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HomeMy WebLinkAbout2014-575-E AMS - Tile Restoration for Justice Facility flooring $6,755DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B [Departmental Use Only] TITLE Justice Flooring FY 2015 ORANGE COUNTY CONTRACT UNDER $15,000.00 NORTH CAROLINA THIS AGREEMENT, made and entered into this 1st day of December, 2014, ( "Effective Date ") by and between Orange County, North Carolina, a body politic and corporate organized under the laws of the State of North Carolina, (the "County "), party of the first part; and Tile Restoration, Inc. (the "Provider "), party of the second part; WITNESSETH: For the purpose and subject to the terms and conditions hereinafter set forth, the County hereby contracts for the services of the Provider, and the Provider agrees to provide the following services to the County in accordance with the terms of this Agreement, time being of the essence: The services and /or materials (hereinafter referred to collectively as "Services ") to be furnished under this Agreement are as follows: Justice Facility flooring, per provided proposa. The term of this agreement rendered shall be from December 1, 2014 to December 12, 2014. Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions, in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. Provider agrees that Provider shall not sub - contract any of the services to be provided in this Agreement, nor shall Provider assign any right or responsibility granted or required by this Agreement, without the prior written approval of the County. SPECIFIC TERMS 1. Payment: The County agrees to pay at the rates specified for Services satisfactorily performed in accord with this Agreement. The amount to be paid by the County shall not exceed six thousand seven hundred fifty five dollars, ($6,755). Payment shall be made within thirty (30) days of an invoice properly submitted to County. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. 2. Non — waiver: Failure by County at any time to require the performance by Provider of any of the provisions hereof shall in no way waive or affect the County's right hereunder to enforce the same, nor shall any waiver by the County of any breach be held to be a waiver of any succeeding breach or a waiver of this Non - Waiver Clause. 3. Independent Contractor: The Provider shall operate as an independent contractor and the County shall not be responsible for any of the Provider's acts or omissions. The Provider shall not be treated as an employee with respect to the Services performed hereunder for federal or state tax, unemployment or workers' compensation purposes. The Provider understands that neither federal, nor state, nor payroll tax of any kind shall be withheld or paid by the County on behalf of the Provider or the employees of the Provider. 4. Insurance: Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may be required by Owner's Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is Revised 7/14 1 DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B incorporated herein by reference and may be viewed at http:Horan eg ouniync.gov/purchasinWconirqg!L.a - If Owner's Risk Manager determines additional insurance coverage is required such additional insurance shall consist of n/a (if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the Owner's Risk Manager. 5. Indemni : The Provider agrees to defend, indemnify, and hold harmless Orange County from all losses, liabilities, claims, demands, suits, costs, damages or expenses (including reasonable attorney's fees) arising from bodily injury, including death, to any person or persons or damage to or destruction of any property caused in whole or in part by any negligent or intentional act or omission on the part of the Provider. 6. Termination: This Agreement may be terminated at any time by mutual written agreement of the parties or by the County upon written notice to the Provider. 7. Entire Agreement and Signatures: The parties have read this Agreement and agree to be bound by all of its terms, and further agree that it constitutes the complete and exclusive statement of the Agreement between the parties unless and until modified in writing and signed by the parties. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. 8. Priori : In determining the basic services to be provided, should any documents be referenced in this Agreement, the terms herein shall have priority in any conflict between the terms of referenced documents and the terms of this Agreement. 9. Governing Law: aw: Both parties agree that this Agreement shall be governed by the laws of the State of North Carolina. Should either party initiate litigation to settle any dispute involving the terms of this Agreement such litigation shall be initiated in the General Court of Justice of North Carolina seated in Orange County, North Carolina. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all anti - discrimination laws. Pursuant to the terms of North Carolina General Statute 153A- 449(b) no county may enter into a contract with a contractor unless the contractor and the contractor's subcontractors comply with the requirements of Article 2 of Chapter 64 of the North Carolina General Statutes. Where applicable, failure to maintain compliance with the requirements of Article 2 of Chapter 64 of the General Statutes constitutes Provider's breach of this Agreement. By executing this Agreement Provider affirms Provider is in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. 10. Non Appropriation: Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable and not appropriated for the performance of County's obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability and non - appropriation of public funds. [SIGNATURE PAGE TO FOLLOW] Revised 7/14 2 DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B IN WITNESS WHEREOF, Orange County and the Provider have signed this Agreement, effective as of the day first written above. O � Ty joV�,l�t tf �auxw�LYS t By• nFZ�ooe County Manager 200 S. Cameron St. P.O. Box 8181 Hillsborough, NC 27278 Revised 7/14 Ply Aned by: o.., By. 8-3e R& Tile Restoration, Inc. 119 East Main St, PO Box 160 Hookerton, NC 28538 DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B Process Description of Area - Justice Side Court House Clean Price TOTAL PRICE k Aen TRIA SaniGLAZE GroutGLAZE irt SaniGL -- E 1ls Your Flooring �r solution Resource ON1 (TIP 1 119 East Main Street Break Room Unisex Restroom $135.00 Hookerton, NC 28538 1 SaniGLAZE GroutGLAZE Phone: 252 - 747 -5411 $135,00 $350.00 Fax: 252- 747 -8931 SaniGLAZE GroutGLAZE Freddy Brooks Orange County Public Works Phone: 919- 245 -2631 Date: 2/18/2014 600 Highway 86 North Fax: 919- 644 -3043 Rep.: Brad Albritton Hillsborough, NC 27278 Email: (brooks @orangecountync,gov Cell : 252 - 916 -2045 Process Description of Area - Justice Side Court House Clean Price TOTAL PRICE 1 SaniGLAZE GroutGLAZE 1st FloorMenk and Women's Lobby Restrooms $1,125.00 $2,495.00 1 SaniGLAZE GroutGLAZE Break Room Unisex Restroom $135.00 $350.00 1 SaniGLAZE GroutGLAZE UnisexRestroom 138 $135,00 $350.00 1 SaniGLAZE GroutGLAZE Menk and Women's Restroom 233 $310.00 $715.00 GroutGLAZE Process Includes: Removal of Contamination from tile, and grout surface Prep to grout lines for restoration Application of Non Porous Grout Resin Color TBD A Fee of 2,5% will be added for all Credit Card Transactions Terms: Net 20 Days TOTAL $3,910.00 Please Remit All Contracts, PO's and Payments To: 119 East Main St PO Box 1601lookerton NC 28538 Estintaled EverGLAZE Extefdled Profectfar Program Cast if proscribed maintenance procedures are follmved $977.50 Proposal Valid for 30 Days Delivery to Job, Sales Tax and Installation are included. All services guaranteed as specified. All work to be complete In a workmanlike manner according to standard practices. Any alteration or deviation from this proposal involving extra costs will be executed only upon written orders, and will become an extra charge over and above the proposal. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Ourworkers are fully covered by Workman's Compensation Insurance. Evidence of Insurance will be provided upon request. Any special requirements or endorsements may Incur additional charges. We do not waive any rights of subrogation against contractor or owner for any loss covered by insurance of any type, SaniGLAZE Restoration Service Is warranted against material defects and workmanship and extends indefinitely as long as the EverGLAZE Program as prescribed is Incorporated In the ongoing maintenance. Glazing Compound colors on color chart represent actual Glazing Compound matedal. Once applied, colors may vary depending on original grout color, porosity and other factors, •• The Restoration will take all precaution to protect adjoining flooring, wails, materials etcetera from exposure to water and /or chemlcals. Any damage that may occur from contact from water and/or chemical is not the responsibility of Tile Restoration Inc and Its staff. Any changes or additional work required or requested by the owner, will be done at an additional charge and must be written. I hereby give Tile Restoration Inc authorization to do the work specified and payment will be made as outlined above. DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B Terms: Net 20 Days TOTAL $2,845.00 Please Remit All Contracts, PO's and Payments To: Tile Restoration Inc. 119 East Main St PO Box 160 Hookerton NC 28538 TA Fro 0 kS Proposal Valid for 30 Days Delivery to Job, Sales Tax and Installation are included. All services guaranteed as specified. All work to be complete in a workmanlike manner according to standard practices. Any alteration or deviation from this proposal involving extra costs will be executed only upon written orders, and will become an extra charge over and above the proposal. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workman's Compensation Insurance. Evidence of Insurance will be provided upon request. Any special requirements or endorsements may incur additional charges. We do not waive any rights of subrogation against contractor or owner for any loss covered by insurance of any type. All Tile Restoration services require a minimum of 72 of cure time before they can be exposed to moisture. If this timeline is not adhered to the customer takes full responsibility for any damage or performance issues that may result. SaniGLAZE Restoration Service Is warranted against material defects and workmanship and extends indefinitely as long as the EverGLAZE Program as prescribed is incorporated in the ongoing maintenance. Glazing Compound colors on color chart represent actual Glazing Compound material. Once applied, colors may vary depending on original grout color, porosity and other factors. " Tile Restoration will take all precaution to protect adjoining flooring, walls, materials etcetera from exposure to water and /or chemicals. Any damage that may occur from contact from water and /or chemical is not the responsibility of Tile Restoration Inc. and it staff. Any changes or additional work required or requested by the owner, will be done at an additional charge and must be written. I hereby give Tile Restoration Inc. authorization to do the work specified and payment will be made as outlined above. TKI+A ■ ■ Your Flooring solution Resource , , ONI�ITV uav - °° x www.tilerestorationinc, com 119 East Main Street Hookerton, NC 28538 Phone: 866 - 327 -4600 Freddy Brooks Phone: 919-245-2636 Date: 12/4/2014 Rep.: Brad Albritton Orange County Public Works 600 Highway 86 North Fax: 919- 644 -3043 Cell : 252 - 916 -2045 Hillsborough, NC 27278 Email: fbrooks@orangecountync.gov Fax: 1- 252 - 376 -1452 Email: brada @tilerestorationinc.com Process Description of Area - Justice Center Price 1 SaniGLAZE GroutGLAZE 2nd Floor Lobby Women's 207 and Men's 214 Restrooms $2,495.00 1 SaniGLAZE GroutGLAZE Judge Chambers Restroom 226 $350.00 GroutGLAZE Process Includes Removal of Contamination from tile and grout surface Prep to grout lines for restoration Application of Non Porous Resin Color #27 Chocolate Terms: Net 20 Days TOTAL $2,845.00 Please Remit All Contracts, PO's and Payments To: Tile Restoration Inc. 119 East Main St PO Box 160 Hookerton NC 28538 TA Fro 0 kS Proposal Valid for 30 Days Delivery to Job, Sales Tax and Installation are included. All services guaranteed as specified. All work to be complete in a workmanlike manner according to standard practices. Any alteration or deviation from this proposal involving extra costs will be executed only upon written orders, and will become an extra charge over and above the proposal. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workman's Compensation Insurance. Evidence of Insurance will be provided upon request. Any special requirements or endorsements may incur additional charges. We do not waive any rights of subrogation against contractor or owner for any loss covered by insurance of any type. All Tile Restoration services require a minimum of 72 of cure time before they can be exposed to moisture. If this timeline is not adhered to the customer takes full responsibility for any damage or performance issues that may result. SaniGLAZE Restoration Service Is warranted against material defects and workmanship and extends indefinitely as long as the EverGLAZE Program as prescribed is incorporated in the ongoing maintenance. Glazing Compound colors on color chart represent actual Glazing Compound material. Once applied, colors may vary depending on original grout color, porosity and other factors. " Tile Restoration will take all precaution to protect adjoining flooring, walls, materials etcetera from exposure to water and /or chemicals. Any damage that may occur from contact from water and /or chemical is not the responsibility of Tile Restoration Inc. and it staff. Any changes or additional work required or requested by the owner, will be done at an additional charge and must be written. I hereby give Tile Restoration Inc. authorization to do the work specified and payment will be made as outlined above. DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B ACORO® CERTIFICATE OF LIABILITY INSURANCE F10/30/2014 DATE (MM /DD /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 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 Jake A Parrott Insurance Agency Inc 2508 N HERRITAGE STREET PO BOX 3547 KINSTON NC 28502 CONTACT Beverly Pike AAI NAME: y PHONE , (252)523 -1041 77777M No: (252) 523 -0195 E -MAIL ADDRESS: P P b ike@ arrottins.