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HomeMy WebLinkAboutMIKE PRLICH AND SONS, INCA-2020-243-01 1 SECOND AMENDMENT' TO AGREEMENT TO PROVIDE ON -CALL Q . pWPtu) rUC,I0­ � 0 EMERGENCY WATER AND SEWER SYSTEM REPAIR SERVICES THIS SECOND AMENDMENT to the above -referenced agreement is entered into on December 1, 2020, by and between Mike Prlich and Sons, Inc. ("Contractor"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California ("City"). RECITALS A. The parties entered into Agreement No. A-2019-142-01, dated August 20, 2019, by which Contractor agreed to provide on -call emergency water and sewer system repair services for the City's Public Works Agency ("Agreement'). The term of the Agreement is for three years, and the Agreement remains in effect through August 19, 2022, with provision for extension. B. On May 5, 2020, the parties entered into First Amendment to Agreement No. A-2020-091- 01 to increase the shared aggregate amount to be expended under the Agreement and the two related agreements for the same services. C. The parties now wish to amend the Agreement to further increase the shared aggregate amount to be expended under the Agreement and two related agreements. The Parties therefore agree: I. Section 2.a, Compensation, is amended to read in its entirety: "City neither warrants nor guarantees any minimum or maximum compensation to Contractor under this Agreement. Contractor shall be paid only for actual services performed under this Agreement at the rates and charges identified in Exhibit B. Contractor is one of three contractors selected to provide services on an as -needed basis under RFP No, 19-032. The annual compensation for services provided by all contractors selected under RFP No. 19-032 shall not exceed the shared aggregate amount of $1,200,000 during the term of this agreement, including any extension periods." 2. Except as modified by this Second Amendment, and all prior amendments, all terms and conditions of the Agreement shall remain in full force and effect. IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to the Agreement on the date and year first written above. ATTEST ,c aisy Gomez clerk of the Council CITY OF SANTA ANA Kristine Ridge City Manager Page 1 of 2 A-2020-243-01 APPROVED AS TO FORM Sonia R. Carvalho City Attorney By: W 0�" T J n M. Funk Senior Assistant City Attorney RECOMMENDED FOR APPROVAL Nabil Saba Executive Director Public Works Agency Page 2 of 2 MIKE PRUCH AND SONS, INC. qaA6LQ Name: Title: MICHAELA. PRLICH PRESIDENT oyuaiy.iyneabyrrancm=n. Francine R. Villareal bate. xoxION ' o.flaz lgA3:x6 os•w' ACORO� CERTIFICATE OF LIABILITY INSURANCE ll.. DATE(MM/DD/YYYY) 10/21/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Patriot Risk & Insurance Services 2415 Campus Drive, Suite #200 Irvine, CA 92612 CONTACT NAME: PHC NE 949 486-7900 FAIX c No: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE HAIG# www.palrisk.com OK07568 INSURERA: Middlesex Insurance Company 23434 INSURED Mike Prilch &Sons, Inc. Elton 5103 Elton St. INSURERS: Navigators Insurance Company 42307 INSURER C: Slate Compensation Insurance Fund INSURERD: IronshoreSpecialty Insurance Co 25445 Baldwin Park CA 91706 INSURER E: Lloyds of London INSURER F: COVERAGES CERTIFICATE NUMBER: 58242193 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 ADDLSUBR POLICY NUMBER POLICY EFF MWDDII^/YV POLICY EXP MMIDDYYYY LIMITS A t/ COMMERCIALGENERAL LIABILITY CLAIMS -MADE OCCUR ✓ ✓ A0152818 8/1/2020 8/1/2021 CURRENCE $1000000 RENTED S Ea occurrence $500000 ✓ (Any one person) $10000 $5,000 Deductible AL & ADV INJURY FGENER�I $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ✓❑ PRO- JECT � LOG AGGREGATE $3,000,000 TS-COMP/OPAGG $2000000 $ OTHER: A AUTOMOBILE LIABILITY A0152818 8/1/2020 8/112021 COMBINED EINGLE_LIMIT F. $1000000 Boo ILV INJU RY(Par person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY Per eccldenl ( ) $ PROPERTY DAMAGE Per accident $ $ H B UMBRELLALIAB ✓ OCCUR LA20EXC7820511C 8/1/2020 8/11 0021 EACH OCCURRENCE AGGREGATE EXCESS LIAR CLAIMS -MADE DED RETENTION$ C WORKERS COMPENSATION EMPLOYERS' LIABILITY YINOFFICRANYPROPMEMB REXCLUDEDP ECUTIVE NIA 9280970-2020 8/1/2020 8/1/2021 ,/ STATUTE ERHAND E001001 E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEIfyes, (Mandatory In NH) describeunderDESCRIPTION E.L. DISEASE -POLICY LIMIT OF OPERATIONS beow D Pollution Liability 004158101 8/112020 8/1/2021 $2,000,000 Occur / $2,000,000 Aggregate $10,000 Deductible. E Professional Liability ELOO-98-0052-2020 8/1/2020 8/1/2021 $1000000 Occurrence/AxIcIregate DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: City of Santa Ana's Emergency Sewer and Water System Repair Services RFP 19-032. The City of Santa Ana, it's officers, employees, agents, volunteers and representatives are named as Additional Insured as respects to General Liability as per endorsement attached as required by written contract. Primary/non-contributory endt attached. 