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HomeMy WebLinkAboutCAG2019-070 - Amendment - L & S Tire Company - 2019 Recycling Events - 06/27/2019 Agreement Routing Form KENT For Approvals, Signatures and Records Management WASHINGTON This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms. (Print on pink or cherry colored paper) Originator: Nancy Y. for Tony Donati Department: Public Works Date Sent: 7/1/19 Date Required: 7/3/19 �o Authorized Director or Designee Date of 3. 0 N/A Ck. to Sign: Council C Mayor Approval: Budget 47005245,64190.7910 Grant? � Yes No Account Number: Type: N/A Vendor or Name: L&S Tire Company Cate 9 Y: Contract = Vendor 1985842 Sub-Category Amendment 0 Number: o Project E Name: 2019 Recycling Events 0 Project Derails: c Add additional $1,800 in anticipation of tires to be collected at fall event. Go E Agreement N/A Basis for 0 Amount: Selection of Other y Contractor: at Q Start Date: 6/27/19 Termination Date: 1 1/1/19 Notice required prior to disclosure? Yes No Contract Number: ❑ CIHC11`�— 01 Q Date Received by City Attorney: Comments: o+ c 3 0 cc N 41 L 3 C Date Routed to the Mayor's Office: 'vt y Date Routed to the City Clerk's Office: a a, cc Date Sent to Originator: Visit Documents.KentWA.gov to obtain copies of all agreements adccW22373_6_1 9 • KENT W A S H I N G T O N AMENDMENT NO. 1 NAME OF CONSULTANT OR VENDOR: L&S Tire Company CONTRACT NAME & PROJECT NUMBER: 2019 Recycling Events ORIGINAL AGREEMENT DATE: 2/13/19 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled 'Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: Due to the amount of tires received at the March Recycling Event, an amendment is necessary for an additional $1,800 in anticipation of the tires to be collected at the October event. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are modified as follows: Original Contract Sum, $3,000 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $3,000 including all previous amendments Current Amendment Sum $1,800 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $4,800 AMENDMENT - 1 OF 2 Original Time for Completion 11/1/19 (insert date) Revised Time for Completion under n/a prior Amendments (insert date) Add'l Days Required (f) for this 0 calendar days Amendment Revised Time for Completion 1.1/1/19 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VENDOR: CITY OF KENT: —� (sig»ature} (signature) Print Name:S+Cf - ri in; lti�(. _-Jd.Ct�I�S Print Name: Michael Mactutis P.E. Its__ fyicrcc�L�j�r ( le Its Environmental Engineering Manager tit DATE:_ -?� 1 fij DATE: �(til ATTEST: APPROVED AS TO FORM: (applicable if Mayor's signature required) t Kent City Clerk Kent Law Department LSS-Recycling Events Am0 I/Donatl AMENDMENT - 2 OF 2 EXHIBIT A THRE COME"JIS.NY Spokane,Washington Tacoma,Washington June 19, 2019 Tony Donati City of Kent 400 West Gowe St Kent,WA 98032 Dear Tony Due to the amount of tires received in the March Recycling Event and the anticipated quantity we expect to receive at the October Event,we are requesting the contract amount be increased and not to exceed$4,800.00. per the city's request,only passenger tires($6.00 with rims and$2.25 without rims) will be accepted. Sincerely, SteffenY Wallac Jacobs Office Manager 8119 North Regal Street Phone: 5o9A64.0976 9215—3"Avenue SW Phone: 253.682.5556 Spokane,WA 99217 Fax: 509,466.7667 Lakewood,WA 99499 Fax: 253.588.0809 L&STIRE-01 SGEUIN A� CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDtYY1Y) 0 210 5/2 01 9 ::THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES GLOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must 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 CNRPAJ CT Susan GeUln Spokane Office PHONE FAX PayneWest Insurance Inc. (A/C,No,Ext): arc,No); 501 N.Riverpoint Blvd.,Ste 403 Ep AIL s,sgeuln@paynewest.com Spokane,WA 99202 INSURERS AFFORDING COVERAGE NAIC 9 INSURER A:Western National Assurance Company 24465 INSURED INSURERB;Pioneer Specialty Insurance Company 40312 L&S Tire Company INSURERC: 8119 N.Regal,Bldg 5 INSURERD: Spokane,WA 99217 INSURER E; --]INSURER F COVERAGES GERTIFtCATE NU BER REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP POLICY NUMBER LIMITS A X COMMERCtAL GENERAL LIABILITY 1,000 000 EACH OCCURRENCE $ , CLAIMS�MADE a OCCUR X CPP0013699 12/08/2018 12/08/2019 DA6IAGETLSEaO eENTED $ 100,000 ME EXP An one rson 6,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE 2,000,000 X POLICY❑JECT LOC PRODUCTS•COMPlOP AGG S 2,000,000 OTHER: EMPLOYERS LIABI $ 1,000,000 WTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 d. ANY AUTO CPP1063215 09101/2018 09/01/2019 BODILY INJURY Per rson $ A TU OS ONLY X ED AU OSULEO A�RREED pN pyyNEp BODILY INJURY Per accident S X AUTOS ONLY X AUTOS