HomeMy WebLinkAbout08-0249
Contract #
. . .
l ! .'
\' . . . 1.: ',' .
-y-New Han?~er County Routing Slil' /j .
(16 . 0 ~ l/ '--' f' Dlfpartment Acct. # IIUb YD ) (J) . !/mUD :
Initials
Date
(/", .....,.
. ./ \
v-C'\~
\~-~-(Yl
'/ ; '\ U "i \~_ J '\ i \ (\J (: I -Y l \ C .
- .,
Contract forlDept. ~.' I \ \ , \ \ L\ \ , \,~:"'I I.. \ (, f
1\ ,,(I\.q- J
~ +D~7~ BU~_ D~o~cractor.. I t\~,J-
......~_~~.._..~~~_"""~~_c..""-.~-'-~.~"~__~~__~.~~. ... . .~"'
TO:~' G~ants Co~rdinator,
. Fmance Director
County Manager
/' , Commission Chairman
I Clerk: to the Board
1 Risk Manager
ounty Attorney
d\~~
~
I,) ( & I (/ ..,
I z../ro
~~
\~\lL~l>1
I.J-<:/.()/\
\'!,I4l.Jl
.
From:
Legal. Dept. Date
) .
l 'IJ U\...I '\ '\
Re: .
,-
,
',.
New Hanover County Contract #08-0249
NORTH CAROLINA
AGREEMENT
NEW HANOVER COUNTY
THIS CONTRACT, made and entered into this k- day of
~cy,~~\)...... , 2007, by and between NEW HANOVER COUNTY, a political
subdivision of the State of North Carolina, hereinafter referred to as "County"; and
BUXTON ENVIRONMENTAL, INC., a North Carolina Corporation hereinafter referred
to as "Contractor".
W!I N E SSE I H:
That the Contractor, for the consideration hereinafter fully set out, hereby
agrees with the County as follows:
1. Performance. Contractor shall fumish all labor, materials, and
equipment and shall perform all work for the project generally described as: Semi-
Annual Groundwater Sampling, Statistical Analysis, and Reporting for the New
Hanover County Secure Landfill in accordance with the specifications set forth in
Exhibit "A", attached hereto, and made a part of this contract as if fully written herein.
All work shall conform to applicable Federal, State and local laws and
regulations.
2. Time of Performance. Contractor shall commence work upon
Notice to Proceed. The duration of this contract will be for three (3) years, with the first
sampling event being in January of 2008.
3. Pavment. County agrees to pay Contractor, for the full and faithful
performance of this agreement, an amount not to exceed the sum Thirty-Eight
Thousand Six Hundred Four ($38,604.00) Dollars.
4. Indemnitv. Contractor shall indemnify and hold the County, its
agents and employees, harmless against any and all claims, demands, causes of
action, or other liability, including attomey fees, on account of personal injuries or death
1
ORIGINAL
New Hanover County Contract # 08-0249
or on account of property damages arising out of or relating to the work to be performed
by Contractor hereunder, resulting from the negligence of or the willful act or omission
of Contractor, his agents, employees and subcontractors.
5. Insurance. Contractor shall maintain insurance from companies
licensed to write business in North Carolina, with an A.M. Best rating of "A" or higher,
and acceptable to New Hanover County, of the kinds and minimum amounts specified
below.
6. Certificates and Notice of Cancellation. Before commencing work
under this contract, Contractor shall furnish County with certificates of all insurance
required below. Certificates shall indicate the type, amount, class of operations
covered, effective date and expiration date of all policies, and shall contain the following
statement:
"The insurance covered by this certificate will not be
canceled or materially altered, except after thirty (30) days
written notice has been received by County".
The certificate of insurance, naming New Hanover County as an additional insured,
shall be further evidenced by an actual endorsement furnished to the County from the
insurer within thirty (30) days of the signing of the contract between the Contractor and
the County.
