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HomeMy WebLinkAbout6075AGENDA BILL CITY OF BREMERTON CITY COUNCIL 5E SUBJECT: Purchase of Bluelight Lateral Lining Systems from Hammerhead Trenchless Study Session Date: COUNCIL MEETING Date: Department: Presenter: Phone: February 12, 2020 February 19, 2020 Public Works & Utilities Milenka Hawkins -Bates (360) 473-5333 SUMMARY: In 2019 the City passed Ordinance No. 5374 which returned responsibility for sanitary sewer laterals in the right-of-way to the City. There are approximately 12,000 sewer laterals in the City, many of which are approaching 100-years old and in need of repair. Repair of these laterals can be accomplished most efficiently and cost effectively using trenchless CIPP LED technology. An added benefit of repairing the sewer laterals is reduced groundwater infiltration into the combined sewer collection system which reduces total system flow and helps us minimize the potential for combined sewer overflows. ATTACHMENTS: 1) Sole Source Letter; 2) Quote; and 3) Product Brochure FISCAL IMPACTS (Include Budgeted Amount): The cost of the Bluelight Lateral Lining System is $180,438.68. The purchase was approved in the 2020 budget. STUDY SESSION AGENDA: ❑x Limited Presentation ❑ Full Presentation STUDY SESSION ACTION: px Consent Agenda ❑ General Business ❑ Public Hearing RECOMMENDED MOTION: Move to approve the purchase of the Bluelight Lateral Lining System from Hammerhead Trenchless; and authorize the Mayor to finalize and execute the agreement with substantially the same terms and conditions as presented. COUNCIL ACTION: KApprove ❑ Deny ❑ Table ❑ Continue ❑ No Action Form Updated 01/02/2018 4 ♦ ii `'' HAMMERHEAD TRENCHLESS �� 500 South CP Avenue • Lake Mills,WI 53551 • USA �/r�w PH:800.331.6653 • INT:+1 920.648.4848 44 G FAX:920.648.1780 • WEB:www.hammerheadtrenchless.com 4441;" SALES QUOTE THIS DOCUMENT IS QUOTED IN USD AND IS VALID UNTIL FEBRUARY 13,2020 BILL TO SHIP TO City of Bremerton City of Bremerton 100 OYSTER BAY AVE 100 OYSTER BAY AVE BREMERTON, WA 98312 USA BREMERTON, WA 98312 USA Phone:360-473-5327 • Fax:pat.jacobsen@cityof.bremerton.gov Phone:360-473-5327 • Fax:pat.jacobsen@cityof.bremerton.gov ATTN:Patrick Jacobsen PART MSRP QUOTED PRICE DESCRIPTION QTY NUMBER (EACH) EACH TOTAL Trailer Package LINING TRAILER,20' 1 922-8401 $ 31,950.00 $ 31,950.00 $ 31,950.00 Inversion Equipment D225-QL QUICKLOK INVERSION DRUM 1 922-1180 $ 15,495.00 $ 15,495.00 $ 15,495.00 WINDOW TINT,QL DRUMS(EA) 1 922-1223 $ 7.18 $ 7.18 $ 7.18 45°ELBOW,6"CAMLOCK 1 922-4916 $ 965.00 $ 965.00 $ 965.00 90°ELBOW,6"CAMLOCK 1 922-4915 $ 965.00 $ 965.00 $ 965.00 4"NOZZLE,6"CAMLOCK 1 922-4919 $ 480.00 $ 480.00 $ 480.00 6"NOZZLE,6"CAMLOCK 1 922-4920 $ 480.00 $ 480.00 $ 480.00 INVERSON HOSE,6"CAM LOCK 1 922-4925 $ 774.00 $ 774.00 $ 774.00 Bluelight Power&Controls and LED Reels POWER SUPPLY ASSY 1 934-0136 $ 17,463.60 $ 17,463.60 $ 17,463.60 EXTENSION REEL,75M 1 934-0001 $ 7,824.60 $ 7,824.60 $ 7,824.60 EXTENSION CABLE,22M 1 934-0002 $ 1,134.00 $ 1,134.00 $ 1,134.00 CONTROL UNIT ASSY 1 934-0131 $ 29,710.80 $ 29,710.80 $ 29,710.80 Bluelight LED Reels SIDE ENTRANCE 1 934-0013 $ 1,360.80 $ 1,360.80 $ 1,360.80 6"BASE,PROPULSION UNIT 1 934-0005 $ 3,402.00 $ 3,402.00 $ 3,402.00 PROPULSION UNIT 1 934-0006 $ 7,881.30 $ 7,881.30 $ 7,881.30 HOSE REEL,10MM X 40M,W/SMALL LED TRAIN 1 934-0127 $ 15,365.70 $ 15,365.70 $ 15,365.70 HANDLE,CONTROL UNIT 1 934-0009 $ 1,134.00 $ 1,134.00 $ 1,134.00 SPACERS&CLEANING KIT WITH TOOLS 1 934-0011 $ 396.90 $ 396.90 $ 396.90 VACUUM KIT 1 934-0012 $ 362.88 $ 362.88 $ 362.88 ��y v, " ? % /<< �� SUBTOTAL(INCLUDING ADDENDUM) $ 156,290.08 TECH LAT UNING SUPPORT DAYS.(COST PER DAY:$950.00) 5 TECHNICAL SUPPORT $ 4,750.00 CUSTOMER NOTES ONE WAY FREIGHT CHARGES $ 4,500.00 ESTIMATED SALES TAXES IF APPUCABLE* $ 14,898.60 TOTAL(USD) $ 180,438.68 "Annlirahla voles tones will ha finali7ari unnn invnire OFFICE NOTES ❑ Credit application approved or on file HAMMERHEAD TRENCHLESS City of Bremerton Jim Moore a,,.��1 Sales Manager Name By 1'vk 6fC_ (nl<n(C'cr February 3,2020 Bluelight Lining System(one reel) q.t., '.° ''2 0 Z o Date Quote Reference# Date Purchase Order Number HammerHead Trenchless,A Charles Machine Works Company. TERMS AND CONDITIONS OF SALE The above in conjunction with the accompanying terms technology,delays of carrier, embargo,governmental normal service items.Equipment and accessories not of and conditions of sale comprise the complete quotation. order or directive or any other difficulties beyond ETC's our manufacture are warranted only to the extent of No other terms and conditions unless specified on the control.Buyer agrees that ETC shall not be liable for the original Manufacturer's Warranty and subject to quote form and signed by an authorized officer of Earth any direct,indirect,consequential or special damages their allowance to us,if found defective by them.ETC Tool Company LLC are valid. which may result from such delays. reserves the right to modify, alter, and improve any product or parts without incurring any obligation to 1.AGREEMENT. 6.DELIVERY TERMS. replace any product or parts previously sold with such The terms and conditions set forth in this agreement Unless otherwise stated on the front of this agreement modified, altered, or improved product or part. No shall constitute the entire agreement between Earth all deliveries shall be F.O.B.ETC's factory. All delivery person is authorized to give any other Warranty,or to Tool Company LLC(ETC)and Buyer and supersedes all expenses including transportation, assume any additional obligation on ETC's behalf unless other agreements and understandings,written or oral made in writing,and signed by an officer of ETC. between the parties with respect to the subject matter. freight,insurance,risk of loss and any other shipping ETC's acceptance of any offer by Buyer is expressly costs, shall be for the account of Buyer. Unless 9.LIMITATION OF ACTIONS. made conditional upon Buyer's acceptance of the terms otherwise directed selection of method and routing of Any claim by Buyer under this agreement must be and conditions as set forth herein and none of Buyers shipments shall be at ETC's discretion. All boxing and brought within 12 months after delivery of the additional or different terms shall apply.Acceptance of packaging charges for export sales shall be added to the product(s)sold by ETC hereunder. ETC's offer to sell is expressly limited to acceptance of price. When special packaging is specified for domestic the terms and conditions herein and no other terms or export sales involving greater expense than that 10.CHANGES. and conditions shall apply unless expressly agreed to customarily supplied,a charge may be made to recover After acceptance by ETC Buyer's order shall not be by ETC in writing. such extra expense.Shipment dates for export sale are subject to cancellation,reduction in amount or shifting approximate and are subject to receipt of all necessary by Buyer of delivery window without ETC's prior 2.PRICE. buyer information,letters of credit,if required and all written permission. All prices exclude federal,state or local taxes,customs, necessary licenses,permits and other documents. 11.CONFIDENTIAL INFORMATION. duties,permits and license fees and any other taxes, fees and expenses will be added to the price or billed 7.INSPECTION AND ACCEPTANCE. Buyer agrees that all information furnished hereunder separately to Buyer where ETC has the legal obligation Buyer must inspect delivered goods and report claims by ETC is proprietary to ETC and such information shall to collect or pay such taxes,fees or expenses.Unless for defects,damages or shortages in writing within ten be held in confidence and shall not be used or disclosed ETC's written quotation indicates otherwise prices in (10)days of delivery or the goods shall be considered by Buyer without ETC's prior written consent,except quotations are subject to change without notice. Prices accepted and such claims shall be deemed waived for the fulfillment of this Agreement. may increase as a result of delays due to changes B.LIMITED WARRANTY. 