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:EMPLOYERS MUTUAL CASUALTY CO 21415 INSURED TILE RESTORATION INC C/O ALBRITTON CO PO BOX 160 HOOKERTON NC 28538 -0160 INSURER B :EMASCO INSURANCE COMPANY 21407 INSURERC: INSURER D: INSURER E : $ 1,000,000 INSURERF: X COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE FX OCCUR COVERAGES CERTIFICATE NUMBER.CL14102908345 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. INTRR TYPE OF INSURANCE ADS L WVDR POLICY NUMBER MMIDIDY/YEYYY MM /DDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE FX OCCUR 5D20546 11/7/2014 11/7/2015 PREM SES (Ea occcurr nce ) $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENI AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OPAGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY (CFO, e'W"da"ISINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS E20546 1/7/2014 11/7/2015 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccident $ NONAWNED HIRED AUTOS AUTOS Medical payments $ 2,000 X UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB DED RETENTION $ $ J20546 11/7/2014 1/7/2015 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUDED7 Y (Mandatory in NH) N /A 5H2O546 11/4/2014 11/4/2015 X I WC L ATU- X OTH- EEL E.L. EACH ACCIDENT $ 1,00 000 E.L. DISEASE - EA EMPLOYEd $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER IS LISTED AS AN ADDITIONAL INSURED AS PERTAINS TO GENERAL LIABILITY, ON A PRIMARY BASIS INCLUDING PRODUCTS & COMPLETED OPERATIONS, VIA A WRITTEN CONTRACT IN PLACE WITH THIS REQUIREMENT INCLUDED. CERTIFICATE HOLDER IS LISTED AS AN ADDITIONAL INSURED AS PERTAINS TO AUTO LIABILITY, VIA A WRITTEN CONTRACT IN PLACE WITH THIS REQUIREMENT INCLUDED. WAIVER OF SUBROGATION IN FAVOR OF ADDITIONAL INSURED APPLIES TO GENERAL AND AUTO LIABILITY AND WORKER'S COMPENSATION, VIA A WRITTEN CONTRACT IN PLACE WITH THIS REQUIREMENT INCLUDED. EXCLUDED OFFICERS IN WORKER'S COMPENSATION COVERAGE: DAVID ALBRITTON & CHARLES ALBRITTON III. CERTIFICATE HOLDER CANCELLATION ORANGE COUNTY PO BOX 8181 HILLSBOROUGH, NC 27278 ACORD 25 (2010/05) INS025 igninns) m 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 Parrott /LEANNE ©1988 -2010 ACORD CORPORATION. All rights reserved. The Ar.t)Pn nmma nnri Innn me ronicfcrcri mnrirc of ACr1Rrl DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION CONTRACT OR AGREEMENT INCLUDING COMPLETED OPERATIONS - PRIMARY AND NONCONTRIBUTORY This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. Section II — Who Is An Insured is amended to include as an additional insured: 1. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy; and 2. Any other person or organization you are required to add as an additional insured under the contract or agreement described in Paragraph 1. above. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury ", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; in the performance of: a. your ongoing operations for the additional insured; or b. "Your work" for the additional insured and included in the "products — completed operations hazard ". However, the insurance afforded to such additional insured described above: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to "bodily injury," "property damage" and "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services including: a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or b. Supervisory, inspection, architectural or engineering activities. 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 the 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, the failure to render, any professional architectural, engineering or surveying services. C. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement described in Paragraph A.1.; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. D. The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary and Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (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. E. All other terms and conditions of this policy remain unchanged. CG7174.3(10 -13) Includes copyrighted material of ISO Properties, Inc, with its permission. Page 1 of 1 DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO ELITE AMENDMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The BUSINESS AUTO COVERAGE FORM is amended to include the following clarifications and extensions of coverage. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. TEMPORARY SUBSTITUTE AUTO PHYSICAL (1) Coverage under this provision is afforded DAMAGE only up to 180 days after you acquire or SECTION I — COVERED AUTOS paragraph C. form the organization, or to the end of the Certain Trailers, Mobile Equipment, and policy period, whichever is earlier. Temporary Substitute Autos is amended by (2) Any organization you acquire or form will adding the following: not be considered an "insured" if: If PHYSICAL DAMAGE COVERAGE is provided by this coverage form for an "auto" you own, the Physical Damage Coverages provided for that owned "auto" are extended to any "auto" you do not own while used with the permission of its owner as a temporary substitute for the covered "auto" you own that is out of service because of breakdown, repair, servicing, "loss" or destruction. The coverage provided is the same as the coverage provided for the vehicle being replaced. B. BLANKET ADDITIONAL INSURED SECTION II — LIABILITY COVERAGE, A.I. Who Is An Insured is amended by adding the following: Any person or organization who is a party to a written agreement or contract with you in which you agree to provide the type of insurance afforded under this Business Auto Coverage Form. This provision applies to claims for "bodily injury" or "property damage" which occur after the execution of any written agreement or contract. C. EMPLOYEES AS INSUREDS The following is added to the Section II — LIABILITY COVERAGE, Paragraph A.I. Who Is An Insured Provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. D. NEWLY FORMED OR ACQUIRED ORGANIZATIONS SECTION II — LIABILITY COVERAGE, A.1. Who Is An Insured is amended by adding the following: Any organization which you acquire or form after the effective date of this policy in which you maintain ownership or majority interest. However: (a) The organization is a partnership or a joint venture; or (b) That organization is covered under other similar insurance. (3) Coverage under this provision does not apply to any claim for "bodily injury" or "property damage" resulting from an "accident" that occurred before you formed or acquired the organization. E. SUBSIDIARIES AS INSUREDS SECTION II — LIABILITY COVERAGE, A.I. Who Is An Insured is amended by adding the following: Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of this policy. However, "insured" does not include any subsidiary that is an "insured" under any other automobile liability policy or was an "insured" under such a policy but for termination of that policy or the exhaustion of the policy's limits of liability. F. COVERAGE EXTENSIONS — SUPPLEMENTARY PAYMENTS SECTION II — LIABILITY COVERAGE, A.2.a. Coverage Extensions, Supplementary Payments (2) and (4) are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. CA7450(7 -14) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 1 of 4 DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B G. FELLOW EMPLOYEE COVERAGE In those jurisdictions where, by law, fellow employees are not entitled to the protection afforded to the employer by workers compensation exclusivity rule, or similar protection. The following provision is added: Subparagraph 5. of paragraph B. Exclusions in SECTION 11 LIABILITY COVERAGE does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. H. PHYSICAL DAMAGE — TOWING SECTION III — PHYSICAL DAMAGE COVERAGE, A.2. Towing is replaced with the following: We will pay for towing and labor costs incurred, subject to the following: a. Up to $100 each time a covered "auto" of the private passenger type is disabled; or b. Up to $500 each time a covered "auto" other than the private passenger type is disabled. However, the labor must be performed at the place of disablement. I. LOCKSMITH SERVICES SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: We will pay up to $250 per occurrence for necessary locksmith services for keys locked inside a covered private passenger "auto ". The deductible is waived for these services. J. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions subparagraph a. Transportation Expenses is replaced by the following: (1) We will pay up to $75 per day to a maximum of $2,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Cause Of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expirations, when the covered "auto" is returned to use or we pay for its "loss ". (2) If the temporary transportation expenses you incur arise from your rental of an "auto" of the private passenger type, the most we will pay is the amount it costs to rent an "auto" of the private passenger type which is of the same like kind and quality as the stolen covered "auto." K. AUDIO, VISUAL, AND DATA ELECTRONIC EQUIPMENT COVERAGE In addition to the Each Accident Limit of Insurance and subject to the provisions of Paragraph C.2. of Section III Physical Damage of the coverage form, we will pay up to $5,000 for "loss" in any one "accident" to all electronic equipment that reproduces, receives, or transmits audio, visual or data signals. L. HIRED