HomeMy WebLinkAboutLeslie & Campbell, Inc. - Fire Department Roofing Rehabilitations 2013wo
NA 100- NOME—
Yakima Fire Department
Station 99 and 95 Roofing Rehabilitations
City Project No. 2352
The bidder is hereby advised that by signature of this proposal he /she is deemed to have acknowledged
all requirements and signed all certificates contained herein.
** Receipt is hereby acknowledged of addendum(s) No.(s)
1
�`���� 5�SeGtb0® SIGNATURE OF AUTHORIZED OFFICIAL(s)
Pikopo
FIRM NAME L genw re 64m Psam. /,1le-
(ADDRESS) 50(o A#r, 4 Vukn R-0. IVA11bA( 64
56g - 45 3 - v 0 7� k/a 9890 3
PHONE NUMBER
STATE OF WASHINGTON CONTRACTORS LICENSE NUMBER LF40 4'cR 1 a Pe
WA STATE EMPLOYMENT SECURITY REFERENCE NO. 761ZZ03004
Note:
(1) This proposal form is not transferable and any alteration of the firm's name entered hereon without prior permission from
the Secretary of Transportation will be cause for considering the proposal irregular and subsequent rejection of the bid.
(2) Please refer to section 1 -02.6 of the standard specifications, re: "Preparation of Proposal," or "Article 4" of the Instructions
to Bidders for building construction jobs.
(3) Should it be necessary to modify this proposal either in writing or by electronic means, please make reference to the
following proposal number in your communication.
Contractor:
Phone:
Address:
PROJECT SCOPE
Yakima Fire Department
Station 91 and 95 Roofing Rehabilitations
CITY OF YAKIMA JOB NO.2352
INVITATION TO QUOTE
CITY OF YAKIMA
ENGINEERING DIVISION
129 NO. 2ND STREET
YAKIMA, WASHINGTON 98901
PHONE 575 -6111
Quotations will be received by the Yakima City
Clerk until: 3:00 PM, May 8, 2013
This contract provides for the removal of existing roofing, repairing existing sub roofing if necessary, and installing new
roofing as well as other related work all in accordance with the Plans and Specifications as prepared by the City Engineer
of the City of Yakima.
INSTRUCTIONS TO THE CONTRACTOR
Please return your lowest price for the following project by 3:00 p.m., May 8th, 2013 to the Yakima City Clerks Office, 151
floor of City Hall. If you have any questions call Dana Kallevig at 576 -6605. The city reserves the right to reject any or all
quotations and to accept any or all items at the price quoted. The city intends to award this contract within 10 calendar
days after bid opening.
- 3 ti3
E
QUOTE
Yakima Fire Department
Contractor's Signature: ✓C�2 Date: / 7 / /3
3
�LULIWIl .7 1 allu 95 Rvvring Renanintations
ITEM
NO.
PROPOSAL ITEM
PAYMENT SECTION
QTY
UNIT
UNIT PRICE
DOLLARS
AMOUNT
DOLLARS
1
MOBILIZATION
Per 2012 WSDOT Standard specification 1 -09.7
1
LS
k 0.00.
2
REMOVAL AND DISPOSAL OF ASBESTOS MATERIAL
Per Contract Specification #13
1
LS
,,y
yP 7, 000•
4f 7GvD•i e
3
ROOF REPAIR YFD STATION #91, COMPLETE
Per Contract Specification #14
1
LS
70, 0(ofIA
4
ROOF REPAIR YFD STATION #95, COMPLETE
Per Contract Specification #14
1
LS,
32d,
y 3, 320•
5 1
6
ROOF SUB SURFACE REPAIR
Per Contract Specification #15
REPAIR OR REPLACEMENT
Per Contract Specification #23
1 FA $10,000.00
1 FA $5,000.00
SUB TOTAL:
STATE SALES TAX 8.2 %:
TOTAL:
$10,000.00
$5,000.00
/(02 980•ffi
0l3, U4.
174 3y
Contractor's Signature: ✓C�2 Date: / 7 / /3
3
Yakima Fire Department
Station 91 and 95 Roofing Rehabilitations
CITY OF YAKIMA JOB NO.2352
SPECIFICATIONS
I. GENERAL /SPECIAL INSTRUCTIONS
1. Description of Project:
This contract provides for the removal of existing roofing, repairing existing sub roofing if necessary, and
installing new roofing as well as other related work all in accordance with the Plans and Specifications as
prepared by the City Engineer of the City of Yakima.
2. Workmanship:
The contractor shall furnish all labor, equipment, and materials, which are necessary to complete the
work as described in these specifications. Quality of workmanship shall conform to that which is usually
provided by the trade in general. A Performance Bond equal to the bid amount shall be required
3. Regulatory Requirements:
The project shall be performed in a manner that is in compliance with all applicable federal, state and
local laws and regulations, including, but not limited to, vehicle regulations (WSDOT /HMTUSA/other),
environmental laws and regulations (EPANVDOE /local), and health and safety laws and regulations
(OSHANVISHA/City Safety Codes).
4. Records:
The contractor shall maintain operational records at its place of business for a minimum of five years.
These records shall include: point of material pick up, type of material, quantity of material.
5. Prevailing Wages:
The contractor will comply with all provisions of Chapter 39.12 RCW - Prevailing Wages on Public Work.
A. RCW 39.12.010 -The Prevailing Rate of Wage: Contact the Department of Labor and Industries,
to confirm current prevailing wage rate for applicable workers on this particular public work
project.
B. RCW 39.12.040 - Statement of Intent to Pay Prevailing Wages and an Affidavit of Wages Paid:
Before the City may pay any sum due on account, it must receive a statement of Intent to Pay
Prevailing Wages approved by the Department of Labor and Industries. Following final
acceptance of a public work project, and before any final money is disbursed, each contractor
and sub- contractor must submit to the City an Affidavit of Wages Paid, certified by the
Department of Labor and Industries.
C. RCW 39.12.070 - Fees Authorized for Approval Certification and Arbitrations: Any fees charged
by the Department of Labor and Industries for approvals or fees to cover costs of arbitration
conducted shall be the responsibility of the contractor.
6. Termination - Cause:
The City reserves the right to terminate this contract at any time, upon written notice, in the event that the
services of the Contractor are deemed by the City to be unsatisfactory, or upon failure to perform any of
the terms and conditions contained in this agreement. In addition to the foregoing right of termination, the
City may terminate this contract, with or without cause, upon thirty (30) days written notice to Contractor.
7. Right to Award:
The City of Yakima reserves the right to make contract award by Schedule or on an all or none basis,
whichever is in the best interest of the City.
8. Submission of Quote:
5
Quote shall be submitted to the City Clerk's Office, Yakima City Hall, 129 North 2nd Street, Yakima, WA,
98901, by 3:00 p.m. on May 8th, 2013 in a sealed envelope labeled Yakima Fire Department, Station 91
and 95 Roofing Rehabilitations, CITY OF YAKIMA JOB NO.2352, with the quote due date written on it.
Bidders will not be allowed to adjust their quotes after submission.
9. No Disturbance:
The contractor shall not disturb grounds or materials outside the sphere of the contracted project.
10. Pre Bid Meeting:
All bidders are required to visit the site prior to submitting their quote to become aware of any problems
that may affect their quote. A Pre Bid meeting is scheduled for Wednesday May 1St, 10:00am, at Station
91 (401 North Front Street). Alternate times may be available for a site visit, but are not guaranteed. If
needed, contact Design Engineer Dana Kallevig, 509.576.6605
11. Coordination:
The contractor will coordinate his work with City of Yakima Construction Supervisor Bruce Floyd at
509.576.6138 or 509.728.3475.
12. Timing:
Successful vendor shall coordinate with contacts listed above as to when work will be accomplished.
Work shall be completed within 30 working days.
13. Removal and Disposal of Asbestos Material:
Contractor will be responsible for the proper removal and disposal of existing asbestos material on the
parapet walls. There is no asbestos in the roof. There is approximately 3000 square feet of W board that
contains asbestos.
Contractor must be certified for asbestos removal as laid out in the following WAC's:
296 -65 -010 Asbestos worker certification
296 -65 -012 Asbestos supervisor certification
296 -65 -017 Asbestos contractor certification
14. Roof Repair, Complete Lump Sum Bid:
The lump sum contract price for "Roof Repair Complete" shall be full pay for performing
the work as specified and per manufacturer's specifications. Including but not limited to; developing all
submittals; furnishing and operating fixed and movable work platforms; accommodating Contracting
Agency inspection access; providing all material, labor, tools, and equipment;
YFD Station #91 (approximately 15,000 sf), YFD Station #95 (approximately 12,500 sf):
• Remove all roofing down to wood decking and dispose of.
