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HomeMy WebLinkAboutPW14-067 - Amendment - #1 - GEI Consultants, Inc. - Brisco-Desimone Levee Improvements Reach 2 & 3 - 05/28/2015 i ecords em KENT Document WASHIN.GTON - 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: GEI Consultants, Inc. Vendor Number:; JD Edwards Number Contract Number: M Iq -- G OD Z This is assigned by City Clerk's Office Project Name: Briscoe-Desimone Levee Reach 2 & 3 Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 5/28/15 Termination Date: 12/31/15 Contract Renewal Notice (Days): 213 Number of days required notice for termination or renewal or amendment .Contract Manager: Kelly Casteel Department Engineering Contract Amount: $152,552.00 Approval Authority:` (CIRCLE ONE Department Director. Mayor City Council Detail: (i.e. address,-location, parcel number,tax id, etc.): An amendment is needed to extend the time of completion to close out the Briscoe Desimone Levee Reach 2 & 3 project. Scope of work remains the same. As of: 08/27/14 KEN T WAS H 1 N G T O N AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: GEI Consultants, Inc. CONTRACT NAME & PROJECT NUMBER: Briscoe-Des!mone Levee Reach 2 & 3 ORIGINAL AGREEMENT DATE: April 3, 2014 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. Due to additonal work that is necessary to close out the project, Reach 2 & 3 construction support was delayed and is scheduled to be complete in the winter of 2015. 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, $1529552.00 including applicable WSST Net Change by Previous Amendments $N/A including applicable WSST Current Contract Amount $1529552.00- including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $1529552.00 AMENDMENT 1 OF 2 b Original Time for Completion 6/1/15 (insert date) Revised Time for Completion under N/A prior Amendments (insert date) Add'I Days Required (f) for this 213 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: µ.if4 A0 CITY ENT: By: By: Ksiian tur� , 0(�siina�ture) Print me. A 0rullot Print Name: Timothy J. LaPorte, P.E. Its %h, i0a a 1% Its Public Worko Director DATE: title) DATE:- APPROVED AS TO FORM: (applicable if Mayor's signature_required) Kent Law Department i [In this field,you may enter the electronic.filepath where the contract has been saved] i - AMENDMENT - 2 OF 2 r I g GEICONS-01 KPAWLOWSKI DATE(MMIDDNYYY) i CERTIFICATE OF LIABILITY INSURANCE 3I6/2015 $ 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 j BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED j REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(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). PRODUCER CONTACT Kathryn.Pawlowski Ames&Gough PHONE f617 328-6555 a/c No: 617 328-6888_ 859 Willard Street A/c No Ezt: { ) Suite 320 E-MAILl SS:boston@amesgough.com y,MA 02169 QUIrIC INSURER(S)AFFORDING COVERAGE NAIC# INSURER A,National Union Fire insurance Company:of Pittsburgh,PA 119445 INSURED INSURER 13.Continental Casualty Company(CNA)A(XV) 120443 GEI Consultants,Inc. INSURER C:AIG Specialty Insurance Company A(XV) 126883 � 180 Grand Ave INSURER D: --- Oakland,CA 94612 INSURER E I INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS: - ADDL S BR POLICY EFF POLICY EXP I R TYPE OF INSURANCE POLICY NUMBER MM/DDNYYY MMIDDNYYY LIMITS LT LTR INSD WVD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AMAGE TO RERTEU-- CLAIMS-MADE ]OCCUR X X 7046470 03/01/2015 03/01/2016 PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 16,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE UMIT APPLIES PER; GENERAL AGGREGATE $ 2,000,000 i PRO- PRODUCTS-COMPIOPAGG $ 2,000,000 ; POLICY JECT LOC _ OTHER: AUTOMOBILE LIABILITY Ee aBINED SINGLE LIMIT $ 1,000,000 A X ANY AUTO X X 2248367 03/01/2016 03/01/2016 BODILY INJURY(Per p erson) $' ALL OWNED_ SCHEDULED BODILY INJURY,(Per accident) $ AUTOS AUTOS X HIRED AUTOS X AUTOOSWNED PROPERTY accident).., $ E 4,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ B EXCESS LIAB CLAIMS-MADE X X 6011396137 03/01/2015 03/01/2016 AGGREGATE $ 4,000,000 j DED I X I RETENTION$ ' WORKERS COMPENSATION Xy PER OH- AND EMPLOYERS'LIABIUTY STATUTE ER i A ANY PROPRIETOR/PARTNER/EXECUTIVE Y— N CA X 026034972 03/01/2016 03/0112016 E.L.EACH ACCIDENT $ — 1,000,000 OFFICER/MEMBER EXCLUDED? 