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HomeMy WebLinkAboutCAG2019-462 - Original - Univar Solutions USA Inc. - 2020 Water Treatment Chemical Supply - 11/08/2019 ,0e*` Agreement Routing Form K"El NT 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 for Tom Cunningham Department: Public Works Date Sent: 11/12/19 Date Required: 11/14/19 �o > Authorized Director or Designee Date of o N/A CL to Sign: Council aMayor Approval: Budget 41005550.63150.7431 Grant? Yes No Account Number. Type: N/A Vendor Univar Solutions USA Inc. Category: Contract Name: Vendor 171785 o Number: Sub-Category EProject Name: 2020 Water Treatment Chemical Supply ,. 0 c Project Supply a water treatment chemical to the City's Water Department. 6, Details: c EAgreement 2 200 Basis for y Amount: r Selection of Quotes Contractor: Q Start Date: 11/8/19 Termination Date: 12 31 20 Notice required prior to Yes No Contract Number: disclosure? Date Received by City Attorney: Comments: c 0 cc h L i+ fd p� Date Routed to the Mayor's Office: 'vt d Date Routed to the City Clerk's Office: a Date Sent to Originator: Visit Documents.KentWA.gov to obtain copies of all agreements adccW22373_6_14 • KENT W n S H I N G T O N GOODS & SERVICES AGREEMENT between the City of Kent and Univar Solutions USA Inc. THIS AGREEMENT is made by and between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Univar Solutions USA Inc. organized under the laws of the State of Illinois, located and doing business at 8201 S. 212th Street, Kent, WA 98032, Phone: (253) 872-5000, Contact: Jennifer Perras (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: The Vendor shall supply the City of Kent Water Department with a water treatment chemical (bid item 11) according to the bid proposal submitted October 29, 2019, 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 December 31, 2020. III. COMPENSATION. The City shall pay the Vendor an amount not to exceed Two Thousand, Two Hundred Dollars ($2,200), 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: Compensation of up to $2,200 is based on an estimate annual need. Actual need may vary as follows: Item 11: zero to 1,000 gals. Therefore, actual compensation will be between $0 and $2,200 and be based on the exact quantity of chemicals ordered by the City. 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. GOODS & SERVICES AGREEMENT - 1 ($20,000 or Less, ind. WSST) 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 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 GOODS & SERVICES AGREEMENT - 2 ($20,000 or Less, including WSST) 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. 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 GOODS & SERVICES AGREEMENT - 3 ($20,000 or Less, including WSST) 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 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. GOODS & SERVICES AGREEMENT - 4 ($20,000 or Less, including WSST) 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. 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. GOODS & SERVICES AGREEMENT - 5 ($20,000 or Less, including WSST) I. Public Records 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 Required. 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: CITY OF KENT: wo/,-ZZ By: J-/j By: (s" ature) gnature) Print Name: 4.w..+ Print Name: David A. Brock, P.E. Its: b/ am, ;P. l (o �..,,.tiers.�l /�..,� ,�- Its: e ty Director Operations Manager-. T (title) DATE: 1 1-S' DATE: �� 8 I NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: VENDOR: CITY OF KENT: Jennifer Perras Timothy J. LaPorte, P.E. Univar Solutions USA Inc. City of Kent 8201 S. 2121h St. 220 Fourth Avenue South Kent, WA 98032 Kent, WA 98032 (253) 872-5000 (telephone) (253) 856-5500 (telephone) (253) 572-5041 (facsimile) (253) 856-6500 (facsimile) ATT T: j I 7 Kent City Clerk Univar-2020 Water Chemicals/Cunningham GOODS & SERVICES AGREEMENT - 6 ($20,000 or Less, including WSST) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I ree to fulfill the five requirements referenced above. 01 By: �%G y For: `.CK.L(��s- ��L��l�t$ �S� , c Title: / 1� _c� 62� Date: 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 WATER TREATMENT CHEMICAL SUPPLY FOR 2020 PROPOSALFORM The undersigned hereby proposes to provide all equipment, labor, materials and supplies to perform the service as specified in this contract (see Special Provisions 1.4 & 1.6) for the following fees: Bidder's Name: Univar Solutions USA Inc. Item Estimated Description Bid Unit Total Annual Unit Prices Usage 11 1,000 25% Sodium Hydroxide $ 2.20 $ 2,200.00 GALS* 1,000 to 2,000 Gal. Deliveries BULK GAL. FOB 212th Treatment Plant Total $ 2,200.00 *Estimated annual need is 1,000 Gals. Actual need may vary. Univar Solutions USA Inc. Company Submitting Proposal Authorized Signature Note; Contractor must submit a firm proposal for the contract term(s). 