THE COVER SHEET FOR THE PURPOSE OF BIDDING AND CONSTRUCTION. SOME FEATURES SUCH AS PENETRATIONS MAY NOT BE SHOWN TO EXACT SCALE FOR PURPOSE OF CLARITY. 2.THE EXISTING ROOF SYSTEM CONSTRUCTIONS WERE OBSERVED AT SELECTED, REPRESENTATIVE AREAS AND ARE LISTED IN THE SPECIFICATIONS. 3.COORDINATE STORAGE AND STAGING AREAS WITH THE OWNER. PROTECT EXISTING BUILDING, EQUIPMENT, SITE FEATURES, AND STORAGE AND STAGING AREAS FROM DAMAGE DUE TO CONSTRUCTION ACTIVITIES. IF DAMAGE OCCURS, REPAIR AREAS TO RETURN THEM TO THEIR CONDITION PRIOR TO THE START OF CONSTRUCTION. 4.FOLLOW ALL OSHA AND ORANGE COUNTY SAFETY REGULATIONS. 5.VERIFY WALK TREAD LOCATIONS WITH THE DESIGNER. 6.PROVIDE A 6' CHAIN LINK FENCE WITH NON-PENETRATING WEIGHTED BASES AT THE MATERIAL STORAGE AREA SHOWN ON THE COVER SHEET UNLESS OTHERWISE APPROVED BY THE OWNER. 7.INSTALL TAPERED INSULATION BEHIND ALL CURBS WIDER THAN 2'. 8.ENTRANCES/EXITS MUST BE PROTECTED THROUGH THE USE OF OVERHEAD PROTECTION. A SPOTTER MAY BE REQUIRED ON THE GROUND WHEN WORK ABOVE IS OCCURRING DURING HOURS WHEN THE BUILDING IS OCCUPIED. DO NOT BLOCK PEDESTRIAN OR VEHICULAR ACCESS TO THE BUILDING. GENERAL NOTES: No.REVISION By Date DRAWN BY: ENGINEER: APPROVAL: DATE: PROJ.:SCALE: DWG. NO. 1.0 RT KEW AS SHOWNJ2400ROOF PLAN1 1.0 SCALE: 3/32" = 1'-0" ROOF PLAN KEW BID DOCUMENTS 08/04/2020ORANGE COUNTY SPORTSPLEX MAIN BUILDING ROOF REPLACEMENTHILLSBOROUGH, NORTH CAROLINAORANGE COUNTY ASSET MANAGEMENT SERVICESAREA OF DECKING RESTORATION #1 & 5/8" Gyp AREA OF DECKING REPAIR #1 & 5/8" Gyp DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 BAR Roofing & Maintenance / 1313 S. Park Dr., Kernersville, NC 27284 / P: 336.391.1670 CHANGE ORDER PROPOSAL PROJECT NAME: ORANGE COUNTY SPORTSPLEX PROJECT ADDRESS: 101 MEADOWLANDS DR, HILLSBOROUGH, NC 27278 CHANGE ORDER #: 4 RE: DEDUCTION FOR DAMAGES TO SKATES DUE TO LEAK TO: ATLAS ENGINEERING ATTN: ROB TATUM This Change Order Proposal is to reflect the change in cost, associated with damages due to a leak. DETAILED SCOPE ADJUSTMENT:  At the start of the project, right after the ballast was removed, a leak was discovered during the next rain event. This leak caused damage to several pairs of skates in the storage room below. CHANGE ORDER COST BREAKDOWN: (9) Youth Figure Skate @ $92/pair......…………………………………………………..$ 828.00 (4) Adult Hockey Skates @ $ 78/pair..…………………………………………………..$ 312.00 (5) Adult Figure Skates @ $ 82/pair…….……………………………………………….$ 410.00 CHANGE ORDER TOTAL……………………………… - $1,550.00 Signature of Acceptance: DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 BAR Roofing & Maintenance / 1313 S. Park Dr., Kernersville, NC 27284 / P: 336.391.1670 CHANGE ORDER PROPOSAL PROJECT NAME: ORANGE COUNTY SPORTSPLEX PROJECT ADDRESS: 101 MEADOWLANDS DR, HILLSBOROUGH, NC 27278 CHANGE ORDER #: 5 RE: 5/8” GYPSUM SUBSTRATE REPLACEMENT & METAL DECK RESTORATION TO: ATLAS ENGINEERING ATTN: ROB TATUM This Change Order Proposal is to reflect the change in cost, associated with additional materials, labor, equipment, etc. to complete the scope below. DETAILED SCOPE ADJUSTMENT:  During the last section of roof replacement, it was discovered that approx. 210 sqft of gypsum substrate was deteriorated/damaged and needed replacement. Upon removal of the gypsum substrate, it was determined that a 5’ x 5’ area of metal deck had minor rust and needed restoration. CHANGE ORDER COST BREAKDOWN: 5/8” Gypsum Substrate Replacement 210 sqft…………………………………………..