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HomeMy WebLinkAboutRohl Global Networks"IMPORTANT. BID ENCLOSED" Bid No. 21-08-01 Utility Undergrounding for Golden Shores OPENING DATE AND TIME: Tuesday, September 28, 2021 at 2:30pm ROH L GLOBAL NETWORKS ROHL Global Networks LP 2875 Jupiter Park Drive Suite 900 Jupiter, FL 33458 561-316-2294 Main 561-768-9453 Fax www. rohlalobaL com City of Sunny Isles Beach Utility Undergrounding for Golden Shores Invitation to Bid No. 21-08-01 ,NY f Table of Contents — Company Information 2 — Qualifications 3 — References 4— Bid Packet ROHL Global Networks LP www.rohlolobal.com Founded 2017 2875 Jupiter Park Drive Suite 900 Jupiter, FL 33458 561-316-2294 Main 561-768-9453 Fax cszklaruk@rohlglobal. com ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) r `� 9/23/2021 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 CONTACT NAME: Gina Barra ato Keyes Coverage Insurance PHONEFAX 5900 Hiatus Road ; 954-724-7000 AIC.No): 954-724-7024 nooREss: gbarragato@keyescoverage.com Tamarac FL 33321 INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Continental Insurance Company 35289 INSURED 16117 INSURER B: National Fire Insurance Company of Hartford 20478 Rohl Global Networks LP; Rohl Networks LP 2875 Jupiter Park Drive INSURER C: ValleForge Insurance Company 20508 INSURER D: Suite 900 Jupiter FL 33458 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 53053237 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 6080023478 1/19/2021 1/19/2022 EACH OCCURRENCE _ $ 1,000,000 DAMAGE TO RENTED CLAIMS -MADE � OCCUR PREMISES Ea occurrence $500,000- MED EXP (Any one person) $ 15,000 X Dad 5,000 PerOcc X EBL Dad 1,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 NFGEN'L X POLICY 71 PEa [ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ X OTHER: At Per Wrtn Cont B AUTOMOBILE LIABILITY Y Y 6080023447 1/19/2021 1/19/2022 COMBINED SINGLE LIMIT $1,000,000 Ea accident 1 000 000 BODILY INJURY (Per person) $ ANY AUTO 1X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ (per a RZtDAMAGE ROPj$ X HIRED AUTOS X AUTOS NO -OWNED $ X Com $1,000 X Coll $1,000 1 A X UMBRELLA LIAB X OCCUR Y Y CUE 6080023464 1/19/2021 1/19/2022 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N Y WC 6 80023450 1/19/2021 1/19/2022X PER OTH- STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED9 ❑NIA (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Job Name: Utility Undergrounding for Golden Shores — ITB No. 21-08-01 City of Sunny Isles Beach is Additional Insured with respect to General Liability per form #CNA74705XX 01/15 and Automobile per form #CNA63359XX 04/12. A Waiver Subrogation is provided in favor of City of Sunny Isles Beach for General Liability per form #CNA74705XX 01/15, Automobile per form #CNA63359XX 04/12 and Workers Compensation per form #WC 00 0313 04/84, as required in written contract. City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach FL 33160 :w aays cancellation- iu tor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD CNABusiness Auto Policy , :,�,j;I+IfII11111jg111l�i1,1�.. ji4f�f�fl�i. .iiliNl....... ... .U a.......: N THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. LIABILITY COVERAGE A. Who Is An Insured The following is added to Section II, Paragraph A.1., Who Is An insured: 2 1. a. Any incorporated entity of which the Named Insured owns a majority of the voting stock on the cc date of inception of this Coverage Form; provided that, N 2 b. The insurance afforded by this provision A.1. does not apply to any such entity that is an insured under any other liability "policy" providing auto coverage. 2. Any organization you newly acquire or form, other than a limited liability company, partnership or N joint venture, and over which you maintain majority ownership interest. M The insurance afforded by this provision A.2.: a. Is effective on the acquisition or formation date, and is afforded only until the end of the policy period of this Coverage Form, or the next anniversary of its inception date, whichever is earlier. O m m b. Does not apply to: S (1) Bodily injury or property damage caused by an accident that occurred before you acquired or N formed the organization; or S 0 (2) Any such organization that is an insured under any other liability "policy" providing auto coverage. 3. Any person or organization that you are required by a written contract to name as an additional insured is an insured but only with respect to their legal liability for acts or omissions of a person, who qualifies as an insured under SECTION II — WHO IS AN INSURED and for whom Liability Coverage is afforded under this policy. If required by written contract, this insurance will be primary O and non-contributory to insurance on which the additional insured is a Named Insured. O 4. An employee of yours is an insured while operating an auto hired or rented under a contract or agreement in that employee's name, with your permission, while performing duties related to the conduct of your business. "Policy", as used in this provision A. Who Is An Insured, includes those policies that were in force on the inception date of this Coverage Form but: 1. Which are no longer in force; or 2. Whose limits have been exhausted. B. Bail Bonds and Loss of Earnings Section Il, Paragraphs A,2. (2) and A.2. (4) are revised as follows: 1. In a.(2), the limit for the cost of bail bonds is changed from $2,000 to $5,000; and �. 2. In a.(4), the limit for the loss of earnings is changed from $250 to $500 a day. Form No: CNA63359XX 104-2012) Policy No: SUA 6080023447 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 01/1912021 Endorsement No: 11; Page: 1 of 4 Policy Page: 85 of 160 Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606 Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Office Inc u5r-d with its nrrrniacinn C. Fellow Employee Business Auto Policy Section 11, Paragraph B,5 does not apply. Such coverage as is afforded by this provision C. is excess over any other collectible insurance. If. PHYSICAL DAMAGE COVERAGE A. Glass Breakage - Hitting A Bird Or Animal - Falling Objects Or Missiles The following is added to Section III, Paragraph A,3.: With respect to any covered auto, any deductible shown in the Declarations will not apply to glass breakage if such glass is repaired, in a manner acceptable to us, rather than replaced. B. Transportation Expenses Section III, Paragraph A.4.a, is revised, with respect to transportation expense incurred by you, to provide: a. $60 per day, in lieu of $20; subject to b. $1,800 maximum, in lieu of $600. C. Loss of Use Expenses Section III, Paragraph A.4.b. is revised, with respect to loss of use expenses incurred by you, to provide: a. $1,000 maximum, in lieu of $600. D. Hired "Autos" The following is added to Section III. Paragraph A,: 5. Hired "Autos" If Physical Damage coverage is provided under this policy, and such coverage does not extend to Hired Autos, then Physical Damage coverage is exterlcfed to: a. Any covered auto you lease, hire, rent or borrow without a driver; and b. Any covered auto hired or rented by your employee without a driver, under a contract in that individual employee's name, with your permission, while performing duties related to the conduct of your business, c. The most we will pay for any one accident or loss is the actual cash value, cost of repair, cost of replacement or $75,000, whichever is less, rnirlus a $500 deductible for each covered auto. No deductible applies to loss caused by fire or lightning. d. The physical damage coverage as is provided by this provision is equal to the physical damage coverage(s) provided on your owned autos. e. Such physical darnage coverage for hired autos will: (1) Include loss of use, provided it is the consequence of an accident for which the Named Insured is legally liable, and as a result of which a monetary loss is sustained by the leasing or rental concern. (21 Such coverage as is provided by this provision will be subject to a limit of $750 per accident. E. Airbag Coverage The following is added to Section III, Paragraph B.3.: The accidental discharge of an airbag shall not be considered mechanical breakdown. Form No: CNA63359XX (04-2012) Policy No: BUA 6060023447 Endorsement Effective fate: Endorsement Expiration Date: Policy Effective Date: 01/19/2021 Endorsement No: 1 1 ; Page: 2 of 4 Policy Page: 66 of 160 Underwriting Company: National Fire Insurance Company of Ilartford, 151 N Franklin Sl, Chicago, Il 60606 "Copyright CNA All Rights Heserved. Includes copyrighted material of the Inaiirnrirr Siwvicps Offira Inc- used with its oerrnission. �!AYA!711 Business Auto Policy F. Electronic Equipment Section III, Paragraphs B,4.c and B.4.d. are deleted and replaced by the following: N c. Physical Damage Coverage on a covered auto also applies to loss to any permanently installed electronic equipment including its antennas and other accessories d. A $100 per occurrence deductible applies to the coverage provided by this provision. G. Diminution In Value The following is added to Section III, Paragraph B,6.: Subject to the following, the diminution in value exclusion does not apply to: a. Any covered auto of the private passenger type you lease, hire, rent or borrow, without a driver for a period of 30 days or less, while performing duties related to the conduct of your business; Q and w Z b. Any covered auto of the private passenger type hired or rented by your employee without a driver for a period of 30 days or less, under a contract in that individual employee's name, with your permission, while performing duties related to the conduct of your business. c. Such coverage as is provided by this provision is limited to a diminution in value loss arising ry directly out of accidental damage and not as a result of the failure to make repairs; faulty or M incomplete maintenance or repairs; or the installation of substandard parts. 2 d. The most we will pay for loss to a covered auto in any one accident is the lesser of: 5 (1) $5,000; or a(2) 20% of the auto's actual cash value (ACV). o III. Drive Other Car Coverage - Executive Officers N O o The following is added to Sections II and III: 1 . Any auto you don't own, hire or borrow is a covered auto for Liability Coverage while being used by, and for Physical Damage Coverage while in the care, custody or control of, any of your "executive officers", except: a. An auto owned by that "executive officer" or a member of that person's household; or •r b. An auto used by that "executive officer" while working in a business of selling, servicing, repairing or parking autos. Such Liability and/or Physical Damage Coverage as is afforded by this provision. (1) Equal to the greatest of those coverages afforded any covered auto; and (2) Excess over any other collectible insurance. 2. For purposes of this provision, "executive officer" means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar governing document, and, while a resident of the same household, includes that person's spouse. Such "executive officers" are insureds while using a covered auto described in this provision. IV. BUSINESS AUTO CONDITIONS A, Duties In The Event Of Accident, Claim, Suit Or Loss The following is added to Section IV, Paragraph A,2,a,: Form No: CNA63359XX (04-2012) Policy No: BUA 6080023447 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 01/19/2021 Endorsement No: 11; Page: 3 of 4 Policy Page: 87 of 160 Underwriting Company: National Fire Insurance Company of Hartford, 151 N Franklin St, Chicago, IL 60606 Copyright CNA All Rights Reserved. Includes copyrighted material of the Insurance Services Offira Ine u -,Rd with itc narmiccinn �4 . A V/. A I Business Auto Policy (4) Your employees may know of an accident or loss. This will not mean that you have such knowledge, unless such accident or loss is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager. The following is added to Section IV, Paragraph A.2.b.: (6) Your employees may know of documents received concerning a claim or suit. This will not mean that you have such knowledge, unless receipt of such documents is known to you or if you are not an individual, to any of your executive officers or partners or your insurance manager. B. Transfer Of Rights Of Recovery Against Others To Us The following is added to Section IV, Paragraph A.S. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have, because of payments we make for injury or damage, against any person or organization for whom or which you are required by written contract or agreement to obtain this waiver from us. This injury or damage must arise out of your activities under a contract with that person or organization. You must agree to that requirement prior to an accident or loss. C. Concealment, Misrepresentation or Fraud The following is added to Section IV, Paragraph 6.2,: Your failure to disclose all hazards existing on the date of inception of this Coverage Form shall not prejudice you with respect to the coverage afforded provided such failure or omission is not intentional. D. Other Insurance The following is added to Section IV, Paragraph B.S,: Regardless of the provisions of Paragraphs 5.a. and 5.d. above, the coverage provided by this policy shall be on a primary non-contributory basis. This provision is applicable only when required by a written contract. That written contract must have been entered into prior to Accident or Loss. E. Policy Period, Coverage Territory Section IV, Paragraph B. 7.(51.