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HomeMy WebLinkAboutJeff Foust Excavating Snow Shovelling136-)3 CONTRACT FOR SNOW AND ICE REMOVAL THIS CONTRACT, made on the � day of e 2017, by and between the CITY OF OSHKOSH, party of the first part, hereinafter referred to as CITY, and JEFF FOUST EXCAVATING, INC., 2824 Clairville Road, Oshkosh, WI 54904, party of the second part, hereinafter referred to as the CONTRACTOR, WITNESSETH: That the CITY and the CONTRACTOR, for the consideration hereinafter named, enter into the following Contract. The CITY's Request for Quotations is attached to this Contract, along with the CONTRACTOR's Prequalification information and work proposal. The terms of this Contract and the CITY's Request for Quotations will prevail over the CONTRACTOR's Proposal if there are any inconsistencies between these documents. ARTICLE I. PROTECT MANAGER A. Assignment of Project Manager. The CONTRACTOR has assigned the primary individual identified below to manage the project described in this Contract. The CONTRACTOR also assigns the second individual identified below as qualified to make all decisions for the CONTRACTOR if the primary person is not available: Primary Contact: Jeff Foust Secondary Contact: Mike Zandler B. Changes in Project Manager. The CITY shall have the right to approve or disapprove of any proposed change from the individual named above as Project Manager. The CITY shall be provided with a resume or other information for any proposed substitute and shall be given the opportunity to interview that person prior to any proposed change. ARTICLE Il. CITY REPRESENTATIVE The CITY shall assign the following individual to manage the project described in this contract: Jean Broennimann, Secretary Steven M. Gohde, P.E., Assistant Director of Public Works ARTICLE III. SCOPE OF WORK The CONTRACTOR shall provide the services described in the CITY's Request for Quotations. The CONTRACTOR may provide additional products and/or services if such products/services are requested in writing by the Authorized Representative of the City. 1:\Pring\SNOW SHOVELING FOLDERS\Snow Removal Contracts\2017\Foust Contract_11-22- Page 1 of 4 17.docc CITY OF OSHKOSH REQUEST FOR QUOTATIONS FOR SNOW AND ICE REMOVAL Work Summary The City of Oshkosh is soliciting Quotations for the periodic removal of snow and ice from sidewalks and handicap ramps/crosswalks adjacent to private properties and over railroad crossings within the municipal boundaries. The CITY is seeking a contractor for a one (1) winter season commitment, starting immediately for the Winter 2017/2016 season. City Ordinances require that property owners keep their public sidewalks clear of snow and ice. When property owners fail to keep their public sidewalks clear of snow and ice, then the CITY is allowed to clear these sidewalks for the property owners, at their expense, for the benefit of the public that may use the sidewalks. Quotations are due to the City of Oshkosh's Engineering Division by 10:00 A.M. on Tuesday, October 31, 2017. Cleaning the public sidewalks adjacent to private properties will represent the majority of snow and ice removal work pursuant to this Contract. Also included within this Contract is the snow and ice removal on sidewalks at railroad crossings. The City of Oshkosh does not guarantee any particular amount of work will be offered during the term of this contract. The work required for this Contract depends on the weather and depends on the number of property owners who fail to clear their sidewalk. For example, in the Winter 2012/2013 season, there were over 950 snow shoveling jobs performed including the sidewalks for 13 railroad crossings. However, in the relatively mild Winter 2011/2012 season, there were only 213 snow shoveling jobs and 13 railroad crossings. Last year, during the 2016/2017 winter season, there was a total of 200 snow shoveling jobs and 0 railroad crossings. The snow shoveling job examples included repeated clearing of certain properties and other random properties that may have only been cleared once. Another important task for the successful contractor will be the ability to conduct themselves in a positive and professional manner when interacting with property owners, tenants, and other citizens. Contractors must be able to handle the occasional difficult situation and/or a person who may be unhappy with the snow and ice removal work being performed by the contractor. Please note the requirements for when information must be submitted to the City have changed. The deadline has been reduced to five (5) business days. All documentation will be processed through the on-line software program developed by the City. The software program can be demonstrated at the request of a prospective contractor. Please contact Steve Gohde at (920)236-5065 to arrange for a demonstration of the software. 1:\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\ 2017\ Request for Page 1 Of 9 Quota tions -9-27-17. docx Prequalification All contractors must be prequalified to quote. Prequalification for the snow and ice removal contract shall be completed on the attached forms. Prequalification forms are due to the City of Oshkosh's Engineering Division by 4:00 P.M. on Thursday, October 26, 2017. The CONTRACTOR must be qualified to furnish all labor, material, and equipment to complete the required work. The CITY will review contractor qualifications based upon experience, available equipment, and their ability to conduct themselves appropriately with the public. The CITY reserves the right to check references and to contact property owners who have hired the CONTRACTOR in the past, whether or not those persons have been disclosed by the CONTRACTOR. The CITY reserves the right to perform other background checks on the CONTRACTOR, as allowed by law, to verify the ability of the CONTRACTOR to interact with property owners, tenants, and other citizens in a professional manner. If the CITY believes it is necessary, the CITY reserves the right to inspect the CONTRACTOR's equipment at any time. Inspection may be during the Pre - qualification period, when evaluating the CONTRACTOR's quotation, and during the contract period. All equipment shall have adequate safety features for working in the right-of-way and be in good operating condition. All motorized equipment, except walk -behind equipment, must have amber flashing light(s) visible from 360°. The only equipment that can be used to clear any surface, such as sidewalks, handicap ramps/crosswalks, and railroad crossings, are shovels or lightweight pieces of equipment that will not crack or damage the surface from which the snow or ice is removed or other property/surfaces. Snow removal equipment shall not disturb or go on private property. As an example, a light-duty skid steer loader/small tractor and bucket that matches the width of the sidewalk may be acceptable. Removing snow and/or ice where unusual conditions have occurred from a site will generally require the use of a front-end loader and dump truck. As part of their prequalification, the CONTRACTOR must describe the snow and ice removal equipment they own or can confirm they have available and intend to use to perform these jobs. At a minimum, the CITY believes contractors should have the following equipment available through ownership or leasing to successfully carry out the requirements of this work: a) Tractor/skid steer loader with appropriate snow removal attachments; b) Shovels and snowblower(s); C) End loader; L\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\ 2017\ Request for Page 2 Of 9 Quota tions_9-27-17. d ocx d) Dump truck; e) Digital camera (s) with capability to date stamp photos; and f) Computer with internet access and Microsoft Internet Explorer 11. In addition to snow removal equipment, CONTRACTOR must have a v� mail address and have the ability to access the City of Oshkosh website and receh input data from/to an on-line software program. Quotation Information CONTRACTOR must provide at least three (3) references of past or ci projects of similar scope to the work described in these Specifications. Contractors should take into account all of the information and requirements in this Request for Quotations. CONTRACTOR must meet all City of Oshkosh insurance requirements and standard terms and conditions (attached). CONTRACTOR must furnish all labor, materials, and equipment necessary to complete the work. CONTRACTOR shall provide names and telephone numbers of their respective primary and back-up contact person(s) once the Contract has been established. All quotations shall include the CONTRACTOR's price for performing the following tasks: 1. Remove all snow and/or ice at a single location/lot with 0 to 100 feet of sidewalk (including rock salt/sand application, if necessary). This includes the removal of all snow and ice at a single location or single lot. Snow and ice cannot be placed in the street. CONTRACTOR shall not pile snow higher than thirty inches (30") above the sidewalk in the intersection and for a distance of thirty feet (30') from the intersection. This price should be calculated with the understanding this base point location or lot may contain anywhere from zero feet (0') to one hundred feet (100') of sidewalk. This price should also be calculated with the understanding rock salt and/or sand may need to be applied at any time. The CITY will pay for one (1) trip to the location or lot. Additional trips to the location or lot because of salting, sanding, or further cleaning will not be reimbursed by the CITY. Before and after condition photos are required. I:\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\ 2017\ Request for Page 3 Of 9 Quo to ti ons_9-27-17. do" 2. Additional footage beyond 100 feet at same location/lot (including rock salt/sand application if necessary). This includes the removal of all snow and ice at a single location or single lot that extends beyond the base point of one hundred feet (100'). Snow and ice cannot be placed in the street. CONTRACTOR shall not pile snow higher than thirty inches (30") above the sidewalk in the intersection and for a distance of thirty feet (30') from the intersection. This price should be calculated for each additional foot of sidewalk. This price should also be calculated with the understanding rock salt and/or sand may need to be applied to each additional foot at any time. The CITY will pay for one (1) trip to the location or lot. Additional trips to the location or lot because of salting, sanding, or further cleaning will not be reimbursed by the CITY. Before and after condition photos are required. 3. Apply rock salt/sand only to 0 to 100 feet of sidewalk at a single location/lot. For those instances when snow and/or ice can be removed to the CITY's satisfaction without shovels or mechanical means, the price shall include the application of rock salt and/or sand only at a single location or single lot. This price should be calculated with the understanding this base point location or lot may contain anywhere from zero feet (0') to one hundred feet (100') of sidewalk. The CITY will pay for one (1) trip to the location or lot. Additional trips to the location or lot for further salting, sanding, or cleaning will not be reimbursed by the CITY. Before and after condition photos are required. 4. Apply rock salt/sand only to additional footage beyond 100 feet at same location/lot. For those instances when snow and/or ice can be removed to the CITY's satisfaction without shovels or mechanical means, the price shall include application of rock salt and/or sand only at a single location or single lot. This price should be calculated for each additional foot of sidewalk beyond the base point distance of one hundred feet (100'). The CITY will pay for one (1) trip to the location or lot. Additional trips to the location or lot for further salting, sanding, or cleaning will not be reimbursed by the CITY. Before and after condition photos are required. 