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HomeMy WebLinkAboutPW14-066 - Amendment - #4 - GEI, Consultants, Inc. - Briscoe-Desimone Levee Reach 1-4 - 12/16/2015 4 I 5 J Records . P� PF KENT 7, w,.� Wna Hi Documentrvornry ' 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: PW1H -0ugu - �w� This is assigned by City Clerk's Office Project Name: Briscoe-Desimone Levee Reach 1-4 Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 12/16/15 Termination Date: 12/31/16 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Kelly Casteel Department: Engineering Contract Amount: $0.00 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Extend the time of completion to December 31, 2016 because the project is extended into an additional construction phase due to the Corp of Engineers project. As of: 08/27/14 KENT AMENDMENT NO. 4 NAME OF CONSULTANT OR VENDOR: GEI Consultants, Inc. CONTRACT NAME & PROJECT NUMBER: Briscoe-Desimone Levee Reach 1 - 4 ORIGINAL AGREEMENT DATE: March 25, 2014 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: The scope of work remains the same, however an amendment is needed to extend the time of completion to December 31, 2016 because the project is extended into an additional construction phase due to the Corp of Engineers project. 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 including applicable WSST Net Change by Previous Amendments $65,690.00 including applicable WSST Current Contract Amount $464,814.00 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $464,814.00 AMENDMENT - 1 OF 2 Original Time for Completion 3/1/15 (insert date) Revised Time for Completion under 12/31/15 prior Amendments (insert date) Add'I Days Required (t) for this 366 calendar days Amendment Revised Time for Completion 12/31/16 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VENDOR: 4ff sq ,CITY OF KENT: By: ) -4 By (sign ture (mature) Print Name c t Print Name: Timothy ]. LaPorte P.E. Its ;r VP Its Public Works Director (ring) DATE: 01!" DATE: ! ,�(title APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department GE[-Briscoe-Desimone Levee 5 Amd 4/Casteel AMENDMENT - 2 OF 2 _ CEICONS-01 KPAWLOWSKI CERTIFICATE OF LIABILITY INSURANCE DATE(M1MDDNYYY) _�--� 1 3/612015 '.. I S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS u,iRTIFICATE 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 certtffcate does not confer rights to the certificate holder In lieu of such endorsement(s), PRODUCER DO,T,'T Kathryn Pawlowski Ames&Gough - PHONE 617 326-6555 Fnx 617 328-6888 859 Willard Street Arc No.Ex[:( ) A!O Not:( ) Suite 320 - E-MAIL bosfon ames Du h.com ADDRESS: g g Quincy,MA 02169 WSURERIS)AFFORDING COVERAGE NAIL$ INSURER A;National Union Fire Insurance Company of Pittsburgh,PA 19445 rNsuEo INSURERB:Continental Casualty Company(CMA)A(KV) 20443 GEI Consultants,Inc. WsuaERc:AIG Specialty insurance Company A{XV) 26883 180 Grand AVG INSURER D: Oakland,CA 94612 INSURER E INSURER F: COVERAGES CERTIFICATENUMSE_R: _ REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUEDTOTIIE INSURED NAMEDA13OVE FORTHE POLICY PERIOD INDICATED, NOTWITHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMENTWITH RESPECTTOWHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALLTH.'E TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IN$R AUDL SUB pOLIDY EFF POLICY EXP LTR TYPE OF INSURANCE INSR_"D POLICYNUMBER MMIpDM'tNI _am ORNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 1,0D0,000 CLAIMS-MADE OCCUR X X 7046470 03/01/2015 OX0112016 pREMIGEs Ea occweence $ 300,000 tAEO EXP(Any one persen) $ 00,000 _ PERSONAL&ADV INJURY Is 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE 3 - 2,000,000 POLICY JECT W LOG PRODUCTS-COMP/OPAW $ 2,000,000 OTHER: AD OMOBILELIAHILITY COMBINED SINGLELIMIT g 1,000,000 Ea mxJ1nl A X ANYAUTO X X 2248367 03/0112015 031011201E BODILY INJURY psr person) $ ALL OWNED AUTOSULEO BODILY INJURY(PeraWderd) $ X HIREDAUTOS X AUTNOOVvNED PereegdenlOA,Y,AGE $ __- X UMBRELLA LIAR X OCCUR EACH COD.URRENCE $ 4,0 00,000 13 EXCESS LIAa CLAIMS-MADE X 'X 6011396137 03/01/2016 0310112016 AGGREGATE $ 4,000,000 DED X RETENTION$_ 0 $ WORKERS COMPENSATION X 8 R UTE I& AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN X 026034972 03/0112015 031011201E EL.EACH ACCIDENT S 1,000,000 '.. OFFICER/MEMBER EXCWDED4 nNIA — (Mandalori,mNH) E.L.DISEASE-EA EMPLOYE $ 1,0001000 Use.describe under 1,000,000 DESCRIPTION OF OPERATIONS belmv E.L.DISEASE-POLICYLIMIT $ C Prof.Liability . 