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HomeMy WebLinkAbout2001 10 22 Consent B Contractual Agreement COMMISSION AGENDA ITEM B CONSENT X INFORMATIONAL PUBLIC HEARING REGULAR October 22, 200 1 Meeting MGR(l---;r;EPT J;t/ Authorization REQUEST: Utility Department Requesting Authorization to enter into a Contractual Agreement for construction of Well #4 at Water Treatment Plant #1. PURPOSE: The purpose of this Board item is to request authorization to enter into a contractual agreement with Diversified Drilling Corporation of Tampa, Florida for the construction of Well #4 near Water Treatment Plant #l at a cost of$273,l50.00 plus a lO% contingency. CONSIDERATIONS: This project is needed to provide an additional water supply source during paek demand periods for the eastern portion of Winter Springs. Bids for this project were opened on October 3, 200l under Bid # ITB-OIO-Ol/GE. The City Clerks summary is attached. The low bidder was Diversified Drilling Corporation of Tampa, Florida, with a bid of$273,l50. The engineer's estimate of construction cost was $250,000. I ----j I ----I. October 22, 200 1 Consent Agenda Item B Page 2 The project scope of work includes all labor, equipment, and materials for the. installation of .an l8" water supply well. All permits have been received. The Capital Projects Coordinator recommendation is attached with the engineers recommendation and also the agreement form. FUNDING: The proposed contract amount of$273,l50 is slightly greater that the $250,000 Budgeted for this project in the Utility Fund 2000 Construction Fund Capital Improvement line code (3640-563l 0). Sufficient savings have occurred on other projects to offset the difference. The funds will be spent over the next l80 days. RECOMMENDA TION: It is recommended that authorization be granted to enter into a contractual Agreement with Diversified Drilling Corporation, Inc. for the construction of an l8" water supply well to augment the water supply to the eastern portion of Winter Springs at a cost of $273, l50 plus a 10% contingency which is payable from the Utility Enterprise Fund 2000 Construction Fund capital improvements line code (#3640-563l 0). IMPLEMENTA TION SCHEDULE: The scope of work will be completed within l20 days of issuance of the NTP. ATTACHMENTS: l. Capital Project Coordinator recommendation 2. City Clerk Summary - Bid' ~ITB-OlO-Ol/GE 3. Proposal and Agreement COMMISSION ACTION: A TT ACHMENT NO. 1 MEMORANDUM - FROM: Kip Lockcuff, P.E. . Utilities/Public Works Directo I George F. Edwards, P.E. ! ~IX Capital Projects Coordinato If ! TO: RE: Bid Analysis, Bid # ITB-010-01/GE Town Center Off Site Sanitary Force Main DATE: October 9, 2001 On Wednesday, October 3, 2001, the City of Winter Springs received two bids for the construction of Well #4 at Water Treatment Plant #1. The bids received were priced as follows: Company Bid Diversified Drilling Corporation $273,150.00 $457,347.00 All Web's Enterprises, Inc. The Engineer's estimate of probable construction cost of the project was $250,000.00. The amount budgeted was $250,000.00. EVALUATION OF RESPONSIVENESS The low bidder, Diversified Drilling Clrporation provided all required documentation to establish bidder responsibility. The bid may be considered responsive. EVALUATION OF RESPONSIBILITY The references supplied by Diversified Drilling Corporation were verified with positive results. After review of the references, the Engineer, CPH, SCADA-Bid Analysis/Recommendation recommended that the contract be awarded to Diversified Drilling Corporation. FUNDING The low bid of $273,150.00 is slightly above the amount budgeted for this project. The funding source is the 2000 Utility Construction Fund. RECOMMENDATION In my opinion, an award of the WTP #1, Well#4 Project to Diversified Drilling Corporation is in the best interest of the City. IMPLEMENTATION SCHEDULE The scope of work will be completed within 120-calendar days of the Notice to Proceed. Attachments: 1) City Clerk's Bid Summary 2) Engineer's Recommendation 3) Bid AnalyslslBreakdown 4) Draft Contract SCADA-Bid Analysis/Recommendation Oct. 8. 2001 4:22PM No.4801 p. 2/2 October 8, 2001 CPH Engineers, Inc. 1117 E. Robinson St. Suite C Orlando, Fl32801 Phone:(407)4~52 . Fax; (40'7) 648-1036 www.cphenginQQrs.com Mr. George Edwards, P.E. City of Winter Springs 1126 East S.R. 434 Winter Springs, Florida 32708 Re: WTP 1 - Well No. 1 .. Engineer's Recommendation to Award Contract CPH Project No. W04104 Dear George: The purpose of this letter is to give the Engineer's recommendation to award the Contract for the construction of the "WTP 1 - Well No. 1"0 We received copies of the bid packages from the City for both of the bidders on the project. CPH Engineers reviewed the tabulated items from the bidders and verified that the Trench Safety Statement and Bid Bond were included in the information provided. The apparent low bidder is Diversified Drilling Corporation with a total bid amount of $273,150.00. From our review of the bid tabulation, it appears that the prices from Diversified Drilling Corporation reflect an understanding of the work required by the plans and specifications. Overall, the prices for each item appear to be reasonable. Diversified Drilling Corporation has done numerous municipal potable water well projects in the Central Florida area. From the infonnation provided and our previous and current experiences, we believe that Diversified Drilling Corporation has the experience and resources to construct the "'WTP 1 - Well No.1" project in accordance with the plans and specifications. Therefore, we recommend that the City of Winter Springs award the construction contract to the low bidder, Diversified Drilling Corporation, in the bid amount of $273,150.00. Please contact us if additional information Is needed concerning the above. Sincerely, CPH ENGIN~~.3>~ ~nSlein. P.E. Project Engineer