HomeMy WebLinkAboutC2017-211 - 3/28/2017 - Approved 2017-211
3/28/17
Ord. 031104
Barcom Construction Inc.
00 52 23 AGREEMENT !!��
This Agreement,for the Project awarded on March 7o,2017,is between the City of Corpus Christi
(Owner)and
Barcom Construction. Inc. (Contractor).
Owner and Contractor agree as follows:
ARTICLE 1—WORK
1.01 Contractor shall complete all Work as specified or indicated in the Contract Documents. The
Work is generally described as:
T.C.Avers Pool Improvements Protect
prolect Number 717021
ARTICLE 2—DESIGNER AND OWNER'S AUTHORIZED REPRESENTATIVE
2.01 The Project has been designed by:
Munoz Engineering
1608 South Brownlee Blvd.
Corvus Christi,TX 78404
2.02 The Owner's Authorized Representative for this Project is:
Wayne Otto.P.E.—Construction Engineer
City of Corpus Christi—Engineering
4917 Holly Rd..85
Corpus Christi.TX 78411
ARTICLE 3—CONTRACT TIMES
3.01 Contract Times
A. The Work is required to be substantially completed within 56 calendar days after the date
when the Contract limes commence to run as provided in the Notice to Proceed and is to
be completed and ready for final payment in accordance with Paragraph 15.06 of the
General Conditions within 56 days after the date when the Contract Times commence to
run.
B. Milestones,and the dates for completion of each,are as defined in SECTION 0135 00
SPECIAL PROCEDURES.
3.02 Liquidated Damages
A. Owner and Contractor recognize that time limits for specified Milestones,Substantial
Completion,and completion and readiness for Final Payment as stated in the Contract
Agreement 00 52 23-1
[Insert Project Name and Number) Rev 0612"2016
INDEXED
Documents are of the essence of the Contract. Owner and Contractor recognize that the
Owner will suffer financial loss if the Work is not completed within the times specified in
Paragraph 3.01 and as adjusted in accordance with Paragraph 11.05 of the General
Conditions. Owner and Contractor also recognize the delays,expense, and difficulties
involved in proving in a legal or arbitration proceeding the actual loss suffered by Owner if
the Work is not completed on time. Accordingly, instead of requiring any such proof,
Owner and Contractor agree that as liquidated damages for delay(but not as a penalty):
1. Substantial Completion: Contractor shall pay Owner$500 for each day that expires
after the time specified in Paragraph 3.01 for Substantial Completion until the Work is
substantially complete.
2. Completion of the Remaining Work: Contractor agrees to pay Owner$500 for each
day that expires after the time specified in Paragraph 3.01 for completion and
readiness for final payment until the Work is completed and ready for final payment in
accordance with Paragraph 15.06 of the General Conditions.
3. Liquidated damages for failing to timely attain Substantial Completion and Final
Completion are not additive and will not be imposed concurrently.
4. Milestones: Contractor agrees to pay Owner liquidated damages as stipulated in
SECTION 0135 00 SPECIAL PROCEDURES for failure to meet Milestone completions.
5. The Owner will determine whether the Work has been completed within the Contract
Times.
B. Owner is not required to only assess liquidated damages,and Owner may elect to pursue
its actual damages resulting from the failure of Contractor to complete the Work in
accordance with the requirements of the Contract Documents.
ARTICLE 4—CONTRACT PRICE
4.01 Owner will pay Contractor for completion of the Work in accordance with the Contract
Documents at the unit prices shown in the attached BID FORM. Unit prices have been
computed in accordance with Paragraph 13.03 of the General Conditions. Contractor
acknowledges that estimated quantities are not guaranteed,and were solely for the purpose of
comparing Bids, and final payment for all unit price items will be based on actual quantities,
determined as provided in the Contract Documents.
Total Base Bid Price $ 589,181.00
ARTICLE 5—PAYMENT PROCEDURES
5.01 Submit Applications for Payment in accordance with Article 15 of the General Conditions.
Applications for Payment will be processed by the OAR as provided in the General Conditions.
5.02 Progress Payments; Retainage:
A. The Owner will make progress payments on or about the 25th day of each month during
performance of the Work. Payment is based on Work completed in accordance with the
Schedule of Values established as provided in the General Conditions.
Agreement 00 52 23-2
[Insert Project Name and Number] Rev O622-2016
B. Progress payments equal to 95 percent of the total earned value to date for completed
Work and properly stored materials will be made prior to Substantial Completion. The
balance will be held as retainage.
C. Payment will be made for the amount determined per Paragraph 5.02.B, less the total of
payments previously made and less set-offs determined in accordance with Paragraph
15.01 of the General Conditions.
D. At the Owner's option, retainage may be required at a higher percentage rate if progress
on the Project is considered to be unsatisfactory. If retainage in excess of the amount
described above is held prior to Substantial Completion, the Owner will place the additional
amount in an interest bearing account. Interest will be paid in accordance with Paragraph
6.01.
E. At the Owner's option,Owner may pay Contractor 100 percent of the Work completed, less
amounts withheld in accordance with Paragraph 15.01 of the General Conditions and less
200 percent of OAR's estimate of the value of Work to be completed or corrected to reach
Substantial Completion. Owner may, at its sole discretion,elect to hold retainage in the
amounts set forth above for progress payments prior to Substantial Completion if Owner
has concerns with the ability of the Contractor to complete the remaining Work in
accordance with the Contract Documents or within the time frame established by this
Agreement. Release or reduction in retainage is contingent upon and consent of surety to
the reduction in retainage.
5.03 Owner will pay the remainder of the Contract Price as recommended by OAR in accordance with
Paragraph 15.06 of the General Conditions upon Final Completion and acceptance of the Work.
ARTICLE 6—INTEREST ON OVERDUE PAYMENTS AND RETAINAGE
6.01 The Owner is not obligated to pay interest on overdue payments except as required by Texas
Government Code Chapter 2251.
6.02 The Owner is not obligated to pay interest on moneys not paid except as provided in Texas
Government Code Chapter 2252.
ARTICLE 7—CONTRACTOR'S REPRESENTATIONS
7.01 The Contractor makes the following representations:
A. The Contractor has examined and carefully studied the Contract Documents and the other
related data identified in the Bidding Documents.
B. The Contractor has visited the Site and become familiar with and is satisfied as to the
general, local,and Site conditions that may affect cost, progress,and performance of the
Work.
C. The Contractor is familiar with Laws and Regulations that may affect cost, progress,and
performance of the Work.
D. The Contractor has carefully studied the following Site-related reports and drawings as
identified in the Supplementary Conditions:
Agreement 00 52 23-3
[Insert Project Name and Number] Rev 05-22-2016
the Sitc;
E. The Contractor has considered the:
1. Information known to Contractor;
2. Information commonly known to contractors doing business in the locality of the Site;
3. Information and observations obtained from visits to the Site; and
4. The Contract Documents.
F. The Contractor has considered the items identified in Paragraphs 7.O1.D and 7.01.E with
respect to the effect of such information,observations, and documents on:
1. The cost, progress, and performance of the Work;
2. The means, methods,techniques,sequences,and procedures of construction to be
employed by Contractor;and
3. Contractor's safety precautions and programs.
G. Based on the information and observations referred to in the preceding paragraphs,
Contractor agrees that no further examinations, investigations,explorations,tests,studies,
or data are necessary for the performance of the Work at the Contract Price, within the
Contract Times, and in accordance with the other terms and conditions of the Contract
Documents.
H. The Contractor is aware of the general nature of Work to be performed by Owner and
others at the Site that relates to the Work as indicated in the Contract Documents.
I. The Contractor has correlated the information known to the Contractor, information and
observations obtained from visits to the Site, reports and drawings identified in the
Contract Documents, and all additional examinations, investigations,explorations,tests,
studies, and data with the Contract Documents.
J. The Contractor has given the OAR written notice of all conflicts,errors, ambiguities, or
discrepancies that the Contractor has discovered in the Contract Documents,and the
written resolution provided by the OAR is acceptable to the Contractor.
K. The Contract Documents are generally sufficient to indicate and convey understanding of
all terms and conditions for performance and furnishing of the Work.
L. Contractor's entry into this Contract constitutes an incontrovertible representation by
Contractor that without exception all prices in the Agreement are premised upon
performing and furnishing the Work required by the Contract Documents.
Agreement 00 52 23-4
[Insert Project Name and Numbed Rev 06-22-2016
ARTICLE 8—ACCOUNTING RECORDS
8.01 Accounting Record Availability: The Contractor shall keep such full and detailed accounts of
materials incorporated and labor and equipment utilized for the Work consistent with the
requirements of Paragraph 13.01 of the General Conditions and as may be necessary for proper
financial management under this Agreement. Subject to prior written notice,the Owner shall
be afforded reasonable access during normal business hours to all of the Contractor's records,
books, correspondence, instructions,drawings, receipts,vouchers,memoranda,and similar data
relating to the Cost of the Work and the Contractor's fee. The Contractor shall preserve all such
documents for a period of 3 years after the final payment by the Owner.
ARTICLE 9—CONTRACT DOCUMENTS
9.01 Contents:
A. The Contract Documents consist of the following:
1. Specifications,forms,and documents listed in SECTION 00 01 00 TABLE OF CONTENTS.
2. Drawings listed in the Sheet Index.
3. Addenda.
4. Exhibits to this Agreement:
a. Contractor's Bid Form.
b. List as necessary.
5. Documentation required by the Contract Documents and submitted by Contractor
prior to Notice of Award.
B. There are no Contract Documents other than those listed above in this Article.
C. The Contract Documents may only be amended, modified, or supplemented as provided in
Article 11 of the General Conditions.
ARTICLE 10—CONTRACT DOCUMENT SIGNATURES
One original of the signed Agreement will be required. The sequence of signatures will be
completed in the following order:
A. CONTRACTOR—Agreement must be signed by a person authorized to bind the firm or
company. If Contractor is a Corporation, agreements must be Attested;
B. ASSISTANT CITY ATTORNEY for the City;
C. DIRECTOR OF ENGINEERING SERVICES;
D. CITY SECRETARY for the City.
ATTEST CITY OF CORPUS CHRISTI
Agreement 00 52 23-5
[Insert Project Name and Numbed Rev06-12-2016
7
-1'e-•032..GC,Gdq tice 1., - , 0
Rebecca Huerta
City Secretary J.H. Edmonds, P.E. 5 Y 7
Director of Engineering Services
APPROVED AS TO LEGAL FORM:\AA_m;\_A__t II
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iltOi 16.%
ace,fav, ---k_c_d ,-(15/11- itiLl--
nr COUwGIL - S l
itnet±:-Kettogg NNwuz. Vi-tC,Q,n -
Assistant City Attorney
SECRETARY
ATTEST(IF CORPORATION) CONTRACTOR
-4
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•
(Seal Below By: re,/,,,,/ ti, 4S
Note: Attach copy of authorization to sign if Title: l lam✓« /''
z/ l`(/.✓z_n e�
person signing for CONTRACTOR is not President,
Vice President,Chief Executive Officer,or Chief 5826 Bear Lane
Financial Officer Address
Corpus Christi,TX 78405
City State Zip
361/851-1000
Phone Fax
mike@barcom.cc
EMail
END OF SECTION
Agreement 00 52 23-6
[Insert Project Name and Number] Rev06-22-2016
TC AYERS POOL SCOPE OF WORK
Project: TC AYERS POOL IMPROVEMENTS
Owner: City of Corpus Christi ADA=Americans with Disabilities Act
Address: 1201 Leopard Street EA=Each
Corpus Christi,Texas 78401 GAL=Gallon
Phone: (361)826-3500 LF=Linear Feet
LS=Lump Sum
SF=Square Feet
SY=Square Yards
AL=Allowance
PROJECT DESCRIPTION
The project will consist of work to restore the pool to active service only.
The pool was removed from service after the summer of 2015. Currently there are significant foundation repairs in the form of cracking and voids
with the pool shell which are undermined in size at this time. These cracks reflect through the concrete shell and caused failure of the pool interior
surface and pool deck. The MEP system is poor condition and inoperable without rehabilitation or replacement with a bypass system. The
existing buildings and restrooms require an overhaul of both the interior and exterior surfaces to be serviceable. The above improvements also
require upgrades to current codes including ADA.
The Scope of Work consist of repairing the pool by injecting foam to fill any below grade voids in order to stabilize the underlying soils,cleaning the
shell forwarded by coating it and replacing the pumping,filtration,chlorination system so the pool can be operational(recommend using two skid
mounted systems)along with neutralization injection system to allow for discharge into the storm water system during cleaning(backwashing).
Included site improvements are to the sidewalks/flatwork plus their joints,new pool entrance for ADA access in compliance by way of a ramp
leading to the side entrance,ADA access into the pool by use of a chairlift,and pool deck area repairs by injecting foam to fill any below grade
voids in order to stabilize the underlying soils,replacement of fencing around entire site along with gate as well as building and facilities which will
include the roof,exterior covering and showers.
At this time the City will not be upgrading the Restrooms and instead will be providing a ADA Complaint Restroom Trailer.
Included a more detail Scope of Work in the Form Bid Items.
ITEM NO. DESCRIPTION ESTIMATED UNIT
QUANTITY
1 Mobilization/Bonds/Insurance 1.00 LS
2 Water Stops at Joints Remove existing material as required to construct new water stop 1.00 LS
along all in pool expansion joints from pool coping to pool coping
Repair of the existing pool shell of any cracks and splices as
3 Shell Repairs 1.00 LS
required to form a smooth surface to accept interior lining
Remove existing material within the former Viewing and Light
4 Close Existing Viewing/Light Portals Portals and install reinforced concrete material anchored to the 3.00 EA
existing pool shell
Investigate extents of any cavity beneath the pool within the portion
5 Foundation Repairs of the deep end to the point that this end joins with the main body 1.00 LS
of the pool,include any pool shell repairs for pentrations,and
ancilary materials required shall be included.
6 Foundation Repair-Urethane Foam Level of the existing pool deck by means of polyurethane foam $75,000.00 AL
injection and hole repairs(to be metered by the pound)
7 Pool Interior Refinishing Install Epoxy Pool Interior finish in accordance with the 1.00 LS
,manufacturer recommendations
8 Pool Coping Repairs Repair of the existing pool coping of any cracks and splices as 1.00 LS
required to form a smooth surface
9 New Pump-1 1/2 HP/Skid units Opt. Provide and install new 1 1/2 HP pump capable of 75 gpm at 30 1.00 EA
feet of head minimum
10 Filtration Unit and Media Install 75 gpm flow poly tank with 75 square foot media 4.00 EA
11 Chlorinator Install commercial grade chlorinator 1.00 EA
12 Water Leveler Install commercial grade water leveler 1.00 EA
J*1we.IC A .POR,TCAyb.Ped Scop.c1Wak RRHT IOW) Page 1 of 2
Project: TC AYERS POOL IMPROVEMENTS
13 (Electrical Wiring and Components Install all new wiring and panels for new equipment. 1.00' LS
Plumbing Piping,Components and Install required piping for return and inflow pool water,piping for
14 Adjustments pool service water to water leveler,valves for isolation and fittings 100'1 LS
for connections and adjustments.
I 15 Equipment Building Install a 10'x 10'Metal Shed to house electrical components and 1.00 LS
equipment
16 -Gate Replacement Replace all entry/exit gates into the facility with like gates 1.001 LS
17 I Chain-link Fencing !Replace existing chain-link fencing to create secure facility 1.00. LS
Parking and Sidewalk Improvements-
Provide parking for two(2)ADA Parking Spaces with required
•
18 .Includes ADA ramp to existing sidewalk (All improvements must be Texas 1.00: LS
Department of Insurance Architectural Barriers Approved)
Install ADA Ramp,Stairs,and Landings at main entrance
•
19 ADA Ramp and Stairs at Front .constructed of 3.000 psi concrete,with all railings required include 1.001 LS
any demolition of existing improvements. All improvements must
be Texas Department of Insurance Architectural Barriers Approved
20 Pool Deck Leveling Level of the existing pool deck by means of polyurethane foam(to 1.00 AL
be metered by the pound),or approved equal
.. . - - __ _.__t_.. - . i
Remove existing expansion joint material and install NP-1
21 I Pool Deck Expansion Joint Repair elastomeric polyurethane sealant with any required fill and backer 1.00 LS
•rod material
22 Pool. Deck Drain Repairs Remove existing pool deck drain covers and replace with plastic 100, LS
:drain covers
23 1Pool Deck Sealing •Prepare and install Cool Pool Deck surface sealant in accordance ' 1 W' LS
i with manufacturers recommendations,or approved equal
I Removal and install of 30 year composite shingle roofing on all the:
24 !Building Repairs-Roof existing buildings at the facility. All construction shall be Texas 1001 LS
Department of Insurance Windstorm approved.
