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HomeMy WebLinkAbout2019-200 20200016 UNIVAR USA Inc. Contract for WTP & WWTP Chemicals (ITB #2019-101) CONTRACTOR: Univar USA Inc. CITY OF AS I-I LAN D CONTACT: Jennifer M. Perras, Municipal Specialist 20 East Main Street ADDRESS: 8201 S. 212th, Kent, WA 98032 Ashland, Oregon 97520 Telephone: 541/488-6002 TELEPHONE: 253-872-5040 Fax: 541/488-5311 EMAIL: muniteam-west @univar.com EFFECTIVE DATE: July 1, 2019 COMPLETION DATE: June 30, 2021 COMPENSATION AND GOODS AND SERVICES TO BE PROVIDED: All chemicals are to be provided and delivered as specified in the ITB#2019-101 bid specifications.The bid submitted by Univar USA Inc. is attached as Exhibit C. Contract was approved by the City Council on May 21, 2019. Water Treatment Plant—Chemical#3 Cytec Superfloc N-300 LMW Flocculant Manufacturer: Cytec Pricing for July 2019 to June 2020 $1,160.00 per order($2.90 per pound, Cost per 55.12lb bag$145.00, Eight(8) bags per order, no additional delivery charge) Pricing for July 2020 to June 2021 $1,260.00 per order($3.15 per pound, Cost per 55.12lb bag$157.50, Eight(8) bags per order, no additional delivery charge) Wastewater Treatment Plant—Chemical #7 Citric Acid (50 Lb Bags) Manufacturer: Tate & Lyle Pricing for July 2019 to June 2020 $2,425.00 per order($0.97 per pound, 50Lb bags, 50 Bags per order, no additional delivery charge) Pricing for July 2020 to June 2021 $2,550.00 per order($1.02 per pound, 50Lb bags, 50 Bags per order, no additional delivery charge) ADDITIONAL TERMS: In the event of a conflict or discrepancy among the contract documents,this City of Ashland Contract for Goods and Services will be primary and take precedence,and any exhibits or ancillary agreements having redundant or contrary provisions will be subordinate to and interpreted in a manner that will not conflict with the said primary City of Ashland Contract. 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. �� Compepsati a r-this-ccaRtrast-inc4 g-alt-Goats-a penses-a .8 Contra •- -- - -,'IS•.••, - .separate_writteci_ •• - • -• - -• '• • • •- • 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, 279B.225, 279B.230, 279B.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 $21,127.46 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. Contract for WTP&WWTP Chemicals#2019-101, Page 1 of 6 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, subrogations, actions, costs, judgments, or other damages, directly, solely, and proximately caused by the negligence of City. 9. Termination: a. Mutual Consent. This contract may be terminated at any time 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 City funding from federal, state, county or other sources is not obtained and continued at levels sufficient to allow for the purchase of the indicated quantity of services; H. 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 Hi. 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. ii. 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. Hi. 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, cord 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. Non-discrimination 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 Contract for WTP&WWTP Chemicals#2019-101, Page 2 of 6 • '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 $2,000,000 for each occurrence for Bodily Injury and Property Damage. c. Automobile Liability insurance with a combined single limit, or the equivalent, of not less than $1,000,000, 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 insurer(s) to 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, excluding Worker's' Compensation, 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 contractor's 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 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. 22. Consultant's compliance with Oregon Tax Law: (1) Consultant represents and warrants to the City that Consultant shall, throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS Chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Consultant; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or Contract for.WTP&WWTP Chemicals#2019-101, Page 3 of 6 provisions. (2) Consultant represents and warrants that, for a period of no fewer than six (6) calendar years preceding the Effectiv of this Agreement, it has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS Chapters 316, 317, and 318 (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Consultant; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax I provisions. Contractor: City of Ashland By By Signat Department Head Print Name Print Name Mar:.a 00.,.I 004E7 Title Date W-9 to be submitted with the signed contract. /f ' a / / Purchase Order No. / v 4 --e• l ,(� =No 0 ,,,00-•-•liORM Alb* A As ttomey Date S Contract for WTP&VVVVfP Chemicals#2019-101, Page 4 of 6 EXHIBIT A CERTIFICATIONS/REPRESENTATIONS: Contractor, under penalty of perjury, 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, it is an independent Contractor as defined in the contract documents, it is authorized to do business in Oregon, it is authorized to act on behalf of the City, and Contractor has checked four or more of the following criteria that apply to its business. (1) I carry 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) I 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. S-33- 1 �t Contractor (Date) Contract for WTP&WWTP Chemicals#2019-101, Page 5 of 6 • • • CITY OF ASHLAND , OREGON EXHIBIT B City of Ashland LIVING ALL employers described WAGE below must comply with City of Ashland laws regulating •a ment of a livin• wa•e. $15.12 per hour effective June 30, 2018 IF (Increases annually every June 30 by the Mr Consumer Price Index) Employees must be paid a portion of business of their 401K and IRS eligible living wage: employer, if the employer has cafeteria plans (including ten or more employees, and childcare) benefits to the has received financial amount of wages received by assistance for the project or the employee. For all hours worked under a business from the City of service contract between their Ashland in excess of ➢ Note: "Employee"does not employer and the City of $21,127.46. include temporary or part-time Ashland if the contract employees hired for less than exceeds$21,127.46 or more. r If their employer is the City of 1040 hours in any twelve- Ashland including the Parks month period. For more For all hours worked in a and Recreation Department. details on applicability of this month if the employee spends policy, please see Ashland 50%or more of the ➢ In calculating the living wage, Municipal Code Section employee's time in that month employers may add the value 3.12.020. working on a project or of health care, retirement, For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall, 20 East Main Street, Ashland, OR 97520 or visit the city's website at www.ashland.or.us. Notice to Employers:This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF ASHLAND Contract for VVTP&VVV TP Chemicals#2019-101, Page 6 of 6 ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/2019 YY) 06/21/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS • CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this w certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 'c m PRODUCER CONTACT 9 — ACM Risk Services Central, Inc. NAME: _ (NC No.ENO: (866) 283-7122 FAX 800-363-0105 Philadelphia PA Office (Am.No.l: as One Liberty Place E-MAIL O 1650 Market Street ADDRESS: _ Suite 1000 Philadelphia PA 19103 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: ACE American Insurance Company 22667 Univar USA, Inc. INSURERS: ,Indemnity Insurance Co of North America 43575 3075 Highland Parkway Suite 200 INSURER C: .ACE Fire underwriters Insurance Co. 20702 Downers Grove IL 60515 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570076924432 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. Limits shown are as requested INSR ADDL SUER POLICY EFF POLICTEXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/ODITYYY1 MMIDD/YWY11 OMITS A X COMMERCIAL GENERAL LIABILITY XSLG71232/36 05/01/2019 06/01/20211 EACH OCCURRENCE $3,000,000 ' CLAIMS-MADE ©OCCUR SIR applies per policy terns & condi ions DAMAGb TO RENTED $1,000,000 PREMISES(Ea occurrence) _ MED EXP(Any one person) Excluded ' PERSONAL 8ADV INJURY $3,000,000 m GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $3,000,000 ry % POLICY �JE0. 