HomeMy WebLinkAboutPW CNT 14-11/Wood Sewer and Excavating CITY OF OSHKOSH
LEGAL DEPARTMENT
215 CHURCH AVENUE, P.O. BOX 1130, OSHKOSH, WI 54903-1130
PHONE: (920) 236-5115 FAX(920) 236-5106
LETTER OF TRANSMITTAL
To: Wood Sewer& Excavating Date: October 2, 2014
E9238 County Road X Pro�ect: Sanitary Sewer Manhole Rehab
New London, WI 54961 From: Carol Marchant, Adm. Assistant
Re: Contract No. 14-11
Attn:
Please find: � Attached ❑ Under Separate Cover
❑ Copy of Letter � Contracts ❑ Amendment ❑ Report ❑ Agenda
❑ Meeting Notes ❑ Photos ❑ Mylars ❑ Change Order ❑ Plans
❑ Specifications ❑ Estimates ❑ Diskette ❑ Zip Disk ❑ Other
Quantit Descri tion
1 Ori inal Si ned Contract No. 14-11
These are being transmitted as indicated below:
❑ For Approval � For Your Use ❑ As Requested ❑ For Review 8� Comment
Remarks:
cc: City Clerk (original)
Public Works, Engineering (original)
City Attorney (copy)
CONSTRUCTION CONTRACT
THIS AGREEMENT, made on the 23rd day of July, 2014, by and befinreen the CITY
OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and WOOD SEWER
& EXCAVATING, INC., E9238 County Road X, New London, WI 54961, party of the
second part, hereinafter referred to as the CONTRACTOR,
WITNESSETH:
That the CITY and the CONTRACTOR, for the consideration hereinafter named,
agree as follows:
ARTICLE I. SCOPE OF WORK
The CONTRACTOR hereby agrees to furnish all of the materials and all of the
equipment and labor necessary, and to perForm all of the work shown on the plans and
described in the specifications for the project entitled or described as follows:
Public Works Contract No. 14-11
for the Sanitary Sewer Manhole Rehabilitation Program, for the Public Works
Department, pursuant to Resolution 14-336 adopted by the Common Council of the City of
Oshkosh on the 22nd day of July, 2014,
all in accordance and in strict compliance with the CONTRACTOR's Proposal and the other
Contract Documents referred to in ARTICLE V of this Contract.
ARTICLE II. TIME OF COMPLETION
The work to be perFormed under this contract shall be commenced and the work
completed within the time limits specified in the Special Conditions and/or
CONTRACTOR's proposal.
ARTICLE III. PAYMENT
(a) The Contract Sum.
The CITY shall pay to the CONTRACTOR for the performance of the Contract the
sum of $393,039.20, adjusted by any changes as provided in the Specifications, or any
changes hereafter mutually agreed upon in writing by the parties hereto, provided,
however, in the event the Proposal and Contract Documents are on a "Unit Price" basis,
the above mentioned figure is an estimated figure, and the CITY shall, in such cases, pay
to the CONTRACTOR for the performance of the Contract the amounts determined for the
total number of each of the units of work as set forth in the CONTRACTOR's proposal; the
number of units therein contained is approximate only, and the final payment shall be
made for the actual number of units that are incorporated in or made necessary by the
work covered by the Contract.
1
..
(b) Progress Payments.
In the event the time necessary to complete this Contract is such that progress payments
are required, they shall be made according to the provisions set forth in the Specifications.
ARTICLE IV. CONTRACTOR TO HOLD CITY HARMLESS
The CONTRACTOR covenants and agrees to protect and hold the CITY harmless
against all actions, claims and demands of any kind or character whatsoever which may in
any way be caused by or result from the intentional or negligent acts of the
CONTRACTOR, his agents or assigns, his employees or his subcontractors related
however remotely to the performance of this Contract or be caused or result from any
violation of any law or administrative regulation, and shall indemnify or refund to the CITY
all sums including court costs, attorney fees, and punitive damages which the CITY may be
obliged or adjudged to pay on any such claims or demands within thirty (30) days of the
date of the CITY's written demand for indemnification or refund.
ARTICLE V. INSURANCE
The Insurance required by the City of Oshkosh as specified in the CITY's
specifications, including addenda, or plans, or instructions, or advertisements, shall be
primarv coverage and that any insurance or self insurance maintained by the City of
Oshkosh, its officers, council members, agents, employees or authorized volunteers will
not contribute to a loss. All insurance shall be based upon the occurrence of an event, and
not based on claims made. All insurance shall be in full force prior to commencing work
and remain in force until the entire job is completed and the length of time that is specified,
if any, in this Contract, the Specifications, whichever is longer.
