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HomeMy WebLinkAbout24-212.01 Inland Asphalt Company - Street & Stormwater Maintenance & Repair ServicesS QCa_n_._-'_e-\-­-' December 19, 2025 Inland Asphalt Company 5111 E Broadway Avenue Spokane, WA 99212 10210 E Sprague Avenue ♦ Spokane Valley WA 99206 Phone: (509) 720-5000 ♦ Fax: (509) 720-5075 ♦ www.spokanevalley.org Email: cityhall@spokanevalley.org Contract No. 24-212.01 Re: Implementation of 2026 option year, Agreement for Street and Stormwater Maintenance and Repair Services, 24-212, executed February 24, 2025 Dear Jared Boucher: The City executed an Agreement for provision of Street and Stormwater Maintenance and Repair Services on February 24, 2025, by and between the City of Spokane Valley, hereinafter "City", and Inland Asphalt Company, hereinafter "Contractor" and jointly referred to as "Parties." The original Agreement states that it was for one year, with three optional one-year terms possible if the parties mutually agree to exercise the options each year. This is the first of three possible option years that can be exercised and runs through December 31, 2026. The City would like to exercise the 2026 option year of the Agreement. The Compensation as outlined in Exhibit A, 2026 to the Agreement, includes the labor and material cost negotiated and shall not exceed $1,500,000. For 2026, the hourly labor costs shall be increased according to the labor rates released by Washington State Labor and Industries on March 1, 2026. The history of the annual renewals, including dollar amounts, is set forth as follows: Original contract amount.........................................$1,500,000 2026 Renewal......................................................$1,500,000 All of the other contract provisions contained in the original Agreement shall remain in place and remain unchanged in exercising this option year. If you are in agreement with exercising the 2026 option year, please sign below to acknowledge the receipt and concurrence to perform the 2026 option year. Please return one copy to the City for execution, along with current insurance information. A fully executed original copy will be mailed to you for your files. CITY OF SPOKANE VALLEY Jo n Hohman, City Manager -2-0 -ZG C, 4 APPROVED AS TO FORM: v,��_ ,if he' Cit-y Attorney Inland -Asphalt Company- - - .,_... ..� II ....Z' ACOR 1 0 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 1/14/2026 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). PRODUCER LibertyMutual Insurance Co. National Insurance East 500 N3rd St, Suite 300 Wausau, WI 54403 CONTACT NAME: Named Insured / CRH O eratin Com an PHONE FAX x A/c No): ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Fire Insurance Company 23035 www.LibertyMutual.com INSURED CPM Development Corporation (120-SPO) dba Inland Asphalt Company 5111 E. Broadway Avenue INSURER B: Liberty Insurance Corporation 42404 INSURERC: INSURERD: INSURER E Spokane WA 99212 INSURER F : CnVFRAnPS CFRTIFICATF NIIMRFR• auna7zoa 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 LTR OF INSURANCE ADDTYPE INSD WVDSUBR POLICY NUMBER POLICY EFF MM DDfYYYY POLICY EXP MM/DD/YYYY LIMITS A �/ COMMERCIALGENERALLIABILITY �/ TB2-C81-004095-115 9/1/2025 9/1/2026 EACH OCCURRENCE $2000000 DAMAGE TO RENTED PREMISES Ea occurrence $300,000 CLAIMS -MADE � OCCUR Primary/Non-Contributory XCU Coverage Included MED EXP (Any one person) $ 50 000 Separation of Insured PERSONAL & ADV INJURY $ 2 00O 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000 000 POLICY � JET 7 LOC $ OTHER: A AUTOMOBILE LIABILITY AS2-C81-004095-125 9/1/2025 9/1/2026 aMNE $2000000 BODILY INJURY (Per person) $ A ANY AUTO ✓ OWNED SCHEDULED AUTOS ONLY AUTOS NON -OWNED AUTOS ONLY AUTOS ONLY AS2-C81-054502-525 Physical Damage Only:HIRED Comprehensive Ded $10,000 9/1/2025 9/1/2026 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident)$ $ Collision Ded $10,000 UMBRELLALIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N OFFICE PRIET ER EXCLUDEDPECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WA7-C8D-004095-025 All except OH, ND, WA, WY WC7-C81-004095-015 W11 MN 9/1/2025 9/1/2025 9/1/2026 9/1/2026 �/ 1 PER STATUTE OERH E.L. EACH ACCIDENT $ 1,000 000 E.L. DISEASE - EA EMPLOYEE $1 O E.L. DISEASE - POLICY LIMIT 1 $ 1 000 000 A Washington Stop Gap Employers Liability Coverage TB2-C81-004095-115 9/1/2025 9/1/2026 BI Each Accident $3,000,000 BI Aggregate Limit $3,000,000 BI Each Employee $3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Spokane Valley is listed as additional insured with regards to the general liability and automobile liability policies, on a primary and non-contributory basis, where required by written contract. 30-day Notice of Cancellation. Waiver of subrogation is included in favor of the additional insured, where required by written contract, and where applicable by law. f`CCTICl/`ATC YAI nCD CAIdCFI I ATInN Clttyy of Spokane Valley 10210 E. Sprague Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Spokane Valley WA 99206 AUTHORIZED REPRESENTATIVE �(�cxL•f G� J n/-tic �. Valerie Reece U lat$tf-LUID AL,UKL1 t.VKrUKAl IVIY. All rlgnis reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I Excl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 1 of 15 AGENCY CUSTOMER ID: 8-004095 LOC #: A R ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Liberty Mutual Insurance Co. National Insurance East ioppment Corporation CbaM Development ompany n (120-SPO) 5111 E. Broadway Avenue POLICY NUMBER Spokane WA 99212 WA7-C8D-004095-025 CARRIER NAIC CODE EFFECTIVE DATE:9/1/2025 Liberty Insurance Corporation 42404 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance (03/16) HOLDER: City of Spokane Valley ADDRESS: 10210 E. Sprague Avenue Spokane Valley WA 99206 Washington WC SIR EW2-68N-054718-665 9/1/2025-9/1-2026 WC: Statutory EL Limit: $1,000,000 SIR: $2,000,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ATTACHMENT 