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HomeMy WebLinkAboutCAG2020-272 - Change Order - #3 - Forrest Gardens LLC - KOA Buffer Land Maintenance - 11/13/2020ApprovalOriginator:Department: Date Sent:Date Required: Authorized to Sign: o Director or Designee o Mayor Date of Council Approval: Budget Account Number: Budget? o Yes o No Grant? o Yes o No Type:Review/Signatures/RoutingDate Received by City Attorney:Comments: Date Routed to the Mayor’s Office: Date Routed to the City Clerk’s Office:Agreement InformationVendor Name:Category: Vendor Number:Sub-Category: Project Name: Project Details: Agreement Amount: Start Date: Basis for Selection of Contractor: Termination Date: Local Business? o Yes o No* *If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace. Notice required prior to disclosure? o Yes o No Contract Number: Agreement Routing Form For Approvals, Signatures and Records Management This form combines & replaces the Request for Mayor’s Signature and Contract Cover Sheet forms. (Print on pink or cherry colored paper) Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20 CHANGE ORDER - 1 OF 3 CHANGE ORDER NO. 3 NAME OF CONTRACTOR: Forrest Gardens LLC (“Contractor”) CONTRACT NAME & PROJECT NUMBER: KOA Buffer ORIGINAL CONTRACT DATE: August 25, 2020 This Change Order amends the above-referenced contract; all other provisions of the contract that are not inconsistent with this Change Order shall remain in effect. For valuable consideration and by mutual consent of the parties, the project contract 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, Contractor shall provide all labor, materials, and equipment necessary to: A change order is necessary to amend the contract amount for additional hog fuel. For a breakdown, see Exhibit A which is attached 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 hereby modified as follows: Original Contract Sum, (including applicable alternates and WSST) $79,996.73 Net Change by Previous Change Orders (incl. applicable WSST) $2,541 Current Contract Amount (incl. Previous Change Orders) $82,537.73 Current Change Order $9,303.53 Applicable WSST Tax on this Change Order $930.35 Revised Contract Sum $92,771.61 Original Time for Completion (insert date) 9t30t20 Revised Time for Completion under prior Change Orders (insert date) tlns/20 Days Required (+) for this Change Order 0 calendar days Revised Time for Completion (;itsert date) tln5l20 Pursuant to the above-referenced contract, Contractor agrees to waive any protest it may have regarding this Change Order and acknowledges and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Change Order, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Change Order, unless otherwise provided, does not relieve the Contractor from strict compliance with the guarantee and warranty provisions of the original contract, pafticularly those pertaining to substantial completion date. All acts consistent with the authority of the Agreement, previous Change Orders (if any), and this Change Order, prior to the effective date of this Change Order, are hereby ratified and affirmed, and the terms of the Agreement, previous Change Orders (if any), and this Change Order 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 contract modification, which is binding on the parties of this contract. 3. The Contractor will adjust the amount of its performance bond (if any) for this project to be consistent with the revised contract sum shown in section 2, above. IN WITNESS, the parties below have executed this Agreement, which will become effective on the last date written below. CONTRACTOR: By:Cþ¿* f Far,ár- (u^", ,tóñl{fftZr*e,Print I fc Ãr DATE: (title) 11t12120 CITY OF KENT: By fu fii--* (s¡gnature) Print Na me: Chad Bieren. P.E. Its Interim Public Works Director DATE: (title) tl/t3 /n¿:t", CHANGE ORDER - 2 OF 3 CHANGE ORDER - 3 OF 3 ATTEST: ___________________________ Kent City Clerk APPROVED AS TO FORM: (applicable if Mayor’s signature required) Kent Law Department Forrest Gardens - KOA CO 3/Valencia-Gica 12.79287Change Order $LO233.8775Amend #325003500800040002500400034770.7515400200076670.757667.O7584337.A25u33.78259277'-.6075t39t5.74713Chanse Order S2541Amend #12s0035008000400025004000263L3154002000682736821.375034.37503.4342537.7312380.6595Balance (based onAmendment 2amount)57036.98t4037.32B¡d Totâl2s003500800040002500400024213154002000661136511.372724.37272.4379996.7311999.509525500.7542999.66KOA Buffer Plant¡ng ProjectBid ltemsMobilizat¡on, Prev Wages reporting, insuranceConstruction entrance with hog fuel, remove and replacefencing, signs, bollards, restore trailMowing/baling/hauling grass in bales away from sitePlowingGrubbing and haulins blackberriesTillinglmport arborist chips, 6" depth hogfuel, no invasivesSpread hogfuelcloseout and cleanupSub-totaloHP to%wssT 10%TOTALCity's holdbackAmendment #2 is only for Time Extens¡onlnvoices paidlst invoice2nd invoiceincreaseEXHIBIT A 08/13/2020 Phillips Insurance 10709 Beardslee Blvd, #201 Bothell, WA 98011 Emily Wortman (425)485-8660 (425)485-8600 ew@phillipsinsurance.net 00000878-296131 23 Forrest Gardens LLC 4519 S 190th Ct Seatac, WA 98188 Ohio Security Insurance Company 24082 A Y BKS58930111 06/25/2020 06/25/2021X X X 1,000,000 1,000,000 15,000 1,000,000 2,000,000 2,000,000 Ohio Security Insurance Company 24082 A Y BKS58930111 06/25/2020 06/25/2021 X X 1,000,000 City of Kent is additional insured per CG88100413 City of Kent 220 Fourth Ave South Kent, WA 98032 (EJW) Printed by EJW on August 13, 2020 at 01:11PM ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSDWVD DATE (MM/DD/YYYY) PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext):E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE Liberty Mutual. INSURANCE Coverage Is Provided In: Ohio Security Insurance Company Common Policy Declarations Policy Number: BKS (21 ) 58 93 0111 Policy Period: From 06/25/2020 To 06/25/2021 12:01 am Standard Time at Insured Mailing Location Named Insured & Mailing Address Agent Mailing Address & Phone No. FORREST GARDENS LLC (425) 485-8660 4519 S 190TH CT PHILLIPS INSURANCE SEATAC, WA 98188 10709 BEARDSLEE BLVD STE 201 BOTHELL, WA 98011-3280 Named Insured Is: LIMITED LIABILITY COMPANY Named Insured Business Is: LANDSCAPE GARDENING In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. SUMMARY OF COVERAGE PARTS AND CHARGES - CUSTOM PROTECTOR This policy consists of this Common Policy Declarations page, Common Policy Conditions, Coverage Parts (which consist of coverage forms and other applicable forms and endorsements, if any, issued to form a part of them) and any other forms and endorsements issued to be part of this policy. COVERAGE PART CHARGES Commercial General Liability IMPORTANT MESSAGES $1,015.00 Total Charges for all of the above coverage parts: Certified Acts of Terrorism Coverage: $6.00 $1, 015.00 (Included) Note: This is not a bill . This policy is auditable. Please refer to the conditions of the policy for details or contact your agent. Issue Date 05/03/20 To report a claim, call your Agent or 1-800-366-6446 Authorized Representative DS70211116 05/03/20 58930111 POLSVCS 235 NCXFPPNO INSURED COPY 002958 PAGE 21 OF 88 10� Liberty Mutual® INSURANCE Coverage Is Provided In: Ohio Security Insurance Company Common Policy Declarations Named Insured Agent FORREST GARDENS LLC 4519 S 190TH CT SEATAC, WA 98188 SUMMARY OF LOCATIONS Policy Number: BKS (21) 58 93 01 11 Policy Period: From 06/25/2020 To 06/25/2021 12:01 am Standard Time at Insured Mailing Location (425) 485-8660 PHILLIPS INSURANCE 10709 BEARDSLEE BLVD STE 201 BOTHELL, WA 98011-3280 This policy provides coverage for the following under one or more coverage parts. Please refer to the individual Coverage Declarations Schedules, or, the individual Coverage Forms for locations or territory definition for that specific Coverage Part. 0001 4519 S 190th Ct, Seatac, WA 98188-5110 POLICY FORMS AND ENDORSEMENTS This section lists the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 00 01 04 13 Commercial General Liability Coverage Form - Occurrence CG 01 81 05 08 Washington Changes CG 01 97 1207 Washington Changes - Employment -Related Practices Exclusion CG 21 0605 14 Exclusion - Access Or Disclosure Of Confidential Or Personal Information And Data -Related Liability - With Limited Bodily Injury Exception CG 21 7001 15 Cap on Losses from Certified Acts of Terrorism CG 21 7601 15 Exclusion of Punitive Damages Related to a Certified Act of Terrorism CG 21 86 1204 Exclusion - Exterior