ONLYOPERTYM AMAGE UMBRELLA LIAB OCCUR aacridd EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY PER OTH- ANY PROPRIETORIPARTNERIEXECUTIVE Ya OFFICUOMMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (Mandatory to NH) If yes,describe under E.L.DISEASE-EA EMPLOYE $ DESCRIPTION OF OPERATIONS balcrOY E.L.DISEASE-POLICY LIMIT D ESCRIPTION OF OPERATIONS/LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Holdr is named as Additional insured as required by contract,per forms attached, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 400 West Gowe St ACCORDANCE WITH THE POLICY PROVISIONS, Kent,WA 98032 AUTHORIZED (JREPRESENTATIVE ACORD 26(2016103) ©1988-2016 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks of ACORD Western National Assurance Company Policy Number: CPP 0013699 16 9706 4th Avenue NE, Ste 200 RENEWAL DECLARATION ,Seattle, WA 98115-2162 Named Insured: www.wnins.com L & S TIRE COMPANY FORMS AND ENDORSEMENTS SCHEDULE I Coverage Line Farm Number Ed, Date Description Commercial Fire IL0123 (11/13) WA Changes - Defense Costs Commercial Fire IL0146 (08/10) WA Common Policy Conditions Commercial Fire IL0157 (07/02) WA Changes Actual Cash value Commercial Fire IL0935 (07/02) Excl of Certain Computer Relat Commercial Fire IL0952 (01/15) Cap on_ Losses from CAT Commercial Fire ILD983 (01/08) WA Amendment of Terrorism Excl Commercial Fire CP0010 (10/12) Bldg and Pere Prop Cvg Form Commercial Fire CP0030 (10/12) Business Income Cvg Form (&RE) 4-1 Gir 41ca1 foi re CPvvnn (0 /68) Commercial Property Conditions Commercial Fire CP0126 (10/12) WA Changes Commercial Fire CP0140 (07/06) Excl Loss due to virus or Bact Commercial Fire CP0160 (12/98) WA Chgs-Domestic Abuse Commercial Fire CP0179 (10/12) WA Changes-Excl Cadges of Lose I Commercial Fire CP1030 (10/12) Cause of Loss - Special Form Commercial Fire CP1220 (10/12) Loss Payable Provisions - WA Commercial Fire WNCP01 (12/14) Property Enhancement Endt ^0"'•,""•c___2l ''arc 'r'NCPDc (10j i6) b(Talipiient breakdown Coverage I Commercial Fire WNCP10 (10/16) Equipment Breakdown Schedule 1!I Commercial Fire WNCP15 (10/16) WA Amendatory Endorsement Commercial Fire WNCP16 (07/07) Equip Breakdown-Other Cond General Liability IL0123 (11/13) WA Changes - Defense Costs General Liability IL0146 (08/10) WA Common Policy Conditions General Liability IL0198 (09/08) Nuclear Energy Liab Excl Endt General Liability CG0001 (04/13) Comml Gen Liab Coverage Form a General Liability CGO197 (12/07) WA, Chgs-Empl-Related Practices General Liability CG0435 (12/07) Employee Benefits Liab Co M General Liability CG0442 (11/03) Stop Gap-Employers Liab-WA General Liability 000450 (05/08) WA Changes - Who Is An Insured General Liability CG2106 (05/14) Excl-Access or Disclosure General Liability CG2109 (06/15) Exclusion-Unmanned Aircraft General Liability CG2116 (04/13) Excl-Designated Prof Service General Liability CG2149 (09/99) Total Pollution Excl Endorse General Liability CG2160 (09/98) Excl-Yr 2000 Computer Rel & Ot General Liability CG2171 (01/15) Excl Oth Acts Terr Outside US General Liability CG2176 (01/15) Excl Punitive Damages General Liability CG2186 (12/04) Excl-Exterior Insul & Fin Sys General Liability CG2426 (04/13) Amendment of Ins. Contract Def General Liability CG2677 (12/04) WA-Fungi or Bacteria Exclusion General Liability WNGL02 (07/10) Punitive Damages Exclusion General Liability WNGL10 (01/04) Excl-Lead Liability Endt General Liability WNGL15 (12/16) Exclusion-Asbestos General Liability WNGL21 (07/14) Abuse or Molestation Excl General Liability WNGL39 (08/18) Comm Gen Liab Enhancement Endt General Liability WNGL49 (07/15) Addl Insd-Own, Less, Cont-Auto Issued Date; 12/10/2018 WN IL 26 07 07 AGENT COPY Page 12 of 12 COMMERICAL GENERAL LIABILITY WN GL 39 08 18 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......................................................... • 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_—......*....,...2­......., ,,_,*...*. • Blanket Additional Insured—Managers Or Lessors Of Premises..................... • Blanket Additional Insured --State Or Governmental Agency Or Subdivision 6 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 ................I.......8 Damage To Premises Rented To You — $300,000..............I..... Medical Payments Increased Limit — $10,000 Or Amount Shown on Declarations...........................9 Conditions • Knowledge of Occurrence, Offense, Claim Or Suit Amended....................... Unintentional Failure To Disclose Hazards 9 Is Waiver of Subrogation...................................................................................................... 