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HomeMy WebLinkAboutPatterson Brothers Lighting Inc; 2020-06-26; PWM20-1154TRANPWM20-1154TRAN Pole Repair at Five Locations Page 1 of 9 City Attorney Approved 1/25/2019 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT POLE REPAIR AT FIVE LOCATIONS: COLLEGE, TAMARACK, CAMINO VIDA ROBLE (2) & OLIVENHAIN This agreement is made on the ______________ day of _________________________, 2020, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Patterson Brothers Lighting, Inc., a California corporation whose principal place of business is PO Box 2037, Lakeside, CA 92040 (hereinafter called "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, 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: Matt Paxson (City Project Manager) WAGE RATES. 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 Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5. The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Contractor and any subcontractors shall comply with Section 1776 of the California Labor Code, which generally requires keeping accurate payroll records, verifying and certifying payroll records, and making them available for inspection. Contractor shall require any subcontractors to comply with Section 1776. DocuSign Envelope ID: 5613794E-1A05-4BF5-9895-B889B330ADCE June 26th PWM20-1154TRAN Pole Repair at Five Locations Page 2 of 9 City Attorney Approved 1/25/2019 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 agreement 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 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: __________Kyle Patterson_____________ 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 of Injuries including accidental death, to any one person in an amount not less than……..$1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ….…$1,000,000 Property damage insurance in an amount of not less than……..$1,000,000 Automobile Liability Insurance in the amount of $1,000,000 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 thirty (30) days written notice shall be given to the City prior to such cancellation. 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. DocuSign Envelope ID: 5613794E-1A05-4BF5-9895-B889B330ADCE PWM20-1154TRAN Pole Repair at Five Locations Page 3 of 9 City Attorney Approved 1/25/2019 INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from 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. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within thirty (30) 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. CONTRACTOR’S INFORMATION. Patterson Brothers Lighting, Inc. PO Box 2037 (name of Contractor) 501334 (street address) Lakeside, CA 92040 (Contractor’s license number) C-10 Electrical 11/30/2020 (city/state/zip) 619-390-2875 (license class. and exp. date) 1000007848 (telephone no.) 619-390-2875 (DIR registration number) 6/30/2021 (fax no.) Kyle@Pattersonbrotherslighting.com (DIR registration exp. date) (e-mail address) /// /// /// /// /// /// /// DocuSign Envelope ID: 5613794E-1A05-4BF5-9895-B889B330ADCE PWM20-1154TRAN Pole Repair at Five Locations Page 4 of 9 City Attorney Approved 1/25/2019 AUTHORITY. The individuals executing this Agreement 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 Agreement. CONTRACTOR PATTERSON BROTHERS LIGHTING, INC., a California corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Kyle Eugene Patterson, President & CFO Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager (print name/title) By: (sign here) Kenneth Andrew Hall, Secretary (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation, Agreement 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: CELIA A. BREWER, City Attorney BY: _____________________________ Assistant City Attorney DocuSign Envelope ID: 5613794E-1A05-4BF5-9895-B889B330ADCE PWM20-1154TRAN Pole Repair at Five Locations Page 5 of 9 City Attorney Approved 1/25/2019 EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each sub-contractor 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 sub-contractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a sub-contractor 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 Portion of Project to be Subcontracted Business Name and Address DIR Registration No. License No., Classification & Expiration Date % of Total Contract NONE Total % Subcontracted: 0% The Contractor must perform no less than