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HomeMy WebLinkAbout2019-069-E AMS - TRI Solutions Seymour Center re-coat DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD [Departmental Use Only] TITLE Seymour-Grnd-Re-Coat FY 2019 ORANGE COUNTY CONTRACT UNDER $5,000.00 NORTH CAROLINA THIS AGREEMENT, made and entered into this 9th day of February, 2019, ("Effective Date")by and between Orange County, North Carolina, a body politic and corporate organized under the laws of the State of North Carolina, (the "County"), party of the first part; and TRI Solutions Inc dba Tile Restoration (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 and/or construction (hereinafter referred to collectively as "Services") to be furnished under this Agreement are as follows: ground floor re-coat of common, Recreation and Cafe floors in the Seymour Center, 2551 Homestead Road, Chapel Hill, as detailed in November 25, 2018 proposal, included. The term of this agreement rendered shall be from Febraury 9,2019 to March 31,2019. Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions, in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. Provider agrees that Provider shall not sub-contract any of the services to be provided in this Agreement, nor shall Provider assign any right or responsibility granted or required by this Agreement,without the prior written approval of the County. SPECIFIC TERMS 1. Pam: 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 four thousand eight hundred dollars, ($4,800). 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 Revised 12/18 1 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD 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 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 be designated here (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. Indemni : The Provider agrees,without limitation,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 in carrying out Provider's duties and obligations related to the Services to be provided in this Agreement. 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 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. Modifications may be evidenced by telefacsimile signature. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the parties to comply with Article I IA and Article 40 of North Carolina General Statute Chapter 66. 8. Governing Law and Priority: Both parties agree that this Agreement shall be governed by the laws of the State of North Carolina and Orange County. 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 state and federal anti-discrimination laws, policies, rules, and regulations and the Orange County Non- Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.oran.eg c�tync. og v/departments/purchasing division/contracts.php.). Any violation of this requirement is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. By executing this Agreement Provider affirms Provider is and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. In determining 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 terms of referenced documents and the terms of this Agreement. 9. Dispute Resolution: Neither party may initiate binding arbitration. Any disputes shall be resolved by nonbinding mediation. If such mediation fails either party may initiate litigation to resolve the dispute. 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. Revised 12/18 2 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD 10. Non Appropriation: Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable and not appropriated for the performance of County's obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability and non-appropriation of public funds. IN WITNESS WHEREOF,Orange County and the Provider have signed this Agreement, effective as of the day first written above. ORANGE COUNTY PROV]rnFR UocuSigned by: UocuSigned by: By: 96JA, P6V�►aiaan. By: A4,& 0.�r�.i�an.. ' 21EF373 454 F-.- Tltle: 87F03CAFA689478--- t,..�..a...a�.�..�......,� - -- - - -- --- 200 S. Cameron St. TRI Solutions Inc dba Tile Restoration P.O. Box 8181 119 East Main Street Hillsborough,NC 27278 Hookerton,NC 28538 Revised 12/18 3 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD TRI ■M Your Flooring ON Solution Resource Tile Restoration Inc 119 East Main St, Hookerton,North Carolina 28538 Phone.2527472821 Fax: 252-376-1452 Freddy Brooks Date: 11/25/2018 08:44 AM Orange County Public Works Phone:919-245-2636 Fax:919-644-3043 Rep.: Brad Albritton 600 Highway 86 North Email:fbrovks@orangecountync.gov Cell;252-916-2045 Hillsborough, NC 27278 Email:brada@tilerestorationine.com Ground Floor - Re-coat Common, Recreation and Cafe Floors Units Process Description of Area Price Per Price 1 460 Ultra Durable Epic Epic Urethane Application-Hallway and Area to left of the $750.00 $750.00 Urethane stairwell 1 460 Ultra Durable Epic Epic Urethane Application-Cafe Floor and Hallway next to $ 1,5%00 $ 1,550.00 Urethane kitchen 1 460 Ultra Durable Epic Epic Urethane Application-Recreation Area $2,500.00 $2,500.00 Urethane Seymour Center Proposal Includes: Prep Sand, Clean Epic Urethane Application of Epic Urethane Finish with non slip additive Project can be separated into multiple mobilizations if needed. Sub Total $4,800.00 50%of Proposal Due Before Work is Scheduled Deposit Due SUT $360.00 Terms:Net 20 Days Total $5,160.00 A fee of 3%will be added for aif all Credir Card fransacdons Please Remi[Al1 Contracts,PO's and Payments To: Tile Restoration Inc.119 East Main St Po Box 160 Hookerton NC 28538 Proposal Valid for 30 bays Delivery to Job,Sales Tax and Installation arc 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 writicn orders,and will become an extra charge over and above the proposal. A11 agreemems contingent upon strikes,accidents or delays beyond our control.owner to carry Are,tornado and other necessary insurance. Our workers arc 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 or subrogation against contractor or owner for any loss covered by insurance of any W. All Tile Restoration services require a minimum of 72 of cure lime 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_'Epoxies chalk and yellow with age,extended exposure to UV and artificial lighting.Lack of ventilation,incomplete mixing,miscataly7ation or the use or heaters that emit carbon dioxide and carbon monoxide during application and initial stages of curing may cause amine blush,possibly affecting adhesion of subsequent topcoats. TRI marketing will send periodic email communication informing you of various service offerings. At any time you wish to stop receiving this information you may opt out from within the email received or contact our office. ••Tile Restoration will take all precaution to protect adjoining flooring,Aral