30-day notice of cancellation 110-days for non-payment of premium. CI of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE tY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Management Division ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana CA 92702 AUTHORIZED REPRESENTATIVE �P A"--fV tee. 0„a. "Ma1u%nNeMfXvjeilm Dave Jacobson A±7 � REVIEWED&APPRovEDBY: ©1988-2015 ACORD C I s v1 ,, VZt&,W 4 ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Risk Management:Ana(yat 50242193 20/21 GL/AU/W.8(WC/POLL I Tina Kennedy 1 10/21/2020 4:36:5e PM (PDT) I Page 1 of 14 This cerl ificate cancels and supersedes ALL previously issued certificates. Mike Prlich & Sons, Inc, POLICY NUMBER: A0152818 COMMERCIAL GENERAL LIABILITY CO 2010 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) Location(s) Of Covered Operations Any person or organization you are required to add as an additional insured under a written contract or agreement In effect prior to any accident, injury, loss or damage. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organizations) shown in the Schedule, but only with respect to liability for "bodily Injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional Insured(s) at the locatlon(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured Is required by a contract or agreement, the Insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CO 2010 0413 B. 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 2. That portion of "your work" out of which the Injury or damage arises has been put to its Intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. ® Insurance Services Office, Inc., 2012 .:.1.H FiskMm,PgnnedWslan �' RE\neWED & APPP'++Rw® By., FvAa''MmC. I Risk Management Analyst 58242193 20/21 WL/AL/W6/WC/P0LL I Tina Kennedy 1 10/21/2020 4:36:50 PM (PDT) I Page 2 of This certificate cancels and supersedes ALL previously issued certificates. C. With respect to the insurance afforded to these additional Insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional Insured is the amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not Increase the applicable Limits of Insurance shown in the Declarations, © Insurance Services Office, Inc., 2012 umi:nun,a�,�tun��31 ow., 3 REVIEWED&APPROVE?BY: t . r Est~ a � 2. vau""5 Risk Management Anayit 58292193 20e21 GL/AU/UM9/WC/POLL I Tina Kennedy 110/21/2020 4:36: 58 PM (PDT) I Page 3 of 19 This certificate cancels and supersedes ALL previously issued certificates. We Prlich & Sons, Inc. POLICY NUMBER: A0152818 COMMERCIAL GENERAL LIABILITY CO 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization you are required to add as All locations and jobs performed that have a written an contract, agreement or permit additional insured under a written contract or agreement In effect prior to any accident, Injury, loss or damage Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional Insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" 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". However: 1. The Insurance afforded to such additional Insured only applies to the extent permitted by law; and 2. If coverage provided to the additional Insured Is required by a contract or agreement, the Insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CO 20 37 0413 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 0Insurance Services Office, Inc., 2012 rem,„ RlekMantententDI*Ian RmAEWED&MPROVMBY: s � `.r. tc. V4Ghe,� Risk Management Analy5t 58242193 20/21 GL/AL/OM9/WC/POLL I Tina Kennedy 1 10/21/2020 4:36:58 PM (PUT) I Page 4 cE 14 This cer ificate cancels and supersedes ALL previously issued certificates. A0152818 Mike Prlich & Sons, Inc. COMMERCIAL GENERAL LIABILITY CIS 70 21 0618 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPECIAL BROAD FORM GENERAL LIABILITY ENDORSEMENT This endorsement modifies the Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. Coverage D. Employee Benefits Liability A. The following is added to Section Coverages 1. Insuring Agreement a. We will pay those sums that the Insured becomes legally obligated to pay as "damages" because of an "occurrence" to which this Insurance applies. We will have the right and duty to defend the Insured against any "suit" seeking those "damages". However, we will have no duty to defend the Insured against any "suit" seeking "damages" to which this insurance does not apply. We may, at our discretion, investigate any "occurrence" and settle any claim or "suit" that may result. But: (1) The amount we will pay for "damages" is limited as described in paragraph B. of this coverage; and (2) Our right and duty to defend