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This Second Amendmentofthe Agreement,entered into this ay of , 2021 (the "EffectiveDate"), by and between the CITY OF ALAMEDA, a municipal corporation (hereinafter"City") and KITTELSON& ASSOCIATES, INC., an Oregon corporation,whose address is 155 Grand Avenue, Suite 505, Oakland, CA 94612 (hereinafter "Provider"), is made with reference to the following:
RECITALS:
A. On November 10, 2020, an agreement was entered into by and between City and Provider (hereinafter "Agreement") in an amount not to exceed $37,850.
B. On June 29, 2021, a First Amendment to Agreement was entered into by and between City and Provider (hereinafter "First Amendment") to increase the compensation by $37,120, for total compensation under the Agreement not to exceed $74,970.
C. City and Provider desire to further modify the Agreement to extend the contract amount on the terms and conditions set forth herein.
NOW, THEREFORE, it is mutually agreed by and between and undersigned parties as follows:
1. Section 2 ("Services to be Performed")of the Agreement is modified to read as follows:
"Provideragreesto do allnecessarywork at its own cost andexpense,to furnishall labor, tools, equipment,materials,except as otherwise specified,and to do all necessarywork includedin ExhibitA asrequested.The Provideracknowledgesthat the work planincluded in Exhibit A is tentativeand does not commit the City to request Providerto performall tasks included therein."
2. Section 3 ("Compensation To Provider"), subsection b., of the Agreement is modified to read as follows:
"b. The total compensation for the work under this Second Amendment is not to exceed S270,906. Total compensation for this Agreement is not to exceed £345,876."
3. Except as expressly modified herein, all other terms and covenants set forth in the Agreement shall remain the same and shall be in full force and effect.
Signatures on Next Page
Kittelson & Associates - 2nd Amendment Page: 2
21st Dec.
UOCU&ign EnvelopeID: 4fc1h43H9-U1B2-45U/-8iaL>-Ufc0C^9/3A/0A IN WITNESS WHEREOF,the partiesheretohave causedthis modificationof Agreement to be executed on the day and yearfirst above written.
KITTELSON & ASSOCIATES, INC.
An Oregon Corporation
Digitallysorted by DavM l Mills
DN:crt^David L Milk o^KJttelson
erttailrdrnillsiatolttdson.corn, c=US
Date. 2021.iai 8 1331:1 B 07->M
David L. Mills
Operations Leader
Kittelson & Associates - 2nd Amendment
CITY OF ALAMEDA
A Municipal Corporation
/^fW/Levttt
^ CMy Manager
RECOMMENDED FOR APPROVAL
-nocitslgriMl by:
-5!DDC1315D92r>*C5...
Andrew Thomas
Planning, Building and Transportation
Director
APPROVED AS TO FORM:
City Attorney
* DflcuBlgnAri by:
Wuaa Qjuuul
* 4QA7*0gDC0i:~*44...
Celena Chen
Chief Planning Counsel
Page: 3
UOCUSJgn tnv«lope ID: 4tlh43H»-U1BS2-45Uir-810D-UtOU49/3A/UA W\ KSTTELSON £2r£2S~~t!fey& ASSOCIATES P510.839.1742 F510.839.0S71 October18,2021 Project#: 24846.001
Ms. Gail Payne
Senior Transportation Coordinator
City of Alameda, CA
RE: Roundabout Project Development
Dear Gail:
Attached is a proposal for a contract amendment to add new work tasks. In Part 1 (Citywide Screening and Project Development), Kittelson will provide roundabout screening and project development based on our conversations with you about continuing to identify potential roundabout applications in the City and advancing promising locations into further project development stages. In Part 2 (Clement/Tilden Way Extension), Kittelson will conduct project scoping activities for the Clement Avenue Extension/Tilden Way Project ("Clement/Tilden project'').
The Clement/Tilden project represents an opportunity to connect the Cross Alameda Trail to the Miller- Sweeney Bridge, improving nonmotorized transportation connections between Alameda and Oakland.
The project also presents an opportunity to improve transit operations in support of existing AC Transit routes accessing BlandingAvenue and to improve existing truck routes by providinga direct connection between Clement Avenue and Tilden Way. These transportation improvements will help support the Northern Waterfront PDA and complete a key connection in the City's multimodal transportation network.
We are excited to continue to bring our roundaboutexpertise to the City of Alamedato help the City advanceits efforts toimprovemultimodalconnectivityand roadwaysafety forall road users. Kittelson& Associates,Inc. (Kittelson) provides experienceand value at every step of the project development process.We have led and completed project planning, scoping, conceptualdesign, and final design projectsat variousscales.Ourexperience at each level of projectdevelopment allowsus to help clients identifyand addresscriticalissuesin earlystagesof projectdevelopment.In additionto ourstronglocal historyof projectexperience,we alsodevelop nationalresearchandguidancedocuments that document and advance best practicesin performance-based design.
Mike Alston will serve as the Project Manager and Erin Ferguson will serve as the Project Principal providingsenior review and quality assurance. Any questions of a technical or contractual nature can be directed to either of us.
Please reviewthis proposalat your earliestconvenience. Thank you for the opportunityto proposeon this project. If you have any questions, please call us at 510.433.8076.
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RmmdobmtScreeningmd Development& Qement/TMenExtension
Sincerely,
Kittelson & Associates, Inc.
Mike Alston, RSP
Senior Engineering Associate
Erin Ferguson, PE
Principal Engineer
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RoundaboutScreeningandDevelopment&Ctement/TitdenExtension
PART A - SCOPE OF WORK
TASK 1: PROJECTINITIATION,COORDINATION,AND MANAGEMENT
Task Purpose:Provide activemanagementof projecttasks, includingfrequentcommunication,budget tracking,and proactivestrategyfor successfulproject completion.
Task 1,1: Kickoff Meeting
The Kittelson team will participate in one project initiation/kick-off meeting with City staff. The budget assumes one two-hour meeting with up to three consultant team members. The purpose of the meeting will be to confirm the scope of work and schedule for the project. Prior to the meeting, Kittelson will identify discussion topics and will provide a draft agenda to the City. Kittelson will provide meeting notes including summary of action items and decisions made at the meeting.
Task 1:1 Deliverables:
Project initiation/kick-off meeting
Agenda and meeting summary
Project schedule
Task 1-2: Project Management and Administration
Throughout the study duration, Kittelson will utilize our in-house resources to actively manage the project, includingour internal project budget and schedule management systems and will regularly keep the team informed on scope, budget, and schedule status. Kittelson will electronically submit monthly invoices and progress reports containing a summary of activities completed during the past month and those expected for the following month.
Task 12 Deliverables:
Monthly invoices and progress reports
Task 1.3: Biweekly Check-in Meetings
Kittelsonwill conduct 30-minutebiweeklyconference callswith the Cityto provide an update regarding ongoing work, to identify any potential issues that require resolution, and to discuss upcoming milestones. The Kittelson team will develop the agenda for each meeting and will distribute notes outliningdecisions, actions, and responsible parties after each meeting.
Task 13 Deliverables:
Meeting agendas and summaries (Word/PDFformat, or shared OneNote notebook) UOCUSign Envelope ID: 4E1h43B*MJ1B2^5U/-810Q4JfcUU4g/3A7UA AlamedaCitywideRoundaboutAnalysisPhase 2 p0ge4of16
RoundaboutScreeningand Development&Oement/TtldenExtension
SCREENING AND DEVELOPMENT
TASK 2: CITYWIDE SCREENING
Purpose: Building off the alreadycompletedPhase 1 citywidescreening,identifylocationsalong the remainingcityarterialandcollectorroadwayswhereroundaboutscouldbefeasibleto construct.
Task 2.1 Conduct Screening
Kittelsonwill conducta network screeningof the City'sarterialand collectorroadwaynetwork to identify locationswhere roundabouts would be feasible. Figure 1 shows the arterialsand collectorsin the City accordingto the City's Transportation Element of the General Plan. Kittelson will work with the Cityto identify any roadwaysthat can be removed from a network screeningif, for example, projectsare already under consideration along certain corridors or if recent improvements have been made such as new traffic signals. Locations that already have been identified to date to exclude are as follows:
• Intersections already analyzed as part of phase 1 of the citywide roundabouts screening including Grand Street/Otis Drive, Tilden Way/Blanding Avenue/Femside Boulevard, Fernside Boulevard/Encinal Avenue, Main Street/Appezzato Parkway, Atlantic Avenue/Constitution Way, Main Street/Willie Stargell Avenue and others;
• Alameda Point and Alameda Landing future roadways due to future developer lead and new General Plan policies directing developers to consider roundabouts; • Central Avenue at Main Street/Pacific Avenue, Third Street/Taylor Avenue, FourthStreet/Ballena Boulevard and Sherman Street/Encinal Avenue (part of Central Avenue Safety Improvement Project);
• Clement Avenue (part of Clement Avenue Safety Improvement Project,Clement Avenue/Tilden Way project and Del Monte development project);
• Harbor Bay Parkway due to the new traffic signal investments; • Lincoln Avenue/Marshall Way/Pacific Avenue corridor between Broadway and Main Street/Central Avenue/Pacific Avenue (evaluation is in process as part of the safety improvement project for this corridor);
• Mecartney Road/Island Drive (evaluation is in process as part of intersection improvement project);
• Park Street due to the Smart City traffic signal investments; • Tilden Way between Bianding Avenue and Broadway (part of Clement Avenue/TildenWay project); and
• Webster Street due to the Smart City traffic signal investments.
Kittelsonwill verify with the City the availabilityof any turning movement counts or traffic volume data which would help to informKittelson'sassumptions regardingwhether a roundabout would be asingle- lane ormultilanethereby changingthe roundabout footprint. In the absence of data, Kittelsonwill use the approachingroadway cross-sectionsto determine whether a single-or multilane roundabout would adequately serve each intersection.
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Roundabout Screening and Development & Clement/Tilden Extension Figure 1: City of Alameda Major Arterial and Collector Roadway Network pv..,,t> > n,f !t
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Street Classifications
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—— RejionalAleiial
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Tianaiiional CoHecor
Loca> Stre^
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Kittelson will develop a set of assumed inscribedcircle diameters (ICDs) to test single- and multilane roundabout footprints at the intersectionsalong these roadways.Using the scaled curb line and parcel data providedbythe City, Kittelsonwill identifyintersectionswhere a roundaboutmay be feasiblegiven the footprint and the extent of any potential right-of-way impacts. In locations where a multilane roundabout may be advisable, Kittelsonwill test a single-and multilane footprint.
Kittelsonwill document our findings in a memorandum (see Task 2.3) for the City includingsupporting maps of the locations identified as potentially feasible.
Task 2.2 Location-Specific Feasibility Assessment
For up to 10 locations where a roundabout footprint appears to be feasible to construct with minimal or no right-of-way conflicts, Kittelson will conduct a more detailed feasibility assessment. The assessment will include considering adjacent land uses, existing and planned bikeways, and any constructability issues. Discussion of site-specific feasibility will be incorporated into the findings memorandum. These top 10 locations will be prioritized usingthe City's high-injurycorridors and intersections, bus routes, and bikeways.
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RoundaboutScreeningand Development&Clement/TildenExtension Task 23 Findings Memorandum
Kittelsonwill preparea draft memorandumdocumentingthe screeningand feasibilityassessmentsand identifying locations on the major arterial and collector network where roundabouts would be a promisingcountermeasure.Upon City reviewof the memorandumand the initialcitywideroundabout screening,Kittelsonand the City will identifythe two locationsfor further projectdevelopmentas part of task 3-
Task 2 Deliverables:
Conference call with the Cityto discuss screening findings and findings memorandum Findings memorandum-draft and final
Two selected locations for project development in Task 3 TASK 3: PROJECT DEVELOPMENT
Purpose of task: Develop roundabout concepts for two locations to prepare projects for subsequent design and environmental clearance phases.
Task 3,1 Task Kickoff Meeting
Kittelson will hold a kickoff meeting with City staff to discuss design objectives and constraints. Priorto the meeting, Kittelson will conduct a site visit to each of the two locations to field review the locations and understand project-specific context and planning and design needs.
Task 3.1 Deliverables
Task kick-off meeting
Agenda and meeting summary
Task 3.2 Concept Design Development
To develop roundabout concepts for each of the two locations, Kittelsonwill:
Conduct a.m. and p.m. traffic operationsanalysis using the Highway CapacityManual 6th edition methodology. The analysis will help to identify the appropriate roundabout lane configurations.
Summarize volume-to-capacity ratios, queue lengths, delay, and level-of-service for the intersections with existing configurations and with the proposed roundabout concepts. Analyze future year traffic volumes at the study intersections to consider future capacity needs. Kittelson willextract relevant future year traffic volume estimates from the Alameda Countytravel demand model andwill confirmappropriatevolume estimates with the City in advance of the analysis.
Prepareone scaled roundaboutconceptsketchdepictedover aerial photography.The sketch will depict edges of the traveled way, key channelization,and central island configuration.
The following geometric design elements will be assessed and incorporated into the concept design sketches developed:
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RoundaboutScreeningandDevelopment&Clement/TildenExtension • Roundabout location and size
0 Lane numbers and assignments
• Horizontal alignment of approach treatments
• Geometric principles of channelization
• Conceptual striping
• Pedestrian, bicycle, and bus design features
• Performance checks for fastest path and design vehicle movements Prepare a summary of findings (in bullet points) and figures of each configuration. Conduct one conference call with the Cityto discuss the concept designs and resultant project findings.
Task 32 Deliverables:
• Two scaled roundabout sketches, one at each location
• Performance checks indicating the fastest path and design vehicle checks • Conference call to discuss concepts and findings
Task 3.2 Assumptions:
• Kittelson will work from available aerial imagery of sufficient resolution for 1 inch = 50 feet at the selected locations (ESRI or Googleaerial, or other commerciallyavailable base map). • The City will provide existinga.m. and p.m. turning movement data includingpedestrian, bike, and truck classificationand counts. TheCity will identifythe desired design vehiclesfor each movement at each location.
• The Crty will providecrash data at the intersectionand along approachingroadwaysfor the most recently available five-year period.
Task 33 Design Refinement
Basedoncommentsand revisionsidentifiedinTask3.2,Kittelsonwill revisethe conceptualdesignsketch for each of the twolocationsand providea scaledsketchelectronicallyfollowingconsultationwith the City. These sketches will form the basis for developingsubsequent horizontalplans in a future project phasethat isnot includedin thisscope. Kittelsonwill compileconceptdesignfindingsand reviseddesigns into asummaryfindingsmemorandum.Kittelsonwill revisethe summaryfindingsmemorandumbased on one consolidated set of City comments.
Task 33 Deliverables
Revised concept designs, one at each location
Findings memorandum documenting the roundabout concept sketches, constraints, and performance checks—draft and final
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RoundaboutScreeningand Development&Clement/nfden Extension
3.4: Commission and Council Hearings
Kittelsonwill support theCity at one TransportationCommissionmeetingand one CityCouncilmeeting.
Kittelsonwill prepare a presentation for the Transportation Commissionmeeting explainingthe project process and outcomes and will present or assist the presentation. City staff can use or revise that presentation for the project's City Councilhearing. Kittelsonwill attend the City Councilmeeting and be available for questions.
Task 3A Deliverables
Attendance and support in developing materials for one Transportation Commission meeting and one City Council hearing.
Task 3.4 Assumptions:
Kittelson will include up to two (2) staff members at each hearing. Each hearing is assumed to last up to four (4) hours.
Task 33 Grant Writing Support
Kittelson will work with the City to identify appropriate grant funding opportunities to pursue for roundabout projects. Kittelson willprepare supportive materials for the Cityto apply for up to two grant applications. These materials will include project descriptions, vicinity/location maps, project schematic layouts, collision summaries and diagrams, and planning-level cost estimates for each application (up to two total).
Task 3.5 Deliverables:
Grant writing assistance task deliverables
TASK 4: PEER REVIEW
Purpose: Review and provide comments on the roundaboutconcept designs includedin the Central AvenueCompleteStreetsprojectandfor theLincolnAvenue/ MarshallWay/ PacificAvenueproject Kittelson will obtain the available information from the City regarding the roundabout concepts and completestreets design for Central Avenue and for Lincoln Avenue / Marshall Way / Pacific Avenue, includingthe horizontalgeometry proposed for roundabouts and the cross-sectionsproposed for the roadways. We will also request any supporting analysis or design checks already completed for roundabouts such as traffic operationsanalysis,truck turning templates, and speed checks.
Kittelson will review the information and provide comments on the roundabout concept designs as it relates to the lane configurations, horizontal alignment, size of the roundabout, roundabout design features (e.g.,length and width of splitterislands),abilityto accommodate trucks,and abilityto manage vehiclespeeds. Wewill documentinour commentsina brief memorandumwithsupportingmark-upsof the roundabout designsas needed to support the comments. We will conduct a conference callwith the City to discuss the comments.
Task 4 Assumptions:
Concepts and filesfor peer review will be provided to-scale and in a CAD or similarfileformat.
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RoundaboutScreeningandDevelopment&Clement/TildenExtension This task assumes up to three total rounds of review at either Central Avenue or Lincoln Avenue / Marshall Way / Pacific Avenue. For the latter project, one review would be comprised of up to four key intersection and a roadway cross-section design.
Task 4 Deliverables:
• Design markups indicating potential for design modifications • Call with City to discuss findings and recommendations UOCUSign hmrelOp©ID:4fc1h43B^U1B2-4bU7-81OP-Ufc0U4973A/aA AlamedaCitywideRoundaboutAnalysisPhase2 pQQ€ 100f16
RoundaboutScreeningandDevelopment&Clement/TifdenExtension PART B: CLEMENT/TILDENWAY EXTENSION
TASK 5; DOCUMENT EXISTING CONDITIONS AND PROJECT UNDERSTANDING Task Purpose:Confirmexistingproject area transportationconditionsand site issues; verifykey project outcomes and constraints.
Task 5.1 Existing Conditions Analysis
Kittelson will confirm and document existing conditions by acquiring and incorporating data provided by the City and collected in this task.
Kittelson will prepare an existing conditions intersection operations model of traffic operations on the project corridor (using PTV Vistro software or similar). Kittelson will conduct a site visit to verify site issues, constraints, and preliminary operational analysis findings. Kittelson will also collect traffic volume data (see below) to build the traffic operations model. Based on City review and comment, Kittelson will prepare a revised final version of the traffic operations model.
Task 5J Data Collection
Kittelson will collect AM and PM weekday peak hour (7-9 APM, 5-7 PM) multimodal turning movement counts at the following intersections on one typical (Tuesday or Thursday) weekday:
• Fruitvale Avenue / BlandingAvenue / Tilden Way / Fernside Boulevard • Tilden Way / Broadway / Eagle Avenue
Task 5J Deliverables:
Draft and Revised ExistingConditions traffic operations models Task 5.1 Assumptions
The City will provide:
Intersection signal timing for the following intersections:
• FruitvaleAvenue/ BlandingAvenue/ TildenWay/ Fernside Boulevard * Tilden Way / Broadway / Eagle Avenue
Any availableoperational informationrelated to the Miller-Sweeneydrawbridgeoperations (e.g., frequency and duration of gate arm activation, signal timing and programming in relation to gate arm)
High resolution aerial imagery ofthe project study limits,ifavailable The ten most recent years of available crash data in the project area UOCUSign hmrelope IU:4fc1h43B5f-O1B2-45D/-81Dl>-Ufc0L>*9/3A/0A AlamedaCitywideRoundaboutAnalysisPhase2 Poge 11of 16
RoundaboutScreeningandDevelopment&Clement/TildenExtension Task 5,2 Existing Conditions and intended Project Outcomes Memorandum Kittelson will prepare a memorandum documenting existing conditions analyzed in Task 5.1 based on the traffic operations model and site visit. The memorandum will describe bike, transit, and truck routes and operations and crash history (noting any trends). The memorandum will succinctly describe current conditions/issues and will include an updated project description and "project intended outcomes" statement The project intended outcomes will define the priorities for concept development and an eventual preferred alternative.
The memorandum will also describe the approach to be taken to develop an appropriate future analysis year scenario (i.e-, develop forecast traffic volumes) and will forecast those turning movement volumes at project intersections for subsequent project analysis based on the Alameda County travel demand model outputs.
Based on City review and comment and the community input received as shown in Task 8, Kittelson will prepare a revised final version of the memorandum.
Task 5 2 Deliverables:
Draft and Revised ExistingConditions and Intended Project Outcomes Memorandum Forecast turning movement counts for future year analysis scenario Task 52 Assumptions:
The City will provide future year analysis scenario assumptions, including nearby development sites, road closures,and laneconfigurationsto match at project scope limits.
TASK 6; CONCEPTUAL ENGINEERING AND ANALYSIS
TaskPurpose:Refine,develop,andevaluatedesignalternativestoselecta preferredalternative Kittelsonwill prepare up to three (3) conceptualdesign alternativesfor the project.These alternatives includethe arrangementof proposedbicyclefacilitiesand bus-onlylanesalongTildenWayandvariations of intersection configuration and control at three intersections:
TildenWay/ FruitvaleAvenue &BlandingAvenue/ Fernside Boulevard Tilden Way / Clement Avenue extension
Tilden Way / Broadway / EagleAvenue
Task 6.1: Meeting to Define Alternatives
Kittelsonand City staffwill host onemeetingto confirmspecificassumptionsfor each alternativeprior to initiatinganalysesand development of taskdeliverables.Citystaff will identifythe relevant parties to attend the meeting(i.e.,City department staff).This workshopwill be heldvirtuallyor in personand will determine the componentsthat will definethe alternativesto be studied.Atthis meeting,Kittelsonand City staff will determine the performancemeasures for evaluation,which may include for example:
qualitativesafetycomparison,capacity,and operationalconsiderations(e.g.,queue storageabilityand implications),constructioncosts,transit operations,and nonmotorizedqualityof service.Kittelsonand City staffwill determinethe appropriateforecastscenariofor projectdevelopment,includingroadway uocuaign Envelop© id: 4tih43Bi^uiB2-4bU/-aioi>Ufeou4g/3A/0A AlamedaCitywideRoundaboutAnalysisPhase 2 p0qe 12 of16
RoundaboutScreeningand Development&Clement/TildenExtension configurationssurrounding the project limits. Based on the forecast scenario, Kittelson will develop scenario analysis volumes using the Alameda County travel demand model.
