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HomeMy WebLinkAbout2015-195-E AMS - Tile Restoration, Inc. for bathroom floor resurfacing with tile and grout at Link Building $6,200 DocuSign Envelope ID: E5CFB54D-45A2-4A52-A7A0-8998D2AA66F6 [Departmental Use Only] TITLE Link GSC Flooring FY 2015 ORANGE COUNTY CONTRACT UNDER $15,000.00 NORTH CAROLINA ,rHIS AGREEMENT, made and entered into this I s,t day of May, 2015, (Effective 1)ate") by and between Orange County, North Carolina, a body politic and corporate organized under the laws (,-)f tile State ol:'North Carolina, (the "County"), party Ofthe first part; and "file Restoration, Inc (tile "Provider"), party of the second part-, W IT N E S S E T 11: For tile 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 C'011llty in accordance with the terms of this Agreement, tune being of tile essence: The services and/or materials (hereinafter referred to collectively as "Services") to be furnished under this Agreement are as Follows: removal of'contaniination from the and grout surface, prep to grout lines for restoration, and apply nonporous Resin to grout to the following floors in the Link Government Services Centel-: Ground and Upper floors Men's and Women's Restroorns, and the Ground Floor Meeting Room Unisex Restroom, per included proposal elated October 16, 2014 The term of this agreement rendered shall be from May 4, 2015 to May 31, 2015 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 tile satisfaction of tile County. Provider shall be responsible for all errors or omissions, in the performance of the Agreement. Provider shall correct any and all errors, omission, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. Provider agrees that Provider shall not sub-contract any of tile 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 ofthe County. SPECIFIC TERMS I -1Uq ..m�nt: The ounty agrees to pay at tile rates specified for Services satisfactorily performed in accord with this Agreement. The amount to be paid by the County shall not exceed six thousand two hundred dollars, ($6,200). 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 thew ork to be performed until such tirne as said work is completed. 2. Non—waiver-. Failure by County at any time to require the pelforniance by Provider of any of the provisions hereof shall in no way waive or affc-ct the County's right hereunder to enforce the sarne, nor shall any waiver by the County of any breach be held to be a waiver ofany succeeding breach or a waiver of' this Non-Waiver Clause. 3. Indgil 4 _Contractor: The Provider shall operate as all independent contractor and the Cojrlllty' Shall not be responsible for all), of the Provider's acts or omissions. The Provider shall not be treated as all employee with respect to the Services performed hereunder for ficderal or state tax, unemployment or workers' compensation purposes. 'Fhe Provider understands that neither federal, nor state, nor payroll tax of any kind shall be withheld or paid by the County on behalf of tile Provider or the employees of the provider. r e)��Sed 10/1-1 1 DocuSign Envelope ID: E5CFB54D-45A2-4A52-A7A0-8998D2AA66F6 I Insurance: Provider shall obtain, at its sole expense, Corruilercial General Liability Insurance, Automobile insurance, Workers' Compensation 111SUrance, 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 MillifuLlin Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at htV//Qrajjge ). L��q a_& ..........� p If Owner's Risk Manager determines additional insurance coverage is required SUch additional insurance shall consist of nJa(if'no additional insurance required inark N/A as being not applicable), Provider shall not coirtmence work until such insurance is in effect. and certification thereofhas been received by tile Owner's Risk Manager. 5. [tide'i'i"I-P.ijy: The Provider agrees to defend, indemnify, and hold hantiless Orange County frorn all losses, liabilities, claims, demands, suits, costs, damages or expenses (ijacluding reasonable attorney's fees) arising frorn bodily injury, including death, to any person or persons or damage to or destruction of any property caused iti whole or in part by any negligent Or intentional act or omission oil the part of the Provider. 