HomeMy WebLinkAboutGEOMATRIX CONSULTANTS, INC. 1B -2006
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SECOND AMENDMENT TO
CONSULTANT AGREEMENT
THIS SECOND AMENDMENT TO CONSULTANT AGREEMENT is entered
into on June 19,2006, by and between Geomatrix Consultants, Inc., a California
corporation ("Consultant") and the City of Santa Ana, a charter city and municipal
corporation of the State of California ("City").
Recitals:
A. The parties entered into Consultant Agreement A-2004-22I dated November 1,2004,
(hereinafter "said Agreement") by which Consultant has provided commercial
industrial NPDES permit inspections.
B. In accordance with the terms and conditions of said Agreement, the parties wish to
renew said Agreement for an additional one-year period and to increase compensation
to pay for services during the extended term.
Wherefore, in consideration of the covenants contained in said Agreement, and subject
to all the terms and conditions of said Agreement, except those amended in this Second
Amendment to Consultant Agreement, the parties agree as follows:
I. Section I, SCOPE OF SERVICES, shall be deleted in its entirety and replaced with
the following:
"Consultant shall conduct Facility Inspections, Inventory Management and
Enforcement Notifications, as set forth in Exhibit A.l, attached hereto."
2. Section 2.a., COMPENSATION, shall be amended to add $100,000 to the total
compensation. Said section 2.a shall be deleted in its entirety and replacing it with
the following:
"City agrees to pay and Consultant agrees to accept as full payment for its services
the rates and charges set forth in Exhibit B-1, attached hereto. Total compensation to
be paid pursuant to said Agreement shall not exceed $600,000.00 during the term of
said Agreement."
3. Section 3, TERM, shall be amended to extend the termination date from October 31,
2006 through October 31,2007.
4. Except as herein amended, all terms and conditions of said Agreement shall remain in
full force and effect.
'.
IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to
Consultant Agreement on the date and year first written above.
ATTEST:
CITY OF SANTA ANA
(l~;~
~ PATRICIA E. HEALY <;
Clerk of the Council
JJ:;(J-v,~ '~~,>>d.::. .V7/(
.<~ DAVIDN. REA'M
, City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
. ./'
By'/'/;' /'./ / /
,,' llr([.-1/?.f/,..,: (("C--r/
Laura Sheedy /
Assistant City Attorney
GEOMATRIX CONSULTANTS, INC.
~S/T
TIMOTHY S, SIMPSON
V.P. and Prin~al Frigineer
~.
Exhibit A-I
SUBJECT: Industrial/Commercial Inspection Program Services
Consultant shall provide the following services associated with the City's
Industrial/ Commercial Inspection Program. These tasks will be performed under the
$100,000 contract extension granted by the City.
o Meetings and bi-weekly updates with City representatives;
o Inventory and inspection program management;
o Facility inspections/re-inspections;
o Complaint responses / enforcement; and
o Program Effectiveness Assessment (PEA) Report assistance.
SCOPE OF WORK
Geomatrix assisted the City with implementation of their industrial/ commercial NPDES
inspection program during the 2004-2006 compliance periods. The City has extended the
existing contract to provide adclitional program assistance during the 2006-2007 compliance
period. The following is a brief description of the scope items that will be provided during
the 2006-2007 compliance period.
Meetings and Bi-Weekly Updates with City Representatives
Geomatrix will provide bi-weekly updates regarding inspection program status and will
attend meetings, as necessary, to coordinate the program with City representatives.
Inventory and Inspection Program Management
This scope item involves day-to-day management of the inspection program, including
logistics of multiple inspectors in the field and management of large volumes of data
collected. The inspection data will be managed using an Access database that will provide
summary information in a usable, efficient manner. Geomatrix will perform weekly quality
assurance/ quality control on the database to verify that information was entered correctly.
Photographs for each inspection will be cataloged and managed by each inspector and
regularly reviewed by the project manager.
Facility InspectionslRe-inspections
Geomatrix will continue to conduct field inspections of commercial and industrial facilities
to evaluate compliance with applicable local surface water quality regulations and related
BMPs. Inspections will be completed in accordance with requirements set forth in Section 9
of the 2003 Orange County DAMP and Santa Ana's LIP. Inspection Program Notification
letters will be sent to facilities at least one week prior to performing the inspection.
