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HomeMy WebLinkAboutContract 56475-R1 CSC No. 56475-Rl CITY OF FORT WORTH CONTRACT RENEWAL NOTICE August 1, 2022 Gomez Floor Covering Inc. Attn: Jeff Carter 1130 Inwood Rd Dallas, Texas 75247 Re: Contract Renewal Notice Contract No. CSC No. 56475 (the"Contract") Renewal Term No. 1: October 1, 2022 to September 30, 2023 The above referenced Contract with the City of Fort Worth expires on September 30, 2022 (the "Expiration Date"). Pursuant to the Contract, contract renewals are at the sole option of the City. This letter is to inform you that the City is exercising its right to renew the Contract for an additional one (1) year period, which will begin immediately after the Expiration Date. All other terms and conditions of the Contract remain unchanged. Please return this signed acknowledgment letter, along with a copy of your current insurance certificate, to the address set forth below, acknowledging receipt of the Contract Renewal Notice. Failure to provide a signed acknowledgment does not affect the renewal. Please log onto PeopleSoft Purchasing 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 Notice, please contact me at the telephone number listed below. Sincerely, City of Fort Worth Property Management Department Megan Fowler (817) 392-6649 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Contract Renewal Page 1 of 2 CSC No. 56475 ACCEPTED AND AGREED: CITY OF FORT `t ORTH CONTRACT COMPLIANCE MANAGER: By signing I acknm%ledge that I am the person responsible for the monitoring and Dana BU!'61�dOAC administration of this contract. including BV: Dana Burgh doff ug3,202220:16CDT) ensuring all performance and reporting Name: Dana Burghdoff requirements. Title: Assistant Cite Manager �tCa�fl. SGr�� B%': Alan H.Shuror(Aug 1,202214:27 CDT) APPROVAL RECOMMENDED: Name: Alan Shuror Title. Assistant Property Management Director Bv: Stev�(Aug 1,202215� :41CDT) APPROVED AS TO FORM AND Name: Steve Coolie LEGALITY: Title: Property Management Director ATTEST. _ Richard A.McCracken(Aug 3,202212:24 CDT) Bt: Name: Christopher Austria 79b161d�g cf Title: Assistant Cite Attorney BN-: Jannette S.Goodall(Aug4,202211:00 CDT) ,o4�nnn Name: Jannette Goodall ppF°FORr��aa CONTRACT AUTHORIZATION: 00000 Title: CON Secretary 0 o° °°�'Oa�O MK C: 1-074 0 0 0 °a��d Date Approved: September 28. 2021 dv0 g=d ° °_411 Form 1295 Certification No.: 2021-793016 00000000 .d �a�AEXASoAp Gomez Floor C'omi-in.u. Inc. Namqj —we Title: Branch Manager Date: 0810112022 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Contract Renemal -� Page 2 of 2 M&C Review Page 1 of 2 Official site of the City of Fort Worth,Texas CITY COUNCIL AGENDA FoRTrll REFERENCE **M&C 21- 13P ITB 21-0060 CARPET DATE: 9/28/2021 NO.: 0744 LOG NAME: AND FLOORING REPAIR AND REPLACE ADK 01 CODE: P TYPE: CONSENT PUBLIC NO HEARING: SUBJECT: (ALL)Authorize an Agreement for the Purchase of Carpet and Flooring Repair and Replacement with Gomez Floor Covering Inc. and DMCA Inc. in a First Year Amount Up to $4,100,000.00 and Authorize Four One-Year Renewals with a Five Percent Annual Increase for Multiple City Departments RECOMMENDATION: It is recommended that the City Council authorize an agreement for carpet and flooring repair and replacement with Gomez Floor Covering Inc. and DMCA Inc. in a first year amount up to $4,100,000.00 and authorize four one-year renewals with a five percent annual increase for multiple city departments. DISCUSSION: The Aviation, Code Compliance, Library, Neighborhood Services, Park& Recreation, Public Events, Property Management and the Water Departments approached the Purchasing Division with the intent to establish a contract for carpet and flooring repair and replacement. The Purchasing Division reviewed the request and subsequently issued an Invitation to Bid (ITB) for these services. ITB 21-0066 consisted of detailed specifications and was advertised in the Fort Worth Star-Telegram each Wednesday beginning on May 19, 2021 through June 16, 2021. A pre-bid conference was held on June 15, 2021 which provided an opportunity for interested bidders to learn more about the City of Fort Worth's requirements and to seek clarification on the ITB requirements. A total of 14 vendors were solicited and responses were received from three (3) potential vendors. All bids were evaluated by a three (3) person team consisting of representatives from Property Management, Business Equity and Parks and Recreation. Each bid was evaluated based on the number of products the vendor is authorized to sell in each category, positive references from entities of similar size, and documentation on how Business Equity Firm(s) services will be utilized to meet the 18\% goal. Based on the qualifications, the City recommends awarding the agreement to Gomez Floor Covering, Inc., and DMCA, Inc. BUSINESS EQUITY: Gomez Floor Covering, Inc. is in compliance with the City's Business Equity Ordinance by commiting to 60\% Business Equity participation on this project. The City's Business Equity goal on this project is 18\%. Additionally, Gomez Floor Covering, Inc. is a certified MBE firm. DMCA, Inc. is in compliance with the City's Business Equity Ordinance by committing to 100\% Business Equity participation on this project. The City's Business Equity goal on this project is 18\%. Additionally, DMCA, Inc. is a certified MBE firm. ADMINISTRATIVE CHANGE ORDER: An administrative change order or increase may be made by the City Manager up to the amount allowed by relevant law and the Fort Worth City Code and does not require specific City Council approval as long as sufficient funds have been appropriated. AGREEMENT TERMS: Upon City Council's approval, this agreement shall begin upon execution and expire one year from that date. RENEWAL TERMS: This agreement may be renewed for four additional one-year terms to include a five percent annual increase to the total amount. This action does not require specific City Council approval provided that the City Council has appropriated sufficient funds to satisfy the City's obligations during the renewal term. FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that funds are available in the current operating budget, as previously http://apps.cfwnet.org/council_packet/mc_review.asp?ID=29292&councildate=9/28/2021 9/29/2021 M&C Review Page 2 of 2 appropriated, in the participating departments' Operating Funds to support the approval of the above recommendation and authorization of an agreement. Prior to any expenditure being incurred, the participating departments have the responsibility to validate the availability of funds. BQN\\ TO Fund Department Account Project Program Activity Budget Reference# Amount ID ID Year Charffield 2 FROM Fund Department Account Project Program Activity Budget Reference# Amount ID ID Year (Chartfield 2) Submitted for City Manager's Office by: Jay Chapa (5804) Dana Burgdoff(8018) Originating Department Head: Reginald Zeno (8517) Steve Cook(5134) Additional Information Contact: Cynthia Garcia (8525) Ashley Kadva (2047) ATTACHMENTS http://apps.cfwnet.org/council_packet/mc_review.asp?ID=29292&councildate=9/28/2021 9/29/2021 CERTIFICATE OF INTERESTED PARTIES Foam 1295 7 of 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. 