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SEWER SYSTEM IMPROVEMENTS
Q ,,MCD ig ,-p4 BUILDINGIT OG TOWN OF NORTH ANDOVER Permit N . Date Received - - APPLICAMINAnON APPLICATION FOR PLANE tw° SACHU Date Issued: IMPORTANT: Applicant must complete all items on this page L(J,�A�r�rF '✓i,P✓ ✓ i f i�`��`�r '�" � /1�'�'�'( �e"'7s-"�- �✓��d"/�I� �l�'� .S 77 ir�✓j✓�✓ i/✓✓f�iii r 1 r ✓,, ✓„ <. P- { ✓p� ✓ '� _� - +� Pn t MAP f "p,ACIC 'NINGrITRIC`C: Historic Dstrit yep Machine Shap Village yds TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family E Industrial Alteration No. of units: I Commercial Repair, replacement Assessory Bldg I I Others:04,n Demolition Other S�e�v- P"'"�`' Eep ,p , 11l1/eIJ`. l Floodpla n u Wetlands EI Vllatershod,District O/1l1at /,S,eWr I( Identification Please Type or Print Clearly) OWNER: Name: °�'� /ta'r'e 14r1do(ler" Phone: Address: CONT '�TC,�;F� '��.r A'/ Phone: 4c>�'- Addre, 19 7 q7 Superwir' o, ructic�n License:� � !0,9 22 Exp. Cate; ✓ , . L / Horne : Exp. Date: • ARCHITECT/ENGINEER Phone: - 1- ' " " Address:'K0 j/% �,� ;s 2sm 0-1444�:, , c 46z c Reg. No. FEE SCHEDULE.BULDING PERMIT,$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BA ED ON$125.00 PER S.F. Total Project Cost: $ 5" I a.1. FEE: Check No.: "le- V"4k-N'�,J e-A IL Receipt No.. NOTE: PerZZ contracting with unregistered ntr ctors do not have access to the guarant fund Signature of Agent/Owner ignature of contractor,� Plans Submitted ❑ Plans Waived,[] Certified Plot Plan El Stamped Plans F1 TYPE OF SEWERAGE DISPOSAL Public Sewer El Taraiing/Massage/Body Art ❑ Swfimning Pools 0 Well El Tobacco Sales ❑ Food Packaging/Sales El Private(septic tank,etc. El Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On J Signature- 60MMENTSAC �0(I ,- I Yk 5 TI-U 0-7,04— Wo•QP-r col>r a 6ey'-t-.6-6 A CONSERVATION Reviewed on Signatur COMMENTS_L� ,c 2 (��,2 HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes_ Planning Board Decision: Comments Consqrwafion Decision: Comments 12- Water&Sewer Connection/s! nature & Da Driveway Permit ee4q, -�PW Town Engineer: Signature:— , x Located 384 Osgood Street SIRE DP�RTI�ENT Temp Lim D _steron site 'yes., i iiiLocated at 124 f r esignature/cyte' b p , 4L C 0 K 4 M E N T 8 � NORTH ® er _t own of A n u' h ver, Mass, fw "rk% O4411-M.KA-1.1 'Q COCHIC[WICK �1. ORATED 01*1 % 5 S V BOARD OF HEALTH PERMIT LD Food/Kitchen Septic System THIS CERTIFIES THAT ........... .01*14... ,,,,,,,,,,,,,,, BUILDING INSPECTOR . . ..... .. . .. ........ Foundation has permission to erect .. buildings on .� .............................................................. ........................ ... %, Rough to be occupied as ...... �!!�.� ......... .i0o `.h!"'f ..` .......................... Chimney Ch" provided that the person accepting this permit all in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES 16 MONTHS `j ELECTRICAL INSPECTOR LESS CONSTCTI TARTS , Rough Service ............. ..... .. ... ............................. Final BU ING INSPECTOR i GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. OFFICE OF BUILDING INSPECTOR � TOWN OF NORTH ANDOVERCONSTRUCTION CONTROL � � rm"^=°. TITLE: ' ~ NAME OF BUILDING: CLecl5f NATURE OF OFPROuECT: , IN ACCORDANCE E116OFTHE MASSACHUSETTS STATE BUILDING CODE, EG|GTKATlONNO BEING AREGISTERED PROFESSIONAL ENG|NEEFUARCHITECHHEREBY CERTIFY THAT| HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ARCHITECTURAL 0 STRUCTURAL MECHANICAL � FIRE PROTECTION 0 ELECTRICAL 0 OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE,SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OFTHE MASSACHUSETTS GT/TE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATiCE8. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review,for conformance tothe design concept,shop drawings,samples and other eubmitta|o which are submitted by the contractor in accordance with the requirements of the construction � documents. 2. Review and approval ofthe quality control procedures for all code-required controlled materials. 3. Bepresent otintervals p phatatothe stage ofconstruction bobecome, generally familiar xuithGt e progress and quality of the work and todetermine, ingeneral, ifthe work isbeing performed inamanner consistent with the construction documents. PURSUANT TOSECTION 11G.2 .2 | SHALL SUBMIT WEEKLY, /\PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION DFTHE WORK, | SHALL SUBMIT AFINAL REPORT ASTOTHE SATISFACTORY COMPLETION AND READINESS[)FTHE PROJECT NAT .16MIM gm MF THIA'A.COLE NOTARY�0131_f% \,W M'assachusetts MYCOMMISSION EXP|R SECTION 00520 TOWN OF NORTH ANDOVER CONTRACT CON'fRrA--C,T## _. DATE: This Contract is entered into on,or as of,this date by and between the Town of North Andover (the"Town"),and Contractor: Waterline Industries,Corp. Address: 7 London Lane Seabrook,NH 03874 Telephone Number: (603)474-7477 Fax Number: (603)474-8578 1. This is a Contract for the procurement of the following: Construction of Rea's Pond Pumping Station Tncludiug all utilities,connection of the proposed station to existing gravity sewer pipe,connection of proposed pump station to the existing forcemain,installation of manholes,maintenance of existing sewer flows during construction,demolition of existing pumping station after acceptance of new station and overall site restoration. I The Contract price to be paid to the Contractor by the Town of North Andover is: $1,594,677.00 3, Payment will be made as follows: Upon completion of work and receipt of invoice,net 30 4. Definitions: 4.1 Acceptance: All Contracts require proper acccptcMce of the described goods or services by the Town of North Andover. Proper acceptance shall be understood to include inspection oi'goods and certification of acceptable performance for services by authorized (Rev 5-2007)Contract by and between ToNvn of North Andover and Waterline Indusides Cap. Page 1 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 Foran, 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 hi 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 `i'he date when the work is sufficiently complete,the services are performed,or the goods delivered,iur 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 July 15,2016,unless extended pursuant to a provision far extension I. 