12.INSTALLMENT. requested by Buyer or Buyer's failure to furnish EARTH TOOL COMPANY LLC, hereinafter sometimes ETC's failure to adhere, or nonconformity with any information requested. ETC reserves the right to referred to as ETC warrants each new industrial increment of the Agreement shall not be a breach of the charge,at any time,a monthly service charge of one product of its own manufacture to be free from defects entire agreement, percent (1 %) or the highest rate allowed by law, in material and workmanship,under normal use and whichever is lower,on accounts outstanding more than service for one full year after delivery to the owner or 13.EXPORT REGULATIONS AND PERMITS. thirty(30)days from the date of invoice,effective as of 1000 operating hours,whichever occurs first. During Buyer will comply with the provisions of the United the thirty first(31st)day from the date of the invoice. States Government's Export Administration the warranty period, the authorized selling 3.PAYMENT TERMS. HammerHead Dealer shall furnish parts without charge regulations, related documentation requirements and shall be responsible controlprocedures.a.Domestic Sales.Unless otherwise stated on the front for any HammerHead product that fails because of internalBuyer defects in material and workmanship.Warranty is void for obtaining any necessary export licenses and of this agreement payment terms for domestic sales are ermits. net thirty(30)days after date of ETC's invoice,except unless warranty registration card is returned within P for progress billings which are due in full upon receipt ten days from the date of purchase.This warranty and 14.APPLICABLE LAW. of invoice. If Buyer fails to fulfill the terms of payment any possible liability of Earth Tool Company LLC This Agreement shall be governed by and construed in or if ETC shall have any doubt at any time as to Buyers hereunder is in lieu of all other warranties,express, accordance with the laws of the State of Wisconsin, financial situation ETC may decline to make further implied,or statutory,including,but not limited to,any United States of America. deliveries except upon receipt of cash or satisfactory warranties of merchantability or fitness for a particular security. This requirement will not release Buyer from purpose.The parties agree that the Buyer's SOLE AND 15.VALIDITY. any previous obligations. ETC's rights under this EXCLUSIVE REMEDY against ETC,whether in contract If any principle of these Terms and Conditions of Sale is Section shall be in addition to all other rights and or arising out of warranties, representations, found to be invalid or unenforceable in any way the remedies available to ETC upon Buyer default. instructions,or defects shall be for the replacement or validity and enforceability of the remaining Conditions repair of defective parts as provided herein.In no event shall not be affected. b.Export Sales. Unless otherwise stated on the front of shall ETC's liability exceed the purchase price of the this agreement payment terms for export sales are product. The Buyer agrees that no other remedy 16.MISCELLANEOUS. 100% net cash in United States currency upon (including, but not limited to, incidental or All clerical errors are subject to corrections.The failure presentation of invoice, bills of lading or other consequential loss)shall be available to him.If,during of ETC to enforce,at any time,any one of the provisions appropriate shipping documents for each shipment of the warranty period,any product becomes defective by of this Agreement shall not be construed to be a waiver products. In addition,unless otherwise agreed to in reason of material or workmanship and Buyer of such provisions or the right of ETC to enforce such writing by ETC, buyer shall have established an immediately notifies ETC of such defect,ETC shall,at its provisions in the future. Buyer may not assign any irrevocable letter of credit in favor of ETC in an amount option,supply a replacement part or request return of rights under this Agreement without the prior written sufficient to cover the price of goods and all additional the product to its plant in Lake Mills,Wisconsin. No consent of ETC. expenses which are for Buyers account and which parts shall be returned without prior written includes such other terms and conditions which are authorization from ETC, and this Warranty does not acceptable to ETC. This letter of credit must be issued obligate ETC to bear any transportation charges in and confirmed by a United States bank acceptable to connection with the repair or replacement of defective ETC,and shall by its length remain in full force and parts. Earth Tool Company LLC will not accept any effect for a period agreed to by ETC to be sufficient for charges for labor and/or parts incidental to the ETC to complete its performance of the sales contract removal or remounting of parts repaired or replaced and shipment of the products to the buyer. If the letter under this Warranty.This Warranty shall not apply to t of credit should expire prior to completion of the order, any part or product which shall have been installed or Buyer is obligated to extend the letter of credit on operated in a manner not recommended by ETC nor to terms acceptable to ETC. Any and all bank handling any part or product which shall have been neglected,or charges,taxes and other expenses related to such letter used in any way which, in ETC's opinion, adversely of credit are the responsibility of the Buyer. affects its performance; nor negligence of proper maintenance or other negligence,fire or other accident; 4.ORDERS. nor with No order shall be valid until accepted by ETC at its respect to wear items;nor if the unit has been altered offices in Lake Mills,WI,United States of America. or repaired outside of a ETC authorized dealership in a 5.FORCE MA[EURE. manner of which,in the sole judgment of ETC affects its performance,stability or reliability;nor with respect to ETC shall not be liable for any delays in delivery of batteries which are covered under a separate orders due in whole or in part,directly or indirectly,to adjustment warranty;nor to any product in which parts fire,act of God,war,strike,shortage of raw materials, not manufactured or approved by ETC have been used, supplies or components, retooling, upgrading of nor to normal maintenance services or replacement of a -- HAMMERHEAD TRENCHLESS 500 South CP Avenue • Lake Mills,WI 53551 • USA PH:800.331.6653 • INT:+1 920.648.4848 FAX:920.648.1780 • WEB:www.hammerheadtrenchless.com SALES QUOTE ADDENDUM THIS DOCUMENT IS QUOTED IN USD AND IS VALID UNTIL FEBRUARY 13,2020 BILL TO SHIP TO City of Bremerton City of Bremerton 100 OYSTER BAY AVE 100 OYSTER BAY AVE BREMERTON, WA 98312 USA BREMERTON, WA 98312 USA Phone:360-473-5327 • Fax:pat.jacobsen@cityof.bremerton.gov Phone:360-473-5327 • Fax:pat.jacobsen@cityof.bremerton.gov ATTN:Patrick Jacobsen PART MSRP QUOTED PRICE DESCRIPTION QTY NUMBER (EACH) EACH TOTAL Wet Out Equipment WT212-3D WET OUT TABLE 1 922-1400 $ 8,307.69 $ 8,307.69 $ 8,307.69 WT-212-3D ROLLER TABLE ASSEMBLY 1 922-7088 $ 1,381.67 $ 1,381.67 $ 1,381.67 Vacuum and Mixing VACUUM SYSTEM 1 922-7196 $ 870.00 $ 870.00 $ 870.00 ELECTRIC DRILL MIXER 1 922-1004 $ 268.50 $ 268.50 $ 268.50 ELECTRONIC SCALE 1 922-1005 $ 244.00 $ 244.00 $ 244.00 MIXING PADDLE 1 922-1016 $ 19.46 $ 19.46 $ 19.46 Compressor and Accessories Hose assy,Bluelight air 3 934-0158 #N/A $ 257.00 $ 771.00 Air Dryer assembly 1 934-0157 #N/A $ 5,066.00 $ 5,066.00 Bluelight Air Y adapter assy 1 934-0156 #N/A $ 113.00 $ 113.00 Cord,50 extention 1 934-0152 #N/A $ 136.00 $ 136.00 Boss Compressor 1 934-0142 UN/A $ 8,410.00 $ 8,410.00 WWETT Show special includes:One(1)Week of Training/Support 1 Misc $ (6,450.00) $ (6,450.00) and 100'ofmaterial at No Charge with Purchase f Al1, BREMERTON THE CITY OF PRIDE AND OPPORTUNITY Executive Correspondence Routing Memo Date: February 19, 2020 Description: Purchase of Bluelight Lateral Lining Systems from Hammerhead Trenchless. Approved at Council February 19, 2020. A project number has been created and once approved Felicia Brown will print the Purchase Order. Action Requested: Mayor Signature Originator: Hillary Hamilton Coordination/Approval/ Recommendation: Public Works Director: Recommended Initials/date 70 z7(9/tA G i-r-r t�v m /i Mayor: Approval/Signature L,j�_.