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HomeMy WebLinkAbout13- McClaughry Access Agreement for sub-slab depressurization December 12, 2013 Tobias & Carrie McClaughry 1050 Boylan Rd. #18 Bozeman, MT 59715 Subject: Access Agreement for Installation, Operation and Maintenance of Sub-slab Depressurization System and Other Mitigation Measures Dear Mr, & Ms. McClaughry Previously you granted the City of Bozeman and its consultants access to your house to conduct indoor and sub-slab testing as part of an ongoing vapor intrusion study conducted to evaluate the possible migration of constituents, including volatile organic compounds (VOCs), from the Bozeman Landfill into surrounding properties. The results of that testing have been evaluated and the City is now recommending and seeking permission to install a sub-slab depressurization system or other possible measures to mitigate against any vapor intrusion that may be occurring from underground sources. This voluntary agreement has been prepared for the purpose of granting the City, its consultants, and contractors access to your house and property as needed to complete the design and installation of a sub-slab depressurization system or other mitigation measures. Before executing this agreement you are asked to review the terms carefully.iWith.your own representatives. If you have any questions during this process please don't hesitate to contact Rick Hinson, City Engineer at 406-582-2280 or Kirk Miller of Tetra Tech at 406-461-0234. Sincerely, Rick Hinson, City Engineer ACCESS AGREEMENT Mr/MsTobias McClaughry MrIMs Carrie McClaughry as Owner(s) of property located at -556 St. Andrews Dr. , (Property) grant the City of Bozeman (City), and its authorized consultants, and contractors access to the Property, including the interior of the house, as reasonable and necessary to design, install, operate and maintain a sub-slab depressurization system (System) consistent with Exhibit A or other mitigation measures which may include, but are not limited to, sealing any cracks and penetrations in the slab or foundation of the home. 1. Grant of Access. Owner(s) grant the City access reasonably necessary to design, install, monitor, and test the System and other mitigation measures (Permitted Activities). Thereafter the City shall have access to the Property at least twice per year, but not more than four times per year, to monitor and maintain the System, or as needed to repair or replace any System components. 2. Term of Agreement. This Agreement shall be in effect for ten (10) years from the date of execution. If the Parties agree it may be extended by any number of successive five (5) year terms. If the Agreement is not extended beyond its fixed term it shall continue year to year thereafter until terminated by either party. 3. Notice. The City shall contact Owner(s) to arrange for access to the Property as provided for here. Owners agree not to tamper with the System or to allow any person not approved by the City to tamper with or work on the System. In the event maintenance or repair is needed Owner(s) agree to notify the City as provided for here or as may be altered in writing: City Contact: Attn: City Engineer 20 East Olive Street PO Box 1230 Bozeman, IVIT 59771-1230 Owner: Tobias & Carrie McClaughry 1050 Boylan Rd. #18 Bozeman, IVIT 59715 4. Design. Prior to installation the City shall provide Owner(s) with final design plans and shall obtain Owner(s)' written approval to proceed. The System will be designed and installed to maximize effectiveness with minimal impact to the Property. 5. Insurance and Indemnification. Also prior to installation, City's contractor(s) will be required to provide City with evidence of adequate commercial general liability coverage naming the Owner(s) as additional insured(s) on a primary non-contributory basis. The City shall be responsible for any damage to the Property caused by the installation of the System or other mitigation measures and agrees to fully repair any such damage. 