Task 6.1 Deliverables:
One two-hour meeting, including agenda, preparatory materials in advance, and meeting notes documenting next steps
Task 6.1 Assumptions:
Kittelson assumes the workshop will be up to two hours long. At the conclusion of the workshop, Kittelson will send out notes and documentation of the alternatives to be developed.
Kittelson will develop concept alternatives with one set of future condition assumptions (i.e., roadway configuration beyond project limits).
Task 6.2: Draft Design Alternatives and Analysis
Kittelson will prepare draft designs for each of the three alternative concepts as well as a future no-build scenario. The designs will be completed to a "sketch-level," with sufficient resolution to exhibit at 1" = 50'. The draft designs would include edges of traveled way, pedestrian and bicycle facilities, crossing treatments, channelization, driveways, and other notations to share key concept elements. The dimensions of travel lanes and bicycle and pedestrian facilities would be included. The sketch-level approach would includeeither hand sketch overlaidon the available base map orcommensurate levelof detail in CAD linework.
Based onthe first round of communityengagement as stated inTask8, the Citywill provide input on the draft designalternatives and will select two staff-preferred alternatives for further refinement inTask 7.
Task 62 Deliverables
Draft concepts for up to three alternatives
TASK 7: CONCEPT REFINEMENT AND EVALUATION
Task Purpose:Evaluateconcepts to select a preferredalternative.
Task 7,1: Revised Alternatives
Based on input andcommentsfrom Task 6, Kittelsonwill refinethe designalternativesand analysisfor two City-preferred alternatives.
Task 7.1 Deliverables:
Revised design alternatives for up to two (2) City-preferred alternatives Task 7,2: Alternatives Evaluation and Conceptual-level Cost Estimates Kittelson will evaluate the alternatives refined in Task 7.1 and a future no-build alternative in relation to the intended project outcomes and performance measures established in the Task 6.1 meeting.
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RoundaboutScreeningand Development&Ctement/TUdenExtension ________„ Kittelsonwill developa draftevaluationcomparisontable andconceptual-levelcost estimatesassociated with the two staff-preferred alternatives refined in Task 7.1 and will prepare a revised, final comparison table and cost estimates based on City staff comments. Up to one meeting is assumed to review comments and edits prior to the revision of task deliverables. Kittelson will compiled the alternatives evaluation, cost estimates, and associated work to date to prepare a draft preferred alternative memorandum. Kittelson will revise the preferred alternatives memorandum based on one set of consolidated City comments.
Task 72 Deliverables:
Draft alternatives evaluation comparison and conceptual cost estimates City and Kittelson meeting to discuss draft comparison and cost estimates Final alternatives evaluation comparison and conceptual cost estimates after community input as stated in Task 8
• Draft and final preferred alternative memorandum
Task 72 Assumptions:
• Collecting survey information is not included.
• Constructability review is not included.
TASK 8: PUBLIC ENGAGEMENT
Taskpurpose:Engagemembersof thepublicto hearandincorporatetheirinputthroughoutthe concept development process.
Task 8.1: Public Meetings and Online Engagement Tools
Kittelsonwill prepare materialsfor and lead the content presentation at two publicmeetings. One publicmeetingwill be identifiedto occurfollowingthe Task6.1 meetingand will present existing conditions andthe concept definitions and approaches to be developed. The second publicmeeting will be held once a draft preferred alternative isselected and will facilitate engagement and community input on the preferred alternative.
In addition to the publicmeetings, Kittelsonwill develop a presentation of the same content from each meeting on theCity'sprojectwebsite.Theengagement materialsfor the project website will parallelthe informationpresented at the two publicmeetings in content and detail;Kittelsonwill providea method of collectinginput on an ongoing basis usingthe City'sonline survey capabilities.
Task 8.1 Deliverables:
Preparation, attendance, and presentation at up to two public meetings Development of supportive online engagement materials to present the information from the public meetings in a digestible online format.
Task 8.1 Assumptions:
The Citywill advertise, schedule, and host the publicmeetings.
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RoundaboutScreeningandDevelopment&Clement/nidenExtension Kittelsonassumesthe publicmeetingswill beheldvirtually.Kittelsonwill bringupto twostaff members to each meeting.
Task 8.2: Commission and Council Hearings
Kittelsonwill support the City at one TransportationCommissionmeetingand one CityCouncilmeeting.
Kittelsonwill prepare a presentation for the Transportation Commissionmeeting explainingthe project process and outcomes and will present or assist the presentation. City staff can use or revise that presentation for the project's City Councilhearing. Kittelsonwill attend the City Councilmeeting and be available for questions.
Task 82 Deliverables:
Attendance and support in developing materials for one Transportation Commission meeting and one City Council hearing.
Task 82 Assumptions:
Kittelson will include up to two (2) staff members at each hearing. Each hearing is assumed to last up to four (4) hours.
TASK 9: 3D VISUALIZATIONS
Kittelson willdevelop a three-dimensional (3D) model of existingconditions and the preferred alternative to demonstrate the design concept. EngineeringCAD files will be used to generate the 3D model to provide accurate representation of the corridor. The model will contain realistic textures, neighboring buildingsand features, street collateral (lights,signs, etc), above-ground utilities,accurate lightingand environmental conditions, and multimodal activity. From the 3D model we will be able to provide the following visual deliverables:
Task 9 Deliverables
Still images- Kittelsonwill produce a varietyof high-quality,rendered imagesfrom the 3D model at key locations tohighlightdifferent perspectives and concepts, Animation - Kittelson will provide a fly-thru video moving through the corridor to demonstrate the existingconditions and the preferred alternative concept.
The above-listed deliverables are effective tools in stakeholder meetings, charrette meetings, and public meetings.3D visuals providea sense of realism to projectsand help provide projecttransparencyby givingthe stakeholders and interested parties useful tools to better understand complexengineering projects.
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Roundabout Screening and Development & Clement/Tilden Extension Page IS of 16
BUDGET
A budget has been developed for Tasks 1-9 and is shown below and includes a 10 percent contingency.
Task
Number Project Task
Person
Hours Budget
1 Project Initiation, Coordination, and Management 106 $21,340 2 Citywide Screening 103 $18,330
3 Project Development 352 $64,890
4 Peer Review 36 $8,265
5 Document Existing Conditions and Project
Understanding 90 $16,670
6 Conceptual Engineering and Analysis 212 $37,030
7 Concept Refinement and Evaluation 212 $36,680
8 Public Engagement 158 $29,040
9 Visualizations 84 $14,560
10% Contingency - $24,101
Total 1,353 $270,906
SCHEDULE
A preliminary schedule has been developed for Tasks 1-9 and is shown below with Task 9 incorporated into the Task 7timeline. The Clement Avenue/Tilden Way project could be completed by November 2022.
TMks
1.0 Project 1ml alien, Coordination, and r/aragRrnrnt
2.0 Gtvv»idescreening
3.0 Pit:.*Mt Oev-ti! Liarlent
4 0 Peer Review
va Document Ettstlng Conditions ann Project Understanding
6.0 Conceptual Engineeringanc Analysis
7.0 Concept PjerfinemenL ard Cv- jj'icir.
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Kickoff Meeting
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D0CUS4gn Envelop© ID:4E1P-43B»-U182*45D7«8lCrI>D&(JU4973A7aA AlamedaCitywideRoundaboutAnalysisPhase 2 page16of 16
RoundaboutScreeningand Development& Oement/niden Extension uocusign Envelope id: 4biF-4JBy-uiBi!-4&u/,-Hiuu-ub0C49/JA/ruA vnoiiirr. vwTs»-T KITTEASC
ACORD CERTIFICATE OF LIABILITY INSURANCE
DATE |MM(DD,'YYYY)
12/16/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVEOR PRODUCER,AND THE CERTIFICATEHOLDER. __ .._^_______._ ~-pyii^^-jf,™j^r |San ABr3rW6NALiNSURED,the policy(ics)must haveADDITIONALINSURED provisionsor beendorsed.
If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate docs not confer any rights to the certificate holder in lieu of such endorsemcnt(s).
PRODUCER
USI Insurance Services NW PR
601 Union Street, Suite 1000
Seattle, WA 98101
INSURED
Kittelson & Associates, Inc.
851 SW 6th Avenue, Suite 600
Portland, OR 97204
COVERAGES CERTIFICATE NUMBER:
nSmeact Please See Below:
&&&•): 206 441 -6300
address: [email protected]
INSURER(S) AFFOROINO COVERAGE
insurer a : Massachusetts Bay Insurance Company
INSURER e : Hanover Insurance Company
insurer c : Allmerica Financial Benefit Ins. Co.
insurer d : XL Specialty Insurance Company
insurer e : Certain Underwriters at Lloyds
INSURER F :
(2Cno^610-362-8530
NAIC*
22306
22292
41840
37885
NONAIC
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
INDICATEO NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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.
POLICY EXPIMSR
LTR TYPE OF INSURANCE
ADDLSUBR
INSR WVD fOUCY NUMBER
XX ZD2D78128002X COMMERCIALGENERALLIABILITY
XCLAIMS-MADE OCCUR
X WA Stop Gap
GEN'l AGGREGATE LIMIT APPLIES PER:
„ PRO- f v
POLICY A jecT A. LOC
___ OTHER:
AUTOMOBILE LIABILITY
X ANY AjTQ
OWNED
AUTOS ONLY
X HIRED
AUTOS ONLY
LZ
SCHEDULED
. AUTOS
NON-OWNED
AUTOS ONLY
X UMBRELLA LIAB JX_ OCCUR
__ EXCESS LIAB | CLAIMS MADE
PEP X RE]5NTI0N%0:
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY r . N
ANY PROPRIETOR'PARTNERiEXECUTIVE
OFFlCErVMEMBEREXCLUDED' N
{Mandatory In NH|
If y*is, dciscribn unfior
DESCRiPTON OF OPERATIONS below
D Professional Liab
Incl. Pollution
E Cyber Liability
X X AW2D78128703
N/A
X UH2D78128102
(Follow Form)
X WM2D78128902
X DPR9970040
ESJ0024874406
POLICY EFF
(MMrDCYYYY) (MMiDO/YYYY)
01 /01 /2021 01 /01 /2022 each occurrence
damagf to rented
PREMISES ;Eb sccurrwice)
MED EXP (Any arm parson)
UMITS
51,000,000
5100,000
$10,000
PERSONAL1 ADV INJURY 31,000,000
GENERALAGGREGATE 32,000,000
PRODUCTS-comtop ago- i 2,000,000
Stop Gap/EL 's 1,000,000
01/01/2021 01/01/2022)fgggftfINGLE^
BODILY INJURY (Per person)
BODILY INJURY (Pot acadcni;
PROPERTY DAMAGE
(Per accident)
.
01/01/2021 01/01/2022 each occurrence
aggregate
01/01/2021 01/01/2022 X
EL EACH ACCIDENT 31,000,000
IE,L. DISEASE-EA EMPLOYEE 31,000,000
ex disease . policy limit 31,000,000
01/01/2021 01/01/2022 $5,000,000 per claim
$5,000,000 annl aggr.
01/01/2021 01/01/2022 $5,000,000 occ/aggr.
PER
S'ATL'TE
OTH-
.ER
s1,000,000
35,000,000
35,000,000
3 DESCRIPTIONOFOPERATIONS I LOCATIONS(VEHICLES |ACORD 101, Additional Remarks Schedule, may be attached l» more space Is required) "Please Note: The limits shown above may not represent the full limits of coverage carried by the Named Insured, but are shown as evidence that coverage Is carried with limits at least as high as is required by contract.**
RE: KAI PN 24846 - City of Alameda On-Call Services 2020. The General Liability and Automobile Liability policies include an automatic Additional Insured endorsement that provides Additional Insured status to City (See Attached Descriptions)
CERTIFICATE HOLDER CANCELLATION
City of Alameda
2263 Santa Clara Avenue, Room 190
Alameda, CA 94501-0000
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHOREED REPRESENTATIVE
ACORD 25 (2016/03) 1 0f2
#S30654456/M30648670
® 19S8-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
PVRZP
uocui&gn Envelope iu: 4bih43B^-uiB2*45U/>3iop»m_OG4gy3AyoA DESCRIPTIONS (Continued from Page 1)
of Alameda, its City Council, boards* commissions, officials*employees, and volunteers, only when there is a written contract that requires such status, and only withregardto work perfbmied on behalf of the named insured. The General Liability and Automobile Liability policies provides a Waiver of Subrogation when required by written contract. The General Liability policy includes an endorsement providing that 30 days notice of cancellation will be given to the Certificate Holder by the Insurance Carder.
SAGtTTA 25,3 (2016/03) 2 of 2
#S3065445€/M30648670
UOCUSign fenvelOpeID: 4fc1h43B!*-U1Bi2-45D/-81Ol>UfeOU49/3A/0A POLICY: AW2D78128703
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE
BROADENING ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage provided by this endorsement, the provisionsof the Coverage Form apply unless modifiedby the endorsement.
1. CANCELLATION EXTENSION
Paragraph A, CANCELLATION 2. b. of the
COMMON POLICY CONDITIONS is
replaced with the following:
b, 60 days before the effective date
of cancellation if we cancel for
any other reason,
SECTION I - COVERED AUTOS
2. EMPLOYEE HIRED "AUTOS"
Description Of Covered Auto
Designation Symbols; Symbol 8 is
replaced by the following:
8 = Hired "Autos" Only - Only those "autos"
you lease, hire, rent or borrow; including
"autos" your employee hires at your
direction, for the purpose of conducting your
business. This does not include any "auto"
you lease, hire, rent, or borrow from any of
your "employees" or partners or members of
their households.
SECTION II - LIABILITY COVERAGE
3. BROADENED NAMED INSURED
The followingis added to the SECTION II -
LIABILITY COVERAGE, Paragraph 1. Who
Is An Insured provision:
d. Any business entity for which you
have a financial interest greater
than 50% of the voting stock or
otherwise have a controlling
interest after the effective date of
this policy or that is newly
acquired or formed by you during
the term of this policy.
The coverage provided by this
provision is afforded until
expiration or termination of this
policy, whichever occurs earlier
The coverage provided by this
provision does not apply to any
business entity described in da
above that qualifies as an
insured under any other
automobile liability policy issued
to that business entity as a
named insured or would have
been an insured except for the
exhaustion of the policy limits or
the insolvency of the insurer.
The coverage provided by this
provision does not apply to
"bodily injury nor "property
damage" arising from an
accident that occurred prior to
your acquiring or forming the
business entity described in d.
above.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Copyright Insurance Services Office, Inc., 1996
461-0155 (9-97)
DOCuSign hriVGlope ID: 4fe1h43B^U1B2*45D/-81Ol>UfcUC49/3A/0A
4. EMPLOYEES AS INSUREDS
The following is added to the SECTION II -
LIABILITY COVERAGE, Paragraph 1. Who
Is An Insured provision:
e. Any employee of yours is an
"insured" while using a covered
"auto" you do not own, hire or
borrow in your business or your
personal affairs.
5. SUPPLEMENTARY PAYMENTS
The following amends SECTION II -
LIABILITY COVERAGE, Paragraph 2.
Coverage Extensions provision:
Paragraph (2) is replaced by the following:
(2) Up to $2500 for cost of bail bonds
(Including bonds for related traffic
law violations) required because
of an "accident" we cover. We do
not have to furnish these bonds.
Paragraph (4) is replaced by the following:
(4) All reasonable expenses incurred
by the "insured" at our request,
including actual loss of earnings
up to $500 a day because of time
off from work.
6. AMENDED FELLOW EMPLOYEE
EXCLUSION
The following is added to the SECTION II -
LIABILITY COVERAGE, B. Exclusions
Paragraph 5. Fellow Employee exclusion:
This exclusion does not apply ifthe
"bodily injury"arises from the use of a
covered "auto" you own or hire. This
coverage is excess over any other
collectible insurance
SECTION III -
COVERAGE.
PHYSICAL DAMAGE
7. EXPENSE OF RETURNING A STOLEN
"AUTO" and SIGN COVERAGE
The followingis added to SECTION III -
PHYSICAL DAMAGE COVERAGE, A.1.
COVERAGE:
d, Expense Of Returning A Stolen
"Auto"
We will pay for the expense of
returning a covered "auto" to you,
e. Sign Coverage
We will pay for loss to signs,
murals, paintings or graphics,
as part of equipment, which are
displayed on a covered "auto".
The most we will pay for "loss" in
any one "accident" is the lesser of:
1. The actual cash value of
the property as of the
time of the "loss"; or
2. The cost of repairing or
replacing the damaged or
stolen property with other
property of like kind and
quality; or
3. $2,000.
8. GLASS BREAKAGE DEDUCTIBLE
The following is added to SECTION III-
PHYSICAL DAMAGE COVERAGE A.
COVERAGE paragraph 3. Glass
Breakage - Hitting a Bird or Animal -
Falling Objects or Missiles:
Any deductible shown in the
Declarations as applicable to the
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Copyright Insurance Services Office, Inc., 1996
461-0155 (9-97)
uocus.gn EnvelopeiD:4tii-43B»-uiB2-45U/-8ioi>UfcOU49r3A/UA covered "auto" will not apply to glass
breakage ifsuch glass is repaired,
rather than replaced.
9. TRANSPORTATION EXPENSE
Paragraph 4, Coverage Extension, of
SECTION III - PHYSICAL DAMAGE
COVERAGE, A. COVERAGE is replaced
with the following:
4. Coverage Extension
We will pay up to $50 per day to a
maximum of $1500 for temporary
transportation expense incurred by
you because of the total theft of a
covered "auto" of the private
passenger type. We will pay only
for those covered "autos" for which
you carry either Comprehensive or
Specified Causes of Loss
Coverage. We will pay for
temporary transportation expenses
incurred during the period beginning
24 hours after the theft and ending,
regardless of the policy's expiration,
when the covered "auto" is returned
to use or we pay for its "loss".
10. HIRED AUTO PHYSICAL DAMAGE
The following is added to SECTION III -
PHYSICAL DAMAGE COVERAGE, A.
COVERAGE:
5. Hired Auto Physical Damage
If hired "autos" are covered "autos"
for LiabilityCoverage and ifPhysical
Damage Coverage of
Comprehensive, Specified Causes
of Loss, or Collisionis provided
under this Coverage Form for any
"auto" you own, then the Physical
Damage Coverage(s) provided is
extended to "autos" you hire without
a driver or youremployee hires,
without a driver, at your
direction, for the purpose of
conducting your business, for a
period of 30 days or less, of like
kind and use as the "autos" you
own, subject to the following:
The most we will pay for any one
loss is the lesser of the following:
a. $50,000 per accident, or
b. cash value, or
c. the cost of repair,
minus the deductible equal to the
lowest deductible applicable to any
owned "auto" for that coverage.
Any deductible shown in the
Declarations does not apply to
"loss" caused by fire or lightning.
Subject to the limitand deductible
stated above, we will provide
coverage equal to the broadest
coverage provided to any covered
"auto" you own, that is applicable to
the loss.
If the loss arises from an accident
for which you are legally liable and
the lessor incurs an actual financial
loss from that accident, we will
cover the lessor's actual financial
loss of use of the hired "auto" for a
period of up to seven consecutive
days from the date of the accident,
subject to a limitof $1,000 per
accident.
11. AUDIO, VISUAL AND DATA
ELECTRONIC EQUIPMENT
COVERAGE
The followingis added to SECTION III -
PHYSICAL DAMAGE COVERAGE, A.
COVERAGE:
6, Audio, Visual and Data Electronic
Equipment Coverage
We will pay for "loss" to any
electronic equipment that receives
Includescopyrightedmaterialof InsuranceServicesOffice, Inc. with its permission.
Copyright, Insurance Services Office, Inc., 1996
461-0155 (9-97)
UOCU^gn fcnvaiope ID: 4fe1h43B»-U1B2-45Dr-81trD-UfeOC49/3A?r0A or transmits audio, visual or data
signals and that is not designed
solely for the reproduction of sound.
Thiscoverage applies onlyifthe
equipment is permanently installed
in the covered "auto" at the time of
the "loss" or the equipment is
removable from a housing unit
which is permanently Installed in the
covered "auto' at the time of the
"loss", and such equipment is
designed to be solely operated by
use of the power from the "auto's"
electrical system, in or upon the
covered "auto", including its
antennas and other accessories,
However, this does not include
tapes, records or discs.
The exclusions that apply to
PHYSICAL DAMAGE COVERAGE,
except for the exclusion relating to
Audio, Visual and Data Electronic
Equipment, also apply to coverage
provided herein. In addition, the
following exclusions apply:
We will not pay , under this
coverage, for either any electronic
equipment or accessories used with
such electronic equipment that is:
1. Necessary for the normal
operation of the covered
"auto" or the monitoring of
the covered "auto's"
operating system; or
2. Both:
a. An integral part of the
same unit housing any
sound reproducing
equipment designed
solely for the
reproduction of sound Ifthe
sound reproducing
equipment is permanently
installed in the covered
"auto", and
b. Permanently installed
in the opening of the dash
or console normally used
by the manufacturer for the
installation of a radio.