cc: Mr. Kipton LOckcuff, Utilities Director J;\W04104\WO\BIO ReCOMM~NOATION.OOC SANFORD · ORLANDO . DELAND . PALM CITY . CAPE CORAL . JACKSONVILLE A TT ACHMENT NO. 2 CITY OF WINTER SPRINGS, FLORIDA 1126 EAST STATE ROAD 434 WINTER SPRINGS. FLORIDA 32708'-2799 Telephone: (407) 327-1800 Fax: (407) 327-4753 E-mail: contactus@winterspringsfl.org BID NUMBER: ITB-010-01lGE BID CLOSING: OCTOBER 3, 2001 Bid Closing Was Called By: Nancy Vobomik, Purchasing Coordinator Bid Opened: Bid Closed: 3:00 p.m. 3 :02 p.m. Witnesses: George Edwards, Capital Projects Coordinator Holly Pierstorff, Assistant To The City Clerk Two (2) Bids Received: l. DIVERSIFIED DRILLING CORPORA nON AGENT: MR. STUART C. ANDERSON, VICE PRESIDENT, P.O. BOX 290699, TAMPA, FLORIDA 33687-0699 TELEPHONE: (813) 988-1132 FACSIMILE: (813) 985-6636 BID AMOUNT: $ 273,150.00 2. ALL WEBB'S ENTERPRISES, INC. AGENT: MR. DAVID W. WEBB, PRESIDENT, 309 COMMERCE WAY, WPITER, FLORIDA 33458 TELEPHONE: (561) 746-2079 FACSIMILE: (561) 746-4199 BID AMOUNT: $457,347.00 Copy: Mr. Kip Lockcuff, Director, Public Works Department Ms. Nancy Vobornik, Purchasing Department Docs\Word\IIIDS\RESULTS\FyOOO I \IT13-0 I 0-0 I GE.doc A TT ACHMENT NO. 3 SECTION 00520 AGREEMENT FORM THIS AGREEMENT MADE THIS DAY OF , 200_ between the CITY OF WINTER SPRINGS of 1126 East State Road 434, Winter Springs, Florida 32708, Seminole County, State of Florida, herein referred to as OWNER and Diversified Drilling Corporation, State of Florida, herein referred to as CONTRACTOR, a person duly licensed as a Contractor in the State of Florida, as follows: 1. . 'DESCRIPTION OF WORK - CONTRACTOR shall perform the work, in accordance with the Contract Documents, at Well #4, Winter Springs, FL. 32708 for the WTP 1 - Well NO.4 Project. 2. CONTRACT DOCUMENTS - The Contract Documents consist of this Agreement; all Technical, General and Supplementary Conditions and Sections contained in the Project Manual; the Drawings as listed on the Bid Form and Index to Drawings; all Addenda issued prior to and all Change Orders issued after execution of this Agreement. These form the Contract and are incorporated into this Contract by this reference. 3. CONTRACT TIME - The CONTRACTOR shall begin work within 10 days after the issuance of a written Notice to Proceed and shall complete the work within 120 calendar days from the date of the Notice to Proceed. Extensions, if any, are authorized by OWNER, and may only be granted in writing. 4. LIQUIDATED DAMAGES - OWNER and CONTRACTOR recognize that time is of the essence of this Agreement and that OWNER will suffer financial loss if the Work is not substantially complete within the time specified in Paragraph 3 above, plus any extensions thereof allowed in accordance with the General Conditions. They also recognize the delays, expense, and difficulties involved in proving in a legal or arbitration proceeding the actual loss suffered by OWNER if the Work is not substantially complete on time. Accordingly, instead of requiring any such proof, OWNER and CONTRACTOR agree that as liquidated damages for delay (but not as a penalty) CONTRACTOR shall pay OWNER $500.00 for each day that expires after the time specified in Paragraph 4 for final completion until the work is finally complete, and that OWNER has paid to CONTRACTOR the consideration of Ten ($10.00) Dollars as consideration for this provision. 5. CONTRACT PRICE. UNIT PRICE CONTRACT - The OWNER will pay the CONTRACTOR in current funds for the performance of the work, subject to additions and deductions by Change Order, the Total Contract Price of Two Hundred Seventy Three Thousand One Hundred Fifty and 00/100 Dollars ($273,150.00). Payments will be made to the CONTRACTOR for actual quantities installed on the basis of the Schedule of Unit Prices included as a part of his Bid, which shall be as fully a part of the Contract as if attached or repeated herein. 6. PROGRESS PAYMENTS - OWNER shall make progress payments on account of the contract price to CONTRACTOR, on the basis of application for payments submitted to the City or their authorized representative, by CONTRACTOR as the work progresses, and in accordance with the Contract Documents. Progress payments may be withheld if: (A) Work is found defective and not remedied; 00520-1 (B) Contractor does not make prompt and proper payments to subcontractors; (C) Contractor does not make prompts and proper payments for labor, materials, or equipment furnished him; (D) Another Contractor is damaged by an act for which Contractor is responsible; (E) Claims or liens are filed on the job; or (F) In the opinion of the City of Winter Springs, Contractor's work is not progressing -satisfactorily. 7. FINAL PAYMENT - OWNER shall withhold up to 10% of the Contract Price throughout the project. The OWNER shall release 50% of the amount withheld upon issuance of the Substantial Completion Certificate. The remaining 50% of the amount withheld shall be released with the Final Payment after the issuance of the Final Completion Certificate. OWNER shall make final payment to CONTRACTOR within thirty (30) days after the work is fully and properly completed, if the contract has been fully and timely performed, but subject to the condition that final payment shall not be due until CONTRACTOR has delivered to OWNER a complete release of liens arising out the contract, or receipt releases of lien fully covering all labor, materials and equipment for which a lien could be filed, or in the alternative a bond satisfactory to OWNER indemnifying him against such claims. By making payments OWNER does not waive claims including but not limited to those relating to: (A) Faulty work appearing after substantial completion has been granted; (B) Work that does not comply with the Contract Documents: (C) Outstanding claims of liens; or (D) Failure of Contractor to comply with any special guarantees required by the Contract Documents. 