6. Installation Costs. The City shall ensure that no liens or encumbrances related to the System are placed on the Property and shall be responsible for all costs associated with the design and installation of the System or other mitigation measures- 2 7. System Ownership. The City shall own the System and shall be responsible for the cost of monitoring, operating and maintaining the System until otherwise agreed by the Parties or until this Agreement is terminated as provided herein. & Electrical Costs. Upon System installation the City shall pay Owner(s) a lump sum to cover projected cost of operating the System for the term of this Agreement based on the present value of the costs of operating the System for 10 years as shown in Exhibit B and should this Agreement be extended beyond the fixed term the City shall pay the Owner(s) an additional lump sum payment for the costs of operating the System for the term of any such extension until this Agreement is terminated. 9. Termination, At any time 60-days prior to the end of any Agreement term then in effect either party may, upon 60-days written notice to the other, terminate this Agreement. Upon termination, unless otherwise agreed to by the parties, the City of Bozeman agrees that it will, at the request of the Owner either convey the entire system to the owner or disconnect electrical service to the System and remove any components of the System requested by the Owner, and repair any damage to the Property that might have been caused in connection with any of the Permitted Activities, and to the extent reasonably possible return the Property to the condition it was in before Permitted Activities were conducted, 10. Binding on Successors. This Agreement is binding on the Parties and any person succeeding to the Parties' respective interests including agents, tenants, heirs, and assigns. Owner agrees to disclose this Agreement to any person or entity holding or accepting any interest in the Property. If the Property is rented, Owner(s) shall provide City with a copy of Exhibit C, "Tenant Acknowledgment" executed by any existing or future tenants. 11. No Admissions. Nothing in this Agreement may be construed as an admission of liability or as a waiver or release of any claim or defense that either Party may have related to vapor intrusion at the Property or otherwise. /�Date: Wcaner- Printed Name S i na J/re --:� 6 t/ W d Date: Owher- printed Name Signature Date: City of Bozeman Chris A. Kukulski, City Manager 3 r MASTER BEDROOM KITCHEN GREAT ROOM BEDROOM cy / II II II g GLOS. CLOS. WANT. II I'I m DINING u BATH II II ll r I II U � BATH 0 BATH w GLOS. BEDROOM r r - � II NOTES -_ — 1. 3" BLACK POLY PERFORATED PIPE — — PLACED AS SHOWN IN CRAWLSPACE. GARAGE I CRAWLSPACE COVERED WITH 15 MIL I, POLY. PENETRATIONS SEALED AND v ( POLY SEALED TO OUTSIDE FOOTINGS. EXISTING PIPE RUNS UP THROUGH ATTIC. FANTECH HP 190 FAN INSTALLED IN ATTIC. PIPING VENTS UP THROUGH ROOF. SECOND SYSTEM INSTALLED IN GARAGE WITH EXTRACTION PORT ON EAST WALL, 4" PVC PIPE EXTENDS UP INTO ATTIC. FANTECH HP 150 FAN INSTALLED. PIPING VENTS UP THROUGH ROOF. J I p II HOMEOWNER REVISED EXHIBIT-A ACKNOWLEDGEMENT INITIALS ` o +S Tnva c,nvHnB.intl".faRrn fraroam tlatl,In[ha m^BlnWl kpmd dTETRA 7ECH.Thl#drawl^P�rtdb—It—Id,m tf dor p dr Wvip,Athepd,rwflfbn tan 10TEYRATE,CKMwi9lrwl wily tl Lvj�luary JO'�„1¢ 4 VAPOR EXTRACTION PIPE MCCLAUJ HRY RESIDENCE (IN CRAWLSPACE) SUB-SLAB DEPRESSURIZATION 0 EXTRACTION POINT LOCATED SYSTEM EXTRACTION, PIPING AND VAPOR MONITORING POINTS EXHIBIT A g c; MASTER BEDROOM KITCHEN GREAT ROOM BEDROOM a CLOS. CLO& RANT. 0 DINING BATH m BATH 0 BATH �. 