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23-158.01OsbornConsultingRidgemontEstatesStormwaterImprovements CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND *OSBORN CONSULTING INCORPORATED* Spokane Valley Contract# 23-158.01 For good and valuable consideration,the legal sufficiency of which is hereby acknowledged, City and the Osborn Consulting Incorporated mutually agree as follows: 1. Purpose: This Amendment is for the Contract for Ridgemont Estates Stormwater Improvement Project by and between the Parties, executed by the Parties on September 20, 2023, and which terminates on December 31, 2024. Said contract is 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 and any amendments thereto which are not specifically modified by this Amendment. 3. Amendment Provisions: The Original Contract is subject to the following amended provisions, which are as follows. All such amended provisions are hereby incorporated by reference herein and shall control over any conflicting provisions of the Original Contract, including any previous amendments thereto. Amendment No. 1 provides funds for added scope of work to the original contract,including,but not limited to,modeling calibration,added open channel monitoring, additional summary of hydraulic modeling results,and updating final reporting that identifies levels of improvement to the existing stormwater system. Section 3 of the Contract is amended to provide a maximum compensation of $391,087.00 4. Compensation Amendment History: This is Amendment # 1 of the Original Contract. The history of amendments to the compensation on the Original Contract and all amendments is as follows: Date Total Compensation Original Contract Amount September 20,2023 $379,797.00 Amendment#1 —This amendment To be executed $ 11,290.00 Total Amended Compensation $391,087.00 The parties have executed this Amendment to the Original Contract this 2.3 day of September, 2024. CITY OF SPOKANESP� VALLEY: OSBORN CONSULTING INCORPRATED: l /j�— J Hohman By: Tarelle Osborn City Manager Its: Authorized Representative APPROVED AS TO FORM: ce o e City Attorney 1 Client#: 1985872 OSBORCON2 YYYY) ACORDr. CERTIFICATE OF LIABILITY INSURANCE 7/24 DATE(M/2024 M/DD/M/DD/ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Please See Below NAME: USI Insurance Services NW PR PHONE,Ext):206 441-6300 FAx{A/C,No): 610-362-8530 (A/C,No 601 Union Street,Suite 1000 E-MAIL ADDRESS: Seattle. Icertre uest usl.com P q Seattle,WA 98101 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A Travelers Indemnity Co of America 25666 INSURED INSURER B:Travelers Property Cas.Co.of America 25674 Osborn Consulting, Inc. INSURER C Travelers Casualty&Surety Co.of Amer 31194 Attn: Megan Isaacks INSURER D:Travelers Casualty Ins Co of America 19046 1800 112th Avenue NE,Suite 220E INSURER E: Bellevue,WA 98004 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. INSR TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP W LIMITS LTRINSR VD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY X X 6806T82776A2447 07/28/2024 07/28/2025 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR PREMISES Eaoccu RENTED $1,000,000 X WA Stop Gap/EL MED EXP(Anyone person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ECOT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: Stop Gap/EL $1,000,000 D AUTOMOBILE LIABILITY X X BA6T8302042447G 07/28/2024 07/28/2025 COMaBINaccident)SI �ED NGLE LIMIT 1e 000e 000 (E _ X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) B x UMBRELLA LIAB X OCCUR X X CUP6T8299362447 07/28/2024 07/28/2025 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS-MADE (Follow Form) AGGREGATE $4,000,000 DED X RETENTION$10,000 $ B WORKERS COMPENSATION X UB7T5635132447G 07/28/2024 07/28/2025 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Professional X 106565360 07/28/2024 07/28/2025 $3,000,000 per claim Liability $5,000,000 annl aggr. DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Project#Contract#23-158(OCI#30-230010), City of Spokane Valley Ridgemont Estates Stormwater Improvements. The General Liability and Automobile Liability policies include an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder, only when there is a written contract that requires such status, and only with regard to work performed by or on behalf of the named insured.The (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Cityof Spokane ValleySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10210 East Sprague Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Spokane Valley,WA 99206 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S45637306/M45630466 AZLZP DESCRIPTIONS (Continued from Page 1) General Liability,Automobile Liability, Workers Compensation and Professional