Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Duthie Electric Service Corporation d.b.a. Duthie Power Services; 2022-11-01; PWM23-2005UTIL
PWM23-2005UTIL BACKUP GENERATOR SERVICING AT MAERKLE RESERVOIR Page 1 of 8 General Counsel Approved 8/2/2022 CARLSBAD MUNICIPAL WATER DISTRICT MINOR PUBLIC WORKS CONTRACT BACKUP GENERATOR SERVICING AT MAERKLE RESERVOIR This agreement is made on the ______________ day of _________________________, 2022, by the Carlsbad Municipal Water District, a Public Agency organized under the Municipal Water Act of 1911, and a Subsidiary District of the City of Carlsbad, hereinafter referred to as “CMWD”, and Duthie Electric Service Corporation, a California corporation d.b.a. Duthie Power Services, whose principal place of business is 2335 E Cherry Industrial Circle, Long Beach, CA 90805-4416 (hereinafter called "Contractor"). CMWD 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 Andrew Wilson (CMWD 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 CMWD’s "duly authorized officer" for the purposes of section 4107 and 4107.5. DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 November1st PWM23-2005UTIL BACKUP GENERATOR SERVICING AT MAERKLE RESERVOIR Page 2 of 8 General Counsel Approved 8/2/2022 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. FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to CMWD 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 (5) years and that debarment by another jurisdiction is grounds for CMWD to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ___________________________________ Print Name: ___________Erik Duthie__ _____________ REQUIRED INSURANCE. The successful contractor shall provide to CMWD, 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 CMWD 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 DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 PWM23-2005UTIL BACKUP GENERATOR SERVICING AT MAERKLE RESERVOIR Page 3 of 8 General Counsel Approved 8/2/2022 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 30 days written notice shall be given to CMWD prior to such cancellation. The policies shall name CMWD as additional insured. The full limits available to the named insured shall also be available and applicable to CMWD as an additional insured. WORKERS COMPENSATION AND EMPLOYER’S LIABILITY. Worker’s Compensation limits as required by the California Labor Code. Workers’ Compensation will not be required if Contractor has no employees and provides, to City’s satisfaction, a declaration stating this. BUSINESS LICENSE. The Contractor and all subcontractors are required to have and maintain a valid City of Carlsbad Business License for the duration of the contract. INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless CMWD and the City of Carlsbad, and its 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 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 CMWD or City of Carlsbad. 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 seven (7) working days after receipt of Notice to Proceed. /// /// /// /// DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 PWM23-2005UTIL BACKUP GENERATOR SERVICING AT MAERKLE RESERVOIR Page 4 of 8 General Counsel Approved 8/2/2022 CONTRACTOR’S INFORMATION. Duthie Electric Service Corporation d.b.a. Duthie Power Services 2335 E Cherry Industrial Circle (name of Contractor) 708125 (street address) Long Beach CA 90805-4416 (Contractor’s license number) C10-ELECTRICAL 6/30/23 (city/state/zip) 562-790-1772 x1220 (license class. and exp. date) 1000027141 6/30/23 (telephone no.) ryan@duthiepower.com (DIR registration number & exp. date) (e-mail address) /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 PWM23-2005UTIL BACKUP GENERATOR SERVICING AT MAERKLE RESERVOIR Page 5 of 8 General Counsel Approved 8/2/2022 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 DUTHIE ELECTRIC SERVICE CORPORATION d.b.a. DUTHIE POWER SERVICES, a California corporation CARLSBAD MUNICIPAL WATER DISTRICT By: By: (sign here) Erik Duthie, Vice-President & CFO Vicki V. Quiram, General Manager as authorized by the Executive Manager (print name/title) By: (sign here) (print name/title) If required by CMWD, 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: CINDIE K. McMAHON, General Counsel BY: _____________________________ General Counsel DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 PWM23-2005UTIL BACKUP GENERATOR SERVICING AT MAERKLE RESERVOIR Page 6 of 8 General Counsel Approved 8/2/2022 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 Total % Subcontracted: _______________ The Contractor must perform no less than 50% of the work with its own forces. DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 None None N/A N/A 0% 0%None 0% N/ANone N/A PWM23-2005UTIL BACKUP GENERATOR SERVICING AT MAERKLE RESERVOIR Page 7 of 8 General Counsel Approved 8/2/2022 EXHIBIT B BACKUP GENERATOR SERVICING AT MAERKLE RESERVOIR JOB QUOTATION Contractor to repair and service the backup generator at Maerkle Reservoir. The generator requires service and repairs outside of the regular preventative maintenance. DESCRIPTION EXTENDED PRICE Indoor Cummins 450 KW generator, serial number C930502032, 5200 Sunny Creek Rd. Contractor to perform the following: Set up A frame to lift engine Drain & properly dispose of hazmat engine coolant Drain & capture engine oil Remove generator controller from engine Remove alternator end from generator engine Remove all necessary components to access faulty rear main seal Remove faulty rear main oil seal Install new rear main oil seal Remove engine guards & shrouds Remove engine drive belts Remove engine cooling system hoses Remove engine thermostats Install new engine thermostats with gaskets & seals as required Install all new cooling system hoses with new hose clamps Install new engine drive belts Adjust drive belts as needed Install engine shrouds & guards Refill cooling system with fresh engine coolant Refill engine with captured oil Reconnect alternator end & generator controls Contractor to test run equipment to ensure proper operation Generator service $18,836.59 Sales tax 241.85 TOTAL NOT-TO-EXCEED *$19,078.44 *Includes taxes, fees, expenses and all other costs. DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 PWM23-2005UTIL BACKUP GENERATOR SERVICING AT MAERKLE RESERVOIR Page 8 of 8 General Counsel Approved 8/2/2022 Notes: CMWD responsible for Contractor’s access to Maerkle Reservoir sites. Generator service is during normal working hours and generator will be out of service 4-5 days to perform this work. CMWD has plans for a rental if it becomes necessary. Contractor’s responsibilities: •Order all necessary parts once PO is received. •All parts received by Contractor prior to work being scheduled. •Warranty statement – all parts & labor covered for (12) month period. Any manufacturer’swarranty that exceeds the (12) month period will be honored for duration of stated coverage. •Safely and responsibly remove hazardous wastes (lube oil, anti-freeze, fuel, etc.) forproper disposal. EPA #CAD981445786 •All consumables and tax included. •Provide detailed service report once generator service completed. DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 PWM23-2005UTIL Exhibit "A" DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 ~ !!JI'!!