0 ®' c BEDROOM CLO& � I I� 0 GARAGE N m - NOTES !9 1. EXACT PLACEMENT OF VAPOR EXTRACTION PIPES TO BE DETERMINED. LOCATION SHOWN IN PLAN IS FOR REFERENCE ONLY, nNE U W A a Th1.[ a4ng.ht yh-Farm byr &m ,r-[hv pMgJW WIM predM 0 IT-TPA TECH.Thl-®nW,ra adb.9 -d,wW--dar ryralA the pdy lj -v..t W TETRA TECH.Mufgi.J.11 b.rowaad 'S'®pt8171�76P'Jfly ZQ'a3 b'A TETPA TECH as tSa" aoU,y-fWpUrywe-f1 Hp,*t TETRA TECH tlov-nat-pPm' 0waa.matou®decumaret Harry alMn9onalmod'Aicatinn ds matl®withal!TETRA T(:•CIttl�M--n-Ppro-sa, P' VAPOR EXTRACTION PIPE MCCLAUGHRY RESIDENCE (IN CRAWLSPACE) SUB-SLAB DEPRESSURIZATION Q VAPOR MONITORING SYSTEM EXTRACTION, PIPING POINT LOCATED AND VAPOR MONITORING POINTS 8f EXTRACTION POINT LOCATED EXHIBIT A U) M 0 Z 65 ca 0 en LU w C.3 r - M -ffi cn 0 2 0 0 CL ca r a) "a CD :3 CD CO LO (n R3 m C3 0 C7 Ca r- (n a CN uj -.-- w co co (D N 0 (0 EN w (N 60 w co 0 1p q CV U? cq :t " I: C� Nt N * P- CN r- co V- C) C> N P- O� C4 P- r- 00 M r N "t CD 00 CD N N r- M r r + CN N N N 04 M M ♦ v), 60-.�6}64 6% 6') 6% 46 ta v SV 40 Q Mu w "a aw w rer .w Eli E tL U) tN Is > uj ui 4w C 0 o E E CL a) 0 yr CL w LU Electricity cost for user submitted device Page l of 1 i,i ul I I II II�� III i!� Ill illlii ii Y, I I I yijii��i ll�l��lli���l'LIIII I�I� 1' I i�l 11�'YI II YIi 1111111�Ii� Home I Install an Attic Fan I Keep Pipes from Freezing I LIED Light Bulb Savings Comparison I Electrical Products I About Us Commonly Used Devices 60 Watt Incandescent Light Bulb Computer'System Drip.Coffee Maker warm Oven at 350 degrees 100 Watt Incandescent Light Bulb Computer System(sleep made) Electric Blanket Space Heater(portable) Compact Fluorescent Lamp Drip Coffee Maker(brew) Furnace Fan LCD HD TV-47 Inch Clothes Dryer Oxygen Concentrator at 3.0 LPM Microwave Oven(Highest Setting) LCD Monitor-22 Inch. Device tame; D zati epressurion Fan Cost Per Hour X0.009859 Wattage of Device: t50 µ Cost Per Day: x;0.236624 Kilowatt Hour Cost: 065729 Cost Per WWeek: $1.656 Hours of use per day 124 Cost Per Month $6.63 Calculate Cost _ Cost Per Year: $86,13 Copyright 2008-2013,Spectrum Research, Inc http://www.electricity-us age.com/Electricity-Usage-Calculator.aspx?Device=Depressurizati... 9/6/2013 Electric Monthly Default Supply Rates Page I of I New,i i l Effective Dare SefetemberI,2013 Electric Residential Electric Ughting Effective Date PricelkWil Change Effactive Date Price/KiNh Chang e Octuber 01 r 2D I 2 So p6,i,l93 S(O 0013019) Octablar 01 2012 $00;x7438 S(O 0000 17) Noverfluer,01,201? SO 061633 S 0 000440 No,enrceral 2012 $0057636 S 0 000398 Doerr 20I2 SD 062433 $0000800 Decerrtrar 01,'2012 $0 058661 S 0 000825 January 01,2013 SO 062358 $(0000077) January 01 2013 S 0 058576a S(O 000082) February 01,201!3 SO 061857 $(Q POG4q9) FO.'"cary01 2013 !10058133 $(0 OCOl March 01.2013 $00625,33 $0 000078 March 01"1 2013 S0068744 $0 6410611 April 01,2"01.3 SC 082481 $q()000052) April 01,2013 S a 068647 $(0000047) May 01,20113 $0062388 $(O 000013) V ay 01,2013 $0 058813 $(0 00=4) Jurip fll,?.Oj 3 053F SO 5 A9 S 0 001.26"I tuna 01,20,15 $0059368 $0 001215:5 July 0 1 2013 SO 065453 $0 001804 July 01r 2013 $0051594 S D 001796 Augusl 01,2013 S0065099 5(i)000354) Aul 01,2013 $0061274 $(0 000320) Seri 01,2"01'3$0065729 $10 00063➢ 9eprerilti 2043 $0061782 $0 000608 General Service 1 Secondary Non Demand General Service I Secondary Demand Effective,Data Pr!cO:kWh Change Effective Date Pm:efKINh Chance Ortcher 01,2012 $0057438 5(0 000017) NovLrl 01,2012 $0 061612 $0 000440 November 01,2012 SO 6F37836 5 0 000398 Decemtpr 01 2012 S 0 062434 $0000802 December 01,2012 $0 056661 S 0 000826 January 01,2011 S 0 062357 $(0 00001 January Q'i,2013 $PO 058579 $(0 000062) February 01,2013 5 0 061858 $lO 000499i February 01,2013 SO 05,8133 5(0 000446) March 01,2013 5 0061856 S 0 000000 March 01,2013 $0 061V44 $0 0006$1 Marr.;hi 0'I,2013 S 0 062534 $0 000670 April 01,2013 