To facilitate efficient data entry, Geomatrix will continue to utilize tablet computers to
collect information in the field. Data collected and input on the tablets in the field will be
transferred directly to the database. Through the use of the database and tablet computers,
Geomatrix was able to complete a significantly higher number of inspections than were
completed in previous years by the City.
If, during the course of our facility inspections, we observe a discharge that may pose a
potential threat to human health or the environment, we will promptly notify the City via
telephone. Within two business days we will provide the City appropriate documentation of
the incident to complete and submit a written report to the RWQCB. For incidents that do
not pose a threat to human health or the environment, we will submit documentation within
5 business days.
Complaint Responses/Enforcement
In addition to the industrial/commercial facility inspections, we will provide personnel to
investigate and respond to complaints related to the City's Water Pollution Regulations.
From our experience, we understand that these investigations will often reguire coordination
with other departments in the City (i.e., code enforcement, fire department) and may also
require periodic re-inspections to verify compliance. If necessary, Geomatrix will also assist
the City in drafting enforcement notices.
Program Effectiveness Assessment (PEA) Report Assistance
Gcomatrix will assist the City with completion of Section C-9 of the PEA Repott. This
section includes detailed summaty infotmation tegarding the commercial/industrial
inspections performed by Geomatrix during the 2005-2006 monitoring year. We will utilize
the industrial/commercial inspection database to sort data obtained during inspections and
populate the PEA tables as appropriate.
COST
Our work will be charged on a time and materials basis according to our existing Agreement
with the City. A breakdown of costs is included on the attached spreadsheet. The budget
increase provides for assistance with completion of Section C-9 of the PEA Report,
completion of approximately 350 of the inspections scheduled for the 2006-2007 compliance
period, and associated project management and coordination with the City.
SUMMARY OF ESTIMATED COSTS
Commercial and Industrial Inspection Program
City of Santa Ana
September 1, 2006
Task No.1 - Meetings and Bi-weekly updates with City Representatives
Senior Engineer/Scientist I (Matthew Lentz) 40 hours @ 13500 $5,400.00
Principal Engineer (Timothy Simpson) 8 hours @ 225.00 $1,800.00
$7,200.00
Task No.2 - Inventory and Inspection Program Management/Database
Development
Staff Engineer/Scientist I (Michael Lowther)
Project Engineer/Scientist I (Brent Smith)
Senior Scientist (Matt Lentz)
10 hours @ 92.00 $92000
30 hours @ 118.00 $3,54000
15 hours @ 135.00 $2,025.00
Task No.3 - Facility Inspections/Re-inspections
Project Assistant (Jarrett Ingram) 50 hours @ 65.00 $3,250.00
Staff Engineer/Scientist I (Michael Lowther) 600 hours @ 92.00 $55,20000
Senior Engineer/Scientist I (Matthew Lentz) 40 hours @ 135.00 $5,400.00
Principal Engineer (Timothy Simpson) 6 hours @ 22500 $1,350.00
Travel Expenses
Mileage (100 miles/day @ 0.37 for 100 days) 100 days@40.00 $4,000.00
Task No.4 - Complaint Responses/Enforcement Assistance
Staff Engineer/Scientist I (Michael Lowther) 80 hours @ 92.00 $7,36000
Senior Engineer/Scientist I (Matthew Lentz) 24 hours @ 135.00 $3,24000
Travel Expenses
Mileage (.37 per mile) 40 days @ 10.00 $400.00
Task No.5 - Program Effectiveness Assessment (PEA) Assistance
Project Engineer/Scientist I (Brent Smith) 40 hours @ 118.00 $4,720.00
Senior Engineer/Scientist I (Matthew Lentz) 8 hours @ 135.00 $1,080.00
Principal Engineer (Timothy Simpson) 1 hours @ 225.00 $225.00
$6,485.00
$69,200.00
$11,000.00
$6,025.00
Tasks 1-5 Total $99,910.00
EXHIBIT B-1
ACORD," CERTIFICATE OF LIABILITY INSURANCE I OATE (MM/DDIYY)
06/26/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Dealey, Renton & Associetes ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P. O. Box 12675 HOLDER. THIS CERTIACATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Oakland, CA 94604.2675 I
510465.3090 Ted Klyama INSURERS AFFORDING COVERAGE
,
-'~-"'--""-,,_.,-,,,".'- . -r ---. .. U'__.._
INSURED INSURER A Greenwich Insurance Company
Geomatrlx Consultants, 'nc. .!.~su_~ERB_ Firema!-l~~ ~und_ln5urance Co.
