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HomeMy WebLinkAboutRINCON CONSULTANTSN-2018-060-01 MAYOR —niAdCF.ON FILE MAYOORR Miguel A. TEMulldo ,�t`OrK WY PROCEED Juanilagille as I WIL INSURANCE EXPIRES COUNCIL MEMBERS ,Yq Cecilia Iglesias CLERK OF` 0 CI.. David Penaloza ,.,erF. MAY Roman Rayne Vicente Sarmientq„ Jose Solorio /�\� p :',� of Pt \4:� ce.«.t/ '�y rm Rincon Consultants, Inc. Attn: Walt Hamann, PG, CEG 250 East First Street, Suite 301 Los Angeles, CA 90012 573•'1GiL�t7 AIL1:.1 PUBLIC WORKS AGENCY 20 Civic Center Plaza . P.O. Box 1988 Santa Ana, California 92702 www.santa-ana.org February 5, 2019 ACTING CITY MANAGER Steven Mendoza CITY ATTORNEY Sonia R. Carvaiho ACTING CLERK OF THE COUNCIL Norma Mitre Re: Extension of Consultant Agreement No. N-2018-060 to provide environmental site assessment services Dear Mr, Hamann: Pursuant to Section 3 ("Term") of Agreement No. N-2018-060 ("`Agreement') entered into by Rincon Consultants, Inc. ("Consultant'), and the City of Santa Ana, dated April 4, 2018, the parties agree to an extension of the term of this Agreement for an additional one (1) year period, from April 5, 2019 through April 4, 2020. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of the Agreement remain unchanged and in full force and effect. PLS Executive Din Public Works CITY OF SANTA ANA Steven Mendoza Acting City Manager APPROVED AS TO FORM J n M. Funk Assistant City Attorney RINCON CONSULTANTS, INC. all Hamann, G, CEG Vice President , Environmental Services ATTEST -- -1 411 Norma Mitre Acting Clerk of Council SANTA ANA CITY COUNCIL Nr,guW A. PWoo Juao Vi6egas Vicente sarmtento David Fertaloza Jose Soiorb Rem., R yna ceozi a giesias Mayor Mayor Pro Tem, Ward 5 Ward r Ward 2 YVard 3 Ward A Ward F (nDAd.g-yr to-w orp b coaS arse rta-ana woysami entai9santa-ena.aa doendoza(alsanta-ana artl Isobr o(¢>saria-ana cra rreynafRlsanlb-ana. oro 5_. g(85 as(A�Sanla-arty orn RINCCON-01 PRISS ouzo CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDD/ V } ,—� n1 roRrvnl G 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 endorsoment(s). PRODUCER License #10E67768 EA -ccT ,Elizabeth Leach Le ends Environmental Ins. Services AtCno,Ext_, 297-553752011 (AA 130Vanfis ic,No):(949)297-5960 INSURED CA 92656 Rincon Consultants, Inc. 210 N Ashwood Ave Ventura, CA 93033 _ INSURER($(AFFGRDING COVERAGE ___, NAIC4 A;Crum & Forster Specialty Insurance_Company�44520 B Trumbull Insurance Company _. _ 27120 _ C:StarStone National Insurance Comfy 25496_ INSURER D: 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 CONTRACTOR 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. _- L ADODL 9UBp IA TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY E%P LIMITS - COMMERCIAL GENERAL LIABILITY EACHEACH O $ 3,000,000 CLAIMS MADE X OCCUR EPK125280 12/17/2018', 12/17/2020 DAMAGES(Eaoc renaa)__. - -$ - PERSONAIBACF NJURY 10,000 3,000,000,, _ GEHL AGGREGATE pL�INT I' APPLIES PER: POLICY �� JEC i_,_ LOC _$ i GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ 4,000,000 4,644,400'. OTHER' l ,Deductible $ 5Q000 B AUTOMOBILE LIABILITY X X ANY Auio 72UUNPT4318 ANY AU COMBINED SINGLE I J M I 1 (Ea eWd.tL $ 12/17/2010 BODILY INJURY (Per Garsou) $ 12/1712018iII 1,000,000 EGHtDDLED I AUTOS ONLY AUTOS GORILY INJURY Per accMeot)_$ _. LX. VRE S ONLY X I AUUT03 O 4 PROPERTY DAMAGE Per a StleFltt £ OCCUR EACH�OCCURRENCE $ O,000,UUU EXCESS LABIAB _X X _ _ EFX111982 12/17/2018' _EACH 12/17/2019 AGGREGATE $ 5,000,000 DED I X R ETEN ( ION$ 10,000: $ C WORKERS COMPENSATION AND EMPLOYERS LIABILITY ( X STATUTE _ERH f YtN T ANY PROPRIMEER}EXCLUDRfE%ECllTiVE� T10190329 42t01t2019 0270112420 CL EACH ACOICEN1 1,000,000 ;S_ gg,,FIGERtMEM i"i,NtA 1,000,000 NH)EXClUDEO? IManddf kn NH} E.L. DISEASE -EA_EMPtGYEE_S 11006,000 DESCRIPTION DESCRIPTION OF OPERATIONS below Iz.L. DISEASE -POLICY LIMIT 5 q Professional Liab I EPK125280 12/17/2018 12/17/2020 Per Claim 11000,000 A (Professional Liab EPK125280 12117/2018 12/17/2020 (Aggregate 4,000,000 DESCRIPTION OF OPERATIONS! LOCATIONS t VEHICLES jACORD lei, Atldiflm,zi Remnrka Schetlu3a, may he attachdtl ft mere space is requlr¢tlj ''.. lonai Liability is written on a Claims Made basis. When required by written contract, the General Liability and Pollution Liability Limits are on a Per iasis while dedicated; the Professional Liability is on a Per Policy basis. Professional Liability Deductible $50,000 Each Claim. of Santa Ana its officers, employees, agents, volunteers and representatives are Included as additional Insureds for General Liability and Auto with respect to work performed for them by the Named Insured as required by written contract, per Blanket Additional Insured endorsement EN0147- 10320-OQ9y OL12yfl" f� .Q:LR0.D Lilpity Coverage Is Primary and Non -Contributory as required by written contract, per endorsement EN0147 (ACHE di r_#VM_1i tz tYt 1V/ {L.� i7..J{ it�7 Y �ICATE OL,DiR CANCELLATION _ 1at.