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HomeMy WebLinkAboutPSA - Security Services for COVID Isolation Quarantine Center - Mikolajewski & Associates, Inc.OPINION OF PROGRAM ADMINISTRATOR* THATMWBE GOAL SETTING UNDER SORYTH BEND MUNICIPAL CODE CHAPTER 14.5 IS NOTREQtARED Date: Date of Board of Public Works or Other Approving Body (Sp ectly) Meeting: Company or Vendor: City DepartinenL City Project Manager: a"", ...... .... ... ToW Expenditure for Contract: Project Nanim z Project Number: Additional Comments, I hereby certify that the above project does not require goal setting under the tennis of South Bend's Inclusive Procurement and Contracting Ordinance # 10693-19, as codified in Chapter 14,5 Article 2, Section 14,5-3 of the South Bend Municipal Code. uIre Michael Patton Program Administrator *Prograrn AdrninMrator means the person designated by and reporting direcdy to the Mayor to support the City's inclusion, diversity, equity, and access goals, Opinion of Progrm Administrator Fomi AGREEMENT FOR SERVICES This Agreement for Services (this "Agreement") is made effective as of April 15, 2020 (the "Effective Date"), by and between the City of South Bend, Indiana, an Indiana municipal corporation (the "City"), acting by and through its Board of Public Works for the benefit of the City's Department of Community Investment, and Mikolajewski & Associates, Inc., an Indiana corporation (the "Provider") (each a "Party" and collectively the "Parties"). For and in consideration of the mutual covenants and promises contained herein, the Parties agree as follows: 1. Recitals. The Governor of the State of Indiana (the "Governor") issued Executive Order 20-08 effective Monday, March 23, 2020, and Executive Order 20-18, effective Monday, April 6, 2020, wherein residents of the State were advised to shelter in place during the COVID-19 global pandemic (the "Emergency"), and, previously, on March 19, 2020, he issued Executive Order 20-05, which suspends procurement rules as they apply to the acquisition of services for the City's response to the Emergency. As a result of the Emergency, individuals who cannot return home while awaiting test results or while recovering from COVID-19 need a place to shelter in place away from others. The City located a site at which such individuals may be temporarily housed during the Emergency (the "Quarantine Site"); however, the City requires security services at the Quarantine Site for the duration of the Emergency. 2. Services. The Provider will provide to the City the services (the "Services") set forth in xh l i .. A, which is attached hereto and incorporated herein by reference (the "Scope of Work"). In the event of any conflict between the terms of this Agreement and the terms of the Scope of Work, the terms of this Agreement will prevail. The Provider will execute its obligations under this Agreement in accordance with the prevailing professional standard of care for such services. 3. C... cgnsation. In exchange for the Provider's performance of the Services, and subject to the terms and conditions of this Agreement, the City will pay the Provider at the rate set forth on Exhibit A. The total sum paid under this Agreement for the initial and renewal terms combined shall not exceed One Hundred Fifty -Two Thousand Six Hundred Forty Dollars ($152,640.00) (the "Contract Amount"). The City will pay the Contract Amount as set forth on Exhibit A. The Provider will not incur or seek reimbursement for any expenses in excess of the Contract Amount and shall not commence any additional work or change the scope of the Services provided unless authorized in writing by the City. No claim for additional compensation shall be made by Provider in the absence of prior written approval of the Parties. 4. Term, Renewal-, Termination.. Unless earlier terminated in accordance with its terms, this Agreement will commence on the Effective Date and end on June 15, 2020. The Parties, upon mutual agreement, may extend the term of this Agreement through July 15, 2020, at the rate set forth in Exhibit -A and pursuant to Section 3 hereof, provided that the funding sources remain available for use for the Services. Notwithstanding the foregoing, the City may terminate this Agreement, in whole or in part, for any reason during the renewal period ten (10) days after delivery of a written termination notice to the Provider, if the City determines that such termination is in the best interest of the City. The City shall not pay for any Services performed after the effective date of such termination notice. 5. Remedies for Breach of Contract. The Provider's failure to complete the Services in accordance with this Agreement will be considered a material breach. In the event of any breach of this Agreement by the Provider, the City may suspend payment to the Provider and may pursue any and all remedies available at law or in equity. 