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HomeMy WebLinkAboutCAG2020-340 - Change Order - #1 - Colvico, Inc. - 212th Treatment Plant Light Pole Installation - 12/01/2020ApprovalOriginator: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. 1 NAME OF CONTRACTOR: Colvico, Inc. (“Contractor”) CONTRACT NAME & PROJECT NUMBER: 212th Treatment Plant ORIGINAL CONTRACT DATE: October 20, 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: No change to the work to be provided, however a change order is needed to extend the time of completion to February 28, 2021. Due to COVID-19 and associated delays in shipping, materials will not be delivered until mid-December. 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) $16,854.20 Net Change by Previous Change Orders (incl. applicable WSST) $0 Current Contract Amount (incl. Previous Change Orders) $16,854.20 Current Change Order $0 Applicable WSST Tax on this Change Order $0 Revised Contract Sum $16,854.20 Original Time for Completion (insert date) t2t3U20 Revised Time for Completion under prior Change Orders (insert date) nla Days Required (t) for this Change Order 59 calendar days Revised Time for Completion (insert date) 2t28t2t 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, particularly 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 Print Name o Its DATE: CITY OF KENT: By: Print Name:David A- B . P.E. Its DATE: /2 (titte) 6 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 Colvico - 212th Treatment Plant CO 1/Swinford ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: 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 RENTEDCLAIMS-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 AGGJECT 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 LIMITDESCRIPTION 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.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 11/5/2020 (509) 343-9528 25615 Colvico, Inc PO Box 2682 Spokane, WA 99220 25666 25674 A 1,000,000 X DCO8M267150COF20 11/1/2020 11/1/2021 300,000 10,000 1,000,000 2,000,000 2,000,000 1,000,000B X 8108M274546 11/1/2020 11/1/2021 9,000,000C X CUP5R3622022026 11/1/2020 11/1/2021 9,000,000 10,000 A DCO8M267150COF20 11/1/2020 11/1/2021 1,000,000 1,000,000 1,000,000 RE: 212th Treatment Plant Light Poles City of Kent, WA is Additional Insured with respect to General Liability for the Ongoing Operations of the Named Insured as required by written contract. General Liability coverage applies as if each insured were the only insured and separately to each insured against whom claim is made or "suit" is brought. General Liability and Auto Liability coverage is Primary Non-Contributory. City of Kent is also an Additional Insured with respect to the Auto Liability insurance. 30 day notice of cancellation is included. Umbrella follows form. Please see forms attached. City of Kent, WA 220 Fourth Avenue South Kent, WA 98032 COLVINC-01 WJOHNDROW Alliant Insurance Services, Inc. 818 W Riverside Ave Ste 800 Spokane, WA 99201 LeAnne Tope, CIC LeAnne.Tope@Alliant.com Charter Oak Fire Insurance Company Travelers Indemnity Company of America Travelers Property Casualty Company of America X X X X X X X COMM RCI L G NERAL IAB L TYEAELII T IS ENDORSEMENT CHANGES T E POLICY.PL ASE READ IT CAREFULLY.H H E BLANKET ADDITIONAL INSURED Thi e dorseme t m d fie i surance prov ded under he f l o ing:s n n o i s n i t o l w COMM RCI L G NERAL IAB LI Y COVERA E PARTEAELITG Any "bodily injury","property dam ge"oar "pe sonal injury