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HomeMy WebLinkAboutPW18-464 - Amendment - #2 - Skillings Connolly, Inc. - Shops Fuel Tank Replacement - 07/15/2019 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 Bryan Bond Department: Public Works Date Sent: 7/15/19 Date Required: 7/17/19 R > Authorized Director or Designee Date of 0 N/A o, to Sign: Council IL cc 11 Mayor Approval: Budget E20018 Grant? Yes No Account Number: Type: N/A Vendor Name: Skillings Connolly, Inc. Category: Contract C Vendor Sub-Category o Number. 177599 g y Amendment EProject Fuel Tank Replacement 4. Name: 0 W. Project +. Details: Provide additional testing. c a Agreement Basis for 0 Amount: $13,658.87 Selection of Other Contractor: d Start Date: 7/15/19 Termination Date: 1 Z/31/19 Notice required prior to Yes No Contract Number: disclosure? 0 11 1 Pn lc� -y ULI Date Received by City Attorney: Comments: v� c 'M 0 N d L Ip Date Routed to the Mayor's Office: Lowi ClErim in Date Routed to the City Clerk's Office: �� JUL 17 2019 Date Sent to Originator: CITY OF KENT Visit Documents.K!! A.gov to obtain copies of all agreements adccW22373 6 19 • KENT W A S H I N G T 0 N AMENDMENT NO. 2 NAME OF CONSULTANT OR VENDOR: Skillings Connolly, Inc. CONTRACT NAME & PROJECT NUMBER: Fuel Tank Replacement ORIGINAL AGREEMENT DATE: December 18, 2018 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: Provide additional testing to ensure decommissioning requirements have been met for all past actions that have taken place on the property in relationship to the Underground Storage Tanks (UST). For a description, see the Consultant's Scope of Work which is attached as Exhibit A and incorporated by this reference. 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, $119,999.85 including applicable WSST Net Change by Previous Amendments $12,431.62 including applicable WSST Current Contract Amount $132,431.47 including all previous amendments Current Amendment Sum $13,658.87 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $146,090.34 AMENDMENT - 1 OF 2 Original Time for Completion 12/31/19 (insert date) Revised Time for Completion under n/a prior Amendments (insert date) Add'I Days Required (f) for this 0 calendar days Amendment Revised Time for Completion 12/31/19 (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: By: signatur gna ure) Print Name: Patrick E. Skil ngs, PMP Print Name: Tim thy J. LaPorte, P.E. Its Vice President Its Public Works Director (title) (title) DATE: July 12, 2019 DATE: Z �D/9 ATTEST: APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent City Clerk Kent Law Department Skillings Connolly-Fuel Tank Replacement Amd 2/Bond AMENDMENT - 2 OF 2 EXHIBIT A SCOPE OF WORK Prepared for: CITY OF KENT SOILS AND WATER ANALYSIS INVESTIGATION July 3,2019 Background: The project site is the City of Kent's Maintenance Shops located at 5821 S.240th St.Kent,WA,immediately east of Russell Road and south of S.240th St. The project entails the preparation of the design documents for a new fueling station and the abandonment(decommissioning)of the existing fueling station after the new fueling station is operational. Additional testing has been requested to ensure decommissioning requirements have been met for all past actions that have taken place on the property in relationship to the Underground Storage Tanks(UST): Skillings Connolly,Inc.(CONSULTANT)will be the prime CONSULTANT for the project. Assumptions: • The CONSULTANT's anticipated SUBCONSULTANTs for the project will include: o ESN Northwest-Vendor • Vendors will be used to supply a drill rig and equipment needed to collect soil samples and a certified lab will be used for soil and water testing for contaminants as part of the abandonment of the existing fuel tanks. • CONSULTANT will utilize all existing AutoCAD base topographical base maps illustrating all pertinent site features both above and below grade in the area of the proposed work. • All meetings and work required by CITY that is not listed herein will be considered extra work. • for purposes of this Agreement,the overall duration of the Project will take place within one month from date of Notice to Proceed. • The contract may be