HomeMy WebLinkAboutPW18-350 - Amendment - #2 - Tierra Right of Way Services, Ltd. - Milwaukee II and Signature Pointe Levees - 10/16/2018 V ,T Records Management Document:
CONTRACT COVER SHEET
FhYs is to ,hie Nconlvlleteri by the piriL�Ir t;rS
to the Uty Ck�,rk's, (Ifficv, AH pc,crtkpass aire to bc4 conlfs�ettad,
I
III You havt� C. LWSVOOS, iAc�asc corqtacI thb i� 0'ry Cktirk's Officc_ at 2 5 3-8, 56-1�5 wv25�,
E] Blue/Motion Sheet Attached
Z Pink Sheet Attached
Vendor Name: Tierra Right of Way Services, Ltd.
Vendor Number (]DE):
Contract Number (City Clerk): PWr6--'95D- 067�r
Category: Contract Agreement
Sub-Category (if applicable): Arriendment
Project Name: Signature Pointe Levee
Contract Execution Date: Date of the Mayor's signature Termination Date: 12/31/22
Contract Manager: Dee Martindale Department: PW: Engineering
Contract Amount: $25,913.00
Approval Authority: E] Director Z Mayor El City Council
Other Details: Provide
de right of way acquisition, relocation services and relocation
assistance services for the project.
a
KENT
AMENDMENT NO. 2
NAME OF CONSULTANT OR VENDOR: Tierra Right of Way Services, Ltd,
CONTRACT NAME & PROJECT NUMBER: Milwaukee II Levee and Signature Pointe Levee
ORIGINAL AGREEMENT DATE: September 2, 2018
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:
Provide Right of Way Acquisiton, Relocation Planning Services
and Relocation Assistance Services for the Signature Pointe
Levee Project, Wagers property.
2. The contract amount and time for performance provisions of Section II "Time of
Completion," and Section III, "Compensation," are modified as follows:
_.....,., ---- ---... .... ...._.-- ._...m .. ._..
Original Contract Sum $39,811.00
including applicable WSST
Net Change by Previous Amendments $-629.00
including applicable WSST
...._.i ont"._....__. -... - �.._, _,. ..............— .,... —_.__...
Current Contract Amount $39,182.00
including all previous amendments
Current Amendment Sum $25,985.00
. ..__.... ... �_...___.. —_......_�. .
Applicable WSST Tax on thi._.s $o
Amendment
Revised Contract Sum $65,167.00
AMENDMENT - 1 OF 2
Origmal Time for Completion 12/31/19
(insert date)
Revised Time for Completion under n/a
prior Amendments
(insert date)
Adn Days Required (t) for this 1,096 calendar days
Amendment
Revised Time for Completion 12/31/22
(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.
fIL T/VE DOR ......_._...... CITY OF
BONSULTA ���
Y .._ ®+ _ BY:...._ a .
l ( fgrY�zi„tu+2 ��i (signature)
Print ame:�� ��c. rF° , `^ Print Name Dana Raloh
Its ! �t Its Mavrr_
?.Y — _...
DATE:_ ( (etle) cr'tl�)
DATE:
._...._. _....._.._ ...._
APPROVED AS TO FORM: _
(applicable if Mayors signature required)
Yent Law Department
l ..a Rn [al Way Mwau4ee 1 (Sgna Wie l'oin[ij nmJ]/MaHntlak �...�...
AMENDMENT - 2 OF 2
EXHIBIT A
e�Me t y
A LAND SERVICES COMPANY
S(pi Lttillwr 24' 20 18,
uperty & Specmli,;t,
('11), of Kum
400 West GowL: S't.
f"'em, WA 98012,
Rc: City are 11"'clil' Sig'fmtlln� P"iwc lxvcc Pr')1ccl
Public \Y urks I U 13 300 I
l6glit of WK q A,wpiisitioti, JUdocauon Hxtmmg "Ivi(.(Is mid Rd"(Liticin AsIklartc( sclvi(('s
Dcslr Cheryl,
Civi'la Right ()f Way SL:j-vIr:L.;' kILL (I iclia), io jikaLLI to pis sett voll with a copc mid budg for: the
ablaut im Ymonci] pri)jcct, Jiiwloscd i�, Llic -wot-IL, mal cost [(It-the pIs'p",ilan,.11 of a Eeh)cillloli
I � P1
Phan, corylplcw a 'ol'�I(: acqui,;Ilinn, �) Lmdloi(l r(locati011 �JJILI 11 singlc telocallon, `ChaseSiTvi(e%' will I'L, provtdcd it I accord anuL' Is'irli thu I Intform Kvlm'naion Assds anise and Rc;tj JIj0jot-(y
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hapun Ri W 8.2b. 111(l WLIstlifigtort Stair Llvc" ePe(111c:Jly (AII)FIII r S "'(I of the
wo�d Inglon (R(M
For pillposL'S oc atid COM, I IMA the f0floIVIIII)
* Them Is III( jaarr rl hollig r["(Jitneul by hctm iol Ihr
* '01C )"111CCI is MVIo'd by ATI OWIIUr ILITI611011d tjr)tj rIL-Crj p ant
* 11C patvc"I in occtlplY it by only a sing'Is- msidt,ftli'll It-nairt 04CU p ant
rclncaIinll J-dan will lit, pji:p'<Ir(d lot 1.' pmjcct,
StaWd hcrein.