7. Commercial General Liabilitv. Including coverage for independent
contractor operations, contractual liability assumed under the provisions of this contract,
products/completed operations liability and broad form property damage liability
insurance coverage. Exclusions applicable to explosion, collapse and underground
hazards are to be deleted when the work involves these exposures. The policy shall
provide liability limits at least in the amount of $1,000,000 per occurrence, combined
single limits, applicable to claims due to bodily injury and/or property damage. New
Hanover County shall be named as an additional insured under this policy.
2
New Hanover County Contract # 08-0249
8. Automobile Liability Insurance. Covering all owned, non-owned .Jfj ofY p'\
and hired vehicles, providing liability limits at least in the amount of $500,000 per oJ;;;~oU \1/
occurrence combined single limits applicable to claims due to bodily injury and/or r \ CP \ tb
property damage.
9. Worker's Com ensation and Em 10 e iabilit Insurance.
Covering all of the Contractor's employees to ngaged in the work under this - . ~ ;...0'\
~\,I./
contract, providing the required statu benefits under North Carolina Workers' fib' \
Compensation Law, and eyers liability insurance providing limits at least in the
0,000/100,000 applicable to claims due to bodily injury by
accident or disease.
10. Professional Liabilitv Insurance. The Contractor will be required to
take out and maintain Professional Liability Insurance providing liability insurance limits
at least in the amount of $1 ,000,000. The Contractor will be required to maintain this
coverage for a period of at least two (2) years beyond substantial completion of the
contract.
11. Indeoendent Contractor. It is mutually understood and agreed that
Contractor is an independent contractor and not an agent of County, and as such,
Contractor, his or her agents and employees shall not be entitled to any County
employment benefits, such as, but not limited to, vacation, sick leave, insurance,
worker's compens::!tion, or pension or retirement benefits.
12. 'Default and Termination. If Contractor fails to prosecute the work
with such diligence as will insure its completion within the contract time, or if Contractor
breaches anyone of the terms or conditions contained in this contract and fails to cure
said breach within three (3) days of County's mailing of Notice of Default, or otherwise
fails to perform the work hereunder to the County's reasonable satisfaction, County
may terminate this contract forthwith.
,,'
13:'tntire Aareement. This agreement constitutes the entire
understanding of the parties.
3
--~
New Hanover County Contract # 08-0249
IN WITNESS WHEREOF, the parties have caused the execution of this
instrument, by authority duly given and on the day and year first above written.
NEW HANOVER COUNTY
-
I
Bruce T. Shell, Coun
Clerk to the Board
BUXTON ENVIRONMENTAL,INC.
[CORPORATE SEAL]
ATTEST:
~
-------
S retary-
This instrument has been pre-
audited in the manner required
by the Local Government Budget
and Fiscal Control Act.
~ A.t?...~.,- /2-/IuI~
County Finance Director
Approved s to form:
~~
County Attomey
NORTH CAROLINA
NEW HANOVER COUNTY
\~
County aforesaid, ertify th Sheila L. Schult personally came before me this day and
acknowledged that she is Clerk to the Board of County Commissioners of New Hanover
County, and that by authority duly given and as the act of the Board, the foregoing
instrument was signed in its name by its County Manager, sealed with its official seal
and attested by herself as its Clerk.
I,
(b. QrbWd
, a Notary Public of the State and
4
.~
" '
New Hanover County Contract # 08-0249
WITNESS my haod aod ~~:::,~:,,~~~,!!daYof_~' ff7~.
", \e\~\\G, CrOIp; '" ~ b. _
$" ""e\ ................ <9.v % N P bl'
~ .,.... """'~"... ~ ry U I
2.>?:'t'lO' ... ~
:: : ~~~ co(\'.('l'I. ':, :.
My commission expires: ~ : . ",pi'.' : ~
:; ". " "LlIo,20' \ : ~
\ \. :~1;'L\C/# f
~ ....': ~ ..... ,.1
....,.. Its ........ C;C' ...,.....
