HomeMy WebLinkAboutSunshine Building and Development Change Order 2 - 4th Addition to WM Improvements -1998 03 03
---~---~-------r--~"-~---~ -----
v,
'.
C/.,.J<
CONTRACT CHANGE ORDER
Change Order No. 2
Engineer Project No. W0452.02
Project Title:
Contractor:
Reason for Change:
City of Winter Sprin~s N. Orlando Fourth Addition W. M. Improvements
Sunshine Buildin~ and Development Cox:p.
Additional items requested by City
Breakdown of Proposed Chan~es and Basis for Payment
(Includes pertinent drawings, specifications, and documentation where necessary)
Item No. and Description Change in Contract
Cost +(-)
1. Add 8" gate valve and box on end of water main on S.R. 434 $664040
2. Add long single service for lift station on David Street. $544.00
(1)
(2)
(3)
(4)
$ 1.188.40
$ 462.030.95
$ 1.866.66
$ 465.086.01
Date: 2. Jz.7/f8
are: 3/ :t--/rr
D.te:}/}/tg ;ff'
Recommended By Engineer: ~
Accepted By Contractor:
Accepted By Owner:
W045202.cha
, <;':i.~' "',~.
~ ,"-,
elF"';"
CONTRACT CHANGE ORDER
Change Order No.
Engineer Project No. W0452.02
Project Title:
Contractor:
Reason for Change:
North Orlando Fourth Addition Water Main Improvements
Sunshine Building and Development COq>Qration
Owner Requested Additions
Breakdown of Proposed Changes and Basis for Payment
(Includes pertinent drawings, specifications, and documentation where necessary)
Item No. and Description Change in Contract
Cost +(-)
1. Additonal underdrain at seven (7) locations at 15 LF each $1,477.35
105 LF @ $ 14.07/LF
2. Add one short shingle service $389.31
1 @ $389.31/EA
3. Add 132 days to the Contract to allow for construction completion, N/C
FDEP certification and final installation/connection of water meters. New
completion dates are:
October 1, 1997 - Substantial completion of water mains/Receipt
of As-Builts
November 1, 1997 - Receipt of FDEP clearance
December 1, 1997 - Final Completion
(1) Total Proposed Change in Contract Cost +(-)
(2) Original Contract Price
(3) Total All Previous Change Orders
$ 1.866.66
$ 462.030.95
$ 0
(4) New Contract Price (Total ofItems 1,2 and 3)
$ 463.897.61
Recommended By Engineer:
Date:
f/z 'f/I1
+/ /~/r)
1/.P;j?1 fPI1
Accepted By Contractor:
Date:
Accepted By Owner:
Date:
W045202,cha
..
~."
~. "~""~F::'-'~~:'?''',:;;",,,'''~'-'''~.
'-'
SECTION 00500
AGREEMENT FORM
1.
GENERAL
THIS AGREEMENT, made this~ day of {; trlA,.r V , 1991, by and between
-
(1) the Citv of Winter Sorinas , hereinafter called the Owner, and
(2) Sunshine Buildina and Develooment doing business as a
(3) Corooration , and hereinafter called the Contractor.
1.01
1.02
WHEREAS, the OWNER and CONTRACTOR are desirous of entering into an, Agreement for
construction of a the North Orlando Fourth Addtion Water Main Imorovements IBid No. 97-001)
by CONTRACTOR for OWNER.
NOW, THEREFORE, for and in consideration of the mutual promises hereinafter exchanged the
parties agree as follows:
1. 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 all are
as fully a part of the Contract as if attached to this Agreement or repeated herein.
2. Scooe of Work - The CONTRACTOR shall perform all work required by
the Contract Documents for the construction of North Orlando Fourth Addition Water Main
Imorovements.
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 one hundred
twenty(120)calendar days from the date of the Notice to Proceed.
4. Liauidated Damaaes - 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 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 $250.00 for each day that expires after the time
specified in Paragraph C for final completion until the work is finally complete.
