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Goforth and Marti DBA G/M Business Interiors; 2021-07-06; PWLCA-1925
LIBRARY LEARNING CENTER 2nd FLOOR CUSTOM RECEPTION DESKS – CONT. NO. PW-LCA-1925 Page 1 of 6 City Attorney Approved 1/22/2020 CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT LIBRARY LEARNING CENTER 2nd FLOOR, CUSTOM RECEPTION DESKS CONT. NO. PW-LCA-1925 GOFORTH & MARTI DBA G|M BUSINESS INTERIORS (GMBI) This agreement is made on the ______________ day of ________________, 2021, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Goforth & Marti DBA G|M Business Interiors, a California Corporation, (“Contractor”), whose principal place of business is 110 W. A. Street, San Diego, CA 92101 (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: Fiona Everett, City Project Manager PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. 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. DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119Debbie Jo McCool Carrie Scott Sheila CrosbyDebbie Jo McCool Suzanne Smithson Ed Garbo, Risk Manager July6th LIBRARY LEARNING CENTER 2nd FLOOR CUSTOM RECEPTION DESKS – CONT. NO. PW-LCA-1925 Page 2 of 6 City Attorney Approved 1/22/2020 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. 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: Laurinda P. Easley 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. DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 LIBRARY LEARNING CENTER 2nd FLOOR CUSTOM RECEPTION DESKS – CONT. NO. PW-LCA-1925 Page 3 of 6 City Attorney Approved 1/22/2020 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. 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 30 working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within 120 working days after receipt of Notice to Proceed. CONTRACTOR’S INFORMATION. Goforth & Marti DBA G|M Business Interiors 110 W. A. Street, Suite 140 (name of Contractor) 944352 (street address) San Diego, CA 92101 (Contractor’s license number) C61 & D34 – Expires 03/31/2022 (city/state/zip) 619-236-0500 (license class. and exp. date) 1000001979 (telephone no.) N/A (DIR registration number) 06/30/2021 (fax no.) mphilbin@gmbi.net (DIR registration exp. date) (e-mail address) /// /// /// /// /// DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 LIBRARY LEARNING CENTER 2nd FLOOR CUSTOM RECEPTION DESKS – CONT. NO. PW-LCA-1925 Page 4 of 6 City Attorney Approved 1/22/2020 