HomeMy WebLinkAboutCAG2019-203 - Original - TMG Services, Inc. - 2019 Annual Chlorination System Service Maintenance - 04/15/2019 KENT
Records Management Document
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to the City Clerk's Office. All portions are to be completed.
If you have questions, please contact the City Clerk's Office at 253-856-5725.
Vendor Name: TMG Services, Inc.
36343
Vendor Number (IDE):
Contract Number (City Clerk): -a2o3
Category: -Contract Agreement
Sub-Category (if applicable): None
Project Name: 2019 Annual Chlorination System Service Maintenance
4/15/19 7/31/19
Contract Execution Date: Termination Date:
Contract Manager:
Tom Cunningham Department: PW: Operations
Contract Amount: $8 7 397.00
Budgeted: ❑✓ Grant?
Part of NEW Budget: Local: 1-1
State: Federal:
Related to a New Position:
Basis for Selection of Contractor? Bid
Approval Authority: ❑✓ Director ❑ Mayor ❑ City Council
Other Details: Vendor shall provide all parts, materials and labor to perform the 2019
annual chlorination system service maintenance at the following City of Kent well sites.
Clark Springs, Kent Springs, East Hill West, Seven Oaks & Armstrong Springs
-40�'do�.
1_117 KEN T
GOODS & SERVICES AGREEMENT
between the City of Kent and
TMG Services, Inc.
THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and TMG Services, Inc. organized under the laws of the State of Washington, located
and doing business at 3216 E Portland Ave, Tacoma, WA 98404, Phone: (253) 779-4160/ Fax: (253) 779-
4165, Contact: Mary Gazdik (hereinafter the "Vendor").
AGREEMENT
I. DESCRIPTION OF WORK.
Vendor shall provide the following goods and materials and/or perform the following services for the
City:
Vendor shall provide all parts, materials and labor to perform the 2019 annual chlorination
system service maintenance at the following City of Kent well sites:
1. Clark Springs - 24875 Kent Kangley Rd
2. Kent Springs - 28600 2161h Ave SE
3. East Hill Well - 24525 1041h Ave SE
4. Seven Oaks - 11834 Kent Kangley Rd
5. Armstrong Springs - 17975 SE 2751h PI
For a detailed description of the scope of work, see the annual service quote which is attached
as Exhibit A and incorporated by this reference.
Vendor acknowledges and understands that it is not the City's exclusive provider of these goods,
materials, or services and that the City maintains its unqualified right to obtain these goods, materials, and
services through other sources.
II. TIME OF COMPLETION. Upon the effective date of this Agreement, Vendor shall complete
the work and provide all goods, materials, and services by July 31, 2019.
III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Eight Thousand,
Three Hundred and Ninety-Seven Dollars ($8,397.00), including applicable Washington State Sales Tax, for
the goods, materials, and services contemplated in this Agreement. The City shall pay the Vendor the
following amounts according to the following schedule:
Vendor shall be paid after completion of inspection of well sites.
GOODS & SERVICES AGREEMENT - 1
($20,000 or Less, incl. WSST)
If the City objects to all or any portion of an invoice, it shall notify Vendor and reserves the option
to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every
effort to settle the disputed portion.
A. Defective or Unauthorized Work. The City reserves its right to withhold payment from Vendor
for any defective or unauthorized goods, materials or services. If Vendor is unable, for any
reason, to complete any part of this Agreement, the City may obtain the goods, materials or
services from other sources, and Vendor shall be liable to the City for any additional costs
incurred by the City. "Additional costs" shall mean all reasonable costs, including legal costs
and attorney fees, incurred by the City beyond the maximum Agreement price specified
above. The City further reserves its right to deduct these additional costs incurred to complete
this Agreement with other sources, from any and all amounts due or to become due the
Vendor.
B. Final Payment: Waiver of Claims. VENDOR'S ACCEPTANCE OF FINAL PAYMENT SHALL
CONSTITUTE A WAIVER OF CLAIMS, EXCEPT THOSE PREVIOUSLY AND PROPERLY MADE AND
IDENTIFIED BY VENDOR AS UNSETTLED AT THE TIME REQUEST FOR FINAL PAYMENT IS
MADE.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCW, the parties make the following representations:
A. The Vendor has the ability to control and direct the performance and details of its
work, the City being interested only in the results obtained under this Agreement.
B. The Vendor maintains and pays for its own place of business from which Vendor's
services under this Agreement will be performed.
C. The Vendor has an established and independent business that is eligible for a business
deduction for federal income tax purposes that existed before the City retained
Vendor's services, or the Vendor is engaged in an independently established trade,
occupation, profession, or business of the same nature as that involved under this
Agreement.
D. The Vendor is responsible for filing as they become due all necessary tax documents
with appropriate federal and state agencies, including the Internal Revenue Service
and the state Department of Revenue.
E. The Vendor has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by Vendor's
business, and has obtained a Unified Business Identifier (UBI) number from the State
of Washington.
F. The Vendor maintains a set of books dedicated to the expenses and earnings of its
business.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thirty (30) days written notice at its address set forth on the signature block of
this Agreement.
VI. CHANGES. The City may issue a written amendment for any change in the goods, materials
or services to be provided during the performance of this Agreement. If the Vendor determines, for any
reason, that an amendment is necessary, Vendor must submit a written amendment request to the person
listed in the notice provision section of this Agreement, section XIV(D), within fourteen (14) calendar days
of the date Vendor knew or should have known of the facts and events giving rise to the requested change.
If the City determines that the change increases or decreases the Vendor's costs or time for performance,
the City will make an equitable adjustment. The City will attempt, in good faith, to reach agreement with
GOODS & SERVICES AGREEMENT - 2
($20,000 or Less, including WSST)
the Vendor on all equitable adjustments. However, if the parties are unable to agree, the City will determine
the equitable adjustment as it deems appropriate. The Vendor shall proceed with the amended work upon
receiving either a written amendment from the City or an oral order from the City before actually receiving
the written amendment. If the Vendor fails to require an amendment within the time allowed, the Vendor
waives its right to make any claim or submit subsequent amendment requests for that portion of the contract
work. If the Vendor disagrees with the equitable adjustment, the Vendor must complete the amended work;
however, the Vendor may elect to protest the adjustment as provided in subsections A through E of Section
VII, Claims, below.
The Vendor accepts all requirements of an amendment by: (1) endorsing it, (2) writing a separate
acceptance, or (3) not protesting in the way this section provides. An amendment that is accepted by
Vendor as provided in this section shall constitute full payment and final settlement of all claims for contract
time and for direct, indirect and consequential costs, including costs of delays related to any work, either
covered or affected by the change.
VII. CLAIMS. If the Vendor disagrees with anything required by an amendment, another written
order, or an oral order from the City, including any direction, instruction, interpretation, or determination
by the City, the Vendor may file a claim as provided in this section. The Vendor shall give written notice to
the City of all claims within fourteen (14) calendar days of the occurrence of the events giving rise to the
claims, or within fourteen (14) calendar days of the date the Vendor knew or should have known of the facts
or events giving rise to the claim, whichever occurs first . Any claim for damages, additional payment for
any reason, or extension of time, whether under this Agreement or otherwise, shall be conclusively deemed
to have been waived by the Vendor unless a timely written claim is made in strict accordance with the
applicable provisions of this Agreement.
At a minimum, a Vendor's written claim shall include the information set forth in subsections A, items
1 through 5 below.
FAILURE TO PROVIDE A COMPLETE, WRITTEN NOTIFICATION OF CLAIM WITHIN
THE TIME ALLOWED SHALL BE AN ABSOLUTE WAIVER OF ANY CLAIMS ARISING IN
ANY WAY FROM THE FACTS OR EVENTS SURROUNDING THAT CLAIM OR CAUSED BY
THAT DELAY.
A. Notice of Claim. Provide a signed written notice of claim that provides the following
information:
1. The date of the Vendor's claim;
2. The nature and circumstances that caused the claim;
3. The provisions in this Agreement that support the claim;
4. The estimated dollar cost, if any, of the claimed work and how that estimate
was determined; and
5. An analysis of the progress schedule showing the schedule change or disruption
if the Vendor is asserting a schedule change or disruption.
B. Records. The Vendor shall keep complete records of extra costs and time incurred as a result
of the asserted events giving rise to the claim. The City shall have access to any of the
Vendor's records needed for evaluating the protest.
The City will evaluate all claims, provided the procedures in this section are followed. If the
City determines that a claim is valid, the City will adjust payment for work or time by an
equitable adjustment. No adjustment will be made for an invalid protest.
C. Vendor's Duty to Complete Protested Work. In spite of any claim, the Vendor shall proceed
promptly to provide the goods, materials and services required by the City under this
Agreement.
GOODS & SERVICES AGREEMENT - 3
($20,000 or Less, including WSST)
D. Failure to Protest Constitutes Waiver. By not protesting as this section provides, the Vendor
also waives any additional entitlement and accepts from the City any written or oral order
(including directions, instructions, interpretations, and determination).
E. Failure to Follow Procedures Constitutes Waiver. By failing to follow the procedures of this
section, the Vendor completely waives any claims for protested work and accepts from the
City any written or oral order (including directions, instructions, interpretations, and
determination).
VIII. LIMITATION OF ACTIONS. VENDOR MUST, IN ANY EVENT, FILE ANY LAWSUIT ARISING
FROM OR CONNECTED WITH THIS AGREEMENT WITHIN 120 CALENDAR DAYS FROM THE DATE THE
CONTRACT WORK IS COMPLETE OR VENDOR'S ABILITY TO FILE THAT SUIT SHALL BE FOREVER BARRED.
