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HomeMy WebLinkAboutContract 48831-R1 23458 1>� CSC NO.48831 0 N PECEfVED J R z ZOJ ov CITY OF FORT WORTH o� C1�l7 oArwo8B CONTRACT RENEWAL NOTICE CITY SECRETARY �, Fdi i X18, 2018 CONTRACT NO, 9 g~Pape-Dawson Consulting Engineers, Inc. 6500 West Frwy,, Suite 700 Fort Worth,Texas 76116 Attn: Craig Bridgewater RE: NOTICE OF CONTRACT RENEWAL Construction Inspection Services for Various City Construction Projects Contract No. CSC No.48831 ("Contract") Contract Amount: $900,000 The above referenced Contract expired on March 8,2018.Authorized work ordered prior to the expiration date may continue; however no new work orders may be processed under this agreement, unless renewed. Pursuant to the Contract,two contract renewals are permitted.This letter is to inform you that the City is exercising its option to renew CSC No.48831 for an additional one-year period, which will begin on the Effective Date established in the renewal document attached hereto. The Hourly Labor Rates in Attachment B will be increased by 2%. The Contract requires certain amendments to comply with recently enacted state laws and other staff-requested changes.The First Renewal and Amendment is attached hereto for your review and execution.The amendments will be incorporated into the original Contract terms with this renewal.All other terms and conditions of the Contract remain unchanged. If your firm agrees to the amendments and renewal terms, please sign and return this acknowledgment letter and the First Renewal and Amendment document and provide a copy of your current insurance certificate to the undersigned. Please log onto BuySpeed Online at http://fortworthtexas.gov/purchasing to insure that your company information is correct and up-to-date If you have any questions concerning this Contract Renewal, please don't hesitate to contact me. Sin c ely ours, oy TPW Capital Delivery 8851 Camp Bowie Blvd. West Fort Worth, Texas 76116 (817) 392-7958 By: Brandon O'Donald Vice President Date: March 29,2018 Printed Namepd Title �� Signature O"ICIAL RECORD CITY SECRETARY FT.WORTH,TX Page 1 of 1 CITY OF FORT WORTH AMENDMENT AND FIRST RENEWAL OF AGREEMENT WHEREAS, this Amendment and Renewal of Agreement is between the City of Fort Worth, ("CITY"), and Pape-Dawson Consulting Engineers, Inc., ("CONSULTANT"); and WHEREAS, CITY and CONSULTANT desire to amend and renew the Original Agreement (City Secretary#48831); and WHEREAS, the Original Agreement and this Renewal were approved by M&C C- 28098 (February 7, 2017), for the Project generally described as: Construction Inspection Services for Various City Construction Projects; NOW, THEREFORE, it is agreed by the CITY and CONSULTANT as follows: Article I The Scope of Services as set forth in the Original Agreement remains unchanged. Article II The CONSULTANT's compensation for this Renewal shall be $900,000.00. Article III The CONSULTANT'S hourly labor rates, Attachment B to the original agreement, shall be increased by two per cent. Article IV Inspectors The Agreement is hereby amended to include the following language: The CITY reserves the right to review the resume, CV or other certifications for each Inspector proffered by CONSULTANT to perform work under this AGREEMENT. CONSULTANT shall make every effort not to change Inspectors accepted by the CITY for the duration of a PROJECT as defined under Task 1, Construction Inspection, of Attachment A to the original AGREEMENT. OFFICIAL RECORD CITY SECRETARY FT.WORTH,TX First Renewal of Agreement Page 1 of 3 Construction Gispection Services f)r hifr-astructure Projects Article V The Agreement is hereby amended to include the following language: Immigration Nationality Act CONSULTANT shall verify the identity and employment eligibility of its employees who perform work under this Agreement, including completing the Employment Eligibility Verification Form (I-9). Upon request by City, CONSULTANT shall provide City with copies of all I-9 forms and