� �� � �� � zo zd Please return to Public Works Administration for final processing upon approval/signature. Public Works& Utilities 1100 Oyster Bay Ave.N.,Bremerton,WA 98312* Phone(360)473-5315 * Fax(360)473-5018 ® DATE (MM/DDNYY) CERTIFICATE OF LIABILITY INSURANCE 04/01/2020 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 Marsh USA Inc. 333 South 7th Street, Suite 1400 Minneapolis, MN 55402-2400 CN 101408137-TORO-XS-2021 INSURED The Charles Machine Works, Inc. dba Hammerhead Trenchless 500 South C.P. Avenue Lake Mills, WI 53551 (`f1VFRArFS CFRTIFICGTF NIIMF3ER� INSURER B : ZUriCh INSURER D C�iIilrLFiikI��ik! 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 LTR OF INSURANCE ADDLSUBRTYPE I=mMD POLICYNUMBER MMDPOLI EFF DN YY MMIDDCY EXP POLICY Y YY LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F OCCUR GLO0378641-00 04/01/2020 04/01/2021 EACH OCCURRENCE $ 1,000,000 -DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2/0002000 GEN'L AGGREGATE LIMIT APPLIES PER: X PRO❑LOC POLICY ❑ JECT OTHER: EXCLUDED $ B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BAP 0378643-00 04/01/2020 04/01/2021 COMBINED SINGLE LIMIT Ea accident $ 2,0002000 _ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLALIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DID RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y OFFICERIM EMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A See Attached 04/0112021 X STATUTE ORH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 10000,000 E.L. DISEASE - POLICY LIMIT _ $ 11000,000 B Products Liability (limits are excess of $1 M SIR) GLO0378642-00 04/0112020 04/01/2021 Occurrence Aggregate 11000,000 21000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) f`CCTICIr`ATC LIAI f11=R CANCFI 1 OTInN 0 City of Bremerton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 100 Oyster Bay Ave. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Bremerton, WA 98312 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101408137 LOC #: Minneapolis ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc. The Charles Machine Works, Inc. dba Hammerhead Trenchless POLICY NUMBER 500 South C.P. Avenue Lake Mills, WI 53551 CARRIER I NAIC CODE EFFECTIVE DATE: Page 2 of 2 ACORD 101 (2008/01) U ZUUS AGUKU IiUKYUKA I IUN. An ngn>cs reserves. The ACORD name and logo are registered marks of ACORD 0002605 SP 0173-001-P02606-I City of Bremerton 100 Oyster Bay Ave. Bremerton, WA 98312 m CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 03/3012021 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 Marsh USA Inc. 333 South 7th Street, Suite 1400 Minneapolis, MN 55402-2400 CN 101408137-TORO-XS-21-22 INSURED The Charles Machine Works, Inc. dba Hammerhead Trenchless 500 South C.P. Avenue Lake Mills, WI 53551 COVERAGES DECEIVE® City of Bremerton Risk Management G3��iLd[ya`���lgllil-]� ii VIV IMI.I Marsh U.S. 0 erationsI NAME: p PnOa CNEE866-966-4664 AIc No): 212-948-5382 EMAIL Minnea olis.CertRe uest marsh.com ADDRESS' P Q Zurich Ameriran Insurance Company � 16535 wA N/A INSURER C : SEE AI 1ACHEU' INSURER D : Zurich American Insurance Company16535 INSURER E : CHI-009453368-04 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSl1RED 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 LTR I TYPE OF INSURANCE ADDL SUBR POLICYNUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLO 0378641-01 04/01/2021 04/01/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE IX I OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 11000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000,000 GENT AGGREGATE LIMIT APPLIES PER'. GENERAL AGGREGATE $ 2,0001000 X POLICY PRO JECT ❑ LOC PRODUCTS - COMPIOPAGG $ EXCLUDED OTHER: $ A AUTOMOBILE LIABILITY BAP 0378643-01 04/01/2021 04/01/2022 COMBINED SINGLE LIMIT Ea accident $ 2,0001000 X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE EXCESS LIAB AGGREGATE $ DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBEREXCLUE rN] (Mandatory in NH) N / A See Attached 04/01/2022 X PER STATUTE oTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,0001000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Products Liability See Attached 04/0112021 04/01/2022 (limits are excess of $1 M SIR) DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Bremerton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 100 Oyster Bay Ave. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Bremerton, WA 98312 ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee Sit aurao►� avx,. t�na�< e ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 0001241 SP 0125-CO1-P01241-I City of Bremerton 100 Oyster Bay Ave. Bremerton, WA 98312 0125-01-00-0001241-0001-0002824 AGENCY CUSTOMER ID: CN101408137 LOC #: Minneapolis aco ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Marsh USA Inc. The Charles Machine Works, Inc. dba Hammerhead Trenchless POLICY NUMBER 500 South C.P. Avenue Lake Mills, WI 53551 CARRIER I NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation Policy Number: WC 0378637-Ot (AOS) Carrier: American Zurich Insurance Company Deductible: $350,000 Policy Number: WC 0378638-Ot (MA, WI) Carrier: Zurich American Insurance Company Deductible-Retro: $350,000 Policy Number: EWS 0378639-01 (NE, WI) Carrier: Zurich American Insurance Company SIR:$450,000 Policy Number: EWS 0378640-01(OK) Carrier: Zurich American Insurance Company SIR:$500,000 Products Liability (Fronted Policy): Policy #GLO 0378642-01 $1M Per Occur $1 M Per Agg $1MPmducts-Completed Operations $1M SIR $1M Ded XS of SIR Page 2 of 2 ACORD 101 (2008101) 0125.01-00.0001241-0002-0002825 © 2008 ACORD CORPORATION. All rights I The ACORD name and logo are registered marks of ACORD • w 1. If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture, you are an insured. Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. c. A limited liability company, you are an I nsured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. J. An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "executive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect to their liability as stockholders. e. A trust, you are an insured. Your trustees are also insureds, but only with respect to their duties as trustees. 2. Each of the following is also an insured: a. Employees And Volunteer Workers Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees", other than either your "executive officers", (if you are an organization other than a partnership, joint venture or limited liability company) or your managers (if you are a limited liability company), but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insureds for: (1) "Bodily injury" or "personal and advertising injury": (a) To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), or to a co- "employee" while in the course of his or her employment or while performing duties related to the conduct of your business, or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse, child, parent, brother or sister of that co -"employee" or "volunteer worker" as a consequence of paragraph (1)(a) above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraphs (1)(a) or (1)(b) above; or (d) Arising out of his or her providing or failing to provide professional health care services. If you are not in the business of providing professional health care services, paragraph (d) does not apply to any nurse, emergency medical technician or paramedic employed by you to