Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
2023-519-E-Planning Dept-Alpha & Omega Group, P.C.-Lake Orange Dam Emergency Action Plan (EAP) - On-Call Dam Engineer
Revised 04/23 1 [Departmental Use Only] TITLE LO_Dam Engineer FY 2023-24 ORANGE COUNTY CONTRACT UNDER $5,000.00 NORTH CAROLINA THIS AGREEMENT, is between Orange County, North Carolina, a body politic organized under the laws of the State of North Carolina, (the "County"), and Alpha & Omega Group, P.C. (the "Provider"). W I T N E S S E T H: For the purpose and subject to the terms and conditions hereinafter set forth, the County hereby contracts for the services of the Provider, and the Provider agrees to provide the services set out below to the County in accordance with the terms of this Agreement, time being of the essence. The services or materials or construction (hereinafter referred to collectively as “Services”) to be furnished under this Agreement are as follows: Lake Orange Dam Emergency Action Plan (EAP) - On-Call Dam Engineer (see Attachment 1 for description of Services). The term of this agreement rendered shall be from September 15, 2023 to June 30, 2024. Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions, in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. Provider agrees that Provider shall not sub-contract any of the services to be provided in this Agreement, nor shall Provider assign any right or responsibility granted or required by this Agreement, without the prior written approval of the County. SPECIFIC TERMS 1. Payment: The County agrees to pay at the rates specified for Services satisfactorily (as determined by the County) performed in accord with this Agreement. The amount to be paid by the County shall not exceed FOUR THOUSAND FIVE HUNDRED DOLLARS, ($4,500.00). Payment shall be made within thirty (30) days of an invoice properly submitted to County. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. 2. Non–waiver: Failure by County at any time to require the performance by Provider of any of the provisions hereof shall in no way waive or affect the County's right hereunder to enforce the same, nor shall any waiver by the County of any breach be held to be a waiver of any succeeding breach or a waiver of this Non-Waiver Clause. 3. Independent Contractor: The Provider shall operate as an independent contractor, and the County shall not be responsible for any of the Provider’s acts or omissions. The Provider shall not be treated as an employee with respect to the Services performed hereunder for federal or state tax, unemployment or workers' compensation purposes. The Provider understands that neither federal, nor state, nor payroll tax of any kind shall be withheld or paid by the County on behalf of the Provider or the employees of the Provider. 4. Insurance: Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any additional insurance as may be required by County’s Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 Revised 04/23 2 incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). If County’s Risk Manager determines additional insurance coverage is required such additional insurance shall be designated here N/A (if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 5. Indemnity: To the extent authorized by North Carolina law the Provider agrees, without limitation, to defend, indemnify, and hold harmless Orange County from all losses, liabilities, claims, demands, suits, costs, damages or expenses (including reasonable attorney's fees) arising from bodily injury, including death, to any person or persons or damage to or destruction of any property caused in whole or in part by any negligent or intentional act or omission on the part of the Provider in carrying out Provider’s duties and obligations related to the Services to be provided in this Agreement. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 6. Termination: This Agreement may be terminated at any time by mutual written agreement of the parties or by the County upon written notice to the Provider. County may suspend this Agreement upon reasonable notice to Provider. 7. Entire Agreement and Signatures: The parties have read this Agreement and agree to be bound by all of its terms, and further agree that it constitutes the complete and exclusive statement of the Agreement between the parties unless and until modified in writing and signed by the parties. Modifications may be evidenced by telefacsimile signature. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. 8. Governing Law and Priority: Both parties agree this Agreement is governed by the laws of the State of North Carolina and Orange County. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal anti-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.). Any violation of this requirement is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. By executing this Agreement Provider affirms Provider is and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. Should any documents, exhibits, or addenda be attached to this Agreement, the terms of this Agreement shall have priority in any conflict with or among the terms of such referenced documents, exhibits. 9. Dispute Resolution: Neither party may initiate binding arbitration. Any disputes shall be resolved by nonbinding mediation. If such mediation fails either party may initiate litigation to resolve the dispute. Should either party initiate litigation to settle any dispute involving the terms of this Agreement such litigation shall be initiated in the General Court of Justice of North Carolina seated in Orange County, North Carolina. Regardless of the outcome of said litigation each party is responsible for its own costs and fees, including attorneys’ fees. DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 Revised 04/23 3 10. Non Appropriation: Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable 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. IN WITNESS WHEREOF, this Agreement is effective upon its execution by Orange County and the Provider. ORANGE COUNTY PROVIDER By: _________________________ By: _________________________ Department Director Title: ________________________ 200 S. Cameron St. Ted L. Bartelt, P.E. P.O. Box 8181 4601 Lake Boone Trail, 3C Hillsborough, NC 27278 Raleigh, NC 26707 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 President Revised 04/23 4 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Alpha & Omega Group, P.C. Vendor Contact Person: Ted L. Bartelt, P.E. (President) Phone: 919- 981-0310 Address: 4601 Lake Boone Trail, 3C City Raleigh State: NC Zip: 27607 Department: Planning Amount: $4,500.00 Purpose: Lake Orange Dam Emergency Action Plan (EAP) - On-Call Dam Engineer Budget Code(s): Lake Orange Operations (#10625020-720013) Vendor # 64223 Vendor Status with NCSOS: Active Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date September 15, 2023 End Date June 30, 2024 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by Planning Director Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation 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. Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services 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 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: DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 9/19/2023 9/25/2023 9/26/2023 9/26/2023 Revised 04/23 5 Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 September 7, 2023 Mr. Christopher J. Sandt, P.E. Staff Engineer Orange County Planning and Inspections Department P.O. Box 8181 131 W. Margaret Lane Hillsborough, NC 27278 Re: Proposal for Dam Engineer On-call Lake Orange Dear Mr. Sandt: Alpha & Omega Group (A&O) is very pleased to offer professional engineering services for this project. It is our understanding that Orange County, North Carolina is seeking professional engineering guidance to Orange County and multi-disciplined general engineering services, as needed, in support of the existing Emergency Action Plan (EAP) for the Lake Orange Dam. Specifically, Orange County is seeking to retain a qualified consulting firm on an annual contractual basis to serve Orange County in the formal role of “Owner’s Engineer” as defined within the Lake Orange Dam EAP. An EAP response would only be activated by Orange County in response to an unusual event or an emergency event at the Lake Orange Dam. A&O understands that an annual contract will be placed with Orange County for the above described services (if needed) and would be renewed on an annual basis, subject to A&O’s performance and the County’s available budget. A&O proposes to provide the annual services on an hourly rate Not-to-exceed $4,500.00 dollars. (Please refer to the attached rate schedule for our hourly rates). We look forward to continuing serving you on this project. Please let me know if you have any questions or need additional information. Sincerely, Alpha & Omega Group, PC Ted L. Bartelt, PE President Attachment 1 - Description of Services DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 b:\projects\2023_000\proposals\schedule of rates 2023.doc 2023 SCHEDULE OF RATES Standard Billing Rates are as follows: Principal $275.00 Per Hour Senior Project Manager $220.00 Per Hour Project Manager $200.00 Per Hour Senior Engineer $225.00 Per Hour Engineer $130.00 Per Hour Engineering Intern $110.00 Per Hour Senior Designer $105.00 Per Hour Designer $90.00 Per Hour Senior Technician $110.00 Per Hour Technician $85.00 Per Hour Administrative $75.00 Per Hour Direct Reimbursable Expense Rates: Vehicular Mileage $0.68 Per Mile In‐House Reproduction Bond Paper (8.5”x11”) Bond Paper (11”x17”) Bond Paper (24”x36”) $0.06 $0.45 $0.60 Per Sheet Per Sheet Per Sheet Bond Paper (30”x42”) $1.00 Per Sheet DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD 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) 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 EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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 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.