A I dic end (if oi,w Scope of Wort k you will 6 id our Cool propo�'))'
I tI tia', team lool's to[ward I rL worli rig%vil 1) n(Ij I
Sit wercly,
Leslic Bcand, SR/WA, PAV/tfA(
Mmi,,tp,r, RIght of Wny Opcivi,jis
I'imri 16( la (,f Way S(rvicos, Ltd.
17553 We Avenue NE . Shoreline, Washington'9'8155 * 206.363.1556 Fast: 206.3
Right63.0106
.f W . Cultural Resources * E n v,r.n rr,u r,,a I Planning
Federal, Sea t u n d Local Pe r ori i..... . GISLCAD Mapping
w w w.t I e r r a-r o w,c o m
'thc (.,tIV clues ❑rat hr,ccr F dcr5d touilk Out dw I r rlrcr, ho%mnwi,, mn nds k, billow Lie.
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09 ( OR JUM 20 to wr II on the wanov Found No t,hup( r I&M K2&,
There Thfru u a ruriglc rr;idc ulud parcel lu au d ar 6tO 1 S 211 Stater, Alm, Arn[lirrri by Incc lain; County
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II th, Ap ni: will cool dena, PvAth Ow (ly 0 A "of 0 Ail Ow I"plact,mcilt loa A]( Alc. "I'hc AlgrIot Avill then
ofiditan A 1 K'o&t; lotj)i cl toll And nli)j clibuo. the thwhinw is cualpliallo If Any ",I er Al A found, tit(,(
in; pummed to the dwfl"cc led Ap J, I, awl a daddou IS "Yodc in &dour Ail Alf, reel ac"mmi site
,It OKI nptim or of I eplui Alto Yon c lialIleter 11 ]'to' If I(jollf K ( 11CII 1), Ile AbLe If tIolt fle:di"plac, I-
it) ILI climmi), a icklm If [of th" rel)"rs to Ito, in( I'( Aiello' ajid vIll i flat dI avith cona At.lots oil
Colnlpi(tion )i [!to PC aclimc, as IKill I I a Agn it Ihn it ,rill licri,lin, an Addin(nnd 1 11 ;j,P IA)a
on XWWAA7. AV urc locCINJI, IV agany 011 AW) Issm IIm imal liar dirnbillff loodanAiioit" An ohe
mP dn.'C' [Iafd�. Prill Ilmemfe Hicageni KAJII dani ivoll",Altli rhesc](Aennj
floflta(ilte to ( lo'low din ;ne tolopiced and (olliploev, D the boilY: is A new toidd, ( n,
spant &I IV a aphem A, o,It It thc 1),IdVA a Id A Mpl. k IS InWqylt In[ 0) ('"LlhanI Wb OVL.
Ani P"CIAL"
11 At AliPpla(cc finlinn— paildl( hofl,aiig, the agnat will xPAPI with the Jiul)lat: )oLIA;oIf,, applifelinill,
ii)(edivalic \vol) the City P I knlPllit 1 )('Pailim.fAl Ito-avor Jimmsm"g of 1W Onombnomi pumsdoln
adviec And A,�Pll I III( e n, rcediPi
A Ili t Ihr loplan I Lio ea eliv j�I approficd 11 or (sy I ml Cin "MAW nef6il,vh)t he nPPII to th..�[%IPpla, , r
Illm Adviluo, Vilna if it](, c,q)cc(ad himj ol(IN", boon, ][A( di!ydaoln,if[ ,[I<- It Ili, n-pliPlIlIkolf haute
VC:,Jllme clew damigh w, Nym hn AlLof Pit call IPVJc JoAllf [It( note ( Ifloqlaily t,I era,11, all (Al K, Plot
Ivognin jxmick, an! hillfwcd and III viccloa,m'y K; vrit civird VillcPc dem.col, (In I vlfg Ail
"d I A an,momh I Im( WWI IV a rqini if Wfd I agf-m to tAVIFLA, I he propciout,,CI)I I o:I I I-rem I it, III I
f1wo'llifig Id, a ri ihr. agivol MAI rwiu'Is
inf"Illimel If moe( lclm(d c�qi, eau, wilh lJ`o '11�,lllal*v and the lm"Hord to All"An rMILIArml kms(,
Are duc print to clofw or irtitfrt in, tlrc agell %,fill plri:palo the
talf ud Kcni, Slhll,"IIIK Poer, L,vi", P(o)"M
ItIliln of'\X'ay RcIcivallon Scli A:C ,
. ....................