ARTICLE VI. COMPONENT PARTS OF THE CONTRACT
This Contract consists of the following component parts, all of which are as fully a
part of this contract as if herein set out verbatim, or if not attached, as if hereto attached:
1. This Instrument
2. The City's Approved Plans
3. Specifications, including any addenda
4. City of Oshkosh Standard Specifications
5. Instructions to Bidders
6. Advertisement for Bids
7. Contractor's Proposal
The Contract Documents are complementary; what is required by one is as binding
as if required by all. Before undertaking each part of the work, the CONTRACTOR shall
carefully study and compare the Contract Documents and check and verify all pertinent
figures and measurements required therein. CONTRACTOR shall promptly report in
writing to the Engineer any conflict, error, ambiguity or discrepancy which CONTRACTOR
may discover and shall obtain written clarification from the Engineer before proceeding with
any work affected thereby.
2
_�
�� In the event that any provision in any of the above component parts of this Contract
conflicts with any provision in any other of the component parts, the provision in the
component part first enumerated above shall govern over any other component part which
follows it numerically except as may be otherwise specifically stated.
IT IS HEREBY DECLARED, UNDERSTOOD AND AGREED that the word
"CONTRACTOR" wherever used in this Contract means the party of the second part and
its/his/their legal representatives, successors, and assigns.
IN WITNESS WHEREOF, the City of Oshkosh, Wisconsin, has caused this contract
to be sealed with its corporate seal and to be subscribed to by its City Manager and City
Clerk and countersigned by the Comptroller of said City, and the party of the second part
hereunto set its, his or their hand and seal the day and year first above written.
In the Presence of: CONTRACTOR
^ WOOD SEWER & EXCAVATING, INC.
�lO (.l M wn�[�
---- By. , "�"
St1P /�nh LA��►('�
(Seal of Contrac�Q�,;,,,,, (Specify Title)
if a Corporatib' t.k:;� ''� :
,����`..... ��a�:
^`w:.-��.E��Fi�;�T�"��� By:
���. „';
:o:��� ���� :���
-����. 1`�g� ��� em (Specify Title)
,";� � .. * ���`
;.,` l,l••..... ..�
<;, 'i���;;�,;�a`� ��� CITY OF OSHKOSH
��;�
� / By: /f7`- i�'c.�'�-�/I-��.
� ? ^(� �-`� Mark A. Rohloff, City Manager
(Wi ness) _____ .
� �.._
. � : � .� _...- n
����� And: � � (
(Witness) Pamela R. Ubrig, City erk
\
APPROVED: I hereby certify that the necessary
provisions have been made to pay
the liability which will accrue under
this contract
ttorney
����
City Comp roller
3
• — r
Liberty Interchange Corporate Center
450 Plymouth Road,Suite 400
�u���TM Plymouth Meeting,PA. 19462-1644
Ph.(610)832-8240
MAINTENANCE BOND
Bond Number: 354-032-669
KNOW ALL MEN BY THESE PRESENTS,that we Wood Sewer&Excavatinq, Inc.
, as principal (the"Principal"),
and Liberty Mutual Insurance Company, a Massachusetts stock insurance company, as surety (the "Surety"), are
held and firmly bound unto City of Oshkosh
, as obligee(the"Obligee"),
in the penal sum of Three Hundred Ninety-Three Thousand Thirty-Nine and 20/100
Dollars($393,039.20 ),
for the payment of which sum well and truly to be made, the Principal and the Surety, bind ourselves, our heirs,
executors, administrators,successors and assigns,jointly and severally,firmly by these presents.
WHEREAS,the Principal has by written agreement dated 07/23/2014 , entered into a contract(the
"ContracY')with the Obligee for Sanitarv Manhole Rehabilitation Program
which contract is by reference made a part hereof.
NOW, THEREFORE, the condition of this obligation is such that if the Principal shall remedy without cost to the
Obligee any defect which may develop during a period of 2 year(s) from the date of completion and
acceptance of the work performed under the Contract, provided such defects are caused by defective or inferior
materials or workmanship,then this obligation shall be null and void; otherwise, it shall be and remain in full force and
effect.
PROVIDED AND SUBJECT TO THE CONDITIONS PRECEDENT:
1. Obligee shall provide both Principal and Surety with written notice of the discovery (Notice of Discovery) of
any item of defective or inferior materials or workmanship during the covered period (a "Covered Item").
Should Principal improperly fail to remedy the Covered Item, then Obligee shall make a written demand
upon the Surety ("Demand")within ninety (90) days of the Obligee's issuance of the Notice of Discovery of
the Covered Item.
