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HomeMy WebLinkAboutWally Schmid Exc Demolition 1419 Nebraska St I La SAMPLE ORI1NAL DEMOLITION CONTRACT THIS AGREEMENT, is entered into on the 29th day of MARCH 2019, by and between the CITY OF OSHKOSH, (CITY), and WALLY SCHMID EXC., INC (name) 7821 SWISS ROAD, OSHKOSH WI 54902 (address), an entity formed pursuant to the laws of the State of Wisconsin, (CONTRACTOR). Based upon the promises and consideration described in this document, the parties' agreement is as follows: ARTICLE I. SCOPE OF WORK The Contractor hereby agrees to furnish all of the materials and all of the equipment and labor necessary, and to perform all of the work shown on the plans and described in the specifications for the project entitled or described as follows: Demolition Quotation No. 2019-0312 for 1419 NEBRASKA ST OSHKOSH WI 54902 GARAGE AND TRIMMING OF VEGETATION and appurtenant work, for the City of Oshkosh, all in accordance and in strict compliance with the City's request for quotations and the other documents referred to in ARTICLE V of this contract and which are fully incorporated into this contract as if fully restated. ARTICLE II. TIME OF COMPLETION The work to be performed under this contract shall commence be completed within the time limits specified in the General Conditions. ARTICLE III. PAYMENT (a) The City shall pay to the Contractor for the performance of the contract the total sum of $3,850.00 adjusted as allowed in the General Conditions or as allowed by law, or any changes hereafter mutually agreed upon in writing by the parties. (b) Progress Payments. In the event the time necessary to complete this Contract is such that progress payments are required, they shall be made according to the provisions set forth in the General Conditions. ARTICLE IV. CONTRACTOR TO INDEMNIFY AND HOLD CITY HARMLESS The Contractor covenants and agrees to protect and hold the City of Oshkosh harmless against all actions, claims and demands of any kind or character whatsoever which may in any way be caused by or result from the intentional or negligent acts of the Contractor, his agents or assigns, his employees or his subcontractors related however remotely to the performance of this Contract or be caused or result from any violation of any law or administrative regulation. The contractor shall indemnify the City for all sums including court costs, attorney fees, damages, and punitive damages which the City may be obliged or adjudged to pay on any such claims or demands within thirty (30) days of the date of the City's written demand for indemnification. Demolition Contract - 1 ARTICLE V. INSURANCE • The Insurance required by the City of Oshkosh as specified in the City's General Conditions, Supplemental Conditions, and addenda, or plans, or instructions, or advertisements, shall be primary coverage and that any insurance or self insurance maintained by the City of Oshkosh, its officers, council members, agents, employees or authorized volunteers will not contribute to a loss. All insurance shall be based upon the occurrence of an event, and not based on claims made. All insurance shall be in full force prior to commencing work and remain in force until the entire job is completed and the length of time that is specified, if any, in this contract, the specifications, whichever is longer. ARTICLE VI. COMPONENT PARTS OF THE CONTRACT This contract between the City and the Contractor consists of the following component parts, all of which are as fully a part of this contract as if herein set out verba- tim, or if not attached, as if hereto attached. : 1. This Document 2. The City's General and any Supplemental Conditions 3. Specifications, including any addenda 4. City of Oshkosh Standard Specifications 5. Invitation for Quotations 6. Advertisement for Quotations 7. Contractor's Proposal The contract documents are complementary; what is required by one is as binding as if required by all. Before undertaking each part of the work, the Contractor shall carefully study and compare the Contract Documents and check and verify all pertinent figures and measurements required therein. Contractor shall promptly report in writing to the Engineer any conflict, error, ambiguity or discrepancy which Contractor may discover and shall obtain written clarification from the Engineer before proceeding with any work affected thereby. In the event that any provision in any of the above component parts of this contract conflicts with any provision in any other of the component parts, the provision in the component part first enumerated above shall govern over any other component part which follows it numerically except as may be otherwise specifically stated. IT IS HEREBY DECLARED, UNDERSTOOD AND AGREED that the word "Contractor" wherever used in this contract means the undersigned contractor and their legal representatives, successors and assigns. IN WITNESS WHEREOF, the City of Oshkosh, Wisconsin, has caused this contract to be sealed with its corporate seal and to be subscribed to by its City Manager and City Clerk and countersigned by the Comptroller of said City, and the party of the second part hereunto set its, his or their hand and seal the day and year first above written. Demolition