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Wood Sewer & Excavating & Oshkosh/Contract 16-20
CONSTRUCTION CONTRACT THIS AGREEMENT, made on the 25th day of May, 2016, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and WOOD SEWER AND EXCAVATING, INC., E9238 County Road X, New London,Wisconsin 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. 16-20 for construction of mini storm sewers and storm sewer laterals at various locations around the City, for the Public Works Department, pursuant to Resolution 16-253 adopted by the Common Council of the City of Oshkosh on the 24th day of May, 2016, 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 111. PAYMENT (a) The Contract Sum. The CITY shall pay to the CONTRACTOR for the performance of the Contract the sum of $213,804.00, 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 primary 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 Plans and Specifications, including all Addenda's 3. City of Oshkosh Standard Specifications 4. Instructions to Bidders 5. Advertisement for Bids 6. 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 AND EXCAVATING, INC, By: �i)p .�,%,�-1�adr� Grey L.. Intl (Seal of CoRtwt 111"l, (Specify Title) if a Cor[ X41,•, co o SEAL 0 1996 (Specify Title) C0 `'t.•�` CITY OF OSHKOSH By: � % E Mark A. Rohloff, City Manager Witne s) `- And: (Witnes ) 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 43it- Arney , - - City Comptroller 3 BOND #WIG 56021 r PERFORMANCE BOND CITY OF OSHKOSH Contract Number 16-20 Date Bond Executed (Date of Contractor Later) 06/02/2016 PRINCIPAUCONTRACTOR(Legal Name and Business Address) Type of Organization Wood Sewer& Excavating, Inc. F-1individual ❑ partnership E9238 Cty Rd X New London, WI 64961 New State of Incorporation Wisconsin SURETY(IES)(Legal Name(s) and Business Address(es)) Penal Sum of Bond$213,804.00 Merchants Bonding Company 6700 Westown Pkwy West Des Moines, IA 50266 OWNER(Legal Mame and Business Address) CITY OF OSHKOSH 215 Church Avenue PO Box 1130 Oshkosh,Wisconsin 54903-1130 OBLIGATION The Contractor and Surety,jointly and severally, bind themselves, their heirs, executors, administrators,successors and assigns to the Owner for payment of the sum shown above or the performance of the Contract identified above,which is incorporated herein by reference. This Bond shall cover any work performed during Initial construction and any warranty period required by the Contract. If there is no Owner Default to pay the Contractor as required under the Contract for work performed or to perform or complete any material term of the Contract, then the Surety(les)obligation under this Bond shall arise after, 1. The Owner provides notice to the Contractor and Surety that the Owner is considering declaring the Contractor in default of the Contract. Within five (5) business days of the Owner's notice, either the Contractor or the Surety may request a conference with the Owner to discuss such default and the remedy therefor. If a conference is requested, the conference shall be scheduled to take place at Owner's principal place of business or another agreed upon location within five(5) business days of the request for conference. If the Owner, Contractor and Surety agree, the Contractor may be allowed a reasonable time to perform the Contract, but such agreement shall not waive the Owner's right, if any, to subsequently declare the Contractor in default; 2. The Owner declares the Contractor in default and notifies the Surety of the declaration of default; and 3. The Owner agrees'to pay the balance of the Contract price in accordance with the terms of the Contract to the Surety or to a qualified Contractor selected to perform the Contract. Failure of the Owner to comply with the notice requirement specified above shall not release the Surety from its obligations. Upon notice from the Owner as provided above, the Surety shall promptly and at Surety's expense take one of the following actions: 1. Arrange for the Contractor, with consent of the Owner, to perform and complete the Contract; 2. Undertake to perform and complete the Contract itself, through qualified agents or independent contractors; 3. Obtain bids or negotiated proposals from qualified contractors acceptable to the Owner to enter into a contract with the Owner for performance and completion of the Contract, to be secured with performance and payment bonds, and to pay to the Owner as damages any amount in excess of the original contract amount for the completion of the Contract; any additional legal, design professional, architect, or consultant fees resulting from any delay in the completion of the Contract: and any applicable liquidated damages specified within the Contract resulting from any delay in the completion of the Contract. 4. Make payment to the Owner, as soon as practicable after an amount is determined for completion of the Contract; or 5. Deny liability in whole or in part and notify the Owner, citing with specificity the reasons for such denial. If the Surety does not proceed with reasonable promptness, Owner may give notice to the Surety and the Surety shall be deemed in default on this Bond five (5) business days after notice by the Owner demanding the Surety perform its obligations under this Bond. Owner shall be entitled to enforce any remedy available to Owner upon default. Except for default of the Surety and Surety's election to perform or complete the Contract itself under paragraph 2 above,Surety's liability shall be limited to the amount of this Bond. Notice to the Contractor or Surety shall be deemed to have been given (1) upon delivery to an officer or person entitled to such notice, if hand delivered; or (ii) two (2) business days following deposit In the United States mail, postage prepaid; (ill)upon delivery by a commercial carrier that will certify the date and time of delivery;or(iv) upon transmission if by facsimile, email or other form of electronic transmission. Notices shall be provided to the Owner, Surety and/or Contractor at their address as specified on this Bond or to a facsimile, email or other electronic address that has been provided In writing to the other party to be used for this purpose. The laws of the State of Wisconsin shall govern the interpretation and construction of this Bond. Winnebago County shall be the venue for all disputes arising under this Bond. Any provision in this Bond that may conflict with statutory or other legal requirement shall be deemed deleted herefrom and provisions conforming to the statutory or other legal requirement shall be deemed Incorporated herein, The