-.Ae�c, <flraJ, g OF t� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana - Public Works Agency AUTHORIZED REPRESENTATIVE Attn: Water Resources Department �t 20 Civic Center Plaza, M-21, P.O. Box 1988 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD v Y AGENCY CUSTOMER ID: RINCCON-01 PRIETOP LOC #: 1 A`CtIR®' ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY License #OE67768 NAMED INSURED Legends Environmental Ins. Services Rincon Consultants, Inc. 210 N Ashwood Ave POLICY NUMBER Ventura, CA 93033 SEE PAGE 1 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 The ACORD name and logo are registered marks of ACORD Policy Number: 72UUNPT4318 ENDORSEME-7 This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COMMERCIAL AUTOMOBILE HA 99 16 03 12 To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED d. Any "employee" of yours while using a A. Subsidiaries and Newly Acquired or covered "auto" you don't own, hire or Formed Organizations borrow in your business or your The Named Insured shown in the personal affairs. Declarations is amended to include: C. Lessors as Insureds (1) Any legal business entity other than a partnership or Joint venture, formed as a subsidiary in which you have an ownership interest of more than 50% on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an "insured" under any other automobile policy or would be an "insured" under such a policy but for its termination or the exhaustion of its Limit of Insurance. (2) Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (a) That is a partnership or joint venture, (b) That is an "insured" under an oth Paragraph A.1. - WHO IS AN INSURED - of Section II - Liability Coverage is amended to add' e. The lessor of a covered "auto" while the "auto" is leased to you under a written agreement if: (1) The agreement requires you to provide direct primary insurance for the lessor and (2) The "auto" is leased without a driver. Such a leased "auto" will be considered a covered "auto" you own and not a covered "auto" you hire. (1) Paragraph A.I. - WHO IS AN INSURED - of Section II - Liability Coverage is amended to add'. y er policy, f. When you have agreed, In a written contract or written agreement, that a (c) That has exhausted its Limit of person or organization be. added as Insurance under any other policy, or an additional insured on your (d) 180 days or more after its business auto policy, such person or acquisition or formation by you, organization is an "Insured", but only unless you have given us notice of to the extent such person or the acquisition or formation, organization is liable for "bodily Coverage does not apply to "bodily Injury" or "property damage" caused injury" or "property damage" that results by the conduct of an "insured" under from an "accident" that occurred before paragraphs a, or b. of Who Is An you formed or acquired the organization. Insured with regard to the B. Employees as Insureds ownM�filtoh¢�/i�Sa$�bf ®/: Paragraph A.1, - WHO IS AN INSURED - of SECTION II - LIABILITY COVERAGE is ovRe �J V V C l J S amended to add: 4rz. ti iv II PAGE OF 12 - 02011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 of ISO Properties, Inc., with its permission ) Page 1 of 5 The insurance afforded to any such E. Primary, and Non -Contributory if additional insured applies only if the Required by Contract "bodily injury" or "property damage" Only with respect to insurance provided to occurs an additional insured in 1-D. - Additional (1) During the policy period, and Insured If Required by Contract, the (2) Subsequent to the execution of such fallowing provisions apply: written contract, and (3) Primary Insurance When Required By (3) Prior to the expiration of the period Contract of time that the written contract This insurance is primary If you have requires such insurance be provided agreed in a written contract or written to the additional insured. agreement that this insurance be (2) How Limits Apply primary. if other insurance is also primary, we will share with all that other If you have agreed in a written contract by trio method described in or written agreement that another Other Ins Other Insurance 5.d. person or organization be added as an additional insured on your policy, the (4) Primary And Non -Contributory To Other most we will pay on behalf of such Insurance When Required By Contract additional insured is the lesser of: if you have agreed in a written contract (a) The limits of Insurance specified in or written agreement that this insurance the written contract or written is primary and non-contributory with the agreement; or additional insured's own insurance, this b) The Limits of Insurance shown in insurance is primary and we will not seek contribution from that other fiha Declarations. insurance. Such amount shall be a part of and not Paragraphs (3) and (d) do not apply to other in addition to Limits of insurance shown insurance to which the additional