Loading...
HomeMy WebLinkAboutPW15-235 - Original - H. D. Fowler Company - Olympic Place Water Main Replacement - 06/30/2015 Records aageentm NT ' ' Document' n, r, 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: H, D. Fowler Company Vendor Number: JD Edwards Number Contract Number: `jv . � .t This is assigned by City Clerk's Office Project Name: Olympic Place Water Main Replacement Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 6/30/15 Termination Date: 12/31/15 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Josh Harris Department: PW Operations Contract Amount: $11,187.19 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Supply materials for the project. As of: 08/27/14 KENT GOODS & SERVICES AGREEMENT between the City of Kent and H. D. Fowler Company THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and H. D. Fowler Company organized under the laws of the State of Washington, located and doing business at 1417 Thornton Ave. SW, Pacific, WA 98047, Phone: (253) 863-8600/Fax: (253) 863-8681, Contact: Michael Owens (hereinafter the "Vendor"). AGREEMENT I. DESCRIPTION OF WORK. Vendor shall provide the following goods and materials and/or perform the following services for the City: The Vendor shall supply materials for the Olympic Place Water Main Replacement project. For a copy of the Vendor's bid and list of materials, see Exhibit A which is attached and incorporated by this reference. Vendor acknowledges and understands that it is not the City's exclusive provider of these goods, materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and services through other sources. II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete the work and provide all goods, materials, and services by December 31, 2015. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Eleven Thousand, One Hundred Eight Seven Dollars and nineteen cents ($11,187.19), including applicable Washington State Sales Tax, for the goods, materials, and services contemplated in this Agreement. The City shall pay the Vendor the following amounts according to the following schedule: GOODS & SERVICES AGREEMENT - 1 (Over$10,000,00, including WSST) After receipt of all materials listed in Exhibit A and receipt of invoice. If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. A. Defective or Unauthorized Work. The City reserves its right to withhold payment from Vendor for any defective or unauthorized goods, materials or services. If Vendor is unable, for any reason, to complete any part of this Agreement, the City may obtain the goods, materials or services from other sources, and Vendor shall be liable to the City for any additional costs incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs and attorney fees, incurred by the City beyond the maximum Agreement price specified above. The City further reserves its right to deduct these additional costs incurred to complete this Agreement with other sources, from any and all amounts due or to become due the Vendor. B. Final Payment: Waiver of. Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT IS MADE. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Vendor has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Vendor maintains and pays for its own place of business from which Vendor's services under this Agreement will be performed. C. The Vendor has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Vendor's services, or the Vendor is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Vendor is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. GOODS & SERVICES AGREEMENT - 2 (Over$10,000.00, including WSST) i E. The Vendor has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Vendor's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Vendor maintains a set of books dedicated to the expenses and earnings of its business, V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. VI. CHANGES. The City may issue a written amendment for any change in the goods, materials or services to be provided during the performance of this Agreement. If the Vendor determines, for any reason, that an amendment is necessary, Vendor must submit a written amendment request to the person listed in the notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days of the date Vendor knew or should have known of the facts and events giving rise to the requested change. If the City determines that the change increases or decreases the Vendor's costs or time for performance, the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with the Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will determine the equitable adjustment as it deems appropriate. The Vendor shall proceed with the amended work upon receiving either a written amendment from the City or an oral order from the City before actually receiving the written amendment. If the Vendor fails to require an amendment within the time allowed, the Vendor waives its right to make any claim or submit subsequent amendment requests for that portion of the contract work. If the Vendor disagrees with the equitable adjustment, the Vendor must complete the amended work; however, the Vendor may elect to protest the adjustment as provided in subsections A through E of Section VII, Claims, below. The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a separate acceptance, or (3) not protesting in the way this section provides. An amendment that is accepted by Vendor as provided in this section shall constitute full payment and final settlement of all claims for contract time and for direct, indirect and consequential costs, including costs of delays related to any work, either covered or affected by the change, VII. CLAIMS. If the Vendor disagrees with anything required by an amendment, another written order, or an oral order from the City, including any direction, instruction, interpretation, or determination by the City, the Vendor may file a claim as provided in this section. The Vendor shall give written notice to the City of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the claims, or within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts or events giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed to have been waived by the Vendor unless a timely written claim is made in strict accordance with the applicable provisions of this Agreement. At a minimum, a Vendor's written claim shall include the information set forth in subsections A, items 1 through 5 below. FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY GOODS & SERVICES AGREEMENT - 3 (Over $10,000,00, including WSST) CLAIMS ARISING IN ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY THAT DELAY. A. Notice of Claim. Provide a signed written notice of claim that provides the following information: 1. The date of the Vendor's claim; 2. The nature and circumstances that caused the claim; 3. The provisions in this Agreement that support the claim; 4, The estimated dollar cost, if any, of the claimed work and how that i estimate was determined; and 5. An analysis of the progress schedule showing the schedule change or disruption if the Vendor is asserting a schedule change or disruption. B. Records. The Vendor shall keep complete records of extra costs and time incurred as a result of the asserted events giving rise to the