• Remove all wall metal, coping metal, misc. flashings and dispose of.
• Install tapered crickets in between roof drains as necessary.
• Install crickets behind large curbs as necessary.
• Directly over wood decking loose lay a 6 mil. Visqueen.
• Mechanically attach a 60 mil. TPO membrane in the color of white.
• Install 60 mil. TPO membrane fully adhered at parapet walls. Wall flashing to go up and
out over top of parapet wood nailer.
• Where wall flashing partially goes up walls install termination bar set in sealant.
• All curbs, pipes, vents, drains and other misc. protrusions to be flashed according to
manufacturer specifications.
• Install TPO walkpad to and from roof access hatches & ladders to large HVAC units
0
• Reseal tops of skylights with np -1 sealant.
• Install new 24 gauge wall metal as necessary at top of wall flashing over termination bar.
• Install new pre finished 24 gauge coping metal including continuous cleat replacing
existing around entire perimeter of building.
• 15 year MDL manufacturer's warranty to be included in bid.
At Fire Station 91 (Front Street), the Contractor shall furnish and install a new steel roof ladder
replacing existing. Cost of ladder and installation shall be included in the bid item, "Roof Repair
YFD Station #91, Complete." Ladder shall, at a minimum, meet the standard provided in
International Mechanical Code - 306.5:
Permanent ladders installed to provide the required access shall comply with the following minimum
design criteria:
1. The side railing shall extend above the parapet or roof edge not less than 30 inches (762 mm).
2. Ladders shall have rung spacing not to exceed 14 inches (356 mm) on center.
3. Ladders shall have a toe spacing not less than 6 inches (152 mm) deep.
4. There shall be a minimum of 18 inches (457 mm) between rails.
5. Rungs shall have a minimum 0.75 -inch (19 mm) diameter and be capable of withstanding a 300 -
pound (136.1 kg) load.
6. Ladders over 30 feet (9144 mm) in height shall be provided with offset sections and landings
capable of withstanding 100 pounds per square foot (488.2 kg /m2). Landing dimensions shall be not
less than 18 inches (457 mm) and not less than the width of the ladder served. A guard rail shall be
provided on all open sides of the landing.
7. Ladders shall be protected against corrosion by approved means.
15. Roof Sub Surface Repair:
This work shall consist of repairing, removing, and /or replacing any plywood surfacing that is deemed
unfit sub surfacing for the new roofing. This shall include all labor, materials, and disposal of existing
materials.
Payment for "Roof Sub Surface Repair" shall be made by force account.
For the purpose of providing a common proposal for all bidders, and for that purpose only, the City has
estimated the force account for "Roof Sub Surface Repair ", and has arbitrarily entered the amount for the
pay item in the proposal to become a part of the total bid by the Contractor.
17. Business License:
All bidders shall have a valid and current business license issued by the City of Yakima covering this type
of work. It will be the contractor's responsibility to obtain any licenses or permits required, to complete the
project.
18. Right to Reject:
The City of Yakima reserves the right to reject any or all quotes or accept any presented which meet or
exceed these specifications and which they may deem to be in the best interest of the City and will not
necessarily be bound to accept the low quote.
19. No Preferences:
No exceptions will be considered that may tend to give an individual bidder a distinct advantage.
20. Contractor's Liability Insurance (Sample Certificate Attached):
The contractor shall obtain and maintain in full force and effect during the term of the contract,
commercial general liability coverage and automobile coverage with insurance carriers admitted to do
business in the State of Washington. The insurance companies must carry a Best's Rating of A- VII or
7
better. The policies will be written on an occurrence basis subject to the following minimum limits of
liability:
Commercial General Liability:
Combined Single Limit: $1,000,000 Per Occurrence
$2,000,000 Annual Aggregate
The City of Yakima, its agents, elected and appointed officials, and employees are to be listed as
additional insured under the policies.
The contractor will provide a Certificate of Insurance to the City as evidence of coverage. The certificate
will provide 45 days notice of cancellation, and under the cancellation section, the wording "endeavor to"
and "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its
agents or representatives" will be crossed out. A copy of the additional insured endorsement attached to
the policy will be included with the certificate.
The contract shall also maintain workers compensation through the State of Washington. If at any time
during the life of the contract or any extension, the contractor fails to maintain the required insurance in
full force and effect, all work under the contract shall be discontinued immediately. Any failure to maintain
the required insurance may be sufficient cause for the City to terminate the contract.
21. Experience Requirements:
Within two days of bid opening, the Contractor with the winning bid shall provide proof that they have
performed a minimum of three (3) successful roofing projects using like materials. Proof must be
submitted before the contract will be awarded.
22. Compliance with Immigration and Naturalization Act
The City of Yakima supports the Federal Immigration, Reform and Control Act of 1986, as amended. The
City requires that all contractors or business entities that contract with the City for the award of any City
contract for public works in excess of Five Thousand Dollars ($5,000), or any other City contract in excess
of Two Thousand Five Hundred Dollars ($2,500), enroll in the E- Verify program or its successor, and
thereafter to verify its employees' proof of citizenship and authorization to work in the United States.
E- Verify will be used for newly hired employees during the term of the contract only; it is not to be used
for existing employees.
The Contractor must remain enrolled in the program for the duration of the contract and be responsible
for verification of every applicable subcontractor. If the contractor has not previously filed an E- Verify
Compliance Declaration with the City, the contractor must sign the attached E- Verify Compliance
Declaration and submit it to the City prior to being awarded the contract. Failure to do so may be cause
for rejection of the bid.
23. Repair or Replacement:
This work shall consist of repair of any incidental damages to miscellaneous items within or adjacent to
the project area. This includes complete replacement of items that are beyond repair as determined by
the Engineer.
Payment for "Repair or Replacement" shall be made by force account.
For the purpose of providing a common proposal for all bidders, and for that purpose only, the City has
estimated the force account for "Repair and Replacement ", and has arbitrarily entered the amount for the
pay item in the proposal to become a part of the total bid by the Contractor.
24. Weather Limits:
Contractors will adhere to all manufactures recommendations and /or limitations while placing new roofing.
CONTRACT ti
THIS AGREEMENT, made and entered into in triplicate, this I day o 2013, by and between the City of Yakima, hereinafter called
the Owner, and Leslie & Campbell, Inc. a Washington Corporation, her i fter called the Contractor.
p 9 P
WITNESSETH:
That in consideration of the terms and conditions contained herein and attached and made a part of this agreement, the parties hereto covenant and
agree as follows:
I. The Contractor shall do all work and furnish all tools, materials, labor and equipment for THE BID AMOUNT OF:
$176,344.36, for Yakima Fire Department- Station 91 and 95 Roofing Rehabilitations, City of Yakima Job No.2352, all in accordance with, and
as described in the attached plans and specifications and the 2012 Standard Specifications for Road, Bridge, and Municipal Construction which are
by this reference incorporated herein and made a part hereof, and shall perform any alterations in or additions to the work provided under this
contract and every part thereof.
Work shall start within ten (10) days after the Notice to Proceed and shall be completed in Thirty (30) working days. The first chargeable working day
shall be the 11 th working day after the date on which the City issues the Notice to Proceed.
If said work is not completed within the time specified, the Contractor agrees to pay to the Owner the sum specified in the Standard Specifications for
each and every day said work remains uncompleted after expiration of the specified time, as liquidated damages.
The Contractors shall provide and bear the expense of all equipment; work and labor of any sort whatsoever that may be required for the transfer of
materials and for constructing and completing the work provided for in this contract and every part thereof, except such as are mentioned in the
specifications to be furnished by the City of Yakima.
II, The City of Yakima hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the
materials and to do and cause to be done the above described work and to complete and finish the same according to the attached plans and
specifications and the terms and conditions herein contained and hereby contracts to pay for the same according to the attached specifications and
the schedule of unit or itemized prices hereto attached, at the time and in the manner and upon the conditions provided for in this contract.
III. INDEMNIFICATION. The Contractor shall defend, indemnify, and hold harmless the City, its officers, elected officials, employees and
agents from and against any and all claims, causes of action, damages, losses, and expenses of any kind or nature whatsoever, including but not
limited to, attorney's fees and court costs, arising out of, relating to, or resulting from The Contractor's performance or non - performance of the
services, duties and obligations required of it under this Agreement.
IV. The Contractor for himself, and for his heirs, executors, administrators, successors, and assigns, does hereby agree to the full
performance of all the covenants herein contained upon the part of the Contractor.
V. It is further provided that no liability shall attach to the City of Yakima by reason of entering into this contract, except as expressly
provided herein.
