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SERVICES AGREEMENT - INDEPENDENT CONTRACTORSERVICES AGREEMENT (INDEPENDENT CONTRACTOR) This Services Agreement ( "Agreement "), effective February ,t,/ , 2015( "Effective Date ") is hereby entered into by City of Clearwater Gas ( "Client ") and Heath Consultants Incorporated ("Contractor"). SECTION ONE -SCOPE OF WORK: The work to be performed by Contractor will be set forth in Exhibit A, Scope of Work. SECTION T W 0 -PRICE /PAYMENT: Client will pay Contractor for work performed as set forth in Exhibit B, Price Schedule. Terms: Net 30. SECTION THREE- RELATIONSHIP OF PARTIES: The parties intend that an independent contractor relationship will be created by this Agreement. Performance and control of the work will lie solely with Contractor. The Contractor is not to be considered an agent or employee of Client for any purpose. SECTION FOUR- CONTRACTOR'S EMPLOYEES QUALIFIED TO PERFORM THE WORK REQUIRED UNDER THIS AGREEMENT UNDER SUBPART N OF SECTION 192 OF THE FEDERAL PIPELINE SAFETY REGULATIONS /WARRANTIES Contractor warrants and represents that it has an Operator Qualification Program as required by Subpart N of Section 192 of the Federal Pipeline Safety Regulations and that the employees who will perform the Work required under this Agreement have been evaluated and are qualified to perform the tasks required under this Agreement. SECTION FIVE - INSURANCE TO BE SECURED: Contractor agrees to maintain such insurance acceptable to Client as set forth on Exhibit C, Insurance Requirements. SECTION SIX - INDEMNIFICATION Contractor shall indemnify and hold Client and its agents, employees, partners, parents, subsidiaries, insurers and affiliates harmless from any losses, costs, claims (including claims of Contractor's employees) , expenses (including attorneys' fees and court costs), suits, actions, judgments , fines, penalties or damages of every nature and description (collectively "losses ") arising out of or resulting from the Contractor 's Work under this Agreement , except that Contractor 's obligation to indemnify Client shall not apply to any losses or liabilities arising from Client 's sole negligence, or that portion of any liabilities that arise out of Client 's contributing negligent acts or negligent omissions. Client's liability for torts shall be governed by Section 768.28, Florida Statutes. Contractor agrees that nothing contained herein shall be construed as a waiver of any sovereign immunity from or limitation of liability the Client may be entitled to under the doctrine of sovereign immunity, or Section 768.28, (G M 15- 2064 - 058/ 161178/1] Florida Statutes. Furthermore, this provision is not intended to, nor shall it be interpreted as, limiting or in any way affecting any defenses the Client may have under Section 768.28, Florida Statutes or as consent to be sued by third parties. Contractor agrees that the Client reserves the right to appoint legal counsel for any and all claims against the Client that may arise related to this Agreement or work performed under this Agreement/Contract. This indemnification obligation shall survive the expiration or termination of the Agreement. Subject to Section 768.28, Florida Statutes, this indemnification obligation shall extend to all costs, expenses and damages arising from any infringement, misappropriation or claim of infringement or misappropriation of any process, product, apparatus or combination patent resulting from the use of any designs or other information furnished by the other party and incorporated in the Work or Ancillary Work. SECTION SEVEN - COMPLIANCE WITH LAW AND SAFETY REQUIREMENTS: All Work will be performed in accordance with the Federal Pipeline Safety Regulations, NFPA 58 and all applicable propane and pipeline industry safety practices and standards, and in accordance with federal, state and local statutes, rules regulations and ordinances. SECTION EIGHT- DURATION/RENEWALICANCELLATION: This Agreement shall be effective upon execution by both parties hereto and shall expire o n December 31, 2018 ( "Term "), unless terminated in accordance with other provisions herein. Client or Contractor may cancel the Agreement upon thirty (30) days advance written notice. In the event this Agreement is terminated under the foregoing provision, Client shall pay Contractor any amounts due for Work performed by Contractor and /or materials or supplies ordered, delivered, and accepted by c l i e n t prior to the date that the termination notice is provided to the non - terminating party . SECTION NINE- CONFIDENTIALITY: Subject to applicable law, including but not limited to Chapter 119, Florida Statutes, Contractor will not disclose to third parties any information concerning its work for Client, including , but not limited to, confidential or trade secret information or information regarding Client's customers or potential customers, business and marketing plans , customer lists, credit information , gas usage patterns, pricing and marketing policies and practices, financial information and other operating policies and procedures. Contractor understands that if it violates this Agreement, Client will suffer irreparable harm. Therefore, in addition to any other remedies available to it, Client will be entitled to seek and obtain injunctive or equitable relief, including orders prohibiting violations of this Agreement. Subject to applicable law, including but not limited to Chapter 119, Florida Statutes, Client will not disclose to third parties any information concerning its work with Contractor, including, but not limited to, confidential or trade secret information or information, business and marketing plans, customer lists, credit information , pricing and marketing policies and practices , financial [GM15 -2064- 058/161178/1] 2 information and other operating policies and procedures . Client understands that if it violates this Agreement , Contractor will suffer irreparable harm. Therefore, in addition to any other remedies available to it, Contractor will be entitled to seek and obtain injunctive or equitable relief, including orders prohibiting violations of this agreement. Contractor understands that Florida has very broad public records law, therefore, notwithstanding the above, agrees to release any and all records as required by law. [G M15-2064-058/161178/1] 2 SECTION TEN- MISCELLANEOUS: (a) Waiver. Neither the failure nor any delay on the part of either party to exercise any right , remedy , power or privilege under this Agreement shall operate as a waiver thereof, nor shall any single or partial exercise of any right, remedy, power or privilege preclude any other or further exercise of the same or of any other right , remedy, power or privilege, nor shall any waiver of any right, remedy, power or privilege with respect to any occurrence be construed as a waiver of such right, remedy , power or privilege with respect to any other occurrence. No waiver shall be effective unless it is in writing and is signed by the party asserted to have granted such waiver. (b) Binding Nature of Agreement. This Agreement shall be binding upon and inure to the benefit of Client and its successors and assigns and shall be binding upon and inure to the benefit of Contractor, its successors and assigns. (c) Provisions Separable. The provisions of this Agreement are independent of and separable from each other, and no provision shall be affected or rendered invalid or unenforceable by virtue of the fact that for any reason any other or others of them may be invalid or unenforceable in whole or in part. (d) Entire Agreement. This Agreement contains the entire understanding among the parties hereto with respect to the subject matter hereof, and supersedes all prior and contemporaneous agreements and understandings, inducements or conditions, express or implied, oral or written, except as herein