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2022-643-E-AMS-WB Brawley Company-WCOB_3rd Floor Minor Upfit Components
Revised 06/21 1 [Departmental Use Only] TITLE WCOB RENO FY 2022/23 NORTH CAROLINA SERVICES AGREEMENT NO RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter “Agreement”), made and entered into this 12th day of December, 2022, (“Effective Date”) by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County") and WB Brawley, (hereinafter, the "Provider"). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Agreement is for services to be rendered by Provider to County with respect to (insert type of project): Additional glass inserts to eight office doors per door elevation. Add two qua outlets to the IT workroom. Additional upper cabinets to the secure file/print room along with the deferred phone room wallcovering are individual scope components that may be included in this additional project. ii) By executing this Agreement, the 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. iii) Time is of the essence with respect to this Agreement. iv) The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. 2. Responsibilities of the Provider a. Services to be provided. The Provider shall provide the County with all services required in Section 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout the United States and in accordance DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Revised 06/21 2 with applicable federal, state and local laws and regulations applicable to the performance of these services. Provider is solely responsible for the professional quality, accuracy and timely completion and submission of all work related to the Basic Services. ii) Provider shall be responsible for all errors or omissions of its agents, contractors, employees, or assigns 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. iii) The Provider shall not, except as otherwise provided for in this Agreement, subcontract the performance of any work under this Agreement without prior written permission of the County. No permission for subcontracting shall create, between the County and the subcontractor, any contract or any other relationship. iv) Provider is an independent contractor of County. Any and all employees of the Provider engaged by the Provider in the performance of any work or services required of the Provider under this Agreement, shall be considered employees or agents of the Provider only and not of the County, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Provider. v) If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Provider represents that it or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. vi) In determining the Basic Services to be provided, should any documents be referenced in this Agreement, the terms of this Agreement shall have priority in any conflict between the terms of referenced documents and the terms of this Agreement. vii) Should this Agreement involve project designs, the construction or creation of which is to be bid out or fulfilled by other contractors, and bidding or negotiation with contractors produce prices which, when added to the other elements of the approved total project cost, produce a cost that is in excess of the approved total project cost, the Provider shall participate with the County in negotiation and design adjustments to the extent such are necessary to obtain prices within the approved total project cost. All activity of the Provider with respect to these matters shall constitute Basic Services and shall be performed by the Provider without additional compensation. If negotiation and design adjustments fail to bring costs within the total project cost the County may reject all bids and Provider will redesign or reduce portions of the project in an effort to reduce the bid prices to within the total project cost and rebid the project. One such redesign is included within Basic Services. If this second letting for bids does not produce bids that are within the approved total project cost initially or after negotiations DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Revised 06/21 3 with the contractor the cost is not reduced to an amount within the total project cost, the Provider is not obligated to engage in further redesign. 3. Basic Services a. Basic Services. The Services to be rendered pursuant to this Agreement are as follows (fully describe services to be provided): WCOB Minor Upfit Components 4. Duration of Services a. Term. The term of this Agreement shall be from 12/02/22 to 03/02/23. b. Scheduling of Services. i) The Provider shall schedule and perform its activities in a timely manner. ii) Should the County determine that the Provider is behind schedule, it may require the Provider to expedite and accelerate its efforts, including providing additional resources and working overtime, as necessary, to perform its services in accordance with the approved project schedule at no additional cost to the County. iii) The Commencement Date for the Provider's Basic Services shall be 12/02/22. 5. Compensation a. Compensation for Basic Services. Compensation for Basic Services shall include all compensation due the Provider from the County for all services satisfactorily (as determined by the County) performed pursuant to this Agreement. The maximum amount payable for Basic Services shall not exceed Ten Thousand Dollars ($10000.00). Payment for satisfactorily performed Basic Services shall become due and payable within thirty (30) days of Provider properly invoicing County. Payment shall be subject to provisions of Section 5(b). b. Disputes. In the event the amount stated on an invoice is disputed by the County, the County may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. 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. c. Additional Services. County shall not be responsible for costs related to any services in addition to the Basic Services performed by Provider unless County requests such additional services in writing and such additional services are evidenced by a written amendment to this Agreement. 6. Responsibilities of the County a. Cooperation and Coordination. The County has designated (Alan Dorman) to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board of DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Revised 06/21 4 Commissioners and who shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance a. General Requirements. Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any additional insurance as may be required by County’s Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). If County’s Risk Manager determines additional insurance coverage is required such additional insurance shall consist of NA (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. 8. Indemnity a. Indemnity. To the extent authorized by North Carolina law the Provider agrees, without limitation, to defend, indemnify and hold harmless the County from all loss, liability, claims or expense, including attorney's fees, arising out of or related to the Project and arising from property damage or bodily injury including death to any person or persons caused in whole or in part by the negligence or misconduct of the Provider except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 9. Amendments to the Agreement a. Changes in Basic Services. Changes in the Basic Services and entitlement to additional compensation or a change in duration of this Agreement shall be made by a written Amendment to this Agreement executed by the County and the Provider. The Provider shall proceed to perform the Services required by the Amendment only after receiving a fully executed Amendment from the County. 10. Termination a. Termination for Convenience of the County. This Agreement may be terminated without cause by the County and for its convenience upon seven (7) days’ prior written notice to the Provider. b. Other Termination. The Provider may terminate this Agreement based upon the County's material breach of this Agreement; provided, the County has not taken all reasonable actions to remedy the breach. The Provider shall give the County seven (7) days' prior written notice of its intent to terminate this Agreement for cause. Either party may terminate this Agreement upon notice to the other party that obligations pursuant to this Agreement are made impractical due to declarations of emergency by Orange County or by North Carolina due to events directly impacting Orange County. Both parties shall DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Revised 06/21 5 remain responsible for all payment and performance due up to the receipt of such notice, but shall have no further obligation or responsibility beyond that date provided the terminating party has taken all reasonable steps to complete the performance of its obligations. c. Compensation After Termination. i) In the event of termination, the Provider shall be paid that portion of the fees and expenses that it has earned to the date of termination, less any costs or expenses incurred or anticipated to be incurred by the County due to errors or omissions of the Provider. Upon request of the County, the Provider shall submit to County all relevant documentation, including but not limited to, job cost records, to support its claims for final compensation. ii) Should this Agreement be terminated, the Provider shall deliver to the County within seven (7) days, at no additional cost, all deliverables including any electronic data or files relating to the Project. d. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. e. Suspension. County may suspend the Basic Services and this Agreement at any time for County’s convenience and without penalty to County upon three (3) days’ notice to Provider. Upon any suspension by County, Provider shall discontinue work on the Basic Services and shall not resume the Basic Services until notified to proceed by County. 11. Additional Provisions a. Limitation and Assignment. The County and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County nor the Provider shall assign or transfer its interest in this Agreement without the written consent of the other. b. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. 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. c. Non-Discrimination. 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 DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Revised 06/21 6 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. d. Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. e. Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. f. Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the Parties. g. Ownership of Work Product. Should Provider’s performance of this Agreement generate documents, items or things that are specific to this Project such documents, items or things shall become the property of the County and may be used on any other project without additional compensation to the Provider. The use of the documents, items or things by the County or by any person or entity for any purpose other than the Project as set forth in this Agreement shall be at the full risk of the County. h. 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 or 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 or non-appropriation of public funds. It is expressly agreed that County shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement. In the event of a change in the County’s statutory authority, mandate or mandated functions, by state or federal legislative or regulatory action, which adversely affects County’s authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Provider DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Revised 06/21 7 of such limitation or change in County’s legal authority. i. Signatures. 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 11A and Article 40 of North Carolina General Statute Chapter 66. j. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Provider’s Name Attention:Alan Dorman WB Brawley P.O. Box 8181 5121 Kingdom Way, Ste 305 Hillsborough, NC 27278 Raleigh NC 27607 [SIGNATURE PAGE TO FOLLOW] DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Revised 06/21 8 IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have hereunder set their hands and seal, all as of the day and year first above written. ORANGE COUNTY: PROVIDER: By: _________________________________ Bonnie Hammersley By: __________________________________ Randall Grub Printed Name and Title DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE 12/20/202212/22/2022 Revised 06/21 9 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Party/Vendor Name: WB Brawley Company Party/Vendor Contact Person: Randall Grub Contact Phone: 919- 636-1338 Party/Vendor Address: 5121 Kingdom Way, Suite 305 City Raleigh State: NC Zip: 27607 Department: AMS Amount: $10000.00 Purpose: WCOB_3rd Floor Minor Upfit Components Budget Code(s): 61370035- 880000-10078 Vendor # 67616 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date Approved by Board Yes No Agenda Date: --- For Section XIV. c. contracts only, Approved by Board in Current FY Budget Yes No This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement: Department Director’s Signature ________________________________________ Date: ________ Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Information Technologies (Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE 12/15/2022 12/21/2022 12/22/2022 12/22/2022 To:Date:12/2/2022 Project:PCCO #: Project ID#:HH Project #: Contractor:Contractor #: Description of change: GC Materials (Attach list with Qty, Item, Unit $, Unit mh, total mh, OT mh, Total $)SUBTOTALS 1. Total Direct Cost of Materials 0 $0.00 2. Sales Tax (NC, Orange County) 7.50% 0 $0.00 3. Shipping, Transportation, Fees $0.00 4. Total for Materials & Shipping $0.00 5. Overhead and Profit on Item 4 10%$0.00 (10% maximum)$0.00 GC Labor:(Attach list(s) with Labor Scope(s), Labor Rate(s), Labor Hour(s) 6. Total Labor:62.50$ 7. Total Supervison:1,188.46$ 8. Payroll Taxes & Insurance 40.0%$500.38 9. Total Labor + Burden (6+7+8)$1,751.35 10. Overhead and Profit on Item 9 10.0%$175.13 (10% maximum on straight labor cost, not premium)$1,926.48 Equipment Rental: (Attach quotes) 11. Equipment Rental (Includes 7.5% Sales Tax, Delivery Fees)$0.00 12. Waste/Dump Fees $0.00 13. Total for Equipment Rental $0.00 14. Overhead and Profit 10.0%$0.00 (10% maximum)$0.00 Subcontractors: (Attach quotes with material and labor backup) 15. Subcontractors $7,148.56 16.Overhead and Profit on Item 15 5.0%$357.43 (5% maximum)$7,505.99 Subtotal Before Bonds and Insurance $9,432.47 GC Bonds and Insurance: 17.Insurance (1% of of direct cost subtotal)$94.32 18.Bonds (1% of direct cost sustotal)$94.32 o)$188.65 Total:$9,621.12 Time Extension Request of:0 day(s) is being requested for this change in scope of work. Notice to Proceed Date: 7/11/2022 Original/Revised Contract Days to Complete:120 Original/Revised Substantial Completion Date:11/8/2022 Additional Contract Days to Complete: Adjusted Contract Days to Complete: Adjusted Substantial Completion Date: 11/8/2022 Contractor's Signature: ___________________________________________________________Date: ________________ Approval Recommended by Design Consultant: ___________________________________________________________Date: ________________ Owner's Representative Approval: ___________________________________________________Date: ________________ cc: WORK PROPOSAL WB Brawley The Contractor agrees to perform the work outlined in this change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Per RFP004: 1) additional glass insets to eight (8) office doors per door elevation FG; 2) Add two (2) qua outlets to the IT wowrkroom #312. This work is contemplated as outside of the completed contract work and will be invoiced directly to Orange County. The RFP005--additional upper cabinets to the secure file/print room (#327) along with the deferred phone room wallcovering are individual scope components that may be included in this additional project entitiled "WCOB Minor Upfit Components" N/A 2022108 Leah Filomena, HH Architecture West Campus 3rd Floor Office Upfit WCOB Minor Upfit Components DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Administrative Processing, Supervision and Management Unit Rate Time Subtotal Total Labor Project Assistant - Administration Hrly Rate 31.25$ 2 62.50$ 62.50$ Supervision Project Superintendent-Work Supervision Hrly Rate $43.27 24 1,038.46$ Project Manager-Project Management and Supervision Hrly Rate $50.00 3 150.00$ 1,188.46$ GC Labor Summary Per PR-02 issued on 12/20/21, replacement of cracked toilet and the repair of eight (8) toilet flanges. DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Subcontractor Summary Harris Electric 1,478.56$ Martin Architectural Products 5,670.00$ 7,148.56$ DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE 511 EAST CHATHAM STREET CARY, NC 27511 PHONE: 919-469-9661 FAX: 919-469-9630 Quote To:WB Brawley Company Date:November 16, 2022 MAP Change #:TBD Job Name:Orange County West Campus Office 3rd Floor Wilmington, NC Location:Hillsborough, NC 27278 Attn:Jeff Thompson Martin Job #:352951 A contract change is being made. Reason for change: MAP COP TBD - RFP #4 Tag #Add Deduct Quantity Description Amount X 8/ea.Existing doors (unistalled & picked up, then delivered &$2,400.00 reinstalled X 8/ea.Full glass cut outs & flush bead $1,030.00 X 8/ea.Flush bead sets finished to match existing door $700.00 X 8/ea.Full glass 1/4" tempered w/glazing tape installed $1,540.00 