6. 'Termination. ]'his Agreement may be terminated at any tinie by mutual written agreement of the parties or by the COUTIty Upon written notice to the Provider. 7, Entire A-grqgrnent and Sienatures: 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 pat-ties. This Agreement together Nvith 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. P io : In determining the basic services to be provided, should any documents be f...........dty referenced in or attached to this Agreement, the terms herein shall have priority in any conflict between tile terms of referenced documents and the terms of this Agreement, 9. Governing Law: Both parties agree that this Agreement shall be governed by tile laws of tile State of North Carolina. Should either party initiate litigation to settle any diSpUte involving the terms of this Agreernent such litigation shall be initiated in the General Court of Justice of North Carolina seated in Orange County, North C arolina, Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations iricluding but not limited to all anti-discrimination laws. 10, D ,S12 arc Res)t tion: Any and all Suits or actions to enforce, interpret, or seek damages with respect to any provision of, or the perfortnance or non-perforniance of, this Agreement shall be brought in the General C,01.11-t Of Justice of North Carolina sitting, in Orange County, North Carolina., It is agreed by tile 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 mediation of any dispute prior to tile bringing Of Such suit Or action. 11. No _ApprolKiation: Provider acknowledges that County is a governmental entity, and the .............—- validity of this Agreement is based upon (lie availability of public funding under the authority of its statutory mandate. ]it the event that public funds are Unavailable and not appropriated for the performance of County's obligations tinder this Agreement, then this Agreement shall automatically expire without penalty to County, immediately upon written notice to Provider ofthe unavailability and non-appropriation of public funds. ISIGNATTIZE PAGE 'rO FOLLOW] Rcvi,wd 10/14 2 DocuSign Envelope ID: E5CFB54D-45A2-4A52-A7A0-8998D2AA66F6 IN WITNESS WHEREOF,County and the Provider have signed this Agreement,effective as of the day first written above. ORANGE COUNTY PROVEDER By: F�DocuSigned by: DocuSigned by: 61VUW'G (kMwtxs By: 0-4AiltW c6untymmm%tt 87F03CAFAB89478... 200 S. Cameron St. Tile Restoration Inc P.O. Box 8 181 119 East Main Street Hillsborough,NC 27278 Hookerton,NC 28538 Revised 10/14 DocuSign Envelope ID: E5CFB54D-45A2-4A52-A7A0-8998D2AA66F6 ........_ SaniGLAZE TRI,tit, SAW t,G(NJtAA iFdAll[SS.0Xt911B'rCWrP rM49AIMG.. �la Yourrioar1"" 1, 'y�'�, rrr tats Solwtkar 8atatn'ee 4" 7 'sl'�M p p'�`x y .� +k..,yr yw..,� J �ni vvw, r g, tar b-qlUna r4pfl :Y Nm porrtrrimoncu a� Txr 119 East Nta n Street „earn y,,,we xar ur Xaititra' Hookertorn, NC 28536 � SAU.stalnmble Flowing Sysranrr Phone 066-327-4600 Freddy Brooks Phone; 919-245-2636 Date 4/24/2015 Orange County Public Works Rep,: Brad Albritton 600 Highway 86 North Fax: 919-644-3043 Cell: 252-916-2045 HillSbOroligh,NC 27278 Email: fbrooks@oraingec(duntitrrc.gov Fax: 1-252-376-1452 Errraul:bradaC tile'retstoratloniirrc,corn Process 13ascri tirtrt aFArea-Link,Servlces BUllcillng Price I Brida iLAZENv/SaruMA?C IstFlourMen'sanriVNarnnen'sRestFaunas S3,000.00 1 E.nduraGLAZE tv(SaniMAX Ground Floor hegland Women'slteatrooms $2,500.00 1 EnduraG LAZE%v/Sanih9AX Ground Floor Meeting Roodn Unisex ltestroom $700,00 Proposal Inn orie;;; Renaosran of contamination frown tik and groom surface Prep to grout lures for restoration Application ofNwi po¢'otis Resrii-C"rataad`l'ltl --C7lAS k orlv9 isty tSrey Application o1 topical Scaler`aanilwl AX A Fee o(2.5%with be acFdeci dur Fall Cnydc i Card