IN WITNESS WHEREOF the parties hereto have caused this agreement to be executed the day and year first herein above written.
CITY OF YAKIMA
CONTRACTOR
6 M ffla 1-. C a Corporation
Contra r
By: /n�----
(Print Name)
Its: ?9a51 hE.&T_
(President, Owner, etc.)
Address: 15NO AWT/aAWK Aa.. //wwrTAP
T
AdA 9B9o3
9
PERFORMANCE BOND
BOND TO CITY OF YAKIMA
KNOW ALL MEN BY THESE PRESENTS:
Bond No. 105911146
That whereas the City of Yakima, Washington has awarded to Leslie & Campbell, Inc. (Contractor) hereinafter designated as the 'Principal' a
contract for the construction of the project designated Yakima Fire Department — Station 91 and 95 Roofing Rehabilitations Proiect No 2352
all as hereto attached and made a part hereof and whereas, said principal is required under the terms of said contract to furnish a bond for the
faithful performance of said contract:
NOW, THEREFORE, we, the principal, and TraWl.Ers Q&�ty and Surety Company of America (Surety), a corporation,
organized and existing under and by virtue of the laws of the State of CT . duly authorized to do business in the State of
Washington, as surety, are jointly and severally held and firmly bound unto the City of Yakima, Washington, in the sum of $176, 344.36 1 (Total
Contract Amount) lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs,
executors, administrators, successors and assigns, jointly and severally, firmly by those presents.
THE CONDITIONS OF THIS OBLIGATIONS IS SUCH, that if the above bonded principal shall faithfully perform all of the provisions of said contract
in the manner and within the time therein set forth, or within such extensions of time as may be granted under said contract, and shall pay all
laborers, mechanics, sub - contractors and material men, and all persons who shall supply said principal or sub - contractors with provisions and
supplies for the carrying on of said work, and shall hold said City of Yakima, Washington, their employees, agents, and elected or appointed officials,
harmless from any damage occasioned to any person or property by reason of any carelessness or negligence on the part of said principal, or any
sub - contractor in the performance of said work and shall indemnify and hold the City of Yakima, Washington, its employees, agents, and elected or
appointed officials, harmless from any damage or expense by reason of failure of performance as specified in said contract or from defects
developing in the material or workmanship provided or performed under said contract, within a period of one year after its acceptance by the City of
Yakima, Washington, then and in that event this obligation shall be void; but otherwise it shall be and remain in full force and effect.
This obligation is entered into in pursuance of the statutes of the State of Washington, and the Ordinances of the City of Yakima, Washington.
IN WITNESS WHEREOF, the said principal and the said surety have caused this bond to be signed and sealed by their duly authorized officers this
day of May , 2013
Lesli pbell, In
(Principal)
By:
D (Signature)
Ittxi r C' 14 "�
(Print Na e)
Approved as to form: Pan-f !!-
(Title)
( homey)
T:ayelers Casualty and Surety Company of America
84 Uu II u W
(Signature)
Lori McKimmy
(Print Name)
Attorney -in -Fact
(Title)
11
WITHOUT THE RED
POWER OF ATTORNEY
TRAVELERSJ Farmington Casualty Company St. Paul Mercury Insurance Company
Fidelity and Guaranty Insurance Company Travelers Casualty and Surety Company
Fidelity and Guaranty Insurance Underwriters, Inc. Travelers Casualty and Surety Company of America
St. Paul Fire and Marine Insurance Company United States Fidelity and Guaranty Company
St. Paul Guardian Insurance Company
Attorney -In Fact No. 226181 Certificate No. 005462667
KNOW ALL MEN BY THESE PRESENTS: That Farmington Casualty Company, St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance
Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States
Fidelity and Guaranty Company are corporations duly organized under the laws of the State of Connecticut, that Fidelity and Guaranty Insurance Company is a
corporation duly organized under the laws of the State of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organized under the
laws of the State of Wisconsin (herein collectively called the "Companies "), and that the Companies do hereby make, constitute and appoint
Donna S. Martinez, Kenneth J. Frick, Alex B. Hodge, Rodney C. Lewis, and Lori McKimmy
of the City of Yakima , State of Washington , their true and lawful Attorneys) -in -Fact,
each in their separate capacity if more than one is named above, to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and
other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of
contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
IN WITNESS WHEREOF, the Companies have caused this instrument to be signed and their corporate seals to be hereto affixed, this 12th
day of February 2013
Farmington Casualty Company
Fidelity and Guaranty Insurance Company
Fidelity and Guaranty Insurance Underwriters, Inc.
St. Paul Fire and Marine Insurance Company
St. Paul Guardian Insurance Company
St. Paul Mercury Insurance Company
Travelers Casualty and Surety Company
Travelers Casualty and Surety Company of America
United States Fidelity and Guaranty Company
rG/.SU.A�` •� J�F \FE 6,4't aN..�MS P \ �' ,II AN O(�F. NARTFORDALi3 Cot N`da •
State of Connecticut
City of Hartford ss.
By:
Robert L. Raney; enior Vice President
On this the 12th day of February 2013 before me personally appeared Robert L. Raney, who acknowledged himself to
be the Senior Vice President of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul
Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers
Casualty and Surety Company of America, and United States Fidelity and Guaranty Company, and that he, as such, being authorized so to do, executed the foregoing
instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
C'.7
In Witness Whereof, I hereunto set my hand and official seal.
My Commission expires the 30th day of June, 2016.
58440 -8 -12 Printed in U.S.A.
WARNING: THIS POWER OF ATTORNEY IS I
`(� cam► (°..
Marie C. Tetreault, Notary Public
THE RED BORDER
NEY IS INVALID WITHOUT THE RED BORDER
This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Farmington Casualty Company, Fidelity
and Guaranty Insurance Company: Fidelity and Guaranty Insurance Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance S
Company, St. Paul Mercury Insurance Company, Travelers Casualty and Surety Company, Travelers Casualty and Surety Company of America, and United States
Fidelity and Guaranty Company, which resolutions are now in full force and effect, reading as follows:
RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President, any Second Vice
President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys -in -Fact and Agents to act for and on behalf
of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the
Company's seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any
of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her; and it is
FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may
delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy
thereof is filed in the office of the Secretary; and it is
FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking
shall be valid and binding, upon the Company when (a) signed by the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice
President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the
Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power
prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is
FURTHER RESOLVED, that the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice President,
any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any
certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for purposes only of executing and attesting bonds
and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal
shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on
the Company in the future with respect to any bond or understanding to which it is attached.
I, Kevin E. Hughes, the undersigned, Assistant Secretary, of Farmington Casualty Company, Fidelity and Guaranty Insurance Company, Fidelity and Guaranty Insurance
Underwriters, Inc., St. Paul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance Company, Travelers Casualty and
Surety Company, Travelers Casualty and Surety Company of America, and United'States Fidelity'and Guaranty Company do hereby certify that the above and foregoing
is a true and correct copy of the Power of Attorney executed by said Companies, which�is in frill force and`effect and has not been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this day of MV 20 13
illGl es�
Kevin E. Hughes, Assistant Sec tary
GI.SU,��r p.)s�•• ' F�pE �6 y o��N..IMSp9 ;P�' �nsu q.` �Jp�tY ANae ��y� t`tt1,�
1 9 8 2 O � i s a: -._ , a HARTFORD, lt7AfF0aq �! <
7977 �:. �nJ �i 'o� m CONN. n � OONN. 1896
any ��', d �bma,n:u;mm�e !S ...... *A d1 �' • �Y! AN�fi`"
To verify the authenticity of this Power of Attorney, call 1- 800 - 421 -3880 or contact us at www.travelersbond.com. Please refer to the Attorney -In -Fact number, the
above -named individuals and the details of the bond to which the power is attached.
OF ATTORNEY IS INVALID WITHOUT THE RED
�' ' 1 la
A� ° CERTIFICATE OF LIABILITY INSURANCE
DATE (MM /DD/Y
5/21/2013 3
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
Terril Lewis & Wilke Ins
P O Box 1789
NAME: CT Donna Martinez
PHONE (509) 248 -3515 FA/7C( o . (509)248 -3673 0.
E-MAIL . dmartinez@ tlwins . com
112 S 4th Street
Yakima WA 98907
INSURERS AFFORDING COVERAGE
NAIC p
INSURERA:Contlnental Insurance Company
5289
INSURED
Leslie & Campbell, Inc.
