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HomeMy WebLinkAboutUNITED STORM WATER, INC. 6D • AGREEMENT TERMINATION Please complete this form when the attached agreement is no longer in effect. Return form to the Deputy Clerk of the Council (M-30). Call 647-5238 if you have any questions. The agreement with United Stormwater, Inc. No. 2013-114-03 was completed on June 30, 2017 and final payment has been made. Department: PWA/Construction Engineering . 0.----- Signature: Date: May 11, 2020 City of Santa Ana Clerk of the Council Revised 05-22-08 MAYOR Miguel A. PuBido MAYOR PROD TE4/ Vicente Samrsento COUNCIWIEWISERS Angelica Amezcua P. David Senavides Michele Madinez Roman Reyna Sal Tinajero 1NuURANCE ON FILE WORK MAY PROCEED UNTIL INSURANCE EXPIRES CLERK OFF COUNCIL DAE: Iv -k, j -I U A-2013-114-03 +'_.� r _ ; CITY MANAGER David Cavazos CITY ATTORNEY Sonia R, Carvalho CLERK OF THE COUNCIL ;rrgu� Maria D. Huizar CITY OF SANTA ANA PUBLIC WORKS AGENCY 20 Civic Center Plaza 10-36 • P.Q. Sox 1988 M-36 Santa Ana, California 92702 www.santa-ana oro May 24, 2016 United Storm Water, hie, Attn: Eduardo Perry, Jr. 1400 E. Valley View Blvd. City of Industry, CA 91746 Re: Agreement A-2012-105; `Contractor Agreement' Extension Dear Mr. Perry; Pursuant to Agreement A-2012-105, entered by United Storm Water, Inc. and the City of Santa Ana, dated June 4, 2012, as amended by Agreement A-2013-114, Agreement A-2013-114-01 and Extension Letter A- 2013-114-02 dated June 17, 2015, Section 4 "Term," the time period of said Agreement is hereby extended for an additional one (1) year period, through June 30, 2017. Additionally, consistent with Section 3 of said Agreement, the total compensation for the new one (1) year period shall not exceed $250,000. The insurance certificates are required to be extended and/or renewed to cover this extension. All other terms and conditions of said Agreement remain unchanged and in full force and effect. Contractor is aware of the requirements of California Labor Code Section 1720, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. Contractor agrees to fully comply with such Prevailing Wage Laws. Insurance certificates are required to be extended and/or renewed to cover this extension. If you have any questions, please contact Thomas Lo in the Public Works Agency at 714-647-5659. Sincere Fred TIousavipour CITf OF SANTA Af,, Executive Director David Cavazos Public Works Agency City Manager SANTA ANA CITY COUNCIL \I A a,yci acv1 `oar mom VI iia. H+mcel A+jr lla da':3_S:ls t,,a sl, ➢�ti)ero Ugy:� :AdY,:Ur .'0 i?c. f19N' 'il9rzi 2 Try,tl 3 V; aid a tiarl 5 'rlara d iti--- APPROVED AS TO FORM: ATTEST: Sonia R. Carvalho City Atto e �J� a�� • �1 !/ M• is D. Huizar Clerk of the Council os Sandoval C >ef Assistant City Attorney c: Clerk of the Council SANTA ANA CITY COUNCIL MiguH A. Pulido vicenta Sarmiento mlchale Marllnez Angelica Ame.a P. David Benavides Roman Reyna Sal T'ma Mayor Mayor Pro Tem. Ward t WVrd3 Wand Ward) Wards Ward noel do(dsanta-aM.r, vaarm or orNsa tla-A sa ory mmar�taz r2sa�ua-ana orp m@r's(ol5amia ana af9 dbenavlUae((3santa-ana oro «evna�sanla-ana.orn st na ero�san A� V CERTIFICATE OF LIABILITY INSURANCE DAT 1/21/2016 ) 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(les) 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 endorsement(s). PRODUCERp Bolton &Com an 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 CONTACT NAME: PHO" o t. 626 799-7000 plc No: 626 583-2117 EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICN ✓ INSURERA: Steadfast Insurance Company 26387 www.boltonco.com 0008309 INSURED United Pumping Service, Inc. United Storm Water, Inc. INSURERS: Zurich American Insurance Company 16535 INSURER C: INSURERD: 4 Lease, Inc. 14000 East Valley Blvd. City of Industry CA 91746 INSURERS: INSURERF: COVFRAc:FR CFRTIFICATIP NI INl 1n11z11n RFa/ISInM NI IMRCR• 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 ADDL INSD SUBR MD POLICY NUMBER POLICY EFF MMIDDNYYV POLICY EXP MMIDDNYVY LIMITS A �/ COMMERCIAL GENERAL LIABILITY ✓ GPLOO8626701 12/31/2015 12/31/2016 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE EVIOCCUR DX �AD PREMISES Ea occurrence) $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY0 PRO- JECT [:] LOC PRODUCTS - COMP/OP AGO $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY BAP008625101 12/31/2015 12/31/2016 EOeBINdEDtSINGLE LIMIT $ 1000,000 BODILY INJURY (Per person) $ ✓ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ ✓ NON -OWNED HIRED AUTOS ✓ AUTOS PROPERTY DAMAGE $ Per accident Ded Con -D& Collision $ 1,000 A UMBRELLA LIAR V OCCUR SXS008626801 12/31/2015 12/31/2016 EACH OCCURRENCE $ 11,000,000 ✓ EXCESS LIAR CLAIMS -MADE AGGREGATE $ 11,000,000 DED I ✓ I RETENTION $0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECDTIVEE. OFFICERIMEMBER EXCLUDED? EN NIA WC008625001 12/31/2015 12/31/2016,/ STATUTE ORH L. EACH ACCIDENT $ 1,006,900 E, L. DISEASE - EA EMPLOYEE S 1,000,000 (Mandatory In NH) Has describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT $ 1,000,000 A Pollution Liability GPL008626701 12/31/2015 12/31/2016 1,000,000 Each Claim A Professional Uab - Claims Made GPLOO8626701 12/31/2015 12/31/2016 1,000,000 Each Claim DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Agreement #A-2013-114-02 GL Additional Insured and Primary & Non -Contributory wording applies per STFESP101 ECW0910 attached as required by wirtten contract. Additional Insured(s): City of Santa Ana, its officers, agents, volunteers and employees. REVIEWED BY: EUNICE HEREDIA (PG ,I OF N ) CFRTIFII Kral npR rANlrPI I Anna Agreement #A-2013-114-02 City of Santa Ana Public Works De artment 20 Civic Center laza M-36 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana, CA 92701 AUTHORIZED REPRESENTATIVE Cassandra Rosales ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 28233910 I UNITPUM-01 1 15-36 GL, Auto, Umb, MC, PCLL, Prof Iii.ab I Alisa Lopez 11/21/2016 4:56:02 PM (PST) I Page 1 of 4 Additional Insured -Automatic -Owners, Lessees Or Contractors Coverage Part One -Commercial General Liability Coverage Part Two -Contractor's Pollution Liability s� ZURICH Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Dale of End. Producer Addl Prem. Relurn Prem. G P L008626701 12/31 /2015 12/31 /2016 75223000 Named Insured and Mailing Address: UNITED PUMPING SERVICE, INC. 14000 VALLEY BLVD CITY OF INDUSTRY. CA 91746-2801 Producer: BOLTON & COMPANY PO BOX 6030 PASADENA, CA 91102-6030 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: Environmental Services Package Policy ❑X COVERAGE PART ONE -COMMERCIAL GENERAL LIABILITY ❑X COVERAGE PART TWO -CONTRACTOR'S POLLUTION LIABILITY 1. Who is an Insured (Section I.) in the COMMON COVERAGE PROVISIONS is amended to include as an insured any person or organization whom you are required to add as an additional insured on this policy under a written contract or written agreement. 2. The insurance provided to the additional insured person or organization applies only to: a. "Bodily injury', "property damage" or "personal and advertising injury" under COVERAGE PART ONE -COMMERCIAL GENERAL LIABILITY, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY and COVERAGE B - PERSONAL AND ADVERTISING INJURY LIABILITY caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; and resulting directly from: (a) Your ongoing operations performed for the additional insured, which is the subject of the written contract or written agreement; or (b) "Your work" completed as included in the "products -completed operations hazard", performed for the additional insured, which is the subject of the written contract or written agreement; and/or b. "Claims" arising out of a "pollution event" under COVERAGE PART TWO - CONTRACTOR'S POLLUTION LIABILITY, caused, in whole or in part, by: (1) Your acts or omissions; or STF-ESP-101-E CW (09/10) Page 1 of 3 (REVIEWED BY ��� / �'�-,. '-'EUNI� 28233710 1 UNI'T11UM-01 115-16 GL, AUCo, Omb, WC, POLL, Prof Liab I Allsa Lopez 11/21/2016 4:56:02 PM IPST) I Page 2 of 4 (2) The acts or omissions of those acting on your behalf, and resulting directly from: (a) "Covered operations" performed for the additional insured, which is the subject of the written contract or written agreement; or (b) "Completed operations" of the 'covered operations" performed for the additional insured, which is the subject of the written contract or written agreement. 3. However, regardless of the provisions of paragraphs 1. and 2. above: a. We will not extend any insurance coverage to any additional insured person or organization: (1) That is not provided to you in this policy; or (2) That is broader coverage than you are required to provide to the additional insured person or organization in the written contract or written agreement; and b. We will not provide Limits of Insurance to any additional insured person or organization that exceed the lower of: (1) The Limits of Insurance provided to you in this policy; or (2) The Limits of Insurance you are required to provide in the written contract or written agreement. 4. The insurance provided to the additional insured person or organization does not apply to: "Bodily injury", 'property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, inspection, architectural or engineering activities. 5. The additional insured must see to it that: a. We are notified as soon as practicable of an 'occurrence", offense or "pollution event', as applicable, that may result in a claim; b. We receive written notice of a claim or "suit' as soon as practicable; and c. A request for defense and indemnity of the claim or "suit' will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured, if the written contract or written agreement requires that this coverage be primary and non-contributory. 6. For the coverage provided by this endorsement: a. The following paragraph is added to Paragraph 8.a. Other Insurance, Conditions (Section V.) in the COMMON COVERAGE PROVISIONS: This insurance is primary insurance as respects our coverage to the additional insured person or organization, where the written contract or written agreement requires that this insurance be primary and non-contributory with respect to any other policy upon which the additional insured is a Named Insured. In that event, we will not seek contribution from any other such insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured. b. The following paragraph is added to Paragraph 8.b. Other Insurance, Conditions (Section V.) in the COMMON COVERAGE PROVISIONS: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit'. This provision does not apply to any STF-ESP-101-E CW (08/10) Page 2 of 3 [ REVIEWED BY:y/2 &/.. 1. EUNICI 28233910 1 UNITPUM-01 1 15-16 GL, Auto, Um , WC, POLL, Prof Liab I Alis Lopez 1 1/21/2016 4:56:02 PM (PST) I Page 3 of 4 policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis. 7. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY SHALL APPLY AND REMAIN UNCHANGED. STF-ESP-101-E CW (09/10) / / A Page 3 of 3 [REVIEWED BY. y EUNICE HEREDIA 28233710 1 tTEEPPUp-01 115-16 GL, Auto, IDM, WC, POLL, Pzof Liab I Aliea Lopez 11/21/2016 4'.56:02 PM (PST) I Page 4 of 4 ASDATE R" CERTIFICATE OF LIABILITY INSURANCE (MM/DD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 3/21/2017 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 Bolton & Company CONTACT NAME: 3475 E. Foothill Blvd., Suite 100 Pasadena, CA 91107 PHONE IFAX A/C No Ext): 626 799-7000 A/C No): (626) 583-2117 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # 12/31/2016 INSURER A: Greenwich Insurance Company 22322 www.boltonco.com 0008309 INSURED United Pumpinq Service, Inc. INSURER B: XL Insurance America, Inc. 24554 INSURER C: XLSpecialty Insurance Company 37885 United Storm Water, Inc. INSURER D: Indian Harbor Insurance Company_____ 36940 4 Lease, Inc. 14000 East Valley Blvd. City of Industry CA 91746 INSURER E: -- INSURER F COVERAGES CERTIFICATE NUMBER! 3d7dFd99 RFVISION NIJMRFR- 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 ADSL SUER NUMBER POLICPOLICY MMIDDYEFF MM/DDN YY LIMITS A / '', COMMERCIAL GENERAL LIABILITY ✓ GEC3001234 12/31/2016 12/31/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1V OCCUR DAMAGE TO PREM SES Ea occur ence $ 50,000 MED EXP (Any one person) $ 5,000 ✓ Property Damage Ded $25,000 ✓ Bodily Injury Ded $25,000 PERSONAL &_ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 '.. POLICY PECTRO ❑ LOC J PRODUCTS - COMP/OP AGG $ 2,000,000 $ !. OTHER: B AUTOMOBILE LIABILITY _ !, ANY AUTO r `` AECO048938 AE00048939 12/31/2016 12/31/2016 12/31/2017 12/31/2017 COMBINEDtSINGLELIMIT $ 11000000 (Ea✓ ciden BODILY INJURY (Per person) $ '.. OWNED