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 CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Laurinda P. Easley, CEO & Secretary SUZANNE SMITHSON Library & Cultural Arts Director as Authorized by the City Manager (print name/title) By: ATTEST: (sign here) For BARBARA ENGLESON City Clerk (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: For CELIA A. BREWER, City Attorney BY: _____________________________ Deputy/Assistant City Attorney /// /// /// /// /// DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 Audra Mahoney Audra Mahoney LIBRARY LEARNING CENTER 2nd FLOOR CUSTOM RECEPTION DESKS – CONT. NO. PW-LCA-1925 Page 5 of 6 City Attorney Approved 1/22/2020 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%___________ DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 LIBRARY LEARNING CENTER 2nd FLOOR CUSTOM RECEPTION DESKS – CONT. NO. PW-LCA-1925 Page 6 of 6 City Attorney Approved 1/22/2020 EXHIBIT B SCOPE OF SERVICES LIBRARY LEARNING CENTER 2nd FLOOR, CUSTOM RECEPTION DESKS Cooperative Purchasing Agreement #US Communities Government Purchasing Alliance 1) Quote includes prevailing wage rate. 2) G|M to receive and inspect new product at G|M’s San Diego Warehouse. 3) G|M to set (1) 2-person desk with height adjustable table and Herman Miller accessories and custom reception office furniture solution desk and storage 4) Please contact Carrie Scott @ (760) 931-4515 to schedule services. 5) G|M will hold product for up to (2) weeks at contractor’s warehouse free of charge. Any product remaining in contractor’s warehouse after this period will incur storage fees Note: Quote will need to be adjusted if services to take place after business hours, or during the weekend. JOB QUOTATION – G|M#187973 dated June 14, 2021 ITEM NO. UNIT QTY DESCRIPTION PRICE 1 EA 1 (02) each office furniture solution custom reception desks, with Herman Miller sit/stand base and Herman Miller screens, (02) each Herman Miller Aeron Stools, (1) ea Herman Miller FLO monitor arm and (02) ea Herman Miller loop CPU holders. $18,290.10 Services (Taxable) $115.00 Services (Non-Taxable) $861.00 Sales Tax (7.750%) $1,426.40 TOTAL* $20,692.50 *Includes taxes, fee’s, expenses and all other costs. DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 02/10/2021 Jenna La FondVan Wyk Risk Solutions150 Ottawa Ave NWSuite 1000Grand Rapids, MI 49503 (616) 942-5070 (616) 942-8199 JennaL@vanwykcorp.com National Union Fire Insurance 19445 GOFORTH & MARTIdba: G/M Business