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HomeMy WebLinkAboutPW16-453 - Amendment - #1 - RH2 Engineering, Inc. - Kent Springs & Pump Station No. 4 - 08/30/2017 I / .R e (1- o r Ci' s M a,n:,.,,,,, a,`g`;`- ""'e' /Ifs l v� KENT D o c u m ent W S H I M CT0W 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: RH2 Engineering, Inc. Vendor Number: ID Edwards Dumber Contract Number: M This is assigned by City Clerk's Office Project Name: Kent Springs & Pump Station 4 Electrical & Generator Upgrades Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: ftW,,,4A&WUN1t . Contract Effective Date: Date of the Mayor's signature Termination Date: 12/31/17 Contract Renewal Notice (Days),: Number of days required notice for termination or renewal or amendment Contract Manager: Bryan Bond Department: PW Operations Contract Amount: $I2,524 00 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Prepare additional updates to the plans and specifications based on review comments from the City. As of: 08/27/14 QR!G1NN.-J_PAGE N0-A—.0F_--7 PAGES • KENT WASHINCYON AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: RH2 Engineering, Inc. CONTRACT NAME & PROJECT NUMBER: Kent Springs and Pump Station 4 Electrical and Standby Generator Upgrades ORIGINAL AGREEMENT DATE: December 27, 2016 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: Prepare additional updates to the plans and specifications based on review comments from the City. For a description, see the Consultant's Scope of Work which is attached as Exhibit A and incorporated by this reference. 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, $79,710.00 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $79,710.00 including all previous amendments Current Amendment Sum $12,524.00 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $92,234.00 AMENDMENT - 1 OF 2 Original Time for Completion 12/31/17 (insert date) Revised Time for Completion under n/a prior Amendments (insert date) Add'l Days Required for this 0 calendar days Amendment Revised Time for Completion 12/31117 (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: C 7 si nat r J (signature) u Print Ilia Pri� Na e zette Cooke L,-' Its rc%,'!,�" AN- Its®_ Mayor z (title DATE: DATE: APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department RI-12 Kent Springs PS 4 Arnd I/Bund AMENDMENT - 2 OF 2 ORIGINAL 1 PAGE NO?) _oF_J_FAGEs EXHIBIT A Scope of Work Amendment No. 1 City of Kent Kent Springs and Pump Station No. 4 Electrical and Standby Generator Upgrades Bid Documents and Permit Review Design Updates August 2017 Background This Scope of Work includes assistance by RH2 Engineering, Inc., (111-12)with specific tasks, as directed by the City of Kent(City),to prepare additional updates to the plans and specifications based on 100-percent review comments from the City. Task 5 — 100-Percent Design Updates Objective: Prepare additional updates to the plans at the direction of the City based on 100-percent and building permit review comments from the City. Approach: 5.1 Prepare Final Bid Documents: Update plans based on additional 100-percent and building permit review comments from the City and prepare final bid documents. Provided by City: • 100-percent design review comments. • Building permit review comments RH2 Deliverables: • One (1)electronic copy of the final plans in AutoCAD(dwg) format on a CD. • One (1)electronic copy of the final plans in PDF on a CD. • One (1)full-size hard copy of final plans. Task 6—Technical Specification Updates Objective: Update technical specifications based on City review comments and prepare final technical specifications. Approach: 6.1 Prepare Final Technical Specifications: Update and prepare final technical specifications based on City review comments. Final specifications shall be provided with a stamped cover sheet. RH2 Deliverables: • One (1)electronic copy of the final technical specifications in PDF and Word format on a CD. 1 8/15/2017 10:41 AM 1:\Data\KEN\117-005\Contract\Amend No.1\PSA SOW Amend No 1_Kent Springs and Pump Station No,4 Electrical and Standby Generator Upgrades.dcx OR1GI,�AL_ IPAGE NO G-_OF_:JPAGES City of Kent Amendment No. 1 Kent Springs and Pump Station No.4 Exhibit A Electrical and Standby Generator Upgrades Scope of Work Bid Documents and Permit Review Design Updates Project Schedule RH2 will commence with the 100-percent design and technical specification updates after receiving a fully- executed amendment. The following project schedule identifies the anticipated