THIS SECTION FURTHER LIMITS ANY APPLICABLE STATUTORY LIMITATIONS PERIOD.
IX. WARRANTY. Vendor warrants that it will faithfully and satisfactorily perform all work
provided under this Agreement in accordance with the provisions of this Agreement. In addition to any
other warranty provided for at law or herein, this Agreement is additionally subject to all warranty provisions
established under the Uniform Commercial Code, Title 62A, Revised Code of Washington. Vendor warrants
goods are merchantable, are fit for the particular purpose for which they were obtained, and will perform in
accordance with their specifications and Vendor's representations to City. The Vendor shall promptly correct
all defects in workmanship and materials: (1) when Vendor knows or should have known of the defect, or
(2) upon Vendor's receipt of notification from the City of the existence or discovery of the defect. In the
event any part of the goods are repaired, only original replacement parts shall be used—rebuilt or used
parts will not be acceptable. When defects are corrected, the warranty for that portion of the work shall
extend for an additional year beyond the original warranty period applicable to the overall work. The Vendor
shall begin to correct any defects within seven (7) calendar days of its receipt of notice from the City of the
defect. If the Vendor does not accomplish the corrections within a reasonable time as determined by the
City, the City may complete the corrections and the Vendor shall pay all costs incurred by the City in order
to accomplish the correction.
X. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any sub-contract, the Vendor, its sub-contractors, or any person acting on behalf of the
Vendor or sub-contractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national
origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who
is qualified and available to perform the work to which the employment relates.
Vendor shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration,
Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached
Compliance Statement.
XI. INDEMNIFICATION. Vendor shall defend, indemnify and hold the City, its officers, officials,
employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits,
including all legal costs and attorney fees, arising out of or in connection with the Vendor's performance of
this Agreement, except for that portion of the injuries and damages caused by the City's negligence.
The City's inspection or acceptance of any of Vendor's work when completed shall not be grounds to
avoid any of these covenants of indemnification.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE VENDOR'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE,
TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER
ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER.
In the event Vendor refuses tender of defense in any suit or any claim, if that tender was made
pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having
jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Vendor's part, then Vendor
shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable
GOODS & SERVICES AGREEMENT - 4
($20,000 or Less, including WSST)
attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the
Vendor's part.
The provisions of this section shall survive the expiration or termination of this Agreement.
XII. INSURANCE. The Vendor shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference.
XIII. WORK PERFORMED AT VENDOR'S RISK. Vendor shall take all necessary precautions and
shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the
contract work and shall utilize all protection necessary for that purpose. All work shall be done at Vendor's
own risk, and Vendor shall be responsible for any loss of or damage to materials, tools, or other articles
used or held for use in connection with the work.
XIV. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price
preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this
Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those
covenants, agreements or options, and the same shall be and remain in full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any
dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section XI of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at
the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written
notice hereunder shall become effective three (3) business days after the date of mailing by registered or
certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this
Agreement or such other address as may be hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment,
the terms of this Agreement shall continue in full force and effect and no further assignment shall be made
without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement
shall be binding unless in writing and signed by a duly authorized representative of the City and Vendor.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering into or forming a part of
or altering in any manner this Agreement. All of the above documents are hereby made a part of this
Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any
language contained in this Agreement, the terms of this Agreement shall prevail.
GOODS & SERVICES AGREEMENT - 5
($20,000 or Less, including WSST)
H. Compliance with Laws. The Vendor agrees to comply with all federal, state, and municipal
laws, rules, and regulations that are now effective or in the future become applicable to Vendor's business,
equipment, and personnel engaged in operations covered by this Agreement or accruing out of the
performance of those operations.
I. Public Rggords Act. The Vendor acknowledges that the City is a public agency subject to the
Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes,
emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may
be subject to public review and disclosure, even if those records are not produced to or possessed by the
City of Kent. As such, the Vendor agrees to cooperate fully with the City in satisfying the City's duties and
obligations under the Public Records Act.
J. City Business License Reguired. Prior to commencing the tasks described in Section I,
Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the
Kent City Code.
K. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any
number of counterparts, each of which shall constitute an original, and all of which will together constitute
this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page
to the other by fax or email and that signature shall have the same force and effect as if the Agreement
bearing the original signature was received in person.
IN WITNESS, the parties below execute this Agreement, which shall become effective on
the last date entered below. All acts consistent with the authority of this Agreement and prior
to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed
to have applied.
VENDOR: _ CI OF KENT:
f
By: A+ By:
( n re) nature)
Print NWe: A I Ccr Print Name: David A. Brock, P.E.
Its: Cr es,cue Af Its: eputy Director Operations Manager
(ti le)
DATE: 0 � DATE: /
NOTICES TO BE SENT TO: E NOTICES TO BE SENT TO:
i
VENDOR: I CITY OF KENT:
Mary Gazdik ' Timothy 3. LaPorte, P.E.
TMG Services, Inc. ( City of Kent
3216 E Portland Ave 1 220 Fourth Avenue South
Tacoma, WA 98404 Kent, WA 98032
3
(253) 779-4160 (telephone) (253) 856-5500 (telephone)
(253) 779-4165 (facsimile) (253) 856-6500 (facsimile)
OV A)
Kent Cit Clerk
GOODS &SERVICES AGREEMENT- 6
($20,000 or Less, including WSST)
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of sex,
race, color, national origin, age, or the presence of all sensory, mental or physical disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
By:
For: -`VG <SerYrCe5 , tic_
Title: ��C S r C,c1�
Date: 9
EEO COMPLIANCE DOCUMENTS - 1 of 3
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and state
laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal
employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2 of 3
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered into on
the (date), between the firm I represent and the City of
Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3 of 3
EXHIBIT A
Page: 1
Quote
T M G SERVICES,INC. Order Number: 0031286
3216 E.PORTLAND
Order Date: 3/15I2019
TACOMA,WA 98404
2537794160
Salesperson: 0000
Customer Number: 1105141
Sold To: Ship To:
KENT,CITY OFIWATER DEPARTMENT KENT,CITY OFANATER DEPARTMENT
220 FOURTH AVENUE SOUTH 5821 S.240TH STREET
KENT,WA 98032 ATTN: TOM CUNNINGHAM
KENT,WA 98032
Confirm To:
Customer P.O. Ship VIA F.O.B. Terns
2019 SERVICE TMG DELIVERED TACOMA,WA NET 30 DAYS
Item Code Unit Ordered Shipped Back Order Price Amount
EAST HILL
/SERVICE LABOR FIELD SERVICE LABOR
HOUR 5.00 0.00 125.00 500.00
/SERVICE TRAVEL FIELD SERVICE TRAVEL TIME
HOUR 1.00 0.00 0.00 125.00 100.00
/SERVICE MILES FIELD SERVICE MILEAGE
MILE 40.00 0,00 0.00 0.50 20.00
W3T98108 AP04389 KIT PM 3/4"STD INJECT
Whse: 000 EACH 1.00 0.00 0.00 111.88 111,88
W3T99091 AAA1343 KIT PM 5"RATEVALVE
Whse: 000 EACH 1,00 0.00 0.00 114.10 114.10
W3T99880 AJA4393 KIT PM V10K
Whse: 000 EACH 1,00 0.00 0.00 106.37 106.37
W3T99090 AAA1160 PM KIT 200/50OPPD VAC
Whse: 000 EACH 2.00 0.00 0.00 176.13 352.26
W2T16924 P41212 ROTAMETER TOP-STOP CHILD
Whse: 000 EACH 2,00 OM 0.00 7.90 15.80
0535J-025 3/8"JIG NATURAL TUBING
Whse: 000 FOOT 15.00 0.00 0.00 1.52 22.80
Clean,inspect,and regasket(1)W&T S10K(50PPD),(1)W&T V10K(50PPD),(1)3/4"injector and
(2)200S vacuum regulators. Replace all tubing. Test both regulators. Test chlorine detector for
proper response to chlorine.
ARMSTRONG SPRINGS
/SERVICE LABOR FIELD SERVICE LABOR
HOUR 4.00 0.00 0.00 125.00 400.00
/SERVICE TRAVEL FIELD SERVICE TRAVEL TIME
HOUR 2.00 0.00 OX 125.00 200,00
/SERVICE MILES FIELD SERVICE MILEAGE
MILE 40.00 0.00 0.00 0.50 20.00
Continued
Page: 2
Quote
T M G SERVICES,INC. Order Number: 0031286
3216 E.PORTLAND Order Date: 3/1 5120 1 9
TACOMA,WA 98404
2537794160
Salesperson: 0000
Customer Number: 1105141
Sold To. Ship To:
KENT,CITY OFIWATER DEPARTMENT KENT,CITY OFIWATER DEPARTMENT
220 FOURTH AVENUE SOUTH 5821 S.240TH STREET
KENT,WA 98032 ATTN: TOM CUNNINGHAM
KENT,WA 98032
Confirm To:
Customer P.O. Ship VIA F.O.B. Terms
2019 SERVICE TMG DELIVERED TACOMA,WA NET 30 DAYS
Item Code Unit Ordered Shipped Back Order Price Amount
W3T98108 AP04389 KIT PM 3/4"STD INJECT
Whse: 000 EACH 1DO 0.00 0.00 111.88 111.88
W3T99091 AAA1343 KIT PM 5'RATEVALVE
Whse: 000 EACH 1.00 0.00 0.00 114.10 114.10
W3T99090 AAA1160 PM KIT 200/500PPD VAC
Whse: OOC EACH 2.00 0.00 0.00 176.13 352.26
W2T9967 AAB3104 STEM ADAPTER
Whse: 000 EACH 1.00 0.00 0.00 50.04 50.04
Clean,inspect and regasket(1)3/4"injector,(1)E10K chlorinator(20PPD),and(2)210S vacuum
regulators. Replace parts as needed. Test system for proper operation. Test leak detector for
proper response to chlorine gas.