SO 058697 S(0000047) April 01,2013 S 0 062482 ${n(300052) May 01.21013 so 0681313 $qQ OOQO!94) May 0 1,2013 S 0 D52389 S(0000093) June 0'6,2013 SO 05 8,15 $0001255 June 01,2013 $0 0636Y)� S 0 001261 Jluly 01,2013 SO 05 594 $0001725 July 0"1 2013 S 0 065454 S 0 001804 August 01 20l3 SO 06127'4 $(0 0 0 0 32,0) August 771,2013 S 0 06,5100 S(S Cell Saptrernbar 0'1,2012 SO 061782 S00005013 Saptorl 2013 $Q:065 7 30 S,o 000930 General Service I Primary Non Demand General Service 1 Primary Demand Effective Date PricelkWirl Change Effective Date PricLIKWh Change October 01,2012 $005,9514 $rO 000018) October 01,2012 S 0 050169 S(O 0000 17) November 01,2DI2 $0 059942 $0000428 November 01,2012 $0 Oc'M"I $0 000301 December 0 9.2'0'12 $0 060722 $0000780 December 01.2012 S 0 06 fi381 w3 0 0008'071 JinuarjOrl 2.013 S0060646 $(0 000076) January 01 2013 $0 35760I $(a 000080) February 01,20113 SD 060160 $(0 000458) February 01 2013 S0056863 S(O 0004314) March 01,2013 $0060817 S 0000657 March 01,20 13 $0057463 S 0 000600 ApnIO1 20113 30 06076 7 $(0 000050) April 01 2013 $0057417 0$(0 000046� May 11,2013 $0060677 S{0 000090) May 01,2013 $0057335 Sp 000062), ,lung 01,2013 $0061903 $0001226 June,01,2013 $0058555 $0 001020 ,July 01,2013 $0083659 $0001755 July 01,2013 $00602,10 S 0 001685 Auquat0l 2013 $0 0E3314 SrO 000344) AuqusC 01,'2013 $0 059925 tha 0003'951 September 01,2013$0 063027 0000813 Soploh'i"p"01,2013 S 0 Orl $0 000505 Irrigation Non Demand irrigation Demand Effective Date PriceikWh Change Effective Date Pricell(Wh Change Optcher 01,2012 50 057438 $fQ 000017) October DI 2012 $0057439 $(0 0011317) Novarniber 01,2012 SO 057036 $0 000398 Noryoni 01,2012 $0 057830 $0 0003138 December 01 201:2 $0 Ob8bO I $0 00082b December 01.2011 S D 05866 4 $0 oll January 01,2013 $0058579 $(0 OOOOl January 01,201:3 0 058579 '5(0 000082) February 01 2013 $O 056133 $(Q 00044b) February 01,2013 0 058133 S(O 0004,16) Mirch 0 1,2013 SO 058744 $0000611 March 0'l,2012 0 058744 S 0 007e I I Apr11 01 2013 80098697 $(0 000047) April 01,2013 5 0 0566537 ,(0 000047) Mly 01 2013 $0 058:613 5(0 000084) May 01 2013 $0058613 $(0000084) jrrino 01 2013 $0 ol $0001255 Jlrn ry 01,2013 5 0 059868 S a 00126S, July al 2015 V)061594 50001726 July 01,2013 10 0615 4 5 0 0017215 August 01 2013 $017161274 S((1 000320) August 01 2013 $0061274 S(0 700 320? Sapkanbel-Ol 2013$0 06178? $0 000'508 Sapiarriblar0l 2013 S 0 061792 $0 00101508 GS-2 Substation GS-2 Transmission Effective Date PricelkWh Change Effective Date P6cefK'Wlh Change October 01 2012 SO 059003 $(O 000018) Octobarol,7012 $0058647 $(0000018) November 01.2012 $0059428 8 0 CO0426 Novarliber 01 2012 $0 069669 5 0 000427 December 01.2112 SO 0601201 $0 001 Occamber Ol r 2032 $0 J:�'9838 S 0 604776.{9 January 01,2013 $0060125 S O 000076) January 01 2013 $0054763 Si(O 0000'75) February 01 2013 SO Ol $(O 0004819 February 01 2013 S 0 0692614 $(0 OPOl March 01,2013 $0060296 t,0100065+2 March 01 2013 S 0 0690,32 S 0 COCIO48 Apir;01,2013 SO 060246 $(O 000050) AproOl 2013 $0 0591182 ,i(a 000050) May 01,2013 $0360155 S(O 000096) May 01 2013 $0 069793 S(0 000089) J unp 01,2011 50106137:2 $0 001216 June 2013 S n op"I oat $0 3017108 July 01,2013 so 06:71 112 It 0 001740 July 01 2013 $0082732 S 0 001731 Auguaf Ol 2171'4 SO 06217D $(O 000342) Augw51 01 2013 $10 062n3 $(n OuQS-i'j) September 01,2013 SO On377 $0 000607 September Or 2013 $0 002997 0 000604 ir-le0lic F'Upply rate",rhani morithly ba#prd or, projCded 92-rrorillrr Mv,kM p0c,E!s �Lj'e re, compoport ID adull d041S irc'unfxj by NVVrr ali,r,ed up Cil all arlpr1r,jul baslr� NWO purchaW�' pvoiluw'rs wld pa5¢10s!rte co't dir,"lly r) AgIrloul nilirkup http://custom.northwestemenergy.com/forms/eleemonthly.asp 9/612013 USA Energy Inflation Forecast Page I of 6 About Us F—F Forecasts,charts and analysis.,.. F-01�R�E!C'ASTC H A RT, Interest Rate Forecast