0 Insured Contract Amended ........10 Personal And Advertising Injury Redefined • Televised;Videotaped Or Electronic Publication....................... WN GL 39 08 18 hctudes copyrighted material of the hsurance Service Office, Inc.,with its permission, Page 1 of 10 COMMERCIAL GENERAL LIABILITY WN GL 39 08 18 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 Fortin identified In this endorsement will be amended as shown below, SECTION 1- COVERAGES AMENDMENTS (3) Parking an "auto" on, or on the ways next to, COVERAGE A -- BODILY INJURY AND PROPERTY premises you own or rent, provided the"auto" D A Alf n n_L_` 1 1 A n1l 1-r V is not owned by or rented or loaned to you or fYlilP'l {4... t.......r..t. it IG It to ut!ill, A. No Owned Aircraft Or Watercraft (4) Llablllty assumed under any "insured con- itenn 2v Exclusions, Paragraph g. is replaced by the tract" for tl!v Ovy-fllership, I l lailltananlce or use following: of aircraft or watercraft; or i g. Aircraft, Auto Or Watercraft (5) "Bodiiy injury" or "property damage- arising "Bodily injury" or"property damage' arising out of out of: the ownership, maintenance, use or entrustment (a) The operation of machinery or equipment to others of orL glrnr,A Orrin= nr tern Prnrnit Ih�F Is 2f;�nhort In nr — ni ; Ignrr owned oroperated by or rented or loaned to any vehicle that would quallfy under the insured. Use includes operation and "loading or definition of-'mobiie equipment" if it were unloading". not subject to a compulsory or financial This exclusion applies even if the claims against responsibility law or other motor vehicle any Insured allege negligence or other wrong- insurance law where It Is licensed or doing In the supenaslon, hiring, empioyr:ent, principally garaged; or training or monitoring of others by that Insured, if (b) The operation of any of the machinery or the"occurrence' which caused the "bodily Injury" equipment listed in Paragraph f, (2) or f. or "property damage" Involved In the ownership, (3) of the definition of "mobile equip- maintenance; use or entrustment to others of env n,ent", aircraft, "auto" or watercraft that is owned or B. Damage To Property Coverage Extensions operated by or rented or loaned to any Insured. This exclusion does not apply to: Item 2, Exclusions, Paragraph ). Is replaced by the pp y following: (1) A watercraft while ashore on premises you j Damage To Property own or rent; (2) A watercraft you do not own that Is: "Property damage" to: (a) Less than 5v feet long; and f1) Property you own, rent, or occupy, Including any costs or expenses Incurred by you, or (b) Not being used to carry persons or prop- any other person, organization or entity, for erty for a charge; repair, replacement, enhancement, restora- This Subparagraph (2) applies to any person, tion or maintenance of such property for any who with your expressed or implied consent, reason, including prevention of injury to a either uses or Is responsible for the use of the person or damage to annthAr'c property watercraft; (2) Premises you sell, give away or abandon, if the "property damage' arises out of any part of those premises; WN GL 39 08 18 Includes copyrighted material of the insurance Service off4ce, hc.,with its pernisslon. Page 2 of 10 (3) Property loaned to you; The Insurance prodded for "property damage" from (4) Personal property In the care, custody or con- the use of elevators and for "property damage" to trol of the insured; borrowed equipment Is excess over any other valid (6) That particular part of real property on which and collectible property insurance (Including any de- you or any contractors or subcontractors ductible portion thereof) available to the insured working directly or indirectly on your behalf whether primary, excess, contingent or on any other are performing operations, if the "property basis. damage" arises out of those operations; or C. Damage To Premises Rented To You (6) That particular part of any property that must item 2. Exclusions, the last paragraph Is replaced by be restored, repaired or replaced because the following: "your work" was incorrectly performed on It, Exclusions c. through n, do not apply to damage by Paragraphs (1), (3) and (4) of this exclusion do not fire, lightning, explosion or sprinkler leakage to apply to "property damage" (other than damage by premises while rented to you or temporarily'occupled fire, lightning, explosion or sprinkler leakage) to by you with permission of the owner. A separate limit premises, including the contents of such premises, of insurance applies to this coverage as described In rented to you for a period of seen or fewer Paragraph 6. of SECTION ill — LIMITS OF consecutive days, A separate limit of insurance INSURANCE. applies to Damage To Premises Rented To You as described In SECTION IiI--LIMITS OF INSURANCE. COVERAGE