Liability policies include an endorsement providing that 30 days notice of cancellation will be given to the Certificate Holder by the Insurance Carrier. Umbrella Liability follow form. SAGITTA 25.3(2016/03) 2 of 2 #S45637306/M45630466 Policy:6806T82776A2447 COMMERCIAL GENERA! • !ABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR ARCHITECTS, ENGINEERS AND SURVEYORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILI I Y 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 listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties. and what is and is not covered. A. Non-Owned Watercraft-75 Feet Long Or Less H. Blanket Additional Insured - Governmental B. Who Is An Insured - Unnamed Subsidiaries Entities - Permits Or Authorizations Relating To Premises C. Who Is An Insured - Retired Partners, Members, Directors And Employees I. Blanket Additional Insured - Governmental Entities - Permits Or Authorizations Relating To D. Who Is An Insured - Employees And Volunteer Operations Workers - Bodily Injury To Co-Employees. Co- Volunteer Workers And Retired Partners. J. Incidental Medical Malpractice Members, Directors And Employees K. Medical Payments- Increased Limit E. Who Is An Insured - Newly Acquired Or Formed L. Amendment Of Excess Insurance Condition - Limited Liability Companies Professional Liability F. Blanket Additional Insured -Controlling Interest M. Blanket Waiver Of Subrogation -When Required G. Blanket Additional Insured - Mortgagees. By Written Contract Or Agreement Assignees. Successors Or Receivers N. Contractual Liability-Railroads PROVISIONS uses or is responsible for the use of a A. NON-OWNED WATERCRAFT - 75 FEET watercraft that you do not own that is: LONG OR LESS (1) 75 feet long or less; and 1. The following replaces Paragraph (2) of (2) Not being used to carry any person Exclusion g., Aircraft, Auto Or Watercraft. or property for a charge: in Paragraph 2. of SECTION I - B. WHO IS AN INSURED - UNNAMED COVERAGES - COVERAGE A - BODILY SUBSIDIARIES INJURY AND PROPERTY DAMAGE The following is added to SECTION II -WHO IS LIABILITY: AN INSURED: (2) A watercraft you do not own that is: Any of your subsidiaries, other than a partnership (a) 75 feet long or less: and or joint venture, that is not shown as a Named (b) Not being used to carry any person Insured in the Declarations is a Named Insured or property for a charge: if: 2. The following replaces Paragraph 2.e. of a. You are the sole owner of, or maintain an SECTION II -WHO IS AN INSURED: ownership interest of more than 50% in, such e. Any person or organization that, with subsidiary on the first day of the policy your express or implied consent, either period: and CG D3 79 02 19 U 2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 6 Includes copyrighted material cf Insurance Services Off.ce.Inc.with its permission. COMMERCIAL GENERAL LIABILITY b. Such subsidiary is not an insured under Unless you are in the business or occupation similar other insurance. of providing professional health care No such subsidiary is an insured for "bodily services. Paragraphs (1)(a), (b). (c) and (d) injury" or "property damage" that occurred, or above do not apply to "bodily injury" arising caused by an out of providing or failing to provide first aid "personal and advertising injury" offense committed: or"Good Samaritan services" by any of your retired partners. members, directors or a. Before you maintained an ownership interest "employees", other than a doctor. Any such of more than 50% in such subsidiary; or retired partners, members, directors or b. After the date, if any, during the policy period "employees" providing or failing to provide that you no longer maintain an ownership first aid or "Good Samaritan services" during interest of more than 50% in such subsidiary. their work hours for you will be deemed to be acting within the scope of their employment For purposes of Paragraph 1. of Section II—Who by you or performing duties related to the Is An Insured, each such subsidiary will be conduct of your business. deemed to be designated in the Declarations as: a. A limited liability company; (2) "Personal injury": b. An organization other than a partnership, (a) To you, to your current or retired joint venture or limited liability company; or partners or members (if you are a partnership or joint venture), to your c. A trust; current or retired members (if you are a as indicated in its name or the documents that limited liability company), to your other govern its structure. current or retired directors or "employees" while in the course of his or C. WHO 15 AN INSURED— RETIRED PARTNERS, her employment or performing duties MEMBERS, DIRECTORS AND EMPLOYEES related to the conduct of your business, The following