insured in the Declarations and described in this has been added as an additional insured Section. When this Insurance Is excess, we will have no (3) Additional Insureds Other Insurance duty to defend the Insured against any "suit" if If we cover a claim or "suit" under this any other insurer has a duty to defend the Coverage Past that may also be covered insured against that "suit", If no other insurer by other insurance available to an defends. we will undertake to do so, but we will additional insured, such additional be entitled to the insured's rights against all Insured must submit such claim or "suit" those other insurers;. to the other insurer for defense and When this insurance is excess over other Indemnity. insurance, we will pay only our share of the However, this provision does not apply amount of the loss. if any, that exceeds the sum to the extent that you have agreed in a of; written contract or written agreement (1) The total amount that all such other that this insurance is primary and non- insurance would pay for the loss in the contributory with the additional insured's absence of this insurance; and own insurance, (2) The total of all deductible and self -insured {4) polies in The Event Of Accident, Claim, amounts under all that other insurance, Suitor Loss We will share the remaining loss, if any, by the (f you have agreed in a written contract method described in Other Insurance 6.d. or written agreement that another person or organization be added as an 2. AUTOS RENTED BY EMPLOYEES additional insured on your policy, the Any "auto" hired or rented by your "employee" additional insured shall be required to on your behalf and at your direction will be comply with the provisions in LOSS considered an "auto" you hire, CONDITIONS2. - DUTIES IN THE EVENT OF ACCIDENT, CLAIM SUIT d �J � V V D BYded , bThe ye OR LOSS — OF SECTION IV BUSINESS AUTO CONDITIONS, In the � 4( /lof In same manner as the Named Insured. PAGES OF fa icc 2011, The Hartford (Includes copyrighted material Form HA 99 16 0312 of 180 Properties, Inc., with its permission.) Page 2 of 6 If an "employee's" personal insurance also applies on an excess basis to a covered "auto" hired or rented by your "employee" on your behalf and at your direction, this insurance will be primary to the"employee's" personal insurance 1 AMENDED FELLOW EMPLOYEE EXCLUSION EXCLUSION 5- - FELLOW EMPLOYEE - of SECTION it - LIABILITY COVERAGE does not apply if you have workers' compensation insurance in -force covering all of your "employees". Coverage is excess over any other collectible insurance. 4, HIRED AUTO PHYSICAL DAMAGE COVERAGE If hirad "autos" are covered "autos" for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Forin for any "auto" you own, then the Physical Damage Coverages provided are extended to !'autos" YOU hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired "auto" is: (1) $100,000; (2) The actual cash value of the damaged or stolen property at the time of the "loss"; or (3) The cost of repairing or replacing the damaged or stolen property, whichever is smallest, minus a deductible The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. Hired Auto Physical Damage coverage is excess over any other collectible insurance. Subject to the above limit, deductible and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will also cover loss of use of the hired "auto" If it results from an "accident", you are legally liable and the lessor incurs an actual financial loss, subject to a maximum of $1000 per "accident" This extension of coverage does not apply to any "auto" you hire or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households, B. PHYSICAL DAMAGE ADDITIONAL TEMPORARY TRANSPORTATION EXPENSE COVERAGE Paragraph A 4 a. of SECTION III - PHYSICAL, DAMAGE COVERAGE is amended to provide a limit of $60 per day and a maximum limit of $1 ,000. 6. LOAN/LEASE GAP COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE, in the event of a total "loss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the "loss" and the "outstanding balance" of the, loan/lease "Outstanding balance" means the amount you owe on the loan/lease at the time of "loss" less any amounts representing taxes; overdue payments; penalties, interest or charges resulting from overdue payments; additional mileage charges: excess wear and tear charges; lease termination fees: security deposits not returned by the lessor; costs for extended warranties, credit life Insurance, health, accident or disability insurance purchased with the loan or lease; and carry-over balances from previous loans or leases, 7, AIRBAG COVERAGE Under Paragraph B. EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: The exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. S. ELECTRONIC EQUIPMENT - BROADENED COVERAGE a, The exceptions to Paragraphs B.4 � EXCLUSIONS - of SECTION III - PHYSICAL DAMAGE COVERAGE are replaced by