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JOB ORDER CONTRACTOR (JOC) CONTRACT
MARICOPA COUNTY, ARIZONA
Electrical Job Order Contractor for Parks and Recreation
Office of Procurement Services
Serial # 200060-JOC
Contract # 200060-JOC
C-70-__________________
Project # 200060-JOC
Parks and Recreation Department, Maricopa County Arizona
2
Division 0 - Bidding & Contract Requirements
Section
Description
Number of Pages
00005
Table of Contents ..............................................................................................
1
00500
Construction Contract ........................................................................................
4
00610
Payment Bond and Performance Bond ..............................................................
3
00700
General Conditions Table of Contents ..............................................................
6
00700
General Conditions to the Construction Contract.............................................. 43
Exhibit A – Definitions to the General Conditions ...........................................
3
Exhibit B – Alternate Dispute Resolution .........................................................
5
Exhibit C – Legal Worker Certification ...........................................................
1
Exhibit D – Request for Proposal for Task Order .............................................
1
Exhibit E – Performance Bond and Payment Bond Forms ...............................
2
Exhibit F – SBE Reporting Document ..............................................................
1
Exhibit G – Request for Qualifications dated 1/9/20 ........................................ ___
Exhibit H – Statement of Qualifications dated 1/9/20 ....................................... ___
Exhibit I – Certificate of Insurance for Job Order Contract ..............................
2
Exhibit J – General Requirements for the Job Order Contracts ........................
All of the exhibits above are incorporated by reference as though fully set forth herein whether or not
physically attached to this contract.
NOTE: All references to “JOC” in this document are understood to mean the Electrical JOC.
END OF SECTION
3
SECTION 00500
JOB ORDER CONTRACT
A.
EFFECTIVE DATE:
This CONTRACT is entered into by and between the Owner and the Job Order Contractor as
Contract No. 200060-JOC, and shall be effective as of ___________, 20____.
B.
OWNER:
MARICOPA COUNTY
c/o Facilities Management Department
401 West Jefferson Street
Phoenix, Arizona 85003
C.
JOB ORDER CONTRACTOR:
Pete Trowbridge
Hawkeye Electric, Inc
10 S. Roosevelt Avenue
Chandler, Arizona 85226
Phone: 480-784-6800, Fax:480-784-6860, Email: pete@hawkeyeelectric.com
D.
RECITALS:
The scope of work and specifications for a broad range of services will be identified in individual
Task Orders which will be issued by the Owner from time to time. See EXHIBIT D hereto.
NOW THEREFORE, intending to be legally bound and for valuable consideration, the receipt and
sufficiency of which are acknowledged, the Owner and Job Order Contractor agree as follows:
E.
AGREEMENT:
Article I.
THE CONTRACT
1.1
The Task Order and other Contract Documents explained in Section 7.1 below and the
definitions which are contained Section 00700, Exhibit A, govern this Job Order Contract.
Article II.
THE WORK
2.1
The Job Order Contractor shall execute the entire Work described by each Task Order,
including work which is reasonably inferable and necessary to produce the results intended by
the Contract and the Task Order.
Article III.
CONTRACT TIME
3.1
The Job Order Contractor shall have access to the area of the Work effective from the date of
the Notice to Proceed for the assigned Task and shall achieve Substantial Completion and Final
Completion of the Work no later than the performance period specified in each Task Order
issued. The length of this Contract for services will be for a period of two (2) years with three
one-year options to extend the contract, but in no event will this Contract’s Term continue
longer than five (5) years from the date of the Contract. The term of this Contract shall not be
extended. All Work issued hereunder must be completed in full by the final expiration date of
this Contract. Extensions to this Contract for years 3, 4 and 5 may only be made by an
amendment signed by both parties. A permission to complete a Task Order that extends into
Year 3, 4 or Year 5 does not extend the Contract in its entirety for the additional year.
3.2
The Job Order Contractor shall achieve Substantial Completion of the Work (as defined in
Section 00700, Article 9.8 herein, and evidenced by a Certificate of Substantial Completion)
not later than as specified in each Task Order.
4
3.3
The Job Order Contractor shall achieve (as defined in Section 00700, Article 9.9 herein, and
evidenced by a Certificate of Final Completion) no later than as specified in each Task Order.
Article IV.
CONTRACT SUM
4.1
The Owner shall pay the Job Order Contractor in current funds for the Job Order Contractor’s
performance of individual Task Orders in an aggregate amount not to exceed Fifteen Million
Dollars ($15,000,000.00) in total, and not to exceed Three Million Dollars ($3,000,000.00) per
Fiscal Year, which Fiscal Year shall be designated by the Owner as beginning on July 1st and
ending on June 30th of the next calendar year. The single maximum value of a task issued
shall not exceed $1,000,000.00. The Owner does not guarantee a minimum Contract Sum
under this Contract, and Job Order Contractor, in accepting this Contract, does not expect a
minimum Contract Sum. Payments will be made in accordance with the sum negotiated for
each specific Task Order.
Maricopa County, at its sole discretion, may require the Job Order Contractor to purchase from
a specified or designated County supplier (i.e. Home Depot) any and/or all available materials
applied or installed by the Job Order Contractor or its subcontractors for a Task Order. The
materials purchased by the Job Order Contractor(s), or its subcontractor(s), shall be purchased
by the Job Order Contractor(s), or its subcontractor’s, using their own funds and/or credit. Any
discounts offered to the JOC by the County’s material supplier shall be passed through to the
County without markup. The County is not a party to these transactions and any issue/disputes
shall be resolved without the involvement of the County.
4.2
FEE AND OVERHEAD CALCULATIONS FOR CONSTRUCTION COSTS UP TO $250,000.00
Overhead must be all inclusive and include all “costs of doing business”. The County will not
pay separately for items such as, but not limited to warranty, project closeout, home office
expense, personal safety equipment, safety personnel, unless safety personnel is specifically
required for the Work being performed and approved by the Owner. The Job Order Contractor
agrees the overhead shall be no more than 8% and the fee shall be capped at 5%.
4.3
FEE AND OVERHEAD CALCULATIONS FOR CONSTRUCTION OVER $250,000.00
Overhead must be all inclusive and include all “costs of doing business”. The County will not
pay separately for items such as, but not limited to warranty, project closeout, home office
expense, personal safety equipment, safety personnel, unless safety personnel is specifically
required for the Work being performed and approved by the Owner. Overhead cost and
percentages in addition to Job Order Contractor fee(s) shall be negotiated between the Job
Order Contractor and the County for any projects exceeding $250,000.00.
Article V.
PROGRESS PAYMENTS
5.1
Progress payments will be made in accordance with Article 9 of the General Conditions to the
Job Order Contract.
Article VI.
FINAL PAYMENT
6.1
Final Payment will be made in accordance with Article 9 of the General Conditions to the Job
Order Contract.
Article VII.
CONTRACT DOCUMENTS
7.1
The Contract consists of the following documents incorporated herein by this reference:
7.1.1
The Job Order Contract – Section 00500.
7.1.2
The General Conditions to the Job Order Contract – Section 00700.
7.1.3
Permits, Change Orders, Change Directives, amendments or modifications to the Contract.
7.1.4
Any and all documents issued during the procurement process for this Contract.
7.1.5
Task Order documents including, but not limited to, Task Orders, associated plans and
specifications.
5
7.1.6
Any addenda to any issued Task Orders or other Contract documents.
7.1.7
Exhibits to Section 00700:
Exhibit A – Definitions to the General Conditions
Exhibit B – Alternate Dispute Resolution
Exhibit C – Legal Worker Certification
Exhibit D – Request for Proposal for Task Order
Exhibit E – Performance Bond and Payment Bond Forms
Exhibit F – SBE Reporting Document
Exhibit G – Request for Qualifications dated _____1/9/2020__
Exhibit H – Statement of Qualifications dated ____1/9/2020__
Exhibit I – Certificate of Insurance for Job Order Contract.
Exhibit J – General Requirements for the Job Order Contracts
All of the exhibits listed above are incorporated by reference as though fully set forth,
whether or not they are physically attached to this Contract.
7.1.8
All amendments to this Contract shall be in writing and approved/signed by both parties.
Maricopa County Office of Procurement Services shall be responsible for approving all
amendments for Maricopa County.
7.1.9
UNIFORM ADMINISTRATIVE REQUIREMENTS:
When applicable and by entering into this Contract the Contractor agrees to comply with
all applicable provisions of Title 2, Subtitle A, Chapter II, PART 200—UNIFORM
ADMINISTRATIVE
REQUIREMENTS,
COST
PRINCIPLES,
AND
AUDIT
REQUIREMENTS FOR FEDERAL AWARDS contained in Title 2 C.F.R. § 200 et seq.
6
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day and date first
above written, in counterparts, each of which shall, without proof or accounting for the other counterparts,
be deemed an original contract.
Electrical Job Order Contractor for Parks and Recreation
200060-JOC
Principal (Signature)
Date
Printed Name
Federal Tax Identification Number
Title
License Number
90924
Vendor Terms
NIGP Commodity Code (Advantage)
COUNTY OF MARICOPA, ARIZONA
RECOMMENDED BY:
ACCEPTED AND APPROVED:
________________________________________
Department Head
Date
Chairman, Board of Supervisors
Date
ATTEST:
________________________________________
Clerk of the Board
Date
LEGAL REVIEW
Approved as to form and within the powers and
authority granted under the laws of the State of
Arizona to Maricopa County.
By:
Deputy County Attorney
Date:
Pete Trowbridge
President, Hawkeye Electric, Inc.
C-11 151297
03/26/20
86-0972617
Parks & Recreation
MARICOPA COUNTY, ARIZONA
200060-JOC
ELECTRICAL JOB ORDER CONTRACTOR FOR PARKS & RECREATION
SERIAL # 200060-JOC
CONTRACT NO. 200060-JOC
COMPANY NAME: HAWKEYE ELECTRIC, INC.
Please fill out the following rate chart with the hourly rates that match the staff classification
description. Rates shall be provided EXCLUSIVE of Overhead and Profit. Please utilize these staff
classifications and do not add or modify any classifications.
STAFF CLASSIFICATION
BILLING HOURLY RATE
Project Manager
$ 90.00
General Foreman
$ 68.00
Journeyman
$ 47.00
Apprentice
$ 35.00
Laborer
$ 26.00
Markups for quoted work is limited to the following overhead and profit percentages:
Overhead – 8%
Profit – 5%
Sincerely,
Pete Trowbridge
President
HAWKEYE ELECTRIC, INC.
INSR
ADDL SUBR
LTR
INSR WVD
DATE (MM/DD/YYYY)
PRODUCER
CONTACT
NAME:
FAX
PHONE
(A/C, No):
(A/C, No, Ext):
E-MAIL
ADDRESS:
INSURER A :
INSURED
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER
POLICY EFF
POLICY EXP
TYPE OF INSURANCE
LIMITS
(MM/DD/YYYY) (MM/DD/YYYY)
COMMERCIAL GENERAL LIABILITY
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
INSURER(S) AFFORDING COVERAGE
NAIC #
Y / N
N / A
(Mandatory in NH)
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
EACH OCCURRENCE
$
DAMAGE TO RENTED
$
PREMISES (Ea occurrence)
CLAIMS-MADE
OCCUR
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
$
PRO-
OTHER:
LOC
JECT
COMBINED SINGLE LIMIT
$
(Ea accident)
BODILY INJURY (Per person)
$
ANY AUTO
OWNED
SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS ONLY
AUTOS
AUTOS ONLY
HIRED
PROPERTY DAMAGE
$
AUTOS ONLY
(Per accident)
$
OCCUR
EACH OCCURRENCE
$
CLAIMS-MADE
AGGREGATE
$
DED
RETENTION $
$
PER
OTH-
STATUTE
ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS below
POLICY
NON-OWNED
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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.
