Loading...
22-226.01DavidEvansAssociatesOnCallTrafficEngineeringServices CONTRACT AMENDMENT TO THE AGREEMENT BETWEEN THE CITY OF SPOKANE VALLEY AND DAVID EVANS&ASSOCIATES, INC. Spokane Valley Contract#22-226.01 For good and valuable consideration, the legal sufficiency of which is hereby acknowledged, City and David Evans&Associates,Inc. mutually agree as follows: 1.Purpose:This Amendment is for the Contract for on-call traffic engineering services by and between the Parties, executed by the Parties on January 6, 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. Termination of Original Contract date amended to December 31,2025. Updated Exhibit B-Fee Schedule;attached hereto as 2024 Exhibit B ANTE Fee Schedule. 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 Compensation Original Contract Amount January 6,2023 $50,000.00 Amendment#1 to be executed $ 0.00 Total Amended Compensation $50,000.00 The parties have executed this Amendment to the Original Contract this 10 I'll dayof November, 024. CITY OF SPOKANE VALLEY: DAVID EVANS&ASSOCIATES,INC.: Digitally signed by Kayla Kruse Kayla Kruse Date:2024.11.25 10:05:33-0833-08'00' Hohman By: Kayla Kruse, Associate City Manager Its: APPROVED S TO FO O e of the tty Attorney 1 EXHIBIT B 2024 FEE SCHEDULE David Evans and Associates,Inc. 908 North Howard Street,Suite 300 Spokane,WA 99201 Updated:November 14,2024 based on March 2024 rates Annual review with possible updates to occur in March Actuals Not to Exceed Table(ANTE) Maximum Direct Labor Direct Labor All Inclusive DEA Job Classification Direct Labor Overhead Fixed Fee Hourly Billing Rate 177.62% 30% Rate NTE NTE NTE NTE Accountant I $40.54 $72.01 $12.16 $124.71 Accountant II $45.60 $80.99 $13.68 $140.27 Accountant III $52.82 $93.82 $15.85 $162.48 Accountant IV $60.57 $107.58 $18.17 $186.33 Accountant V $67.27 $119.48 $20.18 $206.94 Accounting Specialist I $28.26 $50.20 $8.48 $86.93 Accounting Specialist II $36.10 $64.12 $10.83 $111.05 Accounting Specialist III $40.54 $72.01 $12.16 $124.71 Accounting Specialist IV $45.60 $80.99 $13.68 $140.27 Accounting Specialist V $52.82 $93.82 $15.85 $162.48 Administrative Assistant I $28.26 $50.20 $8.48 $86.93 Administrative Assistant II $36.10 $64.12 $10.83 $111.05 Administrative Assistant III $40.54 $72.01 $12.16 $124.71 Administrative Assistant IV $45.60 $80.99 $13.68 $140.27 Administrative Assistant V $52.82 $93.82 $15.85 $162.48 CAD Technician I $36.10 $64.12 $10.83 $111.05 CAD Technician II $40.54 $72.01 $12.16 $124.71 CAD Technician III $45.60 $80.99 $13.68 $140.27 CAD Technician IV $52.82 $93.82 $15.85 $162.48 CAD Technician V $60.57 $107.58 $18.17 $186.33 CartographerI $40.54 $72.01 $12.16 $124.71 Cartographer II $45.60 $80.99 $13.68 $140.27 Cartographer III $52.82 $93.82 $15.85 $162.48 Cartographer IV $60.57 $107.58 $18.17 $186.33 Cartographer V $67.27 $119.48 $20.18 $206.94 Construction Inspection Apprentice $36.10 $64.12` $10.83 $111.05 Construction Inspector I $40.54 $72.01 $12.16 $124.71 Construction Inspector II $45.60 $80.99 $13.68 $140.27 Construction Inspector III $52.82 $93.82 $15.85 $162.48 Construction Inspector IV $60.57 $107.58 $18.17 $186.33 Construction Inspector V $67.27 $119.48 $20.18 $206.94 Construction Services Manager I $60.57 $107.58 $18.17 $186.33 Construction Services Manager II $67.27 $119.48 $20.18 $206.94 Construction Services Manager III $77.75 $138.10 $23.33 $239.17 Construction Services Manager IV $94.64 $168.10 $28.39 $291.13 Deputy Construction Manager $52.82 $93.82 $15.85 $162.48 DesignerI $45.60 $80.99 $13.68 $140.27 Designer II $52.82 $93.82 $15.85 $162.48 Designer III $60.57 $107.58 $18.17 $186.33 Designer IV $67.27 $119.48 $20.18 $206.94 Designer V $77.75 $138.10 $23.33 $239.17 11/14/2024 1 of 4 EXHIBIT B-2024 Fee Schedule (continued) Actuals Not to Exceed Table(ANTE) Maximum Direct Labor Direct Labor All Inclusive DEA Job Classification Direct Labor Overhead Fixed Fee Hourly Billing Rate 177.62% 30% Rate NTE NTE NTE NTE Electrical Engineer III $66.01 $117.25 $19.80 $203.06 Electrical Engineer IV $76.00 $134.99 $22.80 $233.79 Electrical Engineer V $91.72 $162.91 $27.52 $282.15 Electrical Engineer VI $118.66 $210.76 $35.60 $365.02 Electrical Engineer VII $139.48 $247.74 $41.84 $429.07 Electrical Engineering Designer I $51.34 $91.19 $15.40 $157.93 Electrical Engineering Designer II $58.59 $104.07 $17.58 $180.23 Engineer III $60.57 $107.58 $18.17 $186.33 Engineer IV $67.27 $119.48 $20.18 $206.94 Engineer V $77.75 $138.10 $23.33 $239.17 Engineer VI $94.64 $168.10 $28.39 $291.13 Engineer VII $122.68 $217.90 $36.80 $377.39 Engineering Designer I $45.60 $80.99 $13.68 $140.27 Engineering Designer II $52.82 $93.82 $15.85 $162.48 Field Survey Technician II $32.03 $56.89 $9.61 $98.53 Field Survey Technician III $36.10 $64.12 $10.83 $111.05 Field Survey Technician IV $40.54 $72.01 $12.16 $124.71 Field Survey Technician V $45.60 $80.99 $13.68 $140.27 Financial Analyst I $60.57 $107.58 $18.17 $186.33 Financial Analyst II $67.27 $119.48 $20.18 $206.94 Financial Analyst III $77.75 $138.10 $23.33 $239.17 Financial Analyst IV $94.64 $168.10 $28.39 $291.13 Flight Operations Manager $77.36 $137.41 $23.21 $237.97 GIS Analyst I $40.54 $72.01 $12.16 $124.71 GIS Analyst II $45.60 $80.99 $13.68 $140.27 GIS Analyst III $52.82 $93.82 $15.85 $162.48 GIS Analyst IV $60.57 $107.58 $18.17 $186.33 GIS Manager $67.27 $119.48 $20.18 $206.94 Graphic Designer I $40.54 $72.01 $12.16 $124.71 Graphic Designer II $45.60 $80.99 $13.68 $140.27 Graphic Designer III $52.82 $93.82 $15.85 $162.48 Hydrographer I $40.54 $72.01 $12.16 $124.71 Hydrographer II $45.60 $80.99 $13.68 $140.27 Hydrographer III $52.82 $93.82 $15.85 $162.48 Hydrographer IV $60.57 $107.58 $18.17 $186.33 Hydrographer V $67.27 $119.48 $20.18 $206.94 Hydrographer VI $77.75 $138.10 $23.33 $239.17 Hydrographer VII $94.64 $168.10 $28.39 $291.13 Intern I $21.98 $39.04 $6.59 $67.61 Intern II $28.26 $50.20 $8.48 $86.93 Intern III $32.03 $56.89 $9.61 $98.53 Landscape Architect I $40.54 $72.01 $12.16 $124.71 Landscape Architect II $45.60 $80.99 $13.68 $140.27 Landscape Architect III $52.82 $93.82 $15.85 $162.48 Landscape Architect IV $60.57 $107.58 $18.17 $186.33 Landscape Architect V $67.27 $119.48 $20.18 $206.94 11/14/2024 2 of 4 EXHIBIT B-2024 Fee Schedule (continued) Actuals Not to Exceed Table(ANTE) Maximum Direct Labor Direct Labor All Inclusive DEA Job Classification Direct Labor 1 Overhead Fixed Fee Hourly Billing Rate 177.62% 30% Rate NTE NTE NTE NTE Landscape Designer I $36.10 $64.12 $10.83 $111.05 Landscape Designer II $40.54 $72.01 $12.16 $124.71 Landscape Designer III $45.60 $80.99 $13.68 $140.27 Landscape Designer IV $52.82 $93.82 $15.85 $162.48 Marine Geophysicist I $45.60 $80.99 $13.68 $140.27 Marine Geophysicist II $52.82 $93.82 $15.85 $162.48 Marine Geophysicist III $60.57 $107.58 $18.17 $186.33 Marine Geophysicist IV $67.27 $119.48 $20.18 $206.94 Marine Geophysicist V $77.75 $138.10 $23.33 $239.17 Marine Geophysicist VI $94.64 $168.10 $28.39 $291.13 Office Survey Technician I $32.03 $56.89 $9.61 $98.53 Office Survey Technician II $36.10 $64.12 $10.83 $111.05 Office Survey Technician III $40.54 $72.01 $12.16 $124.71 Office Survey Technician IV $45.60 $80.99 $13.68 $140.27 Office Survey Technician V $52.82 $93.82 $15.85 $162.48 Party Chief I $40.54 $72.01 $12.16 $124.71 Party Chief II $45.60 $80.99 $13.68 $140.27 Party Chief III $52.82 $93.82 $15.85 $162.48 Party Chief IV $60.57 $107.58 $18.17 $186.33 PlannerI $45.60 $80.99 $13.68 $140.27 Planner II $52.82 $93.82 $15.85 $162.48 Planner III $60.57 $107.58 $18.17 $186.33 Planner IV $67.27 $119.48 $20.18 $206.94 Project Accountant I $36.10 $64.12 $10.83 $111.05 Project Accountant II $40.54 $72.01 $12.16 $124.71 Project Accountant III $45.60 $80.99 $13.68 $140.27 Project Accountant IV $52.82 $93.82 $15.85 $162.48 Project Accountant V $60.57 $107.58 $18.17 $186.33 Project Controls Specialist I $44.41 $78.88 $13.32 $136.61 Project Controls Specialist II $51.34 $91.19 $15.40 $157.93 Project Controls Specialist III $58.59 $104.07 $17.58 $180.23 Project Controls Specialist IV $66.01 $117.25 $19.80 $203.06 Project Controls Specialist V $76.00 $134.99 $22.80 $233.79 Project Coordinator I $32.03 $56.89 $9.61 $98.53 Project Coordinator II $36.10 $64.12 $10.83 $111.05 Project Coordinator III $40.54 $72.01 $12.16 $124.71 Project Coordinator IV $45.60 $80.99 $13.68 $140.27 Project Coordinator V $52.82 $93.82 $15.85 $162.48 Project Manager I $60.57 $107.58 $18.17 $186.33 Project Manager II $67.27 $119.48 $20.18 $206.94 Project Manager III $77.75 $138.10 $23.33 $239.17 Project Manager IV $94.64 $168.10 $28.39 $291.13 Project Manager V $122.68 $217.90 $36.80 $377.39 Project Manager VI $142.13 $252.45 $42.64 $437.22 Project Surveyor I $52.82 $93.82; , {..x $15.85 $162.48 Project Surveyor II $60.57 $107.58"; $18.17 $186.33 Project Surveyor III $67.27 $119.48 $20.18 $206.94 Project Surveyor IV $77.75 $138.10 u $23.33 $239.17 11/14/2024 3 of 4 EXHIBIT B-2024 Fee Schedule (continued) Actuals Not to Exceed Table(ANTE) Maximum Direct Labor Direct Labor All Inclusive DEA Job Classification Direct Labor Overhead Fixed Fee Hourly Billing Rate 177.62% 30% Rate NTE NTE NTE NTE Public Engagement Professional I $45.60 $80.99 $13.68 $140.27 Public Engagement Professional II $52.82 $93.82 $15.85 $162.48 Public Engagement Professional III $60.57 $107.58 $18.17 $186.33 Public Engagement Professional IV $67.27 $119.48 $20.18 $206.94 Public Engagement Professional V $77.75 $138.10 $23.33 $239.17 Public Engagement Professional VI $94.64 $168.10 $28.39 $291.13 QA/QC Specialist $36.10 $64.12 $10.83 $111.05 QA/QC Specialist II $45.60 $80.99 $13.68 $140.27 QA/QC Specialist III $52.82 $93.82 $15.85 $162.48 QA/QC Specialist IV $60.57 $107.58 $18.17 $186.33 QA/QC Specialist V $67.27 $119.48 $20.18 $206.94 Remote Pilot I $29.10 $51.69 $8.73 $89.52 Remote Pilot II $42.08 $74.74 $12.62 $129.45 Remote Pilot III $65.00 $115.45 $19.50 $199.95 Scientific Instrument Technician I $36.10 $64.12 $10.83 $111.05 Scientific Instrument Technician II $40.54 $72.01 $12.16 $124.71 Scientific Instrument Technician Ill $45.60 $80.99 $13.68 $140.27 Scientific Instrument Technician IV $52.82 $93.82 $15.85 $162.48 Scientific Instrument Technician V $60.57 $107.58 $18.17 $186.33 Scientific Instrument Technician VI $67.27 $119.48 $20.18 $206.94 Scientist I $40.54 $72.01 $12.16 $124.71 Scientist II $45.60 $80.99 $13.68 $140.27 Scientist III $52.82 $93.82 $15.85 $162.48 Scientist IV $60.57 $107.58' $18.17 $186.33 Scientist V $67.27 $119.48 $20.18 $206.94 Survey Analyst I $45.60 $80.99 $13.68 $140.27 Survey Analyst II $52.82 $93.82 $15.85 $162.48 Survey Analyst III $60.57 $107.58 $18.17 $186.33 Survey Manager I $67.27 $119.48 $20.18 $206.94 Survey Manager II $77.75 $138.10 $23.33 $239.17 Survey Manager III $94.64 $168.10 $28.39 $291.13 11/14/2024 4 of 4 Ac P CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/1/2025 11/27/2024 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 rights to the certificate holder in lieu of such endorsement(s). CONT PRODUCER Lockton Companies,LLC NAMEACT 444 W.47th Street,Suite 900 PHONE FAX (A/C.No.Extl: (A/C,No): Kansas City MO 64112-1906 E-MAIL (816)960-9000 ADDRESS: kcasu@lockton.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Zurich American Insurance Company 16535 INSURED DAVID EVANS AND ASSOCIATES,INC. INSURER B:Continental Casualty Company 20443 1397057 2100 S RIVER PARKWAY,SUITE 100 INSURER C:American Guarantee and Liab.Ins.Co. 26247 PORTLAND OR 97201 INSURER D:American Zurich Insurance Company 40142 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 18033384 REVISION NUMBER: XXXXXXX 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY) IMM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY Y N GL09830389 12/1/2024 12/1/2025 EACH OCCURRENCE $ 1,000 000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY X El' LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ �' AUTOMOBILE LIABILITY - y -"N BAP9830390" - - - "12/1/2024 12/1/2025 - COMBINED SINGLE LIMIT $ ---- - __ (Ea accident) 1,000,000 x ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE $ XXXX.XXX AUTOS ONLY AUTOS ONLY (Per accident) $ XXXXXXX UMBRELLA LIAB _ OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE AGGREGATE $ XXXXXXX DED RETENTION$ $ XXXXX.XX WORKERS COMPENSATION PER OTH- N WC9336626 12/1/2024 12/1/2025 STATUTE ER D AND EMPLOYERS'LIABILITY YIN 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 B PROFESSIONAL N N AEH591924704 12/1/2024 12/1/2025 PER CLAIM$2,000,000 LIABILITY ANNUAL AGGREGATE$2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:SPKV.0000.0044.CITY OF SPOKANE VALLEY ON-CALL TRAFFIC ENGINEERING SERVICES.CITY OF SPOKANE IS AN ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY AND AUTO LIABILITY,AND THESE COVERAGES ARE PRIMARY AND NON-CONTRIBUTORY,IF REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 18033384 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF SPOKANE VALLEY ACCORDANCE WITH THE POLICY PROVISIONS. ATTN:RYAN KIPP 10210 E SPRAQUE AVE AUTHORIZED REPRESENTATIV;SPOKANE VALLEY WA 99206 ( 4zre.-4 ©1988 015ORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Miscellaneous Attachment:M503337 Certificate ID: 18033384 Additional Insured — Owners, Lessees Or Contractors — Scheduled Person Or Organization POLICY NO. GLO 9830389 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Location(s) Of Covered Operations Any person or organization you are required to add Any Location where you have agreed, through a written contract, agreement or permit, to provide as an additional insured in a written contract or Additional insured coverage except where such written agreement. Contract or agreement is prohibited by law. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule of this endorsement, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury"caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated in such Schedule. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to"bodily injury"or"property damage"occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms, conditions, provisions and exclusions of this policy remain the same. U-GL-2169-A CW(02/19) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Miscellaneous Attachment:M503356 Certificate ID: 18033384 Additional Insured — Owners, Lessees Or Contractors — Completed Operations POLICY NO. GLO 9830389 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Operations Or Organization(s): Any location or project where you are required to provide Any person or organization you are required to add additional insured status in a written contract or written as an additional insured under a written contract or agreement, except where such contract or agreement is written agreement. prohibited by law. Section II —Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule of this endorsement, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in such Schedule, performed for that additional insured and included in the"products-completed operations hazard". All other terms, conditions, provisions and exclusions of this policy remain the same. U-GL-2168-A CW(02/19) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Miscellaneous Attachment:M503490 Certificate ID: 18033384 POLICY NUMBER: GL09830389 Effective Date: 12/01/2024 - 12/01/2025 Other Insurance Amendment - Primary And ZURICH Non-Contributory This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part 1. The following paragraph is added to the Other Insurance Condition of Section IV - Commercial General Liability Conditions: This insurance is primary insurance to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV - Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or"suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis. All other terms and conditions of this policy remain unchanged. U-GL-1327-B CW Miscellaneous Attachment:M503359 Certificate ID: 18033384 POLICY NUMBER: BAP 9830390 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s)or organization(s)who are "insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. SCHEDULE Name Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS IN A WRITTEI` CONTRACT OR WRITTEN AGREEMENT, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LA1A Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1