1 000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ r If yes,describe under DESCRIPTION OF OPERATIONS below E;L.DISEASE-POLICY LIMIT $ 1,000,000 I C Prof.Liability 17788026 03/01/2016 03/01/2016 Per Claim 6 000,000 C &Pollution Liab. 17788026 03/01/2015 03101/2016 JAggregate 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) All Coveragesare in accordance with the policy terms and conditions. i i Project:Kent Briscoe-Desimone Levee Reach 2&3 Construction Support,City of Kent The City of Kent,King County and the King County Flood Control District are named as Additional Insured on a primary and non-contributory`basis with i respect to general liability for ongoing and completed operations,auto,and umbrella liability as required by written contract,for liability arising out of the p performing y County. y policy y interest/ operations of the named insured while erformin work for the City, District,and the Coun General Liability aBc Includes severabilit of SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE'DESCRIBED POLICIES BE CANCELLED BEFORE j THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of,Kent Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Mr.Ken Langhoiz 20 Faurth Avenue South Kant,WA 98032 AUTHORIZED REPRESENTATIVE i 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I i AGENCY CUSTOMER ID:GEICONS-01 KPAWLOWSKI ..-•-®,� LOC#: a j ADDITIONAL REMARKS SCHEDULE Page I of 1 j AGENCY NAMEDINSUREp rnes`&Gough GEI Consultants,Inc. - 180 Grand Ave POLICY NUMBER Oakland,CA 94612 EE PAGE 9 CARRIER NAIC CODE SEE,PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: &CORD 25 FORM TITLE:Certificate of Liability Insurance I 1 Description of Operations/LocationsNehicies: cross liability provisions.Umbrella policy sits in excess of the general liability,auto and employer's liability.All policies Include a waiver of subrogation in favor of The City of Kent,King County and the King County Flood Control District.30-day notice of cancellation will be issued in accordance with policy terms and conditions. i j i E I I j E E i I j F 1 I f 1 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. j The ACORD name and logo are registered marks of ACORD E i i ENDORSEMENT# This endorsement, effective 12:01 A.M. 03/01/2015 forms a part of Business Auto Policy Policy No. 2248367 Issued to GEI Consultants,Inc. By National Union Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL TO ENTITIES OTHER THAN THE FIRST NAMED INSURED This policy is amended as follows: in the event that the Insurer cancels this policy for any reason other than non-payment of premium; and 1. the cancellation effective date is'prior to this policy's expiration date, 2. the First Named Insured is under an existing contractual obligation to notify a certificate holder when this policy is canceled (hereinafter, the "Certificate Holder($)") and has provided to the Insurer, either directly or through Its broker of record, the email address � of a contact at each such entity; and i 3. the Insurer received this information after the First Named Insured receives notice of cancellation of this policy and prior to this policy's cancellation effective date, via an electronic spreadsheet that Is acceptable to the Insurer, the Insurer will provide advice of cancellation (the "Advice") via e-mail to each such Certificate Holders within days after the First Named Insured provides such information to the Insurer; j provided however, that if a specific number of days is not stated'above,then the Advice will be { provided to such Certificate. Holder(s) as 'soon as reasonably practicable after the First Named ! Insured provides such information to the Insurer. i i Proof of the Insurer emailing the Advice, using the information provided by the First Named Insured,' j will serve as proof thatthe Insurer has fully satisfied Its obligations under this'endorsement. This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights E in any entity not insured under this policy. ! The following Definitions apply to this endorsement: i 1. First Named Insured means the Named Insured shown on the Declarations Page of this policy. 