ends when we have used up the applicable limit of insurance in the payment of judgments or settlements under Coverage D. No other obligation or liability to pay sums or perform acts or services Is covered unless explicitly provided for under Supplementary Payments. b. This insurance applies only to "damages" caused by an "occurrence" during the policy period. The "occurrence" must take place in the "coverage territory" c. "Damages" sustained by any one "employee", including "damages" sustained by such "employee's" dependents and beneficiaries, as a result of a series of related errors or omissions shall be considered one "occurrence". CG 70 21 0618 2. Exclusions This insurance does not apply to: a. "Bodily injury" or mental Injury to any person, "property damage" or "personal and advertising injury". b. Liability assumed by the Insured under any contract or agreement. c. Any claim for: (1) Failure of performance of a contract by any Insurer or other fiduciary entrusted with monies intended to fund "employee benefits"; (2) Insufficiency of funds to meet any obligations under any "employee benefits": (3) Inadequacy of performance of Investments, errors in providing Information on past performance of Investment vehicles or advice given with respect to participation; (4) Your failure to establish any "employee benefits" in compliance with the mandatory provisions of any law governing workers' compensation, unemployment Insurance, social security or disability benefits or any similar state or federal law; (5) Advice given to any person to participate or not to participate in any "employee benefits"; (6) Taxes, fines or penalties, including those Imposed under the Internal Revenue Code or any similar state or local law; (7) "Damages" arising out of wrongful termination of employment, discrimination, or other employment -related practices. g, RIakM¢rugenentDl sdsm REVIEWED&MPRWED BY:' 9 ''�-----� Ruk Management Analypt 58242193 418e21 GL/AU/GMB/WC/POLL Tina Kennedy 10/21/2020 4;36:58 PM (PM') Page 5 of This cer frcate cancels and supersedes ALL previously issued certificates. d. Liability based on: (1) Medical malpractice of any physician or surgeon; (2) Dishonest, fraudulent, criminal or malicious acts or omissions committed by any insured; (3) The Employee Retirement Income Security Act of 1974 or any amendment thereof, or (4) Circumstances of which you were aware, or should have been aware, at the Inception of this insurance. 3. The Supplementary Payments provisions are extended to Coverage D. B. Limit Of Insurance For this additional coverage, Section IN - Limits Of Insurance is amended as follows: 1. Paragraph 2. is replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical Expenses under Coverage C; b. Damages under Coverage A., except damages because of "bodily Injury" or "property damage" Included in the "products - completed operations hazard"; c. Damages under Coverage B; and d. Damages under Coverage D. 2. Subject to the General Aggregate Limit described in paragraph B.I. above, the Each Employee Limit is the most we will pay under Coverage D. for all "damages" sustained by any one "employee", including "damages" sustained by such "employee's" dependents and beneficiaries, because of any one C. Deductible 1. Our obligation under Coverage D. to pay "damages" on behalf of the Insured applies only to the amount of "damages" in excess of any Each Employee Deductible amount shown in the Declarations. 2. The deductible amount applies to all "damages" sustained by any one "employee", including such "employee's" dependents and beneficiaries, because of any one occurrence. 3. The terms of this insurance, Including those with respect to: a. Our right and duty to defend the Insured against "suits" seeking those "damages ; and Page 2 of 9 b. Your duties in the event of an occurrence, claim or "suit" apply regardless of the application of the deductible amount. 4. We may pay any part of all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you should promptly reimburse us for each part of the deductible amount as has been paid by us. D. Coverage D Definitions 1. For Coverage D, only, the following definitions replace the corresponding definitions found in the Commercial General Liability Coverage Part: a. "Employee" means a person actively employed or formerly employed by or on leave of absence, disabled or refired from the named insured. Employee does not include a "leased worker" or a "temporary worker". b. "Occurrence" means an error or omission In the "administration" of "employee benefits". c. "Suit" means a civil proceeding in which "damages" because of an "occurrence" to which Coverage D. applies are alleged. "Suit" Includes: (1) An arbitration proceeding In which such "darnages" are claimed and to which the insured must submit or does submit with our consent; or (2) Any other alternative dispute resolution proceeding in which dame as are claimed and to which the insured submits with our consent. 