1:\Engineering \SNOW SHOVELING FOLDERS\Snow Removal Contracts\2017\Request for Page 4 O{ 9 Quota tions_9-27-17. do" 5. Remove all snow and/or ice from all pavement in the handicap ramp/crosswalk quadrant (including rock salt/sand application if necessary). This includes the removal of all snow and ice from all of the hard surfaces in handicap ramps and adjacent pavement, which are typically in the crosswalk quadrant of street intersections. Snow and ice cannot be placed in the street or be piled to create a vision obstruction at the corner. CONTRACTOR shall not pile snow higher than thirty inches (30") above the sidewalk in the intersection and for a distance of thirty feet (30') from the intersection. This price should also be calculated with the understanding rock salt and/or sand may need to be applied at any time. This price should be calculated for each sidewalk quadrant (corner) of a street intersection, regardless of how many ramps or access points are at a quadrant. This task requires clearing sidewalk and ramp areas leading from the sidewalk to the street. The required result is clear sidewalk access to and from the street. This task will usually require the CONTRACTOR to remove snow from the street to achieve the required result. Therefore, the CONTRACTOR is responsible for snow and ice removal up to four feet (4') into the street beyond the face of curb. Multiple ramps in one (1) corner will only be allowed one (1) charge. The snow and ice from both the initial storm event and also from street plowing operations must be removed. Before and after condition photos are required. This Item only occurs where the ramp/crosswalk is leading to a crossing of a public right of way/street. Item does not apply to driveways/private entrances crossing the area where the sidewalk/pedestrian walkway exists. 6. Remove and dispose of snow from locations where unusual conditions have occurred. I:\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\ 2017\ Request for Page 5 Of 9 Quota tions_9-27-17.docx The CONTRACTOR shall designate a rate for removal and disposal of snow where unusual conditions have occurred, i.e. large piles of snow stockpiled by property owners that intrudes onto public sidewalks. Snow is to be disposed of at CONTRACTOR's own dump site. This price shall be a flat rate to mobilize/demobilize equipment to the site and an hourly rate to load snow. CONTRACTOR will not be paid for drive time to or from the site. Hourly loading rate will be paid for time actually loading snow. In the event multiple loads must be hauled, CONTRACTOR shall provide an hourly rate for hauling. Only actual loading and hauling time will be paid. Idle time waiting will not be paid. Final load disposal shall be part of mobilization/demobilization. CONTRACTOR will also be paid for Proposal Items 1, 2, and/or 5, if snow pile was over sidewalk and/or handicap ramp and work performed complies with Proposal Items 1, 2, and/or 5. CONTRACTOR shall not pile snow higher than thirty inches (30") above the sidewalk in the intersection and for a distance of thirty feet (30') from the intersection. Before and after condition photos are required. Time Requirements Snow and ice removal for the CITY must be given priority. The CONTRACTOR will be e-mailed a snow and ice removal list from the CITY. For lists sent up to 11:00 a.m. of any day, work must begin within four (4) hours (i.e. by 3:00 p.m. that day). Lists sent at or after 11:01 a.m. may be started immediately, if sufficient sunlight remains for proper documentation; work must begin by 8:00 am of the following day. All snow and ice removal required by the CITY for each list must be completed within twenty-four (24) hours after the CITY sends the list to the CONTRACTOR or for lists sent at or after 11:01 a.m., by 10:00 p.m. of the following day. TIME IS OF THE ESSENCE, ALL TIME PERIODS SHALL BE STRICTLY ENFORCED. The CONTRACTOR shall always be ready for immediate snow and ice removal with all equipment in good working condition. The CITY will limit the maximum number of properties due on any day to fifty (50), unless the CONTRACTOR requests additional properties and the CITY has documented properties which require snow removal. Snow and ice removal can only occur between 7:00 a.m. and 10:00 p.m. The CONTRACTOR will be expected to work weekends to complete the work required by the CITY. The only exception to the 24-hour completion requirements is that the CONTRACTOR will not be expected to perform snow and ice removal for the CITY on December 241h, 25th, 26111, and January 1st. The information for each list must be entered into the City of Oshkosh software program within five (5) business days of receipt of the list. In the event of new snowfall or ice accumulation, prior to the CONTRACTOR completing removal of snow/ice from a location/lot, CONTRACTOR shall notify CITY within twenty four (24) hours of the start of the new snowfall which locations/lots need to be rechecked by CITY and placed on new list, if appropriate. I:\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\2017\Request for Page 6 Of 9 Quotations 9-27-17. d ocx Required Work The CONTRACTOR will be furnished, by e-mail, a list of sidewalks, or other areas, to be cleared of snow and/or ice to the bare pavement. Sidewalks and handicap ramps/crosswalks must be cleared of all snow and ice, for the entire width of the walk. In the event the sidewalk abuts the street curb, CONTRACTOR shall clear a minimum width of five feet (5') when the walk is wider than five feet (5') and a minimum width of four feet (4') or full width of sidewalk, if sidewalk is five feet (5') or less in width. If the CONTRACTOR cannot clear snow/ice to the bare pavement, the CONTRACTOR shall apply rock salt and/or sand material to make it safe for pedestrian traffic. The CONTRACTOR shall return within twenty four (24) hours after the salt or sand is applied to remove the snow or ice. In the event the snow/ice cannot be removed during the second trip, CONTRACTOR shall return at least once every twenty four (24) hours until snow/ice is removed. These subsequent trips cannot be charged to the CITY; they are covered under the original trip. Additional snow/ice accumulation on areas still undergoing snow/ice removal cannot be charged to the CITY as an additional trip; this additional snow/ice removal will be included in the original trip. Before and after photos must also be taken immediately before and immediately after the work is performed for all trips. Each return trip must be documented with before and after condition photos with correct date and time reference. Failure to provide photo documentation of return trips shall result in non-payment for work. A doorhanger, supplied by the CITY, must be placed on the front door of every property cleared by the CONTRACTOR. The CONTRACTOR must complete an entire work list before commencing to a new work list; however, the need for return trips will not prevent the CONTRACTOR from proceeding to the next list. In the event the CONTRACTOR is unsure if they should perform work at a property on the list, the CONTRACTOR must notify the CITY via a phone call message to (920)236-5065 within four (4) hours of the original site trip. The CITY will review the property and give direction to the CONTRACTOR. The work may be kept as part of the original list or removed from the list. The CONTRACTOR must document the original site visit with proper photo documentation. The CONTRACTOR shall take all necessary precautions to protect passersby, the public right-of-way, and neighboring property from damage and injury. The CONTRACTOR will be held responsible for damages to sidewalks, trees, structures, grass areas, and any other items due to their operations. 1:\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\2017\Request for Page % Of 9 Quota tions_9.27-17. d ocx Salt and chemicals applied on or near railroad crossings can reduce the resistant properties of timber and ballast. The CONTRACTOR shall limit the use of salt or chemicals on or near railroad crossings. Requirements Before Invoices will be Paid The CONTRACTOR will not be paid for sidewalks cleared that are not on the list provided by the CITY. The CONTRACTOR must complete an entire work list before commencing to a new work list. Within five (5) business days of receipt of a work list, the following information must be entered into the CITY software program for each property: a. Date and exact time of snow and/or ice removal; b. Date and exact time rock salt/sand was applied; C. Approximate length of walk cleared at each location; d. Before and after condition photos (in digital format) of work performed at each location are required. Photos shall clearly identify the location of the property with landmark features in the background (multiple photos may be required). Camera must place correct date stamp on photos. Before and after photos must be taken immediately before and immediately after the work is performed; e. Date, time, location, and photos of any return trips; f. Any comments (for example: return trip required, already cleared, homeowner came out to shovel, etc.). To process proper payment, required information on each property shoveled must be submitted to the Department of Public Works. All photographs taken must clearly show the before and after condition of the sidewalk and be taken with adequate light. The cost of the internet access and photos is considered to be included as part of the pertinent Bid Items. The CONTRACTOR will not be paid for work that is not properly documented or incomplete as per conditions of the Contract. Also, the CONTRACTOR will not be paid for work completed after the 24-hour time limitation has expired, excluding return trips. The CITY will verify work completed and send CONTRACTOR an itemized list of work performed and costs. CONTRACTOR shall review list and, when quantities are agreed upon, submit an invoice for the cost shown with the list attached as documentation. CONTRACTOR shall submit invoices with corrections within one (1) week of receiving itemized list from CITY. L\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\ 2017\ Request for Page 8 of 9 Quota tions_9-27-17. d ocx Public Records As a contractor for a governmental entity, certain records created that relate to work performed for the CITY may be subject to Wisconsin Open Records Statutes. The successful CONTRACTOR agrees to fully cooperate with all requests related to open records requests. Contract The CONTRACTOR will be required to enter into a contract with the CITY. All requirements found in this Request for Quotations will become legally binding terms. The CITY will also include in the Contract other provisions it deems to be necessary. A copy of the contract form to be used is enclosed. While some minor details may be negotiated, contractors should expect to sign a contract in materially the same form as the Contract provided. The length of this Contract will be for one (1) winter season, which will start on November 14, 2017 and end on May 31, 2018. In the event the CITY wishes to terminate this Contract before the end of the contract period, a 7 -day notice shall be given to the CONTRACTOR. In the event the CONTRACTOR wishes to terminate this Contract before the end of the contract period, a 45 -day notice shall be given to the CITY. I:\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\ 2017\ Request for Page 9 Of 9 Quota tions_9-27-17. d ocx CITY OF OSHKOSH --- RECEIVED -_-- 4 M7 OF PUBLIC WORKS DpSVA OSFL, `NLSCpNS1N CONTRACTOR'S PROOF OF RESPONSIBILITY SNOW AND ICE REMOVAL ALL CONTRACTORS PROVIDING QUOTATIONS FOR SNOW AND ICE REMOVAL FOR THE DEPARTMENT OF PUBLIC WORKS SHALL PROVIDE PROOF OF RESPONSIBILITY RETURN QUESTIONNAIRE TO: CITY OF OSHKOSH ENGINEERING DIVISION CITY HALL, ROOM 301 215 CHURCH AVENUE PO BOX 1130 OSHKOSH, WISCONSIN 54903-1130 NOTE: THE CONTENTS OF THIS QUESTIONNAIRE SHALL BE CONFIDENTIAL FOR THE EXCLUSIVE USE OF THE CONTRACTING AGENCY AND SHALL NOT BE MADE PUBLIC EXCEPT BY WRITTEN PERMISSION OF THE PROSPECTIVE CONTRACTOR. (REVISED September 27, 2017) DO NOT REMOVE THIS COVER SHEET FROM THIS DOCUMENT ANSWERS MUST BE TYPEWRITTEN OR IN INK PREQUALIFICATION STATEMENT There is submitted herewith for your consideration is a statement of qualifications of the undersigned to furnish the necessary labor, materials, and skills required to enter upon and complete the Contract for snow and ice removal to be