is added to Paragraph 2. of or to your other "volunteer workers" SECTION II—WHO IS AN INSURED: while performing duties related to the Any person who is your retired partner, member, conduct of your business; director or"employee"that is performing services (b) To the spouse. child, parent, brother or for you under your direct supervision, but only for sister of that current or retired partner, acts within the scope of their employment by you member, director, "employee" or or while performing duties related to the conduct "volunteer worker" as a consequence of of your business. However, no such retired Paragraph (2)(a) above; partner, member, director or "employee" is an insured for: (c) For which there is any obligation to share damages with or repay someone (1) "Bodily injury": else who must pay damages because of (a) To you, to your current partners or the injury described in Paragraph (2)(a) members (if you are a partnership or or(b) above; or joint venture), to your current members (d) Arising out of his or her providing or (if you are a limited liability company) or failing to provide professional health care to your current directors: services. (b) To the spouse, child, parent, brother or (3) "Property damage"to property: sister of that current partner, member or (a) Owned, occupied or used by; or director as a consequence of Paragraph (1)(a) above; (b) Rented to. in the care, custody or control (c) For which there is any obligation to of, or over which physical control is sharebeing exercised for any purpose by: damages with or repay someone else who must pay damages because of you, any of your retired partners, members the injury described in Paragraph (1)(a) or directors, your current or retired or(b)above; or "employees" or "volunteer workers". any current partner or member (if you are a (d) Arising out of his or her providing or failingtoprovideprofessional health care partnership or joint venture), or any current member (if you are a limited liability services. company)or current director. Page 2 of 6 c 2017 The Travelers Indemnity Company.All rights reserved. CG D3 79 02 19 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY D. WHO IS AN INSURED — EMPLOYEES AND organization will be deemed to be VOLUNTEER WORKERS — BODILY INJURY designated in the Declarations as: TO CO-EMPLOYEES, CO-VOLUNTEER a. A limited liability company; WORKERS AND RETIRED PARTNERS, b. An organization other than a partnership, MEMBERS, DIRECTORS AND EMPLOYEES joint venture or limited liability company: The following is added to Paragraph 2.a.(1) of or SECTION II—WHO IS AN INSURED: c. A trust; Paragraphs (1)(a), (b) and (c) above do not as indicated in its name or the documents apply to "bodily injury" to a current or retired co- that govern its structure. "employee" while in the course of the co- "employee's" employment by you or performing F. BLANKET ADDITIONAL INSURED — duties related to the conduct of your business, or CONTROLLING INTEREST to "bodily injury" to your other "volunteer workers" or retired partners, members or 1. The following is added to SECTION II — directors while performing duties related to the WHO IS AN INSURED: conduct of your business. Any person or organization that has financial control of you is an insured with respect to E. WHO IS AN INSURED—NEWLY ACQUIRED liability for "bodily injury", "property damage" OR FORMED LIMITED LIABILITY COMPANIES or "personal and advertising injury" that The following replaces Paragraph 3. of arises out of: SECTION II—WHO IS AN INSURED: a. Such financial control; or 3. Any organization you newly acquire or form. b. Such person's or organization's other than a partnership or joint venture, and ownership, maintenance or use of of which you are the sole owner or in which premises leased to or occupied by you. you maintain an ownership interest of more than 50%, will qualify as a Named Insured if The insurance provided to such person or there is no other similar insurance available organization does not apply to structural to that organization. However; alterations, new construction or demolition operations performed by or on behalf of such a. Coverage under this provision is person or organization. afforded only: 2. The following is added to Paragraph 4. of (1) Until the 180th day after you acquire SECTIO N II—WHO IS AN INSURED: or form the organization or the end of This paragraph does not apply to any the policy period, whichever is premises owner, manager or lessor that has earlier, if you do not report such financial control of you. organization in writing to us within 180 days after you acquire or form it; G. BLANKET ADDITIONAL INSURED — or MORTGAGEES, ASSIGNEES, SUCCESSORS (2) Until the end of the policy period, OR RECEIVERS when that