(a), is revised to provide: a, 45 days of coverage in lieu of 30 days. V. DEFINITIONS Section V, paragraph C. is deleted and replaced by the following: Bodily injury means bodily injury, sickness or disease sustained by a person, including mental anguish, mental injury or death resulting from any of these. Form No: CNA63369XX (04.2012) Endorsement Effective Date: Endorsement Expiration Date: Endorsement No. 11; Page: 4 of 4 Underwriting Company: National Fire Insurance Company of Hartford. 1 51 N Franl<lin St, Chicago, IL 60606 Copyright CNA All Rights Reserved. Includes copyrighted material of the In SllranrP Sorvirac nffiro Inr iicari with itc narmiccinn Policy No: BUA 6080023447 Policy Effective Date: 01;19/2021 Policy Page: 88 of 160 g� N CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE PART as follows. It any other endorsement attached to this policy amends any provision also amended by this endorsement, then that other endorsement controls with respect to such provision, and the changes made by this endorsement with respect to such provision do not apply. TABLE OF CONTENTS 1. Additional Insureds 2. Additional Insured - Primary And Non -Contributory To Addhlonal Insured's Insurance 3. Bodity injury - Expanded Definition 4. Broad Knowledge of Occurrence/ Notice of Occurrence 5. Broad Named Insured 6. Broadened Liability Coverage For Damage To Your Product And Your Work 7. Contractual Liablltty - Railroads S. Electronic Data Liabllity 9. Estates, Legal Representatives and Spouses 10. Expected Or Intended Injury - Exception for Reasonable Force 11. General Aggregate Units of Insurance - Per Project 12. In Rem Actions 13. Inckkw tal Health Care Malpractice Coverage 14. Joint Ventures/Partnership/Limited Liability Companies 15. Legal Liability - Damage To Premises / Alienated Premises / Property In The Named Insured's Care, Custody or Control 16. Liquor Liability 17. Medical Payments 18. Non -owned Aircraft Coverage 19. Non -owned Watercraft 20. Personal And Advertising Injury - Discrimination or Humiliation 21. Personal And Advertising Injury - Contractual Liability 22. Property Damage - Elevators 23. Supplementary Payments 24. Unintentkxral Failure To Disclose Hazards 25. Waiver of Subrogatlon - Blanket 26. Wrap -Up Extension: OCIP CCIP, or Consolidated (Wrap -Up) Insurance Programs CNA74705XX (1-15) Policy No; 6080023478 Page 1 of 17 Endorsement No; 5 The Continental Insurance Co. Effective Date; 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Offka, Inc., with Its permission. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement 1. ADDITIONAL INSUREDS a. WHO IS AN INSURED is amended to include as an Insured any person or organization described in paragraphs A. through H. below whom a Named Insured is required to add as an additional insured on this Coverage Part under a written contract or written agreement, provided such contract or agreement: (1) is currently in effect or becomes effective during the term of this Coverage Part; and (2) was executed prior to: (a) the bodily Injury or property damage; or (b) the offense that caused the personal and advertising Injury, for which such additional insured seeks coverage. b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: (1) a higher limit of insurance than required by such contract or agreement; or (2) coverage broader than required by such contract or agreement, and in no event broader than that described by the applicable paragraph A. through H. below. Any coverage granted by this endorsement shall apply only to the extent permissible by law. A. Controlling Interest Any person or organization with a controlling interest In a Named Insured, but only with respect to such person or organization's liability for bodily Injury, property damage or personal and advertising Injury arising out of: 1. such person or organization's financial control of a Named Insured; or 2. premises such person or organization owns, maintains or controls while a Named Insured leases or occupies such premises; provided that the coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. B. Co-owner of Insured Premises A co-owner of a premises co -owned by a Named Insured and covered under this insurance but only with respect to such co -owner's liability for bodily injury, property damage or personal and advertising injury as co-owner of such premises. C. Lessor of Equipment Any person or organization from whom a Named Insured leases equipment, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the Named Insured's maintenance, operation or use of such equipment, provided that the occurrence giving rise to such bodily Injury, property damage or the offense giving rise to such personal and advertising injury takes place prior to the termination of such lease. D. Lessor of Land Any person or organization from whom a Named Insured leases land but only with respect to liability for bodily injury, property damage or personal and advertising Injury arising out of the ownership, maintenance or use of such land, provided that the occurrence giving rise to such bodily Injury, property damage or the offense giving rise to such personal and advertising injury takes place prior to the termination of such lease. The CNA74705XX (1-15) Policy No: 6080023478 Page 2 of 17 Endorsement No: 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services office, Inc., with its permission. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. E. Lessor of Premises An owner or lessor of premises leased to the Named Insured, or such owner or lessor's real estate manager, but only with respect to liability for bodily injury, property damage or personal and advertising Injury arising out of the ownership, maintenance or use of such part of the premises leased to the Named Insured, and provided that the occurrence giving rise to such bodily Injury or property damage, or the offense giving rise to such personal and advertising injury, takes place prior to the termination of such lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. F. Mortgagee, Assignee or Receiver A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver's liability for bodily injury, property damage or personal and advertising Injury arising out of the Named Insured's ownership, maintenance, or use of a premises by a Named Insured. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. G. State or Governmental Agency or Subdivision or political Subdivisions — Permits A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization but only with respect to such state or governmental agency or subdivision or political subdivision's liability for bodily Injury, property damage or personal and advertising Injury arising out of: 1. the following hazards in connection with premises a Named Insured owns, rents, or controls and to which this insurance applies: 0 a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk „ vaults, street banners, or decorations and similar exposures; or b. the construction, erection, or removal of elevators; or C) c. the ownership, maintenance or use of any elevators covered by this insurance; or 2. the permitted or authorized operations performed by a Named Insured or on a Named Insured's behalf. m The coverage granted by this paragraph does not apply to: a. Bodily Injury, property damage or personal and advertising injury arising out of operations performed for the state or governmental agency or subdivision or political subdivision; or ib. Bodily Injury or property damage included within the products -completed operations hazard. With respect to this provision's requirement that additional insured status must be requested under a written contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the Named Insured to add the governmental entity as an additional Insured, H. Trade Show Event Lessor 1. With respect to a Named Insured's participation in a trade show event as an exhibitor, presenter or displayer, any person or organization whom the Named Insured is required to include as an additional insured, but only with respect to such person or organization's liability for bodily Injury, property damage or personal and advertising injury caused by: ONA74705XX (1-15) Policy No: 6080023478 Page 3 of 17 Endorsement No: 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL, NETWORKS LP Copyright CNA All Rights Reserved. Includes copyrighted materlal of Insurance services Office, Inc., with Its permission. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement a. the Named Insured's acts or omissions; or b. the acts or omissions of those acting on the Named Insured's behalf, in the performance of the Named Insured's ongoing operations at the trade show event premises during the trade show event. 2. The coverage granted by this paragraph does not apply to bodily injury or property damage included within the products -completed operations hazard. 2. ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended to add the following paragraph: If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and non- contributory relative to an additional insured's own insurance, then this insurance is primary, and the Insurer will not seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own insurance means insurance on which the additional insured is a named insured, Otherwise, and notwithstanding anything to the contrary elsewhere in this Condition, the insurance provided to such person or organization is excess of any other insurance available to such person or organization. 3. BODILY INJURY— EXPANDED DEFINITION Under DEFINITIONS, the definition of bodily injury is deleted and replaced by the following: Bodily injury means physical injury, sickness or disease sustained by a person, including death, humiliation, shock, mental anguish or mental injury sustained by that person at any time which results as a consequence of the physical 'injury, sickness or disease. 4. BROAD KNOWLEDGE OF OCCURRENCE/ NOTICE OF OCCURRENCE Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, Offense, Claim or Suit is amended to add the following provisions: A. BROAD KNOWLEDGE OF OCCURRENCE The Named Insured must give the Insurer or the Insurer's authorized representative notice of an occurrence, offense or claim only when the occurrence, offense or claim is known to a natural person Named Insured, to a partner, executive officer, manager or member of a Named Insured, or an employee designated by any of the above to give such notice. B. NOTICE OF OCCURRENCE The Named Insured's rights under this Coverage Part will not be prejudiced if the Named Insured fails to give the Insurer notice of an occurrence, offense or claim and that failure is solely due to the Named Insured's reasonable belief that the bodily injury or property damage is not covered under this Coverage Part. However, the Named Insured shall give written notice of such occurrence, offense or claim to the Insurer as soon as the Named Insured is aware that this insurance may apply to such occurrence, offense or claim. S. BROAD NAMED INSURED WHO IS AN INSURED is amended to delete its Paragraph 3. in its entirety and replace it with the following: 3. Pursuant to the limitations described in Paragraph 4. below, any organization in which a Named Insured has management control: a. on the effective date of this Coverage Part; or CNA74705XX (1-15) Policy No: 6080023478 Page 4 of 17 Endorsement No: 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP Copyright CNA All Hights nesetved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. S 0 0 CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement b. by reason of a Named Insured creating or acquiring the organization during the policy period, qualifies as a Named Insured, provided that there is no other similar liability insurance, whether primary, contributory, excess, contingent or otherwise, which provides coverage to such organization, or which would have provided coverage but for the exhaustion of its limit, and without regard to whether its coverage is broader or narrower than that provided by this insurance. But this BROAD NAMED INSURED provision does not apply to: (a) any partnership, limited liability company or joint venture; or (b) any organization for which coverage is excluded by another endorsement attached to this Coverage Part. For the purpose of this provision, management control means: A. owning interests representing more than 50% of the voting, appointment or designation power for the selection of a majority of the Board of Directors of a corporation; or B. having the right, pursuant to a written trust agreement, to protect, control the use of, encumber or transfer or sell property held by a trust, 4. With respect to organizations which qualify as Named Insured* by virtue of Paragraph S. above, this insurance does not apply to: a. bodily Injury or property damage that first occurred prior to the date of management control, or that first occurs after management control ceases; nor b. personal or advertising injury caused by an offense that first occurred prior to the date of management control or that first occurs after management control ceases. S. The Insurance provided by this Coverage Part applies to Named Insureds when trading under their own names or under such other trading names or doing -business -as names (dba) as any Named Insured should choose to employ. 