...,.'..... #, HanolJ0\ \,\,,,
"'" III"
COUNTY '''111111111,,\1
I, '. J6t[~ L. -roJPof!./) ,a Notary Public of the State and County
aforesaid, certify that C' .kar(i'S "RrtJs tJi~QIJ Ji-personally came before me this day
and acknowledged that (s)he is the Secre ary of BUXTON ENVIRONMENTAL, INC.,
North Carolina corporation, and that by authority duly given and as the act of the
corporation, the foregoing' instrument was signed in its name by its President,
~~...<> 'RD~ b;/lorM \JR, sealed with its official seal and attested by
herself/himself as its Secretary.
WITNESS
_Dtl\fetY'.\?t'X'
my hand and official seal, this 3~ih day of
,2007.
NO~J)j~ ~~
My commission eXPires:~
\.,""'111111'"",,
,.....',...'€..L TAl,..""
..':4.V 1....,..0."
,:-....0 ~....-:.
: 'S NOTARY a <.
: PUBLIC .
- :;: -
~ m My Comm, Expires () E
. Q. November 2 2011 <::
. " '.>.. .
\ <'A'\. A. -~!
',\'if. ~ .....
'.. 'vs: O,s.,
...." URGG "......
'''''''''.IIIUI\\''
5
" .
EXHIBIT A
SPECIAL CONDITIONS
1.1 Proiect Description: The project generally consists of the sampling, Appendix 1
analysis and reporting of seventeen (17) groundwater monitoring wells, two (2)
surface water sampling points and one (1) leachate sampling point on a semi-
annual basis for a period of three (3) years at the New Hanover County Landfill
located at 5210 Highway 421 North, Wilmington, North Carolina.
1.2 Existing Conditions: It is the responsibility of the Contractor, before submitting a
proposal, to thoroughly investigate the site, examine existing records, Federal and
State requirements and regulations, associated plans, specifications and exhibits;
clearly understanding all requirements necessary to perform the sampling,
analysis, and reporting; that the Contractor is fully prepared to sustain all loses
and damages incurred; is prepared to provide all necessary tools, equipment, labor
and materials necessary to successfully complete the work.
1.3 Proiect Closeout: The Contractor shall at all times keep the site free of debris
caused by the Contractor during the sampling and analysis of the groundwater
monitoring wells, surface water sampling points and leachate sampling point.
SAMPLING
1.4 Semi-Annual Monitoring: The Contractor shall sample all sampling points listed
in 1.8 of these conditions for a period of three (3) years. The sampling will be
conducted in January and July of each year beginning in January of 2008. The
contractor shall provide the contact person listed in 2.2 of these conditions with a
minimum of 30 days notice in advance of all sampling/monitoring events.
1.5 Additional Parameters: The Contractor shall also analyze and report any
additional parameters required by the State of North Carolina, Solid Waste
Section, to include, but not limited to, field measurements for pH, conductivity,
turbidity, water temperature, and well depth for each sample location.
1.6 Sampling Collection Protocol: The Contractor shall collect samples utilizing low
flow sampling teclmiques with a submersible Grundfos pump (or equal) and
dedicated Teflon tubing for each well sampled. During sample collection the
Contractor shall conform to the latest acceptable State of North Carolina, Solid
Waste Section, well purging, sample collection, preservation and reporting
protocol. It is the responsibility of the Contractor to store the dedicated Teflon
tubing between sampling events.
1.7 Split Sampling: The Contractor shall be prepared to split samples with Local,
State and/or the USEP A on any and all sampling events,
,', '
1.8 Sampling Point Specifications:
Sampling Point
65-04-E
65-04-00
65-04-H
65-04-I1
65-04-J
65.04-K
65-04-LL
65-04-0
65.04-P
65-04-Q
65-04-R
65-04- Y
65-04-Z
65-04-AA
65-04-BB
65-04-CC
65-04- WT
Surface Water Upstream
Surface Water Downstream
Leachate
Casing Diameterfin.)