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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s).
COVERAGES
CERTIFICATE NUMBER:
REVISION NUMBER:
CERTIFICATE HOLDER
CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ACORD 25 (2016/03)
ACORDTM
CERTIFICATE OF LIABILITY INSURANCE
Amerisure Insurance Company
Travelers Property Cas. Co. of America
3/26/2020
USI Insurance Services LLC
2375 E. Camelback Rd, Suite 250
Phoenix, AZ 85016
Kim Russell
602-666-4893
phx.certificates@usi.com
Hawkeye Electric, Inc
10 S Roosevelt Ave.
Chandler, AZ 85226
19488
25674
A
X
X
X
X
X
CPP2103884
01/15/2020 01/15/2021
1,000,000
300,000
5,000
1,000,000
2,000,000
2,000,000
A
X
X
X
X
X
CA2103883
01/15/2020 01/15/2021
1,000,000
B
X
X
X
10,000
X
X
ZUP61M7233719NF
01/15/2020 01/15/2021
5,000,000
5,000,000
A
Y
X
WC2103887
01/15/2020 01/15/2021 X
1,000,000
1,000,000
1,000,000
A
A
Installation
Floater
Leased/Rented EQ
CPP2103884
CPP2103884
01/15/2020
01/15/2020
01/15/2021
01/15/2021
$350,000 Limit
$1,000 Deductible
$300,000 Lim/$1,000 Ded
The General Liability, Automobile Liability, and Umbrella Liability policies include an automatic
Additional Insured endorsement that provides Additional Insured status to the Certificate Holder and the
additional entities listed, if any, only when there is a written contract that requires such status, and
only with regard to work performed on behalf of the named insured. The General Liability and Umbrella
Liability policies contain a special endorsement with "Primary and Noncontributory" wording, when required
(See Attached Descriptions)
Maricopa County Office Of
Procurement Services
320 West Lincoln Street
Phoenix, AZ 85003
1 of 2
#S28328408/M27637009
HAWKEELE
Client#: 1421249
CYSJD
1 of 2
#S28328408/M27637009
Statement of Qualifications for
Job Order Contractor
SERIAL # 200060-JOC
CONTRACT # 200060-JOC
Due Date: Thursday, January 09, 2020
Due Time: 2:00 PM, Phoenix Time (M.S.T.)
Submitted via www.bidsync.com
10 S. Roosevelt Street, Chandler, AZ 85226
Phone: 480.784.6800 ∙ Fax: 480.784.6860
WWW.HAWKEYEELECTRIC.COM
ROC C11 151297
January 9, 2020
Mr. Paul Shamrock
Procurement Officer
Maricopa County
Office of Procurement Services
160 S. 4th Avenue, Phoenix, AZ 85003
(602) 506.6476
RE:
Hawkeye Electric, Inc.,
Statement of Qualifications – Electrical Job Order Contractor 200060-JOC
Dear Mr. Shamrock,
On behalf of Hawkeye Electric, Inc., I am pleased to present the enclosed statement of qualifications in response to
the above-referenced Maricopa County RFQ. We appreciate the opportunity to be considered as a vendor to
continue serving Maricopa County.
Hawkeye Electric is proud to offer you a strong, committed team of construction professionals and skilled
tradesmen who will provide maximum value for Maricopa County via effective and efficient project management.
We have read and understand all the elements laid out in RFQ and strongly feel our team has all the qualities and
capabilities to surpass expectations in servicing this important contract. Following are some important benefits of
selecting Hawkeye Electric as the Electrical JOC Contract partner for Maricopa County’s Parks & Recreation Dept:
➢ Proven Experience: With a proven track record successfully completing over 30 park new construction and upgrade
projects throughout the State of Arizona, Hawkeye is well versed in coordinating streamlined execution of electrical
work in open park facilities. Our management programs include tools, systems, and procedures developed over time
to guide the Project Team as we prepare and execute insightful, thorough plans for your projects.
➢ Park Experience: Hawkeye currently holds multiple electrical services JOC Contracts with the City of Phoenix,
Maricopa County, City of Glendale, Gilbert Public Schools, and numerous other agencies in and around the Phoenix
Metro Area. Via these contracts, Hawkeye has completed improvements at numerous public park facilities around
the valley. The company is proud of its great track record of rapid response; thorough & accurate troubleshooting;
and efficient, clean execution of the work.
We are confident Hawkeye’s experience and capabilities make us the right team to effectively service Maricopa
County’s Parks & Recreation department. Thanks again for the opportunity to be considered. Please don’t
hesitate to contact me if you have any questions.
Sincerely,
Pete Trowbridge
President
Hawkeye Electric, Inc.
pete@hawkeyeelectric.com
Tab 1:
Prior Experience – 2 pages
Tab 2:
Project Team – 2 pages
Tab 3:
Subcontractor Selection Plan and Project
Management Plan – 1 page
Tab 4:
Budget & Scope Management Capability,
Team Approach Capability, and Ability to
Complete on an Expedited Basis – 1 page
Attachments:
a. GC Arizona License
b. Resumes
c. References
d. Legal Worker Certification
e. Surety Bond
f. Proposal Exceptions
g. Non-Collusion Affidavit
STATEMENT OF QUALIFICATIONS FOR:
ELECTRICAL JOB ORDER CONTRACTOR
MARICOPA COUNTY JOC CONTRACT # 200060-JOC
TABLE OF CONTENTS
Statement of Qualifications
Electrical JOC 200060-JOC
Maricopa County
Office of Procurement Services
160 S. 4th Avenue
Phoenix, AZ 85003
Prior
Experience &
Client References
(tab 1)
PRIOR EXPERIENCE
JOC Contract Reference #1 – City of Phoenix JOC Contract 138441 dated 7/2/14
Contract Name: “Citywide Electrical & Park Lighting”. Agreements completed include:
- Mt. View Park LED Area Lighting
- Green Valley Park Sports Field
Lighting
- Pierce Park Sports Field Lighting
- Encanto Park Lighting Replacement
- EP Enchanted Island Lighting
Replacement
- Villa de Paz Park – New Soccer
Field Lighting
- Cholla Library SES Replacement
- Yucca Library SES Replacement
- South Mountain Comm Tower Gen
Replacement
Current job order agreements Hawkeye is in the process of executing under this contract include:
- Glenrosa Facility Addition of Two
Natural Gas Generators with New
Service Entrance Sections
- Century Library SES & Panel C
Replacement
- Phoenix City Hall Busway
Replacement
JOC Contract Reference #2 – City of Phoenix JOC Contract 143971 dated 1/23/17
Formal Contract Name: “Parks & Recreation Department LED Lighting Replacement”. Agreements
completed under this contract include:
- Palma Park Sports Field Lighting
- Sweetwater Park Sports Field Lighting
- Maryvale Park Sports Field Lighting
- Smith Park Area Lighting & SES Replace
JOC Contract Reference #3 – Maricopa Cty JOC Contract 171091-S dated 3/1/17
Contract Name: “Re-Lamping and Repair Services”. Three largest job orders completed include: Lower
Buckeye Jail Re-Lamp ($251K), Estrella Jail Re-Lamp ($126K), & South Court Tower Re-Lamp ($214K)
JOC Contract Ref. #4 – Gilbert Public Schools Contract No. 18-01-08-22, 9/26/17
Formal Contract Name: “Multi-Award Maintenance Services”. Three largest job orders completed under
this contract are Copier Addition Electrical Distribution Upgrades at Multiple Campuses ($42,340),
Campo Verde HS Lighting Controls Upgrades ($25,650), and Highland HS Projector Receptacles ($27,870)
JOC Contract Ref. #5 – 1GPA Contract No. #17-13PV-03 dated 05-18-17
Formal Contract Name: “Electrical and Lighting Products and Services”. Numerous public agencies
utilize this 1GPA contract to engage Hawkeye. Due to space limitations, this RFP response includes only
reference projects done for City of Surprise. Three largest task orders completed for City of Surprise via
the 1GPA Contract are: Dick McComb Dog Park Lighting Addition ($100,758), Stadium Lighting Addition
($47,998), and Café Remodel ($40,948).
PRIOR EXPERIENCE
HAWKEYE RESPONSES TO RFQ CRITERIA A THROUGH N (TYP OF ALL 5 LISTED REFERENCE PROJECTS)
a/b.) Avg. 3 jobs completed per yr. Take an avg 6 months to complete. Avg. cost per job: $350,000
c.) Services Provided: Design (via 3rd party subconsultant), preconstruction, budgeting, scheduling,
subcontracting to meet min. SBE participation requirements, commissioning, closeout.
d.) Design Phase Cost Estimating Services are required on every Job Order Agreement. Developing
initial conceptual budget estimate, owner access to open-book sub bidding process, and oftentimes
as needed on a project-by-project basis, pricing multiple phasing strategies.
e.) Design phase constructability reviews included pricing comparison of Musco LED versus Green-
Series HID lighting with up front cost comparisons and lifecycle cost comparisons. Many other
services were provided, but due to space limitations in the RFP, we only mention this one.
f.) Design phase VE includes wire size calcs to help ensure wire is not oversized. Also included: site
layout design modifications to take advantage of joint trenching opportunities to reduce cost by
reducing overall linear footage of trench.
g.) Price established via internal estimating & sub bidding. Cost controls successful via contract
inclusion of appropriately sized contingency fund that goes back to the Owner at end of project if
unutilized.
h.) Budgets for task orders varied. Change orders were limited to enhancements requested by Owner,
typically toward end of project with the intent being to utilize remaining unspent contingency.
I.) Construction quality achieved through job walks, excellent Hawkeye Project Foremen, and
coordination with the Owner & AFP Department inspectors.
j.) All task orders completed within schedule.
k.) Problem avoidance – Achieved on front end through proactive design review & feedback. Achieved
during construction by manning the projects with experience project managers & foremen.
l.) Claims resolution – Hawkeye did not have any claims to resolve on any of these projects.
m.) Quality & productivity of interaction between Hawkeye & other stakeholders was and always is
excellent. We utilize MS Outlook platform to track conversations and issues through fruition.
n.) Client references. Please check references. Hawkeye rarely fails to please a customer. References
for Reference projects 1-5 listed above are….
CLIENT REFERENCES FOR ALL FIVE LISTED REFERENCE PROJECTS
#1 Client Reference: Robert Johnson, City of Phx. For contact info, see appendix section 05C.
#2 Client Reference: Jarod Rogers, City of Phx. Jarod.rogers@phoenix.gov, cell:(602) 501.8257
#3 Client Reference: Eric Barcon, Maricopa County. For contact info, see appendix section 05C.
#4 Client Reference: Albert Dutchover. For contact info, see appendix section 05C.
#5 Client Reference: Jeff Martin, City of Surprise Projectg Manager, Jeffery.martin@surpriseaz.com,
cell: (623) 824.6950.
Statement of Qualifications
Electrical JOC 200060-JOC
Maricopa County
Office of Procurement Services
160 S. 4th Avenue
Phoenix, AZ 85003
Project
Team
(tab 2)
PROJECT TEAM
Hawkeye’s Project Team will include:
Name
Title
Role
Time Dedication to This
Contract
Pete Trowbridge
(“PT”)
President
Estimating, Contract Negotiation, and
Contract Startup
100% during contract negotiation &
establishing of working guidelines.
Available as-needed thereafter.
