TOWN OF COBOURG

Request for Proposal

CO16-08

October 24/16

Request for Proposal for Artwork Phase IV – Victoria Square

Please provide one (1) signed original package, five (5) copy packages, one (1) maquette or set of maquettes, and

one (1) copy on a CD/DVD of completed Proposals using the attached forms, in a sealed envelope quoting the above Proposal number and closing date.

Forward before 2:00 p.m. local time Tuesday Jan. 3, 2017 to:

The Corporation of the Town of Cobourg Office of the Clerk

Victoria Hall 55 King Street West

Cobourg, Ontario K9A 2M2

RFP Number CO16-08 Closing Date: 2:00 p.m. local time Tuesday Jan. 3, 2017.

Proposals must be received before the above mentioned time and date, and in accordance with the attached RFP forms, specifications, instructions to Proponents, and

Terms and Conditions.

Contact:

L. Brace, Clerk Town of Cobourg lbrace@cobourg.ca

Town of Cobourg – CO16-08 Request for Proposal for Public Art

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Table of Contents

Part A: The Proposal Requirements 4

1. Introduction 4

2. Call Summary 4

3. Project Descritpion and Background 4

4. Art Goals and Criteria 4

5. Art Location Description 5

6. Budgets 5

7. Site Location Plans 5

8. Artist Eligibility 5

9. RFP Schedule 5

10. Project Authjority and Involvement 6

11. Project Partners and Stakeholders 6

12. Inquiries and Addenda 6

13. Proposal Content 6

14. Evaluations of Proposals 7

15. Formal Contract 8

16. Submission of Proposal 8

Part B: Terms and Conditions 9

1. Improper Delivery 9

2. Signing Requirements 9

3. Applicable Law 9

4. Town not liable for RFP costs 9

5. Required Warranties 9

6. No Obligation to Contract 10

7. Contract Payments 10

8. Limitation of Liability 10

9. Dispute 10

10. No Assignment 10

11. Fit for Use 10

12. No Implied Waiver 10

13. Governing Law 11

Town of Cobourg – CO16-08 Request for Proposal for Public Art

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14. Force Majeur 11

15. Deemed Satisfaction as to Submission 11

16. Default under Project 11

17. Copyright / Reproductions 11

18. Insurance 11

19. Enforcement 11

20. Opening Process 11

21. Privacy and Freedom of Information 11

Part C: Irrevocable Offer 13

Part D: Acceptance of Terms of Use of Property Information 14

Appendix A:Background Information (listed below) 15

Appendix B: Town of Cobourg Certificate of Insurance Form 16/17

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Part A: The Proposal Requirements

1. Introduction

The Corporation of the Town of Cobourg is soliciting proposals from pre-qualified artists for the installation of art in the proposed new town square at the corner of Second and Albert Streets. 2. Call Summary

The Corporation is commissioning art for installation in the, to be constructed, Victoria Square located at the corner of Second and Albert St.(location more fully described in section 5 of this RFP). Submissions are due by Jan. 3/17 with a project completion date of August 10/17. Proposals may be submitted by an artist or teams of artists who have be pre-qualified through an RFI process that will be completed by Nov 8/16.

3. Project Description and Background

Cobourg is to celebrate its 180th. Anniversary in 2017 as Canada celebrates its 150th. Victoria hall and surrounding precinct is a defining element of the Town. Victoria Hall, a national historic site was named after Queen Victoria and officially opened by her son, the Prince of Wales and the future King Edward VII in 1860. On July 1/1867, James Cockburn, Cobourg’s own Father of Confederation, and the first Speaker of the house of Commons, announced Confederation from this building. Victoria Hall experienced decline into the 1980s until community leaders rose to the challenge and their efforts and community support refurbished the grand building to stand as it does today. At the same time as this work our waterfront transformed from an industrial port to the people place that attracts visitor from across the province. In 1999 further community efforts began the process of revitalizing the Victoria precinct with three of the four quadrants surrounding the hall seeing extensive work. The final phase of this improvement project establishes a central public gathering space acting as a square and gateway between our transformed waterfront and our historic downtown. This revitalization aims to create a vibrant, and fully flexible town square for special events, business, performing arts, recreation and farmer’s market. Victoria square will be a meeting place and hub for all members of our community. This special space will be used to tell our stories, remember our history and celebrate our future. As part of a design team or individual the proponent will execute the commissioning of a new work of Art in keeping with the goals of the square development. As part of the re-visioning process, conceptual plans of the new square were developed. These plans provide suggested locations for public art to create the vision of the square.