Is.materials etcetera from exposure to water and/or chemicals.Any damage that may occur from contact from water and/or chemical is not zhc respon s ibi Iiry or Ti It.Restoration Inc.and its staff.Any eh angcs or additional work requ ircd or requested by the owner,will be done at an additional charge and must be written.1 hereby give Tile Restoration Inc.authorization to do the work specified and payment will be made as outlined above DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD ACO CERTIFICATE OF LIABILITY INSURANCE °"02105/05lM201918 THIS CERTIFICATE 13 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 certificats holder Is an ADDITIONAL INSURED,the pollay(les)must have ADDITIONAL INSURED provisions or be endorsed. R SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate doss not confer rights to the certificate holder in lieu of such andomement(s). CONTACT PRODUCER NAME, Jake A Parrott Insurance Agency Inc PHONE , (252)523-1041 lee: (252)623-0145 2508 N HERRTTAGE STREET ADDRESS: adavis@parrottins.com PO BOX 3547 INSURER(S)AFFORDING COVERAGE NAIL KINSTON NC 28502 INSURER A: EMPLOYERS MUTUAL CASUALTY CO 21415 NSIIREO IN,uRm e: ACCIDENT FUND INSURANCE CO OF AMERICA 10166 TRI SOLUTIONS,INC DBA TILE RESTORATION INSURER C: P O BOX 100 INSURER D: HOOKERTON NC ZMM160 INSURER E: NSURER F COVERAGES CERTIFICATE NUMBER. 19120 MASTER 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 RESPECTTO 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. LTR TYPE OF INSURANCE vivo POLICY NUMBER (MWQWYYYYI 9AKIDWYYYY11 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,0D0,D00. DAMAGE 170-REITI= CMS-MADE ® MI rre OCCUR PREMISES Eaxance $CLAIMS-MADE MED FXP(Any one Person) $ 10,D00. A Y Y 5DB6997 01/01/2019 01/01/2020 PERSONAL&ADV INJURY $ 1,000'000. GENL AGGREGATE UMITAPPLIESPER: GENERAL AGGREGATE $ 2,W0,00D. ®PRO-JECT ❑LOC PRODUCTS-COMPIOPAGG $ 2'�'�' POLICYt OTHER AUTOMOBILE LIABILITY �MBIr.SINGLE LIMIT s 1,000,000. ANY AUTO BODILY INJURY(Per person) S A OWNED SCHEDULED Y Y 5ES6997 01/01/2019 01/01/2020 BODILY INJURY(Per aaideMll i AUTOS ONLY AL703 HIRED NON-OWNED PROPERTY DAMAGE s AUTOS ONLY AUTOS ONLY Per eorJdarrt s UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,00D, A EXCESS LIAB CLAIMS-MADE 5JB6997 01/0112019 0110112020 AGGREGATE $ 2,000,000, DED I I RETENTION$ 11 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LJABILlTY YIN STATUTE ER ANY PROPRIErORIPARTNIMEXECUTDE04 N NIA Y WCV6152738 11107l2018 11l0712019 E E.L.EACH ACCIDENT $ 1,000,000 B OFFICERIMEMBER EXCLU (Yamw"yInNH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1'000,D00 CatastrophelJobsits Limit $57,000. INLAND MARINEIINSTALLATION A FLOATER 5C86997 01/01/2019 01/01/2020 Deductible 500. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddNlmml Remarks Schedule,may be nmwtwd N mwe apace Is required) ORANGE COUNTY IS LISTED AS AN ADDITIONAL INSURED AS PERTAINS TO GENERAL LIABILITY,ON A PRIMARY&NON-CONTRIBUTORY BASIS,INCLUDING PRODUCTS&COMPLETED OPERATIONS,VIAA WRITTEN CONTRACT IN PLACE WITH THIS REQUIREMENT INCLUDED. ORANGE COUNTY IS LISTED AS AN ADDITIONAL INSURED AS PERTAINS TO AUTO LIABILITY,VWA 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,VIAA 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 AUTHORED REPRESENTATIVE HILLSBOROUGH INC 27278 ajsq k {lid Q 19SB-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO ELITE EXTENSION 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 C. EMPLOYEES AS INSUREDS DAMAGE The following is added to the Section 11—Covered Section I —Covered Autos Paragraph C. Certain Autos Liability Coverage, Paragraph A.I.Who Is Trailers, Mobile Equipment, and Temporary An Insured provision: Substitute Autos is amended by adding the Any"employee"of yours is an"insured"while using following: a covered "auto" you don't own, hire or borrow in If Physical Damage Coverage is provided by this your business or your personal affairs. coverage form for an "auto" you own, the Physical D. EMPLOYEE HIRED AUTOS Damage Coverages provided for that owned "auto" are extended to any "auto" you do not own 1. Changes In Covered Autos Liability while used with the permission of its owner as a Coverage temporary substitute for the covered "auto" you The following is added to the Who Is An own that is out of service because of breakdown, Insured provision: repair, servicing,"loss"or destruction. An "employee" of yours is an "insured" while The coverage provided is the same as the operating an "auto" hired or rented under a coverage provided for the vehicle being replaced. contract or agreement in an "employee's" B. AUTOMATIC ADDITIONAL INSUREDS name, with your permission, while performing duties related to the conduct of your business. The Who Is An Insured provision under Covered 2. Changes In General Conditions Autos Liability Coverage is changed to include the following as an'insured": Paragraph 5.b. of the Other Insurance Condition in the Business Auto Coverage Form 1. Where Required by a Contract or Agreement is replaced by the following: the following is added: For Hired Auto Physical Damage Coverage,the The Who Is An Insured provision contained in the following are deemed to be covered "autos" Business Auto Coverage Form is amended to you own: add the following: a. Any covered "auto" you lease, hire, rent or Any person or organization whom you become borrow;and obligated to include as an additional insured under b. An covered "auto" hired or rented by your this policy, as a result of any contract or agreement "employee" under a contract in an you enter into which requires you to furnish "employee's" name, with your permission, insurance to that person or organization of the type while performing duties related to the provided by this policy, but only with respect to liability covered by the terms of this policy, arising conduct of your business. out of the use of a covered "auto" you own, hire or However, any"auto"that is leased, hired, rented or borrow and resulting from the acts or omissions by borrowed with a driver is not a covered"auto". you, any of your "employees" or agents. The E. NEWLY FORMED OR ACQUIRED insurance provided herein will not exceed: ORGANIZATIONS (1) The coverage and/or limits of this policy, or Section II — Covered Autos Liability Coverage, (2) The coverage and/or limits required by said A.1.Who Is An Insured is amended by adding the contract or agreement, following: whichever is less. CA7450(11-17) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 1 of 5 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD Any organization which you acquire or form after I. TOWING the effective date of this policy in which you Section III -- Physical Damage Coverage, A.2. maintain ownership or majority interest. However: lowing