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HomeMy WebLinkAboutC2020-254 - 6/9/2020 - Approved a DocuSign Envelope ID:49EB949C-OCF5-43DC-9852-3379AA4730B9 Off' ►.'Y;01Wii oniti SImeakirpM . YU 1852 00 52 23 AGREEMENT This Agreement, for the Project awarded on June 9, 2020, is between the City of Corpus Christi (Owner) and Mako Contracting, LLC (Contractor). Owner and Contractor agree as follows: ARTICLE 1—WORK 1.01 Contractor shall complete all Work as specified or indicated in the Contract Documents. The Work is generally described as: Lipes Blvd.from Yorktown Blvd.to Sun Wood Dr. 18029A ARTICLE 2—DESIGNER AND OWNER'S AUTHORIZED REPRESENTATIVE 2.01 The Project has been designed by: CH2M Hill Engineers, Inc. 555 N.Carancahua,Suite 320 Corpus Christi,TX 78401 2.02 The Owner's Authorized Representative for this Project is: Brett Van Haien, PMP—Assistant Dir.Of Construction City of Corpus Christi—Engineering Services 4917 Holly Rd, Bldg.#5 Corpus Christi,TX 78411 ARTICLE 3—CONTRACT TIMES 3.01 Contract Times A. The Work is required to be substantially completed within 150 days after the date when the Contract Times commence to run as provided in the Notice to Proceed and is to be completed and ready for final payment in accordance with Paragraph 17.16 of the General Conditions within 180 days after the date when the Contract Times commence to run. Agreement 00 52 23-1 LIPES BOULEVARD—YORKTOWN TO SUN WOOD(BOND 2018) PN:18029A Rev 8/2019 CITY OF CORPUS CHRISTI CONTRACTS AND PROCUREMENT DEPARTMENT REQUEST FOR BIDS (“RFB”) LIPES BOULEVARD YORKTOWN TO SUNWOOD (BOND 2018) PROJECT NO. 18029A RFB No. 2936 Release Date: March 1, 2020 CONFORMED/ FINAL CONSTRUCTION COPY DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Table of Contents Section 1 – Notice of Request for Bids ________________________________________ 1 Request for Bids ____________________________________________________________ 1 Term _____________________________________________________________________ 1 Schedule __________________________________________________________________ 1 Delivery Address and Procurement Officer _______________________________________ 2 Section 2 - Instructions to Bidders ____________________________________________ 3 2.1 Pre-bid Conference __________________________________________________________ 3 2.2 Requests for Clarification (Questions and Answers) ________________________________ 3 2.3 Bid Requirements ___________________________________________________________ 3 2.4 Requirements for Selected Bidder: _____________________________________________ 6 2.5 Submission of Bid ___________________________________________________________ 7 2.6 Evaluation Factors ___________________________________________________________ 9 2.7 Bid Acknowledgments ____________________________________________________ 9 Section 3 - Conditions Governing the Procurement __________________________ 13 3.1 RFB Procedural and Content Questions _________________________________________ 13 3.2 Basis for Bid _______________________________________________________________ 13 3.3 Terms and Conditions _______________________________________________________ 13 3.4 Signing of Bids _____________________________________________________________ 13 3.5 Cost of Bids _______________________________________________________________ 14 3.6 Ownership of Bids __________________________________________________________ 14 3.7 Disqualification or Rejection of Bids ___________________________________________ 14 3.8 Right to Waive Irregularities _________________________________________________ 15 3.9 Withdrawal of Bids _________________________________________________________ 16 3.10 Amending of Bids __________________________________________________________ 16 3.11 Bid Offer Firm _____________________________________________________________ 16 3.12 Bidder’s Qualifications ______________________________________________________ 16 3.13 Exceptions to RFB Specifications ______________________________________________ 16 3.14 Consideration of Bids _______________________________________________________ 16 3.15 City’s Reservation of Rights __________________________________________________ 16 3.16 No Obligation _____________________________________________________________ 17 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 3.17 Sufficient Appropriation _____________________________________________________ 17 3.18 Recommendation for Award _________________________________________________ 17 3.19 Construction Contract _______________________________________________________ 17 3.20 Execution of Contract _______________________________________________________ 17 3.21 Disputes __________________________________________________________________ 18 3.22 Contract Term _____________________________________________________________ 18 3.23 Contractor’s Ethical Behavior _________________________________________________ 18 3.24 Use of Subcontractors _______________________________________________________ 18 3.25 Protest Procedure __________________________________________________________ 18 3.26 Insurance Requirements _____________________________________________________ 21 Section 4 - Scope of Work __________________________________________________ 22 4.1 General Requirements/Background Information _________________________________ 22 4.2 Scope of Work _____________________________________________________________ 22 4.3 Work Site and Conditions ____________________________________________________ 22 4.4 Contractor Quality Control and Superintendence _________________________________ 22 Section 5 – Bid Forms ______________________________________________________ 23 Section 6 – Construction Contract Documents (Including Plans and Specifications) _____________________________________________________________ 1 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 1 of 23 Section 1 – Notice of Request for Bids Date Issued: March 1, 2020 Request for Bids A. The City of Corpus Christi (“City” or “Owner”) hereby issues this request for bids (“RFB”). The City is seeking bids from firms interested and qualified in providing construction of a collector roadway in a residential neighborhood that includes utility storm water and wastewater manhole improvements. B. The project scope consists of improvements to approximately 2,900 feet of Lipes Blvd. with a new collector roadway located in a residential neighborhood, including curb and gutter, as well as ADA-compliant sidewalks and ramps. About half of the sidewalk and curb and gutter are to remain in place. Utility improvements include minor storm water improvements and rehabilitation of wastewater manholes. C. The solicitation consists of a Base Bid. Term The work is to be substantially completed within 150 days. Schedule The following is the schedule for this procurement: Date/Time Activity March 1, 2020 Request for Bids published March 11, 2020 at 9:00 a.m. Pre-Bid Conference March 18, 2020 by 5:00 p.m. Requests for Clarification from Bidders are due March 25, 2020 Responses to Requests for Clarification will be posted via Addendum in CivCast Wednesday, April 8, 2020 at 2:00 p.m. BIDS DUE/BID OPENING April, 2020 Projected Date Award of Contract May, 2020 Anticipated Notice to Proceed DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 2 of 23 Delivery Address and Procurement Officer SYLVIA ARRIAGA - PROCUREMENT OFFICER City of Corpus Christi – Contracts and Procurement Department 1201 Leopard St., 1st Floor Corpus Christi, Texas 78401 Phone: (361) 826-3530 Fax: (361) 826-3174 SylviaA@cctexas.com DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 3 of 23 Section 2 - Instructions to Bidders 2.1 Pre-bid Conference A. A Pre-bid Conference will be held as follows: Date: Wednesday, March 11, 2020 Time: 9:00 a.m. Location: City Hall Contracts and Procurement Conference Room 1201 Leopard St. 1st Floor Corpus Christi, Texas 78401 All bidders are highly encouraged to attend this conference to learn more about the requirements of this solicitation. B. Site visit: The City will not conduct a formal site visit; however, Bidders are encouraged to visit the site on their own to acquaint themselves with the general and specific conditions under which they will be required to perform the work, and which may the cost of the performance of the work. 2.2 Requests for Clarification (Questions and Answers) All inquiries or requests regarding this RFB must be submitted in writing online via CivCast (https://www.civcastusa.com/bids) only using the electronic question submission feature specific to this RFB. Such inquiries or requests must be submitted by the due date and time for clarifications provided in this RFB. Any attempt to question City employees regarding this RFB outside of CivCast may result in the City disqualifying that Bidder. Only written responses in CivCast will be binding regarding inquiries requesting clarification or additional information. Written responses will be released in the form of an Addendum. Bidders must acknowledge receipt of all Addenda. 2.3 Bid Requirements A. The Bidder must have operated continuously for a minimum of 5 years as an established firm in providing construction of a collector roadway in a residential area, including ADA compliant sidewalks and ramps, curb and gutter, storm water and wastewater utility improvements, along with other associated work. This experience must be outlined in the Statement of Experience Form provided in this RFB. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 4 of 23 B. The Bidder must not have any outstanding lawsuits nor have been involved in any lawsuits during the last five years that may materially affect its ability to provide the work described herein. Provide information on any lawsuits that would materially affect your ability to provide the work with your bid on the Statement of Experience form. C. The Bidder must not have any outstanding regulatory issues nor had any regulatory issues during the last five years that may materially affect its ability to provide the work described herein. This includes payment of all required taxes. Provide information on any outstanding regulatory issues that would materially affect your ability to provide the work with your bid on the Statement of Experience form. D. The following are requirements for bidding: 1. Statement of Experience – Bidder agrees to provide a Statement of Experience with its bid to demonstrate the Bidder’s responsibility and ability to meet the minimum requirements to complete the Work. Failure to submit the required information in the Statement of Experience may result in the Bid being considered non-responsive. 2. Bid Security Requirements – a. Bidders must submit an acceptable Bid Security with their Bid as a guarantee that the Bidder will enter into a contract for the Project with the Owner within 10 days of Notice of Award of the Contract. The security must be payable to the City of Corpus Christi, Texas in the amount of 5 percent (5%) of the greatest amount bid. b. Bid Security may be in the form of a Bid Bond or a cashier’s check, certified check, money order, or bank draft from a chartered financial institution authorized to operate in the State of Texas. Bidders submitting bids electronically shall scan and upload a copy of the Bid Security as an attachment to their bid. The original Bid Bond, cashier’s check, certified check, money order or bank draft must be enclosed in a sealed envelope, plainly identified on the outside as containing bid documents, the bidder’s name and the job name and number and delivered as required in this Section. c. Bid Bond Requirements: A Bid Bond must guarantee, without qualification or condition, that the Owner will be paid a sum equal to 5 percent (5%) of the greatest amount bid if, within 10 calendar days of Notice of Award of the Contract, the Bidder/Principal: DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 5 of 23 i. fails to enter into a contract for the Project with the Owner; or ii. fails to provide the required Performance and Payment Bonds. d. A Bid Bond may not limit the sum payable to the Owner to be the difference between the Bidder/Principal’s bid and the next lowest bidder. e. The Bid Bond must reference the Project by name. f. Bidders may provide their surety’s standard bid bond form if revised to meet these Bid Bond Requirements. g. Failure to provide an acceptable Bid Security will constitute a non- responsive Bid which will not be considered. h. Failure to provide the required Performance and Payment Bonds will result in forfeiture of the Bid Security to the City as liquidated damages. i. Owner may annul the Notice of Award and the Bid Security of the Bidder will be forfeited if the apparent Selected Bidder fails to execute and deliver the Construction Contract or Amendments to the Construction Contract. The Bid Security of other Bidders whom the Owner believes to have a reasonable chance of receiving the award may be retained by the Owner until the earlier of 7 days after the Effective Date of the Contract or 90 days after the date Bids are opened. j. Bid Securities are to remain in effect until the Contract is executed. The Bid Securities of all but the three lowest responsible Bidders will be returned within 14 days of the opening of Bids. Bid Securities become void and will be released by the Owner when the Contract is awarded or all Bids are rejected. 3. Conflict of Interest Questionnaire - Bidder agrees to comply with Chapter 176 of the Texas Local Government Code which requires a person who enters or seeks to enter into a contract with the City of Corpus Christi to file a Conflict of Interest Questionnaire Form (Form CIQ) with the City of Corpus Christi City Secretary’s Office, if the Bidder has certain business and/or family relationships with officers of the City of Corpus Christi or has given any gifts exceeding $100 in the aggregate to an officer or a family member of an officer. For more DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 6 of 23 information on Form CIQ and to determine if you need to file a Form CIQ, please review the information on the City Secretary’s website at: www.cctexas.com/departments/city-secretary/conflict-disclosure 4. Disclosure of Interest - the City of Corpus Christi’s Code of Ordinances, Section 2-349, as amended, requires all persons and Bidders seeking to do business with the City to provide the Disclosure of Interest information on the City-supplied form included herewith. Every question must be answered. If the question is not applicable, answer with N/A. Bidders are obligated to provide updated information concerning the Disclosure of Interest, as warranted, for the duration of time the bids are under consideration. 5. Business Designation Form – Bidder shall complete, sign and submit the Business Designation Form in the Forms Section. The information requested is for statistical reporting purposes only. Business Designation Form must include the full legal name of the Bidder’s entity. If the name provided is a dba, the Bidder must provide a valid dba certificate. 6. Contractor’s Ethical Behavior Form - By submission of its bid, the Bidder promises that Bidder’s officers, employees, and agents will not attempt to lobby or influence a vote or recommendation related to the Bidder’s bid submitted in response to this RFB, directly or indirectly, through any contact with City Council members or other City officials between the date this RFB is released to the public and the date a Contract is executed by the City Manager or designee, except that Bidder may speak at public comment during open session of a City Council meeting. Such behavior will be cause for rejection of the Bidder’s bid at the discretion of the City Manager or designee. 7. Bid Form – Failure to provide a signed Bid Form with the Bid shall be cause to reject any Bid as non-responsive. 2.4 Requirements for Selected Bidder: A. Form 1295 “Certificate of Interested Parties” (to be submitted if chosen for award) - Bidders must comply with Government Code Section 2252.908 and submit Form 1295 “Certificate of Interested Parties” upon notification that Bidder has been recommended for award. Form 1295 requires disclosure of “interested parties” with respect to entities that enter contracts with cities. These interested parties include: 1. Persons with a “controlling interest” in the entity, which includes: DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 7 of 23 a. an ownership interest or participating interest in a business entity by virtue of units, percentage, shares, stock or otherwise that exceeds 10 percent; b. membership on the board of directors or other governing body of a business entity of which the board or other governing body is composed of not more than 10 members; or c. service as an officer of a business entity that has four or fewer officers, or service as one of the four officers most highly compensated by a business entity that has more than four officers; or 2. A person who acts as an intermediary and who actively participates in facilitating a contract or negotiating the contract with a governmental entity or state agency, including a broker, adviser, attorney or representative of or agent for the business entity who has a controlling interest or intermediary for the business entity. Form 1295 must be electronically filed with the Texas Ethics Commission at https://www.ethics.state.tx.us/whatsnew/elf_info_form1295.htm. The form must then be printed, signed, and filed with the City. For more information, please review the Texas Ethics Commission Rules at https://www.ethics.state.tx.us/legal/ch46.html. A sample copy of Form 1295 has been provided for reference only. B. Insurance/Payment and Performance Bonds – After award of the contract insurance certificates along with applicable Payment and Performance bonds will be required to be submitted for approval before work can begin on the project. Insurance must comply with the Insurance Requirements outlined in this RFB. Bonds must comply with Texas Government Code 2253 and be in the form approved by the City Attorney. 2.5 Submission of Bid A. BIDDER SHALL SUBMIT ITS BID, AS INSTRUCTED HEREIN. All bids must be complete and accurate and in the City-approved format specified herein. B. BIDDER SHOULD SUBMIT ITS BID EITHER ELECTRONICALLY OR IN HARD-COPY, AS INSTRUCTED IN THE RFB. IF SUBMITTING ELECTRONICALLY SUBMIT VIA CIVCAST AT: (www.civcastusa.com) C. The City’s Procurement Policy requires that all bids submitted be sealed, secret, unopened through the DUE DATE FOR BIDS specified in this RFB. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 8 of 23 Therefore, bids submitted directly to the City by facsimile machine, or e- mail will be considered non-responsive and will be eliminated from consideration. D. Bids must be received, on or before the date and time specified in this RFB. Without exception, bids received after this deadline are late, and shall be deemed non-responsive and will not be considered. The City’s Contracts and Procurement Department’s physical and electronic time stamps will govern the cutoff time for accepting bids. E. Bids should not include taxes as the City is tax exempt. The City’s Tax Exemption Certificate will be provided upon request. F. Should there be any shipping involved in this bid, shipping shall be F.O.B. destination and included in the pricing unless specifically listed as a bid item. G. Any time stated in this RFB as a number of days shall be construed as calendar days. H. If the bid indicates “or equal”, bid as specified in the RFB documents unless alternate products have been approved by the City in writing via Addendum. I. Bids submitted on other than the City’s forms or with different terms and conditions not specifically approved during the RFB process will be considered nonresponsive. J. Both hard copy and electronic bids will be publicly opened and read aloud immediately following the date, time and place bids are due. Due to the COVID-19 guideline restrictions, the format for the Public Bid Opening has changed. The physical meeting has been replaced with a Webex meeting. The time and date of the meeting remains the same: Wednesday, April 8, 2020 at 2:00 p.m. The information required to join the meeting is provided as part of this addendum. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 9 of 23 2.6 Evaluation Factors The City will award a contract to the Lowest Responsive, Responsible Bidder. In determining the Lowest Responsive, Responsible Bidder, the City may take into consideration the quality of the product, the adaptability to the particular use required, and the ability, capacity, experience, efficiency and integrity of the bidders as well as their financial responsibility in accordance with the Statement of Experience. Bidders shall comply with the additional detailed instructions regarding submission of bids found in this RFB. 2.7 Bid Acknowledgments A. By submitting a Bid, Bidder makes the following acknowledgments: DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 10 of 23 1. Bidder proposes and agrees, if this Bid is accepted, to enter into an Agreement with Owner on the form included in the Contract Documents, to perform all Work specified or indicated in Contract Documents for the Contract Price indicated in this Bid or as modified by Contract Amendment. Bidder agrees to complete the Work within the Contract Times established in the Agreement or as modified by Contract Amendment and comply with the all other terms and conditions of the Contract Documents. 2. Bidder accepts all the terms and conditions of the bid documents, including those dealing with required Bonds. The Bid will remain subject to acceptance for the period of time listed in the bid documents. 3. Bidder acknowledges that Owner, at its discretion, will correct mathematical errors contained in the Bid and will conform bid items in accordance with SECTION 01 29 01 MEASUREMENT AND BASIS FOR PAYMENT. 4. Bidder accepts the provisions of the Agreement as to liquidated damages in the event of its failure to complete Work in accordance with the schedule set forth in the Agreement. 5. Bidder acknowledges receipt of all addenda. 6. Bidder acknowledges that the Bidder selected for award of the Contract will be the Lowest Responsible Bidder that submits a responsive Bid. Owner will, at its discretion, award the contract to the lowest responsible Bidder for the Base Bid, plus any combination of Add or Deduct Alternates. a. Bidder acknowledges that the estimated quantities are not guaranteed, and final payment for all Unit Price items will be based on actual quantities provided, measured as provided in the Contract Documents. B. By submitting a Bid, Bidder makes the following representations: 1. The Bidder has examined and carefully studied the Contract Documents and the other related data identified in the Bidding Documents. 2. The Bidder has visited the Site and become familiar with and is satisfied as to the general, local, and Site conditions that may affect cost, progress, and performance of the Work. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 11 of 23 3. The Bidder is familiar with Laws and Regulations that may affect cost, progress, and performance of the Work. 4. The Bidder has carefully studied the following Site-related reports and drawings as identified in the Supplementary Conditions: a. Geotechnical Data Reports regarding subsurface conditions at or adjacent to the Site; b. Drawings of physical conditions relating to existing surface or subsurface structures at the Site; c. Underground Facilities referenced in reports and drawings; d. Reports and drawings relating to Hazardous Environmental Conditions, if any, at or adjacent to the Site; and Technical Data related to each of these reports and drawings. 5. The Bidder has considered the: a. Information known to Bidder; b. Information commonly known to contractors doing business in the locality of the Site; c. Information and observations obtained from visits to the Site; and d. The Contract Documents. 6. Based on the information and observations referred to in the preceding paragraphs, Bidder agrees that no further examinations, investigations, explorations, tests, studies, or data are necessary for the performance of the Work at the Contract Price, within the Contract Times, and in accordance with the other terms and conditions of the Contract Documents. 7. The Bidder is aware of the general nature of Work to be performed by Owner and others at the Site that relates to the Work as indicated in the Contract Documents. 8. The Bidder has correlated the information known to the Bidder, information and observations obtained from visits to the Site, reports and drawings identified in the Contract Documents, and all additional examinations, investigations, explorations, tests, studies, and data with the Contract Documents with respect to the effect of such information, observations, and documents on: a. The cost, progress, and performance of the Work; b. The means, methods, techniques, sequences, and procedures of construction to be employed by Bidder; and DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 12 of 23 c. Bidder’s safety precautions and programs. 9. The Bidder has given the OAR written notice of all conflicts, errors, ambiguities, or discrepancies that the Bidder has discovered in the Contract Documents, and the written resolution provided by the OAR is acceptable to the Bidder. 10. The Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performance and furnishing of the Work. 11. Bidder’s entry into this Contract constitutes an incontrovertible representation by Bidder that without exception all prices in the Agreement are premised upon performing and furnishing the Work required by the Contract Documents. 12. Bidder will complete the Work in accordance with the Contract Documents at the prices shown in the BID FORM. a. Extended amounts have been computed in accordance with Paragraph 15.03 of SECTION 00 72 00 GENERAL CONDITIONS. b. Unit Price and figures column will be used to compute the actual Bid price, plus any combination of Add or Deduct Alternates. c. Bidder will complete the Work required to be substantially completed within the time period provided in the Construction Contract. Bidder will complete the Work required for final payment in accordance with Paragraph 17.16 of SECTION 00 72 00 GENERAL CONDITIONS within the time period provided in the Construction Contract. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 13 of 23 Section 3 - Conditions Governing the Procurement 3.1 RFB Procedural and Content Questions A. Any Bidder requiring further clarification of the RFB procedures should submit specific requests for clarification to the Procurement Officer as described in this RFB. B. During a review of this RFB and preparation of the bid, certain errors, omissions or ambiguities may be discovered. If so, or if there are doubts or concerns about the meaning of any part of this RFB, questions should be submitted to the Procurement Officer as described in this RFB. C. Addenda will be issued to address the questions and answers along with any changes to the documents as a result of these clarifications. 3.2 Basis for Bid Only the information contained in this RFB, questions and answers, addenda hereto and information supplied by the City in writing through the Procurement Officer should be used in the preparation of the bid. 3.3 Terms and Conditions With its bid, the Bidder is committing to the terms and conditions as outlined in the Construction Contract. Any concerns over the terms and conditions must be resolved during the procurement stage through the Request for Clarification (question and answer) process. 3.4 Signing of Bids A. By submitting and signing a bid, the Bidder indicates its intention to adhere to the provisions described in this RFB. Bidders must include their correct legal name, state of residency, and federal tax identification number in the Bid Form. The Bidder, or the Bidder’s authorized representative, shall sign and date the Bid Form to accompany all materials included in the submitted Bid. Bids which are not signed and dated in this manner, or which do not contain the required documentation of signatory authority may be rejected as non‐responsive. The individual(s) signing the Bid must have the authority to bind the Bidder to a contract, and if required, shall attach documentation of signatory authority to the Bid Form. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 14 of 23 B. Bidders who are individuals (“natural persons” as defined by the Texas Business Organizations Code §1.002), but who will not be signing the Bid Form personally, shall include in their bid a notarized power of attorney authorizing the individual designated as their authorized representative to submit the Bid and to sign on behalf of the Bidder. C. Bidders that are entities who are not individuals shall identify in their Bid their charter or Certificate of Authority number issued by the Texas Secretary of State and shall submit with their Bid a copy of a resolution or other documentation approved by the Bidder’s governing body authorizing the submission of the Bid and designating the individual(s) authorized to execute documents on behalf of the Bidder. Bidders using an assumed name (an “alias”) shall submit a copy of the Certificate of Assumed Name or similar document. D. Bidders that are not residents of the State of Texas must document their legal authority to conduct business in Texas. Nonresident Bidders that have previously registered with the Texas Secretary of State may submit a copy of their Certificate of Authority. Nonresident Bidders that have not previously registered with the Texas Secretary of State shall submit a copy of the Bidder’s enabling documents as filed with the state of residency, or as otherwise existing. 