HomeMy WebLinkAboutContract 59064-R1CITY OF FORT WORTH
RENEWAL OF AGREEMENT
CSC No. 59064-R1
WHEREAS, this First Renewal of Agreement is between the City of Fort Worth,
("CITY"), and William J. Schultz, Inc. dba Circle C Construction Company
("CONTRACTOR"); and
WHEREAS, CITY and CONTRACTOR entered into that certain Original Agreement
(City Secretary #59064; M&C 23-0130) for Water Main Replacement Contract 2022; and
WHEREAS, M&C 23-0130 authorized up to two 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 24-1138.
NOW, THEREFORE, it is agreed by the CITY and CONTRACTOR as follows:
Article I
The Original Agreement, as amended, 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 Ill
All other provisions of the Original Agreement, as amended, shall remain in full force
and effect. First Renewal of Agreement Circle C Construction Company City Project No. l04265 Water Main Replacement Contract 2022 City Secretary No. 59064 Page I of2
EXECUTED and EFFECTIVE as of the date subscribed by the City's designated
Assistant City Manager.
APPROVED:
City of Fort Worth
William Johnson
Assistant City Manager
DATE: 02/14/2025
APPROVAL RECOMMENDED:
Ch��2�fc�
Ch.tis Harder, P .E.
Director, Water Department
William J. Schultz, Inc. dba
Circle C Constructoin Company
�q J'cf✓dL,
Teresa S. Skelly d
President
APPROVED AS TO FORM AND LEGALITY: M&C: 23-0130(auth.); 24-1138(Funding)
Date: 12/10/2024
Douglas Black (Feb 13, 2025 17:56 CST)
Douglas W. Black
Senior Assistant City Attorney
ATTEST: �A�
Jannette S. Goodall
City Secretary
Contract Compliance Manager:
Form 1295: 2024-1232995
By signing, I acknowledge that I am the person responsible for the monitoring and
administration of this contract, including ensuring all pe1formance and reporting
requ· ements. First Renewal of Agreement Circle C Construction Company City Project No. 104265 Water Main Replacement Contract 2022 City Secretary No, 59064 Pagc2 of2
CITY COUNCIL AGENDA
Create New From This M&C
DATE: 12/10/2024 REFERENCE �*M&C 24- LOG NAME: 60WMAINREPL2022R1-
NO.: 1138 CIRCLEC
CODE: C TYPE: CONSENT PUBLIC NO
HEARING:
SUBJECT: (ALL) Adopt Appropriation Ordinance in the Amount of $1,300,000.00 to Fund the First
Renewal with William J. Schultz, Inc. dba Circle C Construction Company, for Water Main
Replacement Contract 2022 and to Effect a Portion of Water's Contribution to the Fiscal
Years 2025-2029 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 Fund in the amount of
$1,300,000.00, transferred from available PAYGO funds within the Water and Sewer Fund, for the
purpose of funding the First Renewal of the Miscellaneous Water Main Replacements Contract 2022
project (City Project No. 104265) and to effect a portion of Water's contribution to the Fiscal Years
2025-2029 Capital Improvement Program.
DISCUSSION:
On 02/14/2023, Mayor and Council Communication (M&C) 23-0130, the City Council authorized
execution of a contract in the amount of $1,000,000.00, for the Water Main Replacements Contract
2022 (City Secretary Contract No. 59064) and provided for the option of two renewals.
The City and the contractor desire to exercise the first renewal of the contract in the amount of
$1,000,000.00. This M&C will appropriate the funding of the first renewal, plus staff costs.
The work to be performed under this contract consists of extending, replacing and/or relocating water
mains, service lines, and other pertinent construction required to replace existing water mains or as
required to provide water service to individual customer or developers. While funding for this project
comes from the Water and Sewer Capital Projects Fund, the Water Department issues work orders to
the contractor after payment of applicable estimated costs by the customer and/or developer.
In addition to the contract amount, $300,000.00 is required for project management, material testing,
inspection, and real property acquisition.
It is the practice of the Water Department to appropriate its CIP plan throughout the Fiscal Year (FY),
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 2025-2029 Capital Improvement
Program, as follows:
This project will have no impact on the Water DepartmenYs operation budget when completed.
60WMAINREPL2022R1-CIRCLEC
Budget
Capital Revised
Fund Project FY2025 CIP Authority Change FY2025
Name Name Appropriations (Increase/ gud et
Decrease) g
56002 - 104265
W&S ' MISC
Ca ital 2�22 $0.00 This M&C $1,300,000.00 $1,300,000.00
Pro ects WATER
Fund MAIN
REPL
Funding is budgeted in the Transfer to Water/Sewer account of the Water and Sewer operating
budget for the purpose of funding the Water Main Replacements Contract 2022.
FY2025 — Water PAYGO Appropriations per City Ordinance 27107-09-2024
FY2025
Amended
FY2025 PayGo YTD PayGo
Original ��ncludes any Approved
Adopted council for/Moved to This M&C
PayGo actions Capital Projects
subsequent to
budget
adoption)
FY2025
Remaining
PayGo
Balance
FORT �'�'QRTI I
-���--
$92,597,771.00 $92,597,771.00 ($15,552,949.00) ($1,300,000.00) $75,744,822.00
Appropriations for Water Main Replacements Contract 2022 for various locations throughout the City
are depicted below�
Fund Existing Additional project Total*
Appropriations Appropriations
W&S Capital
Project Fund $1,300,000.00 $1,300,000.00 $2,600,000.00
56002
Project Total $1,300,000.00 $1,300,000.00 $2,600,000.00
'Numbers rounded for presentation purposes.
This project will have no impact on the Water DepartmenYs operating budget when completed.
Construction is expected to start January 2025 and be completed by January 2026 or when the
contract amount is exhausted, whichever occurs later.
Business Equity: William J. Schultz, Inc., dba Circle C Construction Co. agrees to maintain its initial
M/WBE commitment of 12 percent that it made on the original contract and extend and maintain that
same M/WBE commitment of 12 percent to this first renewal. Therefore William J. Schultz Inc., dba
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.
This project is located in ALL COUNCIL DISTRICTS.
FISCAL INFORMATION/CERTIFICATION:
The Director of Finance certifies that funds are currently available in the Water & Sewer 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 the MISC 2022 WATER MAIN
REPL project to support the approval of the above recommendation and execution of the contract
renewal. Prior to any expenditures being incurred, the Water Department has the responsibility of
verifying the availability of funds.
Fund Department
ID
Fund Department
ID
Account Project Program Activity Budget Reference #
ID Year (Chartfield 7
Account Project Program Activity Budget Reference #
ID Year (Chartfield 7
Submitted for City Manager's Office by_
Originating Department Head:
Additional Information Contact:
William Johnson (5806)
Chris Harder (5020)
Scott Lafferty (8213)
Amount
Amount
ATTACHMENTS
104265 Water Main Replacements Contract 2022, First Renewal APC Form Renewal 1 Signed RL.pdf (CFW Internal)
60WMAINREPL2022R1-CIRCLEC FID TABLE (WCF 11.1124).XLSX (CFW Internal)
60WMAINREPL2022R1-CIRCLEC funds avail.docx (CFW Internal)
ORD.APP 60WMAINREPL2022R1-CIRCLEC 56002 A025(r1)_(1).docx (Public)
PBS CPN 104265.pdf (CFW Internal)
SAM.gov search Circle C Construction.docx (CFW Internal)
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DOGI I:3-1
PERPORMANt;I: BOND
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BOND NO. 101165224
SL+;CTIUN Ot) 61 13
PERFOItMl�NC1; BOND
THE STATE OF TEXAS §
� KNOW ALL I3Y TH�SE PIt�S�NTS:
COUNTY OI' TARR.ANT §
Thati 4Vc, William J. Schultz, Ina dba Circle C Construction Comp�uy _, lctlown as
"Prii�cipal" hcrein and Mercliants Bondiiig Cpinpany, (Mu_tt�al� _ _— __. __ _ _> � corpocate
surety(sureties, if more th.�n one) duly authorized to do I�usiness in the State of Te�as, l:no«m as
11 "Surcty" hercin (whether one or more), are held and �rmly bound unto the City of Fort Woi�th, a
12 municipal corporation c��eated pursuant to the laws of Texas, known as "City" herein, in the penal
13 sum of, One Million _ Dollars ($ 1,000,000,00�, lawful money
14 of the United States, to be paid in �ort Worth, Tarrant County, Texas for the payment of which
15
16
sum well aud truly to be made, we bind ourselves, our heirs, executo�s, administrators, successors
and assigns, jointly and severally, tii�inly by these presents.
17 WHEREA5, the Principal has entered into a certain written contract with the City
18 awarded tl�e day of ��'ei� ������j�� , 20 _____, which Contt�act is hereby referred to and
19 made a part hereof f�r all Z}uiposes as if' fully set forth hcrein, to fi.�rnish all materials, equipment
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lal�or and other accessoc�ies defined by law, in the prosecution of the Worl<, including any Cl�an�;e
Ordei•s, as provided for in said Contract designated as First Renewal , Water Main
Replacements Contract 2022; City Project No. 1042G5
NOW, TH�REFORE, the condition of this obligation is such that if the said Yrincipal
sha11 faitliiuity perform it obligatiotis under the Contract and shall in all respects duly arid
faithfully perfo►•�n tt�e Work, including Change Orders, uncier the Contract, aceording to the plaris,
specifieations, nnd contract documents therein referred to, acid as well during atty period of
extension of the Coniract that may l�e grantcd on tE�e part ofthe City, then this obligalion slxall be
�nd become null and void, c�therwise to rernaiii iii full foi�ce and effect,
PROVIDED FURTH�R, that if any legal action be filed on this Bond, venue shal] ]ie in
Tarrant County, T'exas or the Unitccl States District Cow-t for the Not•tllcrn District c�f `i"exas, Fort
31 Worth llivision.
C]'I'Y OF FORT WOR'fH
S"f��NUARD CONSTRiJCTIOy SPECIFICA"I'ION DOCIiMENTS
Revised Ju(}� 1, 2011
MW[t2022
City Project No. 104265
First Renewal
00 G I 13 - 2
t'13RPOlCt�4ANl'I; IiONU
Ya�;c'l of2
1 'I'his boncl is m��de �nd executed i�i cornpliance tivitll tlle provisio�is of Cl�aptei• 2253 of t:lie
2 'I'exas Uovei•nmeiit Code, as �me�ided, and all Iiabilities an this bo�ld sl�all be detei�mit�ecl it�
3 accordance �vith the provisions of said statue.
4 IN WI'I'NESS WHEI2�OF, the Principal and tlie Surety l�ave SIGNED and SEAL�D
5 this instrument by duly authoi•ized agents and officei•s on this the
6 December _, 20. 24
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/+5
A"I"I'ES"I':
_� u A�.�� �'_�_��,�, cnpj,,
(Principal) Seci'etary Michele S. La � rd
Witness as to Principal
�i��� �
_.._. _._...--- ---..........._.. ___ _.. ._
Witness as to Surety John A. Mil r
lOth day of
PR[NCIPAL;
William J. Schultz, Inc. dba
Circle C Conshuction Company
BY: �� a `S�S'�
Signattn�e
_Teresa S _Ske�, President____.___ __ _ __._ _
- — - -- --
Name and Title
tiddress:
500 W. Tranunell
_F.�it..W._.o�-th,...TX_ZG.l_44 —...........__......_
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�'/%I. L����.I.,I�
. �
_Sheryl._A._Klutts, Attorne.y.-iu-Fact__..___..___._,
N�mc aud Titic
Addi•ess:
6700_ W e sto���n_Pa i•h�va�..__...._._......._........,
_Wesi.D.es.Moines,_ IA... 502G6-7754
Telephone Number: _(800) 678-8171
��Note: If signed by an afticer of the S�n•ety Company, there n�ust be on file a certified exlract
from the by-laws showing that tt�is person has authority to sign such obligation. I#'
Surcty's ph��sical address is differetrt fi�om its maiiitib address, botl� must be provideci.
The date of flle boi�d shall not be prior to tl�e date the Contract is a�varded.
C1TY OF ('OR"I' WOP�l'H
S"I'ANDAitll CONS'I'RLJCTION SPLiCIFICA7'ION llOCUMGNTS
Reviscd Jtdy l, 2011
MWR2022
City Project No. 104265
First Rene�val
MER�HANT�S��
B C7 N D I N G C O 1v1 P A N Y-,.,
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 lowa, 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 April 27, 2024 and adopted by the Board of
Directors of Merchants National Bonding, Inc., on October 16, 2015 and amended on April 27, 2024.
"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 consenti ng 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 Commonwealih 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 2gth day of July � 2024 •
,......
,�•.•�10Nq •.'+. ."•• � ' •`'. MERCHANTS BONDING COMPANY (MUTUAL)
; O�A,..p•O.. ��.,. :��y��N�� ��SjJp'.� MERCHANTS NATIONAL BONDING, INC.
���.,��R IQ,��,, � r ��. �0'�, ,9���y�� s dlb/a MERCHANTS NATIONAL INDEMNITY COMPANY
,2: 2 c�': p: + �i: 2� re+ ;.
:a: 'O' �: .r-.,... -o- c� ' ��
:z�. 2003 ;'��; :d� y�33 •'�; sy �
-t�'• .��. ��y.
rsd�> �'� : •. d%. •� .
��.''. ' "�.�?�� ��'i�J,/ ���� ����a President
STATEOFIOWA •�'.�a• �T ������, ����»��+��
COUNTY OF DALLAS ss. �""'�
On this 2gth day of July 2024 , 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. �.-.--'_-��
�'A< Penni Miller �` �
� � ps� Commission Number 787952 �,4 — ` `
• � • My Commissian Expires `� � � C� �J {
IOWP January20, 2027 �-�`"�-�-Y
Notary Public
(Expiration of notary's commission does not invalidate this instrument)
I, Elisabeth Sandersfeld, 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 loth day of December , 2024 ,
' ���...��...,,� � .+'"""•.
�.•P�10Nq�'., .•���G,Cp,h*,
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POA 0018 (6/24) •�'••"'•'••`•�•• ••• �'•' �
00(174-I
PAYA11!N'C F30ND
Page I of 2
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THE STAT� OF T�XAS
COUNTY OF 'I'ARRANT
BOND VO. 1O11G5224
SI�,C`I'ION 00 Gl 14
PAYMI:N'I' BOND
�
� I�NOW AI,L I3Y THI+:Sr l'RI;SI'.NTS:
�
R That we, William T Schultz, Inc. dUa Circle C Constniction Com���i� __ lcnown as
____ - --..._ __,._ _ _....-------- .�
9 "Priticipal" 11ez'ein, and Merchants Bondiug Company (Muhial) , a
10 coipoz•ate surety (sureties), duly authorized to do business in the St�ite of `I"e�:as, Icnown as
11 "Suz•ety" herein (whethei• one or mare), are held �nd iir�t�ly bound �into the City of I�oi�t Worth, a
12 municipal coeporation created purs'uant to the laws of the State of Texas, laaowu �s "City" herein,
23 in the penal sum of One Million _ Dollars ($ I,U00,000=00_), lawi�ul
l4 money of i}ie Uiiited Staies, to be paid in I�ai•t WortIi, 'I`ai•c•ant Coutlty, Texas, far tlie paymetlt of
15
16
��hich sum well a�id tcul.y be made, we biud ourselves, oui• lleirs, executoi•s, aclministrators,
successors and assigns, jointly and severally, firmly by these presents:
17 WHER�AS, Principal has entered into a certain written Contract with City, awat•ded the
l8 _ day of ___ �� , 20_____v, �i�l�ich Contract is l�ereby refecred to and
19 tnade a part hereof foi• al( purposes as if fiilly set forth hcrein, to fiunish aIi materials, equipment,
20 labor atid other accessoi•ies as defined by law, in the prosecution o�'the VJorlc as pi•ovided fai• in
21
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said Contract a�id designated as F'irst Renewal, Watei� M:tizi Re�lacemerits Cotit�•act 2022;
City Yro,ject No. 104265
NOW, TIiT,REFOR�, TIIE CONDITION OP THIS OBLIGATION is such that if
Principat sl�all pay al( rrtorlies awing to any (and all) ��ayment bond bene�ciary (as defined it1
Ctaapter 2253 of the Texas Gav�rnment Cade, as amended) in the p�•osecution of the �rork under
the Contract, then this obligatiot� shall be and become null and void; othe�•wise to remain in full
ft�ree and effect.
'1'his bond is madc and execi.ited in compliarice witti the pr•ovisions of Chapter 2253 of the
T'exas Govet�nirie�it Code, as amended, attd all liabilities on this hond shall be determined in
accordatic;e �vith the pi•ovisions of said statute.
CITY OF POR'I' WORTH MWR2022
S'I'ANDARI] CONSTRUC'I'ION SP�:CIP]CATION DOCUMF.,N'TS City Projeci No. i 0�l265
Reviscd July t, 20 t i First Re�te�val
00 Gl l4 � 2
PAY�4EN1' LiUNL)
Y<tec 2 of "L
IN WITN�SS WI�REOF, the Princi�al and Sui•ety have eacl� SIGNED and S�ALED
? this instrument hy ditl�� authorized agents an� officcrs on �i�is the �nrh day of
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4
,—_..-_—__DecezlLl�_e[---_ �
2 24.
PRINCIPAI,:
Willi�m J. Schultz Iuc. dba
_ -- --- _..— .
Cit_cle C C,onshuc.tioii_Coin�any _,
_ ____,
�Y: .1.��_ _�� �s-s�
fi i�;nature �
TereSa S. Ske11y,..President ,, y___
---_
Naoie and 'I'itic
�lddress:
ATTEST:
_._�_�ti�.`,:� ��.,
_ _.___ � _�-.
(Pt�incipal} Secretacy Michele S. nkfard
---- ----_---....._.... _ _ . _ _ _
Witness as to Principal
ATTEST:
(Surety) Secretar
�����JV 6i .
__ _ _.----- . _ — _.._._..... _ t. .x._ ._.._._.
Witness as lo Surety John A. i le�
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50� W. Trammell
Fort Wortli, TX 76140
SURETY;
Me.x�clia ts B�n Com �1n Mutu )
}3Y: J � _
Si�;natuce
Sheryl A. Klutts, Attoniey-in-Fact
_ __.____.
Natnc and `I'itle
Address;
-- - _ —
6700 Westown Parkway _
_ ___
West Des_Mc�ines, IA 5�2fif,�-7754
'T'elephone Numbe�•; �8001 C7R-8171
Note: If signed by an officer of the Surety, there must be on file a cet�tified extt�act frotn tlie
hylaws showing that this person has authority to sign such obligation. lf Surety's physical
addt�ess is different fi•om its mailing address, both must be provided.
'I'he clate of the bond shall tiot be prior to the; date tl�►e Cont�•act is awarded.
END OF SECTION
CITY OF FORT WORTH MWR2022
STANDARD CONSTRUCI'fON SPECIPICATION DOCUMENTS City Project No. IOA265
Revised July 1, 201I �irst Rene�val
MERC ��.ANT�S��
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 lowa, 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 April 27, 2024 and adopted by the Board of
Directors of Merchants National Bonding, Inc., on October 16, 2015 and amended on April 27, 2024.
"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 o bligations 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 consenti ng 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 Zgth day of July � 2024 •
••.��10Nq •''� .. •• � '•'. MERCHANTS BONDING COMPANY (MUTUAL)
�.`'�A . • � �+� .•�0��•���Q�j,p.� MERCHANTS NATIONAL BONDING, INC.
�`Gj .•'pKp�Rq• o'. �'q��.•����R,�.�;S�y•� d/b/a MERCHANTS NATIONAL INDEMNITY COMPANY
e2��'� -o- �v�dr :�`�'..;--'�' -o- �'�'��
;v�: 2003 ,:,,�i,� : �,`•.� �933 �•��; By �/J/� �
J- • � , � `v. j' c�/�r ��
i V''. : ` ; � ' {� • sar/i /
O�J��••.. ..•.�a�J '.d.��•�,...�����•� President
STATE OF I�WA ���������j���������� `��� � y?� ����
COUNTY OF DALLAS ss.
On this 2gth day of July 2024 , 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. �-----�"'----��
�'->. �- �
�p,R�A� s Penni Miller (
Z� o v Commission iVumber 787952 , — l`~'`
• • My Commission Expires �� � � � �
tOWP January20,2027 �`'"'--'�-�'�•
Notary Public
(Expiration of notary's commission does not invalidate this instrument)
I, Elisabeth Sandersfeld, Secretary of MERCHANTS 80NDING 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 1 Oth day of December , 2024 .
' ���,��.....,,� � . •"""•.
.•�p��UfVA�'�. •'p�NG.Cp�'•
. �. s �p• �
;�; o�poRq ,o: :�o.o�Po9�.,�yy.
: � • � � •. 2 ; ; � ' c� ,� .�. .
jZr2 -o- ;�o':G- •a-."Z -o- �� �
'_ ' 2003 � Z � y'� ���� '��.`�' � Secretary
�i,,t%�'. .', `�, ": �d' > . 'i,�'a�• •
I�...�j�I���������'': •V��•���'�*y••♦
POA 0018 (6/24) j'
00 GI 19 - 1
MAIN7'F,NANCL BOND
Pnge 1 of 3
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'TI-IT STATE OF 'TI�`,XAS
COUNTY OF TAItI2ANT
BOND NO. 1011(5224
s�cT�iorr oo �r iy
MAINTENI�NCE BOND
§
§ KNOW ALL BY THESE PI2�S�NTS:
§
'I'hat w�, William J. Sc_liult„z,,_Ina �lba Circle C Constnictic�n Comp�uy , lcilowu as
«Pcincipal" herein a�x1.__�vietc]���ts_.�o��d�ng Cc�inpai�...(Mutual)---_ a corporate surc;ty
_ . ____�
(sureties, if n�ore than one} duly authorized to cio business in tl�e State of Texas, l<nown as
11 "Suz�ety" herein (whethec one or more), are held anc) firinly bound unto the City of I�o�•t Worth, a
12 municipal coi•poration ci•eated pursuant to the laws of the State of Texas, lcnown as "City" hei•ein,
13 in the sum of Oaie MiClic>n Dollal•s ($�_ 1 000.�.00 ), lau�ful tnoney of
14 the Uuited States, to be paid in Fort Woi-th, Tarrant Cuunty, Te�as, for payinent of which sum
15 well aild ti•uly be made niito tl�e City and its successoi•s, we biud oursclves, out• l�eirs, execut�rs,
16 admir�istratoi•s, successoi•s and assigns, jointly atid severally, firmly by these presents.
17
1S WHI;R.�AS, the Principal has entered int� a certain �vritten contract with the City awarded
19 tlie _ day oi� ���'� �' �;�'��'j' 2Q
� , , ��rhich Contract is hereby
20 referred to and a l�lade part hereof for all purposes as if ful ly set forth herein, to furnish all
21 materials, equipment labor and otl�er accessories as defined by law, in the prosecution of the
22 VJoa•k, includirig any Worlc cesultin� fi•om a duly autl�orized Cl�ange C)i•der (co(lectively hereiti,
23 tlle "Work") as pcovided for in said conti•act ai�d designated as l�irst Renewal, Water'Vlai►i
?_4 Replacements Contract 2022; City Project No. 104265; and
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WI�ER�AS, Pr•incipal binds itself to use such maierials and to so construct the Work in
accordance with the pJans, specifications and Contract Documeuts that the Work is ai�d will
remain fi•ee from defects in materials or workmanship for and during the period of two (2) years
after the date of Final Acceptance of the Work by the City ("Maintenance Pei•iod"); and
WHEIttiAS, 1'rincipal l�inds itself to repair or ceconstruct the Work it� wl�c�le or i�� part
upon i•eceiving notice from the City of the iieed tller•efor at any time ��ithin the Maintei�ance
1'eriod.
C1TY OF FOR'I' bVOIt1'31 MVJR2022
S'I'�i�1DARD CONSTRliC7'IO2� SPI:CIF[CATI01� DOCL'1viIs�1TS Ciry Project No. 10�12G5
ftevised July l, 20ll Pirst Rene�val
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MAIN'I'ENANC:� f3U��U
Pagc'1, oi'3
NOW THEI2�FOILE, the condition of this obligation is such tl�at if Pcincipal shall
remedy any defective Work, for which timely notice was provided by City, to a completion
satisfaciot�y� to lhe City, then this obligi�tion sl�ull becoine null 7nd void; otlicrwise to remai�i iii
f�ill fo►�ce and effect.
PROVIDED, HOW�VER, if Principal sha11 iail so �o rep�ic or rec�msh•uct any time(y
noticecl defective �Vork, it is agreed that tlle City inay cause any and aIl such defective Worl: to
be repaii'ed and;oi• 1•eco�isti�ucted `vitli all associated costs thereof'hc;ing hnrne by tt�e Princ;ipal a�id
the Stu�ety under this Maintenancc; hond; a�id
I'ROVIDED FU:RTHT',R, that if any legal action be iiled on this f3ond, venuc shall lie in
Tari•ant Coluity, 'I'exas o�� the IJt�ited States Distcict C,ourt for tlie No��thern Uistt•ict of'I'esas, I�oi•t
Woi�th Division; and
PR()VIDED FLIit'THER, that this obligation shall be colitinuous in nalui�e anci
successive recoveries may be had hereoz� for successive breac(les,
C1TY OF ['OR'C bVOR'I'I1
S'CAi�DARD CON5IRUC"I'10,1 SPECIF[CrYI'[ON DOCUA9[:N'I'S
Revised J�ity l, 20 t 1
MWR?.01.1,
City Project No. ] 042b5
I�irst Rene�val
OOGt 19-3
NIAIN"1'ENANCE: }3C7N[)
Yagc 3 of 3
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TN WITNL;SS WlI�I2�01+', the Principal aud tl�c Slirety have eac:l� S1G�II�,1� a�id SL;ALED tl�is
instrument by duly autl�nrized aget�ts and officers o�l this thc lOth cla,y of._ Deceinber___ _.
_, 20 24 .
ATTEST:
_ �!Y\u�n.�s.�,S��,n1 ._ .
(Principal) Secretary Michele S. i�
Witness as to Pi�iltcij�al
ATTEST:
{Sur ) Sc rctar
� �
Witness as to Surety Jolin A. Mi er
PItiNCli'AI::
Williain J. Sclmltz, Inc. dba
__—_ __ ___
Cu�:le_.C. Coiistntciion_C:o.uip.any.._..._....._.__...._..___.._�_.
t3Y: �� G7 �c�
_
Signature
Teiesa S. Skelly, President
--__ _
Name a�id Titic
Adclress:
500 W. Trammell
Fn,i Wn,fih TX 7(,140 _ _ _ . _
SURETY;
_ . ..._ __
Mercli�nts___ _ n� ig C�mpany_ uhtal)
B Y:
_ _ . .._ _..... --- r _ _ , w....... --- - .. .. _
Signature '
Sheryl A Klutts, Attorney in-F�ct
__ _ _......__--
Name and Title
Address:
___ . _
6700 Westown.Paik�yay
_
_Wzst Des Moines, IA 50266-7754
Teleplione Number: (800) 678-8171
*NoYe; If signed by an officer of the Sucety Company, there must be on file a certified extract
from the by-laws showing that tliis pei•son has autl�ority to sign such obligation. If
Surety's physical address is different from its mailing address, both must be provided.
Thc date of the bond shall not be prior to tlie date the Contract is awarded.
C1TY OF FORT WORTH
STAI�DATtD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised July 1, 2011
MWR2022
City Project No. 10�1?6S
['irtit Rene�val
M�Rc�r��T�� ��.
BONDING COMPANlt."
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 lowa, 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 April 27, 2024 and adopted by the Board of
Directors of Merchants National Bonding, Inc., on October 16, 2015 and amended on April 27, 2024.
"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 a�xed 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 consenti ng 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 Zgth day of July . 2024 •
.�.....
,••.•�10 Nq ••'•. . • • • � "• •. MERCHANTS BONDING COMPANY (MUTUAL)
: O�Q�.,,p.o.,,� �,�. ��•�Q�N..•�Q/1jA.� MERCHANTS NATIONAL BONDING, INC.
; hy,,��'El IQ,4�� �+ +�O��p,P 0,9�;��y'�� , d/bla MERCHANTS NATIONAL INDEMNITY COMPANY
�Q;� -o- O:�' .i-.;�' -o- ��,_,,, �
:� : 2003 .���; : y � 1933 •��; BY �
�;d• •� ; • �' , 'o:• �'J�
',- . .b� ��a.