contained. The express terms hereof control and supersede any course of performance and /or usage of the trade inconsistent with any of the terms hereof. This Agreement may not be modified or amended other than by an agreement in writing. (e) (f) Paragraph Headings. The paragraph headings in this Agreement are for convenience only; they form no part of this Agreement and shall not affect its interpretation. Gender, Etc. Words used herein , regardless of the number and gender specifically used, shall be deemed and construed to include any other number , singular or plural , and any other gender, masculine , feminine or neuter , as the context indicates is appropriate. (g) Number of Days. In computing the number of days for purposes of this Agreement, all days shall be counted, including Saturdays, Sundays and holidays; provided, however, that if the final day of any time period falls on a Saturday, Sunday or holiday on which federal banks are or may elect to be closed, then the final day shall be deemed to be the next day which is not a Saturday, Sunday or holiday. (h) This Agreement may be executed in multiple counterparts, each of which shall be deemed an original for all purposes and all of which shall be deemed collectively to be one agreement. The parties agree that execution of this Agreement by a [GM15- 2064-058/161178/1] 3 party and the delivery of such party's signature by mail, facsimile transmission, or electronic (e -mail) transmission shall be fully effective as the original signature of such party to the fullest extent as if it were the original copy thereof. (i) This Agreement shall be governed and interpreted in accordance with the laws of the State of Florida. Venue of any dispute shall lie in Pinellas County, Florida. SECTION ELEVEN -FORCE M A J E U R E Neither party hereto shall be liable for any failure to perform the terms of this Agreement when such a failure is due to "force majeure" as hereinafter defined. The term "force majeure" as used in this Agreement shall mean any delay or default in performance due to any cause beyond the control of the party claiming force majeure and without such party's fault or negligence , including but not restricted to acts of God or the public, civil disturbances, arrests and restraints by rulers and people; acts of the public enemy, wars, riots, insurrections, sabotage; acts, requests or interruptions of the federal , state or local government or any agency thereof; court orders, present and future valid orders of any governmental authority, or nay officer, agency or any instrumentality thereof; floods, fires, storms, epidemics , landslides, lightning, earthquakes , washouts, explosions , quarantine, strikes, lockouts, or industrial disturbances; interruption of transportation, freight embargos or delays in delivery of equipment or service necessary to the performance of any provision of this Agreement ; inability to secure right of way, labor shortages, breakage or accident to machinery or lines of pipe, or any other cause, whether of the kind herein enumerated or otherwise , not reasonable within the control of the party claiming force majeure. Nothing contained in this section, however, shall be construed to require either party to settle a labor dispute against its will. If as a result of force majeure wither party is unable , wholly or in part, to carry out its obligation under this Agreement , other than the obligation to make payment of money due, then, upon such party's giving notice and a description of such cause in writing to the other party as soon as possible after the occurrence of the cause, the obligation of the party giving such notice, so far as it is affected by the cause specified in such notice, shall be suspended for the duration of the cause. Such cause shall, as far as possible, be remedied with all reasonable dispatch. ARTICLE TWELVE- - NOTICES All notices , except verbal or email notices with respect to minor questions, shall be in writing and shall be delivered by United States first class mail, postage prepaid, personal delivery, facsimile (with printed confirmation) , electronic transmission (e -mail) or nationally recognized overnight carrier to the appropriate party using the following respective addresses: For Client: City of Clearwater Gas: 100 S. Myrtle Ave: Clearwater, FL 33756 -5520: Attention: Brian Langille: 727 -562 -4633: brian.langille@clearwatergas.com [G M 15- 2064-058/161178/11 4 For Contractor: Heath Consultants Incorporated 9030 Monroe Road Houston, Texas 77061 Attention: Gary Lape, Vice President - Operations Phone: 713-844-1303 Email: g. lape @heathus. corn All notices shall be effective on the party addressee from the time received by such party. IN WITNESS WHEREOF, the parties have executed this Agreement on the day and year shown beneath their signatures. WITNESS Countersigned: �(€-tp(terICrt40J George N. Cretekos Mayor Approved as to form: )1Gti Laura Mahony Assistant City Attorney [G M15-2064-058/161178/1] By: HEATH CONSULTANTS INCORPORATED By: Name: 6/4/,-,1 ,<' v (Print) /j Title : Crip-XA ; ,< s (Print) Thereunto duly authorized Date: ✓7 /C' /s Attest: CITY OF CLEARWATER, FLORIDA William B. Horne II City Manager C' Rosemarie CaII City Clerk 5 6 EXHIBIT A SCOPE OF WORK Conduct a Gas System Leak Survey, an Atmospheric Corrosion Survey, and Atmospheric Corrosion Prevention Coating Services. Additional documents pertaining to details attached herein. [The remainder of this page intentionally left blank] DETAILED SPECIFICATIONS 1. INTRODUCTION. The City of Clearwater (City) is located on the West Coast of Florida in the Tampa Bay region. It is the third largest city in the region with an estimated population of 108,000 residents. The City of Clearwater is also a major tourist destination — Clearwater Beach was recently named "Florida's Best Beach Town 2013' by USA Today and was on the "Top Ten List of Best Beaches from Maine to Hawaii ". The City of Clearwater is home to the Philadelphia Phillies Spring Training and Clearwater Threshers Minor League Baseball and hosts several sports tournaments through the year that attract visitors from across the country. Clearwater is home for Winter the Dolphin and the Clearwater Marine Aquarium. Winter's story has made it all the way to Hollywood in the motion picture" Dolphin Tale" and the recently released "Dolphin Tale 2 ", both filmed here in Clearwater. 2. BACKGROUND. Clearwater Gas System (CGS) is owned and operated as an enterprise natural gas utility by the City of Clearwater. It currently has over 850 miles of underground gas main and handles the supply and distribution of both natural and propane (LP) gas throughout northern Pinellas County and Western Pasco County. As a mid -size utility company serving more than 20,000 customers, CGS is recognized as a leader in the natural and propane gas industry. CGS is regulated for safety by the Florida Public Service Commission and the Federal Pipeline Hazardous Material Safety Administration. Since 1923, CGS has provided clean, safe, reliable, economical gas service to the Florida Suncoast Community which it is privileged to serve. CGS prides itself in being a competitive and public service- minded utility provider. 