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HomeMy WebLinkAboutPLACEWORKS (5) J ' n , A-2023-089-06A MAYOR CITY MANAGER Valerie Amezcua Alvaro Nui)ez MAYOR PRO TEM MAY 2 7 X2G CITY ATTORNEY David Ponaloza -- Sonia R.Carvalho COUNCILMEMBERS CITY CLERK Phil eacerra Jennifer L.Hall Johnathan Ryan Hernandez Jessie Lopez Thai Viet Phan Benjamin Vazquez CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza I PO Box 11988 Santa Ana,California 92702 www.santa-ana.ora April 21, 2026 PlaceWorks Attn: Jesse Jones, Associate Principal 3 MacArthur Place, Suite 1100 Santa Ana, CA 92707 Re: Extension of Agreement No.A-2023-089-06 to provide on-call landscape architectural services Pursuant to Section 3 ("Term") of the above-referenced Agreement, entered into by PlaceWorks and the City of Santa Ana,which commenced on May 16, 2023,the parties hereby exercise their option to extend the term of the Agreement for an additional one(1)year through May 15,2027. Any 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. Sincerely Ro o sas, P.E. Acting Executive Director, Public Works Agency CITY OF TA ANA ATTEST 7 } lvaro Nunez ennifer . Hal City Manager City Cl APPROVED AS TO FORM CONSULTANT Al /Gl t�xLL `ti r 4 Karl Nellesen By; Kara L Kosel Assistant City Attorney Title: Vice President, Finance SANTA ANA CITY COUNCIL Valane Amezcua David Penafuza Thai Viet Phan Benjamin Vazquez Jessie Lopez Phil Bacerra Johnathan Ryan Hernandez Mayor Mayor Pro Tern-Ward 6 Ward t Ward 2 Ward 3 Ward 4 Ward 5 vameznua(nlsenta-ana org tloenalozai�sanla-ana.oro Lphan(�eanFaana.org bvaaaue=antaana orq iessielonezr�sania-ana.ora pbacemaasantaana_org anhemandez santa-ana.o ACC>RlDlili CERTIFICATE OF LIABILITY INSURANCE r ATE(MMIDDIYYYY) 07/1112025 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 endorsements. PRODUCER CONTA T Marsh Risk&Insurance Services NAME: 17901 Von Karman Avenue,Suite 1100 OCON o aIc No): (949)399-5800;License 0437153 E-MAIL Irvine,CA 92614ADDRESS: Attn:NewportBeach.CedRequest@marsh,com/F:212-948-4323 INSURERS AFFORDING COVERAGE NAIL 0 CN115158923.01-01-25-26 INSURER A: Starr Surplus Lines Insurance Company 13604 INSURED PlaceWorks,Inc INSURER B: TravelcLLPmpefty Casually Co.OfAmerica 25674 3 MacArthur Place,Suite 1100 INSURER C: Falcon Insurame Group Santa Ana,CA 92707 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: LOS-002212046-35 REVISION NUMBER: 13 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. ICY EXP LTR SU TYPE OF INSURANCE JHM n POLICY NUMBER MM1DDPOLICY EFF MMI�ONYYY LIMITS A X COMMERCIAL GENERAL LIABILITY y y 1000068067251 07/15/2025 07101/2026 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ILI OCCUR DAMAGE ED PREMISES Ea occurrence $ 50,000 X BI&PD Ded.$5,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY❑JECT LOU PRODUCTS-COMPIOPAGG $ 1,000,000 OTHER: Contractors Pollution $ 5,000,000 B AUTOMOBILE LIABILITY y y BA-lN96406A-25-43-G 07/0112025 07/01/2026 CEOMaBBIIIaEeDISINGLE LIMIT $ 1,000,000 AINY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per eccldenl) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per a.Iden l $ X Com !Coll Deductibles $ 1,000 B UMBRELLALIAR X OCCUR EX-6J328756-2543 07/01/2025 07/01/2026 EACHOCCURRENCE $ 4,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $ 4,000,000 DED I I RETENTION$ $ B WORKERS COMPENSATION UB-7K728676-25-43-G 07/01/2025 07ATJ2026 X STATUTE ERH AND EMPLOYERS'LIABILITY Y I N ANYPROPRIETORIPARTNERIEXECUTiVE E.L.EACH ACCIDENT $ 11000,000 OFFICERIMEMBEREXCLUDED? N NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 11000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Errors&Omissions-Claims Made FRS-H-P-PL-00013383-01 0711512025 07/01/2026 Each Claim/Aggregate 5,000,000 Retro Dates:See 2nd Page DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached IFmore space is required) Re:Operations performed by the named insured for the certificate holder City of Santa Ana,its officers,agents,employees,and volunteers are included as additional Insured where required by written contract with respect to General and Auto Liability,This insurance is primary and non- contributory over any existing Insurance and limited to liability arising out of the operations of the named insured and where required by written contract with respect to General Liability,Waiver ofsubrogatien is applicable where required by written contract with respect to General and Auto Liability, APPROVED CERTIFICATE HOLDER CANCELLATION By To Tran'lY rryen ats:18 am— 8 2-. City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Risk Management Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza,4th Floor ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana,CA 92701 AUTHORIZED REPRESENTATIVE e yy ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Policy Number: BA-iN96406A-24-43-G Effective Date: 07/01/2025 