ATTACHMENT 1 - CHDC COR Brownfields RLF 4th Contract Amendment - Executed Copy 2024.pdf

DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166

CITY OF RICHMOND

CONTRACT AMENDMENT
Department: Community Development
Project Manager E-mail:
[email protected]
P.R.No: Vendor No: 1057
'roject Manager: Charice Duckworth
'reject Manager Phone No:
412-2052

3.0./Contract No: ,5430
Description of Services:

Perform remediation of four (4) vacant brownfield sites located at the corner of Fred Jackson Way and Duboce Avenue in North Richmond.

Amendment No. 4 modifies the: (2nd or subsequent amendments D Term, PaymentLimit and Service Plan
"erm and Service Plan
!timendments attach Amendment History page)
Payment Limit 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:

CHDC of North Richmond
Company Name:
, Street Address: 1525-A Fred Jackson Wav
City, State, Zip Code: Richmond, CA 94801
Contact Person: Joanna Griffith, Director of Real Estate Development Telephone: (510) 412-9290Email: [email protected] Business License No: 4000-8986/ Expiration Date:

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 May 21,2019 , which original term commenced on June 1,2019 and terminates December 20, 2020 with an original contract payment limit of $269,792.00. 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.

DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166

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
a municipal corporation
•DS
•DocuSlgnedby:

WL /W^/2 7/2024
•EBB8FAC8420B405..:
-Title: Deputy City Manager
I hereby certify that the Original Contract
and this Amendment have been approved
by the City Council or executed by the City
Manager.

DocuSigned by:
^tLn (jj^(>{\e^
•CO(W3Err4Ai0400...

City Clerh
Approved as to form:

DocuSigntd by:

By | S^^t>^ t^bY^
City Attdm^2
CONTRACTOR:

CHDC of North Richmond
(*The Corporation Chairperson of the Board, President or Vice-Prpsidg^gitjfiUlg^sign on the line below.)
BY I JUA^ (•b'^s
'•—C/9AUb4023CMh3...

Title:

Board, President
(*The Corporation Chief Financial Officer, Secretary or Assistant Secretary should sign on the line below.)
•DocuSlgnedby:

By:.

Title:
6mes fWcs
•71FBBIBIB88
CFO
28BOA5A394BD...

List of Attachments:

1. Amendment Provisions

2. Updated Insurance Certificates
(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)
should have both signatures conform to
designated representative groups pursuant
to Corporations Code Section 313.

Contract Amendment/EJ/TE 09-26-07
DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166 Contrdct Amendment, between the City of Richmond and
CHDC of North Richmond
Amendment No. H.U./Uontract NO.
4 ,5430

AMENDMENT PROVISIONS (TERM AND SERVICE PLAN)

1. Paragraph 2 (Term) of the Original Contract is hereby amended to extend the Contract term. Paragraph 2 of the Original Contract is amended to read as follows:
"2. Term. The effective date of this Contract is
June 1,2019
(Insert original contract commencement date)
and it terminates
December 31, 2024
(Insert new contract termination date)
unless sooner terminated as provided herein."

2. The Service Plan (Exhibit A) of the Original Contract is hereby amended to include the following tasks and/or services:

Contractor shall continue to provide the tasks and services set forth in the original contract - Community Housing Development Corporation of North Richmond (CHDCNR) will follow the guidelines of the Removal Action Workplan (RAW) approved by the Department of Toxic Substances Control (DTSC) for the brownfields site(s) located at 1329 Fred Jackson Way & Duboce Avenue. A total of four (4) vacant potentially contaminated sites will undergo remediation activities to determine if the activities are protective of human health and the environment. The soil removal action will be performed by an approved subcontractor (Adante Inc.) and supervised by the appointed staff of the DTSC.

The DTSC-approved Soil Removal Action Plan to be performed by Adante, Inc. will be attached to this contract as the primary source of work to be performed at the site(s).

The remediation work performed will be funded by the Richmond Brownfields EPA Revolving Loan Fund in the form of a grant to CHDCNR. The vacant parcels are receiving abatement in preparation for the construction of 43 permanently affordable multifamily units to be known as Legacy Court.