2021-793016 Gomez Floor Covering, Inc. Dallas,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 08/1912021 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. 21-0060 Carpet and Flooring Repair and Replace Nature of interest 4 Name of interested Party City,State,Country(place of business) (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION My name is Jeff Carter and my date of birth is 07/22/1961 My address is 7560 Havenridge Lane Kaufman TX 75142 US (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Dallas County, State of TX on the 19tl ay of Aug USt 2021 (month) (year) i lure of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www,ethics.state.tx.us Version V1.1.191b5cdc DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 7/26/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Michele Esqulvel Walthall, Sachse, & Pipes, Inc. PHONE FAX 300 E Sonterra Blvd,#1100 A/C No EXt: 210-477-4281 A/C,No: E-MSan Antonio TX 78258 ADDRESS: michelee@wspinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Travelers Casualty and Surety Company of America 31194 INSURED GOMEZ-5 INSURER B:The Charter Oak Fire Insurance Company 25615 Gomez Floor Covering Inc. dba GFC Contracting INsuRERc: Federal Insurance Company 20281 3816 Binz-Engleman Suite B-125 INSURERD: Starstone Specialty 44776 San Antonio TX 78219 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:408188830 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD MM/DD B X COMMERCIAL GENERAL LIABILITY C09M679640 12/31/2021 12/31/2022 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR PREMISES DAMAGE TO PREMISES Ea occurrence $300,000 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 PRO- JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY BA9M627065 12/31/2021 12/31/2022 COEaMBINED accident SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED FIR ER DAMAGE $ AUTOS ONLY AUTOS ONLY Pera . r accident B X UMBRELLA LIAB X OCCUR CUP9M684477 TCT 12/31/2021 12/31/2022 EACH OCCURRENCE $10,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE $10,000,000 DED RETENTION$ $ A WORKERS COMPENSATION UB9M678330ACR 12/31/2021 12/31/2022 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE FN] N I E.L.EACH ACCIDENT $1,000,000 OFFICE R/M EMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Crime&Fidelity 82581408 3/28/2022 3/28/2023 Emp Theft 2,000,000 D M84577220AEM 4/13/2022 4/13/2023 Contractors Pollution 1,000,000 Deductible Pollution 5,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) The general liability,workers compensation and commercial auto policies include additional insured(except WC),waiver of subrogation and primary and non-contributory&30 Day NOC endorsements that provide such status when required by signed,written contract between the certificate holder and the named insured. Umbrella liability follows form. Contract No.56475 Renewal Term No. 1 October 1,2022 to September 30,2023 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Worth ACCORDANCE WITH THE POLICY PROVISIONS. 900 Monroe Street Suite 402 AUTHORIZED REPRESENTATIVE Fort Worth TX 76102 United States r @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD COMMERCIAL AUTO POLICY NUMBER: BA-9M627065 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SHORT TERM HIRED AUTO - ADDITIONAL INSURED AND LOSS PAYEE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM SCHEDULE Additional Insured (Lessor): Any lessor of a "leased auto" under a leasing or rental agreement of less than 6 months. Designation Or Description Of"Leased Autos": Any "leased auto" under a leasing or rental agreement of less than 6 months. A. Coverage operating a "leased auto" with the 1. Any "leased auto" designated or described in permission of any of the above. the Schedule will be considered a covered 3. Coverage for any "leased auto" described in "auto" you own and not a covered "auto" you the Schedule applies until the end of the hire or borrow for Covered Autos Liability policy period shown in the Declarations or Coverage. when the lessor or his or her agent takes 2. For a "leased auto" designated or described possession of the "leased auto", whichever in the Schedule, the Who Is An Insured occurs first. provision under Covered Autos Liability B. Loss Payable Clause Coverage is changed to include as an 1. We will pay, as interest may appear, you and "insured" the lessor of such "leased auto". the lessor, if your policy includes Hired Auto However, the lessor is an "insured" only for Physical Damage Coverage, for "loss" to a "bodily injury" or "property damage" resulting "leased auto". from the acts or omissions by: 2. The insurance covers the interest of the a. You; lessor unless the "loss" results from b. Any of your"employees" or agents; or fraudulent acts or omissions on your part. 3. If we make any payment to the lessor, we will c. Any person, except the lessor or any obtain his or her rights against any other "employee" or agent of the lessor, party. CA T4 52 02 16 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc.with its permission. C. The lessor is not liable for payment of your "Leased auto" means an "auto" leased or rented premiums. to you, including any substitute, replacement or extra "auto" needed to meet seasonal or other D. Additional Definition needs, under a leasing or rental agreement that As used in this endorsement: requires you to provide direct primary insurance for the lessor. Page 2 of 2 ©2015 The Travelers Indemnity Company.All rights reserved. CA T4 52 02 16 Includes copyrighted material of Insurance Services Office, Inc.with its permission. Policy Number: BA-9M627065 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY WITH OTHER INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM PROVISIONS 2. The following is added to Paragraph B.5., Other 1. The following is added to Paragraph A.1.c., Who Insurance of SECTION IV — BUSINESS AUTO Is An Insured, of SECTION II — COVERED CONDITIONS: AUTOS LIABILITY COVERAGE: Regardless of the provisions of paragraph a. and This includes any person or organization who you paragraph d. of this part S. Other Insurance, this are required under a written contract or insurance is primary to and non-contributory with agreement between you and that person or applicable other insurance under which an organization, that is signed by you before the additional insured person or organization is the "bodily injury" or "property damage" occurs and first named insured when the written contract or that is in effect during the policy period, to name agreement between you and that person or as an additional insured for Covered Autos organization, that is signed