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Hawthorne Machinery Co; 2023-04-12; PWM23-2142UTIL
DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 April12th PWM23-2142UTI L CITY OF CARLSBAD MINOR PUBLIC WORKS CONTRACT SEWER LIFT STATION GENERATOR REPAIR SERVICES This agreement is made on the ______ day of ___________ , 2023, by the City of Carlsbad, California, a municipal corporation, (hereinafter called "City"), and Hawthorne Machinery Co., a California corporation whose principal place of business is 16945 Camino San Bernardo, San Diego, CA 92127 (hereinafter called "Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, as contained in the Standard Specifications for Public Works Construction "Greenbook," latest edition and including all errata; Part 1 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 Jesse Castaneda (City Project Manager). PAYMENT. The City shall withhold retention as required by Public Contract Code Section 9203. All invoices shall be paid within thirty (30) days of receipt. Unless specified otherwise in writing, the Services shall be performed during Vendor's publicized business hours. Services performed outside of such hours will be billed at applicable overtime or double-time rates . WAGE RATES. The general prevailing rate of wages for each craft or type of worker needed to execute the Contract shall be those as determined by the Director of Industrial Relations pursuant to Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. Contractor shall not pay less than the said specified prevailing rates of wages to all workers employed by him or her in execution of the Contract. Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. of the Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5. Sewer Lift Station Generator Repair Services Page 1 of 16 City Attorney Approved 02/14/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 PWM23-2142UTIL 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 the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carlsbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five (5) years and that debarment by another jurisdiction is grounds for the City of Carlsbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: Print Name: Jeffrey Boman REQUIRED INSURANCE. The successful contractor shall provide to the City of Carlsbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers' Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with California admitted insurers that have a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California's List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best's Key Rating Guide of at least "A:X"; OR an alien non-admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than ........ $1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than ....... $1,000,000 Sewer Lift Station Generator Repair Services Page 2 of 16 City Attorney Approved 02/14/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 PWM23-2142UTIL 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 the City prior to such cancellation. The policies shall name the City of Carlsbad as an additional insured. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. WORKERS' COMPENSATION AND EMPLOYER'S LIAB ILITY. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation will not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. BUSIN ESS 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 the City, and its officers and employees, from all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection with the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, rules or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys' fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, California. Start Work: Contractor agrees to start within fifteen (15) working days after receipt of required parts and materials. Completion: Contractor agrees to complete work within three hundred sixty-five (365) working days. Ill Ill Ill Ill Sewer Lift Station Generator Repair Services Page 3 of 16 City Attorney Approved 02/14/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 CONTRACTOR'S INFORMATION. Hawthorne Machinery Co. (name of Contractor) 527880 (Contractor's license number) C-10 I 12/31/2024 (license class. and exp. date) 1000019799 I 6/30/2024 (DIR registration number/exp. date) PWM23-2142UTIL 16945 Camino San Bernardo (street address) San Diego, CA 92127 (city/state/zip) 858-376-6857; 858-583-0027 (telephone no.) efabeyta@hawthornecat.com ( e-mail address) 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 HAWTHORNE MACHINERY CO., a California By: By: (sign here) Jeffrey Boman, General Counsel , Secretary (print name/title) (sign here) Chandra Ramamoorthy, Vice President (print name/title) CITY OF CARLSBAD, a municipal corporation of the State of California By: Vicki V. Quiram, Utilities Director as authorized by the City Manager 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 Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer Otherwi se, 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, City Attorney By: [i1ti,1it-k.. (lvAtnlc{)IA < City Attorney Sewer Lift Station Generator Repair Services Page 4 of 16 City Attorney Approved 02/14/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 PWM23-2142UTI L EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each subcontractor 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 subcontractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a subcontractor 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 Type of Work to Business Name and Address DIR License No., % of be Subcontracted Registration Classification & Total No. Expiration Date Contract NONE Total% Subcontracted: 0% The Contractor must perform no less than 50% of the work with its own forces. Sewer Lift Station Generator Repair Services Page 5 of 16 City Attorney Approved 02/14/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 PWM23-2142UTI L EXHIBIT B SEWER LIFT STATION GENERATOR REPAIR SERVICES JOB QUOTATION ITEM UNIT QTY DESCRIPTION PRICE NO. 1 LS 1 Total cost for Chinquapin lift station generator $15,691.58 2 LS 1 Total cost for Poinsettia lift station generator $15,747.10 3 LS 1 Total cost for Knots lift station generator $1,273.77 4 LS 1 Total cost for Cannon lift station generator $1,555.09 5 LS 1 Total cost for Sand Shell lift station generator $933.74 6 LS 1 Total cost for Fox's lift station generator $1,176.26 7 LS 1 Total cost for Home Plant lift station generator $938.81 8 LS 1 Total cost for Batiquitos lift station generator $2,221.93 9 LS 1 Labor & Material Bond $395.00 TOTAL cost for all (8) lift station generators $39,933.28 and Bond* *Includes taxes, fees, expenses and all other costs. Sewer Lift Station Generator Repair Services Page 6 of 16 City Attorney Approved 02/1 4/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 EXHIBIT C LABOR AND MATERIALS BOND PWM23-2142UTIL Bond No. K09207922 Premium: $395 Premium will be adjusted based on final contract amount WHEREAS, the City Council of the City of Carlsbad, State of California, has awarded to Hawthorne Machinery Co., a California corporation (hereinafter designated as the "Principal"), a Contract for: SEWER LIFT STATION GENERATOR REPAIR SERVICES in the City of Carlsbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in the Office of the City Clerk of the City of Carlsbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the terms thereof require the furnishing of a bond, providing that if Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon or about the performance of the work agreed to be done, or for any work or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth . NOW, TH EREFORE, WE, Hawthorne Machinery Co., as Principal, (hereinafter designated as the "Contractor"), and Federal Insurance Company · as Surety, are held firmly bound unto the City of Carlsbad in the sum of thirty-nine thousand, five hundred thirty eight dollars and 28 cents dollars ($39,538.28), said sum being an amount equal to: One hundred percent (100%) of the total amount payable under the terms of the Contract by the City of Carlsbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH that if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about the performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under this Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of the contractor and subcontractors pursuant to section 13020 of the Unemployment Insurance Code with respect to the work and labor, that the Surety will pay for the same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with California Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in California Civil Code section 9100, so as to give a right of action to those persons or their assigns in any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. Sewer Lift Station Generator Repair Services Page 7 of 8 City Attorney Approved 02/14/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 PWM23-2142UTIL In the event that Contractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. SIGNED AND SEALED, this 28th day of March I I --'-'H=a=w..::..:th...:..;:o=r.:....:.ne=-=-=M=a=c=h=in=e:.:....ry1-=C=o-=--. __ (SEAL) Federal Insurance Company (Surety) ' (Principal) ~y ~ I I I 2023 (~EAL) (SEAL AND NOTARIAL ACKNOWLEDGEMENT OF SURETY -ATTACH ATTORNEY-IN - FACT CERTIFICATE) APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney sy: _o::;._·IA,--'-Ji_·t.