Rick Persig
(“RP”)
Project
Manager
Scheduling, Project Mgmt, Execution, &
Closeout
Rick and Pascal will collaborate on
ensuring there is a PM assigned full
time for management of every task
order with larger jobs managed by Rick
and smaller ones managed by Pascal
Pascal Halle
(“PH”)
Service Dept.
Mgr.
Scheduling, Project Mgmt, Execution, &
Closeout
Foremen
(multiple to be
assigned)
Foreman
Self-Performance of work and
Management of Journeymen
Hawkeye has 35 Foremen on Staff.
There will a Foreman on site 100% of
the time during every project.
Troy Gallegos
(“TG”)
Superintendent
Sporadic Jobsite Safety Auditing &
Reporting. Development of Job Hazard
Analyses as needed
Approx. 15%
Keith Shay
(“KS”)
Safety Director
Sporadic Jobsite Safety Auditing &
Reporting. Development of Job Hazard
Analyses as needed
Approx. 15%
Collectively, the five individuals listed have about 40 years tenure with Hawkeye and have collaborated
on managing dozens of projects over the years. Examples include:
Signal Butte & Elliot Park, Mesa, AZ. All electrical for new park facility. Included 51 new direct-buried
Ameron concrete pathway and parking light poles. PT – Project Mgr.; TG – Super.; KS – Safety Dir.
City of Phx Cordova Court Tower Building LED Upgrade project, which included changing out over 7,000
light fixtures in only 12 weeks to meet a 6/30/19 deadline for the City of Phoenix. PT – Contract
Negotiation & Startup; PH – Project Management; KS – On-Site Safety Inspections & Reporting.
City of Phx Encanto Park – Upgrade to LED Lighting. All new pathway poles & lights throughout park.
PT – Project Mgr.; KS – Safety Dir.
Paloma Park – New 400 acre park development at Lake Pleasant Pkwy & Dixileta in Peoria. Highlights
include installation of over 40 Musco pole lights for new ballfields. Hawkeye’s contract value:
$2.513MM. PT – Estimator; RP – Project Manager; KS – Safety Dir.; TG - Superintendent
Anthem Dog Park – New ground up park. Hawkeye did all electrical for approx. $160K contract. PT –
Estimator; RP – Project Manager; TG – Superintendent; KS – Safety Audits
Due to SOQ size restrictions, these are just a few examples of projects on which this key Hawkeye team
has delivered successfully for Owners over the years. We would be happy to provide more detail upon
request. (see appendix for resumes)
PROJECT TEAM
Statement of Qualifications
Electrical JOC 200060-JOC
Maricopa County
Office of Procurement Services
160 S. 4th Avenue
Phoenix, AZ 85003
Sub Selection and
Project Management
Plan
(tab 3)
SUB SELECTION & PROJECT MANAGEMENT PLANS
SELF PERFORMANCE & SUB SELECTION
Hawkeye plans to self-perform all electrical work
associated with servicing this contract and
subcontract certain support scopes to a 3rd party.
Examples include electrical engineering requiring a
PE stamp, boring, concrete & rebar, core drilling,
and other specialty work. In selecting its subs,
Hawkeye will use a comprehensive subcontractor
selection plan that evaluates firms on many factors
including qualifications and pricing. Key plan
components include:
1. Hawkeye’s extensive database of
subconsultants and subcontractors.
Minimum per scope: 3 bidders.
2. Prepare Instructions to Bidders containing
explanation of scope w/specific items to be
included and excluded along with site
specific info bidders need to prepare a price
that includes everything needed for
complete execution of the work.
3. Prepare Request for Qualifications to be
distributed with the Instructions to Bidders.
The RFQ requires submission of relevant
information about the subcontractor’s ability
to perform on this particular project. Listed
criteria include:
a. Years of Experience
b. Work History
c. Current workload/backlog
d. Current financial statement
e. Name & experience level of supervisor
who would be assigned to the project
f. References from past projects &
customers
g. List of major vendors & suppliers
4. Distribute Instructions to Bidders along
with the RFQ, plans, specifications, and
any other relevant information.
5. Receive & review responses
6. Hawkeye PM review responses, make
selection, and prepare contract.
Sub availability – Hawkeye has a history utilizing
all referenced trade subcontracts listed in the
appendix for over seven years.
Subcontractor References – See Appendix
PROJECT MANAGEMENT PLANNING
Hawkeye Electric’s estimators and project
managers provide a full range of preconstruction
and construction services to fully support our JOC
contracts. We utilize MS excel to calculate pricing
in easy -to-read and understand spreadsheets.
Each subsequent budget iteration is calculated and
displayed in comparison to the prior generation
with cost deltas highlighted for analysis.
We use Bluebeam software to perform
constructability reviews; a software program that
includes an overlay function to quickly compare
each plan sheet with the prior iteration and
highlight changes. Utilization of state-of-the-art
software expedites the design review process
freeing up more time for the preconstruction team
to consider options and price various value
engineering ideas.
We use MS Outlook to communicate with all
stakeholders, creating and using distribution lists
to ensure open lines of communication are
maintained. Arriving at a guaranteed maximum
price for any task order isn’t complete until after
extensive team analysis and discussion of pricing
and accompanying backup from 3rd party subs and
suppliers.
Item 6 above mentions the selection of
subcontractors happening after the sub/supplier
bidding process. This selection is completed jointly
after a review of all bids in a partnering session
between Owner and Hawkeye and A/E if A/E is
engaged as owner’s agent.
Hawkeye utilizes Primavera scheduling software to
produce bar chart CPM-format schedules to track
Owner & A/E issues, procurement, construction,
inspections, project completion, and closeout.
One item specifically mentioned in the RFQ as a
“HIGH PRIORITY” area is an owner concern about
local construction market supply. Hawkeye is the
right choice to minimize this risk because we are a
local industry leader with over 220 employees and
a specialized experienced JOC division with the
tools and resources needed to meet current
demand while forecasting market fluctuations and
preparing for the ebbs and flows that are inherent
in this cyclical industry within which we work.
Statement of Qualifications
Electrical JOC 200060-JOC
Maricopa County
Office of Procurement Services
160 S. 4th Avenue
Phoenix, AZ 85003
Budget & Scope Mgmt Capability;
Team Approach Capability; and
Ability to Expedite Work Completion
(tab 4)
HAWKEYE CAPABILITIES
BUDGET & MANAGEMENT
To maintain budgets on JOC task orders, Hawkeye
starts by working during design to understand the
complete scope and identify risks or areas of work
that are not cost quantifiable at the time of the
pricing exercise. The JOC task order pricing is
finalized and a GMP is established so a PO or
Contract can be issued and the work can
commence. The definable scope is the base
contract value and the cost for dealing with the
risk is covered by an appropriately-sized owner-
controlled contingency. This contingency is broken
out from the base contract value, but still included
in the overall contract.
As more information comes available and the cost
for dealing with the risk can be more accurately
quantified, Hawkeye partners with the Owner to
evaluate and finalize the costs and the dollars
included in the contingency are used to pay for the
work. The unused portion of the contingency is
either A. Credited back to the owner via deductive
change order prior to finalizing and closing out the
contract; or B. Repurposed by the Owner to pay for
upgrades or enhancements to the project.
Hawkeye has successfully used the above-
referenced methodology to manage budgets
successfully on dozens of City of Phoenix JOC task
orders dating back to 2014 and would propose
doing so with Maricopa County as well.
To maintain and control scope on JOC task orders,
Hawkeye once again takes an early, proactive
approach that starts during the design phase. For
us, this is simple. Walk the job, review as-builts,
understand existing conditions, partner with the
Owner and A/E to perform team design review,
and make sure the feedback is incorporated into
the documents prior to the start of the work. Early
and active design-phase participation by the
contractor is the best way to ensure the scope is
clearly defined in the documents. This mitigates
change orders and risk for the entire team.
TEAM APPROACH CAPABILITY
Although there are dozens and dozens of instances
where Hawkeye has excelled participating in
design/build and design/assist projects as a team
member, due to SOQ length limitations, we will
focus in on one current example: Hawkeye’s
$1.45MM JOC Task Order currently underway for
replacing the vertical busway duct electrical
backbone in Phoenix City Hall.
Hawkeye has been in preconstruction on this task
order for over a year during which we have worked
diligently, hand-in-hand with multiple City of Phx
departments, the Facility Manager, and the
Owner’s A/E firm, IMEG. We have overseen and
coordinated the design & permitting processes and
spent countless hours evaluating options and
phasing techniques to come up with the best game
plan for replacing the entire electrical backbone in
the 21-story building without having any on-hours
outages or downtime.
Please check our reference by contacting the COP’s
Public Works Dept. Project Manager, Mark Binelli
(see references section) for more information. We
have no doubt he will confirm Hawkeye has been a
diligent partner and team leader; not only on the
busway replacement project, but on many other
job order agreements as well.
EXPEDITED COMPLETION
Hawkeye saves time on projects by developing a
bar chart schedule at the beginning of the job and
even more importantly, updating & redistributing
it weekly. Why is this more important? Because
all stakeholders need the update in real time so
everyone is aware of time savings generated and
are able to adjust their schedules accordingly.
Otherwise, time savings created early in the
project doesn’t end up expediting the finish date.
As noted previously in this SOQ, Hawkeye uses
state-of-the-art Primavera scheduling software as
the tool for scheduling. The schedules generated
by the software are printed to pdf and emailed out
to the team weekly as attachments to emails. See
attachment 1 for examples of similar projects on
which we have applied aforementioned practices
and techniques to achieve expedited completion.
Finally, the SOQ mentions an Owner High-Priority
Area is to make sure its JOC partner understands
schedule impacts with local permitting agencies.
Hawkeye truly does excel in this area. We are
highly sensitive to the potential schedule impact of
late permit issuance. We head this off at the pass
by meeting early and often with the AHJ during
design review and making sure we are a leader in
birddogging the process.
For example, with the City of Phoenix, we meet
directly with structural and electrical plan
reviewers during the design phase to provide
supplemental information beyond that which is
included in the A/E’s design. City of Phx Structrual
plan reviewer, Adam Sessions, and City of Phx
Electrical plan reviewer, Jim Kruse and attest to
this fact. They are both very used to seeing
Hawkeye in their offices helping answer questions
to help get permits issued early.
Statement of Qualifications
Electrical JOC 200060-JOC
Maricopa County
Office of Procurement Services
160 S. 4th Avenue
Phoenix, AZ 85003
Attachments
1. Contractors License
2. Resumes
3. References
a. Owner
b. Sub/Supplier
4. Legal Worker Certification
5. Bond
6. Proposal Exceptions
7. Non-Collusion Affidavit
Hawkeye Electric
B1 General Contractor License
Expires 03/31/2021
Hawkeye Electric
C11 Commercial Electrical Contractor License
Expires 01/31/2020
Letter of
Transmittal
Pricing
Forms
Other
Forms
Qualifications
Program Description &
Method of Approach
CAREER SUMMARY
27 years of experience
Electrical Journeyman, Foreman,
Project Manager, Superintendent
EDUCATION
Electrical Studies – Southern
Nevada Community College
CONTINUING EDUCATION
Electrical Instructor Apprentice-
ship Program (Utah)
Electrical Instructor
Code/Electrical Theory
Electric League of Arizona, ELC
163 Elect. Code & Inspection II
IEC of Arizona Wiring/Grounding
Electrical Code Update - 2019
LICENSING & CERTIFICATIONS
State of Utah Electrical
Apprenticeship Program and
Licensed Journeyman Electrician
ICC Nat’l Comm. Bldg. Inspector
CLIENT REFERENCES
Tyler Pratt, LEED AP
Sundt Corp.
tmpratt@sundt.com
Nick Veldman, LEED AP
Venn Construction
Nick.veldman@
venncompanies.com
Preston Rivera, CPA
Okland Construction
Cell: (602) 501.2838
TROY GALLEGOS
FIELD SUPERINTENDENT
Working in the electrical contracting industry since 1993, Troy has extensive experience in
numerous market sectors including K-12, multi-family, hospitality, water & wastewater,
and public works/capital improvement projects. Troy has been with Hawkeye since 2009
as a project Foreman and General Field Superintendent.
