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HomeMy WebLinkAboutContract 47315-R1 1 CITY SECRETARY CONTRACT NO. CITY OF FORT WORTH FIRST RENEWAL OF AGREEMENT WHEREAS, the City of Fort Worth, ("City"), and William J. Schultz Inc. dba Circle "C" Construction Company., authorized to do business in Texas, ("Contractor"), entered into that certain ORIGINAL AGREEMENT (City Secretary #47315, M&C C- 27537) for the PROJECT generally described as: Water Main Extensions, Replacements, and Relocations Contract 2015A;and WHEREAS, the ORIGINAL AGREEMENT may be renewed up to two times as provided by M&C C-27537; and WHEREAS, The City and Contractor desire to renew the ORIGINAL AGREEMENT for an additional term at the same price, said FIRST RENEWAL is available in the 2017 operating budget of the Water and Sewer Fund, as appropriated in Ordinance#2183-09-2015. NOW, THEREFORE, it is agreed by the City and Contractor as follows: Article I The Scope of Services as set forth in the ORIGINAL AGREEMENT has not changed. Article II The Contractor's compensation shall be in the amount up to $2,000,000.00. The Term of this renewal agreement shall be for one year, effective as of the effective date or the expenditure of the funding,whichever occurs first. Article III There are no other changes to any other terms or conditions of the ORIGINAL AGREEMENT. OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX First Renewal of Agreement Page 1 of 2 Circle C Construction Company MWERR2015A City Project No.02071 EXECUTED by each party's duly authorized representative and EFFECTIVE as of the date subscribed by the City's designated City Manager. City of Fort Worth William J. Schultz Inc. dba Circle C Construction Company. Jesus J. Chapa T ary f���//y Assistant City Manager 1/«President DATE: ;Z ,,�,—/,;? DATE: APPROVAL RECOMMENDED: Christopher Harder,P.E. Assistant Director, Water Department APPROVED AS TO FORM AND LEGALITY: M&C: C-28090 Date: January 24, 2017 Douglas W. Black ZQ S #� 74 l Y?/00 Sr. Assistant City Attorney ATTEST: AOR y ary J. Kay er City Secretary ...� ®I:FICIAL RECORD CITY SECRETARY FT.WORTH,TX First Renewal of Agreement 2 o 2 f Circle C Construction Company MWPage Page 2 f 2 City Project No.02071 Contract Compliance Manager By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. ZDVF�_ Signature _James A.Deeter Name of Employee —Senior Professional Engineer Title M&C Review Page 1 of 2 Official site of the City of Fort Worth,Texas CITY COUNCIL AGENDA FORTWORTH COUNCIL ACTION: Approved on 1/24/2017 - Ordinance No. 22578-01-2017 DATE: 1/24/2017 REFERENCE C-28090 LOG NAME: 60MWERR2015AR1 - NO.: CIRCLEC CODE: C TYPE: NON- PUBLIC CONSENT HEARING: NO SUBJECT: Authorize First Renewal of City Secretary Contract No. 47315 with William J. Schultz Inc. d/b/a Circle "C" Construction Company in the Amount of$2,000,000.00 for Water Main Extensions, Replacements and Relocations Contract 2015A, at Various Locations Throughout the City, Provide for Additional Project Costs for a Project Total in the Amount of$2,310,000.00 and Adopt Appropriation Ordinance (ALL COUNCIL DISTRICTS) RECOMMENDATION: It is recommended that the City Council: 1. Adopt the attached Appropriation Ordinance increasing estimated receipts and appropriations in the Water Capital Fund in the amount of$2,310,000.00 from available funds; and 2. Authorize the execution of the first renewal of City Secretary Contract No. 47315 with William J. Schultz Inc. d/b/a Circle "C" Construction Company in the amount of$2,000,000.00 for water main extensions, replacements and relocations Contract 2015A. DISCUSSION: On November 17, 2015, Mayor and Council Communication (M&C C-27537) the City Council authorized the City Manager to execute a contract in the amount of$2,000,000.00, with the option of two renewals, with William J. Schultz, Inc. d/b/a Circle "C" Construction Company for water main extensions, replacements and relocations Contract 2015A. The City and the contractor desire to exercise the first renewal of the contract in the amount of $2,000,000.00 and with the same terms and conditions. The work to be performed under this contract consists of extending, replacing and/or relocating water mains, services, and other pertinent construction required to provide water service to individual customers or developers. In addition to the contract amount, $310,000.00 is required for project management, real property acquisitions, survey, material testing, and inspection. This project will have no impact on the Water Department's operating budget when completed. Construction is expected to start March 2017 and be completed by March 2018 or when the contract amount is exhausted. M/WBE OFFICE —William J. Schultz, Inc. d/b/a Circle "C" Construction is in compliance with the City's BDE Ordinance by committing to three percent MBE participation on this renewal. This project is located in ALL COUNCIL DISTRICTS. http://apps.cfwnct.org/council_packet/Me—review.asp?ID=24252&councildate=1/24/2017 1/25/2017 M&C Review Page 2 of 2 FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that upon approval of the above recommendations and adoption of the attached appropriation ordinance, funds will be available in the current capital budget, as appropriated, of the Water Capital Fund. The Fiscal Year 2017 Water Operating Fund budget includes appropriations of$21,060,000.00 for the purpose of providing Pay-As-You-Go funding for water capital projects. After this transfer for Fiscal Year 2017, the balance will be $16,322,232.00. Appropriations for the first renewal of the Water Main Extensions, Replacements and Relocations Contract 2015A project by Fund will consist of the following: FUND Current Proposed Project Appropriations Appropriations Total* Water Capital $2 360,000.00 $2,310,000.00 $4,670,000.00 Fund 59601 Project Total $2,360,000.00 $2,310,000.00 $4,670,000.00 * Numbers rounded for presentation purposes. TO Fund Department 1 Account Project ' Program Activity Budget I Reference# Amount j ID I ID ' Year ( (Chartfield 2) l FROM Fund Department Account Project Program Activity Budget Reference# Amount ID ID I i Year (Chartfield 2) Submitted for City Manager's Office by: Jay Chapa (5804) Originating Department Head: John Carman (8246) Additional Information Contact: Adolfo Lopez (7829) ATTACHMENTS 60MWERR2015AR1 CIRCLEC 1295 Forrm.pdf 60MWERR2015AR1 CIRCLEC WATER CAP 59601 A017.docx SAM William J Schultz Inc dba Circle C Construction Company.pdf 1-ittp:Happs.efwliet.org/council_pael-,et/me review,asp?ID=24252&councildate=1/24/2017 1/25/2017 ® X v V) 0 L D a o o 0 0 0 0 00 0 0 0 0 0 0 O0 O O O O O O O O 0 O O o O C p 0 o 0 0 o 0 p' m o o p o m mo o Ln -, o o m o E m L 0 L ®u N L ai 41 -1 ri 1-1 r-1 '-i 1--1 -1 ri -1 ri c1 rH -1 N O o 0 0 0 O O 0 0 O O O O O w N N N N N N N N N N N N N N V -a LU •• m • N o Ln LLnn t T LNn LNn COC000 W W W coo V •,NLn Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln ri -i c-I -i r-I r-i -i c-1 -A -1 -1 -1 c1 r1 uo 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Q u u u u u u u u u u u u u u Qc I r1 i ri c I c 1 ci c I 1 i ci c I c I c I N 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 N N N N N N N N N N N N N N N G O O o O O O O o O O O O O O NU u u u u u u u u u u u u u 4 r-I ri o 0 0 0 0 0 r j 0 0 0 0 0 W o o m o r+ Ln Ln O o r-I Ln O Ln -i o r-1 m m o m m In -1 o m Ln m O p lD O O o 0 0 0 0 0 0 0 0 0 0 u Ln r-1 -1 m r-+ r-1 --1 m d• d- --I m r-r d- u rn r-i m m 1\ m m m Ln r` m m m r- 0 Q t Ln Ln ui m Ln Ln Ln Ln u) In m m Ln 0 0 0 0 0 0 0 0 0 0 0 0 0 0 m rn m m m m m m m m m m m m d- d 'ct d- It It Z* d d' d d d- dt I 4 o 0 0 0 0 0 0 0 0 0 0 0 o r: o Q- 0 0 0 0 0 0 0 0 0 0 0 0 0 0 s . v LD lD LD lD lD lD LD lD LD W L.D lD t.D . LD 0 0 0 0 o O 0 0 0 0 0 0 o O O wc-I ri r1 ri r-I ci c-i rl r-I � c-I c-i c-I ci '6 O O O o O O O O O o o U O O C lD lD lD LD lD lD lD lD CD W LD CD lD LD C Ol of Ql Q1 0l Dl 61 41 Q1 Ql Dl Ql m m .Q LL Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln Ln r u — d' -U ri r-i r-1 -i --i ri ri ri c1 r-i -i -i ri N 006113- 1 PERFORMANCE BOND Page 1 of 2 1 BOND NO.TXC608522 2 SECTION 00 6113 3 PERFORMANCE BOND 4 5 THE STATE OF TEXAS § 6 § KNOW ALL BY THESE PRESENTS: 7 COUNTY OF TARRANT § 8 9 That we, William J. Schultz, Inc. dba Circle C Construction Company, known as"Principal" 10 herein and Merchants Bonding Company (Mutual), a corporate surety(sureties, if more than one) 11 duly authorized to do business in the State of Texas, known as"Surety" herein (whether one or 12 more), are held and firmly bound unto the City of Fort Worth, a municipal corporation created 13 pursuant to the laws of Texas, known as"City" herein, in the penal sum of, Two Million Dollars 14 ($2,000,000.00), lawful money of the United States, to be paid in Fort Worth, Tarrant County, 15 Texas for the payment of which sum well and truly to be made, we bind ourselves, our heirs, 16 executors, administrators, successors and assigns,jointly and severally, firmly by these presents. 17 WHEREAS, the Principal has entered into a certain written contract with the City 18 awarded the day of JAN 2 4 2017 , 20_, which Contract is hereby referred to and 19 made a part hereof for all purposes as if fully set forth herein, to furnish all materials, equipment 20 labor and other accessories defined by law, in the prosecution of the Work, including any Change 21 Orders, as provided for in said Contract designated as 22 15t Renewal- Water Main Extensions,Replacements,and Relocations, Contract 23 2015A, City Project No, 02071 24 NOW,THEREFORE,the condition of this obligation is such that if the said Principal shall 25 faithfully perform it obligations under the Contract and shall in all respects duly and faithfully 26 perform the Work, including Change Orders, under the Contract, according to the plans, 27 specifications, and contract documents therein referred to, and as well during any period of 28 extension of the Contract that may be granted on the part of the City, then this obligation shall 29 be and become null and void, otherwise to remain in full force and effect. 30 PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in 31 Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort 32 Worth Division. CITY OF FORT WORTH MWERR2015A STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 02071 Revised July 1,2011 006113-2 PERFORMANCE BOND Page 2 of 2 1 PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in 2 Tarrant County,Texas or the United States District Court for the Northern District of Texas, Fort 3 Worth Division. 