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HomeMy WebLinkAboutPW16-433 - Amendment - #1 - Gray & Osborne, Inc. - 640 Zone Booster Station - 12/06/2017 AIR T Document 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: Gray & Osborne, Inc. Vendor Number: JD Edwards Number Contract Number: T \/\/ I� 4�� bVT This is assigned by City Clerk's Office Project Name: 640 Zone Booster Station Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 12/G/17 Termination Date: 6/30/18 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager.--Bryan Bond Department: PW Operations Contract Amount: $0.00 Approval Authority: (CIRCLE ONE) =Departmentrector Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Extend the time of completion to June 30, 2018 due to design has taken longer than expected due to the complexity of the drainage review, _-------- .. .., .. As of: OS/27/14 ``: I 0 T W. AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: Gr- & Osborne, Inc. CONTRACT NAME & PROJECT NUMBER: 640 Zone Booster Station ORIGINAL AGREEMENT DATE: December 16, 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 ;dd 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 June 30, 2018 due to design has taken longer than expected due to the complexity of the drainage review. Permitting also needs to be addressed and a DOH report after the plans are finalized. 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, $241,627.00 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST w....rre.___.._nt_. Contract Amoun....._.t..m. .. ...$241............. ,627.00 _.._ including all previous amendments ........ ........ �..m... Current Amendment Sum $0 _ _ _..._._ _.._�. Applicable WSST Tax on_this $0 Amendment -.. _m ...................... Revised Contract Sum $241,G27.00 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'I Days Required (f) for this 181 calendar days Amendment Revised Time for Completion 6/30/18 (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: (signature) signature) Print Name: Michael B. Johnson Print Name: Timothy J. LaPorte, P.E. Its President Its Public Works Director (title) lie) DATE: 11/20/17 DATE: I 17 APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department Gray&osoorne-640 Zone Booster Statlon Amd 1/Bona AMENDMENT - 2 OF 2 ACX>llI CERTIFICATE OF LIABILITY INSURANCE 9/fi20`171DD" Y' THIS 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 LOW. 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 ondorsement. A statement on this certificate does not confer rights to the certificate holder In tiou of such andorsomenR s. PRODUCER CONTACfi Hall & Company NaMF Allison Andrus p y PHONE 360-626 2007 TAX 360 598 3703 19660 10th Ave NE wtC.NR,satl: — SMF,Nub.. Poulsbo WA 98370 EuriDRESS;aandrus@hallandcoinpany.com INSURER(SI AFFORDING COVERAGE f5A1Cq INSURER 1Hartford Casualty"Insurance Company 129424 INSURED 4 INSURERS Travelers Casualty and Sure 19038 Gray&Osborne Inc INSURER C j 701 Dexter Avenue N#200 INSURER D 1 Seattle WA 98109 „.., ... INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 1237249023 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'. IADDL SUBR POLICY EFF POLICY EXP m, TYPE OF INSURANCE NRn We POLICY NUMBER IMMInnIVVVVI M nroyvvYl LIMITS CLIABILITY __... ........__ _ .. If91 1 _ .. A X ) COMMERCIAL GENERAL LIABILITY62SBADU7309 9/1012017 �911012018 I 7 EAfHOC CE ,$1000000 fSAMAC TO urf rb"Y'R NnU I CLAIMS MADE XIOCCUR EREMIF'IF. ,n el '$300000 IX rP✓XnIJ?RFPn ; II 1$10000�„ ME O EXP(Anv one Deleon) j X m 1,r.n °SifO ..._ ',. 1 ,PERSONAL&Aov INJURY $1 000,000 ( , PRU _ GENERAL AGGRECAFE I32000000 _ GEN L ACGRE GA FE LIMIT APPLIES PE R POLICY X JECI If)� JPIODUGrs COMP/OPA00 $2000000 OTHER UUTOMOBILE LIABILITY � 27 T. ri IN"h l f 52UECJ532]6 9/10/2017 9/10/2018 Vsdolilomf) "1000000 X 1 ANY AUTO I BODILY INJURY(Pill Pcmen) "" ALLOWNE1) fSCHEDW.LD [ I IR AUTOS iAUTOS BODILY NJU Y(feracudem $ 1 NON OVVN[U (IRd$C=R$W rSi4ii HIRED AmO� 4 1 1 i auro5 I I � j II$n smgilaptl. $ _. OCCUR I .$ A X UMBRELLA LIAR X ` 152SBADU7303 9/10� /2017 9/1012018 EACH OCCURRE NCE $1 000,000 ll} EXCESS LIAR 11 AGGREGATE $1 000 000 yy I CLAIMS MPUE nFU 'X i REFENHONS10000 A WORKERS COMPENSATION 5 25BADU7303 j PER UFH "3 AND EMPLOYERS'LIABILITr Y N 9/1012017 9/10/2018 SfAnlih I X ,"1 WA Stop Gap MANY PROPRIETOR/PARTNER/EXECUTIVE f OFFICER/MEMBER EXCW DE09 ��N/AI Et EACH ACCIDENT $1000 11 000 ;(Mandatary in MITI - E L DISEASE-EA E MPLOYE L'$1 000 000 t y es,RPTION describe under $E 00IS000Ag9 POLICY LIMIF 151, DESC describe under OPERATIONS below 000,000 I 000 000 Per B Professional Gab_Claims Made 105339819 9/10/2017 W10/2010 Pollution Dab.Occurrence Form I i .._._DESCRIPTION OF OPERATIONS/LOCATIONS 1VEHICLES (ACOR01a1,Additional Remarks SCM1edule,may de aHacM1ed if more apace is requiretll Re;640 Water Reservoir City of Kent i5 an additional Insured per Written contract or agreement between insured and insured's client on the Genera Liability and Automobile Liability regarding!lability arising out of activities by or on behalf of the named insured. This insurance is primary insurance and any other insurance maintained by the Add itcnal Insured shall be excess Only�and non-contributing wlth this, insurance. A Waiver of subroggation applies to the General Liabllaty Auto Liability,.