AUTO PHYSICAL DAMAGE SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: If hired "autos" are covered "autos" for Liability Coverage, and if Comprehensive, Specified Causes of Loss, or Collision coverage is provided for any "auto" you own, then the Physical Damage coverages provided are extended to "autos" you hire, subject to the following limit and deductible: (1) The most we will pay for loss to any hired "auto" is the lesser of Actual Cash Value or Cost of Repair, minus the deductible. (2) The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. (3) Subject to the above limit and deductible provisions, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. We will pay up to $1,000, in addition to the limit above, for loss of use of a hired auto to a leasing or rental concern for a monetary loss sustained, provided it results from an "accident" for which you are legally liable. M. AUTO LOAN OR LEASE COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE paragraph A.4. Coverage Extensions is amended by the addition of the following: In the event of a total "loss" to a covered "auto" which is covered under this policy for Comprehensive, Specified Cause of Loss, or Collision coverage, we will pay any unpaid amount due, including up to a maximum of $500 for early termination fees or penalties, on the lease or loan for a covered "auto ", less: 1. The amount paid under the PHYSICAL DAMAGE COVERAGE SECTION of the policy; and 2. Any: a. Overdue lease /loan payments at the time of the "loss "; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage. c. Security deposits not returned by the lessor; CA7450(7 -14) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 2 of 4 DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B d. Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and e. Carry-over balances from previous loans or leases. Coverage does not apply to any unpaid amount due on a loan for which the covered "auto" is not the sole collateral. N. PERSONAL PROPERTY OF OTHERS SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: We will pay up to $500 for loss to personal property of others in or on your covered "auto." This coverage applies only in the event of "loss" to your covered "auto" caused by fire, lightning, explosion, theft, mischief or vandalism, the covered "auto's" collision with another object, or the covered "auto's" overturn. No deductibles apply to this coverage. O. PERSONAL EFFECTS COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: We will pay up to $500 for "loss" to your personal effects not otherwise covered in the policy or, if you are an individual, the personal effects of a family member, that is in the covered auto at the time of the "loss ". For the purposes of this extension personal effects means tangible property that is worn or carried by an insured including portable audio, visual, or electronic devices. Personal effects does not include tools, jewelry, guns, money and securities, or musical instruments P. EXTRA EXPENSE FOR STOLEN AUTO SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: We will pay up to $1,000 for the expense incurred returning a stolen covered "auto" to you because of the total theft of such covered "auto ". Coverage applies only to those covered "autos" for which you cant' Comprehensive or Specified Causes Of Loss Coverage. Q. RENTAL REIMBURSEMENT SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding the following: 1. This coverage applies only to a covered "auto" for which PHYSICAL DAMAGE COVERAGE is provided on this policy. 2. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto ". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto ". No deductibles apply to this coverage. 3. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days. a. The number of days reasonably required to repair or replace the covered "auto ". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you; or b. 30 days. 4. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses incurred; or b. $75 per day, subject to a $2,250 limit. 5. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 6. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Physical Damage — Transportation Expense Coverage Extension included in this endorsement. 