4 This bond is made and executed in compliance with the provisions of Chapter 2253 of 5 the Texas Government Code, as amended, and all liabilities on this bond shall be determined in 6 accordance with the provisions of said statue. 7 IN WITNESS WHEREOF, the Principal and the Surety have SIGNED and SEALED this 8 instrument by duly authorized agents and officers on this the day of JAN 2 4 2017 9 , 20 10 PRINCIPAL: 11 William J. Schultz, Inc. dba 12 Circle C Construction Company 13 14 BY: e Zt 15 Signature 16 ATTEST: 17 n/� ► 18 1� Teresa S. Skelly, Vice President 19 (Principal) Secretary, Michele S. L kford Name and Title 20 21 Address: P. O. Box 40328 22 500 W. Trammell 23 Fort Worth,TX 76140 24 25 Witness as to Principal 26 SURETY: 27 Merchantsdin Com an Mutua 28 29 BY: 30 Signature 31 32 Sheryl A. Klutts,Attorney-in-Fact 33 Name and Title 34 35 Address: 6700 Westown Parkway 36 West Des Moines, IA 50266-7754 37 38 Witness as to Sure ,—Joh A. Miller Telephone Number: (800) 678-8171 39 40 41 42 *Note: If signed by an officer of the Surety Company, there must be on file a certified 43 extract from the by-laws showing that this person has authority to sign such 44 obligation. If Surety's physical address is different from its mailing address, 45 both must be provided. The date of the bond shall not be prior to the date the 46 Contract is awarded. 47 CITY OF FORT WORTH MWERR2015A STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 02071 Revised July 1,2011 006114-1 PAYMENT BOND Page 1 of 2 1 BOND NO. TXC608522 2 SECTION 00 6114 3 PAYMENT BOND 4 5 THE STATE OF TEXAS § 6 § KNOW ALL BY THESE PRESENTS: 7 COUNTY OF TARRANT § 8 9 That we, William J. Schultz, Inc. dba Circle C Construction Company, known as 10 "Principal' herein, and Merchants Bonding Company (Mutual), a corporate surety (sureties), duly 11 authorized to do business in the State of Texas, known as "Surety" herein (whether one or 12 more), are held and firmly bound unto the City of Fort Worth, a municipal corporation created 13 pursuant to the laws of the State of Texas, known as "City" herein, in the penal sum of Two 14 Million Dollars ($2,000,000.00), lawful money of the United States, to be paid in Fort Worth, 15 Tarrant County, Texas, for the payment of which sum well and truly be made, we bind ourselves, 16 our heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these 17 presents: 18 WHEREAS, Principal has entered into a certain written Contract with City, awarded the 19 day of JAN 2 4 2017 , 20 , which Contract is hereby referred to and 20 made a part hereof for all purposes as if fully set forth herein, to furnish all materials, equipment, 21 labor and other accessories as defined by law, in the prosecution of the Work as provided for in 22 said Contract and designated as 23 Ist Renewal- Water Main Extensions, Replacements and Relocations Contract 2015A, 24 City Project No, 02071 25 NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Principal 26 shall pay all monies owing to any (and all) payment bond beneficiary (as defined in Chapter 2253 27 of the Texas Government Code, as amended) in the prosecution of the Work under the Contract, 28 then this obligation shall be and become null and void; otherwise to remain in full force and 29 effect. 30 This bond is made and executed in compliance with the provisions of Chapter 2253 of 31 the Texas Government Code, as amended, and all liabilities on this bond shall be determined in 32 accordance with the provisions of said statute. 33 CITY OF FORT WORTH MWERR2015A STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project no. 02071 Revised July 1,2011 006114-2 PAYMENT BOND Page 2 of 2 1 IN WITNESS WHEREOF, the Principal and Surety have each SIGNED and SEALED this 2 instrument by duly authorized agents and officers on this the day of 3 JAN 2 4 2017 , 20 4 5 6 7 PRINCIPAL: 8 William J. Schultz, Inc. dba 9 Circle C Construction Company 10 11 BY: 12 Signature 13 ATTEST: 14 M 15 l 1 ► (�� Teresa S. Skelly, Vice President 16 (Principal) Secretary, Michele S. La ord Name and Title 17 18 Address: P. O. Box 40328 19 500 W.Trammell 20 Fort Worth,TX 76140 21 22 Witness as to Principal 23 SURETY: 24 Merchants B n Com an Mutual 25 26 BY: 27 Signature 28 29 _ Sheryl A. Klutts,Attorney-in-Fact 30 Name and Title 31 32 Address: 6700 Westown Parkway 33 r/' West Des Moines, IA 50266-7754 34 .� 35 Witness as to Surety'John A. Miller Telephone Number: (800) 678-8171 36 37 38 Note: If signed by an officer of the Surety, there must be on file a certified extract from the 39 bylaws showing that this person has authority to sign such obligation. If Surety's physical 40 address is different from its mailing address, both must be provided. 41 42 The date of the bond shall not be prior to the date the Contract is awarded. 43 44 45 END OF SECTION 46 CITY OF FORT WORTH MWERR2015A STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project no. 02071 Revised July 1,2011 006119-1 MAINTENANCE BOND Page 1 of 3 1 BOND NO. TXC608522 2 SECTION 00 6119 3 MAINTENANCE BOND 4 5 THE STATE OF TEXAS § 6 § KNOW ALL BY THESE PRESENTS: 7 COUNTY OF TARRANT § 8 9 That we, William J. Schultz, Inc. dba Circle C Construction Company known as"Principal" 10 herein and Merchants Bonding Company(Mutual), a corporate surety (sureties, if more than one) 11 duly authorized to do business in the State of Texas, known as"Surety"herein (whether one or 12 more), are held and firmly bound unto the City of Fort Worth, a municipal corporation created 13 pursuant to the laws of the State of Texas, known as"City"herein, in the sum of Two Million 14 Dollars ($2,000,000.00), lawful money of the United States, to be paid in Fort Worth,Tarrant 15 County, Texas, for payment of which sum well and truly be made unto the City and its 16 successors, we bind ourselves, our heirs, executors, administrators, successors and assigns, 17 jointly and severally, firmly by these presents. 18 19 WHEREAS, the Principal has entered into a certain written contract with the City awarded 20 the day of JAN '2 4 2017 , 20 , which Contract is hereby 21 referred to and a made part hereof for all purposes as if fully set forth herein, to furnish all 22 materials, equipment labor and other accessories as defined by law, in the prosecution of the 23 Work, including any Work resulting from a duly authorized Change Order (collectively herein, the 24 "Work") as provided for in said contract and designated as 25 26 15t Renewal- Water Main Extensions,Replacements,and Relocations Contract 27 2015A, City Project No, 02071 28 and 29 30 WHEREAS, Principal binds itself to use such materials and to so construct the Work in 31 accordance with the plans, specifications and Contract Documents that the Work is and will 32 remain free from defects in materials or workmanship for and during the period of two (2) 33 years after the date of Final Acceptance of the Work by the City ("Maintenance Period"); and 34 CITY OF FORT WORTH MWERR2015A STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 02071 Revised July 1, 2011 006119-2 MAINTENANCE BOND Page 2 of 3 1 2 NOW THEREFORE, the condition of this obligation is such that if Principal shall remedy 3 any defective Work, for which timely notice was provided by City, to a completion satisfactory to 4 the City, then this obligation shall become null and void; otherwise to remain in full force and 5 effect. 6 7 PROVIDED, HOWEVER, if Principal shall fail so to repair or reconstruct any timely 8 noticed defective Work, it is agreed that the City may cause any and all such defective Work to 9 be repaired and/or reconstructed with all associated costs thereof being borne by the Principal 10 and the Surety under this Maintenance bond; and 11 12 PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in 13 Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort 14 Worth Division; and 15 16 PROVIDED FURTHER,that this obligation shall be continuous in nature and successive 17 recoveries may be had hereon for successive breaches. 18 19 20 CITY OF FORT WORTH MWERR2015A STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 02071 Revised July 1,2011 006119-3 MAINTENANCE BOND Page 3 of 3 1 IN WITNESS WHEREOF,the Principal and the Surety have each SIGNED and SEALED this instrument by 2 duly authorized agents and officers on this the day of JAN 2 4 2011 3 , 20 4 5 PRINCIPAL: 6 William J. Schultz, Inc. dba 7 Circle C Construction Company 8 / 9 BY: 10 Signature 11 ATTEST: 12 13 1 In Teresa S. Skelly,Vice President 14 (Principal)Secretary, Michele S. Lan rd" Name and Title 15 16 Address: P. 0. Box 40328 17 500 W.Trammell 18 Fort Worth,TX 76140 19 20 Witness as to Principal 21 SURETY: 22 Merchants B d' Company Mutual 23 24 BY: 25 Signature 26 27 Sheryl A. Klutts,Attorney-in-Fact 28 Name and Title 29 ATTEST: 30 Address: 6700 Westown Parkway 31 West Des Moines, IA 50266-7754 32 S rety(Secretary)33 ,y 34 //�'�[_� 35 Witness as to Su�tyMA. iller Telephone Number: (800) 678-8171 36 37 *Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the 38 by-laws showing that this person has authority to sign such obligation. If Surety's physical 39 address is different from its mailing address, both must be provided. The date of the bond shall 40 not be prior to the date the Contract is awarded. 41 42 43 CITY OF FORT WORTH MWERR2015A STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS City Project No. 02071 Revised July 1,2011 MERCHANTS BONDING COMPANY, POWER OF ATTORNEY Know All Persons By These Presents,that MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING, INC.,both being corporations of the State of Iowa(herein collectively called the"Companies")do hereby make,constitute and appoint, individually, John A Miller; John R Stockton; Sheryl A Klutts their true and lawful Attorney(s)-in-Fact,to make,execute,seal and deliver on behalf of the Companies,as Surety,bonds,undertakings and other written obligations in the nature thereof,subject to the limitation that any such instrument shall not exceed the amount of: TWENTY-FIVE MILLION($25,000,000.00)DOLLARS This Power-of-Attorney is granted and is signed and sealed by facsimile under and by authority of the following By-Laws adopted by the Board of Directors of Merchants Bonding Company(Mutual)on April 23,2011 and adopted by the Board of Directors of Merchants National Bonding, Inc.,on October 24,2011. "The President,Secretary,Treasurer,or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys-in-Fact,and to authorize them to execute on behalf of the Company,and attach the seal of the Company thereto,bonds and undertakings,recognizances,contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond,undertaking,recognizance,or other suretyship obligations of the Company,and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only,it is agreed that the power and authority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation.It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee,shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only,it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner- Department of Highways of the Commonwealth of Kentucky at least thirty(30)days prior to the modification or revocation. In Witness Whereof,the Companies have caused this instrument to be signed and sealed this 11th day of October 2016 •'• •'• MERCHANTS BONDING COMPANY(MUTUAL) ',`.