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HomeMy WebLinkAboutPW13-004 - Amendment - #2 - A & M Consulting - Utility Coordination Downey Farmstead Project - 12/10/2014 Records manage me KENT Document W ASHINOTON Mti� f y R CONTRACT COVER SHEET i 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. I Vendor Name: A & M Consulting Vendor Number: JD Edwards Number Contract Number: Or, g v !`) - 06 ` 00 This is assigned by City Clerk's Office Project Name: Downey Farmstead Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 12/10/14 Termination Date: 12/31/15 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Alex Murillo Department: Engineering Contract Amount: I Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Extend the time of completion to December 31, 2015. i As of: 08/27/14 i I • KENT wnani«...on ' I AMENDMENT NO. 2 NAME OF CONSULTANT OR VENDOR: A & M Consulting CONTRACT NAME & PROJECT NUMBER: Downey Farmstead ORIGINAL AGREEMENT DATE: January 8, 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 December 31, 2015 because project design is continuing. 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, $9,240.00 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $9,240.00 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 j Amendment Revised Contract Sum $9,240.00 i I I I i AMENDMENT - 1 OF 2 i Original Time for Completion 12/31/13 (insert date) Revised Time for Completion under 12/31/14 prior Amendments i (insert date) Add'I Days Required (t) for this 365 calendar days Amendment Revised Time for Completion 12/31/15 (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: yyr� (sign ur?) t —' s (signature) Print Name. F i" r� y�/1" t t �4Imlez Print Name. Timothy J. LaPorte P.E. Its Z/ r Its Public Works Director (title), - j (title) DATE: DATE APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department A&M Consulting- Dmaney Amd 2/Mudllo AMENDMENT - 2 OF 2 JRK DATR(MMT)IINYYY) CERTIFICATE OF LIABILITY INSURANCE Rool 10/17/2014 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. if SUBROGATIONIS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT ME: _ AJ GALLAGHER & CO INS BRKRS CA/PHS PrP O,N,E.q: (866) 467-8730 ( Hap (877) 905-0457 255202 P: (866) 467-8730 F: (877) 905-0457 p pIESB: PO BOX 33015 INSURER(S)AFFORDING COVERAGE "CA ! SAN ANTONIO TX 78265 29424 wsuseR A: Hartford casualtyIns Co INSURED INSURERS: INSURERC: ARNOLD TOMAC DBA A & M CONSULTING INSURERO: 18119 NE 30TH ST INSURER REDMOND WA 98052 INSURERF: 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. INSA TYPEOFINSURANCE ADDL SURR POLICYNUMRE'R POLLCYEFF POLICYRXP LIANTS "ToNODM COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s2, 000, 000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurmnce 5.300, 000 A X General Llab X 72 SSM UK5025 11/01/2014 11/01/2015 MED EXP(Any one Person) $10, 000 PERSONAL A ADV INJURY s2, 000, 000 Call AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s4, 000, 000 POLICYa PRO-[E LOC PRODUCTS-GOMPIOPAGO 4, 000, 000 JECT OTHER: AUTOMOBILE LIABILITY (Ea azicid Dt'INGLE OMIT s2, 000, 000 ANY AUTO BODILY INJURY(Per parson) 'I A ALL OWNED SCHEDULED' 72 SEN UK5025 11/01/2014 11/01/2015 BODILY INJURY(Per $ AUTOS AUTOS X HIRED AU70S X NON-0N ED PROPERTY DAMAGE IL AUTOS (Pefacchart) UMBRELLA LIAB OCCUR EACH OCCURRENCE EEE EXCESS LIAB CLAIMS-MADE AGGREGATE oEo (P6NS IVIAATI,"ON'r IVOFA'F.'R.S[Od PER OTW A.)LIN OYINGTIJABILITY STATUTE ER ANYPROPRIETORAPARTNEWEXECUTIVE YIN El,EACH ACCIDENT s OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NUJ NIA E.L. EA DISSEEA- EMPLOYEE 9 If yes,describa under EL.DISEASE-POLICY UNIT $ DESCRIPTION OF OPERATIONS below A ENE STOP GAP 72 SBM UK5025 11/01/2014 11/01/2015 $1,000,000/1,000,000/1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD lot,Additional Remarks Schedule,maybe attached If more space is required) Those usual to the Insured's Operations. Certificate Holder is an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE The City of Kent DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Engineering AUTHORIZEDREPRESENTATIVE 222 4TH AVE S KENT, WA 98032 ©1988-2014 ACORD CORPORATION,All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD i IMPORTANT NOTICE TO POLICYHOLDERS To help your insurance keep pace with Increasing costs, we have increased your amount of insurance . . . giving you j r better protection in case of either a partial,or total loss to your property. LO a i If you feel the new amount is not the proper one, please contact your agent or broker. M c-I O C N O Lf] CV Lf) N O O f" 44 !