SIXTH AMENDMENT TO THE
AGREEMENT FOR PROJECT SERVICES BETWEEN THE CITY OF REDONDO
BEACH AND CYPRESS SECURITY, LLC
THIS SIXTH AMENDMENT TO THE AGREEMENT FOR PROJECT SERVICES ("Sixth Amendment") is made between the City of Redondo Beach, a chartered municipal corporation ("City") and Universal Protection Service, LP, a California limited partnership ("Contractor").
WHEREAS, on November 15, 2011, the City and Cypress Security, LLC, a California limited liability company ("Cypress Security, LLC") are parties to that certain Agreement for Project Services between the City and Cypress Security, LLC (the "Agreement"); and
WHEREAS, on November 6, 2012, City and Cypress Security, LLC entered into the First Amendment to the Agreement ("First Amendment") to extend the Agreement to June 30, 2014, and increase the limit for the total amount paid to Cypress Security, LLC to $ 115,000; and
WHEREAS, on May 6, 2014, City and Cypress Security, LLC entered into the Second Amendment to the Agreement ("Second Amendment") to extend the Agreement to June 30, 2015, and increase the limit for the total amount paid to Cypress Security, LLC to 190, 000; and
WHEREAS, on May 19, 2015, City and Cypress Security, LLC entered into the Third Amendment to the Agreement ("Third Amendment") to amend the indemnification provision in the Agreement, extend the Agreement to December 31, 2016, and increase the limit for the total amount paid to Cypress Security, LLC to $ 265,000; and WHEREAS, on December 6, 2016, City and Cypress Security, LLC entered into the Fourth Amendment to the Agreement ("Fourth Amendment") to extend the Agreement to June 30, 2018, add a holiday/overtime hourly rate of $27. 69 effective January 1, 2017, increase the hourly rate and holiday/overtime hourly rate to $ 18. 91 and $ 28.36 effective July 1, 2017, and increase the limit for the Cypress Security, LLC's total compensation by $ 78,000 for a total not to exceed amount of $343,000; and WHEREAS, on December 28, 2017, Cypress Security, LLC converted from a California limited liability company to a limited partnership operating under the name Cypress Private Security, LP, a California Limited Partnership; and WHEREAS, on May 15, 2018, the City and Cypress Private Security, LP, a California Limited Partnership ("Cypress Private Security") entered into the Fifth Amendment to the Agreement ("Fifth Amendment") to extend the Agreement to December 31, 2019, increase the hourly rate to $20. 85 and overtime/holiday rate to $ 31. 27, and effective July 1, 2019, increase the hourly rate to $ 22.29 and the overtime/holiday rate to $ 33.43, 4 0. PE`0jjj000
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and provide a total limit on the Cypress Private Security's compensation in the amount of $424, 148. 50; and
WHEREAS, on June 18, 2019, City, Cypress Security, LLC, and Cypress Private Security entered into a Consent to Assignment to assign the Agreement to Contractor.
WHEREAS, the parties wish to amend the Agreement.
NOW THEREFORE, in consideration of the promises and mutual covenants contained herein, and intending to be legally bound, the parties hereby agree to make the following amendments to the Agreement:
1. TERM. Exhibits " B" through "B- 5" of the Agreement are hereby amended to add Exhibit "B- 6", which extends the Agreement to June 30, 2021. Exhibit "B- 6" is attached hereto and incorporated by reference. Contractor shall commence and complete all services described in Exhibit "A" in accordance with the schedule set forth in Exhibit "B- 6".
2. COMPENSATION. Exhibits " C" through " C- 5" of the Agreement are hereby amended to add Exhibit "C-6" effective January 1, 2020, to increase the hourly rate to $24.34 and overtime/holiday rate to $ 36. 51 to provide a total limit on the Contractor's compensation in the amount of $548,481. 50. Exhibit "C-6" is attached hereto and incorporated by reference. Contractor shall be compensated for the services described in Exhibit "A".