Interiors 110 West A StreetSte 140San Diego, CA 2101 Hiscox Insurance Company 10200 2021/2022 A Y A Medical Payments 5,000 NA A Y City of Carlsbad is included as Additional Insured with respects to General Liability as required by contract or written agreement. A waiver of subrogation is included for Workers Compensation as required by contract or written agreement. 30 days notice of cancellation. Email: City of Carlsbad1635 Faraday AveCarlsbad, CA 92008 GL 518-01-77 3/1/2021 3/1/2022 1,000,000 300,000 10,000 1,000,000 2,000,000 2,000,000 CA 296-16-06 3/1/2021 3/1/2022 1,000,000 WC 080-75-6387 3/1/2021 3/1/2022 1,000,000 1,000,000 1,000,000 B Professional Liability ANE4053725.19 3/1/2021 3/1/2022 $2,000,000 $1,000,000Aggregate Limit Each Occurrence ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDLSUBRLTRINSDWVD DATE (MM/DD/YYYY) PRODUCER CONTACTNAME:FAXPHONE(A/C, No):(A/C, No, Ext):E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOSHIREDNON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION$$PER OTH-STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE 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. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. 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‰–†‹fi¿‰‹–fi –fi ›«‰–†‹fi¿‰‹–fi »†„¿„»… •† »fi”–fi‡•†„ –»fi¿‹•–†› ”–fi ¿ fi•†‰•¿· ¿› ¿ ¿fi‹ –” ‹‚» ›¿‡» fi–¶»‰‹ ˙ —˛˝ ˛ ˛˘ ˙¸ ¸ ˝ —˛ ˛ ˛ ˛ ˝¸˛ ˝ ˛˝¸ ˙ ˛ ˛ ˛ ˙¸ ˚ ˛ ºŁØØ DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 †›«fi¿†‰» ˝»fi“•‰»› ””•‰» †‰ —¿„» –” •‹‚ fi»›»‰‹ ‹– ‹‚» •†›«fi¿†‰» ¿””–fi…»… ‹– ‹‚»›» ¿……•‹•–†¿· •†›«fi»…› ‹‚» ”–··–'•†„ •› ¿……»… ‹– ˝»‰‹•–† •‡•‹› ” †›«fi¿†‰» ” ‰–“»fi¿„» fi–“•…»… ‹– ‹‚» ¿……•‹•–†¿· •†›«fi»… •› fi»fl«•fi»… § ¿ ‰–†‹fi¿‰‹ –fi ¿„fi»»‡»†‹ ‹‚» ‡–›‹ '» '•·· ¿§ –† »‚¿·” –” ‹‚» ¿……•‹•–†¿· •†›«fi»… •› ‹‚» ¿‡–«†‹ –” •†›«fi¿†‰» ˛»fl«•fi»… § ‹‚» ‰–†‹fi¿‰‹ –fi ¿„fi»»‡»†‹ –fi “¿•·¿·» «†…»fi ‹‚» ¿·•‰¿·» •‡•‹› –” †›«fi¿†‰» ›‚–'† •† ‹‚» »‰·¿fi¿‹•–†› '‚•‰‚»“»fi •› ·»›› ‚•› »†…–fi›»‡»†‹ ›‚¿·· †–‹ •†‰fi»¿›» ‹‚» ¿·•‰¿·» •‡•‹› –” †›«fi¿†‰» ›‚–'† •† ‹‚» »‰·¿fi¿‹•–†› DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 ‚•› »†…–fi›»‡»†‹ »””»‰‹•“» ”–fi‡› ¿ ¿fi‹ –” –·•‰§ –•››«»… ‹– § ˝ ˛˝ ˝ —˙ —˝ ˛ ˛¸˙ ˝¸˛ ˛ ˛ˇ¸˛ ¸˛ ˛ ˛ ˛ ‚•› »†…–fi›»‡»†‹ ‡–…•”•»› •†›«fi¿†‰» fi–“•…»… «†…»fi ‹‚» ”–··–'•†„ ¸˝˝˝ ¸ ˚˛ ˛ ˝¸ ˝¸˛ ŁØº łæº «‹‚–fi•ƒ»… ˛»fi»›»†‹¿‹•“» –fi–«†‹»fi›•„†¿‹«fi» ł•† ˝‹¿‹»› ‚»fi»·•‰¿·» —¿„» –” ˝ ˙ ˚˛ –“»fi¿„» ‚– › †›«fi»… •› ¿‡»†…»… ‹– ¿…… …†§ »fi›–† –fi –fi„¿†•ƒ¿‹•–† ›‚–'† •† ‹‚» ›‰‚»…«·» ¿–“» ‹– '‚–‡ §–« »‰–‡» –·•„¿‹»… ‹– •†‰·«…» ¿› ¿† ¿……•‹•–†¿· •†›«fi»… «†…»fi ‹‚•› –·•‰§ ¿› ¿ fi»›«·‹ –” ¿†§ ‰–†‹fi¿‰‹ –fi ¿„fi»»‡»†‹ §–« »†‹»fi •†‹– '‚•‰‚ fi»fl«•fi»› §–« ‹– ”«fi†•›‚ •†›«fi¿†‰» ‹– ‹‚¿‹ »fi›–† –fi –fi„¿†•ƒ¿‹•–† –” ‹‚» ‹§» fi–“•…»… § ‹‚•› –·•‰§ «‹ –†·§ '•‹‚ fi»›»‰‹ ‹– ·•¿•·•‹§ ¿fi•›•†„ –«‹ –” «›» –” ¿ ‰–“»fi»… ¿«‹– –'»“»fi ‹‚» •†›«fi¿†‰» fi –“•…»… '•·· †–‹ »¤‰»»… ‹‚» ·»››»fi –” ł‚» ‰–“»fi¿„» ¿†…æ–fi ·•‡•‹› –” ‹‚•› –·•‰§ –fi ł‚» ‰–“»fi¿„» ¿†…æ–fi ·•‡•‹› fi»fl«•fi»… § ›¿•… ‰–†‹fi¿‰‹ –fi ¿„fi»»‡»†‹ ˛˝ ææ 21 2961606 ˛ œ ˛ ¸˝˝˝ ˛˛˝ ¸ ˛ ˝¸˛ —˙ —˝¸˛ — ˙ —˛˝ ˛ ˛˘ ˛ ˙¸ ˛ ˛¸˙ ¸ —˛˚ ˝¸˛ ˝¸˝ ¸ ˙ ¨ ˝¸—˛˝ ˛ ˛˘˝ ˙ ˛˝ ¸ ¸˝ ˚˛¸ DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 ˝ ˛˝ ˝ —˙ —˝ ˛ ˛¸˙ ¸˝˝˝ ¸ ˚˛ ˛ ŒŁØ łŒæº ¸˛˘ ˛—˛˝˚ ˛˝ ‚•› »†…–fi›»‡»†‹ »””»‰‹•“» ”–fi‡› ¿ ¿fi‹ –” –·•‰§ –•››«»… ‹– § ‚•› »†…–fi›»‡»†‹ ‡–…•”•»› •†›«fi¿†‰» fi–“•…»… «†…»fi ‹‚» ”–··–'•†„ ˚˛ ˛˝˛ ˛˝ ˛˚˛˙ ˝ ˛˝ ¸˝ ł ł ‚» ‰–†‹fi¿‰‹ –fi ¿„fi»»‡»†‹ '¿› »†‹»fi»… •†‹– fi•–fi ‹– ¿†§ ¿‰‰•…»†‹ –fi ·–›› – '¿•“»fi –” ‹‚» fi•„‚‹ –” fi»‰–“»fi§ '•·· …•fi»‰‹·§ –fi •†…•fi»‰‹·§ ¿·§ ‹– §–«fi »‡·–§»»› –fi »‡·–§»»› –” ‹‚» »fi›–† –fi –fi„¿†•ƒ¿‹•–† ¿†… '» fi»›»fi“» –«fi fi•„‚‹› –fi ·•»† ‹– » fi»•‡«fi›»… ”fi–‡ ¿†§ fi»‰–“»fi§ ”«†…› –‹¿•†»… § ¿†§ •†¶«fi»… »‡·–§»» ˝»‰‹•–† ˚ «›•†»›› «‹– –†…•‹•–†› –›› –†…•‹•–†› º fi¿†›”»fi –” ˛•„‚‹› –” ˛»‰–“»fi§ „¿•†›‹ ‹‚»fi› ‹– ¸› •› ¿‡»†…»… ‹– ¿…… ‚» ¿‰‰•…»†‹ –fi ·–›› •› …«» ‹– –»fi¿‹•–†› «†…»fi‹¿»† •† ¿‰‰–fi…¿†‰» '•‹‚ ‹‚» ‰–†‹fi¿‰‹ »¤•›‹•†„ »‹'»»† §–« ¿†… ›«‰‚ »fi›–† –fi –fi„¿†•ƒ¿‹•–† ¿†… –'»“»fi '» '•·· '¿•“» ¿†§ fi•„‚‹ –” fi»‰–“»fi '» ‚¿“» ¿„¿•†›‹ ¿†§ »fi›–† –fi –fi„¿†•ƒ¿‹•–† '•‹‚ '‚–‡ §–« ‚¿“» »†‹»fi»… •†‹– ¿ ‰–†‹fi¿‰‹ –fi ¿„fi»»‡»†‹ »‰¿«›» –” ¿§‡»†‹› '» ‡¿» «†…»fi ‹‚•› –“»fi¿„» –fi‡ ¿fi•›•†„ –«‹ –” ¿† ¿‰‰•…»†‹ –fi ·–›› •” ææ 21 ŒŒŒ ˛ œ ˛ ¸˝˝˝ ˛˛˝ ¸ ˛ ˝¸˛ —˙ —˝¸˛ — PDF created with pdfFactory Pro trial version www.pdffactory.com DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 POLICY NUMBER: ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s)Location And Description Of Completed Operations COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 37 04 13 Page 1 of 1Insurance Services Office, Inc., 2012 A.Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.If coverage provided to the additional insured is required by a contract or agree- ment,theinsuranceaffordedtosuchaddi- tional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B.With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1.Required by the contract or agreement; or 2.Available under the applicable Limits of Insu- rance shown in the Declarations; whichever is less. This endorsement shall not increase the appli- cable Limits of Insurance shown in the Decla- rations. GL518-01-77 ANY PERSON OR ORGANIZATION WHOM YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR PER THE CONTRACT OR AGREEMENT. AGREEMENT YOU HAVE ENTERED INTO. PDF created with pdfFactory Pro trial version www.pdffactory.com PDF created with pdfFactory Pro trial version www.pdffactory.com DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 —˙¸˛˛˛˙ ‚•› »†…–fi›»‡»†‹ ‡–…•”•»› •†›«fi¿†‰» fi –“•…»… «†…»fi ‹‚» ”–··–'•†„ ˛ ˛ ˙ ˚˛ —˛ —¿„»–” —˛˛˙ ˛¸˛˙ ˛ ˝¸˛ †›«fi¿†‰» ˝»fi“•‰»› ””•‰» †‰ —˛¸˝æ— —˛˝ ˙ ˚˛ —˛ ˝ ˛˝ ˝ —˙ —˝ ˛ ˛¸˙ ‚» ”–··–'•†„ •› ¿……»… ‹– ‹‚» ‹‚»fi †›«fi¿†‰» –†…•‹•–† ¿†… ›«»fi›»…»› ¿†§ fi–“•›•–† ‹– ‹‚» ‰–†‹fi¿fi§ —fi•‡¿fi§ †… –†‰–†‹fi•«‹–fi§ †›«fi¿†‰» ‚•› •†›«fi¿†‰» •› fi•‡¿fi§ ‹– ¿†… '•·· †–‹ ›»» ‰–†‹fi•«‹•–† ”fi–‡ ¿†§ –‹‚»fi •†›«fi¿†‰» ¿“¿•·¿·» ‹– ¿† ¿……•‹•–†¿· •†›«fi»… «†…»fi §–«fi –·•‰§ fi –“•…»… ‹‚¿‹ ł ‚» ¿……•‹•–†¿· •†›«fi»… •› ¿ ¿‡»… †›«fi»… «†…»fi ›«‰‚ –‹‚»fi •†›«fi¿†‰» ¿†… ł ˙–« ‚¿“» ¿„fi»»… •† 'fi•‹•†„ •† ¿ ‰–†‹fi¿‰‹ –fi ¿„fi»»‡»†‹ ‹‚¿‹ ‹‚•› •†›«fi¿†‰» '–«·… » fi•‡¿fi§ ¿†… '–«·… †–‹ ›»» ‰–†‹fi•« ‹•–† ”fi–‡ ¿†§ –‹‚»fi •†›«fi¿†‰» ¿“¿•·¿·» ‹– ‹‚» ¿……•‹•–†¿· •†›«fi»… ºŁØØ DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 —˙ ¸˛ †›«fi¿†‰» ˝»fi“•‰»› ””•‰» †‰ Ł —¿„» –” ˚˛ ˛˝˛ ˛˝ ˛˚˛˙ ˝ ˛˝ ¸˝ ˛ ˛ ˙ º ‚•› »†…–fi›»‡»†‹ ‡–…•”•»› •†›«fi¿†‰» fi –“•…»… «†…»fi ‹‚» ”–··–'•†„ ˛ ˛ ˙ ˚˛ —˛ —˛¸˝æ— —˛˝ ˙ ˚˛ —˛ ˝¸ ¿‡» ” —»fi›–† fi fi„¿†•ƒ¿‹•–† †”–fi‡¿‹•–† fi»fl«•fi»… ‹– ‰–‡·»‹» ‹‚•› ˝‰‚»…«·» •” †–‹ ›‚–'† ¿–“» '•·· » ›‚–'† •† ‹‚» »‰·¿fi¿‹•–†› º ‚» ”–··–'•†„ •› ¿……»… ‹– —¿fi¿„fi¿‚ Ł fi¿†›”»fi ” ˛•„‚‹› ” ˛»‰–“»fi§ „¿•†›‹ ‹‚»fi› – ¸› –” ˝»‰ ‹•–† ˚ –†…•‹•–†› » '¿•“» ¿†§ fi•„‚‹ –” fi»‰–“»fi§ '» ‡¿§ ‚¿“» ¿„¿•†›‹ ‹‚» »fi›–† –fi –fi„¿†•ƒ¿‹•–† ›‚–'† •† ‹‚» ˝‰‚»…«·» ¿–“» »‰¿«›» –” ¿§‡»†‹› '» ‡¿» ”–fi •†¶«fi§ –fi …¿‡¿„» ¿fi•›•†„ –«‹ –” §–«fi –†„–•†„ –»fi¿ ‹•–†› –fi §–«fi '–fi …–†» «†…»fi ¿ ‰–†‹fi¿‰‹ '•‹‚ ‹‚¿‹ »fi›–† –fi –fi„¿†•ƒ¿‹•–† ¿†… •†‰·«…»… •† ‹‚» fi–…«‰‹›‰–‡·»‹»… –»fi¿‹•–†› ‚¿ƒ¿fi… ‚•› '¿•“»fi ¿·•»› –†·§ ‹– ‹‚» »fi›–† –fi –fi„¿†•ƒ¿‹•–† ›‚–'† •† ‹‚» ˝‰‚»…«·» ¿–“» ºŁØØ —¸˛˝¸ —— ˛ ˛ ˛ ˛ ˙¸ ˛ DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119 03/01/2021 WC 080-75-6387 GOFORTH & MARTI - DBA: GM BUSINESS INTERIORS NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. DocuSign Envelope ID: BEA56DE9-FD82-4622-9321-4B3172B27119