B — PERSONAL AND ADVERTISING However, the prov#slons of this paragraph do not INJURY LIABILITY apply If coverage for Damage To Premises Rented To D. personal And Advertising injury You Is excluded by endorsement. g In j y Paragraph (2) of this exciuslon.does not apply If the Item 2. Exclusions Is amended by replacing Sub- premises are 'your work" and were never occupied, paragraphs b, and c, with the following: rented or held for rental by you. b, Material Published With Knowledge Of Falsity Paragraphs (3) and (4) of tills exclusion (to not apply "Personal and advertising injury" arising out of to the use of elevators, oral, written, televised, videotaped or electronic publication, in any manner, of material, If done by Paragraphs (3), (4), (5) and (6) of this exclusion do or,at the direction of the insured with knowledge not apply to liability assumed under a sidetrack of its falsity. agreement. c. Material Published Prior To Policy Period Paragraph (4) of tills exclusion does 'not apply to °personal and advertising �inJury" arising out of "property damage" to harrowed equipment while not oral, written, televised, videotaped or electronic being used to perform operations at the Jobsite, publication, in any manner, of material whose first Subject to Paragraph 2.of SECTION III--LIMITS OF publication took place before the beginning of the INSURANCE, the rules below fix the most we will pay for"property damage" under this provislon: policy period. (1) $25,000 any one "occurrence", regardless of the SUPPLEMENTARY PAYMENTS —COVERAGES A number of persons or organizations who sustain AND B damages because of that"occurrence"; E. Supplementary Payments —Coverages A and B (2) $50,000 annual aggregate; and Item 1. is amended by replacing Subparagraphs b. (3) We will pay only for damages In excess of$2,500 and d. with the following: as a result of any one"occurrence", regardless of b. Up to $5,000 for cost of ball bonds required be- the number of persons or organizations who cause of accidents or traffic law violations arising sustain damages because of that "occurrence", out of the use of any vehlcle to which the Bodily We may, or If required by law, pay all or any part injury Liability Cpvorage applies. We do not have of any deductible amount, if applicable, to effect to furnish these bonds. settlement of any claim or"suit". Upon notice of our payment of a deductible amount, you shall d. All reasonable expenses incurred by the insured promptly reimburse us for the part of the at our request to assist us In the Investigation or deductible amount we paid, defense of the claim or"suit",Including actual loss Paragraph (6) of this exclusion does not apply to of earnings up to$600 a day because of time off "property damage" Included In the "products-cam- from work. pleted operations hazard". WN GL 39 08 18 Includes copyrighted material of the Insurance service Office, Inc.,w0h its perMssion. Page 3 of 10 SECTION II—WHO 13 AN INSURED AMENDMENTS The following are added: A. Employee Bodily Injury To A Co-Employee C. Blanket Additional Insured — Vendors — As Re- Paragraph 2, a. (1) is replaced by the following: quired By Contract However, none of these "employees" or 'volunteer 1. Section 11 -- Who Is An Insured Is amended to workers" are Insureds for "bodily injury" or "personal include as an additional insured any person(s) or and advertising injury": organizatlon(s) (referred to throughout this (a) To you, to your partners or members (if you are a endorsement as vendor) with whom you have partnership or joint venture), to your members (if agreed in a written contract, executed prior to you are a limited liability company), to a co- foss, to name as an additional Insured, but only with respect to "bodily Injury" or "property "employee" while In the course of his or her damage" arising out of"your products" which are employment or performing duties related to the conduct of your business, or to your other distributed or sold in the regular course of the 'Wunteer workers" while performing duties vendor's business. related to the conduct of your business; However, f4.'< r iw„ s.u.i F c..,.�h i,.. o a. The insurance afforded to such vendor only 1ti'r io alto spouse, innv, parent, brother or sister or the co-"employee" or 'volunteer worker" as a applies to the extent permitted by law; and consequence of Paragraph (1)(a) above; b. if coverage provided to the vendor Is required r_a r__ t_� there u:__ae__ hit a nnnfrnnt nr nnraantarlt tha incitranna I La) For wruun there is any ouayauun to 3iiare _.. _..., damages with or repay someone else who must afforded to such vendor will not be broader pay damages because of the infua desnriked in than that which volt are reaulred by the I av n;...,; v�.v...v . contract f n agreement on# #n n suck i Paragrapi�v(1)(a) or (b) abovra; or -ontrac, r agreement provide for sack � aa.