0LOC PRODUCTS-COMP/OPAGG $3,000,000 A OTHER: 0 r A AUTOMOBILE LIABILITY ISAH25279578 06/01/201906/01/2020 COMBINED SINGLE LIMIT Commercial Auto (Ea accident) $5,000,000 X ANY AUTO BODILY INJURY(Per person) Z OWNED -SCHEDULED BODILY INJURY(Per ecciderl) m _ _AUTOS AUTOS NON-OWNED PROPERTY DAMAGE Y ONLY _AUTOS ONLY (Per accident) — E 0 UMBRELLA LIAB OCCUR EACH OCCURRENCE 0 EXCESS LIAR CLAIMS-MADE AGGREGATE DEDI (RETENTION B WORKERS COMPENSATIONAND WLRC65891359. 06/01/2019 06/01/2020 x PER STATUTE I OTH- EMPLOYERS'IJABILITY YIN (A0S) ER A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACHACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED)- © NIA WLRC65891396 06/01/2019 06/01/2020 (Mandatory in NH) (AZ, MA) E.L.DISEASE-EA EMPLOYEE $1,000,000 It y describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000— imi DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) Location: Portland. City of Ashland and all employees are included as Additional Insured on the General Liability and Automobile Liability Policies with respect to written contract for delivery of treatment chemicals. Univar is self-insured for physical damage to their vehicles. ' C �.a CERTIFICATE HOLDER CANCELLATION -a..a SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE �y ' POLICY PROVISIONS. ¢ City of Ashland AUTHORIZED REPRESENTATIVE r Attn: Kari Olson ' 90 N. Mountain Avenue i Ashland OR 97520 USA tilV•LC�!/LILYG L S ©1968-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD L--------7 . ` AGENCY CUSTOMER ID: 570000014538 LOC#: ,4 ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk Services Central, Inc. Univar USA, Inc. POLICY NUMBER See Certificate Number: 570076924432 CARRIER NAIC CODE See Certificate Number: 570076924432 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S)AFFORDING COVERAGE NAIC# INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. POLICY POLICY INSR ADDL SUBR POLICY NUMBER EFFECTIVE EXPIRATION LIMITS LTR TYPE OF INSURANCE INSD W VD DATE DATE (MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY A MMTH2527961A 06/01/2019 06/01/2020 Combined $5,000,000 Truckers Liability Single Limi WORKERS COMPENSATION A N/A WCUC65891475 06/01/2019 06/01/2020 (CA, OH, OR, WA) SIR applies per policy terms & conditions C N/A SCFC65891438 06/01/2019 06/01/2020 (WI) ACORD 101(2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD • CHUBB* SIGNATURES Named Insured Endorsement Number Univar Inc. 7 Policy Symbol Policy Number Policy Period - Effective Date of Endorsement MMT 112527961A 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company THE ONLY COMPANY APPLICABLE TO THIS POLICY IS THE COMPANY NAMED ON THE FIRST PAGE OF THE DECLARATIONS. By signing and delivering the policy to you,we state that it is a valid contract. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA(A stock company) BANKERS STANDARD INSURANCE COMPANY(A stock company) ACE AMERICAN INSURANCE COMPANY(A stock company) ACE PROPERTY AND CASUALTY INSURANCE COMPANY(A stock company) INSURANCE COMPANY OF NORTH AMERICA(A stock company) PACIFIC EMPLOYERS INSURANCE COMPANY(A stock company) ACE FIRE UNDERWRITERS INSURANCE COMPANY(A stock company) WESTCHESTER FIRE INSURANCE COMPANY(A stock company) 436 Walnut Street,P.O.Box 1000,Philadelphia,Pennsylvania 19106-3703 REBECCA L.COLLINS,Secretary JOHN J.LUPICA,President CC-1Klli(02/18) Page 1 oft 1• WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS Named Insured UniVar IBC. - Endorsement Number 31 Policy Symbol Policy Number Policy Period Effective Date of Endorsement MMT H2527961A 06/01/2019 TO 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIERS COVERAGE FORM AUTO DEALERS COVERAGE FORM • We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of the use of a covered auto. The waiver applies only to the person or organization shown in the SCHEDULE. SCHEDULE Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. Authorized Representative r DA-13115a(06/14) Page 1 of 1 • POLICY NUMBER: MMT I-12527961A Endorsement Number: 43 COMMERCIAL AUTO CA 23 05 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WRONG DELIVERY OF LIQUID PRODUCTS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. Covered Autos Liability Coverage is changed by adding Delivery is considered completed even if further service or the following exclusion: . maintenance work, or correction, repair or replacement is This insurance does not apply to: required because of wrong delivery. "Bodily injury" or "property damage" resulting from the delivery of any liquid into the wrong receptacle or to the wrong address, or from the delivery of one liquid for another, if the "bodily injury" or"property damage" occurs after delivery has been completed. CA 23 0510 13 ©Insurance Services Office, Inc.,2011 Page 1 of 1 • 1 NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS Named Insured Univar Inc. Endorsement Number 15 Policy Symbol Policy Number Policy Period Effective Date of Endorsement MMT I-12527961A 06/01/2019 TO 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the Information is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM _ AUTO DEALERS COVERAGE FORM Schedule Organization Additional Insured Endorsement • Any additional insured with whom you have agreed to provide such noncontributory insurance, pursuant to and as required under a written contract executed prior to the date of loss. (If no information is filled in, the schedule shall read:"All persons or entities added as additional insureds through an endorsement with the term"Additional Insured°in the title) For organizations that are listed in the Schedule above that are also an Additional Insured under an endorsement attached to this policy,the following is added to the Other Insurance Condition under General Conditions: If other insurance is available to an insured we cover under any of the endorsements listed or described above (the "Additional Insured") for a loss we cover under this policy, this insurance will apply to such loss on a primary basis and we will not seek contribution from the other insurance available to the Additional Insured. • Authorized Representative DA-21666b(06/14) Page 1 of 1 POLICY NUMBER: MMT H2527961A Endorsement Number: 41 COMMERCIAL AUTO CA 99 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLLUTION LIABILITY - BROADENED