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HomeMy WebLinkAbout2015-124-E AMS - Tile Restoration Inc. for floor restoration at Southern Human Services Center DocuSign Envelope ID: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 [Departmental Use Only] TITLE &HS+ looring FY 2015 ORAN('-.'E COUNTY CONTRACT UNDER S15,000.00 NORTH CAROLINA THIS AGREEMENT, niade and entered into this 2nd day of February, 2015, ("Effective Date") by arid 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 'File Restoration, Inc (the "Provider"), party of the second part; WITNESSETH: For the purpose arid subject to the terms and conditions hereinafter set forth, the County hereby contracts for the services of the Provider, and tile Provider agrees to provide the following services to the County in accordance with the terms of this Agreement, time being of the essence: `File services and/or materials (hereinafter referred to collectively as "Services") to be furnished under this Agreement are as follows. removal of contamination from the and grout surface, prep to grout lines for restoration, and apply, SaniGLAZE Resin to grout lities and apply Flat Sani TECH topical Sealer to the following floors: I lealth Department's staff women's and men's restrooms, Health Department's Waiting loom women's and men's restrooms, and tile Social Set-vices Department's wortien's and men's restroorns, per included proposal dated October 16, 2014 Tile term of this agreement rendered shall be from Febraury 2,2015 to February 28, 2015. Provider represents and agrees that 11rovider is qualified to perform and fully capable of'performing and providing tile services required or necessary Linder this Agreement in a fully competent, professional and timely manner to tile satisfaction of the County. Provider shall be respinisible 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 tile 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 tile County. SPECIFIC TERMS I Payment: The County agrees to pay at the rates specified for Services satisfactorily performed in accord with this Agreement. 'File amount to be paid by the County shall not exceed eleven thousand five hundred seventy dollars, ($11,570). Payment shall be made within thirty (30), days of all 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--Nvaiver: 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, not- shall any waiver by tile 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: 'file Provider shall operate as all independent contractor and the County shall not be responsible for any of the Provider's acts or omissions. "rhe Provider shall not be treated as all 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, not* payroll tax of any kind shall be withheld or paid by the County on behalf of the Provider oi•the employees of tile Provider. Re,vised 10J 4 l DocuSign Envelope ID: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 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 docurnent is incorporated herein by reference and may be viewed at in i g , contracts.asp). �yj c ov/purchasiniV If Owner's Risk Manager determines additional insurance coverage is required such additional insurance shall consist of n/a.(if no additional insurance required rnark N/A as being not applicable). Provider shall not coninience work until Such insurance is in effect and certification thereof has been received by the Owner's Risk Manager. 5. Indemnity: 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 Ices) 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 onnission oil the part of the Provider. 6, Termination: 'this Agreement may be terminated at any tine by mutual written agreement of tire parties or by the County upon written notice to the Provider. 7. Entire Agreement and Siggq urea: 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 I IA and Article 40 of North Carolina General Statute Chapter 66. 8. Priori : In deterrnining the basic services to be provided, should any documents be referenced in or attached to this, Agreement, the terms herein shall have priority in any conflict between the terins of referenced documents and the terms of this Agreement. 9. Governing Law: 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. 10. Dispqjg._&sptq_tjgq: Any and all suits or actions to enforce, interpret, or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in tire General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the parties may agree to nonbinding media-Lion of any dispute prior to the bringing of such suit or action. 