nn1wuy Chun Wri"s, ,Mai sip Ahorn DjRKQr( pow OH id scidur at ;I wgueit to uh I A I char ks Aw [base
QvInorsq:
And Cot fi It I 1ln I,li 0 c
Ogcn( wbI C-wil dUm I c the fyiok c I)roceys wi(I I the ic disj,lyjccce or ( onarcri,ia I it)( \trf and
Ulictid/Inoltntln (he. nootit' 10 calmrc that all i %IA111111 tht rr.gnirccl clorrnha-(��, ind that UII
tcrtiU i cq[urt:d a) ba, ni,mcd nn, nywol th)"i t I v Xpla a nwm N , WAR IT ouy a NaW I mnn yw,
do ninve it ct tliPIC le, die alvis MI conihirl a [alai mWk dwough with the duldni cc anal dur(jav I I,
"I", , are Own oblaill(d h(laft III, diyJ,)Ia( 0 the �_jk, mcd, and tha, L yt )jovalcal in the (:o,l'!
rVIU(yco(m I tc TI I, agcniy will [![(a I I c(I I I f Ito I I it (,I I I ce 11)d jin pj)( I n I)If I i I u) "'nice of rv:I L m: and %yaj)
sulti ni r lit, al - I I)I I I
VIC njuni will QNAI 2q it tpainrd d,wun ofaaric"ll born dir tlihela( c,: and mall thi'll JOIPar". dis claim
forilic, nblaill and kitanat it to (11( for at)i(tar,j ( )II,, da,; jan, aCly Lf)IMWed, Oil
1W 10 WM pinjury 11", pay n in I I fvqt a v is and K! sublew IW 1 U) 11 w 0 v to oblain cfa!(k n I rlr 1)ayi wn I of
App-ra"I rhAns. Ilynhut of Men wid Q baud on dy bwz,,FOIL jjonve oI pod,clav [?oin
hr- disj)6C-jlc(aiI Am and Innin the sHchnnitn" nakowni pyovidY lq the ammr,v cmnNin, In
in'llbanal cxpvnse, ala IC"'Illacd, a witarlitc cic [clilln)aijim), claill) h'lni, and InlutlanAl rctluctl l'Ir n1a 1)
vop".; MIT 1W IMPOM (Inv, nmy be bmwd din MY U, (ho ri,alrla(ce of dKl%cny-Cei lay the agent. 11
10 dopUccu tilts In appNd an to do rArternklacuci afar benefit b(ap offcrni, dw al"tat will follow
the ( ac 's Proi.call.ur Wn appok pnw(2041)i W WSLIC 000 (OKI OPP& in oy;Med lWay alld j jMjQjnWd
M c0oll-dicific C Inath (IN policy and ju,cwhav In the n cm that a WI, A"v cm"vs u4ird u) wit it
p'ricld of [act,,, (1) 10'0n-c, nifillctlyst'ITACIn, edoin Irt4yntent., t))yl%r Jo j,jVajji,c,J by bt. (.jtV and Paid
daoujI�jj the jo�,jjjg 11, Kold arty olida, of C2SI1 by dic dnddyni(c, In 11)(tulynalt uiollw1, 11 is CPU I k
c.
JjIln!>iblc that ncli tt Iyloadon 'uIll occur.
Armidc"
WhCrc As [kith lc,n(A Pli,I)ONI, n, the aga,111 well I Calla(( 1111, udsjdka,cc A( denj¢',tlaled Ullctvak
ow r a 11 niuml Nmud "I man JAC to G A k ca, tali iu.6%oiwc inul I iII I I ill o I c I)r,It CIA I I I Is, typically
ivnial As"Slanet, pstaellinns Min umv Hickale porArtirij; addificaital I)S&S irl,I)IOu'wan And
luu,c Yunewak, Ad cool Amin ad, Cc tar: bated walla Aw Wy N, usum pnmqu pMnwnj
I j I C f]j art,
( hum 0" Id"mkorls Oyu owniQ lin ON the not, Ira rind An !Nucno tylgApHiv it ,p,,jjhc
Ap"cill will t1onc dak, ill(' Ill OC(MILIM C IWII'l ('i[y cl oceduics alid f)(AiC icn, aC, do(Mead
w'001 die RI I' l(w I& <o❑[whet. IN agent%oN than ckjw, it, Nawl hIV to the (Aq
C11Y Uf Kvnt, iipai inEeue Iliani, Levee
Rilgll( of Way Rck)CIROUI SCUVICC!