3.5 Cost of Bids This RFB does not commit the City to pay any costs incurred by a Bidder for preparation and submission of a bid or for procuring or contracting for the items to be furnished under this RFB. All costs directly or indirectly related to preparing and responding to this RFB, including all costs incurred for supplementary documentation, shall be borne solely by the Bidder. 3.6 Ownership of Bids All documents submitted in response to this RFB shall become the property of the City. 3.7 Disqualification or Rejection of Bids Bidders may be disqualified and or have their bid rejected for any of the following reasons: 1. There is reason to believe that collusion exists among the Bidders; 2. The Bidder is involved in any litigation against the City; 3. The Bidder is in arrears on an existing contract or has defaulted on previous contracts with the City; 4. The Bidder lacks financial stability; DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 15 of 23 5. The Bidder has failed to perform under previous or existing contracts with the City; 6. The Bidder has failed to use the City’s approved forms; 7. The Bidder has failed to adhere to one or more of the provisions established in this RFB; 8. The Bidder has failed to submit its bid in the format specified herein; 9. The Bidder has failed to submit its bid before the deadline established herein; 10. The Bidder has failed to adhere to generally accepted ethical and professional principles during the bid process; 11. The Bidder has failed to provide a detailed cost summary in the bid if required; 12. The Bid Form is not included or not signed by an individual empowered to bind the Bidder; 13. Failure to provide adequate Bid Security; 14. More than one Bid for the same Work form an individual, firm, partnership or corporation; 15. Failure to have an authorized agent of the Bidder attend the mandatory Pre-Bid Conference, if applicable; 16. Bids received from a Bidder who has been debarred or suspended by the City; 17. Bids received from a Bidder when Bidder or principals are currently debarred or suspended by Federal, State or City governmental agencies; 18. Bids received from a Bidder identified on a list prepared and maintained by the Texas Comptroller under Chapter 2252 of the Texas Government Code; 19. Failure to submit the Statement of Experience; 20. Failure to acknowledge receipt of Addenda; 21. Bidder’s Safety Experience; or 22. Evidence of Bidder’s lack of capacity to perform the Work. 3.8 Right to Waive Irregularities Bids shall be considered “irregular” if they show any omissions, alterations of form, additions or conditions not called for, unauthorized alternate bids or irregularities of any kind. The Procurement Officer reserves the right to waive minor irregularities and mandatory requirements. This right may be exercised at the sole discretion of the Procurement Officer. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 16 of 23 3.9 Withdrawal of Bids Bids may be withdrawn by the Bidder prior to the exact hour and DUE DATE FOR BIDS. 3.10 Amending of Bids A Bidder may amend a bid prior to the exact hour and DUE DATE FOR BIDS. 3.11 Bid Offer Firm By submission of its bid, the Bidder affirms that its bid is firm for 90 days after the DUE DATE FOR BIDS and if awarded a contract the bid then remains firm for the duration of the contract. 3.12 Bidder’s Qualifications The City may make such investigations as necessary to determine the ability of the Bidder to adhere to the requirements specified herein. The Procurement Officer may reject the bid of any Bidder who is not considered to be a responsible Bidder. 3.13 Exceptions to RFB Specifications Although the specifications in the following sections represent the City’s anticipated needs, there may be instances in which it is in the City’s best interest to permit exceptions to specifications and evaluate alternatives. If the RFB specifically allows exceptions or alternates, it is vital that the Bidder make very clear where exceptions are taken to the specifications and how the Bidder will provide alternatives. Therefore, when allowed, exceptions, conditions or qualifications to the provisions of the City’s specifications must be clearly identified as such, together with reasons for taking exception and submitted as a request for clarification during the bid process. If the Bidder does not make clear that an exception is being taken, the City will assume the Bidder is, in its bid, responding to and will meet the specifications and requirements of this RFB. 3.14 Consideration of Bids Discussions may be conducted with responsible Bidders qualified to be selected for award for the purpose of clarification to assure full understanding of and responsiveness to the solicitation requirements. Until award of the Contract is made by the City, the City reserves the right to reject any or all bids, to waive technicalities, to re-advertise for new bids or to proceed with the work in any manner as may be considered in the best interest of the City. Should the City require clarification from the bidder, the City shall contact the individual named as the organization’s contact person in Bid Form. The City may elect to conduct post-submission reference checks. 3.15 City’s Reservation of Rights The City reserves the right to: DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 17 of 23 1. cancel this RFB at any time; 2. reject any or all bids submitted in response to this RFB; 3. waive any material defect, irregularity or informality in any bid or bidding procedure; 4. reissue the RFB; 5. extend the bid opening time and date or any other timelines outlined by the RFB; and procure any item by other means. 3.16 No Obligation In no manner does this RFB obligate the City or any of its agencies to the eventual services offered until confirmed by an executed written Contract. 3.17 Sufficient Appropriation Any Contract awarded as a result of this RFB process may be terminated if sufficient appropriations or authorizations do not exist. The City’s decision as to whether sufficient appropriations and authorizations are available shall be accepted by the Bidder as final. 3.18 Recommendation for Award City staff will recommend to the City Manager that award be made to the Bidder(s) whose bid is determined by the City to be the lowest, responsive, responsible bid for the City. To determine responsibility, the City may consider items such as: 1. ability, capacity, experience, efficiency and integrity of the Bidder; 2. Bidder’s financial responsibility; 3. Bidder’s past performance or relationship with the City or with other entities; 4. Bidder’s safety record; or 5. whether a Bidder is in pending litigation or is involved in a lawsuit or claim against the City 3.19 Construction Contract A copy of the Construction Contract form is attached hereto. The successful Bidder will be required to sign such Construction Contract if selected for award. The City will conform the Contract to changes made during the solicitation process prior to final execution of the Contract. 3.20 Execution of Contract The City Manager shall award or make recommendation of award to City Council of the Contract to the successful Bidder(s) and will designate the successful Bidder(s) (“Contractor”) as the City’s Provider(s). The City will require the Contractor(s) to sign the documents necessary to enter into the required Contract with the City and to provide the required bonds and the necessary DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 18 of 23 evidence of insurance as required in the Contract documents. No Contract for this project may be signed by the City without the authorization of the City Manager and/or City Council, and no Contract shall be binding on the City unless and until it has been approved as to form by the City Attorney’s Office and executed by the City Manager or designee. 3.21 Disputes In the case of any doubt or difference of opinion with regard to the items to be furnished by a Bidder or the interpretation of the provisions of this RFB, the decisions of the City shall be final and binding upon all parties. 3.22 Contract Term The contract will commence on execution of the Contract by the City and the issuance of a notice to proceed. 3.23 Contractor’s Ethical Behavior By submission of its bid, the Bidder promises that Bidder’s officers, employees, and agents will not attempt to lobby or influence a vote or recommendation related to the Bidder’s bid submitted in response to this RFB, directly or indirectly, through any contact with City Council members or other City officials between the date this RFB is released to the public and the date a Contract is executed by the City Manager or designee, except that the Bidder may speak at public comment in open session of a City Council meeting. Such behavior will be cause for rejection of the Bidder’s bid at the discretion of the City Manager or designee. 3.24 Use of Subcontractors The Bidder may use subcontractors in connection with the work performed if awarded a Contract. When using subcontractors, however, the Bidder must comply with the terms of the Construction Contract. . In using subcontractors, the Bidder is responsible for all their acts and omissions to the same extent as if the subcontractor and its employees were employees of the Bidder. All requirements set forth as part of the Contract are applicable to all subcontractors and their employees to the same extent as if the Bidder and its employees had performed the services. 3.25 Protest Procedure A. These procurement protest procedures are applicable to procurement of goods or services by the City of Corpus Christi including where federal funds are used in whole or in part. These protest procedures are also made applicable to recipients awarded a grant of federal funds through the city of Corpus Christi who intend to provide such funds to sub recipients pursuant DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 19 of 23 to an approved plan, project or activity. This protest process does not create any due process rights, but is intended to allow bidders/proposers to raise concerns regarding actions taken pertaining to a bid or other form of competitive solicitation. B. The City’s Contracts and Procurement Department has the authority to settle or resolve any claim of an alleged deficiency or protest. The procedures for notifying the City of Corpus Christi of an alleged deficiency or filing a protest are listed below. If you fail to comply with any of these requirements, the Procurement Officer may dismiss your complaint or protest. C. GROUNDS FOR PROTEST Only protests alleging an issue concerning the following subjects will be considered: 1. Violation of local, state or federal regulation. 2. Issues with the solicitation document that creates an unfair advantage or unleveled playing field. 3. Errors in computing the tabulation or evaluation of a bid or proposal. 4. Discrepancies with material differences or quality of items or services D. PROTEST PROCESS 1. Prior to Bid/Proposal Due Date: If you are a prospective Bidder/Proposer and you become aware of the facts regarding what you believe is a deficiency in the solicitation or solicitation process before the Due Date for receipt of bids/proposals, you must notify the City in writing of the alleged deficiency no later than five days before the Due Date for bids/proposals, giving the City an opportunity to resolve the situation prior to the bid/proposal Due Date. 2. After Bid/Proposal Due Date: If you submit a bid/proposal to the City and you believe that there has been a deficiency in the solicitation process or the award, you have the opportunity to protest the solicitation process or the recommended award as follows: a. You must file written notice of your intent to protest within five calendar days of the date that you know or should have known of the facts relating to the protest. If you do not file a written notice of DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 20 of 23 intent within this time, you have waived all rights to protest the solicitation process or the award. b. You must file your written protest within seven calendar days of the date that you notified the City of your intent to protest. c. You must submit your protest in writing and must include the following information: i. your name, address, telephone, and fax number; and ii. the solicitation number; and iii. a detailed statement of the factual grounds for the protest, including copies of any relevant documents; and iv. signature of the protestor and its representative and evidence of authority to sign; and v. the form of relief requested. d. Your protest must be concise and presented logically and factually to help with the City’s review. e. When the City receives a timely written protest, the Procurement Officer will determine whether the grounds for your protest are sufficient. If the Procurement Officer decides that the grounds are sufficient, the Contracts and Procurement Office will schedule a protest hearing, usually within five (5) working days. If the Procurement Officer determines that your grounds are insufficient, the City will notify you of that decision in writing. 3. Informal Protest Hearing - The protest hearing is informal and is not subject to the Open Meetings Act. The purpose of the hearing is to give you a chance to present your case, it is not an adversarial proceeding. Those who may attend from the City are: representatives from the department that requested the purchase, the Legal Department, the Contracts and Procurement Department, and other appropriate City staff. You may bring a representative or anyone else that will present information to support the factual grounds for your protest with you to the hearing. 4. Protest Decision – A written decision will usually be made within 15 calendar days after the hearing. The City will send you a copy of the DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 21 of 23 hearing decision after the appropriate City staff has reviewed the decision. City staff will inform the Bidder of the date on which the Construction Contract is set to go to City Council for award. 5. Exceptions; Restrictions – When a protest is filed, the City usually will not make an award until a decision on the protest is made. However, the City will not delay an award if the City Manager or the Procurement Officer determines that: a. the City urgently requires the supplies or services to be purchased, or b. failure to make an award promptly will unduly delay delivery or performance. In those instances, the City will notify you and make every effort to resolve your protest before the award. 6. Federal Agency Review – If applicable, every protestor must exhaust all administrative remedies with the City of Corpus Christi as are provided in this Protest Procedure before pursuing a protest to the appropriate federal agency. Reviews of protests by the federal agency are limited to: a. violations of federal law or regulations and the standards set out in the relevant regulations (44 CFR § 13.36.10, 24 CFR § 85.36(b)(12), 24 CFR § 84.41 or as otherwise may be applicable); and b. violations of the City’s Protest Procedures for failure to review a complaint or protest. Any protests received by the federal agency other than those specified above will be referred to the City for handling and resolution. 3.26 Insurance Requirements Insurance requirements will be as outlined in the Construction Contract. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 22 of 23 Section 4 - Scope of Work 4.1 General Requirements/Background Information The Contractor shall provide construction related to providing a new collector roadway and street improvements construction in a residential neighborhood including ADA improvements and utility storm water and wastewater manhole improvements as outlined in this Scope of Work. 4.2 Scope of Work The project scope consists of improvements to approximately 2,900 feet of Lipes Blvd. with a new collector roadway located in a residential neighborhood, including curb and gutter, as well as ADA-compliant sidewalks and ramps. About half of the sidewalk and curb and gutter are to remain in place. Utility improvements include minor storm water improvements and rehabilitation of wastewater manholes. Refer to contract documents, plans and specifications for additional information. 4.3 Work Site and Conditions The work shall be performed on Lipes Boulevard from Yorktown Blvd. to Sunwood Street in Corpus Christi, Nueces County, Texas as described in the attached plans and specifications. Regular working hours are between sun-up and sun-down unless other times are specifically authorized in writing by City. 4.4 Contractor Quality Control and Superintendence The Contractor shall establish and maintain a complete Quality Management Program as per the Plans and Specifications. The Contractor will also provide supervision of the work to insure it complies with the contract requirements. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Page 23 of 23 Section 5 – Bid Forms The Bid must consist of the following items that are to be returned by the due date specified: 1) Bid Form - Bidder is to provide on the attached Bid Form a cost per unit for each construction line item associated with the construction of the project as required in the plans and specifications. 2) Statement of Experience 3) Disclosure of Interest Form 4) Business Designation Form 5) Ethical Behavior Form 6) Bid Security Please refer to the “Instructions to Bidders” for more specific requirements for putting your bid together. Please note that all forms must be completed and signed. Any erasures or other changes must be initialed by the person signing the bid. In the case of a discrepancy between the unit price and total price, the unit price will be presumed to be correct and totals recalculated accordingly. Only one bid will be allowed per firm/company. Bidders should submit either electronically or hard copy as outlined in this RFB, but not both. In the event of receipt of both hard copy and electronic bids by the same company, the City will reject the bid submitted electronically. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 C O N F O R M E D / F I N A L C O N S T R U C T I O N D o c u S i g n E n v e l o p e I D : E 0 A 3 7 6 1 8 - 4 0 B F - 4 D 0 7 - 8 0 3 B - 2 A D F A E 0 5 2 9 0 E D o c u S i g n E n v e l o p e I D : 4 9 E B 9 4 9 C - 0 C F 5 - 4 3 D C - 9 8 5 2 - 3 3 7 9 A A 4 7 3 0 B 9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Table of Contents 00 01 00 - 1 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 00 01 00 TABLE OF CONTENTS Division / Section Title Division 00 Contracting Requirements 00 52 23 Agreement (Rev 8-2019) 00 72 00 General Conditions (Rev 8-2019) 00 73 00 Supplementary Conditions (Rev 8-2019) 00 74 00 Special Conditions for [Name of Program] (Rev 10-2018) Division 01 General Requirements 01 11 00 Summary of Work (Rev 10-2018) 01 23 10 Alternates and Allowances (Rev 10-2018) 01 29 01 Measurement and Basis for Payment (Rev 8-2019) 01 33 01 Submittal Register (Rev 10-2018) 01 35 00 Special Procedures (Rev 10-2018) 01 50 00 Temporary Facilities and Controls (Rev 8-2019) 01 57 00 Temporary Controls (Rev 8-2019) Part S Standard Specifications 020100 Survey Monuments 021020 Site Clearing & Stripping 021080 Removing Abandoned Structures 022020 Excavation & Backfill for Utilities 022021 Control of Ground Water 022022 Trench Safety for Excavations 022040 Street Excavation 022080 Embankment 022100 Select Material 022420 Silt Fence 025205 Pavement Repair, Curb, Gutter, Sidewalk, and Driveway Replacement 025223 Crushed Limestone Flexible Base 025404 Asphalts, Oils, & Emulsions 025412 Prime Coat 025424 Hot Mix Asphalt Concrete Pavement 025608 Inlets DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Table of Contents 00 01 00 - 2 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 Division / Section Title 025610 Concrete Curb & Gutter 025612 Concrete Sidewalks & Driveways 025614 Concrete Curb Ramps 025802 Temporary Traffic Controls During Construction 025805 Work Zone Pavement Markings 025807 Pavement Markings (Paint and Thermoplastic) 025813 Preformed Thermoplastic Striping, Words & Emblems 025816 Raised Pavement Markers 025818 Reference Specification – TxDOT DMS-4200 Pavement Markers (Reflectorized) 025828 Reference Specification – TxDOT DMS-6130 Bituminous Adhesive for Pavement Markers 027202 Manholes 027203 Vacuum testing of Wastewater Manholes 027205 Fiberglass Manholes 027402 Reinforced Concrete Pipe Culverts 027604 Disposal of Waste from Wastewater Cleaning Operations 027611 Cleaning and Televised Inspection of Conduits 028040 Sodding 028300 Fence Relocation 030020 Portland Cement Concrete 032020 Reinforcing Steel 037040 Epoxy Compounds 038000 Concrete Structures 050200 Welding 055420 Frames, Grates, Rings, and Covers Part T Technical Specifications T-34 41 16.93 Poles and Assemblies T-TxDOT 506 TxDOT Item 506 – Temporary Erosion, Sedimentation, and Environmental Controls Appendix Title A Intertek PSI: Geotechnical Engineering Report Revised March 4, 2019 END OF SECTION DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 1 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 00 73 00 SUPPLEMENTARY CONDITIONS These Supplementary Conditions amend or supplement SECTION 00 72 00 GENERAL CONDITIONS and other provisions of the Contract Documents. All provisions not amended or supplemented in these Supplementary Conditions remain in effect. The terms used in these Supplementary Conditions have the meanings stated in the General Conditions. Additional terms used in these Supplementary Conditions have the meanings stated below. ARTICLE 1 – DEFINITIONS AND TERMINOLOGY SC-1.01 DEFINED TERMS A. The members of the OPT as defined in Paragraph 1.01.A.41 consists of the following organizations: City of Corpus Christi, Texas CH2M Hill Engineers, Inc. ARTICLE 4 – COMMENCEMENT AND PROGRESS OF THE WORK SC-4.04 DELAYS IN CONTRACTOR’S PROGRESS A. The allocation for delays in the Contractor’s progress for rain days as set forth in General Conditions Paragraph 4.04.D are to be determined as follows: 1. Include rain days in developing the schedule for construction. Schedule construction so that the Work will be completed within the Contract Times assuming that these rain days will occur. Incorporate residual impacts following rain days such as limited access to and within the Site, inability to work due to wet or muddy Site conditions, delays in delivery of equipment and materials, and other impacts related to rain days when developing the schedule for construction. Include all costs associated with these rain days and residual impacts in the Contract Price. 2. A rain day is defined as any day in which the amount of rain measured by the National Weather Services at the Power Street Stormwater Pump Station is 0.50 inch or greater. Records indicate the following average number of rain days for each month: Month Day Month Days January 3 July 3 February 3 August 4 March 2 September 7 April 3 October 4 May 4 November 3 June 4 December 3 3. A total of 19 rain days have been set for this Project. An extension of time due to rain days will be considered only after 43 rain days have been exceeded in a calendar year and the OAR has determined that a detrimental impact to the construction schedule DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 2 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 resulted from the excessive rainfall. Rain days are to be incorporated into the schedule and unused rain days will be considered float time which may be consumed by the Owner or Contractor in delay claims. ARTICLE 5 – AVAILABILITY OF LANDS; SUBSURFACE CONDITIONS AND PHYSICAL CONDITIONS; HAZARDOUS ENVIRONMENTAL CONDITIONS SC-5.03 SUBSURFACE AND PHYSICAL CONDITIONS A. This Supplementary Condition identifies documents referenced in General Conditions Paragraph 5.03.A which describe subsurface and physical conditions. 1. Geotechnical Reports include the following: a. Geotechnical Engineering Report – Lipes Blvd. Reconstruction Yorktown to Sun Wood, Revised March 4, 2019 SC-5.06 HAZARDOUS ENVIRONMENTAL CONDITIONS AT SITE A. This Supplementary Condition identifies documents referenced in General Conditions Paragraph 5.06 which describe Hazardous Environmental Conditions that have been identified at or adjacent to the Site. No reports of explorations or tests for Hazardous Environmental Conditions at or contiguous to the Site are known to Owner. ARTICLE 6 – BONDS AND INSURANCE SC-6.03 REQUIRED MINIMUM INSURANCE COVERAGE INSURANCE REQUIREMENTS CONTRACTOR’S INSURANCE AMOUNTS Provide the insurance coverage for at least the following amounts unless greater amounts are required by Laws and Regulations: Type of Insurance Minimum Insurance Coverage Commercial General Liability including 1. Commercial Form 2. Premises – Completed Operations 3. Explosions and Collapse Hazard 4. Underground Hazard 5. Products / Completed Operations Hazard 6. Contractual Liability 7. Broad Form Property Damage 8. Independent Contractors 9. Personal & Advertising Injury $1,000,000 Per Occurrence $2,000,000 Aggregate Business Automobile Liability - Owned, Non-Owned, Rented and Leased $1,000,000 Combined Single Limit Workers’ Compensation Statutory DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 3 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 Employer’s Liability $500,000/ 500,000/ 500,000 Excess Liability/Umbrella Liability Required if Contract Price > $5,000,000 $1,000,000 Per Occurrence Contractor’s Pollution Liability / Environmental Impairment Coverage Not limited to sudden and accidental discharge. To include long-term environmental impact for the disposal of pollutants/contaminants. Required if excavation > 3 ft $1,000,000 Per Claim 〼 Required ☐ Not Required Builder’s Risk (All Perils including Collapse) Required for vertical structures and bridges Equal to Full Replacement Cost of Structure and Contents ☐ Required 〼 Not Required Installation Floater Required if installing city-owned equipment Equal to Contract Price ☐ Required 〼 Not Required ARTICLE 7 – CONTRACTOR'S RESPONSIBILITIES SC-7.02 LABOR; WORKING HOURS A. Perform Work at the Site during regular working hours except as otherwise required for the safety or protection of person or the Work or property at the Site or adjacent to the Site and except as otherwise stated in the Contract Documents. Regular working hours are between sunrise and sunset Monday through Saturday unless other times are specifically authorized in writing by OAR. SC-7.04 CONCERNING SUBCONTRACTORS, SUPPLIERS, AND OTHERS A. The Contractor must perform at least 50 percent of the Work, measured as a percentage of the Contract Price, using its own employees. ARTICLE 14 – PREVAILING WAGE RATE REQUIREMENTS SC-14.04 PREVAILING WAGE RATES A. The minimum rates for various labor classifications as established by the Owner are shown below: DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 4 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 Wage Determination (WD) No Construction Type Project Type TX21 Heavy Heavy Construction Projects (including Sewer and Water Line Construction and Drainage Projects) TX29 Highway Highway Construction Projects (excluding tunnels, building structures in rest area projects & railroad construction; bascule, suspension & spandrel arch bridges designed for commercial navigation, bridges involving marine construction; and other major bridges). "General Decision Number: TX20190021 01/04/2019 Superseded General Decision Number: TX20180031 State: Texas Construction Type: Heavy Counties: Nueces and San Patricio Counties in Texas. HEAVY CONSTRUCTION PROJECTS (including Sewer and Water Line Construction and Drainage Projects) Note: Under Executive Order (EO) 13658, an hourly minimum wage of $10.60 for calendar year 2019 applies to all contracts subject to the Davis-Bacon Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2015. If this contract is covered by the EO, the contractor must pay all workers in any classification listed on this wage determination at least $10.60 per hour (or the applicable wage rate listed on this wage determination, if it is higher) for all hours spent performing on the contract in calendar year 2019. If this contract is covered by the EO and a classification considered necessary for performance of work on the contract does not appear on this wage determination, the contractor must pay workers in that classification at least the wage rate determined through the conformance process set forth in 29 CFR 5.5(a)(1)(ii) (or the EO minimum wage rate, if it is higher than the conformed wage rate). The EO minimum wage rate will be adjusted annually. Please note that this EO applies to the above-mentioned types of contracts entered into by the federal government that are subject to the Davis-Bacon Act itself, but it does not apply to contracts subject only to the Davis-Bacon Related Acts, DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 5 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 including those set forth at 29 CFR 5.1(a)(2)-(60). Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts. Modification Number Publication Date 0 01/04/2019 * SUTX1987-001 12/01/1987 Rates Fringes CARPENTER (Excluding Form Setting).........................$ 9.05 Concrete Finisher................$ 7.56 ELECTRICIAN......................$ 13.37 2.58 Laborers: Common......................$ 7.25 Utility.....................$ 7.68 Power equipment operators: Backhoe.....................$ 9.21 Motor Grader................$ 8.72 ---------------------------------------------------------------- WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental. ================================================================ Note: Executive Order (EO) 13706, Establishing Paid Sick Leave for Federal Contractors applies to all contracts subject to the Davis-Bacon Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2017. If this contract is covered by the EO, the contractor must provide employees with 1 hour of paid sick leave for every 30 hours they work, up to 56 hours of paid sick leave each year. Employees must be permitted to use paid sick leave for their own illness, injury or other health-related needs, including preventive care; to assist a family member (or person who is like family to the employee) who is ill, injured, or has other health-related needs, including preventive care; or for reasons DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 6 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 resulting from, or to assist a family member (or person who is like family to the employee) who is a victim of, domestic violence, sexual assault, or stalking. Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts. Unlisted classifications needed for work not included within the scope of the classifications listed may be added after award only as provided in the labor standards contract clauses (29CFR 5.5 (a) (1) (ii)). ---------------------------------------------------------------- The body of each wage determination lists the classification and wage rates that have been found to be prevailing for the cited type(s) of construction in the area covered by the wage determination. The classifications are listed in alphabetical order of ""identifiers"" that indicate whether the particular rate is a union rate (current union negotiated rate for local), a survey rate (weighted average rate) or a union average rate (weighted union average rate). Union Rate Identifiers A four letter classification abbreviation identifier enclosed in dotted lines beginning with characters other than ""SU"" or ""UAVG"" denotes that the union classification and rate were prevailing for that classification in the survey. Example: PLUM0198-005 07/01/2014. PLUM is an abbreviation identifier of the union which prevailed in the survey for this classification, which in this example would be Plumbers. 0198 indicates the local union number or district council number where applicable, i.e., Plumbers Local 0198. The next number, 005 in the example, is an internal number used in processing the wage determination. 07/01/2014 is the effective date of the most current negotiated rate, which in this example is July 1, 2014. Union prevailing wage rates are updated to reflect all rate changes in the collective bargaining agreement (CBA) governing this classification and rate. Survey Rate Identifiers Classifications listed under the ""SU"" identifier indicate that DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 7 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 no one rate prevailed for this classification in the survey and the published rate is derived by computing a weighted average rate based on all the rates reported in the survey for that classification. As this weighted average rate includes all rates reported in the survey, it may include both union and non-union rates. Example: SULA2012-007 5/13/2014. SU indicates the rates are survey rates based on a weighted average calculation of rates and are not majority rates. LA indicates the State of Louisiana. 2012 is the year of survey on which these classifications and rates are based. The next number, 007 in the example, is an internal number used in producing the wage determination. 5/13/2014 indicates the survey completion date for the classifications and rates under that identifier. Survey wage rates are not updated and remain in effect until a new survey is conducted. Union Average Rate Identifiers Classification(s) listed under the UAVG identifier indicate that no single majority rate prevailed for those classifications; however, 100% of the data reported for the classifications was union data. EXAMPLE: UAVG-OH-0010 08/29/2014. UAVG indicates that the rate is a weighted union average rate. OH indicates the state. The next number, 0010 in the example, is an internal number used in producing the wage determination. 08/29/2014 indicates the survey completion date for the classifications and rates under that identifier. A UAVG rate will be updated once a year, usually in January of each year, to reflect a weighted average of the current negotiated/CBA rate of the union locals from which the rate is based. ---------------------------------------------------------------- WAGE DETERMINATION APPEALS PROCESS 1.) Has there been an initial decision in the matter? This can be: * an existing published wage determination * a survey underlying a wage determination * a Wage and Hour Division letter setting forth a position on a wage determination matter DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 8 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 * a conformance (additional classification and rate) ruling On survey related matters, initial contact, including requests for summaries of surveys, should be with the Wage and Hour Regional Office for the area in which the survey was conducted because those Regional Offices have responsibility for the Davis-Bacon survey program. If the response from this initial contact is not satisfactory, then the process described in 2.) and 3.) should be followed. With regard to any other matter not yet ripe for the formal process described here, initial contact should be with the Branch of Construction Wage Determinations. Write to: Branch of Construction Wage Determinations Wage and Hour Division U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 2.) If the answer to the question in 1.) is yes, then an interested party (those affected by the action) can request review and reconsideration from the Wage and Hour Administrator (See 29 CFR Part 1.8 and 29 CFR Part 7). Write to: Wage and Hour Administrator U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 The request should be accompanied by a full statement of the interested party's position and by any information (wage payment data, project description, area practice material, etc.) that the requestor considers relevant to the issue. 3.) If the decision of the Administrator is not favorable, an interested party may appeal directly to the Administrative Review Board (formerly the Wage Appeals Board). Write to: Administrative Review Board U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 4.) All decisions by the Administrative Review Board are final. ================================================================ DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 9 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 END OF GENERAL DECISION " "General Decision Number: TX20190029 01/04/2019 Superseded General Decision Number: TX20180040 State: Texas Construction Type: Highway Counties: Aransas, Calhoun, Goliad, Nueces and San Patricio Counties in Texas. HIGHWAY CONSTRUCTION PROJECTS (excluding tunnels, building structures in rest area projects & railroad construction; bascule, suspension & spandrel arch bridges designed for commercial navigation, bridges involving marine construction; and other major bridges). Note: Under Executive Order (EO) 13658, an hourly minimum wage of $10.60 for calendar year 2019 applies to all contracts subject to the Davis-Bacon Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2015. If this contract is covered by the EO, the contractor must pay all workers in any classification listed on this wage determination at least $10.60 per hour (or the applicable wage rate listed on this wage determination, if it is higher) for all hours spent performing on the contract in calendar year 2019. If this contract is covered by the EO and a classification considered necessary for performance of work on the contract does not appear on this wage determination, the contractor must pay workers in that classification at least the wage rate determined through the conformance process set forth in 29 CFR 5.5(a)(1)(ii) (or the EO minimum wage rate, if it is higher than the conformed wage rate). The EO minimum wage rate will be adjusted annually. Please note that this EO applies to the above-mentioned types of contracts entered into by the federal government that are subject to the Davis-Bacon Act itself, but it does not apply to contracts subject only to the Davis-Bacon Related Acts, including those set forth at 29 CFR 5.1(a)(2)-(60). Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 10 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 Modification Number Publication Date 0 01/04/2019 * SUTX2011-010 08/08/2011 Rates Fringes CEMENT MASON/CONCRETE FINISHER (Paving & Structures)...$ 12.64 FORM BUILDER/FORM SETTER Paving & Curb...............$ 10.69 Structures..................$ 13.61 LABORER Asphalt Raker...............$ 11.67 Flagger.....................$ 8.81 Laborer, Common.............$ 10.25 Laborer, Utility............$ 11.23 Pipelayer...................$ 11.17 Work Zone Barricade Servicer....................$ 11.51 PAINTER (Structures).............$ 21.29 POWER EQUIPMENT OPERATOR: Asphalt Distributor.........$ 14.25 Asphalt Paving Machine......$ 13.44 Mechanic....................$ 17.00 Motor Grader, Fine Grade....$ 17.74 Motor Grader, Rough.........$ 16.85 TRUCK DRIVER Lowboy-Float................$ 16.62 Single Axle.................$ 11.61 ---------------------------------------------------------------- WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental. ================================================================ Note: Executive Order (EO) 13706, Establishing Paid Sick Leave for Federal Contractors applies to all contracts subject to the DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 11 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 Davis-Bacon Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2017. If this contract is covered by the EO, the contractor must provide employees with 1 hour of paid sick leave for every 30 hours they work, up to 56 hours of paid sick leave each year. Employees must be permitted to use paid sick leave for their own illness, injury or other health-related needs, including preventive care; to assist a family member (or person who is like family to the employee) who is ill, injured, or has other health-related needs, including preventive care; or for reasons resulting from, or to assist a family member (or person who is like family to the employee) who is a victim of, domestic violence, sexual assault, or stalking. Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts. Unlisted classifications needed for work not included within the scope of the classifications listed may be added after award only as provided in the labor standards contract clauses (29CFR 5.5 (a) (1) (ii)). ---------------------------------------------------------------- The body of each wage determination lists the classification and wage rates that have been found to be prevailing for the cited type(s) of construction in the area covered by the wage determination. The classifications are listed in alphabetical order of ""identifiers"" that indicate whether the particular rate is a union rate (current union negotiated rate for local), a survey rate (weighted average rate) or a union average rate (weighted union average rate). Union Rate Identifiers A four letter classification abbreviation identifier enclosed in dotted lines beginning with characters other than ""SU"" or ""UAVG"" denotes that the union classification and rate were prevailing for that classification in the survey. Example: PLUM0198-005 07/01/2014. PLUM is an abbreviation identifier of the union which prevailed in the survey for this classification, which in this example would be Plumbers. 0198 indicates the local union number or district council number where applicable, i.e., Plumbers Local 0198. The next number, 005 in the example, is an internal number used in processing the wage determination. 07/01/2014 is the effective date of the DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 12 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 most current negotiated rate, which in this example is July 1, 2014. Union prevailing wage rates are updated to reflect all rate changes in the collective bargaining agreement (CBA) governing this classification and rate. Survey Rate Identifiers Classifications listed under the ""SU"" identifier indicate that no one rate prevailed for this classification in the survey and the published rate is derived by computing a weighted average rate based on all the rates reported in the survey for that classification. As this weighted average rate includes all rates reported in the survey, it may include both union and non-union rates. Example: SULA2012-007 5/13/2014. SU indicates the rates are survey rates based on a weighted average calculation of rates and are not majority rates. LA indicates the State of Louisiana. 2012 is the year of survey on which these classifications and rates are based. The next number, 007 in the example, is an internal number used in producing the wage determination. 5/13/2014 indicates the survey completion date for the classifications and rates under that identifier. Survey wage rates are not updated and remain in effect until a new survey is conducted. Union Average Rate Identifiers Classification(s) listed under the UAVG identifier indicate that no single majority rate prevailed for those classifications; however, 100% of the data reported for the classifications was union data. EXAMPLE: UAVG-OH-0010 08/29/2014. UAVG indicates that the rate is a weighted union average rate. OH indicates the state. The next number, 0010 in the example, is an internal number used in producing the wage determination. 08/29/2014 indicates the survey completion date for the classifications and rates under that identifier. A UAVG rate will be updated once a year, usually in January of each year, to reflect a weighted average of the current negotiated/CBA rate of the union locals from which the rate is based. ---------------------------------------------------------------- DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 13 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 WAGE DETERMINATION APPEALS PROCESS 1.) Has there been an initial decision in the matter? This can be: * an existing published wage determination * a survey underlying a wage determination * a Wage and Hour Division letter setting forth a position on a wage determination matter * a conformance (additional classification and rate) ruling On survey related matters, initial contact, including requests for summaries of surveys, should be with the Wage and Hour Regional Office for the area in which the survey was conducted because those Regional Offices have responsibility for the Davis-Bacon survey program. If the response from this initial contact is not satisfactory, then the process described in 2.) and 3.) should be followed. With regard to any other matter not yet ripe for the formal process described here, initial contact should be with the Branch of Construction Wage Determinations. Write to: Branch of Construction Wage Determinations Wage and Hour Division U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 2.) If the answer to the question in 1.) is yes, then an interested party (those affected by the action) can request review and reconsideration from the Wage and Hour Administrator (See 29 CFR Part 1.8 and 29 CFR Part 7). Write to: Wage and Hour Administrator U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 The request should be accompanied by a full statement of the interested party's position and by any information (wage payment data, project description, area practice material, etc.) that the requestor considers relevant to the issue. 3.) If the decision of the Administrator is not favorable, an interested party may appeal directly to the Administrative DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 14 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 Review Board (formerly the Wage Appeals Board). Write to: Administrative Review Board U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 4.) All decisions by the Administrative Review Board are final. ================================================================ END OF GENERAL DECISION " DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 15 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 ARTICLE 19 – PROJECT MANAGEMENT AND COORDINATION SC-19.21 COOPERATION WITH PUBLIC AGENCIES A. For the Contractor’s convenience, the following telephone numbers are listed: Public Agencies/Contacts Phone Number City Engineer 361-826-3500 CH2M Hill 361-888-8600 CH2M Hill Project Manager 361-792-2046 Traffic Engineering 361-826-3547 Police Department 361-882-2600 Water/ Wastewater/ Stormwater 361-826-1800 (361-826-1818 after hours) Gas Department 361-885-6900 (361-885-6942 after hours) Parks & Recreation Department 361-826-3461 Street Department 361-826-1875 City Street Div. for Traffic Signals 361-826-1610 Solid Waste & Brush 361-826-1973 IT Department (City Fiber) 361-826-1956 AEP 1-877-373-4858 AT&T 361-881-2511 (1-800-824-4424 after hours) Grande Communications 1-866-247-2633 Spectrum Communications 1-800-892-4357 Crown Castle Communications (Network Operations Center) 1-888-632-0931 CenturyLink 361-208-0730 Windstream 1-800-600-5050 Regional Transportation Authority 361-289-2712 Port of Corpus Christi Authority Engr. 361-882-5633 TxDOT Area Office 361-808-2500 Corpus Christi ISD 361-695-7200 ARTICLE 23 – MINORITY / MBE / DBE PARTICIPATION POLICY SC-23.03 Goals A. The goals for participation by minorities and Minority Business Enterprises expressed in percentage terms for the Contractor’s aggregate work force on all construction Work for the Contract award shall be DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 16 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 1. Minority participation goal for this Project has been established to be 45%. 2. Minority Business Enterprise participation goal for this Project has been established to be 15 %. ARTICLE 25 – SHOP DRAWINGS SC-25.03 CONTRACTOR’S RESPONSIBILITIES A. Provide Shop Drawings for the following items: Specification Section Shop Drawing Description 025608 Inlets 025807 Pavement Markings 025813 Preformed Thermoplastic Striping, Words and Emblems 027202 Manholes 027402 Reinforced Concrete Pipe Culverts 055420 Frames, Grates, Rings, and Covers ARTICLE 26 – RECORD DATA SC-26.03 CONTRACTOR’S RESPONSIBILITIES A. Submit Record Data for the following items: Specification Section Record Data Description 022021 Control of Ground Water (Design/Procedure/Testing/SWP3/NOI) 022100 Select Material (Material Conformance & Placement Testing) 022420 Silt Fence (Material Conformance) 025223 Crushed Limestone Flexible Base (Material Conformance & Placement Testing) 025404 Asphalts, Oils and Emulsions (Material Conformance & Placement Testing) 025412 Prime Coat (Material Conformance) 025424 Hot Mix Asphaltic Concrete Pavement - Class A (Material Conformance) 025802 Temporary Traffic Controls During Construction (Material Conformance & Procedure) 025805 Work Zone Pavement Markings (Material Conformance) 025816 Raised Pavement Markers (Material Conformance) DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Supplementary Conditions 00 73 00 - 17 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 Specification Section Record Data Description 027611 Cleaning and Televised Inspection of Conduits (Equipment Conformance/Procedure/Report) 028040 Sodding (Material Conformance) 030020 Portland Cement Concrete (Material Conformance & Procedure) 038000 Concrete Structures (Material Conformance) 050200 Welding (Material Conformance & Procedure) Red Line As-Built Drawings END OF SECTION DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 APPENDIX DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Agreement 00 52 23 - 1 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 00 52 23 AGREEMENT This Agreement, for the Project awarded on June 9, 2020, is between the City of Corpus Christi (Owner) and Mako Contracting, LLC (Contractor). Owner and Contractor agree as follows: ARTICLE 1 – WORK 1.01 Contractor shall complete all Work as specified or indicated in the Contract Documents. The Work is generally described as: Lipes Blvd. from Yorktown Blvd. to Sun Wood Dr. 18029A ARTICLE 2 – DESIGNER AND OWNER’S AUTHORIZED REPRESENTATIVE 2.01 The Project has been designed by: CH2M Hill Engineers, Inc. 555 N. Carancahua, Suite 320 Corpus Christi, TX 78401 2.02 The Owner’s Authorized Representative for this Project is: Brett Van Halen, PMP – Assistant Dir. Of Construction City of Corpus Christi – Engineering Services 4917 Holly Rd, Bldg. #5 Corpus Christi, TX 78411 ARTICLE 3 – CONTRACT TIMES 3.01 Contract Times A. The Work is required to be substantially completed within 150 days after the date when the Contract Times commence to run as provided in the Notice to Proceed and is to be completed and ready for final payment in accordance with Paragraph 17.16 of the General Conditions within 180 days after the date when the Contract Times commence to run. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Agreement 00 52 23 - 2 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 B. Performance of the Work is required as shown in Paragraph 7.02 of the General Conditions. C. Milestones, and the dates for completion of each, are as defined in Section 01 35 00 SPECIAL PROCEDURES. 3.02 Liquidated Damages A. Owner and Contractor recognize that time limits for specified Milestones, Substantial Completion, and completion and readiness for Final Payment as stated in the Contract Documents are of the essence of the Contract. Owner and Contractor recognize that the Owner will suffer financial loss if the Work is not completed within the times specified in Paragraph 3.01 and as adjusted in accordance with Paragraph 11.05 of the General Conditions. Owner and Contractor also recognize the delays, expense, and difficulties involved in proving in a legal or arbitration proceeding the actual loss suffered by Owner if the Work is not completed on time. Accordingly, instead of requiring any such proof, Owner and Contractor agree that as liquidated damages for delay (but not as a penalty): 1. Substantial Completion: Contractor shall pay Owner $2,000 for each day that expires after the time specified in Paragraph 3.01 for Substantial Completion until the Work is substantially complete. Contractor shall pay owner $2,000 for each day that expires after August 24, 2020 until substantial completion is reached for all improvements between Yorktown Blvd. and Lethaby Dr. 2. Completion of the Remaining Work: Contractor agrees to pay Owner $400 for each day that expires after the time specified in Paragraph 3.01 for completion and readiness for final payment until the Work is completed and ready for final payment in accordance with Paragraph 17.16 of the General Conditions. 3. Liquidated damages for failing to timely attain Substantial Completion and Final Completion are not additive and will not be imposed concurrently. 4. Milestones: Contractor agrees to pay Owner liquidated damages as stipulated in SECTION 01 35 00 SPECIAL PROCEDURES for failure to meet Milestone completions. 5. The Owner will determine whether the Work has been completed within the Contract Times. B. Owner is not required to only assess liquidated damages, and Owner may elect to pursue its actual damages resulting from the failure of Contractor to complete the Work in accordance with the requirements of the Contract Documents. ARTICLE 4 – CONTRACT PRICE 4.01 Owner will pay Contractor for completion of the Work in accordance with the Contract Documents at the unit prices shown in the attached BID FORM. Unit prices have been computed in accordance with Paragraph 15.03 of the General Conditions. Contractor acknowledges that estimated quantities are not guaranteed, and were solely for the purpose of comparing Bids, and final payment for all unit price items will be based on actual quantities, determined as provided in the Contract Documents. Total Base Bid Price $ 2,023,240.09 DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Agreement 00 52 23 - 3 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 ARTICLE 5 – PAYMENT PROCEDURES 5.01 Submit Applications for Payment in accordance with Article 17 of the General Conditions. Applications for Payment will be processed by the OAR as provided in the General Conditions. 5.02 Progress Payments; Retainage: A. The Owner will make progress payments on or about the 25th day of each month during performance of the Work. Payment is based on Work completed in accordance with the Schedule of Values established as provided in the General Conditions. B. Progress payments equal to the full amount of the total earned value to date for completed Work minus the retainage listed below and properly stored materials will be made prior to Substantial Completion. 1. The standard retainage is 5 percent. C. Payment will be made for the amount determined per Paragraph 5.02.B, less the total of payments previously made and less set-offs determined in accordance with Paragraph 17.01 of the General Conditions. D. At the Owner’s option, retainage may be increased to a higher percentage rate, not to exceed ten percent, if progress on the Project is considered to be unsatisfactory. If retainage in excess of the amount described above is held prior to Substantial Completion, the Owner will place the additional amount in an interest bearing account. Interest will be paid in accordance with Paragraph 6.01. E. At the Owner’s option, Owner may pay Contractor 100 percent of the Work completed, less amounts withheld in accordance with Paragraph 17.01 of the General Conditions and less 200 percent of OAR’s estimate of the value of Work to be completed or corrected to reach Substantial Completion. Owner may, at its sole discretion, elect to hold retainage in the amounts set forth above for progress payments prior to Substantial Completion if Owner has concerns with the ability of the Contractor to complete the remaining Work in accordance with the Contract Documents or within the time frame established by this Agreement. Release or reduction in retainage is contingent upon and consent of surety to the reduction in retainage. 5.03 Owner will pay the remainder of the Contract Price as recommended by OAR in accordance with Paragraph 17.16 of the General Conditions upon Final Completion and acceptance of the Work. ARTICLE 6 – INTEREST ON OVERDUE PAYMENTS AND RETAINAGE 6.01 The Owner is not obligated to pay interest on overdue payments except as required by Texas Government Code Chapter 2251. Invoices must comply with Article 17 of the General Conditions. 6.02 Except as specified in Article 5, the Owner is not obligated to pay interest on moneys not paid except as provided in Texas Government Code Chapter 2252. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Agreement 00 52 23 - 4 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 ARTICLE 7 – CONTRACTOR’S REPRESENTATIONS 7.01 The Contractor makes the following representations: A. The Contractor has examined and carefully studied the Contract Documents and the other related data identified in the Bidding Documents. B. The Contractor has visited the Site and become familiar with and is satisfied as to the general, local, and Site conditions that may affect cost, progress, and performance of the Work. C. The Contractor is familiar with Laws and Regulations that may affect cost, progress, and performance of the Work. D. The Contractor has carefully studied the following Site-related reports and drawings as identified in the Supplementary Conditions: 1. Geotechnical Data Reports regarding subsurface conditions at or adjacent to the Site; 2. Drawings of physical conditions relating to existing surface or subsurface structures at the Site; 3. Underground Facilities referenced in reports and drawings; 4. Reports and drawings relating to Hazardous Environmental Conditions, if any, at or adjacent to the Site; and 5. Technical Data related to each of these reports and drawings. E. The Contractor has considered the: 1. Information known to Contractor; 2. Information commonly known to contractors doing business in the locality of the Site; 3. Information and observations obtained from visits to the Site; and 4. The Contract Documents. F. The Contractor has considered the items identified in Paragraphs 7.01.D and 7.01.E with respect to the effect of such information, observations, and documents on: 1. The cost, progress, and performance of the Work; 2. The means, methods, techniques, sequences, and procedures of construction to be employed by Contractor; and 3. Contractor’s safety precautions and programs. G. Based on the information and observations referred to in the preceding paragraphs, Contractor agrees that no further examinations, investigations, explorations, tests, studies, or data are necessary for the performance of the Work at the Contract Price, within the Contract Times, and in accordance with the other terms and conditions of the Contract Documents. H. The Contractor is aware of the general nature of Work to be performed by Owner and others at the Site that relates to the Work as indicated in the Contract Documents. I. The Contractor has correlated the information known to the Contractor, information and observations obtained from visits to the Site, reports and drawings identified in the Contract DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Agreement 00 52 23 - 5 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 Documents, and all additional examinations, investigations, explorations, tests, studies, and data with the Contract Documents. J. The Contractor has given the OAR written notice of all conflicts, errors, ambiguities, or discrepancies that the Contractor has discovered in the Contract Documents, and the written resolution provided by the OAR is acceptable to the Contractor. K. The Contract Documents are generally sufficient to indicate and convey understanding of all terms and conditions for performance and furnishing of the Work. L. Contractor’s entry into this Contract constitutes an incontrovertible representation by Contractor that without exception all prices in the Agreement are premised upon performing and furnishing the Work required by the Contract Documents. M. CONTRACTOR SHALL INDEMNIFY, DEFEND AND HOLD HARMLESS THE OWNER’S INDEMNITEES IN ACCORDANCE WITH PARAGRAPH 7.14 OF THE GENERAL CONDITIONS AND THE SUPPLEMENTARY CONDITIONS. ARTICLE 8 – ACCOUNTING RECORDS 8.01 Accounting Record Availability: The Contractor shall keep such full and detailed accounts of materials incorporated and labor and equipment utilized for the Work consistent with the requirements of Paragraph 15.01 of the General Conditions and as may be necessary for proper financial management under this Agreement. Subject to prior written notice, the Owner shall be afforded reasonable access during normal business hours to all of the Contractor’s records, books, correspondence, instructions, drawings, receipts, vouchers, memoranda, and similar data relating to the Cost of the Work and the Contractor’s fee. The Contractor shall preserve all such documents for a period of 3 years after the final payment by the Owner. ARTICLE 9 – CONTRACT DOCUMENTS 9.01 Contents: A. The Contract Documents consist of the following: 1. Solicitation documents. 2. Specifications, forms, and documents listed in SECTION 00 01 00 TABLE OF CONTENTS. 3. Drawings listed in the Sheet Index. 4. Addenda. 5. Exhibits to this Agreement: a. Contractor’s Bid Form. 6. Documentation required by the Contract Documents and submitted by Contractor prior to Notice of Award. B. There are no Contract Documents other than those listed above in this Article. C. The Contract Documents may only be amended, modified, or supplemented as provided in Article 11 of the General Conditions. DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290EDocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Agreement 00 52 23 - 6 LIPES BOULEVARD – YORKTOWN TO SUN WOOD (BOND 2018) PN:18029A Rev 8/2019 ARTICLE 10 – CONTRACT DOCUMENT SIGNATURES ATTEST CITY OF CORPUS CHRISTI Rebecca Huerta City Secretary Michael Rodriguez Chief of Staff __________________________ AUTHORIZED APPROVED AS TO LEGAL FORM: BY COUNCIL ___________________________ Assistant City Attorney ATTEST (IF CORPORATION) CONTRACTOR Mako Contracting, LLC (Seal Below) By: Note: Attach copy of authorization to sign if person signing for CONTRACTOR is not President, Vice President, Chief Executive Officer, or Chief Financial Officer Title: 3636 S. Alameda St., Ste. B-153 Address Corpus Christi, TX 78411 City State Zip 361/561-6256 Phone Fax gg@makocontracting.com EMail END OF SECTION DocuSign Envelope ID: E0A37618-40BF-4D07-803B-2ADFAE05290E 6/24/2020 President DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 7/10/2020 7/30/2020 06/09/2020 M2020-101 7/30/2020 07/07/2020 K&S Insurance Agency 2255 Ridge Road, Ste. 333 P. O. Box 277 Rockwall TX 75087 Natasha Felts (972) 772-7256 (972) 771-4695 nfelts@kandsins.com Mako Contracting LLC 3636 Alameda Suite B #153 Corpus Christi TX 78411 The Cincinnati Insurance Co.10677 Hanover Insurance Company 22292 A EPP0305105 01/27/2020 01/27/2021 1,000,000 500,000 10,000 1,000,000 2,000,000 2,000,000 A EBA0305105 01/27/2020 01/27/2021 1,000,000 A EPP0305105 01/27/2020 01/27/2021 2,000,000 2,000,000 B Contractor's Equipment IHD D477988 01/27/2020 01/27/2021 Leased/ Rented Equip $250,000 [Job #: Job Type: City Project #18029A Lipes BLVD Project] See attached for additional information. City of Corpus Christi 1201 Leopard St. Corpus Christi TX 78401 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Mako Contracting LLCK&S Insurance Agency 25 Certificate of Liability Insurance: Notes Additional Insured and Waiver of Subrogation Form #GA233 02/07 Applies to the General Liability Policy. Primary & Non-Contributory Form #GA233 02/07 Applies to the General Liability Policy. Additional Insured and Waiver of Subrogation Form #AA288 01/16 Applies to the Business Auto Policy. *ALWAYS REFER TO THE ATTACHED POLICY FORMS FOR SPECIFIC WORDING OF SUCH COVERAGE, LIMITS, CONDITIONS & EXCLUSIONS. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 7/8/2020 Sunz Insurance Solutions, LLC ID: (Halcyon HR Inc) c/o Halcyon HR Inc 522 Scotland Drive Corpus Christi, TX 78418 262-504-3843 262-886-3947 United Wisconsin Insurance Company 29157 A WC536-00001-019-SZ 10/1/2019 10/1/2020 3 1,000,000 1,000,000 1,000,000 Rick Leonard Mark Denman mdenman@robertsonryan.com Halcyon HR Inc 522 Scotland Drive Corpus Christi TX 78418 56462978 3 Waiver of Subrogation in favor of all persons or organizations as required by written contract executed prior to the date of loss. Project: #18029A - Lipes Blvd. Project - TX 782 City of Corpus Christi 1201 Leopard St. Corpus Christi TX 78401 Coverage Provided for all covered employees but not subcontractors of: Mako Contracting LLC Effective: 10/1/2018 Blanket waiver of subrogation applies as defined by the attached endorsement. 56462978 | Halcyon HR PEO 536 WOS BLANKET TX420601 | Brittnee Campos | 7/8/2020 8:41:08 AM (EDT) | Page 1 of 3 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B (Ed. 06-2014) Texas Waiver of Our Right to Recover From Others Endorsement This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are requ ired by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1.( ) Specific Waiver Name of person or organization ( x ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2.Operations: All Texas Operations 3.Premium: The premium charge for this endorsement shall be 2% percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4.Advance Premium: This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Insured Policy No. Endorsement No. Premium Insurance Company Countersigned by WC 42 03 04 B (Ed. 06-2014) 1 of 1 © Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved. Halcyon HR Inc WC536-00001-019-SZ 10/01/2019 United Wisconsin Insurance Company 56462978 56462978 | Halcyon HR PEO 536 WOS BLANKET TX420601 | Brittnee Campos | 7/8/2020 8:41:08 AM (EDT) | Page 2 of 3 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 © Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 06 01 (Ed. 1-94) TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. In the event of cancelation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of days advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule 1. Number of days advance notice: 30 Days 2. Notice will be mailed to: This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium: Insurance Company Countersigned by___________________________________________ WC 42 06 01 (Ed. 1-94) Halcyon HR Inc 10/01/2019 United Wisconsin Insurance Company City of Corpus Christi 1201 Leopard St. Corpus Christi TX 78401 56462978WC536-00001-019-SZ 56462978 | Halcyon HR PEO 536 WOS BLANKET TX420601 | Brittnee Campos | 7/8/2020 8:41:08 AM (EDT) | Page 3 of 3 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 1 of 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS'COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A.Endorsement - Table of Contents: Coverage:Begins on Page: 1.Employee Benefit Liability Coverage .................................................................................................2 2.Unintentional Failure to Disclose Hazards.........................................................................................7 3.Damage to Premises Rented to You .................................................................................................8 4.Supplementary Payments ..................................................................................................................9 5.Medical Payments..............................................................................................................................9 6.Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.).......................................................................................................9 7.180 Day Coverage for Newly Formed or Acquired Organizations...................................................10 8.Waiver of Subrogation .....................................................................................................................10 9.Automatic Additional Insured - Specified Relationships:...............................................................10 •Managers or Lessors of Premises; •Lessor of Leased Equipment; •Vendors; •State or Political Subdivisions - Permits Relating to Premises; •State or Political Subdivisions - Permits; and •Contractors' Operations 10.Broadened Contractual Liability -W ork Within 50' of Railroad Property .........................................14 11.Property Damage to Borrowed Equipment ......................................................................................14 12.Employees as Insureds - Specified Health Care Services:...........................................................14 •Nurses; •Emergency Medical Technicians; and •Paramedics 13.Broadened Notice of Occurrence ....................................................................................................14 B.Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1.Employee Benefit Liability Coverage Each Employee Limit:$1,000,000 Aggregate Limit:$3,000,000 Deductible:$1,000 3.Damage to Premises Rented to You The lesser of: a.The Each Occurrence Limit shown in the Declarations; or b.$500,000 unless otherwise stated $ 4.Supplementary Payments a.Bail bonds:$1,000 b.Loss of earnings:$350 5.Medical Payments Medical Expense Limit:$10,000 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 2 of 15 6.Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a. $1,000 Coverage b. $5,000 unless otherwise stated $ Deductibles (Each Occurrence) Coverage a. $250 Coverage b. $250 unless otherwise stated $ COVERAGE PREMIUM BASIS (a)Area (b)Payroll (c)Gross Sales (d)Units (e)Other RATE (For Limits in Excess of $5,000) ADVANCE PREMIUM (For Limits in Excess of $5,000) b.Care, Custody or Control $ TOTAL ANNUAL PREMIUM $ 11.Property Damage to Borrowed Equipment Each Occurrence Limit:$10,000 Deductible:$250 C.Coverages: 1.Employee Benefit Liability Coverage a.The following is added to SECTION I -COVERAGES:Employee Benefit Liability Coverage. (1)Insuring Agreement (a)We will pay those sums that the insured becomes legally obligated to pay as dam- ages caused by any act, er- ror or omission of the in- sured, or of any other per- son for whose acts the in- sured is legally liable,to which this insurance ap- plies. We will have the right and duty to defend the in- sured against any "suit" seeking those damages. However, we will have no duty to defend against any "suit" seeking damages to which this insurance does not apply. W e may, at our discretion, investigate any report of an act,error or omission and settle any claim or "suit" that may re- sult. But: 1)The amount we will pay for damages is limited as described in SEC- TION III -LIMITS OF INSURANCE; and 2)Our right and duty to defend ends when we have used up the appli- cable limit of insurance in the payment of judgments or settle- ments. No other obligation or liabil- ity to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Pay- ments. (b)This insurance applies to damages only if the act,er- ror or omission, is negli- gently committed in the "administration"of your "employee benefit pro- gram"; and 1)Occurs during the pol- icy period; or 2)Occurred prior to the effective date of this endorsement provided: a)You did not have knowledge of a claim or "suit" on or before the ef- fective date of this endorsement. You will be deemed to have knowledge of a claim or "suit" when any "author- ized representa- tive"; DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 3 of 15 i)Reports all, or any part, of the act, error or omission to us or any other insurer; ii)Receives a written or ver- bal demand or claim for dam- ages because of the act,er- ror or omis- sion; and b)There is no other applicable insur- ance. (2)Exclusions This insurance does not apply to: (a)Bodily Injury,Property Damage or Personal and Advertising Injury "Bodily injury", "property damage" or "personal and advertising injury". (b)Dishonest,Fraudulent, Criminal or Malicious Act Damages arising out of any intentional, dishonest, fraudulent, criminal or mali- cious act, error or omission, committed by any insured, including the willful or reck- less violation of any statute. (c)Failure to Perform a Con- tract Damages arising out of fail- ure of performance of con- tract by any insurer. (d)Insufficiency of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit pro- gram". (e)Inadequacy of Perform- ance of Investment / Ad- vice Given With Respect to Participation Any claim based upon: 1)Failure of any invest- ment to perform; 2)Errors in providing in- formation on past per- formance of investment vehicles; or 3)Advice given to any person with respect to that person's decision to participate or not to participate in any plan included in the "em- ployee benefit pro- gram". (f)Workers' Compensation and Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers' compensation, un- employment compensation insurance, social security or disability benefits law or any similar law. (g)ERISA Damages for which any in- sured is liable because of li- ability imposed on a fiduci- ary by the Employee Re- tirement Income Security Act of 1974, as now or hereafter amended,or by any similar federal, state or local laws. (h)Available Benefits Any claim for benefits to the extent that such benefits are available, with reasonable effort and cooperation of the insured,from the applicable funds accrued or other col- lectible insurance. (i)Taxes, Fines or Penalties Taxes, fines or penalties, including those imposed under the Internal Revenue Code or any similar state or local law. (j)Employment-Related Practices Any liability arising out of any: (1)Refusal to employ; (2)Termination of em- ployment; (3)Coercion, demotion, evaluation, reassign- ment, discipline, defa- mation, harassment, humiliation, discrimina- tion or other employ- DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 4 of 15 ment-related practices, acts or omissions; or (4)Consequential liability as a result of (1), (2) or (3) above. This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the injury. (3)Supplementary Payments SECTION I -COVERAGES, SUPPLEMENTARY PAY- MENTS -COVERAGES A AND B also apply to this Coverage. b.Who is an Insured As respects Employee Benefit Liabil- ity Coverage, SECTION II -WHO IS AN INSURED is deleted in its en- tirety and replaced by the following: (1)If you are designated in the Dec- larations as: (a)An individual,you and your spouse are insureds, but only with respect to the con- duct of a business of which you are the sole owner. (b)A partnership or joint ven- ture, you are an insured. Your members, your part- ners,and their spouses are also insureds but only with respect to the conduct of your business. (c)A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insur- eds, but only with respect to their duties as your manag- ers. (d)An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and di- rectors are insureds,but only with respect to their du- ties as your officers or direc- tors. Your stockholders are also insureds, but only with respect to their liability as stockholders. (e)A trust, you are an insured. Your trustees are also in- sureds, but only with re- spect to their duties as trus- tees. (2)Each of the following is also an insured: (a)Each of your "employees" who is or was authorized to administer your "employee benefit program". (b)Any persons, organizations or "employees"having proper temporary authoriza- tion to administer your "em- ployee benefit program" if you die, but only until your legal representative is ap- pointed. (c)Your legal representative if you die,but only with re- spect to duties as such. That representative will have all your rights and du- ties under this Coverage Part. (3)Any organization you newly ac- quire or form, other than a part- nership,joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if no other simi- lar insurance applies to that or- ganization. However,coverage under this provision: (a)Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and (b)Does not apply to any act, error or omission that was committed before you ac- quired or formed the organi- zation. c.Limits of Insurance As respects Employee Benefit Liabil- ity Coverage,SECTION III -LIMITS OF INSURANCE is deleted in its en- tirety and replaced by the following: (1)The Limits of Insurance shown in Section B. Limits of Insur- ance, 1. Employee Benefit Li- ability Coverage and the rules below fix the most we will pay regardless of the number of: (a)Insureds; DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 5 of 15 (b)Claims made or "suits" brought; (c)Persons or organizations making claims or bringing "suits"; (d)Acts, errors or omissions; or (e)Benefits included in your "employee benefit pro- gram". (2)The Aggregate Limit shown in Section B.Limits of Insurance, 1.Employee Benefit Liability Coverage of this endorsement is the most we will pay for all damages because of acts, errors or omissions negligently commit- ted in the "administration"of your "employee benefit pro- gram". (3)Subject to the limit described in (2)above, the Each Employee Limit shown in Section B.Limits of Insurance, 1.Employee Benefit Liability Coverage of this endorsement is the most we will pay for all damages sus- tained by any one "employee", including damages sustained by such "employee's"dependents and beneficiaries, as a result of: (a)An act, error or omission; or (b)A series of related acts, er- rors or omissions,regard- less of the amount of time that lapses between such acts, errors or omissions, negligently committed in the "administration" of your "em- ployee benefit program". However, the amount paid under this endorsement shall not ex- ceed, and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the "employee benefit program". (4)Deductible Amount (a)Our obligation to pay dam- ages on behalf of the in- sured applies only to the amount of damages in ex- cess of the deductible amount stated in the Decla- rations as applicable to Each Employee. The limits of insurance shall not be re- duced by the amount of this deductible. (b)The deductible amount stated in the Declarations applies to all damages sus- tained by any one "em- ployee", including such "em- ployee's"dependents and beneficiaries,because of all acts, errors or omissions to which this insurance ap- plies. (c)The terms of this insurance, including those with respect to: 1)Our right and duty to defend the insured against any "suits" seeking those dam- ages; and 2)Your duties, and the duties of any other in- volved insured, in the event of an act,error or omission, or claim, apply irrespective of the ap- plication of the deductible amount. (d)We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon no- tification of the action taken, you shall promptly reim- burse us for such part of the deductible amount as we have paid. d.Additional Conditions As respects Employee Benefit Li- ability Coverage, SECTION IV - COMMERCIAL GENERAL LIABIL- ITY CONDITIONS is amended as fol- lows: (1)Item 2. Duties in the Event of Occurrence,Offense,Claim or Suit is deleted in its entirety and replaced by the following: 2.Duties in the Event of an Act,Error or Omission, or Claim or Suit a.You must see to it that we are noti- fied as soon as practicable of an act, error or omission which may result in a claim. To the extent possible, no- tice should include: (1)What the act, error or omission was and when it occurred; and (2)The names and addresses of anyone who may suffer dam- ages as a result of the act,error or omission. DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 6 of 15 b.If a claim is made or "suit" is brought against any insured,you must: (1)Immediately record the specifics of the claim or "suit" and the date received; and (2)Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit"as soon as practicable. c.You and any other involved insured must: (1)Immediately send us copies of any demands, notices,sum- monses or legal papers received in connection with the claim or "suit"; (2)Authorize us to obtain records and other information; (3)Cooperate with us in the investi- gation or settlement of the claim or defense against the "suit"; and (4)Assist us, upon our request, in the enforcement of any right against any person or organiza- tion which may be liable to the insured because of an act,error or omission to which this insur- ance may also apply. d.No insured will,except at that in- sured's own cost,voluntarily make a payment,assume any obligation, or incur any expense without our con- sent. (2)Item 5.Other Insurance is de- leted in its entirety and replaced by the following: 5.Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Part, our obligations are limited as follows: a.Primary Insurance This insurance is pri- mary except when c. below applies.If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then,we will share with all that other insurance by the method described in b. below. b.Method of Sharing If all of the other insur- ance permits contribu- tion by equal shares, we will follow this method also.Under this approach each in- surer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other in- surance does not per- mit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of in- surance to the total ap- plicable limits of insur- ance of all insurers. c.No Coverage This insurance shall not cover any loss for which the insured is en- titled to recovery under any other insurance in force previous to the ef- fective date of this Coverage Part. e.Additional Definitions As respects Employee Benefit Li- ability Coverage, SECTION V - DEFINITIONS is amended as fol- lows: (1)The following definitions are added: 1."Administration" means: a.Providing information to "employees", including their dependents and beneficiaries,with re- spect to eligibility for or scope of "employee benefit programs"; b.Interpreting the "em- ployee benefit pro- grams"; c.Handling records in connection with the "employee benefit pro- grams"; or d.Effecting, continuing or terminating any "em- ployee's"participation DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 7 of 15 in any benefit included in the "employee bene- fit program". However, "administration" does not include: a.Handling payroll deduc- tions; or b.The failure to effect or maintain any insurance or adequate limits of coverage of insurance, including but not limited to unemployment in- surance, social security benefits, workers' com- pensation and disability benefits. 2."Cafeteria plans"means plan authorized by applica- ble law to allow "employ- ees" to elect to pay for cer- tain benefits with pre-tax dollars. 3."Employee benefit pro- grams"means a program providing some or all of the following benefits to "em- ployees", whether provided through a "cafeteria plan"or otherwise: a.Group life insurance; group accident or health insurance; den- tal,vision and hearing plans; and flexible spending accounts; provided that no one other than an "em- ployee" may subscribe to such benefits and such benefits are made generally available to those "employees"who satisfy the plan's eligi- bility requirements; b.Profit sharing plans, employee savings plans, employee stock ownership plans, pen- sion plans and stock subscription plans,pro- vided that no one other than an "employee" may subscribe to such benefits and such benefits are made gen- erally available to all "employees" who are eligible under the plan for such benefits; c.Unemployment insur- ance, social security benefits, workers' com- pensation and disability benefits; and d.Vacation plans, includ- ing buy and sell pro- grams; leave of ab- sence programs, in- cluding military, mater- nity, family, and civil leave; tuition assis- tance plans; transporta- tion and health club subsidies. (2)The following definitions are de- leted in their entirety and re- placed by the following: 21."Suit"means a civil pro- ceeding in which money damages because of an act, error or omission to which this insurance applies are alleged. "Suit" includes: a.An arbitration proceed- ing in which such dam- ages are claimed and to which the insured must submit or does submit with our con- sent; b.Any other alternative dispute resolution pro- ceeding in which such damages are claimed and to which the in- sured submits with our consent; or c.An appeal of a civil pro- ceeding. 8."Employee"means a per- son actively employed, for- merly employed, on leave of absence or disabled, or re- tired. "Employee"includes a "leased worker". "Em- ployee"does not include a "temporary worker". 2.Unintentional Failure to Disclose Haz- ards SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 7. Represen- tations is hereby amended by the addi- tion of the following: Based on our dependence upon your rep- resentations as to existing hazards, if un- intentionally you should fail to disclose all such hazards at the inception date of your policy,we will not reject coverage under this Coverage Part based solely on such failure. DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 8 of 15 3.Damage to Premises Rented to You a.The last Subparagraph of Paragraph 2. SECTION I -COVERAGES, COVERAGE A. -BODILY INJURY AND PROPERTY DAMAGE,2.LI- ABILITY Exclusions is hereby de- leted and replaced by the following: Exclusions c.through q.do not apply to damage by fire, explosion, light- ning,smoke or soot to premises while rented to you or temporarily oc- cupied by you with permission of the owner. b.The insurance provided under SEC- TION I -COVERAGES,COVERAGE A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY applies to "property damage" arising out of water damage to premises that are both rented to and occupied by you. (1)As respects W ater Damage Le- gal Liability,as provided in Paragraph 3.b. above: The exclusions under SECTION I -COVERAGES,COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABIL- ITY,2. Exclusions, other than i. War and the Nuclear Energy Liability Exclusion, are deleted and the following are added: This insurance does not apply to: (a)"Property damage": 1)Assumed in any con- tract; or 2)Loss caused by or re- sulting from any of the following: a)Wear and tear; b)Rust, corrosion, fungus, decay,de- terioration, hidden or latent defect or any quality in property that causes it to dam- age or destroy it- self; c)Smog; d)Mechanical break- down including rupture or bursting caused by cen- trifugal force; e)Settling,cracking, shrinking or ex- pansion; or f)Nesting or infesta- tion, or discharge or release of waste products or secretions, by in- sects, birds,ro- dents or other animals. (b)Loss caused directly or indi- rectly by any of the follow- ing: 1)Earthquake, volcanic eruption, landslide or any other earth move- ment; 2)Water that backs up or overflows from a sewer, drain or sump; 3)Water under the ground surface pressing on,or flowing or seeping through: a)Foundations, walls, floors or paved surfaces; b)Basements, whether paved or not; or c)Doors,windows or other openings. (c)Loss caused by or resulting from water that leaks or flows from plumbing, heat- ing, air conditioning, or fire protection systems caused by or resulting from freez- ing, unless: 1)You did your best to maintain heat in the building or structure; or 2)You drained the equipment and shut off the water supply if the heat was not main- tained. (d)Loss to or damage to: 1)Plumbing,heating,air conditioning,fire pro- tection systems,or other equipment or ap- pliances; or 2)The interior of any building or structure, or to personal property in the building or structure caused by or resulting from rain, snow, sleet or ice,whether driven by wind or not. DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 9 of 15 c.Limit of Insurance The Damage to Premises Rented to You Limit as shown in the Declara- tions is amended as follows: (2)Paragraph 6.of SECTION III - LIMITS OF INSURANCE is hereby deleted and replaced by the following: 6.Subject to 5.above, the Damage to Premises Rented to You Limit is the most we will pay under COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, for damages because of "prop- erty damage" to premises while rented to you or tem- porarily occupied by you with permission of the owner, arising out of any one "occurrence"to which this insurance applies. (3)The amount we will pay is lim- ited as described in Section B. Limits of Insurance, 3.Dam- age to Premises Rented to You of this endorsement. 