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HomeMy WebLinkAboutCAG2019-359 - Amendment - #3 - KBA, Inc. - S 228th St UPRR Grade Separation Bridge & Roadway Phase 5 - 10/12/2021ApprovalOriginator:Department: Date Sent:Date Required: Mayor or Designee Date of Council Approval: Grant? Yes No Type:Review/Signatures/RoutingDate Received: City Attorney: Comments: Date Routed: Mayor’s Office City Clerk’s OfficeAgreement InformationVendor Name:Category: Vendor Number:Sub-Category: Project Name: Project Details: Agreement Amount: Start Date: Local Business? Yes No* Business License Verification: If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace. Yes In-Process Exempt (KCC 5.01.045) Notice required prior to disclosure? Yes No Contract Number: This form combines & replaces the Request for Mayor’s Signature and Contract Cover Sheet forms. (Print on pink or cherry colored paper) Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20 Budget Account Number: Budget? Yes No Dir Asst: Sup/Mgr: Dir/Dep: rev. 20210513 FOR CITY OF KENT OFFICIAL USE ONLY Agreement Routing Form For Approvals, Signatures and Records Management (Optional) Basis for Selection of Contractor: * Memo to Mayor must be attached Termination Date: Authorized to Sign: KENT WaSHTNGToN AMENDMENT NO. 3 NAME OF CONSULTANT OR VENDOR KBA. Inc. CONTRACT NAME & PROJECT NUMBER S. 228th Street Union Pacific Railroad Grade Separation Bridoe and Roadway - Phase 5 ORIGINAL AGREEMENT DATE :Julv 3. 2O19 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments, All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: Additional funds are needed to continue to provide construction management services to closeout the project. For a copy of the Consultant's estimate, see Exhibit A which is attached and incorporated by this reference. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are modified as follows: Original Contract Sum, including applicable WSST $717,000 Net Change by Previous Amendments including applicable WSST $123,500 Current Contract Amount including all previous amendments $840,500 Current Amendment Sum $3L,7oo Applicable Amendment WSST Tax on this $o Revised Contract Sum $s4€f0o fl eJ7a,-?po AMENDMENT-1OF2 DR AMENDMENT - 2 OF 2 Original Time for Completion insert date) 6/30/21 Revised Time for Completion under prior Amendments insert date) 12/31/21 Add’l Days Required (±) for this Amendment 0 calendar days Revised Time for Completion insert date) 12/31/21 The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VENDOR: By: signature) PrintName: Its title) DATE: CITY OF KENT: By: signature) Print Name: Dana Ralph Its Mayor title) DATE: ATTEST: Kent City Clerk APPROVED AS TO FORM: applicable if Mayor’s signature required) Kent Law Department KBA - 228th UPRR Grade Sep Ph 5 Amd 3/Barry Kristen M. Overleese President October 6, 2021 10/12/2021 25YEAR5 KBA Labor Hours Project Name: Client Project No.: KBA Project No.: Contract Type: Date Prepared: Prepared by: Salary Escalation 228th St. Union Pacific RR Grade Sep Ph V Jul22 01 9020-01 Cost + Net Fee (on DSC only) st2012021 Sam Schuyler 50/ co'E6OE.