Transactions Terms:Not 20 Days' TOTAL $0,200.00 Please Renrit Alt Contracts,]i and Paynrents'Fri: Fill ltestoratlon Inc. 1t0East Mal it'St P01Ray. 160 t'lool rrton NC:285;t8 Proposal Valid for 30 Days Delivery to Job,Sales Tax and installation are ftluded. All sermcas guaranteed as spedlfrid, Ail words:to be complain in a worFinan9iire r'rwnner ac doing la slandmird p ararces.Any dilatation or devil align from this prepaid lirm"l redra ceTai2 will he nracns@ed only upre w'rbon orders,and will bonorne an el cduarge Hoar al aberva tie psrcraos.7G. AA aaurae nis ccndfragant uymmr ehrMr3a, accicdlamats urrt+a¢axys beyoubc,cxntkac'A.(,?w'ri a lucarvy tyre,tormasdo and c0rW necessalyinsrrlanru'e Our workers ate teyty covered by Workman's Compansaton insurance. Em96e ica ci Insur�tince wMl9 be provided upon re luast,.Any spacial requirerAV.rn4w or endorsements pray, l�nraar basil charges, 'si do not waive any rights oll sistiogation optimal rantrrclor or crwaar for any loss covenad by�nsurrl of any type. At T'i'le Reatamadrin urr+acns etl¢ure a nonllrrnrrrr oa 72 More fire oercra llrey can tae exposed to arrornlrnnm if drpa tr�dlne 8s rtiol ad'S'worardl to doe oustrxmar ta.�as A.dl responsibrrddy for any darnageor poIcirnM ce Issues that may,remitt 5n,nMrit.F 1 P.,ftrwPury 5erv111,—nani d.amP W r;rrwredd rlmWd a,,aul wwvNenamshirr awM narXUU l bld A.ildy ns t-g wa aua il P,.W as as pr—led h I—p narE in th.cood.q rnadntanaxpxa.¢:aazuxa Currparaxd odor.'""IN shwa'trxammnl nr.gAlxl olarn�ti C-rpansai rruatmrgaL C.i..xppl4ed, d..rmp"!'vmry drptndixa ae mianud'.a-L W.,ril and W er d'aGlrnx.•• TO.Rastooity t Ml oly.nll plr—1 P to prrarrvcr addxrlehp liow,a,wrdls,mvalm44 tr"W.hoa—Paamre IN adrwenVmalm.My dmmmga Irld mny rae,.aur tram cnrdaat hamxmmimr mod dammiswd K,.4 edam r.ryxraru itltky d"71.RralarrMy'.Ina.amid dl.'Awfl.Any rdrandlna.ax nddatdaarmr—A rrpdrnd ae raAnxuata9 by M.aw 1,At hm Mama M sn arAdaonal arras.and urarml bn xw(arn.t hcantrydwa Tree Rnaruld.s Pea.mu Wi-1 an dm era.xadr xpxaad ird arvd pi.4 tom mxda ax ounnad crbwxa,. SwailaaAx Rdyraam C.A119 PlwidoA o as Manih(a ymwe) V.wmrrnnay.prpdoad.d3 wme"qd Aprwkw oth firma and ma.rmdive era f--gNamvd orrocm M.,DU%and Coal tramdi mn sus"Istw area lnxtaaimd,.Inl m.ppnt 4044 warmanry Tell AN r.per mr wnnra ammo at In wd.rrxrat I... prcqumaty nuacA..w.afr,airs its,px+ramitio.d the Mail crMma.,'. C.aanna has mmr b to aFnht.al.Is aI dxntt,elmaena a alruxa 0 a.ndr a cha",mr a4dl mrrr ar nvC,daa m. 1wi v IRm ty rd tiaraugpYr myxitan xxuAarx.,) 'yrro vtarrantp doss not cnwar m ooa6na tlut ham*tti lm.d t.1—d„dadbsed,.*nod raphl,,anode x.1tripledr q a1w, r'Rd"M am Will awdy-da'adlinwMiot Adtlrtn I",(a't)darn of rvot iasvaladae ad daraa�A cy mma^a ar r.?a�U.t. rFrd o atiu nmca am aha1....l 1.lite.by virru,a ar Ihls xr .-Iy ao arharvNaa fo damaaa la wy pi,,—na paptrT,whaASn—hoe anw pWar,Mnel ii.o r4acy n cxnoi,o—tar Saanmym d-y roue aahn ua.a 0 In.Ullry ra use rre,c,—al vi rr*4l,0.o delq,t DocuSign Envelope ID: E5CFB54D-45A2-4A52-A7AO-8998D2AA66F6 - 0 1� .�, 111 . ERTIFICAT OF LE ILITY IVSURAN� E 1 /30/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S 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, ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the Ipolicy(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 N�MNM CT Beverly Pike, AAI Jake A Parrott Insurance Agency Inc PHONE C 2)S23�-1041 axc Na lzsaasx cams 2508 N HERRITAGE STREET A"0ApL .bpike@parrottins.com PO BOX 3547 1!1Lt RE s AFFORDING COVERAGE .... _..... NAIC N Rl_)... .... KINSTON NC 28502 INSURERA EMPLOYERS MUTUAL CASUALTY CO 1415 INSURED INSURERB:EMASCO INSURANCE COMPANY 21407 TILE RESTORATION INC INSURER C; _.__..........._._ _.........._. .... .........._._ _....._ ......... C/O ALBRITTON CO INSURER D: PO :BOX 160 INSURER.E t OOKERTON NC 28538-0160 1 INSURER IF: COVERAGES CERTIFICATE NUMEIMCL14102908345 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 CONDITIION OF ANY CONTRACT OR OT'I4ER DOCUMENT WITH RESPECT TO "WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICTS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLUCIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN$k °°..