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. i 7. Permits and Annrovals: 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. (Rcv 5.2007)Contract by and botweer)TWA)t of North Andover and waterline industries Corp. Page 2 w 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 tinder this Contract including, but not limited to the wild 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 ofthis Contact,and(viii)failure to comply with any and all requirements of state law and/or regulations,and Town bylaw and/or regulations. y. The Contractor's Breach and the'fown's Kemedies; Failure of the Contractor to comply with any of the tarns or conditions of this Contract shall be deemed a material breach of this Contract,and the Town of North Andover shalt 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)Cmttract by and between Torn ol'North Andover and waterline t td!tstrice Corp. Pero 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 Coin Bance: 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 Interest: Both the Town and the Contractor acknowledge the provisions of the State Conflict of Interest Law(General Laws Chapter 268A),and this Contract express]y prohibits any activity which shall constitute a violation of that law. The Contractor shall be deemed to have investigated the application of M.G.L.c.268A to the performance of this Contract;and by executing the Contract (Rev 5.2007)CCplrrao by and between Tome ot'Nortb Andover and waterline hdusuies CoT.� Page 4 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 C'onnnonwealth or Subdivision). B. Discrimination The Contractor will carry out the obligations of this Contract in hill compliance with all of the requirements imposed by or pursuant to General Laws Chapter 151E (haw 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. Assiamnent: 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 14 such authority continues in full force and effect as of the bate 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 Amcndments thereof,and in addition thereto, relating to the appointment of the Commissioner of Corporations as its attorzicy,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 or the Commonwealth. 17. Liabilitv of Public Officials: (Rev 5-2007)ContraCt by and between'rown of*North Andover and waterline.Indmims Corp. Page 5 IN To the full extent permitted by law,no official,employee,agent or representative of the Town oi'North Andover shall be individually or personally liable on any obligation of the Town under this Contract. 18. Indei mifrcation: 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, pill regardless of whether or not it is caused in part by any party indemnified hereunder. "Phe 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 unlit the scope of the Contractor's indemnification under this contract. 19. Workers Compensation lnsurance: 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 decmed 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 fumish to the Town evidence of such insurance prior to the execution of this Contract before the same shall bebinding 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 al-4)roval of the'Town,except as otherwise required bylaw. The Contractor shall comply with the provisions Chapter 66A of the General Laws of 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. (Rev 5.2007)Contract by and bowcen'rown of North Andover and Waterline Industries. 6 Co p. Page ;,,- 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 free 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 Recurdkeeping 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 I.aw This Contract and any performance herein shall be governed by and be construed in accordance with the laws of the Cornrnonwealth. Any and all proceedings or actions relating to subject 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. tRov?-2007)Contract by and between ToN m of Norm Andover and W wi in( 1ndu.,encs Copp- Pa 7 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. Binding 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 instnnnent, 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. SuUlemental Conditions: The foregoing provisions apply to all contracts to which the'town of North Andover shall be a party. One of the following"Su " nnlementsmust he"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: [ ] GOODS SUPPLEMENT"G"- Applicable to Contracts for the procurement of .tnitd (governed by the provisions of General Laws Chapter 30B) [ ] SERVICES SUPPLEMENT"S" - Applicable to Contracts for the procurement of'ervices (governed by the provisions of General Laws Chapter 30B) [X 1 CONSTRUCTION SUPPLEMENT"C" - Applicable to Contracts for Construction (Rev 5-2000 ContraQtUy and battvc n Town oft oan Andover and Watahne ladostr es corp.T Yage S 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 THE CONTRACTOR Waterline Industries Corp. rvasio epartznont _.._ Head Company Nance Contract Manager r� `i'own Manager Date Signature Michael A Girard, Vice President Print Narne&Title CERTIFICATION AS TO AVAILABILITY OF FUNDS: i Ta4nc ountant Date (Rev 5-2007)Contnwt by and bonen Tmvn orNnrth Andover and watcrlinr Industdcs f.:`orp. �!c SECTION 00520A SUPPLI Ml'iNT"C" �] CONSTRUCTION SUPPLEMENT"C"-Applicable to Contra cts for the%onstruetion of: (1) 'ktrblic Buildines and Public Works (governed by the provisions of General I.aws Chapter 30B); (2)Public Buildi> (governed by the provisions of General Laws Chapter 149,§44A, et seq.);and (3)Public Works (governed by the provisions of General Laws Chapter 30,§39M,et seq) 1. of North Andover"Contract and General Conditions"and applies This form supplements the"fowntion,reconstruction,alteration,remodeling or repair of public works only to contracts for the construc or public btuldins, • Wherever the law requires one contracting,with a city or town to be bonded,such obligation shall be understood to be a term and condition of this Contract. The Contractor agrees to secure such bond (where required)in the form required by the Town and provide an original thereof to the"Town prior to the commencement of performance. 