-_k_. _11.t_d\Ak __ lA, _______ _ City Attorney Sewer Lift Station Generator Repair Services Page 8 of 8 City Attorney Approved 02/14/2023 I I DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6''--a , ,__, ..._, ..._, Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Know All by These Presents, That FEDERAL INSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Daniel Frazee, David J. Garcia, Matthew C. Gaynor, Andrew Roberts and Kim D. Vasquez of Santee, California -------------·----···················-----------·------------------ each as their true and lawful Attorney·in·Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed in the course of business, and any instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said bonds or obligations. In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and attested these presents and affixed their corporate seals on this 22nd day of February, 2019. · Dawn M. Chloros. i\ssisra111 Secretary S1epl1en M. Haney. Vice President STATE OF NEW JERSEY County of Hunterdon ss. On this 22nd day of February, 2019, before me, a Notary Public of New Jersey, personally came Dawn M. Chloros, to me known to be Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY, the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chloros, being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the foregoing Power of Attorney are such corporate seals and were thereto affixed by authority of said Companies; and that she signed said Power of Attorney as Assistant Secretary of said Companies by like authority; and that she is acquainted with Stephen M. Haney, and knows him to be Vice President of said Companies; and that the signature of Stephen M. Haney, subscribed to said Power of Attorney is in the genuine handwriting of Stephen M. Haney, and was thereto subscribed by authority of said Companies and in deponent's presence. Notarial Seal ROSE CURTIS NOTARY PUBLIC OF NEW JERSEY No. 50072400 eom.-e,q...-:zz,= CERTIFICATION Nrnary Public Resolutions adopted by the Boards ofDirectors of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2016: "RESOLVED, that the following authorizations relate to the execution, for and on behalf of the Company, of bonds, undertakings, recognizances, contracts and other written commitments of the Company entered into in the ordinary course of business (each a "Written Commitment''): (1) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized to execute any Written Commitment for and on behalf of the Company. under the seal of the Company or otherwise. (2) Each duly appointed attorney·in-fact of the Company is hereby authorized to execute any Written Commitment for and on behalf of the Company, under the seal of the Company or otherwise, to the extent that such action is authorized by the grant of powers provided for in such person's written appointment as such attorney-in-fact. (3) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to appoint in writing any person the attorney- in-fact of the Company with full power and authority to execute, for and on behalf of the Company, under the seal of the Company or otherwise, such Written Commitments of the Company as may be specified in such written appointment, which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments. (4) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized, for and on behalf of the Company, to delegate in writing to any other officer of the Company the authority to execute, for and on behalf of the Company, under the Compan)'s seal or othe1wise, such Written Commitments of the Company as are specified in such written delegation, which specification may be by general type or class of Written Commitments or by specification of one or more particular Written Commitments. (5) The signarure of any officer or other person executing any Written Commitment or appointment or delegation pursuant to this Resolution, and the seal of the Company, may be affixed by facsimile on such Written Commitment or written appointment or delegation. FURTHER RESOLVED, that the foregoing Resolution shall not be deemed to be an exclusive statement of the powers and authority of officers, employees and other persons to act for and on behalf of the Company, and such Resolution shall not limit or otherwise affect the exercise of any such power or authority otherwise validly granted or vested." I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY (the "Companies") do hereby certify that (i) (ii) the foregoing Resolutions adopted by the Board of Directors of the Companies are true, correct and in full force and effect, the foregoing Power of Attorney is true, correct and in full force and effect. Given under my hand and seals of said Companies at Whitehouse Station, NJ, this 28th of March, 2023 CJ~\')).~-~ e . . . D:1wn ~I. Cl1loros. Assi~1:1111 Secret:11'}° IN THE EVENT YOU WISH TO VERIFY THE AlITHENTICITY OF THIS BOND OR NOTIFY us or ANY OTHER MATTER, PLEASE CONTACT us AT, Tele hone (908) 903-3493 Fax:(908) 903-3656 , e-mail, $ure @chubb.com FED· VIG-Pl (rev. 08-18) DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of San Diego on March 28, 2023 before me, Lauren Craig, Notary Public (insert name and title of the officer) personally appeared Matthew C. Gaynor who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signatur~--------(Seal) ~•e••••••••••i ••: ~-', LAUREN CRAIG : : ' · .... ~~-~-Notary Public • californ1a z i ~ San Di~o County ~ l , f Commission # 2◄39745 'lj • • My Comm. Expires F!b H, 2027 .• ·~~~l DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 PWM23-2142UTIL Exhibit "D" This quote includes all travel, labor, environmental, taxes to complete the trouble shoot call. Any resultant work found during the original scope of work being performed will e quoted and approved prior to adding to the work order. ' : SEGMENT: 01 OLYMPIAN, Model D25P2, S/N FABL000249 Engine: ModelYPKXL02:7, S/N LP50740:0356588°6 UniUBuilding #': Chinquapin Site Address: 4200 Carlsbad Blvd, Carlsbad Parts Qty Item No Description 4 6512 LINED HOSE CLAMPS 10 80241GL HTR HOSE -SIL -ELBOW 2 0007244 ELBOW 3 2388648 COOLANT-ELG 2 9L3560 ELBOW 2 1CKD1 VALVE,BRASS 1 1 0000-18641 PLUG 5 10000-26132 SOCKET-CONNECTOR 1 10000-48488 LOW COOL SENSOR 1 342-038 HOSE RADIATOR TOP 1 342-039 HOSE RADIATOR BOTT 4 524-057 CLAMP 1 908-347 JOINT 914-005 THERMOSTATASSEMBL 1 916-106 KIT, HOSE 1 994-177 BELT, FAN 1 RADIATOR 036XXPRK RADIATOR (Due to delay in shipping, amount has been encumbered in P142156 but is part of this contract. Total for parts/tax/freight Total Parts Labor = $7,271.66 -See amounts below Qty Item No Desc_rip_tion_ 16 PSF PREVAILING WAGE/ 8 HOURS EACH TECH REGULAR TIME 4 PSF PREVILING WAGE 2 HOURS EACH TECH OVERTIME Total Labor Miscellaneous Qty Item No Description 1 MLF DAILY TRUCK CHG ·-r·-·· EV2 ····-ENVIRONMENTAL/CONSUMABtESFE 1 #45 ESTIMATED PARTS FREIGHT (includes radiator) 1 #45 RENTAL GENERATOR 1 SLS SALES TAX (includes radiator) Total Miscellaneous Segment 01 -Total TOTAL COST for Chinquapin Ext Price $29.28 $77.60 $34.50 $64.50 $48,36 $30,06 $13.31 $5.70 $192.27 $83.06 $308.18 $9.64 $6.38 $13.77 $23.17 $49.08 $6,2~4,61 " $7,273.47 Ext Price $2,672.00 $888.00 $3,560.00 Ext Price $200.Ci0 $400'.00 $542.80 $3,101.81 $613.50 $4,858.11 $15,691.58 $15,691.58 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 SEGMENT: 02 Caterpillar, Model 3306, P~g S/N 8DR00988 Engine: Caterpillar, 3306, $/N 9NR02716 : Parts Qty 1 1 1 1 1 8 12 12 12 8 1 1 1 1 1 1 Labor Qt\j 16 4 6 Miscellaneous Qty 2 1 1 1 1 UniUBuilding#: Poinsettia · S~eAddress: 2425 Poinsettia, Carlsbad Item No Description 1118010 REGULATOR 1143542 VBELT SET 2660889 INDICATOR-PR 2A3398 GASKET 2A3852 PLUG 3393768 COOLANT DEAC 3718946 CM HOSE BULK 3718946 CM HOSE BULK 3718946 CM HOSE BULK 3718946 CM HOSE BULK 4309449 SENSOR GP 5N6062 HOSEA 5N6063 HOSEA 6L8617 CAP 7N0944 GASKET 613-5133 CORE AS-RD TR (Due to delay in shipping, amount has been encumbered in P142156 .but is part of this con_tract. Total for parts/tax/freight= $4,065.85 -Total Paris See amounts helowl Item No Description PSF REMOVE AND REPLACE RADIATOR PREVAILING WAGE/ 8 HOUR REGULAR TIME 2 TECHNICIANS PSF REMOVE AND REVLACE RADIATOR PREVAILING WAGE/ 2 HOURS OVERTIME 2 TECHNICIANS PSF REPLACE FUEL PRESSURE GAUGE AND RESEAL OIL PAN PLUG PREVAILING WAGE 6 HOURS 1 TECH Total Labor Item No Description MLF DAILY TRUCK CHG SLS ESTIMATED SALES TAX (includes radiator) EV2 ENVIRONMENTAL/CONSUMABLES FEE #45 ONE 350KW RENTAL GENERATOR/1 WEEK #45 ESTIMATED FREIGHT (includes radiator) Total Miscellaneous Segment 02 -Total PWM23-2142UTIL Exhibit "D" (continued) Ext Price $90.61 $90.30 $72.12 $5.26 $39.88 $200.64 $18.00 $18.00 $18.00 $12.00 $176.34 $116.88 $78.45 $30.68 $7.14 $3,527.86 $4,502.16 EKt Price $2,672.00 $888.00 $1,002.00 $4,562.00 Ext Price $400.00 $414.78 $400.00 $5,153.57 $314.59 $6,682.94 $15,747.10 TOTAL COST for Poinsettia $15,747.10 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 SEGMENT: 03 Parts Qty 1 Labor Otv 4 Miscellaneous Qty 1 1 1 1 1 PWM23-2142UTIL Exhibit "D" (continued) Kohler Genset Model: 30REOZK, Spec#: GM91476-GA1, S/N 33DGGMGK0036, SI N 30REOZk-CP1 Unit/Building #: t<nots Site Address: 501 Knots Lane, Carlsbad Item No Description Ext Price GM109750 JWH 600 W, 120 V $304.18 Total Parts $304.18 lte·m No Descriotion Ext Price PSM