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. A CERTIFICATE OF LIABILITY INSURANCE ATE DATE(MM/05/31/019 2019 Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFIC HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED ATE THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE BY 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 01 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). !E PRODUCER CONTACT Aon Risk Services Central, Inc. NAME:PHON -O Philadelphia PA Office (A/C.No.EXt): (866) 283-7122 FAX Nu ; 800-363-0105 y` One Liberty Place E-MAIL 1650 Market Street ADDRESS: O suite 1000 x Philadelphia PA 19103 USA INSURER(S)AFFORDING COVERAGE NAIC tl INSUREDUNIV INSURERA: ACE American Insurance Company 22667 3075 H ighland Parkway USA INC INSURERB: Indemnity Insurance Co of North America 43575 075 H Suite 200 INSURERC: ACE Fire Underwriters Insurance co. 20702 Downers Grove IL 60515 USA INSURERD: Illinois Union Insurance Company 27960 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570076477581 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTR TYPE OF INSURANCE POLICY EXP INSD WVD POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY XSLG CLAIMS-MADE X❑OCCUR SIR applies per policy terns & condl ions EACH5one $3�QQQ QQQ PREMence $11000,000 MED Erson) Excluded PERSURY E 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENEE S3,000,000 n X POLICY ❑PRO OC❑L JECT PRODUCTS-COMP/OPAGG S3,000,OOO OTHER. n 0 AUTOMOBILE LIABILITY - ISAH2527957$ 06/01/2019 06/01/2020 COMBINED SINGLE LIMIT 0 Commercial Auto Ea accident $5,000,000 X ANY AUTO BODILY INJURY(Per person) O OWNED SCHEDULED Z AUTOS ONLY AUTOS BODILY INJURY(Per accident) d HIRED AUTOS NON-OWNED PROPERTY DAMAGE A ONLY AUTOS ONLY Per accident U 1E D X UMBRELLALIAB X OCCUR XCG27380566006 06/Ol/2019 06/01/2020 EACH OCCURRENCE $4,000,OOO U EXCESS LIAB CLAIMS-MADE SIR applies per Policy ter s & condl ions AGGREGATE $4,000,000 DIED X RETENTION B WORKERS COMPENSATION AND WLRC6S$91 S 06/O1 2019 06 Ol 2020LS EMPLOYERS'LIABILITY OTH- A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN (ADS) OFFICER/MEMBER EXCLUDED? �NIA WLRC65891396 06/01/2019 06/01/2020 CIDENT $1,000,000 (Mandatory in NH) (AZ MA) Il yes,describe under EA EMPLOYEE S1,OOO,QOO ESCRIPTION OF OPERATIONS below POLICY LIMIT S1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mom space is required) RE: Delivery of water treatment chemicals, Location: All ship to locations in the Bid. City of Kent is included as Additional insured in accordance with the policy provisions of the General Liability and Automobile Liability Insured is self-insured for physical damage to their vehicles. A waiver of Subrogation is granted in favor fpcertificatehe Holder in accordance with the policy provisions of the General Liability, Automobile Liability and Workers' Compensation policies. _ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN ACCORDANCE WITH THE City of Kent POLICY PROVISIONS. Attn: Sean Bauer AUTHORIZED REPRESENTATIVE 220 4th Ave. S. Kent WA 98032 USA �yy c%�c�sbet�q ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD CORPORATION.All rights reserved. AGENCY CUSTOMER ID: 570000014538 LOC#: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMEDINSURED Aon KISK Services Central , Inc. UNIVAR USA INC POLICY NUMBER See Certificate Number: S70076477581 CARRIER NAIC CODE See Certificate Number: 570076477581 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S)AFFORDING COVERAGE NAIC# INSURER INSURER INSURER INSURER `" .err a If a nnlicv heInw dnes net inchvle limitm infnrntinn refer to the cnrreennndina nnliry on the ACORT-)t�i. i V1�it,iLJ certificate form for policy limits. POLICY POLICY LNSR ADDL SUBR EFFECTIVE EXPIRATION LTR TYPE OF INSURANCE EVSD WVD POLICY NUMBER DATE DATE LIMITS MM/DD MM/DD/YYYY AUTOMOBILE LIABILITY A MMTH2527961A 06/01 2019 06 01/2020 Combined $5,000,000 Truckers Liability Single Limi WORKERS COMPENSATION A N/A wcuc65891475 06/01/2019 06/01/2020 (CA, OH, OR, WA) SIR applies per policy to ms & conditions C N/A SCFC65891438 06/01 2019 06/01/2020 (wI) ACORD 101(2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT Named Insured Endorsement Number Univar Inc. 19 :Policy Symbol�G7123273�6�=6/01/2019 Numberiod Effective Date of Endorsement SL to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY The following is added to Section 11.2—Who Is An Insured: e. Any person or organization that you are required to include as an additional insured under this policy because of a written contract that: 1) Is in effect during this policy period; and 2) Was executed prior to the 'occurrence" of the "bodily injury"or"property damage"; and 3) Qualifies as an "insured contract' as defined in this policy. Any such person or organization is an additional insured only for "bodily injury" and "property damage" resulting from: a. "your work" that you do for that additional insured pursuant to such contract; or b. "your product'distributed or sold to that additional insured pursuant to such contract; and such person is only an additional insured for"occurrences" taking place during the period of time required by such contract or until the end of the policy period, whichever is sooner. However: i) The insurance afforded to such additional insured only applies to the extent permitted by law; and ii) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract: x. The insurance provided by this endorsement shall be limited to the Limits of Insurance required by the written contract; and y. This endorsement shall not increase the Limits of Insurance stated in the Declarations under Item 3. Limits of Insurance pertaining to the coverage provided herein. Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless the written contract specifically requires that this insurance apply on a primary or non-contributory basis. XS-21234b(08/13) Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 2 In accordance with the terms and conditions of the policy and as more fully explained in the policy, as soon as practicable, each additional insured must give us prompt notice of any "occurrence" which may result in a claim, forward all legal papers to us, cooperate in the defense of any actions, and otherwise comply with all of the policy's terms and conditions. Authorized Representative XS-21234b(08/13) Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 2 of 2 2 ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — COMPLETED OPERATIONS Named Insured Endorsement Number Univar Inc. 14 �P�ol,cySybol Policy Number �Po�l Effective Date of Endorsement G71232736 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name Of Additional Insured Person(s) Or Or anization s : Location And Description Of Completed Operations AK Steel Corporate 9227 Centre Point Drive West Chester, OH 45069 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II —Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". Authorized Agent XS-21164(11/06) Copyright, Insurance Services Office, Inc., 2004 Page 1 of 1 POLICY NUMBER: XSL G71232736 Endorsement Number: 41 EXCESS GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MISDELIVERY OF LIQUID PRODUCTS COVERAGE This endorsement modifies insurance provided under the following: EXCESS GENERAL LIABILITY COVERAGE Exclusion g. of COVERAGE A (Section 1) does not such operations have been completed or abandoned apply to "bodily injury" or "property damage" arising at the site of such delivery. out of: 1. The delivery of any liquid product into a wrong receptacle or to a wrong address; or Operations which may require further service, main- tenance, correction, repair or replacement of per- t. The erroneous delivery of one liquid product for formance at the wrong address or because of any another by an "auto;" error, defect or deficiency, but which are otherwise if the "bodily injury" or "property damage" occurs after completed, will be deemed completed. XS-20303 (06/06) Reprinted, in part, with permission of ISO Properties, Inc., 2001 Page 1 of 1 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Named Insured Endorsement Number Univar Inc. 62 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71232736 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Person or Organization: Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Authorized Agent XS-6W34(09/95)Ptd. in U.S.A. Page 1 of 1 CHUBS" SIGNATURES Named Insured Endorsement Number Univar Inc. 3 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71232736 o6/01/2019 to o6/oi/2020 Issued By(Name of Insurance Company) ACE American Insurance Company THE ONLY COMPANY APPLICABLE TO THIS POLICY IS THE COMPANY NAMED ON THE FIRST PAGE OF THE DECLARATIONS. By signing and delivering the policy to you,we state that it is a valid contract. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA(A stock company) BANKERS STANDARD INSURANCE COMPANY(A stock company) ACE AMERICAN INSURANCE COMPANY(A stock company) ACE PROPERTY AND CASUALTY INSURANCE COMPANY(A stock company) INSURANCE COMPANY OF NORTH AMERICA(A stock company) PACIFIC EMPLOYERS INSURANCE COMPANY(A stock company) ACE FIRE UNDERWRITERS INSURANCE COMPANY(A stock company) WESTCHESTER FIRE INSURANCE COMPANY(A stock company) 436 Walnut Street,P.O.Box i000,Philadelphia,Pennsylvania igio6-3703 P"\ ut�� 5 REBECCA L.COLLINS,Secretary JOHN J.LUPICA,President CC-iKiii(02/18) _ Page 1 of 1 1 ADDITIONAL INSURED — DESIGNATED PERSONS OR ORGANIZATIONS Named Insured Unlvar Inc. Endorsement Number 4 Policy Symbol Policy Number Policy Period Effective Date of Endorsement ISA H25279578 06/01/2019 To 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM EXCESS BUSINESS AUTO COVERAGE FORM Additional Insured(s): Any person or organization whom you have agreed to include as an additional insured under a written contract, Provided such contract was executed prior to the date of loss A. For a covered "auto,"Who Is Insured is amended to include as an "insured,"the persons or organizations named in this endorsement. However, these persons or organizations are an "insured" only for"bodily injury"or"property damage" resulting from acts or omissions of: 1. You. 2. Any of your"employees" or agents. 3. Any person operating a covered "auto"with permission from you, any of your"employees" or agents. B. The persons or organizations named in this endorsement are not liable for payment of your premium. Authorized Representative DA-91-174c(03/16) Page 1 of 1 POLICY NUMBER: ISA H25279578 Endorsement Number: 40 COMMERCIAL AUTO CA 23 05 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WRONG DELIVERY OF LIQUID PRODUCTS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Covered Autos Liability Coverage is changed by adding Delivery is considered completed even if further service or the following exclusion: maintenance work, or correction, repair or replacement is This insurance does not apply to: required because of wrong delivery. "Bodily injury" or "property damage" resulting from the delivery of any liquid into the wrong receptacle or to the wrong address, or from the delivery of one liquid for another, if the "bodily injury" or "property damage" occurs after delivery has been completed. CA 23 05 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS Named Insured Unlvar Inc. Endorsement Number 25 Policy Symbol Policy Number Policy Period Effective Date of Endorsement ISA H25279578 06/01/2019 To 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIERS COVERAGE FORM AUTO DEALERS COVERAGE FORM We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of the use of a covered auto. The waiver applies only to the person or organization shown in the SCHEDULE. SCHEDULE Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. Authorized Representative DA-13115a(06/14) Page 1 of 1 CHUBB" SIGNATURES Named Insured Endorsement Number Univar Inc. 3 Policy Symbol Policy Number Policy Period Effective Date of Endorsement ISA H25279578 o6/oi/2019 to o6/oi/2020 Issued By(Name of insurance Company) ACE American Insurance Company THE ONLY COMPANY APPLICABLE TO THIS POLICY IS THE COMPANY NAMED ON THE FIRST PAGE OF THE DECLARATIONS. By signing and delivering the policy to you,we state that it is a valid contract. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA(A stock company) BANKERS STANDARD INSURANCE COMPANY(A stock company) ACE AMERICAN INSURANCE COMPANY(A stock company) ACE PROPERTY AND CASUALTY INSURANCE COMPANY(A stock company) INSURANCE COMPANY OF NORTH AMERICA(A stock company) PACIFIC EMPLOYERS INSURANCE COMPANY(A stock company) ACE FIRE UNDERWRITERS INSURANCE COMPANY(A stock company) WESTCHESTER FIRE INSURANCE COMPANY(A stock company) 436 Walnut Street,P.O. Box i000,Philadelphia,Pennsylvania 191o6-3703 REBECCA L.COLLINS,Secretary JOHN J.LUPICA,President CC-lKiii(02/18) __ Page i of 1 1 NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS Named Insured Unlvar Inc. Endorsement Number 14 Policy Symbol IPolicy Number Policy Period Effective Date of Endorsement ISA IH25279578 06/01/2019 To 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM Schedule Organization Additional Insured Endorsement Any additional insured with whom you have agreed to provide such non- contributory insurance, pursuant to and as required under a written contract executed prior to the date of loss. (If no information is filled in, the schedule shall read: `All persons or entities added as additional insureds through an endorsement with the term `Additional Insured"in the title) For organizations that are listed in the Schedule above that are also an Additional Insured under an endorsement attached to this policy, the following is added to the Other Insurance Condition under General Conditions: If other insurance is available to an insured we cover under any of the endorsements listed or described above (the "Additional Insured") for a loss we cover under this policy, this insurance will apply to such loss on a primary basis and we will not seek contribution from the other insurance available to the Additional Insured. Authorized Representative DA-21886b(06/14) Page 1 of 1 POLICY NUMBER: ISA H25279578 Endorsement Number: 39 COMMERCIAL AUTO CA99481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLLUTION LIABILITY - BROADENED COVERAGE FOR COVERED AUTOS - BUSINESS AUTO AND MOTOR CARRIER COVERAGE FORMS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Covered Autos Liability Coverage is changed as "Covered pollution cost or expense" does not follows: include any cost or expense arising out of the 1. Paragraph a. of the Pollution Exclusion applies actual, alleged or threatened discharge, dispersal, only to liability assumed under a contract or seepage, migration, release or escape of agreement. "pollutants": 2. With respect to the coverage afforded by a. Before the "pollutants" or any property in Paragraph A.I. above, Exclusion 6.6. Care, which the "pollutants" are contained are Custody Or Control does not apply. moved from the place where they are B. Changes In Definitions accepted by the "insured"for movement into or onto the covered "auto"; or For the purposes of this endorsement, Paragraph D. of b. After the "pollutants" or any property in the Definitions Section is replaced by the following: which the "pollutants" are contained are D. "Covered pollution cost or expense" means any moved from the covered "auto" to the place cost or expense arising out of: where they are finally delivered, disposed of 1. Any request, demand, order or statutory or or abandoned by the "insured". regulatory requirement that any "insured" or Paragraphs a. and b. above do not apply to others test for, monitor, clean up, remove, "accidents" that occur away from premises contain, treat, detoxify or neutralize, or in any owned by or rented to an "insured"with respect way respond to, or assess the effects of to "pollutants" not in or upon a covered "auto" "pollutants"; or if: 2. Any claim or "suit" by or on behalf of a (1) The "pollutants" or any property in which governmental authority for damages because of the "pollutants" are contained are upset, testing for, monitoring, cleaning up, removing, overturned or damaged as a result of the containing, treating, detoxifying or neutralizing, maintenance or use of a covered "auto"; or in any way responding to or assessing the and effects of"pollutants". (2) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused directly by such upset, overturn or damage. CA 99 48 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number NIVAR INC. .s075 HIGHLAND PARKWAY Policy Number SUITE#200 Symbol: WLR Number:C65891396 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of Insurance Company) ACE AMERICAN INSURANCE COMPANY Insert the policy number.The remainder of the information is to be com feted only when this endorsement is issued subsequent to the preparation of the policy. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS . For the states of CA, UT, TX, refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. -he endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6)of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications. For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A.. 16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program. Authorized Representative WC 00 03 13 (11/05)Ptd. U.S.A. Copyright 1982-83, National Council on Compensation Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number NIVAR INC. .s075 HIGHLAND PARKWAY Policy Number SUITE#200 Symbol: WLR Number: C65891396 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of Insurance Company) ACE AMERICAN INSURANCE COMPANY Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. ALTERNATE EMPLOYER ENDORSEMENT This endorsement applies only with respect to bodily injury