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2021-137 PO 20220181- Adkins Consulting Engineering, LLP
Purchase Order 11,4,ali - Fiscal Year 2022 Page: 1 of: 1 ', s gE:.-s tg. p ti(l i9k5.1 a-:�'zR_g» !---az-36Eti`i :_ B City of Ashland llo o' -t iia€= t e IL « _`= ,I ATTN: Accounts Payable 20 E. Main Purchase L Ashland, OR 97520 Order# 20220181 T Phone: 541/552-2010 0 Email: payable@ashland.or.us V H CIO Public Works Department E ADKINS CONSULTING ENGINEERING, LLP I 51 Winburn Way N 1435 ESPLANADE AVE p Ashland, OR 97520 KLAMATH FALLS, OR 97601 Phone: 541/488-5347 O R T Fx: 541/488-6006 --- 3Z--11�)lix_iiiii V t -�. 8Jr---5 _ en yiv _ _ -= _ I Scott Fleury , ES i T-�V�i-- -'44•1-431.. = [--- Ia jk = gIar-; =lao ,' ' 117 (Bji.gi 775§(- 'E -? -._;.-7,,------7----Z-= _-iQsY Ee17 t._e t{i — __..- 11/01/2021 4019FOB ASHLAND OR/NET30 City Accounts Payable! _ Design Ivy-Morton Waterline 1 Design engineering of the Ivy-Morton waterline project to include 1.0 $34,400.00 $34,400.00 project management, surveying, bidding and construction support services as described in the attached scope of work. Personal Services Agreement($35,000 or Less) Completion date: December 31, 2022 Project Account: E-201404-999 ***************GL SUMMARY*************** 081800-704200 $34,400.00 , By:117k Date: fil-� - - Authorized Signature ` -a=a == $34,400.00 .• FORM #3 CITY OF Alt� lie :�i:for( a k�f.lic;e�a��ccues ASHLAND REQUISITION Dale of request: ,. 10/22/2021 Required dale for delivery: 11/05/2021 Vendor Name Adkins Engineering and Surveying Address,City,State,Zip 1435 Esplanade Ave Klamath Falls,OR 97601 Contact Name&Telephone Number Dan Scales 541-884-4666 Email address DScalas@adkinsengineering.com SOURCING METHOD O Exempt from Competitive Bidding ❑ Invitation to Bid 0 Emergency O Reason for exemption: Dateapproved by Council: 0 Form#13,Written findings and Authorization ❑ AMC 2.50 _(Attach copy of council communication) 0 Written quote or proposal attached ❑ Written quote or proposal attached _(If council approval required,attach copy of CC) ❑ Small Procurement ❑ Request for Proposal Cooperative Procurement Not-exceeding$5,000 Date•approved by Council ❑ State of Oregon • ❑ Direct Award _(Attach copy of council communication) Contract# - El Verbal/Written bid(s)or proposal(s) 0 Request for Qualifications(Public Works) ❑ State of Washington Date approved by Council: Contract# _(Attach copy of council communication) ❑ Other government agency contract Intermediate Procurement • ❑ Sole Source Agency GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) Contract ii . Greater than$5,000 and less than$100,000 ❑ Written quote or proposal attached Jntergovernmental Agreement ❑ (3)Written bids&solicitation attached ❑ Form#4,Personal Services$51(to$75K Agency PERSONAL SERVICES Date approved by Council: 0 Annual cost to City does not exceed$25,000. Greater than$5,000 and less than$75,000 Valid until: (Date) Agreement approved by Legal and approvedlsigned by © Less than$35,000,by direct appointment ❑ Special Procurement -City Administrator.AMC 2.50.070(4) • ❑ (3)Written proposals&solicitation attached ❑ Form#9,Request for Approval 0 Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services$5K to$75K ❑ Written quote or proposal attached approval required.(Attach copy of council communication) 1 Date approved by Council: , Valid until:_ _____ Date • Description of SERVICES Total Cost Design engineering of the Ivy-Morton waterline project to include project management,surveying, bidding and construction support services as described in the attached scope of work. I .:$-....p..4.400 Item# Quantity Unit Description of MATERIALS Unit Price Total Cost L Per attached quotelproposal =, ',TOTAL:COST;: Project Number 2 0 1 4. 0 4 _ Account Number 081 a o o.7 0 4 2 o 0 Account Number__ ___ - Account Account Number - ,*Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this requisition form,I certify that the City's public contracting requirements have been satisfied. Employee: Department Hea, i- E •s I►zb 2. ��.'` 1 ` too . •aterthan$5,000) Department Manager/Supervisor: t Ma a ager: ,, Nu,_- \ �► (Equal to or greater than$25,000) Funds appropriated for current fiscal year: YES/NO - J, \ r't.\1-\ Finan e I-ector-(Equaltoorgreater than$5,000) Date Comments: Form 113-Requisition • • I 1 Memo TO: Gary Milliman,Interim City Manager to1zzl FROM: Scott Fleury,Public Works Director 40 DATE: October 22,2021 RE: City Manager Signature Needed for Personnel Services contract • Background: Attached is a$34,400 personal services contract with Adkins Engineering and Surveying for the design of the Ivy-Morton waterline project. Your signature is requested on forms 3,4 and the contract itself as this contract is greater than$25,000.This is a very important project for the City in that it enables us abandon a failing pump station and better serve the community. This project will also increase fire-flows in some residential areas and help with the resiliency of our water ' system. Funds for this project have been budgeted for this fiscal year. The intent of the Dept is to complete the project engineering this winter and bid this project for spring 2022 construction. • Council Action: None Other Relevant Information: None Insurance waived or reduced?No Who to return to if different from sender? Tami Campos,Ply Administrative Analyst Are all other signatures required collected?Yes • Are all attachments listed included?Yes Attachments: Personal Services Contract Requisition Form Determination to Procure Personal,Services CITY OF ASHLAND 20 East Main Street Tel:541-488.6002 PIF/446A Ashland,Oregon 97520 Fax:541-488-5311 �9 vnw.ashland.or.us TTY: 800-735-2900 1 CITY OF FORM #4 AS H LAN D • DETERMINATIONS TO PROCURE. PERSONAL SERVICES $5,000 to $75,000 To Gary 1Vlilliman,Interim City Manager . . • From: Scott Plenty,Public Works Director • Date: October 22, 2021 Re: DETERMINATIONS TO PROCURE PERSONAL SERVICES In accordance with AMC 2.50.120(A), for personal services contracts greater than$5,000, but less • than $75,000, the Department Head shall make findings that City personnel are not available to perform the services, and that the City does not have the personnel or resources to perform the services required under the proposed contract. Background Professional engineering services are required for the design of water system improvements in the state of Oregon. The City does not have stafEngineers to accomplish this work,nor*it goodpractice f r the City to accept the liability with such activities. As such,it is my recorimzendation that the design of these improvemne,zts to the City's water system be completed by contracted Engineers,as has been the scenario in the past. •, Pursuant to AMC 2.50.120(A),has a reasonable inquiry been conducted.as to the availability of City personnel to perform the services,and that the City does not have the personnel and resources to perform the services required under the proposed contract? • The City does not have thepersonnel or expertise to perform the engineering services for the Ivy-Morton'waterline, as required by the state of Oregon. • Requested by: 4610 . Date: te'u(a i Approved by: 1.01Tyy�� Date: L• O 2to�Z\ i Gary iman,Interim City Manager Comments: • • • • Form#4-Department Head Determinations to Procure Personal Services,.Page 1 of 1,.1012512021 , • PERSONAL SERVICES AGREEMENT ($35,000 OR LESS) CONSULTANT: Adkins Engineering and Surveying • CITY OF ADDRESS: 1435 Esplanade Ave 'ASHLAND Klamath Falls,OR 97601 20 East Main Street TELEPHONE: 541-884-4666 Ashland,Oregon 97520 _ Telephone: 541/488-5587 EMAIL: DScalas@adkinsengineering.com Fax: 541/488-6006 • This Personal Services Agreement(hereinafter"Agreement")is entered into by and between the City of Ashland,an Oregon municipal corporation(hereinafter"City")and Adkins Engineering and Surveying,a domestic professional corporation("hereinafter"Consultant"),for design,surveying,bidding and construction support for the Ivy-Morton waterline project. NOW THEREFORE,in consideration of the mutual covenants contained herein,the City and Consultant hereby agree as follows: • • 1. Effective Date and Duration: This Agreement shall become effective on the date of execution on behalf of the City,as set forth below(the"Effective Date"), and unless sooner terminated as specifically provided herein,shall terminate upon the City's affirmative acceptance of Consultant's Work as complete and Consultant's acceptance of the City's final payment therefore,but not later than December 31,2022. • 2. Scope of Work: Consultant will provide design,surveying,bidding and construction support for the • Ivy-Morton waterline project as more fully set forth in the Consultant's Proposal dated October 11, • 2021,which is attached hereto as"Exhibit A"and incorporated herein by this reference. Consultant's services are collectively referred to herein as the"Work." • • ' • 3. Supporting Documents/Exhibits; Conflicting Provisions: This Agreement and any exhibits or other supporting documents shall be construed to be mutually complementary 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 exhibits or supporting documents. \ • • 4. All Costs Borne by Consultant: Consultant shall,at its own risk,perform the Work described above and,unless otherwise specified in this Agreement,furnish all labor,equipment,and materials required for the proper performance of such Work. • 5. Qualified Work: Consultant has represented,and by entering into this Agreement now represents,that all personnel assigned to the Work to be performed under this Agreement are fully qualified to perform the service to which they will be assigned in a skilled and worker-like manner and,if required to be Page 1 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND ADKINS ENGINEERING AND SURVEYING • registered,licensed or bonded by the State of Oregon,are so registered,licensed and bonded. 