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HomeMy WebLinkAboutWeatherproofing Technologies Inc; 2018-02-12; PWL18-102GSCITY OF CARLSBAD PUBLIC WORKS LETTER OF AGREEMENT SAFETY CENTER DRAIN SUMP ROOF REPAIR PWL 18-102GS This RATIFICATION OF LETTER OF AGREEMENT between Weatherproofing Technologies, Inc., a Delaware __corooration. (Contractor) and the City of Carlsbad (City) is entered into as of the.day of __ fe,b~ \7_._1 i-~,15 , 2018, but effective as of the 12th day of January, 2018, ratifying the work performed fe'r the Safety Center Drain Sump Roof Repair. The Contractor provided all equipment, material and labor necessary to complete the scope of work per Exhibit "A" and City specifications, for a sum not to exceed one thousand four hundred seventy-five dollars ($1,475). This work was completed within three (3) working days after the Notice to Proceed was issued. Upon full execution, the Letter of Agreement is ratified. ADDITIONAL REQUIREMENTS 1. City of Carlsbad Business License 2. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its agents, officers, officials, employees and volunteers, 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 this Contract or work; or from any failure or alleged failure of the contractor to comply with any applicable law, rules or regulations including those relating to safety and health; except for loss or damage which was caused solely by the active negligence of the City; and from any and all claims, loss, damage, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by this Contract, unless the loss or damage was caused solely by the active negligence of the City. The expenses of defense include all costs and expenses, including attorney's fees for litigation, arbitration, or other dispute resolution method. 3. Contractor shall furnish policies of general liability insurance, automobile liability insurance and a combined policy of workers compensation and Employers' Liability in an insurable amount of not less than one million dollars ($1,000,000) each, unless a lower amount is approved by the Risk Manager or the City Manager. Said 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. Insurance is 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. Proof of all such insurance shall be given by filing certificates of insurance with contracting department prior to the signing of the contract by the City. 4. The Contractor shall be aware of and comply with all Federal, State, County and City Statues, Ordinances and Regulations, including Workers Compensation laws (Division 4, California Labor Code) and the "Immigration Reform and Control Act of 1986" (8USC, Sections 1101 through 1525), to include but not limited to, verifying the eligibility for employment of all agents, employees, subcontractors and consultants that are included in this Contract. 5. The Contractor may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, Government Code sections 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seg. _____ init 11)]) init 6. The Contractor hereby acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor from participating in contract bidding. ____ init /YID init Safety Center Drain Sump Roof Repair - 1 -City Attorney Approved 2/29/2016 PWL 18-102GS 7. 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. 8. 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 Section 1770, 1773 and 1773.1 of the California Labor Code. Pursuant to Section 1773.2 of the California Labor code, a current copy of 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 the execution of the work covered by this Letter of Agreement. 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. 9. City Contact: Brian Bacardi 760-434-2944 Contractor Contact: Sten Johnson 858-531-5197 CONTRACTOR WEATHERPROOFING TECHNOLOGIES, INC., a Delaware corporation 3735 Green Rd. Beachwood, OH 44122 P: 858-531-5197 F: 858-488-3529 sajohnson@tremcoinc.com By: (sign here) l i3rJYJ By: CITY OF CARLSBAD, a municipal corporation of the State of California By: ~t Elaine Lukey / lie Works Director as authorized by the City Manager Dated: (Proper notarial acknowledgment of execution by Contractor must be attached. Chairman, president or vice-president and secretary, assistant secretary, CFO or assistant treasurer must sign for corporations. 