3. NO OTHER AMENDMENTS. Except as expressly stated herein, the Agreement shall remain unchanged and in full force and effect. The Agreement, First Amendment, Second Amendment, Third Amendment, Fourth Amendment, Fifth Amendment, and this Sixth Amendment constitute the entire agreement between the parties and supersede any previous oral or written agreement with respect to the subject matter hereof. In the event of any inconsistency between the terms of the Agreement, First Amendment, Second Amendment, Third Amendment, Fourth Amendment, Fifth Amendment, and this Sixth Amendment, the terms of this Sixth Amendment shall prevail.
2-
IN WITNESS WHEREOF, the parfies have executed. this Sixth Amendment in Redondo Beach, California; as of this 19th day of. November, 2019.
CITY OF REDONDO BEACH, UNIVERSAL PROTECTION SERVICE; LP, a chartered municipal corporation a California limited partnership By:
William C. Brand, Mayor: Name
Title: ss:.+: r
ATTEST: APPROVED:
IN WITNESS WHEREOF, the parties have executed this Sixth Amendment in Redondo Beach, California, as of this 19th day of November, 2019.
CITY OF REDONDO BEACH,
a chartered municipal corporation
William C. Brand, Mayor
ATTEST:
Eleanor Manzano, City Clerk
APPROVED AS TO FORM:
Michael W. Webb, City Attorney
UNIVERSAL PROTECTION SERVICE, LP,
a California limited partnership
By:
Name:
Title:
APPROVED:
JJill Buck olz, R sk Manager
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EXHIBIT " B- 6"
SCHEDULE FOR COMPLETION
TERM. The term of this Agreement shall be extended to June 30, 2021, unless otherwise terminated as herein provided.
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EXHIBIT " C- 6"
COMPENSATION
Provided Contractor is not in default under this Agreement, Contractor shall be compensated as provided below.
1. AMOUNT. Contractor shall be paid in accordance with the following schedule.
Effective Period Regular Hourly Rate Holiday/Overtime
Hourly Rate
January 1 2020 to June 30 2021 24. 34 36.51
2. NOT TO EXCEED AMOUNT. In no event shall Contractor's compensation exceed $ 548,481. 50 during the entire term of the Agreement.
3. METHOD OF PAYMENT. Contractor shall provide invoices to City for approval and payment detailing the hours worked, applicable hourly rate, and services performed during the prior month. Invoices must be itemized, adequately detailed, based on accurate records, and in a form reasonably satisfactory to City. Contractor may be required to provide back-up material upon request.
4. SCHEDULE FOR PAYMENT. Payments shall be made monthly, in arrears based upon the time spent during the previous month for which an invoice shall be submitted. City agrees to pay Contractor within thirty (30) days of receipt of the monthly invoice; provided, however, that services are completed to the City's full satisfaction.
5. NOTICE. Written notices to City and Contractor shall be given by registered or certified mail, postage prepaid and addressed to or personally served on the following parties.
Contractor: Universal Protection Service, LP
700 S. Flower St, Suite 400
Los Angeles, CA 90017
Attention: Felix Guerrero, Client Manager
Com: City of Redondo Beach
Community Services Department
415 Diamond Street
Redondo Beach, CA 90277
Attention: Joyce Rooney, Transit Manager
All notices, including notices of address changes, provided under this Agreement are deemed received on the third day after mailing if sent by registered or jt00ry0p
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certified mail. Changes in the respective address set forth above may be made from time to time by any party upon written notice to the other party.
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A`CORL® ATE
CERTIFICATE OF LIABILITY INSURANCE D10131(/ n
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
MARSH USA INC NAME:
FAX
1717 Arch Street MC.
NE
No, Ext): A/ C, No):
Philadelphia, PA 19103
ADDRESS: DDRESS: Attn: Philadelphia.certs@marsh. com/ Fax:( 212) 948- 0360
INSURER(S) AFFORDING COVERAGE NAIC//
CN118025105-AUS-GAWU- 19- 20 INSURER A: Lexington Insurance Company 19437
INSURED
INSURER B: Greenwich Insurance Company 22322
Allied Universal Topco, LLC
See Attached for Additional Named Insureds) INSURER C: XL Insurance America 24554 161 Washington Street, Suite 600
INSURER D: Indian Harbor Insurance Company 36940
Conshohocken, PA 19428
INSURER E: XL Specialty Insurance Company 37885
INSURER F:
COVERAGES CERTIFICATE NUMBER: CLE- 006453532-04 REVISION NUMBER: 0
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY- PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
ADDL SUER POLICY EFF POLICY EXP
LTR INSO WVD POLICY NUMBER MM/ DD/ YYYY) ( MM/ DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 082695264 11/ 01/ 2019 11/ 01/ 2020 EACH OCCURRENCE 10,000, 000
CLAIMS- MADE X OCCUR DAMAGE (
10, 000,000
E TORENTED
PREMISES( Ea occurrence) $
X CONTRACTUAL LIABILITY MED EXP( Any one person) $
X SIR$ 1, 750, 000 PERSONAL& ADV INJURY $ 10,000, 000
GE ' L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000, 000 X POLICY JEQ LOC PRODUCTS- COMP/ OP AGG $ 10, 000, 000
OTHER:
B AUTOMOBILE LIABILITY RAD9437818-03 11/ 01/ 2019 11/ 01/ 2020 COMBINED SINGLE LIMIT $ 5, 000, 000 Ea accident) X ANY AUTO BODILY INJURY( Per person) $
OWNED SCHEDULED
BODILY INJURYPer accident AUTOS ONLY AUTOS
HIRED NON- OWNED PROPERTY DAMAGE
AUTOS ONLY _ AUTOS ONLY Per accident)
DUMBRELLALIAB X OCCUR RES9437994 11/ 01/ 2019 11/ 01/ 2020 EACH OCCURRENCE 10,000, 000 X EXCESS LIAB CLAIMS-MADE EXCESS OF GENERAL LIABILITY AGGREGATE 10, 000, 000 DED RETENTION$
C WORKERS COMPENSATION RWD3001203- 03(AOS) 11/ 01/ 2019 11/ 01/ 2020 X PSER TATUTEoTHAND EMPLOYERS' LIABILITY ER E ANYPROPRIETOR/ PARTNER/ EXECUTIVE Y/ N RWR3001204-03(WI) 11/ 01/ 2019 11/ 01/ 2020 1, 000, 000 OFFICER/MEMBEREXCLUDED? N N/ A
E. L. EACH ACCIDENT $
Mandatory In NH) E. L. DISEASE- EA EMPLOYEE $ 1, 000, 000 If yes, describe under
DESCRIPTION OF OPERATIONS below 1, 000, 000 E. L. DISEASE- POLICY LIMIT '$ DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: As Per Contract or Agreement on File with Insured.
City of Redondo Beach is included as additional insured where required by written contract with respect to General Liability and Auto Liability. Liability coverage shall be primary and non-contributory where required by written contract. Waiver of subrogation is applicable where required by written contract with respect to General Liability, Auto Liability, and Workers Compensation.
CERTIFICATE HOLDER CANCELLATION
City of Redondo Beach
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 415 Diamond Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Redondo Beach, CA 90277 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Manashi Mukherjee 114.Avuvoia. • ..tc_.rvd. a-c,_
1988- 2016 ACORD CORPORATION. All rights reserved.
ACORD 25( 2016/ 03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN 118025105
LOC#: Philadelphia
ARL ADDITIONAL REMARKS SCHEDULE Page 2 of 3
AGENCY NAMED INSURED
MARSH USA INC Allied Universal Topco, LLC
See Attached for Additional Named Insureds)
POLICY NUMBER 161 Washington Street, Suite 600
Conshohocken, PA 19428
CARRIER NAIC CODE
EFFECTIVE DATE;
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance First Named Insured:
Allied Universal Topco, LLC
Additional Named Insureds:
AlliedBarton( NC) LLC
AlliedBarton( NC) LLC, dba Allied Universal Security Services AlliedBarton Security Services LLC
AlliedBarton Security Services LLC, dba Allied Universal Security Services AlliedBarton Security Services LP
AlliedBarton Security Services LP, dba Allied Universal Security Services Allied Security Holdings LLC
Allied Universal Holdco LLC
Andrews International Government Services, Inc.
Andrews International Government Services, Inc., dba Allied Universal Risk Advisory and Consulting Services Apollo Security International, Inc.
C& D Enterprises, Inc.
FJC Security Services, Inc.