� n 25 This Spectrum Policy consists of the Declarations, Coverage Forms, Common Policy Conditions and any 50 other Forms and Endorsements Issued to be a part of the Policy. This insurance is provided by the stock UK insurance company of The Hartford Insurance Group shown below. SBM INSURER: HARTFORD CASUALTY INSURANCE COMPANY i ONE HARTFORD PLAZA, HARTFORD, CT 06155 COMPANY CODE: 3 Policy Number: 52 SBM UK5025 DX THE HARTFORD SPECTRUM POLICY DECLARATIONS ORIGINAL Named Insured and Mailing Address: ARNOLD TOMAC DBA A & M (No., Street, Town, State, Zip Code) CONSULTING h 18119 N.E. 30TH STREET REDMOND WA 98052 m a Policy Period: From 11/01/12 To 11/01/13 1 YEAR Ln 12:01 a.m., Standard time at your mailing address shown above. Exception: 12 noon in New Hampshire. ca Name of Agent/Broker: AJ GALLAGHER RSK MGMT SVCS INC/PHS Ln Code: 812490 N c"v Previous Policy Number: 52 SBM UK5025 0 0 Named Insured is: INDIVIDUAL Audit Period: NON-AUDITABLE Type of Property Coverage: NONE Insurance Provided: in return for the payment of the premium and subject to all of the terms of this policy,we agree with you to provide insurance as stated in this policy. TOTAL ANNUAL PREMIUM IS: $425 MP IN RECOGNITION OF THE MULTIPLE COVERAGES INSURED WITH THE HARTFORD, YOUR POLICY PREMIUM INCLUDES AN ACCOUNT CREDIT. i i Countersigned by 09/17/12 Authorized Representative Date Form SS 00 02 12 06 Page 001 (CONTINUED ON NEXT PAGE) Prnracc nnta• 09/17/12 Pnlicv Fxniratinn Data- 11/01/13 SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 BUSINESS LIABILITY LIMITS OF INSURANCE LIABILITY AND MEDICAL EXPENSES $1, 000,000 MEDICAL EXPENSES -ANY ONE PERSON $ 10,000 PERSONAL AND ADVERTISING INJURY $1,000,000 i I DAMAGES TO PREMISES RENTED TO YOU $ 300,000 rn ANYONE PREMISES I o AGGREGATE LIMITS PRODUCTS-COMPLETED OPERATIONS $2,000,000 m 0 GENERAL AGGREGATE $2, 000,000 Ln o EMPLOYMENT PRACTICES LIABILITY Ln COVERAGE: FORM SS 09 01 N N EACH CLAIM LIMIT $ 5,000 0 0 DEDUCTIBLE -EACH CLAIM LIMIT NOT APPLICABLE AGGREGATE LIMIT $ 5,000 RETROACTIVE DATE: 11012005 I This Employment Practices Liability Coverage contains claims made coverage. Except as may be otherwise provided herein, specified coverages of this insurance are limited generally to liability for injuries for which claims are first made against the insured while the insurance is in force. Please read and review the insurance carefully and discuss the coverage with your Hartford Agent or Broker. The Limits of Insurance stated in this Declarations will be reduced, and may be completely exhausted, by the payment of"defense expense" and, in such event, The Company will not be obligated to pay any further"defense expense" or — sums which the insured is or may become legally obligated to pay as "damages". j BUSINESS LIABILITY OPTIONAL COVERAGES HIRED/NON-OWNED AUTO LIABILITY $1, 000,000 j FORM: SS 01 70 III � III II I Form SS 00 02 12 06 Page 003 (CONTINUED ON NEXT PAGE) SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 I ADDITIONAL INSUREDS: THE FOLLOWING ARE ADDITIONAL INSUREDS FOR BUSINESS LIABILITY COVERAGE IN THIS POLICY. LOCATION 001 BUILDING 001 TYPE MANAGER LESSOR 0 NAME SEE FORM IH 12 00 r� 0 t+t ri .-i 0 to LO O cV N O O rl k O I s Form SS 00 02 12 06 Page 005 (CONTINUED ON NEXT PAGE) SPECTRUM POLICY DECLARATIONS (Continued) POLICY NUMBER: 52 SBM UK5025 SUPPLEMENTAL DECLARATIONS: A service fee of $ 0006 00 is charged for each installment when your premium is paid in installments. The service fee is $ 0006 .00 per withdrawal when you select an electronic fund transfer payment plan. The service fee will be added to the premium amount shown on your premium billing statement. I E- h O M O N N Ln Lli N N O O M o II Form SS 00 45 12 06 Process Date: 09/17/12 Policy Expiration Date: 11/01/13 it I I i i N O M c-I O N O U�C±1 N tll N O O M COMMON POLICY CONDITIONS i, i Form SS 00 05 12 06 COMMON POLICY CONDITIONS All coverages of this policy are subject to the following conditions. A. Cancellation (5) Failure to: 1. The first Named