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Executed Cairns-- CO #1 with Ins. Cert.
EJCDC No. C-510 (2002 Edition)Page 1 of 2 Prepared by the Engineers' Joint Contract Documents Committee and endorsed by the Associated General Contractors of America and the Construction Specifications Institute. Change Order No. ______1_____ Date of Issuance: 06/28/2017 Effective Date: 06/28/2017 Project:Northampton Drainage Relocation Owner: City of Northampton, MA Owner's Contract No.:N/A Contract:Northampton Drainage Relocation Date of Contract:6/16/2017 Contractor:George R. Cairns and Sons, Inc.Engineer's Project No.:20164277.003A The Contract Documents are modified as follows upon execution of this Change Order: Description:See Attachment A Attachments: (List documents supporting change):See Attachment A for description and reason for changes CHANGE IN CONTRACT PRICE:CHANGE IN CONTRACT TIMES: Original Contract Price:Original Contract Times:F Working days F Calendar days Substantial completion (days or date):11/21/17(158 Days) $ 1,797,962.00 Ready for final payment (days or date): 12/21/17 (188 Days) [Increase] [Decrease] from previously approved Change Orders No.____________ to No.____________: [Increase] [Decrease] from previously approved Change Orders No.____________ to No.____________: Substantial completion (days): N/A $ N/A Ready for final payment (days): N/A Contract Price prior to this Change Order:Contract Times prior to this Change Order: Substantial completion (days or date): 11/21/17 (158 Days) $ 1,797,962.00 Ready for final payment (days or date): 12/21/17 (188 Days) [Increase] of this Change Order:[Increase] [Decrease] of this Change Order: Substantial completion (days or date): N/A $ 0 Ready for final payment (days or date): N/A Contract Price incorporating this Change Order:Contract Times with all approved Change Orders: Substantial completion (days or date): 11/21/17 (158 Days) $ 1,797,962.00 Ready for final payment (days or date): 12/21/17 (188 Days) RECOMMENDED: ACCEPTED: ACCEPTED: By: By: By: Engineer (Authorized Signature)Owner (Authorized Signature)Contractor (Authorized Signature) Date: Date: Date: Approved by Funding Agency (if applicable): Date: 6/28/17 6/30/17 6/30/17 EJCDC No. C-510 (2002 Edition)Page 2 of 2 Prepared by the Engineers' Joint Contract Documents Committee and endorsed by the Associated General Contractors of America and the Construction Specifications Institute. ATTACHMENT A CONTRACT CHANGE ORDER NO. 1 Northampton Drainage Relocation NORTHAMPTON, MA 1.1 Insured Parties Adjustment Description: Add Property Owner, Valley Community Development Corporation, and Lender, CEDAC ISAOA/ATIMA, as additional insured parties. Property Owner:Valley Community Development Corporation 30 Market Street Northampton, MA 01060 Lender:CEDAC ISAOA/ATIMA 18 Tremont Street, Suite 500 Boston, MA 02108 This change results in no change in the contract amount. Reason for Change: Valley CDC requested to be added onto the Contractor’s Certificate of Insurance. The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) 6/28/2017 THE ROWLEY AGENCY INC. 45 Constitution Avenue P.O. Box 511 Concord NH 03302-0511 Peggy Johnson (603)224-2562 (603)224-8012 pjohnson@rowleyagency.com George R. Cairns & Sons, Inc. 8 Ledge Road Windham NH 03087 Travelers Indemnity Co 25658 Travelers Prop Cas Co of Amer 25674 Travelers Indemnity Co of CT 25682 A X X X DTCO7615C131IND16 9/30/2016 9/30/2017 Per Project Aggregate Applies Only If Required By Written Contract 1,000,000 300,000 5,000 1,000,000 2,000,000 2,000,000 Employee Benefits A X X X DT8107615C131IND16 9/30/2016 9/30/2017 1,000,000 Uninsured motorist BI-single B X X X 10,000 DTSMCUP7615C131TIL16 9/30/2016 9/30/2017 5,000,000 5,000,000 C N 3A States: CT,MA,NH,VT,ME DTEUB7615C131TCT16 9/30/2016 9/30/2017 X 1,000,000 1,000,000 1,000,000 Northampton Drainage Relocation. CEDAC ISAOA/ATIMA is additional insured under all liability policies except work comp when required by written contract. Peggy Johnson/PAJ CEDAC ISAOA/ATIMA 18 Tremont Street, Suite 500 Boston, MA 02108 The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes, describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S) AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) 6/28/2017 THE ROWLEY AGENCY INC. 45 Constitution Avenue P.O. Box 511 Concord NH 03302-0511 Peggy Johnson (603)224-2562 (603)224-8012 pjohnson@rowleyagency.com George R. Cairns & Sons, Inc. 8 Ledge Road Windham NH 03087 Travelers Indemnity Co 25658 Travelers Prop Cas Co of Amer 25674 Travelers Indemnity Co of CT 25682 A X X X DTCO7615C131IND16 9/30/2016 9/30/2017 Per Project Aggregate Applies Only If Required By Written Contract 1,000,000 300,000 5,000 1,000,000 2,000,000 2,000,000 Employee Benefits A X X X DT8107615C131IND16 9/30/2016 9/30/2017 1,000,000 Uninsured motorist BI-single B X X X 10,000 DTSMCUP7615C131TIL16 9/30/2016 9/30/2017 5,000,000 5,000,000 C N 3A States: CT,MA,NH,VT,ME DTEUB7615C131TCT16 9/30/2016 9/30/2017 X 1,000,000 1,000,000 1,000,000 Northampton Drainage Relocation. Valley Community Development Corporation is additional insured under all liability policies except work comp when required by written contract. Peggy Johnson/PAJ Valley Community Development Corporation 30 Market St. Northampton, MA 01060