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HomeMy WebLinkAboutPW11-081 - Amendment - #4 - Shannon & Wilson, Inc. - Green River Levee Certification Project -01/05/2015 tf $, ® Records an ' KENT Document WA9HINOTON `a.°zl`itt :1 rs:'*.SYtf ail ' 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. j I Vendor Name: Shannon & Wilson, Inc, Vendor Number: JD Edwards Number Contract Number: Y"u'`! 061-00's This is assigned by City Clerk's Office Project Name: Green River Levees Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: Date of the Mayor's signature Termination Date: 12/31/15 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Toby Hallock Department: Engineering Contract Amount: Approval Authority: (CIRCLE ONE) Department Director Mayor City Council j Detail: (i.e. address, location, parcel number, tax id, etc.): Extend the time of completion to December 31, 2015 as project work continues on these Levee systems. As of: 08/27/14 REQUEST FOR MAYOR'S SIGNATURE T Please Fill in All Applicable Boxes ® n c. { 4 A"Wed"by Director 'originator's Name: Toby Hallock Dept/Div, Engineering Extension: 5536 Date Sent: s0/ai t - Date Rego red: r-) 3 'j i_ ;Return to: Nanc Yoshitake CONTRACT TERMINATION DATE: 12/31/15 VENDOR: Shannon & Wilson, Inc; DATE DE COUNCIL APPROVAL: N/A; ATTACH THE COUNCiL MOTION SHEET FOR THE MAYOR - if applicable Brief Explanation of Document: The attached Amendment No. 3 is necessary to extend the time of completion to December 31, 2015 so as project work continues on these Levee systems. All Contracts Must Be Routed Through The Law Department (This area to be completed by the Law Department) Received: Approval 44 � A/ Law Dept. Comments. Date Forwarded to Mayor: ' t Shaded Areas To Be Completed By Administration Staff Received: Cm Recommendations and Comments: Disposition: Date Returned: i I • KENT AMENDMENT NO. 4 NAME OF CONSULTANT OR VENDOR: Shannon & Wilson Inc. CONTRACT NAME & PROJECT NUMBER: Green River Levees ORIGINAL AGREEMENT DATE: January 11, 2011 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 as project work continues on these Levee systems. 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, $50,870.00 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $50,870.00 including all previous amendments i Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $50,870.00 II AMENDMENT - 1 OF 2 I Original Time for Completion 12/31/li (insert date) Revised Time for Completion under 12/31/14 prior Amendments (insert date) I Add'I Days Required (f) 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. I IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VENDOR: CITY OF KENT: 11 ,�- By: By: t (signaturl) ,%Yy (signature) Print Name: c ( t Print N6m6:5y�ette Cooke Its 'S e S v Its Moor {tl le) (xitle)_--- DATE: DATE: / 1t APPROVEDAS TO FORM: (applicable if Mayor's signaturb.required) Kent Law Department _ I, Shannon&Wilson-GR Levees Am0 41Ha11v,k AMENDMENT - 2 OF 2 n- c a® CERTIFICATE OF LIABILITY INSURANCE DATE YY) 12(31 2013 2013 I ! THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER-THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ii ,i must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. CONTACT PRODUCER AME: _C1glyc'& FAX Arthur J.Gallagher Risk Management Services, Inc. PNONE g g D ^EN{,a 5-FRR-1031 Ac o: T S�3Z1f P.O.Box 367 E-MAIL Bellevue WA 98009-0367 0o Essx:ail s..RSia,�m -- INSURER(5}AFFORDINCG COVERAGE _ NAIC# INSURER A: _$-pf9�P�V(,2`�IfV f:n 0{A fNSUREb INSURER B: and hAarine lns24767 Shannon&Wilson,Inc, INSURERc:'Tlg_v_G.lers IndPmnity_G24fAJri4i' --- 400 N.34th Street,Suite 100 INSURERD: Seattle,WA 98103 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:218091648 REVISION NUMBER: THIS IS X CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURE NAMED ABOVE FOR THE POLICY PERIOD INDICATED, .NOTWTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WI;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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MS,SR POLICY EFF POLIC EXP LIMITS TYPE OF INSURANCE ]MEN! D POLICY NUMBER M IDOAYYY MMIDD A GENERALLIABILITY 6309D340343TIL14 11112014 /112016 EACH OCCURRENCE $1,000,000 T X COMMERCIAL GENERAL LIABILITY REW E ERw ccrence $1.00,0000 CLAIMS-MADE O OCCUR MED E%P(Any one raen) $10 000 PERSONAL&ADV INJURY $1,000,POD GENERAL AGGREGATE $2000,000 GEN'LAGGREGATE LIMITAPPLIES PER: - PRODUCTS-COMPIOPAGG $2000000 POLICY X PRO- LOC S I AUTOMOBILE LIABILITY