COVERAGE FOR COVERED AUTOS - BUSINESS AUTO AND MOTOR CARRIER COVERAGE FORMS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Covered Autos Liability Coverage is changed as "Covered pollution cost or expense" does not follows: include any cost or expense arising out of the 1. Paragraph a. of the Pollution Exclusion applies actual, alleged or threatened discharge, dispersal, only to liability assumed under a contract or seepage, migration, release or escape of agreement. "pollutants": 2. With respect to the coverage afforded by a. Before the "pollutants" or any property in Paragraph A.1. above, Exclusion B.6. Care, which the "pollutants" are contained are Custody Or Control does not apply. moved from the place where they are B. Changes In Definitions or by the"insured"for movement into or onto the covered "auto";or For the purposes of this endorsement, Paragraph D.of b. After the "pollutants" or any property in the Definitions Section is replaced by the following: which the "pollutants" are contained are D. "Covered pollution cost or expense" means any moved from the covered "auto" to the place cost or expense arising out of: where they are finally delivered, disposed of 1. Any request, demand, order or statutory or or abandoned by the"insured". regulatory requirement that any "insured" or Paragraphs a. and b. above do not apply to others test for, monitor, clean up, remove, "accidents" that occur away from premises contain, treat, detoxify or neutralize, or in any owned by or rented to an"insured"with respect way respond to, or assess the effects of , to "pollutants" not in or upon a covered "auto" "pollutants"; or 2. Any claim or "suit" by or on behalf of a (1) The"pollutants" or any property in which governmental authority for damages because of the "pollutants" are contained are upset, testing for, monitoring, cleaning up, removing, overturned or damaged as a result of the containing, treating, detoxifying or neutralizing, maintenance or use of a covered "auto"; or in any way responding to or assessing the and • effects of"pollutants". (2) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused directly by such upset,overturn or damage. • CA 99 4810 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 • 1 NOTICE TO OTHERS ENDORSEMENT—SCHEDULE Named Insured U nivar Inc. Endorsement Number 17 Policy Symbol Policy Number Policy Period Effective Date of Endorsement MMT H2527961A 06/01/2019 To 06/01/20201 _ Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A. If we cancel the Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium,we will endeavor, as set out below,to send written notice of cancellation,via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule that you or your representative provide or have provided to us (the "Schedule"). Ybu or your representative must provide us with the physical and/or e-mail address of such persons or organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us on such Schedule. B. The Schedule must be initially provided to us within 15 days after: ,The beginning of the Policy period, if this endorsement is effective as of such date; or ii. This endorsement has been added to the Policy, if this endorsement is effective after the Policy period commences. C. The Schedule must be in an electronic format that is acceptable to us; and must be accurate. D. Our delivery of the notification as described in Paragraph A. of this endorsement will be based on the most recent Schedule in our records as of the date the notice of cancellation is mailed or delivered to the first Named Insured. E. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. F. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to. provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any. Policy cancellation date and will not negate any cancellation of the Policy. G. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with a Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. H. We may arrange with your representative to send such notice in the event of any such cancellation. I. You will cooperate with us in providing the Schedule,or in causing your representative to provide the Schedule. J. This endorsement does not apply in the event that you cancel the Policy. ALL-32687(05/11) • Page 1 of 2 All other terms and conditions of the Policy remain unchanged. Authorized Representative ALL-32687(05/11) Page 2 oft • • l 1 ADDITIONAL INSURED — DESIGNATED PERSONS OR ORGANIZATIONS Named Insured Univar Inc. Endorsement Number 8 Policy Symbol Policy Number Policy Period Effective Date of Endorsement MMT H2527961A 06/01/2019 TO 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is Issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM EXCESS BUSINESS AUTO COVERAGE FORM Additional Insured(s): Anv person or organization whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. A. For a covered"auto,"Who Is Insured is amended to include as an"insured,"the persons or organizations named in this endorsement. However,these persons or organizations are an"insured"only for"bodily injury"or"property damage"resulting from acts or omissions of: 1. You. 2. Any of your"employees"or agents. 3. Any person operating a covered "auto"with permission from you,any of your"employees"or agents. B. The persons or organizations named in this endorsement are not liable for payment of your premium. Authorized Representative DA-9U74c(03/16) Page 1 of 1 • • • • NOTICE TO OTHERS ENDORSEMENT—SCHEDULE NOTICE BY INSURED'S REPRESENTATIVE Named Insured Endorsement Number Univar Inc. 7 • Policy Symbol Policy Number Policy Period Effective Date of Endorsement WCU C65891475 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the Information is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: SPECIFIC EXCESS WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium,we will endeavor, as set out in this endorsement,to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the "Schedule") by allowing your representative to send such notice to such.persons or organizations. This notice will be in addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. B. The notice referenced in this endorsement as provided by your representative is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use. D. We will only be responsible for sending such notice to your representative, and your representative will in turn send the notice to the persons-or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. E. This endorsement does not apply in the event that you cancel the Policy. All other terms and conditions of this Policy remain unchanged. This endorsement is not applicable in the states of AZ, FL,TX, ID,and NM. Authorized Representative WC 99 05 21 (01/11) Page 1 of 1 M. Loss Payments • We shall pay any Loss for which we may be liable under this policy in the following manner: 1. As respects Part One-Workers Compensation Insurance, payment shall first be made by you in accordance with the provisions of the workers compensation law, and we shall reimburse you for such Loss periodically, at intervals of not less than three months, upon receipt from you of proper proofs of payment. 