CONSULTANT FEE DETERMINATION - SUMMARY OF PROJECT COSTS
Tierra Right of Way Services, Ltd.
City of Kent, Signature Pointe Levee Project - Acquisition & Relocation
Direct Labor Total Total Labor Summarized
Labor Classification Employee Rate Hours Cost Costs
Right of Way Ill Director Mack Dickerson $ 57.69 3.00 $ 173.07
Right of Way Project Manager Leslie Beaird $ 52.88 25.00 $ 1,322.00
Melinda
Burkhart/Marge
Senior Right of Way Agent -Acquisition Bailey $ 37.00 45,00 $ 1,665.00
Senior Right of Way Agent - Relocation Ingrid Williams $ 34.00 175.00 $ 5,950.00
Right of Way Technician Derek Frazier $ 25.00 2000. $ 500.00
Administrative Unknown $ 20.00 0.00 $ -
Editor John Murray $ 31.00 0.00 $
Company Total Hours/Direct Labor Cost: 268.00 $ 9,610,07
Labor Overhead Multiplier: 135.83% $ 13,053,36
Fixed Fee Multiplier: 30% $ 2,883.02
Total Labor Cost Subtotal: $ 25,546.45
Direct Reimbursables
Travel (Mileage) 750 Miles $ 0.54 $ 401.25
Travel (Lodging:) Night $ 225.00 $
Travel (Meals:) Daily $ 51.00 $
Travel (Ferry fare) Per trip $29.20 $ -
File Folders 3 Each $ 5.00 $ 15.00
Postage 3 Each $ 7.50 $ 22,50
Reproduction - 8.5"x 11" Pages $ 0.10 $ -
Reproduction - 11"x 17" Pages $ 0.20 $
Reproduction -24"x 36" Sheets $ 0.90 $
Direct Reimbursables Subtotal: $ 438.75
Subcontracted Services
Appraiser Fee Est, $ $
Review Appraiser Fee Est, $ $
Subcontracted Printing Fees Est, $ $
Subcontracted Work Subtotal: $ -
Total Maximum Amount Payable $ 25,985.20
Task Order Total Maximum - Rounded $ 25,985
Residential Owner landlord & Tenant (2 relocations) 75, 75, 25
One acquisition 45 hours
TIERR4 UP IIJ,,f)1I3
4 � T CERTIFICATE OF LIABILITY INSURANCEDATE,MM°DI Y)
..�_..._ ._.......__.�.... __..,._ 10l1112018
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 have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, suh]nrt to the terms and conditions of the policy, certain policies may require an endorsement A statement on
this certlilcalo does not confer rights to the certificate holder in III of such endorsement(s)
P_..
PRODUCER UO2 2S4 5b33 Ii11 A+ Tr resa Alvarado
StuckeyIns s.Assoc Aggencies No>re 60?.j0q,5633 '"' fe02-L79 9336
2850 E Camelback Rd,S1 326 ViI rs+l I IMC P1,L
Phoenix,AZ BSD16 i)L r'i11 U. 6(*.a'aCeta.Aiv'ItlU[Yi1(frltki Ui:kNyi115¢iraflCe.CDi11
Scott Schmidt
11 I 140,j'+l I rrrl I. 1)1,BAmk_ WA,rC u
INSURER A Travelers Indemnity Company i25659
INSURED Tierra,Right of Way .The Charter Oak Fire Insurance +25615
Services LTD .INSURER a
1575 E.River Rd.#201 INSUNEn C XL Specialty Ins 370BS
Tucson,AZ 65718-5831 IMPORFli n,Hiscox Ins Company 10200
INSUMFR E
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DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES IACORD 101 Addhlonsl Roma kx Schedule,11.1 bo anached If mom Spam Is MILL ed)
Prolesslollai Liabibly -Claluis Madr: -kRelro L)ale 05J1111998
RB „otpnaf fre Polnto Lcevec I'Do VIA,Public Works Proj 13.3003
City of Kent is Incloderl dS addNiOrntl In„nrenE as par Written contract as
respects to r1EnOral,rinto and excess bahility coverago on a primary'and non -
colnrlbnlovy basis,
. .. _._ ..... ............ ..... . _...... ........ .._..-
CANCELLATION ..,,.
dm 1,I III Yt,r11f Ttt7E CD I,Ii. - ,
_.... . ....... _....—_....... .� _..— _._.__._. ....._..._..____. ..u„ _._........