With respect to coverage herein, the
LIMITOF INSURANCE provision of
PHYSICAL DAMAGE COVERAGE
is replaced by the following:
1. The most we will pay for all
"loss" to audio, visual or data
electronic equipment and any
accessories used with this
equipment as a result of any
one "accident" is the lesser of
a The actual cash value of
the damaged or stolen
property as of the time of
the "loss"; or
b. The cost of repairing or
replacing the damaged or
stolen property with other
property of like kind and
quality; or
c. $500.
Z An adjustment for
depreciation and physical
condition will be made in
determining actual cash value
at the time of the "loss".
3. Deductibles applicable to
PHYSICAL DAMAGE
COVERAGE, do not apply
to this Audio, Visual and Data
Electronic Equipment
Coverage.
Ifthere is other coverage provided
by this policyfor audio, visual and
data electronic equipment, the
coverage provided herein is
Includes copyrighted material of Insurance ServicesOffice, Inc.with its permission.
Copyright Insurance Services Office, Inc., 1996
461-0155 (9-97)
UQCUSJgn fenvelopeID: 4t1h43B»-U1B2-4bD/-8iai>UfcOU4973A/UA excess. However, you may elect to
apply the limitor any portion thereof
of coverage provided herein to pay
any deductible that is applicable
under the provisions of the other
coverage.
12. RENTAL REIMBURSEMENT and
MATERIAL TRANSFER EXPENSE
The following is added to SECTION III -
PHYSICAL DAMAGE COVERAGE, A.
COVERAGE:
7. Rental Reimbursement and
Material Transfer Expense
This coverage provides only those
Physical Damage Coverages where
a premium is shown in the
Declarations. It applies only to a
covered "auto" described or
designated to which the Physical
Damage Coverages apply.
We will pay for auto rental expenses
and the expenses, incurred by you
because of "loss" to a covered
"auto", to remove and transfer your
materials and equipment from the
covered "auto". Payment applies in
addition to the otherwise applicable
amount of each coverage you have
on a covered "auto". No
deductibles apply to this coverage.
We will pay only for those auto
rental expenses incurred during the
policy period beginning 24 hours
after the "toss" and ending,
regardless of the policy's expiration,
withthe lesser of the following
number of days:
1. The number of days
reasonably required to
repair or replace the
covered "auto". If "loss" is
caused by theft, this
number of days is added
to the number of days it
takes to locate the covered
"auto" and transport it to a
repair shop.
2. 60 days.
Our payment is limited to the lesser
of the following amounts:
1. Necessary and actual
expenses incurred,
including loss of use.
2, $3000.
This auto rental expense coverage
does not apply while there are
spare or reserve "autos" available to
you for your operations.
If "loss" results from the total theft of
a covered "auto" of the private
passenger type, we will pay under
this coverage only that amount of
your rental reimbursement
expenses which is not already
provided for under the SECTION
III* PHYSICAL DAMAGE
COVERAGE, A. 4. Coverage
Extension.
13. AIRBAG COVERAGE
The following is added to SECTION III -
PHYSICAL DAMAGE COVERAGE, B.
Exclusions, paragraph 3.
The portionof this exclusion relating to
mechanical or electrical breakdown does not
applytothe accidentaldischargeofan
atrbag. This coverage is excess of other
collectible insurance or warranty. No
deductible applies to this AirbagCoverage.
Includescopyrightedmaterialof Insurance ServicesOffice, Inc. with its permission.
Copyright, Insurance Services Office, Inc., 1996
461-0155 (9-97)
UOCUiMgn Envelope ID:4fc1h43B^U1BZ-45D7-81Ol>DfeOU4973A70A
14. AUTO LOAN PHYSICAL DAMAGE
EXTENSION
The followingis added to SECTION III -
PHYSICAL DAMAGE COVERAGE, C.
Limit Of Insurance provision:
When a "loss" results in a total loss to a
covered auto you own for which a Loss
Payee is designated in thispolicy, the most
we will pay for "loss" in any one "accident" is
the greater of:
1. The actual cash value of the
damaged or stolen property as of
the time of the "loss"; or
2. The outstanding balance of the
initial loan, less any amounts for
taxes, overdue payments, overdue
paymentcharges,penalties,
interest, any charges for early
termination of the loan, costs for
Credit Life Insurance, Health,
Accident or Disability Insurance
purchased with the loan, and
carry-over balances from previous
loans.
15. AUTO LEASE PHYSICAL DAMAGE
EXTENSION
The following is added to SECTION ill -
PHYSICAL DAMAGE COVERAGE, C.
Limit Of Insurance provision:
If, because of damage, destruction or theft
of a covered "auto", which is a long-term
leased "auto", the lease agreement between
you and the lessor is terminated, "we" will
pay the difference between the amount paid
under paragraph C. LIMIT OF INSURANCE
1. or 2. and the amount due at the time of
"loss" under the terms of the lease
agreement applicable to the leased "auto"
which you are required to pay: less any fees
to dispose of the auto; any overdue
payments; financial penalties
imposed under a lease for excessive use,
abnormal wear and tear or high mileage;
security deposits not refunded by the lessor;
cost for extended warranties, Credit Life
Insurance, Hearth,Accident or Disability
Insurance purchased with the loan; and
carry over balances from previous leases.
This coverage applies only to the initial
lease for the covered "auto" which has not
previously been leased. This coverage is
excess over all other collectible insurance.
SECTION IV - CONDITIONS
16. DUTIES IN THE EVENT OF
ACCIDENT, CLAIM, SUIT OR LOSS
The following is added to SECTION IV -
BUSINESS AUTO CONDITIONS, A. Loss
Conditions, 2. Duties In The Event Of
Accident, Claim, Suit Or Loss:
d. Knowledge of any "accident",
claim, "suit" or "loss" will be
deemed knowledge by you when
notice of such "accident",
claim, "suit" or "loss" has been
received by:
(1)
(2)
(3)
You, if you are an individual;
Any partner or insurance
manager if you are a
partnership; or
An executive officer or
insurance manager if you are
a corporation.
17, BLANKET WAIVER OF
SUBROGATION
Paragraph 5. Transfer Of Rights Of
Recovery Against Others To Us,
SECTION IV - BUSINESS AUTO
CONDITIONS, A. Loss Conditions is
replaced by the following:
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Copyright Insurance Services Office, Inc., 1996
461-0155 (9-97)
U0CUS4gn hnveiope ID: 4t1h43Bi>-U1B2-45U7-81Ol>UfcOC^973A70A Transfer Of Rights Of Recovery 19,
Against Others To Us
HIRED AUTO -WORLDWIDE
COVERAGE
Ifany person or organization to or
for whom we make payment under
this Coverage Form has rights to
recover damages from another,
which have not been waived
through the execution of an "insured
contract", written agreement, or
permit, prior to the "accident" or
"loss" giving rise to the payment,
those rights to recover damages
from another are transferred to us.
That person or organization must do
everything necessary to secure our
rights and must do nothing after the
"accident" or "loss" to impair them.
18. UNINTENTIONAL FAILURE TO
DISCLOSE INFORMATION
The following is added to SECTION IV
BUSINESS AUTO CONDITIONS. B.
General Conditions, paragraph 2.
Concealment, Misrepresentation Or
Fraud:
Your unintentional error in disclosing, or
failure to disclose, any material fact C.
existing after the effective date of this
Coverage Form shall not prejudice your
rights under this Coverage Form.
However, this provision does not affect
our right to collect additional premium or
exercise our right of cancellation or
nonrenewal.
The followingis added to SECTION IV -
Business Auto Conditions, B. General
Conditions, paragraph 7. Policy Period,
Coverage Territory provision:
e. Outside the coverage territory
described in a., b., c, and d.
above for an "accident" or "loss"
resulting from the use of a
covered "auto" you hire, without a
driver, or your employee hires
without a driver, at your direction,
for the purpose of conducting your
business, for a period of 30 days
or less, provided the suit is
brought within The United States
of America or its territories or
possessions.
SECTION V - DEFINITIONS
20. MENTAL ANGUISH
Paragraph C. "Bodily injury", SECTION V
DEFINITIONS is replaced by the following:
"Bodily injury"means bodily injury,
sickness or disease sustained by a
person including death or mental
anguish resulting from any of these.
Includescopyrightedmaterialof InsuranceServicesOffice, Inc. with its permission.
Copyright Insurance Services Office, Inc., 1996
461-0155 (9-97)
UOCUtagn fcnvelope ID:4t1h43B«-U1B2-4bU7-810Lr*Ufc0G4973A70A POLICY: AW2D78128703
THIS ENDORSEMENTCHANGESTHE POLICY. PLEASE READ ITCAREFULLY.
BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY Thisendorsement modifiesinsurance providedunder thefollowing:
BUSINESS AUTO COVERAGE FORM
B.
The following is added to SECTION II -
LIABILITY COVERAGE, Paragraph A.L Who Is
An Insured:
Additional Insured if Required by Contract
If you agree in a written contract, written
agreement or written permit that a person or
organization be added as an additional Insured"
under this Coverage Part, such person or
organization is an Insured*; but only to the extent
that such person or organization qualifies as an
Insured" under paragraph A.1.C, of this Section.
If you agree in a written contract, written
agreement or written permit that a person or
organization be added as an additional 'Insured"
under this Coverage Part the most we will pay on
behalf of such additional Insured" is the lesser of:
(1) The Limits of Insurance for liability coverage
specified in the written contract, written
agreement or written permit; or
(2) The Limits of Insurance for LiabilityCoverage
shown in the Declarations applicable to this
Coverage Part.
Such amount shall be part of and not in addition to
the Limits of Insurance shown in the Declarations
applicable to this Coverage Part. Regardless of
the number of covered "autos", "insureds",
premiums paid, claims made or vehicles involved
in the "accident", the most we will pay for the total
of all damages and "covered pollution cost or
expense" combined resulting from any one
"accident" is the Limit of Insurance for Liability
Coverage shown in the Declarations.
The following is added to SECTION IV -
BUSINESS AUTO CONDITIONS, Paragraph B.
General Conditions, subparagraph 5, Other
Insurance:
Primary and Non-Contributory
If you agree in a written contract, written
agreement or written permit that the insurance
provided to a person or organization who qualifies
as an additional "insured" under SECTION II -
LIABILITY COVERAGE, Paragraph A.1. Who Is
An Insured, subparagraph Additional Insured if
Required by Contract is primary and non-
contributory, the following applies:
The liability coverage provided by this Coverage
Part is primary to any other insurance available to
the additional "insured" as a Named Insured. We
will not seek contribution from any other insurance
available to the additional Insured" except:
(1) For the sole negligence of the additional
"insured"; or
(2) For negligence arising out of the ownership,
maintenance or use of any "auto* not owned
by the additional "insured" or by you, unless
that "auto" is a "trailer" connected to an "auto"
owned by the additional "insured" or by you; or
(3) When the additional "insured" is also an
additional "insured" under another liability
policy.
C. This endorsement will apply only if the "accident"
occurs:
1. During the policy period;
2. Subsequent to the execution of the written
contract or written agreement or the issuance
of the written permit; and
3. Prior to the expiration of the period of time that
the written contract, written agreement or
written permit requires such insurance to be
provided to the additional Insured'.
D. Coverage provided to an additional "insured" will
not be broader than coverage provided to any
other "insured" under this Coverage Part.
ALL OTHER TERMS, CONDITIONS,AND EXCLUSIONSREMAIN UNCHANGED.
461-04781212 Includescopyrightedmaterialof ISO InsuranceServicesOffice,Inc., with itspermission uocusign Envelop*id:4I-ip43B9-dibz-45U/-8101>deol»873A70A POLICY: AW2D78128703
01/01/2021
Kittelson & Associates, Inc.
CJwx^j^
UOCUSign hnvelop© ID:4t1l-43H»-U1B2-45U/-810t>-Ufc0U4a/3AraA POLICY:AW2D78128703| ZD2D78128002| UH2D78128102
THIS ENDORSEMENT CHANGES THEPOLICY. PLEASE READ ITCAREFULLY.
NOTICE OF CANCELLATIONto designated ENTITY(S)
(Including Nonpayment of Premium)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
HANOVER COMMERCIAL FOLLOW FORM EXCESS AND UMBRELLA POLICY
COMMERCIAL PROPERTY COVERAGE PART
BUSINESS AUTO COVERAGE FORM
BUSINESSOWNERS COVERAGE FORM
SCHEDULE
Name of Designated Entity Mailing Address or Email Address Number Days Notice Any Person or Organization to
Whom you have agreed in a written
contract
(See form 221-0163)
The Address for that person or organization
included
in such written request from you to us.
30 (Informationrequiredto complete thisSchedule, ifnot shown above, willbe shown in theDeclarations.) If we cancel this policy for any reason, including
nonpayment of premium, we will give written notice of
such cancellation to the Designated Entity(s) shown in
the Schedule. Such notice may be delivered or sent by
any means of our choosing. The notice to the
Designated Entity(s) will state the effective date of
cancellation.
Unless otherwise noted in the Schedule above, such
notice will be provided to the Designated Entity(s)no
more than the number of days in advance of the
effective date of cancellation that we are required to
provide to the Named Insured for such cancellation. If
the reason for cancellation is nonpayment of premium,
however, we will provide ten days notice.
Such notice of cancellation is solely for the purpose of informingthe DesignatedEntity(s)of the effectivedate
of cancellation and does not grant, alter, or extend any rights or obligations under thispolicy.
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED. 401-12361214 Includescopyrightedmaterialof InsuranceServicesOffice,Inc., with its permission Page 1 of 1 UOCUSagn fcnvelope ID:4t1h-43B%>-U1Bii!-45D7-810LMJfeOt^973A70A POLICY: AW2D78128703 | ZD2D78128002 | UH2D78128102
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ THIS CAREFULLY.
It isagreed that the followingcomplete wording for from 401-1236:
Any person or Organizationto Whom you have agreed in a writtencontract that noticeof cancellationor non-renewalof this policy will be given, but only if:
1. You send us a written request to provide such notice, including the Name and Address of such person or organization, after the First Named Insured receives notice from us of Cancellation or Non-Renewal of this policy; and
2. We receive such written request at least 14 days before the beginning of the applicable number of days shown In this schedule.
Nothing herein contained shall be held to vary,alter,waive or extend any of the terms, conditions, agreements or limitations of the policy other than as above stated.
(Completionofthe following,includingcountersignature,is requiredto makethis endorsementeffectiveonlywhen itis issued subsequent to preparation of the Policy.)
Effective 01/01/2021
Issued to Kittelson & Associates Inc.
By Massachusetts Bay Insurance Company
Countersigned by
Authorized Reoresentative of the Company
221-0163(4-90)
UOCUSign bnvelope IU: 4t1h43BS»-U1B2-45U/-81OtMJtOU48/-3A/0A KULIUY: <slU2U/'in20UU2
THIS ENDORSEMENTCHANGES THE POLICY. PLEASE READ ITCAREFULLY.
GOLD PROPERTY BROADENING ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUILDING AND PERSONAL PROPERTY COVERAGE FORM
CAUSES OF LOSS - SPECIAL FORM
BUSINESS INCOME (AND EXTRAEXPENSE) COVERAGEFORM
BUSINESS INCOME (AND EXTRAEXPENSE) COVERAGE FORM - ACTUAL LOSS SUSTAINED The following is added to C, Limits Of Insurance of Building and Personal Property Coverage Form CP 00 10:
The limits applicable to the Coverages included in this endorsement may either be in addition to or included within the applicable Limits of Insurance. For application of the limits, refer to each coverage within this endorsement.
Refer to SECTION V - DEFINITIONS of this endorsement for additional words or phrases which appear in quotation marks as they have special meanings.
I. COVERAGES
A. Scheduled Coverages
The coverages in this endorsement amend the coverage provided under the Building and Personal Property Coverage Form, Causes of Loss - Special Form, Business Income (and Extra Expense) Coverage Form and Business Income (and Extra Expense) Coverage * Actual Loss Sustained through new coverages and substitute coverage grants. These coverages are subject to the provisions applicable to this policy, except where amended within this endorsement. If any of the property covered by this endorsement is also covered under any other provisions of the policy of which this endorsement is made a part, or if more than one coverage under this endorsement applies, in the event of loss or damage, you may choose only one of these coverages to apply to that loss. The most we will pay in this case is the limit of insurance applying to the coverage you select. Coverages included in this endorsement apply either separately to each described premises or on an "occurrence" basis. Refer to each coverage within this endorsement for application of coverage.
1. Additional Covered Property
2* Brands & Labels
3. Broadened BuildingCoverage
4. Broadened Business Personal Property
5. Building Limit- Inflation Guard
6. Business Income &Extra Expense from
Dependent Properties
7. Catastrophe Allowance
8. Computer and Funds Transfer Fraud
9. Consequential Loss to Stock
10. Contract Penalties
11. Debris Removal
12. Denial of Access to Premises
13. E-Commerce
14. Electronic Data Processing Equipment
15. Employee Theft including ERISA Compliance
16. Employee Tools and Work Clothing
17. Expediting Expense
18. Extended Business Income
Limits of Amended Limits
Insurance of Insurance Page
Included N/A 3
Included N/A 4
Included N/A 4
Included N/A 4
Included N/A 5
$150,000 $ 5
$50,000 N/A 5
$15,000 $ 6
Included N/A 6
$50,000 $ 6
$250,000 $ 6
Included N/A 7
$10,000 $ 7
Included N/A 8
$100,000 $ 8
$25,000 $ 10
$50,000 $ 11
180 Days N/A 11
411-0793 0414 Includescopyrightedmaterialsof InsuranceServices Offices, Inowlthits permission Page 1 of 39 UOCUS&gn fenvelope IU:4b1M3B^U1B;M5U7-S10L>UfcUC^973A7UA (b) Acceptance of fraudulent bills of
lading or shipping receipts.
(2) The most we will pay under this
additional coverage is $50,000 for any
one "occurrence" or the Limit of
Insurance shown in the Amended
Limits Section of this Endorsement,
59. Water Damage, Other Liquids, Powder
or Molten Material Damage
F. Additional Coverage Extensions,
Paragraph 2. of Causes of Loss - Special
Form CP 10 30 is replaced by the
following:
2. Water Damage, Other Liquids,
Powder or Molten Material Damage
a. If loss or damage caused by or
resulting from covered water
damage or other liquid, powder or
molten material damage loss
occurs, we will also pay the cost to
tear out and replace any part of
the building or structure, or, in the
case of underground pipes, lawns,
shrubs or paved areas, to repair
damage to the system or
appliance from which the water or
other substance escapes.
b. Payment under this Additional
Coverage is included within the
applicable Limit of Insurance. The
maximum we will pay for loss or
damage to lawns, shrubs or paved
areas is $50,000 per "occurrence''
or the Limit of Insurance shown in
the Amended Limits Section of
this Endorsement.
THIS IS NOT FLOOD INSURANCE
OR PROTECTION FROM AN
INUNDATION OF SURFACE
WATER, HOWEVER CAUSED.
60. Windblown Debris
The following is added to A. Coverage,
Paragraph 5. Coverage Extensions of
Building and Personal Property Coverage
Form CP 00 10:
Windblown Debris
(1) We will pay your reasonable expenses
to remove the windblown debris
(including trees) from the described
premises, if it is carried to the
described premises from the premises
of others by wind, during the policy
period.
(2) The most we will pay in any one
2D2D781280 01 0901120
"occurrence" in total for the removal of
all windblown debris under this
Extension is $10,000 or the Limit of
Insurance shown in the Amended
Limits Section of this Endorsement.
61. Worldwide Property Off*Premises
The following is added to A. Coverage,
Paragraph 5. Coverage Extensions of
Building and Personal Property Coverage
Form CP 00 10:
Worldwide Property Off-Premises
(1) You may extend the insurance that
applies to your Business Personal
Property and Personal Property of
Others to apply to that property while it
is temporarily outside the coverage
territory if it is:
(a) Temporarily at a location you do
not own, lease or operate;
(b) Temporarily on display or exhibit
at any fair, trade show or
exhibition;
(c) Samples of your "stock" in trade in
the custody of your sales
representatives; or
(d) While "in transit" between the
described premises and a location
described in (a), (b) or (c) above.
(2) The most we will pay for loss or
damage under this Extension is
$75,000 or the Limit of Insurance
shown in the Amended Limits Section
of this Endorsement.
(3) This Extension provides an additional
amount of insurance.
B. Coverages Included within the Blanket
Limit of Insurance
1. Accounts Receivable
The following is added to A. Coverage,
Paragraph 4. Additional Coverages of
Building and Personal Property Coverage
Form CP 00 10:
Accounts Receivable
(1) We will pay for loss or damage caused
by or resulting from a Covered Cause
of Loss to your records of Accounts
Receivable.
Accounts Receivable means:
(a) All amounts due from your
customers that you are unable to
collect;
(b) Interest charges on any loan
411-0793 0414 Includescopyrightedmaterialsof InsuranceServices Offices, Inc. withits permission Page 28 of 39 UOCUSign hnvelOp© ID: 4fc1h43B»-UlB2*45U7-8iaL>-UfcOU4g73A70A maintenance of data
processing equipment or
component parts,
(b) Errors or omissions in processing
or copying. But if errors or
omissions in processing or
copying results in fire or explosion,
we will pay for the direct loss or
damage caused by the fire or
explosion;
(c) Erasure of "research and
development documentation"; or
(d) Unauthorized instructions to
transfer property to any person or
place.
(4) Coverage provided by this Extension
does not apply to "research and
development documentation" which
exist as "electronic data".
(5) We will not pay for loss or damage to
"research and development
documentation" until you actually
replicate such documentation. Repairs
or replication must be made as soon
as reasonably possible after the loss
or damage, but in no event later than
two years after the loss or damage
unless we grant an extension in writing
prior to the expiration of the two-year
period.