claim. The City shall have access to any of the Vendor's records needed for evaluating the protest. The City will evaluate all claims, provided the procedures in this section are followed. If the City determines that a claim is valid, the City will adjust payment for work or time by an equitable adjustment. No adjustment will be made for an invalid protest. C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall proceed promptly to provide the goods, materials and services required by the City under this Agreement. D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor also waives any additional entitlement and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this section, the Vendor completely waives any claims for protested work and accepts from the City any written or oral order (including directions, instructions, interpretations, and determination). VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED. THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD. IX. WARRANTY. Vendor warrants that it will faithfully and satisfactorily perform all work provided under this Agreement in accordance with the provisions of this Agreement. In addition to any other warranty provided for at law or herein, this Agreement is additionally subject to all warranty provisions established under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in accordance with their specifications and Vendor's representations to City. The Vendor shall promptly correct all defects in workmanship and materials: (1) when Vendor knows or should have known of the defect, or (2) upon Vendor's receipt of notification from the City of the existence or discovery of the defect. In GOODS & SERVICES AGREEMENT - 4 (Over$10,000.00, including WSST) the event any part of the goods are repaired, only original replacement parts shall be used— rebuilt or used parts will not be acceptable, When defects are corrected, the warranty for that portion of the work shall extend for an additional year beyond the original warranty period applicable to the overall work. The Vendor shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the defect. If the Vendor does not accomplish the corrections within a reasonable time as determined by the City, the City may complete the corrections and the Vendor shall pay all costs incurred by the City in order to accomplish the correction. X. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement, XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Vendor's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to avoid any of these covenants of indemnification. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Vendor refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Vendor's part, then Vendor shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Vendor's part. The provisions of this section shall survive the expiration or termination of this Agreement. XII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that GOODS & SERVICES AGREEMENT - 5 (Over$10,000.00, including WSST) purpose. All work shall be done at Vendor's own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIV. MISCELLANEOUS PROVISIONS. A. Recyclable Materials, Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Dilutes and Governing Law, This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section XI of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification, No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. GOODS & SERVICES AGREEMENT - 6 (Over $10,000.00, including WSST) H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. City Business License Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. 1. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. VENDOR: CITY OF KENT: By: By: lCy ignattrre) ( nature) Print Name: .� ;r� Print Name: 9-4 %�� pe. Its t ,ti al 05d,Lry Its mjay� Pu&6 O- �irEc>xn✓ (title) t DATE: Cc, 7 t , DATE: 4 �3t'!is NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Michael Owens Timothy 1. LaPorte, P.E. H. D. Fowler Company City of Kent 1417 Thornton Ave, SW 220 Fourth Avenue South Pacific, WA 98047 Kent, WA 98032 (253) 863-8600 (telephone) (253) 856-5500 (telephone) (253) 863-8681 (facsimile) (253) 856-6500 (facsimile) APPROVED AS TO FORM: i Kent Law Department no F.MW oiymam PJJHa,H, GOODS & SERVICES AGREEMENT - 7 (over$10,000,00, including WSST) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By: C �l For: Title: nil tin i a ��i� i S Date: Co ova 1 EEO COMPLIANCE DOCUMENTS - 1 of 3 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments, 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines, EEO COMPLIANCE DOCUMENTS - 2 of 3 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date), between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. j By: For: Title: i Date: EEO COMPLIANCE DOCUMENTS - 3 of 3 EXHIBIT A i OLYMPIC PL i The Water Distribution department will be replacing the existing 2" galvanized water main with 132 LN FT of 4" ductile water main. They will also be replacing all the existing city water service taps with new 1" polyethylene service lines up to the residents' meter. A new 4" water main blow off will be installed at the end of the new water main for future flushing needs. In addition they will also be installing a new 2" air vacuum breaker and a traffic bearing utility vault at the top of the cul-de-sac. I I I i Ili i Bid No:Q273719 Page 1 of 2 Customer: BIDDING CONTRACTORS Quote#: Q273719 Estimator: Michael Owens bid Date: 5/27/2015 Job Name: OLYMPIC PLACE Location: KENT, WA = RPMx Line City UoM Description Unit Price Extended Price 1 146 FT 4"CL52 DI PIPE TJ,CI51/A21.51,C104,C/L,18.25' NOM.LGTH,SBR GASKET 14.91 2,176.86 (131 LBS/FT) 2 2 EA 6"DUCTILE IRON MJ X FLG GATE VALVE AW WA C515 RESILIENT SEAT,LESS 476.49 952,98 ACCESORIES(111 LBS) ! ,LESS MI 356.49 712.98 3 2 EA 4" DUCTILE IRON MA X FL GATE VALVE AW WA C515 RESILIENT SEAT ACCESSORIES(75 LBS) 02 189.02 4 1 EA 6"X 4"FL TEE DI,AW WA C110,C/L(90 LBS) 140.40.54 54 .54 5 1 EA 4" M)90 ELL,DI,AWWA C153,C/L,LBSS ACCESS(26 LBS) 6 2 EA 6" MJ SLEEVE LONG PATTERN DI,AW WA C153 LESS ACCESSORIES(39 LBS) 59.72 119.44 7 1 EA 4"MJ SLEEVE LONG PATTERN DI,AW WA C153 LESS ACCESSORIES(24 LBS) 35.62 35.62 8 1 EA 4"DI BLIND FLANGE 2"FIPTTAP,AWWA C110,NORMALLY BARE FINISH 50.40 50.40 (14 LBS) 9 1 EA 4"X 5'0"DIP SPOOL FLG X PE CEMENT LINED ASPHALTIC COATED 196,61 196.61 10 6 EA 6"WEDGE ACTION MJ KIT FOR DI PIPE W/30DS,WEDGE ACTION GLAND& 33.86 20316 i GASKET 164.04 11 6 EA 4"WEDGE ACTION Ml KIT FOR DI PIPE W/BOLTS,WEDGE ACTION GLAND& 27.34 GASKET 14.12 12 2 EA 6"BLACK BOLT&NUT KI1'8 PER 3/4"X 3 1/4",A 307,GRAOE A,IMPORT 7.06 13 2 EA 4"BLACK BOLT&NUT KIT 8PER 5/8"X 3",A 307,GRAPE A,IMPORT 1.gII 9.89 � 14 2 EA 6"1/8" RING GASKET RED RUBBER, ,96BER,ISO#15 2 EA 4"1/8"RING GASKET RED RUBBER,150N 1,01 16 48 49.44 202 02 16 3 EA 5 40 X Y'IP SADDLE ROMAC 202 BODY ONLY 17 8 EA 5,40"ROMAC U-BOLT WITH NUTSAND WASHERS,ZINC PLATED 7.77 62.16 18 1 EA 5.40 X 2"IP SADDLE ROMAC 202 BODY ONLY 23.88 23.8835.41 106.23 ' 19 3 EA FORD F500-41"IP X IP CORP STOP NO LEAD 181.95 106.23 95 20 1 EA FORD F8500-7-NL'2"IP X IP BALL CORP STOP NO LEAD 20.25 60.75 21 3 EA FORD C16-441"FIP X IPS PI ADAPTER NO LEAD79.086 6.36 7 36 22 3 EA FORD C86-34 3/4"MIP X 1"IPS PI ADAPTER NO LEAD 2 23 20 FT 2"SCH 40 BRASS PIPE ASTM B43,2Q FT LENGTHS 313g 20. .40 24 2 EA 2"90 ELL,BRASS DOMESTIC NO LEAD 76 25 1 EA 2"90 STREET ELL,BRASS DOMESTIC NO LEAD 45.61 45.61 26 3 EA 5/8"X 3/4"FORD VH72-15W-11-33 METER SETTER,KEY VALVE INLET,15" 116,35 349.05 HIGH,CHECK VALVE OUTLET, DP IN&OUT NO LEAD 27 1 EA 2"COMBINATION AIR VALVE AIR RELEASE&AIR VACUUM VALMATIC 489,52 48952 I!, H202C.2,SS TRIM 2,908.16 !i 28 1 EA 444-LA VAULT W/3'X T TRAFFIC LID, BOLT DOWN.SPECIAL ORDER,1 2,908.16 MONTH LEAD TIME. 78.28 29 4 EA 24"VALVE BOX BASE 19.57 30 4 EA 18"VALVE BOX TOP,940E 23.48 93'92 8.70 34.80 31 4 EA WATER LID FOR 940 VALVE BOX,DEEP SKIRT t Bid No:Q273719 Page 2 of 2 '.. Approximate Total 10,216,62 I i I I i II EXHIBIT B INSURANCE REQUIREMENTS FOR SERVICE CONTRACTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Contractor shall obtain insurance of the types described below: 1. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1, The Contractor's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. I EXHIBIT B (Continued) 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. E. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. i i HDFOW-1 OP ID: RK AcoR® CERTIFICATE OF LIABILITY INSURANCE O0 5/2 1 12 01 YY) 05/21 @015 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(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 thel certificate holder in lieu of such endorsement(s). PRODUCER Phone: 503-224-2500 CONCONTACT Bethany Sutherland _ Anchor Insurance&Surety, Inc Fax: 503-224-9830 PHONE 503-224-2500 ac No): 503-224-9830 1201 SW 12th Ave., Suite 500 IC No E.t): _ _... Portland,OR 97205-2030 ADDRESS: bsutherland@anchorias.com Gene M.Dietzman - - - INSURER(S)AFFOROINGCOVERAGE NAICp . _ INSURERA;Travelers Prop Cas Co of Amer 25674 INSURED H. D.Fowler Co.,Inc. INSURER B;Travelers indemnity Co. 25665 PO Box 160 - - Bellevue,WA 9 80 0 9-01 6 0 INSURER C INSURER D: INSURER E: _... 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. INSR' - -ADDL B - POLICY FEE POLICYEXP LIMITS HFIR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDOIYYYY GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 Y-630-SE626040 DAMAGE I O RENTED A X COMMERCIAL GENERAL LIABILITY X 0710112014 07f01/2015 PREMISES(E.occurrence $ 100,000 CLAIMS-MADE FX—I DCCUR MED EXP(Any one parson) $ 5,000 '.. PERSONAL&ADV INJURY $ 1,000,00 ' GENERAL AGGREGATE $ 2,000,00 GEHL AGGREGATE LIMIT APPLIES PER: PRCDUCTS COMP/OP AEG $ _2,000,00 POLICY X PRO- — LOG $ COMBINED SINGLE LIMIT 1,00D,00 AUTOMOBILE LIABILITY Ea accldenl) 5 _.. _. B I X ANY AUTO X Y-810-5E626040 07101/2014 07101/2015 BODILY INJURY(Par person) $ ALL OWNED SCHEDULED i BODILY INJURY(Per accident) S AUTOS AUTOS I NON--OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accdent I $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE _ $ _ 16,000,000 A EXCESS LIAR CLAIMS-MADE YSM-CUP-5E626048 07101/2014 07/01/2015 AGGREGATE $ 15,000,D0 ,I DED X RETENTION$ NIL. I $ 'I TH- WORKERS COMPENSATION TORY LIMI X OER AND EMPLOYERS'LIABILITY YIN Y.630-SE628040 1,000,00 A ANY PROPRIETORIPARTNERIEXECUTIVE❑ NIA 07l0112014 07f01/2015 CLEACH ACCIDENT S _ (MandaOFFICtory In NHR EXCLUDED? ASTOP GAP E.L.DISEASE-EA EMPLOYE S 1,000,00 If(Mandatary In NH) DESCRIPTION OF OPERATIONS below es describe under EL DISEASE-POLICY LIMIT S 1,D00,00 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) RE: Operations of the Insured subject to policy terms and conditions. (See page 2) CERTIFICATE HOLDER CANCELLATION KENTC-2 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, 220 4th Ave S AUTHORIZED REPRESENTATIVE Kent,WA 98032 9/(�/n 0i� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010106) The ACORD name and logo are registered marks of ACORD HDFOW-1 PAGE NOTEPAD INSURED'S NAME H. D. Fowler Co., Inc. OP ID: RK DATE 05121/15 Certificate Holder and all required entities are Additional Insured when required by written contract. Endorsements attached: CG D4 58 10 .OB; CG DO 37 04 05; and CA T3 53 03 10. II POLICY NO.: Y-630-5E626048 INSURED: H.D. Fowler Co., Inc, I COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INTERNATIONAL XTEND ENDORSEMENT This endorsement modifles Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 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 this 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 excluslons 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. Broadened Named Insured K. Bodily Injury to Co-Employees and Co- B. Blanket Additional Insured — Broad Form Volunteer Workers Vendors L. Aircraft Chartered with Crew C. Limited Worldwide Liability Coverage — In- M, Non-Owned Watercraft—Increased from 25 demnily Basis feet to 60 foot D. Damage To Premises Rented To You N. Increased Supplementary Payments Perlis of fire, explosion, lightning, smoke, • Cost of bail bonds Increased to$2,500 water . Loss of earnings increased to $500 per Limit Increased to$300,000 day E. Blanket Waiver of Subrogation 0. Medical Payments—Limit increased to F. Blanket Additional Insured—Owners, Manag- $10,000 par person ers or Lessors of Premises P. Knowledge and Notice of Occurrence or Of- G. Blanket Additional Insured — Lessors of fense Leased Equipment Q. Unintentional Omission H. Incidental Medical Malpractice R. Reasonable Force—Bodily Injury or Properly I. Personal Injury—AssumedbyContract Damage J. Amended Bodily Injury Definition S. Transportation Expenses For Repatriation or Relocation of Injured Or Sick Employees PROVISIONS a. Coverage under this provision Is afforded A. BROADENED NAMED INSURED only until the 1801h day after you acquire 1. The followingIs added to SECTION II—WHO or form the organization or the end of the policy period, whichever is earlier, unless IS AN INSURED: reported in writing to us within 180 days. Any organization, other than a partnership or B. BLANKET ADDITIONAL INSURED — BROAD joint venture, ovor which you malntain owner- FORM VENDORS ship or majority Interest on the effective date e following is added to SECTION II —WHO IS of tile Th e pollcy qualifies as a Named Insured. Th INSURED: However, coverage for any such organization will cease as of the date during the policy pe- Any person or organization that Is a vendor and rlod that you no longer maintain ownership of, that you have agreed In a written contract or or majority Interest in, such organization, agreement to Include as an additional insured on 2. The following replacos Paragraph 4.a, of this Coverage Part Is an Insured, but only with re- SECTION II—WHO IS AN INSURED: spect to liability for "bodily injury" or "property damage"that: CG D4 58 10 08 ©2008 The Travelers Companies,Inc. Page 1 of 9 COMMERCIAL GENERAL LIABILITY a. Is caused by an"occurrence"that takes place dlent, part or container entering Into, aeeom- after you have signed and executed that con- panying or containing such products;or tract or agreement; and b. Any vendor for which coverage as an addi- b. Arises out of "your products" which are dis- tlonal insured specifically is scheduled by en- tributed or sold In the regular course of such dorsement. vendor's business, C. LIMITED WORLDWIDE LIABILITY COVERAGE The insurance provided to such vendor Is subject —INDEMNITY BASIS to the following provisions; 1. The following replaces the definition of "cov- a. The limits of insurance provided to such ven- erage territory"in the DEFINITIONS Section: dor will