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HomeMy WebLinkAboutCAG2020-066 - Amendment - #5 - Raedeke Associates, Inc. - Extended Completion Date to 12/31/2026 - 11/26/24 FOR CITY OF KENT OFFICIAL USE ONLY Sup/Mgr: Agreement Routing Form Dir Asst: • For Approvals,Signatures and Records Management Dir/Dep: KE N T This form combines&replaces the Request for Mayor's Signature and Contract Cover (Optional) WASHINGTON Sheet forms. Originator: Department: Karin Bayes for Stephen Lincoln Public Works Date Sent: Date Required: 0 11/27/2024 12/4/2024 CL Authorized to Sign: Date of Council Approval: C Director or Designee N/A Budget Account Number: Grant?[:]YesZNo D20085 Budget?R]YesE]No Type: N/A Vendor Name: Category: Raedeke Associates, Inc. Contract Vendor Number: Sub-Category: = Amendment 0 Project Name: Signature Pointe Levee E `o Project Details: Extended completion date to 12/31/2026 _ 40 40 Agreement Amount: $0 Basis for Selection of Contractor: Other 47 `Memo to Mayor must be attached 3 Start Date: Upon Execution Termination Date: 12/31/2026 Q Local Business?F--]YesF--]No* If meets requirements per KCC3.70.100,please complete"Vendor Purchase-Local Exceptions'form on Cityspace. Business License Verification:YesEl In-ProcessEl Exempt(KCC 5.01.045) Notice required prior to disclosure? Contract Number: F�YesF�No CAG2020-066 Comments: a1 _ 3 4) H •� i N 3 f0 _ V1 Date Routed to the City Clerk's Office: 1 1/24/24 ac«w»373__,0 Visit Documents.KentWA.gov to obtain copies of all agreements rev.20210513 • KENT WASHINGTON AMENDMENT NO. 5 NAME OF CONSULTANT OR VENDOR: Raedeke Assgciates,In . CONTRACT NAME & PROJECT NUMBER: Signature Pointe Levee ORIGINAL AGREEMENT DATE: February 20, 2020 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: No change to the scope of work; however, an amendment is required to extend the time of completion to December 31, 2026, due to delays in design review and ILA execution. 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, $50,279.20 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $50,279.20 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $50,279.20 AMENDMENT - 1 OF 2 Original Time for Completion 12/31/2020 (insert date) Revised Time for Completion under 12/31/2024 prior Amendments (insert date) Add'I Days Required (f) for this 730 calendar days Amendment _ Revised Time for Completion 12/31/2026 (insert date) 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: CITY OF KENT: �: .� By: y. Print Name: L�rZr'� �D�t' Lv_ l/21�1( � Print Name: Carla Maloney, P.E. Its: Design Engineering Manager DATE: 1 �� DATE: ATTEST: APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent City Clerk Kent Law Department kb-11/26/2924 AMENDMENT - 2 OF 2 Client#: 1045350 RAEDEASC ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/26/2o2a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Select NW _ USI Insurance Services LLC PHONE 206-441-6300 F14XAIC,No 610-362-8503 _ C No Ext: 601 Union Street,Suite 1000 ADDRESS: Select@usi.com Seattle,WA 98101 INSURERS AFFORDING COVERAGE NAIC# 206 441-6300 INSURER A:Travelers Indemnity Company 25658 