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HomeMy WebLinkAboutSCW Contracting PWCA City Hall Structural Steel Bid Set B CIP No. Z20006 03-26-2024 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 Agreement No. AGREEMENT FOR PUBLIC WORKS CONSTRUCTION SCW Contracting Corporation Forthe City Hall Structural Steel Bid Set "B" CIP PROJECT NO. Z20006 This Agreement for Public Works Construction ("Agreement") is made and entered into as of March 26, 2024 by and between the City of Lake Elsinore, a municipal corporation ("City") and SCW Contracting Corporation ("Contractor"). The City and Contractor, in consideration of the mutual promises and covenants set forth herein, agree as follows: 1. The Project and Project Documents. Contractor agrees to construct the following public improvements("work") identified as: City Hall Structural Steel Bid Set "B"(the"Project") The City-approved plans for the construction of the Project, which are incorporated herein by reference and prepared by Staff, are identified as: City Hall Structural Steel Bid Set "B" The Project Documents include this Agreement and all of the following: (1) the Notice Inviting Bids, Instructions to Bidders, Bid Documents including Bidder's Proposal as submitted by the Contractor, Contract Documents, General Specifications, Special Provisions, and all attachments and appendices; (2) everything referenced in such documents, such as specifications, details, standard plans or drawings and appendices, including all applicable State and Federal requirements; (3) all required bonds, insurance certificates, permits, notices, and affidavits; and (4) any and all addenda or supplemental agreements clarifying, amending or extending the work contemplated as may be required to insure completion in an acceptable manner. All of the provisions of the above-listed documents are made a part of this Agreement as though fully set forth herein. 2. Compensation. a. For and in consideration of the payments and agreements to be made and performed by City, Contractor agrees to construct the Project, including furnishing all materials and performing all work required for the Project, and to fulfill all other obligations as set forth in the Bidder's Proposal, such contract price being five million one hundred one thousand nine hundred twenty four dollars and no cents $5,101,924.00. 1 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 b. City hereby promises and agrees to employ, and does hereby employ, Contractor to provide the materials, do the work, and fulfill the obligations according to the terms and conditions herein contained and referred to, for the prices set forth, and hereby contracts to pay the same at the time, in the manner, and upon the conditions set forth in the Project Documents. C. Contractor agrees to receive and accept the prices set forth in the Bidder's Proposal as full compensation for furnishing all materials, performing all work, and fulfilling all obligations hereunder. Such compensation shall cover all expenses, losses, damages, and consequences arising out of the nature of work during its progress or prior to its acceptance including those for well and faithfully completing the work and the whole thereof in the manner and time specified in the Project Documents; and also including those arising from actions of the elements, unforeseen difficulties or obstructions encountered in the prosecution of the work, suspension or discontinuance of the work, and all other unknowns or risks of any description connected with the work. 3. Completion of Work. a. Contractor shall perform and complete all work within 140 working days from the date of commencement specified in the Notice to Proceed, and shall provide, furnish and pay for all the labor, materials, necessary tools, expendable equipment, and all taxes, utility and transportation services required for construction of the Project. b. All work shall be performed and completed in a good workmanlike manner in strict accordance with the drawings, specifications and all provisions of this Agreement as hereinabove defined and in accordance with applicable laws, codes, regulations, ordinances and any other legal requirements governing the Project. C. Contractor shall not be excused with respect to the failure to so comply by any act or omission of the City, the City Engineer, a City inspector, or a representative of any of them, unless such act or omission actually prevents the Contractor from fully complying with the requirements of the Project Documents, and unless the Contractor protests at the time of such alleged prevention that the act or omission is preventing the Contractor from fully complying with the Project Documents. Such protest shall not be effective unless reduced to writing and filed with the City within three (3) working days of the date of occurrence of the act or omission preventing the Contractor from fully complying with the Project Documents. d. City and Contractor recognize that time is of the essence in the performance of this Agreement and further agree that if the work called for under the Agreement is not completed within the time hereinabove specified, damages will be sustained by the City and that, it is and will be impracticable or extremely difficult to ascertain and determine the actual amount of damages the City will sustain in the event of, and by reason of, such delay. It is, therefore, agreed that such damages shall be presumed to be in the amount of 1000 per calendar day, and that the Contractor will pay to the City, or City may retain from amounts otherwise payable to Contractor, such amount for each calendar day by which the Contractor fails to complete the work, including corrective items of work, under this Agreement within the time hereinabove specified and as adjusted by any changes to the work. 2 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 4. Changes to Work. City and Contractor agree that the City may make changes to the work, or suspend the work, and no matter how many changes, such changes or suspensions are within the contemplation of the Contractor and City and will not be a basis for a compensable delay claim against the City nor be the basis for a liquidated damage claim against the Contractor. Any change to the work shall be by way of a written instrument ("change order") signed by the City and the Contractor, stating their agreement to the following: a. The scope of the change in the work; b. The amount of the adjustment to the contract price; and c. The extent of the adjustment to the Schedule of Performance. The City Engineer is authorized to sign any change order provided that sufficient contingency funds are available in the City's approved budget for the Project. All change in the work authorized by the change order shall be performed under the applicable conditions of the Project Documents. City and Contractor shall negotiate in good faith and as expeditiously as possible the appropriate adjustments for such changes. 5. Bonds. Contractor shall provide, before commencing work, a Faithful Performance Bond and a Labor and Material Bond, each for one-hundred percent (100%) of the contract price in the form that complies with the Project Documents and is satisfactory to the City Attorney. 6. Non-Assignability. Neither this Agreement nor any rights, title, interest, duties or obligations under this Agreement may be assigned, transferred, conveyed or otherwise disposed of by Contractor without the prior written consent of City. 7. Licenses. Contractor represents and warrants to City that it holds the contractor's license or licenses set forth in the Project Documents, is registered with the Department of Industrial Relations pursuant to Labor Code Section 1725.5, and holds such other licenses, permits, qualifications, insurance and approvals of whatsoever nature which are legally required of Contractor. Contractor represents and warrants to City that Contractor shall, at its sole cost and expense, keep in effect or obtain at all times during the term of this Agreement, any licenses, permits, insurance and approvals which are legally required of Contractor to practice its profession. Contractor shall maintain a City of Lake Elsinore business license. 8. Indemnity. Contractor shall indemnify, defend, and hold harmless the City and its officials, officers, employees, agents, the County and Board Supervisors, and volunteers from and against any and all losses, liability, claims, suits, actions, damages, and causes of action arising out of any personal injury, bodily injury, loss of life, or damage to property, or any violation of any federal, state, or municipal law or ordinance, to the extent caused, in whole or in part, by the willful misconduct or negligent acts or omissions of Contractor or its employees, subcontractors, or agents, by acts for which they could be held strictly liable, or by the quality or character of their work. The foregoing obligation of Contractor shall not apply when (1) the injury, loss of life, damage to property, or violation of law arises from the sole negligence or willful misconduct of the City or its officers, employees, agents, or volunteers and (2) the actions of Contractor or its employees, subcontractor, or agents have contributed in no part to the injury, loss of life, damage to 3 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 property, or violation of law. It is understood that the duty of Contractor to indemnify and hold harmless includes the duty to defend as set forth in Section 2778 of the California Civil Code. Acceptance by City of insurance certificates and endorsements required under this Agreement does not relieve Contractor from liability under this indemnification and hold harmless clause. This indemnification and hold harmless clause shall apply to any damages or claims for damages whether or not such insurance policies shall have been determined to apply. By execution of this Agreement, Contractor acknowledges and agrees to the provisions of this Section and that it is a material element of consideration. 9. Insurance Requirements. a. Insurance. Contractor, at Contractor's own cost and expense, shall procure and maintain, for the duration of the Agreement, unless modified by the City's Risk Manager, the following insurance policies. i. Workers' Compensation Coverage. Contractor shall maintain Workers' Compensation Insurance and Employer's Liability Insurance for his/her employees in accordance with the laws of the State of California. In addition, Contractor shall require each subcontractor to similarly maintain Workers' Compensation Insurance and Employer's Liability Insurance in accordance with the laws of the State of California for all of the subcontractor's employees. Any notice of cancellation or non-renewal of all Workers' Compensation policies must be received by the City at least thirty (30) days prior to such change. The insurer shall agree to waive all rights of subrogation against City, its officers, agents, employees and volunteers for losses arising from work performed by Contractor for City. In the event that Contractor is exempt from Worker's Compensation Insurance and Employer's Liability Insurance for his/her employees in accordance with the laws of the State of California, Contractor shall submit to the City a Certificate of Exemption from Workers Compensation Insurance in a form approved by the City Attorney. ii. Commercial General Liability Coverage. Contractor shall maintain commercial general liability insurance in an amount not less than one million dollars ($1,000,000) per occurrence for bodily injury, personal injury and property damage. If a commercial general liability insurance form or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to the work to be performed under this Agreement or the general aggregate limit shall be at least twice the required occurrence limit. Required commercial general liability coverage shall be at least as broad as Insurance Services Office Commercial General Liability occurrence form CG 0001 (ed. 11/88) or Insurance Services Office form number GL 0002 (ed. 1/73) covering comprehensive General Liability and Insurance Services Office form number GL 0404 covering Broad Form Comprehensive General Liability. No endorsement may be attached limiting the coverage. iii. Automobile Liability Coverage. Contractor shall maintain automobile liability insurance covering bodily injury and property damage for all activities of the Contractor arising out of or in connection with the work to be performed under this Agreement, including coverage for owned, hired and non-owned vehicles, in an amount of not less than one million dollars ($1,000,000) combined single limit for each occurrence. Automobile liability coverage must be at least as broad as Insurance Services Office Automobile Liability form CA 0001 (ed. 12/90) Code 1 ("any auto"). No endorsement may be attached limiting the coverage. 4 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 b. Endorsements. Each general commercial liability and automobile liability insurance policy shall be with insurers possessing a Best's rating of no less than A:VII and shall be endorsed with the following specific language: i. The City, its elected or appointed officers, officials, employees, agents and volunteers are to be covered as additional insured with respect to liability arising out of work performed by or on behalf of the Contractor, including materials, parts or equipment furnished in connection with such work or operations. ii. This policy shall be considered primary insurance as respects the City, its elected or appointed officers, officials, employees, agents and volunteers. Any insurance maintained by the City, including any self-insured retention the City may have, shall be considered excess insurance only and shall not contribute with it. iii. This insurance shall act for each insured and additional insured as though a separate policy had been written for each, except with respect to the limits of liability of the insuring company. iv. The insurer waives all rights of subrogation against the City, its elected or appointed officers, officials, employees or agents. V. Any failure to comply with reporting provisions of the policies shall not affect coverage provided to the City, its elected or appointed officers, officials, employees, agents or volunteers. vi. The insurance provided by this Policy shall not be suspended, voided, canceled, or reduced in coverage or in limits except after thirty (30) days written notice has been received by the City. C. Deductibles and Self-Insured Retentions. Any deductibles or self-insured retentions must be declared to and approved by the City. At the City's option, Contractor shall demonstrate financial capability for payment of such deductibles or self-insured retentions. d. Certificates of Insurance. Contractor shall provide certificates of insurance with original endorsements to City as evidence of the insurance coverage required herein. Certificates of such insurance shall be filed with the City on or before commencement of performance of this Agreement. Current certification of insurance shall be kept on file with the City at all times during the term of this Agreement. 10. Notices. Any notice required to be given under this Agreement shall be in writing and either served personally or sent prepaid, first class mail. Any such notice shall be addressed to the other party at the address set forth below. Notice shall be deemed communicated within 48 hours from the time of mailing if mailed as provided in this section. If to City: City of Lake Elsinore Attn: City Manager 130 South Main Street Lake Elsinore, CA 92530 With a copy to: City of Lake Elsinore Attn: City Clerk 130 South Main Street Lake Elsinore, CA 92530 5 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 If to Contractor: SCW Contracting Corporation Attn: Attn: Andrew Scrape 2525 N. Old Hwy 395 Fallbrook CA 92028 11. Entire Agreement. This Agreement constitutes the complete and exclusive statement of agreement between the City and Contractor. All prior written and oral communications, including correspondence, drafts, memoranda, and representations, are superseded in total by this Agreement. 12. Amendments. This Agreement may be modified or amended only by a written document executed by both Contractor and City and approved as to form by the City Attorney. 13. Assignment and Subcontracting. Contractor shall be fully responsible to City for all acts or omissions of any subcontractors. Assignments of any or all rights, duties for obligations of the Contractor under this Agreement will be permitted only with the express consent of the City. Nothing in this Agreement shall create any contractual relationship between City and any subcontractor nor shall it create any obligation on the part of the City to pay or to see to the payment of any monies due to any such subcontractor other than as otherwise is required by law. 14. Waiver. Waiver of a breach or default under this Agreement shall not constitute a continuing waiver of a subsequent breach of the same or any other provision under this Agreement. 15. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this Agreement shall continue in full force and effect. 16. Controlling Law Venue. This Agreement and all matters relating to it shall be governed by the laws of the State of California and any action brought relating to this Agreement shall be held exclusively in a state court in the County of Riverside. 17. Litigation Expenses and Attorneys' Fees. If either party to this Agreement commences any legal action against the other party arising out of this Agreement, the prevailing party shall be entitled to recover its reasonable litigation expenses, including court costs, expert witness fees, discovery expenses, and attorneys'fees. 18. Mediation. The parties agree to make a good faith attempt to resolve any disputes arising out of this Agreement through mediation prior to commencing litigation. The parties shall mutually agree upon the mediator and share the costs of mediation equally. If the parties are unable to agree upon a mediator, the dispute shall be submitted to JAMS or its successor in interest. JAMS shall provide the parties with the names of five qualified mediators. Each party shall have the option to strike two of the five mediators selected by JAMS and thereafter the mediator remaining shall hear the dispute. If the dispute remains unresolved after mediation, either party may commence litigation. 19. Authority to Enter Agreement and Administration. Contractor has all requisite power and authority to conduct its business and to execute, deliver, and perform the Agreement. Each party warrants that the individuals who have signed this Agreement have the legal power, right, and authority to make this Agreement and to bind each respective party. The City Manager is authorized to enter into an amendment or otherwise take action on behalf of the City to make the following modifications to the Agreement: (a) a name change; (b) grant 6 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 extensions of time; (c) non-monetary changes in the scope of services; and/or (d) suspend or terminate the Agreement. The City Engineer shall act as the Project administrator on behalf of the City. 20. Prohibited Interests. Contractor maintains and warrants that it has not employed nor retained any company or person, other than a bona fide employee working solely for Contractor, to solicit or secure this Agreement. Further, Contractor warrants that it has not paid nor has it agreed to pay any company or person, other than a bona fide employee working solely for Contractor, any fee, commission, percentage, brokerage fee, gift or other consideration contingent upon or resulting from the award or making of this Agreement. For breach or violation of this warranty, City shall have the right to rescind this Agreement without liability. For the term of this Agreement, no member, officer or employee of City, during the term of his or her service with City, shall have any direct interest in this Agreement, or obtain any present or anticipated material benefit arising therefrom. 21. Equal Opportunity Employment. Contractor represents that it is an equal opportunity employer and it shall not discriminate against any subcontractor, employee or applicant for employment because of race, religion, color, national origin, handicap, ancestry, sex or age. Such non-discrimination shall include, but not be limited to, all activities related to initial employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or termination. 22. Prevailing Wages. a. Contractor and all subcontractors shall adhere to the general prevailing rate of per diem wages as determined and as published by the State Director of the Department of Industrial Relations pursuant to Labor Code Sections 1770, 1773, and 1773.2. Copies of these rates and the latest revisions thereto are on file in the office of the City Clerk of the City of Lake Elsinore and are available for review upon request. b. Contractor's attention is directed to the provisions of Labor Code Sections 1774, 1775, 1776, 1777.5 and 1777.6. Contractor shall comply with the provisions of these Sections. The statutory provisions for penalties for failure to comply with the State's wage and the hours laws will be enforced. C. Labor Code Sections 1774 and 1775 require the Contractor and all subcontractors to pay not less than the prevailing wage rates to all workmen employed in the execution of the contract and specify forfeitures and penalties for failure to do so. The minimum wages to be paid are those determined by the State Director of the Department of Industrial Relations. Labor Code Section 1776 requires the Contractor and all subcontractors to keep accurate payroll records, specifies the contents thereof, their inspection and duplication procedures and certain notices required of the Contractor pertaining to their location. The statutory penalties for failure to pay prevailing wages will be enforced. If the Project has been awarded to Contractor on or after April 1, 2015, Contractor and its subcontractors must furnish electronic certified payroll records to the Labor Commissioner. Beginning January 1, 2016, Contractor and its subcontractors must furnish electronic certified payroll records to the Labor Commissioner without regard to when the Project was awarded to Contractor. d. Labor Code Section 1777.5 requires Contractor or subcontractor employing tradesmen in any apprenticeable occupation to apply to the Joint Apprenticeship Committee nearest the site of the public works project, which administers the apprenticeship program in that trade for a certificate of approval. The certificate will also fix the ratio of apprentices to journeymen to be used in the performance of the Agreement. The Contractor is required to make contributions to funds established for the administration of apprenticeship programs if 7 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 the Contractor employs registered apprentices or journeymen in any apprenticeable trade and if other contractors on the public works site are making such contributions. Information relative to apprenticeship standards, contributions, wage schedules and other requirements may be obtained from the State Director of Industrial Relations or from the Division of Apprenticeship Standards. Labor Code Section 1777.6 provides that it shall be unlawful to refuse to accept otherwise qualified employees as registered apprentices solely on the grounds of race, religious creed, color, national origin, ancestry, sex, or age. e. Eight hours labor constitutes a legal day's work, as set forth in Labor Code Section 1810. 23. Execution. This Agreement may be executed in several counterparts, each of which shall constitute one and the same instrument and shall become binding upon the parties when at least one copy hereof shall have been signed by both parties hereto. In approving this Agreement, it shall not be necessary to produce or account for more than one such counterpart. IN WITNESS WHEREOF, the parties have caused this Agreement to be executed on the date first written above. "CITY" "CONTRACTOR" CITY OF LAKE ELSINORE, a municipal SCW Contracting Corporation corporation igned by: C0478 GGSGRZGRGGA�� City Manager By: Andrew Scrape Its: Vice President ATTEST: DocuSigned by: City Clerk APPROVED AS TO FORM: City Attorney DocuSigned by: Assistant City Manager 8 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 EXHIBIT A CONTRACTOR'S PROPOSAL [ATTACHED] DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 BIDDER'S PROPOSAL CITY HALL BUIDLING CIP PROJECT NO. Z20006 Company: SCW Contracting Corporation Honorable Mayor Members of the Council: In accordance with the Notice Inviting Bids pertaining to the receiving of sealed proposals by the City Clerk of the City of Lake Elsinore for the above titled improvement, the undersigned hereby proposes to furnish all Work to be performed in accordance with the Specifications, Standard Drawings, and the Contract Documents, for the unit price or lump sum set forth in the following schedule: BID SCHEDULE A— Unit Total Bid Item No. Description Quantity Units Price ($) ($) Mobilization & Demobilization Including 1 Construction Schedules 1 LS $127,546.00 $127,546.00 Not To Exceed 3% of Total Bid 2 Labor, Material and Performance Bonds 1 LS $124,000.00 $124,000.00 3 Steel Structure 1 LS $3,135,000.00 $3,135,000.0 4 Safety Netting to remain in place) 1 LS $137,000.00 $137,000.00 5 Back Stairs seconds stairs 1 LS $135,000.00 $135,000.00 6 1 LS $738,318.00 $738,318.00 Steel Roof 7 1 Metal Decking LS $705,060.00 $705,060.00 8 $ $ SCHEDULE A Total Bid: $5 101,924.00 (Figures*) SCHEDULE A Total Bid:Five Million One Hundred One Thousand Nine Hundred Twenty Four Dollars (Words*) *BID MAY BE REJECTED IF TOTAL IS NOT SHOWN FOR BOTH FIGURES AND WORDS. C-2 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 The undersigned agrees to enter into and execute a contract, with necessary bonds, at the unit prices set forth herein and in case of default in executing such contract, with necessary bonds, the check or bond accompanying this bid and the money payable thereon shall be forfeited thereby to and remain the property of the City of Lake Elsinore. The above unit prices include all work appurtenant to the various items as outlined in the Contract Documents and all work or expense required for the satisfactory completion of said items. In case of discrepancies between unit prices and totals, the unit prices shall govern. The undersigned declares that it has carefully examined the Specifications, and Contract Documents, and has investigated the site of the work and is familiar with the conditions thereon. SCVV Comractin 7 Corporation Date: �71P By: Andrew Scrape Vice President Contractor's State License No.: 630435 Class: A, C51, C60 Address: 2525 N. Old Hwy 395 Fallbrook, Ca 92028 Phone: 760-728-1308 FAX: 760-728-2517 C-3 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 ACKNOWLEDGMENT OF ADDENDA RECEIVED CITY HALL BUIDLING CIP PROJECT NO. Z20006 STEEL The Bidder shall acknowledge the receipt of addenda by placing an "X" by each addendum received. Addendum No. 1 Addendum No. 2 Addendum No. 3 Addendum No. 4 If an addendum or addenda have been issued by the City and not noted above as being received by the Bidder, the Bid Proposal may be rejected. - Date C-4 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 NON-COLLUSION AFFIDAVIT CITY HALL BUIDLING CIP PROJECT NO. Z20006 STEEL STATE OF CALIFORNIA } } SS COUNTY OF ) (NAME) Andrew Scrape Affiant being first duly sworn, deposes and says: That he or she is Vice President of (Sole owner, partner or other proper title) SCW Contracting Corporation the party making the foregoing Bid, that the Bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the Bid is genuine and not collusive or sham; that the Bidder has not directly or indirectly induced or solicited any other Bidder to put in a false or sham Bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any Bidder or anyone else to put in a sham Bid, or that anyone shall refrain from bidding; that the Bidder has not in any manner, directly or indirectly sought by agreement, communication, or conference with anyone to fix the bid price of the Bidder or any other Bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other Bidder, or to secure any advantage against the public body awarding the Contract of anyone interested in the proposed Contract;that all statements contained in the Bid are true; and, further, that the Bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company associations, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham Bid. (Public Contract Code Section 7106) Address: 2525 N. Old Hwy 395 Fallbrook, Ca 92028 Telephone No.