Insulation and Finish Systems CG 21 96 03 05 Silica or Silica -Related Dust Exclusion In witness whereof, we have caused this policy to be signed by our authorized officers. Mark Touhey Secretary David Long President To report a claim, call your Agent or 1-844-325-2467 DS 70 21 11 16 05/03/20 58930111 POLSVCS 235 NCXFPPNO INSURED COPY 002958 PAGE 22 OF 88 10� Liberty Mutual® INSURANCE Coverage Is Provided In: Ohio Security Insurance Company Common Policy Declarations Named Insured Agent FORREST GARDENS LLC 4519 S 190TH CT SEATAC, WA 98188 POLICY FORMS AND ENDORSEMENTS - CONTINUED Policy Number: BKS (21) 58 93 01 11 Policy Period: From 06/25/2020 To 06/25/2021 12:01 am Standard Time at Insured Mailing Location (425) 485-8660 PHILLIPS INSURANCE 10709 BEARDSLEE BLVD STE 201 BOTHELL, WA 98011-3280 This section lists all of the Forms and Endorsements for your policy. Refer to these documents as needed for detailed information concerning your coverage. FORM NUMBER TITLE CG 22 79 04 13 Exclusion - Contractors - Professional Liability CG 22 93 04 13 Lawn Care Services - Limited Pollution Coverage CG 24 26 04 13 Amendment of Insured Contract Definition CG 26 77 12 04 Washington - Fungi or Bacteria Exclusion CG 32 21 01 15 Washington Conditional Exclusion of Terrorism Involving Nuclear, Biological or Chemical Terrorism (Relating to Disposition of Federal Terrorism Risk Insurance Act) CG 84 94 12 08 Exclusion - Consolidated Insurance Programs Wrap -Up CG 84 99 08 09 Non -Cumulation Liability Limits Same Occurrence CG 88 10 04 13 Commercial General Liability Extension CG 88 60 1208 Each Location General Aggregate Limit CG 88 65 1208 Voluntary Property Damage Extension CG 88 67 1208 Property Damage - Borrowed Equipment - $100,000 Limit CG 88 70 12 08 Construction Project(s)-General Aggregate Limit (Per Project) CG 88 72 1208 Off Premises Property Damage Including Care, Custody or Control CG 88 77 1208 Medical Expense At Your Request Endorsement CG 88 80 1208 Property Damage - Customers' Goods ($100,000 Limit) CG 89 01 1208 Hired Auto And Non -Owned Auto Liability CG 89 27 1009 Washington Exclusion - Asbestos IL 01 23 11 13 Washington Changes - Defense Costs IL 01 46 08 10 Washington Common Policy Conditions IL 01 98 09 08 Nuclear Energy Liability Exclusion Endorsement (Broad Form) To report a claim, call your Agent or 1-844-325-2467 DS 70 21 11 16 05/03/20 58930111 POLSVCS 235 NCXFPPNO INSURED COPY 002958 PAGE 23 OF 88 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BKS (21) 58 93 Ol 11 10�mutual. Policy Period: INSURANCE From 06/25/2020 To 06/25/2021 Commercial General Liability 12:01 am Standard Time at Insured Mailing Location Declarations Basis: Occurrence Named Insured Agent FORREST GARDENS LLC (425) 485-8660 PHILLIPS INSURANCE SUMMARY OF LIMITS AND CHARGES Commercial DESCRIPTION LIMIT General Each Occurrence Limit 1,000,000 Liability Damage To Premises Rented To You Limit (Any One Premises) 1,000,000 Limits of Insurance Medical Expense Limit (Any One Person) 15,000 Personal and Advertising Injury Limit 1,000,000 General Aggregate Limit (Other than Products - Completed Operations) 2,000,000 Products - Completed Operations Aggregate Limit 2,000,000 Explanation of DESCRIPTION PREMIUM Charges General Liability Schedule Totals 1,009.00 Certified Acts of Terrorism Coverage 6.00 Total Advance Charges: $1,015.00 Note: This is not a bill To report a claim, call your Agent or 1-844-325-2467 DS 70 22 01 08 05/03/20 58930111 POLSVCS 235 NCXFPPNO INSURED COPY 002958 PAGE 25 OF 88 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BKS (21) 58 93 Ol 11 10�mutual. Policy Period: INSURANCE From 06/25/2020 To 06/25/2021 Commercial General Liability 12:01 am Standard Time at Insured Mailing Location Declarations Schedule Named Insured Agent FORREST GARDENS LLC (425) 485-8660 PHILLIPS INSURANCE SUMMARY OF CLASSIFICATIONS - BY LOCATION 0001 4519 S 190th Ct, Seatac, WA 98188-5110 Insured: FORREST GARDENS LLC CLASSIFICATION - 97047 Landscape Gardening Products -Completed Operations Are Subject To The General Aggregate Limit. Members of LLC RATED / PER COVERAGE DESCRIPTION PREMIUM BASED ON - or LLP Payroll 1,000 PREMIUM Premise/Operations 17,800 Dollars Of Payroll 19.265 $343.00 Total. Included CLASSIFICATION - 