provide such services. (2j "Property damage" to property: (aj Owned, occupied or used by, or (b) Rented to, in the care, custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees", "volunteer workers", any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company), b. Real Estate Manager Any person (other than your "employee" or "volunteer worker', or any organization while acting as your real estate manager. c. Temporary Custodians of Your Property Any person or organization having proper temporary custody of your property if you die, but only: (1) With respect to the liability arising out of the maintenance or use of that property; and (2) Until your legal representative has been appointed. d. Legal Representative If You Die Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Part, 3. Newly Acquired or Formed Organization Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain financial Page 12 of 23 Form EH 00 02 06 05 interest of more than 50% of the voting stock, will 5. F�dditional Insureds When Required �y ��ritten qualify as a Named Insured if there is no .other Contract, Written �4greernent Gr Permit similar insurance available to that organization. The following persons) or arganization(s) are an However: additional insured when you have agreed, in a a. Coverage under this provision is afforded only written contract, written agreement or because of until the 90th day after you acquire or form the a permit issued by a state or political subdivision, organization or the end of the "policy period", that such person or organization be added as an whichever is earlier; additional insured on your policy, provided the b. Coverage A does not apply to "bodily injury" or injury or damage occurs subsequent to the „ execution of the contract agreement. property damage that occurred before you acquired or formed the organization; and A person or organization is an additional insured c. Coverage B does not apply to "personal and under this provision only for that period of time advertising injury" arising out of an offense required by the contract or agreement. committed before you acquired or formed the However, no such person or organization is an organization. insured under this provision if such person or 4. Mobile Equipment organization is included as an insured by an With respect to "mobile equipment" registered in endorsement issued by us and made part of this your name under any motor vehicle registration Coverage Patt. law, any person is an insured while driving such a. Vendors equipment along a public highway with your Any persons) or organizations) (referred to permission. Any other person or organization below as vendor), but only with respect to responsible for the conduct of such person is also "bodily injury" or "property damage" arising out an insured, but only with respect to liability arising of "your products" which are distributed or sold out of the operation of the equipment, and only if in the regular course of the vendor's business; no other insurance of any kind is available to that and only if this Coverage Part provides person or organization for this liability. However, coverage for "bodily injury" or "property no person or organization is an insured with damage" included within the "products - respect to: completed operations hazard". a. "Bodily injury" to a co"employee" of the (1) The insurance afforded the vendor is person driving the equipment; or subject to the following additional b. "Property damage" to property owned by, exclusions: rented to, in the charge of or occupied by you This insurance does not apply to: or the employer of any person who is an (a} "Bodily injury" or "property damage" insured under this provision. for which the vendor is obligated to 5. �lonowned Watercraft pay damages by reason of the With respect to watercraft you do not own that is assumption of liability in a contract or less than 51 feet long and is not being used to agreement. This exclusion does not carry persons for a charge, any person is an apply to liability for damages that the insured while operating such watercraft with your vendor would have in the absence of permission. Any other person or organization the contract or agreement; responsible for the conduct of such person is also (b) Any express warranty unauthorized an insured, but only with respect to liability arising by you; out of the operation of the watercraft, and only if (c) Any .physical or chemical change in no other insurance of any kind is available to that the product made intentionally by the person or organization for this liability. vendor; However, no person or organization is an insured (d) Repackaging except when unpacked with respect to: solely for the purpose of inspection, a. "Bodily injury" to a co -"employee" of the demonstration, testing, or the person operating the watercraft; or substitution of parts under instructions b. "Property damage" to property owned by, from the manufacturer, and then rented to, in the charge of or occupied by you repackaged in the original container; or the employer of any person who is an {e) Any failure to make such inspections, insured under this provision. adjustments, tests or servicing as the vendor has agreed to make or Page 13 of 23 0125.Ot-00-0001247.0003-0002826 normally undertakes to make in the With respect to the insurance afforded these usual course of business, in additional insureds, the following additional connection with the distribution or exclusions apply: sale of the products; This insurance does not apply to: (f) Demonstration, installation, servicing (1) Any "occurrence" which takes place after or repair operations, except such you cease to lease that land; or operations performed at the vendor's premises in connection with the sale (2) Structural alterations, new construction or of the product; demolition operations performed by or on (g) Products which, after distribution or behalf of such person or organization. sale by you, have been labeled or d. Architects, Engineers or Surveyors relabeled or used as a container, part Any architect, engineer, or surveyor, but only or ingredient of any other thing or with respect to liability for "bodily injury", substance by or for the vendor; or "property damage" or "personal and (h) "Bodily injury" or "property damage" advertising injury" caused, in whole or in part, arising out of the sole negligence of by your acts or omissions or the acts or the vendor for its own acts or omissions of those acting on your behalf: omissions or those of its employees (1) In connection with your premises; or or anyone else acting on its behalf. (2) In the performance of your ongoing However, this exclusion does not operations performed by you or on your apply to: behalf. (i) The exceptions contained in With respect to the insurance afforded these paragraphs (d) or (f); or additional insureds, the following additional (ii) Such inspections adjustments or exclusions apply: servicing as the vendor has This insurance does not apply to "bodily agreed to make or normally injury", to damage" or "personal and undertakes to make in the usual advertising injury" arising out of the rendering course of business, in connection of or the failure to render any professional with the distribution or sale of the services by or for you, including: products. 