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18-072.03 Power City Electric: ITS Infill Phase 1
•••"%,.., Spokrane ./�Milleyr DEPARTMENT OF PUBLIC WORKS 18-o�7Z .o3 CHANGE ORDER NO: 3 CONSTRUCTION CONTRACT NO: 18-072 PROJECT: ITS Infill, Phase 1 PRIME CONTRACTOR: Power City Electric, Inc CONTRACT DATE: 4/23/2018 CIP NO: 201 DESCRIPTION OF CHANGES This Change Order pertains to Bid Schedule: A Change Order 3 pays, per WSDOT Std Specification 1-09.6 Force Account procedures for the following work: Item No. CO 3.1 CO 3.2 CO 3.3 CO 3.4 CO 3.5 Description Unit Quantity Unit Price FA Avista Delayed Locate for Gas Service at 301 N Fancher CALC 1 $ 0.00 $ 0.00 FA Standby time for Spokane Water Department locate for Home Depot Water Service CALC 1 $ 120.08 $ 120.08 FA UPRR HDD Bore Attempt Compensation CALC 1 $ 10,214.78 $ 10,214.78 FA Conduit Continutity Check under HDD Bore Pits CALC 1 $ 1,108.25 $ 1,108.25 FA Additional Fiber line testing required to add Fancher splice CALC 1 $ 694.73 $ 694.73 Total Amount of this Change Order (incl. Tax): $ 12,137.84 Total Original Contract Working Days: 20 Revisions by Prior Change Orders: 9 PHYSICAL COMPLETION Revision By This Change Order: 0 Total Revised Contract Working Days: 29 CONTRACT AMOUNT THESE CHANGES RESULT IN THE FOLLOWING ADJUSTMENTS OF TOTAL CONTRACT AMOUNT: ORIGINAL TOTAL CONTRACT AMOUNT $ TOTAL PRIOR CONTRACT CHANGE ORDER AMOUNT (through CO #2) TOTAL CONTRACT AMOUNT PRIOR TO THIS CHANGE ORDER NET THIS CHANGE ORDER TOTAL CONTRACT AMOUNT IN HIS CHANGE ORDER $ CONTRACTOR ACCEPTANCE: DATE: The contractor hereby accepts this a justment and ! the terms of Section 1-04.4 of the original contract. RECOMMENDED BY: APPROVED BY: APPROVED BY: Project Manager Public Works Director "// City Manager DATE: DATE: 378,216.28 4,588.88 382, 805.16 12,137.84 394, 943.00 /14:1.10 DATE: (0/1b ATTACHMENTS: Distribution: ORIGINAL TO: City of Spokane Valley Clerk's Office COPIES TO: Contractor, PW Project File, Project Inspector, Finance Department nnr.r me rnna 0201- ITS Infill Project - Phase 1 All Activity as of Nov 6 2018 ERMAN Original Budget CMAQ WSDOT 301 302 Total Revenue 283,341.00 44, 221.00 0.00 327,562.00 Project Prior "Life Adjusted Years 2017 2018 To Date Bucket Aci{'yal Actual Actual Actual Encumbe 283,341.00 100,000.00 152,543.00 0.00 48,884.79 0.00 36,904.73 0.00 684.89 0.00 6,320.99 0.00 223,947.38 100,000.00 122,979.36 0.00 2/3,517 06 100,000.00 166, 205.08 0.00 535,884.00 85,789.52 7,005.88 446,926.74 539,722.14 0.00 9,823.94 0.00 0.00 0.00 -13,662.08 0.00 0.00 0.00 -3,838.14 Preliminary Engineering Salaries & Wages 3,500.00 19,530.00 13,562.81 3,063.97 593.23 17,220.01 0.00 2,309.99 Overtime 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Employee Benefits 1,225.00 6,552.00 4,986.28 969.45 220.54 6,176.27 0.00 375.73 Employee Benefits 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Engineering & Architectural 20,000.00 42,857.00 42,856.74 0.00 0.00 42,856.74 0.00 0.26 Prof. Svcs - Survey 0.00 6,164.00 6,163.55 0.00 0.00 6,163.55 0.00 0.45 Prof. Svcs. - Geotech 0.00 4,255.00 4,009.19 0.00 0.00 4,009.19 0.00 245.81 Advertising 500.00 0.00 1,188.58 0.00 471.81 1,660.39 0.00 -1,660.39 Printing & Binding 500.00 2,338.00 0.00 0.00 0.00 0.00 0.00 2,338.00 Miscellaneous Services 480.00 3,534.00 1,523.41 2,010.00 0.00 3,533.41 0.00 0.59 PE Contingency 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Prelim. Engineering 26,205.00 85,230.00 74,290.56 6,043.42 1,285.58 81,619.56 0.00 3,610.44 Right of Way Salaries & Wages Employee Benefits Employee Benefits Professional Services ROW Acquisition RW - Land Improvements RW Contingency Total Right of Way 0.00 2,091.00 1,579.93 511.77 0.00 2,091.70 0.00 -0.70 782.00 590.53 191.01 0.00 781.54 0.00 0.46 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6,825.00 6,735.50 89.00 0.00 6,824.50 0.00 0.50 2,593.00 2,593.00 0.00 0.00 2,593.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 2,076.00 0.00 0.00 0.00 0.00 0.00 2,076.00 14,367.00 11,498.96 791.78 0.00 12,290.74 0.00 2,076.26 Construction Salaries & Wages 5,000.00 5,000.00 0.00 0.00 16,657.27 16,657.27 0.00 -11,657.27 Overtime 0.00 0.00 0.00 0.00 2,885.51 2,885.51 0.00 -2,885.51 Employee Benefits 1,750.00 1,800.00 0.00 0.00 7,514.31 7,514.31 0.00 -5,714.31 Employee Benefits 0.00 0.00 0.00 0.00 94.34 94.34 0.00 -94.34 Prof. Svcs. Mat. Testing 2,000.00 5,235.00 0.00 0.00 3,267.74 3,267.74 6,452.26 -4,485.00 Prof. Svcs. - Consulting 0.00 9,264.00 0.00 0.00 14,545.41 14,545.41 0.00 -5,281.41 Advertising 1,000.00 0.00 0.00 170.68 774.97 945.65 0.00 -945.65 Printing & Binding 500.00 0.00 0.00 0.00 1,491.78 1,491.78 0.00 -1,491.78 Miscellaneous Services 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Construction 291,107.00 349,672.00 0.00 0.00 325,913.22 325,913.22 56,891.93 -33,133.15 Capital Equipment 0.00 0.00 0.00 16,903.15 16,903.15 0.00 -16,903.15 Contingency 0.00 65,316.00 0.00 0.00 0.00 0.00 0.00 65,316.00 Total Construction 301,357.00 436,287.00 0.00 170.68 390,047.70 390,218.38 63,344.19 -17,275.57 Total Expenditures 327,562.00 535,884.00 85,789.52 7,005.88 391,333.28 484,128.68 63,344.19 -11,588.87 *Wane Valley. Community & Public Works Department 10210 E Sprague Avenue ♦ Spokane Valley WA 99206 Phone: (509) 720-5000 ♦ Fax: (509) 720-5075 ♦ www.spokanevalley.org Memorandum Date: November 2, 2018 To: File From: C. Aldworth Re: Change Order 3, ITS Infill, Phase 1 Project, CIP 0201 1. Describe the Change This Change order pays for the following five items: 3.1 Avista Utilities delay in locating 301 N. Fancher gas service - 7/16 to 7/24. 3.2 Spokane Water Depart delay to locate Home Depot water service on 7/27. 3.3 Attempts to horizontal directional drill under the Union Pacific Railroad tracks July 25th and July 26th, July 27th and July 30th. 3.4 Verification of the continuity of the existing conduit below the boring pits on either side of the Union Pacific railroad on Fancher Road. 3.5 Additional fiber optic splice testing required by the splice at the Union Pacific railroad crossing along Fancher Road. 2. Evolution of the Change 3.1 The Contractor called in Utility locates within the proposed Horizontal Directional Drilling (HDD) area and Avista Utilities could not determine the location of the gas service to 301 N Fancher from July 16th to July 24th. The Contractor potholed five times where directed by Avista, before finding the service. The potholing work is paid under a contract bid item, the drilling subcontractor had not yet mobilized on site, so no work was paid by force account. 