HomeMy WebLinkAbout2013-020 Contract - Taylor Site Development
Contract for GOODS AND SERVICES Less than $50,000
CITY OF CONTRACTOR: Taylor Site Development, Inc.
ASHLAND CONTACT: Mark Taylor
20 East Main Street
Ashland, Oregon 97520 ADDRESS: PO Box 537, Medford, OR 97501
Telephone: 541/488-6002
Fax: 541/488-5311 TELEPHONE: (541) 779-3565
DATE AGREEMENT PREPARED: 12-20-12 FAX: (541) 858-7031
BEGINNING DATE: January 7, 2013 COMPLETION DATE: May 7, 2013
COMPENSATION: $41,503.00
GOODS AND SERVICES TO BE PROVIDED: North Mountain Park Nature Center Addition, as shown on the
contract documents b Robert Saladoff Architect.
ADDITIONAL TERMS: Minus items outlined in Taylor Site Development, Inc. Revised quote dated 12-14-12
NOW THEREFORE, pursuant to AMC 2.50.090 and after consideration of the mutual covenants contained herein the
CITY AND CONTRACTOR AGREE as follows:
1. All Costs by Contractor: Contractor shall, provide all goods as specified above and shall at its own risk and
expense, perform any work described above and, unless otherwise specified, furnish all labor, equipment and
materials required for the proper performance of such work.
2. Qualified Work: Contractor has represented, and by entering into this contract now represents, that any personnel
assigned to the work required under this contract are fully qualified to perform the work to which they will be assigned
in a skilled and worker-like manner and, if required to be registered, licensed or bonded by the State of Oregon, are
so registered, licensed and bonded. Contractor must also maintain a current City business license.
3. Completion Date: Contractor shall provide all goods in accordance with the standards and specifications, no later
than the date indicated above and start performing the work under this contract by the beginning date indicated
above and complete the work by the completion date indicated above.
4. Compensation: City shall pay Contractor for the specified goods and for any work performed, including costs and
expenses, the sum specified above. Payments shall be made within 30 days of the date of the invoice. Should the
contract be prematurely terminated, payments will be made for work completed and accepted to date of termination.
Compensation underthis contract, including all costs and expenses of Contractor, is limited to $25,000.00, unles9;3
separate written contract is entered into by the City.
5. Ownership of Documents: All documents prepared by Contractor pursuant to this contract shall be the property of
city.
6. Statutory Requirements: ORS 279B.220, 2796.225, 2798.230, 2796.235, ORS Chapter 244 and ORS 670.600 are
made part of this contract.
7. Living Wage Requirements: If contractor is providing services under this contract and the amount of this contract
is $19,494 or more, Contractor is required to comply with chapter 3.12 of the Ashland Municipal Code by paying a
living wage, as defined in this chapter, to all employees performing work under this contract and to any subcontractor
who performs 50% or more of the work under this contract. Contractor is also required to post the notice attached
hereto as Exhibit B predominantly in areas where it will be seen by all employees.
8. Indemnification: Contractor agrees to defend, indemnify and save City, its officers, employees and agents harmless
from any and all losses, claims, actions, costs, expenses, judgments, subrogations, or other damages resulting from
injury to any person (including injury resulting in death), or damage (including loss or destruction) to property, of
whatsoever nature arising out of or incident to the performance of this contract by Contractor (including but not limited
to, Contractor's employees, agents, and others designated by Contractor to perform work or services attendant to this
contract). Contractor shall not be held responsible for any losses, expenses, claims, ¢ubrogations, actions, costs,
judgments, or other damages, directly, solely, and proximately caused by the negligence of City.
9. Termination:
a. Mutual Consent. This contract maybe terminated at anytime by mutual consent of both parties.
b. City's Convenience. This contract may be terminated at any time by. City upon 30 days' notice in writing
and delivered by certified mail or in person.
C. For Cause. City may terminate or modify this contract, in whole or in part, effective upon delivery of
written notice to Contractor, or at such later date as may be established by City under any of the following
conditions:
i. If C' funding from federal, state, county or other sources is not obtained and continued at levels
Contract for Goods and Services Less than $50,000, Revised 06/3=012, Page 1 of 5
a `
sufficient to allow for the purchase of the indicated quantity of services;
ii. If federal or state regulations or guidelines are modified, changed, or interpreted in such a way
that the services are no longer allowable or appropriate for purchase under this contract or are
no longer eligible for the funding proposed for payments authorized by this contract; or
iii. If any license or certificate required by law or regulation to be held by Contractor to provide the
services required by this contract is for any reason denied, revoked, suspended, or not renewed.
d. For Default or Breach.
i. Either City or Contractor may terminate this contract in the event of a breach of the contract by
the other. Prior to such termination the party seeking termination shall give to the other party
written notice of the breach and intent to terminate. If the party committing the breach has not
entirely cured the breach within 15 days of the date of the notice, or within such other period as
the party giving the notice may authorize or require, then the contract may be terminated at any
time thereafter by a written notice of termination by the party giving notice.
it. Time is of the essence for Contractor's performance of each and every obligation and duty under
this contract. City by written notice to Contractor of default or breach, may at any time terminate
the whole or any part of this contract if Contractor fails to provide services called for by this
contract within the time specified herein or in any extension thereof.
iii. The rights and remedies of City provided in this subsection (d) are not exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
e. Obligation/Liability of Parties. Termination or modification of this contract pursuant to subsections a, b, or
c above shall be without prejudice to any obligations or liabilities of either party already accrued prior to such
termination or modification. However, upon receiving a notice of termination (regardless whether such notice is
given pursuant to subsections a, b, c or d of this section, Contractor shall immediately cease all activities under
this contract, unless expressly directed otherwise by City in the notice of termination. Further, upon termination.
Contractor shall deliver to City all contract documents, information, works-in-progress and other property that are
or would be deliverables had the contract been completed. City shall pay Contractor for work performed prior to
the termination date if such work was performed in accordance with the Contract.
10. Independent Contractor Status: Contractor is an independent Contractor and not an employee of the City.
Contractor shall have the complete responsibility for the performance of this contract
11. Nondiscrimination Certification: The undersigned certifies that the undersigned Contractor has not discriminated
against minority, women or emerging small businesses enterprises in obtaining any required subcontracts.
Contractor further certifies that it shall not discriminate in the award of such subcontracts, if any. The Contractor
understands and acknowledges that it may be disqualified from bidding on this contract, including but not limited to
City discovery of a misrepresentation or sham regarding a subcontract or that the Bidder has violated any
requirement of ORS 279A 110 or the administrative rules implementing the Statute.
12. Asbestos Abatement License: If required under ORS 468A.710, Contractor or Subcontractor shall possess an
asbestos abatement license.
13. Assignment and Subcontracts: Contractor shall not assign this contract or subcontract any portion of the work
without the written consent of City. Any attempted assignment or subcontract without written consent of City shall be
void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all
persons employed by them, and the approval by City of any assignment or subcontract shall not create any
contractual relation between the assignee or subcontractor and City.
14. Use of Recyclable Products: Contractor shall use recyclable products to the maximum extent economically feasible
in the performance of the contract work set forth in this document.
15. Default. The Contractor shall be in default of this agreement if Contractor: commits any material breach or default of
any covenant, warranty, certification, or obligation it owes under the Contract; if it loses its QRF status pursuant to
the QRF Rules or loses any license, certificate or certification that is required to perform the work or to qualify as a
QRF if Contractor has qualified as a QRF for this agreement; institutes an action for relief in bankruptcy or has
instituted against it an action for insolvency; makes a general assignment for the benefit of creditors; or ceases doing
business on a regular basis of the type identified in its obligations under the Contract; or attempts to assign rights in,
or delegate duties under, the Contract.