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I Excl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 2 of 15 Policy Number: AS2-C81-004095-125, AS2-C81-054502-525 Issued by: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED - NONCONTRIBUTING This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIERS COVERAGE FORM TRUCKERS 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" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage form. Schedule Name of Person(s) or Organizations(s): Any person or organization where the Named Insured has agreed by written contract to include such person or organization Regarding Designated Contract or Project: Any Each person or organization shown in the Schedule of this endorsement is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. The following is added to the Other Insurance Condition: If you have agreed in a written agreement that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations, and the agreement was executed prior to the "bodily injury" or "property damage", then this insurance will be primary and we will not seek contribution from such insurance. AC 84 23 08 11 © 2010, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I EXCl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 3 of 15 POLICY NUMBER: AS2-C81-004095-125, AS2-C81-054502-525 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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 the endorsement. SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. Premium: $ INCL Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I EXC1:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 4 of 15 POLICY NUMBER AS2-C81-004095-125 COMMERCIAL AUTO CA99481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLLUTION LIABILITY - BROADENED COVERAGE FOR COVERED AUTOS - BUSINESS AUTO AND MOTOR CARRIER COVERAGE FORMS This endorsement modifies insurance provided under the following: 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 the endorsement. A. Covered Autos Liability Coverage is changed as follows: 1. Paragraph a. of the Pollution Exclusion applies only to liability assumed under a contract or agreement. 2. With respect to the coverage afforded by Paragraph A.1. above, Exclusion 13.6. Care, Custody Or Control does not apply. B. Changes In Definitions For the purposes of this endorsement, Paragraph D. of the Definitions Section is replaced by the following: D. "Covered pollution cost or expense" means any cost or expense arising out of: 1. Any request, demand, order or statutory or regulatory requirement that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants'; or "Covered pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": a. Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the "insured" for movement into or onto the covered "auto"; or b. After the "pollutants" or any property in which the "pollutants" are contained are moved from the covered "auto" to the place where they are finally delivered, disposed of or abandoned by the "insured". Paragraphs a. and b. above do not apply to "accidents" that occur away from premises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if: 2. Any claim or "suit" by or on behalf of a (1) The "pollutants" or any property in governmental authority for damages which the "pollutants" are contained because of testing for, monitoring, cleaning are upset, overturned or damaged as up, removing, containing, treating, a result of the maintenance or use of detoxifying or neutralizing, or in any way a covered "auto"; and responding to or assessing the effects of (2) The discharge, dispersal, seepage, "pollutants". migration, release or escape of the "pollutants" is caused directly by such upset, overturn or damage. Premium: INCL CA 99 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO i EXc1:XS OT4 I Erin Celing 1 1/14/2026 6:31:06 AM (CST) i Page 5 of Policy Number: AS2-C81-004095-125, AS2-C81-054502-525, TB2-C81-004095-115 Issued By: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Other Person(s)/ Organization(s): Email Address or mailing address: Number Days Notice: Where required by written contract Where required by written contract 90 A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 01 05 11 © 2011, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I EXCl:XS OT4 i Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 6 of 744 POLICY NUMBER: TB2-C81-004095-115 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section I — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule below.- 1. A separate Designated Construction Project General Aggregate Limit applies to each des- ignated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, ex- cept damages because of "bodily injury' or "property damage" included in the "products - completed operations hazard", and for medi- cal expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Con- struction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Ag- gregate Limit shown in the Declarations nor shall they reduce any other Designated Con- struction Project General Aggregate Limit for any other designated construction project shown in the Schedule below. 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 Decla- rations, such limits will be subject to the appli- cable Designated Construction Project Gen- eral Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section 1 — Coverage A, and for all medical expenses caused by accidents under Section I — Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule below: 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 Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Designated Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is prov- ided, any payments for damages because of "bodily injury' or "property damage" included in the "products -completed operations hazard" will reduce the Products -completed Operations Agg- regate Limit, and not reduce the General Agg- regate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section III — Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I Excl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 7 of 745 SCHEDULE Designated Construction Project(s): All Projects. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 2 of 2 88867396 1 8-004095 1 Interest No. 21227908 1 09.2S-09.26 Standard 10-2 WA Stop Gap Excess AUTO I Excl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 8 of 15 POLICY NUMBER: TB2-C81-004095-115 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, 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 above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 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. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. SCHEDULE Name Of Additional Insured Person(s) Location(s) Of Covered Operations Or Organization(s): Any owner, lessee, or contractor for whom you have Any location listed in such agreement agreed in writing prior to a loss to provide liability insurance Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I Excl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) 1 Page 9 of 15 POLICY NUMBER: TB2-C81-004095-115 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any owner, lessee, or contractor for whom you have agreed in writing prior to a loss to provided liability insurance Any location listed in such agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. 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, 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 the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I Excl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 10 of Policy Number TB2-C81-004095-115 Issued by: Liberty Mutual Fire Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE AMENDMENT — SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Person(s) or Organization(s): Any person or organization for which such coverage is required by written contract prior to a loss If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person(s) or organization(s) shown in the Schedule of this endorsement that qualifies as an additional insured on this Policy, this Policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV — Conditions will not apply. Where the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4. Other Insurance of Section IV — Conditions will apply. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured for the same 'occurrence", claim or "suit". LC 24 20 11 18 © 2018 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 88867396 18-004095 1 Interest No. 21227908 109.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I EXCl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 11 of POLICY NUMBER: TB2-C81-004095-115 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule below. Name Of Person Or Organization: As required by written contract or agreement entered into prior to loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 88867396 18-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I Excl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 12 of 15 NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. Schedule Name of Other Person(s) / Email Address or mailing address: Number Days Notice: Organization(s): Schedule on file with the Schedule on file with the 90 Company Company All other terms and conditions of this policy remain unchanged. Issued by Liberty Insurance Corporation 21814 For attachment to Policy No. WA7-C8D-004095-025 Effective Date Premium $ Issued to CRH Americas, Inc. WC 99 20 75 Ed. 12/01 /2016 © 2016 Liberty Mutual Insurance Page 1 of 1 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I EXCl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 13 of WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Not applicable in Alaska, Kentucky, New Hampshire, New Jersey Schedule Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. Where required by contract or written agreement prior to loss and allowed by law. In the states of Connecticut, Florida, Iowa, Maryland, Nebraska and Oregon, the premium charge is 1% of the total manual premium, subject to a minimum premium of $250 per policy. In the states of Alabama, Arizona, Arkansas, Colorado, Delaware, District of Columbia, Georgia, Idaho, Illinois, Indiana, Kansas, Maine, Michigan, Mississippi, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Vermont and West Virginia, the premium charge is 2% of the total manual premium, subject to a minimum premium of $100 per policy. In the states of New York and Tennessee, the premium charge is 2% of the total manual premium, subject to a minimum premium of $250 per policy. In the state of Virginia, the premium charge is 5% of the total manual premium, subject to a minimum premium of $250 per policy. In the state of Hawaii, the premium charge is $250 and determined as follows: The premium charge for this endorsement is 1 % of the total manual premium, subject to a minimum premium of $250 per policy. In the state of Louisiana, the premium charge is 2% of the total standard premium, subject to a minimum premium of $250 per policy. In the state of Massachusetts, the premium charge is 1 % of the total WC 00 03 13 © 1983 National Council on Compensation Insurance. Page 1 of 2 Ed. 04/01 /1984 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I Excl:XS OT4 I Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 14 of manual premium. Issued by Liberty Insurance Corporation 21814 For attachment to Policy No. WA7-C8D-004095-025 Issued to CRH Americas, Inc. Effective Date WC 00 03 13 © 1983 National Council on Compensation Insurance. Ed. 04/01 /1984 Premium $ Endorsement No. Page 2 of 2 88867396 1 8-004095 1 Interest No. 21227908 1 09.25-09.26 Standard 10-2 WA Stop Gap Excess AUTO I Excl:XS OT4 i Erin Celing 1 1/14/2026 8:31:06 AM (CST) I Page 15 of