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HomeMy WebLinkAboutPW15-135 - Amendment - #1 - Shearer Design LLC - Amendment - 12/28/15 l s ag ent}:1 KENT a � Document 5 �3 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: Shearer Design LLC Vendor Number: ]D Edwards Number Contract Number: V y" N�5 "� ?-s ', ---h0 This is assigned by City Clerk's Office Project Name: 72"d Ave. Extension Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 12/28/15 Termination Date: 3/31/16 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Ken Langholz 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 March 31, 2016 because the project was delayed a few months due to funding issues. As of: 08/27/14 KEAIT AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: Shearer Design LLC CONTRACT NAME & PROJECT NUMBER: 72"d Ave. Extension ORIGINAL AGREEMENT DATE: April 9, 2015 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 March 31, 2016 because the project was delayed a few months due to funding issues. 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, $82,161.00 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $82,161.00 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $82,161.00 AMENDMENT - 1 OF 2 Original Time for Completion 12/31/15 (insert date) Revised Time for Completion under n/a prior Amendments (insert date) Add'I Days Required (f) for this 91 calendar days Amendment Revised Time for Completion 3131/16 (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. CONSULTA /VENDOR: CITY OF KENT: I F By: �� =� % By: /z Grp (signature) ) k(signature) Print Name: Print Name: Timothy J. LaPorte P.E. Its i Its Public Works Director (title) / (title)), '..... DATE: ) 15 DATE: F' APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department Shearer-72'Extension 2 Amd 11L ngholz AMENDMENT - 2 OF 2 ® CERTIFICATE OF LIABILITY INSURANCE ACORO DATE(MMIDDYWY) 1/14/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, TH, CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAMEACTMichael Jy Michael J Hall& Company PHONE FAX p y AID No - - 7 AIC No: Hall and Company E-MAIL 19660 loth Ave NE _ADDRESS'certificatesflhallaIldcomD n Poulsbo WA 98370 INSURER(S AFFORDING COVERAGE NAIC# INSuRERA: f CasTtlty InsturaI Company 9_42 INSURED 126D9 INSURER B-Travelers CasuatyandSuret Shearer Design LLC INSURER C: 3613 Phinney Ave N#B INSURER D Seattle WA 98103 _INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER:1756574591 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 ADDLSURF POLICYEFF POLICY EXP LIMITS LTR INSR MD POLICYNUMBER MMIDDIYV MMIDDIYYYY A GENERAL LIABILITY Y Y 528BAIJ6571 /9/2015 19/2016 EACH OCCURRENCE $2,000,000 - AMAGX COMMERCIAL GENERAL LIABILITY PREM SES E Deco Dnce $300,000 CLAIMS-MADE [T]OCCUR MED EXP Any one person) 810,00( X OCP1XCU/BFPD PERSONAL&ADV INJURY $2100,ODD X Separation Insds - GENERAL AGGREGATE $4,000,0013 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMPIOPAGG $4,000,000 POLICY X PRO- LOC _ $ A AUTOMOBILE LIABILITY Y Y 52SBAIJ6571 9/2015 9P2016 Ea see dent S2,000 000_ i ANY AUTO BODILY INJURY(Perporson) $ ALL OWNED SCHEDULED BODILY INJURY(Paracdcant) $ AUTOS AUTOS X "ARXECUSTIVE TOS X AUTOSwNED PPRer..to YDAMAGE $ A LIAB OCCUR EACH OCCURRENCE $LIAB CLAIMS-MADE AGGREGATE $RETENTION$ $ A WORMPENSATION 52SBAIJ6571 192015 /9/2016 X 'A'O ST M1TU- P HWA Stop GapAND. RS'LIABILITY VINANY ORIPARTNERIE%ECUTIVE❑ NIA E.L FACH ACCDENT $1,000,000 OFFIER EXCLUDED'(MenNH) `.L DISEASE-EA EMPLOYEE $1,000,000 If yes,descries under DESCRIPTION OFOPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Professional Llab:Claims Made 106223080 111/2015 UIV2016 $1,000,000 Per Claim $2.000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 1D1,Addltlonal Remarks Schedule,If more space la required) (' Project/Job Name:72nd Ave Extension City of Kent Is an Additional Insured on the Commercial General Liability and Auto Liability when required by written contract or agreement regarding activities by or on behalf of the Named Insured.This insurance Is primary insurance and any other insurance maintained by the Additional Insured shall be excess only and non-contributing with this insurance.A waiver of subrogation applies to the Commercial General Liability,Auto Liability, Umbrella/Excess Liability and Workers Compensation/Employers Liability in favor of the Additional Insured CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED I$' City of Kent ACCORDANCE WITH THE POLICY PROVISIONS. I 400 W Gowe St Kent WA 98032-6019 AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD I,. Shearer Design LLC- The Hartford Policy# 52SBAIJ6571 BUSINESS LIABILITY COVERAGE FORM I� (b) Rented to, in the care, custody or b. Coverage under this provision does not control of, or over which physical apply to: control is being exercised for any (1) "Bodily injury" or "property damage" purpose by you, any of your that occurred;or "employees", "volunteer workers", any partner or member(if you are (2) "Personal and advertising injury" a partnership or joint venture), or arising out of an offense committed any member (if you are a limited before you acquired or formed the liability company). organization. b. Real Estate