2,00
2.00
2.00
2.00
2.00
2.00
2.00
2,00
2.00
2.00
2.00
2,00
2.00
2.00
2.00
2.00
2.00
ANALYSIS
Total Well Depth(ft.)
25.00
30.10
23.50
30.42
39.20
28,80
28.00
42.00
26.00
21.00
40,00
21.00
46.00
26.00
16.00
15.00
30.00
1.9 Analvsis: All sampling points shall be analyzed, at a minimum for the following:
1.9.1 Appendix 1 Volatile Organics:
1) Acetone
2) Acrylonitrile
3) Benzene
4) Bromochloromethane
5) Bromodichloromethane
6) Bromoform
7) Carbon disulfide
8) Carbon tetrachloride
9) Chlorobenzene
10) Chloroethane
11) Chloroform
.\ .
1.9.1 Appendix 1 Volatile Organics(Continued)
12) Chlorodibromomethane
13) DBCP (1,2-Dibromo-3-chloropropane)
14) Ethylene dibromide (EDB)
15) o-Dichlorobenzene
16) p-Dichlorobenzene
17) 1-1,4-Dichloro-2-butene
18) 1,I-Dichloroethane
19) Ethylene dichloride
20) Vinylidene chloride
21) cis-l,2-Dihloroethene
22) t-I,2-Dichloroethene
23) Propylene dichloride
24) cis-l,3-Dichloropropene
25) t-I,3-Dichloropropene
26) Ethylbenzene
27) Methyl butyl keytone
28) Methyl bromide
29) Methlyl chloride
30) Methylene bromide
31) Methylene chloride
32) MEK(2-Butanone)
33) Methyl iodide
34) Methyl isobutyl ketone
35) Styrene
36) 1, 1,1,2- Tetrachloroethane
37) 1,1,2,2- Tetrachloroethane
38) Tetrachloroethylene
I 39) Toluene
40) 1,1,1- Trichloroethane
I 41) I, I ,2- Trichloroethane
42) Trichloroethene
43) CFC-Il (Trichlorofluoromethane)
44) 1,2,3- Trichloropropane
45) Vinyl acetate
46) Vinyl chloride
47) Xylenes (total)
1.9.2 Appendix 1 Metals (Tota\):
1) Antimony
2) Arsenic
3) Barium
4) Beryllium
5) Cadmium
"
.,. ..
1.9.2 Appendix 1 Metals (Total) Continued
6) Chromium
7) Cobalt
8) Copper
9) Lead
10) Nickel
11) Selenium
12) Silver
13) Thallium
14) Vanadium
15) Zinc
1,9.3 Other Parameters: The Contractor shall sample, analyze and report any additional
parameters required under State of North Carolina, Solid Waste Section, landfill
groundwater sampling and analysis requirements and regulations.
REPORTING
2.0 Semi-Annual Report: The Contractor shall provide a report detailing all sites
sampled, analysis results (with appropriate detection limits, field sampling logs,
chain-of-custody forms and other information, including a determination of
groundwater flow direction and an estimate of groundwater flow velocity
overlaid on a site potentiometric map, as necessary to satisfy the State of North
Carolina, Solid Waste Section on Semi-annual landfill groundwater monitoring
and reporting requirements).
2.1 Statistical Report: The Contractor shall provide, with each report, a Statistical
Report determining if there is statistically significant evidence of contamination at
the facility. The statistical analyses will be computed using GRITS tat as provided
by the EP A, including the Kruskal- Wallis Test (a non-parametric analysis of
variance [ANOV A] ) for each Appendix I constituent using the data from the
four(4) most recent sampling events for each background and compliance well,
2.2 Report: The Contractor shall provide the reports noted in these specifications to:
New Hanover County
Department of Environrnental Management
3002 Highway 421 North
Wilmington, North Carolina 28401
Atten: Andrew T. Mulvey
Three (3) copies of the reports noted shall be received within 45 days of the completion
of the sampling event.