__. tlij Arising out or his orherf (3rUtlCtiilU Ui- Idlliliy tU vendor. nrnaArlca professional health care services, 2, With respect to the insurance afforded to these i,,,...de " vendors, the following additional exclusions However, if a suit seeking damages for "bodily Injury" L. or "Personal and ad articinn_ Inliit:t" to env co- pt�Niy' I "employee`or other "volunteer worker' arising out of a. One insurance afforded the vendor does not ails lit the CGurae of the Cu-"eriipivy6e's" or NOlunteer apply tom: I worker's" employment or while performing duties (1) "Bodily Injury" or "property damage" for related to the conduct of your business, or a suit which the vendor Is obligated to pay dam- seeking damages brought by the spouse, child, ages by reason of the assumption of parent, brother or sister of the co-"employee" or other liability In a contract or agreement, This "volunteer worker", Is brought against you or a co- exclusion does not apply to liability for "employes" or a`volunteer worker", we w111 reimburse damages that the vendor would hava In the reasonable costs that you incur in providing a the absence of the contract or dofense to the co-"employee" or `volunteer worker" agreement; against such matters. Any reimbursement made (2) Any express warranty unauthorized by pursuant to this sub-section will be in addition to the you; limits of liability set forth in the Declarations. (3) Any physical or chemical change In the B. Newly Acquired Organizations product made intentionally by the vendor; Paragraph 3. a.is replaced by the following: (4) Repackaging, except. when unpacked a. Coverage Linder this provision is afforded only solely for the purpose of Inspection, until the 180th day after you scqulre or form thA demonstration, testing, or the organization or Ehe end of the policy period, substitution of parts under instructions whichever Is earlier; from the manufacturer, and then repackaged in the original container; WN GIL 39 0818 includes copyrighted material of the insurance Service Office,ine.,with its perrrission. Page 4 of 10 (6) 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 Ili — vendor has agreed to make or normally Limits Of Insurance: undertakes to make in the usual course If coverage provided to the vendor Is required by of business, In connection with the a contract or agreement, the most we will pay on distribution or sale of the products; 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 ingredient of This endorsement shelf not increase the any other thing or substance by or for the applicable Limits of Insurance shown In 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 a, "Bodil In u " exclusion does not apply to: Y J rY , property damage or "personal and advertising injury" arising out (1) The exceptions contained in of the rendering of, or the failure to render, Subparagraphs (4) or (6), or any professional architectural, engineering or (II) Such Inspections, adjustments, tests surveying services, including: or servicing as the vendor has (1) The preparing, approving, or failing to agreed to make or normally prepare or approve, maps, shop undertakes to make in the usual drawings, opinions, reports, surveys, course of business, in connection field orders, change orders or draw(ngs with the distribution or sale of the and specifications; or products. (2) Supervisory, Inspection, architectural or 3, This Provision C. does not apply: 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 addltlonai insured allege any ingredient, part or container, entering negligence or other wrongdoing in the Into, accompanying or containing such supervislon, hiring, employment, training products; or monitoring of others by that insured, if b. To any vendor for which coverage as an add!- the "occurrence" which caused the lional insured specifically Is scheduled by 'bodily Injury" or "property damage", or 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 respect sions of the coverage part or by endorse- to your providing engineering, ment. architectural or surveying services In your capacity as an engineer, architect or surveyor. WN GL 39 08 18 hcludes copirighted material of the hsurance Service vice,hc.,wfth Its pernisslon, page 6 of 10 4, With respect to the insurance afforded to these D. Blanket Additional Insured - Lessor Of Leased additional Insureds, the following additional Equipment exclusion applies: 1. Section II- Who Is An Insured is amended to This insurance does not apply to: Include as an additional Insured any person(s) or organization(s) from whom you lease equipment a. "Bodily