3. E relit : 3.1. In the case of a closed' fi pecication written for a specific.item or items to be frtmisheci under the Base Bid,such specifications shall,as applicable,be in compliance with the Massachusetts General Laves,Chapter 30,Section 39M and Chapter 149,Sec.44A et seq. 3.2. Where the name of an item,material or manufacturer is rncntioned in the Specifications or on the Drawings,except as above noted,the intent is to establish a standard and in no way should be construed to exclude any item or manufacturer not mentioned by name,but whose ign,utility and quality. Final decision shall rest product meets the Specifications as to des with the Project Representative as to its acceptability. 4, Change orders to contracts governed by General Laves Chapter 30B may not increase the quantity of goods or services provides]by more than twenty-five(25%)per rent,in compliance with Sec.1, of Chapter 30B. 5. The Contractor will Carry out the obligations of this contract in foil compliance with all of the requirements imposed by or pursuant to General Laws Chapter 15 t,Sec.1,et seq.(Minimum Wage Law)and any executive orders,piles,regulations,and requirements of the Commonwealth of Massachusetts as they may from lime 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,Sections 26 and 27D(Prevailing Wage),as shall be in force and as amended. 6. The Contractor shall continuously maintain adequate prosection of all work from damage and shall protect the property of the Town and others,including adjacent property,from injury or loss arising (Rev 5-2007)Supplement"C"to Contract bem"n the Town of North Andover Page 1 and in connection with the Contract. The Contractor shall make good any such damage,injury or loss, except as may he directly due to errors in the Contract Documents or caused by agents or employees of the Town,or due to causes beyond the Contractors control and not the Contractor's fault or negligence. 7. The Contzactor shall take all necessary precautions for the safety oferriployCeS on the work,and shall comply with all applicable provisions of Federal,State and local laws and codes to prevent:accidents or injury to persons on,about or adjacent to the premises where the work is being performed. The Contractor will erect and properly maintain at all times,as required by the conditions and progress of the work,all necessary safeguards for the protection of workers and the public,shall post danger signs warning against the hazards created by such features of construction such as pits,protruding nails,hosts,well holes,elevator hatchways,scaffolding,window openings,stairways and falling materials;and shall designate a responsible member of its organization on the work,whose duty shall be the prevention of accidents. 8. The Town shall at all times have access to the work wherever it is in preparation or progress and tine Contractor shall provide suitable accommodations for such access. 9. The Contractor shall appoint a competent superintendent and foreman and any necessary assistants, all of wbom shall be satisfactory to the Town. If the Town in its sole discretion determines that the construction superintendent,foreman,or assistants are unacceptable to the Town,then upon seven days notice from the Town,the Contractor shall replace such person or persons with people acceptable to the Town. 10. 71re Contractor shall,give efficient supervision to the work.using its best skill and attention. The Contractor shall carefully study and compare the drawings,specifications and other instructions and shall at once report to the Town any error,inconsistency or omission which shall be discovered. Included in this responsibility shall be supervision of all work performed by subcontractors on the work. 11. If the Contractor should neglect to prosecute the work properly,or fail to perform the contract or any of its provisions,the Town,upon tree days written notice,may,without prejudice to any other remedy it may have,make good such deficiencies and may deduct the cost thereof from file payment then or thereafter due the Contractor. 12. lwection the Towtr's Project Representative 12.1. The Town shall have the right to designate a project Representative who may make periodic visits to the site to familiarize the Town generally with the progress and quality of the work, and to determine in general if the work is proceeding in accordance with the Contract Documents, 'ilia Project Representative will not be required to tri ake exhaustive or continuous on-site inspections to check the quality or quantity of the work,and will not be responsible for the Contractor's failure to carry out the construction work in accordance with the Contract Documents. During such visits and on the basis of these observations while at the site,the Project Representative will keep the'fown informed on the progress of the work, will endeavor to tmard the Town against defects and deficiencies in the work of contractors, and may condemn structural work as failing to conform to the Contract Documents, The Project Representative shall have authority to act on behalf of the Town only to the extent expressly delegated by the Town,which shall be shown to the Contractor,and shall have authority to stop the work whenever such stoppage may reasonably be necessary to insure the proper execution of the Contract. (Rev 52007)Supplement"C"to Contract between the t oNvit of Nonh Andover page 2. and 12.2. In connection with the work,file Project Representative shall not be responsible for construction methods,means,techniques,sequences or procedures employed by the Contractor or the Contractor's safety programs,requirements,regulations,or precautions. 