ACORD.. CERTIFICATE OF LIABILITY INSURANCE I DATE lMlIIDDIYYYY)
11129107
PRODUCER THIS CERTlRCATE IS ISSUED AS A MATTER OF INFORMATION
Hood, Hargett & Associates Ine ONLY AND CONFERS NO R1GHTll UPON THE CERTlFlCATE
Post Office Box 30127 HOLDeR. THIS CERTlRCATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAOE AFFORDED BY THE POUCIES BELOW.
Charlotte, NC 28230
704374-1863 INSURERS AFFORDING COVERAGE NAIe #
INSUIlED DI8URER" Hudson Speclanty IriB
Buxton EnvIronmental, Inc. INSUReR s:
P.O. Box 11550 INSURER~
(Non-Renew at ran. unless we write alQ INSURER D:
Charlotte, NC 28220 INSURER E:;
Client#: 8453
BUXEN
COVERAGES
THE POLICIES OF lNSURANCE LiSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE fOR THE POLICY PERIOD INDICATED. NOTWJTHSTANDING
NojY REQUIREMENT, TERM OR CONDITION OF AHY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIACATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSlONS AND CONcrrlONS OF SUCH
=:'AGGREGAlE LIMITS BHOWN MAY HAVE BEEN REDUCED BY PAlO CLAl~ ~
L TR 1YPJ: OJ' IN8URAJlCE POLICY NUMBER PO L.MI&
A ~""'UA8lUTY FEC6113796 07/21107 07/21108 EAQtOCC_ S1 000 000
X COMMERaAl. ~eRAl UABaJTY DAMAGE' TO RfN'lliD 550 000
::: ::]. ClAIUS MADE [i] OCCUR NED EXP fAnv... pII"') 55 000
X BUPD Dad:2.500 .....CH.L.ADYINJURY .1000000
GENEJW...AGGREGATE .1 000 000
~~nut.lrTAPfnStPER: PRODlIC'TTj - COMPIOP AGO .1 000 000
X poucy 1 \'l'lI; LOC .
A ~UA8IUIY CON8INEO sINGlE LIMIT $1,0001000
- _ AUTO (EatlCdltent)
- AU. OWNEOAUTOS BOOl. Y INJURY
.
- SCHEDULED A1JT06 (P.-,.....)
1!. HIRED AUTOS FEC6113796 07/21/07 07/21/08 BODlLY INJURY
.
!. N()M..(7f,INCOAl1TOS (~rllCCldent)
- PROPmTY DAMAGE .
, (PerKddtnt)
=rOE LIABIlITY AUlO ONLy ~ EA ACCIDENT .
_AlITO OTHER THAN EA ACe .
AUlOONtY: AGO .
~1lIBREU.A UABIUJY EACH OCCURRENCe .
ocaJR 0 a.AlMS MADE AGGREGATE .
.
~ O'EOUCTlBLE .
RETENTlON . .
WORKERS COMPENSATION AND I ' we STATU- IOJl!"
EMPLOYER&" UA8LITY
MY PROPRIETORIPARTNER/EXECUTN'E E.L EACH ACCIDENT .
OFFlCERlMENBER EXCLUDED? E.L DISEASE - EA e......OYEE $
~~~~~SIMlklw E.L DISEASE - POLICY UUtT S
A OTHER Professional FEC6113796 07/21107 07/21106 $lMM Per ClafrnlPer Agg.
A Contraclons FEC6113796 07/21/07 07/21/08 $lMM Per ClalmlPer Agg.
pollution $2500 Dad Per Clabn
pt:SCRIP1KlN OF QPSlA11ONSft.OCATIOHSfYEHICLDJEl<<"I .,...- ADDED BY ENDORSEMBfT ISPECIALPRCMSIONS
New Hanover County Is added as additionallnsul'8cl under the General
Uabllty
CERTIFICA IE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE tHE EXPIRATION
New Hanover County DATETHEREO',THElSSUlNGlNtuRERWlLLENDEAYOR.TOMAIL -3!L DAYSWR!TTEN
NOnce TO lHE CERTIfICATE NOlDER ....ED TO THE L.I!PT, BUT FIdUJRE TO DO SO SHALL
IMPOSE ICOOBUGATlON OR UABIUTV Of fIJf'i KIND UPOIriIlNE INSURER, rra AGENT& OR.
