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HomeMy WebLinkAboutSeaside Specialty Construction; 2025-04-25; PWM25-3780FACPWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling Cont. No. 4715 Page 1 City Attorney Approved 6/5/24 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT POLICE & FIRE HEADQUARTERS MDF ROOM CEILING; CONT. NO. 4715 This contract is made on the ______________ day of _________________________, 2025 (“Contract”), by the City of Carlsbad, California, a municipal corporation ("City") and Seaside Specialty Construction Inc., a California corporation, whose principal place of business is 7040 Avenida Encinas #104-304, Carlsbad, California, 92011 ("Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, as contained in the Standard Specifications for Public Works Construction “Greenbook,” latest edition and including all errata; Part 1 General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor’s proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carlsbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by Steven Stewart (City Project Manager). PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. PREVAILING WAGE RATES. Any construction, alteration, demolition, repair, and maintenance work, including work performed during design and preconstruction such as inspection and land surveying work, cumulatively exceeding $1,000 and performed under this Contract constitute “public works” under California Labor Code Section 1720 et seq., and are subject to state prevailing wage laws. The general prevailing rate of wages, for each craft or type of worker needed to execute the contract, shall be those as determined by the Director of Industrial Relations pursuant to the Sections 1770, 1773 and 1773.1 of the California Labor Code. Consistent with the requirement of Section 1773.2 of the California Labor code, a current copy of applicable wage rates may be obtained via the internet at: www.dir.ca.gov/dlsr/. Contractor shall not pay less than the said specified prevailing rates of wages to all such workers employed by him or her in the execution of the Contract. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which requires keeping accurate payroll records, verifying and Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E April25th PWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling Cont. No. 4715 Page 2 City Attorney Approved 6/5/24 certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Labor Code Section 1776. DIR REGISTRATION. California Labor Code Section 1725.5 requires the Contractor and any subcontractor or subconsultant performing any public work under this Contract to be currently registered with the California Department of Industrial Relations (‘DIR’), as specified in Labor Code Section 1725.5. Labor Code Section 1771.1 provides that a contractor or subcontractor/subconsultant shall not be qualified to engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Labor Code section 1725.5. Prior to the performance of public work by any subcontractor or subconsultant under this Contract, Contractor must furnish the City with the subcontractor or subconsultant's current DIR registration number. CALIFORNIA AIR RESOURCES BOARD (CARB) ADVANCED CLEAN FLEETS REGULATION. Contractor’s vehicles with a gross vehicle weight rating greater than 8,500 lbs. and light-duty package delivery vehicles operated in California may be subject to the California Air Resources Board (CARB) Advanced Clean Fleets regulations. Such vehicles may therefore be subject to requirements to reduce emissions of air pollutants. For more information, please visit the CARB Advanced Clean Fleets webpage at https://ww2.arb.ca.gov/our-work/programs/advanced-clean-fleets. CALIFORNIA AIR RESOURCES BOARD (CARB) IN-USE OFF-ROAD DIESEL FUELED FLEETS REGULATION. Contractors are required to comply with the requirements of the In-Use Off-Road Diesel-Fueled Fleet regulations, including, without limitation, compliance with Title 13 of the California Code of Regulations section 2449 et seq. throughout the term of the Project. More information about the requirements and Contractor’s required certification is provided in Exhibit C. CONSTRUCTION MANAGEMENT SOFTWARE. Procore Project Management and Collaboration System. This project may utilize the Owner’s Procore (www.procore.com) online project management and document control platform. The intent of utilizing Procore is to reduce cost and schedule risk, improve quality and safety, and maintain a healthy team dynamic by improving information flow, reducing non- productive activities, reducing rework and decreasing turnaround times. The Contractor is required to create a free web-based Procore user account(s) and utilize web-based training / tutorials (as needed) to become familiar with the system. Unless the Engineer approves otherwise, the Contractor shall process all project documents through Procore because this platform will be used to submit, track, distribute and collaborate on project. If unfamiliar or not otherwise trained with Procore, Contractor and applicable team members shall complete a free training certification course located at http://learn.procore.com/procore-certification-subcontractor. The Contractor is responsible for attaining their own Procore support, as needed, either through the online training or reaching out to the Procore support team. It will be the responsibility of the Contractor to regularly check Procore and review updated documents as they are added. There will be no cost to the Contractor for use of Procore. It is recommended that the Contractor provide mobile access for Windows, iOS located at https://apps.apple.com/us/app/procore-construction-management/id374930542 or Android devices located at https://play.google.com/store/apps/details?id=com.procore.activities with the Procore App installed to at least one on-site individual to provide real-time access to current posted drawings, specifications, RFIs, submittals, schedules, change orders, project documents, as well as any deficient observations or punch list items. Providing mobile access will improve communication, efficiency, and productivity for all parties. The use of Procore for project management does not relieve the contractor of any other requirements as may be specified in the contract documents. Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E PWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling Cont. No. 4715 Page 3 City Attorney Approved 6/5/24 FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this Contract and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five (5) years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ___________________________________ Print Name: ____________Steven R. Gough__________ REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers’ Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance written on an “occurrence” basis, including personal & advertising injury, with limits no less than $2,000,000 per occurrence. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. Property damage insurance in an amount of not less than……..$2,000,000 Automobile Liability Insurance in the amount of $2,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the performance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non-scheduled. The automobile insurance certificate must state the coverage is for “any auto” and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that 30 days written notice shall be given to the City prior to such cancellation. Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E PWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling Cont. No. 4715 Page 4 City Attorney Approved 6/5/24 The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS’ COMPENSATION AND EMPLOYER’S LIABILITY. Workers’ Compensation limits as required by the California Labor Code. Workers’ Compensation will not be required if Contractor has no employees and provides, to City’s satisfaction, a declaration stating this. BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Carlsbad Business License for the duration of the contract. INDEMNITY. Contractor agrees to defend (with counsel approved by the City), indemnify, and hold harmless the City and its officers, elected and appointed officials, employees and volunteers from and against all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys’ fees for litigation, arbitration, or other dispute resolution method. THIRD PARTY RIGHTS. Nothing in this Agreement should be construed to give any rights or benefits to any party other than the City and Contractor. JURISDICTION AND VENUE. This Agreement shall be interpreted in accordance with the laws of the State of California. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Contract is San Diego County, California. Start Work: Contractor agrees to start within five (5) working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within ninety (90) working days after receipt of Notice to Proceed. Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E PWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling Cont. No. 4715 Page 5 City Attorney Approved 6/5/24 CONTRACTOR’S INFORMATION. Seaside Specialty Construction Inc. 7040 Avenida Encinas #104-304 (name of Contractor) 631072 (street address) Carlsbad, California, 92011 (Contractor’s license number) C-2 and B / 1/31/2026 (city/state/zip) 760-814-8848 (license class. and exp. date) 1000861462 / 6/30/2025 (telephone no.) Seaside.sg@gmail.com (DIR registration number and exp. date) (e-mail address) AUTHORITY. The individuals executing this Contract and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Contract. [signatures on following page] Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E PWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling Cont. No. 4715 Page 6 City Attorney Approved 6/5/24 CONTRACTOR SEASIDE SPECIALTY CONSTRUCTION INC., a California corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Steven R. Gough, President Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager (print name, title) By: ATTEST: SHERRY FREISINGER, City Clerk (sign here) Kelly Gough, Treasurer By: (print name, title) Faviola Medina, Director of Constituent & Clerk Services If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Contract must be signed by one corporate officer from each of the following two groups: Group A Group B Chairman, President, or Vice-President Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney BY: _____________________________ Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E PWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling Cont. No. 4715 Page 7 City Attorney Approved 6/5/24 EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each subcontractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each subcontractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a subcontractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perform such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion of the work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Type of Work to be Subcontracted Business Name and Address DIR Registration No. & Expiration Date License No., Classification & Expiration Date % of Total Contract Total % Subcontracted: _______________ The Contractor must perform no less than 50% of the work with its own forces. Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E NoneNoneNone None 0 None PWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling Cont. No. 4715 Page 8 City Attorney Approved 6/5/24 EXHIBIT B POLICE & FIRE HEADQUARTERS MDF ROOM CEILING SCOPE of WORK: Contractor to remove and dispose of existing ceiling tile in PFHQ MDF room and install new ceiling tiles (USG #3260 vinyl rock 2x2) into existing ceiling grid, with variable hold down clips. Contractor to also caulk all ceiling penetrations at conduit and other air entry points. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1 Lot 1 Remove existing ceiling tile and grid and Install new ceiling grid and tiles (USG #3260 vinyl rock 2x2 lay- in) with variable hold-down clips and caulk all ceiling penetrations $6,480 TOTAL $6,480 Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E PWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling Cont. No. 4715 Page 9 City Attorney Approved 6/5/24 EXHIBIT C In-Use Off-Road Diesel-Fueled Fleet Regulation Requirements CARB implemented amendments to the In-Use Off-Road Diesel Fueled Fleets Regulations that apply broadly to all self-propelled off-road diesel vehicles 25 horsepower or greater and other forms of equipment used in California. More information about the requirements can be found at https://ww2.arb.ca.gov/our-work/programs/use-road-diesel-fueled-fleets-regulation Contractors are required to comply with the requirements of the In-Use Off-Road Diesel-Fueled Fleet regulations, including, without limitation, compliance with Title 13 of the California Code of Regulations section 2449 et seq. throughout the term of the Project. The City is a “Public Works Awarding Body,” as that term is defined under Title 13 California Code of Regulations Section 2449(c)(46). Accordingly, the Contractor must submit, with their pre-award contract documents, valid Certificates of Reported Compliance (CRC) for the Contractor’s fleet, and for the fleets of any listed subcontractors (including any applicable leased equipment or vehicles). Failure to provide a valid CRC, will limit the city’s ability to proceed with awarding this Contract. Contractor has an on-going obligation for term of this Agreement to provide copies of Contractor’s, as well as all listed subcontractors, most recent CRC issued by CARB. Throughout the Project, and for three (3) years thereafter, Contractor shall make available for inspection and copying any and all documents or information associated with Contractor’s and subcontractors’ fleet including, without limitation, CRC, fuel/refueling records, maintenance records, emissions records, and any other information the Contractor is required to produce, keep or maintain pursuant to the Regulation upon two (2) calendar days’ notice from the City. Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E PWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling Cont. No. 4715 Page 10 City Attorney Approved 6/5/24 EXHIBIT C (CONT.) IN-USE OFF-ROAD DIESEL-FUELED FLEET REGULATION CERTIFICATION Contractor hereby acknowledges that they have reviewed the CARB’s policies, rules and regulations and are familiar with the requirements of In-Use Off-Road Diesel-Fueled Fleet Regulation. Contractor hereby certifies, subject to the penalty of perjury, that the option checked below relating to the Contractor’s fleet, and/or that of their subcontractor(s) (“Fleet”) is true and correct: ☐ The Fleet is subject to the requirements of the Regulation, and the appropriate Certificate(s) of Reported Compliance have been attached hereto. ☐ The Fleet is exempt from the Regulation under Section 2449.1(f)(2), and a signed description of the subject vehicles, and reasoning for exemption has been attached hereto. ☐ Contractor and/or their subcontractor is unable to procure R99 or R100 renewable diesel fuel as defined in the Regulation pursuant to Section 2449.1(f)(3).Contractor shall keep detailed records describing the normal refueling methods, their attempts to procure renewable diesel fuel and proof that shows they were not able to procure renewable diesel (i.e., third party correspondence or vendor bids). ☐ The Fleet is exempt from the requirements of the Regulation pursuant to Section 2449(i)(4) because this Project has been deemed an “emergency”, as that term is defined in Section 2449(c)(18). Contractor shall only operate the exempted vehicles in the emergency situation and records of the exempted vehicles must be maintained, pursuant to Section 2449(i)(4). ☐ The Fleet does not fall under the Regulation or are otherwise exempt and a detailed reasoning is attached to this certification. Name of Contractor: Seaside Specialty Construction Inc. Signature: Name: Steven R. Gough Title: President Date: Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E 4/17/2025 X SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 4/21/2025 Alta Vista Insurance Agency PO Box 1480 Vista CA 92085 Richelle Dela Cruz (888) 724-2124 (760) 630-1597 richelle@aviains.com Seaside Specialty Construction Inc 7040 Avenida Encinas Ste 104-304 Carlsbad CA 92011 OHIO SECURITY INS CO 24082 CALIFORNIA AUTOMOBILE INS CO 38342 AMERICAN FIRE & CAS CO 24066 MARKEL INS CO 38970F A 8 8 8 Y Y BKS62015549 10/04/2024 10/04/2025 1,000,000 500,000 15,000 1,000,000 2,000,000 2,000,000 B 8 8 8 Y Y BA040000012204 01/31/2025 01/31/2026 1,000,000 C 8 8 Y Y ESA62015549 10/04/2024 10/04/2025 1,000,000 1,000,000 D Y Y MWC0140236-07 01/01/2025 01/01/2026 8 1,000,000 1,000,000 1,000,000 CERTIFICATE HOLDER IS LISTED AS ADDITONAL INSURED. Blanket Endorsements attached Forms CG8583, CG8810, CG8860, CG8870, MWC140005, MCA85100817. Project Name: PWM25-3780FAC Police & Fire Headquarters MDF Room Ceiling CITY OF CARLSBAD/CMWD C/O EXIGIS INSURANCE COMPLIANCE SERVICES P.O BOX 947 MURRIETA, CA 92564 Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E ACORD® I ~ I I □ - - ~ □ □ - ------ -H I I I I I □ I POLICYNUMBER: BKS62015549 Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Iii 'I COMMERCtA.L GENEJRAI. l!.!IABIUT¥ CG l5 &3 04 113 THIS, ENDORSEMENT CHANGES THE POLICY. IPliEASEREAD IT CAREFIIJLILY. BLANKET ADD:IJIONAL INSUIREID 1CONTiRACT01RS -IPRODUCTSICOMPLETED1 OPEIRA Tl:ONS This endorsement modifies Insurance P,QYlcted under the following COMME~CIAL GENERAL Llil\BILITY COVE~AGE PART A. Paragraph 2. ur,der :S-Oct>lon U • Who II An Insured Is amended to Include as ao lns1JJ,edl any person or or,ganlzatlon whom you have agreed lo add as an addlllooal Insured In a wl'iuen contrac1 or written agreemeflt. Such person or Oifilanl:i:allon s an additional risured but only w,1.1'1 respect to llablhty ro, ==: Rbodlly lnjuzy" or "pr(.lperty damage•: ~ 1. Cau5,ei;I by •your work;" performed ror th@t aoa1,1i:mal 5,ured that b 1he 5,ubject of the wri1ten contract Qr wr11ten ,egr,eemen • and 2. Included in the •products-completed opera1ion$ ll!;lzard". Howe,..er: 1) The lnstlrance afforded to sucfl adcf~oonal Insured only al'Jl)lles lo tti.e e11.1ent permitted by law; and bl U coveriage prQvicfed to 1ihe additional ir15,ured is required by a cootrac~ or agreement, ~he in5,urence 1;1ffQrc:led 10 51,N;lh Filddi1ion1;1I in$ured 'MIi not be b«.;11;1.der lh~n 1hpl Yttilch yo1,1 ere reguire-o by the concra<:1 or egreement 10 prQvicle ror 5,uch 9d(.[rtion81 insur,e(;J The insurance P(()Vlded by 'ltlls endorsement appilles OP!y 1r the wrine.fl contraci or written agreement signed prior to the 'bodily l111)ury" or "property damage•. We lla'w'e no duty to defend an additional Insured under th s endorsement ur11il we receNe written notice of a "s1.111• b)' the addltional nsured as reQulred in Paragrapl') b. of Col'ldltloo 2. Out H In The· Ev-en1 Of Ocieurref'!ee, ,offerue, Cl:alm Or Sult under Se;eU011 IV • Coml'l'!erelal 1Gef!en1 Liability Conditions. B. Wi1h respect to 1he ln5,1,.1r3noe, provided by this endor~ement, 1he rQIJowing 1;1re aidded to Paragraph 2. E>fel U$lons under SeeUon I • 1Cov,era9e A. -Bodily lf\lury An-d Property Damage Uab Illy: This lnsuml'lOO does not appl)' to 1-i eodll)' lnjvry" or "property dt1ma~• lht1t occurs prior ,o you 00mmenclng ,op,ert111ions al the location w-nere sucl't 8bodlly 11Jurf or "'prOl)erly da1)11a~• occurs.. 2. i Bodily injury' or "property damage" ari~ingi out of the renr;;tering of. Qr the fail re to render, en:,, prQfes$ional architectural, engineerin9 or surveying servloe5i includ.ng: 1. Tbe prepanrig, approving or {a,luire to prepare or approve, maps, shop drawings, opinions, reports, su.vey.s, field orders, mange orders or drawing and speo.ficaoons, and b, SupiervlstJfY, • 11spedi()11, 8ri;:'1rtP.C'uml or eoglnei,!119 ~otl'Y'lttes, ~ ::1:013 Llbot:ty Mut.l!llll l~ncg "1dl.ldoo ctl~JJililhlud ITiiiJlona! ar !11'1:.IYl'illl(;e ~ Offi~. ~. with ,~ pu11T1Q;&i0fl Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Iii 'I I C. Wdh respect fo the iR$1,1rance afforded by this end0f'l5ement, exclt1$ion I. Damage To, Your Work of P,1;1ragraph :2. Exch11slons Lfnder Sectllon I • Covil!l'Sge A -Bod~ly Injury And Property Damage Llablnty rs replaced by the Collowin~: t. Diu»11190 To Your Work "Property <l8rnag-e• to 'your wocik." allisingI out of 1, or an)' 1)811 or II and ·ncluded In lhe 8JProdUQS· con,.plele-d qperations. h~rdl'. D. With ~ect tQ the im;>1,.1rance efforded to these additional in:surec:ts., the fQlh:;.,wing i51 ec;k!ed io Sie-ellon II • Limits of Insurance: If covel'8ge provided to the addit!onal Insured is reQulred by a contract or agreement, t11e mQS• we will £)11;1)' on behailf or the sck:lltlonal ins.ured Is •he amo,m• of insurance: 1. ~eQu 1ed by oontract or agreemen or 2. Available under the applicable Limits of ln,urenoe shown ·n 1he Dedare1ion. whichever ts less. Tn s endorsement shall not Increase 1.he a~plicable Llml,s of Insurance-shown In the Oedaratto ns. E. With respect to Uie ins.urance afforded by this endorsement, Section IV -Commerc:lal Generali Ll.ab"IIIW CondtUons. Is amended as follows: 1. Ttte folowing is tldi;led to P~Ul'lgl,l;lr;tl 2'.. Dutl~ !1'1 T~ Evenl Of OeC:Ul'lr"eMQe, O~nse. Cltltms Qr s u,t: An ad'dltlonal lnstJred ullde1 1hls end'orsemem wlll as soon as practJcable: ,. GiYe written no,tice of en •~rrenoeN Qr en offense lht)t ffl.l'I~ res , It in 1;11 deim or "sun" 1,mder lhis. insurenoe 10 us; b. Tender the defense an(J Indemnity or any claim or •su t" to a insurers wt,om also h8'M'e ill15;urance avallabfe to-the add 1iona:I insured; and c. Agiree •o mak,e ,aYallable any othet insurance whlCh the adcltlonal lnsUJed ha:s lo, a loss we cover under •has Coverage Part. d. We h1;1ve no d\Jty to defend or indemnify en ,1;1dditional ins.1,1re,r;:! under thi!;: encto~emenl 1,.1n1i we receive written notice of a "suir by ~e i!Jdd[tionel "n!;:ured. 2. Paragraph 4. of kction IV -ConuMrel I Gcncffl'I Llabilit)' Conclltlons Is amellded as follows-: b. The follo•.Ning is addei:I to Peregreph ai. P1 ma_ry !nsur,nc:e: If an ood tion81 lnsuroo's pOllcy has an Odrier lns1.m.1r,i.oo p~n making Its policy excess, and ~ou ha't'e· ~reed In a written een'lraci. or 'IWinen agreement 10 PfO't'lde the ood oonal insured coverage on a iprlmary and nonconmbutory basis. lhls pdllcy shall be prlma,y moo we wall not seat: cootrlbu1'0n from the ood1(1(:ln81 lns1Jred's policy ror damages we cover. The following Is addedJ to Paragraph b. Ex0ess. f'f!s,ul'anee: Vl.l'hen e written 00n.1ract Qr ,,muen ooreement, other 1han ai premise!;: lease. le-Climes. renlal conw1;1ct ~ agreement. an equipment rental or lea,e QOnlract or agreement~ or peirmit i:ssved by 1;1 s.t.ate or p,oli1ic1;1I s.ubdMsii;m between YQU and @TI 1_;1r;lditionsl iruwred does, n.ot req1,,1ire lhtS-insuranoe to be primery or p1imary andl nQn-oontribu~ory. thi!;: ms.urence is. exces.s oYer eny olher ln5,\Jranoe for which 1ne additional ins.ured i5 cles.lgneted as. a Named lnsur,edl. Rega 'dles.s of the written agreement between you and an add11lona.l Insured, this Insur- ance· l:s eiccess over any other llllStJra.rtoe wheltleir primary, excess, con1lngoot or on any other ba for which the addltiOool lnstJred hos been added as an addltlonal nsured on other pohdes. i:J 201 J Li bctify M utu.d 11'1$ ur.1nc;; lni;fudet; CQIJl)'Jlghlvd rn~l"Orial ol lm:,ulWl(lU, S~ Offi~, In,;;,, with iet; Pormi&sion , Page• 2 of :2 POLICYNUMBER: BKS62015549 Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E COMMERCIAL GEt4Ei!lAl UA8lUiY CG a810 04 13 -' THIS, ENOORSEME;NT CHANGES THE POLICY. IPl.!EASEREAO IT CAREFIIJU.Y. COMMERCIAL 1G1EN ERAJL LIABHLlrrv EXTENSION This end015iement modifies l~rence p,ovldled under the following: COMMERCIAL GENERAL UIABfLITY COVERAGE PART INDEX , S;t.lBJEC:T i == NON-OWNED AJRORAFT == NON-OWNED WATE~C~FT ~ Ill :== PROPEIRTY DAMAGE LIA81LlrTY • ELEVATORS --!il Iii 'I I -EXTIENDED DA!M1AGE TO PROPERTY RENTED TO YOU (Tenant's. P,-operty Damage, MEDICAL PAYMENTS EXiENS'ION EXTENSIOM OF SIJPPLEMENTA1RY PA'fft1E:NTS -COVBRAGES A A/ND B ADDlrT10NAL INSIJIREO.S • BY CONTRACT, AGREEMENT OR: PERMlT PRIMA.RY AND NON.CONTIFUBUTORY-ADDfflONAL INSIIJFiiEO EXTEN-SlON ADDlrTIONAL [N$l!IREOS • EXT!ENIDED PROTECT10N OJ: YOUR "LIMlil'S, OF [NSI/J RANCE"' WHO IS AN IN.SUlilED -LNCIDENiAL MEDICAL ERRORSt~RACTtC!E AND WHO Ii$ A!N IN<SURED -F'ELLiOW EMPU),YEE EXTENSION • MANA1GIEMEN1T EMPLOYEES NEWL '{ FORMED OR ADDmONALll. Y AOQUIRIED EN/Tlii ES FAILURE TO DISCI.OSE HAZARDS AND PRtOR OCCURRENCES l(NOWLEOGE 10F OCCUFtFtENCE. OFFEiNSE, CLAlr., OR SUIT LIB1ERA!UZATIO:N CLAIIJ-SE BODILY INJURY REDEFINED EXT1ENDED PRO'PERTY DAMAGE WAIVER OFT1RANSFE;R: Of fUGHTS Of RECOVERY AGAJNST OTlHERS f ,Q, US • WHEN REQUIRED IM A 1CONTRACT OR AGREEMENT WITH YOU ~ 2013 Libeti\y Mutual IJ'l5uranc;G CG, 18110 04 13 o,;::lud0& COPY11Dhted material o( im;,vreooe Servkle& Offitlll, Inc •. willl s PE1rmisslon, 2 2 5 6 6 1 1 7 7 7 Pago 1 O'r a Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Iii 'I W•th r~pect 10 coverage afforded b)' !his endorseineni ttrie· provisions of the po&iey appfy 1.1111!