let by the City of Oshkosh. I. IDENTIFICATION A. B. Official Firm Name �j u I I i U JJ I General Telephone 68013Fax C. Address D. E. F. G (City) (State) (Zip Code) ') General E -Mail Address M) 's t 111 1 �(J, / t1 Number of years in business under present firm name / Please check (1), (2) or (3): (1) A Corporation or LLC (2) A Co -Partnership ❑ (3) An Individual ❑ Principal Individuals: (If a Corporation or C,LLC,, answer (If a Co -Partnership, answer below) President doff 1 o oName of Partner Vice Pres. Secretary JLAJ V I U aaJ t�� �I Treasurere J�t lJ�) f If a Corporation or LLC, answer below: (1) When incorporatedHcd- C� Contact information for questions regarc Person's Name of Partner (If a Sole Trader, answer below) Name of Sole Trader (2) In what State Ksconsill this form: Telephone 1 �J( !lam' FAX l � ll! A000 E -Mail Address bIN, as L l- l D td [:\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Cont acts\2017\Biddei s Proof Page 1 of 8 Form 9-27-17.doa II. EXPERIENCE A. EXPERIENCE What is the snow and ice removal experience of the principal individuals, including superintendents and/or foremen, of your present organization? Present Position of Individual's Name Officer in your Organization Years of Snow and Ice Experience Magnitude & Type of Work In What Capacity JeFF -os Cost of Work T t OIL H ^ 1 'T s Average number of employees during the last 12 months: Office Skilled -- Unskilled B. WORK ON HAND List below the Dresent snow and ice removal rontrartc held by vnn Tf nnna nlPacP anfar "T\TnT*,TP" Date Awarded/Location Type of Work Percent Completed Anticipated Completion Date Cost of Work C. PREVIOUS CONTRACTS List below snow and ice removal contracts completed for the last three (3) ears: Date Awarded Location Type of Work Cost of Work 1 L\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\2017\Bidder's Proof Page 2 of 8 Form 9-27-17.do« III. EQUIPMENT A. List below major pieces of equipment owned and available when needed for proposed work. ALL COLUMNS MUST BE COMPLETED. ATTACH ADDITIONAL SHEETS IF NECESSARY ADDITIONAL SHEETS MUST CONTAIN SAME INFORMATION LISTED ON THIS PAGE. NUMBERS OF DESCRIPTION, SIZE, ORIGINAL ACCUMULATED PRESENTYEARS OF ITEM CAPACITY, ETC. COST DEPRECIATION V �� SERVICE 1AEngineenng\SNOW SHOVELING FOLDERS\Snow Removal Contracts\2017\Bidders Proof Page 3 of 8 Form 9-27-17.docx IV. CONTRACTUAL RESPONSIBILITY A. Has your 4rm ever failed in the past ten (10) years to complete work awarded to it? ❑ 'Yes XNo If so, state: Date Owner Owner's Mailing Address (At that time or preferably now if there is a difference.) Full particulars in each instance: (including type of work & amount of contract) B. Has any officer or partner of your firm ever failed in the past ten (10) years to complete a snow and ice removal work handled in his/her own name? ❑ Ye SA No If so, state: Name of Officer/Partner Owner Owner's Mailing Address (At that time or preferably now if there is a difference.) Full particulars in each instance: (including type of work & amount of contract) C. Has any officer or partner of your firm ever been an officer or partner of some other organization during the last ten (10) years that failed to complete a snow and ice removal contract? ❑ Yes )(No If so, state: Date Name of Officer/Partner Name and Mailing Address of Organization Name and Mailing Address of Owner (Address at that time or preferably now if there is a difference.) Full particulars in each instance (including type of work & amount of contract): lAEngineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\2017\Bidder's Proof Page 4 of 8 Form 9-27-17.docx D. Has your firm or any officer or partner of your firm asked to be relie ed from a bid submitted by it to a public awarding authority during the past ten (10) years? ❑ Yes RNo If so, state: Date Owner Owner's Mailing Address (At that time or preferably now if there is a difference.) Full particulars in each instance (including type of work & amount of contract): E. Has your firm or any officer or partner of your firm been relieved from a contract awarded to it during the past ten (10) years? ❑ Yes A No If so, state: Date Owner Owner's Mailing Address (At that time or preferably now if there is a difference.) Full particulars in each instance (including type of work & amount of contract): F. Has firm or anyofficer or river of your firm ever been charged with or convicted of a violation of any wage schedule? ❑ YesNo If so, state: Date Claimant Claimant's Mailing Address (At that time or preferably now if there is a difference.) Full particulars in each instance (including type of work & amount of contract): [: \ Engineering\SNOW SHOVELING FOLDERS \Snow Removal Contracts\2017\ Bidder's Proof Page 5 of 8 Form 9-27-17.do« G. Has your firm; any of its owners; a subsidiary or corporate parent; or any officer, director, or partner thereof, been convicted in the last gire years of violating Section 133.03 Wisconsin Statutes (Unlawful Contracts: Conspiracies)? ❑ Yes No If so, state: Date Claimant Claimant's Mailing Address (At that time or preferably now if there is a difference.) Full particulars in each instance (including type of work & amount of contract): H. Has your firm or anyone employed by your firm been convicted of a felony? ❑ YesX No If so, identify and describe each incident (include county, case number, violation, circumstances): I. Has your firm or anyone employed by your firm been convicted of a misdemeanor or ordinance violation includin Worderly conduct, disturbing the peace, assault, battery, theft, fraud, or similar issues? ❑ Yes No If so, identify and describe each incident (include county, case number, violation, circumstances): 1AEngineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\2017\Bidder's Proof Page 6 of 8 Form 9-27-17.docx VI. CONTRACTOR'S FINANCIAL STATEMENT Condition at close of business of .20 A. ASSETS &ee Cash.................................................................... Accounts Receivable ................................................ Real Estate Equity .................................................. Materials in Stock ........................ Equipment — Book Value ............... Less Depreciation Furniture and Fixtures — Book Value Less Depreciation Other Assets ............................... TOTAL ASSETS .............. B. LIABILITIES ............. $ .............. $ Accounts, Notes & Interest Payable ........................... $ Other Liabilities...................................................... $ TOTAL LIABILnUS..................................... $ NET WORTH (TOTAL ASSETS — TOTAL LIABILITIES).. $ C. Who prepared this balance sheet? v offic-e) D. Are any of your assets assigned? If so, which are assigned? V(--)6 - see C C62Yd1t E. For what purpose are they assigned? bc� Kj I:\Engineering\SNOW SHOVELING FOLDERS\Snow Removal Contracts\2017\13idders Proof Page 7 of 8 Form 9-27-17.doac VII. AFFIDAVIT STATE OF I . n� i COUNTY OF c� � being duly sworn, deposes and says that he/she (Name of Officer/Owner) �1 �/1� { j is theS�d of e l� l.' J3 1 E (,4ya (Title) (Name of Firm) and that the answers to the foregoing questions and all statements therein contained are true and correct, and that any owner or other agency herein named is hereby authorized to supply the municipality, City of Oshkosh, with any information deemed necessary to verify this statement. Signature of Officer/Owner) Subscribed and sworn before me this _1 L L� day of Director of Public Works City Manager My Commission Expires 6 ^aid » U Date !O -3 ® —// Date // 1111-7 f: \ Engineering\SNOW SHOVELING FOLDERS \Snow Removal Contracts \ 2017\ Bidders Proof Form 9-27-17.docx Page 8 of 8 Snow and Ice Removal contracts held by Jeff Foust Excavating; fns. (�) 4 Imprint, Inc. _ 2875 Atlas Avenue 7/20/2017 Town of Algoma Cul de Sacs 89/2017 Town of Algoma Private Roads 8/9/2017 ARC Engineered Products 3675 N Main Street 7/21/2017 Automotive Supply Company 530 W 9th Avenue 8/3/2017 Axle Tech 1005 High Avenue 7/20/2017 Bay Shore Apartments 1001 Bay Shore Drive 7/20/2017 Building Envelope Solutions, LLC 2559 Badger Avenue 9/6/2017 Bethlehem Lutheran Church 1206 Ontario 7/21/2017 Comfort Suites 400 S Koeller Street 8/7/2017 CREW 1325 W Fernau Avenue 7/25/2017 Custom Design Workshop 2663 Oregon Street 7/21/2017 Evco Plastics 450 Ripple Avenue 7/20/2017 First Presbyterian Church 110 Church Avenue 7/20/2017 Fox Valley Technical College Oshkosh Riverside Campus 9/18/2013 Fox Valley Technical College S.J. S anbauer/FABTECH Center 9/18/2013 Fox Valley Technical College Advanced Manufacturing Tech Center 9/18/2013 Ron Gartman 1018 W South Park Avenue 7/21/2017 Highway 44 Business Place 2370, 2380 and 2390 State Road 91 7/20/2017 HOMZ Management - Camelot Court 515-542 Camelot Court 7/20/2017 HOMZ Management - Poplar Grove 1975-1977 Evans 7/20/2017 HOMZ Management - Morningside 2002-2016 Bowen Street 7/20/2017 Hydrite Waukau Ave Facility 10/9/2017 Indian Trail Apartments 516 Algoma Blvd 7/20/2017 Ralph Kallies 5770 Kumbier Road, Pickett 7/21/2017 Greg Kargus 824 W 20th Avenue 7/21/2017 Greg Kargus 832 W 20th Avenue 7/21/2017 Greg Kargus 844 W 20th Avenue 7/21/2017 Greg Kargus 2235 Brookview Court 7/21/2017 Kingsbury, Inc. 455 W Waukau Avenue 7/20/2017 Leonard Leverence 4004 County Road N 7/21/2017 Marsh Family Eyecare 2510 W 9th Avenue 7/20/2017 Meadowbrook Condo Association, Inc. 2240 Meadowbrook Court 9/6/2017 Medspeed 1435 S Washburn Street 7/20/2017 Merphe Investments 430-436 Sullivan Street 7/21/2017 Most Blessed Sacrament Parish 449 High Avenue (Former St. Peter's) 7/20/2017 Most Blessed Sacrament Parish 605 Merritt Avenue (Former St. Mary's 7/20/2017 Most Blessed Sacrament Parish 1333 Walnut Avenue (Former St. Joe's) 7/20/2017 New Life Community Church 3250 W 9th Avenue 7/20/2017 Oshkosh Area Schools - Oakwood 1225 N Oakwood Road 7/20/2017 Oshkosh Area Schools - Lakeside 4991 Highway 45 7/20/2017 Oshkosh Area Schools - Jacob Shapiro 1050 W 18th Avenue 7/20/2017 Oshkosh Area Schools - Carl Traeger 3000 W 20th Avenue 7/20/2017 Oshkosh Athletic Club 1145 S Washburn Street 7/20/2017 Oshkosh Door Company 2501 Universal Street 7/20/2017 Plymouth Congregational Church 1235 Georgia Street 7/21/2017 Standard Forwarding 2700 Universal Street 7/20/2017 St. Johns Evangelical Lutheran Church 808 N Main Street 7/20/2017 Trinity Evangelical Lutheran Church 370 Bowen Street 7/20/2017 Trinity Evangelical Lutheran School 819 School Avenue 7/20/2017 U -Haul 243 Ohio Street 8/16/2017 UWO hauling of snow 11/14/2016 Waukau Creek LLC 1382 and 1388 Maricopa Drive 7/21/2017 Waukau Creek LLC 3042 Wylde Flower 7/21/2017 A.P. Westshore 14000 State Highway 91 7/21/2017 Snow and Ice Removal contracts completed by Jeff Foust Excavating, Inc. ro ear Notal Snow Removal Sales: $ 127,644.10 Axle Tech $ 14,493.55 11% UWO $ 1,134.58 1% New Life $ 5,508.29 4% Oshkosh Schools $ 7,836.51 6% Hwy 44 $ 2,729.23 2% Fox Valley Technical $ 40,300.00 32% Most Blessed $ 8,642.13 7% Town of Algoma $ 12,851.14 10% Most Blessed 9 ,495.4 9,718.50 ear Notal Snow Removal Sales: $ 217,008.46 Axle Tech $ 13,464.47 6% City of Oshkosh $ 37,546.00 17% UWO $ 31,267.51 14% New Life $ 5,602.31 3% Oshkosh Schools $ 8,530.50 4% Hwy 44 $ 2,891.91 1 % Fox Valley Technical $ 39,384.40 18% Most Blessed $ 9,718.50 4% Town of Algoma $ 16,880.30 8% Town of Algoma. 165,285.90 19,401.65 ear Total Snow Removal Sales: $ 197,199.69 Axle Tech $ 10,924.95 6% 4Imprint $ 12,701.27 6% UWO $ 14,430.40 7% New Life $ 6,083.83 3% Oshkosh Schools $ 9,915.72 5% Kingsbury $ 4,790.40 2% Standard Forwarding $ 4,500.23 2% Fox Valley Technical $ 48,564.00 25% Most Blessed $ 12,689.37 6% Town of Algoma. $ 19,401.65 10% 717T,561.92 I J. 