- .-�_.__ ......... ......__._..._._m._.._.._.__ R- POLICY EFF POLICY EXP_ .__. LTR TYPE of INSURANCE POLPCY NUMBER MMA1Dr7/YYYY MMItDD1YYYY LIMITS GENERAL UARRUTY EACH CCCURRENCE $ 1,000,000 E'Fivl �T _....._ X COMrwr7L:FG<IM GENERAL UARIrNTY FREIV*ES IEgpggaeCS"aIL $ 500,000 p rArS.MALF .. ._�OCCUR sr2DS46 11/7/2014 1/7/2015 A VEDEM (ArymrtAperson) $ _ 1.0,0_00 ._........ Iyr RFtNAL.A¢ry INJURY _1,000„000' aaEIaERALA,eTcw,REaATE 5 2,000,000 C'E t AGGREGATE UMIT APPUES PER PRODL CIS-COM.PIOR ACs(.,a $ 2,000,000 P LIcCv X I I I Ds- AUTOMOBILE LIABILITY lM'OM81NE.D SIN(3LF LtlWT 000 A ANY AUTO BOLI JI Y NNJURY IPer persorrl $ ALL OWNED ......� SCHEDULED SE20546 1/7/2414 1./7/2415 SODILY NNJUJRY IPeraacddent) $ AUTOS AUTOS NLIN4.bNNEL PR Prf rrI';r aI C.E.... .............. ....._.,..m ..._...._ .._... HIRED AUTOS .,..............AUTOS' 1ELD.q.�t aLi u $ -1-Meth al n rnents _� .2 000 X UMBRELLA UAB OCCUR EACH OCCURRENCE $ ,000,000 EXCESS LIAB CLAIM$ManADE,' AC'C RE4 ATE $ 2,000,00 O DED RLTENrroN$ 5,7220546 11f7/2tJ1.4 1J7J2a15 $ WORKERS COIMPENSA-I OIV X 'J'u`C 5'Pfe'fkJ , +CTtR ANY PROPRUETOWFAR�NERrEXEC EXECUTIVE YIN m�,., R$ 41546.. ',1/4f217."J.4. 11/d/2e15 8",.;tl_.:.G.A.HYPWCCn,"�ENT.. ...Ef3.�.� __.. AND EMPLOYERS'LIABILITY OFRF-ER/MEPM8LR EXCLUDECi7 Y N1 ..._ I 0m00-1-000 (Mandatory in NH) E.L.LISP 5Em::..C:Am FIM PLOY E E $ 1 CS00,000 ..NIF SCRI e"esf QN under F OPERA FUNS below_.._w..._._..''... .........____ ..... ..... ........._........... ....,_...,,_ .__....�,',. ___...... ..E':.L [Y0 rI�.ASE-POLICY LVIMIT !� 1,000,000� DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additlortal Remarks schedule,it rnore 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ORANGE COUNTY ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 8181 HILLSBOROUGH, NC 2 7278 AUTHORIZED REPRESENTATIVE Allen Parrott/"LEANFTU ACORD 25(2010/05) On 1988;2010 ACORD CORPORATION. All rights reserved. INSn7 a�,,nlr,Ifi+', nl Tho Arrtpn mama oral Ir nn area rank#marl mark.of Al'r(*)Pn DocuSign Envelope ID: E5CFB54D-45A2-4A52-A7A0-8998D2AA66F6 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 additional 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 "bodily 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 injury", 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 AA.; 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 will not seek provide for such additional insured, contribution from any other insurance available to 13� 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 architectural, 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, (10-13) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 1 of 1 DocuSign Envelope ID: E5CFB54D-45A2-4A52-A7A0-8998D2AA66F6 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 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 (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 under 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 "accident" that occurred before you formed The coverage provided is the same as the or acquired the organization, coverage provided for the vehicle being replaced. E. SUBSIDIARIES AS INSUREDS B. BLANKET ADDITIONAL INSURED SECTION 11 — LIABILITY COVERAGE, A.1. 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 legally incorporated subsidiary in which you Any person or organization who is a party to a own more than 50% of the voting stock on the written agreement or contract with you in which you effective date of this policy. However, "insured" agree to provide the type of insurance afforded does riot 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 A.1. Who Is SECTION If — 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 iiin (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.11. Who (4) All reasonable expenses incurred by the Is An Insured is amended by adding the following: "insured" at our request, including