3. SCOPE OF WORK. CGS is seeking a vendor to perform gas leak surveys, corrosion inspections and preventive coating of gas meters at customer locations. All inspections & maintenance work shall be done in accordance with Part 192 (Transportation of Natural and Other Gas by Pipeline) Code of Federal Regulations and Chapter 25 -12 of the FL Administrative Code (Safety of Gas Transportation by Pipeline). Both the "Leak and Atmospheric Corrosion Survey" will cover 100% of our distribution system during the initial nine (9) month period of the contract. Subsequent "Outside Business District" and "Bare metallic /Galvanized steel" leak surveys will be separated into three (3) sections and will be conducted over three (3) years. In addition, Atmospheric Corrosion surveys will be conducted over three (3) years as well. 100% of the "Inside Business District" survey locations will be completed each subsequent year, as required by Federal and State code. Performance of a walking leak and atmospheric corrosion survey of the Inside Business District (commercial) areas and all places where the public is known to congregate frequently where natural gas is serving the property or the gas main is in close proximity; consisting of approximately 850 miles of main and residential of which approximately 98 miles are inside the business district in Pinellas County and approximately 35 miles of main are inside the business district in Pasco County. Performance of a walking leak and atmospheric corrosion survey of approximately ±20,000 residential and commercial gas services in Pinellas County and Pasco Counties. Walking leak and atmospheric corrosion surveys shall additionally encompass seven (7) individual LP gas underground distribution systems, to include applicable piping, and 70 independent LP gas service accounts. All natural gas surveys will be completed with industry approved /accepted flame ionization detection equipment (FIU) or Remote Methane Leak Detector (RMLD) and all leaks will be classified with an approved and calibrated Combustible Gas Indicator (CGI). Propane gas surveys will be completed by bar hole and CGI method only. Atmospheric Corrosion Survey includes all pipeline facilities used in the transportation of gas, including, but not limited to, metallic line pipe, valves and other appurtenances connected to line pipe, fabricated assemblies, and residential, commercial and metering stations. Metallic gas pipeline distribution systems or portions thereof, are subject to atmospheric corrosion or moisture penetration and retention, shall be inspected to assure detection of corrosion before detrimental damage occurs. CGS — Surveys and Services 14 ITB #07 -15 DETAILED SPECIFICATIONS Easement and backyard mains /services will only be completed via a walking survey. Estimated completion time for initial surveys shall be nine (9) months from start date of the contract. All surveys are to be completed during the CGS operational hours of 7:00 A.M. to 3:30 P.M., Monday through Friday. A daily work schedule shall be sent to the Clearwater Gas Dispatch and Operations Coordinator. Any work performed outside this specified timeframe will need to be pre - approved by CGS' Operations Coordinator. CGS will provide all pertinent plain view mapping and service address listings work orders. A letter of identification or magnetic vehicle signs will be issued to the survey team. Survey technicians' completed paperwork will be submitted on a daily basis, to include: all streets and congregate areas surveyed, inclusive of all addresses of service lines surveyed and daily miles of main surveyed in both commercial and residential districts. Each leak and atmospheric corrosion location sited will be clearly marked with yellow paint, to be provided by CGS. The survey technicians will record gas -to -air percentage readings of all leaks encountered. The survey technicians will classify all leaks and atmospheric corrosion located as Class 1, Class 2, or Class 3, with an approved /documented, calibrated CGI. A CGS approved leak and atmospheric corrosion report will be completed by the survey technicians for each leak located on a daily basis. All daily survey activities shall be documented and main line leak location plotted with GPS coordinates and provided on the daily report. Instrument calibration shall be performed daily and documented. The gas survey technicians shall remain on site of all Class 1 leaks and atmospheric corrosion locations until relieved by CGS responders. Consideration shall be given to life safety including establishing a hot zone and necessary evacuations. Gas survey technicians will be Operator Qualification Certified per Code of Federal Regulations (CFR) 49 part 192.801, 192.803, 192.805, 192.807, and 192.809. Proof of training, experience and certification will be provided with the bid, and prior to any new technician(s) being added to the crew performing the resulting contract work. Reference ATTACHMENT A for Survey Procedures Reference ATTACHMENT B for Atmospheric Corrosion Prevention Coating Application The following maps contain the survey areas and mileage per year to be surveyed. Access the maps via the City's FTP site: ftp: / /ftpserver.mvclearwater.com Username = vendor Password = Clearwater Select Purchasing folder to view maps 1. Pasco County Business and Non - Business Mains 2. Pinellas County Business and Non - Business Mains • Approximate miles of distribution mains in the system: 850 + • Approximate number of natural gas service lines in the system: 20,000 + • Approximate miles of jurisdiction system LP distribution mains: 2+ • Approximate number of jurisdictional system LP gas service lines in the system: 70+ 4. The bid shall include the detailed description of the following: • Leak survey equipment device(s) to be used • Tablet/compatible computer device to be used to communicate with CGS • Survey procedures /methods to be used and general scope of work CGS — Surveys and Services 15 ITB #07 -15 DETAILED SPECIFICATIONS • Anticipated work hours per section • Price estimate per day /week for complete services • Qualifications to perform work/work history • Personnel to be used with Operation Qualifications records Personnel Qualifications: All personnel performing surveys will have a minimum of two (2) years documented experience performing mobile and walking gas leakage surveys. Resumes and references to be provided in bid. • All personnel will be current Operator Qualified (OQ) • OQ documentation provided prior to bid award • OQ documentation provided prior to any personnel changes • All personnel subject to DOT Drug & Alcohol testing per 49 CFR Part 199 • Vendor Drug & Alcohol program documentation required with bid • Quarterly PHMSA Drug & Alcohol Statistical reports shall be provided • Drug & Alcohol documentation provided prior to any personnel changes • CGS will be notified immediately of any failures and discoveries of Abnormal Operating Conditions (ADC's) • Annual PHMSA report will be provided to CGS providing test results for 49 CFR Parts 199.119 and 199.229 Equipment Requirements: • A dependable cell phone • Android tablet/computer with or a Digital camera for quality pictures • Flame Ionization (FI) Unit - Bascom Turner Gas Rover with GPS or equivalent • Combustible Gas Indicator (CGI) unit - Bascom Turner Gas Rover with GPS or equivalent • Remote Methane Leak Detector (RMLD) - Heath Consultants- Tunable Diode Laser Absorption Spectroscopy (TDLAS) • Global Positioning System (GPS) unit - Bascom Turner Gas Rover with GPS or equivalent • All GPS /GIS data must meet the following requirements: o Data must be delivered in an ESRI compatible format o GPS locations collected at sub- meter accuracy o Data delivered in State Plane NAD 83 horizontal datum 5. INSURANCE REQUIREMENTS. The Contractor shall, at its own cost and expense, acquire and maintain (and cause any subcontractors, representatives, or agents to acquire and maintain) during the term with the City, sufficient insurance to adequately protect the respective interest of the parties. Coverage shall be obtained with a carrier having an AM Best Rating of A -VII or better. In addition, the City has the right to review the Contractor's deductible or self - insured retention and to require that it be reduced or eliminated. Specifically the Contractor must carry the following minimum types and amounts of insurance on an occurrence basis or in the case of coverage that cannot be obtained on an occurrence basis, then coverage can be obtained on a claims -made basis with a minimum three (3) year tail following the termination or expiration of this Agreement: 1. Commercial General Liability Insurance coverage including but not limited to, premises operations, products /completed operations, products liability, contractual liability, personal injury and advertising injury in the minimum amount of $1,000,000 (one million dollars) per occurrence and S2,000,000 (two million dollars) general aggregate, and $2,000,000 (two million dollars) products /completed operation aggregate. 