4. Art Goals and Criteria

The following vision for Phase IV Victoria Square is to be used as a base for the art commission as supplied by the steering Committee: Victoria Square is to be: A community gathering place that welcomes all citizens and visitors A flexible interactive space A enhanced pedestrian corridor linking our downtown to the water A creative, sustainable and accessible space A space reflecting the heritage of the square A public space that a creates distinct sense of place

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5. Art Location Description

The Victoria Phase IV concept plan outlines seven locations for art within the project. These locations have been designated for consideration for this commissioning and future calls for art in the square. The steering committee suggests that the priority for the initial art installation could be the centre of the square. Artists considering this project are free to interpret the intent of the project and propose an alternate location or locations that are felt to enhance the square and contribute to its success. The square will be paved in paver stones with utilities in the form of communications, electrical and storm available as required.

6. Budget

The total upset limit for the project is set at $140,000.00 This fee is to cover artist’s fees, insurance, study overhead, travel, engineering(if required), materials, fabrication, foundation materials and installation, transportation, documentation, oversight of installation and installation cost. Costs not included in the fee are, installation of all utilities to the perimeter of the installation. All utility installation for the art itself will remain the responsibility of the artist(s) and be included in the submitted cost. . In addition the project budget of $140,000 a stipend of $2,000 per artist or artist team will be provided to those selected as a result of the Phase 1 - EOI process to submit proposes through this RFP. This stipend will constitute the total amount of all payment for submission of proposals.

7. Site Location Plans

Concept Plans, pictures of the site, and other relevant materials are attached as addendum A.

8. Artist Eligibility

An RFI process will proceed the release of this RFP call. A maximum of 4 artists or teams of Artists will be invited to submit proposals for this work. The EOI process will be open to all professional artists practicing in Canada. Artists who have completed projects with similar budgets, scale and scope are preferred. 9. RFP Schedule

This EOI process will be governed according to the following schedule. Although every attempt will be made to meet these dates, the Town reserves the right to modify any or all dates at its sole discretion.

Tuesday Nov 8, 2016 EOI Deadline

Tuesday, November 15, 2016 Release of RFP (invite team of artists)

2:00:00 p.m., Tues. Dec 20,2016

Deadline for Proponents to submit questions

Friday, Dec 23, 2016 Deadline for the Town to respond to questions

2:00:00 p.m,

Tuesday January 3rd, 2017 RFP closes

Jan 4-18, 2017 Evaluate proposals and interview those who submitted qualified proposals

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Thurs. January 19, 2017 Recommendations for award report written

January 30, 2017 Approval by Council

August 10, 2017 Completion of installation

10. Project Authority and Involvement

The final selection of any successful proposal will be by the Council of the Corporation of the Town of Cobourg upon review and recommendation made to it by an evaluation committee being an ad hoc Public Arts Committee. Final approval rests with Town Council. Participation in this RFP in no way guarantees the approval of any agreement with any party. All inquiries shall be directed in writing to the person identified in Section 11.

11. Project Partners and Stakeholders

The Corporation of the Town of Cobourg is the project authority for this Request for Proposals. There are no partners or stakeholders external to the Town of Cobourg for this project.

12. Inquiries and Addenda

All inquiries regarding this RFP are to be directed by email to:

Stephen Peacock, CAO Town of Cobourg speacock@cobourg.ca

Tel: 905-372-4301

Deadlines for the submission of inquiries to the Town and responses are shown in Section 9.

No officer, agent or employee of the Town of Cobourg is authorized to alter orally any portion of this document.