3.2 The HDD subcontractor was forced to wait on standby for two hours until the Spokane Water Department located a water service near the south side of the northern Home Depot entrance on Fancher Road on July 27th. The pothole work is paid under a contract bid item, and the standby time is paid by force account. CO 3 Memo ITS Infill, Phase 1 Project 11/2/18 Page 2 of 2 3.3 The HDD subcontractor attempted to place conduit under the Union Pacific Railroad tracks from the north on July 25th and July 26th, and from the south side on July 27th and July 30th, but was obstructed by a layer of large boulders approximately 12 to fifteen feet deep. After 7 attempts, the Engineer abandoned the crossing attempt. This work is paid by force account for hours worked as documented by the project inspector. 3.4 After the HDD borings under the Union Pacific Railroad was abandoned, the Engineer directed the Contractor to verify that the existing conduit below the boring pits was still competent. The work is paid by force account. 3.5 The failure to cross under the Union Pacific Railroad tracks required introducing a splice in the fiber optic line along Fancher Road between Sprague Avenue and Broadway Avenue. The splice required additional testing which is paid by force account. Contractors Proposal / Negotiation The City requested AGC / WSDOT Blue Book rates for the specialty equipment from WSDOT and from M&L Construction , the HDD boring subcontractor. The City forwarded a cable splicer pay request on behalf of Fibernet to WSDOT for determination. 4. Payment This change order increases the Contract price $12,137.84. The attached spreadsheet and supporting information calculates the cost of the work per WSDOT Force Account procedures. 5. Time No additional contract time was granted 6. Prior Approval The Change Order was approved by Ji ,1 fli won on //' ' /6 . 7. Attachments C 0 3 Spreadsheet. ITS Infill, Phase 1 Project, CIP 0201 C. Aldworth 11/2/2018 Change Order 3 Summary Item Dates Description CO 3 Cost 3.1 July 16 -24 Avista delayed locate for Gas Service at 301 N Fancher $ 3.2 July 27 Water Department delayed locate for Home Depot Water Service $ 120.08 3.3 July 25,26,27 &30 UPRR HDD Bore Attempts Compensation $ 10,214.78 3.4 August 6 Conduit Continuity Check under HDD bore Pits $ 1,108.25 3.5 August 20 & 21 Additional Fiber line testing $ 694.73 Total CO 3 Cost $ 12,137.85 j�� ITS Infill, Phase 1 Project, CIP 0201 C. Aldworth 11/2/2018 Item 3.1 Avista delayed locate for Gas Service at 301 N Fancher 7/16/2018 M&L potholed twice where Avista thought gas service line was located. Paid under Sch A Bid Item 106, Pothole. 2 x $1,000 = $2,000.00 7/20/2018 M&L potholed twice where Avista thought gas service line was located. Paid under Sch A Bid Item 106, Pothole. 2 x $1,000 = $2,000.00 7/24/2018 M&L Potholes at new location painted by Avista and locates gas line. Paid under Sch A Bid Item 106, Pothole. 1 x $1,000 = $1,000.00 Total Payment $5,000.00 City Granted 4 working Days additional time for this delay under Minor Change 1. M&L worked elsewhere so no Standby time. Standby time Prime Power City Electric Labor Trade Name Name No. of Hours Prey. Wage Rate 14.643% FICAIFUTA/ SUI/Liab Ins 9.62% L&I Total Labor 29% FA Fringe Rate Markup Total Labor Cost Total Labor Cost Labor Total 0.00 0.00 EQUIPMENT M&L Standby Equipment Unit Qty Unit Type Time Unit Cost 21% P&O Total Total Equipment No equipment on site Total Equipment Cost Standby 50% Reduction 12% Prime Markup Equipment Total 0.00 0.00 0.00 0.00 Materials Material Item Hours Quantity Unit Type Unit Cost Base Cost Total 0.00 0 21% P&O Total 0.00 0.00 0.00 Total Material Cost Materials Total Total Labor + Equipment + Materials Total Item 3.1 Cost 0.00 0.00 ITS Infill, Phase 1 Project, CIP 0201 C. Aldworth 11/2/2018 Item 3.2 Water Department delayed locate for Home Depot Water Service 7/27/2018 M&L potholed once, 2 hr wait due Spokane Water Dept waterline locate. Paid under Sch A Bid Item 106, Pothole. 1 x $1,000 = $1,000.00 Total Payment $1,000.00 City Granted 1 working Days additional time for this delay under Minor Change 1. Standby time Prime Power City Electric Labor Trade Name Name No. of Hours Prev. Wage Rate 14.843% FICA/FUTA/ SUI/Liab Ins 9.62% L&I Total Labor 29% FA Fringe Rate Markup Total Labor Cost Total Labor Cost 0.00 Labor Total 0.00 EQUIPMENT Time Standby Unit Total M&L Standby Equipment Unit Qty Unit Type Cost 21% P&O Total Equipment 2015 Ditchwitch JT 25 Boring Machine 2 Hr 47.19 94.38 19.82 114.20 114.20 2014 Vactron Vac Trailer Estimate 2 Hr 5.00 10 2.10 12.10 12.10 2005 Dodge Ram 3500 Service Truck 2 Hr 2.86 5.72 1.20 6.92 6.92 1997 Kenworth Mud Truck w/ Vermeer 2 Hr 33.56 67.12 14.10 81.22 81.22 Total Equipment Cost 214.44 Standby Eq. time paid at 1/2 regular time per WSDOT Const, Manual SS 1-09.6 Standby 50% Reduction 107.22 12% Prime Markup 12.87 Equipment Total 120.08 Materials Material Item Hours Quantity Unit Type Unit Cost Base Cost Total 0.00 0 21% P&O Total 0.00 Total Material Cost 0.00 Materials Total 0.00 Total Labor + Equipment + Materials 120.08 Total Item 3.2 Cost 120.08 $olianc. e ITS Infill, Phase 1 Project, CIP 0201 C. Aldworth 11/2/2018 Item 3.3 UPRR HDD Bore Attempts Compensation Sub -item Date Direction Working Hours FA Cost 3.3a 7/25/2018 North to South 7:OOAM to 3:OOPM $ 3,866.56 3.3b 7/26/2018 North to South 7:OOAM to 3:OOPM $ 3,740.68 3.3c 7/27/2018 South to North 7:OOAM to 10:OOAM $ 1,215.34 3.3d 7/30/2018 South to North 7:OOAM to 3:OOPM $ 1,392.20 Total $ 10,214.78 ITS Infill, Phase 1 Project, CIP 0201 C. Aldworth 11/2/2018 Item 3.3a 7/25/18 UPRR HDD Bore Attempts Compensation Prime Labor Trade Name Name No. of Hours Prev. Wage Rate Incl Fringe Total Labor 29% FA Cost Markup Total Labor Cost Operator C Howell Laborer R Judd Laborer D Krause Laborer J Ledbetter JT 25 Boring Machine 8 8 8 2 43.24 38.16 43.24 43.56 345.92 100.32 305.28 88.53 345.92 100.32 87.12 25.26 446.24 393.81 446.24 112.38 Total Labor Cost 1,398.67 12% Prime Markup 167.84 Labor Total 1,566.51 PRIME - EQUIPMENT Total base Total Equipment Item Unit Qty Unit Type Unit Cost cost 21% P&O Total Equipment 2015 Ditchwitch JT 25 Boring Machine 8 1 Hr 101.71 813.68 170.87 984.55 984.55 2014 Vactron Vac Trailer Estimated Rate 8 1 Hr 10.00 80 16.80 96.80 96.80 2005 Dodge Ram 3500 Service Truck 8 1 Hr 30.51 244.08 51.26 295.34 295.34 1997 Kenworth Mud Truck w/ Vermeer 8 1 Hr 69.93 559.44 117.48 676.92 676.92 Total Equipment Cost 2,053.61 12% Prime Markup 246.43 Equipment Total 2,300.05 Materials Material Item Hours Quantity Unit Type Unit Cost Base Cost 21% P&O Total Total Total Material Cost 0.00 Materials Total 0.00 Total Labor + Equipment + Materials 3,866.56 Total Item 