REPLACE JWH / PREVAILING $668.00 WAGE Total Labor $668.00 Item No Description Ext Price MLF DAILY TRUCK CHG $150.00 SLS SALES TAX $43.57 EV2 ENVIRONMENTAL $58.58 #45 CONSUMABLES FEE $19.44 #45 ESTIMATED FREIGHT $30.00 Total Miscellaneous $301 .59 Segment 03 -Total $1,273.7.7 TOT AL COST for Knots $1,273.77 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 SE<;3MENT: 04 Parts Qty 1 Labor Qty 4 Miscellaneous Qty 1 1 1 PWM23-2142UTIL Exhibit "D" (continued) Kohler, Model 350REOZ, S/N 2042544 Engine: Volvo, Model TAD 1241 GE, S/N D12*484346*D1*A Unit/Building#: Cannon Site Address: 2779Cannon Road, Carlsbad Item No Description GM20135-S JWH 2400 W 240V Total Parts Item No Description PSF PREVAILING WAGE/ 4 HOURS Total Labor Item No Description MLF DAILY TRUCK CHG SLS SALES TAX EV2 ENVIRONMENTAL/CONSUMABLES FEE Total Miscellaneous Segment 04 -Total TOTAL COST for Cannon Ext Price $577.37 $577.37 Ext Price $668.00 $668.00 Ext Price $150:00 $63.80 $95.92 $309.72 $1,555.09 $1,555.09 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 SEGMENT: 05 Parts Qty Labor Qty 4 Miscellaneous Qty 1 1 1 Make: Kohler/ John Deere Model: 3029TE150 Serial: PE3029T210258 Unit/Buldng #: Sand Shell Site Address: 613 San Shell Avenue, Carfsbad Item No Description Item No Description PSM PREVAILING WAGE Item No Description EV2 ENVIRONMENTAL SLS SALES TAX MLF DAILY TRUCK CHG PWM23-2142UTI L Exhibit "D" (continued) Ext Price Total Parts $0.00 Ext Price $668.00 Total Labor $668.00 Ext Price $46.63 $19.11 $200.00 Total Miscellaneous $265,74 Segment 05.-Total $933,74 TOTAL COST fo r Sand Shell $933,74 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 PWM23-2142UTIL Exhibit "D" (continued) SEGMENT: 06 Kohler, Model 135ROZJ, S/N 380360 Parts Qty Labor Qty 4 Miscellaneous Qty 1 1 t Engine: John Deere, Model 6081TF001, S/N RG608IT010644 Unit/Building #: Foxes · Site Address: 4155 Harrison St., Carlsbad Item No Description Total Parts Item No Description AES ADVANCED ELECTRICAL SERVICES Total Labor Item No Description MLF DAILY TRUCK CHG SLS SALES TAX EV2 ENVIRONMENTAL FEE Total IVliscellaneous Segment 06 -Total TOTAL COST for Foxes Ext Price $0.00 Ext Price $900.00. $900.00 Ext Price $200.00 $19.87 $56.39 $276.26 $1,176.26 $1,176.26 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 SEGMENT: 07 Parts Qty Labor Qty 4 Miscellaneous Qty 1 1 1 Unit/Building #: Home Plant Site Address: 2359 Carlsbad Blvd Item No Description Item No Description PWM23-2142UTIL Exhibit "D" (continued) Ext Price Total Parts $0.00 Ext Price PSF PREVAILING WAGE REGULAR $668.00 TIME4 HOURS Total Labor $668.00 Item No Description · Ext Price SLS SALES TAX $15.88 MLF DAILY TRUCK CHG $200.00 EV2 ENVIRONMENTAL/CONSUMABLES $54.93 FEE Total Miscellaneous $270.81 Segment 07 - T otal $938.81 TOTAL COST for Home Plant $938.81 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 SEGl\!IENT: 08 Parts Qty 11 11 4 Labor Qt~, 6 2 2 Miscellaneous Qty 1 1 1 1 PWM23-2142UTIL Exhibit "D" (continued) Engine Make: John Deere Engine Model: 6068HFG85 Engine Serial: PE6068N012714 Kohler Generator set: 200REOZJF, GM81290-GA5, 339CGMGH0015, 200kW, 277/480V, 3 Ph UniUBuilding#: Batiquitos Site Address: 7382 Gabbiano Lane, Carlsbad Item No Description Ext Price 3718949 CM HOSE BULK $16.39 3718949 CM HOSE BULK $16.39 5P0598 CLAMP $32.12 Total Parts $64.90 Item No Description Ext Price · PSF 6 HOURS TO RESEAL COOLANT $1,002.00 TEMP SENSOR AT THE TOP OF THE RADIATOR PREVAILING WAGE PSF 2 HOURS TO TROUBLE SHOOT $334.00 LEAK AT LOW COOLANT LEVEL SWITCH AND OTHER LEAKS PR.EVAILING WAGE PSF 2 HOURS IF CONNECTING PUMP $444.00 TO BOTTOM OF RADIATOR TO REPAIR COOLANT LEAKS IS NEEDED PREVAILING WAGE OVERTIME Total Labor ·$1,780.00 Item No Description Ext Price MLF DAILY TRUCK CHG $200.00 SLS SALES TAX $31 .79 EV2 ENVIRONMENTAL $108.34 #45 CONSUMABLES FEE $36.90 Total Miscellaneous $377.03 Segment 08 - T otal $2,221 .93 TOT AL COST for Batiquitos $2,221 .93 The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECTPRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$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 If yes, describe underDESCRIPTION OF OPERATIONS below (Mandatory in NH)OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND 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 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. INSD ADDL WVD SUBR 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 POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: 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 IN ACCORDANCE WITH THE POLICY PROVISIONS. 1/12/2023 Marsh McLennan Agency2821 Corporate Park DriveOpelika AL 36801 Lisa Benefield 334-749-3401 334-745-8785 lisa.benefield@marshmma.com Zurich American Insurance Company 16535 62HAWTHORNEP Great American Insurance Company 16691Hawthorne Machinery Co.Hawthorne CATAttn: Steve Hollingsworth16945 Camino San BernardoSan Diego CA 92127 Federal Insurance Company 20281 Evanston Insurance Company 35378 267299884 A X 2,000,000 X 500,000 10,000 2,000,000 4,000,000 X X Proj/Loc per Con Y Y GLO292517016 2/1/2023 2/1/2024 4,000,000 A 2,000,000 X XX Y Y BAP292517116 2/1/2023 2/1/2024 B X X 25,000,000 10,000 Y Y TUU777952317 X 25,000,000 2/1/2023 2/1/2024 A N Y WC292516916 2/1/2023 2/1/2024 X 1,000,000 1,000,000 1,000,000 DC Pollution LiabilityProfessionalContractors Equipment MMAENV00293335901435 2/1/20222/1/2023 2/1/20242/1/2024 5MM Each/10MM Agg5MM Each/10MM Agg$1,000,000 $10,000 Ded.$25,000 Ret.$35,000 Ded. Professional Liability and Contractor's Pollution coverage share a policy aggregate limit of $10,000,000. Contractors Pollution coverage is written on anoccurrence form; Professional Liability coverage is written on a claims-made and reported form, subject to the following retroactive dates: 8/27/2001 Retro Datefor $2,000,000 Each Claim/$2,000,000 Aggregate11/27/2013 Retro Date for $2,000,000 Each Claim/$2,000,000 Aggregate for installation, fabrication or related services8/19/2019 Retro Date for $3MMx$2MM Each Claim/$8MMx$2MM Aggregate General Liability (for ongoing and completed operations via forms UGL2162) and Auto Liability (per CA20481013) Additional Insured Status is granted to theCity of Carlsbad if required by a written, signed, and dated contract, agreement, or permit. All coverage is subject to the terms, conditions and exclusionsSee Attached... City of Carlsbad/CMWDc/o EXIGIS Insurance Compliance ServicesP.O. Box 947Murrieta CA 92564 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 ~ r ACORD® ~ I '---D □ '-- '-- R □ □ '-- '--~ '--~ '---'--- '---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: 62HAWTHORNEP 1 1 Marsh McLennan Agency Hawthorne Machinery Co.Hawthorne CATAttn: Steve Hollingsworth16945 Camino San BernardoSan Diego CA 92127 25 CERTIFICATE OF LIABILITY INSURANCE contained in the policy form and endorsements. The City of Carlsbad as required by written contract are named additional insured on a primary and non contributory basis on the General Liability andCommercial Auto policies per forms UCA424FCW and UGL1477BCW0413. Waiver of Subrogation is granted to the City of Carlsbad pursuant to written contractper forms WC000313, UGL1477BCW0413, and CA04441013. In the event of a cancellation (for any reason other than nonpayment of premium), 30 days notice will be sent to the City of Carlsbad per formsUGL1521BCW0119ACW, UCA832ACW, and WC990643. Cancellation provision shown is subject to shorter or longer time periods depending on the jurisdictionof, and the reason for, the cancellation. Garage Liability is included under the Zurich Commercial Auto policy with a $1,000,000 limit per location. Umbrellarecognizes additional insured statuses which are required by written contract and afforded by underlying policies (including but not limited to the General Liability,Commercial Auto, and Workers Compensation policies) and endorsements, for no broader coverage than is provided by the underlying insurance and limitingcoverage to the lesser of the following limits: limit specified in form GAI60010697 or limit specified by written contract less the applicable underlying insurancelimits. (provides Additional Insured per form GAI60791098 and Waiver of Subrogation per form GAI61130697). “Stop Gap” Employers Liability is included underWorkers Compensation policy per form WC000303C for the states of ND, OH, WA, WY. DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 I GLO292517015 02/01/2022GLO29251701602/01/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 Additional Insured -Automatic -Owners, Lessees Or Contractors ZURICH ® THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. I Effective Date: This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II -Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured under a written contract or written agreement executed by you, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" and subject to the following: 1. If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a. The Insurance Services Office (ISO) ISO CG 20 10 (10/01 edition); or b. The ISO CG 20 37 (10/01 edition), such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" arises out of: (1) Your ongoing operations, with respect to Paragraph 1.a. above; or (2) "Your work", with respect to Paragraph 1.b. above, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 1., insurance afforded to such additional insured: (a) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (b) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. 