HomeMy WebLinkAboutWILLDAN HOMELAND SOLUTIONS, A DIVISION OF WILLDAN GROUP INC. 7C-2015INGU£{ANCP ON FIDE
WORK MAY PROCEED
UNTIL INSURANCE EXPIRES
CLERK OR COUNCIL,
1 DATE: yta �2
L
THIRD AMENDMENT TO AGREEMENT
C. On December 4, 2013, the parties entered into a Second Amendment of the Agreement #A-
2012-218-002, wherein it was agreed that the scope of services would be amended to replace
Exhibit A with Exhibit A-1 outlining the training and exercise programs under the
Agreement.
D. The parties wish to enter into the Third Amendment of said Agreement to revise Section 4
TERM to provide that the Agreement ends on September 30, 2016, the additional time will
allows the parties to provide training with the outstanding grant funds that remain under the
Agreement.
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 Third Amendment to
Agreement, the parties agree as follows;
Section 4, TERM, shall be amended to extend the term one-year, through September 30,
2016.
2. Except as hereinabove amended, all terms and conditions of said Agreement shall remain in
full force and effect.
1/r
THIS THIRD AMENDMENT TO AGREEMENT is entered into on September 21, 2015,.
by and between Willdan Homeland Solutions, a California corporation ("Consultant') and the
City of Santa Ana, a charter city and municipal corporation organized and existing under the
4
Constitution and laws of the State of California ("City").
J�
RECITALS:
A. The parties entered into Agreement #A-2012-218, dated October 15, 2012, (hereinafter "said
Agreement') by which Consultant has provided grant funded multi-year training and exercise
programs.
Ii. The parties entered into the First Amendment orthe Agreement #A-2012-218-001 on August
21, 2013, wherein they agreed to increase the hourly pay rate for program management
services to $60.58, modify the scope of services to add and delete certain training exercises,
provide for a cost of living increase not to exceed 5% starting January 1, 2014 and annually
thereafter, and add consultant certifications.
C. On December 4, 2013, the parties entered into a Second Amendment of the Agreement #A-
2012-218-002, wherein it was agreed that the scope of services would be amended to replace
Exhibit A with Exhibit A-1 outlining the training and exercise programs under the
Agreement.
D. The parties wish to enter into the Third Amendment of said Agreement to revise Section 4
TERM to provide that the Agreement ends on September 30, 2016, the additional time will
allows the parties to provide training with the outstanding grant funds that remain under the
Agreement.
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 Third Amendment to
Agreement, the parties agree as follows;
Section 4, TERM, shall be amended to extend the term one-year, through September 30,
2016.
2. Except as hereinabove amended, all terms and conditions of said Agreement shall remain in
full force and effect.
1/r
IN WITNESS WHEREOF, the parties hereto have executed this Third Amendment to Agreement
on the date and year first written above.
ATTEST:
I\a W
MARIA D. FIUIZAR DAVID CAVAZOS
Clerk of the Council City Manager
APPROVED AS TO FORM:
WILLDAN HOMELAND SOLUTIONS
SONIA R. CARVALHO
City Attorney
By: `4kwi'u• �a e c ��•c
Laura Rossini James E. Bailey
Senior Assistant City Attorney President and CEO
RECOMME/NDED FOR APPROVAL:
C RARLOOSS✓//ROJAS
Chief of Police
,Acc:ruc.�� CERTIFICATE OF LIABILITY INSURANCE
1012912014 DAEYY'
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed, If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements .
PRODUCER
Dealey, Renton & Associates
P. nt Box 10550
Santa Ana CA 92711-0550
KaGLLtiOCp._._ �— -----
PHONE
NiNo —`
aoorsEss�{tthQrpQ'I�},gd>_g,Cpl�_ ------------- --------
___INSURERISJAFFORDINGCOVERAGE - _ _HAIG4 _
GENERAL LIABILITY
X`"SAMAGETO-PE'NTE
COMMERCIAL GENERALUABILI I
CLAWS -MADE [X__ 1 OCCUR
5674e—
INSURED
_INSURER 6:
Y1119/20t5
Wittlan Homeland Solutions
M5URERC:CI�a[tQ[Qar (LEI 1QS„tlpa C_A1T]p20K—..--_._.