A contract amendment for an extension of "time only" is needed to secure additional grant funding to support the remediation of the site(s).

Contract Amendment/EJ/TE 9-26-07
DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166 Contract Amendment between the City of Richmond and
CHDC of North Richmond
Amendment No. P.U./Contract No.
4 ,5430

AMENDMENT PROVISIONS (AMENDMENT HISTORY)
The first Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on 12/01/2020 for one or more of the following provisions (check those that apply):

Increased contract payment limit by $ _for a payment limit not to exceed $ 269,792.00
[3 Term Amendment (insert new termination date): 12/31/2021 Service Plan
The second Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on 11/29/2021 _ for one or more of the following provisions (check those that apply):

D Increased contract payment limit by $ _for a payment limit not to exceed $269,792.00
Term Amendment (insert new termination date):J_^1^022_
Service Plan
The third Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on 1/6/2023 _for one or more of the following provisions (check those that apply):

Increased contract payment limit by $ _for a payment limit not to exceed $ 269,792.00 ____.

L^J Term Amendment (insert new termination date):.

Service Plan
The fourth Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on_for one or more of the following provisions (check those that apply):

D Increased contract payment limit by $ _for a payment limit not to exceed $ 269,792,00
Term Amendment (insert new termination date):.

D Service Plan
The fifth Contract Amendment was approved by City Council of the City of Richmond or executed by the City Manager on_for one or more of the
following provisions (check those that apply):

Increased contract payment limit by $ _for a payment limit not to exceed $ 9R9 79? nn _.

Term Amendment (insert new termination date):.

Service Plan
locuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166 ACORiy CERTIFICATE OF LIABILITY INSURANCE
DATE (MMfDDfYrT/)
6/11/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRWIATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must 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
Arthur J. Gallagher Risk Management Services, LLC.
595 Market Street, Suite 2100
San Francisco CA 94105
Licensed OD692931

INSURED
Community Housing Development Corporation of North
1535 Fred Jackson Way Ste A
Richmond, CA 94801
^ACT Amber Hatfield
PAH?.NNEo.Extl: 415-536-4078FAX
WC, No):

ADDRESS: [email protected]

INSURER(S) AFFORDING COVERAGE
INSURER A : Philadelphia Indemnity Insurance Company
INSURERS : Houston Casualty Company
INSURERC_:_
INSURER D :

INSURER E :

INSURER F :

NAICff
18058
42374
COVERAGESCERTIFICATENUMBER: 776348189REVISION NUMBER:

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

INSR
LTR
A
A
A
A
A
B

TYPE OF INSURANCE
xCOMMERCIAL GENERAL LIABILITY
CLAIMS-MADE | x | OCCUR
x
x
POLIC
OTHEI
x
x
x
x

ANY AUTO
OWNED
HIRED
GEN'L AGGREGATE LIMIT APPLIES PER:REGATE LIMIT APPLIES PER:
.?c°f D LOG
^: GL Ded: $0

AUTOMOBILE LIABILITY

AUTOS ONLY

AUTOS ONLY
UTO
D
3 ONLY
3 ONLY

LE LIABILITYABILITY
-Y
_Y

UMBRELLA LIAB

EXCESS LIAB
DEDx
sc
Al
N(
Al
<

HEDULED
TOS
iN-OWNED

TOS ONLY
OCCUR

CLAIMS-MADE
RETENTIONS in nnn

WORKERS COMPENSATION
AND EMPLOYERS' LIABILITT y; N

ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
(Mandatory In NH)
If ves. describe under
DESCRIPTION OF OPERATIONS below
Employee Theft/Dishonesty
Excess Employee Theft/Dishonesty
Cyber
ADDL
INSD
N/A
SUBR

VWDPOLICY NUMBER
PHPK2672452
PHPK2672452
PHUB906462
PHPK2672452
PHSD1824644
H24NGP240341-00

POLICY EFF
(MMfDD/Yrrri
4/1/2024
4/1/2024
4/1/2024
4/1/2024
10/26/2023
5/22/2024

POLICY EXP
(MMfDDfYYYYI
4/1/2025
4/1/2025
4/1/2025
4/1/2025
10/26/2025
4/1/2025
LIMITS

EACH OCCURRENCE

DAMAGE TO RENTED
PREMISES (Ea occurrence)
MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGO

COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY (Per person)
BODILY INJURY (Per accident)

PROPERTY DAMAGE
(Per accident)

EACH OCCURRENCE

AGGREGATE

PER I I OTH-

STATUTE I I ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEEI
E.L. DISEASE - POLICY LIMIT
Limit
Limit
Limit
$1,000,000
$100.000
$5,000
$1,000,000
$2,000,000
$2,000,000
$
$1,000,000
$
$
$
$
$10,000,000
$10.000.000
$
$
$
$
$500,000
$1,000,000
$1,000,000
DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) RE: P.O./Contract No: 21300625/2259City of Richmond, its officers, officials, employees, agents and volunteers

CERTIFICATE HOLDER
City of Richmond, its officers, officials,
employees, agents and volunteers
450 Civic Center Plaza, City Manager's office
Richmond CA 94804-0046
USA
1 CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE
to^A^f Ka^fjC'^
ACORD25(2016/03)
© 1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD
DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166 ACORD^ CERTIFICATE OF LIABILITT INSURANCE
PRODUCER (510)235-0353 FAX
M A Hays Insurance
CA License #0094750
232 Broadway
Richmond CA 94804

INSURED
Community Housing Dav. Corp Of North Richmond
1535A Fred Jackson Way
Richmond CA 94801

DATE (MM/DD/YYYY)
6/10/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATiOi^

ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BEL.OW.

INSURERS AFFORDING COVERAGE
INSURERA: Travelers Casualty & Surety)
INSURER & Sequoia Ins. Co.

INSURER C:

INSURER D:

INSURER E:

NAIC#
22985

COVERAGES
RFDUIREMFNT, TERM OP. CONDITION OFANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PCRTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.

AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

NSRI
LTR
B
A
tDD'L]
NSRDlTYPE OF INSURANCE
GENERAL UABILinr

COMMERCIAL GENERAL LIABIUTT
CLAIMS MADE | | OCCUR
GEN'LAGGREGATE LIMIT APPLIES PER;
—| POLICY n?ERCa Pl LOG
AUTOMOBILE UABIUFf3MOBILEUABIUFf

ANY AUTO

ALL OWNED AUTOS

SCHEDULED AUTOS

HIRED AUTOS

NON-OVWEDAUTOS
GARAGE LIABILIPr

ANY AUTO
EXCESSfUMBRELLA LIABILITY

OCCUR I I CLAIMS MADE

DEDUCTIBLE

RETENTION S

WORKERS COMPENSATION AND

EMPLOYERS'UABIUW

ANY PROPRIETOR/PARTNERCXECUTIVE
OFFICEWMEMBER EXCLUDED?
If yes, dBscribe under SPECIAL
PROVISIONS betow
OTHER Directors and
Officers

POLICY NUMBER
QWC1339207
105618912
"OLICY EFFECTIVE
DATE (MM/DDfYY)
02/19/2024
5/24/2024
'01-ICY EXPIRATION
DATE(MM;DDfYY)
02/19/2025
5/24/2025
LIMITS
_EACH OCCURRENCE

DAMAGE TO RENTED
PREMISES (Ea occuronce)
MED EXP (Any one parson)

PERSONAL & ADV INJURY

GENERALAGGREGATE

PRODUCTS - COMP/OP AGG

COMBINED SINGLE LIMIT
(Ea accident)

BODILY INJURY
(Per person)

BODILY INJURY
(Paraccidant)

PROPERTY DAMAGE
(Per accident)

AUTO ONLY - EAACCIDENT

OTHER THAN EAACC
AUTO ONLY:AGO

EACH OCCURRENCE

AGGREGATE

WC STATU-
x iTORYUMn-S I x

OTH-'ER
E.L. EACH ACCIDENT
E,L DISEASE . EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
»
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8 s
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(
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(
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B
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(
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t 1,000,000
, 1,000,000
i 1,000,000
D&O $1,000,000
EELI $1,000,000

CERTIFICATE HOLDER

CITY OF RICHMOND
City Manager's Office
450 CIVIC CENTER PLAZA
RICHMOND, CA 94904-0046

CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE

EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT

FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR UABIUTT OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.

