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R2020-044 2020-02-24RESOLUTION NO. R2020-44 A Resolution of the City Council of the City of Pearland, Texas, awarding a contract, through cooperative purchasing partner OMNIA Partners, for the replacement of the City Hall Annex roof, to Garland Roofing, in the amount of $637,154.00. BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PEARLAND, TEXAS: Section 1. That competitive pricing for replacement of the City Hall Annex roof was obtained through cooperative purchasing partner OMNIA Partners. Section 2. That the City Council hereby awards the contract to Garland Roofing, in the amount of $637,154.00. Section 3. The City Manager or his designee is hereby authorized to execute a contract for the City Hall Annex roof replacement. PASSED, APPROVED and ADOPTED this the 24th day of February, A.D., 2020. AITTS CR TAL ROAq, TRMC, CMC CITY SECRETARY APPROVED AS TO FORM: DARRIN M. COKER CITY ATTORNEY TOM REID MAYOR City of Pearland - 3519 Liberty Drive Pearland, TX 77581 STANDARD CONTRACT FOR SMALL CONSTRUCTION PROJECTS This Contract (Contract) is made between the City of Pearland, Texas (City), and Contractor. The City and Contractor agree to the terms and conditions of this Contract, which consists of the following parts: I. Summary of Contract Terms II. Signatures III. Standard Contractual Provisions IV. Special Terms and Conditions V. Additional Contract Attachments I. Summary of Contract Terms. Contractor: Garland/DBS, Inc. 3800 East 91 sc Street Cleveland, OH 44105 Description of Services: Contractor will provide Roof Replacement Services at City Hall Annex, for the City of Pearland, per the specifications of proposal #25 -TX -2000039 and Omni Partners Contract #PW 1925; Resolution #2020--A�E. Contract Amount: $637,154 Effective Date: 2/26/2020 Termination Date: 4/30/2020 Extension/Renewal: No renewals available. II. Signatures. By signing below, the parties agree to the terms of this Contract: CITY OF P RLAND CONTRACTOR: istant F' ce i for Date Title: '4.�tC ,0. tAc i qa L • to a �i,,Q Date: 2 • /3. 2o2d *Signed by: te: 2-2`1--?4�' ��•��p,ND/DeS City M eager �Q :G�RpORq�•.�2 S Assistant City Manager ��'•. C� DirectorSEAL Superintendent/Manager - - *Contract Signature Authority: Superintendent/Manager -$5,999 or less Director - $6,000 to $30,000 �'•.,�FCAWAO- City Manager/Assistant City Managers - $30,Ob1ILI$60,b00 Council Resolution - $50,000+ CONTRACT/Page 1 III. Standard Contractual Provisions. A. Definitions. Contract means this Standard Contract for Construction Services. Services means the services for which the City solicited bids or received proposals as described in Exhibit "A" attached hereto. B. Services and Payment. Contractor will furnish Services to the City in accordance with the terms and conditions specified in this Contract. Contractor will bill the City for the Services provided at intervals of at least 30 days, except for the final billing. The City shall pay Contractor for the Services in accordance with the terms of this Contract, but all payments to be made by the City to Contractor, including the time of payment and the payment of interest on overdue amounts, are subject to the applicable provisions of Chapter 2251 of the Government Code. C. Termination Provisions. (1) City Termination for Convenience. Under this paragraph, the City may terminate this Contract during its term at any time for the City's own convenience where the Contractor is not in default by giving written notice to Contractor. If the City terminates this Contract under this paragraph, the City will pay the Contractor for all services rendered in accordance with this Contract to the date of termination. (2) Termination for Default. Either party to this Contract may terminate this Contract as provided in this paragraph if the other party fails to comply with its terms. The party alleging the default will give the other party notice of the default in writing citing the terms of the Contract that have been breached and what action the defaulting party must take to cure the default. If the party in default fails to cure the default as specified in the notice, the party giving the notice of default may terminate this Contract by written notice to the other party, specifying the date of termination. Termination of this Contract under this paragraph does not affect the right of either party to seek remedies for breach of the Contract as allowed by law, including any damages or costs suffered by either party. (3) Multi -Year Contracts and Funding. If this Contract extends beyond the City's fiscal year in which it becomes effective or provides for the City to make any payment during any of the City's fiscal years following the City's fiscal year in which this Contract becomes effective and the Cityfails to appropriate funds to make any required Contract payment for that successive fiscal year and there are no funds from the City's sale of debt instruments to make the required payment, then this Contract automatically terminates at the beginning of the first dayof the City's successive fiscal year of the Contract for which the City has not appropriated funds or otherwise provided for funds to make a required payment under the Contract. D. Liability and Indemnity. Any provision of any attached contract document that limits the Contractor's liability to the City or releases the Contractor from liability to the City for actual or compensatory damages, loss, or costs arising from the performance of this Contract or that provides for contractual indemnity by one party to the other party to this Contract is not applicable or effective under this Contract. Except where an Additional Contract Document provided by the City provides otherwise, each party to this Contract is responsible for defending against a nd liable for paying any claim, suit, orjudgment for damages, loss, or costs arising from that party's acts or omissions in the performance of this Contract in accordance with applicable law. This provision does not affect the right of either party to this Contract who is sued by a third party for acts or omissions arising from this Contract to bring in the other party to this Contract as a third -party defendant as allowed by law. CONTRACT/Page 2 E. Assignment. Contractor shall not assign this Contract without the prior written consent of the City. F. Law Governing and Venue. This Contract is governed by the law of the State of Texas and a lawsuit may only be prosecuted on this Contract in a court of competent jurisdiction located in or having jurisdiction in Brazoria County, Texas. G. Entire Contract. This Contract represents the entire Contract between the City and the Contractor and supersedes all prior negotiations, representations, or contracts, eitherwritten or oral. This Contract may be amended only by written instrument signed by both parties. H. Independent Contractor. Contractor shall perform the work under this Contract as an independent contractor and not as an employee of the City. The City has no right to supervise, direct, or control the Contractor or Contractor's officers or employees in the means, methods, or details of the work to be performed by Contractor under this Contract. The City and Contractor agree that the work performed under this Contract is not inherently dangerous, that Contractor will perform the work in a workmanlike manner, and that Contractor will take proper care and precautions to insure the safety of Contractor's officers and employees. I. Dispute Resolution Procedures. The Contractor and City desire an expeditious means to resolve any disputes that may arise between them regarding this Contract. If either party disputes any matter relating to this Contract, the parties agree to try in good faith, before bringing any legal action, to settle the dispute by submitting the matter to mediation before a third party who will be selected by agreement of the parties. The parties will each pay one-half of the mediator's fees. J. Attorney's Fees. Should either party to this Contract bring suit against the other party for breach of contract or for any other cause relating to this Contract, neither party will seek or be entitled to an award of attorney's fees or other costs relating to the suit. K. Severability. If a court finds or rules that any part of this Contract is invalid or unlawful, the remainder of the Contract continues to be binding on the parties. IV. Special Terms or Conditions. None V. Additional Contract Documents. The following specified documents attached to this Contract are part of this Contract, except as follows: any provision contained in any of the Contractor's Additional Contract Documents specified below that conflicts with a Contract provision not included in the Contractor's Additional Contract Documents, does not apply to this Contract. A. Contractor's Additional Contract Documents: 1. Contractor's estimate and scope of work. 2. Payment bond, in the full amount of proposal. 