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HomeMy WebLinkAbout2023-100 PO 20240059- Accurate Plumbing Solutions Purchase Order PIF411 g ` `g Fiscal Year 2024 Page: 1 of: 1 B City of Ashland = LATTN: Accounts Payable Purchase 20 E. Main L Ashland, OR 97520 Order# 20240059 T Phone: 541/552-2010 O Email: payable@ashland.or.us V H 0/0 Facilities Maintenance Div E ACCURATE PLUMBING SOLUTIONS I 90 North Mountain Ave N PO BOX 1503 p Ashland, OR 97520 O MEDFORD, OR 97501 Phone: 541/488-5358 R T Fax: 541/552-2304 . - Y=^ ?�""'� ....,: 's ( •_=-7r-1�1� _ __ _David Arnold - -1 € i=T=-°=s=.Hiatt_al: -_---c4P rilcetili6i;Tidg'_ .--. 08/08/2023 6444 FOB ASHLAND OR/NET30 � Cit Accounts.Pa able On-call Plumbing Services 1 On-call Plumbing•Services 1.0 $5,000.00 $5,000.00 Goods and Services Agreement($35,000 or less) • Completion date: June 30, 2024 . Project Account: ***.*********** GL SUMMARY*************** . 088400-602400 - $5,000.00 • Dater /69/3 _- Authorized Signatu ° 4A PO, — r 5 000.00 i ,FOR2VI #3 CITY OF 1-6$ 4 4SHLAND REQUISITION / • Date of request: 7/17/2023 • Required date for delivery: Vendor Name Accurate Plumbing Solutions Address,City,State,Zip PO Box 1503,or 1234 Corona Ave,Medford,OR 97504 Contact Name&Telephone Number • Laurie Stevens`or Brent Carlson,541-773-3035,apsincplumb( gmaif.com Email address SOURCING METHOD • ❑ Exempt from Competitive Bidding 0 Invitation to Bid - 0 Emergency ❑ Reason for exemption: Date approved by Council: 0 Form#13,Written findings and Authorization ❑ AMC 2.50 _(Attach copy of council communication) 0 Written quote or proposal attached ❑ Written quote or proposal attached _(If council approval required,attach copy of CC) ® Small Procurement 0 Request for Proposal Cooperative Procurement Not exceeding$5,000 Date approved by Council: 1 0 State of Oregon ❑ Direct Award _(Attach copy of council communication) ' Contract# ❑ Verbal/Written quote(s)or proposal(s) 0 Request for Qualifications(Public Works) 0 State of Washington Date approved.by Council: Contract# (Attach copy of council communication) 0 Other government agency contract • Intermediate Procurement 0 Sole Source• Agency GOODS&SERVICES 0 Applicable Form(#5,6,7 or 8) Contract# • Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement ❑ (3)Written bids and solicitation attached 0 Form#4,Personal Services$5K to$75K Agency PERSONAL SERVICES Date approved by Council: 0 Annual cost to City does not exceed$25,000. Greater than$5000 and less than,$75,000 Valid until: (Date) Agreement approved by Legal and approved/signed by ❑ Less than$35,000,by direct appointment 0 Special Procurement I City Administrator.AMC 2.50.070(4) ❑ (3)Written proposals&solicitation attached 0 Form#9,Request for Approval 1 0 Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services$5K to$75K 0 Written quote or proposal attached I approval required.(Attach copy of council communication) Date approved by Council: • Valid until: (Date) • Description of SERVICES Total Cost Plumbing services as needed. I :$5000::001 Item# Quantity Unit Description of MATERIALS •Unit Price Total Cost 1 i $0 $0.00 $0 $0.00 $0 $0.00 ❑ Per attached quote/proposal ;;T.OlTAL,rC:bST Project Number: -_ _ Account Number: 088400-602400 i$j5;Q0'O0) *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisiti form,I certify that the Cii Y's public contracting requirements have been satisfied. Employee: r L'� Department Head: .._��T`� c. .2. . 2 g - '/ �— (Equalti or greater than$5,000) Department Manager/Supervisor: City Manager: Greaterthan$3 ,000)11,1 Funds appropriated for current fiscal yea YE / NO -= ]0 � Finance Director-(Equal eater than$5,000) ate • • Comments: Form#3-Requisition GOODS AND SERVICES AGREEMENT ($35,000 OR LESS) PROVIDER: Accurate Plumbing Solutions PROVIDER'S T Y OF CONTACT: Brent Carlson ' CIASHLAND ADDRESS: PO Box 1503 • 20 East Main Street 1234 Corona Ave. Ashland,Oregon 97520 Medford,OR 97504 Telephone: 541/488-5587 Fax: 541/488-6006 PHONE: 541-773-3035 EMAIL: apsincplumb@gmail.corn • • • This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation (hereinafter "City") and Accurate Plumbing Solutions, (a domestic business corporation)("hereinafter"Provider"),for plumbing services as needed. PROVIDER'S OBLIGATIONS 1.1 Provide restoration and hazardous clean up services as needed and set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Provider expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS,and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The services defined and described in the "SUPPORTING DOCUMENTS" shall hereinafter be collectively referred to as "Work." 1.2 Provider shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder,a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability, and products/completed operations coverage; and o Automobile Liability. 