4.Supplementary Payments Under SECTION I -COVERAGE,SUP- PLEMENTARY PAYMENTS -COVER- AGES A AND B: a.Paragraph 2.is replaced by the fol- lowing: Up to the limit shown in Section B. Limits of Insurance, 4.a.Bail Bonds of this endorsement for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies. W e do not have to furnish these bonds. b.Paragraph 4.is replaced by the fol- lowing: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to the limit shown in Section B.Limits of Insurance, 4.b.Loss of Earnings of this en- dorsement per day because of time off from work. 5.Medical Payments The Medical Expense Limit of Any One Person as stated in the Declarations is amended to the limit shown in Section B. Limits of Insurance, 5. Medical Pay- ments of this endorsement. 6.Voluntary Property Damage and Care, Custody or Control Liability Coverage a.Voluntary Property Damage Cov- erage We will pay for "property damage"to property of others arising out of op- erations incidental to the insured's business when: (1)Damage is caused by the in- sured;or (2)Damage occurs while in the in- sured's possession. With your consent, we will make these payments regardless of fault. b.Care, Custody or Control Liability Coverage SECTION I -COVERAGES,COV- ERAGE A.BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions,j. Damage to Prop- erty, Subparagraphs (3), (4)and (5) do not apply to "property damage"to the property of others described therein. With respect to the insurance provided by this section of the endorsement, the fol- lowing additional provisions apply: a.The Limits of Insurance shown in the Declarations are replaced by the lim- its designated in Section B.Limits of Insurance, 6.Voluntary Property Damage and Care,Custody or Control Liability Coverage of this endorsement with respect to cover- age provided by this endorsement. These limits are inclusive of and not in addition to the limits being re- placed. The Limits of Insurance shown in Section B.Limits of Insur- ance, 6.Voluntary Property Dam- age and Care,Custody or Control Liability Coverage of this endorse- ment fix the most we will pay in any one "occurrence" regardless of the number of: (1)Insureds; (2)Claims made or "suits" brought; or (3)Persons or organizations making claims or bringing "suits". b.Deductible Clause (1)Our obligation to pay damages on your behalf applies only to the amount of damages for each "occurrence" which are in ex- DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 10 of 15 cess of the deductible amount stated in Section B.Limits of Insurance, 6.Voluntary Prop- erty Damage and Care,Cus- tody or Control Liability Cov- erage of this endorsement. The limits of insurance will not be re- duced by the application of such deductible amount. (2)Condition 2. Duties in the Event of Occurrence,Offense, Claim or Suit, applies to each claim or "suit" irrespective of the amount. (3)We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the ac- tion taken, you shall promptly re- imburse us for such part of the deductible amount as has been paid by us. 7.180 Day Coverage for Newly Formed or Acquired Organizations SECTION II -WHO IS AN INSURED is amended as follows: Subparagraph a.of Paragraph 4.is hereby deleted and replaced by the fol- lowing: a.Insurance under this provision is af- forded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 8.Waiver of Subrogation SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS,9. Transfer of Rights of Recovery Against Others to Us is hereby amended by the addition of the following: We waive any right of recovery we may have because of payments we make for injury or damage arising out of your ongo- ing operations or "your work" done under a written contract requiring such waiver with that person or organization and in- cluded in the "products-completed opera- tions hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or damage for which we make payment under this Cov- erage Part. The insured must do nothing after a loss to impair our rights. At our request,the insured will bring "suit"or transfer those rights to us and help us en- force those rights. 9.Automatic Additional Insured -Speci- fied Relationships a.The following is hereby added to SECTION II -WHO IS AN INSURED: (1)Any person or organization de- scribed in Paragraph 9.a.(2)be- low (hereinafter referred to as additional insured)whom you are required to add as an addi- tional insured under this Cover- age Part by reason of: (a)A written contract or agree- ment; or (b)An oral agreement or con- tract where a certificate of insurance showing that per- son or organization as an additional insured has been issued, is an insured, provided: (a)The written or oral contract or agreement is: 1)Currently in effect or becomes effective dur- ing the policy period; and 2)Executed prior to an "occurrence" or offense to which this insurance would apply; and (b)They are not specifically named as an additional in- sured under any other pro- vision of, or endorsement added to, this Coverage Part. (2)Only the following persons or organizations are additional in- sureds under this endorsement, and insurance coverage pro- vided to such additional insureds is limited as provided herein: (a)The manager or lessor of a premises leased to you with whom you have agreed per Paragraph 9.a.(1)above to provide insurance, but only with respect to liability aris- ing out of the ownership, maintenance or use of that part of a premises leased to you, subject to the following additional exclusions: This insurance does not ap- ply to: 1)Any "occurrence" which takes place after you cease to be a tenant in that premises. 2)Structural alterations, new construction or demolition operations performed by or on be- DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 11 of 15 half of such additional insured. (b)Any person or organization from which you lease equipment with whom you have agreed per Paragraph 9.a.(1)above to provide in- surance. Such person(s) or organization(s) are insureds solely with respect to their liability arising out of the maintenance, operation or use by you of equipment leased to you by such per- son(s) or organizations(s). However, this insurance does not apply to any "oc- currence" which takes place after the equipment lease expires. (c)Any person or organization (referred to below as ven- dor) with whom you have agreed per Paragraph 9.a.(1)above to provide in- surance, but only with re- spect to "bodily injury"or "property damage" arising out of "your products" which are distributed or sold in the regular course of the ven- dor's business, subject to the following additional ex- clusions: 1)The insurance afforded the vendor does not apply to: a)"Bodily injury" or "property damage" for which the ven- dor is obligated to pay damages by reason of the as- sumption of liabil- ity in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b)Any express war- ranty unauthorized by you; c)Any physical or chemical change in the product made intentionally by the vendor; d)Repackaging, unless unpacked solely for the pur- pose of inspection, demonstration, testing, or the substitution of parts under in- structions from the manufacturer, and then repackaged in the original con- tainer; e)Any failure to make such inspec- tions, adjustments, tests or servicing as the vendor has agreed to make or normally under- takes to make in the usual course of business, in connection with the distribution or sale of the prod- ucts; f)Demonstration,in- stallation, servic- ing or repair op- erations, except such operations performed at the vendor's premises in connection with the sale of the product; g)Products which, after distribution or sale by you, have been labeled or re- labeled or used as a container, part or ingredient of any other thing or sub- stance by or for the vendor. 2)This insurance does not apply to any in- sured person or organi- zation: a)From whom you have acquired such products, or any ingredient, part or container, entering into, ac- companying or containing such products; or b)When liability in- cluded within the "products- completed opera- tions hazard" has DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 12 of 15 been excluded under this Cover- age Part with re- spect to such products. (d)Any state or political subdi- vision with which you have agreed per Paragraph 9.a.(1)above to provide in- surance, subject to the fol- lowing additional provision: This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connec- tion with premises you own, rent or control and to which this insurance applies: 1)The existence, mainte- nance,repair, construc- tion, erection, or re- moval of advertising signs, awnings, cano- pies,cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar exposures; or 2)The construction, erec- tion, or removal of ele- vators; or 3)The ownership, main- tenance, or use of any elevators covered by this insurance. (e)Any state or political subdi- vision with which you have agreed per Paragraph 9.a.(1)above to provide in- surance, subject to the fol- lowing provisions: 1)This insurance applies only with respect to op- erations performed by you or on your behalf for which the state or political subdivision has issued a permit. 2)This insurance does not apply to "bodily in- jury", "property dam- age" or "personal and advertising injury" aris- ing out of operations performed for the state or political subdivision. (f)Any person or organization with which you have agreed per Paragraph 9.a.(1) above to provide insurance, but only with respect to liability arising out of "your work" performed for that additional insured by you or on your behalf.A person or organi- zation's status as an insured under this provision of this endorsement continues for only the period of time re- quired by the written con- tract or agreement, but in no event beyond the expiration date of this Coverage Part. If there is no written contract or agreement,or if no pe- riod of time is required by the written contract or agreement, a person or or- ganization's status as an in- sured under this endorse- ment ends when your op- erations for that insured are completed. (3)Any insurance provided to an additional insured designated under Paragraph 9.a.(2): (a)Subparagraphs (e)and (f) does not apply to "bodily in- jury" or "property damage" included within the "prod- ucts-completed operations hazard"; (b)Subparagraphs (a), (b), (d), (e)and (f)does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the sole negligence or willful misconduct of the ad- ditional insured or their agents, "employees" or any other representative of the additional insured; or (c)Subparagraph (f)does not apply to "bodily injury", "property damage"or "per- sonal and advertising injury" arising out of: 1)Defects in design fur- nished by or on behalf of the additional in- sured; or 2)The rendering of,or failure to render,any professional architec- tural, engineering or surveying services, in- cluding: DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 13 of 15 a)The preparing, approving or fail- ing to prepare or approve maps, shop drawings, opinions, reports, surveys, field or- ders,change or- ders or drawings and specifications; and b)Supervisory,in- spection, architec- tural or engineer- ing activities. 3)"Your work" for which a consolidated (wrap-up) insurance program has been provided by the primecontractor-project manager or owner of the construction project in which you are in- volved. b.Only with regard to insurance pro- vided to an additional insured desig- nated under Paragraph 9.a.(2)Sub- paragraph (f)above, SECTION III - LIMITS OF INSURANCE is amended to include: The limits applicable to the additional insured are those specified in the written contract or agreement or in the Declarations of this Coverage Part,whichever are less. If no limits are specified in the written contract or agreement, or if there is no written contract or agreement, the limits ap- plicable to the additional insured are those specified in the Declarations of this Coverage Part.The limits of in- surance are inclusive of and not in addition to the limits of insurance shown in the Declarations. c.SECTION IV -COMMERCIAL GEN- ERAL LIABILITY CONDITIONS is hereby amended as follows: (1)Condition 5. Other Insurance is amended to include: (a)Where required by a written contract or agreement, this insurance is primary and / or noncontributory as re- spects any other insurance policy issued to the addi- tional insured, and such other insurance policy shall be excess and /or noncon- tributing, whichever applies, with this insurance. (b)Any insurance provided by this endorsement shall be primary to other insurance available to the additional insured except: 1)As otherwise provided in SECTION IV - COMMERCIAL GEN- ERAL LIABILITY CONDITIONS,5. Other Insurance,b. Excess Insurance; or 2)For any other valid and collectible insurance available to the addi- tional insured as an additional insured by attachment of an en- dorsement to another insurance policy that is written on an excess basis. In such case, the coverage provided under this endorsement shall also be excess. (2)Condition 11. Conformance to Specific Written Contract or Agreement is hereby added: 11.Conformance to Specific Written Contract or Agreement With respect to additional insureds described in Para- graph 9.a.(2)(f) above only: If a written contract or agreement between you and the additional insured specifies that coverage for the additional insured: a.Be provided by the In- surance Services Office additional insured form number CG 20 10 or CG 20 37 (where edi- tion specified); or b.Include coverage for completed operations; or c.Include coverage for "your work"; and where the limits or cov- erage provided to the addi- tional insured is more re- strictive than was specifi- cally required in that written contract or agreement, the terms of Paragraphs 9.a.(3)(a), 9.a.(3)(b) or 9.b. above,or any combination thereof, shall be interpreted as providing the limits or coverage required by the terms of the written contract DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 14 of 15 or agreement, but only to the extent that such limits or coverage is included within the terms of the Coverage Part to which this endorse- ment is attached. If, how- ever,the written contract or agreement specifies the In- surance Services Office ad- ditional insured form num- ber CG 20 10 but does not specify which edition, or specifies an edition that does not exist, Paragraphs 9.a.(3)(a)and 9.a.(3)(b)of this endorsement shall not apply and Paragraph 9.b.of this endorsement shall ap- ply. 10.Broadened Contractual Liability -Work Within 50' of Railroad Property It is hereby agreed that Paragraph f.(1)of Definition 12."Insured contract" (SEC- TION V - DEFINITIONS) is deleted. 11.Property Damage to Borrowed Equip- ment a.The following is hereby added to Ex- clusion j. Damage to Property of Paragraph 2., Exclusions of SEC- TION I -COVERAGES, COVERAGE A.BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY: Paragraphs (3)and (4)of this exclu- sion do not apply to tools or equip- ment loaned to you, provided they are not being used to perform opera- tions at the time of loss. b.With respect to the insurance pro- vided by this section of the endorse- ment, the following additional provi- sions apply: (1)The Limits of insurance shown in the Declarations are replaced by the limits designated in Section B.Limits of Insurance, 11.of this endorsement with respect to coverage provided by this en- dorsement. These limits are in- clusive of and not in addition to the limits being replaced.The Limits of Insurance shown in Section B.Limits of Insurance, 11.of this endorsement fix the most we will pay in any one "oc- currence"regardless of the number of: (a)Insureds; (b)Claims made or "suits" brought; or (c)Persons or organizations making claims or bring "suits". (2)Deductible Clause (a)Our obligation to pay dam- ages on your behalf applies only to the amount of dam- ages for each "occurrence" which are in excess of the Deductible amount stated in Section B.Limits of Insur- ance, 11.of this endorse- ment. The limits of insur- ance will not be reduced by the application of such De- ductible amount. (b)Condition 2. Duties in the Event of Occurrence,Of- fense,Claim or Suit, ap- plies to each claim or "suit" irrespective of the amount. (c)We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon no- tification of the action taken, you shall promptly reim- burse us for such part of the deductible amount as has been paid by us. 12.Employees as Insureds -Specified Health Care Services It is hereby agreed that Paragraph 2.a.(1)(d)of SECTION II -WHO IS AN INSURED, does not apply to your "em- ployees" who provide professional health care services on your behalf as duly li- censed: a.Nurses; b.Emergency Medical Technicians; or c.Paramedics, in the jurisdiction where an "occurrence" or offense to which this insurance applies takes place. 13.Broadened Notice of Occurrence Paragraph a.of Condition 2. Duties in the Event of Occurrence,Offense, Claim or Suit (SECTION IV -COMMER- CIAL GENERAL LIABILITY CONDI- TIONS) is hereby deleted and replaced by the following: a.You must see to it that we are noti- fied as soon as practicable of an "oc- currence" or an offense which may result in a claim. To the extent pos- sible, notice should include: (1)How, when and where the "oc- currence" or offense took place; DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission.Page 15 of 15 (2)The names and addresses of any injured persons and wit- nesses; and (3)The nature and location of any injury or damage arising out of the "occurrence" or offense. This requirement applies only when the "occurrence" or offense is known to an "authorized representative". DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission.Page 1 of 4 THIS ENDORSEMENT CHANGES THE POLICY. PLE ASE READ IT CAREFULLY. CinciPlus® BUSINESS AUTO XC+® (EXPANDED COVERAGE PLUS) ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. A.Blanket Waiver of Subrogation SECTION IV -BUSINESS AUTO CONDI- TIONS, A. Lo ss Condition s, 5. Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury"or "property damage"arising out of the operation of a covered "auto"when you have assumed liability for such "bodily injury"or "property damage"under an "insured contract", provid- ed the "bodily injury"or "property damage"oc- curs subsequent to the execution or the "in- sured contract". B.Noncontributory Insurance SECTION IV -BUSINESS AUTO CONDI- TIONS, B. General Conditions, 5. Other In- surance c.is replaced by the following: c.Regardless of the provisions of Par- agraph a.above,this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any lia- bility assumed under an "insured contract"that requires liability to be assumed on a primary noncontributo- ry basis. C.Additional Insured by Contract SECTION II -LIABILITY COVERAGE,A. Coverage, I. Who is an Insured is amended to include as an insured any person or organi- zation with which you have agreed in a valid written contract to provide insurance as is af- forded by this policy. This provision is limited to the scope of the valid written contract. This provision does not apply unless the valid written contract has been: 1.Executed prior to the accident causing "bodily injury"or "property damage"; and 2.Is still in force at the time of the "accident" causing "bodily injury"or "property dam- age". D.Employee Hired Auto 1.Changes in Liability Coverage The following is added to the Section II - Liability Coverage, A.Coverage, 1. Who is an Insured: An "employee"of yours is an "insured" while operating an "auto"hired or rented under a contract or agreement in that "employee's"name, with your permission, while performing duties related to the conduct of your business. 2.Changes in General Conditions SECTION IV -BUSINESS AUTO CON- DITIONS, B. General Co nditions, 5. Other Insurance is amended b y repla c- ing Paragraph 5.b.with the following: b.For Hired Auto Physical Damage Coverage the following are deemed to be covered "autos"you own: (1)Any covered "auto"you l ease, hire, rent or borrow; and (2)Any covered "auto"hired or rented by your "employee"under a contract in that individual "em- ployee's"name, with your per- mission,while performing duties related to the conduct of your business. DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission.Page 2 of 4 However, any "auto"that is leased, hired,rented or borrowed with a driver is not a covered "auto". E.Audio, Visual and Data Electron ic Equip- ment SECTION III -PHYSICAL DAMAGE COV- ERAGE, C. Limit of Insurance is amended by adding the following: 4.The most we will pay for all "loss"to au- dio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "acci- dent"is the lesser of: a.The actual cash value of the dam- aged or stolen property as of the time of the "accident"; b.The cost of repairing or replacing the damaged or stolen property with oth- er property of like kind and quality; or c.$2,500. Provided the equipment, at the time of the "loss"is: a.Permanently installed in or upon the covered "auto"in a housing, opening or other location that is not normally used by the "auto"manufacturer for the installation of such equipment; b.Removable from a permanently in- stalled housing unit as described in Paragraph 2.a.above; or c.An integral part of such equipment. F.Who is an Insured -Amended SECTION II -LIABILITY COVERAGE,A. Coverage, 1. Who is an Insured is amended by adding the following: The following are "insureds": 1.Any subsidiary which is a legally incorpo- rated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of this cover- age form. However, the insurance afforded by this provision does not apply to any subsidiary that is an "insured"under any other au- tomobile liability policy, or would be an "insured"under such policy but for termi- nation of such policy or the exhaustion of such policy's limits of insurance. 2.Any organization that is newly acquired or formed by you and over which you main- tain majority ownership.The insurance provided by this provision: a.Is effective on the date of acquisition or formation, and is afforded for 180 days after such date; b.Does not apply to "bodily injury"or "property damage"resulting from an "accident"that occurred before you acquired or formed the organization; c.Does not apply to any newly acquired or formed organization that is a joint venture or partnership; and d.Does not apply to an insured under any other automobile liability policy, or would be an insured under such a policy but for the termination of such policy or the exhaustion of such poli- cy's limits of insurance. 3.Any of your "employees"while using a covered "auto "in your business or your personal affairs, provided you do not own, hire or borrow that "auto". G.Liability Coverage Extensions -Supple- mentary Payments -Higher Limits SECTION II -LIABILITY COVERAGE,A. Coverage, 2. Coverage Extensions,a. Sup- plementary Payments is amended by: 1.Replacing the $2,000 Limit of Insurance for bail bonds with $4,000 in (2); and 2.Replacing the $250 Limit of Insurance for reasonable expenses with $500 in (4). H.Amended Fellow Employee Exclusion SECTION II -LIABILITY COVERAGE,B. Ex- clusions,5. Fellow Employee is modified as follows: Exclusion 5. Fellow Employee is deleted. I.Hired Auto -Physical Damage If hired "autos"are covered "autos"for Liability Coverage, then Comprehensive and Collision Physical Damage Coverages as provided un- der SECTION III -PHYSICAL DAMAGE COVERAGE of this Coverage Part are ex- tended to "autos"you hire, subject to the fol- lowing: 1.The m ost we will pay for "loss "to any hired "auto"is $50,000 or the actual cash value or cost to repair or replace, which- ever is the least, minus a deductible. 2.The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage, or $1,000, whichever is less. 3.Hired Auto -Physical Damage coverage is excess over any other collectible insur- ance. DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission.Page 3 of 4 4.Subject to the above limit, deductible, and excess provisions we will provide cover- age equal to the broadest coverage appli- cable to any covered "auto"you own i n- sured under this policy. Coverage includes loss of use of that hired au- to, provided it results from an "accident"for which you are legally liable and as a result of which a m onetary loss is sustained by the leasing or rental concern. The most we will pay for any one "accident"is $3,000. If a limit for Hired Auto -Physical Damage is shown in the Schedule, then that limit replac- es, and is not added to, the $50,000 limit indi- cated above. J.Rental Reimbursement SECTION III -PHYSICAL DAMAGE is amended by adding the following: 1.We will pay for rental reimbursement ex- penses incurred by you for the rental of an "auto"because of a "loss "to a covered "auto". Payment applies in addition to the otherwise applicable amount of each cov- erage you have on a covered "auto". No deductible applies to this coverage. 2.We will pay only for those expenses in- curred during the policy period beginning 24 hours after the "loss"and ending, re- gardless of the policy's expiration, with the lesser of the following number of days: a.The number of days reasonably re- quired to repair the covered "auto". If "loss"is caused by theft,this number of days is added to the number of days it takes to locate the covered "auto"and return it to you; or b.30 days. 3.Our payment is limited to the lesser of the following amounts: a.Necessary and actual expenses in- curred; or b.$50 per day. 4.This coverage does not apply while there are spare or reserve "autos"available to you for your operations. 