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HomeMy WebLinkAboutContract #: 703 - From: 10-01-2013 To: 02-27-2016 - Howard P Fairfield LLC - Town of North AndoverAC40R V CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 09/30/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MCGRIFF, SEIBELS & WILLIAMS OF TEXAS, INC. 5080 Spectrum Dr., Suite 900E CONTACT NAME: A No Ext : (469) 232-2100 C No): E-MAIL ADDRESS: Addison, TX 75001 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:FirstSpecialty Insurance Corporation 34916 12/31/2014 INSURED Howard P. Fairfield, LLC INSURER B :American Casualty Co. of Reading, PA INSURER C: Alamo Group Inc. 1627 E Walnut Street Seguin, TX 78155 INSURER D: INSURER E, DAMA ET RENTED 50,000 PREMISES Ea occurrence $ INSURER F: COVERAGES CERTIFICATE NUMBER:UH6KL2DT REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TypE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY IRG200231500 12/31/2014 12/31/2015 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR DAMA ET RENTED 50,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ EXCLUDED X $100,000 SIR PERSONAL & ADV INJURY $ 1,000,000 X Limit Incl. Products Liability LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $ 4,000,000 POLICY❑PRO- JECT LOC MOTHER: PRODUCTS - COMPIOP AGG $ 4,000,000 I$ B AUTOMOBILE LIABILITY BUA 5082522691 BUA 5082522772 09/30/2015 09/30/2016 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ $ DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Certificate Holder is included as Additional Insured as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover Attn: Contracts & Bids AUTHORIZED REPRESENTATIVE (y' 120 Main Street q \jUjJf`rL• North Andover, MA 01845 Page 1 of 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD TOWN OF NORTH ANDOVER CONTRACT CONTRACT #�Q DATE: O 9 - a 4la01-3 This Contract is entered into on, or as of, this date by and between the Town of North Andover (the "Town"), and Contractor: Howard P. Fairfield, LLC dba HP Fairfield & WH Rose Address: 9 Green Street Skowhegan, ME 04976 Telephone Number: 207-474-9836 Fax Number: 207-474-6526 1. This is a Contract for the procurement of the following: Purchase and service of small equipment (list attached) by Department of Public Works in accordance with MDOTWESTON061 for the "period of October 1, 2013 through February 27, 2016 2. The Contract price to be paid to the Contractor by the Town of North Andover is: Prices in accordance with MDOTWESTON061 3. Payment will be made as follows: Upon completion of services and receipt of invoice, net 30 4. Definitions: 4.1 Acceptance: All Contracts require proper acceptance of the described goods or services by the Town of North Andover. Proper acceptance shall be understood to include inspection of goods and certification of acceptable performance for services by (Rev 5-2007) Contract by and between Town of North Andover and HP Fairfield & WH Rose Page 1 authorized representatives of the Town to insure that the goods or services are complete and are as specified in the Contract. 4.2 Contract Documents: All documents relative to the Contract including (where used) Instructions to Bidders, Proposal Form, General Conditions, Supplementary General Conditions, General Specifications, Other Specifications included in Project Manual, Drawings, and all Addenda issued during the bidding period. The Contract documents are complementary, and what is called for by any one shall be as binding as if called for by all. The intention of the document is to include all labor and materials, equipment and transportation necessary for the proper performance of the Contract. 4.3 The Contractor: The "other party" to any Contract with the Town. This term shall (as the sense and particular Contract so require) include Vendor, Contractor, Engineer, or other label used to identify the other party in the particular Contract. Use of the term "Contractor" shall be understood to refer to any other such label used. 4.4 Date of Substantial Performance: The date when the work is sufficiently complete, the services are performed, or the goods delivered, in accordance with Contract documents, as modified by approved Amendments and Change Orders. 4.5 Goods: Goods, Supplies or Materials. 4.6 SubContractor: Those having a direct Contract with the Contractor. The term includes one who furnished material worked to a special design according to the Drawings or Specifications of this work, but does not include one who merely furnishes material not so worked. 4.7 Work: The services or materials contracted for, or both. 5. Term of Contract and Time for Performance: This Contract shall be fully performed by the Contractor in accordance with the provisions of the Contract Documents on or before February 27, 2016, unless extended pursuant to a provision for extension contained in the Contract documents at the sole discretion of the Town, and not subject to assent by the Contractor, and subject to the availability and appropriation of funds as certified by the Town Accountant. The time limits stated in the Contract documents are of the essence of the Contract. 