arising out o the prov di g,r "f i nThefolowingiaddedtols or fa l re to prov de,any pro e sionaliuifs: arch te tural engineer ng o surv yingic,i r eAnypersonooganzatonthatyoagreeinarriiusevce,ncl ding:r i s i uwritenconractoragreemnttoinludeaanttecs addi ional i sured o thi Cov rage Part i atnnsesn The preparin ,approv ng,or fa li g togiin i sured,ut onlynb:prepa e or approv ,ma s,shoprep drawi gs,opin on ,reports,surv y ,n i s e sWihrepettolabiityfo"bodily injury otscilr"r fi l orders or change orders,or theed"prope ty dam ge that o curs,or fo "perso alra"c r n prepa i g,approv ng,or fa l n torniiigijuycasedbyanofesethatiscommttednr"u f n i , prepa e or app ov ,drawings andrresubsequenttothesigningofthatcontractor ag ee ent and while tha pa t o the contra t ormtrfcr spe i i a io s;andcfctn ag ee ent s in e fe t;andrmifc Su erv so y,in pe t on,archi ect ral opirscitur If a d only to the ex ent that such injury o,n t ,r engineerin a t v t e .g c i i i s dama e is ca sed by a ts o om ssio s o yo ogucrinfur Any "bodi y inju y or "prope ty dam gelr"r a "y ur subco tra tor in the perfo m nce o "y uoncrafor caused by "y ur work an in luded in theo"d cworktowhichthewritencontatoragreemen"t r c t "produ ts-com leted o erat on hazardcppis"appl e .Such person or organiza ion doe noistst un ess the wri ten cont a t o ag ee entltrcrrmqualfyaanaditionalinuredwithrepecttoisdss the independent a t o om ssions o such spe i i a ly requi escsrifcfclr y u to prov de suchoi pe son or organizationr.cov rage fo that addi ional in ured durinertsg the oli y pe iod.p c rTheisuranceprovdedtosuchaditonalinsuredisnidi subje t o he o lo ing p ov sions:c t t f l w r i The ad itional insured m st com ly with thedup If the Lim t o In uran e o thi Cov rage Part fo lowi g dutieisfscfselns: shown in the De laratio s ex eed the m nim mcnciu Giv us wri ten no i e as soon a pra tica leettcscblmtrequiedbythewrittencotratoiisrncroan"o cur en e o an o fe se whi h m yfcrc"r f n c aageeent,the i surance prov ded to thermni re ult i a clai .To t e ex en possible suchsnmhtt,addi ional insured wil be lim ted to suchtli no ice should in l de:t c umnimmrequiredlimts.Fo the purpo e oiuirssf de erm nin whether thi lim tatio applie ,thetigsins How,when an where the "o cur en edcrc" m nim m im t requi ed by the wri ten co tra t oiulisrtncr or o fe se too pla e;f n k cageeentwillbecosideredtoincludethermn The nam s and addre se o any inj redessfumnimmlimtsoanyUmbelaoExessiuifrlrc pe sons an witne s e ;andrdsslabltycovragerequiedfotheaddiionaliiierrt i sured by that writ en cont a t o agreem nt.n t r c r e The nature and lo ation o any inj ry ocfurThiprovsionwillnotincreaethelimtosisisfdamaeariingoutothe"o cur en egsfcrc"i suran e de cribed in Se tioncscn Lim t Ofis or o fe se.f nInurance.s If a cla m is ma e or "sui "i brought agai stidtsnTheinsuranceprovdedtosuchaddiionalit the ad it onal nsureddii:i sured does not ap ly o:n p t Pa e 1 o 2gf COMM RCI L G NERAL IAB LITYEAELI Im e ia ely re ord the spe i i s o themdtccfcf Te der the de ense and i dem i y o anynfnntf cla m or "suit an the date re eiv d;and cla m or "sui "to any prov deri"d c e i t i o othefr i suran e which woul cov r such addi ionalncdetNoiyusasooapractiableandseetfsnsc i sured fo a lo s we cov r.Howev r,thisnrseetoitthatwereeivwritennotieothecetcf condi ion doe not a f ct whethe thetsferclamor"suit a soon a pra ti ablei"s s c c . i suran e prov ded to such addi io alncitn Im e ia ely send us cop es o all legalmdtif i sured i prima