Purchasing Division 2019 Washington Street East Post Office Box 50130 Charleston, WV 25305-0130 State of West Virginia Solicitation Response Proc Folder : 426521 Solicitation Description : Addendum 3-Williamson Ceiling Insulation Project Proc Type : Central Purchase Order Date issued Solicitation Closes Solicitation Response Version 2018-05-03 13:30:00 SR 0211 ESR04261800000004903 1 VENDOR 000000205173 DANHILL CONSTRUCTION CO Solicitation Number: CRFQ 0211 GSD1800000016 Total Bid : $65,000.00 Response Date: 2018-04-26 Response Time: 11:25:47 Comments: FOR INFORMATION CONTACT THE BUYER Jessica S Chambers (304) 558-0246 jessica.s.chambers@wv.gov Signature on File FEIN # All offers subject to all terms and conditions contained in this solicitation DATE Page : 1 FORM ID : WV-PRC-SR-001
Line Comm Ln Desc Qty Unit Issue Unit Price Ln Total Or Contract Amount 1 Building 97 Insulation Project $65,000.00 Comm Code Manufacturer Specification Model # 72152103 Extended Description : Lump-Sum Bid, See Exhibit A Pricing Page Comments: This bid includes R30 Insulation. We were unable to find any manufacturers that make the specified R38 encapsulated insulation. Page : 2
PRODUCER INSURED CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: DATE (MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 09/07/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). BB&T-Carson Insurance Services 300 Summers St., Suite 650 Charleston, WV 25301 304 346-0806 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X TRA0548113 07/01/2017 07/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) $ 500,000 A OTHER: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS A X UMBRELLA LIAB X B Danhill Construction Company PO Box 685 Gauley Bridge, WV 25085 X PD Ded:500 X X EXCESS LIAB X X 0 SCHEDULED AUTOS NON-OWNED AUTOS Client#: 1638974 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY JECT LOC DED RETENTION $ $ WORKERS COMPENSATION PER OTH- X WCB1008781 09/20/2017 09/20/2018 X AND EMPLOYERS' LIABILITY STATUTE ER Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? Y N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Syvannah Patterson FAX 304 346-0806 (A/C, No): 8887513002 SPatterson@BBandT.com INSURER(S) AFFORDING COVERAGE NAIC # Westfield Insurance Company Brickstreet Mutual Insurance Co MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ A Builders Risk TRA0548113 $5,000 Ded $500,000 $ $ $ $ 24112 12372 5,000 1,000,000 2,000,000 2,000,000 X X TRA0548113 07/01/2017 07/01/2018 1,000,000 X X TRA0548113 07/01/2017 07/01/2018 7,000,000 7,000,000 07/01/2017 Temp Loc ** Workers Comp Information ** Voluntary Compensation ; Other States Coverage Proprietors/Partners/Executive Officers/Members Excluded: Robert Hill, President Rebecca Hill, Secretary/Treasurer Broad Form Employers Liability Form# WC990304 Edt Date: 01/01/06 (See Attached Descriptions) 18DANHICON 07/01/2018 5,000,000 Any One Loc 10,000,000 CAT Limit 500,000 In Transit 1,000,000 1,000,000 1,000,000 CERTIFICATE HOLDER Danhill Construction Company P O Box 685 Gauley Bridge, WV 25085 CANCELLATION 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 ACORD 25 (2014/01) 1 of 2 #S18733772/M18733732 The ACORD name and logo are registered marks of ACORD 1988-2014 ACORD CORPORATION. All rights reserved. SEST
DESCRIPTIONS (Continued from Page 1) Blanket Waiver of Subrogation Form# WC000313 Edt Date: 04/01/84 Evidence of Coverage SAGITTA 25.3 (2014/01) 2 of 2 #S18733772/M18733732