6. BROADENED LIABILITY COVERAGE FOR DAMAGE TO YOUR PRODUCT AND YOUR WORK A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete exclusions k. and I. and replace them with the following: This insurance does not apply to: k. Damage to Your Product Property damage to your product arising out of it, or any part of it except when caused by or resulting from: (1) fire; (2) smoke; (3) collapse; or (4) explosion. I. Damage to Your Work Property damage to your work arising out of it, or any part of it and included in the products -completed operations hazard, This exclusion does not apply: (1) If the damaged work, or the work out of which the damage arises, was performed on the Named Insured's behalf by a subcontractor; or CNA74705XX (1-15) Policy No: 6080023478 Page 5 of 17 Endorsement No; 5 The Continental Insurance Co. Effective date; 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP copyright CNA All Rights Reserved. Includes copyrlghtsd materiel of Insurance Services 0111ce, Inc., wHh Its permission. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement (2) If the cause of loss to the damaged work arises as a result of: (a) fire; (b) smoke; (c) collapse; or (d) explosion. B. The following paragraph is added to LIMITS OF INSURANCE: Subject to 5. above, $100,000 is the most the Insurer will pay under Coverage A for the sum of damages arising out of any one occurrence because of property damage to your product and your work that is caused by tire, smoke, collapse or explosion and is included within the product -completed operations hazard. This sublimit does not apply to property damage to your work if the damaged work, or the work out of which the damage arises, was performed on the Named Insured's behalf by a subcontractor. C. This Broadened Liability Coverage For Damage To Your Product And Your Work Provision does not apply if an endorsement of the same name Is attached to this policy. 7. CONTRACTUAL LIABILITY — RAILROADS With respect to operations performed within 50 feet of railroad property, the definition of insured contract is replaced by the following: Insured Contract means: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to a Named Insured or temporarily occupied by a Named Insured with permission of the owner is not an Insured contract; b. A sidetrack agreement; c, Any easement or license agreement; d. An obligation, as required by ordinance, to indemnity a municipality, except in connection with work for a municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to the Named Insured's business (including an indemnification of a municipality in connection with work performed for a municipality) under which the Named Insured assumes the tort liability of another party to pay for bodily injury or property damage to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving or tailing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; (2) Under which the Insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities. 8. ELECTRONIC DATA LIABILITY CNA74705XX (1-15) Policy No: 6080023478 Page 6 of 17 Endorsement No: 5 The Cont i.nental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS I P Copyright CNA All Rights Reserved. Includes copyrighted inalerial of insurance Services 0111ce, Inc., with Its permission. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete exclusion p. Electronic Data and replace it with the following: This insurance does not apply to: p. Access Or Disclosure Of Confidential Or Personal Information And Data -related Liability Damages arising out of: (1) any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, credit card information, health information or any other type of nonpublic information; or (2) the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate electronic data that does not result from physical injury to tangible property. However, unless Paragraph (1) above applies, this exclusion does not apply to damages because of bodily Injury. This exclusion applies even if damages are claimed for notification costs, credit monitoring expenses, forensic expenses, public relation expenses or any other loss, cost or expense incurred by the Named Insured or others arising out of that which is described in Paragraph (1) or (2) above. B. The following paragraph is added to LIMITS OF INSURANCE: Subject to 5. above, $100,000 is the most the Insurer will pay under Coverage A for all damages arising out of any one occurrence because of property damage that results from physical injury to tangible property and arises out of electronic data, 0 C. The following definition is added to DEFINITIONS: 0 $ Electronic data means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. D. For the purpose of the coverage provided by this ELECTRONIC DATA LIABILITY Provision, the definition of property damage in DEFINITIONS is replaced by the following: s Property damage means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; m 0 b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the occurrence that caused it; or c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate electronic data, resulting from physical Injury to tangible property, All such loss of electronic data shall be deemed to occur at the time of the occurrence that caused it. For the purposes of this insurance, electronic data is not tangible property. E. If Electronic Data Liability is provided at a higher limit by another endorsement attached to this policy, then the $100,000 limit provided by this ELECTRONIC DATA LIABILITY Provision is part of, and not in addition to, that higher limit. S. ESTATES, LEGAL REPRESENTATIVES, AND SPOUSES _ The estates, heirs, legal representatives and spouses of any natural person Insured shall also be insured under this policy; provided, however, coverage Is afforded to such estates, heirs, legal representatives, and spouses only for CNA74705XX (1-15) Policy No: 6080023478 Page 7 of 17 Endorsement No: 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services office, Inc., with Its permisslon. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement claims arising solely out of their capacity or status as such and, in the case of a spouse, where such claim seeks damages from marital community property, jointly held property or property transferred from such natural person Insured to such spouse. No coverage is provided for any act, error or omission of an estate, heir, legal representative, or spouse outside the scope of such person's capacity or status as such, provided however that the spouse of a natural person Named Insured and the spouses of members or partners of joint venture or partnership Named Insureds are Insureds with respect to such spouses' acts, errors or omissions in the conduct of the Named Insured's business. 10. EXPECTED OR INTENDED INJURY — EXCEPTION FOR REASONABLE FORCE Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete the exclusion entitled Expected or Intended Injury and replace it with the following: This insurance does not apply to: Expected or Intended Injury Bodily Injury or property damage expected or intended from the standpoint of the Insured. This exclusion does not apply to bodily Injury or property damage resulting from the use of reasonable force to protect persons or property, 11. GENERAL AGGREGATE LIMITS OF INSURANCE - PER PROJECT A. For each construction project away from premises the Named Insured owns or rents, a separate Construction Project General Aggregate Limit, equal to the amount of the General Aggregate Limit shown in the Declarations, is the most the Insurer will pay for the sum of: 1. All damages under Coverage A, except damages because of bodily injury or property damage included in the products�completed operations hazard; and 2. All medical expenses under Coverage C, that arise from occurrences or accidents which can be attributed solely to ongoing operations at that construction project. Such payments shall not reduce the General Aggregate Limit shown In the Declarations, nor the Construction Project General Aggregate Limit of any other construction project. B. All: 1. Damages under Coverage B, regardless of the number of locations or construction projects involved; 2. Damages under Coverage A, caused by occurrences which cannot be attributed solely to ongoing operations at a single construction project, except damages because of bodily Injury or property damage included in the products -completed operations hazard; and 3. Medical expenses under Coverage C caused by accidents which cannot be attributed solely to ongoing operations at a single construction project, will reduce the General Aggregate Limit shown in the Declarations. C. The limits shown in the Declarations for Each Occurrence, for Damage To Premises Rented To You and for Medical Expense continue to apply, but will be subject to either the Construction Project General Aggregate Limit or the General Aggregate Limit shown in the Declarations, depending on whether the occurrence can be attributed solely to ongoing operations at a particular construction project, D. When coverage for liability arising out of the products -completed operations hazard is provided, any payments for damages because of bodily injury or property damage included in the product"ompleted operations hazard will reduce the Products -Completed Operations Aggregate Limit shown in the Declarations, regardless of the number of projects involved. CNA74705XX (1-15) Page 8 of 17 The Continental Insured Name: ROHL Insurance Co. GLOBAL NETWORKS LP Policy No: 6080023478 Endorsement No: 5 Effective Date: 01/19/2021 copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Offire, Inc,., with its permission. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement E. If a single construction project away from premises owned by or rented to the Insured has been abandoned and then restarted, or If the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. F. The provisions of LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to apply as stipulated. 12. IN REM ACTIONS A quasi in rem action against any vessel owned or operated by or for the Named Insured, or chartered by or for the Named Insured, will be treated in the same manner as though the action were In personam against the Named Insured. 13. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE Solely with respect to bodily Injury that arises out of a health care incident: A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled Insuring Agreement is amended to replace Paragraphs 1.b.(1) and 1.b.(2) with the following: b. This insurance applies to bodily injury provided that the professional health care services are incidental to the Named Insured's primary business purpose, and only if: (1) such bodily Injury is caused by an occurrence that takes place in the coverage territory. (2) the bodily Injury first occurs during the policy period. All bodily Injury arising from an occurrence will be deemed to have occurred at the time of the first act, error, or omission that is part of the occurrence; and B. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to: a I. add the following to the Employers Liability exclusion: This exclusion applies only if the bodily injury arising from a health care incident is covered by other liability insurance available to the Insured (or which would have been available but for exhaustion of its limits). If. delete the exclusion entitled Contractual Liability and replace it with the following: ti This insurance does not apply to: Contractual Liability the Insured's actual or alleged liability under any oral or written contract or agreement, including but not " limited to express warranties or guarantees. iii. add the following additional exclusions: This insurance does not apply to: i Discrimination any actual or alleged discrimination, humiliation or harassment, including but not limited to claims based on an individual's race, creed, color, age, gender, national origin, religion, disability, marital status or sexual orientation. Dishonesty or Crime Any actual or alleged dishonest, criminal or malicious act, error or omission. MedicareMedlcald Fraud CNA74705XX (1-15) Policy No: 6080023478 Page 9 of 17 Endorsement No: 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office. Inc., with IIs permission. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement any actual or alleged violation of law with respect to Medicare, Medicaid, Tricare or any similar federal, state or local governmental program. Services Excluded by Endorsement Any health care incident for which coverage is excluded by endorsement. C. DEFINITIONS is amended to: 1. add the following definitions: Health care Incident means an act, error or omission by the Named Insured's employees or volunteer workers in the rendering of: a. professional health care services on behalf of the Named Insured or b. Good Samaritan services rendered in an emergency and for which no payment is demanded or received. Professional health care services means any health care services or the related furnishing of food, beverages, medical supplies or appliances by the following providers in their capacity as such but solely to the extent they are duly licensed as required: a. Physician; b. Nurse; c. Nurse practitioner; d. Emergency medical technician; s. Paramedic; f. Dentist; g. Physical therapist; h. Psychologist; 1. Speech therapist; j. Other allied health professional; or Professional health care services does not include any services rendered in connection with human clinical trials or product testing. ii, delete the definition of occurrence and replace it with the following: Occurrence means a health care incident. All acts, errors or omissions that are logically connected by any common fact, circumstance, situation, transaction, event, advice or decision will be considered to constitute a single occurrence; iii. amend the definition of Insured to: a. add the following: the Named Insured's employees are Insureds with respect to: (1) bodily Injury to a co -employee while in the course of the co -employee's employment by the Named Insured or while performing duties related to the conduct of the Named Insured's business; and GNA74705XX (1-15) Policy No: 6080023478 Page 10 of 17 Endorsement No: 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP copyright CNA All Rights Reserved. Includes copyrighted malarial of InsuranCe Services Office, inc, with Its pormisslun CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement (2) bodily Injury to a volunteer worker while performing duties related 10 the conduct of the Named Insured's business; when such bodily injury arises out of a health care incident. the Named Insured's volunteer workers are Insureds with respect to: (1) bodily injury to a co -volunteer worker while performing duties related to the conduct of the Named Insured's business; and (2) bodily Injury to an employee while in the course of the employee's employment by the Named Insured or while performing duties related to the conduct of the Named Insured's business; when such bodily injury arises out of a health care Incident. b. delete Subparagraphs (a), (b), (c) and (d) of Paragraph 2.a.