506 Lower Ahtanum Rd
INSURER B:De oslters Insurance Company
42587
INSURERC:Continental Casualty Company
0443
INSURER D:
EACH OCCURRENCE
INSURER E
X COMMERCIAL GENERAL LIABILITY
Union Gap WA 98903
INSURER F
COVERAGES CERTIFICATE NUMBER:13 -14 GASU 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
LTR
TYPE OF INSURANCE
ADDL
SUBR
_MD
POLICY NUMBER
POLICY EFF
MMIDDNYYY )
POLICY EXP
(MMIDDNYYYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1, 000, 000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
P REMISES (Ea occurrence
$ 100,000
A
CLAIMS -MADE a OCCUR
028838475
/1/2013
/1/2014
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
-]
PRODUCTS - COMP /OP AGG
$ 2,000,000
JECT F-] POLICY X PRO-
LOC
$
AUTOMOBILE
LIABILITY
OMBINEDI SINGLE LIMIT
1,000,000
X
BODILY INJURY (Per person)
$
B
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
ACP7506120790
/1/2013
/1/2014
BODILY INJURY (Per accident)
$
NON -OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
Per accident
$
Medical payments
$ 5,000
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 9,000,000
AGGREGATE
$ 9,000,000
C
EXCESS LIAB
CLAIMS -MADE
DED X RETENTION$ 10,00
$
5093947011
/1/2013
/1/2014
A
WORKERS COMPENSATION
WC STATU- OTH-
AND EMPLOYERS' LIABILITY YIN
E.L. EACH ACCIDENT
$ 1,000,000
ANY PROPRIETOR /PARTNER /EXECUTIVE
A State Stop Gap
OFFICER /MEMBER EXCLUDED?
(Mandatory in NH)
N/A
4028838475
/1/2013
/1/2014
If yes, describe under
E L. DISEASE - EA EMPLOYEE
$ 1,000,000
E L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
The City of Yakima, City of Union Gap, their agents, employees, volunteers, and elected and appointed
officials are named as additional insureds, per form G- 18652 -J 0712 Coverage is primary and
non - contributory per form G- 18652 -J 0712 Waiver of Subrogation applies per form G- 18652 -J 0712
Project: Yakima Fire Department - Station 91 and 95 Roofing Rehabilitation project No. 2352
v"M r lrf%om i c nvwV_;rn _ L:AIVGtLLA I IUN
City of Yakima
129 N 2nd Street
Yakima, WA 98901
Al'u cu ca tcUTU/Ual
INS025 (201005).01
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
Frick /DONNA~
9 1988 -2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Po 4028838475
Arm
G- 18652 -J
(Ed. 07 -12)
CONTRACTORS' GENERAL LIABILITY EXTENSION ENDORSEMENT
It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE
PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been
excluded or amended by another endorsement attached to this policy.
SCHEDULE
Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the
corresponding policy provisions in the body of this endorsement.
1. Additional insureds
Seven additional insured extensions.
2. Bodily injury — Expanded Definition
3. Broad Knowledge of Occurrence/ Notice of Occurrence
4. Broad Named Insured
5. Broadened Liability Coverage For Damage To "Your, Product" And "Your Work"
Limit: $100,000,
6. Contractual Liability — Railroads
Expanded definition of "insured contract."
7. Contractual Liability For Personal And Advertising Injury
8. Electronic Data Liability
Loss of Electronic Data Limit: $100,000.
9. Expanded Personal And Advertising Injury - Discrimination Or Humiliation
10. Expected Or Intended Injury
Reasonable force — "bodily injury' or "property damage."
11. General Aggregate Limits Of Insurance - Per Project
12. In Rem Actions
13. Incidental Health Care Malpractice Coverage
14. Joint Ventures /Partnership /Limited Liability Companies
Coverage for your interest in such terminated or ended organizations.
15. Legal Liability /Alienated Premises /Borrowed Equipment Coverage
Extended perils.
Default limit increased to $500,000 for Damage to Premises Rented To You.
$25,000 limit for "property damage" to borrowed tools or equipment at a jobsite.
16. Liberalization Clause
17. Liquor Liability Coverage Extension
18. Medical Payments
Limits increased to $15,000.
Reporting increased to three years from the date of accident.
19. Non -owned Aircraft Coverage
20. Non -owned Watercraft
Increased to 75 feet.
21. Primary And Non - Contributory To Other Insurance
22. Property Damage - Elevators
23. Supplementary Payments
Cost of bail bonds increased to $5,000.
Daily loss of earnings increased to $1,000.
24. Unintentional Failure To Disclose Hazards
25. Waiver of Subrogation - Blanket
Waiver of subrogation where required by written contract or written agreement.
26. Wrap -Up Extension
G- 18652 -J (Ed. 07 -12)
Page 1 of 12
Copyright, CNA All Rights Reserved.
1. ADDITIONAL INSURED
SECTION II — WHO IS AN INSURED is amended to
include as an insured any person or organization
(called additional insured) described in paragraphs
A. through G. below whom you are required to add
as an additional insured on this policy under a
written contract or written agreement, provided the
written contract or written agreement:
i. Is currently in effect or becomes effective
during the term of this policy; and
iii. Was executed prior to the "bodily injury,"
"property damage" or "personal injury and
advertising injury" for which the additional
Insured seeks coverage.
However, we will not provide the additional
Insured any broader coverage or any higher limit
of insurance than the least that is:
a. The maximum permitted by law;
b. Required in the written contract or written
agreement;
c. Afforded to you under this policy; or
d. Described in the applicable paragraphs A.
through G. below.
A. Controlling Interest
Any persons or organizations with a controlling
Interest in you but only with respect to their
liability arising out of:
1. Their financial control of you; or
2. Premises they own, maintain or control
while you lease or occupy these premises.
This insurance does not apply to structural
alterations, new construction and demolition
operations performed by or for such additional
insured.
B. Co -owner of Insured Premises
A co -owner of a premises co -owned by you and
covered under this insurance but only with
respect to the co- owner's liability as co -owner of
such premises.
C. Lessor - Equipment
Any person or organization from whom you
lease equipment, but only with respect to
liability for "bodily injury," "property damage"
or "personal 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.
G-1 8662-J (Ed. 07 -12)
Page 2 of 12
G- 18652 -J
(Ed. 07 -12)
2. 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.
D. Lessor - Land
An owner or other interest from whom land has
been leased by you but only with respect to
liability arising out of the ownership,
maintenance or use of that specific part of the
land leased to you and subject to the following
additional exclusions:
This insurance does not apply to:
1. Any 'occurrence" which takes place after
you cease to lease that land; or
2. Structural alterations, new construction or
demolition operations performed by or on
behalf of such additional insured.
E. Lessor - Premises
A manager or lessor of premises but only with
respect to liability arising out of the ownership,
maintenance or use of that specific part of the
premises leased to you and subject to the
following additional exclusions:
This insurance does not apply to:
1. Any 'occurrence" which takes place after
you cease to be a tenant in that premises;
or
2. Structural alterations, new construction or
demolition operations performed by or on
behalf of such additional insured.
F. Mortgagee, Assignee or Receiver
A mortgagee, assignee or receiver but only with
respect to their liability as mortgagee, assignee,
or receiver and arising out of the ownership,
maintenance, or use of a premises by you.
This insurance does not apply to structural
alterations, new construction or demolition
operations performed by or for such additional
insured.
G. State or Governmental Agency or
Subdivision or Political Subdivisions
A state or governmental agency or subdivision
or political subdivision subject to the following
provisions:
1. This insurance applies only with respect to
the following hazards for which the state or
governmental agency or subdivision or
political subdivision has issued a permit or
authorization in connection with premises
Copyright, CNA All Rights Reserved.
ate►
you own, rent, or control and to which this
insurance applies:
a. The existence, maintenance, repair,
construction, erection, or removal of
advertising signs, awnings, canopies,
cellar entrances, coal holes, driveways,
manholes, marquees, hoistaway
openings, sidewalk vaults, street
banners, or decorations and similar
exposures; or
b. The construction, erection, or removal
of elevators; or
c. The ownership, maintenance or use of
any elevators covered by this insurance.
2. 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.
3. This insurance does not apply to:
a. "Bodily injury,' "property damage" or
"personal and advertising injury" arising
out of operations performed for the
federal government, state or
municipality; or
b. "Bodily injury" or "property damage"
included within the "products- completed
operations hazard"
A governmental permit which requires you to
add the governmental entity as an additional
insured will trigger this Provision 1. as if the
permit were a written contract.
2. BODILY INJURY — EXPANDED DEFINITION
SECTION V — DEFINITIONS, the definition of
"bodily injury" is changed to read:
"Bodily injury" means bodily injury, sickness or
disease sustained by a person, including death,
humiliation, shock, mental anguish or mental injury
by that person at any time which results as a
consequence of the bodily injury, sickness or
disease.