SEVEN OAKS
/SERVICE LABOR FIELD SERVICE LABOR
HOUR 4.00 0.00 0.00 125.00 400.00
/SERVICE TRAVEL FIELD SERVICE TRAVEL TIME
HOUR 2.00 0.00 0.00 125.00 200,00
/SERVICE MILES FIELD SERVICE MILEAGE
MILE 40.00 0.00 0.00 0.50 20.00
W3T99880 AJA4393 KIT PM V10K
Whse: 000 EACH 1.00 0.00 0.00 106.34 106.34
W3T99090 AAA1160 PM KIT 200/500PPD VAC
Whse: 000 EACH 2.00 0.00 0.00 176.13 352.26
W3T98108 APQ4389 KIT PM 3/4"STD INJECT
Whse: 000 EACH 1.00 0.00 0.00 111.88 111.88
Clean,inspect,regasket(1)V10K,(1)3/4"injector,and(2)vacuum regulators.
KENT SPRINGS
!SERVICE LABOR FIELD SERVICE LABOR
HOUR 5.50 0.00 0.00 125.00 550.00
Continued
T
Page: 3
Quote
T M G SERVICES,INC. Order Number: 0031286
3216 E.PORTLAND
Order Date: 3/15/2019
TACOMA,WA 98404
2537794160
Salesperson: 0000
C ustom er N u m be r: 1105141
Sold To: Ship To:
KENT,CITY OF/WATER DEPARTMENT KENT,CITY OFIWATER DEPARTMENT
220 FOURTH AVENUE SOUTH 5821 S.240TH STREET
KENT,WA 98032 ATTN: TOM CUNNINGHAM
KENT,WA 98032
Confirm To:
Customer P.O. Ship VIA F.O.B. Terms
2019 SERVICE TMG DELIVEREC TACOMA,WA NET 30 DAYS
Item Code Unit Ordered Shipped Back Order Price Amount
/SERVICE TRAVEL FIELD SERVICE TRAVEL TIME
HOUR 2.00 0,00 0.00 125 X, 200.00
/SERVICE MILES FIELD SERVICE MILEAGE
MILE 40.00 0,00 0.00 0,50 20.00
W3T99090 AAA1160 PM KIT 200150OPPD VAC
Whse: 000 EACH 2.00 0.00 0.00 176.13 352.26
W3T99880 AJA4393 KIT PM V10K
Whse: 000 EACH 2.00 0.00 0.00 106.34 212,68
W3T98108 APQ4389 KIT PM 3/4"STD INJECT
Whse: 000 EACH 2.00 0.00 0,00 111.88 223.76
W2T16924 P41212 ROTAMETER TOP-STOP CHLO
Whse: 000 EACH 2.00 0.00 0.00 7 90 15.80
W3T108272 AAC536920OPPD INLET ASSEMBLY
Whse: 000 EACH 1.00 0.00 0.00 161.86 161,86
Clean,inspect,and regasket(2)210S vacuum regulators with drip leg. (2)V10K automatic
chlorinator(50 PPD)(30 PPD),and 3/4'injectors. Test system to ensure proper operation. Test leak
detector to ensure response to chlorine gas,
CLARK SPRINGS
/SERVICE LABOR FIELD SERVICE LABOR
HOUR 5.00 0.00 0.00 125A0 500,00
/SERVICE TRAVEL FIELD SERVICE TRAVEL TIME
HOUR 2.00 0.00 0.00 125.00 200.00
/SERVICE MILES FIELD SERVICE MILEAGE
MILE 42.00 0.00 0.00 0,50 21.00
W3T99090 AAA1160 PM KIT 200/500PPD VAC
Whse: 000 EACH 2.00 0.00 0.00 176.13 352.26
W3T99880 AJA4393 KIT PM V10K
Whse: 000 EACH 1.00 0.00 0.00 106.34 106.34
Continued
Page: 4
Quote
T M G SERVICES,INC. Order Number: 0031286
3216 E.PORTLAND Order Date: 3/1 5120 1 9
TACOMA.WA 98404
2537794160
Salesperson: 0000
Customer Number: 1105141
Sold To: Ship To:
KENT,CITY OF/WATER DEPARTMENT KENT,CITY OF/WATER DEPARTMENT
220 FOURTH AVENUE SOUTH 5821 S.240TH STREET
KENT,WA 98032 ATTN: TOM CUNNINGHAM
KENT,WA 98032
Confirm To:
Customer P.O. Ship VIA F.O.B. Terms
2019 SERVICE TMG DELIVERED TACOMA,WA NET 30 DAYS
Item Code Unit Ordered Shipped Back Order Price Amount
W3T99091 AAA1343 KIT PM 5"RATEVALVE
Whse: 000 EACH 1.00 0.00 0.00 114,10 114,10
W3T98108 APQ4389 KIT PM 3/4"STD INJECT
Whse: 000 EACH 1.00 0,00 0.00 111.88 111.88
W2T16924 P41212 ROTAMETER TOP-STOP CHLO
Whse: 000 EACH 2,00 0.00 0.00 7.90 15.80
Clean,inspect,'and regasket(2)210S vacuum regulators,(1)V10K(50 PPD),(1)S10K(50 PPD),
and(1)3/4"standard injector. Check system to verify proper operation, Replace parts as needed.
Verify chlorine detectors respond to the presence of chlorine gas. Calibrate the V 10K,
Net Order: 6,939.71
Less Discount: 0.00
Freight: 0.00
Sales Tax: 693.97
Order Total: 7,633.68
EXHIBIT B
INSURANCE REQUIREMENTS FOR
SERVICE CONTRACTS
Insurance
The Contractor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Contractor, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Automobile Liability insurance covering all owned, non-owned, hired
and leased vehicles. Coverage shall be written on Insurance Services
Office (ISO) form CA 00 01 or a substitute form providing equivalent
liability coverage. If necessary, the policy shall be endorsed to provide
contractual liability coverage.
2. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from
premises, operations, independent contractors, products-completed
operations, personal injury and advertising injury, and liability
assumed under an insured contract. The Commercial General Liability
insurance shall be endorsed to provide the Aggregate Per Project
Endorsement ISO form CG 25 03 11 85. The City shall be named as
an insured under the Contractor's Commercial General Liability
insurance policy with respect to the work performed for the City using
ISO additional insured endorsement CG 20 10 11 85 or a substitute
endorsement providing equivalent coverage.
3. Workers' Compensation coverage as required by the Industrial
Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Automobile Liability insurance with a minimum combined
single limit for bodily injury and property damage of
$1,000,000 per accident.
2. Commercial General Liability insurance shall be written with
limits no less than $1,000,000 each occurrence, $2,000,000
general aggregate and a $2,000,000 products-completed
operations aggregate limit.
EXHIBIT B (Continued )
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
insurance:
1. The Contractor's insurance coverage shall be primary insurance as respect
the City. Any Insurance, self-insurance, or insurance pool coverage
maintained by the City shall be excess of the Contractor's insurance and
shall not contribute with it.
2. The Contractor's insurance shall be endorsed to state that coverage shall
not be cancelled by either party, except after thirty (30) days prior
written notice by certified mail, return receipt requested, has been given
to the City.
3. The City of Kent shall be named as an additional insured on all policies
(except Professional Liability) as respects work performed by or on behalf
of the contractor and a copy of the endorsement naming the City as
additional insured shall be attached to the Certificate of Insurance. The
City reserves the right to receive a certified copy of all required insurance
policies. The Contractor's Commercial General Liability insurance shall
also contain a clause stating that coverage shall apply separately to each
insured against whom claim is made or suit is brought, except with
respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than ANII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Contractor before commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Contractor.
® DATE(MM/DD/YYYY)
ACbR" CERTIFICATE OF LIABILITY INSURANCE
04/11/2019
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,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Linda Doherty
NAME:
HENTSCHELL&ASSOC INC A/C No Ext: (253)272-1151 p/c,No):
(253)272-1225
1436 S.Union Ave. E-MAIL Linda Doherty@hentschell.com
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
Tacoma WA 98405-1925 INSURER A: Western National Assurance Co.
INSURED INSURER B:
TMG Services,Inc. INSURER C:
3216 E.Portland Ave. INSURER D:
INSURER E:
Tacoma WA 98404-4929 INSURER F:
COVERAGES CERTIFICATE NUMBER: 18/19GL/Umb/StpGap/Auto 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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.
I POLICY LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYY MM DD/YYYY LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTEIT___
CLAIMS-MADE �OCCUR PREMISES Ea occurrence) $ 100,000
MED EXP(Any one person) $ 15,000
A Y Y CPP112463404 12/02/2018 12/02/2019 PERSONAL&ADV INJURY $ 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY ❑ PJECT
❑LOC PRODUCTS-COMP/OPAGG $ 2,000,000
RO-
X OTHER Employee Benefits $ 1,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
Ea accident
X ANYAUTO BODILY INJURY(Per person) $
A OWNED SCHEDULED Y Y CPP112211704 12/02/2018 12/02/2019 BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
X HIRED H
NON-OWNED PROPERTYDAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
Uninsured motorist $ 1,000,000
UMBRELLA LIAB "'F"'VU W" """' 2,000,000
OCCUR EACH OCCURRENCE $
A EXCESS LAB CLAIMS-MADE Y Y UMB102042004 12/02/2018 12/02/2019 AGGREGATE $ 2,000,000
DIED I X RETENTION$ 10,000 $
WORKERS COMPENSATION I PER OTH-
STATUTE X ER WA State
AND EMPLOYERS'LIABILITY YIN 1,000,000
A ANYPROPRIMB PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A CPP112463404-STOP GAP 12/02/2018 12/02/2019 E.L.EACHACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
2019 Annual Chlorination System Maintenance. The City of Kent is undeer Blanket Primary Non-Contributory Additional Insured with Waiver of Subrogation
as required by written contract or agreement per WNGL49(07-15);WNGL39(07-15),WNGL50(07-15)and WNCA27(06-15)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
City of Kent ACCORDANCE WITH THE POLICY PROVISIONS.