13. Decisions of the Project Representative 13.1, The Project Representative shall,within a reasonable time,make decisions on all claims of the Town or the Contractor and on all other matters relating to the execution and progress of the structural work or the interpretation of the Contract Documents. 13.2. The Project Representative's decision,in matters relating to the project,shall be final,if within the terms of the Contract Documents. 13.3. If,however,the Project Representative fails to render a decision within ten days after the parties have presented their evidence,either party may then avail itself of the remedies provided in this contract or available to it by law. If the Project Representative renders a decision after such remedies have comrnenccd,such decision may be entered as evidence but shall not disturb or interrupt such proceedings except where such decision is acceptable to the parties concerned. 14.1 Use of Premises by the Contractor. 14.1. The Contractor shall confine its apparatus,the storage of materials and the operations of its workmen to limits indicated by law,by-laws,permits or directions of the'Town and shall not unreasonably encumber the premises with its materials. 14.2. The Contractor shall not load or permit any part of the structure to be loaded with a weight that will endanger its safety. 15. Maintenance of Premises: The Contractor shall at all times keep the premises free from accumulation of waste materials or rubbish caused by its employees or work,and at the completion of the work it shall remove all its rubbish from and about the work site and all its tools,scaffolding and surplus materials and shall leave its work"broom-clean",or its equivalent,unless more exactly specified. In case of dispute, the Town may remove the rubbish and charge the cost to the several contractors,as the Town shall determine to be just. 16. Rd�f},1t tglerminate If the Contractor should(1)be adjudged a bankrupt,(2)make a general assignment for the benefit of creditors,(3)have a receiver appointed on account of its insolvency,(4)persistently or repeatedly refuse or fail to supply enough personnel and resources to perform the contract,(5)fail to make prompt payment to subcontractors or to providers of materials or labor,(6)persistently disregard laws and regulations or lawfill directives of the",'own,or M be guilty of a substantial violation of any provision of lite Contract,then the Town may,without prejudice to any other right or remedy and after giving the Contractor(or any surety)seven days written notice, terminate the contract and the employment of the Contractor and take possession of the premises and of all materials,tools and appliances thereon and finish the work by whatever method it dams appropriate. (Rev 5.21167)Supplement"C"to COnln,101 Between the"1 On ufNoRh Andover Page 3 and In such cases,the Contractor shall not be entitled to receive any further payment until the work is finished. If the unpaid amount owed to the Contractor for work already completed shall exceed the expense of finishing the work,including compensation for additional architectural, managerial,legal and administrative services,such excess shall he paid to the Contractor. If such expenses shall exceed such unpaid balances,the Contractor shall pay the difference to the Town. The Contractor shall not be relieved of liability to the Town by virtue of any tennination of this contract,and any claim for damages against the Contractor relating to the Contractor's performance under this contract shall survive any termination hereunder. Notwithstanding any other provision of this Agreement,the Town reserves the right at any time in its absolute discretion to suspend or terminate this Agreement in whole or in part for its convenience upon seven days written notice to the Contractor. The Town shall incur no liability by reason of such termination except for the obligation to pay compensation for all work performed by the Contractor and accepted by the]'own to the termination date. 17. Progress Payments: 17.1. The Contractor shall submit to the Town an itemized Application for Payment,supported to the extent required by tate Town by invoices or other vouchers,showing,payments for materials and labor,payments to Subcontractors and such other evidence of the Contractor's right to payment. 17.2. The Contractor shall,before the fust application,submit to the Town a schedule of values of the various parts of the work,including quantities aggregating the total sum of the Contract,divided so as to facilitate payments to Subcontractors,made out in such form as the Town and the Contractor may agree upon,and,if required,supported by such evidence as to its correctness. This schedule,when approved by the"Town,shall he used as a basis for payment,unless it is found to be in error. If applying for payments,the Contractor shall submit a statement based upon this schedule. 18. Withholdin off Payments 18.1. The Town may withhold or,on account of subsequently discovered evidence,nullity the whole or part of any payment to such extent as may be necessary in its reasonable Opinion to protect the Town of North Andover from loss on account of'. 18.1.1. Defective work not remedied. 18.1.2, Claims filed or reasonable evidence indicating probable filing of claims. 18.1.3. Failure of the Contractor to make payments properly to Subcontractors or for material or labor. 1 A A reasonable doubt that the Contract can be completed for the Balance then unpaid. 18.1.5. Damage to another contractor. 19.1A Delays resulting in liquidated damages. (Rev 5-2007)Supplement"C"to('ontract between fhe'rown of Noah Andover Pagc.4 and 18.2. Withholding of payments shall be in strict compliance with statutory requirements. 