2. Commercial Automobile Liability Insurance coverage for any owned, non - owned, hired or borrowed automobile is required in the minimum amount of $1,000,000 (one million dollars) combined single limit. CGS — Surveys and Services 16 ITB #07 -15 DETAILED SPECIFICATIONS 3. Unless waived by the State of Florida, statutory Workers' Compensation Insurance coverage in accordance with the laws of the State of Florida, and Employer's Liability Insurance in the minimum amount of $100,000 (one hundred thousand dollars) each employee each accident, $100,000 (one hundred thousand dollars) each employee by disease and $500,000 (five hundred thousand dollars) aggregate by disease with benefits afforded under the laws of the State of Florida. Coverage should include Voluntary Compensation, Jones Act, and U.S. Longshoremen's and Harbor Worker's Act coverage where applicable. Coverage must be applicable to employees, contractors, subcontractors, and volunteers, if any. 4. Professional Liability /Malpractice /Errors or Omissions Insurance coverage appropriate for the type of business engaged in by the Contractor with minimum limits of $1,000,000 (one million dollars) per occurrence. If a claims made form of coverage is provided. the retroactive date of coverage shall be no later than the inception date of claims made coverage, unless prior policy was extended indefinitely to cover prior acts. Coverage shall be extended beyond the policy year either by a supplemental extended reporting period (ERP) of as great a duration as available, and with no less coverage and with reinstated aggregate limits, or by requiring that any new policy provide a retroactive date no later than the inception date of claims made coverage. The above insurance limits may be achieved by a combination of primary and umbrella /excess liability policies. Other Insurance Provisions: 1. Prior to the execution of this Agreement, and then annually upon the anniversary date(s) of the insurance policy's renewal date(s) for as long as this Agreement remains in effect, the Contractor will furnish the City with a Certificate of Insurance(s) (using appropriate ACORD certificate, SIGNED by the Issuer, and with applicable ENDORSEMENTS) evidencing all of the coverage set forth above and naming the City as an "Additional Insured" on the Commercial Liability Insurance policy. In addition when requested in writing from the City, Contractor will provide the City with certified copies of all applicable policies. The address where such certificates and certified policies shall be sent or delivered is as follows: City of Clearwater Gas Department P.O. Box 4748 Clearwater, FL 33758 -4748 2. Contractor shall provide thirty (30) days written notice of any cancellation, non- renewal, termination, material change or reduction in coverage. 3. Contractor's insurance as outlined above shall be primary and non- contributory coverage for Contractor's negligence. 4. To the fullest extent permitted by law, Contractor agrees to defend, indemnify, and hold the City, its officers, agents, and employees, harmless from and against any and all liabilities, demands, claims, suits, losses, damages, causes of action, fines or judgments, including costs, attorneys', witnesses', and expert witnesses' fees, and expenses incident thereto, relating to, arising out of, or resulting from: (i) the services provided by Contractor personnel under this Agreement; (ii) any negligent acts, errors, mistakes or omissions by Contractor or Contractor personnel; and (iii) Contractor or Contractor personnel's failure to comply with or fulfill the obligations established by this Agreement/Contract. The stipulated limits of coverage above shall not be construed as a limitation of any potential liability to the City, and failure to request evidence of this insurance shall not be construed as a waiver of Contractor's obligation to provide the insurance coverage specified. CGS — Surveys and Services 17 ITB #07 -15 Bid details/ submittals per Detailed Specification #4, Pages 15 & 16: • The leak survey equipment used will be the RMLD for the Natural Gas and the GMI for the Propane. Tablet to communicate with Clearwater Gas, we have on hand. Please see pages for additional information and Heath's Survey Procedures/ methods to be used and general scope of work. ➢ Work hours per section (Estimated) will be: • BD Leak Survey — 600 Hours • BD A/C -264 Hours • Outside BD Survey — 2640 Hours • Outside BD A/C —1416 Hours • Price Estimate Per Day /Week for complete Services: $336.00 Per Day Per Tech/ $1680.00 Per Week Per Tech • Qualifications to perform work/ work history is attached within • Brian Persenaire - Personnel to be used with OQ Record included - all other Personnel's to be used will be determined once and if awarded RFP EXHIBIT B PRICE SCHEDULE See attached Pricing and Compensation Sheet attached herein 8 PRICING AND COMPENSATION Pursuant to all the contract specifications enumerated and described in this solicitation, Bidder agrees to furnish Surveys and Corrosion Prevention Services to the City of Clearwater at the price(s) stated below. Atmospheric Corrosion Prevention work — Pricing for Years One and Two Year One Year Two Year Three Year Four Business District — Gas Leak Survey Percentage of district to be surveyed/year $ 25200 $ 25956 $ 26735 $ 27537 100% 100% 100% 100% Business District — Atmospheric Corrosion Survey Percentage of district to be surveyed /year $ 11088 $ 3769 $ 3882 $ 3998 1 00% 33 %% 33V/3% 33'/3% Outside Business District — Gas Leak Survey Percentage of district to be surveyed /year $ 110880 $ 37688 $ 38819 $ 39983 100% 331/3% 331/3% 331/3% Outside Business District — Atmospheric Corrosion Survey Percentage of district to be surveyed /year $ 59472 $ 20215 $ 20821 $ 21446 100% 33 %% 33/3% 33'/x% TOTAL ANNUAL COST FOR SURVEYS TO BE PERFORMED $ 206,640 $ 87,628 $ 90,257 $ 92,694 Atmospheric Corrosion Prevention work — Pricing for Years One and Two Coating services (including all labor, misc, materials, equipment, etc.) $ 10 /meter Miscellaneous work $ 42 /hour Services, as stated in the Scope of Work, can be met in timeline indicated V Yes No Payment terms (not less than net 30 days) Net 30 Prompt Payment Discount of N/A % if invoices are paid within N/A Will you accept a procurement card? Yes No (ACH) Will you accept ePay for invoices over $2,500? Yes Vendor Name Heath Consultants Incorporated days of receipt Date: December 16. 