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HomeMy WebLinkAboutG612 Forms GC Insurances I , • OWNER'S INSTRUCTIONS REGARDING THE CONSTRUCTION CONTRACT AIA DOCUMENT G612, PART A PROJECT TITLE: Oak Park Height City Hall DATE: 2 -17 -09 Minnesota OWNER: City of Oak Park Heights PROJECT NO: 0822 NOTATION TO OWNER —In consultation with your attorney, complete this form, which will provide your instruc- tions regarding requirements for construction contracts for this Project. Please return the completed form, along with any other instructions concerning construction- related matters, to the Architect. TO: (ARCHITECT) Buetow & Associates, Inc. ,,,.1 2345 N. Rice Street #210 St. Paul, MN 55113 __ G Attention: Randy L. Engel, Vice President P.. Eu1. p You are hereby instructed to proceed with development of necessary construed( 2 2 ° the advice and information given below: F pd • 1. Project title to be used (if other than above): Oak Park Heights City Hall 2. Legal name and address of the Owner for construction contract purposes: City of Oak Park Heights 14168 Oak Park Boulevard North Oak Park Heights, MN 55082 3. The Owner is a ❑ Corporation ❑ Partnership ❑ Individual Ig Other (specify) Municipal If a corporation: incorporated in the State of Qualified to do business at the Project location X Yes ❑ No 4. Detailed description of building -site property, including designation of property owner if different from the Owner - , identified above: I 5. During the Construction Phase the Owner's Representative will be Eric A. Johnson , whose title is City Administrator On -site field representative(s) of the Owner's permanent staff X. will ❑ will not be utilized during the construction period. . 6. The Project will be constructed utilizing: Single contract, stipulated sum ❑ Single contract, cost of the Work plus a fee ❑ Multiple contracts, stipulated sum ❑ Multiple contracts, cost of the Work plus a fee ❑ Phased construction (fast track) SI ❑ Portions of construction by Owner's own forces ❑ Other (specify) AIA DOCUMENT G612.OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • ©1987 • THE AMERI- CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 G612 -1987 1 III 7 . The method of selecting the Contractor(s) be: a..�,Bidding that is: ) shall X Open and competitive ❑ By invitation only . JKOther (specify) Prequalified Bidders b. ❑ Negotiation with: ❑ A single Contractor ❑ Multiple Contractors ❑ Other (specify) 8. The form(s) of agreement between Owner and Contractor(s) shall be: .74 Stipulated Sum, AIA Document A101 ❑ Abbreviated Form, Stipulated Sum, AIA Document A107 ❑ Cost of the Work Plus a Fee, AIA Document A111 ❑ Abbreviated Form, Cost of the Work Plus a Fee, AIA Document A117 ❑ Stipulated Sum, Furniture, Furnishings and Equipment, AIA Document A171 ❑ Abbreviated Form, Stipulated Sum, Furniture, Furnishings and Equipment, AIA Document A177 ❑ Other (specify and furnish copy) 9. If multiple contracts are to be utilized, the activities of the Contractors will be coordinated by the Owner: ❑ Through the Owner's own forces ❑ Through others (specify) 10. General Conditions of the Contract shall be (inapplicable if A107, A117 or A177 is marked on Item 7 above): XAIA Document A201 (Construction) D AIA Document A271 (Furniture, Furnishings and Equipment) ❑ Other (specify and furnish copy) - 0 11. Supplementary Conditions of the Contract and General Requirements will be discussed and reviewed: With the Owner's Representative, who is David Snyder ❑ Directly with the Owner's attorney, Whose address is Eckberg Lammers, etal Telephone ( 651 ) 3 51-21 31 12. • Contractor's applications for payment will be paid: X By the las t thy of each month ❑ Other (specify) 13. Applications for payment must be received by the Owner Fifteen ( before payment is due. 14. Retainage: a. Until Substantial Completion, retainage from progress payments to the Contractor shall be: `X 10 % of each payment. ❑ % of each payment until the Work is 50% complete, after which remaining partial payments shall be paid in full without reduction of previous retainage. ❑ % of each payment (calculated separately for each Work category) until the Work is 50% com- plete, after which remaining partial payments shall be paid in full without reduction of previous retainage. b. Upon Substantial Completion, retainage shall be reduced to: ❑ % not ❑ $ c. Retained amounts will be paid into an escrow account in a financial institution chosen by the Contractor and approved by the Owner, the interest earnings from which shall accrue to the benefit of the Contractor: D Yes X No 15. Liquidated Damages: V,Required ❑ Not required (Five If required, Liquidated Damages shall be assessed in the amount of $ 500.00 Hundred) per day for each calendar day required to achieve Substantial Completion beyond the date set forth in the Owner - Contractor Agree- . ment, subject to agreed -on adjustments. AIA DOCUMENT 6612. OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • 01987 • THE AMERI- CAN INSTITUTE OP ARCHITECTS, 1735 NEW YORK AVENUE, N.\V.., WASHINGTON, D.C. 20006 G612 -1987 2 (NOTE: When liquidated Damages are to be stipulated, it is important that Subcontractors be made aware of this provision of the Contract. Therefore, while space is provided in the AIA Owner - Contractor Agreement forms for this provision, it is recommended that any enacting clause be set out in the Supplementary Conditions.) 16, Special instructions are attached for items checked. 8( Equal opportunity requirements ❑ Escrow of retainage ❑ Extensions of time 2( Lien waivers — Each billing • W. Monthly affidavits — Prevailing Wage (Minnesota DOLI) ❑ Phased occupancy ❑ Separate contracts ❑ Special time periods during which the Contractor cannot perform construction ❑ Tax exemptions X Wage standards to which the Contractor must conform — Prevailing Wages ❑ Work by the Owner's own forces ❑ Other (specify) • • • • C , , OF 0 #E(w73 Owner . A. .Z .? 1/0y Date AIA DOCUMENT G812 • O "S INSTRUCTIONS • 1987 EDITION • ALA® • ©1987 • THE AMERI- • CAN INSTITUTE OF AR • ECTS, 1735 NEW YORK AVENUE, N.W. , WASHINGTON, D.C. 20006 G612.1987 3 • 1 OWNER'S INSTRUCTIONS FOR INSURANCE AND BONDS AIA DOCUMENT G612, PART B PROJECT: Oak Park Heights City Hall DATE: 2 -17 -09 Minnesota OWNER: City of Oak Park Heights PROJECT NO: 0822 NOTATION TO OWNER —In consultation with your insurance advisor, complete this form, which will provide your instructions regarding your requirements for bonds and insurance for this Project. Please return the completed form, along with any other instructions relating to bonds and insurance, to the Architect. TO:(ARCHITECT) Buetow & Associates, Inc. I 2345 N. Rice Street #210 St. Paul, MN 55113 Attention: Randy L. Engel, Vice President • ■ • You are hereby instructed to include the following information and requirements in a y g � q appropriate locations in the Bid- ding Documents and the Contract Documents. These requirements are based on Article 11 of AIA Document A201, 0 General Conditions of the Contract for Construction, 1987 edition (copy attached hereto), and the completion of these instructions is presumed to be based thereon. • A. CONTRACTOR'S LIABILITY INSURANCE Concerning the insurance described in Paragraph 11.1 of AIA Document A201, 1981 edition, specify the following minimum limits: 1. Workers' Compensation . 