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Kent THE EXPIRATION DATE IKCREOF, NOTICE WILL BE DELIVERED IN
400 West Grove St. ACCORDANCE WITH THE POLICY PROVISIONS.
Kent,WA 98032 ......-____ ........w...... _.� ......... ...___.__.. . ........_
AUTHORIZED REPRESENTATIVE
'0 1w,rL
ACORD 25(2016103) .._.—..1 ....---.—.-ORDll rights
1988 2016 ACORD CORPORATION, All rights reserved,
The ACORD name and logo are registered marks of ACORD
GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: ee0-2J97e332-18-47
OFFICE PAC ISSUE DATE. 07/10/2019
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CO2404 (10-93) WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
WAIVER OF TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
Any person or organization that you have agreed in a written contract or
agreement to waive your right of recovery against, but only for payments
we make because of:
9 ."Bodily injury" or "property damage" that occurs; or,
2."Personal injury" or "advertising injury" caused by an offense
committed; after you have executed that contract or agreement.
(If no entry appears above, information required to complete this
endorsement will be shown in the Declarationsas applicable to this
endorsement.)
The TRANSFER OF RIGHTS OF RECOVERYAGAINST OTHERS TO US Condition (Section
IV-COMMERCIAL GENERAL LIABILITY CONDITIONS)is amended by the addition of
the following:
We waive any right of recovery we may have againstthe person or
organization shown in the Scheduleabove because of payments we make for
injury ordamage arising out of your ongoing operations or'your work" done
under a contract with that personor organization and included in the
"products-completed operations hazards." This waiver appliesonly to the
person or organization shown in the Schedule above.
CG 24 04 10 93
CG TB 03 07 18 Page 1 of 2
GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: 680-2J978332-18-47
OFFICE PAC ISSUE DATE. 07/10/2018
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
C924C4 (10-93) WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
Copyright, Insurance Services Office, Inc., 1992
Page 1 of 1
CG T9 03 07 19 Page 2 of 2
GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: 580-2,I978332-18-47
OFFICE PAC ISSUE DATE: 07/10/2D18
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CGD425 (07-08) OTHER INSURANCE ADDITIONAL INSUREDS PRIMARY AND NONCONTRIBUTORY
WITH RESPECT TO CERTAIN OTHER INSURANCE
This endorsement modifies insurance provided under the following:
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
OTHER INSURANCE -ADDITIONAL INSUREDS -PRIMARY AND NON-CONTRIBUTORY WITH
RESPECT TOCERTAIN OTHER INSURANCE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following is added to Paragraph 4. a., Primarylnsurance, of SECTION
IV- COMMERCIAL GENERAL LIABILITY CONDITIONS:
However, if you specifically agree in a written contractor agreement that
the insurance afforded to anadditional insured under this Coverage Part
must apply ona primary basis, or a primary and non-contributorybasis,
this insurance is primary to other insurance thatis available to such
additional insured which coverssuch additional insured as a named
Insured, and wewill not share with that other insurance, provided that:
(1) The "bodily injury" or "property damage" for whichcoverage is
sought is caused by an 'occurrence"that takes place, and
(2) The "personal injury" or "advertising injury" foiwhich coverage is
sought arises out of an offensethat is committed;subsequent to the
signing and execution of that contract or agreement by you.
CG D4 25 07 08
2008 The Travelers Companies, Inc.
Page 1 of 1
CG T8 04 07 18 Page 1 of 1
GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: 6e0-2J978332-18-47
OFFICE PAC ISSUE DATE, 07/10/2018
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CGD361 (03-05) ADDITIONAL INSURED-DIQLTERS, LESSEES OR CONTRACTORS-SCHEDULED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS -
SCHEDULED PERSON OR ORGANIZATION
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAMES OF ADDITIONAL INSURED PERSON(S) OR ORGAN IZATION(S)',
Any person or organization that you agree in a written contract to
include as an additional insured on this Coverage Part, provided that
such written contract was signed and executed by you before,and is in
effect when, the "bodily injury" or "property damage" occurs or the
"personal injury" or "advertising injury" offense is committed.
LOCATION OF COVERED OPERATIONS:
Any project to which a written contract with the Additional Insured
Person(s)or Organization(s) in the Schedule applies
(INFORMATION REQUIRED TO COMPLETE THIS SCHEDULE, IFNOT SHOWN ABOVE, WILL
BE SHOWN IN THE DECLARATIONS.)