6. Subject to Appropriation: Notwithstanding anything in the Contract documents to the contrary, any and all payments which the Town is required to make under this Contract shall be subject to appropriation or other availability of funds as certified by the Town Accountant. In the absence of appropriation, this Contract shall be immediately terminated without liability for damages, penalties or other charges. 7. Permits and Approvals: Permits, Licenses, Approvals and all other legal or administrative prerequisites to its performance of the Contract shall be secured and paid for by the Contractor. (Rev 5-2007) Contract by and between Town of North Andover and HP Fairfield & WH Rose Page 2 8. Termination and Default: 8.1 Without Cause. The Town may terminate this Contract on seven (7) calendar days notice when in the best interests of the Town by providing notice to the Contractor, which shall be in writing and shall be deemed delivered and received when given in person to the Contractor, or when received by fax, express mail, certified mail return receipt requested, regular mail postage prepaid or delivered by any other appropriate method evidencing actual receipt by the Contractor. Upon termination without cause, Contractor will be paid for services rendered to the date of termination. 8.2 For Cause. If the Contractor is determined by the Town to be in default of any term or condition of this Contract, the Town may terminate this Contract on seven (7) days notice by providing notice to the Contractor, which shall be in writing and shall be deemed delivered and received when given in person to the Contractor, or when received by fax, express mail, certified mail return receipt requested, regular mail postage prepaid or delivered by any other appropriate method evidencing actual receipt by the Contractor. 8.3 Default. The following shall constitute events of a default under the Contract: 1) any material misrepresentation made by the Contractor to the Town; 2) any failure to perform any of its obligations under this Contract including, but not limited to the following: (i) failure to commence performance of this Contract at the time specified in this Contract due to a reason or circumstance within the Contractor's reasonable control, (ii) failure to perform this Contract with sufficient personnel and equipment or with sufficient material to ensure the completion of this Contract within the specified time due to a reason or circumstance within the Contractor's reasonable control, (iii) failure to perform this Contract in a manner reasonably satisfactory to the Town, (iv) failure to promptly re -perform within a reasonable time the services that were rejected by the Town as unsatisfactory, or erroneous, (v) discontinuance of the services for reasons not beyond the Contractor's reasonable control, (vi) failure to comply with a material term of this Contract, including, but not limited to, the provision of insurance and non-discrimination, (vii) any other acts, specifically and expressly stated in this Contract as constituting a basis for termination of this Contact, and (viii) failure to comply with any and all requirements of state law and/or regulations, and Town bylaw and/or regulations. 9. The Contractor's Breach and the Town's Remedies: Failure of the Contractor to comply with any of the terms or conditions of this Contract shall be deemed a material breach of this Contract, and the Town of North Andover shall have all the rights and remedies provided in the Contract documents, the right to cancel, terminate, or suspend the Contract in whole or in part, the right to maintain any and all actions at law or in equity or other proceedings with respect to a breach of this Contract, including damages and specific performance, and the right to select among the remedies available to it by all of the above. (Rev 5-2007) Contract by and between Town of North Andover and HP Fairfield & WH Rose Page 3 From any sums due to the Contractor for services, the Town may keep the whole or any part of the amount for expenses, losses and damages incurred by the Town as a consequence of procuring services as a result of any failure, omission or mistake of the Contractor in providing services as provided in this Contract. 10. Statutory Compliance: 10.1 This Contract will be construed and governed by the provisions of applicable federal, state and local laws and regulations; and wherever any provision of the Contract or Contract documents shall conflict with any provision or requirement of federal, state or local law or regulation, then the provisions of law and regulation shall control. Where applicable to the Contract, the provisions of the General Laws are incorporated by reference into this Contract, including, but not limited to, the following: General Laws Chapter 30B — Procurement of Goods and Services. General Laws Chapter 30, Sec. 39, et seq: - Public Works Contracts. General Laws Chapter 149, Section 44A, et seq: Public Buildings Contracts. 10.2 Wherever applicable law mandates the inclusion of any term and provision into a municipal contract, this Section shall be understood to import such term or provision into this Contract. To whatever extent any provision of this Contract shall be inconsistent with any law or regulation limiting the power or liability of cities and towns, such law or regulation shall control. 