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HomeMy WebLinkAboutContract 58500-R2CSC No. 58500-R2 CITY OF FORT WORTH RENEWAL OF AGREEMENT WHEREAS, this Second Renewal of Agreement is between the City of Fort Worth, ("CITY"), and William J. Schultz, Inc. dba Circle C Construction Comp_ anv ("CONTRACTOR"); and WHEREAS, CITY and CONTRACTOR entered into that certain Original Agreement (City Secretary #58500; M&C 22-0733) for Sewer Main Replacement Contract 2022; and WHEREAS, M&C 22-0733 authorized up to three renewals of the Original Agreement; and WHEREAS, the parties desire to renew the Original Agreement; and WHEREAS, funding for this renewal is available as appropriated by M&C :2 - ojgq. NOW, THEREFORE, it is agreed by the CITY and CONTRACTOR as follows: Article I The Original Agreement is hereby renewed for another term as described therein. Article II The CONTRACTOR's compensation for this Renewal shall remain $1,000,000.00, as specified in the Original Agreement. Article III All other provisions of the Original Agreement shall remain in full force and effect. OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Second Renewal of Agreement Sewer Main Replacement Contract 2022 Circle C Constr. Co. City Secretary No. 58500 City Project No. 103750 Page 1 of 2 EXECUTED and EFFECTIVE as of the date subscribed by the City's designated Assistant City Manager. APPROVED: City of Fort Worth ,-14c� Fernando Costa Assistant City Manager DATE: May 24, 2024 APPROVAL RECOMMENDED: a!, � r Chris Harder, P.E. Director, Water Department William J. Schultz, Inc. dba Circle C Construction Company /��o a �� Teresa S. Skelly President DATE:. - / /-2 APPROVED AS TO FORM AND LEGALITY: v Douglas W. Black Senior Assistant City Attorney ATTEST: P—P Jannette S. Goodall City Secretary Contract Compliance Manager: M&C: 22-0733(authJ; FundinO Date: 9 Form 1295:2024-1115404 By signing, I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting req irements. Q OFFICIAL RECORD CITY SECRETARY La\Nrence Hamikon, P.E., Senior rofessional Engineer FT. WORTH, Tx Second Renewal of Agreement Sewer Main Replacement Contract 2022 Circle C Constr. Co. City Secretary No. 58500 City Project No. 103750 Page 2 of 2 CITY COUNCIL AGENDA Official site of the City of Fort Worth, Texas FORT II Create New From This M&C DATE: 4/9/2024 REFERENCE **M&C 24- LOG NAME: 60SSRCON2022R2- NO.: 0299 CIRCLEC CODE: C TYPE: CONSENT PUBLIC NO HEARING: SUBJECT: (ALL) Adopt Appropriation Ordinance in the Amount of $1,300,000.00 for Sanitary Sewer Main Replacement Contract 2022 with William J. Schultz, Inc. dba Circle C Construction Company and Effect a Portion of Water's Contribution to the Fiscal Years 2024-2028 Capital Improvement Program RECOMMENDATION: It is recommended that the City Council adopt the attached appropriation ordinance increasing estimated receipts and appropriations in the Water and Sewer Capital Projects Fund in the amount of $1,300,000.00, from available PayGo residuals, for the purpose of funding of the Sanitary Sewer Main Replacement Contract 2022 project (City Project No. 103750) and to effect a portion of Water's Contribution to the Fiscal Years 2024-2028 Capital Improvement Program. DISCUSSION: On September 27, 2022, Mayor & Council Communication (M&C) (22-0733) the City Council authorized execution of a contract (City Secretary Contract No. 58500) in the amount of $1,000,000.00, with the option of three renewals, with William J. Schultz, Inc. dba Circle C Construction Company, for Sanitary Sewer Main Replacement Contract 2022. On October 17, 2023, Mayor & Council Communication (M&C 23-0882) the City Council authorized the appropriation of $1,300,000.00 for the first renewal of CSC 58500 for $1,000,000.00 and an additional $300,000.00 for project management, real property acquisitions, survey, material testing, and inspection. The City and the contractor desire to exercise the second renewal of the contract in the amount of $1,000,000.00. This M&C will appropriate the funding for the second renewal, plus staff costs. The work to be performed under this contract consists of repairing, replacing or relocating sewer mains and services. This project will have no impact on the future Water Department operating budget. In addition to the contract amount $300,000.00 is required for project management, real property acquisitions, survey, material testing, and inspection. It is the practice of the Water Department to appropriate its CIP plan throughout the Fiscal Year, instead of within the annual budget ordinance, as projects commence, additional funding needs are identified and to comply with bond covenants. The actions in the M&C will appropriate funds in support of the Water's portion of the City of Fort Worth's Fiscal Years 2024-2028 Capital Improvement Program, as follows: 60SSRCON2022R2-CIRCLEC Capital Project FY2024 CIP Budget Change Revised Fund Name Appropriations Authority (Increase/Decrease) FY2024 Name Budget Fund 103750 — 56002 Sewer Main — W&S Replacement $1,300,000.00 This M&C $1,300,000.00 $2,600,000.00 Capital 2022 Projects Funding is currently available in the Unspecified All -Funds project within the Water & Sewer Capital Project Fund for the purpose of funding the Sanitary Sewer Main Replacement Contract 2022 project. Fund Existing Additional Project Total* Appropriations Appropriations W&S Capital Projects - Fund $2,600,000.00 $1,300,000.00 $3,900,000.00 56002 Project Total $2,600,000.00 $1,300,000.00 $3,900,000.00 *Numbers rounded for presentation purposes. Circle C Construction Co. agrees to maintain its initial M/WBE commitment of 8\% that it made on the original contract and extend and maintain that same M/WBE commitment of 8\% to this first change order. Therefore Circle C Construction Co. remains in compliance with the City's M/WBE Ordinance and attests to its commitment by its signature on the Acceptance of Previous M/WBE Commitment form executed by an authorized representative of its company. The project is located in ALL COUNCIL DISTRICTS. FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that funds are currently available in the Unspecified All -Funds project within the W&S Capital Projects Fund and upon approval of the above recommendation and adoption of the attached appropriation ordinance, funds will be available in the W&S Capital Projects Fund for Sewer Main Replacement 2022 project. Prior to any expenditure being incurred, the Water Department has the responsibility to validate the availability of funds. TO Fund Department Account Project Program Activity Budget Reference # Amount ID ID Year (Chartfield 2) FROM Fund Department Account Project Program Activity Budget Reference # Amount ID ID Year (Chartfield 2) Submitted for Citv Manaaer's Office bv: Fernando Costa (6122) Originating Department Head: Chris Harder (5020) Additional Information Contact: Adolfo Lopez (7829) ATTACHMENTS 60SSRCON2022R2-CIRCLEC FID TABLE (WCF 02.08.24).xlsx (CFW Internal) 60SSRCON2022R2-CIRCLEC.docx (CFW Internal) Entitv Information William J. Schultz. Inc. dba Circle C Construction Comnanv.,pdf (CFW Internal) ORD.APP 60SSRCON2022R2-CIRCLEC 56002 A024(r1).docx (Public) PBS CPN 103750.odf (CFW Internal) 0061 13 - 1 PERFORMANCE BOND Page I of 2 BOND NO. 100161582 2 SECTION 00 6113 3 PERFORMANCE BOND 4 5 THE STATE OF TEXAS § 6 § KNOW ALL BY THESE PRESENTS: 7 COUNTY OF TARRANT § 8 9 That we, William J. Schultz. Inc. dba Circle C Construction Comoanv, known as 10 "Principal" herein and Merchants Bonding Comoanv (Mutual). a corporate surety (sureties, if 11 more than one) duly authorized to do business in the State of Texas, known as "Surety" herein 12 (whether one or more), are held and firmly bound unto the City of Fort Worth, a municipal 13 corporation created pursuant to the laws of Texas, known as "City" herein, in the penal sum of, 14 One Million Dollars ($1,000,000.00), lawful money of the United States, to be paid in Fort 15 Worth, Tarrant County, Texas for the payment of which sum well and truly to be made, we bind 16 ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, 17 firmly by these presents. 18 WHEREAS, the Principal has entered into a certain written contract with the City 19 awarded the day of APR 0 9 2024 , 2024, which Contract is hereby referred to and 20 made a part hereof for all purposes as if fully set forth herein, to furnish all materials, equipment 21 labor and other accessories defined by law, in the prosecution of the Work, including any Change 22 Orders, as provided for in said Contract designated as Second Renewal for Sewer Main 23 ReDlacement Contract 2022; Citv Proiect No. 103750 24 NOW, THEREFORE, the condition of this obligation is such that if the said Principal 25 shall faithfully perform it obligations under the Contract and shall in all respects duly and 26 faithfully perform the Work, including Change Orders, under the Contract, according to the plans, 27 specifications, and contract documents therein referred to, and as well during any period of 28 extension of the Contract that may be granted on the part of the City, then this obligation shall be 29 and become null and void, otherwise to remain in full force and effect. 30 PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in 31 Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort 32 Worth Division. CITY OF FORT WORTH 2"' RENEWAL, SEWER MAIN REPLACEMENT STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CONTRACT 2022 Revised December 8, 2023 City Project No. 103750 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 0061 13 - 2 PERFORMANCE BOND Page 2 of 2 This bond is made and executed in compliance with the provisions of Chapter 2253 of the Texas Government Code, as amended, and all liabilities on this bond shall be determined in accordance with the provisions of said statue. IN WITNESS WHEREOF, the Principal and the Surety have SIGNED and SEALED this instrument by duly authorized agents and officers on this the // day of 2�2 , 2024. ATTEST: (Principal) Secretary Michele S. Lard - Witness as to Principal PRINCIPAL: William J. Schultz, Inc. dba Circle C Construction Comnanv BY: Signature Teresa S. Skelly, President Name and Title Address: 500 W. Trammell P. O. Box 40328 Fort Worth, TX 76140 SURETY: Merchants inaComoativ (Mutual) BY: ignature Sheryl A. Klutts, Attorney -in -Fact Name and Title i Address: 6700 Westown Parkway West Des Moines. IA 50266-7754 Witness as to Surety John A. 4Mi er Telephone Number: (800) 678-8171 Email Address: sherylna,iohnamillerassocinc.com *Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the by-laws showing that this person has authority to sign such obligation. If Surety's physical address is different from its mailing address, both must be provided. The date of the bond shall not be prior to the date the Contract is awarded. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised December 8, 2023 2"d RENEWAL, SEWER MAIN REPLACEMENT CONTRACT 2022 City Project No. 103750 MERCHANTS,, BONDING COMPANY,, POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa, d/b/a Merchants National Indemnity Company (in California only) (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, John A Miller; Sheryl A Klutts their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16, 2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 20th day of March 2023 .o'�'s1101Y • •' - MERCHANTS BONDING COMPANY (MUTUAL) P� q� �•.� ♦'�,;oG ��;�.• MERCHANTS NATIONAL BONDING, INC. 4, tp01? . O : : q© �VP 09 I d/b/a MERCHANTS NATIONAL INDEMNITY COMPANY 2003 1933 c; By J� '' !� J '•• l'�,+� President STATE OF IOWA •'•�....... COUNTY OF DALLAS ss. ;;+4g 6#*� On this 20th day of March 2023 before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. Kim Lee 64`r Commission Number 702737 '- My CdnlMiGSion Expres AOI 14, 2024 �— Notary Public (Expiration of notary's commission does not invalidate this instrument) I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this day of 2024 0)�•ORPOgq.6'p: + "y:0 0A - 2003 ;'�yj 1933 �' �: secretary POA 0018 (10/22) """ ♦• ",. 0061 14 - 1 PAYMENT BOND Page 1 of 2 BOND NO. 100161582 2 SECTION 00 6114 3 PAYMENT BOND 4 5 THE STATE OF TEXAS § 6 § KNOW ALL BY THESE PRESENTS: 7 COUNTY OF TARRANT § 8 9 That we, William J. Schultz, Inc. dba Circle C Construction COmnanv, known as 10 "Principal" herein, and Merchants Bondinl? Comnanv (Mutual), a corporate surety (sureties), duly 11 authorized to do business in the State of Texas, known as "Surety" herein (whether one or more), 12 are held and firmly bound unto the City of Fort Worth, a municipal corporation created pursuant 13 to the laws of the State of Texas, known as "City" herein, in the penal sum of One Million 14 Dollars ($1,000,000.00), lawful money of the United States, to be paid in Fort Worth, Tarrant 15 County, Texas, for the payment of which sum well and truly be made, we bind ourselves, our 16 heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these 17 presents: 18 WHEREAS, Principal has entered into a certain written Contract with City, awarded the 19 day of APRI 0 9 70741 , 2024, which Contract is hereby referred to and made a 20 part hereof for all purposes as if fully set forth herein, to furnish all materials, equipment, labor 21 and other accessories as defined by law, in the prosecution of the Work as provided for in said 22 Contract and designated as Second Renewal for Sewer Main Replacement Contract 2022: 23 City Proiect No. 103750 24 NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if 25 Principal shall pay all monies owing to any (and all) payment bond beneficiary (as defined in 26 Chapter 2253 of the Texas Government Code, as amended) in the prosecution of the Work under 27 the Contract, then this obligation shall be and become null and void; otherwise to remain in full 28 force and effect. 29 This bond is made and executed in compliance with the provisions of Chapter 2253 of the 30 Texas Government Code, as amended, and all liabilities on this bond shall be determined in 31 accordance with the provisions of said statute. 32 CITY OF FORT WORTH 2°d RENEWAL, SEWER MAIN REPLACEMENT STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CONTRACT 2022 Revised December 8, 2023 City Project No. 103750 0061 14 - 2 PAYMENT BOND Page 2 of 2 1 IN WITNESS WHEREOF, the Principal and Surety have each SIGNED and SEALED 2 this instrument by duly authorized agents and officers on this the /y day of 3 ,��y� �� , 2024. 4 5 6 7 8 9 10 12 ATTEST: (Principal) Secretary Michele ankford Witness as to Principal ATTEST: (Surety) Secretar Witness as to Surety John A. iller PRINCIPAL: William J. Schultz, Inc. dba Circle C Construction Company BY: Signature Teresa S. Skelly, Presiders Name and Title Address: 500 W. Trammell P. O. Box 40328 Fort Worth, TX 76140 SURETY: Merchants Bo iy( Company (Mutual) BY: - vz��� Signature Sheryl A. Klutts, Attorney -in -Fact Name and Title Address: 6700 Westown Parkway West Des Moines, Iowa 50266-7754 Telephone Number: (800) 678-8171 Email Address: Sheryl(cDiohnamillerassocinc.com Note: If signed by an officer of the Surety, there must be on file a certified extract from the bylaws showing that this person has authority to sign such obligation. If Surety's physical address is different from its mailing address, both must be provided. The date of the bond shall not be prior to the date the Contract is awarded. END OF SECTION CITY OF FORT WORTH 2" RENEWAL, SEWER MAIN REPLACEMENT STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CONTRACT 2022 Revised December 8, 2023 City Project No. 103750 MERCHANT''"%N, BONDING COMPANY-,, POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa, d/b/a Merchants National Indemnity Company (in California only) (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, John A Miller; Sheryl A Klutts their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16, 2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 20th day of March 2023 . .•`""""'•. » • • "' • •. MERCHANTS BONDING COMPANY (MUTUAL) O'`�Q.�,�N'q< •�'�. •' �jl�t . QISf+•. MERCHANTS NATIONAL BONDING, INC. tN P 0A' `oy'. d/b/a MERCHANTS NATIONAL INDEMNITY COMPANY 2; `� 1933e: By 003 �J. r'•,�J�'' ��11�+,�'�•.. a President STATE OF IOWA�'• .• COUNTY OF DALLAS ss. • •�'""""�� , On this 20th day of March 2023 before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. Kim Lee y Commission Numission i 2737 "s �,ty Gmmission Expires �T t t April 14, 2024 &U-"/ Notary Public (Expiration of notary's commission does not invalidate this instrument) I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this day of 12024 y�43%-- _ . W ;•moo' ��tP(19�'°9�: �� ac'2 -0- ZL. 1933 Secretary : v 2003 10 ti: H 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 BOND NO. 100161582 SECTION 00 6119 MAINTENANCE BOND THE STATE OF TEXAS § COUNTY OF TARRANT § 0061 19 - 1 MAINTENANCE BOND Page 1 of 3 KNOW ALL BY THESE PRESENTS: That we, William J. Schultz, Inc. dba Circle C Construction Comoanv, known as "Principal" herein and Merchants Bonding ComDanv (Mutual), a corporate surety (sureties, if more than one) duly authorized to do business in the State of Texas, known as "Surety" herein (whether one or more), are held and firmly bound unto the City of Fort Worth, a municipal corporation created pursuant to the laws of the State of Texas, known as "City" herein, in the sum of One Million Dollars ($1,000,000.00), lawful money of the United States, to be paid in Fort Worth, Tarrant County, Texas, for payment of which sum well and truly be made unto the City and its successors, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has entered into a certain written contract with the City awarded the day of% te�2024, which Contract is hereby referred to and a made part hereof for all purposes as if fully set forth herein, to furnish all materials, equipment labor and other accessories as defined by law, in the prosecution of the Work, including any Work resulting from a duly authorized Change Order (collectively herein, the "Work") as provided for in said contract and designated as Second Renewal for Sewer Main Replacement Contract 2022; Citv Proiect No. 103750 and 27 WHEREAS, Principal binds itself to use such materials and to so construct the Work in 28 accordance with the plans, specifications and Contract Documents that the Work is and will 29 remain free from defects in materials or workmanship for and during the period of two (2) years 30 after the date of Final Acceptance of the Work by the City ("Maintenance Period"); and 31 32 WHEREAS, Principal binds itself to repair or reconstruct the Work in whole or in part 33 upon receiving notice from the City of the need therefor at any time within the Maintenance 34 Period. CITY OF FORT WORTH 2"`' RENEWAL, SEWER MAIN REPLACEMENT STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS CONTRACT 2022 Revised December 8, 2023 City Project No. 103750 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Z 20 0061 19-2 MAINTENANCE BOND Page 2 of 3 NOW THEREFORE, the condition of this obligation is such that if Principal shall remedy any defective Work, for which timely notice was provided by City, to a completion satisfactory to the City, then this obligation shall become null and void; otherwise to remain in full force and effect. PROVIDED, HOWEVER, if Principal shall fail so to repair or reconstruct any timely noticed defective Work, it is agreed that the City may cause any and all such defective Work to be repaired and/or reconstructed with all associated costs thereof being borne by the Principal and the Surety under this Maintenance bond; and PROVIDED FURTHER, that if any legal action be filed on this Bond, venue shall lie in Tarrant County, Texas or the United States District Court for the Northern District of Texas, Fort Worth Division; and PROVIDED FURTHER, that this obligation shall be continuous in nature and successive recoveries may be had hereon for successive breaches. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised December 8. 2023 2"d RENEWAL, SEWER MAIN REPLACEMENT CONTRACT 2022 City Project No. 103750 0061 19-3 MAINTENANCE BOND Page 3 of 3 1 IN WITNESS WHEREOF, the Principal and the Surety have each SIGNED and SEALED this 2 instrument by duly authorized agents and officers on this the / 141 day of , 3 2024. 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 ATTEST: ylW nl� (Principal) Secretary Michele S. L or� Witness as to Principal ATTEST: PRINCIPAL: William J. Schultz, Inc. dba Circle C Construction Company BY: p �G>Gt.lia0 Signature Teresa S. Skelly, President Name and Title Address: 500 W. Trammell P. O. Box 40328 _Fort Worth TX 761 do SURETY: Merchants $on;Company (Mutual) BY: Signature Sheryl A. Klutts, Attorney -in -Fact Name and Title Address: 6700 Westown Parkway (Sure ) Sec etary West Des Moines. IA 50266=4 t4g..'