220 Fourth Avenue South
AUTHORIZED REPRESENTATIVE
Kent WA 98032
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
ADDITIONAL COVERAGES
Edition Dat
Ref# Description Coverage Code Form No. e
Medical payments MEDPM
Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium
5,000
Ref# EDescription Coverage Code Form No. Edition Date
rinsured motorist combined single limit UNCSL
Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium
1,000,000
Ref# Description Coverage Code Form No. Edition Date
Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium
Ref# Description Coverage Code Form No. Edition Date
Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium
Ref# Description Coverage Code Form No. Edition Date
Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium
Ref# Description Coverage Code Form No. Edition Date
Limit 1 Limit 2 Limit 3 Deductible Amount 76eductible Type Premium
Ref# Description Coverage Code Form No. Edition Date
Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium
Ref# Description Coverage Code Form No. Edition Date
Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium
Ref# Description Coverage Code Form No. Edition Date
Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium
Ref# Description Coverage Code Form No. Edition Date
Limit 1 Limit 2 Limit 3 Deductible Amount Deductible Type Premium
Ref# Description Coverage Code Form No. Edition Date
Limit 1 Limit 2 Limit 3 7Deductible Amount Deductible Type Premium
[OFADTLCV Copyright 2001,AMS Services,Inc.
Additional Named Insureds
Other Named Insureds
Thomas & Mary Gazdik Individual, Additional Named Insured
TMG DBA Engineered Control Product, Inc. C Corporation, Additional Named Insured
OFAPPINF(02/2007) COPYRIGHT 2007,AMS SERVICES INC
POLICY NUMBER: COMMERCIAL GENERAL LIABLITY
WN GL 50 07 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - COMPLETED OPERATIONS
PRIMARY AND NONCONTRIBUTORY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Location And Description Of Completed Operations
Or Organization(s):
PER WRITTEN CONTRACT OR AGREE- AS REQUIRED BY WRITTEN
MENT WHERE YOU AGREED TO NAME CONTRACT
A PARTY OR PARTIES AS
ADDITIONAL INSURED(S)
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 B. With respect to the insurance afforded to these ad-
include as an additional insured the person(s) or ditional insureds, the following additional exclusion
organization(s) shown in the Schedule, but only applies:
with respect to liability for "bodily injury" or "prop-
erty damage" caused, in whole or in part, by This insurance does not apply to:
"your work" at the location designated and de-
scribed in the schedule of this endorsement per- 1. "Bodily injury", "property damage" or "personal
formed for that additional insured and included in and advertising injury" arising out of the render-
the"products-completed operations hazard". ing of, or the failure to render, any professional
However: architectural, engineering or surveying services,
1. The insurance afforded to such additional in-
including:
sured only applies to the extent permitted by a. The preparing, approving, or failing to pre-
law; and pare or approve, maps, shop drawings,
2. If coverage provided to the additional insured opinions, reports, surveys, field orders,
is required by a contract or agreement, the change orders or drawings and specifica-
insurance afforded to such additional insured tions; or
will not be broader than that which you are
required by the contract or agreement to pro- b, Supervisory, inspection, architectural or en-
vide for such additional insured. gineering activities.
WN GL 50 07 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2
This exclusion applies even if the claims D. The following is added to the Other Insurance
against an additional insured allege negligence Condition and supersedes any provision to the
or other wrongdoing in the supervision, hiring, contrary:
employment, training or monitoring of others
by that insured, if the `occurrence' which Primary And Noncontributory Insurance
caused the 'bodily injury' or "property dam- This insurance is primary to and will not seek
age", or the offense which caused the"person- contribution from any other insurance available
al and advertising injury", involved the render- to an additional insured under your policy pro-
ing of or failure to render any professional vided that:
services by you with respect to your providing (1) The additional insured is a Named Insured
engineering, architectural or surveying serv- under such other insurance; and
ices in your capacity as an engineer, architect
or surveyor. (2) You have agreed in writing in a contract or
C. With respect to the insurance afforded to these ad- agreement that this insurance would be pri-
ditional insureds, the following is added to Section mary and would not seek contribution from
III—Limits Of Insurance: any other insurance available to the addition-
al insured.
If coverage provided to the additional insured is re-
quired by a contract or agreement, the most we
will pay on behalf of the additional insured is:
1. The minimum amount required by the contract
or agreement; or
2. The Limits of Insurance shown in the Declara-
tions;
whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
WN GL 50 07 15 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 2 of 2
WN CA 27 06 16
BUSINESS AUTO ENHANCEMENT ENDORSEMENT
The Business Auto Enhancement Endorsement is an optional endorsement that provides coverage enhancements.
The following is a summary of broadened coverages provided by this endorsement. No coverage is provided by this
summary,refer to following endorsement for changes in your policy.
SUMMARY OF COVERAGES PAGE
Accidental Airbag Deployment Coverage 4
Auto Loan/Lease Gap Coverage 4
Blanket Additional Insured 2
Blanket Waiver of Subrogation 5
Broadened Definition of Insured includes:
• Newly Acquired Organizations for up to 180 Days 2
• Employees as Insureds 2
• Subsidiaries in Which You Own 50%or More 2
Deductible Waiver for Glass Repair 3
Employee Hired Auto 2,5
Fellow Employee Coverage 3
Hired Auto Physical Damage Coverage 4
Knowledge of Accident,Claim,Suit or Loss 5
Loss Of Use Expenses-Amended 3
Personal Effects 3
Rental Reimbursement Coverage 4
Supplementary Payments-Amended:
• Bail Bonds up to$6,000 2
• Loss of Earnings up to$500/Day 2
Transportation Expense Limits—Amended 3
Unintentional Failure to Disclose Hazards 5
WN CA 27 06 16 Includes copyrighted material of Insurance Services Office,with its permission Page 1 of 5
WN CA 27 06 16
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
BUSINESS AUTO ENHANCEMENT ENDORSEMENT
This endorsement modifies the insurance provided under the
following:BUSINESS AUTO COVERAGE FORM
With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified
by this endorsement. The SECTIONS of the Business Auto Coverage Form identified in this endorsement will be
amended as shown below.
SECTION 11 — COVERED AUTOS LIABILITY 9. Any "employee" of yours is an "insured" while
COVERAGE AMENDMENTS operating a covered"auto"hired or rented under
A.Who Is An Insured a contract or agreement in the "employee's"
name, with your permission, while performing
SECTION II — COVERED AUTOS LIABILITY duties related to the conduct of your business.
COVERAGE, A. Coverage, 1. Who Is An Insured is amended to add: B. Blanket Additional Insured
d. Any legally incorporated subsidiary of yours in SECTION II — COVERED AUTOS LIABILITY
which you own more than 50% of the voting COVERAGE, A. Coverage, 1. Who Is An Insured,
stock on the effective date of this coverage form_ paragraph c. is amended to add the following:
However, "insured" does not include any Any person or organization who is required under a
subsidiary of yours that is an "insured" under written contract or agreement between you and that
any other automobile liability policy, or would person or organization, that is signed and executed
be an "insured" under such policy but for by you before the "bodily injury" or "property
termination of such policy or the exhaustion on damage" occurs and that is in effect during the
such policy's limits of insurance. policy period, to be named as an additional insured
is an "insured" for Liability Coverage, but only for
e. Any organization which is newly acquired or damages to which this insurance applies and only to
formed by you and over which you maintain the extent that persons or organization qualifies as
majority ownership. However, coverage under an "insured" under the Who Is An Insured provision
this provision: contained in Section il.
(1)is afforded only for the first 180 days after C, Liability Coverage Extensions — Supplementary
you acquire or form the organization or until Payments
the end of the policy period, whichever
comes first; SECTION II — COVERED AUTOS LIABILITY
(2)does not apply to"bodily injury"or"property COVERAGE, A. Coverage, 2. Coverage
damage"that results from an "accident"that Extensions, a. Supplementary Payments is
occurred before you formed or acquired the amended by replacing subparagraphs (2) and (4)
organization; with the following:
(3)does not apply to any newiy acquired or (2) Up to $5,000 for cost of bail bonds (including
formed organization that is a joint venture or bonds for related traffic law violations) required
partnership;and because of an "accident" we cover. We do not
have to furnish these bonds.
(4)does not apply to an "insured" under any (4) All reasonable expenses incurred by the
other automobile liability policy, or would be "insured"at our request, including actual loss of
an "insured" under such a policy but for ter- earnings up to $500 a day because of time off
mination of such policy or the exhaustion of from work.
such policy's limits of insurance.
f. Any "employee" of yours is an "insured" while
using a covered "auto" you don't own, hire or
borrow in your business or your personal affairs.
WN CA 27 06 16 Includes copyrighted material of Insurance Services Office,with its permission Page 2 of 5
D. Fellow Employee Coverage D. Glass Repair—Deductible Waiver
SECTION II — COVERED AUTOS LIABILITY SECTION III—PHYSICAL DAMAGE COVERAGE,A.