~s modffted by lhe endorsement. A. NON-OWN ED AJR,CRAFf Unde'I Paf@l9ri!Ph .2. Ex.clus Ol'lil Qf Sei::Uon I • Covera!JO A • Bodlty llnJu:ry And Property Dam!!lge Ll:aiblllcy, e:1Cdu5,ion 19. Alrel"aft, A1uto Or· Wate~raf1 does not appl)' to an .aircraft provided: 1-It Is l'l!Ot o,vmedl by any insured; 2. It Is l'lired, chartered or looned wttn a Ira ned paid c,-ew; 3. The pillot In oommand hokls a eurrentl)' effecilve oertlficale, 15,sued by the duty constituted! aU1hori1)' ol •he United States of Ameriaii or Canada, desi9na1ing her or nlm a commercial Qr airline pilot; and 4. It Is not being used to carry pe,.sons or property for a charge. HoweYe,, lhe k11surance afforded by this provlslOl'I does not apply •f there Is available to lhe Insured othef valid and cdllectlble insurance, whether primary, eJt"..res:s. (04'1er ttrian Insurance ,,,.-ouen 10 apply speclflcalty lf1 ei«:ess of this policy), con1Jrigent or on an~ othe, basis, lhat would also apply to the loss covered uooef lnis provision. B. NON-OWNED WATE~CFtAFT Under Paragraph 2~ Exeluslons of Se-etcm ! -1Co-verrage A . 8odlly l!'\JUll'Y And Property D!!lmage U1blllly, SubJ;iaragrapti (2~ of e:x-ci~n g. Alrer,aft. Auto Or w.atercn.ft Is replaced by I.he rollbwlng: This exc!uslon does not a~I)' to; ,2.) A walerc,-aft )'OO do nol own that is: {a} Less than 52 feet long; and (b) Not bE12ng1 used 10 ca1ry persons or propett)' ror a charge. C. PROPERTY DAMAG£ LIASILITY • ELEVATORS 1. Under Paragraph 2, E.w:<-1!.lslons of Se~lon I -Cover-ago A • Bodily Injury And Property Dlim.ag Ll1'bll- 1r;, Subpera9raphs (3), (-411 and (6)1 or ei«:fuslon .I. O magei iT o Pirope-rty do not WPlv If such ~p,.roperiy damage" r~ults from lhe use of ele-vat.ors. For lhe P'Ul"POSe of 1hls provision, ,elevators do not Include vehlc!e lifts, Vehicle lifts are lifts or hoists used in automobile service or repair opemtiQns. 2. The following Is added to Section l,V • Comme!"Clal Gef'!eral Ll1bJllty CondlOO<f'!s-, Condltkin 4. Oillhe-r !!'!Sl.!fflflC-., ~ragraph ti,. Excess !MU!"a:!'!CO: The insurance effoirded by lh.r,. pro-vision ot this endorsement is eicce5,5, 011,er ,1;1ny property insur.ance, whether prim:ary, ellioe5os, contingent or on any 01her basis. D. EXT1ENDED DAMAGE TO PROPiERTY RENTED TO YOU (T'.,na:nt''5 Prol',)OIJ1Y Damage) tr Oart139e To Piremi.ses Rented To You Is 001 o1herwtse e:x-ciudoo frOIJI this Coverage Pan: 1. Uooer Panign1ph 2~ Exclusions of Sec:Uon1 1-Cover,age A• IBodily Injury ancl Propcny Damag Ll.ibllity: a. The founh from lhe last paragr-aph ol eicduslon J. D!!lnta~ To Property is Jeplaced by lhe follow- ing; Paragraphs 11), (3) and (4) or tnis ex.cl slon do not appl)' to 'properly damage" (°'her than darm39e by fire, hghlning, e:,i;plosion, smoke, 04I' leakage from an aulooiatk fire protecl)on S)'stern), to: (11 Premises rented 10 yoo fOf □ period of 1 0( rewer consecutive days; 01 (H) Contents that you rent or lease· as part of a premises rental or lease 8greement for a period of more th.an 7 days. P1;1ragrapbs (1 )~ {3) 1;1nd (41) of this exdluslon do not apply lo "J)ropert)' d1;1mage• to a:intents ol prems.es rented to you for a period of 7 or fewer consecutive days, A ~perale li1111i1 of insv1a110e ,1;1pplie3 to this coven;ige ;ps deSO"ibed in Seictlon 111 • Llmll,, of ll'li$Ul"an~. ~ 2013 Libeti\y Mutual IJ'l5uranc;G CG, 18110 04 13 o,;::lud0& COPY11Dhted material o( lm;.vreooe Servkle& Offitlll, Inc •. willl s PE1rmisslon, Pago 2 O'r a Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E ~ Iii 'I ::: b. The last para~r,aph of subsection 2~ Exc:tus.lons s replaced b)' the following: E.:«tusl01T1s e. ,mough n. do not a,pply to damage by fire, llgh'tnln9, e,,:ploslon, smoke or !leakage· from aulomatle fire protection systems to prem ses wh le rented to you or temporar,I)' occupied by you with pemiisslon of the owner, A separate ll'Tllt of Insurance appl-es lo Damage To ~el!flises Rented To Yoo as des.en.bed In Se-elion m -llmils, 01' lns-ur1111co. 2-Paregrt11ph e. 1.!nder S.cdo!'l1 UI -Um!w Of ln.s.u:re.11ce is reP,aced by !he following: 6,. Subject to Parag1aph IS. above, the Oamege To Premi~es Rented n, You Lim ii i:s the mo:sl we im pa)' under OJverage A for damages because of "pr,operfy damage• to: ,~ Any one premise: 11) While rented lo you; or 12) While rented to :,oou or temporarily occuvled by you w.th perm sslon or u,e own et" r or damage by fire, llghll!llng, e:t:plbslon, s11111oke or leakage from automatic-pr(ltecilon sys- tems; or b. Contents thal vou renl or lease as part of a premi.:se~ rental or lease ag1eemenl. 3. As. regards coverage provided by ·this provision D. EXTENDEO DAMAGE TO PROPERTY RENTIED T01 YOU (Tenant's. Piroperty D1:111nage~ -Paf'i!gf'i!ph 9.;t!L. or Defilnltlons i~ l"eiPI~ with the folfQwing: (La. A contr,eic;t for ,1:1 le~s.e ot premises. Howeve.r, that portion of 'the oontr,1:1c;t fQr ,1:1 lease Qf premise., th-at ndemnifie., ,1:1ny pet"SQn or organiz800n fQr di!Jm1::1ge by llre, ligh'lning, explosion. ~moke, or le1::1kege from :a1,1tom:a1ic llre protection s.ys.1e1n5, to premises. while rented 10 you or tempor1;1r:iy QOCIJlpied by you wiJh ~he permission of the owner, or CQr dam1;1ge to oontent:e of sudi premises th-at are inolu{led in your premises. rental 0-1 lee~e egreement, is not an 6ins1JJed oontll!<::16 • E. MEOICA PAYMENTS EXTENS1ON Ir Covc:r39 C IM dleail Paymmts. Is not Olherwlse e:t:oluded, 1fl,e Med1CBJI Pa)'TJlencs provided by this policy are amended as follows: llndet" Paragraph 1, l:nsur ng A,g e~mont or Section 1-Coverage C • Ml die.al Payments., Subparagraph ,b) of Part119rt11ph <1. Is replaced by 'ltle following: ,bl The e:t:penses are curred and repOfted 'Mlhln lhree yea{s or the date or the aocldenl: and F. EX11ENSIQN Q:F SUPPLEMENTA1RY PAYMENTS, .,COVE,RAGES A AND B 1. Under Sl!pplement.Pry P,ymenw • C4)verr111g,H A and B, Per,eigr,eiph 1.1). is repleoed by ~he fO!llowing: b. Up lo Sl,000 tor cost of ball bonds re(lu red because of accldenls or ·11afflc law vjolatiions arising ouc or the use· of an)' vehicle to which the Sodll)' Injury Llablllly Coverage applies. We db not have lo fumlsh these bonds. 2. Paragraph 1.d~ Is replaced b~ the· roltowlng: d. All reasons le eli;penses lnCUTred by the nsured at ot1r reQuest to aS'SiSt 1JS In !tie nves•Jgetion or defense of the clafm or •su,t", lrdud .ng actual '°" of earn ngs up to SS001 a da)' beca se or lime off from work G. ADDITIONAL INS.UREJO!S • BY CONTR'ACl', AGRElEMENT OR PE;RMIT 1. Paragrt11ph 2. under Secllon II • Who l,s. Ani tns.ure<il is amended to include 1,:13. an insured any person or org;jJJnizstion whom YQU haove 1;1greed to il'dd ~ en ecklilionel in~red in e written oonlrlld, written agreement or permit Such person or organizallon is an additional insured but only with ~pect to 118bi ity for "bodily injury''. "prof1er1)' d3ma~• or "pell'Sons and advertl5Jn9 "njurf CTi! !:K!d n v,tu;1fe or~ part by: ;,. Your acts Of 0mlsslons, or the acts or ~ns of ft'w;i~e actin9 on your behalf, in the performa~ of your on going opell!