6. Compensation: City shall pay Consultant the sum of$34,400(thirty-four thousand four hundred dollars)as full compensation for Consultant's performance of all Work under this Agreement. In no event shall Consultant's total of all compensation and reimbursement under this Agreement exceed the • sum of$34,400(thirty-four thousand four hundred dollars)without the express,written approval from the City official whose signature appears below,or such official's successor in office. Payments • shall be made within thirty(30)days of the date of receipt by the City of Consultant's invoice. Should • this Agreement be terminated prior to completion of all Work,payments will be made for any phase of the Work completed and accepted as of the date of termination. 7. Ownership of Work/Documents: All Work,work product,or other documents produced in • furtherance of this Agreement belong to the.City,and any copyl)tight,patent,trademark proprietary or any other protected intellectual property right shall vest in and is hereby assigned to the City. 8. Statutory Requirements: The following laws of the State of Oregon are hereby incorporated by reference into this Agreement: ORS 279B.220,279B.230 and 279B.235. 9. Living Wage Requirements: lithe amount of this Agreement is$22,310.46 or more,Consultant 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. Consultant is also required to post the notice attached hereto as"Exhibit B"predominantly in areas where it will be seen by all employees. t 1 10. Indemnification:Consultant hereby agrees to defend,indemnify,save,and hold City,its officers, employees,and agents hairnless from any and all losses, claims,actions,costs,expenses,judgments, ts,or other damages resultingfrom injuryto anYperson(includinginjur resulting in death)�or damage (including loss or destruction)to property,of whatsoever nature arising out of or incident to the performance of this Agreement by Consultant(including but not limited to,Consultant's employees, agents, and others designated by Consultant to perform Work or services attendant to this Agreement). However,Consultant shall not be held responsible for any losses,expenses,actions,costs,or other E f damages,caused solely by the gross negligence of City. 11. Termination: a. Mutual Consent. This Agreement may be terminated at any time by the mutual consent of both parties. b. City's Convenience. This Agreement may be terminated by City at any time upon not less than thirty(30)days' prior written notice delivered by certified mail or in person. c. For Cause. City may terminate or modify this Agreemnt,in whole or impart,effective upon delivery of written notice to Consultant,or at such later date as may be established by City under any of the following conditions: i. If City funding from federal,state,county or other sources is not.obtained and continued at • levels sufficient to allow for the purchase of the indicated quantity of services; i 1 ii. If federal or state regulations or guidelines are modified,changed,or interpreted in such a Page 2 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND ADKINS ENGINEERING AND • SURVEYING " 1 • way that the services are no longer allowable or appropriate for purchase under this Agreement or are no longer eligible for the funding proposed for payments authorized by this Agreement;or iii. If any license or certificate required by law or regulation to be held by Consultant to provide the services required by this Agreement is for any i reason denied,revoked,suspended,or not • renewed, d. For Default or Breach. � i. Either City or Consultant may terminate this Agreement in the event of a breach of the Agreement by the other. Prior to such termination the party seeking termination shall give to the other party written notice of the breach and its intent to terminate. If the party • • committing the breach has not entirely cured the breach within fifteen(15)days of the date of the notice,or within such other period as the party giving the notice may authorize in writing, then the Agreement may be terminated at any time thereafter by a written notice of termination by the party giving notice. ii. Time is of the essence for Consultant's performance of each and every obligation and duty • • under this Agreement. City,by written notice to Consultant of default or breach,may at any • time terminate the whole or any part of this Agreement if Consultant fails to provide the Work called for by this Agreement within the time specified herein or within any extension thereof. iii. The rights and remedies of City provided in this subsection(d)are not exclusive and are in addition to any other rights and remedies provided by law or under this Agreement. 12. Independent Contractor Status: Consultant is an independent contractor and not an employee of the • City for any purpose. • • • 13. Assignment: Consultant shall not assign this Agreement or subcontract any portion of the Work without the written consent of City. Any attempted assignment or subcontract without written consent • of City shall be void. • 14. Default. The Consultant shall be in default of this AgreementifConsultant: 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 and 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 attempts to assign rights in,or delegate duties under,this Agreement. • • • • 15. Insurance. Consultant shall,at its own expense,maintain the following insurance: a. Workers' Compensation. Consultant shall obtain and maintain Workers' Compensation insurance in compliance with ORS 656.017,which requires subject employers to provide Oregon Workers' Compensation coverage for its subject workers,unless such employers are exempt under ORS 656.126. If exempt under ORS 656.126,Consultant shall certify such exemption to the City. Page 3 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND ADKINS ENGINEERING AND SURVEYING • i • b. Professional Liability insurance with a combined single limit,or the equivalent,of not less than $2,000,000(two million dollars)per occurrence. This is to cover any damages caused by error, • omission or negligent acts related to the Work to be provided under this Agreement. c. General Liability insurance with a combined single limit,oi•the equivalent,of not less than $2,000,000(two million dollars)per occurrence for BodilyIInjury,Death,and Property Damage. d. Automobile Liability insurance with a combined single limit,or the equivalent,of not less than $1,000,000(one million dollars)for each accident for Bodily Injury and Property Damage,including coverage for owned,hired or non-owned vehicles,as applicable. e. Notice of cancellation or change. There shall be no cancellation,material change,reduction of limits or Intent not to renew the insurance coverage(s)without thirty(30)days'prior written notice from the Consultant or its insurer(s)to the City. I f. Additional Insured/Certificates of Insurance. Consultant shall name the City of Ashland,Oregon, and its elected officials,officers and employees as Additional Insureds on any insurance policies, excluding Professional Liability and Workers'Compensation,required herein,but only with respect to Consultant's services to be provided under this Agreement.The consultant's insurance is primary and non-contributory.As evidence of the insurance coverages required by this Agreement, the Consultant shall furnish acceptable insurance certificates and endorsements prior to commencing the Work under this Agreement. I 16. Nondiscrimination: Consultant 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 any Work under this Agreement when employed by Consultant. Consultant agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes,rules • and regulations. Further,Consultant agrees.not to discriminate against a disadvantaged business enterprise,minority-owned business,woman-owned business,a business that a service-disabled veteran • owns or an emerging small business enterprise certified under ORS 200.055,in awarding subcontracts as required by ORS 279A.110. 17. Consultant's Compliance With Tax Laws: 17.1 Consultant represents and warrants to the City that: ' 17.1.1 Consultant shall,throughout the term of this Agreenient,including any extensions hereof, comply with: I (i)All tax laws of the State of Oregon,including but not limited to ORS 305.620 and ORS Chapters 316,317,and 318; 1 (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Consultant;and (iii) Any rules,regulations,charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. 1 17.1.2 Consultant,for a period of no fewer than six(6)calendar years preceding the Effective Date of this Agreement,has faithfully complied with: (i) All tax laws of the State of Oregon,including but not limited to ORS 305.620 and ORS • • Chapters 316,317,and 318; Page 4 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND ADKINS ENGINEERING AND • SURVEYING { f I 1 i • (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Consultant; and (iii) Any rules,regulations,charter provisions,or ordinances that implement or enforce any of the foregoing tax laws or provisions. 18. Governing Law;Jurisdiction: This Agreement shall be governed and construed in accordance with 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. 19. 