completion for each task. Anticipated Deliverables Completion 100-percent Design Updates Amendment Receipt+2 weeks Technical Specification Updates Amendment Receipt+2 weeks 2 8/15/2017 10:41 AM l:\Data\KEN\117-005\Contract\Amend No.1\PSA_SOW_Amend No 1 Kent Springs and Pump Station No.4 Electrical and Standby Generator Upgrades.docz PAGF N0__1 OF j PAGES EXHIBIT B City of Kent Amendment No.1-Kent Springs and Pump Station No.4 Electrical and Standby Generator Upgrades Bid Documents and Permit Review Design Updates Fee Estimate Description Total Total Labor Total Ex P Hours Pence Total Cost Task 5 100-Percent Design Updates 62 $ 9,664 $ 1,759 $ 11,423 5.1 Prepare Final Bid Documents 62 $ 9,664 $ 1,759 $ 11423 } Task 6 Technical Specification Updates 6 $ 1,072 $ 24 1 $ 1,101 6.1 �Prepare Final Technical Specifications 6 $ 1,072 $ 29 ; $ 1,101 s Amendment No.1-Kent Springs and Rump Station No.4 68 $ 10,736 $ 1,788 1 $ 12,524 1:$pam VC NU17-OOSK on"COAmend No.1VP5 A_FEE_Amend No.1_[ant S pmEs a nd P ump S Win n No.4 Electric al and 50 ndby G enerator U pg mdef.ah m BASA01710:39 AM 0WGlNAL-__PAGE NO ko 01r -I.. PAGES EXHIBIT C RH2 ENGINEERING, INC. 2016 SCHEDULE OF RATES AND CHARGES RATE LIST RATE UNIT Professional 1 $137 $/hr 9 Professional 11 $150 $/hr Professional 111 $159 $/hr Professional IV $170 $/hr Professional V $180 $/hr Professional VI $189 $/hr Professional VII $204 $/hr Professional VIII $213 $/hr Professional IX $213 $/hr Technician 1 $96 $/hr Technician 11 $101 $/hr Technician III $129 $/hr Technician IV $137 $/hr Administrative 1 $65 $/hr Administrative II $77 $/hr Administrative III $92 $/hr Administrative IV $108 $/hr Administrative V $128 $/hr CAD/GIS System $27.50 $/hr CAD Plots- Half Size $2.50 price per plot CAD Plots-Full Size $10.00 price per plot CAD Plots-Large $25.00 price per plot Copies(bw) 8.5" X 11" $0.09 price per copy Copies (bw) 8.5" X 14" $0.14 price per copy Copies (bw) 11"X 17" $0.20 price per copy Copies (color) 8.5" X 11" $0.90 price per copy Copies(color) 8.5"X 14" $1.20 price per copy Copies(color) 11"X 17" $2.00 price per copy Technology Charge 2.50% %of Direct Labor price per mile Mileage $0.540 (or Current IRS Rate) Subconsultants 15% Cost+ Outside Services at cost 10/19/201611 09 AM OR!GINIAL_ I PAGE NO_Z OF_�LPAGES ACO CERTIFICATE OF LIABILITY INSURANCE DATE(MMrDDrYYYY) 5/16/2017 - :41S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES .,GLOW. 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(les) 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 CONTACT NAME: JOIIa Bolin Sammamish Insurance, Inc. PHONE (425)898-8780 FAX. No: (425)836-2965 704 228th Ave NE, PMB 373 -AIL .JonaBolin@msn.com INSURERS AFFORDING COVERAGE NAIC p Sammamish WA 98074 INSURERA:Ohio Security Insurance Company 24082 INSURED INSURERB:The Ohio Casualty Insurance Company 24074 Rh2 Engineering Inc INSURERC:Continental Casualty Comp!jay 20443 22722 29th Dr SE Ste 210 INSURERD: INSURER E: Bothell WA 98021 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1751503054 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 TYPE OF INSURANCE ADDL B POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MWDD MAN D X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS-MADE x i OCCUR PREMISES a occurrence $ 2,000,000 BZ857962270 5/29/2017 5/29/2016 MED EXP(Any one person) $ 15,000 PERSONAL BADVINJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY PRO. LOC PRODUCTS-COMPIOPAGG $ 4,000,000 JECT OTHER: $ ,'AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Es accident A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BAS57962270 5/29/2017 5/29/2018 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ 2,000,000 B EXCESS LIAR CLAIMS-MADE AGGREGATE $ 2,000,000 DIED I X I RETENTION$ 10 000 US05796227 5/29/2017 5/29/2018 $ J�DORBWEi5X7QDC9OEAT(VNC PTAT TE X ER AKWMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE NIA (Mandatory In NH) E.L.EACH ACCIDENT $ 2,000,000 A OFFICER/MEMBER n EXCLUDED? BZS57962270 5/29/2017 5/29/2018 E,L,DISEASE-EA EMPLOYEE $ 2,000,000 If yes,describe undo, DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT $ 2,000,000 C Profes I sional Liability ABH004312321 5/29/2017 5/29/2018 Per Claim $3,000,000 Claims Made Deductible $200,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) The certificate holder is named as additional insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 400 West Gowe ACCORDANCE WITH THE POLICY PROVISIONS. I Kent, WA 98032 AUTHORIZED REPRESENTATIVE A Fugitt CPCU/JONA --g _ C 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025 onlam i DATE(MMIDDIYYYY) ACC)R®® CERTIFICATE OF LIABILITY INSURANCE 5/16/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jona Bolin ,_NAME: Sammamish Insurance, Inc. PHONE (425)898-8780 X i425)636-2865 (AIC.