2. The following definitions are added for Coverage D only: a. "Administration" means: (1) Providing Information to employees, including their dependents and beneficiaries, with respect to eligibility for or scope of "employee benefits'; (2) Interpreting "employee benefits'; (3) HandllnR of records in connection with the employee benefits"; or (4) Effecting, continuing or terminating any employee's participation in any benefit Included in "employee benefits" by you or a person or organization authorized by you to perform such acts. However, "administration" does not Include handling payroll deductions. wBkRtun�ewl REMEWED & APPROVEDBY. & , MAUd Risk Manayen nt Analpt 50242193 4 20(21 OL/➢O/I B/WC/POLL I 'Pins Kennedy 110/21/2020 4:36:58 PM (PDT) I Page 6 of 19 This car afasate cancels and supersedes ALL previously issued certificates. b. Damage" means" (1) Those sums that the Insured is legally obligated to pay as a result of negligent errors or omissions to which this Insurance applies. For the purpose of this coverage, "dam- ages" does not include punitive or exemplary damages, requests for restitution, requests for Injunctive or declarative relief, Including associated requests for costs or fees or any other costs, fees or penalties that are not insurable by law; or (2) Other costs, fees or penalties required to be paid by order of enforcement of any federal, state, or local statutes to the extent they are Insurable by law. c. "Employee benefits" means: (1) Insurance programs for: (a) Group Life; (b) Group accident and health; (c) Dental, vision and hearing plans; (d) Flexible spending accounts; (a) Workers' compensation; (f) Unemployment; and (g) Social security and disability benefits. (2) Group Plans for., (a) Profit Sharing; (b) Pensions; (c) Employee stock subscription; (d) Employee savings plans; and (e) Employee stock ownership plans; (3) Vacation plans, including buy and sell programs; leave of absence programs, including military, maternity, family, and civil leave; tuition assistance plans; transportation and health club subsidies; and (4) Other similar employee benefits, Identified by separate endorsement. The above plans must be provided by you and are applicable to you and your employees. 2. Broadened Supplementary Payments Under Section I - Coverages, Supplementary Payments - Coverages A And B: a. Paragra h 1.b. is amended to pay up to $3,000 for cost of bail bonds; and CO 70 21 0616 b. Paragraph 1.d. Is amended to pay for loss of earnings up to $750 a day because of time off from work. 3. Fellow Employee Bodily Injury Paragraph 2.a. of Section II - Who Is An Insured Is replaced by the following: 2. Each of the following is also an Insured: a. Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers" (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: 58242193 L10/21 GL/AU/UMB/WC/POLL Tina Kennedy 110/21/2020 409:58 PM (PDT) I Page 9 of 14 This cer fiicate cancels and supersedes ALL previouely issued certificates. (1) "Personal and advertising Injury': (a) To you, to your partners or members (If you are a partnership or joint venture), to your members (if you are limited liability company), to a co -"employee" while in the course of his or her employment or performing duties related to the conduct of your business or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that oo. employee" or "volunteer worker" as a consequence of paragraph (1)(a) above or (c) For which there is any obligation to share damages with or repay someone else who must damages because of the in uryy described In paragraphs (1)(a) or (b) above. (2) "Bodily injury or "personal and advertising injury arising out of his or her providing or failing to provide professional health care services. But this does not apply to "bodily injury" arising out of nurses, emergency medical technicians or paramedics providing or falling to provide professional health care services. (3) "Property damage" to property: (a) Owned, occupied or used by; (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by; INRisk Managmtodrtmsim REVIEWED&APPROVm BY: 0 P4a P, I�kEt,�t Risk Management Analyst t'- you, any of your "employees", (3) Any of the other Insurance, whether volunteer workers", any partner or primary, excess, contingent or on member (if you area partnership or joint any other basis: venture), or any member (If you are a limited liability company). (a) If the inaured's liability to pay damages is determined in a 4. World Wide Coverage Territory "suit" brought outside the United a. Under Section V - Definitions, Paragraph 4. States of America (including Its