y to ot er insurancensrh pape s receiv d in conne t on with the clairecim av ila le to such addi ional insured whi habtc or "sui ",coopera e wit us in thetth cov r that person or organi ation a aeszs i v stigat on o se tlem nt o the claim oneirtefr name i sured a de cribed i Paragraphdnssn , de e se against the "sui ",and o herwisefntt Ot e In uran e o Se tionhrsc,f c Com e cialmr com ly wit all pol cy o ditio s.p h i c n n Ge eral Liabil ty ondit on .n i C i s Pa e 2 o 2gf COMM RCI L G NERAL IAB LI YEAELIT T IS ENDORSEMENT CHANGES T E POLICY.PL ASE READ IT CAREFULLY.H H E XTEND ENDORSEMENT FOR CONTRACTORS Thi e dorseme t m d fie i surance prov ded under he f l o ing:s n n o i s n i t o l w COMM RCI L G NERAL IAB LI Y COVERAG PA TEAELITER Thi endorsem nt broadens cov rage.Howev r cov rage fo anyseee,e r i ju y,dama e o me i al ex ense descri ed in any o the provnrgrdcpsbfi ion o th s e dorseme t may bssfinne ex luded orc l m ted by anothe endorsem n to this Cov rage Pa t,and the e ciiretersov rage broadening prov sions do no ap ly toeitp the ex en tha cov rage is ex l ded or lim ted by such an entttecuidorsem n .The fo lo ing li ti g i a getlwsnseneral cov rage de cript on only Read al the prov sions o thi endorsesi.l i f s em nt and the re t o y ur pol cy ca e ullesfoirfy to de erm ne r gh s,dut es,and wha i and s not cov red.t i i t i t s i e Wh I An Insured Unnam d Subsid arieoseis In i ental Med cal Mal racti ecdipc Bla ket Addit onal Insured Gov rnme talnien Bla ket Wa v r f Sub ogationnieOr En it e Pe m t Or Au ho iza ions Re ati g Totisristrtln Co tra tua Liab l ty Rai roadncliilsOpeatiosrnDaaeToPremseRenedo YoumgistT An o ganizat on o he than a pa tnership,jo ntritrri v nture or l m ted liab l ty company;oreiiii A rust;t The fol owing is ad ed told a indi a ed in i s nam o the docum n s thasctterett :gov rn it stru ture.e s c Any o yo r sub idiar e ,o her than a pa tnershi ,f u s i s t r p jo n v nture o lim ted liabil ty com any,that iiteriips no shown as a Nam d Insured in thete De la ation i a am d In ured f:c r s s N e s i The fol owing is ad ed toldYoarethesoeownero,o ma ntai anulfrin :ownership intere t o mo e than 50%in,suchsfr Any gov r men al enti y tha ha issued a perm tentttsisubsidiayonthefistdayothepolcyperio;r r f i d or authoriza ion wit re pe t to ope ationsthscrand pe fo med by yo or on your behal and that yourrufSuhsubsidiaryinotaninuredundecssrarerequiredbyanyodinance,law,buil ing coderdsiilaohernurance.m r t i s or written cont act or agreeme t to incl de a anrnus No such subsidiary i a insured fo "bodily inju ysnrr"addi ional i sured on thi Cov rage Pa t is atnsern or "property dama e"tha o curred,o "perso al i sured,but only wi h re pgtcrnntse t to liabi i y fo "bodilycltr i ju y","prope ty dam ge"or "perso al andnrranandavrtsingijuy"caused by an o fe sedeinrfn adv rti ing inj ry"ari ing ou o uch operatio s.e s u s t f s ncomited:m t The in uran e prov ded to such gov r men alscientBeoeyoumantaiedanownershipinteretfrins en ity doe not apply o:t s tomoethan50%i such ub idiary;orfrnss Any "bodi y inju y ,"property dama e olr"g "rAfethedate,i any duri g the poli y periotrf,n c d "pe sonal and adv rti ing injury"a i ing o t oresrsufthatyonolongermantainaownershiuinp operatio s perfo m d fo the gov r men alnrerentiteretoorehan50%n such subsi ia y.n s f m t i d r en ity ort;Fo purpose o Pa agraphrsfr o Se tionfc Who Any "bodily inj ry or "property dam geu"a "Is An Insured,ea h such subsidiary wil becl i clu ed in the "products-co ple edndmtdeemdtoedeignatedintheDeclaratona:e b s i s s operatio s hazard".n Pa e 1 o 3gf COMM RCI L G NERAL IAB LI YEAELIT pharma eut cal co m t ed by o wi h thecismit,r t k owledge o co sent o ,the n urednrnfis.The fo lo i g repla e Pa agraphlwncsr o thef de i i ion o "o cur en e in thefntfcrc"The fol owing i a ded to thelsd Se tion:c Se tio :c n An a t o om ssio com i ted i prov dincrinmtnig "In i ental m d cal se v ce "m a s:c d e i r i s e n or fa l ng to prov de "incidental me icaiiidl Med cal surgi al dental laborato y,x rayi,c ,,r -se v ce ",fi st a d o "Good Sam r tanrisrirai or nur ing se v ce or treatm n ,adv ce osrietirsevce"to a person,unle s yo are irissun i struction o the related fur i hi g on,r n s n fthebusinesorocupatonoprovdinscifig fo d or bev rages;oroeproesionalheathaesevce.f s l c r r i s The furni hing o di pensing o dru s osrsfgrThefolowigrepaesthelatparagrapholnlcsf m d cal dental o surgi al supplie oei,,r c s rPaagaphrrof appl a ce .i n s: The fol o ing i added to Parag aphlwsr ,Unle s yo a e in the business or o cupatiosurcn ,ofoprovdigproesionalhealtcaesevce,f i n f s h r r i s Pa ag aphsrr ,,and abov doe not apply to :"bodily injury"arising out of prov din o ai ing o rov de:i g r f l t p i Thi i surance i ex e s ov r any v li ansnscseadd "In i ental me ica se v ce "by any ocddlrisf col e ti le othe in urance whether prim ry,l c b r s ,a y ur "em loyee "who is a nu se,nurseopsr ex e s,conti gent o on any other ba is,thatcsnrs a sistant,em rgen y me i al techni iasecdccn i av ilab e to any o your "em loy es"fosalfper or arame ic;orpd "bo ily injury that ari e ou o prov ding od"s s t f i r fa l n to prov de "i cidental medi al serv ce "i i g i n c i sFrstaior"Good Sama itan se v ce "byidrris a y o y u "em loyee "o "to any perso to the ex ent notnforpsrnt subje t tocvlunteero Pa ag aphrr o Se t onfci Who Is Anworkers",other than an employed or v lunteer do tor.Any such "em loyee "o c p s In ured.s or "v lu teer wo kers"prov ding o fa l ngonririi to prov de fi st aid or "Good Sama i anirrt The fo lowing is a ded to Paragraphld ,se v ce "during thei work hou s fo yourisrrr ,wil be deem d to be a t ng wi hin thelecit ofscoeotheiemloymntbyyoopfrpeur pe fo m n dutie rela ed to the co du trrigstnc : o yo r busine s.f u s If the insured has a ree in a cont act ogdrr The fo lo i g repla e the la t se tence olwncssnf ag ee ent to waiv that i sured'righ ormenstf Pa ag aphrr of re ov ry against any person o o gan zat on,wecerrii :waiv our right o e ov ry again t uch pe son oefrcessrr organi ation,but only fo pay ents we ma ezrmkFothepurpoeodetemnintherssfrig be ause o :c fapplcableEahOccurrenceLimt,al relatedicil a t or om ssions com i ted i prov di g ocsimtninr "Bo ily i ju y"o "property dam ge"thatdnrra fa l n to prov de "inci ental me icaiigiddl o curs;ocr se v ce ",fi st a d o "Good Sam r tanrisrirai "Pe so al and adv rti ing inj ry"ca sed byrnesuusevce"to any one perso wil be deeme torisnld an o fe se hat i com it edfntsmt;be one "o currence".c The fo lowi g ex lu ion i added to subsequent to the ex cution o thelncssef cont a t orcr Pa ag aphrr ,,of ag ee ent.r m :The fol o ing repla e Pa agraphlwcsr o thef de i i ion o "insured cont act"i thefntfrn Se tion:c"Bo ily inju y or "property dama e"ari ingdr"g s ou o the v ola ion o a penal stat te otfitfur Any ea em nt or l cense agreem nt;s e i e ordi ance rela i g to the sale ontnf Pa e 2 o 3gf COMM RCI L G NERAL IAB LITYEAELI Pa ag aphrr o the de init o o "i