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HomeMy WebLinkAboutPW14-066 - Amendment - #2 - GEI, Consultants, Inc. - Briscoe-Desimone Levee Reach 1-4 - 07/29/2015 i Records Mar gen� e`n �T t ry WASHINOTON Document 5 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: �'� " � This is assigned by City Clerk's Office Project Name: Briscoe-Desimone Levee Reach 1. - 4 Description: ❑ Interlocal Agreement ❑ Change Order N Amendment ❑ Contract ❑ Other: Contract Effective Date: 7/29/15 Termination Date,; 12/31/15 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Kelly Casteel Department: Engineering Contract Amount: Approval Authority: (CIRCLE ONE) CDerpartmentDirector Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Reinstate and extend the time of completion. r- As of: 08/27/14 KEl�!T AMENDMENT NO. 2 NAME OF CONSULTANT OR VENDOR: GEI Consultants, Inc. CONTRACT NAME & PROJECT NUMBER: Briscoe-Desimone Levee Reach 1 - 4 ORIGINAL AGREEMENT DATE: March 25, 2014 I 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 prioritizing other Reaches, Reach 4 is still in design. 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, $399,124.00 eluding applicable WSST Net Change by Previous Amendments $0 including applicable WSST I Current Contract Amount $399,124,00 Lncluding all previous amendments Current Amendment Sum $0 Applicable WSST Tax o n this $0 Amendment Revised Contract Sum $399,124.00 The parties acknowledge that the Agreement terminated by its own terms on July 1, 2015, However, the City and Consultant express their mutual intent and desire to reinstate the Agreement; extend its term through December 31, 2015; and amend the work to include additional duties to be performed in accordance with the same provisions set forth in the original Agreement, except as modified within this Amendment. In addition, the parties wish to ratify and affirm any and all acts consistent with the authority of the Agreement and prior to the effective date of this Amendment. AMENDMENT - 1 OF 2 Original Time for Completion 3/1/15 (insert date) Revised Time for Completion under n/a prior Amendments (insert date) Add'I Days Required (f) for this 183 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/ DO CITY OF KENT: r� � By:A- By: f (sig tur ti (s nature) Print Name: Print Name: Timothy J. LaPorte, P.E. Its 'r t _ Its Public Works Director (title gdbe) DATE:_ p ? DATE 7 % Yr o`er APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department 6E'-6risme-oesimone Levee 5 Ama 2/CaWt l AMENDMENT - 2 OF 2 �.--� GEICONS-01 KPAWLOWSKI '',, CERTIFICATE OF LIABILITY INSURANCE DATINIMAD 31612015 1 3 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS ud�RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BYTHEPOLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER CONTACT Kathryn Pawlowski _ Ames&Gough PHONE 617 328.6555 FAx 617 328-6888 859 Willard Street Aid.No E.q;(_ ) _.._. luc NM:( 1 Suite 320 AGGResS:bo_ston@amesgough.com Quincy,MA 02169 - INSURER(S)AFFORDING COVERAGE NAICfl _ INSURER A:National Union Fire Insurance Company of Pittsburgh,PA 19445 INSURED INSURER B:Continental Casualty Company(CNA)A(XV) 20443 INSURERc:AIG S lty pecia Insurance Company A(XV 26883 GEI Consultants,Inc. --- - - - 180 Grand Ave INSURER D: Oakland,CA 94612 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 rypE OF INSURANCE ADDL SUER POLICY NUMBER MMID lYYYYY MMI-POLICY LIMITS LTft INSO W e _.. A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR X X 7046470 03/0112015 03101l2016 PREMISES Es occunence $ 300,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY 5 1,000,00- GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE. $ 2,000,000 POLICY I�JECOT 71 TOO PRODUCTS-COMPIOPAGG $ 2,000,000 $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ 1,000,000 A X ANY AUTO X X 2248367 03/01/2015 03/01/2016 BODILY INJURY(Per person) $ ALL OWN ED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS --- - NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident f$ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE _ $ 4,000,000 g EXCESS LIAB CLAIMS-MADE X X 6011396137 0310112015 03/0112016 AGGREGATE $ 4,000,000 DED X RETENTION$ 0 -_ SI PER -- WORKERS COMPENSATION - XI STATUTE OERH AND EMPLOYERS'LIABILITY A ANY PROPRIETOWPARTNERIEXECUTIVE VNN X '.026034972 0310V2015 03101/2016 EL EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUOEDi NIAI_� 1,000,000 (Mandatory In NH) E L DISEASE-.EA EMPLOYE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 _DESCRIPTION OF OPERATIONS below _ C 'Prof.Liability 17788026 03/0112016 0310112016 Per Claim 5,000,000 C &Pollution Liab. 17788026 03/01/2015 03101/2016 Aggregate 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additions Remarks Schedule,may be attached If more space is required) All Coverages are in accordance with the policy terms and conditions. Project:Kent Briscoe-Desimone Levee Reach 1,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 respect to general liability for ongoing and completed operations,auto,and umbrella liability as required by written contract,for liability arising out of the SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Kent Public Works Department ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Mr. Ken Langholz 20 Fourth Avenue South Kent,WA 98032 AUTHORIZED REPRESENTATIVE @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD j AGENCY CUSTOMER ID;GEICONS-01 KPAWLOWSKI LOC M 0 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Ames&Gough GEI Consultants,Inc. ------ 180 Grand Ave POLICY NUMBER Oakland,CA 94612 EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORO 25 FORM TITLE: Certificate of Llabllity Insurance Description of Operations/LocationsfVehicles: operations of the named insured while performing work for the City,the District,and the County.General Liability policy includes ,, severability of interest/crass liability provisions. Umbrella policy sits In excess of the general liability, auto and employer's liability; follows form. 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 l I ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. ill The ACORD name and logo are registered marks of ACORD ENDORSEMENT k 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 Holders)") and has provided to the Insurer, either directly or through its broker of record, the amail 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, will serve as proof that the 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 in any entity not insured under this policy, The following Definitions apply to this endorsement; 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 remain the same. Authorized Representative 107414 03/11. •. Page 1 ENDORSEMENT I i This endorsement, effective 12i01 A.M, 03/01/2015 farms a part of policy No. 2248367 Issued to OEI CONSULTANTS, INC. ' by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -WHERE REQUIRED UNDER CONTRACT OR AGREEMENT f 7-hls endorsement modiflos Insurance provided under the followlny: �1 BUSINESS AUTO COVERAGE FORM SCHEDULE � ADDITIONAL INSURED: !j ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATIONS LIABILITY ARISING OUT OF THE USE OF A k; COVERED AUTO. 0 i! I. SECTION II- LIABILITY COVERAGE, A. Coverage, 1.- Who Is Insured, is amended to add; d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy,as a result of any contractor 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 respect to liability arising out of use of a covered "auto". However, the insurance pravidad will not exceed the lesser of: (1) The coverage and/or limits of this policy, or H (2) The coverage and/or limits required by sold contract or agreement. I I' d. �j 4 AHtd Rpr es9ntate or counters[ store n States Where ' Applicablet 87960 (10/05) Page 1 of 1 II ENDORSEMENT 1 This endorsement, effective 12:01 A.M. 03/01/2015 forms a part of policy No. 224e367 Issued to GET Coneultanta, Too, I`fh by National Union Fire Xneurance Company I" Y THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modllfes Insurance provided under the following: BUSINESS AUTO COVERAGE'FORM _......_.. ---__.--.- — ', Section IV - Businoss Auto Conditions, A. Loss Conditions, 5, = Transfer of Rights of Recovery Against Others to Us, is amended to add: However, we will waive any right of recover we have against any person or organization with whom you have entered Into a contract or agreement because of payments we make under this Coverage Farm arising out of an "accident' or"loss" If: (1) The "accident" or "loss" Is due to operations undertaken In accordance with the contract existing between you and such person or organization; and (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, and we reserve our rights or Ilen to be rolmbursed from any recovery funds obtained by any Injured employee, N t i 7 I I III l C �I AUTHORIZED REPRESENTATIVE a i 62897 (6196) ENDORSEMENT # This endorsement, effective 12:01 A.M.3/01/2015-03/01/2016 forms a part of Worker's Compensation Policy Policy No. 026034972 Issued to GET 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 is 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(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 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 ilia 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, will serve as proof that the 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 in any entity not insured under this policy. The following Definitions apply to this endorsement: 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 remain the same. Authorized Representative 107414 03111 Page 1 k I I i ENDORSEMENT I This endorsement, effective 12:01 A.M. 03/01/2015 forms a part of r s policy No. 7046470 issued to GE CONSULTANTS, INC. r by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED- OWNERS, LESSEES, OR CONTRACTORS - COMPLETED OPERATIONS This ondorsement modlfles lnsuranco provided under the foilow/ng: f COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE NAME Or ADDITIONAL INSURED PERSON OR ORGANIZATION: I I 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. LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS: PER THE CONTRACT OR AGREEMENT, I ADDITIONAL PREMIUM: j i (If No entry appears above, information roquired to complete this endorsement will be shown in the Declarations as applicable to the endorsement,) V SECTION 11 •WHO IS AN INSURED Is amended to Include ae an Insured; The