1. The preparing, approving, or failing to (2) This insurance does not apply to any prepare or approve, maps, shop insured person or organization, from drawings, opinions, reports, surveys, field whom you have acquired such products, orders, 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 e. Permits issued By State or (1) Any person or organization from whom Political Subdivisions you lease equipment; but only with Any state or political subdivision, but only with respect to their liability for "bodily injury" or "property damage" or "personal and respect to operations performed by you or on advertising injury" caused, in whole or in your behalf forwhich the as issued a permit. ate or political part, by your maintenance, operation or subdivision use of equipment leased to you by such With respect to the insurance afforded these person or organization. additional insureds, this insurance does not (2) With respect to the insurance afforded to apply to: these additional insureds, this insurance (1) "Bodily injury", "property damage" or does not apply to any "occurrence" which "personal and advertising injury" arising takes place after the equipment lease out of operations performed for the state expires. or municipality; or c. Lessors of Land or Premises (2) "Bodily injury" or "property damage" Any person or organization from whom you included within the "products -completed lease land or premises, but only with respect operations hazard". to liability arising out of the ownership, maintenance or use of that part of the land or premises leased to you. Page 14 of 23 Form EH 00 02 06 06 f. Any Other Party Any other person or organization who is not an insured under paragraphs a. through e. above, but 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: (1) In the performance of your ongoing operations, (2} In connection with your premises owned by or rented to you; or (3) In connection with "your work" and included within the "products -completed operations hazard", but only if; (a) The written contract or agreement requires you to provide such coverage to such additional insured; and (b) This Coverage Part. provides coverage for "bodily injury" or "property damage" included within the "products -completed operations" hazard". With respect to the insurance afforded to these additional insureds, this insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure io render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or {2) Supervisory, inspection, architectural or engineering activities. The limits of insurance that .apply to additional insureds under this .provision is described in Section III -Limits Of Insurance. Such limits of insurance apply only in excess of the "self -insured retention". No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. SECTION III LIMITS OF INSURANCE 1. The Most We Will Pay Subject to item 1.a. of the Insuring Agreement, the Limits of Insurance shown in the Declarations and the rules below fix the most we will pay regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 2. The General Aggregate Limit The General Aggregate Limit is the most we will pay for the sum of: a. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard"; and b. Damages under Coverage B. 3. Products -Completed Operations Aggregate Limit The Products -Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages because of "bodily injury" and "property damage" included in the "products -completed operations hazard". 4. Personal and Advertising Injury Limit Subject to 2. above, the Personal and Advertising Injury Limit is the most we will pay under Coverage B for the sum of all damages because of all "personal and advertising injury" sustained by any one person or organization. 5. Each Occurrence Limit Subject to 2. or 3. above, whichever applies, the Each Occurrence Limit is the most we will pay for damages under Coverage A because of all "bodily injury" and "property damage" arising out of any one "occurrence". 6. How Limits And Self Insured Retention Apply to Additional Insureds If you have agreed in a contract or agreement that another person or organization be added as an insured on your policy: a. You are responsible for ..payment of any "self - insured retention" on behalf of such person or .organization; and b. The most we will pay on behalf of such insured or any other insured endorsed to this Coverage Part is the lesser of: (1) The limits of insurance specified in the contract or agreement; or (2) The Limits of Insurance shown in the Declarations. Any amount we pay shall be in excess of the "self - insured retention" and is part of and not in addition to the Limits of Insurance shown in the Declarations and described in this Section. The Limits of Insurance of this Coverage Part and the amount of the "self -insured retention" apply separately to each "policy period". If the "policy Form EH 00 02 06 05 0125.Ot-00.0001241-0004.0002827 Page 15 of 23 This endorsement modifies insurance provided under the following: COVERAGE COMMERCIAL GENERAL LIABILITY COVERAGE PART (EXCESS) COMMERCIAL GENERAL LIABILITY COVERAGE PART (EXCESS — BROAD FORM) With respect to other insurance available to any person or organization who is an additional insured under this Coverage Part, the following is added to Paragraph 4., Other Insurance of Section IV — Commercial General Liability Conditions: 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance be primary, then subject to the "self -insured retention", this insurance is primary except when Paragraph c. below applies. If other insurance is also primary, we will share with all that other insurance by the method described in Paragraph d. below. b. Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement, or permit that this insurance is primary and non-contributory with the additional insured's own insurance, then subject to the "self -insured retention", this insurance is primary except when Paragraph c. below applies and we will not seek contribution from that other insurance. Paragraphs a. and b. do not apply to insurance to which the additional insured been added as an additional insured. Form EH 24 03 08 09 c. Excess Insurance (1) This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: (a) Your Work That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work'; (b) Aircraft, Auto Or Watercraft 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 Injury And Property Damage Liability; or (c) Property Damage to Borrowed Equipment Or Use Of Elevators If the loss arises out of "property damage" to borrowed equipment or the use of elevators to the extent not subject to Exclusion J. of Section I - Coverage A - Bodily Injury And Property Damage Liability. (2) 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 other (b) The total of all deductible and self - has insured amounts under all that other insurance. © 2009, The Hartford (Includes copyrighted material of Insurance Services Office, Inc., with its permission.) Page 1 of 2 (7) Maintain adequate claim records and supporting data which document reserves for payment of claims, dates and amounts of any settlements, including specific identification of "claim expenses" incurred and paid. d. Acceptance Or Rejection of Settlement Within The "Self -Insured Retention" You, any insured as described in Section II - Who Is an Insured or any insured endorsed to this Coverage Part shall, as respects the "self - insured retention", exercise good faith in evaluating whether to accept or reject a settlement offer extended by a party making a claim. The failure to exercise such good faith by you, and any such insured will relieve us of any obligation to pay any sum in excess of the amount of the settlement that could have been accepted. e. Obligations At The Insureds Own Cast No insureds will, except at the insured's own cost, make or agree to any settlement for a sum in excess of the "self -insured retention" without our consent. If any insured makes a payment, assumes any obligation, or incurs any expense, other than for first aid, without our consent, such payment, obligation or expense will be at the insured's own cost. f. Insureds CJther Insurance If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance available to an insured, such insured must submit such claim or "suit" to the other insurer for defense and indemnity. g. Knowledge Of An Occurrence, Offense, Claim Or Suit Paragraphs a. and b. apply to you or to any insured only when such "occurrence", offense, claim or "suit" is known to: (1) You or any insured that is an individual; (2) Any partner, if you or an insured is a partnership; (3) Any manager, if you or any insured is a limited liability company; (4) Any "executive officer" or insurance manager, if you or an insured is a corporation; (5) Any trustee, if you or an insured is a trust; or (6) Any elected or appointed official, if you or an additional insured is a political subdivision or public entity. Paragraph g. applies separately to you and any insured. 