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Page: 1 Balance Sheet September 30, 2017 ASSETS CURRENT ASSETS: Petty Cash $ 173.35 Checking -West Pointe Bank 29,595.44 Checking-Horicon Bank 182.31 Accounts Receivable 298,422.48 Inventory 45,242.88 TOTAL CURRENT ASSETS 373,616.46 FIXED ASSETS: Equipment 1,015,499.52 Accum Depr-Equipment (897,951.45) Transportation Equipment 1,224,477.30 Accum Depr-Transportation Eq. (1,084,567.14) Leasehold Improvements 14,235.73 Accum Depr-Leasehold Imp. (1,349.29) NET FIXED ASSETS 270,344.67 OTHER ASSETS: Security Deposits 1,000.00 Deferred Income Tax Asset 111,000.00 TOTAL OTHER ASSETS 112,000.00 TOTAL ASSETS $ 755,961.13 Unaudited - For Management Purposes Only n JEFF FOUST EXCAVATING, INC. age:2 (j�,- Balance Sheet September 30, 2017 LIABILITIES AND EQUITY CURRENT LIABILITIES: Line of Credit-Horicon Bank $ 50,000.00 Accounts Payable 263,015.72 Fed & FICA W/H & Employer (76.50) State W/H 2,544.61 Accrued FED Unemployment 123.15 Accrued WI Unemployment 5,325.85 Accrued Interest 1,013.03 WI Sales Tax Payable 707.41 TOTAL CURRENT LIABILITIES 322,653.27 LONG-TERM LIABILITIES: N/P - Carole Lee Foust 14,593.75 N/P-Horicon 20799689001 80,909.51 N/P-TD Auto Finance LLC 20,817.25 N/P-Sheffield Financial 2,471.04 N/P-Ally Financial 6,852.48 N/P-John Deere Financial 30,946.45 N/P-CSM Financial, LLC 24,282.67 N/P-John Deere Financial Gator 10,439.30 TOTAL LONG-TERM LIABILITIES 191,312.45 TOTAL LIABILITIES 513,965.72 STOCKHOLDER'S EQUITY: Capital Stock 5,000.00 Additional Capital 148,086.29 Add'l Cap Sub Off Loans 60,900.00 Retained Earnings (83,910.70) Net Income 111,919.82 TOTAL STOCKHOLDER'S EQUITY 241,995.41 TOTAL LIABILITIES & EQUITY $ 755,961.13 Unaudited - For Management Purposes Only List of Assigned Assets DUMP TRUCKS 1991 FLEET # 1992 HITACHI EX150 HYDRAULIC EXCAVATOR 51 1995 FORD LT 8000 SINGLE -AXLE DUMP W/11' PLOW 21 1992 FORD LTS 8000 TRI -AXLE DUMP 91 1997 CHEVY SINGLE -AXLE DUMP W/9' PLOW AND SALTER 42 1990 FORD LTS 9000 QUAD -AXLE DUMP 62 1996 FORD LTS9000 QUAD -AXLE DUMP 72 1993 MACK QUAD -AXLE DUMP 82 1990 FORD LN8000 SINGLE -AXLE DUMP W/I P PLOW AND SPREADER 13 1999 MACK QUAD -AXLE DUMP 23 2017 MACK QUAD -AXLE DUMP TRAILERS FLEET # 304 1994 BORCO TRI -AXLE SEMI DUMP TRAILER 307 1989 EAST TRI -AXLE SEMI DUMP TRAILER 316 2015 SURE TRAC DUMP TRAILER MODEL ST8214DD-B-140 317 2015 NOVAE -SURE TRAC TRAILER MODEL ST08018 PICK-UP TRUCKS FLEET # 2151 2015 CHEVY SILVERADO 3500 4 -WHEEL DRIVE PICKUP W/PLOW 2041 2004 GMC 2500 4 -WHEEL DRIVE PICKUP W/PLOW HEAVY EQUIPMENT 1991 CASE 580K 4 -WHEEL DRIVE LOADER BACKHOE 1992 HITACHI EX150 HYDRAULIC EXCAVATOR 1989 CASE 1150E DOZER W/6 -WAY BLADE 1990 CASE 721 4 -WHEEL DRIVER LOADER 1995 DRESSER 520C 4 -WHEEL DRIVE LOADER 1995 KOMATSU PC20OLC HYDRAULIC EXCAVATOR 1995 CASE 650G DOZER W/6 WAY BLADE 1996 KOMATUS PC 150 HYDRAULIC EXCAVATOR 1997 C830B HYPAC COMPACTOR 2005 VOLVO ECR88 HYDRAULIC EXCAVATOR 2015 NEW HOLLAND L220 SKID STEER 2015 JOHN DEERE 3046R UTILITY TRACTOR 2016 JOHN DEERE GATOR XUV590 2016 CASE 321F 4 -WHEEL DRIVE LOADER RECEIVED DEPT OF PUBLIC WORKS OSHKOSH, WISCONSIN JEFF FOUST EXCAVATING, INC. 2824 CLAIR"JX ROAD qMOSHKOSH. WISCONSIN 54904 (920) 426-5808 FAX-' (920) 426-4000 PROPOSAL FOR SIDEWALK SNOW AND ICE REMOVAL CONTRACT We, the undersigned, propose to carry out the assigned sidewalk snow and ice removal projects, in accordance with the Specifications, from November 14, 2017 - May 31, 2018 for the following rates. Rates shall include all cost of labor, materials (rock salt, sand, internet access, photo disks, etc.), use of equipment and any incidentals required to complete the work as specified, regardless of the number of personnel engaged in shoveling by hand. or clearing with equipment. 1 2- 1 5. Remove all mow and/or ice at a single location/lot with 0 to 100 feet of sidewalk (including rock salt/sand $ 75.00 application, if necessary) Lump Sum Additional footage beyond 100 feet at same location/lot $ .60 (including rock salt/sand application if necessary) Per Linear Foot Apply rock salt/sand only to 0 to 100 feet of sidewalk at $ 75.00 a single location/lot Lump Sum Apply rock salt/sand only to additional footage beyond $ .75 100 feet at same location/lot Per Linear Foot Remove all snow and/or ice from all pavement in the handicap ramp/crosswalk quadrant (fndudipg rock salt/sand application if necessary) 6. Remove and dispose of snow from locations where unusual cm4 ions have occurred: a. Mobilization/demobMzation from site b. Load snow c. Haul snow —r in NrM.nOzs\Sn x„mo�Caohad6\x,71 !« $ 75.00 Per Intersection Quadrant $ 9o.oa Each 90.00 Equipnnent/L.abor Rate Per Hour 90.00 Equipment/tabor Rate Pec Hour Page I of i FOUST-1 OP ID: RG Atm, o CERTIFICATE OF LIABILITY INSURANCE [7E'm-DDrYYYY) 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 HOLu":. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUbK%JUH11Vn I* VYAlvcu, SUDject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER . CONTACT McClone -Oshkosh NAME: Brian MCClone 505 North Westfield Street n aCNN x;920-233-4000 IF No, 920-233-2728 Oshkosh, WI 54902-4105 1 E-MAIL -- Brian MCClone 13ADDRESS: brian.mccione@mccione.COm 01 S) AFFORDING uB�'�Cwr1 uRERA:UnitedFire(&CasualtyCo�GE 13021 INSURED INSURED Jeff Foust Excavating Inc. �E _�T1' INSURER B: 2824 Clairville Rd. 05F1 Oshkosh, WI 54904 INSURER C : INSURER D: I I INSURER F: I COVFRAGFS CFRTIFICATF NIIMRFR• I79:11Iclnkl kit IIAQCD• 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 IND WVBRD POLICY NUMBER MM DDY EFF MPOMLDI DY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE 1XI OCCUR X 60473986 04/01/2017 04/01/2018 DAMAGES ERoccurr . $ 100.00 MED EXP (Anyone person) $ 5,00 X Aggr Per Proj CG7 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � JE,T [�] LOC GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 Emp Ben. $ 1/200000 OTHER: AUTOMOBILE LIABILITY EOa BINEDtSINGLE LIMIT $ 1,000,000 A X ANY AUTO X 60473986 04/01/2017 04/01/2018 BODILY INJURY (Per person) $ X ALL OWNEDX SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY $ DAMAGE Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAR CLAIMS -MADE X 60473986 04/01/2017 04/01/2018 AGGREGATE $ 2,000,000 DED I X I RETENTION $ 10000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? F—]N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below /A 60473986 04/01/2017 04/01/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,00 _ E.L. DISEASE - EA EMPLOYEE $ 500,000 ---- E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Oshkosh, its officers, council members, agents, employees and authorized volunteers are Additional Insured on a Primary and Non Contributory Basis with respects to General Liability including Ongoing and Completed Operations when required by written contract per forms CG7201 and IL7105; and Additional Insured with respect to Auto Liability on a (cont) �r MI lvf r+Ir nVl-vGr% l�AF41,CLLA I IVIV OSHCI-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Oshkosh ACCORDANCE WITH THE POLICY PROVISIONS, Attn: City Clerk 215 Church Avenue AUTHORIZED REPRESENTATIVE PO Box 1130i� Oshkosh, WI 54903-1130 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERS®N OI ECEIVED - ORGANIZATION - - This endorsement modifies insurance provided under the following: DEC - 5 2011 COMMERCIAL GENERAL LIABILITY COVERAGE PART DEPT OI- PUBLIC WORKS OSHKOSH, WISCONSIN SCHEDULE Name of Additional Insured Person(s) or Organization(s): Locations of Covered Operations CITY OF OSHKOSH AND ITS OFFICERS COUNCIL ANY LOCATION AT WHICH WORK OR MEMBERS AGENTS EMPLOYEES AND AUTHORIZED OPERATIONS ARE PERFORMED BY YOU OR VOLUNTEERS ON YOUR BEHALF Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who is an Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertis- ing injury' caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following addi- tional exclusions apply: CG 2010 07 04 This insurance does not apply to "bodily injury' or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or or- ganization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. © ISO Properties, Inc., 2004 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LL�SEES OR REC IVED CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: DEC -5 2017 COMMERCIAL GENERAL LIABILITY COVERAGE PART DEPT OF M13LIC WORKS OSHKOSH, WISCONSIN SCHEDULE Name of Additional Insured Person(s) or Organization(s): Location and Description of Completed Opera- tions CITY OF OSHKOSH AND ITS OFFICERS COUNCIL ANY LOCATION AT WHICH WORK OR MEMBERS AGENTS EMPLOYEES AND AUTHORIZED OPERATIONS WERE PERFORMED BY YOU OR ON VOLUNTEERS YOUR BEHALF 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 or- ganizations) shown in the Schedule, but only with respect to liability for "bodily injury' or "property damage" 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 insured and included in the "products - completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 CG 72 0102 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXTENDED ULTRA LIABILITY PLUS ENDORSEMEI,TcFtvED T his endorsement modifies insurance provided under the following: NOV 2 2 20117 COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION I - COVERAGES DEPT OF PUBLIC WORKS OSHKOSH, WISCONSIN A. The following changes are made at COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Extended Property Damage At 2. Exclusions exclusion a. Expected or Intended Injury is replaced with the following: "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. 2. Expanded Fire Legal Liability At 2. Exclusions the last paragraph is deleted and replaced by the following: Exclusions c. through n. do not apply to damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of this owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. 3. Non -Owned Watercraft At 2. Exclusions exclusion g. Aircra'4 Auto Or Watercraft (2) (a) is deleted and replaced by the following: (a) Less than 51 feet long; 4. Property Damage — Borrowed Equipment At 2. Exclusions the following is added to paragraph (4) of exclusion j. Damage To Property: This exclusion does not apply to "property damage" to borrowed equipment while at a jobsite and while not being used to perform operations. The most we will pay for "property damage" to any one piece of borrowed equipment under this coverage is $25,000 per occurrence. The insurance afforded under this provision is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. 5. Property Damage Liability — Elevators At 2. Exclusions the following is added to paragraphs (3), (4) and (6) of exclusion j. Damage To Property: This exclusion does not apply to "property damage" resulting from the use of elevators. However, any insurance provided for such "property damage" is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. B. The following coverages are added 1. COVERAGE D - VOLUNTARY PROPERTY DAMAGE COVERAGE "Property damage" to property of others caused by the insured: a. While in your possession; or b. Arising out of "your work". Coverage applies at the request of the insured, whether or not the insured is legally obligated to pay. For the purposes of this Voluntary Property Damage Coverage only: Exclusion j. Damage to Property is deleted and replaced by the following: CG 72 01 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 13 *67080300* 111111111111111111111111111111111111111111111111 CG 72 01 02 15 j. Damage to Property "Property damage" to: (1) Property held by the insured for servicing, repair, storage or sale at premises you own, rent, lease, operate use; (2) Property transported by or damage caused by any automobile", "watercraft" or "aircraft" you own, hire or lease; (3) Property you own, rent, lease, borrow or use, The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 2. COVERAGE E - CARE, CUSTODY AND CONTROL PROPERTY DAMAGE COVERAGE For the purpose of this Care, Custody and Control Property Damage Coverage only: a. Item (4) of Exclusion j. does not apply. The amount we will pay is limited as described below in SECTION 111 - LIMITS OF INSURANCE For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 3. COVERAGE F - ELECTRONIC DATA LIABILITY COVERAGE For the purposes of this Electronic Data Liability Coverage only: a. Exclusion p. of Coverage A — Bodily Injury And Property Damage Liability in Section I — Coverages is replaced by the following: 2. Exclusions This insurance does not apply to: p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. However, this exclusion does not apply to liability for damages because of "bodily injury". b. "Property Damage" means: (1) Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or (2) Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or (3) Loss of, loss of use of, damage to, corruption of, inability to access or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of "electronic data' shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this Electronic Data Liability Coverage, "electronic data" is not tangible property. The amount we will pay is limited as described below in SECTION 111 - LIMITS OF INSURANCE 4. COVERAGE G - PRODUCT RECALL EXPENSE a. Insuring Agreement (1) We will pay 90% of "product recall expense" you incur as a result of a "product recall" you initiate during the coverage period. (2) We will only pay for "product recall expense" arising out of "your products" which have been physically relinquished to others. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE CG 72 01 02 15 Includes copyrighted material of insurance Services Office, Inc., with its permission. Page 3 of 13 CG 72 01 02 15 b. Exclusions This insurance does not apply to "product recall expense" arising out of: (1) Any fact, circumstance or situation which existed at the inception date of the policy and which you were aware of, or could reasonably have foreseen that would have resulted in a "product recall'. (2) Deterioration, decomposition or transformation of a chemical nature, except if caused by an error in the manufacture, design, processing, storage, or transportation of "your product". (3) The withdrawal of similar products or batches that are not defective, when a defect in another product or batch has been found. (4) Acts, errors or omissions of any of your employees, done with prior knowledge of any of your officers or directors. (5) Inherent vice, meaning a natural condition of property that causes it to deteriorate or become damaged. (6) "Bodily Injury" or "Property Damage". (7) Failure of "your product" to accomplish its intended purpose, including any breach of warranty of fitness, quality, efficacy or efficiency, whether written or implied. (8) Loss of reputation, customer faith or approval, or any costs incurred to regain customer market, or any other consequential damages. (9) Legal fees or expenses. (10) Damages claimed for any loss, cost or expense incurred by you or others for the loss of use of "your product". (11) "Product recall expense" arising from the "product recall" of any of "your products" for which coverage is excluded by endorsement. (12) Any "product recall" initiated due to the expiration of the designated shelf life of "your product". 5. COVERAGE H -WATER DAMAGE LEGAL LIABILITY The Insurance provided under Coverage H (Section 1) applies to "property damage" arising out of water damage to premises that are both rented to and occupied by you. The Limit under this coverage shall not be in addition to the Damage To Premises Rented To You Limit. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE 6. COVERAGE I — DESIGNATED OPERATIONS COVERED BY A CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM The following exclusion is added to Paragraph 2. Exclusions of SECTION I — COVERAGES COVERAGE A — BODILY INJURY AND PROPERTY DAMAGE LIABILITY: r. This insurance does not apply to "bodily injury" or "property damage" arising out of either your ongoing operations or operations included within the "products -completed operations hazard" for any "consolidated (Wrap-up) insurance program" which has been provided by the prime contractor/project manager or owner of the construction project in which you are involved. This exclusion applies whether or not a consolidated (Wrap-up) insurance program: a. Provides coverage identical to that provided by this Coverage Part; or b. Has limits adequate to cover all claims This exclusion does not apply if a "consolidated (Wrap-up) insurance program" covering your operations has been cancelled, non -renewed or otherwise no longer applies for reasons other than exhaustion of all available limits, whether such limits are available on a primary, excess or on any other basis. You must advise us of such cancellation, nonrenewal or termination as soon as practicable. For purposes of this exclusion a "consolidated (wrap-up) insurance program" is a program providing insurance coverage to all parties for exposures involved with a particular (typically major) construction project. CG 72 01 02 15 includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 13 *68080310* 11111111111111111111111111111111111111111111111111 CG 72 0102 15 C. SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is amended: 1. To read SUPPLEMENTARY PAYMENTS 2. Bail Bonds Item 1.b. is amended as follows: b. Up to $1,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 3. Loss of Earnings Item 1.d. is amended as follows: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of eamings up to $500 a day because of time off from work. 4. The following language is added to Item 1. However, we shall have none of the duties set forth above when this insurance applies only for Voluntary Property Damage Coverage and/or Care, Custody or Control Property Damage Coverage and we have paid the Limit of Liability or the Aggregate Limit for these coverages. SECTION II- WHO IS AN INSURED A. The following change is made: Extended Reporting Requirements Item 3.a. is deleted and replaced by the following: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. B. The following provisions are added 4. BROAD FORM NAMED INSURED Item 1.f. is added as follows:° f. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the polic period only if there is no other similar insurance available to that entity. However: (1) Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired more than 50 percent of the voting stock; and (2) Coverage B does not apply to "personal and advertising injury' arising out of an offense committed before you acquired more than 50 percent of the voting stock. 5. Additional Insured - Owners, Lessees or Contractors -Automatic Status When Required in Construction or Service Agreement With You a. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy is an insured. Such person or organization is an additional insured only with respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" which may be imputed to that person or organization directly arising out of: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: CG 72 01 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 13 CG 72 0102 15 1. 'Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the 'occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 6. Additional Insured — Limited Products Completed Operations Coverage a. Any person(s) or organization(s), but only with respect to your liability for "bodily injury" or "property damage" which may be imputed to that person(s) or organization(s) directly arising out of "your work" performed for that additional insured and included in the "products -completed operations hazard" is an insured. However: (1) The insurance afforded to such additional insureds only applies to the extent permitted by law; (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. (3) Coverage will cease five years from the completion of "your work" if: (a) a time frame is not stipulated in the written contract or written agreement; or (b) a time frame longer than 5 years is stipulated in the written contract or written agreement However if a lesser time frame is stipulated in the written contract or written agreement then that time frame will prevail. b. With respect to the insurance afforded to any additional insured under this endorsement, the following additional exclusionary language shall apply: This insurance does not apply to "bodily injury" or "property damage" arising out of the rendering of, or the failure to render, any professional architecture, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory, inspection, architectural or engineering activities. 7. Additional Insured - Vendors a. Any person(s) or organization(s) (referred to throughout this additional coverage as vendor), but only with respect to "bodily injury" or "property damage", which may be imputed to that person(s) or organization(s) arising out of .your products" shown with the Schedule which are distributed or sold in the regular course of the vendor's business is an insured. However. (1) The insurance afforded to such vendor only applies to the extent permitted by law, and (2) If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. CG 72 01 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 13 *69080320* I IIIIII IIIII IIIi1 IIIIi 1IIi1 IIi1I IIIII 111II IN 1111 CG 72 0102 15 b. With respect to the insurance afforded to these vendors, the following additional exclusions apply: (1) This insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of t assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container. (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of products. (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product. (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: i. The exceptions contained in Sub -paragraphs d. or f.; or ii. Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any Insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products_ 8. Additional Insured — Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You a. Any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" directly arising out of the maintenance, operation or use of equipment leased to you, which may be imputed to such person or organization as the lessor of equipment. However, the insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; and (2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 9. Additional Insured — Managers or Lessors of Premises a. Any person(s) or organization(s), but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and subject to the following additional exclusions: CG 72 011 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 13 CG 72 01 02 15 This insurance does not apply to: (1) Any 'occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) afforded coverage by the additional coverage. However: (1) The insurance afforded to such additional insured only applies to the extent permitted by law; and (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 10. Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured a. Any architects, engineers or surveyors who are not engaged by you are insureds, but only with respect to liability for "bodily injury" or "property damage" or "personal and advertising injury" which may be imputed to that architect, engineer or surveyor arising out of: (1) Your acts or omissions; or (2) Your acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed by you or on your behalf. But only if such architects, engineers or surveyors, while not engaged by you, are contractually required to be added as an additional insured to your policy. However, the insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; and (2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services, including: (1) The preparing, approving, or failing to prepare or approve, maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or (2) Supervisory, inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services. 11. Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Any state or governmental agency or subdivision or political subdivision is an insured, subject to the following provisions: a. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: (1) The insurance afforded to such additional insured only applies to the extent permitted by law; and (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 72 01 02 iS Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 13 *70080330* 11111111111111111111111111111111111111111111111111 CG 72 0102 15 b. This insurance does not apply to: (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or (2) "Bodily injury" or "property damage" included within the "products -completed operations hazard". 