actual loss of Any organization which you acquire or form after earnings up to $500 a clay 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: E5CFB54D-45A2-4A52-A7A0-8998D2AA66F6 G. FELLOW EMIPLO,YEE 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 adde& form, we will pay up to $5,000 for"loss" in, any one Subparagraph 5. of paragraph B. Exclusions in "accident' to all electronic equipment that SECTIONI 11 LIABILITY COVERAGE does not reproduces, receives, or transmits audio, visual or apply if the "bod0y 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 1111 — 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 clisabledv 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 (3) 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 $1,000, 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: (11) 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 a. Overdue lease/loan payments at the time the amount it costs to rent an "auto" of the of the""loss"; passenger type which is of the same like kind and quality as the stolen covered b. Financial penalties imposed under a lease 1°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. P,age 2 o14 DocuSign Envelope ID: E5CFB54D-45A2-4A52-A7A0-8998D2AA66F6 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 Iby 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 b, $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 while there are "auto"s" collision 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 totali 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 AA. Coverage Extensions is amended by adding not already provided for 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 policy 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. "loss". R. AIRBAG COVERAGE For the purposes of this extension personal effects means tangible property that is wom 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 A.A. 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 20,0100 pounds or (less, to carry Comprehensive or Specified Causes Of Loss which this coverage applies, we will pay at your Coverage. option-, O. RENTAL REIMBURSEMENT a. The verifiable new vehicle purchase price you SECTION III — PHYSICAL DAMAGE COVERAGE, paid for your damaged vehicle, not including A.4. Coverage Extensions is amended by adding any insurance or warranties, the following: b. 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 will 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 ISO Properties,Inc.with its permission. Page 3 of 4 DocuSign Envelope ID: E5CFB54D-45A2-4A52-A7A0-8998D2AA66F6 c. The market value of your damaged vehicle, not W. WAIVER OF TRANSFER OF RIGHTS OF including any furnishings, parts, or equipment not RECOVERY installed by the manufacturer or their dealership. Subparagraph S.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 folloWng. For the purposes of this coverage extension a new S. 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, 1.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 8.2. 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 cancellation or non-renewal. SECTION IV — BUSINESS AUTO CONDITIONS, Y. MENTAL ANGUIISH A.2. Duties in the Event of Accident, Claim, Suit or 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, CA7450(7-14) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 4 of 4 DocuSign Envelope ID: E5CFB54D-45A2-4A52-A7A0-8998D2AA66F6 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 JEd. 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, NORT14 CAROLINA This endorsement changes the policy to which it is attached and is effective an the date issued uniess otherMse stated. (The information below is required only when this endorsement is Issued subsequent to Preparation of the p*llcy,) Endorsement Effective 11/4/2014 Poficy No, 5FI20546 Endorsement No, insured TILE RESTORATION, INC. Premium$ Insurance Company EMASCC) INSURANCE CoMpANy Countersigned by dX44�-JUt,4 '` WC 00 03 13 (Ed. 4-84) Copyright 1963 National Council on Compensatuon Insurance.