be the limits which you agreed to pro- "Coverage territory"means: vide in the written contract or agreement, or a. The United States of America (Including the limits shown In the Declarations of this Coverage Part,whichever are loss. Its territories and possessions), Puerto Rico and Canada; b. The Insurance provided to such vendor does not apply to: b. International waters or airspace, but only L (1) "Bodily injury" or "property damage" for which the vendor Is obligated to pay (1) The "bodily Injury" or "properly dam- damages by reason of the assumption of age" Is caused by an "occurrence" liability In a contract or agreement, This that takes place;or exclusion does not apply to Iiabilily for (2) The "personal Injury" or "advertising damages that the vendor would have In Injury" Is caused by an offense com- the absence of the contract or agreement; milted; (2) Any express warranty unauthorized by in the course of travel or transportation you; between any places Included in Pam- (3) Any physical or chemical change in"your graph a.above; or products" made intentionally by such c, All other parts of the world except the vendor; "prohibited area", but only if the injury or (4) Repackaging, unless unpacked solely for damage arises out of: the purpose of Inspection, demonstration, (1) Goods or products made, sold, han- testing, or the substitution of parts under died or distributed by you, or services Instructions from the manufacturer, and provided by you to your customers or then repackaged In the original container; clients, in the territory described In (5) Any failure to make such Inspections, ad- Paragraph a. above; justmonls, tests or servicing as vendors (2) The activities of a person whose agree to perform or normally undertake to home is In the territory described In perform In the regular course of business, Paragraph a. above, but Is away for a In connection with the distribution or sale short time on your business;or of"your products"; (3) "Personal injury' or "advertising in- (8) Demonstration, installation, servicing or Jury" offenses committed through the repair operations, except such operations Internet or similar electronic means of performed at such vondor's premises in communication; connection with the sale of "your prod- provided that the insured's responsibility to ucts";or pay damages Is determined in a "suit" on the (7) "Your products" which, after distribution merits brought anywhere In the world except or sale by you, have been labeled or re- the "prohibited area", or in a settlement we labeled or used as a container, part or in- agree to. gradient of any other thing or substance With respect to "occurrences"that lake place, by or for such vendor, or "personal Injury" or "advertising Injury' of- Coverage under this provision does not apply to: fenses committed within the territory do- a, Any person or organization from whom you scribed In Paragraph c, above, the following have acquired "your products", or any ingre- conditions apply: Page 2 of 9 ©2008 The Travolors Companies,Inc. CG 04 53 10 08 COMMERCIAL GENERAL LIABILITY (1) This insurance is excess over any valid (4) We will pay expenses Incurred will) and collectible other Insurance available our consent for your defense of the to the insured, whether primary, excess. Insured against any "suit" seeking contingent or on any other basis. damages for"bodily Injury", "property (11) This Insurance is not a substitute for damage", "personal injury' or "adver- "compulsory admitted Insurance" In any tising injury' to which this Insurance country or jurisdiction Included in Para- applies, graph c. above, regardless of whether (5) We may, at our discretion, participate this Insurance would qualify as "compul- in defending the Insured against, or in sory admitted Insurance" In such country the settlement of, any claim or"suit", or jurisdiction or is accepted by the ap- 2. The following is added to the DEFINITIONS propriato authorities as proof of "compul- Section: sory admitted Insurance'. You agree to maintain "compulsory ad- "Prohibited area" means any country or juris- ry diction while any trade sanction, embargo, or mitted insurance"at the limits required by similar regulation Imposed by the United law. Your failure to do so will not Invall- States of America applies to and prohibits the data the coverage provided for such "oc- transaction of business with or within such cufrences" or offenses, but we will only country or jurisdiction, be liable to the same extent we would U. DAMAGE TO PREMISES RENTED TO YOU have been liable had you maintained "compulsory admitted Insurance". 1. The following replaces the last paragraph of For purposes of this Paragraph (11). "corn- Paragraph 2., Exclusions, of SECTION I — pulsory admitted Insurance" means in- COVERAGES — COVERAGE A BODILY IN- surance that is: JURY AND PROPERTY DAMAGE LIABIL- ITY: (1) Required to be in-force to satisfy the legal requirements of a specific coun- Exclusions c. through n, do not apply to dam- try or jurisdiction;and age to promises while rented to you, or tam- 2 Issued b an insurance fund adminis• porarlly occupied by you with permission of O Y the owner, caused by: tared by such country or jurisdiction or issued by an Insurer licensed or a, Fire; permitted by law to do business In b. Explosion; such country or jurisdiction. c, Lightning; (1ii)With respect to defending the Insured d, Smoke resulting from such fire,explosion, against, or the Investigation or settlement or lightning; or of, any claim or"suit" brought against the Insured, the following will apply; o, Water. (1) The phrase "We will pay...,!' In the A separate limit of insurance applies to such first sentence of Paragraph 1.a. of damage to premises as described in Para- SECTION I — COVERAGES — COV- graph 6,of Section III—Limits Of Insurance. ERAGE A BODILY INJURY AND This Insurance does not apply to damage to PROPERTY DAMAGE LIABILITY promises while rented to you, or temporarily and Paragraph 1.a. of SECTION I — occupied by you with permission of the COVERAGES — COVERAGE B owner, caused by: PERSONAL AND ADVERTISING a. Rupture, bursting, or operation of pros- INJURY LIABILITY Is replaced by sure relief devices; the phrase 'We will indemnify the in- sured for...:' b. Rupture or bursting due to expansion or (2) You must arrange to defend the In- swelling of the contents of any building or sured against, and Investigate or set- structure, caused by or resulting from wa- g tor; tle, any claim or"suit (3) Neither you nor any other Involved C. Explosion doom boilers, steam pipes, Insured will make any settlement steam engines,or steam turbines, without our consent, CG D4 68 10 08 0200aThs Travelers Cvnipanlos,Inc. Page 3 of 9 I� COMMERCIAL GENERAL LIABILITY 2. The following replaces Paragraph 5. of SEC- of SECTION IV — COMMERCIAL GENERAL LI- TION III—LIMITS OF INSURANCE: ABILITY.CONDITIONS; Subject to 5, above, the Damage To Prom- We waive any right of recovery we may have ises Rented To You Limit is the most we will against any person or organization because of pay under Coverage A for damages because payments we make for injury or damage arising of "property damage" to any one promises out of premises owned or occupied by or rented while rented to you, or temporarily occupied or loaned to you; ongoing