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2019-343-E DEAPR - Brown Bros install outdoor drinking fountain
Revised 12/18 1 NORTH CAROLINA CONSTRUCTION SERVICES AGREEMENT UNDER $50,000 ORANGE COUNTY THIS CONSTRUCTION AGREEMENT (hereinafter “Agreement”), is made and entered into this 13th day of June, 2019 by and between Orange County, North Carolina (hereinafter the “County” and/or "Owner") party of the first part; and Brown Brothers Plumbing & Heating Co. (hereinafter the "Contractor"), party of the second part; W I T N E S S E T H: For the purpose and subject to the terms and conditions hereinafter set forth, the Owner hereby contracts for the construction services of the Contractor, and the Contractor agrees to provide the construction services to the Owner in accordance with the terms of this Agreement. 1. TERM AND MAXIMUM AMOUNT PAYABLE Beginning and ending dates of contract: 6/13/19 through 7/31/19. The Project Commencement Date shall be 6/24/19. Dollar Amount Not to Exceed: Six Thousand Two Hundred Forty Nine Dollars ($6,249.00) 2. SERVICES Contractor agrees to provide the following construction services (the “Work”): Labor and material included to install new MDF outdoor drinking fountains provided by Orange County DEAPR in the same location as the existing fountains. The new fountains will require the concrete to be cut and the old units removed. New gravel will be installed for the drainage base on the new units. Existing water connections and meter cutoff boxes will be used. New concrete pad will be poured back as the base of both units. Once new concrete is cured a return trip will be to install the new fountains. Contractor shall not sub-contract all or any part of the construction services provided for in this Agreement without prior written approval of the Owner. Contractor shall be responsible for all errors or omissions, in the performance of the Agreement. Contractor shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to Owner. Contractor is solely responsible for obtaining all permits necessary to complete the Work in compliance with local, state, and/or federal law. The Contractor is responsible for all physical damage to owned or rented machinery, tools, equipment, forms, and other items owned, rented or used by the Contractor and/or Subcontractor(s) in the performance of the Work including all of Owner’s property in Contractor’s care, custody, or control, and all such property while it is in transit. 3. PAYMENT Contractor shall submit an invoice for construction services provided. The invoice shall contain Contractor's name and federal tax identification number and shall be signed and dated by an officer of Contractor. It shall detail all construction services provided in payment requests. The Owner will make payments to Contractor within thirty (30) days after receipt of and approval of the invoice by the contracting department. DocuSign Envelope ID: 3F1D7CF6-245A-4714-B5DB-30373A05897A Revised 12/18 2 In the event the amount stated on an invoice is disputed by Owner, then Owner may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. In addition, should Contractor fail to perform its duties under the terms of this Agreement, Owner may, without fault or penalty, withhold any payment associated with the Work to be performed until such time as said work is completed. 4. RELATIONSHIP OF PARTIES Contractor is an independent contractor of the Owner. Contractor represents that it has or will secure, at its own expense, all personnel required in performing the construction services under this Agreement. Such personnel shall not be employees of or have any contractual relationship with the Owner. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized or permitted under state and local law to perform such construction services. It is further agreed that Contractor will obey all State and Federal statutes, rules and regulations which are applicable to provisions of the construction services called for herein. Neither Contractor nor any employee of the Contractor shall be deemed an officer, employee or agent of the Owner. 5. SUSPENSION AND TERMINATION This Agreement may be terminated by Contractor upon thirty (30) days' written notice to the Owner, and the Owner may terminate this Agreement upon thirty (30) days' written notice to Contractor. Owner may suspend the Work at any time for Owner’s convenience and without penalty to Owner upon three (3) days’ notice to Contractor. Upon any suspension by Owner Contractor shall discontinue the Work and shall not resume the Work until notified to proceed by Owner. The notice required by this section or any other notice shall be delivered via certified mail, return receipt requested to the parties at the addresses as shown on the signature page to this Agreement. Such notice is deemed given upon its delivery to, or deposit in a receptacle of, the United States Post Office. 6. INSURANCE REQUIREMENTS Contractor shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any additional insurance as may be required by Owner’s Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). If Owner’s Risk Manager determines additional insurance coverage is required such additional insurance shall be designated here N/A (if no additional insurance required mark N/A as being not applicable). Contractor shall not commence construction work until such insurance is in effect and certification thereof has been received by the Owner's Risk Manager. 7. INDEMNIFICATION Contractor agrees, without limitation, to defend, indemnify, save, and protect Owner and Owner’s lender, if any, harmless from and against any and all claims, liens, liabilities, losses, damages, causes of action, and expenses (including court costs and reasonable attorney’s fees related thereto) arising out of, in connection with, or resulting from any negligence, act or failure to act by the Contractor, the Contractor’s agents, assigns or employees resulting in property damage or personal injury, including death, or other loss related to the Work. Contractor is DocuSign Envelope ID: 3F1D7CF6-245A-4714-B5DB-30373A05897A Revised 12/18 3 responsible for all errors or omissions caused by its agents, contractors, employees, or assigns in the performance of this Agreement. It is the intent of this section to require Contractor to indemnify the Owner to the full extent permitted under North Carolina law. 8. NON-ASSIGNMENT AND OWNER’S REPRESENTATIVE Contractor shall not assign all