HomeMy WebLinkAbout5560PROFESSIONAL SERVICES AGREEMENT
Harlow Drive Safe Routes to School Grant Application
The City of Bremerton ("City") and Parametrix, Inc. ("Consultant"), referred to
collectively as the "Parties," enter into the following Agreement for professional services:
I. Scope: The.Consultant agrees to perform the services more specifically described in the
Scope of Work, dated April 12, 2016, including any attachments thereto , attached hereto as
Exhibit A, which is incorporated by reference herein. The Scope of Work may be modified only
pursuant to Section VII.H of this Agreement. If the Scope of Work provides for unspecified
additional services such services shall only be performed upon the express written request of the
City. Consultant further represents that the services furnished under this Agreement will be
performed in accordance with generally accepted professional practices in effect at the time such
services are performed.
II. Term: The City and the Consultant agree that work will begin on the tasks described in
Exhibit A immediately upon execution of this Agreement. The parties agree that the work
described in Exhibit A is to be completed as provided for in the work schedule attached hereto as
Exhibit B; provided however, that additional time shall be granted by the City for excusable delays
or extra work as provided for in Section IX.A:of this agreement.
III. Compensation: In consideration of the services provided pursuant to this Agreement, the
City shall pay Consultant a lump sum amount $5,000. Consultant's charges and bills shall conform
to the fee schedule attached hereto as Exhibit C and incorporated herein by this reference.
The Consultant shall submit regular billing statements detailing work performed and
amount charged on each task or portion thereof. The descriptions shall conform to and fall within
the categories set out in the Scope of Work and/or Fee Schedule. Upon receipt of a conforming
billing statement, the City shall promptly process payment. PROVIDED, HOWEVER, the City
reserves the right to prioritize scoped work and accelerate and/or delay work tasks under the time
frame set forth in Section 11 herein. The Consultant's labor rates and billing fees shall be as
delineated in Exhibit C.
Consultant shall not perform work beyond the Scope of Work, nor shall be compensated
for such work, unless the Scope of Work or amount of compensation is modified pursuant to this
Agreement. Consultant shall only be compensated for additional services if requested pursuant to
Section I and, if not otherwise provided, such compensation shall be in accordance with Exhibit
C.
If a billing statement does not conform to this Agreement, the City may withhold payment
until the statement is brought into compliance. Such withholding does not relieve Consultant of
its obligations under this Agreement.
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IV. Relationship of Parties: Consultant represents that it is skilled in the matters addressed in
the Scope of Work and is performing independent functions and responsibilities within its field of
expertise. Consultant and its personnel are independent Consultants and not employees of the
City. Consultant and its personnel have no authority to bind the City or to control the City's
employees and other Consultants. None of the benefits provided by the City to its employees,
including, but not limited to, compensation, insurance, and unemployment insurance are available
from the City to the employees, agents, representatives, or sub -Consultants of the Consultant.
Consultant will be solely and entirely responsible for its acts and for the acts of Consultant's agents,
employees, representatives and sub -Consultants during the performance of this Agreement. The
City may, during the term of this Agreement, engage other independent Consultants to perform
the same or similar work.
As an independent Consultant, Consultant is responsible for its own management. The
City's administration and enforcement of this Agreement shall not be deemed an exercise of
managerial control over Consultant or its personnel.
As an independent Consultant, Consultant is responsible for payment of all taxes and
licensing fees necessary to perform its obligations under this Agreement. These taxes and fees
include but are not limited to State industrial insurance, Business & Occupation, State professional
licensing, and City business licensing. If any taxes or fees due the City have been declared
delinquent, the City may withhold the delinquent amount, plus any additional charges arising from
the delinquency, from any payments due Consultant.
V. Indemnification:
A. Consultant shall defend, indemnify and hold the City, its officers, officials,
employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or
suits, including all legal costs and attorney fees, arising out of or in connection with Consultant's
performance of this Agreement, unless Consultant is conducting work pursuant to Subsection B
below.
The City's review or acceptance of any of the work when completed shall not be grounds
to avoid any of these covenants of indemnification.
B. Architects, Engineers and Any Other Professional Listed In and Performing
Services Defined in RCW 4.24.115. Should a court of competent jurisdiction detennine that
Consultant's services provided pursuant to this Agreement is subject to RCW 4.24.115, then, in
the event of liability for damages arising out of bodily injury to persons or damages to property
caused by or resulting from the concurrent negligence of the Consultant and the City, its officers,
officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to
the extent of the Consultant's negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER
OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE
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Kitsap Way Culvert Improvements
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PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE
THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER.
The provisions of this section shall survive the expiration or termination of this Agreement.
VI. Insurance: The Consultant shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which may arise from or in
connection with the performance of the work hereunder by the Consultant, its agents,
representatives, employees, sub -consultants or sub -Consultants.
Before beginning work on the project described in this Agreement, the Consultant shall
provide a Certificate of Insurance evidencing:
1. Automobile Liability insurance with limits no less than $1,000,000 combined single limit
per accident for bodily injury and property damage; and
2. Commercial General Liability insurance written on an occurrence basis with limits no
less than $1,000,000 combined single limit per occurrence and general aggregate for
personal injury, bodily injury and property damage. Coverage shall include but not be
limited to: blanket contractual; products/completed operations/broad form property
damage; explosion, collapse and underground (XCU) if applicable; and employer's
liability; and
3. Excess Liability insurance with limits not less than 1,000,000 limit per occurrence and
aggregate.
4. Professional Liability insurance with limits no less than $1,000,000 limit per
occurrence/claim.
Any payment of deductible or self insured retention shall be the sole responsibility of the
Consultant.
All required policies shall be provided on an "occurrence" basis except professional
liability insurance (if required), which may be provided on a "claims -made" basis.
The City shall be named as an additional insured on the Commercial General Liability
insurance policy, as respects work performed by or on behalf of the Consultant and a copy of an
endorsement that is acceptable to the City, which names the City as an additional insured shall be
attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of
all the required insurance policies and endorsements. The City further reserves the right to reject
any unacceptable policies and/or endorsements.
The Consultant's Commercial General Liability insurance shall contain a clause stating that
coverage shall apply separately to each insured against whom claim is made or suit is brought,
except with respects to the limits of the insurer's liability.