Should any Proponent find any discrepancies in or omissions from this document, or should any Proponent be in doubt as to any meaning in this document, that Proponent is obligated to notify the staff contact in this section to obtain clarification.

Although every effort will be made to ensure that all registered Proponents receive all the addenda, it is the responsibility of each Proponent to ensure all addenda issued have been received.

Addenda shall be considered as an integral part of this RFP document. The Proponent shall provide in their submission a signed copy of all the addenda that have been issued by the Town during this RFP process.

It is the responsibility of the Proponent to obtain clarification of the requirements contained herein, if necessary, prior to submitting a Proposal. Proponents are encouraged to visit the site and a staff member will be available upon request to the above noted contact.

13. Proposal Content

Each proposal submitted to include the following:

Title page, covering letter and table of contents

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Body of Proposal to include: - Statement of Interest (maximum 250 words) - Resume or short Biography of artist or artistic team - Project proposal including: -annotated list of materials included -Maquette -digital images as videos, CDs or prints (A maximum of 10 images maybe presented. Moving images are not to exceed 3 minutes in length) - Detail description of proposal including but not limited to location(s), materials, utility

requirements, schedule of work, budget, payment schedule engineering and architectural information about the art structure, visibility within the sight and lighting information.

Signed Part C: Form of Irrevocable Offer. As part of this offer, Proponents are to indicate their company’s contact information as required on the form provided.

Signed Part D: Acceptance of Terms of Use of Property Information

Evidence of insurance to the Town of Cobourg will be required before execution of any contract.

The Town reserves the right to accept any Proposal as submitted without prior negotiations. Each proposal must also contain each of the following elements:

Accessibility for Ontarians with Disabilities Act (AODA)

Provide a description of how the proposed installation will comply with the Accessibility for Ontarians with Disabilities Act, and

Provide a meaningful description of how the project will advance objectives related to providing increased accessibility to Ontarians with disabilities.

14. Evaluation of Proposals

An evaluation team comprised of art professionals and community members will review all Proposals received and evaluate them in relation to the evaluation criteria and goals of the project. The five (5) member evaluation team consisting of the following members:

Member 1 – Ronald A. Baird, A.O.C.A., R.C.A. (sculptor)

Member 2 – Dorothy Caldwell, R.C.A. (textile)

Member 3 – Donald A. Stuart, C.M., O. Ont., R.C.A., M.F.A., A.O.C.A. (gold/silversmith)

Member 4 – Kenneth J. Forsythe, I.S.A, A.M. (fine art dealer/appraisals)

Member 5 – Gina Brouwer, O.A.A.A., I.S.A., M.F.C. (landscape architect)

They will then provide recommendation as to the preferred proposal.

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As part of the evaluation, Proponents may be invited to attend a formal interview with the evaluation team to provide clarification on their Proposal.

Selection of the successful Proponent will be subject to review and approval by Town Council.

Selection of a proposal(s) will be based on the criteria as outlined in Section 4 (but not solely limited to the above) and any other relevant information provided by the Proponent(s). The Town reserves the right to prioritize and weigh the importance of each criterion confidentially. The Town will not be liable for any costs incurred by Proponents in the preparation of Proposals, site inspections, interviews, or any other services that may be requested as part of the evaluation process other than those outlined in Section 6.

15. Form Contract

Any proponent awarded a contract as a result of this Request for Proposals will, within 30 days of Town Council’s authorization, be required to enter into a Formal Agreement satisfactory to the Town of Cobourg’s Legal Service, which will incorporate or reflect all provisions set out in this RFP and shall reflect the proposal received and any resulting negotiations.

16. Submission of Proposal

Provide one (1) signed original hard copy of proposal with all accompanying information, five (5) copies of proposal package one Maquette or set of Maquette, and one (1) CD/DVD of your Proposal in a sealed package, clearly identified as to the contents and addressed as follows:

Request for Proposal for Artwork Phase IV – Victoria Square

The Corporation of the Town of Cobourg

Office of the Clerk Victoria HAll

55 King Street West Cobourg , Ontario, K9A 2M2

Proposals must be received no later than 2:00:00 p.m. local time Tuesday, January 3, 2016. Proposals received after the above date and time will not be considered and will be returned unopened to the Proponent.