16. Insurance. Contractor shall at its own expense provide the following insurance:
a. Worker's Compensation insurance in compliance with ORS 656.017, which requires subject employers to
provide Oregon workers' compensation coverage for all their subject workers
b. General Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, $2,000,000 or Not Applicable for each occurrence for Bodily Injury and Property
Damage. it shall include contractual liability coverage for the indemnity provided under this contract.
C. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than Enter one:
$200,000, $500,000, $1,000,000, or Not Applicable for each accident for Bodily Injury and Property Damage,
including coverage for owned, hired or non-owned vehicles, as applicable.
d. Notice of cancellation or change. There shall be no cancellation, material change, reduction of limits or
intent not to renew the insurance coverage(s) without 30 days' written notice from the Contractor or its insurers to
Contract for Goods and Services Less than $50,000, Revised 06130/2012, Page 2 of 5
the City.
e. Additional Insured/Certificates of Insurance. Contractor shall name The City of Ashland, Oregon, and its
elected officials, officers and employees as Additional Insureds on any insurance policies required herein but only
with respect to Contractor's services to be provided under this Contract. As evidence of the insurance coverages
required by this Contract, the Contractor shall furnish acceptable insurance certificates prior to commencing work
under this contract. The contractors insurance is primary and non-contributory. The certificate will specify all of the
parties who are Additional Insureds. Insuring companies or entities are subject to the City's acceptance. If
requested, complete copies of insurance policies, trust agreements, etc. shall be provided to the City. The
Contractor shall be financially responsible for all pertinent deductibles, self-insured retentions and/or self-
insurance.
17. Governing Law; Jurisdiction; Venue: This contract shall be governed and construed in accordance with the laws
of the State of Oregon without resort to any jurisdiction's conflict of laws, rules or doctrines. Any claim, action, suit or
proceeding (collectively, 'the claim") between the City (and/or any other or department of the State of Oregon) and
the Contractor that arises from or relates to this contract shall be brought and conducted solely and exclusively within
the Circuit Court of Jackson County for the State of Oregon. If, however, the claim must be brought in a federal
forum, then it shall be brought and conducted solely and exclusively within the United States District Court for the
District of Oregon filed in Jackson County, Oregon. Contractor, by the signature herein of its authorized
representative, hereby consents to the in personam jurisdiction of said courts. In no event shall this section be
construed as a waiver by City of any form of defense or immunity, based on the Eleventh Amendment to the United
States Constitution, or otherwise, from any claim or from the jurisdiction.
18. THIS CONTRACT AND ATTACHED EXHIBITS CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE
PARTIES. NO WAIVER, CONSENT, MODIFICATION OR CHANGE OF TERMS OF THIS CONTRACT SHALL
BIND EITHER PARTY UNLESS IN WRITING AND SIGNED BY BOTH PARTIES. SUCH WAIVER, CONSENT,
MODIFICATION OR CHANGE, IF MADE, SHALL BE EFFECTIVE ONLY IN THE SPECIFIC INSTANCE AND FOR
THE SPECIFIC PURPOSE GIVEN. THERE ARE NO UNDERSTANDINGS, AGREEMENTS, OR
REPRESENTATIONS, ORAL OR WRITTEN, NOT SPECIFIED HEREIN REGARDING THIS CONTRACT.
CONTRACTOR, BY SIGNATURE OF ITS AUTHORIZED REPRESENTATIVE, HEREBY ACKNOWLEDGES THAT
HE/SHE HAS READ THIS CONTRACT, UNDERSTANDS IT, AND AGREES TO BE BOUND BY ITS TERMS AND
CONDITIONS.
19. Nonappropriations Clause. Funds Available and Authorized: City has sufficient funds currently available and
authorized for expenditure to finance the costs of this contract within the City's fiscal year budget. Contractor
understands and agrees that City's payment of amounts under this contract attributable to work performed after the
last day of the current fiscal year is contingent on City appropriations, or other expenditure authority sufficient to allow
City in the exercise of its reasonable administrative discretion, to continue to make payments under this contract. In
the event City has insufficient appropriations, limitations or other expenditure authority, City may terminate this
contract without penalty or liability to City, effective upon the delivery of written notice to Contractor, with no further a
liability to Contractor.
20. Prior Approval Required Provision. Approval by the City of Ashland Council or the Public Contracting Officer is
required before any work may begin under this contract. _
21. Certification. Contractor shall sign the certification attached hereto as Exhibit A and herein incorporated by
reference.
Contractor: City of Ashl
BYZ By
Signature Department Head
Mir e ~ vkr 1~~iw
Print Nam Print Name
l"r~si dP, f~S ,-e 6, l I q~l ~
TiJJ Date
W-9 One copy of a W-9 is to be submitted with 9 O
the signed contract. Purchase Order No.
APPR ED WTTM
igna ~j( l ~
Date
Contract for Goods and Services Less than $50,000, Revised 06130/2012, Page 3 of 5
EXHIBIT A
CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perury, certifies that (a) the
number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be
issued to it and (b) Contractor is not subject to backup withholding because (i) it is exempt from
backup withholding or (ii) it has not been notified by the Internal Revenue Service (IRS) that it is
subject to backup withholding as a result of a failure to report all interest or dividends, or (iii) the IRS
has notified it that it is no longer subject to backup withholding. Contractor further represents and
warrants to City that (a) it has the power and authority to enter into and perform the work, (b) the
Contract, when executed and delivered, shall be a valid and binding obligation of Contractor
enforceable in accordance with its terms, (c) the work under the Contract shall be performed in
accordance with the highest professional standards, and (d) Contractor is qualified, professionally
competent and duly licensed to perform the work. Contractor also certifies under penalty of perjury
that its business is not in violation of any Oregon tax laws, and it is a corporation authorized to act on
behalf of the entity designated above and authorized to do business in Oregon or is an independent
Contractor as defined in the contract documents, and has checked four or more of the following
criteria:
V (1) 1 cant' out the labor or services at a location separate from my residence or is in a
specific portion of my residence, set aside as the location of the business.
✓ (2) Commercial advertising or business cards or a trade association membership are
purchased for the business.
(3) Telephone listing is used for the business separate from the personal residence listing.
(4) Labor or services are performed only pursuant to written contracts.
(5) Labor or services are performed for two or more different persons within a period of one
year.
(6) 1 assume financial responsibility for defective workmanship or for service not provided
as evidenced by the ownership of performance bonds, warranties, errors and omission
insurance or liability insurance relating to the labor or services to be provided.
/lO~/0/1~,
Contracto~'~-,,L (Date)
Contract for Goods and services Less than $50,000, Revised 061302012, Page 4 of 5
I
w .wlfxom
OREGON WORKERS COMPENSATION + saiF
CERTIFICATE OF INSURANCE ,corporation
CERTIFICATE HOLDER:
CITY OF ASHLAND
20 EAST MAIN STREET
ASHLAND, OR 97520
The policy of insurance listed below has been Issued to the Insured named below for the
policy period Indicated. The insurance afforded by the policy described herein is subject to
all the terns, exclusions and conditions of such policy.
POLICY NO. POLICY PERIOD ISSUE DATE
497846 01/01/2013 to 01/01/2014 12/31/2012
INSURED: BROKER OF RECORD:
TAYLOR SITE DEVELOPMENT INC
PO BOX 537
MEDFORD,OR 97501-0036
LIMITS OF LIABILITY:
Bodily Injury by Accident $1,000,000 each accident
Bodily Injury by Disease $1,000,000 each employee
Body Injury by Disease $1,000,000 policy limit
DESCRIPTION OF OPERATIONS/LOCATIONS/SPECIAL ITEMS:
North Mountain Park Nature Center Addition
IMPORTANT:
The coverage described above is in effect as of the issue date of this certificate. It is subject to change
at any time in the future.