is replaced with the following: (1) Coverage under this provision is afforded only We will pay for towing and labor costs incurred, up to 180 days after you acquire or form the subject to the following: organization, or to the end of the policy period, whichever i5 earlier. a. Up to $100 each time a covered "auto" of the private passenger type is disabled; or (2) Any organization you acquire or form will not be b. Up to $500 each time a covered "auto" other considered an"insured"if: than the private passenger type is disabled. (a) The organization is a partnership or a joint venture; or However, the labor must be performed at the place (b) That organization is covered under other L disablement. J L similar insurance. LOCKSMITH SERVICES (3) Coverage under this provision does not apply Section III — Physical Damage Coverage, A.4. to any claim for "bodily injury" or "property Coverage Extensions is amended by adding the damage" resulting from an "accident" that following: occurred before you formed or acquired the We will pay up to $250 per occurrence for organization. necessary locksmith services for keys locked inside F. SUBSIDIARIES AS INSUREDS a covered private passenger "auto". The deductible is waived for these services. Section II — Covered Autos Liability Coverage, A.1.Who Is An Insured is amended by adding the K. TRANSPORTATION EXPENSES following: Section III — Physical Damage Coverage, A.4. Any legally incorporated subsidiary in which you Coverage Extensions Subparagraph a. own more than 50% of the voting stock on the Transportation Expenses is replaced by the effective date of this policy. However, "insured" fallowing: does not include any subsidiary that is an "insured" (1) We will pay up to$75 per day to a maximum of under any other automobile liability policy or was an $2,500 for temporary transportation expense "insured" under such a policy but for termination of incurred by you because of the total theft of a that policy or the exhaustion of the policy's limits of covered "auto" of the private passenger type. liability. We will pay only for those covered "autos' for G. SUPPLEMENTARY PAYMENTS which you carry either Comprehensive or Specified Cause Of Loss Coverage. We will Section II — Covered Autos Liability Coverage, pay for temporary transportation expenses A.2.a. Coverage Extensions. Supplementary incurred during the period beginning 48 hours Payments (2) and (4) are replaced by the after the theft and ending, regardless of the following: policy's expirations, when the covered "auto" is (2) Up to $5,000 for cost of bail bonds (including returned to use or we pay for its"loss". bonds for related traffic law violations) required (2) If the temporary transportation expenses you because of an "accident" we cover. We do not incur arise from your rental of an "auto" of the have to furnish these bonds. private passenger type, the most we will pay is (4) All reasonable expenses incurred by the the amount it costs to rent an "auto" of the "insured"at our request, including actual loss of private passenger type which is of the same earnings up to $500 a day because of time off like kind and quality as the stolen covered from work. "auto". H. FELLOW EMPLOYEE COVERAGE L. AUDIO, VISUAL, AND DATA ELECTRONIC In those jurisdictions where, by law, fellow EQUIPMENT COVERAGE ADDED LIMITS employees are not entitled to the protection Audio, Visual, And Data Electronic Equipment afforded to the employer by workers compensation Coverage Added Limits of$5,000 Per"Loss"are in exclusivity rule, or similar protection. The following addition to the sublimit in Paragraph C.i.b. of the provision is added: Limits Of Insurance provision under Section III — Subparagraph S. of Paragraph B. Exclusions in Physical Damage Coverage. Section II — Covered Autos Liability Coverage M. HIRED AUTO PHYSICAL DAMAGE does not apply if the "bodily injury" results from the Section III — Physical Damage Coverage, A.4. use of a covered"auto"you own or hire. Coverage Extensions is amended by adding the following: C.A7450(11-17) Includes copyrighted material of 180 Properties,Inc.with its permission. Page 2 of 5 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD If hired "autos" are covered "autos" for Liability O. PERSONAL PROPERTY OF OTHERS Coverage, and if Comprehensive, Specified Section 111 — Physical Damage Coverage, A.4. Causes of Loss, or Collision coverage is provided Coverage Extensions is amended by adding the for any"auto" you awn, then the Physical Damage following: coverages provided are extended to "autos" you We will pay up to$500 for loss to personal property hire, subject to the following limit and deductible: of others in or on your covered"auto." (1) The most we will pay for loss to any hired This coverage applies only in the event of"loss" to "auto" is the lesser of Actual Cash Value or your covered "auto" caused by fire, lightning, Cost of Repair, minus the deductible. explosion, theft, mischief or vandalism, the covered (2) The deductible will be equal to the largest "auto's"collision with another object, or the covered deductible applicable to any owned "auto" for "auto's"overturn, that coverage. No deductible applies to "loss" No deductibles apply to this coverage. caused by fire or lightning. (3) Subject to the above limit and deductible P. PERSONAL EFFECTS COVERAGE provisions, we will provide coverage equal to Section III — Physical Damage Coverage, A.4. the broadest coverage applicable to any Coverage Extensions is amended by adding the covered"auto"you own. following: We will pay up to$1,000, in addition to the limit We will pay up to $500 for "loss" to your personal above, for loss of use of a hired auto to a effects not otherwise covered in the policy or, if you leasing or rental concern for a monetary loss are an individual, the personal effects of a family sustained, provided it results from an"accident" member, that is in the covered auto at the time of the for which you are legally liable. "loss". However, any"auto"that is leased, hired, rented or For the purposes of this extension personal effects borrowed with a driver is not a covered"auto". means tangible property that is worn or carried by an insured including portable audio, visual, or electronic N. AUTO LOAN OR LEASE COVERAGE devices. Personal effects does not include tools, Section III — Physical Damage Coverage jewelry, guns, money and securities, or musical Paragraph A.4. Coverage Extensions is amended instruments by the addition of the following: Q. EXTRA EXPENSE FOR STOLEN AUTO In the event of a total "loss" to a covered "auto" Section III — Physical Damage Coverage, A.4. which is covered under this policy for Coverage Extensions is amended by adding the Comprehensive, Specified Cause of Loss, or following: Collision coverage, we will pay any unpaid amount We will pay up to 51,000 for the expense incurred due, including up to a maximum of $500 for early returning a stolen covered "auto" to you because of termination fees or penalties, on the lease or loan the total theft of such covered "auto". Coverage for a covered"auto", less: applies only to those covered "autos" for which you 1. The amount paid under the Physical Damage carry Comprehensive or Specified Causes Of Loss Coverage Section of the policy; and Coverage. 