6. Point of Contact. The City employee identified in Section 11 below will serve as the City's principal point of contact for purposes of this Agreement. 7. Relationship. The Provider shall at all times be an independent contractor for the performance of the Services rather than an employee of the City, and no act or omission to act by the Provider shall in any way bind or obligate the City. No employee of the Provider will be considered or deemed to be an employee of the City. This Agreement is strictly for the benefit of the Parties and not for any third party or person. This Agreement was negotiated by the Parties at arm's length and each of the parties hereto has reviewed the Agreement after the opportunity to consult with independent legal counsel. Neither party shall maintain that the language in the Agreement shall be construed against any signatory hereto. The City and the Provider hereby renounce the existence of any form of agency relationship, joint venture, or partnership between the Provider and the City and agree that nothing contained herein or in any document executed in connection herewith shall be construed as creating any such relationship between the City and the Provider. 8. Confidentiality. The Provider acknowledges that information which the City or a program participant regards as confidential or proprietary in nature, including medical information (the "Information"), may come to the knowledge of the Provider during the Provider's performance of the Services. The Provider shall treat the Information as strictly confidential and agrees that the Provider will not, at any time or in any manner, either directly or indirectly, (i) use, or allowed to be used, any Information for the Provider's own benefit or the benefit of any director, official, employee, or agent or any third party, or (ii) divulge, disclose, or communicate in any manner any Information to any third party without the written consent of the City. The Provider shall be responsible for maintaining the confidentiality of any Information in his possession, including taking appropriate measures to secure said Information against such uses and dissemination and to inform any person to which he allows to access such Information of its confidentiality. Notwithstanding anything to the contrary contained in this Agreement, the Parties will adhere to their respective obligations, if any, under any law or court order, and nothing herein will be construed to relieve either Party of such obligations. The confidentiality provisions of this Agreement remain in full force and effect after, and survive the termination of, the term (including any renewal term) of this Agreement. 9. Indemnification _ofvCity. The Provider acknowledges that the nature of the Services necessitates a high level of care on its part to ensure the safety of its employees and the safety of others, including, but not limited to, requiring protective gear and maintaining insurance. The Provider represents and warrants that it has and will maintain liability and workers compensation insurance for its business and that it will require its employees to wear any necessary protective gear, which gear the City will provide or cause to be provided. The Provider hereby agrees to indemnify, defend, and hold harmless the City and its officials, employees, and agents, from any and all claims of any nature which arise from the performance by the Provider under this Agreement and from all costs and attorney fees in connection therewith, except for claims arising out of the negligence or intentional acts or omissions of the City or its officials, directors, employees, or agents. The obligations of the Provider under this section shall survive the termination of this Agreement. 10. Assigmnent. The Provider shall not assign or subcontract the whole or any part of this Agreement or its obligations hereunder without the prior written consent of the City. 11. Notices. Any notice required or permitted to be delivered hereunder shall be deemed to be delivered when deposited in the United States Postal Service, postage prepaid, registered or certified mail, return receipt requested, addressed to the City or the Provider, as the case may be, at the address set forth below. Provider: Mikolajewski & Associates, Inc. 325 S. Summit Drive South Bend, IN 46619 Attn: Eugene Mikolajewski City: City of South Bend, Indiana Department of Community Investment 227 W. Jefferson Boulevard, Suite 1400 S. South Bend, IN 46601 Attn: Pamela Meyer 12. LIt1A �ority. Each undersigned person executing and delivering this Agreement on behalf of a Party represents and warrants that he or she is a duly authorized representative of such Party and that he or she has been fully empowered to execute and deliver this Agreement on behalf of such Party. 