Contract Forms Packet(checklist, bonds, ins, instructions).docx

CHECK LIST FOR CONTRACT BOOKLETS

PLEASE NOTE: THE ATTACHED INSURANCE CERTIFICATE 1304A IS THE ONLY CERTIFICATE THE CITY OF LIVONIA WILL ACCEPT.

1. Certificate of Insurance Form 1304A must include:

· Evidence of contractor’s public liability and property damage insurance.

· Evidence of contractor’s motor vehicle insurance.

· Evidence of worker’s compensation insurance.

· Evidence of owner’s/contractor’s protective insurance.

In addition we will need the following:

· Endorsement guaranteeing the City of Livonia 30 days notice in the event the policy is cancelled. See attached sample.

· Form CG 20 10 04 13 naming City of Livonia as additional insured. See attached sample.

2. Performance Bond – In favor of the City of Livonia in an amount at least equal to 100% of the contract price from an “A” rating or better company.

3. Maintenance and Guaranty Bond – In an amount at least equal to 100% of the contract price. The guaranty shall cover all work performed and materials furnished under this contract for a period of one (1) year subsequent to the date of the final estimate.

4. Labor and Materials Bond – In an amount at least equal to 100% of the contract price.

All bonds must be signed by a representative of your company.

City of Livonia 1304A (03/15)

PROOF OF INSURANCE FOR CITY OF LIVONIA PROJECTS

Clear Form )Information required by the Federal specifications for Highway construction andlor Act 327, P.A. of 1945 to verify insurance.

The subscribing insurance company certifies that insurance of the types and for limits of liability covering the work under contract with the City of Livonia has been obtained by the contractor named below.

Such insurance, here certified, is written in accordance with the company’s regular policies and endorsements subject to the company’s applicable manuals of rules and rates, except (1) the insurance shall not be subject to the usual “x” - explosion, “c” - collapse or “u” - underground property damage exclusions.

NAME OF INSURED

TYPE OF INSURANCE

POLICY NUMBER & NAME OF INSURANCE COMPANY

(If more than one)

BODILY INJURY AND PROPERTY DAMAGE LIABILITY

General Liability

Commercial General Liability

Claims Made Occurrence

$ P.D. Deductible

XCU Exclusion

Contractual Exclusion

AUTOMOTIVE LIABILITY

Combined Single Limit (Minimum $2,000,000.00)

Any Auto

All Owned Autos

Bodily Injury (per person) (Minimum $500,000.00)

Scheduled Autos

Hired Autos

Bodily Injury (per accident) (Minimum $1,000,000.00)

Non-Owned Autos

Garage Liability

Property Damage (Minimum $1,000,000.00)

Umbrella

Excess Liability Other Than Umbrella

WORKERS COMPENSATION AND

EMPLOYERS LIABILITY

STATUTORY

$ (Each Accident)

$ (Disease - Policy LImit)

$ (Disease - Each Emply.)

Owners Contractors Protective

IL 70 02 09 11

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADVANCE NOTICE OF CANCELLATION, NONRENEWAL OR COVERAGE REDUCTION OR RESTRICTION PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Address

33000 CIVIC CENTER DR. LIVONIA, MI 48154

Person(s) or Organization(s)

CITY OF LIVONIA

Number of Days Notice 30

If this policy is cancelled (other than nonpayment of premium) or nonrenewed or if the coverage provided by this policy is reduced or restricted (except for any reduction in the Limits of Insurance due to claims payments), we will provide written notice to the person(s) or organization(s) listed in the Schedule.

We will provide this notice by mail 30 days in advance of any policy cancellation, nonrenewal or coverage reduc- tion or restriction or as indicated in the Number of Days Notice in the Schedule.

All terms and conditions of this policy apply unless modified by this endorsement.

INS-5

IL 70 02 09 11 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission.

POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 10 04 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s)

Location(s) Of Covered Operations

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but 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; or

2. The acts or omissions of those acting on your behalf;

in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B.

With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:

This insurance does not apply to "bodily injury" or "property damage" occurring after:

1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or

2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.

CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2

C. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or 2.

Available under the applicable Limits of Insurance shown in the Declarations;

whichever is less.

This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.

Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13

25. CONTRACTOR’S AND SUBCONTRACTOR’S INSURANCE

The Contractor shall not commence work under this Contract until he has obtained the insurance required under this paragraph, nor shall the Contractor permit any Subcontractor to commence work on his Subcontract until he has obtained the insurance herein required.

a. Workmen’s Compensation Insurance. The Contractor shall procure and maintain during the life of this Contract, Workmen’s Compensation Insurance for all of his employees who engage in the work to be performed; and, in case any such work is sublet, the Contractor shall require the Subcontractor to provide similar insurance for all of the latter’s employees who engage in the work.

b. Contractor’s Public Liability and Property Damage Insurance. The Contractor shall procure and maintain during the life of this Contract, Contractor’s Public Liability and Property Damage Insurance in the amount of not less than $1,000.000.00 for injuries, including accidental death, to each person; and, subject to the same limit for each person, in the amount of not less than $1,000,000.00 on account of each accident; and, in an amount not less than $1,000,000.00, each accident, for damage to property.

c. Owner’s and Contractor’s Protective Public Liability and Property Damage Insurance. The Contractor shall procure and maintain during the life of this Contract, Owner’s and Contractor’s Protective Public Liability and Property Damage Insurance, in the name of the City, in an amount not less than $1,000,000.00 for injuries, including accidental death, to each person; and, subject to the same limit for each person, in an amount not less than $1,000,000.00 on account of each accident; and in an amount not less than $1,000,000.00, each accident, for damage to property. Such insurance shall include motor vehicle exposure and specific coverage by endorsement, which shall be described in the following manner:

“It is hereby understood and agreed that such insurance as is afforded shall include specific coverage for the so-called Explosion, Collapse and Underground Hazards, which covers damage to property arising directly or indirectly from explosion, damage or structural injury to buildings or adjacent structures arising from operations under this Contract, including excavation or tunneling and damage sustained by wires, conduits, mains, sewers, and the like, occasioned by the Contractor’s sub-surface operations.”

d. Subcontractor’s Public Liability and Property Damage Insurance. The Contractor shall require each of his Subcontractors to procure and maintain during the life of their subcontract, Subcontractor’s Public Liability and Property Damage Insurance in an amount not less than $1,000,000.00 for injuries, including accidental death, to each person; and, subject to the same limit for each person, in an amount not less than $1,000,000.00 on account of each accident; and in an amount not less than $1,000,000.00, each accident, for damage to property.

GC-8

The Contractor shall require each of his Subcontractors to procure and maintain during the life of their subcontract, Owner’s and Contractor’s Protective Public Liability and Property Damage Insurance in an amount not less than $1,000,000.00 for injuries, including accidental death, to each person; and, subject to the same limit for each person, in an amount not less than $1,000,000.00 on account of each accident; and in an amount not less than $1,000,000.00, each accident, for damage to property.

e. Contractor’s Motor Vehicle Bodily Injury and Property Damage Insurance.

(1) The Contractor shall procure and maintain during the life of this Contract, Motor Vehicle Bodily Injury Insurance (Comprehensive Form) in an amount not less than $1,000,000.00 for injuries, including accidental death, to each person; and, subject to the same limit for each person, in an amount not less than $1,000,000.00 on account of each accident; and in an amount not less than $1,000,000.00, each accident for damage to property.

(2) The Contractor shall procure and maintain during the life of this Contract, Hired and Non-Ownership Motor Vehicle Bodily Injury and Property Damage Insurance in an amount not less than $1,000,000.00 for injuries, including accidental death, to each person; and, subject to the same limit for each person, in an amount not less than $1,000,000.00 for each accident; and in an amount not less than $1,000,000.00, each accident, for damage to property.

26. PROOF OF INSURANCE

The Contractor shall provide the City, at the time this Contract is returned by him for execution, the certificates and policy listed below. A guarantee that thirty (30) days notice will be given to the City prior to cancellation of, or change in, any insurance coverage shall be endorsed on each certificate and policy:

1. Four (4) copies of Certificate of Coverage of Contractor’s Workmen’s Compensation Insurance.

2. Four (4) copies of Certificate of Coverage of Contractor’s Public Liability and Property Damage Insurance.

3. Four (4) copies of Certificate of Coverage of Contractor’s Motor Vehicle Bodily Injury and Property Damage Insurance covering owned, hired, and non-owned vehicles.

4. Four (4) copies of Owner’s and Contractor’s Protective Public Liability and Property Damage Insurance Policy.

GC-9

27. PERFORMANCE BOND

The Contractor, within 15 days from the date of acceptance of his proposal, shall execute in favor of the City a Surety Bond Form in an amount at least equal to 100% of the contract price, as security for the faithful performance of this Contract.