by you before the Liability Coverage, but only for damages to which "bodily injury" or "property damage" occurs and this insurance applies and only to the extent of that is in effect during the policy period, requires that person's or organization's liability for the this insurance to be primary and non-contributory. conduct of another"insured". CA T4 74 02 16 ©2016 The Travelers Indemnity Company.All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.with its permission. Policy Number: BA-9M627065 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE —This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF B. BLANKET ADDITIONAL INSURED USE—INCREASED LIMIT C. EMPLOYEE HIRED AUTO I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES—INCREASED LIMIT D. EMPLOYEES AS INSURED J. PERSONAL PROPERTY E. SUPPLEMENTARY PAYMENTS — INCREASED K. AIRBAGS LIMITS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR F. HIRED AUTO — LIMITED WORLDWIDE COV- LOSS ERAGE—INDEMNITY BASIS M. BLANKET WAIVER OF SUBROGATION G. WAIVER OF DEDUCTIBLE—GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED this insurance applies and only to the extent that The following is added to Paragraph A.1., Who Is person or organization qualifies as an "insured" An Insured, of SECTION II —COVERED AUTOS under the Who Is An Insured provision contained in Section II. LIABILITY COVERAGE: Any organization you newly acquire or form dur- C. EMPLOYEE HIRED AUTO ing the policy period over which you maintain 1. The following is added to Paragraph A.1., 50% or more ownership interest and that is not Who Is An Insured, of SECTION II — COV- separately insured for Business Auto Coverage. ERED AUTOS LIABILITY COVERAGE: Coverage under this provision is afforded only un- An "employee" of yours is an "insured" while til the 180th day after you acquire or form the or- operating an "auto" hired or rented under a ganization or the end of the policy period, which- contract or agreement in an "employee's" ever is earlier. name, with your permission, while performing duties related to the conduct of your busi- B. BLANKET ADDITIONAL INSURED ness. The following is added to Paragraph c. in A.1., 2. The following replaces Paragraph b. in B.S., Who Is An Insured, of SECTION II — COVERED Other Insurance, of SECTION IV — BUSI- AUTOS LIABILITY COVERAGE: NESS AUTO CONDITIONS: Any person or organization who is required under b. For Hired Auto Physical Damage Cover- a written contract or agreement between you and age, the following are deemed to be cov- that person or organization, that is signed and ered "autos"you own: executed by you before the "bodily injury" or (1) Any covered "auto" you lease, hire, "property damage" occurs and that is in effect rent or borrow; and during the policy period, to be named as an addi- (2) Any covered "auto" hired or rented by tional insured is an "insured" for Covered Autos your "employee" under a contract in Liability Coverage, but only for damages to which an "employee's" name, with your CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO permission, while performing duties (a) With respect to any claim made or "suit" related to the conduct of your busi- brought outside the United States of ness. America, the territories and possessions However, any "auto" that is leased, hired, of the United States of America, Puerto rented or borrowed with a driver is not a Rico and Canada: covered "auto". (i) You must arrange to defend the "in- D. EMPLOYEES AS INSURED sured" against, and investigate or set- The following is added to Paragraph A.1., Who Is tle any such claim or "suit" and keep us advised of all proceedings and ac- An Insured, of SECTION II — COVERED AUTOS tions. LIABILITY COVERAGE: Any employee of yours is an Insured while us- (ii) Neither you nor any other involved ing a covered "auto" you don't own, hire or borrow "insured" will make any settlement in your business or your personal affairs. without our consent. E. SUPPLEMENTARY PAYMENTS — INCREASED (iii)We may, at our discretion, participate LIMITS in defending the "insured" against, or in the settlement of, any claim or 1. The following replaces Paragraph A.2.a.(2), "suit". of SECTION II — COVERED AUTOS LIABIL- ITY COVERAGE: (iv) We will reimburse the "insured" for sums that the "insured" legally must (2) Up to $3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in- we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para- 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION II — COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE. (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work. tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE—INDEMNITY BASIS within the limit described in Para- The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to make such payments ends when we (5) Anywhere in the world, except any country or have used up the applicable limit of jurisdiction while any trade sanction, em- insurance in payments for damages, bargo, or similar regulation imposed by the settlements or defense expenses. United States of America applies to and pro- hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis. without a driver for a period of 30 days or less you lease, hire, rent (c) This insurance is not a substitute for re- and that is not an "auto" Y quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter- partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada. members of their households. Page 2 of 4 ©2015 The Travelers Indemnity Company.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO You agree to maintain all required or (2) In or on your covered "auto". compulsory insurance in any such coun- This coverage applies only in the event of a total try up to the minimum limits required by theft of your covered "auto". local law. Your failure to comply with compulsory insurance requirements will No deductibles apply to this Personal Property not invalidate the coverage afforded by coverage. this policy, but we will only be liable to the K. AIRBAGS same extent we would have been liable The following is added to Paragraph B.3., Exclu- had you complied with the compulsory in- sions, of SECTION III — PHYSICAL DAMAGE surance requirements. COVERAGE: (d) It is understood that we are not an admit- Exclusion 3.a. does not apply to "loss" to one or ted or authorized insurer outside the more airbags in a covered "auto" you own that in- United States of America, its territories flate due to a cause other than a cause of "loss" and possessions, Puerto Rico and Can- set forth in Paragraphs A.1.b. and A.1.c., but ada. We assume no responsibility for the only: furnishing of certificates of insurance, or a. If that "auto" is a covered "auto" for Compre- for compliance in any way with the laws hensive Coverage under this policy; of other countries relating to insurance. b. The airbags are not covered under any war- G. WAIVER OF DEDUCTIBLE—GLASS ranty; and The following is added to Paragraph