P81O9D340343TILI4 1/112014 /112015 i5a bent 1000000 X ANYAUTO BODILY INJURY(Por pers06) $ aAUTQSAt4UT0S SCHEDULED aODI LY INJURY(Per acUdent) S AUTOS pP to R YI AMAG- $ NON-0WNED AUTOBX OCCUR ZUP15R7312A14NF 111/2014 (V2o15 EACH OCCURRENCE $1.000000 CLAIMS-MADE AGGREGATEION$10000 $ O WORKERS COMPENSATION PHUB9D34034314 111/2014 IV2015 X VJC STATU OTH- ANDEMPLOYERSLUNIALITY YIN ANY PROPRIETORIPARTNEWRXECUTIVE a WA E.L.EACH ACCIDENT _$1,.,OP0,000 OFPICERIMEMSER EXCLuOEDP E.L.DISEASE�EA EMPLOYEE $1000,000 (Mandatary in lun Iro.ti cnbeunder E,L DISEASE-POLICY LIMIT $1000,000 DESCRIPTION OF OPERATIONS below bESCRIPTION OF OPERATIONS I LOCATIONS rVEHICLES(Attach ACORD 101,Atldltinnai Remarks Schedule,It more space is raquired) Workers'Comp-in Washington, Employers'Liability only RE: Project:Green River Levee Improvements,Kent WA (S&W Job#21-1-123399, formerly Job#21-2-60314)The City of Kent is included as Additional Insured for General Liability(per Form�CGD414 0408)and Auto Liability as respects operations of the Named Insured. Primary and Non-Contributory inel for GL and AL where required by written contract. 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, 400 West Gower Kent WA 98032 USA AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD I Client#:330606 SHANNWILI1 ACORD., CERTIFICATE OF LIABILITY INSURANCE DAT 1(03/23120140 Y) +IS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT j PRODUCER NAME: - . PHONE 610-362-8526 Kibble&Prentice, a USI Co PR I, Nu Exn_206 441-6300 - �fr ygr .._ - 601 Union Street,Suite 1000 E-MAIL PL.Certre uest k com.com ADDRESS: 9 p _ - - Seattle,WA 98101 INSURER(S)AFFORDING COVERAGE NAICIf _ INSURER A:LIOyd's of London _ 32727 INSURED INSURER B; Shannon&Wilson,Inc. INSURER C; .— P.O. Box 300303 INSURER D: Seattle,WA 98103 INSURER E: - - INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMEDABOVE FORTHE POLICYPERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 CLT LAIMS, __- INSR ADD L SUER POLICY EFF POLICY E%F LIMITS INR TYPE OF INSURANCE Iry yyyp) POLICYNUMBER MM(DO/YYYY) MM/DDffYYY - GENERALLIABILITY EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY PREMISES EaErtenre CLAIMS-MADE ❑OCCUR MED EXP(Any one poison) _ $ PERSONAL&ADV INJURY $ _ GENERAL AGGREGATE $ DENT AGGREGATE LIMIT APPLES PER: PRODUCTS-COMP/OP AGO $ POLICY JEOT LOC $ - - 60MBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea acddanl BODILY INJURY(Par poison) $ ANY AUTO ALL OWNED SCHEDULED BODILYINJURY(P.1tuaddent) $ — AUTOS PROPERTY DAMAGE HIREDSAUTOG AUTOSWNED Peracedentl _ _. $ $ UMBRELLA LIAa OCCUR EACH OCCURRENCE. _ '$ _ _- EXCE33LIA6 CIAIM3_-MADE AGGREGATE $ DED RETENTION$ WC STATU- OThI- WORKERSCOMPENSATION O ER__.. AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE� E.L.EACHACCIDENT _ $ _ -_ OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ - ,- Ifyes,describeunder EL.DISEASE-POIJGYUMIT. $ DESCRIPTION OFOPERATIONS_belmv - - A Professional & B0140LDUSA1404579 1101/2014 01/0112015 $1,000,000 per claim Contractors $1,000,000 annl aggr. Pollution Liab. DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Addbbnal Runnette Schedule,if more space is required) RE: S&W Job No: 21-2-60314(Location:Green River,Kent,WA !, Project Name: Green River Levee Improvements between River Mile 14.25 to River Mile 22.00, Kent,WA Description of Work:Wetland reconnaissance and biological assessment for five levee improvement locations along the Green River i CERTIFICATE HOLDER CANCELLATION j SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Nancy Yoshitake ACCORDANCE WITH THE POLICY PROVISIONS. 1 220 Fourth Avenue South Kent,WA 98032 AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 off The ACORD name and logo are registered marks of ACORD #S11533258/M11519196 SXFJU i P6309D340343TIL14 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, BLANKET ADDITIONAL INSURED - WRITTEN CONTRACTS (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1, The following is added to SECTION II --WHO IS plies only to such "bodily injury" or "property AN INSURED: damage"that occurs before the end of the pe- riod of time for which the "written contract re- Any person or organization that you agree in a quiring insurance" requires you to provide "written contract requiring insurance to include as such coverage or the end of the policy period, an additional insured on this Coverage Part, but: whichever is earlier. a. Only with respect to liability for"bodily