or any part of this Agreement, including rights to payments, to any other party without the prior written consent of the Owner. The County has designated (Travis Bogle) to act as the County's representative with respect to the Work and shall have the authority to render decisions within guidelines established by the County Manager and/or the County Board of Commissioners and shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 9. NON–APPROPRIATION Contractor acknowledges that Owner 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 Owner’s obligations under this Agreement, then this Agreement shall automatically expire without penalty to Owner immediately upon written notice to Contractor of the unavailability and non-appropriation of public funds. It is expressly agreed that Owner shall not activate this non- appropriation provision for its convenience or to circumvent the requirements of this Agreement, but only as an emergency fiscal measure during a substantial fiscal crisis. In the event of a change in the Owner’s statutory authority, mandate and/or mandated functions, by state and/or federal legislative or regulatory action, which adversely affects Owner’s authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to Owner upon written notice to Contractor of such limitation or change in Owner’s legal authority. 10. DISPUTE RESOLUTION Any dispute with respect to any provision of, or the performance or non-performance of, this Agreement shall be subject to the Dispute Resolution Rules and Procedures for Orange County Design, Building Construction, Renovation, and Repair Projects. The policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). 11. ENTIRE AGREEMENT The parties have read this Agreement and agree to be bound by all of its terms, and further agree that it, together with specifically referenced documents, constitutes the complete and exclusive statement of the Agreement between the parties unless and until modified by a written amendment to this Agreement signed by the parties. Modifications may be evidenced by telefacsimile signatures. Should any conflict arise in the terms of any documents referenced herein and this Agreement the terms of this Agreement shall be given priority and shall control over all other such documents. Should a request for proposals and a proposal be referenced the terms of the request for proposals shall have priority over the terms of the proposal. 12. COMPLIANCE WITH LAW/GOVERNING LAW DocuSign Envelope ID: 3F1D7CF6-245A-4714-B5DB-30373A05897A Revised 12/18 4 Both parties agree that this Agreement shall be governed by the laws of the State of North Carolina and any action brought under this Agreement shall be brought in the General Court of Justice of the State of North Carolina in Orange County. Contractor 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 non-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.orangecountync.gov/departments/purchasing_division/contracts.php). Any violation of the Orange County Non-Discrimination Policy 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 Contractor affirms that Contractor and any subcontractors of Contractor are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Contractor certifies that Contractor has not been identified, and has not utilized the services of any agent or subcontractor identified, on the lists created by the State Treasurer pursuant to G.S. 147-86.58 and G.S. 147-86.81. 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 intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF Orange County and the Contractor have signed this agreement, effective as of the day and date first above written. ORANGE COUNTY CONTRACTOR By _________________________ By ________________________________ County Manager Allen Whitaker, Service Manager 200 S. Cameron St. PO Box 15668 P.O. Box 8181 Durham, NC 27704 Hillsborough, NC 27278 DocuSign Envelope ID: 3F1D7CF6-245A-4714-B5DB-30373A05897A DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A SM. ROW11 gjR.OTHER.S NC License#00282 Proposal April 5 2019 Job Name: Orange Co Parks& Rec Travis Bogie Job Location: 117 Richmond Rd tbogle(cDorang fax Mebane NC 919-245-2673 phone Proposal Includes: Labor and material included to install new MDF outdoor drinking fountains Provided by Orange Parks and Rec in the same location as the existing fountains. The new fountains will require the concrete to be cut and the old units removed. New gravel will be installed for the drainage base on the new units. Existing water connections and meter cutoff boxes will be used. New concrete pad will be poured back as the base of both units. Once new concrete cured return trip will be to install unit's Total $6,249.00 dollars Includes State Sales Tax Exclusions: No repairs not lister!above. Proposal may be withdrawn if not accepted within 30 days. PAYMENTS SHALL BE MADE AS FOLLOWS: payment in full upon completion of work. Authorized Signature: Rick A. Whitaker_President Acceptance: Sharon Kelly DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373AO5897A OP ID: DL a dl--"Rt> CERTIFICATE 4F LIABILITY INSURANCE DATE 05/071201 YY) 05107I2019 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 poiicy(fes) 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 NAME; Kirk Brown Diversified Insurance Solutions LLC �°"�e KXt):919-471 8222 {Ai� No)-.919-471-6607 P.O.Box 15734 ADdRI�ss:kbrown diverseins.com Durham,NC 27704- PRODUCER BR0WBR0 Diane S.Long CUSTOMER ID#: INSURERS)AFFORDING COVERAGE NA]C# INSURED Brown Brothers Plumbing and INSURERA:Builders Premier Insurance Co. 10844 Heating Company, Inc. INSURERS;Builders Mutual Insurance Co. 10844 2820 N. Roxboro Road Durham, NC 27704 INSURERC:Admiral Insurance Co. 44318 Durham, --- INSURER D:Travelers PropertylCasualty 36161 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 S BR POLICY EFF POLICY EXP LTR POLICY NUMBER IMMIDDIYYYYI IMMIRDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X X �PCP0000055 10 12/3112018 12/3112019PIRE'.'ISEEST RENTED Ea occurretice $ 300,000 CLAIMS-MADE OCCUR ED EXP(Any one person) $ 10,000 X contractual liab. __ PERSONAL&ADV INJURY $ 1,000,000 X i Deductible$500. GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY X PRO- LOG $ AUTOMOBILE LIABILITY X X COMBINED SINGLE LIMIT • $ 1,000,000 (Ea accident) A ANY AUTO PCA0006942 OS 12/31/2018 12131I2019 BODILY INJURY(Per person) $ X ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (PER ACCIDENT) X NON-OWNEDAUT08 $ X Deductible -0- $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 S - MUB0004308 01 12131/2018 12/31/2019 DEDUCTIBLE $ X RETENTION $ 10,000 g WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY T RY LIMIT ER B ANY PROFRIETORIPARTNERIEXECUTIVE YIN NIA X WCP004435510 12131/2018 12/31/2019 E.L.EACH ACCIDENT ' $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) �E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS helaw L DISEASE-POLICY LIMIT $ 1,000,000 C Pollution Liab. FEI-ECC-22903-02 08/03/2018 08103/2019 OcclAggr. 