'Removal of existing wood exterior and replace with like material
25 iBuilding Repairs-Exterior and repair fill any cracking in brick. All construction shall be Texas 1.00! LS
Department of Insurance Windstorm approved.
Repair of existing pool showers and provide ADA approved facility
26 Pool Shower Repairs (All improvements must be Texas Department of Insurance 1.00 LS
Architectural Barriers Approved)
Replace existing water fountian and install adjacent water fountain
27 Water Fountain in accordance with ADA Regualations(All improvements must be 1.00 LS
Texas Department of Insurance Architectural Barriers Approved)
Install ADA Regulation approved In pool Chair Lift and all
28 IADA In-pool Chair Lift-Deck Mounted components. All improvements must be Texas Department of 1.00i EA
. insurance Architectural Barriers Approved.
t -__. __-_ __-_ -_ - ._ __-_.. - _t_
29 I Pool Signage Install required signage for pools at required locations 1.00' LS
30 'Wood Deck for Temporary Restrooms- IF APPLICABLE Wood deck adjacent to Restroom Trailer is 10011 LS
Iapprox 10'X20'and fencing needed for ADA Accessibility
..1..35 «..w...nt".Pm.,�„„„",..�,.m,i Page 2 of 2
4CP ;3 I.8.:: CriS.
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7,9
1852
Details Location
Project Number: E16436 County: Nueces
Type: Public Facilities State: TX
Address: 926 Coke Street
Corpus Christi,TX 78401
BID DETAILS
Date: 27 MAR 2017
Time: 12:00PM SCT
Location: City Hall Bldg.—City of Corpus Christi,3rd Floor Engineering Smart Board Room, 1201
Leopard Street,Corpus Christi,TX 78401
SCOPE
The project will consist of work to restore the pool to active service only.
The pool was removed from service after the summer of 2015. Currently there are significant
foundation repairs in the form of cracking and voids with the pool shell which are undermined in size at
this time. These cracks reflect through the concrete shell and caused failure of the pool interior surface
and pool deck. The MEP system is poor condition and inoperable without rehabilitation or replacement
with a bypass system. The existing building requires an overhaul of both the interior and exterior
surfaces to be serviceable. The above improvements also require upgrades to current codes including
ADA.
The Scope of Work consist of repairing the pool by injecting foam to fill any below grade voids in order
to stabilize the underlying soils,cleaning the shell forwarded by coating it and replacing the pumping,
filtration, chlorination system so the pool can be operational (recommend using two skid mounted
systems) along with neutralization injection system to allow for discharge into the storm water system
during cleaning(backwashing). Included site improvements are to the sidewalks/flatwork plus their
joints, new pool entrance for ADA access in compliance by way of a ramp leading to the side entrance,
ADA access into the pool by use of a chairlift,and pool deck area repairs by injecting foam to fill any
below grade voids in order to stabilize the underlying soils, replacement of fencing around entire site
along with gate as well as building and facilities which will include the roof,exterior covering and
showers.
At this time the City will not be upgrading the Restrooms and instead will be providing a ADA Complaint
Restroom Trailer.
Included a more detail Scope of Work and Bidders Work Sheet.
CONTACT ADDRESS CONTACT INFO
City of Corpus Christi Engineering Services Contact: Kevin McCord
1201 Leopard Street Phone: (361)826-3550
Corpus Christi,TX 78401 Email: KevinM3@cctexas.com
Bid Notes:
It is the responsibility of the Contractor bidding the project to be familiar with the Scope of the project
to ensure the accuracy of the bids. Failure to do so may result in errors in the Unit Bid Quantities and or
Bid Amounts.
THE AMERICAN INSTITUTE OF ARCHITECTS
114
AIA Document A310
Bid Bond
KNOW ALL MEN BY THESE PRESENTS, that we Barcom Construction, Inc. as Principal, hereinafter called the
Principal, and Travelers Casualty and Surety Company of America a corporation duly organized under the laws
of the State of Connecticut as Surety,hereinafter called the Surety, are held and firmly bound unto
City of Corpus Christi
as Obligee, hereinafter called the Obligee, in the sum of Five Percent of the Greatest Amount Bid
Dollars(S 5%of G.A.B.)
for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind ourselves, our
heirs,executors, administrators, successors and assigns,jointly and severally, firmty by these presents
WHEREAS, the Principal has submitted a bid for
TC Ayers Pool Repairs
NOW, THEREFORE, if the Obligee shall accept the bid of the Principal and the Principal shall enter into a Contract
with the Obligee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the
bidding or Contract Documents with good and sufficient surety for the faithful performance of such Contract and for
the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the failure of the
Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obligee the difference
not to exceed the penalty hereof between the amount specified in said bid and such larger amount for which the
Obligee may in good faith contract with another party to perform the Work covered by said bid, then this obligation
shall be null and void,otherwise to remain in full force and effect
Signed and sealed this 27th day of March, 2017
Al Barcom Construction,Inc.
/ (Principal) (Seal)
hiff
(Title)
Travelers Casualty and Surety Company of
_ �_ / America
i (Surely) (Seel)
Shei . ink (witness) (I
C A McClure (Title)Attorney-In-Fact
AIA DOCUMENT A310•BID BONO•AIA m•FEBRUARY 1970 ED•THE AMERICAN
INSTITUTE OF ARCHITECTS 1735 N Y AVE N W WASHINGTON D C 20006 1
WARNING THIS POWER OF ATTORNEY IS INVAL•0 WRHOt1T THE RED BORDER
ekes POWER OFATTORNEY
TRAVELERSJ Farmington Casualty Company Si.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Truselers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Pout Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian lasuruner Company
Attorney-In Fael No, 22
7687 Certificate Nu. 006849568
KNOW ALL MEN fit'THESE PRESENTS That Farmington Casually Company.St.Paul fire and Marine Insurance Company.Si. Paul Guardian Insurance
Company,St Paul Mercury insurance Company.Trawlers Casualty and Surety Company Travelers Casually and Surety Company of America.and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut.that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa.and that Fidelity and Guaranty Insurance Underwriters.Inc..is a corporation duly organized under the
taus of the State of Wisconsin therein collect'sely Lilted the-Companics).and that the Companies do hereby make,constitute and appoint
C A McClure:,Kelly J.Brooks.Kenneth i..Meyer,and Michelle Ulcry
of the City of Cypress .State of Texas ,their true and lawful Atuirncy(c)in fiat.
each in their separate capacity if more than one is named 2110‘C.in sign.execute.seal and acknowledge any and all bonds.recngniranccs.cnnehtinnil undertakings and
other writings obligatory in the nature thereof on behalf of die Companies in their business of gu ranieeing the fidelity of persons.guaranteeing the performance of
contracts and tramming or guaranteeing bonds and undenukings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF.the Conipanes has . used this instrument hi Ise„fired and their uwporatc oak M be h,rcin al fixed.flits
dos,.f June 2016 �^
Farmington Casualty Company Si.Paul Mercury Insurance Company
Fidelhy and Guaranty Insurance Company Travelers Casualty and Surety.Company
Fidelity and Guaranty Insurance Underwriters.Inc. Travelers Casualty and Surety Company of America
SI.Paul Fire and Marine lnsunioce Company United Stales Fidelity and Guaranty Company
SI.Paul Guardian(asurunce Company
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Sta.: .f Conn tient By
Cu, Jaffa•rd•. li•r.. icy,timer'.'.,c i'r:..;; n.
On dos the 10th day of June 2016 .before me personally appeared Robert L.Ran:).whit acknowledged himself to
be the Spoor Vice President of Farmington Casualty Company Fidelity and Guaranty Insurance Company.Fidelity.,end Guaranty Insurance Undcrwnters,Int.51 Paul
Fire and Manny insurance Company.St Paul Guardian Insurance Company.St.Paul Mercury Insurance Ci mpany.Travelers Casualty and Surety Company.Travelers
Casualty and Surety Company of America.and L oiled States Fidelity and Guaranty Company.and that he.as such.being authorized so to dn.esecuted the for.gning
instrument for the pus Ilrewin eunt;urryd by riving on behalf of rbc eorpor_unnc by himself as a duly authorized officer
\cfIn Whtnecs Whereof.I hereunto set my hand and official seal W' i v • v
My Commission expires the 311th day of lune._20?I * pere tt `&laic C.11c,uh.Nome Put .c
CIES
58440.5.16 Printed in U.S.A
WARNING THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUTTHE RED BORDER
This Ppwer of Anomey is granted under and by the authority of the following resolutiuni adopted by the Boanic of Directors of Farmington Casualty Company.Fidelity
and Guaranty Insurance Company.Fidelity and Guaranty Insurance Underwriters.Inc..St.Paul Fire and hlarinc Insurance Company.St:Paul Guardian Insurance
Cnmpany,St.Paul Mercury Insurance Company,Travelers Casualty and Surely Company.Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company,which resolutions arc now in full force and effect.reading us follows-
RESOLVED.that the Chairman,the President.arty Vice Chairman.any Executive Vice President,any Senior Vice President,any Vice President.any Second Vice
President.the Treasurer,any Assistant Treasurer.the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf
of the Company and may gine such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the
Company's seal bonds,recognitarsces,contracts of indemnity.and other writings obligatory in the nature of a bond.recognizance,or conditional undertaking,and any
of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her:and it is
FURTHER RESOLVED.that sloe Chairman,the President.any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may
delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy
thereof is filed in the office of the Secretary:and it is
FURTHER RFSOLVF.D,that any hand.recognizance.contract of indemnity,or writing obligatory in the nature of a bond,recognizance.or conditional undertaking
shall be valid and binding upon the Company when(al signed by the President.uny Vice Chaitman,any Executive Vice President,any Senior Vice President or any Vice
President.any Second Vice President,the Treasurer.any Assistant Treasurer.the Corporate Secretary or any Assistant Secretary and duly attested and scaled with the
Company's seal by a Secretary or Assistant Secretary;nr(b)duly executed(under seal,if required)by one or more Attorneys-in-Ian and Agents pursuant to the power
prescribed in his nr her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority:and it is
FURTHER RESOLVED,that the signature of each of the following officers:President.any Executive Vice President,any Senior Vice President,any Vick President.
any Assistant Vee President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any
certificate relating thereto appointing Resident Vice Presidents.Resident Assistant Secretaries or Aunmeyson•Fact for purposes only of executing and attesting bonds
and undertakings and other writings obligatory in the nature thereof.and any such Power of Attorney or certificate beating such facsimile signature or facsimile seat
shall be valid and binding upon the Company and any such power so executed and certified by such facsimile.signature and facsimile seal shall he valid and binding on
the Company in the future with respect to any bond or understanding to which it is attached.
1.Kevin E.Hughes,the undcrsigned,Assisant Secretary,of Farmington Casualty Company.Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance
Underwriters.Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company.St.Paul Mercury Insurance Company.Travelers Casualty and
Surety Company,Traseters Casualty and Surety Company of America.and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing
is a tote and correct copy of the Power of Attorney executed by said Companies,which is in full force and effect and has not been revoked.
27th March17
IN TESTIMONY WHEREOF.I base hereunto set my hand and affixed the seals of said Companies this day of .10 _
-
Kevin E.Hughes.Assistant Sec tory
L�w�, I rot..- _ ,• �. sir, Jl,raw. a O� In Jlmc 6` itPr{d0
tkk
+�y:"*, + _ . • 1 �. lac ID
C! �� � .1(4°.r �,?.� •�71�r�^ as 1
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44. .� / 41..0 .dot .! :j •'a.. ,l IN
Tn verify the authenticity of this Power of Attorney.call 1.800-121.3880 or contact us at www.traselenbond.cons.Please refer to the Annmey•In•Fact number.the
above-named individuals and the details of the bond to which the power is attached.
WARNING THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
Travelers''
IMPORTANT NOTICE
TO OBTAIN INFORMATION OR MAKE A COMPLAINT:
You may contact Travelers Casualty&Surety Company of America,Travelers Casualty
&Surety Company,Travelers Indemnity Company,Standard Fico Insurance Company
and/or Farmington Casualty Company for information or to make a complaint at:
Travelers Bond
Attn: Claims
1500 Market Street
West Tower,Suite 2900
Philadelphia,PA 19102
(267)675-3000
(267)675-3102 Fax
You may contact the Texas Department of Insurance to obtain the information in,
companies.coverages,rights or complaints at:
Texas Department of Insurance
P.O.Box 149104
Austin,TX 78714.9104
(800)252 3439
ATTACH TIES NOTICE TO YOUR BOND.This notice is for information only and
does not become a part or a condition of the attached document and is given to comply
with Section 2253-021.Government Code,and Section 53202,Properly Code,effective
September 1.2001.
Project Nami T.C.AYERS POOL REPAIRS
Project Num E16436
Owner: City of Corpus Christi
Bidder: Barcom Construction
OAR: T.B.D.
Designer: MUNOZ ENGINEERING
BASIS OF BID
DESCRIPTION QTY. UNIT UNIT PRICE AMOUNT
PART A: GENERAL CONDITIONS
Al Mobilization/Bond/Insurance 1 LS Included Included
A2 Coordination&Supervision 1 LS $23,864.00 $23,864.00
I A3 General Labor 1 LS Included Included
A4 DumpsterlHaul off 1 LS $6,354.00 $6,354.00
A5 Containers(On-site Storage) 1 LS $988.00 $988.00
A6 Clean-up/Pressure Washing 1 LS $1,272.00 $1,272.00
A7 Select Demolition 1 LS Included Included
A8 Equipment Rental 1 LS Included Included
A9 Other(Detailed Description Required) 1 LS NA NA
A10 Other(Detailed Description Required) 1 LS NA NA
{ Subtotal Part'A' $32,478.00
PART B: PAVEMENT UNIT PRICE AMOUNT
I)
B1 Testing Allowance(Concrete) 1 LS Excluded Excluded
T B2 Site Demolition and Haul Off 1 LS $5,648.00 $5,648.00
B3 Shell Repair(Minor Patching of Cracks)(Included in Part J) 1 LS NA NA
B4 Foundation Repairs(Patch After Injection-Covered under Allowance) 1 LS NA NA
B5 Repair Coping-Pool Coping Repairs(Included in Part J) 1 LS Included Included
B6 Approaches,curbs 1 LS $11,297.00 $11,297.00
B7 Sidewalks 1 LS 539,538.00 $39,538.00
B8 ADA Ramps 1 LS $7,060.00 $7,060.00
B9 Striping-ADA Spots Only 1 LS $1,130.00 $1,130.00
B10 Pool Deck Sealing-Excluded 1 LS Excluded Excluded
B11 Pool Deck Expansion Joint Repairs 1 LS $14,685.00 514,685.00
812 Other(Detailed Description Required) 1 LS NA NA
Subtotal Part'B' $79,358.00
PART C: BUILDING UNIT PRICE AMOUNT
Cl Exterior Sheathing-plywood 1 LS 5 6,058.00 $6,058.00
C2 Extenor Sheathing-Nardi Board 1 LS 5 12 412.00 512,412.00
C3 Mansard&Soffits Repair 1 LS $7,625.00 $7,625.00
C4 Dampproof Siding 1 LS 5 1,017.00 $1,017.00
C5 Gate Repair!Replacement(See Part J) 1 '' LS Included Included
C6 Fence Repair-New Chainlink(See Part J) 1 LS Included Included
C7 Demolition of Siding/Roofing/Soffit 1 LS $6,467.00 $6.467.00
Subtotal Part'C' $33,579.00
PART D: CARPENTRY(Included in Part C.E,&G) UNIT PRICE AMOUNT
01 Rough Carpentry 1 LS Included Included
D2 Finish Caprentry 1 LS Included Included
D3 Close Existing Viewing/Light Ports 1 LS Included Included
D4 Other(Detailed Description Required) 1 LS NA NA
D5 'Other(Detailed Description Required) 1 LS •NA NA
Subtotal Part'D'(Included In Part C,E,&G) $0.00
PART E: PAINTING UNIT PRICE AMOUNT
Et Close Existing Viewing/Light Ports 1 LS 5 10,591.00 510,591.00
E2 'Paint Building Walls&Siding 1 LS $14,473.00 $14.473.00
E3 'Close Existing Viewing/Light Ports 1 LS Inlcuded Included
E4 'Other(Caulking) 1 LS Inlcuded Included
ES Other(Detailed Description Required) 1 LS NA NA
E6 Other(Detailed Description Required) 1 LS NA NA
Subtotal Part'E' $25,064.00
Project Nam T.C.AYERS POOL REPAIRS A
Project Nuns E16436
Owner: City of Corpus Chnsti
Bidder: Barcom Construction
OAR: T.B.D.