2. Insurer means the insurance company shown in the header on the Declarations page of this ' policy, All other terms, conditions and exclusions shall rernain the same. ' I I Authorized Representative ; 107414, 03/11 Rage' 1 4 I ENDORSEMENT g This endorsement,effective 12:01 A.M. 03/01/2015 form,4 e part of r: policy No._ 2248367 Issued to GE I CONSULTANTS, I NO, i by NATIONAL UNION r I RE INSURANCE COMPANY OF P I TTSBURGH, PA ; } THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CARPFUI_LY, k ADDITIONAL INSURED W WHERE REQUIRED UNDER CONTRACT OR AGREEMENT Th/s endorsement m0lfles Insurance provided under the follow/ny: ` BUSINESS AUTO COVERAGE FORM I SCHEDULE ADDITIONAL INSURED: ANY PERSON OR ORGANIZATION FOR WHOM YOU AR5 CONTRACTUALLY � BOUND Tip PROVIDE ADD I T I ONA1, INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATIONS L.I AS I L.I TY ARISING OUT OF THE USE OF A COVERED AUTO. � I, SECTION It-LIABILITY COVERAGIr,A. Coverage, 9. Who Is Insured, Is amended to add. d,. Any person or organization, shown in the schedule above, to whom you become obligated }j to Include as an additional insured under this polloy,as a result of any contract or agreement you enter Into which requires you to furnish insurance to that person or organization of the type provided by this policy,but only with reepeot to liability arising out of use of a covered "auto". However,the Insurance provided will not exceed the lesser of: (1) The coverage and/or limits of this policy, or p (2) The coverage and/or limits required by said contract or agreement. 4= + f i {{ 4� 1 'i A thorixied Representativo or Cou lterstc�natura(In States Where App�feeble) { 87960 (1 U/05) Page 1 of 1 i ENDORSEMENT I This endorsement, effective 12:01 A.M. 03/0 1/2015 forms a part of � I polley No. 22 367 Issued toG91 consult+anta, Inc, by National Union Fire insurance Company ;? ; THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, f. f WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO Us -fl)Is endarsemenf modifles Insurance provIded under the followlntg: I I. BUSINESS''AtJTO-'COVERAGE'FORM .. Section IV - Business Auto Conditions, A. r Loss Conditions, S. » Transfer of Rights of Recovery !! Against Others to Us, Is amended to add: However, we will waive any right.of recover we have agairnst any person or organization with whom you have ' entered into a contract or agreement because of payments we make under this Coverage Form arising out of i� an"accidenfl or"loss" If: ( I (1) The "accident" or "lass" is due to operations undertaken In accordance with the contract existing I between you and such person or organization;and as (2) The contract or agreement was entered Into prior to any"accident' or loss"; No waiver of the right of recovery will directly or indirectly apply to your employees or employees of the person or organization, p F g and we reserve our rights or lien to be reimbursed from any recovery funds obtained � by any Injured employee. I E AUTHORIZED RI-PRESENTATIVE , f 62897(8/95) I I I i I ENDORSEMENT# I This endorsement, effective 12;01. A.M.3/01/2015-03/01/2016 forms a part of Worker's Compensation Policy i Policy No.026034972 Issued to GEI Consultants,Inc. By National Union Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ iT CAREFULLY. LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL I TO ENTITIES OTHER THAN THE FIRST NAMED INSURED f This policy is amended as follows; I In the event that the Insurer cancels this policy for any reason other than nonpayment of premium, and 1. the cancellation effective date is prior to this policy's expiration date, 2. the First Named Insured is under an existing contractual obligation to notify a certificate holder when this policy is canceled (hereinafter, the "Certificate Holder($)") and has provided to the Insurer, either directly or through its broker of record, the email address of a contact at each such entity; and 3. the Insurer received this information after'the First Named Insured receives notice of cancellation of this policy and prior to this policy's cancellation effective date, via an electronic spreadsheet that is acceptable to the Insurer, the Insurer will provide.advice of cancellation (the "Advice") via e-mail to each such Certificate � Holders within days after the First Named Insured provides such information to the insurer, provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the First Named Insured provides such information to the insurer. Proof of the insurer emailing the Advice, using the information provided by the First Named Insured, j will serve as proof that the Insurer has fully satisfied its obligations under this endorsement, i This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor.shall this endorsement invest any rights � i in any entity not insured under this policy. f The following Definitions apply to this endorsement: 1 First Named Insured means the Named Insured shown on the Declarations Pape of this policy. 