28. LABOR AND MATERIALS BOND

The Contractor, within 15 days from the date of acceptance of his proposal, shall execute in favor of the City a Surety Bond Form in an amount at least equal to 100% of the contract price, as security for the payment of all persons performing labor and furnishing materials in connection with this Contract.

29. MAINTENANCE AND GUARANTEE BOND

The Contractor, as a condition precedent to final payment, shall execute in favor of the City a Maintenance and Guarantee Bond Form in an amount at least equal to 100% of the contract price. The guarantee shall cover all work performed and materials furnished under this Contract for a period of one (1) year subsequent to the date of the final estimate.

PERFORMANCE BOND

KNOW ALL MEN BY THESE PRESENTS, that we ____________________________________

_____________________________________________________________as Principal and _____________________________________________________________________________ as Surety or Sureties, are held and firmly bound unto the CITY OF LIVONIA, Wayne County, Michigan, in the sum of __________________________________________________________ Dollars ($ ), for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, our heirs, executors, administrators, successors and assigns.

THE CONDITION of the foregoing obligation is such that, whereas the said

_____________________________________________________________________________ did on the day of , 20 , by articles of that date, enter into a Contract with the said CITY OF LIVONIA for the construction of

NOW THEREFORE, if the said____________________________________________________ shall well and faithfully do and perform all things agreed to be done and performed by said Contract, according to the terms thereof, then this obligation shall be void, but otherwise, it shall remain in full force and effect.

PROVIDED, that any alterations which may be made in the terms of the Contract or in the work to be done under it, or the granting by the said CITY OF LIVONIA of any extension of time for the performance of the Contract or any other forbearance on either the part of said CITY OF LIVONIA or the Principal, to the other, shall not in any way release the Principal and Surety or Sureties, or either, or any of them, their heirs, executors, administrators, successors, or assigns, from their liability hereunder, notice to the Surety or Sureties of any such alteration, extension of forbearance being hereby waived.

WITNESS, our hands and seals, this___________day of ______________________, 20_______

Signed, sealed and delivered in the ______________________________________

Presence of: By____________________________________

____________________________________ By____________________________________

PB

REV. 2/05

MAINTENANCE AND GUARANTEE BOND

_____________________________________________________________as Principal and _____________________________________________________________________________ as Surety or Sureties, are held and firmly bound unto the CITY OF LIVONIA, Wayne County, Michigan, in the sum of __________________________________________________________ Dollars ($ ), for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, our heirs, executors, administrators, successors and assigns.

THE CONDITION of the foregoing obligation is such that, whereas the Principal did on the

__________day of ______________, 20 , by articles of that date, enter into a Contract with the said CITY OF LIVONIA for the construction of _____________________________________ and , as a condition precedent to receiving final payment on said Contract, to execute the Bond herein described.

NOW THEREFORE, the Principal guarantees that for a period of one (1) year from the date of the final estimate he will, without cost to the City, keep in good order and repair any defect in the work done under said Contract by his employees, agents, subcontractors, or material suppliers, that may develop during said time due to improper materials, defective equipment, workmanship or arrangements, and that he will likewise restore to good condition any work disturbed while correcting such defects, excepting only such part or parts of said work which may have been disturbed without his consent or approval after acceptance thereof by the CITY; and that whenever directed to do so by the CITY, through written notice served personally or by mail upon the Principal at _________________________________________________________________ or upon the Surety or Sureties at ___________________________________________________ _____________________________________________________________________________, he will proceed at once to make the repairs specified, and in case of failure to do so, within one

(1) week from the date of service of said notice or such additional time as may be fixed therein, the CITY shall have the right to purchase such materials and employ such labor and equipment

