HomeMy WebLinkAbout2024-176 AGRMT Gage It Construction LLC L`CITY OF
-ASHLAND Goods and Services Agreement
City Information Contractor Information
City of Ashland Firm Name: Gage it Construction LLC
Attn: Chuck Schweizer Contact: Brian Bowman
20 East Main Street
Address: 7981 11th Street
Ashland, Oregon 97520 White City, OR 97503
Phone: (541) 552-2345 Phone: (541) 779-7007
Email: chuck.schweizer@ashland.or.us Email: brianb@gageit.org
Contract Summary
Procurement Method: direct award
Completion Date: 12/31/2024
Contract Amount: $ 3,800.00
Description of services: repair damaged guardrail on Tolman Creek Rd
Supporting Documents: Quote Dated: 10/13/2024
Dated:
Dated:
Dated:
This Goods and Services Agreement (hereinafter "Agreement") is entered into by and between the
City of Ashland, an Oregon municipal corporation (hereinafter "City") and the Contractor listed under
Contractor Information above, (hereinafter "Contractor"), for the services listed under Description of
Services and the Supporting Documents as noted in the Contract Summary above.
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 the Supporting Documents, t pporting
Documents shall be given precedence in the order listed above.The Contractor's initials 1 herein
signify acknowledgment and agreement to this provision, if applicable, or if not sign "N' " .
The goods and services defined and described in the Supporting Documents shall hereinafter be
collectively referred to as "Work."
Page 1 of 8: Goods and Services Agreement between the City of Ashland and Gage it Construction
1. Term and Termination
1.1. 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 the
Completion Date indicated in the Contract Summary on page one of this Agreement unless
sooner terminated as provided in Subsection 1.2.
1.1. Time is of the essence. Time is of the essence for Contractor's performance of
each and every obligation and duty under this Agreement. City, by written notice to
Contractor of default or breach, may at any time terminate the whole or any part of this
Agreement if Contractor fails to provide the Work called for by this Agreement within the
time specified herein or within any extension thereof.
1.2. Termination
1.2.1. The City and Contractor may terminate this Agreement by mutual agreement at any
time.
1.2.2. 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.
1.2.3. 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.
2. Compensation
2.1. City shall pay Contractor the sum listed as the "Contract Amount" in the Contract Summary
on page one of this Agreement as provided herein as full compensation for the Work as
specified in the supporting documents.
2.2. In no event shall Contractor's total of all compensation and reimbursement under this
Agreement exceed the "Contract Amount" listed in the Contract Summary without express,
written approval from the appropriate Department Head or City Manager. Contractor
acknowledges that any work delivered, or expenses incurred without authorization as
provided herein is done at Contractor's own risk and as a volunteer without expectation of
compensation or reimbursement.
3. Contractor's Obligations
3.1. Performance. Provide the goods or services as set forth in the Supporting Documents
attached hereto and, by this reference, incorporated herein.
3.2. Nondiscrimination. Contractor 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 Contractor.
Contractor agrees to comply with all applicable requirements of federal and state civil rights
and rehabilitation statutes, rules and regulations. Further, Contractor 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
Page 2 of 8: Goods and Services Agreement between the City of Ashland and Gage it Construction
business enterprise certified under ORS 200.055, in awarding subcontracts as required by
ORS 279A.110.
3.3. Subcontractor Notification. In all solicitations either by competitive bidding or negotiation
made by Contractor 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 Contractors of the Contractor's obligations under this Agreement and Title VI of the Civil
Rights Act of 1964 and other federal nondiscrimination laws.
3.4. Living Wage Requirements. If the amount of this Agreement is $26,429.65 or more,
Contractor 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. Contractor is also required to post the notice attached hereto as "Exhibit A"
predominantly in areas where it will be seen by all employees.
4. Contractor's Compliance with Tax Laws
4.1. Contractor represents and warrants to the City that:
4.1.1. Contractor shall, throughout the term of this Agreement, including any extensions
hereof, comply with:
• All tax laws of the State of Oregon, including but not limited to ORS 305.620 and
ORS chapters 316, 317, and 318;
• Any tax provisions imposed by a political subdivision of the State of Oregon
applicable to Contractor; and
• Any rules, regulations, charter provisions, or ordinances that implement or enforce
any of the foregoing tax laws or provisions.
4.1.2. Contractor further certifies that contractor is not in violation of any Oregon tax laws
referenced in ORS 305.380(4).
4.2. Tax Compliance Breach. Contractor'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 Contractor'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.
5. Insurance. Contractor 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 Each
policy of such insurance shall be on an "occurrence" and not a "claims made" form, and shall
include:
5.1. Commercial general liability -- with a combined single limit, or the equivalent, of not less
than $2,000,000 (two million dollars) per occurrence and $3,000,000 (three million dollars) in
the aggregate for Bodily Injury and Property Damage.
Page 3 of 8: Goods and Services Agreement between the City of Ashland and Gage it Construction
5.2. Commercial Automobile Liability -- with a combined single limit, or the equivalent of not
less than $2,000,000 (two million dollars) for each accident for Bodily Injury and
Property Damage, including coverage for owned, hired and non-owned vehicles.
5.3. Additional forms: (See Attached)
5.4. Worker's Compensation. Contractor 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. As evidence of the
insurance required by this Agreement, the Contractor shall furnish an acceptable insurance
certificate prior to commencing any Work with limits not less than $500,000.
5.4.1. Workers' Compensation Exemption: If applicable, Contractor affirms and certifies that
it is exempt from providing Workers' Compensation per ORS 656.027.
Exemption criteria:
Contractor initials if exempt: Date:
6. Additional Insured/Certificates of Insurance. The Contractor shall name the City of Ashland,
Oregon, along with its elected officials, officers, and employees, as Additional Insureds on all
insurance policies (excluding Professional Liability and Workers' Compensation) necessary for
this Agreement. This inclusion applies solely to the services provided by the Contractor under this
Agreement. The Contractor's insurance must be primary and non-contributory. Before
commencing work, the Contractor must provide acceptable insurance certificates as proof of the
required coverage. These certificates must specify all parties included as additional Insureds,
treating each named and additional named insured as if they were covered under separate
policies, without increasing policy limits. Insuring companies or entities must be accepted by the
City. Upon request, the Contractor must provide complete copies of insurance policies and trust
agreements to the City.Additionally,the Contractor must provide an endorsement naming the City,
its officers, employees, and agents as additional insureds by the Effective Date of this Agreement,
accompanied by approved certificate(s) of insurance.
7. Indemnity. Contractor 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 Contractor or its officers, employees, contractors, or agents under this Agreement.
8. 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 addresses set forth above with a copy to:
City of Ashland — Legal Department
20 E. Main Street
Ashland, Oregon 97520
Phone: (541)488-5350
Page 4 of 8: Goods and Services Agreement between the City of Ashland and Gage it Construction
6. Remedies
6.1. In the event Contractor 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:
6.1.1. Termination of this Agreement.
6.1.2. Withholding all monies due for the Work that Contractor has failed to deliver within any
scheduled completion dates or any Work that have been delivered inadequately or
defectively.
6.1.3. Initiation of an action or proceeding for damages, specific performance, or declaratory
or injunctive relief.
6.1.4. 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.
6.2. 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 under the
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 Agreement; or,
without written authorization by the City, attempts to assign rights in, or delegate duties
under, this Agreement.
6.3. Liability Limitation. In no event shall City be liable to Contractor for any expenses related to
termination of this Agreement or for anticipated profits. If previous amounts paid to Contractor
exceed the amount due, Contractor shall pay immediately any excess to City upon written
demand provided.
7. General Provisions
7.1. Non-exclusive Agreement. City is not obligated to procure any specific amount of Work
from Contractor and is free to procure similar types of goods and services from other
Contractors in its sole discretion.
7.2. Independent Contractor Status. Contractor is an independent contractor and not an
employee or agent of the City for any purpose.
7.3. Statutory Requirements. The following laws of the State of Oregon are hereby incorporated
by reference into this Agreement: ORS 279B.220, 27913.230 and 27913.235
7.4. Assignment. Contractor 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. 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 the City of any assignment or subcontract
shall not create any contractual relation between the assignee or subcontractor and the City.
Page 5 of 8: Goods and Services Agreement between the City of Ashland and Gage it Construction
7.5. Force Majeure. 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.
7.6. Deliveries F.O.B destination. Contractor shall pay all transportation and handling charges
for the Goods. Contractor is responsible and liable for loss or damage until final inspection
and acceptance of the Goods by the City. Contractor remains liable for latent defects, fraud,
and warranties.
7.7. Goods Rejection. The City may reject non-conforming Goods and require Contractor to
correct them without charge or deliver them at a reduced price, as negotiated. If Contractor
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).
7.8. Goods Warranty Representation. Contractor 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.
Contractor shall transfer all warranties to the City.
7.9. 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.
7.10. Jurisdiction. 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 Jackson County 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.
7.11. Severance. 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 Contractor and the City set
forth in this Agreement.