2. As respects Part Two — Employers' Liability Insurance, if damages are paid by you, we shall make payment to you within thirty (30) days after we receive proper proofs of your payment of Loss covered under Part Two- Employers' Liability IN WITNESS WHEREOF, the Company has caused this policy to be signed by its President and Secretary, and, where required by law, its Information Page to be countersigned by one of its duly authorized representatives. S r 411141rel REBECCA L.COLLINS,Secretary JOHN J. LUPICA, President CKE-1167M (01/15) ©ACE AMERICAN INSURANCE COMPANY Page 11 of 11 1 ALTERNATE EMPLOYERS ENDORSEMENT • Named Insured . Endorsement Number Univar Inc. 1 Policy Symbol Policy Number Policy Period Effective Date of Endorsement WCU C65891475 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: SPECIFIC EXCESS WORKERS'COMPENSATION AND EMPLOYERS' LIABILITY POLICY This endorsement applies only with respect to bodily injury to your employees while in the course of special or temporary employment by the alternate employer in the state named in Item 2 of the Schedule. Part One (Workers Compensation Insurance) and Part Two (Employer Liability Insurance)will apply as though the alternate employer is insured. If an entry is shown in Item 3 of the Schedule the insurance afforded by this endorsement applies only to work you perform under the contract or at the project named in the Schedule. Under Part One (Workers Compensation Insurance) we will reimburse the alternate employer for the benefits required by the workers compensation law. The insurance afforded by this endorsement is not intended to satisfy the alternate employer's duty to secure its obligations under the workers compensation law. We will not file evidence of this insurance on behalf of the alternate employer with any government agency. We will not ask any other insurer of the alternate employer to share with us a loss covered by this endorsement. Premium will be charged for your employees while in the course of special or temporary employment by the alternate employer. The policy may be canceled according to its terms without sending notice to the alternate employer. Part Four(Claims)applies to you and the alternate employer.The altemate employer will recognize our right.to defend under Parts One and Two and our right to inspect under Part Six. This endorsement is not applicable in FL, ME, NY,and NH. Schedule , • 1. Alternate Employer If Any Address Does not apply to Alaska, or to any employee lease contract/arrangement 2. State of Special or Temporary Employment any state shown in Item 3 of the Information Page 3. Contract or Project • Authorized Representative WC 99 04 40(07/06) ©Chubb.2016.All rights reserved. Page 1 of 1 • Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number UNIVAR INC. 3075 HIGHLAND PARKWAY SUITE#200 Policy Number DOWNERS GROVE IL 60515 Symbol: WLR Number:C65891359 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of Insurance Company) INDEMNITY INS.CO.OF NORTH AMERICA Insert the policy number.The remainder of the information is to be completed only when this endorsement is Issued subsequent to the preparation of the policy. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable far 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 lone not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION AGAINST WHOM YOU 'HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS. For the states of CA, UT,TX, refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications.According to Section 287.150(6)of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications. . For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A.. 16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto):According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program. Authorized Representative WC 00 03 13 (11/05)Ptd.U.S.A. Copyright 1982-83, National Council on Compensation • i Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number UNIVAR INC. 3075 HIGHLAND PARKWAY SUITE#200 Policy Number DOWNERS GROVE IL 60515 Symbol: WLR Number:C65891359 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of Insurance Company) INDEMNITY INS.CO.OF NORTH AMERICA Insert the policy number.The remainder of the information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. NOTICE TO OTHERS ENDORSEMENT—SCHEDULE A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule that you or your representative provide or have provided to us (the "Schedule"). You or your representative must provide us with the physical and/or e-mail address of such persons or organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us on such Schedule. B. The Schedule must be initially provided to us within 15 days after: i. The beginning of the Policy period, if this endorsement is effective as of such date; or ii. This endorsement has been added to the Policy, if this endorsement is effective after the Policy period • commences. C. This endorsement must be in an electronic format that is acceptable to us; and must be accurate. D. Our delivery of the notification as described in Paragraph A. of this endorsement will be based on the most recent Schedule in our records as of the date the notice of cancellation is mailed or delivered to the first Named Insured. E. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. F. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. G. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with a Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail arid physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. H. We may arrange with your representative to send such notice in the event of any such cancellation. I. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. J. This endorsement does not apply in the event that you cancel the Policy. All other terms and conditions of this Policy remain unchanged. • Authorized Representative WC 99 03 70A(08/12) Page 1 of 1 • Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number UNIVAR INC. 3075 HIGHLAND PARKWAY SUITE#200 Policy Number DOWNERS GROVE IL 60515 Symbol: WLR Number:065891359 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of Insurance Company) INDEMNITY INS.CO.OF NORTH AMERICA Insert the policy number.The remainder of the information Is to be completed only when this endorsement is issued subsequent to the preparation of the policy. ALTERNATE EMPLOYER ENDORSEMENT This endorsement applies only with respect to bodily injury to your employees while in the course of special or temporary employment by the alternate employer in the state named in Item 2 of the Schedule. Part One (Workers Compensation Insurance) and Part Two (Employers Liability Insurance) will apply as though the alternate employer is insured. If an entry is shown in Item 3 of the Schedule the insurance afforded by this endorsement applies only to work you perform under the contract or at the project named in the Schedule. Under Part One (Workers Compensation Insurance) we will reimburse the alternate employer for the benefits required by the workers compensation law if we are not permitted to pay the benefits directly to the persons entitled to them. The insurance afforded by this endorsement is not intended to satisfy the alternate employer's duty to secure its obligations under the workers compensation law. We will not file evidence of this insurance on behalf of the alternate employer with any government agency. We will not ask any other insurer of the alternate employer to share with us a loss covered by this endorsement. Premium will be charged for your employees while