Troy’s greatest asset is his ability to effectively communicate and direct Hawkeye’s field
staff of foremen, journeymen, apprentices and laborers. His fair, consistent leadership
and problem-solving abilities have earned him the respect of the Hawkeye staff and clients
as a leader in his field.
SELECTED INDIVIDUAL PROJECT EXPERIENCE
Skysong Infrastructure (Scottsdale, AZ) ($2.2MM)
On-Site Superintendent for construction of electrical and special system infrastructure for the new
Skysong development. Project delivered through CM@Risk delivery method. Contract value: $2.2
million.
Pima County Jail (Tucson, AZ) ($5.0MM)
In addition to providing supervision and leadership to Project Foremen, as General
Superintendent for Hawkeye Electric, Troy personally manages field operations on specific
projects of high priority. Troy served as Hawkeye’s Superintendent for this $5MM
renovation project.
Davis Monthan Air Force Base AMARG Hangar (Tucson, AZ) ($4.0MM)
Field Supervisor for Electrical Scope on 70,000 ground up aircraft hangar. Hawkeye
served on this project under the General Contractor, Okland Construction. Project
Duration: 2014 – 2015.
Signal Butte Park (Mesa, AZ) ($150K)
Field Superintent for new park located in Mesa, AZ near Signal Butte and Elliott Roads. In
this role, Troy oversaw all electrical and site lighting installation.
Presidio of Monterey Barracks (Monterey, CA) ($5.1MM)
Troy represented Hawkeye Electric on site for this project for approximately 18 months
overseeing the installation of all electrical, fire alarm, and low voltage systems. In
addition to supervising all construction, Troy coordinated the procurement of materials
and developed and tracked the status of the electrical installation schedule.
Desert Ridge Marriott Hotel (Scottsdale, AZ) ($2.8MM)
Field Supervisor for Electrical Scope on construction of new ground up hotel.
Letter of
Transmittal
Pricing
Forms
Other
Forms
Qualifications
Program Description &
Method of Approach
Letter of
Transmittal
Pricing
Forms
Other
Forms
Qualifications
Program Description &
Method of Approach
CAREER SUMMARY
21 yr experience
Electrical Foreman,
Superintendent, and Project
Manager
EDUCATION
Duluth Technical College
Commercial and Residential
Wiring
Rick Persig
Project Manager
Rick has been working in the Phoenix Area commercial construction industry since 1992. Over
the years, he has served as project manager for over 50 commercial, education, industrial, and
retail electrical projects ranging in size from simple tenant improvements to shopping centers,
schools, and dormitories. Rick’s vast electrical construction experience has equipped him with
a balanced approach to planning and scheduling, problem solving, and troubleshooting
electrical designs and installation processes.
SELECTED INDIVIDUAL PROJECT EXPERIENCE
Paloma Park – Peoria, AZ ($2.5MM)
Project Manager for new ground-up park including all electrical and lighting. Scope overseen
includes procurement and installation of Musco ballfield lighting for four softball fields and
three dog park areas, pathway lighting with over 100 direct-buried concrete light poles,
building electrical for maintenance building, 2 concessions buildings, and 3 restroom buildings,
and all electrical for pump systems for the lake.
Mesa Aquatic Facility – Mesa, AZ ($400K)
Project Manager for all electrical work involved in the construction of new City of Mesa aquatic
center located on the campus of Mesa High School. Project spanned July, 2014 through April,
2015 and was completed on time. General Contractor was Sun Eagle Construction.
Tohono O’Odham Nursing Care Facility – Sells, AZ ($500K)
Project Manager for construction of Nursing Care Facility located just north of the border
between Arizona and Mexico. 9 month project completed for Southwestern Dakotah, Inc.
Vista Del Sol Dormitory – Arizona State University ($4.8MM)
Project Manager for all electrical work required for construction of two 7-story apartment
buildings with retail at 1st floor, one 2-story community center, one 5-story parking garage,
and miscellaneous site lighting and sport court lighting.
Harrah’s Ak-Chin Casino Hotel Expansion ($1.7MM)
Project Manager all electrical work required for the expansion of the existing hotel casino,
including construction of a 5-story hotel building with 152 guest rooms and upgraded lightning
protection.
Big Two Toyota – Peoria, AZ ($1.8MM)
Project Manager for all electrical work required for new car dealership including showroom
building and service building and all systems work for communications, internet, and service
building equipment power.
Park Place – Phoenix, AZ ($1.3MM)
Project Manager for all electrical work required for (3) 2-story office shell with miscellaneous
site lighting
Attachment 1 – REFERENCE FORMAT
Maricopa County requires a minimum of THREE (3) references and/or a maximum of five (5) (most
recently) completed projects, which are similar in magnitude, complexity, and dollar value. This form
may be replicated as needed to be responsive to the Request for Qualifications
1. Task Order Reference: Campo Verde High School Lighting Controls
Owner Name: Gilbert Public Schools Maintenance and Operations Department
7103 E. Guadalupe Road • Mesa, AZ 85212 • (480) 373.0460
Contact: Albert Dutchover • Department Director • albert.dutchover@gilbertschools.net
Owner Contract No: Solicitation RFP # 18-01-22 Maintenance Services (multi-year electrical job
order contract originally awarded to Hawkeye on September 26, 2017)
Hawkeye removed existing lighting control panels and installed timeclock with contactors and
switches to control the lighting at the Field House & Buildings A, B, C, D, and E. Hawkeye served as
prime contractor. Task order value: $26,650. Project Completion: February, 2019.
2. Task Order Reference: South Mountain Comm. Tower Generator Replacement
Owner Name: City of Phoenix Office of the City Engineer
200 W. Washington St, 5th Flr • Phx, AZ 85003-1611 • Office: (602) 534.3749 • Cell: (602) 339.1536
Contact: Mark Binelli • Project Manager • mark.binelli@phoenix.gov
Owner Contract No: Job Order Contract No. 4108JOC123 (multi-year electrical job order contract
originally awarded to Hawkeye on July 2, 2014)
Design/build services to design & secure permit for new exterior diesel generator (100KW/125KVA,
120/240V 3-ph, 4W), pour equipment pad, install gen @ top of South Mountain, tie in new power &
comm circuits to existing transfer switch, & demo/remove existing old interior generator. Hawkeye
served as prime contractor. Task order value: $126,500. Project Completion: April, 2019
3. Task Order Reference: Phoenix Municipal Court Tower LED Lighting Upgrades
Owner Name: City of Phoenix Public Works Department
2631 S. 22nd Avenue • Phoenix, AZ 85009 • (602) 374.0687
Contact: Jim Gorombei • Energy Management Specialist • james.gorombei@phoenix.gov
Owner Contract No: Job Order Contract No. 4108JOC123 (multi-year electrical job order contract
originally awarded to Hawkeye on July 2, 2014)
Renovation of the entire lighting system for the 9-story court tower building at 300 W. Washington.
Scope included over 7,100 LED 4’ tube lamps, 2,000 ballasts, 900 recessed cans, 800 sconces, 140
lay-in fixtures, and 50 canopy lights. All complete in 8 weeks at night & on weekends. Hawkeye
served as prime contractor. Task order value: $417,409. Project Completion: June, 2019
4. Task Order Reference: Cholla Library SES Replacement
Owner Name: City of Phoenix Public Works Department
2631 S. 22nd Avenue • Phoenix, AZ 85009 • Office: (602) 534.7463 • Cell: (602) 354.6419
Attachment 1 – REFERENCE FORMAT (page 2)
Contact: Robert Johnson • Facilities Project Planner • Robert.x.johnson@phoenix.gov
Owner Contract No: Job Order Contract No. 4108JOC123 (multi-year electrical job order contract
originally awarded to Hawkeye on July 2, 2014)
On this project, Hawkeye was engaged to provide design/build services to develop a plan for
replacing the old non-code compliant interior service entrance section with a new code-compliant
exterior SES. Hawkeye successfully completed this project with zero downtime for the library.
Hawkeye served as prime contractor. Task order value: $165,000. Project Completion: March, 2019
5. Task Order Reference: Maricopa County South Court Tower Lighting Upgrade & Replacement
Owner Name: Maricopa County FMD
401 W. Jefferson Street • Phoenix, AZ 85003 • P: (602) 372.1714 • F: (602) 478.0289
Contact: Eric Barcon • Facilities Capital Project Manager • EricBarcon@mail.maricopa.gov
Owner Contract No: Contract Serial No. 171091-S Re-Lamping and Repair Services (multi-year
electrical job order contract originally awarded to Hawkeye on February 15, 2017)
Re-Lamping of entire South Court Tower Facility with in-kind fluorescent lamps. Primary project
challenge was coordination access through multiple government agencies. Hawkeye served as
prime contractor. Task order value: $214,034. Project Completion: March, 2019
CREDIT INFORMATION / SUB SUPPLIER REFERENCES @ BOTTOM
Hawkeye Electric, Inc.
Phone: 480-784-6800
AZ Lic. 151297 C-11
10 S. Roosevelt Ave.
www.HawkeyeElectric.com
Tax ID #86-0972617
Chandler, AZ 85226
Incorporated: AZ, Nov. 18, 1999
AZ Sales Tax #07-603424
OFFICERS
Patrick Tilton, Chief Executive Officer
Pete Trowbridge, President
1002 S Presidio Dr
919 E. Buffalo Street
Gilbert, AZ 85233
Gilbert, AZ 85295
Pat@HawkeyeElectric.com
Pete@HawkeyeElectric.com
BANKING & CREDIT LINE
Bankers Trust
Contact: Joe DeJong
453 7th Street
Vice President
Des Moines, IA 50309
(515) 245-5251
Credit Line: $1.5MM
jdejong@bankerstrust.com
BONDING
Minard Ames
Contact: Mike Specht
4646 E Van Buren St Ste 200
Vice President, Minard-Ames Insurance Services LLC / Insurica
Phoenix AZ 85008
(602) 273.1625
Capacity: $9.0MM/$20MM
MSpecht@MinardAmes.com
INSURANCE
USI Insurance Services, LLC
Doug Gnas
2375 E. Camelback Rd., Suite 250
Vice President
Phoenix, AZ 85016
(602) 749.4218
Limits: $2MM GL Agg, $5MM Umbrella
Doug.Gnas@USI.com
REFERENCES
Brown Wholesale
Erin Helland (EHelland@Wesco.com)
3425 E Van Buren Ste 140
Phone: 602-304-3213
Phoenix AZ 85008
Fax: 412-222-7408
Crescent Electric
Jeanette Murray (Jeanette.Murray@Cesco.com)
3575 S 28th St Ste 150
Phone: 602-431-5955
Phoenix AZ 85040
Fax: 602-431-6688
Anixter
Doug Fleury (Douglas.Fleury@Anixter.com)
2902 S 44th St
Phone: 407-204-7282
Phoenix AZ 85040
Fax: 847-730-8628
Border States
Natalie Bray (NBray@BorderStates.com)
5519 E Washington Street
Phone: 602-797-4778
Phoenix AZ 85082
Fax: 602-273-7052
I certify that the above information is complete and accurate.
Signed: Pete Trowbridge, President, Hawkeye Electric, Inc.
