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CONTRACT
This agreement, executed in Crestview, Florida _ this day of
2014 between the County, of Okaloosa, Florida, the Owner,
hereinafter called the Party of the First Part, and ti rm jeehho UL. or its successors,
executors, administrators and assigns, hereinafter called the Party of the Second Part.
WITNESSETH:
That for and in consideration of payments, hereinafter mentioned, to be made by the
Party of the First Part, the Party of the Second Part agrees to furnish alll equipment, machinery,
tools and labor; to furnish and deliver all materials required to be furnished and delivered in and
about the improvement and to do and perform all work relating to Bid # RD 14-14, Stormwater
Pipe Rehabilitation Cured-In-Place Pipe in strict conformity with the provisions of this Contract,
the Notice to Contractors, the Specifications approved by the Owner. The said Plans,
Specifications, the Notice to Contractors, and the Proposal are hereby made a part of this
agreement as fully and to the same effect as if the same had been set forth at length in the
body of this agreement.
In consideration of the foregoing promises, the Party of the First Part agrees to pay to the
Party of the Second Part such unit prices for the work actually done as are set out in the
accompanying proposal in the manner provided in the said Specifications.
The Contractor/Consultant shall be prepared to begin work to be performed under the
contract as he set forth in his proposal, but will not proceed until the Contract has been
executed. This contract shall be in effect upon signatures by both parties and shall run through |
the length of the project.
This contract shall commence effective upon execution by both parties and extend
through September 30, 2014 and may be renewed for two (2) additional 12 month periods if in
agreement with both parties.
The contract may be terminated by either partly without cause with 30 day written
notice.
REPRESENTATIVES: The authorized representative of the County shall be:
Clay Simmons, P.E.
1759 S. Ferdon Blvd.
Crestview FL 32536
850-689-5772
E-Mail: csimmons@co.okaloosa.fl.us
The authorized representative for__| wer}udorm Fechrologies Ue shail be:
Contracts: Diane Partridge, Contracting and Attesting Officer
17988 Edison Avenue
Chesterfield, MO 63005
(636) 530-8000
Project Manager: Tad Powell (205) 281-2555 tpowell@insituform.com
EMail: dpartridge@insituform.com
All notices required by this agreement shall be in writing to the representative listed above with a
courtesy copy to the following:
Joanne Kublik
Contracts & Leases
Okaloosa County Purchasing Department
602-C North Pearl Street
Crestview, FL 32536
850-689-5960 / 850-689-5032 (FAX)
E-Mail: jkublik@co.okaloosa.fl.us
IN WITNESS WHEREOF, the Chairman of the Board of County Commissioners, by authority
vested in him, has hereunto subscribed his name on behalf of the County of Okaloosa, Florida,
the Owner, and the said has hereto fixed his signature, the
day and year above written.
WITNESS:
/ Swine t” Dre ane Insituform Technologies, LLC
Debra . Jasper, Contracting and Attesting Officer CONTRACTO
BY Ke. ate iohe
Diane Partridge
Contracting and Attesting Officer
TITLE
STATE OF FLORIDA
COUNTY OF OKALOOSA
This contract is accepted this day of 2014 and is effective on the
day of 2014,
ATIEST: COUNTY OF OKALOOSA, FLORIDA
BY
Gary Stanford Charles K. Windes, Jr. Chairman
Deputy Clerk of Court
INSITUFORM TECHNOLOGIES, LLC
Assistant Secretary’s Certificate
The undersigned, being the Assistant Secretary of Insituform Technologies, LLC, a Delaware
limited liability company, hereby certifies that:
1. The following is a true and correct excerpt from the Limited Liability Company Agreement of the
Company:
Appointments by the President. The President of the Company may from time to time appoint
officers of the Company’s operating divisions, and such contracting and attesting officers of the
Company as the President may deem proper, who shall have such authority, subject to the control
of the Board of Managers, as the President may from time to time prescribe.
2. The President of the Company has, pursuant to the above authority, duly appointed H. Douglas
Thomas, Vice President — Global Procurement/Operations Support, and has appointed Joann
Smith, Denise L. Carroll, Debra Jasper, Jana Lause and Diane Partridge as Contracting and
Attesting Officers of the Company. Each of the foregoing have been fully authorized and
empowered by the President of the Company (i) to certify and to attest the signature of any
officer of the Company, (ii) to enter into afid to bind the Company to perform pipeline
rehabilitation activities of the Company and all matters related thereto, including the maintenance
of one or more offices and facilities of the Company, (iii) to execute and to deliver documents on
behalf of the Company, and (iv) to take such other action as is or may be necessary and
appropriate to carry out the project, activities and work of the Company.
IN WITNESS WHEREOF, I have hereunto affixed my name as Assistant Secretary this 1* day of
January, 2014,
INSITUFORM TECHNOLOGIES, LLC
. — tf
Th
Tod O’Donogtitfe
Assistant Secretary ,
we
ACORD CERTIFICATE OF LIABILITY INSURANCE,,,,,, | “™imponr
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: /f the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER Lockton rompanies LLC St Louis tal x
Three City Place Drive, Suite 900 Ext): FA .
St. Louis MO 63141-7081 7 in No:
(314) 432-0500 ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : Liberty Mutual Fire Insurance Company (64) 23035
INSURED , netvtorm Technologies, LLC INSURER B : Liberty Insurance Corporation (64) 42404
1347989 17988 Edison Avenue ;
Chesterfield MO 63005 WSURERC:
INSURER D :
LINSURER E:
INSURER F :
COVERAGES INSTE02 CERTIFICATE NUMBER: 12756073 REVISION NUMBER: XXXXXXX
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
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.
ADDL |SUBR
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
INSF TYPE OF INSURANCE ADDL |SUBR POLICY NUMBER MADD yy MKS) LIMITS
A | GENERAL LIABILITY Y | N | TB2-641-004218-033 7/1/2013 | 7/1/2014 — [EACH OCCURRENCE s_ 2,000,000
X | commerciat GENERAL LIABILITY PREMISES (Es oettonce 350,000
A BROAD FORM PD/CONTRACTUAL 2
A CLAIMS-MADE| X | OCCUR PER PROJECT AGG. CAP $20M MED EXP (Any one person) _{s 10,000
|_X | Independt Contractor PERSONAL & ADV INJURY _|$ 2,000,000
|X |xcu GENERAL AGGREGATE $ 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - comP/oP AGG] $_ 4,000,000
pouicy! X | 58S Loc $
A | AUTOMOBILE LIABILITY Y | N | AS2-641-004218-023 7/1/2013 | 7/1/2014 |@QMBINED SINGLE LIMIT T 7 000,000
X | ANY AUTO BODILY INJURY (Per person) |$ KX XXXXKK
ma ALL RWNED SCHBQULED BODILY INJURY (Per accident] $ KK XXXXX
HIRED AUTOS AgToS NED COE AMAGE $ XXXXKXX
$ XXXXXXX
UMBRELLA LIAB OCCUR EACH OCCURRENCE § XXXXXXX
| | EXCESS LIAB CLAIMS-MADE| NOT APPLICABLE AGGREGATE $ XXXXXXX
DED RETENTION $
B | WORKERS COMPENSATION VIN N | wA7-64D-009004-443 7/1/2013 | 712014 [|X LWSSTAI] Orr
B ] any PROPRIETOR/PARTNERIEXECUTIVE NIA WC7-641-0042 18-013 (wD 7/1/2013 7/1/2014 E.L. EACH ACCIDENT 3 1 000,000
E.L. DISEASE - EA EMPLOYEE $ 1 .000,000
E.L. DISEASE - POLICY LIMIT $ 1,000 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES {Attach ACORD 101, Additional Remarks Schedule, if more space is required)
RE: BID # RD 14-14, STORMWATER PIPE REHABILITATION CURED-IN-PLACE PIPE. OKALOOSA COUNTY IS ADDITIONAL INSURED
UNDER GENERAL LIABILITY AND AUTOMOBILE LIABILITY AS REQUIRED BY WRITTEN CONTRACT, BUT ONLY WITH RESPECT TO
LIABILITY ARISING OUT OF THE NAMED INSURED’S OPERATIONS. **SEE ATTACHED ENDORSEMENTS**
CERTIFICATE HOLDER
CANCELLATION See Attachment
12756073
OKALOOSA COUNTY
602-C NORTH PEARL STREET
CRESTVIEW FL 32536
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
!
ACORD 25 (2010/05)
©1988- ORD CORPORAMION. All rights reserved
The ACORD name and Iogo are registered marks of ACORD
Policy Number TB2-641-004218-033
Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
NOTICE OF CANCELLATION TO THIRD PARTIES
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
MOTOR CARRIER COVERAGE PART
GARAGE COVERAGE PART
TRUCKERS COVERAGE PART
EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART
SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
COMMERCIAL LIABILITY - UMBRELLA COVERAGE FORM
Schedule
Name of Other Person(s) / Email Address or mailing address: Number Days Notice:
Organization(s):
Per schedule on file with 60
company
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or
organizations shown in the Schedule above. We will send notice to the email or mailing address listed above
at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no
event does the notice to the third party exceed the notice to the first named insured.
B. This advance notification of a pending cancellation of coverage is intended as a courtesy only, Our failure to
provide such advance notification will not extend the policy cancellation date nor negate cancellation of the
policy.
All other terms and conditions of this policy remain unchanged.
LIM 99 01 05 11 © 2011 Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1
Includes copyrighted material of Insurance Services Office, inc., with
its permission.
Policy No: AS2-641-004218-023
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi-
fied by this endorsement.
This endorsement identifies person(s) or organization(s) who are “insureds” under the Who Is An Insured Provi-
sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.
SCHEDULE
Name of Person(s) or Organization(s):
Any person or organization whom you have agreed in writing to add as an
additional insured, but only to coverage and miminum limits of insurance
required by the written agreement, and in no event to exceed either the scope
of coverage or the limits of insurance provided in this policy. For designated
insured added under this policy, and where a written agreement requires the
insured to provide liability insurance on a primary, excess, contingent, or any
other basis, this policy will apply soley on the basis of such written agreement
(If no