Manager 4. Operator Of Mobile Equipment Any person(other than your"employee"or With respect to"mobile equipment" registered in "volunteer worker"), or any organization your name under any motor vehicle registration while acting as your real estate manager, law, any person is an insured while driving such c. Temporary Custodians Of Your equipment along a public highway with your Property permission. Any other person or organization Any person or organization having proper responsible for the conduct of such person is ility temporary custody of your property if you also an insured, but only with respect to Il die, but only: arising out of the operation of the equipmentt,,and and only if no other insurance of any kind Is available (1) With respect to liability arising out of the to that person or organization for this liability, maintenance or use of that property;and However,no person or organization is an insured (2) Until your legal representative has with respect to: been appointed, a. "Bodily injury" to a co-"employee" of the d. Legal Representative If You Die person driving the equipment;or i Your legal representative if you 'die, but b. "Property damage to property owned by, i only with respect to duties as such. That rented to, in the charge of or occupied by representative will have all your rights and you or the employer of any person who is duties under this insurance, an Insured under this provision. e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft With respect to watercraft you do not own that Any subsidiary and subsidiary thereof, of P yours which is a legally incorporated entity is less than 51 feet long and is not being used of which you own a financial interest of to carry persons for a charge, any person Is an more than 50% of the voting stock on the insured while operating such watercraft with effective date of this Coverage Part. your permission. Any other person or The.Insurance afforded herein for any organization responsible for the conduct of subsidiary not shown In the Declarations such person Is also an insured, but only with respect to liability arising out of the operation as a named insured does not apply to injury or damage with respect to which an In the waft anyt, and only a no other insured under this insurance is also an Insurance rg any kind is available to that Insured under another policy or would be person or organization for this liability, an insured under such policy but for its However, no person or organization is an termination or upon the exhaustion of its Insured with respect to: limits of insurance. a. 'Bodily injury" to a co-"employee" of the 3. Newly Acquired Or formed Organization person operating the watercraft;or Any organization you newly acquire or form, b. "Property damage" to properly owned by, other than a partnership, joint venture or rented to, in the charge of or occupied by limited liability company, and over which you you or the employer of any person who is maintain financial interest of more than 50% of an insured under this provision. the voting stock, will qualify as a Named G. Additional Insureds When Required By Insured if there Is no other similar insurance Written Contract, Written Agreement Or available to that organization. However: Permit a. Coverage under this provision is afforded The parson(s) or organizations) identified in only until the 180th day after you acquire Paragraphs a. through f. below are additional or form the organization or the end of the insureds when you have agreed, in a written policy period, whichever is earlier;and Form SS 00 08 04 05 Page 11 of 24 T,o n.r BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a (e) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement,or the issuance of the permit. with the distribution or sale of the A person or organization is an additional products; insured under this provision only for that (f) Demonstration, installation, period of time required by the contract, servicing or repair operations, agreement or permit. except such operations performed However, no such person or organization is an at the vendor's . premises in connect on with the sale of the additional insured under this provision if such person or organization is included as an product; additional insured by an endorsement issued (g) Products which, after distribution by us and made a part of this Coverage Part, or sale by you, have been labeled including all persons or organizations added or relabeled or used as a as additional insureds under the specific container, part or ingredient of any additional insured coverage grants in Section other thing or substance by or for F.