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HomeMy WebLinkAbout2026-158-E-DEAPR-Churchich Recreation (CRD of Hilton Head, Inc.)-Playground repairs and installationRevised 01/24 1 [Departmental Use Only] TITLE Churchich Recreation (CRD of Hilton, Head, Inc.) FY 2025-26 NORTH CAROLINA SERVICES AGREEMENT NO RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter “Agreement”), made and entered into this 28 day of April, 2026, (“Effective Date”) by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County") and Churchich Recreation (CRD of Hilton Head, Inc.), (hereinafter, the "Provider"). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Agreement is for services to be rendered by Provider to County with respect to (insert type of project): Playground Repairs and installation 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 Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Revised 01/24 2 quality, accuracy and timely completion and 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 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) Should any documents, exhibits, or addenda be attached to this Agreement, the terms of this Agreement shall have priority in any conflict with or among the terms of such referenced documents, exhibits, or addenda. vii) Should this Agreement involve project designs, the construction or creation of which is to be bid out or fulfilled by other contractors, and bidding or negotiation with contractors produce prices which, when added to the other elements of the approved total project cost, produce a cost that is in excess of the approved total project cost, the Provider shall participate with the County in negotiation and design adjustments to the extent such are necessary to obtain prices within the approved total project cost. All activity of the Provider with respect to these matters shall constitute Basic Services and shall be performed by the Provider without additional compensation. If negotiation and design adjustments fail to bring costs within the total project cost the County may reject all bids and Provider will redesign or reduce portions of the project in an effort to reduce the bid prices to within the total project cost and rebid the project. One such redesign is included within Basic Services. If this second letting for bids does not produce bids that are within the approved total project cost initially or after negotiations with the contractor the cost is not reduced to an amount within the total project cost, the Provider is not obligated to engage in further redesign. 3. Basic Services Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Revised 01/24 3 a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows (fully describe services to be provided): Installation of replacement parts and repairs on multiple playground structures. 4. Duration of Services a. Term. The term of this Agreement shall be from April 28, 2026 to September 30, 2026. b. Scheduling of Services. i) The Provider shall schedule and perform its activities in a timely manner. 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 April 28, 2026. 5. Compensation a. Compensation for Basic Services. Compensation for Basic Services shall include all compensation due the Provider from the County for all services satisfactorily (as determined by the County) performed pursuant to this Agreement. The maximum amount payable for Basic Services shall not exceed fifteen thousand nine hundred twenty-eight dollars and nine cents Dollars ($15,928.09). Payment for satisfactorily performed 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. c. 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 (Sharon Kelly) to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board of Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Revised 01/24 4 Commissioners and who 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 N/A (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. 8. Indemnity a. Indemnity. To the extent authorized by North Carolina law 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. Either party may terminate this Agreement upon notice to the other party that obligations pursuant to this Agreement are made impractical due to declarations of emergency by Orange County or by North Carolina due to events directly impacting Orange County. Both parties shall Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Revised 01/24 5 remain responsible for all payment and performance due up to the receipt of such notice, but shall have no further obligation or responsibility beyond that date provided the terminating party has taken all reasonable steps to complete the performance of its obligations. c. 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. Upon request of the County, the Provider shall submit to County all relevant documentation, including but not limited to, job cost records, to support its claims for final compensation. 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. 