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HomeMy WebLinkAboutPW15-292 - Change Order - #1 - Evergreen Asphalt & Concrete, Inc. - Repaint Downtown Parking Stalls - 09/24/2015 Records anag e e'n"t WASH,Noro„ Document i 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: Evergreen Asphalt & Concrete, Inc. Vendor Number: JD Edwards Number Contract Number: 1 — 1� - This is assigned by City Clerk's Office Project Name: Downtown Parking Striping Description: ❑ Interlocal Agreement ® Change Order ❑ Amendment ❑ Contract ❑ Other: Contract Effective Date: 9/24/15 Termination Date,: 9/30/15 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Kelly Peterson Department: Engineering Contract Amount: 5$ 00.00 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Modify parking stall layout. As of: 08/27/14 KENT CHANGE ORDER NO. 1 NAME OF CONTRACTOR: Evergreen Asphalt & Concrete Inc. ("Contractor") CONTRACT NAME & PROJECT NUMBER: Downtown Parking Striping ORIGINAL CONTRACT DATE: August 19, 2015 This Change Order amends the above-referenced contract; all other provisions of the contract that are not inconsistent with this Change Order shall remain in effect. For valuable consideration and by mutual consent of the parties, the project contract 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, Contractor shall provide all labor, materials, and equipment necessary to: Modify parking stall layout at locations A, B, and C on Meeker St. and State Ave., and remove all work on Gowe St. we of 4th Ave. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are hereby modified as follows: Original Contract Sum, $6,900.00 (including applicable alternates and WSST) Net Change by Previous Change Orders $0 (incl. applicable WSST) Current Contract Amount $6,900.00 (incl. Previous Change Orders) Current Change Order $500.00 Applicable WSST Tax on this Change $0 Order Revised Contract Sum $7,400.00 i CHANGE ORDER - 1 OF 3 Original Time for Completion 9/30/15 (insert date) Revised Time for Completion under n/a prior Change Orders (insert date) Days Required (f) for this Change 0 calendar days Order Revised Time for Completion 9/30/15 (insert date) In accordance with Sections 1-04.4 and 1-04.5 of the Kent and WSDOT Standard Specifications, and Section VII of the Agreement, the Contractor accepts all requirements of this Change Order by signing below. Also, pursuant to the above-referenced contract, Contractor agrees to waive any protest it may have regarding this Change Order and acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Change Order, unless otherwise provided, does not relieve the Contractor from strict compliance with the guarantee and warranty provisions of the original contract, particularly those pertaining to substantial completion date. All acts consistent with the authority of the Agreement, previous Change Orders (if any), and this Change Order, prior to the effective date of this Change Order, are hereby ratified and affirmed, and the terms of the Agreement, previous Change Orders (if any), and this Change Order 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 contract modification, which is binding on the parties of this contract. 3. The Contractor will adjust the amount of its performance bond (if any) for this project to be consistent with the revised contract sum shown in section 2, above. IN WITNESS, the parties below have executed this Agreement, which will become effective on the last date written below. CONTRACTOR: CITY OF KENT: By: By: (signature) ( gnature) Print Name _. t ' ~~ Print Name: Timothy J. LaPorte P.E. Its -. Its Public Works Director _ ,(trtle) (title) _ DATE: DATE: Zf 5 CHANGE ORDER - 2 OF 3 APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department 2veryreen-oowntovm Pking stnptn9 Cot/connor CHANGE ORDER 3 OF 3 EVER-29 OP ID: LB CERTIFICATE OF LIABILITY INSURANCE 708117115YY5 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(lea) 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 endorsements . PRODUCER 206-285.7735 NAMEACT Laura Buscio Lovsted-Worthington LLC PHONE 200 First Ave West Ste 500 206.285-3461 LArC No Exn•206-838-7015 We Ne): 206-285-3461 Seattle,WA 98119 LA'LSs)au Wendy Pyle - ra@lovstedworthington.com _ INSURER(SIAFFORDING COVERAGE _ NAICp INsuRERA:boposif ors Insurance Company _ INSURED Evergreen Asphalt INSURER &Concrete, Inc. INSURERC: P O Box 1567 --- - - _--- --- Kent,WA 98035 INSURER 0 INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INS, TYPE OF INSURANCE DDL B POLICY NUMBER MMIODNYYY MMIDOryYYY LIMITS LT, GENERAL LIABILITY EACH OCCURRENCE $ 1,()00,000 A X COMMERCIAL GENERAL LIABILI X X ACP3007050259 05/03115 06103/16 D AGE.E.;cc—Ni D 100,000 PREMIS_ES_Ea ocwrrenw $ CLAIMS-MADE a OCCUR MED EXP(Any ane person) $ _ 6,000 PERSONAL S ADV INJURY $ 1,000,00 X Stop Gap GENERAL AGGREGATE $ 2,000,00 GENt AGGREGATE LIMIT APPLIES PER: PRODUCTS,COMP/OP AGO $ 2,000,00 POLICY X PRO-JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident 3 A X ANY AUTO X X ACPSAPD3007050259 06/03/16 05/03116 BODILY INJURY IPer person) $ ALLOWNED SCHEDULED BODILY INJURY(Per ac dent) $ AUTOS _ AUTOS — — HIRED AUTOS NON.O.B. PROPERTY DAMAGE $ AUTOS fper aoc'denll X UMBRELLA LIAR X OCCUR _EAC)I OCCURRENCE $_ 2,000,000 A EXCESS LIAB CLAIMS-MADE ACP3007060269 05/03/15 05/03116 ail AGGREGATE $ 2,000,00 DEO X RETENTION$ 10,000 $ WORKERS COMPENSATION WC S7ATU- X OTH- AND EMPLOYERS'LIABILITY Ir- TORY LIMITS A ANY PROPRIETOR/PARTNERIEXECUPVE Y�[N/A ACP3007050259 05/03116 05/03116 E.L EACH AC DENT $ 1,000,00OFFICER/MEMBER EXCLUDED? WA STOP GAP DISEASE-EAEMPLOYEE $ 1,000,00 (Mandatory in NH) 1 --_ If es,describeunder 1,000,00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Addltlonel Remarks Schedule,It more apace Is required) The City of Kent, its officials, employees and volunteers are additional insured for general liability, but only if required by written contract or written agreement per the attached endorsement CG7323 & ACO101A. Insurance is primary and non-contributory per the attached CG7323. Waiver of subrogation applies per the attached CG7323 & AC0101A. CERTIFICATE HOLDER CANCELLATION, Ili CITY 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 South Kent,WA 98032 AUTHORIZED REPRESENTATIVE '.',.