Loading...
HomeMy WebLinkAboutPW17-187 - Amendment - #1 - Shearer Design LLC - Garrison Creek Bridge - 12/19/2017 � .. T �ro �� � Document WASHI ETON 4 CONTRACT COVER SHEET 0 This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: Shearer Desiqn LLC Vendor Number: JD Edwards Number Contract Number: This is assigned by City Clerk's Office Project Name: Garrison Creek Bridge Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: Contract Effective Date: 12/19/17 Termination Date: 12/31/18 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Steve Lincoln Department: Engineering Contract Amount: $0.00 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax id, etc.): Extend the time of completion to December 31, 2018 due to work is not vet complete. As of: 08/27/14 IVT w,. , ,.o AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: Shearer Design LLC CONTRACT NAME & PROJECT NUMBER: Garrison creek 8ridne ORIGINAL AGREEMENT DATE: April 24 2017 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 necessary to extend the time of completion to December 31, 2018 due to work is not yet complete. 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, $62,252.00 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $62,252.00 including all previous amendments _...._. ................... Current Amendment Sum $0 .......... _........ Applicable WSST Tax on this $0 Amendment ... _ .__._ _..... Revised Contract Sum $62,252.00 AMENDMENT - 1 OF 2 __..........._...m...._ - ..._ _....m...------------- Original Time for Completion 12/31/17 (insert date) _ _..mm..._.._- ._._. _......... Revised Time for Completion under n/a prior Amendments (insert date) this 365 calendar d.........._. a _—ays------- -._... _.._... Add'I Days Required (f) for Amendment ......... ....... _.__ _._ .... _....._ — Revised Time for Completion 12/31/18 (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: By:_ Byr« . ate si natu eu ��. (signature) (' /� 9 Print Name: troaa� PL: . - Print Name: Timothy J. LaPorte,-2 E Its Its_, Public Works Director ( rae) Tarr DATE: DATE: fW-. l 2Cl APPROVED AS TO FORM: (applicable if Mayor's signature required) Law Department Kent D i p Shearer-Garmmn Crk Bridge 2 Amd 1/Lincoln AMENDMENT - 2 OF 2 CERTIFICATE OF LIABILITY INSURANCE CA E,MM°Dm Y, .. - v11/2a17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 1RTIFICATE 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 INSURERS), 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 Endorsementls). PRODUCER 0" Sa It Wallace Hall & Company PHONE "' r F" 19660 10th Ave NE W C.MP.E$1. 36.0 a98 6g28 �L yfl .360 598 �7d3 POUlsbo WA 98370 E'M DDR _A es$ swallace@hallandcornpany corn F .—-- INSDRER(BI AFFORDING COVERAGE NAIC a _ INSURER A.Hartford Casualty Insurance Company '29424 INSURED 12509 INSURER B Travelers Casualty and Surety CO Of 31194 Shearer Design LLC INSURER 3613 Phinney Ave N#8 Seattle WA 98103 INSURER _ INSURER E _ INSURER F. COVERAGES CERTIFICATE NUMBER: 916152832 REVI 0 N 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 WTH 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. 1N5R... .. .. . ...... .. .. .... ........._ "TifDE(LfSD®R ____ ....... POLICY EFF, POLICY E%P TYPE OF INSURANCE (w¢n wvrel POLICY NIIMBFR MMrnnIWYY, MINP py+yyy� LIMITS A "X COMMERCIAL GENERAL LIABILITY Y V 52SBAIJ6571 2/9/2017 2/9/2013 EACH OCCURRENCE $2 000 000 GLAIMa MADE X.� OCCUR vp MY E T FIYEN'frO J 7,$300 000 MED EXP ArY ono Oer and $10 C0U PERSONAL&AOV IfJJIJRY $2 000 000 ®..._ GENLA GREGAPE LIMIT APPLIES PER LCArE 540000100 POLICY Xr C7 IOC PRODUCTS COMP/OPAGG $4000000 RFrtiO 0 rHER 3 _._. ............T jJDTDMCtB1LE LIABILITY V V 525BAIJ6571 2j9/2017 2/972018 $ o-toEfSii+T(`CE'CfhTiT tEb atOnada+E}_ 2 G00 000 ANY AUTO E BODILY INJURY fP pr9o1] $ ALL�S m'cD AUTOSULEO BODILY INJURY(Per ecmtlen911IS X - HIRED AL'f0 .X.. NON-OWNED P4YxSpC:RTY CyhFi6FlCih S AUTOS (pqa eccadmall}.._ I _ I § A X ' UMBRELLA LIAR X SCUP 525BAIJ8571 2i9/2017 2/9/2018 EACH OCCURRENCE $3,000,000 ...... ................. .. ...... EXCESS LIAR CLAIMS-MACE AGGREGATEl$3000,000 DED RETENTION A WORKERS COMPENSATION J IF AND EMPLOYERTICABILITv 525BA J6571 2/9/2017 7J9/2018 rnnlrF X ,t WA Stop GdP IA NY PROPRIETOR/PARTNEWEXECUTIVE Y N( F� t OFFICCUMEMBER EXCWOED9 EL EACIIACCIDENr $1000000 (Mantlatory In NH( ' r C DI EASE.._EA EMPLOYEE,"$1000,000 N/A Ir yes.dmurllm Under -._ —_...... . DE SCRIP RON OF OPER.. ON4 tleinw I EL DISEASE POLICY LIMIT $1000,000 0 Profaseional Liab.Claim.Made 106223080 1111/20'17 1/11/2018 $2,000,000 Per Claim 12,110,000 A99regate DESCRIPTION OF OF E RAT ON I LOCATIONS I VEHICLES (ACORD 101,Aadltlonal Remarka Scbeauk,may Ite attac tied If more apace la mq ui r.O The certificate holder is an additional insured per the attached. 