Contract - 2 In the Presence of: CONTRACTOR By- £ LJcçT�JVC— (Seal of Contractor (Specify Title) if a Corporation.) By: (Specify Title) CITY OF OSHKOSH By: 1/0------ A. Rohloff, City Manager er itness) And: itness) Pamela R. Ubrig, City Ierk APPROVED: I hereby certify that the necess- ary provisions have been made to pay the liability which will accrue under this contract. ity Attor .Y‘O nft T-K),/ )e---- City Comptrol er Demolition Contract - 3 March 11, 2019 EXHIBIT A • QUOTATION FOR: CITY OF OSHKOSH,WISCONSIN Price Quote On:Demolition and Removal of garage and trim vegetation at: Address: 1419 Nebraska Street Oshkosh WI 54902 Gross Cost of Project: $ 550 °= Less Salvage Value**: $ ov QUOTED PRICE $ 3 % 0 Quote for removing sanitary sewer lateral from property line to the City's main in the right of way if necessary: $ **Describe: a) the objects and/or demolition materials expected to be sold for salvage;b) the value anticipated-to be received; arid, c) to whom the objects/material is expected to be sold: tit Demolition materials and debris will be disposed of at(the City must be notified of any changes): I r Name of Landfill: )(Al 11) Address of Landfill: V 5K(i'ccij Operator of Landfill: n Operator Address: S A VYUZ Telephone number: If contaminated/hazardous tanks, soil, or other materials are known to be present, attach a separate page with disposal information for hazardous material. Demolition Quotation Form - 1 • - WALLY SCHMID EXC., INC. 7821 SWISS ROAD OSHKOSH, WI 54902 PROPOSAL TO: CITY OF OSHKOSH MARCH 27TH. 2019 215 CHURCH AVE. ATTN: HOLLY OSHKOSH,WI. 54901 RE: 1419 NEBRASKA ST. WE PROPOSE THE FOLLOWING: REMOVE GARAGE FROM PREMISE TO WINNEBAGO COUNTY LANDFILL REMOVE CONCRETE FLOOR FILL WITH TOPSOIL SEED AND MATT (WATER BY OTHERS)NOT INCLUDED. TRIM ALL VEGETATION TO LOOK ACCEPTABLE. NO EXCAVATING SUM OF $3850.00 MEMBER OF OSHKOSH CHAMBER OF COMMERCE TERMS: 50%DOWN WITH SIGNED PROPOSAL. BALANCE AT COMPLETION. Project subject to lien. PROPOSAL SUBMITTED BY: PROPOSAL ACCEPTED BY: WALLY SCHMID� EXCAVATING,INC. w CALL? c�SiNCY"ll' I WALLY SCHMID DATE: �1 —2 ON l DATE: PHONE 920-688-2496 CELL 920-216-0240 CELL 920-216-0241 0 BBB RATING e-mail wschmidexc@yahoo.com WALTER R. SCHMID, JR. BBB. A+ MASTER PLUMBER RESTRICTED SERVICE #227715 ` Bus NE55 March 11, 2019 EXHIBIT A • I agree to complete the razing, removal, disposal, and site restoration of the above described property according to the requirements of the City's Request for Price Quotations. I will not start work until all permits, licenses, and approvals have been obtained, and I have been notified that all asbestos has been removed and the paperwork has been completed relative to any asbestos work that may need to be done. Based upon my experience, I assert that any salvage values identified in this Quote represent the highest NET value which could be obtained for these materials in the local area. S U� Initial here if you have reviewed Supplemental Conditions for this project, which are attached to the General Conditions as Exhibit B. This price quotation shall be valid for thirty (30) days from the City's due date for price quotations. 110 fawa Name of erson, Firm, or Corporation WyjEL eu4.4 Authorized Signature and Title Print Name and Title 7eai fail c 2aodr6 su�0 Address of Person, Firm, or Corporation 0Shet-t1 tnit (.6'a City State Zip Code ( ) a r ( -o2qO Telephone Number Demolition Quotation Form - 2 �. SCHMI02 OP ID:JV ACORD' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDrnY�1 �,/ • 04/18/2019 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 holderIs an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 920-734-3110 CONTACT DAVID VAN BOOGARD ADEMINO &ASSOCIATES PHONE 920-734-3110 FAX 920-734-6027 (AM,TRUMAN P O BOX 99 (A ,No,Ext): (A/C,No): KIMBERLY, WI 54136-0099 a E-MAIL dvanboogardcademino.com DAVID VAN BOOGARD INSURER(S)AFFORDING COVERAGE NAIC INSURER A:SELECTIVE INSURANCE 19259 INSURED WALLY SCHMID EXCAVATING INC INSURERB: 7821 SWISS RD OSHKOSH,WI 54902 INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. 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. INSR TYPE OF INSURANCE ADDL SUBS POLICY NUMBER D(1'POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MMIDDIV YY1 (MMIDYYY1 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $• 1,000,000 CLAIMS-MADE X OCCUR Y S 2270770 041141201.9 04/14/2020 PREMISES fEa GE TO RENTED occurrence) $ 500,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEM.AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 POLICY .X ,IE& X LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: $ COMINED A AUTOMOBILE LIABILITY Eae cdentSINGLELIMIT $ 1,000,000 X ANY AUTO y S 2270770 04/14/2019 04/14(2020 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY _AUTOSUp Ep BODILYRR INJURYp (Per accident) $ — HIIR DS ONLY- AUTOS ONLY (Pe cad nt) GE $ $ • A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE Y S 2270770 04/14/2019 04/14/2020 AGGREGATE $ 2,000,000 DED X RETENTION $ 0 $ A AND EMPLOYERS'LIABILITY - X STATUTE RTC Y/N WC 9052201 04/14/2019 04/14/2020 ANY PROPRIETOR/PARTNER/EXECLTf1VE N J AE.L.EACH ACCIDENT $ 100,000 OFF dR/M�MBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes.descnbe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Leased/Rented 