INSURED INSURER B:Travelers Property Cas.Co.of America 25674 Raedeke Associates Inc. Travelers Casualty Co.of Amer 31194 INSURER C: lty 8r Surety 2111 N.Northgate Way,#219 Charter Oak Fire Insurance Company 25615 INSURER D: P Y Seattle,WA 98133 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. INSR ADDLSUBR POLICY EFF POLICY EXP LIMITS IN SR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD MMIDD A X'COMMERCIAL GENERAL LIABILITY X X 6809H3434442447 3/31/2024 03/31/202 EACH OCCURRENCE $21000 000 CLAIMS-MADE a OCCUR PREMISES Ea occurrence $1 000 000 MED EXP(Any one person) s5,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 PRO- POLICY F7X JECT LOC PRODUCTS-COMP/OPAGG $4,000,000 OTHER: $ COMBID AUTOMOBILE LIABILITY X X BA5R1448502447G 3/31/2024 03/31/202 Eaa accciden ED SINGLE LIMIT 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED Peoa RTY DAMAGE $ AUTOS ONLY AUTOS ONLY B X UMBRELLA LIAB X OCCUR CU1P5H97811A2a47 3/31/2024 03/3112025 EACH OCCURRENCE $1 000 000 EXCESS LIAR I CLAIMS-MADE AGGREGATE $1 00O 000 DED I X RETENTION$10000 $ A WORKERS COMPENSATION 6809H3434aa2447 3/31/2024 03/31/202 PSTATUTE I ER X OTH- AND EMPLOYERS'LIABILITY ANY OFFICEW RIETOREMBER PEXCLUD ED IE ECUTIVE- N/A **WA STOP GAP** E.L.EACH ACCIDENT $1 000L000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEEI$1$000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Professional X 107062701 3/31/2024 03/31/202 $1,000,000 per claim Liability $1,000,000 annl aggr. - Incl.Pollution DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) RE: RAI Project No.2012-042 and 2020-005. ; Project Name: Signature Point Levee.The General Liability and Automobile Liability policies include an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder,City of Kent,only when there is a written contract that requires such status,and only with regard to work performed on behalf of the named insured.The General Liability and Automobile Liability policies contain a special endorsement with"Primary and Noncontributory"wording, (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD H ABOVE DESCRIBED City of Kent THE XPIRA ION DATTE T EREOF, NOTICEIE B CANCELLED WI N LL BE BEFORE DELIVERED 220 Fourth Avenue South ACCORDANCE WITH THE POLICY PROVISIONS. Kent,WA 98032-0000 AUTHORIZED REPRESENTATIVE ov. /_-;xzz24Aft ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S44164071/M44031789 SAJZP DESCRIPTIONS (Continued from Page 1) when required by written contract.The General Liability,Automobile Liability and Professional Liability policies include an endorsement providing that 30 days notice of cancellation will be given to the Certificate Holder by the Insurance Carrier. SAGITTA 25.3(2016103) 2 of 2 #S44164071/M"031789 POLICY NLWBEt:58D-V-U3444 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REAM IT CAREFULLY. ADDITIONAL INSURED - OWNERS,ERS, LESSEES OFF CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies Insuranca pro videa under the inikwAng: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCIIEDULE Names of Additbonat Insured Pemon(a)or Organixsti or(is)_ Any trerson of organization Mee pu