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HomeMy WebLinkAboutCintas Fire Protection Fire Extinguisher Maintenance 2017PROFESSIONAL SERVICES AGREEMENT FIRE EXTINGUISHER MAINTENANCE FOR CITY OF OSHKOSH THIS AGREEMENT, made on the 29TH day of NOVEMBER, 2017 by and between the CITY of OSHKOSH, hereinafter referred to as CITY, and CINTAS FIRE PROTECTION, 3001 E ENTERPRISE AVE., APPLETON WI 54913, hereinafter referred to as the CONSULTANT. WITNESSETH: That the CITY and the CONSULTANT, for the consideration hereinafter named, enter into the following Agreement. COMPONENT PARTS OF THE AGREEMENT This Agreement consists of the following component parts, all of which are as fully a part of this Agreement as if herein set out verbatim, or if not attached, as if hereto attached: 1. This Instrument 2. Consultant's Professional Services Proposal dated September 27, 2017, and attached hereto. In the event that any provision in any of the above component parts of this Agreement 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. CITY REPRESENTATIVE The CITY shall assign the following individual to manage this Agreement: (HOLLY MAGRADY, CITY OF OSHKOSH, SENIOR BUYER) SCOPE OF WORK The CONSULTANT shall provide the services described in the CONSULTANT's attached Professional Services Proposal. CITY may make or approve changes within the general Scope of Services contained within the Professional Services Proposal and in this AGREEMENT. If such changes affect CONSULTANT's cost or time required for performance of the services, an equitable adjustment will be made through an amendment to this AGREEMENT. City Hall, 215 Church Avenue P.O. Box 1130 Oshkosh, WI 54903-1130 http://www.ci.oshkosh.wi.us RECORDS AND INSTRUMENTS OF SERVICE All reports, drawings, software, data, computer files, and other materials, documents and instruments prepared by the CONSULTANT as instruments of service shall remain the property of the CITY. Any document related to this agreement, whether in electronic or paper form, is considered a public record and shall be provided to the City upon request. The CONSULTANT may provide the City with an explanation of why they believe any document should not be released to the public. The City shall make all final determinations regarding the existence or release of any document related to this agreement. TERM AND TERMINATION A. Term. The work to be performed under this contract is for a three year agreement starting January 12018 through December 31, 2020, with two, one-year optional extensions. B. Termination. 1. For Cause. If either party shall fail to fulfill in timely and proper manner any of the obligations under this Agreement, the other party shall have the right to terminate this Agreement by written notice. In this event, the CONSULTANT shall be entitled to compensation to the date of delivery of the Notice. 2. For Convenience. The CITY may terminate this Agreement at any time by giving written notice to the CONSULTANT no later than 30 calendar days before the termination date. TIME OF COMPLETION The CONSULTANT shall perform the services under this Agreement with reasonable diligence and expediency consistent with sound professional practices. The CITY agrees that the CONSULTANT is not responsible for damages arising directly or indirectly from any delays for causes beyond the CONSULTANT's control. For the purposes of this Agreement, such causes include, but are not limited to, strikes or other labor disputes, severe weather disruptions or other natural disasters, or failure of performance by the CITY. If the delays resulting from any such causes increase the time required by the CONSULTANT to perform its services in an orderly and efficient manner, the CONSULTANT shall be entitled to an equitable adjustment in schedule. SUSPENSION, DELAY, OR INTERRUPTION OF WORK CITY may suspend, delay, or interrupt the Services of CONSULTANT for the convenience of CITY. In such event, CONSULTANT's contract price and schedule shall be equitably adjusted. ASSIGNMENT CONSULTANT shall not have the right to assign this Agreement without the written prior consent of the City. INDEPENDENT CONSULTANT CONSULTANT is an independent CONSULTANT and is not an employee of the CITY. COOPERATION IN LITIGATION AND AUDITS CONSULTANT shall fully and completely cooperate with the City, the City's insurer, the City's attorneys, the City's Auditors or other representative of the City (collectively, the "City" for purposes of this Article) in connection with (a) any internal or governmental investigation or administrative, regulatory, arbitral or judicial proceeding (collectively "Litigation") or internal or governmental Audit, with respect to matters relating to this Agreement; other than a third party proceeding in which