1.2.2 Each policy of such insurance shall be on an"occurrence" and not a"claims made" form, and shall: a Name as additional insured "the City of Ashland, Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named izisured as though a separate policy had been . issued to each,provided that the policy limits shall not be increased thereby; Page 1 of 6: Goods and Services Agreement between the City of Ashland and Accurate Plumbing Solutions • • • Apply as primary coverage for each additional named insured except to the extent that two • or more such policies are intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability;; • • Provider shall immediately notify the City of any change in insurance coverage • Provider shall supply an endorsement naming the City,its officers, employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approvedby the City. 1.3 Provider shall,at its own expense,maintain Worker's Compensation Insurance in compliance with ORS 656.017, which requires subject employers to provide workers' compensation coverage for all of its subject workers. 1.4 Provider agrees that no person shall, on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance.of this Agreement when employed by Provider. Provider agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Provider agrees not to discriminate against a disadvantaged business enterprise,minority-owned business,woman-owned business, a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS 200.055,in awarding subcontracts as required by ORS 279A.110. .1.5 In all solicitations either by competitive bidding or negotiation made by Provider for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Providers of the Provider's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreement is $25,335.05 or more, Provider is required to comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage,as defined in that chapter,to all employees performing Work under this Agreement and to any Subcontractor who performs 50% or more of the Work under this Agreement. Provider is also required to post the notice attached hereto as "Exhibit A"predominantly in areas where it will be seen by all employees. 1.7 Assignment: Provider shall not assign this Agreement or subcontract any portion of the Work to be provided hereunder without the prior written consent of the City. Any attempted assignment or subcontract without written consent of the City shall be void. Provider 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 the City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and the City. 1. CITY'S OBLIGATIONS 1.1 City shall pay Provider the hourly rates effective 7/17/23 as specified in the SUPPORTING DOCUMENTS. 1.2 In no event shall Provider's total of all compensation and reimbursement under this Agreement exceed the sum of$5,000 (this is maximum, not to exceed amount of ENTIRE Agreement) without express, written approval from the City official whose signature appears below, or such official's successor in office. Provider expressly acknowledges that no other person has authority to order or authorize additional Work which.would cause this maximum sum to,be exceeded and that any authorization from the responsible official must be in writing. Provider further acknowledges that any Work delivered or Page 2 of 6: Goods and Services Agreement between the City of Ashland and Accurate Plumbing Solutions • • expenses incurred without authorization as provided herein is done at Provider's own risk and as a volunteer without expectation of compensation or reimbursement. 2. GENERAL PROVISIONS • • 2.1 This is a non-exclusive Agreement. City is not obligated to procure any specific amount of Work from Provider and is free to procure similar types of goods and services from other providers in its sole discretion. 2.2 Provider is an independent contractor and not an employee or agent of the City for any purpose. 2.3 Provider is not entitled to, and expressly waives all claims to City benefits such as health and disability • insurance,paid leave, and retirement. 2.4 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof. It supersedes all prior agreements,negotiations, and representations between the parties, whether written or oral. • 2.5 .This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. 2.6 The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220,279B.230 and 279B.235. •• • 3.7 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the • Circuit Court of the State of Oregon for JacksonCounty unless exclusive jurisdiction is in federal court, • • in which case exclusive venue shall be inthe federal district'court for the district of Oregon. Each party • expressly waives any and all rights to maintain an action underlthis Agreement in any other venue, and • expressly consents that, upon motion of the other party, any case may be dismissed or its venue • transferred, as appropriate,so as to effectuate this choice ofjvenue. 