Date: 8/29/19
(Name and Title)
Request For Qualifications
Page 23
Electrical Job Order Contractor for Parks and Recreation
Thursday, December 12, 2019
Job Order Contractor
Serial# 200060-JOC
Attachment 2 - LEGAL WORKER CERTIFICATION
(Date)
Maricopa County
Office of Procurement Services
160 S. 4th Avenue
Phoenix, Arizona 85003
As required by Arizona Revised Statutes § 41-4401, Maricopa County (the “County”) is prohibited, after September
30, 2008, from awarding a contract to any contractor who fails, or whose subcontractors fail, to comply with Arizona
Revised Statutes § 23-214-A. The undersigned entity warrants that it complies fully with all Federal immigration
laws and regulations that relate to its employees, that it shall verify, through the E-Verify program as jointly
administered by the U.S. Department of Homeland Security and the Social Security Administration or any of its
successor programs, the employment eligibility of each employee hired after December 31, 2007, and that it shall
require its subcontractors and sub-subcontractors to provide the same warranties to the below entity.
The undersigned acknowledges that a breach of this warranty by the below entity or by any subcontractor or sub-
subcontractor under any contract resulting from this solicitation shall be deemed a material breach of the contract, and
is grounds for penalties, including termination of the contract, by the County. The County retains the right to inspect
the records of the below entity, subcontractor and sub-subcontractor employee who performs work under the contract,
and to conduct random verification through E-Verify of the employment records of the below entity and any
subcontractor and sub-subcontractor who works on the contract, to ensure that the below entity and each subcontractor
and sub-subcontractor is complying with the warranties set forth above.
(Firm)
(Address Line 1)
(Print Name)
(Address Line 2)
(Print Title)
(Phone)
(Signature Required)
(Fax)
(Email Address)
(Federal Taxpayer ID Number)
Bid 200060-JOC
Maricopa County
12/11/2019 1:42 PM
p. 26
January 9, 2020
Hawkeye Electric, Inc.
Pete Trowbridge
President
pete@hawkeyeelectric.com
10 S. Roosevelt Avenue
Chandler, AZ 85226
(480) 784.6800
(480) 784.6860
86-0972617
PROPOSAL EXCEPTIONS
NONE.
Request For Qualifications
Page 28
Electrical Job Order Contractor for Parks and Recreation
Thursday, December 12, 2019
Job Order Contractor
Serial# 200060-JOC
Attachment 4 – NON-COLLUSION AFFIDAVIT
STATE OF ARIZONA
)
) ss.
COUNTY OF MARICOPA
)
being first duly sworn, deposes and says:
That he is
of
(Title)
(Name of Business)
bidding on 200060-JOC for the construction of Electrical Job Order Contractor for Parks and Recreation in the
County of Maricopa, State of Arizona.
That, in connection with the above-mentioned project, neither he, nor anyone associated with the aforesaid business,
has, directly or indirectly, participated in any collusion, entered into any contract, combination, conspiracy or other
act in restraint of trade or commerce in violation of the provisions of A.R.S. § 34-251, Article 4, as amended.
(Signature of Affiant)
Subscribed and sworn to before me this
day of
, 20
.
My Commission Expires:
(Notary Public)
Bid 200060-JOC
Maricopa County
12/11/2019 1:42 PM
p. 31
Pete Trowbridge
President
Hawkeye Electric, Inc.
8th January 20
SAGITTA 25.3 (2016/03)
DESCRIPTIONS (Continued from Page 1)
by written contract. The General Liability, Automobile Liability, Umbrella Liability, and Workers
Compensation policies provide a Waiver of Subrogation when required by written contract. The General
Liability and Automobile Liability policies include an endorsement providing that 30 days notice of
cancellation will be given to the Certificate Holder by the Insurance Carrier. Per Project Aggregate
applies.
2 of 2
#S28328408/M27637009
8. Subject to paragraph 5. above [of the CGL Coverage Form], $25,000 is the most we will pay for all
"product recall expenses" arising out of the same defect or deficiency.
5. NONOWNED WATERCRAFT AND NONOWNED AIRCRAFT (HIRED, RENTED OR LOANED WITH PAID
CREW)
Exclusion g. Aircraft, Auto or Watercraft, paragraph (2) is deleted and replaced with the following:
[This exclusion does not apply to:]
(2) A watercraft you do not own that is:
(a) Less than 75 feet long; and
(b) Not being used to carry any person or property for a charge;
Exclusion g. Aircraft, Auto or Watercraft, paragraph (6) is added as follows:
[This exclusion does not apply to:]
(6) An aircraft you do not own, provided that:
(a) The pilot in command holds a currently effective certificate issued by the duly constituted authority
of the United States of America or Canada, designating that person as a commercial or airline
transport pilot;
(b) The aircraft is rented to you with a trained, paid crew; and
(c) The aircraft is not being used to carry any person or property for a charge.
6. BLANKET CONTRACTUAL LIABILITY – RAILROADS
Under SECTION V – DEFINITIONS, paragraph c. of "Insured Contract" is deleted and replaced by the
following:
c. Any easement or license agreement;
'Under SECTION V – DEFINITIONS, paragraph f.(1) of "Insured Contract" is deleted.
7. CONTRACTUAL LIABILITY – PERSONAL AND ADVERTISING INJURY
Under SECTION I – COVERAGE B., paragraph 2. Exclusions, paragraph e. Contractual Liability is
deleted.
8. SUPPLEMENTARY PAYMENTS
Under SECTION I – SUPPLEMENTARY PAYMENTS – COVERAGES A AND B, paragraphs 1.b. and 1.d.
are deleted and replaced with the following:
b. Up to $5,000 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 actual loss of earnings up to $1,000 a day because of time off
from work.
9. BROADENED WHO IS AN INSURED
SECTION II – WHO IS AN INSURED is deleted and replaced with the following:
1. If you are designated in the Declarations as:
a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business
of which you are the sole owner.
b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses
are also insureds, but only with respect to the conduct of your business.
Page 3 of 11
ReferenceConnect
POLICY NUMBER: CPP2103884
c. A limited liability company, you are an insured. Your members are also insureds, but only with
respect to the conduct of your business. Your managers are insureds, but only with respect to their
duties as your managers.
d. An organization other than a partnership, joint venture or limited liability company, you are an
insured. Your "executive officers" and directors are insureds, but only with respect to their duties as
your officers or directors. Your stockholders are also insureds, but only with respect to their liability
as stockholders.
e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as
trustees.
2. Each of the following is also an insured:
a. Your "volunteer workers" only while performing duties related to the conduct of your business, or
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), but only for acts within the scope of their employment by you or while performing
duties related to the conduct of your business. However, none of these "employees" or "volunteer
workers" are insured for:
(1) "Bodily injury" or "personal and advertising injury":
(a) To you, to your partners or members (if you are a partnership or joint venture), to your
members (if you are a limited liability company), to a co-"employee" while in the course of
his or her employment or performing duties related to the conduct of your business, or to
your other "volunteer workers" while performing duties related to the conduct of your
business;
(b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker"
as a consequence of paragraph (1)(a) above;
(c) For which there is any obligation to share damages with or repay someone else who
must pay damages because of the injury described in paragraphs (1)(a) or (b) above; or
(d) Arising out of his or her providing or failing to provide professional health care services
except as provided in provision 10. of this endorsement.
Paragraphs (1)(a), (1)(b) and (1)(c) above do not apply to your "employees" who are:
(i) Managers;
(ii) Supervisors;
(iii) Directors; or
(iv) Officers;
with respect to "bodily injury" to a co-"employee".
(2) "Property damage" to property:
(a) Owned, occupied or used by;
(b) Rented to, in the care, custody or control of, or over which physical control is being
exercised for any purpose by
you, any of your "employees," "volunteer workers", any partner or member (if you are a
partnership or joint venture), or any member (if you are a limited liability company).
b. Any person (other than your "employee" or "volunteer worker"), or any organization while acting as
your real estate manager.
c. Any person or organization having proper temporary custody of your property if you die, but only;
(1) With respect to liability arising out of the maintenance or use of that property; and
(2) Until your legal representative has been appointed.
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d. Your legal representative if you die, but only with respect to duties as such. That representative will
have all your rights and duties under this Coverage Form.
e. Your subsidiaries if:
(1) They are legally incorporated entities; and
(2) You own more than 50% of the voting stock in such subsidiaries as of the effective date of this
policy.
If such subsidiaries are not shown in the Declarations, you must report them to us within 180 days
of the inception of your original policy.
f. Any person or organization, including any manager, owner, lessor, mortgagee, assignee or receiver
of premises, to whom you are obligated under a written contract to provide insurance such as is
afforded by this policy, but only with respect to liability arising out of the ownership, maintenance or
use of that part of any premises or land leased to you, including common or public areas about
such premises or land if so required in the contract.
However, no such person or organization is an insured with respect to:
(1) Any "occurrence" that takes place after you cease to occupy or lease that premises or land; or
(2) Structural alterations, new construction or demolition operations performed by or on behalf of
such person or organization.
g. Any state or political subdivision but only as respects legal liability incurred by the state or political
subdivision solely because it has issued a permit with respect to operations performed by you or on
your behalf.
However, no state or political subdivision is an insured with respect to:
(1) "Bodily injury", "property damage", and "personal and advertising injury" arising out of
operations performed for the state or municipality; or
(2) "Bodily injury" or "property damage" included within the "products-completed operations
hazard."
h. Any person or organization who is the lessor of equipment leased to you to whom you are obligated
under a written contact to provide insurance such as is afforded by this policy, but only with respect
to their liability arising out of the maintenance, operation or use of such equipment by you or a
subcontractor on your behalf with your permission and under your supervision.
However, no such person or organization is an insured with respect to any "occurrence" that takes
place after the equipment lease expires.
i. Any architect, engineer, or surveyor engaged by you under a written contract but only with respect
to liability arising out of your premises or "your work."
However, no architect, engineer, or surveyor is an insured with respect 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:
(1) The preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports,
surveys, change orders, designs or specifications; or
(2) Supervisory, inspection, or engineering services.
This paragraph i. does not apply if a separate Additional Insured endorsement providing liability
coverage for architects, engineers, or surveyors engaged by you is attached to the policy.
If the written contract, written agreement, or certificate of insurance requires primary and non-
contributory coverage, the insurance provided by paragraphs f. through i. above will be primary and
non-contributory relative to other insurance available to the additional insured which covers that person
or organization as a Named Insured, and we will not share with that other insurance.
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3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability
company and over which you maintain ownership or majority interest, will qualify as a Named Insured if
there is no other similar insurance available to that organization. However:
a. Coverage under this provision is afforded until the end of the policy period.
b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you
acquired or formed the organization.
c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed
before you acquired or formed the organization.
d. Coverage A does not apply to "product recall expense" arising out of any withdrawal or recall that
occurred before you acquired or formed the organization.
4. Any person or organization (referred to below as vendor) with whom you agreed under a written
contract to provide insurance is an insured, but only with respect to "bodily injury" or "property damage"
arising out of "your products" that are distributed or sold in the regular course of the vendor's business.
However, no such person or organization is an insured with respect to:
a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of
the assumption of liability in a contract or agreement. This exclusion does not apply to liability for
damages that the vendor would have in the absence of the contract or agreement.
b. Any express warranty unauthorized by you;
c. Any physical or chemical change in "your product" made intentionally by the vendor;
d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing,
or the substitution of parts under instructions from the manufacturer, and then repackaged in the
original container;
e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to
make or normally undertakes to make in the usual course of business, in connection with the
distribution or sale of "your products";
f. Demonstration, installation, servicing or repair operations, except such operations performed at the
vendor's premises in connection with the sale of "your product";
g. "Your products" which, after distribution or sale by you, have been labeled or relabeled or used as a
container, part or ingredient of any other thing or substance by or for the vendor.
h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts
or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion
does not apply to:
(1) The exceptions contained in subparagraphs d. or f.; or
(2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or
normally undertakes to make in the usual course of business, in connection with the
distribution or sale of the products.