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 9/19/2023 (919) 469-2473 (919) 467-4987 25623 Alpha and Omega Group PC Ted Bartelt 4601 Lake Boone Trail Ste 3C Raleigh, NC 27607 12572 25674 25666 31194 A 1,000,000 X 680IJ04070A23 5/19/2023 5/19/2024 1,000,000 5,000 1,000,000 2,000,000 2,000,000 1,000,000B S 2583755 5/19/2023 5/19/2024 5,000,000C CUP4F99980923 5/19/2023 5/19/2024 5,000,000 10,000 D UB9K60615823 5/19/2023 5/19/2024 1,000,000 N 1,000,000 1,000,000 E Professional Liab.106741445R5 5/19/2023 Occurrence 1,000,000 E Professional Liab.106741445R5 5/19/2023 5/19/2024 Aggregate 2,000,000 Operations of the Named Insured covered by the above referenced policies. Orange County and any other required owner, entities, are additional insureds as respects General Liability when required by written contract. Orange County Christopher J. Sandt, PE 131 W. Magaret Lane Suite 201 PO Box 8181 Hillsborough, NC 27278 ALPHAND-01 JMAIN Alera Group 4325 Lake Boone Trail, Suite 200 Raleigh, NC 27607 Lori F. Hamlet lhamlet@trisure.com Phoenix Insurance Company (The) Selective Insurance Co. of America Travelers Property Casualty Company of America Travelers Indemity Company of America (The) Travelers Casualty and Surety Company of America X 5/19/2024 X X X X X X X DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD 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) 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 EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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 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.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 9/25/2023 (919) 469-2473 (919) 467-4987 25623 Alpha and Omega Group PC Ted Bartelt 4601 Lake Boone Trail Ste 3C Raleigh, NC 27607 12572 25674 25666 31194 A 1,000,000 X 680IJ04070A23 5/19/2023 5/19/2024 1,000,000 5,000 1,000,000 2,000,000 2,000,000 1,000,000B S 2583755 5/19/2023 5/19/2024 5,000,000C CUP4F99980923 5/19/2023 5/19/2024 5,000,000 10,000 D UB9K60615823 5/19/2023 5/19/2024 1,000,000 N 1,000,000 1,000,000 E Professional Liab.106741445R5 5/19/2023 Occurrence 1,000,000 E Professional Liab.106741445R5 5/19/2023 5/19/2024 Aggregate 2,000,000 Operations of the Named Insured covered by the above referenced policies. Orange County, its officers, agents and employees are additional insureds as respects General Liability per attached addtional insured form. Orange County 300 West Tryon Street PO Box 8181 Hillsborough, NC 27278 ALPHAND-01 LHAMLET Alera Group 4325 Lake Boone Trail, Suite 200 Raleigh, NC 27607 Lori F. Hamlet lhamlet@trisure.com Phoenix Insurance Company (The) Selective Insurance Co. of America Travelers Property Casualty Company of America Travelers Indemity Company of America (The) Travelers Casualty and Surety Company of America X 5/19/2024 X X X X X X X DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 ElitePac® Commercial Automobile Extension COMMERCIAL AUTO CA 78 09NC 11 17 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Business Auto Coverage Form apply unless modified by the endorsement. AMENDMENTS TO SECTION II - LIABILITY COVER- AGE A. If this policy provides Auto Liability coverage for Owned Autos, the following extensions are applica- ble accordingly: NEWLY ACQUIRED OR FORMED ORGANIZA- TIONS The following is added to SECTION II, A.1. - Who Is An Insured: Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no similar insurance available to that organi- zation. However: 1. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; 2. Coverage does not apply to “bodily injury” or “property damage” resulting from an “accident” that occurred before you acquired or formed the organization. No person or organization is an “insured” with re- spect to the conduct of any current or past partner- ship, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. EXPENSES FOR BAIL BONDS AND LOSS OF EARNINGS Paragraphs (2) and (4) of SECTION II, A.2.a. - Supplementary Payments are deleted in their entirety and replaced with the following: (2) Up to the Limit of Insurance shown on the ElitePac Schedule for the cost of bail bonds (including bonds for related traffic law violations) required because of an “accident” covered under this policy. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the “insured” at our request. This includes actual loss of earnings because of time off from work, which we will pay up to the Limit of Insurance shown on the ElitePac Schedule. EMPLOYEE INDEMNIFICATION AND EMPLOYER’S LIABILITY AMENDMENT The following is added to SECTION II, B.4. - Exclusions This exclusion does not apply to a “volunteer worker” who is not entitled to workers compensation, disability or unemployment compensation benefits. FELLOW EMPLOYEE COVERAGE The Fellow Employee Exclusion, SECTION II, B.5. - is deleted in its entirety. CARE, CUSTODY OR CONTROL AMENDMENT The following is added to SECTION II, B.6. - Exclu- sions: This exclusion does not apply to property owned by anyone other than an “insured”, subject to the following: 1. The most we will pay under this exception for any one “accident” is the Limit of Insurance stated in the ElitePac Schedule; and 2. A per “accident” deductible as stated in the ElitePac Schedule applies to this exception. B. If this policy provides Auto Liability coverage for Owned Autos or Non-Owned Autos, the following extension is applicable accordingly: LIMITED LIABILITY COMPANIES The following is added to SECTION II, A.1. - Who Is An Insured: If you are a limited liability company, your members and managers are “insureds” while using a covered “auto” you don’t own, hire or borrow during the course of their duties for you. BLANKET ADDITIONAL INSUREDS - As Required By Contract The following is added to SECTION II, A.1. - Who Is An Insured: Copyright, 2017 Selective Insurance Company of America. All rights reserved. CA 78 09NC 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 5 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 Any person or organization whom you have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional “insured” on your policy. Such person or organization is an additional “insured” only with respect to liability for “bodily injury” or “property damage” caused, in whole or in part, by your owner- ship, maintenance or use of a covered “auto”. This coverage shall be primary and non-contributory with respect to the additional “insured”. This provision only applies if: 1. It is required in the written contract, written agreement or written permit identified in this section; 2. It is permitted by law; and 3. The written contract or written agreement has been executed (executed means signed by a named insured) or written permit issued prior to the “bodily injury” or “property damage”. C. If this policy provides Auto Liability coverage for Non-Owned Autos, the following extension is appli- cable accordingly: EMPLOYEES AS INSUREDS If this policy provides Auto Liability coverage for Non-Owned Autos, the following is added to SECTION II, A.1. - Who Is An Insured: Any “employee” of yours is an “insured” while using a covered “auto” you don’t own, hire or borrow in your business or your personal affairs. An “employee” of yours is an “insured” while operat- ing an “auto” hired or rented under a contract or agreement in that “employee’s” name with your per- mission, while performing duties related to the con- duct of your business. AMENDMENTS TO SECTION III - PHYSICAL DAMAGE COVERAGE If this policy provides Comprehensive, Specified Causes of Loss or Collision coverage, the following extensions are applicable for those “autos” for which Comprehen- sive, Specified Causes of Loss or Collision coverage is purchased: TOWING AND LABOR SECTION III, A.2. - Towing is deleted in its entirety and replaced with the following: We will pay all reasonable towing and labor costs up to the maximum Limit of Insurance shown on the ElitePac Schedule per tow each time a covered Private Passen- ger Auto, “Social Service Van or Bus” or “Light Truck” is disabled and up to the maximum Limit of Insurance per tow each time a covered “Medium Truck”, “Heavy Truck” or “Extra Heavy Truck” is disabled. For labor charges to be eligible for reimbursement the labor must be performed at the place of disablement. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. GLASS BREAKAGE DEDUCTIBLE The following is added to SECTION III, A.3. - Glass Breakage - Hitting A Bird Or Animal - Falling Objects or Missiles: If damaged glass is repaired rather than replaced, no deductible will apply for such repair. This extension does not apply to Emergency Services Organizations and Governmental Entities. ADDITIONAL TRANSPORTATION EXPENSES SECTION III, A.4.a. - Transportation Expenses is deleted in its entirety and replaced with the following: We will pay up to the maximum Limit of Insurance shown on the ElitePac Schedule for temporary transportation expenses that you incur because of any “loss” to a cov- ered “auto”, but only if the covered “auto” carries the coverages and meets the requirements described in 1. or 2. below: 1. We will pay temporary transportation expenses for total theft of a covered “auto”. We will only pay for such expenses incurred during the period beginning 24 hours after the theft and ending, regardless of the policy’s expiration, when the covered “auto” is re- turned to use or we pay for its “loss”. 