suredffinfn Any prem se whi e rented to yo oislur cont a t i therc"n Se tion is tem ora i y o cupied by you wi h pe m ssioncprlctri de eted.o he owne ;orlftr The co tent o any premi e whi e suchnsfssl prem se i rented to yo ,i y u rent suchissufoThefolowingreplaethedeiitiono"prem selcsfnfis prem se fo a period o sev n or feweisrferdamaeinheg"t Se tionc:conse utiv day .c e s "Pre i e dama e m a s "property dama e"to:m s s g "e n g Pa e 3 o 3gf COMM RCIAL E ERAL IAB LITYEGNLI The sta e e t in th De l ra i ns a etmnsecator a cura e a d co p e ectnmlt;If a l o the o he i sura ce pe m t co t i ut olftrnnrisnrbin by e u l sha e ,w i l fo l w t i m t o l oqarsewllohsehdas.Tho e sta e e ts a e ba e upostmnrsdn Und r th s a pr a h e ch in ure co t i ut s re re e t ti n y ueipocasrnrbepsnaoso a e to us;nmdad e ua a o n s unt l it ha pa d it a pl ca lqlmutisispibe We ha e i sue th s po i y i re i n e up nvsdilcnlaco l m t o in ura ce o no e o th l ss re a ns,i i f s n r n f e o m i y ur e re e ta i ns.o r p s n t o whi he e o e fi st.c v r c m s r The uni te ti n l o i sio o ,o uni t n i na e ronnoamsnfrnetolrr If a y o th o h r i sura ce do s no pe m tnfetennetri i ,a y i f rm ti n pro i e by y u whi h we re i dnnnoaovddocle co tr bu i n by e u l sha e ,we wi l co t i utnitoqarslnrbe up n i issui g th s po i y wi l no pre u i e y uonnilcltjdcor by l m t .Und r th s m t o ,e ch i sure 'siiseiehdanr ri ht unde th s in ura ce Ho e e ,thi pro i i ngsrisn.w v r s v s o sha e is ba e o the ra i o i s a p i a l i irsdntoftplcbelmt do s no a f ct o r ri h to co l ct a di i n letfeugtledtoa o in ura ce to th to a a pl ca l li i s ofsnetlpibemtf pre i m o to e e ci e o r rig t o ca ce l t o omurxrsuhsfnlainr i sura ce o l nsure s.n n f a l i r no re e a i cco d nce w t pp i a l n ura cennwlnaraihalcbeisn l ws o e ul t o s.a r r g a i n If y u spe i i a l a re i a wri t n co t a t oocfclygentenrcr Ex e t wi h re pe t to the Li i s o In ura ce a dcptscmtfsn,n a re m nt tha the i sura ce a fo d d to ageetnnfren a y ri h s o du i s spe i i a l a sig e i th sngtrtecfclysndni i sure un e hi Co e a e Pa t m st p l nnddrtsvrgruapyo Co e a e Pa t to the fi st Na e Insure ,th svrgrrmddi a pri a y ba i ,o a pri a y a d no -m r s s r m r n n i sura ce a pl e :n n p i s co tr bu o y ba is,th s i sura ce is pri a y tonitrsinnmr As i e ch Na e In ure we e the o lfamdsdrnyohrinuracethtiaalblosuchisuretesnasviaetndNaenure;ndmdIsdawhihoessuchnureaanmdisure,c c v r i s d s a e n d Se a a e y to e ch in ure a a n t who cl iprtlasdgismamadwewilnoshaewihthtohrinuracenltrtatesn, i m d o "sui "i b o g tsaertsruh.pro i e ha :v d d t t The "bo i y i j ry o "pro e ty da a e fodlnu"r p r m g "r whi h co e a e i so gh o cur ;ndcvrgsutcsa If the i sure ha ri h s to re o e 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tesfauirolmue If no i e is m i e ,pro f o m i i g wi l be suffi i ntcaldofalnlcettherndpreimfothtpeidadsedeaemuraronnproffoieoontc.no i e t th fi st Na e I sure .The du da etcoermdndet fo a di a d re ro pe ti e p e i m i t e d trutntscvrmusshae "shown as the due date on the bill.If the sum of Ad e t se e t"m a s a no i e th t s br a ca t ovrimnentcaiodsr pu l she to the ge e a pub i o spe i i m rbidnrllcrcfcatheadvanceandauditpremiumspaidforthek te po i y pe i d is gre te tha the e rn dlcroarnae se m nt a o t y ur go ds,pro u ts o ser i egesbuoodcrvcs fo th purp se o a t a ti g custo e s oreoftrcnmrrpremium,we will return the excess to the first Na e nsure .supp rt r .o h p r o