3. Legal Action Against Us No person or organization has a right under this Coverage Part: a. To join. us as a party or otherwise bring us into a "suit" asking for damages from an insured; or b. To sue us under this Coverage Part unless all of its terms have been fully complied with. A person or organization may sue us to recover on an agreed settlement or on a final judgment against an insured; but we will not be liable for damages that are not payable under the terms of this Coverage Part or that are in excess of the applicable limit of insurance. An agreed settlement means a setflement and release of liability signed by us, the insured and the claimant or the claimant's legal representative. 4. Other Insurance This insurance is excess over any other insurance, whether primary, excess, contingent or on any other basis, except when purchased specifically to apply in excess of this insurance. If this insurance is excess over. other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sure of: (1) The total amount that all such other insurance would pay for damages in the absence of this insurance; and (2) The total of all deductible and self -insured amounts under all that other insurance. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for thafi period and send notice to the. first Named Insured. The due date for audit and. retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the "policy period" is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations a. When You Accept This Policy By accepting this policy, you agree: (1) The statements in the Declarations are accurate and complete; �� � �. r.- 0125-01.00-0001241-0005-0002828 ..- (2) Those statements are based upon representations you made to us; and (3) We have issued this policy in reliance upon your representations. b. Unintentional Failure To Disclose Hazards If unintentionally you should fail to disclose all hazards relating to the conduct of your business that exist at the inception date of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. 7. Separation Of Insureds Except with respect to the Limits of Insurance, your responsibility under the "self -insured retention" and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. L Transfer Of Rights Of Recovery Against Others To Us a. Transfer of Rights Of Recovery If the insured has rights to recover all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. b. How Recoveries Shall Be Applied Recoveries shall be applied to reimburse: (1) First, any interest (including the Named Insured) that paid any amount in excess of our Limits of Insurance; (2) Second, us, along with any other insurers having a quota share interest at the same level; and (3) Third, such interests (including the Named Insured) of whom this insurance is excess. However, a different apportionment may be made to effect settlement of a claim by agreement signed by all interests. c. Apportionment Among All Interests Reasonable expenses incurred in the exercise of rights of recovery shall be apportioned aI ong all interests in the ratio of their respective losses for which recovery is sought. Page 18 of 23 d. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. 10. Maintenance of Self -Insured Retention You shall do whatever is required, including provision of sufficient funds, to maintain the "self - insured retention" in full effect during the currency of this policy. If the "self -insured retention" becomes invalid, suspended, unenforceable or un %ollectable for any reason, including bankruptcy or insolvency, we shall be liable only to the extent we would have been had such "self -insured retention" remained in full effect. The first Named Insured shall give us written notice as soon as practicable of any change in the operating status of any "self -insured retention", or when the sum of all incurred losses and "claim expenses" equals or exceeds 70% of the "self - insured retention". 11. Appeals a. For amounts within the "self -insured retention": (1) If we or you with our consent, elect to appeal a judgment, then any resultant additional expenses, settlements or judgments to which this insurance applies shall reduce the amount of the "self - insured retention". We shall be liable for such additional expenses, settlements or judgments that are in excess of the "self - insured retention". (2) If you or any insured, without our consent, elects to appeal a judgment, any resultant additional expenses, settlements or judgments shall not reduce the amount of the "self -insured retention". We shall not be liable for such resultant additional Form EH 00 02 06 05 nnvoonn_�c CFRTICICATF AIIIMRFR• CHI-00945336i3-06 REVISION NUMBER: v 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 LTR A TYPE OF INSURANCE X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ] OCCUR ADDL SUBR POLICY NUMBER GLO 0378641-01 POLICY EFF MMIDD/YYYY 04/01/2021 POLICY EXP MMIDD/YYYY 04/01/2022 LIMITS EACH OCCURRENCE $ 11000,000 PREMISES (Ea occurRA AGE TO rence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO ❑ LOC JECT OTHER: PRODUCTS-COMP/OPAGG $ EXCLUDED A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BAP 0378643-01 04/0112021 0410112022 (Eaaccident)lEDSINGLE LIMIT $ 2,0002000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ C D UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE NIA See Attached See Attached 04/01/2021 04101/2022 04/01/2022 EACH OCCURRENCE $ AGGREGATE $ X STATUTE ORH $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUE FN (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Products Liability (limits are excess of $1 M SIR) E.L. EACH ACCIDENT $ 12000,000 E.L. DISEASE -EA EMPLOYEE $ 13000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICA City of Bremerton 100 Oyster Bay Ave. Bremerton, WA 98312 CANCELLA 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 of Marsh USA Inc. Manashi Mukherjee .,�a^.�.wa� ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 0002321 SP 0125-CO1-P02322-i City of Bremerton 100 Oyster Bay Ave. Bremerton, WA 98312 0125-Ot-00-0002321-0001-0005002 AGENCY CUSTOMER ID: CN101408137 LOC #: Minneapolis AGENCY Marsh USA Inc. POLICY NUMBER .7e1--.i:IL ADDITIONAL REMARKS SCHEDULE NAIC CODE NAMED INSURED The Charles Machine Works, Inc. dba Hammerhead Trenchless 500 South C.P. Avenue Lake Mills, WI 53551 EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation Policy Number: WC 0378637-Ot (AOSj Carrier: American Zurich Insurance Company Deductible: $350,000 Policy Number: WC 0378638-01 (MA, WI) Carrier: Zurich American Insurance Company Deductible-Retro: $350,000 Policy Number: EWS 0378639-01 (NE, WI) Carrier: Zurich American Insurance Company SIR:$450,000 Policy Number: EWS 0378640-01 (OK) Carrier: Zurich American Insurance Company SIR:$500,000 Products Liability (Fronted Policy): Policy #GLO 0378642-01 $1M Per Occur $1 M Per Agg $1MPvoducts-Completed Operations $1M SIR $1 M Ded XS of SIR Page 2 of 2 ACORD 101 (2008/01) 0125-01-00.0002321-0002.0005003 © 2008 ACORD CORPORATION. All rights I The ACORD name and logo are registered marks of ACORD POLICY NUMBER: GLO 0378641-01 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDURSEMEN I CHANGES THE POLICY, PLEASE READ IT CAREFULLY, ADDITIUNAL INSURtD � OWNERS, LESSEES OR CONTRACTORS _ SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: GOMMERGIAL GENERAL LIABILITY CQVERAGE PART SCHEIJULE Name Qf Additional Insured person(sj Or Omanizationfst ANY PERSON OR ORGANIZATION TO WHOM OR TO WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. Location{s) Of Covered Operations