8. DESIGNATION OF PROJECT DIRECTOR OR ARCHITECT OR ENGINEER: DUTIES AND AUTHORITY - The duties and authority of the City are as follows: a. General Administration of Contract. The primary function of the City is to provide the general administration of the contract. In performance of these duties George F. Edwards, P.E. or his authorized representative is the City's Project Director during the entire period of construction. The OWNER (City) may change the Project Director during the term of this contract. b. Inspections. Opinions. and Proaress Reports. The OWNER shall be kept familiar with the progress and quality of the work by CONTRACTOR and may make periodic visits to the work site. The OWNER will not be responsible for the means of construction, or for the sequences, methods, and procedures used therein, or for the CONTRACTOR's failure to perform the work in accordance with the Contract Documents. c. Access to Worksite for Inspections. The OWNER shall be given free access to the 00520-2 worksite at all times during work preparation and progress. The Project Director is not obligated to make exhaustive or continuous on site inspections to perform his duties of checking and reporting on work progress, and any such inspections shall not waive Owner's claim regarding defective work by Contractor. d. Interpretation of Contract Documents: Decisions on Disputes. The OWNER will be the initial interpreter of the contract document requirements, and make decisions on claims and disputes between Contractor and Owner. e. Reiection and StoppaQe of Work. The OWNER shall have authority to reject work which . in its opinion does not conform to the Contract Documents, and in this connection may stop the work or a portion thereof, when necessary. f. Payment Certificates. The OWNER will determine the amounts owing to CONTRACTOR as the work progresses, based on CONTRACTOR's applications and OWNER's inspections and observations, and will issue certificates for progress payments and final payments in accordance with the terms of the Contract Documents. 9. RESPONSIBILITIES OF CONTRACTOR - CONTRACTOR's duties and rights in connection with the project herein are as follows: a. Responsibility for Supervision and Construction. CONTRACTOR shall be solely responsible for all construction under this contract, including the techniques, sequences, procedures and means, for the coordination of all work. CONTRACTOR shall supervise and direct the work, and give it all attention necessary for such proper supervision and direction. b. Discipline and Employment. CONTRACTOR shall maintain at all times strict discipline among his employees, and he agrees not to employ for work on the project any person unfit or without sufficient skill to perform the job for which he was employed. c. FurnishinQ of Labor. Materials. etc. CONTRACTOR shall provide and pay for all labor, materials and equipment, including tools, construction equipment and machinery, utilities, including water, transportation, and all other facilities and services necessary for the proper completion of work on the project in accordance with the Contract Documents. d. Payment of Taxes: Procurement of Licenses and Permits. CONTRACTOR shall secure all licenses and permits necessary for proper completion of the work, paying the fees therefor. CONTRACTOR warrants that it (and subcontractors or tradesmen, if authorized in the Contract Documents) hold or will secure all trade or professional licenses required by law for CONTRACTOR to undertake the contract work. e. CONTRACTOR will provide written guarantee for work and materials for one (1) calendar year after acceptance by OWNER. 00520-3 10. BOND - CONTRACTOR shall supply a materials, performance and payment bond(s) in accordance with Florida law and to the satisfaction of OWNER, in an amount specified in the Contract Documents. 11. MEDIATIONNENUE - The parties agree that should any dispute arise between them regarding the terms or performance of this Agreement, both parties will participate in a mediation. The parties agree to equally share the cost of the mediator. Should the parties fail to resolve their differences through mediation, then any cause of action filed hereunder shall be filed in the Circuit or County Court for Seminole County, Florida. 12. .NOTICES - Any notice or approval under this Contract shall be sent, postage prepaid. to the applicable party at the address shown on the first page of this Contract. Signed, Sealed and Delivered in the presence of: Contractor: Name Address and Telephone Date OWNER: CITY OF WINTER SPRINGS By: Ronald W. McLemore City Manager 1126 East State Road 434 Winter Springs, FL. 32708 407 -327 -1800 00520-4 AGREEMENT FORM THIS AGREEMENT MADE THIS ~ ~ DAY OF _/tl6U~u9~ 200 /between the CITY OF WINTER SPRINGS of 1126 East State Road 434, Winter Springs, Florida 32708, Seminole County, State of Florida, herein referred to as OWNER and Diversified Drilling Corporation, State of Florida, herein referred to as CONTRACTOR, a person duly licensed as a Contractor in the State of Florida, as follows: 1. .DESCRIPTION OF WORK -CONTRACTOR shall perform the work, in accordance with the Contract Documents, at Well #4, Winter Springs, FL. 32708 for the WTP 1 -Well No. 4 Project. 2. CONTRACT DOCUMENTS -The Contract Documents consist of this Agreement; all Technical,. General and Supplementary Conditions and Sections contained in the Project Manual; the Drawings as listed on the Bid Form and Index to Drawings; all Addenda issued, prior to and all Change Orders issued after execution of this Agreement. These form the Contract and are incorporated into this Contract by this reference. 3. CONTRACT TIME -The CONTRACTOR shall begin work within. 10 days after the issuance of a written Notice to Proceed and shall complete the work within 120 calendar days from the date of the Notice to Proceed. Extensions, if any, are authorized by OWNER, and may only be granted in writing. 