\ions for the addioonal Insured 'that are the s.ubtect of ttie written oontll"ttct or written agreement prowded that the •tiodily inlury'" or jpropertv damage" occurs, or the "pell'- sorn:al tind adverUstngi injury" is oomnwtted, subsequen1 to the sigTiing of such written contract or wrii11en agreement; or ~ 2013 Libeti\y Mutual IJ'l5uranc;G CG, 18110 04 13 o,;::lud0& COPY11Dhted material o( lm;.vreooe Servkle& Offitlll, Inc •. willl s PE1rmisslon, Pago l O'r a Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Iii 'I b. Premises or facl!Jties rented b:,i you or used b:,i you; or c:. The maintenance. Cll)eirattan or use by YQU Qf ,e(tl.lipment rentetJ or lea~ed t.o you by iUCh person or organization; or d. Operelioni performed by YQU or on your be~lr f0r whloh l he s:l:.Eite Qr PQli_1ie8'1 sulx;livi$il;m h~ issued a permi1 subject to ~he 'following additional proYisions: f1} Thi$ irliurance does nol apply 10 •bodilv injury", •property damage•, 01 "personal end ad- 'lrertis.ing inj\!lr:,i• ,arising oul of the operations performed for lhe 84s1e or politicel subdivision; f:2') This Insurance does nol apply lo •bodily Injury" Qr "property damage~ lnduded with n the 8COrn~ted operal10ns hazar-d8, f31 !nsurnnoe applies to premises )'OU own, rent, or control but OOII)' "Moth resl)ect to tne fo!lowlng hazarcs: ja) The exis:tence, ~intenanoe, repa.-ir, oons1_ruc1ion. erec1ion. or iremr;wi-1 of advertiilng signs, awn ng:s. canopies, cellar entrtmce:s, 0081 holes, ,;frlv,ewaiys,. manholes, marquees, boist away Qpenings, sld'ew1::1I vaults, s.11ree1 baMers., or cfleoorattans and Similar e;icp,o. sures; or jb) 1he consfln.!ction, erection, or removal c>f elevatQrs; or jc) The owne'1$hip, main,eri1:1nce, or use Qf any elevators c;QVered try lhi~ insurance. However: 1. The nsurance afforoed to such addltlonal nsured ool)' a1>phes 10 the e11.1ent permlued by law; and 2. If coverage pro1Jlded lo lhe addlllooal nsured reQuired by 31 contrnd Of agreemenl, the Insur- ance afforded to such addlliooal Insured wll nol bie twoader than that which y-ou are requ .red by ll'1e conlract or agreement ro prO\llde for such addltioool Insured. Wl1h respect to Paragrnplh 1.a, abo,..e, a per$on's or organlza11on's stalus as an additional Insured 1Jnder this endorsement ends ,.yhen; 11) All work, inciudl'}9 materials, parts or eQU pment furnished In OQnnection with slJ!Ch work:, on lhe i:xojeet (ocher than service, malntenanoe Qr repeirs) to be perfomied by or on behalf of the add1fi0nal lnsurecf(s) at the location of 1he OOYered operations ~s been oompleted: or f2} That por'lion of 'yoiur wi;;inc■ oot of Which the injury or dam1;1ge arl$eS h1;1s beefl pu1 10 It$ intended) U$e' by eny pe~on Qr orgeni~a1ion o'lher then 11no1her QQnlr@Qto.r or suboon1rar;tor en!J',8ged in performing opera1ion1;1 for s principel a-s a part of the same l)l'Qject. Wth respect to Pamgraph 1,b. ab<r'le, a per.son's or orgian~auon's slalus as an addltloool ll')St!red under lh endorsement ends when the r wr1lten oon1raet or written agreement Yiiith you fClf such prem es or faclhtles ends. With respects to Paragraph 1.c. aboYe, lh nsurance dioes not apply to any •oowrrenoe" which takes m,lace after the ec::i pmEmt rent.al 0tr lea,e agreement ~s e~pired or you have returned such ecr lpmenl co the !es:sor. Tlle lnS,Yra.noe pro1Jided b,y tnis enciorsernent applies only If lhe 111111Uen conlra,,ot or written agreemenl Is ~ned prior lo lhe ebodlly nJ r/ Qr "l)rQl>er1)' d&ma~•. We h:i\11/e no ,;futy lo defend an 8ddit1onal insured under Chi.s, endOl'$ement until we receive written lllOtioe of a •su t" b)' 1he, add ilion8'1 Insured as reguifetJ in Perag1aph b. of Condttion 2. Duties In the Even1 Of Oceu:r,,en~-0, Offe-nM, Olaim Or Su I under Se-cUo:TI IV • Co:mm~rel{III Gener11I LI11bll llY Condl- Uo-ns, ~ 2013 Libeti\y Mutual IJ'l5uranc;G CG, 18110 04 13 o,;::lud0& COPY11Dhted material o( lm;.vreooe Servkle& Offitlll, Inc •. willl s PE1rmisslon, Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E ~ Iii 'I 2. Witn respect lo the in5,urance tpro'Ylded b)' 1hi5, endor5emen~, (h_e following are a(Jded to Paragraph 2. Exeh.Js.lons under Seellon I • Cover.age A • 8odl ly lr,Jury And Property Damage U,bll~l.y: This insUJar-.ce does not ap,i;il)' to: l\'I. "Bodily injlJJY" or •property (11;1~e· erisiDQ fr,om the, sole negligence of the 1;1c;ldi1ion1;11 insured. b. "Bodily injwy" or "pr-oiperty cllilmage," 1h31 occurs prior to you c,ommE!f)cing oper1;1th;ms 8t ~he loe1;1tion Yitiere such •bodily iniury11 or jpropen:y clamege" occurs. c:. "Bodily In ury•, iprqpeny damage• or "personal and adYeflJsi;rig njurf arisin9 out of the render- Ing of, or the fallure to ref'ldei-, any professl0'11al arch tectur:al, en9lneerifl9 01 SU1Ve)'ln9 sen,,fces, Including: 11) The preperl~. approYlng, or fa ling to prepare or approve, maps, sh!Jll dra'htngs, openlons, reports, surveys, field Ofders, driange Ofders or drawings and specifiarll!Qns; or (2'") Supervisory, nspectlon. arch tectuuil or engloee.-lng actMtles. This e>rcl\Jslon aoolles even if the claims @98 nst an)' Insured allege negligence or o~er wrongdoing n •he 5,upeNlslon, hiring, employment, training or rnOf!lltonng of others. by lhat 5,ured. if the •occur- rence■ Yd!ilch ClllUSed 1he 'lbodil)' inj~ry• or "prQC)ert)' dama.ge", or the offense which ClllUSed (h_e "per,sonel and t'M:!Yertising IM4ury•, lrwolved the rend'ering or, or the feilure to render, an)' proresslonal archlledural, eng neeril'lg or surveying services. cl. "Bodily lr!Jury" or •property damage• occt1mng after. 11) All worl<, lncludlng materials, parts or eciu pment fumlshed In oonnectlon with sudl work, on •he p,ojeot (other than se:rvioe, malntenanoe or repair;:) to be performed by or on behalf of the ooditional lnsu:r,ecf(s) at the l~tlon of the OOYeJed operations has been oornpleted; or (2') Thal poroon of "your work" out of which lhe lfljui:y or damage arises has been put 10 Its lritendedl use· by any person or orgonl,zalion ott,,er tha" anoltler eon,ractor or suboontractor engoged In performing operations fOf a pnnclpial as a part of the same projee e. Any person or organlii:nlon specaficall)' deslgl'\Elted a.s an additlona nsured for ongob'tg Ol)eratlons by a separate AOOlilONAL IN.SUl!'(ED .iOWNE~S, LESSEES Of:t CO:Nl'R_A.CTORS endorsement Is~ sued by us. and rnad'e a parl of lh policy. :,. With respect lo the lflsull'8nce afforded to ~se add!oonal lnsweds, lhe follow.ng IS added to Smlon Ill • l!.Jlmlts Of ln.sumneo: If coverage proYlded to the addltlonal Insured Is reQulred t;J.y a contract or agreement. ·!he most we ~ Pl3)' on beha1f of the acklltlonal insured Is lhe arn'".ml of ln:suranoe; a. Required by the contrad 01 agreemeflt; or b. Available under the aw;illcable-Limits of lnstJranoe shQWll In the Oectareuons; wblehe\l~r Is less. This endorsement shall not Increase-the applicable Limits of Insurance-shown In the Oedaratio '15. H. PAJMARY AND NONA:ONT1RJBUTOR¥ AO:OITtONAL INSURED EXTENS10N This prO\llslon applles to any [Person or 019anlzall0!fl who Qua!tfles as an adcf r!Jonal lnstJreo under any form or endorsement vnder lihls [Policy. Cond oon ◄• 0th r lnc11.1.ra:n:c:o of SECTION 0/ -,ooMMERCIAIL G1ENERAI!. LIABILlfTY CON Dl TiONS Is amend- ed as r ollows: 1. in,e following Is added to F='aragraph 11. Prlmary lnsur1nco: If an addlt onal nsured s poUcy has an Other Insurance pfOVJSlon maki ngi Its r,olley excess, and ~u ba'<'e agreed In a wr,nefl contract or written agreemenl. to p,o'<'lde lhe addlllonal nsurec coverage on a prlm3TY d nolllCOnlrlbutory biasls, this pot.icy sha be pr mary and we wl not seek eonlrlbu•Joo ·rr-om lhe addltloMI lnst1re<1's poky for damages we cover. ~ 2013 Libeti\)t Mutual IJ'l5uranc;G CG, 18110 04 13 o,;::lud0& COPY11Dhted material o( im;,vreooe Servkle& Offitlll, Inc .. willl s PE1rmisslon, Pago s O'r a Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Iii 'I Whan a written ClOf'llract Off wrilten agreement, other than a premises. lease, facilitias rental c:onlrad or agreement, an equipment r,ental or leas.e oontract or agreement, or permit is.3ued b:,, a st.ate or political euhdivi.sfon between you and en additional ins.ured ooes not require ittis. ins.urance to be primary or prim1;11y and non-,01;m1n"butD1Y, lhis in!>uirance is axcess over any other insurance fOI whil;tl the addi- lional ins.ured ie deeign1;1ted a51 a N(llmed I n5,ured. Regardles.s ,of the written 39reemen1 between y,ou and an acklltlonal Insured, lhis insurance ls e,coess over any it1ther lns1,1nmoe whether primary, excess, contingent or Qn any other basis for whdl ihe ood1tfona:I lnsu,ed has bee'fl added a.