� ✓��� Ili ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010106) The ACORD name and logo are registered marks of ACORD i Policy#ACP3007050259 COMMERCIAL GENERAL LIABILITY j CG 73 23 11 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ENHANCEMENT PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM LOST KEY COVERAGE "Loss"means unintentional damage or SECTION I — COVERAGES, COVERAGE A destruction but does not include disappearance, BODILY INJURY AND PROPERTY DAMAGE theft, or loss of use. LIABILITY, coverage is extended to include the NON-OWNED WATERCRAFT following: SECTION I — COVERAGES, COVERAGE A If a customer's master or grand key, excluding BODILY INJURY AND PROPERTY DAMAGE electronic key card, is lost while in your care, LIABILITY, 2. Exclusions is amended as follows: custody or control we will pay the cost of g, Aircraft, Auto Or Watercraft (2) (a) is replacing the keys, including the master lock and replaced with: all keys used in the same lock, the cost of (a) Less than 51 feet long; and adjusting locks to accept the new keys, or the cost to replace the locks,whichever is less. EXPANDED PROPERTY DAMAGE COV- Limit of Insurance - The most we will pay for ERAGE "loss" arising out of any one "occurrence" is For the purposes of this endorsement only: $5,000, SECTION I — COVERAGES', COVERAGE A SECTION V DEFINITIONS is amended as BODILY INJURY AND PROPERTY DAMAGE follows: LIABILITY, 2. Exclusions is amended as follows: The following definition applies to Lost Key a. Exclusions j.(3),j.(5), and j.(6)are Coverage: deleted in their entirety. "Loss" means unintentional physical damage or b. Exclusion j.(4) is deleted in its entirety destruction to tangible property, including theft or and replaced by the following: disappearance. Tangible property does not Personal property In the care custody or include money or securities. control of the insured: VOLUNTARY PROPERTY DAMAGE 1. for storage or sale at premises you SECTION I — COVERAGES, COVERAGE A own, rent or occupy;or BODILY INJURY AND PROPERTY DAMAGE 2. while being transported by any LIABILITY, coverage is extended to include the aircraft, "auto" or watercraft owned following: or operated by or rented to or loaned At your request,we will pay for"property damage"to to any Insured. property of others caused by you and while in your c. The following exclusions are added: possession, arising out of your business operations 1. The coverage provided by this and occurring during the policy period. endorsement does not apply to Limit of Insurance-The most we will pay for "property damage" arising out of the "loss"arising out of any one"occurrence"is disappearance or loss of use of $500, personal property. SECTION V—DEFINITIONS is amended as 2. The coverage provided by this follows: endorsement does not apply to The following definition applies to Voluntary "property damage" included in the Property Damage coverage: "products-completed operations hazard". CG 73 23 11 11 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 6 with its permission. i I I CG 73 23 11 11 Limit of Insurance - The most we will pay b. Up to $2,500 for cost of bail bonds for "property damage" provided by this required because of accidents or traffic coverage In any one"occurrence"is$5,000, law violations arising out of the use of Deductible - Our obligation to pay for a any vehicle to which the Bodily Injury covered loss applies only to the amount of Liability Coverage applies. We do not loss in excess of$250. have to fumish these bonds. This insurance Is excess over any other valid 2. 1.d.replaced with: and collectible insurance. d. All reasonable expenses incurred by the DAMAGE TO PREMISES RENTED TO YOU insured at our request to assist us in the SECTION I — COVERAGES, COVERAGE A investigation or defense of the claim or BODILY INJURY AND PROPERTY DAMAGE "suit", including actual loss of earnings up to LIABILITY, the last paragraph of 2. Exclusions of is replaced by the following: from work. a day because of time off If Damage to Premises Rented to You is NEWLY FORMED AND ACQUIRED ORGANIZATIONS not otherwise excluded, exclusions c. through n. do not apply to damage by fire, SECTION II — WHO IS AN INSURED is lightning, explosion, smoke or sprinkler amended as follows: leakage to premises while rented to you or 1. 3.a, is replaced with: temporarily occupied by you with permission a. Coverage under this provision is of the owner. A separate limit of insurance afforded only until the 180"day after you applies to this coverage as described in acquire or form the organization or the Section III-Limits of Insurance. end of the policy period, whichever Is SECTION III — LIMITS OF INSURANCE, earlier; paragraph 6 Is replaced with: ADDITIONAL INSURED — WHEN REQUIRED 6. Subject to 5. above, the Damage To IN AN AGREEMENT OR CONTRACT WITH Premises Rented To You Limit is the most YOU PRIMARY AND NON-CONTRIBUTORY l we will pay under Coverage A for damages The following is added to SECTION II—WHO IS because of "property damage" to any one AN INSURED premises,while rented to you,or In the case 4. Any person(s) or organizatlon(s) with whom of damage by fire, lightning, explosion, you have agreed in a valid written contract or smoke or sprinkler leakage, while rented to written agreement that such person or you or temporarily occupied by you