2. If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a. The Insurance Services Office (ISO) ISO CG 20 10 (07/04 edition); or b. The ISO CG 20 37 (07/04 edition), such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf, Includes copyrighted material of Insurance SeNices Office, Inc., with its permission. U-GL-2162-A CW (02/19) Page 1 of 4 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 in the performance of: (a) Your ongoing operations, with respect to Paragraph 2.a. above; or (b) "Your work" and included in the "products-completed operations hazard", with respect to Paragraph 2.b. above, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 2., insurance afforded to such additional insured: (i) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (ii) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. 3. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that you provide that the person or organization be named as an additional insured: a. Under the ISO CG 20 10 (04/13 edition, any subsequent edition or if no edition date is specified); or b. With respect to ongoing operations (if no form is specified), such person or organization is then an additional insured only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is caused, in whole or in part by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf, in the performance of your ongoing operations, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 3., insurance afforded to such additional insured: (a) Only applies to the extent permitted by law; (b) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured; and (c) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement. 4. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that you provide that the person or organization be named as an additional insured: a. Under the ISO CG 20 37 (04/13 edition, any subsequent edition or if no edition date is specified); or b. With respect to the "products-completed operations hazard" (if no form is specified), such person or organization is then an additional insured only to the extent that "bodily injury" or "property damage" is caused, in whole or in part by "your work" and included in the "products-completed operations hazard", which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 4., insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; (2) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured; (3) Only applies if the "bodily injury" or "property damage" occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (4) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-GL-2162-A CW (02/19) Page 2 of 4 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 B. Solely with respect to the insurance afforded to any additional insured referenced in Section A. of this endorsement, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including: 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C. Solely with respect to the coverage provided by this endorsement, the following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV -Commercial General Liability Conditions: The additional insured must see to it that: (1) We are notified as soon as practicable of an "occurrence" or offense that may result in a claim; (2) We receive written notice of a claim or "suit" as soon as practicable; and (3) A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. Solely with respect to the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV -Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition under Section IV - Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E. This endorsement does not apply to an additional insured which has been added to this Coverage Part by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. Solely with respect to the insurance afforded to an additional insured under Paragraph A.3. or Paragraph A.4. of this endorsement, the following is added to Section Ill -Limits Of Insurance: Additional Insured -Automatic -Owners, Lessees Or Contractors Limit The most we will pay on behalf of the additional insured is the amount of insurance: Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-GL-2162-A CW (02/19) Page 3 of 4 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 1. Required by the written contract or written agreement referenced in Section A. of this endorsement; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms, conditions, provisions and exclusions of this policy remain the same. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-GL-2162-A CW (02/19) Page 4 of 4 GLO 292517014 02/01/2021GLO29251701502/01/2022GLO29251701602/01/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 8 General Liability Extended Coverages ZURICH THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. I Effective Date: This endorsement modifies insurance provided under the Commercial General Liability Coverage Part The following changes apply to this Coverage Part. A. Fellow Employee And Incidental Medical Malpractice Coverage Paragraph 2.a.(1) of Section II -Who Is An Insured is replaced by the following: 2. Each of the following is also an insured: a. Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members {if you are a partnership or joint venture) or to your members (if you are a limited liability company); (b) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in Paragraph (1)(a) above; or (c) Arising out of his or her providing or failing to provide professional health care services, except any "bodily injury" or "personal and advertising injury" arising out of: (1) Medical or paramedical services to persons performed by any physician, dentist, nurse, emergency medical technician, paramedic or other licensed medical care person employed by you to provide such services; or (2) Emergency cardiopulmonary resuscitation (CPR) or first aid services performed by any other employee of yours who is not a licensed medical professional. B. Additional Insureds-Lessees Of Premises 1. Section II -Who Is An Insured is amended to include as an additional insured any person or organization who leases or rents a part of the premises you own or manage who you are required to add as an additional insured on this policy under a written contract or written agreement, but only with respect to liability arising out of your ownership, maintenance or repair of that part of the premises which is not reserved for the exclusive use or occupancy of such person or organization or any other tenant or lessee. However, the insurance afforded to such additional insured a. Only applies to the extent permitted by law; Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-GL-14 77 -C CW (03120) Page 1 of 9 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 b. Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured; and c. Ends when the person or organization ceases to lease or rent premises from you. 2. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section Ill -Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the written contract or written agreement referenced in Subparagraph B.1. above (of this endorsement); or b. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This Paragraph B. shall not increase the applicable Limits of Insurance shown in the Declarations. C. Additional Insured -Vendors 1. The following change applies if this Coverage Part provides insurance to you for "bodily injury" and "property damage" included in the ''products-completed operations hazard": Section II -Who Is An Insured is amended to include as an additional insured any person or organization (referred to throughout this Paragraph C. as vendor) who you have agreed in a written contract or wrltten agreement, prior to loss, to name as an additional insured, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. However, the insurance afforded to such vendor: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the written contract or written agreement to provide for such vendor. 2. With respect to the insurance afforded to these vendors, the following additional exclusions apply: a. The insurance afforded the vendor does not apply to: (1) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement: (2) Any express warranty unauthorized by you; (3) Any physical or chemical change in the product made intentionally by the vendor; (4) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (5) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (6) Demonstration, installation, servicing or repair operations, except such operations perfonned at the vendor's premises in connection with the sale of the product; (7) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (8) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (a) The exceptions contained in Subparagraphs (4) or (6) above; or Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-GL-1477-C CW (03120) Page 2 of9 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 (b) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. b. This insurance does not apply to any insured person or organization from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. c. This insurance does not apply to any of "your products" for which coverage is excluded under this Coverage Part. 3. With respect to the insurance afforded to these vendors under this Paragraph C., the following is added to Section Ill -Limits Of Insurance: The most we will pay on behalf of the vendor is the amount of insurance: a. Required by the written contract or written agreement referenced in Subparagraph C.1. above (of this endorsement); or b. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This Paragraph C. shall not increase the applicable Limits of Insurance shown in the Declarations. D. Damage to Premises Rented or Occupied by You 1. The last paragraph under Paragraph 2. Exclusions of Section I -Coverage A -Bodily Injury And Property Damage Liability is replaced by the following: Exclusions c. through n. do not apply to damage by fire; lightning; explosion; windstorm or hail; smoke; aircraft or vehicles; vandalism; weight of snow, ice or sleet leakage from fire extinguishing equipment, including sprinklers: or accidental discharge or leakage of water or steam from any part of a system or appliance containing water or steam to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Damage To Premises Rented To You Limit of Insurance applies to this coverage as described in Section Ill - Limits Of Insurance. 2. Paragraph 6. of Section Ill -Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises while rented to you, or in the case of damage by one or more covered perils to any one premises, while rented to you or temporarily occupied by you with permission of the owner E. Limited Contractual Liability Coverage -Personal and Advertising Injury 1. Exclusion e. of Section I -Coverage B -Personal And Advertising Injury Liability is replaced by the following: 2. Exclusions This insurance does not apply to: e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to: (1) Liability for damages that the insured would have in the absence of the contract or agreement; or (2) Liability for "personal and advertising injury" if: (a) The "personal and advertising injury" arises out of the offenses of false arrest, detention or imprisonment; (b) The liability pertains to your business and is assumed in a written contract or written agreement in which you assume the tort liability of another. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement; and Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-GL-1477-C CW (03/20) Page 3 of 9 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 {c) The "personal and advertising injury" occurs subsequent to the execution of the written contract or written agreement. Solely for purposes of liability so assumed in such written contract or written agreement, reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "personal and advertising injury" described in Paragraph (a) above, provided: (i) Liability to such party for, or for the cost of, that party's defense has also been assumed in the same written contract or written agreement; and (ii} Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. 2. Paragraph 2.d. of Section I -Supplementary Payments -Coverages A and B is replaced by the following: d. The allegations in the "suit" and the information we know about the "occurrence" or offense are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee. 3. The following is added to the paragraph directly following Paragraph 2.f. of Section I -Supplementary Payments -Coverages A and B: Notwithstanding the provisions of Paragraph 2.e.(2) of Section I -Coverage B -Personal And Advertising Injury Liability, such payments will not be deemed to be damages for "personal and advertising injury" and will not reduce the limits of insurance. F. Medical Payments -Increased Reporting Period Paragraph 1.a. of Section I -Coverage C -Medical Payments is replaced by the following; a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations; provided that: (a) The accident takes place in the "coverage territory" and during the policy period; (b) The expenses are incurred and reported to us within three years of the date of the accident; and (c) The injured person submits to examination, at our expense, by physicians of our choice as often as we reasonably require. G. Supplementary Payments The following changes apply to Supplementary Payments -Coverages A and B: Paragraphs 1.b. and 1.d. are replaced by the following: b. Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. H. Broadened Property Damage 1. Elevator Property Damage a. The following is added to Exclusion j. of Section I -Coverage A -Bodily Injury And Property Damage Liability: Paragraphs (3) and (4) of this exclusion do not apply to "property damage" arising out of the use of an elevator at premises you own, rent or occupy. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-GL-1477-C CW (03/20) Page 4 of 9 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 b. The following is added to Section Ill -Limits Of Insurance: Subject to Paragraphs 2., 3. and 5. above, the most we will pay under Coverage A for damages because of "property damage" to property loaned to you or personal property in the care, custody or control of the insured arising out of the use of an elevator at premises you own, rent or occupy is $25,000 any one "occurrence". 2. Property Damage To Borrowed Equipment a. The following is added to Exclusion j. of Section I -Coverage A-Bodily Injury And Property Damage Liability: Paragraph (4) of this exclusion does not apply to "property damage" to equipment you borrow from others at a jobsite. b. The following is added to Section Ill -Limits Of Insurance: Subject to Paragraphs 2., 3. and 5. above, the most we will pay under Coverage A for damages because of "property damage" to equipment you borrow from others at a jobsite is $25,000 any one "occurrence". I. Expected or Intended Injury or Damage Exclusion a. of Section I -Coverage A -Bodily Injury And Property Damage Liability is replaced by the following: a. Expected Or Intended Injury Or Damage "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. J. Definition -Bodily Injury The "bodily injury" definition under the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death sustained by a person which results from that bodily injury, sickness or disease. K. Insured Status -Amateur Athletic Participants Section II -Who Is An Insured is amended to include as an insured any person you sponsor while participating in amateur athletic activities. However, no such person is an insured for: a. "Bodily injury" to: (1) Your "employee", "volunteer worker" or any person you sponsor while participating in such amateur athletic activities; or (2) You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company) while participating in such amateur athletic activities; or b. "Property damage" to property owned by, occupied or used by, rented to, in the care, custody or control of, or over which the physical control is being exercised for any purpose by: (1) Your "employee", "volunteer worker'' or any person you sponsor; or (2) You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). L. Aircraft, Auto Or Watercraft Exclusion g. of Section 1-Coverage A -Bodily Injury And Property Damage Liability is replaced by the following: g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused Includes copyrighted material of Insurance Services Office, Inc , with its permission. U-GL-1477-C CW (03120) Page 5 of 9 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1) A watercraft while ashore on premises you own or rent; (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons for a charge; (3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4) Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; or (5) "Bodily injury" or "property damage" arising out of: (a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or (b) The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment". M. Definitions -Leased Worker, Temporary Worker and Labor Leasing Firm 1. The "leased worker'' and "temporary worker" definitions under the Definitions Section are replaced by the following: "Leased worker" means a person leased to you by a "labor leasing firm" under a written agreement between you and the "labor leasing firm", to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". 'Temporary worker" means a person who is furnished to you to support or supplement your work force during "employee" absences, temporary skill shortages, upturns or downturns in business or to meet seasonal or short- term workload conditions. "Temporary worker" does not include a "leased worker". 2. The following definition is added to the Definitions Section: "Labor leasing firm" means any person or organization who hires out workers to others, including any: a. Employment agency, contractor or services; b. Professional employer organization; or c. Temporary help service. N. Definitions -Your Product and Your Work The "your product" and "your work" definitions under the Definitions Section are replaced by the following: "Your product'': a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a) You; (b) Others trading under your name; or (c) A person or organization whose business or assets you have acquired; and (2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. Includes copyrighted material of Insurance Services Office, Inc .. with its permission. U-GL-1477-C CW (03/20) Page 6 of 9 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance, use, handling, maintenance, operation or safety of "your product"; and (2) The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. "Your work": a. Means: (1) Work, services or operations performed by you or on your behalf; and (2) Materials, parts or equipment furnished in connection with such work, services or operations. b. Includes: (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance. use, handling, maintenance, operation or safety of "your work"; and (2) The providing of or failure to provide warnings or instructions. 