0 State: , Statutory O Voluntary Compensation (by any exempt entities): Same as State Workers Compensation O Applicable Federal (e.g., Longshoremen, harbor work, Work at or outside U.S. Boundaries): Statutory O Maritime: $ 0 Employer's Liability: $ 5 0 0, 0 0 0 Each accident $ 5 0 0, 0 0 0 Disease, Policy limit $ 5 0 0, 0 0 0 Disease, Each employee 0 Benefits required by union labor contracts: As applicable 2. General Liability (including Premises- Operations; Independent Contractors' Protective; Products and Completed Operations; Broad Form Property'Damage): (a) Bodily , 0 u r 0, 0 0 0. 0 0 Each Occurrence $ 2, 000, 00 . 0 0 000 . 00 Aggregate (b) Property 0 0 $ 1 ' 0 Each Occurence $ Aggregate (c) Products and Completed Operations Insurance shall be maintained for a minimum period of 0 1 Cf 2 411 D two year(s) after final payment and the Contractor shall continue to provide evidence of such • coverage to the Owner on an annual basis during the aforementioned period. • • AIA DOCUMENT G612. OWNER'S INSTRUCTIONS • 1987 EDITION • AIA° • ©1987 • THE AMERI- CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 6612 -1987 4 (d) Property Damage Liability Insurance shall include coverage for the following hazards: L2i X (Explosion) C C (Collapse) • ] U (Underground) (e) Contractual Liability (Hold Harmless Coverage): Bo dily M}3ry0 0 0 . 0 0 $ Each Occurrence Propertv0 a e d . 0 0 $ I , 0 Each Occurrence $ 2, 000, 000.00 Aggregate (f) Personal Injury (with Employment Exclusion deleted, if applicable): $ 2, 000, 000. 00 Aggregate (g) If the General Liability policy Includes a General Aggregate, such General Aggregate shall be not less than $ 2 , 0 0 0 , 0 0 0 . 0 0 .Policy shall be endorsed to have General Aggregate apply to this Project only: ❑ Yes ❑ No 3. Umbrella Excess Liability $ 5, 0 0 0, 0 0 0. 0 0 Over primary insurance Retention 4. Automobile Liability (owned, non - owned, hired): Bodily Injury: $ 1, 0 0 0, 0 0 0. 0 0 Each Person $ 1, 0 0 0, 0 0 0. 0 0 Each Accident $ Property , e 000, 0 . 00 $ 1 00 Each Occurrence 5. Aircraft Liability (owned and non - owned) when applicable, as follows: (Select one) • ❑ With limits'proposed by the Contractor for the Owner's approval. ❑ With the following limits: Bodily Injury: $ Each Person $ Each Occurrence Property Damage: $ Each Occurrence 6. Watercraft Liability (owned and non - owned) when applicable, as follows: (Select one) ❑ With limits proposed by the Contractor for the Owner's approval. ❑ With the following limits: Bodily Injury: Each Person Each Occurrence Property Damage: $ Each Occurrence 7. Other Insurance: COVERAGE AMOUNT . t B. OWNER'S LIABILITY INSURANCE Concerning the insurance described in Paragraph 11.2 of AIA Document A201, 1987 edition: (Select one) ff No modification is required. 0 The Contractor shall provide this insurance with the following limits: AIA DOCUMENT G612.OWNER'S INSTRUCTIONS • 1987 EDITION • AIA • ®1987 • TtIE AMERI- CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 G612 ^1987 5 1 • (1)Bodily Injury: • $ Each Occurrence $ Aggregate (2) Property Damage: $ Each Occurrence $ •. Aggregate C. PROPERTY INSURANCE Concerning the insurance described in Paragraph 11.3 of AIA Document A201, 1987 edition: (Complete (a), (b) or (c), and then complete (d) and (e).) (a) ❑ No modification is required; the Owner will purchase (including coverage for all materials and equipment to be incorporated orused in the Project when stored off the site or when in transit). (b) al The Owner will purchase with the following modifications: Builders Risk; Owner's Policy will not cover items stored off -site or items "in- transit ". • (c) ❑ The Contractor shall purchase the following: (Select one) g All -Risk IS Other (specify) Contractor shall secure and maintain Installation Property Insurance - See Sec. D below On the following form: (Select one) ❑ Completed Value ❑ Reporting In the names of the Owner, Contractor, Subcontractor and Sub - subcontractors as their interests may appear with Limits as follows: (Select one) ❑ Amount equal to the Contract Sum for the Work. • ❑ Other (specify) (NOTE: If coverage for alterations and additions to existing structures is to be included under the Owner's existing coverage, specific instructions should be included under Item D below.) (d) Boiler and Machinery Insurance. Concerning the insurance described in Subparagraph 11.3.2 of AIA Document A201, 1987 edition: (1) The Owner -shall provide this insurance with a limit of $ (2) Objects to be insured: .(List objects) • • (e) Loss of Use Insurance. • Concerning the insurance described in Subparagraph 11.3.3 of AIA Document A201, 1987 edition: (Select one) ❑ No modification is required. I) The Contractor shall provide this insurance with limits of $ 3 0 0 , 0 0 0 . 0 0 D. OTHER INSTRUCTIONS RELATED TO BONDS OR INSURANCE (If none, please so indicate.) Installation Property Insurance to be provided by Contractor: Building materials, machinery, equipment and supplies which will become a permanent part of the building or structure and which are used in the construction of and /or installation in the buildings or structures while such property is in transit to or from job sites, in temporary storage, if it has been specifically allocated • and waiting for delivery to job sites where work is in progress or will start within 30 days of such property's deposit at the storage site, or on job sites during installation in or erection of buildings or structures, including while waiting for or during testing. AIA DOCUMENT G612. OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • ©1987 • THE AMER1• G612 -1987 6 CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 0 E. BONDS (a) Performance Bond and Payment Bond as described in Paragraph 11.4 of AIA Document A201, 1987 edition, will be: Required ❑ Not required (b) Required bonds shall be in the amount of (Select one) Performance 0 100% of Contract Sum ❑ % of Contract Sum ❑ $ Payment is 100% of Contract Sum ❑ .% of Contract Sum ❑ $ (c) Form of bonds shall be (Select one) ❑ AIA Document A311 0 AIA Document A312 . ❑ Other (Describe and furnish sample copy if available) (d) Special instructions: 1 1 lG. /-/&,„/ y � 7 oJ�©4 /' ner 411 , 2 ? 0 ' By / Date MA DOCUMENT G612.OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • ©1987 • THE AMERI- CAN INSTITUTE OP ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 G612-1987 7 110 OWNER'S INSTRUCTIONS REGARDING BIDDING PROCEDURES AIA DOCUMENT G612, PART C PROJECT: Oak Park Heights City Hall DATE: 2 -17 -09 Minnesota • OWNER: City of Oak Park Heights PROJECT NO: 0822 NOTATION TO OWNER — Complete this form, which will provide your instructions regarding your requirements for bidding procedures for this Project. Please return the completed form, along with any other instructions relating to bid- ding procedures, to the Architect. • TO: (ARCHITECT) Buetow & Associates, Inc. 2345 N. Rice Street #210 • St. Paul, MN 55113 • • Attention: . Randy L. Engel, Vice President The following information and data, together with that rovided in Parts A and B of this AIA Document G612 are P , transmitted to you for use in connection with preparation of the Bidding Documents. 