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 W GOWe ACCORDANCE WITH THE POLICY PROVISIONS. Kent Kent WA 98032 -- � ---W �AA'U'THO'RIf"ZED�yREPR NTATNE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014101) The ACORD name and logo are registered marks of ACORD Shearer Design LLC - The Hartford Policy # 52SBAIJ6571 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 "property damage" purpose by you, any of your that occurred;or "employees", "volunteer workers", (2) "Personal and advertising injury" any partner or member(if you are arising out of an offense committed a partnership or joint venture), or any member (if you are a limited before you acquired or farmed 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 Iiablity 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) Wth respect to liability adsing out of the to that person or organization for this liability. maintenance or use of that property; and However,no person or organization is an insured (2) Until your legal representative has with respect to: been appointed. a. "Bodily injury" to a co-"employee" of the d. Legal Representative If You Die person driving the equipment;or 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 rapresentaUve 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 awn 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 permisslon, 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 as a named insured does not apply to respect to liability arising out of the operation of the watercraft, and only if no other Injury or damage with respect to wh1di an insurance of any kind is available to that Insured under this insurance is also an person or organization for this liability. insured under another policy or would be 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 Farmed Organization person operaling the watercraft;or Any organization you newly acquire or form, b, "Property damage" to property awned 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 es a Named 6. 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 crganization(s) identified in only until the 180th day after you acquire Paragraphs a. through f. below are additorial or form the organlzation or the end of the insureds when you have agreed, in a written policy period, whichever is earlier;and Form SS 00 08 04 05 Page 11 of 24 The Hartford vt BUSINESS LIABILITY COVERAGE FORM contact, written agreement or because of a (ey 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 oh your agreed to make or normally policy, provided the Injury or damage occurs undertakes to make In the usual subsequent to the execut'on 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, such person or organization is an additional connection with the sale of the at the vendor's premises In onal Insured under this provision if such product; 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 oringredlent of any additional Insured coverage grants in Section other thing or substance by or for F.—Optional Additional Insured Coverages. the vendor;or a. Vendors (h) "Bodily, injury", or "property damage" ansing out of the sole Ary person(s)or organlzation(s) (referred to negligence of the vendor for its 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 in the regular course of the vendors exclusion does not apply However, 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 followlrg additional has agreed to make or normally exclusions: undertakes to make in the usual This insurance does not apply to: course of business, in connection with the distribution (a) "Bodily Injury" or "property or sale of the products. damage" for which the vendor is (2) This insurance does not apply to any obligated to pay damages by insured person or organization from reason of the assumption of liability in a contract or agreement. whom you have acquired such products, or any ingredient, part or container. This exclusion does not apply to entering into, accompanying or liability for damages that he containing such products. vendor would have In the absence of the contract or agreement; b. Lessors Of Equipment (b) Any express warranty ('I) Any person or organization from unauthorized by you; whom you lease equipment; but only (c) Any physical or chemical change with respect to their liability for"bodily nju grope In the product made intentionally o y 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, demonstratlon, testing, person or organization. or the substitution of parts under Instructions from the manufacturer, and then repackaged in the original contalner, Page 12 of 24 Form SS 00 08 04 05 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 your 