2. The Notice of Discovery and the Demand shall be in writing and via certified mail to the Principal and to
the Surety. Notice to the Surety shall be delivered to the attention of the Surety Law Department at the above
address.
3. No suit or action may be commenced by the Obligee against the Surety after the expiration of one(1)year(or
such lesser time period as otherwise permitted by relevant law) from the date of Obligee's discovery of
a Covered Item. If the provision of this paragraph is void or prohibited by law, the minimum period of
limitation available to sureties as a defense in the jurisdiction of the suit shall be applicable.
DATED as of this 17th day of Seqtember , 2014
WITNESS/ATTEST Wood Sewer&Excavating, Inc.
(Principal)
�� �M �'� By: (Seal)
N e:
Title:�
LIBERTY MUTUAL INSURANCE COMPANY
(Surety)
By: � (Seal)
ttorney-in- ct
Robert DOw ey
LMIC-5300 Rev.03/04
TH,IS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRIN��C ON,RED BACKGROUND.
This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated.
Certificate No. sssiaao
• American Fire and Casualty Company Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company WestAmerican Insurance Company
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: That American Fire&Casuatty Company and The Ohio CasuaRy Insurance Company are corporations duly organized under the laws of
the Stffie of New Hampshire,that Liberty Mutual Insurance Company is a corporation dulyorganized under the laws of the State of Massachusetts,and WestAmerican Insurance Company
is a corporation duly organized under the laws of the State of Indiana(herein cotlectivety called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute
and appoint, Chris Steinaqel;Christoaher M.Kema:Connie Smith;Michael J.Douplas;Robert Downey
all of the city of Hudson ,state of wi each individually if there be more than one named,its true and lawiul attomey-in-fact to make,execute,seal,acknowledge
and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shatl
be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their oum proper persons.
IN WITNESS WHEREOF,this Power of Attomey has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed
thereto this 2am day of Julv , 2014 '
� American Fire and Casualty Company �
The Ohio Casuany Insurance Company N
Liberty Mutual insurance Company =
West American Insurance Company •y
N �
�
� .. . ,, , �..,� �, By:
= STATE OF PENNSYLVANIA ss David M.Care ,Assistant Secretary �
+%L COUNTY OF MONTGOMERY =
�
dp� On this 28th day of �ury , 2ota , �fore me personally appeared David M.Carey, who acknowledged 'nimself to be the Assistant Secretary of American Fire and ��
� � Casuatty Company,Liberty Mutual insurance Company,The Ohio Casuatty lnsurance Company,and Wesf Amencan Insurance Company,and that he,as such,being authorized so to do, �W
p� execute the foregoing instNmertt for the purposes ther�in crontained by signing on behalf of the corporationsby himself asa duly authonzed officer. _
a`> > IN WITNESS WHEREOF,I have hereunto subscnbed°rr�yttam�and affixed my notarial seal at Plymouth MeeUng,Pennsybania,on the day and year first above written. O C.
� � ��[/LG�/ /l���1%4�i`'�'R' Q M
'a y'�
l�0.N 5� By' �'a
O i Teresa Pastella,Notary Public d �
— � ea
�i� O �
�. �; ;�-, .� � a
�e
c� This Power ofAttomey is made and executed�� ����aaa�d by authority of the folbwing By-tauus and Authonzations ofAmerican Fire and Casuaky Company,The Ohio Casualty Insurance �n o
d; Company,LibeRy Mutual Insurance Company,aru,�V�st Ai»e[icah Insurance Company which resolutions are now in full force and effect reading as folbws: ��
�
�a� ARTICLE IV-OFFICERS-Section 12.Power ofAttomey.Any officer or other official of the Corporation authonzed forthat purpose in writing by the Chairman or the President,and subject O =
��; to such limitffiion as the Chairman or the President may p�escribe,shall appoint such attomeys-in-faci,as may be necessary to act in behalf of the Corporation to make,execute,seal, w d
O= acknowledge and deliver as surety any and alI undertakings,bonds,recognizances and other surety obNgations. Such attomeys-in-fact,subject to the limitations set forth in their respeclive � �
� � powers of attomey,shail have ful�power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so � a�
�� executed,such instrumerrts shall be as binding as if signed by the President and attested to by the Secretary.Any power or authonty granled to any representative or attomey-in-fact under >�
� � the provisions of this article may be revoked at any time by the Board,the Chairman,the President orby the officer or officers granting such power or authority. ��
♦r N
�� � ARTICLE XIII-Execution of Contracts-SECTION 5.Surety Bonds and Undertakings.Any officer of the Company authonzed for that�arpose in wnting by the chairman or the president, �00
> i and subject to such limitations as the chaimian or the president may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Company to make,execute, �M
Z � seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their �aQ
respective powers of attomey,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so v�
executed such instruments shall be as binding as if signed by the president and attested by the secretary. �c4
Certificate of Designation-The President of the Company,acting pursuant to the Bytaws of the Gompany;authorizes David M.Carey,Assistant Secretary to appoint such attomeys-in- ~�
fac,N as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety
obligations.