5. Contract Price - The OWNER will pay the CONTRACTOR in current funds for the
performance of the work, subject to additions and deductions by Change Order and subject to
the Measurement and Payment Provisions (Section 01150), and subject to actual constructed
quantities; the Total Contract Price of Four Hundred Sixtv Two Thousand Thirtv and 95/100
Dollars ($462.030.95). Payments will be made to the CONTRACTOR on the basis of the
Schedule of Unit Prices included as a part of his/her Bid, which shall be as fully a part of the
Contract as if attached or repeated herein.
(1) Owner
(2) Contractor
(3) Sole Proprietor, Partn_ership, or Corporation
00500-1
----~--~ ~~~ - - ~--~~~~- ~-~
~lOft.-
:""'~=
. ..
..
"'.1. ~
6. Pavments - The Owner will make payments as provided in the General Conditions and
Supplementary Conditions.
7. Engineer - The Project has been designed by Conklin, Porter & Holmes-Engineers, Inc.,
referred to in the documents as the Engineer, whose authority during the progress of
construction is defined in the General Conditions and Supplementary Conditions.
8. .6Qru1 - CONTRACTOR shall supply a materials, performance and payment bond (s) in
accordance with Florida law and to the satisfaction of Owner.
9. MediationlVenue - 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 mutually select a mediator and int he event they cannot
mutually agree upon a mediator, one will be appointed by the American Arbitration Association.
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.
10. CONTRACTOR warrants the Water Main Imorovements will be fit for the City's intended
use and purpose and will comply with all Federal and State laws and regulations.
1.03
IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first
above written.
CONTRACTOR:
Sunshine Buildina and Develooment
Name of Firm
Attest
OWNER:
The Citv of Winter Sorinas
Name of Owner
(Seal)
END OF SECTION
00500-2
,..:,"'"."
02/03/9i 16: O,~
.
'5'
laJ 006
Bond No. 79-0l20~01275-97-l
<r'
SeCTJON 00610
PERFORMANce SONO FORM
Sunsh~ne Bu~lding and
THIS INSTRUMENT WITNESSETH: That we .(1) Development Corp. a (2) Corporation
organized under the laws of the State of Flor~da and regularly authorized to do business in the State of Florida
as Pttnclpal, anclwe (3) United States Fidelity * a (2) Corporation organized under
the laws of the State of Mary Land. and regularly authorized to do business in the State of Florida as Surety, are
hekJ and finnly bound unto C ~ t Y 0 f * * , hereinafter called the OWner in accordance with a Contract hereinafter
refelred to, in the penal sum of (4) ~e Hundred Eiqht *** Dollars ($ 508,234.05 ) lawful
money of the United States, well and truly to be paid unto the said OWner. for the payment of which we bind ourselves,
our heirs, executors, administrators, successors and assignees, jOintly and severally, firmly by these presents:
WHEREAS, the said Princq,aa has entered into a wrttten contract wtth the OWner dated r; tY'"LA "''''\1 J...'1. '" 7 for
the work designated as Na,;tl Otl,nda Fourth Additicn.Water Main Imorovements located in Winter SorfnQs \
in conformitywith Contract Documents hereby referred to and made a part hereof, the same to all intents and purposes I
as if written at length herein. in which Contract the said Principal has contracted to perform the work specifled in said
Contract In accordance with the terms thereof;
NOW, THEREFORE, the condition of this obligation is such that if the Principal shall faithfully perform the Contract on
his (Its) part, and satisfy all covenants, terms, conditions and agreements incurred by the Principal in the performance
of Slid Contract, dunng ltle original term thereof, and any extensions thereof which may be granted by the Owner, with
or without notice to the Surety, and shall satisfy all claims and demands arising thereunder, and shall fully indemnity
and save harmless the Owner from all cost and damage which the Owner might suffer by reason of the failure of the
Prtncipal to do so. and shall fully reimburse and repay to the Owner all costs, damages, and expenses which the Owner
may incur in making good any default by the Principal, including any default based upon failure of the Principal, to fulfill
his obligation to furnish maintenance, repairs, or replacements for any period of time after the work is completed. if
provided for in said Contrad, then this obligation shall be null and void. otherwise it shall remain in full force and effect.