D., Deducti- c. The airbags were not intentionally inflated. ble, of SECTION III — PHYSICAL DAMAGE We will pay up to a maximum of $1,000 for any COVERAGE: one "loss". No deductible for a covered "auto" will apply to L. NOTICE AND KNOWLEDGE OF ACCIDENT OR glass damage if the glass is repaired rather than LOSS replaced. The following is added to Paragraph A.2.a., of H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF SECTION IV—BUSINESS AUTO CONDITIONS: USE—INCREASED LIMIT Your duty to give us or our authorized representa- The following replaces the last sentence of Para- tive prompt notice of the "accident" or "loss" ap- graph A.4.b., Loss Of Use Expenses, of SEC- plies only when the "accident" or "loss" is known TION III —PHYSICAL DAMAGE COVERAGE: to: However, the most we will pay for any expenses (a) You (if you are an individual); for loss of use is $65 per day, to a maximum of $750 for any one "accident". (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- I. PHYSICAL DAMAGE — TRANSPORTATION pany); EXPENSES—INCREASED LIMIT (d) An executive officer, director or insurance The following replaces the first sentence in Para- manager (if you are a corporation or other or- graph A.4.a., Transportation Expenses, of ganization); or SECTION III — PHYSICAL DAMAGE COVER- (e) Any "employee" authorized by you to give no- AGE: tice of the "accident" or"loss". We will pay up to $50 per day to a maximum of M. BLANKET WAIVER OF SUBROGATION $1,500 for temporary transportation expense in- The following replaces Paragraph A.S., Transfer curred by you because of the total theft of a cov- Of Rights Of Recovery Against Others To Us, ered "auto" of the private passenger type. of SECTION IV — BUSINESS AUTO CONDI- J. PERSONAL PROPERTY TIONS : The following is added to Paragraph AA., Cover- 5. Transfer Of Rights Of Recovery Against age Extensions, of SECTION III — PHYSICAL Others To Us DAMAGE COVERAGE: We waive any right of recovery we may have Personal Property against any person or organization to the ex- tent required of you by a written contract We will pay up to $400 for "loss" to wearing ap- signed and executed prior to any "accident" parel and other personal property which is: or "loss", provided that the "accident" or "loss" (1) Owned by an "insured"; and arises out of operations contemplated by CA T3 53 02 15 ©2015 The Travelers Indemnity Company.All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc.with its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance. How- N. UNINTENTIONAL ERRORS OR OMISSIONS ever this provision does not affect our right to col- The following is added to Paragraph B.2., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non-renewal. SECTION IV—BUSINESS AUTO CONDITIONS: Page 4 of 4 ©2015 The Travelers Indemnity Compa ny.All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc.with its permission. POLICY NUMBER:BA-9M627065 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice of Cancellation: 30 PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZ- ATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. PROVISIONS: If we cancel this policy for any statutorily permitted above. We will mail such notice to the address shown reason other than nonpayment of premium, and a in the schedule above at least the number of days number of days is shown for cancellation in the shown for cancellation in the schedule above before schedule above, we will mail notice of cancellation to the effective date of cancellation. the person or organization shown in the schedule IL T4 05 03 11 ©2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 POLICY NUMBER: DT-CO-9M679640-COF COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - AUTOMATIC STATUS IF REQUIRED BY WRITTEN CONTRACT (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. The following is added to SECTION II —WHO IS (a) The Additional Insured — Owners, AN INSURED: Lessees or Contractors — Scheduled Any person or organization that: Person or Organization endorsement CG 20 10 07 04 or CG 20 10 04 13, a. You agree in a "written contract requiring in- the Additional Insured — Owners, surance" to include as an additional insured Lessees or Contractors — Completed on this Coverage Part; and Operations endorsement CG 20 37 b. Has not been added as an additional insured 07 04 or CG 20 37 04 13, or both of for the same project by attachment of an en- such endorsements with either of dorsement under this Coverage Part which those edition dates; or includes such person or organization in the (b) Either or both of the following: the endorsement's schedule; Additional Insured — Owners, Les- is an insured, but: sees or Contractors — Scheduled a. Only with respect to liability for "bodily injury", Person Or Organization endorsement "property damage" or"personal injury"; and CG 20 10, or the Additional Insured — Owners, Lessees or Contractors — b. Only as described in Paragraph (1), (2) or(3) Completed Operations endorsement below, whichever applies: CG 20 37, without an edition date of (1) If the "written contract requiring insur- such endorsement specified; ance" specifically requires you to provide the person or organization is an additional additional insured coverage to that per- insured only if the injury or damage is son or organization by the use of: caused, in whole or in part, by acts or (a) The Additional Insured — Owners, omissions of you or your subcontractor in Lessees or Contractors — (Form B) the performance of "your work" to which endorsement CG 20 10 11 85; or the "written contract requiring insurance" (b) Either or both of the following: the applies; or Additional Insured — Owners, Les- (3) If neither Paragraph (1) nor(2) above ap- sees or Contractors — Scheduled plies: Person Or Organization endorsement (a) The person or organization is an ad- CG 20 10 10 01, or the Additional In- ditional insured only if, and to the ex- sured—Owners, Lessees or Contrac- tent that, the injury or damage is tors — Completed Operations en- caused by acts or omissions of you or dorsement CG 20 37 10 01; your subcontractor in the perform- the person or organization is an additional ance of"your work"to which the "writ- insured only if the injury or damage arises ten contract requiring insurance" sp- out of "your work" to which the "written plies; and contract requiring insurance" applies; (b) The person or organization does not (2) If the "written contract requiring insur- qualify as an additional insured with ance" specifically requires you to provide respect to the independent acts or additional insured coverage to that per- omissions of such person or organi- son or organization by the use of: zation. CG D6 04 08 13 ©2013 The Travelers Indemnity company.All rights reserved. Page 1 of 3 COMMERCIAL GENERAL LIABILITY 2. The insurance provided to the additional insured and collectible other insurance, whether primary, by this endorsement is limited as follows: excess, contingent or on any other basis, that is a. If the Limits of Insurance of this Coverage available to the additional insured when that per- Part shown in the Declarations exceed the son or organization is an additional insured, or is minimum limits of liability required by the any other insured that does not qualify as a "written contract requiring insurance", the in- named insured, under such other insurance. surance provided to the additional insured will 4. As a condition of coverage provided to the addi- be limited to such minimum required limits of tional insured by this endorsement: liability. For the purposes of determining a. The additional insured must give us written whether this limitation applies, the minimum notice as soon as practicable of an "occur- limits of liability required by the "written con- rence" or an offense which may result in a tract requiring insurance" will be considered claim. To the extent possible, such notice to include the minimum limits of liability of any should include: Umbrella or Excess liability coverage required for the additional insured by that "written con- (1) How, when and where the 'occurrence" tract requiring insurance". This endorsement or offense took place; will not increase the limits of insurance de- (2) The names and addresses of any injured scribed in Section III—Limits Of Insurance. persons and witnesses; and b. The insurance provided to the additional in- (3) The nature and location of any injury or sured does not apply to "bodily injury", "prop- damage arising out of the 'occurrence" or erty damage" or "personal injury" arising out offense. of the rendering of, or failure to render, any b. If a claim is made or "suit' is brought against professional architectural, engineering or sur- veying the additional insured, the additional insured services, including: must: (1) The preparing, approving, or failing to (1) Immediately record the specifics of the prepare or approve, maps, shop draw- claim or"suit' and the date received; and ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, (2) Notify us as soon as practicable. approving, or failing to prepare or ap- The additional insured must see to it that we prove, drawings and specifications; and receive written notice of the claim or"suit' as (2) Supervisory, inspection, architectural or soon as practicable. engineering activities. c. The additional insured must immediately send c. The insurance provided to the additional in- us copies of all legal papers received in con- sured does not apply to "bodily injury" or nection with the claim or"suit', cooperate with "property damage" caused by"your work" and us in the investigation or settlement of the included in the "products-completed opera- claim or defense against the "suit', and oth- tions hazard" unless the "written contract re- erwise comply with all policy conditions. quiring insurance" specifically requires you to d. The additional insured must tender the de- provide such coverage for that additional in- fense and indemnity of any claim or "suit' to sured during the policy period. any provider of other insurance which would 3. The insurance provided to the additional insured cover the additional insured for a loss we by this endorsement is excess over any valid and cover under this endorsement. However, this collectible other insurance, whether primary, ex- condition does not affect whether the insur- cess, contingent or on any other basis, that is ance provided to the additional insured by this available to the additional insured. However, if the endorsement is primary to other insurance "written contract requiring insurance" specifically available to the additional insured which cov- requires that this insurance apply on a primary ers that person or organization as a named basis or a primary and non-contributory basis, this insured as described in Paragraph 3. above. insurance is primary to other insurance available 5. The following is added to the DEFINITIONS Sec- to the additional insured under which that person or organization qualifies as a named insured, and tion: we will not share with that other insurance. But "Written contract requiring insurance" means that the insurance provided to the additional insured part of any written contract or agreement under by this endorsement still is excess over any valid which you are required to include a person or or- Page 2 of 3 ©2013 The Travelers Indemnity company.All rights reserved. CG D6 04 08 13 COMMERCIAL GENERAL LIABILITY ganization as an additional insured on this Cover- a. After the signing and execution of the contract age Part, provided that the "bodily injury" and or agreement by you; and "property damage" occurs, and the "personal in- b. While that part of the contract or agreement is jury" is caused by an offense committed, during in effect. the policy period and: CG D6 04 08 13 ©2013 The Travelers Indemnity company.All rights reserved. Page 3 of 3 POLICY NUMBER: DT-CO-9M679640-COF COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART GENERAL DESCRIPTION OF COVERAGE—This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. Aircraft Chartered With Pilot H. Blanket Additional Insured — Lessors Of Leased B. Damage To Premises Rented To You Equipment C. Increased Supplementary Payments I. Blanket Additional Insured — States Or Political Subdivisions—Permits D. Incidental Medical Malpractice J. Knowledge And Notice Of Occurrence Or Offense E. Who Is An Insured — Newly Acquired Or Formed Organizations K. Unintentional Omission F. Who Is An Insured — Broadened Named Insured L. Blanket Waiver Of Subrogation —Unnamed Subsidiaries M. Amended Bodily Injury Definition G. Blanket Additional Insured — Owners, Managers N. Contractual Liability—Railroads Or Lessors Of Premises PROVISIONS INJURY AND PROPERTY DAMAGE LI- A. AIRCRAFT CHARTERED WITH PILOT ABILITY: The following is added to Exclusion g., Aircraft, Exclusions c. and g. through n. do not apply Auto Or Watercraft, in Paragraph 2. of SECTION to "premises damage". Exclusion f.(1)(a) — COVERAGES — COVERAGE A BODILY IN- does not apply to "premises damage" caused JURY AND PROPERTY DAMAGE LIABILITY: by: This exclusion does not apply to an aircraft that a. Fire; is: b. Explosion; (a) Chartered with a pilot to any insured; c. Lightning; (b) Not owned by any insured; and d. Smoke resulting from such fire, explosion, (c) Not being used to carry any person or prop- or lightning; or erty for a charge. e. Water; B. DAMAGE TO PREMISES RENTED TO YOU unless Exclusion f. of Section I—Coverage A 1. The first paragraph of the exceptions in Ex- — Bodily Injury And Property Damage Liability clusion j., Damage To Property, in Para- is replaced by another endorsement to this graph 2. of SECTION I — COVERAGES — Coverage Part that has Exclusion —All Pollu- COVERAGE A BODILY INJURY AND tion Injury Or Damage or Total Pollution Ex- PROPERTY DAMAGE LIABILITY is deleted. clusion in its title. 2. The following replaces the last paragraph of A separate limit of insurance applies to Paragraph 2., Exclusions, of SECTION I — "premises damage" as described in Para- COVERAGES — COVERAGE A. BODILY graph 6. of SECTION III — LIMITS OF IN- SURANCE. CG D3 16 11 11 ©2011 The Travelers Indemnity company.All rights reserved. Page 'I of 6 COMMERCIAL GENERAL LIABILITY 3. The following replaces Paragraph 6. of SEC- C. INCREASED SUPPLEMENTARY PAYMENTS TION III—LIMITS OF INSURANCE: 1. The following replaces Paragraph 1.b. of Subject to 5. above, the Damage To Prem- SUPPLEMENTARY PAYMENTS — COVER- ises Rented To You Limit is the most we will AGES A AND B of SECTION I — COVER- pay under Coverage A for damages because AGE: of "premises damage" to any one premises. b. Up to $2,500 for the cost of bail bonds The Damage To Premises Rented To You required because of accidents or traffic Limit will apply to all "property damage" law violations arising out of the use of any proximately caused by the same "occur- vehicle to which the Bodily Injury Liability rence", whether such damage results from: Coverage applies. We do not have to fur- fire; explosion; lightning; smoke resulting from nish these bonds. such fire, explosion, or lightning; or water; or any combination of any of these causes. 2. The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS — COVER- The Damage To Premises Rented To You AGES A AND B of SECTION I — COVER- Limit will be: AGES: a. The amount shown for the Damage To d. All reasonable expenses incurred by the Premises Rented To You Limit on the insured at our request to assist us in the Declarations of this Coverage Part; or investigation or defense of the claim or b. $300,000 if no amount is shown for the "suit", including actual loss of earnings up Damage To Premises Rented To You to $500 a day because of time off from Limit on the Declarations of this Coverage work. Part. D. INCIDENTAL MEDICAL MALPRACTICE 4. The following replaces Paragraph a. of the 1. The following is added to the definition of"oc- definition of "insured contract" in the DEFINI- currence" in the DEFINITIONS Section: TIONS Section: "Occurrence" also means an act or omission a. A contract for a lease of premises. How- committed in providing or failing to provide ever, that portion of the contract for a "incidental medical services", first aid or lease of premises that indemnifies any "Good Samaritan services"to a person. person or organization for "premises 2. The following is added to Paragraph 2.a.(1) of damage" is not an "insured contract"; SECTION II—WHO IS AN INSURED: 5. The following is added to the DEFINITIONS Section: Paragraph (1)(d) above does not apply to "bodily injury" arising out of providing or fail- "Premises damage" means "property dam- ing to provide: age"to: (i) "Incidental medical services" by any of a. Any premises while rented to you or tem- your "employees" who is a nurse practi- porarily occupied by you with permission tioner, registered nurse, licensed practical of the owner; or nurse, nurse assistant, emergency medi- b. The contents of any premises while such cal technician or paramedic; or premises is rented to you, if you rent such (ii) First aid or"Good Samaritan services" by premises for a period of seven or fewer consecutive days. any of your "employees" or "volunteer workers", other than an employed or vol- 6. The following replaces Paragraph 4.b.(1)(b) of SECTION IV— COMMERCIAL GENERAL unteer doctor. Any such "employees" or LIABILITY CONDITIONS: "volunteer workers" providing or failing to provide first aid or "Good Samaritan ser- (b) That is insurance for "premises damage"; vices" during their work hours for you will or be deemed to be acting within the scope 7. Paragraph 4.b.(1)(c) of SECTION IV — of their employment by you or performing COMMERCIAL GENERAL LIABILITY CON- duties related to the conduct of your busi- DITIONS is deleted. ness. Page 2 of 6 ©2011 The Travelers Indemnity company.All rights reserved. CG D3 16 11 11 COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 5. of 4. Any organization you newly acquire or form, SECTION III—LIMITS OF INSURANCE: other than a partnership, joint venture or lim- For the purposes of determining the applica- ited liability company, of which you are the ble Each Occurrence Limit, all related acts or sole owner or in which you maintain the ma- omissions committed in providing or failing to jority ownership interest, will qualify as a provide "incidental medical services", first aid Named Insured if there is no other insurance or"Good Samaritan services" to any one per- which provides similar coverage to that Or- son will be deemed to be one"occurrence". ganization. However: 4. The following exclusion is added to Para- a. Coverage under this provision is afforded graph 2., Exclusions, of SECTION I — COV- only: ERAGES —COVERAGE A BODILY INJURY (1) Until the 180th day after you acquire or AND PROPERTY DAMAGE LIABILITY: form the organization or the end of the Sale Of Pharmaceuticals policy period, whichever is earlier, if you "Bodily injury" or "property damage" arising do not report such organization in writing out of the willful violation of a penal statute or to us within 180 days after you acquire or ordinance relating to the sale of pharmaceuti- form it; or cals committed by, or with the knowledge or (2) Until the end of the policy period, when consent of, the insured. that date is later than 180 days after you 5. The following is added to the DEFINITIONS acquire or form such organization, if you Section: report such organization in writing to us "Incidental medical services" means: within 180 days after you acquire or form a. Medical, surgical, dental, laboratory, x-ray it, and we agree in writing that it will con- or nursing service or treatment, advice or tinue to be a Named Insured until the end instruction, or the related furnishing of of the policy period; food or beverages; or b. Coverage A does not apply to "bodily injury" b. The furnishing or dispensing of drugs or or "property damage" that occurred before medical, dental, or surgical supplies or you acquired or formed the organization; and appliances. c. Coverage B does not apply to "personal in- "Good Samaritan services" means any emer- jury" or "advertising injury" arising out of an gency medical services for which no compen- offense committed before you acquired or sation is demanded or received. formed the organization. 6. The following is added to Paragraph 4.b., Ex- F. WHO IS AN INSURED — BROADENED NAMED cess Insurance, of SECTION IV — COM- INSURED—UNNAMED SUBSIDIARIES MERCIAL GENERAL LIABILITY CONDI- TIONS: The following is added to SECTION II —WHO IS AN INSURED: The insurance is excess over any valid and collectible other insurance available to the in- Any of your subsidiaries, other than a partnership, sured, whether primary, excess, contingent or joint venture or limited liability company, that is on any other basis, that is available to any of not shown as a Named Insured in the Declara- your "employees" or "volunteer workers" for tions is a Named Insured if you maintain an own- "bodily injury" that arises out of providing or ership interest of more than 50% in such subsidi- failing to provide "incidental medical ser- ary on the first day of the policy period. vices", first aid or "Good Samaritan services" No such subsidiary is an insured for"bodily injury" to any person to the extent not subject to or "property damage" that occurred, or "personal Paragraph 2.a.