COVERAGE, B. Exclusions, S. Fellow Employee, Coverage, 3. Glass Breakage — Hitting A Bird Or
the following is added: Animal— Falling Objects Or Missiles, is amended
Co-Employee Lawsuit Defense Cost by adding the following:
Reimbursement No deductible will apply to glass breakage if such
If a suit seeking damages for"bodily injury" to any glass is repaired, in a manner acceptable to us,
fellow"employee"of the"insured"arising out of and rather than replaced.
in the course of the fellow"employee's"employment E. Hired Auto Physical Damage
or while performing duties related to the conduct of SECTION III—PHYSICAL DAMAGE COVERAGE,A.
your business,or a suit seeking damages brought by
the spouse, child, parent, brother or sister of that Coverage is amended by adding the following:
fellow "employee", is brought against you, we will S. Hired Auto Physical Damage
reimburse reasonable costs that you incur in the if hired "autos" are covered "autos" for Liability
defense of such matters. Any reimbursement made Coverage and if Comprehensive, Specified
pursuant to this sub-section will be in addition to the Causes of Loss, or Collision coverages are pro-
limits of liability set forth In the Declarations. vided under this coverage form for any "auto"
you awn, then the Physical Damage Coverages
SECTION III — PHYSICAL DAMAGE COVERAGE provided are extended to"autos"you hire of like
AMENDMENTS kind and use,subject to the following:
A.Transportation Expense—Limits Amended a. The most we will pay for any one "loss" Is
SECTION III—PHYSICAL DAMAGE COVERAGE,A. $60,000 or the actual cash value or cost to
Coverage, 4, Coverage Extensions, a. Trans- repair or replace,whichever is less,minus a
portation Expenses is amended by replacing $20 deductible;
per dayf$600 maximum limit with$50 per dayf$1000 b. The deductible will be equal to the largest
maximum. deductible applicable to any owned "auto"
for that coverage. Any Comprehensive
B. Hired Auto Physical Damage — Loss Of Use deductible does not apply to "loss" caused
Expenses—Limits Amended by fire or lightening;
SECTION III—PHYSICAL DAMAGE COVERAGE,A. c. Hired Auto Physical Damage coverage is
Coverage, 4. Coverage Extensions, b. Loss of Use excess over any other collectible insurance;
Expenses is amended by replacing the $20 per and
dayf$600 maximum limit with $60 per dayf$750 d. Subject to the above limit, deductible and
maximum limit, excess provisions we will provide coverage
C. Personal Effects Coverage equal to the broadest coverage applicable
SECTION III—PHYSICAL DAMAGE COVERAGE,A. to any covered"auto"you own.
Coverage, 4. Coverage Extensions is amended by If a limit for Hired Auto Physical Damage is
adding the following: indicated in the Declarations, then that limit
c. Personal Effects replaces,and is not added to,the$50,000 limit
indicated above.
We will pay up to$500 for"loss"to personal
effects,which are:
(1) Owned by an"insured';and
(2) In or on your covered"auto."
This coverage applies only in the event of the total
theft of your covered "auto."No deductible applies
to this coverage
WN CA 27 0616 Includes copyrighted material of Insurance Services Office,with Its permission Page 3 of 5
F, Rental Reimbursement G.Accidental Airbag Deployment Coverage
SECTION III—PHYSICAL DAMAGE COVERAGE A. SECTION III—PHYSICAL DAMAGE COVERAGE,A.
Coverage,is amended by adding the following: Coverage is amended by adding the following:
6. Rental Reimbursement 7_Accidental Alrbag Deployment Coverage
This coverage applies only to a covered "auto" We will pay to reset or replace factory Installed
of the private passenger or light truck type as airbag(s) in any covered "auto" for accidental
follows: discharge, other than discharge due to a
a.We will pay for rental reimbursement expenses collision loss.
incurred by you for the rental of a private This coverage is applicable only if comprehen-
passenger or light truck type"auto"because sive coverage applies to the covered"auto".
of loss" to a covered private passenger or This coverage is excess over any other collecti-
light truck type "auto Payment applies in ble insurance or reimbursement by manufac-
addition to the otherwise applicable amount turer's warranty.
of each coverage you have on a covered
private passenger or light truck type H.Auto Loan/Lease Gap Coverage
"auto." No deductibles apply to this SECTION III PHYSICAL DAMAGE COVERAGE,
coverage. Item A., Coverage, is amended by adding the
b.We will pay only for those expenses incurred following:
during the policy period beginning 24 hours 8.Auto Loan/Lease Gap Coverage
after the "loss" and ending, regardless of This coverage applies only to a covered "auto"
the policy's expiration, with the lesser of described or designated in the Schedule or in
the following number of days
the Declarations as including physical damage
(1) The number of days reasonably re- coverage.
quired to repair or replace the covered
private passenger or light truck type In the event of a covered total "loss" to a
"auto". If"loss" is caused by theft,this covered "auto" described or designated in the
number of days is added to the number Schedule or in the Declarations,we will pay any
of days it takes to locate the covered unpaid amount due on the lease or loan for a
private passenger or light truck type covered"auto"less:
"auto"and return it to you;or a. The amount paid under the Physical
(2) 30 days. Damage Coverage Section on the policy;
c. Our payment is limited to the lesser of the and
following amounts: b. Any:
(1) Necessary and actual expenses (1) Overdue lease/loan payments at the
incurred,or time of the"loss";
(2) $50 per day,up to a maximum of (2) Financial penalties imposed under a
$1,000. lease for excessive use,abnormal wear
d.This coverage does not apply while there are and tear or high mileage;
spare or reserve private passenger or light (3) Security deposits not returned by the
truck type"autos"available to you for your lessor;
operations. (4) Costs for extended warranties, Credit
e. If "loss" results from the total theft of a Life Insurance, Health, Accident or
covered "auto" of the private passenger or Disability Insurance purchased with the
light truck type, we will pay under this loan or lease;and
coverage only that amount of your rental
reimbursement expenses which is not (5) Carry-over balances from previous
already provided for under SECTION 111 —
loans or leases.
PHYSICAL DAMAGE COVERAGE, A.
Coverage,4.Coverage Extensions.
For the purposes of this Rental Reimbursement
coverage,light truck is defined as a truck with a
gross vehicle weight of 10,000 lbs. or less as
defined by the manufacturer as the maximum
loaded weight the auto is designed to carry.
WN CA 27 06 16 Includes copyrighted material of Insurance Services Office,with its permission Page 4 of
C. Unintentional Failure to Disclose Hazards
SECTION IV BUSINESS AUTO CONDITIONS
AMENDMENTS SECTION IV—BUSINESS AUTO CONDITIONS, B.
General Conditions, 2. Concealment, Misrepre-
A.Duties In The Event Of Accident,Claim,Suit Or Loss sentation Or Fraud, Is amended by adding the
Amended following paragraph:
SECTION IV—BUSINESS AUTO CONDITIONS, A. If you unintentionally fail to disclose any hazards
Loss Conditions, 2. Duties In The Event Of
existing at the Inception date of the policy,or during
Accident, Claim, Suit Or Loss, a. is amended by the policy period in connection with any additional
adding the following: hazards, we will not deny coverage under this Cov-
This condition applies only when the"accident" or erage Part because of such failure.
"loss"is known to: D. Employee Hired Auto
(1) You,if you are an individual; SECTION IV— BUSINESS AUTO CONDITIONS, B.
(2)A partner,If you are a partnership; General Conditions,5. Other Insurance, paragraph
(3) An executive officer or insurance manager, if b.is deleted and replace by the following:
you are a corporation;or b. For Hired Auto Physical Damage Coverage, the
(4)A member or manager, if you are a limited following are deemed to be a covered "autos"
liability company. you own:
But, this section does not amend the provisions (1) Any covered "auto"you lease,hire,rent or
relating to notification of police, protection or borrow.
examination of the property which was subject to (2) Any covered "auto" hired or rented by
the"loss". your "employee" under a contract in that
B. Blanket Waiver of Subrogation individual "employee's" name, with your
permission, while performing duties
Section IV — BUSINESS AUTO CONDITIONS, A. related to the conduct of your business.
Loss Conditions,6.Transfer of Rights of Recovery However,any"auto"that is leased, hired, rented
following exception:Against Others Us, is amended by adding the or borrowed with a driver is not a covered"auto"
However, we waive any right of recovery we may
have against any person or organization to the
extent required of you by a written contract signed
and executed prior to any "accident" or "loss",
provided that the"accident"or"loss"arises out of
operations contemplated by such contract. The
waiver applies only to the person or organization
designated in such contract.
WN CA 27 0616 Includes copyrighted material of insurance Services Office,with Its permission Page 5 of 6
WNGL390715
COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage en-
hancements. The following is a summary of broadened coverages provided by this endorsement. No coverage is pro-
vided by this summary, refer to following endorsement for changes in your policy.