with organization be added as an additional permission of the owner. The limit is insured on your policy during the policy increased to$300,000, period shown In the Declarations. Such SECTION IV — COMMERCIAL GENERAL person or organization is an additional LIABILITY CONDITIONS, 4. Other Insurance, insured only with respect to liability for b. Excess Insurance (1) (a) (if) is replaced "bodily injury", "property damage" or with: "personal and advertising injury", (11) That is Fire, Lightning, Explosion, The' person or organization added as an Smoke or Sprinkler leakage insurance insured by this endorsement is an insured for premises rented to you or temporarily only to the extent you are held liable due to: occupied by you with permission of the a. Lessors of Leased Equipment owner. Maintenance, operation or use of SUPPLEMENTARY PAYMENTS equipment leased to you by such person SECTION I — COVERAGES, SUPPLEMEN- Rr organization. This Insurance does not TARY PAYMENTS—COVERAGES A AND B is apply to any "occurrence" which takes amended as follows: place after the equipment lease expires. 1. 1. b. replaced with: However, their status as additional insured under this policy ends when their ease, contract or agreement with you for such leased equipment expires. Page 2 of 6 Includes copyrighted material of Insurance Services Office, Inc., CG 73 23 11 11 with its permission. CG 73 23 11 11 b. Managers or Lessors of Premises The insurance does not apply to: The ownership, maintenance or use of (1) "bodily injury", "property damage", or that part of the premises you own, rent, "personal and advertising injury" arising lease or occupy, out of the rendering of or the failure to This insurance does not apply to: render any professional architectural, (1) Any "occurrence" which takes place engineering or survey services, after you cease to be a tenant In that ncluding: premises. (a). The preparing, approving, or failing (2) Structural alterations, new con- to prepare or approve maps, shop struction or demolition operations drawings, opinions, reports, survey, field orders, change orders or performed by or on behalf of the person or organization. drawings and specifications: or However, their status as additional (b) Supervisory, inspection, architec- insured under this policy ends when you tural or engineering activities, cease to be a tenant of such premises. (2) "Bodily Injury" or "property damage" c. State or Political Subdivision - occurring after: Permits (a) All work, including materials, parts Operations performed b you or on our or equipment furnished n P P Y Y Y connection with such work, on the behalf for which the state or political project (other than service, subdivision has issued a permit. maintenance or repairs) to be This insurance does not apply to: performed by or on behalf of the (1) "Bodily injury" or "property damage" additional insured(s) at the location or "personal or advertising injury" of the covered operations has been arising out of operations performed completed; or for the state or municipality; or (b) That portion of "your work" out of which the injury or damage arises (2) "Bodily injury" or "property damage" has been put to its intended use by Included within the "products- any person or organization other completed operations hazard", than another contractor or However, such state or political subcontractor engaged in subdivision's status as additional insured performing operations for a principal under this policy ends when the permit as a part of the same project. ends. However, a person or organization's d. Owners, Lessees, or Contractors status as additional insured under this "Bodily injury", "property damage" or policy ends when your operations for "personal and advertising injury" caused, in that additional insured are completed. whole or in part, by: With respect to paragraph 4 of SECTION II (1) Your acts or omissions;or WHO IS AN INSURED, Condition 4. Other Insurance of Section IV — Commercial (2) The acts or omissions of those acting on General Liability Conditions is replaced by the your behalf; following! In the performance of your ongoing 4. Othcl Insurance operations performed for that additional If other valid and collectible insurance is insured, whether the work is performed by available to the insured for a loss we cover you or on your behalf. under Coverages A or B of this Coverage Part,our obligations are limited as follows: a. Primary Insurance This insurance is primary if you have agreed In a written contract or written agreement: CG 73 23 11 11 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 6 with Its permisslon. - I �l CG 73 23 11 11 (1) That this insurance be primary. If other insurance is also primary, we (2) When this insurance is excess, we will share with all that other will have no duty under Coverages A insurance as described in c. below; or B to defend the additional Insured or against any"suit"if any other insurer (2) The coverage afforded by this has a duty to defend the additional insurance is primary and non- insured against that"suit". If no contributory with the additional other insurer defends, we will insured's own insurance. undertake to do so,but we will be Paragraphs (1) and (2) do not apply entitled to the additional Insured's to other Insurance to which the rights against all those other additional insured has been added insurers, as an additional insured or to other (3) When this Insurance Is excess over insurance described in paragraph b. t other insurance,we will pay only our below, share of the amount of the loss, if b. Excess Insurance any,that exceeds the sum of: (a) The total amount that all such This insurance is excess over: other insurance would pay for (1) Any of the other insurance, whether the foss in the absence of