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 lo; 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 ¢easy to lease that included within the "products- land or be a tenant In that completed operatons hazard". premises;or f. Any Other Party (b) Structural alterations, new (1) Any other person or organlzatk'm 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 in part, by your acts or omissions or (1) Any architect, engineer,or surveyor, but the acts or omissions of those acting only with respect to flabllity for '"bodily on your behalf: injury", "property damage" or "peesanal a In he erfo nonce of your and advertising injury"causac% In whole ( ) I ongoing operations; forma or In part, by your acts or omisskrnss or 9 the acts or omissions of those acting on (b) In connection with your Premises your behalf: owned by or rented to you; or (a) In connection with your premises; (c) In connection with"your work"and or included within the "products- (b) In the perforruance of your completed operations hazard", but ongoing operations performed by only If you or on your behalf. (1) The written contract or written (2) With respect to the Insurance afforded agreement requires you to to these additional insureds, the provide such coverage to following additional exclusion applies: such additional insured; and This Insurance does not apply to (H) 'Phis Coverage Part provides "bodily injury" "property damage" or coverage for"bodily Injury" or "personal and advelsl'ng Injury" "properly damage" included arising out of the rendering off 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 addltional Insureds, this failure to prepare or approve. Insurance does not apply to: maps, shop drawings, opinions, "Bodily Injury" "property damage" or reports, surveys, fled orclers, "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, inspectlor, architectural, engineering or surveying architectural or engineering services, Including: activities. Form SS 00 08 04 05 Page 13 of 24 BUSINESS LIABILITY COVERAGE FORM (a) The preparing, approving, or This General Aggregate limit does not failure to prepare or approve, apply to "property damage" to premises maps, shop drawings, opinions, while rented to you or temporarily reports, surveys, field orders, occupied by you with permission of the change orders, designs or owner, arising out of fire, lightning or drawings and specifications;or explosion. (b) Supervisory, inspection, 3. Each Occurrence Limit architectural or engineering Subject to 2.a. or 2.1h, 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. arfsing cut 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 2.1h. above, the mostwe 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. The Limits 1. The Most Pay 5. Damage To Premises Rented To You Limit ts of of Insurance shown In the fix Declarations and the rules below number the most The Damage To Premises Rented To You Limit Is the most we will pay under Business we will pay regardless of the number of: Liability Coverage for damages because of a. Insureds; "property damage" to any one premises,while b. Claims,made or"suits"brought; or rented to you,or in the case of damage by fire, c. Persons 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 vel pay for: In the case of damage by fire, lightning or a. Damages because of "bodily injury" and explosion,the Damage to Premises Rented To 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 Declaration& written contract, written agreement or This General Aggregate Limit applies permit issued by a state or political separately to each of subdivision;or p y your "locations" 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-ef-way of a the Declarations and described in this Section. railroad. Page 14 of 24 Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM If more than one limit of insurance under this (1) Immediately send us copies of any policy and any endorsements attached thereto demands; notices, summonses or applies to any claim or"stilt", 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, thls other information; paragraph does not apply to the Medical Expenses (3) Cooperate with us in the investigation, unit set forth in Paragraph 3.above. settlement of the claim or defense The Limits of Insurance of this Coverage Part apply against the "suit';and separately to each consecutive annual period and to (4) Assist us, upon our request, In the any remaining period of less than 12 months,starting enforcement of any right against any with the beginning of the policy period shown in the person or organization that may be Declarations, unless the policy period is extended liable to the insured because of injury after issuance for an additional period of less