REPRESENTAlIVES.
~~:~NE __
ACORD 25 (2001108) 1 012
1IS6581l41M65863
RMG
e ACORD CORPORATION 1988
3/004
LMG
LMG
11/29/2007 4:45 PM PAGE
Lih~ CERTIFlCATE OF AUTOMOBILE INSURANCE
Mn
TillS IS TO CERTIFY THAT the named imurcd is at 1hc date of this c crtificatc insured by the company with respect to the automobiles hereinafter
deseribcd for the types of insurance and respective coverages hereinafter designated by cutry of the limits oflialrility or a statement that the coverage
is in cfTcl:t end in accordaDl:c with the: provisions of the Automobile Polic:yin use by sBid compmy.
Ibi. Certificate of InSUfUU:C neither affinnati vc:ly or nc:gativdy amends, extends or alters the coverage afforded by the policy.
Name CHARLES R KLINGMAN SR JULIA KLINGMAN FOR LIEN HOLDER INQUIRIES CALL OR WRITE
l-IOD-.cDlJ-Om
p.o. BOX 2917
Address 515 JEFFERSON DR CHARLOTI'E NC 28270-5345 PHOENIX,AZ lI5ll3S
.... .':.: .'...2"..,,'yl:#~~fn9~9t.t~jff~~{i.~'~Q~;~Jji.b.#@m~~lt:i:Itt!';;~;'i;l#~:l.~~~!,y ....'.".........."'.....:.......::.:............
Policy Number ABI.258-307437-70 Effective Date 04/18/2007 Expiration Date 04/18/2008
PART A PART B PART D - DAMAGE TO YOUR AUTO COVERAGE
Coverages: LIABILITY p~~~~C:~ L~~E~uGs~~:V ~:D:?~jjc:tIB~:A:)i6jtNiY~~~.~.ikJ_9:~~~~~~)ii(.0t~R_si~.;.;.:
Loss Caused byCollision Lo~3 Other ThWl Lo3l:1 Caus
COVERAGE COVERAGE COLLISIOn INCLUDED b Collision
Accidental Death Ben.rrt: $ Proteetion Against Uninsured Motorists: Each NlIID<d lnsw:cd Eaoh Per, S Eaoh Acc,
YES 100/300
D BASICNO-FAULTCOVERAClE D OPTIONAL NO-FAULT COVERAGE
......................., ............":'j~ES~t():Il''.'PF:A.'ttT-QJ49BltES"...................:..:.:.::;,..:......c",.c:.'.,",.:::
Limits of
Liability
500,000
2000
"'Includes
Medical Expens.
POllCY INCLUDES,
.....-..----------.-
......................
....................
Year of Model
Trade Name
2000
Dodge
-...................
----.................
......................
.---.................
---....................
........................
................ .__n_____
...............................--
------...........................
.n...................................
"llClI" Il'I4lca~lr llr:IWIJ c.~ Vll.lUe
"ACV" In41r:atrlr Ar:tulll C~ VIllue
NO
lea: Deductible
leA: D8duchblll
Body Type
DNGOSP/SLT
Identification or Serial Number
IB4 HS28Z6YF111623
.-......................... .
-'-.-.-.-. ~:::.-:-::,:::.::"::.::::,::.::::::.:.:,::.:.:,~::.
..........................
-----.....................
.............................
...................--------------..-.......
....--................
---...----........--...
........................
