HomeMy WebLinkAboutCAG2021-254 - Original - Carey's Small Arms Range Ventilation - Firing Range Ventilation System Upgrade - 05/26/2021KENT
Agreement Routing Form
For Approvals, Signatures and Records Management
This form tombines & replaces the Request for Mayor's Signature and Contract Cover Sheet forms.
(Print on pink or cherry colored paper)WaSHTNGToN
IE
oLee
Originator:
Jalene King
Department:
Police
Date Sent:
5t24121
Date Required:
Authorized to Sign:
E Director or Designee E MaYor
Date of Council Approval
Budget Account Number:
1 00021 00.641 90.31 1 0
Budget? EYes E No
Grant? EYes ENo
Type:
co
ibt
IE
ELorts
E
+,tro
Eq,olrol
Vendor Name:
Carey's Heating & Air Conditioning lnc. dba Carey's Small
Arms Range Ventilation
Category:
Contract
Vendor Number:
2230327
Sub-Category:
project 1r1u*". Firing Range ventilation System upgrade
project Detaits:D€ffiolition of current system and lnstallation of upgraded system
Agreement Amount $36'636.87
Start Date:
Basis for Selection of Contractor:
Termination Date: 90 Days after approval
Local Business? EYes Ef No*
*lf meets requirements per KCC 3.70..-00, please complete "Vendor Purchase-Local Exceptions" form on Cityspace.
Notice required prior to disclosure?
EYes E No
Contract Numben
org
P
J\.o
EEar=Ei
IEtr
.9
UI
Date Received by City Attorney:Comments:
Date Routed to the Mayor's Office:
Date Routed to the City Clerk's Office:
ad(W22373-1-20 Visit Documents.KentWA.gov to obtain copies of all agreements
5/25/2021 The agreement amount of $36,636.87 includes the
amount listed on the scope plus 10.1% sales tax of the
entire contract amount; consultant services and design
services are not taxable so the total contract cost is likely
to be less than $36,636.87.
OK to sign, TW, 5/26/2021.
CAG2021-254
Original
N/A
KE TuatHtiotot
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
Carey's Small Arms Range Ventilation
THIS AGREEMENT ls made between the City of Kent, a Washington munlcipal corporatlon
(hereinafter the "Clty"), and Carey's Heatlng & Air Conditionlng Inc. dba Carey's Small Arms Range
Ventilagon organlzed under the laws of the Slate of lllinols, locat-ed and doing buiiness at 8201 W 183'd
Si., Untt S, tiitey Park, Illlnois 60487, Phone Number (7OB) 532'2449 (hereinafter the "Consultant").
I, DESCRIPTION OF WORK.
The Consultant shall perform the following services for the City in accordance with the following
described plans and/or specificatlons:
The Consultant shall provide all necessary information to upgrade the Clty of Kent firing
range ventilation system, located at24523115 Ave SE, Kent Wa' 98030. This information
will include demolltlon of the current system and lnstallatlon of the upgraded system, as
described ln the attached Exhibit A, incorporated herin.
The Consultant further represents that the services furnished under this Agreement wlll be
performed in accordance wlth generally accepted professlonal practices within the Puget Sound region in
effect at the time those servlces are performed'
II, TItrtE OF COMPLETION. The partles agree that work will begin on the tasks described in
Secgon I above immediately upon the effective date of this Agreement. The Consultant shall complete the
work described ln Sectlon I withingO days of the approved seruices agreement
III. COMPENSATIOI{.
A. The city shall pay the consultant, based on flme and materials, an amount not to exceed
g361036.87, bi the servlces described in this Agreement. Thlt ls the maximum amount to
be iald under thls Agreement for the work descrlbed in Section I above, and shall not be
exceeded without the prior written authorization of the CiW in the form of a negotiated and
executed amendment to this agreement. The Consultant agrees that the hourly or flat rate
charged by it for its services iontracted for herein shall remain locked at the negotiated
rateis; foi a period of one (1) year from the effective date of this Agreement' The
consultant's billlng rates shall be as delineated in ExhibitA.
B. The Consultant shall submit monthly payment involces to the City for work performed, and
a final bllt upon completlon of all services described in this Agreement. The Clty shall
provtde payment within forty-flve (45) days of receipt of an invoice. If the City obJects to
all or iny fortion of an invoice, It shali notify the Consultant and reserues the option to only
pay that iortion of the involce not in dispute. In that event, the pafties wlll immedlately
make every effott to settle the disputed pottlon.
C. Card payment Program. The Consultant may elect to partlclpate ln automated credlt card
paymfils provlOea foFby the City and its financial lnstitutlon. Thls Prog9m is ptovided as
an alternative to payment by check and ls available for the convenience of the Consultant. If
the Consultant voluntarily participates in this Program, the Consultant wlll be solely
CONSULTANT SERVICES AGREEMENT - 1
(Over $20,000)
responsible for any fees lmposed by financial lnstitutions or credlt card companies. The
Consultant shall not charge those fees back to the City'
IV. II{DEPENDENT COilTRACTOR. The parties lntend that an Independent Contractor-
Employer Relatlonshlp wlll be created by this Agrcement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCll/, the partles make the following representations:
A. The Consultant has the ability to control and dlrect the performance and details of its
work, the City being interested only in the results obtained under this Agreement.
The Consultant malntains and pays for its own place of business from which the
Consultant's seruices under this Agreement will be performed.
The Consultant has an established and lndependent business that is ellglble for a
business deduction for federal Income tax purposes that existed before the City
retained the Consultant's services, or the Consultant is engaged ln an independently
established trade, occupation, profession, or business of the same nature as that
involved under this Agreement.
The Consultant is responsible for filing as they become due all necessary tax
documents wlth approprlate federal and state agencles, including the Internal
Revenue Service and the state Department of Revenue.
E. The Consultant has registered its business and established an account wlth the state
Department of Revenue and other state agencies as may be required by the
Consultant! business, and has obtained a Unlfied Business ldentifier (UBI) number
from the State of Washington.
F. The Consultant malntains a set of books dedicated to the expenses and earnlngs of
its business.
V. TERIIINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thlrty (30) days written notice at its address set forth on the signature block of
tnis Rgreement. Aiter termination, the City may take possession of all records and data wlthin the
Consuilant's possesslon pertalnlng to thls proJect, whlch may be used by the City without restrlction. If
the Clty,s use of the Consultant's records or data is not related to this project, it shall be without liability
or legal exposure to the Consultant.
vI. FORCE MAJEURE. Neither party shall be liable to the other For breach due to delay or
fallure in performance resulting from acts of God, acts of war or of the public enemy' riots, pandemlc, flre,
flood, or other natural disaster or acts of government f'force majeure event"). Performance that ls
prevented or delayed due to a force maJeure event shall not result in liability to the delayed party. Both
parties represent to the other that at the time of signlng thls Agreement, they are able to perform as
iequired ind their performance will not be prevented, hlndered, or delayed by the current COVID-19
pandemic, any existing state or natlonal declarations of emergency, or any current social distancing
iestrictions or personaf protective equlpment requirements that may be required under federal, state, or
local law in response to the current pandemic.
If any future performance ls prevented or delayed by a force maJeure event, the party whose
performance is prevented or delayed shall promptly notlfy the other party of the existence and nature of
the force ma5euie event causing the preventlon or delay ln performance. Any excuse from liabillty shall be
effective only to the extent and duration of the force majeure event causing the prevention or delay in
performance and, provlded, that the party prevented or delayed has not caused such event to occur and
continues to use dlllgent, good faith efforts to avoid the effects of such event and to perform the
obligatlon.
Notwithstandlng other provlslons of this section, the Consultant shall not be entitled to, and the
City shall not be liabte for, the payment of any paft of the contract price during a force maJeure event, or
CONSULTANT SERVICES AGREEMENT - 2
(0ver $20,000)
B.
c.
D
any costs, losses, expenses, damages, or delay costs lncurred by the Consultant due to a force maJeure
event. Performance that ls more costly due to a force majeure event is not included within the scope of
this Force Majeure Provision,
If a force maJeure event occurs, the City may direct the Consultant to restart any work or
performance that may have ceased, to change the work, or to take other action to secure the work or the
proJect slte durlng the force majeure event, The cost to restart, change, or secure the work or project site
arislng from a directlon by the Clty under thls clause will be dealt with as a change otder, except to the
extent that the loss or damage has been caused or exacerbated by the failure of the Consultant to fulflll its
obllgations under thls Agreement. Except as expressly contemplated by this sectlon, all other costs wlll be
borne by the Consultant.
VIf. DISCRIITIINATION. In the hiring of employees for the pefformance of work under this
Agreement or any subcontract, the Consultant, its subcontractors, or any person actlng on behalf of the
Consultant or subcontractor shall not, by reason of race, rellglon, color. sex, age, sexual orientation,
national origln, or the presence of any sensory, mental, or physical dlsabillty, discriminate agalnst any
person who is qualified and available to pedorm the work to which the employment relates. The
Consultant shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration,
Comply with Clty Adminlstrative Policy 1.2, and upon completlon of the contract work, file the attached
Compliance Statement.
VIn. INDEMNIFICATION.The Consultant shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or
sults, including all legal costs and attorney fees, arising out of or in connection wlth the Consultant's
performance of thls Agreement, except for that portion of the injurles and damages caused by the Clty's
negligence.
The City's inspection or acceptance of any of the Consultant's work when completed shall not be
grounds to avoid any of these covenants of lndemnlflcation.
Should a court of competent Jurlsdiction determlne that this Agreement is subject to RCW
4,24.L15t then, in the event of liabllity for damages arising out of bodily iniury to persons or damages to
property caused by or resultlng from the concurrent negligence of the Consultant and the City, lts officers,
officials, employees, agents and volunteers, the Consultant's duty to defend, indemniff, and hold the City
harmless, and the Consultantt liabiliW accruing from that obllgatlon shall be only to the extent of the
Consulta nt's negllgence.
IT IS FURTHER SPECTFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE CONSULTANTS WAIVER OF IMMUNIry UNDER INDUSTRJAL
INSUMNCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES
FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER.
In the event the Consultant refuses tender of defense in any sult or any claim, if that tender was
made pursuant to this indemnification clause, and if that refusal is subsequently determlned by a coutt
havlng jurisdlction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part,
then the Consultant shall pay all the City's costs for defense, lncluding 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 Consultant's Part.
The provisions of this section shall suwive the expiratlon or termination of this Agreement.