&Employers Laabiloty and Umbrella) Excess Liability'In favor of the Additional XnSUred, 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 �mm ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Policy#525BADU7303 BUSINESS LIABILITY COVERAGE FORM (b) Rented to, in the care, custody or b. Coverage under this provision does not control of, or over which physical apply to: control is being exercised for any (1) "Bodily injury" or "properly damage" purpose by you, any of your that occurred; or "employees", "volunteer workers", any partner or member (if you are (2) "Personal and advertising injury" a partnership or joint venture), or arising out of an offense committed any member (if you are a limited before you acquired or formed the liability company). organization. b. Real Estate Manager 4. Operator Of Mobile Equipment Any person (other than your"employee"or With respect to "mobile equipment" registered in "volunteer worker"), or any organization your name under any motor vehicle registration while acting as your real estate manager. law, any person is an insured while driving such c. Temporary Custodians Of Your equipment along a public highway with your Property permission. Any other person or organization responsible for the conduct of such person is Any person or organization having proper also an insured, but only with respect to liability temporary custody of your property if you arising out of the operation of the equipment,and die, but only: only if no other insurance of any kind is available (1) With respect to liability arising out of the to that person or organization for this liability, maintenance or use of that property;and However,no person or organization is an insured (2) Until your legal representative has with respect to: been appointed. a. "Bodily injury" to a co-"employae" of the d. Legal Representative If You Die person driving the equipment; or Your legal representative if you die, but b. "Property damage" to property owned by, only with respect to duties as such. That rented to, in the charge of or occupied by representative will have all your rights and you or the employer of any person who is duties under this insurance. an insured under this provision. e. Unnamed Subsidiary 5. Operator of Nonowned Watercraft Any subsidiary and subsidiary thereof, of With respect to watercraft you do not own that yours which Is a legally incorporated entity is less than 51 feet long and is not being used of which you own a financial interest of to carry persons for a charge, any person Is an more than 50% of the voting stock on the insured while operating such watercraft with effective date of this Coverage Part your permission. Any other person or The insurance afforded herein for any organization responsible for the conduct of subsidiary not shown in the Declarations such person is also an insured, but only with respect to liability arising out of the operation as a named insured does not apply to of injury or damage with respect to which an if no other insurance the watercraft, and only insured under this insurance is also an n any kind is available to that insured under another policy or would be person or organization for this liability. an insured under such policy but for its However, no person or organization is an termination or upon the exhaustion of its Insured with respect to: limits of insurance. a. "Bodily injury" to a co-"employee" of the 3. Newly Acquired Or Formed Organization person operating the watercraft;or Any organization you newly acquire or form, b. "Property damage" to property owned by, other than a partnership, joint venture or rented to, in the charge of or occupied by limited liability company, and over which you you or the employer of any person who is maintain financial interest of more than 50% of an insured under this provision. the voting stock, will qualify as a Named , 0. Additional Insureds When Required By Insured if there is no other similar insurance Written Contract, Written Agreement Or