2014 CGS — Surveys and Services 20 ITB #07 -15 EXHIBIT C INSURANCE REQUIREMENTS Insurance requirements attached herein 9 ACOR6 v CERTIFICATE OF LIABILITY INSURANCE DATE fMMIDDM/YY) 1/16/2015 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: If 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 Insgroup, Inc. 1455 W. Loop South, 9th Floor Houston TX 77027 CONTACT Linda Fontenot NAME: l "N Extl, (713) 541 -7272 I (; ,N,)_ (713) 772 -5224 EMAIL lfontenot @insgroup.net INSURER(S) AFFORDING COVERAGE NAIC 1 INSURER A :Wausau Underwriters Ins. Co. 26042 INSURED Heath Consultants Inc. 9030 Monroe Rd. Houston TX 77061 INSURERa:Liberty Insurance Corporation 42404 INSURERC:Steadfast Insurance Company 26387 INSURER D: $ 2,000,000 INSURER E : $ 1,000,000 INSURERF: $ 10,000 COVERAGES CERTIFICATE NUMBER:CL151764760 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POUCY NUMBER POUCY EFF (MDDMYYY) POUCY EXP (MMIDDNYYY) LIMITS A GENERAL X LIABIUTY COMMERCIAL GENERAL LIABILITY X Y TR2Z91452436034 7/30/2014 7/30/2015 EACH OCCURRENCE $ 2,000,000 PREMIISEES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE I X I OCCUR PERSONAL EADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 7 POLICY I ]i' 28:r n LOC $ A AUTOMOBILE _ X — X _HIRED LIABILITY ANY AUTO ALL OWNED AUTOS AUTOS X _ SCHEDULED AUTOS NON -OWNED AUTOS x y RS2291452436024 7/30/2014 7/30/2015 COMBINED SINGLE UMIT (Eaacaeenn $ 1,000,000 BODILY INJURY (Per person) S BODILY INJURY (Per acddent) S PROPERTY DAMAGE (Per accident) S S B X UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS -MADE X Y TH7Z91452436064 7/30/2014 7/30/2015 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 S X I 10,000 DED RETENTIONS WORKERS COMPENSATION AND EMPLOYERS' UABIUTY Y 1 N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) ttyes, desaibe under DESCRIPTION OF OPERATIONS below N 1 A 1 TORYI IIWT3 I IOER E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POUCY LIMIT $ C Professional Liability 6005932316 7/30/2014 7/30/2015 sio,000,000 Aggregate $to,000,000 Each Claim DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) The general and auto liability policies include a blanket automatic additional insured, waiver of subrogation and 30 day notice of cancellation endorsement #LC04430512, #CA20481013, #CA04441013, & #LIM99010511 that provides these features to the certificate holder only when required by written contract between the named insured and the certificate holder that requires such. The general liability policy contains an endorsement #LC24200213 with primary & non - contributory wording. The umbrella policy is follow form and contains a blanket automatic waiver of subrogation and 30 day notice of cancellations #LC24070807 & #IC99991011 that provides these features to the certificate holder only when required by CERTIFICATE HOLDER CANCELLATION City of Clearwater Gas Attn: Brian Langile 100 S Myrtle Ave Clearwater, FL 33756 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 Henry Hochman /LFF rl �! --- c ACORD 25 (2010/05) IIJRn9C rlr,rrc, r, © 1988-2010 ACORD CORPORATION. All rights reserved. 76.. APnD11 APnor. COMMENTS /REMARKS written contract between the named insured and the cetificate holder that requires such. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. ACORd CERTIFICATE OF LIABILITY INSURANCE S017913 DATE (MMIDDIYYYY) 1/16/2015 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 POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder is an ADDITIONAL INSURED, the policylies) must be endorsed. N 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 Commercial Lines Wells Fargo Insurance Services USA, Inc. 6100 Fairview Road Charlotte, NC 28210 CONTACT NAME: PHONE ("tic. E41.. 888- 572 -2412 No. EDAARL to ADDRESS: cert SQ net.COm FAX No): ext 67618 INSURERS) AFFORDING COVERAGE NAIC B INSURER A : Trumbull Insurance Company 27120 INSURED Strategic Outsourcing, Inc F/W/L Heath Consultants Incorporated PO Box 241448 Charlotte, NC 28224 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 8640141 • THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL van SIJBR wvn POUCY NUMBER POLICY EFF (MMIDDIYYYYI POUCY EXP IMMIDOIYYYYI UMITS COMMERCIAL GENERAL UABLRY EACH OCCURRENCE S CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ GEN'L MED EXP (Any one person) S PERSONAL & ADV INJURY S AGGREGATE LIMIT APPUES PER: POUCY PRO- i PRO- j LOC OTHER: GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON-0WNED AUTOS COMBINED SINGLE LIMIT (Es accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) S S UMBRELLA UAB EXCESS LIAR _ r OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DED RETENTION S S A WORKERS COMPENSATION AND EMPLOYERS LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N I (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/ A X 22WEG30001 03/01/2014 03/01/2015 x ! STATUTE ERA E.L. EACH ACCIDENT S 1,000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POUCY LIMIT S 1000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Workers' Compensation coverage is limited to employees leased to Heath Consultants Incorporated by Strategic Outsourcing, Inc. A Waiver of Subrogation applies in favor of certificate holder as required by written contract. CERTIFICATE HOLDER CANCELLATION City of Clearwater Gas 100 S. Myrtle Avenue Clearwater, FL 33756 -5520 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE 9 The ACORD name and logo are registered marks of ACORD ACORD 25 (2014101) ©1988 -2014 ACORD CORPORATION. All rights reserved. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEM ENT Policy Number: 22 WE G30001 Endorsement Number: 17 Effective Date:o3 /01/2014 Effective hour is the same as stated on the Information Page of the policy. Named insured and Address: STRATEGIC OUTSOURCING, INC. PO BOX 241448 CHARLOTTE, NC 28224 This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. SCHEDULE 1. ( ) Special Waiver Name of person or organization (x) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to fumish this waiver. 2. Operations: ALL TEXAS OPERATIONS 3. Premium: The premium charge for this endorsement shall be 2 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: Countersigned by Authorized Representative Form WC 42 03 04 A Printed in U.S.A. Process Date: Policy Expiration Date: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT Policy Number: 22 WE G30001 Endorsement Number: 830 Effective Date: 01/16/2015 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: STRATEGIC OUTSOURCING, INC. PO BOX 241448 CHARLOTTE, NC 28224 This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. In the event of cancellation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of days advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE 1. Number of days advance notice: 30 Client #7913 2. Notice will be mailed to: Holder: City of Clearwater Gas 100 S. Myrtle Avenue Clearwater, FL 33756 -5520 RE: Gas Leak Survey Countersigned by Authorized Representative Form WC 42 06 01 Printed in U.S.A. Policy Number TB2 -Z91- 452436 -034 Issued by Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY ENHANCEMENT FOR CONTRACTORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Index of modified items: Item 1. Reasonable Force Item 2. Non -Owned Watercraft Extension Item 3. Damage To Premises Rented To You - Expanded Coverage Item 4. Bodily Injury To Co- Employees Item 5. Health Care Professionals As Insureds Item 6. Knowledge Of Occurrence Item 7. Notice Of Occurrence Item 8. Unintentional Errors And Omissions Item 9. Bodily Injury Redefinition item 10. Supplementary Payments — Increased Limits Item 11. Property In Your Care, Custody Or Control Item 12. Mobile Equipment Redefinition Item 13. Newly Formed Or Acquired Entities Item 14. Blanket Additional Insured Where Required By Written Contract Lessors of Leased Equipment Managers or Lessors of Premises Mortgagees, Assignees or Receivers Owners, Lessees or Contractors Architects, Engineers or Surveyors Any Person or Organization Item 15. Blanket Additional Insured — Grantors Of Permits Item 16. Waiver Of Right Of Recovery By Written Contract Or Agreement Item 17. Other Insurance Amendment Item 18. Contractual Liability - Railroads Item 1. Reasonable Force Exclusion a. of Section I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Item 2. Non -Owned Watercraft Extension Paragraph (2) of Exclusion g. of Section I - Coverage A - Bodily Injury And Property Damage Liabdity is replaced by the following: (2) A watercraft you do not own that is: LC 04 43 0512 © 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 9 (a) Less than 55 feet long: and (b) Not being used to carry persons or property for a charge; Item 3. Damage To Premises Rented To You - Expanded Coverage A. The final paragraph of 2. Exclusions of Section I - Coverage A - Bodly Injury And Property Damage Liability is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning or explosion or subsequent damages resulting from such fire, lightning or explosion including water damage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III - Limits Of Insurance. B. Paragraph 6. of Section ill — Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of 'property damage" to any one premises, while rented to you, or in the case of damage by fire, lightning, explosion or subsequent damages resulting from such fire, lightning or explosion including water damage to premises while rented to you or temporarily occupied by you with permission of the owner. The Damage To Premises Rented To You Limit is the greater of a. $300.000; or b. The Damage To Premises Rented To You Limit shown on the Declarations. C. Paragraph 9.a. of the definition of "insured contract" in Section V — Definitions is replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion or subsequent damages resulting from such fire, lightning or explosion including water damage to premises whirl rented to you or temporarily occupied by you with permission of the owner is not an 'insured contract". D. The paragraph immediately following Paragraph (6) of exclusion j. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to 'property damage" (other than damage by fire, lightning or explosion or subsequent damages resulting from such fire, lightning or explosion including water damage) to premises, including the contents of such premises, rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limb of Insurance. Item 4. Bodily Injury To Co- Employees A. Paragraph 2. of Section II - Who Is An Insured is amended to include: Each of the following is also an insured: Your supervisory or management "employees" (other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company)) are insureds while in the course of their employment or while performing duties related to the conduct of your business with respect to 'bodily injury": (1) To you: (2) To your partners or members (if you are a partnership or joint venture); LC04430512 0 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 9 (3) To your members (if you are a limited liability company): or (4) To a co- "employee" or "volunteer worker" while that co-"employee" or "volunteer worker" is either in the course of his or her employment by you or while performing duties related to the conduct of your business (including participation in any recreational activities sponsored by you). Your "employees' (other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company)) or "volunteer workers" are insureds while in the course of their employment or while performing duties related to the conduct of your business for a Good Samaritan Act that results in "bodily injury": (1) To you: (2) To your partners or members (if you are a partnership or joint venture); (3) To your members (if you are a limited liability company): or (4) To a co- "employee" or "volunteer worker" while that co- "employee" or "volunteer worker is either in the course of his or her employment by you or while performing duties related to the conduct of your business (including participation in any recreational activities sponsored by you). A Good Samaritan Act means an attempt to rescue or aid a person in imminent or serious peal, provided the attempt is not recklessly made. However, none of these "employees" (including supervisory or management 'employees ") or "volunteer workers" are insureds for the providing or failure to provide professional health care services. B. The insurance provided by this Item 4. will not apply if the injured person's sole remedy for such injury is provided under a workers' compensation law or any similar law. C. Other Insurance The insurance provided by this Item 4. is excess over any other valid and collectible insurance avalable to the insured, whether primary, excess, contingent or on any other basis. Item 5. Health Care Professionals As Insureds A. Paragraphs 2.a.(1)(a) and (d) of Section II - Who Is An Insured do not apply to "bodily injury" or "personal and advertising injury" arising out of the providing of or failure to provide professional health care services by any "employee" or "volunteer" of the Named Insured who is a "designated health care provider" if the "bodily injury" or "personal and advertising injury" occurs in the course and scope of the 'designated health care provider's" employment by the Named Insured. B. With respect to "employees" and "volunteer workers" providing professional health care services, the following exclusions are added to Paragraph 2. Exclusions of Section I — Coverage A — Bodily Injury And Property Damage Liability and Paragraph 2. Exclusions of Section I — Coverage B — Personal And Advertising Injury Liability: This insurance does not apply to: (1) Liability assumed under an "insured contract" or any other contract or agreement; (2) Liability arising out of the providing of professional health care services in violation of law; (3) Liability arising out of the providing of any professional health care services while in any degree under the influence of intoxicants or narcotics; (4) Liability arising out of any dishonest, fraudulent, malicious or knowingly wrongful act or failure to act: or LC 04 43 05 12 © 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 9 (5) Punitive or exemplary damages, fines or penalties. C. The following definition is added to Section V - Definitions: "Designated health care provider" means any "employee" or "volunteer worker" of the Named Insured whose duties include providing professional health care services. including but not limited to doctors, nurses, emergency medical technicians or designated first aid personnel. D. Other Insurance The insurance provided by this Item 5. is excess over any other valid and collectible insurance evadable to the insured, whether primary, excess, contingent or on any other basis. Item 6. Knowledge Of Occurrence Knowledge of an "occurrence' by your agent, servant or "employee" MI not in itself constitute knowledge by you unless your "executive officer or "employee" or other third party designated by you to notify us of "occurrences" has knowledge of the "occurrence ". Item 7. Notice Of Occurrence For purposes of Paragraph 2.a. of Section IV - Conditions, you refers to an "executive officer of the Named Insured or to the "employee" designated by the insured to give us notice. Item 8. Unintentional Errors And Omissions Unintentional failure of the Named Insured to disclose all hazards existing at the inception of this policy shall not be a basis for denial of any coverage afforded by this policy. However, you must report such an error or omission to us as soon as practicable after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non - renewal. item 9. Bodily Injury Redefinition The definition of "bodily injury' in Section V - Definitions is replaced by the following: "Bodily injury' means: a. Bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time; and b. Mental anguish, shock or humiliation arising out of injury as defined in Paragraph a. above. Mental anguish means any type of mental or emotional dlness or distress. Item 10. Supplementary Payments - Increased Limits Paragraphs 1.b. and 1.d. of Section 1 - Supplementary Payments - Coverages A And B, are replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit" including substantiated loss of earnings up to $500 a day because of time off from work. LC 04 43 05 12 C 2012 Lberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 9 Item 11. Property In Your Care, Custody Or Control A. Paragraphs (3) and (4) of exclusion j. of Section I — Coverage A — Bodily Injury and Property Damage Liability only apply to: 1. "Property damage" to borrowed equipment, or 2. "Property damage" to property in your care, custody and control while in transit. B. This insurance does not apply to any portion of a loss for which the insured has available any other valid and collectible