1.6--
2401 E. Katella Avenue, Ste. 220
Anaheim CA 92808
INSURER e -----
$1,000,000
----- -------"--'
X Contractual
INSURER
INSURER F
X
COVERAGES CERTIFICATE NUMBER: 2084374271 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.
LTR
TYPE OF INSURANCE
N
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MMIODIYYYY
_—_--_
LIMITS
A
GENERAL LIABILITY
X`"SAMAGETO-PE'NTE
COMMERCIAL GENERALUABILI I
CLAWS -MADE [X__ 1 OCCUR
Y
301158P020
11/9/2014
Y1119/20t5
EACH OCCURRENCE
$1,000,000
MEO EXP {Am11ne parsonl
910,000 ...... _
PERSONAL&ADV INJURY
$1,000,000
X Contractual
X
BFPO, XCU
GENERAL AGGREGATE
5_2,000,000 _
GEN'L AGGREGATE
LIMIT APPLIES PER,
_
PRODUCTS - COMPIOP AGG
$2,000.000
POLICY
X PRO- LOC
$ _—
A
AUTOMOBILE LIABILRY
8101158P020
11/9/2014
11179/2015
(Eenccitlnnt -,___
1-.000000__ _.
BODILY INJURY (Per person)
$
X ANY AUTO
ALL OWNED I SCHEDULED
AUTOS _.y AUTOS
x IHIREDAUTOS X IAOTO5WNED
BODILY IN.IURY tParaccidaMl
$
SV DacidenDAMAGc 'is
-----
$
UMBRELLA LIAR
OCCUR
fiACli OCCURRENCE
5
AGGREGATE
8
EXCESS UAB
CLMMS_MADE
_
DED I I RETENTION$
_
_
5
C
WORKERS COMPENSATION
ANO CMPLOYERS' LIABILiri-ER-----
ANY PROPRIETOWPARTNERIEXECUTIVE �YIN
OFFICERIMF.MDER EXCWDEp4
NIA
UB7D417816
f!)2014
1102015
x �NC STATIC- 1JTH-
E, L.. EACH ACCIDENT
$I 00Q000
—
tMm,datmyinNH) L_J
EL. DISEASE - EA EMPLOYE
$1,000,000
EL DISEASE -POLICY LIMIT
$1000,000
If yyos. desmbe under
OE SC RIPTION OF OPERATIONS no.
B
Profestilonal Liability
Claims Made
I
AED977441115
11/9/2014
1119/2015
1
I
Per Cla IN $1,000;000
Annual Aggregate $2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ADDED ter. Additional Remarks Schedule, it mora space is required) 1^' tT^�^�����----yye+�,,
General Liability policy excludes claims arising out of the performance of professional services. C_GV GVV✓j„+' tj -.
Independent Contractors are included as respects to General Liability.
30D NOC/10 Day far NGnPay of Prem
City of Santa Ana, its Officers, employees, agents, volunteers and representatives are additional insured as respects
to General Liability as required by written contract. Primary and Non -Contributing coverage, Cross Liability
coverage applies to GL as required by written contract. (WHS)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Santa Ana ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Clerk of the City Council
20 Civic Center f IaZa(M-30) / PG Box 1988 AU HORIZED REPRESENTATIVE
Santa Ana CA 92702
J k0l,p
U 1SBS-ZOtD AUUKU C:OKPUKAI IUN. Atl rlgnlS MISerVed.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
COMMERCIAL GENERAL LIABILITY
6301158PO20
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED - WRITTEN
CONTRACTS (ARCHITECTS, ENGINEERS AND
SURVEYORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. The following is added to SECTION II —WHO IS plies only to such "bodily injury' or "property
AN INSURED: damage" that occurs before the end of the pe -
Any person or organization that you agree in a riod of time for which the "written contract re-
written contract requiring insurance" to include as quirang insurance" requires you to provide
an additional insured on this Coverage Part. but such coverage or tate end of the policy period,
whichever is earlier.
a. Only with respect to liability for "bodily injury",
"property damage" or "personal injury"; and
It, If, and only to the extent that, the injury or
damage is caused by acts or omissions of
you or your subcontractor in the performance
of "your work" to which the "written contract
requiring :nsuranca" applies. The person or
organization does not qualify as an additional
insured with respect to the independent acts
or omissions of such person or organization.
The insurance provided to such additional insured
is limited as follows:
c. In the event thet the Limits of Insurance of
this Coverage Part shown in the Declarations
exceed the limits of liability required by the
"written contract requiring insurance". the in-
surance provided to the additional insured
shall be limited to the limits of liability required
by that "written contract requiring insurance".