operations performed by you with permission of the owner, caused by you or on your behalf, done under a contract by fire; explosion; lightning; smoke resulting with that person or organization; 'your work"; or from such fire, explosion, or lightning; or wa- 'your products", We waive this right where you ter, The Damage To Promises Rented ,ro have agreed to do so as part of a written contract, You Limit will apply to all damage proximately executed by you prior to loss. caused by the same "occurrence", whether F. BLANKET ADDITIONAL INSURED —OWNERS, such damage results from fire; explosion; MANAGERS OR LESSORS OF PREMISES lightning; smoke resulting from such fire, ex- The following Is added to SECTION II—WHO IS plosion, or lightning; water; or any combine- AN INSURED: Ilon of any of these. Any person or organization that Is a premises The Damage To Premises Rented To You owner, manager or lessor and that you have Llmit will be the higher of; agreed In a written contract or agreement to a. $300,000;or name as an additional Insured on this Coverage Part Is an Insured,but oniywith respect to liability b. The amount shown on the Declarations of for "bodily injury", "property damage", "personal this Coverage Part for Damage To Prom- injury"or"advertising Injury"that ises Rented To You Limit. a. Is"bodily injury"or"properly damago"caused 4. Tho following replaces Paragraph a, of tho by an 'occurrence" that lakes place, or "per- definition of"Insured contract' in the DEFINI- sonal injury" or"advertising Injury" caused by TIONS Section: an offense that Is committed, after you have a, A contract for a lease of premises, How- signed and executed that contract or agree- ovor, that portion of the contract for a ment; and lease of premises that Indemnifies any b. Arises out of the ownership, maintenance or person or organization for damage to use of that part of any premises loosed to premises while rented to you, or tompo- you. rattly occupied by you with permission of The Insurance provided to such premises owner, the owner, caused by: manager or lessor is subject to the following pro- (1) Fire; visions: (2) Explosion; a. The limits of insurance provided to such (3) Lightning; premises owner, managor or lessor will be the limits which you agreed to provide In the (4) Smoke resulting from such fire, ex- written contract or agreement, or the limits plosion, or lightning;or shown on the Declarations of this Coverage (5) Water, Part,whichever are less, Is not an"insured contract"; b, The insurance provided to such premises 5, The following replacos Paragraph 4.b.(1)( ) owner,manager or lessor does not apply to: b of SECTION IV— COMMERCIAL GENERAL (1) "Bodily Injury" or 'property damage" LIABILITY CONDITIONS: caused by an 'occurrence" that takes b) That (s Insurance for remises rented to place, or "personal Injury" or"advertising ( P injury" caused by an offense that Is com- you, or temporarily occupied by you with milted, after you cease to be a tenant in the permission of the owner; that premises;or E. BLANKET WAIVER OF SUBROGATION (2) Structural alterations, new construction or The following Is added to Paragraph 8.,Transfer demolition operations performed by or on Of Rights Of Recovery Against Others To Us, Page 4 of 9 0200 1ho Trovolors Oompanl",Inc. CO D4 58 10 08 'I COMMERCIAL GENERAL LIABILITY behalf of such premises owner, manager H. INCIDENTAL MEDICAL MALPRACTICE or lessor. 1. The following Is added to the definition of"oc- c, The Insurance provided to such promises currence"In the DEFINITIONS Section: owner, manager or lessor Is excess over any Unless you are In the business or occupation valid and collectible other Insurance available of providing professional health care services, to such premises owner, manager or lessor, "occurrence" also means an act or emission unless you have agreed in a written contract committed in providing or failing to provide for this Insurance to apply on a primary or "incidental medical services"to a person, contributory basis. 2. The following is added to the DEFINITIONS G. BLANKET ADDITIONAL INSURED — LESSORS Section: OF LEASED EQUIPMENT "Incidental medical services"means: The following is added to SECTION II --WHO IS a. Medical, surgical, dental, laboratory,x-ray AN INSURED: or nursing service or treatment, advice or Any person or organization that is an equipment instruction, or the related furnishing of lessor and that you have agreed in a written con- food or beverages; tract or agreement to include as an additional in- b. The furnishing or dispensing of drugs or surod on this Coverage Part Is an Insured, but medical, dental, or surgical supplies or only with respect to liability for "bodlly Injury", appliances; 'property damage", "personal Injury" or"adverbs- c. First aid; or Ing Injury"that; a. Is "bodily Injury"or"property damage"caused d• "Good Samaritan services", by an "occurrence" that takes place, or "per- "Good Samaritan services" means any emer- sonal injury" or"advertising injury" caused by gency medical services for which no compon- an offense that Is committed, after you have sation is demanded or received, signed and executed that contract or agree- 3. The following Is added to Paragraph 2,a.(1)of ment; and SECTION II—WHO IS AN INSURED: b. Is caused, in whole or In part, by your acts or Unless you are In the business or occupation omissions In the maintenanco, operation or of providing professional health care services, use by you of equipment leased to you by Paragraphs (1)(a), (b), (c) and (d) above do such equipment lessor. not apply to any "bodily Injury" arising out of The insurance provided to such equipment lessor any providing or falling to provide "incidental Is subject to the following provisions: medical services" by any of your "employ- The limits of Insurance provided to such ees", other Ihan an employed doctor. Any equipment lessor will be the limits which you such "employees" providing or falling to pro- agreed to provide in the written contract or vide"incidental medical services" during their agreement, or the limits shown on the Dacia- work hours for you will be deemed to be act- rations of this Coverage Part, whichever are Ing within the scope of their employment by loss. you or performing duties related to the con• b. The Insurance provided to such equipment duct of your business, lessor does not apply to any "bodily Injury"or 4. The following exclusion Is added to Para- "property damage" caused by an "occur- graph 2„ Exclusions, of SECTION I -- COV- ronce" that takes place,or"personal Injury"or ERAGES -• COVERAGE A BODILY INJURY "advertising Injury" caused by an offense that AND PROPERTY DAMAGE LIABILITY: is committed, after the equipment lease ex- Sale Of Pharmaceuticals pires, "Bodily Injury" or "property damage" arising c. The Insurance provided to such equipment out of the willful violation of a penal statute or lessor Is excess over any valid and collectible ordinance relating to the sale of pharmaceuti- olher Insurance available to such equipment cals committed by, or with the knowledge or lessor, unless you have agreed in a written consent of,the insured, contract for this Insurance to apply on a prl- 5. The following Is added to Paragraph S. of mary or contributory basis. SECTION III LIMITS OF INSURANCE: CG D4 50 10 08 02008 The Travelers Companles,Inc, Page 5 of 9 COMMERCIAL GENERAL LIABILITY For the purposes of determining the applica- has also been assumed In the ble Each Occurrence Limit, all related acts or same"insured contract"; and ornisslons committed in the providing or fall- (b) Such attorney fees and litigation ing to provide "Incidental medical services"to expenses are for defense of that any one person will be considered one "oc- party against a civil or alternative currence". dispute resolution proceeding in 6. The following is added to Paragraph 4.b., Ex- which damages to which this In- cess Insurance, of SECTION IV — COM- suranoe applies are alleged. MERCIAL GENERAL LIABILITY CONDI- 2, The following replaces the third sentence of TIONS: Paragraph 2, of SUPPLEMENTARY PAY- This insurance Is excess over any valid and MENTS—COVERAGES A AND Bl collectible other Insurance, whether primary, Notwithstanding the provisions of Paragraph excess, contingent or on any other basis, that 2,b.