Designer: MUNOZ ENGINEERING
PART F: FURNISHINGS UNIT PRICE AMOUNT
Fl ADA Chair lifts I LS $8.388.00 $8,388.00
F2 Other(Detailed Description Required) 1 LS NA NA
F3 Other(Detailed Description Required) 1 LS NA NA
Subtotal Part'F' $8,388.00
PART G: ROOFING UNIT PRICE AMOUNT
G1 Repair/Replace Roofs 1 LS 5 16,521.00 $16,521.00
G2 Demolition of Existing Roofing 1 LS 5 4,801.00 $4,801.00
G3 Redeck Plywood @ Roofs-3/4"Plywood 1 LS 5 7,414.00 $7,414.00
Subtotal Part'G' $28,736.00
PART H: ELECTRICAL UNIT PRICE AMOUNT
1-11 Install Traditional Electrical Wiring 1 LS $5,648.00 $5,648.00
H2 Furnish and Install Electrical Equipment 1 LS Included Included
H3 Equipment Building for Electrical Components(Excluded) 1 LS Excluded Excluded
H4 Other(Detailed Description Required) 1 LS NA NA
Subtotal Part'14' $5,648.00
PART I: PLUMBING UNIT PRICE AMOUNT
11 Install Plumbing Equipment 1 LS Included Included
12 Install Plumbing Piping 1 LS $2,542.00 $2,542.00
13 Furnish and Install Skid Pump Systems as per Scope of Work(Included in J6) 1 LS Included Included
14 Provide(2)showers with automatic release shut-off 1 LS $5,083.00 $5,083.00
IS Drinking Fountains(Hi/Low) 1 LS $3,530.00 $3,530.00
16 Replace Pool Deck Drain Covers with plastic drain covers 1 LS Excluded Excluded
17 Other(Detailed Description Required) 1 LS NA NA
Subtotal Part'I' $31,155.00
PART J: SITE SPECIFIC UNIT PRICE AMOUNT
J1 Remove and Replace Water Stops at Joints(Pool)(Expansion Joints) 1 LS $1,341.00 $1,341.00
J2 Seal(Pool Shell Repairs)-(Minor Plaster Patching) 1 LS $847.00 $847.00
J3 Test&Repair Main Drain System(Not Included) 1 LS Excluded Excluded
J4 Pool Interior Refinish-Paint Only 1 LS $15,109.00 $15,109.00
J5 Pool Signage 1 LS $988.00 $988.00
J6 Filtration Unit and Media 1 LS 5 166,907.00 $166,907.00
J7 Chlorinator 1 LS Included Included
J8 Water Leveler 1 LS Included Included
J9 Start up of Pool 1 LS Included Included
J10 New Chain Link Fencing and Gates around entire Property 1 LS $53,659.00 $53,659.00
J11 2.8 Around Bottom of Fencing 1 LS $2,225.00 $2,225.00
J12 New Handrails @ Front Entry 1 LS $3,813.00 $3,813.00
J13 Pool Coping Repairs 1 LS $1,130.00 $1,130.00
Subtotal Part'J' $246,019.00
PART K: PERMITS UNIT PRICE AMOUNT
K1 Building Permit 1 LS 5 6,778.00 $6,778.00
K2 'Trades Permit 1 LS Included Included
K3 'Other(Detailed Description Required) 1 LS NA NA
K4 Other(Detailed Description Required) 1 LS NA NA
Subtotal Part'K' $6,778.00
PART L: ALLOWANCES!ALTERNATES!SAVINGS UNIT PRICE AMOUNT
L1 URETHANE FOAM INJECTION-FOUNDATION REPAIRS(POOL&DECK) 1 LS $75,000.00 375.000.CO
L2 Other(Detailed Description Required) 1 LS NA NA
L3 Other(Detailed Description Required) 1 LS NA NA
L4 ALTERNATES!SAVINGS SUBTOTAL 1 LS NA NA
Subtotal Part'V $75,000.00
PROJECT TOTAL(Less COP) I $552,203.00
PART M: CONTINGENCY I OVERHEAD!PROFIT UNIT PRICE AMOUNT
M1 Contingency(0.00%) NA NA
M2 Overhead(10%) Included Included
M3 Profit(10%) included Included
M4 Taxes(If Applicable)8.25% NA NA
Subtotal'COP' $0.00
GC PROJECT BID GRAND TOTAL I $552,203.00
Project Nam T.C.AYERS POOL REPAIRS
Project Num E16436
Owner: City of Corpus Christi
Bidder: Barcom Construction
OAR: T.B.D.
Designer: MUNOZ ENGINEERING
PART AA:TEMPORARY RESTROOM FACILITY RENTALS UNIT PRICE AMOUNT
AA7 Restroom Trailer Rental t MO $4,942.00 $4,942.00
AA2 Restroom Cleaning 1 MO $1,236.00 $1,236.00
AA3 Restroom Mob&Demob 1 LS $1,412.00 $1,412.00
AA4 Fencing 150 LF $50.00 $7,500.00
AA5 Concrete flatwork/sidewalk on existing subgrade 1.080 sf $s.5o $9,180.00
AA6 Electrical feeder to Restroom Facility 1 LS $7,060.00 $7,060.00
AA7 Waterline feeder to Restroom Facility 1 LS $5,648.00 $5.648.00
Subtotal Part'AA' $36,978.00
GC PROJECT BID GRAND TOTAL WITH TEMPORARY RESTROOM FACILITY RENTALS $589,181.00
BID CLARIFICATIONS&INSTRUCTIONS
1) Mark-Up cr.Change Orders Maximum(10%)
2) Provide List Of Subcontractors Used
3) Provide Project schedule
4) Excludes ADA Ramp and Stairs at front Entrance(ADA Entrance through back Gate)
5) $75,000 Alowance includes both pool,and deck foam injection
6) City To Provide Portable restroom Trailers and and Ramps/Decks to Meet ADA
7) Excludes Cool Deck sealant/topping around pool
8) Excludes any repairs to pool deck not covered in allowance
9) Excludes Concrete Material Testing
10) Excludes Windstorm Engineering(Inspections
11) Excludes Equipment Shed Building
12) Excludes test and Repair of Main Drain System
13) Excludes Foundation Repairs-Patching atter injections(Included in Injection Allowance)
14) Excludes Fire lanes
15) Excludes new drain Covers
Page 1 of 3
Ordinance amending the FY 2017 Capital Improvement Program
Budget adopted by Ordinance No. 030938 to add Project No. T17021
TC Ayers Pool improvements; transfer and appropriate $712,558
from the Unreserved Fund Balance in No. 1020 General Fund to No.
3280 Parks and Recreation CIP Fund; authorizing the City Manager
or designee to execute a construction contract with Barcom
Construction, Inc. In the amount of $589,181 for TC Ayers Pool
Improvements; and declaring an emergency.
WHEREAS, the City has discovered damage underneath TC Ayers Pool that
requires immediate improvement and elimination of the potential risk;
WHEREAS, City Council hereby finds that this expense is a procurement
necessary to preserve or protect the public health or safety of the municipality's residents
pursuant to Texas Local Government Code section 252.022(aX2); and
WHEREAS, City Council hereby finds that this expense is a procurement
necessary because of unforeseen damage to public machinery, equipment or other
property pursuant to Texas Local Government Code section 252.022(aX3).
NOW, THEREFORE, BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY
OF CORPUS CHRISTI, TEXAS:
SECTION 1. City Council specifically finds that the foregoing statements included in the
preamble of this ordinance are true and correct and adopts such findings for all intents and
purposes related to the authorization of this procurement.
SECTION 2. An amount of$712,558.00 from the Unreserved Fund Balance in No. 1020
General Fund is appropriated and transferred into No. 3280 Parks and Recreation CIP
Fund for TC Ayers Pool Improvements.
SECTION 3. The FY 2017 Capital Improvement Budget adopted by Ordinance No.
030936 is changed to add Project No. T17021 and increase revenues and expenditures in
the amount of$712,558.00
SECTION 4. The City Manager or designee is authorized to execute a construction
contract with Barcom Construction, Inc. in the amount of $589,181.00 for TC Ayers Pool
Improvements.
SECTION 5. The City Manager or designee is authorized to administratively execute all
other documents that may be required related to improvements to and operation of TC
Ayers Pool.
SECTION 6. That upon written request of the Mayor or five Council members, copy
attached, the City Council finds and declares an emergency due to the need for immediate
action necessary for the efficient and effective administration of City affairs and suspends
the Charter rule that requires consideration of and voting upon ordinances at two regular
meetings so that this ordinance is passed and takes effect upon first reading as an
emergency measure this the 28th day of March, 2017.
Ordinance TC Ayers Pool Improvements-Emergency and Inc Findnga.docx
031104 INDEXED
Page 2 of 3
Corpus Christi, Texas
28th Day of March, 2017
TO THE MEMBERS OF THE CITY COUNCIL
Corpus Christi, Texas
For the reasons set forth in the emergency clause of the foregoing ordinance an
emergency exists requiring suspension of the Charter rule as to consideration and
voting upon ordinances at two regular meetings: I/we, therefore, request that you
suspend said Charter rule and pass this ordinance finally on the date it is
introduced, or at the present meeting of the City Council.
Respectfully, Respectfully,
awr..` v\
Mayor
Council Members
The above ordinance was passed by the following vote:
Mayor cam
Rudy Garza rA O
Paulette Guajardo
Michael Hunter 1 •
Joe McComb OIL . A
Ben Molina R f
Lucy Rubio A 41
t �
Greg Smith
Carolyn Vaughn A t
Ordinance TC Ayers Pool Improvements-Eminency and Inc Findirge.Eocx
031104
Page 3 of 3
BdayyPASSED AND APPROVED, this the %/ of ► V 1 , 2017.
ATTEST:
Re (13CE%
. Lr
ecca Huerta Mayor
City Secretary
Ordinance TC Ayers Pool Improvements-Emergency and Inc Findings.docx
P I 11
00 61 13 PERFORMANCE BOND BOND NO. 106624814
Contractor as Principal [Surety Travelers Casualty and Surety
I Name: Barcom Construction,Ina 1 Name:
Company of America
Mailing address(principal place of business): Mailing address(principal place of business):
5826 Bear Lane 4650 Weslway Park Blvd.
Corpus Christi,TX 78405 Houston,TX 77041
1 Physical address(principal place of business)
Owner Same as above
Name: City of Corpus Christi,Texas
Mailing address(principal place of business):
Engineering Services -_-_- - P- g --- g
1201 Leopard Street Suretyis a corporation or anized and existin
p under the laws of the state of: Connecticut
Corpus Christi,Texas 78469
By submitting this Bond,Surety affirms its
authority to do business in the State of Texas and
Contract its license to execute bonds in the State of Texas.
Project name and number: Telephone(main number): 281-606-8400
717021 T.C.Ayers Pool Improvements Project
Telephone(for notice of claim): 281-606-8415
Local Agent for Surety
Name: C.A.McClure
Award Date of the Contract March 29,2017 Address: 13823 Schmidt Road i
Contract Price: $589,181.00 Cypress,TX 77429
Bond , Telephone: 281-890-9294
Email Address: alm@southernamericanins.com
Date of Bond: March 29,2017 The address of the surety company to which any
notice of claim should be sent may be obtained
I (Date of Bond cannot be earlier than Award Date from the Texas Dept.of Insurance by calling the
of the Contract) j following toll-free number:1-800-252-3439
Performance Bond 00 8113-1
117021 T.C.Ayers Pool Improvements Project 7-8-2014
Surety and Contractor,intending to be legally bound and obligated to Owner do each cause this
Performance Bond to be duly executed on its behalf by its authorized officer,agent or representative.
The Principal and Surety bind themselves,and their heirs, administrators, executors,successors and
assigns,jointly and severally to this bond. The condition of this obligation is such that if the Contractor as j
Principal faithfully performs the Work required by the Contract then this obligation shall be null and
void;otherwise the obligation is to remain in full force and effect. Provisions of the bond shall be
pursuant to the terms and provisions of Chapter 2253 and Chapter 2269 of the Texas Government Code
as amended and all liabilities on this bond shall be determined in accordance with the provisions of said I
Chapter to the same extent as if it were copied at length herein. Venue shall lie exclusively in Nueces
County,Texas for any legal action.
'•. Contractor as Principal Barcom Constructi.n,Inc. Surety Travelers Casualty and Surety Company of America
Signature: ,� y� ;��r t Signature:
Name: �J Af / Name: C.A.McClure
4111,
Title Title: Attorney in Fact
Email Address:a it ,de Email Address: alm@southernamericanins.com
(Attach Power of Attorney and place surety seat below)
•
ti
� t
END OF SECTION
Performance Bond 00 61 13 -2
T17021 T .Ayers Pool Improvements Project 7-8-2014
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
• POWER OF ATTORNEY
TRAVELERS J Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
Attorney-In Fact No, Certificate No.0 0 6 8 4 9 6 2 3
227687
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company,St. Paul Guardian Insurance
Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the
laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint
C.A.McClure,Kelly J.Brooks,Kenneth L.Meyer,and Michelle Ulery
of the City of Cypress ,State of Texas ,their true and lawful Attomey(s)-in-Fact,
each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 30th
day of June , 2016 ,
Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
2 I��L • �{RE 6 `'W IRfG P+,tNSUgq JtttY.tNp VpfTpY
0,00` G ` ' ��;......Y•.9 J y 4' pT�
d •� f Oq POg4't Qom:' P T 9•
• fin � NCDRKIRF7ED"., .- �)t �� �rerpnORASE.t•� < £
i 1 9 8 2 0 1977 E /q•.• ml "' m z i .. .n- w MARTFono, < a RD.
E 1951 a .7) ' EALfo•' �'S81LL a` conn. 0 to,,,txwn. z sss
bey, �"+ i .p y� *~�'c Nr+cY c� r 5....AM�Lt °'ij ..ra't.� 6. n�/ + +�a'� 1+141 nor'
Stateof Connecticut4
By:
°2
City of Hartford ss. Robert L.Raney.Senior Vice President
On this the 30th day of June , 2016 ,before me personally appeared Robert L.Raney,who acknowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul
Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers
Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
In Witness Whereof,I hereunto set my hand and official seal. ftW74 (�f ldt. C • i..4 2:61AA-S �1
My Commission expires the 30th day of June,2021. * AUBUG * Marie C.Tctreault.Notary Public
.491EC'
58440-5-16 Printed in U.S.A.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company,Fidelity
and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.;St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance
Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company,which resolutions are now in full force and effect,reading as follows:
RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice
President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf
of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the
Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any
of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is
FURTHER RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may
delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy
thereof is filed in the office of the Secretary;and it is
FURTHER RESOLVED,that any bond,recognizance,contract of indemnity,or writing obligatory in the nature of a bond,recognizance,or conditional undertaking
shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice
President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the
Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power
prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice President,
any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any
certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds
and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal
shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on
the Company in the future with respect to any bond or understanding to which it is attached.