1. Instructions to Bidders shall be: AIA Document A701 ❑ As provided by the Owner 2. Proposal Form shall be prepared by: 181, The Architect ❑ The Owner 3. Bids shall be solicited by: KPublic Advertisement Arranged by ❑ The Owner ❑ The Architect ❑ Private Invitation • Issued by ❑ The Owner • ❑ The Architect 4. Instructions, if an on the method y, o of selection and /or qualification of Bidders: � Prequalification process instituted by the Owner, followed by competitive open bid. 5. Bid Security ❑ Is not required JSI Is required, in the amount of ❑ 8. ❑ 5 % of the total Bid in the form of: ❑ A Bid Bond (AIA Document A310) J$ A Bid Bond ( AIA Form ) (O ther orms) • Cash or Certif Check (Other types of security) AIA DOCUMENT G612 OWNER'S INSTRUCTIONS • 1987 EDITION • AIA' • ©1987 • THE AMERI- CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 6612 -1987 8 • 6. Copies of the Bidding Documents may be made available in plan rooms: g Yes ❑ No If yes, plan rooms will be: lit Designated by the Owner . Z Selected by the Architect 7. Date and time for receipt of Bids: %.(Specify) 3 -31 -09 2:00 PM CST ❑ Will be determined later by the Owner ❑ Shall be determined by the Architect 8. Bids shall be received: ❑ At the Architect's office A $Other (Specify) City Hall Main Counter 9. Bid tabulation forms will be prepared by: ❑ the Owner )the Architect 10. Bids shall be publicly opened and read aloud: Sl Yes ❑ No If opened in private: . Bid tabulation may be furnished to Bidders: X Yes ❑ No Bids may be made public: k Yes ❑ No Special instructions: 11. In addition to the usual original signed Bid, the Owner requires the following: • 12. Bids shall not be withdrawn by Bidders for 60 days after the receipt of Bids. iii 13. If a Contract is awarded, construction at the site may commence: ❑ Upon execution of the Agreement 1F( Upon, but not before, receipt of a Notice to Proceed ❑ Not earlier than _ days after award of the Contract ❑ Other (Specify) 14. Work shall be substantially complete: ❑ calendar days after the Date of Commencement ❑ By , 19 K In the number of calendar days stipulated by the Bidder in the bid form 15. Special instructions: el /4'e iiC , G • Owner / 6 . By/ Date . AIA DOCUMENT • . • INSTRUCTION • O S • 1987 EDITION • AIA® • ©1987 • THE AMERI- CAN INSTITUTE ,. ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 G612 -1987 9 $ • y 1 OWNER'S INSTRUCTIONS REGARDING THE CONSTRUCTION CONTRACT AIA DOCUMENT G612, PART A PROJECT TITLE: 0.116_ P e___ I'C�5 I..E.ZE Ct-tit rta ti DATE: 2 ' 1 7- O q OWNER: G' Q`F-UNL .1 itr(' - 14 PROJECT NO: O gZ 2, NOTATION TO OWNER — consultation i withyoourrattorney, complete this form, which will provide y ur instruc- tions regarding requirements for construction contracts for this Project. Please return the complete r al g with any other instructions concerning construction- related matters, to the Architect. TO: (ARCHITECT) frJJ fNkb �rr ` !KC . 5 2 tEF IztLE S( reet Sui-te Z( Q � Sk-- �� f SS(L 'v Attention: <t l� v i C . v 0 ( c You are hereby instructed to proceed with development of ne ssar ) nstruction -rela do uments on the basis of the advice and information given below: 1 40 1. Project ti - to .e used (if other than above : - 2. Legal name d address of the Owner for construction contract purposes: C,c o o L I' N L f Pc 6 C L4 b , - I* i r • (J - i 41 13° P--C ivitimirmior 3. The Owner is a ❑ Corporation ❑ Partnership ❑ Individual KOther (specify) M 1\\ CI If a corporation: incorporated in the State of Project location Yes ❑ No Qualified to do business at the Proj Q 1 4. Detailed description of building -site property, including designation of property owner if different from the Owner identified above: AA 5. During the Construction Phase the Owner's Representative will be 41 t, UOI- I- )SO'F) , whose title is G (t-- (At f v i5 T(L�T� �' On -site field represe of the Owner's permanent staff will ❑ will not be utilized during the construction period. 6. he Project will be constructed utilizing: Single contract, stipulated sum ❑ Single contract, cost of the Work plus a fee ❑ Multiple contracts, stipulated sum ❑ Multiple contracts, cost of the Work plus a fee 0 ❑ Phased construction (fast track) ❑ Portions of construction by Owner's own forces ❑ Other (specify) AIA DOCUMENT 6612. OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • ©1987 • THE AMERI- CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 G612 -1987 1 A 7. The method of selecting the Contractor(s) shall be: a.1Bidding that is: rl(Open and competitive ❑ By invitation only _ Other (specify) only,., c'VOttt t- {7 e t • b. ❑ Ikegotiation with: ❑ A single Contractor ❑ Multiple Contractors ❑ Other (specify) 8. The form(s) of agreement between Owner and Contractor(s) shall be: Stipulated Sum, AIA Document A101 ❑ Abbreviated Form, Stipulated Sum, AIA Document A1.07 ❑ Cost of the Work Plus a Fee, AIA Document A111 ❑ Abbreviated Form, Cost of the Work Plus a Fee, AIA Document A117 ❑ Stipulated Sum, Furniture, Furnishings and Equipment, AIA Document A171 ❑ Abbreviated Form, Stipulated Sum, Furniture, Furnishings and Equipment, AIA Document A177 ❑ Other (specify and furnish copy) 9. If multiple contracts are to be utilized, the activities of the Contractors will be coordinated by the Owner: ❑ Through the Owner's own forces ❑ Through others (specify) 10. General Conditions of the Contract shall be (inapplicable if A107, A117 or A177 is marked on Item 7 above): ,CIA Document A201 (Construction) ❑ AIA Document A271 (Furniture, Furnishings and Equipment) ❑ Other (specify and furnish copy) 11. Supplementary Conditions of the Contract and General Requirements will be discussed and reviewed: • With the Owner's Representative, who is D 1 ::) SYMQC ❑ Directly with the Owner's attoiney, Whose address is ic L(A MAW Vrf feW Telephone ( ) 35'l 9,,. 