5 2270770 04/14/2019 04/14/2020 $500 Ded 25,000 Equipment DESCRIPTION OF OPERATIONS I LOCATIONS(VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: 670 GRAND ST, OSHKOSH WI 54901 CITY OF OSHKOSH,ITS OFFICERS,COUNCIL MEMBERS,AGENTS,EMPLOYEES& AUTHORIZED VOLUNTEERS ARE ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT SUBJECT TO POLICY TERMS AND CONDITIONS. CERTIFICATE HOLDER CANCELLATION .OSCIT-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY O�'OSHKOSH OF VNINNEBAGO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CTY 215 CHURCH ST AUTHORIZED REPRESENTATIVE BOX �� OSHKOSH,WI 54901 I ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS. POLICY NUMBER: s 2270770 COMMERCIAL GENERAL LIABILITY CG20370704 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Operations Or Organization(s): CITY OF OSHKOSH VARIOUS LOCATIONS 215 CHURCH AVE OSHKOSH, WI 54903 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 include as an additional insured the person(s) or organization(s) 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". Copyright, ISO Properties, Inc.,.2004 CG 20 37 07 04 AGENT'S COPY ____...--",1 SCHMI02 OP ID:JV Ac' J RL CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDlYW1) �----- 04/15/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 920-734-3110 CONTACT DAVID VAN BOOGARD ADEMINO &ASSOCIATES PHONE 920-734-3110 FAX 920-734-6027 1001 TRUMAN P O BOX 99 (A/C,No,Ext): (NC,No): KIMBERLY, WI 54136-0099 n DRESS:dvanboogardtademino.com DAVID VAN BOOGARD INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:SELECTIVE INSURANCE 19259 INSURED WALLY SCHMID EXCAVATING INC INSURER B: 7821 SWISS RD OSHKOSH,WI 54902 INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (M W MIDDIYYI (MMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR Y S 2270770 04/1412019 04/14/2020 PREMISES(Fa rGE TO c ur ence) $ 500,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY X jE X LOC PRODUCTS-COMP/OPAGG . $ 3,000,000 OTHER: $ A AUTOMOBILE LIABILITY ((Ea accident) LIMIT $ 1,000,000 X ANY AUTO y S 2270770 04/14/2019 04/14/2020 BODILY INJURY(Per person) $ OWNED SCHEDULED _ AUTOS ONLY AUTOS VyN BODILY INJURY(Per accident) $ HI ALMOS ONLY AUTOS ONLYEp (Per accde DAMAGE $ A X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE S 2270770 04/14/2019 04/14/2020 AGGREGATE $ 2,000,000 DED X l RETENTION $ 0 $ A WORKERS COMPENSATION X STATUTE ERA AND EMPLOYERS'LIABILITY Y/N WC 9052201 04/14!2019 04/14/2020 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 100,000 (Mande Dry n ) E.L.DISEASE-EA.EMPLOYEE $ If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Leased/Rented S 2270770 04/14/2019 04/14/2020 $500 Ded 25,000 Equipment DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CITY OF OSHKOSH&ITS OFFICERS, COUNCIL MEMBERS,AGENTS,EMPLOYEES& AUTHORIZED VOLUNTEERS ARE ADDITIONAL INSURED FOR ONGOING OPERATIONS PER FORM CG7300&COMPLETED OPERATIONS PER FORM CG2037. CERTIFICATE HOLDER CANCELLATION OSCIT-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF'OSHKOSH OF s EBAGO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN . ACCORDANCE WITH THE POLICY PROVISIONS. CTY 215 CHURCH ST AUTHORIZED REPRESENTATIVE BOX �' OSHKOSH,WI 54901 1 ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ElitePac® General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY • CG73000119 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABlL1Y COVERAGE PART The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. However, if(a)two or more Coverage Parts of this policy,or(b)two or more forms or endorsements within the same Coverage Part apply to a loss, coverage provision(s) with the broadest language will apply, unless specifically stated otherwise within the;particular amendment covering that loss. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. COVERAGES-Amendments B. The following is added to Exclusion g. Aircraft, SECTION I - COVERAGE A BODILY INJURY AND Auto Or Watercraft under COVERAGE A BODILY PROPERTY DAMAGE LIABILITY INJURY AND PROPERTY DAMAGE LIABILITY, 2, Exclusions: EXCLUSIONS This exclusion does not apply to: Employer's Liability Amendment (6) Any aircraft, not owned or operated by any (This provision is not applicable in the State of New insured, which is hired, chartered or loaned with, York). a paid crew. However, if the insured has any The following is added to Exclusion e. Employer's other valid and collectible insurance for "bodily Liability under COVERAGE A.BODILY INJURY AND injury" or "property damage" that would be PROPERTY DAMAGE LIABILITY,2. Exclusions: covered under this provision, or on any other This exclusion also does not apply to any "temporary basis, this coverage is then excess; and subject worker to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV- COMMERCIAL Non-Owned Aircraft,Auto or Watercraft GENERAL LIABILITY CONDITIONS. A. Paragraph (2) of Exclusion g. Aircraft, Auto Or Damage To Premises Rented to You Watercraft under COVERAGE A BODILY INJURY A. The last paragraph of Paragraph 2. Exclusions AND PROPERTY DAMAGE LIABILITY, 2. Exclus- under COVERAGE A BODILY INJURY AND ions is deleted in its entirety and replaced with the. PROPERTY DAMAGE is deleted in its entirety and following: replaced with the following: (2) A watercraft you do