above obligation Is void if the Contractor performs and fulfills all the terms, conditions and agreements of the Contract and any authorized modifications during the term of the original Contract and any extensions thereof. Notice to the Surety Is waived for any modifications agreed upon by Owner and Contractor. Wood Sewer& Excavating, Inc. Merchants Bonding Company Name of Principal/Contractor Name of Surety Title i ent — Care r k.woo Title Robert ney, At rney-in-Fact BOND #WIC 56021 PAYMENT BOND CITY OF OSHKOSH Contract Number 16-20 Date Bond Executed (Date of Contractor Later) 0 610 212 01 6 PRINCIPAVCONTRACTOR (Legal Name and Business Address) Type of Organization Wood Sewer& Excavating, Inc. Individual [] Partnership E9238 Cty Rd X Corporation New London,Wl 54961 State of incorporation Wisconsin SURETY(IES)(Legal Name(s) and Business Address(es)) Penal Sum of Bond$213,804.00 Merchants Bonding Company 6700 Westown Pkwy West Des Moines, IA 50266 OWNER(Legal name and Business Address) CITY OF OSHKOSH 215 Church Avenue PO Box 1130 Oshkosh,Wisconsin 54903-1130 OBLIGATION The Contractor and Surety,jointly and severally, bind themselves, their heirs, executors, administrators, successors and assigns to the Owner to pay for labor, materials and equipment furnished for use in the performance of the Contract identified above, which is incorporated herein by reference, subject to the following terms. If the Contractor promptly makes payment of all sums due to claimants, and defends, indemnifies and holds harmless the Owner from all claims, demands, liens or suits by any person or entity seeking payment for labor, materials or equipment furnished for use in the performance of the Contract, then the Surety and the Contractor shall have no obligation under this Bond. If there Is no Owner Default to pay the Contractor as required under the Contract for work performed or to perform or complete any material term of the Contract, then the Surety(ies) obligation under this Bond shall arise after the Owner has promptly notified the Contractor and the Surety of claims, demands, liens or suits against the Owner or the Owner's property by any person or entity seeking payment for labor, materials or equipment furnished for use in the performance of the Contract and tendered defense of such claims, demands, liens or suits to the Contractor and the Surety. Amounts owed by the Owner to Contractor under the Contract shall be used for performance of the Contract and to satisfy claims, if any, under any Performance Bond. By the Contractor furnishing and the Owner accepting this Bond, they agree that all funds earned by the Contractor in the performance of the Contract are dedicated to satisfy obligations of the Contractor and Surety under this Bond, subject to the Owner's priority to use the funds for the completion of the work. Upon notice and tendering of claims as specified above, the Surety shall promptly and at Surety's expense defend, Indemnify and hold harmless the Owner against such claim,demand, lien or suit. Surely shall answer claimants, with a copy to Owner, within sixty (60) days of the date of the claim, stating the amount that are disputed and the specific basis for challenging any amount that is disputed or pay or arrange for payment of any undisputed amount claimed. Surety shall not be obligated to the Owner, claimants or others for obligations of the Contractor under this Bond that are unrelated to the Contract. The Owner shall not be liable for the payment of any costs or expenses of any claimant under this Bond and shall have no obligation to make payments to, or give notice on behalf of claimants, or otherwise have any obligation to claimants under this Bond. Notice to the Contractor or Surety shall be deemed to have been given; (i) upon delivery to an officer or person entitled to such notice, if hand delivered; or (Ii) two (Z) business days following deposit In the United States mail, postage prepaid; (III) upon delivery by a commercial carrier that will certify the date and time of delivery; or(Iv) upon transmission if by facsimile, email or other form of electronic transmission. Notices shall be provided to the Owner, Surety and/or Contractor at their address as spectfied on this Bond or to a facsimile, email or other electronic address that has been provided in writing to the other parry to be used for this purpose, The laws of the State of Wsconsin shall govern the Interpretation and construction of this Bond. Winnebago County shall be the venue for all disputes arising under this Bond. Any provision In this Bond that may conflict with statutory or other legal requirement shall be deemed deleted herefrom and provisions conforming to the statutory or other legal requirement shall be deemed Incorporated herein. Wood Sewer& Excavating, Inc. Merchants Bonding Company Name of Principal/Contractor Name of Surety \f Title { �, C�reS 1—LAJozd Title o ert o ney,At ey-in-Fact MERCHANTS BONDING COMPANY„, POWER OF ATTORNEY Know AN Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC.,both being corporations of the State of Iowa(herein collectively called the'Compantes)do hereby make,constitute and appoint, Individually, Chris Steinagel; Christopher M Kemp; Connie Smith; Eric Olson; Michael J Douglas; Robert Downey their true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver on behalf of the Companies,as Surety,bonds,undertakings and other written obligations in the nature thereof,subject to the limitation that any such instrument shall not exceed the amount of: TWENTY MILLION($20,000,000.00)DOLLARS This Power-of-Attorney Is granted and Is signed and sealed by facsimile under and by authority of the following By-Lays adopted by the Board of Directors of Merchants Bonding Company(Mutual)on April 23,2011 and adopted by the Board of Directors of Merchants National Bonding,Inc.,on October 24,2011. "The President,Secretary,Treasurer,or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-In-Fact,and to authorize them to execute on behalf of the Company,and attach the seal of the Company thereto,bonds and undertakings,recognizances,contracts of indemnity and other writings obligatory in the nature thereof." 'The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond,undertaking,recognizance,or other suretyship obligations of the Company,and such signature and seal when so used shalt have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only,it is agreed that the power and authority hereby given to the Attorney-In•Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation.It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee,shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-In-Fact cannot be modified or revoked unless prior written personal notice of such Intent has been given to the Commissioner- Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 15th day of August 2015 �""""'k""�`y., •'•1 •'•. MERCHANTS BONDING COMPANY(MUTUAL) ���.