Loading...
HomeMy WebLinkAbout2016-204-E AMS - Tile Restoration Inc. to saniglaze restrooms 114 and 115 at CG DocuSign Envelope ID: BDD226D4-62AD-40CB-ACDA-B1D18954D81A [Departmental Use Only] TITLE Cedar Grove Restrooms FY 2016 ORANGE COUNTY CONTRACT UNDER$15,000.00 NORTH CAROLINA THIS AGREEMENT, made and entered into this I Ith day of April, 2016, ("Effective Date") by and between Orange County, North Carolina, a political subdivision 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: SaniGLAZE Restrooms 114 and 115 in Cedar Grove Community Center, 5800 Highwy 86 North, Hillsborough, as described in provided proposal dated March 25, 2016. The term of this agreement rendered shall be from March 28, 2016 to April 12, 2016. 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 I. 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 three thousand four hundred fifty dollars, ($3,450). 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 County'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 1/16 1 DocuSign Envelope ID: BDD226D4-62AD-40CB-ACDA-B1D18954D81A incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing division/contracts.php). If County's Risk Manager determines additional insurance coverage is required such additional insurance shall consist of (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 County'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 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, its agents, or assigns directly or indirectly related to the Services to be performed pursuant to this Agreement 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. County may suspend this Agreement upon reasonable 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. Priority: In determining the basic services to be provided, should any documents be referenced in or attached to this Agreement, the terms of this Agreement shall have priority in any conflict between the terms 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. 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. By executing this Agreement Provider affirms that Provider is and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. 10. Dispute Resolution: 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 the 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 mediation of any dispute prior to the bringing of such suit or action. 11. 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 1/16 2 DocuSign Envelope ID: BDD226D4-62AD-40CB-ACDA-B1D18954D81A IN WITNESS WHEREOF, County and the Provider have signed this Agreement, effective as of the day first written above. ORANGE COUNTY PROVIDER Docu5igned by: DocuSigned by: bvuVUtt, Lea. trs By: 5 By: ael,�atsn Co y3 fftj ... Title: 87F03CAFAN9i0e. President 200 S. Cameron St. Tile Restoration Inc P.O. Box 8181 119 East Main Street Hillsborough,NC 27278 Hookerton,NC 28538 Revised 1/16 3 DocuSign Envelope ID: BDD226D4-62AD-40CB-ACDA-B1D18954D81A ammonw SaniGLAZE SMARL TOUGH.SEAMLESS.ONFSTEP EPDXY FLOORING., 1 III PoI u1 lilli VI Il�Zhml d VV lil III dl tll mlmllli lil @I Ili IIVI /"..YI 0 Your Flooring ■solution Resource St Nk www.tilerestorationinc.com Plure Peiformanc.e r"' % 1 rnn 119 East Main Street „I bto11111114a Hookerton, INC 28538 Sustafnable Flooring System Phone: 866-327-4600 A product kand of LATUXETE tnternatianal,Inc. IN1010¢ICIVIOI,i Or IHIO IHIO IIIt a Freddy Brooks Phone: 919-245-2636 Date: 3/25/2016 Orange County Public Works Rep.: Brad Albritton 600 Highway 86 North Fax: 919-644 3043 Cell : 252-916-2045 Hillsborough, NC 27278 Email: (brooks @orangecountync.gov Fax: 1-252-376-1452 Email:brada @tilerestorationinc.com Process Cedar Grove Community Center Price 1 SamGLAZE GroutGLAZE Men's 114 and Women's 115 Restroom Floors $3,450.00 Budget Proposal Includes: Cleaning of the and grout surface Prep to grout lines for sealing Application of the SaniGLAZE Grout Resin Color TBD:At job site A Fee of 2.5%will be added for all Credit Card Transactions Terms:Net 20 Days TOTAL $3,450.00 Please Remit All Contracts,PO's and Payments To: Tile Restoration Inc. 119 East Main St PO Box 160 Hookerton NC 28538 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 Ever-GLAZE 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: BDD226D4-62AD-40CB-ACDA-B1D18954D81A DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 11/10/2015 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 CONTACT Beverly ike AAI NAME: y HOE Jake A Parrott Insurance Agency Inc A/c NNo Ext: (252)523-1041 A/C No: (252)523-0195 2508 N HERRITAGE STREET E-MAIL p ADDRESS:b p ike@ arrottins.com PO BOX 3547 INSURER(S)AFFORDING COVERAGE NAIC# KINSTON NC 28502 INSURERA:EMPLOYERS MUTUAL CASUALTY CO 21415 INSURED INSURER B:EMCASCO INSURANCE COMPANY 21407 TILE RESTORATION INC INSURER C: PO BOX 160 INSURER D: INSURER E: HOOKERTON NC 28538-0160 INSURER F: COVERAGES CERTIFICATE NUMBER:CL15103009229 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE A CLAIMS-MADE � OCCUR PREM SESOEa occurrence)l $ 500,000 5D20546 11/7/2015 11/7/2016 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED AUTOS AUTOS 5E20546 11/7/2015 11/7/2016 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident Medical payments $ 5,000 X UMBRELLA LAB OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION$ 5J20546 11/7/2015 11/7/2016 $ WORKERS COMPENSATION PER X OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) 5H2O546 11/7/2015 11/7/2016 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached 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 tcomar @orangecountync.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ORANGE COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 8181 ACCORDANCE WITH THE POLICY PROVISIONS. HILLSBOROUGH, NC 27278 AUTHORIZED REPRESENTATIVE B Pike, AAI/BEVERL ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 rgmnm i DocuSign Envelope ID: BDD226D4-62AD-40CB-ACDA-B1D18954D81A 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 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 A.1.; 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 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 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. CG7174.3(10-13) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 1 of 1 DocuSign Envelope ID: BDD226D4-62AD-40CB-ACDA-B1D18954D81A 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 (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 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 II — LIABILITY COVERAGE, A.1. Who SECTION II — LIABILITY COVERAGE, A.1. 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% 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 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 II — PAYMENTS LIABILITY COVERAGE, Paragraph A.1. Who Is SECTION II — 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 II — 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: BDD226D4-62AD-40CB-ACDA-B1D18954D81A 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 will pay up to $5,000 for "loss" in any one Subparagraph 5. of paragraph B. Exclusions in "accident" to all electronic equipment that SECTION II 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 (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: (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 lease/loan payments at the time private passenger type which is of the same of the"loss"; like kind and quality as the stolen covered b. 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: BDD226D4-62AD-40CB-ACDA-B1D18954D81A 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 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 total theft of a covered O. 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 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 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 A.4. 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 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: BDD226D4-62AD-40CB-ACDA-B1D18954D81A 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 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 cancellation or non-renewal. SECTION IV — BUSINESS AUTO CONDITIONS, Y. MENTAL ANGUISH 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: BDD226D4-62AD-40CB-ACDA-B1D18954D81A COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET WAIVER OF SUBROGATION WHEN REQUIRED IN A WRITTEN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". CG7555(10-13) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 1 of 1 000wSWn Envelope ID: 000uu0o4-6uAo-40Co~^CoA-a1o18854o81A WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT T0 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 opphno 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 tn 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 vvhtLnn contract requiring m waiver of our right to recover from them. moRzo CA8oLzmD 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. 5B20546 Endorsement No, I insured TILE RESTORATION, INC. premium* Insurance Company IMASCO INSURANCE COMPANY counoamignedby VVCO00313 (Ed. 4'84) Copyright 1g8u National Council onCompensation Insurance.