17788026 031OV2015 031011201E Per Claim 5,000,000 C &Pollution Liab. 17788026. 03/010815 031011201E Aggregate 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,AmIttem l Remarks Sohedule,may beakaehed 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 Cif of Kent Public Works Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ( - y P ACCORDANCEWITH THE POLICY PROVISIONS. q Attn:Mr.Ken Langholz 20 Fourth Avenue South Kent,WA 98032 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD ,. AGENCY CUSTOMER ID:GEICONS-01 KPAWLOWSKI LOC#: 0 ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED mes&Gough GEI Consultants,Inc. 180 Grand Ave POLICY NUMBER Oakland,CA 0G612 EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEEP 1 ErFEcnve oare:SEE PAGE 9 ADDITIONAL REMARKS _ THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Llability Insurance Description of OperaticnslLocationsNehicles: or of the named insured while performing work for the City,the District,and the County.General Liability policy includes severability of interest I cross 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 1 I I ACORD 101 (2008101) ©200B ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD f ENDORSEMENT N This endorsement, effective 12:01 A.M. 03/01/2015 forms a part of Business Auto Policy Policy No. 2248367 issued to GEIConsultants, Inc. By National Union Fire Insurance Company THiS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-IVIAiL TO ENTITIES OTHER THAN THE KIRST NAMED INSURED This policy is amended as follows: in the event that the insurer cancels this pollcy 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, olther 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 canceflatipn effective data, 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 Certificata Holder(s) as soon as reasonably practicable after the First Named Insured provides such information to the Insurer, Proof of the insurer emal9ng the Advice, using the information provided b•y the First Named Insured, will serve os 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. r Authorized Representative 107414:03111• •- Pago 1 i I ENDORSEMENT This endorsemant,effective 12:01 AM, 03/01/2015 forms a part of poiloy No. 2248367 issued toGEI COMSULTANTS, INC. f by NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED-WHERE RECIUIRED UNDER CONTRACT OR AGREEMENT a R If 7hls ondw.semant modifies insurance provided under the folloudng: BUSINESS AUTO COVERAGE FORM I SCHEDULE ADDITIONAL INSURED: ANY BOUNDPTO PROVIDER ADDITIONAL INSUREDMSTATUSRBUT OtLYCTOATHE EXTENT OF SUCH PERSON OR ORGANIZATIONS LIAOILITY ARISING OUT OF THE USE OF A COVERED AUTO. 1. SECTION It- LIABILITY COVERAGE,A.Coverage, 1.-Who to Insured, Is amended to add: d, Any person or organization, shown in the schedule sbovo, to whom you become obligated to fnofuda as an additional insured under this popsy,as a result of any contrast or agrcament you enter Into which requires you to furnfsh insurance to that person or organization of the type provided by this policy,but only with respect to flabllfty arising out of use of a eoverod "auto", However,the insurance provided will not exceed the lesser of; (1) The coverage andlor Ifmits of this polloy, or (21 The coverage and/or limits required by sefd oontraot or agreement. t Q �A Counter of natuRepre (in or Cauntoesiggnature (!n States Where e} 67560 (10105) Applicabl Page 1 of 1 � I� I r 1 ENDORSEMENT This endorsement, effeotive 12:01 A.M. 03/01/2015 forms a part of polloy No,2249367 lssuod to Cox Consixltt nt a. zna. by rational Onion Fire xnaurance company THIS M)ORMIENT CHANGES THE POLICY, PLEASE REAP) IT CAREFULM WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US G 7hls