Authorization-By unanimous consent of the Companys Board of Directors,the Company consents thffi facsimile or mechanically reproduced signature of any assistant secretary of the
Company,vuherever appearing upon a certified copy of any power of attomey issued by the Company in connection with surety bonds,shall be vafid and binding upon the Company with
the same force and effect as though manually affixed.
I,Gregory W.DavenpoA,the undersigned,Assistant Secretary,of Amencan Fire and Casualty Campany,The Ohio Casualty Insurance Company,Libe�ty Mutual Insurance Company,and
West American Insurance Company do hereby certify that the original power of attomey of which the fo going is a full,true a�rrect copy of the Power of Attomey executed by said
Companies,is in tull force and effect and has not been revoked. \
IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this � day of ,20�.
By: �y7��'�''�7�
Gregory W.Davenport,Assistant Secretary
LMS 12873 122013 687 of 1000
��� WOODSEW-01 JTOUSEY
. ACOR�� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDM'YY)
� 9/17/2014
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).
PRODUCER CONTACT
NAME:
Ansay&Associates,LLC. GB PHONE g00 236-8652 FpX (920)437-4179
419 South Washington Street AIC No e�:� ) aic No:
PO Box 22368 E-MAIL
Green Bay,WI 54305 ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
�n,suReRa:Cincinnati Insurance Company 10677
INSURED
INSURER B:
Wood Sewer&Excavating Inc INSURER C:
Sue Wood
E9238 Cty X INSURER D:
New London,WI 54961-7820 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTIMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR 7ypE OF INSURANCE ADDL UBR pOLICY NUMBER MM DIDY/YYYY MM/DDYIYYYY LIMITS
LTR
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 'I,OOO,OO
CLAIMS-MADE �OCCUR X EPP 0018996 06/01/2014 06/01/2015 pREMISES Ea occurrence 5 500,00
MED EXP(Any one person) s 10,000
PERSONAL&ADVINJURY $ 'I,OOO,OO
GEN'LAGGREGATELIMITAPPLIESPER: GENER.4LAGGREGATE $ Z,OOO,OO
POLICY�ECT � LOC
PRODUCTS-COMP/OPAGG $ 2,000,00
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ �,OOO,OO
Ea accident
A X ANY AUTO EBA 0018996 06/01/2014 06/01/2015 BODILY INJURY(Per person) $
ALL OWNED SCHEDULED � BODILY INJURY(Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS qUTOS � Per accident
$
X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000
A EXCESS LIAB CLAIMS-MADE X EPP 0018996 06/01/2014 06/�1/2015 AGGREGATE $ 5,000,��
DED X RETENTIONS 0 $-
WORKERS COMPENSATION - X PER OTH-
AND EMPLOYERS'LIABILITY STATUTE ER
A ANYPROPRIETOR/PARTNER/EXECUTIVE Y❑ N�A WC1918284 06/01/2014 06/01/2015 E.L.EACHACCIDENT $ �OO�OO
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ ���,�0
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ rJOO,OO
DESCRIPTION OF OPERATIONS/�OCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
re: Public Works Contrect 14-11
City of Oshkosh,and its officers,council members,agents,employees and authorized volunteers are included as additional insured with respects to general
liability coverage by endorsement GA233 02/07.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Of OShkOSh THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 1130
Oshkosh,WI 54903-1130
AUTHORIZED REPRESENTATIVE
�_/'�'_"
O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
� THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS' COMMERCIAL GENERAL LIABILITY
BROADENED ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Endorsement-Tabie of Contents:
Coverage: Beqins on Page:
1. Employee Benefit Liability Coverage ..................................................................................................2
2, Unintentional Failure to Disclose Hazards..........................................................................................7
3. Damage to Premises Rented to You...................................................................................................8
4. Supplementary Payments.......................:........................................................................................... 9
5. Medical Payments................................................................................................................................9
6. Voluntary Property Damage (Coverage a.)and Care, Custody or Control
Liability Coverage (Coverage b.).........................................................................................................9
7, 180 Day Coverage for Newly Formed or Acquired Organizations.................................................. 10
8. Waiver of Subrogation ....................................................................................................................... 10
9. AutomaticAdditional Insured -Specified Relationships: ................................................................ 10
• Managers or Lessors of Premises;
• Lessor of Leased Equipment;
• Vendors;
• State or Political Subdivisions-Permits Relating to Premises;
• State or Political Subdivisions-Permits;and