. . Witness as to Surety John A4Mi r Telephone Number: (800) 678-8171 Email Address: sheryl@johnamillerassocinc.com *Note: If signed by an officer of the Surety Company, there must be on file a certified extract from the by-laws showing that this person has authority to sign such obligation. If Surety's physical address is different from its mailing address, both must be provided. The date of the bond shall not be prior to the date the Contract is awarded. CITY OF FORT WORTH STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS Revised December 8, 2023 2°d RENEWAL, SEWER MAIN REPLACEMENT CONTRACT 2022 City Project No. 103750 MERCHANTS710�, BONDING COMPANY-,, POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa, d/b/a Merchants National Indemnity Company (in California only) (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, John A Miller; Sheryl A Klutts their true and lawful Attorney(s)-in-Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16, 2015. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof." "The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and aut hority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 20th day of March 2023 . -•'`(�....., ON,Q '• ."•• � �"• •, MERCHANTS BONDING COMPANY (MUTUAL) :.�. • �•,•� •,•�Q1N...C�IfjA,• MERCHANTS NATIONAL BONDING, INC. CO ;'oapoRq o : q�?.'p�p0A� ,�y, d/bla MERCHANTS NATIONAL INDEMNITY COMPANY �'. 2003 ; roc y 1933 c: By •'•d ••• .....•.�t1�.` •', �jy . ••�1 .' President STATE OFIOWA ##" �<<.•� * .,•��•,.•• COUNTY OF DALLAS ss. """' On this 20th day of March 2023 before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. �t''� •�,n Kim Lee o v Commission Number 702737 z ' ` My Commission 50 es April 14, 2024 Notary Public (Expiration of notary's commission does not invalidate this instrument) I, William Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this day of 2024 oflC7 ,q�,:;.�'�,,�• :•�'• 1933 Secretary v . 2003 ��: . SJ. 5,: POA0018 (10/22) """ •••�•••• MERCHANT�� BONDING COMPANY,M MERCHANTS BONDING COMPANY (MUTUAL) • MERCHANTS NATIONAL BONDING, INC. P.O. BOX 14498 - DFS MOINES, IOWA S0306-3498 • (800) 678-8171 - (S15) 243-38S4 FAX Please send all notices of claim on this bond to: Merchants Bonding Company (Mutual) / Merchants National Bonding, Inc. P.O. Box 14498 Des Moines, Iowa 50306-3498 (515) 243-8171 (800) 678-8171 Physical Address: 6700 Westown Parkway, West Des Moines, Iowa 50266 SUP 0073 TX (2/15) POLICY NUMBER: CPP100051064 COMMERCIAL GENERAL LIABILITY CGL 121 (02 21) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONTRACT OR AGREEMENT - ONGOING OPERATIONS AND PRODUCTS -COMPLETED OPERATIONS (TEXAS LIMITED SOLE NEGLIGENCE) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE (OPTIONAL) Name of Additional Insured Persons or Organizations (As required by written contract or agreement per Paragraph A. below.) Locations of Covered Operations (As per the written contract or agreement, provided the location is within the "coverage territory".) (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) A. Section II — Who Is An Insured is amended to include as an additional insured: 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement in effect during the term of this policy that such person or organization be added as an additional insured on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above; and 3. The particular person or organization, if any, scheduled above. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" occurring after the execution of the contract or agreement described in Paragraph 1. above and caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured; or c. "Your work" performed for the additional insured and included in the "products -completed operations hazard" if such coverage is specifically required in the written contract or agreement. With respect to liability of the additional insured for "bodily injury" of an employee or agent of a named insured or the employee of a named insured's subcontractor, coverage shall apply for the partial or sole negligence of the additional insured, but only if such coverage is specifically required in the written contract or agreement. However, the insurance afforded to such additional insured(s) described above: a. Only applies to the extent permitted by law; b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured; CGL 121 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 1 of 2 Copyright 2020 FCCI Insurance Group. QUOTE POLICY NUMBER: CPP100051064 COMMERCIAL GENERAL LIABILITY CGL 121 (02 21) c. Will not be broader than that which is afforded to you under this policy; and d. Nothing herein shall extend the term of this policy. B. The insurance provided to the additional insured does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 1. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. C. This insurance is excess over any other valid and collectible insurance available to the additional insured whether on a primary, excess, contingent or any other basis; unless the written contract or agreement requires that this insurance be primary and non-contributory, in which case this insurance will be primary and non-contributory relative to insurance on which the additional insured is a Named Insured. D. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement described in Paragraph A.1.; or 2. Available under the applicable Limits of Insurance; whichever is less. This endorsement shall not increase the applicable Limits of Insurance. E. Section IV — Commercial General Liability Conditions is amended as follows: The Duties In The Event of Occurrence, Offense, Claim or Suit condition is amended to add the following additional conditions applicable to the additional insured: An additional insured under this endorsement must as soon as practicable: 1. Give us written notice of an `occurrence" or an offense which may result in a claim or "suit' under this insurance, and of any claim or "suit' that does result; 2. Send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions; and 3. Tender the defense and indemnity of any claim or "suit' to any provider of other insurance which would cover the additional insured for a loss we cover under this endorsement and agree to make available all such other insurance. However, this condition does not affect Paragraph C. above. We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a claim or "suit'. F. This endorsement does not apply to any additional insured or project that is specifically identified in any other additional insured endorsement attached to the Commercial General Liability Coverage Form. CGL 121 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 2 of 2 Copyright 2020 FCCI Insurance Group. QUOTE Policy #CPP100051064 FIRST CHOICE CONTRACTORS LIABILITY ENDORSEMENT TABLE OF CONTENTS DESCRIPTION PAGE AdditionalInsured Coverage...................................................................................................................................... 9 BailBonds................................................................................................................................................................... 9 BlanketWaiver of Subrogation................................................................................................................................. 14 BodilyInjury and Property Damage........................................................................................................................... 1 Care, Custody or Control............................................................................................................................................ 3 Contractors Errors and Omissions............................................................................................................................. 6 Contractual Liability (Personal & Advertising Injury).................................................................................................. 2 ElectronicData Liability.............................................................................................................................................. 1 GeneralLiability Conditions...................................................................................................................................... 13 IncidentalMalpractice................................................................................................................................................. 9 Insured........................................................................................................................................................................ 9 Limited Product Withdrawal Expense........................................................................................................................ 3 Limitsof Insurance................................................................................................................................................... 11 Lossof Earnings......................................................................................................................................................... 9 LostKey Coverage..................................................................................................................................................... 8 NewlyFormed or Acquired Organizations............................................................................................................... 11 Non -Owned Watercraft............................................................................................................................................... 1 Property Damage Liability — Borrowed Equipment.................................................................................................... 1 Tenant's Property and Premises Rented To You...................................................................................................... 8 VoluntaryProperty Damage....................................................................................................................................... 2 QUOTE Policy #CPP100051064 COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FIRST CHOICE CONTRACTORS LIABILITY ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM NOTE: The following are additions, replacements and amendments to the Commercial General Liability Coverage Form, and will apply unless excluded by separate endorsement(s) to the Commercial General Liability Coverage Form. The COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended as follows: SECTION I - COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE is amended as follows: 1. Extended "Property Damage" Exclusion 2.a., Expected or Intended Injury, is replaced with the following: a. "Bodily injury' or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. 2. Non -owned Watercraft Exclusion 2.g. (2) (a) is replaced with the following: (a) Less than 51 feet long; and 3. Property Damage Liability — Borrowed Equipment The following is added to Exclusion 2.j. (4): Paragraph (4) of this exclusion does not apply to "property damage" to borrowed equipment while at a jobsite and not being used to perform operations. The most we will pay for "property damage" to any one borrowed equipment item under this coverage is $25,000 per "occurrence". The insurance afforded under this provision is excess over any other valid and collectible property insurance (including deductible) available to the insured, whether primary, excess, contingent or on any other basis. 4. Limited Electronic Data Liability Exclusion 2.p. is replaced with the following: p. Electronic Data Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. The most we will pay under Coverage A for "property damage" because of all loss of "electronic data" arising out of any one 'occurrence" is $10,000. We have no duty to investigate or defend claims or "suits" covered by this Limited Electronic Data Liability coverage. The following definition is added to SECTION V — DEFINITIONS of the Coverage Form: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, CD- ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 1 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) For purposes of this Limited Electronic Data Liability coverage, the definition of 'Property Damage" in SECTION V — DEFINITIONS of the Coverage Form is replaced by the following: 17. "Property damage" means: a. Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; b. Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the 'occurrence" that caused it; c. Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the 'occurrence" that caused it. For purposes of this insurance, "electronic data" is not tangible property. SECTION I — COVERAGES, COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY is amended as follows: Paragraph 2.e. Exclusions —the Contractual Liability Exclusion is deleted. SECTION I — COVERAGES, the following coverages are added: COVERAGE D. VOLUNTARY PROPERTY DAMAGE Insuring Agreement We will pay, at your request, for "property damage" caused by an 'occurrence", to property of others caused by you, or while in your possession, arising out of your business operations. The amount we will pay for damages is described in SECTION III LIMITS OF INSURANCE. 2. Exclusions This insurance does not apply to: "Property Damage" to: a. Property at premises owned, rented, leased or occupied by you; b. Property while in transit; c. Property owned by, rented to, leased to, loaned to, borrowed by, or used by you; d. Premises you sell, give away, or abandon, if the "property damage" arises out of any part of those premises; e. Property caused by or arising out of the "products -completed operations hazard"; f. Motor vehicles; g. "Your product" arising out of it or any part of it; or h. "Your work" arising out of it or any part of it. 3. Deductible We will not pay for loss in any one 'occurrence" until the amount of loss exceeds $250. We will then pay the amount of loss in excess of $250 up to the applicable limit of insurance. 4. Cost Factor In the event of a covered loss, you shall, if requested by us, replace the damaged property or furnish the labor and materials necessary for repairs thereto at your actual cost, excluding profit or overhead charges. CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 2 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) The insurance afforded under COVERAGE D is excess over any other valid and collectible property or inland marine insurance (including the deductible applicable to the property or inland marine coverage) available to you whether primary, excess, contingent or any other basis. Coverage D covers unintentional damage or destruction, but does not cover disappearance, theft, or loss of use. The insurance under COVERAGE D does not apply if a loss is paid under COVERAGE E. COVERAGE E. CARE, CUSTODY OR CONTROL 1. Insuring Agreement We will pay those sums that the insured becomes legally obligated to pay as damages because of "property damage" caused by an 'occurrence", to property of others while in your care, custody, or control or property of others as to which you are exercising physical control if the "property damage" arises out of your business operations. The amount we will pay for damages is described in SECTION III LIMITS OF INSURANCE. 2. Exclusions This insurance does not apply to: "Property Damage" to: a. Property at premises owned, rented, leased or occupied by you; b. Property while in transit; c. Premises you sell, give away, or abandon, if the "property damage" arises out of any part of those premises; d. Property caused by or arising out of the "products -completed operations hazard"; e. Motor vehicles; f. "Your product' arising out of it or any part of it; or g. "Your work" arising out of it or any part of it. 3. Deductible We will not pay for loss in any one 'occurrence" until the amount of loss exceeds $250. We will then pay the amount of loss in excess of $250 up to the applicable limit of insurance. 4. Cost Factor In the event of a covered loss, you shall, if requested by us, replace the damaged property or furnish the labor and materials necessary for repairs thereto at your actual cost, excluding profit or overhead charges. The insurance afforded under COVERAGE E is excess over any other valid and collectible property or inland marine insurance (including the deductible applicable to the property or inland marine coverage) available to you whether primary, excess, contingent or any other basis. The insurance under COVERAGE E does not apply if a loss is paid under COVERAGE D. COVERAGE F. LIMITED PRODUCT WITHDRAWAL EXPENSE 1. Insuring Agreement a. If you are a "seller", we will reimburse you for "product withdrawal expenses" associated with "your product' incurred because of a "product withdrawal' to which this insurance applies. The amount of such reimbursement is limited as described in SECTION III - LIMITS OF INSURANCE. No other obligation or liability to pay sums or perform acts or services is covered. CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 3 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) a. This insurance applies to a "product withdrawal" only if the "product withdrawal" is initiated in the "coverage territory" during the policy period because: (1) You determine that the "product withdrawal" is necessary; or (2) An authorized government entity has ordered you to conduct a "product withdrawal". c. We will reimburse only those "product withdrawal expenses" which are incurred and reported to us within one year of the date the "product withdrawal" was initiated. d. The initiation of a "product withdrawal" will be deemed to have been made only at the earliest of the following times: (1) When you have announced, in any manner, to the general public, your vendors or to your employees (other than those employees directly involved in making the determination) your decision to conduct a "product withdrawal" This applies regardless of whether the determination to conduct a "product withdrawal" is made by you or is requested by a third party; (2) When you received, either orally or in writing, notification of an order from an authorized government entity to conduct a "product withdrawal; or (3) When a third party has initiated a "product withdrawal" and you communicate agreement with the "product withdrawal", or you announce to the general public, your vendors or to your employees (other than those employees directly involved in making the determination) your decision to participate in the "product withdrawal", whichever comes first. e. "Product withdrawal expenses" incurred to withdraw "your products" which contain: (1) The same "defect" will be deemed to have arisen out of the same "product withdrawal"; or (2) A different "defect" will be deemed to have arisen out of a separate "product withdrawal" if newly determined or ordered in accordance with paragraph 1.b of this coverage. 2. Exclusions This insurance does not apply to "product withdrawal" expenses" arising out of: a. Any "product withdrawal" initiated due to: (1) The failure of "your products" to accomplish their intended purpose, including any breach of warranty of fitness, whether written or implied. This exclusion does not apply if such failure has caused or is reasonably expected to cause "bodily injury" or physical damage to tangible property. (2) Copyright, patent, trade secret or trademark infringements; (3) Transformation of a chemical nature, deterioration or decomposition of "your product", except if it is caused by: (a) An error in manufacturing, design, processing or transportation of "your product"; or (b) "Product tampering". (4) Expiration of the designated shelf life of "your product". b. A "product withdrawal", initiated because of a "defect" in "your product" known to exist by the Named Insured or the Named Insured's "executive officers", prior to the inception date of this Coverage Part or prior to the time "your product" leaves your control or possession. c. Recall of any specific products for which "bodily injury" or "property damage" is excluded under Coverage A - Bodily Injury And Property Damage Liability by endorsement. d. Recall of "your products" which have been banned from the market by an authorized government entity prior to the policy period. e. The defense of a claim or "suit" against you for "product withdrawal expenses". CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 4 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) 3. For the purposes of the insurance afforded under COVERAGE F, the following is added to 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit Condition under SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS: e. Duties In The Event Of A "Defect" Or A "Product Withdrawal" (1) You must see to it that we are notified as soon as practicable of any actual, suspected or threatened "defect" in "your products", or any governmental investigation, that may result in a "product withdrawal". To the extent possible, notice should include: (a) How, when and where the "defect" was discovered; (b) The names and addresses of any injured persons and witnesses; and (c) The nature, location and circumstances of any injury or damage arising out of use or consumption of "your product". (2) If a "product withdrawal" is initiated, you must: (a) Immediately record the specifics of the "product withdrawal" and the date it was initiated; (b) Send us written notice of the "product withdrawal" as soon as practicable; and (c) Not release, consign, ship or distribute by any other method, any product, or like or similar products, with an actual, suspected or threatened defect. (3) You and any other involved insured must: (a) Immediately send us copies of pertinent correspondence received in connection with the "product withdrawal"; (b) Authorize us to obtain records and other information; and (c) Cooperate with us in our investigation of the "product withdrawal". 4. For the purposes of this Coverage F, the following definitions are added to the Definitions Section: a. "Defect" means a defect, deficiency or inadequacy that creates a dangerous condition. b. "Product tampering" is an act of intentional alteration of "your product" which may cause or has caused "bodily injury" or physical injury to tangible property. When "product tampering" is known, suspected or threatened, a "product withdrawal" will not be limited to those batches of "your product" which are known or suspected to have been tampered with. c. "Product withdrawal" means the recall or withdrawal of "your products", or products which contain "your products", from the market or from use, by any other person or organization, because of a known or suspected "defect" in "your product", or a known or suspected "product tampering", which has caused or is reasonably expected to cause "bodily injury" or physical injury to tangible property. d. "Product withdrawal expenses" means those reasonable and necessary extra expenses, listed below paid and directly related to a "product withdrawal": (1) Costs of notification; (2) Costs of stationery, envelopes, production of announcements and postage or facsimiles; (3) Costs of overtime paid to your regular non -salaried employees and costs incurred by your employees, including costs of transportation and accommodations; (4) Costs of computer time; (5) Costs of hiring independent contractors and other temporary employees; (6) Costs of transportation, shipping or packaging; (7) Costs of warehouse or storage space; or CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 5 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) (8) Costs of proper disposal of "your products", or products that contain "your products", that cannot be reused, not exceeding your purchase price or your cost to produce the products; but "product withdrawal expenses" does not include costs of the replacement, repair or redesign of "your product', or the costs of regaining your market share, goodwill, revenue or profit. e. "Seller' means a person or organization that manufactures, sells or distributes goods or products. "Seller" does not include a "contractor" as defined elsewhere in this endorsement. The insurance under COVERAGE F does not apply if a loss is paid under COVERAGE G. COVERAGE G. CONTRACTORS ERRORS AND OMISSIONS 1. Insuring Agreement If you are a "contractor', we will pay those sums that you become legally obligated to pay as damages because of "property damage" to "your product', "your work" or "impaired property", due to faulty workmanship, material or design, or products including consequential loss, to which this insurance applies. The damages must have resulted from your negligent act, error or omission while acting in your business capacity as a contractor or subcontractor or from a defect in material or a product sold or installed by you while acting in this capacity. The amount we will pay for damages is described in SECTION III LIMITS OF INSURANCE. We have no duty to investigate or defend claims or "suits" covered by this Contractors Errors or Omissions coverage. This coverage applies only if the "property damage" occurs in the "coverage territory" during the policy period. This coverage does not apply to additional insureds, if any. Supplementary Payments — Coverage A and B do not apply to Coverage G. Contractors Errors and Omissions. 2. Exclusions This insurance does not apply to: a. 'Bodily injury' or "personal and advertising injury". b. Liability or penalties arising from a delay or failure to complete a contract or project, or to complete a contract or project on time. c. Liability because of an error or omission: (1) In the preparation of estimates or job costs; (2) Where cost estimates are exceeded; (3) In the preparation of estimates of profit or return on capital; (4) In advising or failure to advise on financing of the work or project; or (5) In advising or failing to advise on any legal work, title checks, form of insurance or suretyship. d. Any liability which arises out of any actual or alleged infringement of copyright or trademark or trade dress or patent, unfair competition or piracy, or theft or wrongful taking of concepts or intellectual property. e. Any liability for damages: (1) From the intentional dishonest, fraudulent, malicious or criminal acts of the Named Insured, or by any partner, member of a limited liability company, or executive officer, or at the direction of any of them; or (2) Which is in fact expected or intended by the insured, even if the injury or damage is of a different degree or type than actually expected or intended. CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 6 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) f. Any liability arising out of manufacturer's warranties or guarantees whether express or implied. g. Any liability arising from "property damage" to property owned by, rented or leased to the insured. h. Any liability incurred or "property damage" which occurs, in whole or in part, before you have completed "your work." "Your work" will be deemed completed at the earliest of the following times: (1) When all of the work called for in your contract or work order has been completed; (2) When all the work to be done at the job site has been completed if your contract calls for work at more than one job site; or (3) When that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service or maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as complete. I. Any liability arising from "property damage" to products that are still in your physical possession. j. Any liability arising out of the rendering of or failure to render any professional services by you or on your behalf, but only with respect to either or both of the following operations: (1) Providing engineering, architectural or surveying services to others; and (2) Providing or hiring independent professionals to provide engineering, architectural or surveying services in connection with construction work you perform. Professional services include the preparing, approving or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications. Professional services also include supervisory or inspection activities performed as part of any related architectural or engineering activities. But, professional services do not include services within construction means, methods, techniques, sequences and procedures employed by you in connection with construction work you perform. k. Your loss of profit or expected profit and any liability arising therefrom. I. "Property damage" to property other than "your product," "your work" or "impaired property." m. Any liability arising from claims or "suits" where the right of action against the insured has been relinquished or waived. n. Any liability for "property damage" to "your work" if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. o. Any liability arising from the substitution of a material or product for one specified on blueprints, work orders, contracts or engineering specifications unless there has been written authorization, or unless the blueprints, work orders, contracts or engineering specifications were written by you, and you have authorized the changes. p. Liability of others assumed by the insured under any contract or agreement, whether oral or in writing. This exclusion does not apply to liability for damages that the insured would have in the absence of the contract or agreement. 3. For the purposes of Coverage G, the following definition is added to the Definitions section: a. "Contractor" means a person or organization engaged in activities of building, clearing, filing, excavating or improvement in the size, use or appearance of any structure or land. "Contractor" does not include a "seller" as defined elsewhere in this endorsement. 4. Deductible We will not pay for loss in any one "occurrence" until the amount of loss exceeds $250. The limits of insurance will not be reduced by the application of the deductible amount. CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 7 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) We may pay any part or all of the deductible amount to effect settlement of any claim or "suit", and upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. 5. Cost Factor In the event of a covered loss, you shall, if requested by us, replace the damaged property or furnish the labor and materials necessary for repairs thereto at your actual cost, excluding profit or overhead charges. The insurance under COVERAGE G does not apply if a loss is paid under COVERAGE F. COVERAGE H. LOST KEY COVERAGE 1. Insuring Agreement We will pay those sums, subject to the limits of liability described in SECTION III LIMITS OF INSURANCE in this endorsement and the deductible shown below, that you become legally obligated to pay as damages caused by an "occurrence" and due to the loss or mysterious disappearance of keys entrusted to or in the care, custody or control of you or your "employees" or anyone acting on your behalf. The damages covered by this endorsement are limited to the: a. Actual cost of the keys; b. Cost to adjust locks to accept new keys; or c. Cost of new locks, if required, including the cost of installation. 2. Exclusions This insurance does not apply to: a. Keys owned by any insured, employees of any insured, or anyone acting on behalf of any insured; b. Any resulting loss of use; or c. Any of the following acts by any insured, employees of any insured, or anyone acting on behalf of any insured: 1) Misappropriation; 2) Concealment; 3) Conversion; 4) Fraud; or 5) Dishonesty. 3. Deductible We will not pay for loss in any one "occurrence" until the amount of loss exceeds $1,000. The limits of insurance will not be reduced by the application of the deductible amount. We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. EXPANDED COVERAGE FOR TENANT'S PROPERTY AND PREMISES RENTED TO YOU The first paragraph after subparagraph (6) in Exclusion j., Damage to Property is amended to read as follows: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" (other than damage by fire) to premises, including the contents of such premises, rented to you. A separate limit of insurance applies to Damage To Premises Rented To You as described in Section III — Limits Of Insurance. CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 8 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) SECTION I - COVERAGES, SUPPLEMENTARY PAYMENTS — COVERAGE A and B is amended as follows: All references to SUPPLEMENTARY PAYMENTS — COVERAGES A and B are amended to SUPPLEMENTARY PAYMENTS — COVERAGES A, B, D, E, G, and H. 1. Cost of Bail Bonds Paragraph 1.b. is replaced with the following: b. Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Loss of Earnings Paragraph 1.d. is replaced with the following: d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to $500 a day because of time off from work. SECTION II — WHO IS AN INSURED is amended as follows: 1. Incidental Malpractice Paragraph 2.a.(1)(d) is replaced with the following: (d) Arising out of his or her providing or failing to provide professional health care services. However, this exclusion does not apply to a nurse, emergency medical technician or paramedic employed by you to provide medical services, unless: (i) You are engaged in the occupation or business of providing or offering medical, surgical, dental, x-ray or nursing services, treatment, advice or instruction; or (ii) The "employee" has another insurance that would also cover claims arising under this provision, whether the other insurance is primary, excess, contingent or on any other basis. 2. Broadened Who Is An Insured The following are added to Paragraph 2.: Subsidiaries e. Your subsidiaries if: (1) They are legally incorporated entities; and (2) You own more than 50% of the voting stock in such subsidiaries as of the effective date of this policy. If such subsidiaries are not shown in the Declarations, you must report them to us within 180 days of the inception of your original policy. Additional Insureds f. Any person or organization described in paragraphs g. through k. below whom you are required to add as an additional insured on this policy under a written contract or agreement in effect during the term of this policy, provided the written contract or agreement was executed prior to the "bodily injury", "property damage" or "personal and advertising injury" for which the additional insured seeks coverage. However, the insurance afforded to such additional insured(s): (1) Only applies to the extent permitted by law; (2) Will not be broader than that which you are required by the contract or agreement to provide for such additional insured; (3) Will not be broader than that which is afforded to you under this policy; (4) Is subject to the conditions described in paragraphs g. through k. below; and (5) Nothing herein shall extend the term of this policy. CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 9 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) g. Owner, Lessor or Manager of Premises If the additional insured is an owner, lessor or manager of premises, such person or organization shall be covered only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by you or those acting on your behalf in connection with the ownership, maintenance or use of that part of any premises leased to you and subject to the following additional exclusions: (1) Any "occurrence" that takes place after you cease to occupy those premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. h. State or Governmental Agency or Subdivision or Political Subdivision — Permits or Authorizations If the additional insured is the state or any political subdivision, the state or political subdivision shall be covered only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit or authorization. This insurance does not apply to: (1) "Bodily injury`, "property damage", or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or (2) "Bodily injury" or "property damage" included within the "products -completed operations hazard". i. Lessor of Leased Equipment If the additional insured is a lessor of leased equipment, such lessor shall be covered only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. j. Mortgagee, Assignee, or Receiver If the additional Insured is a mortgagee, assignee, or receiver of premises, such mortgagee, assignee or receiver of premises is an additional insured only with respect to their liability as mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of the premises by you. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. k. Vendor If the additional insured is a vendor, such vendor is an additional insured only with respect to liability for "bodily injury" or "property damage" caused by "your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: (1) The insurance afforded to the vendor does not apply to: (a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in absence of the contract or agreement. (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in "your product" made intentionally by the vendor; (d) Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e) Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 10 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: i. The exceptions contained in Subparagraphs d. or f.; or ii. Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 3. Newly Formed or Acquired Organizations Paragraph 3, is amended as follows: a. Coverage under this provision is afforded until the end of the policy period. d. Coverage A does not apply to product recall expense arising out of any withdrawal or recall that occurred before you acquired or formed the organization. SECTION III — LIMITS OF INSURANCE is amended as follows: 1. Paragraph 2. is replaced with the following: 2. The General Aggregate Limit is the most we will pay for the sum of: a. Medical expenses under Coverage C; b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard"; c. Damages under Coverage B; d. Voluntary "property damage" payments under Coverage D; e. Care, Custody or Control damages under Coverage E.; and f. Lost Key Coverage under Coverage H. 2. Paragraph 5. is replaced with the following: 5. Subject to Paragraph 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for the sum of: a. Damages under Coverage A; b. Medical expenses under Coverage C; c. Voluntary "property damage" payments under Coverage D; d. Care, Custody or Control damages under Coverage E; e. Limited Product Withdrawal Expense under Coverage F; f. Contractors Errors and Omissions under Coverage G.; and, g. Lost Key Coverage under Coverage H. because of all "bodily injury" and "property damage" arising out of any one "occurrence". 3. Paragraph 6. is replaced with the following: CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 11 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) 6. Subject to Paragraph 5. above the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage by fire or explosion, while rented to you or temporarily occupied by you with permission of the owner. The Damage to Premises Rented to You Limit is the higher of the Each Occurrence Limit shown in the Declarations or the amount shown in the Declarations as Damage To Premises Rented To You Limit. 4. Paragraph 7. is replaced with the following: 7. Subject to Paragraph 5. above, the higher of $10,000 or the Medical Expense Limit shown in the Declarations is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person. 5. Paragraph 8. is added as follows: 8. Subject to Paragraph 5. above, the most we will pay under Coverage D. Voluntary Property Damage for loss arising out of any one 'occurrence" is $1,500. The most we will pay in any one -policy period, regardless of the number of claims made or suits brought, is $3,000. 6. Paragraph 9. is added as follows: 9. Subject to Paragraph 5. above, the most we will pay under Coverage E. Care, Custody or Control for "property damage" arising out of any one 'occurrence" is $1,000, The most we will pay in any one -policy period, regardless of the number of claims made or suits brought, is $5,000. 7. Paragraph 10. is added as follows: 10. Subject to Paragraph 5. above, the most we will pay under Coverage F. Limited Product Withdrawal Expense for "product withdrawal expenses" in any one -policy period, regardless of the number of insureds, "product withdrawals" initiated or number of "your products" withdrawn is $10,000. 8. Paragraph 11. is added as follows: 11. Subject to Paragraph 5. above, the most we will pay under Coverage G. Contractors Errors and Omissions for damage in any one -policy period, regardless of the number of insureds, claims or "suits" brought, or persons or organizations making claim or bringing "suits" is $10,000. For errors in contract or job specifications or in recommendations of products or materials to be used, this policy will not pay for additional costs of products and materials to be used that would not have been incurred had the correct recommendations or specifications been made. 9. Paragraph 12. is added as follows: 12. Subject to Paragraph 5. above, the most we will pay under Coverage H., Lost Key Coverage for damages arising out of any one occurrence is $50,000. 