�'` � � ��,��( ��''• �NG•... •• MERCHANTS NATIONAL BONDING,INC. ±h..44�POR¢j0.l4�5= �POyq�yy�;. 1933 L); 2003 ,:,�; :ti . �• yy".. ..•";tacit,,• •.6.>' , '\14: STATE OF IOWA 'I r`��bftli�i'illFli!'�+l t ••'•• COUNTY OF Dallas ss. President On this 15th day of August 2015 ,before me appeared Larry Taylor,to me personally known,who being by me sworn did say that he is President of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.;and that the seals affixed to the foregoing Instrument are the Corporate seals of the Companies;and that the sold instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. htgsAc3, WENDY WOODY o Commission Number 781654 My Commission Expires ,A June 20 2017 Notary Pub lr , County,Iowa (Expiration of notary's commission does not invalidate this instrument) I,William Warner,Jr.,Secretary of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by laid Companies, which is still in full force and effect and has not been amended or revoked. p y In Witness Whereof, I have hereunto set m hand and affixed the seal of the Com anles on this da of J 1V1 (j`v�J[(/� 2018 a 9 tti 1'`, 1—;— -O Secretary :moi 1933 POA 0014 (6115) ,I','"�ryiNil„lyl13!'t Aco CERTIFICATE OF LIABILITY INSURANCE DATE(MWDa"YY") 6/2/2016 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(les)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 NAP,1B:CT Br' Hauge nsay&Associates, LLC. GB PHONE 0-236-865 No: - 3 -112. 9 419 South Washington Street IL PO Box 22368 ADDREss:B ' a sa ca Green Bay WI 54305 INSURER(S)AFFORDING COVERAGE NAIC N INSURERA;C1nCinn8t1 InsuranceCDMParly 10677 INSURED WOODSEW--01 INSURERS: Wood Sewer&Excavating Inc INSURERC: E9238 Cty X New London Wl 54961-7820 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:928493440 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, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSR IADOL SBR POLICY NUMBER POUC �Y POLICYCfyY YY LIMITS A GENERAL LIABILITY Y EPP 0018996 6/1/2016 6/1/2017 EACH OCCURRENCE $1.0K000 —DMOFGE TO REN D X COMMERCIAL GENERAL LIABILITY PREMISES a occurrence) $500,000 01-NMS-MADE OCCUR MEQ EXP oneperson) $10000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2 000 000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 000 000 POLICY X PRO- LOC $ AUTOMOBILE LIABILITY EBA00189 611P2016 611!2017 a acclden _$1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS ED AUTOS SCHEDULED BODILY INJURY(Per accideng $ NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS eramIders $ $ X UMBRELLA LIAB X OCCUR EPP 0015996 611/2016 6!112017 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$0 $ WORKERS COMPENSATION EWC0319321 6/112016 6/1/2017 X I YYC STA1 OTH- AND EMPLOYERS'LIABILITY YINLIMIT ANY PROPRIETORrPARTNERIEXECUTIVE OFFICF-PAIEPABEREXCLUDED? ED NIA E.L.EACH ACCIDENT $100, 10 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100,000 Ef SCRIPTION OF OPERATIONS bele:!describe under E.L.DISEASE•POLICY LIMIT $500 000 DES DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addlllonal Remarks Schedule,If more space Is required) re: Public Warks Contract 16-20 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 02107. i 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 PO BOX 1130 ACCORDANCE WITH THE POLICY PROVISIONS. Oshkosh\1549031130 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD I 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-Table of Contents: CoverageBegins 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. Automatic Additional 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 bands: $ 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 S 6. Voluntary Property Damage(Coverage a.) and Care,Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a.$1,000 Coverage b.$5,000 unless otherwise stated $ Deductibles (Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM a Area (For Limits in Excess of (For Limits in Excess of bPayroll $5,000) $5,000) c Gross Sales d i Units el Other b. Care, Custody $ or Control TOTAL.ANNUAL PREMIUM 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the appli- cable limit of insurance 1. Employee Benefit Liability Coverage in the payment of a. The following is added to SECTION I judgments or settle- -COVERAGES: Employee Benefit ments. Liability Coverage. No other obligation or liabil- ity to pay sums or perform ( ) g g ads or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay- obligated to pay as dam- ments. ages caused by any act, er- (b) This insurance applies to ror or omission of the in- damages only if the act, er- sured, or of any other per- ror or omission, is negii- son for whose acts the in- gently committed in the sured is legally liable, to "administration" of your which this insurance ap- "employee benefit pro- plies. We will have the right gram"; and and duty to defend the in- sured against any "suit" 1) Occurs during the pol- seeking those damages. icy period;or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeing damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our )a You did not have discretion, investigate any knowledge of a report of an act, error or claim or "suit" on omission and settle any or claim or "suit" that may re- fectief date of thiore the s sult. But: endorsement. 1) The amount we will pay You will be for damages is limited deemed to have as described in SEC. knowledge of a TION III - LIMITS OF claim or "suit" INSURANCE; and when any "author- 2) Our right and duty to ized representa- defend ends when we tive'; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 2 of 16 S i) Reports all, or formance of investment any part, of the vehicles; or act, error or 3) Advice given to any omission to us person with respect to or any other that person's decision insurer; 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 (f) Workers' Compensation of the act, er- ror or omis- and Similar laws sion; and Any daim arising out of your b) There is no other failure to comply with the applicable insur- mandatory provisions of any ance. workers' compensation, un- employment compensation (2) Exclusions insurance, social security or disability benefits law or any This insurance does not apply similar law. to: (g) ERISA (a) Bodily Injury, Property Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of