date is later than 180 days The following is added to SECTION II—WHO IS after you acquire or form such AN INSURED: organization, if you report such Any person or organization that is a mortgagee. organization in writing to us within assignee, successor or receiver and that you 180 days after you acquire or form it; have agreed in a written contract or agreement b. Coverage A does not apply to "bodily to include as an additional insured on this injury" or "property damage" that Coverage Part is an insured, but only with occurred before you acquired or formed respect to its liability as mortgagee, assignee, the organization; and successor or receiver for"bodily injury", "property damage" or "personal and advertising injury" c. Coverage B does not apply to "personal that: and advertising injury" arising out of an offense committed before you acquired a. Is "bodily injury" or "property damage" that or formed the organization. occurs, or is"personal and advertising injury" For the purposes of Paragraph 1. of Section caused by an offense that is committed, II — Who Is An Insured, each such CG D3 79 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 3 of 6 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY subsequent to the signing of that contract or openings, sidewalk vaults, elevators, street agreement; and banners or decorations. b. Arises out of the ownership. maintenance or I. BLANKET ADDITIONAL INSURED — use of the premises for which that GOVERNMENTAL ENTITIES — PERMITS mortgagee, assignee, successor or receiver OR AUTHORIZATIONS RELATING TO is required under that contract or agreement OPERATIONS to be included as an additional insured on The following is added to SECTION II —WHO IS this Coverage Part. AN INSURED: The insurance provided to such mortgagee. Any governmental entity that has issued a permit assignee, successor or receiver is subject to the or authorization with respect to operations following provisions: performed by you or on your behalf and that you a. The limits of insurance provided to such are required by any ordinance, law, building code mortgagee, assignee, successor or receiver or written contract or agreement to include as an will be the minimum limits that you agreed to additional insured on this Coverage Part is an provide in the written contract or agreement, insured, but only with respect to liability for or the limits shown in the Declarations, "bodily injury". "property damage" or "personal whichever are less. and advertising injury" arising out of such b. The insurance provided to such person or operations. organization does not apply to: The insurance provided to such governmental entity does not apply to: (1) Any "bodily injury" or "property damage" that occurs, or any "personal and a. Any "bodily injury", "property damage" or advertising injury" caused by an offense "personal and advertising injury" arising out that is committed, after such contract or of operations performed for the agreement is no longer in effect;or governmental entity; or (2) Any "bodily injury", "property damage" or b. Any "bodily injury" or "property damage" "personal and advertising injury" arising included in the "products-completed out of any structural alterations, new operations hazard". construction or demolition operations J. INCIDENTAL MEDICAL MALPRACTICE performed by or on behalf of such mortgagee, assignee, successor or 1. The following replaces Paragraph b. of the receiver. definition of "occurrence" in the H. BLANKET ADDITIONAL INSURED — DEFINITIONS Section: GOVERNMENTAL ENTITIES — PERMITS OR b. An act or omission committed in AUTHORIZATIONS RELATING TO PREMISES providing or failing to provide "incidental medical services", first aid or "Good The following is added to SECTION II —WHO IS Samaritan services" to a person, unless AN INSURED: you are in the business or occupation of Any governmental entity that has issued a permit providing professional health care or authorization with respect to premises owned services. or occupied by, or rented or loaned to, you and 2. The following replaces the last paragraph of that you are required by any ordinance, law, Paragraph 2.a.