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HomeMy WebLinkAboutPW13-236 - Amendment - #1 - Gray & Osborne, Inc. - Light Pole Repair - 09/26/2013 r ' ��. Records Management ., Document CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: Gray & Osborne Inc. Vendor Number: JD Edwards Number Contract Number: 1?W 1 This is assigned by City Clerk's Office Project Name: Standard Detail Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 9/26/13Termination Date: 10/31/13 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: John Rostad Department: Engineering Detail: (i.e. address, location, parcel number, tax id, etc.): Extend the time of completion to October 31, 2013 so the consultant can consider alternative repair procedures. S:Publlc\RecordsManagement\Forms\ContractCover\adec7832 11108 0. KENT V/A9MINOTON AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: Gray & Osborne, Inc. CONTRACT NAME & PROJECT NUMBER: Standard Detail for Repair of Existing Light Pole Standards ORIGINAL AGREEMENT DATE: August 29, 2013 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: The scope of work remains the same, however an amendment is needed to extend the time of completion to October 31, 2013 so the Consultant can consider alternative repair procedures. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are modified as follows: Original Contract Sum, $1,900.00 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $1,900.00 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $1,900.00 AMENDMENT - 1 OF 2 Original Time for Completion 9/30/13 (insert date) Revised Time for Completion under a/a prior Amendments (insert date) Add'I Days Required (t) for this 31 calendar days Amendment Revised Time for Completion 10/31/13 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VENDOR: CITY OF KENT: _ � � n 4/7 r _ _ L (sign �, e p) (signature) Prjpame: �fZm_ Print Name: Steve Mullen, P.E. Its ez L -r— Its Transportation Engineering Manager e) (title) DATE: 1� � /� DATE: APPROVED AS TO FORM: (applicable If Mayor's signature required) Kent Law Department Gray&Ofinrne-St Light Restoration Amd 1/RosWd AMENDMENT - 2 OF 2 ACil CERTIFICATE OF LIABILITY INSURANCE 9l11/2013 OATS YYY 13 ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES GLOW. 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 Ileu of such endorsemen s. PRODUCER CONTACT NAME:.. Michael J Hall&Cc Michael J Hall& Company a o"N 0-598_3700 iuc Np: Hall&Company E-MAIL 19660 1 Oth Ave N E ADORE$$, "Cates. halland .co POulsb0 WA 98370 _ _ INSURER(S)AFFORDING COVERAGE NAICq IN�_CAS INS CO 2 INSURED 4 INSURER B:TRAVELERS CAS&SURETY CO OF AM 194 _ Gray&Osborne Inc INSURER C: 701 Dexter Avenue N#200 -" Seattle WA 98109 INSURER D _ INSURER E: INSURER"E: ... COVERAGES CERTIFICATE NUMBER:2108202879 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. ILTR TYPE OF INSURANCE BR POLICYEFF POLICY EXP - - _-- I SR WVD POLICYNUMBER MMIDDNYYY MM/DDNYYY LIMITS A I GENERAL LIABILITY 2SBADU7303 /10/2013 /10/2014 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES AMAGE T Ea occurO R rence) $300,000 ! CLAIMS-MADE I OCCUR ( y semen) $10 000 MED EXP An one arson HX OCP/XCU/BFPD PERSONAL&ADV INJURY $1,000.000 Separation lnsds GENERAL AGGREGATE $2,000.000 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMPIOP ASS $2,000,000 q L POLICY X PRO- Lee $ -- I AUTOMOBILE LIABILITY 52UECJS3276 /10/2013 /10/2014 COMBINED DISIN LELMIT 1000000 _ -f ANY AUTO BODILY INJURY(Per person) $ ALL UTOS OS P AUTOS SCHEDULEDAU BODILY INJURYPeraccident) $ HIREDAUTOSNUN-OWNED -PROPERTYDAMAGE AUTOS (Per...Ideal) $ Is A X I UMBRELLA LIAB Xd OCCUR 52SBADU7303 /1012013 /10/2014 EACH OCCURRENCE 11,DDD,DDD _ EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 ,0 _ $ DEs X RETENTION$10,000 AND EMPLOYERS'LIABILITY YIN "tSBADU7303 ?/'16/2U"i3 7111/20i4 TORyIIMITS X '0'rH- WA Stop Gap. ANV PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1AStoo00 OFFICERIMEMBER EXCLUDED? ❑ N/A _ _.. _ (Mandatory In NH) E.L.DISEASE-F?,EMPLOYE $1,000,000 If yes,describe antler - -- DESCRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICY LIMIT $1,000,000 B Professional Liab:Claims Made 105339819 MO/2013 /10/2014 $1,000,000 Per Claim S1,DDD,DDD Aggregate ',, DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) III Re:Light Standard Detail City of Kent is an addltlonal insured per written contract or agreement between insured and insured's client on the General Liability and Automobile Liability regarding liability arising out of activities by or on behalf of the named insured. This insurance is primary insurance and any other insurance maintained by the Additional Insured shall be excess only and non-contributing with this insurance. A waiver of subrogation applies to the General Liability,Auto Liability, &Employers Liability and Umbrella!Excess Liability in favor of the Additional Insured, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Kent ACCORDANCE WITH THE POLICY PROVISIONS. 