CONSULTANT is a named party and CONSULTANT and the City have not entered into a mutually acceptable joint defense agreement. Such cooperation may include, but shall not be limited to, responding to requests for documents and/or other records, and making CONSULTANT's employees available to the City (or their respective insurers, attorneys or auditors) upon reasonable notice for: (i) interviews, factual investigations, and providing declarations or affidavits that provide truthful information in connection with any Litigation or Audit; (ii) appearing at the request of the City to give testimony without requiring service of a subpoena or other legal process; (iii) volunteering to the City all pertinent information related to any Litigation or Audit; and (iv) providing information and legal representations to auditors in a form and within a timeframe requested. City shall reimburse CONSULTANT for reasonable direct expenses incurred in connection with providing documents and records required under this paragraph and may require, at the City's sole discretion, such expenses to be documented by receipts or other appropriate documentation. Reasonable direct expenses include costs, such as copying, postage and similar costs; but do not include wages, salaries, benefits and other employee compensation. CONSULTANT shall not be entitled to additional compensation for employee services provided under this paragraph. STANDARD OF CARE The standard of care applicable to CONSULTANT's Services will be the degree of skill and diligence normally employed by professional CONSULTANTs or consultants performing the same or similar Services at the time said services are performed. CONSULTANT will re -perform any services not meeting this standard without additional compensation. CITY RESPONSIBILITIES The CITY shall furnish, at the CONSULTANT's request, such information as is needed by the CONSULTANT to aid in the progress of the project, providing it is reasonably obtainable from City records. CONSULTANT may reasonably rely upon the accuracy, timeliness, and completeness of the information provided by CITY. To prevent any unreasonable delay in the CONSULTANT's work, the CITY will examine all reports and other documents and will make any authorizations necessary to proceed with work within a reasonable time period. PAYMENT A. The Agreement Sum. The CITY shall pay to the CONSULTANT for the performance of the Agreement the amount as outline in the Cost portion of the Consultant's Professional Services Proposal. B. Method of Payment. The CONSULTANT shall submit itemized monthly statements for services. The CITY shall pay the CONSULTANT within 30 calendar days after receipt of such statement. If any statement amount is disputed, the CITY may withhold payment of such amount and shall provide to CONSULTANT a statement as to the reason(s) for withholding payment. C. Additional Costs. Costs for additional services shall be negotiated and set forth in a written amendment to this Agreement executed by both parties prior to proceeding with the work covered under the subject amendment. HOLD HARMLESS The CONSULTANT covenants and agrees to protect and hold the City of Oshkosh harmless against all actions, claims, and demands which may be to the proportionate extent caused by or result from the intentional or negligent acts of the CONSULTANT, its agents or assigns, its employees, or its SUBCONSULTANTs related to the performance of this Agreement 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 for those actions, claim, and demands caused by or resulting from intentional or negligent acts as specified in this paragraph. Subject to any limitations contained in Sec. 893.80 and any similar statute, of the Wisconsin Statutes, the City further agrees to hold CONSULTANT harmless from any and all liability, including claims, demands, losses, costs, damages, and expenses of every kind and description (including death), which may be to the proportionate extent caused by or result from the intentional or negligent acts of the CITY, its agents or assigns, its employees, or its SUBCONSULTANTs related to the performance of this Agreement or be caused or result from any violation of any law or administrative regulation, where such liability is founded upon or grows out of the acts or omission of any of the officers, employees or agents of the City of Oshkosh while acting within the scope of their employment. It is the intention of the parties to this Agreement that each party shall be solely responsible for its own actions and activities and the actions and activities of its own officers, employees and agents while acting within the scope of their employment INSURANCE The CONSULTANT agrees to abide by the attached City of Oshkosh Insurance Requirements for