—Optional Additional Insured Coverages. the vendor;or a. Vendors (h) "Bodily, injury". or "property damage" arising out of the sole Any person(s)or organization(s) (referred to negligence of the vendor for its below as vendor), but only with respect to. own acts or omissions or those "bodily injury" or "property damage" arising out of "your products"which are distributed its employees or anyone else acting on its behalf. However,this or sold in the regular course of the vendors business and only if this Coverage Part exclusion does not apply to: provides coverage for "bodily injury' or (i) The exceptions contained In "property damage" included within the Subparagraphs(d)or(f);or "products-completed operations hazard". (it) Such inspections, adjustments, (1) The insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions: undertakes to make in the usual course of business, in This insurance does not apply to: connection with the distribution (a) `Bodily Injury" or 'property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of whom you have acquired such products, liability in a contractor agreement. or any Ingredient, part or container, This exclusion does not apply to entering into, accompanying or lability, for damages that the containing such products, vendor would have in the absence of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty (`i) Any person or organization from unauthorized by you; whom you lease equipment; but only with respect to their liability for"bodily (c) Any physical or chemical change injury", "property damage" or in the product made intentionally "personal and advertising injury" by the vendor; caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such Inspection, demonstration, testing, person or organization. or the substitution of parts under Instructions from the manufacturer, and then repackaged in the original container; i :gage 12 of 24 Form SS 00 08 04 05 L. BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded e. Permits Issued By State Or Political to these additional insureds, this Subdivisions insurance does not apply to any (1) Any state or political subdivision, but "occurrence" which takes place after only with respect to operations you cease to lease that equipment, performed by you or on your behalf for c. Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organization from has issued a permit. whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to; of that part of the land or premises (a) "Bodily injury", "properly damage" leased to you. or "personal and •advertising (2) With 'respect to the Insurance afforded injury" arising out of operations to these additional Insureds, this performed for the state or Insurance does not apply to: municipality;or (a) Any "occurrence" which takes (b) "Bodily injury"or"property damage" place after you cease to lease that included within the "products- land or be a tenant In that completed operations hazard". premises;or f. Any Other Party (b) Structural alterations, new (1) Any other person or organization who construction or demolition is not an Insured under Paragraphs a. operations performed by or on through e. above, but only with behalf of such person or respect to liability for "bodily injury" organization. "property damage" or "personal and d. Architects, Engineers Or Surveyors advertising injury" caused, In whole or (1) Any architect, engineer,or surveyor, but in part, by your acts or omissions or s f those actin omissions o„ the acts or omi g t liability for "bodily onlywith respect o I y P ty „ on your be half., e o "personal u " ro e damage" r Injury",, P P dY 9 p and advertising injury"caused, in whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of those acting on (b) In connection with your premises your behalf: owned by or rented to you;or (a) In connection with your premises; (c) In connection with ,your work"and or included within the "products- (b) In the performance of your completed operations hazard", but ongoing operations performed by only if you or on your behalf. (1) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional Insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to (III This Coverage Part provides "bodily injury", "property damage" or coverage for "bodily Injury" or "personal and advertising injury" 'properly damage" included arising out of the rendering of or the within the .'products- failure to render any professional completed operations hazard", services by or for you,including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional. insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, "Bodily Injury", "property damage" or reports, surveys, Held orders, "personal and advertising injury" change orders, designs or arising out of the rendering of, or the drawings and specifications;or failure to render, any professional (b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services, including: activities. Form SS 00 08 04 05 Page 13 of 24 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or This General Aggregate limit does not failure to prepare or approve, apply to "property damage" to premises maps, shop drawings, opinions, while rented to you or temporarily reports, surveys, field orders, occupied by you with permission of the change orders, designs or owner, arising out of fire, lightning or drawings and specifications;or explosion. (b) Supervisory, inspection, 3. Each Occurrence Limit architectural or engineering Subject to 2.a. or 2.h above, whichever activities. applies, the most we will pay for the sum of all The limits of insurance that apply to additional damages because of all "bodily injury", insureds are described in Section D. — Limits "property damage and medical expenses Of Insurance. arising out of any one "occurrence" is the How this insurance applies when other Liability and Medical Expenses Limit shown in insurance is available to an additional insured the Declarations. is described in the Other Insurance Condition The most we will pay for all medical expenses in Section E.