3.3 7125/18 Cost 3,866.56 ITS Infill, Phase 1 Project, CIP 0201 C. Aldworth 11/2/2018 Item 3.3b 7/26/18 UPRR HDD Bore Attempts Compensation Prime Labor Trade Name Name No. of Hours Prev. Wage Rate Incl Fringe Total Labor 29% FA Cost Markup Total Labor Cost Operator C Howell Laborer R Judd Laborer D Krause JT 25 Boring Machine 8 8 8 43.24 38.16 43.24 345.92 100.32 305.28 88.53 345.92 100.32 446.24 393.81 446.24 Total Labor Cost 1,286.28 12% Prime Markup 154.35 Labor Total 1,440.64 PRIME - EQUIPMENT Total base Total Equipment Item Unit Qty Unit Type Unit Cost cost 21 % P&O Total Equipment 2015 Ditchwitch JT 25 Boring Machine 8 1 Hr 101.71 813.68 170.87 984.55 984.55 2014 Vactron Vac Trailer Estimated rate 8 1 Hr 10.00 80 16.80 96.80 96.80 2005 Dodge Ram 3500 Service Truck 8 1 Hr 30.51 244.08 51.26 295.34 295.34 1997 Kenworth Mud Truck w/ Vermeer 8 1 Hr 69.93 559.44 117.48 676.92 676.92 Total Equipment Cost 2,053.61 12% Prime Markup 246.43 Equipment Total 2,300.05 Materials Material Item Hours Quantity Unit Type Unit Cost Base Cost 21% P&O Total Total Total Material Cost 0.00 Materials Total 0.00 Total Labor + Equipment + Materials 3,740.68 Total Item 3.3b 7/26/18 Cost 3,740.68 ITS Infill, Phase 1 Project, CIP 0201 C. Aldworth 11/2/2018 Item 3.3c 7/27/18 UPRR HDD Bore Attempts Compensation Prime Labor Trade Name Name No. of Hours Prev. Wage Rate Incl Fringe Total Labor 29% FA Cost Markup Total Labor Cost Operator C Howell Laborer C Blue JT 25 Boring Machine 3 3 43.24 38.16 129.72 37.62 114.48 33.20 167.34 147.68 Total Labor Cost 315.02 12% Prime Markup 37.80 Labor Total 352.82 PRIME - EQUIPMENT Total base Total Equipment Item Unit Qty Unit Type Unit Cost cost 21% P&O Total Equipment 2015 Ditchwitch JT 25 Boring Machine 3 1 Hr 101.71 305.13 64.08 369.21 369.21 2014 Vactron Vac Trailer Estimated rate 3 1 Hr 10.00 30 6.30 36.30 36.30 2005 Dodge Ram 3500 Service Truck 3 1 Hr 30.51 91.53 19.22 110.75 110.75 1997 Kenworth Mud Truck w/ Vermeer 3 1 Hr 69.93 209.79 44.06 253.85 253.85 Total Equipment Cost 770.10 12% Prime Markup 92.41 Equipment Total 862.52 Materials Material Item Hours Quantity Unit Type Unit Cost Base Cost 21% P&O Total Total Total Material Cost 0.00 Materials Total 0.00 Total Labor + Equipment + Materials 1,215.34 Total ttem 3.3c 7/27/18 Cost 1,215.34 ITS Infill, Phase 1 Project, CIP 0201 C. Aldworth 11/2/2018 Item 3.3d 7/30/18 UPRR HDD Bore Attempts Compensation Prime Labor Trade Name Name No. of Hours Prev. Wage Rate Incl Fringe Total Labor 29% FA Cost Markup Total Labor Cost Laborer R Barker Laborer C Blue JT 25 Boring Machine 3.5 3.5 38.16 38.16 133.56 38.73 133.56 38.73 172.29 172.29 Total Labor Cost 344.58 12% Prime Markup 41.35 Labor Total 385.93 PRIME - EQUIPMENT Total base Total Equipment Item Unit Qty Unit Type Unit Cost cost 21% P&O Total Equipment 2015 Ditchwitch JT 25 Boring Machine 3.5 1 Hr 101.71 355.985 74.76 430.74 430.74 2014 Vactron Vac Trailer Estimated rate 3.5 1 Hr 10.00 35 7.35 42.35 42.35 2005 Dodge Ram 3500 Service Truck 3.5 1 Hr 30.51 106.785 22.42 129.21 129.21 1997 Kenworth Mud Truck w/ Vermeer 3.5 1 Hr 69.93 244.755 51.40 296.15 296.15 Cat 304 E Mini -Excavator Estimated rate 1 1 Hr 21.99 21.99 4.62 26.61 26.61 Total Equipment Cost 898.46 12% Prime Markup 107.81 Equipment Total 1,006.27 Materials Material Item Hours Quantity Unit Type Unit Cost Base Cost 21% P&O Total Total Total Material Cost 0.00 Materials Total 0.00 Total Labor + Equipment + Materials 1,392.20 Total Item 3.3d 7/30/18 Cost 1,392.20 Dodge 3500 Rental Rate Blue Book 1 On -Highway Light Duty Trucks Page 1 of 2 (,Ise, fielc DODGE 3500 ADD TO SAVED MODELS On -Highway Trucks (/search-results?categories=%5B20%5D&searchfor=) >On -Highway Light Duty Trucks (/search-results?categories=%5820% 5D&searchfor=&subtypes=%58483%5D) > 300 HP & Over 1 COMPARE SIMILAR MODELS (/COMPARE-SIMILAR-MODELS/364491?CONFIGURATIONSEQUENCE=4&MODELYEAR=2005) MARKET POPULARITY: RARE 0 (HTTP://EQUIPMENTWATCH.COM/RESOURCE-LIBRARY/DICTIONARY/MODEL-POPULARITY/) YEAR 2005 v METER READS in Hours or MI/KILM SERIAL NUMBER 3d7k528C6sg741761 YOUR CONFIGURATION* 4 x 2 Horsepower: 410 hp Conventional 410 hp Gasoline Ton Rating: 1 Cab Type: Conventional Power Mode: Gasoline Axle Configuration: 4 x 2 COSTS/RENTAL RATE BLUE BOOK•(/MOD&L'/O.NADGRfiVAYEJIIR(1DI3ODNI-i/llrNlNM016117/01R0116iM/AI.IBR0Mg6 01390 t EDIT Cost Recovery Rate (/model/On-Highway-Trucks/On-Highway-Light-Duty-Trucks/Dodge/3500/364491/cblts/titj9twiLclsrtrLtSTottdlgoDatfhn5elilentttts4&mode Inr.rn�l rhorg. Gym(irnm.urin.uighw2y-rr.trtrdnn.uigh..ry-Light-Duty-Trocke/DoHfy/150/1/3gad9t/costa/intorn,1.rh.rg.7rnnng..r3tion5equence Washington DOT K Or 1 ❑ EnterValuesManually LOCATION Washington OWNERSHIP ADJUSTMENT 100% OPERATING ADJUSTMENT 100% OWNERSHIP TIME STANDARD Monthly Active Rate Rate Effective Date Always Use Current Rate Standby Rate Rate Effective Date Always Use Current Rate Idling Rate Rate Effective Date Always Use Current Rate Ownership Cost (Hourly) Operating Cost (Hourly) $5.71 -$0.741.11.4% from Unadjusted Rate + $24.80 OCollapse Formula • 50.0010% from Unadjusted Rate 0 (https//040•004WANA0A 1ttRMrtgource- //dictionary/fhwa-rate/) $30.51 Ownership Cost, UnadJ Ownership Adjustment Regional Adjustment Year Adjustment (Monthly) (100%) (Washington: -1 7%) (2005: -9.9%) $1,135.00 + $0.00 - $19.30 - $110.45 176 (Hourly Calculation) Ownership Cost (Hourly) Operating Cost (Hourly) (https://e/ttRJ MB•WdtC0•k•Alti 4BLrce- v $2.86 + $0e00 Iii, y/dictionarry/standby-rates/) 0 -50.741 -2.4% from Unadjusted Rate -50371-11.4% from Unadjusted Rate O Expand Formula 50.0010% from Unadjusted Rate Ownership Cost (Hourly) Operating Cost (Hourly) $5.71 -S0.741-11.4% ExpR.d Formula + $19.94 $0.0010% from Unadjusted Rate from Unadjusted Rate -10.36 I -11.2% from Unadjusted Rah 0 (https://diti,A04 0.1MEA(HRMfNlource- li - $ 65 on 5.s/) -10.74 1-2.8% from Unadjusted Rate https: //app. equipmentwatch. com/model/On-Highway-Trucks/On-Highway-Light-Duty-Tr... 10/10/2018 Dodge 3500 Rental Rate Blue Book On -Highway Light Duty Trucks Page 2 of 2 (/se. field 0 0 .li Rate Element Allocation: Ownership Costs Unadjusted (Monthly) Element Percentage Value Depreciation 57% $646.95 Overhaul 28% $317.80 Cost of Facilities Capital 5% $56.75 Indirect 10% $113.50 Rate Element Allocation: Operating Costs (Hourly) Element Percentage Value Fuel @$2.56 80% $19.94 Revised Date: 2nd Half 2018 These are the most accurate rates for the selected Revision Date(s). However, due to more frequent online updates, these rates may not match Rental Rate Blue Book Print. Learn more here (http://equipmentwatch.com/resource-library/product-guides/cost-recovery/#section-1). Contact