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HomeMy WebLinkAbout2021-188 PO 20210153- Altec Industries Inc ' I Purchase Order ,/1Frit1 CITY— • Icy}/) �f�/ �g Fiscal Year 2021( Page: 1 of: 1, tl tl �A4'��� � 4.i}Il� lll" l'K -t �— N c 1 of 11-CI i I ; USFIaL' Iii 1Ti51 pt B City of Ashland L 20 E. Main ATTN:Accounts Payable • Purchase L Ashland, OR 97520 Order# 20210153 T Phone:541/552-2010 • O Email: payable@ashiand.or.us - • ✓ H C/O Fleet/Shop Division E ALTEC INDUSTRIES, INC I 90 North Mountain Ave N PO BOX 11407 • p Ashland, OR 97520 0 BIRMINGHAM,AL 35246-0414 Phone:541/488-5358 R T Fax:541/552-2304 I�=I I -. - _- Wes Hoadle Fl l- 1a -5 I {= Cl E 1 if.) !1 C�1 f G -I 1-1�'=1e1-I —�1_IEf.: I IE1 r I fII I 10/12/2020 6 FOB ASHLAND OR/NET30 Cit Accounts Pa able -- FY 21 Fleet Services • 1 FY 21 Fleet Services 1.0 $30,000.00 $30,000.00 Project Account:• • *********k****# GL SUMMARY*************** 086500-602223 $30 000.00 • • • • • • • • By: � Date: l Authorized Sign.ture V 1 F ——V T '30 000.00 G L • • .. FORM#3 CITY OF ' i • A VOW►:?:•,t`j )'i it Srt►1rt;);,:1r•►.f I'i);!Y ! REQUGSHTOON d•A ab'IA Date of request, 7/31/2020 G / / ' ',• _ray equfed dale for delivery: , • • Vendor Name Grow Altec Service G Address,City,State,Zip 13817 NE Sandy Boulevard.Portland.OR 97230 Contact Name&Telephone NumherPat Madden 560.606-0816 pat.maddenra2altec.com Etnall address SOURCING METHOD ❑ Exempt front Competltbio Bidding • 0 Emergency • ❑ Reason for exemption: ❑ jnvitatlon to Bid El Form 1113,Written findings and Authorization ❑ AMC 2,50 'Date approved by Council: El Written quote or proposal attached , ❑ Written quote orproposai attached (Attach copy of council communication) _(II council approval required,attach copy of CC) ❑ Small Procurement 0 Request for Proposal Cooperative Procurement Not exceeding$5,000 Dale approved by Council: ❑ Stale of Oregon ❑ Direct Award (Altach copy of council communication) Contract 11 , ❑ Verbal/Written quote(s)or proposal(s) f7 Request for Qualifications(Public Works) ❑ Slate of Washington • Dale approved by Council: Contract', (Attach copy of council communication) ❑ Other government agency contract Intermediate Procurement D Sole Source Agency • GOODS&SERVICES . 0 Applicable Form(115,6,7 or 0) Contract„ Greater than$5,000 and Ione than$100,000 • ❑ Written quote or proposal attached Intergovernmental Agreement . ❑ (3)Written quotes and solicitation attached El Form114,Personal Services>$0K&<$76K Agency PERSONAL SERVICES lE1 Special Procurement ❑ Annual cost to City does not exceed$26,000, Greater titan$5,000 and less titan$75,000 ® Form 119,Request for Approval Agreement approved by Legal and approvedlsigned by 0 Direct appointment not to exceed$35,000• ❑ Written quote or proposal attached qy Administrator.AMC 2.60.010(4) 13 (3)Written proposals/written solicilallon Date approved by Council: 0/7/2010 Annual cost to City exceeds$25,000,Council El Form 114,Personal Services>$51(&<$75K Valid until: June 30.2023 •(Date) approval required.(Attach copy of cbunci communication) Description of SERVICES Total Cost FY21•Setvices as needed • .$30,000.00 Item 11 Quantity Unit Description of MATERIALS Unit Price Total Cost [I Per attached quotelproposal TOTAL COST $• Project Number •___ Account Number 086500-602223 'Expenditure must be charged to the appropriate account numbers for the financials to accuratelyrollect 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 requisll/oform,I Wily h 1 the City's public contracting requirements have been set/Wed. Employee: f^�' Department Head: iim(�� ' rdtrm alto or a realer Iran$5,000) Department Manager/Supervisor: Cit cin ttihtr .r�, --I-- (Equ Itoorgreater titan$25,000) Funds appropriated for current fiscal year. /NO • - l/ ..0o7 DepulyFinanceDirector-(Equaltoor area! 1$5,000) Date • Comments: Form 113-Requisition • • • GOODS&SERVICES AGREEMENT PROVIDER: Altec Service Group CITY 4g PROVIDER'S ASHLAND CONTACT: Pat Madden 20 East Main Street Ashland,Oregon 97520 ADDRESS: 131117 NE Sandy Boulevard Telephone: 541/488-5587 Portland,OR 975230 Pax: 541/488-6006 PHONE: 360-606-0616 This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the City of Ashland, an Oregon municipal corporation(hereinafter"City") and Altec Service Group, a domestic business corporation("hereinafter"Provider");for mobile fleet services, 1. PROVIDER'S OBLIGATIONS 1.1 Provide mobile fleet services for FY21 as set forth in the "SUPPORTING DOCUMENTS" attached thereto 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 goods and 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 • Automobile Liability. 