- 760-728-1308 Print Name: A ew Scrape Signature: Title: Vice Preside► Date: SIGNING INSTRUCTIONS TO THE CONTRACTOR Non-Collusion Affidavit must be accompanied by notary certificates for signature. Note the description of the document on the notary certificate. Attach notary certificate immediately following this page; If the Bidder fails to properly sign or omits the required signature, the bid will be considered non- responsive and will be rejected. C-5 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE §1189 �a a 5K.Vq"-.#ia*kto FA.'S.I IsKic G ag.`iiq%t:�.-ci�..t-,k."Nai.ti:4 x.. \.x:F3-.,r-..r.ti. :Y.:4in 9x Rr 4,:sr:.5�.-xt bS:.�..Y.} u.tk,4 ri.=a.4,:;. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California County of San Diego } On 03/08/2024 before me, Elizabeth A. Bulger,Notary Public Date Here Insert Name and Title of the Officer personally appeared Andrew Scrape Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(&)whose names)is/aye subscribed to the within instrument and acknowledged to me that he/s4e/t4ey executed the same in his/hec/tOA* authorized capacity(iies), and that by his/I oW*14eir signature(-,)on the instrument the person(s), or the entity upon behalf of which the person(-,)acted, executed the instrument. I certify under PENALTY OF PERJURY under the ELI7.ABE.TH A,BULGER laws of the State of California that the foregoing Notary Public.California paragraph is true and correct. Q)my San Diego County Commission y 23a7977 WITNESS my hand and official seal. Comm,Expires Feb 19,2025 Signature Place Notary Seal and/or Stamp Above Signatur D a ublic — OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Cily Hall Building CAP Pro-jectNon-Collusion Affidavit Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Andrew Scrape Signer's Name: ❑ Corporate Officer—Title(s): ❑Corporate Officer—Title(s): ❑ Partner— ❑ Limited ❑ General ❑ Partner— ❑ Limited Cl General ® Individual ❑ Attorney in Fact ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Trustee ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer is Representing. Signer is Representing: 020118 National Notary Association DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 BOND NO. --------------- BIDDER'S BOND CITY HALL BUIDLING CIP PROJECT NO. Z20006 STEEL KNOW ALL MEN OR WOMEN BY THESE PRESENTS: That we SCW CONTRACTING CORPORATION as PRINCIPAL, LIBERTY MUTUAL INSURANCE COMPANY hereinafter referred to as "Contractor", and a duly authorized corporate as "Surety," are held and firmly bound unto the City of Lake Elsinore in the penal sum of TEN PERCENT (10%) OF THE TOTAL AMOUNT OF THE BID of the Contractor above named, submitted by said Contractor to the City of Lake Elsinore for the work for said project entitled above, for the payment of which sum in lawful money of the United States, well and truly to be made, to the City of Lake Elsinore to which said bid was submitted, we bind ourselves, our heirs, executors, administrators and successors,jointly and severally, firmly by these presents. In no case shall the liability of the surety hereunder exceed the amount of TEN PERCENT OF GREATER AMOUNT BID (10%), THE CONDITION OF THIS OBLIGATION IS SUCH: That whereas the Contractor has submitted the above-mentioned Bid to the City of Lake Elsinore as aforesaid for the work for said project entitled above. NOW, THEREFORE, if the aforesaid Contractor is awarded the Contract and, within the time and manner required under the Contract documents, after the prescribed forms are presented to him or her for signature, enters into a written Agreement in the prescribed form and in accordance with the Contract documents, and files two bonds with the City of Lake Elsinore, one to guarantee faithful performance and the other to guarantee payment for labor and materials, in accordance with said Contract documents, and as required by law, and files the required insurance certificate(s) in accordance with said Contract documents, then this obligation shall be null and void; otherwise, it shall be and remain in full force and effect until execution of the Agreement or forfeiture pursuant to the Provisions of Sections 20172 and 20174 of the Public Contract Code. In the event suit is brought upon this bond by the City and judgment is recovered, the Surety shall pay all costs incurred by the City in such suit, including a reasonable attorney fee to be fixed by the court. (SIGNATURE PAGE FOLLOWS) C-6 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 BIDDER'S BOND SIGNATURE PAGE CITY HALL BUIDLING CIP PROJECT NO. Z20006 STEEL IN WITNESS WHEREOF, we have hereunto set our hands and seals on this 5TH day of MARCH 2024 BIDDER: CORPORATE SURETY: SCW CONTRACTING LIBERTY MUTUAL Contractor Name: CORPORATION Company Name: INSURANCE COMPANY Address: 2525 NORTH OLD HIGHWAY 395 Address: 790 THE CITY DRIVE SOUTH,SUITE 200 FALLBROOK, CA 92028 ORANGE, CA 92868 Telephone No.: 760/728-1308 Telephone No.: 714/922-2504 Print Name: ANDREW SCAPE Print Name: MARK D. IATAROLA Title: VICE PRE ENT Title: ATTORNEY-IN-FACT Signature: Signature: Date: Date: MARCH 5, 2024 SIGNING INSTRUCTIONS TO THE CONTRACTOR Bidder's Bond must be accompanied by notary certificates for EACH signature. Note the description of the document on the notary certificate. Attach BOTH notary certificates immediately following this page. Corporate Seal may be affixed hereto. The attorney-in-fact for corporate surety must be registered, as such, in at least one county in the State of California. Attach one original Power of Attorney immediately following the notary certificates. If the Bidder fails to properly sign or omits the required signatures, the bid will be considered non- responsive and will be rejected. C-7 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE §1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California 1 County of Sawn J} On 03/08/2024 before me, Elizabeth A. Bulger,Notary Public Date Here Insert Name and Title of the Officer personally appeared Andrew Scrape Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(&)whose name(s) is/aye subscribed to the within instrument and acknowledged to me that he/sloe/t#ey executed the same in his/hewthek authorized capacity(ies), and that by his/heflthesir signature(-,)on the instrument the person(&),or the entity upon behalf of which the person(.&)acted, executed the instrument. I certify under PENALTY OF PERJURY under the EL 17Alaws of the State of California that the foregoing } otary Public A.9ULGER paragraph is true and correct. �r • , �.�-" l�lotary PubNC-California z•.t; San Diego County Commission:2347977 WITNESS my hand and official seal. '+fV OR My Comm.Expires Feb 19,2a25 Signature - Place Notary Seal and/or Stamp Above Signature public OPTIONAL - - Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: City Hall Building CIP Project Bidder's Bond Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Andrew Scrape Signer's Name: ❑ Corporate Officer— Title(s): ❑ Corporate Officer— Title(s): ❑ Partner— ❑ Limited ❑ General ❑ Partner— ❑ Limited ❑ General ® Individual ❑ Attorney in Fact ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Trustee ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: axfvn ��m�+c �����a.���������:�t�tn���s� �re�r��s;rr�a►� o�ea�as��s+�� � -;. ,., <:,< :,: 020118 National Notary Association DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California 1 County of SAN DIEGO J} On 3/5/2024 before me, SANDRA FIGUEROA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared _ MARK D. IATAROLA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(s}is/afesubscribed to the within instrument and acknowledged to me that he/ske,'tHeq executed the same in his/*efA4eif authorized capacityHs), and that by his/hefAhei signature(s)on the instrument the person(fi), or the entity upon behalf of which the person(e)acted,executed the instrument. � I certify under PENALTY OF PERJURY under the S FANN DP�R A��Fl GG Uy E R�OA ` COMM.#2334108 laws of the State of California that the foregoing SAN DIEGO COUNTY paragraph is true and correct. NOTARY PUBLIC-CALIFORNIAZ WITNESS my hand and official seal. MY COMMISSION EXPIRES SEPTEMBER 22,2024 roc.----: Signature Place Notary Seal and/or Stamp Above Signature of Notary !it OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: BIDDER'S BOND Document Date: _ Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: MARK D. IATAROLA _ Signer's Name: ❑ Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): _ ❑ Partner— ❑ Limited ❑ General ❑ Partner— ❑ Limited ❑ General ❑ Individual M Attorney in Fact ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian of Conservator ❑ Trustee ❑ Guardian of Conservator ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: 02017 National Notary Association DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Liberty Mutual Insurance Company mutum. The Ohio Casualty Insurance Company Certificate No: 8205111-024100 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Helen Malonev:John G Malonev:Mark D.latarola;Sandra Figueroa:Tracy Holmes:Tracy Lynn Rodriguez all of the City of Fscondido state of _CA each individually if there be more than one named,its true and lawful attorney-in-fact to make, Ts execute,seal,acknowledge and deliver.for and on its behalf surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 29th day of March 2021 Liberty Mutual Insurance Company INSURE pySK INS& �I Su. The Ohio Casualty Insurance Company West American Insurance Company 's 1912 D`T 1919 ,`, Lu �1991 N Ydy1 �Acuys d� Sprrawvs d�� Ys '�ainu� da GL JsT�j y U By: m " M State of PENNSYLVANIA David M.Carey,Assistant Secretary Cr 0D 0 County of MONTGOMERY ss o (u On this 29th da of March 202I before me personally appeared David M.Care who acknowledged himself to be the Assistant Secrets of Liberty Mutual Insurance a) � Y P y PP Y, 9 Secretary rtY c� m Company,The Ohio Casually Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. } N CC! 0x = IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. Q e.N Qrn Q�'•�y;i}4�H•p. 0-0 , d Comilwnweallh of PenmsyWnia-Notary Seal. Teresa Pastella,Notary Public Montgomery County i ,f/ 7��� ` Q My commission expires March 28,2025 .rr-ems /(,��Q%(,(�-A/ O E Commission number 1125�044 By. N•, �L wE-ov� Member,Pprmrylvpnln.AuoaagionorNoWaa Teresa Pastella,Notary Public < `o 1:110 This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual 3 cc? 0•— Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: a M 4? ARTICLE IV—OFFICERS:Section 12.Power of Attorney. 0 I f° Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the 0 President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety rO >as any and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall-c3 — have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation When so executed,such cca1 Z L) instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the o provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. t0 a ARTICLE XIII—Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, — _ shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 5TH day of MARCH , 2024 w tNSriR 4�Y INSO INSUR 5 a4°�vo�f�yC% ��$caaropgrFq�4 :Po°`�A°yrgy� +u eo fi Y � 1912� 0 �s19190 1991 B ^ yam dig�kenu4baYs 'worpKti �L� y Renee C.Llewellyn,ASSi5tant Secretary --- 7 * > u � �,h * fey Y LMS-12e73 LMIC OCIC WAIC Multi Co 02/21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 REFERENCES CITY HALL BUIDLING CIP PROJECT NO. Z20006 STEEL Failure to demonstrate adequate experience may result in rejection of the bid. For all public agency projects with a similar scope of work which you have worked on (or are currently working on) in the past three (3)years, provide the following required information: 1. Name (Firm/Agency): Bernards Bros,Inc. /Mt. San Jacinto College Address: 555 First Street, San Fernando, Ca 91340 Contact Person: Tavlore Bruce Telephone No.: 818-336-3573 Title of Project: MSJC Stem Building Project Location: San Jacinto, Ca Date of Completion: 3/23/2023 Contract Amount: $2,724,680.00 2. Name (Firm/Agency): Balfour Beatty Construction /Miracosta Community College Address: 13520 Evening-Creek Dr. N STE 270 San Diego. Ca 92128 Contact Person: Scott Hopkins Telephone No.: 858-635-7400 Title of Project: MCCD New Arts Media Building Project Location: Oceanside, Ca Date of Completion: 3/31/2024 Contract Amount: $1,656,413.00 3. Name (Firm/Agency): Miller Construction/Perris Unified School District Address: 8447 Maple Place Rancho Cucamonga, Ca 91730 Contact Person: Aaron Elardo Telephone No.: 909-484-1009 Title of Project: Perris High School Increment 2 Project Location: Perris, Ca Date of Completion: 8/4/2023 Contract Amount: $5,994,000.00 C-9 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 4. Name (Firm/Agency): Erickson-Hall Construction/Anaheim High School District Address: 500 Corporate Dr. Escondido, Ca 92029-1517 Contact Person: Pete Lamirand Telephone No.: 760-566-5465 Title of Project: Magnolia High School Building R Project Location: Anaheim, Ca Date of Completion: 8/29/2023 Contract Amount: $4,776,775.00 5. Name (Firm/Agency): CW Driver/Menifee Union School District Address: 7588 Metropolitan Dr. San Diego, Ca 92108 Contact Person: Vince Holguin Telephone No.: 626-807-8918 Title of Project: Menifee Elementary School#15 Project Location: Menifee, Ca Date of Completion: 626-351-8800 Contract Amount: $2,953,742.00 6. Name (Firm/Agency): Balfour Beatty/Del Mar Union School District Address: 13520 Evening Creek Dr. N, STE 270 San Diego, Ca 92128 Contact Person: Marco Ruelas Telephone No.: 619-721-9799 Title of Project: Del Mar Heights School Rebuild Project Location: Del Mar, Ca Date of Completion: May 2024 Contract Amount: $4,544,678.00 7. Name (Firm/Agency): Erickson-Hall Construction/Downey Unified School District Address: 500 Co orate Dr. Escondido Ca 92029-1517 Contact Person: Mike Arnold Telephone No.: 760-796-7700 Title of Project: Doty Middle School Project Location: Downey. Ca Date of Completion: 4/27/2021 Contract Amount: $4,189,442.00 C-10 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 List any other projects (private, older than three (3) years, etc.)that may represent qualifying similar experience: 1. Name (Firm/Agency): Dempsey Construction/Zephyr Solana LLC Address: 1835 Aston Ave. Carlsbad, Ca 92008 Contact Person: Mike Politte Telephone No.: 760-918-6900 Title of Project: Solana 101 Project Location: Solana Beach, Ca Date of Completion: 9/30/2023 Contract Amount: $4,824,139.00 2. Name (Firm/Agency): Dempsey Construction/KTM North America, Inc. Address: 1835 Aston Ave. Carlsbad, Ca 92008 Contact Person: Bryce Raleigh Telephone No.: 760-918-6900 Title of Project: KTM Headquarters Project Location: Murrieta, Ca Date of Completion: 4/17/2023 Contract Amount: $2,927,995.03 3. Name (Firm/Agency): HITT Contracting/Databank Address: 469 El Camino Real STE 230, Santa Clara, Ca 95050 Contact Person: Lindsay Walsh Telephone No.: 703-929-3263 Title of Project: SAN1 - Databank Site Expansion Project Location: San Diego, Ca Date of Completion: 6/30/2023 Contract Amount: $2,689,170.00 C-11 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 CONTRACTOR'S INFORMATION CITY HALL BUIDLING CIP PROJECT NO. Z20006 STEEL Contractor's License No.: 630435 Class: A, C51, C60 a. Date first obtained: 10-09-1991 Expiration 10/31/2025 b. Has License ever been suspended or revoked? No If yes, describe when and why: N/A c. Any current claims against License or Bond? No If yes, describe claims: N/A Principals in Company (List all—attach additional sheets if necessary): NAME TITLE LICENSE NO. (If Applicable) Jeffrey Scrape President 630435 Andrew Scrape Vice President 630435 Suzanne C. Scrape Secretary 630435 C-12 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 VIOLATIONS OF FEDERAL STATE OR LOCAL LAWS CITY HALL BUIDLING CIP PROJECT NO. Z20006 STEEL 1. Has your firm or its officers been assessed any penalties by an agency for noncompliance or violations of Federal, State or Local labor laws and/or business or licensing regulations within the past five (5) years relating to your construction projects? YES NO (circle one) Federal / State/ Local (circle one) If"yes," identify and describe, (including agency and status): N/A Have the penalties been paid? YES NO (circle one) 2, Does your firm or its officers have any ongoing investigations by any public agency regarding violations of the State Labor Code, California Business and Professions Code or State Licensing Laws? YES NO (circle one) Code/Laws: N/A Section/Article: N/A If"yes," identify and describe, (including agency and status): N/A C-13 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 DISQUALIFICATION OR DEBARMENT CITY HALL BUIDLING CIP PROJECT NO. Z20006 STEEL Has your firm, any officer of your firm, or any employee who has a proprietary interest in your firm ever been disqualified, removed, or otherwise prevented from bidding on, performing work on, or completing a federal, state or local project because of a violation of law or a safety regulation? 9N/A (circle one) If yes, provide the following information (if more than once, use separate sheets): Date: N/A Entity: N/A Location: N/A Reason: N/A Provide Status and any Supplemental Statement: N/A Has your firm been reinstated by this entity? YES / (circle one) N O N/A C-14 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 EXHIBIT B LIST OF SUBCONTRACTORS [ATTACHED] DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 LIST OF SUBCONTRACTORS CITY HALL BUIDLING CIP PROJECT NO. Z20006 STEEL The bidder is required to fill in the following blanks in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Chapter 2 of Division 5, Title 1 of the Government Code of the State of California) and should familiarize itself with Sections 2-3 of the Standard Specifications. Name Under Which Subcontractor is Licensed: The McIntyre Company License Number: 590332 Address of Office, Mill or Shop: 2817 E. Cedar Street, Suite 200, Ontario, CA 91761 Specific Description of Sub-Contract: and Bid Items of Work: Steel Decking Name Under Which Subcontractor is Licensed: License Number: Address of Office, Mill or Shop: Specific Description of Sub-Contract: and Bid Items of Work Name Under Which Subcontractor is Licensed: License Number: Address of Office, Mill or Shop: Specific Description of Sub-Contract: and Bid Items of Work: Name Under Which Subcontractor is Licensed: License Number: Address of Office, Mill or Shop: Specific Description of Sub-Contract: and Bid Items of Work: Subcontractors listed in accordance with the provisions of Section 2-3 must be properly licensed under the laws of the State of California for the type of work that they are to perform. Do not list alternate subcontractors for the same work. C-8 BOND NO. 024270357 PREMIUM $ LABOR AND MATERIALS BOND (100% of Total Contract Amount) WHEREAS, the City Council of the City of Lake Elsinore, State of California, has awarded to and entered into an Agreement with SCW Contracting Corporation (hereinafter designated as "Principal") whereby the Principal agrees to construct or install and complete certain designated public improvements, which said Agreement, effective on the date signed by the City Manager, and identified as CITY HALL BUILDING CIP PROJECT NO. Z20006 STEEL is hereby referred to and made a part hereof; and WHEREAS, under the terms of the Agreement, said Principal is required before entering upon the performance of the work, to file a good and sufficient payment bond with the City of Lake Elsinore to secure the payment of claims to which reference is made in Title 3 (commencing with Section 9000) of Part 6 of Division 4 of the Civil Code. NOW, THEREFORE, we the undersigned Principal and LIBERTY MUTUAL INSURANCE COMPANY, as Surety are held and firmly bound unto the City of Lake Elsinore (hereinafter designated as "City") and all contractors, subcontractors, laborers, material suppliers, and other persons employed in the performance of the Agreement as referred to in Title 3 (commencing with Section 9000) of Part 6 of Division 4 of the California Civil Code, in the sum of FIVE MILLION ONE HUNDRED ONE THOUSAND NINE HUNDRED TWENTY FOUR and 00/100 dollars ($5.1 01,924.00), lawful money of the United States, for materials furnished or labor thereon of any kind, or for amounts due under the Unemployment Insurance Code with respect to such work and labor, that the Surety will pay for the same in an amount not exceeding the sum specified in this bond. In the event suit is brought upon this bond, the Surety shall pay in addition to the face amount thereof, all costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by the City in successfully enforcing this obligation, to be awarded fixed by the court, and to be taxed as costs and to be included in the judgment therein rendered It is expressly stipulated and agreed that this bond shall inure to the benefit of any of the persons, companies, and corporations entitled to file claims under Title 3 (commencing with Section 9000) of Part 6 of Division 4 of the California Civil Code, to give a right of action to such persons or their assigns in any suit brought upon this bond. Should the condition of this bond be fully performed, then this obligation shall become null and void, otherwise it shall be and remain in full force and effect. The surety hereby stipulates and agrees that no change, extension of time, alteration, or addition to the terms of the agreement or the specifications accompanying the same shall in any manner affect its obligation on this bond, and it does hereby waive notice of any such change, extension, alteration, or addition. (SIGNATURE PAGE FOLLOWS) D-13 024270357 BOND NO. SIGNATURE PAGE TO LABOR AND MATERIALS BOND IN WITNESS WHEREOF, we have hereunto set our hands, and seals on this 16TH day of APRIL 20 24 _ BIDDER: SURETY: Contractor Name: SCW CONTRACTING CORPORATION Name: LIBERTY MUTUAL INSURANCE COMPANY Address: 2525 NORTH OLD HIGHWAY 395 Address: P.O.BOX 34526 FALLBROOK,CA 92028 SEATTLE,WA 98124 Telephone No.: 760/728-1308 Telephone No.: 714/922-2504 Print Name: ANPREW SCRAPE,VICE PRESIDENT Print Name: MARK D. IATAROLA Attorney-in-Fact Signature: Signature: Approved atthFQi4lii day of A%A.L 20_24 Attorney City of Lake Elsinore NOTE: This bond must be executed by both parties. Corporate seal may be affixed hereto. All signatures must be acknowledged before a notary public(attach acknowledgments). The attorney-in-fact for the corporate surety must be registered, as such, in at least one county in the State of California. (Attach one original Power of Attorney sheet for each bond). D-14 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE §1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California 1 County of Sabo J} On 04/25/2024 before me, Elizabeth A. Bulger,Notary Public Date Here Insert Name and Title of the Officer personally appeared Andrew Scrape Nome(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(&)whose names)is/afe subscribed to the within instrument and acknowledged to me that he/slae/t4W executed the same in his/bef/t4@k authorized capacity('res),and that by his/he4*eiir signature(&)on the instrument the person(&), or the entity upon behalf of which the person(&)acted,executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing ELIZABETHA.BULGER paragraph is true and correct. ` Notary%blic-California San Diego County WITNESS my hand and official se Commission#2347977 ep y Comm,Expires Feb 14,2025 Signature Place Notary Seal and/or Stamp Above Signature tcry Public OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Labor and Materials Bond City of Lake Elsinore City Hall Bldg CIP No.Z20006 Steel Document Date: 4/16/2024 Number of Pages: 2 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Andrew Scrape Signer's Name: ❑ Corporate Officer—Title(s): ❑Corporate Officer—Title(s): ❑ Partner— ❑ Limited ❑ General ❑ Partner— ❑ Limited ❑ General ® Individual ❑ Attorney in Fact ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Trustee ❑ Guardian or Conservator [] Other: ❑ Other: Signer is Representing: Signer is Representing: 02018 National Notary Association CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§1189 A notary public or other officer completing this certificate verifies onlythe identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California 1 County of SAN DIEGO J} On 4/16/2024 before me, SANDRA FIGUEROA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s)whose name(4 is/afesubscribed to the within instrument and acknowledged to me that he/ehe*tey executed the same in his/*e64heif authorized capacity(ies),and that by his/"-A;eif signature(e)on the instrument the person(,or the entity upon behalf of which the person(a)acted,executed the instrument. SANDRA FIGUEROA I certify under PENALTY OF PERJURY under the �- COMM.