is replaced by the following: territories and possessions), 4. "Coverage territory" means anywhere in Puerto Rico or Canada; or the world. () b That is coverage required b law, other b. The following Is added to Section IV - regulation or governmental authority in a part of the Conditions: "coverage territory" that is Expanded Coverage Territory outside of the United States of (1) If a "suit" to which this insurance applies is America (including Its territories brought outside the United States of and possessions), Puerto Rico or America (Including Its territories and Canada. possessions), Puerto Rico or Canada, we S. Engine Rebuilding And Overhaul Operations will have the right but not the duty to "suit If this Insurance applies to "property damage" defend the insured against such I. included within the "products -completed In any such case in which we elect not to operations hazard", the following exception is defend, the insured will at our option and added to exclusion I. under Paragraph 2., under our supervision: Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability: (a) Make or cause to be made such investigation end defense as are This exclusion does not apply if " or reasonably n reasonably necessary; and damage" arises from "engine rebuilding overhaul operations" conducted by you or on (b) To the extent possible, effect such your behalf. settlement or settlements as we shall "Engine rebuilding or overhaul operations" means deem proper. repair of internal combustion engines or We will reimburse the insured, under component parts of such engines owned by Supplementary Payments, for the others if the repair involves the complete reasonable cost of such investigation and disassembly and reassembly of the engine or defense and, within the limits of liability, for component pert of the engine. the amounts of such authorized This insurance does not apply to "property settlement. damage" to engines or component parts of engines which are used in, or while in practice or (2) All payments or reimbursements we make preparation for, any prearranged racing, speed, for damages because of judgments or demolition or stunting activity. settlements will be made in U.S. currency S. Incidental Medical Malpractice at the prevailing exchange rate at the time the Insured became legally obligated to a. Under Section V - Definitions, the definition pay such sums. All payments or of "bodily injury" Is emended to include injury reimbursements we make for expenses arising out of the rendering or failure to render under Supplementary Payments will be medical services to persons by any physician, dentist, nurse, emergency medical technician made in U.S. currency at the prevailing exchange rate at the time the expenses or paramedic who is employed by you to were incurred. provide such services. (3) Any disputes between you and us as to b. This Insurance does not apply: whether there is coverage under this policy (1) If you are engaged in the business or must be filed In the courts of the United occupation of providing medical services; States of America (including its territories or and possessions), Puerto Rico or Canada. (2) To liability assumed in a contract or c. The following is added to Paragraph4.b. agreement. under the Conditions section: 4. Otherinsurance b. Excess Insurance This Insurance is excess over: Page 4 of 9 aen"� Risk Marm m ntDlWslon REVIEWED&APPR(We)BV: �--' Risk Wkinagement Analyst 58242193 20�21 GL/AU/OMEZWC/POLL I Tina Kennedy 110/21/2020 4: 36: 58 PM (POT) I Page " of 14 This cer 1flcate canes and supersedes ALL previously issued certificates. 7. Damage To Premises Rented To You a. The final paragraph under Paragraph 2., Exclusions of Section 1 - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: Exclusions c., d., e. and g. through n, do not apply to damage to premises while rented to you or temporarily occupied by you with Peu or Ion of the owner. A separate limit of nsurance applies to this cove a as described in Section III - Limits Of Insurance. This insurance does not apply to "property damage" (other than damage by fire1 to premises rented to you for a period of 7 or fewer consecutive days. b. Except for damage arising out of fire, explosion or water discharge, our obligation under this coverage to pay for premises "property damage" on your behalf applies only to the amount of damages in excess of a $5,000 per claim deductible. The deductible applies to all damages sustained by any one person or organization because of premises "property damage". The terms of this Insurance, including those with respect to: (1) Our right and duty to defend the Insured against any "suit" seeking damages to which this Insurance applies; and (2) Your duties in the event of an "occurrence", claim or "sulf' Apply irrespective of the application of the deductible amount. We may pay any part of or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 8. Extended Medical Payments Section I - Coverage C - Medical Payments is extended to apply to medical expenses incurred and reported to us within three years of the date of the accident. 9. Extended Non -Owned Watercraft Paragraph (2)(a) of Exclusion g. under Paragraph 2., Exclusions of Section 1 - Coveragge A - Bodily Injury And Property Damage Liabilhy Is amended, substituting 51 feet for 26 feet 10.Medical Payments - Waiver Of Transfer Of Rights Of Recovery Under Section IV - Commercial General Liability Conditions, Condition 8. Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: CG 70 21 0618 We waive the right of recovery we may have because of payments we make for "bodily inJ'ury under Section I - Coverage C - Medical Payments. 11.Aircraft Chartered With A Crew The following is added to Exclusion g. under Paragmph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability: This exclusion does not apply to an aircraft, not owned by any Insured, charted with a crew by or on behalf of the Insured. This insurance Is excess over any other valid and collectible aircraft Insurance available to the insured, whether such insurance is primary, excess, contingent or on any other basis. 12. Extended Property Damage Exclusion a. under Paraggraph 2., Exclusions of Section 1 - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: a. "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. 13.Hostile Fire -Pollution Clean Up The following Is added to Paragraph (2) of Exclusion f. under Paragraph 2., Exclusions of Section I - Coverage A - Bodily Injury Arid Property Damage Liability: Subparagraphs (2)(a) and (b) do not apply to loss, cost or expense arising out of heat, smoke or fumes from a "hostile fire" covered under paragraph f.(1), above. A separate aggregate limit of $25,000 Is the most we will pay under this coverage for losses during the policy period. The above provision does not apply if a Total Pollution Exclusion endorsement is part of this Coverage Part. 14. Newly Acquired Organizations Paragraph 3.a, of Section it - Who Is An Insured Is amended, substituting 180th day for 901h day. 15.6road Knowledge Of Occurrence, Claim Or Suit Under Section IV - Commercial General Liability Conditions, Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit is amended by the addition of the following: 58242193 20/21 GL/A"/OM9/WC/P0LL I Tina Kennedy 1 10/21/2020 4:36:50 PM (PDT) I Page 9 of 14 This Der ificate cancels and supersedes ALL previously issued certificates. �., RkkManageme M[Ast"n. 8 (REMEWED&pAP{P�R,CYVf® BY. � C F"�hNG�hS ry XMiN24fa(; olm i`---�� Risk Management Analyst Knowledge of an "occurrence", offense, claim or "suit" by an agent or "employee" of any insured or receipt of any demand, notice, summons or other legal paper in connection with a claim or "suit" by any agent or "employee" of any insured shall not In Itself constitute knowledge of the named Insured or receipt of the named Insured, unless a partner, member, manager, "executive officer' or director shall have such knowledge or shall have received such demand, notice, summons or legal paper. 16.8old Premises Property Damage Exclusion 1.(2) under Paragraph 2., Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability does not apply. 17.1.11nintentionalFailure To Disclose Hazards Under Section IV - Commercial General Liability Conditions, the following is added to Condition 6. Representations: If in your representations to us you unintentionally failed to disclose all hazards and exposures subject to this Insurance, we shall not deny all coverage under this policy because of such oversight. 18.Stop Gap Liability The following exception is added to Exclusion e. under Paragraph 2., Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability: This exclusion does not apply to "bodily injury" to an employee of the insured arising out of the course of: a. Employment by the insured; or b. Performing duties related to the conduct of the Insured's business provided such employee is reported and declared under the Workers Compensation Fund of the states of North Dakota, Ohio, Washington or Wyoming, whichever is applicable as respects such injured employee. As used herein, employee includes a "leased worker" or "temporary worker". The insurance provided by this coverage extension does not apply to: a. Punitive or exemplary damage because of "bodily injury" to an employee employed in violation of law; b. "Bodily Injury" to an employee while employed in violation of law with your actual knowledge or the knowledge of any of your "executive officers"; or c. Damages arising out of the discharge of, coercion of, or discrimination against