12. Contractor's applications for a ment will be paid: pY P ❑ By the ►..'7' day of each month ❑ Other (specify) 13. Applications for payment must be received by the Owner 4 (01 days before payment is due. 14. Retainage: a. Until Substantial Completion, retainage from progress payments to the Contractor shall be: X 1 D % of each payment. ❑ % of each a ment until the Work is 50% complete, after which remaining partial payments shall PY P gP a PY be paid in full without reduction of previous retainage. ❑ % of each payment (calculated separately for each Work category) until the Work is 50% com- plete, after which remaining partial payments shall be paid in full without reduction of previous retainage. b. Upon,Substantial Completion, retainage shal1bereduced to: ❑ % 6 ❑ $ c. Retained amounts will be paid into an escrow account in a financial institution chosen by the Contractor and approved by the Owner, the interest earnings from which shall accrue to the benefit of the Contractor: ❑ Yes XNo 15. Liquidated 1 = ages: Required ❑ '! Not required _ If required, Liquidated Damages shall be assessed in the amount of $ r 0 atVZ ({U�FEC Q � Q g per day for each calendar day required to achieve Substantial Completion beyond the date set forth in the Own r- Contractor Agree- ment, subject to agreed -on adjustments. AIA DOCUMENT G612 • OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • ©1987 • THE AMERI- CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 G612 -1987 2 (NOTE: When liquidated Damages are to be stipulated, it is important that Subcontractors be made aware of this • provision of the Contract. Therefore, while space is provided in the AIA Owner- Contractor Agreement forms for this provision, it is recommended that any enacting clause be set out in the Supplementary Conditions.) 16, Special instructions are attached for items checked. Q Equal opportunity requirements ❑ Escrow of retainage ❑ Extensions of time Lien waivers rt.({ 4 D g I �� `� Monthly affidavits p (1- (mk, W Pr (Gt ( 01"► /1 ❑ Phased occupancy ❑ Separate contracts ❑ Special time periods during which the Contractor cannot perform construction ❑ Tax exemptions Wage standards to which the Contractor must conform p t �1,�,4 ❑ ork by the Owner's own forces ❑ Other (specify) • Owner • - By Date AIA DOCUMENT 6612. OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • ©1987 • THE AMERI- CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W, WASHINGTON, D.C. 20006 G612 -1987 3 OWNER'S INSTRUCTIONS FOR II INSURANCE AND BONDS AIA DOCUMENT G612, PART B gat PROJECT: a C p L rC"` (.6 i_c c C `k Y' a t ! DATE: . /cr 1 Z 0 A-eJo--1-1\ O 8 2?� OWNER: C EO,p(�14�.�.(4(j5 PROJECT NO: NOTATION TO OWNER — consultation with your insurance advisor, complete this form, which will provide your instructions regarding your requirements for bonds and insurance for this Project. Please return the completed form, along with any other instructions relating to bonds and insurance, to the Architect. TO: (ARCHITECT) (k'C Ake so 2cc S+ c117-) SSC� Attention: LV� You are hereby instructed to include the following information and requirements in appropriate locations in the Bid - ding Documents and the Contract Documents. These requirements are based on Article 11 of AIA Document A201, 41) General Conditions of the Contract for Construction, 1987 edition (copy attached hereto), and the completion of these instructions is presumed to be based thereon. • A. CONTRACTOR'S LIABILITY INSURANCE Concerning the insurance described in Paragraph 11.1 of AIA Document A201, 1987 edition, specify the following minimum limits: 1. Workers' Compensation State: � r' ❑ Voluntary Compensation (by any exempt entities): e as State Workers Compensation ❑ Applicable Federal (e.g., Longshoremen, harbor work, Work at or outside U.S. Boundaries): Statutory ❑ Maritime: $ ❑ Employer's Liability: $ Each accident $ Disease, Policy limit $ Disease, Each employee ❑ Benefits required by union labor contracts: As applicable 2. General Liability (including Premises- Operations; Independent Contractors' Protective; Products and Completed Operations; Broad Form Property'Damage): (a) Bodily Injury: $ ( O Each Occurrence $ ` (SOD (40 O Aggregate (b) Property Damage: $ I i 000 VO U Each Occurence $ / 000 Aggregate (c) Products and Completed Operations Insurance shall be maintained for a minimum period of ❑ 1 Xi 2 ❑ IWc) year(s) after final payment and the Contractor shall continue to provide evidence of such coverage to the Owner on an annual basis during the aforementioned period. AIA DOCUMENT G612 • OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • ©1987 • THE AMERI- CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 G612 -1987 4 (d) Property Damage Liability Insurance shall include coverage for the following hazards: lg X (Explosion) 16-C (Collapse) KU (Underground) (e) Contractual Liability (Hold Harmless Coverage): Bodily Injury: $ 1 OG 1 006 Each Occurrence Property amage: $ ( b C) I G� (� Each Occurrence $ �t 0 0(5 (545,C9 Aggregate (f) Personal Injury (with Employment Exclusion deleted, if applicable): $ Aggregate (g) If the General Liability policy includes a General Aggregate, such General Aggregate shall be not less than $ . Policy shall be endorsed to have General Aggregate apply to this Project only: ❑ Yes ❑ No 3. Umbrella Excess Liability $ St 0 0 0 1 . O O© Over primary insurance $ Retention • 4. Automobile Liability (owned, non - owned, hired): Bodily Injury: $ ( , o o 0 Each Person $ ooc , occ9 Each Accident Property Damage: $ t 0 OO L OO C' Each Occurrence 5. Aircraft Liability (owned and non - owned) when applicable, as follows: (Select one) ❑ With limits'proposed by the Contractor for the Owner's approval. ❑ With the following limits: Bodily Injury: $ Each Person $ Each Occurrence Property Damage: $ Each Occurrence 6. Watercraft Liability (owned and non - owned) when applicable, as follows: (Select one) ❑ With limits proposed by the Contractor for the Owner's approval. ❑ With the following limits: Bodily Injury: $ Each Person $ Each Occurrence Property Damage: $ Each Occurrence 7. Other Insurance: COVERAGE AMOUNT is B. OWNER'S LIABILITY INSURANCE Co cerning the insurance described in Paragraph 11.2 of AIA Document A201, 1987 edition: (Select one) No modification is required. ❑ The Contractor shall provide this insurance with the following limits: AIA DOCUMENT G612 OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • ©1987 • THE AMERI- CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, •N.W., WASHINGTON, D.C. 20006 G612 -1987 5 • 1 • (1)Bo il niuryi3O O Each Occurrence $ c t d � Aggregate (2)Pro erty Damage: + p $t Ot`X� C70 G Each Occurrence � 7 $ (- d0 4 Aggregate C. PROPERTY INSURANCE Concerning the insurance described in Paragraph 11.3 of AIA Document A 1 , 198 edition: (Complete (a), (b) or (c), and then complete (d) and (e).) ktGl ! cove -e (a) l No modification is required; the Owner • '..:. -- ' • d • : cover.: - or all materials and equipment to be incorporated or in the Project when store. off the s e or ' '...sit). (b)71.The Owner will purchase with the following modifica it • . I c C 70' 6 Wd.0 4 C4.w - t0 .. U.1- 12 --. • ❑ The Contractor shall purchase the following: (Select one (c ) P S g( one) ❑ All -Risk ❑ Other (specify) On the following form: (Select one) ❑ Completed Value ❑ Reporting In the names of the Owner, Contractor, Subcontractor and Sub - subcontractors as their interests may appear with limits as follows: (Select one) ❑ Amount equal to the Contract Sum for the Work. ❑ Other (specify) (NOTE: If coverage for /'iterations and additions to existing structures is to be included under the Owner's vcAr' tuc(I existing coverage, specific instructions should be included under Item D below.) �L (d) Boiler and Machinery Insurance. Concerning the insurance described in Subparagraph 11.3.2 of AIA Document A201, 1987 edition: (1) The Owner shall provide this insurance with a limit of $ f , ( Ret +'. tiafi4.G ✓ (2) Objects to be insured: (List objects) -�-� }‘✓NC- G i- 01\1cam . , • ' —37 (e) Loss of Use Insurance. • Concerning the insurance described in Subparagraph 11.3.3 of AIA Document A201, 1987 edition: (Select one) ❑ No modification is required. � Q G � he Contractor shall provide this insurance with limits of $ e,Lt‘i. D. OTHER INSTRUCTIONS RELATED TO BONDS OR INSURANCE (If none, please so indicate.) 