Lump Sum $5,670.00 Tax Included Total $5,670.00 Accepted:Martin Architectural Products Chase SizemoreDate: Project Manager NOTE:Changes to the scope of work may impact project schedules and duration. NOTE:Signed copy of change must be returned to our office (not by fax) before change can be executed. Please notify our office within seven (7) working days from this date if your records do not correspond. Your immediate attention is appreciated. We are proceeding with this change. Please issue a change order. We are not proceeding without a formal change order. Please issue a change order DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE CHANGE PROPOSAL REQUEST Proposal Request # 4 Date Issued: October 26, 2022 Contractor: W.B. Brawley Address: 5121 Kingdom Way, Suite 305 Raleigh, NC 27607 Attention: Jeff Thompson Project Name: West Campus Office 3rd Floor Upfit Owner: Orange County Address: 131 West Margaret St, Suite 300, Hillsborough, NC 27278 HH #: 21-094 SCO #: N/A Please submit an itemized proposal for changes in the Contract Sum and Contract Time for proposed modifications to the Contract Documents described herein. Submit proposal within 7 days or notify the Architect in writing of the date on which you anticipate submitting your proposal. THIS IS NOT A CHANGE ORDER, CONSTRUCTION CHANGE DIRECTIVE OR A DIRECTION TO PROCEED WITH THE WORK DESCRIBED IN THE PROPOSED MODIFICATIONS. Description: Provide labor and material cost to add glass insets to eight (8) office doors per door elevation FG. Provide labor and material cost to add two (2) quad outlets to the IT Workroom (#312). Requested By: Leah Filomena HH Architecture Cc: Alan Dorman, Orange County DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE EXISTING CONSTRUCTION TO REMAINNEW WALL CONSTRUCTIONRENOVATION PLAN LEGENDPLAN NOTESP01ALIGN FIN. FACE OF NEW WALL WITH FIN. FACE OF EXISTING WALLP02PATCH & REPAIR WALL AT CORNER BENEATH RUBBER BASEP03P04NEW STAINLESS STEEL CORNER GUARD TO MATCH EXISTING - SEE DETAIL 05/A620NEW CONCEALED CORNER GUARD - SEE DETAIL 06/A6202-HR RATED FIRE BARRIERAREA OF WORK NOT IN SCOPEGENERAL NOTESG01G02PATCH & REPAIR CRACKS IN WOOD WINDOW FRAMING TRIM AT EACH WINDOW LOCATION PRIOR TO PAINTINGREPLACE RUBBER WEATHER STRIPPING AT EACH DOUBLE HUNG WINDOW LOCATION 4567891011121314151617LOBBY300300FINANCIALSERVICES331331DEPUTY FINANCIALSERVICES DIRECTOR323323SHAREDCONFERENCE302302ACCT.326326STAIRS308308ELEV.348348ELEC.347347SHAREDACCOUNTANTS319319IT WORKROOM312312WOMEN350350HR SECUREFILE338IT DATACENTER320MOTHER'SROOM321MEN349349SHAREDCONFERENCE337337JAN.330330BREAKROOM329329CORRIDOR328328OFFICE340340FINANCEDIRECTOR333TOUCH DOWNSPACE334334OFFICE335335OFFICE339339HR DIRECTOR341SHAREDOFFICE342OFFICE343343RECEP.301301CORRIDOR336336CORRIDOR324324IT STOR.315315STAIR351351SECURE FILE/PRINT327327SHARED BUDGET322322TOUCH DOWN307307TOUCH DOWN309309IT STORAGE317317IT SUPPORT318318IT SUPPORT316316TOUCH DOWN314314TOUCH DOWNSPACE332332PHONE311311PHONE310310IT SUPPORT304WORK ROOM346STOR.325325OFFICE344344CORRIDOR305305PRINT / COPY306306IT STORAGE303303CORRIDOR313313CORRIDOR345345343344P01P01P01301346319321310_________A52101P01ALIGN12' - 0"12' - 4"9' - 0"ALIGNEQEQ_________A52001345P02_________A52103CLR.5' - 0"338B_________A52003_________A52005M30AM30AM30AM30AM30AM30AM30AM30AM30AM30AM30CM30BP04P03338A3273119290ARDEGISTERE TRCHITECN AO RTHCAROLINKRSTEMARIEE SSHNIHRNAORTHCAROLIN51670EGISTEREDARCHITECTURALCNORPORATIOHARCHITECTUREP.A,.DATE ISSUEDSHEETJOB NUMBERThese drawings are the property of HH Architecture, P.A. They may not be used for any purpose without written permission. Copyright 2022 by HH Architecture, P.A. All rights reserved.Plot Time:PROJECT STATUS1100 Dresser CourtRaleigh, NC 27609Office 919.828.2301Email office@hh-arch.com3/30/2022 3:40:21 PMWEST CAMPUS OFFICE 3RD FLOOR UPFITA1313rd FLOOR PLAN21-094ORANGE COUNTY GOVERNMENT131 WEST MARGARET LANE, SUITE 30003/24/2022PERMIT SETN1/8" = 1'-0"A131013rd FLOOR RENOVATION PLAN0'GRAPHIC SCALE4'16'8'32'NO. REVISION DATEDocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 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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. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE The Cincinnati Insurance Company 5/31/2022 McGriff Insurance Services 1111 Military Cutoff Road #221 Wilmington, NC 28405 910 763-3431 910 763-3431 877-297-1096 WB Brawley Company 3314 Jaeckle Drive Suite 120 Wilmington, NC 28403 10677 A X X X PD Ded:1,000 X Y Y EPP0517147 01/01/2022 01/01/2023 1,000,000 500,000 10,000 1,000,000 2,000,000 2,000,000 A X X X Y Y EPP0517147 01/01/2022 01/01/2023 1,000,000 A X X X 0 Y Y EPP0517147 01/01/2022 01/01/2023 5,000,000 5,000,000 A N Y EWC0631994 01/01/2022 01/01/2023 X 1,000,000 1,000,000 1,000,000 A EQMT Leased/Rente EPP0517147 01/01/2022 01/01/2023 Limit - 75,000 Deductible - 1,000 Project: West Campus 3rd Floor Up-Fit Address: 131 Margaret Lane Suite 300, Hillsborough, NC, 27278 Orange County 300 West Tryon St. Hillsborough, NC 27278 1 of 1 #S30121049/M29892645 21WBBRA1Client#: 1745122 ABLAN 1 of 1 #S30121049/M29892645 DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE This page has been left blank intentionally. DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 1 of 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS'COMMERCIAL GENERAL LIABILITY BROADENED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Endorsement - Table of Contents: Coverage:Begins on Page: 1. Employee Benefit Liability Coverage .......................................................................................3 2. Unintentional Failure To Disclose Hazards .............................................................................9 3. Damage To Premises Rented To You ......................................................................................9 4. Supplementary Payments ......................................................................................................10 5. Medical Payments ...................................................................................................................10 6. 180 Day Coverage For Newly Formed Or Acquired Organizations ...................................10 7. Waiver Of Subrogation ...........................................................................................................11 8. Automatic Additional Insured - Specified Relationships: ..................................................11 • Managers Or Lessors Of Premises; • Lessor Of Leased Equipment; • Vendors; • State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises; and • Mortgagee, Assignee Or Receiver 9. Property Damage To Borrowed Equipment .........................................................................14 10. Employees As Insureds - Specified Health Care Services And Good Samaritan Services ...................................................................................................................................15 11. Broadened Notice Of Occurrence .........................................................................................15 12. Nonowned Aircraft ..................................................................................................................15 13. Bodily Injury Redefined ..........................................................................................................15 14. Expected Or Intended Injury Redefined ...............................................................................15 15. Former Employees As Insureds ............................................................................................15 16. Voluntary Property Damage Coverage And Care, Custody Or Control Liability Coverage ..................................................................................................................................16 17. Broadened Contractual Liability - Work Within 50' Of Railroad Property .........................17 18. Alienated Premises .................................................................................................................17 B. Limits Of Insurance: The Commercial General Liability Limits of Insurance apply to the insurance provided by this endorse- ment, except as provided below: 1. Employee Benefit Liability Coverage Each Employee Limit: $1,000,000 Aggregate Limit: $3,000,000 Deductible Amount: $ 1,000 3. Damage To Premises Rented To You The lesser of: a.The Each Occurrence Limit shown in the Declarations; or b.$500,000 unless otherwise stated $ 4. Supplementary Payments a.Bail Bonds: $2,500 EPP0517147 WB Brawley CompanyDocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 2 of 17 b.Loss Of Earnings: $ 500 5. Medical Payments Medical Expense Limit: $ 10,000 9. Property Damage To Borrowed Equipment Each Occurrence Limit: $10,000 Deductible Amount: $ 250 16. Voluntary Property Damage Coverage (Coverage a.)And Care, Custody Or Control Liability Coverage (Coverage b.) Limits Of Insurance Coverage a. $1,000 Each Occurrence $5,000 Aggregate Coverage b.