(6) We will not pay for loss or damage to
"research and development
documentation" applicable to:
(a) Products that are obsolete;
(b) Existing products you have
withdrawn from the market; or
(c) Existing products you have not
sold in the last twelve months prior
to the loss.
(7) Regardless of the number of insured
locations involved, the most we will
pay under this Extension for loss or
damage in any one "occurrence**at a
described premises is subject to the
Blanket Coverage Limit of Insurance
or the Limit of Insurance shown in the
Amended Limits Section of this
Endorsement.
9. Valuable Papers and Records (Other
Than Electronic Data)
A. Coverage, Paragraph 5. Coverage
Extensions, subparagraph c. of Building
and Personal Property Coverage Form CP
00 10 is replaced by the following:
2D2D781280 01 0901120
c. Valuable Papers and Records
(Other Than Electronic Data)
(1) You may extend the insurance
that applies to Your Business
Personal Property to apply to
direct physical loss or damage to
"valuable papers and records" that
you own, or that are in your care,
custody or control caused by a
Covered Cause of Loss. This
Extension includes the cost to
research, replace or restore the
lost information that previously
existed on "valuable papers and
records" for which duplicates do
not exist
(2) The following Exclusions do not
apply to this Coverage Extension:
(a) Earth Movement; and
(b) Water.
(3) The most we will pay under this
Extension for loss or damage in any
one "occurrence" at a described
premises is subject to the Blanket
Coverage Limit of Insurance or the
Limit of Insurance shown in the
Amended Limits Section of this
Endorsement,
IV. VALUATION
A. E. Loss Conditions, Paragraph 7. Valuation,
subparagraph b, of Building and Personal
Property Coverage Form CP 00 10 is replaced
by the following:
b. If the Limit of Insurance for Building
satisfies the Additional Condition,
Coinsurance, and the cost to repair or
replace the damaged building property is
$2,500 or less, we will pay the cost of
building repairs or replacement.
The cost of building repairs or replacement
does not include the increased cost
attributable to enforcement of any
ordinance or law regulating the
construction, use or repair of any property.
However, the following property will be
valued at the actual cash value even when
attached to the building:
(1) Awnings or floor coverings;
(2) Appliances for refrigerating,
ventilating, cooking, dishwashing or
laundering;
(3) Outdoor equipment or furniture; or
. (4) Retaining walls,
B. The following is added to E. Loss Conditions,
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We will pay the lesser of:
(1) The market value at the time of loss or
damage;
(2) The reasonable cost of repair or
restoration to the condition
immediately before the covered loss or
damage; or
(3) The cost of replacement with
substantially identical property.
For pairs or sets, we will either:
(a) Repair or replace any part to
restore the value and condition of
the pair or set to that immediately
before the covered loss or
damage; or
(b) Pay the difference between the
value of the pair or set before and
after the covered loss or damage.
n. Property of Others - our payment for loss
of or damage to personal property of
others will only be for the account of the
owners of the property. We may adjust
losses with the owners of lost or damaged
property if other than you. If we pay the
owners, such payments will satisfy your
claims against us for the owners' property.
We will not pay the owners more than their
financial interest in the Covered Property.
o. We may elect to defend you against suits
arising from claims of owners or property.
We will do this at our expense.
p. Labor, materials and services that you
furnish or arrange on personal property of
others are valued based on the actual cost
of the labor, materials and services.
q. Finished "stock" you manufactured at the
selling price less discounts and expenses
you otherwise would have had.
r. "Prototypes"
We will not pay more than the lesser of the
following amounts:
(1) The replacement cost of such property
used for the same product, but only if
replacement cost is shown as
applicable to Personal Property in the
Declarations,
However when replacement with
identical property is impossible or
unnecessary, the amount of loss will
be based on the cost to replace with
similar property used to perform the
same functions. Property of others will
be valued in the same manner, but we
V.
ZD2D781280 01 0901120
will not pay more than the amount for
which you are legally liable; or
(2) The amount you actually spend to
repair or replace lost or damaged
"prototypes" used for the same
purpose.
s. "Research and development
documentation":
We will not pay more than the least of the
followingamounts:
(1) Your cost actually spent to reproduce
lost or damaged "research and
development documentation" from
back-up files or original source
documents;
(2) The reasonable cost necessary to
research, repair, restore, recreate,
reconstitute, reproduce or replace
"research and development
documentation", used for the same
product, to their condition immediately
before the loss or damage;
(3) If identical "research and development
documentation" cannot be purchased,
the cost to purchase such
documentation of comparable kind,
functionality and quality; or
(4) The amount you actually spend to
research, repair, restore, recreate,
reconstitute, reproduce or replace
"research and development
documentation", used for the same-
product.
But we will not pay more than the cost to
restore "research and development
documentation" to its condition
immediately prior to the loss.
DEFINITIONS
The following is added to Paragraph H. of Building
and Personal Property Coverage Form CP 0010:
H, Definitions
1. "Antiques* means an object having value
because its:
a. Craftsmanship is in the style or fashion
of former times; and
b. Age is 100 years or older.
2. "Banking premises* means the interior of
that portion of any building occupied by a
banking institution or similar safe
depository.
3. "Communicable disease" means a
bacterial micro-organism transmitted
through human contact with food.
411*0793 0414 Includes copyrighted materials of Insurance Services Offices, Inc. with its permission Page 34 of 39 UOCUSJgn hnvelop© ID: 4fc1F43B^U1SM5D7-810LMJfcUU4973A7UA premises, including:
(1) Payroll; and
(2) The amount of charges which are
the legal obligation of the tenant(s)
but would otherwise be your
obligations.
41. "Research and development
documentation" means written evidence of
facts, information, processes, concepts or
formulas that are directly related to the
development of new products or
enhancement of existing products. Written
evidence includes written papers, plans,
manuscripts, written or inscribed
documents or plans.
"Research and development
documentation" does not include "valuable
papers and records", accounts receivable
or "media", "software" or "data".
42. "Research and development operations"
means your business activities that are
directly related to the development of new
products or the enhancement of existing
products,
43. "Scientific and professional equipment"
means medical, engineering, veterinary,
measurement, recording, analyzing or
similar equipment.
44. "Securities" means negotiable and
nonnegotiable instruments or contracts
representing either "money" or property
and indudes:
a. Tokens, tickets, revenue and other
stamps (whether represented by actual
stamps or unused value in a meter) in
current use; and
b. Evidences of debt issued in
connection with credit or charge cards,
which cards are not issued by you.
but does not include "money".
45. "Soft cost expenses" means additional:
a. Realty taxes and other assessments
that you incur for the period of time
that construction has been extended
beyond the projected completion date;
b. Interest on money borrowed to finance
construction, remodeling, renovation
or repair; and
c. Advertising, public relations and
ZD2D781280 01 0901120
promotional expenses.
46. "Software" means:
a. "Media*;
b. "Electronic data";
c. "Programs and applications";and
d. "Proprietary programs".
47. "Spoilage" means any detrimental change
in physical state of "perishable goods".
Detrimental change includes, but is not
limited to, thawing of frozen goods,
warming of refrigerated goods,
solidification of liquid or molten material,
chemical reactions to material in process,
and reduction in value of time sensitive
materials,
48. "ThefT means the unlawful taking of
property to the deprivation of the insured.
49. "Transfer account0 means an account
maintained by you at a financial institution
from which you can initiate the transfer,
payment or delivery of "money" and
"securities":
a. By means of electronic, telegraphic,
cable, teletype, telefacsimile or
telephone instructions communicated
directly through an electronic funds
transfer system; or
b. By means of written instructions
establishing the conditions under
which such transfers are to be initiated
by such financial institution through an
electronic funds transfer system.
50* 'Valuable papers and records" means:
a. Inscribed, printed or written:
(1) Documents;
(2) Manuscripts; and
(3) Records
including abstracts, books, deeds,
drawings, films, maps or mortgages;
and
b. Similar items stored electronically.
But, "valuable papers and records" does
not mean "money" or "securities".
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 411-0793 0414 Includes copyrighted materials of Insurance Services Offices, Inc. with its permission Page 39 of 39 UOCUStgnbnvelope IU: 4b1f-43Bi»-U1B2-45U7'-B10l>-UbO(^49/3A/UA POLICY: ZD2D78128002
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY BROADENING ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SUMMARY OF COVERAGES
1. Additional Insured by Contract*Agreement or Permit Included
2. Additional Insured - Primary and Non-Contributory Included
3. Blanket Waiver of Subrogation Included
4. Bodily Injury Redefined Included
5. Broad Form Property Damage - Borrowed Equipment, Customers Goods & Use of Elevators Included
6. Knowledge of Occurrence Included
7. Liberalization Clause Included
8. Medical Payments - Extended Reporting Period Included
9. Newly Acquired or Formed Organizations - Covered untilend of policy period Included
10. Non-owned Watercraft 51ft.
11. Supplementary Payments Increased Limits
- Bail Bonds $2,500
- Loss of Earnings $1000
12. Unintentional Failure to Disclose Hazards Included
13. Unintentional Failure to Notify Included
This endorsement amends coverages provided under the CommercialGeneral LiabilityCoverage Part through new coverages, higher limits and broader coverage grants.
1. Additional Insured by Contract, Agreement or
Permit
The following is added to SECTION II - WHO IS
AN INSURED:
Additional Insured by Contract, Agreement or
Permit
a. Any person or organization with whom you
agreed in a written contract, written agreement
or permit that such person or organization to
add an additional insured on your policy is an
additional insured only with respect to liability
for "bodily injury", "property damage", or
"personal and advertising injury" caused, in
whole or in part, by your acts or omissions, or
the acts or omissions of those acting on your
behalf, but only with respect to:
(1) "Your work" for the additional insured(s)
designated in the contract, agreement or
permit;
(2) Premises you own, rent, lease or occupy;
or
(3) Your maintenance, operation or use of
equipment leased to you.
b. The insurance afforded to such additional
insured described above:
(1) Only applies to the extent permitted by
law; and
(2) Will not be broader than the insurance
which you are required by the contract,
agreement or permit to provide for such
additional insured.
421-2915 0615 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 4 UOCUSign hnvelOpe IU:4t1h43H^U1BZ-^5P7-ai0L>-Ufc0t>»973A70A (3) Applies on a primary basis if that is
required by the written contract, written
agreement or permit.
(4) Will not be broader than coverage
provided to any other insured.
(5) Does not apply if the "bodily injury,
"property damage" or "personal and
advertising injury" is otherwise excluded
from coverage under this Coverage Part,
including any endorsements thereto.
This provision does not apply:
(1) Unless the written contract or written
agreement was executed or permit was
issued prior to the "bodily injur/1, "property
damage", or "personal injury and
advertising injur/'.
(2) To any person or organization included as
an insured by another endorsement
issued by us and made part of this
Coverage Part.
(3) To any lessor of equipment:
(a) After the equipment lease expires; or
(b) If the "bodily injury", "property
damage", "personal and advertising
injur/ arises out of sole negligence of
the lessor
(4) To any:
(a) Owners or other interests from, whom
land has been leased which takes
place after the lease for the land ex
pires; or
(b) Managers or lessors of premises if:
(i) The occurrence takes place after
you cease to be a tenant in that
premises; or
(ii) The "bodily injury", "property
damage", "personal injury" or
"advertising injury" arises out of
structural alterations, new con
struction or demolition operations
performed by or on behalf of the
manager or lessor.
(5) To "bodily injury1*, "property damage" or
"personal and advertising injury arising
out of the rendering of or the failure to
render any professional services.
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing in the supervision,
hiring, employment, training or monitoring
of others by that insured, if the
"occurrence" which caused the "bodily
injury" or "property damage" or the offense
which caused the "personal and
advertising injur/ involved the rendering
of or failure to render any professional
services by or for you.
d. With respect to the insurance afforded to
these additional insureds, the following is
added to SECTION ill - LIMITS OF
INSURANCE:
The most we will pay on behalf of the
additional insured for a covered claim is the
lesser of the amount of Insurance:
1, Required by the contract, agreement or
permit described in Paragraph a.; or
2. Available under the applicable Limits of
Insurance shown in the Declarations.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
2. Additional Insured - Primary and Non-
Contributory
The following is added to SECTION IV -
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 4. Other insurance:
Additional Insured - Primary and Non-
Contributory
If you agree in a written contract, written
agreement or permit that the insurance provided to
any person or organization included as an
Additional Insured under SECTION II - WHO IS
AN INSURED, is primary and non-contributory,
the following applies:
If other valid and collectible insurance is available
to the Additional Insured for a loss covered under
Coverages A or B of this Coverage Part, our
obligations are limited as follows:
a. Primary Insurance
This insurance is primary to other insurance
that is available to the Additional Insured
which covers the
Additional Insured as a Named Insured. We
will not seek contribution from any other
insurance available to the Additional Insured
except
(1) For the sole negligence of the Additional
Insured;
(2) When the Additional Insured is an
Additional Insured under another primary
liability policy; or
(3) when b. below applies.
If this insurance is primary, our obligations are
not affected unless any of the other insurance
is also primary- Then, we will share with all
that other insurance by the method described
in c. below.
421-2915 0615 Includes copyrighted materialof Insurance Services Office, Inc., with its permission. Page 2 of 4 PQCUS4gnenvelope IP: 4fc1h43B^P1BSM5P7-81QLM3fcOt>*973A7UA b. Excess Insurance
(1) This insurance is excess over any of the
other insurance, whether primary, excess,
contingent or on any other basis:
(a) That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work";
(b) That is Fire insurance for premises
rented to the Additional Insured or
temporarily occupied by the Additional
Insured with permission of the owner;
(c) That is insurance purchased by the
Additional Insured to cover the
Additional Insured's liability as a
tenant for "property damage" to
premises rented to the Additional
Insured or temporarily occupied by the
Additional with permission of the
owner; or
(d) If the loss arises out of the
maintenance or use of aircraft, "autos"
or watercraft to the extent not subject
to Exclusion g. of SECTION I -
COVERAGE A - BODILY INURY
AND PROPERTY DAMAGE
LIABILITY.
(2) When this insurance is excess, we will
have no duty under Coverages A or B to
defend the insured against any "suit" ifany
other insurer has a duty to defend the
insured against that "suit". If no other
insurer defends, we will undertake to do
so, but we will be entitled to the insured's
rights against all those other insurers.
(3) When this insurance is excess over other
Insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(a) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(b) The total of all deductible and self
insured amounts under all that other
insurance.
We will share the remaining loss, if any,
with any other insurance that is not
described in this Excess Insurance
provision and was not bought specifically
to apply in excess of the Limits of
Insurance shown in the Declarations of
this Coverage Part.
c. Method Of Sharing
If all of the other insurance permits
contribution by equal shares, we willfollow this
method also. Under this approach each
insurer contributes equal amounts until it has
paid its applicable limit of insurance or none of
the loss remains, whichever comes first. If any
of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer's
share is based on the ratio of its applicable
limit of insurance to the total applicable limits
of insurance of all insurers
3. Blanket Waiver of Subrogation
The following is added to SECTION IV -
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 8. Transfer Of Rights
Of Recovery Against Others To Us:
We waive any right of recovery we may have
against any person or organization with whom you
have a written contract that requires such waiver
because of payments we make for damage under
this coverage form. The damage must arise out of
your activities under a written contract with that
person or organization. This waiver applies only to
the extent that subrogation is waived under a
written contract executed prior to the "occurrence"
or offense giving rise to such payments.
4. Bodily Injury Redefined
SECTION V - DEFINITIONS, Definition 3. "bodily
injury is replaced by the following:
3* "Bodilyinjury means bodily injury,sickness or
disease sustained by a person including death
resulting from any of these at any time. "Bodily
injury includes mental anguish or other
mental injury resulting from "bodily injur/.
5. Broad Form Property Damage - Borrowed
Equipment, Customers Goods, Use of
Elevators
a. SECTION I - COVERAGES, COVERAGE A -
BODIUY INJURY AND PROPERTY
DAMAGE LIABILITY, Paragraph 2.
Exclusions subparagraph j. is amended as
follows:
Paragraph (4) does not apply to "property
damage" to borrowed equipment while at a
jobsite and not being used to perform
operations.
Paragraphs (3), (4) and (6) do not apply to
"property damage" to "customers goods" while
on your premises nor do they apply to the use
of elevators at premises you own, rent, lease
or occupy.
b. The following is added to SECTION V -
DEFINTIONS:
24. "Customers goods" means property of
your customer on your premises for the
purpose of being:
421-2915 0615 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 4 POCUS&gn hnvelope IP:4fc1h43B»-P1Bi2-45P7-810L>-PfeUG4973A70A
7. a. worked on; or
b* used in your manufacturing process.
c. The insurance afforded under this provision is
excess over any other valid and collectible
property insurance (including deductible)
available to the insured whether primary,
excess, contingent
Knowledge of Occurrence
The following is added to SECTION IV -
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 2. Duties In the Event
of Occurrence, Offense, Claim or Suit:
e. Notice of an "occurrence", offense, claim or
"suit" will be considered knowledge of the
insured if reported to an individual named
insured, partner, executive officer or an
"employee" designated by you to give us such
a notice.
Liberalization Clause
The following is added
COMMERCIAL
CONDITIONS:
Liberalization Clause
If we adopt any revision that would broaden the
coverage under this Coverage Form without
additional premium, within 45 days prior to or
during the policy period, the broadened coverage
will immediately apply to this Coverage Part.
8. Medical Payments - Extended Reporting
Period
a. SECTION I ~ COVERAGES, COVERAGE C -
MEDICAL PAYMENTS, Paragraph 1.
Insuring Agreement, subparagraph a.(3)(b)
is replaced by the following:
(b) The expenses are incurred and reported
to us within three years of the date of the
accident; and
b. This coverage does not apply if COVERAGE
C - MEDICAL PAYMENTS is excluded either
by the provisions of the Coverage Part or by
endorsement.
9. Newly Acquired Or Formed Organizations
SECTION II - WHO IS AN INSURED, Paragraph
3.a. is replaced by the following:
a* Coverage under this provision is afforded until
the end of the policy period.
to SECTION IV -
GENERAL LIABILITY
10. Non-Owned Watercraft
SECTION I - COVERAGES, COVERAGE A
BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Paragraph 2. Exclusions,
subparagraph g„(2) is replaced by the following:
g. Aircraft, Auto Or Watercraft
(2) A watercraft you do not own that is:
(a) Less than 51 feet long; and
(b) Not being used to carry persons or
property for a charge;
This provision applies to any person who,
with your consent, either uses or is
responsible for the use of a watercraft.
11. Supplementary Payments Increased Limits
SECTION I - SUPPLEMENTARY PAYMENTS
COVERAGES A AND B, Paragraphs 1.b. and
l.d. are replaced by the following:
Ub.Up to $2,500 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which
the Bodily Injury Liability Coverage applies.
We do not have to furnish these bonds.
l.d.AII reasonable expenses incurred by the
insured at our request to assist us in the
investigation or defense of the claim or "sutt",
including actual loss of earnings up to $1000 a
day because of time off from work.
12. Unintentional Failure to Disclose Hazards
The following is added to SECTION IV -
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 6. Representations:
We will not disclaim coverage under this Coverage
Part if you fail to disclose all hazards existing as of the inception date of the policy provided such
failure is not intentional.
13. Unintentional Failure to Notify
The following is added to SECTION IV -
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 2. Duties in the Event
of Occurrence, Offense, Claim or Suit:
Your rights afforded under this policy shall not be
prejudiced if you fail to give us notice of an
"occurrence", offense, claim or "suit", solely due to
your reasonable and documented belief that the
"bodily injury"or "property damage" is not covered
under this policy.
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 421-2915 0615 Includes copyrighted material of Insurance Services Office, Inc., withits permission. Page 4 of 4 UQCUSgn fcnvelope IU:4fc1h43B^U1B2^5D7-810l>UfcOrJ4a73A7(JA POLICY: ZD2D78128002
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AGGREGATE LIMITS OF INSURANCE PER PROJECT AND
PER LOCATION WITH CAP
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Policy Aggregate: $ 10,000,000
(Ifno entry appears above, informationrequired to complete this endorsement will be shown in the Declarations as applicable to this endorsement)
A. The following is added to SECTION III - LIMITS
OF INSURANCE, paragraph 2.:
The General Aggregate Limit applies separately
to:
a. Construction projects away from premises
owned or rented to you; and
b. Each "location" owned by or rented to you.
If the Schedule above is completed, however, a
Policy Aggregate Limit applies. The most we will
pay for the sum of all damages, except for
damages included in the "products-completed
operations hazard", regardless of the number of
insureds, claims made or "suits" brought, persons
or organizations makingclaims or bringing"suits",
or "locations", is the Policy Aggregate
identified in the Schedule above.
Limit
B. This endorsement does not apply to damages
included in the "products-completed operations
hazard".
C, For the purposes of this endorsement, the
following definition is added to SECTION V -
DEFINITIONS:
1. "Location" means premises involving the same
or connecting lots, or premises whose
connection is interrupted only by a street,
roadway, waterway or right-of-way of a
railroad.
ALLOTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 421-3635 0716 Includescopyrightedmaterialsol InsuranceServices Office,Inc.,with its permission. Page 1 of 1 UOCUSignfcnvelop© ID: 4fc1h43B^U1B2^bU^810l>Dfc0O49/3A/-(JA POLICY: 2D2D78128002
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ !TCAREFULLY.