4. LIQUIDATED DAMAGES -OWNER and CONTRACTOR recognize that time is of the essence of this Agreement and that OWNER will suffer financial loss if the Work is not substantially complete within the time specified in Paragraph 3 above, plus any extensions thereof allowed in accordance with ,the General Conditions.. They also recognize the delays, expense, and difficulties involved in proving in a legal or arbitration proceeding the actual loss suffered by OWNER if the Work is not substantially complete on time. Accordingly, instead of requiring any such proof, OWNER and CONTRACTOR agree that as liquidated damages for delay (but not as a penalty) CONTRACTOR shall pay OWNER $500.00 for each day that expires after the time specified in Paragraph 4 for final completion until the work is finally complete, and that OWNER has paid to CONTRACTOR the consideration of Ten ($10.00) Dollars as consideration for this provision. 5. CONTRACT_ PRICE, UNIT PRICE CONTRACT - The OWNER will pay the CONTRACTOR in current funds for the performance of the work, subject to additions anddeductions by Change Order, the Total Contract Price of Two Hundred Seventy Three Thousand One Hundred Fifty and 00/100 Dollars ~$ 273,150.00 Payments will be made to the CONTRACTOR for actual. quantities installed on the basis of the Schedule of Unit Prices included as a part of his Bid, which shall be as fully a part of the Contract as if attached or repeated herein. 6. PROGRESS PAYMENTS.- OWNER shall make progress payments on account of the contract price to CONTRACTOR; on the basis of application for payments submitted to the City or their authorized representative, by CONTRACTOR as the work progresses, and in accordance with the Contract Documents. Progress payments may be withheld if: 00520-1 (B) Contractor does not make prompt and proper payments to subcontractors; (C) Contractor does not make prompts and proper payments for labor, materials, or equipment furnished him; (D) Another Contractor is damaged by an act for which Contractor is responsible; (E) Claims or liens are filed on the job; or (F) In the opinion of the City of Winter Springs, Contractor's work is not progressing satisfactorily. 7. FINAL PAYMENT -OWNER shall withhold up to 10% of the Contract Price throughout the project. The OWNER shall release 50% of the amount withheld. upon issuance of the Substantial Completion Certificate. The remaining 50% of the amount withheld shall be released with the Final Payment after the issuance of the Final Completion Certificate. OWNER shall make final payment to CONTRACTOR within thirty (30) days after the work is fully and properly completed, if the contract has been fully and timely performed, but subject to .the condition that final payment shall not be due until CONTRACTOR has delivered to OWNER a complete release of liens arising out the contract, or receipt releases of lien fully covering all labor, materials and equipment for which a lien could be filed,. or in the alternative a bond satisfactory to OWNER indemnifying him against such claims. By making .payments OWNER does not waive claims including but not limited to those relating to: (A) Faulty work appearing after substantial completion has' been granted; (B) Work that does not comply with the Contract Documents: (C) Outstanding claims. of liens; or (D) Failure of Contractor to comply with any special guarantees required by the Contract Documents. 8. DESIGNATION OF PROJECT DIRECTOR OR ARCHITECT OR ENGINEER: DUTIES AND AUTHORITY -The duties and authority of the City are as follows: a. General Administration of Contract. The primary function of the City is to provide the general administration of the contract. In performance of these duties George F. Edwards, P.E.. or his authorized representative is the City's Project Director during the entire period of construction. The OWNER (City) may change the Project Director during the term of this contract. b. Inspections, Opinions, and Progress Reports. The OWNER shall be kept familiar with the progress and quality of the work by CONTRACTOR and may make periodic visits to the work site. The OWNER will not be responsible for the means of construction, or for the sequences, methods, and procedures used therein, or for the 00520-2 CONTRACTOR's failure to perform the work in accordance with the Contract Documents. c. Access to Worksite for Inspections. The OWNER shall. be given free access to the worksite at all times during work preparation and progress. The Project Director is not obligated to make exhaustive or continuous on site inspections to perform his duties of checking and reporting on work progress, and any such inspections shall not waive Owner's claim regarding defective work by Contractor. d. Interpretation of Contract Documents: Decisions on Disputes. The OWNER will be the initial interpreter of the contract document requirements, and make decisions on claims and disputes between Contractor and Owner. e. Refection and Stoppage of Work. The OWNER shall have authority to reject work which in its opinion does not conform to the Contract Documents, and in this connection may stop the work or a portion thereof, when necessary. f. Pavment Certificates. The OWNER will determine the amounts owing to CONTRACTOR as the work progresses, based on CONTRACTOR'S applications and OWNER's inspections and observations, and will issue certificates for progress payments and final payments in accordance with the terms of the Contract Documents. 