I,Kevin E.Hughes,the undersigned,Assistant Secretary,of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance
Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and
Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing
is a true and correct copy of the Power of Attorney executed by said Companies,which is in full force and effect and has not been revoked.
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 29th day of— March 20 17
ZINN�
Kevin E.Hughes,Assistant Sec tary
rl•1•v
cezt
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u 1977 g ttn a,. 4 ` _ F + Zao "°ri`� HnarFoao, wa�ran
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To verify the authenticity of this Power of Attorney,call 1-800-421-3880 or contact us at www.travelersbond.com.Please refer to the Attorney-In-Fact number,the
above-named individuals and the details of the bond to which the power is attached.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
•
aft
TravelersJ
IMPORTANT NOTICE
TO OBTAIN INFORMATION OR MAKE A COMPLAINT:
You may contact Travelers Casualty&Surety Company of America, Travelers Casualty
& Surety Company,Travelers Indemnity Company, Standard Fire Insurance Company
and/or Farmington Casualty Company for information or to make a complaint at:
Travelers Bond
Attn: Claims
1500 Market Street
West"rower,Suite 29110
Philadelphia, PA 19102
(267)675-3000
(267)675-3102 Fax
You may contact the Texas Department of Insurance to obtain the information on
companies,coverages,rights or complaints al:
Texas Department of Insurance
P.O. Box 149104
Austin,TX 78714-9104
(800)252-3439
ATTACH TIES NOTICE TO YOUR BOND.This notice is for information only and
does not become a part or a condition of the attached document and is given to comply
with Section 2253-021, Government Code, and Section 53.202,Property Cock, effective
September I, 2001.
•
DO 6116 PAYMENT BOND BOND NO. 106624814
Contractor as Principal I Surety Travelers Casualty and Surety
Name: Barcom Construction,Inc. Name: Company of America
Mailing address(principal place of business): i Mailing address(principal place of business):
5826 Bear Lane
4650 Westway Park Blyd.
Corpus Christi,TX 78405 Houston,TX 77041
Physical address(principal place of business):
: Owner I I
Same as above
', Name: City of Corpus Christi,Texas
Mailing address(principal place of business):
Engineering Services Surety is a corporation organized and existing
1201 Leopard Street under the laws of the state of: Connecticut
I Corpus Christi,Texas 78469
By submitting this Bond,Surety affirms its
authority to do business in the State of Texas and
Contract - - 1 its license to execute bonds in the State of Texas.
Project name and number: Telephonene(main numbed:28 281-606-8400
T17021 T.C.Ayers Pool Improvements Project
Telephone(for notice of claim): 281-606-8415
Local Agent for Surety
Name: C.A.McClure
Award Date of the Contract: March 29,2017 ',, Address: 13823 Schmidt Road
Cypress,TX 77429
Contract Price: '589,181.00
Bond Telephone: 281-890-9294
Email Address: alm@southernamericanins cam
Date of Bond: March 29,2017
The address of the surety company to which any
(Date of Bond cannot be earlier than Award Date notice of claim should be sent may be obtained
' of Contract) from the Texas Dept.of Insurance by calling the
following toll-free number 1-800-252-3439
Payment Bond Form 00 6116 - 1
TI7021 T.C.Ayers Pool Improvements Project 7-8-2014
•
Surety and Contractor,intending to be legally bound and obligated to Owner do each cause this Payment
Bond to be duly executed on its behalf by its authorized officer,agent or representative. The Principal
and Surety bind themselves, and their heirs, administrators, executors,successors and assigns,jointly
and severally to this bond. The condition of this obligation is such that if the Contractor as Principal pays
all claimants providing labor or materials to him or to a Subcontractor in the prosecution of the Work
required by the Contract then this obligation shall be null and void;otherwise the obligation is to remain
in full force and effect. Provisions of the bond shall be pursuant to the terms and provisions of Chapter
2253 and Chapter 2269 of the Texas Government Code as amended and all liabilities on this bond shall
be determined in accordance with the provisions of said Chapter to the same extent as if it were copied
at length herein. Venue shall lie exclusively in Nueces County, Texas for any legal action.
Contractor as Principal Barcom Construction, Inc. Surety Traveler asualiy and Surety Company of America
Signature: _ /.d, 41
Signature:
AVANT--az/ j� --
t/` Name: C.A.McClure •
•
Title: / — Title: Attorney in Fact _
Email Address: / 1/ Am.& Email Address: alm@southernamericanins.com
(Attach Power of Attorney and place surety seal below) •
I �
END OF SECTION
Payment Bond Form 00 61 16-2
T17021 T.C.Ayers Pool Improvements Project 7-8-2014
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
401116. POWER OF ATTORNEY
TRAVELERS.1 Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
Attorney-In Fact No. Certificate No. 0 0 6 8 4 9 6 2 2
227687
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company,St. Paul Fire and Marine Insurance Company,St. Paul Guardian Insurance
Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut,that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa,and that Fidelity and Guaranty Insurance Underwriters,Inc.,is a corporation duly organized under the
laws of the State of Wisconsin(herein collectively called the"Companies"),and that the Companies do hereby make,constitute and appoint
C.A.McClure,Kelly J.Brooks,Kenneth L.Meyer,and Michelle Ulery
of the City of Cypress ,State of_ Texas ,their true and lawful Attomey(s)-in-Fact,
each in their separate capacity if more than one is named above,to sign,execute,seal and acknowledge any and all bonds,recognizances,conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF,the Companies have caused this instrument to be signed and then corporate seals to be hereto affixed,this 30th
day of June , 2016
Farmington Casualty Company St.Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters,Inc. Travelers Casualty and Surety Company of America
St.Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St.Paul Guardian Insurance Company
c,ASU.4 C
TF q+" 4.Qi o 82 0 e� '- a * ✓ 4, 2s`RANCt- `n S..009 V;�`1:......•'*t1�D y . ''a! ! , A�
•
State of Connecticut By: v���"'
City of Hartford ss. Robert L.Raney,Senior Vice President
On this the 30th day of June , 2016 ,before me personally appeared Robert L.Raney,who acknowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,Inc.,St.Paul
Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers
Casualty and Surety Company of America,and United States Fidelity and Guaranty Company,and that he,as such,being authorized so to do,executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
nIn Witness Whereof,I hereunto set my hand and official seal. �My Commission expires the 30th day of June,2021. * tit Marie C.Tetreault,Notary PublicC+
49/ DTP
58440-5-16 Printed in U.S.A.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER •
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company,Fidelity
and Guaranty Insurance Company,Fidelity and Guaranty Insurance Underwriters,lnc.;St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance
Company,St.Paul Mercury Insurance Company,Travelers Casualty and Surety Company,Travelers Casualty and Surety Company of America,and United States
Fidelity and Guaranty Company,which resolutions are now in full force and effect,reading as follows:
RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any Second Vice
President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf
of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the
Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in the nature of a bond,recognizance,or conditional undertaking,and any
of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is
FURTHER RESOLVED,that the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice President may
delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is in writing and a copy
thereof is filed in the office of the Secretary;and it is
FURTHER RESOLVED,that any bond,recognizance,contract of indemnity,or writing obligatory in the nature of a bond,recognizance,or conditional undertaking
shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any Senior Vice President or any Vice
President,any Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the
Company's seal by a Secretary or Assistant Secretary;or(b)duly executed(under seal,if required)by one or more Attorneys-in-Fact and Agents pursuant to the power
prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED,that the signature of each of the following officers:President,any Executive Vice President,any Senior Vice President,any Vice President,
any Assistant Vice President,any Secretary,any Assistant Secretary,and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any
certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for purposes only of executing and attesting bonds
and undertakings and other writings obligatory in the nature thereof,and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal
shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on
the Company in the future with respect to any bond or understanding to which it is attached.
I,Kevin E.Hughes,the undersigned,Assistant Secretary,of Farmington Casualty Company,Fidelity and Guaranty Insurance Company,Fidelity and Guaranty Insurance
Underwriters,Inc.,St.Paul Fire and Marine Insurance Company,St.Paul Guardian Insurance Company,St.Paul Mercury Insurance Company,Travelers Casualty and
Surety Company,Travelers Casualty and Surety Company of America,and United States Fidelity and Guaranty Company do hereby certify that the above and foregoing
is a true and correct copy of the Power of Attorney executed by said Companies,which is in full force and effect and has not been revoked.
29th March 17
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this day of ,20 _.
Kevin E.Hughes,Assistant Sec tary
C�S4A<
.ffpio+, ` �a '�• ^ � @(O`'"rrr IN'S.4�9,l7:; C :: : ®
+P p+:..1..N..3n..A4..q.l..9buJtP♦tv 4NFs.
401Y
`?craw G -a 414 '• n90 1977'
To verify the authenticity of this Power of Attorney,call 1-800-421-3880 or contact us at www.travelersbond.com.Please refer to the Attorney-In-Fact number.the
above-named individuals and the details of the bond to which the power is attached.
WARNING:THIS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER
•
•
Travelers'
IMPORTANT NOTICE
TO OBTAIN INFORMATION OR MAKE A COMPLAINT:
You may contact'travelers Casualty& Surety Company of America,Travelers Casualty
& Surety Company,Travelers Indemnity Company, Standard Fire Insurance Company
and/or Farmington Casualty Company for information or to make a complaint at:
Traveler Bond
Ann: Claims
1500 Market Street
West'lower,Suite 2900
Philadelphia, PA 19102
(267)675-3000
(267)675-3102 Fax
You may contact the Texas Department of Insurance to obtain the information on
companies,coverages, rights or complaints at:
Texas Department of Insurance
P.O. Box 149104
Austin,TX 78714-9104
(800)252-3439
ATTACH THIS NOTICE TO YOUR BOND.This notice is for information only and
does not become a part or a condition of the attached document and is given to comply
with Section 2253-021, Government Code, and Section 53.202,Property Code, effective
September I.2001.
eind CERTIFICATE OF LIABILITY INSURANCE GATEIMMme/WrrI
9/27/2016
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: N the certificate holder Is an ADDITIONAL INSURED,the pollcy(Ies)must be endorsed. H SUBROGATION IS WAIVED,subject to
the tenni and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the
certificate holder In Heir of such endorsement(s).
PRODUCER
CONTACT Renee Tertell
Higginbotham Insurance Agency,Inc. MIX Ne F,TE 361-5614237 FAXA lc FAX 361A44-0101
dba Swantner 8 Gordon Insurance Agency.LLC
PO Box 870 eAMnuERaFa rterrell@higginboNam.net
Corpus Christi TX 78403-0870 INBURERNI AFFORDING COVERAGE ENO
INsuiER A:Valley Forge Insurance Company 20508
BEAMED BARCO6 INSURER a:Westchester Fire Insurance Company 21121
Bamom Construction.Inc. mourn c:Continental Casualty Company 20443
Barcom Commercial,Inc. mums o:Travelers Property Casualty Co of A 25674
5828 Bear Lane
Corpus Christi TX 78405 INSURER E:Transportation Insurance Company 20494
INSURER F:
COVERAGES CERTIFICATE NUMBER:1682283263 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTMTHSTANONG ANY REQUIREMENT.TERM OR CONDION OF ANY CONTRACT OR OTHER DOCUMENT 00TH 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 MID CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILLTR TYPE OF INSURANCE M6e VNO POKY NBMBER MR OL 1 IMWONISYy1 1WIIOOf VTI UME
E x I WIarERCIALGENERAL WBIDTV C4034064756 I 9/12/2016 9/12/22017 EACH OCCURRENCE 51.000.000
ONMGEIOREMED
_T CLAWMM
BE I X IO (I
CCUR I PREMISES .acC qql 5100.000
_II MEDEXP We 0551 PENN/ 515.000
_ PERSONAL 6ADV INJURY 51.000.000
GEM.AGGREGATELEERAPPUES PER. GENERAL AGGREGATE 52,000.000
PCUCY❑% 1.777 O LOG PRODUCTS.CWPRVAGG 52.000.000
Or1ER'.
C .WTONA06a WBNT/ C4034064790 9/12/2016 0112/2017 [Ea dititU NUIE UM" 1.000.000
X ANY AUTO BODILY INJURY Mac perm)
ALLGMIE0 MED BODILY INJURY IPM KN
OYI
% HEED AUTOS % N ED PROPERTY!SWAGEAUEp6a
IRN6allq
I
D X WRRCIJAIYB X oiscuR 2UPB1M1439A16NF 9/12/2016 9/122017 EACH OCCURRENCE 15,000.000
EXCISE WB CWMS.MADE AGGREGATE 15.000.000
OED % RETENTION$10.000
p wM1NM
BCOYPNMIWNW
N WC447i] 9/12/2018 9/251017 x STAgift
I ERW
AND EMPLOYERS'MINUTE
Ma PRIXAIETtlIMARTNEREIECUTIVE Yrs NSA E.L.EACH ACCIDENT 1.000.000
CFFITERMEMSER EXCLWED1 I
IYwYmyln NM E.L.RSEASE.EA EMPLOYEE 1,000000
OSiam. b
IPT1ON OP£RATIONSWow I EL.DISEASE-PoLICYMUT 1.000,000
8 9500/25 Risk 121091838005 9/122016 9/12/2017 LoCBMn 57.000.000
ORumace 910,000.000
DEEW 1OI OP OPBRAN W B/LOCATMIIM/VEHICLES ACORD 161.A40115451R111111111itli MASSE ton b .YSIN a man Apia N nquiM1
See Attached...
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CIN of Corpus Christi THE EXPIRATION DATE THEREOF. NONCE WILL BE DELIVERED IN
Alln:Risk Manager ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 9271
Corpus Christ Tx 13469-9277
AMORE= Alin
019SE-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(201401) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:BARCO6
LOGS;
ACO d ADDITIONAL REMARKS SCHEDULE Page 1 of 1
,be1CV NMW W WRW
Higginbotham Insurance Agency, Inc. Barcom Construction, Inc.
Barcom Commercial, Inc.
reuorNuaBER 5826 Bear Lane
Corpus Christi TX 78405
amnia NAC COOS
ShECTVE OATS:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TDLE: CERTIFICATE OF LIABILITY INSURANCE
General Liability policy includes a blanket automatic waiver of subrogation endorsement that provides
this feature only when there is a written contract between the insured and certificate holder that
requires it. (Contractor's General Liability Extension Endorsement CNA/4/05XX 01/15) .
General Liability policy includes a blanket automatic additional insured endorsement that provides
additional insured status to the certificate holder only when there is a written contract between the
insured and certificate holder that requires such status. (Blanket Additional Insured - Owners, Lessees
or Contractors - With Products-Completed Operations Coverage - Form CNA75079XX 01/15) .
General Liability policy includes a primary & non-contributory provision only when there is a written
contract between the insured and certificate holder that requires such provision. (Contractor's General
Liability Extension Endorsement CNA747o5xx 01/15) .
Auto Liability policy includes a blanket automatic waiver of subrogation endorsement that provides this
feature only when there is a written contract between the insured and certificate holder that requires
it. (Contractors Extended BA Plus Coverage Endorsement - Form CNA63359XX 04/12) .
Auto Liability policy includes a blanket automatic additional insured endorsement that provides
additional insured status to the certificate holder only when there is a written contract between the
insured and certificate holder that requires such status. (Texas Additional Insured - Form CA2048
10/13) .
Workers' Compensation policy includes a blanket automatic waiver of subrogation endorsement that
provides this feature only when there is a written contract between the insured and certificate holder
that requires it. (Texas Waiver of Our Right to Recover from Others Endorsement - Form WC 42 03 04B
06/14).
Executive Officers, David & Elaine Hoffman, are excluded under the Workers' Compensation policy.
(Partners, Officers and Others Exclusion - Form WC420308 01/97) .
Umbrella policy follows the terms, definitions, conditions & exclusions of the Scheduled Underlying
General Liability, Auto Liability and Employers Liability Insurance. (Specialty Commercial Umbrella
Liability Policy - Form 50001 02/14) .
Contractors Professional Liability and Pollution Incident Liability Policy info: Columbia Casualty,
Policy* CZB288296539, 11/14/15-16, $2,000,000 Each Claim / $2,000,000 Aggregate.