to your employees while in the course of special or temporary employment by the alternate employer in the state named in Item 2 of the Schedule. Part One (Workers Compensation Insurance) and Part Two (Employers Liability Insurance) will apply as though the alternate employer is insured. If an entry is shown in Item 3 of the Schedule the insurance afforded by this endorsement applies only to work you perform under the contract or at the project named in the Schedule. Under Part One (Workers Compensation Insurance) we will reimburse the alternate employer for the benefits required by the workers compensation law if we are not permitted to pay the benefits directly to the persons entitled to them. The insurance afforded by this endorsement is not intended to satisfy the alternate employer's duty to secure its obligations under the workers compensation law. We will not file evidence of this insurance on behalf of the alternate employer with any government agency. We will not ask any other insurer of the alternate employer to share with us a loss covered by this endorsement. Premium will be charged for your employees while in the course of special or temporary employment by the alternate employer. The policy may be canceled according to its terms without sending notice to the alternate employer. Part Four (Your Duties If Injury Occurs) applies to you and the alternate employer. The alternate employer will recognize our right to defend under Parts One and Two and our right to inspect under Part Six. Schedule 1. Alternate Employer Address IF ANY DOES NOT APPLY TO ANY EMPLOYEE LEASE CONTRACT/ARRANGEMENT 2. State of Special or Temporary Employment ANY STATE SHOWN IN ITEM 3A OF THE INFORMATION PAGE 3. Contract or Project This endorsement is not applicable in the states of AK, HI, MI, OK and TX. Authorized Representative WC 00 03 01A (Ed. 2-89) 0 Copyright 1984, 1988 National Council on Compensation Insurance, Inc.All Rights Reserved. Workers' Compensation and Employers' Liability Policy amed Insured Endorsement Number JINIVAR INC. 3075 HIGHLAND PARKWAY SUITE#200 Policy Number DOWNERS GROVE IL 60515 Symbol: WLR Number: C65891359 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of Insurance Company) INDEMNITY INS. CO. OF NORTH AMERICA Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. NOTICE TO OTHERS ENDORSEMENT— SCHEDULE A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule that you or your representative provide or have provided to us (the "Schedule"). You or your representative must provide us with the physical and/or e-mail address of such persons or organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us on such Schedule. B. The Schedule must be initially provided to us within 15 days after: I. The beginning of the Policy period, if this endorsement is effective as of such date; or ii. This endorsement has been added to the Policy, if this endorsement is effective after the Policy period commences. C. This endorsement must be in an electronic format that is acceptable to us; and must be accurate. D. Our delivery of the notification as described in Paragraph A. of this endorsement will be based on the most recent Schedule in our records as of the date the notice of cancellation is mailed or delivered to the first Named Insured. E. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. F. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. G. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with a Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. H. We may arrange with your representative to send such notice in the event of any such cancellation. I. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. J. This endorsement does not apply in the event that you cancel the Policy. All other terms and conditions of this Policy remain unchanged. Authorized Representative WC 99 03 70A(08/12) Page 1 of 1 Workers'Compensation and Employers' Liability Policy Named Insured Endorsement Number NIVAR INC. j075 HIGHLAND PARKWAY SUITE#200 Policy Number DOWNERS GROVE IL 60515 Symbol: WLR Number:C65891359 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of Insurance Company) INDEMNITY INS. CO. OF NORTH AMERICA Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. ALTERNATE EMPLOYER ENDORSEMENT This endorsement applies only with respect to bodily injury to your employees while in the course of special or temporary employment by the alternate employer in the state named in Item 2 of the Schedule. Part One (Workers Compensation Insurance) and Part Two (Employers Liability Insurance) will apply as though the alternate employer is insured. If an entry is shown in Item 3 of the Schedule the insurance afforded by this endorsement applies only to work you perform under the contract or at the project named in the Schedule. Under Part One (Workers Compensation Insurance) we will reimburse the alternate employer for the benefits required by the workers compensation law if we are not permitted to pay the benefits directly to the persons entitled to them. The insurance afforded by this endorsement is not intended to satisfy the alternate employer's duty to secure its obligations under the workers compensation law. We will not file evidence of this insurance on behalf of the alternate employer with any government agency. We will not ask any other insurer of the alternate employer to share with us a loss covered by this endorsement. Premium will be charged for your employees while in the course of special or temporary employment by the alternate employer. The policy may be canceled according to its terms without sending notice to the alternate employer. Part Four (Your Duties