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HomeMy WebLinkAboutC2015-262 - 8/7/2015 - NA 00 52 23 AGREEMENT This Agreement,for the Project awarded on August 7,2015,is between the City of Corpus Christi (Owner)and Clark Pipeline Services,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: HORNE ROAD,AYERS STREET TO PORT AVENUE(BOND 2012)Contract Re-Assignment PROJECT NUMBER E12100 ARTICLE 2—DESIGNER AND OWNER'S AUTHORIZED REPRESENTATIVE 2.01 The Project has been designed by: NAISMITH ENGINEERING,INC. 4501 GOLLIHAR ROAD CORPUS CHRISTI,TEXAS 78411 2.02 The Owner's Authorized Representative for this Project is: City of Corpus Christi—Capital Programs Phil Boehk,P.E.—Acting Construction Engineer 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 90 days after the date when B. 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 15.06 of the General Conditions within 120 days after the date when the Contract Times commence to run. C. Milestones,and the dates for completion of each,are as defined in SECTION 0135 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 2015-262 8/07/15 00 52 23-1 1ve.(BOND 2012),Project E12100 11-25-2013 Clark Pipeline Services LLC INDEED 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$785.00 for each day that expires after the time specified in Paragraph 3.01 for Substantial Completion until the Work is substantially complete. 2. Completion of the Remaining Work: Contractor agrees to pay Owner$785.00 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 15.06 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 in SECTION 00 30 01 BID FORM EXHIBIT A. Unit prices have been computed in accordance with Paragraph 13.03 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. Amount of Award: Total Base Bid $ 1,964,644.19 ARTICLE 5—PAYMENT PROCEDURES 5.01 Submit Applications for Payment in accordance with Article 15 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. Agreement 00 52 23-2 HORNE ROAD—Ayers St.to Port Ave.(BOND 2012), Project E12100 11-25-2013 B. Progress payments equal to 95 percent of the total earned value to date for completed Work and properly stored materials will be made prior to Substantial Completion. The balance will be held as retainage. 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 15.01 of the General Conditions. D. At the Owner's option, retainage may be required at a higher percentage rate 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 15.01 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 15.06 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. 6.02 The Owner is not obligated to pay interest on moneys not paid except as provided in Texas Government Code Chapter 2252. 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; Agreement 00 52 23-3 HORNE ROAD—Ayers St.to Port Ave.(BOND 2012),Project E12100 11-25-2013 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 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. Agreement 00 52 23-4 HORNE ROAD—Ayers St.to Port Ave.(BOND 2012),Project E12100 11-25-2013 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 13.01 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. Specifications,forms,and documents listed in SECTION 00 0100 TABLE OF CONTENTS. 2. Drawings listed in the Sheet Index. 3. Addenda. 4. Exhibits to this Agreement: a. Contractor's Bid Form Exhibit A. b. Regulator Screening c. Geotechnical Report 5. 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. ARTICLE 10—CONTRACT DOCUMENT SIGNATURES Four original duplicates of the signed Contracts will be required. The sequence of signatures will be completed in the following order: A. CONTRACTOR—Contract must be signed by a person authorized to bind the firm or company* if Contractor is a Corporation contracts must be Attested; B. ASSISTANT CITY ATTORNEY for the City; C. DIRECTOR OF CAPITAL PROGRAMS; D. CITY SECRETARY for the City. Agreement 00 52 23-5 HORNE ROAD—Ayers St.to Port Ave.(BOND 2012),Project E12100 11-25-2013 ACITY OF Ath (i) USC H' S', {/ J.H. Edmonds, P.E. Valeri_ Bray, P.E. Director of Capital Programs (Engineering) Executive Director of Pu lic Works APPROVED AS TO LEGAL FORM: A— Assistant City Attorney ATTEST(IF CORPORATION) CONTRACTOR Clark Pipeline Services,LLC (Seal Below) By: Note: Attach copy of authorization to sign if Title: person signing for CONTRACTOR is not President, Vice President, Chief Executive Officer,or Chief P.O. Box 1214 Financial Officer Address Corpus Christi, TX 78401 City State Zip 361/816-6007 Phone Fax cclark@clarkpipeline.com EMail END OF SECTION Agreement 00 52 23-6 HORNE ROAD—Ayers St.to Port Ave.(BOND 2012),Project E12100 11-25-2013 Capital Programs Memo TO: Ronald L. Olson, City Manager / )7 THRU: Gustavo A. Gonzalez, P. E.,Assistant City Manager of Public orks and Ufiliti THRU: Valerie H. Gray, P. E., Executive Director of Public Works ;al/ FROM: Jeffrey H. Edmonds, P. E., Director of Capital Progr- Jer y Shoemaker, P. E., Senior Program Manager 111144. SUBJECT: Request to Authorize Emergency Repairs ff Home Road—Ayers Street to Port Avenue—Project No. El 2100 Declaration of Emergency DATE: August 4, 2015 SUMMARY: On June 19, 2015, after months of trying to rectify poor performance on the Home Road Street Improvement Project from Ayers Street to Port Avenue, the City terminated the construction contract with Salinas Construction Technologies, Ltd. (Salinas) for cause/contractor default. After terminating Salinas, the City immediately contracted for safety barricading, notified the area businesses of the contractor's termination, and requested Naismith Engineering, the project's design engineer, to provide daily monitoring of the barricades and construction site until further notice. Home Road is a four-lane roadway. Two lanes are currently closed because of the condition the street was left in when the contractor defaulted. To the greatest extent possible, the existing roadway is being maintained by the City's Street Department to try to ensure the remaining two lanes stay in a drivable condition. The City needs to execute an emergency procurement contract with a new construction firm to immediately complete the project and safely restore traffic. Currently the site remains unmanned and creates a daily safety hazard and nuisance. In addition, due to the unfinished work, the area is susceptible to further damage to the public right-of-way and underground facilities. Therefore, to protect the public health and safety, and to avoid any further damage to public property, the construction on Home Road must be completed as soon as possible. ACTIONS TAKEN: 1. The City has contracted directly with Highway Barricades and Services, LLP to continue providing safety barricading at the project location. Page 1 of 2 2. The City has instructed Naismith Engineering to daily check the barricading and job site for safety. 3. The City's Street Department is maintaining the existing two lanes to ensure access to all businesses in the area. FUTURE ACTIONS: 1. Immediately contract for the construction of remaining work with a new contractor to complete the project and restore traffic and safety to the area. CONTRACT AUTHORITY: The City Manager is authorized to approve contracts in excess of $50,000 by Charter Art. X, Sec.2(a) in case of an emergency, but such action must be reported to the Council. Additionally, the Local Government Code 252.022(a) exempts this contract or procurement from the State's competitive bidding requirements because it is necessary: 1. to preserve the property of the municipality; 2. to preserve or protect the public health or safety of the municipality's residents; and 3. due to unforeseen damage to public machinery, equipment or other property. FUNDING: The project will be completed with the funds remaining in the terminated construction contract. RECOMMENDATION: It is recommended that: 1. staff be authorized to administratively secure a new contractor for this project; and 2. an emergency be declared and the City's Charter Art. X, Sec.2(a) be invoked to preserve the property of the municipality, protect the public health or safety of the municipality's residents, and due to unforeseen damage to public machinery, equipment, or property. CONCUR: 404440/ Veronica Ocanas Date Senior Assistant City Attorney APP;OVE� Rona ' L. Olson = - City M- .ager Page 2 of 2 Capital Programs Memo T0: Honorable Mayor and Council Members FROM: Ronald L. Olson, City Manager SUBJECT: Request to Authorize Emergency Repairs Home Road—Ayers Street to Port Avenue—Project No. E12100 Declaration of Emergency DATE: August 4, 2015 SUMMARY: On June 19, 2015, after months of trying to rectify poor performance on the Home Road Street Improvement Project from Ayers Street to Port Avenue, the City terminated the construction contract with Salinas Construction Technologies, Ltd. (Salinas) for cause/contractor default. After terminating Salinas, the City immediately contracted for safety barricading, notified the area businesses of the contractor's termination, and requested Naismith Engineering, the project's design engineer, to provide daily monitoring of the barricades and construction site until further notice. Home Road is a four-lane roadway. Two lanes are currently closed because of the condition the street was left in when the contractor defaulted. To the greatest extent possible, the existing roadway is being maintained by the City's Street Department to try to ensure the remaining two lanes stay in a drivable condition. The City needs to execute an emergency procurement contract with a new construction firm to immediately complete the project and safely restore traffic. Currently the site remains unmanned and creates a daily safety hazard and nuisance. In addition, due to the unfinished work, the area is susceptible to further damage to the public right-of-way and underground facilities. Therefore, to protect the public health and safety, and to avoid any further damage to public property, the construction on Home Road must be completed as soon as possible. ACTIONS TAKEN: 1. The City has contracted directly with Highway Barricades and Services, LLP to continue providing safety barricading at the project location. 2. The City has instructed Naismith Engineering to daily check the barricading and job site for safety. 