Professional Services. WHOLE AGREEMENT / AMENDMENT This document and any specified attachments contain all terms and conditions of the Agreement and any alteration thereto shall be invalid unless made in writing, signed by both parties and incorporated as an amendment to this Agreement. NO THIRD -PARTY BENEFICIARIES This AGREEMENT gives no rights or benefits to anyone other than CITY and CONSULTANT and has no third -party beneficiaries. AGREEMENT NOT TO BE CONSTRUED AGAINST ANY PARTY This Agreement is the product of negotiation between the parties hereto and no term, covenant or provision herein or the failure to include a term, covenant or provision shall be construed against any party hereto solely on the basis that one party or the other drafted this Agreement or any term, covenant or condition contained herein. NO WAIVER Failure of either party to insist upon the strict performance of terms and provisions of this agreement, or any of them, shall not constitute or be construed as a waiver or relinquishment of that party's right to thereafter enforce such term or provision, and that term of the provisions shall continue in full force and effect. NON-DISCRIMINATION The Operator agrees not to discriminate in its operations under this Agreement on the basis of race, color, creed, age, and gender, or as otherwise prohibited by law. A breach of this covenant may be regarded as a material breach of this Agreement SEVERABILITY If any term, covenant, condition or provision of this agreement shall be invalid or enforceable, the remainder of this agreement shall not be affected thereby the remainder of the agreement shall be valid and enforceable to the fullest extent permitted by law. CHOICE OF LAW AND VENUE The laws of the State of Wisconsin shall govern the interpretation and construction of this Agreement. Winnebago County shall be the venue for all disputes arising under this Agreement. 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 CONSULTANT hereunto set its hand and seal the day and year first above written. In the Presence of: (Seal of CONSULTANT if a Corporation.) APPROVED: CONSULTANT Name of Company/Firm By: (Specify Title) CITY OF OSHKOSH By. ark A. Rohloff, City Manager And: Pamela R. Ubrig, City Clerk I hereby certify that the necessary provisions have been made to pay the liability which will accrue under this contract �CQ rtc� Ax�r-n City Comptroller PROPOSAL FIRE EXTINGUISHER MAINTENANCE FOR THE CITY OF OSHKOSH DEPARTMENTS BID SUBMITTAL FORM SECTION I - DRY CHEMICAL STORED PRESSURE Ory Bid Item More or Less Description Each Price Total 1 752 Annual Maintenance Check $ ;2 . $s $ a%�3. av 2 385 1.5 - 6# Extinguisher Recharge $ �� $, Dv 3 344 10 - 30# Extinguisher Recharge $ CE3- .UU $ Z -/1,2,q- 4 1.2, 4 As needed Per pound dry chemical added to extinguishers $ 2 . 25- $ '2-.-2 5'- 5 As needed 1.5 - 6# Extinguisher 6 Year Maintenance $ W $ . 6 As needed 10 - 30# Extinguisher 6 Year Maintenance $ $ U1l 7 As needed 195 - 6# 12 Year Hydro Test $ i1 . vU $ 1� . 8 As needed 10 - 30# 12 Year Hydro Test $ < < $ . 6rJ 9 25 Trip Charge per location $ Id. W $esu . W Total of items 1-9 (basis of award) 61 SECTION II - CLASS -K 10 Qty Bid Item More or Less Description Each Price Total 10 3 2.5# Maintenance 54 fie^ 11 3 2.5# Recharge $ GU $ 12 3 2.5# Hydro Test 9a,110 /-, SECTION III - CARBON DIOXIDE (CO2) Qty Bid Item More or Less Description Each Price Total 13 23 Annual Maintenance Check $_�. 14 1 5# CO2 Extinguisher Recharge $_.w $' 15 5 10# CO2 Extinguisher Recharge $ f1u $ �� • CIL) 16 9 15# CO2 Extinguisher Recharge $Ou $—! SSU. uv 17 9 20# CO2 Extinguisher Recharge $ $�Z. 1s As Needed 5 –10# CO2 Hydro Test $ It . W 19 As Needed 15 – 20# CO2 Hydro T est $ %( --LV $ 10 SECTION IV - WATER (Stored Pressure) Qty Bid Item More or Less Description 20 8 2.5 Gallon Extinguisher Annual Maintenance 21 8 2.5 Gallon Extinguisher Recharge 22 8 2.5 Gallon Extinguisher 5 year Hydro Test (include recharge labor) SECTION V - CLEAN AGENT Qty Bid Item More or Less 23 9 Description Clean Agent Extinguisher Annual Maintenance SECTION VI - MISCELLANEOUS ITEMS Each Price Total $ It . Uv $—&-. uv Each Price Total $, "•�6S $ 5 &,S Bid Item Qty More or Less Description Each Price 24 1 New Extinguisher Cost $ O -t) 25 1 429003 Sentry 10# ABC $_. o,45-& - 4r;trtx 10 47+e . 