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Part B: Terms and Conditions

The following terms and conditions are deemed accepted by all submitters of Proposals in response to this RFP and are deemed incorporated into every contract resulting from this RFP:

1. Improper Delivery

Electronic, telegraphic, telephone, or facsimile submissions in response to this RFP will not be accepted. Late submissions in response will also not be accepted.

2. Signing Requirements

Submissions that are not signed will be rejected. Signing of submissions shall be in the form set out in Part D: Irrevocable Offer which shall be attached to the Proposal. If the submitter of a Proposal is an incorporated company, the Proposal must be executed by the signing officer(s) of the company with the company seal placed beside the signature(s). If the submitter of a Proposal is not an incorporated company, the submitter of a Proposal should sign his or her own name in the presence of a witness who should sign beside the submitter of a Proposal’s name.

3. Applicable Law

This RFP, each submission and the Project itself are each subject to the provisions of all applicable law, including:

The Municipal Freedom of Information and Privacy Act, RSO 1990, c. M54

The Occupational Health and Safety Act, R.S.O. 1990, c.O.1. Each Proponent warrants that they have the experience training and equipment to ensure all work performed under the contract is done safely and in accordance with all applicable health and safety legislation and that they have control over the workplace and are fully responsible for the health and safety of all employees and others present on the site. Each Proponent also acknowledges that the Town is relying on this warranty in its decision to award the contract to the Proponent.

Integrated Accessibility Standards, Ontario Regulation 191/11 made under the Accessibility for Ontarians with Disabilities Act, 2005, section 5 of which regulation states: “…designated public sector organizations shall incorporate accessibility criteria and features when procuring or acquiring goods, services or facilities,”

Accessibility Standards for Customer Service, Ontario Regulation 429/07 made under the Accessibility for Ontarians with Disabilities Act, 2005 applies to provision of goods and services on and after January 1, 2012. This RFP, each submission and the Project itself are also each subject to the provisions of the Purchasing Bylaw of the Corporation of the Town of Cobourg as amended.

4. Town not liable for RFP costs

The Corporation of the Town of Cobourg is not liable for any costs incurred by the submitter of a Proposal in responding to this “Request for Proposal” other than those as outlined in this document.

5. Required Warranties

Each submitter of a Proposal is deemed to expressly declare and warrant in the Proposal that: i. the prices in this Proposal have been arrived at independently from those of any other submitter of a Proposal, ii. the prices in this Proposal have not been knowingly disclosed by the submitter of a Proposal, and will not knowingly be disclosed by the submitter of a Proposal prior to award, directly or indirectly, to any other submitter of a Proposal or competitor, iii. no attempt has been made, nor will be made, to induce any other person to submit or not to submit a Proposal for the purpose of restricting competition, iv. this Proposal is in all respects fair and without collusion or fraud.

v. there has been no violation of copyrights or patent rights in manufacturing, producing or selling the materials and/or services shipped or ordered as a result of this Proposal, and the seller agrees to hold the purchaser harmless from any and all liability, loss, expense, action or suit occasioned by any such violation. vi. all materials and/or services proposed to be supplied to the Corporation of the Town of Cobourg conform in all respects to the standards set forth by Federal and Provincial agencies. vii. The submitter of the Proposal is:

a. competent to perform the work described in this RFP [“the work”]; b. has the necessary qualifications, including knowledge, skill and experience to perform the work, together with the ability to use those qualifications effectively for that purpose;

c. shall supply everything necessary for the performance of the work; d. shall carry out the work in a diligent and efficient manner;

e. ensure the work is of proper quality, material and workmanship; is in full conformity with the specifications; and meets all other requirements of this RFP and any subsequent contract.