11. l arm_Apprroprii tipri: 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 autornatically expire without penalty to County immediately upon written notice to Provider of the unavailability and non•appropriation of public funds. [SIGNATURE PAGE TO FOLLOW1 Rmsed IO/lit 2 DocuSign Envelope ID: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 IN WITNESS WHEREOF,County and the Provider have signed this Agreement, effective as of the day first written above. ORANGE COUNTY PROVWER By: LD—Signed by: D—Signed by: 66wi"it, hmmt-rsb-� By: L— County Manager 87FWCAFA[389478 200 S. Cameron St. Tile Restoration Inc P.O. Box 8181 119 East Main Street Hillsborough,NC 27278 Hookerton,NC 28538 Revised 10/14 DocuSign Envelope ID: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 .............. OAAW 9 Your Hearing A SaWGWE' N Solutim Resouree W 1.1,9 East Main Street ��� Hookerton, NC 28538 Phone. 866-327-4600 Freddy Brooks Phone: 919-245-2636 Date: 10/16/2014 Orange County Pubillc Works Fax: 919-644-3043 Rep.: Brad Albritton 600 Highway 86 North Email: trooksPorangecouritync,gov Cell : 252-916-2045 Hillsborough, NC 27278 Fax: 252-747-8931 Process Description of Area-Southern Human Services Certer p'ri'ce I San!GLAZE EiiduraGLA7E Heidth Department Staff Men's Resimorn $1,615,00 1 Sani(A.A213 rmduraGLAZE [lerdth Department Staff Worricias Restroom $1,615.00 1 SaniGLAZE EnduraGLAZE Health Department Wei tirig Roos)Men's Restroom $2085.00 1 SaniGLAZE EndumGIAZE licalth I)eparldirent Wai ting Room Unisex Restroom j680.00 I SaniGLAZE,Endt3rav GIA7L Health Department Waiting Room Wornens Restroom 52,085,00 I San1CA,A2T-EnduraGLAZE Social security Men's Restroorn $1,235,00 1 SaniQ,A7F EnduraGLAZE Social Security Women's Restroom $2,255.00 Proposal Includes: Retrieval of Contalninat ion from tile and grant surface Prep to grout lines for restondion, Application of Sani(.';IAZE Resin to grout lines:Color'lBD Application of Flat Sarni TECH topical Scaler A Fee of 2.5°.x1 will be added for all Cfud#Cord Trdnsactbns Terms:Net 20 Days TOTAL ]:']case Remit All Contracts,P(Ys and Payments To� "I ile Restoration Inc. 119,Iast Main St PO Box 160 Ilookerton NC:211] Proposal Valid for 30,Days Delivery to Job,Sales Tax and tristaflation 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 becorno 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 WO be provided upon request.Any special requirements or endorsements may lricur 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(,.urn Ume 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. SamG LAZE Restoration Service is warranted against material delects and worNmanship and extends indefinitely as long as the EverGLAZE Program as prescribed is Incorporated In the ongoing maintenance.Glazing Compound colors on color chart represent arlual ajazing 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 Roaring,walls,materials etcetera ftorn 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 arm additional charge and must be written.I hereby give Tile Restoration Inc.authorization to do the work specified and payment will,be rnade as outlined above. 000uSign Envelope ID: oE1o8FF0-ooA1-4F5A~^o39-o3ono4764os6 AC"RV CERTIFICATE OF LIABILITY INSURANCE 10/30/2014 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($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the 1policy(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 ondorsement(s). PRODUCER CONTACT Beverly Pike, AAI Jake A Parrott Insurance Agency Inc PH�NE..,,D, (252)523-1041 FAX C N 252)523 ADDRESS:bpike@parrot tins.com KINSTON NC, 28502 ±!SqRER8-EMPLOYERS MUTUAL CASUA.LTY CO 21415 INSURED INSURER BEMASCO INSURANCE COMPANY 21407 TILE RESTORATION INC' IN�U�E5 SL PO BOX 160 IN SURER E; ,HO,OKERTON NC 28538-0160 INSURER r,:, COVERAGES CERTIFICATE NUMBER:CL14102908345 REVISION NUMBER: THIS IS TO CER!TIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE POLICY PEMOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 'TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR SUER LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER wwootyyyyl (Mw65IYYYYI GE ERAIL LIABIUTY EACH OCCURRENCE $ 1,000,000 1/7/2014 11/7/2015 MEDEXP n A CLAWS-MADE OCCUR 5D20546 1 0 00 POLICY PRO 11.(Yr, S AUTOMOBILE LIABILITY COMMNED SINGLE UMIT A ANY AUTO AUTOS AUTOS HIRED AUTOS NONOW41ED PROPERTY DAMAGE S AUTOS Medical Eaymenis 2,000 X UMBRELLALIAB HCCCUR S 2,000,000 LED 1-1-111 ON S �5J20546 11/7/2014 11/7/2015 S WORKERS COMPENSATION X J_T11 DESCRIPIION OF OPERATIONS�LOCATIONS I VEHICLES (Aftach 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 REQUIRE�SNT 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 SUBROCATION IN FAVOR OF ADDITIONAL INSUPYED APPLIES TO GENERAL AND AUTO LIABILITY AND WOPJ�ER-S COMPENSATION, VIA A WRITTEN CONTRACT IN PLACE WITH THIS REQUIRE1,1ENT INCLUDED. EXCLUDED OFFICERS IN WORKER'S COMPENSATION COVERAGE: DAVID ALBRITTON & CHARLES ALBRITTON III. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ORANGE COUNTY PO BOX 8181 HILLSBOROUGH, NC 27278 AUTHORIZED REPIRESENTATIVE Allen Parrott/7-PANNE ACORD 25(2010/05) 1988-2010 ACORD CORPORATION. All rights reserved, DocuSign Envelope ID: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 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 11 — Who Is An Insured is amended to surveys, field orders, change orders or drawings include as an additional insured: and specifications-, or 1. Any person or organization for whom you are b. Supervisory, inspection, architectural or performing operations when you and such engineering activities. person or organization have agreed in writing in This exclusion applies even if the claims against a contract or agreement that such person or any insured allege negligence or other wrongdoing organization be added as an addltional insured in the supervision, hiring, employment, training or on your policy; and monitoring of others by the insured, if the 2. Any other person or organization you are occurrence" which caused the "bodilly injury" or required to add as an additional insured under property damage", or the offense which caused the the contract or agreement described in personal and advertising injiury", involved the Paragraph 1. above. rendering of, or the failure to render, any Such person(s) or organization(s) is an additional professional architectural, engineering or surveying insured only with respect to liability for "'bodily services. injury", "property damage" or "personal and C. With respect to the insurance afforded to these advertising injury" caused, in whole or in part, by: additional insureds, the following is added to a. Your acts or omissions; or Section III—Limits Of Insurance: b. The acts or omissions of those acting on The most we will pay on behalf of the additional your behalf; insured is the amount of insurance: in the performance of: 1. Required by the contract or agreement a. your ongoing operations for the additional described in Paragraph A.I.; or insured; or 2. Available under the applicable Limits of b. "Your work" for the additional insured and Insurance shown in the Declarations-, included in the "products — completed whichever is less. operations hazard". This endorsement shall not increase the applicable However, the insurance afforded to such additional Limits of Insurance shown in the Declarations. insured described above: D. The following is added to the Other Insurance a. Only applies to the extent permitted by law; Condition and supersedes any provision to the and contrary: b. Will not be broader than that which you are Primary and Noncontributory Insurance required by the contract or agreement to This insurance is primary to and well not seek provide for such additional insured. contribution from any other insurance available to B. With respect to the insurance afforded to these an additional insured under your policy provided additional insureds, the following additional that: exclusion applies: (1) The additional insured is a Named Insured This insurance does not apply to "bodily injury," under such other insurance; and "property damage" and "personal and advertising (2) You have agreed in writing in a contract or injury' arising out of the rendering of, or the failure agreement that this insurance would be primary to render, any professional arcMtectural, and would not seek contribution from any other engineering or surveying services including: insurance available to the additional insured, a. The preparing, approving, or failing to prepare E. All other terms and conditions of this policy remain or approve maps, shop drawings, opinions, reports, unchanged. CG7174,3(10-13) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 1 of I DocuSigin Envelope ID: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ, IT CAREFULLY. COMMERCIAL AUTO ELITE AMENDMENT This endorsement modifies insurance provided Linder 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 lend 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 (a) The organization is a partnership or a by this coverage form for an "auto" you own, the joint venture; or Physical Damage Coverages provided for that (b) That organization is covered under owned "auto"are extended to any"auto"you do not other similar insurance. own while used with the permission of its owner as a temporary substitute for the covered "auto" you (3) Coverage Linder this provision does not own that is out of service because of breakdown, apply to any claim for "bodily injury" or repair, servicing, "loss"or destruction. "property damage" resulting from an The coverage provided is the same as the "accident" that occurred before you formed coverage provided for the vehicle being replaced. or acquired the organization. B. BLANKET ADDITIONAL INSURED E. SUBSIDIARIES AS INSUREDS SECTION 11 — LIABILITY COVERAGE, A.I. Who SECTION 11 — LIABILITY COVERAGE, A.I. Who Is An Insured is amended by adding the following: Is An Insured is amended by adding the following: Any person or organization who is a party to a Any legally incorporated subsidiary in which you own more than 50 written agreement or contract with you in which you % of the voting stock on the effective date of this policy. However, "insured" agree to provide the type, of