agree in a written contract to Include as an adidilbonal insuredf oil Thais Coverage Part,pm%adea that such written mntract was signet by you before and is in effect when, Itw"bodily injury"air"property damage'occurs or t;hs'personal injury'or"edverlii kV inqury"of ease is Leastilan of Covered Operations_ Any pmjea lowhieh a written comma with the A.dldWn:t" Irr wed Pvson(0 or Cwgartral.an(sI In the Schedule applies. (informslraan required tocomple+te riIry Sctrecule, it not shexhin above.will be&,mr n In the Oar_- ratlons.) A. Se3dmcn II—VMo Is An In ved fie omerrdeo to -n• This risur'ance does not spo°,y to'bodily Pajury"of cludle as an additiorttl insuvad the persan(s) W, 'prvpc.-ty diamagW tiocck,rring, 0� "pamornal lrR ary' oeganizefloin(s) show, in " Scnedule but only of 'adverlisinp iraluffj arming out drf an offense MM respect to liabllity tat"bodilly injury' 'prrtpedv edrmmllm after dam�gs", 'pvx sonai Injury' or 'wh mrtasrng Injury' 1, NI work. ufieJuding matenalis, parts or equ.,p- caused, in w0oke or in part,by: ment hum sited An conntA-lion 01h a work, d, foul acts or cm;3slottg; or on I" project (other 1tion service, me:nte- Z The acts or ornissiam of trrose s-eting on your nance or rye irs) to be penormed by or on Wlalf. br-half of lha atlddiornl Ir*.wodasf rat the lova- Ition oP the havered operations has been nom- In the perfowwrice of your angDlrrg operadorna for pletedf: Of the additional insurad(s) at the Jocation(s) desig- nated shave. 2. That portion of'Your work" out of vrwch the B, With respect Ca Cher insur`vnrt�e alfarded to 1ti9aia �tury dxr w�amage t'�71r��itag been past rir Its �. f tena:ed use iDy any person or organization additional insureds, the liollowirng additional exc'a- other than another contractor flr sutsmnCrac- Ouns apply: ex engaged in perfanming orneratans Inr a principal as a pars of fftie same project. CG D3 111 03 05 Copyrdghi 2035 The St. Paul T revelers Corn panies, Inc All rights reserved. Oa Te 01. rya 2 jnclWdes capyrigWe+d 110terlal o' losufance Serve 'DHim Inc.wit,¢, rs raermrssioA,. DATE OF ISSUE- 02/02/2024 Page i of 2 POUCY NUPABER' 2Jk-5h144$5 J-74-47-G EFFECTIVE DATE; 0-VII/2474 ISSUE DATE: 02105/2024 1+TSTINO OP FORA5, t"OAMMS AM SCUML8 MMS TAIS LIATIM SHOWS 122 DER OF FORMS, aCM=YdLEa AND ENDORSE14NTS BY I+Im OF BusiN SS IL TO 03 11 69 4w POLICY DR["rA ATIOHS It T8 01 Dl 01 Folm EOmRs3mm8 AM ScalEOLN $RS It TO 85 06 10 SON VOL:ECT C ITIO" = W":S =KOT" 00&MRCrAL AtrrO CA TO 01 DZ 15 pk- CCVEPJM P) T DECS 4 rTEHS .1 fc 21 CA TO 42 D2 15 BUSINESS AUTO CBYER QZ PART bMrLkRLTTONS (ITRAS 31 CA T4 03 03 i5 BEES. AUTO COV PART DECLAPATICUS-445 CA TO 34 01 16 BUSMOS AU7OJKC {UFf FART-UM SUPFL SCIM CA TO 31 02 15 TASLE 07 CONTE TH-6vaIN3013 AD= C V FQRX CA 00 41 10 35 IMSINESS AUTO l2tn'MtA= 1ORX CA 01 35 10 13 MhSP1LNOTIM CMG CA 20 01 10 13 LESSOR - ADDITIONAL IYJURED AM LOSS PAYEE CA 91 34 10 13 WASHINGTM UNDERZKSUR= )40 ORISTS CUVERA= CA go 03 T O l3 AVTO B=ICAL PAymacmT8 coArEtrAdE CA T4 20 02 15 ALA fiz Pa,d.9 ='02AffxRNT MCA TA 52 02 16 SNORT TA" HIRED AIM - I►M.TTIOK.LL INSUIM AND LD95 PAYEE CA T4 59 02 35 AWMKM