The Consultant's insurance shall be primary insurance as respects the City and it shall be
an affirmative obligation upon Consultant to advise the City's Risk Manager by fax at (360) 473-
5161, or by certified mail, return receipt requested to City of Bremerton, attn: Risk Management,
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345 6°i Street, Suite 600, Bremerton, WA 98337 within two days of the cancellation, suspension
or substantive change of any insurance policy set out herein, and failure to do so shall be construed
to be a breach of this Agreement.
The City also reserves its unqualified right to require at any time and for any reason, proof
of coverage in the form of a duplicate of the insurance policy with all endorsements as evidence
of coverage.
VII. General Conditions:
A. Reports and Information: When requested by the City, Consultant shall furnish
periodic reports and documents on matters covered by this Agreement. The reports and documents
shall be furnished in the time and form requested. Consultant shall maintain accounting records
in accordance with Generally Accepted Accounting Principles (GAAP) to substantiate all billed
amounts.
B. Ownership and Use of Records and Documents: Original documents, drawings,
designs and reports, including those in electronic format, developed under this Agreement are the
property of the City. All written information submitted by the City to the Consultant in connection
with the services performed by the Consultant under this Agreement will be safeguarded by the
Consultant to at least the same extent as the Consultant safeguards like information relating to its
own business. If such information is publicly available or is already in Consultant's possession or
known to it, or is rightfully obtained by the Consultant from third parties, Consultant shall bear no
responsibility for its disclosure, inadvertent or otherwise.
All data, documents and files created by Consultant under this Agreement may be stored
at Consultant's office in Bremerton, Washington. Consultant shall make such data, documents,
and files available to the City upon its request at all reasonable times for the purpose of editing,
modifying and updating as necessary until such time as the City is' capable of storing such
information in the City's offices. Duplicate copies of this information shall be provided to the City
upon its request, and at reasonable cost.
All documents, including all reports, drawings, specifications, computer software or other
items prepared or furnished by Consultant pursuant to this Agreement, are instruments of service
with respect to the project and are the property of the City. Any reuse by the City for other than
the specific purpose intended will be at City's sole risk.
C. Use of Photographs and Images. Consultant shall not use or distribute photographs
or images depicting City officials, personnel, property, or equipment whether prepared by
Consultant or provided by City without prior written consent of the City. The City will not
unreasonably withhold its consent.
D. Work Performed at Consultant's Risk: Consultant shall take all precautions
necessary and shall be responsible for the safety of its employees, agents, and sub -consultants in
the performance of the work hereunder and shall utilize all protection necessary for that purpose.
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All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss
of or damage to materials, tools, or other articles used or held for use in connection with the work.
E. Place of Work: The Consultant shall perform the work authorized under this
Agreement at its offices in Bremerton, Washington. Meetings with the City staff as described in
Exhibit A, Scope of Work, shall take place at the City's offices, or at locations mutually agreed
upon by the parties.
F. Entire Agreement: This Agreement and its Exhibits constitutes the entire agreement
between the Parties, and the Parties acknowledge that there are no other agreements, written or
oral, that have not been set forth in the text of this Agreement.
G. Severability: Should any part of this Agreement be found void, the balance of the
Agreement shall remain in full force and effect.
H. Modification: This Agreement may only be modified by written instrument signed
by both Parties.
1. Written Notices: . All communications regarding this Agreement shall be sent
to the parties at the addresses listed below by registered or 1 st class mail, or by personal service,
and shall be deemed sufficiently given if sent to the addressee at the address stated in this
Agreement or such other address as may be hereafter specified in writing.
City Address:
345 Sixth Street
Suite 600
Bremerton, WA 98337
Consultant Address:
4660 Kitsap Way, Suite A
Bremerton, WA 98312
J. Waiver: Failure to enforce any provision of this Agreement shall not be deemed a
waiver of that provision. Waiver of any right or power arising out of this Agreement shall not be
deemed waiver of any other right or power.
K. Non -Waiver of Breach: The failure of the City to insist upon strict performance of
any of the covenants and agreements contained herein, or to exercise any option herein conferred
in one or more instances shall not be construed to be a waiver or relinquishment of said covenants,
agreements or options, and the same shall be and remain in full force and effect.
L. Compliance with Laws: Consultant shall comply with all applicable Federal, State,
and local laws in performing its obligations under this Agreement.
M. Choice of Law and Venue: This Agreement shall be interpreted according to the
laws of the State of Washington. Any judicial action to resolve disputes arising out of this
Agreement shall be brought in Kitsap County Superior Court.
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Kitsap Way Culvert Improvements
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N. Attorneys' Fees: In the event of litigation to enforce any of the terms or provisions
herein, each party shall pay all its own costs and attorney's fees.
O. Assignment: Any assignment of this agreement by the Contractor without the
written consent of the City shall be void.
VIII. Nondiscrimination: Consultant shall not discriminate in employment or services to the
public on the basis of race, color, national origin, sex, religion, age, marital status, disability, or
sexual orientation except for employment actions based on bona fide occupational qualification.
IX. Termination: This Agreement shall remain in force until completion and acceptance of
the services, terminated by written instrument upon mutual consent, or by the City of Bremerton
for convenience. This Agreement may be immediately terminated for cause by a Party if the other
Party substantially fails to perform through no fault of the terminating Party, and the non-
performing Party does not commence correction of the failure of perfonnance within thirty (30)
days of the terminating Party's sending notice to the non-performing Party. Any Notice by
Consultant shall include a report showing the status of all items listed in the Scope of Work current
through the termination date.
If the City receives reimbursement by any federal, state, or other source for work described in
Section 1 herein, and that funding is withdrawn, reduced or limited in any way, or the project is
cancelled or substantially reduced after the execution date of this Agreement and prior to the
completion of the work, the City may summarily terminate this Agreement.