5.We will pay under this coverage only that amount of your rental reimbursement ex- penses which is not already provided for under SECTION III -PHYSICAL DAM- AGE CO VERAGE,A. Coverage, 4. Coverage Extensions. K.Transportation Expense -Higher Limits SECTION III -PHYSICAL DAMAGE COV- ERAGE, A.Co verage, 4. Coverage Exten- sions is amended by replacing $20 per day with $50 per da y, and $600 maximum with $1,500 maxim um in Extension a. Transpor- tation Expenses. L.Airbag Coverage SECTION III -PHYSICAL DAMAGE COV- ERAGE, B. Exclusions, 3.a.is amended by adding the following: However, the mechanical and electrical breakdown portion of this exclusion does not apply to the accidental discharge of an airbag. This coverage for airbags is excess over any other collectible insurance or warranty. M.Loan or Lease Gap Coverage 1.SECTION III -PHYSICAL DAMAGE COVERAGE, C.Limit of Insurance is deleted in its entirety and replaced by the following, but only for private passenger type "autos"with an original loan or lease, and only in the event of a "total loss "to such a private passenger type "auto": a.The most we will pay for "loss"in any one "accident"is the greater of: (1)The amount due under the terms of the lease or loan to which your covered private passenger type "auto"is subject, but will not include: (a)Overdue lease or loan pay- ments; (b)Financial penalties imposed under the lease due to high mileage, excessive use or abnormal wear and tear; (c)Security deposits not re- funded by the lessor; (d)Costs for extended warran- ties, Credit Life Insurance, Health, Accident or Disabil- ity Insurance purchased with the loan or lease; and (e)Carry-over balances from previous loans or leases, or (2)Actual cash value of the stolen or damaged property. b.An adjustment for depreciation and physical condition will be made in d e- termining actual cash value at the time of "loss ". DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission.Page 4 of 4 2.SECTION V -DEFINITIONS is amended by adding the following, but only for the purposes of this Loan or Lease Gap Coverage: "Total loss"means a "loss"in which the cost of repairs plus the salvage value ex- ceeds the actual cash value. N.Glass Repair -Waiver of Deductible SECTION III -PHYSICAL DAMAGE COV- ERAGE, D. Deductible is amended by adding the following: No deductible applies to glass damage if the glass is repaired in a manner acceptable to us rather than replaced. O.Duties in the Event o f an Accident, Claim, Suit or Loss -Amend ed SECTION IV -BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, 2. Duties in the Event of Accident, Claim, Suit or Loss, a.is amended by adding the following: This condition applies only when the "acci- dent"or "loss"is known to: 1.You, if you are an individual; 2.A partner, if you are a partnership; 3.An executive officer or insurance manag- er, if you are a corporation; or 4.A member or manager,if you are a lim- ited liability company. P.Unintentional Failure to Disclose Hazards SECTION IV -BUSINESS AUTO CONDI- TIONS, B.General Conditions, 2. Conceal- ment, Misrepresentation or Fraud is amended by adding the following: However, if you unintentionally fail to disclose any hazards existing on the effective date of this Coverage Form, we will not deny cover- age under this Coverage Form because of such failure. Q.Mental Anguish Resulting from Bod ily Inju- ry SECTION V -DEFINITIONS, C. "Bodily inju- ry"is deleted in its entirety and replaced by the following: "Bodily injury"means bodily injury, sickness or disease sustained by a person, including men- tal anguish and death sustained by the same person that results from such bodily injury, sickness or disease. "Bodily injury"does not include mental anguish or death that does not result from bodily injury, sickness or disease. R.Coverage for Certain Op erations in Con- nection with Railroads With respect to the use of a covered "auto"in operations for or affecting a railroad: 1.Section V -Definition s, H."Insured con- tract", 1.c.is amended to read: c.An easement or license agreement; 2.Section V -Definition s, H. "Insured con- tract",2.a.is deleted. DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 IA 4087 08 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION OR NONRENEWAL BY US NOTIFICATION TO A DESIGNATED ENTITY This endorsement modifies insurance provided under the following: BUSINESSOWNERS PACKAGE POLICY CLAIMS-MADE EXCESS LIABILITY COVERAGE PART COMMERCIAL AUTO COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL UMBRELLA LIABILITY COVERAGE PART DENTIST'S PACKAGE POLICY EXCESS LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART - CLAIMS-MADE SCHEDULE Name and mailing address of person(s)or organization(s): Number of days notice (other than nonpayment of premium): A.If we cancel or nonrenew this policy for anystatutorily permitted reason other than nonpayment of premium we will mail notice to the person or organization shown in the Schedule.W e will mail such notice at least the number of days shown in the Schedule before the effective date of cancellation or nonrenewal. B.If we cancel this policy for nonpayment of premium, we will mail notice to the person or organization shown in the Schedule.W e will mail such notice at least 10 days before the effective date of cancellation. C.If notice is mailed,proof of mailing to the mailing address shown in the Schedule will be sufficient proof of notice. D.In no event will coverage extend beyond the actual expiration, termination or cancellation of the policy. 1. FOR WHOM YOU ARE REQUIRED IN A WRITTEN CONTRACT THAT WAS EXECUTED ON OR AFTER THE EARLIER OF THE FOLLOWING DATES: A. THE EFFECTIVE DATE OF THIS POLICY, OR B. THE EFFECTIVE DATE OF THE ORIGINAL POLICY OF WHICH THIS POLICY IS A RENEWAL OR REPLACEMENT, AND 2. FOR WHOM YOU ARE REQUIRED IN THAT SAME WRITTEN CONTRACT AS REFERRED TO IN 1. ABOVE TO PROVIDE CANCELLATION NOTICE. 30 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: 49EB949C-0CF5-43D C - 9 8 5 2 - 3 3 7 9 A A 4 7 3 0 B 9 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: 49EB949C-0CF5-43DC-9852-3379AA4730B9 DocuSign Envelope ID: FEBF9D55-4CC8-48C5-AECF-D95A5577032E NOTICE OF AWARD AIL CONTRACTS AND Contractor: Mako Contracting, LLC PROCUREMENT Project: 18029A Lipes Blvd. —Yorktown to Sunwood DEPARTMENT This notice serves as confirmation of award of the referenced Project, to your firm, by the Corpus PO Box 9277 Christi City Council on June 9, 2020 in the amount of $2,023,240.09. Contractor is instructed to Corpus Christi execute all necessary forms and submit all required documentation as outlined in the contract Texas, 78469-9277 document. Phone: The executed agreement and all required insurance and bond submittals are due back to this 361.826.3160 office within 10 calendar days of receipt. A Pre-Construction Meeting will be scheduled within two weeks of returning required contract submittals, pending final execution of the contract. The following document submittals are required to execute the contract: Form 1295 — The State of Texas requires contractor to complete, sign and submit a copy of the Texas Ethics Commission Form 1295, Certificate of Interested Parties. The state website is: www.ethics.state.tx.us Agreement—A completed and filled out agreement form has been provided for your digital signature. The agreement form shall be digitally signed by an authorized officer of the company. Submit signature authority documentation. Performance and Payment Bond—Competed and filled out bond forms have been provided for your physical signature. The bonds cannot be digitally signed. Submit one set of executed hard copy originals. Insurance—Refer to the contract documents, Section 00 73 00,Article 6, for insurance requirements and submit proof of coverage. Submittals will include a Certificate of Insurance referencing the project name and number and all applicable endorsements to the policies. Please contact Sylvia Arriaga, Construction Contracts Administrator, if you have any questions regarding this information. DocuSigned by: V"_Q_ Bim, 6/10/2020 Kim Baker, Director of Contracts and Procurement Date RETURN DOCUMENTS TO: Sylvia Arriaga—Construction Contracts Administrator City of Corpus Christi —Contracts and Procurement 1201 Leopard St. -City Hall, First Floor Corpus Christi, TX 78469-9277 DocuSign Envelope ID:87AB6078-E43D-4E69-BAOF-CAC77ED1 D97B NOTICE TO PROCEED Contractor: Mako Contracting, LLC Project: 18029A Lipes Blvd -Yorktown to Sunwood CONTRACTS AND This notice serves as authorization to begin construction on the referenced project. Contractor PROCUREMENT has been provided an electronic copy of the executed Contract Document. Contractor shall DEPARTMENT begin construction on August 10, 2020. You are hereby advised that all project signs, barricading and signage as required by the plans and specifications, shall be in place and PO Box 9277 approved prior to beginning construction operations. As provided in the contract documents, Corpus Christi all work on this project is to be completed within 150 calendar days,after construction is begun. Texas, 78469-9277 Resident inspection on the project will be provided by the City's Engineering Department Phone: Construction Division. Please notify your designated Construction Inspector 48 hours prior to 361.826.3160 beginning construction. Key dates related to completion of construction, and associated liquidated damages are listed below. DocuSigned by: Issued By:55 9Date: � - 7/31/2020 181C3EWD0344F... Kim Baker, Director of Contracts and Procurement Milestone Dates: Date of Notice to Proceed with Construction August 10, 2020 Anticipated Date of Completion January 7, 2021 Contract Time Calendar Days 150 Cal Days (substantial) 180 Cal Days (final) Liquidated Damages $ 2,000/day (substantial) $ 400 /day (final) Distribution List: Jeff Edmonds, Dir. Engr. Michael Rodriguez, Chief of Staff Claudia Pena, Engr Brett Van Hazel, Constr Kim Baker, CAP Maria Pedraza, CAP Ratna Pottumuthu, Engr Construction Inspectors Construction MAs Design Consult Sylvia Arriaga, CAP Clarissa Johnson,CAP Lynda Herndon, Engr Stacey Pillinger, Engr Zenona Casas, Engr Hilda Mihalco, Engr Sandra Gomez Larijai Francis, Engr Mail Bernal Angelica Garza, CAP Grace Limas, CAP Utilities Mail Box Gerald Garcia, Util Daniel Deng, Util William Creech, Util Brittany Mouttet, Util Maria Godina, Engr Gabriel Ramirez, Util Dan Grimsbo, Util Fred Pena, Util Sarah Munoz, Streets Renee Couture,Traffic Tony Salinas,Traffic Signals Sonny Garza, Land Acq Robert Rocha, Fire Joe Johnson, Parks&Rec Becky Perrin, Parks&Rec Jim Davis,Asset Mgr Charles Mendoza,Asset Mgt David Lehfeldt, Solid Wste Philip Aldridge, Solid Wste Keith Rodriguez, Gas Robert Robles, MIS Peter Collins, IT Richard Martinez,Streets 006113 PERFORMANCE BOND BOND NO. 1001149044 Contractor as Principal Surety Name: Mako Contracting,LLC Name: U.S.Specialty Insurance Company Mailing address(principal place of business): Mailing address(principal place of business): 3636 S.Alameda,Ste,B-153 13403 Northwest Freeway Corpus Christi,TX 78411 Houston,TX 77040 Physical address (principal place of business): Owner 13403 Northwest Freeway Name: City of Corpus Christi,Texas Houston,TX 77040 Mailing address(principal place of business): Engineering Services Surety is a corporation organized and existing 1201 Leopard Street under the laws of the state of: TX Corpus Christi,Texas 78469 By submitting this Bond,Surety affirms its authority to do business in the State of Texas and Contract its license to execute bonds in the State of Texas. Project name and number: Telephone(main number): Proiect No. 18029A 713-744-3700 Lipes Blvd.—Yorktown Blvd.to Sunwood Dr. Telephone(for notice of claim): 713-744-3700 Local Agent for Surety Name: Robert G. Kanuth Award Date of the Contract: June 9.2019 Address: 1814 Holly Road Contract Price: L2,023,240.09 Corpus Christi,TX 78417 Bond Telephone: 940/367-6205 Email Address: rkanuth@kandsins.com Date of Bond: July 6, 2020 The address of the surety company to which any notice of claim should be sent may be obtained C (Date Bond cannot be earlier than Award Date from the Texas Dept. of Insurance by calling the of the Contract) following toll-free number.1-800-252-3439 Performance Bond 006113-1 Lipes Blvd—Yorktown to Sunwood 18029A 7-8-2014 Surety and Contractor, intending to be legally bound and obligated to Owner do each cause this Performance Bond to be duly executed on its behalf by its authorized officer, agent or representative. The Principal and Surety bind themselves, and their heirs, administrators, executors, successors and assigns,jointly and severally to this bond. The condition of this obligation is such that if the Contractor as Principal faithfully performs the Work required by the Contract then this obligation shall be null and void;otherwise the obligation is to remain in full force and effect. Provisions of the bond shall be pursuant to the terms and provisions of Chapter 2253 and Chapter 2269 of the Texas Government Code as amended and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter to the same extent as if it were copied at length herein. Venue shall lie exclusively in Nueces County, Texas for any legal action. Contractor as Principa Surety Signature: /f Signatur Name: Name: Mistie Beck Title: �tr_51 Title: Attorney-in-Fact Email Address: Email Address: mbeck@kandsins.com (Attach Power of Attorney and place surety seal below) END OF SECTION Performance Bond 0061 13-2 Lipes Blvd—Yorktown to Sunwood 18029A 7-8-2014 TOKIO MARI N E HCC POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation,Texas Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, a Maryland corporation and U.S. Specialty Insurance Company, a Texas corporation (collectively, the"Companies"), do by these presents make, constitute and appoint: Johnny Moss, Jay Jordan, Tony Fierro, Jeremy Barnett, Jade Porter, Mistie Beck, Robert G. Kanuth or Jarrett Willson of Rockwall, Texas its true and lawful Attorney(s)-in-fact, each in their separate capacity if more than one is named above, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond penalty does not exceed **'**Ten Million***** Dollars (***510,000,000.00*'* ).This Power of Attorney shall expire without further action on April 23rd,2022.This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved,that the President,any Vice-President, any Assistant Vice-President,any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attorney-in-Fact may be given full power and authority for and in the name of and on behalf of the Company,to execute,acknowledge and deliver,any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or oblcgatory undertakings, including any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder,and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 1st day of June, 2018. AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STA'TES,SURETY,COMPANY U.S.S.PECIAL,TY4N$URANCE COMPANY _ p UR,�ti; �i.. C� �5k5�Rf lF 'ti j y •::ac State of California r; County of Los Angeles -` s,. y, F s By: Daniel P. Aguilar,Vice President A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document On this 1 I day of June, 2018, before me, Sonia 0. Carrejo, a notary public, personally appeared Daniel P.Aguilar, Vice President of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal., saNuo.ux2ea Ho[ery Pubilc-Cetlfwnl ��� Let aipelrs LccntY t_ Ccmmhsfon i 7779e74 Signature (seal) µy C"m.ryptlrn 1p 17,loll I, Kio Lo, Assistant Secretary American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies, which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witness Whereof, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this day of Corporate Seals 4a�tiRAC.9'o" ' 4p�o�g Bond No. _ ti3 y `Fy r Agency No. 17042 .'_ Kia Lo, Assi Secretary HC CSMANPOAOS.*ir19 visit tmhcc.com/surety for more information - � I E; | §$2($ // � � © � ■&a»E � � . ■ate■" ! 2� �ƒ�)■$a , � � JE�E• �a . (E � ¢(7({ . . . . 1 F . §§ \2k � ( � -° J#AEJ k § ' : JEal J!£� , a E0 ] ! {J%¥\ 3 < - . ' ƒ# j •m . .y.. © ' � U.S. Specialty Insurance Company TEXAS COMPLAINT NOTICE IMPORTANT NOTICE AVISO IMPORTANTE 1. To obtain information or make a complaint: Para obtener informacion o para someter una queja: 2. You may contact your agent. Puede comunicarse con su agente. 3. You may call the company's toll free telephone Usted puede llamar al numero de telefono gratis number for information or to make a complaint at: de la compania's para informacion o para someter una queja al: 1-800-486-6695 1-800-486-6695 4. You may also write to the company at: Usted tambien puede escribir a la compahia: 801 S. Figueroa Street,Suite 700 801 S.Figueroa Street,Suite 700 Los Angeles,CA 90017 Los Angeles,CA 90017 5. You may contact the Texas Department of Puede comunicarse con el Departamento de Insurance to obtain information on companies, Seguros de Texas para obtener informacion acerca coverages,rights,or complaints at: de companias,coberturas,derechos,o quejas al: 1-800-252-3439 1-800-252-3439 6. You may write to the Texas Department of Puede escribir al Departamento de Seguros de Insurance at: Texas al: Consumer Protection(111-1A) Consumer Protection(111-1A) P.O.Box 149091 P.O.Box 149091 Austin,TX 78714-9091 Austin,TX 78714-9091 Fax No.(512)490-1007 Fax No.(512)490-1007 Web:hM://www.tdi.texas.eov Web:http://www.tdi.state.tx.us E-mail:ConsumerProtection&di.texas.gov E-mail:ConsumerProtectionna tdi.texas.gov 7. PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS: Should you have a dispute concerning your Si tiene una disputa concerniente a su prima o a premium or about a claim you should contact the un reclamo,debe comunicarse con el agente o la agent or the company first.If the dispute is not compania primero. Si no se resuelve la disputa, resolved,you may contact the Texas Department puede entonces comunicarse con el departamento of Insurance. (TDI)_ 8. ATTACH THIS NOTICE TO YOUR POLICY UNA ESTE AVISO A SU POLIZA This notice is for information only and does not Esta aviso es solo para proposito de information y become a part or condition of the attached no se convierte en parte o condicion del document. documento adjunto. HUSTWONS/HI 00 61 16 PAYMENT BOND BOND NO. 1001149044 Contractor as Principal Surety Name: Mako Contracting, LLC Name: U.S. Specialty Insurance Company Mailing address (principal place of business): Mailing address (principal place of business): 3636 S.Alameda, Ste. B-153 13403 Northwest Freeway Corpus Christi,TX 78411 Houston, TX 77040 Physical address (principal place of business): Owner 13403 Northwest Freeway Name: City of Corpus Christi, Texas Houston,TX 77040 Mailing address (principal place of business): Engineering Services Surety is a corporation organized and existing 1201 Leopard Street under the laws of the state of: TX Corpus Christi, Texas 78469 By submitting this Bond, Surety affirms its authority to do business in the State of Texas and Contract its license to execute bonds in the State of Texas. Project name and number: Telephone (main number): Project No. 18029A 713-744-3700 Lipes Blvd.—Yorktown Blvd. to Sunwood Dr. Telephone (for notice of claim): 713-744-3700 Local Agent for Surety Name: Robert G. Kanuth Award Date of the Contract: June 9, 2020 Address: 1814 Holly Road Contract Price: $2,023,240.09 Corpus Christi,TX 78417 Bond Telephone: 940/367-6205 Email Address: rkanuth@kandsins,com Date of Bond: July 6, 2020 The address of the surety company to which any (Date of Bond cannot be earlier than Aword Date notice of claim should be sent may be obtained of Contract) from the Texas Dept. of Insurance by calling the following toll-free number:1-800-252-3439 Payment Bond Form 006116- 1 Lipes Bvd—Yorktown to Sunwood—Proj 18029A 7-8-2014 Surety and Contractor, intending to be legally bound and obligated to Owner do each cause this Payment Bond to be duly executed on its behalf by its authorized officer, agent or representative. The Principal and Surety bind themselves, and their heirs, administrators, executors,successors and assigns,jointly and severally to this bond. The condition of this obligation is such that if the Contractor as Principal pays all claimants providing labor or materials to him or to a Subcontractor in the prosecution of the Work required by the Contract then this obligation shall be null and void;otherwise the obligation is to remain in full force and effect. Provisions of the bond shall be pursuant to the terms and provisions of Chapter 2253 and Chapter 2269 of the Texas Government Code as amended and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter to the same extent as if it were copied at length herein. Venue shall lie exclusively in Nueces County, Texas for any legal action. Contractor as Princip Surety Signature: gg Signature: - Name: �jc. srir�r �ct'LC Name: Mistie Beck Title: �r�- Title: Attorney-in-Fact Email Address: �4C-vNdrRcdtEmail Address: mbeck@kandsins.com (Attach Power of Attorney and place surety seal below) END OF SECTION Payment Bond Form 00 61 16- 2 Lipes Bvd-Yorktown to Sunwood-Proj 18029A 7-8-2014 TOKEOMARINE HCC POWER OF ATTORNEY AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STATES SURETY COMPANY U.S. SPECIALTY INSURANCE COMPANY KNOW ALL MEN BY THESE PRESENTS: That American Contractors Indemnity Company, a California corporation, Texas Bonding Company, an assumed name of American Contractors Indemnity Company, United States Surety Company, a Maryland corporation and U.S. Specialty Insurance Company, a Texas corporation (collectively, the "Companies"), do by these presents make, constitute and appoint: Johnny Mass, Jay Jordan, Tony Fierro, Jeremy Barnett, Jade Porter, Mistie Beck, Robert G. Kanuth or Jarrett Willson of Rockwall, Texas its true and lawful Attorney(s)-in-fact, each in their separate capacity if more than one is named above, with full power and authority hereby conferred in its name, place and stead, to execute, acknowledge and deliver any and all bonds, recognizances, undertakings or other instruments or contracts of suretyship to include riders, amendments, and consents of surety, providing the bond penalty does not exceed *****Ten Million***** Dollars (*"510,000,000.00*** ).This Powerof Attorney shall expire without further action on April 23r11,2022,This Power of Attorney is granted under and by authority of the following resolutions adopted by the Boards of Directors of the Companies: Be it Resolved,that the President, any Vice-President,any Assistant Vice-President, any Secretary or any Assistant Secretary shall be and is hereby vested with full power and authority to appoint any one or more suitable persons as Attorneys)-in-Fact to represent and act for and on behalf of the Company subject to the following provisions: Attomey-in-Fact may be given full power and authority for and in the name of and on behaif of the Company,to execute,acknowledge and deliver,any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any and all consents for the release of retained percentages andlor final estimates on engineering and construction contracts, and any and all notices and documents canceling or terminating the Company's liability thereunder,and any such instruments so executed by any such Attorney-in-Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary. Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney or any certificate relating thereto by facsimile,and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be valid and binding upon the Company with respect to any bond or undertaking to which it is attached. IN WITNESS WHEREOF, The Companies have caused this instrument to be signed and their corporate seals to be hereto affixed,this 15S day of June, 2018. AMERICAN CONTRACTORS INDEMNITY COMPANY TEXAS BONDING COMPANY UNITED STA S,SURETY-,COMPANY .U.S.SPEC IALTYdN$URANCE COMPANY '}px -air o"' c gE55UR(l •: State of California County of Los Angeles ';.,, n �;..?�`� . ' By: Daniel P.Aguilar,Vice President A Notary Public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document On this 151 day of June, 2018, before me, Sonia O. Carrejo, a notary public, personally appeared Daniel P. Aguilar, Vice President of American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S. Specialty Insurance Company who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. //� , Sd IA 0.G3Meh7 • 1•'�1�i.� f�otery fchac-(a:rfarz•e i:{�`: Lot Ange:es Ccu1y Cc:eads+br7 sihli} M G m,izglrrs FDr i),]dl: Signature (seal) r -^ I, Kia Lo, Assistant Secretary American Contractors Indemnity Company, Texas Bonding Company, United States Surety Company and U.S.Specialty Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by said Companies,which is still in full force and effect; furthermore, the resolutions of the Boards of Directors, set out in the Power of Attorney are in full force and effect. In Witpess Whereof, I have hereunto set my hand and affixed the seals of said Companies at Los Angeles, California this day of. "ppC>'pp �R�dP� g SUR ................. ainy.... Corporate Seals Bond No. V) \\"(A nn i. *' �� ,.._., r 4 s Kio Lo, Assi Secreta Agency No. 17042 '� �,_� ` ;+, w* HCC°MANP0A05,'=:719 visit tmhce.comisurety for more information x @:: I _ o m'o m e I fIf o m e YQ � u3TeLLa i ya w3V, eLL.- g _ a co Sm a r as c�3oae as c�,'oc2p L, O 'u U �Z u- +T -00 or m— c u sUdr•6win�Q '• ! c qu. =U¢�waJ� `¢�� Y Cl) 03 j x2 O. c O i Q ;c 7 m 0 ` 40 m i a o m e i i € U e Ym >.a. I Y a L i a 3aLLco I ! $ aa_ca i m ac� om�'c � i 3 I as c�._ c aLL I ca ro� U auk. I Y �`o�YY_sW � Q9_ i I yE aoc � � ev I 1 U.S. Specialty Insurance Company TEXAS COMPLAINT NOTICE IMPORTANT NOTICE AVISO IMPORTANTE 1. To obtain information or make a complaint: Para obtener informacion o para someter una queja: 2. You may contact your agent. Puede comunicarse con su agente. 3. You may call the company's toll free telephone Usted puede llamar al numero de telefono gratis number for information or to make a complaint at: de la compania's para informacion o para someter una queja al: 1-800-486-6695 1-800-486-6695 4. You may also write to the company at: Usted tambien puede escribir a la compafifa: 801 S.Figueroa Street,Suite 700 801 S. Figueroa Street, Suite 700 Los Angeles,CA 90017 Los Angeles,CA 90017 5. You may contact the Texas Department of Puede comunicarse con el Departamento de Insurance to obtain information on companies, Seguros de Texas para obtener informacion acerca coverages,rights,or complaints at: de companias,coberturas,derechos,o quejas al: 1-800-252-3439 1-800-252-3439 6. You may write to the Texas Department of Puede escribir al Departamento de Seguros de Insurance at: Texas al: Consumer Protection(111-1A) Consumer Protection(111-1A) P.O.Box 149091 P.O.Box 149091 Austin,TX 78714-9091 Austin,TX 78714-9091 Fax No.(512)490-1007 Fax No.(512)490-1007 Web:h=://www.tdi.texas.eov Web:http://www.tdi.state.tx.us E-mail: ConsumerProtectionaa.tdi.texas.gov E-mail:ConsumerProtectionatdi.texas.izov 7. PREMIUM OR CLAIM DISPUTES: DISPUTAS SOBRE PRIMAS O RECLAMOS: Should you have a dispute concerning your Si tiene una disputa concerniente a su prima o a premium or about a claim you should contact the un reclamo,debe comunicarse con el agente o la agent or the company first.If the dispute is not companea primero.Si no se resuelve la disputa, resolved,you may contact the Texas Department puede entonces comunicarse con el departamento of Insurance. (TDI), 8. ATTACH THIS NOTICE TO YOUR POLICY UNA ESTE AVISO A SU POLIZA This notice is for information only and does not Esta aviso es solo para proposito de informacion y become a part or condition of the attached no se convierte en parte o condicion del document. documento adjunto. HCCSTXM(XXIWiu DATE(MM/DD/YYYY) ACS" CERTIFICATE OF LIABILITY INSURANCE 07/07/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the 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 Natasha Felts NAME: K&S Insurance Agency PHONE (g72)772-7256 FAX (972)771-4695 (AC, C No Ext): A/C,No 2255 Ridge Road,Ste.333 E-MAIL nfelts@kandsins.com ADDRESS: P.O. Box 277 INSURER(S)AFFORDING COVERAGE NAIC# Rockwall TX 75087 INSURER A: The Cincinnati Insurance Co. 10677 INSURED INSURER B: Hanover Insurance Company 22292 Mako Contracting LLC INSURER C: 3636 Alameda INSURER D: Suite B#153 INSURER E: Corpus Christi TX 78411 INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDrence $ 500,000 MED EXP(Any one person) $ 10,000 A EPP0305105 01/27/2020 01/27/2021 PERSONAL&ADV INJURY $ 1'000'000 MOTHER LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2'000'000 POLICY PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED EBA0305105 01/27/2020 01/27/2021 BODI LY I NJ U RY(Pe r accide nt) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2'000'000 A EXCESS LAB CLAIMS-MADE EPP0305105 01/27/2020 01/27/2021 AGGREGATE $ 2'000'000 DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE F I ER ANY PROPRIETOR/PARTNER/EXECUTIVEElN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E .DISEASE-POLICY LIMIT $ Contractor's Equipment B IHD D477988 01/27/2020 01/27/2021 Leased/Rented Equip $250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) [Job#: Job Type:City Project#18029A Lipes BLVD Project] See attached for additional information. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Corpus Christi ACCORDANCE WITH THE POLICY PROVISIONS. 1201 Leopard St. AUTHORIZED REPRESENTATIVE Corpus Christi TX 78401 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: .r..� LOC#: ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED K&S Insurance Agency Mako Contracting LLC POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance: Notes Additional Insured and Waiver of Subrogation Form#GA233 02/07 Applies to the General Liability Policy. Primary&Non-Contributory Form#GA233 02/07 Applies to the General Liability Policy. Additional Insured and Waiver of Subrogation Form#AA288 01/16 Applies to the Business Auto Policy. `ALWAYS REFER TO THE ATTACHED POLICY FORMS FOR SPECIFIC WORDING OF SUCH COVERAGE, LIMITS,CONDITIONS&EXCLUSIONS. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 77/8/2020 E(MM/DD/YYYY) 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). CONT PRODUCER Sunz Insurance Solutions, LLC ID: (Halcyon HR Inc) NAMEACT Mark Denman C/o Halcyon HR Inc A//CNNo Ext: 262-504-3843 FAX No: 262-886-3947 522 Scotland Drive E-MAIL Corpus Christi,TX 78418 ADDRESS: mdenman@robertsonryan.