8. Merger. This agreement and the attached exhibits constitute the entire understanding and
agreement between the parties. No waiver, consent, modification or change of terms of this
agreement 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 agreement. Contractor, by signature of its authorized
representative, hereby acknowledges that he/she has read this agreement, understands it, and
agrees to be bound by its terms and conditions.
Page 6 of 8: Goods and Services Agreement between the City of Ashland and Gage it Construction
WITNESS WHEREOF, the parties have executed this Agreement in their respective names by their
duly authorized representatives as of the dates indicated below. This Agreement may be executed in
two counterparts, each of which shall be deemed an original,with equal force and effect as if executed
in a single document.
CITY OF ASHLAND: Gage,it�Construction(CONTRACT R):
gy
Signature Signatures
chuck schweizer ' t ,..w.
Printed Name
10/9/2024 Printed Name
Date
Title
Date
Purchase Order No.
(W-9 is to be submitted with this signed Agreement)
APPROVED AS TO FORM:
City Attorney
Page 7 of 8: Goods and Services Agreement between the City of Ashland and Gage it Construction
Im
City of Ashland
IJ IIIM ,Oft
LIVING
WmAm uE
per hour, effective June 30, 2024.
The Living Wage is adjusted annually every
June 30 by the Consumer Price Index.
• • . , , portion of the business of of health care, retirement,
their employer, if the 401 K, and IRS eligible
employer has ten or more cafeteria plans (including
employees, and has received childcare) benefits to the
➢ For all hours worked under a financial assistance for the employee's amount of wages.
service contract between their project or business from the
employer and the City of City of Ashland over ➢ Note: For temporary and
Ashland if the contract $26,429.65; part-time employees, the
exceeds$26,429.65 or more. Living Wage does not apply
➢ If their employer is the City of to the first 1040 hours worked
➢ For all hours worked in a Ashland, including the Parks in any calendar year, For
month, if the employee and Recreation Department. more details, please see
o Ashland Municipal Code
spends 50%or more of the ➢ In calculating the living wage, Section 3,12.020.
employee's time in that month working on a project or employers may add the value
additional
Call the Ashland City Manager's office at 541-488-6002 or write to the City Manager,
City Hall, 20 East Main Street, Ashland, OR 97520, or visit the City's website at www. shland.or.us.
Notice to Employers: This notice must be posted in areas where it can be seen by all employees.
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A�" CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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
NAME: KC Ferguson
HUB International Northwest, LLC PHONE FAX
P.O. Box 10167 A/C No Ext: 541-687-1117 A/C,No):541-342-8280
E-MEugene OR 97440-2167 ADDRESS: KC.Ferguson@HUBinternational.com
INSURER(S)AFFORDING COVERAGE NAIC#
wsURERA: SAIF Corporation 36196
INSURED GAGEITC-01 INSURERB:Western National Mutual Insurance Company 15377
Gage It Construction LLC INSURERC:Westchester Surplus Lines Insurance Co. 10172
P.O. Box 2604
White City OR 97503-7007 INSURERD:
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER:1858509836 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICYNUMBER MM/DD MM/DD
B X COMMERCIAL GENERAL LIABILITY Y Y CPP 125902203 3/9/2024 3/9/2025 EACH OCCURRENCE $1,000,000
CLAIMS-MADE OCCUR DAMAGE TO RENTED
PREMISES Ea occurrence $300,000
MED EXP(Any one person) $10,000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
PRO-
POLICY� ECT1:1 LOC PRODUCTS-COMP/OP AGG $2,000,000
OTHER: $
B AUTOMOBILE LIABILITY Y Y CPP125700903 3/9/2024 3/9/2025 COMBINED SINGLE LIMIT $1,000,000
Ea accident
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
X HIRED X NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
B X UMBRELLA LIAB X OCCUR UMB 104383303 3/9/2024 3/9/2025 EACH OCCURRENCE $5,000,000
EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000
DED X RETENTION$1 n nnn $
A WORKERS COMPENSATION Y 756250 5/1/2024 5/1/2025 X PER OTH-
AND EMPLOYERS'LIABILITY Y/N STATUTE ER
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
OFFICER/MEMBER EXCLUDED? FY] N/A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
C Pollution Liability Y Y G70974095004 3/9/2024 3/9/2025 Each Occurence: $1,000,000
Aggregate Limit $1,000,000
Deductible: $2,500
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Certificate holder and all entities required by written contract are included as additional insureds on a primary and non-contributory basis with waiver of
subrogation as respects to the general liability including completed operations,auto liability&pollution liability as required by written contract per attached
endorsements. Umbrella is follow form over General Liability,Auto&Employers Liability. Subject to policy limits,terms,conditions and exclusions.
re:Tolman Creek Rd Guardrail Repair
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
20 East Main Street AUTHORIZED REPRESENTATIVE
Ashland OR 97520
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
COMMERICAL GENERAL LIABILITY
CG MU 0009 06 22 COMMERCIAL GENERAL LIABILITY
CG MU 0009 06 22
COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT
The Commercial General Liability Enhancement Endorsement is an optional endorsement that provides coverage en- This endorsement modifies the insurance provided under the following:
lb-cements.The following is a summary of broadened coverages provided by this endorsement. No coverage is pro-
vided by this summary,refer to following endorsement for changes in your policy. COMMERCIAL GENERAL LIABILITY COVERAGE FORM
With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by
SUMMARY OF COVERAGES PAGE this endorsement.The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will
be amended as shown below.
Bodily Injury And Property Damage Liability
• Non Owned Watercraft Up To 50 Feet.......................................................................................2 SECTION I—COVERAGES AMENDMENTS
Property Damage Liability COVERAGE A—BODILY INJURY AND PROPERTY DAMAGE LIABILITY
• Elevators...... ___..... ......._. ___.... ...........__ ._..___._.._--3 A. Non Owned Aircraft Or Watercraft
• Fire,Lightning,Explosion Or Sprinkler Leakage Exception._.____.....___.........__....._...._......3 Item 2.Exclusions,Paragraph g.is replaced by the following:
• Borrowed Equipment($25,000 Per Occurrence,$50,000 Aggregate,
$2,500 Deductible Per Occurrence.......... .......... „„_3 g. Aircraft,Auto Or Watercraft
"Bodily injury"or"property damage'arising out of the ownership,maintenance,use or entrustment to others of any
Supplementary Payments—Amended aircraft,"auto"or watercraft owned or operated by or rented or loaned to any insured.Use includes operation and
• Bail Bonds Up To$5,000.... ._......_. .__.... ......__ ......___........._.3 "loading or unloading".
• Loss of Earnings Up To$5001Day ._......... .......... ..._..... .____.___.._...3 This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the
supervision,hiring,employment,training or monitoring of others by that insured,if the"occurrence"which caused
Who Is An Insured Amendments the"bodily injury"or"property damage'involved in the ownership,maintenance,use or entrustment to others of
• Employee Bodily Injury to A Ct-Employee ..._..... .____.___.._..A any aircraft,"auto"or watercraft that is awned or operated by or rented or loaned to any insured.
• Newly Formed Or Acquired Organizations For Up To 180 Days--..._.... .._.._.___.......4 This exclusion does not apply to:
• Blanket Additional Insured—Vendors—As Required By Contract_ ............._.._.___.---4 (1)A watercraft while ashore on premises you own or rent;
• Blanket Additional Insured—Lessor Of Leased Equipment ..._..... ___.....____.....6 (2)Awatercraft you do not own that is:
• Blanket Additional Insured—Managers Or Lessors Of Promises._..._..............__.....___.._...6
Blanket Additional Insured—State Or Governmental Agency Or Subdivisions (a)Less than 50 feet long;and
Or Political Subdivision—Permits Or Authorizations...... .__----............_...____.......7 (b)Not being used to carry persons or property for a charge;
• Blanket Additional Insured—Slate Or Governmental Agency Or Subdivision This Subparagraph(2)applies to any person,who with your expressed or implied consent,either uses or is
Or Political Subdivision—Permits Or Authorizations Relating To Premises..........................8 responsible for the use of the watercraft;
Damage To Premises Rented To You—$300,000 __.... _..._.. ___........____9 (3)Parking an"auto"on,or on the ways next to,premises you own or rent,provided the"auto"is not owned by or
rented or loaned to you or the insured;
Medical Payments Increased Limit—$10,000 Or Amount Shown on Declarations_....._..___._......_.g (4)Liability assumed under any"insured contract"for the ownership,maintenance or use of aircraft or watercraft;
or
Conditions (5)"Bodily injury"or"property damage"arising out of:
• Knowledge of Occurrence,Offense,Claim Or Suit Amended _.__.. ___.........--9 (a)The operation of machinery or equipment that is attached to,or part of,a land vehicle that would qualify
• Unintentional Failure To Disclose Hazards. .........._. .__._..... _.......___.......9 under the definition of"mobile equipment"if it were not subject to a compulsory or financial responsibility
• Waiver of Subrogation.......... ..._.... ........__. _...__... _..._..___.....10 law or other motor vehicle insurance law where it is licensedor principally garaged;or
(b)The operation of any of the machinery or equipment listed in Paragraph f.(2)or f.(3)of the definition of
Insured Contract Amended ............ ......... ........... ............ ...................10 "mobile equipment".