injury", 2. The following is added to Paragraph 4.a.of SEC- "property damage"or"personal injury";and TION IV— COMMERCIAL GENERAL LIABILITY b, If, and only to the extent that, the injury or CONDITIONS: damage is caused by acts or omissions of The insurance provided to the additional insured you or your subcontractor in the performance In- of "your work" to which the "written contract is excess over any valid and excess, 'other in- requiring insurance applies; The person or on any whether primary, excess, to the a l- organization does not qualify as an additional on any other basis, that e available Ho to the f you tional insured for a loss we cover. However, If you Insured with respect to the independent acts specifically agree in the"written contract requiring or omissions of such person or organization, Insurance"that this insurance provided to the ad- The insurance provided to such additional insured ditional insured under this Coverage Part must is limited as follows: apply on a primary basis or a primary and non- C, in the event that the Limits of insurance of contributory basis, this Insurance is primary to this Coverage Part shown in the Declarations "other insurance" available to the additional in- exceed the limits of liability required by the sured which covers that person or organization as "wri{en contract requiring insurance", the In- a named insured for such loss, and we will not surance provided to the additional insured share with that "other insurance". But this insur- shall be limited to the limits of liability required ance provided to the additional insured still Is ex by that "written contract requiring insurance", cess over any valid and collectible "other insur- This endorsement shall not Increase the limits ance", whether primary, excess, contingent or on j of insurance described In Section III — Limits Insured other basis, that isat available on or tothe additioion isnal Ofinsurance, d. This insurance does not apply to the render- additional insured under any"other insurance", ing of or failure to render any "professional 3. The following is added to SECTION iV — COM- services" or construction management errors MERCIAL GENERAL LIABILITY CONDITIONS: or omissions. Duties Of An Additional Insured e. This Insurance does not apply to "bodily in- As a condition of coverage provided to the addi- jury" or "property damage caused by "your tional insured: work" and included In the "Products- a, The additional insured must give us written completed operations hazard unless the notice as soon as practicable of an "occur- "written contract requiring insurance" specifi- rence" or an offense which may result In a catty requires you to provide such coverage claim. To the extent possible, such notice for that additional Insured, and then the insur- should include: ance provided to the additional insured ap- CG D4 14 04 08 02008 The Travelers Companies,Inc. Page 1 of 9 • I COMMERCIAL GENERAL LIABILITY I L How, when and where the "occurrence" any provider of other insurance which would or offense took place; cover the additional insured for a loss we it. The names and addresses of any Injured cover. However, this condition does not affect persons and witnesses;and whether this insurance provided to the addi- tit. The nature and location of any injury or tional insured is primary to that other insur- damage arising out of the"occurrence"or once available to the additional insured which offense. covers that person or organization as a named insured. b. If a claim Is made or"suit' is brought against 4. The following is added to the DEFINITIONS Sec- the additional Insured, the additional Insured tion: must: I. Immediately record the specifics of the "Written contract requiring Insurance" means that claim or"suit"and the date received;and part of any written contract or agreement under or- !I. Notify us as soon as practicable, which you are required to include a person or or- ganization as an additional insured on this Cover- The additional Insured must, see to it that we age Part, provided that the "bodily injury" and receive written notice of the claim or"suit" as "property damage" occurs and the "personal in- soon as practicable. jury"is caused by an offense committed: c. The additional 'insured must immediately send a. After the signing and execution of the contract us copies of all legal papers received in con- or agreement by you; nection with the claim