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However,coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE—LOSS OF B. BLANKET ADDITIONAL INSURED USE—INCREASED LIMIT C. EMPLOYEE HIRED AUTO I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS -- INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS ERAGE—INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED this insurance applies and only to the extent that The following is added to Paragraph A.1., Who Is person or organization qualifies .as an "insured" An Insured, of SECTION 11—COVERED AUTOS under the Who is An Insured provision contained LIABILITY COVERAGE: in Section If. C. EMPLOYEE HIRED AUTO Any organisation you newly acquire or form dur- 1, The following is added to Paragraph A.1.. ing the policy period over which you maintain 50% or more ownership interest and that is not Who Is An Insured, of SECTION II — COV- separately insured for Business Auto Coverage. ERED AUTOS LIABILITY COVERAGE, Coverage under this provision is afforded only un- An "employee" of yours is an "insured" while til the 180th day after you acquire or form the or- operating an "auto" hired or rented under a ganization or the end of the policy period, which- contract or agreement in an "employee's" ever is earlier, name, with your permission, while performing duties related to the conduct of your bust- B. BLANKET ADDITIONAL INSURED ness. The following is added to Paragraph c. in A.1., 2. The following replaces Paragraph b. in B.S., Who Is An Insured, of SECTION 11—COVERED Other Insurance, of SECTION IV — BUSI- AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS,. Any person or organization who is required under b. For Hired Auto Physical Damage Cover- a written contract or agreement between you and age, the following are deemed to be cov- that person or organization, that Is signed and ered"autos"you own: executed by you before the "bodily injury" or (1) Any covered "auto" you lease, hire, "property damage" occurs and that is in effect rent or borrow; and during the policy period, to be named as an addi- (2) Any covered "auto" hired or rented by tional insured is an "insured" for Covered Autos your "employee" under a contract in Liability Coverage, but only for damages to which an "employee's" name, with your CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office,Inc,with its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered"auto". (i) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured"against, and investigate or set- The followingIs added to Paragraph A.1., Who Is set- tle any such claim or"suit" and keep us advised of ail proceedings and ac An Insured, of SECTION II—COVERED AUTOS tions. LIABILITY COVERAGE: (ii) Neither you nor any other involved Any "employee" of yours is an "insured" while us- "insured" will make any settlement ing a covered"auto"you don't own, hire or borrow in your business or your personal affairs. without our consent. E. SUPPLEMENTARY PAYMENTS — INCREASED (Ili)We may, at our discretion, participate LIMITS in defending the "insured" against, or in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit", of SECTION II --COVERED AUTOS LIABIL- ITY COVERAGE: (iv)We will reimburse the "insured" for sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in- we cover, We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II—COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "Insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work, tion of such claims and your defense of the "Insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COW "suit", but only up to and included ERAGE—INDEMNITY BASIS within the limit described in Para- The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph 1B.7.. Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to 5) Anywhere in the world, except count or make such payments ends when we { Y p Y country have used up the applicable limit of jurisdiction while any trade sanction, em- insurance in payments for damages, bargo, or similar regulation imposed by the settlements or defense expenses. United States of America applies to and pro- hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less (c) This insurance is not a substitute for re- and that is not an "auto"you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter- partners (if you are a partnership). members ritorics and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 02015 The Travelers Indemnity company.All rights reserved. GA T3 53 0215 Indudes copyrighted material of insurance Services Office,Inc.with its permission. COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered"auto". compulsory insurance in any such coun- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered"auto". local law. Your failure to comply with compulsory insurance requirements will No deductibles apply to this Personal