Contractors Professional Liability and Pollution Incident Liability Policy includes Waiver of
Subrogation - Form G-130914 02/11.
Employee Theft policy with Travelers Casualty & Surety Company of America, Policy* 105677128,
09/12/16-17, $1,000,000 Per Occurrence Limit.
workers' Compensation policy includes an endorsement providing that 30 days notice of cancellation will
be furnished to the certificate holder except 10 days notice of nonpayment of premium. (Texas Notice of
Material Change Endorsement - Form WC 42 06 01 07/84) .
General Liability policy includes an endorsement providing that 30 days notice of cancellation will be
furnished to the certificate holder except 10 days notice of nonpayment of premium. (Changes - Notice of
Cancellation or Material Restriction Endorsement - Form CNA74702XX 01/15).
Auto policy includes an endorsement providing that 30 days notice of cancellation will be furnished to
the certificate holder except 10 days notice of nonpayment of premium. (Notice of Cancellation or
material Change - Designated Person or Organization - Form CNA72315XX 02/13) .
Builders Risk policy includes an endorsement providing that 30 days notice of cancellation will be
furnished to the certificate holder except 10 days notice of nonpayment of premium. (Notice to Others
Endorsement - Specific Parties - Form ALL-32688 Ar01/11) .//� req � (
Re: ab.. .yaeu,�eu,. ..P Au. 2.,. 4�6 Oi '`/ia2/ .4b�w 40471fota feto
ACORD 101(2006101) 102008 ACORD CORPORATION. All ABhts rnerved
The ACORD name and logo am registered marks of ACORD
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
It Is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART
as follows. If any other endorsement attached to this policy amends any provision also amended by this endorsement,
Nen that other endorsement controls with respect to such provision, and the changes made by this endorsement with
respect to such provision do not apply.
TABLE OF CONTENTS
1. Additional Insureds
2. Additional Insured•Primary And Non-Contributory To Additional Insured's Insurance
3. Bodily Injury—Expanded Definition
4. Broad Knowledge of Occurrence!Notice of Occurrence
5. Broad Named Insured
6. Broadened Liability Coverage For Damage To Your Product And Your Work
7. Contractual Liability-Railroads
8. Electronic Data Liability
9. Estates,Legal Representatives and Spouses
10. Expected Or Intended Injury—Exception for Reasonable Force
11. General Aggregate Limits of Insurance—Per Project
12. In Rem Actions
13. Incidental Health Care Malpractice Coverage
14. Joint VeatureslPartnershiplLimbed Liability Companies
15. Legal Liability— Damage To Premises /Alienated Premises/ Property In The Named insured's Care,
Custody or Control
16 Liquor Liability
6 17. Medical Payments
g19. Non-owned Aircraft Coverage
19. Non-owned Watercraft
0$@ 20. Personal And Advertising Injury—Discrimination or Humiliation
21. Personal And Advertising Injury-Contractual Liability
22. Property Damage-Elevators
23. Supplementary Payments
24. Unintentional Failure To Disclose Hazards
2S Waiver of Subrogation—Blanket
OEM 26 Wrap-Up Extension:OCIP CCIP,or Consolidated(Wrap-Up)Insurance Programs
EBB
CNA747O5XX(1-15) Policy No: 4034064756
Page 1 of 17 Endorsement No:
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
ccpydwl CIA AORa,b R`sv d. Ntluda cgyda,nd mewled Inseams Services Gecs.Inc..with le permission.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
1. ADDITIONAL INSUREDS
a. WHO IS AN INSURED Is amended to include as an Insured any person or organization described in paragraphs
A.through H.below whom a Named Insured Is required to add as an additional insured on this Coverage Part
under a written contract or written agreement,provided such contract or agreement:
(1) is currently in effect or becomes effective during the term of this Coverage Part;and
(2) was executed prior to:
(a) the bodily injury or property damage;or
(b) the offense that caused the personal and advertising injury,
for which such additional insured seeks coverage.
b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer
will not provide such additional insured with:
(1) a higher limit of insurance than required by such contract or agreement;or
(2) coverage broader than required by such contract or agreement, and In no event broader than that described
by the applicable paragraph A.through H.below.
My coverage granted by this endorsement shall apply only to the extent permissible by law.
A. Controlling Interest
My person or organization with a controlling interest in a Named Insured,but only with respect to such person or
organization's liability for bodily injury,property damage or personal and advertising Injury arising out of
1. such person or organization's finandal control of a Named Insured;or
2. premises such person or organization owns, maintains or controls while a Named Insured leases or
occupies such premises;
provided that the overage granted by this paragraph does not apply to structural alterations, new construction or
demolition operations performed by,on behalf of,or for such additional insured.
B. Co-owner of Insured Premises
A co-owner of a premises co-owned by a Named Insured and covered under this insurance but only with respect
to such co-owner's liability for bodily Injury, property damage or personal and advertising Injury as co-owner
of such premises.
C. Lessor of Equipment
My person or organization from whom a Named Insured leases equipment but only with respect to liability for
bodily Injury,property damage or personal and advertising Injury caused, in whole or in part,by the Named
Insured's maintenance, operation or use of such equipment, provided that the occurrence giving rise to such
bodily Injury,property damage or the offense giving rise to such personal and advertising Injury takes place
prior to the termination of such lease.
D. Lessor of Land
My person or organization from whom a Named Insured leases land but only with respect to liability for bodily
Injury,property damage or personal and advertising injury arising out of the ownership, maintenance or use
of such land, provided that the occurrence giving rise to such bodily Injury, property damage or the offense
giving rise to such personal and advertising Injury takes place prior to the termination of such lease. The
CNA74705XX(1-15) Policy No: 4034064756
Page 2 of 17 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date 09/12/2016
Insured Name:9ARco4 CONSTRUCTION, INC.
Upright olA AI Riaib Rosined. I chairs capy,Id,rol mn W l°,liniments Swim Once.Inc.,with%permission.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by,on behalf of,or for such additional insured.
E. Lessor of Premises
An owner or lessor of premises leased to the Named Insured,or such owner or lessors real estate manager,but
only with respect to liability for bodily injury,property damage or personal and advertising injury arising out of
the ownership,maintenance or use of such part of the premises leased to the Named Insured,and provided that
the occurrence giving rise to such bodily injury or property damage,or the offense giving rise to such personal
and advertising Injury, takes place prior to the termination of such lease. The coverage granted by this
paragraph does not apply to structural alterations, new construction or demolition operations performed by, on
behalf of,or for such additional insured.
F. Mortgagee,Assignee or Receiver
A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receivers
liability for bodily Injury, property damage or personal and advertising injury arising out of the Named
Insured's ownership,maintenance,or use of a premises by a Named Insured.
The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition
operations performed by,on behalf of,or for such additional insured.
G. State or Governmental Agency or Subdivision or Political Subdivisions—Permits
A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization but
only with respect to such state or governmental agency or subdivision or political subdivisions liability for bodily
injury,property damage or personal and advertising injury arising out of
1. the following hazards in connection with premises a Named Insured owns. rents, or controls and to which
this insurance applies:
a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings,
canopies,cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk
vaults,sheet banners,or decorations and similar exposures;or
b. the construction,erection,or removal of elevators;or
c. the ownership,maintenance or use of any elevators covered by this insurance;or
$ 2. the permitted or authorized operations performed by a Named Insured or on a Named Insured's behalf.
@ The coverage granted by this paragraph does not apply to:
a. Bodily injury,property damage or personal and advertising Injury arising out of operations performed
for the state or governmental agency or subdivision or political subdivision;or
b. Bodily injury or property damage included within the products-completed operations hazard.
With respect to this provislon's requirement that additional insured status must be requested under a written
contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the
Named Insured to add the governmental entity as an additional insured.
H. Trade Show Event Lessor
= 1. With respect to a Named Insured's participation in a trade show event es an exhibitor,presenter or displayer,
any person or organization whom the Named Insured Is required to include as an additional insured, but only
with respect to such person or organization's liability for bodily injury, property damage or personal and
advertising Injury caused by.
11
CNA74705XX(1-15) Policy No: 9034064756
Page 3 0117 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:SARCOM CONSTRUCTION, INC.
cyyl itaa,O➢Rib Reserved. Includes c I.1ghltl material of ns,rerca Services Orrice.Fen with i6 permission.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
a. the Named insured's acts or omissions;or
b. the acts or omissions of those acting on the Named Insured's behalf,
in the performance of the Named Insured's ongoing operations at the trade show event premises during the
trade show event
2. The coverage granted by this paragraph does not apply to bodily Injury or properly damage included within
the products-completed operations hazard.
2. ADDITIONAL INSURED-PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE
The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section Is amended to
add the blowing paragraph:
If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and non-
contributory relative to an additional insured's own instance,then this insurance is primary, and the Insurer will not
seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own
insurance means insurance on which the additional insured is a named insured. Otherwise, and notwithstanding
anything to the contrary elsewhere in this Condition,the insurance provided to such person or organization is excess
of any other insurance available to such person or organization.
3. BODILY INJURY—EXPANDED DEFINITION
Under DEFINITIONS,the definition of bodily injury is deleted and replaced by the following:
Bodily Injury means physical injury, sickness or disease sustained by a person, including death, humiliation, shock,
mental anguish or mental Injury sustained by that person at any time which results as a consequence of the physical
injury,sickness or disease.
4. BROAD KNOWLEDGE OF OCCURRENCE/NOTICE OF OCCURRENCE
Under CONDITIONS,the condition entitled Dulles In The Event of Occurrence,Offense,Claim or Suit is amended
to add the following provisions:
A. BROAD KNOWLEDGE OF OCCURRENCE
The Named Insured must give the Insurer or the Insurer's authorized representative notice of an occurrence,
offense or claim only when the occurrence,offense or claim is known to a natural person Named Insured,to a
partner, executive officer, manager or member of a Named Insured, or an employee designated by any of the
above to give such notice.
B. NOTICE OF OCCURRENCE
The Named insured's rights under this Coverage Part will not be prejudiced If the Named Insured falls to give
the Insurer notice of an occurrence, offense or claim and that failure is solely due to the Named Insured's
reasonable belief that the bodily Injury or property damage is not covered under this Coverage Part. However,
the Named Insured shall give written notice of such occurrence,offense or claim to the Insurer as soon as the
Named Insured is aware that this insurance may apply to such occurrence,offense or claim.
5. BROAD NAMED INSURED
WHO 5 AN INSURED is amended to delete its Paragraph 3.in Its entirety and replace it with the following:
3. Pursuant to the limitations described in Paragraph 4. below, any organization In which a Named Insured has
management control:
a. on the effective date of this Coverage Part;or
CNA74705XX(1-15) Policy No: 4034064756
Page 4 0117 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/13/3016
Insured Name:BARCOM CONSTRUCTION, INC.
cep„Ipm cNA M Rights Res.val. Includes ccn.1gnnd msladel or ewnros S.rm Once.bit..with he p.Mvim.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
b. by reason of a Named Insured creating or acquiring the organization during the policy period,
qualifies as a Named Insured, provided that there is no other similar liability insurance, whether primary,
contributory,excess,contingent or otherwise,which provides coverage to such organization,or which would have
provided coverage but for the exhaustion of Its limit, and without regard to whether its coverage is broader or
narrower than that provided by this insurance.
But this BROAD NAMED INSURED provision does not apply to:
(a) any partnership,limited liability company orjoint venture;or
(b) any organization for which coverage Is excluded by another endorsement attached to this Coverage Part.
For the purpose of this provision,management control means:
A. owning interests representing more than 50% of the voting, appointment or designation power for the
selection of a majority of the Board of Directors of a corporation;or
B. having the right,pursuant to a written trust agreement,to protect, control the use of,encumber or transfer or
sell property held by a trust.
4. With respect to organizations which qualify as Named Insureds by virtue of Paragraph 3. above,this insurance
does not apply to:
a. bodily Injury or property damage that first occurred prior to the date of management control, or that first
occurs after management control ceases;nor
b. personal or advertising injury caused by an offense that first occurred prior to the date of management
control or that first occurs after management control ceases.
5. The insurance provided by this Coverage Part applies to Named Insureds when trading under their own names
or under such other trading names or doing-business-as names(dba) as any Named Insured should choose to
employ.
& BROADENED LIABILITY COVERAGE FOR DAMAGE TO YOUR PRODUCT AND YOUR WORK
A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete exclusions k.and I.and replace them with the following:
This insurance does not apply to:
it Damage to Your Product
Property damage to your product arising out of II,or any part of it except when caused by or resulting from:
(1) fire;
(2) smoke;
(3) collapse;or
(4) explosion.
L Damage to Your Work
Property damage to your work arising out of itor any part of it and included in the products-completed
operations hazard.
Tho exclusion does not apply:
(1) If the damaged work, or the work out of which the damage arises, was performed on the Named
Insured's behalf by a subcontractor,or
CNA74705XX(1-15) Policy No: 4034064756
Page 5 of 17 Endorsement Na 1
TRANSPORTATION INSURANCE COMPANY Effective Data 09/12/2016
Insured Name:EARCOM CONSTRUCTION, INC.
CopplgMCNA KRj sResolved. Nodes cop!gnmd mensal of Inseam*entices MMm.Fc..wN,in pmsaion.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
(2) If the cause of loss to the damaged work arises as a result of:
(a) fire;
(b) smoke;
(c) collapse;or
(d) explosion.
B. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5.above,$100,000 Is the most the Insurer 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 productcompleted operations hazard. This sublimit
does not apply to property damage to your work if the damaged work, or the work out of which the damage
arises,was performed on the Named Insured's behalf by a subcontractor.
C. The Broadened Liability Coverage For Damage To Your Product And Your Work Provision does not apply If
an endorsement of the same name is attached to this policy.
7. CONTRACTUAL LIABILITY—RAILROADS
With respect to operations performed within 50 feet of railroad property, the definition of Insured contract Is replaced
by the following:
Insured Contract means:
a, A contract for a lease of premises.However,that portion of the contract for a lease of premises that indemnifies
any person or organization for damage by fire to premises while rented to a Named Insured or temporarily
occupied by a Named Insured wth permission of the owner is not an Insured contract;
b. A sidetrack agreement;
c. My easement or license agreement
d. M obligation, as required by ordinance, to indemnity a municipality, except in connection with work for a
municipality;
e. M elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to the Named Insured's business (including an
indemnification of a municipality in connection with work performed for a munidpalty) under which the Named
Insured assumes the tort liability of another party to pay for bodily Injury or property damage to a third person
or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or
agreement.
Paragraph f.does not include that part of any contract or agreement:
(1) That indemnifies an architect,engineer or surveyor for Injury or damage arising out of
(a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders,change orders or drawings and specifications;or
(b) Giving directions or instructions, or failing to give them. If that Is the primary cause of the Injury or
damage;
(2) Under which the Insured, if an architect, engineer or surveyor, assumes liabitty for an Injury or damage
arising out of the insured's rendering or failure to render professional services, including those listed in (1)
above and supervisory,inspection,architectural or engineering activities.
8. ELECTRONIC DATA LIABILITY
CNA74705)OC(1-15) Policy No: 4034064756
Page 6 of 17 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
ccgrydgM CNA Agfights Rrevea. meudas ccp'gIghdd meatal of lnsinnce Sanies Office.Inc..wit,its y.n®ia,.
CNA/i CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
A Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions Is amended to delete exclusion p.Electronic Data and replace It with the following:
This insurance does not apply to:
p. Access Or Disclosure Of Confidential Or Personal Information And Data-related Liability
Damages arising out of:
(1) any access to or disclosure of any person's or organization's confidential or personal information.
including patents, trade secrets, processing methods, customer lists, financial information, credit card
Information,health information or any other type of nonpublic Information:or
(2) the loss of, loss of use of, damage to, corruption of, inability to access, or Inability to manipulate
electronic data that does not result from physical injury to tangible property.
However, unless Paragraph(1)above applies,this exclusion does not apply to damages because of bodily
Injury.
This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses,
forensic expenses, public relation expenses or any other loss, cost or expense incurred by the Named
Insured or others arising out of that which Is described In Paragraph(1)or(2)above.
B. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5.above, $100,000 is the most the Insurer will pay under Coverage A for all damages arising out of
any one occurrence because of property damage that results from physical injury to tangible properly and
arises out of electronic data.
C. The following definition is added to DEFINITIONS:
Electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or
from computer software (including systems and applications software), hard or floppy disks, CD-ROMS, tapes,
drives,cells,data processing devices or any other media which are used with electronically controlled equipment.
D. For the purpose of the coverage provided by this ELECTRONIC DATA LIABILITY Provision, the definition of
property damage in DEFINITIONS Is replaced by the following:
Property damage means:
a. Physical Injury to tangible property, including all resulting loss of use of that property. All such loss of use
shall be deemed to occur at the time of the physical injury that caused it
b. Loss of use of tangible property that is not physically injured.All such loss of use shall be deemed to occur at
the time of the occurrence that caused It or
c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate
electronic data, resulting from physical injury to tangible property. All such loss of electronic data shall be
deemed to occur at the time of the occurrence that caused it.
For the purposes of this insurance,electronic data is not tangible property.
E. If Electronic Data flablily is provided at a higher lint by another endorsement attached to this policy, then the
$100,000 limit provided by this ELECTRONIC DATA LIABILITY Provision Is part of, and not In addition to, that
higher limit.
9. ESTATES,LEGAL REPRESENTATIVES,AND SPOUSES
BThe estates,heirs,legal representatives and spouses of any natural person Insured shall also be insured under this
polity, provided, however, coverage Is afforded to such estates, heirs, legal represeMatNes, and spouses only for
= CNA7/705XX(1-15) Policy No: 4034064756
Page 7 of 17 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCaI CONSTRUCTION, INC.
copyright CNA AU Rion®Reserved. Includes copyrighted mSedal or Mfurerce Unites Office,hie_wie i¢pantioim.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
claims arising solely out of their capacity or status as such and, in the case of a spouse, where such claim seeks
damages from marital community property, jointly held property or property transferred from such natural person
Insured to such spouse. No coverage is provided for any act, error or omission of an estate, heir, legal
representative,or spouse outside the scope of such person's capacity or status as such, provided however that the
spouse of a natural person Named Insured and the spouses of members or partners of joint venture or partnership
Named Insureds are Insureds with respect to such spouses'acts,errors or omissions In the conduct of the Named
Insured's business.
10. EXPECTED OR INTENDED INJURY—EXCEPTION FOR REASONABLE FORCE
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Expected or Intended Injury and replace It with the following:
This insurance does not apply to:
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.
11. GENERAL AGGREGATE LIMITS OF INSURANCE-PER PROJECT
A. For each construction project away from premises the Named Insured owns or rents, a separate Construction
Project General Aggregate IJmt,equal to the amount of the General Aggregate Limit shown in the Declarations,
Is the most the Insurer will pay for the sum of:
1. All damages under Coverage A.except damages because of bodily injury or property damage included in
the products-completed operations hazard;and
2. Al medical expenses under Coverage C,
that arise from occurrences or accidents which can be attributed solely to ongoing operations at that construction
project Such payments shall not reduce the General Aggregate Limit shown In the Declarations, nor the
Construction Project General Aggregate Limit of any other construction project.
B. All:
1. Damages under Coverage B,regardless of the number of locations or construction projects involved;
2. Damages under Coverage A, caused by occurrences which cannot be attributed solely to ongoing
operations at a single construction project,except damages because of bodily Injury or property damage
included In the products-completed operations hazard;and
3. Medical expenses under Coverage C caused by accidents which cannot be attributed solely to ongoing
operations at a single construction project,
will reduce the General Aggregate Limit shown in the Declarations.
C. The limits shown In the Declarations for Each Occurrence, for Damage To Premises Rented To You and for
Medical Expense continue to apply,but will be subject to either the Construction Project General Aggregate Limit
or the General Aggregate Limit shown In the Declarations, depending on whether the occurrence can be
attributed solely to ongoing operations at a particular construction project.
D. When coverage for liability arising out of the products-completed operations hazard is provided, any payments
for damages because of bodily Injury or property damage included in the products-completed operations
hazard will reduce the Products-Completed Operations Aggregate Limit shown In the Declarations, regardless of
the number of projects involved.
CNA74705)OC(1-15) Policy No: 4034064756
Page 8 of 17 Endorsement No:
TRANSPORTATION INSURANCE COMPANY Effective Date: 0x/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
Copyright CNA AORbhbRvvpd. Inches cWMghdd mn.ln orFslams Sink"ORu. ,c..v*is Amman.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
E. If a single construction project away from premises owned by or rented to the Insured has been abandoned and
then restarted, or it the authorized contracting parties deviate from plans, blueprints, designs, specifications or
timetables,the project will still be deemed to be the same construction project
F. The provisions of LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as
stipulated.
12. IN REM ACTIONS
A quasi in rem action against any vessel owned or operated by or for the Named Insured,or chartered by or for the
Named Insured, will be treated In the same manner as though the action were in personam against the Named
Insured.
13. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE
Solely with respect to bodily Injury that arises out of a health care Incident:
A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Insuring Agreement is amended to replace Paragraphs 1.b.(1)and 1.b.(2)with the following:
b. This insurance applies to bodily Injury provided that the professional health care services are incidental to
the Named Insured's primary business purpose,and only it
(1) such bodily injury is caused by an occurrence that takes place In the coverage territory.
(2) the bodily Injury first occurs during the policy period.Al bodily Injury arising from an occurrence will
be deemed to have occurred at the time of the first act, error,or omission that Is part of the occurrence;
and
B. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions Is amended to:
i. add the following to the Employers Liability exclusion:
This exclusion applies only It the bodily injury arising from a health care incident is covered by other
liability insurance available to the Insured (or which would have been available but for exhaustion of its
limits).
RII. delete the exclusion entitled Contractual Liability and replace it with the following:
This insurance does not apply to:
Contractual Liability
the Insured's actual or alleged liability under any oral or written contract or agreement, including but not
limited to express warranties or guarantees.
III. add the following additional exclusions:
This insurance does not apply to:
MEM
M20 Discrimination
any actual or alleged discrimination, humiliation or harassment, including but not limited to claims based on
BBB an IndMdual's race, creed, color, age, gender, national origin, religion, disability, marital status or sexual
orientation.
Dishonesty or Crime
My actual or alleged dishonest,criminal or malicious act,error or omission.
®EOM MedicarelMadkaid Fraud
CNA74705XX(1-15) PolicyNo: 4034064756
Page 9 of 17 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:RARCOM CONSTRUCTION, INC.
CpwiP.t CNA M Rights Reserve]. Includes copyi1gh led muaiai of Insurance Smokes Office.Inc..,de ha pantlnko.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
any actual or alleged violation of law with respect to Medicare, Medicaid, Tricare or any similar federal,state
or local governmental program.
Services Excluded by Endorsement
Any health care incident for which coverage is excluded by endorsement
C. DEFINITIONS Is amended to:
I. add the following definitions:
Health care Incident means an act, error or omission by the Named Insured's employees or volunteer
workers In the rendering of
a. professional health care services on behalf of the Named Insured or
b. Good Samaritan services rendered In an emergency and for which no payment is demanded or received.
Professional health care services means any health care services or the related furnishing of food,
beverages, medical supplies or appliances by the following providers in their capacity as such but solely to
the extent they are duly licensed as required:
a. Physician;
b. Nurse;
c. Nurse practitioner;
d. Emergency medical technician;
e. Paramedic;
f. Dentist;
g. Physical therapist
h. Psychologist;
I. Speech therapist;
J. Other allied health professional;or
Professional health care services does not Include any services rendered In connection with human clinical
trials or product testing.
II. delete the definition of occurrence and replace it with the following:
Occurrence means a health care incident.All acts,errors or omissions that are logically connected by any
common fact,circumstance,situation,transaction,event,advice or derision will be considered to constitute a
single occurrence;
III. amend the definition of Insured to:
a. add the following:
the Named Insured's employees are Insureds with respect to:
(1) bodily Injury to a co-employee while in the course of the co-employee's employment by the
Named Insured or while performing duties related to the conduct of the Named Insured's
business;and
CNA74705XX(1-15) Policy No: 4039069756
Page 10 of 17 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Dale: 09/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
copyrightaA maom Rrwt Includes cWydghted malarial mhau.,u Services Once,Inc..with Its p.mlwu,.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
(2) bodily injury to a volunteer worker while performing duties related to the conduct of the
Named Insured's business;
when such bodily injury arises out of a health care incident.
the Named Insured's volunteer workers are Insureds with respect to:
(1) bodily injury to a co-volunteer worker while performing duties related to the conduct of the
Named Insureds business;and
(2) bodily Injury to an employee while in the course of the employee's employment by the Named
Insured or while performing duties related to the conduct of the Named Insured's business;
when such bodily Injury arises out of a health care Incident.
b. delete Subparagraphs(a),(b),(c)and(d)of Paragraph 2.a.(1)of WHO IS AN INSURED.
D. The Other Insurance condition is amended to delete Paragraph b.(1) in its entirety and replace it with the
following:
Other Insurance
b. Excess Insurance
(1) To the extent this insurance applies, it Is excess over any other insurance,self insurance or risk transfer
instrument, whether primary,excess, contingent or on any other basis, except for insurance purchased
specifically by the Named Insured to be excess of this coverage.
14. JOINT VENTURES/PARTNERSHIP/LIMITED LIABILITY COMPANIES
WHO IS AN INSURED is amended to delete its last paragraph and replace it with the following:
No person or organization is an Insured with respect to the conduct of any current or past partnership,joint venture or
limited liabilly company that is not shown as a Named Insured in the Declarations,except that if the Named Insured
was a joint venturer, partner,or member of a limited liability company and such joint venture, partnership or limited
liability company terminated prior to or during the policy period,such Named Insured is an Insured with respect to
its interest In such joint venture,partnership or limited liability company but only to the extent that
R a. any offense giving rise to personal and advertising Injury occurred prior to such termination date, and the
personal and advertising Injury arising out of such offense first occurred after such termination date;
a
b. the bodily injury or property damage first occurred after such termination date;and
c. there is no other valid and collectible insurance purchased specifically to insure the partnership,joint venture or
limited liability company;and
If the joint venture, partnership or limited liability company is or was insured under a consolidated (wrap-up)
insurance program,then such insurance will always be considered valid and collectible for the purpose of paragraph
c.above. But this provision will not serve to exclude bodily injury, property damage or personal and advertising
injury that would otherwise be covered under the Contractors General Liability Extension Endorsement provision
® entitled WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS.
Please see that provision for the definition of consolidated(wrap-up)Insurance program.
m 15. LEGAL LIABILITY — DAMAGE TO PREMISES I ALIENATED PREMISES I PROPERTY IN THE NAMED
- INSURED'S CARE,CUSTODY OR CONTROL
- A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions Is amended to delete exclusion J.Damage to Property in its entirety and replace it with the following:
This insurance does not apply to:
B
CNA74705XX(1-15) Policy Na 4034064756
Page 11 of 17 Endorsement Na 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
Copyright CNA AURObs Ruawd, bduds cop,Ir.d mesial or Nsrard Swbv omce.Ina,w ,is PSTNpan.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
) Damage to Properly
Property damage to:
(1) Property the Named Insured owns, rents,or occupies,including any costs or expenses incurred by you,
or any other person, organization or entity, for repair, replacement, enhancement, restoration or
maintenance of such property for any reason, including prevention of injury to a person or damage to
another's property;
(2) Premises the Named Insured sells,gives away or abandons, if the property damage arises out of any
part of those premises;
(3) Property loaned to the Named Insured;
(4) Personal property In the care,Custody or control of the Insured;
(5) That particular part of real property on which the Named Insured or any contractors or subcontractors
working directly or indirectly on the Named Insured's behalf are performing operations, If the property
damage arises out or those operations;or
(6) That particular part of any property that must be restored, repaired or replaced because your work was
incorrectly performed on It.
Paragraphs(1),(3)and(4)of this exclusion do not apply to property damage(other than damage by fire)to
premises rented to the Named Insured or temporarily occupied by the Named Insured with the permission of
the owner, nor to the contents of premises rented to the Named Insured for a period of 7 or fewer
consecutive days.A separate limit of insurance applies to Damage To Premises Rented To You as described
in LIMITS OF INSURANCE.
Paragraph(2)of this exclusion does not apply if the premises are your work.
Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack
agreement.
Paragraph (6) of this exclusion does not apply to properly damage included in the products-completed
operations hazard.
Paragraphs(3)and(4)of this exclusion do not apply to property damage to:
I. tools,or equipment the Named Insured borrows from others,nor
II. other personal property of others in the Named Insured's care,custody or control while being used in the
Named Insured's operations away from any Named Insured's premises.
However,the coverage granted by this exception to Paragraphs(3)and(4)does not apply to:
a. property at a job site awaiting or during such property's Installation,fabrication,or erection;
b. property that is mobile equipment leased by an Insured;
c. property that Is an auto,aircraft or watercraft;
d. property in transit or
e. any portion of property damage for which the Insured has available other valid and colledible
insurance,or would have such insurance but for exhaustion of Its limits,or but for application of one of its
exclusions.
A separate limit of insurance and deductible apply to such property of others. See LIMITS OF INSURANCE
as amended below.
CNA74705XX(1-15) Policy No: 4034064756
Page 12 of 17 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
Copyright OU NI RV's Rrev W. Includes copyrighted mated.,of Insurance Sevbs Office.Inc,.wit its par-Asian
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
B. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions Is amended to delete its last paragraph and replace it with the following:
Exclusions c. through n. do not apply to damage by fire to premises while rented to a Named Insured or
temporarily occupied by a Named Insured with permission of the owner, nor to damage to the contents of
premises rented to a Named Insured for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to this coverage as described in LIMITS OF INSURANCE.
C. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5.above,$25,000 Is the most the Insurer will pay under Coverage A for damages arising out of any
one occurrence because of the sum of all property damage to borrowed tools or equipment, and to other
personal property of others in the Named Insured's care, custody or control, while being used In the Named
Insured's operations away from any Named Insured's premises. The Insurers obligation to pay such property
damage does not apply until the amount of such property damage exceeds$1,000.The Insurer has the right but
not the duty to pay any portion of this$1,000 in order to effect settlement. If the Insurer exercises that right, the
Named Insured will promptly reimburse the Insurer for any such amount.
D. Paragraph 6.,Damage To Premises Rented To You Limit, of LIMITS OF INSURANCE Is deleted and replaced by
the following:
6. Subject to Paragraph 5.above, (the Each Occurrence Limit),the Damage To Premises Rented To You Limit
Is the most the Insurer will pay under Coverage A for damages because of property damage to any one
premises while rented to the Named Insured or temporarily occupied by the Named Insured with the
permission of the owner,including contents of such premises rented to the Named Insured for a period of 7
or fewer consecutive days.The Damage To Premises Rented To You Limit is the greater of
a. $500,000;or
b. The Damage To Premises Rented To You Limit shown In the Declarations.
E. Paragraph 4.b.(1)(a)(1i)of the Other Insurance Condition is deleted and replaced by the following:
(II) That is property insurance for premises rented to the Named Insured,for premises temporarily occupied by
the Named Insured with the permission of the owner, or for personal property of others in the Named
Insured's care,custody or control;
16. LIQUOR LIABILITY
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Liquor Liability.
This LIQUOR LIABILITY provision does not apply to any person or organization who otherwise qualifies as an
additional insured on this Coverage Part.
17. MEDICAL PAYMENTS
® A. LIMITS OF INSURANCE Is amended to delete Paragraph 7. (the Medical Expense Limit)and replace It with the
following:
® 7. Subject to Paragraph 5. above (the Each Occurrence Unlit), the Medical Expense Limit is the most the
Insurer will pay under Coverage C—Medical Payments for all medical expenses because of bodily injury
EMS sustained by any one person.The Medical Expense Limit Is the greeter o1:
(1) $15,000 unless a different amount is shown here: $N,NNN,NNN,NNN; or
(2) the amount shown in the Declarations for Medical Expense Umit.
o CNA74705XX(1-15) Policy No: 4034064756
Page 13 of 17 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCOi CONSTRUCt'ION, INC.