• Contractors'Operations
10. Broadened Contractual Liability-Work Within 50'of Railroad Property......................................... 14
11. Property Damage to Borrowed Equipment....................................................................................... 14
12. Employees as Insureds -Specified Health Care Services: ............................................................ 14
• Nurses;
• Emergency Medical Technicians;and
• Paramedics
13. Broadened Notice of Occurrence...................................................................................................... 14
B. Limits of Insurance:
The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse-
ment, except as provided below:
1. Employee Benefit Liability Coverage
Each Employee Limit: $ 1,000,000
Aggregate Limit: $ 3,000,000
Deductible: $ 1,000
3. Damage to Premises Rented to You
The lesser of:
a. The Each Occurrence Limit shown in the Declarations;or
b. $500,000 unless otherwise stated $
4. Supplementary Payments
a. Bail bonds: $ 1,000
b. Loss of earnings: $ 350
5. Medical Payments
Medical Expense Limit: $ 10,000
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 1 of 15
. i) Reports all, or formance of investment
any part, of the vehicles; or
act, error or
omission to us 3) Advice given to any
or any other person with respect to
insurer; that person's decision
to participate or not to
ii) Receives a participate in any plan
written or ver- included in the "em-
bal demand or ployee benefit pro-
claim for dam- gram".
ages because
of the act, er- (fl Workers' Compensation
ror or omis- and Similar Laws
sion; and Any claim arising out of
b) There is no other your failure to comply with
applicable insur- the mandatory provisions of
ance. any workers' compensation,
unemployment compensa-
(2) Exclusions tion insurance, social secu-
This insurance does not a I rity or disability benefits law
PP Y or any similar law.
to:
(a) Bodily Injury, Property (J) ERISA
Damage or Personal and Damages for which any in-
Advertising Injury sured is liable because of
"Bodil in u " " ro e liability imposed on a fiduci-
Y 1 rY , P P �Y ary by the Employee Re-
damage" or "personal and tirement Income Security
advertising injury". Act of 1974, as now or
(b) Dishonest, Fraudulent, hereafter amended, or by
Criminal or Malicious Act any similar federal, state or
local laws.
Damages arising out of any (h) Available Benefits
intentional, dishonest,
fraudulent, criminal or mali- Any claim for benefits to the
cious act, error or omission, extent that such benefits
committed by any insured, are available, with reason-
including the willful or reck- able effort and cooperation
less violation of any statute. of the insured, from the ap-
(c) Failure to Perform a Con- plicable funds accrued or
tract other coliectible insurance.
Damages arising out of fail- (i) Taxes, Fines or Penalties
ure of performance of con- Taxes, fines or penalties,
tract by any insurer. including those imposed
(d) Insufficiency of Funds under the Internal Revenue
Code or any similar state or
Damages arising out of an local law.
insufficiency of funds to
meet any obligations under (j) Employment-Related
any plan included in the Practices
employee benefit pro- Any liability arising out of
gram". any:
(e) Inadequacy of Perform- (1) Refusal to employ;
ance of Investment / Ad-
vice Given With Respect (2) Termination of em-
to Participation ployment;
Any claim based upon: (3) Coercion, demotion,
1 Failure of an invest- evaluation, reassign-
) Y ment, discipline, defa-
ment to perForm; mation, harassment,
2) Errors in providing in- humiliation, discrimina-
formation on past per- tion or other employ-
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 3 of 15
. (b) Claims made or "suits" (b) The deductible amount
brought; stated in the Declarations
c Persons or or anizations applies to all damages
� ) 9 sustained by any one "em-
making claims or bringing ployee", including such
"suits"; "employee's" dependents
(d) Acts, errors or omissions; or and beneficiaries, because
of all acts, errors or omis-
(e) Benefits included in your sions to which this insur-
"employee benefit pro- ance applies.
gram". (c) The terms of this insurance,
(2) The Aggregate Limit shown in including those with respect
Section B. Limits of Insurance, to:
1. Employee Benefit Liability
Coverage of this endorsement 1) Our right and duty to
is the most we wili pay for all defend the insured
damages because of acts, er- against any 'suits"
rors or omissions negligently seeking those dam-
committed in the "administra- ages; and
tion" of your "employee benefit 2) Your duties, and the
program". duties of any other in-
(3) Subject to the limit described in volved insured, in the
(2) above, the Each Employee event of an act, error or
Limit shown in Section B. Limits omission, or claim,
of Insurance, 1. Employee apply irrespective of the
Benefit Liability Coverage of application of the deductible
this endorsement is the most we amount.