2,000,000 D Third Party Crime 106446766 01/20/2019 01/20/2020 100,000 5000.ded. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,It more space is required) Project: Efland Cheeks Community Center water fountain replacement. Orange County, &all others required by written contract are additional insureds for ongoing&completed operations, on a primary&non-contributory basis, and waivers of subrogation apply in their favor when regulred by written c ontract, er attached forms&endorsements. Umbrella follows form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County, Dept. Of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y p ACCORDANCE WITH THE POLICY PROVISIONS, Environment,Agricultu re,Parks &Recreation AUTHORIZED REPRESENT PO Box 8181 Diane S. Long Hillsborough, NC 27278 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A BROwBRO PAGE 2 NOTEPAD INSUREUS NAME Brown Brothers Plumbing and OP ID: DL Date 05/07/2019 The following forms apply if required by written/executed contract, before a loss: Additional Insured for General Liability Ongoing & Completed Operations and Primary & Non-contributory wording: CG7034 (07/09) , CG7024(03/09) and CG2001(4/13) . Blanket Additional Insured applies to Contractors Pollution Liability for Ongoing & Completed Operations, when required by written contract, per ECC3190712 and ECC5480317. Designated Insured for Auto Liability: CA2048(02/99) . Blanket Waiver of Subrogation for General Liability: CG7051(06/15) . Blanket Waiver of Subrogation for Workers Compensation: WC 000313(04/84) . Blanket Waiver of Subrogation for Contractors Pollution Liability: per ECC3200712. Contractors Pollution Liability: Self Insured Retention $10,000. Contractors Pollution Liability: Mold deductible $25,000. Blanket Additional Insured on Automobile Liability, with Primary and Non-contributory wording, per attached form CA3000(07/14) . Umbrella follows form for General Liability, Automobile Liability and Workers Compensation. A.M. Best Rating A. DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A COMMERCIAL PACKAGE POLICY BUILDERS PREMIER INSURANCE CO. FORM INVENTORY SCHEDULE Post Once Box 150005 Policy Number: PCP 0000055 10 Raleigh, North Carolina 27624-0005 Named Insured: BROWN BROTHERS PLUMBING Agent: 01UERSIRED INSURANCE SOLUTION 0000443 POLICY FORMS SCHEDULE Policy Level Forms Commercial Fire Forms CP0010 (04/02) CP0030 (04/02) CP0090 (07/88) CP0116 (10/00) CP1030 (04/02) CP1218 (06/b5) EM0001 (07/08) 1L0003 (07/02) IL0017 (11/98) IL0269 (07/02) IL0935 (07/02) IL0952 (01/15) IL0995 (01/07) IL6006 (01/10) IL6014 (01/16) PIL002ONC (07/04) General Liability Forms CG0001 (04/13) CCO300 (01/96) CG2001 (04/13) CG2010 (04/13) CG2032 (04/13) CC2037 (04/13) CG2C38 (04/13) CG2106 (05/14) CG2109 (06/15) CG2147 (12/07) CG2149 (09/99) CG2154 (01/96) CC2167 (12/04) CG2170 (01/15) CG2186 (12/04) CG2187 (01/15) CG2196 (03/05) CG2294 (10/01) CG2404 (05/09) CG2503 (05/09) CG2504 (05/09) CG7024 (03/09) CG7030 (07/09) CG7031 (07/09) CG7C32 (07/09) CC7034 (07/09) CG7051 (06/15) IL0003 (09/08) IL0017 (11/98) IL0021 (09/08) IL0269 (09/08) IL1201 (11/85) IL6006 (01/10) Inland Marine Forms CM0001 (06/95) CM0103 (11/85) IL0003 (04/98) I1,0017 (11/98) IL0269 (04/98) IL0935 (08/98) IL0952 (01/15) IL0995 (01/07) IL1201 (11/85) PCM0018 (10/99) PCM0023 (03/02) PCM0042 (07/04) issued Date: 11/01/2018 5CHEE) 0695 INSURED COPY Page 2S of 29 DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A r�r UUUUUaa IV COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Contractor's Blanket Additional Insured Endorsement Products - Completed Operations-A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A_ Section II —WHO IS AN INSURED is amended to include as an additional insured any person or organization when you and such person or organization have agreed in a written contract or written agreement that such person or organization be added to your policy, but only with respect to liability for "bodily injury" or"property damage" caused by "your work" performed for that additional insured and included in the "products-completed operations hazard". When the named insured is required to add an additional insured on this policy, the written contract or written agreement must be: 1. Currently in effect or becoming effective during the term of this policy; 2. Executed prior to a "bodily injury" "occurrence" or "property damage" "occurrence"to which this insurance would apply; and 3. Between a Named Insured and the additional insured B. The insurance provided to the additional insured is subject to the following provisions: 1. That person or organization is an additional insured only for liability caused by your negligence specifically resulting from "your work" for the additional insured as detailed in the written contract or written agreement. 2. The Limits of Insurance (Section Ill) is amended to include: The limits applicable to the additional insured are the lesser of those specified in the written contract or agreement executed between you and the additional insured or in the Declaration of this Coverage Part, whichever is less_ These Limits of Insurance are inclusive of, and are not in addition to, the Limits of Insurance shown in the Declarations and defined in Section III -- Limits of Insurance. 