(1) of WHO IS AN INSURED. D. The Other Insurance condition is amended to delete Paragraph b.(1) in its entirety and replace it with the following: Other Insurance b. Excess Insurance (1) To the extent this insurance applies, it is excess over any other insurance, self insurance or risk transfer instrument, whether primary, excess, contingent or on any other basis, except for insurance purchased specifically by the Named Insured to be excess of this coverage. 14. JOINT VENTURES / PARTNERSHIP / LIMITED LIABILITY COMPANIES WHO IS AN INSURED is amended to delete its last paragraph and replace it with the following: No person or organization is an Insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations, except that if the Named Insured was a joint venturer, partner, or member of a limited liability company and such joint venture, partnership or limited liability company terminated prior to or during the policy period, such Named Insured is an Insured with respect to its Interest in such joint venture, partnership or limited liability company but only to the extent that: a. any offense giving rise to personal and advertising injury occurred prior to such termination date, and the M personal and advertising injury arising out of such offense first occurred after such termination date; g v b. the bodily injury or property damage first occurred after such termination date; and c. there is no other valid and collectible insurance purchased specifically to insure the partnership, joint venture or N limited liability company; and If the joint venture, partnership or limited liability company is or was insured under a consolidated (wrap-up) insurance program, then such insurance will always be considered valid and collectible for the purpose of paragraph c. above. But this provision will not serve to exclude bodily Injury, property damage or personal and advertising injury that would otherwise be covered under the Contractors General Liability Extension Endorsement provision entitled WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS. Please see that provision for the definition of consolidated (wrap-up) Insurance program. 15. LEGAL LIABILITY — DAMAGE TO PREMISES / ALIENATED PREMISES / PROPERTY IN THE NAMED INSURED'S CARE, CUSTODY OR CONTROL A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete exclusion j. Damage to Property in its entirety and replace It with the following: This insurance does not apply to; CNA74705XX (1-15) Policy No: 6080023478 Page 11 of 17 Endorsement No; 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP Copyright CNA AN Rights Reserved. Includes copyrighted material of Insurance Services office, Inc., with Ila permiaslon. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement j. Damage to Property Property damage to: (1) Property the Named Insured owns, rents, or occupies, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2) Premises the Named Insured sells, gives away or abandons, if the property damage arises out of any part of those premises; (3) Property loaned to the Named Insured; (4) Personal property in the care, custody or control of the Insured; (5) That particular part of real property on which the Named Insured or any contractors or subcontractors working directly or indirectly on the Named Insured's behalf are performing operations, if the property damage arises out of those operations; or (6) That particular part of any property that must be restored, repaired or replaced because your work was incorrectly performed on it. Paragraphs (1), (3) and (4) of this exclusion do not apply to property damage (other than damage by fire) to premises rented to the Named Insured or temporarily occupied by the Named Insured with the permission of the owner, nor to the contents of premises rented to the Named Insured for a period of 7 or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You as described in LIMITS OF INSURANCE. Paragraph (2) of this exclusion does not apply it the premises are your work. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (5) of this exclusion does not apply to property damage included In the products -completed operations hazard. Paragraphs (3) and (4) of this exclusion do not apply to property damage to: I. tools, or equipment the Named Insured borrows from others, nor ii. other personal property of others in the Named Insured's care, custody or control while being used in the Named Insured's operations away from any Named Insured's premises. However, the coverage granted by this exception to Paragraphs (3) and (4) does not apply to. a. property at a job site awaiting or during such property's installation, fabrication, or erection; b. property that is mobile equipment leased by an Insured; c. property that is an auto, aircraft or watercraft; d. property in transit; or e. any portion of property damage for which the Insured has available other valid and collectible insurance, or would have such Insurance but for exhaustion of its limits, or but for application of one of its exclusions. A separate limit of insurance and deductible apply to such property of others. See LIMITS OF INSURANCE as amended below. CNA74705XX (1-15) Policy No: 6080023478 Page 12 of 17 Endorsement No: 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP Copyright CNA All Rights Reserved. Includes copyrighted rnaterial of Insurance Services Office, Inc., with its pormisslon. 0 0 S 0 CNA CNA PARAMOUNT Contractors` General Liability Extension Endorsement B. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete its last paragraph and replace it with the following: Exclusions c. through n. do not apply to damage by fire to premises while rented to a Named Insured or temporarily occupied by a Named Insured with permission of the owner, nor to damage to the contents of premises rented to a Named Insured for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in LIMITS OF INSURANCE. C. The following paragraph is added to LIMITS OF INSURANCE: Subject to 5. above, $25,000 is the most the Insurer will pay under Coverage A for damages arising out of any one occurrence because of the sum of all property damage to borrowed tools or equipment, and to other personal property of others in the Named Insured's care, custody or control, while being used In the Named Insured's operations away from any Named Insured's premises. The Insurer's obligation to pay such property damage does not apply until the amount of such property damage exceeds $1,000. The Insurer has the right but not the duty to pay any portion of this $1,000 in order to effect settlement. If the Insurer exercises that right, the Named Insured will promptly reimburse the Insurer for any such amount. D. Paragraph 6., Damage To Premises Rented To You Limit, of LIMITS OF INSURANCE is deleted and replaced by the following: 6. Subject to Paragraph b. above, (the Each Occurrence Limit), the Damage To Premises Rented To You Limit Is the most the Insurer will pay under Coverage A for damages because of property damage to any one premises while rented to the Named Insured or temporarily occupied by the Named Insured with the permission of the owner, including contents of such premises rented to the Named Insured for a period of 7 or fewer consecutive days. The Damage To Premises Rented To You Limit is the greater of: a. $500,000; or b. The Damage To Premises Rented To You Limit shown in the Declarations. E. Paragraph 4.b,(1Xaxl1) of the Other Insurance Condition is deleted and replaced by the following: (11) That is property insurance for premises rented to the Named Insured, for premises temporarily occupied by the Named Insured with the permission of the owner; or for personal property of others in the Named Insured's care, custody or control; 16. LIQUOR LIABILITY Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete the exclusion entitled Liquor Llablllty. This LIQUOR LIABILITY provision does not apply to any person or organization who otherwise qualifies as an additional Insured on this Coverage Part. 17. MEDICAL PAYMENTS A. LIMITS OF INSURANCE is amended to delete Paragraph 7. (the Medical Expense Limit) and replace it with the following: 7. Subject to Paragraph 5. above (the Each Occurrence Limit), the Medical Expense Limit is the most the Insurer will pay under Coverage C — Medical Payments for all medical expenses because of bodily injury sustained by any one person. The Medical Expense Limit is the greater of: (1) $15,000 unless a different amount is shown here: $N,NNN,NNN,NNN; or (2) the amount shown in the Declarations for Medical Expense Limit. CNA74705XX (1-15) Policy No: 6080023478 Page 13 of 17 Endorsement No; 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP copyright GNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with Its permission. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement B. Under COVERAGES, the Insuring Agreement of Coverage C — Medical Payments is amended to replace Paragraph 1.a.(3)(b) with the following: (b) The expenses are incurred and reported to the Insurer within three years of the date of the accident; and 18. NON -OWNED AIRCRAFT Under COVERAGES, Coverage A — Bodily injury and Property Damage Liability, the paragraph entitled Exclusions is amended as follows: The exclusion entitled Aircraft, Auto or Watercraft is amended to add the following: This exclusion does not apply to an aircraft not owned by any Named Insured, provided that: 1. the pilot in command holds a currently effective certificate issued by the duly constituted authority of the United States of America or Canada, designating that person as a commercial or airline transport pilot; 2. the aircraft is rented with a trained, paid crew to the Named Insured; and 3, the aircraft is not being used to carry persons or property for a charge. 19. NON -OWNED WATERCRAFT Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended to delete subparagraph (2) of the exclusion entitled Aircraft, Auto or Watercraft, and replace It with the following. This exclusion does not apply to: (2) a watercraft that is not owned by any Named Insured, provided the watercraft Is: (a) less than 75 feet long; and (b) not being used to carry persons or property for a charge. 20. PERSONAL AND ADVERTISING INJURY —DISCRIMINATION OR HUMILIATION A. Under DEFINITIONS, the definition of personal and advertising Injury is amended to add the following tort: Discrimination or humiliation that results in injury to the feelings or reputation of a natural person. B. Under COVERAGES, Coverage B — Personal and Advertising Injury Liability, the paragraph entitled Exclusions is amended to: 1. delete the Exclusion entitled Knowing Violation Of Rights Of Another and replace it with the following: This Insurance does not apply to: Knowing Violation of Rights of Another Personal and advertising injury caused by or at the direction of the Insured with the knowledge that the act would violate the rights of another and would inflict personal and advertising Injury. This exclusion shall not apply to discrimination or humiliation that results in injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation is not done intentionally by or at the direction of: (a) the Named Insured; or (b) any executive officer, director, stockholder, partner, member or manager (if the Named Insured is a limited liability company) of the Named Insured. 2, add the following exclusions: CNA74705XX (1-15) — Policy No: 6080023478 Page 14 of 17 Endorsement No: 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP Copyrlght CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement This insurance does not apply to: Employment Related Discrimination Discrimination or humiliation directly or indirectly related to the employment, prospective employment, past employment or termination of employment of any person by any Insured. Premises Related Discrimination discrimination or humiliation arising out of the sale, rental, lease or sub -lease or prospective sale, rental, lease or sub -lease of any room, dwelling or premises by or at the direction of any Insured. Notwithstanding the above, there is no coverage for fines or penalties levied or Imposed by a governmental entity because of discrimination. The coverage provided by this PERSONAL AND ADVERTISING INJURY —DISCRIMINATION OR HUMILIATION Provision does not apply to any person or organization whose status as an Insured derives solely from Provision 1. ADDITIONAL INSURED of this endorsement; or attachment of an additional insured endorsement to this Coverage Part. This PERSONAL AND ADVERTISING INJURY —DISCRIMINATION OR HUMILIATION Provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part, 21. PERSONAL AND ADVERTISING INJURY - CONTRACTUAL LIABILITY A. Under COVERAGES, Coverage B —Personal and Advertising Injury Liability, the paragraph entitled Exclusions is amended to delete the exclusion entitled Contractual Liability. co B. Solely for the purpose of the coverage provided by this PERSONAL AND ADVERTISING INJURY - 8 CONTRACTUAL LIABILITY provision, the following changes are made to the section entitled SUPPLEMENTARY PAYMENTS —COVERAGES A AND B. 1. Paragraph 2.d. is replaced by the following: m d. The allegations in the cult and the information the Insurer knows about the offense alleged in such suit are such that no conflict appears to exist between the interests of the Insured and the interests of the indemnitee; U l7 2. The first unnumbered paragraph beneath Paragraph 2J.(2Xb) is deleted and replaced by the following: m So long as the above conditions are met, attorneys fees Incurred by the Insurer in the defense of that indemnitee, necessary litigation expenses incurred by the Insurer, and necessary litigation expenses incurred N by the Indemnitee at the Insurer's request will be paid as defense costs. Such payments will not be deemed to be damages for personal and advertising injury and will not reduce the limits of insurance. C. This PERSONAL AND ADVERTISING INJURY - CONTRACTUAL LIABILITY Provision does not apply if Coverage B —Personal and Advertising Injury Liability is excluded by another endorsement attached to this Covers" Part. This PERSONAL AND ADVERTISING INJURY - CONTRACTUAL LIABILITY Provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part. 22. PROPERTY DAMAGE — ELEVATORS A. Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled Exclusions is amended such that the Damage to Your Product Exclusion and subparagraphs (3), (4) and (S) of the Damage to Property Exclusion do not apply to property damage that results from the use of elevators. C CNA74706XX (1 - 15) Policy No; 6080023478 Page 15 of 17 Endorsement No; 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services ofhce, Inc., with Its permisslon. CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE — ELEVATORS Provision, the Other Insurance conditions is amended to add the following paragraph: This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis that is Property insurance covering property of others damaged from the use of elevators. 23. SUPPLEMENTARY PAYMENTS The section entitled SUPPLEMENTARY PAYMENTS — COVERAGES A AND B is amended as follows: A. Paragraph 11. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000, limit; and B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a $1,000. limit. 24. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named Insured's Coverage Part, the Insurer will not deny coverage under this Coverage Part because of such failure. 26. WAIVER OF SUBROGATION - BLANKET Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to add the following: The Insurer waives any right of recovery the Insurer may have against any person or organization because of payments the Insurer makes for injury or damage arising out of: 1. the Named Insured's ongoing operations; or 2. your work Included in the products -completed operations hazard. However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in a written contract or written agreement, and only if such contract or agreement: 1. is in effector becomes effective during the term of this Coverage Part; and 2. was executed prior to the bodity injury, property damage or personal and advertising injury giving rise to the claim. 26. WRAP-UP EXTENSION: OCIP, CLIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured under a consolidated (wrap-up) Insurance program by applicable state statute or regulation, If the endorsement EXCLUSION — CONSTRUCTION WRAP-UP is attached to this policy, or another exclusionary endorsement pertaining to Owner Controlled Insurance Programs (O.C.I,P.) or Contractor Controlled Insurance Programs (C,C,I.P.) is attached, then the following changes apply: A. The following wording is added to the above -referenced endorsement: With respect to a consolidated (wrap-up) insurance program project in which the Named Insured is or was involved, this exclusion does not apply to those sums the Named Insured become legally obligated to pay as damages because of: 1. Bodily injury, property damage, or personal or advertising injury that occurs during the Named Insured's ongoing operations at the project, or during such operations of anyone acting on the Named Insured's behalf; nor CNA74705XX (1-15) Page 16 of 17 The Continental Insured Name: ROHL Insurance Co. GLOBAL NETWORKS LP Pollcy No: 6080023478 Endorsement No: 5 Effective Date: 01/19/2021 Copyright CNA All nights Reserved. Includes copyrighted malorial of Insurance Services Office. Inc., with Its permission. 8 S 0 CNA CNA PARAMOUNT Contractors' General Liability Extension Endorsement 2. Bodily injury or property damage included within the products -completed operations hazard that arises out of those portions of the project that are not residential structures. B. Condition 4. Other Insurance is amended to add the following subparagraph 4.b.(1)(c): This insurance is excess over: (c) Any of the other insurance whether primary, excess, contingent or any other basis that is insurance available to the Named Insured as a result of the Named Insured being a participant in a consolidated (wrap-up) insurance program, but only as respects the Named Insured's involvement in that consolidated (wrap-up) Insurance program. C. DEFINITIONS is amended to add the following definitions: Consolidated (wrap-up) insurance program means a construction, erection or demolition project for which the prime contractor/project manager or owner of the construction project has secured general liability insurance covering some or all of the contractors or subcontractors involved in the project, such as an Owner Controlled Insurance Program (O.C.I.P.) or Contractor Controlled Insurance Program (C.C.I.P.), Residential structure means any structure where 30% or more of the square foot area is used or is intended to be used for human residency, including but not limited to: 1. single or multifamily housing, apartments, condominiums, townhouses, co-operatives or planned unit developments; and 2. the common areas and structures appurtenant to the structures in paragraph 1. (including pools, hot tubs, detached garages, guest houses or any similar structures). However, when there is no individual ownership of units, residential structure does not include military housing, college/university housing or dormitories, long term care facilities, hotels or motels. Residential structure also does not include hospitals or prisons. This WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS Provision does not apply to any person or organization who otherwise qualifies as an additional insured on this Coverage Part, All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. c:NAt4105XX (1 - 15) Policy No: 6080023478 Page 17 of 17 Endorsement No: 5 The Continental Insurance Co. Effective Date: 01/19/2021 Insured Name: ROHL GLOBAL NETWORKS LP Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services oriioe, Inc., with Its permission, CNAWorkers Compensation And Employers Liability Insurance Polic- ---- -- -- -------------- - - - 1-1-1- ------------------------ 1-1-111, --------------------------- "I --------------------- --- --- ----y Endorsement --------------------- * ----------------------------------------- --- ** _. --------- - ----------------- -- — — - - ---------- C=MCM= ------------------ ------ - - -- _........------------------------------ We ..- We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule Any Person or Organization on whose behalf you are required to obtain this waiver of our right to recover from under a written contract or agreement. 0 The premium charge for the endorsement is reflected in the Schedule of Operations. N 2 All other terms and conditions of the policy remain unchanged. R m oO K This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. ......................... .....------------------- ........-..-..-..-----------t Form No: WC 00 03 13 (04-1984) Policy No: WC 6 80023450 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 01/19/2021 Endorsement No: 3; Page: 1 of 1 Policy Page: 43 of 68 Underwriting Company: Valley Forge Insurance Company. 151 N Franklin St, Chicago, IL 60606 - ----------------- ----- ........... ------ - ------------ ..............-------------------------------------------- ----------------------------- --- - ------------------------------------ Copyright 1983 National Council on Compensation Insurance. c ROHL GLOBAL NETWORKS Litigation History Rohl Global Networks LP has had no Litigation or Arbitrations during the past 5 years. ROHL Global Networks LP 2875 Jupiter Park Drive Suite 900 Jupiter, Florida 33458 DIVISION OF CORPORAIIONS D`/gym l .0rg r �"'r���►y mt „//ir,rl!-�1rll� uj /�/uftC/%I sl_�i�slt_- Department of State / Division of Corporations / Search Records / Search by FEI/EIN Number / Detail by FEI/EIN Number Foreign Limited Partnership ROHL GLOBAL NETWORKS LP Filing Information Document Number B17000000311 FEI/EIN Number 82-3182571 Date Filed 12/19/2017 State DE Status ACTIVE Principal Address 900-2875 JUPITER PARK DRIVE JUPITER, FL 33458 Mailing Address 900-2875 JUPITER PARK DRIVE JUPITER, FL 33458 Registered Agent Name & Address ROHL, JASON 900-2875 JUPITER PARK DRIVE JUPITER, FL 33458 General Partner Detail Name & Address Document Number M17000010719 ROHL GLOBAL NETWORKS GP LLC 900-2875 JUPITER PARK DRIVE JUPITER, FL 33458 Annual Reports Report Year Filed Date 2019 04/04/2019 2020 04/08/2020 2021 02/04/2021 Document Images 02/04/2021 -- ANNUAL REPORT View image in PDF format 04/08/2020 -- ANNUAL REPORT View image in PDF format c ROHL GLOBAL NETWORKS Qualifications Rohl Global Networks (RGN) has been operating in the field of utility installation for over twenty-five years and more specifically with Florida Power and Light (FPL), Comcast (CC), Hotwire (HW), Atlantic Broad Band (AB) and ATT for the past five years. Details on the specific projects follow in this section. Needless to say, intimate familiarity with procedures all of the utility service providers depend upon regarding design criteria, installation details, timeliness and coordination of schedules along with material supply are the backbone of a successful project. RGN has received, managed the storage of and installed over two hundred and eighty thousand linear feet of conduit and related hand holes, equipment chambers and pads in the Sunny Isles Beach Florida project alone. Not only is service quality of prime importance to the utility companies, safety of the general public and installation crews demands the highest level of awareness while working around existing utilities. Our crews are led daily by an onsite safety officer whose only responsibility is safeguarding life and limb of the public and our crews along with the security of active utility lines often in close proximity to our activities. Much of our work, especially within the public right of way demands installation to be accomplished during nighttime and early morning hours which only serve to put higher demands on safety precautions. With limited access to numerous conduit routing sites the utilization of directional boring or missiling operations is a significant tool utilized in the installation of conduit for utility runs. RGN has its own directional boring equipment and unless schedule requirements demand otherwise, executes all of the subsurface access with our own crews. Daily reports, boring records, operations and maintenance logs are fundamental requirements of a safe and efficient boring operation all of which we pride ourselves with the past performance record. Specific details for two current projects follow: a. Project 1. - Sunny Isles Beach (SIB) Collins Avenue Utility Undergrounding Collins Avenue, State Road A1A, from Golden Beach on the North to Hallandale Beach on the South — over two miles in length, and is one of the heaviest travelled thoroughfares in South Florida with daily vehicular trips exceeding forty-five thousand in any given twenty-four hour period. c ROHL GLOBAL NETWORKS Government Center, centrally located in the City is at 18070 Collins Avenue, Sunny Isles Beach FL 33160 which serves as the official project address. b. The project scope includes the installation of conduit, hand holes, equipment slabs, chambers, physical FPL equipment, limited placement of conductor and fiber cable for FPL, ABB, ATT, Comcast, Hotwire, and City fiber, lighting and security systems. Restoration of roadways, sidewalks, driveways and landscaped areas consisting of concrete curbs, gutters, asphalt paving, paver brick and concrete sidewalks. Initial contract value is $6,830,000.00 c. The Owners Representative for the project is HPF Associates, Inc., Paul T. Abbott, 14803 SW SR 45 Archer, FL 32618 305-773-6255, ptgbhtl@AOL.com. The project met substantial completion, per contract requirements, on April 17, 2017. The significance of meeting the contract completion date was the Florida Department of Transportation (FDOT) pending RRR project scheduled to commence May 1, 2017, there was no provision for a delayed start of the FDOT project. Severe penalties were incorporated into the SIB/RGN contract for delayed completion. No penalties were assessed. e. RGN was responsible for design input regarding value engineering alternatives, means and methods, scheduling, execution and installation of the afore noted equipment and services. f. We have taken the liberty of referencing several photographs which indicate the complexity of the raceway installation and an example of the hundreds of unforeseen obstructions encountered during the execution of the work. In fact "a picture, is worth a thousand words". The route of Collins Avenue, SR AIA, though SIB has evolved over the seventy five years of the community's existence. Where sixty story condominium projects now set was once the actual Atlantic Ocean shore line. During the excavation phase of the conduit install old abandoned seawalls, tunnels, building foundations and unmarked active and inactive utilities were encountered. And other than the very few occasions where severely deteriorated cast iron or steel gas lines sprung leaks, no live utilities were interrupted during the installation. Measures incorporated to obviate the impact of the unforeseen encounters were the utilization of alternate excavation methods including smaller equipment, hand excavation and demolition, utilizing ground penetrating radar, and spot excavations to identify potential problem areas. c ROHL GLOBAL. NETWORKS Alternative backfill methods including substantial use of flowable fill were incorporated in the process. a. Project 2. - Sunny Isles Beach (SIB) Atlantic Corridor Utility Undergrounding and Street Lighting The Atlantic Corridor is a primary residential route extending approximately two thirds of the length of the community — one and one half miles long. It includes access to one of the largest elementary public schools in Dade County, and contains entry's and exits to commercial properties fronting onto Collins Avenue along with significant residential property's both high rise and single family. This is a separate and distinct contract with SIB due to timing, funding and scope which includes a decorative street light project. Government Center, centrally located in the City is at 18070 Collins Avenue, Sunny Isles Beach FL 33160 which serves as the official project address. b. The project scope includes the installation of conduit, hand holes, equipment slabs, chambers, physical FPL equipment, limited placement of conductor and fiber cable for FPL, ABB, ATT, Comcast, Hotwire, and City fiber, lighting and security systems. Restoration of roadways, sidewalks, driveways and landscaped areas consisting of concrete curbs, gutters, asphalt paving, paver brick and concrete sidewalks. And a complete new decorative street lighting project consisting of precast and cast in place foundations, power sources, conduit and handhole infrastructure, installation of one hundred and thirty stand alone decorate lighting fixtures. Initial contract value is $6,984,466.00 The Owners Representative for the project is HPF Associates, Inc., Paul T. Abbott, 14803 SW SR 45 Archer, FL 32618, 305-773-6255, ptgbhtl@AOL.com. d. The projects substantial completion, per contract requirements, is March 31, 2019. And as with Contract 1 above is driven by the FDOT RRR project which impacts the physical removal of overhead utility lines along Collins and must occur prior to the installation of the decorative street lighting. e. RGN was responsible for design input regarding value engineering alternatives, means and methods, scheduling, securing material through a competitive bidding process, execution and installation of the afore noted equipment and services. c ROHL GLOBAL NETWORKS f. We, once again, have taken the liberty of referencing multiple photographs which indicate the complexity of the raceway installation and an example of the significant unforeseen obstructions encountered during the execution of the work. The route along the Atlantic corridor is significantly newer than Collins Avenue, however similar complexities were encountered in addition to significant unchartered duct banks installed prior to formal planning and public work permits were required. Measures incorporated to obviate the impact of the unforeseen encounters were the utilization of alternate excavation methods including smaller equipment, hand excavation and demolition, utilizing ground penetrating radar, and spot excavations to identify potential problem areas. No active utilities were disrupted during this project execution. Alternative backfill methods including substantial use of flowable fill were incorporated in the process. 4 r LIVLA 0 r► W { a 04"A• dP a, BeaCh Access , *0i 'Ilk , ffi it Sp. b� Alk Abh AMikamM o I Q) Ln 0 0 Ln Ln C p 2 c c > c a! In 110 C Y cq 2 a1 Q L D a1 > bA v L ro > v C7 LL Z Of Of cc C)u (D C v 0041 Q) a O 00 a) O N a In + Q E NZ, 00 C :3 V) 1O a1 3 @ m C O 0 U - �n u u N•X O L > a) U a)Z Q w r, Z cc O + v L L aJ p 4- p 41 O a) M Q +0 .O 4-- O O C L U Q L a1 U a L L O 41 c u — c 4, c a v o 'L a= �> � ,o 4- L w ai 3 3 Lj- o o �_ LL o n. 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N bA 0 (0 a) U J OA L f0 p0 E C C C C 7 C a) :5;E \� +-+ u O a c LL — > u N` u C C aJ O O L co U U p [n (0 a' + L t qp p cn Q .T .� U O f0 Q v u J N Co Q Q o -C T a-+ D C Y 7 a Vv) I— O 0 U Q- cn :> - `,. 4 jW11 DELIVER TO; INVITATION OPENING: 2:30 City of Sunny Isles TO BID Beach SECTION 4 City Clerk P.M. 09/28/2021 BID 18070 Collins Avenue Sunny Isles Beach, FL SUBMITTAL FORMS ORMS PLEASE QUOTE PRICES F.O.B. DESTINATION, LESS TAXES, DELIVERED IN CITY OF SUNNY ISLES BEACH, FLORIDA NOTE: City of Sunny Isles Beach is exempt from all taxes (Federal, State, and Local). Bid price should be less all taxes. Tax Exemption Certificate furnished upon request. Issued Purchasing Date This Bid Submittal Consists of by: Agent: Issued: Pages 23 through 44 (including Mauricio 8-16-21 all documents within Affidavits) Betancur Sealed bids are subject to the Terms and Conditions of this Invitation to Bid and the accompanying Bid Submittal. Such other contract provisions, specifications, drawings or other data as are attached or incorporated by reference in the Bid Submittal, will be received at the office of the City Clerk at the address shown above until the above stated time and date, and at that time, publicly opened for furnishing the supplies or services described in the accompanying Bid Submittal Requirement. ITB No. 21-08-01 Golden Shores Utility Undergrounding A Bid Deposit in the amount of 50/b of the total amount of the bid shall accompany all bids A Performance Bond in the amount of 100% of the total amount of the bid will be required upon execution of the contract by the successful bidder and City of Sunny Isles Beach. Procurement Agent. Firm Name: Mauricio Betancur Commod/ty Codea FAILURE TO SIGN PAGE 22 OF SECTION 4 BID SUBMITTAL WILL RENDER YOUR BID NON- RESPONSIVE City of Sunny Isles Beach I Invitation to Bid No. 21-08-01 ADDENDA ACKNOWLEDGEMENT INSTRUCTIONS: COMPLETE PART I OR PART II, WHICHEVER APPLIES PART I: �� f a O f � � S'� I I'�-c• LIST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN CONNECTION WITH THIS BID PART II: Addendum #1, Dated Addendum #2, Dated ! fAeMber Addendum #3, Dated Addendum #4, Dated Addendum #5, Dated Addendum #6, Dated Addendum #7, Dated Addendum #8, Dated ❑ NO ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID COMPANY NAME: kk(�10 xtl 1�� rkS L e AUTHORIZED SIGNATURE: ATE: TITLE OF OFFICER:01L.2- '( C`e +e. City of Sunny Isles Beach I Invitation to Bid No. 21-08-01 BID PRICING Bid Title: Golden Shores Utility Undergrounding The undersigned Bidder proposes and agrees, if this Bid is accepted, to enter into an agreement with The City of Sunny Isles Beach to perform and furnish all Work as specified or indicated in the Contract Documents for the Contract Price and within the Contract Time indicated in this Bid and in accordance with the other terms and conditions of the Contract Documents. The Bidder accepts all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to Bidders. This Bid will remain subject to acceptance for 90 days after the day of Bid opening. The Bidder agrees to sign and submit the Agreement and other documents required by the Bidding Requirements within ten days after the date of the City's Notice of Award. In submitting this Bid, the Bidder represents, as more fully set forth in the Agreement, that: The Bidder has familiarized himself/herself with the nature and extent of the Contract Documents, Work, site, locality, and all local conditions and Law and Regulations that in any manner may affect cost, progress, performance, or furnishing of the Work. ■ The Bidder has given the City written notice of all conflicts, errors, discrepancies that it has discovered in the Contract Documents and the written resolution thereof by City is acceptable to the Bidder. This Bid is genuine and not made in the interest of or on behalf of any undisclosed person, firm or corporation and is not submitted in conformity with any agreement or rules of any group, association, organization, or corporation; the Bidder has not directly or indirectly induced or solicited any other Bidder to submit a false or sham Bid; the Bidder has not solicited or induced any person, firm or corporation to refrain from Bidding; and Bidder has not sought by collusion to obtain for itself any advantage over any other Bidders or over the City. The Bidder understands and agrees that the Bid is for unit prices to furnish and install individual Work Items, complete in place. Quantity estimates are provided for the purpose of Bid Evaluation and to establish unit prices for individual Work Items to be contracted by the City, based on the unit prices established under this Bid. The City and the successful Bidder will establish completion times for each individual Work Item and the successful Bidder agrees that the work will be completed within the time frames agreed upon and stipulated in the individual Purchase Orders and/or Notice to Proceed. City of Sunny Isles Beach I Invitation to Bid No. 21-08-01 BID FORM (revised) Note: Some pay items are broken down into material and labor costs. The Sum of these two costs determines the total unit costs. Total Unit Cost will be used to determine Base Price. Where material provided by others, material unit costs to not apply. Cost that do not apply are marked "N/A". Cost included in Total Unit Cost are identified as "INCL". - Total Unit Base Price Quantity Unit Labor Unit Material Cost (total unit - - Cost Unit Cost (labor + cost x material) quantity) 1 Bonds and Insurance 1 LS INCL INCL $200,000.00 $200,000.00 2 Mobilization 1 LS INCL INCL $180,000.00 $180,000.00 3 Maintenance of Traffic 18 MONTHLY INCL INCL $10,000.00 $180,000.00 4 Testing, Surveying and Miscellaneous 1 LS INCL INCL $75,000.00 $75,000.00 5 Indemnification Allowance 1 LS N/A N/A $100 $100 SUBTOTAL DIVISION 1 Install only one(1)-6 inch PVC schedule 40 conduit bundled in 6 one main trench with others for 1,374 LF $40.24 N/A $40.24 $55,289.76 FPL Utility (FPL to furnish material) Install only two (2)-6 inch PVC schedule 40 conduit bundled in 7 one main trench with others for 172 LF $75.45 N/A $75.45 $12,977.40 FPL Utility (FPL to furnish material) Install only three (3)-6 inch PVC schedule 40 conduit bundled in 8 one main trench with others for 20 LF $105.63 N/A $105.63 $2112.60 FPL Utility (FPL to furnish material) Total Unit Base Price Quantity Unit Labor Unit Material Cost (total unit Cost Unit Cost (labor + cost x material) quantity) Install only one (1)-2 inch PVC schedule 40 conduit bundled in 9 one main trench with others for 1,085 LF $26.41 N/A $26.41 $28,654.85 FPL Utility (FPL to furnish material) Install only two (2)-2 inch PVC Base schedule 40 conduit bundled in Total Unit Price Quantity Unit Labor Unit Material 10 one main trench with others for 2,126 LF $45.27 N/A $45.27 $96,244.02 FPL Utility (FPL to furnish material) cost x material) quantity) Install only 50" splice box for Install only three (3)-2 inch PVC 17 FPL Utility (FPL to furnish 6 EA $4401.25 schedule 40 conduit bundled in $4401.25 $26,407.50 material 11 one main trench with others for 10,853 LF $60.36 N/A $60.36 $655,087.08 $2515.00 FPL Utility (FPL to furnish $2515.00 $65,390.00 Utility (FPL to furnish material) material) Install only concrete pad for Install only four (4)-2 inch PVC 19 transformers for FPL Utility 62 EA $3772.50 schedule 40 conduit bundled in $3772.50 $233,895.00 (FPL to furnish material) 12 one main trench with others for 23 LF $75.45 N/A $75.45 $1735.35 FPL Utility (FPL to furnish material) Install only six (6)-2 inch PVC schedule 40 conduit bundled in 13 one main trench with others for 70 LF $96.83 N/A $96.83 $6,778.10 FPL Utility (FPL to furnish material) Install only nine (9)-2 inch PVC schedule 40 conduit bundled in 14 one main trench with others for 135 LF $105.63 N/A $105.63 $14,260.05 FPL Utility (FPL to furnish material) Install only feeder splice box for 15 FPL Utility (FPL to furnish 4 EA $8802.50 N/A $8802.5 $35,210.00 material) only concrete pad for vista E16Install switch cabinets for FPL Utility 2 EA $6287.50 N/A $6287.50 $12,575.00 (FPL to furnish material) Base Total Unit Price Quantity Unit Labor Unit Material Cost (total unit Cost Unit Cost (labor + material) cost x quantity) Install only 50" splice box for 17 FPL Utility (FPL to furnish 6 EA $4401.25 N/A $4401.25 $26,407.50 material 18 Install only 30"handhole for FPL 26 EA $2515.00 N/A $2515.00 $65,390.00 Utility (FPL to furnish material) Install only concrete pad for 19 transformers for FPL Utility 62 EA $3772.50 N/A $3772.50 $233,895.00 (FPL to furnish material) Install only 18"x24" service pull Base 20 boxes for FPL Utility (FPL to 238 EA $817.38 N/A $817.38 $194,536.44 Unit furnish material) Material Cost (total unit • - Cost Supply and install only two (2)-4 (labor + cost x inch PVC schedule 40 conduit 21 bundled in one main trench 3,125 LF $60.36 $23.42 $83.78 $261,812.50 with others for Atlantic 25 conduit bundled in one main Broadband LF $262.82 $137.52 $400.34 $2,802.38 trench with others for Atlantic Supply and install only four (4)- Broadband 4 inch PVC schedule 40 conduit $45.84 $165.30 $792,944.10 22 bundled in one main trench 4,797 LF $119.46 8.921 LF $60.36 $22.92 with others for Atlantic $742,940.88 bundled in one main trench Broadband with others for AT&T Supply and install only six (6)-4 27 4 inch PVC schedule 40 conduit inch PVC schedule 40 conduit LF $119.46 $45.84 $165.30 $287,787.30 bundled in one main trench 23 bundled in one main trench 350 LF $138.33 $68.76 $207.09 $72,481.50 with others for Atlantic Supply and install only six (6)-4 Broadband inch PVC schedule 40 conduit 28 213 LF $142.10 $68.76 Supply and install only eight (8)- $44,913.18 bundled in one main trench 4 inch PVC schedule 40 conduit with others for AT&T $169.76 $91.68 $261.44 $2,614.40 24 bundled in one main trench 10 LF with others for Atlantic Broadband Base Total Unit Price Quantity Unit Labor Unit Material Cost (total unit • - Cost Unit Cost (labor + cost x material) quantity) Supply and install only twelve (12 )-4 inch PVC schedule 40 25 conduit bundled in one main 7 LF $262.82 $137.52 $400.34 $2,802.38 trench with others for Atlantic Broadband Supply and install only two (2)-4 26 inch PVC schedule 40 conduit 8.921 LF $60.36 $22.92 $83.28 $742,940.88 bundled in one main trench with others for AT&T Supply and install only four (4)- 27 4 inch PVC schedule 40 conduit 1,741 LF $119.46 $45.84 $165.30 $287,787.30 bundled in one main trench with others for AT&T Supply and install only six (6)-4 inch PVC schedule 40 conduit 28 213 LF $142.10 $68.76 $210.86 $44,913.18 bundled in one main trench with others for AT&T • Supply and install only one (1)-2 Base 29 inch PVC schedule 40 conduit bundled in one main trench 6,330 LF $26.41 $3.93 $30.34 $192,052.20 with others for AT&T Quantity Unit Labor Unit Material Cost (total unit • Supply and install only two (2)-2 Cost Unit Cost (labor + 30 inch PVC schedule 40 conduit 3,208 LF $45.27 $7.86 $53.13 $170,441.04 bundled in one main trench quantity) with others for AT&T 31 Supply and install only 10"x 15" 84 EA $565.88 $31.29 $597.17 $50,162.28 handhole for AT&T 32 Supply and install only 17"x 30" 48 EA $754.50 $351.37 $1105.87 $53,081.76 36 handhole for AT&T 358 LF $181.08 $31.44 $212.52 $76,082.16 33 Supply and install only 30"x 16 EA $2515.00 $711.26 $3,226.26 $51,620.16 48"x36" handhole for AT&T Supply and install only two (2)- 34 2 -inch PVC schedule 40 conduit 293 LF $45.27 $7.86 $53.13 $15,567.09 bundled in one main trench 38 with others for City conduit 97,125 CF INCL. INCL. $5.75 $558,468.75 • Base Total Unit Price Quantity Unit Labor Unit Material Cost (total unit • 1 Cost Unit Cost (labor + material) cost x quantity) Supply and install only four (4)- 35 2 inch PVC schedule 40 conduit bundled in one main trench 10,944 LF $75.45 $15.72 $91.17 $997,764.48 with others for City conduit Supply and install only eight (8)- 36 2 inch PVC schedule 40 conduit 358 LF $181.08 $31.44 $212.52 $76,082.16 bundled in one main trench with others for City conduit Supply and install only 37 24"X13"X12" pull box for City 20 EA $534.44 $207.92 $742.36 $14,847.20 conduit 38 Flowable Fill 97,125 CF INCL. INCL. $5.75 $558,468.75 39 Asphalt Mill & Resurface 34,583 SY INCL. INCL. $15.00 $518,745.00 40 Construct Concrete Sidewalk 1 ALLOWANCE INCL. INCL. $375,000 41 Urban Walkway 1 ALLOWANCE INCL. INCL. $250,000 42 Concrete fill over FPL conduits 1 ALLOWANCE INCL. INCL. $15,000 43 CONTINGENCY 1 ALLOWANCE N/A N/A $375,000 44ITOTAL BID PRICE I I $33,043.35 I $1873.39 ($1,515,037.49 $6,983,381.51 (Bid Items 1 through 43) BID AMOUNT in FIGURES - $7,998,381.51 BID AMOUNT in WORDS -seven million nine hundred ninety eight thousand three hundred eighty one and fifty one cents Firm Name: Rohl Global Networks LP 2875 Jupiter Park Dr. STE. 900 Jupiter FL, 34998 Street Address: Mailing Address (if different): Telephone No. 561-316-2294 Fax No. 561-768-9453 Email Address:cszklaruk@rohlglobal.com FEIN No. 8?-������ 1 *"By signing this document the bidder agrees to all Terms Print Name: 6jdetd Sze ��rwk Title: 1V - Q re S�e^� THE EXECUTION OF THIS FORM CONSTITUTES THE UNEQUIVOCAL OFFER OF BIDDER TO BE BOUND BY THE TERMS OF ITS BID. FAILURE TO SIGN THIS SOLICITATION WHERE INDICATED ABOVE BY AN AUTHORIZED REPRESENTATIVE SHALL RENDER THE BID NON-RESPONSIVE. THE CITY MAY, HOWEVER, IN ITS SOLE DISCRETION, ACCEPT ANY BID THAT INCLUDES AN EXECUTED DOCUMENT, WHICH UNEQUIVOCALLY BINDS THE BIDDER TO THE TERMS OF ITS OFFER. City of Sunny Isles Beach I Invitation to Bid No. 21-08-01 �w Q �o^ 5� t�Q y1s4•s � SONNY IS �F s �� eF ti n P %�D°�. F�oR�oPSP, Yo 5Uta PNO STATE OF FLORIDA ) COUNTY OF NA ? NON -COLLUSION AFFIDAVIT City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947-0606 Fax: (305) 949-3113 The undersigned being first duly sworn as provided by law, deposes, and says: This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it will be relied upon by said County, in any consideration which may give to and any action it may take with respect to this Bid. The undersigned is authorized to make this Affidavit on behalf of, 9-01n 1 cil o w l lie -liar k s (Name of Corporation, Partnership, Individual, etc.) a, ` 9 , formed under the laws of e `otw CLr e - (Type of Business) (State) of which he is ULc e (Sole Owner, Partner, President, etc.) Neither the undersigned nor any person, firm, or corporation named above nor anyone else to the knowledge of the undersigned, have themselves solicited or employed anyone else to solicit favorable action for this Bid by the City, also that no head of any department or employee therein, or any officer of the City of Sunny Isles Beach, Florida is directly interested therein. This Bid is genuine and not collusive or a sham; the person, firm or corporation named above has not colluded, conspired, connived or agreed directly or indirectly with any proposers or person, firm or corporation, to put in a sham Bid, or that such person, firm or corporation, shall refrain from Bidding, and has not in any manner, directly or indirectly, sought by agreement or collusion, or communication or conference with any person, firm or corporation, to fix the prices of said Bid or Bids of any other proposers; and all statements contained in the Bid or Bids described above true; and further; neither the undersigned, nor the person, firm or corporation named above has directly or indirectly submitted said Bid or the contents thereof, or divulged information or data relative thereto, to any association or to any member or agent thereof. C� l �z laru.ky; ce P(-e-5de..,�- AFFIANT'S NAME AFFIANT'S TITLE TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this Personally Known or Produced Identification; Type of identificationVt?CS�C�`3� t*pr ill",. ERIN P BRITT•BAILEY (Affix seal here) =a. ;��:: Notary Public State of Florida Commission # GG 356710 My Comm. Expires Nov 16, 2023 Bonded through National Notary Assn. day of Smbe.r 20 1 k NOTARY PUBLIC (name 'pr'in�ter*pe 1 of 12 SUNNY IS Ff O� B � F U = FC/F�pF os OF SUN F� PUBLIC ENTITY CRIMES City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947-0606 Fax: (305) 949-3113 SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a) FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES PUBLIC ENTITY CRIMES Pursuant to the provisions of paragraph (2) (a) of Section 287.133, Florida State Statutes - "A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a Bid on a Contract to provide any goods or services to a public entity, may not submit a Bid on a Contract with a public entity for the construction or repair of a public building or public Work, may not submit Bids on leases of real property to a public entity, may not be awarded to perform Work as a Contractor, supplier, Sub -Contractor, or Consultant under a Contract with any public entity, and may not transact business with any public entity in excess of the threshold amount Category Two of Sec. 287.017, FS for thirty six months from the date of being placed on the convicted vendor list". THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. This sworn statement is submitted to City of Sunny Isles Beach by �h�d SZk la��k ��ce gces;c�e-.+ nt individual's name and title] 1 ' for G�, ato�c, I�eor �- P [print name of entity submitting swam statement] whose business address is: �S 75 c.4p er P�� ,� fir. S E moo 33g5_8 and (if applicable) its Federal Employer Identification number (FEIN) is (If the entity had no FEIN, include the Social Security Number of the individual signing this sworn statement: ) 2. 1 understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any Bid or Contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 3. 1 understand that "convicted" or "conviction" as defined in Para. 287.133(1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trail court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non -jury trial, or entry of a plea of guilty or nolo contendere. 4. 1 understand that an "affiliate" as defined in Para. 287.133(1)(a), Florida Statutes, means a.) predecessor or successor of a person convicted of a public entity crime; or b.) Any entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executors, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair 2of12 market value under an arm's length agreement, shall be a prime facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 5. 1 understand that a "person" as defined in Para. 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding Contract and which Bids or applies to Bid on Contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "persons" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in management of any entity. 6. Based on information and belief, the statement which I have marked below is true in relation to the entity I / submitting this sworn statement. (Indicate which statement applies.) V Neither the entity submitting this sworn statement, nor any of it's officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. (Attach a copy of the final order.) I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FLORIDA STATUTES, FOR CATEGORY TWO OF ANY, CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. By: (SIE oLd St l< larc.� k (Prin d Name �X �'(_e�.-E- (Title) Sworn to and subscribed before me this day of MSC'.' 201 by C)cv-6, -s-Zk\cu, (AFFIX N p;S.TAMPEN BAILEY :. Notary Publiate of Florida r. Q Commission # GG 356710 ' o " My Comm. Expires Nov 16, 2023 Sa'nature: Notary Public — State of Flo�l Bonded through National Notary Assn. Print or Type Commissioned'Name Personally Known OR Produced` Identifications Type of Identification Produced b�Q.Ca 3of12 JNNY JS4 5 FS EQUAL OPPORTUNITY / AFFIRMATIVE ACTION tiP c'9'. F,L O�'\Oo s� City of Sunny Isles Beach of suN "� 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947-0606 Fax: (305) 949-3113 EQUAL OPPORTUNITY/AFFIRMATIVE ACTION STATEMENT The contractors and all subcontractors hereby agree to a commitment to the principles and practices of equal opportunity in employment and to comply with the letter and spirit of federal, state, and local laws and regulations prohibiting discrimination based on race, color, religion, national region, sex, age, handicap, marital status, and political affiliation or belief. 0 4 4 W, Elm Firm: Kok 6t.J��( �C�.��Jof �S LP— Address: PAddress: a8� �►P+ P� 1� ��. S! C 9m If r �L. 3 V�� 4of12 NNYs CONFLICT OF INTEREST Y. �F City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles each, FL 33160 r s Telephone: (305) 947-0606 Fax: (305) 949-3113 tiF c,y *^F},L O0.0o IJ TY OF SUN PN CONFLICT OF INTEREST STATEMENT The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the City of Sunny Isles Beach or its agencies. STATE OF FLOR DA1 COUNTY OF 4th Q CO.Gh BEFORE ME, the undersigned authority, personally appeared who was duly sworn, deposes, and states: I am the office in in of L'\ GtQ6,,` 1)ekc,)�kS LIP with a local and principal office 2. The above �amed entity is submitting a Bid for the City of Sunn Isles Beach, Bid No. ) I—A—C) described as Will Vvilderirot.�Adw. 16 [ro" ?i re!. The Affiant has made diligent inquiry and provides t6 informatl n contained in this Affidavit based upon his own knowledge. 3. The Affiant states that only one submittal for the above Bid is being submitted and that the above named entity has no financial interest in other entities submitting Bids for the same project. 4. Neither the Affiant nor the above named entity has directly or indirectly entered into any agreement, participated in any collusion, or otherwise taken any action in restraints of free competitive pricing in connection with the entity's submittal for the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and execution of the Contract for this project. 5. Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise ineligible from participation in contract letting by any local, State, or Federal Agency. 6. Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict of interest due to any other clients, contracts, or property interests for this project. 7. 1 certify that no member of the entity's ownership or management is presently applying for any employee position or actively seeking an elected position with the City of Sunny Isles Beach. 8. 1 certify that no member of the entity's ownership or management, or staff has a vested interest in any aspect of the City of Sunny Isles Beach. 9. In the event that a conflict of interest is identified in the provision of services, I, on behalf of the above named entity, will immediately notify the City of Sunny Isles Beach. Dated this Q—A day of ��x�b�'� 20oZ� . (J�cL AFFIANT SZk jGtf�k Print or Type Name and Title Sworn to and subscribed before me this aniµ day of � �Xh OC.(' 2001. ❑ Personally Known, OR 14 Produced Identification - Type of Id t' (cation �OL4e C5 NOTARY PUBLIC STATE OF FLORIDA Ndtery Public • State of Florida 7f p0J Commissian K GG 356710 5 of 12 My Comm, Expires Nov 16, 7027 80Mded through National Notary Assn, SUNNY IS<F. s O� B DISPUTE DISCLOSURE City of Sunny Isles Beach P'* 18070 Collins Avenue FLOR\OOSY Sunny Isles Beach, FL 33160 of :uo r'� Telephone: (305) 947-0606 Fax: (305) 949-3113 DISPUTE DISCLOSURE FORM Answer the following questions by placing a "X" after "Yes" or "No". If you answer "Yes", please explain in the space provided, or on a separate sheet attached to this form. 1. Has your firm or any of its officers, received a reprimand of any nature or been suspended by the Department of Professional Regulations or any other regulatory agency or professional associations within the last five (5) years? y YES NO X 2. Has your firm, or any member of your firm, been declared in default, terminated or removed from a contract or job related to the services your firm provides in the regular course of business within the last five (5) years? YES NO X 3. Has your firm had against it or filed any requests for equitable adjustment, contract claims, Bid protests, or litigation in the past five (5) years that is related to the services your firm provides in the regular course of business? YES NO X If yes, state the nature of the request for equitable adjustment, contract claim, litigation, or protest, and state a brief description of the case, the outcome or status of the suit and the monetary amounts of extended contract time involved. I hereby certify that all statements made are true and agree and understand that any misstatement or misrepresentation of falsification of facts shall be cause for forfeiture of rights for further consideration of this Bid for the City of Sunny Isles Beach. Roll Firm Authorize gnature �/-,�7/a2l Date "cc) 5 z k l ars., k vice Print or Type Name and Title 6 of 12 VNNY /5< OF d � F V I a Pa F "L O � Swc TY Ot' SUN P� STATE OF FLORIDA ) COUNTY OF ANTI -KICKBACK City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947-0606 Fax: (305) 949-3113 ANTI -KICKBACK AFFIDAVIT I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid will be paid to any employees of the City of Sunny Isles Beach or its elected officials as a commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or by an officer of the corporation. By • q The foregoing instrument was acknowledged before me this `l da of , 20 al , by C� S zk1a�-vL� [name of person], as '��t�i eJ��,��- [type of authority], for kha.l) [name of party on behalf of whom instrument was executed]. AFFIX NOTARY STAMP H P BRITT -BAILEY 04My Notary Public - State of Florida Commission N GG 356712023 Comm. Expires Nov 16, Bonded through National Notary Assn Notary• - o", rrida C`ck �_'�.�ct_v Print or Type Commissioned Name Personally Known OR Produced Identification Type of Identification Produced wecz5 �c�%fnL=R- 7 of 12 OSUNN Y_IS(FB m f 0 4 CONTRACTOR ANTI -BOYCOTT CERTIFICATION P R O•F FLO •° [PURSUANT TO FLORIDA STATUTE § 215.4725] SzJc64A V_ , on behalf of ' ,oO 6EIo6_` 1�.Jqrke, L P , Print Name Company Name certifies that ot f) U does not: Company Name 1. Participate in a boycott of Israel; and 2. Is not on the Scrutinized Companies that Boycott Israel list; and 3. Is not on the Scrutinized Companies with Activities in Sudan List; and 4. Is not on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; and 5. Has not engaged in business operations in Cuba or Syria. /._ Wim. i�� y' c- Vre5O'dQe, ,� Title -7/a Date Anf19 Florida Statute 448.095 directs all public employers, including municipal governments, to verify the employment eligibility of all new public employees through the U.S. Department of Homeland Security's E - Verify System, and further provides that a public employer may not enter into a contract unless each party to the contract registers with and uses the E -Verify system. Florida Statute 448.095 further provides that if a contractor enters into a contract with a subcontractor, the subcontractor must provide the contractor with an affidavit stating that the subcontractor does not employ, contract with, or subcontract with an unauthorized alien. In accordance with Florida Statute 448.095, all contractors doing business with the City of Sunny Isles Beach are required to verify employee eligibility using the E -Verify system for all existing and new employees hired by the contractor during the contract term. Further, the contractor must also require and maintain the statutorily required affidavit of its subcontractors. It is the responsibility of the awarded vendor to ensure compliance with E -Verify requirements (as applicable). To enroll in E -Verify, employers should visit the E -Verify website (https://www.e-verify.gov/employers/enrolling-in-e-verify) and follow the instructions. The contractor must, as usual, retain the 1-9 Forms for inspection. By affixing your signature below you hereby affirm that you will comply with E -Verify requirements. Company Name Kjaa�p:gTu re (1,71kci Sz k Iq k Print Name 8a- 318 -71 Federal Employer Identification Number (FEIN) Date Ov� c,e Pres :cl e.� Title Sworn to and subscribed before me on this thisS�'3 �� day of �Q(- , -]@*@. QUl\ By C -,6J Szktctr'wk ❑ Is personally known to me 1 Has prAuced identification (type of identification produced: U9 �V eCS 4� t l�U Signature of Notary Public ERIN P BRITT•BAILEy Notary Public - State of Florida Commission # GG 35670 61 My Comm. Expires 2023 uarinnal Notary Assn. Print or Stamp of N STATE OF FLORIDA COUNTY OF ) BID BOND City of Sunny Isles Beach 18070 Collins Avenue Sunny Isles Beach, FL 33160 Telephone: (305) 947-0606 Fax: (305) 949-3113 KNOW ALL MEN BY THESE PRESENTS, that we, Rohl Global Networks LP as Principal, and Argonaut Insurance Com a _'as Surety, are held and firmly bound unto the City of Sunny Isles Beac , a municipal corporation o the State of Florida hereinafter referred to as the Owner in the sum of Five Percent of Amount Bid--xx/100 Dollars ($50/6 n 1 R , lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators and successors jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that whereas the Principal has submitted the accompanying Bid dated, Segmber 28 2021 for: Invitation to Bid No 21-08-01 - Utiles Undergrounding for Golden Shores WHEREAS, it was a condition precedent to the submission of said Bid that a cashiers check or Bid Bond in the amount of five percent (5%) of the Base Bid be submitted with said Bid as a guarantee that the Proposers would, if awarded the Contract, enter into a written Contract with the City for the performance of said Contract, within ten (10) consecutive calendar days after written notice having been given of the Award of the Contract. NOW, THEREFORE, the conditions of this obligation are such that if the Principal within ten (10) consecutive calendar days after written notice of such acceptance, enters into a written Contract with the City of Sunny Isles Beach and furnishes the Performance Bond, satisfactory to the City, each in an amount equal to one hundred percent (100%) of the Contract Price, and provides all required Certificates of Insurance, then this obligation shall be void; otherwise the sum herein stated shall be due and payable to the City of Sunny Isles Beach and the Surety herein agrees to pay said sum immediately, upon demand of the City, in good and lawful money of the United States of America, as liquidated damages for failure thereof of said Principal. IN WITNESS WHEREOF, the above bonded parties have executed this instrument under their several seals this 27th day of September 20 9.1 , the name and the corporate seal of each corporate party being hereto affixed and these presents being duly signed by its undersigned representative. IN PRESENCE OF: Rohl Global Networks LP Individual or Partnership Principal 2875 Juniter Park Drive Suite 900 Business Address Jupiter, FL 33458 City, State, and Zip Code 1-866-783-3330 Business Telephone ATTEST: Argonaut Insurance Company (Corporate Surety)* "Impress Corporate Seal DOCUMENT CONTINUES ON NEXT PAGE Affix Corporate Seal 1-866-644-1229 Business Facsimile IMPORTANT By: 941o,-�Ojw Susan A. Welsh, Attorney -in -Fact Surety companies executing bonds must appear on the Treasury Department's most current list (circular 570 as amended) and be authorized to transact business in the State of Florida. 10 of 12 •� -6eeretery IMPORTANT By: 941o,-�Ojw Susan A. Welsh, Attorney -in -Fact Surety companies executing bonds must appear on the Treasury Department's most current list (circular 570 as amended) and be authorized to transact business in the State of Florida. 10 of 12 Argonaut Insurance Company Deliveries Only: 225 W. Washington, 24th Floor Chicago, IL 60606 United States Postal Service: P.O. Box 469011, San Antonio, TX 78246 POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the Argonaut Insurance Company, a Corporation duly organized and existing under the laws of the State of Illinois and having its principal office in the County of Cook, Illinois does hereby nominate, constitute and appoint: Sandra M Winsted Susan A Welsh Michelle D Krebs Judith A Lucky-ERimov. Sandra M Nowak Derek J Elston Christina L. Sandoval, Anna A. Fottnhals Aerie Walton Christopher P Troha Battiomiei Siepierski Jessica B Dempsey Samantha Chierici Kristin L. Hannigan, Nicholas Pantazis. Rachel Fore. Roger J. Paraison Their true and lawful agent(s) and attorneys) -in -fact, each in their separate capacity if more than one is named above, to make, execute, seal and deliver for and on its behalf as surety, and as its act and deed any and all bonds, contracts, agreements of indenmity and other undertakings in suretyship provided, however, that the penal sum of any one such instrument executed hereunder shall not exceed the sum of: $97.550.000.00 This Power of Attorney is granted and is signed and sealed under and by the authority of the f ollowing Resolution adopted by the Board of Directors of Argonaut Insurance Company: "RESOLVED, That the President, Senior Vice President, Vice President, Assistant Vice President, Secretary, Treasurer and each of them hereby is authorized to execute powers of attorney, and such authority can be executed by use of facsimile signature, which may be attested or acknowledged by any officer or attorney, of the Company, qualifying the attorney or attorneys named in the givempower of attorney, to execute in behalf of, and acknowledge as the act and deed of the Argonaut Insurance Company, all bond undertakings and contracts of suretyship, and to affix the corporate seal thereto." IN WITNESS WHEREOF, Argonaut Insurance Company has caused its.ofticial seal to be hereunto affixed and these presents to be signed by its duly authorized officer on the I st day of June, 2021. Argonaut Insurance Company ,•` �vaSURANp�c+ J' C;o�o�f01 % 0 - �= by: ' 6•'••;<LINO�?.�' �r Joshua C. Betz , Senior Vice President STATE OF TEXAS COUNTY OF HARRIS SS: On this Ist day of June, 2021 A.D., before me, allotary Public ofthe State of Texas, in and for the County of Harris, duly commissioned and qualified, came THE ABOVE OFFICER OF THE COMPANY, to me personally known to be the individual and officer described in, and who executed the preceding instrument, and he acknowledged the execution of same, and being by me duly sworn, deposed and said that he is the officer of the said Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and the said Corporate Seal and his signature as officer were duly affixed and subscribed to the said instrument by the authority and direction of the said corporation, and that Resolution adopted by the Board of Directors of said Company, referred to in the preceding instrument is now in force. IN TESTIMONY WHEREOF, I have hereunto set my hand, and affixed my Official Seal at the County of Harris, the day and year first above written. '- KATHLEEN M MEE KS .P� NOTARY PUBLIC STATE OF TEXAS �q�F as Bch MY COMM. EXP. 07/75/25 NOTARY ,O 557902-8 (Notary Public) L the undersigned Officer of the Argonaut Insurance Company, Illinois Corporation, do hereby certifj, that the original POWER OF ATTORNEY of which the foregoing is a full, true and correct copy is still in full force and effect and has not been revoked. t r 1N WITNESS WHEREOF, I have hereunto set my hand, and affixed the Seal of said Company, on the 14111, t d y of'�L _, u ++++++ z�'��� aPoAnsFcFco O.•SE"L've "1 1848 James Bluzard Vice President-Sureq IF YOU HAVE QUESTIONS ON AUTHENTICITY OF THIS DOCUMENT CALL (833) 820 - 9137.