�`��`��•�r1(�t1�� *''� �NG.... •� MERCHANTS NATIONAL BONDING,INC. O CO dp's •�o.�RPQR9.9y� 1933 ;c; •;4Z�. By ",\ • STATE OF IOWA ��'�''�ty�p` cu14���'.�+� ••••• ••••• COUNTY OF Dallas ss. President On this 11th day of October 2016 ,before me appeared Larry Taylor,to me personally known,who being by me sworn did say that he is President of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC.;and that the seals affixed to the foregoing instrument are the Corporate seals of the Companies;and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. ,�P-'A4S WENDY WOODY A a Commission Number 784654 . °°°° : My Commission Expires /owP June 20 2017 (� Notary Pub1iZ',-•+ County,Iowa (Expiration of notary's commission does not invalidate this instrument) I,William Warner,Jr.,Secretary of the MERCHANTS BONDING COMPANY(MUTUAL)and MERCHANTS NATIONAL BONDING,INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this day of C .�� �d� .? V :ice:�` -O- d' • z;— :3' Secretary z Xs 200310c)z ;c 1933 c: POA 0014 (6/15) MERCHANT7SN�-k BONDING COMPANY, MERCHANTS BONDING COMPANY(MUTUAL) • MERCHANTS NATIONAL BONDING, INC. P.O. BOX 14498 , DES MOINES, IOWA 50306-3498 , (800)678-8171 , (515)243-3854 FAX Please send all notices of claim on this bond to: Merchants Bonding Company (Mutual)/Merchants National Bonding, Inc. P.O. Box 14498 Des Moines, Iowa 50306-3498 (515)243-8171 (800) 678-8171 Physical Address: 6700 Westown Parkway, West Des Moines, Iowa 50266 SUP 0073 TX(2/15) CERTIFICATE OF LIABILITY INSURANCE D1/27/20`m) 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 the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Kim Wright NAME: g K&S Insurance Agency PHONE Ext: (972)771-7230 NC Ne; (972)771-4695 2255 Ridge Road, Ste. 333 E-MAILss:kwright@kandsins.com DDRE P. 0. BOX 277 INSURERS AFFORDING COVERAGE NAIC# Rockwall TX 75087 INSURERA:United Fire & Casualty Companv 113021 INSURED INSURERB:Travelers Prop Cas Co of Amer 125674 William J Schultz, Inc. INSURERC:Texas Mutual Insurance Co. 22945 dba Circle C Construction Company INSURERD:Federal Insurance Company 20281 500 W. Trammell Avenue INSURER E: Everman TX 76140 INSURER F: COVERAGES CERTIFICATE NUMBER:16/17 Master cert REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY 85316434 8/12/2016 8/12/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X❑OCCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECRO- D LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 85316434 8/12/2016 8/12/2017 COEaMBINED accident SINGLE LIMIT $ 1,000 000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY AUTOS AUTOS (Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident $ I $ B X UMBRELLALIA13 X OCCUR ZUP41M1142816NF 8/12/2016 8/12/2017 EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10,000 $ C WORKERS COMPENSATIONS 0001193570 8/12/2016 8/12/2017 X PER OTH- AND EMPLOYERS'LIABILITY Y/N TATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? N❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE4$ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 D Leased/Rented Equipment 06706289 8/12/2016 8/12/2017 Per item Limit $500,000 Maximum Limit $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project: Water Main Extensions, Replacements, and Relocations Contract 2015A City Project No. 02071 Please see attached for additional information. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Worth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1000 Throckmorton Street ACCORDANCE WITH THE POLICY PROVISIONS. Fort Worth, TX 76102 AUTHORIZED REPRESENTATIVE �J Gary Thompson/WRIGHT ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025 r201401) COMMENTS/REMARKS Additional Insured forms #CG2010 04/13 & CG2037 04/13 apply to the General Liability Policy. Waiver of Subrogation form #CG7208 02/15 applies to the General Liability Policy. Primary & Non-Contributory Form 4CG2001 04/13 applies to the General Liability Policy. Additional Insured & Waiver of Subrogation form #CA7109 01/06 applies to the Business Auto Policy. Primary & Non-Contributory form #CA7334 09/15 applies to the Business Auto Policy. Waiver of Subrogation Form #WC420304B 06/14 applies to the Workers Compensation Policy. *ALWAYS REFER TO THE ATTACHED POLICY FORMS FOR SPECIFIC WORDING OF SUCH COVERAGE, LIMITS, CONDITIONS & EXCLUSIONS. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. POLICY NUMBER: 85316434 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations ANY PERSON OR ORGANIZATION TO WHOM LOCATIONS DESIGNATED AND YOU HAVE AGREED TO NAME AS ADDI- DESCRIBED IN THE ABOVE TIONAL INSURED BY WRITTEN CONTRACT MENTIONED WRITTEN CONTRACT OR AGREEMENT IF THE CONTRACT OR OR AGREEMENT AGREEMENT IS EXECUTED PRIOR TO LOSS Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional organization(s) shown in the Schedule, but only exclusions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage" occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or 1. Your acts or omissions; or equipment furnished in connection with such 2. The acts or omissions of those acting on your work, on the project (other than service, behalf; maintenance or repairs) to be performed by or in the performance of your ongoing operations for on behalf of the additional insured(s) at the the additional insured(s) at the location(s) location of the covered operations has been designated above. completed;or However: 2. That portion of "your work" out of which the injury or damage arises has been put to its 1. The insurance afforded to such additional intended use by any person or organization insured only applies to the extent permitted by other than another contractor or subcontractor law; and engaged in performing operations for a 2. If coverage provided to the additional insured is principal as a part of the same project. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III— Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most we applicable Limits of Insurance shown in the will pay on behalf of the additional insured is the Declarations. amount of insurance: 1. Required by the contract or agreement; or Page 2 of 2 © Insurance Services Office, Inc., 2012 CG 20 10 04 13 POLICY NUMBER: 85316434 COMMERCIAL GENERAL LIABILITY CG 20 370493 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -- OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION TO WHOM LOCATIONS DESIGNATED AND YOU HAVE AGREED TO NAME AS ADDI- DESCRIBED IN THE ABOVE TIONAL INSURED BY WRITTEN CONTRACT MENTIONED WRITTEN CONTRACT OR AGREEMENT IF THE CONTRACT OR OR AGREEMENT AGREEMENT IS EXECUTED PRIOR TO LOSS Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section 11 — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance; with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage"caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on be half of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and 1. Required by the contract or agreement;or included in the "products -completed operations 2. Available under the applicable Limits of hazard". Insurance shown in the Declarations; However: 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 9 Policy #85316434 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 04 13 © Insurance Services Office, Inc., 2012 Pagel of 1 Policy ##85316434 CG 72 08 02 15 TEXAS - EXTENDED ULTRA LIABILITY PLUS ENDORSEMENT COMMERCIAL GENERAL LIABILITY EXTENSION ENDORSEMENT SUMMARY OF COVERAGES This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. * Extended Property Damage * Expanded Fire Legal Liability to include Explosion, Lightning and Sprinkler Leakage • Coverage for non -owned watercraft is extended to 51 feet in length * Property Damage - Borrowed Equipment * Property Damage Liability - Elevators * Coverage D -Voluntary Property Damage Coverage $5,000 Occurrence with a $10,000 Aggregate * Coverage E - Care, Custody and Control Property Damage Coverage $25,000 Occurrence with a $100,000 Aggregate - $500 Deductible • Coverage F - Electronic Data Liability Coverage - $50,000 * Coverage G - Product Recall Expense $25,000 Each Recall Limit with a $50,000 Aggregate - $1,000 Deductible * Coverage H -Water Damage Legal Liability - $25,000 * Coverage I - Designated Operations Covered by a Consolidated (Wrap-Up) Insurance Program - Limited Coverage * Increase in Supplementary Payments: Bail Bonds to $1,000 * Increase in Supplementary Payments: Loss of Earnings to $500 • For newly formed or acquired organizations - extend the reporting requirement to 180 days * Broadened Named Insured * Automatic Additional Insured - Owners, Lessees or Contractors - Automatic Status When Required in Construction Agreement With You * Contractors Blanket Additional Insured - Limited Products - Completed Operations Coverage * Automatic Additional Insured -Vendors *Automatic Additional Insured - Lessor of Leased Equipment Automatic Status When Required in Lease Agreement With You *Automatic Additional Insured - Managers or Lessor of Premises * Additional Insured - Engineers, Architects or Surveyors Not Engaged by the Named Insured *Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations *Additional Insured - Consolidated Insurance Program (Wrap-Up) Off-Premises Operations Only - Owners, Lessees or Contractors Automatic Status When Required in Construction Agreement With You •Additional Insured - Employee Injury to Another Employee •Automatically included -Aggregate Limits of Insurance (per location) * Automatically included -Aggregate Limits of Insurance (per project) • Knowledge of occurrence - Knowledge of an 'occurrence", "claim or suit' by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. * Blanket Waiver of Subrogation * Liberalization Condition • Unintentional failure to disclose all hazards. If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. * "Insured Contract' redefined for Limited Railroad Contractual Liability * Mobile equipment to include snow removal, road maintenance and street cleaning equipment less than 1,000 lbs GVW * Bodily Injury Redefined REFER TO THE ACTUAL ENDORSEMENT FOLLOWING ON PAGES 2 THROUGH 14 FOR CHANGES AFFECTING YOUR INSURANCE PROTECTION CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 14 CG 72 08 02 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEXAS - EXTENDED ULTRA LIABILITY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION I - COVERAGES A. The following changes are made at COVERAGE A -BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Extended Property Damage At 2. Exclusions exclusion a. Expected or Intended Injury is replaced with the following: "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. 