insurance. whether primary. excess, contingent. or on any other basis, unless such other insurance was specifically purchased by the insured to apply in excess of this policy. C. Limits of Insurance Subject to Paragraphs 2., 3., and 5. of Section 111 — Limits Of Insurance. the most we will pay for insurance provided by Paragraph A., above is: $10,000 Each Occurrence !knit $25,000 Aggregate Limit The Each Occurrence Limit for this coverage applies to all damages as a result of any one "occurrence" regardless of the number of persons or organizations who sustain damage because of that "occurrence ". The Aggregate Limit is the most we will pay for the sum of all damages under this Item 11. item 12. Mobile Equipment Redefinition The definition of "Mobile Equipment° in Section V — Definitions is amended to include self - propelled vehicles with permanently attached equipment less than 1000 pounds gross vehicle weight that are primarily designed for. (1) Snow removal; (2) Road Maintenance, but not construction or resurfacing; or (3) Street cleaning. Item 13. Newly Formed Or Acquired Entities Paragraph 3. of Section 11 — Who Is An Insured is replaced by the following: 3. Any organization, other than a partnership or joint venture, you newly acquire or form and over which you maintain majority ownership or majority interest will qualify as a Named Insured if there is no other similar insurance available to that organization. a. Coverage under this provision is afforded only until: (1) The 180th day after you acquire or form the organization; (2) Separate coverage is purchased for the organization; or (3) The end of the policy period, whichever is earlier. b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and LC 04 43 05 12 © 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 9 c. Coverage B does not apply to "personal and advertising injury' arising out of an offense committed before you acquired or formed the organization. Item 14. Blanket Additional Insured Where Required By Written Contract Paragraph 2. of Section 11- Who Is An Insured is amended to add the following: e. Additional Insured by Written Contract or Written Agreement The following are insureds under the policy when you have agreed in a written contract or written agreement to provide them coverage as additional insureds under your policy: (1) Lessors of Leased Equipment The person(s) or organization(s) from whom you lease equipment, but only with respect to liability for "bodily injury", 'property damage" or "personal and advertising injury caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). (2) Managers or Lessors of Premises: Any manager or lessor of premises leased to you in which the written lease agreement obligates you to procure additional insured coverage. The coverage afforded to the additional insured is limited to liability in connection with the ownership, maintenance or use of the premises leased to you and caused, in whole or in part, by some negligent acts or omissions of you, your 'employees', your agents or your subcontractors. There is no coverage for the additional insured for baby arising out of the sole negligence of the additional insured or those acting on behalf of the additional insured, except as provided below. if the written agreement obligates you to procure additional insured coverage for the additional insured's sole negligence, then the coverage for the additional insured shall conform to the agreement, but only if the applicable law would allow you to indemnify the additional insured for liability arising out of the additional insured's sole negligence. This insurance does not apply to: (a) Any 'occurrence" which takes place after you cease to be a tenant in that premises or to lease that land; or (b) Any premises for which coverage is excluded by endorsement. (3) Mortgagees. Assignees or Receivers: Any person(s) or organization(s) with respect to their liability as mortgagee, assignee or receiver and arising out of the ownership, maintenance or use of your premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. (4) Owners. Lessees or Contractors: any person(s) or organization(s) to whom you are obligated by a written agreement to procure additional insured coverage, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury` caused, in whole or in part, by your acts or omissions or the acts or omissions of your "employees ", your agents, or your subcontractors, in the performance of your ongoing operations. This insurance does not apply to "bodily injury", "property damage ", or "personal and advertising injury` arising out of "your work' included in the "products - completed operations hazard" unless you are required to provide such coverage for the additional insured by the written agreement, and then only for the period of time required by the written agreement and only for liability caused, in whole or in part, by your acts or omissions or the acts or omissions of your "employees ", your agents, or your subcontractors. There is no coverage for the additional insured for liability arising out of the sole negligence of the additional insured or those acting on behalf of the additional insured, except as provided below. LC04430512 ® 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 9 If the written agreement obligates you to procure additional insured coverage for the additional insured's sole negligence, then the coverage for the additional insured shall conform to the agreement, but only if the applicable law would allow you to indemnify the additional insured for liability arising out of the additional insured's sole negligence. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. (5) Architects, Engineers or Surveyors: any architect, engineer, or surveyor engaged by you but only with respect to liability for "bodily injury", "property damage" or °personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In connection with your premises; or (b) In the performance of your ongoing operations. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Supervisory, inspection, architectural or engineering activities. (6) Any Person or Organization Other Than a Joint Venture: Any person or organization (other than a joint venture of which you are a member) for whom you are obligated by a written agreement to procure additional insured coverage, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations: or (b) In connection with premises owned by you. This insurance does not apply to: 1. Any construction, renovation, demolition or installation operations performed by or on behalf of you, or those operating on your behalf; 2. Any person or organization whose profession, business or occupation is that of an architect, surveyor or engineer with respect to liability arising out of the preparation or approval of maps, drawings. opinions, reports, surveys, change orders, designs, specification or the performance of any other professional services by such person or organization; or 3. Any person or organization more specifically covered in Paragraphs e.