IN ADOmON, the Princlpal and Surety, jointJy and severally, expressly guarantee that all materials furnished and
workmanship performed under the Contract and in the construction of the work shall fulfill all requirements of the
Contrad and the Contract Documents with respect to them. This bond shall remain in effect for a period of one year
(LIBRARY NOTE: IF A CITY OF SANFORD JOB, THEY REQUIRE TWO YEARS, AND SHOULD SO REVISED) from
the date of ftnal acceptance.
IT IS HEREBY STIPULATED AND AGREED that any suit based upon any default of the Principal in fulfilling his
obllgatlons to fumish maintenance, repairs, or replacements for any period of time after the Work is completed, if
proWjed for in the Contract. may be brought at any time up to six months after the expiration of the time specifled in the
Contract during which the Contractor has agreed to furnish such maintenance or make such repairs or replacements.
THE SAID SURElY, for value received, hereby stipulates and agrees that no change, extension of time. alteration or
addition to the terms of the Contract or to the Work to be performed thereunder or the Contract Documents
accompanying the same shall in any way affect Its obligations on this Bond. and it does hereby waive notice of any such
ching.. extension of lime, alteration or addition to the terms of the Contract or to the Work or to the Contract
Documents.
..
..
..
02/03/97 16-:09
'Zr
laJ 007
IN WITNESS WHEREOF I this instrument is executed in several counterparts. each on. of which shall be deemed an
ortginal, this the day of I 19_.
~~ (1) Sunshine Building and Development Corp.
~~--
e: L ~ I, d (' ... 9-
I. .
(SEAl) . (2)
...
1-_
(1) Contractor
(2) Surety
;,~.
....
.
..
United States Fidelity and Guaranty
~n~~
T~.: and Licensed Resident Agent
(Attorney in Fad)
Company
,
END OF SECTION
006' 0-2
-.1",'''JfI~;-:-~-
-~'~~:"IlF<'--'
----.~-,--c,-~-- - -,-----~----
02/03/97 16:09
'a'
I4J 008
SECTION 00620
LABOR AND MATERIALS PAYMENT BONO FORM
Sunshine Building and
THIS INSTRUMENT WITNESSETH: That we Rrvelopment Corra ~2} Corporation organiZed under
the laws of the State of Flor ida and regularly authorized to do business in the State of (3) Florida
_ as Principal, and we (~)United * a (2}Corporationganized under the laws attn. State of ~yland
. and regularty authorized to do business in the State of (3)E.: lor i da as Surety, are held and firmly bound unto {5}
Ci t~ of *'l1ereinafter ~I~ the Owner in accordance with a Contract hereinafter r.ferred to, in the penal sum
of (8) our Hundred Dollars ($4 6 ? 1 n:3 OtY6CB money of the United States, well and truly to be Plid unto
the said Owner, for the payment of which we bind ourselves, our heirs, executors, administrators, successors and
assignees, Jointly and sav.rall ,ftrmly by these presents. WHEREAS, the said principal has entered into a written
contract with the Owner dated trIA.... J. (, for work designated as North Orlando Fourth Additlq~ Water Main
ImDfDVements located in Winter Sennas conformity with Contract Documents hereby referred to and made II part
hereof, the same to all Intents and purposes as if written at length herein, in which Contract the said Principal has
contracted to perform the work specified in said Contrad in accordance with the terms thereof;
Bond No. 79-0120-01275-97-1
NOW, THEREFORE, the condition of this obligation Is such that if the Principal shall faithfully satisfy all claims and
demands Incurred by the Principal of said Contract, and shell pay all obligations arising thereunder, and shall fully
Indemnify and save harmless the Owner from all cost and damage which the Owner might suffer by reason of the failure
ofth. Principal to do so, and shall fully reimburse and repay to the Owner all costs, damages, and expenses which the
OWner may incur In making good any default by the Principal, and shall promptly make payment of prevailing wages
to all pel'lOna suPP'Ying labor, equipment or materials for use in the prosecution of the work, whether by subcontractor
or otherwise, and inclUding all insurance premiums on said work as provided for in such Contract, then this obligation
shall be null and void, othel"Nise it shall remain in 1u1l10rce and effect.