infiormation required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 10 0413 O Insurance Services Office, Inc., 2012 Page 1 of 2 POLICY NUMBER% GLO 0378641-01 CQMMERCIAL GENERAL LIABILITY CG 20 37 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL. INSURED � UVVNERS, LESSEES VK CONTRACTORS _ COMPLETED OPERATIONS This endorsement madifies insurance provided under the failawinUV COMMERCIAL GENERAL LIABILITY COVERAGE FART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART Name Of Additional Insured Persons) Or Oraanization(s) ANY PERSON OR ORGANIZATION TO WHOM OR TO WHICH YOU ARE REQUIRED TO PROVIDE ADDITIONAL INSURED STATUS IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. SCHEDULE Location And Des ANY LOCATION OR PROJECT leted Oaerations Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 37 04 13 O Insurance Services Office, Inc., 2012 Page 1 of 2 A. Section fl —Who Is An Insured is amended to include as an additional insured the persons) ar arganizatian(s} shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or °personal and advertising injury" caused, in whole or in part, by: 1. Your acts ar omissions; or 2. The acts or omissions of those acting an your behalf; in the performance of your ongoing operations far the additional insureds} at the iocation(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and �. If coverage provided to the additional insured is required. by a contract qr agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract ar agreement to provide far such additional insured. B. With respect to the insurance afforded to these additional insureds, the fallowing additional exclusions apply: This insurance does not apply to "bodily injury„ ar "property damage" occurring after: 1. All work, including materials, parts or equipment. furnished in connection with such work, on the project (other than service, maintenance ar repairs} to be performed by or an behalf of the additions( insureds} at the location of the covered operations has been completed; ar 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization ether than another contractor ar subcontractor engaged in performing operations for a principal as a park of the same project. C. With respect to the insurance afforded to these additional insureds, the fallowing is added to Section III —Limits Of Insurance: !f coverage provided to the additional insured is required by a contract or agreement, the mast we will pay an behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; ar 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 Shawn in the Declarations. CG ZO 10 04 13 0125-01-00-0002321-0003-0005004 C7 Insurance Services Office, Inc., 2Q12 Page 2 of 2 COMMERCIAL GENERAL LIABILITY CG 20 01 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY* w w j w 1 IW a w a W �..7. • w l Ili This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTVCOMPLETED OPERATIONS LIABILITY COVERAGE PART 'The fiollowing is added to the Other Insurance Condition and supersedes any provision to the contrary. Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that. {1) The additional insured is a Named Insured under such other insurance; and {�) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 41 04 13 a insurance Services Office, Inc., ZQ12 Page 1 of 1 Wolters Kiuwor Financial Services � Uniforrn Formsr�' A. Sectipn 11 -� Whp Is Qn Insured is amended to include as an additional insured the person{s) or organization{s} shown in the Schedule, but only with respect to liabiiity far "bodily injury" or "property damage" caused, in whale or in part, by "your wank" at the location designated and described in the Schedule of this endorsement performed far that additional insured and included in the "products -completed operations hazard". However: 1. The insurance affarded 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. ar agreement, the insurance affarded to such additional insured will not be brander than that which you are required by the contract ar agreement to provide tar such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Sectipn III � Limits Of Insurance; If coverage provided to required by a contract or will pay an behalf of the amount of insurance: the additional insured is agreement, the mast we additional insured is the 1. 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. CG 20 37 t}4 13 0125-Ot-00-0002321-0004-0005005 © Insurance Services Office, Inc., 2012 Page 2 of i �-• ACORD© DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/31/2022 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 riqhts to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh USA Inc. 333 South 7th Street, Suite 1400 Minneapolis, MN 55402-2400 C N 101408137-T O R O-G AW U-22-23 INSURED The Charles Machine Works, Inc. dba Hammerhead Trenchless 500 South C.P. Avenue Lake Mills, WI 53551 COVERAGES RECEDED APR 12 2022 'm City o� Bremerton frisk Maiement CERTIFICATE NUMBER: PHONE Zurich American Insurance INSURER B :NIA INSURER D CHI-009453368-08 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. INSRPOLICY LTR TYPE OF INSURANCE INSD WVD SUER POLICY NUMBER EFF MMIDD/YYYY POLICY EXP MM D/Y DYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLO 0378641-02 04/01/2022 04/01/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $ 11000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,0001000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X PRO - POLICY JECTPRO ❑ LOC PRODUCTS - COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY BAP 0378643-02 04/01/2022 04/01/2023 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED r NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION $ $ C A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA WC 0378637-02 (AOS) $350k Ded WC 0378638 02 (N1A,WI)$350kDed/Retro EWS 0378639-02 NE,WI $450k SIR ( ) 04101/2022 04/01/2022 04/01/2023 04/0112023 04/01/2023 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 A If yes, describe under DESCRIPTION OF OPERATIONS below EWS 0378640-02 ( OK) $500k SIR 04/01/2022 04/01/2023 E.L. DISEASE - POLICY LIMIT $ 150003000 A PRODUCTS LIABILITY GLO 0378642-02 01/01/2022 14/0112121 PER OCCURRENCE 1,000,000 ($1M Ded XS of SIR) (SIR $1M) PROD-COMP/OP AGG 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CFRTIFICATF HOI DFR CANCELLATION City of Bremerton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 100 Oyster Bay Ave. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Bremerton, WA 98312 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE use '2"e. ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ��R17® CERTIFICATE OF LIABILITY INSURANCE D03/31/2023D/YYYY) 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 MARSH USA LLC. 333 South 7th Street, Suite 1400 Minneapolis, MN 55402-2400 C N 101408137-TORO-GAWU-23-24 INSURED The Charles Machine Works, Inc. dba Hammerhead Trenchless 500 South C.P. Avenue Lake Mills, WI 53551 COVERAGES RECEIVED APR City of Bremerton Risk Management CERTIFICATE NUMBER: INSURER S AFFORDING COVERAGE NAIC # A :Zurich American Insurance Com an 16535 B :NIA NIA c :American Zurich Insurance Com an 40142 D: E: CHI-009453368-10 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDD/YYYY MMIDD YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLO 0378641-03 0410112023 0410112024 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREM SES� a oNcurrDence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE $ 2,000,000 POLICY � PRO ❑ LOC X JECT PRODUCTS -COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY BAP 0378643-03 0410112023 0410112024 COMBINED SINGLE LIMIT Ea accident $ 2,000,000 X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ C A A WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY Y / N OFFCER%M MBEREXCLUDED?ECUTIVE N (Mandatory in NH) � N/A WC 0378637-03 (AOS) $350k Detl WC 0378638-03 (MA,WI)$350kDed/Retro EWS 0378639-03 (NE,WI) $450k SIR 04/0112023 04/01/2023 04/0112024 04/01/2024 0410112024 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 A If yes, describe under DESCRIPTION OF OPERATIONS below EWS 0378640-03 OK $500k SIR ( ) 0410112023 0410112024 E.L. DISEASE -POLICY LIMIT $ 1,000,000 A PRODUCTS LIABILITY GLO 0378642-03 0410112023 0410112024 PER OCCURRENCE 1,000,000 ($1 M Ded XS of SIR) (SIR $1 M) AGGREGATE 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) HOLDER CANCELLA City of Bremerton I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 100 Oyster Bay Ave. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Bremerton, WA 98312 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 0000153 SP 0098-CO1-P00153-I City of Bremerton 100 Oyster Bay Ave. Bremerton, WA 98312 0098-01-00-0000153-0001-0000505 POLICY NUMBER: GLO 0378641-01 COMMERCIAL GENERAL LtABILCiY cG�o�oa4�a THIS ENDORSEMENT CHANGES THE POL[CY. PLEASE READ [T CAREFULLY, �►DDITIE'�NAL INSU�t�D � t�ViCN�`�S, L������ t��t Ci)NTRACTtJR � SDHEDULED PERSt�V CAR r������zAT�o�v This endorsement modifies insurance provided under the fottowing: CQMMERCIAL GENERAL LIABILITY GC)VERAGE PART SCHEDULE Name Qf Additionat !neared Person{s} Qr Organization(s} ANY PERSON t7R QRGANIZATtQN TQ WHQM OR T© WHICH YOU ARE REC,�UIREf3 TO PROVibE AC3DiTtONAL INSUREb STATUS IN A WRITTEN CONTRACT CR WRITTEN AGREEMENT,EXGEPTWHFRE SUCH CONTRACT C3R AGREEMENT tS PROHtC31T(=C_7 BY LAW. Lacationls) ©f Covered 4peratians ATION (7R PRQ,JEGT Information required to complete this Schedule, if not shown above, will be shown in the declarations. CG 20 10 04 13� Insurance Services Office, tnc., 2012 Page 1 of 2 Dear Certificate i�ioider: As many companies have moved to a remote working environment, mailing Certificates of h�surance to a physical address can cause unnecessary delays in providing you proof of insurance. To streamline delivery and in an effort to support ourfirm's commitment to sustainability, going forward, we would like to distribute your Certificates of Insurance electronically if passible. We are Kindly requesting Certificate Nalders provide us an email address where we can deliver your COI in the future. please send your resppnse to: USOperations.emailCc�marsh.com and provide the fallowing information so that we can expedite your COI delivery: -- Certi>icate # (Shown below Insured Name �- e.g.: ABC-12�456789-01} -- �-Nlait fvr future delivery E"or undeliverable email addresses, our system is configured to automatically redirect th��� Certificate for delivery via USPS. Lastly, if you no longer need this COl please respond to U5Operations.email@marsl7.com with the Certificate number and we will inactive the record in our system to avoid future automatic delivery. Thank you. US Operations, Marsh USA, inc. r"t r��_a�;is�l�.rs=� azf Ritat��i1 rv1c,E=r3tiarr 0098-01-00-0000153-0002-0000506 POLIGY NUMBER: GLfl 0378641-01 COMMERCIAL GENI�RAL LIABILITY CG 20 37 04 �# 3 THIS ENDQRSEN[ENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDIT'IUNA�. INSU��D — ta'Vil`N��S, L�SS��� C}�2 G�NTRA�TC�RS � CC3MP�,ETED tJPERAT�C3NS This endorsement modifies insurance provided under the following: GOMMERGIAL GENERAL LIABILITY COVERAGE PART PRODUCT'S/COMPLETED OPERATIONS LIABILITY COVERAGE PART Name Of Additional Ins«red Person(sj Or Organizatinn(s) ANY PERSON OR ORGANIZATION Tfl WHOM OR TO WHICH YOU ARE REC�UIRED Tfl PROVIDE ADD1TtONAL INSLiRED STATUS tN A WRITTEN CONTRACT OR WRITTEN AGREEMENT,EXCEPT WhiERE SUCH CONTRACT OR AGREEMENT lS PROHIBITED BY LAW. SCHEnCiLE Location And ©ascription Of Gnmpleted Operations ANY LOCATION flR PROJECT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 37 44 13 � Insurance Services Office, Inc., 2012 Page 1 of 2 A. Section tl _.. Whp Is An Insured. is amended to include as an additional insured the persons) or arganization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "praperty damage" nr "personal and advertising injury" caused, in whole nr in part, by: 1. Your acts ar omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations far the additional insureds} at the Incatian(s} designated above. 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 ar agreement to provide far such additionai insured. C3. With respect to the insurance afforded to these additional insureds, the fallowing additional exclusions apply: This insurance does not. apply to "bodily injury" or "praperty damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (ether than service, maintenance or repairs} to be performed by or vn behalf of the additionai insureds} at the location of the covered operations has been completed; ar 2. That portion of "your work" out of which the injury ar damage arises has been put to its intended use by any person or organization nther than another contractor ar subcontractor engaged in performing operations far a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the fnllawing is added to Section III —Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the mast we will pay nn behalf of the additional insured is the amount of insurance: 1. Required by the cnntract ar agreement; ar 2. Available under the applicable Limits of Insurance shown in the C�eclarativns; whichever is less. This endorsement shall not increase the applicable Limits of Insurance spawn in the C7eclaratians. CG 20 1Q 04'13 0098-01-00-0000153-0003-0000507 insurance Services Office, Inc., 2012 Rage 2 of 2 COMMERCIAL GENERAL LIA�ILI7Y CG 20 0'I Qd 13 THIS ENi�O►RSEMENT CHANGES THE Pt�LICY, PLEASE READ IT CAREFULLY. I�RIIVIARY ANC Nt�NCC}NTRI�UT�}RY ©TREK INSURANCE CC}NDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRObUCTS/COMPLETEC� tr?PERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insuranc+� This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (4} The additional insured is a Named Insured under such other insurance; and (2} You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. CG 20 01 04 13 C7 Insurance Services Office, Inc., 2012 Page 1 of 1 Wolters Kluwer �inartcial Services l Unifnrrn Forrr�srr,, A. Section II �- Wha Is An Insured is amended to include as an additional insured the persons) or orcganizatian(s) shown in the Schedule, but only with respect to liability for "bodily injury" pr "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed far that additional insured and included in the "prnduats-completed operations hazaP�d". 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 additianal insured will not be broader than that which you are required by the contract ar agreement to provide for such additional insured. B. With respect to the insurance afforded to these additianal insureds, the fallowing is added to Section III � Lirnits Of Insurance. if coverage provided to the additional insured is required by a contract nr agreement, the most we will pay an behalf of the additional insured is the amount of insurance: 1. F2equired by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the ©eclarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the ©eclarations. CG 24 37 04 13 0098-01-00-0000153-0004-0000508 rJ Insurance Services Office, Inc., 2t)12 Page 2 of � SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY A 04/01/2024 04/01/2024 X A 2,000,000 WC 037863804 (MA NE WI)$350K Retro 16535 GLO 0378642-04 A 1,000,000 04/01/2025 A X American Zurich Insurance Company PRODUCTS LIABILITY 1,000,000 N/A - 04/01/2025 CHI-009453368-13 04/01/2024 X 03/29/2024 04/01/2025 EWS 0378640-04 (OK) $500k SIR 1,000,000 04/01/2025 ($1M Ded XS of SIR) 1,000,000 AGGREGATE 1,000,000 1,000,000 A 04/01/2025 04/01/2024 04/01/2024 04/01/2025 40142 BAP 0378643-04 PER OCCURRENCE 10,000 04/01/2024 WC 0378637-04 (AOS) $350K DED EWS 0378639-04 (WI) $450k SIR (SIR $1M) 1,000,000 dba Hammerhead Trenchless The Charles Machine Works, Inc. Lake Mills, WI 53551 500 South C.P. Avenue 1,000,000 Zurich American Insurance Company X 333 South 7th Street, Suite 1400 MARSH USA LLC Minneapolis, MN 55402-2400 GLO 0378641-04 N/A N Bremerton, WA 98312 City of Bremerton 100 Oyster Bay Ave. 04/01/2024 C 2,000,000 X A 04/01/2025