any employee in violation of law. Page 6 of 9 19.Additional Insureds a. The following is added to Section 11 - Who Is An Insured. The following are included as Additional Insureds when you have agreed to add the person or organization as an Additional Insured on your policy in a written contract, written agreement or because of a permit issued by a state or political subdivision; provided the injury or damage occurs subsequent to the execution of the contract or agreement or Issuance of the permit: (1) Any Person or Organization you are Performing Work For Any person(s) or organization(s) not an Insured under paragraphs 2. through 6. below, but only with respect to liability for "bodily Injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the Additional Insured, A person's or organization's status as an Additional Insured under this endorsement ends when your operations for that Additional Insured are completed. (2) Lessor of Leased Equipment Any person(s) or organization(s), 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, operations or use of equipment leased to you by such person(s) or organization(s). 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. (3) Lessor of Leased Land Any person(s) or organization(s), but only with respect to liability arising out of the ownership, maintenance or use of that part of the land leased to you by that persons) or organizatlon(s), subject to the following additional exclusions: This insurance does not apply to: (a) Any "occurrence" which takes place after you cease to lease the land; (b) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) that are Additional Insureds under this provision. �T��e _,".e xak�,.genlenro�l",1 REVIEWED&N'PRQVm BY: �� RMManagement Analyst 58242 20e21 GL/AG/OMB/WC/POLL I Tina Kennedy 110/21/2020 4:36:58 PM (POT) I Page 10 of 14 This car ifrcate Cancels and supersedes ALL previously issued certificates. (4) Managers or Lessors of Premises Any person(s) or organization(s); but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you by that person(s) or organization(s); subject to the following additional exclusions: This Insurance does not apply to: (a) Any "occurrence" which takes place after you cease to be a tenant in that premises. (b) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) that are Additional Insureds under this provision. (5) Owners, Lessees or Contractors Any person(s) or organization(s), but 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 (b) The acts of omissions of those acting on your behalf; In the performance of your ongoing operations for the Additional Insured(s). With respect to the insurance afforded to these Additional Insureds, the following additional exclusions apply: This Insurance does not apply to: (a) "Bodily injury", "property damage" or "personal and advertising Injury" arising out of the rendering of, or the failure to render any professional, architectural, engineering or surveying services, including: (1) The preparing, approving, or falling to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (II) Supervisory, Inspection, architectural or engineering activities. CG 70 21 0519 _11 This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured If the "occurrence" which caused the "bodily injury" or "property damage" or the offense which causes the "personal and advertising injury Involved the rendering of or the failure to render any professional architectural, engineering or surveying services. (b) 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 (11) 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 the performing operations for a principal as a part of the same project. (6) State or Political Subdivisions - Permits Or Authorizations Related To Premises Any state or governmental agency or subdivision or political subdivision; but only with respect to the following hazards for which the state or governmental agency or subdivision has issued a permit or authorization In connection with premises 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, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; or (b) The construction, erection or removal of elevators; or (a) The ownership, maintenance or use of any elevators covered by this Insurance. However; (1) The Insurance afforded to such Additional Insureds only applies to the extent permitted by law; and Risk Mm&vnentDMakan .. REVIEWED&APPROVE) Sr. Rsk Management Analyst 58242193 �20/21 CL/AO/OMB/WC/POLL I Tina Kennedy 110121/2020 4:36:58 PM (PDT) I Page 11 of 14 This cex ificate cancels and supersedes ALL previously issued certificates. (2) The Insurance afforded to such Additional Insured will not be broader than that which you are required by the contract or agreement to provide for such Additional Insureds. A person or