2. Any: R. RENTAL REIMBURSEMENT a. Overdue lease/loan payments at the time Section III — Physical Damage Coverage, AA. of the"loss"; Coverage Extensions is amended by adding the b. Financial penalties imposed under a lease following: for excessive use, abnormal wear and tear 1. This coverage applies only to a covered"auto"for or high mileage; which Physical Damage Coverage is provided C. Security deposits not returned by the on this policy. lessor; 2. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" d. Costs for extended warranties, Credit Life because of"loss' to a covered "auto". Payment Insurance, Health, Accident or Disability applies in addition to the otherwise applicable Insurance purchased with the loan or lease; amount of each coverage you have on a covered and "auto".No deductibles apply to this coverage. e. Carry-over balances from previous loans or 3. We will pay only for those expenses incurred leases. during the policy y period beginning 24 hours Coverage does not apply to any unpaid amount after the "loss" and ending, regardless of the due on a loan for which the covered "auto" is not policy's expiration, with the lesser of the the sole collateral. following number of days. CA7450(11-17) Includes copyrighted material of ISO Properties,Inc.with its permission. Page 3 of 5 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD a. The number of days reasonably required to For the purposes of this coverage extension a new repair or replace the covered "auto'. If covered auto is defined as an"auto'of which you are "loss" is caused by theft, this number of the original owner that has not been previously titled days is added to the number of days it which you purchased less than 180 days prior to the takes to locate the covered "auto' and date of loss. return it to you; or U. LOSS TO TWO OR MORE COVERED AUTOS b. 30 days. FROM ONE ACCIDENT 4. Our payment is limited to the lesser of the Section III — Physical Damage Coverage, D. following amounts: Deductible is amended by adding the following: a. Necessary and actual expenses incurred; If a Comprehensive, Specified Causes of Loss or or Collision Coverage"loss"from one"accident"involves b. $75 per day, subject to a$2,250 limit. two or more covered "autos", only the highest deductible applicable to those coverages will be 5. This coverage does not apply while there are applied to the"accident". spare or reserve "autos" available to you for If the application of the highest deductible is less your operations. favorable or more restrictive to the insured than the 6. If"loss" results from the total theft of a covered separate deductibles as applied in the standard form, "auto" of the private passenger type, we will the standard deductibles will apply. pay under this coverage only that amount of This provision only applies if you carry your rental reimbursement expenses which is Comprehensive, Collision or Specified Causes of not already provided for under the Physical Loss Coverage for those vehicles, and does not Damage — Transportation Expense Coverage extend coverage to any covered"autos"for which you Extension included in this endorsement. do not carry such coverage. 7. Coverage provided by this extension is excess V. WAIVER OF DEDUCTIBLE — GLASS REPAIR OR over any other collectible insurance and/or REPLACEMENT endorsement to this policy. Section III — Physical Damage Coverage, D. S. AIRBAG COVERAGE Deductible is amended by adding the following: Section III — Physical Damage Coverage, B.3.a. If a Comprehensive Coverage deductible is shown in Exclusions is amended by adding the following: the Declarations it does not apply to the cost of If you have purchased Comprehensive or Collision repairing or replacing damaged glass. Coverage under this policy, the exclusion relating to W. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, mechanical breakdown does not apply to the SUIT,OR LOSS accidental discharge of an airbag. Section IV — Business Auto Conditions, A.2. T. NEW VEHICLE REPLACEMENT COST Duties In The Event Of Accident, Claim, Suit Or The following is added to Paragraph C. Limit Of Loss is amended by adding the following: Insurance of Section III — Physical Damage Your obligation to notify us promptly of an "accident", Coverage claim, "suit" or "loss" is satisfied ff you send us the In the event of a total"loss"to your new covered auto required notice as soon as practicable after your of the private passenger type or vehicle having a Insurance Administrator or anyone else designated by gross vehicle weight of 20,000 pounds or less, to you to be responsible for insurance matters is notified, which this coverage applies, we will pay at your or in any mariner made aware, of an"accident",claim, option: "suit"or"loss". a. The verifiable new vehicle purchase price you X. WAIVER OF TRANSFER OF RIGHTS OF paid for your damaged vehicle, not including any RECOVERY insurance or warranties. Subparagraph 5. of Paragraph A. Loss Conditions b. The purchase price, as negotiated by us, of a of Section IV — Business Auto Conditions is new vehicle of the same make, model, and deleted in its entirety and replaced with the following. equipment, or most similar model available, not Transfer Of Rights Of Recovery Against Others including any furnishings, parts, or equipment not To Us installed by the manufacturer or their dealership. If any person or organization to or for whom we c. The market value of your damaged vehicle, not make payment under this Coverage Form has including any furnishings, parts, or equipment not rights to recover damages from another, those installed by the manufacturer or their dealership. rights are transferred to us. That person or We will not pay for initiation or set up costs associated organization must do everything necessary to with a loans or leases. secure our rights and must do nothing after "accident"or"loss"to impair them. CA7450(11-17) Includes copyrighted material of 160 Properties,Inc,with its permission. Page 4 of 5 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD However, we waive any right of recovery we may Z. MENTAL ANGUISH have against any person, or organization with Section V •- Definitions, C. is replaced by the whom you have a written