13. l cl tralm- llpwc t 2 t Non- Discrii ination Com ill ance, The Provider shall comply with all applicable laws and regulations in its hiring and employment practices and policies for any activity covered by this Agreement. The Provider shall comply with all federal, state, and municipal laws, regulations, and standards applicable to its activities pursuant to this Agreement including, but not limited to, the requirements imposed by Ind. Code 22-9-1-10 (non-discrimination), the provisions of Ind. Code 5-22-16.5 (disqualification for dealings with the government of Iran), and the provisions of Ind. Code 22-5-1.7 (requiring E-Verify for new employees and prohibiting employment of unauthorized aliens). Each of the foregoing provisions is incorporated herein as if set forth in full, and the Provider certifies that it is in compliance with each such provision and shall remain in compliance through the term of this Agreement. 14. D., rug-Frc c, Wor pla q. The Provider hereby agrees to make a good faith effort to provide and maintain a drug -free workplace. The Provider will give written notice to the City within ten (10) days after receiving actual notice that the Provider or an employee of the Provider within the State of Indiana has been convicted of a criminal drug violation occurring in the workplace. 15. Noii ClllLlSi" n and Acceptance. The Provider attests, subject to the penalties for perjury, that it is the Provider, that it has not, directly or indirectly, to the best of its knowledge after due inquiry, entered into or offered to enter into any combination, collusion or agreement to receive or pay, and that it has not received or paid, any sum of money or other consideration for the execution of this Agreement other than that which appears upon the face of this Agreement. 16. No Waiver. No failure or delay on the part of either Party in exercising any right under this Agreement will operate as a waiver of, or impair, any such right. No single or partial exercise of any such right will preclude any other or further exercise thereof or the exercise of any other right. No waiver of any such right will have effect unless given in a written document signed by the Party waiving such right. No waiver of any right will be deemed a waiver of any other right hereunder. 17. Severabili. In the event any portion of this Agreement shall be held illegal, void, or ineffective, the remaining portions hereof shall remain in full force and effect. If any of the terms or conditions of this Agreement are in conflict with any applicable statute or rule of law, then such terms and conditions shall be deemed inoperative to the extent that they may conflict therewith and shall be deemed to be modified to conform to such law. 18. Entit•c Agrcenient Arl gDcillint.• Applicable ble Law. This Agreement sets forth the entire agreement and understanding between the parties as to the subject matter hereof, and merges and supersedes all prior discussions, agreements, and understandings of any and every nature between them. This Agreement may be amended only by separate writing, signed by authorized representatives of both the Provider and the City. This Agreement will be construed and interpreted according to the laws of the State of Indiana. Signature Page Follows IN WITNESS WHEREOF, the Parties hereto have caused this Agreement for Services to be effective as of the Effective Date stated above. CITY: CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS BOARD OF PUBLIC WORKS Gary A. Gilot, President Elizabeth A. Maradik, Member Therese J. Doran, Member JordannVV.. Gathers, Member Joseph R. Molnar, Member ATTEST: o'21'zda Cif mr n Linda M. Martin, Clerk PROVIDER: MIKOLAJW— J & ASSOCIATES, INC. Ye Date: mm 1✓ lgene Mikolajewski President Date: April 28, 2020 EXHIBIT A Scope of Work The Provider shall provide the City with uniformed, armed security officers at the Quarantine Site twenty-four (24) hours per day, seven (7) days per week at a rate of Thirty -Five Dollars ($35.00) per hour per officer. The Provider may provide an incentive of an additional Fifteen Dollars ($15.00) per hour per officer for work on Memorial Day and Independence Day. A site supervisor shall be present at the site at least forty (40) hours per week, and the City's site manager shall be provided with a contact number for any security -related communications or needs that may arise at any time at no additional cost to the City. At all times, one officer shall be stationed indoors and one officer shall be stationed outdoors in a vehicle. The Provider's site supervisor and the City's site manager