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:~ Deputy City Attorney Safety Center Drain Sump Roof Repair - 2 -City Attorney Approved 2/29/2016 EXHIBIT A SCOPE OF WORK PWL 18-102GS Contractor provided all equipment, labor and materials for work located at Safety Center, 2560 Orion Way, Carlsbad, CA 92010 including: pull primary and overflow drain rings; spud gravel in drain sump and 2' out onto roof down to top layer of felt.; install 2 ply repair with Tremlastic S set in rapid set fabric; Three (3) course perimeter; resurface with Tremlastic S / aggregate; reset drain rings; spud gravel along edge of penthouse and 3 course edge with asphalt mastic / reinforcing webbing; leave job site in a clean and workmanlike manner. Bid is based on prevailing wage labor rates. JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LS 1 Safety Center Drain Sump Roof Repair $1,475.00 TOTAL* $1,475.00 *Includes taxes, fees, expenses and all other costs. Safety Center Drain Sump Roof Repair -3 -City Attorney Approved 2/29/2016 ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) ~ 10/17/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MARSH USA INC. NAME: PHONE I FAX 200 PUBLIC SQUARE, SUITE 3760 'Air 1,.1,.,. c.,-1-\, IA/C Nol: CLEVELAND, OH 44114-1824 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# 34492-CAS-FRONT-17-18 WEATH INSURER A: Zurich American Insurance Comoanv 16535 INSURED INSURER B : American Zurich Insurance Comoanv 40142 WEATHERPROOFING TECHNOLOGIES, INC. TREMCO INCORPORATED AND ITS SUBSIDIARIES INSURER C : N/A N/A 3735 GREEN RD INSURERD: BEACHWOOD, OH 44122 INSURERE: INSURERF: COVERAGES CERTIFICATE NUMBER: CLE-006005009-12 REVISION NUMBER: 18 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR 1 POLICY EFF /~~}5%~1 LTR m~n unm POLICY NUMBER MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY GLO9258791-10 04/01/2017 04/01/2018 EACH OCCURRENCE $ 2,000,000 -D CLAIMS-MADE 0 OCCUR DAMAGE TO RENTED PREMISES /Ea occurrence\ $ 1,000,000 MED EXP (Any one person) $ 10,000 - PERSONAL & ADV INJURY $ 2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 ~ DPRO-DLOC $ 4,000,000 POLICY JECT PRODUCTS· COMP/OP AGG OTHER: $ A AUTOMOBILE LIABILITY BAP9258789-10 04/01/2017 04/01/2018 COMBINED SINGLE LIMIT $ 1,000,000 /Ea accident\ -X ANY AUTO BODILY INJURY (Per person) $ -OWNED -SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ - X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY /Per accident\ $ UMBRELLA LIAB H OCCUR EACH OCCURRENCE $ - EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WC9258790-10 (WI & MA) U4/U1/LUl7 04/01/2018 X I ~ffTUTE I I OTH- AND EMPLOYERS' LIABILITY ER B Y/N WC9258788-10 (AOS) 04/01/2017 04/01/2018 ANYPROPRIETOR/PARTNER/EXECUTIVE 0 EL EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED? N/A EWS5965995-09 (EXCESS OH) 04/01/2017 04/01/2018 (Mandatory in NH) EL DISEASE -EA EMPLOYEE $ 1,000,000 If yes, describe under EXCESS OHIO SIR: $500,000 1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF CARLSBAD IS NAMED AS ADDITIONAL INSURED (EXCEPT FOR WORKERS COMPENSATION) WHERE REQUIRED BY WRITTEN CONTRACT. THE INSURANCE AFFORDED UNDER THE GENERAL LIABILITY POLICY FOR THE ADDITIONAL INSURED(S) IS PRIMARY INSURANCE AND ANY OTHER INSURANCE MAINTAINED BY OR AVAILABLE TO THE ADDITIONAL INSURED(S) IS NON- CONTRIBUTORY. PER COVERAGE FORM, AUTO COVERAGE WILL APPLY ON A PRIMARY BASIS. WAIVER OF SUBROGATION IN FAVOR OF THE ADDITIONAL INSURED(S) UNDER THE GENERAL LIABILITY, AUTOMOBILE LIABILITY, AND WORKERS COMPENSATION POLICIES. CERTIFICATE HOLDER CANCELLATION CITY OF CARLSBAD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1635 FARADAY AVENUE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CARLSBAD, CA 92008 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. I Kevin J. Robinson-I ')~#--~ © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BAP9258789-10 COMMERCIAL AUTO CA 20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: RPM INTERNATIONAL INC. Endorsement Effective Date: 04-01-17 SCHEDULE Name Of Person{s) Or Organization(s): AS REQUIRED TO PROVIDE ADDfflONAL INSURED STATUS ON A PRIMARY, NON-CONTRIBUTORY BASIS. IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW Information reauired to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph 0.2. of Section I -Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20481013 © Insurance Services Office, Inc., 2011 Page 1 of 1 Wolters Kluwer Financial SelVices I Unifonn Forms TM • Coverage Extension Endorsement -Liability Only ZURICH Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Adcfl.Prem Return Prem. BAP9258789-10 04-01-17 P4-01-1s 04-01-17 ~5133-000 ------- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Fonn Motor Carrier Coverage Form A. Amended Who ls An Insured 1. The following is added to the Who Is An Insured Provision in Section 11-Covered Autos Liability Coverage: The following are also "insureds"; a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any ·employee" of yours is also 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. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement. d. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident'' arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance-Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person{s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. B. Amendment-Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section If -Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations} required because of an "accident" we cover. We do not have 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. Includes copyrlghled material of Insurance Services Office. Inc., with Its permission. U-CA-428-A CW (02-14) Page 1 of 3 Blanket Notification to Others of Cancellation or Non-Renewal Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Dale of End. Producer No. BAP9258789-10 34-01-17 04-01-18 04-01-17 25133-000 @ ZURICH Add'I. Prem Return Prem. ----- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial Automobile Coverage Part A. If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a list provided to us by the first Named Insured if you are required by written contract or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to the first Named Insured. Such list: 1. Must be provided to us prior to cancellation or non-renewal; 2. Must contain the names and addresses of only the persons or organizations requiring notification that such Coverage Part has been cancelled or non-renewed; and 3. Must be in an electronic format that is acceptable to us. 8. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail or deliver such notification to each person or organization shown in the list: 1. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or 2. At least 30 days prior to the effective date of: a. Cancellation, if cancelled for any reason other than nonpayment of premium; or b. Non-renewal, but not including conditional notice of renewal. C. Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy only. Our failure to provide such mailing or delivery will not: 1. Extend the Coverage Part cancellation or non-renewal date; 2. Negate the cancellation or non-renewal; or 3. Provide any additionar insurance that would not have been provided in the absence of this endorsement. D. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described In Paragraphs A. and B. of this endorsement. All other terms and conditions of this policy remain unchanged. Includes copyrighted material of lrn;urance Services Office, Inc., with its pemiission. U-CA-832-A CW (01/13) Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC99 06 43 BLANKET NOTIFICATION TO OTHERS OF CANCELLATION OR NONRENEWAL ENDORSEMENT This endorsement adds the following to Part Six of the policy. PART SIX CONDITIONS Blanket Notification to Others of Cancellation or Non renewal 1. If we cancel or non-renew this policy by written notice to you, we will mail or deliver notification that such policy has been cancelled or non-renewed to each person or organization shown in a list provided to us by you if you are required by written contract or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to you. Such list: a. Must be provided to us prior to cancellation or non-renewal; b. Must contain the names and addresses of only the persons or organizations requiring notification that such policy has been cancelled or non-renewed; and c. Must be in an electronic format that is acceptable to us. 2. Our notification as described in Paragraph 1. above will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to you. We will mail or deliver such notification to each person or organization shown in the list: a. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or b. At least 30 days prior to the effective date of: (1) Cancellation, if cancelled for any reason other than nonpayment of premium; or (2) Non-renewal, but not including conditional notice of renewal. 3. Our mailing or delivery of notification described in Paragraphs 1. and 2. above is intended as a courtesy only. Our failure to provide such mailing or delivery will not: a. Extend the policy cancellation or non-renewal date; b. Negate the cancellation or non-renewal; or c. Provide any additional insurance that would not have been provided in the absence of this endorsement. 4. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs 1. and 2. above. All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below Is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 04-01-17 Insured: RPM INTERNATIONAL INC. Policy No.: WC9258788-10 Insurance Company: American Zurich Insurance Company WC 99 0643 Endorsement No. Premium$ (Ed. 01-13) Includes copyright material of the National Council on Compensation Insurance. Inc. used with its permission. © 2012 Copyright National Counci on Compensation Insurance, Inc. All Rights Reserved. Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC990643 BLANKET NOTIFICATION TO OTHERS OF CANCELLATION OR NONRENEWAL ENDORSEMENT This endorsement adds the following to Part Six of the policy. PART SIX CONDITIONS Blanket Notification to Others of Cancellation or Nonrenewal 1. If we cancel or non-renew this policy by written notice to you, we will mail or deliver notification that such policy has been cancelled or non-renewed to each person or organization shown in a list provided to us by you if you are required by written contract or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to you. Such list: a. Must be provided to us prior to cancellation or non-renewal; b. Must contain the names and addresses of only the persons or organizations requiring notif1<::ation that such policy has been cancelled or non-renewed; and c. Must be in an electronic format that is acceptable to us. 2. Our notification as described in Paragraph 1. above will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to you. We will mail or deliver such notification to each person or organization shown in the list: a. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or b. At least 30 days prior to the effective date of: (1) Cancellation, if cancelled for any reason other than nonpayment of premium; or {2) Non-renewal, but not including conditional notice of renewal. 3. Our mailing or delivery of notification described in Paragraphs 1. and 2. above is intended as a courtesy only. Our failure to provide such mailing or delivery will not: a. Extend the policy cancellation or non-renewal date; b. Negate the cancellation or non-renewal; or c. Provide any additional insurance that would not have been provided in the absence of this endorsement. 4. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs 1. and 2. above. All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 04-01-17 Insured: RPM INTERNATIONAL INC. Policy No. WC9258790-10 Insurance Company: American Zurich Insurance Company WC 990643 Endorsement No. Premium$ (Ed. 01-13) Includes copyright material of the National Council on Compensation Insurance, Inc. used with its permission. © 2012 Copyright National Council on Compensation Insurance, Inc. All Righls Reserved. Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY wcoo 0313 {Ed. 04·84} WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named In the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ALL PERSONS AND/OR ORGANIZATIONS AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION. 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 04-0M 7 Insured: RPM International Inc. Effective Polley No. WC9258788-10 Endorsement No. Premium$ Insurance Company: American Zurich Insurance Company Countersigned by l\ 1 ~ ~ --w,~c11 .. :a&~T1.lmlr=~d"'lrfl4\trt---- WC124 (4-84) WC DO 0313 Copyright 1983 National Council on Compensation Insurance, Inc. Page 1 of 1 Uniform Forms TM WORKERS COMPENSATION AND EMPLOYERS LIABlLITY INSURANCE POLICY WC 00 0313 (Ed. 04·84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by lhis policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shafl not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ALL PERSONS AND/OR ORGANIZATIONS AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION. THIS WAIVER DOES NOT APPLY IN WISCONSIN. 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 ls issued subsequent to preparation of the policy.) Endorsement 04-01-17 Effective Policy No. WC9258790-10 Endorsement No. Insured: RPM INTERNATIONAL INC. Premium$ \1' ' Insurance Company: American Zurich Insurance Company Countersigned by ---~-------"'-=---=----- WC124 (4-84) WC 000313 Copyright 1983 National Council on Compensation Insurance, Inc. Page 1 of 1 Uniform Forms TM Waiver of Subrogation Endorsement Insured: RPM INTERNATIONAL INC. Policy No.: EWS5965995-09 This endorsement modifies insurance provided by the following: Endorsement No.: S Effective Date of this Endorsement: 04-0 1-17 Excess Insurance Policy for Self-Insurer of Workers Compensation and Employers Liability This policy is changed to provide: @> ZURICH Part Six -Condition G -Subrogation -Recovery From Others -gives us the right to recover all payments which we have made to you from anyone liable for loss. We agree to waive this right but only to the extent that you perform work under a written contract which requires you to obtain this agreement. Countersigned:------------------------------------- Authorized Signature U-EW-117-B CW (6104) Page I of I Blanket Notification to Others of Cancellation or Non-Renewal Policy No. Eff. Dale of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. GLO9258791-10 04-01-17 04-01-18 04-01-17 25133-000 G ZURICH Add'I. Prem Return Prem. ------- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a list provided to us by the first Named Insured if you are required by written contact or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to the first Named Insured. Such list: 1. Must be provided to us prior to cancellation or non-renewal; 2. Must contain the names and addresses of only the persons or organizations requiring notification that such Coverage Part has been cancelled or non-renewed; and 3. Must be in an electronic format that is acceptable to us. B. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail or deliver such notification to each person or organization shown in the list: 1. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or 2. At least 30 days prior to the effective date of: a. Cancellation, if cancelled for any reason other than nonpayment of premium; or b. Non-renewal, but not including conditional notice of renewal. C. Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy only. Our failure to provide such mailing or delivery will not: 1, Extend the Coverage Part cancellation or non-renewal date; 2. Negate the cancellation or non-renewal; or 3. Provide any additional insurance that would not have been provided in the absence of this endorsement. D. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs A. and B. of this endorsement. All other terms and conditions of this policy remain unchanged. Includes copyrighte<! material of Insurance Services Office, Inc,. with its permission. U-GL-1521-A CW (10/12) Page 1 of 1 POLICY NUMBER: GlO9258791-10 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance 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. CG20010413 CO Insurance Services Office, Inc., 2012 Page 1 of 1 Wolters Kluwer Financial Services j Uniform Fonns ™ @ Waiver Of Subrogation (Blanket) Endorsement ZURICH Polley No Eff Date of Pol Exp Date of Pol Eff Date of End Producer Add'I Prem Return Prem PL0925879 l-10 P4-0l-17 04-01-18 04-01-17 25133-000 $-----$---- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part The following is added to the Transfer Of Rights Of Reconry Against Others To Us Condition: If you are required by a written contract or agreement. which is executed before a loss, to waive your rights of recovery from oth· ers, we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. ANY PERSON(S) OR ORGANIZATION(S) AS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT U-GL-925-B CW ( 12/0 l) Pagel of I Additional Insured -Owners, Lessees Or Contractors - Scheduled Person Or Organization Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add'I. Prem GLO9258791-10 P4-01-17 04-01-18 ~4-01-17 25133-000 ---- • ZURICH Return Prem. -- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: RPM INTERNATIONAL INC. Address (including ZIP Code): 2826 PEARL ROAD MEDINA, OH 44258 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Covered Operations Or Organization(s) ~NY PERSON(S) OR ORGANIZATION(S) AS REQUIRED ANY LOCATION AS REQUIRED BY WRITTEN CONTRACT BY WRITTEN CONTRACT OR AGREEMENT OR WRITTEN AGREEMENT EXECUTED PRIOR TO ~OSS, EXCEPT WHERE SUCH CONTRACT IS PROHIBITED BY LAW A. Section II -Who Is An Insured is amended to include as an additional insured the person or organization shown in the Schedule above, whom you are required to add as an additional insured on this policy under a written contract or written agreement. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations or "your work" as included in the "products-completed operations hazard", which is the subject of the written contract or written agreement at the Location designated and described in the Schedule above. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional Insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: Includes copyrighted material of Insurance Services Office, Inc., with its permission. U·GL-1177-F CW {04113) Page 1 of 2 This insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved, the rendering of or the failure to render any professional architectural, engineering or surveying services. C, The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV - Commercial General Liability Conditions: The additional insured must see to it that: 1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim; 2. We receive written notice of a claim or "suit" as soon as practicable; and 3. A request for defense and indemnity of the claim or "suit'' will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires that this coverage be primary and non-contributory. D. For the purpose of the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV -Commercial General Liability Conditions: Primary and Noncontributory insurance This Insurance Is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV -Commercial General Liability Conditions: This Insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section 111-Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement referenced in Paragraph A. of this endorsement; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. lnctudes copyrighted material of Insurance Services Office, rnc., with its permission. U-GL-1177-F CW (04113) Page2 of2