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viii. The submitter waives all rights of lien which might arise in relation to any contract from this RFP under section 3(1) of the Repair and Storage Liens Act, R.S.O. 1990, c. R.25. ix. The submitter has and follows a health and safety plan for employees and representatives who will be present on the property of the Corporation of the Town of Cobourg as part of any contract arising from this RFP.

6. No Obligation to Contract

Submissions made in response to this Request for Proposal do not constitute the acceptance of a contract with the Town of Cobourg. Submissions constitute offers which the Town may or may not accept on its sole discretion. The Corporation of the Town of Cobourg further reserves the right to accept or reject any or all Proposals or parts of Proposals, to order additional units at the price submitted, or to accept any Proposal considered in its best interest, and to request re-Proposals on the required materials and/or services. The Corporation of the Town of Cobourg also reserves the right to waive irregularities and technicalities and to do so in its sole discretion. The Town of Cobourg reserves the right to include consideration of any outstanding claims against or by the Town, any record of poor performance with the Town and the appropriateness of any key personnel in evaluation of any Proposal and to reject any Proposal based on record of past poor quality of service, claims and disputes or difficulties related to proceedings in completed past projects for the Town.

Each submission of a signed Proposal is deemed an irrevocable offer which may be accepted, at the sole option of the Corporation of the Town of Cobourg and after negotiation, only by entering into a formal contract upon such acceptance the terms, responsibilities, and specifications as required by the Corporation of the Town of Cobourg including but not limited to those set out herein. The Town reserves the right to reject an offer to supply goods and services presented in response to the Town’s procurement processes where the Town determines that the person making the offer is in any way indebted to the Town and in its sole discretion is of the opinion that it is in the Town’s best interests that the offer be rejected.

7. Contract Payments

Unless otherwise specified, should the Corporation of the Town of Cobourg enter into a contract relating to the Project, it will make payment of accounts within thirty (30) days of either the date on which the materials and/or services have been accepted to the satisfaction of the Corporation of the Town of Cobourg, or the date on which the invoice is received, whichever is later.

8. Limitation of Liability

Unless otherwise agreed, should the Corporation of the Town of Cobourg enter into a contract relating to the Project, the other contracting party shall agree to hold the Corporation of the Town of Cobourg harmless from any and all liability, claim, (including damages, fines, insurance adjuster’s fees and legal costs on a full recovery basis), loss, expense, action or suit arising from the Project. Independent of any steps taken by the Town, it shall be the Contractor’s responsibility to investigate and handle any and all third party claims arising from the Project in a professional manner, within 30 days of receipt, and provide a copy of the response to the Town.

Each proponent submitting a proposal in response to this RFP specifically releases the Corporation of the Town of Cobourg, its staff, officers, consultants, agents, Council and councillors from and also specifically waives all liability, loss, expense, action or claim it may have in law or equity arising in any way from processes related to this RFP including but not limited to the award of contract, negotiated terms of contract, reject of proposal, evaluation of proposals, exercise of any privileges pursuant to section C6 above or for any other thing done or not done by the Town or a successful proponent.

9. Dispute

In cases of dispute as to whether or not deliverables meet the requirements of the Corporation of the Town of Cobourg, the decision of such agent as the Corporation of the Town of Cobourg may appoint will be final and binding.

10. No Assignment

Unless otherwise agreed, should the Corporation of the Town of Cobourg enter into a contract relating to the Project, the other contracting party shall not, without the written consent of the Corporation of the Town of Cobourg, assign or subcontract any aspect of the Project or the deliverables.

11. Fit for Use

All things supplied under the Project shall be fit for the use specified in the governing documents whether or not detailed specifications on the various components are not set out in the documents.

12. No Implied Waiver

The failure of either party at any time to require performance by the other party of any provision hereof shall in no way affect his right thereafter to otherwise enforce such provision or to seek damages for the breach thereof.

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13. Governing Law

Any submitter of a Proposal, including those outside the Province of Ontario, agrees that the rights of all parties shall be governed by the laws of the Province of Ontario and that the venue for dispute shall be within the Province of Ontario. Proponents must be able to demonstrate their ability to perform the work under the law of the Province of Ontario and provide such security as might be required and enforceable under the law of the Province of Ontario.