SUMMARY OF COVERAGES PAGE
Bodily Injury And Property Damage Liability
• Non Owned Watercraft Up To 50 Feet......................................................................................2
Property Damage Liability
Elevators....................................................................................................................................3
• Fire, Lightning, Explosion Or Sprinkler Leakage Exception.......................................................3
• Borrowed Equipment{$25,000 Per Occurrence,$50,000 Aggregate,
$2,500 Deductible Per Occurrence.........................................................................................3
Supplementary Payments—Amended
• Bail Bonds Up To$5,000...........................................................................................................4
• Loss of Earnings Up To$500/Day ............................................................................................4
Who Is An Insured Amendments
• Employee Bodily Injury To A Co-Employee...............................................................................4
• Newly Formed Or Acquired Organizations For Up To 180 Days...............................................4
• Blanket Additional Insured—Vendors—As Required By Contract............................................4
• Blanket Additional Insured—Lessor Of Leased Equipment......................................................6
• Blanket Additional Insured—Managers Or Lessors Of Premises..............................................6
• Blanket Additional Insured—State Or Governmental Agency Or Subdivision
Or Political Subdivision—Permits Or Authorizations..............................................................7
• Blanket Additional Insured—State Or Governmental Agency Or Subdivision
Or Political Subdivision—Permits Or Authorizations Relating To Premises...........................8
Damage To Premises Rented To You — $300,000...............................................................................9
Medical Payments Increased Limit — $10,000 Or Amount Shown on Declarations.............................9
Conditions
• Knowledge of Occurrence, Offense, Claim Or Suit Amended...................................................9
• Unintentional Failure To Disclose Hazards................................................................................9
• Waiver of Subrogation..............................................................................................................10
Insured Contract Amended...................................................................................................................10
Personal And Advertising Injury Redefined
• Televised,Videotaped Or Electronic Publication.....................................................................10
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office.Inc.,with its permission. Page 1 of 10
WNGL390715
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
This endorsement modifies the insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified
by this endorsement. The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement
will be amended as shown below.
SECTION I—COVERAGES AMENDMENTS (4) Liability assumed under any "insured con-
COVERAGE A — BODILY INJURY AND PROPERTY tract"for the ownership, maintenance or use
DAMAGE LIABILITY of aircraft or watercraft; or
(5) "Bodily injury" or "property damage" arising
A. Non Owned Aircraft Or Watercraft out of:
Item 2. Exclusions, Paragraph g. is replaced by the (a) The operation of machinery or equip-
following: ment that is attached to, or part of, a
g. Aircraft,Auto Or Watercraft land vehicle that would qualify under the
"Bodily injury" or "property damage" arising out definition of"mobile equipment" if it were
of the ownership, maintenance, use or entrust- not subject to a compulsory or financial
ment to others of any aircraft, "auto" or water- responsibility law or other motor vehicle
craft owned or operated by or rented or loaned insurance law where it is licensed or
to any insured. Use includes operation and principally garaged;or
"loading or unloading". (b) The operation of any of the machinery
This exclusion applies even if the claims against or equipment listed in Paragraph f. (2)
any insured allege negligence or other wrong- or f. (3) of the definition of "mobile
doing in the supervision, hiring, employment, equipment".
training or monitoring of others by that insured, if B. Damage To Property Coverage Extensions
the"occurrence"which caused the"bodily injury" Item 2. Exclusions, Paragraph j. is replaced by the
or "property damage" involved in the ownership, following:
maintenance, use or entrustment to others of
any aircraft, "auto" or watercraft that is owned or j. Damage To Property
operated by or rented or loaned to any insured. "Property damage"to:
This exclusion does not apply to: (1) Property you own, rent, or occupy, including
(1) A watercraft while ashore on premises you any costs or expenses incurred by you, or
own or rent; any other person, organization or entity, for
(2) A watercraft you do not own that is: repair, replacement, enhancement, restora-
tion or maintenance of such property for any
(a) Less than 50 feet long; and reason, including prevention of injury to a
(b) Not being used to carry persons or prop- person or damage to another's property;
erty for a charge; (2) Premises you sell, give away or abandon, if
This Subparagraph (2) applies to any per- the"property damage" arises out of any part
son, who with your expressed or implied of those premises;
consent, either uses or is responsible for the (3) Property loaned to you;
use of the watercraft;
3 Parkin an"auto" on, or on the was next to, (4) Personal property in the care, custody or
( ) g Y control of the insured;
premises you own or rent, provided the
"auto" is not owned by or rented or loaned to
you or the insured;
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 2 of 10
(5) That particular part of real property on which Paragraph (6) of this exclusion does not apply to
you or any contractors or subcontractors "property damage" included in the "products-com-
working directly or indirectly on your behalf pleted operations hazard".
are performing operations, if the "property The insurance provided for "property damage" from
damage"arises out of those operations; or the use of elevators and for "property damage" to
(6) That particular part of any property that must borrowed equipment is excess over any other valid
be restored, repaired or replaced because and collectible property insurance (including any de-
"your work"was incorrectly performed on it, ductible portion thereof) available to the insured
Paragraphs (1), (3) and (4) of this exclusion do not whether primary, excess, contingent or on any other
apply to "property damage" (other than damage by basis.
fire, lightning, explosion or sprinkler leakage) to C. Damage To Premises Rented To You
premises, including the contents of such premises, Item 2. Exclusions, the last paragraph is replaced
rented to you for a period of seven or fewer by the following:
consecutive days. A separate limit of insurance
applies to Damage To Premises Rented To You as Exclusions c. through n. do not apply to damage by
described in SECTION III — LIMITS OF fire, lightning, explosion or sprinkler leakage to
INSURANCE. However, the provisions of this premises while rented to you or temporarily occupied
paragraph do not apply if coverage for Damage To by you with permission of the owner. A separate
Premises Rented To You is excluded by en- limit of insurance applies to this coverage as de-
dorsement. scribed in Paragraph 6.of SECTION III—LIMITS OF
Paragraph (2) of this exclusion does not apply if the INSURANCE.
premises are "your work" and were never occupied, COVERAGE B — PERSONAL AND ADVERTISING
rented or held for rental by you. INJURY LIABILITY
Paragraphs (3) and (4) of this exclusion do not apply
to the use of elevators. D. Personal And Advertising Injury
Paragraphs (3), (4), (5) and (6) of this exclusion do Item 2. Exclusions is amended by replacing Sub-
paragraphs b.and c.with the following:
not apply to liability assumed under a sidetrack
agreement. b. Material Published With Knowledge Of
Paragraph (4) of this exclusion does not apply to Falsity
"property damage" to borrowed equipment while not "Personal and advertising injury" arising out of
being used to perform operations at the jobsite. oral, written, televised, videotaped or electronic
Subject to Paragraph 2. of SECTION III — LIMITS publication, in any manner, of material, if done
OF INSURANCE, the rules below fix the most we by or at the direction of the insured with
will pay for"property damage"under this provision: knowledge of its falsity.
(1) $25,000 any one "occurrence", regardless of the c. Material Published Prior To Policy Period
number of persons or organizations who sustain "Personal and advertising injury" arising out of
damages because of that`occurrence"; oral, written, televised, videotaped or electronic
publication, in any manner, of material whose
(2) $50,000 annual aggregate; and first publication took place before the beginning
(3) We will pay only for damages in excess of of the policy period.
$2,500 as a result of any one 'occurrence", re-
gardless of the number of persons or organiza-
tions who sustain damages because of that "oc-
currence". We may, or if required by law, pay all
or any part of any deductible amount, if applica-
ble, to effect settlement of any claim or "suit".
Upon notice of our payment of a deductible
amount, you shall promptly reimburse us for the
part of the deductible amount we paid.
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 3 of 10
SUPPLEMENTARY PAYMENTS—COVERAGES A The following are added:
AND B C. Blanket Additional Insured — Vendors — As Re-
E. Supplementary Payments—Coverages A and B quired By Contract
Item 1. is amended by replacing Subparagraphs b. 1. Section II —Who Is An Insured is amended to
and d.with the following: include as an additional insured any person(s)or
b. Up to $5,000 for cost of bail bonds required be- organization(s) (referred to throughout this
cause of accidents or traffic law violations aris- endorsement as vendor) with whom you have
ing out of the use of any vehicle to which the agreed in a written contract, executed prior to
Bodily Injury Liability Coverage applies. We do loss, to name as an additional insured, but only
not have to furnish these bonds. with respect to "bodily injury or 'property
damage"arising out of"your products which are
d. All reasonable expenses incurred by the insured distributed or sold in the regular course of the
at our request to assist us in the investigation or vendor's business.
defense of the claim or "suit", including actual However,
loss of earnings up to $500 a day because of
time off from work. a. The insurance afforded to such vendor only
applies to the extent permitted by law; and
b. If coverage provided to the vendor is
SECTION 11—WHO IS AN INSURED AMENDMENTS required by a contract or agreement, the
A. Employee Bodily Injury To A Co-Employee insurance afforded to such vendor will notbe broader than that which you are required
Paragraph 2.a.(1) is replaced by the following: by the contract or agreement to provide for
(1) "Bodily injury" or "personal and advertising such vendor.
injury": 2. With respect to the insurance afforded to these
(a) To you, to your partners or members (if you vendors, the following additional exclusions
are a partnership or joint venture), to your apply:
members (if you are a limited liability com- a. The insurance afforded the vendor does not
pany), or to your other "volunteer workers" apply to:
while performing duties related to the con- (1) "Bodily injury" or "property damage" for
duct of your business; which the vendor is obligated to pay
(b) For which there is any obligation to share damages by reason of the assumption
damages with or repay someone else who of liability in a contract or agreement.
must pay damages because of the injury This exclusion does not apply to liability
described in Paragraph (1)(a)above;or for damages that the vendor would have
(c) Arising out of his or her providing or failing to in the absence of the contract or
provide professional health care services. agreement;
B. Newly Acquired Organizations (2) Any express warranty unauthorized by
Paragraph 3.a. is replaced by the following: you;
a. Coverage under this provision is afforded only (3) Any physical or chemical change in the
product made intentionally by the
until the 180 day after you acquire or form the vendor;
organization or the end of the policy period,
whichever is earlier; (4) Repackaging, except when unpacked
solely for the purpose of inspection,
demonstration, testing, or the
substitution of parts under instructions
from the manufacturer, and then
repackaged in the original container;
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 4 of 10
(5) Any failure to make such inspections, 4. With respect to the insurance afforded to these
adjustments, tests or servicing as the vendors, the following is added to Section III —
vendor has agreed to make or normally Limits Of Insurance:
undertakes to make in the usual course
of business, in connection with the If coverage provided to the vendor is required by
distribution sale of the products; a contract or agreement, the most we will pay on
behalf of the vendor is:
(6) Demonstration, installation, servicing or
repair operations, except such a. The minimum amount required by the
operations performed at the vendor's contract or agreement;or
premises in connection with the sale of b. The Limits of Insurance shown in the
the product; Declarations;
(7) Products which, after distribution or sale whichever is less.
by you, have been labeled or relabeled
or used as a container, part or This endorsement shall not increase the
ingredient of any other thing or applicable Limits of Insurance shown in the
substance by or for the vendor;or Declarations.