#2334108 laws of the State of California that the foregoing SAN DIEGO COUNTY paragraph is true and correct. NOTARY PUBLIC-CALIFORNIAZ MY COMMISSION EXPIRES WITNESS my hand and official seal. SEPTEMBER 22,2024 Signature Place Notary Seal and/or Stamp Above Signature of Nc&ry Public OPTIONAL - - Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: . Capacity(ies) Claimed by Signer(s) Signer's Name: MARK D. IATAROLA Signer's Name: ❑ Corporate Officer-Title(s): ❑ Corporate Officer-Title(s): ,_ . ❑ Partner- ❑ Limited ❑ General ❑ Partner- ❑ Limited ❑ General ❑ Individual N Attorney in Fact ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian of Conservator ❑ Trustee ❑ Guardian of Conservator ❑ Other: _ _ _ _ ❑ Other: -. Signer is Representing: Signer is Representing: 02017 National Notary Association This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Liberty Mutual Insurance Company Mutual. The Ohio Casualty Insurance Company Certificate No: 8205111-024100 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Helen Maloney;John G Maloney-,Mark D Iatarola;Sandra Figueroa;Tracy Holmes;Tracy Lynn Rodriguez all of the city of Escondido state of CA each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 29th day of March 2021 Liberty Mutual Insurance Company %NSU y-tv INS& d ttss�Rq The Ohio Casualty Insurance Company may`G4ara�yy[+ q,L61zP4kQ�RTy `VP�oµ1 v r�r�e West American Insurance Company Ja` FaR+ J — s M 3 �otrt W Y 1912� x�1919 o a 1991 i %..,,., H 0] d� fq.srrusm,db ° 'FkiuPa' by'' Y 'k9tAµ. b r!!.:`• /�• e V cu David M.Carey,Assistant Secretary a State of PENNSYLVANIA ss m rn County of MONTGOMERY p E On this 29th day of March 2021 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance cis 0 m Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes a? > therein contained by signing on behalf of the corporations by himself as a duly authorized officerCU a � IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. Co W �O O N Commonwealth of Pennsylvania-Notary Seal �� 6 LO Teresa Paslella,Notary Public +-� Co Montgomery County "1 yy����//{{}1 y C.2 My commission expires March 28,2025 By: (6 Commission number 1126044 -- - Qj.-. Member,Pennsylvania Asscaubn of Mainr m Teresa Pastell a,Notary Public Q O 11, w O� :3 This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual �op •� Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: 0 4? ARTICLE IV-OFFICERS:Section 12.Power of Attorney. o 0 ' Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the-2 r President may prescribe,shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as suretyCo �D > aCi any and all undertakings,bonds,recognizances and other surety obligations.Such attorneys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall� - have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such Co oa Z0 0 instruments shall be as binding as 9 signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attorney-in-fact under the M provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. to L ARTICLE XIII-Execution of Contracts:Section 5.Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation-The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization-By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 16TH day of APRIL , 2024 .v SHsu ,yZVI ITI$� a 1H8{yR J P� 'Ynrn Ja°ativang_ � G,A�apva'�e1 Cl o � 1912 e1 0 1919 Lu 1991 r) L+�. z w a a a By: hA µP$�`,Ab '+',T �++wAHP�.db� Renee C.[Jewellyri,Assistant Secretary --- - LMS-12e73 LMIC OCIC WAIC Multi Cc 02121 024270357 BOND NO. PREMIUM $ 40,391.00 PREMIUM IS FOR CONTRACT TERM AND ISFAITHFUL PERFORMANCE BOND BASED NFINALUBJECT TONTRA ADJUSTMENT BASED ON FINAL CONTRACT PRICE (100% of Total Contract Amount) KNOW ALL MEN AND WOMEN BY THESE PRESENTS: THAT WHEREAS, the City Council of the City of Lake Elsinore, State of California, known as "City," has awarded to SCW CONTRACTING CORPORATION as Principal hereinafter designated as"Contractor"and have entered into a Contract Agreement whereby the Contractor agrees to construct or install and complete certain designated public improvements, which said Contract Agreement, effective on the date signed by the Mayor, and identified as CITY HALL BUIDLING CIP PROJECT NO.Z20006 STEEL is hereby referred to and made a part hereof; and WHEREAS, said Contractor under the terms of said Contract Agreement is required to furnish a bond guaranteeing the faithful performance of said Contract Agreement; NOW THEREFORE, we the undersigned Contractor and LIBERTY MUTUAL INSURANCE COMPANY as Surety, are held and firmly Bound unto the City of Lake Elsinore, County of Riverside in the penal FNF MILLION ONE HUNDRED ( . I y sum of ONETHDUSANDNINEHI}NOR1=I 7WEN'Y FOUR AND M100 dollars $ r:J, 01,924.00 }, awful mono of the United States,to be paid to the said City or its certain attorney, its successors and assigns; for which payment, well and truly to be made, we bind ourselves, our heirs, executors and administrators, successors and assigns,jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the above bound Contractor, his or her or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenants, conditions and provisions in said Contract Agreement and any alterations thereof made as therein provided, on his or her or their part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless the City of Lake Elsinore, its officers,agents and employees, as therein stipulated, then this obligation shall become null and void; otherwise it shall be and remain in full force and effect. In the event suit is brought upon this bond by the City and judgment is recovered, the Surety shall pay all costs incurred by the City in such suit, including a reasonable attorney fee to be fixed by the court. The Surety hereby stipulates and agrees that no change, extension of time, alteration, or addition to the terms of the Contract Agreement or to the work to be performed thereunder, or the Provisions accompanying the same shall in any way affect its obligations on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the Contract Agreement or to the work or the Provisions. D-10 (SIGNATURE PAGE FOLLOWS) D-11 024270357 BOND NO. SIGNATURE PAGE TO FAITHFUL PERFORMANCE BOND IN WITNESS WHEREOF, we have hereunto set our hands, and seals on this 16TH day of APRIL 20 24 BIDDER: SURETY: Contractor Name: SCW CONTRACTING CORPORATION Name: LIBERTY MUTUAL INSURANCE COMPANY Address: 2525 NORTH OLD HIGHWAY 395 Address: P.O.BOX 34526 FALLBROOK,CA 92028 SEATTLE,WA 98124 Telephone NO.: 760/728-1308 Telephone NO.. 714/922-2504 Print Name: AN W SCRAPE,VICE PRESIDENT Print Name: MARK D. IATAROLA Attorney-In- Approved as t F is day of 20_?,�- Clty,Attorney City of Lake Elsinore NOTE: This bond must be executed by both parties. Corporate seal may be affixed hereto. All signatures must be acknowledged before a notary public attach acknowledgments). The attorney-in-fact for the corporate surety must be registered, as such, in at least one county in the State of California. (Attach one original Power of Attorney sheet for each bond). D-12 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies onlythe identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California 1 County of Sabo J} On 04/25/2024 before me, Elizabeth A. Bulger,Notary Public Date Here Insert Name and Title of the Officer personally appeared Andrew Scrape Nome(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(&)whose name(&) is/afe subscribed to the within instrument and acknowledged to me that he/s4e/t4W executed the same in his/howt4ew authorized capacity(ies),and that by his/hef hesir signature(.&)on the instrument the person(&),or the entity upon behalf of which the person(s)acted, executed the instrument. I certify under PENALTY OF PERJURY under the ELIZABETH A.BULGER laws of the State of California that the foregoing NoUryPublic-Caflfornfa paragraph is true and correct. y - San Dregs County it m Commission t12347977 WITNESS my hand and official seal. my Comm.Expires Feb 19,2025 Signature Place Notary Seal and/or Stamp Above natu f Nata Public OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Performance Bond City of Lake Elsinore City Hall Bldg CIP No.Z20006 Steel Document Date: 4/16/2024 Number of Pages: 3 Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Andrew Scrape Signer's Name: - ❑ Corporate Officer—Title(s): ❑ Corporate Officer—Title(s): ❑ Partner— ❑ Limited ❑ General ❑ Partner— ❑ Limited ❑ General ® Individual ❑ Attorney in Fact ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Trustee ❑ Guardian or Conservator ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: 02018 National Notary Association CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE §1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California 1 County of SAN DIEGO J} On 4/16/2024 before me, _ SANDRA FIGUEROA, NOTARY PUBLIC Date Here Insert Name and Title of the Officer personally appeared MARK D. IATAROLA Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the personN whose name(s}is/afe-subscribed to the within instrument and acknowledged to me that he/64,�executed the same in his/ eif authorized capacity(ies), and that by his/liefAheif signature(s)on the instrument the person(, or the entity upon behalf of which the person(a)acted, executed the instrument. WNOTARY I certify under PENALTY OF PERJURY under the NDRA FIGUEROA laws of the State of California that the foregoing OMM.#2334108 j� paragraph is true and correct. N DIEGO COUNTY PUBLIC-CALIFORNIAZ WITNESS my hand and official seal. OMMISSION EXPIRES SEPTEMBER 22, 2024 -�� v Signature - Place Notary Seal and/or Stamp Above Signature of No ry Public OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: MARK D. IATAROLA Signer's Name: ❑ Corporate Officer-Title(s): ❑Corporate Officer-Title(s): ❑ Partner- ❑ Limited ❑ General ❑ Partner- ❑ Limited ❑ General ❑ Individual 97 Attorney in Fact ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian of Conservator ❑ Trustee ❑ Guardian of Conservator ❑ Other: ❑ Other: Signer is Representing: Signer is Representing: 02017 National Notary Association This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Liberty Mutual Insurance Company Mutual The Ohio Casualty Insurance Company Certificate No: 8205111-024100 SURETY West American Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire,that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana(herein collectively called the"Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint, Helen Maloney;John G.Maloney;Mark D latarola;Sandra Figueroa;Tracy Holmes;Tracy Lynn Rodriguez all of the city of Escondido state of E'a each individually if there be more than one named,its true and lawful attorney-in-fact to make, execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF,this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 29th day of March 2021 Liberty Mutual Insurance Company %14su. 01 INS 1143up The Ohio Casualty Insurance Company 0AA} Mtn ,oaP°fir ZL t4 GaA"Op�Sr �, West American Insurance Company F F C cn U a { .' ❑ Yn 1912 - 9 1919 1991 Naa'�sAextl`+ db ° "rnMeSa,�L mod, 'hn{Axo- aD� •TWi'�J '*•'�,- U By: Co _c`o David M.Carey,Assistant Secretary w } ca State of PENNSYLVANIA County of MONTGOMERY ss o On this 29th day of March 2021 before me personally appeared David M.Carey,who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance U v o m Company,The Ohio Casualty Company,and West American Insurance Company,and that he,as such,being authorized so to do,execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. } IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at King of Prussia,Pennsylvania,on the day and year first above written. p C cn O 4911t1{y Cammpnwaagh o[Penrsyh anw•NaWsy Seal >` ` ie� _ Teresa Paslella,No"Public � /] 0— do gy o f- � Iy Montgomery County If/ IIJ My commission expires March 28,2025 B - ❑t C N Commission number 1126044 y: ` •:r;v_',r V1 b,,.Pam,,, Teresa Pastella,Notary Public `Z d 97 r va a M1ssocia,Icn ar raow�P� rY 17 0� a? This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual 3 C9 •� Insurance Company,and West American Insurance Company which resolutions are now in full force and effect reading as follows: a M 00 ARTICLE IV—OFFICERS:Section 12.Power of Attorney. 86 Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject to such limitation as the Chairman or the L) President may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal,acknowledge and deliver as surety m= > ` any and all undertakings,bonds,recognizances and other surety obligations.Such attomeys-in-fact,subject to the limitations set forth in their respective powers of attorney,shall v M have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so executed,such 0 a) Z 0instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attomey-in-fact under the� m provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. 0 M CL ARTICLE XIII—Execution of Contracts:Section 5 Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president,and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact,as may be necessary to act in behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings, bonds,recognizances and other surety obligations.Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation—The President of the Company,acting pursuant to the Bylaws of the Company,authorizes David M.Carey,Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization—By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds,shall be valid and binding upon the Company with the same force and effect as though manually affixed. I,Renee C.Llewellyn,the undersigned,Assistant Secretary,The Ohio Casualty Insurance Company,Liberty Mutual Insurance Company,and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full,true and correct copy of the Power of Attorney executed by said Companies,is in full force and effect and has not been revoked IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seals of said Companies this 16TH day of APRIL , 2024 W INS�R rtY INS& ,A INSu �JP�oar4x�T9yn �.)�scr9�''�gy GP 4oRrar�.6LU °y� 3 to to s yPa C� R' `�o Sn f� 1912 n o 1919 o 1991r ~~ so��'raMrgF¢a �s �{"n� db3 By.Renee C.Llewellyn,Assistant Secretary LMS-12873 LMIC OCIC WAIC Multi Co 02/21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 03/27/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Hope Perry(Zamichieli) NAME: Michael Ehrenfeld Company Insurance Agents aCC Ext: (619)683-9990 A CX No): (619)683-9999 An Acrisure Agency CA OK07568 E-MAIL hopez@ehrenfeldinsurance.com ADDRESS: 2655 Camino Del Rio North#200 INSURER(S)AFFORDING COVERAGE NAIC# San Diego CA 92108 INSURERA: Hartford Fire Insurance Company 19682 INSURED INSURER B: AXIS Surplus Insurance Co 26620 SCW Contracting Corp INSURER C: Hartford Casualty Insurance Company 029424 2525 N.Old Hwy#395 INSURER D: Westchester Surplus Lines Insurance Co 10172 INSURER E: Aspen Specialty Insurance Company 10717 Fallbrook CA 92028 INSURER F: COVERAGES CERTIFICATE NUMBER: 23-24 ALL LIABILITY REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �X OCCUR PRIM SES Ea oNcE ence $ 300,000 X Contractual Liability MED EXP(Any one person) $ 10,000 A X Deductible: $0 Y Y 53UENOH9024 10/01/2023 10/01/2024 PERSONAL&ADV INJURY $ 1,000,000 MOTHER LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑X PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y Y 53UENOH9025 10/01/2023 10/01/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X Ded-$0 $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 B X EXCESS LIAB CLAIMS-MADE Y Y P00100076463703 10/01/2023 10/01/2024 AGGREGATE $ 5,000,000 DED I X1 RETENTION $ O $ WORKERS COMPENSATION X1 SPERTATUTE EORH AND EMPLOYERS'LIABILITY YIN 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ C OFFICER/MEMBEREXCLUDED? NIA Y 53WEOH9H11 10/01/2023 10/01/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Contractors Pollution Liability Each Pollution Condition $2,000,000 D G4681759AO07 10/01/2023 10/01/2024 General Aggregate $2,000,000 Deductible: $5,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) [Job#:2415-LECH Job Type:) City Hall Building CIP Project No.Z20006 The City of Lake Elsinore,its elected or appointed officers,officials,employees,agents and volunteers are afforded additional insured, primary/non-contributory and waiver of subrogation where required by written contract per attached policy endorsement forms.Should any of the above coverage be provided by an OCIP/Wrap insurance program,these policies will apply for off-site coverage only. 30 Day Notice of Cancellation Except 10 Day Notice of Cancellation Applies For Non Payment of Premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Lake Elsinore ACCORDANCE WITH THE POLICY PROVISIONS. 130 S.Main Street AUTHORIZED REPRESENTATIVE `. Lake Elsinore, CA 92530 7 /tit `filx ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 AGENCY CUSTOMER ID: LOC#: `4` "� ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Michael Ehrenfeld Company Insurance Agents SCW Contracting Corp POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance:Notes INLAND MARINE-CONTRACTORS EQUIPMENT COVERAGE INSURER E:Aspen Specialty Insurance Company-Policy#IMOOPGP23 Effective 10/01/2023-10/01/2024 INSTALLATION FLOATER:$50,000 Limit Per Project EQUIPMENT LEASED/RENTED FROM OTHERS:$250,000 Limit Per Item/Per Occurrence COVERED LOCATION: 2525 N.OLD HIGHWAY 395,FALLBROOK CA 92028 BUSINESS PERSONAL PROPERTY LIMIT--THE MOST "WE"PAY FOR LOSS AT ANY ONE"COVERED LOCATION"-$2,500,000 Includes 1)at the site of installation,fabrication,or erection;or 2)while in temporary storage awaiting installation,fabrication,or erection. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 POLICY NUMBER: 53UENOH9024 3 i THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART INDEX 1. Alienated Premises Coverage....................................................................................................................1 2. Damage To Your Work..............................................................................................................................1 3. That Particular Part....................................................................................................................................1 4. Contractors Limited Professional Liability...................................................................................................2 5. Per Project and Per Location General Aggregate Limits Of Insurance........................................................2 6. Medical Payments Coverage - Including Products - Completed Operations...............................................3 7. Injury To Employee's Reputation With Respect To Incidental Medical Malpractice ....................................3 8. Bodily Injury Employee Suits......................................................................................................................4 9. Consolidated Insurance (Wrap-Up) Programs. ...........................................................................................4 10. Access Or Disclosure Of Confidential Or Personal Information And Data-Related Liability ........................5 11. Supplementary Payments..........................................................................................................................5 12. Two Or More Coverage Parts Or Policies Issued By Us.............................................................................6 13. Notice of Cancellation to Certificate Holders..............................................................................................6 14. Contractual Liability Coverage For Personal And Advertising Injury...........................................................6 15. Insured Contract Definition.........................................................................................................................6 1 . ALIENATED PREMISES COVERAGE of the insured , regardless of whether the Exclusion j. Damage To Property of Section I - "property damage" arises from breach of Coverage A is amended as follows: contract. exception to the exclusion is B. Exclusion I. Damage To Your Work of a. The following p Siectbquladed Qgvthrage A deleted: following: Paragraph (2) of this exclusion does not apply I. Damage to Your Work if the premises are "your work" and were never occupied, rented or held for rental by "Property damage" to that particular part you. of "your work" that must be restored, repaired or replaced because "your work" b. This exception is replaced by the following: was incorrectly performed and included in Paragraph (2) of this exclusion does not apply the "products-completed operations if the premises are "your work". hazard". 2. DAMAGE TO YOUR WORK This exclusion does not apply if the damaged A. Section I - Coverage A - Bodily Injury And work or the work performed incorrectly was Property Damage Liability, Paragraph 1. performed on your behalf by a subcontractor. Insuring Agreement is amended to add the This Paragraph dd&.s not apply if Exclusion following: LhOarbage dtlaeMoiae Work f. Damages because of "property damage" modified by endorsement. include damages the insured becomes 3. THAT PARTICULAR PART legally obligated to pay because of This Paragraph applies to Exclusion j. "property damage" to "your work" or Damage to Property, subparagraphs(5), and (6), caused by "your work", and such "property Exclusion k. Damage to Your Product, and damage" shall be deemed to be caused Exclusion I. Damage to Your Work. by an "occurrence", if not intended or expected from the standpoint Form HS 24 50 12 20 ©2020, The Hartford Page 1 of 7 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 When performing operations as a "general afforded under this Coverage Part is excess over contractor", the term that particular part shall not such other valid and collectible Professional mean the entire construction, improvement or Liability insurance (including any deductible or renovation project. For purposes of this provision, self-insured retention portion thereof), and any the term "general contractor" means the other valid and collectible insurance available to contractor signing the prime construction contract the insured whether primary, excess, contingent for a construction, erection, improvement or or on any other basis. renovation project and that has main responsibility 5. PER PROJECT AND PER LOCATION GENERAL for such project including hiring all of the AGGREGATE LIMITS OF INSURANCE subcontractors and suppliers. 4. CONTRACTORS LIMITED PROFESSIONAL A. For all sums which the insured becomes LIABILITY legally obligated to pay as damages caused by "occurrences" under Section I - Coverage The following exclusion is added to Paragraph 2., Aand for all medical expenses caused by Exclusions of Section I - Coverage A - Bodily accidents under Section I - Coverage C, Injury And Property Damage Liability, and to which can be attributed only to ongoing Paragraph 2., Exclusions of Section I - operations at a single "project" or a single Coverage B - Personal And Advertising Injury "location"; Liability: 1. A separate Per Project General This insurance does not apply to "bodily injury", Aggregate Limit or a separate Per "property damage" or "personal and advertising Location General Aggregate Limit applies injury" arising out of the rendering of or failure to to each "project" or "location", whichever render any professional services by you with is applicable. The Per Project General respect to your providing engineering, Aggregate Limit and Per Location architectural or surveying services in your Aggregate Limit is equal to the amount of capacity as an engineer, architect or surveyor. the General Aggregate Limit shown in the Professional services include: Declarations. (1) The preparing, approving, or failing to prepare 2• The Per Project General Aggregate Limit or approve, maps, shop drawings, opinions, or the Per Location General Aggregate reports, surveys, field orders, change orders, Limit, whichever applies, is the most we or drawings and specifications; and will pay for the sum of all damages under (2) Supervisory or inspection activities performed Coverage A. except damages because of"bodily injury" or "property damage" as a part of any related architectural or included in the "products-completed engineering activities. operations hazard", and for medical This exclusion applies even if the claims against expenses under O+eijearftg any insured allege negligence or other wrongdoing of the number of; in the supervision, hiring, employment, training or a. Insureds; monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or b. Claims made or"suits" brought; or "property damage", or the offense which caused c. Persons or organizations making the "personal and advertising injury", involved the claims or bringing "suits". rendering of or failure to render any professional 3. Any payments made under Coverage A services by you with respect to your providing for damages or under Coverage C for engineering, architectural or surveying services in medical expenses shall reduce the Per your capacity as an engineer, architect or surveyor. Project General Aggregate Limit for that project or the Per Location General This exclusion does not apply to your operations Aggregate for that "location", whichever in connection with construction work performed by applies. Such payments shall not reduce you or on your behalf. the General Aggregate Limit shown in the However, this exception to the exclusion will not Declarations, the Per Project General apply if you are in the business or profession of Aggregate Limit for any other"project", or providing the professional services described the Per Location General Aggregate Limit above independent from the construction work for any other"location". performed by you or on your behalf. 