A. Excusable Delay The right of Consultant to proceed shall not be terminated nor
shall Consultant be charged with liquidated damages for any delays in the completion of the work
due to: 1) any acts of the federal government in controlling, restricting, or requisitioning materials,
equipment, tools, or labor by reason of war, national defense, or other national emergency; 2) any
acts of the City, its consultants, or other public agencies causing such delay; and 3) causes not
reasonably foreseeable by the parties at the time of the execution of the Agreement that are beyond
the control and without the fault or negligence of the Consultant, including, but not restricted to,
acts of God, fires, floods, strikes, or weather of unusual severity. PROVIDED, HOWEVER, that
the Consultant must promptly notify the City within ten (10) calendar days in writing of the cause
of the delay. If, on the basis of the facts and the terms of this Agreement, the delay is properly
excusable, the City shal I, in writing, extend the time for completing the work for a period of time
commensurate with the period of excusable delay.
B. Rights Upon Termination: In the event of termination, the City shall pay for all
services performed by the Consultant to the effective date of termination, as described on a final
invoice submitted to the City. After termination, the City may take possession of all records and
data within the Consultant's possession pertaining to this project which maybe used by the City
without restriction. Any such use not related to the project which Consultant was contracted to
perform shall be without liability or legal exposure to the Consultant.
X. Suspension & Debarment. For contracts involving Federal funding, Consultant hereby
certifies, by signing this agreement, that neither it nor its principals are presently debarred,
Bremerton/Parametri x April 2016
Kitsap Way Culvert Improvements
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suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department or agency. Consultant shall provide
immediate written notice to the City if at any time it learns that it is or has become ineligible for
certification. Should Consultant enter into a covered transaction with another firm. Consultant
agrees by signing this agreement that it will verify that the fine with whom it intends to do
business is not debarred, suspended, ineligible, excluded or disqualified.
CITY OF BREMERTON
.:3!r mAqvmn
Date: -4115/i&
CONSULTANT
By: Jan E. Rosholt
its: Senior Consultant
Date: April 13, 2016
Appr ed as to form: Attest:
ernerton ity Attorn y City Clerk
U \PSO\Shared\Divisions\O17iceSupportSvs\Conlid\from-BRFM\Contracts\00-2016 Contracts\2016 Client Agreements\City of
Bremerton\Harlow Drive\PSA Harlow Dr 041216 doc
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Kitsap Way Culvert Improvements
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April 2016
Parametrix
ENGINEERING PLANNING. ENVIRONMENTAL SCIENCES
EXHIBIT A - SCOPE OF WORK
Harlow Drive Safe Routes to School
Grant Application
INTRODUCTION
This Scope of Work (SOW) describes tasks to be performed by Parametrix for the Harlow Drive Safe Routes to
School Grant Application project. The proposed improvements to be grant funded include a 5 -foot wide sidewalk
on the western side of Harlow Drive extending from Kitsap way to Price Road NW. Two new crosswalks with
speed tables and RRFBs will be provided at the two entrances to Kitsap Lake Elementary School. A 5 -foot wide
sidewalk will connect the two crosswalks on the eastern side of Harlow Drive. Tasks to be performed are
described below:
Task 01 — Grant Application Preparation
Objective
Prepare a Safe Routes to School Program grant application for Harlow Drive.
Activities
The following activities will be performed for this task:
• Prepare a Safe Routes to School Program grant application for Harlow Drive.
Deliverables
The following deliverable will be prepared:
• Completed grant application.
Assumptions
The following assumptions apply to this task:
• The grant application will be completed according to the requirements of the WSDOT Local Programs
Safe Routes to School Program.
• Drainage improvements will be incorporated meeting the requirements of Bremerton Public Works
standards and the Kitsap County Stormwater Manual.
City of Bremerton 233-1896-999
Harlow Drive Safe Routes to School Grant Application A-1 April 2016
Parametrix
ENGINEERING. PLANNING. ENVIRONMENTAL SCIENCES
EXHIBIT B -SCHEDULE
Harlow Drive Safe Routes to School
Grant Application
TASK COMPLETED BY
Notice to Proceed
Final Grant Application
April 15,2016
May 11, 2016
City of Bremerton 233-1896-999
Harlow Drive Safe Routes to School Grant Application B-1 April 2016
Parametrix
ENGINEERING. PLANNING. ENVIRONMENTAL SCIENCES
EXHIBIT C - BUDGET
Harlow Drive Safe Routes to School
Grant Application
TASK COST
Prepare Grant Application $5,000.00
TOTAL (LUMP SUM): $5,000.00
City of Bremerton 233-1896-999
Harlow Drive Safe Routes to School Grant Application C-1 April 2016
Client#: 319834
PARAMINC
ACORD., CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
10/28/2o1s
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 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
NAME: Please send all requests by
USI Kibble & Prentice
PHONEE<t : fax or email ac, No): 610-362-8518
601 Union Street, Suite 1000RECEIVED
AI oRless: CLCertRequest@usi.com
Seattle, WA 98101
__— CLAIMS -MADE � OCCUR
INSURER(S) AFFORDING COVERAGE NAIC #
206-441-6300 f
INSURER A: Hanover American Insurance Co 36064
INSURED
INSURER B: Hanover Insurance Companyhjj 22292
Parametrix, Inc.
INSURER C: Employers Ins Co of Wausau 21458
1019 39th Ave. SE, Suite 100 City of Bremerton
INSURER D: XL Specialty Insurance Compano 37885
Puyallup, WA 98374-6502 Risk Management
INSURER E: Allmerica Financial Benefit Ins 4184.0
INSURER F:
COVERAGES CERTIFICATE NUMBER: K1 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 CONTRACTOR 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.
(NSR
LTR_
TYPE OF INSURANCE
ADDL
INSR
SUBR
WVD
POLICY NUMBER
POLICY EFF POLICY EXP
AMM/DD/YYYY) (MM/DD/YYYY
LIMITS
X COMMERCIAL GENERAL LIABILnY
X
X
ZZ2893486906
A
11/01/2016 11/01/2017
EACH OCCURRENCE $1,000,000
__— CLAIMS -MADE � OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence $1,000,000
MED EXP (Any one person) $10,000
X WA Stop Gap/EL
PERSONAL & ADV INJURY $1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER:
POLICY JECaT LOC
GENERAL AGGREGATE $2,000,000
PRODUCTS - COMP/OP AGG $Included
WA Stop Ga $1,000,000
OTHER:
E
AUTOMOBILE
LIABILITY
X
X
AW2889472706
1/01/2016 11/01/201
CO MBINEDSINGLELIMIT
Ea accident 1,000,000
BODILY INJURY (Per person) $
X
ANY AUTO
_
X
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS X NON -OWNED
AUTOS
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
Per accident
B
X
UMBRELLA LIAB
X
OCCUR
X
X
UH2891561606
1/01/2016
11/01/2017
EACH OCCURRENCE $10000000
AGGREGATE $10,000,000
EXCESS LIAB
CLAIMS -MADE
XS of GL, Auto &
DED X! RETENTION$None
$
Em to ers Liab.