Us (http://equipmentwatch.com/contact-us/) Privacy Policy (http://www.penton.com/PrivacyStatement/tabid/75/Default.aspx) (https://informa.com/) © 2018 Informa https://app.equipmentwatch.com/model/On-Highway-Trucks/On-Highway-Light-Duty-Tr... 10/ 10/2018 WE CALL IT A DRILL. YOU CALL IT YOUR GO -TO MONEYMAKER GA A comfortable operator is a more productive operator, which is why we've equipped the JT25 Horizontal Directional Drill operator's station with a cutting-edge design. It features: • Choice of single -handled control or dual joysticks for • LCD display provides engine diagnostics and easy control of thrust and rotation. • Excellent view of the tool joint when making up and breaking out pipe; open -top vise wrenches are angled toward the operator. • Exceptionally comfortable, new supportive seat design with high armrests. informational messages. • Optional climate -controlled cab, for maximum comfort and productivity in any weather condition. JT25 HORIZONTAL DIRECTIONAL DRILL SPECIFICATIONS 11.5. METO2. DRILLING FLUID SYSTEM ION BOARD/ Spindle speed, max Spindle torque. max Carriage thrust travel speed Carriage pullback travel speed Thrust force Pullback force Ground travel speed Forwara Reverse 220 rpm 4,000 faro 182 fpm 190 fpm 27,000 Ib 27,000 Ib 2.8 mph 5420 5.m 55 m/min 58 m/min 120 kN 120 kN 4.6 km/h 4.6 km/h 2.8 mph Engine Fuel Cooling medium Injection Aspiration Number of cylinders Displacement Bore Stroke Gross horsepower Tier 3/Tier 4 Rated speed Tier 3/Tier 4 Emissons compliance Tier 3 Emasions compliance Tier 4 Cummins•0S84.5 Diesel Liquid Direct Turbocharged & charge ale cooled 4 275 inti 4.5 L 4.21 in 107 mm 4.88 in 124 mm 130 hp 976W 2,500 rpm EPA Tier 3 EPA Tier 4 EU Stage IIIA EU Stage I8 Transport length Width Width wkab Transport height Transport height wkab Weight Weight wkab Ground clearance Entry angle Entry angle. tracks on ground 232.5 in 5.9 m 87 in 2.21,0 87 in 2.21 m 93 in 2.36 m 99.5 in 2.53 m 20,760 Ib 9417 kg 21.360 Ib 9689 kg 5.7 in 145 mm 9-20' 9-17' Specifications are general and sueiect to change without notice. If exact measurements are required, equipment stoup be weighed and measured. Due b selected options, delivered equipment may not necessary match that shown. Pressure, max Flow, max ..11 ,1111. U.S. METRIC 1,200 psi 83 bar 50 gpm 189 I/min Fuel tank Engine lubrication oil w/filter Hydraulic reservoir Engine cooing system Antifreeze tank Diesel exhaust fluid tank 48 gal 13.7 qt 27 gal 24 qt 8 gal 5 gal 1821. 13 L 102 L 22.7 L 30 L 18.9 L Length Joint diameter Pipe diameter Bend radius, min Weight of dhll pipe, lined Weight of lined drill pipe & large box (55 pipe/ Weight of lined drill pipe & small boa (25 pipe) 118 in 2.75 in 2.38 in 1238 88 lb 5,647 Ib 3m 70 mm 60 nun 37.5 m 40 kg 2562 kg 2,7701b 1154 kg Length Joint diameter Pipe diameter Bend radius, min Weight per drill pipe, forged Weight w/drill pipe & large box (55 pipe) Weight w/drill pipe & small box (25 pipe) 0/1711,Y 1211511i 120 in 2.63 in 2.38 in 108.2 ft 73 Ib 4,522 0 3.05m 66.7 mm 60 mm 33 m 33 kg 2187 kg 2,395 Ib 1086 kg SAE reserve capacity rating 195 min SAE cold crank rating 0 0'F 518°F1 950 amps Operator sound Operator sound w/cab Exterior sound power B6 dBA 80 dBA 104 dBA Ditch Witch drtchwrtch-coin EquipmentWatch.. www.equipmentwatch.com All prices shown in US$ Rental Rate Blue Book® Miscellaneous 30K Horizontal Directional Drills Size Class: 20,00130,000 lbs Weight: N/A Configuration for 30K Power Mode Spindle Torque November 1, 2018 Madel Diesel Net Horsepower 115 hp 4000 ft -Ib Blue Book Rates ** FHWA Rate is equal to the monthly ownership cost divided by 176 plus the Ownership Costs hourly estimated operating cost. Monthly Weekly Daily Hourly Published Rates $11,415.00 $3,195.00 $800.00 $120.00 Adjustments Region ( Washington: ($171.22) ($47.92) ($12.00) ($1.80) 98.5%) Model Year ($314.83) ($88.12) ($22.06) ($3.31) (2015: 97.2%) Adjusted Hourly Ownership Cost (100%) Hourly Operating Cost (100%) Total: $10,928.95 $3,058.96 $765.94 $114.89 Estimated Operating Costs Hourly $36.85 $36.85 FHWA Rate** Hourly $101.71 $98.95 Non -Active Use Rates Hourly Standby Rate $47.19 Idling Rate $73.18 Rate Element Allocation Element Percentage Value Depreciation (ownership) 56% $6,392.40/mo Overhaul (ownership) 24% $2,739.60/mo CFC (ownership) 7% $799.05/mo Indirect (ownership) 13% $1,483.95/mo Fuel (operating) @ 3.01 30% $11.08/hr Revised Date: 2nd Haff 2018 These are the most accurate rates for the selected Revision Date(s). However, due to more frequent online updates, these rates may not match Rental Rate Blue Book Print. Visit the Cost Recovery Product Guide on our Help page for more information. The equipment represented in this report has been exclusively prepared for MARY TANTRIELLA (mtantriella@nwagc.org) All material herein © 2003-2018 Penton All rights reserved. EquipmentWatch www.equipmentwatch.com All prices shown in US$ Rental Rate Blue Book® Vermeer D24X40A (disc. 2001) Horizontal Directional Drills Size Class: 20,001-30,000 Ibs Weight: 16,600 lbs. Configuration for D24X40A (disc. 2001) Net Horsepower N/A Power Mode Net Horsepower 125 hp Spindle Torque November 1, 2018 Diesel 4000 ft -Ib Blue Book Rates ** FHWA Rate is equal to the monthly ownership cost divided by 176 plus the hourly estimated operating cost. Published Rates Adjustments Region ( Washington: 98.5%) Model Year (2001: 100%) Adjusted Hourly Ownership Cost (100%) Hourly Operating Cost (100%) Total: Ownership Costs Monthly Weekly Daily Hourly $7,890.00 $2,210.00 $555.00 $83.00 ($118.35) ($33.15) $7,771.65 $2,176.85 ($8.32) ($1.24) $546.68 $81.76 Esti mated Operating Costs Hourly $25.10 $25.10 FHWA Rate** Hourly $69.93 $69.26 Non -Active Use Rates Standby Rate Idling Rate Hourly $33.56 $44.16 Rate Element Allocation Element Percentage Value Depreciation (ownership) 56% $4,418.40/mo Overhaul (ownership) 24% $1,893.60/mo CFC (ownership) 7% $552.30/mo Indirect (ownership) 13% $1,025.70/mo Fuel cost data is not available for these rates. Revised Date: 2nd Half 2018 These are the most accurate rates for the selected Revision Date(s). However, due to more frequent online updates, these rates may not match Rental Rate Blue Book Print. Visit the Cost Recovery Product Guide on our Help page for more information. The equipment represented in this report has been exclusively prepared for MARY TANTRIELLA (mtantriella@nwagc.org) All material herein © 2003-2018 Penton All rights reserved. (TTt Ofkanp� ITS Infill, Phase 1 Project, CIP 0201 C. Aldworth 11/2/2018 Item 3.4 Conduit Continuity Check under HDD bore Pits August 6, 2018 Prime Labor Verified Verified Verified Wage Rate Wage Rate Wage Rate Reg / Incl OT / Incl Double / Incl Total Labor 29% FA Total Labor Trade Name Name No. of Hours Fringe Fringe Fringe Cost Markup Cost Electrician TJurgens Electrician 2.5 95.41 238.53 69.17 307.70 Electrician T Jurgens Electrician 0.5 56.61 28.31 8.21 36.51 Operator Jeff Bass JD 810 Mini Trackhoe (12,000 #I 2 55.15 110.30 31.99 142.29 Operator Jim Bass truckdriver 1.5 66.95 100.43 29.12 129.55 Total Labor Cost 616.05 Labor Total 616.05 PRIME - EQUIPMENT Total base Total Equipment Item Unit Qty Unit Type Unit Cost cost 21% P&O Total Equipment 2003 Chevy 2500 3/4 ton Utility Box truck #307 3 1 Hr 26.48 79.44 16.68 96.12 96.12 2004 Peterbuilt Dump Truck #406 2 1 Hr 42.64 85.28 17.91 103.19 103.19 1973 Miller 544 Backhoe Trailer Estimated rate 2 1 Hr 5.00 10 2.10 12.10 12.10 2015 JD 50G 810 Mini Trackhoe (12,000 #) 2 1 Hr 28.50 57 11.97 68.97 68.97 2007 Ford F250 Service Truck #311 1.5 1 Hr 28.20 42.3 8.88 51.18 51.18 2010 Central Machinery 91762 Plate Wacker Estimated rate 3 1 Hr 3.00 9 1.89 10.89 10.89 Total Equipment Cost 342.45 Rental Equipment Water Trailer Rental United Rental Invoice 159934670-001 cost 123.76 25.99 149.75 149.75 Equipment Total 492.20 Materials Material Item Hours Quantity Unit Type Unit Cost Base Cost 21% P&O Total Total Total Material Cost 0.00 Materials Total 0.00 Total Labor+ Equipment Materials 1,108.25 Total Item 3.4 Cost 1,108.25 ITS Infill, Phase 1 Project, CIP 0201 C. Aldworth 11/2/2018 Item 3.5 Additional Fiber line testing required to add Fancher splice Subcontractor Labor Trade Name Name No. of Hours Prev. Wage Rate Incl Fringe Total Labor 29% FA Cost Markup Total Labor Cost 8/20/2018 Josh Davis Fibernet Splicer 5 50.78 Rate established by Feds 253.90 73.63 327.53 8/21/2018 David Wamer Fibernet Splicer 2.5 50.78 Rate established by Feds 126.95 36.82 163.77 Total Labor Cost 491.30 12% Prime Markup 58.96 Labor Total 550.25 Subcontractor Equipment Total base Total Equipment Item Unit Qty Unit Type Unit Cost cost 21% P&O Total Equipment Splicing Van 7.5 Tools Estimate 100.00 100.00 29.00 129.00 129.00 Total Equipment Cost 129.00 12% Prime Markup 15.48 Equipment Total 144.48 Materials Material Item Hours Quantity Unit Type Unit Cost Base Cost 21% P&O Total Total Total Material Cost 0.00 Materials Total 0.00 Total Labor + Equipment + Materials 694.73 Total Item 3.5 Cost 694.73 U.S. Department of Labor Wage and Hour Division Washington, D.C. 20210 Mr. Brett Johnson Eastern Region Local Programs Washington State Department of Transportation 2714 N Mayfair St. Spokane, WA 99207 JohnsBL@wsdot.wa.gov RE: Project/Contract No.: 18-072 Wage Decision No.: WA180001 Mod. 2 Location: Spokane Valley, Spokane County, Washington WHD No.: 0369 Mr. Johnson: This is in response to your request proposing the addition of a classification and wage rate to the above wage decision in accordance with 29 CFR 5.5(a)(1)(ii). The proposed classification and wage rate is: Classification Basic Hourly Rate Fringe Benefits Cable Splicer — Telephone Line Construction $40.52 $0.00 The request is not approved because the work to be performed by this classification may be performed by a classification already included in the wage decision [see 29 C.F.R, section 5.5(a)(1)(ii)(A)(1)]. The appropriate classification is Cable Splicer (Adams, Ferry, Lincoln, Pend Oreille, Spokane, Stevens & Whitman counties) at a rate of $34.10 per hour plus $16.68 in fringe benefits, for a total hourly compensation of $50.78, and shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed. Your request has been conformed consistent with All Agency Memorandum 213 (http://www.wdol.gov/aam/aaun213.pdt) which describes the conformance process in detail and the basis on which your proposed rate was denied. Any requests for appeal of the conformance decision must be made within thirty (30) days from the date of this letter. If you have any questions or concerns regarding this conformance request, please contact Rob Zolitor at 202- 693-1244 or Zolitor.Robert@dol.gov. Sincerely, Timothy Holmes Acting Section Chief Branch of Construction Wage Determinations 202-693-0838 Holmes.Timothy(&,,dol.gov POWECIT-03 MNEIGHBORS ACOll' O CERTIFICATE OF LIABILITY INSURANCE 4........,-10/1112018 DATE /DDIYYYY) 0/11 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 ri • hts to the certificate holder in lieu of suchppendorsement(s). PRODUCER Spokane Office Paynewest Insurance, Inc. 501 N. Riverpoint Blvd., Ste 403 Spokane, WA 99202 NAMEACT j COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listirg is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. B. C. D. E. Aircraft Chartered With Pilot Damage To Premises Rented To You Increased Supplementary Payments Incidental Medical Malpractice Who Is An Insured — Newly Acquired Or Formed Organizations F. Who Is An Insured — Broadened Named Insured H. I. J. K. L. — Unnamed Subsidiaries M. G. Blanket Additional Insured — Owners, Managers N. Or Lessors Of Premises PROVISIONS A. AIRCRAFT CHARTERED WITH PILOT The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COVERAGES — COVERAGE A BODILY IN- JURY AND PROPERTY DAMAGE LIABILITY: This exclusion does not apply to an aircraft that is: (a) Chartered with a pilot to any insured; (b) Not owned by any insured; and (c) Not being used to carry any person or prop- erty for a charge. B. DAMAGE TO PREMISES RENTED TO YOU 1. The first paragraph of the exceptions in Ex- clusion j., Damage To Property, in Para- graph 2. of SECTION I — COVERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY is deleted. 2. The following replaces the last paragraph of Paragraph 2., Exclusions, of SECTION I — COVERAGES — COVERAGE A. BODILY CG D3 16 11 11 Blanket Additional Insured — Lessors Of Leased Equipment Blanket Additional Insured -- States Or Political Subdivisions — Permits Knowledge And Notice Of Occurrence Or Offense Unintentional Omission Blanket Waiver Of Subrogation Amended Bodily Injury Definition Contractual Liability — Railroads INJURY AND PROPERTY DAMAGE LI- ABILITY: Exclusions c. and g. through n. do not apply to "premises damage". Exclusion f.(1)(a) does not apply to 'premises damage" caused by: a. Fire; b. Explosion; c. Lightning; d. Smoke resulting from such fire, explosion, or lightning; or e. Water; unless Exclusion f. of Section I — Coverage A — Bodily Injury And Property Damage Liability is replaced by another endorsement to this Coverage Part that has Exclusion — All Pollu- tion Injury Or Damage or Total Pollution Ex- clusion in its title. A separate limit of insurance applies to "premises damage" as described in Para- graph 6. of SECTION III — LIMITS OF IN- SURANCE. © 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 6 COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- TION III — LIMITS OF INSURANCE: Subject to 5. above, the Damage To Prem- ises Rented To You Limit is the most we will pay under Coverage A for damages because of "premises damage" to any one premises. The Damage To Premises Rented To You Limit will apply to all "property damage" proximately caused by the same "occur- rence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these causes. The Damage To Premises Rented To You Limit will be: a. The amount shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part; or b. $300,000 if no amount is shown for the Damage To Premises Rented To You Limit on the Declarations of this Coverage Part. 4. The following replaces Paragraph a. of the definition of "insured contract" in the DEFINI- TIONS Section: a. A contract for a lease of premises. How- ever, that portion of the contract for a lease of premises that indemnifies any person or organization for "premises damage" is not an "insured contract"; 5. The following is added to the DEFINITIONS Section: "Premises damage" means "property dam- age" to: a. Any premises while rented to you or tem- porarily occupied by you with permission of the owner; or b. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days. 6. The following replaces Paragraph 4.b.(1)(b) of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: (b) That is insurance for "premises damage"; or 7. Paragraph 4.b.(1)(c) of SECTION IV — COMMERCIAL GENERAL LIABILITY CON- DITIONS is deleted. Page 2 of 6 C. INCREASED SUPPLEMENTARY PAYMENTS 1. The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGE: b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to fur- nish these bonds. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVER- AGES A AND B of SECTION I — COVER- AGES: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. D. INCIDENTAL MEDICAL MALPRACTICE 1. The following is added to the definition of "oc- currence" in the DEFINITIONS Section: "Occurrence" also means an act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person. 2. The following is added to Paragraph 2.a.(1) of SECTION II — WHO IS AN INSURED: Paragraph (1)(d) above does not apply to "bodily injury" arising out of providing or fail- ing to provide: (i) "Incidental medical services" by any of your "employees" who is a nurse practi- tioner, registered nurse, licensed practical nurse, nurse assistant, emergency medi- cal technician or paramedic; or (ii) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or vol- unteer doctor. Any such "employees" or "volunteer workers" providing or failing to provide first aid or "Good Samaritan ser- vices" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your busi- ness. © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 3. The following is added to Paragraph 5. of SECTION III — LIMITS OF INSURANCE: For the purposes of determining the applica- ble Each Occurrence Limit, all related acts or omissions committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one per- son will be deemed to be one "occurrence. 4. The following exclusion is added to Para- graph 2., Exclusions, of SECTION I — COV- ERAGES — COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: Sale Of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuti- cals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances. "Good Samaritan services" means any emer- gency medical services for which no compen- sation is demanded or received. 6. The following is added to Paragraph 4.b., Ex- cess Insurance, of SECTION IV — COM- MERCIAL GENERAL LIABILITY CONDI- TIONS: The insurance is excess over any valid and collectible other insurance available to the in- sured, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" or "volunteer workers" for "bodily injury" that arises out of providing or failing to provide "incidental medical ser- vices", first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II — Who Is An Insured. E. WHO IS AN INSURED — NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4. of SECTION II — WHO IS AN INSURED: CG D3 16 11 11 COMMERCIAL GENERAL LIABILITY 4. Any organization you newly acquire or form, other than a partnership, joint venture or lim- ited liability company, of which you are the sole owner or in which you maintain the ma- jority ownership interest, will qualify as a Named Insured if there is no other insurance which provides similar coverage to that or- ganization. However: a. Coverage under this provision is afforded only: (1) Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or (2) Until the end of the policy period, when that date is later than 180 days after you acquire or form such organization, if you report such organization in writing to us within 180 days after you acquire or form it, and we agree in writing that it will con- tinue to be a Named Insured until the end of the policy period; b. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to "personal in- jury" or "advertising injury" arising out of an offense committed before you acquired or formed the organization. F. WHO IS AN INSURED — BROADENED NAMED INSURED — UNNAMED SUBSIDIARIES The following is added to SECTION II — WHO IS AN INSURED: Any of your subsidiaries, other than a partnership, joint venture or limited liability company, that is not shown as a Named Insured in the Declara- tions is a Named Insured if you maintain an own- ership interest of more than 50% in such subsidi- ary on the first day of the policy period. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal injury" or "advertising injury" caused by an of- fense committed after the date, if any, during the policy period, that you no longer maintain an ownership interest of more than 50% in such sub- sidiary. © 2011 The Travelers Indemnity Company. All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY G. BLANKET ADDITIONAL INSURED — OWNERS, MANAGERS OR LESSORS OF PREMISES The following is added to SECTION 1I — WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract or agreement to in- clude as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury', "property damage", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Arises out of the ownership, maintenance or use of that part of any premises leased to you. The insurance provided to such premises owner, manager or lessor is subject to the following pro- visions: a. The limits of insurance provided to such premises owner, manager or lessor will be the minimum limits which you agreed to pro- vide in the written contract or agreement, or the limits shown on the Declarations, which- ever are less. b. The insurance provided to such premises owner, manager or lessor does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or "personal injury" or "adver- tising injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, lessor or manager. c. The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this in- surance must be primary to, or non- contributory with, such other insurance, in which case this insurance will be primary to, and non-contributory with, such other insur- ance. Page 4 of 6 H. BLANKET ADDITIONAL INSURED — LESSORS OF LEASED EQUIPMENT The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written con- tract or agreement to include as an insured on this Coverage Part is an insured, but only with re- spect to liability for "bodily injury", "property dam- age", "personal injury" or "advertising injury" that: a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising injury" caused by an offense that is commit- ted, subsequent to the execution of that con- tract or agreement; and b. Is caused, in whole or in part, by your acts or omissions in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a. The limits of insurance provided to such equipment lessor will be the minimum limits which you agreed to provide in the written contract or agreement, or the limits shown on the Declarations, whichever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or "property damage" that occurs, or "personal injury" or "advertising injury" caused by an of- fense that is committed, after the equipment lease expires. c. The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, whether primary, excess, contingent or on any other basis, unless you have agreed in the written contract or agreement that this insurance must be primary to, or non-contributory with, such other insurance, in which case this insurance will be primary to, and non -contributors with, such other in- surance. 1. BLANKET ADDITIONAL INSURED — STATES OR POLITICAL SUBDIVISIONS — PERMITS The following is added to SECTION II — WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with operations performed by you or on your behalf and that you are required © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 by any ordinance, law or building code to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal in- jury" or "advertising injury" arising out of such op- erations. The insurance provided to such state or political subdivision does not apply to: a. Any "bodily injury," "property damage," "per- sonal injury" or "advertising injury" arising out of operations performed for that state or po- litical subdivision; or b. Any "bodily injury" or "property damage" in- cluded in the "products -completed operations hazard". J. KNOWLEDGE AND NOTICE OF OCCUR- RENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit, of SECTION IV — COMMERCIAL GEN- ERAL LIABILITY CONDITIONS: e. The following provisions apply to Paragraph a. above, but only for the purposes of the in- surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II — Who Is An Insured: (1) Notice to us of such "occurrence" or of- fense must be given as soon as practica- ble only after the "occurrence" or offense is known by you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your "executive offi- cers" or directors (if you are an organiza- tion other than a partnership, joint venture or limited liability company) or any "em- ployee" authorized by you to give notice of an "occurrence" or offense. (2) If you are a partnership, joint venture or limited liability company, and none of your partners, joint venture members or man- agers are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occur- rence" or offense is known by: (a) Any individual who is: (i) A partner or member of any part- nership or joint venture; CG D3 16 11 11 (3) COMMERCIAL GENERAL LIABILITY (ii) A manager of any limited liability company; or (iii) An executive officer or director of any other organization; that is your partner, joint venture member or manager; or (b) Any "employee" authorized by such partnership, joint venture, limited li- ability company or other organization to give notice of an "occurrence" or offense. Notice to us of such "occurrence" or of an offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your work- ers' compensation insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons de- scribed in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under this Coverage Part may apply. However, if this Coverage Part includes an en- dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution costs arising out of a discharge, release or es- cape of "pollutants" which contains a requirement that the discharge, release or escape of "pollut- ants" must be reported to us within a specific number of days after its abrupt commencement, this Paragraph e. does not affect that require- ment. K. UNINTENTIONAL OMISSION The following is added to Paragraph 6., Repre- sentations, of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not preju- dice 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. L. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: © 2011 The Travelers Indemnity Company. All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- ment to waive that insureds right of recovery against any person or organization, we waive our right of recovery against such person or organiza- tion, but only for payments we make because of: a. "Bodily injury" or "property damage" that oc- curs; or b. "Personal injury" or "advertising injury" caused by an offense that is committed; subsequent to the execution of that contract or agreement. M. AMENDED BODILY INJURY DEFINITION The following replaces the definition of "bodily injury" in the DEFINITIONS Section: Page 6 of 6 3. "Bodily injury" means bodily injury, mental anguish, mental injury, shock, fright, disability, humiliation, sickness or disease sustained by a person, including death resulting from any of these at any time. N. CONTRACTUAL LIABILITY — RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINI- TIONS Section: c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is de- leted. © 2011 The Travelers Indemnity Company. All rights reserved. CG D3 16 11 11 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which CA T3 53 02 15 H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1 The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7., Policy Period, Coverage Territory, of SECTION IV — BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the world, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Cov- ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company) or members of their households. Page 2 of 4 (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit". (iv) We will reimburse the "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limits Of Insurance, of SECTION II — COVERED AUTOS LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION III — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and CA T3 53 02 15 COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or "loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by © 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the person or organization designated in such contract. N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 The unintentional omission of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non -renewal. © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section 11) is amended c) to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance, the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance. This endorsement shall not in- crease the limits of insurance described in Section 111 — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: i. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities. CG D2 46 08 05 The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such Toss, and we will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance, whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: 02005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: i. Immediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to Page 2 of 2 any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. v 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 POLICY NUMBER:DT-CO-1122P508-PHX-18 ISSUE DATE: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION (CONTINUED ON IL T8 03) ADDRESS: THE ADDRESS FOR THAT (CONTINUED ON IL T8 03) SPOKANE WA 99220-2507 Number of Days Notice of Cancellation: 30 PROVISIONS: If we cancel this policy for any statutorily permitted reason other than nonpayment of premium, and a number of days is shown for cancellation in the schedule above, we will mail notice of cancellation to the person or organization shown in the schedule ILT4050311 above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cancellation in the schedule above before the effective date of cancellation. © 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 CHANGE EFFECTIVE DATE: 11-01-17 CHANGE ENDORSEMENT NUMBER: 0002 POLICY NUMBER: DT-CO-1122P508-PHX-18 GENERAL PURPOSE ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - NOTICE OF CANCELLATION PROVIDED BY US IL T4 05 03 11 THIS ENDORSEMEN MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: ALL COVERAGE PARTS INCLUDED IN THIS POLICY CONTINUATION OF FORM IL T4 05 PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS ENDORSEMENT. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. IL T8 03 Page 1 POLICY NUMBER: DT-CO-1122P508-PHX-18 COMMERCIAL GENERAL LIABILITY ISSUE DATE: - - THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY DESIGNATED PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Project(s): EACH "PROJECT" FOR WHICH YOU HAVE AGREED, A WRITTEN CONTRACT WHICH IS IN EFFECT DURING THIS POLICY PERIOD, TO PROVIDE A SEPARATE GENERAL AGGREGATE LIMIT, PROVIDED THAT THE CONTRACT IS SIGNED AND EXECUTED BY YOU BEFORE THE "BODILY INJURY" OR "PROPERTY DAMAGE" OCCURS. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION I), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION I), which can be attributed only to operations at a single desig- nated "project" shown in the Schedule above: 1. A separate Designated Project General Ag- gregate Limit applies to each designated "pro- ject", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations, unless separate Designated Project General Aggregate(s) are sched- uled above. 2. The Designated Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A., except damages because of "bodily injury" or "prop- erty damage" included in the "products - completed operations hazard", and for medi- cal expenses under COVERAGE C, regard- less of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". CG D2 11 01 04 Designated Project General Aggregate(s): IN GENERAL AGGREGATE LIMIT SHOWN ON THE DECLARATIONS 3. Any payments made under COVERAGE A. for damages or under COVERAGE C. for medical expenses shall reduce the Desig- nated Project General Aggregate Limit for that designated "project". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they re- duce any other Designated Project General Aggregate Limit for any other designated "project" shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Project General Ag- gregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A. (SECTION I), and for all medical expenses caused by accidents un- der COVERAGE C. (SECTION I), which cannot be attributed only to operations at a single desig- nated "project" shown in the Schedule above: Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 COMMERCIAL GENERAL LIABILITY 1. Any payments made under COVERAGE A. for damages or under COVERAGE C. for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Ag- gregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Desig- nated Project General Aggregate Limit. C. Part 2. of SECTION III — LIMITS OF INSURANCE is deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B; and b. Damages from "occurrences" under COVERAGE A (SECTION I) and for all medical expenses caused by accidents under COVERAGE C (SECTION I) which cannot be attributed only to operations at a single designated "project" shown in the SCHEDULE above. D. When coverage for liability arising out of the "products -completed operations hazard" is pro - Page 2 of 2 vided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Ag- gregate Limit, and not reduce the General Aggre- gate Limit nor the Designated Project General Aggregate Limit. E. For the purposes of this endorsement the Defini- tions Section is amended by the addition of the following definition: "Project" means an area away from premises owned by or rented to you at which you are per- forming operations pursuant to a contract or agreement. For the purposes of determining the applicable aggregate limit of insurance, each "project" that includes premises involving the same or connecting Tots, or premises whose con- nection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "project". F. The provisions of SECTION III — LIMITS OF INSURANCE not otherwise modified by this en- dorsement shall continue to apply as stipulated. Copyright, The Travelers Indemnity Company, 2004 CG D2 11 01 04