3. BROAD KNOWLEDGE OF OCCURRENCE/
NOTICE OF OCCURRENCE
Condition 2. Duties In The Event of Occurrence,
Offense, Claim or Suit of SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS is amended to add the following
provisions:
A. BROAD KNOWLEDGE OF OCCURRENCE
U-- J0Q0Z -J tcu, U/-1Z)
Page 3 of 12
G- 18652 -J
(Ed. 07 -12)
You must give us or our authorized
representative notice of an "occurrence,"
offense, claim, or "suit" only when the
"occurrence," offense, claim or "suit" is known
to:
(1) You, if you are an individual;
(2) A partner, if you are a partnership;
(3) An executive officer or the employee
designated by you to give such notice, if you
are a corporation; or
(4) A manager, if you are a limited liability
company.
B. NOTICE-OF OCCURRENCE
Your rights under this Coverage Part will not be
prejudiced if you fail to give us notice of an
"occurrence," offense, claim or "suit" and that
failure is solely due to your reasonable belief
that the "bodily injury' or "property damage" is
not covered under this Coverage Part. However,
you shall give written notice of this "occurrence,"
offense, claim or "suit" to us as soon as you are
aware that this insurance may apply to such
"occurrence," offense claim or "suit."
4. BROAD NAMED INSURED
A. Any subsidiary or affiliate organization, other
than a partnership, joint venture or limited
liability company, in which a Named Insured
specifically shown in the Declarations has
management control, directly or through one or
more subsidiary organizations, at the time of
loss will qualify as a Named Insured but only if
there is no other similar insurance available to
such organization, nor similar insurance which
would be available but for exhaustion of its
limits. For the purpose of this provision, similar
insurance means general liability or equivalent
insurance, no matter whether its coverage is
broader or narrower than that provided by this
Insurance. But if the only other similar insurance
is for a "consolidated (wrap -up) program," then
a subsidiary that qualifies as a Named Insured
on such project - specific insurance can still
qualify as a Named Insured on this insurance,
but not for projects covered by the "consolidated
(wrap -up) program."
[Please see Item 26.C. of this endorsement for
the definition of "consolidated (wrap -up)
program. "]
B. This endorsement does not apply to any
organization for which coverage is excluded by
another endorsement attached to this policy.
C. Only for the purpose of this endorsement:
Copyright, CNA All Rights Reserved.
�Z/ J
1. Management control means:
a. Ownership interest representing more
than 50% of the voting, appointment, or
designation power for the subsidiary
organization's governing body; or
b. Having the right, pursuant to a written
contract, or pursuant to the by -laws,
charter, operating agreement, or similar
document of a specifically shown
Named Insured or controlled subsidiary
organization to select, appoint, or
designate a majority of the subsidiary
organization's governing body. Such
contract or document must have been
created prior to the time of loss; or
c. Having the right, pursuant to a written
trust agreement, to protect, control the
use of, encumber or transfer and sell
property held by a trust.
2. Governing body means the Board of
Directors of a corporation.
3. Loss means:
a. The occurring of the "bodily Injury" or
"property damage "; or
b. The committing of the offense that
caused the "personal and advertising
injury."
D. The insurance provided by this policy applies to
Named Insureds when trading under their own
names, or under such trading names or doing -
business-as (DBA) names as any should
choose to employ.
5. BROADENED LIABILITY COVERAGE FOR
DAMAGE TO "YOUR PRODUCT" AND "YOUR
WORK"
G- 18652 -J
(Ed. 07 -12)
I. Damage to Your Work
"Property damage" to "your work" arising out of
it, or any part of it and included in the "products -
completed operations hazard."
This exclusion does not apply:
(1) If the damaged work or the work out of
which the damage arises was
performed on your behalf by a
subcontractor; or
(2) If the cause of loss to the damaged
work arises as a result of:
(a) Fire;
(b) Smoke;
(c) Collapse; or
(d) Explosion.
B. The following paragraph is added to SECTION
III — LIMITS OF INSURANCE:
Subject to 5. above, $100,000 is the most we
will pay under Coverage A for the sum of
damages arising out of any one "occurrence"
because of "property damage" to "your product"
and "your work" that is caused by fire, smoke,
collapse or explosion and is included within the
"product- completed operations hazard." This
sublimit does not apply to "property damage" to
"your work" if the damaged work or the work out
of which the damage arises was performed on
your behalf by a subcontractor.
C. This Provision 5. Broadened Liability
Coverage For Damage To "Your Product"
And "Your Work" does not apply if an
endorsement of the same name is attached to
this policy.
6. CONTRACTUAL LIABILITY — RAILROADS
A. Under SECTION I — COVERAGE A — BODILY With respect to operations performed within 50 feet
INJURY AND PROPERTY DAMAGE of railroad property, the definition of "insured
LIABILITY, Paragraph 2. Exclusions is amended contract" in SECTION V — DEFINITIONS is
to delete exclusions k. and I. and replace them
with the following: replaced by the following:
[This insurance does not apply to:]
k. Damage to Your Product
"Property damage" to "your product" arising
out of it, or any part of it except when
caused by or resulting from:
(1) Fire;
(2) Smoke;
(3) Collapse; or
(4) Explosion.
G-1 8652-J (Ed. 07 -12)
Page 4 of 12
"Insured Contract" means:
a. A contract for a lease of premises. However,
that portion of the contract for a lease of
premises that indemnifies any person or
organization for damage by fire to premises
while rented to you or temporarily occupied by
you with permission of the owner Is not an
"insured contract ";
b. A sidetrack agreement;
c. Any easement or license agreement;
Copyright, CNA All Rights Reserved.
aw►
d. An obligation, as required by ordinance, to
indemnify a municipality, except in connection
with work for a municipality;
e. An elevator maintenance agreement;
That part of any other contract or agreement
pertaining to your business (including an
Indemnification of a municipality In connection
with work performed for a municipality) under
which you assume the tort liability of another
party to pay for 'bodily injury" or "property
damage" to a third person or organization. Tort
liability means a liability that would be imposed
by law in the absence of any contract or
agreement.
Paragraph f. does not include that part of any
contract or agreement:
(1) That indemnifies an architect, engineer or
surveyor for injury or damage arising out of:
(a) Preparing, approving or failing to
prepare or approve maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or drawings
and specifications; or
(b) Giving directions or instructions, or
failing to give them, if that is the primary
cause of the injury or damage;
(2) Under which the insured, if an architect,
engineer or surveyor, assumes liability for
an injury or damage arising out of the
Insured's rendering or failure to render
professional services, including those listed
in (1) above and supervisory, inspection,
architectural or engineering activities.
7. CONTRACTUAL LIABILITY FOR PERSONAL
AND ADVERTISING INJURY
Under SECTION I — COVERAGE B — PERSONAL
AND ADVERTISING INJURY LIABILITY, Paragraph
2. Exclusions is amended to delete exclusion e.
Contractual Liability.
This provision 7. does not apply to any person or
organization who otherwise qualifies as an
additional insured on this Coverage Part.
8. ELECTRONIC DATA LIABILITY
A. Under SECTION I — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE,
Paragraph 2. Exclusions is amended to delete
exclusion p. Electronic Data and replace it with
the following:
[This insurance does not apply to:]
p. Electronic Data
G- 18652 -J (Ed. 07 -12)
Page 5 of 12
G-1 8652-J
(Ed. 07 -12)
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. The following paragraph is added to SECTION
III — LIMITS OF INSURANCE:
Subject to 5. above, $100,000 is the most we
will pay under Coverage A for all damages
arising out of any one "occurrence" because of
"property damage" that results from physical
injury to tangible property and arises out of
"electronic data."
C. The following definition is added to the
SECTION V — DEFINITIONS:
"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, tapes, drives,
cells, data processing devices or any other
media which are used with electronically
controlled equipment.
D. For the purposes of the coverage provided by
this endorsement, the definition of "property
damage" in SECTION V — DEFINITIONS is
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;
b. 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
c. 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 insurance,
"electronic data" is not tangible property.
E. If Electronic Data Liability is provided at a higher
limit by another endorsement attached to this
Copyright, CNA All Rights Reserved.
r 4�A V/
policy, then the $100,000 limit provided by this
Provision 8. Electronic Data Liability is part of,
and not in addition to, that higher limit.
9. EXPANDED PERSONAL AND ADVERTISING
INJURY - DISCRIMINATION OR HUMILIATION
A. SECTION V — DEFINITIONS is amended to add
the following to the definition of "Personal and
advertising injury":
h. Discrimination or humiliation that results in
injury to the feelings or reputation of a
natural person, but only if such
discrimination or humiliation is:
(1) Not done intentionally by or at the
direction of:
(a) The insured; or
(b) Any "executive officer," director,
stockholder, partner, member or
manager (if you are a limited liability
company) of the insured; and
(2) Not directly or indirectly related to the
employment, prospective employment,
past employment or termination of
employment of any person or persons
by any insured.