0. Duties in the Event of Occurrence, Offense, Claim or Suit Condition The following paragraphs are added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV -Commercial General Liability Conditions: Notice of an "occurrence" or of an offense which may result in a claim under this insurance or notice of a claim or "suit'' shall be given to us as soon as practicable after knowledge of the "occurrence", offense, claim or "suit" has been reported to any insured listed under Paragraph 1. of Section II -Who Is An Insured or an "employee" authorized by you to give or receive such notice. Knowledge by other "employees" of an "occurrence". offense. claim or "suit" does not imply that you also have such knowledge. In the event that an insured reports an "occurrence" to the workers compensation carrier of the Named Insured and this "occurrence" later develops into a General Liability claim, covered by this Coverage Part, the insured's failure to report such "occurrence" to us at the time of the "occurrence" shall not be deemed to be a violation of this condition. You must, however, give us notice as soon as practicable after being made aware that the particular claim is a General Liability rather than a Workers Compensation claim. P. Other Insurance Condition Paragraphs 4.a. and 4.b.(1) of the Other Insurance Condition of Section IV -Commercial General Liability Conditions are replaced by the following: 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph c. below. However, this insurance is also primary to and will not seek contribution from any other insurance available to an additional insured provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. Other insurance includes any type of self insurance or other mechanism by which an insured arranges for funding of its legal liabilities. Includes copyrighted material of Insurance Services Office, Inc. with its permission. U-GL-1477-C CW (03/20} Page 7 of 9 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 b. Excesslnsurance (1) This insurance is excess over: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: (i) That is property insurance, Builder's Risk, Installation Risk or similar coverage for "your work"; (ii) That is property insurance purchased by you (including any deductible or self insurance portion thereof) to cover premises rented to you or temporarily occupied by you with permission of the owner; (iii) That is insurance purchased by you (including any deductible or self insurance portion thereof) to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; (iv) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I -Coverage A -Bodily Injury And Property Damage Liability; or (v) That is property insurance (including any deductible or self insurance portion thereof) purchased by you to cover damage to: Equipment you borrow from others at a jobsite; or ii Property loaned to you or personal property in the care, custody or control of the insured arising out of the use of an elevator at premises you own, rent or occupy. (b) Any other primary insurance (including any deductible or self insurance portion thereof) available to the insured covering liability for damages arising out of the premises, operations, products, work or services for which the insured has been granted additional insured status either by policy provision or attachment of any endorsement Other primary insurance includes any type of self insurance or other mechanism by which an insured arranges for funding of its legal liabilities. (c) Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis. Q. Unintentional Failure to Disclose All Hazards Condition 6. Representations of Section IV -Commercial General Liability Conditions is replaced by the following: 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. Coverage will continue to apply if you unintentionally: i. Fail to disclose all hazards existing at the inception of this policy; or ii. Make an error, omission or improper description of premises or other statement of information stated in this policy. You must notify us in writing as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to inception of this Coverage Part. Includes copyrighted material of Insurance Services Office. Inc. with its permission U-Gl-1477-C CW (03/20) Page 8 of 9 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 R. Transfer Of Rights Of Recovery Against others To Us / Waiver of Right of Subrogation Condition 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV -Commercial General Liability Conditions is renamed and replaced by the following: 8. Transfer Of Rights Of Recovery Against Others To Us/ Waiver of Right of Subrogation a. If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them b. If the insured waives its right to recover payments for injury or damage from another person or organization in a written contract executed prior to a loss, we waive any right of recovery we may have against such person or organization because of any payment we have made under this Coverage Part. The written contract will be considered executed when the insured's performance begins or when it is signed, whichever happens first. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. S. Liberalization Condition The following condition is added to Section IV -Commercial General Liability Conditions: Liberalization Clause If we revise this Coverage Part to broaden coverage without an additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in the state shown in the mailing address of your policy. All other terms, conditions, provisions and exclusions of this policy remain the same. Includes copyrighted material of Insurance Services Office, Inc , with its permission. U-GL-1477-C CW (03/20) Page 9 of 9 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO 2925173-13 Effective Date: 02/01/2021 U-GL-1521-B CW (01/19) Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Blanket Notification to Others of Cancellation or Non-Renewal This endorsement applies to insurance provided under the: Commercial General Liability Coverage Part A.If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a list provided to us by the first Named Insured if you are required by written contact or written agreement to provide such notification. Such list: 1.Must be provided to us prior to cancellation or non-renewal; 2.Must contain the names and addresses of only the persons or organizations requiring notification that such Coverage Part has been cancelled or non-renewed; and 3.Must be in an electronic format that is acceptable to us. B.Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail or deliver such notification to each person or organization shown in the list: 1.Within 10 days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or 2.At least 30 days prior to the effective date of: a.Cancellation, if cancelled for any reason other than nonpayment of premium; or b.Non-renewal, but not including conditional notice of renewal, unless a greater number of days is shown in the Schedule of this endorsement for the mailing or delivering of such notification with respect to Paragraph B.1. or Paragraph B.2. above. C.Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy only. Our failure to provide such mailing or delivery will not: 1.Extend the Coverage Part cancellation or non-renewal date; 2.Negate the cancellation or non-renewal; or 3.Provide any additional insurance that would not have been provided in the absence of this endorsement. GLO292517015 02/01/2022GLO29251701602/01/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 ii ZURICH I U-GL-1521-B CW (01/19) Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. D.We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs A. and B. of this endorsement. SCHEDULE The total number of days for mailing or delivering with respect to Paragraph B.1. of this endorsement is amended to indicate the following number of days: * The total number of days for mailing or delivering with respect to Paragraph B.2. of this endorsement is amended to indicate the following number of days: ** * If a number is not shown here, 10 days continues to apply. ** If a number is not shown here, 30 days continues to apply. All other terms and conditions of this policy remain unchanged. DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 GLO 2925170 12 GLO 292517013 GLO 292517014GLO292517015GLO292517016 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 POLICY NUMBER: COMP..ERCIAL GENERAL LIABILITY CG24040509 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: ANY PERSON OR ORGANIZATION THAT REQUIRES YOU TO WAIVE YOUR RIGHTS OF RECOVERY , IN A WRITTEN CONTRACT OR AGREEMENT WITH THE NAMED INSURED THAT IS EXECUTED PRIOR TO THE ACCIDENT OR LOSS. Information reauired to comolete this Schedule if not shown above will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV -Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 □ BAP 2925171 12 02/01/2019 02/01/2020BAP 292517113 02/01/2020 02/01/2021BAP29251711402/01/2021 02/01/2022BAP29251711502/01/2022 02/01/2023BAP29251711602/01/2023 02/01/2024 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 Coverage Extension Endorsement ZURICH Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add'I. Prem Return Prem. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section II -Covered Autos Liability Coverage: The following are also "insureds": ® a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any "employee" of yours is also an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement. d. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you , provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance -Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident", will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form . B. Amendment -Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II -Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-CA-424-F CW (04-14) Page 1 of 6 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section II -Covered Autos Liability Coverage does not apply. D. Driver Safety Program Liability and Physical Damage Coverage 1. The following is added to the Racing Exclusion in Section II -Covered Autos Liability Coverage: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. 2. The following is added to Paragraph 2. in the Exclusions of Section Ill -Physical Damage Coverage of the Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section IV -Physical Damage Coverage of the Motor Carrier Coverage Form: This exclusion does not apply to covered "autos" participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. E. Lease or Loan Gap Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Lease Or Loan Gap Coverage In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan for a covered "auto", less: a. Any amount paid under the Physical Damage Coverage Section of the Coverage Form; and b. Any: (1) Overdue lease or loan payments at the time of the "loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous leases or loans. F. Towing and Labor Paragraph A.2. of the Physical Damage Coverage Section is replaced by the following: We will pay up to $75 for towing and labor costs incurred each time a covered "auto" of the private passenger type is disabled. However, the labor must be performed at the place of disablement. G. Extended Glass Coverage The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section: If glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. H. Hired Auto Physical Damage -Increased Loss of Use Expenses The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the following: Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by: Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-CA-424-F CW (04-14) Page 2 of 6 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2) Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto"; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $3000. I. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Coverage a. We will pay up to $750 for "loss" to personal effects which are: (1) Personal property owned by an "insured"; and (2) In or on a covered "auto". b. Subject to Paragraph a. above, the amount to be paid for "loss" to personal effects will be based on the lesser of: (1) The reasonable cost to replace; or (2) The actual cash value. c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered "auto". No deductible applies to this coverage. However, we will not pay for "loss" to personal effects of any of the following: (1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value. (2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches , precious or semi-precious stones. (3) Paintings, statuary and other works of art. (4) Contraband or property in the course of illegal transportation or trade. (5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same "loss". J. Tapes, Records and Discs Coverage 1. The Exclusion in Paragraph 8.4.a. of Section Ill -Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph 8.2.c. of Section IV -Physical Damage Coverage in the Motor Carrier Coverage Form does not apply. 2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: (a) Are the property of an "insured"; and (b) Are in a covered "auto" at the time of "loss". The most we will pay for such "loss" to tapes, records, discs or other similar devices is $500. The Physical Damage Coverage Deductible Provision does not apply to such "loss". Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-CA-424-F CW (04-14) Page 3 of 6 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 K. Airbag Coverage The Exclusion in Paragraph 8.3.a. of Section Ill -Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph 8.4.a. of Section IV -Physical Damage Coverage in the Motor Carrier Coverage Form does not apply to the accidental discharge of an airbag . L. Two or More Deductibles The following is added to the Deductible Provision of the Physical Damage Coverage Section: If an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you by us, the following applies for each covered "auto" on a per vehicle basis: 1. If the deductible on this policy or Coverage Form is the smaller (or smallest) deductible, it will be waived; or 2. If the deductible on this policy or Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. M. Physical Damage -Comprehensive Coverage -Deductible The following is added to the Deductible Provision of the Physical Damage Coverage Section: Regardless of the number of covered "autos" damaged or stolen, the maximum deductible that will be applied to Comprehensive Coverage for all "loss" from any one cause is $5,000 or the deductible shown in the Declarations, whichever is greater. N. Temporary Substitute Autos -Physical Damage 1. The following is added to Section I -Covered Autos: Temporary Substitute Autos -Physical Damage If Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following types of vehicles are also covered "autos" for Physical Damage Coverage: Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered "auto" you do own but is out of service because of its: 1. Breakdown; 2. Repair; 3. Servicing; 4. "Loss"; or 5. Destruction. 2. The following is added to the Paragraph A. Coverage Provision of the Physical Damage Coverage Section: Temporary Substitute Autos -Physical Damage We will pay the owner for "loss" to the temporary substitute "auto" unless the "loss" results from fraudulent acts or omissions on your part. If we make any payment to the owner, we will obtain the owner's rights against any other party. The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it replaces. 0. Amended Duties In The Event Of Accident, Claim, Suit Or Loss Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following: a. In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss" is known to you (if you are an individual), a partner (if you are a partnership), a member (if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-CA-424-F CW (04-14) Page 4 of 6 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 agent, servant or employee of the "insured" to notify us of any "accident", claim, "suit" or "loss" shall not invalidate the insurance afforded by this policy. Include, as soon as practicable: (1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or "suit" including, but not limited to, the date and details of such claim or "suit"; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. If you report an "accident", claim , "suit" or "loss" to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. P. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. a. Employee Hired Autos -Physical Damage Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other Insurance -Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented under a written contract or written agreement entered into by an "employee" or elected or appointed official with your permission while being operated within the course and scope of that "employee's" employment by you or that elected or appointed official's duties as respect their obligations to you. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". R. Unintentional Failure to Disclose Hazards The following is added to the Concealment, Misrepresentation Or Fraud Condition: However, we will not deny coverage under this Coverage Form if you unintentionally: (1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or (2) Make an error, omission , improper description of "autos" or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy. S. Hired Auto -World Wide Coverage Paragraph 7a.