(1) of SECTION II — WHO IS building code or written contract or agreement to AN INSURED: include as an additional insured on this Coverage Part is an insured, but only with Unless you are in the business or occupation respect to liability for "bodily injury", "property of providing professional health care damage" or "personal and advertising injury" services, Paragraphs (1)(a), (b), (c) and (d) arising out of the existence, ownership, use, above do not apply to "bodily injury" arising maintenance, repair, construction, erection or out of providing or failing to provide: removal of any of the following for which that (a) "Incidental medical services" by any of governmental entity has issued such permit or your "employees" who is a nurse. authorization: advertising signs, awnings, nurse assistant, emergency medical canopies, cellar entrances, coal holes, technician, paramedic, athletic trainer, driveways, manholes, marquees, hoist away audiologist, dietician. nutritionist, Page 4 of 6 C 2017 The Travelers indemnity Company.All nghts reserved. CG D3 79 02 19 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY occupational therapist or occupational that is available to any of your "employees" therapy assistant, physical therapist or for "bodily injury" that arises out of providing speech-language pathologist; or or failing to provide "incidental medical (b) First aid or "Good Samaritan services" services" to any person to the extent not by any of your"employees" or"volunteer subject to Paragraph 2.a.(1) of Section II — workers", other than an employed or Who Is An Insured. volunteer doctor. Any such "employees" K. MEDICAL PAYMENTS—INCREASED LIMIT or"volunteer workers" providing or failing to provide first aid or "Good Samaritan The following replaces Paragraph 7. of services" during their work hours for you SECTION III—LIMITS OF INSURANCE: will be deemed to be acting within the 7. Subject to Paragraph 5. above, the Medical scope of their employment by you or Expense Limit is the most we will pay under performing duties related to the conduct Coverage C for all medical expenses of your business. because of "bodily injury" sustained by any 3. The following replaces the last sentence of one person, and will be the higher of: Paragraph 5. of SECTION III — LIMITS OF a. $10,000; or INSURANCE: For the purposes of determining the b. The amount shown in the Declarations of applicable Each Occurrence Limit, all related this Coverage Part for Medical Expense acts or omissions committed in providing or Limit. failing to provide "incidental medical L. AMENDMENT OF EXCESS INSURANCE services", first aid or "Good Samaritan CONDITION—PROFESSIONAL LIABILITY services" to any one person will be deemed to be one"occurrence". The following is added to Paragraph 4.b.. Excess Insurance. of SECTION IV — 4. The following exclusion is added to COMMERCIAL GENERAL LIABILITY Paragraph 2., Exclusions, of SECTION I — CONDITIONS: COVERAGES — COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE This insurance is excess over any of the other LIABILITY: insurance, whether primary, excess, contingent or on any other basis, that is Professional Sale Of Pharmaceuticals Liability or similar coverage, to the extent the "Bodily injury" or "property damage" arising loss is not subject to the professional services out of the violation of a penal statute or exclusion of Coverage A or Coverage B. ordinance relating to the sale of pharmaceuticals committed by, or with the M. BLANKET WAIVER OF SUBROGATION — knowledge or consent of the insured. WHEN REQUIRED BY WRITTEN CONTRACT 5. The following is added to the DEFINITIONS OR AGREEMENT Section: The following is added to Paragraph 8., Transfer "Incidental medical services" means: Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL a. Medical, surgical, dental, laboratory, x- LIABILITY CONDITIONS: ray or nursing service or treatment. If the insured has agreed in a written contract or advice or instruction, or the related agreement to waive that insured's right of furnishing of food or beverages: or recovery against any person or organization, we b. The furnishing or dispensing of drugs or waive our right of recovery against such person medical, dental, or surgical supplies or or organization. but only for payments we make appliances. because of: 6. The following is added to Paragraph 4.b.. a. "Bodily injury" or "property damage" that Excess Insurance, of SECTION IV — occurs: or COMMERCIAL GENERAL LIABILITY CONDITIONS! b. "Personal and advertising injury" caused by This insurance is excess over any valid and an offense that is committed: collectible other insurance, whether primary. subsequent to the signing of that contract or excess, contingent or on any other basis, agreement. CG D3 79 02 19 ®2017 The Travelers Indemnity Company.All rights reserved. Page 5 of 6 includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY N. CONTRACTUAL LIABILITY—RAILROADS 1. The following replaces Paragraph c. of the definition of "insured contract" in the DEFINITIONS Section; c. Any easement or license agreement; 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is deleted. Page 6 of 6 C 2017 The Travelers Indemnity Company.All rights reserved. CG D3 79 02 19 Includes copyrighted material of Insurance Services Office,Inc.with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION -- "PROFESSIONAL SERVICES" -- ARCHITECTS, ENGINEERS OR SURVEYORS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to Paragraph 2., Exclu- 3. The following is added to the DEFINITIONS Sec- sions, of SECTION I — COVERAGES — COVER- tion: AGE A BODILY INJURY AND PROPERTY "Professional services" means any service requir- DAMAGE LIABILITY: ing specialized skill or training including the fol- Professional Services lowing: "Bodily injury" or "property damage" arising out of a. The preparing, approving, or failing to prepare the rendering of or failure to render any "profes- or approve, maps, shop drawings, opinions, sional services". reports. surveys, field orders, change orders 2. The following is added to Paragraph 2.. Exclu or drawings and specifications: and sions, of SECTION I — COVERAGES — COVER- b. Supervisory, inspection, architectural or engi- AGE B PERSONAL AND ADVERTISING IN- neering activities. JURY LIABILITY Professional Services "Personal injury" or "advertising injury" arising out of the rendering of or failure to render any "pro- fessional services". CG D4 18 11 09 ©2009 The Travelers Indemnity Company Page 1 of 1 Includes copyrighted material of Insurance Services Office,Inc.with its permission. Policy Number: BA6T8302042447G COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS 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. BLANKET ADDITIONAL INSURED H. AUDIO. VISUAL AND DATA ELECTRONIC B. EMPLOYEE HIRED AUTO EQUIPMENT- INCREASED LIMIT C. EMPLOYEES AS INSURED I. WAIVER OF DEDUCTIBLE - GLASS D. SUPPLEMENTARY PAYMENTS - INCREASED J. PERSONAL PROPERTY LIMITS K. AIRBAGS E. TRAILERS - INCREASED LOAD CAPACITY L. AUTO LOAN LEASE GAP F. HIRED AUTO PHYSICAL DAMAGE M. BLANKET WAIVER OF SUBROGATION G. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT A. BLANKET ADDITIONAL INSURED performing duties related to the conduct of The following is added to Paragraph A.1., Who Is your business. An Insured, of SECTION II - COVERED AUTOS 2. The following replaces Paragraph b. in B.5.. LIABILITY COVERAGE: Other Insurance, of SECTION IV - BUSI- Any person or organization who is required under NESS AUTO CONDITIONS: a written contract or agreement between you and b. For Hired Auto Physical Damage Cover- that person or organization. that is signed and age, the following are deemed to be cov- executed by you before the "bodily injury" or ered "autos" you own: "property damage" occurs and that is in effect during the policy period, to be named as an addi- (1) Any covered "auto" you lease, hire, tional insured is an "insured" for Covered Autos rent or borrow; and Liability Coverage. but only for damages to which (2) Any covered "auto" hired or rented by this insurance applies and only to the extent that your "employee" under a contract in person or organization qualifies as an "insured" an "employee's" name, with your under the Who Is An Insured provision contained permission, while performing duties in Section II. related to the conduct of your busi- B. EMPLOYEE HIRED AUTO ness. 1. The following is added to Paragraph A.1., However, any "auto" that is leased, hired, ented or borrowed with a driver is not a Who Is An Insured, of SECTION II - COV- covered"auto". ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while C. EMPLOYEES AS INSURED operating a covered "auto" hired or rented The following is added to Paragraph A.1.. Who Is under a contract or agreement in an "Pm- An Insured, of SECTION II -COVERED AUTOS ployee's" name, with your permission, while LIABILITY COVERAGE: CA T4 20 02 15 U 2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office.Inc.with its permission. COMMERCIAL AUTO Any "employee" of yours is an "insured"while us- (2) An adjustment for depreciation and physical ing a covered "auto"you don't own, hire or borrow condition will be made in determining actual in your business or your personal affairs. cash value in the event of a total "loss". D. SUPPLEMENTARY PAYMENTS — INCREASED (3) If a repair or replacement results in better LIMITS than like kind or quality, we will not pay for the 1. The following replaces Paragraph A.2.a.(2) of amount of betterment. SECTION II —COVERED AUTOS LIABILITY (4) A deductible equal to the highest Physical COVERAGE: Damage deductible applicable to any owned (2) Up to $3,000 for cost of bail bonds (in- covered "auto". cluding bonds for related traffic law viola- (5) This Coverage Extension does not apply to: tions) required because of an "accident" (a) Any "auto" that is hired, rented or bor- we cover. We do not have to furnish rowed with a driver: or these bonds. replaces Paragraph A.2.a.