$ 315.00 Metal Deck Restoration 5’x 5’……....…………………………………………………..$ 87.50 CHANGE ORDER TOTAL……………………………...…...$402.50 Signature of Acceptance: DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 BAR Roofing & Maintenance / 1313 S. Park Dr., Kernersville, NC 27284 / P: 336.391.1670 CHANGE ORDER PROPOSAL PROJECT NAME: ORANGE COUNTY SPORTSPLEX PROJECT ADDRESS: 101 MEADOWLANDS DR, HILLSBOROUGH, NC 27278 CHANGE ORDER #: 6 RE: BASE BID UNUSED ALLOWANCES DEDUCT TO: ATLAS ENGINEERING ATTN: ROB TATUM This Change Order Proposal is to reflect the change in cost, associated with unused portions of the Base Bid Allowances. This proposal includes the costs of COR’s #3 & 5, effectively withdrawing them as stand alone COR’s. COR #4 is also withdrawn as the damaged skates will be billed directly to BAR Roofing. BASE BID ALLOWANCES: 1. Metal Deck Restoration - 1,000 sqft @ $3.50……………….………….…..$3,500.00 2. Metal Deck Replacement - 50 sqft @ $6.25……………….……….…….…..$ 312.50 3. Metal Deck Repair - 100 sqft @ $6.00…..…………………………….$ 600.00 4. Wood Blocking Replacement - 200 bdft @ $3.75………………………….……..$ 750.00 5. Plywood Replacement - 600 sqft @ $4.75…………………………………$2,850.00 6. 5/8” Gypsum Replacement - 1,000 sqft @ $1.50……………………………….$1,500.00 7. Additional Walk Tread - 500 lft @ $8.00……………………………...…...$4,000.00 8. Rubber Paver - 100 ea @ $33.00……………………………….…$3,300.00 9. Tapered Insulation - 3,000 sqft @ $1.30…………………………….…$3,900.00 TOTAL BASE BID ALLOWANCES……………………………………………… $20,712.50 BASE BID ALLOWANCES MINUS USED QUANTITIES Metal Deck Restoration ……………………………………………………………….…$1,487.50 Metal Deck Replacement ……….………………………………………………………..$ 312.50 5/8” Gypsum Replacement …………………………………………………….…………$ 990.00 Rubber Pavers……………………………………………………………………….……..$ 66.00 TOTAL ALLOWANCES USED…………………………………………………..…....$2,856.00 TOTAL UNUSED ALLOWANCES………………...….... - $17,856.50 Signature of Acceptance: DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD Travis Ketron BARRO-2 OP ID: CS 10/28/2020 Cindy Smith Southeastern Agency Group,Inc. 1501 Highwoods Blvd., St # 402 Greensboro, NC 27410 Travis Ketron 336-232-0203 336-218-7487 csmith@sagnc.com Pennsylvania National Bridgefield Casualty Bar Roofing & Maintenance LLC 2237 Bethel Church Rd. Kernersville, NC 27284 A X 1,000,000 X GL9 0739179 07/06/2020 07/06/2021 100,000 5,000 1,000,000 2,000,000 2,000,000 1,000,000A X AU9 0739179 07/06/2020 07/06/2021 X X 1,000,000 XX 5,000,000A UL9 0739179 07/06/2020 07/06/2021 5,000,000 XB 0196-47278 07/20/2020 07/20/2021 1,000,000 Y 1,000,000 1,000,000 A IM90739179 07/06/2020 07/06/2021 270,000 A Rented & leased eq IM90739179 07/06/2020 07/06/2021 50,000 See page 2 ORACOUN Orange County PO Box 8181 Hillsborough, NC 27278 336-232-0203 14990 10335 UM/UIM Installation Float DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524 Date HOLDER CODE INSURED'S NAME PAGENOTEPAD: Certificate holder is automatically included as additional insured for General Liability, according to the terms, conditions & exclusions within the policy with respects to work performed by the insured on behalf of the certificate holder as required by written contract signed by an authorized representative of the named insured and the certificate holder ORACOUN 2 Bar Roofing & Maintenance LLC 10/28/2020 BARRO-2 OP ID: CS DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524