97047 Landscape Gardening Products -Completed Operations Are Subject To The General Aggregate Limit. RATED / PER COVERAGE DESCRIPTION PREMIUM BASED ON - Employees Payroll 1,000 PREMIUM Premise/Operations 26,010 Dollars Of Payroll 19.265 $501.00 0 Total. Included To report a claim, call your Agent or 1-844-325-2467 DS70231016 05/03/20 58930111 POLSVCS 235 NCXFPPNO INSURED COPY 002958 PAGE 26 OF 88 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BKS (21) 58 93 Ol 11 10�mutual. Policy Period: INSURANCE From 06/25/2020 To 06/25/2021 Commercial General Liability 12:01 am Standard Time at Insured Mailing Location Declarations Schedule Named Insured Agent FORREST GARDENS LLC (425) 485-8660 PHILLIPS INSURANCE SUMMARY OF CLASSIFICATIONS - BY LOCATION - continued CLASSIFICATION - 91581 Contractors - Subcontracted Work - In Connection With Construction, Reconstruction, Erection or Repair - Not Buildings RATED / PER COVERAGE DESCRIPTION PREMIUM BASED ON - 1,000 PREMIUM Premise/Operations Dollars Of Total Cost - if any 10.181 Total. Products/Completed Operations 9.363 Total. CLASSIFICATION - 91585 Contractors - Subcontracted Work - In Connection With Construction, Reconstruction, Repair or Erection Of Buildings NOC RATED / PER COVERAGE DESCRIPTION PREMIUM BASED ON - 1,000 PREMIUM Premise/Operations Dollars Of Total Cost - if any 4.478 0 Total. Products/Completed Operations 4.331 Total. SUMMARY OF OTHER COVERAGE COVERAGE DESCRIPTION PREMIUM Hired Auto Liability See Policy Forms and Endorsements List. $59. 00 To report a claim, call your Agent or 1-844-325-2467 DS70231016 05/03/20 58930111 POLSVCS 235 NCXFPPNO INSURED COPY 002958 PAGE 27 OF 88 Coverage Is Provided In: Policy Number: Liberty Ohio Security Insurance Company BKS (21) 58 93 0111 10�mutual. Policy Period: INSURANCE From 06/25/2020 To 06/25/2021 Commercial General Liability 12:01 am Standard Time at Insured Mailing Location Declarations Schedule Named Insured Agent FORREST GARDENS LLC (425) 485-8660 PHILLIPS INSURANCE SUMMARY OF OTHER COVERAGE - continued COVERAGE DESCRIPTION PREMIUM Non -Owned Auto Liability See Policy Forms and Endorsements List. $56. 00 Contractors Custom Protector Coverages See Policy Forms and Endorsements List $50.00 Commercial General Liability Schedule Total $1,009.00 To report a claim, call your Agent or 1-844-325-2467 DS70231016 05/03/20 58930111 POLSVCS 235 NCXFPPNO INSURED COPY 002958 PAGE 28 OF 88 COMMERCIAL GENERAL LIABILITY CG88100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT NON -OWNED AIRCRAFT NON -OWNED WATERCRAFT PROPERTY DAMAGE LIABILITY - ELEVATORS EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) MEDICAL PAYMENTS EXTENSION EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B " ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT LIBERALIZATION CLAUSE BODILY INJURY REDEFINED EXTENDED PROPERTY DAMAGE WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU PAGE 5 6 6 7 7 7 7 7 8 8 © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. A. NON -OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating her or him a commercial or airline pilot; and 4. It is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under this provision. B. NON -OWNED WATERCRAFT Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability, Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABILITY -ELEVATORS 1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3), (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage" results from the use of elevators. For the purpose of this provision, elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV - Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b. Excess Insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part: 1. Under Paragraph 2. Exclusions of Section 1 - Coverage A - Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- ing: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire, lightning, explosion, smoke, or leakage from an automatic fire protection system) to: (i) Premises rented to you for a period of 7 or fewer consecutive days; or (ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III - Limits Of Insurance. 