(8) "Bodily injury or "property damage" 5. With respect to the insurance afforded to these
arising out of the sole negligence of the additional insureds, the following additional
vendor for its own acts or omissions or exclusion applies:
those of its employees or anyone else This insurance does not apply to:
acting on its behalf. However, this
exclusion does not apply to: a. "Bodily injury", "property damage" or
(i) The exceptions contained in "personal and advertising injury" arising out
Subparagraphs(4)or(6); or of the rendering of, or the failure to render,
any professional architectural, engineering
(ii) Such inspections, adjustments,tests or surveying services, including:
or servicing as the vendor has 1 The re a or failingto
agreed to make or normally ( ) preparing,g' approving,
undertakes to make in the usual prepare or approve, maps, shop
course of business, in connection drawings, opinions, reports, surveys,
with the distribution or sale of the field orders, change orders or drawings
products. and specifications; or
3. This Provision C.does not apply: (2) Supervisory, inspection, architectural or
pp y: engineering activities.
a. To any insured person or organization from This exclusion applies even if the claims
whom you have acquired such products, or against an additional insured allege
any ingredient, part or container, entering negligence or other wrongdoing in the
into, accompanying or containing such
products; supervision, hiring, employment, training
or monitoring of others by that insured, if
b. To any vendor for which coverage as an the "occurrence" which caused the
additional insured specifically is scheduled "bodily injury" or "property damage", or
by endorsement; or the offense which caused the "personal
c. When liability included within the "products- and advertising injury", involved the
completed operations hazard" has been ex- rendering of or failure to render any
cluded for such product either by the provi- professional services by you with
sions of the coverage part or by endorse- respect to your providing engineering,
ment. architectural or surveying services in
your capacity as an engineer, architect
or surveyor.
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 5 of 10
D. Blanket Additional Insured — Lessor Of Leased 4. With respect to the insurance afforded to these
Equipment additional insureds, the following additional
1. Section If —Who Is An Insured is amended to exclusion applies:
include as an additional insured any person(s)or This insurance does not apply to:
organization(s)from whom you lease equipment a. "Bodily injury", "property damage" or
when you and such person(s) or organization(s) "personal and advertising injury" arising out
have agreed in writing in a contract or of the rendering of, or the failure to render,
agreement, executed prior to loss, that such any professional architectural, engineering
person(s) or organization(s) be added as an or surveying services, including:
additional insured on your policy. Such (1) The preparing, approving, or failing to
person(s) or organization(s) is an insured only prepare or approve, maps, shop
with respect to liability for "bodily injury", drawings, opinions, reports, surveys,
"property damage" or "personal and advertising
injury" caused, in whole or in part, by your field orders, change orders or drawings
maintenance, operation or use of equipment and specifications;or
leased to you by such person(s) or (2) Supervisory, inspection, architectural or
organization(s). engineering activities.
However, the insurance afforded to such This exclusion applies even if the claims
additional insured: against an additional insured allege
a. Only applies to the extent permitted by law; negligence or other wrongdoing in the
and supervision, hiring, employment, training or
monitoring of others by that insured, if the
b. Will not be broader than that which you are "occurrence" which caused the "bodily
required by the contract or agreement to injury" or "property damage", or the offense
provide for such additional insured. which caused the "personal and advertising
A person's or organization's status as an addi- injury", involved the rendering of or failure to
tional insured under this endorsement ends render any professional services by you with
when their contract or agreement with you for respect to your providing engineering,
such leased equipment ends. architectural or surveying services in your
2. With respect to the insurance afforded to these capacity as an engineer, architect or
additional insureds, this insurance does not ap- surveyor.
ply to any "occurrence" which takes place after E. Blanket Additional Insured — Managers Or Les-
the equipment lease expires. sors Of Premises
3. With respect to the insurance afforded to these 1. Section 11 —Who Is An Insured is amended to
additional insureds, the following is added to include as an additional insured any person(s)or
Section III—Limits Of Insurance: organization(s)with whom you have agreed in a
If coverage provided to the additional insured is written contract, executed prior to loss, to name
required by a contract or agreement, the most as an additional insured, but only with respect to
we will pay on behalf of the additional insured is: liability arising out of the ownership,
a. The minimum amount required by the maintenance or use of that part of the premises
contract or agreement; or leased to you, subject to the following additional
b. The Limits of Insurance shown in the
exclusions:
Declarations; This insurance does not apply to:
whichever is less. a. Any "occurrence" which takes place after
This endorsement shall not increase the you cease to be a tenant in that premises.
applicable Limits of Insurance shown in the b. Structural alterations, new construction or
Declarations. demolition operations performed by or on
behalf of such additional insured.
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office, Inc.,with its permission. Page 6 of 10
However: F. Blanket Additional Insured — State Or
a. The insurance afforded to such additional Governmental Agency Or Subdivision Or Politi-
insured only applies to the extent permitted cal Subdivision—Permits Or Authorizations
by law; and Section It —Who Is An Insured is amended to in-
b. If coverage provided to the additional clude as an additional insured any state or
insured is required by a contract or governmental agency or subdivision or political
agreement, the insurance afforded to such subdivision with whom you have agreed in a written
additional insured will not be broader than contract, executed prior to loss, to name as an
that which you are required by the contract additional insured, subject to the following
or agreement to provide for such additional provisions:
insured. 1. This insurance applies only with respect to op-
t. With respect to the insurance afforded to these erations performed by you or on your behalf for
additional insureds, the following is added to which the state or governmental agency or sub-
Section III—Limits Of Insurance: division or political subdivision has issued a
If coverage provided to the additional insured is permit or authorization.
required by a contract or agreement, the most However:
we will pay on behalf of the additional insured is: a. The insurance afforded to such additional
a. The minimum amount required by the insured only applies to the extent permitted
contract or agreement;or by law; and
b. The Limits of Insurance shown in the b. If coverage provided to the additional
Declarations; insured is required by a contract or
whichever is less. agreement, the insurance afforded to such
additional insured will not be broader than
This endorsement shall not increase the that which you are required by the contract
applicable Limits of Insurance shown in the or agreement to provide for such additional
Declarations. insured.
3. With respect to the insurance afforded to these 2. This insurance does not apply to:
additional insureds, the following additional a. "Bodily injury", "property damage" or "per-
exclusion applies: sonal and advertising injury" arising out of
This insurance does not apply to: operations performed for the federal govern-
a. "Bodily injury", "property damage" or ment, state or municipality; or
"personal and advertising injury" arising out b. `Bodily injury" or "property damage" in-
of the rendering of, or the failure to render, cluded within the "products-completed op-
any professional architectural, engineering erations hazard".
or surveying services, including: 3. With respect to the insurance afforded to these
(1) The preparing, approving, or failing to additional insureds, the following is added to
prepare or approve, maps, shop Section III—Limits Of Insurance:
drawings, opinions, reports, surveys, If coverage provided to the additional insured is
field orders, change orders or drawings required by a contract or agreement, the most
and specifications;or we will pay on behalf of the additional insured is:
(2) Supervisory, inspection, architectural or
engineering activities. a. The minimum amount required by the
contractor agreement; or
This exclusion applies even if the claims b. The Limits of Insurance shown in the
against an additional insured allege
negligence or other wrongdoing in the Declarations;
supervision, hiring, employment, training or whichever is less.
monitoring of others by that insured, if the This endorsement shall not increase the
"occurrence' which caused the "bodily applicable Limits of Insurance shown in the
injury" or "property damage', or the offense Declarations.
which caused the "personal and advertising
injury", involved the rendering of or failure to
render any professional services by you with
respect to your providing engineering,
architectural or surveying services in your
capacity as an engineer, architect or
surveyor.
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 7 of 10
4. With respect to the insurance afforded to these b. The construction, erection or removal of
additional insureds, the following additional elevators; or
exclusion applies: c. The ownership, maintenance or use of any
This insurance does not apply to: elevators covered by this insurance.
a. 'Bodily injury", "property damage' or However,
"personal and advertising injury" arising out a. The insurance afforded to such additional
of the rendering of, or the failure to render, insured only applies to the extent permitted
any professional architectural, engineering by law; and
or surveying services, including: b. If coverage provided to the additional
(1) The preparing, approving, or failing to insured is required by a contract or
prepare or approve, maps, shop agreement, the insurance afforded to such
drawings, opinions, reports, surveys, additional insured will not be broader than
field orders, change orders or drawings that which you are required by the contract
and specifications; or or agreement to provide for such additional
(2) Supervisory, inspection, architectural or insured.
engineering activities. 2. With respect to the insurance afforded to these
This exclusion applies even if the claims additional insureds, the following is added to
against an additional insured allege Section III—Limits Of Insurance:
negligence or other wrongdoing in the If coverage provided to the additional insured is
supervision, hiring, employment, training or required by a contract or agreement, the most
monitoring of others by that insured, if the we will pay on behalf of the additional insured is:
"occurrence" which caused the "bodily
injury" or "property damage", or the offense a. The minimum amount required by the
which caused the "personal and advertising contract or agreement; or
injury", involved the rendering of or failure to b. The Limits of Insurance shown in the
render any professional services by you with Declarations;
respect to your providing engineering,
architectural or surveying services in your whichever is less.
capacity as an engineer, architect or This endorsement shall not increase the
surveyor. applicable Limits of Insurance shown in the
Declarations.