than 12 or damage to which this Insurance months. In that case, the additlonal period will.he may also apply. deemed part of the last preceding period for purposes d. Obligations At The Insured's Own Cost of determining the Limits of Insurance. E. LIABILITY AND MEDICAL EXPENSES co insured will, except at that insured's awn cost, voluntarily make a payment, assume GENERAL CONDITIONS any obligation, or incur any expense, other 1. Bankruptcy than for first aid',without our consent, Bankruptcy or insolvency of the insured or of e, Additional Insured's Other Insurance the insured's estate will not relieve us of our If we cover a claim or "suit" under this obligations under this Coverage Part. Coverage Part that may also be covered 2. Duties In The Event Of Occurrence, by other insurance available to an Offense,Claim Or Suit additional insured, such additional insured a. Notice Of Occurrence Or Offense must submit such claim or "suit" to the other insurer for defense and indemnity. You or any additional insured must see to However, this provision does not apply to - it- that we are notified as soon as the extent that you have agreed in a practicable of an "'occurrence" or an written contract, written agreement or offense which may result in a claim. To permit that this insurance Is primary and the extent possible, notice should include: non-contributory with the additional (1) How, when and where the "occurrence" Insured's own insurance. or offense took place; f. Knowledge Of An Occurrence, Offense, (2) The names and addresses of any Claim Or Suit injured persons and witnesses;and Paragraphs a, and b. apply to you or to (3) The nature and location of any injury any additional Insured only when such or damage arising out of the "occurrence", offense, claim or "suit" Is "occurrence"or offense. known to: b. Notice Of Claim (1) You or any additional insured that is If a claim is made or "suit" Is brought an Individual; against any Insured, you or any additional (2) Any partner, If you or an additional insured must: insured is a partnership; (1) Immediately record the specifics of the (3) Any manager, if you or an additional claim or "suit" and the date received; insured is a limited liability company; and (4) Any "executive officer" or insurance (2) Notify us as soon as practicable, manager, if you or an additional You or any additional insured must see to insured Is a corporation; it that we receive a written notice of the (5) Any trustee, if you or an additional claim or"suit" as soon as practicable. Insured is a trust;or c. Assistance And Cooperation Of The (6) Any elected or appointed official, if you Insured or an additional insured Is a political You and any other Involved insured must: subdivision or public entity. Form SS 00 09 04 05 Page 15 of 24 BUSINESS LIABILITY COVERAGE FORM This Paragraph f. applies separately to (3) We have issued this policy in reliance you and any additional insured. upon your representations. 3. Financial Responsibility Laws _ b. Unintentional Failure To Disclose a. When this policy is certifled as proof of Hazards financial responsibility for the future under If unintentionally you should fail to disclose the provisions of any motor vehicle all hazards relating to the conduct of your financial responsibility law, the insurance business at the inception data of this provided by the policy for "bodily injury" Coverage Part, we shall not deny any liability and "property damage" liability will coverage under this Coverage Part comply with the provisions of the law to because of such failure. the extent of the coverage and limits of 7. Otherinsurance insurance required by that law. b. With respect to "mobile equipment" to a other valid and collectible insurance is available fora loss we cover under this which this insurance applies, we will Coverage Part, our obligations are limited as provide any liability, uninsured motorists, follows: underinsured motorists, no-fault or other coverage required by any motor vehicle a. Primary Insurance law. We will provide the required limits for This insurance is primary except when b. those coverages. below applies. If other insurance is also 4. Legal Action Against Us primary, we will share with all that other No person or organization has a right under insurance by the method described in c. below. this Coverage Form: b. Excess Insurance a. To join us as a party or otherwise bring us into a "suit" asking for damages from an This insurance is excess over any of the insured;or other insurance, whether primary, excess, le. 