IX. INSURANCE. The Consultant shall procure and maintaln for the duration of the
Agreement, insurance of the types and in the amounts descrlbed ln Exhlblt B attached and incorporated by
thls reference.
X. EXCHAI{GE OF INFORMATION. The Clty wlll provide its best efrorts to provide
reasonable accuracy of any informatlon supplled by lt to the Consultant for the purpose of completion of
the work under thls Agreement.
CONSULTANT SERVICES AGREEMENT - 3
(Over $20,000)
xI. owNERtSHIp AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings,
designs, reports, or any other records developed or created under thls Agreement shall belong to and
becolne thi property of the City. All records submltted by the City to the Consultant will be safeguarded
by the Consultant. The Consultant shall make such data, documents, and files available to the City upon
tlie City,s request. The Consultant acknowledges that the Clty is a public agency subject to the Public
Records Act codified ln Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees
to cooperate fully with the CiW in satisfying the City's duties and obligations under the Public Records Act.
The City,s use oi reuse of any of the documents, data, and files created by the Consultant for this proiect
by anyone other than the Consultant on any other project shall be without liability or legal exposure to the
Consultant.
xil. clw's RIGHT OF INSPECTION, Even though the consultant is an independent
contractor wlth the authorlty to control and direct the performance and details of the work authorized
under this Agreement, the work must meet the approval of the Clty and shall be subject to the City's
general right of inspection to secure satisfactory completion,
xilI. woRK PERFORMED AT CONSULTANT'S RISK. The Consultant shall take all necessary
precautions and shall be responsible for the safety of lts employees, agents, and subcontractors in the
berformance of the contract work and shall utilize all protection necessary for that purpose. All work shall
be done at the Consultant's own risk, and the Consultant shall be responsible for any loss of or damage to
materials, tools, or other artlcles used or held fior use in connection with the work.
XIV. HISCELLAI{EOUS PROVISIONS.
A. Recyclable Materials, Puruant to Chapter 3.80 of the Kent City Cocle, the City requires lts
contractors and cons.ritants to use recycled and recyclable products whenever practicable, A price
preference may be avallable for any designated recycled product.
B. Non-WAiyer of Breach. The failure of the City to insist upon strict performance of any of the
covenants anO agreernents contained in thls Agreement, or to exercise any option conferred by this
Agreement in oni or more instances shall not be construed to be a walver or rellnqulshment of those
covenants, agreements or options, and the same shall be and remaln ln full force and effect.
C. Resolutlon of Dlsputes and Governing Lew, Thls Agreement shall be governed by and
construed ln accoraance wlttr the laws of the State of Washlngton. If the parties are unable to settle any
dlspute, dlfference or claim arising from the parties' performance of this Agreement, the exclusive means
of iesoiving that dispute, dtfferencl or clalm, shall only be by filing suit exclusively under the venue, rules
and jurisdlition of the King County Superlor Court, KIng County, Washington_, unless the parties agree in
wrltiig to an alternagve tlispute resolution process. In any claim or lawsuit for damages arising from the
partie6' performance of this Agreement, each party shall pay all its.legal costs_and attorney's fees incurred
in defending or bringlng such clalm or lawsuit, including all appeals, in addition to any other recovery or
award provided by lJwf provtded, however, nothinE in this paragraph shall be construed to limit the City's
right to indemnification under Section VIII of thls Agreement.
D. Written Notice, All communications regarding this Agreement shall be sent to the parties at
the addrcsses tisted on the slgnature page of the Agreernent, unless notified to the contrary. Any wrltten
notice hereunder shall become effectlve lhree (3) business days after the date of mailing by reglstered or
cerlfied mail, and shall be deemed sufficiently given lf sent to the addressee at the address stated in thls
Agreement or such other address as may be hereafter specifted in wrltlng.
E. Asslgnment. Any asslgnment of this Agreement by either party wlthout the written consent
of the non-assigning party shail be vold, If the non-assignlng party gives lts consent to any asslgnment'
the terms of thls ngieement shall continue ln full force and effect and no further assignment shall be
made without addltlonal written consent.
CONSULTANT SERVICES AGREEMENT - 4
(Over $20,00O)
F. Modiflcation, No walver, alteratlon, or modification of any of the provisions of this
Agreement shall be blndlng unless in writing and slgned by a duly authorized representative of the City
and the Consultant.
G. Entire Agreement. The written provisions and terms of this Agreement, together wlth any
Exhiblts attached hereto, shall supersede all prlor verbal statements of any ofrlcer or other representative
of the Clty, and such statements shall not be effective or be construed as entering into or forming a part
of or alterlng ln any manner this Agreement, All of the above documents are hereby made a part of this
Agreement. However, should any language ln any of the Exhibits to thls Agreement conflict wlth any
language contained in this AEreement, the terms of this Agreement shall prevail.
H. Compllance wlth Laws. The Consultant agrees to comply wlth all federal, state, and
municlpal laws, rules, and regulations that are now effective or ln the future become applicable to the
Consultant's business, equlpment, and personnel engaged in operations covered by this Agreement or
accruing out of the performance of those operations.
I. Publlc Records Act. The Consultant acknowledges that the Clty ls a public agency subJect to
the Public Records Act codlffed in Chapter 42.56 of the Revised Code of Washington and documents,
notes, emalls, and other records prepared or gathered by the Consultant in lts pedormance of this
Agreement may be subJect to publlc revlew and disclosure, even lf those records are not produced to or
possessed by the Clty of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying
the City's duties and obligations under the Publlc Records Act.
J. City Business License Requlred. Prior to commenclng the tasks descrlbed ln Section I,
Contractor agrees to provlde proof of a current city of Kent business license pursuant to Chapter 5.01 of
the Kent Clty Code.
CITY OF KENTr
Prlnt Name:
DATE:
By
lla Mrwnr
(signature)
Dana R.alohPrlnt Name:
(tftte)
K. Counteroarts and Signatures bv Fax or Emall.
number of counterparts, each of which shall constitute an origl
Agreement may be executed in any
and all of which will together constitute
thls one Agreement. Further, upon executing thls party may deliver the signature page
to the other by fax or email and that signature shall have same force and effect as if the Agreement
bearing the orlglnal signaturc was received ln person
IN WITNESS, thc paftles below €xecute AgrcGmGnt, which chall becomc cffcctlve on
the last date entered below.All acts co wlth the authority of this Agreement and prior
to lts effectlve date are ratifiad and
to havc appfled,
and the terms of the Agrccmcnt shall be deemcd
CONSULTANT SERVICES AGREEMENT - 5
(Qver $20,000)
NOTICES TO BE SENT TO:
GONSULTANT:
Brlan wright
Carey's Heating &Air Conditloning Inc. dba Carey's
Small Arms Range Ventllation
8201 W. 183 St Unit B
NOTICES TO BE SENT TO:
CITY OF KENT:
Christopher Sprague
City of Kent
220 Fourth Avenue South
Kent, WA 98032
05/26/2021
Tinley Park, Il 60487
(7 o8)s32-2449 (te le pho ne )
o 081429-21 50 (facsl m i le)
(253) 856-5857 (telephone)
(253) 856-6805 (facsimlle)
APPROVED AS TO FOR}-I:
Kent Law Department
ATTEST:
Kent Cle
lln thb ftld. !6n trrNt, €nt:r th3 rlcctlulE tll€e*h whlc th. onbrct has lrcn 3x.di
CONSULTANT SERVICES AGREEMENT . 6
(Over $20,000)
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal oppoftunity.
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 oppoftunity
policies.
The following questions specifically identlfy the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is reguired on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or suppller willfully misrepresents themselves with regard to the
direcllves outllnes, lt wlll be consldered a breach of contract and lt wlll be at the City's sole
determination regardlng suspension or termination for all or part of the Agreement;
The questlons are as follows:
1. I have read the attached City of Kent administratlve pollcy number 1'2'
2. During the time of this Agreement I wlll not discrlmlnate ln employment on the basis of
sex, race, color, national-origin, age, or the presence of all sensory, mental or physical
disabillty.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indlcating commitment as an equal opportunity
employer.
4. Durlng the time of the Agreement I, the prlme contractor, wlll actively consider hiring and
promotion of women and minorities.
5. Before acceptance of thls Agreement, an adherence statement will be signed by me, the
prime Contractor, that the Prime Contractor complied with the requirements as set fotth
above.
By signing below, I agree to fulfill ments referenced a
Date {*l J\
By:
For
Tltle:
EEO COMPLIANCE DOCUMENTS - 1
CXTY OF KENT
ADUINISTRATIVE POLICY
NUMBER: t.2 EFFECTIVE DATE: JanuarY 1, 1998
SUBJECT:
POLICY:
Equal employment opportunlty requlrements for the City of Kent will conform to federal and
stite 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 t6 $rO,Otid or more withln any given year, must take the following afflrmatlve steps:
1. provide a wrltten statement to all new employees and subcontractors indicatlng
commitment as an equal oppoftunity employer.
Z. Acgvely consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully dlsregards t!" City's
nondiscrimination and equal opportunlty requirements shall be considered ln breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Dlrectors of Plannlng, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensurlng that contractors, subcontractols, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
pollcY.
Z. Monitoring to assure adherence to federal, state and local laws, policies and guldelines.
MINORITY AND WOMEN
CONTRACTORS
SUPERSEDES: APril 1' 1996
APPROVED BY JimWhite, MaYor
EEO COMPLIANCE DOCUMENTS . 2
CITY OF KENT
EQUAL EM PLOYM ENT OPPORTU NITY COM PLIANCE STATEM ENT
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
intoonthe(date),betweenthefirmIrepresentandtheCityof
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
Carey’s Heating & Air Conditioning, Inc.
8201 West 183rd St., Unit B, Tinley Park, IL 60487
8201 W 183rd St; Suite B
Tinley Park, IL 60487
Phone: 708-532-2449
Fax: 708-429-2150
Website: careyscentral.com
March 8, 2021
Kent Police Department – Police and Fire Training Center
24523 116th Avenue Southeast
Kent, WA 98030
Attn.: Christopher Sprague
RE: Proposal for Consultant Services for the upgrade of the Indoor Small Arms Range
Ventilation System
Proposal
We propose to furnish all necessary engineering to provide all the information necessary for the
Kent Police Department to get proposals to upgrade the Indoor Small Arms Range Ventilation
System indoor gun range training building. This proposal will address all of the information
required for providing a complete bid for the demolition of the existing system as well as the new
equipment and installation of the upgraded system. Specifically, the design services will include
the following:
• Provide a demolition plan(s) showing:
o Mechanical demolition
o Electrical demolition
o General demolition
• Provide mechanical plans for the new range ventilation system specifying:
o Duct layout
o Equipment
Makeup Air Unit
Exhaust Fan
Filter Rack
Direct Digital Control System
o Gas piping
o Diffusers
o Experience Requirements
o Direct Digital Control Sequence
• Provide Electrical plan showing new power plan for the new Makeup Air Unit, Exhaust
Fan and Control panel power
• Provide Electrical plan for lighting changes or relocation in the “Get Ready Area”
• Provide General Trades Drawing showing any necessary general trades work including
equipment pads, ceiling work, etc.