injury",advertising "property damage" or when you and such person(s) or organlzation(s) "personal and advertising injury" arising out have agreed In writing in a contract or agreement, of the rendering of, or the failure to render, executed prior to loss, that such person(s) or any professional architectural, engineering or organization(s) be added as an additional Insured surveying son-Ices, Including: on your policy. Such person(s) or organizations) (1) The preparing, approving, or failing to Is an Insured only with respect to liability for prepare or approve, maps, shop "bodily injury", "property damage" or "personal drawings, opinions, reports, surveys, and advertising injury"caused, in whole or In part, field orders, change orders or drawings by your maintenance, operation or use of and specifications: or equipment leased to you by such person(s) or (�) Supervisory, Inspection, architectural or organization(s), engineering activities. However, the Insurance afforded to such additional insured: This exclusion applies even If the claims aaalnst an additional In$l_Jrad allege .A, C)nl%, rf annil— fC rho �xt i nermilf-4 by Imar � .+Yt+,vv . I+.,.+,+..w., ...I �•••, egiigerioe or other WrOngd0ing in the and supervision, hiring, employment, training or h. Will not he broader than that which you are monitoring of nfhnrs by fhat ingtired if the egl�ired by 'he co ntract or angreernent o cCCuirence" vv[iiCli caused the"bodily i++,u j" I oro,,ide for such additional instingd, or "DroDerty damagn", or trite_. nffnnSn which A person's or orcianization's status as an add!- caused the "personal and advertising injury", tional Insured under this endorsement ends when Involved the rendering of or failure to render U l env nrnfncGlonnl ganAnn.q by vnI r with rA-,nprt e, rV 1)t i . t i1 : Y C I .: leased equipment ends, i'v'y:;1r4lVrlNltl� or7iiivtaririy, ai+i�itvv'surai yr 3 IJtIlth rnanent to rho 1na::r�r,ne rf>t a a s a surveying services in your capacity as an �. + -speot to flhe Insurance a+0r,4eA w IkI engineer; architect Or fiurveycr- additional Insureds, this insurance does not apply to any "occurrence" which takes place after the B. Blanket Additional Insured - Managers Or Les- 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 I additional Insureds, the following is added to Include as an additional Insured any person(s) or Section ill- 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 agreenent, the most we as an additional Insured, but only with respect to will pay on behalf of the additional insured is: liability arising out of the ownership, maintenance a. The minimum amount required by the or use of that part of the premises leased to you, contract or agreement; or subject to the following additional exclusions: b. The Limits of Insurance shown In the This Insurance3 does not apply to: Declarations; a. Any"occurrence" which takes place after you whichever Is less. cease to be a tenant In that premises. This endorsement shall not increase the b. Structural alterations, new construction or applicable Limits of Insurance shown In the demolition operations performed by or on Declarations, behalf of such additional insured. WN OL 39 08 16 Includes copyrighted material of the Insurance Service Wise, hc.,wlth its perrrtsslon, Pago 6 of 10 However: F. Blanket Additional insured — State Or a. The insurance afforded to such additional Governmental Agency Or Subdivision Or Political Insured only applies to the extent permitted Subdivision —Permits Or Authorizations by law; and Section 11 — Who is An Insured is amended to in- b. If coverage provided to the additional insured clude as an additional insured any state or is required by a contract or agreement, the governmental agency or subdivision or political Insurance afforded to such additional Insured subdivision with whore you have agreed In a written will not be broader than that which you are contract, executed prior to loss, to name as an required by the contract or agreement to additional insured, subject to the following provisions: provide for such additional 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 we However: 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 insured Declarations; is required by a contract or agreement, the whichever Is less. Insurance afforded to such additional Insured will not be broader than that which you are This endorsement shall not increase the required by the contract or agreement to applicable Limits of insurance shown In the provide for such additional insured. Declarations. 