$5,000 Each Occurrence unless otherwise stated $ Deductible Amount (Each Occurrence) Coverage a.$250 Coverage b.$250 unless otherwise stated $ COVERAGE PREMIUM BASIS (a)Area (b)Payroll (c)Gross Sales (d)Units (e)Other RATE (For Limits in Excess of $5,000) ADVANCE PREMIUM (For Limits in Excess of $5,000) b.Care, Custody Or Control $ TOTAL ANNUAL PREMIUM $ DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 3 of 17 C. Coverages 1. Employee Benefit Liability Coverage a.The following is added to Section I - Coverages: Employee Benefit Liability Cover- age (1) Insuring Agreement (a)We will pay those sums that the insured becomes legally obligated to pay as damag- es caused by any act, error or omission of the insured, or of any other person for whose acts the insured is legally liable, to which this insurance applies. We will have the right and duty to defend the insured against any "suit" seeking those damages. However, we will have no duty to defend against any "suit" seeking damages to which this in- surance does not apply. We may, at our discretion, in- vestigate any report of an act, error or omission and settle any claim or "suit" that may result. But: 1)The amount we will pay for damages is limited as described in Section III - Limits Of Insur- ance; and 2)Our right and duty to defend ends when we have used up the appli- cable limit of insurance in the payment of judg- ments or settlements. No other obligation or liabil- ity to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments. (b)This insurance applies to damages only if the act, er- ror or omission, is negligent- ly committed in the "admin- istration" of your "employee benefit program"; and 1)Occurs during the policy period; or 2)Occurred prior to the "first effective date" of this endorsement pro- vided: a)You did not have knowledge of a claim or "suit" on or before the "first ef- fective date" of this endorsement. You will be deemed to have knowledge of a claim or "suit" when any "author- ized representa- tive"; i)Reports all, or any part, of the act, error or omission to us or any other insurer; ii)Receives a written or ver- bal demand or claim for dam- ages because of the act, er- ror or omis- sion; and b)There is no other applicable insur- ance. (2) Exclusions This insurance does not apply to: (a) Bodily Injury, Property Damage Or Personal And Advertising Injury "Bodily injury", "property damage" or "personal and advertising injury". (b) Dishonest, Fraudulent, Criminal Or Malicious Act Damages arising out of any intentional, dishonest, fraudulent, criminal or mali- cious act, error or omission, committed by any insured, including the willful or reck- less violation of any statute. (c) Failure To Perform A Con- tract Damages arising out of fail- ure of performance of con- tract by any insurer. DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 4 of 17 (d) Insufficiency Of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit program". (e) Inadequacy Of Perfor- mance Of Invest- ment/Advice Given With Respect To Participation Any claim based upon: 1)Failure of any invest- ment to perform; 2)Errors in providing in- formation on past per- formance of investment vehicles; or 3)Advice given to any person with respect to that person's decision to participate or not to par- ticipate in any plan in- cluded in the "employee benefit program". (f) Workers' Compensation And Similar Laws Any claim arising out of your failure to comply with the mandatory provisions of any workers' compensation, un- employment compensation insurance, social security or disability benefits law or any similar law. (g) ERISA Damages for which any in- sured is liable because of li- ability imposed on a fiduci- ary by the Employee Re- tirement Income Security Act of 1974, as now or hereafter amended, or by any similar federal, state or local laws. (h) Available Benefits Any claim for benefits to the extent that such benefits are available, with reasonable effort and cooperation of the insured, from the applicable funds accrued or other col- lectible insurance. (i) Taxes, Fines Or Penalties Taxes, fines or penalties, in- cluding those imposed un- der the Internal Revenue Code or any similar state or local law. (j) Employment-Related Prac- tices Any liability arising out of any: (1)Refusal to employ; (2)Termination of employ- ment; (3)Coercion, demotion, evaluation, reassign- ment, discipline, defa- mation, harassment, humiliation, discrimina- tion or other employ- ment - related practices, acts or omissions; or (4)Consequential liability as a result of (1), (2) or (3)above. This exclusion applies whether the insured may be held liable as an employer or in any other capacity and to any obligation to share damages with or repay someone else who must pay damages because of the in- jury. (3) Supplementary Payments Section I - Coverages, Sup- plementary Payments - Cover- ages A And B also apply to this Coverage. b. Who Is An Insured As respects Employee Benefit Lia- bility Coverage, Section II - Who Is An Insured is replaced by the follow- ing: (1)If you are designated in the Dec- larations as: (a)An individual, you and your spouse are insureds, but on- ly with respect to the con- duct of a business of which you are the sole owner. (b)A partnership or joint ven- ture, you are an insured. Your members, your part- DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 5 of 17 ners, and their spouses are also insureds but only with respect to the conduct of your business. (c)A limited liability company, you are an insured. Your members are also insureds, but only with respect to the conduct of your business. Your managers are in- sureds, but only with respect to their duties as your man- agers. (d)An organization other than a partnership, joint venture or limited liability company, you are an insured. Your "execu- tive officers" and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with re- spect to their liability as stockholders. (e)A trust, you are an insured. Your trustees are also in- sureds, but only with respect to their duties as trustees. (2)Each of the following is also an insured: (a)Each of your "employees" who is or was authorized to administer your "employee benefit program"; (b)Any persons, organizations or "employees" having prop- er temporary authorization to administer your "employ- ee benefit program" if you die, but only until your legal representative is appointed; or (c)Your legal representative if you die, but only with re- spect to duties as such. That representative will have all your rights and duties under this Coverage Part. (3)Any organization you newly ac- quire or form, other than a part- nership, joint venture or limited liability company, and over which you maintain ownership or major- ity interest, will qualify as a Named Insured if no other similar insurance applies to that organi- zation. However, coverage under this provision: (a)Is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; and (b)Does not apply to any act, error or omission that was committed before you ac- quired or formed the organi- zation. c. Limits Of Insurance As respects Employee Benefit Lia- bility Coverage, Section III - Limits Of Insurance is replaced by the fol- lowing: (1)The Limits of Insurance shown in Section B. Limits Of Insurance , 1. Employee Benefit Liability Coverage and the rules below fix the most we will pay regardless of the number of: (a)Insureds; (b)Claims made or "suits" brought; (c)Persons or organizations making claims or bringing "suits"; (d)Acts, errors or omissions; or (e)Benefits included in your "employee benefit program". (2)The Aggregate Limit shown in Section B. Limits Of Insurance , 1. Employee Benefit Liability Coverage of this endorsement is the most we will pay for all dam- ages because of acts, errors or omissions negligently committed in the "administration" of your "employee benefit program". (3)Subject to the limit described in (2)above, the Each Employee Limit shown in Section B. Limits Of Insurance, 1. Employee Benefit Liability Coverage of this endorsement is the most we will pay for all damages sus- tained by any one "employee", including damages sustained by such "employee's" dependents and beneficiaries, as a result of: (a)An act, error or omission; or DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 6 of 17 (b)A series of related acts, er- rors or omissions, regard- less of the amount of time that lapses between such acts, errors or omissions; negligently committed in the "administration" of your "employ- ee benefit program". However, the amount paid under this endorsement shall not