the following: Exclusions 4.0. and 4A. do not apply to equipment designed to be operated *solely by use of the power from the "auto's" electrical system that, at the time of "loss", s: (1) Permanently installed in or upon the covered "auto'; (2) Removable from a housing unit which is permanently installed in or upon the covered "auto"; lequif rant described in r 8( Lev ; Wf PAGE, f5 oF_ lio C 2011, The Hartford (includes copyrighted material Form HA 9916 0312 of 180 Properties, Inc., with its permission.) Page 3 of 6 (4) Necessary for the normal operation of the covered "auto" or the monitoring of the covered ,. auto's" operating system b. Section III — Version CA 00 01 03 10 of the Business Auto Coverage Form, Physical Damage Coverage. Limit of Insurance, Paragraph C 2 and Version CA 00 01 10 01 of the Business Auto Coverage Form, Physical Damage Coverage, Limit of Insurance. Paragraph C are each amended to add the following, $1.500 is the most we will pay for "loss" in any one "accident" to all electronic equipment (other than equipment designed solely for the reproduction of sound, and accessories used with such equipment) that reproduces, receives of transmits audio, visual or data signals which, at the time of "loss", is (1) Permanently installed in or upon the covered "auto" in a housing, opening or other location that is not normally used by the "auto" manufacturer for the installation of such equipment, (2) Removable from a permanently Installed housing unit as described in Paragraph 2,a. above or is an integral part of that equipment, or (3) An integral part of such equipment c. For each covered "auto", should loss be limited to electronic equipment only, our obligation to pay for, repair, return or replace damaged or stolen electronic equipment will be reduced by the applicable deductible shown in the Declarations, or $250, whichever deductible is less 9. EXTRA EXPENSE - BROADENED COVERAGE Under Paragraph A - COVERAGE - of SECTION III - PHYSICAL DAMAGE COVERAGE, we will pay for the expense of returning a stolen covered "auto" to you. 10. GLASS REPAIR -WAIVER OF DEDUCTIBLE Under Paragraph 0 - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to glass damage if the glass is repaired rather than replaced. 11, TWO OR MORE DEDUCTIBLES Under Paragraph D. - DEDUCTIBLE - of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: If another Hartford Financial Services Group, Inc, company policy or coverage form that is not an automobile policy or coverage form applies to the same "accident", the following applies (1) If the deductible under this Business Auto Coverage Form is the smaller (or smallest) deductible, it will be waived; (2) If the deductible under this Business Auto Coverage Form Is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible 12. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The requirement in LOSS CONDITIONS 2.a. - DUTIES IN THE EVENT OF ACCIDENT,CLAIM, SUIT OR LOSS - of SECTION IV - BUSINESS AUTO CONDITIONS that you must notify us of an "accident" applies only when the "accident" is known to: (1) You, if you are an individual, (2) A partner, if you are a partnership, (3) A member, if you are a limited liability company; or (4) An executive officer or insurance manager, if you are a corporation, 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of Such failure, 14, HIRED AUTO . COVERAGE TERRITORY Paragraph a. of GENERAL CONDITIONS 7, - POLICY PERIOD, COVERAGE TERRITORY - of SECTION IV - BUSINESS AUTO CONDITIONS is replaced by the following: a. For short-term hired "autos", the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the :'Insureofs" responsibility to pay damages for "bodily injury" or "property damage" is determined in a "suit." the "suit" brought in the United States of America, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. 15 4ROWMAMPA00f Z0,000 TRANSFER MEVI qlF AGAINST 0 \NMSy: BUSINESS AUTO G NDIT DNS is amended by adding the following I- Oc 2011, The Hartford (includes copyrighted material Form HA 99 16 0312 of ISO Properties, Inc., with its permission.) Page 4 of 5 We waive any right of recovery we may have against any person of organization with whom you have a written contract that requires such waiver because of payments we make for damages under this Coverage Form. % RESULTANT MENTAL ANGUISH COVERAGE The definition of "bodily injury" in SECTION V- DEFINITIONS is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by any person, inducing mental anguish or death resulting from any of these. 