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,by mailing using registered or certified United States mail,return receipt requested,postage prepaid,or by electronically confirmed at the address or facsipiile number set forth below: • • If to the City: • Public Works Department Attn: Contract Administrator • 20 East Main Street Ashland,Oregon 97520 With a copy to: City of Ashland-Legal Department 20 East Main Street Ashland,Oregon 97520 If to Consultant: Adkins Engineering and Surveying 1435 Esplanade Ave Klamath Falls,OR 97601 20. Amendments. This Agreement may be amended only by written instrument executed by both parties with the same'formalities as this Agreement. 21. THIS AGREEMENT AND THE ATTACHED EXHIBITS CONSTITUTE THE ENTIRE UNDERSTANDING BETWEEN THE PARTIES. THERE ARE NO UNDERSTANDINGS, AGREEMENTS,OR REPRESENTATIONS,EITHER ORAL OR WRITTEN,NOT SPECIFIED HEREIN REGARDING THIS AGREEMENT. CONSULTANT,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 5 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND ADKINS ENGINEERING AND • SURVEYING • 22. Certification. Consultant shall execute the certification attached hereto as"Exhibit C"and incorporated herein by this reference. IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below • CITY OF ASHLAND: ADKINS ENGINEERING AND SURVEYING (CONSULTANT): SA y' Signatures%-c-kwmuor . Signature fth.'I,.1 - «; 1G 1 rt,,,tr121 Printed Name • 1Q1 6 AR.K 'E`�Il't�AA4 j�1��,lc�a� � . / r 1 Title Title v Date Date �D D l0 Purchase Order No. `W=9 is tO be submitted with this signed Agreement) •• • • • • • • Page 6 of 6: PERSONAL SERVICES AGREEMENT BETWEEN THE CITY OF ASHLAND AND ADKINS ENGINEERING AND SURVEYING j • i I . ENGINEERING&SURVEYING October 11,2021 Kevin Caldwell City Ashland,Public Works 20 East Main Street Ashland,Oregon 97520 - RE: City of Ashland Morton Street to Ivy Street Waterline Replacement Engineering Scope&Fee proposal Dear Mr.Caldwell: Thank you for the opportunity to propose engineering services to the City for design of the Morton Street to Ivy Street Waterline Replacement. From the information provided and our conversations,itis our understanding the City desires to replace^'2,000 feet of existing 14-inch steel water pipe with 12- inch ductile Iron pipe.The new 12-inch waterline will follow the existing alignment from Morton Street to Ivy Street,We also understand that this project has a short design timeframe and will need to bid in spring of 2022. For this project,Adkins will deliver to the City a complete Bid Document Package consisting of Construction Drawings,Boiler Plate General Conditions,Technical Special Provisions(APWA),Bid Item Schedule,and a Construction Cost Estimate.Adkins proposes to complete the project according to the following Tasks and Scope: Task 1 --Project ittlanagemeni ` Task 1 includes Project Administration and Management to ensure on time and on budget completion of project deliverables,coordination with City Staff,and coordination with franchise utilities(if any exist in the project area).For Task 1 we assume that meetings between the City and Adkins will be held at the kick-off and 60%and 90%design stages.We also assume there will be a utility coordination meeting between all affected utility owners. • Task 2 Topographic Surveying Task 2 consists of locating,identifying,and mapping of existing site features including above and underground utilities as well as verifying public right-of-way and property lines as provided by the City. We will utilize our in-house survey department to streamline mapping and minimize costs in the field-to-- finish ield-to-finish process. For Task 2,we assume that utility potholing(or other means of locating)will be performed by City staff • or by a City hired Contractor and that 48-hour notification will be prlovided to Adkins in order to schedule a technician to document depths,sizes,and material of exposed utilities. task 3 -- Design Engineering For Task 3,Adkins will prepare plan&profile design sheets(3 total)proposing the alignment and profile for the new 12"waterline and preliminary estimate of probable construction costs to be submitted and reviewed at the 60%design stage. 1435 Esplanade Ave,Klamath Falls,OR 97601 0 541.884.4666 / 1541.884.5335 1 w AdkinsEngineering.com • For the 90%design stage,Adkins will complete a full set of construction drawings,updated estimate of probable construction costs,a list of Oregon Standard Specifications applicable to the project,and draft Special Provisions applicable to the project. Construction drawings for this stage will include Cover, Existing Conditions Topographic Survey,Plan and Profile, Details,Traffic Control Plan/Details and erosion and sediment control plan.The 90%design stage will conclude with a design review meeting between • the City and Adkins. For the 100%stage,Adkins will deliver final Construction Drawings;a Construction Cost Estimate,and final Special Provisions to the 2021 Oregon Standard Specifications for Construction,and a final Schedule of Bid Items in accordance with the Special Provisions. Task 4 _. Bidding & Construction Support During construction,we assume that the City will perform the primary construction management duties and that Adkins will provide assistance in a limited technical support role.Adkins will:attend the pre- construction conference,provide responses to the City for clarification of design documents and technical specifications,attend up to four construction meetings and site visits,and complete Record Drawings based on City and Contractor provided field notes.' We propose to perform Tasks 1,2,&3 for the Scopes listed above on a Fixed Fee basis for$29,400 and Task 4 on a Time-and-Materials Basis with an estimated budget of$5,000. Additional work requested by the City and not described herein will be performed on a Time and j t Materials basis according to our 2021 Standard Fee Schedule.Prior to performing any additional work Adkins will notify the City's Project Manager that work has been requested outside the scope of the proposed Tasks and Scope and will only perform the additional work once approval has been issued by the City in writing.Additional work explicitly excluded from the scope described herein includes but is not limited to utility potholing,right-of-way or easement developmlent and negotiations,soils investigation and report,environmental or cultural investigations,permitting and construction monitoring,system modeling and capacity design,public involvement,and Owner directed design modifications during construction. Thank you for this opportunity to provide you with this proposal and we look forward to working with the City on this project.Please contact me if you have any questions or would like to discuss any details of this proposal. Sincerely, ti, i I Dan Scales,P.E.&C.W.R.E. Project Manager/Partner c i i ADIKiNS 0 54'1.884.46661 f 541.884.53351 v<AdkinsEngineering.com ENGINEERING&SURVEYING 1435 Esplanade Ave,Klamath Falls,OR 97601 • � a i • EXHIBIT C CERTIFICATIONS/REPRESENTATIONS: Consultant,by and tlu.ough its authorized representative,under penalty of perjury, certifies that(a)the number shown on the attached W-9 form is its correct taxpayer ID (or is waiting for the number to be issued to it and(b)Consultant is not subject to backup withholding because: (i)it is exempts,from bacicup withholding,or(ii)it has not been notified by the Internal Revenue Service(IRS)that it is subject to backup withholding as a result of a failure to report all interest or dividends,or(iii)the IRS has notified it that it is no longer subject to backup withholding. Consultant further represents and warrants to City that: (a)it has the power and authority to enter into this Agreement and perform the Work, (b)the Agreement,when executed and delivered,shall be a valid and binding obligation of Consultant enforceable in accordance with its terms,(c)the work under the Agreement shall be performed in accordance with the highest professional standards,and(d)Consultant is qualified,professionally competent,and duly licensed(if applicable)to perform the Work. Consultant also certifies under penalty of perjury that its business is not in violation of any • Oregon tax laws,it is an independent contractor as defined in the Agreement,it is authorized to • do business in the State of Oregon,and Consultant has checked four or more of the following • criteria that apply to its business. iC (1)Consultant carries out the work or services at allocation separate from a private residence or is in a specific portion of a private residence,set aside as the location of the business. X (2)Commercial advertising or business cards or a trade association membership are purchased for the business. 1C (3)Telephone listing is used for the business separate from the personal residence listing. X (4)Labor or services are performed only pursuant to written contracts. x (5)Labor or services are performed for two or more different persons within a period of one year. X (6)Consultant assumes financial responsibility for defective workmanship or for service not provided as evidenced by the ownership of performance bonds, • warranties,errors and omission(professional liability)insurance or liability insurance relating to the Work or services to be provided. LJ/(Consultant's sigture /Date Page 1 of 1: EXHIBIT C • . EXHIBIT B CITY O••F •A S'H !.A<N,�D, • R E G.:15N City --uf -ii_ shial ril, Li I,/b 1 :\' ' '. v k AGE•ALL employers described below must comply with City of Ashland laws regulating •a ment of a livin• wa e. $1.5.96 per hour9 effective June 309 202.0. 