OF LOYSS 13VI ITIOR MCA. T4 74 02 16 EI,ANRBT ADD=Ia611I, INSUPM - PRIMARY wo NOW-CCMF'9.IBLPIORY KITH 4TIM I.mukh= CA TS 25 01 16 RQADSIGE ABSISTANCZ COVERAGN i1$7'BRLINE' ZWOR.SEmaQR s ZL T3 20 85 19 *0TXCs of CANCELr&TIM Oat aC M PROVIDED By t1a IL T4 00 05 19 DESIG PERSON, 0JkG-NtYTZCE PROVIDIM EY 00 IL T4 13 D3 15 ANMT C0KMQN POLICY C -PROXIaITED CCVG IL 01 33 II 13 lM0HTN7rQN CWMM - DAVOW51 MSTS IL 01 16 D9 08 XUCLEAR EKERGY LIABILITY gICLUSION MWOlR EMENT (BROAD PORK) IL TO 10 12 86 LEER'S CERTIFICATE OF IIPSURh1TC& - FOX9 A IL TB 010101 PA9313; 1 Or 1 COMMER.CIA► AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT ICAREr-ULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the fa owing: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens coverage. However,coverage.kw arry injury,damage or medical expenses described in any of the proOstons of tFs endorsement may be excluded w ,yr led by aj",u itt eod ff-er►t to the Coverage Part. and these coverage broadeeting ptco,/mbn!5 ado Pot wply to the extent that cavemge is exc"aded w I -tited by such ar9 endorsement. �G mving "king is a general obver- age description only. Limitations and exclusions may apply to ttrase coverages. Read all the provisions cV tFs en- dlorsement and the rest of your pcoilicy carefully to clewrrnine rights,duties.and what is and is not covered. A. BLANKET ADDITIONAL INSURED H. AUDIO, VISUAL AND DATA ELECTRONIC B. EMPLOYEE HIRED AUTO EQUIPMENT- 4INCRE SED LIMIT C. EMPLOYEES AS INSURED I. WAIVER OF DEDUCTIBLE-GLASS D. SUPPLEMENTARY PAYMENTS - INCREASED J, PERSONAL PROPERTY UMITS K. ARBAGS E. TRAILERS-INCREASED LOAD CAPACITY L AUTO LOAN LEASE GAP F: HIRED AUTO PHYSICAL DAMAGE M. BLANKET WAIVER OF SUBROGATION Gt PHYSICAL DAMAGE - TRANSPORTATION EXPENSES-INCREASED LIMIT A. BLANKET ADDMONAL INSURED pefrfr9mr-ig duties relaAed to the mriduct of The to-3 wing is added to Paragraph A.1., Who Is your business. An Imo . 0 SEC11ON 11-COVERED AUTOS 2. Tine to"swing rec43ces Paragraph b, in R.S., Uxalt t v-COVERAGE: ter Insurance, o'1 SECTION IV = BUSi- Ar-;r per,--tn nr organ,;atiort v-TM,n is require-d unuo NEW AUTO CONDJT.ON S7 %altien vonh&a t of ar xemetnl teitweEn ym,-old b. gar F�irecl kito Physical. Damage Cover- that persoi or orsgalnizaton, that is sgnecl a,)d age, the following are deemed to be cov- exccutev by you octure Ov "bodily Injury- of crest"autos"you own: 'property damage occurs and teat i5 in effect f1I Any covered ;'auto" you lease, hire, during the pa :y period: tQ i)e named as-an addi- tional insured is an "insured" for Covered Autos rCfxl a-¢�r��e�' "�� Liability Coverage, but only for damages to which l2I Any cavzted'mutt"hired or reined by this insurance applies and only to the extent that your 'employee' under a contrarA in person or orpap7zabon cluaf flies as an 'insum-d' an employee's' name, with your under the Y► to Is k, Insured pfovnsicti contained permission, wh le performing duties In section 11. related to the conduct of your busi- B. EMPLOYEE HIRED AUTO ness. 1. The follorw,g rs added to Paragraph A1.. However, any "auto" that is leased, hired. Who Is ,An Insured. of SECTION II = CO+V• reed � borrowed with a drives is mat a ccwere+o"au:o" ERED AUTOS LIABILITY COVERAGE-. C, EMPLOYEES AS INSURED Art `ernploy�t-' or your; i� an Oinswed' wl It opseraling a ccwered "ak.14' h-Td c, rented �?' foli`crb np�-s adazd to Parag4apr A,1., Who Is under a zontract or agreement in an 'em- An Insured, of SE"ON 11—COVERED AUTOS ployee's' name, with your permission, ., pile LIABILITY COVERAGE-- CA Ts 20 02 15 $ JJ1.9 Tha PrWwO s InoWnntth r.0 PWV JV1 ngtr;:FNW&181 page 1 of 3 Irieludets rxn.*t+rig�,led viiettrie;of Ir:A-rsrx*SuNioes Dlit*.Inc.%Vkh is 00*fPfhi6n POLICY I IUMDER. 590-9s343444-34-47 EFFECTIVE DACE; 01131/2024 ISSUE DATE: 02/02/2024 101ST1 or ro"s, I1 R u".S AM sc"c tlLm wmns TAIS Ll9Tnffi SMWS MIN WMMEk OP MRMS. aCREWLES AND SIMOR911MENTS SI LIM 9F BUSINESS IL TO 19 02 05 OOI H POLICY DRtLARATIONS HP TO 01 02 05 15USINESSOWNSRS COVERAGE FART DS+C'LARATIC&S IL TO 01 01 02 MVJCO 9WWR9ZNfflNT9 AFL $CH=OLH SRS IL T3 14 05 12 CCMKON POLICY CO MITIONS - It MINt3M OetOI1+"Iaowm. S NP 'TI 30 02 05 TABLE OF CONTENTS - SVSIlNESSONNERS CGVSA.AGE PART DELUX9 PLAN KF 90 01 09 15 "MUCU, ZN91= 5 AM OURVWORS FLOC -QRO:XKIWT MP PO 08 09 15 kIC!HITRCT&, ENGINEER& AND SURVEYORS E7►RTROUR" ZNWRSIOl RW NP 'T3 02 02 95 UU8=155OWNERS FROVERTr COVERAGE BFBCIrAL YOM NP T1 05 02 05 AAti MILTMy Pmvil3cIS - 0!'[ICE19 SAP PO 06 11 23 kRCMITZCTS, ENOINEERS AIID SURVEYORS PROPERTY EXH AHCEKENTS IIF T3 70 09 II ELlOCTRONXE! VANDALISM L LUXTATION AND OTI I CR"13RS IP 'T3 07 01 97 PAMUCTIva SAFEGUARDS E=)9aLp=t ' FOR gpitrur.Lzim LOCATIONS AND RESTAURANTS iA T2 23 01 21. MORAL 'IRKAORIOX RISE nl9UU0C8 &CT 030CLO B Ip T3 5p 11 06 awil-mnm sA Pboom - isaR ZCE lwTmkbpTTcw l,uaT71.TIOU NP T.2 56 02 08 Jal EMATORY PROVISIONS - 13P.M 1i13IMXN13 MM E1TAINZaS PMLSONkL PROP CM ZNXhNr KKXNT9 rip T3 00 09 22 079tTAL ASSETS EXCLEFSEO= = D:EGXTAL C=RWWr AND NW-FCIbGISLZ TO)€RM CP 01 &0 03 21 WASHiNGTON CHANGES - DOMESTIC ABUEW. XF 74 21 01 38 WAFlHnMT0ff CHANME COMMERCIAL QXNM AL LIABILITY to V4 49 02 19 TOT 400 ulm T arm maw 1'RO,Incrs CO TO 34 0E 19 TABLE Or COWINTS - C<MIMC AL G aJRAL LLA9ILTTY COVERAGE FORM CO Tl 00 02 19 CQ 20 10 10 01 ADDL THO Owmia L.ES$E:E1:S 01 cohi 'B.AiMRS CG D3 09 02 19 AMEMATORY RIMORSEMEIfFT - PRODUCTS-CO"LETED OPERATIONS RAZA.RD CQ D6 75 02 19 AUMM-WHO TB AICT1V CG D9 10 D9 21 AMENDRZ 7T OF INTEl..LECTUAL PROPERTY ]=LCtSION GN 01 13 11 03 WIRLOYERS DVEREMAD LIABILITY CG D2 03 1E 97 AMEND - NON CUMULATION OF SACS OCC ECG TO 01 03 24 GIIURAL PURPOSE INDORSZKRIYT CQ T9 02 01 24 OEXERAL PURPOSE ZWX)RSBKffNY CG Ts 03 03 24 GENERAL PURPOSE RNDO RS IL TB 1" 0101 WlAQB; 1 OF 2 COMMERC1AL GENERAL:LIABILITY C. MWlhad of Sharing a. The statements in the Declarations are If ai i of the other inr&UfanC a Verrrl _s €a)M kdte3ffl- iccurate :jrO comptetc. by mquot <1ijelres, Vre will fallow this method b, Those statements are based upon Under this approach each Lrisurer contributes representations you rnade to m; and equal amounts until it has paid �is applicable c, Wv have Is d Phis Oicy M ►Oiancae upon limit of insurance or none of the s remains. y owf represer"Uons. whichever comes first. The unintentional 137ission 431, or un,tentional error if any 01 the cbthet insurance does riot permit in, arry infumTr3tiarl provided by you which we relied contrits«rWn by aqua€ shears, we will contrlh41e upon in Asurng &A, policy will anbt prepludict your try jsmits, Undet this method, each insures rig its under this insurance. Howomr, this pmvismn share i5 based on the ratio of its applicable limit .does not affect ov rghl to 4polle,0 acla fli000p of insurance to the total applicable limits at premium cw to eKerdw our tigfYti of cancellation Dr insurance of all insurers. nonre-opwaii in ac-corc nce ro1rh applicable insurance cl. Primary Aid NOWQmUIbVMy Inswan If lays or reguLafmns- Requtimill By b tten ConM el 7. Insureds If you specifica�y agree in a -AThen carlarad or Except wiith respect to the Omits of Irsta:rwvre, and agreeme-lt that the insurance afforded to an any rights or duties specifically assigned in this inSlaaMl d ��nda I tt'- Coverage fart wir,ust apply on Coverage Part to the first Named Insured, this .a primary basis, or 2a pn,tmarp and now insurance applies: tontribuutory bass. this ,nsueance is m'rr wry to a. As of each blamed Insured wire the anly other InSLTance that is available ta] surb inuered Named Insured,and which cci,rers such nsuredd as a named insured. and we N 1 not share with that.other insurance_ b, Separately to-each ensured against whom claim provided that as made or "mat' Is brought (1) The "bodily riiurf or 'Propaeity &ma*e" fa�a 1 s#er r Rights Of RecoveryAgainst�3t1>�rs which rowrage is sough occurs; arod To Us (2) The "personal, and advertising injury" for If O to 1 risure:d Nis righus lax d!'cvo—all cw part of any which rovnrage is sought rs caused by an payment we have made under this Coverage Part, offense thmar :committed' those rights are transferred to us. The insured must do noW,'-ig after boss to impair them. At our requiest, subsequent_ to the signing of that cone-Tact air the ^lsuread wall hiring Tsuyr or Iransfer those rig�-Its agreerrtent by you. to us and'raelp Its eeiforce thein.. 5. Premium Audit 9, When We Do Not Renew a. M. Yea cornpute all premiums for this C;overaat, If we&-cide not to renew This Overage Parr, uur*NIP Palm in accordance with our rules and rates. mar, cn adeiwer to the first Named Insured shown in b. Premium snown an this Caverage Pm ns tht: DeclarmUons wtItten notice cal the nonreoew.O R not less than 10 days before the a pirabon dale. dvar►i, prtatiiauirl i a paosra=lraiu�fiyr y At the close of eacn audllf period we wr I Compute If notice is maile& proof of mailing %ill be sufficient Cite earned premium for that period anad send prof of notice notice to the firsts Named Iris;,zee. ?doe due elate SECTnON►!-DEFIm-nDN5 for audit and retrospective premiums is the e>atp 1. 'Advervae^rrent' means a notice that is broadcast or shown as the due date on the biip. If the sum of pulbli0ed to the gerperWl putout. Or 4MCifit malcrt he advance and audit premiums pai�z for fly stg%rtents about your+ goods, products or smpc es poircy period is greator Main. the a-urned for the purpose of uttractine; tusloeft- M or premium, we % ' retttrn the excess to the first sup"rters. For the purpom of t,� �,clelinitlax-1; Mlarr►aad In3ura'O c. The first Namee insured must keep Records of a• placed that are n.19a1or o include m Ironic the irlrra�rmatil>Rn v,re need for Rr>`rnium Rlaced on the trrtern�et or art sor"ar Electronic rompata bon, and send us copies at such bmnI-s means o�comma�,tcation; 8r9d as we Vlay rawquest b. Regarding website5, only that part of a webske that is about your goods, products or services 6, PepresEntations for the purposes of attracting customers or By accepting this policy,you agme: supporters is cansiclened an advert�senient Poo 16 in ?i 201171to"r4weLw5 indemnity Camper AA P*ft Pearrved. GG T1 OD 0219 :inadreg4aydgNM moian0 ort Inpuranon servjc ,[!atom u'I-- alth IN parrriOR01 IPCCIC`+f NUMBER: "A-5R144850-3-9-47-K3 EFFECTIVE DATE; I0-413112024 ISS E DATE: 02/05 f 202# LY$TICMi Or ""Si 90MR6DtlEN'i'S AM EC99DULB M0 THIS LIST72 SHOWS TIM M MMER OF FORMS, SCUEDULES AND ENDORSEMENTS BY LIDS OF BUSINW5 IL TO 03 11 69 C=x'7y=- X POLICY DECLAIRATIONS IL T8 01 01 02 FoRm KNp+7tiSf3lQ nr13 Aw scnvUw Numus IL TO 05 06 10 COMVIN P4L1iL'T 004DIT10ft = 'K"9Ifl0r0N CONKE iCIAL At7TO CK T8 01 02 IS lkk- COVIR AaR Phi DEC$ I rTEW 1 Cc 21 MCA TO 02 0 2 15 RU:9I11E19 S ADM C{7M1'323M PART lDR AALTIONS (IT K 31 CA T4 03 02 15 BUS AUTO COV PART DDM AICATIONS-4t.5 CA TO 30 02 16 f3USLNZSS AU3QfXC COV PART-UK UUPFL SCHID CA TO 31 02 15 T 3Lx QPI Cvxrrst9TR-Buslv8fff3 3 WXQ coy Fo9x CA 00 02 10 13 BUSUESS AUM WVEfARK F RY C& 01 3 S 10 13 RKSIMNOTOR CMi3 CA 20 01 10 13 LESSOR - ADDITIONAL INSUREL? AJ0 LOSS (PAYEE CA 21 34 10 13 WASHIb 7MN UNDERINSUR1) MOTORISTS CMRAGE CA 90 03 10 33 AVTO R=ICAL PAYiUNT15 Ca9fgy.=E CA T4 30 02 15 Atrm F-WRIAGE PLUJ9 RMWRs'3fXNT CA T4 52 02 16 SHORT TERM HIRED AUTO - A=lT7OK kL INSUR= AND LOSS PAYEE S9 03 13 XWOMtMT, OF SNPLOYOR OEFInTIOR CA T4 74 02 16 p,t.1MMM ADDITIONAL XXaUR2D - PArKWt ALD �tifrP�-L'4d1CduA�kSYIIDR 191TR OTf:= I&IMURmcs CA T6 2S 07 18 ROADSID13 ABBISTANCE CWZRAA3 11MRLINB EmoRsiffi s IL T2 20 65 15 WTIC6 OF CANCELLATION Olt *0MRf%TMXL 1PROV110RD E8 17,8 IL T4 00 05 19 DE8113 PERSON, ()"-NOTICE PROVIDED BY US IL T4 12 03 15 AllRSIADT COMMON POLICY CMD-PROKIBITED CCVG IL 01 23 11 23 l3i.@.'A WGT4N CMMM - I)XVIMSS =TB IL 02 58 09 08 WXMEAR ENERGY LIABIL17Y EXCLUSION BtMMSEMM (BROAD FORK) IL rG 10 12 86 L=3+1iD1ER'S CERTIFICATE OF INSURANCE - FORK A IL TB 010101 TAGS; 1 OF 1 COWER{CIAL AUTO THIS ENDORSEMENT {CHANGr-=S T14E IOI, CY. PLEASE READ IT r=FU LY. BLANKET ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE Th:n c"orsstrtlent modifit-s inswaince prowitled urxk-r the to-owing; BUSINESS AUTO COVERAGE FORM PRDV15IONS Z Irne fallow+;fjq Is added to Paragraph 0.5.. Other 1. he follovAng is.added to Paragraph PLI�c-, Who Insurance of SECTION RJ - BUSINESS AUTO Ls An kip ed, of SECTION I - COVERED CONDITIONS: AUTOS LLWILITY COVERAGE, Regardless of the provisions os paragraph a_ and Yhis InclAes any Derson of organ,zawn who you paragraph d. of ah�s xart S. tdiiaer Insurance, I*- are e6gL vd under v wri"n contract ow Insurance is primary to and non-contributory vAth v.�roerne-iI Kwxweett you •inO Kill piprsom or tapplt�,abin oti vi -Istitati a andler which an organization, Vut is SVned by you bOure the additional insured person or orga katkX1 is the 'bodily injury" or "pr'operby damage' occuus and fivl rmm+dd Insueed w!heM the ww. en ronleaet at that is in effect during, the policy period, to name agreement between you and that person of as an adi tfonat insureci for Covered A ubD5 organizalron, tKil. 5i!ziT*d1 �y you beads the Liability Coverage, but only for damages to which 'bodil� injury' or 'property damage' occurs and phis hisuranre applies and only 1a the extent of that m nti effect cl uring the *Cy peried.. jequlres that per'�on's or anizawn's Ciab ay for the tlhis insurance to be primary and non-conbbutory. condom of aootheq'inoA�Tecr CA T46 T4 02 16 _.301-5 1 hp I rx.�L;oiq Ir4am"t ampp w At rvo Tvsmrd paye I of 1 nnk&s oopyriuMid na Wr. ct hpauaaw€"Vic a MA,14ros wnh h:.Fc.misaan. FK)LICY TfLWER: 680-SH343444-24-47 ISSUE DATE: 02/02J2024 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE DEAD IT CAREEI,J1.LY. DESIGNATED Nl TED PERSON OR ORGANIZATION NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US Th,s endoTsemcnrt modKm insmanrre provided ulxler the Ir3.:a►wing: ALL COVERAGE PARTS INCWDED IN THIS POLICY �CHEIDIJLE CANCELLATION: Number of fay*Nooce, 30 WHEN WE DO NOT RENEW(Mmm owai Number of Numb of Days Notice; 30 PIERSON Oft ORG ANMXTI I; AWf I?86tEOK OR ORRGMISiRTION TO WHOK YCV HAVE AGREED IN Il 111RIWEN Cabfr ULCT THAT wvrllcor bF CATION OR I IMU"AL OF Tula POLICY WILL BE GIVEN, BUT ONLY IFS 3. YOU SEND US A WRITTEN REQUEST TO PROVIDE guca WrICB. Ils1t'_I.t7Llllr`: TILE ymm AM ADDRE5I1 or 9uCH FERUM OR DRGRNIZKTION, AFTER THE FIRST WOM 1USIORIRD ItIMSMS IGtOTICS "09 US 471E 'THE CANCBLLILTION OR NOURSNBwAL OF 'LEIS POLICY; ]4 M 2. WE Izacktvic H-VCR %IZITIZN =tlzst AT LFAST 14 HAYS BEFORE THE BE4IMUM OF MM APPLICABLE NUMBER OF DAYS J99OWN INS R108" Y"Gllr 'x'13AT 1319"Oli 09 ok"Ni G- ATION IN#CiLMED IN SUCK 'WRITTEN R6Q Eff FROM YOU TO US IPROVISIADNS 10, If aap do not ranfnv 1gris fnllcy for afr) *g'yly A, If vm cancel 1h.s police fox any IeWlly perrrr;led permmed reasv, Other than nornpaMwt of reason other than nonpayirrient of premium, and a premium. ana a. nu► heir of c-rvf i�: 0 won for number of clays is shown far Cancetlation in the When We Do Not Renew iNonrenewaf} in the Schedule albDve, we will mail ratice of Schedule al ve. we will mail nutii;e of cance;ation to the person ax organization shown noruenerwal tD the person or oTganizatinn shcvnr in such Srhecule. We wi"mail such -notice to the in su.cn Schedule We will mail such notice to the address Shu. f� in the Scladule atove! at le.-Sl the address shown in the ScFedu v above at least the number of days shown for Canc0atp rn in such numL*r & t'ays shown for Wren VVe Do Not 5chedwe oefore the effecwe date of carKellation, Renev� Wonrenewalli in sue Schedu'ie befcxe the effective date at norlrenfMwat. 1L T4(10"05 19 ed 201 A YhR`Traodws Indemnity UamWr AJ r Svs m—,cvw Page T of