Capriraa M RiON Rnm.l. Includes coprigh.d mai Sal of Insurance Services Moe.loc..with Its pemtsbm.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
B. Under COVERAGES, the Insuring Agreement of Coverage C — Medical Payments is amended to replace
Paragraph 1.a.(3)(b)with the following:
(b) The expenses are incurred and reported to the Insurer within three years of the date of the accident and
19. NON-OWNED AIRCRAFT
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions Is amended as follows:
The exclusion entitled Aircraft Auto or Watercraft is amended to add the following:
This exclusion does not apply to an aircraft not owned by any Named Insured,provided that:
1. 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;
2. the aircraft is rented with a trained,paid crew to the Named Insured;and
3. the aircraft is not being used to carry persons or property for a charge.
19. NON-OWNED WATERCRAFT
Under COVERAGES, Coverage A — Bodily Injury and Properly Damage Liability, the paragraph entitled
Exclusions is amended to delete subparagraph (2) of the exclusion entitled Aircraft, Auto or Watercraft, and
replace it with the following.
This exclusion does not apply to:
(2) a watercraft mat Is not owned by any Named Insured,provided the watercraft Is:
(a) less than 75 feet long;and
(b) not being used to carry persons or properly fora charge.
20. PERSONAL AND ADVERTiSING INJURY—DISCRIMINATION OR HUMILIATION
A. Under DEFINITIONS,the definition of personal and advertising Injury Is amended to add the following tort:
Discrimination or humiliation that results in injury to the feelings or reputation of a natural person.
B. Under COVERAGES, Coverage B — Personal and Advertising Injury Liability, the paragraph entitled
Exclusions is amended to:
1. delete the Exclusion entitled Knowing Violation Of Rights Of Another and replace it with the following:
This insurance does not apply to:
Knowing Violation of Rights of Another
Personal and advertising injury caused by or at the direction of the Insured with the knowledge that the act
would violate the rights of another and would inflict personal and advertising injury. This exclusion shall not
apply to discrimination or humiliation that results In injury to the feelings or reputation of a natural person, but
only if such discrimination or humiliation is not done intentionally by or at the direction of:
(a) the Named Insured;or
(b) any executive officer, director, stockholder, partner, member or manager (if the Named Insured is a
limited liability company)of the Named Insured.
2. add the following exclusions:
CNA74705XX(1-15) Policy No: 9034069756
Page 14 of 17 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
Copyright CNA MRidhbaawel. Includes copyrighted mamtel ofhs,rerce Services Office.Inc..with itspmasin.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
This insurance does not apply to:
Employment Related Discrimination
Discrimination or humiliation directly or indirectly related to the employment, prospective employment, past
employment or termination of employment of any person by any Insured.
Premises Related Discrimination
discrimination or humiliation arising out of the sale, rental, lease or sub-lease or prospective sale, rental,
lease or sub-lease of any room,dwelling or premises by or at the direction of any Insured.
Notwithstanding the above, there is no overage for fines or penalties levied or imposed by a governmental entity
because of discrimination.
The overage provided by this PERSONAL AND ADVERTISING INJURY-DISCRIMINATION OR HUMILIATION
Provision does not apply to any person or organization whose statuses an Insured derives solely from
Provision 1.ADDITIONAL INSURED of This endorsement;or
attachment of an additional insured endorsement to this Coverage Part.
This PERSONAL AND ADVERTISING INJURY-DISCRIMINATION OR HUMILIATION Provision does not apply to
any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
21. PERSONAL AND ADVERTISING INJURY•CONTRACTUAL LIABILITY
A. Under COVERAGES, Coverage B -Personal and Advertising Injury Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Contractual Liability.
B. Solely for the purpose of the coverage provided by this PERSONAL AND ADVERTISING INJURY •
CONTRACTUAL LIABILITY provision, the following changes are made to the section entitled
SUPPLEMENTARY PAYMENTS-COVERAGES A AND B:
1. Paragraph 2.d.is replaced by the following:
d. The allegations in the suit and the information the Insurer knows about the offense alleged in such suit
are such that no conflict appears to exist between the interests of the Insured and the interests of the
indemnitee;
a
2. The first unnumbered paragraph beneath Paragraph 2.f.(2)(b)Is deleted and replaced by the following:
So long as the above conditions are met, attorneys fees incurred by the Insurer In the defense of that
indemnitee,necessary litigation expenses incurred by the Insurer,and necessary litigation expenses incurred
by the indemnitee at the Insurer's request will be paid as defense costs.Such payments will not be deemed
to be damages for personal and advertising injury and will not reduce the limits of insurance.
C. This PERSONAL AND ADVERTISING INJURY - CONTRACTUAL LIABILITY Provision does not apply if
Coverage B-Personal and Advertising Injury Liability is excluded by another endorsement attached to this
Coverage Part.
- This PERSONAL AND ADVERTISING INJURY - CONTRACTUAL LIABILITY Provision does not apply to any
- person or organization who otherwise queries as an additional insured on this Coverage Part.
e
= 22. PROPERTY DAMAGE-ELEVATORS
- A. Under COVERAGES, Coverage A - Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended such that the Damage to Your Produce Exclusion and subparagraphs(3),(4)and(6)of
the Damage to Property Exclusion do not apply to property damage that results from the use of elevators.
1=1 CNA74705XX(1-15) Policy No: 4034064756
Page 15 of 17 Endorsement Na 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
UgRigMCNA h RIph Reserved. NCWs ccp,1olUed natal of Insurance Services Oau.Inc..with Bs ,..,ã ,.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
B. Soley for the purpose of the overage provided by this PROPERTY DAMAGE- ELEVATORS Provision, the
Other Insurance conditions Is amended to add the following paragraph:
This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other
basis that Is Property insurance covering property of others damaged from the use of elevators.
23. SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS—COVERAGES A AND B is amended as follows:
A. Paragraph t.b. Is amended to delete the$250 limit shown for the cost of bail bonds and replace it with a$5,000.
limit and
B. Paragraph 14. Is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a
$1,000.limit.
24. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
If the Named Insured unintentionally falls to disclose all existing hazards at the inception date of the Named
insured's Coverage Par,the Insurer will not deny overage under this Coverage Part because of such failure.
25. WAIVER OF SUBROGATION-BLANKET
Under CONDITIONS,the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to
add the following:
The Insurer waives any right of recovery the Insurer may have against any person or organization because of
payments the Insurer makes for injury or damage arising out ot.
1. the Named Insured'ongoing operations;or
2. your work included In the productscompleted operations hazard.
However,this waiver applies only when the Named Insured has agreed In writing to waive such rights of recovery In
a written contract or written agreement,and only H such contract or agreement
1. is In effect or becomes effective during the term of this Coverage Part;and
2. was executed prior to the bodily Injury, property damage or personal and advertising injury giving rise to the
claim.
26. WRAP-UP EXTENSION:OCIP,CCIP,OR CONSOLIDATED(WRAP-UP)INSURANCE PROGRAMS
Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any
construction project In the state of Alaska, that is not permitted to be insured under a consolidated (wrap-up)
Insurance program by applicable state statute or regulation.
If the endorsement EXCLUSION—CONSTRUCTION WRAP-UP is attached to this policy, or another exclusionary
endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.) or Contractor Controlled Insurance
Programs(C.C.I.P.)is attached,then the following changes apply:
A. The following wording Is added to the above-referenced endorsement:
Wah respect to a consolidated (wrap-up) insurance program project in which the Named Insured Is or was
involved,this exclusion does not apply to those sums the Named Insured become legally obligated to pay as
damages because ot.
1. Bodily injury,property damage,or personal or advertising Injury that occurs during the Named Insurees
ongoing operations at the project, or during such operations of anyone acting on the Named Insured's
behalf;nor
CNA74705XX(1-15) Policy No: 4034064756
Page 16 of 17 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
Copaadhl CNA All Fars Revmtl. Include!'cogigMed malarial UWuraoa salvos Office.Inc..with Its pemission.
CNA CNA PARAMOUNT
Contractors' General Liability Extension Endorsement
2. Bodily Injury or properly damage included within the productscompleted operations hazard that arises
out of those portions of the project that are not residential structures.
B. Condition 4.Other Insurance is amended to add the following subparagraph 4.b.(1)(c):
This insurance is excess over:
(c) My of the other insurance whether primary, excess,contingent or any other basis that is insurance available
to the Named Insured as a result of the Named Insured being a participant in a consolidated (wrap-up)
Insurance program, but only as respects the Named Insured's involvement in that consolidated(wrap-up)
Insurance program.
C. DEFINITIONS Is amended to add the following definitions:
Consolidated(wrap-up) Insurance program means a construc0on, erection or demolition project for which the
prime contractorlproject manager or owner of the construction project has secured general liability insurance
covering some or all of the contractors or subcontractors involved in the project, such as an Owner Controlled
Insurance Program(O.C.I.P.)or Contractor Controlled Insurance Program(C.C.I.P.).
Residential structure means any structure where 30%or more of the square foot area is used or is intended to
be used for human residency,including but not limited to:
1. single or multifamily housing, apartments, condominiums, townhouses, co-operatives or planned unit
developments;and
2. the common areas and structures appurtenant to the structures In paragraph 1. (including pools, hot tubs,
detached garages,guest houses or any similar structures).
However, when there is no individual ownership of units, residential structure does not include military housing,
college/university housing or dormitories, long term care facllitles, hotels or motels. Residential structure also
does not include hospitals or prisons.
This WRAP-UP EXTENSION:OCIP,CCIP,OR CONSOLIDATED(WRAP-UP) INSURANCE PROGRAMS Provision
does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part.
i All other terms and conditions of the Policy remain unchanged.
E
This endorsement,which forms a part of and Is for attachment to the Policy issued by the designated Insurers,takes effect
on the effective date of said Policy at the hour stated in said Policy, unless another effective date Is shown below, and
expires concurrently with said Policy.
MEI
is
IMI
to
s
mat
CNA74705XX(1-15) Policy No: 4034064756
Page 17 of 17 Endorsement No: 1
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name;EARCON CONSTRUCTIOx, INC.
GROOM CNA m Rots Reserved. Includes cepsItwd melee&of hisesnceRevs®e Once.Inc..with a Per^tSme.
CNA CNA PARAMOUNT
Blanket Additional Insured -Owners, Lessees or
Contractors -with Products-Completed
Operations Coverage Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL UABILITY COVERAGE PART
It is understood and agreed as follows:
I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named
Insured Is required by written contract to add as an additional insured on this coverage part, including any such
person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such
person or organization Is an Insured only with respect to such person or organization's liability for.
A. unless paragraph B.below applies,
1. bodily injury,property damage,or personal and advertising injury caused in whole or in part by the acts
or omissions by or on behalf of the Named Insured and in the performance of such Named Insured's
ongoing operations as specified in such written contract;or
2. bodily injury or property damage caused in whole or in part by your work and included in the products-
completed operations hazard,and only If
a. the written contract requires the Named Insured to provide the additional insured such overage;and
b. this coverage part provides such coverage.
B. bodily injury,property damage,or personal and advertising injury arising out of your work described in such
written contract but only It
1. this coverage part provides coverage for bodily Injury or property damage included within the products
completed operations hazard;and
2. the written contract specifically requires the Named Insured to provide additional insured coverage under
the 11-85 or 10-01 edition of CO2010 or the 10-01 edition of CG2037.
II. Subject always to the terms and conditions of this policy, including the limits of insurance,the Insurer will not provide
such additional insured with:
A. coverage broader than required by the written contract;or
B. a higher limit of insurance than required by the written contract.
§ III. The insurance granted by this endorsement to the additional insured does not apply to bodily Injury, property
damage,or personal and advertising Injury arcing out of:
A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services,
including:
1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,
field orders,change orders or drawings and specifications;and
uo
2. supervisory, inspection,architectural or engineering activities;or
C B. any premises or work for which the additional insured Is specifically listed as an additional insured on another
endorsement attached to this coverage pan.
N. Notwithstanding anything to the contrary In the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS,
the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional
insured whether on a primary,excess,contingent or any other basis. However,if this insurance is required by written
CNA75079)O((1-15) Policy No: 4034064756
Page 1 of 2 Endorsement No: 3
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
Copyright CNA All Rights Reserved. Includes copyrighted mast&&el Is cars.Services omv.Inc..with I6 gamldlm.
CNA CNA PARAMOUNT
Blanket Additional Insured - Owners, Lessees or
Contractors -with Products-Completed
Operations Coverage Endorsement
contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to
insurance on which the additional insured Is a named insured.
V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL
LIABILITY CONDITIONS Is amended as follows:
The Condition entitled Duties In The Event of Occurrence,Offense,Claim or Suit is amended with the addition
of the following:
My additional insured pursuant to this endorsement will as soon as practicable:
1. give the Insurer written notice of any claim,or any occurrence or offense which may result in a claim:
2. except as provided In Paragraph IV. of this endorsement, agree to make available any other insurance the
additional insured has for any loss covered under this coverage pan;
3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer In the
investigation,defense,or settlement of the claim;and
4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program
applies to a loss that the Insurer covers under this coverage pail. However, If the written contract requires
this insurance to be primary and non-contributory,this paragraph (4)does not apply to insurance on which
the additional insured is a named insured.
The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer
receives written notice of a claim from the additional insured.
VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS Is amended to
add the following definition:
Written contract means a written contract or written agreement that requires the Named Insured to make a person
or organization an additional insured on this coverage part,provided the contract or agreement:
A. is currently in effect or becomes effective during the term of this policy,and
B. was executed prior to:
1. the bodily Injury or properly damage;or
2. the offense that caused the personal and advertising injury
for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law.
All other terms and conditions of the Policy remain unchanged.
This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers,takes effect
on the effective date of said Policy at the hour stated In said Policy, unless another effective date Is shown below, and
expires concurrently with said Policy.
CNA750797IX(1-15) Policy No: 9034064756
Page 2 of 2 Endorsement No: 3
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:spacaM CONSTRUCTION, INC.
Copright CNA AO 111015 Resented. blames,cpr6red malaW of Fw,uce Solas Oew.Int,veN paMss'vi.
CNA CNA PARAMOUNT
Waiver of Transfer of Rights of Recovery Against
Others to the Insurer Endorsement
This endorsement modifies insurance provided under the folkwAng:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
CITY OF CORPUS CHRISTI DEPARTMENT OF ENGINEERING SERVICES
Information required to complete this Schedule,if not shown above,will be shown in the Declarations.
It Is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To The Insurer
is amended by the addition of the following:
Solely with respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery
the Insurer may have against such person or organization because of payments the Insurer makes for Injury or damage
arising out of the Named Insured's ongoing opera ions or your work done under a contract with that person or
organization and included in the products-completed operations hazard.
NI other terms and conditions of the Policy remain unchanged.
iThis endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers,takes effect
on the effective date of said Policy at the hour stated In said Policy, unless another effective date is shown below, and
expires concurrently with said Policy.
0
0
le
O
B CNA750011XX(1-15( Policy No: 9034069756
Page 1 of 1 Endorsement No: 6
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCOM CONSTRUCTION, INC.
Copyright CNA All RIahm Reseractl. Includes coPYIEDMS mtl.isl of Nvmu Services Ogb.Nm..with ib Va®Ion.
CNA CNA PARAMOUNT
Changes - Notice of Cancellation or Material
Restriction Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABIUTY COVERAGE PART
EMPLOYEE BENEFITS LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
STOP GAP LIABILITY COVERAGE PART
TECHNOLOGY ERRORS AND OMISSIONS LIABILITY COVERAGE PART
SPECIAL PROTECTIVE AND HIGHWAY UABILITY POLICY—NEW YORK DEPARTMENT OF TRANSPORTATION
SCHEDULE
Number of days notice(other than for nonpayment of premium): 030
Number of days notice for nonpayment of premium: N/A
Name of person or organization to whom notices/III be sent CITY OF CORPUS CHRISTI DEPARTMENT OF
ENGINEERING SERVICES
Address; ATTN: CONTRACT ADMINISTRATOR
P.O. BOX 9277
CORPUS CHRISTI
TX 78469-9277
If no entry appears above,the number of days notice for nonpayment of premium will be 10 days.