insurance afforded, does not include any subsidiary that is an "insured" under this Business Auto Coverage Form. under any other automobile liability policy or was an This provision applies to claims for"bodily injury" or "insured under such a policy but for termination of ,.property damage" which occur after the execution that policy or the exhaustion of the policy's limits of of any written agreement or contract. liability. C. EMPLOYEES AS INSUREDS F. COVERAGE EXTENSIONS — SUPPLEMENTARY The following is added to the Section 11 — PAYMENTS LIABILITY COVERAGE, Paragraph AA. Who Is SECTION 11 — LIABILITY COVERAGE, A.2.a. An Insured Provision: Coverage Extensions, Supplementary Payments Any "employee" of yours is an "insured"'while using (2) and (4) are replaced by the following: a covered "auto" you don't own, hire, or borrow in (2) Up to $5,000 for the cost of bail bonds your business or your personal affairs, (including bonds for related traffic law D. NEWLY FORMED OR ACQUIRED violations) required because of an "accident" ORGANIZATIONS we cover. We do not have to furnish these bonds. SECTION 11 — LIABILITY COVERAGE, A.1. Who Is An Insured is amended by adding the following: (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of Any organization which you acquire or form after earnings up to $500 a day because of time off the effective date of this policy in which you from work. maintain ownership or majority interest. However: CA7450(7.14) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 1 of 4 DocuSign Envelope ID: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 G. FELLOW EMPLOYEE COVERAGE K. AUDIO, VISUAL, AND DATA ELECTRONIC In those jurisdictions where, by law, fellow EQUIPMENT COVERAGE employees are not entitled to the protection In addition to the Each Accident Limit of Insurance afforded to the employer by workers compensation and subject to the provisions of Paragraph C.2. of exclusivity rule, or similar protection. The following Section III Physical Damage of the coverage provision is added: form, we wall pay up to $5,000 for"'loss"' in any one Subparagraph 5. of paragraph B. Exclusions in "accident" to all electronic equipment that SECTION 11 LIABILITY COVERAGE does not reproduces, receives, or transmits audio, visual or apply if the "bodily injury" results from the use of a data signals. covered "auto"you own or hire. L. HIRED AUTO PHYSICAL DAMAGE H. PHYSICAL DAMAGE—TOWING SECTION III— PHYSICAL DAMAGE COVERAGE, SECTION III — PHYSICAL DAMAGE COVERAGE, A.4. Coverage Extensions is amended by adding A.2. Towing is replaced with the following: the following: We will pay for towing and labor costs incurred, If hired "autos" are covered "autos" for Liability subject to the following: Coverage, and if Comprehensive, Specified Causes of Loss, or Collision coverage is provided a. Up to $100 each time a covered "auto" of the for any "auto" you own, then the Physical Damage private passenger type is disabled-, or coverages provided are extended to "autos" you b. Up to $500 each time a covered "auto"' other hire, subject to the following limit and deductible-, than the private passenger type is disabled. (1) The most we will pay for loss to any hired However, the labor must be performed at the place ,auto" is the lesser of Actual Cash Value or of disablement. Cost of Repair, minus the deductible. I. LOCKSMITH SERVICES (2) The deductible will be equal to the largest SECTION III— PHYSICAL DAMAGE COVERAGE, deductible applicable to any owned "auto' for A.4. Coverage Extensions is amended by adding that coverage. No deductible applies to "loss" the following: caused by fire or lightning. We will pay up to $250 per occurrence for ( ) 'Subject to the above limit and! deductible necessary locksmith services for keys locked inside provisions, we will provide coverage equal to a covered private passenger "auto". The the broadest coverage applicable to any deductible is waived for these services. covered "auto" you own. J. PHYSICAL DAMAGE — TRANSPORTATION We will pay up to $1,1000, in addition to the limit EXPENSES above, for loss of use of a hired auto to a leasing or rental concern for a monetary loss SECTION III— PHYSICAL DAMAGE COVERAGE, sustained, provided it results from an "accident" A.4. Coverage Extensions subparagraph a. for which you are legally liable. Transportation Expenses is replaced by the M. AUTO LOAN OR LEASE COVERAGE following: (1) We will pay up to $75 per day to a maximum of SECTION III — PHYSICAL DAMAGE COVERAGE $2,500 for temporary transportation expense paragraph A.4. Coverage Extensions is amended incurred by you because of the total theft of a by the addition of the following: covered "auto" of the private passenger type. In the event of a total "loss," to a covered ':'auto" We will pay only for those covered "autos" for which is covered under this policy for which you carry either Comprehensive or Comprehensive, Specified Cause of Loss, or Specified Cause Of Loss Coverage, We will Collision coverage, we will pay any unpaid amount pay for temporary transportation expenses due, including up to a maximum of $500 for early incurred during the period beginning 48 hours termination fees or penalties, on the lease or loan after the theft and ending, regardless of the for a covered "auto", less-, policy's expirations, when the covered "auto" is 1. The amount paid under the PHYSICAL returned to use or we pay for its "loss", DAMAGE COVERAGE SECTION of the policy-, (2) If the temporary transportation expenses you and incur arise from your rental of an "auto" of the 2. Any.