will be points of contact along with the individuals named in Paragraph 1 I of this Agreement. The City will provide or cause to be provided face masks and gloves for use by the officers during their shifts at the Quarantine Site. The officers are expected to wear such protective gear and to practice social distancing etiquette as recommended by the St. Joseph County, Indiana Health Department and/or the Centers for Disease Control and Prevention. The Provider is not expected to provide direct medical assistance as a part of the Services. Services shall be authorized by the City for the Quarantine Site and shall be paid for by the City. Provider shall submit an itemized invoice to the City's contact person on a weekly basis for payment within thirty (30) days of its receipt. When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS (Must be completed for all quotes and bids. Please type or print) STATE OF ��✓�N, ) SS: COUNT The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that: 1. Contractor has not, nor has any other member, representative, or agent of the firm, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and without any agreement, understanding or combination with any other person in reference to such bidding. Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and 2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency; and 3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment activities in Iran. a. For purposes of this Certification, "Iran" means the government of Iran and any agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time -to -time. b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged in investment activities in Iran if either: i. Contractor, its successor or its affiliate, provides goods or services of twenty million dollars ($20,000,000) or more in value in the energy sector of Iran; or ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty million dollars ($20,000,000) or more in credit to another person for forty-five (45) days or more, if that person will (i) use the credit to provides goods and services in the energy sector in Iran; and (ii) at the time the financial institution extends credit, is a person identified on list published by the Indiana Department of Administration.. Non -Collusion Non -Debarment Affidavit Non Iran Form 2016 4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify Program is included and attached as part of this bid/quote; and 5. Contractor shall require his/her/its subcontractors performing work under this public contract to certify that the subcontractors do not knowingly employ or contract with an unauthorized alien, nor retain any employee or contract with a person that the subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is participating in the E-Verify Program. The Contractor agrees to maintain this certification throughout the term of the contract with the City of South Bend, and understands that the City may terminate the contract for default if the Contractor fails to cure a breach of this provision no later than thirty (30) days after being notified by the City. 6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by the City of South Bend through its agencies, boards, or commissions shall not discriminate against any employee or applicant for employment in the performance of a City contract with respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or indirectly related to employment because of race, sex, religion, color, national origin, ancestry, age, gender expression, gender identity, sexual orientation or disability that does not affect that person's ability to perform the work. In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials, or any combination of the foregoing including, but not limited to, public works contracts awarded under public bidding laws or other contracts in which public bids are not required by law, the City, its agencies, boards, or commissions may consider the Contractor's good faith efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining the lowest, responsible, responsive bidder. In no event shall persons or entities seeking the award of a City contract be required to award a subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board shall prohibit that person or entity from being awarded a City contract for a period of one (1) year from the date of such determination, and such determination may also be grounds for terminating the contact for which the discriminatory practice or noncompliance pertains. 7. The undersigned contractor agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions. Contractor agrees not to discriminate against or intimidate any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sex, gender expression, gender identity, sexual Non -Collusion Non -Debarment Affidavit Non Iran Form 2016 orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). 