3. Performance bond; in the full amount of proposal. B. City's Additional Contract Documents: 1. Contractor Insurance Requirements and Agreement CONTRACT/Page 3 CONTRACTOR'S SCOPE OF WORK Scope of services shall include the contractor providing Roof Replacement Services at City Hall Annex, for the City of Pearland, per the specifications of proposal #25 -TX -2000039 and Omni Partners Contract #PW1925. Pricing is as reflected on the attached contractor's quote. CONTRACT/Page 4 Garland/DBS, Inc. 3800 East 91St Street Cleveland, OH 44105 Phone: (800) 762-8225 Fax: (216) 883-2055 ROOFING MATERIAL AND SERVICES PROPOSAL City Hall Annex City of Pearland 3523 Liberty Dr. Pearland, TX 77581 Date Submitted: 01/20/2020 Proposal #: 25 -TX -200039 OMNIA / MICPA # PW1925 Purchase orders to be made out to: Garland/DBS, Inc. Ellowlne, SSub wy.fofG Please Note: The following budget/estimate is being provided according to the pricing established under the Master Intergovernmental Cooperative Purchasing Agreement (MICPA) with Racine County, WI and OMNIA Partners, Public Sector (U.S. Communities). The line item pricing breakdown from Attachment C: Bid Form should be viewed as the maximum price an agency will be charged under the agreement. Garland/DBS, Inc. administered an informal competitive process for obtaining quotes for the project with the hopes of providing a lower market -adjusted price whenever possible. Scope of Work: 1. Coordinate with City of Pearland personnel to obtain all necessary permits prior to beginning construction, lay down and storage areas must be approved in writing by COP Project Manager prior to receiving materials on-site. 2. Completely remove existing roof systems down to the lightweight insulating concrete deck. Contractor shall only remove the amount of roofing that they will be able to complete and dry -in that working day. 3. Eliminate any unutilized curbs, penetrations and projections in the roof system. 4. Mechanically attach 1/8" : 12" tapered polyisocyanurate insulation system through the lightweight insulating concrete into the underlying steel deck. 5. Adhere 1/2" x 4' x 4' Securock to the tapered insulation system utilizing Insul-lock HR, dualcomponent urethane foam insulation adhesive. 6. Heat fuse by torch, one ply of HPR Torchbase to the prepared substrate. Roofing plies shall be installed, starting at the drains and working outward, in a shingle fashion as not to create any back laps. 7. Heat fuse by torch, one ply of Stressply IV Plus UV Mineral to the prepared base ply. Roofing plies shall be installed, starting at the drains and working outward, in a shingle fashion as not to create any back laps. Page 1 of 4 8. Drains and plumbing vents shall be stripped in under the cap sheet, with a finished two - plies above the lead flange. All flanged penetrations shall be primed and set in a liberal bed of bituminous mastic prior to stripping -in of roofing plies. 9. Contractor shall shop fabricate perimeter edge metal system of 24 -gauge prefinished galvanized steel. Continuous cleat shall be fabricated of 22-ga galvanized steel. Flanges shall be primed and set in a liberal bed of bituminous mastic. 10. At rise wall conditions, the existing copper through -wall flashing shall be trimmed flush with the masonry wall prior to base flashing being installed. 11. At rise walls, install one ply of self -adhering underlayment to the primed masonry. Underlayment shall be brought over the perimeter blocking and terminated. 12. Fasten steel hat channels through the existing masonry and install new 24 -gauge pre - finished "M" Panel. Contractor shall shop fabricate associated "J" -Trim flashing, receivers, and counterflashings with wind clips. Foam closures shall be installed at the head with urethane sealant. 13. Terminate all base flashings with aluminum termination bar and three -course with Flashing Bond Mastic and mesh. 14. All sheet -metal component colors must be approved in writing by the COP Project Manage prior to installation. 15. Coat all base flashing assemblies with two coats of Pyramic, acrylic flashing coating. 16. At the completion of the job, a final close-out walk will be performed. Contractor shall be responsible to address any areas which hold water for more than 48 -hours. 17. Roofing manufacturer shall perform site visits and job progress inspections, three days per week minimum. Weekly reports will be generated and delivered to the COP Project Manager. 18. Contractor shall deliver at the completion of the project, a two-year labor and workmanship warranty. 19. Manufacturer shall deliver at the completion of the project, a thirty-year, NDL (No Dollar Limit) warranty, covering all labor and materials. Attachment C: Bid Form - Line Item Pricing Breakdown Item # Item Description Unit Price Quantity Unit Extended Price Tear -off & Dispose of Debris: SYSTEM TYPE 2.07 BUR W/ Insulation and Mineral Surfacing - Lightweight / Gyp Deck $ 2.11 26,500 SF $ 55,915 Insulation Recovery Board & Insulations Options: INSULATION SLOPE OPTION 4.28 Provide a 1/8" Tapered Polyisocyan u rate Insulation System while Maintaining the Average R -Value; Adhered with Insulation Adhesive $ 5.64 26,500 SF $ 149,460 Page 2 of 4 Page 3 of 4 Roof Deck and Insulation Option: LIGHTWEIGHT CONCRETE/GYPSUM ROOF DECK - TORCH APPLIED / SELF-ADHERING APPLICATION INSULATION OPTION: Must Mechanically Attach a 6.14.01 Base Sheet; Adhere Polyisocyanu rate in Insulation Adhesive / Adhere Treated Gypsum Insulation Board with Glass-Mat (e.g. DensDeck / Securock / Equal) with Insulation Adhesive to Provide an Average R- Value of 20 In Compliance FM 1-90 Requirements $ 6.73 26,500 SF $ 178,345 2-PLY ROOF SYSTEMS - COMBINATIONS OF A BASE PLY & A CAP SHEET (TOP PLY) PLEASE NOTE: BASE PLY & CAP SHEET COMBINATIONS MUST BE APPROVED BY THE MANUFACTURER: ROOF CONFIGURATION 12.03.01 1 Ply of Torch Base Sheet Installed with Torch Application: BASE PLY OPTION: SBS Modified Asphalt-Based, Fiberglass Reinforced Torch Base Sheet - Minimum of 80 Ibf/in tensile Torch-Applied Base Sheet (ASTM D 5147) $ 2.59 26,500 SF $ 68,635 2-PLY ROOF SYSTEMS - COMBINATIONS OF A BASE PLY & A CAP SHEET (TOP PLY) PLEASE NOTE: BASE PLY & CAP SHEET COMBINATIONS MUST BE APPROVED BY THE MANUFACTURER: ROOF CONFIGURATION 12.11.01 1 Ply of Mineral Surfaced, Torch-Applied Cap Sheet Installed with Torch Application: ROOFING MEMBRANE OPTION: ASTM D 6162 SBS Fiberglass/Polyester Reinforced Modified Bituminous Sheet Material Type III - Minimum 300 Ibf/in tensile Torch-Applied Membrane $ 6.20 26,500 SF $ 164,300 NEW FLASHINGS FOR ROOFING SYSTEMS & RESTORATION OPTIONS: Torch Applied Flashings - Minimum 1 Ply of Torch Base and Torch Mineral Cap Sheet; Torch Applied FLASHING OPTION: BASE PLY: 20.02.01 SBS Modified Polyester/Fiberglass Reinforced Base Torch Applied Flashing Ply - 80 Ibf/inch tensile (ASTM D 5147); TOP PLY: ASTM D 6162 SBS Fiberglass/Polyester Reinforced Modified Bituminous Sheet Material Type III - 300 Ibf/in Tensile Torch Applied Membrane $ 17.01 280 SF $ 4,763 Sub Total Prior to Multipliers j $ 621,418 MULTIPLIER - MULTIPLE MATERIAL STAGINGS Multiplier is applied when labor production is effected by the time it takes to stage a roof multiple times. 