-No.Ex0 (A/C.No1.—_----- 704 228th Ave NE, PMB 373 E-MAIL JonaBolin@msn.com A_DDRE$S_- ----------. --.- INSURER(S)AFFORDING COVERAGE _ NAIC 0 Sammamish WA 98074 _ _ INSURERA:Ohio Security_Insurance Company_____ 24082 _ INSURED — INSURERB:The Ohio Casualty Insurance Compaq 24074 Rh2 Engineering Inc INSURER c:Continen_t_a_1_Casualty Company 20443 22722 29th Dr SE Ste 210 INSURERD: _INSURER E: —..----------_.-- -- ----- — ----- --- Bothell WA 98021 1 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1751503054 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. tNSR TYPE OF INSURANCE A SUER POLICY NUMBER POLICY M DD�Y MM1OD1YYY LIMITS LTR ------ X 1 COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE S 2,000,000 V 1 DAAMA�(a€TO RENTED A - CLAIMS-MADE FX OCCUR i I III`PREMISES(Eaoccurrence) $ 2,000,000 X 5/29/2018I 15,000BZ557962270 5/29/2017 MEDEXP(Anyoneperson) — - PERSONAL&ADV INJURY S 2,000,000 i GEN'LAGGREGATE LIMIT APPLIES PER. FGENERAI�AGGREGATE S _ 4,000,000 X POLICY PRO I LOC 4,000,000 ❑JEC7 RODUCTS-COMPIOP AGG $ OTHER: � I ------- S AUTOMOBILE LIABILITY If CO aBINE�D SINGLE LIMIT S 1,000,000 X ANY AUTO I BODILY INJURY(Per person) S A ALL OWNED SCHEDULED I I BOOYINURY(Peraccdent) $ AUTOS AUTOS X BAS57962270 �I NON-OWNED 1 PROPERTY DAMAGE S HIRED AUTOS I 'AUTOS gEer accidentL S I UMBRELLA LIAR OCCUR I EACH OCCURRENCE S 2,000,000 - — EXCESS LIAB I AGGREGATE $ CLAIMS-MADE __ _ 2 000,000 _r— �' __ US05796227 5/29/2017 5/29/2018 $ DED X RETENTION S 10 000 }SDORBIbtt4X)61dB?3NtDlro(Oi1C I $_TATUTE I X 'ERH ROWMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE , I i­E.L.EACH ACCIDENT S 2,000,000 Rl OFFICEMEMBER EXCLUDED? N N I A '! BZS57962270 5/29/2017 5/29/2018 A (Mandatory in NH) E L DISEASE-EA_ EMPLOYES 2,000,000 If es.describe under I DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT I S 2,000,000 I C IProfeaaional Liability ICI EAEH004312321 1,1111017i 5/29/2018 Per Claim $3,000,000 i I{ Claims Made j Deductible $200.000 I DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schodule,may be attached If more apace 15 required) The certificate holder is named as additional insured per BP0452 (General Liability) and CA8810 (Auto Liability) . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 400 West Gowe ACCORDANCE WITH THE POLICY PROVISIONS. Kent, WA 98032 AUTHORIZED REPRESENTATIVE A Fugitt CPCU/JONA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401) POLICY NUMBER: BZS57962270 BUSINESSOWNERS BP 04 52 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: City of Kent Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II—Liability is amended as follows: b. This insurance does not apply to: A. The following is added to Paragraph C.Who Is An (1) 'Bodily injury", "property damage" or Insured: "personal and advertising injury" arising 3. Any state or governmental agency or out of operations performed for the subdivision or political subdivision shown in the federal government, state or Schedule is also an additional insured, subject municipality; or to the following provisions: (2) 'Bodily injury" or "property damage" a. This insurance applies only with respect to included within the "products-completed operations performed by you or on your operations hazard". behalf for which the state or governmental B. With respect to the insurance afforded to these agency or subdivision or political additional insureds, the following is added to subdivision has issued a permit or Paragraph D. Liability And Medical Expenses authorization. Limits Of Insurance: However: If coverage provided to the additional insured is (1) The insurance afforded to such required by a contract or agreement, the most we additional insured only applies to the will pay on behalf of the additional insured is the extent permitted by law; and amount of insurance: (2) If coverage provided to the additional 1. Required by the contract or agreement; or insured is required by a contract or 2. Available under the applicable Limits Of agreement, the insurance afforded to Insurance shown in the Declarations; such additional insured will not be whichever is less. broader than that which you are required by the contract or agreement to This endorsement shall not increase the provide for such additional insured. applicable