This paragraph 4. does not apply to any insured person or organization from which you have acquired
"your product", or any ingredient, part, or container, entering into, accompanying or containing "your
product". This paragraph 4. also does not apply if a separate Additional Insured endorsement, providing
liability coverage for "bodily injury" or "property damage" arising out of "your product" that is distributed
or sold in the regular course of a vendor's business, is attached to the policy.
No person or organization is an insured with respect to the conduct of any current or past partnership, joint
venture or limited liability company that is not shown as a Named Insured in the Declarations.
10. INCIDENTAL MALPRACTICE LIABILITY
As respects provision 9., SECTION II – WHO IS AN INSURED, paragraph 2.a.(1)(d) does not apply to any
nurse, emergency medical technician or paramedic employed by you to provide medical or paramedical
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services, provided that you are not engaged in the business or occupation of providing such services, and
your "employee" does not have any other insurance that would also cover claims arising under this provision,
whether the other insurance is primary, excess, contingent or on any other basis.
Under SECTION II – LIMITS OF INSURANCE, provisions 11. through 14. of this endorsement amend the policy
as follows:
11. AGGREGATE LIMITS PER PROJECT
The General Aggregate Limit applies separately to each of your construction projects away from premises
owned by or rented to you.
12. AGGREGATE LIMITS PER LOCATION
The General Aggregate Limit applies separately to each of your locations, but only when required by written
contract, written agreement or certificate of insurance. As respects this provision 12., your locations are
premises you own, rent or use involving the same or connecting lots or premises whose connection is
interrupted only by a street, roadway, waterway or right-of-way of a railroad. However, your locations do not
include any premises where you, or others acting on your behalf, are performing construction operations.
13. INCREASED MEDICAL PAYMENTS LIMIT
A.
SECTION III – LIMITS OF INSURANCE, paragraph 7., the Medical Expense Limit, is subject to all of
the terms of SECTION III – LIMITS OF INSURANCE and is the greater of:
1. $10,000; or
2. The amount shown in the Declarations for Medical Expense Limit.
B. This provision 13. does not apply if COVERAGE C MEDICAL PAYMENTS is excluded either by the
provisions of the Coverage Form or by endorsement.
14. DAMAGE TO PREMISES RENTED TO YOU – SPECIFIC PERILS AND INCREASED LIMIT
A. The word fire is changed to "specific perils" where it appears in:
1. The last paragraph of SECTION I – COVERAGE A, paragraph 2. Exclusions;
2. SECTION IV, paragraph 4.b. Excess Insurance.
B. The Limits of Insurance shown in the Declarations will apply to all damage proximately caused by the
same event, whether such damage results from a "specific peril" or any combination of "specific perils."
C. The Damage To Premises Rented To You Limit described in SECTION III – LIMITS OF INSURANCE,
paragraph 6., is replaced by a new limit, which is the greater of:
1. $1,000,000; or
2. The amount shown in the Declarations for Damage To Premises Rented To You Limit.
D. This provision 14. does not apply if the Damage To Premises Rented To You Limit of SECTIONI –
COVERAGE A is excluded either by the provisions of the Coverage Form or by endorsement.
E. "Specific Perils" means fire; lightning; explosion; windstorm or hail; smoke; aircraft or vehicles; riot or
civil commotion; vandalism; leakage from fire extinguishing equipment; weight of snow, ice or sleet; or
"water damage".
"Water damage" means accidental discharge or leakage of water or steam as the direct result of the
breaking or cracking of any part of a system or appliance containing water or steam.
15. BROADENED LEGAL LIABILITY COVERAGE FOR LANDLORD'S BUSINESS PERSONAL PROPERTY
Under SECTION I – COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2.
Exclusions, j. Damage to Property, the first paragraph following paragraph (6) is deleted and replaced with
the following:
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Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to
a landlord's business personal property that is subject to, or part of, a premises lease or rental agreement
with that landlord.
The most we will pay for damages under this provision 15. is $10,000. A $250 deductible applies.
Under SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, provisions 16. through 18. of this
endorsement amend the policy as follows:
16. BROADENED KNOWLEDGE OF OCCURRENCE
Under 2. Duties In The Event Of Occurrence, Offense, Claim, Or Suit, paragraph a. is deleted and
replaced and paragraphs e. and f. are added as follows:
a. You must see to it that we are notified as soon as practicable of an "occurrence" or an offense,
regardless of the amount, which may result in a claim. Knowledge of an "occurrence" or an offense by
your "employee(s)" shall not, in itself, constitute knowledge to you unless one of your partners,
members, "executive officers", directors, or managers has knowledge of the "occurrence" or offense.
To the extent possible, notice should include:
(1) How, when and where the "occurrence" or offense took place;
(2) The names and addresses of any injured persons and witnesses; and
(3) The nature and location of any injury or damage arising out of the "occurrence" or offense.
e. If you report an "occurrence" to your workers compensation carrier that develops into a liability claim for
which coverage is provided by this Coverage Form, failure to report such an "occurrence" to us at the
time of the "occurrence" shall not be deemed a violation of paragraphs a., b., and c. above. However,
you shall give written notice of this "occurrence" to us as soon you become aware that this "occurrence"
may be a liability claim rather than a workers compensation claim.
f. You must see to it that the following are done in the event of an actual or anticipated "covered recall"
that may result in "product recall expense":
(1) Give us prompt notice of any discovery or notification that "your product" must be withdrawn or
recalled. Include a description of "your product" and the reason for the withdrawal or recall;
(2) Cease any further release, shipment, consignment or any other method of distribution of like or
similar products until it has been determined that all such products are free from defects that could
be a cause of loss under the insurance.
17. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
Paragraph 6. Representations is deleted and replaced with the following:
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are accurate and complete;
b. Those statements are based upon representations you made to us;
c. We have issued this policy in reliance upon your representations; and
d. This policy is void in any case of fraud by you as it relates to this policy or any claim under this
policy.
We will not deny coverage under this Coverage Form if you unintentionally fail to disclose all hazards
existing as of the inception date of this policy. You must report to us any knowledge of an error or
omission in the description of any premises or operations intended to be covered by this Coverage Form
as soon as practicable after its discovery. However, this provision does not affect our right to collect
additional premium or exercise our right of cancellation or nonrenewal.
18. TRANSFER OF RIGHTS (BLANKET WAIVER OF SUBROGATION)
Paragraph 8. Transfer of Rights Of Recovery Against Others To Us is deleted and replaced with the
following:
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8. If the insured has rights to recover all or part of any payment we have made under this Coverage Form,
those rights are transferred to us. The insured must do nothing after loss to impair them. At our
request, the insured will bring "suit" or transfer those rights to us and help us enforce them. However, if
the insured has waived rights to recover through a written contract, or if "your work" was commenced
under a letter of intent or work order, subject to a subsequent reduction to writing with customers whose
customary contracts require a waiver, we waive any right of recovery we may have under this Coverage
Form.
19. EXTENDED NOTICE OF CANCELLATION AND NONRENEWAL
Paragraph 2.b. of A. Cancellation of the COMMON POLICY CONDITIONS is deleted and replaced with the
following:
b. 60 days before the effective date of the cancellation if we cancel for any other reason.
Under SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 9. When We Do Not
Renew is deleted and replaced with the following:
9. When We Do Not Renew
If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured
shown in the Declarations written notice of the nonrenewal not less than 60 days before the
expiration date.
If notice is mailed, proof of mailing will be sufficient proof of notice.
20. MOBILE EQUIPMENT REDEFINED
Under SECTION V – DEFINITIONS, paragraph 12. "Mobile equipment", paragraph f. (1) does not apply to
self-propelled vehicles of less than 1,000 pounds gross vehicle weight.
21. ADDITIONAL DEFINITIONS
1. SECTION V – DEFINITIONS, paragraph 4. "Coverage territory" is replaced by the following definition:
"Coverage territory" means anywhere in the world with respect to liability arising out of "bodily injury,"
"property damage," or "personal and advertising injury," including "personal and advertising injury"
offenses that take place through the Internet or similar electronic means of communication provided the
insured's responsibility to pay damages is determined in a settlement to which we agree or in a "suit" on
the merits, in the United States of America (including its territories and possessions), Puerto Rico and
Canada.
2. SECTION V – DEFINITIONS is amended by the addition of the following definitions:
"Covered recall" means a recall made necessary because you or a government body has determined
that a known or suspected defect, deficiency, inadequacy, or dangerous condition in "your product" has
resulted or will result in "bodily injury" or "property damage".
"Product Recall expenses" mean only reasonable and necessary extra costs, which result from or are
related to the recall or withdrawal of "your product" for:
a. Telephone and telegraphic communication, radio or television announcements, computer time and
newspaper advertising;
b. Stationery, envelopes, production of announcements and postage or facsimiles;
c. Remuneration paid to regular employees for necessary overtime or authorized travel expense;
d. Temporary hiring by you or by agents designated by you of persons, other than your regular
employees, to perform necessary tasks;
e. Rental of necessary additional warehouse or storage space;
f. Packaging of or transportation or shipping of defective products to the location you designate; and
g. Disposal of "your products" that cannot be reused. Disposal expenses do not include:
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(1) Expenses that exceed the original cost of the materials incurred to manufacture or process
such product; and
(2) Expenses that exceed the cost of normal trash discarding or disposal, except as are
necessary to avoid "bodily injury" or "property damage".
22. REASONABLE FORCE – BODILY INJURY OR PROPERTY DAMAGE
Under SECTION I – COVERAGE A., paragraph 2. Exclusions, subparagraph a. Expected Or Intended
Injury is deleted and replaced with the following:
[This insurance does not apply to:]
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.
23. BROADENED LIABILITY COVERAGE FOR DAMAGE TO YOUR PRODUCT AND YOUR WORK
A. Under SECTION I – COVERAGE A., paragraph 2. Exclusions, exclusion k. Damage to Your Product
and exclusion l. Damage to Your Work are deleted and replaced with the following:
[This insurance does not apply to:]
k. Damage to Your Product
"Property damage" to "your product" arising out of it or any part of it, except when caused by or
resulting from:
(1) Fire;
(2) Smoke:
(3) "Collapse"; or
(4) Explosion.
For purposes of exclusion k. above, "collapse" means an abrupt falling down or caving in of a
building or any part of a building with the result that the building or part of the building cannot be
occupied for its intended purpose.
l. Damage to Your Work
"Property damage" to "your work" arising out of it or any part of it and included in the "products-
completed operations hazard". This exclusion does not apply:
(1) If the damaged work or the work out of which the damage arises was performed on your
behalf by a subcontractor; or
(2) If the cause of loss to the damaged work arises as a result of:
(a) Fire;
(b) Smoke;
(c) "Collapse"; or
(d) Explosion.
For purposes of exclusion l. above, "collapse" means an abrupt falling down or caving in of a
building or any part of a building with the result that the building or part of the building cannot be
occupied for its intended purpose.
B. The following paragraph is added to SECTION III – LIMITS OF INSURANCE:
Subject to 5. above [of the CGL Coverage Form], $100,000 is the most we will pay under Coverage A for
the sum of damages arising out of any one "occurrence" because of "property damage" to "your product"
and "your work" that is caused by fire, smoke, collapse or explosion and is included within the "product-
completed operations hazard". This sublimit does not apply to "property damage" to "your work" if the
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damaged work, or the work out of which the damage arises, was performed on your behalf by a
subcontractor.