This certificate is issued as a matter of information only and confers no rights to the certificate holder.
This certificate does not amend, extend or alter the coverage afforded by the policies above. This
certificate does not constitute a contract between the issuing insurer, authorized representative or
producer and the certificate holder.
AUTHORIZED REPRESENTATIVE
President and CEO
4
400 High Street SE
Salem, OR 97312
P: 800.285.8525
r ern non nnnn
OP ID: RMB
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
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 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 endorse s . '
PRODUCER $41-245-1111 IAMB: Marcia Poliman
United Risk Solutions, Inc. 541-2454112 PHOxE 641-245-1111 I FAX
VC NO. 541-245-1112
PO Box 938
Medford, OR 97801-0067 Amnsea: marCla.pollman nitedrisk.com
PRODUCER
TAYL02C
CUSTOMER Ip op, INSURERS) AFFORDING COVERAGE Noce
INSURED Taylor Site Development Inc. INSURER A: West American Insurance Co.
PO Box 537 UIeLNER a: American Insurance Company
Medford, OR 97501 INSURERC:Ohio Casualty 24074
INSURER D:
INSURER E :
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
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.
TYPE OF INSURANCE
INSR POMCY NUMBER MR)CYEFF MSV E% UNITS
GENERAL UAM TTY EACH OCCURRENCE $ 1,000,006
A X GOMMERGIALGENERALUXBILRY X BKW1254278864 10/08112 10/08/13 PREA11ses Ee oaMrorSro $ 1,000,000
CLMM8 AADE OCCUR MED EXP (Anr one Peron) S 15,00
PERSONAL S NOV IN.0.1RY S 1,000,000
GENERAL AGGREGATE $ 2,000,000
OENL AGGREGATE LIMB APPLIES PER: PRODUCTS-GOMPK]PAGG S 2,000,000
POLICY X PRO- LOC f
AECT AUTOMOBILE LIABILITY X COMBINED SINGLE LIMB $ 1,666,666
B JX ANYAUTO BAA1254278864 10/08112 10/09113 (Ee sods )
BODILYIWURY(Per Penn) S
ALLOWNEDAIlr08 BOOILYINJURY(Pme nl) S
SCHEDULED AUTOS PROPERTY DAMAGE
HIREDAU'rOS (Per smidet) NON OWNED AUTOS S
S
X UMBRELLA UAB X OCOUR EAQ OCCURRENCE $ 2,000,06
C U801255283947 1o/0an2 loroan3
DEDUCTIBLE $
EXCESS OAS CLAIMS-MADE OEL.DIS~SE-EA $ 2,000,
X RETENnCN S 10,000 S
WORKERS COMPENSATION OTH-
ANDEMPLOYERSLIABILITY YIN ANY PROPRIETORIPARTNER IEXEWTNE NT S
OFFIC "EMBER EXCLUDED? NIA
(MMdMory In NH) EMPLO S
11 yyeess,,CesCSO
DESCRIPnDNOF OFO LICY LIMIT $
OPERATIONS Debr
DESMMONOFOPERATIONSILOCATIONSIVEHK:LESpwA<NACORD101,MdkbnWRemrbfth uKsmome bnpubM)
Re: Nature Center Addition at North Mountain Park
The City of Ashland, Oregon, and Its elected officials, officers and
employees are Additional Insured per attached CA8810 01110 and CG8811 10/09;
coverage Is Pri narryy and Non-Cofributory, for General Liability. Cancellation
r attached CGS 061 05/11.
CERTIFICATE HOLDER CANCELLATION
CITA803
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCMUED BEFORE
City of Ashland THE EXPIRATION DATE THEREOF, NOTICE VALL BE DELIVERED IN
20 E Main Street ACCORDANCE WITH THE POLICY PROVISIONS.
Ashland, OR 97520
AUTHORIZED R~EP~RS.ES~E~NNT/TATIVE ~~/J 1y
~LSR//r/e Q A~/%'_
®1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
I
COMMERCIAL AUTO
CA 88 10 01 10
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified
by the endorsement
COVERAGE INDEX
SUBJECT PROVISION NUMBER
ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT 3
ACCIDENTAL AIRBAG DEPLOYMENT 12
AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 18
AMENDED FELLOW EMPLOYEE EXCLUSION 5
AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13
BROAD FORM INSURED 1
BODILY INJURY REDEFINED 21
EMPLOYEES AS INSUREDS (including employee hired auto) 2
EXTENDED CANCELLATION CONDITION 22
EXTRA EXPENSE - BROADENED COVERAGE 10
GLASS REPAIR - WAIVER OF DEDUCTIBLE 15
HIRED AUTO PHYSICAL DAMAGE(Including employee hired auto) 6
HIRED AUTO COVERAGE TERRITORY 20
LOAN / LEASE GAP 14
PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE) 16
PERSONAL EFFECTS COVERAGE 11
PHYSICAL DAMAGE - ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8
RENTAL REIMBURSEMENT g
SUPPLEMENTARY PAYMENTS 4
TOWING AND LABOR 7
UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 17
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 19
SECTION II - LIABILITY COVERAGE is amended as follows:
1. BROAD FORM INSURED
SECTION it - LIABILITY COVERAGE, paragraph A.1. - WHO IS AN INSURED Is amended to include
the following as an insured:
d. Any legally incorporated entity of which you own more than 50 percent of the voting stock
during the policy period. However, "insured" does not include any organization that:
(1) Is a partnership or joint venture; or
(2) Is an insured under any other automobile policy; or
(3) Has exhausted its Limit of insurance under any other automobile policy.
Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in
excess of this policy.
e. Any organization you newly acquire or form, other than a partnership orjoint venture, of which
you own more than 50 percent of the voting stock. This automatic coverage is afforded only for
180 days from the date of acquisition or formation. However, coverage under this provision
does not apply:
(1) If there is similar Insurance or a self-insured retention plan available to that organization;
02010 Liberty Mutual Insurance Company. All rights reserved.
CA SS 10 01 10 Includes copyrighted material of Insurance Services Office Inc., with Its Permission Page 1 of 7
(2) If the Limits of Insurance of any other insurance policy have been exhausted; or
(3) To "bodily injury" or "property damage" that occurred before you acquired or formed the
organization.
2. EMPLOYEES AS INSUREDS
SECTION If - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include
the following as an insured:
f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but
only for acts within the scope of their employment by you. Insurance provided by this endorse-
ment is excess over any other insurance available to any "employee".
g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract
or agreement in that "employee's" name, with your permission, while performing duties re-
lated to the conduct of your business and within the scope of their employment. Insurance
provided by this endorsement is excess over any other insurance available to the "employee".
3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT
SECTION II - LIABILITY COVERAGE, paragraph A.I. - WHO IS AN INSURED is amended to include
the following as an Insured:
h. Any person or organization with respect to the operation, maintenance or use of a covered
"auto", provided that you and such person or organization have agreed In a written contract,
agreement, or permit issued to you by governmental or public authority, to add such person, or
organization, or governmental or public authority to this policy as an "insured".
However, such person or organization is an "insured":
(1) Only with respect to the operation, maintenance or use of a covered "auto";
(2) Only for "bodily injury" or "property damage" caused by an "accident" which takes
place after you executed the written contract or agreement, or the permit has been
issued to you; and
(3) Only for the duration of that contract, agreement or permit
4. SUPPLEMENTARY PAYMENTS
SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para-
graphs (2) and (4) are replaced by the following:
(2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations) required
because of an "accident" we cover. We do not have to fumish these bonds,
(4) All reasonable expenses Incurred by the insured at our request, including actual loss of earn-
ings up to $500 a day because of time off from work.