~ SALE~C:~ RENTALS 2335 E Cherry Industrial Circle Long Beach, CA 90805-4416 Proposal To: 24 Hour Service Generators • Fire Pumps • Transfer Switches Phone (562) 790-1772 (800) 394-7697 Fax (562) 408-3020 Lie# 708125 Service Location: QUOTE Quote Number: -me10158 Work Order Id: 197575 Date: 09/29/2022 Submitted By: NA THAN WOODS Page: 1 of 2 Andrew Wilson Utilities Supervisor City of Carlsbad -Utilities Department 5200 Sunny Creek Rd 5200 Sunny Creek Rd Carlsbad CA 92008 (760)603-7325 andrew.wilson@carlsbadca.gov Option# 1 Equipment 450 KW Carlsbad CA 92008 CAR520-002 Manufacturer Cummins Model 450DFEC Serial # C930502032 Year: 0000 Size 450.00 -480 THIS QUOTE IS FOR RECOMMENDED CORRECTIONS TO EMERGENCY EQUIPMENT TRAVEL TO JOBSITE, GAIN ACCESS TO EMERGENCY EQUIPMENT SET UP A FRAME TO LIFT ENGINE DRAIN & PROPERLY DISPOSE OF HAZMAT ENGINE COOLANT DRAIN & CAPTURE ENGINE OIL REMOVE GENERA TOR CONTROLLER FROM ENGI NE REMOVE ALTERNATOR END FROM GENERATOR ENGINE REMOVE ALL NECESSARY COMPONENTS TO ACCESS FAUL TY REAR MAIN SEAL REMOVE FAUL TY REAR MAIN OIL SEAL INSTALL NEW REAR MAIN OIL SEAL REMOVE ENGINE GUARDS & SHROUDS REMOVE ENGINE DRIVE BEL TS REMOVE ENGINE COOLING SYSTEM HOSES REMOVE ENGINE THERMOSTATS INSTALL NEW ENGINE THERMOSTATS WITH GASKETS & SEALS AS REQUIRED INSTALL ALL NEW COOLING SYSTEM HOSES WITH NEW HOSE CLAMPS INSTALL NEW ENGINE DRIVE BELTS ADJUST DRIVE BEL TS AS NEEDED INSTALL ENGINE SHROUDS & GUARDS REFILL COOLING SYSTEM WITH FRESH ENGINE COOLANT REFILL ENGINE WITH CAPTURED OIL RECONNECT ALTERNATOR END AND GENERATOR CONTROLS TEST RUN EQUIPMENT TO ENSURE PROPER OPERATION Initial: _____ _ Total Estimated Sales Tax Estimated Total Sale 18,836.59 241.85 19,078.44 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED?(Mandatory in NH) DESCRIPTION OF OPERATIONS belowIf yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIREDAUTOS ONLY 7/5/2022 IOA Insurance Services130 VantisSuite 250Aliso Viejo CA 92656 Elizabeth Leach 949-297-5962 949-297-5960 elizabeth.leach@ioausa.com License#: 0E67768 Travelers Property Casualty Company of America 25674 DUTHELE-01 Crum & Forster Specialty Insurance Company 44520Duthie Electric Service Corp dba: Duthie Power Services2335 E. Cherry Industrial CircleLong Beach CA 90805 Houston Casualty Company 42374 HSB Specialty Insurance Company 14438 1617153953 A X 1,000,000 X 300,000 5,000 1,000,000 2,000,000 X Y Y Y6302A626927 7/1/2022 7/1/2023 2,000,000 Deductible 0 A 1,000,000 X X X Y Y 8102N3387402114G 7/1/2022 7/1/2023 A X X 15,000,000YCUP3S17641A22NF7/1/2022Y 7/1/2023 15,000,000 X 10,000 A XYUB7K4755032114G7/1/2022 7/1/2023 1,000,000 1,000,000 1,000,000 BCD Contractors PollutionContractors ProfessionalCyber PKC111856HCC2168107660810502 7/1/20227/1/20223/15/2022 7/1/20237/1/20233/15/2023 Occurence/AggregateEach Claim/AggregateEach Claim/Aggregate $3,000,000$1,000,000$2,000,000 The certificate holder(s) is/are included as an additional insured(s) with respects to General Liability for On-going and Completed Operations as per policy formCG D6 04 02 19 and Auto Liability as per policy form CA T3 53 02 15; General Liability and Auto Liability are Primary and Non-Contributory as per policy formsCG T1 00 02 19 and CA 00 01 10 13; Waiver of Subrogation applies to General Liability as per policy form CG D4 58 02 19, Auto Liability as per policy form CAT3 53 02 15 and Workers Compensation as per policy form WC 99 03 76; Additional Insured and Waiver of Subrogation applies to Umbrella Liability only asrequired by written contract; Umbrella Liability follows form. Per Project Aggregate Endorsement policy form CG D3 21 01 04 is provided as required by awritten contract; All coverage is only applicable as required by written contract. Contractors PollutionSee Attached... City of Carlsbad/CMWDc/o EXIGIS Insurance Compliance ServicesP.O. Box 947Murrieta CA 92564 DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 ~ D □ ~ ~ Fl □ □ ~ ~ ~ ~ ~ ~ ~ ~ H I I I I I □ ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: DUTHELE-01 1 1 IOA Insurance Services Duthie Electric Service Corp dba: Duthie Power Services2335 E. Cherry Industrial CircleLong Beach CA 90805 25 CERTIFICATE OF LIABILITY INSURANCE $10,000 Deductible *Contractors Professional (Claims Made)$10,000 Each Claim Deductible DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 I COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED – AUTOMATIC STATUS IF REQUIRED BY WRITTEN CONTRACT (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following is added to SECTION II – WHO IS AN (a)The Additional Insured – Owners, Les- INSURED:sees or Contractors – Scheduled Person or Organization endorsement CG 20 10Any person or organization that:07 04 or CG 20 10 04 13, the Additionala.You agree in a written contract or agreement to Insured – Owners, Lessees or Contrac-include as an additional insured on this Coverage tors – Completed Operations endorse-Part; and ment CG 20 37 07 04 or CG 20 37 04 13,b.Has not been added as an additional insured for or both of such endorsements with eitherthe same project by attachment of an endorse-of those edition dates; orment under this Coverage Part which includes (b)Either or both of the following: the Addi-such person or organization in the endorsement's tional Insured – Owners, Lessees or Con-schedule;tractors – Scheduled Person Or Organi-is an insured, but:zation endorsement CG 20 10, or the Ad- ditional Insured – Owners, Lessees ora.Only with respect to liability for "bodily injury" or Contractors – Completed Operations en-"property damage" that occurs, or for "personal dorsement CG 20 37, without an editioninjury" caused by an offense that is committed, date of such endorsement specified;subsequent to the signing of that contract or agreement and while that part of the contract or the person or organization is an additional in-agreement is in effect; and sured only if the injury or damage is caused, in whole or in part, by acts or omissions ofb.Only as described in Paragraph (1),(2)or (3)be- you or your subcontractor in the performancelow, whichever applies: of "your work" to which the written contract or(1)If the written contract or agreement specifical-agreement applies; orly requires you to provide additional insured (3)If neither Paragraph (1)nor (2)above applies:coverage to that person or organization by the use of:(a)The person or organization is an addi- tional insured only if, and to the extent(a)The Additional Insured – Owners, Les- that, the injury or damage is caused bysees or Contractors – (Form B) endorse- acts or omissions of you or your subcon-ment CG 20 10 11 85; or tractor in the performance of "your work"(b)Either or both of the following: the Addi-to which the written contract or agree-tional Insured – Owners, Lessees or Con-ment applies; andtractors – Scheduled Person Or Organi- (b)Such person or organization does notzation endorsement CG 20 10 10 01, or qualify as an additional insured with re-the Additional Insured – Owners, Lessees spect to the independent acts or omis-or Contractors – Completed Operations sions of such person or organization.endorsement CG 20 37 10 01; The insurance provided to such additional insured isthe person or organization is an additional in- subject to the following provisions:sured only if the injury or damage arises out of "your work" to which the written contract or a.If the Limits of Insurance of this Coverage Partagreement applies;shown in the Declarations exceed