A. SECTION II -WHO IS AN INSURED IS AMENDED TO INCLUDE AS AN ADDITIONAL
INSURED THE PERSON(S) OR ORGANIZATIONS) SHOWN IN THE SCHEDULE, BUT ONLY
WITH RESPECT TO LIABILITY FOR "BODILY INJURY", "PROPERTY DAMAGE",PERSONAL
INJURY OR "ADVERTISING INJURY" CAUSED, IN WHOLE OR IN PART, BY:
1. YOUR ACTS OR OMISSIONS; OR
2. THE ACTS OR OMISSIONS OF THOSE ACTING ON YOUR BEHALF;IN THE
PERFORMANCE OF YOUR ONGOING OPERATIONS FOR THE ADDITIONALINSURED(S) AT
THE LOCATION(S) DESIGNATED ABOVE.
B. WITH RESPECT TO THE INSURANCE AFFORDED TO THESE ADDITIONAL INSURED,
THEFOLLOWING ADDITIONAL EXCLUSIONS APPLY;
This insurance does not apply to bodily injury or property damage"
occurring, or personal injury or advertising injury arising out of an
CG Te 02 07 18 Page 1 of 2
GFNERAL PURPOSE ENDORSEMENT POLICY NUMBER: 6e0-2J97 93 3 2-18-47
OFFICE PAC ISSUE DATE: 07/10/2018
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CGD361 (03-05) ADDITIONAL INSURED-OWNERS, LESSEES OR CONTRACTORS-SCHEDULED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
offense committed, after:
1. ALL WORK, INCLUDING MATERIALS, PARTS OR EQUIPMENT FURNISHED IN
CONNECTION WITH SUCH WORK, ON THE PROJECT (OTHER THAN SERVICE,
MAINTENANCEOR REPAIRS) TO BE PERFORMED BY OR ON BEHALF OF THE ADDITIONAL
INSURED(S)AT THE LOCATION OF THE COVERED OPERATIONS HAS BEEN COMPLETED,
OR
2. THAT PORTION OF "YOUR WORK" OUT OF WHICH THE INJURY OR DAMAGE ARISES
HAS BEEN PUT TO ITS INTENDED USE BY ANY PERSON OR ORGANIZATION OTHER THAN
ANOTHER CONTRACTOR OR SUBCONTRACTOR ENGAGED IN PERFORMING OPERATIONS FOR
APRINCIPAL AS A PART OF THE SAME PROJECT.
CGD361 0305
Copyright 2005 The St. Paul Travelers Companies, Inc. All rights
reserved.
Includes copyrighted material of Insurance Services Office, Inc. with its
permission.
Page 1 of 1
CG TO 02 07 1B Page 2 of 2
GENERAL PURPOSE ENDORSEMENT POLICY NUMBER: 580-2J978332-1e-47
OFFICE PAC ISSUE DATE: 07/10/2018
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED-OWNERS, LESSEES OR CONTRACTORS-COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED
OPERATIONS
THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
NAMES OF ADDITIONAL INSURED PERSON(S) OR ORGANIZATION(S):
Any person or organization that you agree in a written contract
to include as an additional insured on this Coverage Part for
"bodily injury" or "property damage" included in the
products-completed operations hazard, provided that such
contract was signed and executed by you before, and is in effect
when, the "bodily injury or "property damage" occurs.
LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS: Any project to
which a written contract with the Additional Insured Persons)
or Organization(s) in the Schedule applies.
(INFORMATION REQUIRED TO COMPLETE THIS SCHEDULE, IF NOT SHOWN
ABOVE, WILL BE SHOWN IN THE DECLARATIONS )
A. SECTION II - WHO IS AN INSURED IS AMENDED TO INCLUDE AS AN ADDITIONAL
INSURED THE PERSON(S) OR ORGANIZATION(S) SHOWN IN THE SCHEDULE, BUT ONLY
WITH RESPECT TO LIABILITY FOR "BODILY INJURY', "PROPERTY DAMAGE"
CAUSED, IN WHOLE OR IN PART, BY "YOUR WORK" AT THE LOCATION DESIGNATED
AND DESCRIBED IN THE SCHEDULE OF THIS ENDORSEMENT PERFORMED FOR
THAT ADDITIONAL INSURED AND INCLUDED IN THE "PRODUCTS-COMPLETED
OPERATIONS HAZARD".