li- ability imposed on a fiduci- "Bodily injury", "property ary by the E=mployee 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, stats 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 are committed by any insured, available, with reasonable including the willful or reek- effort and cooperation of the less violation of any statute. insured, from the applicable c funds accrued or other col- ( ) Failure to Perform aCon-tract lectible Insurance. Damages arising out of fail- (1) Taxes, Fines or Penalties ure of perforrnance of con- Taxes, fines or penalties, tract by any insurer. including those imposed d In of Funds under the Internal Revenue ( } Y Code or any similar state or Damages arising out of an local law. insufficiency of funds to ()) Employment Related meet any obligations under Practices any plan included in the "employee benefit pro- Any liability arising out of gram". any: (e) Inadequacy of Perform- (1) Refusal to employ; ance of Investment 1 Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, evaluation, reassign- 1) Failure of any invest- ment, discipline, defa- ment to perform; mation, harassment, 2) Errors in prmAding in- humiliation, discrimina- forrnation 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 menti related practices, (e) A trust, you are an insured. acts or omissions;or Your trustees are also in- sureds, but only with re- (4) Consequential liability spect to their duties as trus- as a result of(1), (2) or tees, (3)above. This exclusion applies (2) Each of the following is also an pp insured: whether the insured may be held liable as an employer (a) Each of your "employees" or in any other capacity and who is or was authorized to to any obligation to share administer your "employee damages with or repay benefit program". someone else who must pay damages because of (b) Any persons, organizations the injury. or "employees" having proper temporary authoriza- (3) Supplementary Payments tion to administer your "em- SECTION I - COVERAGES, "em- pee die,benbut�otnlyrugntil your SUPPLEMENTARY PAY- legal representative is ap- MENTS -COVERAGES A AND pointed, B also apply to this Coverage. b. Who is an Insured (c) Your legal representative if you die, but only with re- As respects Employee Benefit Liabil- spect to duties as such. ity Coverage, SECTION 11 -WHO IS That representative will AN INSURED is deleted in its en- have all your rights and du- tirety and replaced by the following: ties under this Coverage Part. (1) If you are designated in the Dec- (3) Any organization you newly ac- larations as: quire or form, other than a part- (a) An individual, you and your nership, joint venture or limited spouse are insureds, but liability company, and over only with respect to the con- which you maintain ownership or dud of a business of which majority interest, will qualify as a you are the sole owner. Named Insured if no other simi- lar insurance applies to that or- (b) A partnership or joint ven- ganization. However, coverage ture, you are an insured. under this provision: Your members, your part- ners, and their spouses are (a) Is afforded only until the also insureds but only with 180th day after you acquire respect to the conduct of or farm the organization or your business. the end of the policy period, whichever is earlier; and (c) A limited liability company, you are an insured, Your (b) Does not apply to any act, members are also insureds, error or omission that was but only with respect to the committed before you ac- conduct of your business. quired or formed the organi- Your managers are insur- zation. eds, but only with respect to c. Limits of Insurance their duties as your manag- ers. As respects Employee Benefit Liabil- (d) An organization other than a ity Coverage, SECTION III - LIMITS partnership, joint venture or OF INSURANCE is deleted in its en- limited liability company, tirety and replaced by the following: you are an insured, Your (1) The Limits of Insurance shown "executive officers" and di- in Section B. Limits of Insur- rectors are insureds, but ance, 1. Employee Benefit Li- only with respect to their du- ability Coverage and the rules ties as your officers or direc- below fix the most we will pay tors. Your stockholders are regardless of the number of: also insureds, but only with respect to their liability as (a) Insureds; stockholders. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with Its permission. Page 4 of 15 (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations applies to all damages sus- (c) Persons or organizations tained by any one "em- making daims or bringing ployee", including such"em- "suits'; ployee's" dependents and (d) Acts, errors or omissions;or beneficiaries, because of all acts, errors or omissions to (e) Benefits included in your which this insurance ap- "employee benefit pro- plies. 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 1) Our right and duty to Coverage of this endorsement defend the insured is the most we will pay for all against any "suits" damages because of acts, errors seeking those dam- or omissions negligently commit- ted in the "administration" of ages; and your "employee benefit pro- 2) Your duties, and the gram". 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 ap- Benefit Liability Coverage of plication 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 no- tification of the action taken, (a) An act, error or omission;or you shall promptly reim- (b) A series of related acts, er- burse us for such part of the rors or omissions, regard- deductible amount as we less of the amount of time 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 fol- However, the amount paid under lows. this endorsement shall not ex- (1) Item 2. Duties in the Event of ceed, and will be subject to the Occurrence, Offense, Claim or limits and restrictions that apply Suit is deleted in its entirety and to the payment of benefits in any replaced by the following: plan included in the "employee benefit program". 2. Duties in the Event of an Act, Error or (4) Deductible Amount Omission, or Claim or Suit a. You must see to it that we are noti- (a) Our obligation to pay dam- fled 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 dalm. 