9. RESPONSIBILITIES OF CONTRACTOR - CONTRACTOR's duties and rights in connection with the project herein are as follows: a. Responsibility for Supervision and Construction. CONTRACTOR shall be solely responsible for all construction under this contract, including the techniques, sequences, procedures and means, for the coordination of all work. CONTRACTOR shall supervise and direct the work, and give it all attention necessary for such proper supervision and direction. b. Discipline and Employment. CONTRACTOR shall maintain at all times strict discipline among his employees, and he agrees not to employ for work on the project any person unfit or without sufficient skill to perform the job for which he was employed. c. Furnishing of Labor. Materials etc. CONTRACTOR shall provide and pay for all labor, materials and- equipment, including tools, construction equipment and machinery, utilities, including water, transportation, and all other facilities and services necessary for the proper completion of work on the project in accordance with -the Contract Documents. d. Pavment of Taxes: Procurement of Licenses and Permits. CONTRACTOR shall secure all licenses and permits necessary for proper completion of the work, paying the fees therefor. CONTRACTOR warrants that it (and subcontractors or tradesmen, if authorized in the Contract Documents) hold or will secure all trade or professional licenses required by law for CONTRACTOR to undertake the contract work. e. CONTRACTOR will provide written. guarantee for work and materials for one (1) calendar year after acceptance by OWNER. . 00520-3 10. BOND -CONTRACTOR shall supply a materials, performance and payment bond(s) in accordance with Florida law and to the satisfaction of OWNER, in an amount specified in the Contract Documents. 11. MEDIATIONNENUE -The parties agree that should any dispute arise between them regarding the terms or performance of this .Agreement, both parties will participate in mediation. The parties agree to equally share the cost of the mediator. Should the parties fail to resolve their differences through mediation, then any cause of action filed hereunder shall be filed in the Circuit or County Court for Seminole County, Florida. 12. NOTICES -Any notice or approval under this Contract shall be sent, postage prepaid, to the applicable party at the address shown on the first page of this Contract. Signed, Sealed and Delivered in the presence of: ~ ~~ DIVERSIFIED DRILLING CORPORATION Contractor: me P.0. BOX 290699 TAMPA, FL 33687-0699 Address and Telephone Date OWNER: ~.. = CITY OF WINTER' S~P~RIN~GS By: Ronald V'!: McLemore City Manager. 1126 East Stag Road 434 Winter Springs, FL..;~2708, 407-327-1800 00520-4 ACCRD,~ CERTIFICATE OF .~. LIABILITY INSURANCE °io~3oi~ao ~~ r. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER 813-496-81D0 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ED JACOBS ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. FEDERATED MUTUAL INSURANCE CO COMPANIES AFFORDING COVERAGE PO BOX 31716 TAMPA, FL 33631 COMPANY FEDERATED MUTUAL INSURANCE CO. A INSURED COMPANY DIVERSIFIED DRILLING CORPORATION B PO BOX 290699 COMPANY FL 33687 TAMPA C , COMPANY D C[iVEl~AGES~ >r. - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LI STED BELOW HAVE BEEN. ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDRION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS NOTWITHSTANDING ANY REQUIREMENT ED , INDICAT , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, TIFICATE MAY BE ISSUED OR MAY PERTAIN , CER EXCLUSIONS AND CONDffIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MpuDp~yy~ POLICY EXPIRATION DATE (YMlDDfYY) LIMITS GENERALAGGREGATE S GEN ERALLIABIUTY OMMERCIAL GENERAL LIABILITY PRODUCTS- COMPIOP AGG S C CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $ WNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ O FIRE DAMAGE (Ami one tire) S MED EXP (Any ona person) $ AUT OMOBILE LFABILITY COMBINED SINGLE LIMIT $ TO ANY AU ALL OWNED AUTOS BODILY INJURY Par erson) S SCHEDULED AUTOS p ( HIRED AUTOS BODILY INJURY Per acddent) $ 'NON-0WNED AUTOS ( PROPERTY DAMAGE S IUTY AUTO ONLY - EA ACCIDENT $ GA RAGE LIA8 ANY AUTO OTHER THAN AUTO ONLY: _ EACH ACCIDENT $ AGGREGATE 5 BILITY I EACH OCCURRENCE $ EXC A ESS L UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM _ $ A S COMPENSATION AND 2asa~o4 o4rov01 04/01/02 roRY uMlrs ER =:=: WORKER EMPLOYERS' VABILITY EL EACH ACCIDENT $ SOO,OOO THE PROPRIETOR! }~ INCI EL DISEASE-POLICY LIMIT $ SOO,OOO PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ ~JOO,OOO OTHER DESCRIPTION OF OPERATIONS/LOCATIONS)VEH[CLESfSPECUtI FTEMS THE INSURANCE COMPANY HEREBY WAIVES ITS RIGHTS OF SUBROGATION AS {T APPLEES TO PROJECT: WTP 1 -WELL NO. 4. CCRTIFICA7C 11QLDER CANCELLATIQN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF WINTER SPRINGS EXPIRATwN DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1126 EAST S.R. 434 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, WINTER SPRINGS, FL 32708 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 11A81LITY OF ANY FND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AyFHORRE R RESENTATIVE ~ ~ /J I J (~ j ~ .--- 9 R ACQRD 25-5 (1195) 8$._:; D CORPORATION 1 ~ ACO ;.,.. ..,_._ ACORD CERTIFICATE 'QF DATE (MM/DD/YY) L!A$IL1T.Y INSURANCE 1a~3ar2aal r~ ~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER 813-496-81fl0 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ED JACOBS ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. FEDERATED MUTUAL INSURANCE CO COMPANIES AFFORDING COVERAGE PO BOX 31716 FL 33631 TAMPA COMPANY FEDERATED MUTUAL INSURAPICE CO. , A INSURED COMPANY DIVERSIFIED DRILLING CORPORAT{ON B PO B©}(zsa6~a COMPANY FL 33687 TAMPA C , COMPANY I D z. C,OVE#2AG;ES, ~s ES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICI TER REQUIREMENT M OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS , INDICATED, NOTWITHSTANDING ANY THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, R MAY PERTAIN , CERTIFICATE MAY BE ISSUED O LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICIES . EXCLUSIONS AND CONDITIONS OF SUCH ~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DDJYY) POCKY EXPIRATION DATE (MMIDD/YY) LIMITS L TR GENERALRGGREGATE $ GEN ERAL LIABILITY I ITY PRODUCTS - COMPIOP AGG S L COMMERCIAL GENERAL LIAB ~ OCCUR PERSONAL R ADV INJURY $ _= CLAIMS MADE 'S PROT ' EACH OCCURRENCE S S S CONTRACTOR OWNER FIRE DAMAGE (Airy one tire) $ MED EXP (Any one parson) $ AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY lNJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Peracadent) $ NON-OWNED AUTOS PROPERTY DAMAGE $ AUTO ONLY-EA ACCIDENT $ --- _-- GA RAGE LIABILITY OTHERTHAN AUTO ONLY: ' - - ANY AUTO EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ EXC ESS LIABILITY AGGREGATE S UMBRELLA FORM OTHER THAN UMBRELLA FORM _ $ ,,,. Za~s~aa a4Ia1Ia1 aaral~a2 TORY LIMITS ER - A WORKERS COMPENSATION AND 5aa Oaa EMPLOYERS' LIABILITY EL EACH ACCIDENT $ THE PROPRIETORI 1{ INCL El DISEASE-POLICY LIMIT $ 5aa,aaa PRRrN~RS/EXecunvE OFFIC f!S A~t~: EXUL CL DIOCAOC C,S GMI'LQY6G r nn,nnn OTHER DESCRIPTION OF OPERATONS/LOCATIONSIVEHICLES/SPECIAL ITEMS THE INSURANCE COMPANY HEREBY WAIVES ITS RIGHTS OF SUBROGATION AS IT APPLIES TO PROJECT: V~iTP 1 -WELL NO. 4. tii~RTIFICAT~ HOLDER CgNGE(,(k,gTlON' ` SHOULD ANY OF THE ABOVE DESCRIBED POLIgE3 BE CANCELLED BEFORE THE CPH ENGINEERS, INC. EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1117 E. ROBINSON STREET 3a DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ORLANDO, FL 3Laa1 BUT FaLURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, RS AGENTS OR REPRESENTATIVES. E AyjHORIZ D PRESENTATI I V ' " ((,~~ ~~~ " "° CORD 25-S (1195) 1988 . ~a ACORD CORPORATION ` FILE No.892 14130 'O1 1011 ID~DDC_CORPORATE FAX~813 985 6636 SECTION 00620 INSURANCE ENDORSEMENT FORM Name of Project: WTP 1 -Well No. 4. Owner: City of Winter Sorinas 1126 East S.R. 434 Winter Sorinos. Florida 32708 City PAGE li 1 THIS IS TO CERTIFY that the numbered policies identified by the attached Certificates of Insurancehave been issued by the below-stated company in conformance with the limits and requirements asset forth in the General Conditions and Supplementary Conditions. The insurance company will give at least thirty (30) days' written notice by registered mail to the Owner and the Engineer prior to any material change or cancellation of said policy or policies. ATTACH CERTIFICATES OF INSURANCE ANO INDICATE TYPE OF INSURANCE, POLICY NUMBER, EFFECTIVE DATE, EXPIRATION DATE, AND LIMITS OFlNSURANCE. THE CERTIFICATES OF INSURANCEARE TO INDICATETHENAMED INSURED, AND ARE TO IDENTIFY THE OWNER, ENGINEER AND OTHER PARTIES IDENTIFIED IN THE SUPPLEMENTARYCONDITIONSASAOD/T/ONALNAMEDlNSURED. THEOWNERANDENGINEERARETOBENAMED AS CERTIFICATEHOLDERS. ENDORSEMENT e Owner's Representative, the Engineer, Architect, and their consultants, and a t=t#~eir officers, agents, an are included as additionally named insure ~ policies but only while acting in their capacity as suc a sec o the originally named insured, his subcontractors, agents, and emplo orma ove-referenced contract; provided, however, that if amage Is ultimately determined to be the esult of the sole 0 one or more of the aforesaid additionally named insured, this insurance sha ~ This endorsement shall not operate to increase the insurance company's total limit of liability hereunder. The insurance company hereby waives its rights of subrogation. Named Insured .. Insurance Company Street & Num BY ~ i Authorized,~'epresentativ~ (Attach Acknowledgment) Engineer: CPH Engineers. Ing; 11 i 7 E. Robinson Street Orlando. Florida 32801 ~. State Zip ~j~. ~A~~/~S ignature and Printed Name) END OF SECTION :.~,: 00620-1 ~~ acoRD -CERTIFICATE OF LIABILITY INSURANC~SR Rs DATE(MM/DDIYY) IVER-3 11/O1/O1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wallace Welch & Willingham Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE '`~" 3810 16th Street North HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P . O . Box 33020 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. St. Petersburg FL 33733 Phone:727-522-7777 Fax:727-521-2902 INSURERS AFFORDING COVERAGE INSURED INSURER A: CNA Insurance Com anies INSURER B: Zur].Ch Insurance CO an Diversified Drilling Corp INSURER C: ~ax L933 687 0 699 INSURER D: - T F INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 ~" A X COMMERCIAL GENERAL LIABILITY TCP2024764059 04/09/01 04/09/02 FIRE DAMAGE (Any one tire) _ $ 50,000 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5 , 000 X P/O PERSONAL 8 ADV INJURY .. $ 1 , 000 , 000 ~ X P/(`O GENERAL AGGREGATE $ 2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2 , 000 , 000 POLICY X PRO LOC JECT AUT OMOBILE LWBILITY COMBINED SINGLE LIMIT $ 1 000 000 A X ANY AUTO BUA2024764885 04/09/01 04/09/02 (Eaaxident> , , ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN ~ ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ 5 , 000 , 000 ~~ ~~ $ X OCCUR ~ CLAIMSMADE AUC9277982 04/09/01 04/09/02 AGGREGATE $ 10 000,000. i $ DEDUCTIBLE _. _. $ X RETENTION $ O $ WORKERS COMPENSATK)N AND TORY LIMITS ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ A OTHER Rented/Leased E i nt Covera a TCP2024764059 04/09/01 04/09/02 Limit $500,000 Ded $1 000 DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONSADDED BY ENDORSEMENT/SPECUIL PROVISIONS Project: WTP 1-Well No.4 -includes Waiver of Subrogation -Certificate Holder is Additional Insured per attached section 00620. CERTIFICATE HOLDER Y ADDITIONAL INSURED; INSURER LETTER: _ CANCELLATION S CITYWIN City of Winter Springs 1126 East S.R. 434 Winter Springs FL 32708 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR - REPRESENTArnE3. ACORD 25$ (7/97) ~ - ®AGORD GORPC7KA I IUP! 79SS - r' r FILE No.885 1029 'O1 17:12 ID:DDC_Ca2PORATE FAX:813 985 6ti36 pq(~ y g SECTION 00620 INSURANCE ENDORSEMENT FORM Name of Project: WTP 1 -Well No. a. Owner: Engineer: City of Winter Borings C_PH Engineers. Inc. 1126 East S.R. 434 1117 E. Robinson Stmt Winbr Sgringa. Florida 3?