not own that is: Exclusions c.through n. do not apply to damage by (a) Less than 26 feet long and not being used to fire, lightning or explosion to premises rented to you carry persons or property for a charge;or or temporarily occupied. by you with the permission (b) At least 26 feet, but less than 60 feet long, of the owner. A separate limit of insurance applies to and not being used to carry persons or this coverage as described in SECTION III - LIMITS property for a charge. Any person is an OF INSURANCE. insured who uses or is responsible for the. use of such watercraft with your expressed or implied consent. However, if the insured has any other valid and collectible insurance for "bodily injury" or "property damage" that would be covered under this provision, or on any other basis, this coverage is then excess, and subject to. Condition 4. Other Insurance, b. Excess Insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS. Copyright,2018 Selective Insurance Company of America. All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 3 of 9 INSURED'3'COPY B. Paragraph 6. under SECTION III - LIMITS OF This exclusion applies even if damages are INSURANCE is deleted in its entirety and replaced claimed for notification costs, credit monitoring with the following: expenses, forensic expenses, public relations 6. Subject to Paragraph 5. above, the most we will expenses or any other loss, cost or expense pay under COVERAGE A for damages because incurred by you or others arising out of that of"property damage"to any one premises, while which is described in Paragraph (1) or (2) rented to you, or in the case of damage caused above. by fire, lightning or explosion, while rented to you B. The following paragraph is added to SECTION III - or temporarily occupied by you with permission LIMITS OF INSURANCE: of the owner, for all such damage caused by fire, Subject to 5 above, the most we will pay under lightning or explosion proximately caused by the COVERAGE A for"property damage" because of all. same event, whether such damage results from loss of "electronic data" arising out of any one. fire; lightning or explosion or any combination of ";occurrence" is a sub-limit of$100,000. the three, is the amount shown in the Declara- tions for the Damage To Premises Rented To SECTION I.:COVERAGE C MEDICAL PAYMENTS. You Limit EXCLUSIONS C. Paragraph a.of Definition 9."Insured contract" under Any Insured Amendment SECTION V- DEFINITIONS is deleted in its entirety Exclusion a. Any insured under COVERAGE C and replaced with the following: MEDICAL PAYMENTS,2. Exclusions is deleted in its a A contract for a lease of premises. However, that entirety and replaced with the following: portion of the contract for a lease of premises a. Any Insured that indemnifies any person or organization for damage by fire, lightning or explosion to To any insured. premises while rented to you or temporarily This exclusion does not apply to: occupied by you with the permission of the (1) "Not-for-profit members°; owner is not an"insured contract"; Electronic Data Liability (2) "Golfing facility" members who. are not paid .a fee, salary, or other compensation; or A. Exclusion p.Access or Disclosure Of Confidential (3) "Volunteer:workers"; Or Personal Information And Data-related Liability under COVERAGE A BODILY INJURY This exclusion exception does not apply if COVERAGE AND PROPERTY DAMAGE LIABILITY, 2. C MEDICAL PAYMENTS is excluded by another Exclusions is deleted in its entirety and replaced by endorsement to this Coverage Part the following: Product Amendment p. Access or Disclosure Of Confidential Or Exclusion f. Products-Completed Operations Hazard Personal Information And Data-related under COVERAGE C MEDICAL PAYMENTS, 2. Liability Exclusions is deleted in its entirety and replaced with Damages arising oilt of the following: (1) Any access to ordisclosure of any person's f. Products-Completed Operations Hazard or 'organizations confidential or personal. Included within the "products-completed Operations information, including patents, trade secrets, hazard". processing methods, customer lists,financial information, credit card information This exclusion does not apply to"your products" sold or any other type of nonpublic information; for use or consumption on your premises,While such or products are still on your premises. (2) The loss of, loss of use of, damage to, This exclusion exception, does not apply if COVERAGE corruption of, inability to access, or inability C MEDICAL PAYMENTS is excluded by another to manipulate "electronic data"that does not endorsement to this Coverage Part. result from physical injury to tangible SECTION I SUPPLEMENTARY PAYMENTS- property. COVERAGES A AND B Expenses For Bail Bonds And Loss Of Earnings A.. Subparagraph 1.b. under SUPPLEMENTARY PAYMENTS-COVERAGES A AND B is deleted in its entirety and replaced with the following: b. Up to $5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to'which Bodily Injury Liability Coverage applies. We do not have to furnish these.bonds. Copyright, 2018 Selective Insurance.Company of America:All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 4 of 9 INSURED'S copy B. Subparagraph 1.d. under SUPPLEMENTARY a. Coverage under this provision is