19. Claims b t ontractor and Liab'litof Town All claims by the Contractor against the'Cownshall,unless otherwise provided by law,be initiated by a written claim submitted to the Town no later than seven(7)calendar days after the event or the first appearance of the circumstances causing the claim. The claim shall set forth in detail all known facts and circumstances supporting the claim. The Contractor shall continue its performance under this contract regardless of the submission or existence of any claims. The limit of liability of the Town under this Agreement is limited to the compensation provided herein for work actually performed,and shall in no event include liability for delays or for incidental,special or consequential damages or lost profits or for damages or loss from causes beyond the Town's reasonable control. 20. Liquidated Damages: Because both parties recognize(1)that the time for completion of this Contract is of the essence, (2)that the Town will suffer loss if the work is not completed within the contract time specified, plus any extension thereof allowed in accordance with the provisions of this contract,and(3)the delays,expense and difficulties involved in a legal proceeding to determine the actual loss suffered by the Town if the work is not compleled in lime,it is agreed that the Contractor will pay the Town as liquidated damages representing an estimate of delay damages,not as a penalty,the sum of One'Thousand Dollars($1,000)per day for each calendar day of delay until the work is completed,whether the work is completed by the Contractor or some other.person. The Town's right to impose liquidated damages shall in no way prohibit or restrict the'Town's right to bring a low legal action for damages in lieu of or in addition to its option to impose liquidated damages. Tie Town may deduct any liquidated damages from money due the Contractor,and if such payment is insufficient to cover the liquidated damages,then the Contractor shall pay the amount due. 21. The Contractors'Mutual Responsibility: Should the Contractor cause damage to any separate subcontractor on the work,the Contractor agrees,upon due notice,to settle with such contractor by agreement,or by recourse to remedies provided bylaw or by the provisions of the contract. If such separate contractor sues the Town on account of any damage alleged to have been sustained,the Town shall notify the Contractor, who shall defend such proceedings at the'fown's expense and,if any judgment against the Town arises therefrom,the Contractor shall pay or satisfy it and pay all costs incurred by the'Town. 22. Separate Contracts: 22.1, The Town reserves the right to let other Contracts to connection with this work tinder similar General Conditions. The Contractor shall afford other contractors reasonable opportunity for the introduction and storage of their materials and the execution of their work,and shall properly connect and coordinate its work,vith theirs. 22.2. If any part of the Contractor's work depends,for proper execution or results,upon the work of an),other contractor,the Contractor shall inspect and promptly report to the Town any defects in such work that render it unsuitable for such proper execution and results. Failure of the Contractor to so inspect and report shall constitute tut acceptance (Rev 5-2007)Supplement"C"to Contract between the Town of North Andover Page i and of the other contractor's work as fit and proper for the reception of its work except as to defects which may develop in the other contractor's work after the execution of its work. 22.3. To insure the proper execution of its subsequent work,the Contractor shall measure work already in place and shall at once report to the Town any discrepancy between the executed work and the Drawings. 23. Subcontracts: 23,1, All Subcontracts shall be awarded in conformity with the requirements of the General Latus,Commonwealth of Massachusctts,Chapter 149,sections 44A to 44I..,inclusive. 23.2. The Contractor agrees that itis as fully responsible to the Town for the acts and omissions of its Subcontractors and of persons either directly or indirectly employed by them,as it is for the acts and omissions of persons directly employed by it. 23.3. Nothing contained in the Contract Documents shall create any contractual relationship between any Subcontractor and the Town. 24, Contrac(gr--Subcontraetor ROIDInIS: The Contractor agrees to bind every Subcontractor and every Subcontractor agrees to be bound by the terms of the Agreement,the General Conditions of the Contract,the Supplementary General Conditions,the Drawings and Specifications,as far as applicable to its work,including the provisions of the General Laws,Commonwealth of Massachusetts,Chapter 149,Section 44A, et seq. 25. indemnification: 25.1. `f he Contractor shall indemnify,defend and save harmless the'l own,its officers,agents and employees from and against any and all damages,liabilities,actions,suits, proceedings,claims,demands,losses,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 theta 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 bereunder.'fhe 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 employed by any of them or anyone for whose acts ally of them may be liable,including damages caused by bis,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. 25,2. In any and all claims against the Town or any of their agents or employees by any employee of the Contractor,any Subcontractor,anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable,the indemnification obligation larder this paragraph shall not be limited in any way by any limitation oil the amount or type of damages,compensation or benefits payable by or for the Contractor ar (Rev 5-2007)Supplement"C"to Contract betwaen tho I own of North Andover Pale G and IJ any Subcontractor under Workmen's Compensation Acts,disability benefit acts or other employee benefit acts. 25.3. The intent of the Specifications regarding insurance is to specify minimum coverage and ininimum 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. 