HomeMy WebLinkAboutPW15-249 - Amendment - #2 - GeoEngineers, Inc. - East Valley Highway Metro Sewer Repair - 12/16/2016 lcords Ma!nafgemn t
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Document
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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: GeoEngineers Inc.
Vendor Number:
JD Edwards Number
Contract Number: p WIS ` 7 000
This is assigned by City Clerk's Office
Project Name: East Valley Highway Metro Sewer Repair
Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract
❑ Other:
Contract Effective Date: 12/16/16 Termination Date: 12/31/17
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) (De Mayor City Council
Detail: (i.e. address, location, parcel number, tax id, etc.):
Extend the time of completion due to King County (Metro) still has not repaired the sewer
or the roadway and the City needs the Consultant under contract until the repairs have
been completed.
As of: 08/27/1.4
KEI�I7"
WnS HINa.TON
AMENDMENT NO.
NAME OF CONSULTANT OR VENDOR: GeoEngineers, Inc.
CONTRACT NAME & PROJECT NUMBER: East Valley Highway Metro Sewer Repair
ORIGINAL AGREEMENT DATE: July 21, 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 December 31,
2017 due to King County (Metro) still has not repaired the
sewer or the roadway and the City needs the Consultant under
contract until the repairs have been completed.
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, $34,575.00
including applicable WSST
Net Change by Previous Amendments $0
including applicable WSST
Current Contract Amount $34,575.00
including all previous amendments
Current Amendment Sum $0
Applicable WSST Tax on this $0
Amendment
Revised Contract Sum $34,575.00
AMENDMENT - 1 OF 2
Original Time for Completion 12/31/15
(insert date)
Revised Time for Completion under 12/31/16
prior Amendments
(insert date)
Add'I Days Required (t) for this 365 calendar days
Amendment
Revised Time for Completion 12/31/17
(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: CITY OF KENT:
1
By:
Y By y caa u e
signature)r <. '(sJ nature)
Print Na ., �r' a �,. >° W" ZZ Print Name: Timothy J. LaPorte, P.E.
t
Its 'f =, Its Public Wo>r s Director
(title) vim" (t�tlelr
DATE: t t f ; DATE:
APPROVED AS TO FORM:
(applicable if Mayor's signature required)
Kent Law Department
GeoEnglneers-EVH Metro Sewer Repair Amid 2/1-engholz
AMENDMENT - 2 OF 2
GEOEINC-01 WALDENKI
CERTIFICATE OF LIABILITY INSURANCE DA3/31/2016YY)
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
( )W. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
t RESENTATIVE 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 NAMEAOT Willis Towers Watson Certificate Center
Willis of Seattle,Inc. PHONE g77 945-7378 FAX
X No): (888)467-2378
C/o 26 Century Blvd _alrjo Ext:
( )
P.O.Box 305191 ADDRESS:certificates@willis.com
Nashville,TN 37230-5191
INBURER(S)AFFOROING COVERAGE NAiCq '.
INSURER A:Continental Insurance Company 35289
INSURED INSURER B:National Fire Insurance Company of Hartford 20478
GeoEngineers,Inc. INSURERC:Liberty Insurance Corporation 42404
8410154th Ave.NE INSURER D:Valley Forge Insurance Company 20508
Redmond,WA98052 INSURER E:AGCS Marine Insurance Company 22837
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDLSUBR POLIOYEFF POLICY EXP LIMITS
LTR TYPE OF INSURANCE INSD Me POLICY NUMBER MMIDDIYYYY MM/ODNYYY
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE N OCCUR X 6024049165 03/31/2016 03/31/2017 DAMAA=RENTED100,000
PREMISES Ea occurrence $
MED EXP(Any one person) $ 15,000
i —_
PERSONALBADV INJURY "d 1,000,000
GE 11 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $.._ 2,000,000
POLICY JECOT "..J LOD PRODUCTS-COMP/OP AGO 1$ 2,000,000
OTHER: WA STOPGAP $ 1,000,000
FOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
Ea accident) _
B X
ANY AUTO X 6024049196 03/31/2016 03/31/2017 BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS AUTOS
NON-OWNED PerCacmtlentDAMAGE $
HIRED AUTOS AUTOS
X UMBRELLA LAG X OCCUR EACH OCCURRENCE_ $ 1,000,000
C EXCESS LIAB CLAIMS-MADE TH7-661-066735-016 03/31/2016 03/31/2017 AGGREGATE $ 1,000,000
DED X RETENTION$ 10,000 $
WORKERS COMPENSATION -
AND EMPLOYERS'LIABILITY X STATUTE _. EORH
Y D ANY PROPRIETORIPARTNER/EXECUTIVE � / 6024049179 03131/201610 3/3 112 0 1 7 E.L.EACH ACCIDENT $ 1,000,000
OFFICEPJMEMBER EXCLUDEDP LJ NIA
(Mandatory in NH) E.L,DISEASE EA EMPLOYEE $ 1,000,000
live,deRIPTION OF OPERATIONS below scribe under
D C E.L.DISEASE-POLICY LIMIT $ 1,000,00D
,.
E Business Pars Prop MXI 93039816 03/31/2016 03/31/2017 985,83
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
RE:City of Kent East Valley Highway Metro Sewer Repair,GeoEngineers No.0410-151-03 0
USL&H and Maritime Employers Liability coverage is included under Workers'Compensation coverage evidenced above. ,
City of Kent is included as an Additional Insured as respects to General Liability and Auto Liability as required by written contract.
I
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
I ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
City of Kent gyp
400 West GOING
',Kent WA 98032
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD '',.
N
Architects, Engineers and Surveyors General Liability
Extension Endorsement
It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE
PART as follows. If any other endorsement attached to this policy amends any provision also amended by this
endorsement, then that other endorsement controls with respect to such provision, and the changes made by this
endorsement with respect to such provision do not apply.
TABLE OF CONTENTS
1. Additional Insureds
2. Additional Insured- Primary And Non-Contributory To Additional Insured's Insurance
3. Additional Insured—Extended Coverage
4. Boats
5. Bodily Injury—Expanded Definition
6. Broad Knowledge of Occurrence/Notice of Occurrence
7. Broad Named Insured
8. Contractual Liability—Railroads
9. Estates, Legal Representatives and Spouses
10. Expected Or Intended Injury—Exception for Reasonable Force
11. General Aggregate Limits of Insurance— Per Location
12. In Rem Actions
13. Incidental Health Care Malpractice Coverage
14. Joint Ventures/Partnership/Limited Liability Companies
15. Legal Liability—Damage To Premises
16. Liquor Liability
17. Medical Payments
18. Non-owned Aircraft Coverage
19. Non-owned Watercraft
20. Personal And Advertising Injury—Discrimination or Humiliation
21. Personal And Advertising Injury- Contractual Liability
22. Property Damage—Elevators
23. Retired Partners, Members, Directors And Employees
24. Supplementary Payments
25. Unintentional Failure To Disclose Hazards
26. Waiver of Subrogation—Blanket
27. Wrap-Up Extension: OCIP, CCIP or Consolidated(Wrap-Up) Insurance Programs
I
CNA74858XX (1-15) Policy No: 6024049165
Page 1 of 17 Endorsement No:
Effective Date: 3/3 112 0 1 6
Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance services Office,Inc.,with Its permission.