Personal And Advertising Injury Redefined
• Televised,Videotaped Or Electronic Publication .......... ..._.... ...___.___.....10
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B. Damage To Property Coverage Extensions COVERAGE B—PERSONAL AND ADVERTISING INJURY LIABILITY
Item 2.Exclusions,Paragraph j.is replaced by the following:
j. Damage To Property D. Personal And Advertising Injury
"Property damage"to: Item 2.Exclusions is amended by replacing Sub-paragraphs b.and c.with the following:
(1)Property you own,rent,or occupy,including any costs or expenses incurred by you,or any other person, b. Material Published With Knowledge Of Falsity
organization or entity,for repair,replacement,enhancement,restoration or maintenance of such property for "Personal and advertising injury"arising out of oral,written,televised,videotaped or electronic publication,in any
any reason,including prevention of injury to a person or damage to another's property; manner,of material,if done by or at the direction of the insured with knowledge of its falsity.
(2)Premises you sell,give away or abandon,if the"property damage"arises out of any part of those premises; c. Material Published Prior To Policy Period
(3)Property loaned to you, "Personal and advertising injury"arising out of oral,written,televised,videotaped or electronic publication,in any
(4)Personal property in the care,custody or control of the insured; manner,of material whose first publication took place before the beginning of the policy period.
(5)That particular part of real property on which you or any contractors or subcontractors working directly or
indirectly on your behalf are performing operations,if the"property damage"arises out of those operations;or SUPPLEMENTARY PAYMENTS—COVERAGES A AND B
(6)That particular part of any property that must be restored,repaired or replaced because"your work"was E. Supplementary Payments—Coverages A and B
incorrectly performed on it. Item 1.is amended by replacing Subparagraphs b.and d.with the following
Paragraphs(1),(3)and(4)of this exclusion do not apply to"property damage"(other than damage by fire,lightning, b. Up to$5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of
explosion or sprinkler leakage)to premises,including the contents of such premises,rented to you for a period of seven any vehicle to which the Bodily Injury Liability Coverage applies.We do not have to furnish these bonds.
or fewer consecutive days.A separate limit of insurance applies to Damage To Premises Rented To You as described
in SECTION III—LIMITS OF INSURANCE. However,the provisions of this paragraph do not apply if coverage for d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the
Damage To Premises Rented To You is excluded by endorsement_ claim or"suit",including actual loss of earnings up to$500 a day because of time off from work.
Paragraph(2)of this exclusion does not apply if the premises are"your work"and were never occupied,rented or held SECTION II—WHO IS AN INSURED AMENDMENTS
for rental by you. A. Employee Bodily Injury To A Co-Employee
Paragraphs(3)and(4)of this exclusion do not apply to the use of elevators. Paragraph 2.a.(1)is replaced by the following.
Paragraphs(3),(4),(5)and(6)of this exclusion do not apply to liability assumed under a sidetrack agreement. However,none of these"employees"or"volunteer workers"are insureds for"bodily injury"or"personal and advertising
Paragraph(4)of this exclusion does not apply to"property damage"to borrowed equipment while not being used to injury"
perform operations at the jobsite.Subject to Paragraph 2.of SECTION III—LIMITS OF INSURANCE,the rules below (a)To you,to your partners or members(if you are a partnership orient venture),to your members(if you are a limited
fix the most we will pay for"property damage'under this provision: liability company),to a co-'employee"while in the course of his or her employment or performing duties related to
the conduct of your business,or to your other"volunteer workers'while performing duties related to the conduct of
(1)$25,000 any one"occurrence",regardless ofthe number of persons or organizations who sustain damages because your business;
of that"occurrence'; (b)To the spouse,child,parent,brother or sister of the co-"employee"or"volunteer worker'as a consequence of
(2)$50,000 annual aggregate;and Paragraph(1)(a)above;
(3)We will pay only for damages in excess of$2,500 as a result of any one"occurrence",regardless of the number of (c)For which there is any obligation to share damages with or repay someone else who must pay damages because
persons or organizations who sustain damages because of that"occurrence".We may,or if required by law,pay of the injury described in Paragraph(1)(a)or(b)above;or
all or any part of any deductible amount,if applicable,to effect settlement of any claim or"suit".Upon notice of our (d)Arising out of his or her providing or failing to provide professional health care services.
payment of a deductible amount,you shall promptly reimburse us for the part of the deductible amount we paid. However,if a suit seeking damages for"bodily injury"or"personal and advertising injury"to any co-"employee"or other
Paragraph(6)of this exclusion does not apply to"property damage'Included in the"products-completed operations 'volunteer worker"arising out of and In the course of the co-"employee's"or"volunteer worker's"employment or while
hazard", performing duties related to the conduct of your business,or a suit seeking damages brought by the spouse,child,
parent,brother or sister of the co-"employee"or other"volunteer worker',is brought against you or a co-"employee"or
The insurance provided for"property damage"from the use of elevators and for"property damage"to borrowed a"volunteer worker',we will reimburse the reasonable costs that you incur in providing a defense to the co-"employee"
equipment is excess over any other valid and collectible property insurance(including any deductible portion thereof) or"volunteer worker"against such matters.Any reimbursement made pursuant to this sub-section will be in addition to
available to the insured whether primary,excess,contingent or on any other basis. the limits of liability set forth in the Declarations.
C. Damage To Premises Rented To You B. Newly Acquired Organizations
Item 2.Exclusions,the last paragraph is replaced by the following: Paragraph 3.a.is replaced by the following:
Exclusions c.through n.do not apply to damage by fire,lightning,explosion or sprinkler leakage to premises while a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the
rented to you or temporarily occupied by you with permission of the owner.A separate limit of insurance applies to this end of the policy period,whichever is earlier;
coverage as described in Paragraph 6.of SECTION III—LIMITS OF INSURANCE.
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The following are added: 5. With respect to the insurance afforded to these additional insureds,the following additional exclusion applies:
C. Blanket Additional Insured—Vendors—As Required By Contract This insurance does not apply to:
1. Section 11—Who Is An Insured is amended to include as an additional insured any persons)or organization(s) a. "Bodily injury","property damage"or"personal and advertising injury"arising out of the rendering of,or the
(referred to throughout this endorsement as vendor)with whom you have agreed in a written contract,executed failure to render,any professional architectural,engineering or surveying services,including:
prior to loss,to name as an additional insured,but only with respect to"bodily injury"or"property damage"arising (1)The preparing,approving,or failing to prepare or approve,maps,shop drawings,opinions,reports,surveys,
out of"your products"which are distributed or sold in the regular course of the vendor's business. field orders,change orders or drawings and specifications;or
However, (2)Supervisory,inspection,architectural or engineering activities.
a. The insurance afforded to such vendor only applies to the extent permitted by law;and This exclusion applies even if the claims against an additional insured allege negligence or other
b. If coverage provided to the vendor is required by a contract or agreement,the insurance afforded to such vendor wrongdoing in the supervision,hiring,employment,training or monitoring of others by that insured,if the
will not be broader than that which you are required by the contract or agreement to provide for such vendor. occurrence"which caused the"bodily injury"or"property damage",or the offense which caused the
"personal and advertising injury',involved the rendering of or failure to render any professional services by
2. With respect to the insurance afforded to these vendors,the following additional exclusions apply: you with respect to your providing engineering,architectural or surveying services in your capacity as an
a. The insurance afforded the vendor does not apply to: engineer,architect or surveyor.