3. The City's Street Department is maintaining the existing two lanes to ensure access to all businesses in the area. Page 1 of 2 FUTURE ACTIONS: 1. Immediately contract for the construction of remaining work with a new contractor to complete the project and restore traffic and safety to the area. CONTRACT AUTHORITY: The City Manager is authorized to approve contracts in excess of $50,000 by Charter Art. X, Sec.2(a) in case of an emergency, but such action must be reported to the Council. Additionally, the Local Government Code 252.022(a) exempts this contract or procurement from the State's competitive bidding requirements because it is necessary: 1. to preserve the property of the municipality; 2. to preserve or protect the public health or safety of the municipality's residents; and 3. due to unforeseen damage to public machinery, equipment or other property. FUNDING: The project will be completed with the funds remaining in the terminated construction contract. Page 2 of 2 TABULATION OF BIDS DEPARTMENT OF ENGINEERING SERVICES - CITY OF CORPUS CHRISTI, TEXAS TABULATED BY:Jeffrey Edmonds,P.E.,DIRECTOR OF ENGINEERING SERVICES TIME OF COMPLETION:BASE BID: 90 CALENDAR DAYS HORNE ROAD CLARK PIPELINE AYERS STREET TO PORT AVENUE P.O.BOX 9396 PROJECT E12100(RE-ASSIGMENT) CORPUS CHRISTI,TEXAS 78469 BOND 2012 STR 871 Basis of Bid Item Estimated Description Unit No. Quantity Items in Base Bid(excluding Allowances)per SECTION 01 29 01 MEASUREMENT AND BASIS FOR PAYMENT STREET IMPROVEMENTS A-01 Final Surface(3"Type D HMAC) SY 6,118 26.40 161,515.20 A-02 Initial Surface(2.5"Type B HMAC) SY 6,118 21.78 133,250.04 A-03 Seal Coat(One Course) SY 6,118 5.06 30,957.08 A-04 Prime Coat, MC-30(0.15 Gal/SY) GAL 918 6.60 6,058.80 A-OS 10"Cement Treated Recycled Asphalt and Base(5%) SY 6,909 38.50 265,996.50 Rmv&Repl Water Service Connections EA 9 2,800.00 25,200.00 A-06 Ecogrid,Tcnsar TX 5 S1= 6,909 - A-07 Subgrade Preparation(6"minimum) SY 6,909 4.84 33,439.56 A-08 Excavation and Embankment SY 6,909 6.05 41,799.45 A-09 Reflective Pavement Markers(Type 1)(White)(4")(Broken) LF 440 2.41 1,060.40 A-10 Reflective Pavement Markers(Type 1)(White)(4")(Solid) LF 1,663 3.58 5,953.54 A-11 Reflective Pavement Markers(Type 1)(Yellow)(4")(Broken) LF 220 0.70 154.00 A-12 Reflective Pavement Markers(Type 1)(Yellow)(4")(Solid) LF 1,920 5.74 11,020.80 A-13 Reflective Pavement Markers(Type 1)(White)(8")(Solid) LF 215 1.75 376.25 A-14 Reflective Pavement Markers(Type 1)(Yellow)(24")(Solid Gore) LF 60 7.00 420.00 A-15 Reflective Pavement Markers(Type 1)(White)(Arrow,Word or Symbol' EA 10 245.00 2,450.00 A-16 Raised Pavement Markers(Type I-C) EA 62 9.80 607.60 A-17 Raised Pavement Markers(Type II-A-A) EA 40 9.80 392.00 A-18 Raised Pavement Markers(Type II-B-B) EA 3 9.80 29.40 A-19 2"PVC(Sch 40) Electrical Conduit LF 870 13.00 11,310.00 A-20 4"PVC(Sch 40) Electrical Conduit LF 870 25.00 21,750.00 A-21 Plastic Pull Boxes with 3"Gravel EA 3 2,500.00 7,500.00 A-22 Concrete Driveways SF 6,654 10.95 72,861.30 A-23 Block Sodding SY 320 6.86 2,195.20 A-24 Stormwater Pollution Prevention Plan LS 1 10,000.00 10,000.00 A-25 Traffic Control Plan LS 1 22,000.00 22,000.00 A-26 Ozone Action Day EA 2 2,100.00 4,200.00 A-27 Sidewalk Demolition SF 2,825 1.68 4,746.00 A-28 Curb and Gutter Demolition LF 894 5.31 4,747.14 A-29 Concrete Driveway Demolition SF 2,971 3.26 9,685.46 A-30 Pavement Repair SY 23 181.31 4,170.13 A-31 Regulatory Signage EA 11 490.00 5,390.00 A-32 Relocation of Existing Signage EA 2 560.00 1,120.00 A-33 Mobilization LS 1 119,000.00 119,000.00 A-34 Demobilization LS 1 35,000.00 35,000.00 Bonds 35,000.00 Proposal Form Exhibit A HORNE ROAD-Ayers St.to Port Ave.(BOND 2012),Project E12100(RE-ASSIGNMENT) 00 30 01 -1 TABULATION OF BIDS DEPARTMENT OF ENGINEERING SERVICES - CITY OF CORPUS CHRISTI, TEXAS Item Estimated Description Unit No. Quantity 1,091,355.85 ADA COMPLIANCE A-35 5 Foot Concrete Sidewalk SF 5,272 6.53 34,426.16 A-36 Header Curb(Up to 2'in Height) LF 650 39.01 25,356.50 A-37 Concrete Curb Ramp EA 8 1,303.24 10,425.92 A-38 Type"C"Crosswalk Stripe(24") LF 1,293 15.40 19,912.20 A-39 Type"C"Crosswalk Stripe(12") LF 983 15.40 15,138.20 105,258.98 STORMWATER IMPROVEMENTS A-40 Standard 5 Foot Curb Inlet EA 2 4,741.52 9,483.04 A-41 Modified 5 Foot Curb Inlet EA 4 6,502.09 26,008.36 A-42 Inlet Extension EA 8 1,089.71 8,717.68 A-43 Standard Curb and Gutter LF 1,788 19.75 35,313.00 A-44 18" Reinforced Concrete Pipe(Class III) LF 180 91.16 16,408.80 A-45 24"Reinforced Concrete Pipe(Class III) LF 60 127.89 7,673.40 A-46 Trench Safety for Stormwater Lines LF 240 8.06 1,934.40 A-47 Trench Safety for Curb Inlets EA 6 374.73 2,248.38 A-48 Connect Proposed Lateral to Existing Box Culvert EA 4 2,015.54 8,062.16 A-49 Existing Curb Inlet Demolition EA 4 931.23 3,724.92 A-50 Remove Existing Reinforced Concrete Pipe LF 115 21.65 2,489.75 122,063.89 WASTEWATER SYSTEMS IMPROVEMENTS - A-51 8"PVC Gravity Line(6 to 8 Foot Depth) LF 24 98.04 2,352.96 A-52 15"PVC Gravity Line(6 to 8 Foot Depth) LF 585 110.19 64,461.15 A-53 15"PVC Gravity Line(8 to 11 Foot Depth) LF 285 125.16 35,670.60 A-54 8"PVC Gravity Line Rehabilitation by CIPP LF 234 141.35 33,075.90 A-55 Trench Safety for Wastewater Lines LF 1,722 3.12 5,372.64 A-56 4 Foot Diameter Fiberglass Manhole(6 to 8 Foot Depth) EA 3 8,764.55 26,293.65 A-57 4 Foot Diameter Fiberglass Manhole(8 to 11 Foot Depth) EA 1 10,992.54 10,992.54 A-58 5 Foot Diameter Fiberglass Manhole(6 to 8 Foot Depth) EA 1 12,741.85 12,741.85 A-59 Trench Safety for Wastewater Manhole EA 4 952.86 3,811.44 A-60 Wastewater Service Reconnections EA 10 2,500.00 25,000.00 A-61 12"Diameter PVC(C-900) Forcemain LF 328 83.15 27,273.20 A-62 20"Long Pattern Sleeve EA 1 4,221.50 4,221.50 A-63 20"X 12" D.I.M.J.TEE with Restraints EA 1 3,741.00 3,741.00 A-64 12"Spool Piece(Min. 3') EA 1 621.81 621.81 A-65 12" D.I.M.J.90 DEG Bend with Restraints EA 1 1,302.44 1,302.44 A-66 12" D.I.M.J.45 DEG Bend with Restraints EA 5 1,171.57 5,857.85 A-67 12"D.I.M.J. 11 1/4 DEG Bend with Restraints EA 3 1,015.03 3,045.09 A-68 20"D.I.M.J.Gate Valve with Restraints and Valve Boxes EA 1 17,944.75 17,944.75 A-69 12"D.I.M.J.Gate Valve with Restraints and Valve Boxes EA 1 4,195.83 4,195.83 A-70 Traffic Control Plan for Forcemain Connection LS 1 5,013.27 5,013.27 A-71 Pavement Repair SY 390 72.03 28,091.70 A-72 Rehabilitate Existing Brick/Concrete Manhole EA 1 4,578.83 4,578.83 A-73 Exterior Manhole Drop Connection EA 1 3,856.47 3,856.47 A-74 Grout Fill Wastewater Line to be Abandoned in Place LF 870 17.88 15,555.60 A-75 Wastewater Manhole to be Demolished/Abandoned EA 3 1,364.80 4,094.40 A-76 Wastewater By-Passing LS 1 14,240.92 14,240.92 363,407.39 WATER SYSTEM IMPROVEMENTS A-77 6"PVC Waterline LF 80 - A-78 8"PVC Waterline LF 870 - A-79 Trench Safety for Waterlines LF 1,495 - A-80 8"D.I.M.J.45 DEG Bend with Restraints EA 20 - Proposal Form Exhibit A HORNE ROAD-Ayers St.to Port Ave.(BOND 2012),Project E12100(RE-ASSIGNMENT) 00 30 01 -2 TABULATION OF BIDS DEPARTMENT OF ENGINEERING SERVICES - CITY OF CORPUS CHRISTI, TEXAS Item Estimated Description Unit No. Quantity A-81 8"x 6"D.I.M.J.Tee with Restraints EA 1 - A-82 8"D.I.M.J.Gate Valve with Restraints and Valve Boxes EA 4 - A-83 8"Spool Piece(MIN. 2') EA 8 - A-84 8"AC to PVC Adaptor EA 2 - A-85 8"Long Pattern Sleeve EA 2 - A-86 6"D.I.M.J.Gate Valve with Restraints and Valve Boxes EA 1 - A-87 Fire Hydrant Assemblies EA 3 - A-88 Water Service Reconnections EA 11 - A-89 Grout Fill Wastewater Lines to be Abandoned LF 860 - GAS SYSTEM IMPROVEMENTS A-90 Backfill and Compaction of 6"Wrapped Steel Line CY 350 28.70 10,045.00 A-91 Grout Fill Gas Line to be Abandoned in Place LF 1,000 10.89 10,890.00 20,935.00 EXISTING BOX CULVERT REHABILITATION A-92 Point Repairs(Cracks,etc.)(Condition 1) EA 44 822.33 36,182.52 A-93 Point Repairs(Spalls,holes,exposed rebar,etc.)(Condition 2 and 3) EA 7 1,591.76 11,142.32 A-94 Miscellaneous Debris Removal SY 278 116.90 32,498.20 A-95 Silt Removal SY 500 21.66 10,830.00 A-96 Confined Space Working Environment LS 1 8,499.14 8,499.14 99,152.18 REGIONAL TRANSPORTATION AUTHORITY IMPROVEMENTS A-97 8"Concrete Bus Pad(with Crushed Limestone) SF 630 26.73 16,839.90 A-98 Concrete Shelter/Landing Pad SF 300 71.02 21,306.00 A-99 Demolition of Existing Concrete Bus Pad SF 600 11.04 6,624.00 A-100 Demolition of Existing Concrete Shelter Pad SF 300 25.67 7,701.00 52,470.90 A Total Base Bid Items Amount(Sum of Extended Amounts for each Base Bid Line Item A-01 $ 1,854,644.19 B Add(+)or Deduct(-)(See Note 1) C Total Adjusted Base Bid Amount(A and B) $ 1,854,644.19 Allowances in Base Bid per SECTION 01 23 10 ALTERNATES AND ALLOWANCES D-01 Allowance for Street Lighting by Others LS 1 $ 55,000.00 D-02 Allowance for Unanticipated Utility Adjustments(Stormwater) LS 1 $ 10,000.00 D-03 Allowance for Unanticipated Utility Adjustments(Wastewater) _ LS 1 $ 10,000.00 D-04 Allowance for Unanticipated Utility Adjustments(Water) LS 1 $ 10,000.00 D-05 Allowance for Soil Removal and Replacement(Environmental) LS 1 $ 25,000.00 D Total Allowance Amount(Sum of Extended Amounts for Each Allowance Line Item) $ 110,000.00 E Total Base Bid(Sum of C and D) $ 1,964,644.19 Alternates to be considered for inclusion in the Contract per SECTION 01 23 10 ALTERNATES AND ALLOWANCES F-01 F-02 F-03 F Total Amount for Alternates for Consideration(Sum of Extended Amounts for Each G Total Base Bid and Alternates for Consideration(Sum of E and F) $ 1,964,644.19 Contract Times H Bidder agrees to reach Substantial Completion in 90 days I Bidder agrees to reach Final Completion in 120 days Notes Provision is made for Bidder to include an addition or deduction in the Bid to reflect any last minute adjustments in price. The addition or 1 deduction,if made,will be applied proportionately to the following Items:[List Base Bid Items to which the Add or Deduct will be applied.] Proposal Form Exhibit A HORNE ROAD-Ayers St.to Port Ave.(BOND 2012),Project E12100(RE-ASSIGNMENT) 00 30 01 -3 00 30 02 COMPLIANCE TO STATE LAW ON NONRESIDENT BIDDERS Chapter 2252 of the Texas Government Code applies to the award of government contract to nonresident bidders. This law provides that: "a government entity may not award a governmental contract to a nonresident bidder unless the nonresident underbids the lower bid submitted by a responsible resident bidder by an amount that is not less than the amount by which a resident bidder would be required to underbid the nonresident bidder to obtain a comparable contract in the state in which the nonresident's principal place of business is located." "Nonresident bidder"refers to a person who is not a resident of Texas. "Resident bidder"refers to a person whose principal place of business is in this state,including a contractor whose ultimate parent company or majority owner has its principal place of business in this state. Check the statement that is correct for Bidder. 0 Bidder qualifies as a nonresident bidder whose principal place of business or residency is in —/the State of Q Bidder(includes parent company or majority owner)qualifies as a resident bidder whose principal place of business is in the State of Texas. The Owner will use the information provided in the State of Texas Comptroller's annual publication of other states'laws on contracts to evaluate the Bids of nonresident Bidders. Bidder: l '� Company Name: C,PC yr s};1 t-L-C_ go. Ct 1 �e.L.t �.ri its ped or printed) By: (signet ach evidence of au ority to sign Name: ',s,�o Q (type4i or printed) Title: rte i 4� Business address: •7 11_14 ?.„ C.,ti `iaC 7 31 Phone: (,(- t1,- 04'7 Email: cc e // ' rr END OF SECTION Compliance to State Law on Nonresident Bidders 00 30 02-1 (Insert Project Name and Number] 11-25-2013 00 30 04 CONFLICT OF INTEREST QUESTIONNAIRE CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other person doing business with local governmental entity This questionnaire reflects changes made to the law by H.9.1481,80th Leg.,Regular Session. OFFICREONLY This questionnaire is being filed in accordance with Chapter 176,Local Government Code gate Received by a person who has a business relationship as defined by Section 176.001(1-a)with a focal governmental entity and the person meets requirements under Section 176.006(a). By laWthisqueslionnaire must be tried with the records administrator of the local governmental try not later than the 7th business day after date the person becomes aware of facts that require the statement to be filed. See Section 176.006.Local Government Code. A person commits an offense if the person knowingly violates Section 176.006. Local Government Code.An offense under this section is a Class C misdemeanor. J Name of person who has a business relationship with local governmental entity. 