4. The limits shown in the Declarations for In the event this insurance applies to any injury, Each Occurrence, Damage To Premises damage, loss, cost or expense covered by Rented To You and Medical Expense Professional Liability insurance issued by a continue to apply. However, instead of company unaffiliated with us, then the insurance Page 2 of 7 Form HS 24 50 12 20 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 being subject to the General Aggregate 2. "Location" means a premises an insured Limit shown in the Declarations, such limits owns or rents and where such insured will be subject to the applicable Per Project performs business operations other than General Aggregate Limit if attributable only construction-related operations. Each to ongoing operations at a single "project" "location" involving the same or connecting or the Per Location General Aggregate if lots, or premises whose connection is attributable only to ongoing operations at a separated by a street, roadway, waterway single "location". or right-of-way railroad shall be considered B. For all sums which the insured becomes legally a single "location." "Location" does not obligated to pay as damages caused by include a premises that is a "project". "occurrences" under Section I - Coverage A This provision does not apply if the Per Project and the and for all medical expenses caused by Per Location General Aggregate Limit has been accidents under Section I - Coverage C , otherwise modified by endorsement. which cannot be attributed only to ongoing 6. MEDICAL PAYMENTS COVERAGE - INCLUDING operations at a single "project" or a single PRODUCTS-COMPLETED OPERATIONS "location"; Paragraph 1.a. of the Insuring Agreement - 1. Any payments made under Golverage A Coverage C is replaced by the following: damages or under Coverage C for medical expenses shall reduce the amount available 1. Insuring Agreement under the General Aggregate Limit or the a. We will pay medical expenses as described Products-Completed Operations Aggregate below for "bodily injury" caused by an Limit, whichever is applicable; and accident: 2. Such payments shall not reduce any Per (1) On premises you own or rent; Project General Aggregate Limit or any Per (2) On ways next to premises you own or Location General Aggregate Limit. rent; C. When coverage for liability arising out of the (3) Because of your operations; or "products-completed operations hazard" is provided, any payments for damages because (4) Included within the definition of the of "bodily injury" or "property damage" included "products-completed operations in the "products-completed operations hazard" hazard;" will reduce the Products-Completed Operations provided that: Aggregate Limit, and not reduce the General (1) The accident takes place in the Aggregate Limit,or any Per Project General "coverage territory" and during the Aggregate Limit or any Per Location General Aggregate Limit. policy period; D. The provisions of Section III - Limits Of (2) The expenses are incurred and reported to us within three years of the Insurance not otherwise modified by this date of the accident; and endorsement shall continue to apply as stipulated. (3) The injured person submits to E. For the purposes of Paragraph 5., the following examination, at our expense, by physicians of our choice as often as we definitions apply: reasonably require. "Project" means a premises an insured does not 7. INJURY TO EMPLOYEE'S REPUTATION WITH own or rent and where such insured performs RESPECT TO INCIDENTAL MEDICAL construction-related operations. Each "project" MALPRACTICE involving the same or connecting lots, or premises whose connection is separated by a A. The following is added to Paragraph 1.e. of the street, roadway, waterway, railroad or Insuring Agreement - Coverage A: right-of-way shall be considered a single (3) p With respect to incidental medical "project". malpractice, "bodily injury" includes 1. If a "project" has been abandoned and then damages claimed for injury to emotions or restarted, or if the authorized contracting reputation of an "employee" arising out of parties deviate from plans, blueprints, the rendering or failure to render designs, specifications or timetables, the professional health care services as a "project" shall be considered a single physician, dentist, nurse, emergency "project". "Project" does not include a medical technician or paramedic services. premises that is a "location". Form HS 24 50 12 20 Page 3 of 7 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 B. The following exclusion is added to Coverage "Bodily injury" or "property damage" resulting B - Personal and Advertising Injury: from "repair work" or "punch list work" at a "Personal and advertising injury arising out of "wrap project or premises" but only when the the rendering or failure to render professional applicable "consolidated insurance (wrap-up) health care services as a dentist program" does not apply or no longer applies physician,nurse, emergency medical technician or to such "repair work" or"punch list work". paramedic. This exception does not apply to the cost of 8. BODILY INJURY EMPLOYEE SUITS performing such "repair work" or "punch list work", or to the "repair work" or "punch list A. "Bodily injury" as listed in Paragraph 2.a.(1) of work" itself. Section II - Who Is An Insured, does not apply to 2.a.(1)(a) through 2.a.(1)(c). D. Additional Insured Extension B. Part a. of Paragraph 4. Nonowned Watercraft "Bodily injury" or "property damage" for which in Section II - Who Is An Insured does not you are solely an additional insured under the "consolidated insurance (wrap-up) program". apply. 9. CONSOLIDATED INSURANCE (WRAP-UP) The coverage provided under Paragraphs 9.A PROGRAMS through 9.D. above is subject to all terms, conditions and exclusions of this policy. The following exclusion is added to Section I For purposes of Paragraph 9, the following Coverage A: definitions apply: pp Y: This insurance does not apply to any "bodily injury" "Consolidated insurance (wrap-up) program" or "property damage" arising out of any "wrap means any agreement or arrangement, including project or premises" where an insured under this any contractor-controlled, owner-controlled, policy is or was also an insured under one or more project-specific or similar insurance program under commercial general liability (CGL) policies which one or more contractor(s) working on a (including any umbrella or excess policies that specified project are insured under one or more include the commercial general liability policy(ies) commercial general liability (CGL) policies as underlying insurance) included within a (including any umbrella or excess policies that consolidated insurance (wrap-up) program. This include the commercial general liability policy(ies) exclusion applies even if the limits of insurance for as underlying insurance) issued by a specified such "consolidated insurance (wrap-up) program" carrier for injury or damage arising out of are exhausted or not collected for any reason, operations conducted in connection with or including bankruptcy or insolvency of the insurer necessary or incidental to the project. providing coverage for the "consolidated insurance (wrap-up) program". This exclusion also applies if "Insured's operations" means all operations the CGL coverage afforded under the performed by a named insured (and not "consolidated insurance (wrap-up) program" is sub-contracted or performed by others on the narrower in scope than the coverage provided by insured's behalf). this policy. "Punch list work" means the "insured's operations" This exclusion does not apply to: at or in connection with a "wrap project or premises" in order to complete the work called for A. Products-Completed Operations Hazard in an insured's contract for the "wrap project or Exception premises". "Bodily injury" or "property damage" arising out "Repair work" means the "insured's operations" of an "insured's operations" at or in connection that are service, maintenance, correction, repair, with a "wrap project or premises" when such replacement work or periodic "bodily injury" or "property damage" inspection performed by an insured at or in commences after the "products-completed connection with a "wrap project or premises", in operations hazard" coverage or any completed order to replace or repair an insured's completed operations extension coverage provided by the work. applicable "consolidated insurance (wrap-up) program" has ended or is no longer in effect. Wrap projector premises means any premises or construction, erection, improvement or renovation B. Off-Site Location Exception project subject to a "consolidated insurance "Bodily injury" or "property damage" resulting (wrap-up) program". from an "insured's operations" at or in 10. ACCESS OR DISCLOSURE OF CONFIDENTIAL connection with a "wrap project or premises" at OR PERSONAL INFORMATION AND DATA- a location to which the applicable "consolidated RELATED LIABILITY insurance (wrap-up) program" does not apply. C. Repair Work And Punch List Work Exception Page 4 of 7 Form HS 24 50 12 20 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 A. Exclusion p. of Section I - Coverage A - C. The following Paragraph is added to Section Bodily Injury And Property Damage Liability III - Limits Of Insurance: is replaced by the following: Subject to Paragraph 5. Each Occurrence p. Access Or Disclosure Of Confidential Limit, the most we will pay under Coverage A Or Personal Information And for "property damage" because of all loss of Data-Related Liability "electronic data" arising out of any one Damages arising out of: "occurrence" is $100,000, unless modified by endorsement. (1) Any access to or disclosure of any person's or organization's confidential D. The following definition is added to Section V or personal information, including -Definitions: patents, trade secrets, processing "Electronic data" means information, facts or methods, customer lists, financial programs: information, credit card information, a. Stored as or on; health information or any other type of nonpublic information; or b. Created or used on; or (2) the loss of, loss of use of, damage to, c. Transmitted to or from; corruption of, inability to access, or computer software, (including systems and inability to manipulate "electronic data" applications software) hard or floppy disks, that does not result from physical CD-ROMS, tapes, drives, cells, data injury to tangible property. processing devices or any other media which This exclusion applies even if damages are used with electronically controlled are claimed for notification costs, credit equipment. monitoring expenses, forensic expenses, E. For the purposes of the coverage provided by public relations expenses or any other this provision, the definition of "property loss, cost or expense incurred by you or damage" in Section V - Definitions is others arising out of that which is replaced by the following: described in Paragraph (1) or(2) above. "Property damage" means: However, unless Paragraph (1) above a. Physical injury to tangible property, applies, this exclusion does not apply to including all resulting loss of use of that liability for damages because of "bodily property. All such loss of use shall be p Y� injury". deemed to occur at the time of the B)f Exclusion w. Section 1 - Coverage B - physical injury that caused it; Personal and Advetising Injury is replaced b. Loss of use of tangible property that is not by the following: : physically injured. All such loss of use w. Access Or Disclosure Of Confidential shall be deemed to occur at the time of Or Personal Information the "occurrence"that caused it; or "Personal and advertising injury" arising c. Loss of, loss of use of, damage to, out of any access to or disclosure of any corruption of, inability to access, or person's or organization's confidential or inability to properly manipulate "electronic personal information, including patents, data", resulting from physical injury to trade secrets, processing methods, tangible property. All such loss of customer lists, financial information, credit "electronic data" shall be deemed to occur card information, health information or any at the time of the "occurrence" that caused other type of nonpublic information. it. This exclusion applies even if damages For the purposes of this insurance, "electronic are claimed for notification costs, credit data" is not tangible property. monitoring expenses, forensic expenses, 11. SUPPLEMENTARY PAYMENTS public relations expenses or any other loss, cost or expense incurred by you or In the Supplementary Payments - Coverages A others arising out of any access to or and B provision: disclosure of any person's or organization's The limit for the cost of bail bonds is increased to confidential or personal information. $2 500. Form HS 24 50 12 20 Page 5 of 7 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 12. TWO OR MORE COVERAGE PARTS OR (2) Assumed in a contract or agreement that POLICIES ISSUED BY US is an "insured provided the If this policy and any other policy issued to an "personal and advertising injury" occurs insured by us or any affiliated company provides subsequent to the execution of the coverage that applies to the same claim or contract or agreement. Solely for the damages, the maximum applicable limit(s) of purposes of liability assumed in an liability or limit of insurance under all the policies "insured contract", reasonable attorney will not exceed the highest applicable limit of fees and necessary litigation expenses liability or limit of insurance under any one policy. incurred by or for a party other than an This condition does not apply to any policy issued insured are deemed to be damages by us or an affiliated company specifically written because of "personal and advertising to apply as excess insurance over this policy. injury", provided: 13. NOTICE OF CANCELLATION TO CERTIFICATE (a) Liability to such party for, or for the HOLDER(S) cost of, that party's defense has also been assumed in the same "insured This policy is subject to the following additional contract"; and Conditions: (b) Such attorney fees and litigation A. If this policy is cancelled by the Company, expenses are for defense of that party other than for nonpayment of premium, notice against a civil or alternative dispute of such cancellation will be provided at least resolution proceeding in which thirty (30) days in advance of the cancellation damages to which this insurance effective date to the certificate holder(s) with applies are alleged. mailing addresses on file with the agent of record or the Company. 15. INSURED CONTRACT DEFINITION B. If this policy is cancelled by the Company for a. INSURED CONTRACT-CONSTRUCTION nonpayment of premium, or by the insured, OPERATIONS AND MUNICIPAL WORK notice of such cancellation will be provided Paragraph d. of the definition of "insured within (10) days of the cancellation effective contract" in Section V - Definitions is deleted date to the certificate holder(s) with mailing and replaced by the following: addresses on file with the agent of record or An obligation, as required by ordinance, to the Company. indemnify a municipality. If notice is mailed, proof of mailing to the last b. CONTRACTUAL LIABILITY known mailing address of the certificate holder(s) on file with the agent of record or the Company will Paragraph f. of the definition of "insured be sufficient proof of notice. contract" is deleted and replaced by the Any notification rights provided by this following: endorsement apply only to active certificate That part of any other contract or agreement holder(s) who were issued a certificate of pertaining to your business (including an insurance applicable to this policy's term. indemnification of a municipality in connection Failure to provide such notice to the certificate with work performed for a municipality) under which you assume the tort liability of another holder(s) will not amend or extend the date the party to pay for "bodily injury", "property cancellation becomes effective, nor will it negate damage", or "personal and advertising injury" cancellation of the policy. Failure to send notice to a third person or organization. Tort liability shall impose no liability of any kind upon the means a liability that would be imposed by law Company or its agents or representatives. in the absence of any contract or agreement. 14. CONTRACTUAL LIABILITY COVERAGE FOR Paragraph f. includes that part of any contract PERSONAL AND ADVERTISING INJURY or agreement that indemnifies a railroad for Exclusion e. of SECTION I - COVERAGE B "bodily injury", "property damage", or PERSONAL AND ADVERTISING INJURY "personal and advertising injury" arising out of LIABILITY is replaced by the following: construction or demolition operations, within This insurance does not apply to: 50 feet of any railroad property and affecting any railroad bridge or trestle, tracks, e. Contractual Liability road-beds, tunnel, underpass or crossing. "Personal and advertising injury" for which the However, Paragraph f. does not include insured has assumed liability in a contract or that part of any contract or agreement: agreement. This exclusion does not apply to liability for damages: (1) That indemnifies an architect, (1) That the insured would have in the engineer or surveyor for injury or absence of the contract or agreement; or damage arising out of: Page 6 of 7 Form HS 24 50 12 20 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 (a) Preparing, approving, or failing to (2) Under which the insured, if an prepare or approve, maps, shop architect, engineer or surveyor, drawings, opinions, reports, assumes liability for an injury or surveys, field orders, change damage arising out of the insured's orders or drawings and rendering or failure to render specifications; or professional services, including those (b) Giving directions or instructions, or listed in (1) above and supervisory, failing to give them, if that is the inspection, architectural or primary cause of the injury or engineering activities. damage; or All other terms and conditions in the policy remain unchanged. Form HS 24 50 12 20 Page 7 of 7 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 �v POLICY NUMBER: 53UENOH9024 i COMMERCIAL GENERAL LIABILITY COVERAGE FORM Various provisions in this policy restrict coverage. (1) The "bodily injury" or"property damage" is Read the entire policy carefully to determine rights, caused by an "occurrence" that takes duties and what is and is not covered. place in the "coverage territory"; Throughout this policy the words "you" and "your" (2) The "bodily injury" or "property damage" refer to the Named Insured shown in the occurs during the policy period; and Declarations, and any other person or organization (3) Prior to the policy period, no insured listed qualifying as a Named Insured under this policy. The under Paragraph 1. of Section II - Who Is words "we", "us" and "our" refer to the stock insurance company member of The Hartford An Insured and no "employee" authorized providing this insurance. by you to give or receive notice of an p g occurrence or claim, knew that the The word "insured" means any person or "bodily injury" or "property damage" had organization qualifying as such under Section II - occurred, in whole or in part. If such a Who Is An Insured. listed insured or authorized "employee" Other words and phrases that appear in quotation knew, prior to the policy period, that the marks have special meaning. Refer to Section V - "bodily injury" or "property damage" Definitions. occurred, then any continuation, change SECTION I -COVERAGES or resumption of such "bodily injury" or "property damage" during or after the COVERAGE A BODILY INJURY AND PROPERTY policy period will be deemed to have been DAMAGE LIABILITY known prior to the policy period. 1. Insuring Agreement c. "Bodily injury" or "property damage" will be a. We will pay those sums that the insured deemed to have been known to have becomes legally obligated to pay as damages occurred at the earliest time when any because of "bodily injury" or "property insured listed under Paragraph 1. of Section II damage" to which this insurance applies. We - Who Is An Insured or any "employee" will have the right and duty to defend the authorized by you to give or receive notice of insured against any "suit" seeking those an "occurrence" or claim: damages. However, we will have no duty to (1) Reports all, or any part, of the "bodily defend the insured against any "suit" seeking injury" or "property damage" to us or any damages for "bodily injury" or "property other insurer; damage" to which this insurance does not (2) Receives a written or verbal demand or apply. We may, at our discretion, investigate claim for damages because of the "bodily any occurrence and settle any claim or suit injury" or"property damage"; or that may result. But: (1) The amount we will pay for damages is (3) Becomes aware by any other means that bodily injury or property damage has limited as described in Section III - Limits occurred or has begun to occur. Of Insurance and d. Damages because of "bodily injury" include (2) Our right and duty to defend ends when damages claimed by any person or we have used up the applicable limit of organization for care loss of services or insurance in the payment of judgments or death resulting at any time from the "bodily settlements under Coverages A or B or injury". medical expenses under Coverage C. e. Incidental Medical Malpractice And Good No other obligation or liability to pay sums or Samaritan Coverage perform acts or services is covered unless explicitly provided for under Supplementary "Bodily injury" arising out of the rendering of Payments- Coverages A and B. or failure to render the following health care b. This insurance applies to "bodily injury" and services by any "employee" or "volunteer "property damage" only if: worker" shall be deemed to be caused by an occurrence for: HG 00 01 09 16 Page 1 of 21 ©2016 The Hartford (Includes copyrighted material of Insurance Services Office, Inc. with its permission.) DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 (1) Professional health care services such as: (a) Liability to such party for, or for the (a) Medical, surgical, dental, laboratory, x- cost of, that party's defense has also ray or nursing services or treatment, been assumed in the same "insured advice or instruction, or the related contract"; and furnishing of food or beverages; (b) Such attorney fees and litigation (b)Any health or therapeutic service, expenses are for defense of that party treatment, advice or instruction; or against a civil or alternative dispute (c) The furnishing or dispensing of drugs resolution proceeding in whichdamages to which this insurance or medical, dental, or surgical supplies applies are alleged. or appliances; or (2) First aid services, which include: c. Liquor Liability "Bodily injury" or "property damage" for which (a) Cardiopulmonary resuscitation,whether performed manually or with a any insured may be held liable by reason of: defibrillator; or (1) Causing or contributing to the intoxication (b) Services performed as a Good of any person; Samaritan. (2) The furnishing of alcoholic beverages to a For the purpose of determining the limits of person under the legal drinking age or insurance, any act or omission together with underthe influence of alcohol; or all related acts or omissions in the furnishing (3) Any statute, ordinance or regulation of these services to any one person will be relating to the sale, gift, distribution or use considered one "occurrence". of alcoholic beverages. However, this Incidental Medical Malpractice This exclusion applies even if the claims And Good Samaritan Coverage provision against any insured allege negligence or applies only if you are not engaged in the other wrongdoing in: business or occupation of providing any of the (a) The supervision, hiring, employment, services described in this provision. training or monitoring of others by that 2. Exclusions insured; or This insurance does not apply to: (b) Providing or failing to provide transportation with respect to any a. Expected Or Intended Injury person that may be under the influence "Bodily injury" or "property damage" expected of alcohol; or intended from the standpoint of the if the "occurrence" which caused the "bodily insured. This exclusion does not apply to injury" or "property damage", involved that bodily injury or property damage resulting which is described in Paragraph (1), (2) or(3) from the use of reasonable force to protect above. persons or property. However, this exclusion applies only if you b. Contractual Liability are in the business of manufacturing, "Bodily injury" or "property damage" for which distributing, selling, serving or furnishing the insured is obligated to pay damages by alcoholic beverages. For the purposes of this reason of the assumption of liability in a exclusion, permitting a person to bring contract or agreement. This exclusion does alcoholic beverages on your premises, for not apply to liability for damages: consumption on your premises, whether or (1) That the insured would have in the not a fee is charged or a license is required absence of the contract or agreement; or for such activity, is not by itself considered the (2) Assumed in a contract or agreement that business of selling, serving or furnishing is an "insured contract", provided the alcoholic beverages. "bodily injury" or "property damage" d. Workers' Compensation And Similar Laws occurs subsequent to the execution of the Any obligation of the insured under a workers' contract or agreement. Solely for the compensation, disability benefits or purposes of liability assumed in an unemployment compensation law or any "insured contract", reasonable attorney similar law. fees and necessary litigation expenses e. Employer's Liability incurred by or for a party other than an insured are deemed to be damages "Bodily injury"to: because of "bodily injury" or "property (1) An "employee" of the insured arising out of damage", provided: and in the course of: Page 2 of 21 HG 00 01 09 16 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 (a) Employment by the insured; or (c) Which are or were at any time (b) Performing duties related to the transported, handled, stored, treated, conduct of the insured's business; or disposed of, or processed as waste by (2) The spouse, child, parent, brother or sister or for: of that "employee" as a consequence of (i) Any insured; or Paragraph (1) above. (iii) Any person or organization for This exclusion applies: whom you may be legally (1) Whether the insured may be liable as an responsible; employer or in any other capacity; and (d)At or from any premises, site or (2) To any obligation to share damages with location on which any insured or any or repay someone else who must pay contractors or subcontractors working damages because of the injury. directly or indirectly on any insured's This exclusion does not apply to liability behalf are performing operations if the "pollutants" are brought on or to the assumed by the insured under an "insured contract". premises, site or location in connection f. Pollution with such operations by such insured, contractor or subcontractor. However, (1) "Bodily injury" or "property damage" this subparagraph does not apply to: arising out of the actual, alleged or (i) "Bodily injury" or"property damage" threatened discharge, dispersal, seepage, arising out of the escape of fuels, migration, release or escape of "pollutants": lubricants or other operating fluids which are needed to perform the (a)At or from any premises, site or normal electrical, hydraulic or location which is or was at any time mechanical functions necessary for owned or occupied by, or rented or the operation of"mobile equipment" loaned to, any insured. However, this or its parts, if such fuels, lubricants subparagraph does not apply to: or other operating fluids escape (i) "Bodily injury" if sustained within a from a vehicle part designed to building and caused by smoke, hold, store or receive them. This fumes, vapor or soot produced by exception does not apply if the or originating from equipment that "bodily injury" or "property damage" is used to heat, cool or dehumidify arises out of the intentional the building, or equipment that is discharge, dispersal or release of used to heat water for personal the fuels, lubricants or other use, by the building's occupants or operating fluids, or if such fuels, their guests; lubricants or other operating fluids (i i) "Bodily injury" or"property damage" are brought on or to the premises, for which you may be held liable, if site or location with the intent that you are a contractor and the owner they be discharged, dispersed or or lessee of such premises, site or released as part of the operations location has been added to your being performed by such insured, policy as an additional insured with contractor or subcontractor; respect to your ongoing operations (i i) "Bodily injury" or"property damage" performed for that additional sustained within a building and insured at that premises, site or caused by the release of gases, location and such premises, site or fumes or vapors from materials location is not and never was brought into that building in owned or occupied by, or rented or connection with operations being loaned to, any insured, other than performed by you or on your behalf that additional insured; or by a contractor or subcontractor; or (iii) "Bodily injury" or"property damage" (iii) "Bodily injury" or"property damage" arising out of heat, smoke or fumes arising out of heat, smoke or fumes from a "hostile fire"; from a "hostile fire"; or (b)At or from any premises, site or (e)At or from any premises, site or location which is or was at any time location on which any insured or any used by or for any insured or others for contractors or subcontractors working the handling, storage, disposal, directly or indirectly on any insured's processing or treatment of waste; behalf are performing operations if the HG 00 01 09 16 Page 3 of 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 operations are to test for, monitor, (4) Liability assumed under any "insured clean up, remove, contain, treat, contract" for the ownership, maintenance detoxify or neutralize, or in any way or use of aircraft or watercraft; respond to, or assess the effects of, (5) "Bodily injury" or "property damage" "pollutants". arising out of: (2) Any loss, cost or expense arising out of (a) The operation of machinery or any: equipment that is attached to, or part (a) Request, demand, order or statutory or of, a land vehicle that would qualify regulatory requirement that any under the definition of "mobile insured or others test for, monitor, equipment" if it were not subject to a clean up, remove, contain, treat, compulsory or financial responsibility detoxify or neutralize, or in any way law or other motor vehicle insurance respond to, or assess the effects of, law where it is licensed or principally "pollutants"; or garaged; or (b) Claim or suit by or on behalf of a (b) The operation of any of the machinery governmental authority for damages or equipment listed in Paragraph f.(2) because of testing for, monitoring, or f.(3) of the definition of "mobile cleaning up, removing, containing, equipment"; or treating, detoxifying or neutralizing, or (6) An aircraft that is not owned by any in any way responding to, or assessing insured and is hired, chartered or loaned the effects of, "pollutants". with a paid crew. However, this exception However, this paragraph does not apply to does not apply if the insured has any other liability for damages because of "property insurance for such "bodily injury" or damage" that the insured would have in "property damage", whether the other the absence of such request, demand, insurance is primary, excess, contingent order or statutory or regulatory or on any other basis. requirement, or such claim or "suit" by or h. Mobile Equipment on behalf of a governmental authority. "Bodily injury" or "property damage" arising g. Aircraft, Auto Or Watercraft out of: "Bodily injury" or "property damage" arising (1) The transportation of "mobile equipment" out of the ownership, maintenance, use or by an "auto" owned or operated by or entrustment to others of any aircraft, "auto" or rented or loaned to any insured; or watercraft owned or operated by or rented or (2) The use of"mobile equipment" in, or while loaned to any insured. Use includes operation in practice for or while being prepared for and 'loading or unloading". any prearranged racing, speed, This exclusion applies even if the claims demolition, or stunting activity. against any insured allege negligence or i. War other wrongdoing in the supervision, hiring,employment, training or monitoring of others Bodily injury or property damage", however by that insured, if the "occurrence" which caused, arising, directly or indirectly, out of: caused the "bodily injury" or "property (1) War, including undeclared or civil war; damage" involved the ownership, (2) Warlike action by a military force, including maintenance, use or entrustment to others of action in hindering or defending against an any aircraft, "auto" or watercraft that is owned actual or expected attack, by any or operated by or rented or loaned to any government, sovereign or other authority insured. using military personnel or other agents; This exclusion does not apply to: or (1) A watercraft while ashore on premises you (3) Insurrection, rebellion, revolution, usurped own or rent; power, or action taken by governmental (2) A watercraft you do not own that is: authority in hindering or defending against (a) Less than 51 feet long; and any of these. (b) Not being used to carry persons for a j Damage To Property charge; "Property damage"to: (3) Parking an "auto" on, or on the ways next (1) Property you own, rent, or occupy, to, premises you own or rent, provided the including any costs or expenses incurred "auto" is not owned by or rented or loaned by you, or any other person, organization to you orthe insured; or entity, for repair, replacement, Page 4 of 21 HG 00 01 09 16 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 enhancement, restoration or maintenance m. Damage To Impaired Property Or Property of such property for any reason, including Not Physically Injured prevention of injury to a person or damage "Property damage" to "impaired property" or to another's property; property that has not been physically injured, (2) Premises you sell, give away or abandon, arising out of: if the "property damage" arises out of any (1) A defect, deficiency, inadequacy or part of those premises; dangerous condition in "your product" or (3) Property loaned to you; "your work"; or (4) Personal property in the care, custody or (2) A delay or failure by you or anyone acting control of the insured; on your behalf to perform a contract or (5) That particular part of real property on agreement in accordance with its terms. which you or any contractors or This exclusion does not apply to the loss of subcontractors use of other property arising out of sudden working directly or indirectly on your behalf and accidental physical injury to "your are performing operations, if the "property product" or "your work" after it has been put damage" arises out of those operations; or to its intended use. (6) That particular part of any property that n. Recall Of Products, Work Or Impaired must be restored, repaired or replaced Property because "your work" was incorrectly p y performed on it. Damages claimed for any loss, cost or Paragraphs (1), (3) and (4) of this exclusion expense incurred by you or others for the loss do not apply to "property damage" (other than of use, withdrawal, recall, inspection, repair, damage by fire) to premises, including the replacement, adjustment, removal or disposal contents of such premises, rented to you for a of: period of seven or fewer consecutive days. A (1) "Your product"; separate limit of insurance applies to Damage (2) "Your work"; or To Premises Rented To You as described in (3) "Impaired property"; Section III - Limits Of Insurance. Paragraph (2) of this exclusion does not apply if such product, work, or property is withdrawn if the premises are "your work" and were or recalled from the market or from use by never occupied, rented or held for rental by any person or organization because of a you. known or suspected defect, deficiency, Paragraphs (3) and (4) of this exclusion do inadequacy or dangerous condition in it. not apply to "property damage" arising from o. Personal And Advertising Injury the use of elevators. "Bodily injury" arising out of "personal and Paragraphs (3), (4), (5) and (6) of this advertising injury". exclusion do not apply to liability assumed p. Access or Disclosure Of Confidential Or under a sidetrack agreement. Personal Information And Data-related Paragraphs (3) and (4) of this exclusion do Liability not apply to "property damage" to borrowed Damages arising out of: equipment while not being used to perform (1) Any access to or disclosure of any operations at the job site. persons or organizations confidential or Paragraph (6) of this exclusion does not apply personal information, including patents, to "property damage" included in the trade secrets, processing methods, "products-completed operations hazard". customer lists, financial information, credit k. Damage To Your Product card information, health information or any "Property damage" to "your product" arising other type of nonpublic information; or out of it or any part of it. (2) The loss of, loss of use of, damage to, I. Damage To Your Work corruption of, inability to access, or "Property damage" to "your work" arising out inability to manipulate electronic data. of it or any part of it and included in the This exclusion applies even if damages are "products-completed operations hazard". claimed for notification costs, credit This exclusion does not apply if the damaged monitoring expenses, forensic expenses, work or the work out of which the damage public relations expenses or any other loss, arises was performed on your behalf by a cost or expense incurred by you or others subcontractor. arising out of that which is described in Paragraph (1) or(2) above. HG 00 01 09 16 Page 5 of 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 However, unless Paragraph (1) above detoxifying or neutralizing or in any applies, this exclusion does not apply to way responding to or assessing the damages because of"bodily injury". effects of an "asbestos hazard". As used in this exclusion, electronic data s. Recording And Distribution Of Material Or means information, facts or programs stored Information In Violation Of Law as or on, created or used on, or transmitted to "Bodily injury" or "property damage" arising or from computer software, including systems directly or indirectly out of any action or and applications software, hard or floppy omission that violates or is alleged to violate: disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which (1) The Telephone Consumer Protection Act are used with electronically controlled (TCPA), including any amendment of or equipment. addition to such law, q. Employment-Related Practices (2) The CAN-SPAM Act of 2003, including any amendment of or addition to such law; "Bodily injury"to: (3) The Fair Credit Reporting Act (FCRA), and (1) A person arising out of any "employment- an amendment of or addition to such law, ; or ��� related practicesy including the Fair and Accurate Credit (2) The spouse, child, parent, brother or sister Transaction Act (FACTA); or of that person as a consequence of"bodily (4) Any federal, state or local statute, injury" to that person at whom any ordinance or regulation, other than the 9 "employment-related practices" are TCPA or CAN-SPAM Act of 2003 or FCRA directed. and their amendments and additions, that This exclusion applies: addresses, prohibits or limits the printing, (1) Whether the injury-causing event dissemination, disposal, collecting, described in the definition of"employment- recording, sending, transmitting, related practices" occurs before communicating or distribution of material employment, during employment or after or information. employment of that person; Damage To Premises Rented To You - (2) Whether the insured may be liable as an Exception For Damage By Fire, Lightning Or employer or in any other capacity; and Explosion (3) To any obligation to share damages with Exclusions c. through h. and j. through n. do not or repay someone else who must pay apply to damage by fire, lightning or explosion to damages because of the injury. premises while rented to you or temporarily r. Asbestos occupied by you with permission of the owner. A separate limit of insurance applies to this (1) Bodily injury or property damage coverage as described in Section III - Limits Of arising out of the "asbestos hazard". Insurance. (2) Any damages, judgments, settlements, COVERAGE B PERSONAL AND ADVERTISING loss, costs or expenses that: INJURY LIABILITY (a) May be awarded or incurred by reason 1. Insuring Agreement of any claim or suit alleging actual or a. We will pay those sums that the insured threatened injury or damage of any becomes legally obligated to pay as damages nature or kind to persons or property because of "personal and advertising injury" which would not have occurred in to which this insurance applies. We will have whole or in part but for the "asbestos the right and duty to defend the insured hazard"; against any "suit" seeking those damages. (b)Arise out of any request, demand, However, we will have no duty to defend the order or statutory or regulatory insured against any "suit" seeking damages requirement that any insured or others for "personal and advertising injury" to which test for, monitor, clean up, remove, this insurance does not apply. We may, at our encapsulate, contain, treat, detoxify or discretion, investigate any offense and settle neutralize or in any way respond to or any claim or"suit"that may result. But: assess the effects of an "asbestos (1) The amount we will pay for damages is hazard"; or limited as described in Section III - Limits (c) Arise out of any claim or suit for Of Insurance; and damages because of testing for, (2) Our right and duty to defend end when we monitoring, cleaning up, removing, encapsulating, containing, treating, have used up the applicable limit of insurance in the payment of judgments or Page 6 of 21 HG 00 01 09 16 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 settlements under Coverages A or B or h. Wrong Description Of Prices medical expenses under Coverage C. "Personal and advertising injury" arising out of No other obligation or liability to pay sums or the wrong description of the price of goods, perform acts or services is covered unless products or services. explicitly provided for under Supplementary i. Infringement Of Intellectual Property Payments- Coverages A and B. Rights b. This insurance applies to "personal and (1) "Personal and advertising injury" arising advertising injury" caused by an offense out of any actual or alleged infringement arising out of your business but only if the or violation of any intellectual property offense was committed in the "coverage rights such as copyright, patent, territory" during the policy period. trademark, trade name,trade secret, trade 2. Exclusions dress, service mark or other designation This insurance does not apply to: of origin or authenticity; or a. Knowing Violation Of Rights Of Another (2) Any injury or damage alleged in any clam "Personal and advertising injury" arising out of or "suit" that also alleges an infringement an offense committed by, at the direction or or violation of any intellectual property with the consent or acquiescence of the right, whether such allegation of insured with the expectation of inflicting infringement or violation is made by you or "personal and advertising injury". by any other party involved in the claim or "suit", regardless of whether this b. Material Published With Knowledge Of insurance would otherwise apply. Falsity However, this exclusion does not apply if the "Personal and advertising injury" arising out of only allegation in the claim or "suit" involving oral, written or electronic publication, in any any intellectual property right is limited to: manner, of material, if done by or at the (1) Infringement, in your"advertisement", of: direction of the insured with knowledge of its (a) Copyright; falsity. c. Material Published Prior To Policy Period (b) Slogan; or "Personal and advertising injury" arising out of (c) Title of any literary or artistic work; or oral, written or electronic publication, in any (2) Copying, in your "advertisement", a manner, of material whose first publication person's or organization's "advertising took place before the beginning of the policy idea" or style of"advertisement". period. j. Insureds In Media And Internet Type d. Criminal Acts Businesses "Personal and advertising injury" arising out of "Personal and advertising injury" committed a criminal act committed by or at the direction by an insured whose business is: of the insured. (1) Advertising, broadcasting, publishing or e. Contractual Liability telecasting; "Personal and advertising injury" for which the (2) Designing or determining content of web insured has assumed liability in a contract or sites for others; or agreement. This exclusion does not apply to (3) An Internet search, access, content or liability for damages that the insured would service provider. have in the absence of the contract or agreement. However, this exclusion does not apply to Paragraphs a., b. and c. of the definition of f. Breach Of Contract "personal and advertising injury" under the "Personal and advertising injury" arising out of a Definitions Section. breach of contract, except an implied contract to For the purposes of this exclusion, the placing use another's "advertising idea" in your of frames, borders or links, or advertising, for "advertisement". you or others anywhere on the Internet, is not g. Quality Or Performance Of Goods - Failure by itself, considered the business of To Conform To Statements advertising, broadcasting, publishing or "Personal and advertising injury" arising out of telecasting. the failure of goods, products or services to k. Electronic Chatrooms Or Bulletin Boards conform with any statement of quality or "Personal and advertising injury" arising out of performance made in your"advertisement". an electronic chatroom or bulletin board the HG 00 01 09 16 Page 7 of 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 insured hosts, owns, or over which the (4) Computer code, software or programming insured exercises control. used to enable: I. Unauthorized Use Of Another's Name Or (a)Your web site; or Product (b)The presentation or functionality of an "Personal and advertising injury" arising out of "advertisement" or other content on the unauthorized use of another's name or your web site. product in your e-mail address, domain name q. Right Of Privacy Created By Statute or metatags, or any other similar tactics to mislead another's potential customers. "Personal and advertising injury" arising out of the violation of a person's right of privacy m. Pollution created by any state or federal act. "Personal and advertising injury" arising out of However, this exclusion does not apply to the actual, alleged or threatened discharge, liability for damages that the insured would dispersal, seepage, migration, release or have in the absence of such state or federal escape of"pollutants" at any time. act. n. Pollution-Related r. Violation Of Anti-Trust law Any loss, cost or expense arising out of any: "Personal and advertising injury" arising out of (1) Request, demand, order or statutory or a violation of any anti-trust law. regulatory requirement that any insured or s. Securities others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in Personal and advertising injury arising out of any way respond to, or assess the effects the fluctuation in price or value of any stocks, of, "pollutants"; or bonds or other securities. (2) Claim or suit by or on behalf of a t. Recording And Distribution Of Material Or governmental authority for damages Information In Violation Of Law because of testing for, monitoring, "Personal and advertising injury" arising cleaning up, removing, containing, directly or indirectly out of any action or treating, detoxifying or neutralizing, or in omission that violates or is alleged to violate: any way responding to, or assessing the (1) The Telephone Consumer Protection Act effects of, "pollutants". (TCPA), including any amendment of or o. War addition to such law, "Personal and advertising injury", however (2) The CAN-SPAM Act of 2003, including caused, arising, directly or indirectly, out of: any amendment of or addition to such law; (1) War, including undeclared or civil war; (3) The Fair Credit Reporting Act (FCRA), and (2) Warlike action by a military force, including any amendment of or addition to such law, action in hindering or defending against an including the Fair and Accurate Credit actual or expected attack, by any Transaction Act (FACTA); or government, sovereign or other authority (4) Any federal, state or local statute, using military personnel or other agents; ordinance or regulation, other than the or TCPA or CAN-SPAM Act of 2003 or FCRA (3) Insurrection, rebellion, revolution, usurped and their amendments and additions, that power, or action taken by governmental addresses, prohibits or limits the printing, authority in hindering or defending against dissemination, disposal, collecting, any of these. recording, sending, transmitting, p. Internet Advertisements And Content Of communicating or distribution of materialor information. Others "Personal and advertising injury" arising out u. Employment-Related Practices of: "Personal and advertising injury"to: (1) An "advertisement" for others on your web (1) A person arising out of any "employment- site; related practices"; or (2) Placing a link to a web site of others on (2) The spouse, child, parent, brother or sister your web site of that person as a consequence of personal and advertising injury to that employment-related (3) Content, including information, sounds, person at whom any „ text, graphics, or images from a web site practices" are directed. of others displayed within a frame or border on your web site; or Page 8 of 21 HG 00 01 09 16 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 This exclusion applies: COVERAGE C MEDICAL PAYMENTS (1) Whether the injury-causing event 1. Insuring Agreement described in the definition of"employment- a. We will pay medical expenses as described related practices" occurs before below for "bodily injury" caused by an employment, during employment or after accident: employment of that person; (1) On premises you own or rent; (2) Whether the insured may be liable as an employer or in any other capacity; and (2) On ways next to premises you own or rent; or (3) To any obligation to share damages with or repay someone else who must pay (3) Because of your operations; damages because of the injury. provided that: v. Asbestos (1) The accident takes place in the "coverage (1) "Personal and advertising injury" arising territory" and during the policy period; out of the "asbestos hazard". (2) The expenses are incurred and reported (2) Any damages, judgments, settlements, to us within three years of the date of the loss, costs or expenses that: accident; and (a) May be awarded or incurred by reason (3) The injured person submits to of any claim or suit alleging actual or examination, at our expense, by threatened injury or damage of any physicians of our choice as often as we nature or kind to persons or property reasonably require. which would not have occurred in b. We will make these payments regardless of whole or in part but for the "asbestos fault. These payments will not exceed the hazard"; applicable limit of insurance. We will pay (b)Arise out of any request, demand, reasonable expenses for: order or statutory or regulatory (1) First aid administered at the time of an requirement that any insured or others accident; test for, monitor, clean up, remove, (2) Necessary medical, surgical, X-ray and encapsulate, contain, treat, detoxify or dental services, including prosthetic neutralize or in any way respond to or devices; and assess the effects of an "asbestos hazard"; or (3) Necessary ambulance, hospital, professional nursing and funeral services. (c)Arise out of any claim or suit for damages because of testing for, 2. Exclusions monitoring, cleaning up, removing, We will not pay expenses for"bodily injury": encapsulating, containing, treating, a. Any Insured detoxifying or neutralizing or in any To any insured, except "volunteer workers". way responding to or assessing the