the minimum (2)If the written contract or agreement specifical-limits required by the written contract or agree- ly requires you to provide additional insured ment, the insurance provided to the additional in-coverage to that person or organization by sured will be limited to such minimum requiredthe use of:limits. For the purposes of determining whether CG D6 04 02 19 ú 2017 The Travelers Indemnity Company. All rights reserved.Page 1 of 2Do not attach this form to a policy. It is for informational use only.POLICY NUMBER: Y6302A626927 DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 COMMERCIAL GENERAL LIABILITY this limitation applies, the minimum limits required result in a claim. To the extent possible, such by the written contract or agreement will be con- notice should include: sidered to include the minimum limits of any Um-(a)How, when and where the "occurrence"brella or Excess liability coverage required for the or offense took place;additional insured by that written contract or (b)The names and addresses of any injuredagreement. This provision will not increase the persons and witnesses; andlimits of insurance described in Section III – Limits (c)The nature and location of any injury orOf Insurance.damage arising out of the "occurrence" orb.The insurance provided to such additional insured offense.does not apply to: (2)If a claim is made or "suit" is brought against(1)Any "bodily injury", "property damage" or the additional insured:"personal injury" arising out of the providing, (a)Immediately record the specifics of theor failure to provide, any professional archi-claim or "suit" and the date received; andtectural, engineering or surveying services, including:(b)Notify us as soon as practicable and see to it that we receive written notice of the(a)The preparing, approving, or failing to claim or "suit" as soon as practicable.prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or-(3)Immediately send us copies of all legal pa- ders or change orders, or the preparing, pers received in connection with the claim or approving, or failing to prepare or ap- "suit", cooperate with us in the investigation prove, drawings and specifications; and or settlement of the claim or defense against the "suit", and otherwise comply with all policy(b)Supervisory, inspection, architectural or conditions.engineering activities. (4)Tender the defense and indemnity of any(2)Any "bodily injury" or "property damage" claim or "suit" to any provider of other insur-caused by "your work" and included in the ance which would cover such additional in-"products-completed operations hazard" un- sured for a loss we cover. However, this con-less the written contract or agreement specifi- cally requires you to provide such coverage dition does not affect whether the insurance for that additional insured during the policy provided to such additional insured is primary period.to other insurance available to such additional insured which covers that person or organiza-c.The additional insured must comply with the fol- tion as a named insured as described in Par-lowing duties: agraph 4., Other Insurance, of Section IV –(1)Give us written notice as soon as practicable Commercial General Liability Conditions.of an "occurrence" or an offense which may Page 2 of 2 ú 2017 The Travelers Indemnity Company. All rights reserved.CG D6 04 02 19Do not attach this form to a policy. It is for informational use only.DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 POLICY NUMBER: Y6302A626927 DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 4. other Insurance If valid and collectible other insurance is available to the insured for a loss we cover under Coverages A cr B of this Cm,erage Part, oLr obligatims are limlted as described in Parag-aphs a. and b. belCMI. As used anywhere in this Coverage Part, other insurance means insurance. or the funding of la;;ses, that is pro.tided by, through or m behalf of: (i} Another insurance canpany; (ii} Us or any ci our affiliated insurance companies, except when the Non cumulatioo of Each Occurrence Limit provision of Paragraph 5. of Section Ill -Limits Of Insurance or the Non cumulation of Persrnal ard Advertising Injury Limit provision of Par,::graph 4. of Section Ill - Limits of Insurance applies because the Ameldment -Non Curnulatim Of Each Occurrence Limit Of Liroility And Non Cumljaim Of Personal And Advertising Injury Limit eldcrsement is included in this policy; (iii) Any risk retention gr0l4); or (iv) Any self-insurance metha:l or program, in which case the insured will be deemed to be the pro.tider of other insurance. 01her insurance does not include umbrella insurance, or excess insurance, that was brug,t spe:;ifically to apply in excess of the Limits of Insurance shOJ\111 in the Declarations of this Cowrage Pat. As used anyM1ere in this Coverage Part, other insurer means a provider of other insurance. As used in Paragraph c. belON, insurer means a provida-ci insurance. a. Primary Insurance This insurance is primary except when Paragraph b. belCMI applies. If this insurance is primary, our oljigations are not affected unless any of the otha-insurance is also primary. Then, we will share with all that other insurance by 1he methcd described in Paragraph c. belON, except when Pa-agraph d. belo.v ~plies. b. Excess lnsurance (1) This insurance is excess O'llff: (a) Any of the other insurance, whether primary, excess, ccntingent or on any other basis: (i) That is Fire, Extende::l Coverage, Builder's Risk, lnstallaticn Risk or similar coverage for "your work"; (ii) That is insurance for "premises danage''; (iii) If the loss arises out of the maintenmce or use of aircraft, "autos" or watercraft to the extent not subject to any exclusion in this Coverage Part that applies to aircraft, "autoo" a-watercraft; (iv) That is insurance availrole to a premises ovvner, manager or lessor tha: qualifies as an insured u nder Paragraph 4. of Section II - Who Is An Insured, except when Pa--agraph d. belovv ~plies; a- (v) That is insurance available to an equipment lessor that qualifies as an insured Lmder Paragraph 5. of Section II -Who Is An Insured, except wt1en Paragraph d. belo,v applies. (b) Any of the other insurmce, whether primary, excess, crntingent or a1 any other basis, that is availrole to the insured when the insured is an additional insured, or is any other insured that does not qualify as a nmlEd insured, under such other insurance. (2) When this insurance is excess, we will hctve no duty under Coveages A or B to defend the insured against any "suit" if a1y other insurer has a duty to deferld the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all trose other insurers. (3) When this insurance is excess over o1her insurance, we will pay only w r sha--e of the amou,t of the loss, if any, that exceeds the sum of: (a) The total amo..mt that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self- insured amounts under all that other insurance. (4) We will share the remaining loss, if any, with any other insurance that is not described in this Excess lnsurmce provision and was not boug,t specifically to ar:ply in e:>«::ess of the Limits of Insurance shONn in the Declarations of this Coverage Part. CG T10002 19 © 2017 Tl1e Travelers Indemnity Company. All rights reserved. Page 15 of 21 Includes copyrighted material of Insurance services Office, Inc. ·,11th