0 Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originally bled questionnaire becomes incomplete or inaccurate.) Name of local government officer with whom filer has employment or business relationship. I4A- Name of Officer This section(item 3 including subparts A, B. C&D) must be completed for each officer with whom the filer has an employment or other business relationship as defined by Section 176.001(1-a),Local Government Code. Attach additional pages to this Fonn CIQ as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income.other than investment income,from the flier of the questionnaire? nYes �No B. Is the tiler of the questionnaire receiving or likely to receive taxable income,other than investment income,from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity? LJ Yes FIN° C. Is the tiler of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director,or holds an ownership 0110 percent or more? n ves EllrNo D.Describe each employment or business relationship with the local government officer named in this section. 8 � rr Sliprature of person doing business with the governmental entity Adopted 06/28/2007 00 30 05 City of Corpus Christi Disclosure of Interest SUPPUER NUMBER 70 BE ASSIGNED BY ITY- PURCHASING DIVISION Cky of CITY OF CORPUS CHRISTI Carpus Christi DISCLOSURE OF INTEREST City of Corpus Christi Ordinance 17112,as amended,requires all persons or firms seeking to do business with the City to provide the following information. Every question must be answered. If the question is not applicable, answer with "NA". See reverse side for Filing Requirements, Certifications and COMPANY NAME: C .1-f, 4-s Ll.( ?i :.ti S4,40-4 P.0.130X: 121'1 STREET ADDRESS: CITY: g ,;, ; '1- ZIP: 05/8/ FIRM IS: 1. Corporation 8 2. Partnership 3. Sole Owner 0 4. Association S. Other DISCLOSURE QUESTIONS If additional space is necessary,please use the reverse side of this page or attach separate sheet. I. State the names of each employee"of the City of Corpus Christi having an "ownership interest" constituting 3%or more of the ownership in the above named"firm." Name Job Title and City Department(if known) 2.State the names of each "official" of the City of Corpus Christi having an "ownership interest" constituting 3%or more of the ownership in the above named"firm." Name Title f14 3. State the names of each"board member"of the City of Corpus Christi having an"ownership interest" constituting 3%or more of the ownership in the above named"firm." Name Board,Commission or Committee MIA 4. State the names of each employee or officer of a"consultant" for the City of Corpus Christi who worked on any matter related to the subject of this contract and has an "ownership interest" constituting 3%or more of the ownership in the above named"firm." Name Consultant ra1A FILING REQUIREMENTS If a person who requests official action on a matter knows that the requested action will confer an economic benefit on any City official or employee that is distinguishable from the effect that the action will have on members of the public in general or a substantial segment thereof,you shall disclose that fact in a signed writing to the City official,employee or body that has been requested to act in the matter, unless the interest of the City official or employee in the matter is apparent. The disclosure shall also be made in a signed writing filed with the City Secretary. [Ethics Ordinance Section 2-349(d)] CERTIFICATION I certify that all information provided is true and correct as of the date of this statement,that I have not knowingly withheld disclosure of any information requested; and that supplemental statements will be promptly submitted to the City of Corpus Christi,Texas as changes occur. Certifying Person: ,�� C (w L Title: j rc t i b (Type«Mot) Signature P of Certifying �- Date: V7/0_ DEFINITIONS a. "Board member." A member of any board, commission, or committee appointed by the City Council of the City of Corpus Christi,Texas. b. "Economic benefit". An action that is likely to affect an economic interest if it is likely to have an effect on that interest that is distinguishable from its effect on members of the public in general or a substantial segment thereof. c. "Employee." Any person employed by the City of Corpus Christi,Texas either on a full or part- time basis,but not as an independent contractor. d. "Firm." Any entity operated for economic gain,whether professional,industrial or commercial,and whether established to produce or deal with a product or service,including but not limited to,entities operated in the form of sole proprietorship,as self-employed person, partnership,corporation,joint stock company,joint venture, receivership or trust, and entities which for purposes of taxation are treated as non-profit organizations. e. "Official." The Mayor, members of the City Council, City Manager, Deputy City Manager, Assistant City Managers,Department and Division Heads,and Municipal Court Judges of the City of Corpus Christi,Texas. 1. "Ownership Interest." Legal or equitable interest, whether actually or constructively held, in a firm, including when such interest is held through an agent, trust, estate, or holding entity. "Constructively held" refers to holdings or control established through voting trusts, proxies, or special terms of venture or partnership agreements." g. "Consultant."Any person or firm, such as engineers and architects, hired by the City of Corpus Christi for the purpose of professional consultation and recommendation. 00 30 06 NON-COLLUSION CERTIFICATION STATE OF TEXAS COUNTY OF NUECES OWNER: City of Corpus Christi,Texas 1201 Leopard Street Corpus Christi,Texas 78401 CONTRACT: Insert Project Name Insert Project Number Bidder certifies that the it has not been a party to any collusion among Bidders in the restraint of freedom of competition by agreement to submit a Bid at a fixed price or to refrain from bidding;or with any official or employee of the Owner as to quantity,quality,or price in the prospective contract,or any other terms of said prospective contract;or in any discussion between Bidders and any official of the Owner concerning exchange of money or other thing of value for special consideration in the letting of a contract. c (� Company Name: I LLL bw �k .t� ��{'c�I'A, ‘<.vyiLcJ By: (sign -attach evidence o(�aut iirityi t!o sign) Name: CLL L _ l' - l�t�k (type!or printed) Title: Business address: _ �j a& I214 C .1 iX -z'' 1 Phone: 3l-11G'(000 i Email: tc_Lke f END OF SECTION Non-Collusion Certification 00 30 06-1 [Insert Project Name and Number) 11-25-2013 00 61 13 PERFORMANCE BOND BOND NO. 4400040 Contractor as Principal Surety Name: Clark Pipeline Services,LLC Name: SureTec Insurance Company Mailing address(principal place of business): Mailing address(principal place of business): P.O. Box 1214 9737 Great Hills Trail, Suite 320 Corpus Christi,TX 78401 Austin, TX 78759 Physical address(principal place of business): Owner Same Name: City of Corpus Christi,Texas Mailing address(principal place of business): Capital Programs Surety is a corporation organized and existing 1201 Leopard Street under the laws of the state of: Texas Corpus Christi,Texas 78401 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): 866-732-0099 #E12100 Home Road—Ayers St.to Port Ave. (Bond 2012)Contract Re-Assignment Telephone(for notice of claim): Same Local Agent for Surety Name: Kerry Woods/ Keetch & Assoc. Award Date of the Contract: August 7,2015 Address: 1718 Santa Fe Street Corpus Christi, TX 78404 / Contract Price: $1,964,644.19 Telephone: 361-883-3803 Bond Email Address: kwoods®keetchins.com Date of Bond: August 11, 2015 / The address of the surety company to which any notice of claim should be sent may be obtained (Date of 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 00 61 13 1 7-8-2014 Corpus Christi Standards-Regular Projects 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 Nu County, Texas for any legal action. Contractor as Principal Surety Sur c Insurance om Clark Pipeli Se ices Signature: Signature: Name: ril T ripkt-,, C- it- Name: Dennis M. Descant, Jr. Title: pre+S;kevt Title: Attorney in Fact Email Address: ('C lcr KP, 1c.c0" Email Address: dennis.descant@bch-insurance.com (Attach Power of Attorney and place surety seal below) END OF SECTION Performance Bond 00 61 13 2 7-8-2014 Corpus Christi Standards-Regular Projects 00 61 16 PAYMENT BOND BOND NO. 4400040 Contractor as Principal Surety Name: Clark Pipeline Services,LLC Name: SureTec Insurance Company Mailing address(principal place of business): Mailing address(principal place of business): P.O. BOX 1214 9737 Great Hills Trail, Suite 320 Corpus Christi,TX 78401 Austin, TX 78759 Physical address(principal place of business): Owner Same Name: City of Corpus Christi,Texas Mailing address(principal place of business): Capital Programs Surety is a corporation organized and existing 1201 Leopard Street under the laws of the state of: Texas Corpus Christi,Texas 78401 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): 866-732-0099 #E12116 Home Road—Avers St.to Port Ave. (Bond 2012)Contract Re-Assignment Telephone(for notice of claim): Same Local Agent for Surety Name: Kerry Woods/Keetch & Assoc. Award Date of the Contract: August 7,2015 Address: 1718 Santa Fe Street Corpus Christi, TX 78404 Contract Price: $1,964,644.19 Telephone: 361-883-3803 Bond Email Address: kwoods@keetchins.com August 11, 2015 Date of Bond: The address of the surety company to which any (Date of Bond cannot be earlier than Award 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 00 61 16-1 7-8-2014 Corpus Christi Standards-Regular Projects 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 pied at length herein. Venue shall lie exclusively in Nueces County, Texas •r any legal acti . Cantrcf�git i r ai Prince al r ces Surety SureT-• Insuzanc ar Signature: g Signature: Name: CJ g .J k,v- C . CicirName: Dennis M. Descant, Jr. Title: pee., Title: Attorney in Fact Email Address: rc(arIc[�LeTt G., Email Address: dennis.descant@bch-insurance.com �/ (Attach Power of Attorney and place surety seal below) END OF SECTION Payment Bond Form 00 61 16 2 7-8-2014 Corpus Christi Standards-Regular Projects I POA a: 4221073 I SureTec Insurance Company LIMITED POWER OF ATTORNEY Know All Men by These Presents, That SURETEC INSURANCE COMPANY (the "Company"), a corporation duly organized and existing under the laws of the State of Texas, and having its principal office in Houston, Harris County, Texas, does by these presents make,constitute and appoint / Deborah Bishop,Jeffrey L.Brady, Dennis M. Descant,Jr.,Cheryl A.Sanders its true and lawful Attorney-in-fact,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 waivers to