2. Expanded Fire Legal Liability At 2. Exclusions the last paragraph is deleted and replaced by the following: Exclusions G. through n. do not apply to damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage to premises while rented to you or temporarily occupied by you with permission of this owner. A separate limit of insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. 3. Non-Owned Watercraft At 2. Exclusions exclusion g. Aircraft, Auto Or Watercraft (2) (a) is deleted and replaced by the following: (a) Less than 51 feet long; 4. Property Damage —Borrowed Equipment At 2. Exclusions the following is added to paragraph (4) of exclusion j. Damage To Property: This exclusion does not apply to "property damage" to borrowed equipment while at a jobsite and while not being used to perform operations. The most we will pay for "property damage" to any one piece of borrowed equipment under this coverage is $25,000 per occurrence. The insurance afforded under this provision is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. 5. Property Damage Liability — Elevators At 2. Exclusions the following is added to paragraphs (3), (4) and (6) of exclusion j. Damage To Property: This exclusion does not apply to "property damage" resulting from the use of elevators. However, any insurance provided for such "property damage" is excess over any valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. B. The following coverages are added: 1. COVERAGE D -VOLUNTARY PROPERTY DAMAGE COVERAGE "Property damage" to property of others caused by the insured: a. While in your possession; or b. Arising out of"your work". Coverage applies at the request of the insured, whether or not the insured is legally obligated to pay. For the purposes of this Voluntary Property Damage Coverage only: Exclusion j. Damage to Property is deleted and replaced by the following: CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 14 CG 72 08 02 15 j. Damage to Property "Property damage" to: (1) Property held by the insured for servicing, repair, storage or sale at premises you own, rent, lease, operate or use; (2) Property transported by or damage caused by any "automobile", "watercraft" or"aircraft" you own, hire or lease; (3) Property you own, rent, lease, borrow or use. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 2. COVERAGE E -CARE, CUSTODY AND CONTROL PROPERTY DAMAGE COVERAGE For the purpose of this Care, Custody and Control Property Damage Coverage only: a. Item (4) of Exclusion j. does not apply. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 3. COVERAGE F - ELECTRONIC DATA LIABILITY COVERAGE For the purposes of this Electronic Data Liability Coverage only: a. Exclusion p. of Coverage A — Bodily Injury And Property Damage Liability in Section I — Coverages is replaced by the following: 2. Exclusions This insurance does not apply to: p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. However, this exclusion does not apply to liability for damages because of"bodily injury" b. "Property Damage" means: (1) Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; or (2) Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the `occurrence" that caused it; or (3) Loss of, loss of use of, damage to, corruption of, inability to access or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of"electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this Electronic Data Liability Coverage, "electronic data" is not tangible property. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE 4. COVERAGE G - PRODUCT RECALL EXPENSE a. Insuring Agreement (1) We will pay 90% of "product recall expense" you incur as a result of a "product recall' you initiate during the coverage period. (2) We will only pay for "product recall expense" arising out of "your products" which have been physically relinquished to others. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 14 CG 72 08 02 15 b. Exclusions This insurance does not apply to "product recall expense" arising out of: (1) Any fact, circumstance or situation which existed at the inception date of the policy and which you were aware of, or could reasonably have foreseen that would have resulted in a "product recall". (2) Deterioration, decomposition or transformation of a chemical nature, except if caused by an error in the manufacture, design, processing, storage, or transportation of"your product". (3) The withdrawal of similar products or batches that are not defective, when a defect in another product or batch has been found. (4) Acts, errors or omissions of any of your employees, done with prior knowledge of any of your officers or directors. (5) Inherent vice, meaning a natural condition of property that causes it to deteriorate or become damaged. (6) "Bodily Injury" or"Property Damage". (7) Failure of "your product" to accomplish its intended purpose, including any breach of warranty of fitness, quality, efficacy or efficiency, whether written or implied. (8) Loss of reputation, customer faith or approval, or any costs incurred to regain customer market, or any other consequential damages. (9) Legal fees or expenses. (10) Damages claimed for any loss, cost or expense incurred by you or others for the loss of use of "your product". (11) "Product recall expense" arising from the "product recall" of any of "your products" for which coverage is excluded by endorsement. (12) Any "product recall" initiated due to the expiration of the designated shelf life of"your product". 5. COVERAGE H -WATER DAMAGE LEGAL LIABILITY The Insurance provided under Coverage H (Section 1) applies to "property damage" arising out of water damage to premises that are both rented to and occupied by you. The Limit under this coverage shall not be in addition to the Damage To Premises Rented To You Limit. The amount we will pay is limited as described below in SECTION III - LIMITS OF INSURANCE. 6. COVERAGE I — DESIGNATED OPERATIONS COVERED BY A CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM The following exclusion is added to Paragraph 2. Exclusions of SECTION I — COVERAGES COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY: r. This insurance does not apply to "bodily injury" or "property damage" arising out of either your ongoing operations or operations included within the "products-completed operations hazard" for any "consolidated (Wrap-up) insurance program" which has been provided by the prime contractor / project manager or owner of the construction project in which you are involved. This exclusion applies whether or not a consolidated (Wrap-up) insurance program: a. Provides coverage identical to that provided by this Coverage Part; or b. Has limits adequate to cover all claims. This exclusion does not apply if a "consolidated (Wrap-up) insurance program" covering your operations has been cancelled, non-renewed or otherwise no longer applies for reasons other than exhaustion of all available limits, whether such limits are available on a primary, excess or on any other basis. You must advise us of such cancellation, nonrenewal or termination as soon as practicable. For purposes of this exclusion a "consolidated (wrap-up) insurance program" is a program providing insurance coverage to all parties for exposures involved with a particular (typically major) construction project. CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 14 CG 72 08 02 15 C. SUPPLEMENTARY PAYMENTS -COVERAGES A AND B is amended: 1. To read SUPPLEMENTARY PAYMENTS 2. Bail Bonds Item 1.b. is amended as follows: b. Up to $1,000 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. 3. Loss of Earnings Item 1.d, is amended as follows: 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. 4. The following language is added to Item 1. However, we shall have none of the duties set forth above when this insurance applies only for Voluntary Property Damage Coverage and/or Care, Custody or Control Property Damage Coverage and we have paid the Limit of Liability or the Aggregate Limit for these coverages. SECTION II - WHO IS AN INSURED A. The following change is made: Extended Reporting Requirements Item 3.a. is deleted and replaced by the following a. .Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. B. The following provisions are added: 4. BROAD FORM NAMED INSURED Item 1.f. is added as follows: f. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy period only if there is no other similar insurance available to that entity. However: (1) Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired more than 50 percent of the voting stock; and (2) Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired more than 50 percent of the voting stock. 5. Additional Insured - Owners, Lessees or Contractors - Automatic Status When Required in Construction or Service Agreement With You a. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy is an insured. Such person or organization is an additional insured only with respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" which may be imputed to that person or organization directly arising out of: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. However, the insurance afforded to such additional insured: 1. Only applies to the extent permitted by law; and 2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 14 CG 72 08 02 15 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily 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. 2. "Bodily injury" or"property damage" occurring after: a. All 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 b. That portion of"your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 6. Additional Insured — Limited Products Completed Operations Coverage a. Any person(s) or organization(s), but only with respect to your liability for "bodily injury" or "property damage" which may be imputed to that person(s) or organization(s) directly arising out of "your work" performed for that additional insured and included in the "products-completed operations hazard" is an insured. However: (1) The insurance afforded to such additional insureds only applies to the extent permitted by law; (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. (3) Coverage will cease five years from the completion of"your work" if: (a) a timeframe is not stipulated in the written contract or written agreement; or (b) a timeframe longer than 5 years is stipulated in the written contract or written agreement. However if a lesser timeframe is stipulated in the written contract or written agreement then that time frame will prevail. b. With respect to the insurance afforded to any additional insured under this endorsement, the following additional exclusionary language shall apply: This insurance does not apply to "bodily injury" or "property damage" arising out of the rendering of, or the failure to render, any professional architecture, 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. 7. Additional Insured -Vendors a. Any person(s) or organization(s) (referred to throughout this additional coverage as vendor), but only with respect to "bodily injury" or "property damage", which may be imputed to that person(s) or organization(s) arising out of "your products" shown with the Schedule which are distributed or sold in the regular course of the vendor's business is an insured. However: (1) The insurance afforded to such vendor only applies to the extent permitted by law; and (2) If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such vendor will not be broader than that which you are required by the contract or agreement to provide for such vendor. CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 14 CG 72 08 02 15 b. With respect to the insurance afforded to these vendors, the following additional exclusions apply: (1) This insurance afforded the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the 'substitution of parts under instructions from the manufacturer, and then repackaged in the original container. (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of products. (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product. (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: i. The exceptions contained in Sub-paragraphs d. or f.; or ii. Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 8. Additional Insured — Lessor of Leased Equipment — Automatic Status When Required in Lease Agreement With You a. Any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" directly arising out of the maintenance, operation or use of equipment leased to you, which may be imputed to such person or organization as the lessor of equipment. However, the insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; and (2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 9. Additional Insured —Managers or Lessors of Premises a. Any person(s) or organization(s), but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and subject to the following additional exclusions: CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 14 CG 72 08 02 15 This insurance does not apply to: (1) Any 'occurrence" which takes place after you cease to be a tenant in that premises. (2) Structural alterations, new construction or demolition operations performed by or on behalf of the person(s) or organization(s) afforded coverage by this additional coverage. However: (1) The insurance afforded to such additional insured only applies to the extent permitted by law; and (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 10. Additional Insured -Engineers, Architects or Surveyors Not Engaged by the Named Insured a. Any architects, engineers or surveyors who are not engaged by you are insureds, but only with respect to liability for "bodily injury" or"property damage" or "personal and advertising injury" which may be imputed to that architect, engineer or surveyor arising out of. (1) Your acts or omissions; or (2) Your acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed by you or on your behalf. But only if such architects,- engineers or surveyors, while not engaged by you, are contractually required to be added as an additional insured to your policy. However, the insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; and (2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or failure to render any professional services, including: (1) The preparing, approving, or failing to prepare or approve, maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or (2) Supervisory, inspection or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the 'occurrence" which caused the "bodily 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 services. 11. Additional Insured - State or Governmental Agency or Subdivision or Political Subdivision - Permits or Authorizations Any state or governmental agency or subdivision or political subdivision is an insured, subject to the following provisions: a. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: (1) The insurance afforded to such additional insured only applies to the extent permitted by law; and (2) If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 8 of 14 CG 72 08 02 15 b. This insurance does not apply to: (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or (2) "Bodily injury" or"property damage" included within the "products-completed operations hazard". 12. Additional Insured Consolidated Insurance Program (Wrap-Up) Off-Premises Operations Only - Owners, Lessees or Contractors a. Any persons or organizations for whom you are performing operations, for which you have elected to seek coverage under a Consolidated Insurance Program, when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy is an insured. Such person or organization is an additional insured only with respect to your liability which may be imputed to that person or organization directly arising out of your ongoing operations performed for that person or organization at a premises other than any project or location that is designated as covered under a Consolidated Insurance Program. A person's or organization's status as an insured under this endorsement ends when your operations for that insured are completed. b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies. This insurance does not apply to: "Bodily injury", "property damage", or "personal and advertising injury" arising out of the rendering of, or 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; and (2) Supervisory, inspection 13. Additional Insured -Employee Injury to Another Employee With respect to your "employees" who occupy positions which are supervisory in nature: Paragraph 2.a.(1) of SECTION II —WHO IS A NAMED INSURED is amended to read: a. "Bodily injury" or"personal and advertising injury" (1) To you, to your partners or members (if you are a partnership or joint venture), or to your members (if you are a limited liability company); (2) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraph (1)(a) above; or (3) Arising out of his or her providing or failing to provide professional healthcare services. Paragraph 3.a. is deleted. For the purpose of this Item 13 only, a position is deemed to be supervisory in nature if that person performs principle work which is substantially different from that of his or her subordinates and has authority to hire, direct, discipline or discharge. SECTION III - LIMITS OF INSURANCE A. The following Items are deleted and replaced by the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard'; and c. Damages under Coverage B; and d. Damages under Coverage H. CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 9 of 14 CG 72 08 02 15 3. The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products-completed operations hazard" and Coverage G. 6. Subject to 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 any one premises, while rented to you, or in the case of damage by fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage while rented to you or temporarily occupied by you with permission of the owner. B. The following are added: 8. Subject to Paragraph 5. of SECTION III — LIMITS OF INSURANCE $25,000 is the most we will pay under Coverage H for Water Damage Legal Liability. 9. Coverage G - Product Recall Expense Aggregate Limit $50,000 Each Product Recall Limit $25,000 a. The Aggregate Limit shown above is the most we will pay for the sum of all "product recall expense" you incur as a result of all "product recalls" you initiate during the endorsement period. b. The Each Product Recall Limit shown above is the most we will pay, subject to the Aggregate and $1,000 deductible, for "product recall expense" you incur for any one "product recall' you initiate during the endorsement period. We will only pay for the amount of Product Recall Expenses which are in excess of the deductible amount. The deductible applies separately to each Product Recall. The limits of insurance will not be reduced by the amount of this deductible. We may, or will if required by law, pay all or any part of any deductible amount. Upon notice of our payment of a deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid. 10. Aggregate Limits of Insurance (Per Location) The General Aggregate Limit applies separately to each of your "locations" owned by or rented to you or temporarily occupied by you with the permission of the owner. "Location" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. 11. Aggregate Limits of Insurance (Per Project) The General Aggregate Limit applies separately to each of your projects away from premises owned by or rented to you. 12. With respects to the insurance afforded to additional insureds afforded coverage by items 5 through 13 of SECTION II —WHO IS AN INSURED above, the following is added: The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the contract or agreement; b. Available under the applicable Limits of Insurance shown in the Declarations; Whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. 13. Subject to 5. of SECTION III — LIMITS OF INSURANCE, a $5,000 'occurrence" limit and a $10,000 "aggregate" limit is the most we will pay under Coverage A for damages because of "property damage" covered under Coverage D -Voluntary Property Damage Coverage. For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 10 of 14 CG 72 08 02 15 14. Subject to 5. of SECTION III — LIMITS OF INSURANCE, a $25,000 'occurrence" limit and a $100,000 "aggregate" limit is the most we will pay under Coverage E - Care, Custody and Control Coverage regardless of the number of. a. Insureds; b. Claims made or"suits" brought; or G. Persons or organizations making claims or bringing "suits". Deductible - Our obligation to pay damages on your behalf applies only to the amount of damages in excess of $500. This deductible applies to all damages because of "property damage" as the result of any one 'occurrence" regardless of the number of persons or organizations who sustain damages because of that 'occurrence". We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. As respects this coverage "Aggregate" is the maximum amount we will pay for all covered 'occurrences" during one policy period. For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to defend ends when we have paid the Limit of Liability or the Aggregate Limit for this coverage. 15. Subject to 5. of SECTION III — LIMITS OF INSURANCE, the most we will pay for "property damage" under Coverage F - Electronic Data Liability Coverage for loss of "electronic data" is $50,000 without regard to the number of"occurrences". SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS A. The following conditions are amended: 1. Knowledge of Occurrence a. Condition 2., Items a. and b. are deleted and replaced by the following: (1) Duties In The Event Of Occurrence, Offense, Claim Or Suit (a) You must see to it that we are notified as soon as practicable of an 'occurrence" or an offense which may result in a claim. Knowledge of an 'occurrence" by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. To the extent possible, notice should include: i. How, when and where the 'occurrence" took place; ii. The names and addresses of any injured persons and witnesses, and iii. The nature and location of any injury or damage arising out of the 'occurrence" or offense . (b) If a claim is made or"suit" is brought against any insured, you must: L Immediately record the specifics of the claim or"suit' and the date received; and ii. Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit' as soon as practicable. Knowledge of a claim or "suit' by your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an officer of the named insured has received such notice from the agent, servant or employee. 2. Where Broad Form Named Insured is added in SECTION II — WHO IS AN INSURED of this endorsement, Condition 4. Other Insurance b. Excess Insurance (1).(a) is replaced by the following: (a) Any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to an insured solely by reason of ownership by you of more than 50 percent of the voting stock, and not withstanding any other language in any other policy. This provision does not apply to a policy written to apply specifically in excess of this policy. CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 11 of 14 CG 72 08 02 15 B. The following are added: 1. Condition (5) of 2.c. (5) Upon our request, replace or repair the property covered under Voluntary Property Damage Coverage at your actual cost, excluding profit or overhead. 10. Blanket Waiver Of Subrogation We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of: premises owned or occupied by or rented or loaned to you, ongoing operations performed by you or on your behalf, done under a contract with that person or organization, "your work", or "your products". We waive this right where you have agreed to do so as part of a written contract, executed by you before the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense is committed. 11. Liberalization If a revision to this Coverage Part, which would provide more coverage with no additional premium becomes effective during the policy period in the state designated for the first Named Insured shown in the Declarations, your policy will automatically provide this additional coverage on the effective date of the revision. 12. Unintentional Failure to Disclose All Hazards Based on our reliance on your representations as to existing hazards, if you unintentionally should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. 13. The following conditions are added in regard to Coverage G - Product Recall Expense In event of a "product recall', you must a. See to it that we are notified as soon as practicable of a "product recall'. To the extent possible, notice should include how, when and where the "product recall' took place and estimated "product recall expense". b. Take all reasonable steps to minimize "product recall expense". This will not increase the limits of insurance. G. If requested, permit us to question you under oath at such times as may be reasonably required about any matter relating to this insurance or your claim, including your books and records. Your answers must be signed. d. Permit us to inspect and obtain other information proving the loss. You must send us a signed, sworn statement of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. e. Cooperate with us in the investigation or settlement of any claim. f. Assist us upon our request, in the enforcement of any rights against any person or organization which may be liable to you because of loss to which this insurance applies. g. Claims Handling (1) Within 15 days after we receive written notice of claim, we will: (a) Acknowledge receipt of the claim. If we do not acknowledge receipt of the claim in writing, we will keep a record of the date, method and content of the acknowledgment; (b) Begin any investigation of the claim; and (c) Request a signed, sworn proof of loss, specify the information you must provide and supply you with the necessary forms. We may request more information at a later date, if during the investigation of the claim such additional information is necessary. (2) We will notify you in writing as to whether: (a) The claim or part of the claim will be paid; (b) The claim or part of the claim has been denied, and inform you of the reasons for denial; (c) More information is necessary; or (d) We need additional time to reach a decision. If we need additional time, we will inform you of the reasons for such need. CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 12 of 14 CG 72 08 02 15 (3) We will provide notification, as described in (2)(a) through (2)(d) above, within: (a) 15 business days after we receive the signed, sworn proof of loss and all information we requested; or (b) 30 days after we receive the signed, sworn proof of loss and all information we requested, if we have reason to believe the loss resulted from arson. If we have notified you that we need additional time to reach a decision, we must then either approve or deny the claim within 45 days of such notice. h. We will pay for covered loss or damage within 5 business days after: (1) We have notified you that payment of the claim or part of the claim will be made and have reached agreement with you on the amount of loss; or (2) An appraisal award has been made. However, if payment of the claim or part of the claim is conditioned on your compliance with any of the terms of this policy, we will make payment within 5 business days after the date you have complied with such terms. L Catastrophe Claims If a claim results from a weather related catastrophe or a major natural disaster, the claim handling and claim payment deadlines described in a. and b. above are extended for an additional 15 days. Catastrophe or Major Natural Disaster means a weather related event which is: (1) Declared a disaster under the Texas Disaster Act of 1975; or (2) Determined to be a catastrophe by the State Board of Insurance. j. The term "business day", as used in this endorsement, means a day other than Saturday, Sunday or a holiday recognized by the state of Texas. k. We will issue loss payment to the first Named Insured shown in the Declarations and any mortgagee or loss payee as designated. 14. Limited Railroad Contractual Liability The following conditions are applicable only to coverage afforded by reason of the redefining of an "insured contract" in the DEFINITIONS section of this endorsement: a. Railroad Protective Liability coverage provided by ISO form CG 0035 with minimum limits of$2,000,000 per occurrence and a $6,000,000 general aggregate limit must be in place for the entire duration of any project. b. Any amendment to the Other Insurance condition of form CG 0035 alters the primacy of the coverage or which impairs our right to contribution will rescind any coverage afforded by the redefined "insured contract" language. c. For the purposes of the Other Insurance condition of form CG 0035 you, the named insured, will be deemed to be the designated contractor. SECTION V - DEFINITIONS A. At item 12. Mobile Equipment the wording at f.(1) is deleted and replaced by the following: f.(1) Equipment designed primarily for: (a) Snow removal; (b) Road maintenance, but not construction or resurfacing; or (c) Street cleaning; except for such vehicles that have a gross vehicle weight less than 1,000 lbs which are not designed for highway use. B. Item 3. "bodily injury" is deleted and replaced with 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, sickness or disease. C. Item 9. "Insured Contract" c. is deleted and replaced with the following: G. Any easement or license agreement; D. Item 9. "Insured Contract" f.(1) is deleted E. The following definitions are added for this endorsement only: 23. "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tape drives, cells, data processing devices or any other media which are used with electronically controlled equipment. CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 13 of 14 CG 72 08 02 15 24. "Product recall" means a withdrawal or removal from the market of "your product" based on the determination by you or any regulatory or governmental agency that: a. The use or consumption of "your product" has caused or will cause actual or alleged "bodily injury" or "property damage"; and b. Such determination requires you to recover possession or control of "your product" from any distributor, purchaser or user, to repair or replace "your product", but only if "your product" is unfit for use or consumption, or is hazardous as a result of. (1) An error or omission by an insured in the design, manufacturing, processing, labeling, storage, or transportation of"your product"; or (2) Actual or alleged intentional, malicious or wrongful alteration or contamination of "your product' by someone other than you. 25. "Product recall expense" means reasonable and necessary expenses for: a. Telephone, radio and television communication and printed advertisements, including stationery, envelopes and postage. b. Transporting recalled products from any purchaser, distributor or user, to locations designated by you. G. Remuneration paid to your employees for overtime, as well as remuneration paid to additional employees or independent contractors you hire. d. Transportation and accommodation expense incurred by your employees. e. Rental expense incurred for temporary locations used to store recalled products. f. Expense incurred to properly dispose of recalled products, including packaging that cannot be reused. g. Transportation expenses incurred to replace recalled products. h. Repairing, redistributing or replacing covered recalled products with like products or substitutes, not to exceed your original cost of manufacturing, processing, acquisition and/or distribution. These expenses must be incurred as a result of a "product recall'. CG 72 08 02 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 14 of 14 Policy #185316434 CA 71 09 01 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO ULTRA ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COVERAGE INDEX Descriptio n Page TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE 1 BROAD FORM INSURED 1 EMPLOYEES ASINSUREDS 2 ADDITIONAL INSURED STATUS BY CONTRACT, AGREEMENT OR PERMIT 2 AMENDED FELLOW EMPLOYEE EXCLUSION 2 TOWING AND LABOR 2 PHYSICAL DAMAGE ADDITIONAL TRANSPORTATION EXPENSE COVERAGE 3 EXTRA EXPENSE -THEFT 3 RENTAL REIMBURSEMENT AND ADDITIONAL TRANSPORTATION EXPENSE 3 PERSONAL EFFECTS COVERAGE 4 AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE 4 AIRBAG ACCIDENTAL DISCHARGE 4 AUTO LOAN/LEASE TOTAL LOSS PROTECTION ENDORSEMENT 4 GLASS REPAIR — DEDUCTIBLE AMENDMENT 5 AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS 5 WAIVER OF SUBROGATION REQUIRED BY CONTRACT 5 UNINTENTIONAL FAILURE TO DISCLOSE 5 HIRED, LEASED, RENTED OR BORROWED AUTO PHYSICAL DAMAGE 5 EXTENDED CANCELLATION CONDITION 6 The COVERAGE INDEX set forth above is informational only and grants no coverage. Terms set forth in (Bold Italics) are likewise for information only and by themselves shall be deemed to grant no coverage. A. TEMPORARY SUBSTITUTE AUTO PHYSICAL B. BROADENED LIABILITY COVERAGES DAMAGE SECTION II — LIABILITY COVERAGE in Paragraph A. SECTION I—COVERED AUTOS, paragraph C. Certain Coverage at 1. Who Is An Insured is amended to Trailers, Mobile Equipment and Temporary include the following: Substitute Autos is amended by adding the following at the end of the existing language: (Broad Form Insured) If Physical Damage Coverage is provided under this d. Any legally incorporated subsidiary in which you Coverage form for an "auto" you own, the Physical own more than 50% of the voting stock on the Damage coverages provided for that owned "auto" are effective date of the Coverage Form. However, the extended to any "auto" you do not own while used with Named Insured does not include any subsidiary that the permission of its owner as a temporary substitute for is an "insured" under any other automobile policy or the covered "auto" you own that is out of service would be an "insured" under such a policy but because of its breakdown, repair, servicing, "loss", or for its termination or the exhaustion of its Limit destruction. of Insurance. CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 6 CA 71 09 01 06 e. Any organization that is acquired or formed by you, C. AMENDED FELLOW EMPLOYEE EXCLUSION during the term of this policy and over which you maintain majority ownership. However, the Named Only with respect to your "employees" who occupy Insured does not include any newly formed or positions which are supervisory in nature, SECTION 11. acquired organization: LIABILITY B. Exclusion 5. Fellow Employee is (1) That is a joint venture or partnership, replaced by: (2) That is an "insured" under any other policy, 5. Fellow Employee (3) That has exhausted its Limit of Insurance under "Bodily Injury": any other policy, or (a) To you, or your partners or members (if you are a partnership or joint venture), or to your (4) 180 days or more after its acquisition or members (if you are a limited liability formation by you, unless you have given us company); notice of the acquisition or formation. Coverage does not apply to "bodily injury" or (b) To your "executive officers" and directors (if "property damage" that results from an accident that you are an organization other than a occurred before you formed or acquired the partnership, joint venture, or limited liability company) but only with respect to organization. performance of their duties as your officers or directors; (Employee as Insureds) (c) For which there is an obligation to share f. Any employee of yours while acting in the course of damages with or repay someone else who your business or your personal affairs while using a must pay damages because of the injury covered "auto" you do not own, hire or borrow. described in paragraph a and b above; or (Additional Insured Status by Contract, Agreement (d) Arising out of his or her providing or failing or Permit) to provide professional health care services. g. Any person or organization whom you are required For purposes of this endorsement, a position is deemed to add as an additional insured on this policy under to be supervisory in nature if that person performs a written contract or agreement; but the written principle work which is substantially different from that contract or agreement must be: of his or her subordinates and has authority to hire, (1) Currently in effect or becoming effective during transfer, direct, discipline or discharge. the term of this policy; and D. BROADENED PHYSICAL DAMAGE COVERAGES (2) Executed prior to the "bodily injury" or "property damage". SECTION III — PHYSICAL DAMAGE COVERAGE The additional insured status will apply only with respect Coverage is amended as follows: to your liability for "bodily injury" or "property damage" (TOWING AND LABOR) which may be imputed to that person(s) or 2. Towing and Labor organization(s) directly arising out of the ownership, maintenance or use of the covered "autos" at the We will pay towing and labor costs incurred, up to the location(s) designated, if any. limits shown below, each time a covered "auto" Coverage provided by this endorsement will not exceed classified and rated as a private passenger type, "light the limits of liability required by the written contract or truck" or"medium truck" is disabled: written agreement even if the limits of liability stated in (a) For private passenger type vehicles or"light the policy exceed those limits. This endorsement shall trucks" we will pay up to $75 per not increase the limits stated in Section 11. C. Limits of disablement. "Light trucks" have a gross Insurance. vehicle weight (GVVV) of 10,000 pounds or For any covered "auto" you own this Coverage Form less. provides primary coverage. CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 6 CA 71 09 01 06 (b) For "medium trucks" we will pay up to $150 (2) We will pay only for expenses incurred per disablement. "Medium trucks" have a during the policy period and beginning 24 gross vehicle weight (GVW) of 10,001 lbs. hours after the "loss" and ending, regardless to 20,000 pounds. of the policy's expiration, with the lesser of the following number of days: However, the labor must be performed at the place of (a) The number of days reasonably disablement. required to repair or replace the covered (PHYSICAL DAMAGE ADDITIONAL "auto." If "loss" is caused by theft, this TRANSPORTATION EXPENSE COVERAGE) number of days is added to the number of days it takes to locate the covered 4. Coverage Extensions "auto" and return it to you, or a. Transportation Expense is amended to (b) 30 days. provide the following limits: (3) Our payment is limited to the lesser of the We will pay up to $50 per day to a maximum of following amounts: $1,000. All other terms and provisions of this (a) Necessary and actual expenses section remain applicable. incurred; or (EXTRA EXPENSE- THEFT) (b) $35 per day. The following language is added to 4. Coverage (c) This coverage does not apply while Extensions: there are spare or reserve "autos" G. Theft Recovery Expense available to you for your operations. If you have purchased Comprehensive (d) If "loss" results from the total theft of a Y p p covered "auto" of the private passenger Coverage on an "auto" that is stolen, we will pay or light truck type, we will pay under this the expense of returning that stolen auto to you. coverage only that amount of your The limit for this coverage extension is $5,000. rental reimbursement expense which is not already provided for under the (RENTAL REIMBURSEMENT AND ADDITIONAL SECTION III — PHYSICAL DAMAGE TRANSPORTATION EXPENSE) COVERAGE, A. Coverage, 4. d. Rental Reimbursement Coverage Extensions, a. Transportation Expenses. We will provide Rental Reimbursement and (PERSONAL EFFECTS COVERAGE) Additional Expense coverage only for those Physical Damage coverages for which a e. Personal Effects premium is shown in the Declarations or schedule pages. Coverage applies only to a If you have purchased Comprehensive Coverage on this policy for an "auto" you own covered "auto" of the private passenger or light and that "auto" is stolen, we will pay, without truck (10,000 lbs. or less gross vehicle weight) type for which Physical Damage coverages application of a deductible, up to $500 for Personal Effects stolen with the "auto". The apply. insurance provided under this provision is (1) We will pay for auto rental expense and the excess over any other collectible insurance. For expense incurred by you because of "loss" this coverage extension, Personal Effects to remove and transfer your materials and means tangible property that is worn or carried equipment from a covered "auto" to a by an "insured". Personal Effects does not covered "auto." Payment applies in addition include tools, jewelry, guns, musical to the otherwise applicable coverage you instruments, money, or securities. have on a covered "auto." No deductible