fifty percent (50%) of the work with its own forces. DocuSign Envelope ID: 5613794E-1A05-4BF5-9895-B889B330ADCE PWM20-1154TRAN Pole Repair at Five Locations Page 6 of 9 City Attorney Approved 1/25/2019 EXHIBIT B Pole Repair at five locations: College, Tamarack, Camino Vida Roble (2) and Olivenhain Contractor will provide all labor, equipment and materials (unless otherwise specified) necessary to install five new streetlight poles located in the City of Carlsbad: 1. College Blvd., 250 feet north of Tamarack Ave. on the east side – WO# 593366 2. Tamarack Ave. at Talus Way on the northwest corner – WO# 593365 3. Camino Vida Roble at Las Palmas Dr. on the north side of intersection – WO# 595517 4. Olivenhain Rd. approx. 1,000 feet West of Rancho Santa Fe Rd. on the south side – WO# 595518 5. Camino Vida Roble approx. 200 ft West of Las Palmas Dr. on the South side – WO# 596032 Contractor’s work shall include: removing debris from original poles; installing new, contractor provided Ameron Contemporary 2B2-26 street light poles with anti-graffiti coating (or equivalent) on existing foundations; installing new, contractor provided mast arms; installing city provided LED light fixtures and city provided photo-cells; installing foundation caps; and miscellaneous electrical work between the handhole and street light and within the pole or fixture. Contractor will return all poles to complete working condition. All required traffic control will be provided by the Contractor in accordance with the latest edition of the California Manual of Uniform Traffic Control Devices (CAMUTCD). All work shall be performed in accordance with the City of Carlsbad’s Engineering Standards, the 2018 Standard Specifications for Public Works Construction (Greenbook), and 2018 Caltrans Standard Plans and Caltrans Specifications. JOB QUOTATION ITEM NO. UNIT QTY DESCRIPTION PRICE 1. LS 1 Replace light pole at College Blvd., 250 feet north of Tamarack Ave. on the east side on existing foundation with contractor supplied 2B2-26 pole with graffiti coating, replace cap and restore power. $4,625 2. LS 1 Replace light pole at Tamarack Ave at Talus Way on the northwest corner on existing foundation with contractor supllied 2B2-26 pole with graffiti coating, replace cap and restore power. $4,625 3. LS 1 Replace light pole at Camino Vida Roble at Las Palmas Dr. on the north side of intersection on existing foundation with contractor supllied 2B2-26 pole with graffiti coating, replace cap and restore power. $4,500 4. LS 1 Replace light pole at Olivenhain Rd. approx. 1,000 feet west of Rancho Santa Fe Rd. on the south side on existing foundation with contractor supllied 2B2-26 pole with graffiti coating, replace cap and restore power. $5,025 5. LS 1 Replace light pole at Camino Vida Roble approx. 200 ft West of Las Palmas Dr. on the South side on existing foundation with contractor supllied 2B2-26 pole with graffiti coating, replace cap and restore power. $4,500 TOTAL* $23,275.00 *Includes taxes, fees, expenses and all other costs DocuSign Envelope ID: 5613794E-1A05-4BF5-9895-B889B330ADCE PWM20-1154TRAN Pole Repair at Five Locations Page 7 of 9 City Attorney Approved 1/25/2019 EXHIBIT B CONTINUED Pole Repair at five locations: College Blvd., Tamarack Ave., Camino Vida Roble at Las Palmas, Olivenhain Rd. and Camino Vida Roble West of Las Palmas (Site Images) DocuSign Envelope ID: 5613794E-1A05-4BF5-9895-B889B330ADCE PWM20-1154TRAN Pole Repair at Five Locations Page 8 of 9 City Attorney Approved 1/25/2019 EXHIBIT B CONTINUED Pole Repair at five locations: College Blvd., Tamarack Ave., Camino Vida Roble at Las Palmas, Olivenhain Rd. and Camino Vida Roble West of Las Palmas (Site Images) DocuSign Envelope ID: 5613794E-1A05-4BF5-9895-B889B330ADCE PWM20-1154TRAN Pole Repair at Five Locations Page 9 of 9 City Attorney Approved 1/25/2019 EXHIBIT B CONTINUED Pole Repair at five locations: College Blvd., Tamarack Ave., Camino Vida Roble at Las Palmas, Olivenhain Rd. and Camino Vida Roble West of Las Palmas (Site Images) DocuSign Envelope ID: 5613794E-1A05-4BF5-9895-B889B330ADCE aACORITY Nea CERTIFICATE OF LIABILITY INSURANCE ASHLEYLANCTOT DATE (MMIDDIYYYY) 71212019 -PATTBRO-01 - REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERSNO RIGHTS UPON THE CERTIFICATE HOLDER.THISCERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSUREDprovisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement onthiscertificatedoesnotconferrightstothecertificateholderinlieuofsuchendorsement(s). PRODUCER NFP Property &Casualty Services,Inc.6333 Greenwich DriveSuite230SanDiego,CA 92122 Sane Lynne Grayson-Glazer Mio,Ext):(B58)869-8311 [FAXwo):(858)869-8301 (alc.EMAL...Lynne.Glazer@nfp.com INSURER(S)AFFORDING COVERAGE NAIC # insuRERA :Colony Insurance Company 39993 INSURED INSURER B :Nationwide Mutual Insurance Company 23787J Patterson Brothers Lighting,Inc.INSURERC :State Comp Insurance Fund of CA 35076P.O.Box 2037 INSURERD ;Lakeside,CA 92040 INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIODINDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWITH 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 REDUCEDBYPAID CLAIMS. INSR TYPE OF INSURANCE eS yee POLICY NUMBER (hboinn|(aD)LIMITS A X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $1,000,000|cLams-mave X occur x 103GL002439801 71112019 7/1/2020 [PAMAGETORENTED|100,000 |_|MED EXP(Any one person)$5,000 |_|PERSONAL &ADVINJURY__|$1,000,000 GEN'L AGGREGATELIMIT APPLIES PER:GENERAL AGGREGATE $2,000,000 POLICY SES |LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER:$B AUTOMOBILE LIABILITY GOMBINEDSINGLE LIMIT $1,000,000 X ANY AUTO ACP3047201492 7/1/2019 7/11/2020 BopiLy INJURY (Perperson)$[|OWNED SCHEDULEDAUTOSONLYAUTOS BODILY INJURY (Peraccident)$r PROPERTY DAMAGE—TURRRiS ONLY NOMSEN iy (Per accident)$ $ A UMBRELLA LIAB X occur EACH OCCURRENCE $2,000,000 X EXCESS LIAB CLAIMS-MADE XS4246906 74112019 7/1/2020 .qorecate $2,000,000 DED ||RETENTIONS $ C |woRKERS COMPENSATION PER OTH-AND EMPLOYERS'LIABILITY YIN X |STATUTE ||ERANYPROPRIETORPARTNERIEXECUTIVEx(91364702019 71112019 7/1/2020 |)cacu accipenr 5 1,000,000Ri:OrFIGERM Mari EXCLUDED NIA 1.000.000andatoryinNE.L.DISEASE -EAEMPLOYEE!$1000;If yes,describe under 1,000,000DESCRIPTIONOFOPERATIONSbelowE.L,DISEASE -POLICY LIMIT $nN notice to the City of Carisbad/CMWDperform U688A-0813.*CERTIFICATE ISSUED DUE TO POLICY RENEWAL. DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD101,Additional Remarks Schedule,may be attached if more spaceis requiredTheCityofCarlsbadisanadditionalinsured,as requiredby written contract with the named insured,per the attached CG2010 07 04 and CG2037 07 04 formsregardstoGeneralLiability.Waiver of Subrogation applies per the attached SCIF 10217 in regards to Workers Compensation.Blanket forms apply as requiredbywrittencontractwiththenamedinsured.Should any ofthe required policies be cancelled before the expiration date thereof,we will mail 30 days written cio EXIGIS Insurance Compliance ServicesP.O.Box 4668 -ECM #35050 New York,NY 10163-4668 | CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORECityofCarlsbad/CMWD THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED INityofCarlsbaACCORDANCEWITHTHEPOLICYPROVISIONS. AUTHORIZED REPRESENTATIVESeer ACORD25(2016/03)©1988-2015 ACORD CORPORATION.All rights reserved. The ACORD nameandlogo are registered marks of ACORD Policy#103GL002439801 THIS ENDORSEMENT CHANGESTHE POLICY.PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION OR NON-RENEWAL —CERTIFICATE HOLDERS This endorsement modifies insurance provided underthe following: COMMERCIAL GENERALLIABILITY COVERARGE PARTPRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Person(s)or Organization(s)Including Mailing Address: City of Carlsbad/CMWDc/o EXIGIS Insurance Compliance Services P.O.Box 4668 -ECM #35050 New York,NY 10163 The Person(s)or Organization(s)listing or described in the SCHEDULE above have requested that they receive written notice of cancellation or non-renewal whenthis policy is cancelled or non-renewedby us. We will endeavor to mail or deliver 30 days written notice (10 days for non-payment of premium by the Insured)to the Person(s)or Organization(s)listed or described in the SCHEDULE.; The notification of cancellation or non-renewal of the policy is solely for the purpose of informing the Person(s)or Organization(s)shown in the SCHEDULEtheeffective date of cancellation or non-renewal and doesnotgrant,alter,or extend any rights or obligations underthis policy.Our failure to provide such notification to the Person(s)or Organization(s)shown in the SCHEDULE will not extend any policy cancellation or non-renewal date nor impact or negate any cancellation or non-renewal of the policy. This endorsementdoes notentitle the Person(s)or Organization(s)listed or described in the SCHEDULE aboveto any benefit,rights or protection underthis policy. Any provision of this endorsementthat is in conflict with a statute or rule is hereby amended to conform to that statute or rule. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. U688A-0813 Includes copyrighted material of ISO Properties,Inc.,Page 1 of 1withitspermission. ENDORSEMENT AGREEMENT BROKER COPY WAIVER OF SUBROGATION BLANKET BASIS 9136470-19 RENEWAL NA HOME OFFICE 3-32-60-78 SAN FRANCISCO EFFECTIVE JULY 1,2019 AT 12.01 A.M.PAGE 1 OF ALL EFFECTIVE DATES ARE AND EXPIRING JULY 1,2020 AT 12.01 A.M. AT 12:01 AM PACIFICSTANDARDTIMEORTHETIMEINDICATEDATPACIFICSTANDARDTIME PATTERSON BROTHERS LIGHTING,INC PO BOX 2037LAKESIDE,CA 92040 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. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE2.00%OF THE TOTAL POLICY PREMIUM. SCHEDULE PERSONOR ORGANIZATION JOB_DESCRIPTION ANY PERSON OR ORGANIZATION BLANKET WAIVER OF FOR WHOM THE NAMED TNSURED SUBROGATION HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WATVER NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY,ALTER,WAIVE OR EXTEND ANY OF THE TERMS,CONDITIONS,AGREEMENTS,OR LIMITATIONS OF THIS POLICY OTHER THAN AS STATED.NOTHING ELSEWHERE IN THIS POLICY ‘SHALL BE HELD TO VARY,ALTER,WAIVE OR LIMIT THE TERMS,CONDITIONS,AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT COUNTERSIGNED AND ISSUED AT SAN FRANCISCO:JULY 1,2019 hinoeakahftaf Loner Aycnn.2572 AUTHORIZEN REPRESENTATIVE PRESIDENT AND CEO SCIF FORM 10217 IREV 7 2014)OLO oP 21) POLICY NUMBER:103GL002439801 COMMERCIAL GENERALLIABILITYCG20100704 THIS ENDORSEMENT CHANGESTHE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED —OWNERS,LESSEES ORCONTRACTORS—SCHEDULED PERSON ORORGANIZATION This endorsement modifies insurance provided underthe following: COMMERCIAL GENERALLIABILITY COVERAGE PART SCHEDULE NameOf Additional Insured Person(s)(Or Organization(s):~Location(s)Of Covered Operations All persons or organizations as required by written contract As designated in written contract with the Named with the Named Insured.Insured. NO Information required to complete this Schedule,if not shown above,will be shown in the Declarations. A.Section [I —Who Is An Insured is amended to B.With respect to the insurance afforded to these CG 20 10 07 04 include as an additional insured the person(s)or organization(s)shown in the Schedule,but onlywithrespecttoliabilityfor"bodily injury","property damage"or "personal and advertising injury"caused,in wholeorin part,by: 1.Your acts or omissions;or 2.The acts or omissions of those acting on yourbehalf; in the performance of your ongoing operations fortheadditionalinsured(s)at the location(s)desig- nated above. ©ISOProperties,Inc.,2004 additional insureds,the following additional exclu- sions apply: This insurance does not apply to "bodily injury"or "property damage"occurring after: 1.All work,including materials,parts or equip-ment furnished in connection with such work, on the project (other than service,maintenanceorrepairs)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 beenputtoits in- tended use by any person or organization oth- er than another contractor or subcontractor engaged in performing operations for a princi-pal as a part of the same project. Page 1 of 1 POLICY NUMBER:103GL002439801 COMMERCIAL GENERALLIABILITYCG20370704 THIS ENDORSEMENT CHANGESTHE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED —OWNERS,LESSEES ORCONTRACTORS—COMPLETED OPERATIONS This endorsement modifies insurance provided underthe following: COMMERCIAL GENERALLIABILITY COVERAGE PART SCHEDULE NameOf Additional Insured Person(s)Or Organization(s):Location And Description Of Completed Opera- tions All persons or organizatiohs as required by written contract with the Named Insured. As designated in written contract with the NamedInsured. Information required to complete this Schedule,if not shown above,will be shownin the Declarations. Section Il -Who Is An Insured is amendedto include as an additional insured the person(s)or organiza-tion(s)shown in the Schedule,but only with respect to liability for "bodily injury"or "property damage"caused,in whole orin part,by "your work”at the location desig- nated and described in the schedule of this endorse- ment performed for that additional insured and includedinthe"products-completed operations hazard”. CG 20 37 07 04 ©ISO Properties,Inc.,2004 Page 1 of 1 Oo