=oE-gEoo Month Jan-21 Feb-21 Mar-21 Apr-21 May-21 Jun-21 Jul-21 Aug-21 Sep-21 Oct-21 Nov-21 Days/Mo 20 20 23 22 20 22 21 22 21 21 2t) Hr/Mo 160 160 184 176 160 176 168 176 168 168 160 Exha Work 60/o 8o/o 12Yo 12o/o 12Yo 12o/o 12o/o 12o/o 12Yo 11Yo 10o/o Adi Hr/Mo 170 173 206 197 179 197 188 197 1BB 186 176 Actuals Estlmate Sep-21 Oct-21 Nov-21 Sam Schuyler Jill Carter Jen Payne Paige Barnes Cameron Bloomer Gary Paxton Nshana Key Dane Setzer (M2) Project Manager (A4) Contract Admin (A5) Contract Admin (A4) Contract Admin (E4) FEIOE (T5) lnspector (P3) Prolect Assistant (E3) Eno. Prof. lll $72.50 $38.00 $34.60 $52.00 $51.00 $34.00 $38 00 $75 $3e $44 $54 $54 $35 $38 .24 .48 .40 .00 .00 .56 .00 $77.52 $42.0C $0.01 $42.44 $56.0C $55.68 $0.01 $39.0C 128 26 5 7 2,581 879 389 1,615 5 1 E 26; 247 89 69 24 1 ,518 bJJ 300 1.087 55 1 7 798 52; I 1 7 8 6 ??4 2 4 4 140 ; 129 fl; 60 '1 29 10; ; 88 ; 50 67 47 1 'T 1 84 I 80 126 to/ 28 89 85 Direct Sep-2'1 Oct21 Nov-21 530 o/ 914 441 311 583 328 166 556 1 ,762 1 ,686 1,446$ $ $ 30,029 2,818 191 2,568 814 124 20,742 6,t19 2,004 67 @ $6/hour (Plus iax) us Misc: 59/166 55tt3,505 20,742 s14 441 311Direct Expenses Item aot 32833,037 8,790 , ,i it','iit i::::,:rl1;rl lr,i.;: i ,l'til .f il itll:r,::i;' ,li:lr,llr:' 1l;1, ]il, li!llli.):i, I Total Costs 2019 Total 2020 Total 2021 Tolal 1 ,762 1 ,686 1,446 Subconsu Combined Costs Sep-21 Ocl-21 Nov-21 I@ Subtotal - Subconsultant Costs 80,052 7,450 Subconsultants .lj.l,t)t;rl ii:rj!::r, iLrltt.'..,] .lti.j I'r: i'ri \,, t i lt..t Lr'i til,.:i, rlri,,lfill); 47,523 30,086 6,410 16,226 Total Costs 2019 Total 2020 Total 2021 lolal Sep-21 0ct-21 Nov-21 $75.24 $39.48 $44.40 $0.01 $54.00 $54.00 $35.s6 $38.00 $77.52 $42,00 $0.01 $42.44 $56.00 $55.68 $0.01 $39.00 $ $ $ $ $ $ $ $ 9,741 1,028 156 276 140,438 46,727 13,677 61.879 363 38 156 13,806 12,572 3,009 5,154 948 81,972 34,1 55 10,668 41,287 4,225 42 276 44,660 20.592 620 42 7,S4; 4,914 s43 2; 7,196 4,914 155 310 310620426465233 233 310 42 3,360 4,4803,724 2,632 6,513 4,251 4t 1,400 42 4,704 21 1,624 21 4,928 85 2,772 Sam Schuyler Jill Carter Jen Payne Paige Barnes Cameron Bloomer Gary Paxton Nshana Key Dane Setzer (M2) Project Manager (A4) Contract Admin (A5) Contract Admin (A4) Contract Admin (E4)FE/OE (T5) lnspector (P3) Project Assistant (E3) Enq, Prof. lll $/2.50 $38.00 $34 60 $0.01 $52.00 $51.00 $34.00 $38.00 $ 273,921$ 21,75r3 381.257 29,943 922 43,1 63 174,183 10,229 243,551 69,/95 10,606 94,544 13,416 1,034 18,479 12,674 881 17,546 6,323 4,211 8,512 5,414 759 7,140 3,089 496 4,016 1,597 308 2,028 5,057 551 6,816 551 6,491 4,83310,493 968 363 484 14,305 3,957 2,942 5,396 