organization is an Additional Insured under this provision only for the period of time required by the contract or agreement. However, no such person or organization is an insured under this Additional Insured coverage if Included as an insured by an endorsement issued by us and made a part of this coverage part. b. The following is added to Section III - Limits of Insurance If you have agreed in a written contract or written agreement that another person or organization be added as an Additional Insured on your policy, the most we will pay on behalf of that Additional Insured is the lessor of: 1. The Limits of Insurance specified in the written contract or written agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations. This amount shall be a part of and not in addition to Limits of Insurance shown In the Declarations and described in Section III. c. The following is added to Section IV - Commercial General Liability Conditions: If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an Additional Insured, such Additional Insured must submit such claim or "suit" to the other Insurer for defense and Indemnity. However, this provision does not apply to the extent that you have agreed in a written contract or written agreement that this Insurance is primary and non-contributory with the Additional Insured's own Insurance. d. The following Is added to Section IV - Commercial General Liability Conditions 4.b.(1) of Excess Insurance: (c) Any other insurance available to an Additional Insured covered by this policy. However, the following provisions apply to other insurance available to any person or organization who is an Additional Insured under this coverage part. Page 8 of 9 (1) This Insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other Insurance is also primary, we will share with that other Insurance by the method described In Method of Sharing section below. (IQ If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the Additional Insured's own Insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs (1) and (11) do not apply to other Insurance to which the Additional Insured has been specifically named as an Additional Insured under a separate endorsement. 26.Mental Anguish The definition of "bodily injury" under Section V - Definitions is replaced by the following: "Bodily Injury" means bodily injury, sickness or disease sustained by a person, including "mental anguish" or death resulting from any of these at any time. The following definition is added to Section V - Definitions: "Mental anguish" means extreme pain or distress Inflicted upon an Individual's emotional and intellectual condition with regard to the individual's response to the environment. 21.Non-Employment Related Discrimination The following is added to the definition of "personal and advertising injury" under Section V - Definitions: Discrimination against or harassment of a person if: a. Coverage for such discrimination or harassment is permitted by law; and b. The discrimination or harassment Is not committed by or at the direction of: (1) You; (2) If you are an individual, your spouse; (3) If you are a partnership, a partner or his or her spouse; (4) If you are a joint venture, a member of the joint venture or his or her spouse; (5) If you are a limited liability company, any of your members or managers; or (6) If you are an organization other than a partnership, joint venture, or limited IlabIII!Y company, any of your "executive officers', directors or stockholders. w +� "k Managmod Dkieton 6rfY o}� st REVIEWE[)&APPROV®BY: RukManagement Ana{ys[ 58242193 20/21 GL/AU/UMS/WC/POLL I Tina Kennedy 110121/2020 4:36:58 PM (PDT) I Page 12 of 14 This car ificate cancels and supersedes ALL previously issued certificates. This Insurance does not apply to "personal and advertising Injury" arising out of any Insured's failure to comply with any responsibilities or duties required by the Americans With Disabilities Act, any amendments or additions or any similar state or local law. All other terms and provisions of this policy remain unchanged. CG 70 21 0616 w�_xny RiaManagrnvcntUfvialon W,%, REsatD&DDP,P`R/,.o}v/mRY/. Risk Management Analyst 58292193 20121 M/AU/OMB/WC/POLL I Tina Kennedy 110/21/2020 4:36:58 PM (PDT) I Page 13 of 19 This car ifncate cancels and supersedes ALL previously issued certificates. A0152818 Mike Prlich & Sons, Inc. COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other Insurance; and CG 20 01 0413 (2) You have agreed In writing in a contract or agreement that this Insurance would be primary and would not seek contribution from any other insurance available to the additional insured. ® Insurance Services Office, Inc., 2012 &REVIEWED & APPROVEE) BY.' 7 �tfi�hGN.4 A. 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