1 .The Living Wage is adjusted annually everyraps June 30 by the Consumer Price Index. Employees must be paid a portion of business of their 401K and IRS eligible ) living wage: employer,if the employer has cafeteria plans(including ten or more employees,and . childcare)benefits to the has received financial amount of wages received by assistance for the project or the employee. For all hours worked under a business from the City of service contract between their Ashland in excess of ➢ Note: For temporary and employer and the City of $22,310.46. part-time employees,the • Ashland if the contract Living Wage does dot apply i I exceeds$22,310.46 or more. ➢ If their employer is the City of to the first 1040 hours worked Ashland,including the Parks in any calendar year. For D. For all hours worked in a and Recreation Department. more details,please see month if the employee spends - Ashland Municipal Code 50%or more of the ' In calculating the living wage, Section 3.12.020. employee's time in that month employers may add the value } working on a project or of health care,retirement, • For additional information: Call the Ashland City Administrator's office at 541-488-6002 or write to the City Administrator, City Hall,20 East Main Street,Ashland, OR 97520,or visit the City's website at www.ashland.or.us. Notice to Employers: This notice must be posted predominantly in areas where it can be seen by all employees. CITY OF ,1 S HLAND Page I of I: EXHIBITB I • / DATE(MWDD/YYYY) ACCORD • CERTIFICATE OF.LIABILITY INSURANCE , 10/25/2021 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER - CONTACT AssuredPartners of Washington LLC PHONE Allison Barga FAX 19660 10th Ave NE (@A�tc.No.Ext.360-626-2007 (AIC.No):360-626-2007 Poulsbo WA 98370 ADDRESS: alllsonibarga@assuredpartners.com NsUREe(s)AFFORDING COVERAGE NAIC# j . INSURER A:LIBERTY INSURANCE UNDERWRITERS INC 19917 INSURED 26459 INSURER B: Adkins Consulting Engineering LLP 1435 Esplanade Ave INSURER C: Klamath Falls OR 97601 INSURER D: INSURERE: INSURER F: . . • COVERAGES CERTIFICATE NUMBER:43210694 REVISION NUMBER: • THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE 1NSD WV() POLICY NUMBER (MM/DD/YYYY) IMMIDD/YYYYI LIMITS COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENED CLAIMS-MADE I I OCCUR PREMISES(Ea occurrence) $ • MED EXP(Any one person) $ PERSONAL BADV INJURY S GEM.AGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE _ $ . POLICY 'ECT OTHER: LOC , PRODUCTS-COMP/OP AGO S _ S AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT $ (Ea accident) _ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ • AUTOS ONLY _AUTOS ONLY (Per accldeni) • I S UMBRELLA LIAB _OCCUR - EACH OCCURRENCE S - EXCESS LIAB CLAIMS-MADE • AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION PER I OTH- AND EMPLOYERS'LIABILITY Y/N .STATUTE I ER OFF ROPRIE B�XCLUDEDXECUTIVE N/A E.L.EACH ACCIDENT S (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S If yes.descdbe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ A Professional LIab:Claims Made Y AEXNYABLIOX004 3/10/2021 3/10/2022 $2,000,000 Per claim 54.000,000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may bo allached If more spaco Is required) ' 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 ' a/4 ie 754/e I • ©1908-2015 ACORD CORPORATION, All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE • • P DATE® A EP CERTIFICATE OF LIABILITY INSURANCE 10125/2021 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 poiicy(Ies)must hiave 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: Janice Sharp Great Basin Insurance,Inc. PHONE 826 Main Street wc.No.Eel):541-412-5507 FAX No:541-884-0052 Klamath Falls OR 97601 ADDRESS: Janice.6harp@orebasIn.com i INSURER(S)AFFORDING COVERAGE NAIC# 1 INSURER A:Employers Mutual Casually Company 21415 INSURED ADKICON-02 INSURER B:SAIF Corporation 36196 Adkins Consulting Engineering,LLP INsuRIRc: 1435 Esplanade Ave. Klamath Falls OR 97601 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:798682762 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 B'PAID CLAIMS. INSRADDL SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE ' INSD WVD POLICY NUMBER (MMIDD/YYYY) iMMIDDIYYYY) - f A X COMMERCIAL GENERAL LIABILITY Y 6D23786 8/1/2021 8/1/2022 EACH OCCURRENCE $1,000,000 CLAIMS-MADE I X I OCCUR I DAMAGE TO RENTED PREMISES(Ea occurrence) $1,000,000 I. i MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEM_AGGREGATE LIMIT APPUESPER: GENERAL AGGREGATE $2,000,000 PRO- n LOC PRODUCTS $2;000,000 I POLICY n/ECT I 1 $ OTHER: A AUTOMOBILE LIABILITY V 6523786 8/1/2021 8/1/2022 COMBINEO.SINGLELIMIT $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) $ A X UMBRELLA LIAB X OCCUR 6J23786 8/1/2021 8/1/2022 EACH OCCURRENCE $2,000,000 - - EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED X RETENTIONS in,rtnn $ ' B WORKERS COMPENSATION 773481 8/1/2021 8/1/2022' X STATUTE ETH- :• AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETORIPARTNERIEXECUTIVE I I NIA E.L.EACH ACCIDENT $500,000 i OFFICERIMEMBEREXCLUDED4 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 i I If yes,describe under EL.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS belowr ' DESCRIPTION OF OPERATIONS I,,LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be allachad II More apace le required) ( I The City of Ashland,Oregon,and Its elected officials,officers and employees are Additional Insureds for general liability and auto policy per the attached endorsement forms:CA745 Commercial Auto Elite Extension and EMC Liability Elite ENDT CG7578.The insurance is primary and non-contributory. • 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 er>..777,4— .41--();QiL i ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD • I COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ELITE EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM The COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include the following clarifications and extensions of coverage.The provisions of the Coverage Form apply unless modified by endorsement. A. EXPECTED OR INTENDED INJURY The aggregate limit listed above is the most we will Section I —Coverage A, Exclusion a. is amended pay for all damages because of"property damage" as follows: to property in the care custody and control of or property loaned to an insured during the policy a. "Bodily injury" or "property damage" expected period. or intended from the standpoint of an insured. Any payment we make for damages because of This exclusion does snot apply to "bodily injury" "property dama e" to property or"property damage resulting from the use of 9 P P y in the care, custody reasonable force to protect persons or property. and control of or property loaned to an insured will apply against the General Aggregate Limit shown in B. NON-OWNED WATERCRAFT the declarations. Section I — Coverage A, Exclusion g.(2) is b. Our obligation to pay damages on your behalf amended as follows: applies only to the amount of damages in (2) A watercraft you do not own that is: excess of the deductible amount listed above, (a) Less than 60 feet long;and We may pay any part or all of the deductible amount listed above. We may pay any part or (b) Not being -used to carry person(s) or all of the deductible amount to effect settlement property for a charge; of any claim or "suit" and upon notification by C. EXTENDED PROPERTY DAMAGE COVERAGE tis, you will promptly reimburse us for that part Section I—Coverage A, Exclusions j.(3) and(4) is of the deductible we paid. amended to add the following: c. If two or more coverages apply under one Paragraphs (3) and (4) of this exclusion do not "occurrence", only the highest per claim deductible applicable to these coverages will apply to tools or equipment loaned to you, provided apply they are not being used to perform operations at the time of loss. d. Insurance provided by this provision is excess over any -other insurance, whether primary, SCHEDULE excess, contingent or any other basis. Since Limits Of Insurance Deductible insurance provided by this endorsement is excess, we will have no duty to defend any $5,000 Each Occurrence $250 Per Claim claim or"suit" to which insurance provided by $10,000 Annual Aggregate this endorsement applies if any other insurer has a duty to defend such a claim or"suit". If a. The each occurrence limit listed above is the rio other insurer defends, we will undertake to most we will pay for all damages because of do so, but we will be entitled to the insured's "property damage" to property in the care, rights against all those other insurers. custody and control of or property loaned to an D. PROPERTY DAMAGE—ELEVATORS insured as the result of any one "occurrence", regardless of the number of: Section I—Coverage A.2. Exclusions paragraphs (1) insureds; j.(3), j.(4), j.