or"suit", cooperate with b, while that part of the contract or agreement is us in the investigation or settlement of the In effect; and claim or defense against the "suit", and oth- erwise comply with all policy conditions, c. Before the end of the policy period. d. The additional insured most tender the de- fense and indemnity of any claim or "suit" to u? Vm� O55—Z O I o� U� I 1 � Page 2 of 2 ©Zoos The Travelers Companies,Inc. CG Deb 18 0$08 014524 i P6309D340343TIL14 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT" CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE - ADDITIONAL. INSUREDS This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS b. The "personal Injury"or"advertising Injury"for j COMMERCIAL GENERAL LIABILITY CONDITIONS which coverage is sought arises out of an ot- (Section IV), Paragraph 4. (Other Insurance), is fense committed amended as follows: subsequent to the signing and execution of that 1. The following Is added to Paragraph a, Primary contract or agreement by you. Insurance. 2. The first Subparagraph (2) of Paragraph b. Ex- However, if you specifically agree in a written con- cess Insurance regarding any other primary In- tract or written agreement that the Insurance pro- surance available to you is deleted. vided to an additional insured under this 3. The following is added to Paragraph b. Excess Coverage Part must apply on a primary basis, or Insurance, as an additional subparagraph under a primary and non-contributory basis, this insur- Subparagraph(1): ante is primary to other insurance that is avail- That Is available to the insured when the insured able to such additional insured which covers such Is added as an additional insured under any other additional insured as a named Insured, and we policy, including any umbrella or excess policy, will not share with that other insurance, provided that: a. The "bodily Injury" or "property damage" for which coverage is sought occurs; and Pps� m r� r Pmn�'is®m � C F U r' CC DO 37 04 05 Copyright 2005 The St. Paul Travelers Companies, Inc.All rights reserved. Page 1 of 1 OSk930 i I #P8109D340343TZL14 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT i This endorsement modifies insurance provided under the following: i BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modl- fled by the endorsement. GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However,coverage for any Injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part,and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights,duties,and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE -- LOSS OF USE—INCREASED LIMIT B. B NKET ADDITIONAL INSURED 1. PHYSICAL DAMAGE —'TRANSPORTATION EXPENSES—INCREASED LIMIT . EMPLOYEE HIRED AUTO J. PERSONAL EFFECTS D. EMPLOYEES AS INSURED K. AIRBAGS E. SUPPLEMENTARY PAYMENTS— INCREASED L. NOTICE AND KNOWLEDGE OF ACCIDENT LIMITS LOSS F. HIRED AUTO — LIMITED WORLDWID M. BLA KET WAIVER OF SUBROGATION COVERAGE—INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE—GLASS N. INTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED executed by you before the "bodliy Injury" or The following is added to Paragraph A.1., Who Is "property damage" occurs and that is in effect An Insured, of SECTION It — LIABILITY COV- during the policy period, to be named as an addl- ERAGE: (tonal insured is an "insured" for Liability Cover- age, but only for damages to which this insurance Any organization you newly acquire or farm dur- applies and only to the extent that person or or- ing the policy period over which you maintain ganization qualities as an "insured" under the 50%" or more ownership interest and that Is not Who is An Insured provision contained In Section separately insured for Business Auto Coverage. II. Coverage under this provision Is afforded only un- C. EMPLOYEE HIRED AUTO III the 180th day after you acquire or form the or- ganization or the end of the policy period, which- 1. The following is added to Paragraph A.1., ever is earlier. Who Is An Insured, of SECTION 11 -- LI- B. BLANKET ADDITIONAL INSURED ABILITY COVERAGE: The following is added to Paragraph o. in A.1., An "employee" of yours is an "insured" while Who Is An Insured,of SECTION II—LIABILITY operating an "auto" hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission,white performing Any person or organization who is required under duties related to the conduct of your busi- a written contract or agreement between you