5. AMENDED FELLOW EMPLOYEE EXCLUSION
In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to
the employer by the workers compensation exclusivity rule, or similar protection, the following
provision Is added:
SECTION II - LIABILITY, exclusion 8.5. FELLOW EMPLOYEE does not apply if the "bodily injury"
results from the use of a covered "auto" you own or hire.
SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows:
8. HIRED AUTO PHYSICAL DAMAGE
Paragraph A.4. Coverage Extensions of SECTION III - PHYSICAL DAMAGE COVERAGE, is amended
by adding the following:
If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified
Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any
"auto" you own, then the Physical Damage coverages provided are extended to "autos":
a. You hire, rent or borrow; or
02010 Liberty Mutual Insurance Company. All rights reserved.
CA 88 10 01 10 Includes copyrighted material of Insurance Services office Inc., with its Permission. Page 2 of 7
b. Your "employee" hires or rents under a written contract or agreement in that "employee's"
name, but only if the damage occurs while the vehicle is being used in the conduct of your
business,
subject to the following limit and deductible:
A. The most we will pay for "loss" in any one "accident" or "loss" Is the smallest of:
(1) $50,000; or
(2) The actual cash value of the damaged or stolen property as of the time of the "loss"; or
(3) The cost of repairing or replacing the damaged or stolen property with other property of
like kind and quality, minus a deductible.
B. The deductible will be equal to the largest deductible applicable to any owned "auto" for that
coverage.
C. Subject to the limit, deductible and excess provisions described in this provision, we will
provide coverage equal to the broadest coverage applicable to any covered "auto" you own.
D. Subject to a maximum of $750 per "accident", we will also cover the actual loss of use of the
hired "auto" if it results from an "accident", you are legally liable and the lessor Incurs an
actual financial loss.
E. This coverage extension does not apply to:
(1) Any "auto" that Is h[red, rented or borrowed with a driver; or
(2) Any "auto" that is hired, rented or borrowed from your "employee".
For the purposes of this provision, SECTION V - DEFINITIONS Is amended by adding the following:
"Total loss" means a "loss" in which the coat of repairs plus the salvage value exceeds the actual
cash value.
7. TOWING AND LABOR
SECTION III - PHYSICAL DAMAGE COVERAGE, paragraph A.2. Towing, is amended by the addition
of the following:
We will pay towing and labor costs incurred, up to the limits shown below, each time a covered
"auto" classified and rated as a private passenger type, "light truck" or "medium truck" is dis-
abled:
a. For private passenger type vehicles, we will pay up to $50 per disablement.
b. For "light trucks", we will pay up to $50 per disablement. "Light trucks" are trucks that have a
gross vehicle weight (GVW) of 10,000 pounds or less.
c. For "medium trucks" , we will pay up to $150 per disablement. "Medium trucks" are trucks that
have a gross vehicle weight (GVW) of 10,001 - 20,000 pounds.
However, the labor must be performed at the place of disablement.
8. PHYSICAL DAMAGE- ADDITIONAL TRANSPORTATION EXPENSE COVERAGE
Paragraph A.4 a., Coverage Extension of SECTION III - PHYSICAL DAMAGE COVERAGE, Is amend-
ed to provide a limit of $50 per day and a maximum limit of $1,500
02010 Liberty Mutual Insurance Company. All rights reserved.
CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Ina, with Its Permission. Page 3 of 7
9. RENTAL REIMBURSEMENT
SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the following:
a. We will pay up to $75 per day for rental reimbursement expenses incurred by you for the rental
of an "auto" because of "accident" or "loss", to an "auto" for which we also pay a "loss"
under Comprehensive, Specified Causes of Loss or Collision Coverages. We will pay only for
those expenses incurred after the first 24 hours following the "accident" or "loss" to the
covered "auto."
b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many
cases may be substantially less than $75 per day, and will only be allowed for the period of
time it should take to repair or replace the vehicle with reasonable speed and similar quality, up
to a maximum of 30days.
c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove
and replace your tools and equipment from the covered "auto".
d. This coverage does not apply unless you have a business necessity that other "autos" avail-
able for your use and operation cannot fill.
9. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will
pay under this coverage only that amount of your rental reimbursement expenses which is not
already provided under Paragraph 4. Coverage Extension.
C No deductible applies to this coverage.
For the purposes of this endorsement provision, materials and equipment do not include "personal
effects" as defined in provision 11.
10. EXTRA EXPENSE - BROADENED COVERAGE
Under SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, we will pay for the expense of
returning a stolen covered "auto" to you. The maximum amount we will pay is $1,000.
11. PERSONAL EFFECTS COVERAGE
A. SECTION 111 - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, is amended by adding the
following:
If you have purchased Comprehensive Coverage on this policy for an "auto" you own and that
"auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal
effects" stolen with the "auto."
The insurance provided underthis provision Is excess over any other collectible Insurance.
B. SECTION V - DEFINITIONS is amended by adding the following:
For the purposes of this provision, "personal effects" mean tangible property that is worn or
carried by an Insured." "Personal effects" does not Include tools, equipment, jewelry, money
or securities.
12. ACCIDENTAL AIRBAG DEPLOYMENT
SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS is amended by adding the follow-
ing:
If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion for
"loss" relating to mechanical breakdown does not apply to the accidental discharge of an alrbag.
Any Insurance we provide shall be excess over any other collectible insurance or reimbursement by
manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov-
erage or warranty.
13. AUDIO, VISUAL AND DATA ELECTRONIC EOUIPMENT COVERAGE
SECTION III - PHYSICAL DAMAGE COVERAGE, B. EXCLUSIONS, exception paragraph a. to exclu.
sions 4.c. and 4.d. is deleted and replaced with the following:
(2010 Liberty Mutual Insurance Company. All rights reserved
CA 88 10 01 10 Includes copyrighted materiel of Insurance Services Office Inc., with its Permission. Page 4 of 7
Exclusion 4.c. and 4.d. do not apply to:
a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not
designed solely for the reproduction of sound, if the equipment is permanently installed in the
covered "auto" at the time of the "loss" and such equipment is designed to be solely operated
by use of the power from the "auto's" electrical system, in or upon the covered "auto" and
physical damage coverages are provided for the covered "auto"; or
If the "loss" occurs solely to audio, visual or data electronic equipment or accessories used with
this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property
will be reduced by a $100 deductible.
14. LOAN I LEASE GAP COVERAGE
A. Paragraph C., LIMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is
amended by adding the following:
The most we will pay for a "total loss" to a covered "auto" owned by or leased to you in any
one "accident" is the greater of the:
1. Balance due under the terms of the loan or lease to which the damaged covered "auto" Is
subject at the time of the "loss" less the amount of:
a. Overdue payments and financial penalties associated with those payments as of the
date of the "loss",
b. Financial penalties imposed under a lease due to high mileage, excessive use or ab-
normal wear and tear,
c. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability
Insurance purchased with the loan or lease,
d. Transfer or rollover balances from previous loans or leases,
e. Final payment due under a "Balloon Loan",
f. The dollar amount of any unrepalred damage which occurred prior to the "total loss"
of a covered "auto",
g. Security deposits not refunded by a lessor,
It. All refunds payable or paid to you as a result of the early termination of a lease
agreement or as a result of the early termination df any warranty or extended service
agreement on a covered "auto",
I. Any amount representing taxes,
j. Loan or lease termination fees; or
2. The actual cash value of the damage or stolen property as of the time of the "loss".
An adjustment for depreciation and physical condition will be made in determining the actual
cash value at the time of the "loss". This adjustment is not applicable In Texas.
B. ADDITIONAL CONDITIONS
This coverage applies only to the original loan for which the covered "auto" that incurred the
loss serves as collateral, or lease written on the covered "auto" that incurred the loss.