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. There are no third-party beneficiaries of this Agreement and nothing in this Agreement, express or implied, is intended to confer on any person other than the parties hereto (and their respective successors, heirs and permitted assigns), any rights, remedies, or obligations. 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. Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Revised 01/24 6 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 Orange County policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/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. 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 or 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 or 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. In the event of a change in the County’s statutory authority, mandate or mandated Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Revised 01/24 7 functions, by state or federal legislative or regulatory action, which adversely affects County’s authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Provider of such limitation or change in County’s legal authority. i. 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 11A 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 Provider’s Name Attention:Sharon Kelly Churchich Recreation P.O. Box 8181 Sue Churchich, President Hillsborough, NC 27278 sue@churchichrecreation.com [SIGNATURE PAGE TO FOLLOW] Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Revised 01/24 8 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: PROVIDER: By: _________________________________ Travis Myren, County Manager By: __________________________________ Sue Churchich, President Printed Name and Title Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Revised 01/24 9 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Churchich Recreation (CRD of Hilton Head, Inc.) Vendor Contact Person: Sue Churchich Phone: 843-757-3156 Address: 20 Towne Drive, PMB 186 City Blufton State: SC Zip: 29910 Department: DEAPR Amount: $15,928.09 Purpose: Playground repairs and installatio Budget Code(s): 61370035 800000 20039 Vendor # 68785 Vendor Status with NCSOS: Current/Active Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date April 28, 2026 End Date September 30, 2026 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement. This agreement is approved as to technical form and content. Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services 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 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: Received for record retention: Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 4/28/2026 4/30/2026 4/30/2026 4/30/2026 Revised 01/24 10 Office of the Clerk to the Board __________________________________________Date:________ Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Churchich Recreation (CRD of Hilton Head, Inc.) 20 Towne Drive PMB 186 Bluffton, SC 29910 8437573156 Quote ADDRESS Orange County NC 1100 US 70 W PO Box 8181 Hillsborough, NC 27278 SHIP TO Orange County NC 1100 US 70 W PO Box 8181 Hillsborough, NC 27278 QUOTE #6578 DATE 04/23/2026 P.O. NUMBER to follow ACTIVITY DESCRIPTION QTY RATE AMOUNT MREC 713248 PARTS CARTON STAIRS 1 47.00 47.00T MREC 713266 PARTS CARTON 714502 1 82.00 82.00T MREC 7148502 CHAMELEON SLIDE RIGHT TURN SECTION 1 908.00 908.00T MREC 7148503 CHAMELEON SLIDE LEFT TURN SECTION 1 908.00 908.00T MREC 714999Z CUSTOMER SERVICE KIT (NO PRICE)1 0.00 0.00T MREC 984167 PARTS CARTON - 714750 1 130.00 130.00T MREC 984351BL DECK, KC SQUARE FPS Blu 1 1,117.00 1,117.00T MREC 985490 WINDOW-RECTANGULAR FOR 30 ID TUBE 2 361.00 722.00T MREC 986041PLM STEPPING POD 2 271.00 542.00T MREC 986498 PARTS CARTON-HONEYCOMB POD 2 14.98 29.96T MREC 987141BE STAIR, 24" ATA ACCESS FPS BE 1 1,033.00 1,033.00T MREC 989740PLM CHAMELEON ASSEMBLY, EXIT SECT 1 1,054.00 1,054.00T MREC 990072 PARTS CARTON-KC SQ.TRANSFER POINT 1 55.00 55.00T MREC 990465BL PVC STAIR-3' SQUARE TRANSFER POINT BL 1 856.00 856.00T MREC 992483PLM TROLLEY ASSY, GLIDER 1 539.00 539.00T MREC HW984027-1 HKIT 714753105 M1/1 1 14.98 14.98T Wabash Valley LR300D 32 Gallon Wabash Trash Receptacle w/ dome lid, ingrd post, liner 4 739.00 2,956.00T Freight Shipping Charge 1 934.15 934.15T Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 ACTIVITY DESCRIPTION QTY RATE AMOUNT NC Installation NC Installation 1 4,000.00 4,000.00T 50% Deposit Required at Time of Order SUBTOTAL 15,928.09 TAX 1,194.61 TOTAL $17,122.70 Accepted By Accepted Date Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 04/20/2026 Correll Insurance Group of Hilton Head PO Box 6869 Hilton Head Island SC 29938 Krista Juarez (843) 785-7733 krista@correllhhi.com CRD of Hilton Head, INC 20 Towne Drive PMB 186 Bluffton SC 29910 Cincinnati Insurance Co 10677 Progressive Northern Ins. Co.38628 Auto Owners Insurance Co 18988 Lloyds of London CL25121680431 A Y Y CSU0264088 08/23/2025 08/23/2026 1,000,000 100,000 Exc 1,000,000 2,000,000 2,000,000 B Y Y 866735579 12/11/2025 12/11/2026 1,000,000 Policy Fee A 0 Y Y CSU0264090 08/23/2025 08/23/2026 2,000,000 2,000,000 C N Y