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 f insurance shall not be re- (2) The names and addresses of oins of by the amount b this anyone who may suffer dam- 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 b. If a claim is made or"suit" is brought b. Method of Sharing against any insured, you must: If all of the other insur- (1) Immediately record the specifics ante permits contribu- of the claim or "suit" and the tion by equal shares, date received; and we will follow this method also. Under (2) Notify us as soon as practicable. this approach each in- You must see to it that we receive surer contributes equal written notice of the claim or"suit"as amounts until it has soon as practicable, paid its applicable limit of insurance or none of c. You and any other involved insured the loss remains, must: whichever comes first. (1) Immediately send us copies of If any of the other in- any demands, notices, sum- surance does not per- monses or legal papers received mit contribution by in connection with the claim or equal shares, we will "suit"; contribute by limits. Under this method, (2) Authorize us to obtain records each insurer's share is and other Information; based on the ratio of its Cooperate with us in the investi- applicable limit of in- (3) Coo p surance to the total ap- gation or settlement of the claim plicable limits of insur- or defense against the "suit"; ance of all Insurers. and (4) Assist us, upon our request, in c. No Coverage the enforcement of any right This insurance shall not against any person or organiza- cover any loss for Von which may be liable to the which the insured is en- Insured because of an act, error titled to recovery under or omission to which this insur- any other insurance in anoe may also apply. force previous to the ef- d. No insured will, except at that in- festive date of this sured's own cost, voluntarily make a Coverage fart. payment, assume any obligation, or e. Additional Definitions incur any expense without our con- sent. As respects Employee Benefit Li- ability Coverage, SECTION V - (2) Item 5. Other Insurance is de- DEFINITIONS is amended as fol- leted in its entirety and replaced lows: by the following: (1) The following definitions are 5. Other Insurance added: If other valid and collectible 1. "Administration" means: insurance is available to the insured for a loss we cover a. Providing information to under this Coverage Part, "employees", including our obligations are limited their dependents and as follows: beneficiaries, with re- spect to eligibility for or a. Primary Insurance scope of "employee This insurance is pri- benefit programs'; mary except when c. b. Interpreting the "em- below applies. If this ployee benefit pro- insurance Is primary, grams'; our obligations are not affected unless any of c. Handling records in the other insurance is connection with the also primary. Then, we "employee benefit pro- will share with all that grams"; or other insurance by the d. Effecting, continuing or method described in b. terminating any "em- below. ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 6 of 15 in any benefit included benefits, workers' eom- 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- grams; leave of ab- a. Handling payroll deduc- sence programs, in- tions; or cluding military, mater- b. The fellate to effect or nity, family, and civil maintain any insurance leave; tuition tr porassta- or adequate limits of trance pians; transporta- coverage of insurance, tion and health dub subsidies. including but not limited to unemployment in- (2) The following definitions are de- surance, social security leted in their entirety and re- benefits, workers' oom- placed by the following: pensation and disability benefits. 21. "Suit' means a civil pro- ceeding in which money 2. ''Cafeteria plans" means damages because of an act, plan authorized by applica- error or omission to which ble law to allow "employ- this insurance applies are ees" to elect to pay for ear- alleged. "Suit" includes: fain benefits with pre-tax dollars. a. An arbitration proceed- ing in which such dam- 3. "Employee benefit pro- ages are claimed and grams" means a program to which the insured providing some or all of the must submit or does following benefits to "em- submit with our con- ployees", whether provided sent; through a"cafeteria plan" or otherwise: b. Any other alternative dispute resolution pro- a. Group life insurance; 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 pro- other than an "em- ceeding. ployee" may subscribe g, "Employee" means a per- to such benefits and son actively employed, for- such benefits are made merly employed,on leave of generally available to those "employees"who absence "Employed' ncludes satisfy the plan's eligi- a "leased worker". "Em- bility requirements; ployee" does not include a b. Profit sharing plans, "temporary worker'. employee savings 2. Unintentional Failure to Disclose Haz- plans, employee stock ards ownership plans, pen- sion plans and stock SECTION IV-COMMERCIAL GENERAL_ subscription plans, pro- LIABILITY CONDITIONS, 7. Represen- vided that no one other tations is hereby amended by the addi- than an "employee" tion of the following: may subscribe to such benefits and such Based on our dependence upon your rep- benefits are made gen- resentations as to existing hazards, if un- erally available to all intentionally you should fail to disclose all "employees" who are such hazards at the inception date of your eligible under the pian policy, we will not reject coverage under for such benefits, this Coverage Part based solely on such c. Unemployment insur- failure. ance, social security Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 7 of 15 3. Damage to Promises Rented to You f) Nesting or infesta- tion, or discharge a. The last Subparagraph of Paragraph or release of 2. SECTION I - COVERAGES, waste products or COVERAGE A. - BODILY INJURY secretions, by in- AND PROPERTY DAMAGE, 2. LI- sects, birds, ro- ABILITY Exclusions is hereby de- dents or other leted and replaced by the following: animals. Exclusions c.through q.do not apply (b) Loss caused directly or indi- to damage by fire, explosion, light- rectly by any of the follow- ning, smoke or soot to premises ing: while rented to you or temporarily oc- cupied by you with permission of the 1) Earthquake, volcanic owner. eruption, landslide or any other earth move- b. The insurance provided under SEC- ment; TION I -COVERAGES, COVERAGE A. BODILY INJURY AND PROP- 2) Water that backs up or ERTY DAMAGE LIABILITY applies overflows from a sewer, to "property damage" arising out of drain or sump; water damage to premises that are 3) Water under the ground both rented to and occupied by you. surface pressing on, or (1) As respects Water Damage Le- flowing or seeping gal Liabillty, as provided in through: Paragraph 3.b.above: a) Foundations, The exclusions under SECTION walls, floors or I - COVERAGES, COVERAGE paved surfaces; A. BODILY INJURY