and ness. that person or organization, that is signed and r CA T3 53 03 10 02010 The Travelers Indemnity Company. Page 1 of 4 Includes copyrighted materiel of Insurance Services Office,Inc.with its permission. i COMMERCIAL AUTO 2, The following replaces Paragraph b. in 6.5., within such country or jurisdiction, for Liability Other insurance, of SECTION IV — BUSI- Coverage for any covered "auto" that you NESS AUTO CONDITIONS: lease, hire, rent or borrow without a driver for b. For Hired Auto Physical Damage Cover- a period of 30 days or less and that is not an age, the following are deemed to be cov- "auto" you lease, hire, rent or borrow from ered"autos"you own: any of your"employees", partners (if you are 1 An covered "auto" you lease, hire, a partnership), members (IF you are a limited ( ) Y Y liability company) or members of their house- rent or borrow;and holds. (2) Any covered"auto"hired or rented by (a) With respect to any claim made or "suit" your "employee" under a contract in brought outside the United States of that Individual "employees" name, America, the territories and possessions with your permission, while perform- of the United States of America, Puerto ing duties related to the conduct of Rico and Canada: your business. "auto"that is leased, hired, (1) You must arrange to defend the "et- However, any� sured"against, and Investigate or set- rented or borrowed with a driver is not a tie any such claim or "suit"and keep covered"auto". us advised of all proceedings and ae= D. EMPLOYEES AS INSURED lions. The following is added to Paragraph A.1.,Who Is (11) Neither you nor any other Involved An Insured, of SECTION 11 — LIABILITY COV- "insured" will make any settlement ERAGE: without our consent. Any"employee"of yours is an "insured"while us- (111)We may, at our discretion, participate ing a covered"auto"you don't own,hire or borrow in defending the 'Insured" against, or In your business or your personal affairs. in the settlement of, any claim or % E. SUPPLEMENTARY PAYMENTS — INCREASED 11su1N'. LIMITS (iv)We will reimburse the 'insured" for 1. The following replaces Paragraph A.2.a.(2), sums that the "Insured" legally must of SECTION ii LIABILITY COVERAGE: pay as damages because of "bodily Injury"or"property damage" to which (2) Up to $3,000 for cost of bail bonds (in- this insurance applies, that the "in- cluding bonds for related traffic law viola- sured" pays with our consent, but tions) required because of an "accident" only up to the limit described in Para- we cover. We do not have to furnish graph C., Limit Of Insurance, of SEC- these bonds. TION 11—LIABILITY COVERAGE. 2- The following replaces Paragraph A.2.a.(4), (v) We will reimburse the "insured" for of SECTION It--LIABILITY COVERAGE: the reasonable expenses Incurred (4) All reasonable expenses incurred by the with our consent for your investlga- "insured" at our request, including actual tion of such claims and your defense loss of earnings up to $500 a day be- of the "insured" against any such cause of time off from work. "suit", but only up to and included P. HIRED AUTO — LIMITED WORLDWIDE GOV- within the limit described in Para- ERAGE—INDEMNITYBASIS graph C., Limit Insurance, of SECTION II — LIABILITY COVER- The following replaces Subparagraph (5) in Para- AGE, and not in addition to such limit, graph B.7., Policy Period, 'Coverage Territory, Our duty to make such payments of SECTION IV — BUSINESS AUTO GONDI- ends when we have used up the ap- TIONS: pifcable limit of Insurance in pay- (5) Anywhere in the world, except any country or ments for damages, settlements or jurisdiction while any trade sanction, em- defense expenses. bargo, or similar regulation imposed by the (b) This insurance is excess over any valid United States of America applies to and pro- and collectible other Insurance available hibits the transaction of business with or t Page 2 of 4 02010 TheTravelers Indemnity Company. CA T3 53 0310 Includes copyrighted matelot of Insurance Services Office,Inc.Win its permission. COMMERCIAL AUTO to the "insured" whether primary, excess J. PERSONAL EFFECTS contingent or on any other basis. The following is added to Paragraph A.4., Cover- (c) This insurance Is not a substitute for re- age Extensions, of SECTION III — PHYSICAL quired or compulsory Insurance in any DAMAGE COVERAGE; country outside the United States, Its ter- Personal Effects Mertes and possessions, Puerto Rico and Canada. We