• Provide any required general conditions required for the project
• Do any necessary site visits to gather information for the design and drawings.
TOTAL PRICE: $33,276.00
Please let me know if there are any questions.
Respectfully,
Brian Wright
Carey’s Small Arms Range Ventilation
EXHIBIT B
INSURANCE REQUIREMENTS FOR
CONSULTANT SERVICES AGREEMENTS
Insurance
The Consultant 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 Consultant, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Consultant 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 Iiability coverage.
Commercial General Liability insurance shall be written on
iSO occurrence form CG 00 01' The City shall be named as
an Additional Insured under the Consultant'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.
2. Workers'Compensation coverage as required by the
Industrial Insurance laws of the State of Washington'
B. Minimum Amounts of Insurance
Consultant 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 $2,000,000 each occurrence, $4,000,000
general aggregate,
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 Consultant'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 Consultant's
insurance and shall not contribute with it.
2. The Consultant'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 Consultant 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 Consultant'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 ArVIL
E. Verification of Coverage
Consultant 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 Consultant before commencement of the work.
F. Subcontractors
Consultant 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 Consultant.
--ACORD"
CAREY.l
GERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDTYYYY)
04t05t2021
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 COVEMGE 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: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
thiscertificatedoesnotconferrightstothecertificateholderinlieuofsuchendorsement(9)l
$Plll+cr Alice Sullivan
708-361 -531 6lJ8.\Eo. E,$, 708-36 1 -5300
up.comuas
NAIC #INSURERIS} AFFORDING COVERAGE
'10677rNsuRFp a. Gincinnati lnsurance Companv
PRODUCER
Hunt lnsurance Agency, lnc.
12000 S. Harlem Avenue
Palos Heights, lL 60463-1153
Matthew J. Hunt
708-361 -5300
36940TNSTJRER ".lndian
Harbor lnsurance Go,
INSIIRFR C,
INSURER D :
INSI IRFR F '
INSURER F :
carev's Heatino & Air Conditionlno, lnc.Carei's Small Arms Ranqe Ventilafion82olvv. i83rd Street. Unit B
Tinley Park, lL 60487
INSURED
THIS S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSU E D TO THE INS UR E D NAM E D ABOVE FOR THE POLICY PER loD
N DICATED N OTWTHSTANDIN ANY R EQ UIR EMENT TERM OR o ND tTro N OF ANY CONTRACT OR OTHER DOCUMEN T W TH RESPECT TO WHICH TH S
CERTIFICATE MAY BE ISSU ED R MA PERTAI N,TH E INSU RANC E AFFORDED BY THE POLIC ES DESCRIBED HEREI N IS S U BJ ECT TO ALL TH E TERM 5
EXCL USION S AN D CONDITIONS OF SU CH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM S
INSRITR TYPE OF INSURANCE
Annl SUBR POLICY NUMBER POLICY EFFtitir/nhNwl POLICY EXPrMM/NNEVYI LIMITS
A X COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE X OCCUR
POLICY
LIMIT APPLIES
PRO-JECT I I
PER:
LOC
X X EPP 0067640 04t01t2021 0410112022
FACH OCCIJRRENCE $1,000,000
DAMAGE TO RENTED
PRFMISFS lFa occurrence)500,
MFD EXP lAnv one Derson)10,0
PFRSONAI & ANV IN.IIIRY $1,000,000
GFNERAL AGGREGATE $2,000,000
PRONI ICTS - COMP/OP AGG $2,000,000
s 1,000,000Emp Ben,
A AUTOMOBILE LIABILITY
X ANY AUTO
OWNED
AUTOS ONLY
HIRED
AUTOS ONLY
SCHEDULED
AUTOS
NON-OWNED
AUTOS ONLY
X X EBA 0067640 04t01t2021 0410112022
s 1,000,000
BoDILY INJURY (Per person)$
Ronll Y lN.ll iRY lPer accidentl g
PROPERTY DAI\4AGE
lPer accident)$
g
A X UMBRELLA LIAB
EXCESS LIAB
X OCCUR
CLAIIVlS-MADE EPP 0067640 ofit01t2021 0410112022
EACH OCCURRENCE ,000
AGGRFGATE
DED X RETENTION $0 C
A WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
O FF I CER/l\ilEl\,,l BER EXCLU DED?
(Mandatory in NH)
ll yes, describe undernFqcRlPTlnN nF nPFRATInNS helnw
N N/A X EWC 0481698 04t0112021 04t01t2022
X PERSTATI ITF
OTH-FD
F I FACH ACCIDFNT s 1,000,000
FI DISEASE-EAEMPLOYEE 1,000,000
tr r ntsFAsF - Pot lcY I lMlT
,|
B
B
Pollution
Professional
PEC00325551 1
PEC00325551 1
04t01t2021
04t01t2021
04t01t2022
04to'|.12022
Pollution
Prof 3,000,
DESCR|PTIONOFOPERAT|ONS/LOCATTONS/VEHICLES (ACORDl0l,AdditionalRemarksschedule,maybeaftachedifmorespaceisrequired)
City of Kent is an additional insureds with respects to generyl and auto
tiat5ilitv coveraqe on a Primarv and Non-contributorv ba'sis if so agreed in a
writtei contrac-t executed pri<ir to the loss with the ihsured' A waiVer of
subroqation applies in favbr of the additional insureds on the general
liabilit!, auto lidbility and workers compensation policies if so agreed in
KENTN-1
City of Kent
220 Fourth Ave S
Kent, WA 98032
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ffar-r*Yn"#
@ 1988-2015 ACORD CORPORATION. All rights reserved'
The ACORD name and logo are registered marks of ACORD
ACORD 25 (2016/03)
HOLDER CODE
INSURED'S NAME
CAREY.l
OP lD:AS
prce 2
Date 0410512021
KENTN.lNOTEPAD:
a wll-tten contract executed pr{or to the loss with the insured. Umbrellaf,olLowg form.
A 30. day written notice of cancellaEion applies il accordance with policyprovisions. 10 day cancellation for non-paymenE of premium.
Forms Attached
GA233
AA4
AA4
wc0
GA4
L77
L72
00313
72TT'
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS ADDITIONAL INSURED . AUTOMATIC STATUS
AND AUTOMATIC WAIVER OF SUBROGATION
WHEN REQUIRED IN WRITTEN CONTRACT, AGREEMENT,
PERMIT OR AUTHORIZATION - ILLINOIS
This endorsement modifies insurance provided under the following
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A Additional lnsured - Owners, Lessees Or
Contractors - Automatic Status For Other
Parties When Required ln Written Contract
Or Agreement With You
1. Section ll - Who ls An lnsured is
amended to include as an additional in-
sured any person or organization you
have agreed in writing in a contract or
agreement to add as an additional in-
sured on this Coverage Part. Such per-
son(s) or organization(s) is an additional
insured only witr respect to liability for:
a. "Bodily injury'', "propedy damage' or
"personal and advertising injury"
caused, in whole or in part, by the
performance of your ongoing opera-
tions by you or on your behalf, under
that written contract or written
agreement. Ongoing operations does
not apply to "bodily injury" or "proper-
ty 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 loca-
tion of the covered operations
has been completed; or
(2) That portion of '!our work" out of
which the injury or damage aris-
es has been put to its intended
use by any person or organiza-
tion other than another contrac-
tor or subcontractor engaged in
performing operations for a prin-
cipal as a part of the same pro-
ject; and
b. "Bodily injury'' or "property damage"
caused, in whole or in part, by '!our
work" performed under that written
contract or written agreement and in-
cluded in the "products-completed
operations hazard", but only if:
(1) The Coverage Part to which this
endorsement is attached Pro-
vides coverage for "bodily injury"
or "property damage" included
within the "products-completed
operations hazard"; and
(2) The written contract or written
agreement requires you to Pro-
vide additional insured coverage
included within the "products-
completed operations hazard"
for that person or organization.
lf the written contract or written
agreement requires you to provide
additional insured coverage included
within the "products-completed oper-
ations hazard" for a specified length
of time for that person or organiza-
tion, the "bodily injury" or "propefi
damage" must occur prior to the ex-
piration of that period of time in order
for this insurance to apply.
lf the written contract or written
agreement requires you to Provide
additional insured coverage for a
person or organization per only ISO
additional insured endorsement form
number CG 20 10, without sPeciffing
an edition date, and without specifi-
cally requiring additional insured
coverage included within ihe "prod-
ucts-completed operations hazard",
this Paragraph b. does not apply to
that person or organization.
lf the written contract or written agree-
ment described in Paragraph 1, above
specifically requires you to provide addi-
tional insured coverage to that person or
organization:
a. Arising out of your ongoing opera-
tions or arising out of '!our work"; or
2
lncludes copyrighted material of lnsurance
Services Office, lnc., with its permission.GA472lL 09 18 Page 1 of3
b. By way of an edition of an ISO addi-
tional insured endorsement that in-
cludes arising out of your ongoing
operations or arising out of '!our
work";
then the phrase caused, in whole or in
part, by in Paragraph A"1.a. and/or Para-
graph A1.b. above, whichever applies, is
replaced by the phrase arising out of.
3, With respect to the insurance afforded to
the additional insureds described in Para-
graph A"1., the following additional exclu-
sion applies:
This insurance does not apply to "bodily
injun/', "propedy damage" or "personal
and advertising injury" arising out of the
rendering of, or the failure to render, any
professional architectural, engineering or
surveying services, including:
a. The preparing, approving or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or draw-
ings and specificaiions; or
b. Supervisory, inspection, architectural
or engineering activities.
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing in the supervision, hir-
ing, employment, training or monitoring of
others by that insured, if the "occurrence"
which caused the "bodily injury" or "prop-
erty damage", or the offense which
caused the "personal and adverlising inju-
ry", involved the rendering of, or the fail-
ure to render, any professional architec-
tural, engineering or surveying services.