12. Additional Insured Consolidated Insurance Program (Wrap -Up) Off -Premises Operations Only - Owners, Lessees or Contractors a. Any persons or organizations for whom you are performing operations, for which you have elected to seek coverage under a Consolidated Insurance Program, when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy is an insured. Such person or organization is an additional insured only with respect to your liability which may be imputed to that person or organization directly arising out of your ongoing operations performed for that person or organization at a premises other than any project or location that is designated as covered under a Consolidated Insurance Program. A person's or organization's status as an insured under this endorsement ends when your operations for that insured are completed. b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies. This insurance does not apply to: "Bodily injury", "property damage", or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and (2) Supervisory, inspection 13. Additional Insured - Employee Injury to Another Employee With respect to your "employees" who occupy positions which are supervisory in nature: Paragraph 2.a.(1) of SECTION II — WHO IS A NAMED INSURED is amended to read: a. "Bodily injury' or "personal and advertising injury" (1) To you, to your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company); (2) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph (1)(a) above; or (3) Arising out of his or her providing or failing to provide professional healthcare services. Paragraph 3.a. is deleted, For the purpose of this Item 12 only, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, direct, discipline or discharge. SECTION III - LIMITS OF INSURANCE A. The following Items are deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard"; and c. Damages under Coverage B; and d. Damages under Coverage H. CG 72 01 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 13 CG 72 0102 15 3. The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard" and Coverage G. 6. Subject to 5. above, the Damage to Premises Rented to You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage while rented to you or temporarily occupied by you with permission of the owner. B. The following are added: 8. Subject to Paragraph 5. of SECTION IiI — LIMITS OF INSURANCE $25,000 is the most we will pay under Coverage H for Water Damage Legal Liability. 9. Coverage G- Product Recall Expense Aggregate Limit $50,000 Each Product Recall Limit $25,000 a. The Aggregate Limit shown above is the most we will pay for the sum of all "product recall expense" you incur as a result of all "product recalls" you initiate during the endorsement period. b. The Each Product Recall Limit shown above is the most we will pay, subject to the Aggregate and $1,000 deductible, for "product recall expense" you incur for any one "product recall" you initiate during the endorsement period. We will only pay for the amount of Product Recall Expenses which are in excess of the deductible amount. The deductible applies separately to each Product Recall. The limits of insurance will not be reduced by the amount of this deductible. We may, or will if required by law, pay all or any part of any deductible amount. Upon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid. 10. Aggregate Limits of Insurance (Per Location) The General Aggregate Limit applies separately to each of your "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. 11. Aggregate Limits of Insurance (Per Project) The General Aggregate Limit applies separately to each of your projects away from premises owned by or rented to you. 12. With respects to the insurance afforded to additional insureds afforded coverage by items5 through 13 of SECTION II —WHO IS AN INSURED above, the following is added: The most we Wil pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; b. Available under the applicable Limits of Insurance shown in the Declarations; Whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations_ 13. Subject to 5. of SECTION III — LIMITS OF INSURANCE, a $5,000 'occurrence" limit and a $10,000 "aggregate" limit is the most we will pay under Coverage A for damages because of "property damage" covered under Coverage D - Voluntary Property Damage Coverage. For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. CG 72 0102 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 10 of 13 ,'°a°„° 11111111111111111111111111111111111111111111111111 CO 72 01 02 15 14. Subject to S. of SECTION III — LIMITS OF INSURANCE, a $25,000 "occurrence" limit and a $100,000 "aggregate" limit is the most we will pay under Coverage E - Care, Custody and Control Coverage regardless of the number of: a.lnsureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". Deductible - Our obligation to pay damages on your behalf applies only to the amount of damages in excess of $500. This deductible applies to all damages because of "property damage" as the result of any one 'occurrence" regardless of the number of persons or organizations who sustain damages because of that "occurrence". We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. As respects this coverage "Aggregate" is the maximum amount we will pay for all covered 'occurrences" during one policy period. For the purposes of this Care, Custody and Control. Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 15. Subject to 5. of SECTION III — LIMITS OF INSURANCE, the most we will pay for "property damage" under Coverage F - Electronic Data Liability Coverage for loss of "electronic data" is $50,000 without regard to the number of "occurrences", SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS A. The following conditions are amended 1. Knowledge of Occurrence a. Condition 2., Items a. and b. are deleted and replaced by the following: (1) Duties In The Event Of Occurrence, Offense, Claim Or Suit (a) You must see to it that we are notified as soon as practicable of an 'occurrence" or an offense which may result in a claim. Knowledge of an 'occurrence" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. To the extent possible, notice should include: I. How, when and where the "occurrence" took place; ii. The names and addresses of any injured persons and witnesses, and iii. 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 any insured, you must: L Immediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. Knowledge of a claim or "suit" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. 2. Where Broad Form Named Insured is added in SECTION Il — WHO IS AN INSURED of this endorsement, Condition 4. Other insurance b. Excess Insurance (1).(a) is replaced by the following: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to an insured solely by reason of ownership by you of more than 50 percent of the voting stock, and not withstanding any other language in any other policy. This provision does not apply to a policy written to apply specifically in excess of this policy. CG 72 01 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 11 of 13 CG 72 0102 15 B. The following are added: 1. Condition (5) of 2.c. (5) Upon our request, replace or repair the property covered under Voluntary Property Damage Coverage at your actual cost, excluding profit or overhead. 10. Blanket Waiver Of Subrogation We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: premises owned or occupied by or rented or loaned to you, ongoing operations performed by you or on your behalf, done under a contract with that person or organization, "your work", or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you before the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense is committed. 11. Liberalization If a revision to this Coverage Part, which would provide more coverage with no additional premium becomes effective during the policy period in the state designated for the first Named Insured shown in the Declarations, your policy will automatically provide this additional coverage on the effective date of the revision. 12. Unintentional Failure to Disclose All Hazards Based on our reliance on your representations as to existing hazards, if you unintentionally should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal, 13. The following conditions are added in regard to Coverage G - Product Recall Expense In event of a "product recall', you must a. See to it that we are notified as soon as practicable of a "product recall'. To the extent possible, notice should include how, when and where the "product recall' took place and estimated "product recall expense". b. Take all reasonable steps to minimize "product recall expense". This will not increase the limits of insurance. c. If requested, permit us to question you under oath at such times as may be reasonably required about any matter relating to this insurance or your claim, including your books and records. Your answers must be signed. d. Permit us to inspect and obtain other information proving the loss. You must send us a signed, sworn statement of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. e. Cooperate with us in the investigation or settlement of any claim. f. Assist us upon our request, in the enforcement of any rights against any person or organization which may be liable to you because of loss to which this insurance applies. 14. Limited Railroad Contractual Liability The following conditions are applicable only to coverage afforded by reason of the redefining of an "insured contract' in the DEFINITIONS section of this endorsement: a. Railroad Protective Liability coverage provided by ISO form CG 0035 with minimum limits of $2,000,000 per occurrence and a $6,000,000 general aggregate limit must be in place for the entire duration of any project. b. Any amendment to the Other Insurance condition of form CG 0035 alters the primacy of the coverage or which impairs our right to contribution will rescind any coverage afforded by the redefined "insured contract" language. c. For the purposes of the Other Insurance condition of form CG 0035 you, the named insured, will be deemed to be the designated contractor. CG 72 01 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 12 of 13 "'°.°"°. 111111111111111111111111111111111111111111111111 CG 72 0102 15 SECTION V - DEFINITIONS A. At item 12. Mobile Equipment the wording at f.(1) is deleted and replaced by the following: f.(1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; except for such vehicles that have a gross vehicle weight less than 1,000 Ibs which are not designed for highway use. B. Item 3. "bodily injury" is deleted and replaced with the following: 3. "bodily injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sickness or disease. C. Item 9. "Insured Contract" c. is deleted and replaced with the following: c. Any easement or license agreement; D. Item 9. "Insured Contract" f.(1) is deleted E. The following definitions are added for this endorsement only 23. "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tape drives, cells, data processing devices or any other media which are used with electronically controlled equipment. 24. "Product recall" means a withdrawal or removal from the market of "your product" based on the determination by you or any regulatory or governmental agency that: a. The use or consumption of "your product' has caused or will cause actual or alleged "bodily injury" or "property damage"; and b. Such determination requires you to recover possession or control of "your product" from any distributor, purchaser or user, to repair or replace "your produc(', but only if "your product" is unfit for use or consumption, or is hazardous as a result of: (1) An error or omission by an insured in the design, manufacturing, processing, labeling, storage, or transportation of "your product"; or (2) Actual or alleged intentional, malicious or wrongful alteration or contamination of "your product' by someone other than you. 25. "Product recall expense" means reasonable and necessary expenses for: a. Telephone, radio and television communication and printed advertisements, including stationery, envelopes and postage. b. Transporting recalled products from any purchaser, distributor or user, to locations designated by you. c. Remuneration paid to your employees for overtime, as well as remuneration paid to additional employees or independent contractors you hire. d. Transportation and accommodation expense incurred by your employees. e. Rental expense incurred for temporary locations used to store recalled products. f. Expense incurred to properly dispose of recalled products, including packaging that cannot be reused. g. Transportation expenses incurred to replace recalled products. h. Repairing, redistributing or replacing covered recalled products with like products or substitutes, not to exceed your original cost of manufacturing, processing, acquisition and/or distribution. These expenses must be incurred as a result of a "product recall". CG 72 01 02 15 Includes copyrighted material of Insurance Services Office, Inc., with Its permission. Page 13 of 13 FOUST-1 OP ID: RG AcoRo CERTIFICATE OF LIABILITY INSURANCE DATE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 1 03//17/201617/2016 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Brian McClone McClone - Oshkosh PHONN EM : 920-233-4000 A/C No ; 920-233-2728 505 North Westfield Street _ Oshkosh, 54902-4105 E-MAIL brian.mccione@mcclone.com ' to Brian McClone " RECEIVED INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: United Fire & Casualty Co 13021 INSURED Jeff Foust Excavating Inc.