will pay for all damages sus-
tained by any one "employee", (d) We may pay any part or all
including damages sustained by of the deductible amount to
such "employee's" dependents effect settlement of any
and beneficiaries, as a result of: claim or "suit" and, upon
notification of the action
{a) An act, error or omission;or taken, you shall promptly
(b) A series of related acts, er- reimburse us for such part
rors or omissions, regard- of the deductible amount as
less of the amount of time we have paid.
that lapses _between such d. Additional Conditions
acts, errors or omissions,
As respects Employee Benefit Li-
negligently committed in the ability Coverage, SECTION IV -
'administration of your em- COMMERCIAL GENERAL LIABIL-
ployee benefit program". ITY CONDITIONS is amended as
However, the amount paid un- follows:
der this endorsement shall not (1) Item 2. Duties in the Event of
exceed, and will be subject to Occurrence, Offense, Claim or
the limits and restrictions that Suit is deleted in its entirety and
appiy to the payment of benefits replaced by the following:
in any plan included in the "em-
ployee benefit program". 2, Duties in the Event of an Act, Error or
(4) Deductible Amount Omission, or Claim or Suit
a Our obli ation to a dam- a. You must see to it that we are noti-
� ) 9 P Y fied as soon as practicable of an act,
ages on behalf of the in- error or omission which may result in
sured applies only to the a claim. To the extent possible, no-
amount of damages in ex- tice should include:
cess of the deductible
amount stated in the Decla- (1) What the act, error or omission
rations as applicable to was and when it occurred; and
Each Employee, The limits
of insurance shall not be (Z) The names and addresses of
reduced by the amount of anyone who may suffer dam-
this deductible. ages as a result of the act, error
or omission.
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 5 of 15
. in any benefit included benefits, workers' com-
in the "employee bene- pensation and disability
fit program', benefits; and
However, "administration" d. Vacation plans, includ-
does not include: ing buy and sell pro-
a. Handling payroll de-
grams; leave of ab-
ductions; or sence programs, in-
cluding military, mater-
b. The failure to effect or nity, family, and civil
maintain any insurance leave; tuition assis-
or adequate limits of tance plans; transpor-
coverage of insurance, tation and health club
including but not limited subsidies,
to unemployment in- (2) The following definitions are
surance, social security deleted in their entirety and re-
benefits, workers' com- placed by the foliowing:
pensation and disability
benefits. 21. "Suit" means a civil pro-
ceeding in which money
2. "Cafeteria plans" means damages because of an
plan authorized by.applica-
ble law to allow "employ- act, error or omission to
which this insurance applies
ees" to elect to pay for cer- are alleged. "Suit"includes:
tain benefits with pre-tax
dollars. a. An arbitration pro-
3. "Employee benefit pro- ceeding in which such
grams" means a program damages are claimed
providing some or all of the and to which the in-
following benefits to "em- sured must submit or
pioyees", whether provided does submit with our
through a "cafeteria pian" or consent;
otherwise: b. Any other alternative
a. Group life insurance; dispute resolution pro-
ceeding in which such
group accident or damages are claimed
health insurance; den- and to which the in-
tal, vision and hearing sured submits with our
plans; and flexible consent; or
spending accounts;
provided that no one c. An appeal of a civil
other than an "em- proceeding.
ployee" may subscribe
to such benefits and 8. "Employee" means a per-
such benefits are made son actively employed, for-
generally available to merly employed, on leave
those "employees"who of absence or disabled, or
satisfy the pian's eligi- retired, "Employee" in-
bility requirements; cludes a "leased worker".
"Employee" does not in-
b. Profit sharing plans, clude a "temporary worker".
employee savings
plans, employee stock 2. Unintentionai Failure to Disciose Haz-
ownership plans, pen- ards
sion plans and stock SECTION IV- COMMERCIAL GENERAL
subscription plans, LIABILITY CONDITIONS, 7. Represen-
provided that no one tations is hereby amended by the addi-
other than an em- tion of the following:
ployee" may subscribe
to such benefits and Based on our dependence upon your
such benefits are made representations as to existing hazards, if
generally available to unintentionally you should fail to disclose
ail "employees" who ail such hazards at the inception date of
are eligible under the your policy, we will not reject coverage
plan for such benefits; under this Coverage Part based solely on
c. Unemployment insur-
such failure.
ance, social security
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc., with its permission. Page 7 of 15
• caused by or resulting 5. Medical Payments
from rain, snow, sleet
or ice, whether driven The Medical Expense Limit of Any One
by wind or not. Person as stated in the Declarations is
amended to the limit shown in Section B,
c. Limit of Insurance Limits of Insurance, 5. Medical Pay-
The Damage to Premises Rented to
ments of this endorsement.