Limits Of Insurance shown in the Declarations. BP 04 52 07 13 C Insurance Services Office, Inc., 2012 Page 1 of 1 COMMERCIAL AUTO CA 88 10 01 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. COVERAGEINDEX SUBJECT PROVISION NUMBER ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT 3 ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 18 AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13 BROAD FORM INSURED 1 BODILY INJURY REDEFINED 21 EMPLOYEES AS INSUREDS (including employee hired auto) 2 EXTENDED CANCELLATION CONDITION 22 EXTRA EXPENSE- BROADENED COVERAGE 10 GLASS REPAIR-WAIVER OF DEDUCTIBLE 15 HIRED AUTO PHYSICAL DAMAGE(including employee hired auto) 6 HIRED AUTO COVERAGE TERRITORY 20 LOAN / LEASE GAP 14 PARKED AUTO COLLISION COVERAGE(WAIVER OF DEDUCTIBLE) 16 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 RENTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 17 WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US 19 SECTION II -LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED 5 SECTION II - LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of which you own more than 50 percent of the voting stock ti during the policy period. However, "insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy; or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization; ©2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but only for acts within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the "employee". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE, paragraph .A.I. - WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an "insured". However, such person or organization is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto"; (2) Only for "bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations ) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earn- ings up to $500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION II - LIABILITY, exclusion 13.5. FELLOW EMPLOYEE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. ~ SECTION III -PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow; or ©2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 2 of 7 b. Your "employee" hires or rents under a written contract or agreement in that "employee's" name, but only if the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for "loss" in any one "accident" or "loss" is the smallest of: (1) $50,000; or (2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. D. Subject to a maximum of $750 per "accident", we will also cover the actual loss of use of the hired "auto" if it results from an "accident", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: (1) Any "auto" that is hired, rented or borrowed with a driver; or (2) Any "auto" that is hired, rented or borrowed from your "employee". For the purposes of this provision, SECTION V-DEFINITIONS is amended by adding the following: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. TOWING AND LABOR SECTION III - PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition of the following: We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is dis- abled: a. For private passenger type vehicles, we will pay up to $50 per disablement. b. For 'light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a gross vehicle weight (GVW) of 10,000 pounds or less. c. For"medium trucks" ,we will pay up to $150 per disablement. "Medium trucks" are trucks that have a gross vehicle weight (GVW) of 10,001 -20,000 pounds. However, the labor must be performed at the place of disablement. 8. PHYSICAL DAMAGE- ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, is amend- ed to provide a limit of $50 per day and a maximum limit of $1,500 ©2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION III -PHYSICAL DAMAGE COVERAGE,A. COVERAGE,is amended by adding the following: a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an "auto" because of "accident" or "loss", to an "auto" for which we also pay a "loss" under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident" or "loss" to the covered "auto." b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a maximum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" avail- " able for your use and operation cannot fill. e. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4. Coverage Extension. f. No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRA EXPENSE-BROADENED COVERAGE Under SECTION III-PHYSICAL DAMAGE COVERAGE,A. COVERAGE,we will pay for the expense of returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000. 