22.03 Situations include, but are not limited to staging materials to perform work on multiple roof levels, planned shutdowns and restarts, portion of the job is over sensitive work areas requiring staging from more than one point, etc. 20 % $ 124,284 Total After Multipliers $ 745,701 Page 3 of 4 Base Bid Total Maximum Price of Line Items under the MICPA: $ 745,701 Proposal Price Based Upon Market Experience: $ 637,154 Garland/DBS Price Based Upon Local Market Comaetition: Perkins Roofing Company, Inc. $ 637,154 FW Walton $ 645,899 CS Advantage USAA Inc. $ 646,720 J R Jones Roofing $ 919,631 Unforeseen Site Conditions: Wood Blocking (Nailer) Replacement $ 5.70 per Ln. Ft. Additional Insulation Replacement $ 5.70 per Sq. Ft. Decking Replacement $ 11.40 per Sq. Ft. Potential issues that could arise during the construction phase of the project will be addressed via unit pricing for additional work beyond the scope of the specifications. This could range anywhere from wet insulation, to the replacement of deteriorated wood nailers. Proposal pricing valid 60 days from proposal date listed above. Clarifications/Exclusions: 1. Sales and use taxes are excluded. 2. Permits are included. 3. Bonds are included. 4. Plumbing, Mechanical, Electrical work is excluded. 5. Masonry work is excluded. 6. Interior Temporary protection is excluded. 7. Any work not exclusively described in the above proposal scope of work is excluded. If you have any questions regarding this proposal, please do not hesitate to call me at my number listed below. Respectfully Submitted, S&" Ravel¢ Steve Rojek Garland/DBS, Inc. (216) 430-3613 Page 4 of 4 CITY OF PEARLAND CONTRACTOR INSURANCE REQUIREMENTS & AGREEMENT REQUIREMENTS Contractors performing work on City property or public right-of-way for the City of Pearland shall provide the City a certificate of insurance or a copy of their insurance policy(s) evidencing the coverages and coverage provisions identified herein. Contractor's insurance will be primary payer. Contractors shall provide the City evidence that all subcontractors performing work on the project have the same types and amounts of coverages as required herein or that the subcontractors are included under the contractor's policy. All insurance companies and coverages must be authorized by the Texas Department of Insurance to transact business in the State of Texas and must be acceptable to the City of Pearland. Listed below are the types and amounts of insurances required. The City reserves the right to amend or require additional types and amounts of coverages or provisions depending on the nature of the work. TYPE OF INSURANCE AMOUNT OF INSURANCE PROVISIONS 1. Workers' Compensation Statutory Limits City is to be listed as additional Employers' Liability $100,000 per occurrence insured with waiver of subrogation and 30 -day notice of cancellation 2. Commercial General (Public) Personal Injury - $1,000,000 per Liability to include coverage person; Property Damage - or material change in coverage. for: $1,000,000 per occurrence; a) Premises/Operations General Aggregate - $1,000,000 b) Products/Completed Operations c) Independent Contractors d) Personal Injury e Contractual Liability 3. Business Auto Liability to Combined Single Limit - include coverage for: $1,000,000 a) Owned/Leased vehicles b) Non -owned vehicles c Hired vehicles Certificate of Insurance forms may be emailed to Purchasing Department at: ebids(a_pearlandtx.gov. Questions regarding required insurance should be directed to City of Pearland Purchasing Department ebids(@Pearlandtx.gov. This form must be signed and returned with your bid/quotation. You are stating that you do have the required insurance and if selected to perform work for the City, will provide the certificates of insurance with the above requirements to the City. A purchase order will not be issued without evidence of required insurance. AGREEMENT I agree to provide the above described insurance coverages within 10 working days if selected to perform work for the City of Pearland. I also agree to provide the City evidence of insurance coverage on any and all subcontractors performing work on the project. Project/Bid# ,ZS - T� - Zcx5c>31F Company: Printed Nai Signature: CONTRACT/Page 9 1101•••• D/D '` S '• i POI,r'gT�•; SEAL: �''••,�FL AW ARS ��.•�,. Document A312 TM —2010 Conforms with The American Institute of Architects AIA Document 312 Performance Bond CONTRACTOR: (Name, legal status and address) Garland/DBS, Inc. 3800 East 91 st Street Cleveland, OH 44105 OWNER: (Name, legal status and address) City of Pearland 3519 Liberty Drive Pearland, TX 77581 CONSTRUCTION CONTRACT Date: February 13, 2020 Amount: ;$637,154.00 Description: (Name and location) SDR q GOat>r: February 13, 2020 o parli@- than Construction Contract Date) SEA . mot�?it: $637,154.00 ��'•. �ELAWP `�••• Bond Number: 30092161 SURETY: (Name, legal status and principal place of business) Continental Casualty Company 151 N Franklin Street CHICAGO, IL 60606 State of Inc: Illinois City Hall Annex - Pearland, TX Modifications to this Bond: F7,( None F --- ] See Section 16 CONTRACTOR AS PRINCIPAL SURETY This document has important legal consequences. Consquitation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. Company: (Corporate seal) Company: (Corporate seal) Garland/DBS, Inc. Continental Casualty Company Signature: Signature: t Name -R7,4,jjC A . AA(pe.,p,c+'G Name TV Cat L. Woodruff, Attorney in Fact And Title: C70 f p .Q o j j L4 And Title: (Any additional signatures appear on the last page of this Performance Bond) (FOR INFORMATION ONLY— Name, address and telephone) AGENT or BROKER: OWNER'S REPRESENTATIVE: Marsh (Architect, Engineer or other party:) Marsh USA Inc. 200 Public Square Cleveland, OH 44114 216-937-1379 § 1 The Contractor and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to the Owner for the performance of the Construction Contract, which is incorporated herein by reference. § 2 If the Contractor performs the Construction Contract, the Surety and the Contractor shall have no obligation under this Bond, except when applicable to participate in a conference as provided in Section 3. § 3 If there is no Owner Default under the Construction Contract, the Surety's obligation under this Bond shall arise after .1 the Owner first provides notice to the Contractor and the Surety that the Owner is considering declaring a Contractor Default. Such notice shall indicate whether the Owner is requesting a conference among the Owner, Contractor and Surety to discuss the Contractor's performance. If the Owner does not request a conference, the Surety may, within five (5) business days after receipt of the Owner's notice, request such a conference. If the Surety timely requests a conference, the Owner shall attend. Unless the Owner agrees otherwise, any conference requested under this Section 3.1 shall be held within ten (10) business days of the Surety's receipt of the Owner's notice. If the Owner, the Contractor and the Surety agree, the Contractor shall be allowed a reasonable time to perform the Construction Contract, but such an agreement shall not waive the Owner's right, if any, subsequently to declare a Contractor Default; .2 the Owner declares a Contractor Default, terminates the Construction Contract and notifies the Surety; and .3 the Owner has agreed to pay the Balance of the Contract Price in accordance with the terms of the Construction Contract to the Surety or to a contractor selected to perform the Construction Contract. § 4 Failure on the part of the Owner to comply with the notice requirement in Section 3.1 shall not constitute a failure to comply with a condition precedent to the Surety's obligations, or release the Surety from its obligations, except to the extent the Surety demonstrates actual prejudice. § 5 When the