contract, agreement or following: permit executed prior to the "loss" that requires a •goply injury' means bodily injury, sickness or waiver of recovery for payments made for damages disease sustained by a person, including mental arising out of your operations done under contract anguish or death resulting from bodily injury, sickness with such person or organization. or disease Y. UNINTENTIONAL FAILURE TO DISCLOSE AA. USERAL17AnON EXPOSURES If we revise this endorsement to provide greater Section IV — Business Auto Conditions, B.2. coverage without additional premium charge, we will Concealment, Misiepresentation, Or Fraud is automatic* provide the additional coverage to all amended by adding the following: endorsement holders as of the day the revision is If you unintentionally fail to disclose any exposures effective in your state. existing at the inception data of this policy,we will not deny coverage under this Coverage Form solely because of such failure to disclose. However, this provision does not affect our right to coact additional premium or exercise our right of cancellation or non- renewal. CA745Q M17) Includes copyrighted materW d ISO Properdes,Inc.with its pennteeion. Page 5 of 5 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT—AGGREGATE LIMITS OF INSURANCE (PER PROJECT) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The General Aggregate Limit under LIMITS OF INSURANCE (Section III) applies separately to each of your projects away from premises owned by or rented to you. Includes copyrighted material of Insurance Services Office,Inc.with its permission. Form CG7429(Ed. 11-98) Copyright,Insurance Services Office,Inc.,1984 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD WORKM O AT t AM EW WYM LIAORM POSURAM POMP WC 00 0313 ft 4-" WAWMt OF OW NOW TO IMCOVMt FROM OTHM RIiDORORMT We hm the right to racorrer our payrnards from sworn Wft for an Wray ooa wW by this Policy. We wiu riot eMo ce or rat spdnet the parson or wgwdudoe named &r lire Sdwdula. (This a0raemeM appibs ordy to the " mlt that you parlmm work under a written contract that req*= you to all lids Ow"a rt from ur.) Thin agreement shad rant eperet-draft or fr y to barwtit aim sat ra=W in the Sdwdub. Sohe&ft Any parson or orgerdawlion that you perbrm work for that b liable for an lr*oy,ommW by this ploy.that prbr to the injury ha written em bM rem a wahrer of aer right to re from them. W"81*1118ddwnges ar pdW to otdch h Is sftdwd and b ealadn an aro dada beLmd sodas alhawbs atatad. L�hMrraraaaa Mlair le rayutr�d erdlr+rhan�ar�enao�l h bawd sa6sp�oatts paps�m�dlha�r9�� ma " pa ft ft WCV61LS2730 =Amn maw P TRI Solutions,Inc dba Tile Restoration per: Mom m Opal ACCOM FUND M CO OF AlrWWA CAW"N*W • we 00= 1s ft 484) aognfa toes Not aW Cmd ae C on b DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ELITE EXTENSION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM The COMMERCIAL GENERAL LIABILITY COVERAGE FORM is amended to include the following clarifications and extensions of coverage.The provisions of the Coverage Form apply unless modified by endorsement. A. EXPECTED OR INTENDED INJURY The aggregate limit listed above is the most we will Section I — Coverage A, Exclusion a. is amended pay for all damages because of"property damage" as follows: to property in the care custody and control of or injury" or " property loaned to an insured during the policy a. "Bodily ' property damage" expected period or intended from the standpoint of an insured. This exclusion does not apply to "bodily injury' Any payment we make for damages because of or "property damage" resulting from the use of "Property damage" to property in the care, custody reasonable force to protect persons or property. and control of or property loaned to an insured will B. NON-OWNED WATERCRAFT apply against the General Aggregate Limit shown in the declarations. Section I — Coverage A, Exclusion g.(2) is b. Our obligation to pay damages on your behalf amended as follows: applies only to the amount of damages in (2) A watercraft you do not own that is: excess of the deductible amount listed above. (a) Less than 60 feet long; and We may pay any part or all of the deductible amount listed above. We may pay any part or (b) Not being used to carry person(s) or all of the deductible amount to effect settlement property for a charge, of any claim or "suit" and upon notification by C. EXTENDED PROPERTY DAMAGE COVERAGE us, you will promptly reimburse us for that part Section I—Coverage A, Exclusions j.(3)and (4) is of the deductible we paid. amended to add the following: c. If two or more coverages apply under one Paragraphs (3) and (4) of this exclusion do not "occurrence", only the highest per claim apply to tools or equipment loaned to you, provided deductible applicable to these coverages will they are not being used to perform operations at apply. the time of loss. d. Insurance provided by this provision is excess over any other insurance, whether primary, SCHEDULE excess, contingent or any other basis. Since Llmits Of Insurance Deductible insurance provided by this endorsement is excess, we will have no duty to defend any $5,000 Each Occurrence $250 Per Claim claim or "suit" to which insurance provided by $10,000 Annual Aggregate this endorsement applies if any other insurer has a duty to defend such a claim or "suit". If a. The each occurrence limit listed above is the no other insurer defends, we will undertake to most we will pay for all damages because of do so, but we will be entitled to the insured's "property damage" to property in the care, rights against all those other insurers. custody and control of or property loaned to an D. PROPERTY DAMAGE—ELEVATORS insured as the result of any one "occurrence", regardless of the number of: Section I—Coverage A.2. Exclusions paragraphs (1) insureds; j.(3), j.(4), j.