available to that organization. However: Permit a. Coverage under this provision is afforded The persons) or organizations) identified in only until the 180th day after you acquire Paragraphs a. through f. below are additional or form the organization or the end of the insureds when you have agreed, in a written policy period,whichever Is earlier, and Form SS 00 OS 04 OS ,�`" Page 11 of 24 The Hartford Pblicy f;52SBADU7303 BUSINESS LIABILITY COVERAGE FORM contract, written agreement or because of a (e) Any failure to make such permit issued by a state or political inspections, adjustments, tests or subdivision, that such person or organization servicing as the vendor has be added as an additional insured on your agreed to make or normally policy, provided the Injury or damage occurs undertakes to make in the usual subsequent to the execution of the contract or course of business, in connection agreement, or the issuance of the permit. with the distribution or sale of the A person or organization is an additional products; insured under this provision only for that (f) Demonstration, installation, period of time required by the contract, servicing or repair operations, agreement or permit. except such operations performed However, in connection with the sale of the such person or organization is an at the vendor's premises in additional insured under this provision if such produck person or organization is included as an additional insured by an endorsement issued (g) Products which, after distribution by us and made a part of this Coverage Part, or sale by you, have been labeled including all persons or organizations added or relabeled or used as a as additional insureds under the specific container, part or ingredient of any additional insured coverage grants in Section other thing or substance by or for F.-Optional Additional Insured Coverages. the vendor;or a. Vendors (h) "Bodily injury" or "property Any person(s) or organizations) (referred to damage" a negligence of the vendor for its out of the sole below as vendor), but only with respect to own acts or omissions or those of "bodily injury" or "property damage" arising its employees or anyone else out of "your products" which are distributed acting on its behalf. However,this or sold the regular course of the ender Part exclusion does not apply to; business and only if this Coverage Part provides coverage for "bodily injury" or (i) The exceptions contained in "property damage" included within the Subparagraphs (d)or(f); or "products-completed operations hazard". (ii) Such inspections, adjustments, (1) The insurance afforded to the vendor tests or servicing as the vendor is subject to the following additional has agreed to make or normally exclusions: undertakes to make in the usual This insurance does not apply to: course of business, inconnection with the distribution (a) "Bodily injury" or "property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of liability in a contract or agreement. whom you have acquired such products, This exclusion does not apply to or any ingredient, part or container, liability for damages that the entering into, accompanying or vendor would have in the absence containing such products, of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty (1) Any person or organization from unauthorized by you; whom you lease equipment; but only (c) Any physical or chemical change with respect to their liability for"bodily in the product made intentionally injury", "property damage" or "personal and advertising injury' by the vendor; caused, in whole or in part, by your (d) Repackaging, except when maintenance, operation or use of unpacked solely for the purpose of equipment leased to you by such inspection, demonstration, testing, person or organization. or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; Page 12 of 24 Form SS 00 08 04 05 Policy#525BADU7303Policy# 52SBADU7303 BUSINESS LIABILITY COVERAGE FORM (2) With respect to the insurance afforded e. Permits Issued By State Or Political to these additional insureds, this Subdivisions insurance does not apply to any (1) Any state or political subdivision, but "occurrence" which takes place after only with respect to operations you cease to lease that equipment. performed by you or on your behalf for c. Lessors Of Land Or Premises which the state or political subdivision (1) Any person or organization from has issued a permit. whom you lease land or premises, but (2) With respect to the insurance afforded only with respect to liability arising out to these additional insureds, this of the ownership, maintenance or use insurance does not