3. The insurance provided to the additional insured does not apply to "bodily injury" or"property damage" arising out of the rendering of, or the failure to render any professional services by you or on your behalf, but only with respect to the,following operations: a. Providing engineering, architectural or surveying services to others in your capacity as an engineer, architect or surveyor; and b. Providing, or hiring independent professional firms to provide, engineering, architectural or surveying services in connection with construction work you perform_ Professional services include: c. The preparing, approving, failing to prepare, approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and d. Supervisor or inspection activities performed as part of any related architectural or engineering activities. e. However, professional services do not include services within construction means, methods, techniques, sequences and procedures employed by you in connection with your operations in your capacity as a construction contractor. CG 70 24 03 09 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 2 Copyright, Insurance Services Office, Inc., 1997 DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A 4. The following replaces Exclusion I under 2. Exclusions of Section I-COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1. Damage to Your Work This insurance does not apply to "property damage" to "your work" arising out of it or any part of it and included in the "products-completed operations hazard"_ 5. When a written contract or written agreement requires coverage to be provided for"bodily injury" or "property damage" within the "products-completed operations hazard", coverage will not apply to "bodily injury" or"property damage"which occurs after: a_ The period of time required by the written contract or written agreement; or b_ Five years from the completion of"your work" on the project that is the subject of the written contract or written agreement. 6. Any coverage provided to the additional insured by this endorsement shall be excess over any other insurance naming the additional insured as an insured whether primary, excess, contingent or on any other basis, unless the written contract or written agreement in effect during this policy period and executed by you prior to an "occurrence" specifically requires that the insurance be provided on either a primary or on a primary and noncontributory basis. 7_ The insurance provided in this endorsement does not apply to "bodily injury", or"property damage" arising out of"your work" for which a consolidated (wrap-up) insurance program has been provided by the prime contractor, project manager or owner of a construction project in which you are involved. 8_ The following is added to SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2., Duties In The Event of Occurrence, Offense, Claim or Suit: e. An additional insured under this endorsement must comply with all provisions of this section. f. The company may audit or require a copy of the contract. CG 70 24 03 09 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 2 of 2 copyright, insurance Services Office, Inc., 1997 DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A PCP 0000055 10 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Except as otherwise stated in this endorsement, premises. the terms and conditions of the policy apply to the insurance stated below_ b. Structural alterations, new construction or demolition operations The following is added to the Commercial General performed by or on behalf of the Liability Coverage Form, Section II —WHO IS AN person or organization from whom INSURED: you lease property_ 4. The person(s) or organizations(s) from 7. The person(s) or organization(s) from whom equipment has been leased, but whom land is leased but only with only with respect to their liability arising respect to liability arising out of the out of the maintenance, operation or use ownership, maintenance or use of that by you of equipment leased to you by part of land leased to you_ The following such person(s) or organization(s), subject additional exclusions apply: to the following additional exclusions: This insurance does not apply: This insurance does not apply to: a. Any "occurrence" which takes place a. To any "occurrence" which takes after you cease to lease that land; place after the equipment lease expires; b. Structural alterations, new construction or demolition operations b. To "bodily injury" or "property performed by or on behalf of the damage" arising out of the sole person or organization from whom negligence of the person or land has been leased. organization from whom equipment has been leased. 8. Any state or political subdivision subject to the following additional provisions: 5. The person(s) or organization(s) shown in the Declarations as mortgagee, assignee, This insurance applies only with respect or receiver, but only with respect to their to the following hazards for which the liability as mortgagee, assignee, or state or political subdivision has issued a receiver and arising out of the ownership, permit in connection with premises you maintenance, or use of the premises by own, rent, or control and to which this you. insurance applies: This insurance does not apply to a_ The existence, maintenance, repair, structural alterations, new construction construction, erection, or removal of and demolition performed by or for that advertising signs, awnings, canopies, person or organization_ cellar entrances, coal holes, driveways, manholes, marquees, 6. The person(s) or organization(s) from hoistaway openings, sidewalk vaults, whom you lease property but only with street banners, or decorations and respect to liability arising out of the similar exposures; or ownership, maintenance or use of that part of the premises leased to you and b. The construction, erection, or removal subject to the following additional of elevators; or exclusions: c. The ownership, maintenance, or use This insurance does not apply to: of any elevators covered by this insurance. a. Any "occurrence" which takes place after you cease to be a tenant in that CG 70 34 07 09 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1997 Page 1 of 2 DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A 9. Any architect, engineer or surveyor c. When our coverage for you under this engaged by you but only with respect to policy or a renewal of this policy liability arising out of your premises or terminates and is not continued by "your work". other insurance provided by us. "Work contract" means a written This insurance, with respect to such agreement into which you enter for architects, engineers, or surveyors, does work performed by you or on your not apply to "bodily injury", "property behalf. damage", "personal and advertising injury" arising out of the rendering or 11.Any person or organization to whom you failure to render any professional services are obligated by virtue of a written by or for you including: "insured contract" to provide insurance such as is afforded by this policy, but a. The preparing, approving, or