Insured shown in the (a) Furnish necessary heat, water, Declarations may cancel this policy by mailing sewer service or electricity for 30 or delivering to us advance written notice of consecutive days or more, except cancellation. during a period of seasonal 2. We may cancel this policy by mailing or unoccupancy; or delivering to the first Named Insured written (b) Pay property taxes that are owing m notice of cancellation at least: and have been outstanding for a. 5 days before the effective date of more than one year following the cancellation if any one of the following date due, except that this oconditions exists at any building that is provision will not apply where you are in a bona Covered Property in this policy: fide dispute with the taxing authority regarding payment C, (1) The building has been vacant or of such taxes. 'n unoccupied 60 or more consecutive "' b. 10 days before the effective date of o days. This does not apply to: M a) Seasonal unoccu anc ; or cancellation if we cancel for nonpayment x ( P y of premium. (b) Buildings in the course of c. 30 days before the effective date of construction; renovation or cancellation if we cancel for any other addition. reason. Buildings•with 65% or more of the rental 3. We will mail or deliver our notice to the first units or floor area vacant or unoccupied Named Insured's last mailing address known o are considered unoccupied under this to us. provision. (2) After damage by a Covered Cause of 4. Notice of cancellation will state the effective date of cancellation. The policy period will end Loss, permanent repairs to the on that date. building: S. If this policy is canceled, we will send the first (a) Have not started; and Named Insured any premium refund due. (b) Have not been contracted for, Such refund will be pro rata. The cancellation within 30 days of Initial payment of will be effective even if we have not made or loss. offered a refund. 6. If notice is mailed, proof of mailing will be (3) The building has: sufficient proof of notice. (a) An outstanding order to vacate; 7. If the first Named Insured cancels this policy, (b) An outstanding demolition order; we will retain -no less than $100 of the or premium. (c) Been declared unsafe by B. Changes governmental authority. This policy contains all the agreements between you (4) Fixed and salvageable items have and us concerning the insurance afforded. The first been or are being removed from the Named Insured shown in the Declarations is building and are not being replaced, authorized to make changes in the terms of this policy This does not apply to such removal with our consent. This policy's terms can be — that is necessary or incidental to any amended or waived only by endorsement issued renovation or remodeling, by us and made a part of this policy. Form SS 00 05 12 06 Page 1 of 3 i COMMON POLICY CONDITIONS I c. Yourtenant. L. Premium Audit You may also accept the usual bills of lading or a. We will compute all premiums for this policy in shipping receipts limiting the liability of carriers. accordance with our rules and rates. This will not restrict your insurance. b. The premium amount shown in the K. Transfer Of Your Rights And Duties Under This Declarations is a deposit premium only. At the Policy close of each audit period we will compute the Your rights and duties under this policy may not be earned premium for that period. Any transferred without our written consent except i p due as a result n additional premium found the case of death of an individual Named Insured. of the audit are due and payable on notice to the first Named Insured. If the deposit If you die, your rights and duties will be transferred premium paid for the policy term is greater to your legal representative but only while acting than the earned premium, we will return the within the scope of duties as your legal excess to the first Named Insured. representative. Until your legal representative is c. The first Named Insured must maintain all appointed, anyone having proper temporary records related to the coverage provided by custody of your property will have your rights and this policy and necessary to finalize the o duties but only with respect to that property. premium audit, and send us copies of the N same upon our request. 