(4) of (b) Any "auto" that is hired, rented or bor- 2. The following prowed from your"employee". SECTION II—COVERED AUTOS LIABILITY G. PHYSICAL DAMAGE — TRANSPORTATION COVERAGE: EXPENSES—INCREASED LIMIT (4) All reasonable expenses incurred by the The following replaces the first sentence in Para- "insured" at our request, including actual graph A.4.a., Transportation Expenses, of loss of earnings up to $500 a day be SECTION III — PHYSICAL DAMAGE COVER- cause of time off from work. AGE: E. TRAILERS—INCREASED LOAD CAPACITY We will pay up to $50 per day to a maximum of The following replaces Paragraph C.1. of SEC- $1,500 for temporary transportation expense in- T1ON I—COVERED AUTOS: curred by you because of the total theft of a coy- 1. "Trailers" with a load capacity of 3,000 ered "auto"of the private passenger type. pounds or less designed primarily for travel H. AUDIO, VISUAL AND DATA ELECTRONIC on public roads. EQUIPMENT—INCREASED LIMIT F. HIRED AUTO PHYSICAL DAMAGE Paragraph C.1.b. of SECTION III — PHYSICAL The following is added to Paragraph A.4., Cover- DAMAGE COVERAGE is deleted. age Extensions, of SECTION III — PHYSICAL I. WAIVER OF DEDUCTIBLE—GLASS DAMAGE COVERAGE! The following is added to Paragraph D., Deducti- Hired Auto Physical Damage Coverage ble, of SECTION III — PHYSICAL DAMAGE If hired "autos" are covered "autos" for Covered COVERAGE: Autos Liability Coverage but not covered "autos" No deductible for a covered "auto" will apply to for Physical Damage Coverage, and this policy glass damage if the glass is repaired rather than also provides Physical Damage Coverage for an replaced. owned "auto", then the Physical Damage Cover- J. PERSONAL PROPERTY age is extended to "autos" that you hire, rent or The following is added to Paragraph A.4., Cover- borrow subject to the following: age Extensions, of SECTION III — PHYSICAL (1) The most we will pay fur "loss" to any one DAMAGE COVERAGE: "auto" that you hire, rent or borrow is the Personal Property Coverage lesser of: We will pay up to $400 for "loss" to wearing ap- (a) $50,000: parel and other personal property which is: (b) The actual cash value of the damaged or (1) Owned by an"insured";and stolen property as of the time of the (2) In or on your covered "auto". "loss"; or This coverage only applies in the event of a total (c) The cost of repairing or replacing the theft of your covered "auto". damaged or stolen property with other No deductibles apply to Personal Property cover- property of like kind and quality. age. Page 2 of 3 ©2015 The Travelers Indemnity Company.All rights reserved. CA T4 20 02 15 Includes copyrighted material of Insurance Services Office.Inc.with its permission. COMMERCIAL AUTO K. AIRBAGS (2) Any: The following is added to Paragraph B.3.. Exclu- (a) Overdue lease or loan payments at the sions. of SECTION III — PHYSICAL DAMAGE time of the"loss": COVERAGE: Exclusion 3.a. does not applyto "loss" to one or (b) Financial penalties imposed under a lease for excessive use. abnormal wear more airbags in a covered "auto" you own that in- and tear or high mileage: flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but (c) Security deposits not returned by the les- only: sor. a. If that "auto" is a covered "auto" for Compre- (d) Costs for extended warranties, Credit Life hensive Coverage under this policy; Insurance, Health. Accident or Disability b. The airbags are not covered under any war- Insurance purchased with the loan or ranty: and lease: and c. The airbags were not intentionally inflated. (e) Carry-over balances from previous loans or leases. We will pay up to a maximum of $1.000 for any one"loss". M. BLANKET WAIVER OF SUBROGATION L. AUTO LOAN LEASE GAP The following replaces Paragraph A.S., Transfer The following is added to Paragraph A.4., Cover- Of Rights Of Recovery Against Others To Us, age Extensions. of SECTION III — PHYSICAL of SECTION IV — BUSINESS AUTO CONDI- TIONS:DAMAGE COVERAGE: Auto Loan Lease Gap Coverage for Private 5. Transfer Of Rights Of Recovery Against Passenger Type Vehicles Others To Us In the event of a total "loss" to a covered "auto" of We waive any right of recovery we may have the private passenger type shown in the Schedule against any person or organization to the ex- or Declarations for which Physical Damage Cov- tent required of you by a written contract exe- erage is provided, we will pay any unpaid amount cuted prior to any "accident" or "loss", pro- due on the lease or loan for such covered "auto" vided that the "accident" or"loss"arises out of less the following: the operations contemplated by such con- (1) The amount paid under the Physical Damage tract. The waiver applies only to the person or Coverage Section of the policy for that "auto": organization designated in such contract. and CA T4 20 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 3 of 3 Includes copyrighted material of Insurance Services Office.Inc.with its permission. POLICY NUMBER 6806T82776A2447 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice: 30 WHEN WE DO NOT RENEW (Nonrenewal): Number of Days Notice: 30 PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OR NONRENEWAL 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 OR NONRENEWAL 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 SCHEDULE. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZ- ATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US, PROVISIONS B. If we do not renew this policy for any legally A. If we cancel this policy for any legally permitted permitted reason other than nonpayment of reason other than nonpayment of premium. and a premium, and a number of days is shown for number of days is shown for Cancellation in the When We Do Not Renew (Nonrenewal) in the Schedule above, we will mail notice of Schedule above, we will mail notice of cancellation to the person or organization shown nonrenewal to the person or organization shown in such Schedule. We will mail such notice to the n such Schedule. We will mail such notice to the address shown in the Schedule above at least the address shown in the Schedule above at least the number of days shown for Cancellation in such number of days shown for When We Do Not Schedule before the effective date of cancellation. Renew (Nonrenewal) in such Schedule before the effective date of nonrenewal. IL T4 00 05 19 'J 2019 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 POLICY NUMBER: BA6T8302042447G THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED PERSON OR ORGANIZATION - NOTICE OF CANCELLATION OR NONRENEWAL PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE 30 CANCELLATION: Number of Days Notice: 30 WHEN WE DO NOT RENEW (Nonrenewal): Number of Days Notice: PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OR NONRENEWAL 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 OR NONRENEWAL 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 SCHEDULE. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZ- ATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. PROVISIONS B. If we do not renew this policy for any legally A. If we cancel this policy for any legally permitted permitted reason other than nonpayment of reason other than nonpayment of premium, and a premium, and a number of days is shown for number of days is shown for Cancellation in the When We Do Not Renew (Nonrenewal) in the Schedule above. we will mail notice of Schedule above. we will mail notice of cancellation to the person or organization shown nonrenewal to the person or organization shown in such Schedule. We will mail such notice to the in such Schedule. We will mail such notice to the address shown in the Schedule above at least the address shown in the Schedule above at least the number of days shown for Cancellation in such number of days shown for When We Do Not Schedule before the effective date of cancellation. Renew (Nonrenewal) in such Schedule before the effective date of nonrenewal. IL T4 00 05 19 t 2019 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 ��► WORKERS COMPENSATION TRAVELERS J AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 99 06 R4 (00) - 001 POLICY NUMBER: UB7T5635132447G NOTICE OF CANCELLATION OR NONRENEWAL TO DESIGNATED PERSONS OR ORGANIZATIONS The following is added to PART SIX - CONDITIONS : Notice Of Cancellation Or Nonrenewal To Designated Persons Or Organizations If we cancel or non-renew this policy for any reason other than non-payment of premium by you. we will provide notice of such cancellation or non-renewal to each person or organization designated in the Schedule below. We will mail or deliver such notice to each person or organization at its listed address at least the number of days shown for that person or organization before the cancellation or nonrenewal is to take effect. You are responsible for providing us with the information necessary to accurately complete the Schedule below. If we cannot mail or deliver a notice of cancellation or nonrenewal to a designated person or organization because the name or address of such designated person or organization provided to us is not accurate or complete. we have no responsibility to mail. deliver or otherwise notify such designated person or organization of the cancellation or nonrenewal. SCHEDULE Name and Address of Designated Persons or Organizations: Number of Days Notice: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT 30 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 RECEIVED SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium S insurance Company Countersigned by ST ASSIGN: Page 1 oil ®2013 The Travelers Indemnity Company.All rights reserved. i