B. Under SECTION I — COVERAGE B —
PERSONAL AND ADVERTISING INJURY
LIABILITY, Paragraph 2. Exclusions is
amended to add the following additional
exclusions:
[This insurance does not apply to:]
Discrimination Relating To Room,
Dwelling or Premises
"Personal or advertising injury" caused by
discrimination directly or indirectly related to
the sale, rental, lease or sub -lease or
prospective sale, rental, lease or sub -lease
of any room, dwelling or premises by or at
the direction of any insured.
Fines Or Penalties
Fines or penalties levied or imposed by a
governmental entity because of
discrimination.
This provision 9. does not apply to any person
or organization who otherwise qualifies as an
additional insured on this Coverage Part.
10. EXPECTED OR INTENDED INJURY
Under SECTION I —COVERAGE A— BODILY
INJURY AND PROPERTY DAMAGE
LIABILITY, Paragraph 2. Exclusions is
amended to delete exclusion a. Expected or
G- 18652 -J (Ed. 07 -12)
Page 6 of 12
G- 18652 -J
(Ed. 07 -12)
Intended Injury and replace it with the
following:
[This insurance does not apply to :]
a. Expected or Intended Injury
"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.
11. GENERAL AGGREGATE LIMITS OF
INSURANCE - PER PROJECT
A. For each construction project away from
premises you own or rent, a separate
Construction Project General Aggregate
Limit, equal to the amount of the General
Aggregate Limit, is the most we will pay for
the sum of:
1. All damages under Coverage A, except
damages because of "bodily injury' or
"property damage" included in the
"products- completed operations
hazard "; and
2. All medical expenses under Coverage
C,
that arise from "occurrences" or
accidents which can be attributed solely
to ongoing operations at that
construction project. Such payments
shall not reduce the General Aggregate
Limit shown in the Declarations, nor the
Construction Project Aggregate Limit of
any other construction project.
B. All:
1. Damages under Coverage B, regardless of
the number of locations or construction
projects involved;
2. Damages under Coverage A, caused by
"occurrences" which cannot be attributed
solely to ongoing operations at a single
construction project, except damages
because of "bodily injury" or "property
damage" included in the "products -
completed operations hazard "; and
3. Medical expenses under Coverage C
caused by accidents which cannot be
attributed solely to ongoing operations at a
single construction project,
will reduce the General Aggregate Limit shown
in the Declarations.
Copyright, CNA All Rights Reserved.
AMALMM
C. The limits shown in the Declarations for Each
Occurrence, for Damage To Premises Rented
To You and for Medical Expense continue to
apply, but will be subject to either the
Construction Project Aggregate Limit or the
General Aggregate Limit, depending on whether
the "occurrence" can be attributed solely to
ongoing operations at a particular construction
project.
D. When coverage for liability arising out of the
"products - completed operations hazard" is
provided, any payments for damages because
of "bodily injury' or "property damage" included
in the "products - completed operations hazard,"
regardless of the number of locations involved
will reduce the Products- Completed Operations
Aggregate Limit shown in the Declarations.
E. If a single construction project away from
Premises owned by or rented to the insured has
been abandoned and then restarted, or if the
authorized contracting parties deviate from
plans, blueprints, designs, specifications or
timetables, the project will still be deemed to be
the same construction project.
F. The provisions of SECTION III — LIMITS OF
INSURANCE not otherwise modified by this
endorsement shall continue to apply as
stipulated.
12. IN REM ACTIONS
Any action in rem against any vessel owned or
operated by or for you, or chartered by or for you will
be treated in the same manner as though the action
were in personam against you.
In rem is a term used to designate actions instituted
against the thing, as distinct from actions against
the person, which are said to be in personam.
13. INCIDENTAL HEALTH CARE MALPRACTICE
COVERAGE
A. With respect only to "bodily injury" that arises
out of a "health care incident," COVERAGE A —
BODILY INJURY AND PROPERTY DAMAGE
LIABILITY OF SECTION I — COVERAGES is
amended to replace Insuring Agreement
Paragraphs 1.b.(1) and 1.b.(2) with the
following:
b. This insurance applies to "bodily injury' only
if you are not in the business of providing
professional health care services, and only
If:
G- 18652 -J
(Ed. 07 -12)
(a) "Bodily injury' caused by a "health
care incident" will be considered
caused by an "occurrence "; and
(b) All acts, errors or omissions that
are logically connected by any
common fact, circumstance,
situation, transaction, event, advice
or decision will be considered to
constitute a single "occurrence ";
(2) The "bodily Injury' occurs during the
policy period. All "bodily injury" arising
from an "occurrence" will be deemed to
have occurred at the time of the first
act, error, or omission that is part of the
"occurrence "; and
B. With respect only to the insurance provided by
this Provision 13., Exclusion 2.e. Employer's
Liability of SECTION I — COVERAGE A —
BODILY INJURY AND PROPERTY DAMAGE,
is amended to append the following:
Only for "bodily injury" not covered by other
liability insurance (including state - sanctioned
self insurance) available to the insured (or which
would be available but for exhaustion of its
limits), this exclusion does not apply to "bodily
injury" that arises out of a "health care incident."
C. SECTION V — DEFINITIONS is amended to add
the following new definition:
"Health care incident" means a negligent act,
error or omission by your "employees" or
"volunteer workers" working on your behalf In
the rendering of or failure to render professional
health care services in any of the following
capacities, or the related furnishing of food,
beverages, medical supplies or appliances:
a. Physician;
b. Nurse;
C. Emergency medical technician;
d. Paramedic;
e. Chiropractor;
f. Dentist;
g. Athletic trainer;
h. Audiologist;
I. Physical therapist;
I. Psychologist;
(1) The "bodily injury" is caused by an k. Speech therapist;
"occurrence" that takes place in the I. Other allied health professional; or
"coverage territory." For the purpose of
this insurance:
G- 18652 -J (Ed. 07 -12)
Page 7 of 12
Copyright, CNA All Rights Reserved.
m. Provider of first aid or Good Samaritan
services rendered in an emergency and for
which no payment is demanded or received.
D. SECTION I — COVERAGE A — BODILY INJURY
AND PROPERTY DAMAGE, Paragraph 2.
Exclusions is amended to add the following
additional exclusions. These new exclusions
apply only to this Incidental Health Care
Malpractice Coverage:
[This insurance does not apply to:]
Dishonesty or Crime
Any dishonest, criminal or malicious act, error or
omission.
Clinical Trials 1 Product Testing
Acts, errors or omissions that occur in the
course of human clinical trials or product
testing.
Medicare /Medicaid Fraud
Medicare or Medicaid fraud or abuse.
Services Excluded by Endorsement
Any "health care incident" for which coverage is
excluded by endorsement.
E. SECTION V —DEFINITIONS is amended to add
the following subparagraph to Paragraph f. of
the definition of "insured contract ":
Paragraph f. does not include that part of any
contract or agreement:
(4) Under which you assume another's tort
liability for "bodily injury" arising out of the
rendering of or failure to render professional
health care services.
F. SECTION II -- WHO IS AN INSURED is
amended to add the following provisions:
1. Your "employees" are insureds with respect
to:
a. "bodily injury" to a co-"employee" while
in the course of the co- "employee's"
employment by you or while performing
duties related to the conduct of your
business; and
b. "bodily injury" to a "volunteer worker"
while performing duties related to the
conduct of your business;
when such "bodily injury" arises out of a
"health care incident."
2. Your "volunteer workers" are insureds with
respect to:
G- 18652 -J (Ed. 07 -12)
Page 8 of 12
GA 8652 -J
(Ed. 07 -12)
a. "bodily injury" to a co- "volunteer worker"
while performing duties related to the
conduct of your business; and
b. "bodily injury' to an "employee" while in
the course of the "employee's"
employment by you or while performing
duties related to the conduct of your
business;
when such "bodily injury" arises out of a
"health care incident."
3. Paragraphs 2.a. (1)(a), (b) and (c) of
SECTION II — WHO IS AN INSURED do
not apply to "bodily injury" for which
insurance is provided this Provision 13.
4. Paragraph 2.a.(1)(d) of SECTION II — WHO
IS AN INSURED is deleted.
G. With respect to the insurance provided by this
Provision 13., the following is added to
Paragraph 4.b.(1) of SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS:
To the extent this insurance applies, it is excess
over any of the other insurance (including
qualified self insurance), whether primary,
excess, contingent or on any other basis, except
for insurance purchased specifically by you to
be excess of this policy.