—Liability And Medical Expenses because of "bodily injury" sustained by any General Conditions. one person is the Medical. Expenses Limit No person or organization is an Insured with shown in the Declarations. respect to the conduct of any current or past 4. Personal And Advertising Injury Limit partnership, joint venture or limited liability Subject to 2.b. above, the most we will pay for company that e not shown as a Named Insured In the sum of all damages because of all j the Declarations. "personal and advertising injury" sustained by D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal LIMITS OF INSURANCE and Advertising Injury Limit shown in the Declarations. 1, The Most We Will Pay 5. Damage To Promises Rented To You Limit The Limits of Insurance shown in the The Damage To Premises Rented To You Declarations and the rules below fix the most we will pay regardless of the number of: Limit is the most we will pay under Business Liability Coverage for damages because of a. Insureds; "property damage" to any one premises,while b. Claims,made or"suits"brought; or rented to you,or in the case of damage by fire, c. Persons ororganizations making claims or lightning or explosion, while rented to you or bringing "suits". temporarily occupied by you with permission of 2. Aggregate Limits the owner. The most we will pay for: In the case of damage by fire, lightning or explosion,the Damage to Premises Rented To a. Damages because of "bodily injury" and You Limit applies to all damage proximately "property damage" included in the caused by the same event, whether such "products-completed operations hazard"is damage results from fire, lightning or explosion the Products-Completed Operations or any combination of these, Aggregate Limit shown in the 5, How Limits Apply To Additional Insureds Declarations. b. Damages because of all other "bodily The most we will pay on behalf of a person or Injury", "property damage" or "personal organization who is an additional insured and advertising injury", including medical under this Coverage Part Is the lesser of: expenses, is the General Aggregate Limit a. The limits of Insurance specified in a shown in the Declarations. written contract, written agreement or This General Aggregate Limit applies permit issued by a state or political separately to each of your "locations" subdivision; or owned by or rented to you. b. The Limits of Insurance shown in the "Location" means premises involving the Declarations. same or connecting lots, or premises Such amount shall be a part of and not in whose connection is Interrupted only by a addition to 0he Limits of Insurance shown in street, roadway or right-of-way of a the Declarations and described in this Section. rallroad, Page 14 of 24 Form 58 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM If more than one limit of insurance under this (1) Immediately send us copies of any policy and any endorsements attached thereto demands; notices, summonses or applies an es to claim or"suit", the most we will pay legal papers received in connection Y with the claim or"suit"; is the under this policy and the endorsements ' single highest limit of liability of all coverages (2) Authorize us to obtain records and applicable to such claim or "suit". However, this other information; paragraph does not apply to the Medical Expenses (3) Cooperate with us in the investigation, limit set forth In Paragraph 3.above, settlement of the claim or defense The Limits of Insurance of this Coverage Part apply against the"suit";and separately to each consecutive annual period and to (4) Assist us, upon our request, in the any remaining period of less than 12 months,starting enforcement of any right against any with the beginning of the policy period shown in the person or organization that may be Declarations, unless the policy period is extended liable to the insured because of injury after issuance for an additional period of less than 12 or damage to which this Insurance months. In that case, the additional period will.be may also apply, deemed part of the last preceding period for purposes d, obligations At The Insured's Own Cost of determining the Limits of Insurance. No insured will, except at that insured's own E. LIABILITY AND MEDICAL EXPENSES cost, voluntarily make a payment, assume GENERAL CONDITIONS any obligation, or Incur any expense, other 1. Bankruptcy than for first aid,without our consent. Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance the insured's estate will not relieve us of our If we cover a claim or "suit" under this obligations under this Coverage Part. Coverage Part that may also be covered 2. Duties In The Event of Occurrence, by other insurance available to an Offense,Claim Or Suit additional insured, such additional Insured a. Notice Of occurrence Or Offense must submit such claim or suit" to the other Insurer for defense and indemnify. You or any additional Insured must see to However, this provision does not apply to it- that we are notified as soon as the extent that you have agreed in a practicable of an "occurrence" or an written contract, written agreement or offense which may result in a claim. To permit that this insurance is primary and the extent possible, notice should include: non-contributory with the additional (1) How,when and where the "occurrence" Insured's own insurance. or offense took place; f, Knowledge Of An Occurrence, Offense, (2) The names and addresses of any Claim Or Suit injured persons and witnesses; and Paragraphs a. and b. apply to you or to (3) The nature and location of any injury any additional insured only when such or damage arising out of the "occurrence", offense, claim or "suit" Is "occurrence"or offense, known to: b. Notice Of Claim (1) You or any additional insured that is if a claim is made or "suit" Is brought an individual; against any insured, you or any additional (2) Any partner, if you or an additional insured must: insured Is a partnership; (1) Immediately record the specifics of the (3) Any manager, if you or an additional claim or "suit" and the date received; insured Is a limited liability company; . and (4) Any "executive officer" or insurance (2) Notify us as soon as practicable. manager, if you or an additional You or any additional Insured must see to insured is a corporation; it that we receive a written notice of the (5) Any trustee, if you or an additional claim or"suit" as soon as practicable, insured Is a trust;or c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you Insured or an additional Insured is a political You and any other Involved insured must: subdivision or public entity. Form SS 00 08 04 05 Pago'15 of 24 i , � I BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to (3) We have Issued this policy In reliance you and any additional insured, upon your representations. 3. Financial Responsibility Laws b. Unintentional Failure To Disclose a. When this policy is certified as proof of Hazards financial responsibility for the future under If unintentionally you should fail to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the inception date of this provided by the policy for "bodily injury" Coverage Part, we shall not deny any liability and "property damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of 7, Other Insurance insurance required by that law. If other valid and collectible insurance is j b. With respect to "mobile equipment" to available for a loss we cover under this which this insurance applies, we will Coverage Part, our obligations are limited as provide any liability, uninsured motorists, follows: underinsured motorists, no-fault or other coverage required by any motor vehicle a. Primary Insurance law. We will provide the required limits for This insurance Is primary except when b. those coverages. below applies. If other insurance is also 4. Legal Action Against Us primary, we will share with all that other insurance by the method described in c. No person or organization has a right under below. this Coverage Form: a. To join us as a party or otherwise bring us b. Excess Insurance into a "suit" asking for damages from an This insurance is excess over any of the insured;or other insurance, whether primary, excess, b. To sue us on this Coverage Form unless contingent or on any other basis: all of its terms have been fully complied (1) Your Work. with. That is Fire, Extended Coverage, A person or organization may sue us to recover Builder's Risk, Installation Risk or on an agreed settlement or on a final judgment similar coverage for'your work"; against an insured; but we will not be liable for (2) Premises Rented To You damages that are not payable under the terms of That is fire, lightning or explosion this insurance or that are in excess of the insurance for premises rented to you applicable limit of insurance, An agreed or temporarily occupied by you with settlement means a settlement and release of permission of the owner; Liability signed by us, the insured and the claimant or the claimant's legal representative. (3) Tenant Liability 5. Separation Of Insureds That Is insurance purchased by you to cover your liability as a tenant for Except with respect to the Limits of Insurance, "property damage" to premises rented and any rights or duties specifically assigned to you or temporarily occupied by you In this policy to the first Named Insured, this with permission of the owner; insurance applies: a. As if each Named Insured were the only (4) Aircraft, Auto Or Watercraft Named Insured; and If the loss arises out of the maintenance b. Separately to each insured against whom or use of aircraft, "autos"or watercraft to a claim is made or"suit"is brought. the extent not subject to Exclusion g. of Section A.—Coverages. 6. Representations (5) Property Damage To Borrowed a. When You Accept This Policy Equipment Or Use Of Elevators By accepting this policy, you agree: If the loss arises out of "property (1) The statements in the Declarations damage" to borrowed equipment or are accurate and complete; the use of elevators to the extent not (2) Those statements are based upon subject to Exclusion k, of Section A.