supporting eligibility documentation for each employee who performs work under this Agreement. CONSULTANT shall adhere to all Federal and State laws as well as establish appropriate procedures and controls so that no services will be performed by any CONSULTANT employee who is not legally eligible to perform such services. CONSULTANT SHALL INDEMNIFY CITY AND HOLD CITY HARMLESS FROM ANY PENALTIES, LIABILITIES, OR LOSSES DUE TO VIOLATIONS OF THIS PARAGRAPH BY CONSULTANT, CONSULTANT'S EMPLOYEES, SUBCONTRACTORS, AGENTS, OR LICENSEES. City, upon written notice to CONSULTANT, shall have the right to immediately terminate this Agreement for violations of this provision by CONSULTANT. Article VI The Agreement is hereby amended to include the following language: Prohibition on Contracts with Companies Boycotting Israel CONSULTANT acknowledges that in accordance with Chapter 2270 of the Texas Government Code, the City is prohibited from entering into a contract with a company for goods or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. The terms "boycott Israel" and "company" shall have the meanings ascribed to those terms in Section 808.001 of the Texas Government Code. By signing this contract, CONSULTANT certifies that CONSULTANT's signature provides written verification to the City that CONSULTANT.(1)does not boycott Israel;and(2)will not boycott Israel during the term of the contract. Article VII All other provisions of the Original Agreement not expressly amended herein, shall remain in full force and effect. First Renewal of Agreement Page 2 of 3 Coristrriction lnspectinn Services fi)r lriti istnicture Projects EXECUTED and EFFECTIVE as of the date subscribed by the City's designated City Manager. APPROVED: City of Fort Worth Pape-Dawson Consulting Engineers, Inc. us n Alanis Brandon O'Donald Assistant City Manager Vice President DATE: ` DATE: March 29, 2018 APtVAL RECOMMENDED: "17 1Dou iersig, P.E. Dire r, Transportation/Public Works Department APPROVED AS TO FORM AND LEGALITY: dd M&C:9649�_, R Date: Douglas W. Black Assistant City Attorney oRT�'O ATT :_ ry J. Kays r * ' City Secretary •7FXP5 . 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 reqUirenicnts. OFFICIAL RECORD oy Teal Construction Manager CITY �'!e �Y®�1�� Y♦RA First Renewal of Agreement Page 3 of 3 Construction Inspection Services for Infrastructure Projects Client#:158373 PAPEDAWS ACORD... CERTIFICATE OF LIABILITY INSURANCE D �DDrYYYY) 1/22/2018 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 ALWR THE COVERAGE AFFORDED BY-THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSU SURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain}policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER coME:ACT Zacha Vacek NA USI Southwest aN E ,718 490-4566 FAX A1C No): 713-490-4700 9811 Katy Freeway,Suite 500 E•MmL . zachary.vacek@usi.com Houston,TX 77024 INSURERS AFFORDING COVERAGE NAIC# 713 490-4600 INSURER A Berkley Insurance Company 32603 INSURED INSURER 13: Pape-Dawson Consulting Engineers,Inc. INSURER C 2000 NW Loop 410 INSURER D: San Antonio,TX 78213-4640 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE 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. LTRA TYPE OF INSURANCE DOL UBR POLICY NUMBER POLICY fYYYY MMIDD/YYYV LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE LJ OCCUR A AI R occcu anc $ MED EXP(Any oneperson) S PERSONAL It ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE $ D PRO- POLICY POLICY JECT u LOC PRODUCTS•COMP/OP AGG $ OTHER. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT i ANY AUTO BODILY INJURY(Por person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per en S UMBRELLA LIAO OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS MADE AGGREGATE $ _ IDED I I RETENTI N WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY •— ANY PROPRIETOR/PARTNER/EXECUTIVE-1Y t N E.L EACH ACCIDENT !� OFFICER MEMBER EXCLUDED? N;A (Mandatory In NH) EL DISEASE.EA EMPLOYEE $ 11 yes,descnbe un DESCRIPTIONOFdtPERATt NS below E.L.DISEASE.POLICY LIMIT S A Professional AEC9019254 2/28/2018 02128/2019 $5,000,000 per claim Liability $5,000,000 annl aggr. claims made DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) "Supplemental Name" Pape-Dawson Consulting Engineers,Inc. Pape-Dawson Engineers,Inc. VRRSP Consultants, LLC,but only for Pape Dawson's legal liability arising out of Professional Services provided by VRRSP Consultants,LLC. CERTIFICATE HOLDER CANCELLATION City of Fort Worth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn :Transportation&Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 8851 Camp Bowie West Blvd Fort Worth,TX 76116 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S22368767/M22362389 JYCZP I DATE(KVV001�YYY) -ACC-)R" CERTIFICATE OF LIABILITY INSURANCE 02120,'2018 UPON THE CERTIFICATE HOLDER,THIS COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE IJ ES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, he policy(iesl Trust have ADDITIONAL INSURED provisions or be 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 endorserncrt(s). .PRODUCER CONTACT J ut y SU n1 m.er,� PHONE Tl-,.e E3ziy`1-o'Sali C=roup,Inc (2110)822-1571 FAX (210)822-6027 AIC No E.-,!: 1900 N'W Lccp 2,10,Suite 200corn. ADDRE 5- 11- 11 11,45URERIS)AFFORDING COVERAGE ConMan',ni Insurarce Co 35289 S3n Anlor.,o IX 7B213 INSURER A: INSURED INSURER 13: Na INSURER Ins.of Harbord2C476 PAPE CAWSON CONSULTING ENGINEERS,INC INSURER c: Am--r-can Casually Cc of Readirg PA 20427 DSA:PAPE-DAVVSON EINGMEERS,INC, INSURER D: 2000 N11)LOOP 410 INSURER E: SAN ANTONIO TX 76213 INSURER F COVERAGES CERTIFICATE NUMBER: CLIS22011330 REVISION NUMBER: INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AIL THE TERMS, N,THE THIS IS TO CERTIFY THAT THE POLICIES OF INJISURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD iNLII1,;AIED. NO-PA11THSIANDING ANYREQUIRE?'.1ENT,TERMOR CCNDITION OF ANY CONTRACT OR OTHER DOCUMENT W!TH RESPECT TO'WHICHI THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, EXCLUSIONS AND CONDITIONS OF:SUCH POL'ICJES`7LIMITS SHOVVNNIAY HAVE BEEN REDUCE[)BY PAID CLAIMS. T1-A'9—R —ADo-L -— -----P'a"Li-c7EFF POLICY EXP LTR I TYPE OF INSURANCE INSD WVD I POLICY NUMBER fMM1DDNYYYL (MM,'DD LIMITS x CCMMERCIA'-GENERAL LIABILITYEACH OCCURRENCE S CLAIMS-MADE Ex OCCUR PREMISES lEa a,ru!,e,ce) S 500,000 -MED EXP(Any one person! S 15,000 A 5999-145087 02128!201 B 02728/2019 PERSONAL&ADV INJURY S 11,000,090 GEN"LAGGREGATE LIMITAPPI-IES PER GENERALAGGREGATE s 2,000,000 Fl- PRO --- - �, 2,00�0OYO POLICY 19 JECT LOC PRODUCTS-7S-10111�01 AIC OTHER 1 5 AUTOMOBILE LIABILITY COMBINED S!INGLE LIV17 s 1,000,000 (Ea icc,dentl x ANYAUTO BODILY INJURY fPe,person) S 13 GIANE'DO'_Y SCHEDULED 501994-45106 02128/2018 0212812019 SOCILY INJURY IPer ac6denz) S AUT6,, "LTOS xHIRED PROPERTY DAMAGE GE AUTOS 01,11-Y AUTOS ONLY accident) U61EIR-ELLA LIAB0,000,000 x I x OCCUR OCCURRENCE 1 A EXCESS GED�LIAISI 5099445123 02,2612018 02;'2812319 AGGREGATEIs 10,000.000 CLA MS MA�DE 10,000 RETENTION 5 WORAERS COMPENSATION' ANI)EMPLOYERS*LIABILITY 'STATUTEY/N I ER ANY V'- I S 1,000,000 C OrFICER:MEMBEREXr.I.'jLE57'- I­7A] N/A 5090445,090 02,12F/2018 02/2F12011 9 (Mandatory in NH) -E L.DISEASE-EA EMPLOYEE If Vas iJesc�lhe under DESCRIPTION OF OPERATIONS baow E L DISEASE-POLICY LIMIT I S 1'000'0 O DESCRIPTION OF OPERATIONS LOCATIONS!VFH;CLES (ACORD 101,AddMQnjI Remarks Scoed.li.rIvy tiff @V,.chI:d 11 mor-spay Is raqt.-lrad) I3 III ii CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN C;Iv of Fort Worth Transpoilation Public Works ACCORDANCE WITH THE POLICY PROVISIONS. 