1.2.2 Each policy of such insurance shall be on an"occurrence"and not a"claims made"form,and shall: O 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; O Apply to each named and additional named insured as though a separate policy had been issued'to each,provided that the policy limits shall not be increased thereby; • 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 o Be evidenced by•a certificate or certificates of such insurance approved by the City. • Page 1 of5:Agreement between the City of Ashland and Altec Service Group • I I 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 oldie State of-Oregon for JacksonCounty unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives,any and.all rights to maintain an action under this 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 of venue. • 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,Iiabilities,'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. - - i • 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 eirtent permitted the intent of Provider and the City set forth in this Agreement. • 4. SUPPORTING DOCUMENTS The following documents are,by this reference,expressly incorporated in this Agreement,and are collectively referred to in this Agreement asthe,"SUPPORTING DOCUMENTS:" • U The Provider's complete written Rate Sheet dated April 13,2020 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 extentthe 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 • f . 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, 2020, unless sooner terminated as provided in Subsection 6.2. 3 ' rage 3 of is Agreement between the City of Ashland and Altec Service Group • ' • • 9.1.2 Provider,for a period of no fewer than six(6)calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (1) 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. 9.2 Provider's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision ofthe State of Oregon shall constitute a material breach ofthis Agreement. Further, any violation of Provider's warranty, as set forth in this Article 9,shall constitute a material broach 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 inequity. IN'WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the slates set forth below. ' I CITY OF ASHLAND: Altec Service Group(PROVIDER): By: Signature BY/6 � . - -- Signa %© '4' S^ • Printed Name Printr d'lame ..4,, , c SL5pocLV.-s4 OR. 'Mv6.leSYe Title Title /6/6/z ' (.O? La , ,���.�Q Date Date ! (T9 is to be submitted with this signed Agreement) Purchase Order No. ' I . II • Page 5 of5:Agreement between the City of Ashland and Altec Service Group ® I N - Service Group . To:Whom it may concern • From:John Denny Date:April 13,2020 Subject: Current Rate Sheet(Oregon) • Hourly Rates: Shop:$120 - Shop Location:Portland,OR. • Mobile(MST):$143 Preventative Maintenance Inspections are flat rated per unit and are available upon request. • Thank you, John Denny Area Service Manager • 707-693-2525 Office 530-304-9666 Cell john.denny@altec.com • • • • • • rilt!'7tec Service Altec Service Scheduled Maintenance Prices Group , Pricing Is for labor only. Material(Filter,Lube,etc)costs are additional. Pricing As of 21-Oct-2019(Subject To Change Without Notice) Service Unit Description - Interval Price* PM Inspection SMALL AERIAL UNITS 40'AND UNDER WITHOUT MATERIAL HANDLING 6 Month $ 275 (AT,AO) 1 Year $ 385 PM Inspection LARGE AERIAL UNITS UNDER 65' 6 Month $ 410 , (AM,AA,AN,LRV) 1 Year $ 600 PM Inspection LARGE DERRICKS AND PRESSURE DIGGERS 6 Month $ 685 (D2000-D4000,DT80,HD) 1 Year $ 875 PM Inspection CHIPPER 1 Year $ 500 DOT Inspection 2 AXLE •. •1 Year $ 110 3-4 AXLE 1 Year ,$ , 165 Dielectric Test CAT B/C;BOOM&ISO GRIP(WHEN APPLICABLE) &LINER 1 Year $ 325 Dielectric Test CAT B/C;BOOM&ISO GRIP(WHEN APPLICABLE) 1 Year $ 200 Dielectric Test PLATFORM LINER 1 Year $ 150 Dielectric Test CAT B/C;BOOM&LINER&ISO GRIP(WHEN APPLICABLE) , 1 Year $ 200 (PRICE DISCOUNTED WHEN DONE WITH PM) • Dielectric Test HOTSTICK' 1 Year $ 75 Dielectric Test INSULATED LINK $ 155 Rev:21-Oct-2019 ' I ' • l ® DATE(MMIDD/YYYY) .a►`oRD CERTIFICATE OF LIABILITY INSURANCE 12/29/2020 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 certificateholder is an.ADDITIONAL INSURED,the.policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to,the terms and conditionsof 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 Bridgette Taul MCGRIFF,SEIBELS&WILLIAMS,INC. NAME: 9 P.O.Box 10265 (NC.No. Ext);800-476-2211 FAX No): Birmingham,AL 35202 E-MAIL riff.com ADDRESS:btaul me g - _ INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Lexington Insurance Company 19437 INSURED INSURER B:Hartford Fire Insurance Company 19682 Altec Industries,Inc. 1450 N 1st.Street INSURER C:AIG Specialty Insurance Company 26883 Dixon,CA 95620 . INSURER D:Trumbull Insurance Company •27120 INSURER E:Hartford Casualty.Insurance Company 29424 INSURER F: COVERAGES CERTIFICATE NUMBER:YQBX9FU2 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: INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS A X COMMERCIAL GENERAL UABIUTY 013136094 06/01/2020 06/01/2021 