26 1 429902 Sentry 5# ABC $ (06). i4A v 2. Z(s l61 w 27 1 Install or Relocate Fire Extinguisher $ 28 1 Fire Extinguisher Service $ 29 1 Technical Service (per hours) _Jhr 30 1 FXD's and Letters $ . W e4 31 1 Regulatory/Compliance Fee 11 Payment terms JUST IJ Date Submitted: M/b-7 Name of Company: n/y7' f- z7 grr Submitted by: (name and title) ElCil✓2 Email address: ( (t re- e C/il-TS--(-&� Address of Company: 3001 iF� / � 1 ��i��� �,� -W5,13 Phone: 58 U '%3 5- WG r Email of Inspector: -T&O 12 AC ® CERTIFICATE OF LIABILITY INSURANCE DAT (MM/4010 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon Risk Services Northeast, Inc. C/o Aon Client Services CONTACT PHONEFAX (ac. No. Ext): (866) 283-7122 AJC. No.: (800) 363-0105 E-M/UL 4 overlook Point Lincolnshire IL 60069 USA ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: The Travelers Indemnity Co Of CT 25682 Cintas Corporation and Its Subsidiaries INSURER B: Travelers Property Cas CO of America 25674 6800 Cintas Blvd Po Box 625737 INSURER c: Westchester Fire Insurance Company 10030 INSURER D: Cincinnati OH 45262 USA INSURER E: DAMACLAIMS-MADE $1,000,000 PREMISESTC PREMISES Ea occunence INSURER F: COVERAGES CERTIFICATE NUMBER: 570069301646 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. Limits shown are as requested iNSR LTR TYPE OF INSURANCE DDD UE POLICY NUMBER MMIDD/YYYY MMIDDlYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y HC EGLSA M TCT EACH OCCURRENCE $2,000,000 ❑X OCCUR DAMACLAIMS-MADE $1,000,000 PREMISESTC PREMISES Ea occunence MED EXP (Any one person) $5,000 X Contractual Liability PERSONAL &ADV INJURY $1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY MPRO ❑ LOC J ECT PRODUCTS - COMP/OP AGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY Y HC2E-CAP-472M4651-TCT-17 07/01/2017 07/01/2018 COMBINED SINGLE LIMIT $5,000,000 Ea accident BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident C X UMBRELLALIABX EXCESS LIAB OCCUR CLAIMS -MADE Y G22035277012 SIR applies per policy terns 07/01/2017 & condi 07/01/2018 ions EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I X RETENTION B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YM OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) NIA HC21UB472M470617 WC -AOS 07/01/2017 07/01/2018 X STATUTE OERH E. L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Oshkosh and its officers, council members, agents, emplo ees and authorized volunteers are included as Additional Insured on the General Liability, Automobile Liability and Umbrella Liability policies, but only with respect to work performed under contract between the Certificate Holder and the Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. city of Oshkosh AUTHORIZED REPRESENTATIVE Attn: City clerk 215 Church Ave. PO Box 1130 Oshkosh wt 54903-1130 OSA �.�Grasa s6r.�rerO ssa ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: HC2E-GLSA-472M4731-TCT-17 EFFECTIVE DATE: 07-01-17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization that you have agreed in a "written contract requiring insurance" to include as an additional insured on your Commercial General Liability policy and that has not been added as an additional insured by attachment of an endorsement under this Coverage Part which includes such person or organization in the endorsement's schedule. However, such person or organization is only an additional insured with respect to liability for "bodily injury" or "property damage" (or for "personal injury" or "advertising injury" if coverage for such injury is required by the "written contract requiring insurance") that is in fact caused by your negligence or the negligence of those acting on your behalf in the performance of "your work" in connection with services provided to the additional insured to which the "written contract requiring insurance" applies. The insurance provided to the additional insured by this endorsement is further limited as follows: a. In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits of liability required by a "written contract requiring insurance" for that additional insured, the insurance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement shall not increase the limits of insurance described in SECTION III — LIMITS OF INSURANCE. b. The insurance provided to the additional insured does not apply to "bodily injury" or "property damage" (or "personal injury" or "advertising injury" if coverage for such injury is required by the "written contract requiring insurance") arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, or supervision of such services or activities. C. The insurance provided to the additional insured does not apply to "bodily injury" or "property damage" included in the "products -completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured. d. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization or with respect to "bodily injury" or "property damage" (or "personal injury" or "advertising injury' if coverage for such injury is required by the "written contract requiring insurance") caused by the negligence of such person or organization. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" for that additional insured specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that other insurance. But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is CG T8 01 Page 1 of 3 POLICY NUMBER: HC2E-GLSA-472M4731-TCT-17 EFFECTIVE DATE: 07-01-17 available to the additional insured when that person or organization is an additional insured under such other insurance. If the "written contract requiring insurance" for that additional insured specifically requires that this insurance include a provision in which the insurer waives any right of recovery against that additional insured because of payments made under the insurance provided to the additional insured, then we will waive such right of recovery. As a condition of coverage provided to the additional insured by this endorsement: a. The additional insured must give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. If a claim is made or "suit" is brought against the additional insured, the additional insured must: (1) Immediately record the specifics of the claim or "suit' and the date received; and (2) Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable. C. The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. As a condition of coverage provided to the additional insured by this endorsement, the additional insured must tender the defense and indemnity of any claim or "suit' to any provider of other insurance which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insurance provided to the additional insured by this endorsement is primary to other insurance available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. The following definition is added to SECTION V — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional insured, provided that the "bodily injury' and "property damage" occurs (or the "personal injury" or "advertising injury', if coverage for such injury is required by the "written contract requiring insurance", is caused by an offense committed): a. After the signing and execution of the contract or agreement by you; CG T8 01 Page 2 of 3 POLICY NUMBER: HC2E-GLSA-472M4731-TCT-17 EFFECTIVE DATE: 07-01-17 While that part of the contract or agreement is in effect, or as long as the written agreement specifically provides, whichever is later; and C. Before the end of the policy period. Copyright 2014 The Travelers Indemnity Company. All rights reserved. CG T8 01 Page 3 of 3 POLICY NUMBER: HC2E-GLSA-472M4731-TCT-17 ISSUE DATE: 06-29-17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY- NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice of Cancellation: 30 PERSON OR ORGANIZATION: Any person or organization to whom you have agreed in a written contract that notice of cancellation of this policy will be given, but only if: 1. You send us a written request to provide such notice, including the name and address of such person or organization, after the first Named Insured receives notice from us of the cancellation of this policy; and 2. We receive such written request at least 14 days before the beginning of the applicable number of days shown in this endorsement. ADDRESS: The address for that person or organization included in such written request from you to us. PROVISIONS: If we cancel this policy for any statutorily permitted reason other than nonpayment of premium, and a number of days is shown for cancellation in the schedule above, we will mail notice of cancellation to the person or organization shown in the schedule above. We will mail such notice to the address shown in the schedule above at least the number of days shown for cancellation in the schedule above before the effective date of cancellation. IL T4 05 03 11 © 2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 POLICY NUMBER: HC2E-GLSA-472M4731-TCT-17 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 06-15-17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Any person or organization, except any architect, engineer or surveyor, that you agree in a written contract to in- clude as an additional insured on this Coverage Part, provided that the written contract: a. Specifically requires you to use ISO form CG 20 37 07 04 to include such person or organization as an addi- tional insured; and b. Was signed and executed by you before, and is in effect when, the "bodily injury" or "property damage" oc- curs or the "personal injury" or "advertising injury" offense is committed. Location And Description Of Completed Operations Any project to which an applicable written contract described in the Name Of Additional Person(s) Or Organiza- tion(s) section of this Schedule applies. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organ- ization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional in- sured and included in the "products -completed opera- tions hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1