10.3 The Contractor shall give all notices and comply with all laws and regulations bearing on the performance of the Contract. If the Contractor performs the Contract in violation of any applicable law or regulation, the Contractor shall bear all costs arising therefrom. 10.4 The Contractor shall keep itself fully informed of all existing and future State and National Laws and Municipal By-laws and Regulations and of all orders and decrees of any bodies or tribunals having jurisdiction in any manner affecting those engaged or employed in the work, of the materials used in the work or in any way affecting the conduct of the work. If any discrepancy or inconsistency is discovered in the Drawings, Specifications or Contract for this work in violation of any such law, by-law, regulation, order or decree, it shall forthwith report the same in writing to the Town. It shall, at all times, itself observe and comply with all such existing and future laws, by-laws, regulations, orders and decrees; and shall protect and indemnify the Town of North Andover, and its duly appointed agents against any claim or liability arising from or based on any violation whether by him or its agents, employees or subcontractors of any such law, by-law, regulation or decree. 11. Conflict of Intere Both the Town and the Contractor acknowledge the provisions of the State Conflict of Interest Law (General Laws Chapter 268A), and this Contract expressly prohibits any activity which shall constitute a violation of that law. The Contractor shall be deemed to have investigated the (Rev 5-2007) Contract by and between Town of North Andover and HP Fairfield & WH Rose Page 4 application of M.G.L. c. 268A to the performance of this Contract; and by executing the Contract documents the Contractor certifies to the Town that neither it nor its agents, employees, or subcontractors are thereby in violation of General Laws Chapter 268A. 12. Certification of Tax Compliance This Contract must include a certification of tax compliance by the Contractor, as required by General Laws Chapter 62C, Section 49A (Requirement of Tax Compliance by All Contractors Providing Goods, Services, or Real Estate Space to the Commonwealth or Subdivision). 13. Discrimination The Contractor will carry out the obligations of this Contract in full compliance with all of the requirements imposed by or pursuant to General Laws Chapter 151B (Law Against Discrimination) and any executive orders, rules, regulations, and requirements of the Commonwealth of Massachusetts as they may from time to time be amended. 14. Assi nment: Assignment of this Contract is prohibited, unless and only to the extent that assignment is provided for expressly in the Contract documents. 15. Condition of Enforceability Against the Town: This Contract is only binding upon, and enforceable against, the Town if. (1) the Contract is signed by the Town Manager or its designee; and (2) endorsed with approval by the Town Accountant as to appropriation or availability of funds; and (3) endorsed with approval by the Town Counsel as to form. 16. Corporate Contractor: If the Contractor is a corporation, it shall endorse upon this Contract (or attach hereto) its Clerk's Certificate certifying the corporate capacity and authority of the party signing this Contract for the corporation. Such certificate shall be accompanied by a letter or other instrument stating that such authority continues in full force and effect as of the date the Contract is executed by the Contractor. This Contract shall not be enforceable against the Town of North Andover unless and until the Contractor complies with this section. The Contractor, if a foreign corporation, shall comply with the provisions of the General Laws, Chapter 181, Sections 3 and 5, and any Acts and Amendments thereof, and in addition thereto, relating to the appointment of the Commissioner of Corporations as its attorney, shall file with the Commissioner of Corporations a Power of Attorney and duly authenticated copies of its Charter or Certificate of Incorporation; and said Contractor shall comply with all the laws of the Commonwealth. (Rev 5-2007) Contract by and between Town of North Andover and HP Fairfield & WH Rose Page 5 17. Liability of Public Officials: To the full extent permitted by law, no official, employee, agent or representative of the Town of North Andover shall be individually or personally liable on any obligation of the Town under this Contract. 18. Indemnification: The Contractor shall indemnify, defend and save harmless the Town, the Town's officers, agents and employees, from and against any and all damages, liabilities, actions, suits, proceedings, claims, demands, losses, costs, expenses, recoveries and judgments of every nature and description (including reasonable attorneys' fees) that may arise in whole or in part out of or in connection with the work being performed or to be performed, or out of any act or omission by the Contractor, its employees, agents, subcontractors, material men, and anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, regardless of whether or not it is caused in part by any party indemnified hereunder. The Contractor further agrees to reimburse the Town for damage to its property caused by the Contractor, its employees, agents, subcontractors or material men, and anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including damages caused by his, its or their use of faulty, defective, or unsuitable material or equipment, unless the damage is caused by the Town's gross negligence or willful misconduct. The existence of insurance shall in no way limit the scope of the Contractor's indemnification under this contract. 