(1) through (5) above. The insurance afforded to any person or organization as an insured under this Paragraph 2.e.: (1) Applies only to coverage and minimum limits of insurance required by the written agreement or written contract, but in no event exceeds either the scope of coverage or the limits of insurance provided by this policy; LC04430512 © 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 9 (2) Does not apply to any person or organization for any "bodily injuy, "property damage" or "personal and advertising injury" if any other additional insured endorsement attached to this policy applies to that person or organization with regard to the "bodily injury, "property damage" or 'personal and advertising injury": (3) Applies only if the "bodily injury" or "property damage" occurs, or offense giving rise to "personal and advertising injury' is committed, subsequent to the execution of the written agreement and (4) Applies only if the written agreement is in effect at the time the "bodily injury" or "property damage" occurs, or at the time the offense giving rise to the "personal and advertising injury" is committed. Rem 15. Blanket Additional Insured — Grantors Of Permits Paragraph 2. of Section II - Who Is An Insured is amended to add the following: Any state, municpality or political subdivision with respect to any operations performed by you or on your behalf, or in connection with premises you own, rent or control and to which this insurance applies, for which the state. municipality or political subdivision has issued a permit. However. this insurance does not apply to: 1. "Bodily injury', "property damage" or 'personal and advertising injury" arising out of operations performed for the state, municipality or political subdivision: 2. Any "bodily injury' or "property damage" included within the 'products - completed operations hazard ", except when required by written contract or agreement initiated prior to loss; or 3. "Bodily injury', "property damage" or "personal and advertising injury", unless negligently caused, in whole or in part, by you or those acting on your behalf. Item 16. Waiver Of Right Of Recovery By Written Contract Or Agreement The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery because of payments we make under this policy for injury or damage arising out of your ongoing operations or your work" included in the "products - completed operations hazard' that we may have against any person or organization with whom you have agreed in a written contract or agreement to waive your rights of recovery but only if the "bodily injury" or 'property damage" occurs, or offense giving rise to "personal and advertising injury' is committed subsequent to the execution of the written contract or agreement. Item 17. Other Insurance Amendment If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person or organization that qualifies as an additional insured on this policy, this policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV — Conditions will not apply. Where the applicable written agreement does not specify on what basis the Iiabiity insurance will apply, the provisions of Paragraph 4. Other Insurance of Section IV — Conditions will govern. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same "occurrence ", claim or "suit ". Item 18. Contractual Liability — Railroads Paragraph 9. of Section V - Definitions is replaced by the following: 9. "Insured Contract" means: LC04430512 C 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 9 a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract "; b. A sidetrack agreement; c. Any easement or license agreement; d. An obligation, as required by ordinance. to indemnify a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders. change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failing to render professional services. including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities. LC 04 43 0512 ® 2012 Liberty Mutual Insurance. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 9 POLICY NUMBER: AS2- Z91- 452436 -024 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. [Name Of Person(s) Or Organization(s): SCHEDULE Any person or organization where the named insured has agreed by written contract to include such person or organization as a designated insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph 0.2. of Section I - Covered Autos Coverages of the Auto Dealers Coverage Form. CA20481013 O Insurance Services Office. Inc., 2011 Page 1 of 1 POLICY NUMBER: AS2 -Z91- 452436 -024 COMNERCIALAUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SCHEDULE 1 Name(s) Of Persons) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. Premium: S Ind Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the "loss" under a contract with that person or organization. CA04441013 © Insurance Services Office, Inc., 2011 Page 1 of 1 Policy Number: AS2 -Z91-452436- 024 Issued By: Liberty Mutual Fire insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modes 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 Schedule Name of Other Person(s)/ Organization(s): Email Address or mailing address: Number Days Notice: Per Schedule on File with Company 30 • 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 maiing 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 0511 C 2011, Liberty Mutual Group of Companies. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 1 Policy Number TB2 -Z91- 452436 -034 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) / Organization(s): Per Schedule On Fite With The Company Email Address or mailing address: Number Days Notice: Per Schedule On File With The Company 30 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. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 Policy Number T82- 291 - 452436 -034 Issued by LIBERTY MUTUAL FIRE INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE AMENDMENT — SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS /COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Person or Organization: Scheduled Additional Insured Blanket Additional Insured and Waiver of Subrogation- Manager or Lessors of Premises Expanded Blanket Additional insured and Waiver of Subrogation (for installation purposes) Blanket Additional Insured and Waiver of Subrogation- Person or Organization Additional Insured - Architects, Engineers or Surveyors Additional Insured - State, Municipality or Political Subdivision - Permits Additional Insured and Waiver of Subrogation - Lessor of Leased Equipment Additional Insured - Owners, Lessees or Contractors - Scheduled Person or Organization Additional Insured - Owners, Lessees or Contractors - Completed Operations If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person or organization shown in the Schedule of this endorsement that qualifies as an additional insured on this policy, this policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV - Conditions will not apply. If the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4. Other Insurance of Section IV - Conditions will govern. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for the same "occurrence ", claim or "suit ". LC 24 20 02 13 © 2013 Liberty Mutual Insurance. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 252201400003900037 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following; We waive any right of recovery we may have against any person or organization with whom you have agreed in writing prior to an "occurrence" to waive your rights because of payments we make for injury or damage arising out of your ongoing operations or "your work" done undcr a contract with that person or organization and included in the "products- completed operations hazard ". Ibis endorsement is executed by the LIBERTY INSURANCE CORPORATION Premium 5 Effective Date Pnr attachment to Policy No. Audit Basis Itsued'1'o Expiration Date 1117 - %91.452436.064 3-kttf 49.4-'-°17 Countersigned by Authorized Representative Issued Sales Office and No. End. Serial No. 25 LC 24 07 08 07 Page 1 of 1 Endorsement number 41 for policy number TH7 -Z91- 452436 -064 Named Insured Heath Consultants Incorporated This endorsement is effective 07/30/2014 and will terminate with the policy. It is issued by the company designated in the Declaration. All other provisions of the policy remain unchanged. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Change Endorsement It is agreed that Endorsement 40, UM 99 01 05 11 Notice of Cancellation to Third Parties is amended as follows: Schedule is replaced with the following: Name of Other Person(s) / Organization(s): Email Address or mailing address: Number Days Notice: Per schedule company on file with 30 No Premium Change Issued: BAM 12/12/2014 1C9999 10 -11