3.8 Provider shall defend,save,hold harmless and indemnify the City and its officers,employees and agents from and against any and all claims,suits, actions, losses, 'damages, liabilities, costs, and expenses of any nature resulting from, arising out of, or relating to the.activities of Provider or its officers, employees, contractors,or agents under this Agreement, • 3.9 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God,strikes,lockouts,accidents,or other events beyond the control of the other or the other's officers,employees or agents. • 3.10 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions,but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable,preserving to the fullest extent permitted the intent of Provider and the City set forth in this Agreement. 3.11 Deliveries will be F.O.B destination. Provider shall pay all transportation and handling charges for the Goods.Provider is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Provider remains liable for latent defects,fraud, and warranties. • Page 3 of 6: Goods and Services Agreement between the City of Ashland and Accurate Plumbing Solutions 3.12 The City may inspect and test the Goods. The City may reject non-conforming Goods and require Provider to correct them without charge-or deliver them at a reduced price, as negotiated. If Provider does not cure any defects within a reasonable time, the City may reject the Goods and cancel this Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code, ORS Chapter 72(UCC). 3.13 Provider represents and warrants that the Goods are new, current, and fully warranted by the manufacturer. Delivered Goods Will comply with SUPPORTING DOCUMENTS and be free from defects in labor,material and manufacture.Provider shall transfer all warranties to the City, 4. SUPPORTING DOCUMENTS 4.1 The following documents are, by this reference, expressly incorporated in this Agreement, and are collectively referred to in this Agreement as the"SUPPORTING DOCUMENTS:" • The Provider's complete,written Rate Sheet dated July 6,2023 4.2 This Agreement and the SUPPORTING DOCUMENTS shall be construed to be mutually complimentary and supplementary wherever possible. In the event of a conflict which cannot be so resolved,the provisions of this Agreement itself shall control over any conflicting provisions in any of the SUPPORTING DOCUMENTS. In the event of conflict between provisions of two of the SUPPORTING DOCUMENTS,the several supporting documents shall be given precedence in the order listed in Article 4.1. 5. REMEDIES 5.1 In the event Provider is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or,in equity,including,but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Provider has failed to deliver within any scheduled completion dates or any Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages; specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly, collectively,successively or in any order whatsoever. 5.2 In no event shall City be liable to Provider for any expenses related to termination of this Agreement or for anticipated profits.If previous amounts paid to Provider exceed the amount due,Provider shall pay immediately any excess to City upon written demand provided. 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date"), and shall continue in full force and effect until June 30, 2024, unless sooner terminated as provided in Subsection 6,2, 6.2 Termination 6.2.1 The City and Provider may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may, upon not less than thirty (30)days' prior written notice,terminate this Agreement for any reason deemed appropriate in its sole discretion. Page 4 of& Goods and Services Agreement between the City of Ashland and Accurate Plumbing Solutions 6.2.3 Either party may terminate this Agreement,with cause, by not less than fourteen(14) days'prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery,by sending via a'reputable commercial overnight courier, or by mailing using registered or certified'United States mail, return receipt requested, postage prepaid, to the address set forth below: • If to the City: • . • City of Ashland—Facilities Maintenance Department Attn: David Arnold • 20 E.Main Street • Ashland,Oregon 97520 Phone: (541)552-2292 With a copy to: • City of Ashland—Legal Department • 20 E.Main Street Ashland,OR 97520 • Phone: (541)488-5350 If to Provider: Accurate Plumbing Brent Carlson PO Box 1503 Medford, OR 97504 •541-773-3035 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision,term,condition, or covenant contained in this Agreement shall not be construed as'a waiver of any subsequent breach,whether or not of the same nature. 