This endorsement shall not increase the limits
of insurance described in Section III — Limits
Oflnsurance.
d. This insurance does not apply to the render-
ing of or failure to render any "professional
services" or construction management errors
or omissions.
a. This Insurance does no: apply to "bodily in-
jury" or "property damage" caused by "your
work" and included in the "products -
completed operations hazard" unless the
"written contract requiring insurance" specifi-
cally requires you to provide such coverage
for that additional insured, and then the insur-
ante provided to the additional insured ap-
2. The following is added to Paragraph 4.a. of SEC-
TION IV — COMMERCIAL GENERAL LIABILITY
CONDITIONS
The Insurance provided to the additional insured
is excess over any valid and collectible "other in-
surance", whether primary, excess, contingent or
on any other basis, that is available to the addi-
tional insured for a loss we cover. However, if you
specifically agree in the "written contract requiring
insurance" that this insurance provided to the ad-
ditlonai insured under this Coverage Pan mus!
apply on a primary basis or a primary and non-
contributory basis. this insurance Is primary to
"after insurance" available to :he additional in.
cured which covers that person or organization as
a ranted insured for such loss, and we will not
share with that '"other insurance' But this insur.
ance provided to the additional Insured still is ex-
cess over any valid and collectible "other insur-
ance", whether primary, excess, contingent or on
any other basis, that Is available to the additional
insured when that person or organization is an
additional insured under any "other insurance
8. The following is added to SECTION IV — COM-
MERCIAL GENERAL LIABILITY CONDITIONS:
Duties Of An Additional insured
As a condition of coverage provided to the adds-
tional insured:
a. The additional insured must give us written
notice as soon as practicable of an 'occur-
rence" or an offense which may result in a
claim. To the extent possible, such notice
should include.
CG D414 04 08 02008'rhe Trzveiers compan'es. .nc.
Page 1 of 2
COMMERCIAL GENERAL LIABILITY
I. How, when and where the "occurrence"
or offense took place;
Il. The names and addresses of any injured
persons and witnesses; and
Ili. The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
b. If a claim is made or "suit" is brought against
the additional Insured, the additional insured
must:
Immediately record the specifics of the
claim or "suit" and the date received; and
H. Notify us as soon as practicable.
The additional Insured must see to it that we
receive written notice of the claim or "suit" as
soon as practicable.
c. The additional insured must immediately send
us copies of all legal papers received in con-
nection with the claim or "suit", cooperate with
us In the investigation or settlement of the
claim or defense against the "suit", and oth-
erwise comply with all policy conditions.
d. The additional insured must tender the de-
fense and indemnity of any claim or "suit" to
Page 2of2
any provider of other Insurance which would
cover the additional insured for a loss we
cover. However, this condition does not affect
whether this Insurance provided to the addi-
tional insured is primary to that other insur-
ance available to the additional insured which
covers that person or organization as a
named Insured.
4. The following is added to the DEFINITIONS Sec-
tion:
"Written contract requiring insurance" means that
part of any written contract or agreement under
which you are, required to Include a person or or-
ganization as an additional insured on this Cover-
age Part, provided that the "bodily injury" and
"property damage" occurs and the "personal in-
jury" is caused by an offense committed:
a, After the signing and execution of the contract
or agreement by you;
b. While that part of the contract or agreement is
In effect; and
c. Before the end of the policy period
02 000 The Travelers Campanies, Inc.
F
CG D4 14 04 00
CERTIFICATE OF LIABILITY INSURANCE A, FrMM�I1201YYVY}
w ��,�D/
THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE (HOLDER. THUS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF IINSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUIBROGATION 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 CONTACT
NAME.
Aon. Risk. Insurance Ser'Vic,es West., Inca. Pi6lgf__-------- _-__._. ---- ..5 ............ ..............