EACH OCCURRENCE $ 5,000,000 CLAIMS-MADE D OCCUR PREMISES(Ea REN ccu ence) $ 3,000,000 — MED EXP(Any one person) $ N/A X PERSONAL&ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 1 POLICY n PRJECOT- ❑LOC PRODUCTS-COMP/OP AGG $ 10,000,000 OTHER: $ B AUTOMOBILE LIABILITY 21CSES27903 06/01/2020 06/01/2021 COMBINED SINGLE LIMIT (Ea accident) 3,000,000 _ X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED X BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS _ XHIRED y NON-OWNED • PROPERTY DAMAGE $ AUTOS ONLY _ AUTOS ONLY (Per accident) $ C X UMBRELLA LIAB X OCCUR 18895685 06/01/2020 06/01/2021 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ • $ D WORKERS COMPENSATION 21WNS27900(AOS) 06/01/2020 06/01/2021 X STATUTE OTH- ER E AND EMPLOYERS'LIABILITY 21XWES27902(AL,MO,NC) 1,000,000 • ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N El.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? n N 1 A (Mandatory In NH) • EL DISEASE-EA EMPLOYEE $ ' 1,000,000 If yes,describe under . 1000000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 $ $ ' $ $ $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) RE:Service,Maintenance,or Repair • The City of Ashland,Oregon,its officers,agents and employees are additional insured under General Liability and Automobile Liability,on a primary and non-contributory basis as required by written contract.See cancellation endorsement form attached. CERTIFICATE HOLDER ,• CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN . ACCORDANCE WITH THE POLICY PROVISIONS. City of Ashland AUTHORIZED REPRESENTATIVE / 20 East Main Street --_ / Ashland,OR 97520 /' • Page 1 of 7 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) , The ACORD name and logo are registered marks of ACORD POLICY NUMBER:. 21 CSE $27903 COMMERCIAL AUTO CA 20 48 02 99 - THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFLI4LY, DESIGNATED INSURED This endorsement modifies Insorance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorseMent,the provisions of the Coverage Forin apply unless modified by.thiS andorSsmerit This endorsement identifies pertion(s)or cirganitation(s)'who are"insureds"under the Who Is An Insured Provision of ttM Coverage Form.This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effectiVe on the inception date of the policy unless another date is indleated below. • Warned insured Countersigned by ALTEC, (Authorized Representative) SCHEDULE Name of person(s)or Organization(s): Any person or organization that you are kequired to include ag an additional insured on this coverage form in a written contract or agreement that is signed end executed by you before the "bodily injury" or. "property damage" occurs and, that is .in effect during the policy period. • • Of no entry appears above,information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "instinxi" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 40 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 Page 2 of 7 Altec, Inc. Policy No.21CSES27903 THIS ENDORSEMENT CHANGES THE POLICY.. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional on file with the agent of record will be sufficient Conditions: proof of notice. If this policy is cancelled by the Company, other Any notification rights provided by this than for nonpayment of premium, notice of such . endorsement apply only to active certificate • cancellation will be provided to the certificate holder(s) who were issued a certificate of holder(s) with mailing addresses on file with the insurance applicable to this policy's term. agent of record. Such notice will be provided Failure to provide such notice to the certificate within 30 days of the Company's receipt of holder(s) will not amend or extend the date the certificate holder(s) information from the agent of cancellation becomes effective, nor will it negate record. cancellation of the policy. Failure to send notice If notice is mailed, proof of mailing to the last shall impose no liability of any kind upon the known mailing address•of the certificate holder(s) Company or its agents or representatives. • • • • • 1 , Form IH 0310 06 11 Page 1 of 1 • © 2011,The Hartford • YQBX9FU2 Page 3 of 7 ENDORSEMENT: Forms a part of Policy No.: 013136094 Issued to: Altec,Inc. Attn:Mark Bertovic • By: LEXINGTON INSURANCE COMPANY ADDITIONAL INSURED REQUIRED BY WRITTEN CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY POLICY A. Section II —Who Is An Insured is amended to include any person or organization you are required to include as an additional insured on this policy by a written contract or written agreement in effect during this policy period and executed prior to the "occurrence" of the "bodily injury" or "property damage." B. The insurance provided to the above described additional insured under this endorsement is limited as follows: • 1. COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE (Section I -Coverages) only. • 2. The person or organization is only an additional insured with respect to liability arising out • of "your work" or "your product" for that additional insured. 3. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract or written agreement, the insurance provided by this endorsement shall be limited to the Limits of Insurance required by the written contract or written agreement. 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. 4. The insurance provided to suchan additional insured does not apply to "bodily injury" or "property damage" arising out of an architect's, engineer's or surveyor's rendering of or failure to render any professional services including: i The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and ii Supervisory, inspection, architectural or engineering activities. 5. This insurance does not apply to "bodily injury"or "property damage"arising out of "your work" or "your product" included in the "products-completed operations hazard" unless • • you are;requiredto provide such coverage by written contract or written agreement. 6. 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 a written contract or written agreement specifically requires that this insurance apply on a primary and non-contributory basis. Manuscript Form Page 1 of 2 ' Page 4 of 7 YQBX9FU2 • C. 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. All other terms and conditions of the policy remain the same. • Authorized Representative • • • • 1 • • • • ' J • I Manuscript Form Page 2 of 2 • Page 5 of 7 YQBX9FU2 . .._ ENDORSEMENT#038 • • Forms a part of policy no.: 013136094 Issued to; AVEC, INC. ATTN: MARK BERTOVIC By: LEXINGTON INSURANCE COMPANY • ADVICE OF CANCELLATION TO ENTITIES OTHER THAN THE NAMED INSURED LIMITED TO E-MAIL NOTIFICATION This policy is amended as follows; • Inthe event that the Insurer cancels:this policy forany reason other than non payment of premium, and . 1. The cancellation'effdctive,date.is.prior tothis policy's expiration date; 2. The First Named insured is under an existing contractual obligation 'to notify a certificate holder:When thispoliey is canceled {hereinafter,the "Certificate Holdertsi") and`has provided to the Insurer; either directly or through Its broker of record,the:.email address of the contact • at:such entity, and .the Insurer :received this information after the First Named Insured receives notice of .cancellation of this policy.and prior to this pol;cy s candellation'effective•date, via an electronic spreadsheet that is acceptable to the Insurer,. • the Insurer will provide advice of cancellation(the."Advices":via.0-mall-to streh'Vertificate Holders. • • .Probf Of the insurer emalling.the Advice,.using the.information•provided by the First Noinedi Insured, will . ..serve as proof that the Insurer has fully satisfied its obligations under.this.endorsement. • This endorsement does nota€feet, in anyway, coverage provided.under this policy.Or the cancellation of this policy or the. effective date thereof, nor shall-this endorsement Invest any rights in any entity not insured under this policy. • • The following.Definitions apply to this endorsement: 1. First Named insured means the Named Insured shown'on the Declarations Page of This policy. 2; Insurer means the insurance company shoWn in the. header on the Declarations Page. of this policy. All Other terms and conditions remain unchanged, • '4,44. 3-$14.- Authorized Representative OR Countersignature tin states where applicable) LlXDOCO21 LXb404 • • Page.6 of 7 YQBX9FU2 Altec, Inc. Policy No.21 WNS27900 • THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • NOTICE OF CANCELLATION TO CERTIFICATE HOLDER(S) This policy is subject to the following additional on file with the agent of record will be sufficient Conditions: proof of notice. If this policy is cancelled by the Company, other Any notification rights provided by this than for nonpayment of premium, notice of such endorsement apply only to active certificate • cancellation will be provided to the certificate holder(s) who were issued a certificate of holder(s) with mailing addresses on file with the insurance applicable to this policy's term. agent of record. Such notice will be provided Failure to provide such notice to the certificate within 30. days of the Company's receipt of holder(s) will not amend or extend the date the certificate holder(s) information from the agent of cancellation becomes effective, nor will it negate record. cancellation of the policy. Failure to send notice If notice is mailed, proof of mailing to the last • shall impose no liability of any kind upon the known mailing address of the certificate holder(s) Company or its agents or representatives. • • • • • • • • Form IH 0310 0611 Page 1 of 1 © 2011,The Hartford Page 7 of 7 YQBX9FU2