~7pg Orlando. Florida 32801 THIS IS TO CERTIFY that the numbered poNcies klentifled by the attached Certiticcates of Insurance have been issued by the below-stated company in conformance with the limits and requirements as set forth in the General CondRions and Supplementary Conditions. The insurance company will give at least thirty (30) days' written notice by registered mail to the Owner and the Engineer prior to any material change or cancepatign of said policy or policies. ATTACHCERT/fiCATESOPINSURANCEANOlNO1CATETYPEOF/NSURAJyCE, pOLICYNC/MgER, EFFECTIVEDATE, EXPIAAT/ONDATE,ANDLIiNITSOF/NSUfL1NCE. THECERTIFM.A7ESOFINSURANCEARETOIN011tAATETHEAfAMEO INSURED, ANO ARE TO IDENT/FY THE OWNER, FiW31NEER AND OTHER PARTIES IOENrIFTEp IN T} fE SUPPLEMENTARYCWVplT10NSASADD1170NA1_NAMEDINSURED. THEOWNERANDENGINEERARETOBENAMED AS CERTIF7CATEMOLDERS ENDORSEMENT The Owner, the Owner's Representative, the Engineer, Architect, and their cgnsuRants, and each of their officers, agents, and empbyees are included as additionally named insured under said policies but only while acting in their capacity as such and only as respects operations of the originally named insured, his subcontractors, agents, and employees in the performance of the above-referenced contract; provided, however, that if the loss or damage is ultimately determined to be the proximate result of the sole negligence of one or more of the aforesaid additionally named insured, this insurance shall not apply. This endorsement shall not operate to increase the insurance company's total limit of liability hereunder. The insurance company hereby waives its rights of subrogation against the additionally named insured. _Diversified Drilling Corn Named Insured Insurance Company 24n5 T.i~r; nn Way ~ Maitland 37751 Street d~ Number CRy ~~ State Zip -~ ~~~~ r~n~cnv nepresentatrve (signature and Printed Name) (Attach Acknowledgment) ENI) OF SECTION 00620-1 PAGE 116' RCVD AT 10129!01 x:16:03 PM (Eastern StandarG Time)' SYR:FAXSERVERl10 `DMS:S211901' CSO):813 98S 6636 `DURATION (mm•ss~:02.16 ., : " FILE IVo.885 1029 'Ol 17:12 Ii):DDC_CORPORATE FAX:813 985 6636 PAGE 2i g SECTION 00620 INSURANCE ENDORSEMENT FUHAA Name of Project: WTP 1 -Well No. 4. Owner: Engineer: City of Winter Sorlnas CPH Engineers. Inc_ ff 1~t3 East 3.R, 4S4 1 ] 17 E. Robinson Street Winter Serinos. Florida 32708 Orlando, Florida 32801 THIS IS TO CERTIFY that the numbered policies identified by the attached Certitficatea of Insurance have been issued by the below-stated company in conformance with the limits and requirements as set forth in the General Conditions and Supplementary Conditbns. The insurance company will give at feast thirty (30) days' written notice by registered mait to the Owner and the Engineer prior to any material change or cancellation of said policy orpolicies. ATTACNCERTIFICATESOFINSURANCEANOINOICATE7YPEOFINSURANCE POLICYNUMBER, EFFECTIVEDATE, EXPIRATIONOATE, ANOL/M17SOF/NSURANCE THECERTlF1CATESOFINSURANCI: ARETOlND1CATETHENAAIEO INSURED, AND ARE TO IOEIVTIFY THE OWNER, ENGINEER A11~ 07HER PAR77ES /OENTIFlEO 1N 7NE SUPPLEMENTARYCONpf7YONSASAD01T14NALNAMEOlNSC1RE0. THEOWNERANDENGINEERARETOBENAMEO AS CERTIFICATE HOLDEA~ ENDORSEMENT The Owner, the Owner's Representative, the Engineer, Architect, and their consuRants, and each of their officers, agents, end empbyess are included as additionally named insured under said policies but only while acting in their capacity as such and only as respects operations of the originally named insured, his subcontractors, agents, and empbyees in the performance of the above-referenced contract; provided, however, that if the loss or damage is ultimately determined to be the proximate result of the sole negligence of one or more of the aforesaid additionally named insured, this insurance shall not apply. This endorsement shall not operate to increase the insurance compan~s total Ifmft of liability hereunder. The insurance company hereby waives its rights of subrogation against the additionally named insured. Diversified Drilling Corp. Named insured .Zurich Insurance Co. Insurance Company 1800 Pembrook Drive, Ste 100, Orlando, FL 32810 Street a Number Cdy~ State Zio red Representative (Signature and Printed Name) Acknowledgment) ENQ OF SECTION 00620-1 PACE 2j6' RCVD AT 10f29~14:16:03 PM (Eastern Standard Tifnej `SVR:FAXSERVERIIO' ONIS:S112901' CS~:813 98S 6636 `DURATION pl~llss):02.16 ACORD CERTIFICATE OF LIABILITY INSURANC~SR ~ IVER-3 °ATE(MM/DD/YY) 11/O1/O1 ~ ~~ PRODUCER + Wallace Welch & Willingham Inc 3810 16th Street North P . O . Box 33020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. St. Petersburg FL 33733 Phone:727-522-7777 Fax:727-521-2902 INSURERS AFFORDING COVERAGE ; INSURED INSURER A: CNA Insurance CO anies INSURER B: Zurich Insurance Co an Diversified Drilling Corp INSURER C: PO BOX 290699 FL 33687-0699 T INSURER D: ampa INSURER E: COVERAGES 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 CONTRACTOR 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .- LTR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE MMID LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 ~-r A $ COMMERCIAL GENERAL LIABILITY TCP2024764059 04/09/01 04/09/02 FIRE DAMAGE (Any one fire) $50,000 CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 5 , 000 ~( P/O PERSONAL &ADV INJURY $ 1 , 000 , 000 - J( p/CO GENERAL AGGREGATE $ 2, 000, 000 , :: } GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG S 2 , 0 0 0 , 0 0 0 POLICY ][ PRO- LOC JECT AUT OMOBILE LUIBILITY COMBINED SINGLE LIMIT A X ANY AUTO BUA2024764885 04/09/01 04/09/02 (Ea accident) $ 1 000 000 r ~ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ ]( HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per acadeM) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN ~ ACC $ ` AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE S 5 , 000 , 000 W $ $ OCCUR ~ CLAIMSMADE AUC9277982 04/09/01 04/09/02 AGGREGATE $ 10,000,000..:_.,+ $ ,- ~ DEDUCTIBLE S $ RETENTION $ 0 $ - WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LWBILITY E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ A OTHER Rented/Leased E i ent Covers a TCP2024764059 04/09/01 04/09/02 Limit $500,000 Ded $1 000 DESCRIPTK)N OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSK)NS ADDED BY ENDORSEMENT/SPECUIL PROVISIONS Project WTP 1-Well No.4 -includes Waiver of Subrogation -Certificate ,- Holder is Additional Insured per attached section 00620. CERTIFICATE HOLDER Y ADDITIONAL INSURED; INSURER LETTER: _ CANCELLATION ~, PH Engineers Ina . 