AUTHORIZED REPRESENTATIVE
^^ ACORD 25 (2001/08)
fj^j INS025 (oioe).05ELECTRONIC IASER FORMS,;, INC.-lfiOOt327.0545 '--©^PORD CORPORATION 1988

Page 1 of 2 ends

DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166

IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements).

DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.

ACORD 25 (2001/08)
(J^- INS025 (0108).01 Page 2 of 2
3ocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166 ^CORD9 CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)
06/11/2024
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.

PRODUCER
Acrisure of California, LLC., dba
All Spectrum Insurance Brokers
3155 Olsen Drive #400
San Jose CA 95117

INSURED
Adanta, Inc
1040 Main Street Ste 110-A
Napa CA 94559
^JIACT Erin McCullough
FA^O.EXH: (408)739-8300 I <% No!(866) 826-6781
IiMDARKS: [email protected]

INSURER(S) AFFORDING COVERAGE
INSURERA : Benchmark Specialty Insurance Company
INSURER B : United Financial Casualty Co.

INSURER c: Travelers Property Casualty Company of America INSURER D:

INSURER E:

INSURERF:

NAIC#
17180
11770
25674
COVERAGESCERTIFICATE NUMBER: CL2452920586REVISION NUMBER:

INSR

LTRTYPE OF INSURANCEINSDWVDPOLICY NUMBERPOLICY EFF
(MM/DD/YYYY)

POLICY EXP
(MM/DD/YYTT)LIMITS

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE I /'N OCCUR

EACH OCCURRENCE

DAMAGE TO RENTED
PREMISES fEa occurrence)
MED EXP (Any one person)
MNGRP200101602/06/202402/06/2025PERSONAL 8, ADV INJURY
GEN'LAGGREGATE LIMITAPPLIES PER:GENERALAGGREQATE
POLICY
OTHER:

PRO-

JECTLOGPRODUCTS - COMP/OPAGG
Hired/Non-owned
3,000,000
50,000
10,000
3,000,000
3,000,000
3,000,000
$ 1,000,000

AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT
(Ea accident)$ 1,000,000

ANY AUTO
OWNED

AUTOS ONLY
HIRED

AUTOS ONLY
BODILY INJURY (Per person)
xlSCHEDULED
AUTOS

NON-OWNED

AUTOS ONLY
97489436111/10/202311/10/2024BODILY INJURY (Per accident)

PROPERTY DAMAGE
(Per accident)
xlUMBRELLA LIAB

EXCESS LIAB
xlOCCUR

CLAIMS-MADE
EACH OCCURRENCE1,000,000
MNGR-X-200057102/22/202402/06/20251,000,000
DEDRETENTION $

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
[f yes, describe under
DESCRIPTION OF OPERATIONS below
Y;N
Y
xl
PER

STATUTE
OTH-
ER
UB-6K28473705/31/202405/31/2025E.L EACH ACCIDENT1,000,000 E.L DISEASE - EA EMPLOYEE1,000,000
E.L. DISEASE - POLICY LIMIT1,000,000
Professional Liability
Contractors Pollution LiabilityMNGRP200101602/06/202402/06/2025 Each Claim
Each Pollution Claim
$3,000,000
$3,000,000
DESCRIPTION OF OPERATIONS; LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may bs attached if more space is required) If required by a written contract/agreement per the attached endorsements MG-UN-0018 07 2022 (ongoing) and MG-UN-0005 07 2022 (product/completed operations), The City of Richmond, its officers, officials, employees, agents and volunteers is listed as an additional insured with respects to General Liability coverages. Such insurance shall be primary and non-contributory to any other insurance with respects to General Liability coverages per form MG-UN-0006 07 2022. Waiver of Subrogation applies with respects to General Liability coverages per form MG-UN-0004 07 2022 and with respects to Workers' Compensation coverages per form WC 99 03 76 (A).