26. The C'ontractor's Insurance: 26.1. The Contractor shall purchase and maintain such insurance as will protect die Contractor from claims set forth below which may arise out of or resuh 1rwn the Contractor's operations under the Contract,whether such operations be by itself or by any Subcontractor or by anyone directly or indirectly employed by any of them or by anyone for whose acts any of them may be liable. 26.1.1. Claims under Worker's Compensation,disability benefit and other similar employee benefit acts; 26.1.2. Claims for damages because of bodily injury,occupational sickness or disease,or death of its employees,and claims insured by usual personal injury liability coverage; 26.1.3. Claims for damage because of bodily injury,sickness or disease,or death of any person other than its employees,and claims insured by usual personal liability coverage; 26.1.4. Claims for damages because of injury to or destruction of tangible property, including loss of use resulting therefrom. 26.2. The insurance required by time above shall be written for not less than the following rilmunum limits of liability: 26.2.1. Worker's Colpcnsation I surattce Requirements Workers'Compensation coverage as required by the laws ofthe Commonwealth of `. Massachusetts. 26.2.2. Liability Insurance Regumrrvfents Liability insurance shall include all major divisions and shall be on a comprehensive general basis including Premises and Operations,Chvners and Contractor's Protective,Products and Completed Operations,and Owned,Non-owned and Hired Motor Vehicles.All such insurance shall be written for not less than any limits of liability required by law,unless otherwise provided in the contract documents,or the following limits,whichever are greater: (Rev 5-2007)Supplement"C"to Contract between the'tovra of North Andover Page 7 and Comprehensive General Liability Insurance (Broad Form) Bodily Injury $1,000,000 per parson $3,000,000 per occurrence Property Damage $1,000,000 per occurrence $3,000,000 annual aggregate Automobile Liability Insurance $500,000 per person $1,000,000 per occurrence Excess Liability(Umbrella) $5,000,000 Excess Liability(Umbrella)Insurance(Subcontractors) $1,000,000 or 1.5 times the value of The subcontract,wbichever is I Iigher 26.3. The above insurance policies shall also be subject to the following requireulents: 26.3.1. Insurance coverage for the Contractor's Comprehensive General Liability,as hereinafter specified under Paragraph entitled"Protective Liability Insurance" shall be written by one and the same insurance company to avoid the expense of duplicate and/or overlapping coverage and to facilitate and expedite the settlement of claims. 26.3.2. Certificates of Insurance acceptable to the'fown shall be addressed to and filed with the Town prior to commencement of the work. Renewal certificates shall be addressed to and filed with the Town at least ten(10)days prior to the expiration date of required policies. 26.3.3. No insurance coverage shall be subject to cancellation without at least thirty(30) days prior written notice forwarded by registered or certified mail to the Town. The Town shall also he notified of the attachment of any restrictive amendments to the policies. 26.3.4, All Certificates of Insurance shall be on the"TALLA"or"ACCO)"Ccrtificate.of insurance form,shall contain true transcripts from the policies,authenticated by the proper officocr of the Insurer,evidencing in particular those insured,the extent of coverage,the location and operations to which the insurance applies,the expiration date and the above-mentioned notice clauses. 26.3.5. All premium costs shall be included in the Contractor's bid. 26.3.6. All insurance shall be written car an occurrence basis.Coverage shall be maintained without intetntption from(late of the Contract until date of final payment and termination of any coverage required to be maintained atler payment. (Rev 5-2007)supplement"C"to Contract bahveen the"Down of Nort1L Audover page S and 27. protective Liabilit insurance: 27.1. The Contractor shall purchase and maintain such insurance as described in the preceding paragraph as will protect the Town from clamors which may arise from operations under the Contract,including operations performed for the named insureds by independent contractors and general inspection thereof by the narned insureds. 27.2, The Contractor shall also purchase and maintain such insurance as will protect the Town against Automobile Non-Ownership Liability in connection with the.Contractor's operations tinder the Contract,whether such operations he by itself or by any Subcontractor or by anyone directly or indirectly employed by any of them,or by anyone for whose acts any of them may be liable. 27.3. The limits of liability for coverage required under the preceding paragraphs shall be as specified under the provisions hereof governing the Contractor's General Liability Policy, 27.4. 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 and amendments,shall be the sole responsibility of time Contractor. 28. Liens: Neither the Final Payment nor any part of the retained percentage shall become clue until the Contractor,if required,shall deliver to the Town a complete release of all liens arising out of the Contract,or receipts in full in lieu thereof and,if required in either case,an affidavit that as far as it has knowledge or information,the releases and receipts include all the labor and material for which a lien could be filed. The Contractor shall comply with all statutory provisions of the General Laws of the Commonwealth of Massachusetts with regard to liens,Chapter 254 and 149 as amended(as a minimum requirement). 