11. PERSONAL EFFECTS COVERAGE A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following: If you have purchased Comprehensive Coverage on this policy for an auto you own and that "auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible insurance. B. SECTION V-DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is worn or carried by an insured_" "Personal effects" does not include tools, equipment, jewelry, money or securities. 12. ACCIDENTAL AIRBAG DEPLOYMENT SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow- ing: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for "loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov- erage or warranty. 13. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c. and 4.d. is deleted and replaced with the following: 02010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 4 of 7 Exclusion 4.c. and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, if the equipment is permanently installed in the covered "auto" at the time of the "loss" and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto" and physical damage coverages are provided for the covered "auto"; or If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a$100 deductible. 14. LOAN / LEASE GAP COVERAGE A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any one "accident" is the greater of the: 1. Balance due under the terms of the loan or lease to which the damaged covered "auto" is subject at the time of the "loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the 'loss", b. Financial penalties imposed under a lease due to high mileage, excessive use or ab- normal wear and tear, c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a"Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered "auto", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto", I. Any amount representing taxes, j. Loan or lease termination fees; or 2. The actual cash value of the damage or stolen property as of the time of the "loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the "loss". This adjustment is not applicable in Texas. s B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto" that incurred the loss serves as collateral, or lease written on the covered "auto" that incurred the loss. C. SECTION V-DEFINTIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: "Total loss" means a "loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A "balloon loan" is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. ©2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 5 of 7 15. GLASS REPAIR-WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE(WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an "insured"; b. Legally parked; and c. Unoccupied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or s organization engaged in the automobile business. SECTION IV -BUSINESS AUTO CONDITIONS is amended as follows: 17. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this " policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 18. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. Member, if you are a limited liability company; 4. An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: (1) How, when and where the "accident' or 'loss" took place; (2) The "insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 19. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident' or 'loss", our rights are waived also. ©2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 6 of 7 20. HIRED AUTO COVERAGE TERRITORY SECTION IV- BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period, Coverage Territory, is amended by the addition of the following: f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined in a "suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with a driver. SECTION V -DEFINITIONS is amended as follows: 21. BODILY INJURY REDEFINED Under SECTION V-DEFINTIONS, definition C.is replaced by the following: "Bodily injury" means physical injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 22. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 60 days prior notice of cancella- tion. 0 ©2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 7 of 7 / / / / / r / / / / / / r / / / / / / r / / / r , � r / / r, f / / / > /i/l I/iI/ ,ll J,...rD�/�/„ �/,////��///j/✓«/,//..i... /////��> �l .,�L �f//IIJI/,. ! ,.N,li,. .. �//%/./�//�//,I�r%///����// rr ,/ f , / r � / f / 1 / r � / l r / / / / / / f / f / l / / / / / / / / / / r/ / r / / i / / / / r / / / / / / f / / / / / / / / / / f / / / / / f /