-s an addi1!onat insured on other policies. I. ADOlllONAL INS!URBOS • EXTENDED PR011EC110N OF YOUR '"LIMITS OF INSIJRANCe■ Thi5, prcwision epplies to any person ,or organiuilion who quitlifles as @n edd'rt»onttl IRS4,Jred under any form or endorsement under this polcy. 1. The following i:!1. added tor Oondilion 2. Outile-s lln The Event 0 11' Occurrem:e, 10ffense, Ct:alm or :Sull= An addillonal 1nsuired IJflder ·this end0rsement wil 851 :soon as p,a~ble; il!L Gl..,e written notioe of an •c,ccurrenoe• or an it1ffense lhttt msy re5,ul1 n a claim or "suir under lhfS lnsuranoe lor us; h. Tender lhe defense and inr;Jemnity of any cl(llim ,or "suit" tQ all insUiers wham ,also haive ins.urance a'a'ailabfe tor the addmona1 ineu1ed1; and c;;. Agree tQ ma e avall1;1b.1e any other insuranoe which lhe additional fn5,1.1red bes for Si I~ we cover undeir lhi5 Covera~ Part. d. We n&'a'e no, duty to defend or ndemnify 811 addltlon nsured under this end0rsement until we recetVe written notice ,of a "sui1H by lhe additMJnal Insured. 2. The II mils of lnsurnnoe appl 1Cable to the ad(lltlonal lnM1red aire •hose specified in a w«itten contract or written ag;reemen\ or the mlts or in5,ur3nce as s.tated In the Oeclaratlons ,oG this policy and defined In Section Ill • Umlts of Insurance of this .ooley. whdlever ar,e less. These llmlls are Inclusive of and not In ood tlon to the mlts of Insurance avallatle under 1hls policy. J. WHO, IS AN INSURrED ■INCIDENTAL MEDICAL ERrRORSIIMALPRACTICE WHO, IS AN IN.SU RrED • FELLOW EM PLOY£~ EXTENSION • MANAOEMEINT EMPLOV~E$ Paragraph .2.a.(1) of :Sesea 0<11 Ill r Who 1,. An Insured is replaoed with the ro1Jowing: 11) "Bodily Injury" or "persoool and adver1lslll)9 lnjur)i'': (a) To yoo, to ~u parmers or members ~ r )•ou are a ~artners p or Jolnl venture~ to )'OU/ members (Ir you are ai limited llablllty company), to ai co-"employee" wh,le In 1be coorse of h s or her em~>'· menl or performll')!l du~es related to the conduct or >'Our buslnes:s., or to )'our other "volunteer workers" while perform, ng duties related to lhe conduct of your business: ~I>) To lhe spouse, ehlld, parent, broiner or slsleJ of thal co-"employee" OJ "volunteer WOfker" as a conseQUenoo or Paragraph 1(1 l f 111 abO\le; (e) For ....tlich 1here is any obligation m 51hare damages wllh or repay 5,omeone el5ie who musl pay damages because it1r 1he inl\Jry de5icribed 'n Paragraphs (11 lei) or (hi above; or (di Arising out or his or her PfQ'a'idfng ,or (ei ng lo prcwide pirofe5,sJonal health e3re services. However, if you are not in lhe business of pmviding pro,fe-s,sionaf health care• services or providing prores- sional health care peP.10nnel tQ others, or if coverage ·for providing pro,fessionaf heel1tt cere ser• vices. i5 nol otherwise excluded by 5,eparat,e enoorsemenl, 1hi5, provi5,ion (Para.graph Id') does not apply. Paragraphs ~a) and lbl Hbo..,e do not apply lo "bodil>' injury" or "personal imdl @d'a'efltlsing Injury" ca 5-ed by an Hemplo,yee• ...mo, i5o ad lng in a supervisory capacity for you. Supervisory capacity as used herein me@ns lhe •employee's.H job re5,,pons.ibifmes a5,5,igned by y~. inolucles the dlreci supe~fon of o,11,er ■emr;,lo:,-• ees• of you:rs.. However, ncme of lhe51e •employee-sa are i~reds. for "'bodil>' Injury" or "per5,0nal alld ~ 2013 Libeti\y Mutual IJ'l5uranc;G o,;::lud0& COPY11Dhted material o( im;,vreooe Servkle& Offitlll, Inc .. willl s PE1rmisslon, Pago 6 O'r a Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E ~ Iii 'I advertising injuryw a11S111g out of 1heir willful QOnduct, which is. defined a:s the pul!pOseful or willful inten1 tQ C81.15e 11bodily injury" or 'iJ)er50na1 and ~vernsing injury", or et11use-d in whQ\e or ·n par1 by lheir into:icica- lio.n b,y liquor or control~ substances. The coverage pro-11Jded by prO\lislon J. Is excess over any 01her valid and collectab1e insurance i.'!'t,l&ilable to your "employee•. K. tilEWl Y FO'RME,01 OR ADDITIONALI.. Y AOQIJfRED EN1T1TIES P1;1regreph 3. or 5-ec:thm D -Wno 1, An l'nt'l.lred is repll;lced by the following: S. Any organ zabon )'OU newly acquire or form .arld Olfflr which you malntaln owner.ship or majority 1.oterest. wlll Quahfy 8S a Named Insured If there Is f!IO o1her s mllar Insurance aYa able to that organization. However: a, Coverage under lhis. provision is afforded only unfil lhe expir1;11ion or the policy period in which the entity W,i!IS. .seq ired or Conned b)' you; b. Co-\l'erage A does not appty lo •bodily injury" or "property damage" lhat ocourred before you aoquLfed or formed lhe oroan~wn: and ~-Coverage B ooe5l not apply IQ "per5()nal and li.ldveirtising injuJY" arising out of an offense committ.e(I befQl'e YQ1.l ~uired or formed the organiz~1ion. d. Reoorns and de:s.criptlons. of operauons must be malnU:iined b:, the nrst t"amed lnsl.ffed. No 1pet'$Qn or org~i~tion ~ 1;1n i~r~ with respec'I 10 lhe 00nduct ot 1;1ny clJfrent or p1;1s1 ~rtnership, joint venture or limited lfabl[ity company 1h1;11 is nQt sho•,.m 1;1-5, e N8med lll5,\lre,d in the Declarelions or q1.11;11ifies 85 an ilt$Ured under 1his provision. L. FA!ILURE TO DllSClOSE IMAZARDS AND PRIOR OCCURRENCES Under Section IV -Co~eri;h!il General lh1bl!lty Conditions, the followJngi Is added to Coindi1lon 6, R:ep:re.- sentallons: Your ~lure to d®O$e ,;di ~rd$ or pnQr •~rrences• elCi$1ing 1;1s of the inception date or 1he PQlicy sh.all 11101 prejui;:[ioe the ooverag~ affortled by thi51 pdlicy pro1,1id'ed $UCh f;pilure mo disdlose all hazero5l or prl01 •occur1en~" s not intentiQnsl. N. l<NOWLEOGE OF OCCU~RENCE, OJ:FEJNSE, CLAI.M OR SUIT Under 5-eetlon n,1 • Commer-elial General UablUty Corn:lltloruii, 1he fo!IQWing is added to Condition 2. Ou~les. ln1 The IEve;r,t of 10ceurr,enc~, O~nSie, Cl;eJm Or S1,.11lt: l<ncwdedge of an "occunrence•, offense, c!ttlm or •suit• by an 39ent, servant or 'employee," of tm:,i Insured shall not In itself constitute lkno'h1edge of the lnsureo unless a111 ifl!sured 11.'Sled under Fl'aragraJ;lh 1. of :Sectlop II -Who Is An Insured or a person who has been designated by u,em 10 reoelve reports of "occurrences". offenses, clelrns or 'suits" shall tlave received sud'I noclce from the agent, servant or "emplo)'ee'. N. Ll8ERALIZATION CLAIJ.ISE Ir we revise this Cornmercaal General Lia 1111)' Extension Endorsement to provide more coverage without addJtiona1 prernhJm charoe, your polrcy wll aulOITI8blly provide the coverage as of lhe day the revision is effedh1e In )'our st.ate. O. BOOll Y INJU~Y REDEFINED Under Sea!on V • Oefl r, Uons, Oefln.it10n 3-. Is replaced by lhe following: 3. "Bodily Injury" means ~hysical injury, 51lcknes.s or rj}5ease sustained by 8 person. This, indudes. mental anguish, mental ln[\JI)', shook, flligh1 or death lhat results from such phy$ical inlury, sick- ness or disea$e. ~ 2013 Libeti\y Mutual IJ'l5uranc;G CG, 18110 04 13 o,;::lud0& COPY11Dhted material o( im;,vreooe Servkle& Offitlll, Inc .. willl s PE1rmisslon, Pago 7 O'r a Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Iii 'I P. E_XliEPIIOED Pl:tOPERTY DA!lilii\GE Eltlctuslan a. of COVERAGE A. BODILY [NJ 1/J RY AND PROPERTY D•AMAGE l!JIABIUTY i$ replaced by ihe folowing: a. Expecte(l Or Intended lnJ1,1ry eBodlly Inf ry• or "l)rOl)er'I)' dam~e• expected or incended from •he 5,tanclpoint or the insured. This e;,ccl1JS10n does n.ot ap,ply to 'bodily ll'lfury' or 1property oomage" ~lting from the use of reasonable force to prot.eet persons or p1oper1y, Q. WAWER OF TRANSFER OF RilGHT$ 10F RECOVERY' A·GAINST OTHER$ T10 1)$ -WlrlEN [REQUIRED IN A CONTRA1CT OR AGREEMENT WITlrll YOU Under Seetlon IV • Commer.elal Gener-al Llabnlty Condl~lons, the fQllowlng is added to Condition 8. Trans- fer Of Rights Of Recovery A!:JB[ns.t Others To U11: We watve any right of rearvery we may ha¥e ~at.ost a person or 04!'91.'