.....................-.--
!ZiP I
Such in.ur!lllCC a. i. afforded by the policy for 1088 of or dmnallC to the automobile i. payable, a. intere.t may
appear, to the named insured and the Los6 Payee :indicated below in accordance with terms of the Loss Payabl
Clause on the reverse side hereof:
Term of Loan,
From: I
To,
The mSUTlUlce described herein is in effect on the date of this certificate and shall remmn in force until
canceled in accordance with the terms of the policy,
o Liberty Mutual Fire In.urance Company
I!!I Liberty Mutuallnsurance Company
o LM lnsurance Corporation
Loss PAYEE and ADDRESS
o Liberty In.urance Corporation
o The First Liberty lnsurance Corporation
o Liberty Mutual Mid Atlantic lnsurance Co
~. it 1/111 u-.."..( ~,k~/
SECRBTAR'lf"l PRESIDE~~
Dated 11l129/2007 I At IPHOENlXICRC I
Countersigned t1. "'<L.-d4fH--....
Signanbe of Authorized Representative
PS 485 RI7 "The insurance covered by this certificate will not 7/30/02
be canceled or materially altered, except after thirty (30) days
. tt -7>\ Y - - "" b.......J F; "-...J,,,'_~"',T~'
wrJ. en notice has been received by Countv" U-f/""--- 'I ..,.-,- jj:'I.--.?-
IMPORTANT
If 1I1e certificate holder is an ADDITIONAL INSURED,1I1e poIicy(ies) must be endorsed, A stateman!
on 1I1is certificate does not confer rights to 1I1e certificate holder in lieu of such endorsement(s),
If SUBROGATION IS WAIVED, subject to the terms and condillons of 1I1e policy, certain policies may
_ire an endorsement. A s1alement on this certificate does not confer rights to 1I1e certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of InslJ/ance on Ihe reverse side of this form does not constitute e contract between
the issuing insurer(s), authorized representative or producer, and 1I1e certificate holder, nor does R
effirmalively or negatively amend, extend or alter the coverage a_ by the policies listed 1I1ereon.
ACORD 25-5 (20011U8l 2 of 2
f/S858841M65883
LMG
11/29/2007 4:45 PM PAGE
4/004
LMG
P08eZ
LOSS PAYABLE CLAUSE
Loss or _08e under this policy shall be paid.. inlerest may appear to YOlllll1d Ibelosspayee ShOWD on the fml p08e of this certificale,
This insuram:e covering the interest of the loss payee shaD not become invalid because ofyour:fraucIDltDt acts or omissions, unless the
loss results from your conveI1iion, secretion or embezzlement of your cove;red auto. However. we reserve the right to cancel the policy
Of! pormitted by policy tcmm and tho llDn(;cllation aholl laminate thi6 agreement llfI to the 1068 pCl}'ods interest. We will gi.ve the some
advance notice of cancellalion to the loss payee as we give to the named insured shown in the declEll1l1ions.
When we pay the 10.. payee, we shal~ 10 Ihe exlenl ofpaymenl, be sllbrogated 10 Ihe loss payee's righls of recovery,
LOSS PAYABLE CLAUSE (NORTH CAROLINA)
Loss or dam08e under this policy shall be paid as inlerest may appear to YOIl lII1d Ibeloss payee shown on thefust P"8e of this
certificate, This insurance covering the inl....st of the loss payee shall become invalid only because ofyoarconv....ion, secrelion of
yoar covered aulo, However, we r.sav. the righlto canc.1 the policy as p.nnitted by policy I.nns and Ih. cancellation shalllenninat.
this w-anent as to the lor, payee's interest. W t wiJlgiv.. the loss payee 10 days Dotiee of nncellation.