this primary, excess, contingent or on insurance;and any other basis: (b) The total of all deductible and (a) That is Fire, Extended self-insured amounts under all Coverage, Builder's Risk, that other insurance. Installation Risk or similar coverage for"your work"; (4) We will share the remaining loss, if any, with any other insurance that is (b) That is fire, lightning, or not described in this Excess explosion insurance for Insurance provision and was not premises rented to you or bought specifically to apply in temporarily occupied by you with excess of the Limits of Insurance permission of the owner; shown in the Declarations of this (c) That is insurance purchased by Coverage Part. you to cover your liability as a c. Method Of Sharing tenant for "property damage" to If all of the other insurance available to premises rented to you or the additional insured permits. temporarily occupied by you with contribution by equal shares,we will permission of the owner;or follow this method also, Under this (d) If the loss arises out of the approach each insurer contributes equal maintenance or use of aircraft, amounts until it has paid its applicable "autos" or watercraft to the limit of insurance or none of the loss extent not subject to Exclusion remains,whichever comes first. g. of Section I — Coverage A — If any of the other insurance available to Bodily Injury And Property the additional insured does not permit Damage Liability. contribution by equal shares,we will (e) That is any other insurance contribute by limits. Under this method, available to an additional each insurer's share is based on the insured under this endorsement ratio of its applicable limit of insurance to covering liability arising out of the total applicable limits of insurance of the premises or operations, or all insurers. products completed operations, for which the additional Insured has been added as an additional insured by that other insurance. Page 4 of 6 Includes copyrighted material of Insurance Services Office, Inc., CG 7323 11 11 with its permission. i CG 73 23 11 11 EMPLOYEE BODILY INJURY TO ANOTHER MEDICAL PAYMENTS EMPLOYEE SECTION III — LIMITS OF INSURANCE, SECTION II — WHO IS AN INSURED The Paragraph 7. is replaced: following Paragraph is added to 2.a.(1) 7. Subject to 5. above, the higher of: Paragraphs 2.a.(1)(a), (b) and (c) do not a. $10,000;or apply to."bodily Injury" to a co-"employee" in the course of the co-"employee's" b. The amount shown in the Declarations employment by you, or to "bodily Injury" to a for Medical Expense Limit is the most co-"volunteer worker" while performing we will pay under Coverage C for all duties related to the conduct of your medical expenses because of "bodily business. Injury"sustained by one person. BROAD FORM NAMED INSURED This coverage does not apply if Coverage C — SECTION II — WHO IS AN INSURED The Medical Payments is excluded either by the following Paragraph is added to 2. provisions of any coverage forms attached to the policy or by endorsement. e. Any business entity incorporated or KNOWLEDGE OF AN OCCURRENCE organized under the laws of the United State SECTION IV — COMMERCIAL GENERAL of America (Including any State thereof), its LIABILITY CONDITIONS, The following Is added territories or possessions or Canada g (including any Province thereof) In which the to 2. Duties In The Event Of Occurrence, Named Insured shown in the Declarations Offense, Claim Or Suit condition: owns, during the policy period, an interest of e. Knowledge of an occurrence, offense, claim more than fifty percent. If other valid or suit by an agent or employee of any collectible insurance is available to any insured shall not In Itself constitute business entity covered by this solely by knowledge of the insured unless you, a reason of ownership by the Named Insured partner, if you are a partnership; or an shown in the Declarations in excess of fifty executive officer or insurance manager, if percent, this insurance is excess over the you are a corporation receives such notice of other insurance, whether primary, excess, an occurrence, offense, claim or suit from contingent, or on any other basis. the agent or employee. AGGREGATE LIMIT PER LOCATION f. The requirements in Section IV — SECTION III — LIMITS OF INSURANCE The Conditions Paragraph 2.b. will not be following paragraph is added to paragraph 2: considered breached unless there is The General Aggregate Limit under Section knowledge of occurrence as outlined in III Limits of Insurance applies separately to paragraph e. above. each of your locations owned by or rented to UNINTENTIONAL FAILURE TO DISCLOSE you or temporarily occupied by you with the HAZARD permission of the owner. For the purposes of SECTION IV — COMMERCIAL GENERAL this provision, location means premises LIABILITY CONDITIONS, 6. Representations is involving the same or connecting lots, or amended to include: premises whose connection is interrupted only by a public street, roadway,waterway or d. Your failure to disclose all hazards or prior railroad right-of-way. "occurrences" or offenses existing as of the inception date of the policy shall not AGGREGATE LIMIT PER PROJECT prejudice the coverage afforded by this SECTION III — LIMITS OF INSURANCE The policy provided such failure to disclose all following paragraph Is added to paragraph 2: hazards or prior"occurrences"or offenses Is The General Aggregate Limit under Section not 'intentional. This provision does not III Limits of Insurance applies separately to affect our right to collect additional premium each of your construction projects away from or exercise our right of cancellation or non- premises owned by or rented to you. renewal. I i CG 73 23 11 11 Includes copyrighted material of Insurance Services Office, Inc., Page 5 of 6 with its permission. I it I i I CG 73 23 11 11 WAIVER OF SUBROGATION BROADENED BODILY INJURY DEFINITION SECTION IV — COMMERCIAL GENERAL (MENTAL ANGUISH) LIABILITY CONDITIONS, 0. Transfer of Rights SECTION V — DEFINITIONS is amended as of Recovery Against Others to Us is amended follows: to Include: 1. 