1 400 West Gowe Kent WA 98032 AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Policy#528BAOU7303 BUSINESS LIABILITY COVERAGE FORM (b) Rented to, In the care, custody or b. Coverage under this provision does not control of, or over which physical apply to: control is being exercised for any (1) "Bodily injury" or "property damage" purpose by you, any of your that occurred;or 'employees", "volunteer workers", any partner or member (If you are (2) "Personal and advertising injury" a partnership or joint venture), or arising out of an offense committed any member (if you are a limited before you acquired or formed the liability company). organization. b. Real Estate Manager 4. Operator Of Mobile Equipment Any person (other than your"employee"or _ With respect to"mobile equipment" registered in "volunteer worker"), or any organization your name under any motor vehicle registration while acting as your real estate manager. law, any person is an Insured while driving such c. Temporary Custodians Of Your equipment along a public highway with your Property permission, Any other person or organization Any parson or organization having proper responsible for the conduct of such person is also an Insured, but only with respect to liability temparary custody of your properly if you arising out of the operation of the equipment,and die,but only: only if no other insurance of any kind is available (1) With respect to liability arising out of the to that person or organization for this liability. . maintenance or use of that property;and However,no person or organization is an insured (2) Unfit your legal representative has with respect to: been.appointed. a, "Bodily injury" to a co-"employee" of the d. Legal Representative If You Die person driving the equipment;or Your legal representative if you die, but b• "Property damage" to property owned by, . only with respect to duties as such. That rented to, in the charge of or occupied by representative will have all your rights and you or the employer of any person who is duties under this insurance. an insured under this provision. e. Unnamed Subsidiary S. Operator of Nonowned Watercraft Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that yours which is a legally incorporated entity is less than 51 feet long and is not being used of which you own a financial interest of to carry persons for a charge,any person Is an more than 50°/o of the voting stock on the insured while operating such watercraft with effective date of this Coverage Part. your permission, Any other person or The insurance afforded herein for any organization responsible for the conduct of subsidiary not shown in the Declarations such person is also an insured, but only with as a named. insured does not apply to respect to liability arising out of the operation injury or damage with respect to which an of the watercraft, and only if no other insured under this insurance Is also an Insurance of any kind is available to that insured under another policy or would be person or organization for this liability, an insured under such polioy but for Its However, co person or organization is an termination or upon the exhaustion of its Insured with respect to: limits of insurance. a. "Bodily injury" to a co-"employee" of the 3. Newly Acquired Or Formed Organization person operating the watercraft;or Any organization you newly acquire or form, b• "Property damage" to property owned by, other than a partnership, joint venture or rented to, in the charge of or occupied by . limited liability company, and over which you you or the employer of any person who is maintain financial interest of more than 50% of an Insured under this provision. the voting stock, will qualify as a Named 6. Additional Insureds When Required By insured If there Is no other similar insurance Written Contract, Written Agreement Or available to that organization. However: Permit a. Coverage under this provision is afforded The person(s) or organization(s) identified in only until the 180th day after you acquire Paragraphs a. through f. below are additional or,fomm the organization or the end of the insureds when you have agreed, in a written policy period,whichever is earlier; and Form SS 00 08 04 05 Page 11 of 24 The Hartford Policy#52SBADU7303 BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a (e)' Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the Injury or damage occurs undertakes to make In the usual subsequent to the execution of the contract or course of business, in connection agreement, or the Issuance of the permit. with the distribution or sale of the A *person or organization is an additional products; Insured under. this provision only for that (f) Demonstration, installation, period of time required by the contract, servicing or repair operations, agreement or permit. except such operations performed However, no such parson or organization is an at the vendor's premises Inconnection with the sale of the additional insured under this provision if such product; person or organization is Included as an additional Insured by an endorsement issued (g) Products which, after distribution by us and made a part of this Coverage Part, or sate by you, have been labeled including all persons or organizations added or .relabeled or used as a as additional insureds under the specific container, part or Ingredient of any additional Insured coverage grants