(2) of Section I—Coverage A— Bodily In- es available to any of your "employees" for jury And Property Damage Liability or Para- "bodily Injury that arises out of providing or graph 2.e, of Section I — Coverage B — Per- failing to provide "incidental medical services" sonal and Advertising Injury Liability, such to any parson to the extent not subject to payments will not be deemed to be damages Paragraph 2.a.(1) of SECTION II — WHO IS because of"bodily Injury", "property damage" AN INSURED. or "personal Injury", and will not reduce the 1. PERSONAL INJURY — ASSUMED BY CON- limits of Insurance. TRACT 3. The following replaces Paragraph 2.d. of 1. The following replaces Exclusion e., Contrao- SUPPLEMENTARY PAYMENTS — COVER- teal Liability, in Paragraph 2, of SECTION I AGES A AND B: — COVERAGES — COVERAGE B PER- d. The allegations In the "suit' and the in- SONAL AND ADVERTISING INJURY LI- formation we know about the "occur- ABILITY: rence"or offense are such that no conflict e. Contractual Liability appears to exist between the Interests of "Personal Injury"or"advertising Injury'for the Insured and the Interests of the In- which the Insured is obligated to pay demnitee; damages by reason of the assumption of 4, The following replaces the first subparagraph liability In a contract or agreement. Tile of Paragraph f, of the definition of "insured exclusion does not apply to: contract"in the DEFINITIONS Section: (1) Liabllity for damages that (lie Insured f, That part of any other contract or agree- would have In the absence of the meet pertaining to your business (Includ- contract or agreement; or Ing an Indemnification of a municipality in connection with work performed for a (2) Liability for damages because of municipality)under which you assume the "personal Injury" assumed in a con- tort liability of another party to pay for tract or agreement that Is an "Insured "bodily injury," "property damage"or"per- contract", provided that the "personal sonal Injury"to a third person or organize- injury" is caused by an offense cam• tlon. Tort liability means a liability that milled subsequent to the execution of would be Imposed by law in the absence the contract or agreement. Solely for of any contract or agreement. the purposes of liability assumed in J. EXTENSION OF COVERAGE — BODILY IN. an "Insured contract', reasonable at- JURY torneys fees and necessary litigation The following replaces tho definition of"bodily in- expenses incurred by or for a party jury"In the DEFINITIONS Section: other than an insured will be deemed to be damages because of "personal "Bodily injury" means bodily Injury, mental an- Injury',provided that: guish, mental Injury, shock, fright, disability, hu- (a) Liability to such party for, or for miliatlon, sickness or disease sustained by a per- son, Including death resulting from any of these at p y anytlme. i i Page 6 of 9 02008 The Travelers Companies,Inc. CG D4 58 10 08 i COMMERCIAL GENERAL LIABILITY K. BODILY INJURY TO CO-EMPLOYEES AND vehicle to which the Bodily Injury Liability CO-VOLUNTEER WORKERS Coverage applies. We do not have to fur- The following is added to Paragraph 2.a.(1) of nish these bonds. SECTION II—WHO IS AN INSURED: 2. The following replaces Paragraph 1.d. of Paragraph (1)(a) above does not apply to "bodlly SUPPLEMENTARY PAYMENTS — COVER. Injury"to a co-"employee"In the course of the co- AGES A AND B of SECTION I — COVER. 'employee's" employment by you or performing AGES; duties related to the conduct of your business, or d, All reasonable expenses Incurred by the to "bodily injury'to your other"volunteer workers" Insured at our request to assist us in the while performing duties related to the conduct of Investigation or defense of the claim or your business, "suit", Including actual loss of earnings up L. AIRCRAFT CHARTERED WITH CREW to $500 a day because of lime off from j The foflowing Is added to Exclusion g., Aircraft, work. Auto Or Watercraft,in Paragraph 2.of SECTION 0, MEDICAL PAYMENTS—INCREASED LIMITS I — COVERAGES — COVERAGE A BODILY IN- The following replaces Paragraph 7.of SECTION JURY AND PROPERTY DAMAGE LIABILITY: Ill—LIMITS OF INSURANCE; This exclusion does not apply to an aircraft that 7. Subject to 5. above, the Medical Expense is: Limit Is the most we will pay under Coverage (a) Chartered with crew to any Insured; C. for all medical expenses because of "bod- b Not owned b any Insured; and fly Injury" sustained by any one person, and O Y will be the higher of: (c) Not being used to carry any person or prop- (a) $10,000; or erty for a charge. (b) The amount shown on the Declarations of M. NON-OWNED WATERCRAFT this Coverage Part for Medical Expense 1. The following replaces Paragraph (2) of Ex- Limit. clusion g., Aircraft, Auto Or Watercraft, In P. KNOWLEDGE AND NOTICE OF OCCUR- Paragraph 2. of SECTION I —COVERAGES RENCE OR OFFENSE — COVERAGE A BODILY INJURY AND The following Is added to Paragraph 2., Duties In PROPERTY DAMAGE LIABILITY: The Event of Occurrence, Offense, Claim or (2) A watercraft you do not own that Is; Suit, of SECTION IV — COMMERCIAL GEN- (a) Fifty feet long or less;and ERAL LIABILITY CONDITIONS; (b) Not being used to carry any person or e. The following provisions apply to Paragraph property for a charge, a. above, but only for the purposes of the In- 2. The following Is added to Paragraph 2. of surance provided under this Coverage Part to SECTION II—WHO IS AN INSURED: you or any Insured listed In Paragraph 1.or 2, of Section 11—Who Is An Insured: Any person or organization that,with your ex- (1) Notice to us of such "occurrence" or of- press or Implied consent, either uses or is re- fense must be given as soon as practice- sponslble for the use of a watercraft that you bie only after the "occurrence" or offense do not own that is: is known to you (if you are an Individual), (1) Fifty foot long or less;and any of your partners or members who is (2) Not being used to carry any person or an Individual (if you are a partnership or property for a charge, joint venture), any of your managers who N. INCREASED SUPPLEMENTARY PAYMENTS Is an individual (if you are a limited Ile company), any of your trustees who iss an an 1. The following replaces Paragraph 1.b. of Individual (if you are a trust), any of your SUPPLEMENTARY PAYMENTS — COVER- "executive officers"or directors(if you are AGES A AND B of SECTION i -- COVER- an organization other than a partnership, AGES; joint venture, limited liability company or b. Up to $2,500 for cost of bail bonds re- trust) or any "employee" authorized by quired because of accidents or traffic law you give notice of an "occurrence" or violations arising out of the use of any offense. CG Da 58 10 011 Q2008 The Trevalm coaraolos,Inc. Pago 7 of 9 COMMERCIAL.GENERAL LIABILITY (2) If you are a partnership,joint venture, lim- relied upon In Issuing this policy will not prejudice Ited liability company or trust,and none of your rights under this Insurance. However, this your partners, joint venture members, provision does not affect our right to collect add!- managers or trustees are individuals, no- llonal premium or to exercise our rights of cancel- tice to us of such "occurrence"or offense lation or nonrenewal in accordance with applica- must be given as soon as practicable only ble Insurance laws or regulations. after the"occurrence"or offense Is known R. REASONABLE FORCE -- BODILY INJURY OR by: PROPERTY DAMAGE (a) Any Individual who is: The following replaces Exclusion a„ Expected Or (1) A partner or member of any pars- Intended Injury, in Paragraph 2, of SECTION I — nershlporjolntvenlure; COVERAGES — COVERAGE A BODILY IN. (11) A manager of any limited liability JURY AND PROPERTY DAMAGE LIABILITY: company; a. Expected or Intended Injury or Damage (111)A trustee of any trust; or "Bodily Injury"or"property damage"expected (iv)An executive officer or director of or intended from the standpoint of the In- any other organization; sured. This exclusion does not apply to "bod- Ily Injury" or"property damage" resulting from that is your partner, joint venture the use of reasonable force to protect any member, manager or trustee; or person or property. (b) Any "employee" authorized by such S. TRANSPORTATION EXPENSES FOR REPA- partnership, joint venture, limited I!- TRIATION OR RELOCATION OF INJURED OR ability company, trust or other organ(- SICK EMPLOYEES zation to glue notice of an "occur- 1. The following Is added to SUPPLEMENTARY onto"or offense, PAYMENTS — COVERAGE A AND B of l (3) Notice to us of such "occurrence" or of- SECTION I--COVERAGES: fense will be deemed to be given as soon as practicable if It Is given In good faith as We will reimburse you for the reasonable soon as practicable to your workers' transportation expenses"that you Incur, over compensation Insurer. This applies only if and above "normal transportation costs", for you subsequently give notice to us of the the repatriation or relocation of any of your In- "occurrence" or offense as soon as prat- lured, diseased, sick or deceased "employ- 11cable after any of file persons described ass". But only if: in Paragraphs e.(1) or (2) above discov- a. The Injury, disease, sickness, or death ers that the "occurrence" or offense may occurred during the policy period and result In sums to which the insurance while such "employee" was employed or provided under this Coverage Part may assigned to work by you anywhere In the apply. world other than: However, if this policy Includes an endorse- (1) The United States of America (mclud- monl that provides limited coverage for"bod- Ing its territories and possessions), ily Injury" or "property damage" or pollution Puerto Rico and Canada; and costs arising out of a discharge, release or (2) Any country or jurisdiction in the escape of "pollutants" which contains a ro- "prohibited area"; qulroment that the discharge, release or es- cape of "pollutants" must be reported to us b. The relocation or repatriation is neces- within a specific number of days after Its sary in the opinion of competent medical abrupt commencement, this Paragraph e, authorities;and does not affect that requirement. c, The relocation or repatriation is from the Q. UNINTENTIONAL OMISSION country where the Injury, disease, sick- ness, th death occurred to a destination The following is added to Paragraph 6., Re pre- in another country, sentations, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS; The most we will pay as reasonable "trans- The unintentional omission of, or unintentional er- portation expenses" for the repatriation or re- The In, any Information provided by you which we location of any one of your "employees" Is Page 8 of 9 9 200B The Travelers companies,[no, CO D4 58 10 08 COMMERCIAL GENERAL. LIABILITY $25,000, The most we will pay as reasonable 3. The following is added to the DEFINITIONS "transportation expenses" for the repatriation section: or relocation of all of your "employees" Is "Normal transportation costs" means the $50,000. These payments will not reduce the costs of transporting your"employee" In good limits of Insurance. health, and In conformance with your busi- 2, The following is added to Paragraph 4.b., Ex- ness travel policy, from the country of injury, cess insurance, of SECTION IV — COM- disease, sickness, or death to the country of MERCIAL GENERAL LIABILITY CONDI- relocation or repatriation. TIONS: "Transportation expenses" Includes the fol- This Insurance is excess over any valid and lowing expanses: collectible other insurance, whether primary, a. Costs of embalming to meet United excess, contingent or on any other basis, that States standards; and Is available for the reasonable "transportation expenses" that you Incur, over and above b, All reasonable expenses of transportation "normal transportation costs", for the repalria- to return the remains of the deceased to tion or relocation of any of your Injured, dis- the country of burial or funeral. cased,sick or deceased"employees". CG 04 68 10 08 02008 The Travelers companies,Ino. Page 9 of 9 POLICY NO.: Y-630-5E626048 INSURED: H.D. Fowler Co., Inc. 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 COMMERCIAL GENERAL LIABILITY CONDITIONS which coverage is sought arises out of an of- (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): ance 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 wo policy,including any umbrella or excess policy, wlll not share will) that other Insurance, provided that: a. The "bodily injury" or "properly damago" for which coverage Is sought occurs;and CG DO 37 04 06 Copyright 2005 The St. Paul Travolors Companies, Inc.All rights reserved. Page 1 of 1 POLICY NO.: Y-810-5E626048 INSURED: H.D. Fowler Co., Inc. COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied 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 ondorsoment 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 oxciudod 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 on- 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. BLANKET ADDITIONAL INSURED I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT C. EMPLOYEE HIRED AUTO J, PERSONAL EFFECTS D. EMPLOYEES AS INSURED K. AIRBAGS E. SUPPLEMENTARY PAYMENTS — INCREASED L. NOTICE AND KNOWLEDGE OF ACCIDENT LIMITS OR LOSS F. HIRED AUTO — LIMITED WORLDWIDE M. BLANKET WAIVER OF SUBROGATION COVERAGE—INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A, BROAD FORM NAMED INSURED executed by you before the "bodily Injury" or The following Is added to Paragraph A.1., Who Is "property damage" occurs and that Is In effect An Insured, of SECTION 11 — LIABILITY COV- during