in the course of special or temporary employment by the alternate employer. The policy may be canceled according to its terms without sending notice to the alternate employer. Part Four (Your Duties If Injury Occurs) applies to you and the alternate employer. The alternate employer will recognize our right to defend under Parts One and Two and our right to inspect under Part Six. Schedule 1. Alternate Employer Address IF ANY DOES NOT APPLY TO ANY EMPLOYEE LEASE CONTRACT/ARRANGEMENT 2. State of Special or Temporary Employment ANY STATE SHOWN IN ITEM 3A OF THE INFORMATION PAGE 3. Contract or Project \ This endorsement is not applicable in the states of AK, HI, MI, OK and TX. Authorized Representative WC 00 03 01A (Ed.2-89) ©Copyright 1984, 1988 National Council on Compensation Insurance, Inc.All Rights Reserved. Workers'Compensation and Employers'Liability Policy Named Insured _ Endorsement Number UNIVAR INC. 3075 HIGHLAND PARKWAY SUITE#200 Policy Number DOWNERS GROVE IL 60515 Symbol: WLR Number:C65891359 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of Insurance Company) INDEMNITY INS.CO.OF NORTH AMERICA Insert the policy number.The remainder of the Information Is to be completed only when this endorsement is Issued subsequent to the preparation of the policy. 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 ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS. For the states of CA, UT, TX, refer to state specific endorsements. This endorsement is not applicable in KY, NH, and NJ. The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications.According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party td the contract is an employer in the construction group of code classifications. For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A.. 16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto).According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program. Authorized Representative WC 00 03 13 (11/05)Ptd.U.S.A. Copyright 1982-83,National Council on Compensation • i Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number UNIVAR INC. I 3075 HIGHLAND PARKWAY SUITE#200 Policy Number DOWNERS GROVE IL 60515 Symbol: WLR Number:C65891359 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of insurance Company) INDEMNITY INS.CO.OF NORTH AMERICA Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. NOTICE TO OTHERS ENDORSEMENT—SCHEDULE A. If we cancel this Policy prior to its expiration date by notice td you or the first Named insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule that you or your representative provide or have provided to us (the "Schedule"). You or your representative must provide us with the physical and/or e-mail address of such persons or organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us on such Schedule. B. The Schedule must be initially provided to us within 15 days after: I. The beginning of the Policy period, if this endorsement is effective as of such date; or Ii. This endorsement has been added to the Policy, if this endorsement is effective after the Policy period commences. C. This endorsement must be in an electronic format that is acceptable to us; and must be accurate. D. Our delivery of the notification as described in Paragraph A. of this endorsement will be based on the most recent Schedule in our records as of the date the notice of cancellation is mailed or delivered to the first Named Insured. E. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. F. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal . obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. G. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with a Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. H. We may arrange with your representative to send such notice in the event of any such cancellation. I. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. J. This endorsement does not apply in the event that you cancel the Policy. All other terms and conditions of this Policy remain unchanged. Authorized Representative WC 99 03 70A(08/12) Page 1 of 1 Workers'Compensation and Employers'Liability Policy Named Insured Endorsement Number UNIVAR INC. 3075 HIGHLAND PARKWAY SUITE#200 Policy Number DOWNERS GROVE IL 60515 Symbol: WLR Number:C65891359 Policy Period Effective Date of Endorsement 06-01-2019 TO 06-01-2020 06-01-2019 Issued By(Name of Insurance Company) INDEMNITY INS.CO.OF NORTH AMERICA Insert the policy number.The remainder of the information is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. ALTERNATE EMPLOYER ENDORSEMENT This endorsement applies only with respect to bodily injury to your employees while in the course of special or temporary employment by the alternate employer in the state named in Item 2 of the Schedule. Part One (Workers Compensation Insurance) and Part Two (Employers Liability Insurance)will apply as though the alternate employer is insured. If an entry is shown in Item 3 of the Schedule the insurance afforded by this endorsement applies only to work you perform under the contract or at the project named in the Schedule. Under Part One (Workers Compensation Insurance) we will reimburse the alternate employer for the benefits required by the workers compensation law if we are not permitted to pay the benefits directly to the persons entitled to them. The insurance afforded by this endorsement is not intended to satisfy the alternate employer's duty to secure its obligations under the workers compensation law. We will not file evidence of this insurance on behalf of the alternate employer with any government agency. We will not ask any other insurer of the alternate employer to share with us a loss covered by this endorsement. • Premium will be charged for your employees while in the course of special or temporary employment by the alternate employer. The policy may be canceled according to its terms without sending notice to the alternate employer. Part Four (Your Duties If Injury Occurs) applies to you and the alternate employer. The alternate employer will recognize our right to defend under Parts One and Two and our right to inspect under Part Six. Schedule 1. Alternate Employer - Address IF ANY DOES NOT APPLY TO ANY EMPLOYEE LEASE CONTRACT/ARRANGEMENT • 2. State of Special or Temporary Employment ANY STATE SHOWN IN ITEM 3A OF THE INFORMATION PAGE 3. Contract or Proiect • • This endorsement is not applicable in the states of AK, HI, MI, OK and TX. • Authorized Representative WC 00 03 01A (Ed.2-89) ©Copyright 1984, 1988 National Council on Compensation Insurance,Inc.All Rights Reserved. • • • 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS Named Insured UniVar Inc. Endorsement Number 25 Policy Symbol Policy Number Policy Period Effective Date of Endorsement ISA H25279578 06/01/2019 To 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This Endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM • MOTOR CARRIERS COVERAGE FORM AUTO DEALERS COVERAGE FORM We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of the use of a covered auto. The waiver applies only to the person or organization shown in the SCHEDULE. SCHEDULE Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. Authorized Representative DA-13115a(06/14) I Pagel oft NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS Named Insured Unlvar Inc. Endorsement Number 14 Policy Symbol Policy