CG 20 37 07 04
cG T8 01 07 18 Page I of 2
GENERAL PURPOSE ENDORSEMENT POI ICY NU MRFR eBO-2J978332-1R-47
OFFICE PAC ISSUE DATE: 07/10/2018
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED-OWNERS, LESSEES OR CONTRACTORS-COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
Copyright ISO Properties, Inc. 2004
Page 1 of 1
CG TB 01 07 18 Page 2 of 2
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
AUTO COVERAGE PLUS ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE —This endorsernent broadens coverage. However, coverage for any
injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or
limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to
the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover-
age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en-
dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BLANKET ADDITIONAL INSURED H. AUDIO, VISUAL AND DATA ELECTRONIC
B. EMPLOYEE HIRED AUTO EQUIPMENT— INCREASED LIMIT
C. EMPLOYEES AS INSURED I. WAIVER OF DEDUCTIBLE—GLASS
D. SUPPLEMENTARY PAYMENTS — INCREASED J. PERSONAL PROPERTY
LIMITS K. AIRBAGS
E. TRAILERS— INCREASED LOAD CAPACITY L. AUTO LOAN LEASE GAP
F. HIRED AUTO PHYSICAL DAMAGE M. BLANKET WAIVER OF SUBROGATION
G. PHYSICAL DAMAGE — TRANSPORTATION
EXPENSES—INCREASED LIMIT
A. BLANKET ADDITIONAL INSURED performing duties related to the conduct of
The following is added to Paragraph A.1.1 Who Is your business.
An Insured, of SECTION II —COVERED AUTOS 2. The following replaces Paragraph b. In B.5.,
LIABILITY COVERAGE: Other Insurance, of SECTION IV — BUSI-
Any person or organization who is required under NESS AUTO CONDITIONS:
a written contract or agreement between you and b. For Hired Auto Physical Damage Cover-
that person or organization, that is signed and age, the following are deemed to be cov-
excted damage"by ubefore the
ed bodily injury' or ered "autos" you own:
.,propertythat is in effect
during the policy period, to be named an s (1) Any covered "auto" you lease, hire,rent or borrow, and
tional insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to which (2) Any covered "auto" hired or rented by
this insurance applies and only to the extent that your "employee" under a contract in
person or organization qualifies as an "insured" an "employee's" name, with your
under the Who Is An Insured provision contained permission, while performing duties
in Section II related to the conduct of your busi-
S. EMPLOYEE HIRED AUTO ness,
1. The following is added to Paragraph A.1., However, any "auto" that is leased, hired,
Who Is An Insured, of SECTION II — COV. rented or borrowed with a driver is not a
ERED AUTOS LIABILITY COVERAGE: covered "auto".
An "employee" of yours is an "insured" while C. EMPLOYEES AS INSURED
operating a covered "auto" hired or rented The following is added to Paragraph A.1., Who Is
under a contract or agreement in an "em- An Insured, of SECTION II —COVERED AUTOS
ployee's" name, with your permission, while LIABILITY COVERAGE.
CA T4 20 02 15 Cr 2015 The Travelers Indemnity Company, All rights reserved, Page 1 of 3
Includes copyrighted manorial of Insurance services Office, Inc.whir Its permissiun.
COMMFPCIAI..AUTO
Any "employee" of yours is an "insured"while us- (2) An adjustment for depreciation and physical
ing a covered "auto" you don't own, hire or borrow condition will be made in determining actual
in your business or your personal affairs. cash value in the event of a total "loss".
D. SUPPLEMENTARY PAYMENTS — INCREASED (3) If a repair or replacement results in better
LIMITS than like kind or quality, we will not pay for the
1. The following replaces Paragraph A.2.a.(2) of amount of betterment.
SECTION II —COVERED AUTOS LIABILITY (4) A deductible equal to the highest Physical
COVERAGE: Damage deductible applicable to any owned
(2) Up to $3,000 for cost of ball bonds (in- covered "auto
cluding bonds for related traffic law viola- (5) This Coverage Extension does not apply to:
tions) required because of an "accident"
we cover, We do not have to furnish (a) Any "auto" that i hired, rented or bor-
these bonds, owed with a driver, or
(b) Any "auto" that is hired, rented or bor-
2. The following replaces Paragraph A.2.a.(4) of rowed from your"employee".
SECTION II —COVERED AUTOS LIABILITY
COVERAGE: G. PHYSICAL DAMAGE — TRANSPORTATION
(4) All reasonable expenses incurred by the EXPENSES—INCREASED LIMIT
"insured" at our request, including actual The following replaces the first sentence in Para-
loss of earnings up to $500 a day be- graph AA.a., Transportation Expenses, of
cause of time off from work. SECTION III — PHYSICAL DAMAGE COVER-
E. TRAILERS—INCREASED LOAD CAPACITY AGE:
The following replaces Paragraph C.1. of SEC- We will pay up to $50 per day to a maximum of
T
The I —COVERED AUTOS: $1,500 for temporary transportation expense in-
curred by you because of the total theft of a cov-
1. "Trailers" with a load capacity of 3,000 ered"auto" of the private passenger type.