failing to only with respect to liability arising out prepare or approve, maps, shop of the ownership, maintenance, or use drawings, opinions, reports, surreys, of that part of any premises or land field order; change orders, or leased to you_ drawings and specifications; and This does not apply to: b. Supervisory, inspection, architectural or engineering activities_ a. Any "occurrence" that takes place after you cease to be a tenant on 10_Any person or organization other than an those premises, or cease to lease the architect, engineer or surveyor, which land; or requires in a "work contract" that such person or organization be made an b_ Structural alterations, new insured under this policy. However, such construction or demolition operations person or organization shall be an insured performed by or on behalf of such only with respect to covered "bodily insured. injury", "property damage", "personal and advertising injury" caused, in SECTION V-DEFINITIONS whole or in part, by: The following is added: a. Your acts or omissions; or 23."Work contract" means a written agreement into which you enter b. The acts or omissions of those acting for work performed by you or on on your behalf; your behalf. In the performance of your ongoing operations for the additional insured(s) only at the location designated by the "work contract" The coverage afforded to such person or organization does not apply to "bodily injury", "property damage" "personal and advertising injury" occurring after the earliest of the following times: a. When "your work" under the "work contract" (other than service, maintenance or repairs) has been completed. b. When that portion of "your work" under the "work contract" out of which any injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 70 34 07 09 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Copyright, Insurance Services Office, Inc., 1997 Page 2 of 2 DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A PCF 0000055 10 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY -� OTHER INSURANCE CONDITION+! This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a Condition and supersedes any provision to the contract or agreement that this insur- contrary: ance would be primary and would not Primary And Noncontributory Insurance seek contribution from any other insur- ance available to the additional insured_ This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named In- sured under such other insurance; and CG 20 01 04 13 D Insurance Services office, Inc_, 2012 Page 1 of 1 DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A PCP 0000055 10 CG 70 51 06 15 COMMERCIAL GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY SUMMARY OF COVERAGE AND INDEX This is a summary of the various coverages provided by this form. No coverage is provided by this summary. This endorsement is subject to the provisions of your policy, which means that it is subject to all limitations and conditions applicable to the coverage forms attached to this policy unless specifically deleted, replaced, or modified herein. This endorsement is applicable only to those premises described in the Declarations. INDEX 1. Bodily Injury — Mental Anguish Included 2. Off Premises Care, Custody Or Control Coverage $25,000 3. Incidental Medical Malpractice Included 4. Amendment Of Insured Contract Definition Included 5. Liberalization Clause Included 6. Unintentional Failure To Disclose Hazards Included 7. Lost Keys Of Others $500 Occurrencel$1,500 Aggregate 8. Medical Payments $15,000 9. Broadened Mobile Equipment included 10.Newly Formed Or Acquired Organizations Included 11.Non-Owned Aircraft Included 12.Watercraft Coverage Enhancement Included 13.Aggregate Limits Per Project Included 14.Personal And Advertising Injury - Electronic Publication Included 15.Property Damage Liability - Borrowed Equipment $25,000 16.Supplementary Payments (Bail Bonds) Enhancement $5,000 17.Damage To Premises Rented To You Limit $500,000 18.Knowledge Of An Occurrence, Claim, Or Suit Included 19.Voluntary Property Damage Coverage $5,000 Occurrencel$10,000 Aggregate 20.Waiver Of Transfer Of Rights Of Recovery Against Others Included 21.Duties In The Event Of Occurrence, Offense, Claim Or Suit Included 22,Primary And Noncontributory —Other Insurance Condition Included DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A 10.Newly Formed Or Acquired Organizations SECTION 11—WHO IS AN INSURED Paragraph 3. and subparagraphs a., b. and c. are changed as follows: 3. Any organization you newly acquire or form, other than a partnership, joint venture, or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization_ However: a. Coverage under this provision applies only until the Mh day after you acquire or form the organization or at the end of the policy period, whichever is earlier. b. Coverage A does not apply to"bodily injury" or"property damage" that occurred before you acquired or formed the organization; and c. Coverage B does not apply to"personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. No person or organization is an insured with respect to the conduct of any current or past partnership,joint venture, or limited liability company that is not shown as a Named Insured in the Declarations. 11.Non-Owned Aircraft The following is added to Subparagraph g. of 2. Exclusions of SECTION I—COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: (6) An aircraft with a paid crew, that is hired, chartered or loaned but is not owned by the insured. 1 Z.Watercraft Coverage Enhancement Sub-paragraph(2)of paragraph g.Aircraft,Auto Or Watercraft of paragraph 2. Exclusions of Section I - Coverage A are replaced by the following: g. Aircraft, Auto, Or Watercraft (2) A watercraft you do not own that is: (a) Less than 51 feet long; and (b) Not being used to carry persons or property for a charge; 13. Aggregate Limits Per Project A. For all sums which the Insured becomes legally obligated to pay as damages caused by"occurrences" under Coverage A(Section 1), and for all medical expenses caused by accidents under Coverage C (Section 1), which can be attributed only to ongoing operations at a single construction project away from premises owned by or rented to you: 1. A separate Single Construction Project General Aggregate Limit applies to each construction project away from premises owned by or rented to you, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Single Construction Project General Aggregate Limit Is the most we will pay for the sum of all damages under Coverage A, except damages because of'bodily injury" or"property damage" included in the"products-completed operations hazard", and for medical expenses under Coverage C regardless of the number of. a. Insureds; Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 CG70510615 6 1 P a g e DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A b. Claims made or"suits" brought; or c. Persons or organizations making claims or bringing "suits." 