FJC Security Services, Inc., dba Allied Universal Security Services Guardsmark( Puerto Rico), LLC
Guardsmark( Puerto Rico), LLC, dba Allied Universal Security Services, LLC Guardsmark( Puerto Rico), LLC, dba Universal Protection Service, LLC Intelligent Access Systems of North Carolina, LLC
Intelligent Access Systems of North Carolina, LLC, dba Allied Universal Technology Services Intelligent Access Systems of North Carolina, LLC, dba Securadyne Systems Mid-Atlantic Peoplemark, Inc.
Peoplemark, LLC
Securadyne Systems Intermediate LLC
Securadyne Systems Intermediate LLC, dba Allied Universal Technology Services Securadyne Systems Texas LLC
Securadyne Systems Texas LLC, dba Allied Universal Technology Services SFI Electronics, LLC
SFI Electronics, LLC, dba Allied Universal Technology Services SFI Electronics, LLC, dba Allied Universal Security Systems SFI Electronics, LLC, dba Universal Protection Security Systems Spectaguard Acquisition LLC
Staff Pro Inc.
Staff Pro Inc., dba Allied Universal Event Services
Surveillance Specialties, Ltd.
Surveillance Specialties, Ltd., dba Allied Universal Technology Services Surveillance Specialties, Ltd., dba Securadyne Systems Northeast Universal Building Maintenance, LLC
Universal Building Maintenance, LLC, dba Allied Universal Janitorial Services Universal Protection Security Systems, LP
Universal Protection Security Systems, LP, dba Allied Universal Technology Services Universal Protection Security Systems, LP, dba Allied Universal Security Systems Universal Protection Service of Canada Co.
Universal Protection Service of Canada Co., dba Allied Universal Security Services of Canada Co.
Universal Protection Service of Canada Corporation
ACORD 101 ( 2008/01) 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: CN 118025105
LOC#: Philadelphia
ACORO® ADDITIONAL REMARKS SCHEDULE Page 3 of 3
AGENCY NAMED INSURED
MARSH USA INC Allied Universal Topco, LLC
See Attached for Additional Named Insureds)
POLICY NUMBER 161 Washington Street, Suite 600
Conshohocken, PA 19428
CARRIER NAIC CODE
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, • FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Universal Protection Service of Canada Corporation., dba Allied Universal Security Services of Canada Universal Protection Service, LLC
Universal Protection Service, LLC, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LLC, dba Allied Universal Security Services Universal Protection Service, LLC, dba Allied Universal Security Services, LLC Universal Protection Service, LP
Universal Protection Service, LP, dba Allied Universal Risk Advisory and Consulting Services Universal Protection Service, LP, dba Allied Universal Security Services Universal Protection Service, LP, dba Allied Universal Security Services, LP Universal Protection Service of Seattle, LLC
Universal Protection Service of Seattle, LLC, dba Allied Universal Security Services Universal Services of America, LP
Universal Thrive Technologies, LLC
Universal Thrive Technologies, LLC, dba Allied Universal Technology Services Universal Thrive Technologies, LLC, dba Allied Universal Monitoring and Response Center Universal Thrive Technologies, LLC, dba Thrive Intelligence U. S. Security Associates, Inc.
U. S. Security Associates, Inc., dba Allied Universal Risk Advisory and Consulting Services U. S. Security Associates Aviation Services, Inc.
U. S. Security Associates Holding Corp.
U. S. Security Associates Holdings ll Corp.
U. S. Security Associates Holdings, Inc.
U. S. Security Associates Staffing, Inc.
U. S. Security Holdings, Inc.
Vance Executive Protection, In.
Vance International Consulting, Inc.
Cypress Private Security LP, Cypress Security LLC as an additional Insured as required by written contract.
ACORD 101 ( 2008/ 01) 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: RAD943781803 XIC 414 1013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE. FORM
AUTO DEALERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
Schedule
Additional Insured(s) Work
Any person or organization you have agreed to All Operations include as an additional insured underwritten contract, provided such contract was executed prior to the date of loss.
COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an " insured" the person or organization listed in the Schedule above, but only with respect to liability for "bodily injury" or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of:
1. You, while using a covered " auto"; or
2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered " auto" with your permission;
in the performance of your work as described in the Schedule above.
