CITY OF RICHMOND
CONTRACT AMENDMENT
Department: Public Works Project Manager: Angela Walton Project Manager E-mail: Project Manager Phone No:
[email protected] (510) 255-9688
P.R. No: Vendor No: 5916 P.O./Contract No: 5334
Description of Services:
On call construction management and inspection services for various City projects Amendment No.. _modifies the: (2" or subsequent amendments attach Amendment History page) /Term, Payment Limit and Service Plan / Payment Limit and Service Plan /Term and Service Plan Service Plan
The parties to this Contract Amendment do mutually agree and promise as follows:
1. Parties. The parties to this Contract Amendment are the City of Richmond, California, a municipal corporation (City), and the following named Contractor:
Company Name: Swinerton Management and Consulting
Street Address: 10 Clay Street, Suite 275
City, State, Zip Code: Oakland, CA 94607-3548
Contact Person: Jeffrey Gee
Telephone: (650) 483-7412 Email: [email protected]
Business License No:40060289 / Expiration Date: June 26, 2021 A California V corporation, limited liability corporation general partnership, limited partnership, / individual, L non-profit corporation, / individual dba as [specify:]
other [specify:]
2. Purpose. This Contract Amendment is being entered into to amend the Contract between City and Contractor which was approved by the City Council of the City of Richmond or executed by the City Manager on June 30, 2020 , which original term commenced on July 1, 2020 and terminates June 30, 2023 with an original contract payment limit of $450,000.00 • Said contract shall hereinafter be referred to as the "Original Contract" and is incorporated herein by reference.
3. Original Contract Provisions. The parties hereto agree to continue to abide by those terms and conditions of the Original Contract, and any amendments thereto, which are unaffected by this Contract Amendment.
4. Amendment Provisions. This Contract Amendment is subject to the Amendment Provisions attached hereto, which are incorporated herein by reference, and which control over any conflicting provisions of the Original Contract, or any amendment thereto.
5. City of Richmond Business License Active Status Maintained. Pursuant to Municipal Code Section 7.04.030, the Contractor must maintain its City of Richmond business license for this Contract Amendment to be deemed to be in effect.
6. Insurance Coverage Updated and Maintained. Pursuant to the Original Contract, the Contractor shall provide the City with updated insurance certificates, and the Contractor shall maintain insurance coverage, for this Contract Amendment to be deemed to be in effect.
7. Signatures. These signatures attest the parties' agreement hereto:
CITY OF RICHMOND, CALIFORNIA CONTRACTOR:
a municipal corporation
Swinerton Management and Consulting
That (*The Corporation Chairperson of the Board, President or Vice-President should sign on the line below.)
Title: mayor
By.
I hereby certify that the Original Contract Title: Vice President and this Amendment have been approved
by the City Council or executed by the City (*The Corporation Chief Financial Officer, Secretary or Manager. Assistant Secretary should sign on the line below.) By:
Chry clerk (teputy) THe: SVP, SECRETARY
(NOTE: Pursuant to California Corporations
Code Section 313, if Contractor is a
corporation or nonprofit organization, this
Contract (1) should be signed by the
Chairperson of the Board, President or
Vice-President and the Chief Financial
Officer, Secretary or Assistant Secretary; (2)
List of Attachments: should have both signatures conform to Amendment Provisions designated representative groups pursuant Updated Insurance Certificates to Corporations Code Section 313.
Contract Amendment/EJ/TE 09-26-07
Contract Amendment between the City of Richmond and
Swinerton Management and Consulting
Amendment No. P.O./Contract No.
1 5334
AMENDMENT PROVISIONS (PAYMENT LIMIT AND SERVICE PLAN)
Paragraph 3 (Payment Limit) of the Original Contract is hereby amended to increase the payment limit by $450,000.00 . Paragraph 3 of the Original Contract is amended to read as follows:
"3. Payment Limit. City's total payments to Contractor under this Contract Amendment shall not exceed $900,000.00 including expenses." "The City of Richmond shall not pay for services that exceed the Contract Payment Limit without the prior written approval of the City Manager if the total Contract amount does not exceed $10,000 or without the prior approval of the city Council if the total Contract amount is over $10,000."