apply to: of that part of the land or premises (a) "Bodily injury", "property damage" leased to you. or "personal and advertising (2) With respect to the insurance afforded injury" arising out of operations to these additional Insureds, this performed for the state or insurance does not apply to: municipality; or (a) Any "occurrence" which takes (b) "Bodily injury" or"property damage" place after you cease to lease that included within the "products- land or be a tenant in that completed operations hazard". premises; or f. Any Other Party (b) Structural alterations, new (1) Any other person or organization who construction or demolition is not an insured under Paragraphs a. operations performed by or on through e. above, but only with behalf of such person or respect to liability for "bodily injury", organization. "property damage" or "personal and d. Architects, Engineers Or Surveyors advertising injury" caused, in whole or (1) Any architect, engineer, or surveyor, but in part, by your acts or omissions or only with respect to liability for "bodily the acts or omissions of those acting injury", "properly damage" or "personal on your behalf: and advertising injury' caused, in whole (a) In the performance of your or in part, by your acts or omissions or ongoing operations; the acts or omissions of these acting on (b) In connection with your premises your behalf, owned by or rented to you; or (a) In connection with your premises; (c) In connection with "your work"and or included within the "products- (b) In the performance of your completed operations hazard", but ongoing operations performed by only if you or on your behalf. (i) The written contract or written (2) With respect to the insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This insurance does not apply to (ii) This Coverage Part provides "bodily injury", "property damage" or coverage for "bodily injury" or "personal and advertising injury" "property damage" included arising out of the rendering of or the within the "products- failure to render any professional completed operations hazard". services by or for you,including: (2) With respect to the insurance afforded (a) The preparing, approving, or to these additional insureds, this failure to prepare or approve, insurance does not apply to: maps, shop drawings, opinions, "Bodily injury", "property damage" or reports, surveys, field orders, "personal and advertising injury" change orders, designs or arising out of the rendering of, or the drawings and specifications;or failure to render,. any professional (b) Supervisory, inspection, architectural, engineering or surveying architectural or engineering services, including: activities. Form SS 00 08 04 05 Page 13 of 24 Policy 52SBAD U 7303 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or This General Aggregate limit does not failure to prepare or approve, apply to "property damage" to premises maps, shop drawings, opinions, while rented to you or temporarily reports, surveys, field orders, occupied by you with permission of the change orders, designs or owner, arising out of fire, lightning or drawings and specifications; or explosion. (b) Supervisory, inspection, 3. Each Occurrence Limit architectural or '' engineering Subject to 2.a, or 2.b above, whichever activities. applies, the most we will pay for the sum of all The limits of insurance that apply to additional damages because of all "bodily injury", Insureds are described In Section D. — Limits "property damage" and medical expenses Of Insurance. arising out of any one "occurrence" is the How this insurance applies when other Liability and Medical Expenses Limit shown in insurance is available to an additional insured the Declarations. is described in the Other Insurance Condition The most we will pay for all medical expenses in Section E.—Liability And Medical Expenses because of "bodily injury" sustained by any General Conditions. one person is the Medical Expenses Limit No person or organization is an insured with shown in the Declarations. respect to the conduct of any current or past 4. Personal And Advertising Injury Limit partnership, joint venture or limited liability Subject to 2.1b. above, the most we will pay for company that is not shown as a Named Insured in the sum of all damages because of all the Declarations. "personal and advertising injury" sustained by D. LIABILITY AND MEDICAL EXPENSES any one person or organization is the Personal LIMITS OF INSURANCE and Advertising Injury Limit shown in the Declarations. 