Wh.n w. pay th.l... pay.., w. shall, 10 the exlenl ofpaym.n~ be subrogated 10 th.loss payee" righls of recovery,
LOSS PAYABLE CLAUSE (TEXAS)
Loss or dam08' under Coverage for Dam08.lo your Aulo shall b. paid lIS interest may app.ar to YOIl and the loss pay.. ShOWD on Ibe
frst P86e of this certificate. This insurance covering tbe interest of the loss payee shall not become invalid because ofyour:&audulent
acts or omissions, unless the loss: remits from your conversion, secretion or embezzlement of your covered sato. However, we reserve
Ih. riShllo canc.llh. policy .. pennittod by policy lerm. and the canc.llation .hall lerminate this O8reemenlllllo lb. 10.. pay..'.
interest. We will give the same advance notice of cancelJ.ioD to the loss payee as we give to the named insured shown in the
d.claralions,
When w. pay the 10.. pay.., w. shal~ 10 Ih. .xtent of paym enI, b. sllbrogated 10 the loss pay..'s rights of r.covery,
NOTICE TO
OTHERS IF
CANCELLATION
OCCURS
"We" will not cancel "Your" Policy or reduce the insurance under any of its coverages until at
1_ 10 dll)'. after w. have mailed a written notice of web canc.lllIIion or r.daotion 10 the
person(s) nam.d .. additional inlerest on r,ven<e side,
Additional Insured (Lessor) - Appliel when additional insured is corqdetcd. on revene sic1c.
AS1019 (cd 12-89)
AS 1187 11 90
(PP 03190886)
Description of "your leased auto": as described on reverse side.
Any liability and any required no-f8l111 coverag.s afforded by Ih is policy for "yollr I....d 8I1to" also apply 10 th. I.ssor nam ed in Ibis
endorsement as lID addltional inllllRd. This insumnce is llI1bJeCllo the following additional provisIons:
I. w. will pay dlDlloges forwhicb lb. lessor becomes
legally responsible only if the damages arise out of acts or omissions of:
(0) you or lII1Y "filmily member", or
(b) any olber person ."ceplth.lessororany employ.. or O8enl ofth.lessorusing "yollr leas. aulo",
2. "'Yoar lease auto" means:
(a) an 11I10 shown in Ih. Declarations or in this .ndonemenl which you I.... for a continuous p.riod ofat 1east six months Ilnder a
written agreemenl.wieb requires you to provide primary insuranc. for the lessor, and
(b) any S1Ibstillll. orreplacemenl aulo furnished by lb. lessor nam.d in this endors.m.nt
3. If we I.nninat. this policy, notice will also be mail.d to th.l.ssor,
4. The lessor is not responsible for payment of premiums.
5, Tb. desisnation oflb.l.ssor.. an additional insured shall nol openlle 10 increase our limits ofliobility,
This endorsement must be attached to the Change Endorsement when issued after the policy is written,
Copyright, Insurance Services Office, Inc" 1986
/
SUBCONTRACTOR'S WAIVER OF WORKERS'
COMPENSATION COVERAGE
c<<:.Y-
I certify that I am a subcontractor, that I am"EI ~p~p1~;;'~ ~~~rtn..r and that I
have no employees.
I hereby waive any right to benefits under the North Carolina Workers'
Compensation Act which might arise out of and in the course of my work as a
subcontractor for New Hanover County.
-1J,~'-o1-
Date
L+\u...) t,Jv:nw,.J.llF.,.i\~l :r.u<.
. .
Name of subcontractor
~
/-' ,.-...,--
.... ---------
Si at~ubcontractor
~ J?""" i ~v,.)
NEW HANOVER COUNTY
WANDA M. COPLEY
County Attorney
KEMP P. BURPEAU
Deputy ComIty Attomey
SHARON J. HUFFMAN
Assistant County Attonley
December 7, 2007
Buxton Environmental, Inc.
Attn: Ross Klingman, P. Q, President
PO Box 11550
Charlotte, NC 28220
RE: New Hanover Contract # 08-0249
Dear Mr. Klingman:
Enclosed please find your copy of the above referenced contract. Thank you for your
assistance in this matter. If you have any questions please give us a call.
Sincerely,
~~,~~~
Margaret Dunlap
Administrative Support Specialist
Office ofthe County Attorney
Enclosure
230 Govemmelll Cellter Drive' Snite # 125 - Wilmington, N C 28403
Phone: 910-798,7153, Fax: 910.798,7157
www.llhcgov.c.om