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 Builders Risk, Installation Risk or on an agreed settlement or on a final judgment similar coverage for'your work"; against an insured; but we will not be liable for (2) Premises Rented To You damages that are not payable under the terms of That is fire, lightning or explosion this insurance or that are in excess of the insurance for premises rented to you applicable limit of insurance. An agreed or temporarily occupied by you with settlement means a settlement and release of permission of the owner; liability signed by us, the insured and the claimant or the claimant's legal representative. (3) Tenant Liability S. Separation Of Insureds That is Insurance purchased by you to cover your liability as a tenant for Except with respect to the Limits of Insurance, and any rights or duties specifically assigned "grope ty 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 Y the loss arises out of the maintenance b or use of aircraft, "autos"or watercraft to . Separately to each insured against whom a claim is made or"suit"is brought. the extent not subject to Exclusion g. of Section A.—Coverages. 6. Representations (5) Property Damage 70 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 06 04 05 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 wdl 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 a applicable limit of insurance to the total below, applicable limits of insurance of all insurers. (b) Primary And Non-Contributory B. 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 part of any payment, including permit that this insurance is Supplementary Payments, we have made primary and non-comributoiy 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. Walver Of Rights Of Recovery (Walvar Insured has been added as an Of Subrogation) additional insured. If the insured has waived any rights of When this Insurance Is excess, we will recovery against any person or have no duty under this Coverage Part to organizatlon for all or part of any payment, defend the insured against any"suit"If any including Supplementary Payments, we other insurer has a duty to defend the have made under this Coverage Part, we insured against that "suit". If no other also waive that right, provided the Insured insurer defends, we will undertake to do waived their rights of recovery against so, but we will be entitled to the insured's such person or organization In a contract, rights against ail those other Insurers, agreement or permit that was executed prior to the Injury or damage. Form SS 00 03 04 05 Page 17 of 24 l ` COMMON POLICY CONDITIONS M coverages ofthis policy are subject to the following conditions. A. Cancellation (5) Failure to; 1. The first Named Insured shown in the (a) Furnish necessary heat, water, Declarations may cancel this policy by mailing sewer service or electricity for 30 or delivering to us advance written notice of consecutive days or more, except m cancellation. during a period of seasonal 2. We may cancel this policy by malting or unoceupancy; or delivering to the first Named Insured written (h) Pay property taxes that are owing notice of cancellation at least: and have been outstanding for a, 5 days before the effective date of more than one year following the o cancellation If any one of the following date due, except - that this m' conditions exists at any building that is provision wilt not apply where you a Covered Property In this policy: are n a bona fide dispute with the taxing authority regarding payment (1) The Building has been vacant or of such taxes. Ln o unoccupied sg or more consecutive days.This does not applyto: 6 10 days Before the effective date of qa Seasonal unoccu anc ; or cancellation If we cancel for nonpayment * O P Y of premium. (b) Buildings in the course of c. 30 days before the effective date of construction, renovation or cancellation if we cancel for any other additlon. reason. Buildings wRh 050/S or more of the rental 3, We will mail or deliver our notice to the first units or floor area vacant or unoccupied Named Insu ed's Iasi mailing address known are considered unoccupied under this to us. provision. 4. Notice of cancellation will state the effective 12) After damage by a Covered Cause of date of cancellation. The policy period will end Loss, permanent repairs to the on that date. building: S. If this policy Is canceled, we will send the first (a) Hove not started; and Named Insured any premium refurtd due. (b) Have not been contracted for, Such refund will be pro rata, The canceilation within 30 days of Initial payment of will be effective even if we have not made or loss. offered a refund. (3) The building has: 0. If notice is mailed, proof of mailing will be (a) An euistandfng order to vacate; sufficient proof of notice, 7. ff the first Named Insured cancels this policy, (b) An outstandfng demolition