supplemented to extend time and add budget for any unintended findings upon the outcomes of the soils investigation. • CITY will provide the CONSULTANT's project manager a written request for any extra work not specifically included herein. • Deliverables will be a fully executed report with all soils analysis results from the onsite investigation. • CONSULTANT's assumed total hours for attendance at project meetings are shown on the Fee spreadsheet. CITY Will Provide the Following: 1. Utility locates as needed prior to soil testing and drilling. Change Management: This is a time and materials contract with a not to exceed maximum without a supplement to the contract. The level of effort for various tasks listed in the budgeted hours spreadsheet is an estimate and actual hours may vary for each line item.The contract will be managed to the contract maximum,not the task level budgets. Skillings Connolly,Inc. Page 1 of 7 Project No 18184 Extra-01 City of Kent Soil and Water Analysis/Permitting Services to be Provided by CONSULTANT: The following tasks are anticipated as part of the CONSULTANT's work for the project. Task 1 Project Management and Coordination The CONSULTANT will: 1. Provide overall project coordination and project management throughout the duration of the onsite investigation and report generation process. 2. Setup and manage project files. 3. Prepare up to one(1)monthly invoices along with progress summary reports. Deliverables: • Meeting Minutes • Monthly Invoices accompanied by a progress report. It is anticipated the monthly progress report will address: o Scope,Schedule and Budget status; o Work that was completed during the last month; o Discuss issues that have arisen that may require additional work due to soils sample findings; o Discuss any unresolved issues,or outstanding questions awaiting response; o Provide an anticipated 30-day look-ahead of anticipated work or issues to resolve. Task 2 Soil Sampling and Soils Analysis Introduction CITY,pursuant to the direction received from ongoing meetings,desires additional testing for tank decommissioning to be conducted and added to the existing soils investigation already performed. The work includes additional sample locations for soils testing and analysis for potential contaminated materials,which includes analysis of both soils and groundwater samples taken at the existing UST location. A comparison of the containment levels to MTCA Method A Cleanup Standards will be made and required permitting for decommissioning through the Department of Ecology(ECY)will be provided. Plan and Coordinate Field Work:ESN Northwest will coordinate with the CONSULTANT to determine the appropriate field exploration locations for soils testing.This will include reviewing existing information to evaluate where additional data is needed. Conduct Site Reconnaissance and Utility Locates:Prior to conducting field exploration program,ESN Northwest will conduct a reconnaissance of the site.This reconnaissance will be focused on identifying critical surface features of the site and identifying the best exploration locations.During our site reconnaissance,CONSULTANT and CITY will mark proposed boring locations and utility locates for the boring locations. Conduct Field Exploration:CONSULTANT and ESN Northwest proposes to drill six(6)geotechnical borings in support of the proposed developments.This will include six(15)15-foot borings to be advanced in the area of the location of the fuel tanks.All exploration activities will be monitored full time by a qualified Biologist provided by CONSULTANT and the ESN Northwest field crew.We expect that drilling of the proposed six(6)borings will take approximately one(1)working day. Skillings Connolly,Inc. Page 2 of 7 Project No 18184-T02 City of Kent Soil and Water Analysis Investigation Generate Boring Logs and Assign Laboratory Testing:Soil samples retrieved from the borings will be sealed in plastic bags and taken to the laboratory for further examination and testing.Selected soil samples will be tested to determine if contaminants exist.These tests will include NWTPH-Dx+x(diesel range-extended) and BTEXEPA 8021(unleaded).Soil information will