AND b) Basements, PROPERTY DAMAGE LIABIL- whether paved or ITY, 2. Exclusions, other than i. not, or War and the Nuclear Energy Liability Exclusion, are deleted c) Doors, windows or and the following are added; other openings. This insurance doss not apply (c) Loss caused by or resulting to: from water that leaks or (a) "Property damage": flaws from plumbing, heat- ing, air conditioning, or fire 1) Assumed in any con- protection systems caused tract;or by or resulting from freez- 2) Loss caused by or re- ing, unless: sulting from any of the 1) You did your best to following: maintain heat in the building or structure; or a) Wear and tear; 2) You drained the b) Rust, corrosion, equipment and shut off fungus, decay, de- the water supply if the terioration, hidden heat was not main- or latent defect or tained. any quality in property that (d) Loss to or damage to: causes it to dam- age or destroy it- 1) Plumbing, heating, air self; conditioning, fire pro- tection systems, or c) Smog, other equipment or ap- d) Mechanical break pliances;or down including 2) The interior of any rupture or bursting building or structure, or caused by cen- to personal property in trifugal force; the building or structure caused by or resulting e) Settling, cracking, from rain, snow, sleet shrinking or ex- or ice, whether driven pansion;or by wind or not. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 8 of 115 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 Declara- 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 We will pay for "property damage" to the following: 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"prop- erty damage" to premises With your consent, we will make while rented to you or tem- these payments regardless of fault. porarily occupied by you with permission of the b. Care, Custody or Control Liability owner, arising out of any Coverage one 'occurrence" to which SECTION I - COVERAGES, COV- this insurance applies. ERAGE A. BODILY INJURY AND (3) The amount we will pay is lim- PROPERTY DAMAGE LIABILITY, ited as described in Section B. 2. Exclusions, j. Damage to Prop. Limits of Insurance, 3. Dam- erty, Subparagraphs (3), (4) and (5) age to Premises Rented to do not apply to "property damage"to You of this endorsement. the property of others described therein. 4. Supplementary Payments With respect to the insurance provided by Under SECTION I - COVERAGE, SUP- this section of the endorsement, the fol- PLEMENTARY PAYMENTS - COVER- lowing additional provisions apply: AGES AAND B: a. The Limits of Insurance shown in the a. Paragraph 2. is replaced by the fol- Declarations are replaced by the lim- lowing: its designated in Section B. Limits of U to the limit shown in Section B. Insurance, 6. Voluntary Property P Cdy Limits of Insurance, 4.a.Bail Bonds Damage and Care, ustoor Control Liability Coverage 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- b. Paragraph 4. is replaced by the fol- ale and Care, Custody or Control lowing: Liability Coverage of this endorse- ment fix the most we will pay in any All reasonable expenses incurred by one "occurrence" regardless of the the insured at our request to assist number of: us in the investigation or defense of 1 Insureds; the claim or "suit", including actual loss of earnings up to the limit shown (2) Claims made or "suits" brought; in Section B. Limits of Insurance, or 4.b. Loss of Earnings of this en- dorsement per day because of time (3) Persons or organizations malting off from work. claims or bringing"suits". S. Medical Payments b. Deductible Clause The Medical Expense Limit of Any One (1) Our obligation to pay damages Person as stated in the Declarations is on your behalf applies only to amended to the limit shown in Section B. the amount of damages for each "occurrence" which are in ex- Includes copyrighted material of insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 9 of 15 cess of the deductible amount (1) Any person or organization de- stated in Section B. Limits of scribed in Paragraph 9.a.(2) be- Insurance, 6. VoluntaryProp- low (hereinafter referred to as ertyy Damage and Care, Cus- additional insured) whom you tody or Control Liability Cov- are required to add as an addi- erage of this endorsement. The tional insured under this Cover- limits of Insurance will not be re- age Part by reason of: duoed by the application of such deductible amount. (a) A written contract or agree- ment; or (2) Condition 2. Duties in the Event of Occurrence, Offense, (b) An oral agreement or con- Claim or Suit, applies to each tract where a certificate of claim or"suit" irrespective of the insurance showing that per- amount. son or organization as an additional insured has been (3) We may pay any part or all of issued, the deductible amount to effect settlement of any Balm or "suit" is an Insured, provided: and, upon notification of the ac- (a) The written or oral contract tion taken,you shall promptly re- or agreement Is: imburse us for such part of the deductible amount as has been 1) Currently in effect or paid by us. becomes effective dur- 7. 180 Day Coverage for Newly Formed or ian tl the policy period; Acquired Organizations SECTION it - WHO IS AN INSURED is 2) "occurrence" or offense Executed prior to an amended as follows: occur to which this insurance Subparagraph a, of Paragraph 4. is would apply;and hereby deleted and replaced by the fol- (b) They are not specifically lowing: named as an additional in- a. Insurance under this provision is af- sured under any other pro- forded only until the 180th day after vision of, or endorsement you acquire or form the organization added to, this Coverage or the end of the policy period, Part. whichever is earlier; (2) Only the following persons or 8. Waiver of Subrogation organizations are additional in- sureds under this endorsement, SECTION IV-COMMERCIAL GENERAL and insurance coverage pro- LIABILITY CONDITIONS, 9. Transfer of vided to such additional insureds Rights of Recovery Against Others to is limited as provided herein: Us Is hereby amended 6y the addition of the following: promises The manager or lessor of a premises leased to you with We waive any right of recovery we may whom you have agreed per have because of payments we make for Paragraph 9.a.