BLANKET ADDITIONAL INSURED BY CONTRACTOR AGREEMENT - WITH
PRODUCTS-COMPLETED OPERATIONS COVERAGE
This endorsement modifies insurance providedunder the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
The following is added to SECTION II - WHO IS
AN INSURED:
Additional Insured - Written Contract,
Agreement or Permit
a. Any person or organization as required by a
written contract, agreement or permit to add
as an additional insured on your policy is an
additional insured but only with respect to
liability for "bodily injury", "property damage*,
or 'personal and advertising injury" caused, in
whole or in part, by your acts or omissions, or
the acts or omissions of those acting on your
behalf, and only with respect to:
(1) "Your work" for the additional insured(s)
designated in the contract, agreement or
permit;
(2) Premises you own, rent, lease or occupy;
(3) Your maintenance, operation or use of
equipment leased to you; or
(4) "Your work" for the additional insured(s)
designated in the contract, agreement or
permit including "bodily injury"or "property
damage" included in the "products-
completed operations hazard" provided
that:
(a) This Coverage Part provides such
coverage; and
(b) The written contract, agreement or
permit requires such coverage for the
additional insured.
b. If the written contract or agreement specificatty
requires you to add an additional insured to
your policy viaendorsement CG 20 10 11 85,
CG 20 10 10 93, CG 20 10 03 97, CG 20 10
10 01 or endorsement CG 20 37 10 01, then
the words "caused in whole or in part by*" in
parageph a. above are replaced by the words
"arising out of.
c. The insurance afforded to such additional
insured described above:
(1) Only applies to the extent permitted by
law.
(2) Will not be broader than the insurance
which you are required by the contract,
agreement or permit to provide for such
additional insured.
(3) Is primary to and will not seek contribution
from any other insurance available to such
additional insured 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.
(4) Will not be broader than coverage
provided to any other insured.
(5) Does not apply if the "bodily injury",
"property damage" or "personal and
advertising injury" is otherwise excluded
from coverage under this Coverage Part,
including any endorsements thereto.
d. This provision does not apply;
(1) Unless the written contract or agreement
was executed or permit was issued prior
to the "bodily injury", "property damage",
or "personal and advertising injury".
(2) To any person or organizationincludedas
an insured by another endorsement
issued by us and made part of this
Coverage Part.
(3) Ifthe "bodilyinjury","propertydamage1,or
"personal and advertising injury"arises out
of sole negligence of the additional
insured.
(4) To any lessor of equipment:
(a) After the equipment lease expires; or
(b) If the "bodily injury", "property
damage", or "personal and advertising
injury"arises out ofsole negligence of
the lessor
421-449010 18 Includescopyrightedmaterialof InsuranceServices Office,Inc.,with lis permission.
Copyright2017 The HanoverInsurance Company.AllRightsReserved.
Pagel of 2
UOCUSignfcnvelope ID:4fc1F-43H»-U1B2-45U/-81OL>-UbOC49/3A/0A (5) To any:
(a) Owners or other interests from whom
land has been leased if the
"occurrence" takes place or the
offense is committed after the lease
for the land expires; or
(b) Managers or lessors of premises if:
(i) The occurrence takes place after
you cease to be a tenant in that
premises; or
(II) The "bodily injury", "property
damage", "personal and
advertising injuryw arises out of
structural alterations, new con
struction or demolition operations
performed by or on behalf of the
manager or lessor
(6) To "bodily injury", "property damage" or
"personal and advertising injury" arising
out of the rendering of or the failure to
render any professional services.
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing in the supervision,
hiring,employment, training ormonitoring
of others by that insured, if the
"occurrence" which caused the "bodily
injury"or "propertydamage" or the offense
which caused the "personal and
advertising injury" involved the rendering
of or failure to render any professional
services by or foryou.
B. With respect to the insurance afforded to these
additional insureds, the following is added to
SECTION III - LIMITS OF INSURANCE:
The most we will pay on behalf of the additional
insured for a covered claim is the lesser of the
amount of insurance:
1. Required by the written contract, agreement or
permit described in paragraph A.a.; or
2. Available under the applicable Limits of
Insurance shown in the Declarations or any
endorsement to this policy.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 421-449010 18 IncludescopyrightedmaterialofInsuranceServicesOffice,Inc., with itspeimission.
Copyright2017 The HanoverInsuranceCompany.All RightsReserved.
UQCUHign hnvelope ID:4fc1r-43HS*-OlBZ-4&U/-810l>PfcOU49iT3A/UA POLICY: ZD2D78128002
COMMERCIAL GENERAL LIABILITY
CG 00 01 04 13
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
Various provisions in this policy restrict coverage.
Read the entire policy carefully to determine rights,
duties and what is and is not covered.
Throughout this policy the words "you" and "your"
refer to the Named Insured shown in the Declarations,
and any other person or organization qualifying as a
Named Insured under this policy. The words "we",
"us" and "our" refer to the company providing this
insurance.
The word "insured" means any person or organization
qualifying as such under Section II - Who Is An
Insured.
Other words and phrases that appear in quotation
marks have special meaning. Refer to Section V -
Definitions.
SECTION I - COVERAGES
COVERAGE A - BODILY INJURY AND PROPERTY
DAMAGE LIABILITY
1. Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "bodily injury"or "property damage"
to which this insurance applies. We will have
the right and duty to defend the insured against
any "suit" seeking those damages. However,
we will have no duty to defend the insured
against any "suit" seeking damages for "bodily
injury" or "property damage" to which this
insurance does not apply. We may, at our
discretion, investigate any "occurrence" and
settle any claim or "suit"that may result. But:
(1) The amount we will pay for damages is
limited as described in Section III - Limits
Of Insurance; and
(2) Our right and duty to defend ends when we
have used up the applicable limit of
insurance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.
No other obligation or liability to pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments - Coverages A and B.
b. This insurance applies to "bodily injury" and
"property damage" only if:
(1) The "bodily injury" or "property damage" is
caused by an "occurrence" that takes place
in the "coverage territory";
(2) The "bodily injury" or "property damage"
occurs during the policy period; and
(3) Prior to the policy period, no insured listed
under Paragraph 1. of Section II - Who Is
An Insured and no "employee" authorized
by you to give or receive notice of an
"occurrence" or claim, knew that the "bodily
injury" or "property damage" had occurred,
in whole or in part. If such a listed insured
or authorized "employee" knew, prior to the
policy period, that the "bodily injury" or
"property damage" occurred, then any
continuation, change or resumption of such
"bodily injury" or "property damage" during
or after the policy period will be deemed to
have been known prior to the policy period.
"Bodily injury" or "property damage" which
occurs during the policy period and was not,
prior to the policy period, known to have
occurred by any insured listed under
Paragraph 1. of Section II -Who Is An Insured
or any "employee" aufliorized by you to give or
receive notice of an "occurrence" or claim,
includes any continuation, change or
resumption of that "bodily injury" or "property
damage" after the end of the policy period.
, "Bodily injury" or "property damage" will be
deemed to have been known to have occurred
at the earliest time when any insured listed
under Paragraph 1. of Section II - Who Is An
Insured or any "employee" authorized by you to
give or receive notice of an "occurrence" or
claim:
(1) Reports all, or any part, of the"bodilyinjury"
or "property damage" to us or any other
insurer;
(2) Receives a written or verbal demand or
claim for damages because of the "bodily
injury"or "propertydamage"; or
(3) Becomes aware by any other means that
"bodily injury" or "property damage" has
occurred or has begun to occur.
. Damages because of "bodily injury" include
damages claimed by any person or
organization for care, loss of services or death
resulting at anytime from ttie "bodilyinjury".
CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 16 UOCU&gn hnvelOOOID:4b1h43H!f>U1B2-45D7-81UD-UkUU49/3A7UA
2. Exclusions
This insurance does not apply to:
a. Expected Or Intended Injury
"Bodily injury" or "property damage" expected
or intended from the standpoint of the insured.
This exclusion does not apply to "bodily injury"
resulting from the use of reasonable force to
protect persons or property.
b. Contractual Liability
"Bodily injury" or "property damage" for which
the insured is obligated to pay damages by
reason of toe assumption of liability in a
contract or agreement. This exclusion does not
apply to liabilityfor damages:
(1) That the insured would have in the absence
of the contract or agreement; or
(2) Assumed in a contract or agreement that is
an "insured contract", provided the "bodily
injury" or "property damage" occurs
subsequent to the execution of the contract
or agreement. Solely for the purposes of
liability assumed in an "insured contract",
reasonable attorneys' fees and necessary
litigationexpenses incurred by or for a party
other than an insured are deemed to be
damages because of "bodily injury" or
"property damage", provided:
(a) Liabilityto such party for, or for the cost
of, that party's defense has also been
assumed in the same "insured contract";
and
(b) Such attorneys' fees and litigation
expenses are for defense of that party
against a civil or alternative dispute
resolution proceeding in which damages
to which this insurance applies are
alleged.
c. Liquor Liability
"Bodily injur/' or "property damage" for which
any insured may be held liable by reason of:
(1) Causing or contributing to the intoxication of
any person;
(2) The furnishing of alcoholic beverages to a
person under the legal drinking age or
under the influence of alcohol; or
(3) Any statute, ordinance or regulation relating
to the sale, gift, distribution or use of
alcoholic beverages.
This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in:
(a) The supervision, hiring, employment,
training or monitoring of others by that
insured; or
(b) Providing or failing to provide
transportation with respect to any
person that may be under the influence
of alcohol;
if the "occurrence" which caused the "bodily
injury" or "property damage", involved that
which is described in Paragraph (1), (2) or (3)
above.
However, this exclusion applies only if you are
in the business of manufacturing, distributing,
selling, serving or furnishing alcoholic
beverages. For the purposes of this exclusion,
permitting a person to bring alcoholic
beverages on your premises, for consumption
on your premises, whether or not a fee is
charged or a license is required for such
activity, is not by itself considered the business
of selling, serving or furnishing alcoholic
beverages.
d. Workers' Compensation And Similar Laws
Any obligation of the insured under a workers'
compensation, disability benefits or
unemployment compensation law or any
similar law.
e. Employer's Liability
"Bodily injury" to:
(1) An "employee" of the insured arising out of
and En the course of:
(a) Employment by the insured; or
(b) Performing duties related to the conduct
of the insured's business; or
(2) The spouse, child, parent, brother or sister
of that "employee" as a consequence of
Paragraph (1) above.
This exclusion applies whether the insured
may be liable as an employer or in any other
capacity and to any obligation to share
damages with or repay someone else who
must pay damages because of the injury.
This exclusion does not apply to liability
assumed by the insured under an "insured
contract".
UOCUSign hnvelOpe ID:4fc1h4aB»-D1BZ-45U7-810D-DfeUU49/3A70A f. Pollution
(1) "Bodily injury" or "property damage" arising
out of the actual, alleged or threatened
discharge, dispersal, seepage, migration,
release or escape of "pollutants":
(a) At or from any premises, site or location
which is or was at any time owned or
occupied by, or rented or loaned to, any
insured. However, this subparagraph
does not apply to:
(i) "Bodily injury" if sustained within a
building and caused by smoke,
fumes, vapor or soot produced by or
originating from equipment that is
used to heat, cool or dehumidify the
building, or equipment that is used to
heat water for personal use, by the
building's occupants or their guests;
(ii) "Bodily injury" or "property damage"
for which you may be held liable, if
you are a contractor and the owner
or lessee of such premises, site or
location has been added to your
policy as an additional insured with
respect to your ongoing operations
performed for that additional insured
at that premises, site or location and
such premises, site or location is not
and never was owned or occupied
by, or rented or loaned to, any
insured, other than that additional
insured; or
(Hi) "Bodily Injury" or "property damage"
arising out of heat, smoke or fumes
from a "hostile fire";
(b) At or from any premises, site or location
which is or was at any time used by or
for any insured or others for the
handling, storage, disposal, processing
or treatment of waste;
(c) Which are or were at any time
transported, handled, stored, treated,
disposed of, or processed as waste by
or for:
(i) Any insured; or
(Ii) Any person or organization for whom
you may be legally responsible; or
(d) At or from any premises, site or location
on which any insured or any contractors
or subcontractors working directly or
indirectly on any insured's behalf are
performing operations if the "pollutants"
are brought on or to the premises, site
or location in connection with such
operations by such insured, contractor
or subcontractor. However, this
subparagraph does not apply to:
(i) "Bodily injury" or "property damage"
arising out of the escape of fuels,
lubricants or other operating fluids
which are needed to perform the
normal electrical, hydraulic or
mechanical functions necessary for
the operation of "mobile equipment"
or its parts, if such fuels, lubricants
or other operating fluids escape from
a vehicle part designed to hold, store
or receive them. This exception does
not apply if the "bodily injury" or
"property damage" arises out of the
intentional discharge, dispersal or
release of the fuels, lubricants or
other operating fluids, or if such
fuels, lubricants or other operating
fluids are brought on or to the
premises, site or location with the
intent that they be discharged,
dispersed or released as part of the
operations being performed by such
insured, contractor or subcontractor;
(ii) "Bodily injury^ or "propertydamage"
sustained within a building and
caused by the release of gases,
fumes or vapors from materials
brought into that building in
connection with operations being
performed by you or on your behalf
by a contractor or subcontractor; or
(iii) "Bodily injur/1 or "property damage"
arising out of heat, smoke or fumes
from a "hostile fire".
(e) At or from any premises, site or location
on which any insured or any contractors
or subcontractors working directly or
indirectly on any insured's behalf are
performing operations if the operations
are to test for, monitor, clean up,
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, "pollutants".
CG 00 01 04 13 Insurance Services Office, Inc., 2012 Page 3 of 16 uocusign Envelope id: 4tih43B»-uiBZ-4bU7-8iOD-UfcOL>*9r3A/0A (2) Any loss, cost or expense arising out of
any:
(a) Request, demand, order or statutory or
regulatory requirement that any insured
or others test for, monitor, clean up,
remove, contain, treat, detoxify or
neutralize, or in any way respond to, or
assess the effects of, "pollutants"; or
(b) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring,
cleaning up, removing, containing,
treating, detoxifying or neutralizing, or in
any way responding to, or assessing the
effects of, "pollutants".
However, this paragraph does not apply to
liability for damages because of "property
damage" that the insured would have in the
absence of such request, demand, order or
statutory or regulatory requirement, or such
claim or "suif by or on behalf of a
governmental authority.
g. Aircraft, Auto Or Watercraft
"Bodily injury"or "property damage" arising out
of the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft owned or operated by or rented or
loaned to any insured. Use includes operation
and "loading or unloading".
This exclusion applies even if the claims
against any insured allege negligence or other
wrongdoing in the supervision, hiring,
employment training or monitoring of others by
that insured, if the "occurrence" which caused
the "bodily injur/' or "property damage"
involved the ownership, maintenance, use or
entrustment to others of any aircraft, "auto" or
watercraft that is owned or operated by or
rented or loaned to any insured.
This exclusiondoes not apply to:
(1) A watercraft while ashore on premises you
own or rent;
(2) A watercraft you do not own that is:
(a) Less than 26 feet long; and
(b) Not being used to carry persons or
property for a charge;
(3) Parking an "auto" on, or on the ways next
to, premises you own or rent, provided the
"auto" is not owned by or rented or loaned
to you or the insured;
(4) Liability assumed under any "insured
contract" for the ownership, maintenance or
use of aircraft or watercraft; or
(5) "Bodilyinjury" or "property damage" arising
out of:
(a) The operation of machinery or
equipment that is attached to, or part of,
a land vehicle that would qualify under
the definition of "mobile equipmenf if it
were not subject to a compulsory or
financial responsibility law or other
motor vehicle insurance law where it is
licensed or principally garaged; or
(b) The operation of any of the machinery
or equipment listed in Paragraph f.(2) or
f.(3) of the definition of "mobile
equipment".
h. Mobile Equipment
"Bodily injury" or "property damage" arising out
of:
(1) The transportation of "mobile equipmenf by
an "auto" owned or operated by or rented or
loaned to any insured; or
(2) The use of "mobile equipment" in, or while
In practice for, or while being prepared for,
any prearranged racing, speed, demolition,
or stunting activity.
i. War
"Bodily injury" or "property damage", however
caused, arising, directly or indirectly, out of:
(1) War, including undeclared or civilwar;
(2) Warlike action by a militaryforce, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
j. Damage To Property
"Property damage" to:
(1) Property you own, rent, or occupy, including
any costs or expenses incurred by you, or
any other person, organization or entity, for
repair, replacement, enhancement,
restoration or maintenance of such property
for any reason, including prevention of
injury to a person or damage to another's
property;
(2) Premises you sell, give away or abandon, if
the "property damage" arises out of any
part of those premises;
(3) Property loaned to you;
UQCUSign hnvelop© ID: 4t1h43B»-UlBi2-45D/.810l>IJfeUG49/3A70A (4) Personal property in the care, custody or
control of the insured;
(5) That particular part of real property on
which you or any contractors or
subcontractors working directly or indirectly
on your behalf are performing operations, if
the "property damage" arises out of those
operations; or
(6) That particular part of any property that
must be restored, repaired or replaced
because "your work" was incorrectly
performed on it.
Paragraphs (1), (3) and (4) of this exclusion do
not apply to "property damage" (other than
damage by fire) to premises, including the
contents of such premises, rented to you for a
period of seven or fewer consecutive days. A
separate limit of insurance applies to Damage
To Premises Rented To You as described in
Section III - Limits Of Insurance.
Paragraph (2) of this exdusion does not apply
if the premises are "your work" and were never
occupied, rented or held for rental by you.
Paragraphs (3), (4), (5) and (6) of this
exclusion do not apply to liability assumed
under a sidetrack agreement.
Paragraph (6) of this exclusion does not apply
to "property damage" included in the "products-
completed operations hazard".
k. Damage To Your Product
"Property damage" to "your producf arising out
of it or any part of it.
I. Damage To Your Work
"Property damage" to "your work" arising out of
it or any part of it and included in the "products-
completed operations hazard".
This exclusion does not apply if the damaged
work or the work out of which the damage
arises was performed on your behalf by a
subcontractor.
m. Damage To Impaired Property Or Property
Not Physically Injured
"Property damage" to "impaired property" or
property that has not been physically injured,
arising out of:
(1) A defect, deficiency, inadequacy or
dangerous condition in "your product" or
"your work"; or
(2) A delay or failure by you or anyone acting
on your behalf to perform a contract or
agreement in accordance with its terms.
This exclusion does not apply to the loss of use
of other property arising out of sudden and
accidental physical injury to "your product" or
"your work" after it has been put to its intended
use.
n. Recall Of Products, Work Or Impaired
Property
Damages claimed for any loss, cost or
expense incurred by you or others for the loss
of use, withdrawal, recall, inspection, repair,
replacement, adjustment, removal or disposal
of:
(1) "Your producf;
(2) "Your work"; or
(3) "Impaired property";
if such product, work, or property is withdrawn
or recalled from the market or from use by any
person or organization because of a known or
suspected defect, deficiency, inadequacy or
dangerous condition in it.
o. Personal And Advertising Injury
"Bodily injury" arising out of "personal and
advertising injury".
p. Electronic Data
Damages arising out of the loss of, loss of use
of, damage to, corruption of, inability to access,
or inabilityto manipulate electronic data.
However, this exclusion does not apply to
liabilityfor damages because of "bodilyinjury".
As used in this exclusion, electronic data
means information, facts or programs stored as
or on, created or used on, or transmitted to or
from computer software, including systems and
applications software, hard or floppydisks, CD-
ROMs, tapes, drives, cells, data processing
devices or any other media which are used
with electronically controlled equipment.
q. Recording And Distribution Of MaterialOr
Information In Violation Of Law
"Bodily injury" or "property damage" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN-SPAMAct of 2003, induding any
amendment of or addition to such law;
(3) The Fair Credit Reporting Act (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transactions Act (FACTA); or
CG 00 01 04 13 »Insurance Services Office, Inc., 2012 Page 5 of 16 uocusagn Envelope id: 4tiH43B»-uiBZ-45D7-8iOD-fJfeOC^9r3A70A (4) Any federal, state or local statute,
ordinance or regulation, other than the
TCPA, CAN-SPAM Act of 2003 or FCRA
and their amendments and additions, that
addresses, prohibits, or limits the printing,
dissemination, disposal, collecting,
recording, sending, transmitting,
communicating or distribution of material or
information.
Exclusions c. through n. do not apply to damage
by fire to premises while rented to you or
temporarily occupied by you with permission of the
owner. A separate limit of insurance applies to this
coverage as described in Section III - Limits Of
Insurance,
COVERAGE B - PERSONAL AND ADVERTISING
INJURY LIABILITY
1. Insuring Agreement
a. We will pay those sums that the insured
becomes legally obligated to pay as damages
because of "personal and advertising injury" to
which this insurance applies. We will have the
right and duty to defend the insured against
any "suif seeking those damages. However,
we will have no duty to defend the insured
against any "suif seeking damages for
"personal and advertising injury" to which this
insurance does not apply. We may, at our
discretion, investigate any offense and settle
any claim or "suit" that may result. But:
(1) The amount we will pay for damages is
limited as described in Section III - Limits
Of Insurance; and
(2) Our right and duty to defend end when we
have used up the applicable limit of
insurance in the payment of judgments or
settlements under Coverages A or B or
medical expenses under Coverage C.
No other obligation or liabilityto pay sums or
perform acts or services is covered unless
explicitly provided for under Supplementary
Payments - Coverages A and B.
b. This insurance applies to "personal and
advertisinginjury"caused by an offense arising
out of your business but only if the offense was
committed in the "coverage territory"during the
policy period.