its penntssion. DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 COMMERC IAL GENERAL LIABILITY c. Method Of Sharing If all of the other insurance permits contribution by equal sha-es, we ,..,;11 follow this metrod also. Under this approach each insurer contributes equal amwnts until it has paid its applicable limit cf insurance cr na1e of the loss remains. whichever comes first. If any of the other insurance does not perm it cortributim by equal shaes, we will contribute by limits. Under this method, each insurer's sha-e is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. d. Primary And Non-Contributory Insurance If Required By Written Contract If ya.i specifically agree in a written contract or agreenent that the insurance afforded to an insured under th is Cover.::ge Part must apply on a primay basis, or a primary ard nm- cortributory basis, this insurance is primary to other insurance that is available to such insured which CO\IB'"S such insured as a named insured, and we will not share with that other insurance, provided that: (1) The "bodily injury" or "property damage" for which cova~ is SOLJQht occurs: and (2) The "persona and advertising injL¥y" for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreenent by ya.i. 5. Premium Audit a. We will compute all premiums for this Co.erage Part in acccrcmce with a ir rules and ra:es. b. Premium sho.1\111 in this Coverage Part as aclvalce premiLrn is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is tt-E date sho,11111 as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greaer than the ecTned premiwn, we will return the e>eess to the f irst Named Insured. c. The first Named Insured must keep records of the infcrmatim we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting tli s p:;licy, yw agree: a. The statements in the Declarations ae accurate and complete; b. Those statements a-e based upon representations 'yOU made to us; and c. We have issued this policy in reliaice upon yair rep-esentations. The unintentional omission of, or unintertional error in, any information provided by ')OU which we relied upon in issuing this policy will not prejudice your rights under this insurance. HO\'Vever, this provision doos nct affect our right to collect additional premium or to exercise our rights of cancellatioo or na1ren6'1Val in accordance with applicable insurance laws cr regulatims. 7. Separation Of Insureds Except with respect to the Limits ci Insurance, and any rights or duties specifically assigned in this Co\€1"age Part to the first Named Insured, this insurance ~plies: a. As if each Named Insured were the only Named Insured; aid b. Separately to each insured against whan claim is rnade er "suit'' is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to reCXJ\/er all or part of any paymBlt we ha\A3 made under this Cover~e Part, those rights ae transferred to us. The insured must do nothing after loss to impair them. At our request, the insL1red will brirg "suit" or transfer those rights to us and help us enforce then. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we w ill mail or deliver to the first Named Insured shown in the Declarations written notice of the na1renewal nct less than 30 days before the expiration date. If notice is mailed, proof of rnailirg will be sufficient proof of notice. SECTION V -DEFINITIONS 1. "Advertisement" means a notice that is broa::lcast cr published to the general public cr specific market segments about ya.ir goa:ls, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that ae published include material placed on the Internet or on sim ilar electronic means of cornmLn icatim ; and b. Reg3rding websites, only that part of a website that is about your goods, products or services for the purposes of attracting customers or supporters is considered an adl.ertisETT1ent. Page16of21 <-> 2017 Tl1e Travelers lncJernnity Company. All rights reservecJ. CG T1000219 Includes copyrigl1led rna1erial of Insurance Services Office, Inc. with its permission. COMM RCI L G NERAL IAB LI YEAELIT T IS ENDORSEMENT CHANGES T E POLICY. PL ASE READ IT CAREFULLY.H H E XTEND ENDORSEMENT FOR MANUFACTURERS AND WHOLESA ERSL Thi e dorseme t m d fie i surance prov ded under he f l o ing:s n n o i s n i t o l w COMM RCI L G NERAL IAB LI Y COVERAG PA TEAELITER GE ERAL D SCRIP ION O CO ERAGENETFV –Thi endorsem nt broa ens cov rage.Howev r,cov rage fo anysedeeer i ju y,dama e o me i al ex ense descri ed in any o the provnrgrdcpsbfi ion o th s e dorseme t may bssfinne or l m ted by anothe endorsem n to this Cov rage Pa t, and the e coviireterse age broa ening prov sions do no apply tordit the ex en tha cov rage is ex l ded or lim ted by such an entttecuidorsem n . The fo lo ing li ti g i a getlwsnseneral cov rage de cript o only Read al the prov sion o thi enesin.l i s f s dorsem n and the re t o pol cy e t s f i to de erm ne righ s, dutie , and wha s and i not ov red.t i t s t i s c e A.Wh I An Insured –Unnam d Subsid arieoseis H.Bla ket Addit onal Insured –Gov rnme talnien En it e –Pe m t Or Au ho iza ions Re ati g TotisristrtlnB.Wh Is An In ured –Em loy es And Vol nteerospeu Ope atio srnWokrs–Bodily Injury To Co Emplo ee Andre-y s I.Bla ket Additio al In ured –Grantors OfnnsCoVolnteer o ke s-u W r r F an hi ercssC.Wh Is An In ured –Newly Acqui ed Or Fo medosrr J.In i ental Med cal Mal racti ecdipcLiied Liabil ty ompaniemtiCs K.Med cal Paym nts –In rea ed Lim tiecsiD.Bla ket Addi ional Insured –Broad For Vendo sntmr L.Blan et Wa v r f ubrogationkieOSE.Bla ket Addi ional Insured –Cont ol i g ntere tntrlnIs M.Co tra tua iabil ty –Rai roadnclLilsF.Bla ket Addi ional Insured –Mortgagee ,n t s Assi nee , Su ce so s O ece v rsgscsrrRie G.Bla ket Addit onal Insured –Gov rnme talnien E t t e –Pe m t Or Au ho iza ions Re ati g Toniisristrtln Prem seis P O ISIONRVS a.Be o e you ma ntai ed an ownership intere tfrinsAWHIS AN INSU ED –UNNAMED.O R o mo e than 50% i such ub idiary;orfrnssSUBSDIARIESI The fol owing is ad ed told SE TION II –WHO IS bC.Af e the date, i any duri g the poli y periodtrf,n c that yo no longer ma ntain a ownershipuinANINSURED: i tere t o m re than 50% n such subsi ia ynsfoidr.Any o you subsidia ie , ot er than a partne shipfrrshr or joint v nture that is not shown a a Nam de,s e Fo purpose o Pa agraphrsfr 1.o Se tionfc II –WhoIsured i the eclara ion i a am d Insured i :n n D t s s N e f Is An Insured ea h such subsidiary wil be,c la.Y u are the so e owner o ,o m in ai anolfratn deem d to e de ignated in the Declarat on a :e b s i s sownership intere t o more than 50% in,suchsf a.A im ted l ab l ty company;l i i i isubsidiayonthefist day o the pol cy periodrrfi; and b.An o ganizat on o he than a pa tnership,jo ntritrrib.Su h subsidiary i not an in ured undecssr v nture or l m ted liab l ty company;oreiiiisiilaoher nsuran e.m r t i c c.A rust;tNosuchsubsidiaryiainsuredfo"bodily inju ysnrr" a indi a ed in i s nam o the docum n s thasctterettor"property dama e"tha o curred, o "perso algtcrn gov rn it stru ture.e s cand a v rt sing i ju y"caused by an o fe sedeinrfn com i ted:m t CG 4 58 02 19D ©Pa e 1 o 5gf2017 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission excluded carefullyyour POLICY NUMBER: Y6302A626927 DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 COMM RCI L G NERAL IAB LI YEAELIT B WH IS AN INSURED –EMPLO EES AND.O Y a.A im ted l ab l ty company;l i i i iVOUNER O KERS –BODI Y IN URY TLTEWRLJO b.An organiza ion o her than a pa tnership,t ,t rCOEMPLOEESAND CO VO UN E R-Y -L T E jo n v nture or li i ed l abi i y com any;i t e m t i l t pWOKERSRorThe fol o ing is added to Paragraphlw 2.a.