1 AIA DOCUMENT G612 • OWNER'S INSTRUCTIONS • 1987 EDITION • AIA© • ©1987 • THE AMERI- G612-1987 6 CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 E. BONDS (a) Performance Bond and Payment Bond as described in Paragraph 11.4 of AIA Document A201, 1987 edition, will be: 4 equired ❑ Not required (b) Required bonds shall be in the amount of (Select one) Performance ,100% of Contract Sum ❑ % of Contract Sum ❑ $ Payment 100% of Contract of Contract Y � Sum ❑ % o Co ac Sum ❑ $ (c) Form of bonds shall be (Select one) yC ❑ AIA Document A311 •J AIA Document A312 ,per" ' ❑ Other Y ( XI) ' p (Describe and furnish sample copy if available) tc oo c )p kV (d) Special instructions: Owner By Date • AIA DOCUMENT G612. OWNER'S INSTRUCTIONS • 1987 EDITION • AIA ® • ©1987 • THE AMERI- CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 6612 -1987 7 OWNER'S INSTRUCTIONS REGARDING BIDDING PROCEDURES AIA DOCUMENT G612, PART C t I o � p rug - � G. - 7 (a PROJECT: l `twvreSC41 DATE: OWNER: Gr a f -Q' G t.GW PROJECT NO: e g Z 7 " - NOTATION TO OWNER Complete this form, which will provide your instructions regarding your requirements for bidding procedures for this Project. Please return the completed form, along with any other instructions relating to bid- ding procedures, to the Architect. TO: (ARCHITECT) 1 (it-r ' JS COCQJ SS t(.5 • Attention: `( 4 �� VP V The following information and data, together with that provided in Parts A and B of this AIA Document G612, are transmitted to you for use in connection with preparation of the Bidding Documents. • 1. Instructions to Bidders shall be: XLAIA Document A701 ❑ As provided by the Owner 2. Proposal Form shall be prepared by: The Architect ❑ The Owner 3. Bids shall be solicited by: '" Public Advertisement Arranged by ❑ The Owner ❑ The Architect ❑ Private Invitation Issued by ❑ The Owner ❑ The Architect 4. Instructions, if any, on the method of selection and /or qualification of Bidders: s- C. k Vl X1 'S (■.,<9T'-T '1 C. 4 GGA)Vel/ MINIPILL 5. Bid Security ❑ Is not required Is required, in the amount of ❑ $ . 5 % of the total Bid in the form of: ❑ A Bid Bond (AIA Document A310) • gi-A pi ) ther { _ e � ' � ASK or Ce► t ► �e A f, (Other types of curity) AIA DOCUMENT 6612 • OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • ©1987 • THE AMERI- (asi 2 -1987 8 CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 t • • - 6. Copies of the Bidding Documents may be made available in plan rooms: %Yes ❑ No If yes, plan rooms will be: W'Designated by the Owner ,Selected by the Architect 7. Date and time for receipt of Bids: .(Specify) 3 (- o `Z =oa ?vv\. GS ❑ Will be determined later by the Owner ❑ Shall be determined by the Architect 8. Bids shall be received: ❑ At the Architect's offic Other (Specify) Gt a (I. U'M. V\ Co v\ 9. Bid tabulation forms will be prepared by: ❑ the Owner 1 the Architect 10. Bids shall be publicly opened and read aloud: iyes ❑ No If opened in private: Bid tabulation may be furnished to Bidders: XYes ❑ No Bids may be made public: Yes ❑ No Special instructions: 11. In addition to the usual original signed Bid, the Owner requires the following: 12. Bids shall not be withdrawn by Bidders for days after the receipt of Bids. 13. If a Contract is awarded, construction at the site may commence: ❑ Upon execution of the Agreement PKUpon, but not before, receipt of a Notice to Proceed ❑ Not earlier than days after award of the Contract ❑ Other (Specify) 14. Work shall be substantially complete: ❑ calendar days after the Date of Commencement ❑ By , 19 (In the number of calendar days stipulated by the Bidder in the bid form 15. Special instructions: • • Owner • By Date AIA DOCUMENT 6612. OWNER'S INSTRUCTIONS • 1987 EDITION • AIA® • ©1987 • THE AMERI- G612 -1987 9 CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 .2 claims for damages because of bodily injury, occupa- other than the Owner has an insurable interest in the property tional sickness or disease, or death of the Contractor's required by this Paragraph 11.3 to be covered, whichever Is employees; earlier. This insurance shall include interests of the Owner, the .3 claims for damages because of bodily Injury, sickness Contractor, Subcontractors and Sub-subcontractors in the or disease, or death of any person other than the Con- Work. tractors employees; 11.3.1.1 Property insurance shall be on an all -risk policy form .4 claims for damages insured by usual personal injury and shall insure against the perils of fire and extended coverage liability coverage which arc sustained (1) by a person and physical loss or damage including, without duplication of as a result of an offense directly or indirectly related to coverage, theft, vandalism, malicious mischief, collapse, fake - employment of such person by the Contractor, or (2) work, temporary buildings and debris removal including by another person; demolition occasioned by enforcement of any applicable legal .5 claims for damages, other than to the Work 'itself, requirements, and shall cover reasonable compensation for because of injury to or destruction of tangible prep architect's servieu and expenses required as a result of such erty, including loss of use resulting therefrom; insured loss. Coverage for other perils shall not be required .6 claims for damages because of bodily Injury, death of unless otherwise provided In the Contract Documents. a person or property damage arising out of owner- 11.3.1.2 If the Owner does not intend to purchase such prop - ship, maintenance or use of a motor vehicle; and crty insurance required by the Contract and with aD of the .7 claims Involving contractual liability insurance appli- coverages in the amount described above, the Owner shall so cable to the Contractor's obligations under Paragraph inform the Contractor in writing prior to commencement of 3.18. the Work. 'The Contractor may then effect insurance which will protect the interests of thc Contractor, Subcontractors and Sub- 11.1.2 The insurance required by Subparagraph 11.1.1 shall be subcontractors in the Work, and by appropriate Change Order written for not less than limits of liability specified in the Con- the cost thereof shall be charged to the Owner. If the Conine- tract Documents or required by law, whichever coverage IS tor is d.unagcd by the failure or neglect of the Owner to pur- greater. Coverages, whether written on an occurrence or chase or maintain insurance as described above, without sO claims-made basis,_ shall be maintained without interruption notifying the Contractor, then the Owner shall bear all reason- from date of commencement of the Work until date of final able costs properly attributable thereto. payment and termination of any covetage required to be main- ' tained after final payment. 