— representations you made to us; and Coverages. Page '16 of 24 Form SS 00 08 04 05 1: BUSINESS LIABILITY COVERAGE FORM (6) When You Are Added As An When this insurance is excess over other Additional Insured To Other insurance, we will pay only our share Of Insurance the amount of the loss, if any, that That is other insurance available to exceeds the sum of: you covering liability, for damages (1) The total amount that all such other arising out of the premises or insurance would pay for the loss in the operations, or products and completed absence of this insurance;and operations, for which you have been (2) The total of all deductible and self- added as an additional insured by that insured amounts under all that other insurance;or insurance.. (7) When You Add Others As An We will share the remaining loss, if any,with Additional Insured To This any other insurance that is not described in Insurance this Excess Insurance provision and was not That is other Insurance available to an bought specifically to apply in excess of the additional insured. Limits of Insurance shown in the However, the following provisions Declarations of this Coverage Part. apply to other insurance available to c. Method Of Sharing any person or organization who is an If all the other Insurance permits additional Insured underthis Coverage contribution by equal shares,we will follow Part: this method also. Under this approach, (a) Primary Insurance When each insurer contributes equal amounts Required By Contract until it has paid its applicable limit of This insurance Is primary if you insurance or none of the loss remains, I ' have agreed in a written contract, whichever comes first. written,agreement or permit that If any of the other insurance does not permit this insurance be primary. If other contribution by equal shares, we will insurance is also primary, we will contribute by limits. Underthis method,each share with all that other insurance insurers share is based on the ratio of Its by the method described in c. applicable limit of Insurance to the total below. applicable limits of insurance of all Insurers. (b) Primary And Non-Contributory S. Transfer Of Rights Of Recovery Against To Other Insurance When Others To Us Required By Contract a. Transfer Of Rights Of Recovery If you have agreed In a written If the insured has rights to recover all or contract, wrlften agreement or p any art of payment, including I permit that this insurance is Supplementary Payments, we have made primary and non-contributory with under this Coverage Part, those rights are the additional insured's own transferred to us. The Insured must do insurance, this insurance Is nothing after loss to Impair them. At our primary and we will not seek request, the insured will bring "suit" or contribution from that other transfer those rights to us and help us insurance, enforce them. This condition does not Paragraphs(a) and (b)do not apply to apply to Medical Expenses Coverage. other insurance to which the additional b. Waiver Of Rights Of Recovery (Waiver Insured has been added as an Of Subrogatlon) additional insured. If the insured has waived any rights of When this•insurance is excess, we will recovery against any person or have no duty under this Coverage Part to organization for all or part of any payment, defend the Insured against any"suit"if any including Supplementary Payments, we other insurer has a duty to defend the have made under this Coverage Part, we insured against that "suit". If no other also waive that right, provided the Insured insurer defends, we will undertake to do waived their rights of recovery against so, but we will be entitled to the insured's such person or organization in e contract, rights against all those other insurers. agreement or permit that was executed prior to the Injury or damage. i Form SS 00 08 04 05 Page 17 of 24 I COMMON POLICY CONDITIONS All coverages of this policy are subject to the following Conditions, A. Cancellation (5) Failure to; 1. The first Named Insured shown In the (a) Furnish necessary heat, water, Declarations may cancel this policy by mailing sewer service or electricity for 30 or delivering to us advance written notice of consecutive days or more, except cancellation. during a period of seasonal 0 2. We may cancel this policy by mailing or unoccupancy;or delivering to the first Named Insured written (b) tray property taxes that are owing notice of cancellation at least: and have been outstanding for 11 a. 5 days before the effective date of more than one year Following the o cancellation if any one of the following date due, except that this conditions exists at any building that is provision will not apply where you Covered property(ri this policy: are in a bona fide dispute with the a taxing authority regarding payment N (1) The building has been vacant or ofsuchtaxes. N unoccupied 60 or more Consecutive b 10 days before the effective date of days. This does not applyfo: cancellation if we Cancel for nonpayment o (a) Seasonal unoccupancy; or of premium. u (b) Buildings in the course of c. 30 days before the effective date of _ construction, renovation or cancellation if we cancel for any other addition, reason. Buildings with 65% or more of the rental 3. We will mail or deliver our notice to the first units or floor area vacant or unoccupied Named Insured's last mailing address known are considered unoccupied under this to us. provision. 