0 rV Lrl CV 0 r i Our President and Secretary have signed this policy. Where required by law,the Declarations page has also been N countersigned by our duly authorized representative. Terence Shields,Secretary Andr6 A.Napoli,President i it Ii THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM This endorsement modifies insurance provided under the following: BUSINESS LIABILITY COVERAGE FORM o OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM SPECIAL PROPERTY COVERAGE FORM STANDARD PROPERTY COVERAGE FORM UMBRELLA LIABILTY PROVISIONS O C N O A. Disclosure Of Federal Share Of Terrorism 3. The act Is a violent act or an act that is N Losses dangerous to human life, property or N The United States Department of the Treasury will infrastructure and is committed by an individual o reimburse insurers for 85% of that portion of insured or Individuals acting as part of an effort to losses attributable to"certified acts of terrorism"that coerce the civilian population of the United * exceeds the applicable insurer deductible. States or to influence the policy or affect the However, if aggregate industry insured losses under conduct of the United States Government by — coercion. the federal Terrorism Risk Insurance Act, as amended ("TRIA") exceed $100 billion in a Program If aggregate industry insured losses attributable to Year (January 1 through December 31), the "certified acts of terrorism" under TRIA exceed $100 Treasury shall not make any payment for any billion in a Program Year (January 1 through portion of the amount of such losses that exceeds December 31), and we have met, or will meet, our $100 billion. The United States government has not insurer deductible under TRIA, we shall not be liable charged any premium for their participation in for the payment of any portion of the amount of such covering terrorism losses. losses that exceed $100 billion. In such case, your B. coverage for terrorism losses may be reduced on a . Cap On Insurer Liability for Terrorism Losses pro-rata basis in accordance with procedures A "certified act of terrorism" means an act that is established by the Treasury, based on its estimates certified by the Secretary of the Treasury, in of aggregate industry losses and our estimate that concurrence with the Secretary of State and the we will exceed our insurer deductible. In Attorney General of the United States to be an act accordance with the Treasury's procedures, of terrorism under TRIA. The criteria contained in amounts paid for losses may be subject to further TRIA for a "certified act of terrorism" include the adjustments based on differences between actual following: losses and estimates. 1. The act results in insured losses in excess of$5 C. Application Of Exclusions million in the aggregate, attributable to all types The terms and limitations of any terrorism exclusion, of insurance subject to TRIA; and the inapplicability or omission of a terrorism 2. The act results in damage within the United exclusion, or the inclusion of terrorism coverage, do States, or outside the United States in the case not serve to create coverage for any loss which of certain air carriers or vessels or the premises would otherwise be excluded under this Coverage of an United States mission;and Form or Policy, such as losses excluded by the Nuclear Hazard Exclusion or the War And Military Action Exclusion. Form SS 50 19 03 12 Page 1 of 1 O 2012, The Hartford it POLICY NUMBER: 52 SBM UK5025 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. I i ADDITIONAL INSURED - MANAGER/LESSOR II THE CITY OF KENT h PUBLIC WORKS ENGINEERING 222 FOURTH AVE. SO. KENT WA 98032 M 14 0 N N Ln N N lfl N 0 0 .