2101 Webster Street, 12th Floor INSURER C
Oakland. CA 94612 ----.---- .....-........-
H~~,~ER 0: .m_ ...
INSURER E:
Cllent#: 149
GEOMACONS
COVERAGES
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 PERTAJN, THE INSURANCE AFFORDED BY THE POliCIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES- AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NSR J ----"---."'.~.-.- ".. 'pcfiJc-Y-EFFECTIVE
L' TYPE OF INSURANCE POLICY NUMBER DATE M D
A ~_~ERAL LIABIUTY
.~ X iCOMMERCIALGENERAlLlABlllTY
r=-r: CLAIMS MADE [xl OCCUR !
~~~~~~i~~1 Contr'- i
t~EN'LAGGREG~;~'~~~~ I
POlICY ,--- X PRO----
GEC000340606
07/01/06
.POLICY EXPIRATION
TE
, 07/01/07
UUITS
. EACH OCCURR~Nc:.~.._____lJl"QQ..QJ.QOO
FIRE DAMAGE (~y one filll) !1...QQO.OOO
!'"~;~~~~7=~~'~;~ "-, ;~:~~~ 000-'--
>--_.._,.,.,-,._~~>-.;.._...,."'-'"~_.,..._._,....
'._~~~~~ AGGREGATE _.-b2.000.Q_90
.~ROOUCTS .CO~F/OP AGG ,'s2.Q_OO.OOO
A AUTOMOBIL.E UASlUTV
~'] ANY AUTO
U ALL OWNED AUrOS
U SCHEDULED AUTOS
~--~.J HJRED AUTOS
I' ~J NON-OWNED AUTOS
--.-J '___.'....'........___._.__
,n 1_
iAEC000340706
i
I
I
I
07/01/06
07/01107
I COMBINED SINGLE UMIT
i (Ea acddef1!)
'1.000,000
; BODILY INJURY
! jP8f"persoo}
BODILY INJURY
(PeracCidllnl)
i
.
..-.,~_...._~-_.,._...
. ..,
PROPERTY DAMAGE
(Per accident)
,
exCESS L1ABIUTY
OCCUR
Its!
>-~~GE LIABIUTY
ANY AUTO
l=:J DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
I WZP80941390
07/01/06
, 07/01107
t..~l!!.<2._qNL Y . EA A~~~~~-H-:--'~'
. OTHER THAN __...___----;---___
AUTO ONLY: AGG I $
E~'i~URR:ENC~.....,._~_~.__~___.
l AGGREGATE .-.---------1.!-.____.
I,
}"=:-'~:':':::'---'-
OTH-
CLAIMS MADE<
B
A :' OTHER Professional
Contractors
ollutlon Llab.
DESCRIPTION OF OPERATJOHS/LOCATJONSNEHICLES/EXCLUSIONS ADDED BY ENOORSEMENT/sPECIAL PROVISIONS
GENERAL LIABILITY POLICY EXCLUDES CLAIMS ARISING OUT OF THE PERFORMANCE OF PROFESSIONAL
SERVICES.
GENERAL LIABILITY ADDITIONAL INSURED: The City of Santa Ana,
its officers. employees, agents. volunteers and representatives
(See Attached Descriptions)
CERTIFICATE HOLDER
I PEC000342405
I 07/01/06
107/01/07
;
x we STATU- I
__.._,..Im'i...UMlIS...,;
,!02::_~~~.~I.!?~~~.L~,1..,_900,OO~__...,.
E.L..Q.ISEASE -EA ~PLOYEE]' 51,09.0,000
E.l. DISEASE. POLleY LIMIT f 51 000,000
$5.000,000 per Claim
I $5.000.000 Annl Aggr.