endorsement modifies insurance provided under the foff"Tng: $action IV - Susiness Auto condftiatta, A. . Loss Coodltians, 5, - Transfer of Flgfrts of Recovery Atdalnst Others to Us,is amended to add: , Flowover, we.will waive any right of racovsr we have against any person or organization with whom you hava entered Info a contract or egreemenl beoause of payments we make under ibis eovarago Form orfeing out of an"accident" or"Jose' If: (1) The "accident" or "loss" Is due to operations undertaken in accordance with the. oontraot existing between you and suoh person or organization;and (2) The oontraot or agreomont was ontered Into prior to any"acoldent" or"loss", No waiver of the fight of recovery wlif dfrootly or Indireotiy apply to your employees or amployoes of the person or organlzation, and wo reserve our rights or lian to be reimbursed from any rocovary funds obtained by any Injured employee, I ! t AUTHORIZLD REPRCSENTATIVE I I 62897(619b) r I. . ENDORSEMENTff' 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. gy 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 cance(lation effective date is prior to this policy's expiration date; 2, the First Named Insured is under an existing contractual obligation to notify a certificato 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 omall 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 Certifieata 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 Holders) as soon as reasonably practicable after the First Named insured provides such Infcrmatlon to the insurer. Proof of the Insurer emniling the Advice, using the information provided by the First Named Insured, will servo as proof that the Insurer has fully satiefled Its.o6l(gatlons 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 po&cy. 2, Insurer means the insurance company shown in the header on the Declarations page of this policy, I All other terms, conditions and exclusions shall remain the sama. I, I Authorized Representative ; 107414 03/111 Page 1 ENDORSEMENT This endorsement, effeotfvo 12:01 A,M,03/01/2015 forms a part of polfcY No, 7046470 issued to GEf COWLI TANTS, IISO. I by NATIONAL UNION FIRE INSURANCE GGNPANY OF PITTSBUROH, PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED- OWNERS,,LESSEES, ON CONTRACTORS . COMPLETf;L7 OPERATIONS This endorsementmodlflea lnvmr noe nrovldol ondeY the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM PPP SCNEOULE NAME OF ADDITIONAL INSURED PERSON OR ORGANIZATION; I ANY PERSON OR ORGANIZATION WOM YOU BECOME OBLIGATFD TO INCLUDE As AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO, LOCATION AND Dt=SCRIPTION OF COMPLETED OPERATIONS: PEP 714E CONTRACT OR AGREEMENT, ADDITIONAL PREMIUM; (If No entry appears above, fnformatlort required to complete this ondorsemont will be shown in the Oeclaratfons as appircab(e to the endorsement.) SECTION it-WHO IS AN INSURED is amanded to Include as an Insured; The person or organfzatfon shown in the Sohodule; but only with respect to INW(rty arfslnU out of "your work" at the location designated and described In the schedule of this endorsement performed for that eddltionaf Insured and Included In the "products.compiated operations hazard All other terms and condflions rernaro unohamfled, II �I 6�rfzodRerresentatheor gCountoesi nature On States Where fnoludss ca yri htM me anal oP ppftoa5fal 97807 WOS) Wwa000 8or lees oflloo,kc„w�th Ire permissloe. Page 1 of 1 + 1 i 8NDOR39NIENT This endorsement, effective 12:01 A$1, 03/01/2015 forms a part of yy� R,. pollcyNo. 