You Limit as shown in the Deciara- 6. Voluntary Property Damage and Care,
tions is amended as follows: Custody or Control Liability Coverage
(2) Paragraph 6, of SECTION III - a. Voluntary Property Damage Cov-
LIMITS OF INSURANCE is erage
hereby deleted and replaced by
the following: We will pay for"property damage" to
property of others arising out of op-
6. Subject to 5, above, the erations incidental to the insured's
Damage to Premises business when:
Rented to You Limit is the
most we will pay under (1) Damage is caused by the in-
COVERAGE A. BODILY sured; or
INJURY AND PROPERTY (2) Damage occurs while in the in-
DAMAGE LIABILITY, for sured's possession.
damages because of
"property damage" to With your consent, we will make
premises while rented to these payments regardless of fault.
you or temporarily occupied
by you with permission of b. Care, Custody or Control Liability
the owner, arising out of Coverage
any one "occurrence" to SECTION I - COVERAGES, COV-
which this insurance ap- ERAGE A. BODILY INJURY AND
plies. PROPERTY DAMAGE LIABILITY, 2.
(3) The amount we will pay is lim- Exclusions,j. Damage to Property,
ited as described in Section B. Subparagraphs (3), (4) and (5) do
Limits of Insurance, 3. Dam- not apply to "property damage" to
age to Premises Rented to the property of others described
You of this endorsement. therein.
4. Supplementary Payments With respect to the insurance provided by
this section of the endorsement, the fol-
Under SECTION I - COVERAGE, SUP- lowing additional provisions apply:
PLEMENTARY PAYMENTS - COVER-
AGES A AND B: a. The Limits of Insurance shown in the
Declarations are replaced by the lim-
a. Paragraph 2. is replaced by the fol- its designated in Section B, Limits of
lowing: Insurance, 6. Voluntary Property
Up to the limit shown in Section B. Damage and Care, Custody or
Limits of Insurance, 4.a. Bail Bonds Control Liability Cov.erage of this
of this endorsement for cost of bail endorsement with respect to cover-
bonds required because of accidents age provided by this endorsement.
or traffic law violations arising out of These limits are inclusive of and not
the use of any vehicle to which the in addition to the limits being re-
Bodily Injury Liability Coverage ap- placed. The Limits of Insurance
plies. We do not have to furnish shown in Section B. Limits of Insur-
these bonds. ance, 6. Voluntary Property Dam-
age and Care, Custody or Control
b. Paragraph 4. is replaced by the fol- Liability Coverage of this endorse-
lowing: ment fix the most we will pay in any
one "occurrence" regardless of the
All reasonable expenses incurred by number of:
the insured at our request to assist
us in the investigation or defense of (1) Insureds;
the claim or "suiY', including actuai (2) Claims made or "suits" brought;
loss of earnings up to the limit shown or
in Section B. Limits of Insurance,
4.b. Loss of Earnings of this en- (3) Persons or organizations mak-
dorsement per day because of time ing claims or bringing "suits".
off from work.
Includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc., with its permission. Page 9 of 15
. you cease to be a ten- c) Any physical or
ant in that premises, chemical change
in the product
2) Structural alterations, made intentionally
new construction or by the vendor;
demolition operations
performed by or on be- d) Repackaging, un-
half of such additional less unpacked
insured. solely for the pur-
b An erson or or anization pose of inspection,
� � y P g demonstration,
from which you lease testing, or the
equipment with whom you substitution of
have agreed per Paragraph parts under in-
9.a.(1) above to provide in- structions from the
surance. Such person(s) or manufacturer, and
organization(s) are insureds then repackaged
solely with respect to their in the original
liability arising out of the container;
maintenance, operation or
use by you of equipment e) Any failure to
leased to you by such per- make such in-
son(s) or organizations(s). spections, adjust-
However, this insurance ments, tests or
does not apply to any "oc- servicing as the
currence"which takes place vendor has
after the equipment lease agreed to make or
expires, normally under-
takes to make in
(c) Any person or organization the usual course
(referred to below as ven- of business, in
dor) with whom you have connection with
agreed per Paragraph the distribution or
9.a.(1) above to provide in- sale of the prod-
surance, but only with re- ucts;
spect to "bodily injury'' or
"property damage" arising fl Demonstration, in-
out of"your products" which stallation, servic-
are distributed or sold in the ing or repair op-
regular course of the ven- erations, except
dor's business, subject to such operations
the following additionai ex- performed at the
clusions: vendor's premises
in connection with
1) The insurance afforded the sale of the
the vendor does not product;
apply to:
a) "Bodily injury" or g) Products which,
after distribution or
"property damage" sale by you, have
for which the ven- been labeled or
dor is obligated to relabeled or used
pay damages by as a container,
reason of the as- part or ingredient
sumption of liabil- of any other thing
ity in a contract or or substance by or
agreement. This for the vendor.