be presented in a summary report upon completion of the testing by the laboratory. Assumptions: • Site access will be provided to Skillings Connolly and their subcontractors. • Identification of potentially contaminated soils is not anticipated.If contaminated soils are encountered the CITY will be contacted for direction. • Work by ESN Northwest will include identification or evaluation of contaminants that may be present in the soil or groundwater. • CITY will call for utility locates prior to soil investigation. • Soil and groundwater samples will be collected using a geoprobe with use of an air-knife to avoid utility impacts. • Collected samples will be analyzed for NWTPH-Dx+x(diesel range-extended)and BTEXEPA 8021 (unleaded). • Laboratory analytical results will be compared to the Model Toxics Control Act(MTCA)"Method A Cleanup". Sample Collection and Reporting Assumptions: • Geoprobe borings will be advanced at six(6)distinct locations. • Discreet soil sample and groundwater samples will be collected from each boring. • Groundwater samples will be collected at the groundwater interface. • ESN Northwest will conduct each boring. ESN Northwest will utilize an air-knife in order to avoid impacts to encountered utilities. • Each boring will be decommissioned and sealed using clay bentonite as per ECY guidelines. • Collected samples will be maintained on ice through delivery to the laboratory. • CITY will conduct all coordination and correspondence with ECY regarding the results of laboratory analysis. • CONSULTANT will provide oversight and review of field sample collection and comparison of results to cleanup standards. • If contaminants are present within the soils and exceed MTCA cleanup levels,an additional supplement for a cleanup plan and associated work for cleanup for contaminated soils will be provided in a new scope and budget. Task Description: 1. Provide coordination with the CITY and SUBCONSULTANT. 2. Review utility locates and generate a Sample Analysis Plan for onsite investigation work. 3. CONSULTANT will develop a Sample Analysis Plan(SAP)which will include logistics for site preparation,planning,scheduling and procedures. 4. CONSULTANT will collect soil and groundwater samples from six(6)distinct borings.Collected samples will be delivered to ESN Northwest's laboratory for analysis,following method NWTPH- Dx+x(Diesel range-extended)and BTEXEPA(unleaded). A Chain-of-Custody will be completed for all collected samples,from point of collection to laboratory delivery. Skillings Connolly,Inc. Page 3 of 7 Project No 18184-T02 City of Kent Soil and Water Analysis Investigation 5. CONSULTANT will prepare a Technical Letter describing sample collection methodology,analytical results,and a description comparing sample results to MTCA Cleanup levels. Deliverable: • Six(6)discreet soil samples. • Six(6)Discreet groundwater samples. • Chain-of-Custody Record. • Memo detailing sampling collection. • Technical letter • Final Report Deliverables: • CONSULTANT will provide CITY with a digital and hard copy of the Draft and Final Soils Investigation Report. END SCOPE OF WORK Prepared by:'� �, D6/28/2019 Grant Gil Reviewed by., (: =06/28/2019 Ryan fmith,PLS CFedS Reviewed by: 06/28/2019 P trick E. iflings,PMP Skillings Connolly,Inc. Page 4 of 7 Project No 18184-T02 City of Kent Soil and Water Analysis Investigation EXHIBIT B-1 CONSULTANT COST COMPUTATION—MAN-HOURS PROJECT NO.18184-EXTRA 1 I a KENT PUBLIC WORKS DEPARTMENT v A O KENT MAINTENANCE FACILITY UST DECOMMISSIONING z m n SOILS AND WATER ANALYSIS INVESTIGATION a n C 0 CI Z Z m 0 2 r. 1 2 mm v i z z a D O z TASK It TASK DESCRIPTION 1 PROJECT M ANAGEMENT AND COORDINATION 4 Provide overall project management and 1 2 coordination. Conduct periodic,minimum of bi-weekly phone 5 conferences with Client to discuss work progress and 1 status. Provide coordination with other team members 6 (subconsultants),including phone coordination, 4 meetings,and emails. 7 Prepare up to one(1)monthly invoices along with progress summary reports. 