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HomeMy WebLinkAboutStafford SDHC LLC dba San Diego Crane and Hoist Co; 2021-11-02; PSA22-1706UTILPSA22-1706UTIL City Attorney Approved Version 6/12/18 1 AGREEMENT FOR ANNUAL SERVICE & INSPECTION OF TWO OVERHEAD MONORAIL CRANES AND SPREADER BARS AT BATIQUITOS & POINSETTIA LIFT STATION STAFFORD SDCH, LLC DBA SAN DIEGO CRANE AND HOIST CO. THIS AGREEMENT is made and entered into as of the ______________ day of ___________________, 2021, by and between the City of Carlsbad, a municipal corporation, ("City"), and Stafford SDCH, LLC, an Arizona limited liability company d.b.a. San Diego Crane and Hoist Co., ("Contractor”). RECITALS City requires the professional services of a consultant that is experienced in overhead crane service and inspection. Contractor has the necessary experience in providing these professional services, has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the “Services”) that are defined in Exhibit “A”, attached and incorporated by this reference in accordance with the terms and conditions set forth in this Agreement. 2. TERM This Agreement will be effective for a period of sixty (60) days from the date first above written. 3. COMPENSATION The total fee payable for the Services to be performed will be twelve hundred dollars ($1,200). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. City reserves the right to withhold a ten percent (10%) retention until City has accepted the work and/or the Services specified in Exhibit “A.” 4. 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 Agreement 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 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 such workers employed by him or her in the execution of the 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. DocuSign Envelope ID: 1FF1CF4C-047E-4746-9648-8576234EFC04 2nd November PSA22-1706UTIL City Attorney Approved Version 6/12/18 2 5. STATUS OF CONTRACTOR Contractor will perform the Services as an independent contractor and in pursuit of Contractor’s independent calling, and not as an employee of City. Contractor will be under the control of City only as to the results to be accomplished. 6. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys’ fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. 7. INSURANCE Contractor will obtain and maintain policies of commercial general liability insurance, automobile liability insurance, a combined policy of workers' compensation, employers liability insurance, and professional liability insurance from an insurance company authorized to transact the business of insurance in the State of California which has 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, in an amount of not less than one million dollars ($1,000,000) each, unless otherwise authorized and approved by the Risk Manager or the City Manager. Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims- made coverage. The insurance will be in force during the life of this Agreement and will not be canceled without thirty (30) days prior written notice to the City by certified mail. City will be named as an additional insured on General Liability which shall provide primary coverage to the City. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Contractor will furnish certificates of insurance to the Contract Department, with endorsements to City prior to City’s execution of this Agreement. 8. NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement. For City For Contractor Name Timothy Smith Name Ron Lemmer Title Utilities Maintenance Planner Title Project Manager Department Public Works Address 1606 Coolidge Ave. City of Carlsbad National City, CA 91950 Address 5950 El Camino Real Phone No. 619-474-0070 Carlsbad, CA 92008 Email ron@sandiegocrane.com Phone No. 760-603-7341 DocuSign Envelope ID: 1FF1CF4C-047E-4746-9648-8576234EFC04 PSA22-1706UTIL City Attorney Approved Version 6/12/18 3 Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 9. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests in all categories. Yes ☐ No ☒ 10. COMPLIANCE WITH LAWS Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment and will obtain and maintain a City of Carlsbad Business License for the term of this Agreement. 11. TERMINATION City or Contractor may terminate this Agreement at any time after a discussion, and written notice to the other party. City will pay Contractor's costs for services delivered up to the time of termination, if the services have been delivered in accordance with the Agreement. 12. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees it 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 seq. Contractor further acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to terminate this Agreement. 13. JURISDICTIONS AND VENUE Contractor agrees and stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Agreement is the State Superior Court, San Diego County, California. 14. ASSIGNMENT Contractor may assign neither this Agreement nor any part of it, nor any monies due or to become due under it, without the prior written consent of City. 15. AMENDMENTS This Agreement may be amended by mutual consent of City and Contractor. Any amendment will be in writing, signed by both parties, with a statement of estimated changes in charges or time schedule. /// /// /// /// DocuSign Envelope ID: 1FF1CF4C-047E-4746-9648-8576234EFC04 PSA22-1706UTIL City Attorney Approved Version 6/12/18 4 16. 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 STAFFORD SDCH, LLC, a limited liability company d.b.a. SAN DIEGO CRANE AND HOIST CO. CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Vicki V. Quiram, Utilities Director, as authorized by the City Manager Patrick Stafford, Managing Member (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, Secretary, President, or Assistant Secretary, Vice-President 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: 1FF1CF4C-047E-4746-9648-8576234EFC04 PSA22-1706UTIL EXHIBIT “A” SCOPE OF SERVICES ITEM NO. UNIT QTY DESCRIPTION PRICE 1 LS 1 Contactor to perform the annual service and inspection for two overhead monorail cranes and spreader bars. Contractor to provide documentation of services and inspections performed for both cranes and spreader bars. $1,200 TOTAL NOT-TO-EXCEED *$1,200 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: 1FF1CF4C-047E-4746-9648-8576234EFC04 5/6/2021 M&P Specialty Insurance 1179 Sunset Blvd. P.O. Box 4119 West Columbia SC 29171 Aaron Miller (803)936-1601 (803)936-1366 amiller@mpspecialty.com Stafford SDCH, LLC DBA San Diego Crane & Hoist 1606 Coolidge Ave. National City CA 91950 United Specialty Insurance Company 12537 Pennsylvania Manufacturers Association Ins12262 Carolina Casualty Insurance Company 10510 General Security Indemnity Co of AZ 20559 Arch Specialty Insurance Company 21199 Lloyds of London 32727 20-21 A X X X XCU/Contractual Liability X On Hook Riggers Liability X X Y DLJ-GL-00000037-00 11/1/2020 11/1/2021 1,000,000 100,000 10,000 1,000,000 2,000,000 2,000,000 Deductible:$10,000 B D X X X X X Y 152001-10-41-43-3 11/1/2020 11/1/2021 XA-000018-00 11/1/2020 11/1/2021 1,000,000 Deductible:0 A E X X X 0 DLJ-EX-00000210-00 11/1/2020 11/1/2021 UXP1034569-01 11/1/2020 11/1/2021 15,000,000 15,000,000 C N CCWC294803 12/1/2020 12/1/2021 X 1,000,000 1,000,000 1,000,000 A Motor Truck Cargo IICHMPP-0003115-01 11/1/2020 11/1/2021 Limit $1,000,000 F Professional Liability B0621PSTAF001420 6/5/2020 11/1/2021 Limit $5,000,000 City of Carlsbad/CMWD is Additional Insured on General Liabiity and Auto Liability as required per written contract. Coverage provided is on a primary and non-contributory basis. A Waiver of Subrogation has been provided in favor of City of Carlsbad/CMWD on General Liability, Auto Liability and Workers Compensation as required per written contract. City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 947 Murrieta, CA 92564 Michael Beall/APM Y The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L.EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE Ifyes,describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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 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. INSDADDL WVDSUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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 POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 thecertificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S)AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) POLICY NUMBER: ORANGL000151-01POLICY NUMBER: DLJ-GL00000037-00 POLICY NUMBER: ORANGL000151-00POLICY NUMBER: DLJ-GL-00000037-00 POLICY NUMBER: ORANGL000151-01POLICY NUMBER: DLJ-GL-00000037-00 POLICY NUMBER: ORANGL000151-01POLICY NUMBER: DLJ-GL-00000037-00 POLICY NUMBER: 151901-10-41-43-3POLICY NUMBER: 152001-10-41-43-3 COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 04 49 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance – Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". INSURED COPY POLICY NUMBER: 152001-10-41-43-3 POLICY NUMBER: 151901-10-41-43-3POLICY NUMBER: 152001-10-41-43-3 12/1/2019 AMWC294802 Berkley Casualty Company 12/1/2020 CCWC294803 Carolina Casualty Insurance Company 10/19/2021 M&P Specialty Insurance 1179 Sunset Blvd. P.O. Box 4119 West Columbia SC 29171 Aaron Miller (803)936-1601 (803)936-1366 amiller@mpspecialty.com Stafford SDCH, LLC DBA San Diego Crane & Hoist 1606 Coolidge Ave. National City CA 91950 United Specialty Insurance Company 12537 Pennsylvania Manufacturers Association Ins12262 Arch Specialty Insurance Company 21199 Carolina Casualty Insurance Company 10510 Lloyds of London 32727 21-22 A X X X X,C,U/ContractualLiability X On Hook Riggers Liability X X Y DLJ-GL-00000037-01 11/1/2021 11/1/2022 1,000,000 50,000 5,000 1,000,000 2,000,000 2,000,000 Riggers Liability 1,000,000 B X X X X Y 152001-10-41-43-4 11/1/2021 11/1/2022 1,000,000 A C X X X 10,000 DLJ-EX-00000210-01 11/1/2021 11/1/2022 UXP1034569-02 11/1/2021 11/1/2022 15,000,000 15,000,000 D N CCWC294804 12/1/2021 12/1/2022 X 1,000,000 1,000,000 1,000,000 A Motor Truck Cargo DLJ-CP-00000010-01 11/1/2021 11/1/2022 Limit:$1,000,000 E Professional Liability B0621PSTAF001421 11/1/2021 11/1/2022 Limit:$5,000,000 City of Carlsbad/CMWD is Additional Insured on General Liabiity and Auto Liability as required per written contract. Coverage provided is on a primary and non-contributory basis. A Waiver of Subrogation has been provided in favor of City of Carlsbad/CMWD on General Liability, Auto Liability and Workers Compensation as required per written contract. City of Carlsbad/CMWD c/o EXIGIS Insurance Compliance Services P.O. Box 947 Murrieta, CA 92564 Michael Beall/APM Y The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS PERSTATUTE OTH-ER E.L.EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE Ifyes,describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNEDAUTOSAUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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 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. INSDADDL WVDSUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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 POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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 thecertificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE(A/C, No, Ext): PRODUCER ADDRESS:E-MAIL FAX(A/C, No): CONTACTNAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S)AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED INACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) 12/1/2019 AMWC294802 BerkleyCasualtyCompanyCarolina Casualty Insurance Company 12/1/2021 CCWC294804 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 CG 24 04 05 09 Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SCHEDULE Name Of Person Or Organization: 8. Transfer Of Rights Of Recovery Against Others To UsSection IV – Conditions: POLICY NUMBER: DLJ-GL-00000037-01 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 01 04 13 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY –OTHER INSURANCE CONDITION Other Insurance Primary And Noncontributory Insurance (1) (2) POLICY NUMBER: DLJ-GL-00000037-01 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 37 04 13 Page 1 of 1 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – COMPLETED OPERATIONS SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations A. Section II – Who Is An Insured 1. 2. B. Section III – Limits Of Insurance: 1. 2. POLICY NUMBER: DLJ-GL-00000037-01 POLICY NUMBER: DLJ-GL-00000037-01 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 10 04 13 Page 1 of 2 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations A. Section II – Who Is An Insured 1. 2. 1. 2. B. 1. 2. POLICY NUMBER: DLJ-GL-00000037-01 Page 2 of 2 CG 20 10 04 13 C. Section III – Limits Of Insurance: 1. 2. POLICY NUMBER: 151901-10-41-43-3POLICY NUMBER: 152001-10-41-43-3POLICY NUMBER: 152001-10-41-43-4 CA 04 49 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 1 A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance – Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "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 such "insured". INSURED COPY POLICY NUMBER: 152001-10-41-43-4 COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. POLICY NUMBER: 151901-10-41-43-3POLICY NUMBER: 152001-10-41-43-3POLICY NUMBER: 152001-10-41-43-4