(1) of Section II — Who Is An injury" or "advertising injury" caused by an of- Insured. fense committed after the date, if any, during the E. WHO IS AN INSURED — NEWLY ACQUIRED policy period, that you no longer maintain an OR FORMED ORGANIZATIONS ownership interest of more than 50% in such sub- The following replaces Paragraph 4. of SECTION sidiary. II—WHO IS AN INSURED: CG D3 16 11 11 ©2011 The Travelers Indemnity company.All rights reserved. Page 3 of 6 COMMERCIAL GENERAL LIABILITY G. BLANKET ADDITIONAL INSURED — OWNERS, H. BLANKET ADDITIONAL INSURED — LESSORS MANAGERS OR LESSORS OF PREMISES OF LEASED EQUIPMENT The following is added to SECTION II —WHO IS The following is added to SECTION II —WHO IS AN INSURED: AN INSURED: Any person or organization that is a premises Any person or organization that is an equipment owner, manager or lessor and that you have lessor and that you have agreed in a written con- agreed in a written contract or agreement to in- tract or agreement to include as an insured on clude as an additional insured on this Coverage this Coverage Part is an insured, but only with re- Part is an insured, but only with respect to liability spect to liability for "bodily injury", "property dam- for "bodily injury", "property damage", "personal age", "personal injury"or"advertising injury"that: injury"or"advertising injury"that: a. Is "bodily injury" or 'property damage" that a. Is "bodily injury" or "property damage" that occurs, or is "personal injury" or "advertising occurs, or is "personal injury" or 'advertising injury" caused by an offense that is commit- injury" caused by an offense that is commit- ted, subsequent to the execution of that con- ted, subsequent to the execution of that con- tract or agreement; and tract or agreement; and b. Arises out of the ownership, maintenance or b. Is caused, in whole or in part, by your acts or use of that part of any premises leased to omissions in the maintenance, operation or you. use of equipment leased to you by such equipment lessor. The insurance provided to such premises owner, The insurance provided to such equipment lessor manager or lessor is subject to the following pro- is subject to the following provisions: visions: a. The limits of insurance provided to such a. The limits of insurance provided to such equipment lessor will be the minimum limits premises owner, manager or lessor will be which you agreed to provide in the written contract or agreement, or the limits shown on the minimum limits which you agreed to pro- vide in the written contract or agreement, or the Declarations, whichever are less. the limits shown on the Declarations, which- ever are less. b. The insurance provided to such equipment lessor does not apply to any "bodily injury" or b. The insurance provided to such premises "property damage" that occurs, or "personal owner, manager or lessor does not apply to: injury"or"advertising injury" caused by an of- (1) Any "bodily injury" or "property damage" fense that is committed, after the equipment that occurs, or"personal injury" or"adver- lease expires. tising injury" caused by an offense that is c. The insurance provided to such equipment committed, after you cease to be a tenant lessor is excess over any valid and collectible in that premises; or other insurance available to such equipment (2) Structural alterations, new construction or lessor, whether primary, excess, contingent demolition operations performed by or on or on any other basis, unless you have behalf of such premises owner, lessor or agreed in the written contract or agreement manager. that this insurance must be primary to, or c. The insurance provided to such premises non-contributory with, such other insurance, owner, manager or lessor is excess over any in which case this insurance will be primary valid and collectible other insurance available to, and non-contributory with, such other in- to such premises owner, manager or lessor, surance. whether primary, excess, contingent or on I. BLANKET ADDITIONAL INSURED — STATES any other basis, unless you have agreed in OR POLITICAL SUBDIVISIONS—PERMITS the written contract or agreement that this in- The following is added to SECTION II —WHO IS surance must be primary to, or non- AN INSURED: contributory with, such other insurance, in which case this insurance will be primary to, Any state or political subdivision that has issued a and non-contributory with, such other insur- permit in connection with operations performed by ance. you or on your behalf and that you are required Page 4 of 6 ©2011 The Travelers Indemnity company.All rights reserved. CG D3 16 11 11 COMMERCIAL GENERAL LIABILITY by any ordinance, law or building code to include (ii) A manager of any limited liability as an additional insured on this Coverage Part is company; or an insured, but only with respect to liability for (iii)An executive officer or director of "bodily injury", "property damage", "personal in- any other organization; jury" or"advertising injury" arising out of such op- erations. that is your partner, joint venture member or manager; or The insurance provided to such state or political (b) Any "employee" authorized by such subdivision does not apply to: partnershi p,p, joint venture, limited li- a. Any "bodily injury," "property damage," "per- ability company or other organization sonal injury" or"advertising injury" arising out to give notice of an "occurrence" or of operations performed for that state or po- offense. litical subdivision; or (3) Notice to us of such "occurrence" or of an b. Any "bodily injury" or "property damage" in- offense will be deemed to be given as cluded in the "products-completed operations soon as practicable if it is given in good hazard". faith as soon as practicable to your work- J. KNOWLEDGE AND NOTICE OF OCCUR- ers' compensation insurer. This applies RENCE OR OFFENSE only if you subsequently give notice to us The following is added to Paragraph 2., Duties In of the "occurrence" or offense as soon as The Event of Occurrence, Offense, Claim or practicable after any of the persons de- Suit, of SECTION IV — COMMERCIAL GEN- scribed in Paragraphs e. (1) or (2) above ERAL LIABILITY CONDITIONS: discovers that the"occurrence" or offense may result in sums to which the insurance e. The following provisions apply to Paragraph provided under this Coverage Part may a. above, but only for the purposes of the in- apply. surance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. However, if this Coverage Part includes an en- of Section II—Who Is An Insured: dorsement that provides limited coverage for "bodily injury" or "property damage" or pollution (1) Notice to us of such "occurrence" or of- costs arising out of a discharge, release or es- fense must be given as soon as practica- cape of "pollutants"which contains a requirement ble only after the "occurrence" or offense that the discharge, release or escape of "pollut- is known by you (if you are an individual), ants" must be reported to us within a specific any of your partners or members who is number of days after its abrupt commencement, an individual (if you are a partnership or this Paragraph e. does not affect that require- joint venture), any of your managers who ment. is an individual (if you are a limited liability K. UNINTENTIONAL OMISSION company), any of your "executive offi- cers" or directors (if you are an organiza- The following is added to Paragraph 6., Repre- tion other than a partnership,joint venture sentations, of SECTION IV — COMMERCIAL or limited liability company) or any "em- GENERAL LIABILITY CONDITIONS: ployee" authorized by you to give notice The unintentional omission of, or unintentional of an "occurrence" or offense. error in, any information provided by you which (2) If you are a partnership, joint venture or we relied upon in issuing this policy will not preju- limited liability company, and none of your dice your rights under this insurance. However, partners, joint venture members or man- this provision does not affect our right to collect agers are individuals, notice to us of such additional premium or to exercise our rights of "occurrence" or offense must be given as cancellation or nonrenewal in accordance with soon as practicable only after the "occur- applicable insurance laws or regulations. rence"or offense is known by: L. BLANKET WAIVER OF SUBROGATION (a) Any individual who is: The following is added to Paragraph 8., Transfer (i) A partner or member of any part- Of Rights Of Recovery Against Others To Us, nership or joint venture; of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: CG D3 16 11 11 ©2011 The Travelers Indemnity company.All rights reserved. Page 5 of 6 COMMERCIAL GENERAL LIABILITY If the insured has agreed in a contract or agree- 3. "Bodily injury" means bodily injury, mental ment to waive that insured's right of recovery anguish, mental injury, shock, fright, disability, against any person or organization, we waive our humiliation, sickness or disease sustained by right of recovery against such person or organiza- a person, including death resulting from any tion, but only for payments we make because of: of these at any time. a. "Bodily injury" or "property damage" that oc- N. CONTRACTUAL LIABILITY—RAILROADS curs; or 1. The following replaces Paragraph c. of the b. "Personal injury" or "advertising injury" definition of "insured contract" in the DEFINI- caused by an offense that is committed; TIONS Section: subsequent to the execution of that contract or c. Any easement or license agreement; agreement. 2. Paragraph f.(1) of the definition of "insured M. AMENDED BODILY INJURY DEFINITION contract" in the DEFINITIONS Section is de- leted. The following replaces the definition of "bodily injury" in the DEFINITIONS Section: Page 6 of 6 ©2011 The Travelers Indemnity company.All rights reserved. CG D3 16 11 11 POLICY NUMBER:DT-CO-9M679640-COF-18 ISSUE DATE: 12-26-18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY - NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS INCLUDED IN THIS POLICY SCHEDULE CANCELLATION: Number of Days Notice of Cancellation: 30 PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM (CONTINUED ON IL T8 03) ADDRESS: THE ADDRESS FOR THAT PERSON CONTINUED ON IL T8 03 SAN ANTONIO TX 78219-2236 PROVISIONS: If we cancel this policy for any statutorily permitted above. We will mail such notice to the address shown reason other than nonpayment of premium, and a in the schedule above at least the number of days number of days is shown for cancellation in the shown for cancellation in the schedule above before schedule above, we will mail notice of cancellation to the effective date of cancellation. the person or organization shown in the schedule IL T4 06 03 11 ©2011 The Travelers Indemnity Company. All rights reserved. Page 1 of 1 POLICY NUMBER: DT-CO-9M679640-COF-18 GENERAL PURPOSE ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED ENTITY NOTICE OF CANCELLATION PROVIDED BY US IL T4 05 03 11 THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: ALL COVERAGE PARTS INCLUDED IN THIS POLICY CONTINUATION OF FORM IL T4 05, PERSON OR ORGANIZATION: ANY PERSON OR ORGANIZATION TO WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1. YOU SEND US A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVED NOTICE FROM US OF THE CANCELLATION OF THIS POLICY; AND 2. WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS SCHEDULE. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. IL T8 03 Page 1 TRAVELERS WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 42 06 01 (00) — 001 POLICY NUMBER: UE-9M678330-18-26-G TEXAS NOTICE OF MATERIAL CHANGE ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A. of the Information Page. In the event of cancelation or other material change of the policy, we will mail advance notice to the person or organization named in the Schedule. The number of days advance notice is shown in the Schedule. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE 1, NUMBER OF DAYS ADVANCE NOTICE: 30 (or**) 2. NOTICE WILL BE MAILED TO: ANY PERSON OR ORGANIZATION WITH WHOM YOU HAVE AGREED IN A WRITTEN CONTRACT THAT NOTICE OF CANCELLATION, NONRENEWAL OR MATERIAL REDUCTION IN COVERAGE OF THIS POLICY WILL BE GIVEN, BUT ONLY IF: 1.YOU SEE TO IT THAT WE RECEIVE A WRITTEN REQUEST TO PROVIDE SUCH NOTICE, INCLUDING THE NAME AND ADDRESS OF SUCH PERSON OR ORGANIZATION, AFTER THE FIRST NAMED INSURED RECEIVES NOTICE FROM US OF THE CANCELLATION NONRENEWAL OR MATERIAL REDUCTION IN COVERAGE OF THIS POLICY; AND 2 . WE RECEIVE SUCH WRITTEN REQUEST AT LEAST 14 DAYS BEFORE THE BEGINNING OF THE APPLICABLE NUMBER OF DAYS SHOWN IN THIS ENDORSEMENT. ADDRESS: THE ADDRESS FOR THAT PERSON OR ORGANIZATION INCLUDED IN SUCH WRITTEN REQUEST FROM YOU TO US. ** Number of days Notice specified in the Certificate of Insurance to all holders of such certificates. DATE OF ISSUE: 12-31-18 STASSIGN: Page 1 of 1 TRAVELERS JW WORKERS COMPENSATION AND ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY HARTFORD CT 06183 ENDORSEMENT WC 42 03 04( B) — 001 POLICY NUMBER: UB-9M678330-18-26-G 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. 1• ❑ Specific Waiver ❑R 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: $SEE SCHEDULE This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 12-26-18 STASSIGN: Page 1 of 1 ©Copyright 2014 National Council on Compensation Insurance, Inc.All Rights Reserved.