9. PROVIDER'S COMPLIANCE WITH TAX LAWS 9.1 Provider represents and warrants to the City that: 9.1.1 Provider 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 • Provider; and • (iii) Any rules,regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. • • • 9.1.2 Provider,for a period of no fewer than six(6) calendar years preceding the Effective Date of this •• • A• greement, 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; Page 5 of 6: Goods and Services Agreement between the City of Ashland and Accurate Plumbing Solutions • • (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Provider; and (iii) Any rules,regulations, charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9,shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. CITY OF ASHLAND: Accurafte�P.uzn n_ Sol :'o • (PROVIDER): • By: „alb By: ._ ign. Signature Steffi y e1ic CAr\ w\ Printed Name Printed Name Title Title Date Date (W-9 is to be submitted with this signed Agreement) Purchase Order No. Aril 40 c7 Page 6 of 6: Goods and Services Agreement between the City of Ashland and Accurate Plumbing Solutions • .QAccgRATE AccgRATE PLUMBING SOLUTIONS = ELECTRICAL SOLUTIONS • Accurate Plumbing Solutions and Accurate Electrical Solutions Mailing:PO Box 1503, Medford OR 97501 Office: 1234 Corona Ave.,.Medford,OR 97504 541-773-3035 Fax:541-773-3980 CCB#218683 Email:ansincolumbPannail.com • July 6, 2023 Dear Customer, • We are honored to have the opportunity to work with you. I want to provide the pricing we will have for this current contract. If you have any questions, please don't hesitate to reach out to myself or Brent Carlson,the owner. Excavator and Operator-$125 an Hour Laborer-$85 an Hour Journeyman Plumber-$155 an hour • Electrician - $120 an Hour Vactor Truck-$200 an hour with a 2 hour minimum. • Camera/Locate-$175 an hour All services have a one hour minimum, except the Vac truck that has a two hour minimum. Bore jobs we will have to look at to bid, every job is different. Thank you for continuing to support Accurate Plumbing Solutions and Accurate Electrical Solutions! A CERTIFICATE OF LIABILITY( INSURANCE CORD DAT 07/2/20/YYYY) 07/20/2023 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: It the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT FEDERATED MUTUAL INSURANCE COMPANY PNPAME: CLIENT CONTACT CENTER HOME OFFICE:P.O.BOX 328 fA/ANA/e,EoII:888-333-4949 (plc,Ile):507-446-4664 OWATONNA,MN 55060 nnoREss:CLIENTCONTACTCENTERaFEDINS.COM INSURERS AFFORDING COVERAGE NAIL 8 INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 184-231-9 INSURER B: CARLSON CORP,ACCURATE PLUMBING SOLUTIONS INSURER C: PO BOX 1503 MEDFORD,OR 97501-0112 INSURER 0: I INSURER E: INSURER F: I COVERAGES CERTIFICATE NUMBER;108 REVISION NUMBER:4 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 su8JECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCEDgpgBY PAID CLAIMS.• p i MOW)ILqq TR TYPE OF INSURANCE A SDR WVOR POLICY NUMBER (MppMNSIYYEYYYI li Il d/DD)Y ), OMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE nOCCUR DAMAGETO. ENrED PREMISES_ $100,000 IFa orrl,rmnr MED SEP(Any one person) EXCLUDED A Y N 9329570 11/01/2022 11/01/2023 PERSONALS Any INJURY $1,003,000 CENT LLAGGREGATE DE APPLIES PEA GENERAL AGGREGATE $2,000,000 pram ['LOC - PRODUCTS&COMP/OP AGO $2,000,000 OTHER: ggi�pp AUTOMOBILE LIABILIqqTY (Ec accdden0Slt)OLE LIMIT 51,000,000 X ANYAUTO _ BODILY INJURY(Per Person) A OWNED AUTOS ONLY SACIiEoDULED Y N 9329570 11/01/2022 11/01/2023 BODILY INJURY(Por Accident _HIREDAUTOS ONLY _AUUTT0.S ONLY • rROPAER)d DAMAGE • X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $1,000,000 A EXCESS LIAR CLAIMS-MADE Y N 9329571 11/01/2022 111/01/2023 AGGREGATE $1,000,000 DED I IRETENRON WORKERS COMPENSATION PER STATUTE I 10THER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT OFRCERWEMBER EXCLUDED? C N/A (Mandatory In NH) E.L DISEASE'EA EMPLOYEE If yes,describe ander DESCRIPTION OF OPERATIONS below E.L DISEASE•POLICY LIMIT • DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may he attached II more space Is required) SEE ATTACHED PAGE • CERTIFICATE HOLDER CANCELLATION 184-231-9 108 4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED CITY OF ASHLAND 20 E MAIN ST BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ASHLAND,OR 97520-1814 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1088-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2018/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:184-231-9 .4tCQ LOC#: ADDITIONAL REMARKS SCHEDULE Page 1 or• AGENCY NAMED INSURED FEDERATED MUTUAL INSURANCE COMPANY CARLSON CORP,ACCURATE PLUMBING SOLUTIONS PO BOX 1503 POLICY NUMBER MEDFORD,OR 97501-0112 SEE CERTIFICATE#108.4 CARRIER MAID CODE EFFECTIVE DATE:SEE CERTIFICATE#108.4 SEE CERTIFICATE#108A • ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 26 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER TS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. COMMERCIAL UMBRELLA FOLLOWS FORM ACCORDING TO THE TERMS, CONDITIONS, AND ENDORSEMENTS FOUND IN THE COMMERCIAL UMBRELLA POLICY. • • • ACORD 101(2008/01) O 2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. WHO IS AN INSURED for"bodily injury"and "property damage" liability is amended to include: Any person or organization other than a joint venture, for which you have agreed by written contract to procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered "auto"with your permission. However,this additional insurance does not apply to: (1) The owner or anyone else from whom you hire or borrow a covered "auto". This exception does not apply if the covered "auto"is a "trailer"connected to a covered "auto"you own. (2) Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her household. (3) Someone using a covered "auto" while he or she is working in•a business of selling, servicing, repairing, parking or storing"autos"unless that business is yours. (4) Anyone other than your "employees", partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their "employees", while moving property to or from a covered "auto". (5) A partner (if you are a partnership), or a• member (if you are a limited liability company) for a covered "auto"owned by him or her or a member of his or her household. ' B. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms,. conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any insured,or to procure insurance. C. The limits of insurance applicable to such insurance shall be the lesser of the limits required by the agreement between the parties, or the limits provided by this policy. D. Additional exclusions. The insurance afforded to any person or organization as an insured under this endorsement does not apply: 1. To"loss"which occurs prior to the date of your contract with such person or organization; 2. To "loss" arising out of the sole negligence of any person or organization that would not be an insured except for this endorsement. 3. To "loss" for any leased or rented "auto" when the lessor or his or her agent takes possession of the leased or rented "auto"or the policy period ends,whichever occurs first. Includes copyrighted material of Ihsurance Services Office, Inc.with its permission. CA-F-127(03-03) Policy Number:9329570• Transaction Effective Date:11/01/2022 COMMERCIAL GENERAL LIABILITY CG 20 3312 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN A WRITTEN CONSTRUCTION AGREEMENT WITH,YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section 11 - Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or additional insureds, the following additional organization for whom you are performing exclusions apply: operations When you and such person or This insurance does not apply to; organization have agreed in writing in a contract 1. "Bodily injury", "property damage" or or agreement that such person or organization be "personal and advertising injury" arising out added as an additional insured on your policy. of the rendering of, or the failure to render, Such person or organization is an additional insured only with respect to liability for "bodily any professional architectural, engineering or injury", "property damage" or "personal and surveying services, including: advertising injury"caused, in whole or in part, by: a The preparing, approving, or failing to 1. Your acts or omissions;or prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, 2. The acts or omissions of those acting on your change orders or drawings and behalf; specifications;or in the performance of your ongoing operations for b Supervisory, inspection, architectural or the additional insured. engineering activities. However, the insurance afforded to such This exclusion applies even if the claims additional insured: against any insured allege negligence or other 1. Only applies to the extent permitted by law; wrongdoing in the' supervision, hiring, and employment, training or monitoring of others 2. Will not be broader than that which you are by that insured, if the "occurrence" which required by the contract or agreement to caused the "bodily injury" or "property provide for such additional insured. damage", or the offense which caused the A person's or organization's status as an "personal and advertising injury", involved the additional insured under this endorsement ends rendering of or the failure to render any when your operations for that additional insured professional architectural, engineering or are completed. surveying services. II © Insurance Services Office, Inca', 2018 Page 1 of 2 CO 20 33 12 19 Policy Number: 9329570 j Transaction Effective Date:11/01/2022 111 2. "Bodily injury" or "property damage" C. With respect to the insurance afforded to these occurring after: additional insureds, the following is added to a. All work, including materials, parts or Section III-Limits Of Insurance: equipment furnished in connection with The most we will pay on behalf of the additional such work, on the project (other than insured is the amount of insurance: service, maintenance or repairs) to be 1. Required by the contract or agreement you performed by or on behalf of the additional have entered into with the additional insured; insured(s) at the location of the covered or operations has been completed; or 2. Available under the applicable limits of b. That portion of "your work" out of which insurance; the injury or damage arises has been put to its intended use by any person or whichever is less. organization other than another.contractor This endorsement shall not increase the. or subcontractor engaged in performing applicable limits of insurance. operationsfor a principal as a part of the • same project. • • • • •• • • Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 33 12 19 Policy Number: 9329570 Transaction Effective Date:11/01/2022