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: United Wisconsin Insurance Company 29157 INSURED INSURER B: Halcyon HR Inc 522 Scotland Drive INSURERC: Corpus Christi TX 78418 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 56462978 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 POLICY NUMBER MM/DD MM/DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 1:1PREMISES OCCUR DAMAGETOEaRENTEDoccurrence $ MED EXP(Any one person) $ PERSONAL R ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D PRO JECT � LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED 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 accident UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC536-00001-019-SZ 10/1/2019 10/1/2020 �/ STATUTE EERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ 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 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Coverage Provided for all covered employees but not subcontractors of:Mako Contracting LLC Effective: 10/1/2018 Waiver of Subrogation in favor of all persons or organizations as required by written contract executed prior to the date of loss. Blanket waiver of subrogation applies as defined by the attached endorsement. Project:#18029A-Lipes Blvd.Project-TX CERTIFICATE HOLDER CANCELLATION 782 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Corpus Christi THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1201 Leopard St. ACCORDANCE WITH THE POLICY PROVISIONS. Corpus Christi TX 78401 AUTHORIZED REPRESENTATIVE Rick Leonard ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 56462978 1 Halcyon HE PEO 536 WOS BLANKET TX420601 I Brittnee Campos 17/8/2020 8:41:08 AM (EDT) I Page 1 of 3 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B (Ed. 06-2014) Texas Waiver of Our Right to Recover From Others Endorsement This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization (x ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: All Texas Operations 3. Premium: The premium charge for this endorsement shall be 2% percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 10/01/2019 Policy No. Endorsement No.56462978 Insured WC536-00001-019-SZ Premium Halcyon HR Inc Insurance Company Countersigned by United Wisconsin Insurance Company WC420304B (Ed. 06-2014) 1 of 1 56462978ICH c n BE PEO 536 WOS BLANKET X420 01l$B Blorlttnee CamposnC.7�II RighosBReseoaetli (EDT) Page 2 of 3 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 06 01 (Ed. 1-94) TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. In the event of cancelation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of days advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule 1. Number of days advance notice: 30 Days 2. Notice will be mailed to: City of Corpus Christi 1201 Leopard St. Corpus Christi TX 78401 This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 10/01/2019 Policy No.WC536-00001-019-Sz Endorsement No. 56462978 Insured Premium: Halcyon HR Inc Insurance Company Countersigned by United Wisconsin Insurance Company WC 42 06 01 (Ed. 1-94) ©Copyright 2014 National Council on Compensation Insurance,Inc.All Rights Reserved 56462978 Halcyon HE PEO 536 WOS BLANKET TX423601 I Britt- Campos 17/8/2020 8:41:08 AM (EDT) I Page 3 of 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS' COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement -Table of Contents: Coverage: Begins on Page: 1. Employee Benefit Liability Coverage.................................................................................................2 2. Unintentional Failure to Disclose Hazards.........................................................................................7 3. Damage to Premises Rented to You.................................................................................................8 4. Supplementary Payments..................................................................................................................9 5. Medical Payments..............................................................................................................................9 6. Voluntary Property Damage(Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.).......................................................................................................9 7. 180 Day Coverage for Newly Formed or Acquired Organizations...................................................10 8. Waiver of Subrogation .....................................................................................................................10 9. Automatic Additional Insured -Specified Relationships: ...............................................................10 • Managers or Lessors of Premises; • Lessor of Leased Equipment; • Vendors; • State or Political Subdivisions- Permits Relating to Premises; • State or Political Subdivisions- Permits; and • Contractors' Operations 10. Broadened Contractual Liability -Work Within 50' of Railroad Property.........................................14 11. Property Damage to Borrowed Equipment......................................................................................14 12. Employees as Insureds-Specified Health Care Services: ...........................................................14 • Nurses; • Emergency Medical Technicians; and • Paramedics 13. Broadened Notice of Occurrence....................................................................................................14 B. Limits of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $ 1,000,000 Aggregate Limit: $ 3,000,000 Deductible: $ 1,000 3. Damage to Premises Rented to You The lesser of: a. The Each Occurrence Limit shown in the Declarations; or b. $500,000 unless otherwise stated $ 4. Supplementary Payments a. Bail bonds: $ 1,000 b. Loss of earnings: $ 350 5. Medical Payments Medical Expense Limit: $ 10,000 Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 1 of 15 6. Voluntary Property Damage (Coverage a.) and Care, Custody or Control Liability Coverage (Coverage b.) Limits of Insurance (Each Occurrence) Coverage a.$1,000 Coverage b.$5,000 unless otherwise stated $ Deductibles(Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS RATE ADVANCE PREMIUM (a) Area (For Limits in Excess of (For Limits in Excess of (b) Payroll $5,000) $5,000) (c) Gross Sales (d) Units e Other b. Care, Custody $ or Control TOTAL ANNUAL PREMIUM 11. Property Damage to Borrowed Equipment Each Occurrence Limit: $ 10,000 Deductible: $ 250 C. Coverages: have used up the appli- cable limit of insurance 1. Employee Benefit Liability Coverage in the payment of a. The following is added to SECTION I judgments or settle- - COVERAGES: Employee Benefit ments. Liability Coverage. No other obligation or liabil- (1) Insuring Agreement ity to pay sums or perform acts or services is covered (a) We will pay those sums that unless explicitly provided for the insured becomes legally under Supplementary Pay- obligated to pay as dam- ments. ages caused by any act, er- This insurance applies to ror or omission of the in- (b) sured, or of any other per- damages only if the act, er- ror gli- son for whose acts the in- gently or omission, is nently committed in the sured is legally liable, to ge which this insurance aadministration" of your plies. We will have the right "employee benefit pro- and duty to defend the in- sured against any "suit' 1) Occurs during the pol- seeking those damages. icy period; or However, we will have no duty to defend against any 2) Occurred prior to the "suit" seeking damages to effective date of this which this insurance does endorsement provided: not apply. We may, at our discretion, investigate any a) You did not have report of an act, error or knowledge of a omission and settle any claim or "suit" on claim or "suit" that may re- or before the ef- sult. But: fective date of this endorsement. 1) The amount we will pay for damages is limited You will be as described in SEC- deemed to have TION III - LIMITS OF knowledge of a INSURANCE; and claim or suit when any "author- 2) Our right and duty to ized representa- defend ends when we tive"; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 2 of 15 i) Reports all, or formance of investment any part, of the vehicles; or act, error or omission to us 3) Advice given to any or any other person with respect to insurer; that person's decision to participate or not to ii) Receives a participate in any plan written or ver- included in the "em- bal demand or ployee benefit pro- claim for dam- gram". ages because of the act, er- (f) Workers' Compensation ror or omis- and Similar Laws sion; and Any claim arising out of your b) There is no other failure to comply with the applicable insur- mandatory provisions of any ance. workers' compensation, un- employment compensation (2) Exclusions insurance, social security or disability benefits law or any This insurance does not apply similar law. to: (a) Bodily Injury, Property (g) ERISA Damage or Personal and Damages for which any in- Advertising Injury sured is liable because of li- ability imposed on a fiduci- 'Bodily injury", "property ary by the Employee Re- damage,, or "personal and tirement Income Security advertising injury". Act of 1974, as now or (b) Dishonest, Fraudulent, hereafter amended, or by Criminal or Malicious Act any similar federal, state or local laws. Damages arising out of any (h) Available Benefits intentional, dishonest, fraudulent, criminal or mali- Any claim for benefits to the cious act, error or omission, extent that such benefits are committed by any insured, available, with reasonable including the willful or reck- effort and cooperation of the less violation of any statute. insured, from the applicable (c) Failure to Perform a Con- funds accrued or other col- tract lectible insurance. Damages arising out of fail- (i) Taxes, Fines or Penalties ure of performance of con- Taxes, fines or penalties, tract by any insurer. including those imposed (d) Insufficiency of Funds under the Internal Revenue Code or any similar state or Damages arising out of an local law. insufficiency of funds to meet any obligations under (j) Employment-Related any plan included in the Practices "employee benefit pro- Any liability arising out of gram". any: (e) Inadequacy of Perform- (1) Refusal to employ; ance of Investment / Ad- vice Given With Respect (2) Termination of em- to Participation ployment; Any claim based upon: (3) Coercion, demotion, 1 Failure of an invest- evaluation, reassign- ) y ment, discipline, defa- ment to perform; mation, harassment, 2) Errors in providing in- humiliation, discrimina- formation on past per- tion or other employ- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 3 of 15 ment-related practices, (e) A trust, you are an insured. acts or omissions; or Your trustees are also in- 4 Consequential liability sureds, but only with re- ( ) eq ty spect to their duties as trus- as a result of(1), (2) or tees. (3) above. (2) Each of the following is also an This exclusion applies insured: whether the insured may be held liable as an employer (a) Each of your "employees" or in any other capacity and who is or was authorized to to any obligation to share administer your "employee damages with or repay benefit program". someone else who must pay damages because of (b) Any persons, organizations the injury. or "employees" having proper temporary authoriza- (3) Supplementary Payments tion to administer your "em- ployee benefit program" if SUPPLEMENTARY PAY- you die, but only until your MENTS -COVERAGES A AND legal representative is ap- B also apply to this Coverage. pointed. b. Who is an Insured (c) Your legal representative if you die, but only with re- As respects Employee Benefit Liabil- spect to duties as such. ity Coverage, SECTION II -WHO IS That representative will AN INSURED is deleted in its en- have all your rights and du- tirety and replaced by the following: ties under this Coverage Part. (1) If you are designated in the Dec- larations as: (3) Any organization you newly ac- quire or form, other than a part- (a) An individual, you and your nership, joint venture or limited spouse are insureds, but liability company, and over only with respect to the con- which you maintain ownership or duct of a business of which majority interest, will qualify as a you are the sole owner. Named Insured if no other simi- lar insurance applies to that or- (b) A partnership or joint ven- ganization. However, coverage ture, you are an insured. under this provision: Your members, your part- ners, and their spouses are (a) Is afforded only until the also insureds but only with 180th day after you acquire respect to the conduct of or form the organization or your business. the end of the policy period, (c) A limited liability company, whichever is earlier; and you are an insured. Your (b) Does not apply to any act, members are also insureds, error or omission that was but only with respect to the committed before you ac- conduct of your business. quired or formed the organi- Your managers are insur- zation. eds, but only with respect to their duties as your manag- ers. As respects Employee Benefit Liabil- (d) An organization other than a ity Coverage, SECTION III - LIMITS partnership, joint venture or OF INSURANCE is deleted in its en- limited liability company, tirety and replaced by the following: you are an insured. Your (1) The Limits of Insurance shown "executive officers" and di- in Section B. Limits of Insur- rectors are insureds, but ance, 1. Employee Benefit Li- only with respect to their du- ability Coverage and the rules ties as your officers or direc- below fix the most we will pay tors. Your stockholders are regardless of the number of: also insureds, but only with respect to their liability as (a) Insureds; stockholders. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 4 of 15 (b) Claims made or "suits" (b) The deductible amount brought; stated in the Declarations c Persons or organizations applies to all damages sus- ( ) g tained by any one "em- making claims or bringing ployee", including such "em- "suits"; ployee's" dependents and (d) Acts, errors or omissions; or beneficiaries, because of all acts, errors or omissions to (e) Benefits included in your which this insurance ap- "employee benefit pro- plies. gram". (c) The terms of this insurance, (2) The Aggregate Limit shown in including those with respect Section B. Limits of Insurance, to: 1. Employee Benefit Liability Coverage of this endorsement 1) Our right and duty to is the most we will pay for all defend the insured damages because of acts, errors against any "suits" or omissions negligently commit- seeking those dam- ted in the "administration" of ages; and your "employee benefit pro- 2) Your duties, and the gram". duties of any other in- (3) Subject to the limit described in volved insured, in the (2) above, the Each Employee event of an act, error or Limit shown in Section B. Limits omission,or claim, of Insurance, 1. Employee apply irrespective of the ap- Benefit Liability Coverage of plication of the deductible this endorsement is the most we amount. will pay for all damages sus- tained by any one "employee", (d) We may pay any part or all including damages sustained by of the deductible amount to such "employee's" dependents effect settlement of any and beneficiaries, as a result of: claim or"suit" and, upon no- tificationa An act, error or omission; or of the action taken, ( ) you shall promptly reim- (b) A series of related acts, er- burse us for such part of the rors or omissions, regard- deductible amount as we less of the amount of time have paid. that lapses between such d. Additional Conditions acts, errors or omissions, As respects Employee Benefit Li- negligently committed in the ability Coverage, SECTION IV - "administration" of your "em- COMMERCIAL GENERAL LIABIL- ployee benefit program". ITY CONDITIONS is amended as fol- However, the amount paid under lows: this endorsement shall not ex- (1) Item 2. Duties in the Event of ceed, and will be subject to the Occurrence, Offense, Claim or limits and restrictions that apply Suit is deleted in its entirety and to the payment of benefits in any replaced by the following: plan included in the "employee benefit program". 2. Duties in the Event of an Act, Error or (4) Deductible Amount Omission, or Claim or Suit a. You must see to it that we are noti- (a) Our obligation to pay dam- fied as soon as practicable of an act, ages on behalf of the in- error or omission which may result in sured applies only to the a claim. To the extent possible, no- amount of damages in ex- tice should include: cess of the deductible amount stated in the Decla- (1) What the act, error or omission rations as applicable to was and when it occurred;and Each Employee. The limits of insurance shall not be re- (2) The names and addresses of duced by the amount of this anyone who may suffer dam- deductible. ages as a result of the act, error or omission. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 5 of 15 b. If a claim is made or"suit" is brought b. Method of Sharing against any insured, you must: If all of the other insur- (1) Immediately record the specifics ance permits contribu- of the claim or "suit" and the tion by equal shares, date received; and we will follow this 2 Notify us as soon as practicable. method also. Under ( ) fy p this approach each in- You must see to it that we receive surer contributes equal written notice of the claim or"suit"as amounts until it has soon as practicable. paid its applicable limit of insurance or none of c. You and any other involved insured the loss remains, must: whichever comes first. (1) Immediately send us copies of If any of the other in- any demands, notices, sum- surance does not per- monses or legal papers received mit contribution by in connection with the claim or equal shares, we will "suit"; contribute by limits. Under this method, (2) Authorize us to obtain records each insurer's share is and other information; based on the ratio of its (3) Cooperate with us in the investi- applicable limit of in- gation or settlement of the claim surance to the total ap- or defense against the "suit'; plicable limits of insur- and ance of all insurers. (4) Assist us, upon our request, in c. No Coverage the enforcement of any right This insurance shall not against any person or organiza- cover any loss for tion which may be liable to the which the insured is en- insured because of an act, error titled to recovery under or omission to which this insur- any other insurance in ance may also apply. force previous to the ef- d. No insured will, except at that in- fective date of this sured's own cost, voluntarily make a Coverage Part. payment, assume any obligation, or e. Additional Definitions incur any expense without our oon- sent. As respects Employee Benefit Li- ability Coverage, SECTION V - (2) Item 5. Other Insurance is de- DEFINITIONS is amended as fol- leted in its entirety and replaced lows: by the following: (1) The following definitions are 5. Otherinsurance added: If other valid and collectible 1. 'Administration" means: insurance is available to the insured for a loss we cover a. Providing information to under this Coverage Part, "employees", including our obligations are limited their dependents and as follows: beneficiaries, with re- spect to eligibility for or a. Primary Insurance scope of "employee This insurance is pri- benefit programs'; mary except when c. b. Interpreting the "em- below applies. If this ployee benefit pro- insurance is primary, grams'; our obligations are not affected unless any of c. Handling records in the other insurance is connection with the also primary. Then, we "employee benefit pro- will share with all that grams'; or other insurance by the method described in b. d. Effecting, continuing or below. terminating any "em- ployee's" participation Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 6 of 15 in any benefit included benefits, workers' oom- in the "employee bene- pensation and disability fit program". benefits; and However, "administration" d. Vacation plans, incud- does not include: ing buy and sell pro- grams; leave of ab- a. Handling payroll deduc- sence programs, in- tions; or cluding military, mater- b. The failure to effect or nity, family, and civil maintain any insurance leave; tuition assis- or adequate limits of tance plans; transporta- coverage of insurance, tion and health dub including but not limited subsidies. to unemployment in- (2) The following definitions are de- surance, social security leted in their entirety and re- benefits, workers' oom- placed by the following: pensation and disability benefits. 21. "Suit' means a civil pro- ceeding in which money 2. "Cafeteria p damages because of an act, plan authorized by applica- error or omission to which ble law to allow "employ- this insurance applies are ees" to elect to pay for cer- alleged. "Suit' includes: tain benefits with pre-tax dollars. a. An arbitration proceed- ing in which such dam- 3. "Employee benefit pro- ages are claimed and grams" means a program to which the insured providing some or all of the must submit or does following benefits to "em- submit with our con- ployees", whether provided sent; through a "cafeteria plan" or otherwise: b. Any other alternative dispute resolution pro- a. Group life insurance; ceeding in which such group accident or damages are claimed health insurance; den- and to which the In- tal, vision and hearing sured submits with our plans; and flexible consent; or spending accounts; provided that no one c. An appeal of a civil pro- other than an "em- ceeding. ployed' may subscribe to such benefits and 8. "Employee" means a per- such benefits are made son actively employed, for- generally available to merly employed, on leave of those "employees" who absence or disabled, or re- satisfy the plan's eligi- tired. "Employee' includes bility requirements; a "leased worker". "Em- ployee" does not include a b. Profit sharing plans, 'temporary worker". employee savings plans, employee stock 2. Unintentional Failure to Disclose Haz- ownership plans, pen- ards sion plans and stock SECTION IV-COMMERCIAL GENERAL subscription plans, pro- LIABILITY CONDITIONS, 7. Represen- vided that no one other tations is hereby amended by the addi- than an employee" tion of the following: may subscribe to such benefits and such Based on our dependence upon your rep- benefits are made gen- resentations as to existing hazards, if un- erally available to all intentionally you should fail to disclose all "employees" who are such hazards at the inception date of your eligible under the plan policy, we will not reject coverage under for such benefits; this Coverage Part based solely on such c. Unemployment insur- failure. ance, social security Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 7 of 15 3. Damage to Premises Rented to You f) Nesting or infesta- tion, or discharge a. The last Subparagraph of Paragraph or release of 2. SECTION I - COVERAGES, waste products or COVERAGE A. - BODILY INJURY secretions, by in- AND PROPERTY DAMAGE, 2. LI- sects, birds, ro- ABILITY Exclusions is hereby de- dents or other leted and replaced by the following: animals. Exclusions c. through q. do not apply (b) Loss caused directly or indi- to damage by fire, explosion, light- rectly by any of the follow- ning, smoke or soot to premises ing: while rented to you or temporarily oc- cupied by you with permission of the 1) Earthquake, volcanic owner. eruption, landslide or any other earth move- b. The insurance provided under SEC- ment; TION I -COVERAGES, COVERAGE A. BODILY INJURY AND PROP- 2) Water that backs up or ERTY DAMAGE LIABILITY applies overflows from a sewer, to "property damage" arising out of drain or sump; water damage to premises that are both rented to and occupied by you. 3) Water under the ground surface pressing on, or (1) As respects Water Damage Le- flowing or seeping gal Liability, as provided in through: Paragraph 3.b. above: a) Foundations, The exclusions under SECTION walls, floors or - COVERAGES, COVERAGE paved surfaces; A. BODILY INJURY AND PROPERTY DAMAGE LIABIL- b) Basements, ITY, 2. Exclusions, other than i. whether paved or War and the Nuclear Energy not; or Liability Exclusion, are deleted and the following are added: c) Doors, windows or other openings. This insurance does not apply (c) Loss caused by or resulting to: from water that leaks or (a) "Property damage": flows from plumbing, heat- ing, air conditioning, or fire 1) Assumed in any con- protection systems caused tract; or by or resulting from freez- 2) Loss caused by or re- ing, unless: sulting from any of the 1) You did your best to following: maintain heat in the a) Wear and tear; building or structure; or b Rust, corrosion, 2) You drained the equipment and shut off fungus, decay, de- the water supply if the terioration, hidden heat was not main- or latent defect or tained. any quality in property that (d) Loss to or damage to: causes it to dam- age or destroy it- 1) Plumbing, heating, air self, conditioning, fire pro- tection systems, or C) Smog; other equipment or ap- d) Mechanical break- pliances; or down including 2) The interior of any rupture or bursting building or structure, or caused by oen- to personal property in trifugal force; the building or structure e Settling, cracking, caused by or resulting g, g, from rain, snow, sleet shrinking or ex- or ice, whether driven pansion; or by wind or not. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 8 of 15 c. Limit of Insurance Limits of Insurance, 5. Medical Pay- ments of this endorsement. The Damage to Premises Rented to You Limit as shown in the Declara- 6. Voluntary Property Damage and Care, tions is amended as follows: Custody or Control Liability Coverage (2) Paragraph 6. of SECTION III - a. Voluntary Property Damage Cov- LIMITS OF INSURANCE is erage hereby deleted and replaced by the following: We will pay for "property damage" to property of others arising out of op- 6. Subject to 5. above, the erations incidental to the insured's Damage to Premises business when: Rented to You Limit is the most we will pay under (1) Damage is caused by the in- COVERAGE A. BODILY sured; or INJURY AND PROPERTY (2) Damage occurs while in the in- DAMAGE LIABILITY, for sured's possession. damages because of "prop- erty damage" to premises With your consent, we will make while rented to you or tem- these payments regardless of fault. porarily occupied by you with permission of the b. Care, Custody or Control Liability owner, arising out of any Coverage one "occurrence" to which SECTION I - COVERAGES, COV- this insurance applies. ERAGE A. BODILY INJURY AND (3) The amount we will pay is lim- PROPERTY DAMAGE LIABILITY, ited as described in Section B. 2. Exclusions, j. Damage to Prop- Limits of Insurance, 3. Dam- erty, Subparagraphs (3), (4) and (5) age to Premises Rented to do not apply to "property damage"to You of this endorsement. the property of others described therein. 4. Supplementary Payments With respect to the insurance provided by Under SECTION I - COVERAGE, SUP- this section of the endorsement, the fol- PLEMENTARY PAYMENTS - COVER- lowing additional provisions apply: AGES AAND B: a. The Limits of Insurance shown in the a. Paragraph 2. is replaced by the fol- Declarations are replaced by the lim- lowing: its designated in Section B. Limits of Up to the limit shown in Section B. Insurance, 6. Voluntary Property Damage and Care, Custody or Limits of Insurance, Bail Bonds Control Liability Coverage of this of this endorsement foror cost of bail endorsement with respect to cover- bonds required because of accidents age provided by this endorsement. or traffic law violations arising out of These limits are in of and not the use of any vehide to which the in addition to the limits being re- Bodily Injury Liability Coverage ap- plies. We do not have to furnish shown in Section B. Limits of Insur- ance, 6. Voluntary Property Dam- b. Paragraph 4. is replaced by the fol- age and Care, Custody or Control lowing: Liability Coverage of this endorse- ment fix the most we will pay in any All reasonable expenses incurred by one "occurrence" regardless of the the insured at our request to assist number of: us in the investigation or defense of the daim or "suit", including actual (1) Insureds; loss of earnings up to the limit shown (2) Claims made or "suits" brought; in Section B. Limits of Insurance, or 4.b. Loss of Earnings of this en- dorsement per day because of time (3) Persons or organizations mating off from work. claims or bringing "suits". 5. Medical Payments b. Deductible Clause The Medical Expense Limit of Any One (1) Our obligation to pay damages Person as stated in the Declarations is on your behalf applies only to amended to the limit shown in Section B. the amount of damages for each "occurrence" which are in ex- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 9 of 15 cess of the deductible amount (1) Any person or organization de- stated in Section B. Limits of scribed in Paragraph 9.a.(2) be- Insurance, 6. Voluntary Prop- low (hereinafter referred to as erty Damage and Care, Cus- additional insured) whom you tody or Control Liability Cov- are required to add as an addi- erage of this endorsement. The tional insured under this Cover- limits of insurance will not be re- age Part by reason of: duced by the application of such deductible amount. (a) A written contract or agree- ment; or (2) Condition 2. Duties in the Event of Occurrence, Offense, (b) An oral agreement or con- Claim or Suit, applies to each tract where a certificate of claim or"suit" irrespective of the insurance showing that per- amount. son or organization as an additional insured has been (3) We may pay any part or all of issued, the deductible amount to effect settlement of any claim or "suit" is an insured, provided: and, upon notification of the ac- (a) The written or oral contract tion taken, you shall promptly re- or agreement is: imburse us for such part of the deductible amount as has been 1) Currently in effect or paid by us. becomes effective dur- ing the policy period; 7. 