2. Insurer means the insurance company shown in the header on the Declarations page of this policy. j All other terms, conditions and exclusions shall remain the same. { Authorized Representative 107414 03/11 Page 1 i I i ENDORSEMENT i This andorsement, effective 12 Q4 A.M.03/01/2015 forms a part of � k t. policy No. 7046470 issued to CE I CONSULTANTS, INC. by NAT i ONAL UNION FIRE INSURANCE COMPANY OF P l TTSBURGH, PA THIS ENDORSEMENT GRANGES THE POLICY. PLEASIE READ IT CAREFULLY. ADDITIONAL INSURED- OWNERS, LESSEES, OR CONTRACTORS - COMPLETED ! OPERATIONS This endorsement modlfles Insurance prdvlded under the followfny: COMMERCIAL GENERAL LIABILITY COVERAG5 FORM r{ I SCHEDULE NAME OP ADDITIONAL INSURED PERSON OR ORGANIZATION; ANY PERSON OR ORGANIZATION WHOM YOU BECOME OBL I GATED TO INCLUDE A3 AN , 1 ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT.. OR 'AOREEMENT YOU HAVE ENTERED INTO. E. LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS: PER TIME CONTRACT OR AGREEMENT. i ADDITIONAL,PREMIUM., is (If No entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) SECTION It-WHO IS AN INSURED Is amended to Include as an insured; Thai parson or organization shown in the Schedule, but only with respect to liability arising out of your work" at the location designated and described Its the schedule of this endorsement ; per for that additional insured and Included in the "products-completed operations hazard". All other terms and conditions remain unchanged. oil i I { s , i i e is I k. uthoriz d Re resentative or Cotinteral nature(its States Where lnaludes copyrighted rrtnterlei a 4pplinabfe 97837 (4108) Insuranoe Strvices Offico,Inc.,with Its,perrxflsslon. Page 1 of 1 �' i ENDORSEIVIENT This endorsement, effective 12;01 A.M. 03/01/2015 forms a part of � I policy No. 704G470 issued to GE I CONSULTANT$, INC. I 4 by NATIONAL UNION F f RE INSURANCE COMPANY OF P I TTSBURGH, 'PA THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED- OWNERS, LESSEES, OR CONTRACTORS SCHEDULED PERSON OR ORGANIZATION This endorsement modlfles Insurance provlded under the fnUowlntd; i COMMERCIAL GENERAL LIABILITY COVERAGE FOfiM SCHEDULE NAME OF PERSON OR ORGANIZATION; ANY PERSON OR ORGANIZATION WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO, f f� I f � i j (it no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the andorsement.) l A. SECTION lI-WHO IS AN INSURED Is amended to Include as an Insured, �l The person of organization shown In the schedule, but only with respect to liability arising j out of your ongoing operations performed for that additional insured, I B. With respect to the Insurance afforded to these additional insureds, SECTION ! COVERAGES, COV15RAOE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. - � Exclusions, Is amended to Include the following additional exclusion; `} This Insurance does not apply to "bodily injury" or "property damage" aczcurrIng after: (1) all work, including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintsnance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or, (2) that portion of "your work" out of which the injury or damage arises has been put toits i intended use by any person or organization other than another contractor or � I suboontractor engaged in performing operations for a principal as a part of the same project. All ether terms and conditions remain unchanged, I I E I uthoriz d Re resantativa or s, Cou tersl nature(In States Where l Appifcabta11 1 97838-(4/08) Includes oopyrighted material of Page 9 of 1 4 Insuranno seryloos Ofko,l►oc,with its permission. � 1 i i E GET Consultants,Inc. Effective 03/01/2015-03/01/2016 POLICY NUMBER: #7046470 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO U I This endorsement modifies insurance provided under the following: I COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ; Pursuant to applicable written contract or agreement you enter into. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: t We waive any right of recovery we may have against the 'person or'organization shown in the:Schedule above because of payments we make for injury or damage;arising aut of your ongoing operations or your work done under a contract with that person or organization and included in the "products- complete operations hazard". This waiver applies f only to l the person or organization shown in the I Schedule!above. 