2. Exclusions
This insurance does not apply to:
a. Knowing Violation Of Rights Of Another
"Personal and advertising injury" caused by or
at the direction of the insured with the
knowledge that the act would violate the rights
of another and would inflict "personal and
advertising injury".
b. Material Published With Knowledge Of
Falsity
"Personal and advertising injury" arising out of
oral or written publication, in any manner, of
material, if done by or at the direction of the
insured with knowledge of its falsity.
c. Material Published Prior To Policy Period
"Personal and advertising injury" arising out of
oral or written publication, in any manner, of
material whose first publication took place
before the beginning of the policy period.
d. Criminal Acts
"Personal and advertising injury" arising out of
a criminal act committed by or at the direction
of the insured.
e. Contractual Liability
"Personal and advertising injury" for which the
insured has assumed liability in a contract or
agreement This exclusion does not apply to
liability for damages that the insured would
have in the absence of the contract or
agreement
f. Breach Of Contract
"Personal and advertising injury" arising out of
a breach of contract, except an implied
contract to use another's advertising idea in
your "advertisement".
g. Quality Or Performance Of Goods - Failure
To Conform To Statements
"Personal and advertising injury" arising out of
the failure of goods, products or services to
conform with any statement of quality or
performance made in your "advertisement".
h. Wrong Description Of Prices
"Personal and advertising injury" arising out of
the wrong description of the price of goods,
products or services stated in your
"advertisemenf.
UOCUSignEnvelope ID: 4fclh43B5#-D1B2-45D7-810D-DEUU49/3A?rUA i. Infringement Of Copyright, Patent,
Trademark Or Trade Secret
"Personal and advertising injury" arising out of
the infringement of copyright, patent,
trademark, trade secret or other intellectual
property rights. Under this exclusion, such
other intellectual property rights do not indude
the use of another's advertising idea in your
"advertisement".
However, this exclusion does not apply to
infringement, in your "advertisement of
copyright, trade dress or slogan.
j. Insureds In Media And Internet Type
Businesses
"Personal and advertising injury" committed by
an insured whose business is:
(1) Advertising, broadcasting, publishing or
telecasting;
(2) Designing or determining content of web
sites for others; or
(3) An Internet search, access, content or
service provider.
However, this exclusion does not apply to
Paragraphs 14.a., b. and c. of "personal and
advertising injury" under the Definitions
section.
For the purposes of this exclusion, the placing
of frames, borders or links, or advertising, for
you or others anywhere on the Internet, is not
by itself, considered the business of
advertising, broadcasting, publishing or
telecasting.
k. Electronic Chatrooms Or Bulletin Boards
"Personal and advertising injury" arising out of
an electronic chatroom or bulletin board the
insured hosts, owns, or over which the insured
exercises control.
I. Unauthorized Use Of Another's Name Or
Product
"Personal and advertising injury" arising out of
the unauthorized use of another's name or
product in your e-mail address, domain name
or m etatag, or any other similar tactics to
mislead another's potential customers.
m. Pollution
"Personal and advertising injur/' arising out of
the actual, alleged or threatened discharge,
dispersal, seepage, migration, release or
escape of "pollutants" at any time.
n. Pollution-related
Any loss, cost or expense arising out of any:
(1) Request, demand, order or statutory or
regulatory requirement that any insured or
others test for, monitor, clean up, remove,
contain, treat, detoxify or neutralize, or in
any way respond to, or assess the effects
of, "pollutants"; or
(2) Claim or suit by or on behalf of a
governmental authority for damages
because of testing for, monitoring, cleaning
up, removing, containing, treating,
detoxifying or neutralizing, or in any way
responding to, or assessing the effects of,
"pollutants".
o. War
"Personal and advertising injury", however
caused, arising, directly or indirectly, out of:
(1) War, induding undedared or civil war;
(2) Warlike action by a military force, including
action in hindering or defending against an
actual or expected attack, by any
government, sovereign or other authority
using military personnel or other agents; or
(3) Insurrection, rebellion, revolution, usurped
power, or action taken by governmental
authority in hindering or defending against
any of these.
p. Recording And Distribution Of Material Or
Information In Violation Of Law
"Personal and advertising injury" arising
directly or indirectly out of any action or
omission that violates or is alleged to violate:
(1) The Telephone Consumer Protection Act
(TCPA), including any amendment of or
addition to such law;
(2) The CAN-SPAM Act of 2003, induding any
amendment of or addition to such law;
(3) The Fair Credit ReportingAct (FCRA), and
any amendment of or addition to such law,
including the Fair and Accurate Credit
Transactions Act (FACTA); or
(4) Any federal, state or local statute,
ordinance or regulation, other than the
TCPA, CAN-SPAM Act of 2003 or FCRA
and their amendments and additions, that
addresses, prohibits, or limits the printing,
dissemination, disposal, collecting,
recording, sending, transmitting,
communicating or distribution of material or
information.
CG 00 01 04 13 Insurance Services Office, Inc., 2012 Page 7 of 16 UOCUSign Envelope ID: 4fc1h43B^U1BM5U/-810LMJfcUW973A/UA
COVERAGE C - MEDICAL PAYMENTS
1. Insuring Agreement
a. We will pay medical expenses as described
below for "bodilyinjury"caused by an accident:
(1) On premises you own or rent;
(2) On ways next to premises you own or rent;
or
(3) Because of your operations;
provided that
(a) The accident takes place in the
"coverage territory" and during the policy
period;
(b) The expenses are incurred and reported
to us within one year of the date of the
accident; and
(c) The injured person submits to
examination, at our expense, by
physicians of our choice as often as we
reasonably require.
b. We will make these payments regardless of
fault. These payments will not exceed the
applicable limit of insurance. We will pay
reasonable expenses for:
(1) First aid administered at the time of an
accident;
(2) Necessary medical, surgical, X-ray and
dental services, including prosthetic
devices; and
(3) Necessary ambulance, hospital,
professional nursing and funeral services.
2. Exclusions
We will not pay expenses for "bodilyinjury":
a. Any Insured
To any insured, except "volunteer workers".
b. Hired Person
To a person hired to do work for or on behalf of
any insured or a tenant of any insured.
c. Injury On Normally Occupied Premises
To a person injured on that part of premises
you own or rent that the person normally
occupies.
d. Workers' Compensation And Similar Laws
To a person, whether or not an "employee" of
any insured, if benefits for the "bodily injury"
are payable or must be provided under a
workers' compensation or disability benefits
law or a similar law.
e. Athletics Activities
To a person injured while practicing, instructing
or partidpating in any physical exercises or
games, sports, or athletic contests.
f. Products-Completed Operations Hazard
Included within the "products-completed
operations hazard".
g. Coverage A Exclusions
Excluded under Coverage A.
SUPPLEMENTARY PAYMENTS - COVERAGES A
ANDB
1. We will pay, with respect to any claim we
investigate or settle, or any "suif against an
insured we defend:
a* All expenses we incur.
b. Up to $250 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which
the Bodily Injury LiabilityCoverage applies. We
do not have to furnish these bonds.
c. The cost of bonds to release attachments, but
only for bond amounts within the applicable
limit of insurance. We do not have to furnish
these bonds.
d. All reasonable expenses incurred by the
insured at our request to assist us in the
investigation or defense of the daim or "suif,
induding actual loss of earnings up to $250 a
day because of time off from work.
e. All court costs taxed against the insured in the
"suit". However, these payments do not include
attorneys' fees or attorneys' expenses taxed
against the insured.
f. Prejudgment interest awarded against the
insured on that part of the judgment we pay. If
we make an offer to pay the applicable limit of
insurance, we will not pay any prejudgment
interest based on that period of time after the
offer.
DQCUaign Envelope ID: 4E1f»43B^U1B2-45U7-810l>DE0G49/3A70A g. All interest on the full amount of any judgment
that accrues after entry of the judgment and
before we have paid, offered to pay, or
deposited in court the part of the judgment that
Is within tiie applicable limitof Insurance.
These payments will not reduce the limits of
insurance.
If we defend an insured against a "suif and an
indemnitee of the insured is also named as a party
to the "suif, we will defend that indemnitee if all of
the following conditions are met:
a. The "suif against the indemnitee seeks
damages for which the insured has assumed
the liability of the indemnitee in a contract or
agreement that is an "insured contract";
b. This insurance applies to such liability
assumed by the insured;
c. The obligation to defend, or the cost of the
defense of, that indemnitee, has also been
assumed by the insured in the same "insured
contract";
d. The allegations in the "suit" and the information
we know about the "occurrence" are such that
no conflict appears to exist between the
interests of the insured and the interests of the
indemnitee;
e. The indemnitee and the insured ask us to
conduct and control the defense of that
indemnitee against such "suif and agree that
we can assign the same counsel to defend the
insured and the indemnitee; and
f. The indemnitee:
(1) Agrees in writing to:
(a) Cooperate with us in the investigation,
settlement or defense of the "suif;
(b) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
"suif;
(c) Notifyany other insurer whose coverage
is available to the indemnitee; and
(d) Cooperate with us with respect to
coordinating other applicable insurance
available to the indemnitee; and
(2) Provides us withwritten authorization to:
(a) Obtain records and other information
related to the "suif; and
(b) Conduct and control the defense of the
indemnitee in such "suif.
So long as the above conditions are met,
attorneys' fees incurred by us in the defense of
that indemnitee, necessary litigation expenses
incurred by us and necessary litigation expenses
incurred by the indemnitee at our request will be
paid as Supplementary Payments.
Notwithstanding the provisions of Paragraph
2.b.(2) of Section I - Coverage A - Bodily Injury
And Property Damage Liability, such payments will
not be deemed to be damages for "bodily injury"
and "property damage" and will not reduce the
limits of insurance.
Our obligation to defend an insured's indemnitee
and to pay for attorneys1 fees and necessary
litigation expenses as Supplementary Payments
ends when we have used up the applicable limitof
insurance in the payment of judgments or
settlements or the conditions set forth above, or
the terms of the agreement described in
Paragraph f. above, are no longer met.
SECTION II -WHO IS AN INSURED
1, Ifyou are designated in the Declarations as:
a. An individual, you and your spouse are
insureds, but only with respect to the conduct
of a business of which you are the sole owner.
b. A partnership or joint venture, you are an
insured. Your members, your partners, and
their spouses are also insureds, but only with
respect to the conduct of your business.
c. A limited liabilitycompany, you are an insured.
Your members are also insureds, but only with
respect to the conduct of your business. Your
managers are insureds, but only with respect
to their duties as your managers,
d. An organization other than a partnership, joint
venture or limited liability company, you are an
insured. Your "executive officers" and directors
are insureds, but only with respect to their
duties as your officers or directors. Your
stockholders are also insureds, but only with
respect to their liabilityas stockholders.
e. A trust, you are an insured. Your trustees are
also insureds, but only with respect to their
duties as trustees.
CG 00 01 04 13 ) Insurance Services Office, Inc., 2012 Page 9 of 16 DOCUSign Envelope ID:4tlh43B»-U1B2-4bD/-81OL%DEOU4g/3A/0A
2. Each of the following is also an insured:
a. Your "volunteer workers" only while performing
duties related to the conduct of your business,
or your "employees", other than either your
"executive officers" (if you are an organization
other than a partnership, joint venture or limited
liabilityoompany) or your managers (if you are
a limited liability company), but only for acts
within the scope of their employment by you or
while performing duties related to the conduct
of your business. However, none of these
"employees" or "volunteer workers" are
insureds for:
(1) "Bodily injury" or "personal and advertising
injury":
(a) To you, to your partners or members (if
you are a partnership or joint venture),
to your members (if you are a limited
liability company), to a co-"employee"
while in the course of his or her
employment or performing duties related
to the conduct of your business, or to
your other "volunteer workers" while
performing duties related to the conduct
of your business;
(b) To the spouse, child, parent, brother or
sister of that co-"employee" or
"volunteer worker" as a consequence of
Paragraph (1)(a) above;
(c) For which there is any obligation to
share damages with or repay someone
else who must pay damages because of
the injury described in Paragraph (1)(a)
or (b) above; or
(d) Arising out of his or her providing or
failing to provide professional health
care services.
(2) "Property damage" to property:
(a) Owned, occupied or used by;
(b) Rented to, In the care, custody or
control of, or over which physical control
is being exercised for any purpose by;
you, any of your "employees", "volunteer
workers", any partner or member (ifyou are
a partnership or joint venture), or any
member (if you are a limited liability
company).
b. Any person (other than your "employee" or
"volunteer worker"), or any organization while
acting as your real estate manager.
c. Any person or organization having proper
temporary custody of your property if you die,
but only:
(1) With respect to liability arising out of the
maintenance or use of that property; and
(2) Until your legal representative has been
appointed.
d. Your legal representative if you die, but only
with respect to duties as such. That
representative will have all your rights and
duties under this Coverage Part.
3. Any organization you newly acquire or form, other
than a partnership, joint venture or limited liability
company, and over which you maintain ownership
or majority interest, will qualify as a Named
Insured if there is no other similar insurance
available to that organization. However
a. Coverage under this provision is afforded only
until the 90th day after you acquire or form the
organization or the end of the policy period,
whichever is earlier;
b. Coverage A does not apply to "bodily injury" or
"property damage" that occurred before you
acquired or formed the organization; and
c. Coverage B does not apply to "personal and
advertising injury" arising out of an offense
committed before you acquired or formed the
organization.
No person or organization is an insured with respect
to the conduct of any current or past partnership, joint venture or limited liability company that is not shown
as a Named Insured in the Declarations.
SECTION III - LIMITS OF INSURANCE
1. The Limits of Insurance shown in the Declarations
and the rules below fix the most we will pay
regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or
bringing "suits".
2. The General Aggregate Limit is the most we will
pay for the sum of:
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except damages
because of "bodily injur/' or "property damage"
induded in the "products-completed operations
hazard"; and
c. Damages under Coverage B.
UOCUSign Envelope ID: 4E1h43B»-U1BZ-45D/-81OL>-DfeUU4g/3A70A
3. The Products-Completed Operations Aggregate
Limit is the most we will pay under Coverage A for
damages because of "bodily injur/* and "property
damage" induded in the "products-completed
operations hazard".
4. Subject to Paragraph 2. above, the Personal And
Advertising Injury Limit is the most we will pay
under Coverage B for the sum of all damages
because of all "personal and advertising injury"
sustained by any one person or organization.
5. Subject to Paragraph 2, or 3. above, whichever
applies, the Each Occurrence Limit is the most we
will pay for the sum of:
a. Damages under Coverage A; and
b. Medical expenses under Coverage C
because of all "bodily injury" and "property
damage" arising out of any one "occurrence".
6. Subject to Paragraph 5. above, the Damage To
Premises Rented To You Limit is the most we will
pay under Coverage A for damages because of
"property damage" to any one premises, while
rented to you, or in the case of damage by fire,
while rented to you or temporarily occupied by you
with permission of the owner.
7. Subject to Paragraph 5. above, the Medical
Expense Limit is the most we will pay under
Coverage C for all medical expenses because of
"bodily injury" sustained by any one person.
The Limits of Insurance of this Coverage Part apply
separately to each consecutive annual period and to
any remaining period of less than 12 months, starting
with the beginning of the policy period shown in the
Declarations, unless the policy period is extended
after issuance for an additional period of less than 12 months. In that case, the additional period will be
deemed part of the last preceding period for purposes
of determining the Limitsof Insurance.
SECTION IV - COMMERCIAL GENERAL LIABILITY
CONDITIONS
1. Bankruptcy
Bankruptcy or insolvency of the insured or of the
insured's estate will not relieve us of our
obligations under this Coverage Part
2. Duties In The Event Of Occurrence, Offense,
Claim Or Suit
a. You must see to it that we are notified as soon
as practicable of an "occurrence" or an offense
which may result in a claim. To the extent
possible, notice should include:
(1) How, when and where the "occurrence" or
offense took place;
(2) The names and addresses of any injured
persons and witnesses; and
(3) The nature and location of any injury or
damage arising out of the "occurrence" or
offense.
b. If a claim is made or "suif is brought against
any insured, you must
(1) Immediately record the specifics of the
claim or "suit" and the date received; and
(2) Notifyus as soon as practicable.
You must see to It that we receive written
notice of the claim or "suif as soon as
practicable.
c. You and any other involved insured must:
(1) Immediately send us copies of any
demands, notices, summonses or legal
papers received in connection with the
claim or "suit";
(2) Authorize us to obtain records and other
information;
(3) Cooperate with us in the investigation or
settlement of the claim or defense against
the "suif; and
(4) Assist us. upon our request, in the
enforcement of any right against any
person or organization which may be liable
to the insured because of injury or damage
to which this insurance may also apply.
d. No insured will, except at that insured's own
cost, voluntarily make a payment, assume any
obligation, or incur any expense, other than for
first aid, without our consent.
3. Legal Action Against Us
No person or organization has a right under this
Coverage Part:
a. To join us as a party or otherwise bring us into
a "suif asking for damages from an insured; or
b. To sue us on this Coverage Part unless all of
its terms have been fully complied with.
A person or organization may sue us to recover on
an agreed settlement or on a final judgment
against an insured; but we will not be liable for
damages that are not payable under the terms of
this Coverage Part or that are in excess of the
applicable limit of insurance. An agreed settlement
means a settlement and release of liability signed
by us, the insured and the claimant or the
claimant's legal representative.
CG 00 01 0413 © Insurance Services Office, Inc., 2012 Page 11 of 16 uocusign Envelope id: 4tiH43B»-DiBZ«45D7-8iOL%UEOC4gr3A^0A
4. Other Insurance
If other valid and collectible insurance is available
to the insured for a loss we cover under
Coverages A or B of this Coverage Part, our
obligations are limited as follows:
a. Primary Insurance
This insurance is primary except when
Paragraph b. below applies. Ifthis insurance is
primary,our obligations are not affected unless
any of the other insurance is also primary.
Then, we will share with all that other
insurance by the method described in
Paragraph c. below.
b. Excess Insurance
(1) This insurance is excess over:
(a) Any of the other insurance, whether
primary, excess, contingent or on any
other basis:
(i) That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work";
(ii) That is Fire insurance for premises
rented to you or temporarily
occupied by you with permission of
the owner;
(iii) That is insurance purchased by you
to cover your liability as a tenant for
"property damage" to premises
rented to you or temporarily
occupied by you with permission of
the owner; or
(iv) If the loss arises out of the
maintenance or use of aircraft,
"autos" or watercraft to the extent not
subject to Exclusion g. of Section I -
Coverage A - Bodily Injury And
Property Damage Liability.
(b) Any other primary insurance available to
you covering liability for damages
arising out of the premises or
operations, or the products and
completed operations, for which you
have been added as an additional
insured.
(2) When this insurance is excess, we will have
no duty under Coverages A or B to defend
the insured against any "suif if any other
insurer has a duty to defend the insured
against that "suif. If no other insurer
defends, we will undertake to do so, but we
will be entitled to the insured's rights
against all those other insurers.
(3) When this insurance is excess over other
insurance, we will pay only our share of the
amount of the loss, if any, that exceeds the
sum of:
(a) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(b) The total of all deductible and self-
insured amounts under all that other
insurance.
(4) We will share the remaining loss, if any,
with any other insurance that is not
described in this Excess Insurance
provision and was not bought specifically to
apply in excess of the Limits of Insurance
shown in the Declarations of this Coverage
Part.
c. Method Of Sharing
If all of the other insurance permits contribution
by equal shares, we will follow this method
also. Under this approach each insurer
contributes equal amounts until it has paid its
applicable limit of insurance or none of the loss
remains, whichever comes first.
If any of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer's
share is based on the ratio of its applicable
limit of insurance to the total applicable limits of
insurance of all insurers.
5. Premium Audit
a. We will compute all premiums for this
Coverage Part in accordance with our rules
and rates.
b. Premium shown in this Coverage Part as
advance premium is a deposit premium only.
At the close of each audit period we will
compute the earned premium for that period
and send notice to the first Named Insured.
The due date for audit and retrospective
premiums is the date shown as the due date
on the bill. If the sum of the advanoe and audit
premiums paid for the policy period is greater
than the earned premium, we will return the
excess to the first Named Insured.
c. The first Named Insured must keep records of
the information we need for premium
computation, and send us copies at such times
as we may request
6. Representations
By accepting this policy, you agree:
a. The statements in the Declarations are
accurate and complete;
UOCUSJgn Envelope ID:4fc1h43B^U1B2-45D/-81OD-UEUG49/3A70A b. Those statements are based upon
representations you made to us; and
c. We have issued this policy in reliance upon
your representations.
7. Separation Of Insureds
Except with respect to the Limits of Insurance, and
any rights or duties specifically assigned in this
Coverage Part to the first Named Insured, this
insurance applies:
a. As if each Named Insured were the only
Named Insured; and
b. Separately to each insured against whom claim
is made or "suit"is brought
8. Transfer Of Rights Of Recovery Against Others
To Us
If the insured has rights to recover all or part of
any payment we have made under this Coverage
Part, those rights are transferred to us. The
insured must do nothing after loss to impair them.
At our request, the insured will bring "suit" or
transfer those rights to us and help us enforce
them.
9. When We Do Not Renew
Ifwe decide not to renew this Coverage Part, we
will mail or deliver to the first Named Insured
shown in the Declarations written notice of the
nonrenewal not less than 30 days before the
expiration date.
If notice is mailed, proof of mailing will be sufficient proof of notice.
SECTION V - DEFINITIONS
1. "Advertisement" means a notice that is broadcast
or published to the general public or specific
market segments about your goods, products or
services for the purpose of attracting customers or
supporters. For the purposes of this definition:
a. Notices that are published indude material
placed on the Internet or on similar electronic
means of communication; and
b. Regarding web sites, only that part of a web
site that is about your goods, products or
services for the purposes of attracting
customers or supporters is considered an
advertisement
2. "Auto" means:
a. A land motor vehicle, trailer or semitrailer
designed for travel on public roads, including
any attached machinery or equipment or
b. Any other land vehicle that is subject to a
compulsory or financial responsibility law or
other motor vehicle insurance law where it is
licensed or principally garaged.