C
WORKERS COMPENSATIONX
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
N/A
WCCZ91447422016
States: CA CO ID
IL NM OR UT
1/01/201611/01/201
X PERT OTH-
E.L. EACH ACCIDENT $1 000000
------- - -
E.L. DISEASE - EA EMPLOYEE $1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
USL&H included
for above
1/01/2016
states+W
11/01/2017
E.L. DISEASE - POLICY LIMIT $1,000,000
$1,000,000 Per Claim
D
Professional
DPR9907916
Liability
Pollution Legal
$1,000,000 Aggregate
(Claims Made
Liab included
Retro Date: 1/1/1969
DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
233-1896-131 - Harlow Drive Safe Routes to School Grant Application. City of Bremerton is Additional Insured
as respects General Liability if required by written contract per attached endorsement.
City of Bremerton
345 6th Street, Suite 600
Bremerton, WA 98337
ACORD 25 (2014/01) 1 Of 1
#S19195029/M19194860
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
@ 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
CNMJU
ZZ2 8934869
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
COMMERCIAL GENERAL LIABILITY BROADENING ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SUMMARY OF COVERAGES
1.
Additional Insured by Contract, Agreement or Permit
Included
2.
Additional Insured — Primary and Non -Contributory
Included
3.
Blanket Waiver of Subrogation
Included
4.
lBodily Injury Redefined
Included
5.
Broad Form Property Damage — Borrowed Equipment, Customers Goods & Use of Elevators
Included
6.
Knowledge of Occurrence
Included
7.
Liberalization Clause
Included
8.
Medical Payments — Extended Reporting Period
Included
9.
1 Newly Acquired or Formed Organizations - Covered until end of policy period
Included
10.
Non -owned Watercraft
51 ft.
11.
Supplementary Payments Increased Limits
- Bail Bonds
$2,500
- Loss of Earnings
$1000
12.
Unintentional Failure to Disclose Hazards
Included
13.
Unintentional Failure to Notify
Included
This endorsement amends coverages provided under the Commercial General Liability Coverage Part through
new coverages, higher limits and broader coverage grants.
1. Additional Insured by Contract, Agreement or
Permit
The following is added to SECTION II — WHO IS
AN INSURED:
Additional Insured by Contract, Agreement or
Permit
a. Any person or organization with whom you
agreed in a written contract, written agreement
or permit that such person or organization to
add an additional insured on your policy is an
additional insured only with respect to liability
for "bodily injury", "property damage", or
"personal and advertising injury" caused, in
whole or in part, by your acts or omissions, or
the acts or omissions of those acting on your
behalf, but only with respect to:
(1) "Your work" for the additional insured(s)
designated in the contract, agreement or
permit;
(2) Premises you own, rent, lease or occupy;
or
(3) Your maintenance, operation or use of
equipment leased to you.
b. The insurance afforded to such additional
insured described above:
(1) Only applies to the extent permitted by
law; and
(2) Will not be broader than the insurance
which you are required by the contract,
agreement or permit to provide for such
additional insured.
421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 4
(3) Applies on a primary basis if that is
required by the written contract, written
agreement or permit.
(4) Will not be broader than coverage
provided to any other insured.
(5) Does not apply if the "bodily injury',
"property damage" or "personal and
advertising injury' is otherwise excluded
from coverage under this Coverage Part,
including any endorsements thereto.
c. This provision does not apply:
(1) Unless the written contract or written
agreement was executed or permit was
issued prior to the "bodily injury', "property
damage", or "personal injury and
advertising injury'.
(2) To any person or organization included as
an insured by another endorsement
issued by us and made part of this
Coverage Part.
(3) To any lessor of equipment:
(a) After the equipment lease expires; or
(b) If the "bodily injury", "property
damage", "personal and advertising
injury' arises out of sole negligence of
the lessor
(4) To any:
(a) Owners or other interests from. whom
land has been leased which takes
place after the lease for the land ex-
pires; or
(b) Managers or lessors of premises if:
(i) The occurrence takes place after
you cease to be a tenant in that
premises; or
(ii) The "bodily injury', "property
damage", "personal injury" or
"advertising injury" arises out of
structural alterations, new con-
struction or demolition operations
performed by or on behalf of the
manager or lessor.
(5) To "bodily injury', "property damage" or
"personal and advertising injury" arising
out of the rendering of or the failure to
render any professional services.
This exclusion applies even if the claims
against any insured allege negligence or
other wrongdoing in the supervision,
hiring, employment, training or monitoring
of others by that insured, if the
"occurrence" which caused the "bodily
injury' or "property damage" or the offense
which caused the "personal and
advertising injury" involved the rendering
of or failure to render any professional
services by or for you.
d. With respect to the insurance afforded to
these additional insureds, the following is
added to SECTION III — LIMITS OF
INSURANCE:
The most we will pay on behalf of the
additional insured for a covered claim is the
lesser of the amount of insurance:
1. Required by the contract, agreement or
permit described in Paragraph a.; or
2. Available under the applicable Limits of
Insurance shown in the Declarations.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
2. Additional Insured — Primary and Non -
Contributory
The following is added to SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 4. Other insurance:
Additional Insured — Primary and Non -
Contributory
If you agree in a written contract, written
agreement or permit that the insurance provided to
any person or organization included as an
Additional Insured under SECTION II — WHO IS
AN INSURED, is primary and non-contributory,
the following applies:
If other valid and collectible insurance is available
to the Additional Insured for a loss covered under
Coverages A or B of this Coverage Part, our
obligations are limited as follows:
a. Primary Insurance
This insurance is primary to other insurance
that is available to the Additional Insured
which covers the
Additional Insured as a Named Insured. We
will not seek contribution from any other
insurance available to the Additional Insured
except:
(1) For the sole negligence of the Additional
Insured;
(2) When the Additional Insured is an
Additional Insured under another primary
liability policy; or
(3) when b. below applies.