4. Notice of cancellation will state the effective (2) After damage by a Covered Cause of date of cancellation. The policy period will end Loss, permanent repairs to the on that date. building: 5. If this policy is canceled, we will send the first (a) Have notstarted; and Named insured any premfum refund due. (b) t`fava not been contracted for, Such refund will be pro rata. The cancellation 3� within 30 days of initial payment of will be effective even if we have not made or foss, offered a refund. 6. If notice is miffed, proof of rn0ling will be (3) 'Cho building has: sufficient proof of notice. (a) An outstanding order la vacate; 7. If tiro first Named Insured cancels this policy, (b) Art outstanding demolition ordor we will retain no less than $100 of the or premium. (c) Been declared unsafe by S. Changes governmental authority. This policy contains all the agreements bemeon you (4) Fixed and salvageable items have and us concerning the Insurance afforded. 'rho first B been or are being removed from the Named Insured shown in the Declarations is building and are not being replaced, authorized to make changes in the terms of this policy This does not apply to such removal with our consent. This pagcy'3 lemis can be that is necessary or incidental to any amended or waived only by endorsement Issued renovation or remodeling. by us and made a part of this poffcy. I Form SS 00 05 12 06 faage'l of 3 O 2006,The Hartford COMMON POLICY CONDITIONS C, concealment,Misrepresentation Or Fraud 1. Premiums This policy is void in any case of fraud by you as it 1. The first Named Insured shown in the relates to this policy at any time. It is also void if you Declarations! or any other insured,at any time,Intentionally conceal a, is responsible for the payment of all or misrepresent a material fact concerning: premiums; and 1. This policy; b, Will be the payee for any return premiums 2, The Covered Property; we pay, 3. Your Interest in the Covered Property;or 2. computedThe ium shown rIn thetes in Declareffect ations time was 4. Acialm under this policy. the policy was Issued. If applicable, on each D. Examination of Your Books And Records renewal, continuation or anniversary of the We may examine and audit your books and effective date of this policy, we will compute records as they relate to the policy at any time the premium in accordance with our rates and during the policy period and up to three years rules then in effort, afterward. 3. With our consent, you may continue this policy E. inspections And Surveys In force by paying a continuation premium for We have the right but are nut obligated to: each successive nne-year period. The premium must be: 1. Make inspections and surveys at any time; a, paid to us prior to the anniversary date;and 2, Give you reports on the conditions we find;and b. Determined in accordance with Paragraph 3. Recommend changes. 2.above. Any inspections, surveys, reports or our forms then In effect will apply. If you do recommendations relate only to insurability and the not pay the continuation premium, this policy premiums to be charged, We do not mate safety will exptre on tine first anniversary date that we inspections. We do not undertake to perform the duty have not received the premium. of any person or organizatlon to provide for Ito health 4 Changes in exposures or changes in your or safetyof an person. And we do not represent or o use of Y p acquisition r operation, a business e bun p �N warrant that conditions: locations that are not shown in the Declarations 1. Are safe or healthful;or may occur during the policy period, if so,we may 2. Comply with laws, regulations, codes or bepuire an de determined accional ordance with oemium. Thaturrates anrmium dll standards, This condition applies not only to us, but also to rules then in effect. any rating, advisory, rate service or similar J. Transfer Of Rights of Recovery Against Others organizatfon which makes insurance inspections, To Us surveys, reports or recommendations. Applicable to Property Coverage: F. insurance Under Two or More Coverages If any person or organization to or for whom we If two or more of this poilcy's coverages apply to make payment under this policy has rights to the same loss or damage, we will not pay more recover damages from another, those rights are than the actual amount of the loss or damage, transferred to us to the extent of our payment. G, Liberalization That person or crganizatie must €10 everything necessary to secure our rights and must, do If we adopt any revision that would broaden the nothing after loss to impair them. But you may coverage under this policy without additional waive your rights against another party in writing: premium within 45 days prior to or during the policy I. prior to a toss to your Covered Property. period, the broadened coverage will immediately apply to this policy. 