CERTIFICATE HOLDER
City of Richmond
450 Civic Center Plaza
Richmond
_L
CA 94804

CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

TheACORD name and logo are registered marks ofACORD
DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166

ADDITIONAL INSURED ENDORSEMENT - OWNERS,

LESSEES OR CONTRACTORS
Effective Date: 02/06/2024
Policy Number: MN6R-P-2001016
Insured Name: Adanta, Inc.

Writing Company: Benchmark Specialty Insurance Company
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

CONTRACTORS POLLUTION LIABILITY POLICY

SCHEDULE
NAME OF PERSON(S) OR ORGANIZATION(S):

Any person(s) or organization(s) whom the Named Insured (Named Insured) agrees, in a written contract, to name as an additional insured. However, this status exists only for the project specified in that contract.

The following condition is added to the policy and supersedes anything to the contrary:

A. SECTION II-WHO IS AN INSURED is amended to include the person(s) or organization shown in the SCHEDULE as an additional insured, but only with respect to liability arising out of your ongoing operations performed for that insured.

B. With respect to the insurance afforded to these additional insureds, the following exclusion is added:

This insurance does not apply to bodily injury ("bodily injury") or property damage ("property damage") occurring after:
(1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance, or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or
(2) That portion of your work ("your work") out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.

All other terms and conditions remain the same.

MG-UN-0018 07/2022
DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166

ADDITIONAL INSURED ENDORSEMENT - OWNERS,

LESSEES OR CONTRACTORS - COMPLETED

OPERATIONS
Effective Date: 02/06/2024
Policy Number: MN6R-P-2001016
Insured Name: Adanta, Inc.

Writing Company: Benchmark Specialty Insurance Company
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

CONTRACTORS POLLUTION LIABILITY POLICY

SCHEDULE
NAME OF PERSON(S) OR ORGANIZATION(S):

LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS:

Project locations in which this endorsement is required by contract.

The following condition is added to the policy and supersedes anything to the contrary:

SECTION II - Who Is An Insured is amended to include the person(s) or organization shown in the SCHEDULE as an additional insured, but only with respect to liability for bodily injury ("bodily injury") or property damage ("property damage") arising out of your work ("your work") at the location designated and described in the SCHEDULE of this endorsement performed forthat additional insured and included in the products-completed operations hazard ("products-completed operations hazard").

All other terms and conditions remain the same.

MG-UN-0005 11/2023
DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166

PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT
Effective Date:

Policy Number:

Insured Name:

Writing Company:
02/06/2024
MNGR-P-2001016
Adanta, Inc.

Benchmark Specialty Insurance Company
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABIUTT COVERAGE FORM

CONTRACTORS POLLUTION LIABILITY POLICY

PROFESSIONAL LIABILITY POLICY

SITE POLLUTION LIABILITY POLICY

SCHEDULE
NAME OF PERSON(S) OR ORGANIZATION(S):

Any person(s) or organization(s) whom the Named Insured (Named Insured) agrees, in a written contract, to provide Primary and/or Non-Contributory status of this insurance. However, this status exists only for the project specified in that contract.

LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS:

Project locations in which this endorsement is required by contract.

The following condition is added to the policy and supersedes anything to the contrary:

This policy shall be considered primary to any similar insurance held by third parties in respect to work performed by an insured under any written contractual agreement with such third party. It is further agreed that any other insurance which the person(s) or organization(s) named in the schedule may have is excess and noncontributorytothis insurance.

MG-UN-0006 07/2022
DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US
Effective Date: 02/06/2024
Policy Number: MNGR-P-2001016
Insured Name: Adanta, Inc.

Writing Company: Benchmark Specialty Insurance Company
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE FORM

CONTRACTORS POLLUTION LDIBILITY POLICY

FOLLOW FORM EXCESS LIABILITY POLICY

PROFESSIONAL LIABILITY POLICY

SCHEDULE
NAME OF PERSON(S) OR ORGANIZATION(S):

Any person(s) or organization(s) where required by written contract, executed prior to the start of Operations.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The following condition is added to the policy and supersedes anything to the contrary:

We waive any right of recovery we may have against the person(s) or organization(s) shown in the SCHEDULE above because of payments we make for injury or damage arising out of your ongoing operations or your work ("your work") done under a contract with that person(s) or organization(s) and included in the products-completed operations hazard (products-completed operations hazard/"products completed operations hazard"). This waiver applies only to the person(s) or organizations) shown in the SCHEDULE of this endorsement.