MGB-1

MAINTENANCE AND GUARANTEE BOND

as may be necessary; to undertake, do and make such repairs, and to be reimbursed by the Principal, Surety or Sureties for the full expense thereof. If it is necessary to make any repair or set a barricade at once to protect life and property, the CITY may take such action immediately, without notice to the Principal, Surety or Sureties. The CITY shall not be obliged to obtain the lowest bids for doing the work, or any part thereof, but the sums actually therefore shall be reimbursed by either the Principal, Surety or Sureties. In this connection, the judgment of the CITY shall be final and conclusive. If the Principal, for a period of one (1) year from the date of the final estimate, shall keep the work done under the aforesaid Contract in good order and repair, excepting only such part or parts of said work which may have been disturbed without his consent or approval after acceptance there by the CITY, and shall, whenever given notice as herein provided, immediately proceed to make specified repairs, or, in default thereof, shall reimburse the CITY for expenses incurred in making such repairs, and shall fully indemnify, defend and save the CITY harmless from all suits and actions for damages of every name and description brought or claimed against it, for or on account of any injury or damage to person or property received or sustained by any party or parties, by or from any of the acts or omissions or through the negligence of the Principal’s employees, agents, subcontractors or material suppliers in the performance of the work required by said Contract, and from any and all claims arising under the Workman’s Compensation Act of the State of Michigan, as amended, then the above obligation shall be void, otherwise to remain in full force and effect.

IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed by their

MGB-2

LABOR AND MATERIALS BOND

______________________________________________________________as Principal and _____________________________________________________________________________ as Surety or Sureties, are held and firmly bound unto the CITY OF LIVONIA, Wayne County, Michigan, in the sum of __________________________________________________________ Dollars ($ ), for the payment of which, well and truly to be made, we hereby jointly and severally bind ourselves, our heirs, executors, administrators, successors and assigns.

THE CONDITION of the foregoing obligation is such that, whereas the said

_____________________________________________________________________________ did on the day of , 20 , by articles of that date, enter into a Contract with the said CITY OF LIVONIA for the construction of and the payment for all labor and materials used therein.

NOW THEREFORE, if the said____________________________________________________ shall pay for all labor and materials used in the fulfillment of said Contract, and shall pay for subcontractors doing work thereon, and shall indemnify and save harmless the said CITY OF LIVONIA from and against all damages by reason of liens for labor or materials furnished thereof, then this obligation shall be void, but otherwise it shall remain in full force and effect.

PROVIDED, that any alterations which may be made in the terms of the Contract or in the work to be done under it, or the granting by the said CITY OF LIVONIA of any extension of time for the performance of the Contract or any other forbearance on either the part of said CITY OF LIVONIA or the Principal, to the other, shall not in any way release the Principal and Surety or Sureties, or either, or any of them, their heirs, executors, administrators, successors, or assigns, from their liability hereunder, notice to the Surety or Sureties of any such alteration, extension of forbearance being hereby waived.

WITNESS, our hands and seals, this day of __, 20_______

Signed, sealed and delivered in the ______________________________________

Presence of: By____________________________________

By

LMB REV. 2/05

CONTRACT’S DECLARATION

I herby declare that I have not, during the period to

, A.D. 20 . Performed any work, furnished any material, sustained any loss, damage or delay for any reason, including soil conditions encountered or created, or otherwise done anything for which I shall ask, demand sue for, or claim compensation from the City Of Livonia, the Owner, or its agents, in addition to the regular items set forth in the contract numbered , and dated AD 20 for executed between myself and the City Of Livonia, and in the Change Orders for work issued by the City of Livonia in writing as provided thereunder, except as I hereby make claim for additional compensation and/or extension of time, as set forth on the itemized statement attached hereto.

There is/is not (circle one) an itemized statement attached.

The Contractor further certifies that all his indebtedness for labor and materials incorporated in the work covered by this estimate has been full paid and/or satisfactory arrangements with materials suppliers have been made.

Contractor

By:

Title

Date:

CD

CONTRACTOR'S AFFIDAVIT

STATE OF MICHIGAN )

ss

COUNTY OF )

The undersigned hereby warrants and certifies that all of his (its) indebtedness arising by reason of the said Contract has been fully paid or satisfactorily secured; and that all claims from subcontractors and others for labor and material used in accomplishing the said project, as well as all other claims arising from the performance of the said Contract, have been fully paid or satisfactorily settled. The undersigned further agrees that, if any such claim should hereafter arise, he (it) shall assume responsibility from the same immediately upon request to do so by the said City of Livonia.

The undersigned, for a valuable consideration, the receipt of which is hereby acknowledged, does waive, release and relinquish any and all claims or right of lien which he (it) now has or may hereafter acquire upon the subject premises for labor and material used in accomplishing said project owned by the said City of Livonia.

This affidavit is freely and voluntarily given with full knowledge of the facts, on this day of , 19 .

Subscribed and sworn to before me

(Contractor)

By Title on this day of , 19

Notary Public County, Michigan

My Commission Expires:

CA