2 SOIL SAMPLE AND SOILS ANALYSIS Develop a Sample Analysis Plan(SAP)which will include logistics for site preparation,planning, 4 scheduling,and procedures. Collect soil and groundwater samples from six(6) distinct borings. Collected samples will be delivered 1 to ESN Northwest's Laboratory for analysis,following 2 method NWTPH=Dx-x(Diesel range-extended)and 9 9 BTEXEP(A(unleaded). A Chain-of-Custody will be completed for all collected samples,from point of collection to laboratory delivery. 3 Collect data. 4 4 Process data. 4 5 Write draft technical memorandum. 8 6 Submit draft technical memorandum. 2 8 Submit final draft technical memorandum to j 1 8 Consultant. HOURS PER DISCIPLINE 12 45 1 Skillings Connolly,Inc. Page 5 of 7 Project No 18184-T02 City of Kent Soil and Water Analysis Investigation EXHIBIT B-2 CONSULTANT COST COMPUTATION—SUMMARY NEGOTIATED HOURLY RATE(NHR): DAM 'r nmm X Rate — Cost ENVIRONMENTAL MANAGER 12 X $214.58 = $2,574.98 SR ENVIRONMENTAL SCIENTIST 45 X $118.80 = $5,345.98 PROJECT ADMINISTRATOR 1 X $115.83 = 5115,83 ADMINISTRATIVE ASSISTANT 0 X $111.37 = $0.00 Total Hours= 58 Total NHR= $8 036J9 REIMBURSABLES: Mileage 176 x $0.580 = $102.08 Miscellaneous Expenses $0,00 x 10% _ $0.00 Total Expenses= $102.08 SUBCONSULTANT COST(See Exhibit E): ESN Northwest $5,520.00 X 0% _ $5,520DO r Total Subconsultants= $5,520.00 SUB-TOTAL(NHR+REIMBURSABLES+SUBCONSULTANTS): Sub Total= $13,658.87 MANAGEMENT RESERVE FUND: SUB TOTAL= $13,658.87 x 0% = MRF= $0.00 GRAND TOTAL GRAND TOTAL = , PREPARED BY: / tii DATE: 06/28/2019 "I. REVIEWED BY: DATE: O6/28/2019 Patrick E.Sk" PMP $killings Connolly,Inc. Page 6 of 7 Project No 18184-TO2 City of Kent Soil and Water Analysis Investigation EXHIBIT B-3 CONSULTANT COST COMPUTATION—EXPENSES !tem. j Description Basis Quantity Rate Total 1 Telephone Month $0.00 2 Auto Rental Each $0.00 3 Lodging Day $0.00 4 Per Diem-Meal Day $0.00 5 Photo Copies-Blk&White Each $0.10 $0.00 6 Photo Copies-Color Each $0.35 $0.00 7 Half Sized Prints Each $0.50 $0.00 8 Full Sized Prints Each $6.1O $0.00 9 Postage Month $0.00 10 Shipping Month $0.00 11 FAXs Each $0.00 12 Miscellaneous Project Costs Month $0.00 13 Miscellaneous Survey Costs Estimated $0.00 14 Traffic Control Estimated $0.00 f Total Miscellaneous Expenses $0.00 Mileage Per Mile 176 0.580 $102.08 Total Expenses $102.08 Assumptions 1 Telephone Estimated 2 Auto Rental Estimated trips 3 Mileage I Estimated miles 4 Lodging 5 Per Diem-Meal 6 i Photo Copies-Blk&White Estimated 7 Photo Copies-Colored Estimated 8 Half Sized Prints 9 Full Sized Prints 10 Postage Estimated it Shipping Estimated 12 FAXs Estimated 13 Miscellaneous Project Costs Estimated 14 Miscellaneous Survey Costs Estimated 15 Purchase Order Estimated Prepared by: Grant Gilmore June 28,2019 Skillings Connolly,Inc. Page 7 of 7 Project No 18184-TO2 City of Kent Soil and Water Analysis Investigation Client#: 324969 SKILLCON ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD YYYY} THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS B 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 r 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 any rights to the certificate holder in lieu of such endorsemenes [601 ODUCER CT SI Insurance Services NW PR NAME: PHONE -.__ ... __ _.- .FAX-... ... Union Street,Suite 1000 LIc,No Est( 206 441 6300 _ 1 Pab: -362 8530 E G1AIL .---- I certre uest usi.com - attle,WA 98101 ADDRESS: P_-----Q._.._.._�-..._�---------____-_------ ---------__. INSURERS)AFFORDING COVERAGE NAIC R - _----" --"'- 'INSURER A T velw property Cai.C----- orka INSURED __._.__ __-----_—__ __--_-_ ,.- _ 25674 Skiilings Connolly, Inc. INSURERS:XLSpe=IaaylnsuraneeCoorp-y 37885 --- _ 6016 Lacey Blvd.SE INSURER C T—.1—Ina Ity Co Pa y or CT 25682 Lacey, WA 98503 INSURER D: ; INSURER E COVERAGES CERTIFICATE NUMBER: 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 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR __ _ I) OLTSUt3'! -_ ._. -_.._ LTR TYPE OF INSURANCE t RI POLICY EFF POLICY EXP _- - - -- - -- '7 iN8r3�YJVD-�___,_ —__POLICY NUMBER ---__-_ _jMM/DD/YYY`I�:(MNVDAlYYYYZ LIMITS /� X.COMMERCIAL GENERAL LIABILITY f � " -i- I I6805H560029 2/181201812/18/2015 EACHoccuRREN E s1,000,000 CLAIMS-MADE _X;OCCUR f 0 RENTED - { � tEES�(Es_occurcence)._,. I$1,000,000 MED EXP(Any one person) 1$10.000 .PERSONAL 8.4DVINJURY $1,000 000 GF.V't AGGREGATE LIMIT APPLIES PER --—- _-- ---- -- 1 f PRO. ! GENERAL AGGREGATE 52;000,000 POLICY' Xl JECT LOC j PRODUCTS-COMP/OP AGG $2,000,000 i -- -- i OTHER C t AUTOMOBILE LIABILITY - "- I BA6752L594 12/1812018 1 211 81201 9 OMi31NED SINGLE LIMIT Ee aaWenll _ $1,000,000 SCHEDULED -- X ANY O`.NNED AUTO _...i I t 90DtLY INJURY(Per person)..!