in Section other thing or substance by or for F,—Optional Additional Insured Coverages, the vendor;or a. Vendors (h) "Bodily injury" or "property i Any person(s)or organizadon(s) (referred to damage" arising out of the sole below as vendor), but only with respect to negligence of the vendor for its "bodily injury" or "properly damage" existing own acts or omissions or those ofng its employees or anyone else out of "your products" which are distributed acting on its behalf. However,this or sold in the regular course of the vendor's exclusion does not apply to: business and only if this Coverage Part provides coverage for "bodily injury" or (1) The exceptions contained in "property damage" included within the Subparagraphs(d) or(f); or "products-completed operations hazard", (ff) Such inspections, adjustments, (1) The Insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions: undertakes to make in the usual This Insurance does not apply to: course of business, inconnection with the distribution (a) "Bodily injury" or "property or sale of the products. damage" for which the vendor is obligated to pay damages by (2) This insurance does not apply to any reason of the assumption of insured person or organization from liability in a contract or agreement, whom you have acquired such products, This exclusion does not apply to or any ingredient, part or container, liability for damages that the entering into, accompanying or vendor would have in the absence containing such products. of the contract or agreement; b, Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only (c) Any physical or chemical change with respect to their liability for "bodily in the product made intentionally injury", "property damage" or "personal and advertising Injury" by the vendor; caused, In whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization. or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Page 12 of 24 Form SS 00 08 04 05 Policy#52SaADU7303Pdicy# 528BADU7303 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded e. Permits Issued By State Or Political to these additional insureds, this Subdivisions insurance does not apply to any (1) Any state or political subdivision, but "occurrence" which takes place after' only with respect to operations you cease to lease that equipment. performed by you or on your behalf for c. Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organization from has issued a permit. whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to: of that part of the land or premises (a) "Bodily injury", "properly damage" leased to you. or "personal and advertising (2) With respect to the insurance afforded injury" arising out of operations to these additional insureds, this performed for the state or insurance does not apply to: municipality;or (a) Any "occurrence" which takes . (b) "Bodily Injury"or"property damage" place after you cease to lease that included within the "products- land or be a tenant in that completed operations hazard". premises;or f. Any Other Party (b) Structural alterations, new (1) Any other person or organization who construction or ' demolition is not an insured under Paragraphs a. operations performed by or on through e. above, but only with behalf of such person or respect to liability for "bodily injury", organization. "property damage" or "personal and d.,Architects, Engineers Or Surveyors advertising injury" caused, In whole or (1) Any architect, engineer, or surveyor,but in part, by your acts or omissions or only with respect to liability for "bodily the acts or omissions of those acting injury", "property damage" or "personal on your behalf: and advertising Injury" caused, In whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of those acting on (b) In connection with your premises your behalf: owned by or rented to you; or (a) In connection with your premises; (c) In connection with"your work"and or Included within the "products- (b) In the performance of your completed operations hazard", but ongoing operations performed by only if you or on your behalf. (1) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional Insureds, the provide such coverage to following additional exclusion applies: such additional Insured;and This insurance does not apply to (ii) This Coverage Part provides "bodily Injury", "property damage" or coverage for "bodily injury" or "personal and advertising injury" "property damage" included arising out of the rendering of or the within the "products- failure to render any professional completed operations hazard", services by or for you,including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, reports, surveys, field orders, Bodily injuryn "property damage" or change orders, designs or personal and advertising injury" g g arising out of the rendering of, or the drawings and specifications;or (allure to render, any professional (b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services, including: activities. Form 88 00 03 04 05 Page 13 of 24 Policy#52SBADU7303 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or This General Aggregate limit does not failure to prepare or approve, apply to "property damage" to premises