(1)of c.A rust;tSETINII–WHO I AN INSUREDCOS: a indi a ed i its name or the do um ntssctncePaagaphsrr(1)(a),(b)and (c)abov do not ap lyep that gov rn t structure.e i sto"bodi y injury to a co "em loyee while in thel"-p " cour e o he co "em loyee s"em loy en by yousft-p 'p m t D B ANKET ADDIT ONAL IN URED –B OAD.L I S Ror pe fo m ng dutie re a ed to the conduct o yourrrisltf F RM VENDO SORbuines, o to "bodily i ju y to your othessrnr"r The fol owing is ad ed told SE TION II –WHO ISC"v luntee worke s"while dutieorrs AN INSU EDR:re a ed to the conduct o yo r busine s.l t f u s Any perso o organ zat on that i a v ndor annriisedC.WH IS AN INSURED –N WLY ACQU REDOEI that y u hav agree in a wri ten co tra t ooedtncrOFOMEDLIMITEIABILTCOPANIESRRDLIYMageeent to a an addi ional insured onrmstThe fo lowing repla e Pa agraphlcsr 3.of SECTI NO th s Cov rage Part i a in ured, but only wi hiesnstII–WHO I AN IN U EDSSR:re pe t to lia il ty fo "bodily injury or "prope tyscbir"r 3.Any o gani at on y u newly a qui e or fo mrziocrr,dama e thatg": ot er than a partnershi or joi t v nture anhpne,d a.Occurs subse uent to the signing o thatqfowhih yo a e the so e owner o in whi hfcurlrc cont a t or ag eem nt; andrcreyu ma nta n an owne ship intere t o moreoiirsf b.Ari e out o "y ur products"that aressfothan50%, wi l quali y a a Nam d Insured iflfse di trib ted o so d in the regular course osurlfthee i no othe sim la i surance av ilable torsrirna such v ndor'busine s.e s sthatorganizaio. owev r:t n H e The insurance prov ded to such v ndor is subje tieca.Cov rage unde thi prov sion is a fo dedersifr to the o lowing prov sion :f l i sonyl: a.The lim t o in urance prov ded to suchisfsi(1)Unt l the 180th day a ter you a quireifc v ndor wil be the m nim m li i s tha y ueliumttoor fo m the organi ation o the end orzrf to prov de in the writ en cont a t oitrcrthepolcyperiodwhihevris earl er,i ,c e i o the lim t shown in therisiyu do not report such o ganizat oforin i writ ng to us wi hin 180 days a tenitfr y u a quire o fo m i ; oocrrtr b.The in urance prov ded to such v ndor doesies no ap ly o:t p t(2)Un il the end o the pol cy periodtfi, when that date is late than 180 dayrs (1)Any ex ress warranty no authorized byptater y u a qui e or for suchfocrm y u or any di tri utio or sa e fo aosbnlrorganiation,i you report suchzf pu po e not authorized by yo ;r s uorganiation in wri ing to us wit izthn (2)Any change i "y u products"m de bynora180 ay a te yo a qui e or o m it;d s f r u c r f r such v ndor;eb.Cov ragee A does not apply to "bodily i ju y"o "property dama e that o currednrrg"c (3)Re a kaging,unle s unpa ked so e y fopcscllr be o e you a qui ed or fo med thefrcrr the purpo e o i spectio , dem n tratio ,s f n n o s n organi ation;andz te tin , o the sub tit tion o part undesgrsufsr i struction fro the m n fa ture , andnsmaucrc.Cov ragee B doe not ap ly to "perso alspn then repackaged in the orig nal containe ;i rand adv rti i g injury ari ing out o aesn"s f n o fe se com i ted be o e y u a qui ed ofnmtfrocrr (4)Any fai ure to ma e such in pect on ,l k s i sfomedthe o ganiza io .r r t n ad ustme t , tests o se v cing ajnsrris v ndors agree to perfo m or no m llyerraFote purpose o Pa agraphrhsfr 1. o Se tiofcn II unde take to pe fo m in the regularrrr–Who Is An Insured each such o gan zat on,r i i cour e o bu ine s, in connectio wi h thesfssntwilbedeeed to be designated in thelm di trib tion or ale o "y ur p oduct ";s u s f o r s Pa e 2 o 5gf ©CG 4 58 02 19D2017 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission performing agreed agreement, Declarations, whichever are less. include Declarations as: DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 COMM RCI L G NERAL IAB LI YEAELIT l ab l ty a m rtgagee,a signee succe so oiiisos,s r r()5 De o stra ion instal a ion, se v ci g omnt,l t r i n r re e v r fo "bodi y i ju y ,"property dam ge ocierlnr"a "rreaioperatios,ex ept such o e ationsprncpr "pe sonal and adv rti ing i ju y"thatresnr:pe fo med a such v ndor s prem se inrrte'i s connect on with the sale o "y uifor a.Is "bo ily inju y or "prope ty dama e"thatdr"r gprodct"; orus o curs, o i "pe sonal an adv rti ing injurycrsrdes" caused by an o f n e that is com it ed,f e s m t()6 "Yo r product "that a te di tribution ous,f r s r subsequent to the si ning o that co tra t ogfncrsale by you, hav bee labeled oenr re a eled or used a a con aine , part o ag ee ent;andlbstrrrm i gred en o any o her thing or sub tancenitfts b.Ari e out o the ownership, m in enance ossfatrbyoron behal o such v ndor.f f e use o the prem se fo whi h that mo tgagee,f i s r c r a signee succe so o re eiv r is requi eds,s r r c e rCovrage under thi p ov sion doe not apply toesris: unde that cont act o ag ee ent to berrrrma.Any pe son o o ganizat on from whom yourrri i clu ed a an a dit onal insured on thisndsdihavacquied"y ur produ ts", or anyeroc Cov rage Parte.i gredien , part or con aine en ering in o,n t t r t t The insurance prov ded to such mo tgagee,i racomanyng o contain ng such produ ts;c p i r i c a signee succe so o re eiv r is subje t to thes,s r r c e cor fo lowi g prov sions:l n ib.Any v ndo fo whi h cov rage a anerrces a.The lim t o in urance prov ded to suchisfsiaddtionalinsuredspeifcalyischeulebyicilsddmrtgagee, a signee,succe so o re eiv rossrrceedosemnt.n r e wil be the m n m m l m t tha y u agreed toliiuiistoEBANKETADDTONALINSUED–.L I I R prov de in the writ en con ra t or agreem nt,i t t c eCONROLNG IN ERE TTLITS or the li i s shown in the m t1.The fo lo ing is added tolw SE TI N II –WHOCO whi hev r are e s.c e l sISANINSURED:b.The i surance prov ded to such person onirAnypeson or o gan zat on that ha fi an ialrriisnc organi ation oe not apply to:z d scontoloyois an i sured wit re pe t torfunhsc (1)Any "bodily inj ry or "property dam geu"a "l ab l ty fo "bodily inj ry ,"property dam geiiiru"a "that occurs, or any "pe sonal andror"pe sonal a d adv rti i g inj ry"that a i ernesnurss adv rti ing inju y ca sed by an o fe seesr"u f nouo:t f that i com it ed,a ter such con ra t osmtftcra.Su h i an ial cont ol orcfncr;ag ee ent s no lon er in e fe t; ormigfcr b.Su h person'or o ganizat on'scsri (2)Any "bodi y inju y ,"property dama e olr"g "rownership,ma ntenance or use ofi "pe sonal and adv rti ing inj ry"ari ingresuspremseleaed o or o cupied by y u.i s s t c o ou o any structural al eratio s, newtftn constru tion o dem li ion ope ationscrotrTheisuranceprovded to such person onir pe fo med by or on behal o suchrrfforganiation does not apply to structuralz m rtgagee,assignee,succe so oosrraleraton, new constr ction or dem li iotisuotn re e v r.c i eoperatios pe fo me by or on behal o suchnrrdff pe son or organizationr.G.B ANKET ADD T ONAL INSURED –L I I GO E N ENT L EN IT ES –P RMIT OVRMATIESR2.The fo lowing is added to Paragraphl 4.ofSETINII–WHO I AN INSU EDCOSR:AU HO I ATI N RELAT N O P EMISETRZOSIGTRS Thi pa agraph does not apply to anysr The fol owing is ad ed told SE TION II –WHO ISC prem se owner,manager or le sor tha haissts AN INSU EDR:fi a cial o trol o yo .n n c n f u Any gov r men al enti y tha ha issued a perm tentttsi F B ANKET ADD T ONAL INSURED –.L I I or aut orizat o