Stock Nfarket Forecast Real Estate Forecast Exclianze Rate Forecast Economic Forecast USA Energy Inflation Forecast USA Energy Inflation Rate Forecast Target Month Forecast HOT FA Forecast for the USA Energy Inflation Rate for the year August 2014 15.71% 12,80% ending in the target month indicated based on the Consumer Price Index for Ali Urban Consumers: Updated Monday,August 26,2013, Energy,net seasonally adjvisted Inflation Rate for All Urban Consumers:Energy-5 Year History 30% 20% 106 -20% •30% 1108 112009 112010 112011 112012 M013 112014 1/15 Annual US Inflation Rate for Energy is platted monthly in gray(Consumer Price Index for All Urban Consumers:Energy).The forecast forthe target month is shown In green,Other links retated to this economic indicator are below. Inflation Rate Forecast Energy 10YoarChart-CPI-Ener_qy US Inflation Rate Forecast 53 Year Graph-Consumer Price Index-E!LoMr Inflation:Food,Energy,Housing,Medical etc. Current Analysis&Forecast: US Energy inflation Rate Commentary 6092 e ENERGY INFLATION RATE July,2013 Data: The forecast for the US Energy Inflation Rate is in the table at the top of this page.Forecast-Chart,com is forecasting that Energy Inflation Rates will be roughly 15,71%over the next year.The table shows a HDTFA of 12 80%which suggests that the inflation rate for energy prices In the US for the 12 months ending August,2014 could easily fall between 28.51%and 2.91% Links to Forecasts for many other economic indicators may be found at the top of this page.The energy price index used in this article is the Consumer Price Index for All Urban Consumers Energy,hereinafter referred as the energy price index. Annual US Energy Inflation Rate Last Month -2.6% Last Year......... 47% Last 5 Years 2A% Last 10 Years. 71% Last 20 Years 4.9% Annual Energy Inflation Rate:Highs&Lows High(Last 12 Months) 47% (July,2013) Low(Last 12 Months) -8.9% (August,2012) High(Since January,1958) 47.1% (April,1980) Low(Since January,1958) -28.1% (August,2009) The annual Energy Inflation Rate for the 12 months ended in Juty,2013 was 4.75W That's 1,57%percent higher than the 12 months ended in June,2013 which inflated at a rate of 3,18%,It is 10,34%percent higher than the 12 months ended in July,2012 which inflated at a rate of-5,59W The rise in inflation rates from June to July indicates that the short term inflation trend in energy prices has been up.If that trend continues,we should see an inflation rate for the 12 months ended in August,2013 that is close to 6.32%. The USA Energy Inflation Rate one year ago was-5.59%.Over the last year, http://forecast-chart.com/inflation-usa-energy.html 9/612013 USA Energy Inflation Forecast Page 2 of 6 imiauoninEne energy lance inoexwas 4,t0-,10 Ine average raze over me iasx-iu years was 7.20%. Lower inflation over the last 12 months compared to the average inflation over the last 10 years serves as an indicator that the long term trend in the Energy Inflation Rate is down.Inflation expectations shoutd be adjusted accordingly. Forecast-Chart.com's historical research covers Energy Inflation Rate data back to January,1958.The average annual inflation rate in energy prices during that period of history was 4.92%.The highest rate was 47.13%.The lowest rate was-28.09%. The high was attained in the 12 months ended in April of 1980.The low was achieved in the 12 months ended in August of 2009. Recent rates experienced in the 12 months ended in July of 2013 are similar to the historical 4,92%average. This page provides a five year chart and a forecast for the US Energy inflation Rate.For links to longer term charts,look at the links under the five year chart (above).One link opens a ten year chart Another opens our longest term graph on the Energy Inflation Rate,Just one glance at Forecast-Chart.com's long term charts can provide tremendous insight into