maps, shop drawings, opinions, while rented to you or temporarily reports, surveys, field orders, occupied by you with permission of the change orders, designs or owner, arising out of fire, lightning or drawings and specifications; or explosion. (b) Supervisory, inspection, 3. Each Occurrence Limit architectural or ''engineering Subject to 2.a, or 2.b above, whichever activities. applies, the most we will pay for the sum of all The limits of insurance that apply to additional damages 'because of all "bodily injury" insureds are described in Sectlon D. — Limits "property damage" ,and medical expenses Of Insurance. arising out of any one "occurrence" is the How this insurance applies when other Liability and Medical Expenses Limit shown in insurance is available to an additional insured the Declarations. is descrlbed In the Other Insurance Condition The most we will pay for all medical expenses in Section E.--Liability And Medical Expenses because of "bodily injury" sustained by any General Conditions, one person is the Medical Expenses Limit No person or organization Is an Insured with shown in the Declarations, respect to the conduct of any current or past 4. Personal And Advertising Injury Limit partnership, joint venture or limited liability Subject to 2.b.above, the most we will pay for company that is not shown as a Named Insured in the sum of all damages because of all the Declarations_ personal and advertising injury" sustained by D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal LIMITS OF INSURANCE and Advertising Injury Limit shown in the Declarations. 1. The Most We Will Pay 5. Damage To Promises Rented To You Limit The Limits of Insurance shown in the The Damage To Premises Rented To You Declarations and the rules below fix the most we will pay regardless of the number-of, Limit is the most we will pay under Business a. Insureds; Liability Coverage for damages because of "property damage" to any one premises, while b. Claims made or"suits"brought; or rented to you, or in the case of damage by fire, c. Persons or organizations making claims or lightning or explosion, while rented to you or bringing "suits". temporarily occupied by you with permission of 2. Aggregate Limits the owner. The most we will pay for: In the case of damage by fire, lightning or explosion,the Damage to Premises Rented To a. Damages because of "bodily injury" and You Limit applies to all damage proximately "property damage" Included in the caused by the same event, whether such "products-completed operations hazard" Is damage results from fire, lightning or explosion the Products-Completed Operations or any combination of these. Aggregate Limit shown In the G. How Limits Apply To Additional Insureds Declarations. b. Damages because of all other "bodily The most we will pay on behalf of a person or injury", "property damage" or "personal organization who is an additional Insured and advertising injury", including medical under this Coverage Part is the lesser of: expenses, is the General Aggregate Limit a. The limits of insurance specified in a shown in the Declarations. written contract, written agreement or This General Aggregate Limit applies permit issued by a state or political separately to each of your "locations" subdivision;or owned by or rented to you. b. The Limits of Insurance shown in the "Location" means premises involving the Declarations. same or connecting lots, or premises Such amount shall be a part of and not In whose connection Is interrupted only by a addition to the Limits of Insurance shown in street, roadway or right-of-way of a the Declarations and described in this Section. railroad. Page 14 of 24 Form SS 00 08 04 05 Policy#52SBADU7303 BUSINESS LIABILITY COVERAGE FORM If more than one limit of insurance under this (1) Immediately send us copies of any policy and any endorsements attached thereto demands, notices, summonses or applies to any claim or"suit", the most we will pay legal papers received, In connection under this. policy and the endorsements is the with the claim or"suit"; single highest limit of liability of all coverages (2) Authorize us to obtain records and applicable to such claim or "suit". However, this other Information; paragraph does not apply to the Medical Expenses limit set forth In Paragraph 3.above. (3) Cooperate with us In the investigation, settlement of the claim or defense The Limits of Insurance of this Coverage Part apply against the"suit": and separately to each consecutive annual period and to (4) Assisi us, upon our request,, In the any remaining period of less than 12 months,starting enforcement of any right against any with the beginning of the policy period shown in the be may person or organization that m Declarations, unless the policy period is extended liable to the Insured because be after issuance for an additional period of less than 12 ry or damage to which this Insurance months. In that case, the additional period will be may also apply. deemed part of the fast preceding period for purposes of determining the Limits of Insurance, d, Obligations At The Insured's Own Cost E. LIABILITY AND MEDICAL EXPENSES No insured will, except at that insured's own