�� INSURER B: ��+ 2824 Clairville Rd. r;;(1,i L Oshkosh, WI 54904 INSURER C: C WO �0�8jHRER D: � lsCON 1tl19URER E: U5 i l�U INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. 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. INSIR LTR TYPE OF INSURANCE I DDD W /BR POLICY NUMBER POLICY EFF MMIDDM'YY POLICY EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE � OCCUR X 60473986 04/01/2017 04/01/2018 RENTED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 X Aggr Per Proj CG7 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY FX] jE O- LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Emp Ben. $ 1/200000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 Ea accident _ BODILY INJURY (Per person) $ AX ANYAUTO X 60473986 04/01/2017 04/01/2018 X ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident XX NON -OWNED HIREDAUTOS AUTOS $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 A EXCESS LIAB CLAIMS -MADE X 60473986 04/01/2017 04/01/2018 DED I X I RETENTION $ 10000 $ A WORKERS COMPENSATIONX AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 60473986 04/01/2017 04/01/2018 PER TH- STATUTE ER E.L. EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - EA EMPLOYEE $ 500,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 A Scheduled Equipmnt 60473986 04/01/2017 04/01/2018 Limit 661,85 Deductibl 1,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Oshkosh, its officers, council members, agents, employees and authorized volunteers are Additional Insured on a Primary and Non Contributory Basis with respects to General Liability including Ongoing and Completed Operations when required by written contract per forms CG7201 and IL7105; and Additional Insured with respect to Auto Liability on a (cont) CERTIFICATE HOLDER CANCELLATION OSHCI-1 City of Oshkosh Attn: City Clerk 215 Church Avenue PO Box 1130 Oshkosh, WI 54903-1130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD IL 71 05 10 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: RECEIVED COMMERCIAL GENERAL LIABILITY COVERAGE PART NN 2 2 2017 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART COMMERCIAL UMBRELLA COVERAGE PART DEPT Ol,' PUBLIC WORKS OSHKOSH, WISCONSIN The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured; (3) The additional insured gives us prompt written notice of any "occurrence" which may result in a claim and prompt written notice of "suit"; (4) The additional insured immediately forwards all legal papers to us, cooperates in the investigation or settlement of the claim or defense against the "suit", and otherwise complies with policy conditions. 15) The additional insured must tender the defense and indemnity of any claim or "suit" to any other insurer which also insures against a loss we cover under this policy. This includes, but is not limited to, any insurer which has issued a policy of insurance in which the additional insured qualifies as an insured. For the purpose of this requirement, the term "insures against" refers to any self-insurance and to any insurer which issued a policy of insurance that may provide coverage for the loss, regardless of whether the additional insured has actually requested that the insurer provide the additional insured with a defense and/or indemnity under that policy of insurance. (6) The additional insured agrees to make available any other insurance that the additional insured has for a loss we cover under this policy. IL 71 05 10 14 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 *78080410* 1 CA 71 41 10 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LAND IMPROVEMENT CONTRACTORS ASSOCIATION (LICA) s BUSINESS AUTO ULTRA ENDORSEMENT -P�CEIVEL) This endorsement modifies insurance provided under the following: - BUSINESS AUTO COVERAGE FORM COVERAGE INDEX T?EPT OVpUSHWISC NS NS OSIAKO, Description Page TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE 1 DRIVE OTHER CAR COVERAGE 1 BROAD FORM INSURED 2 EMPLOYEES AS INSUREDS 2 ADDITIONAL INSURED STATUS BY CONTRACT, AGREEMENT OR PERMIT 2 AMENDED FELLOW EMPLOYEE EXCLUSION 2 TOWING AND LABOR 3 PHYSICAL DAMAGE ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 3 EXTRA EXPENSE - THEFT 3 RENTAL REIMBURSEMENT AND ADDITIONAL TRANSPORTATION EXPENSE 3 PERSONAL EFFECTS COVERAGE 4 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 4 AIRBAG ACCIDENTAL DISCHARGE 4 AUTO LOAN/LEASE TOTAL LOSS PROTECTION ENDORSEMENT 4 GLASS REPAIR — DEDUCTIBLE AMENDMENT 5 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 5 WAIVER OF SUBROGATION REQUIRED BY CONTRACT 5 UNINTENTIONAL FAILURE TO DISCLOSE 5 HIRED, LEASED, RENTED OR BORROWED AUTO PHYSICAL DAMAGE 5 EXTENDED CANCELLATION CONDITION 5 EXTENDED MEDICAL PAYMENT COVERAGE, UNINSURED AND UNDERINSURED 5 MOTORISTS COVERAGE EXTENDED PHYSICAL DAMAGE COVERAGE 6 LIBERALIZATION 6 The COVERAGE INDEX set forth above is informational only and grants no coverage. Terms set forth in (Bold Italics) are likewise for information only and by themselves shall be deemed to grant no coverage. A. TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE SECTION I — COVERED AUTOS, paragraph C. Certain Trailers, Mobile Equipment and Temporary Substitute Autos is amended by adding the following at the end of the existing language: If Physical Damage Coverage is provided under this because of its breakdown, repair, servicing, "loss", or destruction. B. DRIVE OTHER CAR COVERAGE The following language is added to SECTION I — COVERED AUTOS- as paragraph D. Drive Other Car Coverage, Coverage form for an "auto" you own, the Physical If Liability Coverage is provided by this Coverage Form, Damage coverages provided for that owned "auto" are any "auto" you don't own, hire or borrow is a covered extended to any "auto" you do not own while used with "auto" for Liability Coverage while being used by: the permission of its owner as a temporary substitute for the covered "auto" you own that is out of service CA 71 41 10 11 Includes Copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 6 1. You, if you are designated in the Declarations as an Indvidual; 2. Your partners or members, if you are designated in the Declarations as a partnership or joint venture; 3. Your members or managers, if you are designated in the Declarations as a limited liability company; 4. Your "executive officers", if you are designated in the Declarations as an organization other than an individual partnership, joint venture or limited liability company; and 5. The spouse of any person named in B.1 through B. 4. while a resident of the same household. except: a. Any "auto" owned by that individual or by any member of his or her household. b. Any "auto" used by that individual or his or her spouse while working in a business of selling, servicing, repairing or parking "autos". "Executive officer" means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar governing document. C. BROADENED LIABILITY COVERAGES SECTION II — LIABILITY COVERAGE in Paragraph A. Coverage at 1. Who Is An Insured is amended to include the following: (Broad Form Insured) d. Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. e. Any organization that is acquired or formed by you, during the term of this policy and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (1) That is a joint venture or partnership, (2) That is an "insured" under any other policy, CA 71 41 10 11 (4) 180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation. Coverage does not apply to "bodily injury" or "property damage" that results from an accident that occurred before you formed or acquired the organization. (Employee as Insureds) f. Any employee of yours while acting in the course of your business or your personal affairs while using a covered "auto" you do not own, hire or borrow. (Additional Insured Status by Contract, Agreement or Permit) g. Any person or organization whom you are required to add as an additional insured on this policy under a written contract or agreement; but the written contract or agreement must be: (1) Currently in effect or becoming effective during the term of this policy; and (2) Executed prior to the "bodily injury" or "property damage". The additional insured status will apply only with respect to your liability for "bodily injury" or "property damage" which may be imputed to that person(s) or organization(s) directly arising out of the ownership, maintenance or use of the covered "autos" at the location(s) designated, if any. Coverage provided by this endorsement will not exceed the limits of liability required by the written contract or written agreement even if the limits of liability stated in the policy exceed those limits. This endorsement shall not increase the limits stated in Section II. C. Limits of Insurance. For any covered "auto" you own this Coverage Form provides primary coverage. D. AMENDED FELLOW EMPLOYEE EXCLUSION Only with respect to your "employees" who occupy positions which are supervisory in nature, SECTION Il. LIABILITY B. Exclusion 5. Fellow Employee is replaced by: 5. Fellow Employee "Bodily Injury": (a) To you, or your partners or members (if you are a partnership or joint venture), or to your members (if you are limited liability company); (3) That has exhausted its Limit of Insurance under (b) To your "executive officers" and directors (if any other policy, or you are an organization other than a partnership, joint venture, or limited liability company) but only with respect to CA 71 41 10 11 Includes Copyrighted material of Insurance Services Office, Inc. with its permission. Page 2 of 6 performance of their duties as your officers or directors; (c) For which there is an obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph a and b above; or (d) Arising out of his or her providing or failing to provide professional health care services. For purposes of this endorsement, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, transfer, direct, discipline or discharge. E. BROADENED PHYSICAL DAMAGE COVERAGES SECTION III — PHYSICAL DAMAGE COVERAGE Coverage is amended as follows: (TOWING AND LABOR) 2. Towing and Labor We will pay towing and labor costs incurred, up to the limits shown below, each time a covered "auto" classified and rated as a private passenger type, "light truck" or "medium truck" is disabled: (a) For private passenger type vehicles or "light trucks" we will pay up to $75 per disablement. "Light trucks" have a gross vehicle weight (GVW) of 10,000 pounds or less. (b) For "medium trucks" we will pay up to $150 per disablement. "Medium trucks" have a gross vehicle weight (GVW) of 10,001 lbs. to 20,000 pounds. However, the labor must be performed at the place of disablement. (PHYSICAL DAMAGE ADDITIONAL TRANSPORTATION EXPENSE COVERAGE) 4. Coverage Extensions a. Transportation Expense is amended to provide the following limits: We will pay up to $50 per day to a maximum of $1,000. All other terms and provisions of this section remain applicable. (EXTRA EXPENSE - THEFT) The following language is added to 4. Coverage Extensions: c. Theft Recovery Expense If you have purchased Comprehensive Coverage on an "auto" that is stolen, we will pay CA 71 41 10 11 the expense of returning that stolen auto to you. The limit for this coverage extension is $5,000. (RENTAL REIMBURSEMENT AND ADDITIONAL TRANSPORTATION EXPENSE) d. Rental Reimbursement We will provide Rental Reimbursement and Additional Expense coverage