14. Force Majeur

Neither party shall be held responsible for any remedy arising from delay or failure to perform obligations under this RFP or the Project when such delay or failure is due to fires, strikes, floods, acts of God or the Queen’s enemies, lawful acts of public authorities, or delays or defaults caused by common carriers, which cannot reasonably be foreseen or provided against.

15. Deemed Satisfaction as to Submission

The submission of a Proposal shall be deemed conclusive proof that the submitter of a Proposal has satisfied itself as to all the requirements set out in the RFP, all the conditions which may be encountered, what materials and/or services he/she will be required to supply, or any other matter which may enter into the carrying out of the Project. No claims will be entertained by the Corporation of the Town of Cobourg based on the assertion by the submitter of a Proposal that it was uninformed as to any of the requirements of the Proposal.

16. Default under Project

In case of a default of performance of the Project, the Corporation of the Town of Cobourg reserves the right to transfer the Project to another source. All additional expenses arising from such transfer will be charged to the original submitter of a Proposal or contractor and are due forthwith.

17. Copyright / Reproduction

The Artist reserves all reproduction rights, including the right to claim statutory copyright in the Work. The Artist retains the full copyright in the preliminary designs and any incidental works made in the creation of the Work. All approved reproductions will have the following copyright notice: © (Artist’s name) (Year ____). The Work may not be photographed, sketched, painted, or reproduced in any manner whatsoever without the express, written consent of the Artist.

18. Insurance

Any selected Proponent shall be required to provide Commercial General Liability Insurance, structured on a “per occurrence” basis, and motor vehicle liability, in the amount of no less than five million dollars ($5,000,000.00). WSIB coverage shall be provided as required by or available under law. Additional insurance may also be required depending on the nature of bids submitted. Policies shall be in a form satisfactory to the Town and shall be kept in full force during the complete period. The Town shall be named as an additional Insured on the Commercial General Liability policy, and any successful Proponent shall provide evidence of all insurance coverages required by completing the Certificate of Insurance (see Attachments) provided by the Town, and if required, proof of WSIB coverage, before the Town shall enter into of a contract in relation to this Request for Proposal.

19. Enforcement

Any successful Proponent will have to enter into a legally binding agreement with the Corporation of the Town of Cobourg. Where any breach of the terms of that agreement should occur, the Town shall review all legal remedies available to it and use any appropriate remedies to protect the interests of the Corporation of the Town of Cobourg including law suit or application before the appropriate court or tribunal. All submitters of Proposals in response to this RFP hereby acknowledge and attorn to the jurisdiction of the choice of the Town of Cobourg in any such legal process.

20. Opening Process

The following processes shall be used when RFP submissions are opened: Only the name of each Proponent will be released at the time of opening. The pricing component and the ranking of all accepted submissions may be reported to council.

21. Privacy and Freedom of Information

All submissions and attached materials received in response to this RFP are deemed to be the property of the Town of Cobourg as of the date of their submission except to the extent they are protected as third party material under applicable privacy law. The Municipal Freedom of Information and Protection of Privacy Act (MFIPPA or the Act) applies to all tenders, quotations and Proposals submitted to the Corporation of the Town of Cobourg. Tenders, quotations and Proposals will be received in confidence and are subject to the disclosure requirements of the Act. Pursuant to orders made by the Information and Privacy Commissioner/Ontario, the Town shall not withhold the following information from tenders, quotations or Proposals, if requested through the MFIPPA process by any person or business:

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· the cover letter to the tender, quotation, or Proposal; · the table of contents; · lists of figures, tables, and appendices; and · any information regarding the form and structure of a tender, quotation or a Proposal (i.e. information which may disclose the manner in which the document is constructed). Proponents should identify any portions of their Proposal which contain a trade secret, scientific, technical, financial, commercial or labour relations information supplied in confidence and which will cause harm if disclosed. The Town of Cobourg cannot ensure that any given portion of any materials received in response will not be ordered released under MFIPPA.