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Single Construction Project General Aggregate Limit for that construction project away from premises owned by or rented to the insured. Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Single Construction Project General Aggregate Limit of any other separate construction project away from premises owned by or rented to the insured. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Single Construction Project General Aggregate Limit. B. For all sums which the insured becomes legally obligated to pay as damages caused by'occurrences" under Coverage A (Section 1),and for all medical expenses caused by accidents under Coverage C (Section 1), which cannot be attributed only to ongoing operations at a single construction project away from premises owned by or rented to you: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce any Single Construction Project General Aggregate Limit. C. When coverage for liability arising out of the"products-completed operations hazard" is provided, any payments for damages because of"bodily injury" or"property damage" included in the"products-completed operations hazard," regardless whether such liability arose from: 1. any construction project from premises owned by or rented to you; or 2. any construction project away from premises owned by or rented to you will reduce the Products-Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Single Construction Project General Aggregate Limit. D. If a single construction project away from premises owned by or rented to you has been abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same single construction project. B. The provisions of Limits of Insurance (Section 111) not otherwise modified by this endorsement shall continue to apply as stipulated. 14.Personal And Advertising Injury - Electronic Publication A_ Sub-paragraphs b., d.,and a of paragraph 14."Personal and Advertising Injury" (of Section V—Definitions) are replaced by the following: b. Malicious prosecution or abuse of process; d. Oral,written, televised, videotaped, or electronic publication of material that slanders or libels a person or organization or disparages a person's or organization's goods, products, or services; Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 CG70510615 7 1 P a g e DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A 18.Knowledge Of Occurrence, Claim, Or Suit SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS—AMENDMENTS The following is added to paragraph 2_ e. The Duties in paragraph 2. do not apply until after the"occurrence" or offense to: (1) You, if you are an individual; (2) A Partner, if you are a partnership; (3) An"executive officer" or insurance manager, if you are a corporation; (4) Your elected or appointed officials, trustees, board members, or your insurance manager if you are an organization other than a partnership,joint venture, or limited liability company. 19.Voluntary Property Damage Coverage: The following coverage is added: At your request, we will pay for"loss" to tangible property of others arising out of your business operations, The most we will pay for this coverage is$5,000 for each "occurrence"with a$10,000 aggregate limit during the policy period. The"loss" must occur during the policy period and in the"coverage territory." "Loss" means unintended damage or destruction. "Loss"does not mean disappearance, abstraction, theft, or voluntary parting with property as a result of trick, scheme, or false pretense. Voluntary Property Damage Coverage does not apply to: A. Damage arising out of the ownership, maintenance, use, or entrustment of any "auto"; B. Property you own, occupy, rent or lease from others, or C. Property on your premises for sale, service, repair or storage. If the policy to which this endorsement is attached is written with a property damage liability deductible, the deductible shall apply to this Voluntary Property Damage Coverage. The limits of coverage stated above shall not be reduced by the amount of this deductible. } 20.Waiver Of Transfer Of Rights Of Recovery Against Others Paragraph 8.Transfer Of Rights Of Recovery Against Others To Us (of SECTION IV--COMMERCIAL GENERAL LIABILITY CONDITIONS) The following is added: We will waive any right of recovery we may have against a person or organization because of payments we have made under this insurance for injuries or damages arising out of"your work" done under a written contract with that person or organization provided that: a. Such written contract with that person or organization contains a contractual provision that prevents you from exercising your right(s)of recovery against such person or organization Our waiver of any right of recovery as stated above only applies to that person or organization identified above and only if the injury or damage occurs during the policy period and subsequent to the execution of such written contract. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 CG70 §10616 101Page DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A 21.Duties In The Event Of Occurrence, Offense, Claim, Or Suit Paragraph 2.a., SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, The following is added to a. Knowledge of an "occurrence", claim or"suit" by the agent, servant or"employee" of any insured shall not in itself constitute knowledge of the insured unless; You, if you are an individual; • A partner, if you are a partnership; A member or manager, if you are a limited liability company; • An executive officer or designee, if you are a corporation; • A trustee, if you are a trust; or A designee, if you are any other type of organization. shall have received notice from its agent, servant or"employee." Paragraph 2.b., SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, The following is added to b. Knowledge of an "occurrence", claim or"suit" by the agent, servant or"employee" of any insured shall not in itself constitute knowledge of the insured unless; • You, if you are an individual; • A partner, if you are a partnership; • A member or manager, if you are a limited liability company; • An executive officer or designee, if you are a corporation; • A trustee, if you are a trust, or • A designee, if you are any other type of organization. shall have received notice from its agent, servant or"employee." 