3. "Bodily injury"is deleted and replaced with If required by a written contract executed the following: prior to loss, we waive any right of "Bodily injury" means physical injury, subrogation we may have against the sickness or disease to a person and, if contracting person or organization because arising out of the foregoing, mental anguish, of payments we make for Injury or damage mental injury, shock or humiliation, including arising out of your ongoing operations or death at any time resulting therefrom. "your work" done under a contract with that person or organization and included in the "products-completed operations hazards". LIBERALIZATION SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 10, Liberalization is added as follows: If we revise this coverage form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in your state. All terms and conditions of this policy apply unless modified by this endorsement. I Page 6 of 6 Includes copyrighted material of Insurance Services Office, Inc., CG 73 23 11 11 with its permission. Policy#ACPBAPD3007050259 COMMERCIAL AUTO AC0102WA0310 '.. THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION EN®®RSEMENT- WASHINGTGN This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM A. CHANGES FOR TRAILERS AND FARM C. BLANKET ADDITIONAL INSURED EQUIPMENT Any person or organization which you have 1. Under the COVERED AUTOS Section, agreed to name as an additional insured in a the following are added to Paragraph C. written contract, executed prior to an accl- Certain Trailers, Mobile Equipment and dent, other than a contract for the lease or Temporary Substitute Autos: rental of a vehicle Is an "Insured" for Liability 4. "Trailers" designed to be towed by a Coverage,but only to the extent that person private passenger type "auto" or a or organization qualifies as an 'Insured" pickup, panel truck or van if not used under the Who Is An Insured Provision con- for business purposes, other than tained in the LIABILITY COVERAGE farming or ranching. SECTION of the Coverage Form 5. Farm wagons or farm implements D. REPLACED EXCLUSIONS while being towed by a covered "au- The Expected or Intended Injury Exclusion to.,. In the LIABILITY COVERAGE SECTION Is B. CHANGES FOR ADDITIONAL NEWLY replaced by the following: ACQUIRED VEHICLES Expected or Intended Injury 2, Paragraph B.2 of the COVERED AUTOS "Bodily injury"or"property damage"which is SECTION Is replaced by the following: expected or Intended by the "Insured". This 2. If Symbol(s)Tor 67 Is entered next to exclusion applies even If the resulting "bodi- a coverage in Item Two of the Decla- ly injury"or"property damage": rations, an "auto"you acquire will be a. Is of a different kind, quality or degree a covered "auto" for that coverage than initially expected or Intended;or only If: b. is sustained by a different person,entity, a. We already cover at least one real property, or personal property than "auto" you own for that coverage that initially expected or intended. or it replaces an "auto" you pre- E. ADDITIONAL EXCLUSIONS viously owned that had that cov- The following exclusions are added to the erage;and LIABILITY COVERAGE SECTION: b. You tell us within 30 days after Damage to Named Insured's property you acquire it that you want us to cover it for that oo0erage, Any claim or"suit" for"property damage" by The most we will pay for Physical Dam- you or on your behalf against any other per- age Coverage for "loss" under this Cov- son or entity that Is also a Named Insured erage Extension Is $100,000 per "auto', under this policy. subject to the largest deductible applica- Abuse or Molestation ble to any"auto"for that Coverage. AC 01 02WA 03 10 Includes copyrighted material of Insurance Services Office,,Ino,, with its permission Page 1 of 4 ACP DAPD M-7050269 LNE 16135 INSURED COPY AC0102031000 9001 75 0023682 AC 01 02WA 03 10 "Bodily injury" or"property damage"aris- b. Resulting from food or drink furnished ing out of: with these services. a. The actual or threatened abuse or "Bodily injury" or "property damage" result- molestation by anyone or any person Ing from the handling of corpses, while in the care, custody or control F. MOTOR HOME CONTENTS COVERAGE of any"insured",or 1. For a covered "auto" that is a motor home b. The negligent: the following exclusions are added to the 1) Employment; PHYSICAL DAMAGE COVERAGE 2) Investigation; SECTION: 3) Supervision; Motor Home Contents 4) Reporting to the proper author- This insurance does not apply to; ties,or failure to so report;or a. "Loss"to the covered "auto's" contents, 5) Retention; except equipment usual to trucks or pd- vate passenger"autos". of a person for whom any"insured"is b. "Loss" to TV antennas, awnings or ca- or ever was legally responsible and whose conductwouid be excluded by banes. Paragraph a.above. c, "Loss" to equipment designed to create Abuse means an act which is committed added living facilities. with the Intent to cause harm. However, these exclusions do not apply if Explosives Miscellaneous Personal Property Coverage is provided by endorsement to this policy, "Bodily Injury" or "property damage" caused by the explosion of explosives G. ACCIDENTAL AIRBAG DISCHARGE you make,sell or transport. COVERAGE Rolling Stores Under Paragraph B.3.a. of the PHYSICAL DAMAGE COVERAGE SECTION, the following If a covered "auto" is a rolling store, "bo- Is added: dily injury"or"property damage"resulting Mechanical breakdown does not Include