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Part C: Irrevocable Offer

I hereby offer to provide the requirements under RFP CO16-08 on behalf of the Corporation of the Town of Cobourg according to the terms set out in this Proposal as well as in RFP CO16-08 including the requirement for and acceptance by a formal contract acceptable to the Corporation of the Town of Cobourg.

I also agree that this irrevocable offer shall be open to acceptance by the Town for a period of one hundred and twenty (120) days from the closing date for the receipt of Proposals.

Witness Signed

OR Name

(Affix Company Seal if applicable) Title

Vendor Name

Address

City/Prov.

Postal Code

Telephone

email

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Part D: Acceptance of Terms of Use of Property Information

I hereby acknowledge that the property information provided as part of Request for Proposals No. CO14-08 is provided for information purposes only, does not constitute engineering or planning advice and that the Town of Cobourg makes no guarantee of its accuracy or completeness and that I agree it is my sole responsibility to verify any aspect of the information that may be relevant to decisions made by me in submitting my proposal. I agree to hold the Town of Cobourg harmless for any result of any decision I or my agents may make as a result of using the information provided and any reliance I may place on the information provided is done so at my sole risk and with full knowledge of the limitations described within this request for proposals.

Witness Signed

OR Name

(Affix Company Seal if applicable) Title

Vendor Name

Address

City/Prov.

Postal Code

Telephone

Email

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APPENDIX ‘A’

Background Information

Victoria Square Slide Presentation

Victoria Square Slide Presentation Notes

Victoria Square 3D Sketch

Victoria Square 2016 Update

Victoria Square 3D Video

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APPENDIX ‘B’

Town of Cobourg Certificate of Insurance Form

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CERTIFICATE OF INSURANCE THE TOWN OF COBOURG

This is to certify that the insured named below is insured as described below.

PROJECT/CONTRACT/LEASE/AGREEMENT/PERMIT/TENDER to which this certificate applies – MUST BE SPECIFIED

RFP CO16-08 Request for Proposal for Artwork, Phase IV, Victoria Square.

NOTE: ORIGINAL CERTIFICATES SIGNED BY YOUR INSURER OR INSURANCE BROKER ONLY WILL BE ACCEPTED

Name of Insured

Telephone Number

( )- - Street Name (of Insured)

City

Postal Code

Type of Insurance Insurer’s Name Policy Number Effective Date Expiry Date

Limits of Liability YR MO DAY YR MO DAY

Commercial general liability

umbrella excess

other:

Motor vehicle liability

Motor Vehicle Liability – as per list of vehicles on file with insurer

Commercial General Liability – Occurrence Basis, Including Personal Injury, Property Damage Broad Form Property Damage, Contractual Liability, Non-Owned Automobile Liability, Owner’s and Contractor’s Protective Coverage, Products – Completed Operations, Contingent Employers Liability, Cross Liability Clause and Severability of Interest Clause.

Tenants Legal Liability No OR Yes... (limit) Liquor Liability No OR Yes

AMOUNT OF DEDUCTIBLE (property damage and/or bodily injury) $

This is to certify that the Policies of Insurance as described above have been issued by the undersigned to the Insured named above and are in force at this time. The insurance afforded by the policies described herein is subject to all the

terms, exclusions and conditions of such policies.

If cancelled or changed in any manner that would affect the Town of Cobourg as outlined in coverage specified herein for any reason so as to affect this certificate, thirty (30) days prior written notice by registered mail or facsimile transmission will be given by the insurer(s) to:

Ian Davey, Director of Corporate Services

Town of Cobourg

55 King St West

Cobourg, on, K9A 2M2

Tel: (905) 372-4301 ext. 4201 Fax: (905) -372-7421

Date YR.

MO.

DAY

Name of Insurance Company or Broker (completing form)

Street Name (Insurer or Insurance Broker)

City

Postal Code

Name of Authorized Representative or Official (please print)

Telephone Number

( )- - Fax Number

( )- -

Signature of Authorized Representative or Official