However, "auto" does not include "mobile
equipmenf.
3. "Bodily injury" means bodily injury, sickness or
disease sustained by a person, induding death
resulting from any of these at any time.
4. "Coverage territory" means:
a. The United States of America (including its
territories and possessions), Puerto Rico and
Canada;
b. Internationalwaters or airspace, but only if the
injury or damage occurs in the course of travel
or transportation between any places included
in Paragraph a. above; or
c. All other parts of the world if the injury or
damage arises out of:
(1) Goods or products made or sold by you in
the territory described in Paragraph a.
above;
(2) The activities of a person whose home is in
the territory described in Paragraph a.
above, but is away for a short time on your
business; or
(3) "Personal and advertising injury" offenses
that take place through the Internet or
similar electronic means of communication;
provided the insured's responsibility to pay
damages is determined in a "suif on the merits, in
the territory described in Paragraph a. above or in
a settlement we agree to.
5. "Employee" includes a "leased worker".
"Employee" does not include a "temporary
worker".
6. "Executive officer" means a person holding any of
the officer positions created by your charter,
constitution, bylaws or any other similar governing
document
7. "Hostile fire" means one which becomes
uncontrollable or breaks out from where it was
intended to be.
8. "Impaired property" means tangible property, other
than "your producf or "your work", that cannot be
used or is less useful because:
a. It incorporates "your producf or "your work"
that is known or thought to be defective,
deficient, inadequate or dangerous; or
b. You have failed to fulfill the terms of a contract
or agreement;
if such property can be restored to use by the
repair, replacement adjustment or removal of
"your producf or "your work" or your fulfillingthe
terms of the contract or agreement.
CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 13 of 16 UOCUSign Envelope ID:4E1h43B»-U1B2-4bU/-810D'UEUU49r3A70A
9. "Insured contracf means:
a. A contract for a lease of premises. However,
that portion of the contract for a lease of
premises that indemnifies any person or
organization for damage by fire to premises
while rented to you or temporarily occupied by
you with permission of the owner is not an
"insured contracf;
b. A sidetrack agreement;
c. Any easement or license agreement, except in
connection with construction or demolition
operations on or within 50 feet of a railroad;
d. An obligation, as required by ordinance, to
indemnify a municipality, except in connection
with work for a munidpality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement
pertaining to your business (induding an
indemnification of a municipality in connection
with work performed for a municipality) under
which you assume the tort liability of another
party to pay for "bodily injury" or "property
damage" to a third person or organization. Tort
liabilitymeans a liabilitythat would be imposed
by law in the absence of any contract or
agreement.
Paragraph f. does not include that part of any
contract or agreement:
(1) That indemnifies a railroadfor "bodilyinjury"
or "property damage" arising out of
construction or demolition operations, within
50 feet of any railroad property and
affecting any railroad bridge or trestle,
tracks, road-beds, tunnel, underpass or
crossing;
(2) That indemnifies an architect, engineer or
surveyor for injury ordamage arising out of:
(a) Preparing, approving, or failing to
prepare or approve, maps, shop
drawings, opinions, reports, surveys,
field orders, change orders or drawings
and specifications; or
(b) Giving directions or instructions, or
failing to give them, if that is the primary
cause of the injury or damage; or
(3) Under which the insured, if an architect,
engineer or surveyor, assumes liability for
an injury or damage arising out of the
insured's rendering or failure to render
professional services, including those listed
in (2) above and supervisory, inspection,
architectural orengineering activities.
10»"Leased worker" means a person leased to you by
a labor leasing firm under an agreement between
you and the labor leasing firm, to perform duties
related to the conduct of your business. "Leased
worker*does not include a "temporary worker".
11."Loading or unloading" means the handling of
property:
a. After it is moved from the place where it is
accepted for movement into or onto an aircraft,
watercraft or "auto";
b. While it is in or on an aircraft, watercraft or
"auto"; or
c. While it is being moved from an aircraft,
watercraft or "auto" to the place where it is
finally delivered;
but "loading or unloading" does not indude the
movement of property by means of a mechanical
device, other than a hand truck, that is not
attached to the aircraft, watercraft or "auto".
12,"Mobile equipment" means any of the following
types of land vehicles, including any attached
machinery or equipment:
a. Bulldozers, farm machinery, forklifts and other
vehicles designed for use principallyoff public
roads;
b. Vehicles maintained for use solely on or next to
premises you own or rent;
c. Vehicles that travel on crawler treads;
d. Vehicles, whether self-propelled or not,
maintained primarily to provide mobility to
permanently mounted:
(1) Power cranes, shovels, loaders, diggers or
drills; or
(2) Road construction or resurfacing equipment
such as graders, scrapers or rollers;
e. Vehicles not described in Paragraph a., b., c.
or d. above that are not self-propelled and are
maintained primarily to provide mobility to
permanently attached equipment of tiie
following types:
(1) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment; or
(2) Cherry pickers and similar devices used to
raise or lower workers;
f. Vehicles not described in Paragraph a.f b., c.
or d. above maintained primarily for purposes
other than the transportation of persons or
cargo.
UOCUiagn Envelope ID:4E1h43B^U1BM5D7-8iaD^DE0U4973A7UA
However, self-propelled vehicles with the
following types of permanently attached
equipment are not "mobile equipment" but will
be considered "autos":
(1) Equipment designed primarilyfor:
(a) Snow removal;
(b) Road maintenance, but not construction
or resurfacing; or
(c) Street cleaning;
(2) Cherry pickers and similar devices mounted
on automobile or truck chassis and used to
raise or lower workers; and
(3) Air compressors, pumps and generators,
including spraying, welding, building
cleaning, geophysical exploration, lighting
and well servicing equipment.
However, "mobile equipmenf does not include
any land vehldes that are subject to a compulsory
or financial responsibility law or other motor
vehicle insurance law where it is licensed or
principally garaged. Land vehicles subject to a
compulsory or financial responsibility law or other
motor vehide insurance law are considered
"autos".
13. "Occurrence" means an accident, including
continuous or repeated exposure to substantially
the same general harmful conditions.
14. "Personal and advertising injury" means injury,
induding consequential "bodily injury", arising out
of one or more of tiie following offenses:
a. False arrest, detention or imprisonment
b. Malicious prosecution;
c. The wrongful eviction from, wrongful entry into,
or invasion of the right of private occupancy of
a room, dwelling or premises that a person
occupies, committed by or on behalf of its
owner, landlord or lessor;
d. Oral or written publication, in any manner, of
material that slanders or libels a person or
organization or disparages a person's or
organization's goods, products or services;
e. Oral or written publication, in any manner, of
material that violates a person's right of
privacy;
f. The use of another's advertising idea in your
"advertisement"; or
g. Infringing upon another's copyright, trade dress
or slogan in your "advertisement".
15. "Pollutants" mean any solid, liquid, gaseous or
, thermal Irritant or contaminant, including smoke,
vapor, soot, fumes, acids, alkalis, chemicals and
waste. Waste includes materials to be recycled,
reconditioned or reclaimed.
16."Products-completed operations hazard":
a. Includes all "bodily injury" and "property
damage" occurring away from premises you
own or rent and arising out of "your producf or
"your work" except:
(1) Products that are still in your physical
possession; or
(2) Work that has not yet been completed or
abandoned. However, "your work" will be
deemed completed at the earliest of the
following times:
(a) When all of the work called for in your
contract has been completed.
(b) When all of the work to be done at the
job site has been completed if your
contract calls for work at more than one
job site.
(c) When that part of the work done at a job
site has been put to its intended use by
any person or organization other than
another contractor or subcontractor
working on the same project.
Work that may need service, maintenance,
correction, repair or replacement, but which
is otherwise complete, will be treated as
completed.
b* Dees not include "bodily injury" or "property
damage" arising out of:
(1) The transportation of property, unless the
injury or damage arises out of a condition in
or on a vehicle not owned or operated by
you, and that condition was created by the
"loadingor unloading"of that vehide by any
insured;
(2) The existence of tools, uninstalled
equipment or abandoned or unused
materials; or
(3) Products or operations for which the
classification, listed in the Declarations or in
a policy Schedule, states that products-
completed operations are subject to the
General Aggregate Limit.
17. "Property damage" means:
a. Physical injury to tangible property, including
all resulting loss of use of that property. All
such loss of use shall be deemed to occur at
the time of the physical injurythat caused it; or
b. Loss of use of tangible property that is not
physically injured. Allsuch loss of use shall be
deemed to occur at the time of the
"occurrence" that caused it.
For the purposes of this insurance, electronic data
is not tangible property.
CG 00 01 04 13 © Insurance Services Office, Inc., 2012 Page 15 of 16 UOCUSign EnvelopeID: 4E1h43B^U1BM&D7-810L%UEUW973A7aA
As used in this definition, electronic data means
information, facts or programs stored as or on,
created or used on, or transmitted to or from
computer software, induding systems and
applications software, hard or floppy disks, CD-
ROMs, tapes, drives, cells, data processing
devices or any other media which are used with
electronically controlled equipment
18."Suif means a civil proceeding in which damages
because of "bodily Injury", "property damage" or
"personal and advertising injury" to which this
insurance applies are alleged. "Surf includes:
a. An arbitration proceeding in which such
damages are claimed and to which the insured
must submit or does submit with our consent;
or
b. Any other alternative dispute resolution
proceeding in which such damages are
daimed and to which the insured submits with
our consent.
19. "Temporary worker" means a person who is
furnished to you to substitute for a permanent
"employee" on leave or to meet seasonal or short-
term workload conditions.
20. "Volunteer worker" means a person who is not
your "employee", and who donates his or her work
and acts at the direction of and within the scope of
duties determined by you, and is not paid a fee,
salary or other compensation by you or anyone
else for their work performed for you.
21. "Your producf:
a. Means:
(1) Any goods or products, other than real
property, manufactured, sold, handled,
distributed or disposed of by:
(a) You;
(b) Others tradingunder your name; or
(c) A person or organization whose
business or assets you have acquired;
and
(2) Containers (other than vehicles), materials,
parts or equipment furnished in connection
with such goods or products.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
producf;and
(2) The providing of or failure to provide
warnings or instructions.
c. Does not include vending machines or other
property rented to or located for the use of
others but not sold.
22. "Your work":
a. Means:
(1) Work or operations performed by you or on
your behalf; and
(2) Materials, parts or equipment furnished in
connection with such work or operations.
b. Includes:
(1) Warranties or representations made at any
time with respect to the fitness, quality,
durability, performance or use of "your
work"; and
(2) The providing of or failure to provide
warnings or instructions.
UOCUSign fcnvelop*}ID:4t1h43Ba-D1B2-45U/-81UU-UEOG4a/3A/0A POLICY: ZD2D78128002 COMMERCIAL GENERAL LIABILITY
CG 2417 10 01
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTUAL LIABILITY - RAILROADS
Thisendorsement modifiesinsuranceprovidedunder thefollowing:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Scheduled Railroad:
as required by written contract agreement or permit
Designated Job Site:
as required by written contract agreement or
permit
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement)
With respect to operations performed for, or affecting, a Scheduled Railroad at a Designated Job Site, the
definition of "insured contracf in the Definitions sec
tion is replaced by the following:
9. "Insured Contract" means:
a. A contract for a lease of premises. However,
that portion of the contract for a lease of prem
ises that indemnifies any person or organiza
tion for damage by fire to premises while rented
to you or temporarily occupied by you with
permission of the owner is not an "insured con
tracf;
b. A sidetrack agreement;
c. Any easement or license agreement;
d. An obligation, as required by ordinance, to
indemnify a munidpality, except in connection
with work for a municipality;
e. An elevator maintenance agreement;
f. That part of any other contract or agreement
pertaining to your business (including an in
demnification of a municipality in connection
with work performed for a municipality) under
which you assume the tort liability of another
party to pay for "bodily injury"or "property dam
age" to a third person or organization. Tort li
ability means a liability that would be imposed
by law in the absence of any contract or
agreement.
Paragraph f. does not include that part of any
contract or agreement:
(1) That indemnifies an architect engineer or
surveyor for injuryor damage arising out of:
(a) Preparing, approving or failing to pre
pare or approve maps, shop drawings,
opinions, reports, surveys, field orders,
change orders or drawings and specifi
cations; or
(b) Giving directions or instructions, or fail
ing to give them, if that is the primary
cause of the injury or damage;
(2) Under which the insured, if an architect,
engineer or surveyor, assumes liability for
an injury or damage arising out of the in
sured's rendering or failure to render pro
fessional services, including those listed in
Paragraph (1) above and supervisory, in
spection, architectural or engineering activi
ties.
CG 24 17 10 01 © ISO Properties, Inc., 2000 Page 1 of 1 DOCUSgntnVOlOp©IU:4fc1h43H»-U1B2-45U7-B10l>UfcOW9r3A7UA POLICY: DPR9970040
PROFESSIONAL, ENVIRONMENTAL AND NETWORK SECURITY LIABILITY
POLICY -
ARCHITECTS, CONSULTANTS AND ENGINEERS
THIS IS A "CLAIMS-MADE AND REPORTED" POLICY. THIS POLICY REQUIRES THAT A CLAIM BE
MADE AGAINST THE INSURED DURING A POLICY YEAR AND REPORTED TO THE COMPANY, IN WRITING, DURING THAT POUCY YEAR OR AUTOMATIC EXTENDED REPORTING PERIOD.
CERTAIN STATES MANDATE SPECIFIC WARNINGS, EXCEPTIONS OR CONDITIONS MODIFYING THE TERMS AND CONDITIONS OF THIS POLICY. PLEASE READ THIS POLICY CAREFULLY, INCLUDING THE DECLARATIONS AND ALL ENDORSEMENTS.
THIS POLICY CONTAINS PROVISIONS THAT UMIT THE AMOUNT OF CLAIM EXPENSES THE COMPANY IS RESPONSIBLE TO PAY IN CONNECTION WITH CLAIMS. CLAIM EXPENSES SHALL BE SUBJECT TO ANY APPLICABLE DEDUCTIBLE AMOUNT. THE PAYMENT OF CLAIM EXPENSES WILL REDUCE THE LIMITS OF LIABILITY STATED IN ITEM 3. OF THE DECLARATIONS.
In consideration of the payment of the Policy Premium stated in Item 5. of the Declarations, and in reliance upon the statements contained in the Application and any other supplemental materials and information submitted to the Company with respect to this Policy, and subject to all the terms and conditions of this Policy, the Company agrees with the NAMED INSURED as follows:
I. INSURING AGREEMENTS
A. Professional Liability
The Company agrees to pay on behalf of the INSURED all sums in excess of the Deductible, subject to the Policy Limits of Liability,that the INSURED becomes legally obligated to pay as DAMAGES and/or CLAIM EXPENSES as a result of any CLAIM(S) first made against the INSURED during a POLICY YEAR and first reported to the Company, in writing, during that POLICYYEAR orwithinsixty (60)days afterthe end ofthat POLICYYEAR, providedthat:
1. The CLAIM(S)arises out of a WRONGFULACT;
2. Such WRONGFULACT was committedor alleged to have been committedon or after the applicable Retroactive Date(s)stated in Item 6. of the Declarations;and
3. Prior to the ANNIVERSARY DATE stated in Kern 7. of the Declarations, none of the INSURED'Sdirectors,officers, principals,partners or onsurancemanagers knew or should have knownthat suchWRONGFULACT mightgiverise to a CLAIM(S).
B. Contractors Pollution Legal Liability
The Companyagrees to pay on behalf of the INSURED all sums in excess of the Deductible, subjectto the Policy Limits of Liability,that the INSURED becomeslegallyobligatedto pay as DAMAGES and/or CLAIM EXPENSES as a result of any CLAIM(S) first made against the INSURED during a POLICY YEAR and first reported to the Company, in writing, during that POLICYYEAR orwithinsixty(60)days afterthe endofthatPOLICYYEAR, providedthat
1. The CLAIM(S) is for POLLUTION CONDITIONS arising out of the performance of CONTRACTINGSERVICESrendered by or on behalf of theINSURED;
2. The CONTRACTING SERVICES out of which the POLLUTION CONDITIONS arise were performed on or after to the applicable Retroactive Date(s) stated in Item 6. of the Declarations; and
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© 2016 X.L. America, Inc. All Rights Reserved.
May not be copied without permission.
UOCU^gn hnv©lop© IU:4fclh43B%MJlB2!-45U/-81Ol>UfeOU49/3A/0A
2. The specificnatureand extentofthe injuryor damage that has beensustained;and
3. How the INSUREDfirst becameawareofsuch CIRCUMSTANCE(S), then any CLAIM(S) that may subsequentlybe made againstthe INSURED arising out of such reported CIRCUMSTANCE(S)shall be deemed to have been made on the date first written notice of the CIRCUMSTANCE(S)was received by tiie Company. This right conferred upon the INSURED in this Paragraph shall terminate at the end of the POLICYPERIOD and shall not exist duringthe AutomaticExtendedReportingPeriodor OptionalExtendedReportingPeriod.
XI. OTHER CONDITIONS
A. Cancellation
This Policy may be canceled by the NAMED INSURED by surrender thereof to the Company or any of its authorized agents or by mailing to the Company written notice stating when thereafter the cancellation shall be effective. This Policy may be canceled by the Company by mailing to the NAMED INSURED, at the address stated in Item 1. of the Declarations, written notice stating when, not less than thirty (30) days ttiereafter (or ten (10) days thereafter for non-payment of premium), such cancellation shall be effective. The mailing of notice as aforesaid shall be suffident proof of notice. The time of surrender or he effective date and hour of cancellation stated in the notice shall become the end of the POLICY PERIOD. Delivery of such written notice either by the NAMED INSURED or by the Company shall be equivalent to mailing.
If this Policy is canceled, earned premium shall be computed in accordance with the Company's guidelines with respect to cancellation. Premium adjustment may be made either at the time cancellation is effected or as soon as practicable after cancellation becomes effective, but payment or tender of unearned premium is not a condition of cancellation.
EL Action Against The Company
No action may be brought against the Company unless, as a condition precedent thereto, there shall have been full compliance with all of the terms of this Policy, nor until the amount of the INSUREDS obligationto pay shall have been finally determined either by judgment against the INSURED in a contested proceeding after final judgment has been rendered and any appeal decided, or bywrittenagreement of the INSURED,the dafimantand the Company. No person or organization shall have any right under this Policy to join the Company as a party to any action against the INSURED to determine the INSURED'S liability, nor shall the INSURED or the INSURED'Slegal representative join the Company in such action. Bankruptcyor insolvencyof the INSURED or the INSURED'S estate shall not relieve the Company of any of its obligations hereunder.
C. Assignment
This Policymay not be assigned or transferred withoutwrittenconsent of the Company.
D. Subrogation
In the event of any payment under this Policy, the Company shall be subrogated to all the INSURED'Srights of recovery therefor against any person or organization,and the INSURED shall execute and deliver instruments and papers and do whatever else is necessary to secure such lights. The INSUREDshall do nothingafter a CLAIM(S)to prejudice such rights.
However,it is agreed that the Company waives its rights of subrogation under thisPolicyagainst clients of the INSUREDas respects any CLAiM(S)arising fromPROFESSIONALSERVICES,or CONTRACTINGSERVICES under the dienfs contract requiring waiver of subrogation, but only to the extent required by written contract.
LDD 050 1116 Page 15 of 16 12/12/2019 6:16:40 PM
© 2016 X.L. America, Inc. All Rights Reserved.
May not be copied without permission.
UOCUSign hnvelOpeID: 4fc1h43B»-U1BZ-45D/-810LM)tL0U4973A/0A Thisendorsement,effective12:01 a.m., 01 /01/21 formsa part of PolicyNo.DPR9970040
Issued to Kittelson & Associates, Inc.
bv XL Specialty Insuranoe Company,
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
POLICY CANCELLATION - NOTICE TO DESIGNATED ENTITIES
This endorsement modifies insurance provided under the following:
PROFESSIONAL. ENVIRONMENTAL AND NETWORK SECURITY LIABILITYPOLICY- ARCHITECTS,
CONSULTANTS AND ENGINEERS
Section XI. OTHER CONDITIONS, Paragraph A. Cancellation is amended by the addition of the following:
In the event that the Company cancels this Policy for any statutorily permitted reason other than non payment of premium, the Company agrees to provide thirty (30) days' notice of cancellation of this Policy to any entity with whom the NAMED INSURED agreed in a written contract or agreement would be provided with notice of cancellation of this Policy, provided that:
1. The Company reoeives, at least fifteen (15) days prior to the date of cancellation, a written request from the NAMED INSUREDto provide notice of cancellation to entities designated by the NAMED INSURED to receive such notice and;
2. The written request includes the name and address of each person or entity designated by the NAMED INSURED to receive such notice.
This endorsementdoes not applyto non-renewalofthe Policy,cancellationat the INSURED'Srequest, or to cancellationof the Policy for non-payment of premium to the Company or to a premium finance company authorized to cancel the Policy. Furthermore, nothing contained in this endorsement shall be construed toprovideany rightsunder the Policyto the entitiesreceivingnoticeof cancellationpursuant to tiiis endorsement nor shall this endorsement amend or alter the effective date of cancellation stated in the cancellation notice issued to the NAMED INSURED.
All othertermsand conditionsofthe Policyremainunchanged.
LDD4521116 Page1of1 12/12/20196:16:40 PM
© 2016 X.L, America, Inc. All Rights Reserved,
May not be copied without permission.
UGCUSJgn hnvelop© ID: 4fc1h43B!*.U1BZ-45D/-8iaD-Ufc0G49/3A/aA ,'ihc-
/fXHanover
Insurance Group..