only for those Physical Damage coverages for which a premium is shown in the Declarations or schedule pages. Coverage applies only to a covered "auto" of the private passenger or light truck (10,000 lbs. or less gross vehicle weight) type for which Physical Damage coverages apply. (1) We will pay for auto rental expense and the expense incurred by you because of "loss" to remove and transfer your materials and equipment from a covered "auto" to a covered "auto." Payment applies in addition to the otherwise applicable coverage you have on a covered "auto." No deductible applies to this coverage. (2) We will pay only for expenses incurred during the policy period and beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered "auto." If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you, or (b) 30 days. (3) Our payment is limited to the lesser of the following amounts: (a) Necessary and actual expenses incurred; or (b) $35 per day. (c) This coverage does not apply while there are spare or reserve "autos" available to you for your operations. (d) If "loss" results from the total theft of a covered "auto" of the private passenger or light truck type, we will pay under this coverage only that amount of your rental reimbursement expense which is not already provided for under the SECTION III — PHYSICAL DAMAGE COVERAGE, A. Coverage, 4. Coverage Extensions, a. Transportation Expenses. CA 71 41 10 11 Includes Copyrighted material of Insurance Services Office, Inc. with its permission. Page 3 of 6 (PERSONAL EFFECTS COVERAGE) e. Personal Effects If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $500 for Personal Effects stolen with the "auto". The insurance provided under this provision is excess over any other collectible insurance. For this coverage extension, Personal Effects means tangible property that is worn or carried by an "insured". Personal Effects does not include tools, jewelry, guns, musical instruments, money, or securities. (AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE) (Deletion of Audio Visual Equipment Exclusion) f. Audio, Visual and Data Electronic Equipment Coverage. We will pay for "loss" to any electronic equipment that receives or transmits audio, visual or data signals and that is not designed solely for the reproduction of sound. This coverage applies only if the equipment is permanently installed in a covered "auto" at the time of the "loss" or the equipment is removable from a housing unit which is permanently installed in a covered "auto" at the time of the "loss", and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto." (1) We will pay with respect to a covered "auto" for "loss" to any accessories used with the electronic equipment described above. However, this does not include tapes, records or discs. (2) In addition to the exclusions that apply to Physical Damage Coverage with exception of the exclusion relating to audio, visual and data electronic equipment, the following exclusions also apply: (3) We will not pay for any electronic equipment or accessories used with such electronic equipment that are: CA 71 41 10 11 An integral part of the same unit housing any sound reproducing equipment designed solely for the reproducing of sound if the sound reproducing equipment is permanently installed in the covered "auto": and Permanently installed in the opening of the dash or console normally used by the manufacturer for the installation of a radio. (4) With respect to this coverage, the most we will pay for all "loss" of audio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "accident" is the lesser of: (a) The actual cash value of the damaged or stolen property as of the time of the "loss"; (b) The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality; or $1,000, minus a deductible of $100. An adjustment for depreciation and physical condition will be made in determining actual cash value at the time of loss. If a repair or replacement results in better than like kind or quality, we will not pay for the amount of the betterment. If there is other coverage provided for audio, visual and data electronic equipment, the coverage provided herein is excess over any other collectible insurance. (AIRBAG ACCIDENTAL DISCHARGE) F. SECTION III — PHYSICAL DAMAGE COVERAGE, B. Exclusions is amended as follows: The following language is added to Exclusion 3.: If you have purchased Comprehensive or Collision Coverage under this policy, this exclusion does not apply to mechanical breakdown relating to the accidental discharge of an air bag. This coverage applies only to a covered auto you own and is excess of any other collectible insurance or warranty. No deductible applies to this coverage. (a) Necessary for the normal operation of G. AUTO LOAN/LEASE TOTAL LOSS PROTECTION the covered "auto" for the monitoringSECTION III — PHYSICAL DAMAGE COVERAGE — C. the covered "auto's" operating system;; or Limit of Insurance is amended by adding the following (b) Both: language: CA 71 41 10 11 Includes Copyrighted material of Insurance Services Office, Inc. with its permission. Page 4 of 6 4. In the event of a total "loss" to a covered "auto" shown in the Schedule pages, subject at the time of the "loss" to a loan or lease, we will pay any unpaid amount due on the lease or loan for a covered "auto" less: a. The amount paid under the Physical Damage Coverage Section of the policy; and b. Any: (1) Overdue lease / loan payments at the time of the "loss"; (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage. (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (5) Carry-over balances from previous loans or leases. (GLASS REPAIR — DEDUCTIBLE AMENDMENT) Under D., Deductible in SECTION Ill. PHYSICAL DAMAGE COVERAGE is amended by adding the following: Any deductible shown in the Declarations as applicable to the covered "auto" will not apply to glass breakage if the damaged glass is repaired, rather than replaced. H. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS Under SECTION IV — BUSINESS AUTO CONDITIONS, Subsection A., Loss Conditions, the following is added to paragraph 2. Duties In The Event of Accident, Suit or Loss: d. Knowledge of any "accident," "claim," "suit" or "loss" will be deemed knowledge by you when notice of such "accident," "claim," "suit" or "loss" has been received by: (1) You, if you are an individual, (2) Any partner or insurance manager if you are a partnership; (3) An executive officer or insurance manager, if you are a corporation; CA 71 41 10 11 (5) Your officials, trustees, board members or insurance manager, if you are a not-for-profit organization. I. WAIVER OF SUBROGATION REQUIRED BY CONTRACT Under SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions 5. Transfer of Rights of Recovery Against Others to Us the following language is added: However, we waive any rights of recovery we may have against the person or organization with whom you have agreed in writing in a contract, agreement or permit, to provide insurance such as is afforded under the policy to which this endorsement is attached. This provision does not apply unless the written contract or written agreement has been executed, or permit has been issued, prior to the "bodily injury" or "property damage." J. UNINTENTIONAL FAILURE TO DISCLOSE Under SECTION IV — BUSINESS AUTO CONDITIONS, Subsection B. General Conditions, the following is added to 2. Concealment, Misrepresentation Or Fraud: Your unintentional error in disclosing, or failing to disclose, any material fact existing at the effective date of this Coverage Form, or during the policy period in connection with any additional hazards, will not prejudice your rights under this Coverage Form. K. HIRED, LEASED, RENTED OR BORROWED AUTO PHYSICAL DAMAGE Under SECTION IV — BUSINESS AUTO CONDITIONS B. General Conditions 5. Other Insurance Paragraph 5.b. is replaced by the following: b. (1) For "Comprehensive" and "Collision" Auto Physical Damage provided by this endorsement, the following are deemed to be covered "autos" you own: (a.) Any Covered "auto" you lease, hire, rent or borrow; and (b.) Any Covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto" (4) Your members, managers or insurance (2) Limit of Insurance For This Section manager, if you are a limited liability company; or The most we will pay for any one "loss" is the lesser of the following.- CA ollowing:CA 71 41 10 11 Includes Copyrighted material of Insurance Services Office, Inc. with its permission. Page 5 of 6 (a) $50,000 per accident, or (b) actual cash value at the time of loss, or (c) cost of repair. minus a $500 deductible. An adjustment for depreciation and physical condition will be made in determining actual cash value in the event of a total loss. No deductible applies to "loss" caused by fire or lightning. (3) This Hired Auto Physical Damage coverage is excess over any other collectible insurance. (4) Definitions For This Section (a) Comprehensive Coverage: from any cause except the covered "auto's" collision with another object or the covered "auto's" overturn. We will pay glass breakage, "loss" caused by hitting a bird or animal and, "loss" caused by falling objects or missiles. (b) Collision Coverage: caused by the covered "auto's" collision with another object or by the covered "auto's" overturn. L. EXTENDED CANCELLATION CONDITION A. Under CANCELLATION, of the COMMON POLICY CONDITIONS form, item 2.b. is replaced by the following: C. 60 days before the effective date of cancellation if we cancel for any other reason M. EXTENDED AUTO MEDICAL PAYMENTS AND UNINSURED AND UNDERINSURED MOTORIST COVERAGE If Auto Medical Payments Coverage, Uninsured Motorists Coverage or Underinsured Motorists Coverage is provided by endorsement to the Coverage Form to which this endorsement attaches, the following qualify as an "insured" for each coverage provided: 1. You, if you are designated in the Declarations as an Individual; 2. Your partners or members, if you are designated in the Declarations as a partnership or joint venture; 3. Your members or managers, if you are designated in the Declarations as a limited liability company; 4. Your "executive officers", if you are designated in the Declarations as an organization other than an individual partnership, joint venture or limited liability company; and CA 71 41 10 11 5. The "family member" of any person named in 1 through 4 above while "occupying" a covered "auto" or while a pedestrian when struck by an "auto" you do not own, any "auto" not owned by that individual or not owned by any "family member." "Executive officer" means a person holding any of the officer positions created by your charter, constitution, by-laws or any other similar governing document. "Family member" means a person related to the individual named in the Declarations by blood, marriage or adoption who is a resident of the individual's household, including a ward or foster child. "Occupying" means in, upon, getting in, on, out or off. N. EXTENDED PHYSICAL DAMAGE COVERAGE If Physical Damage Coverage is provided by the Coverage Form to which this endorsement attaches, any private passenger type "auto" you don't own, hire or borrow is a covered "auto" for Physical Damage Coverage while in the care, custody or control of any individual named in B.I. through B.4. or his or her spouse while a resident of the same household except: a. Any "auto" owned by that individual or by any member of his or her household. b. Any "auto" used by that individual or his or her spouse while working in a business of selling, servicing, repairing or parking "autos". Our obligation to pay for repair, return or to replace damaged or stolen property will be reduced by a deductible equal to the amount of the largest deductible shown for any owned private passenger type "auto" applicable to Physical Damage Coverage. If there are no private passenger type "autos", the deductible shall be $50 for Comprehensive and $100 for Collision Coverage. No deductible will apply to "loss" caused by fire or lightning. O. LIBERALIZATION If we revise this endorsement to provide greater coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. CA 71 41 10 11 Includes Copyrighted material of Insurance Services Office, Inc. with its permission. Page 6 of 6