7046470 iesuedto 0E1 CONSULTANTS, Iwe, t by NATIONAL UNION FIRE INSURANCE COMPANY OF PiTTSBURGH, PA THIS ENDORSEMENT CHANGES THr`POLICY, PLEASE READ IT CAREFULLY. i' ADDITIONAL INSURED- OWNERS, LESSEES, OR CONTRACTORS - SCHEDULM PERSON OR ORGANVATION TB(s endorsement modifles fnsweinca protdded under the following; s COMMERCIAL GENERAL LiA81LITY COVERAGE FORM SCHEDULE NAME OF PERSON OR ORGANIZATIONt ANY PERSON OR ORGANIZATION WHOM YOU BHCONE OBLIGAM TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE RNTERED INTO. i i (If no entry appears above, infofmatfon required to Comptoto this endorsement will be shown in the Declarations as applicable to the endorsement.) A. SECTION 11-WfiO iSM INSURED is amended to inotuda as an Insured; The person o� organization shown In the schedule, but only with respect to Nablifty arising out of your ongoing operations performed for that additional insured. a B, With respect to the Insurenca afforded to those, additional fnaureds, SECTION I - COVERAGES, COVE AON A - SODILY iNJUNY AND PROPERTY DAMAGE LIABILITY, 2. - p Exoluslons, is amended to include the following additronal exclusion; This Insurance does not apply to "bodily injury" or"property damage" oecurrin0 altar: fil all work, including materfals, parts or dqulpment furnished in connection with such worn, on the project(other than service, maintenanos or repairs) to be performed by or on behalf of the additlonaf insuredfe) at the site of the covered operations has boon oomplated; or, f2) that portion of "your work" out of which the InJuty or damage arlasa has bean put to its Intended use by any person or erMIZitlon other than another contractor or subcontractor engagod In performing operations for a principai as a part of the same Project Alf other terrna and conditions remain unchanged. uthortzed Ro resentative or �ountorsignature fin States Whore ppp pplfeefi(e 87$86 (}/08) Servlae cOfrrn ,nod meter1 pfPage 1 of 1 1/18U(dP.CR$DNrRtl9 ntt1C1,Inc.,with its parmis0on. i i 1 GEI Consultants,lne, Effective 03/01/2015-03/01/2016 '.. POLICY NUMBER: #7046470 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVER( 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 Pursuant to ap00)rganlzatlow licable written contract or agreement you enter into, ] Information re uired t com lete 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—Condiffobs. 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. I i I CG 24 04 05 09 ©insurance Services Ofilce, Inc., 2008 Page 1 of 1 ENDORSEMENT# This endorsement, effective 12:01 A.M. 03/01/2015-03/01/2016forms a part of General Liability Package Policy Policy No. 7046470 issued to GEIConsultants, Inc. Ay 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 Palley 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 entail 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 pclicy and prior to this policy's cancellation effective date, via an eloctronic 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, than 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 sat!sfied 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 slid exclusions shall remain the same. I Authorized Representative 107414'03/11, ., ., Page i ' GEI Consultants, Inc. G-140428-A CNA Policy 46 0113 9613 7 (Ed, 10101) 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: 3 c* * 10 DAYS NOTICE WILL APPLY TO NON-PAYMENT OF PREMIUM. s � I i i G-140428-A Page 1 of 1 (Ed. 10/01) d I WAIVER OP OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT ` This endorsement charges the policy to whioh It Is attached effective on inception date or the pollcy unless a different ! data Is Indioafsd below. (The following"eltsohing olause nand bs oorprelod only when!his ondotsemsnl Is is vstf soWso- vent to prspa, 'Ion of the peiloy}. I This endorsement, efeocttve 12:01 AM 03/01/2015 forms a part of Poticy No. 026034972 Issued to cas consuleanta, zno. Syi;ational Union rise lnsuxance Company Premium We have the right to recover,our payments from anyone liable for M Injury co4ered by this pollcy,We will not enforco our right against the person or organlzatlon named in the Schnduls. This agreement applles only to the extent Chet you ;y perform waric under a written oanf(oot that regolros you to obfafn this agreement from us, o i This agreement shall not operate directly or lndlreofly to benefit any one not named in the Schedule, Scheduta i I i i r � f 1 u y t R I[E€r9 E, Thfe form Is not applicable in California, Kontaoky, New Nampsh!re, New Jersey, North Dakota, Ohlo, Tennessee, Texas, Utah, or�'i'sfiington. C a' we on 0313 Countersigi)sd by k' (Ed, 04184) --- -- ------ - 6 Authorized Reprosentative