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 op- This Insurance does not apply to: erations performed for the federal govern- meet, state or municipality;or a. "Bodily Injury", "property damage" or b, Modify Injury"or"property damage" Included "personal and advertising injury" arising out within the "products-completed operations of the rendering of, or the failure to render, hazard". any professional architectural, engineering or 3. With respect to the insurance afforded to these surveying services, including: additional Insureds, the following Is added to ( ) The preparing, approving, or failing to Section III—Limits Of insurance: prepare or approve, maps, shop If coverage provided to the additional insured is drawings, opinions, reports, surveys, required by a contract or agreement, the most we field orders, change orders or drawings and specifications; or will pay on behalf of the additional Insured Is: (2) Supervisory, inspection, architectural or a. The minimum amount required by the engineering activities. contract or agreement; or This exclusion applies even if the claims b. The Limits• of Insurance shown In the against an additional Insured allege Declarations; negligence or other wrongdoing In the whichever Is less, supervision, hiring, employment, training or This endorsement shall not increase the monitoring of others by that Insured, if the 14 occurrence applicable Limits of Insurance shown in the which caused the"bodlly Injury" applicablons, or "property damage", or the offense 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. W N GL 39 08 1 a Inctudes cop,Irighted rnatertal of the Insurame Service office, he„w Rh RS 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, maintenanco 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 or by law; and surveying services, including: b. If coverage provided to the additional insured (1) The preparing, approving, or failing to Is required by a contract or agreement, the prepare or approve, maps, shop Insurance afforded tosuch additional insured drawings, opinions, reports, surveys, will not be broader than that which you are Hold ordors, change ordom or drawings required by the contract or agreement to and specifications; or provide for such additional insured. (2) Supervisory, inspection, architectural or 2. With respect to the Insurance afforded to these engineering activities. additional Insureds, the following Is added to This exclusion applies even .If the claims Section III—Urnits Of Insurance: aydlria1 ail au(itl�nal ilisur�ru t#iiUM it uoverauu provtioeo to trie additional insures Is negligence or other wrongdoing in the required by a contract or agreement, the most we supervision, hiring, employment training or will pay on behalf of the additional Insured is: monitoring ai others by that insured, If the `occurrence" which caused the"bodily njl!rv" u. -no r linimum amount required" by the i "ploperly i.V1i110.1i1 VI a mernan" GI or urvu�rcy damage", or itils offense which g eguegrl the "personal and advertising fnj�,i I b. Ine Limits of insurance shown in the Involved the rendering of or failure to render Declarations: any professional Services by you with respect to your providing engineering, architectural or wilic he:e is iess. svrvevinri RAnAr AR in your rarnar.lty a,z an This endor4ement shall not increase thA applicable Lin-llits of iilsuianee 5rhow 71 lit file ellgFIIGC7r, i111%l lftC(il Uf zUI YCYUf. �N G. Blanket Additional Insured — State Or Declarations. Governmental Agency Or Subdivision Or Political 3. With respect to the insurance afforded to these Subdivision --Permits Or Authorizations Relating additional insureds, the following additional To Premises exclusion applies: Section II — Who Is An Insured is amended to in- This Insurance does not apply to: elude as an additional insured any state or a. "Bodily injury", "property damage" or ciovernmental agency or suhdiyision or nniitinal 'inerennal and a(Nertislnn inhin,l` nrlclnn n,il subdivision with whom you have agreed in a written of the rendering of, or the failure to render, contract, executed prior to loss, to name as an any professional architectural, engineering or additional Insured, subject to the following provision: surveying seMces, including: 1. This insurance applies only with respect to the fol- (1) The preparing, approving, or failing to lowing hazards for which the state or prepare or , approve, maps, shop governmental agency or subdivision or political drawings, opinions, reports, surveys, subdivision has Issued a permit or authorization field orders, change orders or drawing_s in connection with premises you own, rent or and specifications; or control and to which this insurance applies: (2) Supervisory, Inspection, architectural or. a. The existence, maintenance, repair, engineering activities. 