t4 ADDITION. the Pri~l and Surety, Jointly and severally, expressly guarantee that the OWner will be held harmless
from any liens, claims, demands or obligations In conjunction with materials or services provided with respect to this ,
Contract. This bond shall remain in effect for a period of one year from the date of ftnal acceptance. The Owner may
sue on this Bond, and any person furnishing material or performing labor, either as an individual or as a Subcontractor,
shall have the right to sue on this Bond in the name of the Owner for his use and benefit. The said Surety, for value
received, herehy stipUlates and agrees that no change. extension of time. alteration or addition to the terms of the
COntract or to the Work to be performed thereunder or the Contract Documents accompanying the same shall in any
way affect its obligations on this Bond, and ~ does hereby waive notice of any such change, extension of time, alteration
or addition to the terms of the Contract or to the Work or to the Contract Documents.
PROVIDED, FURTHER, that no nnal settlement between the Owner and 'the Contractor shalt abridge the right of any
~neficiary hereunder, whose claim may be unsatisfied.
I....
.
'1
(1) Contractor
(2) Sole Proprietor, Pannenship or Corporation
(3) State in which project is located
(4) Surety
(5) Owner
(6) 100 percent of the Contract
The Pft'Iftfone and limitations of section 255.05 or section
713.23, Florida Statutes, whlchevor Is applicable to the
contract, ant Incorporated In this bond by reference.
* States Fidelity and Guaranty Company
** Winter Springs, FL
*** Sixty-Two Thousand Thirty and 95/100----
00620-1
. 02/03/97 ..16:10
'C
141 009
IN WITNESS WHEREOF. this instrument i. executed in several counterparts, each one of which shall be deemed an
original, this the day of . 19B...
(SEAL)
I. .
(SEAL)
<1l ~~,~;?;::ent
'" ~(f.'d.:j
~ U~"!J:;;;;qZ2rant
---- .w~s Dona us ~ng (
T~e: and Licensed Resident Agent
(Attorney in Fact)
(1) contractor
(2) Surety
I~.
,....
....
\-
\. .
,....
\. .
,.~
END OF SECTION
00620-2
Corp.
mpany
,
.,- -~',,~' '~,,- .,~~~~,~~,
"",'-U~::~',~~W0~~''"''~
~
1041895
UNITED STATES FIDELITY AND GUARANTY COMPANY
POWER OF ATTORNEY
NO. 106664
~" U S F-"-Gw
" IISHllCI
KNOW ALL MEN BY rnESE PRESENTS: That UNITED STATES FIDELITY AND GUARANTY COMPANY, a corporation orpnized aad existing
UDder the laws ofthe State of MarylaDd aad haviDg ill priDcipal office at the City of Baltimore, in the State of Marylaad, does herehy constitute aad appoiDt
Lewis Donald Rushing, David Tobin Johnson, Gilbert Oswalt Bennett, Robert Harris Dixon
and Alan Douglas Moore
ofthe City of Pensacola ,State of Florida ill tNe aDd lawful Attomey(s)-iD-Fact, elliCh iD their separate
capacity if more tbaa ODe is named above, to sign ill Dame as surety to, aDd to execute, seal aad acknowledge any aDd all boDds, undertakiDgs, contrac:1I aDd other
writteD iDStnuneDts in the nature thereof on behalf of the COmpaDY iD ill busiDess of guaranteeiDg the fidelity of persons; guaranteeiDg the perfol11lllDce of cODtrac:tS;
aDd executiDg or guaranteeiDg boDds aad uDdertakillgs required or permitted iD any ac:tioDs or proceediDgs allowed by law.
ID WitDess Whereof, the said UNITED STATES FIDELITY AND GUARANTY COMPANY has caused this iDStnmteDt to be sealed witb ill corporate seal,
duly Ittested by tbe signatures of ill Senior Vice President and Assistant Secretsry, this 22nd day of January ,A.D. 1993 .