2. For “loss” other than total theft of a covered “auto” under Comprehensive or Specified Causes of Loss Coverage, or for any “loss” under Collision Coverage to a covered “auto”, we will only pay for those tem- porary transportation expenses incurred during the policy period beginning 24 hours after the “loss” and ending, regardless of the policy’s expiration, with the lesser of the number of days reasonably required to repair or replace the covered “auto” or 30 days. Paragraph 2. of this extension does not apply while there are spare or reserve “autos” available to you for your operations. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. Copyright, 2017 Selective Insurance Company of America. All rights reserved. CA 78 09NC 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 5 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 HIRED AUTO PHYSICAL DAMAGE COVERAGE The following is added to SECTION III, A.4. - Coverage Extensions: Physical Damage coverage is hereby extended to apply to Physical Damage “loss” to “autos” leased, hired, rented or borrowed without a driver. We will provide cov- erage equal to the broadest coverage available to any covered “auto” shown in the Declarations. But, the most we will pay for “loss” to each “auto” under this coverage extension is the lesser of: 1. The Limit of Insurance stated in the ElitePac Schedule; or 2. The actual cash value of the damaged or stolen property as of the time of the “loss”; or 3. The actual cost of repairing or replacing the dam- aged or stolen property with other property of like kind and quality. A part is of like kind and quality when it is of equal or better condition than the pre- accident part. We will use the original equipment from the manufacturer when: (a) The operational safety of the vehicle might otherwise be impaired; (b) Reasonable and diligent efforts to locate the appropriate rebuilt, aftermarket or used part have been unsuccessful; or (c) A new original equipment part of like kind and quality is available and will result in the lowest overall repair cost. For each leased, hired, rented or borrowed “auto” our obligation to pay “losses” will be reduced by a deductible equal to the highest deductible applicable to any owned “auto” for that coverage. No deductible will be applied to “losses” caused by fire or lightning. SECTION IV, B. 5. Other Insurance Condition, Para- graph 5.b. is deleted in its entirety and replaced by the following: For Hired Auto Physical Damage Coverage, the follow- ing are deemed to be covered “autos’” you own: 1. Any covered “auto” you lease, hire, rent, or borrow; and 2. Any covered “auto” hired or rented by your “employee” under a contract or agreement in that “employee’s” name, with your permission, while per- forming duties related to the conduct of your busi- ness. However, any “auto” that is leased, hired, rented or borrowed with a driver is not a covered “auto”. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. HIRED AUTO LOSS OF USE COVERAGE The following is added to SECTION III, A.4. - Coverage Extensions: We will pay expenses for which you are legally responsi- ble to pay up to the Limit of Insurance shown on the ElitePac Schedule per “accident” for loss of use of a leased, hired, rented or borrowed “auto” if it results from an “accident”. This coverage extension does not apply to Emergency Services Organizations, Governmental Entities, and Schools. AUTO LOAN/LEASE GAP COVERAGE (Not Available in New York) The following is added to SECTION III, A.4. - Coverage Extensions: In the event of a total “loss” to a covered “auto” we will pay any unpaid amount due on the lease or loan for a covered “auto”, less: 1. The amount paid under the Physical Damage Cover- age Section of the policy; and 2. Any: a. Overdue lease/loan payments at the time of “loss”; b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear, high mileage or similar charges; c. Security deposits not refunded by the lessor or financial institution; d. Costs for extended warranties, credit life, health, accident, or disability insurance purchased with the loan or lease; and e. Carry-over balances from previous leases or loans. You are responsible for the deductible applicable to the “loss” for the covered “auto”. PERSONAL EFFECTS The following is added to SECTION III, A.4. - Coverage Extensions: If this policy provides Comprehensive Coverage for a covered “auto” you own and that covered “auto” is stolen, we will pay up to the Limit of Insurance shown on the ElitePac Schedule, without application of a deducti- ble, for lost personal effects that were in the covered “auto” at the time of theft. Personal effects do not include jewelry, tools, money, securities or valuable papers. This coverage is excess over any other collectible insurance. AIRBAG COVERAGE The following is added to SECTION III, B.3.a. - Exclusions: Mechanical breakdown does not include the accidental discharge of an airbag. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. Copyright, 2017 Selective Insurance Company of America. All rights reserved. CA 78 09NC 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 5 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 EXPANDED AUDIO, VISUAL, AND DATA ELECTRON- IC EQUIPMENT COVERAGE SECTION III, B.4. - Exclusions This exclusion does not apply to the following: 1. Global positioning systems; 2. “Telematic devices”; or 3. Electronic equipment that reproduces, receives or transmits visual or data signals and accessories used with such equipment, provided such equipment is: a. Permanently installed in or upon the covered “auto” at the time of the “loss”; b. Removable from a housing unit that is perma- nently installed in the covered “auto” at the time of the “loss”; c. Designed to be solely operated by use of power from the “auto’s” electrical system; or d. Designed to be used solely in or upon the covered “auto”. For each covered “loss” to such equipment, a deductible of $50 shall apply, unless the deductible otherwise appli- cable to such equipment is less than $50, at which point the lower deductible, if any, will apply. COMPREHENSIVE DEDUCTIBLE - LOCATION TRACKING DEVICE The following is added to SECTION III, D. - Deductible: Any Comprehensive Coverage Deductible shown in the Declarations will be reduced by 50% for any “loss” caused by theft if the covered “auto” is equipped with a location tracking device and that device was the sole method used to recover the “auto”. PHYSICAL DAMAGE LIMIT OF INSURANCE SECTION III, C. - Limit Of Insurance is deleted in its entirety and replaced with the following: The most we will pay for a “loss” in any one “accident” is the lesser of: 1. The actual cash value of the damaged or stolen property as of the time of the “loss”; or 2. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality. This coverage extension does not apply to Emergency Services Organizations and Governmental Entities. AMENDMENTS TO SECTION IV - BUSINESS AUTO CONDITIONS DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following is added to SECTION IV, A.2.a. - Duties In The Event Of Accident, Claim, Suit Or Loss: The notice requirements for reporting “accident” claim, “suit” or “loss” information to us, including provisions related to the subsequent investigation of such “acci- dent”, claim, “suit” or “loss” do not apply until the “acci- dent”, claim, “suit” or “loss” is known 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 members, managers or insurance manager, if you are a limited liability company; 5. 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. But, this section does not amend the provisions relating to notification of police or protection or examination of the property that was subject to the “loss”. WAIVER OF SUBROGATION SECTION IV, A.5. - Transfer Of Rights Of Recovery Against Others To Us is deleted in its entirety and replaced with 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” resulting from the ownership, maintenance or use of a covered “auto” but only when you have assumed liability for such “bodily injury” or “property damage” in an “insured con- tract”. In all other circumstances, if a person or organiza- tion to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. MULTIPLE DEDUCTIBLES The following is added to SECTION IV, A. - Loss Conditions: If a “loss” from one event involves two or more covered “autos” and coverage under Comprehensive or Specified Causes of Loss applies, only the highest applicable deductible will be applied. CONCEALMENT, MISREPRESENTATION OR FRAUD The following is added to SECTION IV, B.2. - Conceal- ment, Misrepresentation Or Fraud: If you should unintentionally fail to disclose any existing hazards in your representations to us prior to the incep- tion date of the policy or during the policy period in connection with any newly discovered hazards, we will not deny coverage under this Coverage Form based upon such failure. Copyright, 2017 Selective Insurance Company of America. All rights reserved. CA 78 09NC 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 5 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 POLICY PERIOD, COVERAGE TERRITORY SECTION IV, B.7. - Policy Period, Coverage Territory is deleted in its entirety and replaced