If this insurance is primary, our obligations are
not affected unless any of the other insurance
is also primary. Then, we will share with all
that other insurance by the method described
in c. below.
421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 4
b. Excess Insurance
(1) This insurance is excess over any of the
other insurance, whether primary, excess,
contingent or on any other basis:
(a) That is Fire, Extended Coverage,
Builder's Risk, Installation Risk or
similar coverage for "your work";
(b) That is Fire insurance for premises
rented to the Additional Insured or
temporarily occupied by the Additional
Insured with permission of the owner;
(c) That is insurance purchased by the
Additional Insured to cover the
Additional Insured's liability as a
tenant for "property damage" to
premises rented to the Additional
Insured or temporarily occupied by the
Additional with permission of the
owner; or
(d) If the loss arises out of the
maintenance or use of aircraft, "autos"
or watercraft to the extent not subject
to Exclusion g. of SECTION I —
COVERAGE A — BODILY INURY
AND PROPERTY DAMAGE
LIABILITY.
(2) When this insurance is excess, we will
have no duty under Coverages A or B to
defend the insured against any "suit" if any
other insurer has a duty to defend the
insured against that "suit". If no other
insurer defends, we will undertake to do
so, but we will be entitled to the insured's
rights against all those other insurers.
(3) When this insurance is excess over other
Insurance, we will pay only our share of
the amount of the loss, if any, that
exceeds the sum of:
(a) The total amount that all such other
insurance would pay for the loss in the
absence of this insurance; and
(b) The total of all deductible and self
insured amounts under all that other
insurance.
We will share the remaining loss, if any,
with any other insurance that is not
described in this Excess Insurance
provision and was not bought specifically
to apply in excess of the Limits of
Insurance shown in the Declarations of
this Coverage Part.
insurer contributes equal amounts until it has
paid its applicable limit of insurance or none of
the loss remains, whichever comes first. If any
of the other insurance does not permit
contribution by equal shares, we will contribute
by limits. Under this method, each insurer's
share is based on the ratio of its applicable
limit of insurance to the total applicable limits
of insurance of all insurers
3. Blanket Waiver of Subrogation
The following is added to SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 8. Transfer Of Rights
Of Recovery Against Others To Us:
We waive any right of recovery we may have
against any person or organization with whom you
have a written contract that requires such waiver
because of payments we make for damage under
this coverage form. The damage must arise out of
your activities under a written contract with that
person or organization. This waiver applies only to
the extent that subrogation is waived under a
written contract executed prior to the "occurrence"
or offense giving rise to such payments.
4. Bodily Injury Redefined
SECTION V — DEFINITIONS, Definition 3. "bodily
injury" is replaced by the following:
3. "Bodily injury" means bodily injury, sickness or
disease sustained by a person including death
resulting from any of these at any time. "Bodily
injury" includes mental anguish or other
mental injury resulting from "bodily injury".
5. Broad Form Property Damage — Borrowed
Equipment, Customers Goods, Use of
Elevators
a. SECTION I — COVERAGES, COVERAGE A —
BODILIY INJURY AND PROPERTY
DAMAGE LIABILITY, Paragraph 2.
Exclusions subparagraph j. is amended as
follows:
Paragraph (4) does not apply to "property
damage" to borrowed equipment while at a
jobsite and not being used to perform
operations.
Paragraphs (3), (4) and (6) do not apply to
"property damage" to "customers goods" while
on your premises nor do they apply to the use
of elevators at premises you own, rent, lease
or occupy.
b. The following is added to SECTION V —
DEFINTIONS:
c. Method Of Sharing 24. "Customers goods" means property of
If all of the other insurance permits your customer on your premises for the
contribution by equal shares, we will follow this purpose of being:
method also. Under this approach each
421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 4
a. worked on; or
b. used in your manufacturing process.
c. The insurance afforded under this provision is
excess over any other valid and collectible
property insurance (including deductible)
available to the insured whether primary,
excess, contingent
6. Knowledge of Occurrence
The following is added to SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 2. Duties in the Event
of Occurrence, Offense, Claim or Suit:
Notice of an 'occurrence", offense, claim or
"suit" will be considered knowledge of the
insured if reported to an individual named
insured, partner, executive officer or an
"employee" designated by you to give us such
a notice.
7. Liberalization Clause
The following is added to SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS:
Liberalization Clause
If we adopt any revision that would broaden the
coverage under this Coverage Form without
additional premium, within 45 days prior to or
during the policy period, the broadened coverage
will immediately apply to this Coverage Part.
8. Medical Payments — Extended Reporting
Period
a. SECTION I — COVERAGES, COVERAGE C —
MEDICAL PAYMENTS, Paragraph 1.
Insuring Agreement, subparagraph a.(3)(b)
is replaced by the following:
(b) The expenses are incurred and reported
to us within three years of the date of the
accident; and
b. This coverage does not apply if COVERAGE
C — MEDICAL PAYMENTS is excluded either
by the provisions of the Coverage Part or by
endorsement.
9. Newly Acquired Or Formed Organizations
SECTION II — WHO IS AN INSURED, Paragraph
3.a. is replaced by the following:
a. Coverage under this provision is afforded until
the end of the policy period.
10. Non -Owned Watercraft
SECTION I — COVERAGES, COVERAGE A
BODILY INJURY AND PROPERTY DAMAGE
LIABILITY, Paragraph 2. Exclusions,
subparagraph g.(2) is replaced by the following:
g. Aircraft, Auto Or Watercraft
(2) A watercraft you do not own that is:
(a) Less than 51 feet long; and
(b) Not being used to carry persons or
property for a charge;
This provision applies to any person who,
with your consent, either uses or is
responsible for the use of a watercraft.
11. Supplementary Payments Increased Limits
SECTION I — SUPPLEMENTARY PAYMENTS
COVERAGES A AND B, Paragraphs 1.b. and
1.d. are replaced by the following:
1.b.Up to $2,500 for cost of bail bonds required
because of accidents or traffic law violations
arising out of the use of any vehicle to which
the Bodily Injury Liability Coverage applies.
We do not have to furnish these bonds.
1A.All reasonable expenses incurred by the
insured at our request to assist us in the
investigation or defense of the claim or "suit',
including actual loss of earnings up to $1000 a
day because of time off from work.
12. Unintentional Failure to Disclose Hazards
The following is added to SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 6. Representations:
We will not disclaim coverage under this Coverage
Part if you fail to disclose all hazards existing as of
the inception date of the policy provided such
failure is not intentional.
13. Unintentional Failure to Notify
The following is added to SECTION IV —
COMMERCIAL GENERAL LIABILITY
CONDITIONS, Paragraph 2. Duties in the Event
of Occurrence, Offense, Claim or Suit:
Your rights afforded under this policy shall not be
prejudiced if you fail to give us notice of an
"occurrence", offense, claim or "suit', solely due to
your reasonable and documented belief that the
"bodily injury" or "property damage" is not covered
under this policy.
ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED.
421-2915 06 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 4
I 1AA b- 1/1/-1
zwC.� 1 ,oit l
'—/ I `� ✓` "I V 110"V't
AoRo CERTIFICATE OF LIABILITY INS RAN E
DATE (MMIDDNYY1)
10/19/2017
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).
Dealey, Renton & Associates o
P. O. Box 126750.
Oakland CA 94604-2675 REc,E��D
CONTAPRODUCER NAME: Alison Muller
PHONE. 510-465-3090 FAJX 119: 510-452-2193
Ext)
ADD IL . Insurance.Certificates@dealeyrenton.com
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: National Fire Insurance Co of Hartford 120478
f 1
INSURED PARAMETRI
INSURER B:Valley Fore Insurance Company 120508
INSURER C: Continental Insurance Company 35289
Parametrix, Inc.
1019 39th Ave. SE City of Bremerton
Puyallup WA 98374-6502 Risk Management r�
O
INSURER D :American Casualty Company of Readin PA 20427
INSURERE:XL Specialty Insurance Co. 137,885
INSURER F
COVERAGES CERTIFICATE NUMBER: 870934272 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 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
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
POLICY EFF',';
MMIDDIYYYY
POLICY EXP
MM/DD/YYYY
LIMITS' =
A
X
COMMERCIAL GENERAL LIABILI
Y
Y
6050531366
11/1/2017
11/1/2018
EACH OCCURRENCE $1,000,000
CLAIMS -MADE X O UR
PWA
DAMAGE TO RENTED
PREMISES Ea occurrence $1,000,000
X
MED EXP (Any one person) $10,000
Stop Gap/EL
PERSONAL 8 ADV INJURY $1,000,000
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $2,000,000
GEN'L
POLICYJE ❑ LOC
OTHER:
PRODUCTS -COMP/OP AGG $2,000,000
WA Stop Gap $1,000,000
B
AUTOMOBILE LIABILITY
Y
Y
6050531352
11/1/2017
11/1/2018
1 COMBINED SINGLE LIMIT $
Ea accident 1,000,000
BODILY INJURY (Per person) $
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIREDNON-OWNED
X AUTOS ONLY X AUTOS ONLY
BODILY INJURY (Per accident) $
PROPERTY DAMAGE
Per accident $
Is
C
X
UMBRELLA LIAB
X
OCCUR
6050531433
11/1/2017
11/1/2018
EACH OCCURRENCE $10,000,000
AGIGREGATE $10,000,000
EXCESS LIAB
CLAIMS -MADE
DED !X I RETENTION $O
$
D
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
NIA`
Y
6050531383
6050531402
11/1/2017
11/1/2017
11/1/2018
11/1/2018
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT $1,000,000
E.L. DISEASE - EA.EMPLOYEE $1,000,000
If yes, describe under .
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT 1 $1,000,000
E
Professional Liability
DPR9918654
11/1/2017
11/1/2018
$1,000,000 / per Claim
Claims Made
$1,000,000: Annual Aggregate
Pollution Liability Included
Retroactive Date: 01/01/1969
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Project Number: 233-1896-131 - Harlow Drive Safe Routes to School Grant Application.'°City of Bremerton is Additional Insured as respects
General Liability if required by written contract per attached endorsement.
CERTIFICATE HOLDER CANCELLATION
------ - SHOULD ANY OF=THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Bremerton THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
345 6th Street ACCORDANCE WITH THE POLICY PROVISIONS. .
Suite 600
Bremerton WA 98337
AUTHORIZED REPRESENTATIVE
CC)1988-2015ACORD CORPORATION- All riehfs rpsprvpd_
ACORD,25:.(2016/03,) The ACORD name and logo are registered marks of ACORD
A
r -
Blanket Additional Insured - Owners, Lessees or
Contractors - with Products -Completed
Operations Coverage Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
It is understood and agreed as follows:
1. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the
Named Insured is required by written contract to add as an additional insured on this coverage part, including
any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement.
However, such person or organization is an Insured only with respect to such person or organization's liability
for:
A. unless paragraph B. below applies,
1. bodily injury, property damage, or personal and advertising injury caused in whole or in part by the
acts or omissions by or on behalf,of the Named Insured and in the performance of such Named
Insured's ongoing operations as specified t* d insuch written contract; or
...
2. bodily injury or property damage caused in whole or in part by your work and included in the
products -completed operations hazard, and only if
a. the written contract requires the Named Insured to provide the additional insured such coverage;
and
b. this coverage part provides such coverage.
B. bodily injury, property damage, or personal and advertising injury arising out of your work described in
such written contract, but only if:
1. this coverage part provides coverage for bodily injury or property damage included within the
products completed operations hazard; and
2. the written contract specifically requires the Named Insured to provide additional insured coverage
under the 11-85 or 10-01 edition of CG201 0 or the 10-01 edition of CG2037.
IL Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not
provide such additional insured with:
A coverage broader than required by the written contract; or
B. abigher,limit of insurance than required by the written contract.
Ill. The -insurance granted by this endorsement to the additional insured does not apply to bodily injury, property
damage, or personalarld advertising injury arising out of:'
A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services,
including:
1. the preparing, approving, -or failing ;to prepare or approve maps; shop drawings, opinions,, reports,
surveys, field orders, change orders or drawings- and specifications; and
2. supervisory, inspection, architectural or engineering 'activities; or
B. any premises or work for which the additional insured is specifically listed as an additional insured on another
endorsement attached to this coverage part.