effects of an "asbestos hazard". b. Hired Person w. Access Or Disclosure Of Confidential Or To a person hired to do work for or on behalf Personal Information of any insured or a tenant of any insured. "Personal and advertising injury" arising out of c. Injury On Normally Occupied Premises any access to or disclosure of any person's or To a person injured on that part of premises organization's confidential or personal you own or rent that the person normally information, including patents, trade secrets, occupies. processing methods, customer lists, financial d. Workers Compensation And Similar Laws information, credit card information, health information or any other type of nonpublic To a person, whether or not an "employee" of information. any insured, if benefits for the "bodily injury" are This exclusion applies even if damages are payable or must be provided under a workers' claimed for notification costs, credit compensation or disability benefits law or a monitoring expenses, forensic expenses, similar law. public relations expenses or any other loss, e. Athletics Activities cost or expense incurred by you or others To a person injured while practicing, arising out of any access to or disclosure of instructing or participating in any physical any person's or organization's confidential or exercises or games, sports, or athletic personal information. contests. HG 00 01 09 16 Page 9 of 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 f. Products-Completed Operations Hazard assumed by the insured in the same "insured Included within the "products-completed contract"; operations hazard". d. The allegations in the "suit" and the g. Coverage A Exclusions information we know about the "occurrence" Excluded under Coverage A are such that no conflict appears to exist between the interests of the insured and the SUPPLEMENTARY PAYMENTS - COVERAGES interests of the indemnitee; A AND B 1. We will pay, with respect to any claim we e. The indemnitee and the insured ask us to investigate or settle, or any "suit" against an conduct and control the defense of that insured we defend: indemnitee against such suit and agree that we can assign the same counsel to defend a. All expenses we incur. the insured and the indemnitee; and b. Up to $1,000 for cost of bail bonds required f. The indemnitee: because of accidents or traffic law violations arising out of the use of any vehicle to which (1) Agrees in writing to: the Bodily Injury Liability Coverage applies. (a) Cooperate with us in the investigation, We do not have to furnish these bonds. settlement or defense of the "suit"; c. The cost of appeal bonds or bonds to release (b) Immediately send us copies of any attachments, but only for bond amounts demands, notices, summonses or legal within the applicable limit of insurance. We do papers received in connection with the not have to furnish these bonds. "suit"; d. All reasonable expenses incurred by the (c) Notify any other insurer whose insured at our request to assist us in the coverage is available to the investigation or defense of the claim or "suit", indemnitee; and including actual loss of earnings up to $500 a (d) Cooperate with us with respect to day because of time off from work. coordinating other applicable e. All court costs taxed against the insured in insurance available to the indemnitee; the "suit". However, such costs do not and include attorneys' fees, attorneys' expenses, (2) Provides us with written authorization to: witness or expert fees, or any other expenses of a party taxed to the insured. (a) Obtain records and other information f. Prejudgment interest awarded against the related to the "suit"; and insured on that part of the judgment we pay. If (b) Conduct and control the defense of the we make an offer to pay the applicable limit of indemnitee in such "suit". insurance, we will not pay any prejudgment So long as the above conditions are met, interest based on that period of time after the attorneys' fees incurred by us in the defense of offer. that indemnitee, necessary litigation expenses g. All interest on the full amount of any judgment incurred by us and necessary litigation expenses that accrues after entry of the judgment and incurred by the indemnitee at our request will be before we have paid, offered to pay, or paid as Supplementary Payments. deposited in court the part of the judgment Notwithstanding the provisions of Paragraph that is within the applicable limit of insurance. 2.b.(2) of Section I - Coverage A - Bodily Injury These payments will not reduce the limits of And Property Damage Liability, such payments insurance. will not be deemed to be damages for "bodily 2. If we defend an insured against a "suit" and an injury" and "property damage" and will not reduce indemnitee of the insured is also named as a the limits of insurance. party to the "suit", we will defend that indemnitee Our obligation to defend an insured's indemnitee if all of the following conditions are met: and to pay for attorneys' fees and necessary a. The "suit" against the indemnitee seeks litigation expenses as Supplementary Payments damages for which the insured has assumed ends when: the liability of the indemnitee in a contract or a. We have used up the applicable limit of agreement that is an "insured contract"; insurance in the payment of judgments or b. This insurance applies to such liability settlements; or assumed by the insured; b. The conditions set forth above, or the terms of c. The obligation to defend, or the cost of the the agreement described in Paragraph f. defense of, that indemnitee, has also been above, are no longer met. Page 10 of 21 HG 00 01 09 16 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 SECTION II -WHO IS AN INSURED "volunteer worker" as a consequence 1. If you are designated in the Declarations as: of Paragraph (1)(a) above; a. An individual, you and your spouse are (c) For which there is any obligation to insureds, but only with respect to the conduct share damages with or repay someone of a business of which you are the sole else who must pay damages because owner. of the injury described in Paragraphs b. A partnership or joint venture, you are an (1)(a) or(1)(b) above; or insured. Your members, your partners, and (d)Arising out of his or her providing or their spouses are also insureds, but only with failing to provide professional health respect to the conduct of your business. care services. c. A limited liability company, you are an If you are not in the business of providing insured. Your members are also insureds, but professional health care services: only with respect to the conduct of your (a) Subparagraphs (1)(a), (1)(b) and (1)(c) business. Your managers are insureds, but above do not apply to any "employee" only with respect to their duties as your or "volunteer worker" providing first aid managers. services; and d. An organization other than a partnership, joint (b)Subparagraph (1)(d) above does not venture or limited liability company, you are apply to any nurse, emergency medical an insured. Your "executive officers" and technician or paramedic employed by directors are insureds, but only with respect to you to provide such services. their duties as your officers or directors. Your (2) "Property damage"to property: stockholders are also insureds, but only with respect to their liability as stockholders. (a) Owned, occupied or used by, e. A trust, you are an insured. Your trustees are (b) Rented to, in the care, custody or also insureds, but only with respect to their control of, or over which physical duties as trustees. control is being exercised for any 2. Each of the following is also an insured: purpose by a. Employees And Volunteer Workers you, any of your "employees", "volunteer workers", any partner or member (if you Your "volunteer workers" only while are a partnership or joint venture), or any performing duties related to the conduct of member (if you are a limited liability your business, or your "employees", other company). than either your"executive officers" (if you are b. Real Estate Manager an organization other than a partnership, joint venture or limited liability company) or your Any person (other than your "employee" or managers (if you are a limited liability "volunteer worker"), or any organization while company), but only for acts within the scope acting as your real estate manager. of their employment by you or while c. Temporary Custodians Of Your Property performing duties related to the conduct of Any person or organization having proper your business. temporary custody of your property if you die, However, none of these "employees" or but only: "volunteer workers" are insureds for: (1) With respect to liability arising out of the (1) "Bodily injury" or"personal and advertising maintenance or use of that property; and injury": (2) Until your legal representative has been (a) To you, to your partners or members (if appointed. you are a partnership or joint venture), d. Legal Representative If You Die to your members (if you are a limited liability company), to a co-"employee" Your legal representative if you die, but only while in the course of his or her with respect to duties as such. That employment or performing duties representative will have all your rights and related to the conduct of your duties under this Coverage Part. business, or to your other "volunteer e. Unnamed Subsidiary workers" while performing duties Any subsidiary, and subsidiary thereof, of related to the conduct of your yours which is a legally incorporated entity of business; which you own a financial interest of more (b)To the spouse, child, parent, brother or than 50% of the voting stock on the effective sister of that co-"employee" or that date of the Coverage Part. HG 00 01 09 16 Page 11 of 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 The insurance afforded herein for any A person or organization is an additional insured subsidiary not named in this Coverage Part under this provision only for that period of time as a named insured does not apply to injury required by the contract or agreement. or damage with respect to which such insured However, no such person or organization is an is also a named insured under another policy insured under this provision if such person or or would be a named insured under such organization is included as an insured by an policy but for its termination or the exhaustion endorsement issued by us and made a part of of its limits of insurance. this Coverage Part. 3. Newly Acquired Or Formed Organization a. Vendors Any organization you newly acquire or form, Any person(s) or organization(s) (referred to other than a partnership, joint venture or limited below as vendor), but only with respect to liability company, and over which you maintain "bodily injury" or "property damage" arising financial interest of more than 50% of the voting out of"your products" which are distributed or stock, will qualify as a Named Insured if there is sold in the regular course of the vendor's no other similar insurance available to that business and only if this Coverage Part organization. However: provides coverage for "bodily injury" or a. Coverage under this provision is afforded only "property damage" included within the until the 180th day after you acquire or form "products-completed operations hazard". the organization or the end of the policy (1) The insurance afforded the vendor is period, whichever is earlier; subject to the following additional b. Coverage A does not apply to "bodily injury" exclusions: or "property damage" that occurred before This insurance does not apply to: you acquired or formed the organization; and a "Bodily " or"property dama e" for c. Coverage B does not apply to "personal and ( ) injury" g 9 pp Y p which the vendor is obligated to pay advertising injury" arising out of an offense damages by reason of the assumption committed before you acquired or formed the of liability in a contract or agreement. organization. This exclusion does not apply to 4. Nonowned Watercraft liability for damages that the vendor With respect to watercraft you do not own that is would have in the absence of the less than 51 feet long and is not being used to contract or agreement; carry persons for a charge, any person is an (b)Any express warranty unauthorized by insured while operating such watercraft with your you; permission. Any other person or organization (c)Any physical or chemical change in the responsible for the conduct of such person is product made intentionally by the also an insured, but only with respect to liability vendor; arising out of the operation of the watercraft, and (d) Repackaging, except when unpacked only if no other insurance of any kind is available solely for the purpose of inspection, to that person or organization for this liability. demonstration, testing, or the However, no person or organization is an insured substitution of parts under instructions with respect to: from the manufacturer, and then a. "Bodily injury" to a co-"employee" of the repackaged in the original container; person operating the watercraft; or (e) Any failure to make such inspections, b. "Property damage" to property owned by, adjustments, tests or servicing as the rented to, in the charge of or occupied by you vendor has agreed to make or normally or the employer of any person who is an undertakes to make in the usual insured underthis provision. course of business, in connection with 5. Additional Insureds When Required By the distribution or sale of the products; Written Contract, Written Agreement Or (f) Demonstration, installation, servicing Permit or repair operations, except such The following person(s) or organization(s) are an operations performed at the vendor's additional insured when you have agreed, in a premises in connection with the sale of written contract, written agreement or because of the product; a permit issued by a state or political subdivision, (g) Products which, after distribution or that such person or organization be added as an sale by you, have been labeled or additional insured on your policy, provided the relabeled or used as a container, part injury or damage occurs subsequent to the or ingredient of any other thing or execution of the contract or agreement. substance by or for the vendor; or Page 12 of 21 HG 00 01 09 16 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 (h)"Bodily injury" or "property damage" omissions of those acting on your behalf: arising out of the sole negligence of the (1) In connection with your premises; or vendor for its own acts or omissions or (2) In the performance of your ongoing those of its employees or anyone else operations performed by you or on your acting on its behalf. However, this behalf. exclusion does not apply to: (i) The exceptions contained in Sub- With respect to the insurance afforded these paragraphs (d) or(f)or additional insureds, the following additional exclusion applies: (ii) Such inspections, adjustments, This insurance does not apply to bodily tests or servicing as the vendor has injury", "property damage" or "personal and agreed to make or normally advertising injury" arising out of the rendering undertakes to make in the usual of or the failure to render any professional course of business, in connection services by or for you, including: with the distribution or sale of the products. 1. The preparing, approving, or failing to (2) This insurance does not apply to any prepare or approve, maps, shop drawings, insured person or organization, from opinions, reports, surveys, field orders, whom you have acquired such products, change orders or drawings and or any ingredient, part or container, specifications; or entering into, accompanying or containing 2• Supervisory, inspection, architectural or such products. engineering activities. b. Lessors Of Equipment This exclusion applies even if the claims (1) Any person(s) or organization(s) from against any insured allege negligence or whom you lease equipment; but only with other wrongdoing in the supervision, hiring, respect to their liability for "bodily injury", employment, training or monitoring of others "property damage" or "personal and by that insured, if the "occurrence" which advertising injury caused, in whole or in caused the "bodily injury" or "property damage", or the offense which caused the part, by your maintenance, operation or "personal and advertising injury", involved the use of equipment leased to you by such rendering of or the failure to render any person(s) or organization(s). professional services by or for you. (2) With respect to the insurance afforded to e. Permits Issued By State Or Political these additional insureds this insurance Subdivisions does not apply to any occurrence which takes place after the equipment lease Any state or political subdivision, but only with expires. respect to operations performed by you or on c. Lessors s. Land Or Premises your behalf for which the state or political subdivision has issued a permit. Any person or organization from whom you With respect to the insurance afforded these lease land or premises, but only with respect additional insureds, this insurance does not to liability arising out of the ownership, apply to: maintenance or use of that part of the land or premises leased to you. (1) "Bodily injury", "property damage" or With respect to the insurance afforded these "personal and advertising injury" arising additional insureds the following additional out of operations performed for the state exclusions apply: or municipality; or pp y: (2) "Bodily injury" or "property damage" This insurance does not apply to: included within the "products-completed 1. Any "occurrence" which takes place after operations hazard". you cease to lease that land; or f. Any Other Party 2. Structural alterations, new construction or Any other person or organization who is not demolition operations performed by or on an additional insured under Paragraphs a. behalf of such person or organization. through a above, but only with respect to d. Architects, Engineers Or Surveyors liability for "bodily injury", "property damage" Any architect, engineer, or surveyor, but only or"personal and advertising injury" caused, in with respect to liability for "bodily injury", whole or in part, by your acts or omissions or "property damage" or "personal and the acts or omissions of those acting on your advertising injury" caused, in whole or in part, behalf: by your acts or omissions or the acts or (1) In the performance of your ongoing operations; HG 00 01 09 16 Page 13 of 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 (2) In connection with your premises owned No person or organization is an insured with respect by or rented to you; or to the conduct of any current or past partnership, (3) In connection with "your work" and joint venture or limited liability company that is not included within the "products-completed shown as a Named Insured in the Declarations. operations hazard", but only if SECTION III - LIMITS OF INSURANCE (a) The written contract or agreement 1. The Most We Will Pay requires you to provide such coverage The Limits of Insurance shown in the to such additional insured; and Declarations and the rules below fix the most we (b)This Coverage Part provides coverage will pay regardless of the number of: for "bodily injury" or "property damage" a. Insureds; included within the "products- completed operations hazard". b. Claims made or"suits" brought; or However: c. Persons or organizations making claims or (1) The insurance afforded to such additional bringing "suits". insured only applies to the extent 2. General Aggregate Limit permitted by law; and The General Aggregate Limit is the most we will (2) If coverage provided to the additional pay for the sum of: insured is required by a contract or a. Medical expenses under Coverage C; agreement, the insurance afforded to such b. Damages under Coverage A, except additional insured will not be broader than damages because of "bodily injury" or that which you are required by the contract "property damage" included in the "products- or agreement to provide for such completed operations hazard"; and additional insured. c. Damages under Coverage B. With respect to the insurance afforded to 3. Products-Completed Operations Aggregate these additional insureds, this insurance does not apply to: Limit "Bodily injury", "property damage" or The Products-Completed Operations Aggregate "personal and advertising injury" arising out of Limit is the most we will pay under Coverage A the rendering of, or the failure to render, any for damages because of "bodily injury" and professional architectural engineering or "property damage" included in the "products- surveying services, including: completed operations hazard". (1) The preparing, approving, or failing to 4. Personal And Advertising Injury Limit prepare or approve, maps, shop drawings, Subject to 2. above, the Personal and opinions, reports, surveys, field orders, Advertising Injury Limit is the most we will pay change orders or drawings and under Coverage B for the sum of all damages specifications; or because of all "personal and advertising injury" (2) Supervisory, inspection, architectural or sustained by any one person or organization. engineering activities. 5. Each Occurrence Limit This exclusion applies even if the claims Subject to 2. or 3. above, whichever applies, the against any insured allege negligence or Each Occurrence Limit is the most we will pay for other wrongdoing in the supervision, hiring, the sum of: employment, training or monitoring of others a. Damages under Coverage A; and by that insured, if the "occurrence" which b. Medical expenses under Coverage C caused the "bodily injury" or "property damage", or the offense which caused the because of all "bodily injury" and "property "personal and advertising injury", involved the damage"arising out of any one "occurrence". rendering of or the failure to render any 6. Damage To Premises Rented To You Limit professional services by or for you. Subject to 5. above, the Damage To Premises The limits of insurance that apply to additional Rented To You Limit is the most we will pay insureds is described in Section III - Limits Of under Coverage A for damages because of Insurance. "property damage" to any one premises, while How this insurance applies when other insurance rented to you, or in the case of damage by fire, is available to the additional insured is described lightning or explosion, while rented to you or in the Other Insurance Condition in Section IV - temporarily occupied by you with permission of Commercial General Liability Conditions. the owner. Page 14 of 21 HG 00 01 09 16 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 In the case of damage by fire, lightning or b. Notice Of Claim explosion, the Damage to Premises Rented To If a claim is made or "suit" is brought against You Limit applies to all damage proximately any insured, you or any additional insured caused by the same event, whether such must: damage results from fire, lightning or explosion or any combination of these. (1) Immediately record the specifics of the claim or"suit" and the date received; and 7. Medical Expense Limit (2) Notify us as soon as practicable. Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverage C for all You or any additional insured must see to it medical expenses because of "bodily injury" that we receive written notice of the claim or "suit" as soon as practicable. sustained by any one person. 8. How Limits Apply To Additional Insureds c. Assistance And Cooperation Of The Insured If you have agreed in a written contract or written agreement that another person or organization You and any other involved insured must: be added as an additional insured on your policy, (1) Immediately send us copies of any the most we will pay on behalf of such additional demands, notices, summonses or legal insured is the lesser of: papers received in connection with the a. The limits of insurance specified in the written claim or"suit"; contract or written agreement; or (2) Authorize us to obtain records and other b. The Limits of Insurance shown in the information; Declarations. (3) Cooperate with us in the investigation or Such amount shall be a part of and not in settlement of the claim or defense against addition to Limits of Insurance shown in the the "suit"; and Declarations and described in this Section. (4) Assist us, upon our request, in the The Limits of Insurance of this Coverage Part apply enforcement of any right against any person separately to each consecutive annual period and to or organization which may be liable to the any remaining period of less than 12 months, insured because of injury or damage to starting with the beginning of the policy period which this insurance may also apply. shown in the Declarations, unless the policy period d. Obligations At The Insureds Own Cost is extended after issuance for an additional period of No insured will, except at that insured's own less than 12 months. In that case, the additional cost, voluntarily make a payment, assume period will be deemed part of the last preceding any obligation, or incur any expense, other period for purposes of determining the Limits of than for first aid, without our consent. Insurance. e. Additional Insureds Other Insurance SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS If we cover a claim or "suit" under this 1. Bankruptcy Coverage Part that may also be covered by other insurance available to an additional Bankruptcy or insolvency of the insured or of the insured, such additional insured must submit insured's estate will not relieve us of our such claim or "suit" to the other insurer for obligations under this Coverage Part. defense and indemnity. 