CIVA
Architects, Engineers and Surveyors General Liability
Extension Endorsement
1. ADDITIONAL INSUREDS
a. WHO IS AN INSURED is amended to include as an Insured any person or organization described in
paragraphs A. through I. below whom a Named Insured is required to add as an additional insured on this
Coverage Part under a written contract or written agreement, provided such contract or agreement:
(1) is currently in effect or becomes effective during the term of this Coverage Part; and
(2) was executed prior to:
(a) the bodily injury or property damage; or
(b) the offense that caused the personal and advertising injury,
for which such additional insured seeks coverage.
b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the
Insurer will not provide such additional insured with:
(1) a higher limit of insurance than required by such contract or agreement; or
(2) coverage broader than required by such contract or agreement, and in no event broader than that
described by the applicable paragraph A.through I. below.
Any coverage granted by this endorsement shall apply only to the extent permissible by law.
A. Controlling Interest
Any person or organization with a controlling interest in a Named Insured, but only with respect to such
person or organization's liability for bodily injury, property damage or personal and advertising injury
arising out of:
1. such person or organization's financial control of a Named Insured; or
2. premises such person or organization owns, maintains or controls while a Named Insured leases or
occupies such premises;
provided that the coverage granted by this paragraph does not apply to structural alterations, new
construction or demolition operations performed by, on behalf of, or for such additional insured.
B. Co-owner of Insured Premises
A co-owner of a premises co-owned by a Named Insured and covered under this insurance but only with
respect to such co-owner's liability for bodily injury, property damage or personal and advertising injury
as co-owner of such premises.
C. Engineers, Architects or Surveyors Engaged By You
An architect, engineer or surveyor engaged by the Named Insured, but only with respect to liability for
bodily injury, property damage or personal and advertising injury caused in whole or in part by the
Named Insured's acts or omissions, or the acts or omissions of those acting on the Named Insured's
behalf:
a. in connection with the Named Insured's premises; or
b. in the performance of the Named Insured's ongoing operations.
But the coverage hereby granted to such additional insureds does not apply to bodily injury, property
damage or personal and advertising injury arising out of the rendering of or failure to render any
professional services by, on behalf of, or for the Named Insured, including but not limited to:
CNA74858XX (1-15) Policy No:
Page 2 of 17 Endorsement No:
Effective Date:
Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance services Office,Inc.,with its permission.
N
Architects, Engineers and Surveyors General Liability
Extension Endorsement
1. the preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports,
surveys, field orders, change orders or drawings and specifications; or
2. supervisory, inspection, architectural or engineering activities.
D. Lessor of Equipment
Any person or organization from whom a Named Insured leases equipment, but only with respect to liability
for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the
Named Insured's maintenance, operation or use of such equipment, provided that the occurrence giving
rise to such bodily injury, property damage or the offense giving rise to such personal and advertising
injury takes place prior to the termination of such lease.
E. Lessor of Land
Any person or organization from whom a Named Insured leases land but only with respect to liability for
bodily injury, property damage or personal and advertising injury arising out of the ownership,
maintenance or use of such land, provided that the occurrence giving rise to such bodily injury, property
damage or the offense giving rise to such personal and advertising injury takes place prior to the
termination of such lease. The coverage granted by this paragraph does not apply to structural alterations,
new construction or demolition operations performed by, on behalf of, or for such additional insured.
F. Lessor of Premises
An owner or lessor of premises leased to the Named Insured, or such owner or lessor's real estate
manager, but only with respect to liability for bodily injury, property damage or personal and advertising
injury arising out of the ownership, maintenance or use of such part of the premises leased to the Named
Insured, and provided that the occurrence giving rise to such bodily injury or property damage, or the
offense giving rise to such personal and advertising injury, takes place prior to the termination of such
lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or
demolition operations performed by, on behalf of, or for such additional insured.
G. Mortgagee,Assignee or Receiver
A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or
receiver's liability for bodily injury, property damage or personal and advertising injury arising out of the
Named Insured's ownership, maintenance, or use of a premises by a Named Insured.
The coverage granted by this paragraph does not apply to structural alterations, new construction or
demolition operations performed by, on behalf of, or for such additional insured.
H. State or Governmental Agency or Subdivision or Political Subdivisions — Permits
A state or governmental agency or subdivision or political subdivision that has issued a permit or
authorization but only with respect to such state or governmental agency or subdivision or political
subdivision's liability for bodily injury, property damage or personal and advertising injury arising out of:
1. the following hazards in connection with premises a Named Insured owns, rents, or controls and to
which this insurance applies:
a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings,
canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings,
sidewalk vaults, street banners, or decorations and similar exposures; or
b. the construction, erection, or removal of elevators; or
c. the ownership, maintenance or use of any elevators covered by this insurance; or
i
CNA74858XX (1-15) Policy No:
Page 3 of 17 Endorsement No:
Effective Date:
Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance services Office,Inc.,with its permission.
q��
Architects, Engineers and Surveyors General Liability
Extension Endorsement
2. the permitted or authorized operations performed by a Named Insured or on a Named Insured's
behalf.
The coverage granted by this paragraph does not apply to:
a. Bodily injury, property damage or personal and advertising injury arising out of operations
performed for the state or governmental agency or subdivision or political subdivision; or
b. Bodily injury or property damage included within the products-completed operations hazard.
With respect to this provision's requirement that additional insured status must be requested under a written
contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the
Named Insured to add the governmental entity as an additional insured.
I. Trade Show Event Lessor
1. With respect to a Named Insured's participation in a trade show event as an exhibitor, presenter or
displayer, any person or organization whom the Named Insured is required to include as an additional
insured, but only with respect to such person or organization's liability for bodily injury, property
damage or personal and advertising injury caused by:
a. the Named Insured's acts or omissions; or
b. the acts or omissions of those acting on the Named Insured's behalf,
in the performance of the Named Insured's ongoing operations at the trade show event premises during
the trade show event.
2. The coverage granted by this paragraph does not apply to bodily injury or property damage included
within the products-completed operations hazard.
2. ADDITIONAL INSURED- PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE
The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended
to add the following paragraph:
If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and non-
contributory relative to an additional insured's own insurance, then this insurance is primary, and the Insurer will
not seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own
insurance means insurance on which the additional insured is a named insured. Otherwise, and notwithstanding
anything to the contrary elsewhere in this Condition, the insurance provided to such person or organization is
excess of any other insurance available to such person or organization.
3. ADDITIONAL INSURED—EXTENDED COVERAGE
When an additional insured is added by this or any other endorsement attached to this Coverage Part, WHO IS
AN INSURED is amended to make the following natural persons Insureds.