(6) and k. do not apply to use of elevators. This insurance afforded by this provision (2) claims made or"suits"brought; - is eXcess over any valid and collectible property (3) persons or organizations making claims or insurance (including any deductible) available to bringing"suits". the insured and Section IV—Commercial General Liability Conditions Paragraph 4. Other Insurance is changed accordingly. CG7578(6-17) Includes copyrighted material of ISO Propertles,Inc.with Its permission. Page 1 of 6 E. FIRE,LIGHTNING OR EXPLOSION DAMAGE a. Currently in effect or becomes effective Except where it is used in the term "hostile fire", the during the policy period;and word fire includes fire,lightning or explosion wherever b. Executed prior to an "occurrence" or it appears in the Coverage Form. offense to which this insurance would I s Under Section I — Coverage A, the last paragraph apily. (after the exclusions)is replaced with the following: However, the insurance afforded to such Exclusions c. through n. do not apply to damage by additional insured: fire, smoke or leakage from automatic fire protection a. Only applies to the extent permitted by law; systems to premises while rented to you or and temporarily occupied by you with permission of the b. Will not be broader than that which you are owner. A separate limit of insurance applies to this coverage as described in Section III — Limits of required by the contract or agreement to provide for such additional insured;and Insurance. F. MEDICAL PAYMENTS c. Applies only if the person or organization is not specifically named as an additional If Section I — Coverage C. Medical Payments insured under any other provision of, or Coverage., .is not otherwise excluded from this endorsement added to, Section II — Who Coverage Form: Is An Insured of this policy. The requirement, in the Insuring Agreement, of2. As provided herein, the insurance coverage Coverage C., that expenses must.be incurred and _ provided to such additional insureds is limited reported to us within one year of the accident date is to: changed to three years. G. SUPPLEMENTARY PAYMENTS a. Any Controlling Interest, but only with respect to their liability arising out of their Supplementary Payments — Coverages A and B financial control of you; or premises they Paragraphs 1:b. and 1:d. are replaced by the own, maintain, or control while you lease or following:. ' occupy these premises. 1.b.Upto $5,000 for cost of bail bonds required This insurance does not apply to structural because of accidents or traffic law violations " alterations, new construction and arising out of the use of any vehicle to which the demolition operations performed by or for Bodily Injury Liability Coverage applies. We do that person or organization. not have to furnish these bonds. b. Any, architect, engineer, or surveyor 1.d.All reasonable expenses incurred by the insured engaged by you but only with respect to at our request to assist us in the investigation or liability for "bodily injury", "property defense of the claim or "suit", including actual damage" or "personal and advertising loss of earnings up to $500 a day because of injury" caused, in whole or in part, by your time off from work. acts or omissions or the acts or omissions H. SUBSIDIARIES AS INSUREDS of those acting on your behalf: Section II—Who Is An Insured is amended to add (1) In connection with your premises; or the following: (2) In the performance of your ongoing 1.f. Any legally incorporated subsidiary in which you operations. own more than 50% of the voting stock on the With respect to the insurance afforded to effective date of this•policy. However, insuredthese additional insureds,the following does not include any subsidiary that is an insured additional.exclusion applies: under any other general liability policy, or would I have been an insured under such a policy but for This insurance does not apply to "bodily ; 1 termination of that policy or the exhaustion of that injury", "property damage"or"personal and policy's limits of liability. advertising injury" arising out of the rendering of or the failure to render any I. BLANKET ADDITIONAL INSUREDS — AS professional services by or for you, REQUIRED BY CONTRACT including: 1. Section II—Who Is An Insured is amended to (1) The preparing, approving, or failing to include as an additional insured any person(s)or prepare or approve, maps, shop organization(s)subject to provisions in Paragraph drawings, opinions, reports, surveys, 2. below, (hereinafter referred to as additional • field orders,change orders or drawings insured) when you and such person(s) or and specifications;or organization(s) have agreed in a written contract (2) Supervisory, inspection, architectural or or written agreement that such person(s) or engineering activities. organization(s)be added as an additional insured on your policy provided that the written contract or agreement is: : . CG7578(6-17) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 2 of 6 This exclusion applies even if the claims This insurance does not apply to: • against any insured allege negligence or (a) "Bodily injury", "property damage"or other wrongdoing in the supervision, hiring, "personal and advertising injury" employment, training or monitoring of arising out of operations performed others by that insured, if the "occurrence" for the federal government, state or which caused the "bodily injury" or municipality;or "property damage", or the offense which caused the "personal and advertising (b) "Bodily injury" or "property damage" i injury", involved the rendering of or the included within the "products- failure to render any professional services completed operations hazard". by or for you. e. Any vendor, but only with respect to"bodily c. Any manager or lessor of a premises injury" or "property damage" arising out of leased to you, but only with respect to "your products"which are distributed or sold liability arising out of the ownership, in the regular course of the vendor's maintenance or use of that part of a business. premises leased to you, subject to the With respect to the insurance afforded to following additional exclusions: these vendors, the following additional This insurance does not apply to: exclusions apply: (1) Any "occurrence" which takes place (1) The insurance afforded any vendor does after you cease to be a tenant in that not apply to: premises. (a) "Bodily injury" or"property damage" (2) Structural alterations, new construction for which any vendor is obligated to or demolition operations performed by pay damages by reason of the or on behalf of such additional insured. assumption of liability in a contract or d. Any state or governmental agency or agreement. This exclusion does not subdivision or political subdivision, subject to apply to liability for damages that any vendor would have in the absence of the following: the contract or agreement; (1) This insurance applies only with respect (b) Any express warranty unauthorized to the following hazards for which any by you; state or governmental agency or subdivision or political subdivision has (c) Any physical or chemical change in issued a permit or authorization in the product made intentionally by connection with premises you own, rent any vendor; or control and to which this insurance (d) Repackaging, except when applies: unpacked solely for the purpose of (a) The existence, maintenance, repair, inspection, demonstration, testing, construction, erection or removal of or the substitution of parts under advertising signs, awnings, instructions from the manufacturer, canopies, cellar entrances, coal and then repackaged in the original holes, driveways, manholes, container; marquees, hoist away openings, (e) Any failure to make such sidewalk vaults, street banners or inspections, adjustments, tests or decorations and similar exposures; servicing as any vendor has or agreed to make or normally (b) The construction, erection or undertakes to make in the usual removal of elevators;or course of business, in connection (c) The ownership, maintenance or use with the distribution or sale of the of any elevators covered by this products; insurance. (f) Demonstration, installation, servicing or repair operations,This insurance applies only with trespect except such operations performed to operations performed by you or on your behalf for which any state or at any vendor's premises in connection with the sale of the governmental agency or subdivision or product; political subdivision has issued a permit or authorization. (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for any vendor; or CG7578(6-17) Includes copyrighted material of ISO Properties,Inc.with Its permission. Page 3 of 6 � ) p � p (h) "Bodily injury" or "property A person's or organization's status as an damage" arising out of the sole additional insured under this endorsement negligence of any vendor for its ends when their contract or agreement with i own acts or omissions or those of you for such leased equipment ends. I, its employees or anyone else With respect to the insurance afforded to I acting on its behalf. However, this these additional insureds, this insurance i exclusion does not apply to: does not apply to any "occurrence" which (i) The exceptions contained in takes place after the equipment lease Subparagraphs(d)or(f);or expires. i (ii) Such inspections, adjustments, i. Any Owners, Lessees, or Contractors for tests or servicing as any whom you are performing operations, but vendor has agreed to make or only with respect to liability for "bodily normally undertakes to make in injury", "property damage"or"personal and the usual course ofbusiness, advertising injury" caused, in whole or in in connection with the part, by: distribution or sale of the (1) Your acts or omissions;or products. . (2), The acts or omissions of those acting (2) This insurance does not apply to any on your behalf; insured person or organization, from r in the performance of your ongoing whom you have acquired such products, or any ingredient, part or operations for the additional insured. i container, entering into, accompanying A person's or organization's status as an or containing such products. additional insured under this endorsement f. Any Mortgagee,Assignee Or Receiver, but ends when your operations for that only with respect to their liability as additional insured are completed. mortgagee, assignee, or receiver and With respect to the