24. BROADENED BODILY INJURY COVERAGE
Under SECTION V – DEFINITIONS, the definition of "bodily injury" is deleted and replaced with the following:
3. "Bodily injury"
a. Means physical:
(1)
Injury;
(2)
Disability;
(3)
Sickness; or
(4)
Disease;
sustained by a person, including death resulting from any of these at any time.
b. Includes mental:
(5)
Anguish;
(6)
Injury;
(7)
Humiliation;
(8)
Fright; or
(9)
Shock;
directly resulting from any "bodily injury" described in paragraph 3.a.
c. All "bodily injury" described in paragraph 3.b. shall be deemed to have occurred at the time the
"bodily injury" described in paragraph 3.a. occurred.
25. DESIGNATED COMPLETED PROJECTS – AMENDED LIMITS OF INSURANCE
When a written contract or written agreement between you and another party requires project-specific limits
of insurance exceeding the limits of this policy;
A. for "bodily injury" or "property damage" that occurs within any policy period for which we provided
coverage; and
B. for "your work" performed within the "products-completed operation hazard"; and
C. for which we previously issued Amendment Of Limits Of Insurance (Designated Project Or Premises) CG
71 94 either during this policy term or a prior policy term; and
D. that designated project is now complete;
the limits of insurance shown in the CG 71 94 schedule will replace the limits of insurance of this policy for
the designated project and will continue to apply for the amount of time the written contract or written
agreement requires, subject to the state statute of repose for the project location. These limits are inclusive
of and not in addition to the replaced limits.
©Amerisure Companies
©2018 Vertafore, Inc. All Rights Reserved.
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTOR’S BLANKET ADDITIONAL INSURED ENDORSEMENT –
FORM A
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Policy Number
Agency Number
Policy Effective Date
Policy Expiration Date
Date
Account Number
Named Insured
Agency
Issuing Company
1.
a.
SECTION II - WHO IS AN INSURED is amended to add as an additional insured any person or
organization:
(1) Whom you are required to add as an additional insured on this policy under a written contract or
written agreement relating to your business; or
(2) Who is named as an additional insured under this policy on a certificate of insurance.
b.
The written contract, written agreement, or certificate of insurance must:
(1) Require additional insured status for a time period during the term of this policy; and
(2) Be executed prior to the "bodily injury", "property damage", or "personal and advertising injury"
leading to a claim under this policy.
c.
If, however:
(1) “Your work” began under a letter of intent or work order; and
(2) The letter of intent or work order led to a written contract or written agreement within 30 days of
beginning such work; and
(3) Your customer’s customary contracts require persons or organizations to be named as additional
insureds;
we will provide additional insured status as specified in this endorsement.
2.
The insurance provided under this endorsement is limited as follows:
a.
That person or organization is an additional insured only with respect to liability caused, in whole or in
part, by:
(1)
Premises you:
(a) Own;
(b) Rent;
(c) Lease; or
(d) Occupy;
(2)
Ongoing operations performed by you or on your behalf. Ongoing operations does not apply to
“bodily injury” or “property damage” occurring after:
Includes copyrighted material of Insurance Services Office, Inc.
CG 70 48 10 15
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CPP2103884
Hawkeye Electric, Inc
USI INSURANCE SERVICES, LLC AMERISURE INSURANCE
COMPANY
01/15/2020
01/15/2021
(a)
All work to be performed by you or on your behalf for the additional insured(s) at the site of the
covered operations is complete, including related materials, parts or equipment (other than
service, maintenance or repairs); or
(b)
That portion of “your work” out of which the injury or damage arises is put to its intended use by
any person or organization other than another contractor working for a principal as a part of the
same project.
(3)
Completed operations coverage, but only if:
(a)
The written contract, written agreement, or certificate of insurance requires completed
operations coverage or “your work” coverage; and
(b)
This coverage part provides coverage for “bodily injury” or “property damage” included within
the “products-completed operations hazard”.
However, the insurance afforded to such additional insured only applies to the extent permitted by law.
b.
If the written contract, written agreement, or certificate of insurance:
(1)
Requires “arising out of” language; or
(2)
Requires you to provide additional insured coverage to that person or organization by the use of
either or both of the following:
(a)
Additional Insured – Owners, Lessees or Contractors – Scheduled Person Or Organization
endorsement CG 20 10 10 01; or
(b)
Additional Insured – Owners, Lessees or Contractors – Completed Operations endorsement CG
20 37 10 01;
then the phrase “caused, in whole or in part, by” in paragraph 2.a. above is replaced by “arising out of”.
c.
If the written contract, written agreement, or certificate of insurance requires you to provide additional
insured coverage to that person or organization by the use of:
(1)
Additional Insured – Owners, Lessees or Contractors – Scheduled Person Or Organization
endorsement CG 20 10 07 04 or CG 20 10 04 13; or
(2)
Additional Insured – Owners, Lessees or Contractors – Completed Operations endorsement CG 20
37 07 04 or CG 20 37 04 13; or
(3)
Both those endorsements with either of those edition dates; or
(4)
Either or both of the following:
(a)
Additional Insured – Owners, Lessees or Contractors – Scheduled Person Or Organization
endorsement CG 20 10 without an edition date specified; or
(b)
Additional Insured – Owners, Lessees or Contractors – Completed Operations endorsement CG
20 37 without an edition date specified;
then paragraph 2.a. above applies.
d.
Premises, as respects paragraph 2.a.(1) above, include common or public areas about such premises if
so required in the written contract or written agreement.
e.
Additional insured status provided under paragraphs 2.a.(1)(b) or 2.a.(1)(c) above does not extend
beyond the end of a premises lease or rental agreement.
f.
The limits of insurance that apply to the additional insured are the least of those specified in the:
(1)
Written contract;
(2)
Written agreement;
(3)
Certificate of insurance; or
(4)
Declarations of this policy.
The limits of insurance are inclusive of and not in addition to the limits of insurance shown in the
Declarations.
Includes copyrighted material of Insurance Services Office, Inc.
Page 2 of 4
CG 70 48 10 15
g.
The insurance provided to the additional insured does not apply to "bodily injury", "property damage", or
"personal and advertising injury" arising out of an architect’s, engineer’s, or surveyor’s rendering of, or
failure to render, any professional services, including but not limited to:
(1)
The preparing, approving, or failing to prepare or approve:
(a) Maps;
(b) Drawings;
(c) Opinions;
(d) Reports;
(e) Surveys;
(f) Change orders;
(g) Design specifications; and
(2)
Supervisory, inspection, or engineering services.
h.
SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4. Other Insurance is
deleted and replaced with the following:
4.
Other Insurance.
Coverage provided by this endorsement is excess over any other valid and collectible insurance
available to the additional insured whether:
a. Primary;
b. Excess;
c. Contingent; or
d. On any other basis;
but if the written contract, written agreement, or certificate of insurance requires primary and non-
contributory coverage, this insurance will be primary and non-contributory relative to other insurance
available to the additional insured which covers that person or organization as a Named Insured, and
we will not share with that other insurance.
i.
If the written contract, written agreement, or certificate of insurance as outlined above requires additional
insured status by use of CG 20 10 11 85, then the coverage provided under this CG 70 48 endorsement
does not apply except for paragraph 2.h. Other Insurance. Additional insured status is limited to that
provided by CG 20 10 11 85 shown below and paragraph 2.h. Other Insurance shown above.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person or Organization: Blanket Where Required by Written Contract, Agreement, or
Certificate of Insurance that the terms of CG 20 10 11 85 apply
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown
in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you.
CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984
Includes copyrighted material of Insurance Services Office, Inc.
CG 70 48 10 15
Pages 3 of 4
j.
The insurance provided by this endorsement does not apply to any premises or work for which the
person or organization is specifically listed as an additional insured on another endorsement attached to
this policy.
Includes copyrighted material of Insurance Services Office, Inc.
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CG 70 48 10 15
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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 this 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.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named Insured:
Endorsement Effective Date:
SCHEDULE
Name Of Person(s) Or Organlzatlon(s): Any persona or organization when you and such person or
organization have agreed in writing in a contract or agreement that such person or organization be added
as an additional insured on your policy prior to performance of the agreement.
Information reauired to comolete 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 D.2. of Section
I - Covered Autos
Coverages of the Auto Dealers Coverage Form.
CA 20 48 10 13
© Insurance Services Office, Inc., 2011
Page 1 of 1
POLICY NUMBER:
COMMERCIAL AUTO
CA20481013
CA2103883
01/15/2020
Hawkeye Electric, Inc.
POLICY NUMBER: CA2103883
COMMERCIAL AUTO
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.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named Insured: Hawkeye Electric, Inc.
Endorsement Effective Date:
SCHEDULE
Name(s) Of Person(s) Or Organization(s): Any person or organization when you and such person or
organization have agreed in writing in a contract or agreement that such person or organization be added
with waiver of transfer of rights on your policy prior to performance of the agreement.
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
01/15/2020
WORKERS COMPENSATION AND EMPLOYERS
LIABILITY
INSURANCE POLICY
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
WC 000313
(Ed. 4-84)
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. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
"Any person or organization required by written contract or certificate of insurance."
"This endorsement is not applicable in California, Kentucky, New Hampshire,
New Jersey, Texas and Utah."
"This endorsement does not apply to policies in Missouri where the employer is m the construction
group of code classifications. According to Section 287 .150(6) of the Missouri Statues, a
contractual provision purporting to waive subrogation rights is against public policy and void where
one party to the contract is an employer in the construction group of code classifications."
This endorsement changes the policy to which
it is attached and
is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective
Premium$
Endorsement No.
Insurance Company Amerisure Mutual Insurance Company
Countersigned by
WC 00 0313
(Ed. 4-84)
Copyright 1983 National Council on Compensation
Insurance.
Hart Forms & Services
Reorder No 14-4888
Policy No.
Insured
Hawkeye Electric Inc
WC2103887
01/15/2020
This page has been left blank intentionally.
UMBRELLA
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ª
2016 The Travelers Indemnity Company. All rights reserved.
EU 00 01 07 16
a.
Seeking
damages
to
which
this
insurance does not apply; or
b.
If
any
other
insurer
h
as
a
duty
to
defend.
3.
When
we
have
the
duty
to
defend,
we
may,
at
our
discretion,
investigate
and
settle
any
claim
or
"suit".
In
all
other
cases,
we
may,
at
our
discretion,
participate
in
the
investigation,
defense
and
settlement
of
any
claim
or
"sui
t
"
for
damages
to
which
this
insurance
may
apply.
If
we
exercise
such
right
to
participate,
all
expenses
we
inc
ur
in
doing
so
will
not
reduce
the
applicable
limits
of insurance.
4.
Our
duty
to
defend
ends
when
we
have
used
up
the
applicable
limit
of
insurance
in
the
payment
of
judgments
or
settlements,
or
defense
expenses
if
such
expenses
are
within
the limits of insurance of this policy.
5.
We
will
pay,
with
res
pect
to
a
claim
we
investigate
or
settle,
or
"suit"
against an insured we defend:
a.
All expenses we incur.
b.
The cost of:
(1)
Bail
bonds
required
because
of
accidents
or
traffic
law
violations
arising
out
of
the
use
of
any
vehicle
to
which
this insurance applies; or
(2)
Appeal
bonds
and
bonds
to
release attachments;
but
only
for
bond
am
ounts
within
the
applicable
limit
of
insurance.