(6) and k. do not apply to use of elevators. This insurance afforded by this provision (2) claims made or"suits"brought; is excess over any valid and collectible property (3) persons or organizations making claims or insurance (including any deductible) available to bringing"suits". the insured and Section IV—Commercial General Liability Conditions Paragraph 4. Other Insurance is changed accordingly. CG7578(6-17) Includes copyrighted material of 130 Properties,Inc.with its permission, Page 1 of 6 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD E. FIRE,LIGHTNING OR EXPLOSION DAMAGE a. Currently in effect or becomes effective Except where it is used in the term "hostile fire", the during the policy period; and word fire includes fire, lightning or explosion wherever b. Executed prior to an "occurrence" or it appears in the Coverage Form. offense to which this insurance would Under Section I — Coverage A, the last paragraph apply. (after the exclusions)is replaced with the following: However, the insurance afforded to such Exclusions c. through n. do not apply to damage by additional insured: fire, smoke or leakage from automatic fire protection a. Only applies to the extent permitted by law; systems to premises while rented to you or and temporarily occupied by you with permission of the b, Will not be broader than that which you are owner. A separate limit of insurance applies to this required by the contract or agreement to coverage as described in Section III — Limits of Insurance. provide for such additional insured;and F. MEDICAL PAYMENTS c. Applies only if the person or organization is If Section I — Coverage C. Medical Payments not specifically named as an additional insured under any other provision of, or Coverage is not otherwise excluded from this endorsement added to, Section II — Who Coverage Form: Is An Insured of this policy. The requirement, in the Insuring Agreement of 2. As provided herein, the insurance coverage Coverage C., that expenses must be incurred and provided to such additional insureds is limited reported to us within one year of the accident date is to: changed to three years. G. SUPPLEMENTARY PAYMENTS a. Any Controlling Interest, but only with respect to their liability arising out of their Supplementary Payments — Coverages A and B financial control of you; or premises they Paragraphs 1.16. and 1.d. are replaced by the own, maintain, or control while you lease or following: occupy these premises. 1.b.Up to $5,000 for cost of bail bonds required This insurance does not apply to structural because of accidents or traffic law violations alterations, new construction and arising out of the use of any vehicle to which the demolition operations performed by or for Bodily Injury Liability Coverage applies. We do that person or organization. not have to furnish these bonds. b. Any architect, engineer, or surveyor 1 A.All reasonable expenses incurred by the insured engaged by you but only with respect to at our request to assist us in the investigation or liability for "bodily injury", "property defense of the claim or "suit", including actual damage" or "personal and advertising loss of earnings up to $500 a day because of injury" caused, in whole or in part, by your time off from work. acts or omissions or the acts or omissions H. SUBSIDIARIES AS INSUREDS of those acting on your behalf: Section II —Who Is An Insured is amended to add (1) In connection with your premises; or the following: (2) In the performance of your ongoing 11 Any legally incorporated subsidiary in which you operations. own more than 50% of the voting stock on the With respect to the insurance afforded to effective date of this policy. However, insured these additional insureds,the following does not include any subsidiary that is an insured additional exclusion applies: under any other general liability policy, or would This insurance does not apply to "bodily have been an insured under such a policy but for termination of that policy or the exhaustion of that injury", "property damage"or"personal and policy's limits of liability. advertising injury" arising out of the rendering of or the failure to render any I. BLANKET ADDITIONAL INSUREDS — AS professional services by or for you, REQUIRED BY CONTRACT including: 1. Section II —Who Is An Insured is amended to (1) The preparing, approving, or failing to include as an additional insured any person(s) or prepare or approve, maps, shop organization(s)subject to provisions in Paragraph drawings, opinions, reports, surveys, 2. below, (hereinafter referred to as additional field orders, change orders or drawings insured) when you and such person(s) or and specifications; or organization(s) have agreed in a written contract (2) Supervisory, inspection, architectural or or written agreement that such person(s) or engineering activities. organization(s) be added as an additional insured on your policy provided that the written contract or agreement is: CG7578(6-17) Includes copyrighted material of 180 Properties,Inc.with Its permission. Page 2 of 6 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD This exclusion applies even if the claims This insurance does not apply to: against any insured allege negligence or (a) "Bodily injury", "property damage" or other wrongdoing in the supervision, hiring, "personal and advertising injury" employment, training or monitoring of arising out of operations performed others by that insured, if the occurrence" for the federal government, state or which caused the "bodily injury" or municipality;or property damage", or the offense which caused the "personal and advertising (b) "Bodily injury" or "property damage" injury", involved the rendering of or the included within the "products- failure to render any professional services completed operations hazard". by or for you. e. Any vendor, but only with respect to "bodily c. Any manager or lessor of a premises injury" or "property damage" arising out of leased to you, but only with respect to 'your products" which are distributed or sold liability arising out of the ownership, in the regular course of the vendors maintenance or use of that part of a business. premises leased to you, subject to the With respect to the insurance afforded to following additional exclusions: these vendors, the following additional This insurance does not apply to: exclusions apply: (1) Any "occurrence" which takes place (1) The insurance afforded any vendor does after you cease to be a tenant in that not apply to: premises. (a) "Bodily injury' or "property damage" (2) Structural alterations, new construction for which any vendor is obligated to or demolition operations performed by pay damages by reason of the or on behalf of such additional insured. assumption of liability in a contract or d. Any state or governmental agency or agreement. This exclusion does not subdivision or political subdivision, subject to apply to liability for damages that any the following: vendor would have in the absence of the contract or agreement; (1) This insurance applies only with respect (b) Any express warranty unauthorized to the following hazards for which any by you; state or governmental agency or subdivision or political subdivision has (c) Any physical or chemical change in issued a permit or authorization in the product made intentionally by connection with premises you own, rent any vendor; or control and to which this insurance (d) Repackaging, except when applies: unpacked solely for the purpose of (a) The existence, maintenance, repair, inspection, demonstration, testing, construction, erection or removal of or the substitution of parts under advertising