2. The Service Plan (Exhibit A) of the Original Contract is hereby amended to include the following tasks and/or services:
The Service Plan remains the same as described in the original contract Contract Amendment/EJ/TE 9-26-07
ACORD® DATE (MM/DD/VYY)
CERTIFICATE OF LIABILITY INSURANCE
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
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements).
Arthur J. Gallagher & Co. Insurance Brokers of CA. (AIC, No, Ext): 415-391-1500 FAC, No: 415-391-1882 1160 Battery Street
ADDRESS: [email protected]
INSURERS) AFFORDING COVERAGE
INSURER A: Liberty Mutual Fire Insurance Company 23035
INSURED INSURER B: Zurich American Insurance Company 16535 Swinerton Builders INSURER C: Starr Indemnity & Liability Company 38318 dba Swinerton Management & Consulting
INSURER D: National Fire & Marine Insurance Co 20079
260 Townsend Street
San Francisco CA 94107 INSURERE: Indian Harbor Insurance Company 36940 INSURER F: First Liberty Insurance Corporation 33588
COVERAGES CERTIFICATE NUMBER: 435028968
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
ELEONE AND CONTINE OF EUT PRE IN NET ENTANE ELSE BE A CAN HERE SULET A HE TENS,
INSR ADDL SUBR LIMITS
LTR TYPE OF INSURANCE INSO WVD POLICY NUMBER
GL0023224704 8/1/2020 I $2,000,0000
B X COMMERCIAL GENERAL LIABILITY Y 8/1/2021 EACH OCCURRENCE
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES (Ea occurrence) - $ 300,000 MED EXP (Any one person) SNA
PERSONAL & ADV INJURY $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4.000,000 PRO- PRODUCTS - COMP/OP AGG $4,000,000
POLICY LOC
$1,000,000
OTHER: COMBINED SINGLE LIMIT
AS2661066493020 8/1/2020 8/1/2021 $2,000,000
AUTOMOBILE LIABILITY (Ea accident)
BODILY INJURY (Per person) $
X ANY AUTO
OWNED SCHEDULED. BODILY INJURY (Per accident) $
AUTOS ONLY
HIRED NON-OWNED
AUTOS ONLY AUTOS ONLY
Deductible $ 100,000
X 1000585239201 8/1/2020 8/1/2021 EACH OCCURRENCE $5,000,000
UMBRELLA LIAB OCCUR
EXCESS LIAB AGGREGATE $5,000,000
CLAIMS-MADE
DED RETENTION $
WORKERS COMPENSATION WA666D066493030 8/1/2020 8/1/2021 X STATUTE T TETH
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? EL. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH)
EESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 E Professional Lly 2nd Layer) 42XSF30224505 1/20: 3/1/202 Each Occ/Ag 2000000 CE0744604204 1/20: 3/1/202 ach Claim/Agg lin
JOB 2010007 RATIONS LOCATIONS VEHICLES (ACOR 101, Adioal Romake Schedule, may be atacted more spool require ADDITIONAL INSURED The yo and monie Sears for is ens Cly Per agents and volunteers.
CERTIFICATE HOLDER CANCELLATION
City of Richmond
Att: Mr. Tawfic Halaby
AUTHORIZED REPRESENTATIVE
Rich Mind A 9904-0046
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ZURICH®
Additional Insured - Automatic - Owners, Lessees Or
Contractors
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Policy No. GLO023224704 Effective Date: 08/01/2020
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
A. Section II - Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured under a written contract or written agreement executed by you, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" and subject to the following:
1. If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements:
a. The Insurance Services Office (ISO) ISO CG 20 10 (10/01 edition); or b. The ISO CG 20 37 (10/01 edition),
such person or organization is then an additional insured with respect to such endorsements), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" arises out of:
(1) Your ongoing operations, with respect to Paragraph 1.a. above; or (2) "Your work", with respect to Paragraph 1.b. above,
which is the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 1., insurance afforded to such additional insured:
(a) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and
(b) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured.