(1) above to injury or damage arising out of your ongo- provide insurance, but only ing operations or"your work" done under with respect to liability aris- a written contract requiring such waiver ing out of the ownership, with that person or organization and in- maintenance or use of that cluded in the 'products-completed opera- part of a premises leased to tions hazard". However, our rights may you, subject to the following only be waived prior to the "occurrence" additional exclusions: giving rise to the injury or damage for which we make payment under this Cov- This insurance does not ap- erage Part. The insured must do nothing ply to: after a loss to impair our rights. At our 1) Any"occurrence" which request, the insured will bring "suit" or takes place after you transfer those rights to us and help us en- cease to be a tenant in force those rights. that premises. 9. Automatic Additional Insured - Specl- 2) Structural alterations, fled Relationships new construction or a. The following is hereby added to demolition operations SECTION II -WHO IS AN INSURED: performed by or on be- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 10 of 15 half of such additional solely for the pur- insured. pose of inspection, demonstration, (b) Any person or organization testing, or the from which you lease substitution of equipment with whom you parts under in- have agreed per Paragraph structlons from the 9.a.(1) above to provide in- manufacturer, and surance. Such person(s) or then repackaged organization(s) are Insureds in the original con- solely with respect to their tainer; liability arising out of the maintenance, operation or e) Any failure to use by you of equipment make such inspec- leased to you by such per- tions, adjustments, son(s) or organizations(s). tests or servicing However, this insurance as the vendor has does not apply to any "oc- agreed to make or currence"which takes place normally under- after the equipment lease takes to make In expires, the usual course of business, in (c) Any person or organization connection with (referred to below as ven- the distribution or dor) with whom you have sale of the prod- agreed per Paragraph ucts; 9.a.(1) above to provide in- surance, but only with re- f) Demonstration, in- spect to "bodily injury" or stallation, servic- "property damage" arising Ing or repair op- out of"your products" which erations, except are distributed or sold in the such operations regular course of the ven- performed at the dor's business, subject to vendor's premises the following additional ex- in connection with clusions: the sale of the 1) The insurance afforded product; the vendor does not g) Products which, apply to: after distribution or "Bodily injury" or sale by you, have a Y been labeled or re- "property damage" labeled or used as for which the ven- a container, part or dor is obligated to ingredient of any pay damages by other thing or sub- reason of the as- stance by or for sumption of liabil- the vendor. ity in a contract or agreement. This 2) This insurance does exclusion does not not apply to any in- apply to liability for sured person or organi- damages that the zation: vendor would have In the absence of a) From whom you the contract or have acquired agreement; such products, or any ingredient, b) Any express war- part or container, ranty unauthorized entering into, ac- by you; companying or c Any physical or containing such products;or chemical change In the product b) When liability in- made intentionally cluded within the by the vendor; "products- completed opera- d) Repackaging, tions hazard" has unless unpacked Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with Its permission. Page 11 of 15 been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1) above speck to such to provide insurance, but products. oniy with respect to liability d An state or political subdi- arising out of "your work" ( } Y p performed for that additional vision with which you have insured by you or on your agreed per Paragraph behalf. A person or organi- 9.a.(1) above to provide in- zation's status as an insured surance, subject to the fol- under this provision of this lowing additional provision: endorsement continues for This insurance applies only only the period of time re- with respect to the following quired by the written con- hazards for which the state tract or agreement,but in no or political subdivision has event beyond the expiration Issued a permit In connec- date of this Coverage Part. tion with premises you own, If there is no written contract rent or control and to which or agreement, or if no pe- this insurance applies: riod of time is required by the written contract or 1) The existence, malnte- agreement, a person or or- nance, repair, oonstruc- ganization's status as an in- tion, erection, or re- sured under this endorse- moval of advertising ment ends when your op- signs, awnings, cano- erations for that insured are pies, cellar entrances, completed. coal holes, driveways, ( )3 An insurance provided to an manholes, marquees, additional insurd designated hoist away openings, under Paragraph 9.a.(2): sidewalk vaults, street banners, or decorations (a) Subparagraphs (e) and (f) and similar exposures; does not apply to "bodily in- or jury" or "property damage" 2) The construction, erect- included within the "prod- tion, or removal of ele- ucts-completed operations vators; or hazard"; 3) The ownership, main- (b) (Subparagraphs (a), (h), (d), tenance, or use of any �(e)and (f)does not apply to elevators covered by bbodily injury", property damage" or "personal and this insurance. advertising injury" arising (e) Any state or political subdi- out of the sole negligence or vision with which you have willful misconduct of the ad- agreed per Paragraph dilional insured or their 9.a.(1) above to provide in- agents, "employees" or any surance, subject to the fol- other representative of the lowing provisions: additional insured;or 1) This insurance applies (c) Subparagraph does not only with respect to op- apply to "bodily Injury", erations performed by "property damage" or "per- you or on your behalf sonal and advertising injury" for which the state or arising out of. political subdivision has issued a permit. 