A106565102 12/11/2025 12/11/2026 1,000,000 1,000,000 1,000,000 D Excess Liability Layer 2 Y Y CSR0003880 08/23/2025 08/23/2026 Each Occurence 3,000,000 Aggregate 3,000,000 Orange County, its officers, agents and employees are designated as additional insured. Certificates are issued based on the insurance coverage included in the insurance program at the time this certificate was issued. Please review the certificate and contract to be certain the coverage provided meets the contractual obligations. To request any changes to the policy, the named insured must contact our agency. Orange County 300 West Tryon Street P.O. Box 8181 Hillsborough NC 27278 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Uninsured motorist combined single limit UMCSL 1,000,000 Underinsured motorist combined single limit UNCSL 1,000,000 Waiver of Subrogation WVSUB $75.00 AACSL AACSL 1,000,000 $156.00 Medical payments MEDPM 5,000 Blanket Additional Insured BLKAI $75.00 Underinsured motorist property damage UNDPD 1,000,000 0 Uninsured motorist property damage UMPD 1,000,000 200 Uninsured Motorist Fund Charge UMFEE $8.00 General Aggregate GENAG 2,000,000 WC & Employer's liability WCEL $1,534.00 ADDITIONAL COVERAGES Ref #Description Edition DateForm No.Coverage Code Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Copyright 2001, AMS Services, Inc.OFADTLCV Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Expense constant EXCNT $260.00 BWVSB BWVSB $200.00 Increased employer's liability INEL $120.00 ADDITIONAL COVERAGES Ref #Description Edition DateForm No.Coverage Code Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Ref #Description Coverage Code Form No.Edition Date Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium Copyright 2001, AMS Services, Inc.OFADTLCV Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Agency Code Policy Number16-0033-00 A106-565-102 We have the right to recover our payments from anyone liable for any injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Worker's Compensation and Employers Liability Insurance Policy WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT WC 00 03 13 27060 (10-86) Any person for whom, or organization in which, you perform a service. SOUTH CAROLINA Page of27060 (10-86)11 Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 Includes copyrighted material of Insurance CSGA 4087 12 12 Services Office, Inc., with its permission.Page 1 of 1 COMMERCIAL GENERAL LIABILITY CSGA 4087 12 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - PER CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer of Rights of Recovery Against Others to Us of SECTION IV - CONDITIONS: If you have agreed, in a written contract or agreement, to provide a waiver of any right of recovery against a person or organization, we will waive any right of recovery we may have against that person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to that person or organization for which you have agreed to in a written contract to provide said waiver. Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 &200(5&,$/*(1(5$//,$%,/,7< &*  7+,6(1'256(0(17&+$1*(67+(32/,&<3/($6(5($',7&$5()8//<  &*‹,QVXUDQFH6HUYLFHV2IILFH,QF3DJHRI  35,0$5<$1'121&2175,%8725<±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ocusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 CSGA 4114 06 24 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 1 of 2 COMMERCIAL GENERAL LIABILITY CSGA 4114 06 24 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED(S)-OWNERS, LESSEES OR CONTRACTORS -AUTOMATIC STATUS FOR OTHER PARTIES WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU -OPERATIONS AND COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A.Section II -Who Is An Insured is amended to include as an additional insured: 1.Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional in- sured on your policy; and 2.Any other person or organization you are re- quired to add as an additional insured under the contract or agreement described in Para- graph 1.above. Such person(s)or organization(s) is an addi- tional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1.Your acts or omissions in the performance of your ongoing operations for the addi- tional insured described in paragraph A.1. or A.2.above; 2.The acts or omissions of those acting on your behalf in the performance of your on- going operations for the additional insured described in paragraph A.1.or A.2.above; or 3."Your work" performed for the additional insured described in paragraph A.1.or A.2.above and included in the "products- completed operations hazard". If not specified otherwise in the written contract or agreement described in paragraph A.1.of this endorsement, a person's or organization's status as an additional insured under this en- dorsement ends one year after your operations for the person or organization described in par- agraph A.1.are completed. The written con- tract or agreement must be currently in effect or become effective during the term of this Cover- age Part. The contract or agreement must be executed prior to the "bodily injury", "property damage" or "personal and advertising injury" to which this endorsement pertains. However: 1.The insurance afforded to such additional insured described above only applies to the extent permitted by law; and 2.If coverage provided to an additional in- sured described above is required by a contract or agreement, the insurance af- forded to such additional insured will not be broader than that which you are re- quired by the contract or agreement to pro- vide. B.With respect to the insurance afforded to these additional insureds,the following additional ex- clusions apply: This insurance does not apply to: 1."Bodily injury", "property damage" or "per- sonal and advertising injury" arising out of the rendering of,or the failure to render, any professional architectural, engineering or surveying services, including: a.The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or draw- ings and specifications; or Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 CSGA 4114 06 24 Includes copyrighted material of Insurance Services Office, Inc., with its permission.Page 2 of 2 b.Supervisory,inspection, architectural or engineering activities. 2."Bodily injury" or "property damage" aris- ing out of "your work"for which a consoli- dated (wrap-up)insurance program has been provided by the prime contractor/pro- ject manager or owner of the construction project in which you are involved. 3."Bodily injury", "property damage" or "per- sonal and advertising injury" to any em- ployee of you or to any obligation of an ad- ditional insured to indemnify another be- cause of damages arising out of such in- jury. 4."Bodily injury", "property damage"or "per- sonal and advertising injury" for which the Named Insured is afforded no coverage under this policy of insurance. C.With respect to the insurance afforded to these additional insureds, SECTION III -LIMITS OF INSURANCE is amended to include: The limits applicable to an additional insured described herein are those specified in the writ- ten contract or agreement described in para- graph A.1.of this endorsement or in the Decla- rations of this Coverage Part,whichever is less. If no limits are specified in the written contract or agreement described in paragraph A.1., the limits applicable to the additional insureds are those specified in the Declarations of this Cov- erage Part. The limits of insurance are inclusive of and not in addition to the limits of insurance shown in the Declarations. D.With respect to the insurance afforded to these additional insureds, SECTION IV -COMMER- CIAL GENERAL LIABILITY CONDITIONS,4. Other Insurance is amended to include: Any coverage provided herein will be excess over any other valid and collectible insurance available to an additional insured whether pri- mary, excess, contingent or on any other basis unless you have agreed in a written contract or written agreement executed prior to any loss that this insurance will be primary. This insur- ance will be noncontributory only if you have so agreed in a written contract or written agree- ment executed prior to any loss and this cover- age is determined to be primary. Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 L404 (05/09) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONSTRUCTION PROJECT GENERAL AGGREGATE LIMIT WHEN REQUIRED BY CONTRACT AND MAXIMUM PER POLICY GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Limits Of Insurance Maximum Per Policy General Aggregate Limit $5,000,000 A. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I - Coverage A - Bodily Injury And Property Damage Liability, and for all medical expenses caused by accidents under Section I - Coverage C - Medical Payments, which can be attributed only to ongoing operations at a single construction project: 1. A separate Construction Project General Aggregate Limit applies to each construction project when required in a written construction contract or agreement, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Construction Project General Aggregate Limit for that construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Construction Project General Aggregate Limit for any other construction project. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Construction Project General Aggregate Limit. 5. The Maximum Per Policy General Aggregate Limit shown in the Schedule is the most we will pay for the sum of all Construction Project General Aggregate Limits and the General Aggregate Limit shown in the Declarations regardless of the number of: a. Insureds; b. Claims made or "suits" brought; c. Persons or organizations making claims or bringing "suits"; or d. Construction projects. Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 L404 (05/09) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 2 B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I - Coverage A - Bodily Injury And Property Damage Liability, and for all medical expenses caused by accidents under Section I - Coverage C - Medical Payments, which cannot be attributed only to ongoing operations at a single construction project: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit shown in the Declarations or the Products-Completed Operations Aggregate Limit shown in the Declarations, whichever is applicable; and 2. Such payments shall not reduce any Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit shown in the Declarations, and not reduce the General Aggregate Limit shown in the Declarations nor the Construction Project General Aggregate Limit. D. If the applicable construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications, or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III - Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. All other terms and conditions of this policy remain unchanged. Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 34 Form 2366 (02/11) BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided by the Commercial Auto Policy, Motor Truck Cargo Legal Liability Coverage Endorsement, and/or Commercial General Liability Coverage Endorsement, as appears on the declarations page. All ter ms and conditions of the policy apply unless modified by this endorsement. If you pay the fee for this Blanket Additional Insured Endorsement, we agree with you that any person or organization with whom you have executed a written agreement prior to any loss is added as an additional insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to such additional insured only as a person or organization liable for your opera- tions and then only to the extent of that liability. This endorsement does not apply to acts, omissions, products, work, or operations of the additional insured. Regardless of the provisions of paragraph a. and b. of the “Other Insurance” clause of this policy, if the person or organization with whom you have executed a written agreement has other insurance under which it is the first named in- sured and that insurance also applies, then this insurance is primary to and non-contributory with that other insurance when the written contract or agree- ment bet ween you and that person or organization, signed and executed by you before the bodily injury or property damage occurs and in effect during the policy period, requires this insurance to be primar y and non-contributor y. In no way does this endorsement waive the “Other Insurance” clause of the pol- icy, nor make this policy primary to third par ties hired by the insured to perform work for the insured or on the insured’s behalf. ALL OTHER TERMS, LIMITS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. Form 2367 (06/10) BLANKET WAIVER OF SUBROGATION ENDORSEMENT This endorsement modifies insurance provided by the Commercial Auto Policy, Motor Truck Cargo Legal Liability Coverage Endorsement, and/or Commercial General Liability Coverage Endorsement, as appears on the declarations page. All ter ms and conditions of the policy apply unless modified by this endorsement. Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581 35 If you pay the fee for this Blanket Waiver of Subrogation Endorsement, we agree to waive any and all subrogation claims against any person or organization with whom a written waiver agreement has been executed by the named insured, as required by written contract, prior to the occurrence of any loss. ALL OTHER TERMS, LIMITS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. Form 2368 (06/10) LOAN/LEASE GAP COVERAGE ENDORSEMENT This endorsement modifies insurance provided by the Commercial Auto Policy. All ter ms and conditions of the policy apply unless modified by this endorsement. INSURING AGREEMENT—LOAN/LEASE PAYOFF COVERAGE If you pay the premium for this coverage, and the insured auto for which this coverage was purchased is deemed by us to be a total loss, we will pay, in addition to any amounts otherwise payable under Par t II of your policy, the difference bet ween: 1. the actual cash value of the insured auto at the time of the total loss; and 2. any greater amount the owner of the insured auto is legally obligated to pay under a written loan or lease agreement to which the insured auto is subject at the time of the total loss, reduced by: a. unpaid finance charges or refunds due to the owner for such charges; b. excess mileage charges or charges for wear and tear; c. charges for extended warranties or refunds due to the owner for extended warranties; d. charges for credit insurance or refunds due to the owner for credit insurance; e. past due payments and charges for past due payments; and f. collection or repossession expenses. However, our payment under this coverage shall not exceed the limit of liability shown on the declarations page. The limit of liability is a percentage of the actual cash value of the insured auto at the time of the loss. This coverage applies only if you have purchased both Comprehensive Coverage and Collision Coverage for that insured auto and the loss is covered under one of those coverages. ALL OTHER TERMS, LIMITS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. Docusign Envelope ID: 1A6F375D-5051-8A14-822E-DFF04D0E2581