4, This Paragraph A. does not apply to addi-
tional insureds described in Paragraph B.
B. Additional lnsured - State Or Governmental
Agency Or Subdivision Or Political Subdi-
vision - Automatic Status When Required
ln Written Permits Or Authorizations
1. Section ll - Who ls An lnsured is
amended to include as an additional in-
sured any state or governmental agency
or subdivision or political subdivision you
have agreed in writing in a contract,
agreement, permit or authorization to add
as an additional insured on this Coverage
Part. Such state or governmental agency
or subdivision or political subdivision is an
additional insured only with respect to op-
erations performed by you or on your be-
half for which the state or governmental
agency or subdivision or political subdivi-
sion issued, in writing, a contract, agree-
ment, permit or authorization.
2. With respect to the insurance afforded to
the additional insureds described in Para-
graph 8.1., the following additional exclu-
sions apply:
This insurance does not apply to:
a. "Bodily injury'', "property damage" or
"personal and advertising injury" aris-
ing out of operations performed for
the federal government, state or mu-
nicipality; or
b. "Bodily injun/' or "propefty damage"
included within the "Products-
completed operations hazard."
C. The insurance afforded to additional insureds
described in Paragraphs A" and B.:
1. Only applies to the extent permifted by
law; and
2. Will not be broader than that which you
are required by the written contract, writ-
ten agreement, written permit or written
authorization to provide for such addition-
alinsured;
3. Does not apply to any person, organiza-
tion, state, governmental agency or sub-
division or political subdivision specifically
named as an additional insured for the
same project in the schedule of an en-
dorsement added to this Coverage Part;
and
4. Does not apply to the City of Chicago, its
officers, employees and agents with re-
spect to liability caused by or arising ftom:
a. The building or disassembly of scaf-
folding by or for you; or
b. The use of such scaffolding.
D. With respect to the insurance afforded to the
additional insureds described in Paragraphs
A. and 8., the following is added to Section lll
- Limits Of lnsurance:
The most we will pay on behalf of the addi-
tional insured is tre amount of insurance:
1. Required by the written contract, written
agreement, written permit or written au-
thorization described in Paragraphs A.
and B.;or
2. Available under the applicable Limits of
lnsurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the appli-
cable Limits of lnsurance shown in the Decla*
rations.
lncludes copyrighted material of lnsurance
Services Office, lnc., with its permission.GA472lL 0918 Page 2 of 3
E. Section lV - Commercial General Liability
Gonditions is amended to add the following:
Automatic Additional Insured Provision
This insurance applies only if the "bodily inju-
ry" or "property damage" occurs, or the "per-
sonal and advertising injury'' offense is com-
mitted:
1, During the policy period; and
2. Subsequent to your execution of the writ-
ten contract or written agreement, or the
issuance of a written permit or written au-
thorization, described in Paragraphs A.
and B.
F. Except when G. below applies, the following is
added to Section lV - Gommercial General
Liability Gonditions, 5. Other lnsurance,
and supersedes any provision to the contrary:
When Other Additional lnsured Goverage
Applies On An Excess Basis
This insurance is primary to other insurance
available to the additional insured described in
Paragraphs A. and B. except:
1, As otherwise provided in Section lV -
Commercial General Liability Condi-
tions, 5. Other lnsurance, b. Excess ln-
surance; or
2. For any other valid and collectible insur-
ance available to the additional insured as
an additional insured by attachment of an
endorsement to another insurance policy
that is written on an excess basis. ln such
case, this insurance is also excess.
G. The following is added to Section lV - Com-
mercial General Liability Conditions, 5.
Other Insurance, and supersedes any provi-
sion to the contrary:
Primary Insurance When Required By Writ-
ten Contract, Agreement, Permit Or Au-
thorization
Except when wrapup insurance applies to the
claim or "suif' on behalf of the additional in-
sured, this insurance is primary to any other
insurance available to the additional insured
described in Paragraphs A. and B. provided
that:
1. The additional insured is a Named ln-
sured under such other insurance; and
2. You have agreed in writing in a contract,
agreement, permit or authorization de-
scribed in Paragraph A or B. that this in-
surance would be primary to any other in-
surance available to the additional in-
sured.
As used in this endorsement, wrapup insur-
anre means any insurance provided by a con-
solidated (wrapup) insurance program.
Primary And Noncontributory lnsurance
When Required By Written Contract,
Agreement, Permit Or Authorization
Except when wrapup insurance applies to the
claim or "suit' on behalf of the additional in-
sured, this insurance is primary to and will not
seek contribution from any other insurance
available to the additional insured described in
Paragraphs A. and B. provided that:
1. The additional insured is a Named ln-
sured under such other insurance; and
2, You have agreed in writing in a contract,
agreement, permit or authorization de-
scribed in Paragraph A" or B. that this in-
surance would be primary and would not
seek contribution from any other insur-
ance available to the additional insured.
As used in this endorsement, wrapup insur-
ance means any insurance provided by a con-
solidated (wrapup) insurance program.
H. Section lV - Commerclal General Liability
Conditions, 9. Transfer Of Rights Of Re-
covery Against Others To Us is amended by
the addition of the following:
We waive any right of recovery we may have
against any additional insured under this en-
dorsement against whom you have agreed to
waive such right of recovery in a written con-
tract, written agreement, written permit or writ-
ten authorization because of payrents we
make for injury or damage arising out of your
ongoing operations or '!our work" done under
a written contract, written agreement, written
permit or written authorization. However, our
rights may only be waived prior to the "orcur-
rence" giving rise to the injury or damage for
which we make payment under this Coverage
Part. The insured must do nothing after a loss
to impair our rights. At our request, the insured
will bring "suif' or transfer those rights to us
and help us enforce those rights.
lncludes copyrighted material of lnsurance
Services Office, lnc., with its permission.GA472lL 09 18 Page 3 of 3
8PP0067640
THIS ENDORSEIVIENT SHANGE$ THE POLICY. PLEASE READ IT CAREFULLY.
GONTRAGTORS' COMMERGIAL GENERAL LIABILITY
BROADENED ENDOR$EMENT
This endorsement modifies insurance provided under ihe following:
COMMERCIAL GENERAL LIABILIry COVERAGE PART
A. Endorsement. Table of Contents:
Cq:yerpget
Ernployee Benefl t Llabll ity
DiUnintentional Failure to rds
Damage lo Premisss Rented to You,,.,..,,...
Control
Beg!.ns on Page:
1.
2.
3,
4.
5,
o,
7,
8.
9.
2
7I
sI
10
::::,::::::::.:::,:.:::::.:,:: ::::::,: I 3
10.
. Monagers or Lessors of Premises;. Lessot of Leased Equipment;
' Vendors;
' Stato or Political Subdivisions . Permits Relating to Premises;. State or PoliticalSubdivisions - Permits;and
' Contractors'Operations
Property
11.
12.
. Emergency Medical Technicians; and
' Paramedics
13. Broadened Notice of Occurrence.,...,..,,..,,...,. ............,...,...14
B. Limits of lnsurance:
The Cornmercial Generel Liabillly Limits of lnsurance apply to the insurance provided by this endorse
ment, except as provided below:
1, Employee Benefit Liability Coverage
14
14
14
3, Damage to Premises Rented to You
The lesser ot
a. Tne Each Occurrence Lirnit shown in the Declarations; or
b, $500,000 unless otherwlse stated $
4. SupplementaryPayments
a. Bail bonds: $ 1,000
b. Loss ofearnlngs: $ 350
5. Medical Payments
MedicalExpenso Limit: $ 10,000
Each Employso Limii: $
Aggregate Llmlt: $Deductible: $
1,000,000
3,000,000
1,000
lncludos copyrighted rnaterial of lnsurance
Seruices Offioe, lnc., with its pormission,GA233 02 07 Page 1 of15
6.V^oluntary Property Damage (Coverage a.) and Care, Custody or Control Liabillty Coverage(Coverage b.)
Limits of lnsurance (Each Occurrence)
Govorage a. $1,000'
Coverage b, $5,000 unless othenvise stated $
-
Deductibles (Each Occurrence)
Coverage a. $250
Coverage b, $250 unless othenvise stated $
-
11. Property Damage to Borrowed Equiprnent
Each Occurronce Limit $ 10,000Deduotibls: $ 250
COVERAGE PREMIUM BASIS
Area
Payroll
Gross Sales
Units
Olher
RATE
(For Limits in Excess of
$5,000)
ADVANCE PREMIUM
(For Limits in Excess of
$5,000)
b.Care, Custody
or Control $
TO',ALANNUAL PREMIUM $
C. Coverages:
1. Employee Benefit Liability Coverago
a. The following js addod to SECTION I
- GOVERAGES: Employee Beneflt
Liability Coverage,
(1) lnsuring Agreement
(a) We willpay those sums ihat
the insured becomes legally
obligaied to pay as darn'
ages caused by any act, er-
ror or omission of the in-
sured, or of any other per-
son for whose acts the in-
sured is legally liable, to
which this lnsurance ap-
plies. We willhave the right
and duty to defend the ln-
sured against any "suit"
seeking those darnages.
However, we will have no
duty to defend against any
"suit" seeking damages lo
whlch lhis insurance does
not apply. We may, at our
discretion, investigate any
report of an act, orr0r or
omtsslon and settle any
clairn or "suit" that may re-
sult, But:
1) The arnount we will pay
for damages is limited
as described in $EC-
TtoN ilt " LlMtTs oF
lN$URANCE;and
2) Our right and duty to
defend ends when wo
lncludes copyrighted material of lnsurance
Servicos Office, lnc., with its permission.
have used up the aP-
plicable lirnit of insur-
ance in the payment ofjudgments or settle-
ments.
No other obligation or liabil-
Ity to pay sums or perlorm
acts or services is covered
unless explicltly provided for
under Supplernentary Pay,
menis,
(b) This insurance applies to
damages only if ihe act, er-
ror or ornission, is negli"
gently committed in the
"administration" of your
"ernployee benefit pro-
gram"; and
1) Occurs during the pol'
icy pedod; or
2') Occurrsd prior to the
effective date of thls
endorsement provided:
a) You dld not have
knowledge of a
claim or "suit" on
or befqre the ef-
fective date of this
endorsernent.