Owner has satisfied the conditions of Section 3, the Surety shall promptly and at the Surety's expense take one of the following actions: § 5.1 Arrange for the Contractor, with the consent of the Owner, to perform and complete the Construction Contract; § 5.2 Undertake to perform and complete the Construction Contract itself, through its agents or independent contractors; § 5.3 Obtain bids or negotiated proposals from qualified contractors acceptable to the Owner for a contract for performance and completion of the Construction Contract, arrange for a contract to be prepared for execution by the Owner and a contractor selected with the Owner's concurrence, to be secured with performance and payment bonds executed by a qualified surety equivalent to the bonds issued on the Construction Contract, and pay to the Owner the amount of damages as described in Section 7 in excess of the Balance of the Contract Price incurred by the Owner as a result of the Contractor Default; or § 5.4 Waive its right to perform and complete, arrange for completion, or obtain a new contractor and with reasonable promptness under the circumstances: .1 After investigation, determine the amount for which it may be liable to the Owner and, as soon as practicable after the amount is determined, make payment to the Owner; or .2 Deny liability in whole or in part and notify the Owner, citing the reasons for denial. § 6 If the Surety does not proceed as provided in Section 5 with reasonable promptness, the Surety shall be deemed to be in default on this Bond seven days after receipt of an additional written notice from the Owner to the Surety demanding that the Surety perform its obligations under this Bond, and the Owner shall be entitled to enforce any remedy available to the Owner. If the Surety proceeds as provided in Section 5.4, and the Owner refuses the payment or the Surety has denied liability, in whole or in part, without further notice the Owner shall be entitled to enforce any remedy available to the Owner. § 7 If the Surety elects to act under Section 5.1, 5.2 or 5.3, then the responsibilities of the Surety to the Owner shall not be greater than those of the Contractor under the Construction Contract, and the responsibilities of the Owner to the Surety shall not be greater than those of the Owner under the Construction Contract. Subject to the commitment by the Owner to pay the Balance of the Contract Price, the Surety is obligated, without duplication, for .1 the responsibilities of the Contractor for correction of defective work and completion of the Construction Contract; .2 additional legal, design professional and delay costs resulting from the Contractor's Default, and resulting from the actions or failure to act of the Surety under Section 5; and .3 liquidated damages, or if no liquidated damages are specified in the Construction Contract, actual damages caused by delayed performance or non-performance of the Contractor. § 8 If the Surety elects to act under Section 5.1, 5.3 or 5.4, the Surety's liability is limited to the amount of this Bond. § 9 The Surety shall not be liable to the Owner or others for obligations of the Contractor that are unrelated to the Construction Contract, and the Balance of the Contract Price shall not be reduced or set off on account of any such unrelated obligations. No right of action shall accrue on this Bond to any person or entity other than the Owner or its heirs, executors, administrators, successors and assigns. § 10 The Surety hereby waives notice of any change, including changes of time, to the Construction Contract or to related subcontracts, purchase orders and other obligations. § 11 Any proceeding, legal or equitable, under this Bond may be instituted in any court of competent jurisdiction in the location in which the work or part of the work is located and shall be instituted within two years after a declaration of Contractor Default or within two years after the Contractor ceased working or within two years after the Surety refuses or fails to perform its obligations under this Bond, whichever occurs first. If the provisions of this Paragraph are void or prohibited by law, the minimum period of limitation available to sureties as a defense in the jurisdiction of the suit shall be applicable. § 12 Notice to the Surety, the Owner or the Contractor shall be mailed or delivered to the address shown on the page on which their signature appears. § 13 When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction was to be performed, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. § 14 Definitions § 14.1 Balance of the Contract Price. The total amount payable by the Owner to the Contractor under the Construction Contract after all proper adjustments have been made. including allowance to the Contractor of any amounts received or to be received by the Owner in settlement of insurance or other claims for damages to which the Contractor is entitled, reduced by all valid and proper payments made to or on behalf of the Contractor under the Construction Contract. § 14.2 Construction Contract. The agreement between the Owner and Contractor identified on the cover page, including all Contract Documents and changes made to the agreement and the Contract Documents. § 14.3 Contractor Default. Failure of the Contractor, which has not been remedied or waived, to perform or otherwise to comply with a material term of the Construction Contract. § 14.4 Owner Default. Failure of the Owner, which has not been remedied or waived, to pay the Contractor as required under the Construction Contract or to perform and complete or comply with the other material terms of the Construction Contract. § 14.5 Contract Documents. All the documents that comprise the agreement between the Owner and Contractor. § 15 If this Bond is issued for an agreement between a Contractor and subcontractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. § 16 Modifications to this bond are as follows: (Space is provided below for additional signatures of added parties, other than those appearing on the cover page.) CONTRACTOR AS PRINCIPAL SURETY Company: (Corporate Seal) Company: (Corporate Seal) Signature: Name and Title: Address Signature: Name and Title: Address Document A312 TM —2010 Conforms with The American Institute of Architects AIA Document 312 Payment Bond Bond Number: 30092161 CONTRACTOR: (Name, legal status and address) Garland/DBS, Inc. 3800 East 91 st Street Cleveland, OH 44105 OWNER: (Name, legal status and address) City of Pearland 3519 Liberty Drive Pearland, TX 77581 CONSTRUCTION CONTRACT Date: February 13, 2020 Amount: $637,154.00 bos cription: (Name and location) 60 CID OR X21 0 F.' SEA ID February 13, 2020 (N�t earlier than Construction Contract Date) �FLAWAR� Amount:$637,154.00 SURETY: (Name, legal status and principal place of business) Continental Casualty Company 151 N Franklin Street CHICAGO, IL 60606 State of Inc: Illinois City Hall Annex - Pearland, TX This doc irnent has i -Portant legal consequences. Consultation with an attorney is encouraged with respect to its completion or modification. Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. Modifications to this Bond: F—V-] None = See Section 18 CONTRACTOR AS PRINCIPAL SURETY Company: (Corporate Seal) Company: (Corporate Seal) Garland/DBS, Inc. Continental Casualty Company D Signature: Signature: —,"'l-Aw Name r�p�K �O . rCKGoC, AST+L. Name ,thy L. Woodruff, Jorney in Fact And Title: CCVV+p a I1,c 4 And Title: (Any additional signatures appear on the last page of this Payment Bond) (FOR INFORMATION ONLY — Name, address and telephone) AGENT or BROKER: OWNER'S REPRESENTATIVE: Marsh USA Inc. 200 Public Square (Architect, Engineer or other party:) Cleveland, OH 44114 216-937-1379 § 1 The Contractor and Surety, jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to the Owner to pay for labor, materials and equipment furnished for use in the performance of the Construction Contract, which is incorporated herein by reference, subject to the following terms. § 2 If the Contractor promptly makes payment of all sums due to Claimants, and defends, indemnifies and holds harmless the Owner from claims, demands, liens or suits by any person or entity seeking payment for labor, materials or equipment furnished for use in the performance of the Construction Contract, then the Surety and the Contractor shall have no obligation under this Bond. § 3 If there is no Owner Default under the Construction Contract, the Surety's obligation to the Owner under this Bond shall arise after the Owner has promptly notified the Contractor and the Surety (at the address described in Section 13) of claims, demands, liens or suits against the Owner or the Owner's property by any person or entity seeking payment for labor, materials or equipment furnished for use in the performance of the Construction Contract and tendered defense of such claims, demands, liens or suits to the Contractor and the Surety. § 4 When the Owner has satisfied the conditions in Section 3, the Surety shall promptly and at the Surety's expense defend, indemnify and hold harmless the Owner against a duly tendered claim, demand, lien or suit. § 5 The Surety's obligations to a Claimant under this Bond shall arise after the following: § 5.1 Claimants, who do not have a direct contract with the Contractor, .1 have furnished a written notice of non-payment to the Contractor, stating with substantial accuracy the amount claimed and the name of the party to whom the materials were, or equipment was, furnished or supplied or for whom the labor was done or performed, within ninety (90) days after having last performed labor or last furnished materials or equipment included in the Claim; and .2 have sent a Claim to the Surety (at the address described in Section 13). § 5.2 Claimants, who are employed by or have a direct contract with the Contractor, have sent a Claim to the Surety (at the address described in Section 13). § 6 If a notice of non-payment required by Section 5.1.1 is given by the Owner to the Contractor, that is sufficient to satisfy a Claimant's obligation to furnish a written notice of non-payment under Section 5.1.1. § 7 When a Claimant has satisfied the conditions of Sections 5.1 or 5.2, whichever is applicable, the Surety shall promptly and at the Surety's expense take the following actions: § 7.1 Send an answer to the Claimant, with a copy to the Owner, within sixty (60) days after receipt of the Claim, stating the amounts that are undisputed and the basis for challenging any amounts that are disputed; and § 7.2 Pay or arrange for payment of any undisputed amounts. § 7.3 The Surety's failure to discharge its obligations under Section 7.1 or Section 7.2 shall not be deemed to constitute a waiver of defenses the Surety or Contractor may have or acquire as to a Claim, except as to undisputed amounts for which the Surety and Claimant have reached agreement. If, however, the Surety fails to discharge its obligations under Section 7.1 or Section 7.2, the Surety shall indemnify the Claimant for the reasonable attorney's fees the Claimant incurs thereafter to recover any sums found to be due and owing to the Claimant. § 8 The Surety's total obligation shall not exceed the amount of this Bond, plus the amount of reasonable attorney's fees provided under Section 7.3, and the amount of this Bond shall be credited for any payments made in good faith by the Surety. § 9 Amounts owed by the Owner to the Contractor under the Construction Contract shall be used for the performance of the Construction Contract and to satisfy claims, if any, under any construction performance bond. By the Contractor furnishing and the Owner accepting this Bond, they agree that all funds earned by the Contractor in the performance of the Construction Contract are dedicated to satisfy obligations of the Contractor and Surety under this bond, subject to the Owner's priority to use the funds for the completion of the work. § 10 The Surety shall not be liable to the Owner, Claimants or others for obligations of the Contractor that are unrelated to the Construction Contract. The Owner shall not be liable for the payment of any costs or expenses of any Claimant under this Bond, and shall have under this Bond no obligation to make payments to, or give notice on behalf of, Claimants or otherwise have any obligations to Claimants under this Bond. § 11 The Surety hereby waives notice of any change, including changes of time, to the Construction Contract or to related subcontracts, purchase orders and other obligations. § 12 No suit or action shall be commenced by a Claimant under this Bond other than in a court of competent jurisdiction in the state in which the project that is the subject of the Construction Contract is located or after the expiration of one year from the date (1) on which the Claimant sent a Claim to the Surety pursuant to Section 5.1.2 or 5.2, or (2) on which the last labor or service was performed by anyone or the last materials or equipment were furnished by anyone under the Construction Contract, whichever of (1) or (2) first occurs. If the provisions of this Paragraph are void or prohibited by law, the minimum period of limitation available to sureties as a defense in the jurisdiction of the suit shall be applicable. § 13 Notice and Claims to the Surety, the Owner or the Contractor shall be mailed or delivered to the address shown on the page on which their signature appears. Actual receipt of notice or Claims, however accomplished, shall be sufficient compliance as of the date received. § 14 When this Bond has been furnished to comply with a statutory or other legal requirement in the location where the construction was to be performed, any provision in this Bond conflicting with said statutory or legal requirement shall be deemed deleted herefrom and provisions conforming to such statutory or other legal requirement shall be deemed incorporated herein. When so furnished, the intent is that this Bond shall be construed as a statutory bond and not as a common law bond. § 15 Upon request by any person or entity appearing to be a potential beneficiary of this Bond, the Contractor and Owner shall promptly furnish a copy of this Bond or shall permit a copy to be made. § 16 Definitions § 16.1 Claim. A written statement by the Claimant including at a minimum: .1 the name of the Claimant; .2 the name of the person for whom the labor was done, or materials or equipment furnished; .3 a copy of the agreement or purchase order pursuant to which labor, materials or equipment was furnished for use in the performance of the Construction Contract; .4 a brief description of the labor, materials or equipment furnished; .5 the date on which the Claimant last performed labor or last furnished materials or equipment for use in the performance of the Construction Contract; .6 the total amount earned by the Claimant for labor, materials or equipment furnished as of the date of the Claim; .7 the total amount of previous payments received by the Claimant; and .8 the total amount due and unpaid to the Claimant for labor, materials or equipment furnished as of the date of the Claim. § 16.2 Claimant. An individual or entity having a direct contract with the Contractor or with a subcontractor of the Contractor to Furnish labor, materials or equipment for use in the performance of the Construction Contract. The term Claimant also includes any individual or entity that has rightfully asserted a claim under an applicable mechanic's lien or similar statute against the real property upon which the Project is located. The intent of the Bond shall be to include without limitation in the terms "labor, materials or equipment" that part of water, gas, power, light, heat, oil, gasoline, telephone service or rental equipment used in the Construction Contract, architectural and engineering services required for performance of the work of the Contractor and the Contractor's subcontractors, and all other items for which a