In no event shall any person or organization listed in the Schedule become an " insured" pursuant to this Endorsement if such person or organization is solely negligent.
IT IS FURTHER AGREED THAT IN NO EVENT SHALL ANY CONTRACT OR AGREEMENT ALTER THE CONDITIONS, COVERAGES OR EXCLUSIONS SET FORTH IN THIS POLICY.
All other terms and conditions of this policy remain unchanged.
XIC 414 1013 G 2013 X.L. America, Inc. All Rights Reserved. Page 1 of 1 May not be copied without permission.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
POLICY NUMBER: RAD943781803 COMMERCIAL AUTO
CA 04 44 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured: ALLIED UNIVERSAL TOPCO, LLC
Endorsement Effective Date: November 1, 2019
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of loss.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against
Others To Us condition does not apply to the
person( s) or organization( s) shown in the Schedule,
but only to the extent that subrogation is waived prior to the " accident" or the " loss" under a contract with that person or organization.
CA 04 44 10 13 Insurance Services Office, Inc., 2011 Page 1 of 1 ENDORSEMENT# 050
This endorsement, effective 12: 01 AM 11/ 01/ 2019
Forms part of policy number: 082695264
Issued to: ALLIED UNIVERSAL TOPCO, LLC
By: LEXINGTON INSURANCE COMPANY
ADDITIONAL INSURED- DESIGNATED PERSON OR ORGANIZATION
This endorsement modifies insurance provided by the following:
GUARDSECURE GENERAL AND PROFESSIONAL LIABILITY COVERAGE FORM A. SECTION II- Who Is An insured is amended to include as an additional insured a person( s) or organization( s) who is required to be added by written contract or written agreement which does not require that a specific form number be used.
B. The insurance provided to additional insureds applies only to" bodily injury"," property damage', professional liability" or" personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf In the performance of your ongoing operations for the additional insured; or" your work" performed for that additional insured and included in the" products- completed operations hazard" However:
1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
C. With respect to the insurance afforded to these additional insureds, the following is added to Section III— Limits of Insurance:
If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insuranc e shown in the Declarations.
D. The additional insured must see to it that:
1. We are notified as soon as practicable of an" occurrence" or offense that may result in a claim.
2. We receive written notice of a claim or" suit" as soon as practicable; and
3. A request for defense and indemnity of the claim or" suit" will promptly be brought against any policy issued by another insurer under which the additional insured also has rights an insured or additional insured.
E. This insurance is primary to and will riot seek contribution from any other insurance available to an additional insured under your policy provided that:
1. The additional insured is a Named Insured under such other insurance; and
2. 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.
All other terms and conditions remain as written.
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LEXD00O21
LX0404
ENDORSEMENT# 24
This endorsement, effective 12: 01 AM 11/ 01/ 2019
Forms part of policy number: 082895264
Issued to: ALLIED UNIVERSAL TOPCO, LLC
By: LEXINGTON INSURANCE COMPANY
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following:
SECURITY GUARD GENERAL AND PROFESSIONAL LIABILITY COVERAGE PART
SCHEDULE
Name of person or Organization:
Where required by written contract.
If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement)
The TRANSFER OF RECOVERY AGAINST OTHERS TO US Condition( Section IV— CONDITIONS) is amended by the addition of the following:
We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or' your work' done under a contract with that person or organization and included in the" products-completed operations hazard.' This waived applies only to the person or organization shown in the Schedule above, All other terms and conditions remain as written.
LEXD00O21
LX0404
Q 2TS:2
Amthnttzed Ri rt; ensllvc.
Sspr uerst+grottro qtr states whs rq, QF } irpbl i
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 Ed. 4- 84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. ( This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
Any person or organization where waiver of our right to recover is required by written contract with such person or organization provided such contract was executed prior to the date of loss.
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.) Endorsement Effective 11- 01- 2019 Policy No. RWD3001203-03 Endorsement No.
Insured ALLIED UNIVERSAL TOPCO, LLC
Insurance Company Countersigned by
r
XL Insurance America, Inc.
WC 00 03 13
Ed. 4-84)
1983 National Council on Compensation Insurance.