You wlll bs
deemed to have
knowledge of a
clalrn or "suit"when anv
"authorized repre'-
sentativo"i
GA 233 02 07 Page 2 of '!5
i) Reports all, or
any part, of theact, effor or
omisslon lo usoi 6ny other
Insurer;
ii) Receives a
wriilen or ver-
bal demand or
claim for darn-
ages because
of the aot, er-ror or omis'
sion; and
There is no othor
applicable insur-
ance.
Workers' Cornpensation
and Slmilar Laws
Any claim arising out of
your failure to comply with
the mandatory provis!ons of
any workers' compensatlon,
unemployment compensa-
tion insurance, social secu'
riiy or disability benefits law
or any similar law.
(g) ERI$A
Damages for which any in"
sured is liable becauss of
liabilitylmposed on a fiduci-
ary by the Employee Re-
tirement lncorne $ecurity
Act of 1974, as now or
hereafler amended, or by
any similar federal, state or
locallaws,
(h) Available Benefits
Any claim for benefits to the
axtent that suoh benefits
are available, wlth reason-
able effort and cooperatlon
of the lnsured, from the ap-
plicable funds accrued or
other collectible insurance,
{i) Taxes, Fines or Ponalties
Taxes, finos or penallies,
including lhose imposed
under the lnternal Rovenue
Code or any slmilar stale or
local law.
0) Employment-Related
Practices
Any liability arising out of
any:
(1) Relusalto employ;
(2) Termination of em-
PloYment;
(3) Coercion, demotion,
evaluation, reassign-
ment, discipline, defa-maiion, haraesmont,
humiliation, discrimina-
tion or other ernploy-
3)
formance of inveslment
vehicles; or
Advice glven to any
person with respect to
thal person's decision
to padicipate or not to
participate in any plan
includad in the "em.ployee benefit pro-
gramt'.
(f,
b)
(2) Excluslons
Thls insurarrce does not apply
to;
(a) Bodily lnJury, Property
Damage or Personal and
Adverlislng lnjury
"Bodily lnjury", "property
damage" or "personal and
advertising injury",
(b) Dishonest, Fraudulent,
Griminal or Maliclous Act
Damages arlslng out of anyintentional, dishonest,
fraudulent, criminal or mali-
cious act, error or omission,
committed by any lnsured,
lncluding the will{ul or reck-
Iess violation of any statute,
(c) Failure to Perforrn a Con.
tract
Damages arising out of fail-
ure of performance of con-
tract by any insurer.
(d) lnsufficiency of Funds
Darnages arising out of an
insufficiency of funds io
meet any obligations under
any plan included in the"employee benefit pro.
gram,'.
(e) lnadequacy of Perform'
ance of lnvestment / Ad.
vice Given With Respect
to Pa*icipation
Any claim based upon:
1) Failure of any invest-
mant to perform;
2l Errors in provlding in.
formation on past per-
tncludes copyrighied material of lnsurance
Services Office, lnc., with its permission.GA 233 02 07 Page 3 of 15
b.
ment-related practicos,. acts or ornisslons; of
{4) Consequential liablliiy
as a resull of (1), (2) or
(3) above.
This exclusion applies
whether the insured rnay be
held liable as an emplbyer
or in any olher capaclty and
to any obligation to share
damages with or 16pay
someone else who mustpay damages because of
lhe injury.
(3) $upplementary Payments
SECTION I , COVERAGES,SUPPLEMENTARY PAY.
MENTS.COVERAGESAAND
B also apply to this Coverage.
Who ls an Insured
As respects Employee Benefit Liabil.
Ity Coverage, SECTION ll . WHO tS
AN INSURED is doleted in its en-
tire$ and replaced by the following:
(1) lf you are designated in the
Declarations as:
(a) An individual, you and your
spouse are insureds, but
only with respect to the
conduci of a business of
which you are the sole
owner.
(b) A partnership or joint ven-
ture, you are an insured,
Your members, your part.
ners, and their spouses are
also insureds but only with
respect to the conduct of
your business.
(c) A limited liability company,
you are an insured. Your
members are also insureds,
but only with rospect to the
conduct of vour business.Your managers are in-
sureds, but only wilh re.
spect to thelr duties a6 your
managers.
(d) An organization other than
a partnership, joint venture
or llmited liability company,
you are an lnsured, Your
"executive officers" and di.
rectors are insureds, but
only with rospect to their
duiies as your officers or di-
rectors. Your stockholders
are also insureds, but only
with rospoot to their liability
as stockholders.
{e) A lrust, you ar6 an insured,
Your trustees are also ln.
sureds, but only with re-
spect to their duties as
trustees.
(2J Each of the lollowing is also an
insured:
(a) Each of your "employee$"
who is or was authorized to
admlnister your "employae
benefit program".
(b) Any persons, organlzationsor "employees" having
proper temporary authori-
zation to adrninister your
"ernployee benefit program"
if you die, but only until your
legal represenlative ls ap-
pointed.
(c) Your legal representative il' you die, but only with re-
spect to dutles as such.That representalive will
have all your rights and du-
ties under this Coverage
Pafi.
(3) Any organization you newly ac-
quire or forn, other than a part-
nership, joint venturo or limiled
liability company, and over
whlch you malntain ownership
or majority interest, will qualify
as a Named lnsured if no other
similar insurance applies to thai
organization. However, oovgr-
age under this provision;
(a) ls afforded only until the
1801h day afler you acquire
or form the organiza{ion or
the end of the policy period,
whichever is earlier; and
(b) Does not apply to any act,
error or omission that was
commltted before you ac-
quired or formed the or,
ganizalion,
Limits of lnsurancec,
As respects Employee Benellt Llabll-
ity Coverage, SECTION lll - LIMITS
OF INSURANCE is deleted in its en'
tirety and replacod by the following:
(1) The Limits of lnsurance shown
in Section B, Limits of lnsur-
ance, 1. Employee Benefit Li'
ability Coverage and the rules
below fix the moet wo will pay
regardless of the number of:
(a) lnsurods;
lncludes copyrighted material of lnsurance
Services Of'fice, lnc., wiih its permission.GA 233 02 07 Page4of15
(b) Claims made or ,'suits"
broughtl
(c) Persons or organizations
making claims or bringing
"suitst';
(d) Acts, errors or omissions; or
(e) Benefits included in your
"ernploy€e benefit pro,
916mrr,
(2) The Aggregate Llmit shown ln
$ection B. Limits of lnsurance,
1, Employee Beneflt Llablltty
Coverage of this endorsement
is the most we will oav for ali
damages because of acts, er-rors or omisslons negligently
committed in the "administra'
tion" of your "employee benefit
program",
(3) Subject to the limit described in
{2) above, the Each Emp]oyee
Limit shovun in Seotion B, Limitsof lnsurance, 1, Employee
Benefit Liability Coverage of
this endorsement is the most we
will pay for all darnages ous-
talned by any one "employee",
including damages sustained by
such "employee's" dependents
and beneficiaries, as a result of:
(a) An act, error or omission; or
(bJ A series of related acls, er-
rors or omieeions, regard-
less of the amount of lime
that lapses between such
acts, errors or omissions,
negligently cornmitted in the
"administration" of your "em-
ployee benefit program".
However, the amount paid un-
der this ondorsement shall not
exceed, and will be subject tothe limits and restrictions' that
apply to the payment of benefits
in any plan included in the "em-
ployee benefil program".
(4) Deductibte.Amount
(a) Our obligation lo pay dam-
ages on behalf of ihe in-
sured applios only to the
amount of damages in ex.cess of the deductible
amount stated ln the Decla.
rations as applicable lo
Each Employee. The limits
of insurancs shall noi be
reduced by tho amounl of
thls deductlble.
(b)The deductible amount
stated in the Declarations
applies to all damages
sustained by any one "em-ployee", including such
"employee's" dependents
and beneficiaries. because
of all acts, errors or omis-
sions to which this insur-
anco applies.
(c) The terms of this insurance,
including lhose wiih respect
to:
1) Our rlght and
defend the
against any
seeklng those
ages; and
duty to
insured
"suitst'
dam-
2.
lncludes copyrighted material of lnsurance
Services Olfice, lnc,, with iis permission.
Your duties, and the
duties of any other in-
voived insured, in the
event of an act, error or
ornission, or claim,
apply irrespective of the
aPPllcation of ihe deductible
arnount.
(d) We may pay any part or all
of the deductible amouni to
effeot setllement of any
claim or "suit" and, upQn
noiification of the action
taken, you shall promptly
relmburse us for such part
of the deductible amount as
we have paid.
d. AddltlonalConditions
As respects Employee Benefit Li.
ability Coverage, SECTION lV
COMMERCIAL GENEML LIABIL.
tTY C0NDITIONS is amended as
follows:
{1) ltem 2, Duties in the Event of
Occurrence, Offense, Clalm or
Suit is deleted in its entirety and
repleced by the following:
Duties [n the Event of an Act, Error or
Omission, or Claim or Suit
a. You must see to it that we are noti-
fied as soon as practlcable of an act,
error or omlssion which rnay result in
a claim, To the extent possible, no-
tice should include:
t1) What the act, error or omlsslon
was and when il occurred; and
(2) The names and addresses of
anyone who rnay suffer dam-
ages as a resull of lhe act, enor
or omission,
2l
GAz33 02 A7 Page5of15
b, lf a clalm is made or "sult" is brouoht
against any irrsured, you must:
(1) lmmedialely record the specifics
of ihe claim or "suit" and the
date recelved; and
(2) Notifu us as soon as prac{icable,
You must see to it that we receive
written notice of the claim or "suit" as
s00n as precticable.
c, You and any other involved insured
must:
{1) lmmediately send us copies of
any demands, nolices, surn*
monses or legal papers re-
ceived in connection with lhe
claim or "suit";
(2) Authorize us lo obtain records
and other information;
(3) Cooperate with us in lhe investi-
gation or settlemsnt of the clairn
or defense against the "suit";, and
(4) Assist us, upon our request, in
the enforcement of any rlght
against any person or organiza-
tion whlch may be liable io the
insured because of an act, error
or ornission to which this insur-
ance may also apply,
d. No insured will, oxcept at that ln-
sured'$ own cost, voluntarily make a
payment, assume any. obligation, or
incur any expense wiihoul our con-
s€nt,
(2) ltern 5, Other lnsurance is de-
leted in its entirety and replaced
by ihe following:
5. Other lnsurance
lf other valld and collectible
insurance is avallable lo the
insured for a loss we cover
under this Coverage Part,
our obligations are lirnited
as follows:
a, Prlmary lnsurance
This insurance is prl-
mary except when c.
below applies. lf this
insurance is primary,
our obligalions are not
affecled unless any of
the other insurance is
also primary, Then, we
will share with all that
other insurance by the
method described in b.
below,
e.
lncludss c0pyilghted material of lnsurance
$ervicos Office, lnc., with lts perrnission.
b, Method of Sharing
lf all of the other insur-
ance permiis contribu-
tion by equal shares,we wlll follow thls
method also. Under
this approach each in,
surer contributes equal
amounts until it has
paid lts appllcable limil
of insurance or none ofthe loss remalns,
whichever comes first.
lf any of the olher ln-
surance does not per-mit contribution bY
equal shares, we wlll
contribute by limits.