(5) of the Policy Period, Coverage Territory Condition is replaced by the following: (5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less, T. Bodily Injury Redefined The definition of "bodily injury" in the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-CA-424-F CW (04-14) Page 5 of 6 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 U. Expected Or Intended Injury The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section II -Covered Auto Liability Coverage is replaced by the following: Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. V. Physical Damage -Additional Temporary Transportation Expense Coverage Paragraph A.4.a. of Section Ill -Physical Damage Coverage is replaced by the following: 4. Coverage Extensions a. Transportation Expenses We will pay up to $50 per day to a maximum of $1,000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". W. Replacement of a Private Passenger Auto with a Hybrid or Alternative Fuel Source Auto The following is added to Paragraph A. Coverage of the Physical Damage Coverage Section: In the event of a total "loss" to a covered "auto" of the private passenger type that is replaced with a hybrid "auto" or "auto" powered by an alternative fuel source of the private passenger type, we will pay an additional 10% of the cost of the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a maximum of $2500. The covered "auto" must be replaced by a hybrid "auto" or an "auto" powered by an alternative fuel source within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease agreement. To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of propulsion power. The other source of propulsion power must be electric, hydrogen, propane, solar or natural gas, either compressed or liquefied. To qualify as an "auto" powered by an alternative fuel source, the "auto" must be powered by a source of propulsion power other than a conventional gasoline engine. An "auto" solely propelled by biofuel, gasoline or diesel fuel or any blend thereof is not an "auto" powered by an alternative fuel source. X. Return of Stolen Automobile The following is added to the Coverage Extension Provision of the Physical Damage Coverage Section: If a covered "auto" is stolen and recovered , we will pay the cost of transport to return the "auto" to you . We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. All other terms, conditions, provisions and exclusions of this policy remain the same. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-CA-424-F CW (04-14) Page 6 of 6 BAP 2925171 12 02/01/2019 BAP 292517113 02/01/2020 BAP 292517114 02/01/2021 BAP292517115 02/01/2022 BAP292517116 02/01/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 POLICY NUMBER : COMMERCIAL AUTO CA 20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL V. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: HAWTHORNE MACHINERY co . Endorsement Effective Date: SCHEDULE Name Of Person(s) Or Organization(s): ONLY THOSE PERSONS OR ORGANIZATIONS WHERE REQUIRED BY WRITTEN CONTRACT Information reauired to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II -Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I -Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 481013 © Insurance Services Office, Inc., 2011 Page 1 of 1 BAP 2925171 12 02/01/2019 BAP 292517113 02/01/2020 BAP 292517114 02/01/2021 BAP292517115 02/01/2022 BAP292517116 02/01/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 POLICY NUMBER: COMMERCIAL AUTO CA 04 4410 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL V. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: HAWTHORNE MACHINERY co . Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): ALL PERSONS AND /OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WI TH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA04441013 © Insurance Services Office, Inc., 2011 Page 1 of 1 BAP 2925171 12 02/01/2019 02/01/2020BAP 292517113 02/01/2020 02/01/2021BAP 292517114 02/01/2021 02/01/2022BAP29251711502/01/2022 02/01/2023BAP29251711602/01/2023 02/01/2024 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 Blanket Notification to Others of Cancellation or Non-Renewal Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add'I. Prem THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Conmercial Automobile Coverage Part ® ZURICH Return Prem. A. If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a list provided to us by the first Named Insured if you are required by written contact or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to the first Named Insured . Such list: 1. Must be provided to us prior to cancellation or non-renewal; 2. Must contain the names and addresses of only the persons or organizations requiring notification that such Coverage Part has been cancelled or non-renewed; and 3. Must be in an electronic format that is acceptable to us. B. Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail or deliver such notification to each person or organization shown in the list: 1. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or 2. At least 30 days prior to the effective date of: a. Cancellation , if cancelled for any reason other than nonpayment of premium; or b. Non-renewal, but not including conditional notice of renewal. C. Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy only. Our failure to provide such mailing or delivery will not: 1. Extend the Coverage Part cancellation or non-renewal date; 2. Negate the cancellation or non-renewal ; or 3. Provide any additional insurance that would not have been provided in the absence of this endorsement. D. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs A. and B. of this endorsement. All other terms and conditions of this policy remain unchanged. Includes copyrighted material of Insurance Services Office, Inc., with its permission. U-CA-832-A CW (01 / 13) Page 1 of 1 WC 2925169 1202/01/2019 02/01/2020 WC 29251691302/01/2021 WC 29251691402/01/2022 WC292516915WC29251691602/01/2023 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 990643 BLANKET NOTIFICATION TO OTHERS OF CANCELLATION OR NONRENEWAL ENDORSEMENT This endorsement adds the following to Part Six of the policy. PART SIX CONDITIONS Blanket Notification to Others of Cancellation or Nonrenewal 1. If we cancel or non-renew this policy by written notice to you, we will mail or deliver notification that such policy has been cancelled or non-renewed to each person or organization shown in a list provided to us by you if you are required by written contract or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to you. Such list: a. Must be provided to us prior to cancellation or non-renewal; b. Must contain the names and addresses of only the persons or organizations requiring notification that such policy has been cancelled or non-renewed; and c. Must be in an electronic format that is acceptable to us. 2. Our notification as described in Paragraph 1. above will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to you. We will mail or deliver such notification to each person or organization shown in the list: a. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or b. At least 30 days prior to the effective date of: (1) Cancellation, if cancelled for any reason other than nonpayment of premium ; or (2) Non-renewal, but not including conditional notice of renewal. 3. Our mailing or delivery of notification described in Paragraphs 1. and 2. above is intended as a courtesy only. Our failure to provide such mailing or delivery will not: a. Extend the policy cancellation or non-renewal date; b. Negate the cancellation or non-renewal; or c. Provide any additional insurance that would not have been provided in the absence of this endorsement. 4. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs 1. and 2. above. All other terms and conditions of this policy remain unchanged. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Insured: HAWTHORNE MACHINERY CO. Insurance Company: ZURICH AMERICAN INSURANCE COMPANY WC 99 06 43 Endorsement No. 001 Premium $ INCL (Ed. 01 -13) Includes copyright material of the National Council on Compensation Insurance, Inc. used with its permission. © 2012 Copyright National Council on Compensation Insurance, Inc. All Rights Reserved. Page 1 of 1 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT WC 00 0313 (Ed. 4-84) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule AL L PERS ONS OR ORGANIZATIONS WC000313 (Ed. 4-84) © 1983 National Council on Compensation Insurance. DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 0403 06 Ed. 4-84 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0 mium otherwise due on such remuneration. Person or Organization ALL PERSONS OR ORGANIZATIONS WC 252 (4-84) WC 04 03 06 (Ed . 4-84) Schedule Job Description % of the California workers' compensation pre- Page 1 of 1 Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add’l. Prem Return Prem. GLO 2925170-13 02/01/2020 02/01/2021 02/01/2020 18298000 INCL Other Insurance Amendment – Primary And Non- Contributory U-GL-1327-B CW (04/13) Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured: Address (including ZIP Code): This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part 1.The following paragraph is added to the Other Insurance Condition of Section IV – Commercial General Liability Conditions: This insurance is primary insurance to and will not seek contribution from any other insurance available to an additional insured under this policy provided that: a.The additional insured is a Named Insured under such other insurance; and b.You are required by a written contract or written agreement that this insurance would be primary and would not seek contribution from any any other insurance available to the additional insured. 2.The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV – Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis. All other terms and conditions of this policy remain unchanged. GLO292517014 02/01/2021 02/01/2022GLO29251701502/01/2022 02/01/2023GLO29251701602/01/2023 02/01/2024 DocuSign Envelope ID: 297AA008-3535-40EE-BBDF-DA86560BFEF6 ® ZURICH