LOS AnR� eles CA OffiCe IAJC.No. Ext( (866) 281-x'122 I'C.No.¢. 1500) 363 (I',Lr15
707 w! Shire Cou)evard E-MAIL
Suite 2600 ADDRESS:
Los Angeles CA 90017-0460 USA INSUIREIR(S) AFFORDING COVERAGE MAIC#
INSURED
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THUS
INSURER A:
National Fire Ins, . Co.. of (Hartford
20478
willdan Homeland Solutions
IVSD
INSURER 8:
The Continental Insurance Company
35289
2401 F. Kat:ella Avenue, Ste.
220
X COMMERCIAL. GENERALLUABILITY
Anaheim CA 92806 USA
'. 2:
INSURER C:
LPX1ngtOrI Insurance Company
19437
CL.AINTS,MADEOCCUR
INSURER, U:
INSURER E::
INSURER F:
r:r7VFR'Ar;F:S
C'FR'nlFtf'.ATF NIIM,R,FP - F7r1nrnnF,4rrQ.
Gi F4A1 CIriN NIIIMRG'C1^
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 THUS
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. Limits shown are as requested
LS
TYPE OF INSURANCE
IVSD
WVD
POILICY NUMBER
.MMI/DDIYYYY
iiiMiODIYVYN
'.... LIMITS
X COMMERCIAL. GENERALLUABILITY
'. 2:
9/t'"-)
:.ry
EACHOCCURRENCE $1..,000,000
CL.AINTS,MADEOCCUR
E TO RENTED $1.,000,000
PREMISE Fa cccurrencet
MFG EXP [Arty one person.(
PERSONAL M ADV INJURY $1,000,000
SERI AGGREGATE (LIMIT APPLIES PER:
GENERAL AGGPEGArE S2,()00,000
POLICY � RFO Ell
EOL
PRODUCTS COMPbOP AGr S2,000,000
OTHER.
.__._.__...-.,.._...._._....._-._..--.__
A
AUTO MOBILE LIABILITY
6020541619
11/09,/201S
11./019/2016
C".OMIMNEDSINGLELIIMIC
'Ea accident
BODILY INJURY ( Per person)
X AN.:Y A.U'.LD
ALL OWNED 'SCHEDULED
BODILY INJURY (Par aceidenti
AUTOS. AUTt71.
PPOPERtY DAMAGE
HIREDAUTOS NON -OWNED
',......_... AU VO5
Per 2Crddenk
UMBRELLA, LIIAB OCCUP
EACH. Or C,r.IRRENCE
EXCESS LIAR CLAIMS -MADE
AGGREGATE
DELT I RETENTIIiJNi
B
WORMERS COMPENSATION( AND
60226474ZZ
I3./09120I.5
1I/09/2016
EMPLOYERS LIABILITY VrN
_ p.>
workers COm crsati Ort AOS
,F7
TA7VJTE_ �
1.....
B
AN`.✓ n'POPRIN TOH! P0.R7 NLP 1 E'xEC•U7lVE
OFrIUCAUMEMUEREXCLUDE01 N
NRA
6020:x41572
1.V./LsJ/2r1t5'31./09/201f
LL EACH AGLIL1EhlT
I $1, a(a(1, 0116
,.SEA L EMPLOY
E.L G#, _ VEE 51,000,000
yMandlaloryan NH)
Workers Compensation CA
If yes, desenbe undaa
E.N.. DISEA'a E-POLICV LIMlT $1, f)00, 000
DE ICJMPTION OF C1PERA'I'IONS below
C
contractor, Prof
028174912
11/09/2015
11/09/'2016
Per Chaim S1,000,000
Professional Liability
Aggregate S1,000,000.
SIR $250,000
DESCRIPTION OF OPERATIONS i' LOCATIONS t VEHICLES QACOR.O 1011 Additional Remarks Schedule, may be attached if more apace is requiredp
RP.; multi -yeas training and exercise plan (NITER) City of Santa Ana, ils officers, eomployeers, agents, volunteers and
representatives are additional Insured as respects. to General and AUto Liability policies; and, the Generali Liab'1irty policies
evidenced herein is primiary and non-contr'Ibutory to other, insurance available, in accordance with the policy provisions Cross
Li abillity<:r�verage applies to General Liabiiity. (WIHS). General Liability policy excludes cl ailmis arising out. o4 the performance
of professional Services, Independent contractors are included as respects to C€neral Liability.
CERTIFICATE HOLDER CANCELLATION
City of Santa Ana.
Attn: Clerk of the City Council
20 Civic Center"
P'Vaza(M-'30)
PO Box 1988
Santa Ana CA 927'0,2'.. USA.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE, THEREOF, NOTICE WMILL BE DELIVERED IN ACCORDANCE, WITH THE
POLICY PROVISIONS..