with the following: Under this Coverage Form, we cover “accidents” and “losses” occurring: a. During the policy period shown in the Declarations; and b. Within the “Coverage Territory”. We also cover “loss” to or “accidents” involving a cov- ered “auto” while being transported between any of these places. TWO OR MORE COVERAGE FORMS OR POLICIES ISSUED BY US - DEDUCTIBLES The following is added to SECTION IV, B.8. - Two Or More Coverage Forms Or Policies Issued By Us: If a “loss” covered under this Coverage Form also involves a “loss” to other property resulting from the same “accident” that is covered under this policy or another policy issued by us or any member company of ours, only the highest applicable deductible will be applied. AMENDMENTS TO SECTION V - DEFINITIONS BODILY INJURY INCLUDING MENTAL ANGUISH (Not Applicable in New York) The definition of bodily injury is deleted in its entirety and replaced by the following: “Bodily injury” means bodily injury, sickness, or disease sustained by a person, including death resulting from any of these. “Bodily injury” includes mental anguish resulting from bodily injury, sickness or disease sus- tained by a person. ADDITIONS TO SECTION V - DEFINITIONS COVERAGE TERRITORY “Coverage Territory” means: 1. The United States of America (including its territories and possessions), Canada and Puerto Rico; and 2. Anywhere in the world, except for any country or jurisdiction that is subject to trade or other economic sanction or embargo by the United States of America, if a covered “auto” is leased, hired, rented, or borrowed without a driver for a period of 30 days or less, and the insured’s responsibility to pay “dam - ages” is determined in a “suit” on the merits in and under the substantive law of the United States of America (including its territories and possessions), Puerto Rico, or Canada, or in a settlement we agree to. If we are prevented by law, or otherwise, from defending the “insured” in a “suit” brought in a location described in Paragraph 2. above, the insured will conduct a defense of that “suit”. We will reimburse the “insured” for the reasonable and necessary expenses incurred for the de- fense of any such “suit” seeking damages to which this insurance applies, and that we would have paid had we been able to exercise our right and duty to defend. EXTRA HEAVY TRUCK “Extra Heavy Truck” means a truck with a gross vehicle weight rating of 45,001 pounds or more. HEAVY TRUCK “Heavy Truck” means a truck with a gross vehicle weight rating of 20,001 pounds to 45,000 pounds. LIGHT TRUCK “Light Truck” means a truck with a gross vehicle weight rating of 10,000 pounds or less. MEDIUM TRUCK “Medium Truck” means a truck with a gross vehicle weight rating of 10,001 pounds to 20,000 pounds. SOCIAL SERVICE VAN OR BUS “Social Service Van or Bus” means a van or bus used by a government entity, civic, charitable or social service organization to provide transportation to clients inci- dental to the social services sponsored by the organiza- tion, including special trips and outings. TELEMATIC DEVICE “Telematic Device” includes devices designed for the collection and dissemination of data for the purpose of monitoring vehicle and/or driver performance. This in- cludes Global Positioning System technology, wireless safety communications and automatic driving assistance systems, all integrated with computers and mobile com- munications technology in automotive navigation sys- tems. VOLUNTEER WORKER “Volunteer worker” means a person who performs business duties for you, for no financial or other compen- sation. Copyright, 2017 Selective Insurance Company of America. All rights reserved. CA 78 09NC 11 17 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 5 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 ;D9EGH;C;DI!!L8!++!+.!,.!$++%!( IHEC=O!GMF<?J7 ;CFBEN;GH!B?67?B?IN!FEB?8N 6D9 LEGA;GH!8ECF;DH6I?ED WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT ,,- FE<!KFN<I!JHL7I< ?7IK=FI;!9K!,2-4/ L8)5B2,2-14)./)03)> NT!WPeT!cWT!aXVWc!c^!aTR^eTa!^da!_Ph\T]cb!Ua^\!P]h^]T![XPQ[T!U^a!P]!X]Ydah!R^eTaTS!!Qh!cWXb!_^[XRh+!!NT!fX[[!]^c! T]U^aRT!^da!aXVWc!PVPX]bc!cWT!_Tab^]!^a!^aVP]XiPcX^]!]P\TS!X]!cWT!KRWTSd[T+!&LWXb!PVaTT\T]c!P__[XTb!^][h!c^!cWT! TgcT]c!cWPc!h^d!_TaU^a\!f^aZ!d]STa!P!faXccT]!R^]caPRc!cWPc!!aT‘dXaTb!h^d!c^!^QcPX]!cWXb!PVaTT\T]c!Ua^\!db+’! LWXb!PVaTT\T]c!bWP[[!]^c!^_TaPcT!SXaTRc[h!^a!X]SXaTRc[h!c^!QT]TUXc!P]h!^]T!]^c!]P\TS!X]!cWT!KRWTSd[T+! H8>;9JB; 9;H?=D6I;9!EG=6D?O6I?ED5 9;H?=D6I;9!F;GHED5 7EP!G<IJFE!FI!FI>7E@Q7K@FE!=FI!N?@9?!K?<!@EJLI<;!?7J!7>I<<;! 8P!NI@KK<E!9FEKI79K!<O<9LK<;!GI@FI!KF!CFJJ!KF!=LIE@J?!K?@J! N7@M<I* >;L?!H@!CKKM?7 I;A?KL!;KKCAG7 H@,0),3)./- - DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150 DocuSign Envelope ID: 9D0EF707-5719-4D7D-8A28-3BC04A88F150