the ac- from the handling, use or condition of any cidental discharge of an airbag. Item the "Insured" makes, sells or dlstrl- butes If the Injury or damage occurs after H. PHYSICAL DAMAGE LIMIT OF INSURANCE the "Insured" has given up possession of Under PHYSICAL DAMAGE COVERAGE the item.' SECTION, Paragraph C, Limit of Insurance Is Wrong Delivery of Liquid Products replaced by the following: "Bodily injury" or "property damage" re- C. Limit Of Insurance sulting from the delivery of any liquid Into 1. The most we will pay for "loss" In any the wrong receptacle or to the wrong ad- one"accident"is the lesser of: dress, or from the delivery of one liquid a. The actual cash value of the dam- for another, if the "bodily injury" or"prop- aged or stolen property as of the . erty damage" occurs after the delivery time of the"loss";or has been completed. b. The cost of repairing or replacing Delivery Is considered completed even If the damaged or stolen property. further service or maintenance work, or 2, $1,000 Is the most we will pay for"loss" correction, repair or replacement is re- in any one "accident" to all electronic Professional because wrong delivery. equipment that reproduces,receives or Professional Services "Bodily Injury": a. Resulting from the providing or the failure to provide any medical or oth- er professional services. Page 2 of 4 Includes copyrighted material of Insurance Services 011iee,Inc.,with Its permission AC 01 02WA 03 10 ACP DAPD30-0.7060259 ME 15135 INSURED COPY AM02031000 0001 76 0023683 l �I AC 01 02WA 03 10 transmits audio, visual or data signals 1, GLASS REPAIR—WAIVER OF DEDUCTIBLE which,at the time of"loss",is: Under Paragraph D. Deductible of the a. Permanently installed in or upon PHYSICAL DAMAGE COVERAGE SECTION, the covered "auto" in a housing, the following is added: opening or other location that Is No deductible applies to glass damage if the not normally used by the "auto' glass Is repaired rather than replaced. manufacturer for the Installation J. AMENDED DUTIES IN EVENT OF ACCIDENT, of such equipment. CLAIM, SUIT, OR LOSS b. Removable from a permanently The requirement in Loss Condition 2.a,Duties In Installed housing unit as de- The Event Of Accident, Claim, Suit Or Loss—of scribed in Paragraph 2.a. above the BUSINESS AUTO CONDITIONS SECTION or is an Integral part of that and the MOTOR CARRIER CONDITIONS equipment;or SECTION that you must notify us of an "acci- c. An integral part of such equip- dent", "claim", "suit", or"loss" applies only when ment. the "accident", "claim", "suit", or "loss" Is known 3. An adjustment for depreciation and to : physical condition will be made in de- 1. You,if you are an individual termining actual cash value in the 2. A partner, if you are a partnership; event of total"loss". 3. An executive officer or the employee deslg- 4. The cost of repairing or replacing nated by you to give such notice if you are a may: corporation;or a. Be based on an estimate which 4. A member, if you are a limited liability com- Includes parts furnished by the pany. original equipment manufacturer K.or other sources including non- UNINTENTIONAL FAILURE TO DISCLOSE original equipment manufactur. HAZARDS ers and The BUSINESS AUTO CONDITIONS SECTION b. Include a deduction for better- and MOTOR CARRIER CONDITIONS ment for a part or parts that are SECTION-B.2. are amended by the addition of normally subject to repair or re- the following: placement during the useful life If you unintentionally fall to disclose any hazards of the "auto" such as, but not If- existing at the inceptlon date of your policy, we mhod to tires and batteries, will not deny coverage under this Coverage Betterment means the difference Form because of such failure, However, this between the actual cash value of provision does not affect our right to collect addi- a part immediately before the tional premium or exercise our right of cancella- "loss" and the cost to replace tion or nonrenewal, that part with a new part, L. AUTOS HIRED OR RENTED BY EMPLOYEES . 5. If we offer to pay the actual cash val- If hired or rented"autos"are covered"autos"on ue of the damaged or stolen proper- this policy,the following provisions apply: ty, we will value auto advertising A. Changes In Liability Coverage wraps, paint customization,and simi- lar business related advertising mod- The following Is added to the Who is An In- shred Provision in the LIABILITY Iflcations, in addition to the actual COVERAGE SECTION: cash value of the property. Auto ad- vertising wraps, paint customlzatlon, An"employee"of yours is an "Insured" while and similar business related advertis- operating an "auto" hired or rented under a Ing modifications will be valued at the contract or agreement In that "employee's" cost to replace them with an adjust- moot made for depreciation and physical condition. AC 01 02WA 03 10 Includes copyrighted material of Insurance Services Office,Inc., with its permission Page 3 of 4 ACP BAPWD-0.70$0259 MV 16136 INSURED COPY 4MI02031000 0001 75 0023684 AC 01 02WA 03 10 '... name, with your permission, while per- M. EMERGENCY LOCKOUT- PRIVATE forming duties related to the conduct of PASSENGER VEHICLES your business. We will reimburse you up to $50 for reasonable B. Changes In General Conditions expense Incurred for the services of a locksmith Paragraph 5.b. of the Other Insurance to gain entry into your covered "auto" of the pd- Condition and Paragraph 5.f, of the vate passenger type subject to these provisions: Other Insurance Condition in the Motor 1, Your door'key or key entry pad has been Carrier Coverage Form is replaced by the lost, stolen or locked in your covered "auto" following: and you are unable to enter such"auto",or For Hired Auto Physical Damage Cover- 2. . Your key or key entry