$ -- ' I ., AUTOS ONLY AUTOS BODILY INJURY(Par et) $ t �r HIRED t -�AUTOS ONLY ;X ! —t auaden q�7perONLOY � ! PROPERTYOAAIAGE !t I UMBRELLA LIAB OCCUR I -- -- CH OCCURRENCE A EXCESS LIgB CLAIMS-MAOE) i :AGGREGATE $ _.I -._ - I RETENTION$ A I WORKERS COMPENSATION I �� .._ . AND EMPLOYERS'LIABILITY ! 6805H560029 12/18/2018 12/18/2019 1S 9IUiE.,_1 X!tR"-) ANY PROPR E T OR/PARTNERIEXECUTIVE YIN :OFRCERIMEMBEREXCLUDED? I N� NIA TWA Stop Gap) =L EACH ACCIDENT If1,000;000 (Mandatory in NH) - E L DISEASE MPLOYE EAEF_,$1,000,000 If describe describe under ...--- __-- 1( _.. DESCRIPTION OF OPERATIONS belay E L DISEASE POLICY LIMIT $1 000,000 B Professional DPR9922486 3/02/201803/02/2019 $3,000,000 per claim Liability $3,000,000 annl aggr. I DESCRIPTION OF OPERATIONS;LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Project#18184, Public Works Operations Facility New Fuel System. The General Liability policy includes an automatic Additional Insured endorsement that provides Additional insured status to the Certificate Holder,only when there is a written contract that requires such status, and only with regard to work performed on behalf of the named insured. CERTIFICATE HOLDER CANCELLATION City of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 220 Fourth Avenue South ACCORDANCE WITH THE POLICY PROVISIONS. Kent,WA 98032 AUTHOLLRI--ZE__D REPRESENTATIVE 0 1988.2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S24515000/M24418760 VXJZP Policy Number 6805H560029 GENERAL PURPOSE ENDORSEMENT OFFICE PAC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGD361 (03-05) - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAMES OF ADDITIONAL INSURED PERSON(S) OR ORGANIZATION(S): Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part, provided that such written contract was signed and executed by you before,and is in effect when, the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense is committed. LOCATION OF COVERED OPERATIONS: Any project to which a written contract with the Additional Insured Person(s) or Organization(s) in the Schedule applies. (INFORMATION REQUIRED TO COMPLETE THIS SCHEDULE, IF NOT SHOWN ABOVE, WILL BE SHOWN IN THE DECLARATIONS.) A. SECTION II - WHO IS AN INSURED IS AMENDED TO INCLUDE AS AN ADDITIONALINSURED THE PERSON(S) OR ORGANIZATION(S) SHOWN IN THE SCHEDULE, BUT ONLY WITH RESPECT TO LIABILITY FOR "BODILY INJURY", "PROPERTY DAMAGE", PERSONAL INJURY OR "ADVERTISING INJURY"CAUSED, IN WHOLE OR IN PART, BY: 1. YOUR ACTS OR OMISSIONS; OR 2. THE ACTS OR OMISSIONS OF THOSE ACTING ON YOUR BEHALF; IN THE PERFORMANCE OF YOUR ONGOING OPERATIONS FOR THE ADDITIONAL INSURED(S) AT THE LOCATION(S) DESIGNATED ABOVE. B. WITH RESPECT TO THE INSURANCE AFFORDED TO THESE ADDITIONAL INSURED, CG T8 04 12 18 Page 1 of 2 Policy Number 6805H560029 GENERAL PURPOSE ENDORSEMENT OFFICE PAC THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGD361 (03-05) - ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: THE FOLLOWING ADDITIONAL EXCLUSIONS APPLY: THIS INSURED DOES NOT APPLY TO "BODILY INJURY"OR "PROPERTY DAMAGE" OCCURRING, OR "PERSONAL INJURY" OR "ADVERTISING INJURY' ARISING OUT OF AN OFFENSE COMMITTED,AFTER: 1. ALL WORK, INCLUDING MATERIALS, PARTS OR EQUIPMENT FURNISHED IN CONNECTION WITH SUCH WORK, ON THE PROJECT(OTHER THAN SERVICE, MAINTENANCE OR REPAIRS)TO BE PERFORMED BY OR ON BEHALF OF THE ADDITIONAL INSURED(S)AT THE LOCATION OF THE COVERED OPERATIONS HAS BEEN COMPLETED; OR 2. THAT PORTION OF"YOUR WORK"OUT OF WHICH THE INJURY OR DAMAGE ARISES HAS BEEN PUT TO ITS INTENDED USE BY ANY PERSON OR ORGANIZATION OTHER THAN ANOTHER CONTRACTOR OR SUBCONTRACTOR ENGAGED IN PERFORMING OPERATIONS FOR A PRINCIPAL AS A PART OF THE SAME PROJECT. CG D3 61 03 05 Copyright 2005 The St. Paul Travelers Companies, Inc. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. CG T8 04 12 18 Page 2 of 2