Under this method,
each insurer's share is
based on the ratio of its
appticable limit of in-
surance to the totai ap-
plicable limits of insur-
bnce of all insurers.
c, No Coverage
This insurance shall not
cover any loss for
which the insured is
entitled to recovery un-
der anv olher insur-
ance in'force previous
to the effeclive date of
lhis Coverage Pad.
Additional Definitlons
As respects Ernployee Benefit Li-
abitity Coverags, SECTION V -
DEFINITION$ is amended as fol-
lows:
(1) The following definitions are
added:
l, "Administralion"means:
a. Providing informaiion to
"ernployees", including
their dependents and
beneficiaries, wiih re-
spect to eligibility for or
scope ol "ernployee
benefit programs";
b, lnterpreting ihe "em'ployee benefit pro-
grams";
c, Handling records in
connection wilh the
"employeo benefit pro-
grams"; or
d. Effectlng, continuing or
termlnatlng any "em-
ployoe's" participallon
GA 233 02 07 Page 6 of 15
2."Cafeteria plans" means
plan auihoriied by applica-
ble law to allow "employ-
ees" to elect to pay for cer-taln benefits with pre.tax
dollars.
"Employee benefit pro-
grams" means a program
providing some or all of the
following benefils to "em.
ployeos", whether provided
through a "cafgteria plan" or
othenvise:
in any benefit included
in tho "ernployee bene-
fit program".
However, "administlation"
does not include;
a. Handling payroll de-
0ucuons; or
b. The failure to effect or
maintain any insurancoor adequato llrnits of
covera96 of lnsurance,
lncluding but not llmitedto unomployment in-
surance, social security
bonefits, workers' com-
pensation and disability
benefits.
benefits, workers' com-
pensallon and dtsabillty
ben8lits; and
d. Vacalion plans, includ,
lng. buy and sotl pro-
grarns; leave of ab,senco programs, in-
cluding mllitary, mater-
nity, farnily, and civilleave; tuitlon assls-
tance plans; transpor.
tatlon and health club
subsidies.
(2) The following definitions are
deleted in their enlirety and re-
placed by the following;
21. "Suit" means a civil pro-
ceeding in which money
damages because of an
acl, error or ornission to
which ihis insurance applies
are allegBd. "Suit'' includes:
a. An arbitration pro-
ceeding in which such
damages are claimed
and to which the ln-
sured must submit 0r
does subrnit with our
consenti
b. Any other alternativo
dispute resolution pro-
ceedlng ln which such
damages are claimod
and to which the in-
sured submils wlth our
consent; or
c. An appeal of a clvil
proceeding,
8, "Employee'' rneans a per-
son aclively omployed, for.
merly empioyed, on leave
of absence or disabled, orreiired, "Employee" in-
cludes a "leased worker".
''Employee" does not in'
clude a "temporary worker",
Unlntentlonal Failure to Disclose Haz.
ards
SECTION IV. COMMERCIAL GENERAL
Lt.A.BlLlTY GONDITION$, 7. Represen.
tations is hereby arnended by the addl.
tion of the followihg:
Based on our dependence upon your
representaiions as to exisiing hazards, if
unintentionally you should fail to disolose
all such hazards at the inception dato ol
your policy, we will not rejrict coverage
under this Coverage Part bassd solely on
such failure.
3
a, Group life insurance;group accident or
heaith insurance; den-
tal, vlslon and hearlngplans; and flexlbiespending accounts;
provided that no oneother than an "em-ployee" may subscribeto such benefits and
such beneflts are made
generally available to
lhose "employees" who
satisfy the plan's eligi-
bilily requirements;
b. Profll sharlng plans,ernployee savings
plans, employee stock
ownership plans, pen-
sion plans and stocksubscription plans,
provided that no oneother lhan an "etfl-
ployee" may subscribeto such beneflts and
such benefits are rnade
generally available toall "employees" who
aro eligible under the
plan for such benefits;
c. Unemployrnent insur-€nse, social security
2.
lncludes copyrighted material of lnsurance
Services Office, lnc., wlth its permission.GA 233 02 07 Page 7 of 15
3. Damage to Premlses Rented to you
a. The last Subparagraph of paragraphZ. SECTION I . COVERAGES,
COVERAGE A. " BODILY INJURY
AND PROPERTY DAMAGE, ?. LI.
ABILITY Exclusions is herebv de-
leted and reptaced by the foilowing:
Exclusions c, throuoh a. do not aonlvlo damage by firel ex'ptosion, tigjtr[-
nin-g, smoke or soot to premlses
while rented to vou or tehroorarilv
occuplod by you'with permis'sion oi
rne owner.
b, The insurance provided under SEC-
TION I . COVERAGES, COVERAGEA. BODILY INJURY AND PROP.
ERTY DAMAGE LIABILITY appliesto "proporty damage" arising out of
water damage to premlses that are
both rented to and occupied by you.
(1) As respects Water Damage Le.gat Liability, as providdd in
Paragraph 3.b. above:
The exclusions under SECTIONI. COVERAGES, COVERAGEA. BODILY INJURY AND
PROPERTY DAMAGE LIABIL"
lTY, 2. Excluslons, other lhan i,
War and the Nuclear EnerEv
Liability Exclusion, are delet6d
and the followlng are added;
This insurance does not apply
to:
(a) "Property damage";
1) Assumed in any con-
tract; or
2l Loss caused by or re-
sulting from any of the. 'tollowlng:
a) Wear and tear;
b) Rust, corrosion,fungus, decay,
deterloratlonf hld-
den or latent de-
fect or any qualityin properly that
causes it to dam-
age or destroy it-
self;
Smog;
Mechanicalbreakdown in-
cluding ruplure orbursting causedby centrilugal
force;
e) Seitling, cracking,
shrlnking or ex-
pansion; or
0 Nesting or infesta.
tion, or dischargeor release of
wasle products or
secretions, by in-
secls, birds, ro-dents or other
animals,
(b) Loss caused directly or indi-
rectly by any of the follow-
tng:
1) Earthquake, volcsnic
eruption, landslide or
any other earth move-
ment;
2l Water that backs up or
overflows from a
sswer, drain or sump;
Water under the
ground surface press-
ing on, or flowing or
seeping through:
a) Foundatlons,
walls, floors or
paved surfaces;
b)Basements,
whether paved or
noi; or
c) Doors, windows or
other openings.
(c) Loss causod by or resulting
from water that leaks or
flows from plumbing, heat-
ing, air conditioning, or fire
protectlon systems caused
by or resulting from freez-
ing, unless:
1) You did your best to
maintain heal in the
building or structure; or
2l You drained the
equipment and shut off
the waler supply if the
heat was not rnain-
tahed,
(d) Loss lo or damage tol
ll Plumbing, heating, air
conditioning, fire pro-
tection systems, ot
other equipmenl or ap.
pliances; or
2l The lnterior of any
building or structure, or
[o personal properly in
ihe building or slructure
3)
c)
d)
lncludos copyrighted material of lnsurance
Services Office, lnc,, with its permission,GA 233 02 07 Page I of 15
4.
ceused by or resuliing
frorn raln, snow, sledtor ice, whether driven
by wind or not,
c. Llmit of lnsurance
The Damage to Premises Renied to
You Llmit as shown in the Declara-
tions is amended as follows:
(2) Paragraph 0. of SECTION llt .
LIMITS oF INSURANCE is
herqb.y deleted and replaced by
lhe fbllowing:
6. Subject to 5. above, theDamage to Premises
Rented lo You Linrit is the
rnost we will pay under
COVERAGE A. BODILY
INJURY AND PROPERTY
DAMAGE LIABILITY, foTdamages because of"property damage" to
premises whlle rented to
you or temporarily occupied
by you with permlsslon ofthe owner, arising out ofany one "occurenc€" to
wh jch lhis insurance ap-
Plies,
(3) The amount we will pay is lim-
ited as described in Sectlon B.
Limits of lnsurance, 3. Dam'
age to Premises Rented to
You of this endorsement,
$upplementary Fayments
UNder SECTION I - COVERAGE, SUP.
PLEMENTARY PAYMENTS . COVER.
AGES A AND B:
a, Paragraph 2, is replaced by the fol-
lowing:
Up to lhe limit shown in Seclion B,
Limits of lnsurance, 4.a. Bail Bonds
of this endorsement for cost of bait
bonds required because of accidents
or traffic law violalions arisinq out of
the use of any vehlcle to wh'ich the
Bodily lnjury Liability Coverage ap-plies, We do not have to furnish
lhese bonds.
b. Paragraph 4. is replaced by lhe fol.
lowing:
All reasonable expenses incurred by
the lnsured al odr request to assis't
us in the investiqalion or defense ofthe claim or "suit", lncluding actual
loss of earnings up to tho limil shown
in Section B. Limits of Insurance,
4.b. Loss of Earnings of this sn-
dorsement per day because of time
off from work.
5, Medical Payments
The Medical Expense Limlt of Any One
Person as stated in the Declarali'ons is
amended to the limit $hown in Section B.
Lirnits of lnsurance, 5. Medical Pay.
ments of this endorsement.
6. Voluntary Property Damage and Care,
Custody or Control Liability Coverage
a. Voluntary Property Damage Cov-
erage
We willpay for "property damage" to
property of others arising out of op'
erations incidental to lhe lnsured's
business when:
(1) Damage is caused by the in-
suredi or
(2) Damage occurs while in the in.
sured's possession,
With your consent, we will make
these payments regardless of fault.
b. Gare, Custody or Control Liablllty
Coverage
SECTION I . COVERAGES, COV.
ERAGE A. BODILY INJURY AND
PROPERTY DAMAGE LIABILITY, 2.