the historical trends of the financial markets. The US Government's inflation economics policy attempts to control inflation. High inflation and negative inflation(deflation)can have damaging effects on the economy. Commentary 6092 e ENERGY INFLATION RATE June,2013 Data: The forecast for the US Energy Inflation Rate is in the table at the top of this page.Forecast-Chart.com is forecasting that Energy Inflation Rates will be roughly 15.48%over the next year.The table shows a HDTFA of 12.87%which suggests that the inflation rate for energy prices in the US for the 12 months ending July,2014 could easily fall between 28.34%and 2.61%.Links to Forecasts for many other economic indicators may be found at the top of this page.The energy price index used in this article is the Consumer Price Index for All Urban Consumers:Energy,hereinafter referred as the energy price index. Annual US Energy inflation Rate Last Month 19.9% Last Year... ....... ...3.2% Last 5 Years 27% Last 10 Years.................7.2% Last 20 Years 4.9% http://forecast-chart,com/inflation-usa-energy.himl 9/6/2013 AC° CERTIFICATE OF LIABILITY INSURANCE DATe(MMIODff,YYI �,...�.—' 10/1812013 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($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the polcy(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 to lieu of such endorsement(s). PRODUCER NAME! CADE RASMUSSEN INSURANCE UNLIMITED cN m.Elrl;406-586-1818 rC,M1Ig1:406-586-8881 703 W MENDENHALL not RIESS: LADE MTINSURANCEUNLIMITED.COM BOZEMAN, MT 59715 INSURERS AFFORDING COVERAGE NAIL INSURERA-AUSTIN MUTUAL INSURANCE COMPANY INSURED INSURER B DON DICKSON INSURER C: TRIPLE R MITIGATION INSURER!!: 6640 SYPES CANYON RD INSURER E: BOZEMAN MT 59715 1 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. gNSR... ADDL SUER POLICY EFF POLICY EXP � .�_.-..,..,..m.,...., LTR TYPE OF INSURANCE POLICY NUMBER MMIDOIYYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000__ X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED -- A BP 1731015 09 PREMISES Ea occurrence $100,00© CLAIMS-MADE I'"ll OCCUR MED EXP(Any ere person) s5,000 [PERSONAL&AOVINJURY $1,000,000 .... GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPfOPAGG 82,000,000 POLICY PRO LOC JECI F7 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 300 0.00 `{2/13 09/1.2/14 Ea accident _m $ ANY AUTO BODI LY I NJURY(Per person) $ -- ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS PROPERTY DAMAGE - HIRED AAUTOS ( NON-OWNED $ .... AUTOS Per accidonl $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ S WORKERS COMPENSATION 0TH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERtEXECUTIVE F— E-L.EACH ACCIDENT S NIA _ CFFICER(MEMBER EXCLUDED? {Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ Ifyes,deseriba under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS d LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION TOBIAS &CARRIE MCiCLAU'GHRY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1050 BOYLAN RD#fi18 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN BOZEMAN, MT 59715 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CADE RASMUSSEN O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Printed by CCR on October 18,2013 at 08A8AM Exhibit C TENANT ACKNOWLEDGEMENT 1, (Tenant's Name), agree to cooperate with and allow the City of Bozeman (City), its consultants and contractors to enter the property and dwelling I lease from , Owner(s)/Land lord, located at (address) in Bozeman NIT to design, install, monitor, operate, and maintain a sub-slab depressurization system and other measures for the purpose mitigating subsurface vapor intrusion. I have been provided with a copy, of the Access Agreement entered in to between Owner and City for the same purpose and agree to comply with all applicable terms. Date: Owner- Printed Name Signature