I
ADDfTIONAlINSURED ;lNSUReRLETTER:
CANCELLATION
City of Santa Ana
Public Works Agency
Attn: Joe Parco
Civic Center Plaza M.36
Santa Ana. CA 92701
SHOULD AHYQf THE ABOVE DESCRtBED POLICIES BE CANCELLED BEFORE THE EXPtRAllON
DATE THEREOF, THE ISSUING INSURER WJ~XlaTOMAIL30..-....DAYSWRmEN
NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFTJOCIUAlIl8OCJOOC!lJGn IIfl.k
~~tl~
ACORD 25-5 (7197)1 of 2
AUTHORIZED REPRESENTATIVE
--r- J {f;
#M163481
NMF
@ ACORD CORPORATION 1988
are additional insurads to generalllablllly.
DESCRIPTIONS (Continued from Page 1)
Insurance Is primary per polley form.
AMS 25.3 (07/97) 2
of2
#M163481
~
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"~
POLICY NUMBER: GEC000340606
COMMERCIAL GENERAL LIABILITY
CG20100704
'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
[ --Nam~Of AdditionallnsuredP~;;~n(s)--~------- '-''''' - ----"1
;i~Y of ,~~'~:';o.') - - -t Al-;- =~~""'.~~O~.i:~1
I Public Works Agency Santa Ana, its officers, '
Attn: Joe Parco employees, agents, volunteers and
l::::o~:~::::;:~o:<..~~:~~:;,;:~~~~~::~J
A. Section 1\ . Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property
damage" or "personal and 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 location(s) desig-
nated above_
B. With respect to the insurance afforded to these
additional insureds, the following additional exclu-
sions apply:
This insurance does not apply to "bodiiy injury" or
"properly damage" occurring after:
1. All work, including materials, parts or equip-
ment furnished in connection with such work,
on the project (other than service, mainte-
nance or repairs) to be performed by or on
behalf of the additional insured(s) at the loca-
tion of the covered operations has been com-
pleted; 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 subcontrator
engaged in performing operations for a
principal as a part of the same project.
PRIMARY INSURANCE:
IT, IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY
AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED
SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS
INSURANCE_
SEVERABILITY OF INTEREST:
IT IS AGREED THAT EXCEPT WITH RESPECT TO THE LIMIT OF INSURANCE, THIS
COVERAGE SHALL APPLY AS IF EACH ADDITIONAL INSURED WERE THE ONLY INSURED
AND SEPARATELY TO EACH INSURED AGAINST WHOM CLAIM IS MADE OR SUIT IS
BROUGHT.
CG 20 10 07 04
~ 3~pyright, ISO Properties, Inc., 2004
Page 1 of 1
UNIFORM
.;
Client#: 149
GEOMACONS
ACORDT"
CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
Dealey, Renton & Associates
P. O. Box 12675
Oakland, CA 94604-2675
51 0 465-3090
A-~-).N
A -,tOOS--/7/
If -,2006 .{~J'
OATE (MMlDOIYY)
06/20/07
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGIITS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Geomatrix Consultants, Inc.
2101 Webster Street, 12th Floor
Oakland, CA 94612
I . INSURERS AFFORDING COVERAGE
~--- -------.---.--..------ ----------
INSURER A; Gr~~~~ich Insuran~~_~C?~e.l!!"L_______.._
INSURER B; Fireman's Fund Insurance Co.
-----------~-------- --~-
i INSURER C:
INSURED
i INSURER D:
! INSURER E;
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
~i~ i TYPE OF INSURANCE I POLICY NUMBER ----lp8k'fl ~'J~g~~E
A I GENERAL LIABILITY !GEC000340607 07/01/07
~X. C~MEACIALGENERAL~IABllITY i
l...- ; CLAIMS MADE [X] OCCUR I
[X Contractual i
lxJCG2417 RR Cont I
I G~'L AGGREGATE lIM IT APPLIES PER: I
POLICY X jRO,:! LOC
L.IMITS
AUTOMOBILE LIABILITY
X ANY AUTO
H ALL OWNED AUTOS
[.--1 SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
AEC000340707
I
!