180 Day Coverage for Newly Formed or and Acquired Organizations SECTION II - WHO IS AN INSURED is 2) Executed prior to an amended as follows: "occurrence" or offense to which this insurance Subparagraph a. of Paragraph 4. is would apply;and hereby deleted and replaced by the fol- (b) They are not specifically lowing: named as an additional in- a. Insurance under this provision is af- sured under any other pro- forded only until the 180th day after vision of, or endorsement you acquire or form the organization added to, this Coverage or the end of the policy period, Part. whichever is earlier; (2) Only the following persons or 8. Waiver of Subrogation organizations are additional in- sureds under this endorsement, SECTION IV-COMMERCIAL GENERAL and insurance coverage pro- LIABILITY CONDITIONS, 9. Transfer of vided to such additional insureds Rights of Recovery Against Others to is limited as provided herein: Us is hereby amended by the addition of the following: (a) The manager or lessor of a premises leased to you with We waive any right of recovery we may whom you have agreed per have because of payments we make for Paragraph 9.a.(1) above to injury or damage arising out of your ongo- provide insurance, but only ing operations or "your work" done under with respect to liability aris- a written contract requiring such waiver ing out of the ownership, with that person or organization and in- maintenance or use of that cluded in the "products-completed opera- part of a premises leased to tions hazard". However, our rights may you, subject to the following only be waived prior to the "occurrence" additional exclusions: giving rise to the injury or damage for which we make payment under this Cov- This insurance does not ap- erage Part. The insured must do nothing ply to: after a loss to impair our rights. At our 1) Any"occurrence" which request, the insured will bring "suit' or takes place after you transfer those rights to us and help us en- cease to be a tenant in force those rights. that premises. 9. Automatic Additional Insured - Speci- 2) Structural alterations, fied Relationships new construction or a. The following is hereby added to demolition operations SECTION II -WHO IS AN INSURED: performed by or on be- Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 10 of 15 half of such additional solely for the pur- insured. pose of inspection, demonstration, (b) Any person or organization testing, or the from which you lease substitution of equipment with whom you parts under in- have agreed per Paragraph structions from the 9.a.(1) above to provide in- manufacturer, and surance. Such person(s) or then repackaged organization(s) are insureds in the original con- solely with respect to their tainer; liability arising out of the maintenance, operation or e) Any failure to use by you of equipment make such inspec- leased to you by such per- tions, adjustments, son(s) or organizations(s). tests or servicing However, this insurance as the vendor has does not apply to any "oc- agreed to make or currence" which takes place normally under- after the equipment lease takes to make in expires. the usual course person or organization of business, in (c) Any p g connection with (referred to below as ven- the distribution or dor) with whom you have sale of the prod- agreed per Paragraph ucts; 9.a.(1) above to provide in- surance, but only with re- f) Demonstration, in- spect to "bodily injury" or stallation, servic- "property damage" arising ing or repair op- out of"your products" which erations, except are distributed or sold in the such operations regular course of the ven- performed at the dor's business, subject to vendor's premises the following additional ex- in connection with clusions: the sale of the 1) The insurance afforded product; the vendor does not g) Products which, apply to: after distribution or a "Bodilyinjury" or sale by you, have 1 Y been labeled or re- "property damage" labeled or used as for which the ven- a container, part or dor is obligated to ingredient of any pay damages by other thing or sub- reason of the as- stance by or for sumption of liabil- the vendor. ity in a contract or agreement. This 2) This insurance does exclusion does not not apply to any in- apply to liability for sured person or organi- damages that the zation: vendor would have in the absence of a) From whom you the contract or have acquired agreement; such products, or any ingredient, b) Any express war- part or container, ranty unauthorized entering into, ac- by you; companying or containing such c) Any physical or products; or chemical change in the product b) When liability in- made intentionally cluded within the by the vendor; "products- Repackaging, completed opera- d) tions hazard" has unless unpacked Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 11 of 15 been excluded (f) Any person or organization under this Cover- with which you have agreed age Part with re- per Paragraph 9.a.(1) above spect to such to provide insurance, but products. only with respect to liability d An state or political subdi- arising out of "your work" ( ) Y p performed for that additional vision with which you have insured by you or on your agreed per Paragraph behalf. A person or organi- 9.a.(1) above to provide in- zation's status as an insured surance, subject to the fol- under this provision of this lowing additional provision: endorsement continues for This insurance applies only only the period of time re- with respect to the following quired by the written con- hazards for which the state tract or agreement, but in no or political subdivision has event beyond the expiration issued a permit in connec- date of this Coverage Part. tion with premises you own, If there is no written contract rent or control and to which or agreement, or if no pe- this insurance applies: riod of time is required by the written contract or 1) The existence, mainte- agreement, a person or or- nance, repair, construc- ganization's status as an in- tion, erection, or re- sured under this endorse- moval of advertising ment ends when your op- signs, awnings, cano- erations for that insured are pies, cellar entrances, completed. coal holes, driveways, manholes, marquees, (3) Any insurance provided to an hoist away openings, additional insured designated sidewalk vaults, street under Paragraph 9.a.(2): banners, or decorations (a) Subparagraphs (e) and (f) and similar exposures; does not apply to "bodily in- or jury" or "property damage" 2) The construction, erec- included within the "prod- tion, or removal of ele- ucts-completed operations vators; or hazard"; 3) The ownership, main- (b) Subparagraphs (a), (b), (d), tenance, or use of any (e) and (f) does not apply to elevators covered by bodily injury", 'property this insurance. damage" or "personal and advertising injury" arising (e) Any state or political subdi- out of the sole negligence or vision with which you have willful misconduct of the ad- agreed per Paragraph ditional insured or their 9.a.(1) above to provide in- agents, "employees" or any surance, subject to the fol- other representative of the lowing provisions: additional insured; or 1) This insurance applies (c) Subparagraph (f) does not only with respect to op- apply to "bodily injury", erations performed by "property damage" or "per- you or on your behalf sonal and advertising injury" for which the state or arising out of: political subdivision has issued a permit. 1) Defects in design fur- nished by or on behalf 2) This insurance does of the additional in- not apply to "bodily in- sured; or jury", "property dam- age" or "personal and 2) The rendering of, or failure advertising injury" aris- render, any ing out of operations professional architec- performed for the state sural, engineering or or political subdivision. surveying services, in- cluding: Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 12 of 15 a) The preparing, primary to other insurance approving or fail- available to the additional ing to prepare or insured except: approve maps, shop drawings, 1) As otherwise provided opinions, reports, in SECTION IV - surveys, field or- COMMERCIAL GEN- ders, change or- ERAL LIABILITY ders or drawings CONDITIONS, 5. and specifications; Other Insurance, b. and Excess Insurance; or b) Supervisory, in- 2) For any other valid and spection, architec- collectible insurance tural or engineer- available to the addi- ing activities. tional insured as an additional insured by 3) "Your work" for which a attachment of an en- consolidated (wrap-up) dorsement to another insurance program has insurance policy that is been provided by the written on an excess primecontractor-project basis. In such case, manager or owner of the coverage provided the construction project under this endorsement in which you are in- shall also be excess. volved. (2) Condition 11. Conformance to b. Only with regard to insurance pro- Specific Written Contract or vided to an additional insured desig- Agreement is hereby added: nated under Paragraph 9.a.(2) Sub- paragraph Specific (f) above, SECTION III - Written Contract or LIMITS OF INSURANCE is amended to include: Agreement The limits applicable to the additional With respect to additional insured are those specified in the insureds described in Para- written contract or agreement or in graph 9.a.(2)(f)above only: the Declarations of this Coverage If a written contract or Part, whichever are less. If no limits agreement between you are specified in the written contract or and the additional insured agreement, or if there is no written specifies that coverage for contract or agreement, the limits ap- the additional insured: plicable to the additional insured are those specified in the Declarations of a. Be provided by the In- this Coverage Part. The limits of in- surance Services Office surance are inclusive of and not in additional insured form addition to the limits of insurance number CG 20 10 or shown in the Declarations. CG 20 37 (where edi- c. SECTION IV -COMMERCIAL GEN- tion specified); or ERAL LIABILITY CONDITIONS is b. Include coverage for hereby amended as follows: completed operations; (1) Condition 5. Other Insurance is or amended to include: c. Include coverage for (a) Where required by a written "your work"; contract or agreement, this and where the limits or cov- insurance is primary and / erage provided to the addi- or noncontributory as re- tional insured is more re- spects any other insurance strictive than was specifi- policy issued to the addi- cally required in that written tional insured, and such contract or agreement, the other insurance policy shall terms of Paragraphs be excess and / or noncon- 9.a.(3)(a), 9.a.(3)(b) or 9.b. tributing, whichever applies, above, or any combination with this insurance. thereof, shall be interpreted (b) Any insurance provided by as providing the limits or this endorsement shall be coverage required by the terms of the written contract Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 13 of 15 or agreement, but only to (c) Persons or organizations the extent that such limits or making claims or bring coverage is included within "suits". the terms of the Coverage Part to which this endorse- (2) Deductible Clause ment is attached. If, hcyw- (a) Our obligation to pay dam- ever, the written contract or ages on your behalf applies agreement specifies the In- only to the amount of dam- surance Services Office ad- ages for each "occurrence" ditional insured form num- which are in excess of the ber CG 20 10 but does not Deductible amount stated in specify which edition, or Section B. Limits of Insur- specifies an edition that ance, 11. of this endorse- does not exist, Paragraphs ment. The limits of insur- 9.a.(3)(a) and 9.a.(3)(b) of ance will not be reduced by this endorsement shall not the application of such De- apply and Paragraph 9.b. of ductible amount. this endorsement shall ap- ply. (b) Condition 2. Duties in the 10. Broadened Contractual Liability -Work Event of Occurrence, Of- fense, Claim or Suit, ap- plies 50' of Railroad Property plies to each claim or "suit' It is hereby agreed that Paragraph f.(1)of irrespective of the amount. Definition 12. "Insured contract" (SEC- (c) We may pay any part or all TION V-DEFINITIONS) is deleted. of the deductible amount to 11. Property Damage to Borrowed Equip- effect settlement of any ment claim or"suit" and, upon no- tification of the action taken, a. The following is hereby added to Ex- you shall promptly reim- clusion j. Damage to Property of burse us for such part of the Paragraph 2., Exclusions of SEC- deductible amount as has TION I -COVERAGES, COVERAGE been paid by us. A. BODILY INJURY AND PROP- ERTY DAMAGE LIABILITY: 12. Employees as Insureds - Specified Health Care Services Paragraphs (3) and (4) of this exclu- sion do not apply to tools or equip- y g ment loaned to you, provided they 2.a.(1)(d) of SECTION II - WHO IS AN are not being used to perform opera- INSURED, does not apply to your "em- tions at the time of loss. ployees" who provide professional health care services on your behalf as duly li- b. With respect to the insurance pro- censed: vided by this section of the endorse- ment, the following additional provi- a. Nurses; sions apply: b. Emergency Medical Technicians; or (1) The Limits of insurance shown in c. Paramedics, the Declarations are replaced by the limits designated in Section in the jurisdiction where an "occurrence" B. Limits of Insurance, 11. of or offense to which this insurance applies this endorsement with respect to takes place. coverage provided by this en- dorsement. These limits are in- 13. Broadened Notice of Occurrence clusive of and not in addition to Paragraph a. of Condition 2. Duties in the limits being replaced. The the Event of Occurrence, Offense, Limits of Insurance shown in Claim or Suit (SECTION IV -COMMER- Section B. Limits of Insurance, CIAL GENERAL LIABILITY CONDI- 11. of this endorsement fix the TIONS) is hereby deleted and replaced most we will pay in any one "oc- by the following: currence" regardless of the number of: a. You must see to it that we are noti- (a) Insureds; fied as soon as practicable of an "oc- currence" or an offense which may (b) Claims made or "suits" result in a claim. To the extent pos- brought; or sible, notice should include: (1) How, when and where the "oc- currence" or offense took place; Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 14 of 15 (2) The names and addresses of This requirement applies only when any injured persons and wit- the "occurrence" or offense is known nesses; and to an"authorized representative". (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. Includes copyrighted material of Insurance GA 233 02 07 Services Office, Inc., with its permission. Page 15 of 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CinciPlus° BUSINESS AUTO XC+° (EXPANDED COVERAGE PLUS) ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. A. Blanket Waiver of Subrogation This provision does not apply unless the valid written contract has been: SECTION IV - BUSINESS AUTO CONDI- TIONS, A. Loss Conditions, S. Transfer of 1. Executed prior to the accident causing Rights of Recovery Against Others to Us is "bodily injury"or "property damage"; and amended by the addition of the following: 2. Is still in force at the time of the "accident" We waive any right of recovery we may have causing "bodily injury" or "property dam- against any person or organization because of age". payments we make for "bodily injury" or "property damage" arising out of the operation D. Employee Hired Auto of a covered "auto" when you have assumed 1. Changes in Liability Coverage liability for such "bodily injury" or "property damage" under an "insured contract", provid- The following is added to the Section II - ed the "bodily injury" or "property damage" oc- Liability Coverage, A. Coverage, 1. curs subsequent to the execution or the "in- Who is an Insured: sured contract". An "employee" of yours is an "insured" B. Noncontributory Insurance while operating an "auto" hired or rented SECTION IV - BUSINESS AUTO CONDI- under a contract or agreement in that TIONS, B. General Conditions, S. Other In- "employee's" name, with your permission, while performing duties related to the surance c. is replaced by the following: conduct of your business. c. Regardless of the provisions of Par- 2. Changes in General Conditions agraph a. above, this Coverage Form's Liability Coverage is primary SECTION IV - BUSINESS AUTO CON- and we will not seek contribution DITIONS, B. General Conditions, S. from any other insurance for any Iia- Other Insurance is amended by replac- bility assumed under an "insured ing Paragraph 5.b. with the following: contract" that requires liability to be assumed on a primary noncontributo- b. For Hired Auto Physical Damage ry basis. Coverage the following are deemed to be covered "autos"you own: C. Additional Insured by Contract (1) Any covered "auto" you lease, SECTION II - LIABILITY COVERAGE, A. hire, rent or borrow; and Coverage, I. Who is an Insured is amended to include as an insured any person or organi- (2) Any covered "auto" hired or zation with which you have agreed in a valid rented by your "employee" under written contract to provide insurance as is af- a contract in that individual "em- forded by this policy. ployee's" name, with your per- mission, while performing duties This provision is limited to the scope of the related to the conduct of your valid written contract. business. Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission. Page 1 of 4 However, any "auto" that is leased, a. Is effective on the date of acquisition hired, rented or borrowed with a driver or formation, and is afforded for 180 is not a covered "auto". days after such date; E. Audio, Visual and Data Electronic Equip- b. Does not apply to "bodily injury" or ment "property damage" resulting from an SECTION III - PHYSICAL DAMAGE COV- "accident" that occurred before you ERAGE, C. Limit of Insurance is amended acquired or formed the organization; by adding the following: c. Does not apply to any newly acquired 4. The most we will pay for all "loss" to au- or formed organization that is a joint venture or partnership; and dio, visual or data electronic equipment and any accessories used with this d. Does not apply to an insured under equipment as a result of any one "acci- any other automobile liability policy, dent" is the lesser of: or would be an insured under such a a. The actual cash value of the dam- policy but for the termination of such policy or the exhaustion of such poli- aged or stolen property as of the time cys limits of insurance. of the "accident"; 3. Any of your "employees" while using a b. The cost of repairing or replacing the auto damaged or stolen property with oth- covered in your business or your epersonal affairs, provided you do not own, r property of like kind and quality; or hire or borrow that"auto". c. $2,500. G. Liability Coverage Extensions - Supple- Provided the equipment, at the time of the mentary Payments - Higher Limits "loss" is: SECTION II - LIABILITY COVERAGE, A. a. Permanently installed in or upon the Coverage, 2. Coverage Extensions, a. Sup- covered "auto" in a housing, opening plementary Payments is amended by: or other location that is not normally 1. Replacing the $2,000 Limit of Insurance used b the "auto" manufacturer for p g y for bail bonds with $4,000 in (2); and the installation of such equipment; b. Removable from a permanently in- 2. Replacing the $250 Limit of Insurance for stalled housing unit as described in reasonable expenses with $500 in (4). Paragraph 2.a. above; or H. Amended Fellow Employee Exclusion c. An integral part of such equipment. SECTION II - LIABILITY COVERAGE, B. Ex- clusions, S. Fellow Employee is modified as follows: SECTION II - LIABILITY COVERAGE, A. Exclusion S. Fellow Employee is deleted. Coverage, 1. Who is an Insured is amended by adding the following: I. Hired Auto - Physical Damage The following are "insureds": If hired "autos" are covered "autos"for Liability Coverage, then Comprehensive and Collision 1. Any subsidiary which is a legally incorpo- Physical Damage Coverages as provided un- rated entity of which you own a financial der SECTION III - PHYSICAL DAMAGE interest of more than 50% of the voting COVERAGE of this Coverage Part are ex- stock on the effective date of this cover- tended to "autos" you hire, subject to the fol- age form. lowing: However, the insurance afforded by this 1. The most we will pay for "loss" to any provision does not apply to any subsidiary hired "auto" is $50,000 or the actual cash that is an "insured" under any other au- value or cost to repair or replace, which- tomobile liability policy, or would be an ever is the least, minus a deductible. "insured" under such policy but for termi- nation of such policy or the exhaustion of 2. The deductible will be equal to the largest such policy's limits of insurance. deductible applicable to any owned "auto" 2. Any organization that is newly acquired or for that coverage, or $1,000, whichever is less. formed by you and over which you main- tain majority ownership. The insurance 3. Hired Auto - Physical Damage coverage provided by this provision: is excess over any other collectible insur- ance. Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission. Page 2 of 4 4. Subject to the above limit, deductible, and K. Transportation Expense - Higher Limits excess provisions we will provide cover- age equal to the broadest coverage appli- SECTION III - PHYSICAL DAMAGE COV- cable to any covered "auto" you own in- ERAGE, A. Coverage, 4. Coverage Exten- sured under this policy. sions is amended by replacing $20 per day with $50 per day, and $600 maximum with Coverage includes loss of use of that hired au- $1,500 maximum in Extension a. Transpor- to, provided it results from an "accident" for tation Expenses. which you are legally liable and as a result of which a monetary loss is sustained by the L. Airbag Coverage leasing or rental concern. The most we will SECTION III - PHYSICAL DAMAGE COV- pay for any one "accident" is $3,000. ERAGE, B. Exclusions, 3.a. is amended by If a limit for Hired Auto - Physical Damage is adding the following: shown in the Schedule, then that limit replac- However, the mechanical and electrical es, and is not added to, the $50,000 limit indi- breakdown portion of this exclusion does not cated above. apply to the accidental discharge of an airbag. J. Rental Reimbursement This coverage for airbags is excess over any other collectible insurance or warranty. SECTION III - PHYSICAL DAMAGE is amended by adding the following: M. Loan or Lease Gap Coverage 1. We will pay for rental reimbursement ex- 1. SECTION III - PHYSICAL DAMAGE penses incurred by you for the rental of COVERAGE, C. Limit of Insurance is an "auto" because of a "loss" to a covered deleted in its entirety and replaced by the "auto". Payment applies in addition to the following, but only for private passenger otherwise applicable amount of each cov- type "autos" with an original loan or lease, erage you have on a covered "auto". No and only in the event of a "total loss" to deductible applies to this coverage. such a private passenger type "auto": 2. We will pay only for those expenses in- a. The most we will pay for "loss" in any curred during the policy period beginning one "accident" is the greater of: 24 hours after the "loss" and ending, re- (1) The amount due under the terms gardless of the policy's expiration, with of the lease or loan to which the lesser of the following number of your covered private passenger days: type "auto" is subject, but will not a. The number of days reasonably re- include: quired to repair the covered "auto". If (a) Overdue lease or loan pay- "loss" is caused by theft, this number ments; of days is added to the number of days it takes to locate the covered (b) Financial penalties imposed "auto"and return it to you; or under the lease due to high b. 30 days. mileage, excessive use or abnormal wear and tear; 3. Our payment is limited to the lesser of the (c) Security deposits not re- following amounts: funded by the lessor; a. Necessary and actual expenses in- (d) Costs for extended warran- curred; or ties, Credit Life Insurance, b. $50 per day. Health, Accident or Disabil- ity Insurance purchased 4. This coverage does not apply while there with the loan or lease; and are spare or reserve "autos" available to you for your operations. (e) Carry-over balances from previous loans or leases, or S. We will pay under this coverage only that amount of your rental reimbursement ex- (2) Actual cash value of the stolen penses which is not already provided for or damaged property. under SECTION III - PHYSICAL DAM- b. An adjustment for depreciation and AGE COVERAGE, A. Coverage, 4. physical condition will be made in de- Coverage Extensions. termining actual cash value at the time of"loss". Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission. Page 3 of 4 2. SECTION V - DEFINITIONS is amended P. Unintentional Failure to Disclose Hazards by adding the following, but only for the purposes of this Loan or Lease Gap SECTION IV - BUSINESS AUTO CONDI- Coverage: TIONS, B. General Conditions, 2. Conceal- ment, Misrepresentation or Fraud is "Total loss" means a "loss" in which the amended by adding the following: cost of repairs plus the salvage value ex- ceeds the actual cash value. However, if you unintentionally fail to disclose any hazards existing on the effective date of N. Glass Repair-Waiver of Deductible this Coverage Form, we will not deny cover- SECTION III - PHYSICAL DAMAGE COV- age under this Coverage Form because of such failure. ERAGE, D. Deductible is amended by adding the following: Q. Mental Anguish Resulting from Bodily Inju- No deductible applies to glass damage if the ry glass is repaired in a manner acceptable to us SECTION V - DEFINITIONS, C. "Bodily inju- rather than replaced. ry" is deleted in its entirety and replaced by O. Duties in the Event of an Accident, Claim, the following: Suit or Loss - Amended "Bodily injury" means bodily injury, sickness or SECTION IV - BUSINESS AUTO CONDI- disease sustained by a person, including men- tal anguish and death sustained by the same TIONS, A. Loss Conditions, 2. Duties in the person that results from such bodily injury, Event of Accident, Claim, Suit or Loss, a. is sickness or disease. 'Bodily injury" does not amended by adding the following: include mental anguish or death that does not This condition applies only when the "acci- result from bodily injury, sickness or disease. dent"or 'loss" is known to: R. Coverage for Certain Operations in Con- t. You, if you are an individual; nection with Railroads 2. A partner, if you are a partnership; With respect to the use of a covered "auto" in operations for or affecting a railroad: 3. An executive officer or insurance manag- er, if you are a corporation; or 1. Section V - Definitions, H. "Insured con- tract", 1.c. is amended to read: 4. A member or manager, if you are a lim- ited liability company. c. An easement or license agreement; 2. Section V - Definitions, H. "Insured con- tract", 2.a. is deleted. Includes copyrighted material of ISO AA 288 01 16 Properties, Inc., with its permission. Page 4 of 4 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION OR NONRENEWAL BY US NOTIFICATION TO A DESIGNATED ENTITY This endorsement modifies insurance provided under the following: BUSINESSOWNERS PACKAGE POLICY CLAIMS-MADE EXCESS LIABILITY COVERAGE PART COMMERCIAL AUTO COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL UMBRELLA LIABILITY COVERAGE PART DENTIST'S PACKAGE POLICY EXCESS LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART PROFESSIONAL UMBRELLA LIABILITY COVERAGE PART-CLAIMS-MADE SCHEDULE Name and mailing address of person(s) or organization(s): 1. FOR WHOM YOU ARE REQUIRED IN A WRITTEN CONTRACT THAT WAS EXECUTED ON OR AFTER THE EARLIER OF THE FOLLOWING DATES: A. THE EFFECTIVE DATE OF THIS POLICY, OR B. THE EFFECTIVE DATE OF THE ORIGINAL POLICY OF WHICH THIS POLICY IS A RENEWAL OR REPLACEMENT, AND 2. FOR WHOM YOU ARE REQUIRED IN THAT SAME WRITTEN CONTRACT AS REFERRED TO IN 1. ABOVE TO PROVIDE CANCELLATION NOTICE. Number of days notice(other than nonpayment of premium): 30 A. If we cancel or nonrenew this policy for any statutorily permitted reason other than nonpayment of premium we will mail notice to the person or organization shown in the Schedule.We will mail such notice at least the number of days shown in the Schedule before the effective date of cancellation or nonrenewal. B. If we cancel this policy for nonpayment of premium, we will mail notice to the person or organization shown in the Schedule. We will mail such notice at least 10 days before the effective date of cancellation. C. If notice is mailed, proof of mailing to the mailing address shown in the Schedule will be sufficient proof of notice. D. In no event will coverage extend beyond the actual expiration, termination or cancellation of the policy. IA 4087 08 11