pad has been lost or age, Hie following are deemed to be cov- stolen and you have changed the lock to ered"autos"you own: prevent an unauthorized entry;and 1. Any covered "auto" you lease, hire, 3. Original copies of receipts for services of a rent or borrow;and locksmith must be provided before relm- 2. . Any covered"auto"hired or rented by bursementis payable. your "employee" under a contract In N. LIBERALIZATION that individual "employee's" name, Paragraph 3.of the Other Insurance Condition in with your permission, while perform- the Business Auto Coverage Form is replaced by ing duties related to the conduct of the following: If we adopt any revision that would your business. broaden the coverage under this policy without However,any"auto" that is leased,hired, additional premium within 60 days prior to or dur- rented or borrowed with a driver is not a ing the policy period,the broadened coverage will covered"auto". immediately apply to this policy. All terms and conditions of this policy apply unless modified by this endorsement. Page 4 of 4 Includes copyrighted material of Insurance Services Office,Inc.,with Is permission AC 01 02WA 03 10 ACP BAPD30-0-70SO259 t.7JE 15135 INSURED COPY AC0102031000 0001 75 0023505 Policy#ACPBAPD3007050259 COMMERCIAL AUTO AC 01 01 A 031.0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO ADVANTAGE ENDORSEMENT I This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM A. NEWLY ACQUIRED OR FORMED ENTITIES d. Any "employee"of yours Is an "insured" The Named Insured shown in the Declarations while using a covered "auto" you don't is amended to Include any organization you own, hire or borrow In your business or newly acquire or form, other than a partnership, your personal affairs. .joint venture, or limited liability company, and D. SUPPLEMENTARY PAYMENTS — BAIL over which you maintain ownership or majority BONDS (more than 50%) interest; if there is no other Paragraph A.2.a. (2) of the LIABILITY similar insurance available to that organization. COVERAGE SECTION Is revised as follows; Covera%e under this provision is afforded until (2) Up to $2,500 for cost of bail bonds (in- the 180 day after you acquire or form the or- cluding bonds for related traffic law vi- .genization or the end of the policy period, whi- chever Is later. olations) required because of an "acci- dent" we cover. We do not have to B. TEMPORARY SUBSTITUTE AUTOS — furnish these bonds. PHYSICAL DAMAGE COVERAGE E. SUPPLEMENTARY PAYMENTS — LOSS OF The following Is added to paragraph C. Certain EARNINGS Trailers, Mobile Equipment And Temporary LIABILITY th 4 2 A. .a.( ) o e Substitute Autos of the — COVERED AUTOS Paragraphi SECTION: COVERAGE SECTION Is revised as follows: If Physical Damage Coverage is provided by (4) All reasonable expenses incurred by the "in- this Coverage Form, the following types of sured" at our request, including actual loss Vehicles are also covered"autos" for Physl- of earnings up to $500 a day because of cal Damage Coverage: time off from work. Any "auto" you do not own while used with F. FELLOW EMPLOYEE. — OFFICERS, the permission of its owner as a temporary MANAGERS,AND SUPERVISORS substitute for a covered "auto" you own that Paragraph B.5.A, Fellow Employee in the Is out of service because of its: LIABILITY COVERAGE SECTION is replaced a. Breakdown; as follows; b. Repair; A. "Bodily injury" to any fellow "employee" of the, "insured"arising out of and in the course c. Servicing; of the fellow "employee's" employment or d. "Loss";or while performing duties related to the con- e. Destruction duct of your business. This exoluslon does The coverage that applies Is the same as not apply to an "insured" who occupies a the coverage provided for the vehicle being position as an officer, manager,or supervi- replaced. sor. C. EMPLOYEES AS INSUREDS — NONOWNED G. PERSONAL EFFECTS AND PROPERTY OF AUTOS OTHERS EXTENSION The following is added to paragraph A.I. Who Is 1. Paragraph B.6. Care, Custody or Control of An Insured of the LIABILITY COVERAGE the LIABILITY COVERAGE SECTION, does SECTION: not'apply to "property damage"to property, other than your property, up to an amount AC Oi 01 A 03 10 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 3 with Its permission ACP BAPDJM-7050269 UJE 16135 INSURED COPY AC01 01 0 31 0 0b 0001 75 0023679 III AC 01 01 A 0310 not exceeding $250 In any one "accident". 2) Financial penalties imposed under a Coverage Is excess over any otter valid and lease for excessive use, abnormal collectible Insurance. wear and tear or high mileage; 2. The following paragraph is added to A.4. 3) Security deposits not refunded by a Coverage Extensions of the — PHYSICAL lessor; DAMAGE COVERAGE SECTION: 4) Costs of extended warranties, Cre- c. We will pay up to $500 for your property dit Life insurance, Health, Accident, that is lost or damaged as a result of a or Disability insurance purchased covered "loss", without applying a de- with the lease;and ductible. Coverage is excess over any 5) Carry-over balances from previous other valid and collectible Insurance. leases. H. HIRED AUTO PHYSICAL DAMAGE 2. This coverage only applies to a"loss"which If covered "auto" designation symbols 1,8,61 or is also covered under this policy for Com- 68 apply to Liability Coverage and if at least one prehenslve, Specified Causes of Loss, or "auto" you own is covered by this policy for Collision coverage. Comprehensive, Specified Causes of Loss, or 3. Coverage does not apply to any unpaid Collision coverages, then the Physical Damage amount due on a loan for which the covered coverages provided are extended to "autos"you "auto"is not the sole collateral, lease, hire, rent or borrow without a driver; and K. RENTAL REIMBURSEMENT COVERAGE provisions in the Business Auto Coverage Form applicable to Hired Auto Physical Damage ap- 1, This coverage applies only to a covered"au- ply. The deductible will be equal to the largest to" for which Physical Damage Coverage is deductible applicable to any owned "auto" for provided on this policy. that coverage. Any Comprehensive deductible 2. We will pay for rental reimbursement ex- does not apply to fire or lightning. penses Incurred by you for the rental of an L EXPANDED TOWING COVERAGE "auto"because of"loss" to a covered"auto", We will pay up to: Payment applies In addition to the otherwise applicable amount of each coverage you 1. $100 for a covered "auto" you own of the have on a covered "auto." No deductibles private passenger type,or apply to this coverage. 