7. Coverage provided by this extension is excess over any other collectible insurance and /or endorsement to this policy. R. AIRBAG COVERAGE SECTION III — PHYSICAL DAMAGE COVERAGE, B.3.a. Exclusions is amended by adding the following: If you have purchased Comprehensive or Collision Coverage under this policy, the exclusion relating to mechanical breakdown does not apply to the accidental discharge of an airbag. S. NEW VEHICLE REPLACEMENT COST The following is added to Paragraph C. Limit of Insurance of SECTION III — PHYSICAL DAMAGE COVERAGE In the event of a total "loss" to your new covered auto of the private passenger type or vehicle having a gross vehicle weight of 20,000 pounds or less, to which this coverage applies, we will pay at your option: a. The verifiable new vehicle purchase price you paid for your damaged vehicle, not including any insurance or warranties. b. The purchase price, as negotiated by us, of a new vehicle of the same make, model, and equipment, or most similar model available, not including any furnishings, parts, or equipment not installed by the manufacturer or their dealership. CA7450(7 -14) Includes copyrighted material of ISO Properties, Inc, with its permission. Page 3 of 4 DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B c. The market value of your damaged vehicle, not including any furnishings, parts, or equipment not installed by the manufacturer or their dealership. We will not pay for initiation or set up costs associated with a loans or leases. For the purposes of this coverage extension a new covered auto is defined as an "auto" of which you are the original owner that has not been previously titled which you purchased less than 180 days prior to the date of loss. T. LOSS TO TWO OR MORE COVERED AUTOS FROM ONE ACCIDENT SECTION III — PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by adding the following: If a Comprehensive, Specified Causes of Loss or Collision Coverage `loss" from one "accident" involves two or more covered "autos ", only the highest deductible applicable to those coverages will be applied to the "accident ". This provision only applies if you carry Comprehensive, Collision or Specified Causes of Loss Coverage for those vehicles, and does not extend coverage to any covered "autos" for which you do not carry such coverage. U. WAIVER OF DEDUCTIBLE — GLASS REPAIR OR REPLACEMENT SECTION III — PHYSICAL DAMAGE COVERAGE, D. Deductible is amended by adding the following: If a Comprehensive Coverage deductible is shown in the Declarations it does not apply to the cost of repairing or replacing damaged glass. V. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT, OR LOSS SECTION IV — BUSINESS AUTO CONDITIONS, A.2. Duties in the Event of Accident, Claim, Suit or Loss is amended by adding the following: d. Your obligation to notify us promptly of an "accident', claim, "suit" or 'loss" is satisfied if you send us the required notice as soon as practicable after your Insurance Administrator or anyone else designated by you to be responsible for insurance matters is notified, or in any manner made aware, of an "accident', claim, "suit' or "loss ". W. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY Subparagraph 5. of paragraph A. Loss Conditions of SECTION IV BUSINESS AUTO CONDITIONS is deleted in its entirety and replaced with the following. 5. Transfer of Rights of Recovery Against Others to Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. However, we waive any right of recovery we may have against any person, or organization with whom you have a written contract, agreement or permit executed prior to the "loss" that requires a waiver of recovery for payments made for damages arising out of your operations done under contract with such person or organization. X. UNINTENTIONAL FAILURE TO DISCLOSE EXPOSURES SECTION IV — BUSINESS AUTO CONDITIONS, B.2. Concealment, Misrepresentation, or Fraud is amended by adding the following: If you unintentionally fail to disclose any exposures existing at the inception date of this policy, we will not deny coverage under this Coverage Part solely because of such failure to disclose. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or non - renewal. Y. MENTAL ANGUISH SECTION V — DEFINITIONS, C. is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish or death resulting from bodily injury, sickness or disease. Z. LIBERALIZATION If we revise this endorsement to provide greater coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. CA7450(7 -14) Includes copyrighted material of ISO Properties, Inc. with its permission. Page 4 of 4 DocuSign Envelope ID: E727AB00- 9790- 421A- A227- 5C55E57ECF4B WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4 -84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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 Any person or organization that you perform work for that is liable for an injury, covered by this policy, that prior to the injury has written contract requiring a waiver of our right to recover from them. NORTH CAROLINA 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 11/4/2014 Policy No. 5H2O546 Endorsement No. 1 Insured TILE RESTORATION, INC. Premium$ Insurance Company EMASCO INSURANCE COMPANY Countersigned by dt4am.,.+!% WC 00 03 13 (Ed. 4 -84) Copyright 1983 National Council on Compensation Insurance.