Number Policy Period Effective Date of Endorsement ISA H25279578 06/01/2019 TO 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM AUTO DEALERS COVERAGE FORM Schedule Organization Additional Insured Endorsement Any additional insured with whom you have agreed to provide such non- contributory insurance, pursuant to and as required under a written contract executed prior to the date of loss. (If no information is filled in, the schedule shall read:`All persons or entities added as additional insureds through an endorsement with the term"Additional Insured"in the title) For organizations that are listed in the Schedule above that are also an Additional Insured under an endorsement attached to this policy, the following is added to the Other Insurance Condition under General Conditions: If other insurance is available to an insured we cover under any of the endorsements listed or described above (the "Additional Insured") for a loss we cover under this policy, this insurance will apply to such loss on a primary basis and we will not seek contribution from the other insurance available to the Additional Insured. Authorized Representative DA-21886b(06/14) Page 1 of 1 POLICY NUMBER: ISA H25279578 Endorsement Number: 39 COMMERCIAL AUTO CA 99 48 1013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLLUTION LIABILITY - BROADENED COVERAGE FOR COVERED AUTOS - BUSINESS AUTO AND • MOTOR CARRIER COVERAGE FORMS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Covered Autos Liability Coverage is changed as "Covered pollution cost or expense" does not follows: include any cost or expense arising out of the 1. Paragraph a. of the Pollution Exclusion applies actual, alleged or threatened discharge, dispersal, only to liability assumed under a contract or seepage, migration, release or escape of agreement. "pollutants": 2. With respect to the coverage afforded by a. Before the "pollutants" or any property in Paragraph A.1. above, Exclusion B.6. Care, which the "pollutants" are contained are Custody Or Control does not apply. moved from the place where they are accepted by the"insured"for movement into B. Changes In Definitions or onto the covered"auto';or For the purposes of this endorsement, Paragraph D.of b. After the "pollutants" or any property in the Definitions Section is replaced by the following: which the "pollutants" are contained are D. "Covered pollution cost or expense" means any moved from the covered "auto" to the place cost or expense arising out of: where they are finally delivered, disposed of 1. Any request, demand, order or statutory or or abandoned by the"insured". regulatory requirement that any "insured" or Paragraphs a. and b. above do not apply to others test for, monitor, clean up, remove, "accidents" that occur away from premises contain, treat, detoxify or neutralize, or in any owned by or rented to an"insured"with respect way respond to, or assess the effects of ' to "pollutants" not in or upon a covered "auto" "pollutants";or if: • 2. My claim or "suit' by or on behalf of a (1) The"pollutants" or any property in which governmental authority for damages because of the "pollutants" are contained are upset, testing for, monitoring, cleaning up, removing, overturned or damaged as a result of the containing, treating, detoxifying or neutralizing, maintenance or use of a covered "auto"; or in any way responding to or assessing the and effects of"pollutants". (2) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused directly by such upset, overturn or damage. .. I CA 99 4810 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 NOTICE TO OTHERS ENDORSEMENT - SCHEDULE NOTICE BY INSURED'S REPRESENTATIVE Named Insured Univar Inc. Endorsement Number 16 Policy Symbol Policy Number Policy Period Effective Date of Endorsement ISA H25279578 06/01/2019 TO 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A. If we cancel this Policy prior to its expiration date by notice to you or the first Named Insured for any reason other than nonpayment of premium, we will endeavor, as set out in this endorsement, to send written notice of cancellation, to the persons or organizations listed in the schedule that you or your representative create or maintain (the "Schedule") by allowing your representative to send such notice to such persons or organizations. This notice will be in addition to our notice to you or the first Named Insured, and any other party whom we are required to notify by statute and in accordance with the cancellation provisions of the Policy. B. The notice referenced in this endorsement as provided by your representative is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). The failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule will impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. C. We are not responsible for verifying any information in any Schedule, nor are we responsible for any incorrect information that you or your representative may use. D. We will only be responsible for sending such notice to your representative, and your representative will in turn send the notice to the persons or organizations listed in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. E. This endorsement does not apply in the event that you cancel the Policy. All other terms and conditions of this Policy remain unchanged. Authorized Representative ALL-32686(01/11) Page 1 of 1 1 ADDITIONAL INSURED— DESIGNATED PERSONS OR ORGANIZATIONS Named Insured Univar Inc. Endorsement Number 4 Policy Symbol Policy Number Policy Period Effective Date of Endorsement ISA H25279578 06/01/2019 TO 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information Is to be completed only when this endorsement is Issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM AUTO DEALERS COVERAGE FORM MOTOR CARRIER COVERAGE FORM EXCESS BUSINESS AUTO COVERAGE FORM Additional Insured(s): Any person or organization whom you have agreed to include as an additional insured • under a written contract, provided such contract was executed prior to the date of loss. A. For a covered"auto,"Who Is Insured is amended to include as an "insured,"the persons or organizations named in this endorsement. However,these persons or organizations are an "insured"only for"bodily injury"or"property damage" resulting from acts or omissions of: 1. You. 2. Any of your"employees"or agents. 3. Any person operating a covered"auto"with permission from you, any of your"employees"or agents. B. The persons or organizations named in this endorsement are not liable for payment of your premium. Authorized Representative DA-9U74c(03/16) Page 1 of 1 • 1 I WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Named Insured Endorsement Number Univar Inc. 62 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71232736 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Person or Organization: Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss. We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Authorized Agent XS-6W34(09/95)Ptd. in U.S.A. Page 1 of 1 • • CHUBB¶ SIGNATURES • Named Insured Endorsement Number Univar Inc. 3 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71232736 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company THE ONLY COMPANY APPLICABLE TO THIS POLICY IS THE COMPANY NAMED ON THE FIRST PAGE OF THE DECLARATIONS. By signing and delivering the policy to you,we state that it is a valid contract. INDEMNITY INSURANCE COMPANY OF NORTH AMERICA(A stock company) BANKERS STANDARD INSURANCE COMPANY(A stock company) ACE AMERICAN INSURANCE COMPANY(A stock company) ACE PROPERTY AND CASUALTY INSURANCE COMPANY(A stock company) INSURANCE COMPANY OF NORTH AMERICA(A stock company) PACIFIC EMPLOYERS INSURANCE COMPANY(A stock company) ACE FIRE UNDERWRITERS INSURANCE COMPANY(A stock company) WESTCHESTER FIRE INSURANCE COMPANY(A stock company) 436 Walnut Street,P.O.Box 1000,Philadelphia,Pennsylvania 19106-3703 (26briele, 01111-47— REBECCA L.COLLINS,Secretary JOHN J.LUPICA,President CC-1Kiii(02/18) Page 1 of 1 1 NON-CONTRIBUTORY ENDORSEMENT FOR ADDITIONAL INSUREDS Named Insured Endorsement Number Univar Inc. 42 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71232736 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the information is to be completed only when this endorsement is Issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: • EXCESS COMMERCIAL GENERAL LIABILITY POLICY Schedule Organization Additional Insured Endorsement Any additional insured with whom you have agreed to provide such non- contributory insurance, pursuant to and as required under a written contract executed prior to the date of loss. (If no information is filled in, the schedule shall mad:"All persons or entities added as additional insureds through an endorsement with the term"Additional Insured"in the title) For organizations that are listed in the Schedule above that are also an Additional Insured under an endorsement attached to this policy,the following is added to Section IV.4: If other insurance is available to an insured we cover under any of the endorsements listed or described above (the "Additional Insured") for a loss we cover under this policy, this insurance will apply to such loss and is primary (subject to satisfaction of the"retained limit"), meaning that we will not seek contribution from the other insurance available to the Additional Insured. Your"retained limit"still applies to such loss,and we will only pay � Y P Y the Additional Insured for the"ultimate net loss" in excess of the"retained limit'shown in the Declarations of this policy. Authorized Representative XS-20288a(05/14) ©Chubb.2016.All rights reserved. Page 1 of 1 1 • ■ • ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION Named Insured Endorsement Number Univar Inc. 5 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71232736 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the Information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Name of Person or Organization: Any person or organization whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage"or"personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III— Limits Of Insurance And Retained Limit: If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Authorized Representative XS-6W25b(04/13) Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 1 NOTICE TO OTHERS ENDORSEMENT,SCHEDULE Named Insured UniVar IBC. Endorsement Number 45 • Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71232736 06/01/2019 To 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the Information is to be completed only when this endorsement Is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • A. If we cancel the Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium,we will endeavor, as set out below, to send written notice of cancellation,via such electronic or other form of notification as we determine, to the persons or organizations listed in the schedule that you or your representative provide or have provided to us (the "Schedule"). You or your representative must provide us with the physical and/or e-mail address of such persons or organizations, and we will utilize such e-mail address or physical address that you or your representative provided to us on such Schedule. B. The Schedule must be initially provided to us within 15 days after I. The beginning of the Policy period, if this endorsement is effective as of such date; or ii. This endorsement has been added to the Policy, if this endorsement is effective after the Policy period commences. C. The Schedule must be in an electronic format that is acceptable to us; and must be accurate. D. Our delivery of the notification as described in Paragraph A. of this endorsement will be based on the most recent Schedule in our records as of the date the notice of cancellation is mailed or delivered to the first Named Insured. E. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. F. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon us, our agents or representatives, will not extend any Policy cancellation date and will not negate any cancellation of the Policy. G. We are not responsible for verifying any information provided to us in any Schedule, nor are we responsible for any incorrect information that you or your representative provide to us. If you or your representative does not provide us with a Schedule, we have no responsibility for taking any action under this endorsement. In addition, if neither you nor your representative provides us with e-mail and physical address information with respect to a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. H. We may arrange with your representative to send such notice in the event of any such cancellation. I. You will cooperate with us in providing the Schedule,or in causing your representative to provide the Schedule. J. This endorsement does not apply in the event that you cancel the Policy. ALL-32687(05/11) Page 1 of 2 All other terms and conditions of the Policy remain unchanged. Authorized Representative ALL-32687(05/11) Page 2 of 2 r 1 ADDITIONAL INSURED-.VENDORS Named Insured - Endorsement Number Univar Inc. 18 Policy Symbol Policy Number Policy Period Effective Cate of Endorsement XSL G71232736 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY SCHEDULE Your Products:All of your products. Name of Person(s) or Organization(s) (Vendor):Any Vendor whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. A. SECTION II -WHO IS AN INSURED is amended to include as an additional insured any person(s) or organization(s) (referred to throughout this endorsement as vendor) shown in the Schedule, but only with respect to "bodily injury" or "property damage" arising out of"your products" shown in the Schedule which are distributed or sold in the regular course of the vendor's business. However: 1. The insurance afforded to such vendor only applies to the extent permitted by law;and 2. If coverage provided to the vendor is required by a contract or agreement,the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. B. With respect to the insurance afforded to these vendors,the following additional exclusions apply: 1. The insurance afforded the vendor does not apply to: a. "Bodily injury" or"property damage"for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express'warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; XS-6W31c(02/17) Includes copyrighted material of Insurance Services Office,Inc.with its permission. Page 1 of 2 e. Any failure to make such inspections,adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of the products; 1. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container,part or ingredient of any other thing or substance by or for the vendor;or h. "Bodily injury" or"property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However this exclusion does not apply to: (t) The exceptions contained in Sub-paragraphs d.or f.;or (2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of the products. 2. This insurance does not apply to any insured person or organization,from whom you have acquired such products,or any ingredient,part or container,entering into,accompanying or containing such products. C. With respect to the insurance afforded to these vendors,the following is added to SECTION III—LIMITS OF INSURANCE AND RETAINED LIMIT: If coverage provided to the vendor is required by a contract or agreement,the most we will pay on behalf of the vendor is the amount of insurance: 1. Required by the contract or agreement;or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the Limits of Insurance shown in the Declarations. Authorized Representative XS-6W3m(02/17) Includes copyrighted material of Insurance Services Office,Inc.with its permission. Page 2 of 2 r • ' • I ADDITIONAL INSURED WHERE REQUIRED BY WRITTEN CONTRACT Named Insured i Endorsement Number Univar Inc. 19 Policy Symbol Policy Number Policy Period Effective Date of Endorsement XSL G71232736 06/01/2019 to 06/01/2020 Issued By(Name of Insurance Company) ACE American Insurance Company Insert the policy number.The remainder of the Information is to be completed only when this endorsement is Issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: EXCESS COMMERCIAL GENERAL LIABILITY POLICY The following is added to Section 11.2—Who Is An Insured: e. Any person or organization that you are required to include as an additional insured under this policy because of a written contract that: 1) Is in effect during this policy period; and P YP 2) Was executed prior to the"occurrence"of the"bodily injury"or"property damage"; and 3) Qualifies as an "insured contract"as defined in this policy. Any such person or organization is an additional insured only for "bodily injury" and "property damage"resulting from: a. "your work"that you do for that additional insured pursuant to such contract; or b. "your product"distributed or sold to that additional insured pursuant to such contract;and such person is only an additional insured for"occurrences"taking place during the period of time required by such contract or until the end of the policy period,whichever is sooner. However: i)The insurance afforded to such additional insured only applies to the extent permitted by law; and ii) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract: • x. The insurance provided by this endorsement shall be limited to the Limits of Insurance required by the written contract; and y. This endorsement shall not increase the Limits of Insurance stated in the Declarations under Item 3. Limits of Insurance pertaining to the coverage provided herein. Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless the written contract specifically requires that this insurance apply on a primary or non-contributory basis. XS-21234b(08/13) Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 2 • • In accordance with the terms and conditions of the policy and as more fully explained in the policy, as soon as practicable, each additional insured must give us prompt notice of any "occurrence" which may result in a claim, forward all legal papers to us, cooperate in the.defense of any actions, and otherwise comply with all of the policy's terms and conditions. • • Authorized Representative XS-21234b(08/13) Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 2 of 2 Purchase Order 'aft CI.TY Fiscal Year 2020 Page: 1 of: 1 B City of Ashland I ATTN: Accounts Payable Purchase L Ashland alOR 97520 Order# 20200016 T Phone: 541/552-2010 O Email: payable @ashland.or.us V E H CIO Wastwater Treatment Plant UNIVAR USA INC N 3075 HIGHLANDS PKWAYS i 1195 Oak Street D STE 200 P Ashland, OR 97520 O DOWNERS GROVE, IL 60515-5560 Phone: 541/488-5348 T Fax: 541/552-2364 O David Gies 06/19/2019 4715 FOB ASHLAND OR/NET30 Cit Accounts Pa able WWTP Chemicals 1 WWTP Chemicals ITB#2019-101 5 ORDR $2,425.0000 $12,125.00 Chemical#7 Citric Acid (50 Lb Bags) Pricing for July 2019 to June 2020 $2,425.00 per order($0.97 per pound, 50Lb bag, 50 Bags per order, no additional delivery charge) Project Account: Project Account: 2 Pricing for July 2020 to June 2021 5 ORDR $2,550.0000 $12,750.00 $2,550.00 per order($1.02 per pound, 50Lb bag, 50 Bags per order, no additional delivery charge) Project Account: GL SUMMARY *** ***«******* 086100-601500 $24,875.00 By 6'U` i't Date: iQ O�v t' t Authorized Signature gig:' $24,875.00 FORM #3 CITY OF A o ( & ASHLAND 1 REQUISITION Date of request: - 9 Vendor Name O n i 1/c e% Address,City,State,Zip Contact Name Telephone Number Email address SOURCING METHOD ❑ Exempt from Competitive Bidding 5Y Invitation to Bid 4 ❑ Emergency ❑ Reason for exemption: Date approved by Council:"y–7(— � s ❑ Form#13,Written findings and Authorization ❑ AMC 2.50 --(Attach copy of council communication) ❑ Written quote or proposal attached ❑ Written quote or proposal attached (If council approval required,attach copy of CC) ❑ Small Procurement ❑ Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: ❑ State of Oregon ❑ Direct Award _(Attach copy of council communication) Contract# ❑ VerbaliWritten quote(s)or proposal(s) ❑ Request for Qualifications(Public Works) ❑ State of Washington Intermediate Procurement Date approved by Council: Contract#_ GOODS&SERVICES (Attach copy of council communication) ❑ Other government agency contract Greater than$5,000 and less than$100,000 ❑ Sole Source Agency __ ❑ (3)Written quotes and solicitation attached ❑Applicable Form(#5,6,7 or 8) Contract# PERSONAL SERVICES ❑Written quote or proposal Intergovernmental Agreement attached Form Greater than$5,000 and less than$75,000 ❑ Form#4, Personal Services>$5K&<$75K Agency y ❑Direct appointment not to exceed$35,000 ❑Annual cost to City does not exceed$25,000. ❑ Special Procurement 0(3)Written proposals/written solicitation Agreement approved by Legal a,iu approved/signed by Form#4,Personal Services>$5K&<$75K ❑ Form#9,Request for Approval ❑ $ $ ❑ Written quote or proposal attached City Administrator.AMC 2.50.073(4) Date approved by Council: ❑Annual cost to City exceeds$25/:37,Council Valid until: (Date) approval required.(Attach copy of council communication) Description of SERVICES Total Cast $ Item# Quantity Unit Description of MATERIALS Unit Price Trtar Cost I 7SZ7 0 Per attached quote/proposal TOTAL COST Crl Expenditure must be charged to the appropriate account numbers for the financials to reflect the actual expenditures accurately. y/ 25 Project Number -_ _ _ Account Number oa6,1QQ-4 0J5-a:c.D$_,. ' Project Number _ _ _ Account Number - $ ,_C',X2.'°,Q Project Number _ _ _ Account Number - $ , , IT Director in collaboration with department to approve all hardware and software purchases: 401 „/l�/7 _ By signing this requisitio rm,I certify that t >City's public contracting requirements have been satisfied. IT Director Date Support Yes/No Employee: - le /--xi---, Department Head: ‘.4 ZQ (Equal to or greater than f900) Department Manager/Supervisor: City Administrator: (Equal to or greater than$25,000) Funds appropriated for current fiscal year: E / NO (0(c)-6)/ Finance Director-(Equal to or greater than$5,000) Date Comments: ��rw Form#3-Requisition