person or organization shown In the Sohodule, but only with respect to liability arising out of "your work" at the locntlon designated and described In the schedule of this endorsement performed for that additional Insured and Included In the "products•complotad operations hazard All other terms and conditions remain unchanged. �I P n r, N, I i II L S 's�" Plutho�rized Re resemal(ve or hi Ccunteraf nature (fitStates Where Inoludoa copyrighted material orApplfeable)I 97807 (4108) Incuranea SoNloea Oflloo,[no,,with Its permtaslon, Page 1 of 1 1 f { i ENDORSEMENT 1 This endorsement, effective 12:01 A.M, 03/01/2015 forms a part of 1 Policy No, 7046470 issued to BE CONSULTANTS, INC. by NATIONAL UNION FiRE INSURANCE COMPANY OF PITTSBURGH, PA I' THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. E ADDITIONAL INSURED OWNERS, LESSEES, OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement mod/ffes Insurance prov/ded under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE NAME OF PERSON OR ORGANIZATiONt 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, it l: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) A. SECTION If-WHO IS AN INSURED is amended to Include as an insured; The parson or organization shown in the schedule, but only with respect to liability arising out of your ongoing operations performed for that additional insured. B. With respect to the Insurance afforded to these additionel insureds, SECTION I - COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2, - Exclusions, is amended to include the following additional exclusion; j This insuranco does not apply to "bodily injury" or "property damage" occurring after: fl) all work, Including materials, parts or equipment furnished in connection with such 4 work, on the project(other than service, maintenance or repairs) to be performed by or G on behalf of the additional insurad(s) at the site of the covered operations has been completed; or, (21 that portion of "your work" out of which the injury or damage arises has been put to its er intended use by any person or organization other than another contractor or g � subcontractor engaged in performing operations for a principal as a part of the same project. V All other terms and conditions remain unchanged, �IKufhozed Ro resentative or g Countersignature, (In States Whore ppifcobfe 97838 (4/08) Inoludos copyrighted materfal of Page 1 of 1 li Insurance Sorvlcos Office, Inc.,with Its pormiselon. i i. GEI Consultants, Ine. 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 US This endorsement modifies insurance provided under the following: 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: 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 out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 ©Insurance Services Office, Inc., 2008 Page 1 of 1 0 i ENDORSEMENT A This endorsement, effective 12:01 A.M. 03/0 1/20 1 5-03/0 1/201 6forms a part of General Liability Package Policy Policy No. 7046470 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 Holders)") and has provided to the Insurer, either directly or through its broker of record, the small address of a contact at each such entity; and 3. the Insurer received this information after tite 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 a-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 Certlficate Holder(s) as soon as reasonably practicable after the First Named Insured provides such information to the Insurer, Proof of the Insurer email(ng 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 in any entity not insured under this policy. The following Definitions apply to this endorsement: 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 remain the same. I I i III Authorized Representative 107414 03/11, Page 1 GEI Consultants, Inc . G-140428-A H Policy 46011396137 (Ed. 10/01) Eff : 03/01/15-03/01/16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CHANGES - NOTICE OF CANCELLATION 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 2. Address: AGREEMENT TO MAIL PRIOR WRITTEN WITH BROKER. NOTICE OF CANCELLATION. 3. Number of days advance notice: 30* * 10 DAYS NOTICE WILL APPLY TO NON-PAYMENT OF PREMIUM. � I I j G-140428-A Page 1 of 1 (Ed. 10/01) f WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT i This endorsement changes the policy to which it is attached effective on Inception date of the policy unless a different date is Indicated below. (rho following"ailaohing 01aum" nand ba compfoI only when Ihls ondorsament to Issued subuaquont to preparatIon of ffio poiloy). This endorsement, effective 12:01 AM 03/01/2015 forms a part of Policy No. 026034972 Issued to GEI Consultants, Inc, r By Nat:ional Union Fire Insurance Company Premium 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 orgonlzallon named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us, a This agreement shall not operate directly or Indirectly to benefit any one not named in the Schedule, Schedule I V fl 0 r c w (t( i k f This form Is not applicable in Cattfornla, Kentucky, New Hampshire, New Jersey, North Dakota, Ohio, Tennessee, Texas, Utah, or Washington, h 0 WC 00 03 13 Counter8igned by f (Ed. 04/84) Authorized Representative k I a I� i c