IV. NoWrthstandi ng anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY
CON DITIONS,.the Condition entitled other Insurance, this insurance is e . xc . ess -of all other insurance .. available
to the additional insured whether,on a primary, excess, contingent or any other basis. However, if this insurance
CNA75079XX (1=15) Policy No: -6050531366
Page 1 of 2.. 'Endorsement'No:
Effective ,Date: 111/01/2017
Insured Name: Parametrix, Inc.
-Copyright CNA All -Rights Reserved. Includes,6opyrighted,materiEil:cif tnsurance.SeT.viresiDffice,,Inc, �with. its, permission.
Blanket Additional Insured - Owners, Lessees or
Contractors - with Products -Completed
Operations Coverage Endorsement
is required by written contract to be primary and non-contributory, this insurance will be primary and non-
contributory relative solely to insurance on which the additional insured is a named insured.
V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL
LIABILITY CONDITIONS is amended as follows:
The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the
addition of the following:
Any additional insured pursuant to this endorsement will as soon as practicable:
1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim;
2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance
the additional insured has for any loss covered under this coverage part;
3. sendthe Insurer copies of all legal: papers received, and otherwise cooperate with the Insurer in the
investigation, def or settlement of the claim;'and
4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or
program applies to a loss that the Insurer covers under this coverage part. However, if the written
contract requires this insurance to be primary and non-contributory, this paragraph (4) does not apply to
insurance on which the additional insured is a named insured.
The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer
receives written notice of a claim from the additional insured.
VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended
to add the following definition:
Written contract means a written contract or written agreement that requires the Named Insured to make a
person or organization an additional insured on this coverage part, provided the contract or agreement:
A. is currently in effector becomes effective during the term of this policy; and
B. was executed prior to.
1. the bodily injury or property damage; or
2. the offense that caused the personal and advertising injury
for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent,permissible by law.
All other terms and conditions of the Policy remain unchanged.;
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated .Insurers, takes
effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown
below, and expires concurrently with said Policy.
CNA75079XX (1-15) Policy -No: 6950531366
Page 2.of2 Endorsement No:
Effective Date: 11/01/2017 .
Insured Name: Parametrix, Ino.
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission.
CNA63359XX
(Ed. 04/12)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS EXTENDED COVERAGE ENDORSEMENT
- BUSINESS AUTO PLUS
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
I. LIABILITY COVERAGE
A. Who Is An Insured
The following is added to Section 11, Paragraph
A1., Who Is An Insured:
1. a. Any incorporated entity of which the
Named Insured owns a majority of the
voting stock on the date of inception of
this Coverage Form;..previded that,.
b. The 'insurance afforded by this provision.
A.1. does not apply to any such entity
that is an "insured" under any other
liability "policy" providing "auto"
coverage.
2. Any organization you newly acquire or form,
other than a limited liability company,
partnership or joint venture, and over which
you maintain majority ownership interest.
The insurance afforded by this provision
A2.:
a. Is effective on the acquisition or
formation date, and is afforded only until
the end of the policy period of this
Coverage Form, or the next anniversary
of its inception date, whichever is
earlier.
b. Does not apply to:
(1) "'Bodily.injury".or '!property damage"
caused by , ani "accident"' that
occurred before you acquired or
.formed the organization; or
(2) Any such. organization that is an
'insured" under any other liability
"policy" providing "auto" coverage.
3.. Any person or. organization that you are.
required by a written contract to name as an
additional insured is an "insured" but only
with respect to their legal liability for acts or
omissions of a person, who qualifies as an
'Insured" under Section II — Who is An
Insured and -for whom.Liability Coverage is
afforded under -this policy. If required by
written contract, this insurance will be
primary and non-contributory :to insurance
on,which the additional insured is a.Named
'Insured.
4. An "employee" of yours is an "insured" while
operating an "'auto" hired or rented under a
contract or agreement in that "employee"s"
name, with your permission, while
performing duties related to the conduct of
your business.
"Policy," as used in this provision A. Who Is An
Insured, includes those policies that were in
force on the inception date of this Coverage
- Form but:.:.
1. Which are no longer in force; or
2. Whose limits have been exhausted.
B. Bail Bonds and Loss of Earnings
Section 11, Paragraphs A.2. (2) and A.2. (4)
are revised as follows:
1. In a.(2), the limit for the cost of bail bonds is
changed from $2,000 to $5,000; and
2. In a.(4), the limit for the loss of earnings is
ganged from $250 to $500 a day.
C. Fellow Employee
Section 11, Paragraph B.5 does not apply.
Such coverage as is afforded by this provision
C. is excess over any other collectible
insurance.
11. PHYSICAL DAMAGE COVERAGE
A Glass ;Breakage -- Hitting A Bird Or Animal -
Failing Objects Or Missiles
The following is added to Section III,
Paragraph A3.:
With respect - to any covered "auto," any
deductible shown -in the Declaration_ s will not
apply to glass- breakage I if such glass is
repaired,, in a manner acceptable to us, rather.
than replaced.
B. Transportation. Expenses
Section 111, Paragraph A4.a. is revised, with
respect to transportation expense incurred by
you, to provide:
a. - $60 per day, in lieu of $20; subject to
b. $1,800 maximum, in lieu of $600.
CNA63359XXCopyright,-CNA corporation, 2000. Page 1 of 3
;(Ed.104'112) dricludes copyrighted,material"af theInsurance'Services •Office -used with Its permission.
CNA63359XX
CN
(Ed. 04/12)
C. Loss of Use Expenses
Section III, Paragraphs B.4.c and B.4.d. are
Section III, Paragraph A.4.b. is revised, with
deleted and replaced by the following:
respect to loss of use expenses incurred by you,
c. Physical Damage Coverage on a covered
to provide:
"auto" also applies to "loss" to any
a. $1,000 maximum, in lieu of $600.
permanently installed electronic equipment
including its antennas and other
D. Hired "Autos"
accessories.
The following is added to Section III,
d. A $100 per occurrence deductible applies to
Paragraph A.:
the coverage provided by this provision.