If Injury Occurs) applies to you and the alternate employer. The alternate employer will recognize our right to defend under Parts One and Two and our right to inspect under Part Six. Schedule 1. Alternate Employer Address IF ANY DOES NOT APPLY TO ANY EMPLOYEE LEASE CONTRACT/ARRANGEMENT 2. State of Special or Temporary Employment ANY STATE SHOWN IN ITEM 3A OF THE INFORMATION PAGE 3. Contract or Protect This endorsement is not applicable in the states of AK, HI, MI, OK and TX. Authorized Representative WC 00 03 01A (Ed. 2-89) ©Copyright 1984, 1988 National Council on Compensation Insurance, Inc.All Rights$eserved. Workers'Compensation and Employers' Liability Policy Named Insured Endorsement Number NIVAR INC. j075 HIGHLAND PARKWAY SUITE#200 Policy Number DOWNERS GROVE IL 60515 Symbol: WLR Number:C65891359 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of Insurance Company) INDEMNITY INS.CO. OF NORTH AMERICA Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS . For the states of CA, UT, TX, refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications. For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A.. 16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program. Authorized Representative WC 00 03 13 (11/OS)Ptd. U.S.A. Copyright 1982-83, National Council on Compensation 1 ALTERNATE EMPLOYERS ENDORSEMENT Named Insured Endorsement Number Univar Inc. 1 :Pjolicy Symbol �CN5891475 umber �0=101/2019 od Effective Date of Endorsement U to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: SPECIFIC EXCESS WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY POLICY This endorsement applies only with respect to bodily injury to your employees while in the course of special or temporary employment by the alternate employer in the state named in Item 2 of the Schedule. Part One (Workers Compensation Insurance) and Part Two (Employer Liability Insurance) will apply as though the alternate employer is insured. If an entry is shown in Item 3 of the Schedule the insurance afforded by this endorsement applies only to work you perform under the contract or at the project named in the Schedule. Under Part One (Workers Compensation Insurance) we will reimburse the alternate employer for the benefits required by the workers compensation law. The insurance afforded by this endorsement is not intended to satisfy the alternate employer's duty to secure its obligations under the workers compensation law. We will not file evidence of this insurance on behalf of the alternate employer with any government agency. We will not ask any other insurer of the alternate employer to share with us a loss covered by this endorsement. Premium will be charged for your employees while in the course of special or temporary employment by the alternate employer. The policy may be canceled according to its terms without sending notice to the alternate employer. Part Four(Claims) applies to you and the alternate employer. The alternate employer will recognize our right to defend under Parts One and Two and our right to inspect under Part Six. This endorsement is not applicable in FL, ME, NY, and NH. Schedule 1. Alternate Employer If Any Address Does not apply to Alaska, or to any employee lease contract/arrangement 2. State of Special or Temporary Employment any state shown in Item 3 of the Information Page 3. Contract or Project Authorized Representative WC 99 04 40(07/06) `©Chubb. 2016.All rights reserved. Page 1 of 1 1. Loss Payments We shall pay any Loss for which we may be liable under this policy in the following manner: 1. As respects Part One - Workers Compensation Insurance, payment shall first be made by you in accordance with the provisions of the workers compensation law, and we shall reimburse you for such Loss periodically, at intervals of not less than three months, upon receipt from you of proper proofs of payment. 2. As respects Part Two — Employers' Liability Insurance, if damages are paid by you, we shall make payment to you within thirty (30) days after we receive proper proofs of your payment of Loss covered under Part Two- Employers' Liability IN WITNESS WHEREOF, the Company has caused this policy to be signed by its President and Secretary, and, where required by law, its Information Page to be countersigned by one of its duly authorized representatives. utl' — REBECCA L.COLLINS,Secretary 5� JOHRI J. LUPICA, President CKE-1167M (01/15) ©ACE AMERICAN INSURANCE COMPANY Page 11 of 11 NOTICE TO OTHERS ENDORSEMENT— SCHEDULE NOTICE BY INSURED'S REPRESENTATIVE Named Insured Endorsement Number Univar Inc. 7 ]Pol�:icyyymbol :C6 cy Number Policy Period Effective Date of Endorsement 5891475 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: SPECIFIC EXCESS WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium, we will endeavor, as set out in this endorsement, to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the "Schedule") by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. B. The notice referenced in this endorsement as provided by your representative is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use. D. We will only be responsible for sending such notice to your representative, and your representative will in turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. E. This endorsement does not apply in the event that you cancel the Policy. All other terms and conditions of this Policy remain unchanged. This endorsement is not applicable in the states of AZ, FL, TX, ID, and NM. Authorized Representative WC 99 05 21 (01/11) Page 1 of 1 1 NOTICE TO OTHERS ENDORSEMENT— SCHEDULE Named Insured Unlvar Inc. Endorsement Number 17 Policy Symbol Policy Number Policy Period Effective Date of Endorsement MMT �112527961A 06/01/2019 To 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A. If we cancel the Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule that you or your representative provide or have provided to us (the "Schedule"). You or your representative must provide us with the physical and/or e-mail address of such persons or organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us on such Schedule. B. The Schedule must be initially provided to us within 15 days after: i. The beginning of the Policy period, if this endorsement is effective as of such date; or ii. This endorsement has been added to the Policy, if this endorsement is effective after the Policy period commences. C. The Schedule must be in an electronic format that is acceptable to us; and must be accurate. D. Our delivery of the notification as described in Paragraph A. of this endorsement will be based on the most recent Schedule in our records as of the date the notice of cancellation is mailed or delivered to the first Named Insured. E. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. F. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. G. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with a Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. H. We may arrange with your representative to send such notice in the event of any such cancellation. I. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. J. This endorsement does not apply in the event that you cancel the Policy. ALL-32687(05/11) Page 1 of 2 All other terms and conditions of the Policy remain unchanged. Authorized Representative ALL-32687 (05/11) Page 2 of 2 1 ADDITIONAL INSURED — DESIGNATED PERSONS OR ORGANIZATIONS Named Insured Univar Inc. Endorsement Number 8 Policy Symbol Policy Number Policy Period Effective Date of Endorsement M MT IH2527961A 06/01/2019 To 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM EXCESS BUSINESS AUTO COVERAGE FORM Additional Insured(s): Any person or organization whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss A. For a covered "auto,"Who Is Insured is amended to include as an "insured,"the persons or organizations named in this endorsement. However, these persons or organizations are an "insured" only for"bodily injury" or"property damage" resulting from acts or omissions of.- 1. You. 2. Any of your"employees" or agents. 3. Any person operating a covered "auto"with permission from you, any of your"employees"or agents. B. The persons or organizations named in this endorsement are not liable for payment of your premium. Authorized Representative DA-91J74c(03/16) Page 1 of 1 1 ?QI.JGYN'UMBER: MMT H2527961A Endorsement Number: 1 FORM MCS-90 Revised 01/05/2017 OMB No.:2126-0008 Expiration:01/31/2020 USDOT Number: Date Received _ A Federal Agency may not conduct or sponsor,and a person is not required to respond to,nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number.The OMB Control Number for this information collection is 2126-0008.Public reporting for this collection of information is estimated to be approximately 2 minutes per response,including the time for reviewing instructions,gathering the data needed,and completing and reviewing the collection of information.All responses to this collection of information are mandatory.Send comments regarding this burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden to:Information Collection Clearance Officer,Federal Motor Carrier Safety Administration,MC-RRA,Washington,D.C.20590. United States Department of Transportation h Federal Motor Carrier Safety Administration Endorsement for Motor Carrier Policies of Insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980 FORM MCS-90 Issued to Univar Inc. of Illinois (Motor Carrier name) (Motor Carrier state or province) Dated at Wilmington, DE 19803 on this 7`" day of June , 20 19 Amending Policy Number: MMT H2527961A Effective Date: 06/01/2019 Name of Insurance Company: ACE American Insurance Company Countersigned by: " (authorized company representative) The policy to which this endorsement is attached provides primary or excess insurance,as indicated for the limits shown (check only one): This insurance is primary and the company shall not be liable for amounts in excess of$ 5,000,000 for each accident. This insurance is excess and the company shall not be liable for amounts in excess of$ for each accident in excess of the underlying limit of$ (or each accident. Whenever required by the Federal Motor Carrier Safety Administration(FMCSA),the company agrees to furnish the FMCSA a duplicate of said policy and all its endorsements.The company also agrees,upon telephone request by an authorized representative of the FMCSA, to verify that the policy is in force as of a particular date.The telephone number to call is: 215-640-4555. Cancellation of this endorsement may be effected by the company or the insured by giving(1)thirty-five(35)days notice in writing to the other party(said 35 days notice to commence from the date the notice is mailed, proof of mailing shall be sufficient proof of notice),and(2)if the insured is subject to the FMCSA's registration requirements under 49 U.S.C. 13901, by providing thirty(30) days notice to the FMCSA(said 30 days notice to commence from the date the notice is received by the FMCSA at its office in Washington, DC). (continued on next page) FORM MCS-90 Page 1 of 3 MC1622u_�01-17)Wolters Kluwer Financial Services, Inc. I Uniform Forms ---- r FORM MCS-90 Revised 01/05/2017 OMB No.:2126-0008 Expiration:UT/31'/Z029 DEFINITIONS AS USED IN THIS ENDORSEMENT Accident includes continuous or repeated exposure to conditions or Environmental Restoration means restitution for the loss,damage, which results in bodily injury,property damage,or environmental or destruction of natural resources arising out of the accidental damage which the insured neither expected nor intended. discharge,dispersal,release or escape into or upon the land, Motor Vehicle means a land vehicle,machine,truck,tractor,trailer, atmosphere,watercourse,or body of water,of any commodity or semitrailer propelled or drawn by mechanical power and used on transported by a motor carrier.This shall include the cost of removal a highway for transporting property,or any combination thereof. and the cost of necessary measures taken to minimize or mitigate damage to human health,the natural environment,fish,shellfish, Bodily Injury means injury to the body,sickness,or disease to any and wildlife. person,including death resulting from any of these. Public Liability means liability for bodily injury,property damage, Property Damage means damage to or loss of use of tangible and environmental restoration. property. The insurance policy to which this endorsement is attached or violation thereof,shall relieve the company from liability or provides automobile liability insurance and is amended to assure from the payment of any final judgment,within the limits of compliance by the insured,within the limits stated herein,as a liability herein described,irrespective of the financial condition, motor carrier of property,with Sections 29 and 30 of the Motor insolvency or bankruptcy of the insured.However,all terms, rarriar Art of 1QRn anri tha n Jac anri rani datinne of tho Darin-1 Aitin..� ...J It..,it�tin..�in tho r...lir.,t..,.,hirL.tho o..rl.,.�o..,o..t Motor Carrier Safety Administration(FMCSA). is attached shall remain in full force and effect as binding between In consideration of the premium stated in the policy to which this the insured and the company.The insured agrees to reimburse endorsement is attached,the insurer(the company)agrees to pay, the company for any payment made by the company on account within the limits of liability described herein, any final judgment of any accident,claim,or suit involving a breach of the terms of recovered against the insured for public liability resulting from the policy,and for any payment that the company would not have negligence in the operation, maintenance or use of motor vehicles been obligated to make under the provisions of the policy except subject to the financial responsibility requirements of Sections for the agreement contained in this endorsement. 29 and 30 of the Motor Carrier Act of 1980 regardless of whether It is further understood and agreed that,upon failure of the or not each motor vehicle is specifically described in the policy company to pay any final judgment recovered against the insured and whether or not such negligence occurs on any route or in as provided herein,the judgment creditor may maintain an action any territory authorized to be served by the insured or elsewhere. in any court of competent jurisdiction against the company to Such insurance as is afforded,for public liability,does not apply compel such payment. to injury to or death of the insured's employees while engaged in The limits of the company's liability for the amounts prescribed the course of their employment,or property transported by the in this endorsement apply separately to each accident and any insured,designated as cargo. It is understood and agreed that payment under the policy because of anyone accident shall not no condition, provision,stipulation,or limitation contained in operate to reduce the liability of the company for the payment of the policy,this endorsement, or any other endorsement thereon, final judgments resulting from any other accident. (continued on next page) FORM MCS-90 Page 2 of 3 MC1622u(01-'7)_ - #Q117711 11ACS-190 Revised 01/05/2017 OMB No.:2126-0008 Expiration:01/31/2020 HEDULE OF LIMITS - PUBLIC LIABILITY Type of carriage Commodity transported January 1,1985 (1)For-hire(in interstate or foreign commerce,with a Property(nonhazardous) $750,000 gross vehicle weight rating of 10,000 or more pounds). (2)For-hire and Private(in interstate,foreign,or Hazardous substances,as defined in 49 CFR 171.8, $5,000,000 intrastate commerce,with a gross vehicle weight rating transported in cargo tanks,portable tanks,or hopper- of 10,000 or more pounds). type vehicles with capacities in excess of 3,500 water gallons;or in bulk Division 1.1, 1.2,and 1.3 materials, Division 2.3,Hazard Zone A,or Division 6.1, Packing Group I,Hazard Zone A material; in bulk Division 2.1 or 2.2;or highway route controlled quantities of a Class 7 material,as defined in 49 CFR 173.403. (3)For-hire and Private(in interstate or foreign Oil listed in 49 CFR 172,101;hazardous waste, commerce,in any quantity;or in intrastate commerce, $1,000,000 hazardous materials,and hazardous substances in bulk only;with a gross vehicle weight rating of defined in 49 CFR 171.8 and listed in 49 CFR 172.101, 10,000 or more pounds). but not mentioned in(2)above or(4)below. (4)For-hire and Private(In interstate or foreign Any quantity of Division 1.1, 1.2,or 1.3 material;any $5,000,000 commerce,with a gross vehicle weight rating of less quantity of a Division 2.3,Hazard Zone A,or Division than 10,000 pounds). 6.1, Packing Group I, Hazard Zone A material;or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173.403. 'The schedule of limits shown does not provide coverage.The limits shown in the schedule are for information purposes only. MC1622u f0?_1_Z) FORM MCS-90 Page 3 of 3