exclusion does not
apply to liability for 2) This insurance does
damages that the not appiy to any in-
vendor would sured person or or-
have in the ab- ganization:
sence of the con-
tract or agree- a) From whom you
ment; have acquired
such products, or
b) Any express war- any ingredient,
ranty unauthorized part or container,
by you; entering into, ac-
Includes copyrighted material of insurance
GA 233 02 07 Services Office, Inc.,with its permission. Page 11 of 15
• of the additional in- spects any other insurance
sured; or policy issued to the addi-
2 The renderin of, or tional insured, and such
) 9 other insurance policy shall
failure to render, any be excess and / or noncon-
professional architec- tributing, whichever applies,
tural, engineering or with this insurance.
surveying services, in-
ciuding: (b) Any insurance provided by
this endorsement shall be
a) The preparing, primary to other insurance
approving or fail- available to the additional
ing to prepare or insured except:
approve maps,
shop drawings, 1) As otherwise provided
opinions, reports, in SECTION IV
surveys, field or- COMMERCIAL GEN-
ders, change or- ERAL LIABILITY
ders or drawings CONDITIONS, 5. Other
and specifications; Insurance, b. Excess
and insurance; or
b) Supervisory, in- 2) For any other valid and
spection, archi- collectible insurance
tectural or engi- available to the addi-
neering activities, tional insured as an
3 "Your work" for which a additional insured by
) attachment of an en-
consolidated (wrap-up) dorsement to another
insurance program has insurance policy that is
been provided by the written on an excess
primecontractor-project basis, In such case,
manager or owner of the coverage provided
the construction project under this endorse-
in which you are in- ment shall aiso be ex-
volved. cess.
b. Only with regard to insurance pro- (2) Condition 11. Conformance to
vided to an additional insured desig- Specific Written Contract or
nated under Paragraph 9.a.(2) Sub- Agreement is hereby added:
paragraph (fl above, SECTION III -
LIMITS OF INSURANCE is amended 11. Conformance to Specific
to include: Written Contract or
Agreement
The limits applicable to the additional
insured are those specified in the With respect to additionai
written contract or agreement or in insureds described in Para-
the Declarations of this Coverage graph 9.a.(2)(fl above only:
Part, whichever are less. If no limits
are specified in the written contract If a written contract or
or agreement, or if there is no written agreement between you
contract or agreement, the limits ap- and the additional insured
plicable to the additional insured are specifies that coverage for
those specified in the Declarations of the additional insured:
this Coverage Part. The limits of in- a. Be provided by the In-
surance are inclusive of and not in surance Services Of-
addition to the limits of insurance fice additional insured
shown in the Declarations. form number CG 20 10
c. SECTION IV - COMMERCIAL GEN- or CG 20 37 (where
ERAL LIABILITY CONDITIONS is edition specified);or
hereby amended as follows: b. Include coverage for
(1) Condition 5. Other Insurance is completed operations;
amended to include: or
(a) Where required by a written c. Include coverage for
contract or agreement, this "your work';
insurance is primary and / and where the limits or cov-
or noncontributory as re- erage provided to the addi-
Includes copyrighted material of insurance
GA 233 02 07 Services Office, Inc.,with its permission, Page 13 of 15
, TIONS) is hereby deleted and replaced (2) The names and addresses of
by the following: any injured persons and wit-
a. You must see to it that we are noti- nesses; and
fied as soon as practicable of an (3) The nature and location of any
"occurrence" or an offense which injury or damage arising out of
may result in a ciaim. To the extent the "occurrence" or offense.
possible, notice shouid inciude:
This requirement applies only when
(1) How, when and where the "oc- the "occurrence" or offense is known
currence" or offense took place; to an "authorized representative",
includes copyrighted material of Insurance
GA 233 02 07 Services Office, Inc., with its permission. Page 15 of 15