insurance afforded to arising out of the ownership, maintenance, these additional insureds,the following or use of the premises by you. additional exclusions apply: This insurance does not apply to structural Thlis insurance does not apply to: alterations, new construction and 1 demolition operations performed by or for (1) "Bodily injury", "property damage" or that person or organization. personal and advertising injury"arising AnyOwners Or Other Interests From out of the rendering of, or the failure to g. render, any professional architectural, Whom Land Has Been Leased, but only engineering or surveying services, with respect to liability arising out of the including: ownership, maintenance or use of that part of the land leased to you. (a) The preparing, approving, or failing to prepare or approve, maps, shop With respect to the insurance afforded to drawings, opinions, reports, these additional insureds,the following surveys, field orders, change additional exclusions apply: orders or drawings and (1) This insurance does not apply to: specifications;or Supervisory, (a) Any "occurrence" which takes (b) inspection, . place after you cease to lease that architectural or engineering land; or activities. (b) Structural alterations, new This exclusion applies even if the claims construction or demolition against any insured allegenegligence or other wrongdoing in the supervision, hiring, � operations performed by or on p g ' behalf of such additional insured, employment, training or monitoring of h. Any person or organization from whom you others by that insured, if the "occurrence' lease equipment, but only with respect to which caused the "bodily injury or property damage", or the offense which liability for "bodily injury", "property caused the "personal and advertising damage" or "personal and advertising injury" caused, in whole or in part by your injury , involved the rendering of or the ! failure to render any professional maintenance, operation or use of architectural, engineering or surveying equipment leased to you by such person(s) 1 services. or organization(s). 1 I (2) "Bodily injury" or "property damage occurring after: ' I I, ! f CG7578(6.17) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 4 of 6 (a) All work, including materials, parts This endorsement shall not increase the or equipment furnished in applicable Limits of Insurance shown in the connection with such work, on the Declarations. project (other than service, J. COVERAGE FOR INJURY TO CO-EMPLOYEES maintenance or repairs) to be AND/OR YOUR OTHER VOLUNTEER WORKERS performed by or on behalf of the additional insured(s) at the location Section Il—Who is an Insured,Paragraph 2.a.'(1)is of the covered operations has been amended to add the following: completed;or e. paragraphs(a),(b),and(c)do not apply to your (b) That portion of "your work" out of '"employees" or"volunteer workers"with respect which the injury or damage arises to "bodily injury" to a co-"employee" or other has been put to its intended use by 'volunteer worker". any person or organization other Damages owed to an injured co-"employee" or than another contractor or "volunteer worker" will .be reduced by any subcontractor engaged in amount paid or available to the injured co- performing operations for a "employee" or "volunteer worker" under any principal as a part of the same other valid and collectible insurance. project. K. HEALTH CARE SERVICE PROFESSIONALS AS j. Any Grantor of Licenses to you, but only INSUREDS-INCIDENTAL MALPRACTICE with respect to their liability as grantor of1 licenses to you. Section II—Who is an Insured, Paragraph 2.a. (1) (d)is amended as follows: Their status as additional insured under This provision does not appl• y to Nurses, Emergency this endorsement ends when: Medical Technicians, or Paramedics who provide 1. The license granted to you by such professional health care services on your behalf. person(s)or organization(s)expires;or However this exception does not apply if you are in 2. Your license is terminated or revoked the business or occupation of providing any such by such person(s) or organization(s) professional services. prior to expiration of the license as L. NEWLY FORMED OR ACQUIRED stipulated by the contract or ORGANIZATIONS agreement. k. Any Grantor of Franchise, but only with Section II —Who Is An Insured, Paragraph 3.a. is respect to their liabilityas replaced by the following: grantor of a i franchise to you. 3.a. Coverage under this provision is afforded until I. Any Co-owner of Insured Premises, but the end of the policy period. only with respect to their liability as co- This provision does not apply if newly formed or owner of any insured premises. acquired organizations coverage is excluded either by m. Any Concessionaires Trading Under Your the provisions of the Coverage Form or by endorsements. Name, but only with respect to their liability as a concessionaire trading under your M. DAMAGE TO PREMISES RENTED TO YOU name. Section III — Limits of Insurance, Paragraph.6. is 3. Any insurance provided to any additional replaced by the following: insured does not apply to "bodily injury", Subject to 5.a. above, the Damage To Premises "property damage"or"personal and advertising Rented To You Limit, or $500,000, whichever is injury" arising out of the sole negligence or higher; is the most we will pay under Coverage A for willful misconduct of the additional insured or its damages because of"property damage" to any one agents, "employees" or any other premises, while rented to you, or in the case of representative of the additional insured, damage by fire, smoke or leakage from automatic 4. With respect to the insurance afforded to these protection systems,while rented to you or temporarily additional insureds, the following is added to occupied by you with permission of the owner. Section III—Limits of Insurance: N. MEDICAL PAYMENTS—INCREASED LIMITS If coverage provided to any additional insured Section III — Limits of Insurance, Paragraph 7. is is required by a contract or agreement, the replaced by the following: most we will pay on behalf of the additional insured is the amount of insurance: 7. Subject to Paragraph 5. above, $10,000 is the Medical Expense Limit we will pay under a. Required bythe contract or agreement; or Coverage C for all medical expenses because of b. Available under the applicable Limits of "bodily injury" sustained by any one person, Insurance shown in the Declarations; unless the amount shown on the Declarations of whichever is less. this Coverage Part for Medical Expense Limit states: 1 CG7578(6-17) Includes copyrighted material of ISO Properties,Inc!with Its permission. Page 5 of 6 r (a) No Coverage;or (2) You have agreed in writing in a contract or (b) $1,000; or ' agree ent that this insurance would be primary and would not seek contribution from any other (c) $5,000;or insurance available to the additional insured. (d) A limit higher than$10,000. However, if the additional insured has been added 1 as an additional insured on other O. DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE,CLAIM OR SUIT policies,whether primary, excess, contingent or on any other basis, this insurance is excess Section IV — Commercial General Liability over any other insurance regardless of the Conditions Paragraph 2. is amended to add the written agreement between you and an following: additiohal insured. e. The requirement in Condition 2.a.that you must Q. UNINTENTIONAL FAILURE TO DISCLOSE see to it that we are notified as soon as EXPOSURES } practicable of an "occurrence" or an offense Section IV — Commercial General Liability which may result in a claim, applies only when Condition's Paragraph 6. Representations is the"occurrence"or offense is known to: amended to add the following: (1) You, if you are an individual or a limited 'If you unintentionally fail to disclose any exposures • liability company; existing at the inception date of your policy;we will not (2) A partner,if you are a partnership; deny coverage under the Coverage Form solely (3) A member or manager, if you are a limited because of such failure to disclose. However, this liability company; provision does not affect our right to collect additional (4) An "executive officer" or insurance enewa premium or exercise our right of cancellation or non- renewal. on- manager,if you are a corporation;or (5) A trustee,if you are a trust. This provision does not apply to any known injury or damage which is excluded under:any other f. The requirement in Condition 2.b. that you provision of this policy. must see to it that we receive notice of a claim R. WAIVER OF TRANSFER OF RIGHTS OF or "suit as soon as practicable will not be RECOVERY AGAINST OTHERS TO US, considered breached unless the breach occurs 1 after such claim or"suit"is known to: Section IV — Commercial General Liability Condition Paragraph 8. Transfer Of Rights 'Of (1) You, if you are an individual or a limited Recovery Against Others To Us is amended to liability company; add the following: (2) A partner;if you are a partnership; We waive any right of recovery we .may have (3) A member or manager, if you are a limited against any person or.organization'against whom liability company; you have agreed to waive such right of recovery in (4) An "executive officer" or insurance a .written contract or agreement because of manager,if you are a corporation;'or payments we make for injury or damagearising out (5) A trustee,if you are a trust, of your ongoing operations.or "your work" done under.a:contract with that 'person or'organization P. PRIMARY