GENERAL CONDITIONS cost, voluntarily make a payment, assume any obligation, or Incur any expense, other 1. Bankruptcy than for first aid,without our consent Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance the insured's estate will not relieve us of our If we cover a claim or "suit" under this obligations under this Coverage Part. Coverage Part that may also be covered 2. Duties In The Event Of Occurrence, by other insurance available to an Offense,Claim Or Suit additional insured, such additional insured a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the other insurer for defense and indemnity. You or any additional Insured must see s; However, this provision does not apply to It- that we are notified as soon as p pp y practicable of an "occurrence" or an the extent that you have agreed in a offense which may result in a claim. To written contract, written agreement or - j the extent possible, notice should include: permit that this insurance is primary and non-contributory with the additional (1) How,when and where the "occurrence" Insured's own insurance, or offense ace; f, Knowledge Of An Occurrence, Offense, (2) The nameses and addresses of any Claim Or Suit Injured persons and witnesses;and Paragraphs a. and b. apply to you or to (3) The nature and location of any injury any additional Insured only when such or damage arising out of the "occurrence", offense, claim or "suit" is "occurrence"or offense. known to: b, Notice Of Claim (1) You or any additional insured that Is If a claim is made or "suit" is brought an individual; against any Insured, you or any additional (2) Any partner, If you or an additional insured must: insured is a partnership; (1) Immediately record the specifics of the claim or "suit" and the date received; (3) Any manager, if you or an additional insured is a limited liability company; and (2) Notify us as soon as practicable. (4) Any "executive officer" or insurance manager, if you or an additional You or any additional insured must see to insured is a corporation; it that we receive a written notice of the claim or"suit"as soon as practicable. (5) Any trustee, if you or an additional insured is a trust; or c. Assistance And Cooperation Of The (6) Any elected or appointed official, If you Insured or an additional insured is a political You and any other Involved Insured must: subdivision or public entity. Form SS 00 08 04 05 Page 15 of 24 Policy#5'2SBADU7303 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to (3) We have issued this policy in reliance you and any additional insured. upon your representations, 3. Financial Responsibility Laws b. Unintentional Failure To Disclose a. When this policy Is certified as proof of Hazards financial responsibility for the future under If unintentionally you should fail to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the 'inception date of this provided by the policy for "bodily injury" Coverage Part, we shall not deny any liability and "property damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of 7, Other Insurance Insurance required by that law. b. With respect to "mobile equipment" to If other valid and collectible. insurance Is which this insurance applies, we will available for a loss we cover under this provide any liability, uninsured motorists, Coverage Part, our obligations are limited as underinsured motorists, no-fault or other follows; coverage required by any motor vehicle � a. Primary Insurance law. We will provide the required limits for This insurance is primary except when b. those coverages. below applies. If other insurance is also 4. Legal Action Against Us primary, we will share with all that other No person or organization has a right under insurance by the method described in c. this Coverage Form: below. a. To join us as a party or otherwise bring us b. Excess Insurance Into a "sutt" asking for damages from an This insurance is excess over any of the insured; or other insurance, whether primary, excess, b. To sue us on this Coverage Form unless contingent or on any other basis: all of its terms have been fully complied (1) Your Work with, That is Fire, Extended Coverage, A person or organization may sue us to recover Builder's Risk, Installation Risk or on an agreed settlement or on a final judgment similar coverage for"your work"; against an insured; but we will not be liable for (2) Premises Rented To You damages that are not payable under the terms of That is fire, lightning or explosion insurance for premises rented you this insurance or that are in excess of the applicable limit of insurance. An agreed in temporarily occupied you with settlement means a settlement and release of permission of the owner; liability signed by us, the insured and the claimant or the claimant's legal representative. (3) Tenant Liability 5. Separation Of Insureds That is insurance'purchased by you to JIN Except with respect to the Limits of Insurance, cover your liability as a tenant for and any rights or duties specifically assigned "property damage" to premises rented in this policy to the first Named Insured, this to you or temporarily occupied by you insurance applies: with permission of the owner; a. As if each Named Insured were the only (4) Aircraft,Auto Or Watercraft Named insured;and If the loss arises out of the maintenance b. Separately to each insured against whom or use of aircraft, "autos"or watercraft to a claim is made or"suit' is brought, the extent not subject to Exclusion g. of Section A.