- private passenger type, the most we will pay is the amount it costs to rent an "auto" of the a. Overdue leaselloan payments at the time private passenger type which is of the same of the"loss""; like kind and quality as the stolen covered lb. Financial penalties imposed under a lease "`auto,''' 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: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 d. Costs for extended warranties, Credit Life 3. We will pay only for those expenses, incurred Insurance, Health, Accident or Disability during the policy period beginning 24 hours Insurance purchased with the loan or lease, after the "loss" and ending, regardless of the and policy's expiration, with the lesser of the e. Carry-over balances from previous loans or following number of days. leases. a. The number of days reasonably required to repair or replace the covered "auto". If Coverage does not apply to any unpaid amount "loss" is caused by theft, this number of due on a loan for which the covered "auto" is not days is added to the number of days it the sole collateral, takes to locate the covered "auto" and N. PERSONAL PROPERTY OF OTHERS return it to you-, or SECTION III ­ PHYSICAL DAMAGE COVERAGE, b. 30 days. A.4. Coverage Extensions is amended by adding 4. Our payment is limited to the lesser of the the following: following amounts: We will pay up to $500 for loss to personal property a. Necessary and actual expenses incurred-, of others in or on your covered "auto." or This coverage applies only in the event of "loss" to lb. $75 per day, subject to a $2,250 limit. your covered 'auto' caused by fire, lightning, explosion, theft, mischief or vandalism, the covered 5. This coverage does not apply whine there are ""auto's" collusion with another object, or the covered spare or reserve .'autos" available to You for `.auto's" overturn, your operations, No deductibles apply to this coverage. 6. If"loss" results from the total theft of a covered 0. PERSONAL EFFECTS COVERAGE "auto" of the private passenger type, we will pay under this coverage only that amount of SECTION III — PHYSICAL DAMAGE COVERAGE, your rental reimbursement expenses which is A.4. Coverage Extensions is amended by adding not already provided' under the Physical the following: Damage — Transportation Expense Coverage We will pay up to $500 for "loss" to your personal Extension included in this endorsement. effects not otherwise covered in the pohcy or, if you 7. Coverage provided by this extension is excess are an individual, the personal effects of a family over any other collectible insurance and/or member, that is in the covered auto at the time of the endorsement to this policy, llloss R. AIRBAG COVERAGE For the purposes of this extension personal effects means tangible property that is worn or carried by an SECTION, III — PHYSICAL DAMAGE COVERAGE, insured including portable audio, visual, or electronic B.3.a.Exclusions is amended by adding the following; devices. Personal effects does not include tools, If you have purchased Comprehensive or Collision jewelry, guns, money and securities, or musical Coverage under this policy, the exclusion relating to instruments mechanical breakdown does not apply to the P. EXTRA EXPENSE FOR STOLEN AUTO accidental discharge of an airbag. SECTION III — PHYSICAL DAMAGE COVERAGE, S. NEW VEHICLE REPLACEMENT COST AA. Coverage Extensions is amended by adding The following is added to Paragraph C. Limit of the following-. Insurance of SECTION III — PHYSICAL DAMAGE We will pay up to $1,000 for the expense incurred COVERAGE returning a stolen covered "auto" to you because of In the event of a total "loss" to your new covered the total theft of such covered "auto". Coverage auto of the private passenger type or vehicle having applies only to those covered "autos" for which you a gross vehicle weight of 20,000 pounds or less, to carry Comprehensive or Specified Causes Of Loss which, this coverage applies, we will pay at your Coverage. option: Q. RENTAL REIMBURSEMENT a. The verifiable new vehicle purchase price you SECTION III — PHYSICAL DAMAGE COVERAGE, paid for your damaged vehicle, not including AA. Coverage Extensions is amended by adding any insurance or warranties, the following: lb. The purchase price, as negotiated by us, of a 1. This coverage applies only to a covered"auto"for new vehicle of the same make, model, and which PHYSICAL DAMAGE COVERAGE is equipment, or most similar model available, not provided on this policy, including any furnishings, parts, or equipment 2. We W11I pay for rental reimbursement expenses not installed by the manufacturer or their incurred by you for the rental of an "auto" dealership. 