5. Hired "Autos"
G. Diminution In Value
If Physical Damage coverage is provided under
The following is added to Section Ill,
this policy, and such coverage does not extend
Paragraph B.6.:
to Hired Autos, then Physical Damage coverage
Subject to the following, the "diminution in
is extended to:
value" exclusion does not apply to:
a. Any covered "auto" you lease, hire, rent
a. Any covered "auto" of the private
or borrow without a driver; and
passenger :type you lease,. -hire, rent or: ._.
b. Any :covered "auto" hired or rented by::
bt3rrow,. without a .driver for. a -period :of
your "employee" without a driver, under
30 days or less, while performing duties
a contract in that individual.
related to the conduct of your business;
"employee's" name, with your
and
permission, while performing duties
b. Any covered "auto" of the private
related to the conduct of your business.
passenger type hired or rented by your
c. The most we will pay for any one
"employee" without a driver for a period
"accident" or "loss"' is the actual cash
of 30 days or less, under a contract in
value, cost of repair, cost of
that individual "employee's" name, with
replacement or $75,000, whichever is
your permission, while performing
less, minus a $500 deductible for each
duties related to the conduct of your
covered auto. No deductible applies to
business.
'9oss"' caused by fire or lightning.
c. Such coverage as is provided by this
d. The physical damage coverage as is
provision is limited to a "diminution in
provided by this provision is equal to the
value"' loss arising directly out of
physical damage coverage(s) provided
accidental damage and not as a result
on your owned "autos."
of the failure to make repairs; faulty or
incomplete maintenance or repairs; or
e. Such physical damage coverage for
the installation of substandard parts.
hired "autos" Oil:
d: The most we will pay for "loss" to a
(1) Include loss of use, provided it is
covered "auto" in any one accident is
the consequence of an "accident"
the lesser of:
for .which the Rained_ Insured is
,
legally liable, and as a result of
(1) $5,000; or
which a monetary loss is sustained
(2) 20% of the '"auto's" actual. cash
by the leasing or rental concern,
value (ACV).
(2) Such coverage as is provided by
111. Drive Other Car Coverage —'Executive Officers
this provision will be subject to a
limit of $750 per "accident."
The following is added to Sections 11 and III:
E. Alrbag Coverage
1. , Any "auto" you don't own, hire or borrow .is a
The following is .added to Section III,
covered "auto" for Liability Coverage while being
Paragraph B.3.:
used by; and for Physical Damage Coverage
while in the care, custody or control of, any of
The accidental discharge of, an airbag shall not
your "'executive officers," except:
be considered mechanical breakdown.
a. An "auto" owned by that "executive officer"
F... Electronic Equipment
or a member of that person's,household; or.
CNA63359XX Copyright, CNA Corporation, 2000. ;Page 2:of.3
(Ed. 04/12) Includes copyrighted material of the Insurance
Services Office used with its permission.
14, cNA
b. An ""auto" used by that "executive officer"
while working in a business of selling,
servicing, repairing or parking "autos."
Such Liability and/or Physical Damage
Coverage as is afforded by this provision.
(1) Equal to the greatest of those
coverages afforded any covered "auto";
and
(2) Excess over any other collectible
insurance.
2. For purposes of this provision, "executive
officer" means a person holding any of the
officer positions created by your charter,
constitution, by-laws or any other similar
governing document, and, while a resident of
the same household, .includes that person's
spouse....,
Such `executive officers"- are "insureds" while
using a covered "auto" described in this
provision.
IV. BUSINESS AUTO CONDITIONS
A. Duties In The Event Of Accident, Claim, Suit
Or Loss
The following is added to Section IV,
Paragraph A.2.a.:
(4) Your "employees" may know of an
"accident" or "loss." This will not mean
that you have such knowledge, unless
such "accident" or "loss" is known to
you or if you are not an individual, to
any of your executive officers or
partners or your insurance manager.
The following is added to Section IV,
Paragraph A.2.b.:
(6)
Your. "employees" may , know , of
documents received concerning a claim
or "suit." This will not mean that you
have such knowledge, unless receipt of
such documents is known -to you or if
you are not an individual, to any of your
executive officers or partners or .your
insurance manager.
'B. Transfer Of Rights ' Of Recovery Against
Others To Us
CNA63359XX
(Ed. 04/12)
The following is added to Section IV,
Paragraph A.5. Transfer Of Rights Of
Recovery Against Others To Us:
We waive any right of recovery we may have,
because of payments we make for injury or
damage, against any person or organization for
whom or which you are required by written
contract or agreement to obtain this waiver from
us.
This injury or damage must arise out of your
activities under a contract with that person or
organization.
You must agree to that requirement prior to an
"accident" or "loss."
C. Concealment, Misrepresentation or Fraud
The following is added to Section IV,
Paragraph'13 :2
Your failure to disclose all hazards existing on the
date of inception of this Coverage Form shall not
prejudice you with respect to the coverage afforded
provided such failure or omission is not intentional.
D. Other Insurance
The following is added to Section IV,
Paragraph B.5.:
Regardless of the provisions of Paragraphs 5.a.
and 5.d. above, the coverage provided by this
policy shall be on a primary non-contributory
basis. This provision is applicable only when
required by a written contract. That written
contract must have been entered into prior to
"Accident" or "Loss."
E. Policy Period, Coverage Territory
Section IV, Paragraph B. 7.(5):(a). is revised to
provide:
a. 45 days of coverage in lieu of 30 days.
V. _ DEFINITIONS
Section V. Paragraph C. is deleted and replaced
by the following:
"Bodily injury" means bodily injury, sickness or
disease sustained .by a person, including mental
anguish, mental injury. or death resulting from. any of
these.
CNA63359XX Copyright, CNA Corporation, 2000. Page 3 of 3
,(Ed.104/1;2,) Includes"copyrighted material of the Insurance Services Office used with its permission.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
WC 00 0313
(Ed. 4-84)
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce
our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you
perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
:Endorsement Effective Policy No. Endorsement No.
Insured Premium $
Insurance Company Countersigned by
WC 00 0313
(Ed. 4-84) •Copyright1983"NationaliCouncil ion Compensation Insurance.