e o hi de i i i nmdIdoesFrteupssftsfnto: The fi st Na e In ure m st k e re o d ormdsduepcrsf No i e th t a e publ she i cl de m t r atcsaridnuaeil th in o m t o we ne d fo pre i m pl ce o the Int rn t o oefrainermuadneern sim l r e e tr n cialcoi co p t ti n a d se d us co i s a such t m smuao,n n p e t i e m a s o co m ni a i n;a denfmucton a we m y re u st.s a q e Re a di g we sit s,o l tha pa t o a we si egrnbenytrfbt th t is a o t y u go d ,pro u ts o se v ceabuorosdcrris fo th pur o e o a t a t ng custo e s orepssftrcimrrByacetigtiplcyogre:c p n h s o i ,y u a e supp rt r i co si e e a a v rt se e toessndrdndeimn. Pa e 16 o 21gf POLICY :ISSUE D : NUMBER ATE THIS ENDORSEMENT CHANGES THE POLICY. PLE ASE READ IT CAREFULLY. DESIGNATED PERSO N OR ORG ANIZATION –NOTICE OF CANCELLATIO N PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION:Number of Days Notice: PERSON OR ORGANIZATION: ADDRESS: PROVISIONS If we cancel this policy for any legally permitted reason other than nonpayment of premium, and a number of days is shown for Cancellation in the Schedule above, we will mail notice of cancellation to the person or organization shown in s uch Schedule. We will mail such notice to the address shown in the Schedule above at least the number of days shown for Cancellation in such Schedule before the effective date of cancellation. IL T4 05 05 19 ú 2019 The Tra ve le rs Indemnity Co mpa ny.All rights rese rve d.Page 1 of 1 COMM RCI L AUTOEA T IS ENDORSEMENT CHANGES T E POLICY.PL ASE READ IT CAREFULLY.H H E BLANKET ADDITIONAL INSURED PRIMA Y ANDR NON-CONTRIBUTORY WITH OTHE INSURANCER CONTRACTORS Thi e dorseme t m d fie i surance prov ded under he f l o ing:s n n o i s n i t o l w BUS NE S A TO OV RAGE F RMISUCEO P O ISION 2.R V S The fol o ing i added to Paragraphlws B 5..,O hetr In u ancesr of SE TION IV BU IN S AUTCSESO1.The fol owing is a ded to Pa agrapldrh c.in A.1.,COND T ONIIS:Wh Is An Insuredo,of SE TION Il COVEREDC AU OS LIAB LIT CO E AGETIYVR:Re ardle s o the prov sions o pa ag aphgsfifrr a.and pa ag aphrr d.of this part 5.O her Insurancet,thisThiicludesanypesonororganizationwhoyosnruisuraneiprimrytoandnon-contri utory witncsabharerequiedunderawritencotratortncrapplcableotheinuranceunderwhichanirsageeent,that is signed by y u be o e thermofr addi ional insured person o organiza ion is atrt"bodi y inju y or "property dam ge o curs andlr"a "c name i sured when a writ en co tra t odntncrthatiiefetduringthepoliyperiod,to namsnfcce ag ee ent with you,tha i signed by you be orermtsfaanadditonalisuredfoCovredAutosinresthe"bodily inj ry or "property dama e"o cursu"g cLiailtyCovrage,but only fo dam ges to whi hbierac and that i in e fe t duri g the poli y perio ,s f c n c dthsinsuraneapplieandonlytotheexentoicstfreuiethiinsuranetobeprimryandnon-q r s s c athatpersonsoroganizaio's l abi i y fo the'r t n i l t r cont ibutoryr.conduct o anothe "in ured".f r s CA 4 99 2 16T0 Pa e 1 of 1g © 2016 The Travelers Indemnity Company. All rights reserved. to the in this © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. © 2016 The Travelers Indemnity Company. All rights reserved. service after a event"first of a advisor"in the for you of solely for a © 2016 The Travelers Indemnity Company. All rights reserved. (2)for mailing of materials travel officers, a advisor"solely for a For the from that have (3) to the of a Any us. a advisor"in you minimizing to you from a event" Chief Executive Officer; Chief Financial Officer; f. you are a any acting in the