G. Blanket Additional Insured — State Or 3. With respect to the insurance afforded to these
Governmental Agency Or Subdivision Or Politi- additional insureds, the following additional
cal Subdivision — Permits Or Authorizations Re- exclusion applies:
lating To Premises This insurance does not apply to:
Section II —Who Is An Insured is amended to in- a. 'Bodily injury", "property damage' or
clude as an additional insured any state or "personal and advertising injury" arising out
governmental agency or subdivision or political of the rendering of, or the failure to render,
subdivision with whom you have agreed in a written any professional architectural, engineering
contract, executed prior to loss, to name as an or surveying services, including:
additional insured, subject to the following provision: (1) The preparing, approving, or failing to
1. This insurance applies only with respect to the prepare or approve, maps, shop
following hazards for which the state or drawings, opinions, reports, surveys,
governmental agency or subdivision or political field orders, change orders or drawings
subdivision has issued a permit or authorization and specifications; or
in connection with premises you own, rent or (2) Supervisory, inspection, architectural or
control and to which this insurance applies: engineering activities.
a. The existence, maintenance, repair,
construction, erection or removal of
advertising signs, awnings, canopies, cellar
entrances, coal holes, driveways, manholes,
marquees, hoist away openings, sidewalk
vaults, street banners or decorations and
similar exposures; or
WN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 8 of 10
This exclusion applies even if the claims
against an additional insured allege SECTION IV — COMMERCIAL GENERAL LIABILITY
negligence or other wrongdoing in the CONDITIONS AMENDMENTS
supervision, hiring, employment, training or A. Knowledge Of Occurrence
monitoring of others by that insured, if the
"occurrence" which caused the "bodily Item 2. Duties In The Event Of Occurrence, Of-
injury" or "property damage", or the offense fense, Claim or Suit is amended by adding the fol-
which caused the "personal and advertising lowing:
injury", involved the rendering of or failure to e. You must give us or our authorized representa-
render any professional services by you with tive prompt notice of an "occurrence", claim or
respect to your providing engineering, loss only when the "occurrence", claim or loss is
architectural or surveying services in your known to:
capacity as an engineer, architect or
surveyor. (1) You, if you are an individual;
(2) A partner, if you are a partnership;
SECTION III — LIMITS OF INSURANCE AMEND- (3) An executive officer or insurance manager, if
MENTS you are a corporation; or
A. Damage To Premises Rented To You (4) A member or manager, if you are a limited
Paragraph 6. is replaced by the following: liability company.
6. Subject to Paragraph 5. above, the most we will B. Other Insurance
pay under Coverage A for damages because of Item 4. Other Insurance, b. Excess Insurance (1)
"property damage" to any one premises, while (a)(ii) is replaced by the following:
rented to you, or in the case of damage by fire, (ii) That is fire, lightning, explosion or sprinkler leak-
lightning, explosion or sprinkler leakage, while age insurance for premises rented to you or
rented to you or temporarily occupied by you temporarily occupied by you with permission of
with permission of the owner is the greater of: the owner;
a. $300,000; or C. Unintentional Failure To Disclose Hazards
b. The amount shown next to the Damage To Item 6. Representations is replaced by the
Premises Rented To You Limit in the Decla- following:
rations. 6. Representations And Unintentional Failure
However, the provisions of this paragraph do not To Disclose Hazards
apply if Damage To Premises Rented To You a. By accepting this policy, you agree:
Coverage is excluded by endorsement. (1) The statements in the Declarations are
B. Medical Expense Limit accurate and complete;
Paragraph 7. is replaced with the following: (2) Those statements are based upon
7. Subject to Paragraph 5. above, the most we will representations you made to us; and
pay under Coverage C for all medical expenses (3) We have issued this policy in reliance
because of "bodily injury" sustained by any one upon your representations.
person is the greater of: b. If you unintentionally fail to disclose any haz-
a. S10,000; or ards existing at the inception date of your
policy, we will not deny coverage under this
b. The amount shown next to the Medical Ex- Coverage Part because of such failure.
pense Limit in the Declarations. However, this provision does not affect our
This insurance does not apply if coverage for right to collect additional premium or exer-
Medical Expenses is excluded either by the pro- cise our right of cancellation or non-renewal.
visions of the coverage part or by endorsement.
WIN GL 39 07 15 Includes copyrighted material of the Insurance Service Office,Inc.,with its permission. Page 9 of 10
D. Waiver of Subrogation SECTION V—DEFINITIONS AMENDMENTS
Item B. Transfer of Rights of Recovery Against A. Insured Contract Amended
Others to Us is hereby amended by the addition of Paragraph 9.a.is replaced by the following:
the following:
We waive any right of recovery we may have be- a. A contract for a lease of premises. However,
cause of payments we make for injury or damage that portion of the contract for a lease of prem-
arising out of your ongoing operations or"your work" ises that indemnifies any person or organization
done under a written contract, executed prior to loss, for damage by fire, lightning, explosion or sprin-
requiring such waiver with that person or organiza- kler leakage to premises while rented to you or
tion and included in the "products-completed opera- temporarily occupied by you with permission of
tions hazard". However, our rights may only be the owner is not an"insured contract";
waived prior to the "occurrence" giving rise to the B. Personal And Advertising Injury Redefined
injury or damage for which we make payment under Paragraph 14. d. and e. are replaced by the follow-
this Coverage Part. The insured must do nothing ing:
after a loss to impair our rights. At our request, the
insured will bring "suit"or transfer those rights to us d. Oral, written, televised, videotaped or electronic
and help us enforce those rights. publication of material that slanders or libels a
person or organization or disparages a person's
or organization's goods, products or service;
e. Oral, written, televised, videotaped or electronic
publication of material that violates a person's
right of privacy;
WN GL 39 07 15 Includes copyrighted material of the Insurance service Office, Inc.,with its permission. Page 10 of 10
COMMERCIAL GENERAL LIABILITY
WN GL 49 07 15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - AUTOMATIC STATUS WHEN
REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU
PRIMARY AND NONCONTRIBUTORY
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these
include as an additional insured any person or or- additional insureds, the following additional exclu-
ganization for whom you are performing opera- sion applies:
tions when you and such person or organization This insurance does not apply to:
have agreed in writing in a contract or agreement 1. "Bodily injury", "property damage"or"personal
that such person or organization be added as an and advertising injury" arising out of the ren-
additional insured on your policy. Such person or dering of, or the failure to render, any profes-
organization is an additional insured only with re- sional architectural, engineering or surveying
spect to liability for "bodily injury", "property dam- services, including:
age" or "personal and advertising injury" caused, a. The preparing, approving, or failing to pre-
in whole or in part, by: pare or approve, maps, shop drawings,
1. Your acts or omissions; or opinions, reports, surveys, field orders,
2. The acts or omissions of those acting on your change orders or drawings and specifica-
behalf; tions; or
in the performance of your ongoing operations for b. Supervisory, inspection, architectural or
the additional insured. engineering activities.
A person's or organization's status as an additional This exclusion applies even if the claims
insured under this endorsement ends when your against an additional insured allege negli-
operations for that additional insured are complet- gence or other wrongdoing in the supervision,
ed. hiring, employment, training or monitoring of
However: others by that insured, if the "occurrence"
1. The insurance afforded to such additional in- which caused the "bodily injury" or "property
sured only applies to the extent permitted by damage', or the offense which caused the
law; and "personal and advertising injury", involved the
rendering of or failure to render any profes-
2. If coverage provided to the additional insured sional services by you with respect to your
is required by a contract or agreement, the in- providing engineering, architectural or survey-
surance afforded to such additional insured ing services in your capacity as an engineer,
will not be broader than that which you are re- architect or surveyor.
quired by the contract or agreement to provide
for such additional insured.
WN GL 49 07 15 Page 1 of 2
Includes copyrighted material of Insurance Services Office,Inc.,with its permission.
2. 'Bodily injury" or "property damage" occurring D. The following is added to the Other Insurance
after: Condition and supersedes any provision to the
a. All work, including materials, parts or contrary:
equipment furnished in connection with Primary And Noncontributory Insurance
such work, on the project (other than ser- This insurance is primary to and will not seek
vice, maintenance or repairs) to be per- any contribution from any other insurance
formed by or on behalf of the additional in- available to an additional insured under your
sured(s) at the location of the covered
operations has been completed;or policy provided that:
(1) The additional insured is a Named Insured
b. That portion of "your work" out of which
under such other insurance;and
the injury or damage arises has been put
to its intended use by any person or or- (2) You have agreed in writing in a contract or
ganization other than another contractor or agreement that this insurance would be
subcontractor engaged in performing op- primary and would not seek contribution
erations for a principal as a part of the from any other insurance available to the
same project. additional insured.
C. With respect to the insurance afforded to these
additional insureds, the following is added to Sec-
tion III—Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is:
1. The minimum amount required by the contract
or agreement; or
2. The Limits of Insurance shown in the Declara-
tions;
whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
WN GL 49 07 15 Page 2 of 2
Includes copyrighted material of Insurance Services Office,Inc.,with its permission.