14. JOINT VENTURES / PARTNERSHIP I LIMITED
LIABILITY COMPANIES
A. The following is added to SECTION II — WHO
IS AN INSURED:
4. You are an insured when you had an
interest in a joint venture, partnership or
limited liability company which terminated or
ended prior to or during this policy period,
but only to the extent of your interest in such
joint venture, partnership or limited liability
company. This coverage does not apply:
a. Prior to the termination date of any joint
venture, partnership or limited liability
company;
b. If there Is other valid and collectible
insurance purchased specifically to
insure the partnership, joint venture or
limited liability company; or
c. To a joint venture, partnership or limited
liability company which is or was
insured under a "consolidated (wrap -up)
insurance program."
Copyright, CNA All Rights Reserved.
[Please see Item 26.C. of this endorsement
for the definition of "consolidated (wrap -up)
program. ']
B. The last paragraph of SECTION 11 — WHO IS
AN INSURED is deleted and replaced by the
following:
Except as provided under the Contractors'
General Liability Extension Endorsement or by
the attachment of another endorsement (if any),
no person or organization Is an insured with
respect to the conduct of any current or past
partnership, joint venture or limited liability
company that is not shown as a Named Insured
In the Declarations.
15. LEGAL LIABILITY /ALIENATED PREMISES/
BORROWED EQUIPMENT
A. Under SECTION I — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE,
Paragraph 2. Exclusions Is amended to delete
exclusion j. Damage to Property in its entirety
and replace it with the following:
[This insurance does not apply to:]
J. Damage to Property
"Property damage" to:
(1) Property you own, rent, or occupy;
(2) Premises you sell, give away or
abandon, if the "property damage"
arises out of any part of those
premises;
(3) Property loaned to you;
(4) Personal property in the care, custody
or control of the insured;
(5) That particular part of real property on
which you or any contractors or
subcontractors working directly or
indirectly on your behalf are performing
operations, if the "property damage"
arises out of those operations; or
(6) That particular part of any property that
must be restored, repaired or replaced
because "your work" was incorrectly
performed on it.
Paragraph (2) of this exclusion does not
apply if the premises are "your work."
Paragraphs (3) and (4) of this exclusion do
not apply to "property damage" to tools or
equipment loaned to you. A separate limit
of insurance applies to such tools or
equipment that are damaged while being
used in your operations.
%.-J- iovac -a kau. ur - -I[j
Page 9 of 12
G-1 8652-J
(Ed. 07 -12)
Paragraphs (1), (3) and (4) of this exclusion
do not apply to "property damage" (other
than damage by fire) to premises rented to
you or temporarily occupied by you with the
permission of the owner, or to the contents
of premises rented to you for a period of 7
or fewer consecutive days. A separate limit
of insurance applies to Damage To
Premises Rented To You as described in
SECTION III — LIMITS OF INSURANCE.
Paragraphs (3), (4), (5) and (6) of this
exclusion do not apply to liability assumed
under a sidetrack agreement.
Paragraph (6) of this exclusion does not
apply to "property damage" included in the
"products- completed operations hazard."
B. Under SECTION I — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE the last
paragraph of Paragraph 2. Exclusions is deleted
and replaced by the following.
Exclusions c. through n. do not apply to
damage by fire to premises while rented to you
or temporarily occupied by you with permission
of the owner nor to the contents of premises
rented to you for a period of 7 or fewer
consecutive days.
A separate limit of insurance applies to this
coverage as described in SECTION III — LIMITS
OF INSURANCE.
C. The following paragraph is added to SECTION
III — LIMITS OF INSURANCE:
Subject to 5. above, $25,000 is the most we will
pay under Coverage A for damages arising out
of any one "occurrence" because of "property
damage" to tools or equipment loaned to you by
others that occurs while the equipment is being
used to perform operations.
D. Paragraph 6. Damage To Premises Rented To
You Limit of SECTION III — LIMITS OF
INSURANCE is replaced by the following:
6. Subject to Paragraph 5. above, (the Each
Occurrence Limit), the Damage To
Premises Rented To You Limit is the most
we will pay under SECTION — I —
COVERAGE A for damages because of
"property damage" to any one premises
while rented to you or temporarily occupied
by you with the permission of the owner,
Including contents of such premises rented
to you for a period of 7 or fewer consecutive
days. The Damage To Premises Rented To
You Limit is the greater of:
a. $500,000; or
Copydght, CNA All Rights Reserved.
a�
b. The Damage To Premises Rented To
You Limit shown in the Declarations.
E. Paragraph 4.b.(1)(a)(Ii) of SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS is deleted and replaced by the
following:
(11) That is property insurance for premises
rented to you, for premises temporarily
occupied by you with the permission of the
owner; or for personal property of others In
your care, custody or control;
F. This Provision 15. does not apply if Damage To
Premises Rented To You Liability under
SECTION — I — COVERAGE A is excluded by
endorsement.
16. LIBERALIZATION CLAUSE
If we adopt a change in our forms or rules which
would broaden coverage for contractors under this
endorsement without an additional premium charge,
your policy will automatically provide the additional
coverage as of the date the revision is effective in
your state.
17. LIQUOR LIABILITY
Under SECTION I — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE, Paragraph 2.
Exclusions is amended to delete exclusion c.
Liquor Liability.
This provision 17. does not apply to any person or
organization who otherwise qualifies as an
additional insured on this Coverage Part.
18. MEDICAL PAYMENTS
A. Paragraph 7. Medical Expense Limit, of
SECTION III — LIMITS OF INSURANCE is
deleted and replaced by the following;
7. Subject to Paragraph 5. above (the Each
Occurrence Limit), the Medical Expense
Limit is the most we will. pay under
SECTION — 1 — COVERAGE C for all
medical expenses because of "bodily injury"
sustained by any one person. The Medical
Expense Limit is the greater of:
(1) $15,000; or
(2) The amount shown in the Declarations
for Medical Expense Limit.
G-1 8652-J
(Ed. 07 -12)
This paragraph B. does not apply to medical
expenses incurred in the state of Missouri.
18. NON -OWNED AIRCRAFT
Under SECTION I — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE LIABILITY.
Paragraph 2. Exclusions is amended such that
exclusion g. Aircraft, Auto or Watercraft does not
apply to an aircraft you do not own, provided that:
1. The pilot in command holds a currently effective
certificate issued by the duly constituted
authority of the United States of America or
Canada, designating that person as a
commercial or airline transport pilot;
2. The aircraft is rented to you with a trained, paid
crew; and
3. The aircraft does not transport persons or cargo
for a charge.
20. NON -OWNED WATERCRAFT
Under SECTION 1— COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE LIABILITY,
Paragraph 2. Exclusions is amended to delete
subparagraph (2) of exclusion g. Aircraft, Auto or
Watercraft and replace it with the following.
[This exclusion does not apply to:]
(2) A watercraft you do not own that is:
(a) Less than 75 feet long; and
(b) Not being used to carry persons or property
for a charge.
21. PRIMARY AND NON - CONTRIBUTORY TO
OTHERINSURANCE
With respect to any person or organization that is an
additional insured under this Coverage Part, the
following is added to Paragraph 4. of SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS:
If you have agreed in writing in a contract or
agreement that this insurance is primary and non-
contributory relative to an additional insured's own
insurance, then this insurance is primary and we will
not seek contribution from that other insurance. For
the purpose of this Provision 21., the additional
insured's own insurance means insurance on which
the additional insured is a Named Insured.
B. Paragraph 1.a.(3)(b) of SECTION I — This Provision 21. does not apply in situations
COVERAGE C MEDICAL PAYMENTS, is where the endorsement on this policy affording
replaced by the following: coverage to the additional insured specifies that this
Insurance is excess over any other insurance
(b) The expenses are incurred and reported to available to that additional insured.
us within three years of the date of the 22 PROPERTY DAMAGE — ELEVATORS
accident; and
G- 18652 -J (Ed. 07 -12)
Page 10 of 12
Copyright, CNA All Rights Reserved.
A. Under SECTION I — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE,
Paragraph 2. Exclusions is amended such that
exclusion k. Damage to Your Product, and
subparagraph (3), (4) and (6) of exclusion J.
Damage to Property do not apply "property
damage" that results from the use of elevators.
B. With respect only to the coverage provided by
this endorsement, Condition 4. Other 26.
Insurance in SECTION IV — COMMERCIAL
GENERAL LIABILITY CONDITIONS is
amended to add the following subparagraph
b.(1)(a)(v):
4. Other Insurance
b. Excess Insurance
(1) This insurance is excess over:
(a) Any of the other insurance,
whether primary, excess,
contingent or on any other
basis:
(v) That is Property insurance
covering property of others
damaged from the use of
elevators.