If the additional insured is:
a. An individual, then his or her spouse is an Insured;
b. A partnership or joint venture, then its partners, members and their spouses are Insureds;
c. A limited liability company, then its members and managers are Insureds; or
d. An organization other than a partnership,joint venture or limited liability company, then its executive officers,
directors and shareholders are Insureds;
but only with respect to locations and operations covered by the additional insured endorsement's provisions,
and only with respect to their respective roles within their organizations.
CNA74858XX (1-15) Policy No:
Page 4 of 17 Endorsement No:
Effective Date:
Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission.
Architects, Engineers and Surveyors General Liability
Extension Endorsement
Please see the ESTATES, LEGAL REPRESENTATIVES, AND SPOUSES provision of this endorsement for
additional coverage and restrictions applicable to spouses of natural person Insureds.
4. BOATS
Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the paragraph entitled
Exclusions is amended to add the following additional exception to the exclusion entitled Aircraft, Auto or
Watercraft:
This exclusion does not apply to:
Any watercraft owned by the Named Insured that is less than 30 feet long while being used in the course of
the Named Insured's inspection or surveying work.
5. BODILY INJURY—EXPANDED DEFINITION
Under DEFINITIONS,the definition of bodily injury is deleted and replaced by the following:
Bodily injury means physical injury, sickness or disease sustained by a person, including death, humiliation,
shock, mental anguish or mental injury sustained by that person at any time which results as a consequence of
the physical injury,sickness or disease.
6. BROAD KNOWLEDGE OF OCCURRENCE/NOTICE OF OCCURRENCE
Under CONDITIONS, the condition entitled Duties in The Event of Occurrence, Offense, Claim or Suit is
amended to add the following provisions:
A. BROAD KNOWLEDGE OF OCCURRENCE
The Named Insured must give the Insurer or the Insurer's authorized representative notice of an
occurrence, offense or claim only when the occurrence, offense or claim is known to a natural person
Named Insured, to a partner, executive officer, manager or member of a Named Insured, or to an
employee designated by any of the above to give such notice.
B. NOTICE OF OCCURRENCE
The Named Insured's rights under this Coverage Part will not be prejudiced if the Named Insured fails to
give the Insurer notice of an occurrence, offense or claim and that failure is solely due to the Named
Insured's reasonable belief that the bodily injury or property damage is not covered under this Coverage
Part. However, the Named Insured shall give written notice of such occurrence, offense or claim to the
Insurer as soon as the Named Insured is aware that this insurance may apply to such occurrence, offense
or claim.
7. BROAD NAMED INSURED
WHO IS AN INSURED is amended to delete its Paragraph 3. in its entirety and replace it with the following:
3. Pursuant to the limitations described in Paragraph 4, below, any organization in which a Named Insured has
management control:
a. on the effective date of this Coverage Part; or
b. by reason of a Named Insured creating or acquiring the organization during the policy period,
qualifies as a Named Insured, provided that there is no other similar liability insurance, whether primary,
contributory, excess, contingent or otherwise, which provides coverage to such'organization, or which would
have provided coverage but for the exhaustion of its limit, and without regard to whether its coverage is
broader or narrower than that provided by this insurance.
I I
CNA74868XX(1-15) Policy No:
Page 5 of 17 Endorsement No:
Effective Date:
Insured Name:
copyright CNA All Rights Reserved, Includes copyrighted material of Insurance services Office,Inc.,with its permission.
CNA
Architects, Engineers and Surveyors General Liability
Extension Endorsement
But this BROAD NAMED INSURED provision does not apply to:
(a) any partnership, limited liability company or joint venture; or
(b) any organization for which coverage is excluded by another endorsement attached to this Coverage
Part.
For the purpose of this provision, management control means:
A. owning interests representing more than 50% of the voting, appointment or designation power for the
selection of a majority of the Board of Directors of a corporation; or
B. having the right, pursuant to a written trust agreement, to protect, control the use of, encumber or
transfer or sell property held by a trust.
4. With respect to organizations which qualify as Named Insureds by virtue of Paragraph 3. above, this
insurance does not apply to:
a. bodily injury or property damage that first occurred prior to the date of management control, or that
first occurs after management control ceases; nor
b. personal or advertising injury caused by an offense that first occurred prior to the date of
management control or that first occurs after management control ceases.
5. The insurance provided by this Coverage Part applies to Named Insureds when trading under their own
names or under such other trading names or doing-business-as names (dba) as any Named Insured should
choose to employ.
8. CONTRACTUAL LIABILITY—RAILROADS
With respect to operations performed within 50 feet of railroad property, the definition of insured contract is
replaced by the following:
Insured Contract means:
a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that
indemnifies any person or organization for damage by fire to premises while rented to a Named Insured or
temporarily occupied by a Named Insured you with permission of the owner is not an insured contract;
b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a
municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement pertaining to the Named Insured's business (including an
indemnification of a municipality in connection with work performed for a municipality) under which the
Named Insured assumes the tort liability of another party to pay for bodily injury or property damage to a
third person or organization. Tort liability means a liability that would be imposed by law in the absence of any
contract or agreement.
Paragraph f. does not include that part of any contract or agreement:
(1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of:
(a) Preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports,
surveys,field orders, change orders or drawings and specifications; or
CNA74858XX (1-15) Policy No:
Page 6 of 17 Endorsement No:
Effective Date:
Insured Name:
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
N
,Architects, Engineers and Surveyors General Liability
Extension Endorsement
(b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or
damage;
(2) Under which the Insured, if an architect, engineer or surveyor, assumes liability for an injury or damage
arising out of the insured's rendering or failure to render professional services, including those listed in
(1) above and supervisory, inspection, architectural or engineering activities.
9. ESTATES, LEGAL REPRESENTATIVES,AND SPOUSES
The estates, executors, heirs, legal representatives, administrators, trustees, beneficiaries and spouses of any
natural person Insured or living trust shall also be insured under this policy; provided, however, coverage is
afforded to such estates, executors, heirs, legal representatives, administrators, trustees, beneficiaries and
spouses only for claims arising solely out of their capacity or status as such and, in the case of a spouse,
where such claim seeks damages from marital community property, jointly held property or property transferred
from such natural person Insured to such spouse. No coverage is provided for any act, error or omission of an
estate, heir, legal representative, or spouse outside the scope of such person's capacity or status as such,
provided, however, that the spouse of a natural person Named Insured, and the spouses of members or
partners of joint venture or partnership Named Insureds are Insureds with respect to such spouses' acts,
errors or omissions in the conduct of the Named Insured's business.
10. EXPECTED OR INTENDED INJURY—EXCEPTION FOR REASONABLE FORCE
Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Expected or Intended Injury and replace it with the
following:
I This insurance does not apply to:
Expected or Intended Injury
Bodily injury or property damage expected or intended from the standpoint of the Insured. This exclusion
does not apply to bodily injury or property damage resulting from the use of reasonable force to protect
persons or property.
11. GENERAL AGGREGATE LIMITS OF INSURANCE-PER LOCATION
A. A separate Location General Aggregate Limit, equal to the amount of the General Aggregate Limit, is the
most the Insurer will pay for the sum of:
1. All damages under Coverage A, except damages because of bodily injury or property damage
included in the products-completed operations hazard; and
2. All medical expenses under Coverage C,
that arise from occurrences or accidents which can be attributed solely to ongoing operations at that
location. Such payments shall not reduce the General Aggregate Limit shown in the Declarations, nor the
Location General Aggregate Limit of any other location.
B. All:
1. Damages under Coverage B, regardless of the number of locations involved;
2. Damages under Coverage A, caused by occurrences which cannot be attributed solely to ongoing
operations at a single location, except damages because of bodily injury or property damage included
in the products-completed operations hazard; and
3. Medical expenses under Coverage C caused by accidents which cannot be attributed solely to ongoing
l
operations at a single location,
will reduce the General Aggregate Limit shown in the Declarations.
CNA74858XX (1-15) Policy No:
Page 7 of 17 Endorsement No:
Effective Date:
Insured Name:
Copyright CNA All Rights Reserved, Includes copyrighted material of Insurance Services Office,Inc.,with its permission.
CNA
Architects, Engineers and Surveyors General Liability
Extension Endorsement
C. For the purpose of this GENERAL AGGREGATE LIMITS OF INSURANCE - PER LOCATION Provision,
"location" means:
1. a premises the Named Insured owns or rents; or
2. a premises not owned or rented by any Named Insured at which the Named Insured is performing
operations pursuant to a contract or written agreement. If operations at such a location have been
discontinued and then restarted, or if the authorized parties deviate from plans, blueprints, designs,
specifications or timetables,the location will still be deemed to be the same location.
For the purpose of determining the applicable aggregate limit of insurance, premises involving the same or
connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-
way of a railroad shall be considered a single location.
D. The limits shown in the Declarations for Each Occurrence, for Damage To Premises Rented To You and for
Medical Expense continue to apply, but will be subject to either the Location General Aggregate Limit or the
General Aggregate Limit, depending on whether the occurrence can be attributed solely to ongoing
operations at a particular location.
E. When coverage for liability arising out of the products-completed operations hazard is provided, any
payments for damages because of bodily injury or property damage included in the products-completed
operations hazard, regardless of the number of locations involved, will reduce the Products-Completed
Operations Aggregate Limit shown in the Declarations.
F. The provisions of LIMITS OF INSURANCE not otherwise modified by this GENERAL AGGREGATE LIMITS
OF INSURANCE - PER LOCATION Provision shall continue to apply as stipulated.
12. IN REM ACTIONS
A quasi in rem action against any vessel owned or operated by or for the Named Insured, or chartered by or for
the Named Insured, will be treated in the same manner as though the action were in personam against the
Named Insured.
13. INCIDENTAL HEALTH CARE MALPRACTICE COVERAGE
Solely with respect to bodily injury that arises out of a health care incident:
A. Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the Insuring
Agreement is amended to replace Paragraphs 1.b.(1) and 1.b.(2)with the following:
b. This insurance applies to bodily injury provided that the professional health care services are incidental
to the Named Insured's primary business purpose, and only if:
(1) such bodily injury is caused by an occurrence that takes place in the coverage territory.
(2) the bodily injury first occurs during the policy period. All bodily injury arising from an
occurrence will be deemed to have occurred at the time of the first act, error, or omission that is
part of the occurrence; and
B. Under COVERAGES, Coverage A— Bodily Injury And Property Damage Liability, the paragraph entitled
Exclusions is amended to:
i. add the following to the Employers Liability exclusion:
This exclusion applies only if the bodily injury arising from a health care incident is covered by other
liability insurance available to the Insured (or which would have been available but for exhaustion of its
limits).
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ii. delete the exclusion entitled Contractual Liability and replace it with the following:
This insurance does not apply to:
Contractual Liability
the Insured's actual or alleged liability under any oral or written contract or agreement, including but not
limited to express warranties or guarantees.
Ill. to add the following additional exclusions:
This insurance does not apply to:
Discrimination
any actual or alleged discrimination, humiliation or harassment, including but not be limited to claims
based on an individual's race, creed, color, age, gender, national origin, religion, disability, marital status
or sexual orientation.
Dishonesty or Crime
Any actual or alleged dishonest, criminal or malicious act, error or omission.
Medicare/Medicaid Fraud
any actual or alleged violation of law with respect to Medicare, Medicaid, Tricare or any similar federal,
state or local governmental program.
Services Excluded by Endorsement
Any health care incident for which coverage is excluded by endorsement.
C. DEFINITIONS is amended to:
i. add the following definitions:
Health care incident means an act, error or omission by the Named Insured's employees or
volunteer workers in the rendering of:
a. professional health care services on behalf of the Named Insured or
b. Good Samaritan services rendered in an emergency and for which no payment is demanded or
received.
Professional health care services means any health care services or the related furnishing of food,
beverages, medical supplies or appliances by the following providers in their capacity as such but solely
to the extent they are duly licensed as required:
a. Physician;
b. Nurse;
c. Nurse practitioner;
d. Emergency medical technician;
e. Paramedic;
f. Dentist;
g. Physical therapist;
h. Psychologist;
f. Speech therapist;
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Architects, Engineers and Surveyors General Liability
Extension Endorsement
j. Other allied health professional; or
Professional health care services does not include any services rendered in connection with human
clinical trials or product testing.
ii. delete the definition of occurrence and replace it with the following:
Occurrence means a health care incident. All acts, errors or omissions that are logically connected by
any common fact, circumstance, situation, transaction, event, advice or decision will be considered to
constitute a single occurrence;
iii. amend the definition of Insured to:
a. add the following:
the Named Insured's employees are Insureds with respect to:
(1) bodily injury to a co-employee while in the course of the co-employee's employment by
the Named Insured or while performing duties related to the conduct of the Named
Insured's business; and
(2) bodily injury to a volunteer worker while performing duties related to the conduct of the
Named Insured's business;
when such bodily injury arises out of a health care incident.
the Named Insured's volunteer workers are Insureds with respect to:
(1) bodily injury to a co-volunteer worker while performing duties related to the conduct of the
Named Insured's business; and
(2) bodily injury to an employee while in the course of the employee's employment by the
Named Insured or while performing duties related to the conduct of the Named Insured's
business;
when such bodily injury arises out of a health care incident.
b. delete Subparagraphs(a), (b), (c)and (d)of Paragraph 2.a.(1) of WHO IS AN INSURED.
D. The Other Insurance condition is amended to delete Paragraph b.(1) in its entirety and replace it with the
following:
Otherinsurance
b. Excess Insurance
(1) To the extent this insurance applies, it is excess over any other insurance, self insurance or risk
transfer instrument, whether primary, excess, contingent or on any other basis, except for insurance
purchased specifically by the Named Insured to be excess of this coverage.
14. JOINT VENTURES/PARTNERSHIP/LIMITED LIABILITY COMPANIES
A. Past Joint Ventures, Partnerships, Limited Liability Companies
The following is added to WHO IS AN INSURED:
If the Named Insured was a joint venturer, partner, or member of a limited liability company and such joint
venture, partnership or limited liability company terminated prior to or during the policy period, such Named
Insured is an Insured with respect to its interest in such joint venture, partnership or limited liability company
but only to the extent that:
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a. any offense giving rise to personal and advertising injury occurred prior to such termination date, and
the personal and advertising injury arising out of such offense, first occurred after such termination
date;
b. the bodily injury or property damage first occurred after such termination date; and
c. there is no other valid and collectible insurance purchased specifically to insure the partnership, joint
venture or limited liability company.
If the joint venture, partnership or limited liability company is or was insured under a consolidated (wrap-up)
insurance program, then such insurance will always be considered valid and collectible for the purpose of
paragraph c. above. But this provision will not serve to exclude bodily injury, property damage or personal
and advertising injury that would otherwise be covered under the Architects, Engineers And Surveyors
General Liability Extension Endorsement provision entitled WRAP-UP EXTENSION: OCIP, CCIP, OR
CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS. Please see that provision for the definition of
consolidated(wrap-up) insurance program.
B. Participation In Current Professional Joint Ventures
The following is added to WHO IS AN INSURED:
The Named Insured is also an Insured for participation in a current joint venture that is not named on the
Declarations, but only if such joint venture meets all of the following criteria:
a. Each and every one of the Named Insured's co-venturers are architectural, engineering or surveying
firms only; and
b. There is no other valid and collectible insurance purchased specifically to insure the joint venture.
However, the Named Insured is an Insured only for the conduct of such Named Insured's business within
such a joint venture. The Named Insured is not insured for liability arising out of the acts or omissions of
other co-venturers, nor of their partners, members or employees.
C. WHO IS AN INSURED is amended to delete its last paragraph and replace it with the following:
Except as provided under this Architects, Engineers And Surveyors General Liability Extension
Endorsement or by the attachment of another endorsement(if any), no person or organization is an Insured
with respect to the conduct of any current or past partnership, joint venture or limited liability company that is
not shown as a Named Insured in the Declarations.
15. LEGAL LIABILITY — DAMAGE TO PREMISES / ALIENATED PREMISES / PROPERTY IN THE NAMED
INSURED'S CARE, CUSTODY OR CONTROL
A. Under COVERAGES, Coverage A— Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete exclusion j. Damage to Property in its entirety and replace it with the
following:
This insurance does not apply to:
j. Damage to Property
Property damage to:
(1) Property the Named Insured owns, rents, or occupies, including any costs or expenses incurred by
you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or
maintenance of such property for any reason, including prevention of injury to a person or damage to
another's property;
(2) Premises the Named Insured sells, gives away or abandons, if the property damage arises out of
any part of those premises;
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Architects, Engineers and Surveyors General Liability
Extension Endorsement
(3) Property loaned to the Named Insured;
(4) Personal property in the care, custody or control of the Insured;
(5) That particular part of real property on which the Named Insured or any contractors or
subcontractors working directly or indirectly on the Named Insured's behalf are performing
operations, if the property damage arises out of those operations; or
(6) That particular part of any property that must be restored, repaired or replaced because your work
was incorrectly performed on it.
Paragraphs (1), (3) and (4) of this exclusion do not apply to property damage (other than damage by
fire) to premises rented to the Named Insured or temporarily occupied by the Named Insured with the
permission of the owner, nor to the contents of premises rented to the Named Insured for a period of 7
or fewer consecutive days. A separate limit of insurance applies to Damage To Premises Rented To You
as described in LIMITS OF INSURANCE.
Paragraph (2) of this exclusion does not apply if the premises are your work.
Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack
agreement.
Paragraph (6) of this exclusion does not apply to property damage included in the products-
completed operations hazard.
Paragraphs (3) and (4)of this exclusion do not apply to property damage to:
i. tools, or equipment the Named Insured borrows from others, nor
ff. other personal property of others in the Named Insured's care, custody or control while being used
in the Named Insured's operations away from any Named Insured's premises.
However, the coverage granted by this exception to Paragraphs (3) and (4) does not apply to:
a. property at a job site awaiting or during such property's installation, fabrication, or erection;
b. property that is mobile equipment leased by an Insured;
c. property that is an auto, aircraft or watercraft;
d. property in transit; or
e. any portion of property damage for which the Insured has available other valid and collectible
insurance, or would have such insurance but for exhaustion of its limits, or but for application of one
of its exclusions.
A separate limit of insurance and deductible apply to such property of others. See LIMITS OF
INSURANCE as amended below.
B. Under COVERAGES, Coverage A— Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete its last paragraph and replace it with the following:
Exclusions c. through n. do not apply to damage by fire to premises while rented to a Named Insured or
temporarily occupied by a Named Insured with permission of the owner, nor to damage to the contents of
premises rented to a Named Insured for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to this coverage as described in LIMITS OF INSURANCE.
C. The following paragraph is added to LIMITS OF INSURANCE:
Subject to 5. above, $25,000 is the most the Insurer will pay under Coverage A for damages arising out of
any one occurrence because of the sum of all property damage to borrowed tools or equipment, and to
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other personal property of others in the Named Insured's care, custody or control, while being used in the
Named Insured's operations away from any Named Insured's premises. The Insurer's obligation to pay
such property damage does not apply until the amount of such property damage exceeds $1,000. The
Insurer has the right but not the duty to pay any portion of this $1,000 in order to effect settlement. If the
Insurer exercises that right,the Named Insured will promptly reimburse the Insurer for any such amount.
D. Paragraph 6., Damage To Premises Rented To You Limit, of LIMITS OF INSURANCE is deleted and
replaced by the following:
6. Subject to Paragraph 5. above, (the Each Occurrence Limit), the Damage To Premises Rented To You
Limit is the most the Insurer will pay under Coverage A for damages because of property damage to
any one premises while rented to the Named Insured or temporarily occupied by the Named insured
with the permission of the owner, including contents of such premises rented to the Named Insured for
a period of 7 or fewer consecutive days. The Damage To Premises Rented To You Limit is the greater
of:
a. $500,000; or
b. The Damage To Premises Rented To You Limit shown in the Declarations.
E. Paragraph 4.11b.(1)(a)(11)of the Other Insurance Condition is deleted and replaced by the following:
(if) That is property insurance for premises rented to the Named Insured, for premises temporarily occupied
by the Named Insured with the permission of the owner; or for personal property of others in the Named
Insured's care, custody or control;
16. LIQUOR LIABILITY
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Liquor Liability.
This LIQUOR LIABILITY Provision does not apply to any person or organization who otherwise qualifies as an
additional insured on this Coverage Part.
17. MEDICAL PAYMENTS
A. LIMITS OF INSURANCE is amended to delete Paragraph 7. (the Medical Expense Limit) and replace it with
the following:
7. Subject to Paragraph 5. above (the Each Occurrence Limit), the Medical Expense Limit is the most the
Insurer will pay under Coverage C for all medical expenses because of bodily injury sustained by any
one person. The Medical Expense Limit is the greater of:
(1) $15,000 unless a different amount is shown here: @ @ @ @ @ @ @ @ @ @ @; or
(2) the amount shown in the Declarations for Medical Expense Limit.
B. Under COVERAGES, the Insuring Agreement of Coverage C— Medical Payments is amended to replace
Paragraph ll.a.(3)(b) with the following:
(b) The expenses are incurred and reported to the Insurer within three years of the date of the accident; and
This Paragraph B. does not apply to medical expenses incurred in the state of Missouri.
18. NON-OWNED AIRCRAFT
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended as follows:
The exclusion entitled Aircraft, Auto or Watercraft is amended to add the following:
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Architects, Engineers and Surveyors General Liability
Extension Endorsement
This exclusion does not apply to an aircraft not owned by any Named Insured, provided that:
1. the pilot in command holds a currently effective certificate issued by the duly constituted authority of the
United States of America or Canada, designating that person as a commercial or airline transport pilot;
2. the aircraft is rented with a trained, paid crew to the Named Insured; and
3. the aircraft is not being used to carry persons or property for a charge.
19. NON-OWNED WATERCRAFT
Under COVERAGES, Coverage A — Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended to delete subparagraph (2) of the exclusion entitled Aircraft, Auto or Watercraft, and
replace it with the following.
This exclusion does not apply to:
(2) a watercraft that is not owned by any Named Insured, provided the watercraft is:
(a) less than 75 feet long; and
(b) not being used to carry persons or property for a charge.
20. PERSONAL AND ADVERTISING INJURY—DISCRIMINATION OR HUMILIATION
A. Under DEFINITIONS, the definition of personal and advertising injury is amended to add the following tort:
Discrimination or humiliation that results in injury to the feelings or reputation of a natural person.
B. Under COVERAGES, Coverage B — Personal and Advertising Injury Liability, the paragraph entitled
Exclusions is amended to:
1. delete the Exclusion entitled Knowing Violation Of Rights Of Another and replace it with the following:
This insurance does not apply to:
Knowing Violation of Rights of Another
Personal and advertising injury caused by or at the direction of the Insured with the knowledge that
the act would violate the rights of another and would inflict personal and advertising injury. This
exclusion shall not apply to discrimination or humiliation that results in injury to the feelings or reputation
of a natural person, but only if such discrimination or humiliation is not done intentionally by or at the
direction of:
(a) the Named Insured; or
(b) any executive officer, director, stockholder, partner, member or manager (if the Named Insured is
a limited liability company) of the Named Insured.
2. add the following exclusions:
This insurance does not apply to:
Employment Related Discrimination
discrimination or humiliation directly or indirectly related to the employment, prospective employment,
past employment or termination of employment of any person by any Insured.
Premises Related Discrimination
discrimination or humiliation arising out of the sale, rental, lease or sub-lease or prospective sale, rental,
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lease or sub-lease of any room, dwelling or premises by or at the direction of any Insured.
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Architects, Engineers and Surveyors General Liability
Extension Endorsement
Notwithstanding the above, there is no coverage for fines or penalties levied or imposed by a governmental entity
because of discrimination.
The coverage provided by this PERSONAL AND ADVERTISING INJURY -DISCRIMINATION OR
HUMILIATION Provision does not apply to any person or organization whose status as an Insured derives solely
from
Provision 1. ADDITIONAL INSURED of this endorsement; or
attachment of an additional insured endorsement to this Coverage Part.
21. PERSONAL AND ADVERTISING INJURY-CONTRACTUAL LIABILITY
A. Under COVERAGES, Coverage B -Personal and Advertising Injury Liability, the paragraph entitled
Exclusions is amended to delete the exclusion entitled Contractual Liability.
B. Solely for the purpose of the coverage provided by this PERSONAL AND ADVERTISING INJURY -
LIMITED CONTRACTUAL LIABILITY provision, the following changes are made to the section entitled
SUPPLEMENTARY PAYMENTS-COVERAGES A AND B:
1. Paragraph 2.d. is replaced by the following:
d. The allegations in the suit and the information the Insurer knows about the offense alleged in such
suit are such that no conflict appears to exist between the interests of the Insured and the interests
of the indemnitee;
2. The first unnumbered paragraph beneath Paragraph 2.f.(2)(b) is deleted and replaced by the following:
So long as the above conditions are met, attorney's fees incurred by the Insurer in the defense of that
indemnitee, necessary litigation expenses incurred by the Insurer, and necessary litigation expenses
incurred by the indemnitee at the Insurer's request will be paid as defense costs. Such payments will
not be deemed to be damages for personal and advertising injury and will not reduce the limits of
insurance.
C. This PERSONAL AND ADVERTISING INJURY - LIMITED CONTRACTUAL LIABILITY Provision does not
apply if Coverage B -Personal and Advertising Injury Liability is excluded by another endorsement
attached to this Coverage Part.
This PERSONAL AND ADVERTISING INJURY - CONTRACTUAL LIABILITY Provision does not apply to any
person or organization who otherwise qualifies as an additional insured on this Coverage Part.
22. PROPERTY DAMAGE- ELEVATORS
A. Under COVERAGES, Coverage A- Bodily Injury and Property Damage Liability, the paragraph entitled
Exclusions is amended such that the Damage to Your Product Exclusion and subparagraphs (3), (4) and
(6) of the Damage to Property Exclusion do not apply to property damage that results from the use of
elevators.
B. Solely for the purpose of the coverage provided by this PROPERTY DAMAGE- ELEVATORS Provision, the
Other Insurance conditions is amended to add the following paragraph:
This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any
- other basis that is Property insurance covering property of others damaged from the use of elevators.
23. RETIRED PARTNERS, MEMBERS, DIRECTORS AND EMPLOYEES
WHO IS INSURED is amended to include as Insureds natural persons who are retired partners, members,
directors or employees, but only for bodily injury, property damage or personal and advertising injury that
results from services performed for the Named Insured under the Named Insured's direct supervision. All
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Architects, Engineers and Surveyors General Liability
Extension Endorsement
limitations that apply to employees and volunteer workers also apply to anyone qualifying as an Insured under
this Provision.
24. SUPPLEMENTARY PAYMENTS
The section entitled SUPPLEMENTARY PAYMENTS—COVERAGES A AND B is amended as follows:
A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a
$5,000. limit; and
B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a
$1,000. limit.
25. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named
Insured's Coverage Part,the Insurer will not deny coverage under this Coverage Part because of such failure.
26. WAIVER OF SUBROGATION - BLANKET
Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended
to add the following:
The Insurer waives any right of recovery the Insurer may have against any person or organization because of
payments the Insurer makes for injury or damage arising out of:
1. the Named Insured's ongoing operations; or
2, your work included in the products-completed operations hazard.
However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of
recovery in a written contract or written agreement, and only if such contract or agreement:
1. is in effect or becomes effective during the term of this Coverage Part; and
2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise
to the claim.
27. WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED(WRAP-UP) INSURANCE PROGRAMS
Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to
any construction project in the state of Alaska, that is not permitted to be insured under a consolidated(wrap-
up)insurance program by applicable state statute or regulation.
If the endorsement EXCLUSION — CONSTRUCTION WRAP-UP is attached to this policy, or another
exclusionary endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.) or Contractor
Controlled Insurance Programs (C.C.I.P.) is attached, then the following changes apply:
A. The following wording is added to the above-referenced endorsement:
With respect to a consolidated (wrap-up) insurance program project in which the Named Insured is or
was involved, this exclusion does not apply to those sums the Named Insured become legally obligated to
pay as damages because of:
1. Bodily injury, property damage, or personal or advertising injury that occurs during the Named
Insured's ongoing operations at the project, or during such operations of anyone acting on the Named
Insured's behalf; nor
2. Bodily injury or property damage included within the products-completed operations hazard that
arises out of those portions of the project that are not residential structures.
B. Condition 4. Other Insurance is amended to add the following subparagraph 4.b.(1)(c):
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Extension Endorsement
This insurance is excess over:
(c) Any of the other insurance whether primary, excess, contingent or any other basis that is insurance
available to the Named Insured as a result of the Named Insured being a participant in a consolidated
(wrap-up) insurance program, but only as respects the Named Insured's involvement in that
consolidated(wrap-up) insurance program.
C. DEFINITIONS is amended to add the following definitions:
Consolidated (wrap-up) insurance program means a construction, erection or demolition project for which
the prime contractor/project manager or owner of the construction project has secured general liability
insurance covering some or all of the contractors or subcontractors involved in the project, such as an Owner
Controlled Insurance Program (O.C.I.P.) or Contractor Controlled Insurance Program (C.C.I.P.).
Residential structure means any structure where 30% or more of the square foot area is used or is
intended to be used for human residency, including but not limited to:
1. single or multifamily housing, apartments, condominiums, townhouses, co-operatives or planned unit
developments; and
2. the common areas and structures appurtenant to the structures in paragraph 1. (including pools, hot
tubs, detached garages, guest houses or any similar structures).
However, when there is no individual ownership of units, residential structure does not include military
housing, college/university housing or dormitories, long term care facilities, hotels or motels. Residential
structure also does not include hospitals or prisons.
This WRAP-UP EXTENSION: OCIP, CCIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS
Provision does not apply to any person or organization who otherwise qualifies as an additional insured on this
Coverage Part.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes
effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown
below, and expires concurrently with said Policy.
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Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc.,with its permission.
Policy Number: 6024049196 Effective Date: 3/31/2016
CNA CNA XX
(Ed.d. 04/04/12)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS EXTENDED COVERAGE ENDORSEMENT
- BUSINESS AUTO PLUS -
This endorsement modifies insurance provided underthe following:
BUSINESS AUTO COVERAGE FORM
I. LIABILITY COVERAGE 4. An "employee" of yours is an "insured" while
A. Who Is An Insured operating an "auto" hired or rented under a
contract or agreement in that "employee's"
The following is added to Section II, Paragraph name, with your permission, while
AA., Who Is An Insured: performing duties related to the conduct of
1. a. Any incorporated entity of which the your business.
Named Insured owns a majority of the "Policy," as used in this provision A. Who Is An
voting stock on the date of inception of Insured, includes those policies that were in
this Coverage Form; provided that, force on the inception date of this Coverage
b. The insurance afforded by this provision
Form but:
A.1. does not apply to any such entity 1. Which are no longer in force; or
that is an "insured" under any other 2. Whose limits have been exhausted.
liability "policy" providing "auto"
coverage. B. Bail Bonds and Loss of Earnings
2. Any organization you newly acquire or form, Section II, Paragraphs A.2. (2) and A.2. (4)
other than a limited liability company, are revised as follows:
partnership or joint venture, and over which 1. In a.(2), the limit for the cost of bail bonds is
you maintain majority ownership interest. changed from $2,000 to$5,000; and
The insurance afforded by this provision 2, In a.(4), the limit for the loss of earnings is
A.2.: changed from $250 to$500 a day.
a. Is effective on the acquisition or C. Fellow Employee
formation date, and is afforded only until
the end of the policy period of this Section II, Paragraph B.5 does not apply.
Coverage Form, or the next anniversary
of its inception date, whichever is Such coverage as is afforded by this provision
earlier. C. is excess over any other collectible
insurance.
b. Does not apply to: 11. PHYSICAL DAMAGE COVERAGE
(1) "Bodily injury" or "property damage"caused by an "accident" that A. Glass Breakage — Hitting A Bird Or Animal —
occurred before you acquired or Falling Objects Or Missiles
formed the organization; or The following is added to Section III,
(2) Any such organization that is an Paragraph A.3.:
"insured" under any other liability With respect to any covered "auto," any
"policy" providing "auto" coverage. deductible shown in the Declarations will not
3. Any person or organization that you are apply to glass breakage if such glass is
required by a written contract to name as an repaired, in a manner acceptable to us, rather
additional insured is an "insured" but only than replaced.
with respect to their legal liability for acts or B. Transportation Expenses
omissions of a person, who qualifies as an
"Insured" under Section II — Who Is An Section III, Paragraph AA.a. is revised, with
Insured and for whom Liability Coverage is respect to transportation expense incurred by
afforded under this policy. If required by you, to provide:
written contract, this insurance will be a. $60 per day, in lieu of$20; subject to
primary and non-contributory to insurance
on which the additional insured is a Named b. $1,800 maximum, in lieu of$600.
Insured.
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C. Loss of Use Expenses Section. III, Paragraphs BA.c and B.4.d. are
Section ill, Paragraph AA.b. is revised, with deleted and replaced by the following:
respect to loss of use expenses incurred by you, c. Physical Damage Coverage on a covered
to provide: "auto" also applies to "loss" to any
a. $1,000 maximum, in lieu of$600. permanently installed electronic equipment
including its antennas and other
D. Hired "Autos" accessories.
The following is added to Section III. d. A$100 per occurrence deductible applies to
Paragraph A.: the coverage provided by this provision.
5. Hired "Autos" G. Diminution In Value
If Physical Damage coverage is provided under The following is added to Section Ill,
this policy, and such coverage does not extend Paragraph B.6.:
to Hired Autos, then Physical Damage coverage Subject to the following, the "diminution in
is extended to: value" exclusion does not apply to:
a. Any covered "auto" you lease, hire, rent a. Any covered "auto" of the private
or borrow without a driver; and passenger type you lease, hire, rent or
b. Any covered "auto" hired or rented by borrow, without a driver for a period of
your "employee" without a driver, under 30 days or less, while performing duties
a contract in that individual related to the conduct of your business;
"employee's" name, with your and
permission, while performing duties b. Any covered "auto" of the private
related to the conduct of your business. passenger type hired or rented by your
c. The most we will pay for any one "employee" without a driver for a period
"accident" or "loss" is the actual cash of 30 days or less, under a contract in
value, cost of repair, cost of that individual "employee's" name, with
replacement or $75,000, whichever is your permission, while performing
less, minus a $500 deductible for each duties related to the conduct of your
covered auto. No deductible applies to business.
"loss" caused by fire or lightning. c. Such coverage as is provided by this
d. The physical damage coverage as is provision is limited to a "diminution in
provided by this provision is equal to the value" loss arising directly out of
physical damage coverage(s) provided accidental damage and not as a result
on your owned "autos." of the failure to make repairs; faulty or
e. Such physical damage coverage for incomplete maintenance or repairs; or
p y g g the installation of substandard parts.
hired "autos" will:
d. The most we will pay for "loss" to a
(1) include loss of use, provided it is covered "auto" in any one accident is
the consequence of an "accident" the lesser of:
for which the Named Insured is
legally liable, and as a result of (1) $5,000; or
which a monetary loss is sustained (2) 20% of the "auto's" actual cash
by the leasing or rental concern. value (ACV).
(2) Such coverage as is provided by III. Drive Other Car Coverage—Executive Officers
this provision will be subject to a
limit of$750 per "accident." The following is added to Sections II and III:
E. Airbag Coverage 1. Any "auto" you don't own, hire or borrow is a
The following is added to Section 111, covered "auto" for Liability Coverage while being
Paragraph 8.3.: used by, and for Physical Damage Coverage
while in the care, custody or control of, any of
The accidental discharge of an airbag shall not your"executive officers," except:
be considered mechanical breakdown. a. An "auto" owned by that "executive officer"
F. Electronic Equipment or a member of that person's household; or
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(Ed. 04/12)
b. An "auto" used by that "executive officer" The following is added to Section IV,
while working in a business of selling, Paragraph A.5. Transfer Of Rights Of
servicing, repairing or parking "autos." Recovery Against Others To Us:
Such Liability and/or Physical Damage We waive any right of recovery we may have,
Coverage as is afforded by this provision. because of payments we make for injury or
(1) Equal to the greatest of those damage, against any person or organization for
coverages afforded any covered "auto"; whom or which you are required by written
and contract or agreement to obtain this waiver from
us.
(2) Excess over any other collectible This injury or damage must arise out of your
insurance, activities under a contract with that person or
2. For purposes of this provision, "executive organization.
officer" means a person holding any of the You must agree to that requirement prior to an
officer positions created by your charter, "accident" or"loss."
constitution, by-laws or any other similar
governing document, and, while a resident of C. Concealment, Misrepresentation or Fraud
the same household, includes that person's spouse. The following is added to Section IV,
Paragraph B.2.:
Such "executive officers" are "insureds" while Your failure to disclose all hazards existing on the
using a covered 'auto" described in this date of inception of this Coverage Form shall not
provision. prejudice you with respect to the coverage afforded
IV. BUSINESS AUTO CONDITIONS provided such failure or omission is not intentional.
A. Duties In The Event Of Accident, Claim, Suit D. Other Insurance
Or Loss
The following is added to Section IV,
The following is added to Section IV, Paragraph B.5.:
Paragraph A.2.a.: Regardless of the provisions of Paragraphs 5.a
(4) Your "employees" may know of an and 5.d. above, the coverage provided by this
"accident" or "loss." This will not mean policy shall be on a primary non-contributory
that you have such knowledge, unless basis. This provision is applicable only when
such "accident" or "loss" is known to required by a written contract. That written
you or if you are not an individual, to contract must have been entered into prior to
any of your executive officers or "Accident" or"Loss."
partners or your insurance manager. E. Policy Period, Coverage Territory
The following is added to Section IV, Section IV, Paragraph B. 7.(5).(a), is revised to
Paragraph A 2.b.: provide:
(6) Your "employees" may know of documents received concerning a claim a. 45 days of coverage in lieu of 30 days.
or "suit." This will not mean that you V. DEFINITIONS
have such knowledge, unless receipt of
such documents is known to you or if Section V. Paragraph C. is deleted and replaced
you are not an individual, to any of your by the following:
executive officers or partners or your "Bodily injury" means bodily injury, sickness or
insurance manager. disease sustained by a person, including mental
B. Transfer Of Rights Of Recovery Against anguish, mental injury or death resulting from any of
Others To Us these.
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It is understood and agreed that:
If the Named Insured has agreed under written contract to provide notice of cancellation to a party to whom
the Agent of Record has issued a Certificate of Insurance, and if the Insurer cancels a policy term described on
that Certificate of Insurance for any reason other than nonpayment of premium,then notice of cancellation will
be provided to such Certificate holders at least 30 days in advance of the date cancellation is effective.
If notice is hailed, then proof of mailing to the last known mailing address of the Certificate holder on file with
the Agent of Record will be sufficient to prove notice.
Any failure by the Insurer to notify such persons or organizations will not extend or invalidate such
cancellation, or impose any liability or obligation upon the Insurer or the Agent of Record.
All other terms and conditions of the policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers,
takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another ,
effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy.
Norm No: CNA75014XX(O1-2015) Policy No: 6024049165
Endorsement Effective Date: 3/31/2016 Policy Effective Date:3/31/2016
Endorsement No: (ENDSEQNUM] ; Page: a of b
Underwriting Company: UWCOMP, UWADDRI UWADDR2,UWCITY,UWSTATE UWZE1
®Copyright CNA All Rights Reserved.
Terra Insurance Company TERRA
I (A Risk Retention Group) INSURANCE COMPANY
Two Fifer Avenue, Suite 100
Corte Madera, CA 94925
CERTIFICATE OF INSURANCE
DATE
01/01/16
NAME AND ADDRESS OF INSURED
GeoEngineers,Inc.
I101 Fawcett Avenue, Suite 200
Tacoma, WA 98402
This certifies that the"claims made"insurance policy(described below by policy number)written on forms in
use by the Company has been issued. This certificate is not a policy or a binder of insurance and is issued as a
matter of information only,and confers no rights upon the certificate holder. This certificate does not alter,
amend or extend the coverage afforded by this policy.
The policy of insurance listed below has 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 policy described herein is
subject to all the terms,exclusions and conditions of such policy. Aggregate limits shown may have been
reduced by paid claims.
TYPE OF INSURANCE Professional Liability
POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE
216019 01/01/16 12/31/16
LIMITS OF LIABILITY $1,000,000 EACH CLAIM
$1,000,000 ANNUAL AGGREGATE
PROJECT DESCRIPTION
City of Kent, East Valley Highway Metro Sewer Repair, GeoEngineers No, 0410-151-03
CANCELLATION: If the described policy is cancelled by the Company before its expiration date,
the Company will mail written notice to the certificate holder thirty (30) days in advance, or ten
(10)days in advance for non-payment of premium. If the described policy is cancelled by the
insured before its expiration date, the Company will mail written notice to the certificate holder
within thirty (30) days of the notice to the Company from the insured.
CERTIFICATE HOLDER ISSUING COMPANY:
TERRA INSURANCE COMPANY
City of Kent (A Risk Retention Group)
Attn:Nancy Yoshitake
400 West Gowe
Kent,Washington 98032
rresiaent