afforded only PAYMENTS-COVERAGES A AND B is deleted in until the 180th day after you acquire or form the its entirety and replaced with the following:. organization or the end of the policy period, d. All reasonable expenses incurred by the insured whichever is earlier. However, COVERAGE A at our request to assist us in the investigation or does not apply to "bodily injury or "property defense of the claim or "suit", including actual damage that occurred before.you acquired or loss: of earnings up to $1,000 a day because of formed the organization.. time off from work. B. The following paragraph is added to SECTION II SECTION II WHO IS AN INSURED-Amendments -WHO IS AN INSURED, Paragraph 3: Not-for-Profit Organization Members If you are engaged in the business of con- struction of dwellings three stories or less in The following paragraph is added to SECTION II =WHO height, or other buildings three stories or less in IS AN INSURED: height and less than 25,000 square feet in area, If you are an organization other than a partnership, joint you will also be an insured with respect to "your venture, or a limited liability company,and you are a not- work" only, for the period of time described for-profit organization, the following are included as above,for your,liability arising out of the conduct additional insureds: of any partnership or joint venture of which you 1. Your officials; are or were a member, even if that partnership or joint venture is not shown as a Named 2. Your trustees; Insured. However, this provision only applies if 3. Your members; you maintain or maintained an interest of at least 4. Your board members; fifty percent in that partnership or joint venture for the period of that partnership or joint venture. 5. Your commission members; This provision does not apply to any partnership or joint 6. Your agency members; venture that has been dissolved or otherwise ceased to 7. Your insurance managers; function for more than thirty-six months. 8. Your elective or appointed officers; and With respect to the insurance provided by this provision, Newly Formed or Acquired Organizations, the 9. Your"not-for-profit members". following is added to SECTION IV - COMMERCIAL However only with respect to their liability for your GENERAL LIABILITY, Paragraph 4. Other Insurance, activities or activities they perform on your behalf. Subparagraph b. Excess Insurance:. Employees As Insureds Modified The insurance provided by this provision, Newly Formed A. Subparagraph 2.a.(1)(a) under SECTION II - WHO or Acquired Organizations, is excess over any other IS AN INSURED does not apply to "bodily injury to insurance available to the insured, whether primary, worker'',caused by a `co-"employee" excess, contingent or on any other basis. a "temporary who is not a"temporary worker". (All other provisions of this section remain unchanged). B. Subparagraph 2.a.(2) under SECTION II - WHO IS Blanket Additional Insureds - As Required By AN INSURED does not apply to "property damage" Contract to the property of a "temporary worker" or"volunteer Subject to the Primary and Non-Contributory provision worker" caused by a co°employee" who is not a set forth in this endorsement, SECTION II -WHO IS AN "temporary worker"or"volunteer worker. INSURED is amended to include as an additional C. Subparagraph 2.a.(1Xd) under SECTION II - WHO insured: IS AN INSURED does not apply to "bodily injury" A. Owners, Lessees or Contractors/Architects, caused by cardio-pulmonary resuscitation or first aid Engineers and Surveyors services administered by a co-"employee". 1. Any person or organization for whom you are With respect to this provision only, Subparagraph (1)"of `performing operations when you and such Exclusion 2. e. Employer's Liability under SECTION I- person or organization have agreed in a written COVERAGES, COVERAGE A BODILY INJURY AND contract,written agreement or written permit that PROPERTY DAMAGE LIABILITY does not apply. such person or organization be added as an Newly Formed Or Acquired Organizations additional insured on your commercial general A. Subparagraph 3.a. under SECTION II -WHO IS AN liability policy; and INSURED is deleted in its entirety and replaced with the following: Copyright,2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 5 of 9 INSURED'S COPY 2. Any other person or organization; including any 'With respect to.the insurance afforded to these _ architects; engineers or surveyors not engaged additional insureds, this insurance does not by you, whom you are required to add as an apply to any "occurrence" which takes place additional insured under your policy in the after the equiprnentlease expires. contract or agreement in Paragraph 1..above: 2. :Managers.or Lessors of Premises Such person or organization is an additional insured Any person or organization from whom you only with respect to liability for "bodily injury", ;lease premises, but only'with respect`to liability "property damage" or "personal and advertising arising out of the ownership,maintenance or use injury" caused, in whole or in part, by: of that part of the premises leased to you: a,; Your acts or omissions;:or This insurance does not apply to any "occur b. The :acts of omissions :of those acting on :rence"which takes