2. $250 for a covered "auto" you own that is 3. We will pay only for those expenses In- not of the private passenger type, curred during the policy period beginning 24 for towing and labor costs Incurred each time hours after the"loss"and ending,regardless the covered"auto" is disabled. However, the la- of the policy's expiration, with the lesser of bor must be performed at the place of disable- the following number of days: ment. a. The number of days reasonably re- This coverage applies only for an "auto"covered quired to repair or replace the covered on this policy for Comprehensive or Specified "auto". If "loss" is caused by theft, this Causes of Loss Coverage and Collision Cove- number of days is added to the number rages. of days It takes to locate the covered J. AUTO LOAN OR LEASE COVERAGE "auto' and return It to you. 1. In the event of a total "loss" to a covered b. The number of days shown In the Sche- "auto", we will pay any unpaid amount due dole. on the loan or lease, including up to a max- 4. Our payment is limited to the lesser of the imum of $500 for early termination fees or following amounts: penalties,for your covered"auto"less: 1. Necessary and actual expenses in- a. The amount paid under the- PHYSICAL curred, DAMAGE COVERAGE SECTION of this 2. $76 for any one day or for a maximum policy;and of 30 days. b. Any: 5. This coverage does not apply while there 1)' Overdue lease/loan payments at the are spare or reserve"autos' available to you time of the"loss"; for your operations. Page 2 of 3 Includes copyrighted material of Insurance Services Office, Inc AC 0101 A 0310 with Its permission. ACP BAPD30-0.7050259 UjJ 15136 INSURED COPY AC0101031000 0001 76 09236BO AC 01 01 A 03 10 6. If "loss" results from the total theft of a cov- 5. The provisions of paragraphs 1.and 3. do ered "auto" of the private passenger type, not apply to a covered "auto"of the private we will pay under this coverage only that passenger type or a vehicle with a gross ve- amount of your rental reimbursement ex- hicle weight of 20,000 pounds or less which penses which is not already provided for is a now vehicle. under the PHYSICAL DAMAGE In the event of a total "loss" to your now ve- COVERAGE Coverage Extension. hlcle to which this coverage applies, we will 7. Coverage does not apply to any covered pay at your option: "auto"for which coverage is provided by en- a, The verifiable new vehicle purchase dorsementform OA9923 on this policy. price you paid for your damaged ve- hicle, not Including any Insurance or L. EXPANDED TRANSPORTATION EXPENSE warranties purchased; Paragraph AA.a. of the PHYSICAL DAMAGE b. ;If it is available, the purchase price, as COVERAGE SECTION Is replaced by the fol- negotiated by us,of a newvehicle of the lowing: same make, model, and equipment or We will pay up to $50 per day to a maximum of the most similar model available, not in- $1000 for temporary transportation expense in- ciuding any furnishings, parts, or equip- curred by you because of the total theft of a ment not installed by the manufacturer covered "auto" of the private passenger type, or man ufacturers'dealership;or. We will only pay for those covered "autos" for c. The market value of your damaged ve- which you carry Comprehensive or Specified hicle, not including any furnishings, Causes of Loss Coverage. We will pay for tem- parts, or equipment not installed by the porary transportation expenses incurred during manufacturer or manufacturer's dealer- the period beginning 48 hours after the theft and ship. ending, regardless of the policy's expiration, We,will not pay for initiation or set up costs when the covered "auto"is returned to us or we associated with loans or loases pay for Its "loss". In this endorsement, a new vehicle means M. EXTRA EXPENSE—STOLEN AUTOS an "auto"of which you are the original owner The following paragraph is added to Section that has not been previously tilled and which AA. of the— PHYSICAL DAMAGE COVERAGE you purchased less than 365 days before SECTION: the date.of the"loss", c. We will pay for up to $5,000 for the expense O. BLANKET WAIVER OF SUBROGATION of returning a stolen covered "auto" to you. The following is added to paragraph 5. Transfer We will pay only for those covered "autos" Of Rights Of Recovery Against Others To Us of for which you carry Comprehensive or Spe- — BUSINESS AUTO and MOTOR CARRIER offied Causes of Loss Coverage CONDITIONS SECTIONS: N. NEW VEHICLE REPLACEMENT COST We waive any right of recovery we may have The following Is added to paragraph C.Limit of against any person or organization to the extent Insurance of the PHYSICAL DAMAGE required of you by a written contract executed COVERAGE SECTION: prior to any "accident" because of payments we make for damages under this coverage form. All terms and conditions of this policy apply unless modified by this endorsement. AC 01 01A 0310 Includes copyrighted material of Insurance Services Office, Inc., page 3 of 3 with its permission ACP SAP D30-0-7050259 ME 15135 INSURED COPY A=01031000 0001 76 0023061