"a It Is understood and agreed that in the event of cancellation or any material restrictions In coverage during the policy
i period, the Insurer also agrees to mail prior written notice of cancellation or material restriction to the person or
organization listed In the above Schedule. Such notice will be sent prior to such cancellation in the manner prescribed in
the above Schedule.
All other terms and conditions of the Policy remain unchanged.
This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers,takes effect
on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and
® expires concurrently with said Policy.
=ear
ire
CNA74702XX(1-15) Policy No: 4034064756
Page 1 of 1 Endorsement No: 19
TRANSPORTATION INSURANCE COMPANY Effective Date: 09/12/2016
Insured Name:BARCCM C@1STRUCCION, INC.
camnem nu An Nights R.ser.d.
Hareem Construction, Inc. CNA83359XX
CNA Pclicy4 C4039064790 (Ed.84112)
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
CONTRACTORS EXTENDED COVERAGE ENDORSEMENT
- BUSINESS AUTO PLUS -
This endorsement modifies Insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
L LIABILITY COVERAGE name,with your permission,while performing
duties related to the conduct of your business.
A. Who Is An Insured
"Policy," as used in this provision A.Who Is An
The folbwing Is added to Section II, Paragraph Insured,includes those policies that were In farce
A.1.,Who Is An Insured: on the inception date of this Coverage Form but
1. a. Any incorporated entity of which the 1. Which are no longer in force;or
Named Insured owns a majority of the
voting stock on the date of inception of 2. Whose limits have been exhausted.
this Coverage Form;provided that, B. Ball Bonds and Loss of Earnings
b. The insurance afforded by this provision Section 6, Paragraphs Al. (2) and A.2.(4) are
A.1. does not apply to any such entity revised as follows:
that Is an "insured" under any other
liability"policy'providing'auto'coverage. 1. In a.(2). the limit for the cost of bail bonds Is
2. Any organization you newly acquire or form, changed from$2,000 to$5,000;and
other than a limited liability company, 2. In a.(4), the limit for the loss of earnings is
partnership or joint venture, and over which changed from$250 to$500 a day.
you maintain majority ownership interest C. Fellow Employee
The insurance afforded by this provision A.2.: Section II,Paragraph 8.5 does not apply.
a. Is effective on the acquisition or formation Such coverage as Is afforded by this provision C.
date,and Is afforded only until the end of is excess over any other collectible insurance.
the policy period of this Coverage Form,
or the next anniversary of Its Inception Il. PHYSICAL DAMAGE COVERAGE
date,whichever is earlier. A. Glass Breakage -Hitting A Bird Or Animal -
b. Does not apply to: Falling Objects Or Missiles
if (1) "Bodily injury' or "property damage" The following Is added to Section III, Paragraph
$ mused by an "accident" that A.3.:
occurred before you acquired or With respect to any covered'auto,'any deductible
loaned the organization;or shown in the Declarations will not apply to glass
(2) Any such organization that is an breakage if such glass is repaired, in a manner
'insured" under any other liability acceptable to us,rather than replaced.
"policy"providing"auto'coverage. B. Transportation Expenses
3. Any person or organization that you are Section III, Paragraph AAs. is revised, with
= required by a written contract to name as an
® additional insured is an'insured'but only with respect to transportation expense incurred by you,
rossrespect to their legal liability for acts a to provide:
omissions of a person, who qualifies as an a. $60 per day, in lieu of$20;subject to
insured' under Section II - Who Is An
Insured and for wham Liability Coverage Is b. $1,800 maximum,in lieu of$600.
afforded under this policy. If required by C. Loss of Use Expenses
written contract,this insurance will be primary
and noncontributory to insurance on which Section III, Paragraph AA.b. is revised, with
= the additional insured is a Named Insured. respect to loss of use expenses incurred by you,
4. to provide:
An 'employee' of yours is an insured"while
® operating an "auto" hired or rented under a a. $1,000 maximum,in lieu of$600.
contract or agreement In that "employee's"
CNA6335%XX cwsv. cmecapa.um,taw. Page 1 of 3
(Ed.04112) wenn apydgMd meow of the hawse ao.bes Messed with b pamvipn.
CNA63359XX
(Ed.04112)
D. Hired"Autos" d. A $100 per occurrence deductible applies to
The following is added to Section III. Paragraph the coverage provided by this provision.
A.: G. Diminution In Value
5. Hired"Autos" The following Is added to Section III, Paragraph
If Physical Damage coverage is provided under B.6.'
This policy,and such coverage does not extend to Subject to the following,the "diminution in value"
Hired Autos, then Physical Damage coverage Is exclusion does not apply to:
extended to: a. Any covered "auto" of the private
a. Any covered "auto" you lease, hire, rent passenger type you lease, hire, rent or
or borrow without a driver,and borrow,without a driver for a period of 30
b. Any covered 'auto' hired or rented by days or less, while performing duties
your'employee"without a driver, under a related to the conduct of your business;
and
contract in that indMdual "employee's°
name, with your permission, while b. Any covered "auto" of the private
performing duties related to the conduct passenger type hired or rented by your
of your business. "employee"without a driver for a period of
C. The most we will pay for any one 30 days or less, under a contract in that
' individual "employees name, with your
accident' or loss" is the actual cash
value, cost of repair,cost of replacement permission, while performing duties
or $75,000, whichever Is less, minus a related to the conduct of your business.
$500 deductible for each covered auto. c. Such coverage as is provided by this
No deductible applies to loss"caused by provision Is limited to a "diminution In
fire or lightning. value" loss arising teeth/ out of
d. The physical damage coverage as is accidental damage and not as a result of
provided thisprovision Isequal to the the failure to make repairs; faulty or
by incomplete maintenance or repairs;or the
physical damage coverage(s)provided on installation of substandard parts.
your owned"autos."
e. Such physical damage coverage for hired d. The most we will pay for floss" to a
"autos"will: covered"auto" in any one accident is the
lesser of:
(1) Include loss of use, provided it Is the (1) $5,000;or
consequence of an "accident" for
which the Named Insured is legally (2) 20%of the°auto's"actual cash value
liable, and as a result of which a (ACV).
monetary loss is sustained by the Ill. Drive Other Car Coverage—Executive O(flcers
leasing or rental concern.
(2) Such coverage as is provided by this The following Is added to Sections II and III:
provision will be subject to a limit of 1. Any "auto" you don't own, hire or borrow is a
$750 per"accident" covered "auto' for Liability Coverage while being
E. Airbag Coverage used by, and for Physical Damage Coverage
while In the care,custody or control of,any of your
The following Is added to Section III, Paragraph "executive officers,"except
B.3.: a. An"auto"owned by that'executive officer'.or
The accidental discharge of an airbag shall not be a member of that person's household;or
considered mechanical breakdown. b. An "auto' used by that "executive officer"
F. Electronic Equipment while working in a business of selling,
Section III, Paragraphs BA.c and BA.d. are servicing,repairing or parking'eutos.'
deleted and replaced by the following: Such Liability and/or Physical Damage Coverage
c. Physical Damage Coverage on a covere0 as is afforded by this provision.
"auto" also applies to loos' to any (1) Equal to the greatest of those coverages
permanently installed electronic equipment afforded any covered"auto";and
including Its antennas and other accessories.
CNA63359XX caves ow CalioratIrry xwo. Page 2 of 3
(Ed.04112) t s mpMaraa mewmi of me I ware series&Office used".a,he pernwim.
CNA63359XX
(Ed.04/12)
(2) Excess over any other collectible damage, against any person or organization for
insurance. whom or which you are required by written
2. For purposes of this provision, "executive officer contract or agreement to obtain this waiver from
means a person holding any of the officer us.
positions created by your charter,constitution, by- This injury or damage must arise out of your
laws or any other similar governing document, activities under a contract with that person or
and, while a resident of the same household, organization.
Includes that Person's spouse. You must agree to that requirement prior to an
Such "executive officers" are "insureds" while 'accident"or loss."
using a covered"auto"described In this provision. C. Concealment,Misrepresentation or Fraud
N. BUSINESS AUTO CONDITIONS The following is added to Section IV, Paragraph
A. Duties In The Event Of Accident, Claim,Suit Or B.2.:
Loss Your failure to disclose all hazards existing on the date
The following Is added to Section IV, Paragraph of inception of this Coverage Form shall not prejudice
A2.a.: you with respect to the coverage afforded provided
(4) Your "employees" may know of an such failure or omission is not intentional.
"accident" or loss.' This will not mean D. Other Insurance
that you have such knowledge, unless The following is added to Section N, Paragraph
such"accident'or"loss"is known to you 8.5.:
or if you are not an individual, to any of
your executive officers or partners or your Regardless of the provisions of Paragraphs 5.a.
insurance manager. and 5.d. above, the coverage provided by this
The following Is added to Section IV, Paragraph policy shell be on a primary non-contributory
A16: basis. This provision Is applicable only when
required by a written contract That written
(6) Your "employees' may know of contract must have been entered into prior to
documents received concerning a claim "Accident"or"Loss."
or"suit."This will not mean that you have E. Polley Period,Coverage Territory
such knowledge, unless receipt of such
documents Is known to you or if you are Section IV, Paragraph B. 7.(5).(a). is revised to
not an individual,to any of your executive provide:
officers or partners or your insurance
manager. a. 45 days of coverage in lieu of 30 days.
B. Transfer Of Rights Of Recovery Against Others V. DEFINITIONS
d To Us Section V. Paragraph C. is deleted and replaced by
xthe following:
The following is added to Section IV, Paragraph
A.S. Transfer Of Rights Of Recovery Against "Bodily Injury means bodily Injury,sickness or disease
Others To Us: sustained by a person, including mental anguish,
We waive any right of recovery we may have, mental Injury or death resulting from any of these.
because of payments we make for injury or
e_
CNA63359XX Copyright,oaACep0u.0m,2000. Page 3 of 3
(Ed.04/12) Includes mm„yuim„wenni of the re"ece Services Once used with its pew n.
POLICY NEER INSURED NANS AND ADDRESS
C 4034064790 BARCOM CONSTRUCTION, INC.
5826 BEAR LANE
CORPUS CHRISTI, TX 78405
POLICY CHANGES
CA2048 DESIGNATED INSURED BLANKET
This Change Endorsement changes the Policy. Please read it carefully.
This Change Endorsement is a part of your Policy and takes effect on the
effective date of your Policy, unless another effective date is Shown.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED BLANKET
ANY PERSON OR ORGANIZATION THAT THE NAMED INSURED IS OBLIGATED TO
PROVIDE INSURANCE WHERE REQUIRED BY A WRITTEN CONTRACT OR AGREEMENT
IS AN INSURED, BUT ONLY WITH RESPECT TO LEGAL RESPONSIBILITY FOR
ACTS OR OMISSIONS OF A PERSON OR ORGANIZATION FOR WHOM LIABILITY
COVERAGE IS AFFORDED UNDER THIS POLICY.
EBB
saa
EEG
g. ,..44. as ( L
cwnaol1Wm.a
G-56015-8 (ED. 11/91)
CNA CN( d2391)
02/13)
NOTICE OF CANCELLATION OR MATERIAL CHANGE - DESIGNATED PERSON
OR ORGANIZATION
It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows:
In the event of cancellation or material change that reduces or restricts the insurance provided by this Coverage Form,we
agree to send prior notice of cancellation or material change to the person or organization scheduled below at the address
scheduled below. This endorsement does not emend our obligation to notify the Named Insured of cancellation as
described in the Common Policy Conditions or In another endorsement attached to this policy.
SCHEDULE
1. Number of days advance notice:
10 Days If we cancel for non-payment of premium.
30 Days If the policy Is cancelled for any other reason,or If coverage is restricted or reduced by endorsement.
2. Person or OrganIzation's Name and Address
Name: 'Per Schedule On File'
Attention: Cancellation notification to the above
Street Address: entities will not apply to cancellation
City,State,ZIP: for non payment of premium
e-mail address:
All other terms and conditions of the Policy remain unchanged.
o CNA723151IX(02/13) Policy No: C4034064790
Page 1 of 1 Endorsement No;
Effective Date: 09/12/16
Insured Name:BARCOM CONSTRUCTION, INC.
Copyright CNA NI Rights Reserve&.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 0304 B
(Ed.6-14)
TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3A.of the
Information Page.
We have the right to recover our payments from anyone liable for an Injury covered by this policy.We will not enforce our
right against the person or organization named In the Schedule,but this waiver appNes only with respect to bodily injury
arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver
from us.
This endorsement shall not operate directly or indirectly to benefit anyone not named In the Schedule.
The premium for this endorsement is shown in the Schedule.
Schedule
1. ( ) Specific Waiver
Name of person or organization
(X) Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
2. Operations:ALL TEXAS LOCATIONS AND OPERATIONS
3. Premium:
The premium charge for this endorsement shall be 2 percent of the premium developed on payroll in connection with
work performed for the above person(s)or organization(s)arising out of the operations described.
4. Advance Premium:SEE SCUD
g'e
This endorsement changes the policy to with 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 Effectve 09/12/16 Policy Na. NC434064773 Endorsement No.
Insured Barcom Construction, Inc. Premium
® Insurance Company Countersigned by
® INC 420304B
(Ed.06-14)
Capyiiale 2014 Nafonal Council on Compensation Insurance.Inc.NI Rights Reserved.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 06 01
(Ed.7-84)
TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3A. of the
Information Page.
In the event of cancellation or other material change of the policy, we will mail advance notice to the person or
organization named In the Schedule.The number of days advance notice Is shown in the Schedule.
This endorsement shall not operate directly or Indirectly to benefit anyone not named In the Schedule.
Schedule
1. Number of days advance notice: 30
2. Notice will be mailed to: CITY OF CORPUS CHRISTI
DEPARTMENT OF ENGINEERING
SERVICE
ATTN: CONTRACT ADMINISTRATOR
P.O. BOX 9277
CORPUS CHRISTI, TX 78469-9277
® This endorsement changes the policy to%Nth a is attached and is effects on the data issued orders otherwise stated.
(The information below is required only whin this endorsement is issued su ssqusnt to preparation of the policy.)
Endorsement Effective 09/12/16 Policy No. WC439064773 Endorsement No.
insured Barcom Construction, Inc. Premium$
O
WC 420601
(Ed.7-84)
CERTIFICATE OF INTERESTED PARTIES FORM 1295
1 ort
Complete Nos.1-4 end 6 B there we Interested parties. OFFICE USE ONLY
Complete Nos.1,2,3,5.and Gil there are no Interested partes. CERTIFICATION OF FILING
1 None of business entity filing form,and the city,state and country of the business entity's place Certificate Numben
of business.
Barcom Construction,Inc 2017-187350
Corpus Christi,TX United States Cale RIM:
2 Name of governmental entity or state agency that Is a party to the canbatt for which the form is 04/04/2017
being filed.
City of Corpus Christi pate Acknowledged:
ark- 4151 1-
3 Provide the Identification number used by the governmental'Miry or elate agency to track or Identify the contract,and provide a
description of the services,goods,or other property to be provided under the contract
117021
Construction
Nature of interest
Name of Interested Party City,State,Country(plate of business) (check applicable)
Controlling Intermediary
5 Check only If then is NO Interested Party. o
6 AFFIDAVIT l swear,or affirm,underpe nnkyop0ty. but and penury,that the above disclosure is and correct
s?!;a� JAMIE E.VICKERS
*41 NOTARY PUBLIC ile`
3....,..71 State of Texas .�AMx
Comm.Exp.00-21.2019
Signature of aufhorizetl a mntractlrp business entity
AFFIX NOTARY STAMP I SEAL ABOVE ` �j // //
Swomb subscribed belle me,by the said ,J./1/ /( 4/( /4Qn.tray the Yi-15 day of Y/ / ,
20 /j,to cerdywhich,witness my d and seal of office. 111
.."111.4‘ Am/P f kir&6 /ea tai/ y
lure of officer ad Motoring oath Printed name of officer administering T�Mcer administering oath
)
-provided by Texas Ethics Commission vmvtethics.slate.h.us Version V1.0.083