07/01/07
EACH CXURRENCE $1 000 000
r fiRE DAMAGE !tny one firet $1 OOO.J}OO ~_~_
~ I
!-f;lED EXP (Anyone person) ! 55,000 _
~~SONA'::i\!lE.:(_!!'l.:l!:!~~__!J1,OOOt~__
GENERAL AGGREGATE_._._____ ~.bQ00..QQ..0____
PRODU(;TS -COMP/oP AGG $20QQ,OO"Q_______
!
A
07/01/08
, COMBINED SINGLE LIMIT I
i (Ea accident) . $1,000,000
f----------t--------
I BODILY INJURY I $
, (Per person) I
BODILY INJuRY
(Per acciden1)
$
; PROPERTY DAMAGE
i (Per accidenl)
$
i GARAGE LIABILITY
"--I ANY AUTO
I AUTO ONLY - EA ACCIDENT i L_____~__._____.
OTHER THAN
AUTO ONLY:
---t-
EXCESS LIABILITY ;
........J OCCUR 0 CLAIMS MADE
!
,'---,
! i DeDUCTIBLE
n ReTENTION
EACH OCCURRENCE
EA ACC $
AGG $
--- _$_-------_...-
$
. AGGREGATE
)----.---
~
I
t
is
;
i$
i-L-_______
$
B I WORKERS COMPENSATION AND !!WZP80953183
; EMPLOYERS' LIABIUTY
-+
;
;
i OTHER
i 07/01/07
I
I X wc ~lfJHs 1____ eJ~-
i EL EACH ACCIDENT . $1,000,000
. ~ I
!E.L. DISEASE -EA EMPLq~_~L~1,000~00 _.______
t . E L DISEASE - POLICY LIMIT I $1,000,000
I_~
~7/A
07/01/08
i
DESCRIPTION OF OPERATlONSlLOCATIONSNEHICLESlEXClUSIONS ADDED BY ENOORSEMENTISPECIAL PROVISIONS
General Liability Policy excludes claims arising out of the performance of professional
services.
Ref:#8586. The City of Santa Ana, its officers, employees, agents,
volunteers and representatives are additional insureds to general
liability. Insurance is primary and non-contributing.
CERTIFICATE HOLDER
, ADDmONAL INSURED;INSURERLETTER:
CANCELLATION
City of Santa Ana, M-93
AUn: Nasser
20 Civic Center Plaza
Santa Ana, CA 92702
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL.LED BEFORE TH E EXPIRATION
DATE THEREOF, THE ISSUfNG INSURER WI~Xllt1ll: TOMAIL30........_DAYSWRITTEN
NonCETOTHE CERTIFICATE HOLDERNAMEDTOTHELEFT.xK!l[X~1(
~!ll:J{V('ltIX.IR:XDM~K~:l:Jl:!ll:~
)fQK~1OO1II*X
AUTHORIZED REPRESENTATIVE
7~ 1ff--"'-'--
I
ACORD 25-$ (7/97)1 of 1
#M195996
NMF @ ACORD CORPORATION 1988
J .
POLICY NUMBER: GEC000340607
COMMERCIAL GENERAL LIABILITY
CG 20 100704
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) -r- --l
Or Organzlation(s): __~_--=--=- ~ocation(s) Of Covered Operations I
r;i~y of Santa Ana, M-93 i Ref:#8586. The City of S~
I ~ttn: Nasser I Ana, its officers, employ~~;;. I
I 20 Civic Center Plaza - agents, volunteers and I
: Santa Ana, CA 92702 representatives are additional ~
i I insureds. '
llnform-":t~q-';;r;;;;t;, complete this Scl1ed~~t shown ebove, will be shown in the Declarations. --J
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 10 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 location(s) desig-
nated above.
B. With respect to the insurance afforded to these
additional insureds, the following additional exclu-
sions apply:
This insurance does not apply to "bodily injury" or
"property damage" occurring after:
1. All work; including materials, partsor equip-
ment furnished in connection with such work,
on the project (other than service, mainte-
nance or repairs) to be performed by or on
behalf of the additional insured(s) at the loca-
tion of the covered operations has been com-
pleted; 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 $ubcontrator
engaged in performing operations for a
principal as a part of the same project.
PRIMARY INSURANCE:
IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY
AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED
SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS
INSURANCE.
CG 20 10 07 04
~ 2)2-
Copyright, ISO Properties, Inc., 2004
Page 1 of 1
UNIFORM