1117 E. Robinson Street Orlando E'L 32801 CPHENIG SHOULD ANY OF THE ABOVE DESCRIBED POLK:IE8 BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN`y NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL ' IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR' "' REPRESENTATroE3. ACORD 25~S (7/97) ` ~ C~JACORD CORPORATION 7965 FILE No.885 1029 'O1 17:12 ID:DDC_CGtPORATE FAX:813 985 t'~36 SEC710N 00620 INSURANCE INDORSEMENT FORM Name of Project: WTP 1 -Well No. 4. Owner: Engineer: CPH Er 7 E. PAGE 2~ 6 xtnmar sonnA$. Ronda x2708 Orlando. Florida 32801 THIS IS TO CERTIFY that the numbered polk:ies ldentifted by the attached Certiflr:atea of Insurance have been issued by the below-stated company In conformance with the limits and requirements as set forth In the General Conditions and Supplementary Conditions. The insurance company will give at least thirty (30) days' written notice by registered mail to the Owner and tt-e Engineer prior to any material change or cancellation of said policy or polk:ies. ATTACHCEATlF/CATESOF/NSURANCEANOIND/CATETYPEQFIN~SCIRgIyCE, POL/CYNUIIBER, EFFECTINEDATE, EXPIRATfONQATE,ANf~L/MITSOF/NSURRNCE THECEATIFICATESOFINSURANCEARETOlNO1CATETHENAMEO INSURED, ANO ARE TO IDENTIFY THE OWNER, ENGINEER AND OTHER PARTJES 10EIVTT1F1E0 !N THE SC/PPLEMENTARYCOWp1T/ONSgSADA/TIONALN~tMEOINSC/RED. THEOWNERANDENGINEERAAETOBENAMEO AS CERT/f/CATE MOLDEAS ENDORSEMENT The Owner, the Owner's Representative, the Engineer, Architect. and their consultants, and each of their officers, agents, and employees are included as additionally named Insured under said polk:ies but only white acting in their capacity as such and only as respects operations of the originally named inaurod, his subcontractors, agents, and employees In the performance of the above-reierencgd contract; provided, however, that if the loss or damage is ultimately determined to be the proximate result of the sole negligence of one or more of the aforesaid additionally named insured, this insurance shall not apply. This endorsement shall not operate to increase the insurance company~s total limit of liability hereunder. The insurance company hereby waives Its rights of subrogation against the additionally named insured. -Diversif? ed Drilling Corp Named Insured r.nra Tnettranra (`n~ Insurance Company - 24n5 T.ttri Pn Way ~ Mai rl anrj ~ FL X2751 Street ~ Number ~ Crty ~~ State zip Acknowledgment) and Printed ENp OF SECTION 00620-1 PAGE ?16' RCVD AT 101191014:16:03 PM ~Easteln Standar0 Timej' SVR:FAXSERVER110 `DNIS:S112902' CSID:813 983 6636' DURATION (mmss):02.16 FILE No.885 1029 'O1 17:12 ID:DDC_CQ2P012ATE FAX:813 985 6636 pA(~ 2, g SECTION 00620 INSURANCE ENDORSEMENT FORM Name of Project: WTP 1 -Well No 4 Owner: Engineer: City of Winter Sorlnas CPH Eno(neers inn 1126 East S.R. 4.~4 1117 E. Robinson Street WIMer SoAno$. Florida ~a.2~08 Orlando. Florida ~2am THIS IS TO CERTIFY that the numbered policies identified by the attached CettMcates of Insurance have been issued by the below•stated company in conformance with the limits and requirements as set forth in the General Conditions and Supplementary Condtttons. The insurance company will give at least thirty (30) days' written note by registered mail to the Owner and the Engineer prior to any material change or cancellation of said policy or policies. ATTACHCERTIF/CATESOF/NSURANCEANDIND/CATETYPEpFINSURANCE, POLICY/AMBER, EFFECT/VEDATE, EXP/RAT/ONMTE,AND L/MITSOF/NSURANC1w THECERT/F/CATESOFINSURANCEARETOINOICATETHENAMED INSURED, ANO ARE TD IDENTIFY 71•IE OWNER, ENGINEER Alm OT)YER PARTIES IDENTIFIED 1N THE SUPPLEMENTARYCONDITIONSASADDl770NALNAMED/NSUREO. THEOWNERANDENGINEERARETt7BENAMED AS CERTIFICATE HOLDERS ENDORSEMENT The Owner, the Owners Representative, the Engineer, Architect, and their consultants, and each of their officers, agents, and empbyess are included as additionally named insured under said policies but only while acting in their capacity as such and only as respects operations of the originally named insured, his subcontractors, agents, and employees in the performance of the above-referenced contract; provided, however, that if the loss or damage is ultimately determined to be the proximate result of the sole negligence of one or more of the aforesaid additionally named insured, this insurance shall not apply. This endorsement shall not operate to increase the insurance company's total limit of !lability hereunder. The insurance company hereby waives its rights of subrogation against the additionally named insured. Diversified Drilling Corp. Named Insured Zurich Insurance Co Insurance Company 1800 Petnbrook Drive, Ste 100,. Orlando, FL 32810 Street 6 Number City /) State Zip - ~, i ~. yea Representative (Signature and Printed Name) Acknowledgment) ENp OF SECTION Oos20-t PAGE 116' RCVD AT 101191014:16:03 PM Eastern Standard Timej' S4R:fAXSERVER110' DNIS:S111901' CSD:813 98S 6636' DURATION (mmssj:01.16 MEMORANDUM TO: Andrea Lorenzo - Luaces, City Clerk FROM: George Edwards, P.E., Capital Projects Coordinat i~E: Documentation for WTP #1- Well #4 City of Winter Sarin_gs Bid # ITB-010-01/GE DATE: February 1, 2002 Transmitted herewith are the following executed documents for your files: 1) Notice of Award 2) Agreement 3) Notice to Proceed 4) Certificate of Liability Insurance 5) Performance Bond and Labor and Materials Payment Bond „~~,~