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, CA7450(7.14) Includes copyrighted material of 150 Properties,Inc.with its permission. Page 3 Of 4 DocuSign Envelope ID: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 c. The market value of your damaged vehicle, not WV WAIVER OF TRANSFER OF RIGHTS OF including any furnishings, parts, or equipment not RECOVERY installed by the manufacturer or their dealership. Subparagraph 5.of paragraph A.Loss Conditions of We will not pay for initiation or set up costs associated SECTION IV BUSINESS AUTO CONDITIONS is with a loans or leases, deleted in its entirety and replaced with the following, For the purposes, of this coverage extension a new 5. Transfer of Rights of Recovery Against covered auto is defined as an "auto" of which you are Others to Us the original owner that has not been previously titled If any person or organization to or for whom we which you purchased less than 180 days prior to the make payment under this Coverage Form has date of loss, rights to recover damages from another, those T. LOSS TO TWO OR MORE COVERED AUTOS rights are transferred to us. That person or FROM ONE ACCIDENT organization must do everything necessary to SECTION III — PHYSICAL DAMAGE COVERAGE, secure our rights and must do nothing after D.Deductible is amended by adding the following, accident"or"loss"to impair them, If a Comprehensive, Specified Causes of Loss or However, we waive any right of recovery we Collision Coverage"loss"from one"accident" involves may have against any person, or organization two or more covered "autos", only the highest with whom you have a written contract, deductible applicable to those coverages will be agreement or permit executed prior to the applied to the"accident". "loss" that requires a waiver of recovery for This provision, only applies if you carry payments made for damages arising out of Comprehensive, Collision or Specified Causes of your operations done under contract with such Loss Coverage for those vehicles, and does not person or organization, extend coverage to any covered"autos"for which you X. UNINTENTIONAL FAILURE TO DISCLOSE do not carry such coverage. EXPOSURES U. WAIVER OF DEDUCTIBLE — GLASS REPAIR OR SECTION IV — BUSINESS AUTO CONDITIONS, REPLACEMENT B.2. Concealment, Misrepresentation, or Fraud SECTION III — PHYSICAL DAMAGE COVERAGE, is amended by adding the following: D.Deductible is amended by adding the following: If you unintentionally fail to disclose any exposures If a Comprehensive Coverage deductible is shown in existing at the inception date of this policy, we will the Declarations it does not apply to the cost of not deny coverage under this Coverage Part solely repairing or replacing damaged glass, because of such failure to disclose, However, this V. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, provision does not affect our right to collect SUIT,OR LOSS additional premium or exercise our right of SECTION IV — BUSINESS AUTO CONDITIONS, cancellation or non renewal. A.2. Duties in the Event of Accident, Claim, Suit or Y. MENTAL ANGUISH Loss is amended by adding the following: SECTION V— DEFINITIONS, C. is replaced by the d. Your obligation to notify us promptly of an, following, accident", claim, "suit" or"loss" is satisfied if you "Bodily injury" means bodily injury, sickness, or send us the required notice as soon as disease sustained by a person, including mental practicable after your Insurance Administrator or anguish or death resulting from bodily injury, anyone else designated by you to be responsible :sickness or disease. for insurance matters is notified, or in any manner Z. LIBERALIZATION made aware, of an "accident", claim, "suit" or "loss'", 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, CA7450i(7-14) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 4 of 4 DocuSign Envelope ID: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 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 pWiicy. 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 endorsernent changes the policy to which it is attached and is effective on the date Issued unless otherwise staled. (The information below Is required only when this endorsement is issued subsequent to preparation of the poiicy.) Endorsement Effective 11/4/2014 Policy No. 5H2O546 Endorsement No, Insured TILE RESTORATION, INC. Premium$ Insurance Company EMASCO INSURANCE COMPANY Countersigned by dk44� WC CO 03 13 (Ed. 4-84) Copyright 1983 National Council on Compensation Insurance.