—Coverages. 6, Representations (5) Property Damage To Borrowed a. When You Accept This Policy Equipment Or Use Of Elevators By accepting this policy, you agree: If the loss arises out of "property (1) The statements in the Declarations damage" to borrowed equipment or are accurate and complete; the use of elevators to the extent not (2) Those statements are based upon subject to Exclusion k, of Section A.— representations you made to us;and Coverages. Page 16 of 24 Form SS 00 08 04 05 i Policy#528RADU7303 BUSINESS LIABILITY COVERAGE FORM (6) When You Are Added As An When this Insurance is excess over other Additional Insured To Other Insurance, we will pay only our share of Insurance the amount of the loss, if any, that That is other insurance available to exceeds the sum of: you covering liability for damages (1) The total amount that all such other arising out of the premises or insurance would pay for the loss in the operations, or products and completed absence of this insurance; and operations, for which you have been (2) The total of all deductible and self- added as an additional insured by that insured amounts under all that other insurance;or insurance. (7) When You Add Others As An We will share the remaining lass,If any,with Additional Insured To This any other insurance that is not described in Insurance this Excess Insurance provision and was not That Is other Insurance available to an bought specifically to apply in excess of the additional insured. Limits of Insurance shown in the However, the following provisions Declarations of this Coverage Part. apply to other insurance available to e. Method Of Sharing any person or organization who is an if all the other insurance permits additional insured under this Coverage contribution by equal shares,we will follow Part: this method also. Under this approach, (a) Primary Insurance When each insurer contributes equal amounts Required By Contract until it has paid its applicable limit of This insurance is primary if you Insurance or none of the loss remains, have agreed in a written contract, whichever comes first. written agreement or permit.that If any of the other insurance does not permit this insurance be primary. If other contribution by equal shares, we wtif insurance is also primary, we will contribute by limits. Under this method,each share with all that other Insurance Insurer's share is based on the ratio of its by the method described in c, applicable limit of Insurance to the total below, applicable limits of insurance of all insurers, " (b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against To ' Other Insurance When Others To Us Required By Contract a. Transfer Of Rights Of Recovery If you have agreed in a written If the insured has rights to recover all or contract, written agreement or part of any payment, Including permit that this insurance is Supplementary Payments, we have made primary and non-contributory whit under this Coverage Part, those rights are the additional insured's own transferred to us. The insured must do insurance, this insurance is nothing after loss to impair them, At ogry primary and we will not seek request, the insured will bring "suit" or contribution from that other transfer those rights to us and help us insurance. enforce them. This condition does not Paragraphs (a) and (b)do not apply to apply to Medical Expenses Coverage. other insurance to which the additional `3 b, Waiver Of Rights Of Recovery (Waiver insured has been added as an Of Subrogation) additional insured. If the insured has waived any rights of When this insurance Is excess, we will recovery against any person or have no duty under this Coverage Part to organization for all or part of any payment, defend the Insured against any"suit" if any Including Supplementary Payments, we other insurer has a duty to defend (lie have made under this Coverage Part, we insured against that "suit". If no other also waive that right, provided the insured insurer defends, we will undertake to do waived their rights of recovery against so, but we will be entitled to the insured's such person or organization in a contract, rights against all those other insurers. agreement or permit that was executed prior to the injury or damage. Fonn SS 00 08 04 05 Page 17 of 24 i Pdicy#G2UECJS3276 y THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AND RIGHTS OF RECOVERY AGAINST OTHERS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM i A. Any person or organization whom you are required by contract to name as additional insured is an "Insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision of Section II - LIABILITY COVERAGE. B. For any person or organization for whom you are required by contract to provide a waiver of subrogation, the Loss Condition-TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable. i I ill Form HA 99 13 0187 Printed in U.S.A.