ex- ceed, and will be subject to the limits and restrictions that apply to the payment of benefits in any plan included in the "employee benefit program." (4) Deductible Amount (a)Our obligation to pay dam- ages on behalf of the in- sured applies only to the amount of damages in ex- cess of the Deductible Amount stated in the Decla- rations as applicable to Each Employee. The limits of insurance shall not be re- duced by the amount of this deductible. (b)The Deductible Amount stated in the Declarations applies to all damages sus- tained by any one "employ- ee", including such "employ- ee's" dependents and bene- ficiaries, because of all acts, errors or omissions to which this insurance applies. (c)The terms of this insurance, including those with respect to: 1)Our right and duty to defend the insured against any "suits" seeking those damag- es; and 2)Your duties, and the du- ties of any other in- volved insured, in the event of an act, error or omission, or claim; apply irrespective of the ap- plication of the Deductible Amount. (d)We may pay any part or all of the Deductible Amount to effect settlement of any claim or "suit" and, upon no- tification of the action taken, you shall promptly reim- burse us for such part of the Deductible Amount as we have paid. d. Additional Conditions As respects Employee Benefit Lia- bility Coverage, Section IV - Com- mercial General Liability Condi- tions is amended as follows: (1)Item 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit is replaced by the following: 2. Duties In The Event Of An Act, Error Or Omission, Or Claim Or Suit a.You must see to it that we are notified as soon as practicable of an act, error or omission which may result in a claim. To the extent possible, notice should include: (1)What the act, error or omission was and when it oc- curred; and (2)The names and addresses of any- one who may suf- fer damages as a result of the act, error or omission. b.If a claim is made or "suit" is brought against any insured, you must: (1)Immediately record the specifics of the claim or "suit" and the date received; and (2)Notify us as soon as practicable. You must see to it that we receive written no- tice of the claim or "suit" as soon as practicable. c.You and any other in- volved insured must: (1)Immediately send us copies of any demands, notices, summonses or le- gal papers re- DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 7 of 17 ceived in connec- tion with the claim or "suit"; (2)Authorize us to ob- tain records and other information; (3)Cooperate with us in the investigation or settlement of the claim or defense against the "suit"; and (4)Assist us, upon our request, in the en- forcement of any right against any person or organi- zation which may be liable to the in- sured because of an act, error or omission to which this insurance may also apply. d.No insured will, except at that insured's own cost, voluntarily make a payment, assume any obligation, or incur any expense without our consent. (2)Item 5. Other Insurance is re- placed by the following: 5. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is prima- ry except when c.below applies. If this insurance is primary, our obliga- tions are not affected unless any of the other insurance is also prima- ry. Then, we will share with all that other insur- ance by the method de- scribed in b.below. b. Method Of Sharing If all of the other insur- ance permits contribu- tion by equal shares, we will follow this meth- od also. Under this ap- proach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other in- surance does not permit contribution by equal shares, we will contrib- ute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insur- ers. c. No Coverage This insurance shall not cover any loss for which the insured is entitled to recovery under any other insurance in force previous to the effective date of this Coverage Part. e. Additional Definitions As respects Employee Benefit Lia- bility Coverage, Section V - Defini- tions is amended as follows: (1)The following definitions are added: 1."Administration" means: a.Providing information to "employees", including their dependents and beneficiaries, with re- spect to eligibility for or scope of "employee benefit programs"; b.Interpreting the "em- ployee benefit pro- grams"; c.Handling records in connection with the "employee benefit pro- grams"; or d.Effecting, continuing or terminating any "em- ployee's" participation in DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 8 of 17 any benefit included in the "employee benefit program". However, "administration" does not include: a.Handling payroll deduc- tions; or b.The failure to effect or maintain any insurance or adequate limits of coverage of insurance, including but not limited to unemployment insur- ance, social security benefits, workers' com- pensation and disability benefits. 2."Cafeteria plans" means plans authorized by applica- ble law to allow "employees" to elect to pay for certain benefits with pre-tax dollars. 3."Employee benefit pro- grams" means a program providing some of all of the following benefits to "em- ployees", whether provided through a "cafeteria plan" or otherwise: a.Group life insurance; group accident or health insurance; dental, vision and hearing plans; and flexible spending ac- counts; provided that no one other than an "em- ployee" may subscribe to such benefits and such benefits are made generally available to those "employees" who satisfy the plan's eligibil- ity requirements; b.Profit sharing plans, employee savings plans, employee stock ownership plans, pen- sion plans and stock subscription plans, pro- vided that no one other than an "employee" may subscribe to such benefits and such bene- fits are made generally available to all "employ- ees" who are eligible under the plan for such benefits; c.Unemployment insur- ance, social security benefits, workers' com- pensation and disability benefits; and d.Vacation plans, includ- ing buy and sell pro- grams; leave of ab- sence programs, includ- ing military, maternity, family, and civil leave; tuition assistance plans; transportation and health club subsidies. 4."First effective date" means the date upon which cover- age was first effected in a series of uninterrupted re- newals of insurance cover- age. (2)The following definitions are de- leted in their entirety and re- placed by the following: 8."Employee" means a person actively employed, formerly employed, on leave of ab- sence or disabled, or retired. "Employee" includes a "leased worker". "Employee" does not include a "tempo- rary worker". 21."Suit" means a civil proceed- ing in which money damag- es because of an act, error or omission to which this in- surance applies are alleged. "Suit" includes: a.An arbitration proceed- ing in which such dam- ages are claimed and to which the insured must submit or does submit with our consent; b.Any other alternative dispute resolution pro- ceeding in which such damages are claimed and to which the in- sured submits with our consent; or c.An appeal of a civil pro- ceeding. DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 9 of 17 2. Unintentional Failure To Disclose Haz- ards Section IV - Commercial General Liabil- ity Conditions, 7. Representations is amended by the addition of the following: Based on our dependence upon your rep- resentations as to existing hazards, if un- intentionally you should fail to disclose all such hazards at the inception date of your policy, we will not reject coverage under this Coverage Part based solely on such failure. 