8851 Camp Bowie West Blvd. AUTHORIZED REPRESENTATIVE Ft'V'Jolh TX 76116 - (D 1988-2015 ACORD CORPORATION. All rights reserved, ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD CNA PARAMOUNT CMA Blanket Additional Insured - Owners, Lessees or Operations Coverage Endorsement Thinmoj|fieuinsurama �videdunder the ��ina C0N .11ERC)ALGENERAL L\AB|L13 YCOVERAGE PART |tiounderstood and agreed ssfoUo�o� i The WHO !SAN INSURED section ioamendeU in odd as an |ruued any person or o/gan|zaUun ,vhom the Named Insured is required bywritten cuntraotboadd as an additional insured on 'his coverage paM, including any such person or organization, if ariy. specifically set forth or. the Schedule attachment tothis endorsement Hmvvever. such person or organization is art Insured only with respect|usuch person or organization's liability for: A. unless paragraph B.below applies, 1. bodily injury,property damage, or personal and advertising injury caused in%,,iholie or in part by the acts o/omissions hyuror. behalf offile Named Insured and inthe padbrmanceofsuch Named|nsured's ongoing operations asnper-I5adinsuch written contract; or 2, bodily injury or property damage caused in whole or in part by your work and included in the products- completed operations hazard, and only if roduc\s'cump{e$edmpombonshazooJ.andon|y|y o, the written contract retluires the Named Insured to provide the additional insured such coverage; and b. this coverage part provides such coverage, 8. bodily injury, property 6ammge, or personal and advertising injury arising out o/your work described in such writ-ten contract, but only if: 1. this coverage part provides coverage for bodily injury or property damage included within the products completed operations hazard; and 2. the written contract specifically requires the Named Insured to provide additional insured coverage under the 11'86nr1O-Oi edition of CG2D1Oorthe 10'O1 edition ofCG2O37, U. Subeo\akwayutuVhstermsandoonditionsofthispnUcy. inoudingikelimhaofinsurance.1ho |nsurz' oiUno! pravide such additional insured wi\h� A. coverage broader than required bythe written conhacti or B. ehigher limit o/insurance than required bythe written contract, � \V. The inazmnra granted hythis endmaemarhhu the additional insured does not apply to bodily injury, property � damage, o,personal and advertising injury arising out ot A. U/e rendering of, or the taUom to nander, any professional architectural, mn8inee6ng, or surveying services, indudinQ� 1. the preparing appmv)ng, orhaiknQ to prepare orapprove mapm. shop drawings, opin|ons, vapo:­ts. surveys, field o,Ue/n. change onJoru o/drav/inga and aPeoi�caUoom;and 2. oup*n/isory. \oaAeciion, archibac'u,a|urenginaehnQaciivhiss-or B. mny pnemises or work h`rnhiuh the aogNiona| insured iaspe��coUy listed as an additional |nsunao on another endcmemen8attauhedozthis coverage no,t e�ee IV. Noh//ins'snding anything to the cun�ary in ihIc aedian entitled COMMERCIAL GENERAL LIABILITY C011410T0N3' the Condidon erittled Other |nsuranco, this inoy,anos i_c; excess oi� all oUh:' insurance mvaNable to thie add/Uonal in»u»edwhether uoephmm,y. ox:c_�sconbngeoiurany other basis. . il this insurance ismqu/reo' bywritten Insured Name. �IAru DAwsom I0I�n��rms c�ozn�£n�' �mc. CNA PARAMOUNT CNA Blanket Additional Insured - Owners, Lessees or Contractors - with Prod ucts-Completed Operations Coverage Endorsement contract to be primary and non_Cuo�ribuiory. this insurance wiU be primary and non'caMwbutory rbbve no! ly in msurunceonwhich the add;tiune| inouedisenamed insured, V. So|e/ywbh respect &otha {nsomnoe granted bythsmndomemen(. the section EntitledCOMMERCIAL GENERAL LIABILITY CONDITIONS iasmendedoafollows: TheCondit:�onenhUedQu\iay\nTheEw*ntofOcuurnynne. OUansm, Claimor5uitiaamondodwhh\heedddion o[the following: Any additional insured pursuant btNmendorsement will assoon aapracticable] 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; %. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the addihone| insured has for any!oescovered under this coverage part, 3. send the Insurer copies of all, legal papem reoeixsd, and otherwise cooperate wdh Me Insurer in the investigation,defense, orymNammnto<1heclaim; and 4. 'Lender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers undo/this coverage pert. However, if the written contract requires this insurance to be primary and non-oon(hhutmy, this paragraph (4) does not apply to insurance on which the additional insured isenamed insured, The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice ofaclaim from the additional insured, Vi Solely with respect to the insurance granted by this andusement, the section entitled DEFINITIONS is amended to add the following dsfinhion, Written contract means aw,itten contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage pad. provided the contract oragreement: A. /ecurrently inaffect nrbacomaseffective during the term ofthis po|ioy� and B. vias executed prior to. | 1. the bodily injury orproperty damage: or | 2. the offense that caused the personal and advertising injury for which the additional insured seeks coverage, Any coverage granted bythis endorsement o."|| apply ao|e|ytothe extent permissible bylaw. All other'ennaand conditions nfthe po|icyremain unchanged, This endors�rnent,whi-h forms a oar,of an' is for attachment to ther-Policy issued by the desssi�nated Insurers, lakes effect on the effective dale ci� sad Policy at the hour stated in sai� Pol�cy, uniess another effective date is shown below, and exilires con--urrently vv­ CHA75079XX (1-15) Po|iuyNo� 5oa9*4L)o8-/ Page 2of2 Endorsement No: -1z The couLioe­caz zusucarce CC), EffectiveDaLa: 02/28/2o18 Insured Name, PAPE u�XSom cuwsIM-FzmG um3zN1eopo. INC °X�its ret,­riiSSlm CNA PARAMOUNT CNA Waiver of Transfer of[ Rights of Recovery Against Othars to the Insurer Endorsement This endoraemanimudi,iesinnunancepmvdodUnder tnefollowinD, CU��E�C!ALGENERAL LIABILITY COVERAGE PART PRDDUCTS/�O;8PLETE� OPERATIONS UA8)L!TYCOVERAGE PART SCHEDULE ]`�arne Of Person Or NG _01 OR A'R:SMEN- TO VAIW' SU-H R!'HTS OF RECOVERY, BUT ONLY 1F SUCH CONTRACT OR AGREEMEN-_'; CIAT information requIrerl j d to complete this Schedule, if not shown above,wil! be sho,.Ain in the Declarations, |,|a understood and agreed that the condition endUedTransfer OfRights Of Recovery Against Others To The Insurer isamended bythe addition ofthe following: Solely with reupect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery the insurer may have against such person or organization because of payments the Insurer makes for injury or damage arising out of the Named \nyured's ongoing operations or your work done under a contract with that person or organization and included iothe products-completed operations hazard, All other terms and onndidonsofthe Poky remain undhangad, se rse 't � CNA75008XX (1-15) PolicyNo� 509944S01-7 Page 1 of 1 Endorsement No� 13 Tlic ccmcinc.ncaz insurance Co, Effective Date uz/za/zoza Insured Name, PAPE oAwsow comooLIzmo smGzmaEns' INC. CNA PARAMOUNT CNA Changes - NOtiGe of Cancellation or Material Restriction Endorsement This pndomemun\modifiem/nou/enmapmvl,dedundarthe hollevving COMINIERC|ALGEMERALLIABILITY COVERAGEPART EKAPLUYEEBENE-FITS LIABILITY COVERAGEPART LIQUOR LIABILITY COVERAGE PART OVVWERSAND CONT RACTORSPROTECTIVE LIABILITY COVERAGE PART PRODDCTS/CDj'v1PLETEDOPERATIONS LIABILITY COVERAGE: PART RAILROAD PROTECTIVE LIABILITY COVERAGE PART STOP GAP LIABILITY COVERAGE PART TECHNOLOGY ERRORS AND OMISSIONS LIABILITY COVERAGE PART SPECIAL PROTECTIVE AND HIGHWAY LIABILITY POLICY-NEWYORK DEPARTMENT OF TRANSPORTATION Number of days notice(other than for nonpayment of premium), �Number of-daysnofice for nonpzWm­ent of premium: C) Name of person or organization to whom notice will be seft PER SCHEDOLE ON PILE Address: PER SCUDULE ON FILE DER SCHEDULE ON FILE I'no entry appears above, the number of days notice for nonpayment of premium will be 10 day& h \oundarchood and agreed that in \haevent nfcancellation mrany material restrictions in coverage during the policy period, 1he Insurer also agrees to mall prior written notice of cancellation or mater|al restriction to the person or organization listed in the above Schedule. �Dudh notice will be sent prior to such cancellation In the manner p»0cnbnd in the above Schedule. AUother terms and conditions ofthe Policy remain unchanged, This pndolrsement,vihich forms a part of and is for attachnient to the Policy issued ty !he designated Insurers, takes eflect on the effective da!e of said Po!icy at the ho r stated in said Pol'cy, ijnlnss another eff d te is shoNn below. and expi-es concurrently with said Polt-',V- �:� ------------- '------- CNA74702XX (1'15) PolicyNo. 5099445087 Page of Endu/aementMo� zo The continental insurance Co. EffecUve Da<e. oz/zo/zczo InsuredName PAPE ouwSUN CoNaoLrzmo amC-zmooRS' zwc. onp'�mmCNA AJ/n/on*nvSewed POLICY NTM�MEF INSURED WAYM AJTD P—DDRESS C S099445ioh P A pi I LAWSON CONS'JLTiNs 2000 NW TAQP 410 SP. 4' PNTON-10, TX 78213 POLICY CH�iGES MAO 0 4 0 This Change Endorsement changes the Policy, Please read it carefully. Thi,, Change Endorsement is a part of your Policy and takes affect. on the effective date of your Policy, unless another effective date is sho�,m. THIS ENDORSF-MPNIF CHAI,,GES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED B1,411KET ANY PERSON OR ORGAN--,ZATION TrLAT THE NA.MSD INSURED IS OBLIT GATED TO PROVIDF. !NSURANC-, WHERP RFQU-,R---,2j BY A W.RTTTEN C0`-TRACT n.R AGRFEMC�N71 IS IN !NSU QED, BUT ONLY WITP RvSPECT TO LEGAL RES?ONSIBILITY FOR ACTS OR OMISSIONS OF A PERSGN OR ORGANIIZA'-P-ION FOR VMOM LIAKLITY CCVER.AGE. IS AFFORDED UNDER THIS POLICY, d Chairman WwMry G-56015-B (ED. 11/91� P 0 1-1 CY NIL4 vlj B E R CONIMERGIAL AUTO CA 04 44 110 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This e nd'o r, ifol I za�nent modifies insurance provideci under the Ilowing' AUTO DEALERS,COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM v'Jith respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the poilcy effective on the inception date of the policy unless another date is indicated below, Named Insured: PAPE DAWSON CONSULTING F14-GIN-2ERS, TNC. (SEE ENDT) Endorsement Effective Date: 02/26/20:8 SCHEDULE Name(s) Of Person(s) Or Organization(s): ANY PERSON OR ORGA:NTIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRIT72N 1=-1TR_kCT OR AGREEMENT TO OBTAIN THIS WAIVER FROX, US, YOU MUST AGREE TO TI-HAT REQUIREMENT PHiCR TO LOSS Information r ovm in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the ",accident' or the "loss" under a contract with that person or organization. CA 04 44 10 13 Copyright, Insurance Set-vices Office, Inc., 2011 Page 1 of 1 CNA72316XX CRA (Ed, 02113) NOTICE OF CANCELLATION OR MATERIAL CHANGE — DES\GNATEDPERSON OR ORGANIZATION bisunda?stood andagreed v)a this endo,oementamondmthe BUSINESS AUTO COVERAGE FO0MaafoJows: (nthe evewofounoo||ebunormaterial change that reduces uresthc',ts'he insurance Providedb this Cove-age Form, we agree\osend phornohceo/cancellation ormaterial change \othe personoo i hon scheduledbelow atthe agdreas scheduled below. This endorsemert does ncX amend our obligation to n.otify the Narned Insured of cuncaUahon as described in the Common Pol'cy Conditions or In another endorsement attached to this policy. SCHEDULE 1. Number ofdays advance notice: iDays ifwecancel for non-payment ofpremium. C — Days if the policy is cancelled for any offier reason, or if coverage is restl icted or reduced by endorsement. 2. Person orOrganization's Name and Address Narne: PER SCHEDULE ON FILE Attentiom Stree�Address City, State,ZIP7_F_ e-mail address; All other terms andconditions ofthe Policy remain unchanged CNA72315XX (02)13) Policy No, Page I of 1 Endorsement No: Effective Date: n2/25/2018 }neuredName- ?APE owmsoN cnmSnL7zmG Emozm�Eoao' zac. (sso Emor) Copyright umxAll Rights Reserved. Workers Compensation And Employers Liability Insurance CNAPolicy Endorspi-nent 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. n Specific Waiver Name of person or organization Blanket Waiver Any person or organization for whom the Named insured has agreed by written contract to furnish this waiver, 2. Operations: All Texas Operations 3. Premium: The premium charge for this endorsement shall be 2% percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: Refer to Schedule of Operations Ail other terms and conditions of the policy remain unchanged, This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date ofaid policy at the hour stated in said policy, unless another effective date (the Endorsement Effective D:tel) is shown below, and expires concurrently with said policy) unless another expiration date is shown below. Form No:WC 42 03 04 B (06.20141 Policy No:WC 5 99445090 i Endorsement Effective Date-- Endorsement Expiration Date: Policy Effective Date:0212812016, Endorsement No: 7;Page: 1 of 1 Policy Page: 38 of 42 Underwriting Company: American Casualty Company of Reading,Pennsylvania, 333 5 Wabash Ave, Chicago, IL 60604 i Copyright 2014 National Council on Compensation Insurance,Inc.All Rights Reserved. IvVorkers Compenisation And Er-iinjoyers Liability Insurance CM Policy In tnis part, `ow alalnoals' maaos inunjalz_ approved or prescribed by we Texas Dt;pc` men, of lnsC:rance. C. Remuneration Number 2 ,s arnended to read' 2. Alf ot';­ier petseris en aged in 'v.,ork 1hot ,voi�id make (is liable under Parl, O,ie CV'Vorl,?rs Con-,perI53110,1 insulanGf") of this policy, I-Ili's o9ragra.011 2 lvd! not apply if you give us proof to the errlpl�jy'efs of these oersons lawfully secued v:orkcrq compensation insurance, E. Final Premium NI_Jrnber 2 is amended to read: 2. If you cancel, final premium will be calculated pro rata based on the time this policy was in force. Final premium will not be less than the pro rata share of the minimum premium. PART SIX—CONDITIONS A. Inspection is amended by adding this sentence: Your failure to comply with the safety recornniiendaiionis made as a result of an Inspection may cause the policy to be canceled by us. C. Transfer of Your Rights and Duties is amended to read: Your rights and duties under this policy may not be transferred without our written consent. If you die, coverage will be provided for your surviving spouse or your legal representative, This applies only with respect to their acting in the capacity as an employer and only for the workplaces listed in Items I and 4 on the information Page, D. Cancelation is amended to read: 1. You may cancel this policy. You must mail or deliver advance notice to us stating when the cancelation is to take effect. 2. We may cancel this policV. We may also decline to renew it. We must give you written notice of can­eIa-,;on or nonrenewal. That notice will be sent certified mail or delivered to you in person. A copy of the \,v(itrler) notice ioiili be sen: to the Texas Department of lnsuranz:e—Division of Workers' Compensation. 3. Notce of cancelation or nonrene�,,jal niust be sent to you not later than tine 30th day be-fore the date on which the cancelation or nonrenewal becomes effective, except that we may send thf� notice not later than the 10th day bef-ire the date on which the cancelation or nonrenewal becomes effective if we cancel or do not renew because of: a. Fraud in obtaining coverage, b. Misrepresentation of the amount of payroll for purposes of premium calculation; c. Failure to pay a premium when payment was due; d, An increase In the hazard for which you seek coverage that results from an action or omission and that wouji produce an Increase in -me rate, including an increase because of failure to comply vvith reasonaMa r6corrorlendavons fcr loss cconLrol nor to comply vvithinl a reasonable parlod vvith racornnlendationls desionad to rediuce a hazard that is Under Your coI'irrc!- e. A deierm;.-na-,'on dy the Commissioner of Insurance that the contir,_iatil—i of the po!;cy livould Waco us in violat;wl of the lav'`', or 1,%,culd bn hazardouis to, the ;`iterests of -ulbscribie-s, creditors, or t-ie general Public. Form tick. WC 42 03 01 H !07-20163 Pokey ND:WC 5 99445090 Endc"Semant EffL'ct"ve Date: Endorieweni Expiration Dc;te Policy Effective Dale,02/28/2018 FMD'se'llem No. 5; Pzqe- 2 of 4 Pohvy Page. 34 of 42 Cornpany: An�eijc3n Casualty Cr,;-,pany of Readi;)g Pef­rnsvlwinia, 333 S VVemosh Ava, Chicago, IL 60604 CoIpyrig!-,, 2015 National Council on Cornparisation Insurance, Inc. Ad Rights Reserved,