10. Paragraph 13. is added as follows: 13. The General Aggregate Limit applies separately to: a. Each of your projects away from premises owned by or rented to you; or b. Each "location" owned by or rented to you. "Location" as used in this paragraph means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. 11. Paragraph 14. is added as follows: 14. With respect to the insurance afforded to any additional insured provided coverage under this endorsement: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 12 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) a. Required by the contract or agreement; or b. Available under the applicable Limits of Insurance; whichever is less. This endorsement shall not increase the applicable Limits of Insurance. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: 1. Subparagraph 2.a. of Duties In The Event Of Occurrence, Offense, Claim, or Suit is replaced with the following: a. You must see to it that we are notified as soon as practicable of an 'occurrence" or an offense which may result in a claim. This requirement applies only when the "occurrence" or offense is known to the following: (1) An individual who is the sole owner; (2) A partner, if you are a partnership or joint venture; (3) An "executive officer" or insurance manager, if you are a corporation; (4) A manager, if you are a limited liability company; (5) A person or organization having proper temporary custody of your property if you die; (6) The legal representative of you if you die; or (7) A person (other than an "employee") or an organization while acting as your real estate manager. To the extent possible, notice should include: (1) How, when and where the 'occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the 'occurrence" or offense. 2. The following is added to Subparagraph 2.b. of Duties In The Event Of Occurrence, Offense, Claim, or Suit: The requirement in 2.b.applies only when the 'occurrence" or offense is known to the following: (1) An individual who is the sole owner; (2) A partner or insurance manager, if you are a partnership or joint venture; (3) An "executive officer" or insurance manager, if you are a corporation; (4) A manager or insurance manager, if you are a limited liability company; (5) Your officials, trustees, board members or insurance manager, if you are a not -for -profit organization; (6) A person or organization having proper temporary custody of your property if you die; (7) The legal representative of you if you die; or (8) A person (other than an "employee") or an organization while acting as your real estate manager. 3. The following is added to paragraph 2. of Duties in the Event of Occurrence, Offense, Claim or Suit: e. If you report an 'occurrence" to your workers compensation carrier that develops into a liability claim for which coverage is provided by the Coverage Form, failure to report such an `occurrence" to us at the time of the 'occurrence" shall not be deemed a violation of paragraphs a., b., and c. above. However, you shall give written notice of this `occurrence" to us as soon as you become aware that this `occurrence" may be a liability claim rather than a workers compensation claim. CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 13 of 14 Copyright 2020 FCCI Insurance Group QUOTE COMMERCIAL GENERAL LIABILITY CGL 088 (02 21) 4. Paragraph 6. is replaced with the following: 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. Any error or omission in the description of, or failure to completely describe or disclose any premises, operations or products intended to be covered by the Coverage Form will not invalidate or affect coverage for those premises, operations or products, provided such error or omission or failure to completely describe or disclose premises, operations or products was not intentional. You must report such error or omission to us as soon as practicable after its discovery. However, this provision does not affect our right to collect additional premium charges or exercise our right of cancellation or nonrenewal. 5. The following is added to paragraph 8. Transfer Of Rights Of Recovery Against Others To Us: We waive any right of recovery against any person or organization, because of any payment we make under this Coverage Part, to whom the insured has waived its right of recovery in a written contract or agreement. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person or organization prior to loss. 6. Paragraph 10. is added as follows: 10. Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in the applicable state(s). CGL 088 (02 21) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 14 of 14 Copyright 2020 FCCI Insurance Group QUOTE Policy #CPP100051064 COMMERCIAL GENERAL LIABILITY CG 20 01 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. © Insurance Services Office, Inc., 2018 Page 1 of 1 Insured Copy POLICY NUMBER: CA100051065 AUTO FIRST CHOICE COVERAGE ENDORSEMENT TABLE OF CONTENTS DESCRIPTION PAGE AirbagCoverage........................................................................................................................................................3 Auto Loan/Lease Gap Coverage...............................................................................................................................3 BroadForm Insured...................................................................................................................................................1 Concealment, Misrepresentation or Fraud................................................................................................................4 Deductible..................................................................................................................................................................3 Duties in the Event of Accident, Claim, Suit or Loss.................................................................................................4 FellowEmployee.......................................................................................................................................................2 Fire Department Service Charge...............................................................................................................................2 Other Insurance for Hired Auto Physical Damage Coverage...................................................................................4 Lossof Earnings........................................................................................................................................................2 Lossof Use Expenses...............................................................................................................................................2 SupplementaryPayments.........................................................................................................................................2 Transfer of Rights of Recovery against Others to Us...............................................................................................4 Transportation Expenses..........................................................................................................................................2 Policy #CA100051065 COMMERCIAL AUTO CAU 058 (10 22) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO FIRST CHOICE COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM NOTE: The following are additions, replacements and amendments to the Business Auto Coverage Form, and will apply unless excluded by separate endorsement(s) to the Business Auto Coverage Form. With respect to coverages provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by this endorsement. The Business Auto Coverage Form is amended as follows: SECTION II — COVERED AUTOS LIABILITY COVERAGE is amended as follows: A. Paragraph 1. Who Is An Insured in section A. Coverage is amended by the addition of the following: d. Any legally incorporated subsidiary of yours in which you own more than 50% of the voting stock on the effective date of this coverage form. However, "insured" does not include any subsidiary that is an "insured" under any other liability policy or would be an "insured" under such a policy but for its termination or the exhaustion of its limits of insurance. In order for such subsidiaries to be considered insured under this policy, you must notify us of such subsidiaries within 60 days of policy effective date. e. Any organization you newly acquire or form during the policy period, other than a partnership or joint venture, and over which you maintain sole ownership or a majority interest. However, coverage under this provision: (1) Does not apply if the organization you acquire or form is an "insured" under another liability policy or would be an "insured" under such a policy but for its termination or the exhaustion of its limits of insurance; (2) Does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and (3) Is afforded only for the first 90 days after you acquire or form the organization or until the end of the policy period, whichever comes first. f. Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an additional insured is an "insured" for Liability Coverage, but only for damages to which this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section II. g. Any "employee" of yours using: (1) a covered "auto" you do not own, hire or borrow, or a covered "auto" not owned by an "employee" or a member of his or her household, while performing duties related to the conduct of your business or your personal affairs; or (2) an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. However, your "employee" does not qualify as an insured under this paragraph (2) while using a covered "auto" rented from you or from any member of the "employee's" household h. Your members, if you are a limited liability company, while using a covered "auto" you do not own, hire or borrow, while performing duties related to the conduct of your business or your personal affairs. CAU 058 (10 22) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 1 of 4 Copyright 2021 FCC[ Insurance Group COMMERCIAL AUTO CAU 058 (10 22) B. Paragraphs (2) and (4) under section 2. Coverage Extensions, a. Supplementary Payments are deleted and replaced by the following: (2) Up to $3,000 for cost of bail bonds (including bonds for related traffic violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" solely at our request, including actual loss of earnings up to $500 a day because of time off from work. C. Paragraph 5. under section B. Exclusions is deleted and replaced by the following: 5. Fellow Employee "Bodily injury" to: a. Any fellow "employee" of the "insured" arising out of and in the course of a fellow "employee's" employment or while performing duties related to the conduct of your business. However, this exclusion does not apply to your "employees" that are officers or managers if the "bodily injury" results from the use of a covered "auto" you own, hire or borrow. Coverage is excess over any other collectible insurance; or b. The spouse, child, parent, brother or sister of that fellow "employee" as a consequence of Paragraph a. above. SECTION III — PHYSICAL DAMAGE COVERAGE is amended as follows: A. Paragraph 4. Coverage Extensions under section A. Coverage is deleted and replaced by the following: 4. Coverage Extensions a. Transportation Expenses We will pay up to $50 per day to a total maximum of $1,500 for temporary transportation expense incurred by you due to covered loss to any covered auto. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes Of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 24 hours after a loss and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". b. Loss of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or agreement. We will pay for loss of use expenses if caused by: (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for hired "autos' (2) Specified Causes of Loss only if the Declarations indicate that Specified Causes of Loss Coverage is provided for hired "autos"; or (3) Collision only if the Declarations indicate that Collision Coverage is provided for hired "autos". However, the most we will pay for any expenses for loss of use to any one vehicle is $75 per day, to a total maximum of $1,500. B. The following is added to paragraph 4. Coverage Extensions under section A. Coverage: c. Fire Department Service Charge When a fire department is called to save or protect a covered "auto", its equipment, its contents, or occupants from a covered cause of loss, we will pay up to $1,000 for your liability for fire department service charges assumed by contractor or agreement prior to loss. No deductible applies to this additional coverage. CAU 058 (10 22) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 2 of 4 Copyright 2021 FCCI Insurance Group COMMERCIAL AUTO CAU 058 (10 22) d. Auto Loan/Lease Gap Coverage The following provisions apply: (1) If a long term leased "auto", under an original lease agreement, is a covered "auto" under this coverage form and the lessor of the covered "auto" is named as an additional insured under this policy, in the event of a total loss to the leased covered "auto", we will pay any unpaid amount due on the lease, less the amount paid under the Physical Damage Coverage Section of the policy; and less any: (a) Overdue lease or loan payments including penalties, interest, or other charges resulting from overdue payments at the time of the "loss"; (b) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not refunded by the lessor; (d) Costs for extended warranties, Credit Life Insurance, Health Accident or Disability Insurance purchased with the loan or lease; and (e) Carry-over balances from previous loans or leases. (2) If an owned "auto" is a covered "auto' under this coverage form and the loss payee of the covered "auto' is named a loss payee under this policy, in the event of a total loss to the covered "auto', we will pay any unpaid amount due on the loan, less the amount paid under the Physical Damage Coverage Section of the policy; and less any; (a) Overdue loan payments at the time of the "loss"; (b) Costs for extended warranties, Credit Life Insurance, Health Accident or Disability Insurance purchased with the loan; and (c) Carry-over balances from previous loans. C. Paragraph 3. under section B. Exclusions is deleted and replaced by the following: 3. We will not pay for "loss" due and confined to: a. Wear and tear, freezing, mechanical or electrical breakdown b. Blowouts, punctures or other road damage to tires This exclusion does not apply to such "loss" resulting from the total theft of a covered "auto'. However, this exclusion does not include the discharge of an airbag in a covered "auto' you own that inflates due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b and A.1.c.but only: a. If that "auto' is a covered "auto' for Comprehensive Coverage under this policy; b. The airbags are not covered under any warranty; and c. The airbags were not intentionally inflated We will pay up to a maximum of $1,000 for any one "loss". D. Section D. Deductible is deleted and replaced by the following: D. Deductible For each covered "auto', our obligation to pay for, repair, return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Declarations prior to the application of the Limit of Insurance provided that: 1. The Comprehensive or Specified Causes of Loss Coverage deductible applies only to "loss" caused by: a. Theft or mischief or vandalism; or b. All perils. CAU 058 (10 22) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 3 of 4 Copyright 2021 FCCI Insurance Group COMMERCIAL AUTO CAU 058 (10 22) 2. Regardless of the number of covered "autos" damaged or stolen, the maximum deductible applicable for all "loss" in any one event caused by: a. Theft or mischief or vandalism; or b. All perils; will be equal to five times the highest deductible applicable to any one covered "auto" on the Policy for Comprehensive or Specified Causes of Loss Coverage. The application of the highest deductible used to calculate the maximum deductible will be made regardless of which covered "autos" were damaged or stolen in the "loss". 3. Any Comprehensive Coverage deductible shown in the Declarations does not apply to: a. "Loss" arising out of theft of your vehicle if your vehicle is equipped with an active GPS tracking system. b. Glass damage if repaired rather than replaced. SECTION IV — BUSINESS AUTO CONDITIONS is amended as follows: A. The following is added to paragraph a. under section A. Loss Conditions, 2. Duties in the Event of Accident, Claim, Suit or Loss: This duty applies when the "accident", claim, "suit" or "loss" is first known to: (a) You, if you are an individual; (b) A partner, if you are a partnership; (c) An executive officer or insurance manager, if you are a corporation; or (d) A member or manager, if you are a limited liability company. B. Condition 5. Transfer of Rights of Recovery against Others to Us under section A. Loss Conditions is deleted and replaced by the following: 5. Transfer of Rights of Recovery against Others to Us If a person or organization to or for whom we make payment under this coverage form has rights to recover damages from another, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. However, if the insured has waived rights to recover through a written contract, or if your work was commenced under a letter of intent or work order, subject to a subsequent reduction in writing of such a waiver with customers whose customary contracts require a waiver, we waive any right of recovery we may have under this coverage form. C. The following is added to Condition 2. Concealment, Misrepresentation or Fraud under section B. General Conditions: However, if you unintentionally fail to disclose any hazards at the inception of your policy, we will not deny coverage under this coverage form because of such failure. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. D. Paragraph b. of Condition 5. Other Insurance under section B. General Conditions is deleted and replaced by the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own; (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto", nor is any "auto" you hire from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. CAU 058 (10 22) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 4 of 4 Copyright 2021 FCCI Insurance Group Policy #CA100051065 COMMERCIAL AUTOMOBILE CAU 082 (01 15) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTOMATIC INSURED - BUSINESS AUTO POLICY PRIMARY/NON-CONTRIBUTING WHEN REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM This endorsement is subject to the terms, conditions, exclusions and any other provisions of the BUSINESS AUTO COVERAGE FORM or any endorsement attached thereto unless changes or additions are indicated below. For the purpose of this endorsement, Section II.A.1. Who Is An Insured is amended by adding the following: 1. Any person or organization when you and such person have agreed in writing in a contract signed and executed by you prior to the loss for which coverage is sought, that such person or organization be added as an "insured" on your auto policy. Such person or organization shall be an "insured" to the extent your negligent actions or omissions impose liability on such "insured" without fault on its part. 2. This insurance is primary and non-contributory to other liability coverages of the person or organization being added to this policy as an "insured" when so required in a written contract or agreement that is executed prior to the loss for which coverage is sought. CAU 082 (01 15) Includes copyrighted material of the Insurance Services Office, Inc., with its permission. Page 1 of 1 Copyright 2015 FCCI Insurance Group. t --X t uuo WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 04 B EMPLOYERS LIABILITY POLICY Insured copy TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization (X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: All Texas operations 3. Premium: The premium charge for this endorsement shall be 2.00 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: Included, see Information Page This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 8/12/23 at 12:01 a.m. standard time, forms a part of: Policy no. 0002051085 of Texas Mutual Insurance Company effective on 8/12/23 Issued to: WILLIAM J SCHULTZ INC DBA: CIRCLE C CONSTRUCTION COMPANY This is not a bill NCCI Carrier Code: 29939 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 QVr6t6t, 044J-1 Authorized representative 8/11 /23 WC420304B