19. Workers Compensation Insurance: The Contractor shall provide by insurance for the payment of compensation and the furnishing of other benefits under Chapter 152 of the General Laws of Massachusetts (The Worker's Compensation Act) to all employees of the Contractor who are subject to the provisions of Chapter 152 of the General Laws of Massachusetts. Failure to provide and continue in force such insurance during the period of this Contract shall be deemed a material breach of this Contract, shall operate as an immediate termination thereof, and Contractor shall indemnify the Town for all losses, claims, and actions resulting from the failure to provide the insurance required by this Article. The Contractor shall furnish to the Town evidence of such insurance prior to the execution of this Contract before the same shall be binding on the parties thereto, except if specifically waived by the Town. 20. Documents, Materials, Etc. Any materials, reports, information, data, etc. given to or prepared or assembled by the Contractor under this Contract are to be kept confidential and shall not be made available to any individual or organization by the Contractor (except agents, servants, or employees of the Contractor) without the prior written approval of the Town, except as otherwise required by law. The Contractor shall comply with the provisions Chapter 66A of the General Laws of (Rev 5-2007) Contract by and between Town of North Andover and HP Fairfield & WH Rose Page 6 Massachusetts as it relates to public documents, and all other state and federal laws and regulations relating to confidentiality, security, privacy and use of confidential data. Any materials produced in whole or in part under this Contract shall not be subject to copyright, except by the Town, in the United States or any other country. The Town shall have unrestricted authority to, without payment of any royalty, commission, or additional fee of any type or nature, publicly disclose, reproduce, distribute and otherwise use, and authorize others to use, in whole or in part, any reports, data or other materials prepared under this Contract. All data, reports, programs, software, equipment, furnishings, and any other documentation or product paid for by the Town shall vest in the Town at the termination of this Contract. The Contractor shall at all times, during or after termination of this Contract, obtain the prior written approval of the Town before making any statement bearing on the work performed or data collected under this Contract to the press or issues any material for publication through any medium. 21. Audit, Inspection and Recordkeeping At any time during normal business hours, and as often as the Town may deem it reasonably necessary, there shall be available in the office of the Contractor for the purpose of audit, examination, and/or to make excerpts or transcript all records, contracts, invoices, materials, payrolls, records of personnel, conditions of employment and other data relating to all matters covered by this Agreement. 22. Payment The Town agrees to make all reasonable efforts to pay to the Contractor the sum set forth in the Contractor's bid or proposal within thirty (30) days of receipt of an invoice detailing the work completed and acceptance from the Town of the work completed. 23. Waiver and Amendment Amendments, or waivers of any additional term, condition, covenant, duty or obligation contained in this Contract may be made only by written amendment executed by all signatories to the original Agreement, prior to the effective date of the amendment. To the extent allowed by law, any conditions, duties, and obligations contained in this Contract may be waived only by written Agreement by both parties. Forbearance or indulgence in any form or manner by a party shall not be construed as a waiver, nor in any manner limit the legal or equitable remedies available to that party. No waiver by either party of any default or breach shall constitute a waiver of any subsequent default or breach of a similar or different matter. 24. Forum and Choice of Law This Contract and any performance herein shall be governed by and be construed in accordance with the laws of the Commonwealth. Any and all proceedings or actions relating to subject (Rev 5-2007) Contract by and between Town of North Andover and HP Fairfield & WH Rose Page 7 matter herein shall be brought and maintained in the courts of the Commonwealth or the federal district court sitting in the Commonwealth, which shall have exclusive jurisdiction thereof. This paragraph shall not be construed to limit any other legal rights of the parties. 25. Notices Any notice permitted or required under the provisions of this Contract to be given or served by either of the parties hereto upon the other party hereto shall be in writing and signed in the name or on the behalf of the party giving or serving the same. Notice shall be deemed to have been received at the time of actual service or three (3) business days after the date of a certified or registered mailing properly addressed. Notice to the Contractor shall be deemed sufficient if sent to the address set forth in the Contract and to the Town of North Andover by being sent to the Town Manager, Town Hall, 120 Main Street, North Andover, Massachusetts 01845. 