AUTHORIZED REPRESENTATIVE
Oc I9ISB-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014101) The ACORD Werra logo are registered marcs of ACORD
�,,
C068021 A
(Ed. 02/13)
It is understood and agreed that:
If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record
has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any
reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificate holders at
least 30 days in advance of the date cancellation is effective.
If notice is mailed, then proof of mailing to the last known mailing address of the Certificate, holder on file with the
Agent of Record will be sufficient to prove notice.
Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or Impose any
liability or obligation upon us or the Agent of Record,
�%41 "• IV
Insured Name,:
'2�
Policy No: 5088210281
Endorsement No: N/A
Effective Date-, 11/09/2015
opy'right ONA, All Rights Reserved.
e'.neo
CC68021A
34 VA (Ed. 02/13)
It is understood: and agreed that,
If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record
has issued a Certificate of Insurance,, and if we cancel a policy term described on that Certificate of Insurance for any
reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificate holders at
least 30 days in advance of the date cancellation is effective.
If notice is mailed, then proof of mailing to the last known, mailing address of the Certificate holder on file with the
Agent of Record will be sufficient to prove notice.
Any failure by us to notify such persons or organizations will not extend or lonvaliildate such, cancellation, or impose any
liabifity or obligation upon us or the Agent of Record.
CC68021A (Ed. 02/13)
Page 1 of I
Insured Name:
Policy No: 6020541586
Endorsement No: N/A
Effective Date: 11/0912015
Copyright CNA All Rights Reserved.
CC68021A
Off"A (Ed. 02/13)
"ISF&MA1111111%
If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record
has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any
reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificate holders at
least 30 day's in advance of the date cancellation is effective.
If notice is mailed, then proof of marling to the last known mailing address of the Certificate holder on file with the
Agent of Record will be sufficient to prove notice.
liability or obligation upon us or the Agent of Record.
CC6802'1A (Ed. 02/13) Policy No, 60,20541572
Page 1 of 1 Endorsement No: N/A
Effective Date: 11/09/2015
Insured Name: copyright CNA All Rights Reserved
CC68021A
CNA (Ed. 02/13)
If you have agreed under written contract wwwovide notice of cancellation to a party to whom the Agent of Record
has issued a Certificate of Insurance, and if we cancel a policy term, described on that Certificate of Insurance for any
reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificate holders at
least 30 days in advance of the date cancellation is effective.
If notice is mailed, then proof of mafling to the last known mailing address of the Certificate holder on file with the
Agent of Record will be sufficient to prove notice.
liability or obligation upon us or the Agent of Record.
CC68021A (Ed. 02113)
Page 1 of 1
Insured Name:
2
Policy No: 6022647422
Endorsement No: N/A
Effective Date: 11/09/2015
Copyright CNA Alt Rights Reserved.
CC68021A
(Ed, 02/13)
-00 , A
K;WVWV;99
reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificate holders at
least 30 days in advance of the date cancellation is effective,
If notice is mailed, then proof of mailing to the last known mailing address of the Certificate ho,lder on file with the
Agent of Record will be sufficient to prove notice.
liabifity or obIlgation upon us or the Agent of Record.
CC68021 A (Ed. 02/13)
Page 1 of 1
Insured Name-.
Copyright CNA All Rights Reserved.
Policy No: 6020541619
Endorsement No: N/A
. - w,A in n 4 r
Po� iiq`,,iurnbero 51089210281
CNA PARAMOUNT
Blanket Additional Insured - Owners, Lessees or
Contractors - with Prod ucts-Com pleiteid
Operations Coverage Endorsement
i ims eirtaurserriera muciffIFT-TrITIT-1117 �7771.eci una
COMMERCIAL GENERAL LIABILITY COVERAGE PART
It is understood and agreed as follows:
L The WHO IS AN INSURED section: is amended to add as an Insured any person or organization whom the r%aml!M,,._'
Insured is required by written contract to add as an ad6tional inisured on this coverage part, including any such
person: or organization, if any, speoffically set forth on the Schedule attachment to this endorsement. However, such
person or organization is an Insured only with respect to such person or organizationi's liability fbr�
I bodily injury, property damage, or personal and advertis,ing injury caused in whole or in part by the acts
or omissions by or on behalf of the Named Insured and in the performance of such Named Insured's
ongoing operations ais specified in such written contract-, or
2. bodily injury or property damage caused in whole or in part by your work and included in the products -
completed operations hazard, and only if
athe written contract requires the Named Insured to provide the additional insured such coverage-, and
b., this coverage part provides such coverage.