22.Primary And Noncontributory - Other Insurance Condition The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and (2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the additional insured. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1997 CG70510615 111Page DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A PCA 0006942 08 COMMERCIAL AUTO CA 30 00 07 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AUTO ENHANCEMENT ENDORSEMENT SUMMARY OF COVERAGE AND INDEX This is a summary of the various coverages provided by this form. No coverage is provided by this summarV. This endorsement is subject to the provisions of your policy, which means that it is subject to all limitations and conditions applicable to the coverage forms attached to this policy unless specifically deleted, replaced, or modified herein. A. Blanket Additional Insureds Included B. Employee Hired Auto: Liability Included Physical Damage Included C. Limited Liability Company As An Insured Included D. Newly Acquired Or Formed Entities: Included E. Supplementary Payments: Bail Bonds $3,000 Reasonable Expenses Due to Our Request $500 Per Day F. Hired Autos Physical Damage: Lesser of$50,000 or ACV Loss of Use $75 Per Day/$750 Per Loss G. Towing And Labor Private Passenger Types/"Light Trucks" $75 Per Disablement/$300 Total Other Than Private Passenger Types I"Light Trucks" $150 Per Disablement/$300 Total H. Personal Effects $500 I. Transportation Expenses—All Vehicle Types Temporary Transportation $75 Per Occurrence/$750 Total Return of Stolen Auto $5,000 J. Rental Reimbursement— Private Passenger Type I"Light Truck" $75 Per Day/$750 Per Occurrence K. Electronic Equipment Included L. Loan I Lease Gap Coverage Included M. Glass Repair Comprehensive Deductible Waived N. Waiver Of Subrogation Included O. Unintentional Omissions Included CA 30 00 07 14 Includes copyrighted material of Insurance Services Office, Inc Page 1 of 6 with its permission DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A COMMERCIAL AUTO CA 30 00 07 14 This endorsement modifies insurance provided under b. For Hired Auto Physical Damage Coverage, the following: the following are deemed covered "autos" you own: A. BLANKET ADDITIONAL INSUREDS (1) Any covered"auto' you lease, hire, rent, Under Section II— LIABILITY COVERAGE A. or borrow; and Coverage 1.Who Is An Insured is amended to include as an additional"insured": (2) Any covered "auto" hired or rented by your"employee" under a contract in that Any person or organization with who is required individual "employee's" name provided under a written contract with you to be included as your permission has been given and the an "insured" under this policy, but only with respect "employee" is performing duties related to their legal liability for acts or omissions of a to the conduct of your business, person for whom Liability Coverage is afforded under this policy. However, any "auto" that is leased, hired, rented, or borrowed, with a driver, is not a covered "auto". This coverage shall be primary and not contributory with respect to the person or organization included C. LIMITED LIABILITY COMPANY AS AN as an"insured" under this section. Any other INSURED insurance that person or organization has shall be excess and not contributory with respect to this The following is added to Section 11— LIABILITY insurance, only if it is required in the written COVERAGE A. Coverage 1. contract, permit, or agreement identified in this Who Is An Insured. section and is allowed by law. f. If your business is structured as a Limited B. EMPLOYEE HIRED AUTO Liability Company, you are an insured for any covered "auto". The section Who is An The following is added to Section II—LIABILITY Insured that applies to anyone else using a COVERAGE A.Coverage 1. covered"auto" you own, hire, or borrow also Who Is An Insured: applies to Limited Liability Companies. The members and managers of the Limited e. An "employee" of yours is an "insured"while Liability Company are also"insureds"while operating a covered "auto" hired or rented under an using a covered "auto" you do not own, hire, agreement or contract in that"employee's" name, or borrow, but only during the course of their with your permission, only when performing duties employment duties for you. However, related to the conduct of your business. members and managers are not an "insured" for any covered "autos" owned by them or Section IV—BUSINESS AUTO CONDITIONS,B. General members of their household. Conditions,5.Other Insurance, b.is deleted and replaced by the following: CA 30 00 07 14 includes copyrighted material of Insurance Services Office, Inc rage 2 of 6 with its permission DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A COMMERCIAL.AUTO CA 30 00 07 14 the Declarations Page. Any Comprehensive Coverage deductible shown on the Declarations Page does not apply to"loss" caused by fire or lightning. Additionally, the Comprehensive Coverage deductible does not apply to glass, only when that glass is repaired. Should the glass be replaced, the applicable Comprehensive Coverage deductible will apply. N. WAIVER OF SUBROGATION Section IV--BUSINESS AUTO CONDITIONS,A. Loss Conditions, 5, Transfer Of Rights Of Recovery Against Others To Us is deleted in its entirety and replaced by the following: 5. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization because of payments we make for"bodily injury" or"property damage"arising out of a covered "auto"only when you have assumed liability for such "bodily injury" or "property damage" under an "insured contract'. In all other respects, if a person or organization to, or from whom,we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. This provision only applies if the written Contract, permit, or agreement has been Executed or issued prior to the occurrence of any "bodily injury" or "property damage". O. UNINTENTIONAL OMISSIONS The following is added to Section IV—Business Auto Conditions, B. General Conditions, 2. Concealment, Misrepresentation, Or Fraud: We will not deny coverage under this policy if you fail to disclose all hazards existing as of the inception date of the policy, as long as such failure is not intentional. CA 30 00 07 14 Incfudes copyrighted material of Insurance Services Office, Inc Page 6 of 6 with its permission DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A POLICY NUMBER: PCA 0006942 08 COMMERCIAL,AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is in- dicated below. Named Insured: BROWN BROTHERS PLUMBING & HEATING GO INC Endorsement Effective Date: SCHEDULE Name Of Person(s) Or Drganizatian(s): ANY OR ALL PERSON(S) OR ORGANIZATION(S)AS REQUIRED BY WRITTEN/EXECUTED CONTRACT, FOR .JOBS IN THE STATE OF NORTH CAROLINA Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Cover- age, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section 11 — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coveragesof the Auto Dealers Coverage Form. CA 20 48 10 13 © Insurance Services Office, Inc_, 2011 Page 1 of 1 DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-64) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION THAT IS REQUIRED BY WRITTEN CONTRACT EXCEPT OPERATIONS RELATED TO WRAP-UPS_ BUILDERS MUTUAL INSURANCE COMPANY INC IS NOT A CONTRIBUTOR TO ANY WRAP-UP PROTECT. 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 Policy No. Endorsement No. Insured Premium insurance Company Countersigned by WC 00 03 13 (Ed. 4-34) Copyright 1983 National Council on Compensation Insurance. DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 ( d. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule EXCLUDES OPERATIONS ON-SITE UNDER A WRAP-UP COVERAGE FOR SKANSKA USA IN NORTR CAROLINA. WC 00 03 13 04 84 COVERS ONLY OPERATIONS OFF-SITE NOT INCLUDED IN WRAP-UP OPERATIONS. BUILDERS MUTUAL INSURANCE COMPANY INC IS NOT A CONTRIBUTOR TO ANY WRAP-UP PROJECT- 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 Policy No. Endorsement No. Insured Premium n insurance Company Countersigned by WC 00 03 13 (Ed. 4-84) Copyright 1983 National Council on Compensation insurance. DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A ORMI BF011101-13 P11-1111bilIg 6E I 10 Pdnmary and ry is CJIdorSC111C1i1.,CCFG(;[I v 0 BI-1/20 I(X at(,,it;lres to mid Imills'a part(11 Pol icy Num lx,F- .J'olivy. Please)-Cmcl it Carol'utly. 1115 el1d0u3(,-,1Y1(1ii1 lyiodific,;imuralicc,provided miler ilm Cowrat, indicated 11dow: COMMERCIAL �AL LIABILRYTt)VERAGE C014'17ILM-71'01"N POL-URDINT LIABILITY COY BRA01 P', SCHEDULE 7 Name of Pern on or OrgaikizatIMI: Ally Or Ofgallizafioll(t,)-whom(11,C NctrriGcllrlstrr ec1 ague-cs,ill ;I tivi itmu contract,to pruvide Primary aad/or of I 1hig 1-Towmr,thig status uxikSts only for the bt Colimidev.,111(m of ail .1dilitiu-mal pmmiium of Mplilt0c and uotwiffis b wit)I li.�, 'lily I thing Colitaillal it] 111'r,policy to 11w coll1r;Iry, it is Hereby agrocd 11IM: -110hey M1.111 be coils.,idered primary tuarty stmilm lb.6-d 1pal11IC-S ill mipcct towolk paRmilo'd by You 1111der ally t hataul t"t-11 P111C,11 111i"I P'111Y- It a; uLhur pCuqmI(s)or o!galkizatioli(a)mulmO jil 11105o11(:A1110 may llIV(, IS, aml Ilml- collivibil[017 L-CC-510-0317 DowSQn Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A Bmwn BmUmqs PWaMMg&AdMg A W, Endweement NumMW 11 Mold Deduclibie Undomemen't This miduisuipl., n1laches to and Forms a pwLaf 11"Aicyljumllu FRIACC122903-01 TO mWmwmmt olial)gfs 1.11C PaUY, 1,1107so Ic"Id it rardiffly. M CUUMMUM Of MI ZkdditiOttlkl I)MMiU111 Ot t wida 1110 covenigq Parl(B)indicawd beloki": CONTRACTORS POLLUTION LIABILUY(--'.0VVRAGJ`, 1AWFE-8SIO'NA1:,LIABILITY COVLJZAGE� Ta comsidclxatioa of 11w,Im-mlium.diargod.and xiutLmitllstalidillg allything 4,ultwhlf,d in 111io Policy to the coulmy,it.is hac"byagrbod that such c"o-vol-ae'e, area in iamb Dwcd by US Poliuysliall be-subject to a in cadt Abu adding Avelly or Aditwelly out,ot or in cuthmumacc WiMmhuti. Alogycd or threalmod existeacc, gowth,qPf(mJ,Pvolif6ratioll, dimiulvgk:- dinprugal,sccpagq,release or ezcatjw,of air Y Ibl-111 oU1111gug,im-'113dilig lm)'W ov lllildr-,w,mid awy laycutmitiz,q)oftz,sccals or bypi,odImli prodlicod or i k7loatic"il, by tImgi. It is also agrcud flial all c-qxj=3 and Costs dcscribcd unocr Ow o aPhlclueulary PaymcM ScAm stAcd hi the Covmmp Form shall bc stil?Jrct 1 o the deductible. DowSQn Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A Dnwn DmIl,em Plurlrbbg ti,! IcdAg Cu lr,c t1��ff��1� �r�c}c�r�elt�ent hh_tiriber: �'1 'y13�r t 1i15 Cl1L16r'SClrir rity drec. iva f,/_31'. w s atwdxs k,mid Co>:tits tt.l?att o1l�otiay l TunYltc•J nndorscJtIont changes tlsc Policy. Plemm,i-(,.,,id it carr.f'lit , '�llitr CtlLlU9"i35ii1lGltl JY1{7LlJlJ�BliliJt,J'e"Jil{:C pJ�OYlLlti[l tiJ{Llt7t'Qf1i J.OAlUS1t1r1�y- CONTRACTORS POL>f,UTIRON LIABILITY COME RACII,('ART }"-lil1T're,or Perso#!or O 11mlif-attU{{: Au;y or to-wliotll tltLi lVt'TJ7'ICtC.�111.C}Ji'!'(j�lz7iCC:S;, J;t_.i written cutiLeact,to provide a waRr lowcvor.this ittal;ir; {S;xisln dilly ror 1lrG pr(�jcc:l spg died ill drat cotrt.ract_ 't'lte CoJtitxr{ty vmives ar i rigid t rrocovay ii may have agaiw;[t},c ttcj-�,wci or organization shown in air,ahovr,�Sc1 cdulc bm-atis-,orhayluelitn tha cottlparly rt akc,-,.Eor•iiij{rr'y or Llattm%c aJ Whg orti of-(lie hi.sm'ed s wi-,rk Llwic uuL}r.•r a conb ol. IVMt ila�tayo-sga of.a2"gallizati{rrt.. '1.'}rQ Ivaivor applic,; ux)ly to t4c per;;{fir or at-gaitization in tltc above-„c edtrle. uIldcr Yla 51wil thin cxiLluicatuctit esor.ro OWN am txJby;t1C%TRA c.ltallge 111n:.cube of c:ovel-age or illcic.ue 1},to.tlggivt,:tt s Li{lt.its of 1Jisur.,n,,{ :isstY�s! i!>t1t�.]�eJr}ar�rtiovs_ F-CC 320-0 12 DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A Mown DaMem PHUng&WhaW w co h it-, AutomaVc Additiorval Wwsurc.,d — ovinwero" ow cridorsci tic.)it,01-friu.tivo gkinWH MWIalms in fond Amos a pna of Pdbylknnbor ht colibide-ralioll of ills akIditional proaliolli of - inudiRes hourauct pnwWcd War To hMwwKg: CONTRACTORS rOLLUTION UABILYYY COV Ell A(�'E J."AlCl' of Or Orgymi�,.Iiiow A.ny poraus)(g)or 11w in a w6t(cli conLvacl,to linilica';lilt athlitiollat instifod. Bownwcr, tbi,s4ahl, gz'aip,ts only for t1ta J)rqled gpedric(I in fliat contract- UIG PGE.8011 or orgimization dmun I Th WAde is irichuled an as WWUL 10 only frith rmpeck to 111.11-1woma'.s or orgLiniatiou',i vicarioll" I ial)ility ari�siug ow oryour oiI Flo rorlyloll for 111A ilimlrc(i- DonuS&nEnveoPo 0 � �3F1o7c�o4nn-4.1 4~5~- _3 --------- 13cliedula of Forym and miqh ( --------'-------- - ---- - -! ---' / k`C,CC-316-0712 Nuclear Eiimi-gy Liability -----'`— `