11.3.1.3 if the property insurance requires minimum deducti- bles and such deductibles are identified in thc Contract Docu- 11.1.3 Certificates of Insurance acceptable to the Owner shall menu "" '°„ .: tiali:pay costs notcovOr rod„becaPe� Al be filed with the Owner prior to commencement of the Work. Ids deducdblt if the Owner or insurer increases the recpti d" il These Certificates and the insurance policies required by this minimum deductibles above the amounts so identified or if the Paragraph 11.1 shall contain a provision that coverages Owner elects to purchase this insurance with voluntary deduc- afforded under the • •lades will not bc cancelled or allowed to tiblc amounts, the Owner shiall be responsible for payment of * expire until at leas ` A " :� ' ,' 1 e ` ',`.` as been given the additional costs not covered because of such increased or to the Owner. If any of the foregoing insurance coverages are voluntary deductibles. If deductibles are not identified in the required to remain In force after final payment and are reason- Contract Documents, the Owner shall pay costs not covered ably available, an additional certificate evidencing continuation because of deductibles. of such coverage shall be submitted with the final Application 11.3.1.4 Unless otherwise provided in the Contract Docu- for Payment as required by Subparagraph 9.10.2. Information menus, this property insurance shall cover portions of the Work concerning reduction of coverage shall be furnished by the stored off the site after written approval of the Owner at the Contractor with reasonable promptness in accordance with the value established in the approval, and also portions of the Work Contractor's information and belief. in transit) 11.2 OWNER'S LIABILITY INSURANCE i 11.3.2 Boller and Machinery Insurance. The Owner shall 11.2.1 The Owner shall be responsible for purchasing and purchase and maintain boiler and machinery insurance maintaining the Owner's usual liability insurance. Optionally, required by the Contract Documents or by law, which shall the Owner may purchase and maintain other insurance for self- specifically cover such insured objects during Itutallation and protection against claims which may arise from operations until final acceptance by the Owner; this insurance shall include under the Contract. The Contractor shall not bc responsible interests of the Owner, Contractor, Subcontractors and Sub - for purchasing and maintaining this optional Owner's liability subcontractors in the Work, and the Owner and Contractor insurance unless 'specifically required by the Contract shall be named insureds. Documents. 11.3.3 Loss of Use insurance. The Owner, at thc Owner's 11.3 PROPERTY INSURANCE option, may purchase and maintain such insurance as will 11.3.1 Unless otherwise provided, the Owner shall purchase insure the Owner against loss of use of the Owner's property and maintain, sn a company or companies lawfully authorized duc to fire or other hazards, however caused. The Owner to do business in the jurisdiction in which the Project is waives all rights of action against thc Contractor for loss of use located, property insurance in the amount of the initial Con- of the Owner's property, including consequential losses due to tract Sum as well as subsequent modifications thereto for the fire or other hazards however caused. entire Work at the site on a replacement cost basis without vol- 11.3.4 If thc Contractor requests in writing that insurance for unary deductibles. Such property insurance shall be main - risks other than thou described herein or for other special haz- talthed, unless otherwise provided in the Contract Documents ands bc included In the property Insurance policy, the Owner or otherwise agreed in writing by all persons and entitles who shall, if possible, include such insurance, and the cost thereof are beneficiaries of such insurance, until final payment has been shall be charged to the Contractor by appropriate Change • made as provided in Paragraph 9.10 or until no person or entity Order. AMA DOCUMENT A201 • GENERAL CONDITIONS OF THE CONTRACT FOR CONSTRUCTION • FOURTEENTH EDITION 20 A201.1987 Au° • 01987 THE AMERICAN INSTITUTE OF ARCHITECTS, 1735. NEW YORK AVENUE. N.W., WASHINGTON, U.C.20006 WARNING Unflcensed photocopying violates U.S. copyright laws and Is subject to legal prosecution. • • OWNER'S INSTRUCTIONS FORL INSURANCE AND BONDS AIA DOCUMENT G612, PART B PROJECT: Oak Park Heights City Hall DATE: 2 -17 -09 Minnesota OWNER: City of Oak Park Heights PROJECT NO: 0822 NOTATION TO OWNER — consultation with your insurance advisor, complete this form, which will provide your instructions regarding your requirements for bonds and insurance for this Project. Please return the completed form, along with any other instructions relating to bonds and Insurance, to the Architect. TO: (ARCHITECT) Buetow & Associa Inc. 2345 N. Rice Street x1210 St. Paul, MN 55113 Attention: Randy L. Engel, Vice President You are hereby instructed to Include the following information and requirements in appropriate locations in the Bid- ding Documents and the Contract Documents. These requirements are based on Article 11 of AIA Document A201, General Conditions of the Contract for Construction, 1987 edition (copy attached hereto), and the completion of these instructions Is presumed to be based thereon. A. CONTRACTOR'S LIABILITY INSURANCE Concerning the Insurance described In Paragraph 11.1 of AIA Document A201, 1987 edition, specify the following minimum IimIts: I. Workers' Compensation 0 State: , Statutory O Voluntary Compensation (by any exempt entities): Satne as State Workers Compensation O Applicable Federal (e.g., Longshoremen, harbor work, Work at or outside U.S. Boundaries): Statutory 0 Maritime: )(Employer's Liability: 3 I 1 � OO 1 D 00 • Each accident $ 1 1 600 H2O , Disease, Policy limit S - it 500 0 •Disease, Each employee 0 Benefits required by union labor contracts: As applicable 2. General Liability (Including Premises - Operations; Independent Contractors' Protective; Products and Completed Operations; Broad Form Property'Damage): (a) BodiBu rnjury: $ r t $ C O O Each Occurrence f" (i *a G lat. 3 000, C?G'tj:1 . Aggregate tMG't' w 1' ► mixia t txuee cou.via. ' (b) Property Damage: $ t, 606 000 Each Occurcnce $ N OC{b 0 00 . Aggregate (c) Products and Completed Operations Insurance shall be maintained for a minirnum period of X 0 2 ❑ year(s) after final payment and the Contractor shall continue to provide evidence of such coverage to the Owner on an annual basis during the aforementioned period. AIA DOCUMENT 6612 • OWNER'S INSTRUCTIONS • 1997 EDmON • AIA' • 01987 • THE MIERI• CAN L'isimrrS OP ARCHrrrers. ans NEW YORK AVENUE, N.W., wAssalarorr, DC. 20006 G612 -1987 4 • (d) Property Damage Liability Insurance shall include coverage for the following hazards: X (Explosion) C (Collapse) )IKU (Underground) (e) Contractual Liability (Hold Harmless Coverage): Bodily injury: s I / OO • Each Occurrence Property Datna e: $ t SC:0 • Each Occurrence . 