(1)"Bodily injury"or"property damage"for which the vendor is obligated to pay damages by reason of the D. Blanket Additional Insured—Lessor Of Leased Equipment
assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages 1. Section II—Who Is An Insured is amended to include as an additional insured any persons)or organizations)
that the vendor would have in the absence of the contract or agreement; from whom you lease equipment when you and such persons)or organization(s)have agreed in writing in a
(2)Any express warranty unauthorized by you; contract or agreement,executed prior to loss,that such person(s)or organizaticn(s)be added as an additional
(3)Any physical or chemical change in the product made intentionally by the vendor; insured on your policy.Such person(s)ororganization(s)is an insured only with respect to liability for"bodily injury",
(4)Repackaging,except when unpacked solely for the purpose of inspection,demonstration,testing,or the "property damage"or"personal and advertising injury"caused by your negligent acts or omissions in the
substitution of parts under instructions from the manufacturer,and then repackaged in the original maintenance,operation or use of equipment leased to you by such persons)or organization(s).
container; However,the insurance afforded to such additional insured:
(5)Any failure to make such inspections,adjustments,tests or servicing as the vendor has agreed to make or a. Only applies to the extent permitted by law;and
normally undertakes to make in the usual course of business,in connection with the distribution or sale of b. Will not be broader than that which you are required by the contract or agreement to provide for such additional
the products, insured_
(6)Demonstration,installation,servicing or repair operations,except such operations performed at the c. Does not apply to any"occurrence"which takes place after the equipment lease expires;
vendor's premises in connection with the sale of the product; A persons or organization's status as an additional insured under this endorsement ends when their contract or
(7)Products which,after distribution or sale by you,have been labeled or relabeled or used as a container, agreement with you for such leased equipment ends.
part or ingredient of any other thing or substance by or for the vendor,or 2. With respect to the insurance afforded to the Lessor,the following additional exclusions apply:
(8)"Bodily injury"or"property damage"arising out of the sole negligence of the vendor for its own acts or "Bodily injury"or"property damage"arising out of:
omissions or those of its employees or anyone else acting on its behalf.However,this exclusion does not (1)The assumption of liability in a contract or agreement.This exclusion does not apply to liability for damages
apply to: that the Lessor would have in the absence of the contract or agreement,
(1) The exceptions contained in Subparagraphs(4)or(6);or (2)Any express warranty made by the Lessor;
(it)Such inspections,adjustments,tests or servicing as the vendor has agreed to make or normally (3)The demonstration,installation,servicing,inspections,adjustments,tests,repair,or maintenance operations
undertakes to make in the usual course of business,in connection with the distribution or sale of the by or for the Lessor;
products. (4)The negligence or strict liability of the Lessor for its own acts or or omissions or those of its employees or
anyone else acting on its behalf;or
3. This Provision C.does not apply: (5)Any failure on the part of the Lessor to provide information,instructions and/or warnings with respect to the
a. To any insured person or organization from whom you have acquired such products,or any ingredient,part or maintenance,use or operation of the equipment.
container,entering into,accompanying or containing such products, 3. With respect to the insurance afforded to these additional insureds,the following is added to Section III—Limits
b. To any vendor for which coverage as an additional insured specifically is scheduled by endorsement;or Of Insurance.
c. When liability included within the"products-completed operations hazard"has been excluded for such product If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf
either by the provisions of the coverage part or by endorsement_ of the additional insured is.
4. With respecttothe insurance afforded to these vendors,thefollowing is added to Section III—Limits Of Insurance a. The minimum amount required by the contract or agreement;or
If coverage provided to the vendor is required by a contract or agreement,the most we will pay on behalf of the b. The Limits of Insurance shown in the Declarations;
vendors whichever is less.
a. The minimum amount required by the contract or agreement;or This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
b. The Limits of Insurance shown in the Declarations,
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations_
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4. With respect to the insurance afforded to these additional insureds,the following additional exclusion applies: F. Blanket Additional Insured—State Or Governmental Agency Or Subdivision Or Political Subdivision—Permits
This insurance does not apply to: Or Authorizations
a. "Bodily injury","property damage"or"personal and advertising injury"arising out of the rendering of,or the Section II—Who Is An Insured is amended to include as an additional insured any state or governmental agency or
failure to render,any professional architectural,engineering or surveying services,including: subdivision or political subdivision with whom you have agreed in a written contract,executed prior to loss,to name as
(1)The preparing,approving,or failing to prepare or approve,maps,shop drawings,opinions,reports,surveys, an additional insured,subject to the following provisions:
field orders,change orders or drawings and specifications;or 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or
(2)Supervisory,inspection,architectural or engineering activities governmental agency or subdivision or political subdivision has issued a permit or authorization.
This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing However:
In the supervision,hiring,employment,training or monitoring of others by that Insured,if the"occurrence"which a. The insurance afforded to such additional insured only applies to the extent permitted by law,and
caused the"bodily injury"or"property damage",or the offense which caused the"personal and advertising b. If coverage provided to the additional insured is required by a contract or agreement,the insurance afforded to
providing
involved the rendering of or failure in render any your capacity
services by you with respect ry your such additional insured will not be broader than that which you are required by the contract or agreement to
providing engineering,architectural or surveying services in your ppaciky as an engineer,architect or surveyor.
provide For such additional insured.
E. Blanket Additional Insured—Managers Or Lessors Of Premises 2. This insurance does not apply to:
1. Section 11—Who Is An Insured is amended to include as an additional insured any person(s)or organization(s) a. "Bodily injury","property damage"or"personal and advertising injury"arising out of operations performed for
with whom you have agreed in a written contract,executed prior to loss,to name as an additional insured,but only the federal govemment,state or municipality;or
with respect to liability arising out of the ownership,maintenance or use of that part of the premises leased to you,
subject to the following additional exclusions: b. "Bodily injury"or"property damage"included within the"products-completed operations hazard".
This insurance does not apply to: 3. With respect to the insurance afforded to these additional insureds,the following is added to Section 111—Limits
Of Insurance:
a. Any"occurrence"which takes place after you cease to be a tenant in that premises.
b. Structural alterations,new construction or demolition operations performed by or on behalf of such additional 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
insured. :
However: a. The minimum amount required by the contract or agreement,or
a. The insurance afforded to such additional insured only applies to the extent permitted by law;and b. The Limits of Insurance shown in the Declarations;
b. If coverage provided to the additional insured is required by a contract or agreement,the insurance afforded to whichever is less.
such additional insured will not be broader than that which you are required by the contract or agreement to This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
provide for such additional insured. 4. With respect to the insurance afforded to these additional insureds,the following additional exclusion applies:
2. With respect to the insurance afforded to these additional insureds,the following is added to Section III—Limits This insurance does not apply to:
Oflnsurance:
a. "Bodily injury","property damage" "personal and advertising injury"arising out of rendering of,or the
If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf failure to render,any professional architectural,
hitectural,engineering or surveying services,Including:
of the additional insured is: (1)The preparing,approving,or failing to prepare or approve,maps,shop drawings,opinions,reports,surveys,
a. The minimum amount required by the contract or agreement;or field orders,change orders or drawings and specifications;or
b. The Limits of Insurance shown in the Declarations, (2)Supervisory,inspection,architectural or engineering activities.
whichever is less. This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. in the supervision,hiring,employment,training or monitoring of others by that insured,if the"occurrence"which
3. With respect to the insurance afforded to these additional insureds,the following additional exclusion applies: caused the"bodily injury"or"property damage",or the offense which caused the"personal and advertising
injury',involved the rendering of or failure to render any professional services by you with respect to your
This insurance does not apply to: providing engineering,architectural or surveying services in your capacity as an engineer,architect or surveyor.
a. "Bodily injury","property damage"or"personal and advertising injury"arising out of the rendering of,or the G. Blanket Additional Insured—State Or Governmental Agency Or Subdivision Or Political Subdivision—Permits
failure to render,any professional architectural,engineering or surveying services,including: Or Authorizations Relating To Premises
(1)The preparing,approving,or failing to prepare orapprove,maps,shop drawings,opinions,reports,surveys, Section II—Who Is An Insured is amended to include as an additional insured any state or governmental agency or
field orders,change orders or drawings and specifications,or subdivision or political subdivision with whom you have agreed in a written contract,executed prior to loss,to name as
(2)Supervisory,inspection,architectural or engineering activities an additional insured,subject to the following provision:
This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing 1. This insurance applies only with respect to the following hazards for which the state or governmental agency or
in the supervision,hiring,employment,training or monitoring of others by that insured,ifthe"occurrence"which subdivision or political subdivision has issued a permit or authorization in connection with premises you own,rent
caused the"bodily injury"or"property damage",or the offense which caused the"personal and advertising or control and to which this insurance applies:
injury",involved the rendering of or failure to render any professional services by you with respect to your
providing engineering,architectural or surveying services in your capacity as an engineer,architect or surveyor. a. The existence,maintenance,repair,construction,erection or removal of advertising signs,awnings,canopies,
cellar entrances,coal holes,driveways,manholes,marquees,hoist away openings,sidewalk vaults,street
banners or decorations and similar exposures,or
b. The construction,erection or removal of elevators;or
c. The ownership,maintenance or use of any elevators covered by this insurance.