B. bodily injury, property damage, or personal and advertising Injury arising out of your work described in such
written contract, but only if;
1, this coverage part provides coverage for, bodily injury or property damage included within the products
completed operations hazard; and
2. the written contract specifically requires the Named Insured to provide additional insured coverage under
the 11-85 or 10-01 edition of CG20 10 or the 10-01 edition of CG2037.
11, Subject always to the terms and conditions of this policy, inclu61rig the lirnits of insurance, the Insurer will not provide
such additional insured with:
A. coverage broader than required by the written contract, or
T B. a higher limit of insurance than requiredby the written contract
IlL The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property
damage, or personal and advertising injury arising out of:
A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services,
including;
1. the preparing, approving, or fading to prepare or approve maps,, shop drawings, opinions, reports, surveys,
field orders,, change orders or drawings and specifications; and
2. supervisory, inspection, architectural or engineering activities; or
B. any premises or work for which the additionai insured is specifically listed as an additional insured on another
endorsement attached to this coverage part,
IV, Notwithstanding, anything to the contrary in the section entitled COMMERCIAL G,ENIERAL LIABILITY CONDITIONS,
the Condition entitled Other Insurance, this insurance is excess of all other insurance available to, the additional
insured whether, on a p6mary, excess, contingent or any other basis. However, if this insurance is required by written
Pokcy Nw,irnbe508821,028t
CNA CNA PARAMOUNT
Blanket Additional Insured - Owners, Lessees or
Contractors - with Prod u cts-Corn plete,d
Operations Coverage Endorsement
contract to be primary and non-contributory, this insurance will be primary and non-contributory relative solely to
insurance on which the additional insured is a named insured.
V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL
LIABILITY CONDITIONS is amended as follows�
The Condition entitled Duties In The Event of Occurrence, Offense, Clairn or Suit is amended with the addition
of the following:
Any additional insured pursuant to this, endorsement wfli as soon as practicabler,
1 . give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim-,
2'. except as provided in Paragraph IV of this endorsement, agree to make available any other insurance the
additional insured has for any loss covered under this coverage part-,
3. send the Insurer copies of all legal papers received, and otherwise cooperate with the 111SUrer in the
investigation, defense, or settlement of the claim; and
4. tendeir the defense and indemnity of any claim to any other insurer or self insurer whose policy or progirary)
apphes to a loss that the Insurer covers under this coverage part. Flo,weve,r, if the written contract requires
this insurance to be primary and non-contributory, thiis paragraph (4) does riot appily to insurance on which
the additionat insured' is a narned insured.
The Insurer has no duty to defend or indemnify an additronal insured tinder this endorsement until the Insurer
receives written notice of a claim from the additional insured
V1. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to
add the following definition:
Written contract means a wrRten contract or written agreement that requires the Named Insured to make a person
or organization an additional insured on thrs coverage part, provided the contract or agreement�
A. is currently in effect or becomes effective during the term of this policy; and
1a the bodily injury or property damage; or
2, the offense that caused the personal and advertising injury
,for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent permissible by law .
on: the effective date of siaid Policy at the hour stated in sa�d Policy, unless another effective date is sih;own beiow, ajn
expires concurrently with s,a,id Policy.
Policy Nu,lrnber6020541619
CONTRACTORS EXTENDED CO'VERA1GE ENDORSEMENT
- B U S I N E S S AJJXf_)_RUJ51:,'_
This endorsement modifies insurance provided under the follol
III 116DOWiNFE ME
ITONVITIUMM
The foHowing is added to Section 11, Paragraph;
A.I., Who Is An Insured:
1. a. Any incorporated entity of which the
Named Insured owns a majority of the
voting stock on the date of inception of
this Coverage Form-, provided that,
bl. The insurance afforded by this provision
AA. does not apply to any such entity
that is an "insured" under any other
habil "'policy" providing "auto," coverage.
2. Any organization you newly acquire or form,
other than a limited liability company,
partnership or joint venture, and over which
you maintain majority ownership initerest,
The insurance afforded by this provision A.2,:
a. Is effective on: the acqurosdion or formation
,date, and is afforded Only until the end of
the policy period of this Coverage Form,
or the next anniversary of Its inception
date', whichever is earlier,
b'. Does not apply to,
(1) "Bodily injury" or "property damage"'
caused by an "accident" that
occurred before you acquired or
formed the organization; or
(211 Any such organization that is an
insured" under any other liability
policy" providing "auto" coverage.