applies to this coverage. CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 6 CA 71 09 01 06 (AUDIO, VISUAL AND DATA ELECTRONIC (4) With respect to this coverage, the most we EQUIPMENT COVERAGE) will pay for all "loss" of audio, visual or data electronic equipment and any accessories (Deletion of Audio Visual Equipment Exclusion) used with this equipment as a result of any one "accident" is the lesser of: f. Audio, Visual and Data Electronic (a) The actual cash value of the damaged Equipment Coverage. or stolen property as of the time of the We will pay for "loss" to any electronic "loss"; equipment that receives or transmits audio, (b) The cost of repairing or replacing the visual or data signals and that is not designed damaged or stolen property with other solely for the reproduction of sound. This property of like kind and quality; or coverage applies only if the equipment is $1,000; permanently installed in a covered "auto" at the time of the "loss" or the equipment is removable minus a deductible of$100. from a housing unit which is permanently An adjustment for depreciation and physical installed in a covered "auto" at the time of the condition will be made in determining actual "loss", and such equipment is designed to be cash value at the time of loss. If a repair or solely operated by use of the power from the replacement results in better than like kind "auto's" electrical system, in or upon the or quality, we will not pay for the amount of covered "auto." the betterment. (1) We will pay with respect to a covered "auto" If there is other coverage provided for audio, for "loss" to any accessories used with the visual and data electronic equipment, the electronic equipment described above. coverage provided herein is excess over any However, this does not include tapes, other collectible insurance. records or discs. (2) In addition to the exclusions that apply to (AIRBAG ACCIDENTAL DISCHARGE) Physical Damage Coverage with exception D. SECTION III — PHYSICAL DAMAGE COVERAGE, of the exclusion relating to audio, visual and B. Exclusions is amended as follows: data electronic equipment, the following exclusions also apply: The following language is added to Exclusion 3.: (3) We will not pay for any electronic If you have purchased Comprehensive or Collision equipment or accessories used with such Coverage under this policy, this exclusion does not electronic equipment that are: apply to mechanical breakdown relating to the (a) Necessary for the normal operation of accidental discharge of an air bag. This coverage the covered "auto" for the monitoring of applies only to a covered auto you own and is the covered "auto's" operating system; excess of any other collectible insurance or warranty. or No deductible applies to this coverage. (b) Both: E. AUTO LOAN/LEASE TOTAL LOSS PROTECTION An integral part of the same unit SECTION III — PHYSICAL DAMAGE COVERAGE — C. housing any sound reproducing Limit of Insurance is amended by adding the following equipment designed solely for the language: reproducing of sound if the sound reproducing equipment is permanently 4. In the event of a total "loss' to a covered "auto" installed in the covered "auto"; and shown in the Schedule pages, subject at the time of Permanently installed in the opening of the "loss" to a loan or lease, we will pay any unpaid the dash or console normally used by amount due on the lease or loan for a covered the manufacturer for the installation of a "auto" less: radio. CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 6 CA 71 09 01 06 a. The amount paid under the Physical Damage (4) Your members, managers or insurance Coverage Section of the policy; and manager, if you are a limited liability b. Any: company; or (5) Your officials, trustees, board members or (1) Overdue lease / loan payments at the time insurance manager, if you are a of the "loss"; not-for-profit organization. (2) Financial penalties imposed under a lease G. WAIVER OF SUBROGATION REQUIRED BY for excessive use, abnormal wear and tear or high mileage; CONTRACT (3) Security deposits not returned by the lessor; Under SECTION IV, BUSINESS AUTO CONDITIONS, A. Loss Conditions 5. Transfer (4) Costs for extended warranties, Credit Life of Rights of Recovery Against Others to Us Insurance, Health, Accident or Disability the following language is added: Insurance purchased with the loan or lease; However, we waive any rights of recovery we may and have against the person or organization with whom (5) Carry-over balances from previous loans or you have agreed in writing in a contract, agreement leases. or permit, to provide insurance such as is afforded under the policy to which this endorsement is (GLASS REPAIR — DEDUCTIBLE AMENDMENT) attached. This provision does not apply unless the written contract or written agreement has been Under D., Deductible is amended by adding the executed, or permit has been issued, prior to the following: "bodily injury" or"property damage." Any deductible shown in the Declarations as H. UNINTENTIONAL FAILURE TO DISCLOSE applicable to the covered "auto" will not apply to glass breakage if the damaged glass is repaired, Under SECTION IV — BUSINESS AUTO rather than replaced. CONDITIONS, Subsection B. General Conditions , F. AMENDED DUTIES IN THE EVENT OF the following is added to 2. Concealment, ACCIDENT, CLAIM, SUIT OR LOSS Misrepresentation Or Fraud: Your unintentional error in disclosing, or failing to Under SECTION IV — BUSINESS AUTO CONDITIONS, disclose, any material fact existing at the effective Subsection A., Loss Conditions , the following is date of this Coverage Form, or during the policy added to paragraph 2. Duties In The Event of period in connection with any additional hazards, will Accident, Suit or Loss: not prejudice your rights under this Coverage Form. d. Knowledge of any "accident," "claim," "suit" or 1. HIRED, LEASED, RENTED OR BORROWEDAUTO PHYSICAL DAMAGE "loss" will be deemed knowledge by you when notice of such "accident," "claim," "suit" or "loss" Under SECTION IV— BUSINESS AUTO CONDITIONS has been received by: B. General Conditions 5. Other Insurance (1) You, if you are an individual; Paragraph 5.b. is replaced by the following: (2) Any partner or insurance manager if you are b. (1) For "Comprehensive" and "Collision" Auto a partnership; Physical Damage provided by this endorsement, the following are deemed to be covered "autos" (3) An executive officer or insurance manager, you own: if you are a corporation; (a) Any Covered "auto" you lease, hire, rent or borrow; and CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 6 CA 71 09 01 06 (b) Any Covered "auto" hired or rented by your (3) This Hired Auto Physical Damage coverage is "employee" under a contract in that excess over any other collectible insurance. individual "employee's" name, with your permission, while performing duties related (4) Definitions For This Section to the conduct of your business. (a) Comprehensive Coverage: from any cause However, any "auto" that is leased, hired, rented or except the covered "auto's" collision with borrowed with a driver is not a covered "auto" another object or the covered "auto's" overturn. We will pay glass breakage, "loss" (2) Limit of Insurance For This Section caused by hitting a bird or animal and, "loss" The most we will pay for any one "loss" is the caused by falling objects or missiles. lesser of the following: (b) Collision Coverage: caused by the covered "auto's" collision with another object or by (a) $50,000 per accident, or the covered "auto's" overturn. (b) actual cash value at the time of loss, or J. EXTENDED CANCELLATION CONDITION (c) cost of repair. A. Under CANCELLATION, of the COMMON POLICY CONDITIONS form, item 2.b. is replaced by the minus a $500 deductible. An adjustment for following: depreciation and physical condition will be made in determining actual cash value in the event of b. 60 days before the effective date of cancellation a total loss. No deductible applies to "loss" if we cancel for any other reason caused by fire or lightning. CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 6 Policy #85316434 CA 73 34 09 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON-CONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The following language replaces SECTION IV BUSINESS AUTO CONDITIONS Part B. General Conditions 5. Other Insurance c.: c. Regardless of the provisions of Paragraph a. above, this Coverage Form's Covered Autos Liability Coverage is primary for any liability assumed under an "insured contract". This coverage will also be non-contributory if it is required by the terms of the "insured contract". CA 73 34 09 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 1eAnxxrd3mutuai@ Insurance Company WORKERS'COMPENSATION AND WC 42 03 04 B EMPLOYERS LIABILITY POLICY Insured Copy 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. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following"attaching clause"need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement,effective on 08/12/2016 at 12:01 a.m.standard time,forms a part of: Policy No.0001193570 of Texas Mutual Insurance Company effective on 08/12/2016 Issued to: WILLIAM J SCHULTZ INC & DBA: CIRCLE C CONSTRUCTION COMPANY de— Premium: $0.00 Authorized Representative NCCI Carrier Code:29939 08/11/2016 PO Box 12058,Austin,TX 78711-2058 1 of 1 (800)859-5995 1 Fax(800)359-0650 1 texasmutual.com WC 42 03 04 B C-28090 - C CERTIFICATE OF INTERESTED PARTIES FORM X295 101`1 Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2016-149100 William J Schultz Inc dba Circle C Construction Company Fort Worth,TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 12/27/2016 being filed. City of Fort Worth Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a description of the services,goods,or other property to be provided under the contract. 02071 Water Main Extensions, Replacements and Relocations Contract 2015A 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling I Intermediary Skelly,Teresa Fort Worth,TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct. MICHELE S.LANJ7,2019 Notary Public �+ * *t STATE OF TEX My Comm.Eotary �1176946-6 My Signature of authorized agent of concling business entity AFFIX NOTARY STAMP/SEAL ABOVE Sworn to and subscribed before me,by the said TP./'G!5 R. this the day ofC.�sy1 2t7 ,to certify which,witness my hand and seal of office. Signature of officer adminis oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277