wit respe t to prem se ownedhinhcis MO T A E S ASSIGN ES,SU CES O SRGGE,E C S R or o cupied by,o rented o loa ed to,y u ancrrnodOECEIERSRRVthatyoae requi ed by any ordinan e, law,u r r c bu l ing co e o writ en cont a t or ag ee ent toiddrtrcrmThe fol owing is ad ed told SE TION II –WHO ISC i clu e as an a ditio al insured on thi Cov ragenddnseANINSUEDR:an insured, but on y with re pe t to lia il tylscbiAnypeson o o ganiza io tha is a mo tgagee,r r r t n t r fo "bodi y inj ry ,"prope ty dam ge or "perso alrlu"r a "nasigneesuccesoor re eiv r and tha yos,s r c e t u and adv rti ing injury arising out o thees"fhavagreed i a writ en cont a t o agreem nt toentrcre ex stence owne ship,use mai tenance repai ,i ,r ,n ,riclueas an a ditio al insured on thi Cov ragenddnse constru tion,ere tion or remov l o any o theccaffPatis an insured, but only wit re pe t to itsrhsc fo lowi g fo whi h that gov rnme tal enti y halnrcents CG 4 58 02 19D ©Pa e 3 o 5gf2017 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission Declarations, Part is DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 COMM RCI L G NERAL IAB LI YEAELIT se v ce ", fi st a d o "r i s r i rissuedsuch permit or authorization:advertising Good Sam r tanai si n , awni gs, canopie , cel ar entran e , coalgsnslcs se v ce "to a person,unle s yo are irissun ho es, driv way , ma holes, marquees, hoi tlesns the busine s or o cupat on o prov dinscifig away open ng , sidewalk v ults, e ev tor , streetisalas pro e sional hea th a e serv ce .f s l c r i sbannersodeoraton.r c i s 2.The fo lowi g rep a es the la t paragraph olnlcsfHBANKETADDTONALINSURED–L I I Pa ag aphrr 2..(1)a of SECTI N II –WHO ISOGOENENTL EN IT ES –P RMIT OVRMATIESR AN IN UREDS:AU HO I ATI N RELATIN TO OP R-T R Z O S G E Unle s yo a e in the business or o cupatiosurcnATONISoprovdig pro e sional healt ca e se v ce ,f i n f s h r r i sThe fol owing is ad ed told SE TION II –WHO ISC Pa ag aphsrr (1)a)(,(b),(c)and (d)abov doeANINSUEDR:no apply to "bodily injury arising out ot"f prov din o ai ing o rov deigrfltpiAnygovernmentalentity that has issued a permit : or authoriza ion wit re pe t to ope ationthscrs (a)"Inci ental m di a se v ce "by any odeclrisfpefomedby y u or on your behal and that yorrofu y ur "em loyee "who is a nurseopsarerequired by any o dinance,law, buil ing coderd a sistant,em rgen y m d calseceior written cont act or agreeme t to incl de a anrnus pa am dic,athlet c trai er, audiolog st,r e i n iaddiionalisured on thi Cov rage Pa t is atnsern die i ian, nutri ion st, o cupatio altcticnisured, but only wi h re pe t to liabi i y fo "bodilyntscltr the apist or occupational therapyrijuy,"prope ty dam ge"or "perso al andnr"r a n a sistant,physical therap st o spee h-s i r cadvrtiinginjryariing ou o uch operatio s.e s u "s t f s n la guage pat ologist;ornhTheinuraneprovdedtosuch gov r men alscient (b)F rst ai or "Good Sama itan se v ce "byidrrisenitydoenotapply o:t s t any o yo r "em loyee "o "v lunteerfupsroa.Any "bodi y inju y ,"property dama e olr"g "r worke s", o her than an emp oye ortldr"pe sonal and adv rti ing injury a i ing o t ores"r s u f v lunteer do tor. Any such "em loyee "o c p soperatios perfo m d fo the gov r men alnrerent or "v lu teer wo kers"prov ding o fa l ngonririienityort;to prov de fi st aid or "Good Sama i anirrtb.Any "bodily inj ry or "property dam geu"a "se v ce "during thei work fo yourisrricluedin the "products-co ple edndmt wil be deem d to be a ting wi hi thelectnoperatios hazard .n "sco e o thei em loy ent by y u opfrpmorIBANKETADDTONALINSURED–.L I I pe fo m n dutie rela ed to the co du trrigstncGRANTRS O RAN HIS SOFFCE o yo r busine s.f u s The fol owing is ad ed told SE TION II –WHO ISC 3.The fo lo i g repla e the la t se ten e olwncssncfANINSUEDR:Pa ag aphrr 5.of SE TION III –LIMITS OCFINSUANERC:Any person o o ganizat o tha grants a fra chi errintns to you i an insured, but on y wi h re pe t tosltsc Fo the purpo e o dete m nin therssfriglabltyfo"bodi y i ju y ,"property dam ge"oiiirlnr"a r appl cable Ea h Occurren e Lim t,al relatediccil"pe sonal an adv rti ing injury"a i ing o t ordesrsuf a t or om ssions com i ted i prov di g ocsimtninryur operatio s in the franchi e granted by thaonst fa l n to prov de "inci ental me icaiigiddlpeson or organizationr.se v ce ", fi st a d o "Good Sam r tanrisrirai se v ce "to any one perso wil be dee ed torisnlmIfawriten cont a t o agreem nt ex sts betweetrcrein be one "o currence .c "y u and such addit onal in ured, the l m t ooisiisf i suran e prov ded to such insured wi l be thencil 4.The fo lowi g is a ded tolnd m nim m l m t that you agreed to prov de in the Pa agraphiuiisir 2.,Exclus onis, of SE TION I –CCOERAGE–CO ERAGE A –BODI YVSVLwriten cont a t o agreemen ,o the lim t showntrcrtris INJU Y AND P OP RT DAMAGERREYLABIIYILT:J IN IDEN AL ED CAL ALPRACTI E.C T M I M C Sa e O Ph rmaceu icalslfat1.The fo lo i g rep ace Pa agraphlwnlsr b.o thef "Bo ily inju y or "property dama e"ari ingdr"g sdeiiion o "o cur en e in thefntfcrc" ou o the v ola ion o a penal stat te otfitfurDFINTIONEISSetion:c ordi ance rela i g to the sale ofntnb.An a t o om ssio com i ted i prov dincrinmtnig pharma eut cal co m t ed by,o wit thecismitrhor fa l ng to prov de "incidental me icaiiidl k owledge o co sent o ,the n urednrnfis. Pa e 4 o 5gf ©CG 4 58 02 19D2017 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission nurse, technician, hours exclusion in the Declarations, whichever are less. DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 COMM RCI L G NERAL IAB LI YEAELIT 5.The fol owing i a ded to thelsd D FIN TION a.E I S $10,00; or0 Se tio :c n b.The am unt shown i the oonf"In i ental m d cal se v ce "m a s:c d e i r i s e n th s Cov rage Part fo Medi al Ex enseiercp Lim t.ia.Med cal surgi al dental laborato y,x rayi,c ,,r - or nur ing se v ce or treatm n , adv ce osrietir L B ANKET WAIVER O SUB O ATION.L F R Gistructionotherelatedfurihig on,r n s n f The fo lowing is a ded to Paragraphld 8.,Tra sfenrfodor bev rages; oroe O Righ s O Rec very Against O hers To Uftfots,b.The furni hing o di pensing o dru s osrsfgr of SE TION IV –CO MERCIAL GENERALCMmdcaldentalosurgialsupplieoei,,r c s r L AB LIT COND T ONIIYIIS:appl a ce .i n s If the insured has a ree in a cont act ogdrr6.The fol o ing i added to Parag aphlwsr 4.b.,ag ee ent to waiv that i sured'righ ormenstfEcess In urancexs, of SE TION IV –C re ov ry against any person o o gan zat on, wecerriiCOMERCILGENRAL LIAB LI YMAEIT waiv our right o e ov ry against such pe son oefrcerrCONDTIONIS:organi ation,but only fo pay ents we ma ezrmk Thi i surance i ex e s ov r any v li ansnscseadd be ause o :c f col e ti le othe in urance whether prim ry,l c b r s ,a a."Bo ily i ju y"o "property dam ge"thatdnrraexes, conti gent o on any other ba is,thatcsnrs o curs; ocriavilabe to any o your "em loy es"fosalfper b."Pe so al and adv rti ing inj ry"ca sed byrnesuu"bo ily injury that ari e out o prov ding od"s s f i r fa l n to prov de "i cidental medi al se an o fe se that i com it ediigincfnsmt;rv ce "i s to any perso to the ex ent not subje t tontc subsequent to the ex cution o the cont a t oefrcrPaagaphrr2.a.1)(o Se tiofcn II –Who Is An ag ee ent.r mInureds.M.CON RACTUAL IABILIT –RAIL OADTLYRSK.MED CAL PA MEN S –INCREASED LI ITIYTM 1.The fol o ing repla e Pa agraphlwcsr c.o thefThe fo lowing repla e Pa agraphlcsr 7.of SECTI NO de i i ion o "insured cont act"i thefntfrnII–L MIT F INSURANCEIISO:D FIN TIONEIS Se tion:c 7.Su je t to Paragraphbc 5.abov ,the Medicael c.Any ea em nt or l cense agreem nt;s e i eExenseLimt is the mo t we will pay undepisr 2.Pa ag aphrr f.1)(o the de init o o "i suredffinfnCovrageeCfoalmeical ex enserldps cont a t"i thercn D FINI IONETS Se tion iscbeauseo"bodily i ju y sustained by anycfnr"de eted.lone erson,and will be he ighe o :p t h r f CG 4 58 02 19D ©Pa e 5 o 5gf2017 The Travelers Indemnity Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission Declarations DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 Y6302A626927 07 01 22 DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY ISSUE DATE: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY TOTAL GENERAL AGGREGATE LIMIT DESIGNATED PROJECT(S)-GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Total General Aggregate Limit: $ Designated Project(s): (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.