2. Duties In The Event Of Occurrence, Offense, I this provision does not apply to the Claim Or Suit extent that you have agreed in a written a. Notice Of Occurrence Or Offense contract or written agreement that this You or any additional insured must see to it insurance is non-contributory that we are notified as soon as practicable of with the additional insured's own insurance. an "occurrence" or an offense which may f. Knowledge Of An Occurrence, Offense, result in a claim. To the extent possible, Claim Or Suit notice should include: Paragraphs a. and b. apply to you or to any (1) How, when and where the "occurrence" or additional insured only when such offense took place; "occurrence", offense, claim or"suit" is known (2) The names and addresses of any injured to: persons and witnesses; and (1) You or any additional insured that is an (3) The nature and location of any injury or individual; damage arising out of the "occurrence" or (2) Any partner, if you or the additional offense. insured is a partnership; HG 00 01 09 16 Page 15 of 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 (3) Any manager, if you or the additional (3) Tenant Liability insured is a limited liability company; That is insurance purchased by you to (4) Any "executive officer" or insurance cover your liability as a tenant for manager, if you or the additional insured is "property damage" to premises rented to a corporation; you or temporarily occupied by you with (5) Any trustee, if you or the additional permission of the owner; insured is a trust; or (4) Aircraft,Auto Or Watercraft (6) Any elected or appointed official, if you or If the loss arises out of the maintenance or the additional insured is a political use of aircraft, "autos" or watercraft to the subdivision or public entity. extent not subject to Exclusion g. of This duty applies separately to you and any Section I - Coverage A - Bodily Injury And additional insured. Property Damage Liability; 3. Legal Action Against Us (5) Property Damage To Borrowed No person or organization has a right under this Equipment Or Use Of Elevators Coverage Part: If the loss arises out of"property damage" a. To join us as a party or otherwise bring us to borrowed equipment or the use of elevators to the extent not subject to into a suit asking for damages from an Exclusion j. of Section I - Coverage A - insured; or Bodily Injury And Property Damage b. To sue us on this Coverage Part unless all of Liability; its terms have been fully complied with. (6) When You Are Added As An Additional A person or organization may sue us to recover Insured To Other Insurance on an agreed settlement or on a final judgment Any other insurance available to you against an insured; but we will not be liable for covering liability for damages arising out damages that are not payable under the terms of of the premises or operations, or products this Coverage Part or that are in excess of the and completed operations, for which you applicable limit of insurance. An agreed have been added as an additional insured settlement means a settlement and release of by that insurance; or liability signed by us, the insured and the claimant or the claimant's legal representative. {7) When You Add Others As An Additional Insured To This Insurance 4. Other Insurance If other valid and collectible insurance is Any other insurance available to an additional insured. available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our However, the following provisions apply to obligations are limited as follows: other insurance available to any person or organization who is an additional insured a. Insurance underthis coverage part. This insurance is primary except when b. (a) Primary Insurance When Required below applies. If other insurance is also By Contract primary, we will share with all that other insurance by the method described in c. This insurance is primary if you have below. agreed in a written contract or written agreement that this insurance be b. Excess Insurance primary. If other insurance is also This insurance is excess over any of the other primary, we will share with all that insurance, whether primary, excess, other insurance by the method contingent or on any other basis: described in below. (1) Your Work (b)Primary And Non-Contributory To That is Fire, Extended Coverage, Builder's Other Insurance When Required By Risk, Installation Risk or similar coverage Contract for"your work"; If you have agreed in a written (2) Premises Rented To You contract, written agreement, or permit That is fire, lightning or explosion that this insurance is primary and non- contributory with the additional insurance for premises rented to you or insured's own insurance,this insurance temporarily occupied by you with is primary and we will not seek permission of the owner; contribution from that other insurance. Page 16 of 21 HG 00 01 09 16 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 Paragraphs (a) and (b) do not apply to computation, and send us copies at such other insurance to which the additional times as we may request. insured has been added as an additional 6. Representations insured. a. When You Accept This Policy When this insurance is excess, we will have no duty under Coverages A or B to defend By accepting this policy, you agree: the insured against any "suit" if any other (1) The statements in the Declarations are insurer has a duty to defend the insured accurate and complete; against that "suit". If no other insurer defends, (2) Those statements are based upon we will undertake to do so, but we will be representations you made to us; and entitled to the insured's rights against all (3) We have issued this policy in reliance those other insurers. upon your representations. When this insurance is excess over other insurance, we will pay only our share of the b. Unintentional Failure To Disclose Hazards amount of the loss, if any, that exceeds the If unintentionally you should fail to disclose all sum of: hazards relating to the conduct of your (1) The total amount that all such other business that exist at the inception date of insurance would pay for the loss in the this Coverage Part, we shall not deny absence of this insurance; and coverage under this Coverage Part because (2) The total of all deductible and self-insured of such failure. amounts under all that other insurance. 7. Separation Of Insureds We will share the remaining loss, if any, with Except with respect to the Limits of Insurance, any other insurance that is not described in and any rights or duties specifically assigned in this Excess Insurance provision and was not this Coverage Part to the first Named Insured, bought specifically to apply in excess of the this insurance applies: Limits of Insurance shown in the Declarations a. As if each Named Insured were the only of this Coverage Part. Named Insured; and c. Method Of Sharing b. Separately to each insured against whom If all of the other insurance permits claim is made or"suit" is brought. contribution by equal shares, we will follow g. Transfer Of Rights Of Recovery Against this method also. Under this approach each Others To Us insurer contributes equal amounts until it has paid its applicable limit of insurance or none a. Transfer Of Rights Of Recovery of the loss remains, whichever comes first. If the insured has rights to recover all or part If any of the other insurance does not permit of any payment, including Supplementary contribution by equal shares, we will Payments, we have made under this contribute by limits. Under this method, each Coverage Part, those rights are transferred to insurer's share is based on the ratio of its us. The insured must do nothing after loss to applicable limit of insurance to the total impair them. At our request, the insured will applicable limits of insurance of all insurers. bring "suit" or transfer those rights to us and 5. Premium Audit help us enforce them. a. We will compute all premiums for this b. Waiver Of Rights Of Recovery (Waiver Of Coverage Part in accordance with our rules Subrogation) and rates. If the insured has waived any rights of b. Premium shown in this Coverage Part as recovery against any person or organization advance premium is a deposit premium only. for all or part of any payment, including At the close of each audit period we will Supplementary Payments, we have made compute the earned premium for that period under this Coverage Part, we also waive that and send notice to the first Named Insured. right, provided the insured waived their rights The due date for audit and retrospective of recovery against such person or premiums is the date shown as the due date organization in a contract, agreement or on the bill. If the sum of the advance and permit that was executed prior to the injury or audit premiums paid for the policy period is damage. greater than the earned premium, we will 9. When We Do Not Renew return the excess to the first Named Insured. If we decide not to renew this Coverage Part, we c. The first Named Insured must keep records of will mail or deliver to the first Named Insured the information we need for premium shown in the Declarations written notice of the HG 00 01 09 16 Page 17 of 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 nonrenewal not less than 30 days before the c. All other parts of the world if the injury or expiration date. damage arises out of: If notice is mailed, proof of mailing will be (1) Goods or products made or sold by you in sufficient proof of notice. the territory described in above; SECTION V - DEFINITIONS (2) The activities of a person whose home is 1. "Advertisement" means the widespread public in the territory described in a. above, but is dissemination of information or images that has away for a short time on your business; or the purpose of inducing the sale of goods, (3) "Personal and advertising injury" offenses products or services through: that take place through the Internet or a. (1) Radio; similar electronic means of communication (2) Television; provided the insured's responsibility to pay damages is determined in the United States of (3) Billboard; America (including its territories and possessions), (4) Magazine; Puerto Rico or Canada, in a "suit" on the merits (5) Newspaper; or according to the substantive law in such territory or b. Any other publication that is given widespread in a settlement we agree to. public distribution. 7. "Employee" includes a "leased worker". However, "advertisement"does not include: "Employee" does not include a "temporaryworker". a. The design, printed material, information or 8. "Employment-Related Practices" means: images contained in, on or upon the packaging or labeling of any goods or a. Refusal to employ that person; products; or b. Termination of that person's employment; or b. An interactive conversation between or c. Employment-related practices, policies, acts among persons through a computer network. or omissions, such as coercion, demotion, 2. "Advertising idea" means any idea for an evaluation, reassignment, discipline, "advertisement". defamation, harassment, humiliation, 3. "Asbestos hazard" means an exposure or discrimination or malicious prosecution threat of exposure to the actual or alleged directed at that person. properties of asbestos and includes the mere 9. "Executive officer" means a person holding any presence of asbestos in any form. of the officer positions created by your charter, 4. "Auto" means: constitution, by-laws or any other similar governing document. a. A land motor vehicle, trailer or semitrailer 10."Hostile fire" means one which becomes designed for travel on public roads, including uncontrollable or breaks out from where it was any attached machinery or equipment; or intended to be. b. Any other land vehicle that is subject to a 11."Impaired property" means tangible property, compulsory or financial responsibility law or other than "your product" or "your work", that other motor vehicle insurance law where it is cannot be used or is less useful because: licensed or principally garaged. However, "auto" does not include "mobile a. It incorporates "your product" or "your work" equipment". that is known or thought to be defective, deficient, inadequate ordangerous; or 5. "Bodily injury" means physical: b. You have failed to fulfill the terms of a a. Injury; contract or agreement; b. Sickness; or if such property can be restored to use by the c. Disease repair, replacement, adjustment or removal of sustained by a person and, if arising out of the "your product" or "your work", or your fulfilling the above, mental anguish or death at any time. terms of the contract or agreement. 6. "Coverage territory" means: 12."Insured contract" means: a. The United States of America (including its a. A contract for a lease of premises. However, territories and possessions), Puerto Rico and that portion of the contract for a lease of Canada; premises that indemnifies any person or b. International waters or airspace, but only if organization for damage by fire, lightning or the injury or damage occurs in the course of explosion to premises while rented to you or travel or transportation between any places temporarily occupied by you with permission included in a. above; or of the owner is subject to the Damage to Page 18 of 21 HG 00 01 09 16 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 Premises Rented To You Limit described in 14."Loading or unloading" means the handling of Section III - Limits of Insurance; property: b. A sidetrack agreement; a. After it is moved from the place where it is c. Any easement or license agreement, accepted for movement into or onto an including an easement or license agreement aircraft, watercraft or"auto"; in connection with construction or demolition b. While it is in or on an aircraft, watercraft or operations on or within 50 feet of a railroad; "auto or d. An obligation, as required by ordinance, to c. While it is being moved from an aircraft, indemnify a municipality, except in connection watercraft or "auto" to the place where it is with work for a municipality; finally delivered; e. An elevator maintenance agreement; but "loading or unloading" does not include the f. That part of any other contract or agreement movement of property by means of a mechanical pertaining to your business (including an device, other than a hand truck, that is not indemnification of a municipality in connection attached to the aircraft, watercraft or"auto". with work performed for a municipality) under 15."Mobile equipment" means any of the following which you assume the tort liability of another types of land vehicles, including any attached party to pay for bodily injury or property machinery or equipment: damage" to a third person or organization, provided the "bodily injury" or "property a. Bulldozers, farm machinery, forklifts and other damage" is caused, in whole or in part, by vehicles designed for use principally off public you or by those acting on your behalf. Tort roads; liability means a liability that would be b. Vehicles maintained for use solely on or next imposed by law in the absence of any to premises you own or rent; contract or agreement. c. Vehicles that travel on crawler treads; Paragraph f. includes that part of any contract d. Vehicles, whether self-propelled or not, or agreement that indemnifies a railroad for maintained primarily to provide mobility to bodily injury or property damage arising permanently mounted: out of construction or demolition operations, within 50 feet of any railroad property and (1) Power cranes, shovels, loaders, diggers or affecting any railroad bridge or trestle, tracks, drills; or road-beds, tunnel, underpass or crossing. (2) Road construction or resurfacing However, Paragraph f. does not include that equipment such as graders, scrapers or part of any contract or agreement: rollers; (1) That indemnifies an architect, engineer or e. Vehicles not described in a., b., c. or d. above surveyor for injury or damage arising out of: that are not self-propelled and are maintained (a) Preparing, approving, or failing to primarily to provide mobility to permanently prepare or approve, maps, shop attached equipment of the following types: drawings, opinions, reports, surveys, (1) Air compressors, pumps and generators, field orders, change orders or drawings including spraying, welding, building and specifications; or cleaning, geophysical exploration, lighting (b) Giving directions or instructions, or and well servicing equipment; or failing to give them, if that is the (2) Cherry pickers and similar devices used to primary cause of the injury or damage; raise or lower workers; or f. Vehicles not described in a., b., c. or d. above (2) Under which the insured, if an architect, maintained primarily for purposes other than engineer or surveyor, assumes liability for the transportation of persons or cargo. an injury or damage arising out of the However, self-propelled vehicles with the insured's rendering or failure to render following types of permanently attached professional services, including those listed equipment are not "mobile equipment" but will in (1) above and supervisory, inspection,architectural or engineering activities. be considered autos„. . 13."Leased worker" means a person leased to you (1) Equipment designed primarily for: by a labor leasing firm under an agreement (a) Snow removal; between you and the labor leasing firm, to (b) Road maintenance, but not perform duties related to the conduct of your construction or resurfacing; or business. "Leased worker" does not include a (c) Street cleaning; temporary worker". HG 00 01 09 16 Page 19 of 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 (2) Cherry pickers and similar devices (2) Work that has not yet been completed or mounted on automobile or truck chassis abandoned. However, "your work" will be and used to raise or lower workers; and deemed completed at the earliest of the (3) Air compressors, pumps and generators, following times: including spraying, welding, building (a) When all of the work called for in your cleaning, geophysical exploration, lighting contract has been completed. and well servicing equipment. (b)When all of the work to be done at the However, "mobile equipment" does not include job site has been completed if your any land vehicle that is subject to a compulsory contract calls for work at more than or financial responsibility law or other motor one job site. vehicle insurance law where it is licensed or (c) When that part of the work done at a principally garaged. Land vehicles subject to a job site has been put to its intended compulsory or financial responsibility law or other use by any person or organization motor vehicle insurance law are considered other than another contractor or "autos". subcontractor working on the same 16."Occurrence" means an accident, including project. continuous or repeated exposure to substantially Work that may need service, the same general harmful conditions. maintenance, correction, repair or 17."Personal and advertising injury" means replacement, but which is otherwise injury, including consequential "bodily injury", complete, will be treated as completed. arising out of one or more of the following b. Does not include "bodily injury" or "property offenses: damage"arising out of: a. False arrest, detention or imprisonment; (1) The transportation of property, unless the b. Malicious prosecution; injury or damage arises out of a condition c. The wrongful eviction from, wrongful entry in or on a vehicle not owned or operated into, or invasion of the right of private by you, and that condition was created by occupancy of a room, dwelling or premises the "loading or unloading" of that vehicle that a person or organization occupies, by any insured; committed by or on behalf of its owner, (2) The existence of tools, uninstalled landlord or lessor; equipment or abandoned or unused d. Oral, written or electronic publication, in any materials; or manner, of material that slanders or libels a (3) Products or operations for which the person or organization or disparages a classification, listed in the Declarations or person's or organization's goods, products or in a policy Schedule, states that products- services; completed operations are subject to the e. Oral, written or electronic publication, in any General Aggregate Limit. manner, of material that violates a person's 20."Property damage" means: right of privacy; a. Physical injury to tangible property, including f. Copying, in your "advertisement", a person's all resulting loss of use of that property. All or organization's "advertising idea" or style of such loss of use shall be deemed to occur at "advertisement"; or the time of the physical injury that caused it; g. Infringement of copyright, slogan, or title of or any literary or artistic work, in your b. Loss of use of tangible property that is not "advertisement". physically injured. All such loss of use shall 18."Pollutants" mean any solid, liquid, gaseous or be deemed to occur at the time of the thermal irritant or contaminant, including smoke, "occurrence"that caused it. vapor, soot, fumes, acids, alkalis, chemicals and As used in this definition, computerized or waste. Waste includes materials to be recycled, electronically stored data, programs or software reconditioned or reclaimed. are not tangible property. Electronic data means 19."Products-completed operations hazard": information, facts or programs: a. Includes all "bodily injury" and "property a. Stored as or on; damage" occurring away from premises you b. Created or used on; or own or rent and arising out of "your product" or"your work" except: c. Transmitted to or from; (1) Products that are still in your physical computer software, including systems and possession; or applications software, hard or floppy disks, CD- Page 20 of 21 HG 00 01 09 16 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 ROMS, tapes, drives, cells, data processing 25. "Your work": devices or any other media which are used with a. Means: electronically controlled equipment. (1) Work or operations performed by you or 21."Suit" means a civil proceeding in which on your behalf; and damages because of "bodily injury", "property damage" or "personal and advertising injury" to (2) Materials, parts or equipment furnished in which this insurance applies are alleged. "Suit" connection with such work or operations. includes: b. Includes a. An arbitration proceeding in which such (1) Warranties or representations made at damages are claimed and to which the any time with respect to the fitness, insured must submit or does submit with our quality, durability, performance or use of consent; or "your work", and b. Any other alternative dispute resolution (2) The providing of or failure to provide proceeding in which such damages are warnings or instructions. claimed and to which the insured submits with our consent. 22."Temporary worker" means a person who is furnished to you to substitute for a permanent "employee" on leave or to meet seasonal or short-term workload conditions. 23."Volunteer worker" means a person who a. Is not your"employee"; b. Donates his or her work; c. Acts at the direction of and within the scope of duties determined by you; and d. Is not paid a fee, salary or other compensation by you or anyone else for their work performed for you. 24."Your product": a. Means: (1) Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a)You; (b) Others trading under your name; or (c)A person or organization whose business or assets you have acquired; and (2) Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b. Includes (1) Warranties or representations made at any time with respect to the fitness, quality, durability, performance or use of "your product"; and (2) The providing of or failure to provide warnings or instructions. c. Does not include vending machines or other property rented to or located for the use of others but not sold. HG 00 01 09 16 Page 21 of 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 POLICY NUMBER: 53 UEN OH9024 COMMERCIAL GENERAL LIABILITY EFFECTIVE DATE: 10/01/2023 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION - DESIGNATED OPERATIONS COVERED BY A CONSOLIDATED (WRAP-UP) INSURANCE PROGRAM This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Description and Location of Operation(s): All locations and all projects that a consolidated (wrap-up) insurance program has been provided by the prime contractor, project manager or owner of the construction project. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The following exclusion is added to paragraph 2., This exclusion applies whether or not the consolidated Exclusions of COVERAGE A - BODILY INJURY AND (wrap-up) insurance program: PROPERTY DAMAGE LIABILITY (Section 1 (1) provides coverage identical to that provided by Coverages): this Coverage Part; This insurance does not apply to "bodily injury" or "property damage" arising out of either your ongoing (2) has limits adequate to cover all claims; or operations or operations included within the (3) remains in effect. "products-completed operations hazard" at the location described in the Schedule of this endorsement, as a consolidated (wrap-up) insurance program has been provided by the prime contractor/project manager or owner of the construction project in which you are involved. CG 21 54 01 96 Copyright, Insurance Services Office, Inc., 1994 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 POLICY NUMBER: 53UENOH9025 COMMERCIAL AUTOMOBILE HA99161221 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED e. Employees as Insureds Paragraph .1. - WHO IS AN INSURED - of (1). Any "employee" of yours while using a Section II - Liability Coverage is amended to covered "auto" you don't own, hire or add the following: borrow in your business or your d. Subsidiaries and Newly Acquired or personal affairs. Formed Organizations f. Lessors as Insureds The Named Insured shown in the (1). The lessor of a covered "auto" while the Declarations is amended to include: "auto" is leased to you under a written (1) Any legal business entity other than a agreement if: partnership or joint venture, formed as a (a) The agreement requires you to subsidiary in which you have an provide direct primary insurance for ownership interest of more than 50% on the lessor and the effective date of the Coverage Form. (b) The "auto" is leased without a However, the Named Insured does not driver. include any subsidiary that is an "insured" under any other automobile Such a leased "auto" will be considered a policy or would be an "insured" under covered "auto" you own and not a covered such a policy but for its termination or "auto" you hire. the exhaustion of its Limit of Insurance. g. Additional Insured if Required by Contract (2) Any organization that is acquired or (1) When you have agreed, in a written formed by you and over which you contract or written agreement, that a maintain majority ownership. However, person or organization be added as an the Named Insured does not include any additional insured on your business auto newly formed or acquired organization: policy, such person or organization is an (a) That is a partnership or joint "insured", but only to the extent such venture, person or organization is liable for "bodily injury" or "property damage" (b) That is an "insured" under any other caused by the conduct of an "insured" policy, under paragraphs a. or b. of Who Is An (c) That has exhausted its Limit of Insured with regard to the ownership, Insurance under any other policy, or maintenance or use of a covered "auto." (d) 180 days or more after its The insurance afforded to any such acquisition or formation by you, additional insured applies only if the unless you have given us notice of "bodily injury" or "property damage" the acquisition or formation. occurs: Coverage does not apply to "bodily (a) During the policy period, and injury" or "property damage" that results (b) Subsequent to the execution of such from an "accident" that occurred before written contract, and you formed or acquired the organization. Form HA 99 16 12 21 Page 1 of 5 ©2021, The Hartford (Includes copyrighted material of Insurance Services Office, Inc. with its permission.) DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 (c) Prior to the expiration of the period This insurance is primary if you have of time that the written contract agreed in a written contract or written requires such insurance be provided agreement that this insurance be to the additional insured. primary. If other insurance is also (2) How Limits Apply primary, we will share with all that other If you have agreed in a written contract insurance by the method described in or written agreement that another Other Insurance 5.d. person or organization be added as an (2) Primary And Non-Contributory To Other additional insured on your policy, the Insurance When Required By Contract most we will pay on behalf of such If you have agreed in a written contract additional insured is the lesser of: or written agreement that this insurance (a) The limits of insurance specified in is primary and non-contributory with the the written contract or written additional insured's own insurance, this agreement; or insurance is primary and we will not (b) The Limits of Insurance shown in seek contribution from that otherinsurance. the Declarations. Such amount shall be a part of and not Paragraphs (1) and (2) do not apply to other insurance to which the additional insured in addition to Limits of Insurance shown has been added as an additional insured. in the Declarations and described in this Section. When this insurance is excess, we will have (3) Additional Insureds Other Insurance no duty to defend the insured against any suit if any other insurer has a duty to If we cover a claim or "suit" under this defend the insured against that "suit". If no Coverage Part that may also be covered other insurer defends, we will undertake to by other insurance available to an do so, but we will be entitled to the insured's additional insured, such additional rights against all those other insurers. insured must submit such claim or "suit" When this insurance is excess over other to the other insurer for defense and insurance, we will pay only our share of the indemnity. amount of the loss, if any, that exceeds the However, this provision does not apply sum of: to the extent that you have agreed in a (1) The total amount that all such other written contract or written agreement insurance would pay for the loss in the that this insurance is primary and non- absence of this insurance; and contributory with the additional insured's own insurance. (2) The total of all deductible and self- insured amounts under all that other (4) Duties in The Event Of Accident, Claim, insurance. Suit or Loss We will share the remaining loss, if any, by If you have agreed in a written contract the method described in SECTION IV- or written agreement that another Business Auto Conditions, B. General person or organization be added as an Conditions, Other Insurance 5.d. additional insured on your policy, the additional insured shall be required to 3. AUTOS RENTED BY EMPLOYEES comply with the provisions in LOSS Any "auto" hired or rented by your "employee" CONDITIONS 2. - DUTIES IN THE on your behalf and at your direction will be EVENT OF ACCIDENT, CLAIM , SUIT considered an "auto" you hire. OR LOSS — OF SECTION IV — The SECTION IV- Business Auto Conditions, B. BUSINESS AUTO CONDITIONS, in the General Conditions, 5. OTHER INSURANCE same manner as the Named Insured. Condition is amended by adding the following: 2. Primary and Non-Contributory if e. If an "employee's" personal insurance also Required by Contract applies on an excess basis to a covered Only with respect to insurance provided to "auto" hired or rented by your"employee" on an additional insured in A.1.g. - Additional your behalf and at your direction, this Insured If Required by Contract, the insurance will be primary to the following provisions apply: "employee's" personal insurance. (1) Primary Insurance When Required By Contract Page 2 of 5 Form HA 99 16 12 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 4. AMENDED FELLOW EMPLOYEE EXCLUSION obligation for any difference between the actual EXCLUSION 5. - FELLOW EMPLOYEE - of cash value of the "auto" at the time of the "loss" SECTION II - LIABILITY COVERAGE does not and the "outstanding balance" of the loan/lease. apply if you have workers' compensation "Outstanding balance" means the amount you insurance in-force covering all of your owe on the loan/lease at the time of "loss" less "employees". any amounts representing taxes; overdue Coverage is excess over any other collectible payments; penalties, interest or charges insurance. resulting from overdue payments; additional 5. HIRED AUTO PHYSICAL DAMAGE COVERAGE mileage charges; excess wear and tear charges; lease termination fees; security deposits not If hired "autos" are covered "autos" for Liability returned by the lessor; costs for extended Coverage and if Comprehensive, Specified warranties, credit life Insurance, health, accident Causes of Loss, or Collision coverages are or disability insurance purchased with the loan provided under this Coverage Form for any or lease; and carry-over balances from previous "auto" you own, then the Physical Damage loans or leases. Coverages provided are extended to "autos" you 8. AIRBAG COVERAGE hire or borrow, subject to the following limit. The most we will pay for "loss" to any hired Under Paragraph B. EXCLUSIONS - of SECTION III PHYSICAL DAMAGE "auto" is: COVERAGE, the following is added: (1) $100,000; The exclusion relating to mechanical breakdown (2) The actual cash value of the damaged or does not apply to the accidental discharge of an stolen property at the time of the "loss"; or airbag. (3) The cost of repairing or replacing the 9. ELECTRONIC EQUIPMENT - BROADENED damaged or stolen property, COVERAGE whichever is smallest, minus a deductible. The a. The exceptions to Paragraphs BA - deductible will be equal to the largest deductible EXCLUSIONS - of SECTION III - PHYSICAL applicable to any owned "auto" for that DAMAGE COVERAGE are replaced by the coverage. No deductible applies to "loss" following: caused by fire or lightning. Hired Auto Physical Exclusions 4.c. and 4.d. do not apply to Damage coverage is excess over any other equipment designed to be operated solely by collectible insurance. Subject to the above limit, use of the power from the "auto's" electrical deductible and excess provisions, we will system that, at the time of"loss", is: provide coverage equal to the broadest coverage applicable to any covered "auto" you (1) Permanently installed in or upon the own. covered "auto"; We will also cover loss of use of the hired "auto" (2) Removable from a housing unit which is if it results from an "accident", you are legally permanently installed in or upon the liable and the lessor incurs an actual financial covered "auto"; loss, subject to a maximum of $1000 per (3) An integral part of the same unit housing "accident". any electronic equipment described in This extension of coverage does not apply to Paragraphs (1) and (2) above; or any "auto" you hire or borrow from any of your (4) Necessary for the normal operation of the "employees", partners (if you are a partnership), covered "auto" or the monitoring of the members (if you are a limited liability company), covered "auto's" operating system. or members of their households. b. Section III, Physical Damage Coverage, 6. PHYSICAL DAMAGE - ADDITIONAL Limit of Insurance, Paragraph C.2. is TEMPORARY TRANSPORTATION EXPENSE amended to add the following: COVERAGE $1,500 is the most we will pay for "loss" in Paragraph AA.a. of SECTION III - PHYSICAL any one "accident" to all electronic DAMAGE COVERAGE is amended to provide a equipment (other than equipment designed limit of $50 per day and a maximum limit of solely for the reproduction of sound, and $1,000. accessories used with such equipment) that 7. LOAN/LEASE GAP COVERAGE reproduces, receives or transmits audio, Under SECTION III - PHYSICAL DAMAGE visual or data signals which, at the time of COVERAGE, in the event of a total "loss" to a "loss", is: covered "auto", we will pay your additional legal Form HA 99 16 12 21 Page 3 of 5 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 (1) Permanently installed in or upon the (2) A partner, if you are a partnership; covered "auto" in a housing, opening or (3) A member, if you are a limited liability other location that is not normally used company; or by the "auto" manufacturer for the installation of such equipment; (4) An executive officer or insurance manager, if you are a corporation. (2) Removable from a permanently installed 14. UNINTENTIONAL FAILURE TO DISCLOSE housing unit as described in Paragraph HAZARDS 2.a. above or is an integral part of that equipment; or If you unintentionally fail to disclose any hazards (3)An integral part of such equipment. existing at the inception date of your policy, we will not deny coverage under this Coverage c. For each covered "auto", should loss be Form because of such failure. limited to electronic equipment only, our obligation to pay for, repair, return or replace 15. HIRED AUTO -COVERAGE TERRITORY damaged or stolen electronic equipment will SECTION IV, BUSINESS AUTO CONDITIONS, be reduced by the applicable deductible PARAGRAPH B. GENERAL CONDITIONS, 7. - shown in the Declarations, or $250, POLICY PERIOD, COVERAGE TERRITORY - whichever deductible is less. is added to include the following: 10. EXTRA EXPENSE - BROADENED (6) For short-term hired "autos", the coverage COVERAGE territory with respect to Liability Coverage is Under Paragraph A. - COVERAGE- of SECTION anywhere in the world provided that if the III - PHYSICAL DAMAGE COVERAGE, we will "insured's" responsibility to pay damages for pay for the expense of returning a stolen covered "bodily injury" or "property damage" is "auto"to you. determined in a "suit," the "suit" is brought in the United States of America, the territories 11. GLASS REPAIR-WAIVER OF DEDUCTIBLE and possessions of the United States of Under Paragraph D. - DEDUCTIBLE - of America, Puerto Rico or Canada or in a SECTION III - PHYSICAL DAMAGE COVERAGE, settlement we agree to. the following is added: 16. WAIVER OF SUBROGATION No deductible applies to glass damage if the Paragraph 5. TRANSFER OF RIGHTS OF glass is repaired rather than replaced. RECOVERY AGAINST OTHERS TO US - of 12. TWO OR MORE DEDUCTIBLES SECTION IV - BUSINESS AUTO CONDITIONS Under Paragraph D. - DEDUCTIBLE - of A. Loss Conditions is amended by adding the SECTION III - PHYSICAL DAMAGE COVERAGE, following: the following is added: We waive any right of recovery we may have If another Hartford Financial Services Group, against any person or organization with whom Inc. company policy or coverage form that is not you have a written contract that requires such an automobile policy or coverage form applies to waiver because of payments we make for the same "accident", the following applies: damages under this Coverage Form. (1) If the deductible under this Business Auto 17. RESULTANT MENTAL ANGUISH COVERAGE Coverage Form is the smaller (or smallest) The definition of "bodily injury" in SECTION V- deductible, it will be waived; DEFINITIONS, C. is replaced by the following: (2) If the deductible under this Business Auto "Bodily injury" means bodily injury, sickness or Coverage Form is not the smaller (or disease sustained by any person, including smallest) deductible, it will be reduced by mental anguish or death resulting from any of the amount of the smaller (or smallest) these. deductible. 18. EXTENDED CANCELLATION CONDITION 13. AMENDED DUTIES IN THE EVENT OF Paragraph 2. of the COMMON POLICY ACCIDENT, CLAIM, SUIT OR LOSS CONDITIONS - CANCELLATION - applies The requirement in LOSS CONDITIONS 2.a. - except as follows: DUTIES IN THE EVENT OF ACCIDENT, If we cancel for any reason other than CLAIM, SUIT OR LOSS - of SECTION IV - nonpayment of premium, we will mail or deliver BUSINESS AUTO CONDITIONS that you must to the first Named Insured written notice of notify us of an "accident" applies only when the cancellation at least 60 days before the effective "accident" is known to: date of cancellation. (1) You, if you are an individual; Page 4 of 5 Form HA 99 16 12 21 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 19. HYBRID, ELECTRIC, OR NATURAL G S b. A"hybrid" auto is defined as an auto with an VEHICLE PAYMENT COVERAGE internal combustion engine and one or more In the event of a total loss to a "non-hybrid" auto electric motors; and that uses the internal for which Comprehensive, Specified Causes of combustion engine and one or more electric Loss, or Collision coverages are provided under motors to move the auto, or the internal this Coverage Form, then such Physical combustion engine to charge one or more Damage Coverages are amended as follows: electric motors, which move the auto. a. If the auto is replaced with a "hybrid" auto or 20. VEHICLE WRAP COVERAGE an auto powered solely by electricity or In the event of a total loss to an "auto" for which natural gas, we will pay an additional 10%, Comprehensive, Specified Causes of Loss, or to a maximum of$2,500, of the "non-hybrid" Collision coverages are provided under this auto's actual cash value or replacement Coverage Form, then such Physical Damage cost, whichever is less, Coverages are amended to add the following: b. The auto must be replaced and a copy of a In addition to the actual cash value of the "auto", bill of sale or new lease agreement received we will pay up to $1,000 for vinyl vehicle wraps by us within 60 calendar days of the date of which are displayed on the covered "auto" at the "loss," time of total loss. Regardless of the number of c. Regardless of the number of autos deemed autos deemed a total loss, the most we will pay a total loss, the most we will pay under this under this Vehicle Wrap Coverage provision for Hybrid, Electric, or Natural Gas Vehicle any one "loss" is $5,000. For purposes of this Payment Coverage provision for any one coverage provision, signs or other graphics "loss" is $10,000. painted or magnetically affixed to the vehicle are For the purposes of the coverage provision, not considered vehicle wraps. a. A "non-hybrid" auto is defined as an auto that uses only an internal combustion engine to move the auto but does not include autos powered solely by electricity or natural gas. Form HA 99 16 12 21 Page 5 of 5 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 A AAA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA Policy Number: 53 WE OH9H11 Endorsement Number: Effective Date: 10/01/2023 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: SCW Contracting Corporation 2525 OLD HIGHWAY 395 FALLBROOK CA 92028 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from us Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 01/21/22 Policy Expiration Date: 10/01/24 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 AXIS EXCESS INSURANCE AXh C� Endorsement Effective Date of Endorsement Policy Number Premium Number 12:01 a.m. on 10/01/2023 P-001-000764637-03 N/A AMENDATORY ENDORSEMENT—ADDITIONAL INSURED AND PRIMARY AND NON-CONTRIBUTORY FOLLOW FORM It is agreed the policy is amended to include the following language: This insurance shall follow form the Additional Insured status and Primary and Non-Contributory language of the followed policy. It is agreed and understood that the coverage provided by this policy will be no broader than the followed policy. All other provisions of the policy remain unchanged. AXIS 1011779 0119 Page 1 of 1 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 Westchester A Chubb Company ADDITIONAL INSURED ENDORSEMENT—ONGOING WORK OR OPERATIONS Named Insured Endorsement Number SCW Contracting Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G4681759A 007 10/01/2023 to 10/01/2024 10/01/2023 Issued By(Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE: Name of Person(s)or Organization(s):As required by written contract,prior to a loss to which this insurance applies. (If no entry appears above,information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II - WHO IS AN INSURED is amended to include as an additional insured the persons or organizations shown in the Schedule,but only with respect to liability for injury or damage,to which this insurance applies,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 the additional insureds. However: i. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement,the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds,the following exclusion is added: Exclusions This insurance does not apply to injury or damage occurring after: a. All work or operations,including materials,parts or equipment furnished in connection with such work or operations, on the project (other than service, maintenance or repairs) to be performed by you or on your behalf at the site of the covered operations has been completed;or b. 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 the additional insured as a part of the same project. ENV-3250(12/18) Includes copyrighted material of Insurance Services Office,Inc.with its permission Page t of 2 (221oi2.1) DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 Westchester A Chubb Company C. With respect to the insurance afforded to these additional insureds, the following is added to SECTION III—LIMITS OF INSURANCE: 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: i. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. ENV-3250(12/18) Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 2 of 2 (221012.1) DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 Westchester A Chubb Company ADDITIONAL INSURED ENDORSEMENT—PRODUCTS-COMPLETED OPERATIONS HAZARD Named Insured Endorsement Number SCW Contracting Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G4681759A 007 10/01/2023 to 10/01/2024 10/01/2023 Issued By(Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization(s): As required by written contract,prior to a loss to which this insurance applies. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. SECTION II — WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for injury or damage, to which this insurance applies, caused by or resulting from your work performed for that additional insured and included in the products-completed operations hazard, and only to the extent that such injury or damage is caused,in whole or in part,by your negligence or the negligence of those acting on your behalf. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds,the following is added to SECTION III- LIMITS OF INSURANCE: 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: i. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms and conditions of this policy remain unchanged. ENV-3251(12/18) Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 1 (22ioi2.2) DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 Westchester A Chubb Company PRIMARY AND NONCONTRIBUTORY—OTHER INSURANCE CONDITION Named Insured Endorsement Number SCW Contracting Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G 68i 59A oo7 to of 2023 to to of 2024 10 0i 202 Issued By(Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: CONTRACTOR'S POLLUTION LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary and Noncontributory Insurance This policy is primary to, and will not seek contribution from, any other insurance available to an additional insured under this policy,provided that: a. The additional insured is a named insured under such other insurance; and b. The named insured has agreed in a written contract or agreement that this insurance would: (1) act as primary insurance;and (2)would not seek contribution from any other insurance available to the additional insured. All other terms and conditions of this policy remain unchanged. ENV-3253(12-18) Includes copyrighted material of Insurance Services Office,Inc.with its permission Page 1 of 1 (266562.2) DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 Named Insured Endorsement Number SCW Contracting Policy Symbol Policy Number Policy Period Effective Date of Endorsement CPW G4681759A 007 10/01/2023 to 10/01/2024 10/01/2023 Issued By(Name of Insurance Company) Westchester Surplus Lines Insurance Company Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization:As required by written contract, prior to a loss to which this insurance applies. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products-completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same. ENV-3143(03-05) Includes copyrighted material of Insurance Services Office, Inc.with its permission Page 1 of 1 DocuSign Envelope ID:7F519FD7-8B2F-485E-BACO-3A6A9667AD30 BUSINESS LICENSE CITY OF LAKE ELSINORE This business license is issued for revenue purposes only and does not grant authorization Administrative Services-Licensing to operate a business. This business license is issued without verification that the holder is 130 South Main Street, Lake Elsinore, CA 92530 subject to or exempted from licensing by the state,county,federal government,or any PH(951)674-3124 other governmental agency. Business Name: SCW CONTRACTING CORPORATION BUSINESS LICENSE NO. 022745 Business Location: 2525 OLD HIGHWAY 395 Business Type: GENERAL ENGINEERING CONTRACTOR FALLBROOK,CA 92028-8794 Owner Name(s): JEFFREY SCRAPE Issue Date: 2/1/2024 Expiration Date: 1/31/2025 SCW CONTRACTING CORPORATION 2525 OLD HIGHWAY 395 FALLBROOK, CA 92028-8794 Starting January 1,2021,Assembly Bill 1607 requires the prevention of gender-based discrimination of business establishments.A full notice is available in English or other languages by going to:https://www.dca.ca.gov/publications/ TO BE POSTED IN A CONSPICUOUS PLACE THIS IS YOUR LICENSE • NOT TRANSFERABLE Electronic Record and Signature Disclosure created on:2/5/2018 9:41:59 AM Parties agreed to:Shannon Buckley,Barbara Leibold,Andrew Scrape,Jason Simpson,Candice Alvarez,Gus Papagolos CONSUMER DISCLOSURE From time to time, Carahsoft OBO City of Lake Elsinore (we,us or Company)may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign, Inc. (DocuSign) electronic signing system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the `I agree' button at the bottom of this document. Getting paper copies At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after signing session and, if you elect to create a DocuSign signer account, you may access them for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below. Withdrawing your consent If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below. Consequences of changing your mind If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. To indicate to us that you are changing your mind, you must withdraw your consent using the DocuSign `Withdraw Consent' form on the signing page of a DocuSign envelope instead of signing it. This will indicate to us that you have withdrawn your consent to receive required notices and disclosures electronically from us and you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us. All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure,we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process,please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us. How to contact Carahsoft OBO City of Lake Elsinore: You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows: To contact us by phone call: 951-674-3124 x269 To contact us by email send messages to: lreyes@lake-elsinore.org To advise Carahsoft OBO City of Lake Elsinore of your new e-mail address To let us know of a change in your e-mail address where we should send notices and disclosures electronically to you, you must send an email message to us at lreyes@lake-elsinore.org and in the body of such request you must state: your previous e-mail address, your new e-mail address. We do not require any other information from you to change your email address.. In addition, you must notify DocuSign, Inc. to arrange for your new email address to be reflected in your DocuSign account by following the process for changing e-mail in the DocuSign system. To request paper copies from Carahsoft OBO City of Lake Elsinore To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an e-mail to lreyes@lake-elsinore.org and in the body of such request you must state your e-mail address, full name, US Postal address, and telephone number. We will bill you for any fees at that time, if any. To withdraw your consent with Carahsoft OBO City of Lake Elsinore To inform us that you no longer want to receive future notices and disclosures in electronic format you may: i. decline to sign a document from within your DocuSign session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an e-mail to lreyes@lake-elsinore.org and in the body of such request you must state your e-mail, full name, US Postal Address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process.. 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By checking the `I agree' box, I confirm that: I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF ELECTRONIC CONSUMER DISCLOSURES document; and I can print on paper the disclosure or save or send the disclosure to a place where I can print it, for future reference and access; and • Until or unless I notify Carahsoft OBO City of Lake Elsinore as described above, I consent to receive from exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to me by Carahsoft OBO City of Lake Elsinore during the course of my relationship with you.