3. Any person or Organization that you are
required by a written contract to namie as an
additional insured is an "insured" but only with
respect to their legal hablility for acts or
omissions of a person, who qualifies as an
"insured" under Section 11 — Who Is An
Insured and for whom Liability Coverage is
afforded! under this policy, If required by
written contract, this insurance will be primary
and non-contributory to insurance on which
the additional insured is a Named Insured.
4. An "employee" of' yours is an "'insured" while
operafing an "auto," hired or rented under a
contract or agreement in that "employee's"
CNA63359XX
(Ed. 04112)
narne, with your permission, while performing
duties related to the conduct of your business,
"Policy," as used in this provision A. Who Is An
Insured, includes those policies that were in force
on the inception date of this Coverage Form but,
1. Which are no longer in force, or
2. Whose firrits have been exhausted.
I
Section It, Paragraphs
revised as follows:
1. In a.(2), the limit for the cost of bail bonds is
changed from $2,000 to $5,0100; and
2. In a.l the firnit 'for the loss of earnings is
changed from $250 to $500 a day.
NMUMMC��
Section 11, Paragraph B.5 does not. apply,
Such coverage ails is afforded by this proOsOln C
is excess over any other collectlible �nsurance.
A. Gliass Breakagie — Hitting A Bird Or Animal —
Failing Objects Or Missides
'The foHowing is added to Section U1, Paragraph
A.3.�
With respect to any covered "auto," any deductible
shown in the Declarations wffl not apply to glass
breakage if such glass is repaired, in a manner
acceptable to us, rather than replaced,
Section Ill, Paragraph A.4.a. is revised, with
respect to transportation expenise mcurred by you,
to provlide�
a. $60 per day, in lieu of $201-1 subject to
b. $1,800 maximumil, in lieu of $600.
21�=
Section IllParagraph A.4,b, is revised, with
respect to loss of use expenses incurred by you,
to provide
a. $1,000 maximum, in lieu of $600
GNA63359XX Copyright, CNA Corporatton, 2000
(Ed, 04112) Includes copyrVoed rnaterial of the tInsurance ServIces Office used vt Its pl
>
tAll I
ftflCy NLM'iber, 6020511619
The following is added to Section M, Paragrap�',
HNIMMMIM. Mo
Hired Autos, then Physical Damage coverage �s
extended to�
a. Any covered"'auto"" YOU lease, hire, rent
or borrow, without a driver, and
ti. Any covered "auto" hired or rented by
your ""employee"" without a driver, under a
contract in that individual "employee's"
name, with Your permission, white
performing duties related to the conduct
Of your business.
C. The most we will pay for any one
"accident" or ""loss"' is the actual cash
value, cost of repair, cost of replacement
or $75,000, whichever is less, minus a
$500 deductible for each covered auto.
No deductible applies to "loss"' caused by
fire or lightning.
d. The physical damage coverage as is
provided by this provision is equal to the
physical damage coverages) provided on
your owned "autos."
e, Such physical damage coverage for hired
" autos" will:
(1) Include loss of use, provided it is the
consequence of an "accident" for
which the Named Insured is legally
liable, and as a result of which a
monetary loss is sustained by the
ifeasing or rental concern.
(2) Such coverage as is providled by this
provision will be Subject to a limit of
$756 per "'accident "
E. Airbagi Coverage
The following: is added to Section Ill, Paragraph
The accidental discharge of an airbag shall not be
considered mechanical breakdown.
F. Electronic Equipment
Section Ill, Paragraphs B.4.c: and BA.d. are
deleted and replaced by the following,
c. Physical Damage Coverage on a covered
lauto" also applies to "loss" to any
permanently installed electronic equipment
including its antennas and other accessories,
CNA63359XX
(Ed, 04/12)
d. A $1GO per occurrence deductible applies to
the coverage provided by this provision.