} A. The Total General Aggregate Limit stated in the Schedule above is the most we will pay for the sum of all: 1. Medical Expenses under COVERAGE C (SECTION I); 2. Damages under COVERAGE A (SECTION I), except damages because of "bodily injury" or "property damage" included in the "products- completed operations hazard"; and 3. Damages under COVERAGE B (SECTION I) regardless of the number of: a. Insureds; b. Claims made or "suits" brought; c. Persons or organizations making claims or bringing "suits"; or d. Designated "projects" listed in the SCHED- ULE above. B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A (SECTION I), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION I), which can be at- tributed only to operations at a single designated "project" shown in the Schedule above: 1. A separate Designated Project General Ag- gregate Limit applies to each designated "pro- ject", and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. Subject to the Total General Aggregate Limit stated in the Schedule above, the Designated Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations haz- ard", and for medical expenses under COV- ERAGE C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". CG 03 21 01 04 Copyright, The Travelers Indemnity Company, 2004 Page 1 of 2 DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 COMMERCIAL GENERAL LIABILITY 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce both the Total General Aggregate Limit stated in the Schedule above, and the Designated Project General Aggregate Limit for that designated "project". Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Project General Aggregate Limit for any other designated "project" shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Decla- rations, such limits will be subject to both the Total General Aggregate Limit stated in the Schedule above, and the applicable Desig- nated Project General Aggregate Limit. C. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under COVERAGE A (SECTION I), and for all medical expenses caused by accidents un- der COVERAGE C (SECTION I), which cannot be attributed only to operations at a single desig- nated "project" shown in the Schedule above: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the Total General Aggregate Limit stated in the Schedule above and the General Aggregate Limit, or the Products-Completed Operations Aggregate Limit, whichever is ap- plicable; and 2. Such payments shall not reduce any Desig- nated Project General Aggregate Limit. As respects this Provision C., the limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Ex- pense continue to apply. D. Part 2. of SECTION Ill -LIMITS OF INSURANCE is deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage B; and b. Damages from "occurrences" under COVERAGE A (SECTION I) and for all medical expenses caused by accidents under COVERAGE C (SECTION I) which cannot be attributed only to operations at a single designated "project" shown in the SCHEDULE above. E. When coverage for liability arising out of the "products-completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-Completed Operations Ag- gregate Limit, and not reduce the Total General Aggregate Limit stated in the Schedule above, the General Aggregate Limit, or the Designated Pro- ject General Aggregate Limit. F. For the purposes of this endorsement the Defini- tions Section is amended by the addition of the following definition: "Project" means an area away from premises owned by or rented to you at which you are per- forming operations pursuant to a contract or agreement. For the purposes of determining the applicable aggregate limit of insurance, each "project" that includes premises involving the same or connecting lots, or premises whose con- nection is interrupted only by a street, roadway, waterway or right-of-way of a railroad shall be considered a single "project". G. The provisions of LIMITS OF INSURANCE (SECTION Ill) not otherwise modified by this en- dorsement shall continue to apply as stipulated. Page 2 of 2 Copyright, The Travelers Indemnity Company, 2004 CG 03 21 01 04 POLICY NUMBER: 810-2N338740-21-14-G DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE -This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by arnother endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS -INCREASED LIMIT S F. HIRED AUTO -LIMITED WORLDWIDE COV- ERAGE -INDEMNITY BASIS G . WAIVER OF DEDUCTIBLE -GLASS PROVISIONS A. BROAD FO RM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. I. J . K. L. M. N. HIRED AUTO PHYSICAL DAMAGE -LOSS OF USE -INCREASED LIMIT PHYSICAL DAMAGE -TRANSPORTATION EXPENSES -INCREASED LIMIT PERSONAL PROPERTY AIRBAGS NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS BLANKET WAIVER OF SUBROGATION UNINTENTIIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -COV- ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.5., Other lnsur.ince, of SECTION IV -BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 @2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission. DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 COMMERCIAL AUTO pennission, while perfonning duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. SUPPLEMENTARY PAYMENTS -INCREASED LIMITS 1. The following replaces Paragraph A.2.a.(2), of SECTION II -COVERED AUTOS LIABIL- ITY COVERAGE: (2) Up to $3,000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4), of SECTION II -COVERED AUTOS LIABIL- ITY COVERAGE: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day be- cause of time off from work. F. HIRED AUTO -LIMITED WORLDWIDE COV- ERAGE -INDEMNITY BASIS The following replaces Subparagraph (5) in Para- graph B.7., Policy Period, Cover.ige Territory, of SECTION IV -BUSINESS AUTO CONDI- TIONS: (5) Anywhere in the wor1d, except any country or jurisdiction while any trade sanction, em- bargo, or similar regulation imposed by the United States of America applies to and pro- hibits the transaction of business with or within such country or jurisdiction, for Cov- ered Autos Liability Coverage for any covered "auto" that you lease, hire, rent or borrow without a driver for a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from any of your "employees•, partners (if you are a partnership), members (if you are a limited liability company) or members of their households. (.:1) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. (iii) We may, at our discretion, participate