1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder may result in forfeiture of contractual payments. hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this a19 day of , 20 ;'b Contractor der (Fa m Signat r o Contractor/Bidder or Its Agent Printed Name and Title Subscribed and sworn to before me this My Commission Expires 6�1 KLZ County of Residence Non -Collusion Non -Debarment Affidavit Non Iran Form 2016 day of 4))!" t , 20 Notary Pubiic APSHA L. BROWN Notary Public, State of Indiana Coun!y of St Joseph SEAL Commission N W174 Gomm1-1— EX01'.. Junes 2a, 2021 MIKO&AS-01 KS 'RUEBI ACORO DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 4/15/2020 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. .. ._ —�._... �w IMPORTANT: If the certificate holder is an_ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsementfsl. 1 n riderck& Sri der Agency, Inc. PO EcT Kim Sirtat3 wng F L PRODUCER y — __..� � AIc N 09 664- 1 91Ickngtd Drive W p, Ex9_ (09 664 1800.. Bloomington, IL 61701 E�wAl rt INSURED Mikolajewski & Associates Inc 325 S Summit Dr South Bend, IN 46619-2336 COVERAGES ..... CERTIFICATE NUII R: R 'V/ISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN _ _p _m ISSUED TO THE INSURED NAMED ABOVE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF FOR THE POLICY PERIOD 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, CONDITIONS OF SUCH P _,... MAY HAVE REDUCED BY PAID CLAIMS INSR - TYPE OF INSURANCE DLICIES-.,LIMITS„SHOWN AODL SIyBRA ... ...M. .COMMERCIAL -._.A _..... ...' POLICY NUMBER .... ." "` .."""""" �.....,....-..•— -.- .-. POLNCY EFF POLICY E3fP LIMITS IPcI GENERAL LIABILITY CLAIMS -MADE p OCCUR At Fi CICCRFiC NCE AMAGE'rORINI`ED Y MFMl,' FO. J! FRS r �FK C 9 _ ...._ AOV IN J �._. CENL Cf'REGA�F A R- LIMIT APPLIES PER. POLICY Y E PLY LOC G�MTUFtY.. E _.. A , ECT PROOUCT'S_ OONVF�dCd' OTHER, .... _. ...�.: .....W®.... _.._ ... """'".. _ AUTOMOBILE LIABILITY INED INCLELI MIT ...i„�k..a '�Dl- $ ANYAUTO OWNED SCHEDULED OD%LY %IIJNJRY % or eryuar �' �, � �. 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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of South Bend Indiana THE EXPIRATION DATE THEREOF„ NOTICE WILL BE DELIVERED IN Department of Community Investment ACCORDANCE WITH THE POLICY PROVISIONS. 227 W. Jefferson Boulevard, Su'tte 1400, S. South Bend, IN 46601 AUTHORIZED REPRESENTATIVE f .......�—._... _... "'.Fa.. .. _..RD 25 ..... ....... —. _.... ........._ . �.M. ........ ACO(2016I03) The ACORD name and logo are registe ..... ©1988-2015 ACORD CORPORATION. All rights reserved. red marks of ACORD MIKO&AS-01 Kf>T, I CERTIFICATE OF LIABILITY INSURANCE mmmm 4/17/2020 .� DATE (MMIDD/YYYY) 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. If the certificate IS WAIVED, subject to the terms and conditions of the policy, certain policies mmmmm �mmm mmITITITITITITo statement �� nt WW holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. J � p y, may require an endorsement. A statement on this certificate does not confer r18hts to the certificate holder in lieu of such endorsement(s) 1 ilyrick and tDrive A/ No ExKI(309) 664I1800 I I. PRODUCER O TACT Sn der & Sn der Agency, Inc. PHONE -1885 N� O 664 m Bloomington, IL 61701 EµMAIL 9 ADDRE'SR, INSURED Mikolajewski & Associates Inc 325 S Summit Dr South Bend, IN 46619-2336 A. COVRAGE_. .....CERTIFICATE NUMBER: R: _...... 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 �..-- TYPE OF INSURANCE ADDL SUBR .... .... _._........ ,... .. ........ _... - ,........... .... __. ._... ---- . . �M POLICY NUMBER POLICY EFF POLICY EXP LIMITS ........ I�.�Iz .ar�!a.._ .......__..�. MAai�'�...iAei�ala COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE [- OCCUR DAMAGE TO RENTED Pr)' t$E$ V9uik.IS ) 1.. ...,.,, MEN EXP, An one -person) ...-... �.- _.m PERSONAL & ADV INJURY $ POLICY AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE PRO- �... .� JECT" LOC PRODUCTS - GOMP/OP AGG $ _. .. OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I ss7Grl ) $. ..... ... ANY AUTO BODILY I . Per erson $, . AUTOS ONLY _ AUTOS BODILY INJURY (Per,acadenI) - -_ AUti ti ONLY A4J� NFeAiEudetAhti/ GF.... $ UMBRELLA LIAB OCCUR EACH OCCUENCE RR $ ..... EXCESS LIAR CLAIMS -MADE AGGREGATE $,,... . DE) RETENTION $ $ ........ YEN..____... 5300002258201 5/1/20_._ A WORKERS COMPENSATION _ X PER FORTH AND EMPLOYERS' LIABILITY .,TATUTF _ ANY PROPRIETOR/PARTNER/EXECUTIVE � 2O 5/1/2021 500,000 FFPGERIMEMBER EXCLUDED? N / A E.L. DISEASE GEA EMPLOYEE $ (Mandatory in NH)-_.._..-11 500,000 If yes, describe under _�_ DESCRIPTION OF OPERATIONS belowE.L. DISEASE POLICY LIMIT $ 500,00(I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of South Bend Indiana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Department of Community Investment 227 W. Jefferson Boulevard, Suite 1400 S. --- ........ South Bend, IN 46601 AUTHORIZED REPRESENTATIVE ...................... ....... ...... _._...._. ACORD 25 (2016/03) ... ©1988 2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE (MMIDDNYYY) A .AC"R"CERTIFICATE OF LIABILITY INSURANCE 04/15/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT ss Ledgestone Insurance Group PHONE D309 on E266e2507--- jj ,Nra}:(309 26'3-2510 410 N. Main Street WC. NtsxEXII ( ) I ) East Peoria IL 61611 INSURETS) AFFORDING COVERAGE NAIC p A Secura Insurance Companies 22 593 INSURED (DIG) z3u-yoze Mikolajewski & Associates, Inc INSURER6: INSURER C.' 325 S Summit Dr INSURERD: South Bend IN 46619 ,.INSURER ,E: INSURER F : COVERAGES CIFIRTIFICATIF NIIMWIRFR-Cart ID 49RG RFVISIAN 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 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. IN SRR AI}7LNF.... TYPE OF INSURANCE POLICY NUMBER POLICY EF MMIQ Yk YYY.. ........... . .-. F � PC,7LL..Y E14ir. MMIDD 7 LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 I I DAMAGE 701t6NT0 .- �CLAIMS-MADE ! X,I OCCUR CP003314278 12/01/201912/01/2020 PREMISES.(Eaaccurrggqg) $_ 100,000 F MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY .-, $ 1,000,000 GEN'LAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000 000 _., .. PRO- , ..... ............._. POLICYJECT �„ �LOC PRODUCTS COMP/OPAGG $ 2,000 000 OTHER: $ AUTOMOBILE LIABILITY COMBI N ED SINGL E LIMIT (Ca„a,cldont), $ 1,000,000 ANY AUTO CP003314278 12/01/201912/01/2020 BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS ��,,. _. BODILY INJURY (Per accident) .---___ $ X„ HIRED X NON -OWNED PROPB.RTY�DAMAGE . $ AUTOS ONLY AUTOS ONLY (Farr A idgcrl) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y / N .--- STATUTE ,' OIL.,..... ANYPROPRI ETOR/PARTNER/EXECUTI VE OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE EA EMPLOYEE $ If yes, describe under _, DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A Professional Liability CP003314278 12/01/2019 12/01/2020 Each "Wrongful Act" $ 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of South Bend, Indiana ACCORDANCE WITH THE POLICY PROVISIONS. Department of Community Investment 227 W Jefferson Blvd AUTHORIZED REPRESENTATIVE Suite 1400 S South Bend IN 46601 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Paqe 1 of 1 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 4/20/2020 _ . . Name Pam Me er Department DCI BPW Date 4/28/2020 Phone Extension 5845 IIV^,efi,Wik f�",OIGJIN�AXdS'AWIk�'F'T.M.MkN�Y�1RFVTF� � .._ �..0 vz—vr ,n Y�YMMIY�Y�Y�Y�Y�Y�Y�Y�YdCIYC y'�'w�:^.a.�:+NimW,l3n�'—��'�^C,�&;'pm�Imm@BIXfr"M�����������IIdmIA�mIAAdII���mIIdI���III�IPW:0.Y�.v i�NNHBCi.mai�:� ��Aw�F»!f!P(9bWJd �� "��....W....... — 1 r�mm. ..����--------- ..emu Review and App�c al 1 e,�red Prior to Submittal to Board Diversity Compliance ® Officer Name Michael Patton and Inclusion Officer . ,m__---BPW Attorney � ....��_ ® Attorney Name l i D M e Cl.�....ww _.�_--____,�.. ........ ara canes Dept. Attorney Z Attorney Name Sandra Kenned Purchasing Z Michael Schmidt������ _ __....� Check the A a �t'o �r� �caC ...�,�.� m m_-. � ........__�............�. __ .1he A ) �� Item I yd .:.._l c tr a c All Submissions ® Professional Services Agreement ❑ Contract ❑ Proposal ......._ .... ❑ Open Market Contract ❑ Amendment/Addendum El Special Purchase, QPA ❑ Bid Opening El Bid Award F-1 Req. to Advertise ❑ Title Sheet Quote Opening Proposal Opening Chg. Order, No. _ Other: Company or Vendor Name New Vendor MBE/WBE Contractor Project Name Project Number Funding Source Account No. Amount Terms of Contract Purpose/Description E] Quote Award Ej C/O & PCA No Traffic Control E Reject Bids/Quotes 0 PCA Resolution F Ease./Encroach Department of Community Investment ....� ^_ Yes If .... .....�.............. _�___ _.....m.__. �.......... .... ...... ....__—. ® Yes, Approved by Purchasing �] No MBE Completed E-Verify Form Attached ❑ Nos COVID Isolation Ouarantine Center Securitv 408-0401-415.39.30 152,640.00 -not to exceed 04 16 2020 — 065/2020� allows 30 extension to July 15,2020 --- Provides for 24/7 security services at Isolation Center -..m.._ ................. ,... For C1���n&, Orders Onl �w�r. :. Amount of Increase $ � .. .....,, � ....� �.... Decrease �$ Previous Amount $ .................... ----- -- .................................----- _ ___.-........m Increase m..mam /o Current Percent of Changer Decrease ( %)_.................................. ............ New Amount $ Increase % .......... ........ ___ ._ .__._. Total Percent of Change: Decrease ( %) Time Extension Amount:. _..--------------------- ---- —------.... .....r. New Comoletion Date: