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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 9080 UTILITY INFRASTRUCTURE SYSTEM IMPROVEMENTS AND REHABILITATION ON-CALLOfficial Purchasing Document Last updated 1/19/2022 AMENDMENT #3 AGREEMENT BETWEEN THE CITY OF FORT COLLINS AND C & L WATER SOLUTIONS, INC. 9080 UTILITY INFRASTRUCTURE IMPROVEMENTS & REHAB ON-CALL This Third Amendment (Amendment #3) is entered into by and between the CITY OF FORT COLLINS (the “City”) and C & L WATER SOLUTIONS, INC. (the “Service Provider”). WHEREAS, the Service Provider and the City entered into an Agreement effective July 20, 2020 (the “Agreement”); and WHEREAS, the Service Provider and the City entered into an Amendment effective August 31, 2022 (the “Agreement”); and WHEREAS, the Service Provider and the City entered into an Amendment effective December 7, 2022 (the “Agreement”); and WHEREAS, Service Provider and the City desire to amend the Agreement to extend the Agreement. NOW, THEREFORE, in consideration of the foregoing recitals and the mutual promises herein contained, the parties agree as follows: 1. The term will be extended for six (6) additional months, June 20, 2023 through December 19, 2023. Except as expressly amended by this Amendment #3, all other terms and conditions of the Agreement shall remain unchanged and in full force and effect. In the event of a conflict between the terms of the Agreement and this Amendment #3, this Amendment #3 shall prevail. IN WITNESS WHEREOF, the parties have executed this Third Amendment the day and year shown. CITY OF FORT COLLINS: By: Gerry Paul Purchasing Director Date: C & L WATER SOLUTIONS, INC.: By: Christopher Larson Chief Operations Officer Date: DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 7/21/20237/24/2023 03/29/2023 Moody Insurance Agency, Inc. 8055 East Tufts Avenue Suite 1000 Denver CO 80237 Moody Insurance (303) 824-6600 (303) 370-0118 certrequest@moodyins.com C & L Water Solutions, Inc. 12249 Mead Way Littleton CO 80125 BITCO General Insurance Corporation 20095 Steadfast Insurance Company 26387 Pinnacol Assurance 41190 23-24 Master A Y CLP3728019 04/01/2023 04/01/2024 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 A CAP3728020 04/01/2023 04/01/2024 1,000,000 A 10,000 CUP3728021 04/01/2023 04/01/2024 5,000,000 5,000,000 C N CAP3728020 04/01/2023 04/01/2024 1,000,000 1,000,000 1,000,000 B Excess Umbrella AEC425049202 04/01/2023 04/01/2024 Excess Limit $5,000,000 in Excess of $5,000,000 RE: City of Fort Collins are included as additional insured on the General Liability policy when required by written contract. City of Fort Collins 700 Wood Street Fort Collins CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 C & L Water Solutions, Inc. 00003188 Moody Insurance Agency, Inc. 25 Certificate of Liability Insurance: Notes ADDITIONAL NAMED INSUREDS JC Construction Equioment, LLC 12525 Jamison Place, LLC Candle Business Ventures, LLC Candle-Utah Business Ventures, LLC PROFESSIONAL / POLLUTION LIABILITY Policy Number: CPP2034446-12 Policy Effective Dates: 4-1-2023 to 4-1-2024 Insurer: Nautilus Insurance Co. (NAIC #17370) Claims Made Policy Aggregate: $5,000,000 Professional Liability Aggregate: $1,000,000 Professional Deductible: $25,000 Pollution Liability Aggregate: $5,000,000 Pollution Deductible: $10,000 CONTRACTORS EQUIPMENT POLICY Policy Number: CLP3728019 Policy Effective Dates: 4-1-2023 to 4-1-2024 Insurer: BITCO General Insurance Corp. (NAIC #20095) Total Insurable Value: $8,621,674 Deductible: $3,000 LEASED / RENTED EQUIPMENT POLICY Policy Number: CLP3728019 Policy Effective Dates: 4-1-2023 to 4-1-2024 Insurer: BITCO General Insurance Corp. (NAIC #20095) Limit: $375,000 Deductible: $1,000 INSTALLATION FLOATER POLICY Policy Number: CLP3728019 Policy Effective Dates: 4-1-2023 to 4-1-2024 Insurer: BITCO General Insurance Corp. (NAIC #20095) Jobsite Limit: $1,000,000 Catastrophe Limit: $1,000,000 Temporary Storage Limit: $1,000,000 In Transit Limit: $1,000,000 Deductible: $1,000 CONTRACTUAL LIABILITY APPLIES PER POLICY TERMS AND CONDITIONS GENERAL LIABILITY GL3085 09/11 form attached includes: Blanket Additional Insured when required by written contract. Blanket Additional Insured Ongoing & Completed Operations when required by written contract. Blanket Primary & Non-Contributory status applies when required by written contract. Blanket Waiver of Subrogation status applies when required by written contract. AUTO LIABILITY AP0401 10/17 form attached includes: Blanket Additional Insured status applies when required by written contract. Blanket Primary & Non-Contributory status applies when required by written contract. Blanket Waiver of Subrogation status applies when required by written contract. WORKER’S COMPENSATION Form attached includes: Blanket Waiver of Subrogation status applies when required by written contract. UMBRELLA POLICY Umbrella Policy is on a follow form basis for underlying insurance coverages: General Liability, Automobile Liability, and Employers Liability. Additional Insured status, including Primary and Non-Contributory status, will follow form when required by written contract. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 C & L Water Solutions, Inc. 00003188 Moody Insurance Agency, Inc. 25 Certificate of Liability Insurance: Notes 1st EXCESS LIABILITY POLICY 1st Excess Liability Policy is on a follow form basis for underlying insurance coverages: Umbrella Policy. **PLEASE NOTE: Hard copies of endorsements will not be mailed. ALL endorsements will only be sent electronically via email. Please send your email address and endorsement request to certrequest@moodyins.com for forms and future emailings** ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 BITCO GENERAL INSURANCE CORPORATION BITCO NATIONAL INSURANCE COMPANY AP-0401 (10/17) -1- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BROADENED COVERAGE - AUTOMOBILES The following modifies insurance provided under: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Co verage Form apply unless modified by this endorsement. 1 - Broad Form Named Insured 11 - Bodily Injury Extension 2 - Automatic Waiver of Subrogation 12 - Hired Auto Physical Damage 3 - Automatic Additional Insured 13 - Enhanced Supplementary Payments 4 - Primary and Noncontributory - Other Insurance Condition 14 - Fellow Employee Coverage for Designated Positions 5 - Unintentional Failure to Disclose Hazards 15 - Physical Damage – Transportation Expenses 6 - Extended Notice of Cancellation, Non-Renewal 16 - Rental Reimbursement Coverage 7 - When We Do Not Renew 17 - Loan/Lease Gap Coverage 8 - Notice of Knowledge of Accident or Loss 18 - Accidental Air Bag Discharge Coverage 9 - Employees as Insured 19 - Glass Repair – Waiver of Deductible 10 - Employee Hired Autos 1. BROAD FORM NAMED INSURED SECTION II. A. 1. - WHO IS AN INSURED - Paragraph d. is added: d. Any organization you newly acquire or form, except for a partnership, joint venture or limited liability company, and over which you maintain majority ownership or interest (51% or more) or for which you have assumed the active management, will qualify as a Named Insured if there is no other similar insurance available to that organization. However, coverage under this provision is only afforded until the end of the policy period or the 12-month anniversary of the policy inception date, whichever is earlier. 2. AUTOMATIC WAIVER OF SUBROGATION Section IV – Business Auto Conditions, Paragraph A.5., Transfer of Rights of Recovery Against Others to Us, is deleted and replaced with the following: a. If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. b. If required by a written contract executed prior to loss, we waive any right of recovery we may have against any person or organization because of payments we make for damages under this coverage form. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 AP-0401 (10/17) -2- 3. AUTOMATIC ADDITIONAL INSURED SECTION II – WHO IS AN INSURED, Paragraph A.1, is amended to include as an "insured" any person or organization who is required by written contract or agreement to be an additional insured on your policy, but only with respect to liability arising out of operations performed by you or on your behalf for the additional insured. 4. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 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 such "insured". 5. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Although we relied on your representations as to existing and past hazards , if unintentionally you should fail to disclose all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Form because of such failure. 6. EXTENDED NOTICE OF CANCELLATION, NON-RENEWAL The COMMON POLICY CONDITIONS, Item A.2.b. is deleted and replaced with the following: A.2.b. 60 days before the effective date of the cancellation if we cancel for any other reason. 7. WHEN WE DO NOT RENEW SECTION IV – BUSINESS AUTO CONDITIONS, is amended to add Item B.9.: a. If we choose to nonrenew this policy, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date. b. If we do not give notice of our intent to nonrenew as prescribed in a. above, it is agreed that you may extend the period of this policy for a maximum additional sixty (60) days from its scheduled expiration date. Where not otherwise prohibited by law, the existing terms, conditions and rates will remain in effect during that extension period. It is further agreed that so long as it is not otherwise prohibited by law, this one-time sixty-day extension is the sole remedy and liquidated damages available to the insured as a result of our failure to give the notice as prescribed in 9. a. above. 8. NOTICE OF KNOWLEDGE OF ACCIDENT OR LOSS SECTION IV - BUSINESS AUTO CONDITIONS, Item A.2.a. is deleted and replaced with the following: 2. Duties in the Event of Accident, Claim Suit or Loss: a. You must see to it that we are notified of an "accident", "claim", "suit" or "loss" which may result in a claim as soon as practicable after the "occurrence" has been reported to you, a partner, a member, an officer, or an employee designated to give notice to us. Notice should include: DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 AP-0401 (10/17) -3- (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. 9. EMPLOYEES AS INSURED The following is added to the Section II - Covered Autos Liability Coverage, Paragraph A.1. Who Is An Insured provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. 10. EMPLOYEE HIRED AUTOS A. Changes In Covered Autos Liability Coverage The following is added to the Who Is An Insured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. B. Changes In General Conditions Paragraph 5.b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph 5.f. of the Other Insurance - Primary And Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: 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 an "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". 11. BODILY INJURY EXTENSION SECTION V - DEFINITIONS, Paragraph C. is deleted and replaced by the following: C. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from any of these, at any time. Mental anguish means any type of mental or emotional illness or disease. 12. HIRED AUTO PHYSICAL DAMAGE SECTION III.A.4. - Coverage Extensions - Paragraph c. is added: c. Hired Auto Physical Damage If Comprehensive, Specified Causes of Loss or Collision coverage is provided under this policy, then Hired Auto Physical Damage is provided for that coverage part subject to the following: DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 AP-0401 (10/17) -4- (1) The most we will pay for any one "accident" or "loss" under this Hired A uto Physical Damage Coverage is the lesser of: (a) The any one "Accident" or "Loss" amount of $100,000; (b) The actual cash value; or (c) Cost of repair. Our obligation to pay for a loss in c.(1) above will be reduced by a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. The deductible will be waived for "loss" caused by fire or lightning. (2) Subject to paragraph c.(1). above, we will provide coverage equal to the broadest physical damage coverage applicable to any covered "auto" shown in the declarations. (3) When you are required by written contract to indemnify a lessor for actual financial loss because of loss of use of a hired "auto" resulting from a covered "accident" or "loss ", we will cover that financial loss subject to the limit specified in paragraph c.(1). 13. ENHANCED SUPPLEMENTARY PAYMENTS SECTION II.A.2.a. COVERAGE EXTENSIONS, Supplementary Payments (2) and (4) are replaced by the following: (2) Up to $2,500 for the cost of bail bonds (including bonds for related traffic laws violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $350 a day because of time off from work. 14. FELLOW EMPLOYEE COVERAGE FOR DESIGNATED POSITIONS The Fellow Employee Exclusion contained in Section II.B.5. does not apply to the following positions or job titles: foreman, supervisor, manager, officer, partner or other senior level "employee". Coverage is excess over all other collectible insurance. 15. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES SECTION III.A.4.a. Transportation Expenses, is replaced by the following: a. Transportation Expenses We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto". We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Cause of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expirations, when the covered "auto" is returned to use or we pay for its "loss". For autos provided with temporary transportation expense, the following physical damage coverage will apply: (1) The most we will pay for any one "accident" or "loss" under the temporary transportation expense physical damage coverage is the lessor of: (a) The any one "Accident" or "Loss" amount of $100,000; (b) The actual cash value; or DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 AP-0401 (10/17) -5- (c) Cost of repair. Our obligation to pay for a loss in a.(1) above will be reduced by a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. The deductible will be waived for "loss" caused by fire or lightning. (2) Subject to paragraph a.(1). above, we will provide coverage equal to the broadest physical damage coverage applicable to any covered "auto" shown in the declarations. (3) When you are required by written contract to indemnify a lessor for actual financial loss because of loss of use of a hired "auto" resulting from a covered "accident" or "loss", we will cover that financial loss subject to the limit specified in paragraph a.(1). 16. RENTAL REIMBURSEMENT COVERAGE SECTION III.A.4. - Coverage Extensions - Paragraph d. is added. d. If you carry Comprehensive, Specified Causes of Loss or Collision coverage for the damaged covered "auto" as provided under this policy, then Rental Reimbursement Coverage is provided for that coverage part subject to the following: 1. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" other than theft, to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. 2. We will only pay for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: (a) The number of days reasonably required to repair or replace the covered "auto"; or, (b) 30 days. (c) Our payment is limited to the lesser of the following amounts: (1) Necessary and actual expenses incurred; or (2) $50 per day. 17. LOAN/LEASE GAP COVERAGE Physical Damage Coverage is amended by the addition of the following: In the event of a total "loss" to a covered "auto", we will pay your additional legal obligation for any difference between the actual cash value of the "auto" at the time of the loss and the "outstanding balance" of the loan/lease, not to exceed $2,500 for any one vehicle or $25,000 annually in aggregate. For the purposes of this endorsement, "outstanding balance" means the amount you owe on the loan/lease at the time of loss less any amounts representing taxes, overdue payments, penalties, interest or charges resulting from overdue payments, additional mileage charges, excess wear and tear charges or lease termination fees, costs for extended warranties, credit Life Insurance; Health, Accident or Disability Insurance purchased with the loan or lease; and carry-over balances from previous loans or leases. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 AP-0401 (10/17) -6- 18. ACCIDENTAL AIR BAG DISCHARGE COVERAGE SECTION III.B.3.a - Exclusions. This exclusion does not apply to the accidental discharge of an air bag. 19. GLASS REPAIR - WAIVER OF DEDUCTIBLE SECTION III.D - Deductible is replaced with the following: 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 . Any Comprehensive Coverage deductible shown in the Declarations does not apply to "l oss" caused by fire or lightning. The deductible does not apply to glass damage if the glass is repaired rather than replaced. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -1- THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. UTILITY CONTRACTORS EXTENDED LIABILITY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM It is agreed that the provisions listed below apply only upon the entry of an X in the box next to the caption of such provision. A. Partnership and Joint Venture Extension B. Contractors Automatic Additional Insured Coverage – Ongoing Operations C. Automatic Waiver of Subrogation D. Extended Notice of Cancellation, Nonrenewal E. Unintentional Failure to Disclose Hazards F. Broadened Mobile Equipment G. Personal and Advertising Injury - Contractual Coverage H. Nonemployment Discrimination I. Liquor Liability J. Broadened Conditions K. Automatic Additional Insureds – Equipment Leases L. Insured Contract Extension - Railroad Property and Construction Contracts M. Construction Project General Aggregate Limits N. Fellow Employee Coverage O. Property Damage to the Named Insured's Work P. Care, Custody or Control Q. Electronic Data Liability Coverage R. Consolidated Insurance Program Residual Liability Coverage S. Automatic Additional Insureds – Managers or Lessors of Premises T. Automatic Additional Insureds – State or Governmental Agency or Political Subdivisions – Permits or Authorizations U. Contractors Automatic Additional Insured Coverage – Completed Operations V. Additional Insured – Engineers, Architects or Surveyors A. PARTNERSHIP AND JOINT VENTURE EXTENSION The following provision is added to SECTION II - WHO IS AN INSURED : The last full paragraph which reads as follows: No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. is deleted and replaced with the following: With respect to the conduct of any past or present joint venture or partnership not shown as a Named Insured in the Declarations and of which you are or were a partner or member, you are an insured, but only with respect to liability arising out of "your work" on behalf of any partnership or joint venture not shown as a Named Insured in the Declarations, provided no other similar liability X X X X X X X X X X X X X X X X X X X X X X DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -2- insurance is available to you for "your work" in connection with your interest in such partnership or joint venture. B. CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE – ONGOING OPERATIONS SECTION II – WHO IS AN INSURED is amended to include as an additional insured any person or organization who is required by written contract to be an additional insured on your policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1.Your acts or omissions; or 2.The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for theadditional insured(s) at the project(s) designated in the written contract. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1.All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2.That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as aNamed Insured in theDeclarations andwe will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. C. AUTOMATIC WAIVER OF SUBROGATION Item 8.of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS , is deleted and replaced with the following: 8. Transfer of Rights of Recovery Against Others to Us and Automatic Waiver of Subrogation. a.If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. b.If required by awritten contract executed prior toloss, we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of "your work" for that person or organization. D. EXTENDED NOTICE OF CANCELLATION, NONRENEWAL Item A.2.b. of the COMMON POLICY CONDITIONS , is deleted and replaced with the following: A.2.b.60 days before the effective date of the cancellation if we cancel for any other reason. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -3- Item 9.of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS , is deleted and replaced with the following: 9. WHEN WE DO NOT RENEW a.If we choose to nonrenew this policy, we will mail or deliver tothe first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date. b.If we do not give notice of our intent to nonrenew as prescribed in a.above, it is agreed that you may extend the period of this policy for a maximum additional sixty(60) days from its scheduled expiration date. Where not otherwise prohibited by law, the existing terms, conditions andrates will remain ineffect during that extension period. It is further agreed that so long as it is not otherwise prohibited by law, this one time sixty day extension is the sole remedy and liquidated damages available to the insured as a result of our failure to give the notice as prescribed in 9. a.above. E. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Although we relied on your representations as toexisting andpast hazards, if unintentionally you should fail todisclose all such hazards at theinception dateof your policy, we will not deny coverage under this Coverage Form because of such failure. F. BROADENED MOBILE EQUIPMENT Item 12.b. of SECTION V - DEFINITIONS , is deleted and replaced with the following: 12.b.Vehicles maintained for use solely on or next to premises, sites or locations you own, rent or occupy. G. PERSONAL AND ADVERTISING INJURY - CONTRACTUAL COVERAGE Exclusion 2.e. of SECTION I, COVERAGE B is deleted. H. NONEMPLOYMENT DISCRIMINATION Unless "personal and advertising injury" is excluded from this policy: Item 14. of SECTION V - DEFINITIONS , is amended to include: "Personal and advertising injury" also means embarrassment or humiliation, mental or emotional distress, physical illness, physical impairment, loss of earning capacity or monetary loss, which is caused by "discrimination." SECTION V - DEFINITIONS , is amended to include: "Discrimination" means the unlawful treatment of individuals based on race, color, ethnic origin, age, gender or religion. Item 2. Exclusions of SECTION I, COVERAGE B , is amended to include: "Personal and advertising injury" arising out of "discrimination" directly or indirectly related to the past employment, employment or prospective employment of any person or class of persons by any insured; "Personal and advertising injury" arising out of "discrimination" by or at your, your agents or your "employees" direction or with your, your agents or your "employees" knowledge or consent; DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -4- "Personal and advertising injury" arising out of "discrimination" directly or indirectly related to the sale, rental, lease or sub-lease or prospective sale, rental, lease or sub-lease of any dwelling, permanent lodging or premises by or at the direction of any insured; or Fines, penalties, specific performance or injunctions levied or imposed by a governmental entity, or governmental code, law, or statute because of "discrimination." I. LIQUOR LIABILITY Exclusion 2.c. of SECTION I, COVERAGE A , is deleted. J. BROADENED CONDITIONS Items 2.a.and 2.b.of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS , are deleted and replaced with the following: 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit: a.You must see to it that we are notified of an"occurrence" or an offense which may result ina claim as soon as practicable after the "occurrence" has been reported to you, one of your officers or an "employee" designated to give notice to us. 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. b.If a claim is made or "suit" is brought against any insured, you must: (1)Record the specifics of the claim or "suit" and the date received as soon as you, one of your officers, or an "employee" designated to record such information is notified of it; and (2)Notify us in writing as soon as practicable after you, one of your officers, your legal department or an "employee" you designate to give us such notice learns of the claims or "suit." Item 2.e. is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS : 2.e.If you report an "occurrence" to your workers compensation insurer which develops into a liability claim for which coverage is provided bythe Coverage Form, failure toreport such "occurrence" to us at the time of "occurrence" shall not be deemed in violation of paragraphs 2.a., 2.b., and 2.c. However, you shall give written notice of this "occurrence"to us as soon as you are made aware of the fact that this "occurrence" may be a liability claim rather than a workers compensation claim. K. AUTOMATIC ADDITIONAL INSUREDS - EQUIPMENT LEASES SECTION II - WHO IS AN INSURED is amended to include any person or organization with whom you agree in a written equipment lease or rental agreement toname as anadditional insured with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, at least in part, by your maintenance, operation, or use by you of the equipment leased to you by such person or organization, subject to the following additional exclusions. The insurance provided to the additional insured does not apply to: 1."Bodily injury" or "property damage" occurring after you cease leasing the equipment. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -5- 2."Bodily injury" or "property damage" arising out of the sole negligence of the additional insured. 3."Property damage" to: a.Property owned, used or occupied by or rented to the additional insured; or b.Property in the care, custody or control of the additional insured or over which the additional insured is for any purpose exercising physical control. This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as aNamed Insured in theDeclarations andwe will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. L. INSURED CONTRACT EXTENSION - RAILROAD PROPERTY AND CONSTRUCTION CONTRACTS Item 9. of SECTION V - DEFINITIONS , is deleted and replaced with the following. 9."Insured Contract" means: a.A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b.A sidetrack agreement; c.Any easement or license agreement; d.An obligation, as required by ordinance, toindemnify amunicipality, except in connection with work for a municipality; e.An elevator maintenance agreement; f.That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for "bodily injury" or "property damage" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1)That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a)Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b)Giving directions or instructions, or failing to give them,if that is the primary cause of the injury or damage; or (2)Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in (1) above and supervisory, inspection, architectural or engineering activities. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -6- M. CONSTRUCTION PROJECT GENERAL AGGREGATE LIMITS This modifies SECTION III - LIMITS OF INSURANCE . A.For all sums which can beattributed only toongoing operations at a single construction project for which the insured becomes legally obligated topay as damages caused by an "occurrence" under SECTION I - COVERAGE A, and for all medical expenses caused by accidents under SECTION I - COVERAGE C : 1.Aseparate Construction Project General Aggregate Limit applies to each construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2.The Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard," and for medical expenses under COVERAGE C regardless of the number of: a.Insureds; b.Claims made or "suits" brought; or c.Persons or organizations making claims or bringing "suits." 3.Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the Construction Project General Aggregate Limit for that construction project. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Construction Project General Aggregate Limit for any other construction project. 4.The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue toapply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Construction Project General Aggregate Limit. B.For all sums which cannot beattributed only toongoing operations at a single construction project for which the insured becomes legally obligated to pay as damages caused by an "occurrence" under SECTION I - COVERAGE A, and for all medical expenses caused by accidents under SECTION I - COVERAGE C : 1.Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and 2.Such payments shall not reduce any Construction Project General Aggregate Limit. C.Payments for damages because of "bodily injury" or "property damage" included inthe "products- completed operations hazard" will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Construction Project General Aggregate Limit. D.If a construction project has been abandoned, delayed, or abandoned andthen restarted, or if the authorized contracting parties deviate fromplans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E.The provisions of SECTION III - LIMITS OF INSURANCE not otherwise modified by this endorsement shall continue to be applicable. N. FELLOW EMPLOYEE COVERAGE DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -7- Exclusion 2.e. Employers Liability of SECTION I, COVERAGE A, is deleted and replaced with the following: 2.e."Bodily injury" to (1)An "employee" of the insured arising out of and in the course of: (a)Employment by the insured; or (b)Performing duties related to the conduct of the insured's business; or (2)Thespouse, child, parent, brother or sister of that "employee" as a consequence of paragraph (1) above. This exclusion applies: (1)Whether the insured may be liable as an employer or in any other capacity; and (2)To any obligation to share damages with or repay someone else who must pay damages because of the injury. This exclusion does not apply to: (1)Liability assumed by the insured under an "insured contract"; or (2)Liability arising from any action or omission of a co-"employee" while that co-"employee" is either in the course of his or her employment or performing duties related to the conduct of your business. Item 2.a. (1)(a) of SECTION II - WHO IS AN INSURED , is deleted and replaced with the following: 2.a. (1)(a)To you, to your partners or members (if you are a partnership or joint venture) or to your members (if you are a limited liability company), or to your "volunteer workers" while performing duties related to the conduct of your business. O. PROPERTY DAMAGE TO THE NAMED INSURED'S WORK Exclusion l of SECTION I, COVERAGE A . is deleted and replaced with the following: l. Damage to Your Work "Property damage" to "your work" arising out of it or any part of it and included in the "products completed operation hazard." This exclusion applies only to that portion of any loss in excess of $50,000 per occurrence if the damaged work and the work out of which the damage arises was performed by you. This exclusion does not apply if the damaged work or the work out of which the damage arises was performed on your behalf by a subcontractor. P. CARE, CUSTODY OR CONTROL Exclusion 2.j.4 of SECTION I, COVERAGE A. is deleted and replaced with the following: 2.j.4 Personal property inthe care, custody or control of theinsured. However, for personal property in the care, custody or control of you or your "employees," this exclusion applies only tothat portion of any loss in excess of $25,000 per occurrence, subject to the following terms and conditions; DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -8- (a)The most that we will pay under this provision as an annual aggregate is $100,000, regardless of the number of occurrences. (b)This provision does not apply to "employee" owned property or any property that is missing where there is not physical evidence to show what happened to the property. (c)The aggregate limit for this coverage provision is part of the General Aggregate Limit and SECTION III - LIMITS OF INSURANCE is changed accordingly. (d)In the event of damage to or destruction of property covered by this exception, you shall, if requested by us, replace the property or furnish the labor and materials necessary for repairs thereto, at actual cost to you, exclusive of prospective profit or overhead charges of any nature. (e)$2,500 shall be deducted from the total amount of all sums you became obligated to pay as damages on account of damage to or destruction of all property of each person or organization, including the loss of use of that property, as a result of each "occurrence." Our limit of liability under the endorsement as being applicable to each "occurrence" shall be reduced by the amount of the deductible indicated above; however, our aggregate limit of liability under this provision shall not be reduced by the amount of such deductible. The conditions of the policy, including those with respect to duties in the event of "occurrence," claims or "suit" apply irrespective of the application of the deductible amount. We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon notification of theaction taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us. Q. ELECTRONIC DATA LIABILITY COVERAGE 1. Exclusion 2.p. Electronic Data of SECTION I, COVERAGE A,is deleted and replaced with the following: 2.p.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. 2.The following definition is added to SECTION V – DEFINITIONS: “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. 3.For the purposes of this coverage, the definition of “property damage” in SECTION V – DEFINITIONS is replaced by the following: “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; or c.Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", resulting fromphysical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. For the purposes of this insurance, "electronic data" is not tangible property. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -9- R. CONSOLIDATED INSURANCE PROGRAM RESIDUAL LIABILITY COVERAGE With respect to “bodily injury”, “property damage”, or ‘personal and advertising injury” arising out of your ongoing operations; or operations included within the“products-completed operations hazard”, the policy to which this coverage is attached shall apply as excess insurance over coverage available to “you” under a Consolidated Insurance Program (such as an Owner Controlled Insurance Program or Contractors Controlled Insurance Program). Coverage afforded by this endorsement does not apply to any Consolidated Insurance Program involving a “residential project” or any deductible or insured retention, specified in the Consolidated Insurance Program. The following is added to Section V – Definitions “Residential project” means any project where 30% or more of the total square foot area of the structures on the project is used or is intended tobeused for human residency. This includes but is not limited to single or multifamily housing, apartments, condominiums, townhouses, co-operatives or planned unit developments and appurtenant structures (including pools, hot tubs, detached garages, guest houses or any similar structures). A“residential project” does not include military owned housing, college/university owned housing or dormitories, long term care facilities, hotels, motels, hospitals or prisons. All other terms, provisions, exclusions and limitations of this policy apply. S. AUTOMATIC ADDITIONAL INSUREDS - MANAGERS OR LESSORS OR PREMISES SECTION II – WHO IS AN INSURED is amended to include: Any person or organization with whom you agree in a written contract or written agreement to name as anadditional insured but only with respect toliability arising out of theownership, maintenance or use of that part of the premises, designated in the written contract or written agreement, that is leased to you and subject to the following additional exclusions: This insurance does not apply to: 1.Any “occurrence" which takes place after you cease to be a tenant in that premises. 2.Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured listed in the written contract or written agreement. This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as aNamed Insured in theDeclarations andwe will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. T. AUTOMATIC ADDITIONAL INSUREDS – STATE OR GOVERNMENTAL AGENCY OR POLITICAL SUBDIVISIONS – PERMITS OR AUTHORIZATIONS SECTION II – WHO IS AN INSURED is amended to include any state or governmental agency or subdivision or political subdivision with whom you are required by written contract, ordinance, law or building code to name as an additional insured subject to the following provisions: This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -10- 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”. This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as aNamed Insured in theDeclarations andwe will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. U. CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE – COMPLETED OPERATIONS SECTION II – WHO IS AN INSURED is amended to include as an additional insured any person or organization who is required by written contract to be an additional insured onyour policy for completed operations, but only with respect toliability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the project designated in the contract, performed for that additional insured and included in the "products-completed operations hazard". This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as aNamed Insured in theDeclarations andwe will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. V. ADDITIONAL INSURED – ENGINEERS, ARCHITECTS OR SURVEYORS SECTION II – WHO IS AN INSURED is amended to include as an additional insured any architect, engineer or surveyor who is required by written contract to be an additional insured on your policy, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1.Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations performed by you or on your behalf. This includes such architect, engineer or surveyor, who may not beengaged by you, but is contractually required to be added as an additional insured to your policy. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services, including: 1.The preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or 2.Supervisory, inspection or engineering services. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 GL-3085 (09/11) -11- This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as aNamed Insured in theDeclarations andwe will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026 7501 E. Lowry Blvd. Denver, CO 80230-7006 303.361.4000 / 800.873.7242 Pinnacol.com C & L Water Solutions Inc 12249 Mead Way Littleton, CO 80125 Moody Insurance Agency Inc 8055 E. Tufts Ave Ste 1000 Denver, CO 80237 (303) 824-6600 7501 E. Lowry Blvd Denver, CO 80230-7006 Page 1 of 1 P FRISBIEB - Underwriter 03/29/2023 14:25:20 1095870 81325052 359-B NCCI #: WC000313B Policy #: 1095870 ENDORSEMENT:Blanket Waiver of Subrogation Effective Date:April 1, 2023 Expires on: April 1, 2024 Pinnacol Assurance has issued this endorsement March 29, 2023 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. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE To any person or organization when agreed to under a written contract or agreement, as defined above and with the insured, which is in effect and executed prior to any loss. DocuSign Envelope ID: E5BE3C85-4A26-4B4A-A9AD-5F1784DE9026