-i m Form IH 120011 85 T SEQ.NO. 002 Printed in U.S.A. Page 001 Process Date: 0 9/17/12 Expiration Date: 11/01/13 THE �IARTFORD Named insured: ARNOLD TOMAC DBA A & M Policy Number: 52 SBM UK5025 Effective Date: 11/01/12 Expiration Date: 11/01/13 i Company Name: AJ GALLAGHER RSK MGMT SVCS INC/PHS ! r 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Ln TRADE OR ECONOMIC SANCTIONS ENDORSEMENT N N o This insurance does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from providing insurance, including, but not limited to,the payment of claims. x All otherterms and conditions remain unchanged. Form IH 99 4104 09 Page 1 of 1 POLICY NUMBER: 52 SBM UK5025 THIS ENDORSEMENT IS ATTACHED TO AND MADE PART OF YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. i DISCLOSURE PURSUANT TO TERRORISM RISK LO INSURANCE ACT j r` 0 m SCHEDULE 0 Cq N O Ill NTerrorism Premium(Certified Acts): LO o $ $5.00 0 n1 A. Disclosure Of Premium C. Cap On Insurer Liability for Terrorism Losses In accordance with the federal Terrorism Risk If aggregate industry Insured losses attributable to Insurance Act, as amended ("TRIA"), we are "certified acts of terrorism" under TRIA exceed $100 required to provide you with a notice disclosing the billion in a Program Year (January 1 through portion of your premium, if any, attributable to December 31) and we have met, or will meet, our coverage for certified acts of terrorism under TRIA. insurer deductible under TRIA, we shall not be liable The portion of your premium attributable to such for the payment of any portion of the amount of such coverage is shown in the Schedule of this losses that exceed $100 billion. In such case, your endorsement. coverage for terrorism losses may be reduced on a B. Disclosure Of Federal Share Of Terrorism pro-rata basis in accordance with procedures Losses established by the Treasury, based on its estimates The United States Department of the Treasury will of aggregate industry losses and our estimate that we will exceed our insurer deductible. In reimburse insurers for 85% of that portion of insured losses attributable to "certified acts of terrorism" with the Treasury's procedures, amountiss paid for ai under TRIA that exceeds the applicable insurer losses may be subject to further adjustments based on differences between actual losses and estimates. deductible. However, if aggregate industry insured losses under D. All other terms and conditions remain the same. TRIA exceed $100 billion in a Program Year (January 1 through December 31), the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. The United States government has not charged any premium for their participation in covering terrorism losses. Form SS 83 76 03 12 Page 1 of 1 ref 9n19 Tha Flartfnrri Policy Number: 52 SSM UK5025 I IMPORTANT NOTICE TO POLICYHOLDERS DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT a rr 0 SCHEDULE Ln a a 0 N N Terrorism Premium (Certified Acts): Ln $ $5.00 N N N O O a m A. Disclosure Of Premium C. Cap On Insurer Liability for Terrorism Losses In accordance with the federal Terrorism Risk If aggregate industry insured losses attributable to Insurance Act, as amended ("TRIA"), we are "certified acts of terrorism" under TRIA exceed $100 required to provide you with a notice disclosing the billion in a Program Year (January 1 through portion of your premium, if any, attributable to December 31), and we have met, or will meet, our coverage for certified acts of terrorism under TRIA, insurer deductible under TRIA, we shall not be liable The portion of your premium attributable to such for the payment of any portion of the amount of such coverage is shown in the Schedule of this losses that exceed $100 billion. In such case, your endorsement. coverage for terrorism losses may be reduced on a B. Disclosure Of Federal Share Of Terrorism pro-rata basis in accordance with procedures Losses established by the Treasury, based on its estimates of aggregate industry losses and our estimate that The United States Department of the Treasury will we will exceed our insurer deductible. In accordance reimburse insurers for 85°to of that portion of insured with the Treasury's procedures, amounts paid for losses attributable to certified acts of terrorism' losses may be subject to further adjustments based under TRIA that exceeds the applicable insurer on differences between actual losses and estimates. deductible. D. All other terms and conditions remain the same. However, if aggregate industry insured losses under TRIA exceed $100 billion in a Program Year (January 1 through December 31), the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. The United States government has not charged any premium for their participation in covering terrorism losses. Form SS 83 80 03 12 Page 1 of 1 O 2012,The Hartford (Includes copyrighted material of the Insurance Services Office, Inc., with its permission.)