29. Guarantees: 29.1 The Contractor guarantees and warrants to the Town that all labor famished under this Contract will be competent to perform the tasks undertaken,that the product of such labor will yield only first-class results,that materials and equipment furnished will be of good quality and new unless otherwise permitted by this Contract;and that the Work will be of good quality,free from faults and detects and in strict conformance with this Contract. All Work not conforming to these requirements may be considered defective. 29.2, If at any time any part of the work constructed under tine terms of this contract shalt in the opinion of the Town Manager require repairing due to defective work or materials furnished by the Contractor,he may notify the Contractor in writing to make the required repairs. If the Contractor shall neglect to start such repairs within ten days of the date of giving it notice thereof and to complete the wane to the satisfaction of the Town Manager with reasonable dispatch,then the latter may employ other persons to make such repairs. The Town shall charge the expense thereof to the Contractor and may use any moneys still retained to pay for the same,and if such sum is insufficient,the Contractor shall be obligated to pay the balance thereof. (Rev 5-2007)5upplemmn"C"to ContraCt Uchveeu the tOm171 of North Andover Page 9 and 29-3. All guarantees and warranties required in the various Sections of the Specifications which originate with a Subcontractor or Manufacturer must be delivered to the Town before final payment to the Contractor may be made for the arninuit ofthat subtrade or for the phase of work to which the guarantee or warranty relates. The failure to deliver a required guarantee or warranty shall be held to constitute a failure of the Subcontractor to fully complete his work in accordance with the Contract Documents. The Contractor's obligation to correct work is in addition to,and not in substitution of,such guarantees or warranties as may be required in the various Sections of the Specifications. This Agreement is intended to take effect as a scaled instrument. Witness our hands and seals hereto: Dated: The Town of North Andover by: Town Manager To"Vou ritant Certified as to Appropriation Jt P The Contractor by: . Au&)FIZC(iSignature Ignature Michael A. Girard, Vice President (Rev 5,2007)Supplement"C"to COntract between the Town of North Andover Pale 10 and The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia s�•" Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers- TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le�iblV Name(Business/Organization/Iudividual): Address: -91 L®''v Da'V L f- ok 14 ®3� � Phone#: City/State/Zip: SEA-�� . /V Are you an employex?Check the ap'i•oprlate box: Type o£project(1'ec�uired): 1.KfI am.a.employer with : employees(full and/or part-time).* 7. Q New construction 2. I am a sole proprietor or partnership and have no employees working for me in 8. F1 Remodeling any capacity.[No workers'comp.insurance required.] 9. Demolition 3..Q I am a homeowner doing all work myself..[No workers'comp.insurance required.]t 10❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 11.E] repairs or additions ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12.El Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13,n Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 14 El Other 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no,employees.[No workers'comp.insurance required.] *any applicant that checks box#1 must also rill out the section below showing their workers'compensation policy information. homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not,those entities have . employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. X am an etaiployet'that is providing ivorkets'compensation insurance for my employees.'Below is the policy and jolt site information. o! 90 c161��c Insurance Company Name: Policy#1 or S elf-ins,Lic.#:A ZC LA/9 $4 313 O S Expiration Date: Job Site Address: l($F 6:i«4 i Avvlt Ze4 City/State/Zip:IU l vlvoo% � 44 03 5�/moi Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 1.52,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA.for insurance coverage verification. X do liet'eby cet'tif undet'tltepaitis andpenalties ofpetjuty that the information provided above is true and correct. Date: Si nature: Phone#: tr0 3-99 _Z Official use only. Do not write in this area,to he completed by city or town Official.. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ��®�®® DATE(MM/DD/YYYY) CERTIFICATELIABILITY INSURANCE 7/27/2015 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 CONTACT NAME: Pamela J. Poland, CIC Hoyle W Johnson Insurance PHONE (802)223-7735 JAICFAA/C No: (E02)223-7515 119 River Street E-MAIL ADDRESS:ppoland@ nwj insurance.com P.O. BOX 279 INSURERS AFFORDING COVERAGE NAIC# Montpelier VT 05601-0279 INSURERA:Old Republic General Ins Corp4139 INSURED INSURER B National Union Fire Co 19445 Waterline Industries Corporation INSURERC:Hanover Insurance Company 2292 7 London Lane INSURER D: INSURER E: Seabrook NH 03874 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1492822252 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 ADDLTYPE OF INSURANCE INSR WVD SUER POLICY NUMBER MMIDDIYYYY LICY EFF POLICY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A CLAIMS-MADE a OCCUR X A2CG95931304 10/1/2014 10/1/2015 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO X LOC $ AUTOMOBILE LIABILITY COMBINED tSINGLE LIMIT S 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED 2CA95931304 10/1/2014 10/1/2015 AUTOS AUTOS BODILY INJURY(Per accident) S NON-OWNED PROPERTY RTY DAMAGE E HIRED AUTOS AUTOS Medical Payments $ 10,000 UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 10,000,000 B X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 '.... DED RETENTIONS 8766142 10/1/2014 10/1/2015 $ jA WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY T RY LIMITS ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACHACCIDENT $ 1,0 0000 OFFICER/MEMBER EXCLUDED? [bj] N/p` 10/1/2014 10/1/2015 (Mandatory in NH) 2CW95931305 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I $ 1,000,000 '... C Builders Risk Coverage IRV9721385 10/1/2014 10/1/2015 Any Single Location $5,000,000 $2,500 Deductible Per Building DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate issued as respects to North Andover, MA Rea's Pond Pumping Station Replacement. Town of North Andover and Woodward & Curran are Additional Insured on General Liability per form CG20100413, on a primary basis per form CGENGN00290906, with a 30-day cancellation clause per form ILENGN00040911. All referenced forms are attached to and form part of this certificate. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 384 Osgood Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Pamela Poland/PAM � ��7� ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(gmnn5)m Tho Arr1Rrl nnmo nnrl Innn aro ronictororl mnrkc of ARr1Rr1 ACC7,RKY CERTIFICATE OF LIABILITY INSURANCE 10/1/20152015 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 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 nights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Diane Case M&T Insurance Agency,Inc. PHONE215-504-1215' Fax Net,215-504-1235 41 University Drive,Ste.405 E-MAIL dccasey@mtb.com Newtown PA 18940 INSURERS AFFORDING COVERAGE NAIC;# INSURERA:National Union Insurance Co. 19445 INSURED wsuRERB:North River Insurance Co. 21105 Waterline Industries Corp. INSURER C:New Hampshire Insurance Co. 23841 Dumke Dreamsbuilder LLC INSURERD;GreatAmerican Ins,Co. 116691 7 London Lane Seabrook, NH 03874 INSURER E: w6URER F• ''... COVERAGES CERTIFICATE NUMBER:226900992 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. IN7R TYPE OFwSURANCE1PSD EFF D POLICY NUMBER 1013 NI POLICY LIMITS LA X COMMERCIAL GENERAL LIABILITY Y Y 3372225 10/1/2015 9/1/2016 EACH OCCURRENCE $1000,000 CLAIMS-MADE 5XI OCCUR PREMISES 0=8=001 $300.000 MED EXP(Any one on $10,000._. PERSONAL&ADV INJURY $1000,000 GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2000000 POLICY a MOT a LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 10l/245 9/1/2016 EacdanINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ __- ALTOWNED SCHEDULED BODILY INJURY( Pot socidsnq $ AHIUREODSAUTOS AAUUTT00-OSNMED P dent AGE $ $ B X UMBRELLA LM X OCCUR Y Y 5811059502 10/1/2015 9/1/2016 EACHOOCURRENCE $10,000,000 EXCESS UAB SMS-MADE AGGREGATE $10,000,000 DED RETENTIONS $ C WORKERS COMPENSATION Y 14267881 10/1/2015 8/1/2016 X I PTER AND EMPLOYERS'LIABILITY S ANY PROPRIErOR/PARTNER/EXECUTNE YNIA EL.EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) EL.DISEASE-EAEMPLOYEE $1,000,000 Ir yyes descdbeund�r DESGIRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICY LIMIT $1,000,000 D Builders Risk Coverage IMP4212643 1011/2015 9/1/2016 Any Single Location $5,000,000 Deductible Per Bldg $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached Irmo.space is required) WC:Proprietor/Partner/Executive/Officer Excluded-Ralph Dumke and Maria Dumke. RE:North Andover MA Res's Pond Pumping Station Replacement. CG2010-0413-Add kional Insured CG2037-0413-Add'ti Insured-Completed Operations CG2404-0509-Waiver of Subrogation CG2001-0413-Primary&Non-Contributory WG000313-Waiver of Subrogation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 384 Osgood Street North Andover MA 01845 AUTHORtmt)REPRESENTATIVE U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD ACCMEPrd CERTIFICATE OF LIABILITY INSURANCE DATE(MMlODIYYYY) 10!1/2015 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(les)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 TACT Diane Case M&T Insurance Agency,Inc. PHONE ,215-504-1215' 1 TAAfXC. .215-504-1235 41 Univers y Drive,Ste.405 -M IL dccaseyQmtb.com Newtown PA 18940 AnnRpas! INSURERS AFFORDING COVERAGE NAIC# INSURERA:National Union Insurance Co. 19445 INSURED INSURERB:North River Insurance Co. 21105 Waterline Industries Corrpp INSURER New Hampshire Insurance Co. 23841 Dumke DreamsbuilderITC INSURERD:GlreatAmerican Ins.Co. 16691 7 Landon Lane Seabrook, NH 03874 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:226900992 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. ADDLSUSR INSR TYPE OF INSURANCE D POLICY NUMBER MOMIUDO EFF POUa EXP LIMBS A X COMMERCIAL GENERAL LIABILITY Y Y 3372226 10/1/2015 9/1/2016 EACH OCCURRENCE 51000,000 CLAIMSWADE ❑X OCCUR PREMISES Eaoccurrenoe $300,000 MED EXP(Any oneperson) $10.000 PERSONAL&ADV INJURY 51000000 GEN LAGGREGA7E LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PPRODUCTS $2,000,000Jkor OTHER: INULE LIMIT $ A AUTOMOBILELIABS.tTY Y Y 3194384 1011/2016 9/1/2010 accident $1,000,000 X AALN�YpAUUTTO BODILY INJURY(Per person) $ AUTOS ED CtED PRO ULED LY INJURY(PG accident) $ HIRED AUTOS AUTOSPaacd and $ $ B X UMBRELLA LIAB X OCCUR Y Y 6811069602 1011!2016 9/1/2016 EACH OCCURRENCE $10,000,000 EXCESS UAS CLAIMS-MADE AGGREGATE $10,000,000 DED I I RETENTIONS $ C WORKERS COMPENSATION y 14267861 10/1/2016 9/1/2016 XEMUTE T " AND EMPLOYERS'LIABILITY YINEL.EACH ACCIDENT $1,000,00,000 ANY PROPRIErOR/PARTNEREKECUTNE r-v-1 NIA OFFICERIMEMBER EXCLUDED? (Mandatory In NH) EL.DISEASE-EAEMPLOYEE $1,000,000 Ir yes eacdbo under DESG�RIPTIDNOFOPERATIONS below E,L.DISEASE-POUCYLIMIT $1,000,000 D Builders Risk Coverage IMP4212643 10/1/2016 9/1/2016 Any Single Location $6,000,000 Deductible Per Bldg $2,600 DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) WC:Propdetor/Partner/Executive/Officer Excluded-Ralph Dumke and Maria Dumke. RE:North Andover MA Res's Pond Pumping Station Replacement. CO2010-0413-Add Andover, Insured CG2037-0413-Add'ti Insured-Completed Operations CG2404-0509-Waiver of SubrOgaticn CG2001-0413-Primary&Non-Contributory C000313-Waiver of Subrogation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 384 Osgood Street North Andover MA 01845 AUTHORIZED PRESENTATIVE 171988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks Of ACORD Massachusetts Department of Puoiic Safety Board of Building Regulations and Standards License: CS-106227 Construction Supervisor JAN P VASTL Y ; PO Box 159 NORTH SALEM NH 03073 i Expiration: Commissioner 10/03/2017 J