will pay up to $400 for "loss" to wearing ap- You agree to maintain all required or parel and other personal effects which are: compulsory Insurance in any such coun- (1) Owned by an"insured"; and try up to the minimum limits required by (2) In Cron your covered"auto". local law, Your failure to comply with This coverage applies only in the event of a total compulsory insurance requirements will theft of your covered"auto". not invalidate the coverage afforded by this policy,but we will only be liable to the No deductibles apply to this Personal Effects samy extent we would have been liable coverage. had you complied with the compulsory in- K. AIRBAGS surance requirements. The following is added to Paragraph B.3., Exelu- (d) It(a understood that we are not an admit- slons, of SECTION III — PHYSICAL DAMAGE ted or authorized insurer outside the COVERAGE: United States of America, Its territories Exclusion 3.a. does not apply to 'loss" to one or and possessions, Puerto Rico and Can- more airbags in a covered"auto"you own that in- furnishing We assume no responsibility for the any way with the laws of insurance, or flate due to a cause other than a cause of"loss" for compliance in any furnishing of certificates set forth in Paragraphs A.1.b. and A.1.c., but of other countries relating to insurance. only: G. WAIVER OF DEDUCTIBLE—GLASS a. If that "auto" is a covered "auto"for Compre- The fallowing is added to Paragraph D.,Doductf- henslve Coverage under this policy; ble, of SECTION Ill — PHYSICAL DAMAGE b. The atrbags are not covered under any war- COVERAGE: ranty;and No deductible for a covered "auto" will apply to c. The airbags were not intentionally Inflated. glass damage If the glass is repaired rather than We will pay up to a maximum of $1,000 for any replaced. one"loss". H. H(RED AUTO PHYSICAL DAMAGE—LOSS OF L. NOTICE AND KNOWLEDGE OF ACCIDENT OR USE—INCREASED LIMIT LOSS The following replaces the last sentence of Para- The following is added to Paragraph A.2.a.,'of graph A.4.b., Loss Of Use Expenses, of SEC- SECTION IV--BUSINESS AUTO CONDITIONS; TiON III—PHYSICAL DAMAGE COVERAGE: Your duty to give us or our authorized represents- However, the most we will pay for any expenses live prompt notice of the "accident' or"loss" ap- for loss of use is $65 per day, to a maximum of piles only when the"accident" or"loss" Is known $750 for any one"accident to: 1. PHYSICAL DAMAGE — TRANSPORTATION (a) You(if you are an individual); EXPENSES—INCREASED LIMIT (b) A partner(if you are a partnership); The following replaces the first sentence in Para- (e) A member (if you are a limited liability com- graph AA.a., Transportation Expenses, of pany); SECTION III — PHYSICAL DAMAGE COVER- (d) An executive officer, director or insurance AGE' manager(if you are a corporation or other or- We will pay up to $50 per day to a maximum of ganization);or $1,500 for temporary transportation expense In- (a) Any"employee"authorized by you to give no- curred by you because of the total theft of a cov- lice of the"accident"or"loss", j Bred"auto"of the private passenger type. i CA T3 53 03 10 02010 rho Travelers IndemnIty Company. Page 3 of 4 li Includes copyrighted material of Insurance services Office.Inv,with Its permission. i r '! COMMERCIAL AUTO M. BLANKET WAIVER OF SUBROGATION such contract, The waiver applies only to the The following replaces Paragraph A.S., Transfer person or organization designated In such Of Rights Of Recovery Against Others To Us, contract. of SECTION IV — BUSINESS AUTO CONpt- N. UNINTENTIONAL ERRORS OR OMISSIONS TIONS: The following is added to Paragraph 6.2., Con- 5, Transfer Of Rights Of Recovery Against cealment, Misrepresentation, Or Fraud, of Others To Us SECTION IV—BUSINESS AUTO CONDITIONS: We waive any right of recovery we may have The unintentional omission of, or unintentional against any person or organization to the ex- error In, any information given by you shall not tent required of you by a written contract prejudice your rights under this Insurance. How- signed and executed prior to any "accident" ever this provision does not affect our right to col- or"loss",provided that the"accident"or"loss" lest additional premium or exercise our right of arises out of operations contemplated by cancellation or non-renewal, r t Page 4 of 4 td 2010 The Travelers indemnity Company, CA T3 53 0310 Includes copyrighted maledol of Insurance Services OFFloe,Inc,with its permission,