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However,
a. The insurance afforded to such additional insured only applies to the extent permitted by law;and SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS AMENDMENTS
b. If coverage provided to the additional insured is required by a contract or agreement,the insurance afforded to A. Knowledge Of Occurrence
such additional insured will not be broader than that which you are required by the contract or agreement to Item 2.Duties In The Event Of Occurrence,Offense,Claim or Suit is amended by adding the following:
provide for such additional insured. e. You must give us or our authorized representative prompt notice of an"occurrence",claim or loss only when the
2. With respect to the insurance afforded to these additional insureds,the following is added to Section III—Limits "occurrence",claim or loss is known to:
Of Insurance: (1)You,if you are an individual;
If coverage provided to the additional insured is required by a contract or agreement,the most we will pay on behalf (2)A partner,if you are a partnership;
of the additional insured is:
(3)An executive officer or insurance manager,if you are a corporation;or
a. The minimum amount required by the contract or agreement,or
(4)A member or manager,if you are a limited liability company.
b. The Limits of Insurance shown in the Declarations; B. Other Insurance
whichever is less. Item 4.Other Insurance,b.Excess Insurance(1)(a)(ii)is replaced by the following:
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations_ (if)That is fire,lightning,explosion or sprinkler leakage insurance for premises rented to you or temporarily occupied
3. With respect to the insurance afforded to these additional insureds,the following additional exclusion applies: by you with permission of the owner,
This insurance does not apply to: C. Unintentional Failure To Disclose Hazards
a. 'Bodily injury',"property damage'or"personal and advertising injury"arising out of the rendering of,or the Item 6.Representations is replaced by the following:
failure to render,any professional architectural,engineering or surveying services,including: 6. Representations And Unintentional Failure To Disclose Hazards
(1)The preparing,approving,or failing to prepare or approve,maps,shop drawings,opinions,reports,surveys,
field orders,change orders or drawings and specifications;or a. By accepting this policy,you agree:
(2)Supervisory,inspection,architectural or engineering activities. (1)The statements in the Declarations are accurate and complete,
This exclusion applies even if the claims against an additional insured allege negligence or other wrongdoing (2)Those statements are based upon representations you made to us;and
in the supervision,hiring,employment,training or monitoring of others by that insured,ifthe"occurrence"which (3)We have issued this policy in reliance upon your representations,
caused the"bodily injury"or"property damage',or the offense which caused the"personal and advertising b. If you unintentionally fail to disclose any hazards existing at the inception date of your policy,we will not deny
injury",involved the rendering of or failure to render any professional services by you with respect to your coverage under this Coverage Part because of such failure. However,this provision does not affect our right
providing engineering,architectural or surveying services in your capacity as an engineer,architect or surveyor. to collect additional premium or exercise our right of cancellation or non-renewal.
D. Waiver of Subrogation
SECTION III—LIMITS OF INSURANCE AMENDMENTS Item 8.Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following:
A. Damage To Premises Rented To You We waive any right of recovery we may have because of payments we make for injury or damage arising out of your
Paragraph 6.is replaced by the following: ongoing operations or"your work"done under a written contract,executed prior to loss,requiring such waiver with that
6. Subject to Paragraph 5.above,the most we will pay under Coverage Afor damages because of"property damage" person or organization and included in the"products-completed operations hazard".However,our rights may only be
to any one premises,while rented to you,or in the case of damage by fire,lightning,explosion or sprinkler leakage, waived prior to the"occurrence'giving rise to the injury or damage for which we make payment under this CoveragePart.The insured must do nothing after a loss to impair our rights.At our request,the insured will bring"suit"or transfer
while rented to you or temporarily occupied by you with permission of the owner is the greater of. those rights to us and help us enforce those rights.
a. $300,000;or
b. The amount shown next to the Damage To Premises Rented To You Limit in the Declarations. SECTION V—DEFINITIONS AMENDMENTS
However,the provisions of this paragraph do not apply if Damage To Premises Rented To You Coverage is A. Insured Contract Amended
excluded by endorsement. Paragraph 9.a.is replaced by the following:
B. Medical Expense Limit a. A contract for a lease of premises. However,that portion of the contract for a lease of premises that indemnifies
Paragraph 7.is replaced with the following: any person or organization for damage by fire,lightning,explosion or sprinkler leakage to premises while rented to
7. Subject to Paragraph 5.above,the most we will pay under Coverage C for all medical expenses because of"bodily you or temporarily occupied by you with permission of the owner is not an"insured contract",
injury"sustained by any one person is the greater of: B. Personal And Advertising Injury Redefined
a. $10,000;or Paragraph 14.d.and e.are replaced by the following:
b. The amount shown next to the Medical Expense Limit in the Declarations. d. Oral,written,televised,videotaped or electronic publication of material that slanders or libels a person or
This insurance does not apply if coverage for Medical Expenses is excluded either by the provisions ofthe coverage organization or disparages a persons or organization's goods,products or service;
part or by endorsement. e. Oral,written,televised,videotaped or electronic publication of material that violates a pemon's right of privacy,
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COMMERCIAL GENERAL LIABILITY
WN GL 139 06 18 B. With respect to Additional Insured—Com- D. With respect to the insurance afforded to
pleted Operations,coverage is limited as fol- these additional insureds, the following is
lows: added to Section III—Limits Of Insurance:
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. (1)Aperson or organization's status as an in- If coverage provided to the additional insured
su red under Additional Insured—Com- is required by a contract or agreement,the
period Operations continues only for the most we will pay on behalf of the additional
ADDITIONAL INSURED—CONTRACTORS— period of time required by any written con- insured is:
OPERATIONS AND COMPLETED OPERATIONS— tract or agreement. (1)The minimum amount required by the
(2)The insurance provided to the additional contract or agreement;or
WITH ADDITIONAL INSURED REQUIREMENT
insured does not apply to"bodily injury', (2)The Limits of Insurance shown in the Dec-
IN CONSTRUCTION CONTRACT "property damage"or"personal and ad- Iarations;
vertising injury'arising out of"your work"
forwhich a consolidated(wrap-up
)insur- whichever is less.
ance program has been provided by the This endorsement shall not increase the ap-
This endorsement modifies insurance provided under the following: prime contractor-project manager or peicabee Limits of Insurance shown in the Dec-
owneroftheconstructionprojectinwhich Iarations.
COMMERCIAL GENERAL LIABILITY COVERAGE PART you a re involved. E. With respect to the insurance afforded to
3. Primary and Noncontributory these additional insureds,the following addi-
The following is added to the Other Insurance tional exclusion applies:
1. Additional Insured—Operations (2)That portion of"your work"out of which Condition and supersedes any provision to the This insurance does not apply to:
A. Section II—Who Is An Insured is amended the injury or damage apses has been put contrary. "Bodily injury',to its intended use by any person or or- y a 1 y, "property damage"or"per-
to include as an additional insured: Primary And Noncontributory Insurance renal and advertising injury'arising outy the
gr sub ion other than another contractor fssioof,or failure to render, pro-
(1)Any person or organization for whom you or subcontractor engaged in performing This insurance is primary to and will not seek con- rendering y
are performing operations when you and fessional architectural,engineering orsurvey-
such person or organization have agreed operations for a principal as a part of the addition from any other insurance available to an ing services,including:
in writingin a contract or agreement that same project. additional insured under your policy provided that:
9 (1)The preparing, approving, or failing to
such person or organization be added as 2. Additional Insured—Completed Operations (1)The additional insured is Named Insured un- prepare or approve,maps,shop draw-
an additional insured on your policy;and A. Section II—Who Is An Insured is amended der such other insurance;and ings,opinions,reports,surveys,field or-
(2)Any other person or organization you are to include as an additional insured: (2)You have agreed in writing in a contract or ders, change orders or drawings and
required to add as an additional insured (1)Any person or organization forwhom you agreement that this insurance would be on- specifications;or
under the contract or agreement de- are performing operations when you and mary and would not seek contribution from (2)Supervisory,inspection,architectural or
scribed in Paragraph 1.above. such person or organization have agreed any otherinsurance available to the additional engineering activities.
Such person(s)or organization(s)is an add- in writing in a contract or agreement that insured.
tional insured only with respect to liability for such person or organization be added as 4. Other Provisions Applicable to Additional In- This exclusion applies even if the claims
"bodily injury","property damage"or"per- an additional insured on your policy;and sured—Operations and Additional Insured— against an additional insured allege negli-
sonal and advertising injury"caused,in (2)Any other person or organization you are Completed Operations gence or otherwrongdoing in the supervision,
whole or in part,by: required to add as an additional insured hiring,employment,training or monitoring of
a. le or in acts or omissions;or under the contract or agreement de- A. The Amendment of Insured Contract Defini- others by that insured,if the"occurrence'
scribed h Paragraph o above. tion(Endorsement CG 24 26)does not apply which caused the"bodily injury'or"property
b. The acts or omissions of those acting on to an additional insured. damage",or the offense which caused the
our behalf; Such person(s)or organization(s)is an addi- p Paragraph p g injury',involved the
y tional insured only with respect to liability for B. The coverage provided under Para ra h f.of "personal and advertising in ur
in the performance of your ongoing opera- ,� ,� " the definition of"insured contract"under Sec- rendering of or failure to render any profes-
bodiey injury', property damage"in per-
tionsfor the additional insured. tion V—Definitions does not apply to an ad- sional services by you with respect to your
sr in al,advertising injury"caused,in whole ditional insured under this endorsement un- providing engineering,architectural or survey-
,B. With respect to Additional Insured-Opera- or in part,by: p i Y-
tions,coverage is limited as follows: a. Your acts or omissions;or less required by a written contract or ing services u your capacity as an engineer,
This insurance does not apply to"bodily in- agreement. architect or surveyor.
b. The acts or omissions of those acting on C. The insurance afforded to such additional in-
jury'or"property damage"occurring after: your behalf;
1 All work, including materials, arts or sured only applies to the extent permitted by
() 9 P and included in the"products-completed op- law;and
equipment furnished in connection with erations hazard".
such work,on the project(other than ser- If coverage provided to the additional insured
vice,maintenance or repairs)to be per- is required by a contract or agreement,the in-
formed by or on behalf of the additional surance afforded to such additional insured
insured(s)at the location of the covered will not be broader than thatwhich you are re-
operations has been completed;or quired by the contract or agreement to provide
for such additional insured.
WN GL 139 06 18 Page 1 of 2 WN GL 139 06 18 Page 2 of 2
Includes c.pyrghtedmatedal of Insurance services office,Inc.,with its pennissian_ Incwdes c.pyr,ghttl m .mllof Insurance services office,Inc.,with its penniss-
WN CA 80 06 19
WN CA 80 06 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO ENHANCEMENT EDGE ENDORSEMENT
The Business Auto Enhancement Edge Endorsement is an optional endorsement that provides coverage enhancements. BUSINESS AUTO ENHANCEMENT EDGE ENDORSEMENT
The following is a summary of broadened coverages provided by this endorsement. No coverage is provided by this
summary,refer to the following endorsement for changes in your policy. This endorsement modifies the insurance provided under the following:
SUMMARY OF COVERAGES PAGE BUSINESS AUTO COVERAGE FORM
Accidental Airbag Deployment Coverage 5 With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by
this endorsement.The SECTIONS of the Business Auto Coverage Form identified in this endomementwill be amended as
Audio,Visual and Data Electronic Equipment—Limit Amended 5 shown below.
Auto Loan/Lease Gap Coverage 5 SECTION I — COVERED AUTOS COVERAGE e. Any organization which is newly acquired or
Blanket Additional Insured 3 AMENDMENTS formed by you and over which you maintain
A. Temporary Substitute Vehicle Physical Damage majority ownership. However,coverage under
Blanket Waiver of Subrogation 5 this provision:
SECTION I — COVERED AUTOS, C. Certain
Broadened Definition of Insured includes: Trailers, Mobile Equipment And Temporary (1)is afforded only for the first 180 days after you
Substitute Autos is amended by adding the acquire or form the organization or until the
• Newly Acquired Organizations for up to 180 Days 2 following: end of the policy period,whichever comes
• Employees as Insureds 2 If a covered"auto"you own is out of service because first;
• Subsidiaries in Which You Own 50%or More 2 of its: (2)does not apply to"bodily injury'or"property
a. Breakdown; damage"that results from an"accident"that
Deductible Waiver for Glass Repair 4 occurred before you formed or acquired the
b. Repair; organization;
Employee Hired Auto 6 c. Servicing; (3)does not apply to any newly acquired or
Fellow Employee Coverage 3 d. "Loss',or formed organization that is a joint venture or
e. Destruction; partnership;and
Hired Auto Physical Damage Coverage 3,6 the Physical Damage Coverages provided by the (4)does not apply to an"insured"under any
Business Auto Coverage Forth for that disabled other automobile liability policy or would be
Knowledge of Accident,Claim,Suit or Loss 5 covered"auto"are extended to any"auto"you do not an"insured"under such a policy but for ter-
Loss Of Use Expenses-Amended 3 own while used with the permission of its owner as a mination of such policy or the exhaustion of
temporarysubstitute for the covered"auto"that is out such policy's limits of insurance.
Personal Effects 3 ofservice. f. Any"employee"of yours is an insured"while
SECTION 11 — COVERED AUTOS LIABILITY using a covered"auto'you don't own,hire or
Primary and Noncontributory If Required by a Written Contract or Written Agreement 6 COVERAGE AMENDMENTS borrow in your business or your personal affairs.
Rental Reimbursement Coverage 4 A. Who Is An Insured g. Any"employee"of yours is an"insured"while
operating a covered"auto"hired or rented under
Supplementary Payments-Amended: SECTION 11 — COVERED AUTOS LIABILITY a contract or agreement in the "employee's'
• Bail Bonds up to$5,000 3 COVERAGE,A.Coverage,1.Who Is An Insured is name,with your permission,while performing
amended to add: duties related to the conduct of your business.
• Loss of Earnings up to$500/Day 3 d. Any legally incorporated subsidiary of yours in
Temporary Substitute Vehicle Physical Damage 2 which you own more than 50%of the voting stock
on the effective date of this coverage form.
Towing 3 However, "insured" does not include any
subsidiary of yours that is an"insured"under any
Transportation Expense Limits—Amended 3 other automobile liability policy or would be an
Unintentional Failure to Disclose Hazards 6 "insured"under such policy but for termination of
such policy or the exhaustion on such policy's
limits of insurance.
WN CA 80 06 19 Page 1 of 6
WN CA 800819 Includes copyri9med merenai o finsurance Services Off-,wan i¢permission Page 2of6
I ncludes capydghtetl materiel ai Insurance Services Off-,wdh i6 pennissian_
B. Blanket Additional Insured SECTION III — PHYSICAL DAMAGE COVERAGE E. Glass Repair—Deductible Waiver G. Rental Reimbursement
SECTION II — COVERED AUTOS LIABILITY AMENDMENTS SECTION III—PHYSICAL DAMAGE COVERAGE, SECTION III—PHYSICAL DAMAGE COVERAGE A.
COVERAGE,A.Coverage,1.Who Is An Insured, A. Towing A.Coverage,3.Glass Breakage—Hitting A Bird Coverage,is amended by adding the following:
paragraph c.is amended to add the following: SECTION III—PHYSICAL DAMAGE COVERAGE, Or Animal — Falling Objects Or Missiles, is 6. Rental Reimbursement
Any person or organization who is required under a A.Coverage,2.Towing,is amended by adding the amended by adding the following: This coverage applies only to a covered"auto"of
written contract or agreement between you and that following: No deductible will apply to glass breakage if such the private passenger or light truck type as
person or organization,that is signed and executed 2. Towing glass is repaired,in a manner acceptable to us,rather follows:
by you before the"bodily injury'or"property damage" We will pay up to$250 for towing and labor costs than replaced. a. We will pay for rental reimbursement
occurs and that is in effect during the policy period,to incurred each time a covered"auto"is disabled. F. Hired Auto Physical Damage expenses incurred by you for the rental of a
be named as an additional insured is an"insured"for However,the labor must be performed at the SECTION III—PHYSICAL DAMAGE COVERAGE, private passenger or light truck type"auto'
Liability Coverage,but only for damages to which this place of disablement.This$250 limit is reduced A.Coverage is amended by adding the following: because of"loss"to a covered private pas-
insurance applies and only to the extent that persons b an applicable towing limit shown in the senger or light truck type"auto'. Payment
or organization qualifies as an"insured"under the y Y PP 9 5. Hired Auto Physical Damage applies in addition to the otherwise applicable
g q declarations. If hired"autos"are covered"autos"for Liability amount of each coverage you have on a
Who Is An In
provision contained in Section II. 9
Regardless of the number of disablements,the Coverage and if Comprehensive, Specified covered private passenger or light track type
C. Liability Coverage Extensions—Supplementary maximum amount we will pay under this Causes of Loss,or Collision coverages are pro- "auto" No deductibles apply to this
Payments endorsement for all towing and labor costs vided under this coverage forth for any"auto"you coverage.
SECTION II — COVERED AUTOS LIABILITY combined during anyone year is$2,500. own, then the Physical Damage Coverages b. We will pay only for those expenses incurred
COVERAGE, A. Coverage, 2. Coverage B. Transportation Expense—Limits Amended provided are extended to"autos"you hire of like during the policy period beginning 24 hours
Extensions, a. Supplementary Payments is kind and use,subject to the following: after the"loss"and ending,regardless of the
amended by replacing subparagraphs(2)and(4)with SECTION III—PHYSICAL DAMAGE COVERAGE, a. The most we will pay for any one"loss'is
A.Coverage,4.Coverage Extensions,a.Trans- l policy's expiration,with the lesser of the fol-
the following: $50,000 or the actual cash value or cost to lowing number of days:
2 Up
to$5,000 for cost of bail bonds(inducing pertati/$ Expenses is amended by replacing$20 repair or replace,whichever is less,minus a 1 The number of days reasonablyrequired
1) P 9 per day/$600 maximum limit with$50 per day/$1,000 deductible; O q
bonds for related traffic law violations)required maximum. to repair or replace the covered private
because of an"accident"we cover. We do not b. The deductible will be equal to the largest passenger or light truck type"auto'. If
have to furnish these bonds. C. Hired Auto Physical Damage— Loss Of Use deductible applicable to any owned"auto"for "loss'is caused by theft,this number of
(4)All reasonable expenses incurred bythe"insured" Expenses—Limits Amended that coverage.Any Comprehensive deducti- days is added to the number of days it
SECTION III—PHYSICAL DAMAGE COVERAGE, ble does not apply to"loss"caused by fire or takes to locate the covered private
at our request,including actual loss fr earnings
A.Coverage,4.Coverage Extensions,b.Loss of lightening; or li ht truck a"auto"and
up to$500 a day because of time off from work. 9 9 passenger 9 NP
Use Expenses is amended by replacing the$20 per c. Hired Auto Physical Damage coverage is return it to you;or
D. Fellow Employee Coverage day/$600 maximum limit with $50 per day/$750 excess over any other collectible insurance; (2)30 days.
SECTION II — COVERED AUTOS LIABILITY maximum limit. and c. Our payment is limited to the lesser of the
COVERAGE,B.Exclusions,5.Fellow Employee, D. Personal Effects Coverage d. Subject to the above limit,deductible and following amounts:
the following is added: excess provisions we will provide coverage (1 NecessaryP
and actual expenses
Co-Employee Lawsuit Defense Cost SECTION III—PHYSICAL DAMAGE COVERAGE, equal to the broadest coverage applicable to )incurred,or
Reimbursement A.Coverage,4.Coverage Extensions is amended any covered"auto"you own.
by adding the following: If a limit for Hired Auto Physical Damage is (2)$50 per day,up to a maximum of$1,000.
If a suit seeking damages sur d"arising
injury'to any Y 9
fellow"employee"of the"insured"arising out of and c. Personal Effects indicated in the Declarations, then that limit
in the course of the fellow"employee's"employment We will pay up to$500 for"loss"to personal replaces,and is not added to,the$50,000 limit
or while performing duties related to the conduct of effects,which are: indicated above.
your business,or a suit seeking damages brought by (1)Owned by an"insured";and
the spouse,child,parent,brother or sister of that (2)In oron your covered"auto"
fellow"employee',is brought against you,we will This coverage applies only in the event of the total
reimburse reasonable costs that you incur in the theft of your covered"auto."No deductible applies to
defense of such matters. Any reimbursement made this coverage
pursuant to this sub-section will be in addition to the
limits of liability set forth in the Declarations.
WN CA 80 06 19 Includes copyrighted metertel of Insurance sarvicas Office,wah trs parmfss- Page 3 of WN CA 80 06 19 Includes copyrighted me mllof Insurance sarvicas Office,wah trs par,,ssion Page 4 of
d. This coverage does not apply while there are (2)Financial penalties imposed under a C. Unintentional Failure to Disclose Hazards E. Primary and Noncontributory If Required By
spare or reserve private passenger or light lease for excessive use,abnormal wear SECTION IV—BUSINESS AUTO CONDITIONS,B. Written Contract or Written Agreement
truck type"autos"available to you for your and tear or high mileage; General Conditions,2.Concealment,Misrepre- SECTION IV—BUSINESS AUTO CONDITIONS,B.
operations. (3)Security deposits not returned by the sentation Or Fraud, is amended by adding the General Conditions,5.Other Insurance c., the
e. If"loss' results from the total theft of a lessor; following paragraph: following is added and supersedes any provision to
covered"auto"of the private passenger or (4)Costs for extended warranties, Credit If you unintentionally fail to disclose any hazards the contrary:
light truck type,we will pay under this cover- Life Insurance, Health, Accident or existing at the inception date of the policy,or during This Coverage Form's Covered Autos Liability
age only that amount of your rental reim- Disability Insurance purchased with the the policy period in connection with any additional Coverage is primary to and will not seek contribution
bursement expenses which is not already loan or lease;and hazards,we will not deny coverage under this Cov- from any other insurance available to an"insured"
provided for under SECTION III—PHYSICAL
DAMAGE COVERAGE, A. Coverage, 4. (5)Carry-over balances from previous loans erage Part because of such failure. under your policy provided that:
Coverage Extensions. or leases. D. Employee Hired Auto (1)Such"insured"is a Named Insured under such
For the purposes of this Rental Reimbursement J. Audio,Visual and Data Electronic Equipment— SECTION IV—BUSINESS AUTO CONDITIONS,B. other insurance;and
coverage,light truck is defined as a truck with a LimitAmended General Conditions,S.Otherinsurance,paragraph (2)You have agreed in writing in a contract or
gross vehicle weight of 10,000 Ibs.or less as SECTION III-PHYSICAL DAMAGE COVERAGE,C. b.is deleted and replace by the following: agreement that this insurance would be primary
defined by the manufacturer as the maximum Limits of Insurance,1.b.is amended by replacing b. For Hired Auto Physical Damage Coverage,the and would not seek contribution from any other
loaded weight the auto is designed to carry. the$1,000 limit with a$2,500 limit. following are deemed to be a covered"auto"you insurance available to such"insured".
H. Accidental Airbag Deployment Coverage own:
SECTION III—PHYSICAL DAMAGE COVERAGE, SECTION IV — BUSINESS AUTO CONDITIONS (1)Any covered"auto"you lease,hire,rent or
A.Coverage is amended by adding the following: AMENDMENTS borrow.
7. Accidental Airbag Deployment Coverage A. Duties In The Event Of Accident,Claim,Suit Or (2)Any covered"auto'hired or rented by your
We will pay to reset or replace factory installed Loss Amended "employee'under contract in that individual
airbag(s)in any covered"auto"for accidental SECTION IV—BUSINESS AUTO CONDITIONS,A. "employee's"name,with your permission,
discharge,other than discharge due to a collision Loss Conditions, 2. Duties In The Event Of while performing duties related to the conduct
loss. Accident,Claim,Suit Or Loss,a.is amended by of your business.
This coverage is applicable only ifcomprehensive adding the following: However,any"auto"that is leased,hired,rented
coverage applies to the covered"auto". This condition applies only when the"accident"or or borrowed with a driver is not a covered"auto".
This coverage is excess over any other collectible "loss"is known to:
insurance or reimbursement by manufacturer's (1)You,if you are an individual;
warranty. (2)A partner,if you are a partnership;
I. Auto Loan/Lease Gap Coverage (3)An executive officer or insurance manager,if you
SECTION III PHYSICAL DAMAGE COVERAGE, are a corporation;or
Item A., Coverage, is amended by adding the (4)A member or manager,if you are a limited liability
following: company.
8. Auto Loan/Lease Gap Coverage But this section does not amend the provisions
This coverage applies only to a covered"auto' relating to notification of police,protection or exami-
described or designated in the Schedule or in the nation ofthe property which was subject to the"loss".
Declarations as including physical damage B. Blanket Waiver of Subrogation
coverage.
In the event of a covered total"loss"to a covered Section IV—BUSINESS AUTO CONDITIONS,A.
"auto"described or designated in the Schedule or Loss Conditions, 5. Transfer of Rights of
in the Declarations, we will pay any unpaid Recovery Against Others to Us,is amended by
amount due on the lease or loan for a covered adding the following exception:
"auto"less: However,we waive any right of recovery we may
a. The amount paid under the Physical Damage have against any person or organization to the extent
Coverage Section on the policy;and required of you by a written contract signed and
executed prior to any"accident"or"loss",provided
b. Any: that the"accident"or"loss"arises out of operations
(1)Overdue Ieasedoan payments at the time contemplated by such contract. The waiver applies
of the"loss"; only to the person or organization designated in such
contract.
WN CA 80 06 19 Includes copyrighted metertel of Insurance Services Office,wfh,ts per—s- Page 5 of WN CA 80 06 19 Includes copyrighted me mllof Insurance Services Office,wfh,ts par,,ssion Page 6 of
Westchester
A Chubb bb Company
ADDITIONAL INSURED ENDORSEMENT—ONGOING WORK OR OPERATIONS
Named Insured Endorsement Number
Gage It Construction, LLC
Policy Symbol Policy Number Policy Period Effective Date of Endorsement
CPW G70974095 004 3/9/2024 To 3/9/2025 3/9/2024
Issued By(Name of Insurance Company)
Westchester Surplus Lines Insurance Company
Insert the policy number.The remainder of the information is to he 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:
CONTRACTORS POLLUTION LIABILITY COVERAGE PART
SCHEDULE:
Name of Person(s)or Organization(s):
As required by written contract, prior to a loss to which this insurance applies
(If no entry appears above,information required to complete this endorsement will be shown in the Declarations as
applicable to this endorsement.)
A. SECTION II -WHO IS AN INSURED is amended to include as an additional insured the persons or
organizations shown in the Schedule,but only with respect to liability for injury or damage, to which this
insurance applies,caused,in whole or in part,by:
i. Your acts or omissions;or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insureds.
However:
i. 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 exclusion is added:
Exclusions
This insurance does not apply to injury or damage occurring after:
a. All work or operations,including materials,parts or equipment furnished in connection with such
work or operations, on the project (other than service, maintenance or repairs) to be performed
by you or on your behalf at the site of the covered operations has been completed;or
ENV-3250(12/18) Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 2
(22uoi2.1)
Westchester
A Chubb CC,ur°a1g atiyP
b. That portion of your work out of which the injury or damage arises has been put to its intended
use by any person or organization other than another contractor or subcontractor engaged in
performing operations for the additional insured as a part of the same project.
C.With respect to the insurance afforded to these additional insureds,the following is added to SECTION
III—LIMITS OF INSURANCE:
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:
i. 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.
All other terms and conditions of this policy remain unchanged.
ENV-3250(12/18) Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 2 of 2
(221012.1)
Westchester
A Chubb bb CC,urnpany
ADDITIONAL INSURED ENDORSEMENT- PRODUCTS-COMPLETED OPERATIONS HAZARD
Named Insured Endorsement Number
Gage It Construction, LLC
Policy Symbol Policy Number Policy Period Effective Date of Endorsement
CPW G70974095 004 3/9/2024 To 3/9/2025 3/9/2024
Issued By(Name of Insurance Company)
Westchester Surplus Lines Insurance Company
Insert the policy number.The remainder of the information is to he 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:
CONTRACTORS POLLUTION LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
As required by written contract, prior to a loss to which this insurance applies
(If no entry appears above,information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
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 injury or damage, to which this
insurance applies, caused by or resulting from your work performed for that additional insured and
included in the products-completed operations hazard, and only to the extent that such injury or
damage is caused,in whole or in part,by your negligence or the negligence of those acting on your behalf.
However:
i. 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:
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:
i. 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.
All other terms and conditions of this policy remain unchanged.
ENV-3251(12/18) Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 1
(221012.2)
Westchester
A Chubb bb CC,uraspanyP
PRIMARY AND NONCONTRIBUTORY—OTHER INSURANCE CONDITION
Named Insured Endorsement Number
Gage It Construction, LLC
Policy Symbol Policy Number Policy Period Effective Date of Endorsement
CPW G70974095 004 3/9/2024 To 3/9/2025 3/9/2024
Issued By(Name of Insurance Company)
Westchester Surplus Lines Insurance Company
Insert the policy number.The remainder of the information is to he 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:
CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART
The following is added to the Other Insurance Condition and supersedes any provision to the contrary:
Primary and Noncontributory Insurance
This policy is primary to, and will not seek contribution from,any other insurance available to an
additional insured under this policy,provided that:
a. The additional insured is a named insured under such other insurance;and
b. The named insured has agreed in a written contract or agreement that this insurance
would:
(i) act as primary insurance;and
(2)would not seek contribution from any other insurance available to the additional insured.
All other terms and conditions of this policy remain unchanged.
ENV-3253(12-18) Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 1
(266562.2)
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US
Named Insured Endorsement Number
Gage It Construction, LLC
Policy Symbol Policy Number Policy Period Effective Date of Endorsement
CPW G70974095 004 3/9/2024 To 3/9/2025 3/9/2024
Issued By(Name of Insurance Company)
Westchester Surplus Lines Insurance Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
CONTRACTORS POLLUTION LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
As required by written contract, prior to a loss to which this insurance applies
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the
addition of the following:
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.
All other terms and conditions remain the same.
ENV-3143(03-05) Includes copyrighted material of Insurance Services Office, Inc.with its permission Page 1 of 1
www.saif.com
■
saif Work.
Life.
Oregon.
Carrier no: 20001 Endorsement no: WC000313
(Ed. 430B)
SAIF policy: 756250 Gage It Construction LLC
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 shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
Description: ALL OPERATIONS
Contractor name: Persons and/or organizations with whom the insured-employer is required by
written contract to waive subrogation rights.
This endorsement does not alter the rights of an injured worker to pursue recovery from another party
or SAIF to receive a statutory share of recoveries by an injured worker, even from the party listed in the
schedule.
The premium charge for this endorsement is based on one (1) percent of your manual premium.
Effective date: May 01, 2024
This endorsement changes the policy to which it is attached and is effective on the date issued unless
otherwise stated.
Countersigned April 08, 2024 at Salem, Oregon
C"�
W0000313 Chip Terhune
(Ed. 430B) President and Chief Executive Officer
400 High Street SE
Salem,OR 97312
P:800.285.8525
F: 503.373.8020
Pol_PC1_E430B
Form ® Request for Taxpayer Give form to the
(Rev.March 2024) Identification Number and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue Service Go to www.irs.gov/FormW9 for instructions and the latest information.
Before you begin.For guidance related to the purpose of Form W-9,see Purpose of Form,below.
1 Name of entity/individual.An entry is required.(For a sole proprietor or disregarded entity,enter the owner's name on line 1,and enter the business/disregarded
entity's name on line 2.)
Gage It Construction, LLC
2 Business name/disregarded entity name,if different from above.
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1.Check 4 Exemptions(codes apply only to
Conly one of the following seven boxes. certain entities,not individuals;
n see instructions on page 3):
c ✓❑ Individual/sole proprietor ❑ C corporation ❑ S corporation ❑ Partnership ❑ Trust/estate
0
w ❑ LLC.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership) ' . Exempt payee code(if any)
a c Note:Check the"LLC"box above and,in the entry space,enter the appropriate code(C,S,or P)for the tax
classification of the LLC,unless it is a disregarded entity.A disregarded entity should instead check the appropriate Exemption from Foreign Account Tax
o box for the tax classification of its owner. Compliance Act(FATCA)reporting
❑ Other(see instructions) code(if any)
0.
;i- 3b If on line 3a you checked"Partnership"or"Trust/estate,"or checked"LLC"and entered"P"as its tax classification, (Applies to accounts maintained
y and you are providing this form to a partnership,trust,or estate in which you have an ownership interest,check PP
P. this box if you have any foreign partners,owners,or beneficiaries.See instructions . . . . . . . . ❑ outside the United States.)
co
a) 5 Address(number,street,and apt.or suite no.).See instructions. Requester's name and address(optional)
PO Box 2604
6 City,state,and ZIP code
White City,OR 97503
7 List account number(s)here(optional)
•. Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a — M — [--I—�
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a or
TIN,later.
Employer identification number
Note:If the account is in more than one name,see the instructions for line 1.See also What Name and
Number To Give the Requester for guidelines on whose number to enter. 9 3 — 1 1 2 4 0 4 6 9
Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.1 am not subject to backup withholding because(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.1 am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You mus r ss out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report in rest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of curd property,cancellation of de , ontributions to an individual retirement arrangement(IRA),and,generally,payments
other than interest and divide s, u re not required to sign the e ification,but you must provide your correct TIN.See the instructions for Part II,later.
Sin g
g Si nature of .0/7
Here U.S.person Date CT �/
nS New line 3b has been added to this form.A flow-through entity is
General Instructi
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise foreign partners,owners,or beneficiaries when it provides the Form W-9
noted. to another flow-through entity in which it has an ownership interest.This
Future developments.For the latest information about developments change is intended to provide a flow-through entity with information
related to Form W-9 and its instructions,such as legislation enacted regarding the status of its indirect foreign partners,owners,or
after they were published,go to www.irs.gov/FormW9. beneficiaries,so that it can satisfy any applicable reporting
requirements.For example,a partnership that has any indirect foreign
What's New
partners may be required to complete Schedules K-2 and K-3.See the
Partnership Instructions for Schedules K-2 and K-3(Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line.An LLC that is a disregarded entity should check the Purpose of Form
appropriate box for the tax classification of its owner.Otherwise,it
An individual or entity(Form S is requester)who is required to file an
should check the"LLC"box and enter its appropriate tax classification.
information return with the IRS s giving you this form because they
Cat.No.10231X Form W-9(Rev.3-2024)
AMENDMENT NO. 1
to
GOODS &SERVICES AGREEMENT
between
THE CITY OF ASHLAND,
an Oregon municipal corporation,
("City")
and
Gage it Construction LLC,
a(Limited liability company),
("Provider")
for
Repair damaged guardrail on Tolman Creek Road
RECITALS
A. The City and Provider previously entered into a Goods and Services Agreement effective October
13,2024(the"Agreement"), for the service of repairing a damaged guardrail on Tolman Creek Road,
B. The City and Provider now wish to amend the Agreement to increase the amount of compensation
to be paid to Provider.
AGREEMENT
NOW THEREFORE,in consideration of the mutual benefits and obligations set forth
herein, the parties agree as follows:
1. Amend Section 2 of the Agreement as follows,with strikeout wording deleted and
underscored wording added:
2.1 City shall pay Provider the sum of 4 100 (&-3;800) as provided herein as full
compensation for the Work as specified in the SUPPORTING DOCUMENTS,
2.2 In no event shall Provider's total of all compensation and reimbursement under this
Agreement exceed the sum of 4 l00 (&-3,-8N) without the 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 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. This Amendment No. 1 is effective upon being signed by both parties.
3. Except as specifically modified by this Amendment No. 1,the terms and conditions of the
Agreement remain in fill force and effect.
Page 1 of 2: Amendment No. 1 to Goods&Services Agreement between the City of Ashland and Gage It Construction
LLC
IN WITNESS WHEREOF the parties have caused this Amendment No. I to be signed in their
respective names by their duly authorized representatives as of the s set forth below:
CIT76huc AS LAND OREGON Gage It o ruction LLC
Z p
By: By:
c Schweizer
P rated Name: ge.,
Date: ('
�� � Title:
Date: o h p 1:-�J 2,q
Page 2 of 2: Amendment No, I to Goods&Services Agreement between the City of Ashland and Gage It Construction
LLC