in defending the "insured" against, or in the settlement of, any claim or "suit'1. (iv) We will reimburse lthe "insured" for sums that the "insured" legally must pay as damages because of "bodily injury" or "property damage" to which this insurance applies, that the "in- sured" pays with our consent, but only up to the limit described in Para- graph C., Limits Of Insurance, of SECTION II -COVERED AUTOS LIABILITY COVERAGE. (v) We will reimburse the "insured" for the reasonable expenses incurred with our consent for your investiga- tion of such claims and your defense of the "insured" against any such "suit", but only up to and included within the limit described in Para- graph C., Limits Of Insurance, of SECTION II -COVERED AUTOS LIABILITY COVERAGE, and not in addition to such limit. Our duty to make such payments ends when we have used up the applicable limit of insurance in payments for damages, settlements or defense expenses. (b) This insurance is excess over any valid and collectible other insurance available to the "insured" whether primary, excess, contingent or on any other basis. (c) This insurance is not a substitute for re- quired or compulsory insurance in any country outside the United States, its ter- ritories and possessions, Puerto Rico and Canada. Page 2 of 4 C 2015 The Travelers Indemnity Company. All riOllts reserved. CA T3 53 02 15 Includes copyrigllted material of Insurance Se1V1ces Office, Inc. Wltll its perrmssion. DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by !local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE-GLASS The following is added to Paragraph D., Deducti- ble, of SECTION Ill -PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE -LOSS OF USE -INCREASED LIMIT The following replaces the last sentence of Para- graph A.4.b., Loss Of Use Expenses, of SEC- TION Ill-PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE -TRANSPORTATION EXPENSES-INCREASED LIMIT The following replaces the first sentence in Para- graph A.4 . .i., Tr.insport.ition Expenses, of SECTION Ill -PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1 ,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph A.4., Cover- .ige Extensions, of SECTION Ill -PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for "loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION Ill -PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV -BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accidenr or "loss" ap- plies only when the "accident" or "loss" is known to: (.i) You (if you are an individual); (b) A partner (if you are a partnership); (c ) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.5., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV -BUSINESS AUTO CONDI- TIONS: 5. Tr.insfer Of Rights Of Recovery Ag.iinst Others To Us We waive any nght of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by CA T35302 15 C 2015 The Travelers lnderMity company. All rights reserved. Page 3 of 4 Includes copyrighted matenal of Insurance SelVlces Office, Inc. wrth its pernussion. DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 COMMERCIAL AUTO such contract. The waiver applies only lo the person or organization designated in such contract N. UNINTENTIONAL ERRORS OR OMISSIONS The following is added to Paragraph B.2., Con- cealment, Misrepresentation, Or Fraud, of SECTION IV -BUSINESS AUTO CONDITIONS: The unintentional om1ss1on of, or unintentional error in, any information given by you shall not prejudice your rights under this insurance. How- ever this provision does not affect our right to col- lect additional premium or exercise our right of cancellation or non-renewal. Page 4 of 4 C 2015 The Travelers Indemnity Company_ All riohts reserved. CA T3 53 02 15 lnciudes copyrighted material of Insurance Se/vices Office, Inc. willl its permission. COMMERCIAL AUTO CA 00 01 10 13 © Insurance Services Office, Inc., 2011 Page 9 of 12 4.Loss Payment – Physical Damage Cover- ages At our option, we may: a.Pay for, repair or replace damaged or sto- len property; b.Return the stolen property, at our ex- pense. We will pay for any damage that results to the "auto" from the theft; or c.Take all or any part of the damaged or stolen property at an agreed or appraised value. If we pay for the "loss", our payment will in- clude the applicable sales tax for the dam- aged or stolen property. 5.Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. B.General Conditions 1.Bankruptcy Bankruptcy or insolvency of the "insured" or the "insured's" estate will not relieve us of any obligations under this Coverage Form. 2.Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other "insured", at any time, intentionally con- ceals or misrepresents a material fact con- cerning: a.This Coverage Form; b.The covered "auto"; c.Your interest in the covered "auto"; or d.A claim under this Coverage Form. 3.Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the re- vision is effective in your state. 4.No Benefit To Bailee – Physical Damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any per- son or organization holding, storing or trans- porting property for a fee regardless of any other provision of this Coverage Form. 5.Other Insurance a.For any covered "auto" you own, this Coverage Form provides primary insur- ance. For any covered "auto" you don't own, the insurance provided by this Cov- erage Form is excess over any other col- lectible insurance. However, while a cov- ered "auto" which is a "trailer" is con- nected to another vehicle, the Covered Autos Liability Coverage this Coverage Form provides for the "trailer" is: (1)Excess while it is connected to a mo- tor vehicle you do not own; or (2)Primary while it is connected to a covered "auto" you own. b.For Hired Auto Physical Damage Cover- age, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered "auto" you own. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". c.Regardless of the provisions of Para- graph a. above, this Coverage Form's Covered Autos Liability Coverage is pri- mary for any liability assumed under an "insured contract". d.When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis. 6.Premium Audit a.The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy be- gan. We will compute the final premium due when we determine your actual ex- posures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance, if any. The due date for the final premium or retrospective pre- mium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due, the first Named Insured will get a refund. POLICY NUMBER: 810-2N338740-21-14-G DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICYONE TOWER SQUARE DATE OF ISSUE: 06-28-19 ST ASSIGN:Page 1 of 1 HARTFORD CT 06183 ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT – CALIFORNIA (BLANKET WAIVER) 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. The additional premium for this endorsement shall be mium. 2.00 % of the California workers' compensation pre- Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. 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 Insured Policy No. Endorsement No. Premium Insurance Company Countersigned by Travelers Property Casualty Company of America Duthie Electric Service Corp dba: Duthie Power Services UB-7K475503-21-14-G 07-01-22 UB-7K475503-20-14-G 07-01-22 DocuSign Envelope ID: F6C2AAB8-DB0E-44F6-B30C-BEB2AE6C21E0 TRAVELER/r'·