Exclusions, j. Damage to Property,
Subparagraphs (3), (4) and (5) do
not apply to "property damage" to
the property of others described
lherein
With respect to the insurance provlded by
this section of the endor$emenl, the fol-
lowing additional provisions apply:
a, The Limits of lnsurance shown ln the
Declarations are replaced by the lim.
its designated in Section B. Limits of
lnsurance, 6. Vo,luntary Property
Damage and Care, Custody or
Control Liabiliiy Coverage of this
endorssment with respect to cover.
age provided by thls endorsement.
These limits are inclusive of and notin addition lo the limits being re-placed. The Limits of lnsurance
shown in Section B, Limlts of lnsur-
ance, 6. Voluntary Property Dam-
age and Care, Custody or Gontrol
Liability Coverage of this endorse.
ment fix ihe most we will pay in any
one "occurrencg" regardless of the
number of:
(1) lnsureds;
{2) Claims made or "suiis" brought;
ot
(3) Persons or organizalions mak-
ing claims or bringlng "sults''.
GA 233 02 07
lncludes copyrighted material of lnsurance
Services Offico, lnc., wiih its permisslon,Page I of15
b, Deductible Clause
(1) Our obligation to pay damageson your behalf applies onlV to
lhe amount of damaoes for riach
"occurrence" whlch-are ln ex"
cess of the deduotible amouni
stated in Seotion B. Limits of
lnsurance, 6. Voluntary Prop.
erty Damage and Care, Cus-
tody or Control Liability Cov-
erage of this endorsement. The
limits of insuranoe will not be re-
duced by the application of such
deductible amount.
(2) Condition 2. Duties in the Event
of Occunence, Offen$e, Claim
or Sult, applles to each claim or
"suit" irrespeclive of the amount.
(3) We may bay any part or all of
ths deductible amount to etfect
sotilemenl of sny clairn or "suit"
and, upon notification of the ac.
tion taken, you shall prompily
reimburse us for such pari of the
deductible amouni as has been
paid by us.
180 Day Coverage for Newly Formed or
Acquired Organizationo
$ECTION II . WHO IS AN IN$URED is
amended as follows:
Subparagraph a. of Paragraph 4. is
hereby delsted and replaced by the fol.
lowing:
a, Insurance under this provision is af.
forded only untll the 180th day after
you acquire or forrn the organizationor the end of the policy period,
whichever ls earlier;
Waiver of Subrogation
SECT]ON IV. COMMERCIAL GENERAL
LIABILITY CONDITIONS, L Transfer of
Rlghts of Recovery Against Others to
Us is hereby amended by the addition of
the following:
We waive any right of recovery we may
have because of payments we make for
lnjury or darnage arising oul of your on.
going operations or "your work" done un-der a writton con(ract requiring such
waiver with that person or organization
and included in the "products-dompleted
operalians hazard". However, our rights
may only be waived prior to the "occur-
rence'' giving dse to the injury or damage
for which we make payment under this
Coverage Part, The insured must do
nothing after a loss to impair our rights.
At our request, the insured will bring "suit"
or transfer those rights to us and help us
enforco those rights.
Automatic Addltlonal Insured - Speci-
fled Relatlonshlps
a. The following is hereby added lo
SECTION II. WHO IS AN INSURED:
(1) Any person or organization de-
scribed ln Paragraph 9.a.(2)
below (hereinafter referred to as
additional insured) whom you
are required to add as an addi-
tional insured under this Cover-
age Part by reason of:
(a) A written contract or
agreomont;or
{b) An oral aureement or con-' ' iract wheie a certificate of
insurance showing that per-
son or organizatlon as on
additional insured has been
issued,
is an insured, provlded:
(a) The wriiten or oral oontract
or agreernent is:
1) Currently in effect orbecomes effective
during the policy pe-
riod;and
2l Executed prior to an
"ogcurrence" or offense
to which this lnsurance
would apply; and
{b) They are nol specifically
named as an additional in-
sured under any other pro-
vision of, or endorsement
added to, this Coverage
Part.
(2) Only the following persons or
organizalions are additional ln-
$ursd$ under this ondorsement,
and insuranco coverage pro"
vided to such additional in-
sureds is limited a$ provided
hereinr
(a) The rnanager or le$sor of a
premises leased to you with
whom you have agreed per
Paragraph 9.a,(1) above to
provido insurance, but only
with respect to liability aris-
ing out of lhe ownership,
maintenance or use of that
part CIt a premlses leased to
you, subject to the following
additional exclusions;
This lnsurance does not
apply to:
1) Anv "occurrence"' which takes place after
9.
7
I
lncludes copyrighted rnaterial of lnsurance
$ervices Offico, lnc., with its permission.GA 233 02 07 Page 10 of15
you ceaso to be a ten-
ant ln that premlses,
2l StructUral alterations,new construction or
demolition operations
performed by or on be-
half of such additional
insured.
(b) Any person or organizdtionfrom which you lease
equiprnenl with whom you
have agreed per Paragraph
9,a.(1) above to provide in-
surance, $uch person(s) or
organization(s) are insureds
solely with respect to their
liability arlsing out of the
maintenanca, operation oruse by you of equipment
leased to you by such per-
son(s) or organlzations(s).
Howevor, this insurance
does not apply to any "oc-
currsnce" whlch takes place
after the equipment lease
exprres,
(c) Any person or organization
(referred to below as ven-
dor) with whom you haveagreed per Paragraph
9.a.(1) above to provide in-
surance, but only with re.
spact to "bodily injury" or
"property darnage" arising
out of "your products" which
are dlstrlbuted or sold ln the
regular course of ths ven-
dor's business, subJect to
the following additional ex.
clusions:
1) The insurance affordedthe vendor does not
aPply to:
a) "Bodily inJury" or
"property damage"
for which the ven"
dor is obligated topay damages by
reason of the as-
sumption of liabll-
ity ln a contract or
agreernent. This
exclusion does not
apply to liability for
damages that ihevendor would
have in the ab-
sence of the con,tract or agree-
ment;
b) Any express war-
ranty unauthorized
by you;
c) Any physical or
chemlcal changein the product
made intentionally
by lhe vendor;
d) Repackaging, un-less unpacked
solely for the pur-
pose of inspection,
dernonslrailon,
testing, or thesubstitutlon ofparts under in'
structions from the
manufacturer, andlhen repackagedin the original
conlainer;
e) Any fallure tomake such in-
spectiono, adjust"
menig, iests or
seruiclng as thevendor has
agreed to make or
normally under-
takes to make in
the usual coursoof business, in
connection with
the distribution or
sale of the prod-
ucts;
f)
s)
Dernonslrallon, in-
stallation, servic-
lng or repair op-
erations, exceptsuch operatlons
performed at the
vendor's premises
in connection with
the sale of the
produot;
Products which,
after dlstribulion or
sale by you, have
been labeted or
relabeled or usedas a container,
paft or lngredient
of any other thing
or substance by or
for tho vendor.
This insurance does
not apply to any in.
sured person or or.
ganizalion:
a) From whom younave acqulreo
such producls, orany lngredienl,
part or container,
entering into, ac-
2t
lncludes copyrlghted maierial of lnsurance
$ervices Office, lnc,, with its permission,GA233 02 07 Page 11 of 15
companying otcontalning such
products; or
b) When liabitity in-
cluded within the
"products-
completed opera.
tions hazard" hasboen excluded
under this Cover.
age Part with re.spect to such
products.
(d) Any state or polltical subdi.
vision with which you haveagreed per Paragraph
9.a.(1) above to provlde ln'
surance, subject to the fol.
lowing additional provision:
Thls insurance applies only
with respect to the following
hazards for which the state
or political subdivision has
lssued a permit in connec-
tion with premises you ownr
rent or control and io which
lhis insu rance appl ies;
1) The existence, mainte-
nance, repair, con-
struction, erectloR, or
removal of advertising
signs, awnings, cano-
pies, cellar entrances,
coal holes, driveway$,
manholes, marquees,
holst away openings,
sidewalk vaults, street
bannero, or decora-
tlons and similar expo.
sures; 0r
2) The construction, erec-
tlon, or removal of ele-
vators; or
3) The ownership, main-
tenance, or use of any
elevators covered by
this insurance,
(e) Any state or politlcal subdi.
vision with which you haveagreod per Paragraph
S.a-(1) above to provide in-
surance, subiect to the fol-
lowing provisions:
1) This insuranco applies
only with respect to op-
eratlons performed by
you or on your bohalf
for which the state or
political subdivision has
issuod a permit.
2, This insurance doos
not apply to I'bodlty ln-jury", "property dam-
age" or "personal and
advertislng injury" aris-ing out of operalions
performed for the state
or political subdivision,
(A Any person or organization
with which you have agreodper Paragraph 9.a.(1)
above to provide insurance,
but only with respect to li-
ability arising out of "your
work" performed for that
additional insured by you or
on your behalf. A person or
oroanizalion's slatus as an
iniured under this provision
of this endorsement contin-
ues for only the period of
tirne required bY the written
contract or agreement, bul
in no event beyond the ex-
piration date of this Cover-
age Part, lf there is no
written contract or agree-
rnent, or if no period of lime
ls required bY the written
coniract or agreemont, a
pBrson 0r organization's
status as an insured underthis endorsernent ends
when your operatlons for
that insured are completed,
{3} Anv insurance nrovided to an' ' additional insuied designated
under Paragraph 9.a.{2):
(a) Subparagraphs (e) and (f)
does not apply to "bodily
Injury" or "property damage"
inbluded withln lhe "prod.
ucts-cornplotad oPerations
hazard";
tb)
additional insured or their
agents, "employees" or any
olher represeniative of the
additionalinsured; or
(c) Subparagraph (f) does not
apply to "bodily injury",
"property damage" ot- "per-
sonal and advertising injury"
arislng out of:
1) Defects ln deslgn fur-
nlshed by or on behalf
raphs (a), (b), (d),
does not 6pply to
, "ploperty
ersonal anddam
out of
or willful
GA 233 02 07
lncludes copyrighted material of lnsurance
Services Offlce, lnc., wlth its permlsslon,Page 12 of 15
3)
of the additional ln-
sured; or
The rendering of, or
failure to render, any
professl0nal architec.
lural, engineering or
surveylng services, ln.
cluding:
a) The preparing,
approving or fail-
ing to prepare orapprove maps,shop drawings,
opinions, reports,
surveys, field or-
ders, change or-
ders or drawings
and specifications;
and
b) Supervlsory, in-
speclion, archi-
teclural or engi-
neerlng actlvities.
"Your work" for which a
consolidated (wrap-up)
insurance program has
been provldsd by the
p rimecon lra cto r-project
rnanager or owner of
the construction project
in which you are in-
volved.