26. Bindiny, on Successors: This Contract shall be binding upon the Contractor, its assigns, transferees, and/or successors in interest (and where not corporate, the heirs and estate of the Contractor). 27. Complete Contract: This instrument, together with its endorsed supplements, and the other components of the contract documents, constitutes the entire contract between the parties, with no agreements other than those incorporated herein. 28. Supplemental Conditions: The foregoing provisions apply to all contracts to which the Town of North Andover shall be a party. One of the following "Supplements" must be "checked" as applicable to this Contract, shall be attached hereto, and shall in any event apply as the nature of the Contract requires. The Supplement contains additional terms governing the Contract: [ X ] GOODS SUPPLEMENT "G" - Applicable to Contracts for the procurement of Goods (governed by the provisions of General Laws Chapter 3013) [ X ] SERVICES SUPPLEMENT "S" - Applicable to Contracts for the procurement of Services (governed by the provisions of General Laws Chapter 3013) [ ] CONSTRUCTION SUPPLEMENT "C" - Applicable to Contracts for Construction (Rev 5-2007) Contract by and between Town of North Andover and HP Fairfield & WH Rose Page 8 IN WITNESS WHEREOF the parties have hereto and to two other identical instruments set forth their hands the day and year first above written. THE TOWN �,/ ?-1 3 - _100�11/_ (PA-- Div&on/D�epaq&ent Head Contract ger Town Manager Date THE CONTRACTOR Company Name �_a: � - o c- Signature Date Print Name & Title APPROVED AS TO FORM: Town Counsel V Date CERTIFICATION AS TO AVAILABILITY OF FUNDS: �m PPA To n ccountant Date (Rev 5-2007) Contract by and between Town of North Andover and HP Fairfield & wH Rose Page 9 SUPPLEMENT "G" 1. This form supplements the general provisions of the Contract between the Town of North Andover and Howard P. Fairfield, LLC (dba HP Fairfield & WH Rose), which Contract is a contract for the procurement of goods. 2. "Goods" shall mean Goods, Supplies, or Materials, as described in the Contract. 3. Change Orders: Change orders may not increase the contract price by more than twenty-five percent (25%), in compliance with General Laws Chapter 30B, §13. 4. This Contract for purchase includes the following delivery, installation or setup requirements: Delivery to Department of Public Works 384 Osgood Street North Andover MA 01845 i Dated: 4z THE TOWN OF NORTH ANDOVER B C� Y• T wn Manager THE CONTRACTOR By: (Rev 5-2007) Supplement "G" to Contract between the Town of North Andover Page 1 and HP Fairfield & WH Rose SUPPLEMENT "S" 1. This form supplements the general provisions of the Contract between the Town of North Andover, and Howard P. Fairfield, LLC (dba HP Fairfield & WH Rose), which Contract is a contract for the procurement of services. 2. "Services" shall mean furnishing of labor, time, or effort by the Contractor. This term shall not include employment agreements, collective bargaining agreements, or grant agreements. Change Orders: Change orders for contracts subject to Massachusetts General laws Chapter 30B may not increase the quantity of services by more than twenty-five (25%) per cent, in compliance with General Laws Chapter 30B, § 13. 4. Minimum Wage/Prevailing Wage; The Contractor will carry out the obligations of this Contract in full compliance with all of the requirements imposed by or pursuant to General Laws Chapter 151, § 1, et seq. (Minimum Wage Law) and any executive orders, rules, regulations, and requirements of the Commonwealth of Massachusetts as they may from time to time be amended. The Contractor will at all times comply with the wage rates as determined by the Commissioner of the Department of Labor and Industries, under the provisions of General Laws Chapter 149, 26 to 27D (Prevailing Wage), as shall be in force and as amended. Insurance: The Contractor shall obtain and maintain the following insurance: 5.1 Workers Compensation lnsurance of the scope and amount required by the laws of the Commonwealth of Massachusetts. 5.2 Broad Form Commercial General Liability coverage with limits of at least $1 Million per occurrence and $3 Million aggregate, and which shall cover bodily injury, death, or property damage arising out of the work. 5.3 Automobile Liability Coverage, including coverage for owned, hired, or borrowed vehicles with limits of at least $1 Million per person, and $1 Million per accident. 5.4 The intent of the Specifications regarding insurance is to specify minimum coverage and minimum limits of liability acceptable under the Contract. However, it shall be the Contractor's responsibility to purchase and maintain insurance of such character and in such amounts as will adequately protect it and the Town from and against all claims, damages, losses and expenses resulting from exposure to any casualty liability in the performance of the work. 5.5 All required insurance shall be certified by a duly authorized representative of the insurers on the "MIIA" or "ACORD" Certificate of Insurance form incorporated into and made a part of this agreement. Properly executed certificates signifying adequate coverage in effect for the duration of the contract with renewal certificates issued not less than 30 days prior to (Rev 5-2007) Supplement "S" to Contract between the Town of North Andover Page 1 and HP Fairfield & WH Rose expiration of a policy period, must be submitted to the Town prior to commencement of this Agreement. 5.6 The Town shall be named as an additional insured on the above referenced liability policies, and the Contractor's insurance shall be the primary coverage. The cost of such insurance, including required endorsements or amendments, shall be the sole responsibility of the Contractor. 6. Indemnification: The Contractor shall indemnify, defend and save harmless the Town, its officers, agents and employees from and against any and all damages, liabilities, actions, suits, proceedings, claims, demands, losses, costs, expenses, recoveries and judgments of every nature and description (including reasonable attorneys' fees) brought or recovered against them that may arise in whole or in part out of or in connection with the work being performed or to be performed, or out of any act or omission by the Contractor, its employees, agents, subcontractors, material men, and anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable, regardless of whether or not it is caused in part by any party indemnified hereunder. The Contractor further agrees to reimburse the Town for damage to its property caused by Contractor, its employees, agents, subcontractors or material men, and anyone directly or indirectly or indirectly employed by any of them or anyone for whose acts any of them may be liable, including damages caused by his, its or their use of faulty, defective or unsuitable material or equipment, unless the damage is caused by the Town's gross negligence or willful misconduct. The existence of insurance shall in no way limit the scope of this indemnification. APPROVED AS TO FORM ONLY: Town Counsel I CERTIFY THAT FUNDS ARE AVAILABLE IN ACCOUNT No Town ccountant TOWN OF NORTH ANDOVER ,.4AI40,� Tow anager 101-n-13 Department/DjysioHead THE CONTRACTOR: (Rev 5-2007) Supplement "S" to Contract between the Town of North Andover Page 2 and HP Fairfield & WH Rose SECTION 2.00 -- PROCUREMENT PURPOSE and SCOPE 2.10 Procurement Scope This solicitation is issued pursuant to Commonwealth of Massachusetts's regulations 801 CMR 21.00. The purpose of this solicitation is to establish an award of a limited price agreement contract to compile a list of multiple qualified vendors for the purchase and service of small equipment as required by Massachusetts Department of Transportation (MassDOT) in accordance with the specifications contained herein. Categories that will fall under this RFR are as follows but not limited to: Light towers cement mixers, portable & tow able Line painting machines, walk behind Walk behind asphalt grinders mini excavators wood chippers fork lifts hot boxes for asphalt air compressors tow behind trailers misc. landscape equipment misc. industrial equipment diesel portable generators waste oil burners mortar mixers skid steers (wheeled & tracked) skid steer attachments diesel pumps & accessories 3 point hitch attachments This RFR will be seeking percentage discounts from each vendor's current price list by manufacturer or catalog along with hourly rates for service. This solicitation is being issued by the MassDOT to interested parties for the submission of sealed bids for a contract to provide MassDOT with the purchase and service of small equipment in accordance with the specifications contained herein. SECTION 3.00 -- ACQUISITION METHOD 1. Acquisition Method will be an outright purchase contract for goods & services. 2. Multiple Contractors. 3. Any other Agency of the Commonwealth or municipalities may contract under this RFR but MUST execute a separate contract that meets their own legal and business requirements. 4. Eligible Users of the contract will be responsible for ordering, procuring and paying for any materials purchased under this contract. 5. MassDOT will only be responsible for those goods or services ordered by an agent of MassDOT. SECTION 4.00 -- CONTRACT AWARD 4.10 Multiple Award This Request for Response (RFR) sets out the Specifications for Purchasing and Service of Small Equipment as required by Massachusetts Department of Transportation and other Commonwealth entities. Prior to a contract award for this RFR, contractors may be required to present evidence to MassDOT that they have the necessary equipment, storage facilities, experience, ability, and capital. to furnish the required goods & services in the manner prescribed and to perform the required work satisfactorily. MDOTWESTON061 9 ACCORD® CERTIFICATE OF LIABILITY INSURANCE DAT2/30/2014 Y) 12/30/2014 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTERTHE COVERAGE AFFORDED BYTHE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MCGRIFF, SEIBELS & WILLIAMS OF TEXAS, INC. 5080 Spectrum Dr., Suite 900E Addison, TX 75001 CONTACT NAME: A N Ext : (469) 232-2100 FANo): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :First Specialty Insurance Corporation 34916 IRG200231500 