signs, awnings, instructions from the manufacturer, canopies, cellar entrances, coal and then repackaged in the original holes, driveways, manholes, container; marquees, hoist away openings, (e) Any failure to make such sidewalk vaults, street banners or inspections, adjustments, tests or decorations and similar exposures; servicing as any vendor has or agreed to make or normally (b) The construction, erection or undertakes to make in the usual removal of elevators;or course of business, in connection (c) The ownership, maintenance or use with the distribution or sale of the products; of any elevators covered by this insurance. {f) Demonstration, installation, (2) This insurance applies only with respect servicing or repair operations, to operations performed by you or on except such operations performed your behalf for which any state or at any vendors premises in governmental agency or subdivision or connection with the sale of the political subdivision has issued a permit product, or authorization. (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for any vendor; or CG7578(6-17) Includes copyrighted material of ISO properties,Inc.with Its permission. Page 3 of 6 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD (h) "Bodily injury" or "property A person's or organization's status as an damage" arising out of the sole additional insured under this endorsement negligence of any vendor for its ends when their contract or agreement with own acts or omissions or those of you for such leased equipment ends. its employees or anyone else With respect to the insurance afforded to acting on its behalf. However, this these additional insureds, this insurance exclusion does not apply to: does not apply to any "occurrence" which (1) The exceptions contained in takes place after the equipment lease Subparagraphs(d)or(f); or expires. (11) Such inspections, adjustments, 1. Any Owners, Lessees, or Contractors for tests or servicing as any whom you are performing operations, but vendor has agreed to make or only with respect to liability for "bodily normally undertakes to make in injury", "property damage" or"personal and the usual course of business, advertising injury" caused, in whole or in in connection with the part, by: distribution or sale of the (1) Your acts or omissions;or products. (2) The acts or omissions of those acting (2) This insurance does not apply to any on your behalf; insured person or organization, from whom you have acquired such in the performance of your ongoing products, or any ingredient, part or operations for the additional insured. container, entering into, accompanying A person's or organization's status as an or containing such products. additional insured under this endorsement f. Any Mortgagee, Assignee Or Receiver, but ends when your operations for that only with respect to their liability as additional insured are completed. mortgagee, assignee, or receiver and With respect to the insurance afforded to arising out of the ownership, maintenance, these additional insureds,the following or use of the premises by you. additional exclusions apply: This insurance does not apply to structural This insurance does not apply to: alterations, new construction and demolition operations performed by or for (1) "Bodily injury", "property damage" or that person or organization. "personal and advertising injury"arising g. Any Owners Or Other Interests From out of the rendering of, or the failure to Whom Land Has Been Leased, but only render, any professional architectural, with respect to liability arising out of the engineering or surveying services, ownership, maintenance or use of that part including: of the land leased to you. (a) The preparing, approving, or failing With respect to the insurance afforded to to prepare or approve, maps, shopdrawings, opinions, reports, these additional insureds,the following surveys, field orders, change additional exclusions apply: orders or drawings and (1) This insurance does not apply to: specifications; or (a) Any "occurrence" which takes (b) Supervisory, inspection, place after you cease to lease that architectural or engineering land;or activities. (b) Structural alterations, new This exclusion applies even if the claims construction or demolition against any insured allege negligence or operations performed by or on other wrongdoing in the supervision, hiring, behalf of such additional insured. employment, training or monitoring of h. Any person or organization from whom you others by that insured, if the "occurrence" lease equipment, but only with respect to which caused the "bodily injury" or liability for "bodily injury', "property "property damage", or the offense which damage" or "personal and advertising caused the "personal and advertising injury' caused, in whole or in part by your injury", involved the rendering of the maintenance, operation or use of failure to render any professional equipment leased to you by such person(s) architectural, engineering or surveying services. or organization(s). (2) "Bodily injury" or "property damage" occurring after: CG7578(6-17) Includes copyrighted material of ISO Properlies,Inc.with Its permission. Page 4 of 6 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD (a) All work, including materials, parts This endorsement shall not increase the or equipment furnished in applicable Limits of Insurance shown in the connection with such work, on the Declarations. project (other than service, J. COVERAGE FOR INJURY TO CO-EMPLOYEES maintenance or repairs) to be AND/OR YOUR OTHER VOLUNTEER WORKERS performed by or on behalf of the additional insured(s) at the location Section II—Who Is an Insured, Paragraph 2.a.(1)is of the covered operations has been amended to add the following: completed;or e. Paragraphs(a),(b), and(a)do not apply to your (b) That portion of "your work" out of "employees" or'volunteer workers" with respect which the injury or damage arises to "bodily injury' to a co-"employee" or other has been put to its intended use by "volunteer worker". any person or organization other Damages owed to an injured oo-"employee" or than another contractor or "volunteer worker" will be reduced by any subcontractor engaged in amount paid or available to the injured co- performing operations for a "employee" or 'volunteer worker" under any principal as a part of the same other valid and collectible insurance. project. K. HEALTH CARE SERVICE PROFESSIONALS AS J. Any Grantor of Licenses to you, but only INSUREDS-INCIDENTAL MALPRACTICE with respect to their liability as grantor of Section II —Who is an Insured, Paragraph 2.a. (1) licenses to you. (d)is amended as follows: Their status as additional insured under This provision does not apply to Nurses, Emergency