mechanic's lien may be asserted in the jurisdiction where the labor, materials or equipment were furnished. § 16.3 Construction Contract. The agreement between the Owner and Contractor identified on the cover page, including all Contract Documents and all changes made to the agreement and the Contract Documents. § 16.4 Owner Default. Failure of the Owner, which has not been remedied or waived, to pay the Contractor as required under the Construction Contract or to perform and complete or comply with the other material terms of the Construction Contract. § 16.5 Contract Documents. All the documents that comprise the agreement between the Owner and Contractor. § 17 If this Bond is issued for an agreement between a Contractor and subcontractor, the term Contractor in this Bond shall be deemed to be Subcontractor and the term Owner shall be deemed to be Contractor. § 18 Modifications to this bond are as follows: (Space is provided below for additional signatures of added parties, other than those appearing on the cover page.) CONTRACTOR AS PRINCIPAL SURETY Company: (Corporate Seal) Company: (Corporate Seal) Signature: _ Name and Title: Address Signature: _ Name and Title: Address POWER OF ATTORNEY APPOINTING INDIVIDUAL ATTORNEY-IN-FACT Know All Men By These Presents, That Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company (herein called "the CNA Companies), are duly organized and existing insurance companies having their principal offices in the City of Chicago, and State of Illinois, and that they do by virtue of the signatures and seals herein affixed hereby make, constitute and appoint Cathy L. Woodruff , Individually of Cleveland I Ohio , their true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on their behalf bonds, undertakings and other obligatory instruments of similar nature — In Unlimited Amounts — Surety Bond Number: 30092161 Principal: Garland/DBS, Inc. Obligee: City of Pearland and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their insurance companies and all the acts of said Attorney, pursuant to the authority hereby given is hereby ratified and confirmed. This Power of Attorney is made and executed pursuant to and by authority of the By -Law and Resolutions, printed on the reverse hereof, duly adopted, as indicated, by the Boards of Directors of the insurance companies. In Witness Whereof, the CNA Companies have caused these presents to be signed by their Vice President and their corporate seals to be hereto affixed on this 3rd day of June, 2015. C►.SIb1 Yx+e Continental Casualty Company National Fire Insurance Company of Hartford r'OgPORAtE �, � artatgr�n American C 1ty Company of R m& Pennsylvania o JULY 11. SEAL. 1902 ' f8p7 Paul T. Bruflat & President State of South Dakota, County of Minnehaha, ss: On this 3rd day of June, 2015, before me personally came Paul T. Bruflat to me known, who, being by me duly sworn, did depose and say: that he resides in the City of Sioux Falls, State of South Dakota; that he is a Vice President of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company ofReading, Pennsylvania, a Pennsylvania insurance company described in and which executed the above instrument; that he knows the seals of said insurance companies; that the seals affixed to the said instrument are such corporate seals; that they were so affixed pursuant to authority given by the Boards of Directors of said insurance companies and that he signed his name thereto pursuant to like authority, and acknowledges same to be the act and deed of said insurance companies. �4M!I�iS�MMiwh!f �tititilwtiMaw zloty rat out My Commission Expires February 12, 2021 S. Eich Notty NotPublic CERTIFICATE I, D. Bult, Assistant Secretary of Continental Casualty Company, an Illinois insurance company, National Fire Insurance Company of Hartford, an Illinois insurance company, and American Casualty Company of Reading, Pennsylvania, a Pennsylvania insurance company do hereby certify that the Power of Attorney herein above set forth is still in force, and further certify that the By -Law and Resolution of the Board of Directors of the insurance companies printed on the reverse hereof is still in force. In testimony whereof I have hereunto subscribed my name and affixed the seal of the said insurance companies this 13th day of February , 2020 , !�`G��4T �tSUJ4 rpe fi++1 Go"PORATO ,,�,pA�ONgrF JULY 11, v SEAL ` tliY? � NAlt14� '�s Foran F68534-2012 Continental Casualty Company National Fire Insurance Company of Hartford American Casualty Company of Reading, Pennsylvania D. Bult Assistant Secretary A� o® CERTIFICATE OF LIABILITY INSURANCE Doznai2020D THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh USA, Inc. 4400 Comerica Bank Tower CONTACT NAME: PHONE FAx A1C No ADDRE ss: AIex.Porter@marsh.com 1717 Main Street Dallas, TX 75201-7357 Attn: dallas.certs@marsh.com INSURERS AFFORDING COVERAGE NAIC# INSURERA: Liberty Surplus Insurance Corp 10725 CN102137489-GIDBS-GAWX+-19- INSURED Garland/DBS, Inc, 3800 East 91st Street INSURER B : Travelers Indemnity Co 25658 INSURER C: Liberty Insurance Underwriters Inc. 19917 INSURER D : The Charter Oak Fire Insurance Company 25615 Cleveland, OH 44105 INSURER E : Aspen American Insurance Com an 43460 INSURER F: Endurance American Specialty Insurance Company 41718 CnVFRAGES CERTIFICATE NUMBER: HOU-003609598-01 REVISION NUMBER: 1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRIi TYPE OF INSURANCE ADDL SUBR WVD POLICY NUMBER POLICYEFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY 1000353805-01 12/05/2019 12/05/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 7x I OCCUR ccur encs $ PREM SES Ea occurrence) MED EXP (Anyone person) $ 10,000 X SIR -$100,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY � JECT F7 LOC $ OTHER: B AUTOMOBILE LIABILITY 810 -2L222506 -1943-G 12/05/2019 12/05/2020 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident BODILY INJURY (Per person) $ X ANY AUTO X OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident X UMBRELLALIAB X OCCUR 1000021686-10 12/05/2019 12/05/2020 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN N OFFICER/MEMBEREXCLUE � (Mandatory In NH) N I A POUR -8N30973-1-19 5 12/05/2020 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E Inland Marine IMZ325419 (Ded: $50,000) 12/05/2019 12105/2020 Installation Floater 1,000,000 F Inland Marine ARL30000500802 (Ded: $25,000) 1210512019 1210512020 Leased/Rented Equip 100,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (ACORD 101, Addltlonal Remarks Schedule, maybe attached If more space Is required) City of Pearland is included as additional Insured where required by written contract with respect to General Liability and Auto Liability. This insurance Is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured subject to policy terms and conditions, Waiver of subrogation is applicable where required by written contract and subject to policy terms and conditions. CFRTIFICATF_ HOLDER CANCELLATION City of Pearland SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 3519 Liberty Drive THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Pearland, TX 77581 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _y4.atiA'Qoti @ 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN 102137489 LOC #: Dallas A " ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY Marsh USA, Inc. NAMED INSURED Garland/DBS, Inc. 3800 East 91 at Street Cleveland, OH 44105 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: 0G1MC1ar41G1C1:l7 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Other property deductibles may apply as per policy terms and conditions. ACORD 101 (2008101) U 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to TL..L. 11 ...:.. . GI 1J�t.ilCra1 I CIUUIJCIIICILL. lilt= IUIIUVVII19IIJLuRJ1:)lhC CXLCIL ULQL coverage is CXCIUUCJ Or IIn1LCU Uy.JULLalI.Jl i.VwGr- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE —INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with Its permission. COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION 11 — COVERED AUTOS LIABIL- ITY COVERAGE: (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (1) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved insuredwdi make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to make such payments ends when we (5) Anywhere in the world, except any country or have used up the applicable limit of jurisdiction while any trade sanction, em- insurance in payments for damages, bargo, or similar regulation imposed by the settlements or defense expenses. United States of America applies to and pro- hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada, members of their households. Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with Its permission. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United Stales of Afflefica, ILS ieffilurles and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY COMMERCIAL AUTO (2) In or on your covered "auto", This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- udle due to a cause other than r a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: The following is added to Paragraph AA., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION 111 — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex - We will a u to $400 for "loss" to wearing ap- tent required of you by a written contract pay P 9 signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 ® 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with Its permission. COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. Page 4 of 4 © 2015 The Travelers Indemnity Compa ny. All rights reserved . CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with Its permission. POLICY NUMBER: 810 -2L222506 -19-43-G ISSUE DATE: 11-13-19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EARLIER NOTICE OF CANCELLATIONMONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice: 60 WHEN WE DO NOT RENEW (Nonrenewal): PROVISIONS: A. For any statutorily permitted reason other than nonpayment of premium, the number of days re- quired for notice of cancellation, as provided in the CONDITIONS Section of this insurance, or as amended by any applicable state cancellation endorsement applicable to this insurance, is in- creased to the number of days shown in the SCHEDULE above. Number of days Notice: 60 B. For any statutorily permitted reason other than nonpayment of premium, the number of days re- quired for notice of When We Do Not Renew (Nonrenewal), as provided in the CONDITIONS Section of this insurance, or as amended by any applicable state When We Do Not Renew (Nonrenewal) endorsement applicable to this in- surance, is increased to the number of days shown in the SCHEDULE above. IL T3 20 09 97 Copyright, The Travelers Indemnity Company, 1997 Page 1 of 1 _ Liberty Surplus Insurance Commercial General Liability Corhorad°" LIBERTY SURPLUS INSURANCE CORPORATION (A New Hampshire Stock Insurance Company, hereinafter the "Company") ENDORSEMENT NO. 42 Effective Date: 12/05/2019 Policy Number: 1000353805.01 Issued To: Garland Industries, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: As required by written contract signed by both parties prior to any `occurrence" in which coverage is sought under this Policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 CO Insurance Services Office, Inc., 2008 Commercial General Liability Effective Date: Liberty SttrE)Ius Insuranc e Corlx)ralinn LIBERTY SURPLUS INSURANCE CORPORATION (A New Hampshire Stock Insurance Company, hereinafter the "Company') Policy Number: Issued To: ENDORSI NIEN'T NO.4 12/05/2019 1000353805-01 Garland Industries, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location and Description Of Covered Operations As required by written contract signed by both All Locations and Description of Covered parties prior to any "occurrence" in which coverage Operations is sought under this policy. (Information required to complete this Schedule, if not shown above, will be shown in the Declarations) Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". mu] CG 20 37 07 04 0 ISO Properties, Inc., 2004 Liberty Surplus ItiSUr)I)( C Commercial General Liability t<it1,<t�.,ric�t�. LIBERTY SURPLUS INSURANCE CORPORATION (A New Hampshire Stock Insurance Company, hereinafter the "Company') ENDORSEMENT NO. 13 Effective Date: 12/05/2019 rolicy I�*umber: 1000353505-01 Issued To: Garland Industries, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancellation if we cancel for non-payment of premium; or b. 600 days before the effective date of cancellation if we cancel for any other reason. 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us. 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. 5. If this policy is cancelled, we will send the first Named Insured any premitun refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. The cancellation will be effective even if we have not made or offered a refund. G. If notice is mailed, proof of mailing will be sufficient proof of notice. MUTI CGL 10 07 0103 10� Liberty "Irphis Insurint e Commercial General Liability Co'p"'t"fD LIBERTY SURPLUS INSURANCE CORPORATION (A New Hampshire Stcxk Insurance Company, hereinafter the "Company") ENDORSEMENT NO. 37 Effective Date: 12/05/2019 Policy Numbcr: 1000353305-01 Issued To: Garland Industries, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE CLAUSE ENDORSEMENT To the extent that this insurance is afforded to any additional insured under the policy, such insurance shall apply as primary and not contributing with any insurance carried by such additional insured, as required by written contract. Nothing herein contained shall be held to waive, vary, alter or extend any condition or provision of the policy other than as above stated. CGL 10 31 04 03 TRAVELERS, WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 06 R3 (00) POLICY NUMBER: (POUB-8N30973-1-19) NOTICE OF CANCELLATION TO DESIGNATED PERSONS OR ORGANIZATIONS The following is added to PART SIX — CONDITIONS: Notice Of Cancellation To Designated Persons Or Organizations If we cancel this policy for any reason other than non-payment of premium by you, we will provide notice of such cancellation to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organiza- tion before the cancellation is to take effect. You are responsible for providing us with the information necessary to accurately complete the Schedule below, If we cannot mail or deliver a notice of cancellation to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete, we have no responsibility to mail, deliver or otherwise notify such designated person or organization of the cancellation. SCHEDULE Number of Name and Address of Designated Persons or Organizations: Days Notice ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN 30 CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1. YOU SEE TO IT THAT WE RECEIVE A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS ENDORSEMENT. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. DATE OF ISSUE: 12-20-19 ST ASSIGN: Page 1 of 3 © 2013 The Travelers Indemnity Company. All rights reserved. TRAVELERS WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 99 06 R3 (00) POLICY NUMBER: (POUB-SN30973-1-19) Number of Name and Address of Designated Persons or Organizations: Days Notice DATE OF ISSUE: 12-20-19 ST ASSIGN: Page 2 of 3 © 2013 The Travelers Indemnity Company. All rights reserved. TRAVELERS ONE TOWER SQUARE HARTFORD, CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 06 R3 (00) POLICY NUMBER: (POUB-8N30973-1-19) Name and Address of Designated Persons or Organizations: Number of Days Notice All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Insured Insurance Company Policy No. Countersigned by Endorsement No. Premium $ DATE OF ISSUE: 12-20-19 ST ASSIGN: Page 3 of 3 © 2013 The Travelers Indemnity Company. All rights reserved. TRAVELERS/, WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD, CT 06183 ENDORSEMENT WC 00 03 13 (00) -01 POLICY NUMBER: (POUB-BN30973-1-19) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. DATE OF ISSUE: 12-20-19 ST ASSIGN: Commercial General Liability Effective Date Liberty Surplus Insurance Corporation LIBERTY SURPLUS INSURANCE CORPORATION (A New Hampshire Stock Insurance Company, hereinafter the "Company') Policy Number: Issued To: ENDORSEMENT NO. 1 12/05/2019 1000353805-01 Garland Industries, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) As required by written contract signed by both parties prior to any "occurrence" in which coverage is sought under this policy. (Information required to complete this Schedule, if not shown above, will be shown in the Declarations) Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to you. CG 20 26 07 04 Copyright, Insurance Services Office, Inc., 2004 �.. J__. _...r •_1 TIN, later. Note: If the account Is in more than one name, see the instructions for line 1. Also see'What Name and Number To Give the Requester for guidelines on whose number to enter. or number allaMMlll©Ill M"M19 ■:M -Ali■ GertITication Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) Indicating that I am exempt from FATCA reporting Is correct. Certification instructions. You must cross out item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later. Sign( Signature , �.� Here U.S. personn 110-.1��_ Date ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest Information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to wwwdrs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who Is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), Individual taxpayer Identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099 -INT (interest earned or paid) • Form 1099 -DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third parry network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding, See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) Request for Taxpayer Give Form to the Form Identification Number and Certification requester. Do not (Rev. October 2018) Department of the Treasury send to the IRS. internal Revenue Service ► Go to wwwJrs.gov/FormW9 for instructions and the latest information. 1 Name (as shown on your income tax return). Name Is required on this line; do not leave this line blank. GARLAND/DBS, INC. 2 Business name/disregarded entity name, If different from above M 3 Check appropriate box for federal tax classification of the person whose name Is entered on line 1. Check only one of the 4 Exemptions (codes apply only to mfollowing seven boxes. certain entitles, not individuals; see a Instructions on page 3): o ElIndividual/sole proprietor or ElC Corporation H S Corporation ❑ Partnership ❑ Trust/estate w single -member LLC Exempt payee code (f any) ppd), c Z+'+e2 ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ► o 2 Note: Check the appropriate box In the line above for the tax classification of the single -member owner. Do not check Exemption from FATCA reporting c LLC If the LLC Is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC Is coded(f any) — another LLC that Is not disregared from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that L a o is disregarded from the owner should check the appropriate box for the tax classification of its owner. y❑ Other (see Instructions) ► (Apples to accounts maintained outside the U.S.) N 5 Address (number, street, and apt, or suite no.) See instructions. Requester's name and address (optional) M 3800 EAST 91ST STREET rn 6 City, state, and ZIP code CLEVELAND, OHIO 44105 7 List account number(s) here (optional) Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number _ m — For individuals, this is generally your social security number (Sate). However, fora backup wlien, sole resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other on+i+ion !+!a %,n . emnic%My Hantifinatinn niimhar (FIN). If vnu rin not have a number. see How to oeta �.. J__. _...r •_1 TIN, later. Note: If the account Is in more than one name, see the instructions for line 1. Also see'What Name and Number To Give the Requester for guidelines on whose number to enter. or number allaMMlll©Ill M"M19 ■:M -Ali■ GertITication Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) Indicating that I am exempt from FATCA reporting Is correct. Certification instructions. You must cross out item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later. Sign( Signature , �.� Here U.S. personn 110-.1��_ Date ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest Information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to wwwdrs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who Is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), Individual taxpayer Identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099 -INT (interest earned or paid) • Form 1099 -DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third parry network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding, See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) Garland/DBS, Inc. 3800 East 91St Street ' Cleveland, OH 44105 D B S Phone: (800) 762-8225 Fax: (216) 883-2055 since 1895 OWNER BILLING INFO SHEET Project Name: Customer PO/Contract ID: Garland/DBS Proposal/Project Tlx: OWNER INFORMATION Owner Name: Owner AP Contact (Name): Owner AP Contact (Phone): Owner AP Contact (email): BILLING DELIVERY METHOD Invoice Mailing Address: Invoice Email Address: TAX EXEMPT STATUS Tax Exempt Y/N: If you are an exempt entity, please attach a copy of your Construction Sales and Use Exemption Certificate per your state's requirement. PREVAILING WAGE COORDINATION (if applicable) Prevailing Wage Coordinator: Prevailing Wage Coordinator (phone): Prevailing Wage Coordinator (email): SPECIAL INSTRUCTIONS OWNER AUTHORIZED SIGNATURE Signature: Date: Owner Rep Printed: Return completed forms to DBSPM@garlandind.com. Please contact John Anderson at (216) 430-3539 (or your specific Project Manager) with any questions. GDI payment terms: Net 30 WAR�— CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2020-587842 Garland/DBS, Inc. Cleveland, OH United States Date Filed: 02/13/2020 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Pearland Date Acknowledged: g Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 25-TX-200039 Roofing Services - City Hall Annex 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary Percaciante , Frank Cleveland, OH United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLAR ION My name is t ! i ! and my date �f of birth is p f My address is d66 ,� �f 7/ s �T o o es 41 OA , , (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in + s/,s,•, CreCounty, State of , on the - • /—lay of , 20Za 1h� �-.,-rte �`�a�IxND14) n''a (month) (year) q� '•�� e Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics 6nmmTssion vAvX.ethics.state.tx.us Versinn V1.1.3aFiaaf7d WAR�— House Bill 89 Verification I, a --I` Di d s'. , (Person representative (hereafter referred to as "Representative") of name), the undersigned C= 4R[Ar-Ad l 1,20S, =3C (company or business name, hereafter referred to as "Business Entity"), being an adult over the age of eighteen (18) years of age, after being duly sworn by the undersigned notary, do hereby depose and affirm the following: That Representative is authorized to execute this verification on behalf of Business Entity; 2. That Business Entity does not boycott Israel and will not boycott Israel during the term of any contract that will be entered into between Business Entity and the City of Pearland; and 3. That Representative understands that the term "boycott Israel' is defined by Texas Government Code Section 2270.001 to mean refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business�j�,J�,�el or in an Israeli -controlled territory, but does not include an action made for ofAl e, Ess purposes. ci • SEAL 6FLAWM& •. SIGNAKURE OF REPRESENTATIVE SUBSC D AND SWORN TO BEFORE ME, the undersigned authority, on this day of , 20 NotaryP�Olic- oil OF 7,ye Patty sue J huroczy State of Ohio 0 Notary Public Commission No, 2018 -RE -725008 My Commission Expires 5/21/2023