pounds or less designed primarily for travel H. AUDIO, VISUAL AND DATA ELECTRONIC
on public roads, EQUIPMENT— INCREASED LIMIT
F. HIRED AUTO PHYSICAL DAMAGE Paragraph C.1.b. of SECTION III — PHYSICAL
The following is added to Paragraph AA., Cover- DAMAGE COVERAGE is deleted.
age Extensions, of SECTION III — PHYSICAL I. WAIVER OF DEDUCTIBLE—GLASS
DAMAGE COVERAGE:
The following is added to Paragraph D., Deducti-
Hired Auto Physical Damage Coverage ble, of SECTION III — PHYSICAL DAMAGE
If hired "autos" are covered "autos" for Covered COVERAGE:
Autos Liability Coverage but not covered "autos" No deductible for a covered "auto" will apply to
for Physical Damage Coverage, and this policy glass damage if the glass is repaired rather than
also provides Physical Damage Coverage for an replaced.
owned "auto", then the Physical Damage Cover- J. PERSONAL PROPERTY
age is extended to "autos" that you hire, rent or The following is added to Paragraph AA., Cover-
borrow subject to the following: age Extensions, of SECTION III — PHYSICAL
(1) The most we will pay for "loss" to any one DAMAGE COVERAGE',
"auto" that you hire, rent or borrow is the Personal Property Coverage
lesser of: We will pay up to $400 for "loss" to wearing ap-
(a) $50,000, parel and other personal property which is:
(b) The actual cash value of the damaged or (1) Owned by an "insured", and
stolen property as of the time of the (2) In or on your covered "auto",
"loss", or This coverage only applies in the event of a total
(c) The cost of repairing or replacing the theft of your covered "auto".
damaged or stolen property with other No deductibles apply to Personal Property cover-
property of like kind and quality. age.
Page 2 Of 3 p 2015 The Travelers Indemnity Company. All rights reserved. CA T4 20 02 15
Includes copyrighted material of Insurance Services Office,Inc with its permission„
COMMERCIAL AUTO
K. AIRBAGS (2) Any:
The following is added to Paragraph B.3., Exclu- (a) Overdue lease or loan payments at the
sions, of SECTION III — PHYSICAL DAMAGE time of the "loss".
COVERAGE:
(b) Financial penalties imposed under a
Exclusion 3.a. does not apply to "loss" to one or lease for excessive use, abnormal wear
more airbags in a covered "auto" you own that in- and tear or high mileage,
flate due to a cause other than a cause of "loss" (
set forth in Paragraphs A.1.b. and A.1.c., but c) Security deposits not returned by the les-
only: sor,
a. If that "auto" is a covered "auto" for Cornpre- (d) Costs for extended warranties, Credit Life
hensive Coverage under this policy; Insurance, Health, Accident or Disability
b. The airbags are not covered under any war- Insurance purchased with the loan or
ranty, and lease; and
C. The airbags were not intentionally inflated. (e) Carry-over balances from previous loans
orleases.
We will pay up to a maximum of $1,000 for any M. BLANKET WAIVER OF SUBROGATION
one"loss".
L. AUTO LOAN LEASE GAP The following replaces Paragraph A.S., Transfer
Of Rights Of Recovery Against Others To Us,
The following is added to Paragraph AA., Cover- of SECTION IV — BUSINESS AUTO CONDI-
age Extensions, of SECTION III — PHYSICAL TIONS:
DAMAGE COVERAGE:
Auto Loan Lease Gap Coverage for Private 5. Transfer Of Rights Of Recovery Against
Passenger Type Vehicles Others To Us
In the event of a total "loss"to a covered "auto" of We waive any right of recovery we Inay have
the private passenger type shown in the Schedule against any person or organization to the ex-
or Declarations for which Physical Damage Cov- tent required of you by a written contract exe-
erage is provided, we will pay any unpaid amount cuted prior to any "accident" or "loss", pro-
due on the lease or loan for such covered "auto" vided that the"accident" or"loss" arises out of
less the following. the operations contemplated by such con-
(1) The amount paid under the Physical Damage tract. The waiver applies only to the person or
Coverage Section of the policy for that"auto", organization designated in such contract.
and
CA T4 20 02 15 02015 The Travelers Indeninity Company. All rights reserved. Page 3 of 3
Includes copyrighted maiedal of Insurance Services Office, Inc.with its permission,
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