order; we will retain ro less than $100 of the or premium. (c) Been declared unsafe by B. Changes gevemmental authority. This policy contains all the agreements between you WM (4) Fixed and salvageable Items have and us concerning the insurance afforded. The first been or are being removed from the Named Insured shown In the Declarations is budding and are not being replaced, authorized to make changes in the terms of this policy This does not apply to such removal with our consent This policy's terms can be that fa necessary or Incidental to any amended or waived only by endorsement issued renovation or remodeling, by us and made a part of this policy. Form SS 00 05 12 06 Page 1 of 3 © 2006,The Hartford COMMON POLICY CONDITIONS C. Concealment, Misrepresentation Or Fraud I. Premiums This policy is veld in any case of fraud by you as it 1. The first Named Insured shown in the relates to this policy at any time. It is also void if You Declarations: or any other insured,at any tlmer,Intentional conceal a. Is responsible for the payment of all or misrepresent a material fact concerning: premiums; and 1. This policy; b, Will be the payee for any return premiums 2, The Covered Property; we pay. 3. Your interest In the Covered Property; or 2. Tile premium shown in the Declarations was 4. A claim under this policy. computes! based on rates in effect at the time the policy was Issued, if applicable„ on each D. Examination Of Your Books And Records renewal, continuation or anniversary of the We may examine and audit your books and effective date of this poiBcy, we will compute: records as they relate to the policy at any time the premium in accordance with our rates and during the policy period and up to three years rules then in effect, afterward. 3, With our consent, you may continue this policy E. Inspections And Surveys in force by paying a continuation premium for each successive one-year period, The We have the right but are not obl'gated to: premium must be: 1. Make inspections and surveys at any time; a. paid to us pdorto the anniversary date; and 2. Give you reports on the condition we find;and b. Determined in accordance with Paragraph 3. Recommend changes. 2.above. Any inspections, surveys, reports or Our forms ,,an in effect will apply. If you do recortmendat'ioos relate only to insurability and the not pay the continuation premrtam, this policy premiums to be cligIgod, We do not make safety will expire on the first anniversary date that we inspections. We do not undertake to perform.tho duty have not received the premium. of arty person or organlzatml to provide for the health 4, Changes In exposures or changes In Your or safety of any person. And we do not represent or businessoperation, aociuisition or use of warrant that conditions: locations that are not shown In ilia Declarations J. Are safe or healthful; or may ocour dwInri the policy period. if So,we may 2. Comply with laws, regulations, codas or reguir^o on additional premium. That premium will be determined in accordance all our rates and standards. Mies then In effect. Tlmis condition appfles not only to us, but also to any rating, advisory, rate service or similar J. Transfer of Rights Of Recovery Against Others organization which makes imurance inspections, To Us surveys, reports or recommendations. Applicable to Properly Coverage: F. Insurance Under Two Or More Coverages h, ony person Or Organization to or for whom we If two or more of this Policy's coverages apply to make payment unrier this policy has rights to the same Toss or damage, we will not pay more reouver° damages irom another, those rPghis are than the actual amount of the loss or damage. transferred to us to the extent of our payment. G. liberalization T'het poison or organicallon must do everything necessary to secure our rights and must do If we adopt any revision that Would broaden the nol,hIng offer Coss to impair them. But you may roverage under this policy without additional waiwo your rights against another party in walking', premium within 45 days prior to or during the policy I. prior to a loss io your Covered Property. period, the broadened coverage will EminedIately apply to this policy. 