place after you cease to be a your behalf; tenant of that premises,:. in the performance of your ongoing operations 3. Mortgagees,Assignees or Receivers performed forthe additional insured.In.Paragraph 1, Any person or organization with respect to their above,: :liability as mortgagee,, assignee:or receiver and "property damage" or "personal and However,this insurance does notappl.y to: ;arising out of the ownership maintenance or use "Bodily injury",., of your premises. adVertising injury" arising out of the rendering of, or This insurance does not apply to any the failure to render, any professional:arc.hitectural, 'occurrence' which takes place after the. engineering or surveying services by. or for you, mortgage is satisfied, or the assignment or including: receivership ends. a. The preparing, approving, or failing. to 4. Any Person or Organization Other Than A prepare or approve, maps, shop,drawings, Joint Venture opinions, reports, surveys, field` orders, Any person or organization (other than a joint change orders or drawings and specifi- venture of which you are a member), but Only cations;and with respect to liability for "bodily injury''; b. Supervisory, inspection; architectural or "property damage" or personal and advertising: engineering activities. injury" caused, in whole or in part, by your acts. Professional services do not include services.within or omissions or the acts of omissions of those construction means, methods, techniques, acting on your behalf in the performance of your sequences and procedures employed ou, in 'ongoing operations or in connection with q by y property owned by ou.. connection with your operations in your capacity. as p� }arty y. a construction contractor. 5. State or Governmental Agency or Political A• person or organization's status es an additional Subdivision -Permits or Authorizations insured; Under this endorsement ends when your Any State or governmental agency orsubdivision. operations'for the person or organization described or political subdivision, but only with respect to: in Paragraph 1.above are completed. a. operations performed by you or on your. B. Other Additional Insureds behalf for which the:state or governmental Any of the following .persons or organizations with agency or subdivision or political subdivision. whom you have agreed in a written contract, written has issued a permit or authorization;:or agreement or written permit that such persons or :b. The following hazards for which the state or organizations'be:added as an additional insured on governmental agency or subdivision or your commercial general liability policy. political subdivision has issued a permit or 1. Lessors of Leased Equipment authorization in connection with premises you own, rent or control and to which this Any person or :organization. from whom yoU insurance applies: lease equipment, but only with respect to liability for ."bodily injury"; "property damage" or "per- sonal and advertising injury" caused, in whole or in part, by your maintenance,operation or use of equipment leased to ,you by such person or organization. Copyright,2018 Selective Insurance Company of America.All rights reserved.. CG 7300 01 1:9. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Paget.of 9 ZNSURED'S COPY (1) The existence, maintenance, repair, c. Any physical or chemical change in the product construction, erection or removal of made intentionally by the vendor; advertising signs, awnings, canopies, d. Repackaging, unless unpacked solely for the cellar entrances, coal holes, driveways, purpose of inspection, demonstration, testing, or manholes, marquees, hoist away the substitution of parts under instructions from openings, sidewalk vaults, street, the manufacturer, and then repackaged in the banners or decorations and similar original container; exposures; e. Any failure to make such inspections, (2) The construction, erection or removal of adjustments, tests or servicing as the vendor elevators;or has agreed,to make or normally undertakes to (3) The ownership, maintenance or use of make in the usual course of business in any elevators covered by this insurance. connection with the sale of the product;or This insurance does not apply to: f. Products which, after distribution or sale by you, have been labeled or re-labeled or used as a (a) "Bodily injury" or "property damage" container, part of ingredient of any other thing or arising out of operations performed, substance by or for the vendor; however this for the federal government, state or insurance does not apply to any insured person municipality;or or organization, from wtio you have acquired (b) "Bodily injury" or "property damage" such products, or any ingredient, part or included within the "products- container, entering into, accompanying or con- completed operations hazard". taining such products: With respect to Paragraphs 2: through 4., this The provisions of this coverage extension do not apply insurance does not apply to structural unless the written contract or written agreement has alterations; new construction or demolition been signed by the Named. Insured prior to the "bodily operations performed by or on behalf of such injury"or"property damage". person or organization. Incidental Malpractice The provisions of this coverage extension do not apply Subparagraph 2.a.