SCHEDULED AUTOS ONLY AUTOSHIRED BODILY INJURY (Per accident) $ ✓ AUTOS ONLY ✓ AUTOS ONLDY Peri accldenDAMAGE $ Ded Comp & Collision $ 1,000 C '.. UMBRELLA LIAB ✓ OCCUR UECO048940 12/31/2016 12/31/2017 EACH OCCURRENCE $ 15,000,000 AGGREGATE $ 15,000,000 ✓ EXCESS LIAB CLAIMS -MADE ':- DED I ✓ RETENTION$0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUDED? N/A WEC3001235 12/31/2016 12/31/2017 �/ STATUTE ORH _ER EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Pollution Liability PECO048963 12/31/2016 12/31/2017 15,000,000 Each Claim / $25,000 (Ded) D Professional Liab - Claims Made PECO048963 12/31/2016 12/31/2017 15,000,000 Each Claim / $25,000 (Ded) DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) GL Additional Insured applies per CG20100413 & CG20370413 attached, only if required by written contract/agreement. GL Primary & Non -Contributory Wording applies per XIL4240605 attached. Re: Agreement #A-2013-114-03 in City of Santa Ana. Excess Policy follows form. Additional Insured(s): City of Santa Ana, its officers, agents, volunteers and employees. [ft -V{FVtiIE BY: 11iFDIA QPcCF :T1 CERTIFICATE HOLDER CANCELLATION Cit of Santa Ana Public Works A enc M 22 Construction E geneering 20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Santa Ana, CA 92702 Cassandra Rosales Q 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 3,1715123 1 U1 I TPUM-6L 1 1 -17 GL,. Auto, Uinb, 19C, POLL, Prof :,'jeb 1 S1 ­,,,on ,non ,a,tl, 1 ,/. /,,illi 4:41; 001 PH ("DT) f mage POLICY NUMBER: GEC3001234 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. . r0 10 W11 ZZIAMILOM,111 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Any person or organization where required by written All Locations as required per written contract. contract provided that such contract was executed prior to the date of loss. 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", "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) 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. CG 20 10 04 13 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 3715123 1 13111TPOM-07. 1 16-1.7 (,5:, Autc,, Omb, WC, PALL, Pros Li:3b I Smith, t 3i21/i01. 4:41:00 PM ("D'I') I Faage 2 of °. —E--t—J- t Ia�CCE —H—E---R---E.—D--[—A IF G C)F } Page 1 of 2 C. With respect to the insurance afforded <othese 2. Available under the applicable Umdo of additional inourede, the following is added to Insurance shown inthe Declarations; Section U|— Limits Of Insurance: ' whiohevorinless. If coverage provided to the additional insured is This endorsement ehuU not increase the required by contract or ogneemont, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount nfinsurance: 1. Required by the contract or agreement; or Page 2 of 2 @ Insurance Services Office, Inc., 2012 CG 20 10 04 13 mmo 1 � )IIzom+N / 16 -n sL, m*~. a�b. *c, rm^ a° ual, I �,-,r"° -- i`^ 1 nzymn^m.ouro ,PIDT. / c���"f S POLICY NUMBER: GEC3001234 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 0 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person or organization where required by written contract provided that such contract was executed prior to the date of loss. All Locations as required per written contract., Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — 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. 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. CG 20 37 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 34745423 1 UIJITPUM-01 f 16-1i GL, P -t,), U,rb, WC, POLL, Pt of LiaL r Shannon ;rit:h 1 3,,211201 4:91:00 PH (=IDT1 1 G.gH 9 of , This endorsement, effective 12:01 a.m.,12m1a016,fonne a part of Policy No.GEC3001234 issued to United Pumping Service, Inc. by Greenwich Insurance Company. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART Kioagreed that h>the extent that insurance isafforded toanyAdditiona||noured underthis policy, this insurance shall apply h ryendnotoonhibubngwithanyinsumnoaoaniedbysuohAdditiono| Insured, as required by written contract. All other terms and conditions of this policy remain unchanged. XIL4240605 @.28O5.XLAmerica, Inc. 34-/ 154 1 M IzTIoH-m / `6-n o, w"°' Lhlib' WC'' POLL, ,=*u,h ! Sh,,= C,n Sid .^ . uu/zon ^.^1.00I'M 'mx. / P.« �"f, I