STATE OF �O�/VA ••��.� s•• �,'j••���?'' •'��� i i���`��� President
COUNTY OF DALLAS ss. """�
On this Zgth day of July 2024 , 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. �._ �`""'�^�
,,p,'��A�s Penni Miller �'` �
� � � Commission Number 787952 �,5 - ` �`
• • My Commission Expires ``�,_ � p
iOWP January 20, 2027 �-`�.-J`"---•"�j �""�`' �"'---
Notary Public
(Expiration of notary's commission does not invalidate this instrument)
I, Elisabeth Sandersfeld, 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 10th day of December , 2024 .
���...�....,,, �.•---••.
o''p���fVA�''o •'p�'��!.�fl�'•.
:��•'RPO,I� •�p':� ;�O? i�,Pp� 'o�.• �+Il
c �y : GO q>;• 2 : ; ''C�4 �.,; :�.s. :
?Z:2 -o- v:�� �;� r,.; .
. r-..... -o- � .
' _ ' 2003 ; ;,L?; ; y.' � 933 � �' secretary
%v � . +��;. �;a0:'
;i�vj•., ; •����: .� �•. •' 1 :
�..,�ty''•• � ••':���.. �� �'�';r.f ' �L�.
POA 0018 (6/24) """"'�� �"�
MERCHA.I�T�
BONDING COMPANYT�
MERCHANTS [�ONDWG CnMPANY (MUTUAL) • MERCHANTS NATIONAL BONDING, INC.
P.O. Qox 14498 � D[S MOINES, IOWA 50306-3498 �(800) 678-8171 �(515) 243-3854 FAX
Please send all notices of claim on this bond to:
Merchants Bonding Company (Mutual) / Merchants National Bonding, Inc.
P.O. Box 14498
Des Moines, Iowa 50306-3498
(515) 243-8171
(800)678-8171
Physical Address: 6700 Westown Parkway, West Des Moines, Iowa 50266
SUP 0073 TX (2/15)
��
POLICY NUMBER: CPP100051064 COMMERCIAL GENERAL LIABILITY
CGL 121 (02 21)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LE�SEES 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 pertorming 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.
DUOTE
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 contract or 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 "suiY' under this
insurance, and of any claim or "suiY' that does result;
2. Send us copies of all legal papers received in connection with the claim or "suiY', cooperate with us in the
investigation or settlement of the claim or defense against the "suiY', and otherwise comply with all policy
conditions; and
3. Tender the defense and indemnity of any claim or "suiY' 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
Additional Insured 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
Newly Formed 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
Pollcy #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:
"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 Watercra#t
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.
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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
1. 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 "properry 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.
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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
producY' 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.
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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 "defecY' 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 producY', 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".
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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"DefecY' Or A"Product Withdrawal"
(1) You must see to it that we are notified as soon as practicable of any actual, suspected or
threatened "defecY' 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 "defecY' 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 followi�g definitions are added to the Definitions Section:
a. "DefecY' 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 producY' 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) Cosks of transportation, shipping or packaging;
(7) Costs of warehouse or storage space; or
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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 dis;honest, fraudulent, malicious or criminal acfs 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.
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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 pertormed 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.
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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 "suiY', 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 "suiY' 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.
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QUOTE
COMMERCIAL GENERAL LIABILITY
CGL 088 (02 21)
SECTION 1- 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 "suiY', including actual loss of earnings up to $500 a day because of time off from work.
SECTION 11— 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.
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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 producY' 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;
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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
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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
CG20011219
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
CG20011219
(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.
O 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
AutoLoanlLease 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
TransportationExpenses ..........................................................................................................................................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 pertorming 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
Copyrlght 2021 FCCI 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
"accidenY' 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 "accidenY' 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.
�
X utua
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 lhe policy lo which it is attached effective on the inception date of the policy unless a diNerent 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 8/12/24 at 12:01 a.m. standard lime, forms a part of:
Policy no. 0002051085 of Texas Mutual Insurance Company effective on 8/12/24
Issued to: WILLIAM J SCHULTZ INC
DBA: CIRCLE C CONSTRUCTION COMPANY
This is not a bill
NCCI Carrier Code: 29939
.:/ r••� i
�
Authorized representative
8/9/24
PO Box 12058, Austin, TX 78711-2058
1 of 1 texasmutual.com �(800) 859-5995 � Fax (800) 359-0650 WC 42 03 04 B