G. Diminution In Value
The follow�ng is added to, Section Ill, Paragraph
Subject to the following, the "diminution in value""
exclusion does not apply to:
a. Any covered ""auto" of the prtivate
passenger type you lease, hire, rent or
borrow, without a driver for a period of 30
days or less, while performing duties
related to the conduct of your business;
and
�biAny covered "auto"' of the private
passenger type hired or rented by your
"employee" without
a, for a period of
30 days or less, under a contract in that
indMduai "employee's" name, Wth your
permission, while performing duties
related to the conduct of your business
c. Such coverage as is provided by this
provision is limited to a "diminution in
val'ue'" loss arising directly out of
accidental damage and not as a result of
the failure to make repairs, faulty or
incomplete maintenance or repairs, or the
installation of substandard parts,
d. The most we will pay for, "loss" to a
covered "auto" in any one accident is the
lesser of:
(1) $5,000-1 or
(2) 20% of the "auto's" actual cash value
(ACV),
111. Drive Other Car Coverage — Executive Officers
The following is added to Sections 11 and 11V
I Any "auto"' you don't own, hire or borrow is a
covered "auto" for Liability Coverage while being
used by, and for Physical Damage Coverage
while in the care, custody or control of, any of your
11 executive officers," except:
a, An "auto" owned by that "'executive officer" or
a member of that person's household; or
b. An "auto" used by that "executive officer'
while working in a business of selling,
servicing, repairing or parking ",autos.""
Such Liability and/or Physical Damage Coverage
as is afforded by this provision.
(1) Equal to the greatest of those coverages
,afforded any covered ""auto"; and
CNA63359XX Copynghl, CNA Cmporaiion 2000
(Ed, 04112) IndUdOS copynghted matwW of the Insurance Seomces Office used )NO As pemssmn
P6:k'y Number, 6020541619
(2) Excess over any other collectible
insurance,
2. For purposes of this provision, "executive officer"
rneans a person holding any of the officer
posibons created by Your charter, constitution, by-
laws or any other similar governing i document,
and, while a resident of the same household,
includes that person's spouse
Such "executive officers" are "insureds"" while
using a covered "'auto" described in this provision,
IV, BUSINESS AUTO CONDITIONS
A. Duties In The Event Of Accident, Claim, Suit Or
Loss
The following is added to Section IV, Paragraph
A.2.a..
(4) Your "employees"may know of an
'.accident" or "loss." This will not mean
that you have such knowledge, unless
such "'accident" or "loss" is known to you
or if you are not an individual, to any of
your executive officers orr partners or YOLU
insurance manager.
The following is added to Section IV, Paragraph
A, .b.:
(6) Your, "employees" may know of
documents received concerning a claim
or "suit." This will not mean that you have
such knowledge, unless receipt of such
documents is known to you or of you are
not an individual, to any of your executive
officers or partners or your insurance
manager.
B. Transfer Of Rights Of Recovery Against Others
To Us
The following is added to Section IV, Paragraph,
A.S. Transfer Of Rights Of Recovery Against
Others To Uli
We waive arry right of recovery we may have,
because of payments we make for injury or
CNA 633:59XX
(Ed, 04112)
CNA63359XX
(Ed 04/12)
damage, against any person or organizafion for
whom or which you are required by written
contract or agreement to obtain this waiver from
us.
This injury or damage must arise out of your
activities under a contract with that person or
orgianization
You must agree to that requirement prior to an
"accident" or 10SSr"
C, Concealment, Misrepresentation or Fraud
The following is added to Section IV, Paragraph
Your failure to disclose all hazards existing on the date
of inception of this Coverage Form shall not prejudice
You with respect to the coverage, afforded provided
such failure or ornission is not intentionall,
The following is added to Section IV, Paraigraph
Regardless of the provisions of Paragraphs 6.a.
and 5.d. above, the coverage provided by this
policy shall' be on a primary non-c!on!tributory
basis, This provision is applicable only when
required by a written contract, That written
contract must have been entered into prior to
"Accident" or 1 -D -is,"
a=
Section IV, Paragraph B. 7.(5).(a)., is revised to
provide�
a. 45 days of coverage in lieu of 30 days,
PAMPT411MMIM
Section V. Paragraph C. is deleted and replaced by
the folloi
"Bodily injury" means bodily injury, sickness or disease
sustained by a person, includiing mental anguish,
mental injury or death resufting from any of these.
Copyrighl, CNA Corpomwin 2000
hdudes wpyr4V�, ,4"�`r' Mi
pater the % (,'e �nfli�lnSeOffused w
rwces. ice ith its pePei g
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