117. EXTENDED CANCELLATION CONDITION Paragraph 2. of the COMMON POLICY CONDITIONS - CANCELLATION - applies except as follows: If we cancel for any reason other than nonpayment of premium, we will mail or deliver to the first Named Insured written notice of cancellation at least 60 days before the effective date of cancellation, 18. HYBRID, ELECTRIC, OR NATURAL GAS VEHICLE PAYMENT COVERAGE In the event of a total loss to a "non -hybrid" auto for which Comprehensive, Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended as follows: a. If the auto is replaced with a "hybrid" auto or an auto powered solely by electricity or natural gas, we will pay an additional 10%, to a maximum of $2500, of the "non hybrid" auto's actual cash Value or replacement cost, whichever is less, i auto must be replaced and a copy of a bill of sale or new lease agreement received by us within 60 calendar days of the date of "loss," c. Regardless of the number of autos deemed a total loss, the most we will pay Linder this Hybrid, Electric. or Natural Gas Vehicle Payment Coverage provision for any one "loss" is $10,000 For the purposes of the coverage provision, a.A "non -hybrid" auto is defined as an auto that uses only an internal combustion engine to move the auto but does not include autos powered solely by electricity or natural gas, b.A "hybrid" auto is defined as an auto with an internal combustion engine and one or more electric motors, and that uses the internal combustion engine and one or more electric motors to move the auto, or the internal combustion engine to charge one or more electric motors, which move the auto. 19. VEHICLE WRAP COVERAGE In the event of a total loss to an "auto" for which Comprehensive Specified Causes of Loss, or Collision coverages are provided under this Coverage Form, then such Physical Damage Coverages are amended to add the following: In addition to the actual cash value of the "auto", we will pay up to $1,000 for vinyl vehicle wraps which are displayed on the covered "auto" at the time of total loss. Regardless of the number of autos deemed a total loss, the most we will pay under this Vehicle Wrap Coverage provision for any one "loss" is $5,000. For purposes of this coverage provision, signs or other graphics painted or magnetically affixed to the vehicle are not considered vehicle wraps. R�V�EWED BY: P4 E F Oc 2011, The Hartford (Includes copyrighted material Form HA 9916 03 112 of ISO Properties, Inc., with its permission.) Pago 5 of 5 POLICY #: EPK125280 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Nave of Additional Per5on(s) or Organization(s) Location And Description Of Completed — Operations Where Required by Written Contract. Where Required by Written Contract, Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section UI — Who Is An Insured within the Common Provisions is amended to include as an 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". REVIEWED BY, Fl� GO. EN0320-0211 Page I of 1 POLICY# EPK125280 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following. COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section III — Who Is An Insured within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", property damage" or "personal and advertising injury" cause, in whole or in part, by: 1, Your acts or omissions; or 1 The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. T With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1 All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 4. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. REVIEWED BY. PAGE-2. OF-Lo- EN0321-0211 Page 1 of 1 WITH WAIVER OF SUBROGATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART ERRORS AND OMISSIONS LIABILITY COVERAGE PART )f Additional Insured Person(s) or IRequired Sy \Written Con tract A. SECTION III — WHO IS AN INSURED within the Common Provisions is amended to include as an additional insured the person(s) or organization(s) indicated in the Schedule shown above, but only with respect to liability arising out of "your work" for that person or organization performed by you, or by those acting on your behalf. B. As respects additional insureds as defined above, this insurance also applies to "bodily injury" or "property damage" arising out of your negligence when the following written contract requirements are applicable: I . Coverage available under this coverage part shall apply as primary insurance. Any other insurance available to these additional insureds shall apply as excess and not contribute as primary to the insurance afforded by this endorsement. Z We waive any right of recovery we may have against the person(s) or organization(s) indicated in the Schedule shown above because of payments we make for injury or damage arising out of "your work" performed under a written contract with that person(s) or organ ization(s), 3. The term "additional insured" is used separately and not collectively, but the inclusion of more than one "additional insured" shall not increase the limits or coverage provided by this insurance. This Endorsement does not reinstate or increase the Limits of Insurance applicable to any "claim" to which the coverage afforded by this Endorsement applies, REVIEWED BY: PAGE-LJ- OF---i2-- ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED, EN0147-1 111 Page 9 of 1