MG-UN-0004 07/2022
DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166 POLICY NUMBER: MNGR-P-2001016COMMERCIAL GENERAL LIABILITY CG 25 03 03 97
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

DESIGNATED CONSTRUCTION PROJECT(S)

GENERAL AGGREGATE LIMIT
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE
Designated Construction Projects:

All projects occurring away from premises owned or rented by you. We will pay no more than $5,000,000 for all| claims or "suits" under this policy that are subject to the General Aggregate (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)
A. For all sums which the insured becomes legally
obligated to pay as damages caused by
"occurrences" under COVERAGE A (SECTION
I), and for all medical expenses caused by acci-
dents under COVERAGE C (SECTION l),Which
can be attributed only to ongoing operations at a
single designated construction project shown in
the Schedule above:

1. A separate Designated Construction Project
General Aggregate Limit applies to each
designated construction project, and that limit
is equal to the amount of the General Aggre-
gate Limit shown in the Declarations.

2. The Designated Construction Project General
Aggregate Limit is the most we will pay for
the sum of all damages under COVERAGE
A, except damages because of "bodily injury"
or "property damage" included in the
"products-completed operations hazard", and
for medical expenses under COVERAGE C
regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims
or bringing "suits".

3. Any payments made under COVERAGE A
for damages or under COVERAGE C for
medical expenses shall reduce the Desig-
nated Construction Project General Aggre-
gate Limit for that designated construction
project. Such payments shall not reduce the
General Aggregate Limit shown in the Decla-
rations nor shall they reduce any other Des-
ignated Construction Project General Aggre-
gate Limit for any other designated construc-
tion project shown in the Schedule above.

4. The limits shown in the Declarations for Each
Occurrence, Fire Damage and Medical Ex-
pense continue to apply. However, instead of
being subject to the General Aggregate Limit
shown in the Declarations, such limits will be
subject to the applicable Designated Con-
struction Project General Aggregate Limit.

B. For all sums which the insured becomes legally
obligated to pay as damages caused by
"occurrences" under COVERAGE A (SECTION
I), and for all medical expenses caused by acci-
dents under COVERAGE C (SECTION I), which
cannot be attributed only to ongoing operations
at a single designated construction project shown
in the Schedule above:

1. Any payments made under COVERAGE A
for damages or under COVERAGE C for
medical expenses shall reduce the amount
available under the General Aggregate Limit
or the Products-Completed Operations Ag-
gregate Limit, whichever is applicable; and

2. Such payments shall not reduce any Desig-
nated Construction Project General Aggre-
gate Limit.

C. When coverage for liability arising out of the
"products-completed operations hazard" is pro-
vided, any payments for damages because of
"bodily injury" or "property damage" included in
the "products-completed operations hazard" will
reduce the Products-Completed Operations Ag-
gregate Limit, and not reduce the General Ag-
gregate Limit nor the Designated Construction
Project General Aggregate Limit.

CO 25 03 03 97Copyright, Insurance Services Office, Inc., 1996Page 1 of 2 DocuSign Envelope ID: OA361644-7FDB-48F9-BB77-E774539D7166 TRAVELERST • WORKERS COMPENSATION

ONE TOWER SQUARE
HARTFORD CT~06183
ENDORSEMENT WC 00 03 13 (00) - 001
POLICY NUMBER: UB-6K284737-24-42-G

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 any one not named in the Schedule.

SCHEDULE
DESIGNATED PERSON:

DESIGNATED ORGANIZATION:

ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED

BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER.

DATE OF ISSUE: 04-16-24 ST ASSIGN: PAGElOFl

Richmond City CouncilNovember 26, 2024

Richmond City Council
November 26, 2024