UNITED STATES FIDELITY AND GUARANTY COMPANY
(Signed) BY"'~I2'" ..
~ b .Senior Vice PresideDt
(Signed) By........ ..............:..............................
~i~istaDt Secretary
BALTlMORECITY ) ss: ~ ~()
Oathis 22nddayof January 'A.D~199 ~};mepersoD&I1~~\~RObert J. Lamendola
Senior Vice PresideDtoftheUNITEDSTATES FIDELITY ANDGUA COMPANY~ N'aul D. Sims ,Assistant
Secretary of said Company, with botb of whom I am persoDally ~ Dted, who bei.Dg bJ.."'~faJly duly swom tblt they, the said Robert J.
Lamendola aad Paul D. S ,~ \iererespectivel or Vice PresideDtaDdthe Assistaat Secretary of
tbe said UNITED STATES FIDELITY AND GUA ANY. the c~iot described iD an xec:uted the foregoiDg Power of Attomey; that tbey
elliCh knew tbe seal of said corporation; that th~~al iI to said po~er ~eY was sucb co , that it was so affixed by order of the Board of Directors
of said corporation, and that they signed their~1Ie thereto by I~. Dior Vice Pres*tl ssistaDt Secretary, respectively, of the COmpaDY.
My CommissioD expires the 11 th day ia~"" ~~l9' 5.
~\o. ~ ~~ . ~ ~~. -' / .
~ (s;....'O ..~O~,\~p.~~~
This Power of Attorney is granted UDder and. b!.j"'~~f the followiDg Resolutions adopted by tbe Board of Directors of tbe UNITED STATES
FIDELITY AND GUARANTY COMPANY on Septem~~992:
RESOL YED, that iD cODDectioD witb tbe fidelity and surety insurance business of tbe Company, all boDds' uDderlaltings, contrlliCts aad otber instNments
relatiDg to said business may be signed, executed, aad IliClmowledged by persons or entities appoiDted as Attomey(s).in-Fact pumaant to a Power of Attomey issued in
accordance witb these resolutions. Said Power(s) of Attomey for aad on bebalf of the Company may and sball be executed iD tbe name and on behalf oftbe Company,
either by the Chairmaa, or the President, or an Executive Vice Presiden\, or a Senior Vice President, or a Vice President or an Assistaat Vice President, jointly witb tbe
Secretsry or aa Assistant Secretary, uDder their respective designatioDs. The signature of sucb officers may be engraved, printed or lithograpbed. The signature of elliCb
of the foregoiq officen and the seal of the Compaay may be a.fflXed by facsimile to any Power of Attomey or to any certificate relating tbereto appointing
Attomey(s}ia-Fact for purposes oaly of executing and attestiDg bonds and uaderlaltings and otber writings obligatory in the nature tbereof, aad, unless subsequently
revoked and subject to any limitations set fortb tberein, any sucb Power of Attomey or certificate bearing such facsimile signature or facsimile seal shaIJ be valid aDd
bindiq upon the Company aad aay such power so executed and certified by sucb facsimile signature and facsimile seal sball be valid and bindiDg upon tbe Company
with respect to any bond or undertalcing to whicb it is validly attacbed.
RESOLVED, tbat Attomey(s)-in-Fact sball have tbe power aDd autbority, unless subsequently revoked and, in any case, subject to tbe tenns aDd limitatioDs
of the Power of Attorney issued to them, to execute and deliver on bebalf oftbe Company and to attacb tbe seal ofthe Co~any to any aDd all boDds and undertakillgs,
and otber writiqs obligatory in tbe Dature tbereof, and any sucb instNment executed by sucb Attomey(s)-in-Fact sball be as binding upon the Co~any as if signed by
aa Executive Officer and sealed and attested to by tbe Secretary oftbe Company.
I, P au 1 D. Sims , aD Assistant Secretsry of tbe UNITED STATES FIDELITY AND GUARANTY COMPANY.
do bereby certify that tbe foregoiDg is a tNe excerpt from tbe ResolutioD of the said Co~any as adopted by its Board of Directors on September 24, 1992 and that tbis
Resolution is in full force aad effect
I, the undersigned Assistant Secretary of the UNITED STATES FIDELITY AND GUARANTY COMPANY do bereby certify that tbe foregoing Power of
Attomey is iD full fon:e aDd effect aDd has Dot been revoked. 1t
ID Testimony Whereof, I bave hereunto set my baDd and tbe seal of t ITED STATES FIDELITY AND GUARANTY COMPANY on this day
0( ~Qnnnn~nP.n~.nnnn
~~~ Assistant Secretary
~ il'~
STATE OF MARYLAND)
FS 3 (10-92)
~'~:c~Z'-,-~~~C----~------
--~-------=",~'''.''~'7:'_;-'' ~
-- ----------~ <r: -~-'jl"
~l
F i she r-B I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
r own I nc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P 0 Box 7 1 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Pensaco I a I F L 32593-07 1 1 COMPANIES AFFORDING COVERAGE
WEL / c r COMPANY
904-432-7474 A U S F I RE I NSURANCE CO
INIUftED COMPANY
Sunsh i ne B I dg a Deve I opment Co B CNA I nsu r ance Compan i e.
At t n : Amo r et LaRosa COMPANY
P 0 Box 1 80958 C
Casse I be r ry I FL 327 1 8-0958 COMPANY
I D
~1~aWIMm;$.rit1ll\ttt:i1::itttt:\:ii::t:::l::::::i:i:::it:itIttlIW::\t:ll:11:ill:tt@ttI111WrI1Mlililllit::1:111111:l111:11It::1Witlt\:111111:::l:::t\::::lil:i:i:it:l::1:1mi::tm::lll~~~~:II:::::::::::::1:::l:i:I::i::::l:il:I:::::::
THISIS TO CERTIFY THA TTHEPOLICIESOFINSURANCELISTEDBELOWHA VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICA TED,NOTWITHST ANDING ANY REQUIREMENT, TERMOR 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co TYPE 0' INIUftANCE POLICY NUMaER POLICY EI'FECTIVE POUCY IllPlRATION
LTR DATE (MMlDDIYY) DATI (MMlDDIYY) LIMrrl
QENERAL LIAaLITY GENERAL AGGREGATE $ 2000000
i--
B X COMMERCIAL GENERAL LIABILITY C 1446 1 9785 4/ 09 / 96 4/09 / 97 PRODUCTS.COMP tOP AGG $ 2000000
1/ I CLAIMS MADE W OCCUR PERSONAL & ADV INJURY $ 1 000000
OWNER'S & CONTRACTOR'S PAOT EACH OCCURRENCE $ 1 000000
I--
FIRE DAMAGE (Any one fire) $ 50000
i--
MED EXP (Any one person) $ 5000
AUTOMoau UAaLrrY
i-- COMBINED SINGLE LIMIT $
B ~ ANY AUTO C 1446 1 6496 4/ 09 /96 4/09 /97 1 000000
ALL OWNED AUTOS BODILY INJURY $
i-- (Per person)
SCHEDULED AUTOS
I--
~ HIRED AUTOS BODILY INJURY $
~ NON.QWNED AUTOS (Per accident)
i-- PROPERTY DAMAGE $
QARAQE LIAaLrrY AUTO ONLY EA ACCIDENT $
I-- -=
ANY AUTO OTHER THAN AUTO ONLY:
I--
EACH ACCIDENT $
I--
AGGREGATE $
EXCEII UAaLITY EACH OCCURRENCE $ 8000000
A ~ UMBRELLA FORM 5530244085 4/09 /96 4/ 09 / 97 AGGREGATE $ 1 6000000
OTHER THAN UMBRELLA FORlA $
WORKERI COMPINIATION AND I STATUTORY L1lAITS
EMPLOYlRI'LIAaLrrY EACH ACCIDENT $
THE PROPRIETOR/ R INCL DISEASE POLICY LIMIT $
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL DISEASE EACH EMPLOYEE $
OTHER
DIICRIPTION 0' OPERATIONIJLOCATlONIIVIHICLEIIIPICIAL rrlMl
Ref , No r t h Or I ando 4th Add i t i on Wa te r Ma i n I mp r ovement s . The C i ty of W i n t e r
.
Sp r i ngs I i t s r ep r esent at i ve I Conk I i n I Po r te r a Ho I mes I Eng i nee r s I nc I t he
a r ch i t ec t t he i r consu I t ant . off i ce r s aaent s a EmDI ovees a r e addd i t i ana I i ns
1~.tl:lg'Hjlllt1iI11it:::f:::::::::::::::::::I:::::::::::tl11illil::::::::::II::::::tl:::\:::::::i:lli:::li:111ImijliltBI1%1:%i:::::::::i:i:li:m::::li:llill:::::1:::::::::::::::::::~:::::::::::~::::::111:1:::::::1i:i:l:::::::::::::::I::1i:::li::::I:::::::1:::::r
IHOULD ANY 0' THI AaoVE DEICRlalD POUCIEI aE CANCILUlD IIFORE TH.
692380000 EXPIRATION DATE THERIO', THE IIIUINQ COMPANY WLL ENDEAVOR TO MAL
C i ty of W i n t e r Sp r i ngs 30 .tfAYS WRrrTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
1 1 26 Eas t SR 434 IUT FA ~~ETO MAL IUCH NOTI,......... IMPOSE NO OBUQATION OR LIAaLrrY
W i nt e r Sp r i ngs FL 32708 c ~ A' Y KIN UPON THI CO,j..AN~~ ~QINTI OR RIPREIINTATlVlI.
I
.... .'~li2'-'LJ :J!z;/ .02380000
A..., ~.:
ti_D.:~i::lii.iiil1itt:::::r::lil:::::::::::::::ii:r::::i:r::11:111iillMI::::::n::::::::::\I:il:::1i:l111:11t::::::::::~::tr:::::::II:~~~:::::~::::::\::::::::::I::;il@itllfillt:::::ir".ll:::::::1::11:l11J.liBi.:raiiiiBtitiiU&:r
~.. . {r .,
02/Q3/97 16:12
'If
tal 012
.' -,' · SECTlON 00652
CERTIFICATE OF INSURANCE AND ENDORSEMENT
Description of Contract North Orlando Fourth Addition Water Main ImDrovements
Owner:
Engineer.
CIt.v of 'Mnter SorinQS
1126 East S.R 434-
Winter SDrinQs. FL 32708
Conklin, Porter & Holmes - Engineers, Inc.
1104 E. Robinson Street
Orlanda, Florida 32801
Type of Insurance:
COMPREHENSIVE GENERAL LIABILITY INSURANCe
THIS 1$ TO CERTIFY thet the following numbered polides have been issued by the below-stated company in
conformance with the limits and requiremems sat forth in the General Conditions and Supplemental Conditions.
The Insurance company will give at 'east thirty (30) days' written notice by registered mail to the Owner and the Engineer
prior to any matelial change or cancellation of said policy or policies.
See attached Accord Form 25 for limits.
POLICY NUMBER EFFECTIVE DATE
Cl44619785 4-9-96
EXPIRATION OA TE
4-9-97
ENDORSEMENT
The Owner, the Owners Representative, the Engineer, the Architect. and their consultants. and each of their officers,
agents, and employees, are included aa additionally named insured under said policies but only while ac;ting 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 mar. 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 r1ghts of subrogation against the additionally named insured.
Sunshine BId & Development Co CNA Insurance Co
Named Insured Insurance Company
...
. ..
291 Anchor St
Street & Number
P.O Rnv 154
Street & Number
CIty & State
(Attach Acknowledgement)
(Nc1ice: No substitution or revision to the above certificate and endorsement will be accepted. If the insurance called
for is provided by more than one company, a separate certificate in the exact above form shall be provided for each
company.)
END OF SECTION
00652.1