AND NONCONTRIBUTORY — 1 ADDITIONAL INSURED EXTENSION and included in the"products completed operations hazard", Section IV — Commercial General Liability S. MENTAL ANGUISH Conditions Paragraph 4. Other Insurance is amended to add the following: Section V I--Definition 3.is replaced by the following: This insurance is primary to and will not seek ''Bodily injury" means bodily injury, sickness or contribution from any other insurance available to disease sOstained by a person, including mental an additional insured under your policy provided anguish or death resulting from bodily injury, that: sickness or disease. (1) The additional insured is a Named Insured T. LIBERALIZATION } under such other insurance;and If we revise this endorsement to provide greater coveragewithout additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. } i I CG7578(6-17) Includes copyrighted material of ISO Properties,Inc.wit Ih Its permission. Page 6 of 6 • COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO ELITE EXTENSION This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE FORM The BUSINESS AUTO COVERAGE FORM is amended to Include the following clarifications and extensions of • coverage.With respect to coverage provided by-this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. A. TEMPORARY SUBSTITUTE AUTO PHYSICAL C. EMPLOYEES AS INSUREDS DAMAGE The foillowing is added to the Section Il—Covered Section I—Covered Autos Paragraph C. Certain Autos Liability Coverage, Paragraph A.1.Who is Trailers, Mobile Equipment, and Temporary An insured provision: Substitute Autos is amended by adding the Any"employee"of yours is an"insured"while using folla covered "auto" you don't own, hire or borrow In If Physical Damage Coverage is provided by this your business or your personal affairs. coverage form for an"auto"you own, the Physical D. EMPLOYEE HIRED AUTOS Damage Coverages provided for that owned � "auto" are extended to any"auto" you do not own 1. Changes In Covered Autos Liability while used with the permission of Its owner as a Coverage temporary substitute for the covered "auto" you The following is added to the Who Is An own that is out of service because of breakdown, Insured provision: repair,servicing,"loss"or destruction. An "employee" of yours is an "Insured" while The coverage provided is the same as the operating an "auto" hired or rented under a coverage provided for the vehicle being replaced. contract or agreement in an "employee's" B. AUTOMATIC ADDITIONAL INSUREDS name, with your permission, while performing The Who Is An Insured provision under Covered duties related to the conduct of your business. Autos Liability Coverage is changed to include 2. Changes In General Conditions the following as an"insured": Paragraph 5.b. of the Other Insurance 1. Where Required by a Contract or Agreement Condition in the Business Auto Coverage Form the following is added: is replaced by the following: The Who Is An insured provision contained in the For Hired Auto Physical Damage Coverage,the Business Auto Coverage Form is amended to following are deemed to be covered "autos" add the following: you own: Any person or organization whom a. Any covered"auto"you lease, hire, rent or g you become borrow;and obligated to include as an additional Insured under this policy,as a result of any contract or agreement b. Any covered "auto"hired or rented by your you enter into which requires you to furnish "employee" under a contract in an insurance to that person or organization of the type "employee's" name, with your permission, provided by this policy, but only with respect to while performing duties related to the liability covered by the terms of this policy, arising conduct of your business. out of the use of a covered "auto"you own, hire or However,any"auto"that Is leased, hired, rented or borrow and resulting from the acts or omissions by borrowed with a driver is not a covered"auto". you, any of your "employees" or agents. The Insurance provided herein will not exceed: E. NEVVLY FORMED OR ACQUIRED ORGANIZATIONS (1) The coverage and/or limits of this policy,or Section II — Covered Autos Liability Coverage, (2) The coverage and/or limits required by said A.1.Who Is An Insured is amended by adding the contract or agreement, following: whichever is less. CA7450(11-17) Includes copyrighted material of ISO Properties,Inc,with its permission. Page 1 of 5 • • • • Any organization which you acquire or form after I. TOWING the effective date of this policy in which youSection Ill — Physical Damage Coverage, A.2. i maintain ownership or majority interest.However: Towing is replaced with the following: I. (1) Coverage under this provision is afforded only We will pay for towing and labor costs Incurred, • up to 180 days after you acquire or form the subject to the following: • organization, or to the end of the policy period, i whichever is earlier. a. Up to $100 each time a covered "auto" of the (2) Any organization you acquire or form will not be private passenger type is disabled;or considered an"Insured"if: b. Up to $500 each time a covered "auto" other • • (a) The organization Is partnership or a joint than the private passenger type is disabled. • Ai venture;or However,the labor must be performed at the place (b) That organization Is covered under other of disablement. similar Insurance. ' J LOCKSMITH SERVICES (3) Coverage under this provision does not apply Section IU — PhysicalDamage Coverage, A.4. to any claim for "bodily Injury" or "property Coverage'Extensions is amended by adding the damage" resulting from an "accident" that following: I occurred before you formed or acquired the We will pay up to $250 per occurrence for organization. necessary locksmith services for keys locked inside F. SUBSIDIARIES AS INSUREDS a covered private passenger "auto". The deductible is waived for these services. Section II — Covered Autos Liability Coverage, K. TRANSPORTATION EXPENSES A.1.Who Is An insured is amended by adding the following: Section Ill — Physical Damage Coverage, A.4. Any legally incorporated subsidiary In which you Coverage; Extensions Subparagraph a. own more than 50% of the voting stock on the Transportation Expenses is replaced by the effective. date of.ihis policy. However, "insured" following: ' does not include any subsiddiary that is an"insured" (1) We will pay up to$75 per day,to a maximum of under any other automobile liability policy or was an $2,508 for temporary transportation expense "Insured"under such a policy but for termination of incurred by you because of the total theft of a j that policy or the exhaustion of the policy's limits of covered "auto" of the private passenger type. liability. We will pay only for those covered "autos" for G. SUPPLEMENTARY PAYMENTS which j you carry either Comprehensive or Specified Cause Of Loss Coverage. We will Section II.,-.. Covered Autos Liability Coverage, pay for temporary transportation -expenses A.2.a. Coverage Extensions, Supplementary incurred during the period'beginning 48 hours ' Payments (2) and (4) are replaced by the after the theft and ending, regardless of the following: policy's expirations,when the covered"auto"Is (2) Up to $5,000 for cost of ball bonds (including returned to use or we pay for its"loss". bonds for related traffic law violations)required (2) If the temporary transportation expenses you because of an accident we cover. We do not incur arise from your rental of an"auto" of the have to furnish these bonds. private,passenger type,the most we will pay is (4) All reasonable expenses incurred; by the the amount it costs to rent an "auto" of the "Insured"at our request,including actual loss of private; passenger type which is of the same earnings up to.$500 a day because of time off like kind and quality as the stolen covered from work. "auto". H. FELLOW EMPLOYEE COVERAGE L. AUDIO, VISUAL, AND DATA ELECTRONIC In those jurisdictions where, by law, fellow EQUIPMENT COVERAGE ADDED LIMITS employees are not entitled to the protection Audio, Visual,*And Data Electronic,Equipment afforded to the employer by workers compensation Coverage'Added Limits of$5,000 Per"Loss"are in exclusivity rule,or similar protection. The following addition to;the sublimit in Paragraph C.1.b. of the provision is added: • Limits Of Insurance provision under Section Ill— Subparagraph 5. of Paragraph B. Exclusions in Physical Damage Coverage. Section 11 — Covered Autos Liability Coverage M. HIRED AUTOPHYSICAL DAMAGE does not apply If the"bodily Injury"results from the SIII — Physical'Damage Coverage, A.4. use of a covered"auto"you own or hire. Coverage',Extensions Is amended by adding the following: 1 • CA7450(11.17) I Includes copyrighted material of ISO Properties,Inc.with'Its permission. Page 2 of 5 •II 1 1 If hired "autos" are covered "autos" for Liability O. PERSONAL PROPERTY OF OTHERS Coverage, and If Comprehensive, Specified Section III — Physical Damage Coverage, A.4, Causes of Loss, or Collision coverage is provided Coverage Extensions Is amended by adding the for any"auto"you own, then the Physical Damage following: coverages provided are extended to "autos" youWe will pay up to$500 for loss to personal property hire,subject to the following limit and deductible: of others In or on your covered"auto." (1) The most we will pay for loss to any hired This a overage applies only in the event of"loss"to "auto" is the lesser of Actual Cash Value or your covered "auto" caused by fire, lightning, Cost of Repair,minus the deductible, explosion,theft,mischief or vandalism,the covered (2) The deductible will be equal to the largest "auto's"collision with another object,or the covered deductible applicable to any owned "auto" for "auto's"overturn. that coverage. No deductible applies to"loss" caused by fire or lightning. No deductibles apply to this coverage. (3) Subject to the above limit and deductible P. PERSONAL EFFECTS COVERAGE provisions, we will provide coverage equal to Section ill — Physical Damage Coverage, A.4. the broadest coverage applicable to any Coverage Extensions is amended by adding the covered"auto"you own. following: We will pay up to$1,000, In addition to the limit We will pay up to $500 for "loss" to your personal above, for loss of use of a hired auto to a effects not otherwise covered In the policy or, if you leasing or rental concern for a monetary loss are an individual, the personal effects of a family sustained,provided it results from an"accident" member,that Is in the covered auto at the time of the for which you are legally liable. "loss" For the purposes of this extension personal effects However,any"auto"that is leased, hired,rented or means tangible property that is worn or carried by an borrowed with a driver is not a covered"auto". insured Including portable audio,visual, or electronic N. AUTO LOAN OR LEASE COVERAGE devices. Personal effects does not include tools, Section 111 — Physical Damage Coverage jewelry, guns, money and securities, or musical Paragraph A.4.Coverage Extensions Is amended instruments by the addition of the following: Q. EXTRA EXPENSE FOR STOLEN AUTO In the event of a total "loss" to a covered "auto" Section III — Physical Damage Coverage, A.4. which Is covered under this policy for Coverage Extensions is amended by adding the Comprehensive, Specified Cause of Loss, or following: Collision coverage, we will pay any unpaid amount We will pay up to $1,000 for the expense Incurred due, including up to a maximum of$500 for early returning a stolen covered "auto" to you because of termination fees or penalties, on the lease or loan the total theft of such covered "auto". Coverage for a covered"auto",less: applies only to those covered "autos" for which you 1. The amount paid under the Physical Damage carry iComprehensive or Specified Causes Of Loss Coverage Section of the policy;and Coverage. 2. Any: R. RENTAL REIMBURSEMENT a. Overdue lease/loan payments at the time' Section Ill — Physical Damage Coverage, A.4. of the"loss"; Coverage Extensions Is amended by adding the following: b. Financial penalties Imposed under a lease 1 • 1. This coverage applies onlyto a covered"auto"for for excessive use, abnormal wear and tear which Physical Damage Coverage is provided or high mileage; on this policy. c. Security deposits not returned by the 2. We will pay for rental reimbursement expenses lessor; incurred by you for the rental of an "auto" d. Costs for extended warranties, Credit Life because of"loss"to a covered "auto". Payment Insurance, Health, Accident or Disability applies in addition to the otherwise applicable Insurance purchased with the loan or lease; amount of each coverage you have on a'covered and "auto".No deductibles apply to this coverage. e. Carry-over balances from previous loans or 3. We will pay only for those expenses Incurred leases, during the policy period beginning 24 hours Coverage does not apply to any unpaid amount after the "loss" and ending, regardless of the due on a loan for which the covered"auto"Is not policy's expiration, with the lesser of the the sole collateral. following number of days. CA7450(11-17) Includes copyrighted material of ISO Properties,Inc.with Its permission. Page 3 of 5 1 I a. The number of days reasonably required to For the purposes of this coverage extension a new I I repair or replace the covered "auto". If covered,auto is defined as an"auto"of which you are 1 "loss" is caused by theft, this number of the original owner that has not been previously titled I days is added to the number of days It which you purchased less than 180 days prior to the � takes to locate the covered "auto" and date of loss.) return it to you;or U. LOSS TO TWO OR MORE COVERED AUTOS i b. 30 days. FROM ONE ACCIDENT ( a 4. Our payment Is limited to the lesser of the Section ,Ill — Physical Damage Coverage, D. following amounts; Deductible(s amended by adding the following: a. Necessary and actual expenses incurred; If a Comprehensive, Specified.Causes of Loss or or Collision Coverage loss"from one"accident'involves sub est to a$2,250 limit. two or more covered "autos", only :the highest b. $75per day, ldeductible applicable to those,coverages will be 5. This coverage does not apply while there are applied to the"accident". spare or reserve "autos"available to you for If.the application.of the.,highest deductible is less your operations. favorable of more restrictive to the insured than the 6. If"loss"results from the total theft of a covered separate deductibles as applied In the standard form, "auto" of the private passenger type, we will the standard deductibles will apply. pay under this coverage only that amount of This provision only applies if you carry your rental reimbursement expenses which is Comprehensive, Collision or Specified Causes of not already provided for under the Physical Loss Coverage for those vehicles, and does not Damage — Transportation Expense Coverage extend coverage to any covered"autos"for which you Extension included in this endorsement. do not carr such coverage. 7. Coverage provided by this extension Is excess V. WAIVER OF DEDUCTIBLE—GLASS REPAIR OR over any other collectible insurance and/or REPLACEMENT • endorsement to this policy. Section III — Physical Damage Coverage, D. S. AIRBAG COVERAGE Deductible is amended by adding the following: Section iii Physical Damage Coverage, B.3.a. If a Comprehensive Coverage deductible Is shown in Exclusions is amended by adding the following: the Declarations it does not apply to the cost of If you have purchased Comprehensive or Collision repalring.or replacing damaged glass. Coverage under this policy, the exclusion relating to W. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, mechanical breakdown does not apply to the SUIT,OR LOSS accidental discharge of an airbag. Section IV -- Business Auto Conditions, A2. T. NEW VEHICLE REPLACEMENT COST Duties In The Event Of Accident, Claim, Suit Or • The following Is added to Paragraph C. Limit Of , Loss Is amended by adding the following: Insurance of Section IIi — Physical Damage Your obligation to notify us promptly of an"accident", Coverage claim, "suit" or "loss" is satisfied if you send us the In the event of a total loss"to your new covered auto required notice as soon as practicable after your Insurance Administrator or anyone else designated by of the private passenger type or vehicle having a you to be responsible for insurance matters is notified, gross vehicle weight of 20,000 pounds or less, to or in any manner made aware,of an"accident",claim, which this coverage applies, we will pay at your "suit"or"loss". option: X. WAIVER OF TRANSFER OF RIGHTS OF a. The verifiable new vehicle purchase price you paid for your damaged vehicle, not Including any RECOVERY insurance or warranties. Subparagraph 5. of Paragraph A. Loss Conditions b. The purchase price, as negotiated by us, of a of Section Iv — Business Auto Conditions is new vehicle of the same make, model, and deleted in Ifs entirety and replaced with the following. equipment, or most similar model available, not Transfer Of Rights Of Recovery Against Others including ny furnishings,parts,or equipment not To Us installed by the manufacturer or their dealership. If any person or organization to or for whom we c. The market value of your damaged vehicle, not make payment under this Coverage Form has including any furnishings,parts,or equipment not rights to recover damages from another, those installed by the manufacturer or their dealership. rights are transferred to us. That person or . We will not pay for initiation or setup costs associated organization must do everything necessary to secure our rights and must do nothing after, with a loans or leases. "accident"or loss"to impair them. I. CA7450(11.17) Includes copyrighted material of ISO Proportlos,Inc.withIts permission. Page 4 of 5 1 j J • • However, we waive any right of recovery we may Z. MENTAL ANGUISH have against any person, or organization with Section V — Definitions, C. Is replaced by the whom you have a written contract, agreement or following: permit executed prior to the "loss" that requires a "Bodily injury' means bodily injury, sickness or waiver of recovery for payments made for damages disease sustained by a person, Including mental arising out of your operations done under contract anguish or death resulting from bodily injury,sickness with such person or organization. or disease. Y. UNINTENTIONAL FAILURE TO DISCLOSE AA, LIBERALIZATION Section IV EXPOSURES— Business Auto Conditions, B,2. If we I revise this endorsement to provide greater Concealment, BMisrepresentation,issAuoOr Fraud, is coverage without additional premium charge,we will automatically provide the additional coverage to all amended by adding the following: endorsement holders as of the day the revision Is If you unintentionally fall to disclose any exposures effective in your state. existing at the inception date of this policy,we will not deny coverage under this Coverage Form solely because of such failure to disclose. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non- renewal. • ' I CA7460(11-17) Includes copyrighted materiel of ISO Properties,Inc.with ire permission. Page 6 of 6