Only with regard to insurance pro-
vided to an addilional insured desig-
nated under Paragraph 9.a,(2) Sub-
peragraph (f) above, SEGTION lll "
LIMITS OF INSURANCE is amended
to include:
The limits applicable to the addiiional
insured are those specified in the
written contract or asreement or in
lhe Declarations of -this Coverage
Part, whichever are less. lf no limlts
are specified in the written contract
or agreement, or if there is no written
contracl or agreement, the limits ap-
plicable to the additional insured are
those specified in the Declarations of
this Coverage Part. The limits of in-
surance are inolusive of and not in
addliion to the llmits of lnsurance
shown in the Declarations.
SECTION IV. COMMERCIAL GEN.
ERAL LIA,BILITY coNDlTloN$ is
hereby amend€d as follows:
(1) Condition 5. Other lnsurance is
amended to include:
(a) Where required by a written
contract or. agreement, this.
insurance is primary and /or nonconlributory as re-
spects any olher insurance
pollcy lssued to the addl.
iional insured, and such
other insurance policy shall
be excess and I or noncon-
tribuling, whichever applies,
with this insurance,
(b) Any insurance provided by
this endorsemeni shall be
prlmary to other insurance
available to the additional
insured except:
1) As otherwise providodiN SECTION IV
COMMERCIAL GEN.ERAL LIABILITY
coNDlTloNs, S.Other
lnsurance, b, Excess
lnsurance; or
2) For any other valid and
collectible insurance
availahle lo the addi-
tional insured as an
additionat lnsured bY
atlaohment of an en-
dorsemeni to another
insurance policy that is
wriften on an excess
basls, [n such case,
the coverage provided
under lhls endorse'
ment shall also be ex-
ces5.
(2) Condition 11. Conformance to
Soeciflc Writtsn Contract or
A'greement ls hereby added:
1f . Conformance to SpecificWritten Contract or
Agreement
With respect to additional
insureds described in Para-
graph 9.a,{2)(f) above only:
lf a written contract or
agreement bel.ween You
and the additional insured
specifles that coverage for
the additional insured:
a. Be provided by ihe ln-
surance $ervices Ot
fice additional lnsured
form number CG 20 10
or CG 20 37 (where
odition specified); or
b, lnclude coverage for
completed operalions;
0r
c. lnclude ooverage for
"your work";
and where the limits or cov-
erage provided to the addi-
2')
b.
c
GA233 02 07
lncludes copyrighted materlal of lnsurance
$orvlces Office, lnc., wlth its permission.Page 13 of15
tional insured is more re-
strlctlve than was specifi-
cally required in that wriften
contract or agreemeni, theterms of Paragraphs
9.a.(3)(a), 9.a.(3)(b) or e.b.
above, or any cornbination
thereof, shall be lnterpretedas providing the limits or
coverage required by the
terrns of the written contract
or aqreement, but only to
the eltsnt thit suitr fmiis oi
coverage is lncluded within
ihe terms of the Coveraoe
Part to which this endors"e-
rnent is attached. li, how-
ever, the writton contract or
agreement specifies the ln-surance Servlces Offlce
additional insured form
number CG 20 10 but does
not specify which edition, or
specifles an edition that
does not exist, Paragraphs
9.a.(3)(a) and e.a.(3)(b) of
this ondorsement shall not
apply and Paragraph I.b. of
thls endorsement shall ap.
plv,
10. Broadened Contractual Liabitity' Work
Within 50' of Railroad Proporty
It is hereby agreed that Paragraph f.(1) ol
Definltion 12. "lnsured contract" ($EC-
TION V. DEFINITIONS) is deleted. '
11. Property Darnage to Borrowed Equip-
ment
a. The foilowlng is hereby added to Ex.
clusion j, Damage to Property of
Paragraph 2., Exclusions of SEC.
TION I . GOVERAGES, COVERAGE
4,. BODILY INJURY AND PROP-
ERTY DAMAGE LIABILITY;
Paragraphs (3) and (4) of lhis exclu-
sion do not apply to tools or equip-
ment loaned to you, provided they
are not being used to perform opera.
tions at the time of loss.
b, With respect to the insurance pro"
vlded by thls sectlon of the en-
dorsement, ihe followlng additlonal
provislons apply:
{1} Tho Limits of insurance shown
in the Declarations are replaced
by the limits designated in Sec,
tion B. Limits of lnsurance, 11.
of this endorsement with respectto coverago provlded by this
endorsement, These limits are
inclusive of and not in addition to
the limits being replaced, The
Limits of lnsurance shown ln
Section B. Limits of lnsurance,
11. of this endorsomont fix the
most we wlll pay ln any one "oo.curence" regardless of the
number of;
(a) lnsureds;
(b) Glaims made or "suits"
brought; or
{") Persons or organizations
making clairns or bring
"suils".
(2) Deductible Clause
(a) Our obligation tq pqy dq.m-
ages on your behalf applies
only to the amount of dam"
ages for each "occurrence"
which are lrr excess of the
Deductible amount stated in
$eotion B. Limits of lnsur-
ance, 11. of this endorse-
ment. The limits of insur-
ance willnot be reduced bY
the application of such ge.
ductible amount.
(b) Condition 2. Duties ln the
Event of Occurrencs, Of'
fense, Claim or Suit, aP'
plies to each clalm o[ "suit"
irrespoctive ol the amounl,
(c) We may pay anY Part or all
of the deductible amount to
effect seitl6ment of any
claim or "suit" and, uPon
nolificalion of tlro action
taken, you shall promPtlY
reimburse us for such Part
of the deductible arnount as
has been Pald bY us.
12. Employ€ss as lnsureds - Specified
Health Care Services
It is hereby agreed that Paragraph
2.a,(1)(d) ol SECTION ll - WHo tS AN
INSUREB, does not apply to your "em-
,ployees" who provide professlonal heallh
care services on your behalf as duiy li-
censed:
a. Nurses;
b. EmergencyMedicaiTechnicians: or
c. Pararnedics,
in the jurisdiction where an "occurrence"
or offonse to which this insurance appiies
lakes place.
13. Broadened Notice of Occurrence
Paragraph a. ol Condition 2. Duties in
the Event ol Occurrence, Offense,
Clatm or Suit (SECTION lV. COMMER.
CIAL GENERAL LIABILITY CONDI.
lncludes copyrighted rnaterial of lnsuranco
Servicos Office, lnc., with its permisslon,GA 233 02 07 Pago 14 ot 15
Ilg.NS) is hereby deteted and reptaced
by the followingl '
a. You must see lo it that we are notl-fied as soon as practicable of an
"occurrence" or an offonse which
may result in a claim. To the extenl
possible, notice should include:
(1) How, when and where the ,bc.
cunenc€" or ofFense took place;
(2) The narnes and addresses ofany injured persons and wit-
nesses: and
(3) The nature and location of any
injury or damage arlsing out of
the "occunence" or offense.
This requirement applies only when
the "occurrence" or offensg is known
to an "authorized representative".
GA233 0? 07
lncludes copyrtghted material of lnsurance
Services Office, lnc,, with its permission,Fage 15 of '15
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION . AUTO
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
This endorsement changes the policy effective on the inception date of the policy unless another date is indi-
cated below.
epresentative)
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
1. Blanket Waiver of Subrogation
SECTION IV . BUSINESS AUTO CONDI-
TIONS, A. Loss Conditions, 5. Transfer of
Rights of Recovery Against Others to Us is
amended by the addition of the following:
We waive any right of recovery we may have
against any person or organization because
of payments we make lor "bodily injury" or
"property damage" arising out of the operation
of a covered "auto" when you have assumed
liability for such "bodily injury" or "property
damage" under an "insured contract", pro-
vided the "bodily injury" or "property damage"
occurs subsequent to the execution of the "in-
sured contract".
Policy Number:
EBA 006 76 40
E ndorsement Effective:
04-0L-2021
Named lnsured
CAREYS HEATING & AIR CONDITIONING INC
-Z*/A."*of ZE ,z
Countersigned by
AA 4172 09 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED BY CONTRACT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
This endorsement changes the policy effective on the inception date of the policy unless another date is indi-
cated below.
o presen
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
SECTION ll - LIABILITY COVERAGE, A. Cover-
age, l. Who is an Insured is amended to include
as an insured any person or organization with
which you have agreed in a valid written contract
to provide insurance as is afforded by this policy.
This provision is limited to the scope of the valid
written contract.
This provision does not apply unless the valid
written contract has been executed prior to the
"bodily injury" or "property damage".
Endorsement Effective
0410u2021
PolicyNumber: E8A0067640
Named lnsured
Carey's Heating & Air Conditioning, Inc.
Countersigned by t//,',rz/*,*o/: 7€*2
444171 1105
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY INSURANCE
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
This endorsement changes the policy effective on the inception date of the policy unless another date is indi-
cated below.
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
Noncontributory lnsurance
SECTION IV . BUSINESS AUTO CONDI-
TIONS, B. General Gonditions, 5. Other ln-
surance is replaced by the following:
c. Regardless of the provisions of Para-
graph a. above, this Coverage Form's Li-
ability Coverage is primary and we will
not seek contribuiion from any other in-
surance for any liability assumed under
an "insured contract" that requires liability
to be assumed on a primary noncon-
tributory basis.
e
1
Endorsement Effective:
04 - 0L -21
Policy Number:
EBA 006 76 40
Named lnsured
CAREYS HEATING & AIR CONDITIONING INC
Countersigned by
.,/o////.,o, J: //*.,2
A441741105
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURAI.ICE 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 shall not operate directly or indirectly to benefit anlone not named in the Schedule.
Schedule
Blanket Waiver of Subrogation
If you are reguired by a written contract or agreement,
which is executed before a loss, to waive your rights of
recovery from others, we agree to waive our rights of
recovery.
This waiver of righ
for whom the Namedto furnish this wai
waiver with respectInsured has no cont
ts applies to any person or organization
Insured has agreed by written contractver, but shall- not be construed to be a
to any other operations in which the
ractual interest,
This endorsement changes the policy to which it is attached and is effective on the date issued unless other-
wise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective 04-0L-202L Policy No.EWc 048 16 98-01 Endorsement No.
InsuTed CAREY's HEATING & AIR CONDITIONING INC
lnsurance Company TUE crNcrNNATr cASUALTY coMPANY
Countersigned by
Premium $rwcr,
wc 00 03 13
@ tgSS National Council on Compensation lnsurance.
. //rr.y',1'/,'or";%1.,.r