!nlzatlon because ol pay111ents we 11111ake for ln,ury OIi' damage arising out of your ongoing operations or "your wortc" done under a cootmct with 'lflal person or organlunloo and lnclUded In tne "products-oom~eted opernllons hazard• provided: 1. Y,ou and that person or organliatlori !lave egreecl il'I writing In a oontra-ct or agreement that you W81ve 'SUCh rights agalnsl that person or organlz:allon; and 2. The injury or (la,nage 0001.1re sub5equent to the exeQJ!ion of 1he written oontract or v«itten agree- ment ~ 2013 Libeti\y Mutual IJ'l5uranc;G CG, 18110 04 13 o,;::lud0& COPY11Dhted material o( lm;.vreooe Servkle& Offitlll, Inc •. willl s PE1rmisslon, Pago i8 O'r i8 Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Iii 'I COMMERC4Al GENElRAL LIABILITY CG380012 08 THIS, ENOORSEME;NT CHANGES THE POLICY. IPLEASE FtEAO IT CAREFll.J!J..Y, EAC·H LOCATION GENERAL A,GGREGA TIE LIMIT This end'orsemenl modifies Insurance proYld'ed under the follOWtng,: COMMERCIA.L GE~ERAl IJ.i\!BILITY COVERAGE PAR;T A. For all sums whk:h the In.sured becomes legall)' obllgated to pay as damages caused by Hoccurreooes'" under SocilJon I • Covcr-agC" A • Bodily ir,juiry Ancl P,roperty Dam19e· Ll!!!bl lily, and for al rnedlcal eJC• penses caused by acclden.ts undef Soi:Uon I• Cover19e CM ctlcai Paym nts, whictlt can be attnbuted onl)' to op,era1lons at a sing itoca1lon• owned b)' or refiled to you: 1. A 5,eparn1e Ea.ch loca1ion General Aggrega!e Linwt appliee to ~ch 'loC(!tion", ,and thal mit is equal to the, amount of ~he General Agg;reg£1te Limi1 5,hown in lhe Dederalion$. 2. The Each LQC81lQn G,eneral Aggregate Umit Is Che m~ we will pay for the 5,um of all dam~es under Coverage A, except damages because of •oodily in~ry• or "J)ropert)' damaoe• included n the "products-completed operacions hazard", and ror med~I expenses under Co'l'erage C regard~ less Qf the number ot a. !Insureds; h. Claims m:ade or "$uit5," brought; or e. Persons or organlza1lons 1118kln9 dalms or brlng n9 msutts•. 3. An'/ payments made undef Coverage A for damages or undeJ Coverage C for medlca expenses shall reduce the Each Localloo General A9!lregate Lilmll for 1hal "location•. Such P8Yrnent:s shall oot reduce the Gene,al Aggregate Llm.t shown n 1.he Declarations no, shall they reduce any othef Each LocatilJll General .i\99 egate Limit for any o,her "iloca~on" . .t.. The lilnni1s shown i:n the Declar1;1tion5, ror E1;1ch Occurrence, Fire Darnege end Medical Expense, continue lo ,l:lpg;ll)'. However, instead e>f being subject to the General Aggre,g1;11e Limit 5,hQWn ·n 1he Oe-i::larations, sudl limils w-11 be 5-Ubiect to the 8:J:lpbble E~ LC!C8tion Gener.el Aggreg;ate Limit. B. For all Sl..!ms whl-c:h !he In.sured becomes legally obligated to pay as oomages caused by "occurreooes" under Section I • Covcngo A • Bo-dily ll'l)uiry Ancl Property Damage Liabl lity, and for all medlcal &;ic- penses caused b'j accldenas undeJ :Section I • Coverage C M ctlcal Payments, wh eh canno4 be attrib- uted only lo operations at a single "locatlOn" owned by or rented to you: 1. An)' paymen1s 1118de undef Coverage A for dem8C]es 01 undef Coverage C for. medlca expense5, shell reduce the, amounl available under the General "'9gregete Limit or the Product!i<'-Complel~ Opet"ation5, Aggregate Lim"t, whictiev-et" is applica~e; 1;1nd 2. Such payments shall not r,ed\Jce any Each LocallCllrl General Aggregate Lim C. When coverage for 1:.iabi1ity ari5,ing oot of ;the "produo1s-completed Ol)eretiol'1$ haz:ell'd~ is provided, en:,, payments. for deme!;Jes because of 'bodil)' injury• or •property demS19e• included in lhe "1produds- c~le1ed Qperations haz1;1n;i" will red1J0e ~he PTI;>dUQls-Complet.ed Operati0fll5, Aggre91;1te Lilllit, imd not reduce 1he General Aggregate Limit nor the Each Loca1lon Genera! Aggregale Limit. D. For the purposes of N'lls endorsemen the rolow1ng cteflnl,loo actded 10 Soctlon V • Do'finitiorw: "LOC81ion" means premi5,es lnvofv,ing lhe 5,ame or oonneding !(its, or premi5-es 'M'!Ose connediOifl is. interrupted only by a 5'reel, roadway, waterway or righ1-of-way of 81 railroad, E. The provisions o( Se-cti«1 tll • Llmils Of lnsurane not othet'W se mod,fied by th.is end'orsemen• shall coottnue to appty as sllpulated. CG 8860 12 O& Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E '5 COMMERCIAL GENERAL LIABILITY CG 88 70 12 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONSTRUCTION PROJECT(S) -GENERAL AGGREGATE LIMIT (PER PROJECT} 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 "occurrences" under Section I -Coverage A -Bodily Injury And Property Damage Liability, and for all medical ex- penses caused by accidents under Section I -Coverage C Medical Payments, which can be attributed only to ongoing operations at a single construction project away from premises owned by or rented to you: 1. A separate Construction Project General Aggregate Limit applies to each construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations . 2. The Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard", and for medical expenses under Cov- erage 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 Construction Project General Aggregate Limit for that construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Construction Project General Aggregate Limit for any other construction project. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I -Coverage A -Bodily Injury And Property Damage Liability, and for all medical ex- penses caused by accidents under Section I -Coverage C Medical Payments, which cannot be attrib- uted only to ongoing operations at a single construction project away from premises owned by or rented to you: 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 Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Construction Project General Aggregate Limit. D. If the applicable 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 Ill -Limits Of Insurance not otherwise modified by this endorsement shall continue to apply. CG 88 70 12 08 Includes copyrighted material of ISO Properties, Inc., with its permission. Page 1 of 1 Copyright 2017 Mercury Insurance Services, LLC. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permission MCA85100817-CA Page 1 of 6 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Business Auto Broadening Endorsement This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM I. NEWLY ACQUIRED OR FORMED ENTITY (BROAD FORM NAMED INSURED) II. EMPLOYEES AS INSUREDS III. AUTOMATIC ADDITIONAL INSURED IV. EMPLOYEE HIRED AUTO LIABILITY V. SUPPLEMENTARY PAYMENTS VI. FELLOW EMPLOYEE COVERAGE VII. ADDITIONAL TRANSPORTATION EXPENSE VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE X. LOAN/LEASE GAP COVERAGE XI. GLASS REPAIR – DEDUCTIBLE WAIVER XII. TWO OR MORE DEDUCTIBLES XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS XIV. WAIVER OF SUBROGATION XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT XVIII. HIRED AUTO – COVERAGE TERRITORY XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH POLICY NUMBER: BA040000012204 Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Copyright 2017 Mercury Insurance Services, LLC. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permission MCA85100817-CA Page 2 of 6 BUSINESS AUTO COVERAGE FORM I. NEWLY ACQUIRED OR FORMED ENTITY (Broad Form Named Insured) SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: d. Any business entity newly acquired or formed by you during the policy period provided you own 50% or more of the business entity and the business entity is not separately insured for Business Auto Coverage. Coverage is extended up to a maximum of 180 days following acquisition or formation of the business entity. Coverage under this provision is afforded only until the end of the policy period. Coverage does not apply to an “accident” which occurred before you acquired or formed the organization. II. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: e. Any “employee” of yours is an "insured" while using a covered “auto" you don't own, hire or borrow in your business or your personal affairs. III. AUTOMATIC ADDITIONAL INSURED SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: f. Any person or organization that you are required to include as additional insured on the Coverage Form in a written contract or agreement that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period is an "insured" for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. IV. EMPLOYEE HIRED AUTO LIABILITY SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: g. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. V. SUPPLEMENTARY PAYMENTS SECTION II – LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Supplementary Payments, Subparagraphs (2) and (4) are replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We are not obligated to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Copyright 2017 Mercury Insurance Services, LLC. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permission MCA85100817-CA Page 3 of 6 VI. FELLOW EMPLOYEE COVERAGE: SECTION II – LIABILITY COVERAGE, B. Exclusions, 5. Fellow Employee This exclusion does not apply if you have workers’ compensation insurance in-force covering all of your “employees”. Coverage is excess over any other collectible insurance. VII. ADDITIONAL TRANSPORTATION EXPENSE SECTION III - PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Transportation Expenses, is replaced with the following: We will pay up to $50 per day to a maximum of $1000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy’s expiration, when the covered "auto" is returned to use or we pay for its "loss". If your business shown in the Declarations is other than an auto dealership, we will also pay up to $1,000 for reasonable and necessary costs incurred by you to return a stolen covered auto from the place where it is recovered to its usual garaging location. VIII. HIRED AUTO PHYSICAL DAMAGE COVERAGE SECTION III – PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, the following is added: c. If Liability Coverage is provided in this policy on a Symbol 1 or a Symbol 8 basis and Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this coverage form for any "auto" you own, then the Physical Damage Coverages provided are extended to "autos" you hire, subject to the following limit: (1) The most we will pay for "loss" to any hired "auto" is $50,000 or Actual Cash Value or Cost of Repair, whichever is less (2) $500 deductible will apply to any loss under this coverage extension, except that no deductible shall apply to “loss” caused by fire or lightning Subject to the above limit and deductible we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own of similar size and type. This coverage extension is excess coverage over any other collectible insurance. IX. ACCIDENTAL AIRBAG DEPLOYMENT COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE, B. Exclusions, 3.a., is amended to add the following: This exclusion does not apply to the accidental discharge of an airbag. Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Copyright 2017 Mercury Insurance Services, LLC. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permission MCA85100817-CA Page 4 of 6 X. LOAN/LEASE GAP COVERAGE SECTION III - PHYSICAL DAMAGE COVERAGE C. Limit of Insurance, the following is added: 4. In the event of a "total loss" to a covered "auto" shown in the schedule or declarations for which Collision and Comprehensive Coverage apply, we will pay any unpaid amount due on the lease or loan for that covered “auto,” less: a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any: (1) Overdue lease/loan payments at the time of the “loss”; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage. (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (5) Carry-over balances from previous loans or leases. The most we will pay under Auto Loan/Lease Gap Coverage for an insured auto is 25% of the actual cash value of that insured auto at the time of the loss. XI. GLASS REPAIR – DEDUCTIBLE WAIVER SECTION III - PHYSICAL DAMAGE COVERAGE, D. Deductible, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. XII. TWO OR MORE DEDUCTIBLES SECTION III -PHYSICAL DAMAGE COVERAGE, D. Deductible, the following is added: If two or more "company" policies or coverage forms apply to the same accident: 1. If the applicable Business Auto deductible is the smallest, it will be waived; or 2. If the applicable Business Auto deductible is not the smallest, it will be reduced by the amount of the smallest deductible; or 3. If the loss involves two or more Business Auto coverage forms or policies the smallest deductible will be waived. For the purpose of this endorsement "company” means the company providing this insurance and any of the affiliated members of the Mercury Insurance Group of companies. XIII. AMENDED DUTIES IN EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions, 2. Duties In The Event Of Accident, Claim, Suit, Or Loss, a., In the event of "accident", you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation. Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Copyright 2017 Mercury Insurance Services, LLC. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permission MCA85100817-CA Page 5 of 6 XIV. WAIVER OF SUBROGATION SECTION IV - BUSINESS AUTO CONDITIONS, A. Loss Conditions, 5. Transfer of Rights Of Recovery Against Others To Us, section is replaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. XV. UNINTENTIONAL ERROR, OMISSION, OR FAILURE TO DISCLOSE HAZARDS SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 2. Concealment, Misrepresentation, or Fraud, the following is added: Any unintentional omission of or error in information given by you, or unintentional failure to disclose all exposures or hazards existing as of the effective date or at any time during the policy period shall not invalidate or adversely affect the coverage for such exposure or hazard or prejudice your rights under this insurance. However, you must report the undisclosed exposure or hazard to us as soon as reasonably possible after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. XVI. EMPLOYEE HIRED AUTO PHYSICAL DAMAGE SECTION IV – BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, b. For Hired Auto Physical Damage Coverage, is replaced by the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: 1. Any covered "auto" you lease, hire, rent or borrow; and 2. Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". XVII. PRIMARY AND NONCONTRIBUTORY IF REQUIRED BY CONTRACT SECTION IV – BUSINESS AUTO CONDITIONS, B. General Conditions, 5. Other Insurance, the following is added and supersedes any provision to the contrary: e. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Copyright 2017 Mercury Insurance Services, LLC. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its Permission MCA85100817-CA Page 6 of 6 XVIII. HIRED AUTO - COVERAGE TERRITORY SECTION IV - BUSINESS AUTO CONDITIONS, B. General Conditions, 7. Policy Period, Coverage Territory, e. Anywhere in the world if:, is replaced by the following: e. Anywhere in the world if: (1) A covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less; and (2) The "insured’s" responsibility to pay damages is determined in a "suit" on the merits, in the United States of America, the territories and possessions of the United States of America, Puerto Rico, or Canada or in a settlement we agree to. XIX. BODILY INJURY REDEFINED TO INCLUDE RESULTANT MENTAL ANGUISH SECTION V – DEFINITIONS, C. "Bodily Injury” is amended by adding the following: "Bodily injury" also includes mental anguish but only when the mental anguish arises from other bodily injury, sickness, or disease. Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E Docusign Envelope ID: 44D41CD0-BA09-4CB0-95EE-72658FBC9F6E WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY MWC 1400 0510 BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA 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 any 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule 1. Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Premium: The additional premium charge for this endorsement shall be ~ percent of the California Workers' Compensation premium otherwise due subject to a minimum premium of $750 per policy. 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: 01/01/2025 Policy No. MWC0140236-07 Endorsement No. Insured: Seaside Specialty Construction, Inc Premium $(See Attached) Insurance Company: Markel Insurance Company Countersigned by _____________ _ MWC14000510 Includes copyrighted material of National Council on Compensation Insurance with its permission Copyright 1983 National Council on Compensation Insurance. Page 2 of2