2, After a loss to your Covered Property Only if, at H. Other Insurance -Property Coverage time of loss,that party is one of the following: If (hero is other insurance covering file same loss a, Someone insured by this insurance; or damage, we wAI pay only for the amount of b. A business firm: covered loss or damage in excess of the amount (1) owned or controlled by you;or due from that other insurance, whether you can That awns or controls you; or reflect on it or not. But we will not pay More than t2) the applicable Limit of Insurance. Page 2 of 3 Form SS 00 05 12 06 COMMON POLICY CONDITIONS c. Yourtenant. L. Premium Audit You may also accept the usual bills of lading or a. We will compute all premiums for this policy in shipping receipts limiting the liability of carriers. accordance with our rules and rates. This will not restrict your Insurance, b� The premium amount shown in the K. Transfer of Your Rights And Duties Under This Declarations is a deposit premium only. At the Policy close of each audit period we will compute the Your rights and duties under this policy may not be earned premium for that period. Any transferred without our written consent except in additional premium found to result a due as to the case of death of an individual Named Insured. of the audit are due and payable notice the first Named Insured. if the deposit If you die, your tights and duties will be transferred premium paid for the policy term is greater co to your legal representative but only while acting than the earned premium, we will return the within the scope of duties as your legal excess to the first Named Insured. representative, Until your legal representative is c. The first Named Insured must maintain all appointed, anyone having proper temporary records related to the coverage provided by custody of your property will have your rights and this policy and necessary to finalize the o duties but only with respect to that property. premium audit, and send us copies of the same upon our request. m 0 w° N N (V O Our President and Secretary have signed this policy. Where required by law,the Declarations page has also been countersigned by our dufy authorized representative. I Ilorr�de.liun4,5€�ntar� fuanAiia'ada,!'resident , � I d I i i Form 330005i206 Page 3of3 �� i ' L SUPER STRETCH SUMMARY SUMMARY OF COVERAGE LIMITS This Is a summary of the Coverages and the Limits of Insurance provided by the Super Stretch Coverage form d, SS 04 74 which Is included In this policy. No coverage Is provided by this summary. Refer to coverage farm M SS 04 74 to determine the scope of your insurance protection. The Limits of Insurance for the following Additional Coverages are in addition to any other limit of insurance provided under this policy; Blanket Coverage Limit of Insurance:$150,000 N Blanket Coverages Accounts Receivable-OWOff Premises N Computers and Media o Debris Removal o Personal Property of Others o Temperature Change Valuable Papers and Records-On/Off Premises Coverage Limit Brands and Labels Up to Business Personal Property Limit Claim Expenses $ 10,000 -- Computer Fraud $5,000 Employee Dishonesty(including ERISA) $25,000 Fine Arts $25,000 Forgery $25,000 Laptop Computers-Worldwide Coverage $ 10,000 Off Promises Utility Services—Direct Damage $25,000 Outdoor Signs Full Value Pairs or Sets Up to Business Personal Property Limit Property at Other Premises $ 10,000 Salespersons' Samples $ 5,000 Sewer and Drain Back Up Included Up to Covered Property Limits Sunp Overflow or Sump Pump Failure $25,000 Tenant Building and Business Personal Property $20,000 Coverage-Required by Lease Transit Property in the Care of Carriers for I-Ilre $10,000 Unauthorized Business Card Use $ 5,000 i i Form SS 84,15 00 07 Page 'I of 2 02007, The Hartford I The Limits of Insurance for the following Coverage Extensions are a replacement of the Limit of Insurance provided under the Standard Property Coverage Form or the Special Property Coverage Form,whichever applies to the policy: Coverage Limit Newly Acquired or Constructed Property—180 Days Building $1,000,000 Business Personal Property $500,000 Business Income and Extra Expense $500,000 Outdoor Property $25,000 aggregate/$1,000 per item Personal Effects $25,000 Property Off Premises $25,000 The following changes apply only if Business Income and Extra Expense are covered under this policy. The Limits of Insurance for the following Business Income and Extra Expense Coverages are in addition to any,other Limit of Insurance provided under this policy: Coverage Limit Business Income Extension for Off-Premises Utility Services $25,000 Business Income Extension for Web Sites $50,00017 days Business Income from Dependent Properties $50,000 The following Limit of insurance for the following Business Income Coverage Is a replacement of the Limit of Insurance provided under the Standard Property Coverage Form or the Special Property Coverage Form, whichever applies to the policy: Coverage Limit Extended Business Income 90 Days i The following changes apply to Loss Payment Conditions: Coverage Limit Valuation Changes Commodity Stock Included "Finished Stock" Included Mercantile Stock- Sold Included Page 2 of 2 Form SS 8415 09 07