4 OCO 000. Aggregate (f) Personal Injuryy� Employment Exclusion deleted, if applicable): 3 1 1 4cg7 vClD • V. rcgat c (g) If the General Liability policy includes a General Aggregate, such General Aggregate shall be not Less than S '3 Oc 1) non . . Policy shall be endorsed to have General Aggregate apply to this Project only: 0 Ycs 3. Umbrella Excess Liability 3 Over primary i stn.!rec M {p MY.d., 4o &ult.4 Retcniton G L- 1 t xo .u. 1. Automobile Liability (owned, non - owned, hired): Bodily Intjury: sue Each PC Accident S t ' iO4{4 0A041014 on 1 Each cident 1 t �µ'i CA" }S( W Prop Damage: 6101 4t' 3 $ I 'Std r'IDO . Each Occurrence 5. Aircraft Liability (owned and non•owned) when applicable, as follows: (Select one) 1u U � • ❑ With limits'proposed by the Contractor for the Owner's approval. ❑ With the following limits: Bodily Injury: S Each Person 3 Each Occurrence Property Damage: 3 Each Occurrence 6. Watercraft Liability (owned and non-owned) when applicable_, as follows: (Select one) Vet o�(� LIT With limits proposed by the Contractor for the tuner's approval. 0 With the following limits: Bodily Injury: Each Petson 3 Each Occu rrence Property Damage: Each Occurrence 7. Other Insurance: COVERAGE AMOUNT B. OWNER'S LIABILITY INSURANCE Concerning the insurance described in Paragraph 11.2 of AIA Document A201, 1987 edition: (Select one) )4No modification is required. O The Contractor shall provide this insurance with the following limits: Aw oocu!'ENr um • crsteR•s I::STRUCTno :tS • I 7 EDITION • AI A • 3 1sa7 • i ts - A IER1• CAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVENUE, I'M., 'x:cslICICTO , n C. 2C .S G612 -1987 5 i t ' (I)Bodily Injury: $ Each Occurrence 3 Aggregate (2)Property Damage: 3 Each Occurrence S • Aggregate C. PROPERTY INSURANCE Concerning the insurance described in Paragraph 11.3 of AIA Document A201, 1987 edition: (Complete (a), (b) or (c), and then complete (d) and (e).) (a) 0 No modification IS required; the Owner will purchase (including coverage for all materials and equipment to be incorporated or used in the Project when stored off the site or when in transit). (b)The Owner will purchase with the following modifications: tt_o�ci'�S RI — l c GG t C' \ f \ tai i` ' c is es 1t� c' 1 .1 - (c) 0 The Contractor shall purchase the following: (Select o77e) • .All•Risk 0 Other (specify) On the following form: (Select one) O Completed Value 0 Reporting In the names of the Owner, Contractor, Subcontractor and Sub - subcontractors as their interests may appear with limits as follows: (Select one) 0 Amount equal to the Contract Sum for the Work. ❑ Other (specify)_ (NOTE: If coverage for alterations and additions to existing structures is to be included under the Owner's existing coverage, specific instructions should be included under Item D below.) (d) Boiler and Machinery Insurance. Concerning the Insurance described In Subparagraph 11.3.2 of MA Document A201, 1987 edition: (I) The Owner shall provide this insurance with a limit Of $ 71 004 000 - y, (2) Objects to b e insured: (List objects) • a $ ; h ' cairn LACI ' 6ti -too(I I /01)C ti /07) 0o • (e) Loss of Use Insurance. Concerning the insurance described in Subparagraph 11,3.3 of AIA Documen A201, 1987 edition: 7l (Select one) �No modification is required. (Doss -L t i t i \ l 4I 'S I'u'(- `1; s f '' 15 its jam; l 0 The Contractor shall provide this insurance with limits of 3. — __. 0 � a D. OTHER INSTRUCTIONS RELATED TO BONDS OR INSURANCE none, please so indicate. accoq • ctw v MO0O MA DOCUMENTG612 • OWNERS INST UCI7ONS • 1997 EDITION • MA= • x01987 • rxa AMEM. CAN tNATtruTE OF ARCHITECTS, 1735 NEW YORK AVENUE. N.W. WASH GTON. D.C. 2 0005 G612 -1987 6 • • E. BONDS (a) Performance Bond and Payment Bond as described in Paragraph 11.4 of ALA Document A201, 1987 edition, will be: X Required ❑ Not required (b) Required bonds shall pe in the amount of (Select one) Performance .00% of Contract Sum ❑ % of Contract Sum ❑ $ Payment 100% of Contract Sum 0 % of Contract Sum ❑ $ (c) Form of bonds shall be (Sec one) ❑ AIA Document A3I 1 AIA Document A312 ❑ Other (Describe and furnish sample copy if available) (d) Special instructions: Owner By Date 411 A1A DOCUMENT G612.OWNEWS INSTRUCTIONS • 1987 EDmoN • Alne CAN INSTITUTE OP ARCHITECTS, 1735 NEW YORK AVENUE, NW., WASHINGTON, D.C. 2C006 6612 -1987 7 • OWNER'S INSTRUCTIONS FOR INSURANCE AND BONDS A!A DOCUMENT G612, PART B • PROJECT: Oak Park Heighta City Hall DATR: 2 -17 -09 Minnesota OWNER: City of Oak Park Heights PROJECT NO: 0822 NOTATION TO OWNER consultation with your insurance advisor, complete this form, which will provide your Instructions regarding your requirements for bonds and insurance for this Project. Please return the completed form, along with any othcr instructions relating to bonds and insurance, to the Architect. TO: (ARCHITECT) Buctow & Associates, Inc. 2345 N. Rice Street #210 St. Paul, MN 55113 Attention: Randy L. Engel, Vice President • Yon are hereby instructed to include the following information and requirements in appropriate locations In the Bid- ding Documents and the Contract Documents. These requirements are based on Article 11 of AIA Document A201, General Conditions of the Contract for Construction, 1987 edition (copy attached hereto), and the completion of these Instructions is presumed to be based thereon. • P • A. CONTRACTOR'S LIABILITY INSURANCE Concerning the insurance described in Paragraph 11.1 of AIA Document A201, 1981 edition, specify the following minimum limits: 1. Workers' Compensation ❑ State: , Statutory O Voluntary Compensation (by any exempt entitles): Same as State Workers Compe nsation ❑ Applicable Federal (e.g., Longshoremen, harbor tp W". work, Work at or outside U.S. Boundaries): Statutor ❑ Maritime: $ ;Ze; c (rl, e •�e� O Employe is Liability: 1 • - - r $ _ 'j • • • fr • ~ Each accident S`_ 5 Q • l Disease, Policy limit $i� ?t7 • • • t'; Isease, Each employee O Benefits required by union labor contracts: As applicable 2. General Liability (including Premises - Operations; Independent Contractors' Protective; Products and Completed Operations; Broad Form Property'Dan>age): (a) Bodily injury: $ fi o00. 