1 i I ; i i i CG 24 04 05 09 O Insurance Services Office,Inc., 2008 Page 1 of 1 ❑ 1 I; 4 1 I I 1 ENDORSEMENT# This endorsement, effective 12:01 A.M. 03/01/2015-03/01/201.6forms.a part of General Liability Package Policy { Policy No, 7046470 Issued to GE1 Consultants,Inc, I I By,National Union Fire Insurance Company. { THIS ENDORSEMENT CHANCES THE POLICY. PLEASE READ IT CAREFULLY. LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL f i TO ENTITIES OTHER THAN THE FIRST NAMED INSURED f This policy is amended as follows; i In the event that the Insurer cancels this policy for any reason other than non-payment of premium, i and 1. the cancellation effective date is prior to this policy's expiration date; { 2. the First Named Insured is under an existing contractual obligation to notify a certificate holder when this policy is canceled (hereinafter, the "Certificate Holder(s)") and has provided to the Insurer, either directly or through its broker of record, the email address of a contact at each such entity; and 3. the Insurer received this information after the First.Named 'Insured receives notice of canceliation of this policy and prior to this policy's cancellation effective dater via an electronic spreadsheet that is acceptable to the Insurer, the Insurer will provide advice of cancellation (the`"Advice") via e-mail to each such Certificate Holders within days after the First Named Insured provides such information to the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate'Holder(s) as soon as reasonably practicable after the First;Named' Insured provides such Information to the Insurer. I Proof of the Insurer emailing the Advice, using the information provided by the First Named Insured, will serve as proof that the Insurer has fully satisfied its obligations under this endorsement, i This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof,nor shall this endorsement invest any rights j in any entity not insured under this policy. F I' The following,Definitions apply to this endorsement; 1. First Named insured means the Named Insured shown on the Declarations Page of tills policy. 2. Insurer means the insurance company shown in the header on the Declarations page of this policy, i All other terms, conditions and exclusions shall remain the same. i i i Authorized'Reprosentati ve 107414:03/1'I fags 1 i i i i GEI Consultants, Inc. G-140428-A OVA Policy #6011396137 (Ed. 10101) Eff: 03/01/15-03/01/16 i THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CHANGES - NOTICE OF CANCELLATION I This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA PLUS COVERAGE PART In the event of cancellation of this coverage,we agree to mail prior written notice of cancellation to: SCHEDULE .1. Name: ANY PERSON OR ORGANIZATION YOU ARE REQUIRED BY WRITTEN CONTRACT OR ADDRESS: PER CERTIFICATES ON FILE I R 2. Address: AGREEMENT TO MAIL PRIOR WRITTEN WITH BROKER. NOTICE OF. CANCELLATION. 3. Number of days advance notice: 3 0* ' r * 10 DAYS NOTICE WILL APPLY' TO NON-PAYMENT OF PREMIUM, i i i n 0 0 N O O N s i I' Page 1 of 1 G-140428-A (Ed.10/01) r WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT h This endorsement changes the policy to which It is attached effective on inception date of the policy unless a different I date is indicated below. 1 i (Itio rollokvinfl"altaching cleuso" naafi be completed only Mon oils andorssment to Isawd subaeyuent.to pmparatton of lire polray} � This endorsement, effeotive 12:01 AM 03/01/2015 forms a part of Policy No. 026034972 j t Issued to GEI Consultants, Inc, By National Union Piro insurance Company I s r , Premium 6 We have the right to recover our payments from anyone liable for an Injury covered by this policy, We will not enforce our right against the person or organization named In the Schedulo.This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us, This agreement shall not operate directly or Indirectly to benefit any one not named In the Schedule, ; l Schedule i I i w I M I I I ; f' c- i I This form Is not applicable In California, Kentucky, New Hampshire, New Jersey, North Dakota, Oh.lo, Tennessee, l Texas, Utah, or Washington. , I a: wo 00 0313 Countersigned by (Ed. 04104) Authorized Representative f' I i; E }