C. SECTION V - DEFINTIONS is changed by adding the following:
As used In this endorsement provision, the following definitions apply:
"Total loss" means a "loss" In which the cost of repairs plus the salvage value exceeds the
actual cash value.
A "balloon loan" is one with periodic payments that are insufficient to repay the balance over
the term of the loan, thereby requiring a large final payment.
02010 Liberty Mutual Insurance Company. All rights reserved.
CA 88 10 01 10 Includes copyrighted material of insurance Services Office Ina, with its Permission. Page 5 of 7
16. GLASS REPAIR - WAIVER OF DEDUCTIBLE
Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the
addition of the following:
No deductible applies to glass damage if the glass is repaired rather than replaced.
18. PARKED AUTO COLLISION COVERAGE (WAIVER OF DEDUCTIBLE)
Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE Is amended by the
addition of the following:
The deductible does not apply to "loss" caused by collision to such covered "auto" of the private
passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by
the manufacturer as maximum loaded weight the "auto" Is designed to carry while it is:
a. In the charge of an "insured";
b. Legally parked; and
c. Unoccupied.
The "loss" must be reported to the police authorities within 24 hours of known damage.
The total amount of the damage to the covered "auto" must exceed the deductible shown in the
Declarations.
This provision does not apply to any "loss" H the covered "auto" Is in the charge of any person or
organization engaged in the automobile business.
SECTION IV - BUSINESS AUTO CONDITIONS is amended es follows:
17. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS
SECTION IV- BUSINESS AUTO CONDITIONS, Paragraph 6.2. is amended by adding the following:
If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the
inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this
policy will not be prejudiced.
However, you must report the undisclosed hazard of exposure as soon as practicable after Its
discovery, and we have the right to collect additional premium forany such hazard orexposure.
18. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS
SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced In its entirety by the
following:
a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when It Is
known to:
1. You, if you are an individual;
2. A partner, if you are a partnership;
3. Member, if you are a limited liability company;
4. An executive officer or the "employee" designated by the Named Insured to give such
notice, if you are a corporation.
To the extent possible, notice to us should Include:
(1) How, when and where the "accident" or "loss" took place;
(2) The "Insureds" name and address; and
(3) The names and addresses of any injured persons and witnesses.
19. WAIVER OFTRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.6.. Transfer of Rights of Recovery
Against Others to Us, is amended by the addition of the following:
If the person or organization has waived those rights before an "accident" or "loss", our rights are
waived also.
02010 Liberty Mutual Insurance Company. All rights reserved.
CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc., with its Permission. Page 6 of 7
20. HIRED AUTO COVERAGE TERRITORY
SECTION IV - BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period, Coverage Territory, is
amended by the addition of the following:
f. For "autos" hired 30 days or less, the coverage territory is anywhere in the world, provided that
the insured's responsibility to pay for damages is determined in a "suit", on the merits, In. the
United States, the territories and possessions of the United States of America,.Puerto Rico or
Canada or in a settlement we agree to.
This extension of coverage does not apply to an "auto" hired, leased, rented or borrowed with
a driver.
SECTION V - DEFINITIONS is amended as follows:
21. BODILY INJURY REDEFINED
Under SECTION V - DEFINTIONS, definition C. Is replaced by the following:
"Bodily injury" means physical Injury, sickness or disease sustained by a person, including mental
anguish, mental injury, shock, fright or death resulting from any of these at any time.
COMMMON POLICY CONDITIONS
22. EXTENDED CANCELLATION CONDITION
COMMON POLICY CONDITIONS, paragraph A. - CANCELLATION condition applies except as fol-
lows:
If we cancel for any reason other than nonpayment of premium, we will mail to the first Named
Insured written notice of cancellation at least 60 days before the effective date of cancellation. This
provision does not apply in those states which require more than 60 days prior notice of cancella-
tion.
02010 Liberty Mutual Insurance Company. All rights reserved
CA 88 10 01 10 Includes copyrighted materiel of insurance Services Office Inc., with its Permission. Page 7 of 7
COMMERCIAL GENERAL LIABILITY
CG 88 11 10 09
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY EXTENSION
(Oregon)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
INDEX
SUBJECT PAGE
NON-OWNED AIRCRAFT 2
NON-OWNED WATERCRAFT 2
PROPERTY DAMAGE LIABILITY - ELEVATORS 2
EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2
MEDICAL PAYMENTS EXTENSION 3
EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B 3
ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT 3
PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5
ADDITIONAL INSUREDS. EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE" 5
WHO IS AN INSURED - INCIDENTIAL MEDICAL ERRORSIMALPRACTICE AND WHO IS AN INSURED - 8
FELLOW EMPLOYEE EXTENSION - MANAGEMENT EMPLOYEES
NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 8
FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7
KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT 7
LIBERALIZATION CLAUSE 7
BODILY INJURY REDEFINED 7
EXTENDED PROPERTY DAMAGE 7
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 7
WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU
02010 Liberty Mutual Insurance Company. All rights reserved.
CO 8811 10 09 Includes copyrighted materiel of insurance Services office Inc., with its permission. Page 1 of 7
With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by
the endorsement.
A. NON-OWNED AIRCRAFT
Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability,
exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided:
1. It is not owned by any insured;
2. It is hired, chartered or loaned with a trained paid crew;
3. The pilot in command holds a currently effective certificate, issued by the duly constituted authority of
the United States of America or Canada, designating her or him a commercial or airline pilot; and
4. It is not being used to carry persons or property for a charge.
However, the Insurance afforded by this provision does not apply if there is available to the insured other
valid and collectible insurance, whether primary, excess (other then insurance written to apply specifically
in excess of this policy), contingent or on any other basis, that would also apply to the loss covered under
this provision.
B. NON-OWNED WATERCRAFT
Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liability,
Subparagraph (2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following:
This exclusion does not apply to!
(2) A watercraft you do not own that is:
(a) Less then 52 feet long; and
(b) Not being used to carry persons or property for a charge;
C. PROPERTY DAMAGE LIABILITY - ELEVATORS
1. Under Paragraph 2. Exclusions of Section I - Coverage A - Bodily Injury And Property Damage Liabil-
ity, Subparagraphs (3), (4) and (8) of exclusion J. Damage To Property do not apply If such "property
damage" results from the use of elevators. For the purpose of this provision, elevators do no include
vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations.
2. The following Is added to Section IV - Commercial General Liability Conditions, Condition 4. Other
Insurance, Paragraph b. Excess Insurance:
The insurance afforded by this provision of this endorsement is excess over any property insurance,
whether primary, excess, contingent or on any other basis.
D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage)
If Damage To Premises Rented To You is not otherwise excluded from this Coverage Part:
1. Under Paragraph 2. Exclusions of Section I -Coverage A - Bodily Injury and Property Damage Liability:
a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow-
ing:
Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage", other than damage
by fire, lightning, explosion, smoke or leakage from automatic fire protection system) to:
(i) Premises rented to you for a period of 7 or fewer consecutive days; or
(ii) Contents that you rent or lease as part of a premises rental or lease agreement for a period of
more than 7 days.
Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to contents of
premises rented to you for a period of 7 or fewer consecutive days.
02010 Liberty Mutual insurance Company. All rights reserved.
CG 88 11 10 09 Includes copyrighted material of Insurance Services Office Inc., with its permission. Page 2 of 7
A separate limit of Insurance applies to this coverage as described In Section 111 - Limits of
Insurance.
b. The last paragraph of subsection 2. Exclusions is replaced by the following:
Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke, or leakage
from automatic fire protection systems to premises while rented to you or temporarily occupied by
you with permission of the owner. A separate limit of Insurance applies to Damage To Premises
Rented To You as described in Section III - Limits of Insurance.
2. Paragraph 5. under Section III - Limits of Insurance is replaced by the following:
6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will
pay under Coverage A for damages because of "property damage" to:
e. Any one premise:
(1) While rented to you, or
(2) While rented to you or temporarily occupied by you with permission of the owner for
damage by fire, lightning, explosion, smoke or leakage from automatic protection sys-
tems; or
b. Contents that you rent or lease as part of a premises rental or lease agreement.
As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU
(Tenant's Property Damage)- Paragraph g.a. of Definitions Is replaced with the following:
g.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises
that Indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or
leakage from automatic fire protection systems to premises while rented to you or temporarily
occupied by you with the permission of the owner, or for damage to contents of such premises
that are included in your premises rental or lease agreement, is not an "insured contract".
E. MEDICAL PAYMENTS EXTENSION
If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy
are amended as follows:
Under Paragraph 1. Insuring Agreement of Section I - Coverage C - Medical Payments, Subparagraph
(b) of Paragraph a. Is replaced by the following:
(b) The expenses are Incurred and reported within three years of the date of the accident; and
F. EXTENSION OF SUPPLEMENTARY PAYMENTS - COVERAGES A AND B
1. Under Supplementary Payments -Coverages A and 8, Paragraph 1.b. Is replaced by the following:
b. Up to $3,000 for cost of bell bonds required because of accidents or traffic low violations arising
out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have
to furnish these bonds.
2. Paragraph 1.d. Is replaced by the following:
d. All reasonable expenses incurred by the Insured at our request to assist us in the investigation or
defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time
off from work.
G. ADDITIONAL INSUREDS - BY CONTRACT, AGREEMENT OR PERMIT
1. Paragraph 2. under Section II - Who Is An Insured is amended to include as an Insured any person or
organization whom you have agreed to add as an additional Insured in a written contract, written
agreement or permit. Such person or organization is an additional insured but only with respect to
liability for "bodily injury", "property damage" or "personal and advertising injury" caused by:
02010 Liberty Mutual Insurance Company. All rights reserved.
CG Sg 11 10 09 Includes copytighted material of Insurance Services office Inc., with its permission. Page 3 of 7
a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance
of your on going operations for the additional Insured that are the subject of the written contract or
written agreement provided that the "bodily injury" or "property damage" occurs, or the "per-
sonal and advertising injury" is committed, subsequent to the signing of such written contract or
written agreement; or
b. Premises or facilities rented by you or used by you; or
c. The maintenance, operation or use by you of equipment rented or leased to you by such person or
organization; or
d. Operations performed by you or on your behalf for which the state or political subdivision has
issued a permit subject to the following additional provisions:
(1) This insurance does not apply to "bodily Injury", "property damage", or "personal and ad-
vertising injury" arising out of the operations performed for the state or political subdivision;
(2) This insurance does not apply to "bodily injury" or "property damage" included within the
"completed operations hazard".
(3) Insurance applies to premises you own, rent, or control but only with respect to the following
hazards:
(a) The existence, maintenance, repair, construction, erection, or removal of advertising
signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees,
hoist away openings, sidewalk vaults, street banners, or decorations and similar expo-
sures; or
(b) The construction, erection, or removal of elevators; or
(c) The ownership, maintenance, or use of any elevators covered by this insurance.
With respect to Paragraph I.e. above, a person's or organization's status as an additional insured
under this endorsement ends when:
(1) All work, including materials, parts or equipment furnished in connection with such work, on
the project (other than service, maintenance or repairs) to be performed by or on behalf of the
additional Insured(s) at the location of the covered operations has been completed; or
(2) That portion of "your work" out of which the injury or damage arises has been put to its
intended use by any person or organization other than another contractor or subcontractor
engaged in performing operations for a principal as a part of the same project.
With respect to Paragraph 1.b.above, a person's or organization's status as an additional insured under
this endorsement ends when their written contract or written agreement with you for such premises or
facilities ends.
With respects to Paragraph t.c. above, this Insurance does not apply to any "occurrence" which takes
place after the equipment rental or lease agreement has expired or you have returned such equipment
to the lessor.
The insurance providedby this endorsement applies only If the written contract or written agreement
is signed prior to the "bodily injury" or "property damage".
We have no duty to defend an additional insured under this endorsement until we receive written
notice of a "suit" by the additional Insured as required in Paragraph b. of Condition 2. Duties In the
Event Of Occurrence, Offense, Claim Or Suit under Section IV - Commercial General Liability Condi-
tions.
2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2.
Exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability:
02010 Liberty Mutual Insurance Company. All rights reserved.
CG 88 11 10 09 Includes copyrighted material of Insurance Services Office Ina, with its permission. Page 4 of 7
This Insurance does not apply to:
a. "Bodily Injury" or "property damage" arising from the sole negligence of the additional Insured.
b. "Bodily Injury" or "property damage" that occurs prior to you commencing operations at the
location where such "bodily Injury" or "property damage" occurs.
c. "Bodily injury", "property damage" or "personal and advertising Injury" arising out of the render-
Ing of, or the failure to render, any professional architectural, engineering or surveying services,
including:
(1) The preparing, approving, or falling 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.
d. "Bodily injury" or "property damage" occurring after:
(1) All work, Including materiels, parts or equipment furnished In connection with such work, on
the project (other than service, maintenance or repairs) to be performed by or on behalf of the
additional insured(s) at the location of the covered operations has been completed; or
(2) That portion of "your work" out of which the injury or damage arises has been put to its
Intended use by any person or organization other than another contractor or subcontractor
engaged In performing operations for a principal as a part of the same project.
e. Any person or organization specifically designated as an additional Insured for ongoing operations
by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is-
sued by us and made a part of this policy.
H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION
This provision applies to any person or organization who qualifies as an additional Insured under any form
or endorsement under this policy.
Condition 4. Other Insurance of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amend-
ed as follows:
a. The following is added to Paragraph a. Primary Insurance:
If an additional insured's policy has an Other Insurance provision making Its policy excess, and yot)
have agreed in a written contract or written agreement to provide the additional insured coverage on e
primary and noncontributory basis, this policy shall be primary and we will not seek contribution from
the additional Insured's policy for damages we cover.
b. The following Is added to Paragraph b. Excess Insurance:
When a written contract or written agreement, other than a premises lease, facilities rental contract or
agreement, an equipment rental or lease contract or agreement, or permit Issued by a state or political
subdivision between you and an additional Insured does not require this insurance to be primary or
primary and non-contributory, this insurance is excess over any other Insurance for which the addi-
tional insured is designated as a Named Insured.
Regardless of the written agreement between you and an additional insured, this Insurance is excess
over any other insurance whether primary, excess, contingent or on any other basis for which the
additional insured has been added as an additional insured on other policies.
1. ADDITIONAL INSUREDS- EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE"
This provision applies to any person or organization who qualifies as an additional Insured under any
form or endorsement under this policy.
1. The following is added to Condition 2. Duties In The Event Of Occurrence, Offense, Claim or Suit:
02010 Liberty Mutual Insurance Company. All rights reserved.
CG 8811 10 09 includes copyrighted material of Insurance Services Office Inc., with Its permission. Page 5 of 7
An additional Insured under this endorsement will as soon as practicable:
a. Give written notice of an "occurrence" or an offense, that may result in a claim or "suit" under
this insurance to us;
b. Tender the defense and indemnity of any claim or "suit" to all insurers whom also have
insurance available to the additional insured; and
c. Agree to make available any other insurance which the additional insured has for a loss we
cover under this Coverage Part.
d. We have no duty to defend or indemnify an additional insured under this endorsement until
we receive written notice of a "suit" by the additional insured.