2. Paragraph 6. under Section III - Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to: a. Any one premise: (1) While rented to you; or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) - Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 1. Under Supplementary Payments - Coverages A and B, Paragraph 1.b. is replaced by the following: b. Up to $3,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. G. ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section 11 - Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 8 b. Premises or facilities rented by you or used by you; or c. The maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury", "property damage", or "personal and ad- vertising injury" arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage" included within the "completed operations hazard". (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insur- ance 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. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (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. With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage". We have no duty to defend an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi- tions. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" arising from the sole negligence of the additional insured. b. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or "property damage" occurs. c. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occur- rence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury" or "property damage" occurring 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. e. Any person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a. Primary Insurance: If an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 8 b. The following is added to Paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS - EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit: An additional insured under this endorsement will as soon as practicable: a. Give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnify an additional insured under this endorsement until we receive written notice of a "suit" by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to the limits of insurance available under this policy. J. WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS / MALPRACTICE WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced with the following: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co -"employee" while in the course of his or her employ- ment or performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of Paragraph (1) (a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1) (a) or (b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not apply. Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ- ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 8 advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury", or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J. is excess over any other valid and collectable insurance available to your "employee". K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3. of Section II -Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L. FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Repre- sentations: Your failure to disclose all hazards or prior 'occurrences" existing as of the inception date of the policy shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior 'occurrences" is not intentional. M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT Under Section IV - Commercial General Liability Conditions, the following is added to Condition 2. Duties In The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an 'occurrence", offense, claim or "suit' by an agent, servant or "employee" of any insured shall not in itself constitute knowledge of the insured unless an insured listed under Paragraph 1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of "occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or "employee". N. LIBERALIZATION CLAUSE If we revise this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V - Definitions, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. Q. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization 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" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization; and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 8