(1)(d) under SECTION II - WHO IS unless the written contract or written agreement has AN INSURED is deleted in its entirety and replaced with been signed by the Named Insured or written permit the following: issued prior to the "bodily injury' or"property damage" or (d) Arising out of his or her providing or failing to provide "personal and advertising injury". professional health care services. Broad Form Vendors Coverage This does not apply to nurses, emergency medical Subject to the Primary and Non-Contributory provision technicians or paramedics if you are not in the set forth in this endorsement, SECTION If-WHO IS AN business or occupation of providing any such INSURED is amended to include as an additional professional services. insured any person or organization (referred to below as " vendor) for whom you have agreed in a written contract This also does not apply to bodily njut caused by cardio-pulmonary resuscitation or first aid services or written agreement to provide coverage as an " " additional insured under your policy. Such person or administered by a co-employee . organization is an additional insured only with respect to This provision does not apply if you are a Social Service "bodily injury" or "property damage" arising out of "your or Senior Living risk. products" which are distributed or sold in the regular SECTION IV - COMMERCIAL GENERAL LIABILITY course of the vendor's business. However, the insurance CONDITIONS-Amendments afforded the vendor does not apply to: a. "Bodily injury" or"property damage"for which the Knowledge Of Occurrence,Claim,Suit Or Loss vendor is obligated to pay damages by'reason of The following is added to Paragraph 2. Duties in the the assumption of liability in a contract or Event of Occurrence, Offense, Claim or Suit under agreement; however this exclusion does not SECTION IV - COMMERCIAL GENERAL LIABILITY apply to liability for damages that the vendor CONDITIONS: would have in the absence of the contract or The requirements under this paragraph do not apply until agreement; after the"occurrence"or offense is known to: b. Any express warranty unauthorized by you; 1. You, if you are an individual; 2. A partner, if you are a partnership; Copyright, 2018 Selective Insurance Company of America.All rights reserved. CG 73 00 0119 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 7 of 9 INSURED'S COPY 3. An "executive officer" or insurance manager, if you 3. You have assumed the liability of that person or are a corporation.; organization in that same contract, and it is. an • 4. Your members, managers or insurance manager, if "insured contract". you are a limited liability company; or The section above only applies to that person or organization identified above and only if the "bodily 5. Your elected or appointed officials, officers, injury' or 'property damage" occurs subsequent to the members, trustees, board members; commission members, agency members, or your administrator or execution of the written contract or written agreement. your insurance, manager if you are an organization Liberalization other than a partnership, joint venture, or limited The following condition is added to SECTION IV- liability company. COMMERCIAL GENERAL LIABILITY CONDITIONS: Primary and Non-Contributory Provision If we revise this Coverage Part to provide more coverage The following is added to Paragraph 4. Other Insur- without additional premium charge, subject to our filed ance, b. Excess Insurance. under SECTION IV- company rules, your policy will automatically provide the COMMERCIAL GENERAL LIABILITY CONDITIONS: additional coverage as of the day the revision is effective This insurance is primary to and we will not seek. in your state. contribution from any other insurance available to ;An Two or More Coverage Parts or Policies Issued By additional insured under this policy provided that: Us (1) The additional insured is a Named Insured under (This provision is not Applicable in the state of New York such"other insurance;and or Wisconsin). (2) You have agreed in a written contract, written The following condition is added: to SECTION IV - agreement or written permit that this insurance COMMERCIAL GENERAL LIABILITY CONDITIONS:. would be primary and would not seek contribution It is our intention that the various coverage parts or from any other insurance available to the additional policies issued to you by us, or any company affiliated insured. with us, do. not provide any duplication or overlap of Unintentional Failure To Disclose Hazards coverage. We have exercised diligence to draft our The following is added to Paragraph:6. Representations coverage parts and policies to reflect this intention. under SECTION IV - COMMERCIAL GENERAL However,.if the facts and circumstances that will respond LIABILITY CONDITIONS: to any claim or "suit" give .rise to actual or claimed duplication or overlap of coverage between the various However, if you should unintentionally fail to disclose any coverage parts or policies issued to you .by us or any existing hazards in your representations to us at the company affiliated with us, the limit of insurance under inception date of the policy, or during