the conditions of contracts and consents of surety for: Five Million and 00/100 Dollars($5,000,000.00) and to bind the Company thereby as fully and to the same extent as if such bond were signed by the President,sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said Attorney-in-Fact may do in the premises. Said appointment shall continue in force until _ 12/31/2015 and is made under and by authority of the following resolutions of the Board of Directors of the SureTec Insurance Company: 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 Attorney(s)-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 of behalf of the Company,to execute,acknowledge and deliver,any and all bonds,recognizances,contracts,agreements or indemnity and other conditional or obligatory undertakings 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. (Adopted at a meeting held on 2014 of April, 1999.) In Witness Whereof SURETEC INSURANCE COMPANY has caused these presents to be signed by its President,and its corporate seal to be hereto affixed this 21st day of March,A.D.2013. SURETEC INSURANCE COMPANY ("":".uila MCF C{ 'q'; By; •r' ` 1 by�- John 7ros Jr. `resident y ,z:State of Texas ss' rCom,ty of Harris . On this 21st day of March,A.D.2013 before me personally came John Knox Jr.,to me known,who,being by me duly sworn,did depose and say.that he resides in Houston, Texas, that he is President of SURETEC INSURANCE COMPANY, the company described in and which executed the above instrument;that he knows the seal of said Company;that the seal affixed to said instrument is such corporate seal;that it was so affixed by order of the Board of Directors of said Company;and that he signed his name thereto by like order. JACQUELYN MALDONADO , Notary Pubic 111) Stateeot sMyCamm,Exp xp.S51�'18t2017 Jacqlyn Maldonado,Notary Public My commission expires May 18,2017 I,M.Brent Beaty,Assistant Secretary of SURETEC INSURANCE COMPANY,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney,executed by said Company,which is still in full force and effect;and furthermore,the resolutions of the Board of Directors,set out in the Power of Attorney are in full force and effect. 11th August 2015 ,A.D. Given under my hand and the seal of said Company at Houston, Texas this day of_._.. 9 Lii . Bre.t Beaty,Assistant.ecretary Any instrument Issued in excess of the penalty stated above is totally void and without any validity. For verification of the authority of this power you may call(713)812-0800 any business day between 8:00 am and 5:00 pm CST. ( _ ____ SureTec Insurance Company THIS BOND RIDER CONTAINS IMPORTANT COVERAGE INFORMATION Statutory Complaint Notice To obtain information or make a complaint:You may call the Surety's toll free telephone number for information or to make a complaint at: 1-866-732-0099.You may also write to the Surety at: SureTec Insurance Company 9737 Great Hills Trail, Suite 320 Austin, Tx 78759 You may contact the Texas Department of Insurance to obtain information on companies,coverage,rights or complaints at 1-800-252- 3439.You may write the Texas Department of Insurance at PO Box 149104 Austin,TX 78714-9104 Fax#: 512-475-1771 Web:http://www.tdi.state.tx.us Email:ConsumerProtection@tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim,you should contact the Surety first. If the dispute is not resolved,you may contact the Texas Department of Insurance. Terrorism Risks Exclusion The Bond to which this Rider is attached does not provide coverage for, and the surety shall not be liable for, losses caused by acts of terrorism, riot, civil insurrection, or acts of war. Exclusion of Liability for Mold, Mycotoxins, Fungi & Environmental Hazards The Bond to which this Rider is attached does not provide coverage for, and the surety thereon shall not be liable for, molds, living or dead fungi, bacteria, allergens, histamines, spores, hyphae, or mycotoxins, or their related products or parts, nor for any environmental hazards, bio-hazards, hazardous materials, environmental spills,contamination, or cleanup, nor the remediation thereof, nor the consequences to persons, property, or the performance of the bonded obligations, of the occurrence, existence, or appearance thereof. 1 Texas Rider 010106 / ' DDATE(LiGVOD:YriY) ACORN CERTIFICATE OF LIABILITY INSURANCE `---- 8/5/2015 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of tho 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 CONTACTAE: Nicole Ybanez Swantner&Gordon Insurance Agency PHONE — FAX - A Higginbotham Company _(AJC..No.Est)•361 561 2194 LJOJIQ).361-8440101 PO Box 870 AADD"RESS•nybanez@higginbotham.net _— Corpus Christi TX 78403 INSURER(S)AFFORDING COVERAGE _ � NAIC C INSURER A:Ohio Security 24082 INSURED CPCINT INSURER B:Ohio Casualty Insurance Company 24074 _ CPC Interests, LLC dba Clark Pipeline Services INSURER C:Texas Mutual Insurance Company 122945 PO Box 1214 — i — Corpus Christi TX 78401 INSURER ___ __ ________ __ j INSURER E:– fINSURER F: COVERAGES CERTIFICATE NUMBER: 1893739647 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 I . •ADDL'SUBR•----. - -- I POLICY EFF POLICY EXP i LTR, TYPE OF INSURANCE . INSD':VND I POLICY NUMBER i(MMIDDIYYYY)I(MMIDDIYYYY), LIMITS A X i COMMERCIAL GENERAL LIABILITY v 1 BLS56512183 ;2/1/2015 ! 2/1/2016 ILEACH OCCURRENCE $1,000,000 / OHMAGE T�RENTED — I CLAIMS MADE X I OCCUR I � �/ PREMIS�ES1Ea occurre 51,000,000 MED EXP(Any one person) S 15,000 _ , PERSONAL&ADV INJURY_ $1,000,000 / - j GEN•L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X 1 POLICY PRO- F. LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: / I I ,Contractors Poll 155100,000 BAS56512183 2/1/2015 2/1/2016 'CUM,BINEO SINGLE LIMIT A 'AUTOMOBILE LIABILITY I 51,000,000 i �/ / ,(Ea accident) I X. ANY AUTO / BODILY INJURY(Per person) S /f I AUTOWNED . 1 SCHEDULED ,/ BODILY INJURY(Per accident) S 1J`- AUTOS • NON-OWNED -PWOPEA`IY DAMAGE 1 X HIRED AUTOS i X AUTOS (Per accident) I$ V1s B I X i UMBRELLA LIAB x l OCCUR US056512183 2/1/2015 2/1/2016 EACH OCCURRENCE $5,000,000 1 EXCESS LIAB i I CLAIMS-MADE V _AGGREGATE 55,000,000 i I DED 'X I RETENTION 5510.000 I I I $ ;WORKERS COMPENSATION TSF0001282215 2/1/2015 2/1/2016 x PEAR TUTE I ]ETH ;AND EMPLOYERS'LIABILITY Y/N - , !ANY PROPRIETOR/PARTNER/EXECUTIVE ' V E.L.EACH ACCIDENT 161,000,000 :OFFICER/MEMBER EXCLUDED? Y N/A I ;(Mandatory In NH) E L.DISEASE-EA EMPLOYEE$1,000,000 / If yes.desn be under i1 DESCRIPTION OF OPERATIONS belay ! FEL DISEASE-POLICY LIMIT I$1,000,000 i 1 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability,Automobile, and Umbrella Liability[Follows Form Underlying] policies include blanket automatic additional insured endorsements that provide additional insured status to the certificate holder only when there is a written contract between the insured and certificate holder that requires such status. See Attached... 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-Capital Programs ACCORDANCE WITH THE POLICY PROVISIONS. Sylvia Arriaga-Construction Contracts Mgr PO Box 9277 AUTHORIZED REPRESENTATIVE Corpus Christi TX 78469-9277 a~�J� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CPCINT LOC#: ACORD ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Swantner&Gordon Insurance Agency CPC Interests, LLC dba Clark Pipeline Services PO Box 1214 POLICY NUMBER Corpus Christi TX 78401 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 General Liability,Automobile,Workers Compensation&Umbrella Liability[Follows Form Underlying] policies include blanket automatic waiver of subrogation endorsements that provide this feature only when there is a written contract between the insured and certificate holder that requires it. General Liability&Automobile policies include Primary Coverage to the certificate holder only when there is a written contract between the insured and certificate holder that requires such status. General Liability,Automobile, and Workers Compensation policies include an endorsement providing that 30 days'notice of cancellation will be furnished to the certificate holder except 10 days notice of nonpayment of premium. Owners Project#E12100 NEI Project#9008 Home Rcad-Ayers Street to Port Avenue(Bond 2012) ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 6g1/„ 1Y COMMERCIAL GENEIB(,JJP5 S(! CG 88 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX SUBJECT PAGE NON-OWNED AIRCRAFT 2 NON-OWNED WATERCRAFT 2 PROPERTY DAMAGE LIABILITY •ELEVATORS 2 EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) 2 MEDICAL PAYMENTS EXTENSION 3 EXTENSION OF SUPPLEMENTARY PAYMENTS •COVERAGES A AND B 3 V.-ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 3 PRIMARY AND NON-CONTRIBUTORY- ADDITIONAL INSURED EXTENSION 5 ADDITIONAL INSUREDS -EXTENDED PROTECTION OF YOUR "LIMITS OF INSURANCE” 6 WHO IS AN INSURED -INCIDENTAL MEDICAL ERRORS/MALPRACTICE AND WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION -MANAGEMENT EMPLOYEES 6 NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES 7 FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES 7 KNOWLEDGE OF OCCURRENCE, OFFENSE,CLAIM OR SUIT 7 Ts LIBERALIZATION CLAUSE 7 BODILY INJURY REDEFINED 7 EXTENDED PROPERTY DAMAGE 8 JWAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - 8 WHEN REQUIRED IN A CONTRACT OR AGREEMENT WITH YOU 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copynghted material of Insurance Services Office.Inc.,with its permission. Page 1 of 8 With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement A. NON-OWNED AIRCRAFT Under Paragraph 2. Exclusions of Section I -Coverage A•Bodily Injury And Property Damage Liability, exdusion g.Aircraft, Auto Or Watercraft does not apply to an aircraft provided: 1. It is not owned by any insured; 2. It is hired, chartered or loaned with a trained paid crew; 3. The pilot in command holds a currently effective certificate. issued by the duly constituted authority of ® the United States of America or Canada, designating her or him a commercial or airline pilot and SW 4. It is not bei used to carry persons or property fora charge. However, the insurance afforded by this provision does not apply if there is available to the insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically 1 IBEI in excess of this policy). contingent or on any other basis, that would also apply to the loss covered under Ithis -. B. NON-OWNED WATERCRAFT 1Under Paragraph 2.Exclusions of Section I•Coverage A-Bodily Injury And.Property Damage Liability, Subparagraph (2)of exclusion g.Aircraft, Auto Or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) Less than 52 feet long; and a (b) Not being used to carry persons or property for a charge. C. PROPERTY DAMAGE LIABIUTY•ELEVATORS 1. Under Paragraph 2. Exclusions of Section I•Coverage A•Bodily Injury And Property Damage Liabil- ity, Subparagraphs (3). (4) and (6) of exclusion j. Damage To Property do not apply if such "property damage' results from the use of elevators. For the purpose of this provision. elevators do not include vehicle lifts. Vehicle lifts are lifts or hoists used in automobile service or repair operations. 