3. Damage To Premises Rented To You a.The last Paragraph of 2. Exclusions under Section I - Coverage A - Bod- ily Injury And Property Damage Li- ability is replaced by the following: Exclusions c.through q.do not apply to "property damage" by fire, explo- sion, lightning, smoke or soot to premises while rented to you or tem- porarily occupied by you with permis- sion of the owner, for which the amount we will pay is limited to the Damage To Premises Rented To You Limit as described in Section III - Limits Of Insurance. b.The insurance provided under Sec- tion I - Coverage A - Bodily Injury And Property Damage Liability ap- plies to "property damage" arising out of water damage to premises that are both rented to and occupied by you. (1)As respects Water Damage Le- gal Liability, as provided in Para- graph 3.b.above: The exclusions under Section I - Coverage A - Bodily Injury And Property Damage Liability,2. Exclusions, other than i. War and the Nuclear Energy Liabil- ity Exclusion (Broad Form) , are deleted and the following are added: This insurance does not apply to: (a)"Property damage": (i)Assumed in any con- tract or agreement; or (ii)Caused by or resulting from any of the follow- ing: 1)Wear and tear; 2)Rust or other cor- rosion, decay, de- terioration, hidden or latent defect or any quality in property that caus- es it to damage or destroy itself; 3)Smog; 4)Mechanical break- down, including rupture or bursting caused by centrif- ugal force; 5)Settling, cracking, shrinking or ex- pansion; 6)Nesting or infesta- tion, or discharge or release of waste products or secre- tions, by insects, birds, rodents or other animals; or 7)Presence, growth, proliferation, spread or any ac- tivity of fungus, in- cluding mold or mildew, and any mycotoxins, spores, scents or byproducts pro- duced or released by fungi. (b)"Property damage" caused directly or indirectly by any of the following: (i)Earthquake, volcanic eruption, landslide or any other earth move- ment; (ii)Water that backs up or overflows or is other- wise discharged from a sewer, drain, sump, sump pump or related equipment; (iii)Water under the ground surface pressing on, or flowing or seeping through: 1)Foundations, walls, floors or paved surfaces; DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 10 of 17 2)Basements, whether paved or not; or 3)Doors, windows or other openings. (c)"Property damage" caused by or resulting from water that leaks or flows from plumbing, heating, air condi- tioning, fire protection sys- tems, or other equipment, caused by or resulting from freezing, unless: (i)You did your best to maintain heat in the building or structure; or (ii)You drained the equip- ment and shut off the water supply if the heat was not maintained. (d)"Property damage" to: (i)Plumbing, heating, air conditioning, fire protec- tion systems, or other equipment or applianc- es; or (ii)The interior of any building or structure, or to personal property in the building or structure, caused by or resulting from rain, snow, sleet or ice, whether driven by wind or not. c. Limit Of Insurance With respect to the insurance afford- ed in Paragraphs 3.a. and 3.b.above, the Damage To Premises Rented To You Limit as shown in the Decla- rations is amended as follows: (1)Paragraph 6. of Section III - Limits Of Insurance is replaced by the following: 6.Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A - Bodily Injury And Property Dam- age Liability for damages because of "property dam- age" to any one premises: a.While rented to you, or temporarily occupied by you with permission of the owner; b.In the case of damage by fire, explosion, light- ning, smoke or soot, while rented to you; or c.In the case of damage by water, while rented to and occupied by you. (2)The most we will pay is limited as described in Section B. Limits Of Insurance , 3. Damage To Premises Rented To You of this endorsement. 4. Supplementary Payments Under Section I - Supplementary Pay- ments - Coverages A And B: a.Paragraph 2.is replaced by the fol- lowing: Up to the limit shown in Section B. Limits Of Insurance , 4.a.Bail Bonds of this endorsement for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage ap- plies. We do not have to furnish these bonds. b.Paragraph 4.is replaced by the fol- lowing: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit", including actual loss of earnings up to the limit shown in Sec- tion B. Limits Of Insurance , 4.b. Loss Of Earnings of this endorsement per day because of time off from work. 5. Medical Payments The Medical Expense Limit of Any One Person as stated in the Declarations is amended to the limit shown in Section B. Limits Of Insurance, 5. Medical Pay- ments of this endorsement. 6. 180 Day Coverage For Newly Formed Or Acquired Organizations Section II - Who Is An Insured is amended as follows: Subparagraph a.of Paragraph 3.is re- placed by the following: a.Insurance under this provision is af- forded only until the 180th day after DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 11 of 17 you acquire or form the organization or the end of the policy period, whichever is earlier; 7. Waiver Of Subrogation Section IV - Commercial General Liabil- ity Conditions, 9. Transfer Of Rights Of Recovery Against Others To Us is amended by the addition of the following: We waive any right of recovery we may have against any person or organization against whom you have agreed to waive such right of recovery in a written contract or agreement because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a written contract or agree- ment with that person or organization and included in the "products-completed oper- ations hazard". However, our rights may only be waived prior to the "occurrence" giving rise to the injury or damage for which we make payment under this Cov- erage Part. The insured must do nothing after a loss to impair our rights. At our re- quest, the insured will bring "suit" or trans- fer those rights to us and help us enforce those rights. 8. Automatic Additional Insured - Speci- fied Relationships a.The following is added to Section II - Who Is An Insured: (1)Any person(s) or organization(s) described in Paragraph 8.a.(2)of this endorsement (hereinafter re- ferred to as additional insured) whom you are required to add as an additional insured under this Coverage Part by reason of a written contract, written agree- ment, written permit or written authorization. (2)Only the following persons or or- ganizations are additional in- sureds under this endorsement, and insurance coverage provided to such additional insureds is lim- ited as provided herein: (a) Managers Or Lessors Of Premises The manager or lessor of a premises leased to you with whom you have agreed per Paragraph 8.a.(1)of this en- dorsement to provide insur- ance, but only with respect to liability arising out of the ownership, maintenance or use of that part of the prem- ises leased to you, subject to the following additional exclusions: This insurance does not ap- ply to: (i)Any "occurrence" which takes place after you cease to be a tenant in that premises; (ii)Structural alterations, new construction or demolition operations performed by or on be- half of such additional insured. (b) Lessor Of Leased Equip- ment Any person or organization from whom you lease equipment when you and such person(s) or organiza- tion(s) have agreed per Par- agraph 8.a.(1)of this en- dorsement to provide insur- ance. Such person(s) or or- ganization(s) are insureds only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or or- ganization(s). A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. However, this insurance does not ap- ply to any "occurrence" which takes place after the equipment lease expires. (c) Vendors Any person or organization (referred to below as ven- dor) with whom you have agreed per Paragraph 8.a.(1)of this endorsement to provide insurance, but on- ly with respect to "bodily in- jury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 12 of 17 vendor's business, subject to the following additional exclusions: (i)The insurance afforded the vendor does not apply to: 1)"Bodily injury" or "property damage" for which the ven- dor is obligated to pay damages by reason of the as- sumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; 2)Any express war- ranty unauthorized by you; 3)Any physical or chemical change in the product made intentionally by the vendor; 4)Repackaging, ex- cept when un- packed solely for the purpose of in- spection, demon- stration, testing, or the substitution of parts under in- structions from the manufacturer, and then repackaged in the original con- tainer; 5)Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normal- ly undertakes to make in the usual course of busi- ness, in connection with the distribution or sale of the products; 6)Demonstration, in- stallation, servicing or repair opera- tions, except such operations per- formed at the ven- dor's premises in connection with the sale of the product; 7)Products which, af- ter distribution or sale by you, have been labeled or re- labeled or used as a container, part or ingredient of any other thing or sub- stance by or for the vendor; or 8)"Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omis- sions or those of its employees or anyone else acting on its behalf. How- ever, this exclusion does not apply to: a)The excep- tions contained in Paragraphs (c) (i) 4) or 6) of this en- dorsement;or b)Such inspec- tions, adjust- ments, tests or servicing as the vendor has agreed to make or nor- mally under- takes to make in the usual course of business, in connection with the distri- bution or sale of the prod- ucts. (ii)This insurance does not apply to any insured person or organization: 1)From whom you have acquired such products, or any ingredient, part DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 13 of 17 or container, enter- ing into, accompa- nying or containing such products; or 2)When liability in- cluded within the "products- completed opera- tions hazard" has been excluded un- der this Coverage Part with respect to such products. (d) State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations Relating To Premises Any state or governmental agency or subdivision or po- litical subdivision with which you have agreed per Para- graph 8.a.(1)of this en- dorsement to provide insur- ance, subject to the follow- ing additional provision: This insurance applies only with respect to the following hazards for which the state or governmental agency or subdivision or political sub- division has issued a permit or authorization in connec- tion with premises you own, rent or control and to which this insurance applies: (i)The existence, mainte- nance, repair, construc- tion, erection or removal of advertising signs, awnings, canopies, cel- lar entrances, coal holes, driveways, man- holes, marquees, hoist away openings, side- walk vaults, street ban- ners or decorations and similar exposures; or (ii)The construction, erec- tion or removal of eleva- tors; or (iii)The ownership, mainte- nance or use of any el- evators covered by this insurance. (e) Mortgagee, Assignee Or Receiver Any person or organization with whom you have agreed per Paragraph 8.a.(1) of this endorsement to provide in- surance, but only with re- spect to their liability as mortgagee, assignee, or re- ceiver and arising out of the ownership, maintenance, or use of the premises by you. However, this insurance does not apply to structural alterations, new construction and demolition operations performed by or for that per- son or organization. (3)The insurance afforded to addi- tional insureds described in Par- agraph 8.a.(1)of this endorse- ment: (a)Only applies to the extent permitted by law; and (b)Will not be broader than that which you are required by the written contract, written agreement, written permit or written authorization to pro- vide for such additional in- sured; and (c)Does not apply to any per- son, organization, vendor, state, governmental agency or subdivision or political subdivision, specifically named as an additional in- sured under any other provi- sion of, or endorsement added to, this Coverage Part, provided such other provision or endorsement covers the injury or damage for which this insurance ap- plies. b.With respect to the insurance afford- ed to the additional insureds de- scribed in Paragraph 8.a.(1)of this endorsement, the following is added to Section III - Limits Of Insurance : The most we will pay on behalf of the additional insured is the amount of in- surance: (1)Required by the written contract, written agreement, written permit or written authorization described DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 14 of 17 in Paragraph 8.a.(1)of this en- dorsement; or (2)Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. c. Section IV - Commercial General Liability Conditions is amended to include the following: Automatic Additional Insured Pro- vision This insurance applies only if the "bodily injury" or "property damage" occurs, or the "personal and advertis- ing injury" offense is committed: (1)During the policy period; and (2)Subsequent to your execution of the written contract or written agreement, or the issuance of a written permit or written authori- zation, described in Paragraph 8.a.(1). d. Section IV - Commercial General Liability Conditions is amended as follows: Condition 5. Other Insurance is amended to include: Primary And Noncontributory In- surance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured per Paragraph 8.a.(1)of this endorsement provided that: (1)The additional insured is a Named Insured under such other insurance; and (2)You have agreed in writing in a contract, agreement, permit or authorization described in 8.a.(2) of this endorsement that this in- surance would be primary and would not seek contribution from any other insurance available to the additional insured. 9. Property Damage To Borrowed Equip- ment a.The following is added to Exclusion 2.j. Damage To Property under Sec- tion I - Coverage A - Bodily Injury And Property Damage Liability: Paragraphs (3)and (4)of this exclu- sion do not apply to tools or equip- ment loaned to you, provided they are not being used to perform operations at the time of loss. b.With respect to the insurance provid- ed by this section of the endorse- ment, the following additional provi- sions apply: (1)The Limits of Insurance shown in the Declarations are replaced by the limits designated in Section B. Limits Of Insurance , 9. Property Damage To Borrowed Equipment of this endorsement with respect to coverage provid- ed by this endorsement. These limits are inclusive of and not in addition to the limits being re- placed. The Limits of Insurance shown in Section B. Limits Of Insurance, 9. Property Damage To Borrowed Equipment of this endorsement fix the most we will pay in any one "occurrence" re- gardless of the number of: (a)Insureds; (b)Claims made or "suits" brought; or (c)Persons or organizations making claims or bringing "suits". (2) Deductible Clause (a)Our obligation to pay dam- ages on your behalf applies only to the amount of dam- ages for each "occurrence" which are in excess of the Deductible Amount stated in Section B. Limits Of Insur- ance, 9. Property Damage To Borrowed Equipment of this endorsement. The limits of insurance will not be re- duced by the application of such deductible amount. (b) Section IV - Commercial General Liability Condi- tions, 2. Duties In The Event Of Occurrence, Of- fense, Claim Or Suit, ap- plies to each claim or "suit" irrespective of the amount. DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 15 of 17 (c)We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and, upon no- tification of the action taken, you shall promptly reim- burse us for such part of the deductible amount as has been paid by us. 10. Employees As Insureds - Specified Health Care Services And Good Samar- itan Services Paragraph 2.a.(1)(d)under Section II - Who Is An Insured does not apply to: a.Your "employees" who provide pro- fessional health care services on your behalf as a duly licensed nurse, emergency medical technician or paramedic in the jurisdiction where an "occurrence" or offense to which this insurance applies takes place; or b.Your "employees" or "volunteer work- ers", other than an employed or vol- unteer doctor, providing first aid or good samaritan services during their work hours for you will be deemed to be acting within the scope of their employment by you or performing du- ties related to the conduct of your business. 11. Broadened Notice Of Occurrence Paragraph a.of Condition 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit under Section IV - Com- mercial General Liability Conditions is replaced by the following: a.You must see to it that we are notified as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, no- tice should include: (1)How, when and where the "oc- currence" or offense took place; (2)The names and addresses of any injured persons and wit- nesses; and (3)The nature and location of any injury or damage arising out of the "occurrence" or offense. This requirement applies only when the "occurrence" or offense is known to an "authorized representative". 12.Nonowned Aircraft The following is added to Exclusion 2.g. Aircraft, Auto Or Watercraft under Sec- tion I - Coverage A - Bodily Injury And Property Damage Liability: This exclusion does not apply to an air- craft you do not own, provided that: a.The pilot in command holds a current effective certificate, issued by a duly constituted authority of the United States of America or Canada, desig- nating that person as a commercial or airline transport pilot; b.The aircraft is rented with a trained, paid crew; and c.The aircraft does not transport per- sons or cargo for a charge. 13. Bodily Injury Redefined Section V - Definitions, 4. "Bodily injury" is replaced by the following: 4."Bodily injury" means bodily harm or injury, sickness, disease, disability, humiliation, shock, fright, mental an- guish or mental injury, including care, loss of services or death resulting from any of these at any time. 14. Expected Or Intended Injury Redefined The last sentence of Exclusion 2.a. Ex- pected Or Intended Injury under Sec- tion I - Coverage A - Bodily Injury And Property Damage Liability is replaced by the following: This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect per- sons or property. 15. Former Employees As Insureds The following is added to Paragraph 2. under Section II - Who Is An Insured: 2. Each of the following is also an in- sured: Any of your former "employees", di- rectors, managers, members, part- ners or "executive officers", including but not limited to retired, disabled or those on leave of absence, but only for acts within the scope of their em- ployment by you or for duties related to the conduct of your business. DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 16 of 17 16. Voluntary Property Damage Coverage a. Coverage D - Voluntary Property Damage Coverage Section I - Coverages is amended to include the following: (1) Insuring Agreement (a)We will pay the cost to re- pair or replace "property damage" to property of oth- ers arising out of operations incidental to your business when: 1)Damage is caused by you; or 2)Damage occurs while in your possession. At your written request, we will make this payment re- gardless of whether you are at fault for the "property damage". If you, at our request, re- place, or make any repairs to, damaged property of others, the amount we will pay under Voluntary Prop- erty Damage Coverage will be determined by your actu- al cost to replace or repair the damaged property, ex- cluding any profit or over- head. Any payment we make un- der Voluntary Property Damage Coverage shall not be interpreted as an admis- sion of liability by you or by us. It shall be your duty, not our duty, to defend any claim or "suit" to which this insurance applies. No other obligation or liabil- ity to pay sums or perform acts or services is covered. (b)This insurance applies to "property damage" only if: 1)The "property damage" takes place in the "cov- erage territory"; and 2)The "property damage" occurs during the policy period. (2) Exclusions This insurance does not apply to "property damage" that would be excluded by Coverage A - Bodi- ly Injury And Property Damage Liability, 2. Exclusions , except for j. Damage To Property, par- agraphs (3), (4), (5) and (6), k. Damage To Your Product , and l. Damage To Your Work . (3) Definitions For purposes of Voluntary Property Damage Coverage only, the following definitions un- der Section V - Definitions are replaced by the following: 16."Occurrence" means an in- cident, including continuous or repeated exposure to substantially the same gen- eral harmful conditions that result in "property damage". 20."Property damage" means physical injury to tangible property. "Electronic data" is not tangible property, and "property damage" does not include disappearance, ab- straction or theft. b. Care, Custody Or Control Liability Coverage For purposes of the coverage provid- ed by Care, Custody Or Control Li- ability Coverage in this endorsement only: (1) Section I - Coverage A - Bodily Injury And Property Damage Liability, 2. Exclusions, j. Damage To Property , Subpara- graphs (3), (4) and (5)do not ap- ply to "property damage" to the property of others described therein. (2)It shall be your duty, not our duty, to defend any claim or "suit" to which this insurance applies. No other obligation or liability to pay sums or perform acts or ser- vices is covered. This Paragraph (2) supersedes any provision in the Coverage Part to the contrary. (3)"Property damage" for which Care, Custody Or Control Lia- bility Coverage provides cover- DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE Includes copyrighted material of Insurance GA 233 09 17 Services Office, Inc., with its permission.Page 17 of 17 age shall be deemed to be caused by an "occurrence" but shall not serve to limit or restrict the applicability of any exclusion for "property damage" under this Coverage Part. c. Limits Of Insurance And Deducti- bles For purposes of the coverage provid- ed by Voluntary Property Damage Coverage and Care, Custody Or Control Liability Coverage, Section III - Limits Of Insurance is amended to include the following: (1)The Limits of Insurance shown in the Declarations are replaced by the limits designated in Section B. Limits Of Insurance, 16. Voluntary Property Damage Coverage And Care, Custody Or Control Liability Coverage, in this endorsement. These limits are inclusive of, and not in addi- tion to, the limits being replaced. The Limits of Insurance shown in the Schedule fix the most we will pay regardless of the number of: (a)Insureds; (b)Claims made or "suits" brought; or (c)Persons or organizations making claims or bringing "suits". (2) (a) Subject to (3)below, the Voluntary Property Dam- age Coverage, Each Occur- rence Limit Of Insurance is the most we will pay for the sum of damages under Vol- untary Property Damage Coverage; (b)The Care, Custody Or Con- trol Liability Coverage, Each Occurrence Limit Of Insurance is the most we will pay for the sum of damages under Care, Custody Or Control Liability Coverage; because of all "property damage" arising out of any one "occur- rence". (3)The Voluntary Property Dam- age Coverage, Aggregate Limit Of Insurance is the most we will pay for the sum of all damages under Voluntary Property Damage Coverage. This limit applies separately to each "cov- erage term". (4) Deductible Clause (a)Our obligation to pay dam- ages on your behalf applies only to the amount of dam- ages for each "occurrence" which are in excess of the Deductible Amount stated for the applicable coverage in the Schedule. The limits of insurance will not be re- duced by the application of such Deductible Amount. (b) Section IV - Commercial General Liability Condi- tions, 2. Duties In The Event Of Occurrence, Of- fense, Claim Or Suit, ap- plies to each claim or "suit" irrespective of the amount. (c)We may pay any part or all of the Deductible Amount to effect settlement of any claim or "suit" and, upon no- tification of the action taken, you shall promptly reim- burse us for such part of the Deductible Amount as has been paid by us. 17. Broadened Contractual Liability - Work Within 50' Of Railroad Property Section V - Definitions, 12. "Insured con- tract" is amended as follows: a.Paragraph c.is replaced by the fol- lowing: c.Any easement or license agree- ment; b.Paragraph f.(1)is deleted in its entire- ty. 18. Alienated Premises Exclusion 2.j. Damage to Property, Paragraph (2)under Section I - Cover- age A - Bodily Injury And Property Damage Liability does not apply if the premises are "your work". DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE This page has been left blank intentionally. DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE AA 4172 09 09 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY BLANKET WAIVER OF SUBROGATION AUTO This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indi cated below Endorsement Effective:Policy Number: Named Insured: Countersigned by: (Authorized Representative) With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement 1 Blanket Waiver of Subrogation SECTION IV BUSINESS AUTO CONDI TIONS, A Loss Conditions, 5 Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following: 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 the operation of a covered "auto" when you have assumed liability for such "bodily injury" or "property damage" under an "insured contract", pro vided the "bodily injury" or "property damage" occurs subsequent to the execution of the "in sured contract" WB Brawley Company EPP051714701/01/2022 DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE This page has been left blank intentionally. DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE AA 4174 11 05 THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ IT CAREFULLY PRIMARY AND NONCONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indi cated below Endorsement Effective: Policy Number: Named Insured: Countersigned by: (Authorized Representative) With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement 1 Noncontributory Insurance SECTION IV BUSINESS AUTO CONDI TIONS, B General Conditions, 5 Other In surance is replaced by the following: c Regardless of the provisions of Para graph a above, this Coverage Form’s Li ability Coverage is primary and we will not seek contribution from any other in surance for any liability assumed under an "insured contract" that requires liability to be assumed on a primary noncon tributory basis EPP0517147 WB Brawley Company DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE This page has been left blank intentionally. DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED BY CONTRACT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. SECTION II – LIABILITY COVERAGE, A. Coverage, I. Who is an Insured is amended to include as an insured any person or organization with which you have agreed in a valid written contract to provide insurance as is afforded by this policy. This provision is limited to the scope of the valid written contract. This provision does not apply unless the valid written contract has been executed prior to the “bodily injury” or “property damage”. AA 4171 11 05 WB Brawley Company EPP0517147 DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE This page has been left blank intentionally. DocuSign Envelope ID: 270168C8-F741-48EF-B67D-C3C5DCCB71CE