3,814 Subtotal Direct Salary Costs Overhead (Home) @ Overhead (Field) @ 165,72Yo 146.88% 167.650/" 144.90Yo 156.16% 144.89o/o $ 403,014 s 82.176 44,085 8,983 253,780 52,255 105,149 20,938 3,934 479 19,513 4,025 18,427 3,802 15,273 3,148 12,723 1,897 13,314 1,624 7,602 927 9,715 1,187 7,240 883 12,423 1,517 11,8t4 1,45030.00% Subtotal Overhead Costs Fee (on DSC onlv) @ 47 923 20,8.790 30 441 311 166583328 556 597 7 1,686 1 ,446 9141,762 10 $ $ 33,037 3,505 4,580 14,496 13,920Cost To Complete 2020 2021 . ;'irir;?rllTitleEmployee 872,200 r'iiJ;,:l)i !li.l.l;': ,,lm,llir ii;.r,, " ll!t'ir,"i lliiill, .:\irtji:;.11,Total DSC 2019 Total 2020 Total 2021 TolalRate Rate 88,559 54B,BB3 234,758 45,127 52,814 30,361 21,857 22,971 8,856 11,343 8,434 201 I Rate Original Contract Supplement 1 Supplement 2 Contract total Cost to Complete Supplement Needed $ 717,000 $ 80,400 $ 43,100 840,500 $ 872,200 $ (31,700) EXHIBIT A SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 5/12/2021 Dealey,Renton &Associates 3697 Mt.Diablo Blvd,Suite 230 Lafayette CA 94549 Dani Schulze 510-465-3090 510-452-2193 DesignProCerts@AssuredPartners.com License#:0020739 XL Specialty Insurance Co.37885 KBAINC0-03 The Travelers Indemnity Company of America 25666KBA,Inc. 11201 SE 8th Street,Ste 160 Bellevue WA 98004 Travelers Property Casualty Company of America 25674 The Travelers Indemnity Company 25658 1999037470 B X 1,000,000 X 1,000,000 X Contractual Liab 10,000 Included 1,000,000 2,000,000 X Y Y 6806N033449 5/10/2021 5/10/2022 2,000,000 D 1,000,000 X X X Y Y BA6N034864 5/10/2021 5/10/2022 C X X 9,000,000YCUP6N0361875/10/2021Y 5/10/2022 9,000,000 X 10,000 B X6806N0334495/10/2021 5/10/2022 WA STOP GAP 1,000,000 1,000,000 1,000,000 A Professional Liability + Contractors Pollution Liability DPR9977632 5/10/2021 5/10/2022 Per Claim Annual Aggregate $2,000,000 $4,000,000 Umbrella Liability policy is a follow-form underlying General Liability/Auto Liability/Employers Liability. RE:Project No.B17057-03 -S 228th St Union Pacific Railroad Grade Separation –Phase 5 The City of Kent is named as an additional insured as respects general and auto liability as required per written contract or agreement.General and Auto Liability are Primary/Non-Contributory per policy form wording. Severability of Interest applies to General and Auto Liability.SEVERABILITY OF INTERESTS (Per CG 00 01 10 01)7.Separation of Insureds -Except with respect to the Limits of Insurance,and any rights or duties specifically assigned in this Coverage Part to the first Named Insured,this insurance applies:a.As if each Named Insured were the only Named Insured;and b.Separately to each insured against whom claim is made or suit is brought.30 Day Notice of Cancellation 30 Day Notice of Cancellation City of Kent Attn:Nancy Yoshitake 220 Fourth Avenue,South Kent WA 98032                                                                                         Policy #: BA7R748905                                                                                                                                                                                                                                   ÐÑÔ×ÝÇÒËÓÞÛÎ COMMERCIAL GENERAL LIABILITY ISSUED DATE: ÌØ×ÍÛÒÜÑÎÍÛÓÛÒÌÝØßÒÙÛÍÌØÛÐÑÔ×ÝÇòÐÔÛßÍÛÎÛßÜ×ÌÝßÎÛÚËÔÔÇò    ̸·­»²¼±®­»³»²¬³±¼·º·»­·²­«®¿²½»°®±ª·¼»¼«²¼»®¬¸»º±´´±©·²¹æ ÝÑÓÓÛÎÝ×ßÔÙÛÒÛÎßÔÔ×ßÞ×Ô×ÌÇÝÑÊÛÎßÙÛÐßÎÌ    øײº±®³¿¬·±²®»¯«·®»¼¬±½±³°´»¬»¬¸·­Í½¸»¼«´»ô·º²±¬­¸±©²¿¾±ª»ô©·´´¾»­¸±©²·²¬¸»Ü»½´¿®¿¬·±²­ò÷ Í»½¬·±²×× É¸±×­ß²×²­«®»¼·­¿³»²¼»¼¬±·²ó ̸·­·²­«®¿²½»¼±»­²±¬¿°°´§¬±þ¾±¼·´§·²¶«®§þ±® ½´«¼»¿­¿²¿¼¼·¬·±²¿´·²­«®»¼¬¸»°»®­±²ø­÷±® þ°®±°»®¬§¼¿³¿¹»þ±½½«®®·²¹ô±®°»®­±²¿´·²¶«®§Œ ±®¹¿²·¦¿¬·±²ø­÷­¸±©²·²¬¸»Í½¸»¼«´»ô¾«¬±²´§ ±®¿¼ª»®¬·­·²¹·²¶«®§Œ¿®·­·²¹±«¬±º¿²±ºº»²­» ©·¬¸®»­°»½¬¬±´·¿¾·´·¬§º±®þ¾±¼·´§·²¶«®§þôþ°®±°»®¬§ ½±³³·¬¬»¼ô¿º¬»®æ ¼¿³¿¹»þôþ°»®­±²¿´·²¶«®§Œ±®¿¼ª»®¬·­·²¹·²¶«®§þ ß´´©±®µô·²½´«¼·²¹³¿¬»®·¿´­ô°¿®¬­±®»¯«·°ó½¿«­»¼ô·²©¸±´»±®·²°¿®¬ô¾§æ ³»²¬º«®²·­¸»¼·²½±²²»½¬·±²©·¬¸­«½¸©±®µô DZ«®¿½¬­±®±³·­­·±²­å±®±²¬¸»°®±¶»½¬ø±¬¸»®¬¸¿²­»®ª·½»ô³¿·²¬»ó ²¿²½»±®®»°¿·®­÷¬±¾»°»®º±®³»¼¾§±®±²̸»¿½¬­±®±³·­­·±²­±º¬¸±­»¿½¬·²¹±²§±«®¾»¸¿´º±º¬¸»¿¼¼·¬·±²¿´·²­«®»¼ø­÷¿¬¬¸»´±½¿ó¾»¸¿´ºå ¬·±²±º¬¸»½±ª»®»¼±°»®¿¬·±²­¸¿­¾»»²½±³ó·²¬¸»°»®º±®³¿²½»±º§±«®±²¹±·²¹±°»®¿¬·±²­º±®°´»¬»¼å±®¬¸»¿¼¼·¬·±²¿´·²­«®»¼ø­÷¿¬¬¸»´±½¿¬·±²ø­÷¼»­·¹ó ̸¿¬°±®¬·±²±ºþ§±«®©±®µþ±«¬±º©¸·½¸¬¸»²¿¬»¼¿¾±ª»ò ·²¶«®§±®¼¿³¿¹»¿®·­»­¸¿­¾»»²°«¬¬±·¬­·²óÉ·¬¸®»­°»½¬¬±¬¸»·²­«®¿²½»¿ºº±®¼»¼¬±¬¸»­»¬»²¼»¼«­»¾§¿²§°»®­±²±®±®¹¿²·¦¿¬·±²¿¼¼·¬·±²¿´·²­«®»¼­ô¬¸»º±´´±©·²¹¿¼¼·¬·±²¿´»¨½´«ó ±¬¸»®¬¸¿²¿²±¬¸»®½±²¬®¿½¬±®±®­«¾½±²¬®¿½ó­·±²­¿°°´§æ ¬±®»²¹¿¹»¼·²°»®º±®³·²¹±°»®¿¬·±²­º±®¿ °®·²½·°¿´¿­¿°¿®¬±º¬¸»­¿³»°®±¶»½¬ò ݱ°§®·¹¸¬îððë̸»Í¬òп«´Ì®¿ª»´»®­Ý±³°¿²·»­ôײ½òß´´®·¹¸¬­®»­»®ª»¼ò п¹»ï±ºï ײ½´«¼»­½±°§®·¹¸¬»¼³¿¬»®·¿´±º×²­«®¿²½»Í»®ª·½»­Ñºº·½»ôײ½ò©·¬¸·¬­°»®³·­­·±²ò Any person or organization that you agree in a written contract, on this Coverage Part, provided that such written contract was signed and executed by you before, and is in effect when the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense is committed. Any project to which an applicable written contract with the described in the Name of Additional Insured Person(s) or Organization(s) section of this Schedule applies. 6806N033449 5/12/2021 ÐÑÔ×ÝÇÒËÓÞÛÎæ COMMERCIAL GENERAL LIABILITY ISSUED DATE: ÌØ×ÍÛÒÜÑÎÍÛÓÛÒÌÝØßÒÙÛÍÌØÛÐÑÔ×ÝÇòÐÔÛßÍÛÎÛßÜ×ÌÝßÎÛÚËÔÔÇò   ̸·­»²¼±®­»³»²¬³±¼·º·»­·²­«®¿²½»°®±ª·¼»¼«²¼»®¬¸»º±´´±©·²¹æ ÝÑÓÓÛÎÝ×ßÔÙÛÒÛÎßÔÔ×ßÞ×Ô×ÌÇÝÑÊÛÎßÙÛÐßÎÌ    ײº±®³¿¬·±²®»¯«·®»¼¬±½±³°´»¬»¬¸·­Í½¸»¼«´»ô·º²±¬­¸±©²¿¾±ª»ô©·´´¾»­¸±©²·²¬¸»Ü»½´¿®¿¬·±²­ò ·­¿³»²¼»¼¬±·²ó ´±½¿¬·±²¼»­·¹²¿¬»¼¿²¼¼»­½®·¾»¼·²¬¸»­½¸»¼«´»±º ½´«¼»¿­¿²¿¼¼·¬·±²¿´·²­«®»¼¬¸»°»®­±²ø­÷±®±®ó ¬¸·­»²¼±®­»³»²¬°»®º±®³»¼º±®¬¸¿¬¿¼¼·¬·±²¿´·²ó ¹¿²·¦¿¬·±²ø­÷­¸±©²·²¬¸»Í½¸»¼«´»ô¾«¬±²´§©·¬¸ ­«®»¼¿²¼·²½´«¼»¼·²¬¸»þ°®±¼«½¬­ó½±³°´»¬»¼±°»®¿ó ®»­°»½¬¬±´·¿¾·´·¬§º±®þ¾±¼·´§·²¶«®§þ±®þ°®±°»®¬§¼¿³ó ¬·±²­¸¿¦¿®¼þò ¿¹»þ½¿«­»¼ô·²©¸±´»±®·²°¿®¬ô¾§þ§±«®©±®µþ¿¬¬¸» ×ÍÑЮ±°»®¬·»­ôײ½òôîððì п¹»ï±ºï Any person or organization that you agree in a written contract to include as an additional insured on this Coverage Part for "bodily injury" or "property damage" included in the "products- completed operations hazard", provided that such contract was signed and executed by you before, and is in effect when, the bodily injury or property damage occurs. Any project to which an applicable contract described in the Name of Additional Insured Person(s) or Organization(s) section of this Schedule applies. 5/12/20216806N033449 COMMERCIAL GENERAL LIABILITY c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this methoo, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. d. Primary And Non-Contributory Insurance If Required By Written Contract If you specifically agree in a written contract or agreement that the insurance afforded to an insured under this Coverage Part must apply on a primary basis, or a primary and non- contributory basis. this insurance is primary to other insurance that is available to such insured which covers such insured as a named insured, and we will not share with that other insurance, provided that: (1) The "bodily injury'' or "property damage" for which coverage is sought occurs; and (2) The "personal and advertising injury" for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit perioo we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation , and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written not ice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V -DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding websites, only that part of a website that is about your goods, prooucts or services for the purposes of attracting customers or supporters is considered an advertisement. Page 16 of 21 © 2017 The Travelers Indemnity Company. All rights reserved. CG T1000219 Includes copyrighted material of Insurance Services Office, Inc. with its permiss ion. Policy #6806N033449 6806N0334496806N033449 COMMERCIAL GENERAL LIABILITY that is available to any of your "employees"occupational therapist or occupational for "bodily injury" that arises out of providingtherapy assistant, physical therapist or or failing to provide "incidental medicalspeech-language pathologist; or services" to any person to the extent not(b)First aid or "Good Samaritan services"subject to Paragraph 2.a.(1)of Section II –by any of your "employees" or "volunteer Who Is An Insured.workers", other than an employed or volunteer doctor. Any such "employees"K. MEDICAL PAYMENTS – INCREASED LIMIT or "volunteer workers" providing or failing The following replaces Paragraph 7.ofto provide first aid or "Good Samaritan SECTION III – LIMITS OF INSURANCE:services" during their work hours for you 7.Subject to Paragraph 5.above, the Medicalwill be deemed to be acting within the scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business.because of "bodily injury" sustained by any one person, and will be the higher of:3.The following replaces the last sentence of Paragraph 5.of SECTION III – LIMITS OF a.$10,000; orINSURANCE: b.The amount shown in the Declarations ofFor the purposes of determining the this Coverage Part for Medical Expenseapplicable Each Occurrence Limit, all related Limit.acts or omissions committed in providing or failing to provide "incidental medical L. AMENDMENT OF EXCESS INSURANCE services", first aid or "Good Samaritan CONDITION – PROFESSIONAL LIABILITYservices" to any one person will be deemed The following is added to Paragraph 4.b.,to be one "occurrence".Excess Insurance, of SECTION IV –4.The following exclusion is added to COMMERCIAL GENERAL LIABILITYParagraph2.,Exclusions, of SECTION I –CONDITIONS: COVERAGES – COVERAGE A – BODILY This insurance is excess over any of the otherINJURY AND PROPERTY DAMAGE insurance, whether primary, excess, contingentLIABILITY:or on any other basis, that is ProfessionalSale Of Pharmaceuticals Liability or similar coverage, to the extent the "Bodily injury" or "property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of M. BLANKET WAIVER OF SUBROGATION –pharmaceuticals committed by, or with the WHEN REQUIRED BY WRITTEN CONTRACTknowledge or consent of the insured.OR AGREEMENT5.The following is added to the DEFINITIONS The following is added to Paragraph 8.,TransferSection: Of Rights Of Recovery Against Others To Us,"Incidental medical services" means:of SECTION IV – COMMERCIAL GENERAL a.Medical, surgical, dental, laboratory, x-LIABILITY CONDITIONS: ray or nursing service or treatment,If the insured has agreed in a written contract oradvice or instruction, or the related agreement to waive that insured's right offurnishing of food or beverages; or recovery against any person or organization, we b.The furnishing or dispensing of drugs or waive our right of recovery against such personmedical, dental, or surgical supplies or or organization, but only for payments we makeappliances.because of: 6.The following is added to Paragraph 4.b.,a."Bodily injury" or "property damage" thatExcess Insurance, of SECTION IV –occurs; orCOMMERCIAL GENERAL LIABILITY b."Personal and advertising injury" caused byCONDITIONS: an offense that is committed;This insurance is excess over any valid and subsequent to the signing of that contract orcollectible other insurance, whether primary, excess, contingent or on any other basis,agreement. CG D3 79 02 19 ú 2017 The Travelers Indemnity Company. All rights reserved.Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy #6806N033449                                                                                                                                            Policy #: BA7R748905