2. If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements:
a. The Insurance Services Office (ISO) ISO CG 20 10(07/04 edition); or b. The ISO CG 20 37(07/04 edition),
such person or organization is then an additional insured with respect to such endorsements), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is caused, in whole or in part, by:
(1) Your acts or omissions; or
(2) The acts or omissions of those acting on your behalf, U-GL-2162-A CW (02/19)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
INTERNAL USE ONLY
in the performance of:
(a) Your ongoing operations, with respect to Paragraph 2.a. above; or (b) "Your work" and included in the "products-completed operations hazard", with respect to Paragraph
2.b. above,
which is the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 2., insurance afforded to such additional insured:
(i) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and
(ii) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured.
3. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that you provide that the person or organization be named as an additional insured:
a. Under the ISO CG 20 10(04/13 edition, any subsequent edition or if no edition date is specified); or b. With respect to ongoing operations (if no form is specified), such person or organization is then an additional insured only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is 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, which is the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 3., insurance afforded to such additional insured:
(a) Only applies to the extent permitted by law;
(b) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured; and
(c) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement.
4. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that you provide that the person or organization be named as an additional insured:
a. Under the ISO CG 20 37 (04/13 edition, any subsequent edition or if no edition date is specified); or b. With respect to the "products-completed operations hazard" (if no form is specified), such person or organization is then an additional insured only to the extent that "bodily injury" or "property damage" is caused, in whole or in part by "your work" and included in the "products-completed operations hazard", which is the subject of the written contract or written agreement.
However, solely with respect to this Paragraph 4., insurance afforded to such additional insured:
(1) Only applies to the extent permitted by law;
(2) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured;
(3) Only applies if the "bodily injury" or "property damage" occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (4) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured.
U-GL-2162-A CW (02/19)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
INTERNAL USE ONLY
B. Solely with respect to the insurance afforded to any additional insured referenced in Section A. of this endorsement, the following additional exclusion applies:
This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including:
1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or
2. Supervisory, inspection, architectural or engineering activities.
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 injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services.
C. Solely with respect to the coverage provided by this endorsement, the following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV - Commercial General Liability Conditions:
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 may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory.
D. Solely with respect to the coverage provided by this endorsement:
1. The following is added to the Other Insurance Condition of Section IV - Commercial General Liability Conditions:
Primary and Noncontributory insurance
This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that:
a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured.
2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition under Section IV - Commercial General Liability Conditions:
This insurance is excess over:
Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis.
E. This endorsement does not apply to an additional insured which has been added to this Coverage Part by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured.
F. Solely with respect to the insurance afforded to an additional insured under Paragraph A.3. or Paragraph A.4. of this endorsement, the following is added to Section III - Limits Of Insurance:
Additional Insured - Automatic - Owners, Lessees Or Contractors Limit • The most we will pay on behalf of the additional insured is the amount of insurance:
U-GL-2162-A CW (02/19)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
INTERNAL USE ONLY
1. Required by the written contract or written agreement referenced in Section A. of this endorsement; or
2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
All other terms, conditions, provisions and exclusions of this policy remain the same.
J-GL-2162-A CW (02/19)
Pace 4 of 4
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
INTERNAL USE ONLY
Other Insurance Amendment - Primary And Non-
ZURICH
Contributory
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add'l. Prem Return Prem.
GL0023224704 8/1/2020 : 8/1/2021 8/1/2020 09109000
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured: Swinerton Incorporated et al
Address (including ZIP Code): 2300 Clayton Road, Suite 800 Concord, CA 94520
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
1. The following paragraph is added to the Other Insurance Condition of Section IV - Commercial General Liability Conditions:
This insurance is primary insurance to and will not seek contribution from any other insurance available to an additional insured under this policy provided that:
a. The additional insured is a Named Insured under such other insurance; and b. You are required by a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured.
2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV - Commercial General Liability Conditions:
This insurance is excess over:
Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis:
All other terms and conditions of this policy remain unchanged.
U-GL-1327-B CW (04/13)
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
POLICY NUMBER: GL0023224704 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
ny Person or Organization that requires You to waive your Rights of Recovery, in a written contract o agreement with the Named Insured that is executed prior to the accident or loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Section IV - Conditions:
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 waiver applies
only to the person or organization shown in the
Schedule above.