1. The Most We Will Pay 5. Damage To Premises Rented To You Limit The Limits of Insurance shown in the The Damage To Premises Rented To You Declarations and the rules below fix the most we will pay regardless of the number of: Limit is the most we will pay under Business a. Insureds; Liability Coverage for damages because of "property damage" to any one premises, while b. Claims made or"suits"brought; or rented to you, or in the case of damage by fire, c. Persons or organizations making claims or lightning or explosion, while rented to you or bringing "suits". temporarily occupied by you with permission of 2. Aggregate Limits the owner. The most we will pay for: In the case of damage by fire, lightning or explosion, the Damage to Premises Rented To a. Damages because of "bodily injury" and You Limit applies to all damage proximately "property damage" included In the caused by the same event, whether such "products-completed operations hazard" Is damage results from fire, lightning or explosion the Products-Completed Operations or any combination of these. Aggregate Limit shown in the Declarations. 6. How Limits Apply To Additional Insureds b. Damages because of all other "bodily The most we will pay on behalf of a person or injury", "property damage" or "personal organization who is an additional insured and advertising injury", including medical under this Coverage Part is the lesser of; expenses, is the General Aggregate Limit a. The limits of insurance specified in a shown in the Declarations. written contract, written agreement or This General Aggregate Limit applies permit issued by a state or political separately to each of your "locations" subdivision; or owned by or rented to you. b. The Limits of Insurance shown in the "Location" means premises involving the Declarations, same or connecting lots, or premises Such amount shall be a part of and not in whose connection is interrupted only by a addition to the Limits of Insurance shown in street, roadway or right-of-way of a the Declarations and described in this Section. railroad. Page 114 of 24 Form SS 00 08 04 05 Policy#52sBAeu7303 Bl15INESS LIABILITY COVERAGE FORM If more than one limit of insurance under this (1) Immediately send us copies of any policy and any endorsements attached thereto demands, notices, summonses or applies to any claim or"suit", the most we will pay legal papers received in connection under this policy and the endorsements is the with the claim or"suit"; single highest limit of liability of all coverages (2) Authorize us to obtain records and applicable to such claim or "suit". However, this other information; paragraph does not apply to the Medical Expenses limit set forth in Paragraph 3.above. (3) Cooperate with us in the investigation, settlement of the claim or defense The Limits of Insurance of this Coverage Part apply against the "suit"; and separately to each consecutive annual period and to any remaining period of less than 12 months, starting (4) Assist us, upon our request, in the with the begin person or beginning of the policy period shown in the enforcementof any right against any Declarations, unless the policy period is extended erson or organization that may be after issuance for an additional period of less than 12 liable to the insured because of injury months. In that case, the additional period will be or damage which this Insurance deemed part of the last preceding period for purposes may also apply . of determining the Limits of Insurance. d. Obligations At The Insured's Own Cost E. LIABILITY AND MEDICAL EXPENSES No insured will, except at that insured's own GENERAL CONDITIONS cost, voluntarily make a payment, assume any obligation, or incur any expense, other 1. Bankruptcy than for first aid,without our consent. Bankruptcy or insolvency of the insured or of e. Additional Insured's Other Insurance the insured's estate will not relieve us of our If we cover a claim or "suit" under this obligations under this Coverage Part. Coverage Part that may also be covered 2. Duties In The Event Of Occurrence, by other insurance available to an Offense, Claim Or Suit additional insured, such additional insured a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the You or any additiorai insured must see to other insurer for defense and indemnity, it- that we are notified as soon as However, this provision does not apply to practicable of an "occurrence" or an the extent that you have agreed in a offense which may result in a claim. To written contract, written agreement or the extent possible, notice should include: permit that this insurance is primary and non-contributory with the additional (1) How, when and where the "occurrence" insured's own insurance. or offense took place; f. Knowledge Of An Occurrence, Offense, (2) The names and addresses of any Claim Or Suit injured persons and witnesses; and Paragraphs a. and b. apply to you or to (3) The nature and location of any Injury any additional insured only when such or damage arising out of the "occurrence", offense, claim or "suit" is "occurrence"or offense. known to- b. Notice Of Claim (1) You or any additional insured that is If a claim is made or "suit" is brought an individual; against any insured, you or any additional (2) Any partner, if you or an additional insured must: insured is a partnership; (1) Immediately record the specifics of the (3) Any manager, if you or an additional claim or "suit" and the date received; insured is a limited liability company; and (2) Notify us as soon as practicable. (4) Any "executive officer" insurance manager, ifyou or an additional You or any additional insured must see to insured is a corporation, it that we receive a written notice of the (5) Any trustee, if you or an additional claim or"suit"as soon as practicable. insured is a trust or c. Assistance And Cooperation Of The 6 An elected or a Insured O Y appointed official, if you or an additional insured is a political You and any other involved insured must: subdivision or public entity. Form SS 00 08 04 05 Page 15 of 24 Poky'4 525EIADU7303 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to (3) We have issued this policy in reliance you and any additional insured, upon your representations, 3. Financial Responsibility Laws In. Unintentional Failure To Disclose a. When this policy is certified as proof of Hazards financial responsibility for the future under If unintentionally you should fall to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the inception date of this provided by the policy for "bodily injury" Coverage Part, we shall rot deny any liability and "property damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of 7, Other Insurance insurance required by that law_ If other valid and collectible insurance is b. With respect to "mobile equipment" to available for a loss we cover under this which this insurance applies, we will provide any liability, uninsured motorists, Coverage Part, our obligations are limited as follows: underinsured motorists, no-fault or other coverage required by any motor vehicle 'I,c.• a. Primary Insurance law, We will provide the required limits for This insurance is primary except when b. those coverages, below applies. If other insurance is also 4. Legal Action Against Us primary, we will share with all that other No person or organization has a right under insurance by the method described in c. this Coverage Form: I a. To join us as a party or otherwise bring us b. Excess Insurance into a "suit" asking for damages from an This insurance is excess over any of the insured; or other insurance, whether primary, excess, Is. To sue us on this Coverage Form unless contingent or on any other basis: all of its terms have been fully complied (1) Your Work with. That is Fire, Extended Coverage, A person or organization may sue us to recover Builder's Risk, installation Risk or on an agreed settlement or on a final judgment similar coverage for"your work"; against an insured; but we will not be liable for (2) Premises Rented To You damages that are not payable under the terms of this insurance or that are in excess of the That is fire, lightning or explosion applicable limit of insurance. An agreed insurance for premises rented to you settlement means a settlement and release of or temporarily occupied by you with liability signed by us, the insured and the permission of the owner; claimant or the claimant's legal representative. (3) Tenant Liability 5. Separation Of Insureds That is insurance purchased by you to Except with respect to the Limits of insurance, cover your liability as a tenant for and any rights or duties specifically assigned "property damage" to premises rented in this policy to the first Named Insured, this to you or temporarily occupied by you insurance applies: with permission of the owner; a. As if each Named Insured were the only (4) Aircraft, Auto Or Watercraft Named Insured; and If the loss arises out of the maintenance I Separately to each insured against whom or use of aircraft, "autos"or watercraft to a claim is made or"suit"is brought the extent not subject to Exclusion g. of Section A.—Coverages. 6. Representations (5) Property Damage To Borrowed a. When You Accept This Policy Equipment Or Use Of Elevators By accepting this policy, you agree: If the loss arises out of "property (1) The statements in the Declarations damage" to borrowed equipment or are accurate and complete; the use of elevators to the extent not (2) Those statements are based upon subject to Exclusion k, of Section A.— representations you made to us; and Coverages. Page 16 of 24 Form SS 00 08 04 05 Policy#525aADU7303 BUSINESS LIABILITY COVERAGE FORM (6) When You Are Added As An When this insurance is excess over other Additional Insured To Other insurance, we will pay only our share of Insurance the amount of the loss, if any, that That is other insurance available to exceeds the sum of: you covering liability for damages (1) The total amount that all such other arising out of the premises or insurance would pay for the loss in the operations, or products and completed absence of this insurance;and operations, for which you have been (2) The total of all deductible and self- added as an additional insured by that insured amounts under all that other insurance; or Insurance. (7) When You Add Others As An We will share the remaining loss, if any,with Additional Insured To This any other insurance that is not described in Insurance this Excess Insurance provision and was not That is other insurance available to an bought specifically to apply in excess of the additional insured. Limits of Insurance shown in the However, the following provisions Declarations of this Coverage Part. apply to other insurance available to c. Method Of Sharing any person or organization who Is an If all the other insurance permits additional insured under this Coverage contribution by equal shares, we will follow Part: this method also. Under this approach, (a) Primary Insurance When each insurer contributes equal amounts Required By Contract until it has paid its applicable limit of This insurance is primary if you insurance or none of the loss remains, have agreed in a written contract, whichever comes first. written agreement or permit that If any of the other insurance does not permit this insurance be primary. If other contribution by equal shares, we will insurance is also primary, we will contribute by limits. Under this method, each share with all that other insurance insurer's share is based on the ratio of its by the method described In c. applicable limit of insurance to the total below. applicable limits of insurance of all insurers. ,#r (b) Primary And Non-Contributory 8. Transfer Of Rights Of Recovery Against To Other Insurance When Others To Us Required By Contract a. Transfer Of Rights Of Recovery If you have agreed in a written If the insured has rights to recover all or contract, written agreement or that this insurance is permit Part of any payment, including Supplementary Payments, we have made primary and non-contributory with under this Coverage Part, those rights are the additional insured's own transferred to us. The insured must do insurance, this insurance is nothing after loss to impair them. At our primary and we will not seek request, the insured will bring "suit" or contribution from that other transfer those rights to us and help us insurance. enforce them. This condition does not Paragraphs (a) and (b)do not apply to apply to Medical Expenses Coverage. other insurance to which the additional "b, Waiver Of Rights Of Recovery (Waiver insured has been added as an Y Of Of additional insured. When this insurance Is excess, we will If the insured has waived any rights of recovery against any person or have no duty under this Coverage Part to organization for all or part of any payment, defend the insured against any"suit"if any including Supplementary Payments, we other insurer has a duty to defend the have made under this Coverage Part, we insured against that "suit". It no other also waive that right, provided the insured insurer defends, we will undertake to do waived their rights of recovery against so, but we will be entitled to the insured's such person or organization in a contract, rights against all those other insurers. agreement or permit that was executed prior to the injury or damage. Form SS 00 08 04 05 Page 17 of 24 �odlcy#620 ECJ 53276 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AND RIGHTS OF RECOVERY AGAINST OTHERS This endorsement modifies insurance provided under the following; BUSINESS AUTO COVERAGE FORM A Any person or organization whom you are required by contract to name as additional insured Is an "insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision of Section II - LIABILITY COVERAGE B For any person or organization for whom you are required by contract to provide a waiver of subrogation, the Loss Condition-TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable. Form 199 13 01 87 Printed in U S A