INSURED Howard P. Fairfield, LLC INSURER B:Sentry Insurance Company INSURER C: Alamo Group Inc. 1627 E Walnut Street X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FRI OCCUR Seguin, TX 78155 INSURER D INSURER E: INSURER F: PREMISES Ea occurrence $ 50,000 CUVLKACitti CERTIFICATE NUMBER:KF5KE3BG RFVlglnhl NIIMRFR- 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD[YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY IRG200231500 12/31/2014 12/31/2015 EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FRI OCCUR PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ EXCLUDED X $100,000 SIR PERSONAL &ADV INJURY $ 1,000,000 X Limit Incl. Products Liability GENERAL AGGREGATE $ 4,000,000 L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 PRO X M'POLICYF7]JECT LOC $ B AUTOMOBILE LIABILITY 901806803 901806804 09/30/2014 09/30/2015 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident ( ) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N / A - TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below T, is DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The Certificate Holder is included as Additional Insured as respects General Liability as required by written contract. I.CK 11rIL Al t MULLltK CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover Contracts &Bids AUTHORIZED REPRESENTATIVE 120 120 Main Street North Andover, MA 01845 r! Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACORD® CERTIFICATE OF LIABILITY INSURANCE DAT9/29/2014 Y) 09I29I2014 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 ALTERTHE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MCGRIFF, SEIBELS & WILLIAMS OF TEXAS, INC. 5080 Spectrum Dr., Suite 900E CONTACT NAME: a/c° No Ext : (469) 232-2100 A No): Addison, TX 75001 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:Llberty Surplus Insurance Corporation 10725 12/31/2013 INSURED Howard P. Fairfield, LLC INSURER B :Sentry Insurance Company INSURER C: Alamo Group Inc. 1627 E Walnut Street Seguin, TX 78155 INSURER D INSURER E: A A 50,000 PREMISES Ea occurrence $ INSURER F: PERSONAL & ADV INJURY $ 1,000,000 COVERAGES CERTIFICATE NUMBER:PA7WXSZO REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE I D S POLICY NUMBER EFF MM DDPOLICY/YYYY POLICY EXP MMIDD/YYYY LIMITS A GENERAL LIABILITY 100001771904 12/31/2013 12/31/2014 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR A A 50,000 PREMISES Ea occurrence $ MED EXP (Any one person) $ EXCLUDED PERSONAL & ADV INJURY $ 1,000,000 X $100,000 SIR X Limit Incl, Products Liability GENERAL AGGREGATE I $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PE� LOC $ B AUTOMOBILE LIABILITY 901806803 901806804 09/30/2014 09/30/2015 COMBINED)SINGLE LIMIT Ea accident1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I RETENTION $ $ WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS' LIABILITY Y/ N TQRY LIMIJS ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F N I A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) _ -If yos. z±escrihe L'nd- DESCRIPTION OF OPERAI IONS below E.L. DISEASE - POLICY LIMIT $ $ DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The Certificate Holder is included as Additional Insured as respects General Liability as required by written contract. GERTIFIGATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover AUTHORIZED REPRESENTATIVE Attn: Contracts & Bids 120 Main Street North Andover, MA 018451 Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2010/05) Issued May ` COMMONWEALTH OF MASSACHUSETTS 200400 CONTRACTOR AUTHORIZED SIGNATORY LISTING CONTRACTOR LEGAL NAME: P2�t2 GLC A CONTRACTOR VENDOR/CUSTOMER CODE: M INSTRUCTIONS: Any Contractor (other than a sole -proprietor or an individual contractor) must provide a listing of individuals who are authorized as legal representatives of the Contractor who can sign contracts and other legally binding documents related to the contract on the Contractor's behalf. In addition to this listing, any state department may require additional proof of authority to sign contracts on behalf of the Contractor, or proof of authenticity of signature (a notarized signature that the Department can use to verify that the signature and date that appear on the Contract or other legal document was actually made by the Contractor's authorized signatory, and not by a representative, designee or other individual.) NOTICE: Acceptance of any payment under a Contract or Grant shall operate as a waiver of any defense by the Contractor challenging the existence of a valid Contract due to an alleged lack of actual authority to execute the document by the signatory. For privacy purposes DO NOT ATTACH any documentation containing personal information, such as bank account numbers, social security numbers, driver's licenses, home addresses, social security cards or any other personally identifiable information that you do not want released as part of a public record. The Commonwealth reserves the right to publish the names and titles of authorized signatories of contractors. AUTHORIZED SIGNATORY NAME TITLE Rod Winter President & CEO John Briare Vice President Nicole Terreri Vice President I certify that I am the President, Chief Executive Officer, Chief Fiscal Officer, Corporate Clerk or Legal Counsel for the Contractor and as an authorized officer of the Contractor I certify that the names of the individuals identified on this listing are current as of the date of execution below and that these individuals are authorized to sign contracts and other legally binding documents related to contracts with the Commonwealth of Massachusetts on behalf of the Contractor. I understand and agree that the Contractor has a duty to ensure that this listing is immediately updated and communicated to any state department with which the Contractor does business whenever the authorized signatories above retire, are otherwise terminated from the Contractor's employ, have their responsibilities changed resulting in their no longer being authorized to sign contracts with the Commo lth or whenever new signatories are designated. Date: Signature Title: President & CEO Telephone: 262-796-6122 Fax: 262-784-0886 Email:rwinter@specializedindustries.com [Listing can not be accepted without all of this information completed.] A copy of this listing must be attached to the "record copy" of a contract filed with the department. r Issued May COMMONWEALTH OF MASSACHUSETTS 2004 CONTRACTOR AUTHORIZED SIGNATORY LISTING CONTRACTOR LEGAL NAME: CONTRACTOR VENDOR/CUSTOMER CODE: PROOF OF AUTHENTICATION OF SIGNATURE This page is optional and is available for a department to authenticate contract signatures. It is recommended that Departments obtain authentication of signature for the signatory who submits the Contractor Authorized Listing. This Section MUST be completed by the Contractor Authorized Signatory in presence of notary. Signatory's full legal name (print or type): Rodney C. Winter Title:Pres X y -411A ci Signature as it will appear on contract or other AWb Jor/u n. 13R/A (Complete only in presence of notary): AUTHENTICATED BY NOTARY OR CORPORATE CLERK (PICK ONLY ONE) AS FOLLOWS: 1, ) (NOTARY) as a notary public certify that I witnessed the signature of the aforementi d signatory above and I verified the individual's identity on this date: —,20 3 IVY commission expires on: /Z -/S'- 13 AFFIX NOTARY SEAL 1, (CORPORATE CLERK) certify that I witnessed the signature of the aforementioned signatory above, that I verified the individual's identity and confirm the individual's authority as an authorized signatory for the Contractor on this date: , 20 AFFIX CORPORATE SEAT, CERTIFICATIONS CERTIFICATE OF NON -COLLUSION The undersigned certifies under penalties of perjury that this bid or proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the word "person" shall mean natural person, business, partnership, corporation, committee, union, club or other organization, entity, or group of individuals. Signature `� Date 1*/Y1�� Print Name & Title Company Name CERTIFICATE OF TAX COMPLIANCE Pursuant to Chapter 62C of the Massachusetts General Laws, Section 49A (b), I authorized signatory for Name of individual Name of contractor do hereby certify under the pains and penalties of perjury that said contractor has complied with all laws of the Commonwealth of Massachusetts, and the Town of North Andover, relating to taxes, permit or other fees, reporting of employees and contractors, and withholding and remitting child support. �>/0 I% ignature Date f/.�141,3 A� �" CERTIFICATE OF LIABILITY INSURANCE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS page 1 of 1 09/09/2FDATE(MM/DDNYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Willis of Wisconsin, Inc. c/o 26 Century Blvd. LIMITS PHONE . 877-945-7378 FAx 888-467-2378 E-MAIL certificates@willis.com P. O. Box 305191 Nashville, TN 37230-5191 INSURER(S)AFFORDING COVERAGE 4AIC # 2083820862 INSURERA:National Fire Insurance Company of HarV.4 20478-001 9/1/2014 INSURED DAMAGE TO RENTED PREMISES Eaoocurence $ 200,000 Howard P. Fairfield, LLC INSURERS: INSURERC: 9 Green Street Skowhegan, ME 04976 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMRFR• 2n421 Tan DCVICIAKI \II IRAQOD.n__ 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 TYPE OF INSURANCEDD' SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY Y 2083820862 6/1/2013 9/1/2014 EACH OCCURRENCE $ 1 000,000 DAMAGE TO RENTED PREMISES Eaoocurence $ 200,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MED EXP (Any one person) $ 15,000 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 17 POLICY PRO-AFCT LOC $ A AUTOMOBILE LIABILITY 2097340725 6/1/2013 9/1/2014 COMBINED OMBI ED) INGLELIMIT $ 1,000,000 BODILY INJURY(Per person) $ ANYAUTO ALL OWNEDX AUTOS AUTOS BODILY INJURY(Per accident) $ SCHEDULED HIREDAUTOS NON -OWNED AUTOS PR PERTYDAMA E (Per accident) $ $ UMBRELLALIAB OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I RETENTION $ $ WORKERS COMPENSATIONU- AND EMPLOYERS'LIABILITY YINTWC E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ IMandato y In NH) f yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required) THIS VOIDS AND REPLACES PREVIOUSLY ISSUED CERTIFICATE DATED: 9/5/2013 WITH ID: 20315886 Town of North Andover is Additional Insured for General Liability with respect to work performed by the Insured. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover I AUTHORIZED REPRESENTATIVE Attn: Contracts & Bids 120 Main Street North Andover, MA 01845 Coll:4204680 Tt,1:1653448 Certelo32176n Cc)19RR-2ninACARnr`ARDnaATIA1J All -1,6---A ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD