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15-035.01 Stone Creek Land Design: Browns Park Volleyball Courts Ph 1 CONTRACT AMENDMENT FOR THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND STONE CREEK LAND DESIGN & DEVELOPMENT, LLC Contract #15-035 For good and valuable consideration, the legal sufficiency of which is hereby acknowledged, City and Stone Creek Land Design&Development, LLC mutually agree as follows: 1. Purpose: This Amendment is for the Contract for Browns Park Volleyball Courts Construction— Phase 1 Project by and between the Parties, executed by the Parties on March 25, 2015, and which terminates on May 1, 2015. Total compensation under the Original Contract is not to exceed $169,668.74. Said contract shall be referred to as the "Original Contract" and its terms are hereby incorporated by reference. 2. Original Contract Provisions: The Parties agree to continue to abide by those terms and conditions of the Original Contract, dated March 25, 2015, and any amendments thereto, which are not specifically modified by this Amendment. 3. Amendment Provisions: This Amendment is subject to the following amended provisions, which are as follows. All such amendment provisions are hereby incorporated by reference herein and shall control over any conflicting provisions of the Original Contract, including any previous amendments thereto. COP#2 (Exhibit 1) is made a part of the contract. Contract date is extended until May 22, 2015. 4. Compensation Amendment History: This is Amendment#1 of the Original Contract and the history of amendments to Stone Creek Land Design& Development LLC's compensation is as follows: Date Compensation Original Contract Amount 3/25/15 $169,668.74 Amendment#1 4/14/15 $ 10,862.58 Total Amended Compensation $180,531.32 1 b The parties have executed this Amendment to the Original Contract this /, day of 2015. CITY OF SPOKANE VALLEY: C• " ' • CTOR: • Mike Jackso " By: I• urate11414in City Manag- Its: . Manager ATTEST: APPROVED AS TO FORM: Cp. ,J/ittz/ Christine Bainbridge, City Clerk Office f the City" orney 2 • STONI3CREEK LAND DESIGN&DEVELOPMENT Change Order Form EXHIBIT #1 Date: 4/8/2015 Customer/Client Name: City of Spokane Valley Job: Browns park volleyball courts construction phase 1 Project No: 14-002A Change order No: COP #2 Stone Creek representative name: Shawn Walker Description of Work to Be Done: Installation of sleeves and footings (14) for the volleyball courts. Price does not include rebar, gravel base, or sleeves. Sleeves to be provided by volleyball association. Equipment/Labor/Materials Cost 1. Excavate for Sleeves, backfill and compact. $3,950.50 2. Set Sonotubes(18" Diameter) $2,750.15 3.Pour concrete/set sleeves. $1,906.58 4. Line Pump $1,385.95 Sub Total:$ 9,993.18 8.7% Sales Tax:$ 869.40 Total:$10,862.58 WE AGREE TO MAKE THE CHANGE(S) SPECIFIED. THIS CHANGE ORDER BECOMES PART OF ALL WORK TO BE PERFORMED UNDER THE SAME TERMS AND CONDITIONS AS SPECIFIED IN THE ORIGINAL CONTRACT. By:(Stone Creek Land Design &Development, Inc.) By: (Client/or supervisor on-site) 5/11/2015 STONE CREEK LAND DSGNIDEV LLC Home Tokio en Espanol Col-gait Search L&I ,1-7lndex Help My Secure 1.&t Safety Claims&Insurance Workplace Rights Trades&Licensing 0 Washington State Department of Labor & industries STONE CREEK LAND DSGN/DEV LLC Owner or tradesperson 4009 E FRANCIS AVE SPOKANE,WA 99217 MARTIN,JOSHUA DAVID 509-892-4026 Principals SPOKANE County MARTIN,JOSHUA DAVID,PARTNER/MEMBER Doing business as STONE CREEK LAND DSGNIDEV LLC WA UBi No. Business type 603 338 890 Limited Liability Company Parent company STONE CREEK LAND DSGNIDEV LLC License Verify the contractor's active registration I license/certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. STONECL869JG Effective—expiration 04/07/2014—04/07/2016 Bond Western Surety Co $12,000.00 Bond account no. 61986165 Received by L&I Effective dr 04/07/2014 04102/2014 Expiration date Until Canceled Insurance Liberty Northwest Ins Corp $1,000,000.00 Policy no. BKA58638908 Received by L&I Effective date 04129/2015 05101/2015 Expiration date 06/01/2016 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts haps://secure.inlwa-gav/verify/D stall.aspx?UBI=603338890&UC=STON ECL869JG&SAW=Feiss 112 W11/2015 STONE CREEK LAND DSGN/DEV LLC No L&I tax debts aro recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know If the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account Is current. 292,311.00 Doing business as STONE CREEK LAND DESIGN&DEVE Estimated workers reported Quarter 1 of Year 2015"11 to 20 Workers" L&I account representative TO f GARY HONG(360)902-4823-Email:HONC235@inl.wa.gov IWorkplace safety and health No inspections during the previous 6 year period, 0 Washington State Dept.of Labor&Industries.Use of this sSe Is subjed to the laws of the slate of Washington. hltpsJ/secure.lnl.wa.gov/verify/Delaif.aspx?U BI=603338890&LIC=STONEC L869JG&SAW=False 212 STONCRE-04 KGEHRS ACC/FICO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYY1) �� 4130!2015 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(les)must 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 endorsernent(s) e r_ i t„ ; f ..:. I CONTACT PRODUCER , NAME: Spokane Office PHONE 609 838-3501 FAX No):(509)838-3511 P . INC,No.Extl:( ) PayneWest insurance Inc. -,. ( l;I•l ' EMAIL 601 N.Riverpoint Blvd.,Ste 403 ` � ADDRESS: Spokane,WA 99202 , INSURER(S)AFFORDINGCOVERAGE NAIC0 r,.,;t ,i.' 24066 t"" • "' , tNsuaERA:American Fire and Casualty Co - INSURED INSURER e:Ohio Casualty Insurance 24074 Stone Creek Land Design&Development,LLC INSURER C: 4009 E Francis INSURER D: Spokane,WA 99217 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 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. INSRLTYPE OF ADOL SUER POLICY EFF POLICY EXP LIMITS INSURANCE INSO VND POLICY NUMBER (MMIDD/YYYYI (MMIDDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1,000,001 � DaaaGETo RENTED 1,000,001 CLAIMS•MADE I"1 OCCUR X X BKA56638908 05!0112015 05!0112016 pREMISES(Eaoceurrence) $ MED EXP(Any one person) 5 16,001 PERSONAL B ADV INJURY 5 1,000,001 GEIfEL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,008 PO- PRODUCTS-COMP/OP AGG 5 2,000,00' OTHER:OTHCYER: JECT LOC WA Stop Gap S 1,000,001 COMBINED SINGLE LIMIT $ 1,000,00' AUTOMOBILE LIABILITY (Ea accident) _ A X ANY euro X X BAA56638908 05101/2015 05/01/2016 BODILY INJURY(Per person) $ AALLOOSNED SSCCHHEESDULED BODILY INJURY(Per acddent) $ NON-0NNED PROPERTY DAMAGE S(Per acddenl) HIREOAUTOS AUTOS 5 11 ii UMBRELLA UAB X OCCUR EACH OCCURRENCE S 4,000,001 B EXCESS UAB CLAIMS•MADE US056638908 05/0112015 05/0112016 AGGREGATE 5 4,000,001 DED X RETENTIONS 10,000 S WORKERS COMPENSATION STA UTE ER AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVEE.L EACH ACCIDENT S OFFICER/MEMBEREXCLUDED? I I NIA (Mandatory In NH) E.L DISEASE-EA EMPLOYEE 5 if yes,describe under E.L DISEASE-POUCY LIMIT 5 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If mom space Is required) WA L&I Account#'s Stone Creek LLC 1292,311.00 SCS Spray Service LLC 1292,311.01 Zetin Contractors LLC 1292,311-02 RE:Browns Park Volleyball Courts Construction-Phase I City of Spokane Valley Is named as additional Insured for ongoing and completed operations.Insurance is primary and waiver of subrogation applies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Spokane Valley ACCORDANCE WITH THE POLICY PROVISIONS. Parks and Recreation Department 2426 N.Discovery Place Spokane,WA 99216 AUTHORIZED REPRESENTATIVE�ee, �/ /�{�ti ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CWP 6000412 - 23 05/01/14 AS1 05/01/14 COMMERCIAL GENERAL LIABILITY CL CG 00 13 0813 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY PLATINUM ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. MEDICAL PAYMENTS If SECTION I-COVERAGE C MEDICAL PAYMENTS is not otherwise excluded from this Coverage Part: 1. The Medical Expense Limit provided by this policy,subject to the terms of SECTION III-LIMITS OF INSURANCE, shall be the greater of; a. $10,000; or b. The Medical Expense Limit shown in the Declarations of this Coverage Part. B. FIRE,LIGHTNING,EXPLOSION,SMOKE AND SPRINKLER LEAKAGE DAMAGE TO PREMISES YOU RENT If damage to premises rented to you under Coverage A. is not otherwise excluded from this policy, the following applies: 1. The last paragraph of SECTION I-COVERAGE A.2.Exclusions is deleted and replaced by the following: Exclusions c. through n. do not apply to damage by fire,lightning, explosion,smoke or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of Insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. 2. Paragraph 6. of SECTION III - LIMITS OF INSURANCE is deleted and replaced by the following: 6. Subject to Paragraph 5.above,the greater of: a. $300,000;or b. the Damage To Premises Rented To You Limit shown in the Declarations; is the most we will pay under COVERAGE A for damages because of"property damage"to any one premises,while rented to you or temporarily occupied by you with The permission of the owner. 3. Paragraph 4.b.(1)(a)(li) Other Insurance of SECTION IV • COMMERCIAL GENERAL LIABILITY CONDITIONS Is deleted and replaced by the following: (II) That is Fire, Lightning, Explosion, Smoke or Sprinkler Leakage insurance for premises rented to you or temporarily occupied by you with the permission of the owner; 4. Paragraph 9.a.of SECTION V-DEFINITIONS is deleted and replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of the owner is not an Insured contract"; CL CO 0013 0813 Includes copyrighted material of Insurance Services Page 1 of 6 Office.Inc.with its permission C. LIMITED NON-OWNED WATERCRAFT 1, Paragraph g.(2) of SECTION I - COVERAGE A.2. Exclusions is deleted and replaced by the following: A watercraft you do not own that is: a. Less than 51 feet long;and b. Not used to carry persons or property for a charge. D. SUPPLEMENTARY PAYMENTS SECTION I-SUPPLEMENTARY PAYMENTS-COVERAGES A AND B Is amended as follows: 1. The limit of insurance in paragraph 1.b. Is Increased from$250 to$2,500;and 2, The limit of insurance in paragraph 1,d. is increased from$260 to$500. E. AUTOMATIC ADDITIONAL INSURED - SPECIFIED RELATIONSHIPS - PRIMARY NON-CONTRIBUTORY The following is added to Paragraph 2.of SECTION II-WHO IS AN INSURED: e. Any person or organization described below, when you are obligated by virtue of a written 'contract or agreement that such person be added as an additional insured on your policy. When required by virtue of a written contract or agreement, coverage provided to any additional insured will be on a primary basis and will not seek contribution from the additional insured's policy. Only the following persons or organizations are additional insureds under this endorsement: (1) Managers Or Lessors Of Premises. The manager or lessor of a premise leased to you, but only with respect to liability arising from the ownership, maintenance or use of that part of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: (a) Any"occurrence"which takes place after you cease to be a tenant of that premises. (b) Structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor. (2) Lessor Of Leased Equipment. Any person or organization from whom you lease equipment, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s)or organization(s). However, this insurance does not apply to any"occurrence" which takes place after the equipment lease expires. (3) Vendors. Any person or organization, but only with respect to "bodily injury" or "property damage" arising out of "your products" shown in the Schedule which are distributed or sold in the regular course of the vendor's business,subject to the following additional exclusions: a. The insurance afforded the vendor does not apply to: 1. "Bodily injury" or "property damage" for which the vendor Is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; 2. Any express warranty unauthorized by you; 3. Any physical or chemical change in the product made intentionally by the vendor; CL CO 0013 0813 Includes copyrighted material of insurance Services Page 2 of 6 Office,Inc.wish its permission 4. Repackaging, unless unpacked solely for the purpose of Inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer,and then repackaged in the original container; 5. Any failure to make such inspections, adjustments, tests or servicing as the • vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of the products; 6. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; 7. Products which,after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. b. This insurance does not apply to any Insured person or organization, from whom you have acquired such products,or any ingredient, part or container, entering into, accompanying or containing such products. (4) State Or Political Subdivision - Permits Or Authorizations Relating To Premises. Any state or political subdivision,subject to the following additional provision: This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with premises you own, rent, or control and to which this insurance applies: (a) The existence, maintenance, repair,construction,erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings,sidewalk vaults, street banners,or decorations and similar exposures;or (b) The construction, erection,or removal of elevators;or (c) The ownership,maintenance,or use of any elevators covered by this insurance. Limits of insurance for such additional insured are the limits in this coverage form or the limits you and such additional insured agreed to by virtue of a contract or agreement,whichever Is less. These limits are inclusive of and are not in addition to the Limits Of Insurance shown in the Declarations. When required by virtue of a written contract or agreement, coverage provided to any additional insured AUTOMATIC ADDITIONAL INSURED - SPECIFIED RELATIONSHIPS - PRIMARY NON-CONTRIBUTORY will be on a primary basis and will not seek contribution from the additional insured's policy. F. BROADENED NAMED INSURED-NEWLY ACQUIRED 180 DAYS Paragraph 3.of SECTION II•WHO IS AN INSURED is deleted and replaced by the following: Any organization you newly acquire or form,other than a joint venture,and over which you maintain ownership or majority interest of more than 50%will be a Named insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period,whichever is earlier. b. COVERAGE A does not apply to "bodily injury" or"property damage" that occurred before you acquired or formed the organization. c. COVERAGE B does not apply to"personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. G. AGGREGATE LIMITS OF INSURANCE The General Aggregate Limit under SECTION III - LIMITS OF INSURANCE applies separately to each of your: CL CG 0013 0813 Includes copyrighted material of Insurance Services Page 3 of$ Office,Inc.with Its permission 1. Projects away from premises owned by or rented to you. 2. "Locations"owned by or rented to you. "Location" means premises involving the same or connecting lots, or premises whose connection Is interrupted only by a street,roadway,waterway or right-of-way of a railroad. When paragraph B.Construction Project General Aggregate Limit on form CL CG 00 20 is a part of this policy,then paragraph G. Aggregate Limits of insurance of this endorsement does not apply. H. KNOWLEDGE OF OCCURRENCE The following is added to paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS: e. A report of an"occurrence", offense,claim or"suit"to: (1) You, if you are an individual, (2) A partner, if you are a partnership, (3) An executive officer,if you are a corporation,or (4) A manager,if you are a limited liability company; is considered knowledge and requires you to notify us of the "occurrence", offense, claim,or"suit"as soon as practicable. f. We are considered on notice of an "occurrence", offense, claim or"suit"that is reported to your Workers'Compensation insurer for an event which later develops into an"occurrence", offense, claim or"suit"for which there is coverage under this policy. However,we will only be considered on notice if you notify us as soon as you know the claim should be addressed by this policy rather than your Workers'Compensation policy. I. UNINTENTIONAL OMISSIONS The following is added to paragraph 6. Representations of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: d. If you unintentionally fail to disclose any exposures existing at the Inception date of your policy,we will not deny coverage under this Coverage Part solely because of such failure to disclose. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. This provision does not apply to any known Injury or damage which is excluded under any other provision of this policy. .I, MENTAL ANGUISH Paragraph 3.of SECTION V-DEFINITIONS is deleted and replaced by the following: 3. "Bodily injury" means bodily injury,sickness or disease sustained by a person, including mental anguish or death resulting from any of these at any time. K. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS Paragraph 8, Transfer Of Rights Of Recovery Against Others To Us of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended by the addition of the following: We waive any right of recovery we may have because of payments we make for"bodily injury" or "property damage" arising out of your ongoing operations or "your work" done under a contract requiring such waiver with that person or organization and included in the "products-completed operations hazard". However,our rights may only be waived prior to the"occurrence"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"suit"or transfer those rights to us and help us enforce those rights. CL CG 00 13 08 13 Includes copyrighted material of Insurance Services Page 4 of 6 Office,Inc.with its permission Paragraph K.WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS does not apply if another waiver of transfer of rights of recovery against others is endorsed separately to this policy. L. OTHER INSURANCE When Coverage applies In this General Liability Enhancement Endorsement, no other coverage or limit of insurance in the policy applies to loss or damage insured by this coverage. M. NON-EMPLOYMENT DISCRIMINATION LIABILITY(DEFENSE WITHIN LIMITS) The following is added to paragraph 14. "Personal and advertising Injury" SECTION V - DEFINITIONS of COMMERCIAL GENERAL LIABILITY COVERAGE FORM: h. Non-employment discrimination. Non-employment discrimination means violation of a person's civil rights with respect to such person's race, color, national origin, religion, gender, marital status, age, sexual orientation or preference,physical or mental condition,or any other protected class or characteristic established by any federal, state or local statutes, rules or regulations. Non-employment discrimination does not include violation of civil rights arising out of past,present or prospective employment. Our obligation under the Personal and Advertising Injury Liability Coverage to pay non- employment discrimination liability damages on your behalf applies only to the amount of damages in excess of$5,000 deductible as the result of any one offense regardless of the number of persons or organizations who sustain damages because of the offense. The most we will pay for all damages for non-employment discrimination is $15,000 annual agg regate. No other liability to pay sums or perform acts or services is covered. Supplemental Payments - Coverages A and B do not apply to non-employment discrimination coverage. N. ADDITIONAL INSURED-OWNERS, LESSEES OR CONTRACTORS OR OTHERS-AUTOMATIC, INCLUDING PRIMARY NON-CONTRIBUTORY • 1. SECTION II -WHO IS AN INSURED is amended to include as an additional insured any person or organization for whom you are performing operations when you are obligated by virtue of a written contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for"bodily injury","property damage"or"personal and advertising injury"caused by your ongoing operations for the additional insured and only to the extent that such "bodily injury", "property damage" or "personal and advertising injury' Is caused by your negligence or the negligence of those performing operations on your behalf. This insurance does not apply to "bodily injury", "property damage", "personal and advertising Injury"included within the"products-completed operations hazard". This insurance does not apply to any additional insured scheduled on your policy by separate endorsement 2. Limits of Insurance Limits of insurance for such additional insured are the limits in this coverage form or the limits you and such additional insured agreed to by virtue of a contract or agreement, whichever is less. These limits are Inclusive of and are not in addition to the Limits Of Insurance shown in the Declarations. 3. Exclusions A. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of: 1. The rendering of or failure to render any professional services by you or on your behalf, but only with respect to either or both of the following operations: CL CG 00 13 08 13 Includes copyrighted material of insurance Services Page 5 of 6 Office,Inc.with Its permission a. Providing engineering, architectural or surveying services to others in your capacity as an engineer,architect or surveyor;and b. Providing, or hiring Independent professionals to provide, engineering, architectural or surveying services in connection with construction work you perform. 2. Subject to Paragraph 3. below,professional services Include: a. Preparing, approving, or falling to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications;and b. Supervisory or inspection activities performed as part of any related architectural or engineering activities. 3. Professional services do not include services within construction means, methods, techniques, sequences and procedures employed by you or performed by or for the construction manager, its employees or its subcontractors in connection with your ongoing operations. B."Bodily injury"or"property damage"occurring after: 1. All work, Including materials,parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed;or 2. That portion of"your work"out of which the injury or damage arises has been put to Its . Intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 4. Primary Non-Contributory When required by virtue of a written contract or agreement,coverage provided to any additional Insured by ADDITIONAL INSURED - OWNERS, LESSEES, CONTRACTORS OR OTHERS - ONGOING OPERATIONS -AUTOMATIC, INCLUDING PRIMARY NON CONTRIBUTORY will be on a primary basis and will not seek contribution from the additional Insureds policy. • CL CG 0013 0813 Includes copyrighted material of Insurance Services Page 6 of 6 Office,Inc.with its permission • CWP 6000612 - 23 05/01/14 AS1 05/01/14 THiS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES, CONTRACTORS OR OTHERS - COMPLETED OPERATIONS - AUTOMATIC, INCLUDING PRIMARY NON-CONTRIBUTORY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. SECTION II -WHO IS AN INSURED is amended to include as an additional insured any person(s)or organization(s)when you are obligated by virtue of a written contract or agreement that such person or organization(s)be added as an additional insured to your policy. Such person or organization is an additional insured only with respect to liability for"bodily injury","property damage" or"personal and advertising injury" caused by"your work"for the additional insured and only to the extent that such "bodily injury", "property damage" or "personal and advertising injury" is caused by your negligence, or the negligence of those performing operations on your behalf, for that additional Insured and included in the"products-completed operations hazard". This Insurance does not apply to any additional insured scheduled on your policy by separate endorsement. B. LIMITS OF INSURANCE Limits of insurance for such additional insured are the limits in this coverage form or the limits you and such additional insured agreed to by virtue of a contract or agreement, whichever is less. These limits are inclusive of and are not in addition to the Limits Of Insurance shown in the Declarations. C. With respect to the insurance afforded to these additional insureds,the following additional exclusions apply to"bodily injury","property damage"or"personal and advertising injury"arising out of: 1, The rendering of or failure to render any professional services by you or on your behalf, but only with respect to either or both of the following operations: a. Providing engineering, architectural or surveying services to others in your capacity es an engineer,architect or surveyor;and b. Providing or hiring independent professionals to provide, engineering, architectural or surveying services in connection with construction work you perform. 2. Subject to paragraph 3.below, professional services include: a. Preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports,surveys,field orders,change orders,or drawings and specifications;and b. Supervisory or inspection activities performed as part of any related architectural or engineering activities. 3. Professional services do not include services within construction means, methods, techniques, sequences and procedures employed by you or performed by or for the construction manager,its employees or its subcontractors in connection with your products-completed operations. D. PRIMARY NON-CONTRIBUTORY When required by virtue of a written contract or agreement, coverage provided to any additional insured by ADDITIONAL INSURED — OWNERS, LESSEES, CONTRACTORS OR OTHERS — COMPLETED OPERATIONS — AUTOMATIC, INCLUDING PRIMARY NON-CONTRIBUTORY will be on a primary basis and will not seek contribution from the additional insured's policy. CL CG 20 48 01 14 Includes Copyrighted material of Insurance Services Page 1 of 1 Office,Inc with Its permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY COMMERCIAL AUTOMOBILE EXPANSION ENDORSEMENT - PLATINUM This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following provides a broad range of coverage in addition to that provided by the basic policy. In some Instances, a higher limit or broader coverage Is available. Should the policy Indicate broader coverage or higher limits than provided by this endorsement,the higher limits or broader coverage shall apply. A. BROADENED NAMED INSURED (2) A person's or organization's status aThe Named Insured shown in the Declarations is while aadditional insuredexistsronly amended to include: you are performing operations for that additional insured. Any organization, other than a joint venture,over (3) Section II, Paragraph C. Limits of which you maintain ownership or majority inter- Insurance for person or organization est of more than 50%, unless that organization added as additional insured are is an "insured" under any other automobile pol- 1 those specified in the written con- icy or would be an "insured" under such a policy tract or agreement, or in this cover- but for the exhaustion of its Limit of Insurance, age form,whichever is less. These however; limits of Insurance are inclusive of 1, Coverage under this provision Is afforded and are not in addition to the Limits only until the 180th day after you acquire or of Insurance shown in the Declara- form the organization or the end of the policy tions. period,whichever Is earlier. (4) This insurance applies on a primary 2. Coverage does not apply to"bodily Injury"or and non-contributory basis if that is "property damage" that occurred before you required by the written contract or acquired or formed the organization. agreement. B. ADDITIONAL INSURED BY CONTRACT OR (5) This insurance does not apply AGREEMENT unless the written contract or agreement has been executed prior The following is added to Section II - Liability to the "bodily Injury" or "property Coverage,Paragraph A.1.: damage". d. Any person or organization for whom you C. ADDITIONAL INSURED-EMPLOYEES are performing operations if you and such person or organization have agreed In writ- The following is added to the Section II—Liability ing in a contract or agreement that such Coverage, Paragraph A.1, Who Is An Insured person or organization be added as an addi- Provision: tional Insured on your policy. Any"employee" of yours Is an "Insured" while us- (1) Such person or organization is an ing a covered "auto"you don't own, hire or borrow additional Insured only with respect in your business or your personal affairs. to liability for"bodily injury" or"prop- D. EXTENDED COVERAGE-BAIL BONDS arty damage": Section II — Liability Coverage, Paragraph (a) Caused by an "accident", and A.2.a.(2). Is deleted and replaced by the follow- (b) Resulting from the ownership, ing: maintenance or use of a coy- (2) Up to $5,000 for cost of bail bonds ered"auto". (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. CW 34 68 01 12 Includes Copyrighted material of Insurance Services Page 1 of 5 Office,Inc.,with Its permission E. EXTENDED COVERAGE - LOSS OF EARN- J. LEASED OR FINANCED "AUTOS" - PHYSI- ING CAL DAMAGE COVERAGE Section II — Liability Coverage, Paragraph The following is added to Section III — Physical A.2.a.(4) is deleted and replaced by the follow- Damage Coverage, Paragraph C. ing: 4. In the event of a total "loss" to a covered (4) All reasonable expenses incurred by "auto", we will pay any unpaid amount due the "insured" at our request, Includ- on the lease or loan for a covered "auto", ing actual loss of earning up to$500 less: a day because of time off from work. a. The amount under the Physical Damage F. FELLOW EMPLOYEE COVERAGE Coverage section of the policy; and The Fellow Employee Exclusion contained In b. Any: Section II —Liability Coverage does not apply. (1) Overdue lease/loan payments at the This coverage is excess over any other collect- able insurance. time of the"loss"; G. AUTO MEDICAL PAYMENTS COVERAGE - (2) Financial penalties imposed under a INCREASED LIMIT lease for excessive use, abnormal wear and tear or high mileage; If the"insured" is wearing a seat belt at the time (3) Security deposits not returned by an "accident" occurs, the LIMIT OF 1NSUR- the lessor; ANCE for AUTOMOBILE MEDICAL PAYMENTS COVERAGE shown in the Declarations will be (4) Costs for extended warranties, double the limit shown. All other terms and con- Credit Life Insurance, Health, Acci- ditions applicable to MEDICAL PAYMENTS re- dent or Disability Insurance pur- main unchanged. chased with the loan or lease;and H. COVERAGE EXTENSION AS A CONSE- (5) Carry-over balances from previous QUENCE OF THEFT OF AN "AUTO" loans or leases. 1. Transportation Expense K. GLASS DEDUCTIBLE Section III — Physical Damage Coverage, Section III — Physical Damage Coverage, Para- Paragraph A.4.a.is deleted and replaced by graph D. is deleted and replaced by the follow- the following: ing: a. We will also pay up to $75 per day to a D. DEDUCTIBLE maximum of $2,500 for temporary For each covered "auto" our obligation to transportation expense incurred by you pay for,repair, return or replace damaged or because of the total theft of a covered "auto" of the "private passenger type". stolen property will be reduced by the appll- We will pay only for those covered cable deductible shown in the Declarations. "autos" for which you carry either Com- Any Comprehensive Coverage deductible prehensive or Specified Causes of Loss shown in the Declarations does not apply to: Coverage. We will pay for temporary 1. "Loss"caused by fire or lightning;or transportation expenses incurred during 2. "Loss"when you elect to patch or repair the period beginning 48 hours after the theft and ending, regardless of the pol- glass rather than replace. icy's expiration,when the covered"auto" L. EXTENDED COVERAGE - ELECTRONIC is returned to use or we pay for its EQUIPMENT "loss". Paragraph C.2.a. Limits of Insurance of Section We will also pay reasonable and neces- III—Physical Damage Coverage is deleted.: sary expenses to facilitate the return of the stolen "auto"to you. We will pay with respects to a covered"auto"for "loss"to antennas and other accessories neces- I. EXTENDED COVERAGE-AIRBAGS sary for use of the electronic equipment. How- Section III— Physical Damage Coverage, Para- ever, this does not Include tapes, records or graph 8.3.a. does not apply to the unintended discs. discharge of an airbag. Coverage is excess over any other collectible insurance or warranty specifically designed to provide coverage. CW 34 68 01 12 Includes Copyrighted material of Insurance Services Page 2 of 5 Office,Inc.,with Its permission M. EXTENDED COVERAGE - PERSONAL EF- P. PHYSICAL DAMAGE COVERAGE - HIRED FECTS "AUTOS The following is added to Section III -- Physical You may extend the Comprehensive, Specified Damage Coverage, Paragraph A.4.: Causes of Loss and Collision coverages pro- d. Physical Damage Coverage on a cov- vided on your owned "autos" to any "auto" you ered"auto"may be extended to loss"to lease, rent, hire or borrow from someone other your personal property or, if you are an than your employees or partners or members of individual, the personal property of a their households subject to the following: family member, that is in the covered 1. The most we will pay in any one"loss"is the "auto"at the time of loss". least of $100,000, the actual cash value of the"auto"or the cost to repair or replace the The most we will pay for any one "loss" "auto", except that such amount will be re- under this coverage extension Is$500. duced by a deductible to be determined as N. TOWING AND LABOR COVERAGE follows: Section III — Physical Damage Coverage, Para- a. The deductible shall be equal to the graph A.2.is deleted and replaced by the follow- amount of the highest deductible shown ing: for any owned"auto"of the same classi- If a private passenger type "auto" or light truck fication for that coverage. In the event there Is no owned "auto" of the same "auto" (0-10,000 Lbs. GVW) is provided both classification, the highest deductible for Comprehensive and Collision Coverage, we will any owned"auto'will apply for that cov- pay up to $150 for towing and labor costs in- erage. curred each time such "auto" is disabled. If a medium, heavy or extra-heavy truck or extra- b. No deductible will apply to"loss" caused heavy Truck-tractor "auto" (greater than 10,000 by fire or lightning. Lbs.GVW)is provided both Comprehensive and 2. Coverage provided under this extension will: Collision Coverage, we will pay up to $250 for towing and labor costs incurred each time such a. Be excess over any other collectible "auto" is disabled. However, the labor must be Insurance; performed at the place of disablement. b. Pay, in addition to the limit set forth in O. EXTENDED COVERAGE - CUSTOMIZED P.1. above, up to $500 per day, not to FURNISHINGS exceed$3,500 per"loss"for: The following is added to Section III — Physical (1) Any costs or fees associated with Damage Coverage, Paragraph A.4.: the"loss"to a hired"auto";and e. Physical Damage Coverage on a coy- (2) Loss of use, provided it Is the con- ered "auto"may be extended to"loss"to sequence of an "accident" for which custom furnishings including, but not you are legally liable, and as a result limited to special carpeting and insula- of which a monetary loss is sus- tion, height-extending roofs, and custom tamed by the leasing or rental con- murals, paintings, or other decals or cern. graphics, custom signage and custom Q. RENTAL REIMBURSEMENT COVERAGE non-factory paint. Our limit of liability for loss to custom We will pay for rental reimbursement expenses furnishings shall be the least of: incurred by you for the rental of an "auto" be- cause of"loss"to a covered "auto". (1) Actual cash value of the stolen or 1. Payment applies in addition to the otherwise damaged property; applicable amount of each coverage you (2) Amount necessary to repair or re- have on the covered"auto". place the property; or 2. No deductible applies to this coverage. (3) $1,000 3. We will pay only for those expenses incurred This coverage extension does not apply during the policy period beginning 24 hours to electronic equipment. after the"loss"and ending, regardless of the expiration date of the policy, with the lesser of the following: CW 34 68 01 12 Includes Copyrighted material of Insurance Services Page 3 of 5 Office,Inc.,with Its permission a. When the covered "auto" has been re- (b) Any"auto"used by that individual paired or replaced,or or his or her spouse while working b. When the total amount paid under this ine a business p rionsgl"aut servicing, repairing or parking"autos". coverage extension reaches$2,500. 2. Changes In Auto Medical Payments And 4. Our payment is limited to the lesser of the Uninsured And Underinsured Motorists following amounts: Coverages a. Necessary and actual expenses in- The following is added to Who Is An Insured: curved. Any individual named in R.1.a and his or her b. Not more than$75 per day. "family members"are"insured"while"occupy- 5. We will pay up to an additional $300 for the "occupy- ing" or 5. a pedestrian when being struck reasonable and necessary expenses you in- cur by any"auto"you don't own except: to remove your materials and equipment Any"auto" owned by that individual or by any from the covered "auto" and replace such 'family member". materials and equipment on the rental 3. Changes In Physical Damage Coverage "auto". Any private passenger type "auto" you don't 6. This coverage does not apply while there own,hire or borrow is a covered"auto'while In are spare or reserve"autos" available to you the care, custody or control of any individual for your operations. named In R.1.a or his or her spouse while a 7. If"loss" results from the total theft of a cov- resident of the same household except: ered "auto" of the "private passenger type", a. Any "auto" owned by that individual or by we will pay under this coverage only that any member of his or her household. amount of your rental reimbursement ex- b. Any"auto" used by that individual or his or penses which is not already provided for un- her spouse while working in a business of der the Physical Damage Coverage Exten- selling, servicing, repairing or parking slon. "autos". R. DRIVE OTHER CAR COVERAGE 4. The most we will pay for the total of all dam- 1. Changes In Liability Coverage ages under LIABILITY COVERAGE, AUTO MEDICAL PAYMENTS, UNINSURED MO- a. Any"auto"you don't own,hire or borrow is TORISTS COVERAGE and UNDERIN- a covered "auto" for Liability Coverage SURED MOTORISTS COVERAGE is the while being used by: LIMIT OF INSURANCE shown in the Dacia- (1) You, if you are designated in the rations as applicable to owned"autos". Declarations as an individual; 5. Our obligation to pay for, repair, return or (2) Your partners or members, if you replace damaged or stolen property under are designated in the Declarations PHYSICAL DAMAGE COVERAGE, will be as a partnership or joint venture; reduced by a deductible equal to the amount of the largest deductible shown for any (3) Your members or managers, if you owned private passenger type "auto" appli- are designated in the Declarations cable to that coverage. If there are no as a limited liability company; owned private passenger type "autos", the (4) Your "executive officers", if you are deductible shall be $50 for Comprehensive designed in the Declarations as an Coverage and $100 for Collision Coverage. organization other than an Individ- No deductible will apply to"loss" caused by ual, partnership,joint venture or lira- fire or lightning. ited liability company;and E. Additional Definition (5) The spouse of any person named in As used in this section; R. DRIVE OTHER R.1.a.1. through R.1.a.(4) while a CAR COVERAGE: resident of the same household. "Family member" means a person related to except: the Individual named in R.1.a by blood, mar- (a) Any "auto" owned by that individ- nage or adoption who is a resident of the Indi- ual or by any member of his or vidual's household, including a ward or foster child. her household. CW 34 68 01 12 Includes Copyrighted material of Insurance Services Page 4 of 5 Office,Inc.,with its permission S. KNOWLEDGE OF OCCURRENCE T. WAIVER OF SUBROGATION BY CONTRACT The following is added to Section 1V— Business OR AGREEMENT Auto Conditions, Paragraph A.2.: The following Is added to Section IV - Business d. Notice of an "accident" or "loss" will be Auto Conditions,Paragraph A.5.: considered knowledge of yours only if We waive any right of recovery we may have reported to you, if you are an individual, against any "Insured" provided coverage under a partner, an executive officer or an em- this endorsement under B., ADDITIONAL IN- ployee designated by you to give us SURED BY CONTRACT OR AGREEMENT, but such notice. only as respects "loss" arising out of the opera- tion, maintenance or use of a covered "auto" s. Notice of an "accident" or"loss" to your pursuant to the provisions or conditions of the Workers Compensation insurer, for an event which later develops into a claim written contract or agreement. for which there is coverage under this U. UNINTENTIONAL OMISSIONS policy, shall be considered notice to us, The following is added Section IV - Business but only if we are notified as soon as Auto Conditions, Paragraph B.2.: you know that the claim should be ad- dressed by this policy, rather than your We will not deny coverage under this policy if Workers Compensation policy. you fail to disclose all hazards existing as of the f. Your rights under this policy shall not be inception date of the policy, provided such fail- prejudiced if you fail to give us notice of urs is not intentional. an "accident" or "loss", solely due to V LIBERALIZATION your reasonable and documented belief If we revise this endorsement to provide greater that the event is not covered by this poi- coverage without additional premium charge,we icy. will automatically provide the additional cover- The following is added to Section IV--Bust- age to all endorsement holders as of the day the ness Auto Conditions, Paragraph 2.b.: revision is effective in your state. (6) Knowledge of the receipt of docu- ments concerning a claim or "suit" will be considered knowledge of yours only If receipt of such docu- ments is known to you, if you are an individual, a partner, an executive officer or an employee designated by you to forward such documents to us. CW 34 68 01 12 Includes Copyrighted material of Insurance Services Page 5 of 5 Office,Inc.,with Its permIssion