2. The following is added to Section IV • Commercial General Liability Conditions, Condition 4. Other Insurance, Paragraph b.Excess insurance: The insurance afforded by this provision of this endorsement is excess over any property insurance, whether primary. excess, contingent or on any other basis. D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) s It Damage To Premises Rented To You is not otherwise excluded from this Coverage Part i 1. Under Paragraph 2.Exclusions of Section I-Coverage A-Bodily Injury and Property Damage Liability: a. The fourth from the last paragraph of exclusion j. Damage To Property is replaced by the follow- s Paragraphs (1),(3)and (4)of this exclusion do not apply to"property damage' (other than damage by Are, lightning, explosion. smoke. or leakage from an automatic fire protection system) to: (I) Premises rented to you for a period of 7 or fewer consecutive days; or (II) Contents that you rent or lease as part of a premises rental or lease agreement for a period of more than 7 days. Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage' to contents of premises rented to you for a period of 7 or fewer consecutive days. A separate limit of insurance applies to this coverage as described in Section Ill • Limits of ® 2013 Liberty Mutual Insurance CO III 10 0413 Includes copyrighted material a Insurance Services OHloe,Inc.,with Its pemdsebn. Page 2 of 6 b. The last paragraph of subsection 2. Exclusions is replaced by the following: Exclusions c. through n. do not apply to damage by fire, lightning, explosion, smoke or leakage from automatic fire protection systems to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section Ill -Limits Of Insurance. 2. Paragraph 6. under Section III -Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of"property damage" to: a. Any one premise: (1) While rented to you: or (2) While rented to you or temporarily occupied by you with permission of the owner for damage by fire, lightning, explosion, smoke or leakage from automatic protection sys- tems; or b. Contents that you rent or lease as part of a premises rental or lease agreement. 3. As regards coverage provided by this provision D. EXTENDED DAMAGE TO PROPERTY RENTED TO YOU (Tenant's Property Damage) -Paragraph 9.a. of Definitions is replaced with the following: 9.a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, or leakage from automatic tire protection systems to premises while rented to you or temporarily occupied by you with the permission of the owner, or for damage to contents of such premises that are included in your premises rental or lease agreement, is not an "insured contract". E. MEDICAL PAYMENTS EXTENSION If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this policy are amended as follows: Under Paragraph 1. Insuring Agreement of Section I-Coverage C -Medical Payments, Subparagraph (b) of Paragraph a. is replaced by the following: (b) The expenses are incurred and reported within three years of the date of the accident; and F. EXTENSION OF SUPPLEMENTARY PAYMENTS -COVERAGES A AND B 1. Under Supplementary Payments -Coverages A and B,Paragraph 1.b. is replaced by the following: b. Up to 53,000 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 applies. We do not have to furnish these bonds. 2. Paragraph 1.d. is replaced by the following: d. 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 $500 a day because of time off from work. G ADDITIONAL INSUREDS -BY CONTRACT, AGREEMENT OR PERMIT 1. Paragraph 2. under Section II -Who Is An Insured is amended to include as an insured any person or organization whom you have agreed to add as an additional insured in a written contract, written agreement or permit. Such person or organization is an additional insured but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused in whole or in part by: a. Your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your on going operations for the additional insured that are the subject of the written contract or written agreement provided that the "bodily injury" or "property damage" occurs, or the "per- sonal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or © 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Page 3 of 8 • b. Premises or facilities rented by you or used by you; or c. The malignance, operation or use by you of equipment rented or leased to you by such parson or or d. Operations performed by you or on your behalf for which the state or political subdivision has issued a permit subject to the following additional provisions: (1) This insurance does not apply to "bodily injury', "property damage", or 'personal and ad- vertising injury arising out of the operations performed for the state or political subdivision; (2) This insurance does not apply to "bodily injury" or "property damage' included within the "completed operations hazard'. (3) Insurance applies to premises you own, rent, or control but only with respect to the following hazards: I (a) The existence. maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways. manholes, marquees, hoist away openings, sidewalk vaults, street banners, or decorations and similar expo- sures; or (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If°overage provided to the additional insured is required by a contract or agreement, the insur- ance afforded to such additional insured wit not be broader than that which you are required by the contract or agreement to provide for such additional insured. With respect to Paragraph 1.a. above, a person's or organization's status as an additional insured under this endorsement ends when: (1) At work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project With respect to Paragraph 1.b. above, a person's or organization's status as an additional insured under this endorsement ends when their written contract or written agreement with you for such premises or facilities ends. With respects to Paragraph 1.c. above, this insurance does not apply to any 'occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this endorsement applies only if the written contract or written agreement is signed prior to the"bodily injury" or'property damage". We have no duty to defend an additional insured under this endorsement untt we receive written notice el a 'suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In the Event Of Occurrence. Offense. Claim Or Suit under Section W -Commercial General Liability Condi- tions. 0 2O13Uberty Mutual Insurance CO x610 0413 tndudssoapyrlplded material of Insurance lierviass Office,Inc.,with Its painda ton. Page 4 of 8 2. With respect to the insurance provided by this endorsement, the following are added to Paragraph 2. Exclusions under Section 1-Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or"property damage" arising from the sole negligence of the additional insured. b. 'Bodily injury' or "property damage' that occurs prior to you commencing operations at the location where such "bodily injury" or"property,, damage' occurs. c. "Bodily injury", 'property damage" or"personal and advertising injury' arising out of the render- ing of, or the failure to render, any professional architectural. engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions. reports, surveys, field orders, change orders or drawings and specifications; or (2) Supervisory. inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, liking, employment, training or monitoring of others by that insured, if the "occur- rence' which caused the "body injury" or "property damage", or the offense which caused the "personal and advertising injury', involved the rendering of, or the failure to render, any professional architectural, engineering or surveying services. d. "Bodily injury' or"property damage" occurring after: (1) Al work, including materials, parts or equipment furnished in connection with such work, on the project (other than service. maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been oonpleted; or (2) That portion of your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. e. My person or organization specifically designated as an additional insured for ongoing operations by a separate ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS endorsement is- sued by us and made a part of this policy. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section IO -Limits Of insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of One additional insured is the amount of insurance: a. Required by the contract or agreement; or b. Available under Vie applicable Limits of insurance shown in the Declarations; $ whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Dedaratio ns. H. PRIMARY AND NON-CONTRIBUTORY ADDITIONAL INSURED EXTENSION This provision applies to any person or organization who qualifies as an additional insured under any form = or endorsement under this policy. Condition 4.Other Insurance of SECTION IV-COMMERCIAL GENERAL UABIUTY CONDITIONS is amend- ed as follows: a. The following is added to Paragraph a.Primary Insurance: If an additional insureds policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis, this policy shall be primary and we wilt not seek contribution from the additional insured's policy for damages we cover. • 2013 t ibery Mutual Insurance CO 88 10 0413 Includes copyrgbtsd material of insurance Services Office,Inc.,with its permission. Page S of 8 b. The following is added to Paragraph b.Excess Insurance: Mien a written contract or written agreement, other than a premises lease. facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a state or political subdivision between you and an additional insured doss not require this insurance to be primary or primary and non-oontrdwtory, this insurance is excess over any other insurance for which the addi- tional insured is designated as a Named Insured. Regardless of the written agreement between you and an additional insured. this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the additional insured has been added as an additional insured on other policies. I. ADDITIONAL INSUREDS •EXTENDED PROTECTION OF YOUR LIMITS OF INSURANCE" This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this policy. 1. The following is added to Condition 2.Duties in The Event Of Occurrence, Offense, Claim or Suit An additional insured under this endorsement will as soon as practicable: a. Give written notice of an"occurrence" or an offense that may result In a claim or"suit" under this insurance lo us; b. Tender the defense and indemnity of any claim or 'suit' to all insurers whom also have insurance available to the additional insured; and c. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part. d. We have no duty to defend or indemnity an additional insured under this endorsement until we receive written notice of a'suit' by the additional insured. 2. The limits of insurance applicable to the additional insured are those specified in a written contract or written agreement or the limits of insurance as stated in the Declarations of this policy and defined in Section It - Umits of Insurance of this policy, whichever are less. These limits are inclusive of and not in addition to is imits of insurance available under this policy. J. WHO IS AN INSURED •INCIDENTAL MEDICAL ERRORS I MALPRACTICE WHO IS AN INSURED -FELLOW EMPLOYEE EXTENSION •MANAGEMENT EMPLOYEES Paragraph 2.a.(1)of Section It•Who Is An Insured is replaced with the following: (1) 'Bodily injury' or'personal and advertising injury': (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (I you are a limited liability company), to a co-"employee" while in the course of his or her employ- s ment or performing duties related to the conduct at your business, or to your other "volunteer workers' while performing duties related lo the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co'employee or "volunteer worker' as a consequence of Paragraph (1)(a)above; _ (c) For which there is any obligation to sham damages with or repay someone else who must pay damages because of the injury described in Paragraphs (1)(a)or(b)above; or (d) Arising out of his or her providing or failing to provide professional health care services. However, if you are not in the business of providing professional health care services or providing profes- sional health care personnel to others, or if coverage for providing professional health care ser- • vices is not otherwise excluded by separate endorsement, this provision (Paragraph (d))does not appy. Paragraphs (a)and(b)above do not apply to"bodily injury" or"personal and advertising injury" caused by an'employee who is acting M a supervisory capacity for you. Supervisory capacity as used herein means the 'employee's' job responsibilities assigned by you, includes the direct supervision of other 'employ- ees' of yours. However, none of these "employees" are insureds for "bodily injury' or 'personal and 0 20131.efsrly Mutual Insurance CO Ile 10 0413 includes copyrighted materiel of Insurance Services Orbs.Inc.,with Its permission. Page 6 of a advertising injury arising out of their willful conduct. which is defined as the purposeful or willful intent to cause"bodily injury or 'personal and advertising injury, or caused in whole or in part by their intoxica- tion by liquor or controlled substances. The coverage provided by provision J.is excess over any other valid and collectable insurance available to your "employee. K. NEWLY FORMED OR ADDITIONALLY ACQUIRED ENTITIES Paragraph 3.of Section Il-Who Is An Insured is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar Insurance available to that organization. However. a. Coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. Coverage A does not apply to"bodily injury" or"property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to 'personal and advertising injury arising out of an offense committed before you acquired or formed the organization. d. Records and descriptions of operations must be maintained by the first Named Insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations or qualifies as an insured under this provision. L FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES Under Section IV•Commercial General Liability Conditions, the following N added to Condition 8.Repre- sentations: Your failure to disclose all hazards or prior 'occ urences" existing as of the inception date of the poky shall not prejudice the coverage afforded by this policy provided such failure to disclose all hazards or prior "occurrences" is not intentional. U. KNOWLEDGE OF OCCURRENCE,OFFENSE,CLAIM OR SUIT Under Section IV -Commercial General Liability Conditions, the following is added to Condition 2.Dugs hi The Event of Occurrence, Offense, Claim Or Suit: Knowledge of an "occurrence', offense, claim or 'silt" by an agent, servant or "employee' of any insured shall not in itself constitute icnowledge of the insured unless an insured listed under Paragraph 1.of Section II-Who is An Insured or a person who has been designated by them to receive reports of -occurrences", offenses, claims or "suits" shall have received such notice from the agent. servant or 'employee". e N. UBERALQATION CLAUSE if we revile this Commercial General Liability Extension Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the day the revision is effective in your state. O. BODILY INJURY REDEFINED Under Section V-Definitions, Definition 3.is replaced by the following: 3. "Bodily Injury' means physical injury, sickness or disease sustained by a person. This includes mental anguish, mental injury, shock, fright or death that results from such physical injury, sick- ness or disease. ® 2013 Liberty Mutual bsurarmce CS 88 10 0413 Includes copyrighted material or insurance!Services 011los.Inc.,with Its permission. Page 7 of 8 P. EXTENDED PROPERTY DAMAGE Exclusion a. of COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY is replaced by the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A Q. A CONTRACT OR AGREEMENT WITH YOU Under Section IV -Commercial General Liability Conditions, the following is added to Condition 8.Trans- fer Of Rights Of Recovery Against Others To Us: We waive any right of recovery we may have against a person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard" provided: 1. You and that person or organization have agreed in writing in a contract or agreement that you waive such rights against that person or organization: and 2. The injury or damage occurs subsequent to the execution of the written contract or written agree- ment. F. a T) 2013 Liberty Mutual Insurance CG 88 10 04 13 Includes copyrighted material of Insurance Services Office,Inc,with its permission. Page 8 of 8 3� COMMERCIAL GENERAL LIABILITY pt‘ 6(45 CG 86 )1) ` THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. • / ADDITIONAL INSURED -AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Paragraph 2. under Section II - Who Is An Insured is amended to include as an insured any person or s organization whom you have agreed to add as an additional insured in a written contract or written agreement. Such person or organization is an additional insured but only with respect to liability for `bodily injury" or"property damage": 1. Caused by "your work" performed for that additional insured hat is the subject of the written contract or written agreement: and 2. Included in the "products-completed operations hazard'. However. a) The insurance afforded to such additional insured only applies to the extent permitted by law: and b) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional nsured The insurance provides by this endorsement applies only if the written contract or written agreement is signed pnor to the "bodily injury" or"property damage'. We have no duty to defend an additional insured under this endorsement until we receive written notice of a"suit" by the additional insured as required in Paragraph b. of Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV-Commercial General Liability Conditions. B. With respect to the insurance orovided by this endorsement, the following are added to Paragraph 2. Exclusions under Section I-Coverage A-Bodily Injury And Property Damage Liability: This insurance does not apply to: 1. "Bodily injury" or "property damage" that occurs prior to you commencing operations at the location where such "bodily injury" or"property damage" occurs. 2. "Bodily injury' or "property damage" arising out of the rendering of. or the failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawing and specifications; and b. Supervisoy, inspection, arch tectural or engineering activities. O 2013 Liberty Mutual Insurance CG 86 11 04 13 Includes copyrighted material of Insurance Services Office.Inc.with its permission. Page 1 of 2 C. With respect to the insurance afforded to these additional insureds. the following is added to Section II- Umits of Insurance: If coverage provided to the additional insured is required by a contract or agreement. the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by contract or agreement; or 2. Available under the applicable limits of Insurance shown in the Declaration. whichever is lees. This endorsement shall not increase the applicable Limits of Insurance shown in the Declaraao no. 0. With respect to the insurance afforded by this endorsement. Section N-Commercial General Liability Conditions is amended as follows 1. The following is added to Paragraph 2.Dulles in The Event Of Occurrence, Offense, Claims Or Suit: An additional Insured under this endorsement will as soon as practicable: a. Give written notice of an"occurrence" or an offense that may result In a claim or "sur under this insurance to us; b. Tender the defense and indemnity of any claim or 'sur to all insurers whom also have insurance available to the additional insured; and C. Agree to make available any other insurance which the additional insured has for a loss we cover under this Coverage Part d. We have no duly to defend or indemnify an additional insured under this endorsement until we receive written notice of a"suir by the additional insured. 2. Paragraph 4.of Section IV-Commercial General Liability Conditions is amended as follows a. The following is added to Paragraph a.Primary insurance: lf an additional insured's policy has an Other Insurance provision making its policy excess, and you have agreed in a written contract or written agreement to provide the additional insured coverage on a primary and noncontributory basis. this policy shall be primary and we will not seek contribution from the additional insured's policy for damages we cover. b. The following is added to Paragraph b.Ehmoess Insurance: When a written contract or written agreement, other than a premises lease,facilities rental contract or agreement, an equipment rental or lease contract or agreement, or permit issued by a slate or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurer= for which the additional insured is designated as a Named insured. Regardless of the written agreement between you and an additional insured, this insur- ance is excess over any ober insurance whether primary, excess, contingent or on any crier basis for which the additional insured has been added as an additional insured on other policies. • • 2013 Liberty;Meal Insurance CG M 11 0413 Induces copyrighted material of Insurance Services Oboe.Inc.with its permission. Page 2 of 2 6(fca fg 'COMMERCIAL GENERAL LIABILITY 9) 1'.. / CG 89 70 04 13 tO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. JAMENDMENT OF CANCELLATION PROVISIONS This endorsement modifies insurance providec under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART • Any term or provision of the Cancellation Conditions of the policy or any endorsement amending or replac- SEM ing such Conditions is amended by the following: f you have agreed in a written contract or written agreement to provide a person or organization notice of cancellation we agree to the followirg: Provide 30 days prior written cancellation notice to such person or organization for reasons other than nonpayment of premium, out only if we are provided will a schedule of persons or organizations with whom you have agreed to provide notification more than 30 days before the cancellation is to take 1M=I=I effect. For purposes of this endorsement, knowledge of the agent as to the persons or organizations requesting notice of cancellation is insufficient to invoke our duty to provide notice of cancellation unless the identity of the persons or organizations is provided directly to us in accordance with the terms of this endorsement. Failure to provide notice to a person or organization in accordance with the terms of this endorsement shall not extend the effective date of the cancellation or otherwise affect cancellation of the policy as to any insured. co 2013 Liberty Mutual Insurance CG 89 70 04 13 Includes copyrighted material of Insura me Services Office.Inc..with its permission. Page 1 of 1 Q COMMERCIAL AUTO nA' t ci)045( 111il � CA88100110 cbtr3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: 'BUSINESS AUTO COVERAGE FORM - With respect to coverage afforded by this endorsement, the provisions of the policy apply unless modified by the endorsement. COVERAGE INDEX S SUBJECT PROVISION NUMBER " s /ADDITIONAL INSURED BY CONTRACT. AGREEMENT OR PERMIT 3 ACCIDENTAL AIRBAG DEPLOYMENT 12 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 18 - AMENDED FELLOW EMPLOYEE EXCLUSION 5 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 13 BROAD FORM INSURED 1 BODILY INJURY REDEFINED 21 - EMPLOYEES AS INSUREDS (including employee hired auto) 2 EXTENDED CANCELLATION CONDITION 22 EXTRA EXPENSE-BROADENED COVERAGE 10 GLASS REPAIR-WAIVER OF DEDUCTIBLE 15 HIRED AUTO PHYSICAL DAMAGE(including employee hired auto) 6 HIRED AUTO COVERAGE TERRITORY 20 LOAN !LEASE GAP 14 PARKED AUTO COLLISION COVERAGE(WAIVER OF DEDUCTIBLE) 16 PERSONAL EFFECTS COVERAGE 11 PHYSICAL DAMAGE -ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 8 RENTAL REIMBURSEMENT 9 SUPPLEMENTARY PAYMENTS 4 TOWING AND LABOR 7 / UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS 17 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US 19 SECTION II-LIABILITY COVERAGE is amended as follows: 1. BROAD FORM INSURED SECTION II - LIABILITY COVERAGE, paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: d. Any legally incorporated entity of wnich you own more than 50 percent of the voting stock during the policy period. However. Insured" does not include any organization that: (1) Is a partnership or joint venture; or (2) Is an insured under any other automobile policy: or (3) Has exhausted its Limit of Insurance under any other automobile policy. Paragraph d. (2) of this provision does not apply to a policy written to apply specifically in excess of this policy. e. Any organization you newly acquire or form, other than a partnership or joint venture, of which you own more than 50 percent of the voting stock. This automatic coverage is afforded only for 180 days from the date of acquisition or formation. However, coverage under this provision does not apply: (1) If there is similar insurance or a self-insured retention plan available to that organization; 02010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 1 of 7 (2) If the Limits of Insurance of any other insurance policy have been exhausted; or (3) To "bodily injury" or "property damage" that occurred before you acquired or formed the organization. 2. EMPLOYEES AS INSUREDS SECTION II - LIABILITY COVERAGE,paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: f. Any "employee" of yours while using a covered "auto" you do not own, hire or borrow but only for acts 'within the scope of their employment by you. Insurance provided by this endorse- ment is excess over any other insurance available to any "employee". g. An "employee" of yours while operating an "auto" hired or borrowed under a written contract or agreement in that "employee's" name, with your permission, while performing duties re- lated to the conduct of your business and within the scope of their employment. Insurance provided by this endorsement is excess over any other insurance available to the 'employee". 3. ADDITIONAL INSURED BY CONTRACT, AGREEMENT OR PERMIT SECTION II - LIABILITY COVERAGE,paragraph A.1. -WHO IS AN INSURED is amended to include the following as an insured: h. Any person or organization with respect to the operation, maintenance or use of a covered "auto", provided that you and such person or organization have agreed in a written contract, agreement, or permit issued to you by governmental or public authority, to add such person, or organization, or governmental or public authority to this policy as an"insured" However, such person or organization is an "insured": (1) Only with respect to the operation, maintenance or use of a covered "auto": (2) Only for 'bodily injury" or "property damage" caused by an "accident" which takes place after you executed the written contract or agreement, or the permit has been issued to you; and (3) Only for the duration of that contract, agreement or permit 4. SUPPLEMENTARY PAYMENTS SECTION II - LIABILITY COVERAGE, Coverage Extensions, 2.a. Supplementary Payments, para- graphs (2)and (4) are replaced by the following: (2) Up to S3,000 for cost of bail bonds (including bonds for related traffic violations ) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the insured at our request, including actual loss of earn- ings up to S500 a day because of time off from work. 5. AMENDED FELLOW EMPLOYEE EXCLUSION In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to a the employer by the workers compensation exclusivity rule, or similar protection, the following provision is added: SECTION II - LIABILITY, exclusion 8.5. FELLOW EMPLOYEE does not apply if the "bodily injury" _ results from the use of a covered "auto" you own or hire. SECTION III-PHYSICAL DAMAGE COVERAGE is amended as follows: 6. HIRED AUTO PHYSICAL DAMAGE Paragraph A.4. Coverage Extensions of SECTION III -PHYSICAL DAMAGE COVERAGE,is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss or Collision coverage are provided under the Business Auto Coverage Form for any "auto" you own, then the Physical Damage coverages provided are extended to "autos": a. You hire, rent or borrow: or Q2010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc.,with its Permission. Page 2 of 7 b. Your ' " hires or rents under a written contract or agreement in that 'employee's" name, but only If the damage occurs while the vehicle is being used in the conduct of your business, subject to the following limit and deductible: A. The most we will pay for loss' in any one'accident" or loss" is the smallest of: (1) 550,000; or (2) The actual cash value of the damaged or stolen property as of the time of the loss'; or (3) The cost of repairing or replacing the damaged or stolen property with other property of Bce kind and quality, minus a deductible. B. The deductible will be equal to the largest deductible applicable to any owned "auto' for that coverage. C. Subject to the limit, deductible and excess provisions described in this provision, we will provide coverage equal to the broadest coverage applicable to any covered 'auto" you own. D. Subject to a maximum of S750 per 'accident', we will also cover the actual loss of use of the hired 'auto' if it results from an 'accident", you are legally liable and the lessor incurs an actual financial loss. E. This coverage extension does not apply to: (1) My 'auto' that is hired, rented or borrowed with a driver; or (2) My "auto' that is hired, rented or borrowed from your "employee'. For the purposes of this provision, SECTION V-DEFINITIONS is amended by adding the following: "Total loss" means a loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. 7. TOWING AND LABOR SECTION IN-PHYSICAL DAMAGE COVERAGE,paragraph A2.Towing. is amended by the addition of the following: We will pay towing and labor costs incrred, up to the limits shown below. each time a covered 'auto' classified and rated as a private passenger type, light truck" or "medium truck" is dis- abled a. For private passenger type vehicles, we will pay up to S50 per disablement b. For light tri", we will pay up to S50 per disablement 'Light trucks" are trucks that have a gross vehicle weight (GVW)of 10,000 pounds or less. c. For"medium trucks' .we will pay up to$150 per disablement "Medium trucks' are trucks that have a gross vehicle weight (GVW)of 10,001-20,000 pounds. However. the labor must be performed at the place of disablement 0. PHYSICAL DAMAGE- ADDITIONAL TRANSPORTATION EXPENSE COVERAGE Paragraph A.4.a.. Coverage Extension of SECTION III-PHYSICAL DAMAGE COVERAGE,is amend- ed to provide a limit of S50 per day and a maximum limit of$1,500 t S2010 Uberty Mutual Insurance Company-AU rights reserved CA 0010 01 10 Includes copyrighted material of Insurance Services Office Inc,with its Permission. Page 3 of 7 9. RENTAL REIMBURSEMENT SECTION III-PHYSICAL DAMAGE COVERAGE,A.COVERAGE,is amended by adding the following: a. We wit pay up to $75 per day for rental reimbursement expenses incurred by you for the rental of an 'auto" because of "accident' or "toss", to an 'auto' for which we also pay a loss' under Comprehensive. Specified Causes of Loss or Collision Coverages. We will pay only for those expenses incurred after the first 24 hours following the "accident' or loss" to the covered "auto." b. Rental Reimbursement will be based on the rental of a comparable vehicle, which in many cases may be substantially less than $75 per day, and will only be allowed for the period of time it should take to repair or replace the vehicle with reasonable speed and similar quality, up to a nundmum of 30 days. c. We will also pay up to $500 for reasonable and necessary expenses incurred by you to remove and replace your tools and equipment from the covered "auto". d. This coverage does not apply unless you have a business necessity that other "autos" avail- able for your use and operation cannot fill. e. If'loss" results from the total theft of a covered "auto" of the private passenger type, we wB pay under this coverage only that amount of your rental reimbursement expenses which is not already provided under Paragraph 4.Coverage Extension. L No deductible applies to this coverage. For the purposes of this endorsement provision, materials and equipment do not include "personal effects" as defined in provision 11. 10. EXTRA EXPENSE-BROADENED COVERAGE Under SECTION III-PHYSICAL DAMAGE COVERAGE,A.COVERAGE,we will pay for the expense of returning a stolen covered "auto' to you. The maximum amount we will pay is$1,000. 11. PERSONAL EFFECTSCOVERAGE A. SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE. is amended by adding the If you have purchased Comprehensive Coverage on this policy for an"auto" you own and that "auto" is stolen, we will pay, without application of a deductible, up to $600 for "personal effects" stolen with the "auto." The insurance provided under this provision is excess over any other collectible Insurance. B. SECTION V-DEFINITIONS is amended by adding the following: For the purposes of this provision, "personal effects" mean tangible property that is wom or carried by an insured." "Personal effects" does not include tools, equipment, Jewelry, money or securities. = 12 ACCIDENTAL AIRBAG DEPLOYMENT SECTION III-PHYSICAL DAMAGE COVERAGE,B.EXCLUSIONS is amended by adding the follow- ing: $ If you have purchased Comprehensive or Collision Coverage under this policy. the exclusion for 'loss" relating to mechanical breakdown does not apply to the accidental discharge of an airbag. Any insurance we provide shall be excess over any other collectible insurance or reimbursement by manufacturer's warranty. However, we agree to pay any deductible applicable to the other cov- erage or warranty. 13. AUDIO. VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SECTION III-PHYSICAL DAMAGE COVERAGE,B. EXCLUSIONS, exception paragraph a. to exclu- sions 4.c. and 4.d. is deleted and replaced with the following: 02010 Liberty Mutual insurance Company.All rights reserved. CA 8810 01 10 Includes copyrighted material or Insurance Services Moe Inc.,with its Permission. Page 4 of 7 Exclusion 4.c.and 4.d. do not apply to: a. Electronic equipment that receives or transmits audio, visual or data signals, whether or not designed solely for the reproduction of sound, If the equipment Is permanently installed in the covered "auto' at the time of the 'loss' and such equipment Is designed to be solely operated by use of the power from the "auto's' electrical system, in or upon the covered 'auto' and physical damage coverages are provided for the covered "auto"; or If the 'loss' occurs solely to audio, visual or data electronic equipment or accessories used with this equipment, then our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by a$100 deductible. 14. LOAN I LEASE GAP COVERAGE A. Paragraph C., UMIT OF INSURANCE of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by adding the following: The most we will pay fora"total loss' to a covered "auto" owned by or leased to you in any one"accident" is the greater of the: 1. Balance due under the terms of the ban or lease to which the damaged covered "auto" is subject at the time of the'loss" less the amount of: a. Overdue payments and financial penalties associated with those payments as of the date of the'lose, b. Financial penalties imposed under a lease due to high mileage, excessive use or ab- normal wear and tear, c. Costs for extended warranties. Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease, d. Transfer or rollover balances from previous loans or leases, e. Final payment due under a"Balloon Loan", f. The dollar amount of any unrepaired damage which occurred prior to the "total loss" of a covered 'auto", g. Security deposits not refunded by a lessor, h. All refunds payable or paid to you as a result of the early termination of a lease agreement or as a result of the early termination of any warranty or extended service agreement on a covered "auto', I. My amount representing taxes, j. Loan or lease termination fees: or 2. The actual cash value of the damage or stolen property as of the time of the loss". An adjustment for depreciation and physical condition will be made in determining the actual cash value at the time of the loss". This adjustment is not applicable in Texas. B. ADDITIONAL CONDITIONS This coverage applies only to the original loan for which the covered "auto' that incurred the loss serves as collateral, or lease written on the covered "auto" that incurred the loss. C. SECTION V-DEFINTIONS is changed by adding the following: As used in this endorsement provision, the following definitions apply: "Total loss' means a loss" in which the cost of repairs plus the salvage value exceeds the actual cash value. A"balloon loan' is one with periodic payments that are insufficient to repay the balance over the term of the loan, thereby requiring a large final payment. 02010 Liberty Mutual Insurance Company.AA rights resolved. CA 08 10 01 10 Includes copyrighted material d Insurance Services Office Inc..with Is Permission. Page 5 of 7 15. GLASS REPAIR-WAIVER OF DEDUCTIBLE Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 16. PARKED AUTO COLLISION COVERAGE(WAIVER OF DEDUCTIBLE) Paragraph D. Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE is amended by the addition of the following: The deductible does not apply to "loss" caused by collision to such covered "auto" of the private passenger type or light weight truck with a gross vehicle weight of 10,000 lbs. or less as defined by the manufacturer as maximum loaded weight the "auto" is designed to carry while it is: a. In the charge of an"insured": b. Legally parked; and c. Unoccupied. The "loss" must be reported to the police authorities within 24 hours of known damage. The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business. SECTION IV-BUSINESS AUTO CONDITIONS is amended as follows: 17. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS, Paragraph B.2. is amended by adding the following: If you unintentionally fail to disclose any hazards, exposures or material facts existing as of the inception date or renewal date of the Business Auto Coverage Form, the coverage afforded by this policy will not be prejudiced. However, you must report the undisclosed hazard of exposure as soon as practicable after its discovery, and we have the right to collect additional premium for any such hazard or exposure. 18. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.2.a. is replaced in its entirety by the following: a. In the event of "accident", claim, "suit" or "loss", you must promptly notify us when it is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership: 3. Member, if you are a limited liability company; 4. An executive officer or the "employee" designated by the Named Insured to give such notice, if you are a corporation. To the extent possible, notice to us should include: (1) How, when and where the "accident" or "loss" took place: (2) The"insureds" name and address; and (3) The names and addresses of any injured persons and witnesses. 19. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US SECTION IV - BUSINESS AUTO CONDITIONS, paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is amended by the addition of the following: If the person or organization has waived those rights before an "accident" or "loss", our rights are waived also. 02010 Liberty Mutual Insurance Company.All rights reserved. CA 88 10 01 10 Includes copyrighted material of Insurance Services Office Inc..with its Permission. Page 6 of 7 20. HIRED AUTO COVERAGE TERRITORY SECTION IV-BUSINESS AUTO CONDITIONS, paragraph B.7., Policy Period. Coverage Territory, is amended by the addition of the following: f. For"autos" hired 30 days or less. the coverage territory is anywhere in the world, provided that the insured's responsibility to pay for damages is determined In a"suit", on the merits, in the United States, the territories and possessions of the United States of America, Puerto Rico or Canada or in a settlement we agree to. This extension of coverage does not apply to an'auto" hired, leased, rented or borrowed with a driver. SECTION V-DEFINITIONS Is amended as follows: 21. BODILY INJURY REDEFINED Under SECTION V-DEFINTIONS, definition C.is replaced by the following: "Bodily injury' means physical injury, sickness or disease sustained by a person. including mental I ® anguish, mental injury. shock, fright or death resulting from any of these at any time. COMMMON POLICY CONDITIONS 22. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS, paragraph A. -CANCELLATION condition applies except as fol- lows: If we cancel for any reason other than nonpayment of premium, we will mail to the first Named Insured widen notice of cancellation at least 60 days before the effective date of cancellation. This provision does not apply in those states which require more than 80 days prior notice of cancella- tion. z a .2010 Uberly Mutual Insurance Company.Ail rights reserved. CA et:10 0110 includes copyrighted material of Insurance Services Otice tnc..with as Permission. Page 7 of 7 COMMERCIAL AUTO c5i1/25 [05- P-13/ CA88620113 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. JWAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Tis endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM The Transfer Of Rights of Recovery Against Others To Us Condition does not apply to the person(s), or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the 'accident" or the "loss" under a contract with that person or organization. SCHEDULE Name(s) of Person(s) or Organization(s): BLANKET AS REQUIRED BY WWRITTEN CONTRACT (If no name appears above, the information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement). 2013 Liberty Mutual Insurance CA 88 62 01 13 Includes copynghted material of Insurance Services Office,Inc.,with its permission. Page 1 of 1 q5(p ali9Y COMMERCIAL AUTO '/ � CA 88 60 07 12 I) 011)\'' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. V AMENDMENT OF CANCELLATION PROVISIONS Any term or provision of the Cancellation Conditions of the policy or any endorsement amending or replac- ing such Conditions is amended by the following: If you have agreed in a written contract or written agreement to provide a person or organization notice xiof cancellation we agree to the following: a. Provide 30 days prior written cancellation notice to such person or organization for reasons other than nonpayment of premium, but only if we are provided with a schedule of persons or organizations with whom you have agreed to provide notification more than 30 days before the cancellation is to take effect. For purposes of this endorsement, knowledge of the agent as to the persons or organizations requesting notice of cancellation is insufficient to invoke our duty to provide notice of cancellation unless the identity of the persons or organizations is provided directly to us in accordance with the terms of this endorsement. Failure to provide notice to a person or organization in accordance with the terms of this endorsement shall not extend the effective date of the cancellation or otherwise affect cancellation of the policy as to any insured. a O 2012 Liberty Mutual Insurance CA 88 60 07 12 Includes copyrighted material of Insurance Services Office.Inc.,with its permission. Page 1 of 1 WORKERSLIABI'COMPENSATIONLIINSURANCE ANDPOLICY EMPLOYERS TexasMutual® Insurance Company WC 42 03 04 B 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 2.00 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 INCLUDED, SEE INFORMATION PAGE, Tns endorsement changes the policy to which it is attaches effective on:ne inception date of the pol.cy unless a cif`eren:da:e a,ndicated ce'or1 (The blaring"allach:ng clause reed b completed only when Itis endorsement is issued subsequent to preparation of the pokey) This endorsement,effective on at 12:01 A.M.standard time,forms a part of Policy No. TSF-000 1282215 20150201 of the Texas Mutual Insurance Company ssuec:o CPC INTERESTS LLC } Endorsement No. Premium S 141/12 NCCI Carrier Code 29939 Authorized Representative WC420304B(ED.6-01-2014) INSURED'S COPY ()USER 1-30-2015 RS'COMPENSATION AND EMPL exa.si1Iutu WORKELIABILITY INSURANCE POLICY OYERS Insurance Company WC 42 06 01 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 cancellation 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 2. Notice will be mailed to: PER LIST ON FILE Tnis endorsement changes the policy to which it is attaches effective on:he inception date of the potty unless a cifferen:dates indicated be ow. (The fo laving-attacn,rg clause' reed ce completed cmy when this endorsement is issued si.hsepuer.t to preparation of the pot cy) This endorsement,effective on J at 12 01 A.M.standard time.forms a part of Policy No. TSF-0001282215 20150201 et the Texas Mutual Insurance Company ssuee:o CPC INTERESTS LLC -&Z _______. Endorsement No. Premium S 7/4"4-32 NCCI Carrier Cede 29939 Authorized Representative WC420601(ED.1-94) I NSURED'S COPY OUSER 1-30-2015