Property not invalidate the coverage afforded by coverage. this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph B.3., Exclu. had you complied with the compulsory in- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- Exclusion 3.a. does not apply to "loss" to one or ted or authorized insurer outside the more airbags In a covered "auto"you own that in- United States of America, its territories fiate due to a cause other than a cause of"loss" and possessions, Puerto Rica and Can- set forth in Paragraphs A.1.b. and A.i.c., but ada. We assume no responsibility for the only: furnishing of certificates of insurance, or a. If that "auto" is a covered "auto" for Compre- for compliance in any way with the laws hensive Coverage under this policy; of other countries relating to insurance, b. The airbags are not covered under any war- G. WAIVER OF DEDUCTIBLE--GLASS ranty; and The following is added to Paragraph D., Deducti- c. The airbags were not intentionally Inflated. ble, of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE: one"loss". No deductible for a covered "auto" will apply to L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather than LOSS replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF The following is added Paragraph A.2.a., of SECTION IV—BUSINESSS AUTO CONDITIONS:: USE—INCREASED LIMIT Your duty to give us or our authorized representa- The following replaces the last sentence of Para- tive prompt notice of the "accident" or "loss" ap- graph A.4.b., Loss Of Use Expenses, of SEC- plies only when the "accident" or "loss" is known TION III—PHYSICAL DAMAGE COVERAGE: to: However, the most we will pay for any expenses (a) You (if you are an individual); for loss of use is $65 per day, to a maximum of (b) A partner(if you are a partnership): $750 for any one."accident". (e) A member (if you are a limited liability com- I. PHYSICAL DAMAGE — TRANSPORTATION pany); EXPENSES—INCREASED LIMIT (4) An executive officer, director or insurance The following replaces the first sentence in Para- manager(if you are a corporation or other or- graph A.4.a., Transportation Expenses, of ganization),or SECTION III -- PHYSICAL DAMAGE COVER- (e) Any"employee" authorized by you to give no- AGE: tice of the"accident"or"loss". We will pay up to $50 per day to a maximum of M. BLANKET WAVER OF SUBROGATION $1,500 for temporary transportation expense in- The following replaces Paragraph A.S., Transfer curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us, ered"auto"of the private passenger type, of SECTION IV — BUSINESS AUTO CONDI- J. PERSONAL PROPERTY TIONS: The following is added to Paragraph A.4., Cover- S. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- Personal tent required of you by a written contract We will pay up to S400 for "loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or"loss", provided that the"accident" or"loss" (1) Owned by an"insured"; and arises out of operations contemplated by CA T3 S3 02 15 0 2015 The Travelers Indemnity Company.All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services OfCce,Inc.with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this Insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col- The following is added to paragraph 8.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non-renewal. SECTION IV—BUSINESS AUTO CONDITIONS: Page 4 of 4 0 2015 The Travelers Indemnity compa ny.All rights reserved, CA T3 53 02 15 Includes copyrighted material of Insurance Services Office,Inc.with Its permission. COMMERCIAL GENERAL LIABILITY SSGL-0288 02 24 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED, PRIMARY AND NONCONTRIBUTORY AND WAIVER OF SUBROGATION AMENDATORY ENDORSEMENT Policy Number: 1000068067251 Effective Date: 07/15/2025 at 12:01 A.M. Named Insured: Placeworks, Inc, This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the Declarations page, Please read the endorsement and respective policy(ies)carefully. COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name Of Person(s)Or Organizatiion(s), Where Required By Written Contract It is hereby agreed as follows: 1. SECTION II-WHO IS AN INSURED Is amended to include the following: a. Any person(s) or organization(s) that you are required to include as an additional insured under this policy by written contract or written agreement or that Is listed in the SCHEDULE above is an additional Insured under this policy. Such additional insured status applies only with respect to liability arising out of"your work" for or on behalf of that person(s) or organization(s) pursuant to such written contract or written agreement. However,the insurance afforded to such additional insured(s): (1) only applies to the extent permitted by law;and (2) will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured(s). b. With respect to the insurance afforded to the additional insured(s), SECTION III—LIMITS OF INSURANCE is amended to include the following: The most we will pay on behalf of the additional insured(s)is the amount of insurance: (1) Required by the contract or agreement; or (2) Available under the applicable limits of insurance; whichever is less, This endorsement shall not Increase the applicable limits of insurance. 2. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other insurance is amended to SSGL-0288 02 24 Copyright©Starr Surplus Lines insurance Company. All rights reserved. Page 1 of 2 Includes copyrighted material of Insurance Services Office,Inc.,with Its permission. include the following,which supersedes any provision to the contrary: -r 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: a. The additional insured is a Named Insured under such other insurance;and b. 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. 3. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer Of Rights Of Recovery Against Others To Us is amended to include the following: We waive any right of recovery against any person or organization, because of any payment we make under this policy,to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the Insured has waived its right of recovery against such person or organization prior to loss. All other terms and conditions of the policy remain unchanged, SSGL-0288 02 24 Copyright Starr Surplus Lines insurance Company. All rights reserved. Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. ENERGY$ENVIRONMENTAL LIABILITY SSEE-0237 02 24 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED, PRIMARY AND NONCONTRIBUTORY AND WAIVER OF SUBROGATION AMENDATORY ENDORSEMENT Policy Number. FRS-H-P-PL-00013383-01 Effective Date: 07/15/2025 at 12:01 A.M. Named Insured: Placeworks, Inc, This endorsement modifies the insurance coverage form(s) listed below that have been purchased by you and evidenced as such on the Declarations page. Please read the endorsement and respective policy(ies)carefully. CONTRACTORS' POLLUTION LIABILITY COVERAGE FORM PROFESSIONAL LIABILITY COVERAGE FORM SITE POLLUTION LIABILITY COVERAGE FORM SCHEDULE Where Required By Written Contract It is hereby agreed as follows: 1. SECTION II-WHO IS AN INSURED is amended to include the following: a. Any person(s) or organization(s) that you are required to include as an additional insured under this policy by written contract or written agreement or that is listed in the SCHEDULE above is an additional insured under this policy. Such additional insured status applies only with respect to liability arising out of "your work" for or on behalf of that person(s) or organization(s) pursuant to such written contract or written agreement. However,the insurance afforded to such additional insured(s): (1) only applies to the extent permitted by law; and (2) will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured(s). b. With respect to the insurance afforded to the additional insured(s), SECTION III—LIMITS OF INSURANCE Is amended to include the following. The most we will pay on behalf of the additional insured(s)is the amount of insurance: (1) Required by the contract or agreement; or (2) Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. SSEE-0237 02 24 Page 1 of 2 Copyright O Starr Surplus Lines Insurance Company. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc.,used with its permission. 2. SECTION IV-- CONDITIONS, 4. Other Insurance is amended to include the following, which 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: a. The additional insured is a Named Insured under such other Insurance,and b. 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. 3. SECTION IV -- CONDITIONS, 7. Transfer Of Rights Of Recovery Against Others To Us is amended to include the following: We waive any right of recovery against any person or organization, because of any payment we make under this policy,to whom the insured has waived its right of recovery In a written contract or agreement. Such waiver by us applies only to the extent that the Insured has waived its right of recovery against such person or organization prior to loss. All other terms and conditions of the policy remain unchanged. SSEE-0237 02 24 Page 2 of 2 Copyright t7 Starr Surplus tines Insurance Company. All rights reserved. Includes copyrighted material of insurance Services Office, Inc., used with its permission. TRAVG LER5 WORKERS COMPENSATION AND ONE TOWER SQUARE HA]xTT+aRD CT 06183 EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 0313 (00)-003 POLICY NUMBER; UU-7R728676-25-43-G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written Contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. SCHEDULE DESIGNATED PERSON: DESIGNATED ORGANIZATION: ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER. DATE OF ISSUE: 07-14-25 STASSIGN: PAGE 1 OF1