23. SUPPLEMENTARY PAYMENTS
A. Under Section I — Supplementary Payments —
Coverages A and B, Paragraph 1.b., the limit of
$250 shown for the cost of bail bonds is
replaced by $5,000:
B. In Paragraph 1.d., the limit of $250 shown for
daily loss of earnings is replaced by $1,000.
24. UNINTENTIONAL FAILURE TO DISCLOSE
HAZARDS
If unintentionally you should fail to disclose all
existing hazards at the inception date of your policy,
we will not deny coverage under this Coverage Part
because of such failure.
25. WAIVER OF SUBGROGATION - BLANKET
Under SECT ION 1 V — COMMERCIAL GENERAL
LIABILITY CONDITIONS, The Transfer Of Rights
Of Recovery Against Others To Us Condition is
amended by the addition of the following:
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:
G-1 8652--,J
(Ed. 07 -12)
However, this waiver applies only when you have
agreed in writing to waive such rights of recovery In
a contract or agreement, and only if the contract or
agreement:
1. Is in effect or becomes effective during the term
of this policy; and
2. Was executed prior to loss.
WRAP- UP EXTENSION: OWNER CONTROLLED
INSURANCE PROGRAM, CONTRACTOR
CONTROLLED INSURANCE PROGRAM OR
CONSOLIDATED (WRAP -UP) INSURANCE
PROGRAMS
Note: The following provision does not apply to any
public construction project in the state of Oklahoma,
nor to any construction project in the state of
Alaska, that is not permitted to be insured under a
"consolidated (wrap -up) insurance program" by
applicable state statute or regulation:
If the endorsement EXCLUSION —
CONSTRUCTION WRAP -UP or another
exclusionary endorsement pertaining to Owner
Controlled Insurance Programs (O.C.I.P.) or
Contractor Controlled Insurance Programs
(C.C.I.P.) is attached to this policy, then the
following changes apply:
A. The following wording is added to the
endorsement:
With respect to a "consolidated (wrap -up)
insurance program" project in which you are or
were involved, this exclusion does not apply to
those sums you become legally obligated to pay
as damages because of:
1. "Bodily injury," "property damage," or
"personal or advertising injury" that occurs
during your ongoing operations at the
project, or during such operations of anyone
acting on your behalf; nor
2. "Bodily injury" or "property damage"
included within the "products- completed
operations hazard" that arises out of those
portions of the project that are not
"residential structures."
B. SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS is amended to add the
following subparagraph 4.b.(1)(c) to Condition
4. Other Insurance:
[This insurance is excess over:]
1. Your ongoing operations; or (c) Any of the other insurance whether primary,
excess, contingent or any other basis that is
2. "Your work" included in the "products completed Insurance available to you as a result of
operations hazard." your being a participant in a "consolidated
G- 18652 -J (Ed. 07 -12) (wrap -up) insurance program," but only as
Page 11 of 12
Copyright, CNA All Rights Reserved.
respects your involvement in that
"consolidated (wrap -up) insurance
program,"
C. SECTION V — DEFINITIONS is amended to add
the following definition:
"Consolidated (wrap -up) insurance program"
means a construction, erection or demolition
project for which the prime contractorlproject
manager or owner of the construction project
has secured general liability insurance covering
some or all of the contractors or subcontractors
involved In the project, such as an Owner
Controlled Insurance Program (O.C.I.P.) or
Contractor Controlled Insurance Program
(C.C.I.P.).
"Residential structure" means any structure
where 30% or more of the square foot area is
used or is intended to be used for human
All other terms and conditions of the Policy remain unchanged.
G-1 8652-J
(Ed. 07 -12)
residency including but not limited to single or
multifamily housing, apartments, condominiums,
townhouses, co- operatives or planned unit
developments and also includes their common
areas and/or appurtenant structures (including
pools, hot tubs, detached garages, guest
houses or any similar structures). When there is
no individual ownership of units, residential
structure does not include military housing,
collegetuniversity housing or dormitories, long
term care facilities, hotels, or motels.
Residential structure also does not include
hospitals or prisons.
This provision 26. does not apply to any person
or organization who otherwise qualifies as an
additional insured on this Coverage Part.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes
effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown
below, and expires concurrently with said Policy.
G- 18652 -J (Ed. 07 -12)
Page 12 of 12
Material used with permission of ISO Properties, Inc
Copyright, CNA All Rights Reserved.
Policy #: 4028838475
G- 140331 -C
(Ed. 10/10)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS
- WITH PRODUCTS - COMPLETED OPERATIONS COVERAGE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE (OPTIONAL)
Name of Additional Insured Persons Or Organizations
(As required by "written contract" per Paragraph A. below.)
Locations of Covered Operations
(As per the "written contract," provided the location is within the "coverage territory" of this Coverage Part.)
A. Section Il - Who Is An Insured is amended to
include as an additional insured:
1. Any person or organization whom you are
required by "written contract" to add as an
additional insured on this Coverage Part; and
2. The particular person or organization, if any,
scheduled above.
B. The insurance provided to the additional insured is
limited as follows:
2. We will not provide the additional insured any
broader coverage or any higher limit of
Insurance than the least that is:
3.
1. The person or organization is an additional
insured only with respect to liability for "bodily
injury," "property damage," or "personal and
advertising injury" caused in whole or in part by:
a. Your acts or omissions; or 4.
b. The acts or omissions of those acting on
your behalf
in the performance of your ongoing operations
specified in the "written contract'; or
c. "Your work" that is specified in the "written
contract" but only for "bodily injury" or
"property damage" included in the
"products- completed operations hazard,"
and only if:
(1) The "written contract" requires you to
provide the additional insured such
coverage; and
(2) This Coverage Part provides such
coverage.
a. Required by the "written contract ";
b. Described in B.I. above; or
C. Afforded to you under this policy.
This insurance is excess of all other insurance
available to the additional insured whether on a
primary, excess, contingent or any other basis.
But if required by the "written contract," this
insurance will be primary and non - contributory
relative to insurance on which the additional
insured is a Named Insured.
The insurance provided to the additional insured
does not apply to "bodily injury," "property
damage," or "personal and advertising injury
arising out of:
a. The rendering of, or the 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, architectural or
engineering activities; or
G- 140331 -C Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 2
(Ed. 10/10)
!112
b. Any premises or work for which the
additional insured is specifically listed as an
additional insured on another endorsement
attached to this Coverage Part.
C. SECTION IV — COMMERCIAL GENERAL
LIABILITY CONDITIONS is amended as follows:
1. The Duties In The Event of Occurrence,
Offense, Claim or Suit condition Is amended to
add the following additional conditions
applicable to the additional insured:
An additional insured under this endorsement
will as soon as practicable:
(1) Give us written notice of an "occurrence" or
an offense which may result in a claim or
"suit" under this insurance, and of any claim
or "suit" that does result; D.
(2) Except as provided in Paragraph 13.3 of this
endorsement, agree to make available any
other insurance the additional insured has
for a loss we cover under this Coverage
Part;
(3) Send us copies of all legal papers received,
and otherwise cooperate with us in the
investigation, defense, or settlement of the
claim or "suit "; and
(4) Tender the defense and indemnity of any
claim or "suit" to any other insurer or self
insurer whose policy or program applies to a
loss we cover under this Coverage Part.
But if the "written contract" requires this
insurance to be primary and non-
contributory, this provision (4) does not
apply to insurance on which the additional
insured is a Named Insured.
G- 140331 -C
(Ed. 10/10)
We have no duty to defend or indemnify an
additional insured under this endorsement until
we receive from the additional insured written
notice of a claim or "suit."
2. With respect only to the insurance provided by
this endorsement, the first sentence of
Paragraph 4.a. of the Other Insurance Condition
is deleted and replaced with the following:
4. Other Insurance
a. Primary Insurance
This insurance is primary and non-
contributory except when rendered
excess by endorsement G- 140331 -C,
or when Paragraph b. below applies.
Only for the purpose of the insurance provided by
this endorsement, SECTION V — DEFINITIONS is
amended to add the following definition:
"Written contract" means a written contract or
written agreement that requires you to make a
person or organization an additional insured on this
Coverage Part, provided the contract or agreement:
1. Is currently in effect or becomes effective during
the term of this policy; and
2. Was executed prior to:
a. The "bodily injury" or "property damage "; or
b The offense that caused the "personal and
advertising injury"
for which the additional insured seeks coverage
under this Coverage Part.
G- 140331 -C Includes copyrighted material of Insurance Services Office, Inc., with Its permission Page 2 of 2
(Ed. 10110)