000 Each Occurrence $ 4 090 000 A88refiate (b) Property Damage: S l to c I °° 0 taeh Occurence 8 Zi oon Po 0 Aggregate (c) Products and Completed Operations insurance �„a , ,,, ,,,�,,,, , for a minimum period of ❑ 1 � 2 ❑ 1 0 year(s) after final payment and the Contractor shall continue to provide evklence of Such coverage to the Owner on an annual basis during the aforementioned period. AIA DOcUUENT GM • OWNER'S INSTRUCTIONS • 1987 rnmON • AIAa • ® 1987 • ME AMERI• CAN INSiTTUIE OF ARCIIIr8e1E, 1735 NEW YORK AVENU/I, NW., WASIMMYkr, D.C. 20o0G G612-1987 4 • • • (d) Property Damage Liability Insurance shall include coverage for the following hazards: )4 X (Explosion) C (Collapse) U (Underground) (e) Contractual Liability (Hold Harmless Coverage): Bodily Injury: t-u S 1 000 Each Occurrence Property Damage: S 1 I ° °o Each Occurrence 1 0 0 0 1 0 0 0- Aggregate — + (t) Personal Injury (with Employment Exclusion deleted, if aISplicable): 3_'L CO c` C.0 • Aggregate (a) tt Ute tie—octal I iabiliry policy include' a General At•gre ate, such General Aggregate shall be not less th.ul S — '• 0 0(% CCC)C - .Policy shall be endorsed to have General aggregate apply to this Project only: Yes 0 No 3. Umbrella Excess Liability 5 000 00 0 ()vet pion- y in.q!ctro• Retention 4. Automobile Liability (owned, non- owned, hired): Bodily Injury: S \ 000 0 0 O Each Permit' S l 0 00 l Of) O . Each Accident Property Damage: SA 0 00 000 Each Occurrence 5. Aircraft Liability (owned and non-owned) when applicable, as follows: (Spier.# one) t1 With limits'proposecl by the Contractor for the Owner's approval. .\ 0 With the following limits: I3odily Injury: / /// � .Each Person -- Each Occurrence Property Damage: —� _ Each Occurrence !r. Watercraft Liability (owned and non - owned) when :gi rlicabk, as follows: (.Selec, nue) ��� 171 \Viii limits proposed by the Contractor for the Owner's :top oval. 1� Y 11 \Vith the following limits: Bodily Injury: Each Person �- — Each Occurrence Property Damage: - --- Each OcCLIrrctice 7. Other insurance: COVERAGE AMOUNT 13. OWNER'S LIABILITY INSURANCE / Concerning the insurance describer n Paragraph 11.2 of AIA Document A201, 1987 edition: (Select one 14 No modification is required. U The Contractor shall provide this insurance with the following limits: AIA DOCUMENT G612.OWNER'S LNSTRucT1ONs • 1937 EDITION • AIA° • 01987 • THE AMERI- CAN INSTITUTE OF ARCHITECTS. 1733 NEW YORK ANreNUE, N.. \7., WAs1INNGTor . D.C. 2013 -,5 G012 - 1987 5 1 • • • (1)Bodily Injury: 5 Each Occurrence $ Aggregate (2)Property Damage: $ Each Occurrence $ • Aggregate C. PROPERTY INSURANCE Concerning the Insurance described in Paragraph 11.3 of AIA Document A201, 1987 edition: (Complete (a), (b) or (c), and tben complete (d) and (e).) (a) U No tnodificatlon IS requital; the Owner will purchase (including coverage for all materials and equipment to be hworporated (R in the Project when soared oft the site or when in transit). (b)0 The Owner will purchase with the following modifications: • i, V3Ott -DEQ 5 \Sk V 1 , 0 0 , Of.33 - ` y � - ky on,rt 140 0wr►rce ckoeS10 o7 COVE • [Tt��tr S �or� 1 � o _st c a� vo r (c) tie'fhc Contractor shall purchase the following: (Select one) 11 "1 Its §,,Other(specIY) e0iuq ` r1V5f -(,, t/c 1 (UVef/ZJ46'5 . 1 1 On th following form: (Select one) 0 Completed Value (fiV6A1 0 Reporting ti , .Lt In the names of the Owner, Contractor, Subcontractor and Sub- subcontractors as their interests may ( ¢ >' appear with limits as follows: (Select one) 0 Amount equal to the Contract Sum for the @Volk. 0 Other (specify) -- -- (NOTE: If coverage for alterations and additions to existing structures Is to be included under the Owner's • existing coverage, specific instructions should be Included under Item 1) below.) ; ' d ) Boiler and Machinery Insurance. Concerning the insurance described in Subparagraph 11 . • .. ment A201, 1987 edition: (1) The Owner -shall provide this Insurance • mit of $ (2) Objects to be insured: objects _.. ++ --,, �/ of • (c) Loss of Use Insurance. • Concerning the insurance described in Subparagraph 11.3.3 of AIA Document A201, 1987 edition: (Select one) No modification is required, VI/' -- o The Contractor shall provide this Insurance with Emits of $ _ /' D. OTHER INSTRUCTIONS RELATED TO BONDS OR INSURANCE (A/O 11/4 F� (If none, please so indicate.) 41;1 0 AIA DOCUMENT 0612. INSTRUCTIONS • 1987 eD1TION • AIA° • 81967 • THE AMERI- CAN INSTITUTE OF ARQQTECIS, 1735 NEW YORK AVENUE, N.W., WASHINGTON, D.C. 20006 G612 -1987 6 1 B. BONDS (a) Perfotmancc Bond and Payment Bond as described in Paragraph 11.4 of AlA Document A201, 1987 edition, will be: ❑ Not required (b) Required bonds shalloe in the amount of (Select are) Performance 100% of Contract Sum 0 % of Contract Sum 0 $ Payment 100% of Contract Sum 0 96 of Contract Sum O $ • • (c) Form of bonds shall be ) D AIA Dort A311 , A DOOM= A312 D Other • (d) Special 11151111010113: ( �f sample copy l am) • Y Owner By Date etnooCUts$ tree 12 •oarmrsxsTRxnons•rsereana+•,W.° • •maims*. • CAN =MUM OP kaantac13,1735 env VOPX AVENU N wASHOIOTOK D.C. 2m6 661•1987 7 • . $ 9 .. '' tn? F `�' :z ® N-1 'Y & w DATE IMMrDDM') _ ACORD a 3 ®� ® T� i t ®� � 9 2 2a THIS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED, IS IN FORCE, AND CONVEYS ALL THE IGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY. ER PHONEIFAX U: 651- 464 -3333 ,651 -464 -7596 I COMPANY (AIG, No, Es Landmark Insurance Services LMCIT- Berkley Risk Services, I 232 Lake Street South 145 University Avenue West Forest Lake MN 55025 St. Paul MN 55103 Kate Tipping CODE: SUB CODE: AGENCY CUSTOMER ID N: OAKPA -1 INSURED LOAN NUMBER POLICY NUMBER City of Oak Park Heights CMC29841 Eric Johnson, City Admin. EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 14168 Oak Park Blvd 04/01/09 07/07/10 TERMINATED IF CHECKED Oak Park Heights MN 55082 -6476 THIS REPLACES PRIOR EVIDENCE DATED: kp q . tiitiM 4 7 *�.:. , m, "` ,,...�1 .:: ° 00��11 a .. ,...:, . :... 1'Y1 s ir i' � i'!>aii ... LOCATION/DESCRIPTION 001 BUILDERS RISK COVERAGE ON CONSTRUCTION 14168 Oak Park Blvd North OF NEW CITY HALL Oak Park Heights MN 55082 >`M�','kc° c if* : t :, .:. ., 4. ,¢ ^' +:.:i t : .. .'l H t . ,....., beE . r...:. . x +: .,, 3 , .: _x , .. ' `' 's:. a' '✓I M .. , i. , :-3. X 7 „ ::..s%, I5 COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE Premise 001 Building 002 BLANKET BUILDING AND PERSONAL PROPERTY 7000000 500 INCLUDING BUILDING MATERIALS ON PREMISES BUILDERS RISK FORM • .tgg t i "-s„ i . W,ER Y i lkztC>.tCy�?l 4 Ft',~$I }` r �° ' z., ,_ .. NO r <. .:..£ `, :.�.,.,�n,.,,, g''.,x., ,, • Equipment Breakdown coverage to be added as equipment within the new building becomes operational) Binder may be updated on policy renewal date of 07- 07 -09. 0 1 t v A C,7 b 64 4... f (a,Ga or% sf '���'„ z? .. ;''»'c`�.�f:'.aYi�t;, r.. "' �5`'�a,.......:.,`i •;``"?: r "r^ 's spa„ ...:"ar ,'3� A .'i , .bu..�s . }`;. .., t r . .. , „... . , »< ,..,.s;�..,., , :4.: THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT FOR EACH POLICY PERIOD. SHOULD THE POLICY BE TERMINATED, THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW 10 DAYS . WRITTEN NOTICE, AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT INTEREST, IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BY LAW. 2! � � �� � � �. �! � � �, 7 � °3 e, "� �� �•'��'r, s .� c ` ''•." } . a��r r a` ?,t+ *f r +�' S � r ,...... III I NAME AND ADDRESS MORTGAGEE ADDRN)NAL INSURED • LOSS PAYEE LOAN N AUTHORIZED REPRESENTATIVE KAtoev‘66zw R . 1 .aii, i. )q D.%# (h S :3'S S x Tl^§„�, 3;u9 ✓A` wn , ,,7fl 3�. w. t,'s' °'fb v.,y`!yv"t ' z' `Yf' S3. 3Yy� .j,f FF� I