2. The limits of insurance applicable to the additional insured are those specified in a written contract
or written agreement or the limits of insurance as stated in the Declarations of this policy and
defined in Section III - Limits of Insurance of this policy, whichever are less. These limits are
inclusive of and not in addition to the limits of insurance available under this policy.
J. WHO IS AN INSURED- INCIDENTIAL MEDICAL ERRORS / MALPRACTICE
WHO IS AN INSURED - FELLOW EMPLOYEE EXTENSION- MANAGEMENT EMPLOYEES
Paragraph 2.a.(1) of Section II - Who Is An Insured is replaced with the following:
(1) "Bodily injury" or "personal and advertising Injury":
(a) To you, to your partners or members (if you are a partnership or joint venture(, to your members (if
you are a limited liability company), to a co-"employee" while in the course of his or her employ-
ment or performing duties related to the conduct of your business, or to your other "volunteer
workers" while performing duties related to the conduct of your business;
(b) To the spouse, child, parent, brother or sister of that co-"employee" or "volunteer worker" as e
consequence of Paragraph (1) (a) above;
(c) For which there is any obligation to share damages with or repay someone else who must pay
damages because of the Injury described In Paragraphs (1) (a) or (b) above; or
(d) Arising out of his or her providing or failing to provide professional health care services. However,
if you are not in the business of providing professional health care services or providing profes-
sional health care personnel to others, or if coverage for providing professional health care ser-
vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d)) does not
apply.
Paragraphs (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by
an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means
the "employee's" job responsibilities assigned by you, includes the direct supervision of other "employ-
ees" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and
advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to
cause "bodily injury" or "personal and advertising Injury", or caused in whole or in part by their intoxica-
tion by liquor or controlled substances.
The coverage provided by provision J. is excess over any other valid and collectable insurance available to
your"' employee".
K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES
Paragraph 3. of Section If - Who Is An Insured is replaced by the following:
3. Any organization you newly acquire or form and over which you maintain ownership or majority
Interest, will qualify as a Named Insured if there is no other similar insurance available to that
organization. However:
a. Coverage under this provision is afforded only until the expiration of the policy period in
which the entity was acquired or formed by you:
b. Coverage A does not apply to "bodily Injury" or "property damage" that occurred before you
acquired or formed the organization; and
02010 Liberty Mutual Insurance Company. All rights reserved.
CG 88 11 10 09 includes copyrighted material of insurance Services Office Inc., with its permission. Page 6 of 7
c. Coverage B does not apply to "personal and advertising Injury" arising out of an offense
committed before you acquired or formed the organization.
d. Records and descriptions of operations must be maintained by the first Named Insured.
No person or organization is an insured with respect to the conduct of any current or past partnership, joint
venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies
for as an Insured under this provision
L FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES
Under Section IV - Commercial General Liability Conditions, the following is added to Condition 8. Repre-
sentations:
Your failure to disclose all hazards or prior "occurrences" existing as of the inception date of the policy
shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or
prior "occurrences" Is riot Intentional.
M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
Under Section IV - Commercial General Liability Conditions, the following Is added to Condition 2. Duties
In The Event of Occurrence, Offense, Claim Or Suit
Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of any
Insured shall not In Itself constitute knowledge of the Insured unless an Insured listed under Paragraph
1. of Section II - Who Is An Insured or a person who has been designated by them to receive reports of
"occurrences", offenses, claims or "suits" shall have received such notice from the agent, servant or
"employee".
N. LIBERALIZATION CLAUSE
If we revise this Commercial General Liability Extension Endorsement to provide more coverage without
additional premium charge, your policy will automatically provide the coverage as of the day the revision is
effective in your state.
0. BODILY INJURY REDEFINED
Under Section V - Definitions, Definition 3. is replaced by the following:
3. "Bodily Injury" means physical injury, sickness or disease sustained by a person. This includes
mental anguish, mental Injury, shock, fright or death that results from such physical injury, sick-
ness or disease.
P. EXTENDED PROPERTY DAMAGE
Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the
following:
a. Expected Or Intended Injury
"Bodily Injury" or "property damage" expected or Intended from the standpoint of the insured.
This exclusion does not apply to "bodily Injury" or "property damage" resulting from the use of
reasonable force to protect persons or property.
0. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A
CONTRACT OR AGREEMENT WITH YOU
Under Section IV - Commercial General Liability Conditions, the following Is added to Condition 8. Trans-
fer Of Rights Of Recovery Against Others To Us:
We waive any right of recovery we may have against a person or organization 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"
provided:
1. You and that person or organization have agreed in writing in a contract or agreement that you
waive such rights against that person or organization; and
2. The Injury or damage occurs subsequent to the execution of the written contract or written agree-
ment.
02010 Liberty Mutual Insurance Company. All rights reserved.
CG BB 11 1008 Includes copyrighted material of Insurance services office Inc., with Its Permission. Page 7 of 7
IL 02 79 09 08
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
OREGON CHANGES - CANCELLATION
AND NONRENEWAL
This endorsement modifies insurance provided under the following:
CAPITAL ASSETS PROGRAM (OUTPUT POLICY) COVERGE PART
COMMERCIAL AUTOMOBILE COVERAGE PART
COMMERCIAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL INLAND MARINE COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
CRIME AND FIDELITY COVERAGE PART
EMPLOYMENT-RELATED PRACTICES LIABILITY COVERAGE PART
EQUIPMENT BREAKDOWN COVERAGE PART
FARM COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
MEDICAL PROFESSIONAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
A. Paragraph 2. of the Cancellation Common violation of the insurance laws
Policy Condition is replaced by the following: of Oregon or any other state; or
2. If this policy has been in effect for: (7) Loss or decrease in reinsurance
covering the risk.
a. Fewer than 60 days and is not a re-
newal policy, we may cancel for any c. 60 days or more or is a renewal poli-
reason. cy, we may cancel for any other rea-
b. 60 days or more or is a renewal poll- son approved by the commissioner
cy, we may cancel only for one or by rule, but only with respect to in-
more of the following reasons: surance provided under the follow-
(s) Nonpayment of premium; ing:
(2) Fraud or material misrepresenta- (1) A package policy that includes
tion made by you or with your commercial property and com-
knowledge in obtaining the poll- mercial liability Insurance;
cy, continuing the policy or in (2) Commercial Automobile Cover-
presenting a claim under the age Part;
policy;
(3) Substantial increase in the risk (3) Commercial General Liability
Coverage Part;
of loss after insurance coverage (4) Commercial Property Coverage
has been Issued or renewed, in-
cluding but not limited to an In- Part -Legal Liability Coverage
Form;
crease in exposure due to rules,
legislation or court decision; (5) Commercial Property Coverage
Part - Mortgageholders Errors
(4) Failure to comply with reason- And Omissions Coverage Form;
able loss control recommenda-
tions; (6) Employment-related Practices
(5) Substantial breach of contrac- Liability Coverage Part;
tual duties, conditions or war- (7) Farm Coverage Part - Farm Li-
ranties; ability Coverage Form;
(6) Determination by the (8) Liquor Liability Coverage Part;
commissioner that the continu- (9) Products/Completed Operations
ation of a line of insurance or Liability Coverage Part; or
class of business to which the (10) Medical Professional Liability
policy belongs will jeopardize Coverage Part.
our solvency or will place us In
IL 02 79 09 08 ®ISO Properties, Inc., 2007 Page 1 of 2
B. Paragraph 3. of the Cancellation Common However, if this policy is issued for a
Policy Condition is amended by the addition term of more than one year and for addi-
of the following: tional consideration the premium is guar-
3. We will mail or deliver to the first Named anteed, we may not refuse to renew the
Insured written notice of cancellation, policy at its anniversary date.
stating the reason for cancellation. Nonrenewal will not be effective until at
C. The following is added to the Cancellation least 45 days after the first Named In-
Common Policy Condition: sured receives our notice.
7. Number Of Days' Notice Of Cancellation: 2. Mailing Of Notices
a. With respect to insurance provided a. If notice of cancellation or
under 2.c.(1) through (10) above, nonrenewal is mailed, a post office
cancellation will not be effective until certificate of mailing will be conclu-
at least 10 working days after the sive proof that the first Named In-
first Named Insured receives our no- sured received the notice on the third
tice. calendar day after the date of the cer-
b. With respect to insurance other than tificate of mailing.
that provided under 2.c.(1) through b. The following provision applies with
(10) above, cancellation will not be respect to coverage provided under
effective until at least: the Farm Coverage Part:
(1) 10 days after the first Named In- If the first Named Insured has affir-
sured receives our notice, if we matively consented to our use of an
cancel for nonpayment of premi- electronic record to deliver notice of
um; or cancellation or nonrenewal and has
(2) 30 days after the first Named In- not withdrawn such consent, then
sured receives our notice, If we the electronic record delivering no-
cancel for any other reason. tice of cancellation or nonrenewal
satisfies the requirement that the no-
D. Paragraph B. of the Cancellation Common tice of cancellation or nonrenewal be
Policy Condition does not apply. provided, or made available, to the
E. The following are added and supersede any first Named Insured in writing .If we
provision to the contrary: send the first Named Insured the
1. Nonrenewal electronic record with a request for a
We may elect not to renew this policy by return receipt and we receive the re-
mailing or delivering to the first Named turn receipt. If we do not receive the
Insured, at the last mailing address return receipt, we may cancel or
known to us, written notice of nonrenew the policy only after pro-
nonrenewal before the: viding or delivering the notice of can-
cellation or nonrenewal to the first
a. Expiration date of the policy; or Named Insured In writing, subject to
b. Anniversary date of the policy if the . Paragraph 2.e. above.
policy is written for a term of more
than one year or without a fixed ex-
piration date.
Page 2 of 2 *ISO Properties, Inc., 2007 IL 02 79 09 08
COMMERCIAL GENERAL LIABILITY
CG 80 61 0511
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AMENDMENT OF CANCELLATION PROVISIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Any term or provision of the Cancellation Conditions of the policy or any endorsement amending or replacing such Conditions
is amended by the following:
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the person or organization
shown in the Schedule below. In no event will the notice to the person or organization scheduled below exceed the
notice to the first named insured.
B. Our obligation to send notice to the person or organization listed in the Schedule below will terminate at the earlier of
the current policy period expiration or when you no longer have a legal or contractual obligation to such person or
organization to maintain insurance coverage under a policy which requires that such person or organization be notified
in the event of cancellation.
SCHEDULE
1. Name:
City of Ashland
Project: Nature Center Addition at North Mountain Park
2. Address:
20 E. Main St.
Ashland, OR 97520
3. Number of days advance notice:
30
All other terms and conditions of this policy remain unchanged.
® 2011 Liberty Mutual Agency Corporation. All rights reserved.
CG 80 6105 11 Includes copyrighted material of Insurance services office, Inc., with Its permission. Page 1 of 1
QTY RECO DER Page 1/ 1
CITY OF ASHLAND ;:.,DATE ''PO 71
1/9/2013 11390 1390
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 001735 SHIP TO: Ashland Parks
TAYLOR SITE DEVELOPMENT INC C/O 90 N. MOUNTAIN
PO BOX 537 (541) 488-5354
MEDFORD, OR 97501 ASHLAND, OR 97520
FOB Point: Req. No.:
Terms: Net Dept.:
Req. Del. Date: Contact: Rachel Dials
special Inst: Confirming? NO
Description UnItPrice Ext. Price
North Mountain Park 41,503.00
Nature Center Addition
Contract for Goods and Services
Beginninq date: January 7, 2013
Completion date: May 7, 2013
rm
SUBTOTAL 41 503.00
BILL To: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 41;503.00
ASHLAND OR 97520
Account Number -,Brojecb Number "Amount Acc'oynt.Number
E 410.03.22.00.70420 E 000303.999 41 503.00
u orked Si atfu VENDOR COPY
FORM#3 CITY OF
A request for a Purchase Order ASHLAND
REQUISITION Date of request:. I / 1411 Z
Required date for delivery:
Vendor Name cki-~Iop_Sir£- Qeyvl4fr t+
Address, City, State, Zip t D. (w S3
Contact Name & Telephone Number yL k ( c' _ 31
Fax Number
C~~iI x.-x-- ~D3)
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emergency
❑ Reason for exemption: Invitation to Bid (Copies on fil$) ❑ Form #13, Written findings and Authorization
❑ AMC 2.50 ate approved by Council: ti I A ❑ Written quote or proposal attached
❑ Written quote or proposal attached
❑ Small Procurement Cooperative Procurement
Less than $5,000 ❑ Request for Proposal (Copies on Me) ❑ State of Oregon
❑ Direct Award Dale approved by Council: Contract #
❑ Verbal/Written quote(s) or proposal(s) ❑ State of Washington
Intermediate Procurement ❑ Sole Source Contract #
GOODS & SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract
$5,000 to $100,000 ❑ Written quote or proposal attached Agency
❑ (3) Written quotes attached ❑ Form #4, Personal Services $5K to $75K Contract #
PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement
$5,000 to $75,000 ❑ Form #9, Request for Approval ❑ Agency
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council:
❑ (3) Written proposals attached Date approved by Council: (Date)
❑ Form #4, Personal Services $5K to $75K Valid until: Date
Description of SERVICES Total Cost
orYl9 luKN Qrr>^ut_ ~1[th1 G~2 Aei'k(tio~i q~ .
s\:w,~nwtius~rL+cAXVN\oX')6J$ -4I5b~
r
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
TOTAL COST
❑ Per attached quotelproposal $
Project Number ~CO Q ~ct~j Account Number!lD-CIZ~-ZZ-10D-'&) U_(D
Account Number Account Number
`Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures.
IT Director in collaboration with department to approve all hardware and software purchases:
ITDirector Date Support -Yes/No
ynmg this quisid form, I certify that the City's public contracting requirements hay been satisfied.
Employee Signature: V I Y /1 Department Head Signature:/
i (Equal to or greater than $5,000)
Additional signatures (if applicable): / U A vt QUI
Funds appropriated for current fiscal year NO A~/~ U t N P13
Finance Director- (Equal to orgre han $ 5,000) Date
Comments:
Form #3-Requisition .
STEVE ENNIS ARCHITECT
TRANSMITTAL SHEET
TO: FROM:
Rachel Dials Steve Ennis
Recreation Superintendent
COMPANY: DATE:
Ashland Parks and Recreation 1/3/13
ADDRESS:
340 South Pioneer Street
Ashland, OR 97520
RE:
North Mountain Park DELIVERED TO NATURE
Nature Center Addition CENTER
❑ URGENT ❑ FOR REVIEW ❑ PLEASE COMMENT ❑ PLEASE REPLY ❑ PLEASE RECYCLE
NOTES/COMMENTS:
Rachel,
Attached are the following from Taylor Site Development for your review and approval:
1. Signed copy of the Contract.
2. W-9.
3. Workers Compensation Certificate of Insurance.
4. Certificate of Liability Insurance, including four Endorsements.
The paperwork looks complete to me and I copied the pages I needed. The Contractor would like to start on
1/15/13. Please let me know if there is anything else I can do to get this project started.
S erely,
Steve Ennis
P. O. BOX 4051 - 2870 NANSEN DRIVE - MEDFORD, OR 97501
PHONE: (541) 618-9155 - FAX: (541) 618-9156