2. After a loss to your Covered Prop" onlyif, at (;me of loss,that party is one Of tkie fralfowing: H. Other Insurance -property Coverage a, someone insured by this insurance; If ihere Is other Insurance covering the lama loss or damage, we will pay only for the amount of b. A business firm: cowered loss or damage in excess of the amorint (1) Owned or controlled by you; or due Elam that other insurance, whether You can (2) That owns or controls you; or collect on it or not. But we will not pay more than the applicable Limit or Insurance. Form S3 00 05 12 06 page 2 of 3 COMMON POLICY CONDITIONS c. Yourtenant. L. Premium Audit You may also accept the usual bills of lading or a. We will compute all premiums for this policy In shipping receipts limiting the liability of carriers. accordance with our rules and rates. This will not restrict your Insurance. b. The premium amount shown in the K. Transfer Of Your Rights And Duties Under This Declarations is a deposit premium only. At the Policy close of each audit period we will compute the earned premium for that period. Any Your rights and duties under this policy may not be additional premium found to be due as a result transferred without our written consent except in of the audit are due and payable on notice to the case of death of an frtdiAdual Named Insured, the first Named insured. If the deposit If you die, your rights and duties wlli he transferred premium paid for the policy term is greater m to your legal representattve but only while acting than the earned premium, we will return the a withln the scope of duties as your legal excess to the first Named Insured. representative. Until your legal representative is c. The first Named Insured must maintain all appointed, anyone haing proper temporary records related to the coverage provided by a custody of your property will have your rights and his policy and necessary to finalize the 00 duties but only with respect to that property. premium and€, and send us copies of the same upon our request. 0 0 w N N 0 a H Our President and Secretary have signed this policy. Where required by law,the Declarations page has also been ,5 countersigned by our duly authorized representative. y�- CorraldC.Nun4,5ea'Nary 'Juan Android,President e t� 5 �d Form SS 00 GS 12 06 Page 3 of 3 SUPER STRETCH SUMMARY SUMMARY OF COVERAGE LIMITS This Is a summary of the Coverages and the Umits of Insurance provided by the Super Stretch Coverage form SS 04 74 whldh is Included in this policy. No coverage is provided by this summary. Refer to coverage form M SS 04 74 to determine the scope of your insurance protection. The Limits of Insurance for the following AddlVanal Coverages are In addition to any other limit of insurance provided underthis policy: Blankat Coverage Limit of Insurance:$150,000 u Blanket Covera es Accounts Receivable- Cn/Off Premises N Computers and Media o Debrls Removal o Personal Property of Others o Temperature Change Valuable Papers and Records-On/Off Premises — Coverage Limit o Brands and Labels Up to Business Personal Property Limit Claim Expenses $ 10,000 '— Computer Fraud $5,000 Employee Dishonesty (including ERISA) $25,000 Fine Arts $25,000 Forgery $25,000 Laptop Computers-Worldwide Coverage $10,OOo Off Premises Utility Services—Direct Damage $25,000 Outdoor Signs Full Value Pairs or Sets Up to Business Personal Property Limit Property at Other Premises $10,000 Salespersons' Samples $ 5,000 Sewer and Drain Back Up Included Up to Covered Property Limits Sump Overflow or Sump Pump Failure $25,000 Tenant SullldIng and Business Personal Property $20,000 Cowen-age-Required by Lease Transit Property in the Care of Carriers for Hire $10,000 Unauthorized Business Card Use $ 5,000 Form SS 84,15 09 07 Page 1 of 2 Q 2007. The Hartford 4 , The Limits of Insurance for the following Coverage Extensions are a replacement of the Limit of Insurance provided under the Standard Property Coverage Form or the Special Property Coverage Form,whichever applies to the policy: Coverage Limit Newly Acquired or Constructed Property—180 Days Building $1,000,000 Business Personal Property $500,000 Business Income and Extra Expense $500,000 Outdoor Property $25,000 aggregate/$1,000 per Item " Personal Effects $25,000 Property Off-Premises $25,000 The fallowing changes apply only If Business Income and Extra Expense are covered under this policy. The Limits of Insurance for the following Business Income and Extra Expense Coverages are in addition to any other Limit of Insurance provided under this policy: Cove rag a Limit Business Income Extension for Off-Premises Utility Services $25,000 Business Income Extension for Wet) Sites $50,000f7 days Business Income from Dependent Properties $50,600 The following Limit of Insurance for the following Business income Coverage Is a replacement of the I...Imlt of insurance provided under the Standard Property Coverage Form or the Spedal Property Coverage Form, whichever applies to the policy: Coverage Limit Extended Business Income 90 Days The following changes apply to Lass Payment Conditions: Coverage Limit Valuatfon Changes Commodity Stock Included "Finished Stock" Included Mercantile Stock - Sold Included i ,I Page 2 of 2 Farm 83 84 15 09 07 ,