1) Defects in design fur- nished by or on behalf 2) This insurance does of the additional in- not apply to "bodily in- sured; or jury", "property dam- age" or "personal and 2) The rendering of, or failure advertising injury" aris- render, any Ing out of operations professional architec- performed for the state sural, engineering or or political subdivision. surveying services, !n- or Includes copyrighted material of Insurance GA233 02 07 Services office, Inc.,with its permission. Page 12 of 15 a) The preparing, primary to other insurance approving or fail- available to the additional ing to prepare or insured except: approve maps, 1) As otherwise provided shop drawings, in SECTION IV - opinions, reports, COMMERCIAL GEN- surveys, field or- ERAL LIABILITY ders, change or- CONDITIONS, 5. ders or drawings and specifications; Other Insurance, b, and Excess Insurance; or b) Supervisory, in- 2) For any other valid and spection, architec- collectible insurance tural or engineer- available to the addl- ing activities. tional insured as an additional insured by 3) "Your work" for which a 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 prim eoontractor-project basis. In such case, manager or owner of the coverage provided the construction project under this endorsement in which you are in- shall also be excess. volved. (2) Condition 11. Conformance to b, only with regard to insurance pro- Specific Written Contract or vided to an additional insured desig- Agreement is hereby added: nated under Paragraph 9.a.(2) Sub- 11. Conformance to Specific paragraph [f) above, SECTIO [II - Written Contract or LIMITS OF INSURANCE Is amended Agreement to include: The limits applicable to the additional With respect to additional insured are those specified in the insureds described in Para- written contract or agreement or in graph 9.a.(2)(f)above only: the Declarations of this Coverage If a written contract or Part,whichever are less. If no limits agreement between you are specified in the written contract or and the additional insured agreement, or if there is no written specifies that coverage for contract or agreement, the limits ap- the additional insured; plicable to the additional Insured are those specified in the Declarations of a. Be provided by the In- this Coverage Part. The limits of in- surance Services Office surance are inclusive of and not in additional insured form addition to the limits of insurance number CO 20 10 or shown in the Declarations. CG 20 37 (where edi- c. SECTION IV - COMMERCIAL GEN- tion specified); or ERAL LIABILITY CONDITIONS is b. Include coverage for hereby amended as follows: completed operations; or (1) Condition 5. Other Insurance is amended to include: c. Include coverage for (a) Where required by a written "your work"; contract or agreement, this and where the limits or cov- insurance is primary and 1 erage provided to the addi- or noncontributory as re- tional insured is more re- spects any other insurance strictive than was specifi- policy issued to the addi- cally required in that written tional insured, and such contract or agreement, the other insurance policy shall terms of Paragraphs be excess and I or nonoon- 9.a.(3)(a), 9.a.(3)(b) or 9.b. tributing, whichever applies, above, or any combination with this Insurance. thereof, shall be interpreted asor (b) Any insurance provided by co providing the limitsveragerequired by the this endorsement shall be co terms of the written contract Includes copyrighted material of Insurance GA233 02 07 Services Office, Inc.,with its permission. Page 13 of 15 r 1 or agreement, but only to (c) Persons or organizations the extent that such limits or making daims or bring coverage is included within "suits". the terms of the Coverage Part to which this endorse- (2) Deductible Clause ment is attached. If, how- (a) Our obligation to pay dam- ever, the written contract or ages on your behalf applies agreement specifies the In- only to the amount of dam- surance Services Office ad- ages for each "occurrence" ditional insured form num- which are in excess of the ber CG 20 10 but does not Deductible amount stated in specify which edition, or Section B, Limits of Insur- specifies an edition that ante, 11, of this endorse- does not exist, Paragraphs ment. The limits of insur- 9.a.(3)(a) and 9.a.(3)(b) of ante will not be reduced by this endorsement shall not the application of such De- apply and Paragraph 9.b. of ductible amount. this endorsement shall ap- ply. (b) Condition 2. Duties in the Evenof nceOf- 10. Broadened Contractual Liability-Work nse, Claim or Suit,, f ap Within 50' of Railroad Property plies to each claim or "suit' It is hereby agreed that Paragraph f.(1 of irrespective of the amount. Definition 12. "Insured contract" (SEC- (c) We may pay any part or all TION V-DEFINITIONS) is deleted. of the deductible amount to 11. Property Damage to Borrowed Equip- effect settlement of any meat claim or"suit"and, upon no- tification of the action taken, a. The following is hereby added to Ex- you shall promptly reim- clusion j Damage to Property of burse us for such part of the Paragraph 2., Exclusions of SEG- deductible amount as has TION I -COVERAGES, COVERAGE been paid by us. A. BODILY INJURY AND PROP- 12, Employees as Insureds - Specified PROP- ERTY DAMAGE LIABILITY: HealthCareServices p Paragraphs (3) and (4) of this exclu- sion do not apply to tools or equip- y g ment loaned to you, provided they 2.a.(14fiof SECTION II - WHO IS AN are not being used to perform opera- INSt! E , does not apply to your "em- tions at the time of loss. ployees" who provide professional health care services on your behalf as duly li- b. With respect to the insurance pro- tensed: vided by this section of the endorse- ment, the following additional provi- a. Nurses; sions apply: b. Emergency Medical Technicians;or (1) The Limits of insurance shown in c. Paramedics, the Declarations are replaced by the limits designated in Section in the jurisdiction where an "occurrence" B. Limits of Insurance, 11. of or offense to which this insurance applies this endorsement with respect to takes place. coverage provided by this en- dorsement. These limits are in- 13. Broadened Notice of Occurrence clusive of and not in addition to Paragraph a, of Condition 2. Duties in the limits being replaced. The the Event of Occurrence, Offense, Limits of Insurance shown in Claim or Suit(SECTION IV-COMMER- Section B. Limits of Insurance, CIAL GENERAL LIABILITY CONDI- 11. of this endorsement fix the TIONS) is hereby deleted and replaced most we will pay in anyone "oc- by the following: currents regardless of the number of: a. You must see to it that we are noti- fied as soon as practicable of an "oc- currence" or an offense which may (b) Claims made or "suits" result in a claim. To the extent pos- brought;or sible, notice should include: (1) Flow, when and where the "oc- currence"or offense took place; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 14 of 15 (2) The names and addresses of This requirement applies only when any injured persons and wit- the "occurrence" or offense is known nesses; and to an"authorized representative". (3) The nature and location of any injury or damage arising out of the"occurrence"or offense. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc.,with its permission. Page 15 of 16