SCHEDULE OF UNDERLYING POLICIES
Insured: KITTELSON & ASSOCIATES
Effective on and after 01/01/21 12:01 A.M. Standard Time This Schedule is part of Policy Number; UH2D78128102
CARRIER, POLICY NUMBER & PERIOD TYPE OF POLICY APPLICABLE LIMITS OR AMOUNT OF INSURANCE (a) Carrier: MASSACHUSETTS BAY
INSURANCE COMPANY
Commercial General Liability $1,000,000 Occurrence/ Each Claim Policy Number: ZD2D78128002 Owned Autos $1,000,000 Personal Injury Policy Period: 01/01/2021-01/01/2022 Non-owned&Hired Autos $1,000,000 Advertising Injury $2,00Ot000
Incl in Gen Agg
General Aggregate
Product/Completed Operations
Aggregate
(a) Carrier: HANOVER INSURANCE CO.
FOREIGN
Commercial General Liability $2,000,000 Occurrence/ Each Claim Policy Number: RH2H39955700 OwnedAutos $2,000,000 Personal Injury Policy Period: 01/01/2021-01/01/2022 Non-owned&Hired Autos $2,000,000 Advertising Injury $4,000,000
$4,000,000
General Aggregate
Product/Completed Operations
Aggregate
(b) Carrier:ALLMERICAFINANCIALBENEFITS
INS.CO.
Policy Number: AW2D78128703
Comprehensive Automobile
Liability including
El Owned Autos
BodilyInjuryand PropertyDamage LiabilityCombined:
$1,000,000 Each Acddent
Policy Period: 01/01/2021-01/01/2022 0 Non-Owned&Hired Autos Bodily Injury $ Each Person
$ Each Acddent
Property Damage:
$ Each Acddent
(c) Carrier: Garage Liability BodilyInjury and PropertyDamage LiabilityCombined:
Policy Number:
Policy Period:
Dealers
Service Garage Operations
Each Acddent
$
$
Auto Only
Other than Auto Only
$ Aggregate
Garage Operations
$ Other than Auto Only
An UX" markedin thebox providedindicatesthesebroadeningoroptionalcoverageare providedin theUnderlyingInsurance 47541003 12 14 Page 4
Includescopyrightedmaterialof Insurance ServicesOffice, Inc. with its permission Aaent
U0CUS4gnEnvelopeID:4tlF-43B»-U1BZ-45D/-81UD-UtOU49riA/0A J\;Hanover
Insurance Group-
(d) Carrier:ALLMERICAFINANCIALBENEFITS
INS. CO.
Policy Number:WM2D78128902
PolicyPeriod: Q1/01/2021-01/01/2022
Standard Workers* Compensation
& Employers* Liability
NEW YORK ONLY;
The Umbrella Coverage for
Workers' Compensation and
Employers Liabilityis not
applicable in situations where an
employee is subject to the New
York Workers* Compensation Law.
Coverage B - Employers Liability
Bodily Injury byAcddent
$1,000,000 Each Acddent
Bodily Injury by Disease
$1,000,000 Each Employee
$1,000,000 Aggregate
(e) Carrier
Policy Number.
Policy Period:
Liquor Liability $ Each Common Cause
$ Other
$ Aggregate
$ Other
(f) Carrier:
Policy Number
Policy Period:
Professional Liability $ Each Occurrence
$ Each Claim
$ Other
$ Aggregate
$ Other
(g) Carrier:
Policy Number
Policy Period:
Directors &Officers Liability $ Each Occurrence
$ Each Claim
$ Other
$ Aggregate
$ Other
(h) Carrier MASSACHUSETTS BAY INS. CO
Policy Number: ZD2D78128002
Policy Period: 01/01/2021-01/01/2022
Stop Gap Liability Bodily Injury by Accident
$ 1,000,000 Each Acddent
Bodily Injury by Disease
$ 1,000,000 Each Employee
$ 1,000,000 Aggregate
(!) Carrier:
Policy Number:
Policy Period:
Abuse and Molestation $ Each Occurrence
$ Each Claim
$ Other
$ Aggregate
0) Carrier:
Policy Number
Policy Period:
Foreign $ Each Occurrence
$ Each Claim
$ Other
$ Aggregate
(k) Carrier MASSACHUSETTSBAY
INSURANCE COMPANY
Policy Number ZD2D78128002
Policy Period: 01/01/2021-01/01/2022
Employee Benefits Liability $ Each Occurence
$1,000,000 Each Claim
$ Other
$2,000,000 Aggregate
47541003 1214 Page 5
Includes copyrightedmaterialof Insurance Services Office, Inc. with its permission Aaent
UOCUSign hnvelOpe ID:4fc1h43B^D1B2-45U/-810l>IJfcUU4g73A/UA POLICY: UH2D78128102
HANOVER COMMERCIAL FOLLOW FORM EXCESS AND
UMBRELLA POLICY
Variousprovisionsofthis policyrestrictcoverage.Readtheentirepolicycarefullytodeterminerights, dutiesand what is and is not covered.
We will not paysums or perform acts or servicesunless explicitlyprovidedfor in this policy.
Throughoutthis policy the words you and your referto the Named Insuredshown in the Declarationsand any other personororganizationqualifyingas a Named Insuredunderthis policy."The words we, us and our referto the Company providing this insurance.
Other words andphrases that appear inquotation marks have special meaning. Refer to the DefinitionsSection of this policy.
I. INSURING AGREEMENTS
1* Cove rage A-Follow Form Excess Liability
Insuring Agreement
a. We will pay on behalf of the insured those
sums in excess of the "underlying
insurance* which the insured becomes
legally obligated to pay as damages,
provided:
(1) Such damages are covered by
"underlying insurance*;
(2) The event which triggers coverage on
the "underlying insurance" takes place
during the policy period of this
insurance, and
(3) The applicable Limit of Insurance of
the "underlying insurance0 is
exhausted by payment of judgments,
settlements, related costs or expenses
for damages also covered under this
policy. We will not pay ifthe Limit of
Insurance of "underlying insurance" is
exhausted by payment fordamages to
which this insurance does not also
apply.
b* We will not pay damages that the
"underlying insurance* does not pay for
any reason other than exhaustion of limits
of the "underlying insurance" by payment
of judgments, settlements, related oosteor
expenses.
c. The terms and conditions of the
"underlying insurance1* in effect at the
inception of this policy apply unless they
are inconsistent with the terms and
conditions of this policy.
d. The amount we will pay for damages is
limited as described in section VI. LIMITS
OF INSURANCE.
e. We have no obligation under this
insurance with respect to any claim or
"suit" settled without our consent.
i This policy does not apply to any part of
loss within the Limit of Insurance of
"underlying insurance", or any related
costs or expenses.
g. No other obligation or liabilityto pay sums
or perform acts or services is covered
unless explicitlyprovidedfor under section
II. DEFENSE AND SETTLEMENT and
section V. SUPPLEMENTAL
PAYMENTS.
2. Coverage B - Umbrella Liability Insuring
Agreement
a. We will pay on behalf of the insured those
sums in excess of the "retained limit"
shown in the Declarations which the
insured becomes legally obligated to pay
as damages because of "bodily injury",
"property damage", "personal injury" and
"advertising injury" to which this coverage
applies, provided:
(1) The:
(a) "Bodily injury" or "property
damage" is caused by an
"occurrence"; or
(b) "Personal injury"and "advertising
injury" is caused by an offense
arising out of your business;
Which took place within the coverage
territory as described in section IV.
COVERAGE TERRITORY;
(2) The "bodily injury*1 or "property
damage" occurs during the policy
period, and the offense causing
"personal injury"or "advertisinginjury"
is first committed during our policy
period; and
475-0001 01 18 induces copyrightedmaterialof IrvaicariceServicesOfficeJnc, with its peimi^ion.
Copyright2017 The Hanover Insurance Group, Inc.Ail Rights Reserved.
UQCUSign hnvelOpe ID:4fc1F-43B^U1B2-45D7-810l>Ut0L>»9/3A7UA
NOTICE OF CANCELLATION TO DESIGNATED ENTITY(S)
(Including Nonpayment of Premium)
This endorsement modifies insurance provided under the following:
WORKERS* COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY
SCHEDULE
Name of Designated Entity Mailing Address or Email Address Number Days Notice ANY PERSON OR THE ADDRESS FOR THAT 30
ORGANIZATION TO WHOM PERSON OR ORGANIZATION
(SEE FORM 331-0230 INCLUDED IN SUCH WRITTEN
FOR COMPLETE NAME) REQUEST FROM YOU TO US
'
Informationrequired to complete this Schedule, if not shown above, willbe shown in the Declarations.
If we cancel this policy for any reason, including nonpayment of premium, we will give written notice of such can cellation to the Designated Entrty(s) shown in the Schedule. Such notice may be delivered or sent by any means of our choosing. The notice to the Designated Entity(s)will state the effective date of cancellation.
Unless otherwise noted in the Schedule above, such notice will be provided to the Designated Entity(s)no more than the number of days in advance of the effective date of cancellation that we are required to provide to the Named Insured for such cancellation. If the reason for cancellation is nonpayment of premium, however, we will provide ten days notice.
Such notice of cancellationis solelyfor the purpose of informingthe Designated Entity(s)of the effectivedate of cancellation and does not grant, alter, or extend any rights or obligations under thispolicy.
ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED.
This endorsement changes the policyto which it is attached and is effective on the date issued unless otherwise stated.
(The information below Is required only when this endorsement Is Issued subsequent to preparationof the policy.)
Endorsement Effective 01/01/2021 Policy No, WM2D78128902 Insured ^jtte|son£ Associates Inc lnsuranceCompany AllmericaFinancialBenefitInsuranceCompany 33143410911
Countersigned
By
Includes copyrighted materials from ISO, Inc. 2003
UQCUSign hrwelope ID: 4t1h43H»-U1BZ-45Uif-810lJ-Ut0t^9/3A/aA
MANUSCRIPT FORM
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
IT IS AGREED THAT THE COMPLETE NAME FOR THE NOTICE OF CANCELLATION TO THE DESIGNATED ENTITY(S) FORM 331-0341(09/11) IS AS FOLLOWS:
DESIGNATED ENTITY:
ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN
CONTRACT THAT NOTICE OF CANCELLATION OR NON-RENEWAL OF THIS POLICY WILL BE GIVEN, BUY ONLY IF:
1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING
THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE
FIRST INSURED RECEIVES FROM US OF CANCELLATION OR NON-RENEWAL OF THIS POLICY; AND
2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE.
UOCUSign envelope ID:4t1P43B^D1B2-45D/*810LMJfcOCJ4973A70A Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, agreements or limitation of the policy other than as above states.
(Completionof the following,includingcountersignature,is requiredto make this endorsement effectiveonlywhen it is issued subsequent to preparation of the Policy.)
Effective 01/01/2021 thisendorsementforms a partof PoBcyNo. WM2D78128902 issued to Kittelson & Associates Inc
By Allmerica Financial Benefit Insurance Company
Date of Issue Countersigned by
Authorized Representative of the Company
331-02301003 Page 1 of1
UOCU^gn hnveiop© ID: 4fc1h43B^U1BM5D7«8l0LMJfcUl^973A7UA WORKERS1 COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 00 03 13
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement changes the policyto which it is attached effective on the inception date of the policy unless a different date is indicated below.
(Thefollowing"attachingdense" need be completedonlywhen thisendorsement is Issued subsequent topreparationof the policy.) This endorsement, effective on 01/01/2021 standard time, forms a part of r> ,- Kt lAMion-ro-oonAo xu. Allmerica Financial Benefit Insurance CompanyPolicy No. WM2D78128902 of the (NAME OF INSURANCE COMPANY)
issuedto Kittelson&Associates,Inc. f\ f\&
Authorized Representative
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 anyone not named in the Schedule.
Schedule
AK,AZ,DClFLJD,IL/MD/MA/MO#NY,NC,OR,PA,VA
THIS ENDORSEMENT APPLIES AS A BLANKET WAIVER
OF SUBROGATION FOR THOSE PARTIES HAVING A WRITTEN
CONTRACT WITH THE POLICYHOLDER REQUIRING A WAIVER
OF SUBROGATION FOR WORKERS COMPENSATION COVERAGE OF THE POLICYHOLDERS EMPLOYEES.
WC00 03 13 Copyright 1983 National Councilon Compensation Insurance Page 1 of 1 DOCUSignEnvelope ID:4£lF-43B|M31B2-45IJ7-81UD-DfcOG4973A70A
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA We havethe rightto recoverourpaymentsfrom anyoneliablefor an injurycoveredbythis policy.We will notenforceourright against»ie personororganizationnamedinthe Schedule.(This agreementappliesonlyto the extentthat you performwork under a written contract that requires you to obtain this agreement from us.) You must maintainpayrollrecordsaccuratelysegregatingthe remunerationof youremployees whiteengaged inthe work described in the Schedule.
The additionalpremiumfor thisendorsementshall be 2%of the Californiaworkers'compensationpremiumotherwisedue on such remuneration.
Schedule
Person or Organization Job Description
APPLIES AS BLANKET WAIVER
FOR THOSE HAVING A WRITTEN
CONTRACT WITH THE POLICY
HOLDER REQUIRING WOS FOR
WC POLICYHOLDER EMPLOYEES.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The Information below is required only when tils endorsement is Issued subsequent to preparation of the policy.) EndorsementEffective 01/01/2021 PolicyNo, WM2D78128902
insured KITTELSON & ASSOCIATES, insuranceCompany ALLMERICA FINANCIAL ASSOCIATES. iNC.
INC.
Countersigned By
WC 04 03 06 (Ed 04-84)
UOCUSign tnvelOp© IU: 4t1r-43H»-U1fcl^-45U/r-81UD-Ut0CJ49/3A/UA
WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 00 01 06 A (Ed. 4-92)
LONGSHORE AND HARBOR WORKERS' COMPENSATION ACT
COVERAGE ENDORSEMENT
This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below.
(The following"attachingclause**need be completed only when this endorsement is issued subsequent to preparationof the policy.) This endorsement, effective on 01701/2021 at 12:01 A.M. standard time, forms a part of Pate)
PolicyNo. WM2D78128902 0f the AllmericaFinancialBenefitsInsuranceCompany (NAME OF INSURANCE COMPANY)
issued to Kittelson & Associates, Inc.
Authorized Representative
This endorsement applies only to work subject to the Longshore and Harbor Workers" Compensation Act in a state shown in the Schedule. The policy applies to that work as though that state were listed in Item 3.A. of the Information Page.
General Section C. Workers' Compensation Law is replaced by the following:
C. Workers9 Compensation Law
Workers' Compensation Law means the workers' or workmen's compensation law and occupational disease law of each state or territory named in Item 3.A. of the Information Page and the Longshore and Harbor Workers' Compensation Act (33 USC Sections 901-950). It includes any amendments to those laws that are in effect during the policy period. It does not include any other federal worker's or workmen's compensation law, other federal occupational disease law or the provisions of any law that provide nonoccupational disability benefits.
Part Two (Employers' LiabilityInsurance), C. Exclusions., exclusion 8„ does not apply to work subject to the Longshore and Harbor Workers' Compensation Act.
This endorsement does not apply to work subject to the Defense Base Act, the Outer Continental Shelf Lands Act, or the Nonappropriated Fund Instrumentalities Act.
Schedule
Longshore and Harbor Workers'
State Compensation Act Coverage Percentage
NY 78.8%
VA 73.0%
The rates for classifications with code numbers not followed bythe letter "F are rates for work not ordinarilysubject to the Longshore and Harbor Workers' Compensation Act. Ifthis policy covers work under such classifications, and ifthe work is subject to the Longshore and Harbor Workers' Compensation Act, those non-F classification rates will be Increased by the Longshore and Harbor Workers' Compensation Act Coverage Percentage shown in the Schedule.
WC 419 (4-92)
WC 00 01 06 A (Ed. 4-92) Copyright 1983, 1991 NationalCouncilon Compensation Insurance. Page 1 of 1 UOCUSignhnvelOpe ID:4fc1f-43B^U1B2-45D7-810L>UfcOU4973A70A
TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3A. of the Information Page,
We have the rightto recover our payments from anyone liable for an injurycovered by this policy.We will not enforce our rightagainst the person or organizationnamed in the Schedule, but this waiver applies onlywith respect to bodily injuryarisingout of theoperationsdescribedinthe Schedulewhere you are requiredbya writtencontractto obtain this waiver from us.
This endorsement shall not operate directly or indirectlyto benefit anyone not named in the Schedule.
The premium for this endorsement is shown in the Schedule.
Schedule
1. SpecificWaiver
Name of person or organization
S Blanket Waiver
Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
2. Operations: ALLTEXAS OPERATIONS
3. Premium:
The premium charge for this endorsement shall be 2 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Advance Premium:
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) EndorsementEffective 01/01/2021 PolicyNo WM2D78128902
insured Kittelson&AssociatesInc. p^ f\D
AllmericaFinancialBenefitInsuranceCompany ^Jm^.iJ^^^
Insurance Company Countersigned by _J
WC 42 03 04 B (Ed. 6-14)© Copyright2014 NationalCouncilon Compensationinsurance, Inc. All RightsReserved. uocuiiign bnveiope o. 4hir-4atia-uiB^-45U/-Hiuu-ubuC4y/JA/-UA doo/erify
Corporate Resolution of Signing Authority 9.23.20.pdf
DocVerify ID:
ited:
Pages:
Remote Noti
D3EB7D19-38D6-4C48-A58F-8A78F399E3B5
September 25, 2020 17:07:51 -5:00
2 Yes / State: VA
thedocum I iryoi
and ins this di
merit.
E-Signature Summary
E-Signature 1: Brandon L. Nevers (BLN)
September 28. 2020 09:34:28 -5:00 [B0BE89E0AC52] [108.56.160.217] [email protected] (Principal) (Personally Known)
E-Signature Notary: Bonnie Leo Clark (BLC)
September 28, 2020 09.34:28 -500 [4C88464BEB45] [72.83.103.43] bclark@kittel5&n. com
I, Bonnie Lee Clark, did witness the participants named above electronically sign this document.
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mcVarthi id r^FRTr.''i-3snR-tc.tR-A.!;HC-.A7SF.iniF3as 111 tM-cfrfaz-tftf-l DOCUSignEnvelope ID:4fc1h43BSMJ1B2^5U7-810L>UfcOt^g73A7UA
CORPORATE RESOLUTION OF SIGNING AUTHORITY
KITTELSON & ASSOCIATES, INC.
The undersigned, being the ChiefExecutiveOfficerof Kittelson&Associates, Inc., an Oregon corporation (the "Company"),does hereby certify that at a meeting of the Board of Directorsof the Companyduly called and held on September 23,2020 at which a quorum was present and acted throughout, the Board of Directorsadopted the followingresolution, which has not been modified or rescinded:
WHEREAS,pursuant to Article2.1 of the Company's Amended and Restated Bylaws,adopted by the Board of Directors on June 13, 2017, all corporate powers shall be exercised by or under the authority of, and the business and affairs of the Company shall be managed under the direction of, the Company's Board of Directors.
RESOLVED, that the following officers of the Company are hereby authorized to sign any and all documents as may be necessary to represent the business interests of the Company:
Brandon L Nevers, President, Chief Executive Officer, Director Karl A, Passetti, Vice President, Chairman of the Board Lawrence A. Van Dyke, VicePresident, Chief Financial Officer Marc A* Butorac, Vice President, Secretary, Director
David L. Mills, Vice President
Edward J. Myers, Vice President
RESOLVED, that in addition to the aforementioned officers, the following individuals are hereby authorized to execute business solicitations, client contract documentation, and consultant contract documentation on behalf of the Company:
Michael N. Aronson James M* Hughart Bastian J* Schroeder Justin A. Bansen Wayne K. Kittelson Conor M. Semler
Chris. L Brehmer Julia A. Kuhn Jason A. Simmers
Scott G. Beaird Felipe Ladron de Guevara Damian Stefanakis Adam M. Burghdoff Kevin S. Lee Hermanus J. Steyn
Ryan J. Cunningham Laurence B. Lewis Christopher B. Tiesler Andrew J. Daleiden Jane Lim-Yap Mark A. Vandehey
Sonia A. Daleiden, Director Eric D. Lindstrom John Paul Weesner Richard G. Dowling Bailey R. Lozner Wende L Wilber
Timothy A. Erney Dorret C Oosterhoff Susan L. Wright
Erin M. Ferguson Brian L. Ray Y. Vamshi Krishna
John R. Freeman, Jr. John R. Ringert Anthony S, Yi, Director Jessica A. Josselyn James M. Schoen
RESOLVED, that this Resolution supersedes all previous resolutions passed by the Board of Directors and/or previous consents of the Board of Directors relevant to signingauthority.
Dated this 28th _day of September 2020.
By: e
BrattdfttiL Nevm
l]*r4«fT«»<!*JFii**m-M^ D
Brandon L Nevers, Chief Executive Officer
[See Attached Notarial Certificate]
Jo*V*Hfw ID! D:iFB7r)ia-3Stl6-4C:,lB-ASRF-aA7flF3!WF3B£ III uocuSign bnveiope id. 4bii-4aBa-uiB^-4bU/r-aiou-ULUC4s/3AroA
NOTARIAL CERTIFICATE
State of
Virginia
County of
Fairfax
28th
Signed before me onSeptember'
Kittelson & Associates, Inc.
_, 2020 by Brandon L, Nevers, ChiefExecutiveOfficerof
;_-•.,..,.::,,. CWt
Notary Public - State of.
Virginia
Bonnie Lee Clark
Registration # 7844836
Electronic Notary Public
| Commonwealthof Virginia
i commission expires the 31 day of Jul 2023
Document Description
This certificate is attached to Kittelson & Associates, Inc's Corporate Resolution of Signing Authority, dated September 28 , 2020, consisting of one page.
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