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 W N GL 39 08 18 Includes copyrighted material of tho hsurame sorylce effico,hc.,with its perrrission. Page 8 of 10 This exclusion applies even If the claims SECTION IV — COMMERCIAL GENERAL LIABILITY against an additional insured allege CONDITIONS AMENDMENTS negligence or other wrongdoing In the supervision, hiring, employment, training or A. Knowledge Of Occurrence monitoring of others by that Insured, If the Itern 2. Duties in The Event Of Occurrence, Of- "occurrence" which caused the "bodily injury" fense, Claim or Suit Is amended by adding the fol- or "property damage", or the offense which lowing: caused the "personal and advertising injury", e. YOU must glVa us or our authorized representa- inwlved the rendering of or failure to render tive prompt notice of an 'occurrence", claim or any professional services by you with respect loss only when the "occurrence", claim or loss Is to your providing engineering, architectural or surveying services in your capacity as an known to: engineer, architect or surveyor. (1) You, if you are an individual; (2) A partner, if you are a partnership; SECTION III—LIMITS OF INSURANCE AMENDMENTS (3) An executive officer or insurance manager, if A. Damage To Premises Rented To You you are a corporation; or Paragraph 6, is replaced by the following: (4) A member or manager, If you are a limited liability company. 6. Subject to Paragraph 5, above, the most we will B, Other Insurance 11 pay under Coverage A for damages because of property damage" to any one premises, while Item 4. Other Insurance, b. Excess Insurance (1) rented to you, or In the case of damage by fire, (a) (11) is replaced by the following; lightning, explosion or sprinkler leakage, while (11) That Is fire, lightning, explosion or sprinkler leak- rented to you or temporarily occupied by you with age Insurance for premises rented to you or permission of the owner Is the greater of: temporarily occupied by you with permission of a. $300,000; or the owner; b. The amount shown next to the Damage To C. Unintentlonal Failure To Disclose Hazards Premises Rented To You Limit In the Decla- Item 6. Representations Is replaced by the following: rations, 6. Representations And Unintentional Failure To However, the provisions of this paragraph do not 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 Llmlt accurate and complete; Paragraph 7, is replaced with the following: (2) Those statements are based upon repre- 7. Subject to Paragraph 5. above, the most we will sentations 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 fall to disclose any haz- a. $10,000; or ards existing at the Inception date of your b. The amount shown next to the Medical Ex- policy, we will not deny coverage under this pense Limit in the Declarations. Coverage Part because of such failure. This Insurance does not apply if coverage for However, this provision does not affect ourright to collect additional premium or exercise Medjca( Expenses is excluded either by the pro- our right of cancellation or non-renewal, visjons of the coverage part or by endorsement. WN GL 39 08 18 includes copyrighted rraterial of the Insurance service afice, hc.,with its pernission. Page 9 of 10 D. Waiver of Subrogation SECTION V—DEFINITIONS AMENDMENTS Item 8. 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 because a. A contract for a lease of premises. However, that of payments we make for injury or damage arising out portion of the contract for a lease of premises that of your ongoing operations or"your work" done under indemn18es any person or organization for a written contract, executed prior to loss, requiring damage by fire, lightning, explosion or sprinkler such waiver with that person or organization and leakage to premises while rented to you or Included in the "products-completed operations temporarily occupied by you with permission of hazard". However, our rights may only be waived the owner is not an"insured contract"; prior to the 'occurrence" giving rise to the Injury or B. Personal And Advertising Injury Redefined damage for which we make payment under this Paragraph 14, d.and e.are replaced by the following: 1 Coverage Part. The insured must do nothing after a loss to Impair our 141ghts. At our request, the insured d. Oia!, Written, televised, videotaped or electronic will bring "suit"or transfer those rights to us and help publication of material that slanders or libels a us enforce those rights. person or organization or disparages a person's or organization's goods, products or service; ! e. Gra, ml'Ukan, idaysod, videotaped or electronic publication of material that violates a person's right of privacy; i I I I I WN GL 39 08 18 includes copy lighted rmterial of the insurance Service Cffice,trtc.,with fis perrrisston. Page 10 of 10