We
do
not
have
to
furnish
these
bonds.
c.
All
reasonable
expenses
incurred
by
the
insured
at
ou
r
request
to
assist
us
in
the
inv
estigation
or
defense
of
such
claim
or
"suit",
including
actual
loss
of
earnings
up
to
$1,000
a
day
because
of
time off from work.
d.
All
court
costs
taxed
against
the
insured
in
the
"suit".
However,
these
payments
do
not
include
attorneys'
fees
or
attorneys'
expenses
taxed
against
the
insured.
e.
Prejudgment
interest
awarded
against
the
insured
on
that
part
of
the
judgment
we
pay.
If
we
make
an
offer
to
pay
the
applicable
limit
of
insurance,
we
will
not
pay
any
prejudgment
interest
based
on
that
period
of
time
after
the offer.
f.
All
interest
that
accrues
on
the
full
amount
of
any
ju
dgment
after
entry
of
the
judgment
and
before
we
have
paid,
offere
d
to
pay
o
r
deposited
in
court
the
part
of
the
judgment
that
is
within
the
applicable
limit
of
i
nsurance.
If
we
do
not
pay
p
art
of
the
judgment
for
any
r
eason
other
than
it
is
more
than
t
he
applicable
limit
of
insurance,
we
will
not
pay
any
interest
that
accrues
on
that portion of the judgment.
With
respect
to
a
claim
we
investigate
or
settle, or
"suit"
against
an
insured
we
defend
under
COVERAGE
A
-
EXCESS
FOLLOW
-FORM
LIABILITY
,
these
payments
will
not
reduce
the
applicable
limits
of
insurance,
but
only
if
the
applicable
"underlying
insurance"
provides
for
such
payments
in
addition
to
its
limits
of
insurance.
With
respect
to
a
claim
we
investigate
or
settle, or
"suit"
against
an
insured
we
defend
under
COVERAGE
B
-
UMBRELLA
LIABILITY
,
these
payments
will
not
reduce
t
he
applicable limits of insurance.
SECTION II -
WHO IS AN INSURED
A.
COVERAGE
A
-
EXCESS
FOLLOW
-FORM
LIABILITY
With
respect
to
Coverage
A
,
the
following
persons
and
organizations
qualify as insureds:
1.
The
Named
Insured
shown
in
the
Declarations; and
2.
Any
other
person
or
organization
qualifying
as
an
insured
in
the
"underlying
insurance".
If
you
have
agreed
to
provide
ins
urance
for
that
person
or
organization
in
a
written
contract or agreement:
a.
The
limits
of
insura
nce
afforded
to
such
person
or
organi
zation
will be:
(1)
The
amount
by
w
hich
the
minimum
limits
of
insurance
you
agreed
to
prov
ide
such
person
or
organization
in
that
written
contract
or
agreement
exceed
the
total
l
imits
of
insurance
of
all
applicable
"underlying insurance"; or
(2)
The
limits
of
insurance
of
this
policy;
whichever is less; and
b.
Coverage
under
this
policy
does
not
apply
to
such
person
or
organization
if
the
mi
nimum
limits
of
insurance
you
agreed
to
provide
such
person
or
organization
in
that
written
contract
or
agreement
are
wholly
within the
total limits
of insurance
of
all
available
applicable
"underlying insurance".
POLICY NUMBER: ZUP61M7233719NF
UMBRELLA
EU 00 01 07 16
ª
2016 The Travelers Indemnity Company. All rights reserved.
Page 15
of 23
b.
To sue
us on
this insurance unless
all
of
its
terms
have
been
fully
complied with.
2.
A
person
or
organization
may
sue
us
to
recover
on
an
agreed
settlement
or
on
a
final
judgment
against
an
insured.
We
will
not
be
liable
for
damages that:
a.
Are
not
payable
und
er
the
terms
of this insurance; or
b.
Are
in
excess
of
the
applicable
limit of insurance.
An
agreed
settlement
means
a
settlement
and
release
of
liability
signed
by
us,
the
insured
and
the
claimant
or
the
claimant's
legal
representative.
L.
MAINTENANCE OF UNDERLYING INSURANCE
1.
The
insurance
afforded
by
each
policy
of
"underlying
insurance"
will
be
maintained
for
the
full
policy
period
of
this
Excess
Follow-Form
And
Umbrella
Liability
Insurance.
This
provision
does
not
apply
to
the
reduction
or
exhaustion
of
the
aggregate
limit
or
limits
of
such
"underlying
insurance"
solely
by
payments
as
permitted
in
Paragraphs
4.a.(1)
,
(2)
and
(3)
of
COVERAGE
A
-
EXCESS
FOLLOW-FORM
LIABILITY
of
SECTION
I
-
COVER
AGES
.
As
such
policies
expire,
you
will
renew
them
at
limits
and
with
co
verage
at
least
equal
to
the
expiring
limits
of
insurance.
If
you
fail
to
comply
with
the
above
requirements,
Coverage
A
is
not
invalidated.
H
owever,
in
the
event
of
a
loss,
we
will
pay
only
to
the
extent
that
we
would
have
paid
had
you
complied
with
the
above
requirements.
2.
The
first
Named
Insur
ed
shown
in
the
Declarations
must
give
us
written
notice
of
any
change
in
the
"underlying insurance"
as respects:
a.
Coverage;
b.
Limits of insurance;
c.
Termination of any coverage; or
d.
Exhaustion of aggregate limits.
3.
If
you
are
unable
to
recover
from
any
"underlying
in
surer"
because
you
fail
to
comply
with
any
term
or
condition
of
t
he
"underlying
insurance",
Coverage
A
is
not
invalidated.
However,
we
will
pay
for
any
loss
only
to
the
extent
that
we
would
have
paid
had
you
complied
with
that
term
or
condition
in
that
"underlying insurance".
M.
OTHER INSURANCE
This
insurance
is
excess
over
any
valid
and
collectible
"other
insurance"
whether
such
"other
insurance"
is
stated
to
be
primary,
contributing,
excess,
contingent
or
otherwise.
This
provision
does
not
apply
to
a
policy
bought
specifically
to
apply as excess of this insurance.
However,
if
you
specifically
agree
in
a
written
contract
or
agreement
that
the
insurance
provided
to
any
person
or
organization
that
qualifies
as
an
insured
under
this
insurance
must
apply
on
a
primary
basis,
or
a
primary
and
non-
contributory
basis,
then
insurance
provided
under
Coverage
A
is
subject
to
the following provisions:
1.
This
insura
nce
will
apply
before
any
"other
insurance"
that
is
available
to
such
additional
insured
which
covers
that
person
or
org
anization
as
a
named
insured,
and
w
e
will
not
share
with
that
"other
insur
ance",
provided
that
the
injury
or
damage
for
which
coverage
i
s
sought
i
s
caused
by
a
n
"event"
that
takes
place
or
is
committed
subsequent
to
the
signing
of that contract or agreement by you.
2.
This
insurance
is
sti
ll
excess
over
any
valid
and
col
lectible
"other
insurance",
whether
primary,
excess,
contingent
or
otherwise,
which
covers
that
person
or
orga
nization
as
an
additional
insured
or
as
any
other
insured
that
does
no
t
qualify
as
a
named insured.
N.
PREMIUM
1.
The
first
Named
Insur
ed
shown
in
the
Declarations
is
responsible
for
the
payment
of
all
premiums
and
will
be
the payee for any return premiums.
2.
If
the
premium
is
a
f
lat
charge,
it
is
not
subject
to
adjust
ment
except
as
provided in Paragraph
4.
below.
3.
If
the
premium
is
other
than
a
flat
charge,
it
is
an
advance
premium
only.
The
earned
premium
will
be
computed
at
the
end
of
the
policy
period,
or
at
the
end
of
each
year
of
the
policy
period
if
t
he
policy
period
is
two
years
or
longer,
at
the
rate
shown
in
the
Declarations,
subject
to
the Minimum Premium.
4.
Additional
premium
may
become
payable
when
coverage
is
provided
for
additional
insureds
under
the
provisions
of
SECTION
II
-
WHO
IS
AN
INSURED
.
O.
PREMIUM AUDIT
The
premium
for
this
policy
is
the
amount
stated
in
Item
5.
of
the
Declarations.
The
premium
is
a
flat
ANY PERSON OR ORGANIZATION WITH WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT OR
AGREEMENT TO WAIVE YOUR RIGHT OF RECOVERY, BUT ONLY FOR PAYMENTS WE MAKE
BECAUSE OF DAMAGES TO WHICH THIS INSURANCE APPLIES, AFTER YOU HAVE EXECUTED
THAT CONTRACT OR AGREEMENT.
UMBRELLA
EU 02
89
07
16
ª
2016
The Travelers Indemnity Company. All rights reserved.
Page 1 of 1
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT
CAREFULLY.
WAIVER OF RIGHTS OF RECOVERY FROM OTHERS
This endorsement modifies insurance provided under the following:
EXCESS FOLLOW-FORM AND UMBRELLA LIABILITY INSURANCE
SCHEDULE OF DESIGNATED PERSONS
OR ORGANIZATIONS
Designated Person Or Organization:
PROVISIONS
The following
is adde
d to
Paragraph
T.
,
WAIVER
OR TRANSFER
OF RI
GHTS OF
RECOVERY AGA
INST
OTHERS TO US
, of
SECTION V -
CONDITIONS:
If
the
insured
has
rights
to
recover
all
or
part
of
any
payment
we
have
made
under
this
insurance,
those
rights
are
transferred
to
us
unless
the
insured
has
waived
its
rights
of
recovery
against
a
person
or
organization
shown
in
the
Schedule
Of
Designated
Persons
Or
Organizations
above
in
a
contract
or
agreement
that
is
executed
before
loss.
In
that
case,
we
will
waive
the
right
of
recovery
we
would
otherwise
have
against
such
person
or
organization.
Policy No.: ZUP61M7233719NF
This page has been left blank intentionally.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTICE OF CANCELLATION, NONRENEWAL OR MATERIAL
CHANGE - THIRD PARTY
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
COMMERCIAL UMBRELLA LIABILITY COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM
TRUCKERS COVERAGE FORM
Subject to the cancellation provisions of the Coverage Form to which this endorsement is attached, we will not:
1. Cancel;
2. Nonrenew; or,
3. Materially change (reduce or restrict)
this Coverage Form, except for nonpayment of premium, until we provide at least
3 o
days written notice of
such cancellation, non renewal or material change. Written notice will be to the person or organization named in
the Schedule. Such notice will be by certified mail with return receipt requested.
This notification of cancellation, non renewal or material change to the person or organization named in the
Schedule is intended as a courtesy only. Our failure to provide such notification will not:
1.
Extend any Coverage Form cancellation date;
2.
Negate the cancellation as to any insured or any certificate holder;
3.
Provide any additional insurance that would not have been provided in the absence of this endorsement;
or
4.
Impose liability of any kind upon us.
This endorsement does not entitle the person or organization named in the Schedule to any benefits, rights or
protection under this Coverage Form.
SCHEDULE
Name Of Person Or Organization
Any person or organization holding a certificate of insurance issued
for you, provided the certificate:
1. Refers to this policy;
2. States that notice of:
a. Cancellation;
b. Nonrenewal; or
c. Material change reducing or restricting coverage;
will be provided to that person or organization;
3.
Is in effect at the time of the:
a. Cancellation;
b. Nonrenewal; or
c. Material change reducing or restricting coverage; and
4.
Is on file at your agent or broker's office for this policy
IL 7066 0714
Mailing Address
The address shown for that person or organization in
that certificate of insurance
Policy No.: CPP2103884, CA2103883
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