this endorsement ends when: Medical Technicians, or Paramedics who provide 1. The license granted to you by such professional health care services on your behalf. person(s)or organization(s)expires;or However this exception does not apply if p pp y � you are in 2. Your license is terminated or revoked the business or occupation of providing any such by such person(s) or organization(s) professional services. prior to expiration of the license as L. NEWLY FORMED OR ACQUIRED stipulated by the contract or ORGANIZATIONS agreement. It. Any Grantor of Franchise, but only with Section II —Who Is An Insured, Paragraph 3.a. is respect to their liability as grantor of a replaced by the following: franchise to you. 3.a. Coverage under this provision is afforded until I. Any Co-owner of Insured Premises, but the end of the policy period. only with respect to their liability as co- This provision does not apply if newly formed or owner of any insured premises. acquired organizations coverage is excluded either by m. Any Concessionaires Trading Under Your the provisions of the Coverage Form or by Name, but only with respect to their liability endorsements. as a concessionaire trading under your M. DAMAGE TO PREMISES RENTED TO YOU name. Section III — Limits of Insurance, Paragraph 6. is 3. Any insurance provided to any additional replaced by the following: insured does not apply to "bodily injury", Subject to 5.a. above, the Damage To Premises "property damage" or"personal and advertising Rented To You Limit, or $500,000, whichever is injury" arising out of the sole negligence or higher, is the most we will pay under Coverage A for willful misconduct of the additional insured or its damages because of "property damage" to any one agents, "employees" or any other premises, while rented to you, or in the case of representative of the additional insured. damage by fire, smoke or leakage from automatic 4. With respect to the insurance afforded to these protection systems,while rented to you or temporarily additional insureds, the following is added to occupied by you with permission of the owner. Section III—Limits of Insurance: N. MEDICAL PAYMENTS—INCREASED LIMITS If coverage provided to any additional insured Section III — Limits of Insurance, Paragraph 7. is is required by a contract or agreement, the replaced by the following: most we will pay on behalf of the additional 7. Subject to Paragraph 5. above, $10,000 is the insured is the amount of insurance: a. Required b the contract or agreement; or Medical Expense Limit we will pay under q Y 9 Coverage C for all medical expenses because of b. Available under the applicable Limits of "bodily injury" sustained by any one person, Insurance shown in the Declarations; unless the amount shown on the Declarations of whichever is less. this Coverage Part for Medical Expense Limit states: CG7578(6-17) Includes copyrighted material of ISO Properties,Inc,with its permission. Page 5 of 6 DocuSign Envelope ID: F521C9FC-AF1E-46C1-BD79-B6069BD1C2DD (a) No Coverage; or (2) You have agreed in writing in a contract or (b) $1,000; or agreement that this insurance would be primary and would not seek contribution from any other (c) $S,OQQ; or insurance available to the additional insured. (d) A limit higher than $10,000. However, if the additional insured has been O. DUTIES IN THE EVENT OF OCCURRENCE, added as an additional insured on other OFFENSE,CLAIM OR SUIT policies, whether primary, excess, contingent or on any other basis, this insurance is excess Section IV — Commercial General Liability over any other insurance regardless of the Conditions Paragraph 2, is amended to add the written agreement between you and an following: additional insured. e. The requirement in Condition 2.a.that you must Q. UNINTENTIONAL FAILURE TO DISCLOSE see to it that we are notified as soon as EXPOSURES practicable of an "occurrence" or an offense Section IV — Commercial General Liability which may result in a claim, applies only when Conditions Paragraph 6. Representations is the"occurrence"or offense is known to: amended to add the following: (1) You, if you are an individual or a limited If you unintentionally fail to disclose any exposures liability company; existingthe inception date of at p your policy,we will not (2) A partner, if you are a partnership; deny coverage under the Coverage Form solely (3) A member or manager, if you are a limited because of such failure to disclose. However, this liability company; provision does not affect our right to collect additional (4) An "executive officer" or insurance Premium or exercise our right of cancellation or non- manager, if you are a corporation; or renewal. (5) A trustee, if you are a trust. This provision does not apply to any known injury or damage which is excluded under any other f. The requirement in Condition 2.b. that you provision of this policy. must see to It that we receive notice of a claim R. WAIVER OF TRANSFER OF RIGHTS OF or "suit" as soon as practicable will not be RECOVERY AGAINST OTHERS TO US considered breached unless the breach occurs after such claim or"suit"is known to: Section IV — Commercial General Liability (1) You, if you are an individual or a limited Condition Paragraph S. Transfer Of Rights Of liability company; Recovery Against Others To Us is amended to (2) A partner, if you are a partnership; add the following: We waive any right of recovery we may have (3) A member or manager, if you are a limited against any person or organization against whom liability company; you have agreed to waive such right of recovery in (4) An "executive officer" or insurance a written contract or agreement because of manager, if you are a corporation;or payments we make for injury or damage arising out (5) A trustee, if you are a trust. of your ongoing operations or "your work" done P. PRIMARY AND NONCONTRIBUTORY — under a contract with that person or organization ADDITIONAL INSURED EXTENSION and included in the "products completed operations hazard". Section IV — Commercial General Liability S. MENTAL ANGUISH Conditions Paragraph 4. Other Insurance is amended to add the following: Section V—Definition 3.is replaced by the following: This insurance is primary to and will not seek "Bodily injury" means bodily injury, sickness or contribution from any other insurance available to disease sustained by a person, including mental an additional insured under your policy provided anguish or death resulting from bodily injury, that: sickness or disease. (1) The additional insured is a Named Insured T. LIBERALIZATION under such other insurance;and 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. 10137578(6-17) Includes copyrighted material of ISO Properties,Inc.with Its permission. Page 6 of 6