the policy period in all such coverage parts or policies combined shall not connection with any additional hazards, we shall not exceed the highest applicable limit under this coverage, deny coverage under this Coverage Part based upon or any one of the other coverage forms or policies such failure to disclose hazards. This condition does not apply to any Excess or Umbrella Waiver Of Transfer Of Rights Of.Recovery policy issued by us specifically to apply as excess The following is added to Paragraph 8. Transfer of insurance over this coverage part or policy to which this Rights Of Recovery Against Others To Us under coverage part is attached. SECTION IV - COMMERCIAL GENERAL LIABILITY SECTION V-DEFINITIONS CONDITIONS: Discrimination We will waive any right of recovery we may have against a person or organization because of payments we make (This provision does not apply in New York). for"bodily injury'or"property damage" arising out of your A. The following is added to Definition 14. "Personal Ongoing operations or "your work° done under a written and advertising injury": contract or written agreement and included in the "Personal and advertising injury" also means "products-completed operations hazard", if: "discrimination"that results in injury to the feelings or 1. You have agreed to waive any right of recovery reputation of a natural person, however only if such against that person or organization in a written "discrimination"or humiliation is: contract or written agreement; 1. Not done by or at the direction of: 2. Such person or organization is an additional insured ;a. The insured; or on your policy;or Copyright,2018 Selective Insurance Company of America. All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 8 of 9 INSURED'0 COPY b. Anyone considered an insured under b. Loss of, loss of use of, damage to, corruption of, . SECTION II-WHO IS AN INSURED; inability to access, or inability to properly 2. Not done intentionally to cause harm to another manipulate "electronic data", resulting `from physical injury to tangible property. All such loss person. of "electronic data" shall be deemed to occur at 3. Not directly or indirectly related to the em- the time of the"occurrence"that caused it. ployment, prospective employment or termi- nation of employment of any person or persons For the purpose of the Electronic Data Liability coverage b a" iisured. provided by this endorsement, "electronic data" is not y nyi 4. Not arising Out of any "advertisement" by the tangible property. insured. Employee Amendment B. The following definition is added to SECTION V fi iti b "Employee under SECTION V- DEFINI- DEFINITIONS• TIONS is deleted in its entirety and replaced by the following: "Discrimination"means: 5. "Employee" includes a "leased worker", or a a. Any act or conduct that would be considered "temporary worker". If you are a School, "Employee" discrimination under any applicable federal, also includes a student teacher. state,or local statute, ordinance or law; Golfing Facility bs Any act .or conduct that results in disparate The following definition is added to SECTION V - treatment of, or has disparate impact on, a DEFINITIONS: person, because of that person's race, religion, gender, sexual orientation, age, disability or "Golfing facility" means a golf course, golf club, driving physical impairment;or range, or miniature golf course. c. Any act or conduct characterized or interpreted Mental Anguish Amendment as discrimination by a. Person based on that (This provision does not apply in New York). person's race, religion, gender, sexual orients- Definition 3. "Bodily injury" under SECTION V- tion, age, disability or physical impairment. DEFINITIONS is deleted in its entirety and replaced with It does not include acts or conduct characterized or the following: interpreted as sexual intimidation or sexual harass- 3. "Bodily injury" means bodily injury, sickness or Merit, .or intimidation or harassment based one disease sustained by a person, including death person's gender. resulting from any of these at any time. This includes Electronic Data mental anguish resulting from any bodily :injury, The following definition is added to SECTION V- sickness or disease sustained by a person. (In New DEFINITIONS: York, mental anguish has been determined to be "Electronic data" means information, facts or programs "bodily injury"). stored as or on, created or used On, or transmitted to Or Not-for-profit Member from computer software, including systems and The following definition is added to SECTION V- applications software, hard or floppy disks„ CD-ROMS, DEFINITIONS: tapes; drives,cell, data processing devices or any other "Not-for-profit member" means a person who is a media which are used with electronically controlled member of a not-for-profit organization, including clubs equipment For the purpose of the Electronic Data and churches, who receives no financial or other Liability coverage provided by this endorsement compensation. Definition 17."Property damage" is deleted in its entirety and replaced by the following: 17. "Property damage" means: a. 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 Copyright,2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 9 of 9 INSURED'S COPY