the policy period, to be named as an adds ERAGE: fional Insured Is an "Insured" for Liability Cover- age, but only for damages to which this insurance Any organization you newly acquire or form dur- applies and only to the extent that person or or- Ing the policy period over which you maintain ganization qualifies as an "insured" under the 60% or more ownership Interest and that is not Who Is An Insured provision contained in Section separately insured for Business Auto Coverage. it. Coverage under this provision is afforded only un- C. EMPLOYEE HIRED AUTO Ill the 1801h 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 c. In AA An "employee" of yours Is an "insured" while Who Is An Insured, of SECTION 11 — LIABILITY operating an "auto" hired or ranted under a COVERAGE: contract or agreement in that "employee's" name, with your permission, while 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 CA T3 63 03 10 ©2010 The Travelers Indomnily Company. Page 1 of 4 Includes copyrighted material of Insurance services Office,Inc,with Its permission. COMMERCIAL AUTO 2. The following replacos Paragraph b. In B.5., within such country or jurisdiction,for Liability Other Insurance, of SECTION IV — SUSI• 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 doomed to be cov- "auto" you lease, hire, rent or borrow from ered"autos"you own, any of your "employees", partners (if you are a partnership), members (if you are a limited (1) Any covered "auto" you lease, hire, liability company) or members of their house- rent or borrow; and holds. (2) Any covered "auto" hired or rented by (a) Willi respect to any claim made or "suit' your "employoo" under a contract in brought outside the United Stales of that Individual "employeo's" name, America, the territories and possessions with your permission, while perform- of the United States of America, Puerto Ing dutles related to the conduct of Rico and Canada; your business, (1) You must arrange to defend the "In- However, any"auto"that is leased, hired, sured"against, and Investigate or set- rented or borrowed with a drfvor Is not a tle any such claim or"suit" and keep covered "auto", us advised of all proceedings and so- D. EMPLOYEES AS INSURED lions. The following Is added to Paragraph A.1., Who Is (II) Neither you nor any other Involved An Insured, of SECTION II — LIABILITY COV• "insured" will make any settlement ERAGE; without our consent. Any"employee" of yours Is an "insured" while us- (if!)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 "still" 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 properly damage" to which (2) Up to $3,000 for cost of ball bonds (in- (iris Insurance applies, that the "in- cluding bonds for related traffic law viola- sured" pays with our consent, but lions) 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 II—LIABILITY COVERAGE. 2. The following replaces Paragraph A.2.a.(4), (v) We will reimburse the "Insured" for of SECTION II—LIABILITY COVERAGE: the reasonable expenses Incurred (4) All reasonable expenses Incurred by the with our consent for your Invesliga- "insured" at our request. Including actual lion of such claims and your defense loss of earnings up to $500 a day be- of the "Insured" against any such cause of time off from work. "suit", but only Lip to and Included F. HIRED AUTO — LIMITED WORLDWIDE COV- within the limit dos in Para- ERAGE—INDEMNITYBASIS graph C., Limit Insurance, of SECTION II — LIAA InsBILITY COVER- The following replaces Subparagraph (5) in Para- AGE, and not In addition to such limit. graph B.7„ Polley Period, Coverage Territory, Our duly to make such payments of SECTION IV — BUSINESS AUTO CONDI- ends when we have used up the ap- TIONS: plicable limit of Insurance in pay- (5) Anywhere In the world, except any country or menls for damages, settlements or jurisdiction while any trade sanction, em- defense expenses. bargo, or similar regulation Imposed by the (b) This Insurance Is excess over any valid United States of America applies to and pro- and collectible other insurance available hibils the transaction of business with or Page 2 of 4 ©2010 The Travelers Indemnity Company. CA T3 53 03 10 Includes copyrlghted material of Insurance$eNh es Orifice,Inc,with 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 ro- age Extensions, of SECTION III -- PHYSICAL quired or compulsory insurance In any DAMAGE COVERAGE: country outside the United States, its let- Personal Effects diaries and possessions, Puerto Rice 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 or on 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 llable to the No deductibles apply to this Personal Effects same extent we would have been liable coverage. had you compiled with the compulsory in- K. AIRBAGS surance requirements. The following is added to Paragraph B.3., Exclu- (d) It is understood (hat we are not an admit- slons, of SECTION III -- PHYSICAL DAMAGE led or authorized Insurer outside the COVERAGE: United Slates of America, Its lerrilories ICI and possessions, Puerto Rico and Can- Exclusion 3,a. does not apply to "loss" to one or ada. We assume no responsibility for the more alrbags In a covered "auto"you own that In- furntshfng of certificates of Insurance, or flate due to a cause other than a cause of "loss" for compliance in any way with the laws sot 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., Deducti- henslve Coverage under this policy; ble, of SECTION III — PHYSICAL DAMAGE In. The airbags are not covered under any war- COVERAGE: ranty; and No deductible for a covered "auto" will apply to c. The alrbags 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. HIRED 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 AA.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 representa- 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 plies only when the "accident" or"loss" is known $750 for any one "accident". to: I. 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 A.4.a., Transportation Expenses, of parry); SECTION III — PHYSICAL DAMAGE COVER- AGE: (d) An executive officer, director or Insurance 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- curred by you because of the total theft of a cov- (e) Any"employee" authorized by you to glue no- tice of the"accident"or"loss". Bred "auto"of the private passenger type. CA T3 53 03 10 ©2e1e The Travelers Indemnity company. Page 3 of 4 Includes copyrighlod material of Insurance Sewlces Once,Inc,with Its permisslon. �I I COMMERCIAL AUTO M. BLANKET WAIVER OF SUBROGATION such contract. The waiver applies only to the The following replaces Paragraph A.5., Transfer person or organization designated in such Of Rights Of Recovery Against Others To Us, contract, of SECTION IV — BUSINESS AUTO CONDI- W UNINTENTIONAL ERRORS OR OMISSIONS TIONS: The following Is added to Paragraph B.2„ Con- ti. Transfer Of Rights Of Recovery Against ceahrient, 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 ox- 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" lect additional premium or exercise our right of arises out of operations contemplated by cancellation or non-renewal. I� i i i I I I i Page 4 of 4 ©2010 The Travelers Indemnity Company, CA T3 53 03 10 Includes copyfighled material of Insurance services Office,Inc.eAth Its permission.