CG 24 04 05 09 © Insurance Services Office, Inc., 2008 ers Kluwer Financial Services Unitom oms M POLICY NUMBER: AS2-661-066493-020 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.
SCHEDULE
Name(s) Of Person(s) Or Organization(s):
ny person or organization for whom you perform work under vritten contract if the contract requires you to obtain thi agreement from us, but only if the contract is executed prior to the injury or damage occurring.
Premium: $ INCL
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 organizations) shown in the Schedule,
ut only to the extent that subrogation is waived prio
o the "accident" or the "loss" under a contract wit
that person or organization.
CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 POLICY NUMBER: AS2661066493020 COMMERCIAL AUTO
CA 20 01 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LESSOR - ADDITIONAL INSURED AND LOSS PAYEE
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.
SCHEDULE
Insurance Company: Liberty Mutual Fire Insurance Company Policy Number: AS2661066493020 Effective Date: 08/01/2020 Expiration Date: 08/01/2021
Named Insured:
Address:
Additional Insured (Lessor): SEE ATTACHED SCHEDULE
Address:
Designation Or Description Of "Leased Autos: SEE ATTACHED SCHEDULE CA 20 01 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 2 Coverages Limit Of Insurance
Covered Autos Liability $ Each "Accident"
Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Comprehensive Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Collision $ Deductible For Each Covered "Leased Auto"
Specified Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus Causes Of Loss $ Deductible For Each Covered "Leased Auto" Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Coverage 2. The insurance covers the interest of the lessor unless the "loss" results from fraudulent acts or
1. Any "leased auto" designated or described in omissions on your part. the Schedule will be considered a covered
"auto" you own and not a covered "auto" you 3. If we make any payment to the lessor, we will hire or borrow. obtain his or her rights against any other party.
2. For a "leased auto" designated or described in C. Cancellation the Schedule, the Who Is An Insured provision 1. If we cancel the policy, we will mail notice to the under Covered Autos Liability Coverage is lessor in accordance with the Cancellation changed to include as an "insured" the lessor
Common Policy Condition.
named in the Schedule. However, the lessor is
an "insured" only for "bodily injury" or "property 2. If you cancel the policy, we will mail notice to damage" resulting from the acts or omissions the lessor.
3. Cancellation ends this agreement.
a. You; D. The lessor is not liable for payment of your b. Any of your "employees" or agents; or premiums.
c, Any person, except the lessor or any E. Additional Definition "employee" or agent of the lessor, operating
As used in this endorsement:
a "leased auto" with the permission of any of
the above. "Leased auto" means an "auto" leased or rented to you, including any substitute, replacement or extra
3. The coverages provided "auto" needed to meet seasonal or other needs, Thorseover apply rodny leased auto"
under a leasing or rental agreement that requires
described in the Schedule until the expiration you to provide direct primary insurance for the date shown in the Schedule, or when the lessor
or his or her agent takes possession of the
"leased auto", whichever occurs first.
B. Loss Payable Clause
1. We will pay, as interest may appear, you and
the lessor named in this endorsement for "loss"
to a "leased auto".
POLICY NUMBER: AS2-661-066493-020 COMMERCIAL AUTO
CA 20 48 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
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 identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.
SCHEDULE
Name Of Person(s) Or Organization(s):
Any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minimum limits of insurance required by the written agreement, and in no event to exceed either the scope of coverage or the limits of insurance provided in this policy.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision
contained in Paragraph A.1. of Section II - Covered
Autos Liability Coverage in the Business Auto and
Secion - Covered Autos Coverages of the Autt
Dealers Coverage Form
CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1
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.
Not applicable in Alaska, Kentucky, New Hampshire and New Jersey.
The Waiver does not apply to any right to recover payments which the Minnesota Workers Compensation Reinsurance Association may have or pursue under M.S. 79.36.
Schedule
Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual.
Where required by contract or written agreement prior to loss and allowed by law.
In the states of Arizona and North Carolina, the premium charge is 2% of the total manual premium, subject to a minimum premium of $100 per policy.
In the states of Connecticut, Florida, lowa, Maryland, Nebraska and Oregon, the premium charge is 1% of the total manual premium, subject to a minimum premium of $250 per policy.
In the state of Louisiana, the premium charge is 2% of the total standard premium, subject to a minimum premium of $250 per policy.
In the state of Hawaii, the premium charge is $5,509 and determined as follows: The premium charge for this endorsement is 1% of the total manual premium, subject to a minimum premium of $250 per policy.
In the state of Massachusetts, the premium charge is 1% of the total manual premium.
In the state of New York, the premium charge is 2% of the total manual premium, subject to a minimum premium of $250 per policy.
In the state of Virgina, the premium charge is 5% ofthe total manual premium, subject to a minimum premium of $250 per policy.
Issued by First Liberty Insurance Corporation
For attachment to Policy NoWA666D066493030 Effective Date 8/1/2020 Premium $ Issued to Swinerton Incorporated
WC 00 03 13 © 1983 National Council on Compensation Insurance. Page 1 of 1 Ed. 04/01/1984
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -
CALIFORNIA
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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration.
Schedule
Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of $ 250 per policy.
Person or Organization Job Description
Where required by contract or Any
written agreement prior to loss and
allowed by law.
Issued by First Liberty Insurance Corporation
For attachment to Policy NoWA666D066493030 Effective Date 8/1/2020 Premium $ Issued to Swinerton Incorporated
WC 04 03 06 Page 1 of 1
Ed: 04/1984
Notification to Others of Cancellation ZURICH®
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. Add'l. Prem Return Prem.
GLO 0232247-04 08/01/2020 08/01/2021 09109000 INCL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
Liquor Liability Coverage Part
Products/Completed Operations Liability Coverage Part
A. If we cancel this Coverage Parts) by written notice to the first Named Insured for any reason other than nonpayment of premium, we will mail or deliver a copy of such written notice of cancellation:
1. To the name and address corresponding to each person or organization shown in the Schedule below; and
2. At least 10 days prior to the effective date of the cancellation, as advised in our notice to the first Named Insured, or the longer number of days notice if indicated in the Schedule below.
B. If we cancel this Coverage Parts) by written notice to the first Named Insured for nonpayment of premium, we will nail or deliver a copy of such written notice of cancellation to the name and address corresponding to each person or organization shown in the Schedule below at least 10 days prior to the effective date of such cancellation.
C. If notice as described in Paragraphs A. or B. of this endorsement is mailed, proof of mailing will be sufficient proof of such notice.
SCHEDULE
Number of
Name and Address of Other Person(s) / Organization(s): Days Notice:
ANY PERSON OR ORGANIZATION WITH WHOM YOU HAVE AGREED, 30
THROUGH WRITTEN CONTRACT, AGREEMENT OR PERMIT
All other terms and conditions of this policy remain unchanged.
U-GL-1446-A CW (05/10
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
NOTICE OF CANCELLATION TO THIRD PARTIES
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured.
B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the Schedule
Name of Other Email Address or mailing address: Number Days Notice:
Person(s) /
Organization(s): 30
Any person/organization with whom you have agreed through written contract, agreement or permit executed to give such notice
All other terms and conditions of this policy remain unchanged.
Issued by First Liberty Insurance Corp
For attachment to Policy No. WA666D066493030 Effective Date Premium $ Issued to Swinerton Incorporated
WC 99 20 75 © 2016 Liberty Mutual Insurance Page 1 of 1 Ed. 12/01/2016
Policy Number: AS2-661-066493-020
Issued By: Liberty Mutual Fire Insurance Co.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
NOTICE OF CANCELLATION TO THIRD PARTIES
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
MOTOR CARRIER COVERAGE PART
GARAGE COVERAGE PART
TRUCKERS COVERAGE PART
EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART
SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
Schedule
Name of Other Person(s)/ Email Address or mailing Number Organization(s): address: Days
Notice:
Any person/organization with whom you have agreed through written contract, 30 agreement or permit executed to give such notice
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured.
B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy.
All other terms and conditions of this policy remain unchanged.
LIM 99 01 05 11 © 2011, Liberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission.