Loading...
HomeMy WebLinkAboutAgenda 05-21-24; 6-c - Approval of Budget Amendment #9-A – Capital Reallocation for Orange County Schools 1 ORD-2024-011 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: May 21, 2024 Action Agenda Item No. 6-c SUBJECT: Approval of Budget Amendment #9-A — Capital Reallocation for Orange County Schools DEPARTMENT: County Manager, Orange County Schools ATTACHMENT(S): INFORMATION CONTACT: Efland Cheeks Renovation Contract Kirk Vaughn, (919) 245-2153 PURPOSE: To consider approval of Budget Amendment #9-A for Orange County Schools to reallocate capital funds from a variety of existing capital projects to fund roofing work at Orange High, a roof replacement at New Hope Elementary, and interior renovations at Efland Cheeks Elementary. BACKGROUND: The Orange County Schools District submitted a capital budget amendment request to move funds from existing capital projects to fund the Orange High Arts Wing, Auditorium and Main Hall Roof Renovation, New Hope Elementary Roof Replacement, and Efland Cheeks Elementary Interior Renovations. In reviewing the District's current capital balance spending plans, the Woolpert consultant noted that these projects did not align with the sequence or scope of the Woolpert Option C High Priority Needs recommendations. Because the County counted both School Districts' existing capital balances when arranging funding for the Option C recommendations, funding these projects would reduce the amount of funding available for other projects that Woolpert identified as high priority needs in the District. The first project is the Orange High School Cultural Arts Wing, Auditorium and Main Hall Roof Replacement. Woolpert noted that the roof had four (4) years of useful life left before needing replacement. Orange County Schools staff stated that while the overall roof is in good shape and has additional useful life, some components of the roof have had significant leaks and were graded as a D during the District's 2016 Roof Assessment. The second project is the New Hope Roof Replacement. Woolpert assessed the roof to have six (6) years of useful life. The District similarly reports that the roof received a grade of D in the 2016 roofing assessment and that they are experiencing leaks throughout the building. They are also experiencing some visible separation of the standing seam roof and stagnant moisture seeping into the cavity of the wall due to the poor design of the gutter system. The third project is the Efland Cheeks Renovation. The Woolpert consultant noted significant deficiencies at Efland Cheeks, but only recommended a $1.3 million budget to address the highest priority needs. The District has entered into a contract to make $4.795 million in renovations. This 2 expands the scope beyond the Woolpert recommendations to include plumbing renovations, bathroom renovations, and canopy and flooring replacements. The District notes that plumbing replacement is due to waste drainage issues that cause the building not to have usable bathrooms. The bathroom renovations are intended to make the classroom bathrooms Americans with Disabilities Act (ADA) compliant, and the canopy replacements will protect the building against severe weather. The District also wanted to address flooring deficiencies since they were already closing down wings to address other needs. In addition, the District did reach out to Woolpert while scoping the project, and the consultant affirmed that the planned work did not conflict with the recommended improvements and that the broader scope would improve the building's condition and educational adequacy to some degree. District staff have asked that the Board of Commissioners consider these amendments at the earliest opportunity since the Efland Cheeks renovation project is already under contract and is due to begin work over the summer. Advancing this project will also affect the amount of funding available for other high priority needs that Woolpert has recommended and the related project sequencing that will be presented to the Board at the June 4, 2024 Business meeting. The proposed Budget Amendment #9-A amends the following project ordinances, reallocating funds already in the School Capital Fund: River Park Elementary- OCS (-$546) -Project# 50001 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Bond Proceeds $135,000 $0 $135,000 Transfer from General Fund $390,468 ($546) $389,922 Total Project Funding $525,468 ($546) $524,922 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $525,468 ($546) $524,922 Total Costs $525,468 ($546) $524,922 Hillsborough Elementary- OCS (-$42,598) -Project# 50005 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Transfer from General Fund $362,899 ($42,598) $320,301 Total Project Funding $362,899 ($42,598) $320,301 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $362,899 ($42,598) $320,301 Total Costs $362,899 ($42,598) $320,301 3 Elementary#8- OCS (-$300,000) - Project# 50011 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Transfer from General Fund $300,000 ($300,000) $0 Total Project Funding $300,000 ($300,000) $0 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $300,000 ($300,000) $0 Total Costs $300,000 ($300,000) $0 Electric Service Upgrades - OCS (-$6000) - Project# 51002 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Alternative Financing $50,000 $0 $50,000 Transfer from General Fund $33,000 ($6,000) $27,000 Total Project Funding $83,000 ($6,000) $77,000 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $83,000 ($6,000) $77,000 Total Costs $83,000 ($6,000) $77,000 Handicap Accessibility- OCS (-$304,846) - Project# 51005 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised 2/3rds Net Debt Bonds $16,000 $0 $16,000 Transfer from General Fund $467,300 ($304,847) $162,453 Total Project Funding $483,300 ($304,847) $178,453 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $483,300 ($304,847) $178,453 Total Costs $483,300 ($304,847) $178,453 4 Planning For Future Projects - OCS (-$4,168) - Project# 51007 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Transfer from General Fund $778,000 ($4,168) $773,832 Total Project Funding $778,000 ($4,168) $773,832 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $778,000 ($4,168) $773,832 Total Costs $778,000 ($4,168) $773,832 HVAC Upgrades - OCS (-$78,443) - Project# 51013 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Qualified School Construction Bonds $722,621 $0 $722,621 Transfer from General Fund $891,740 ($78,443) $813,297 Total Project Funding $1,614,361 ($78,443) $1,535,918 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $1,614,361 ($78,443) $1,535,918 Total Costs $1,614,361 ($78,443) $1,535,918 Central Elementary Air(-$7,144) - Project# 51016 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Transfer from General Fund $118,584 ($7,144) $111,440 Total Project Funding $118,584 ($7,144) $111,440 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $118,584 ($7,144) $111,440 Total Costs $118,584 ($7,144) $111,440 5 Fire/Safety Upgrades - OCS (-$421,975) - Project# 51024 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Alternative Financing $75,000 $0 $75,000 2/3rds Net Debt Bonds $35,000 $0 $35,000 Transfer from General Fund $864,918 ($421,975) $442,943 Lottery Proceeds $250,000 $0 $250,000 Total Project Funding $1,224,918 ($421,975) $802,943 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $1,224,918 ($421,975) $802,943 Total Costs $1,224,918 ($421,975) $802,943 Classroom/Building Improvements - OCS (-$3,428,033) - Project# 51025 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Alternative Financing $3,048,177 ($1,766,683) $1,281,494 2/3rds Net Debt Bonds $289,500 $0 $289,500 Transfer from General Fund $2,794,703 ($1,661,350) $1,133,353 Qualified School Construction Bonds $2,946,819 $0 $2,946,819 Total Project Funding $9,079,199 ($3,428,033) $5,651,166 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $9,079,199 ($3,428,033) $5,651,166 Total Costs $9,079,199 ($3,428,033) $5,651,166 Window Replacements - OCS (-$707,836) - Project# 51026 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Alternative Financing $269,691 $0 $269,691 2/3rds Net Debt Bonds $30,000 $0 $30,000 Transfer from General Fund $813,802 ($707,836) $105,966 Total Project Funding $1,113,493 ($707,836) $405,657 6 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $1,113,493 ($707,836) $405,657 Total Costs $1,113,493 ($707,836) $405,657 Mechanical Systems - OCS (-$616,296) - Project# 51029 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Alternative Financing $1,361,331 ($616,296) $745,035 Transfer from General Fund $435,809 $0 $435,809 Total Project Funding $1,797,140 ($616,296) $1,180,844 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $1,797,140 ($616,296) $1,180,844 Total Costs $1,797,140 ($616,296) $1,180,844 School Safety and Security- OCS (-$56,329) - Project# 51034 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Alternative Financing $656,733 ($56,329) $600,404 2/3rds Net Debt Bonds $428,073 $0 $428,073 Transfer from General Fund $452,651 $0 $452,651 Total Project Funding $1,537,457 ($56,329) $1,481,128 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $1,537,457 ($56,329) $1,481,128 Total Costs $1,537,457 ($56,329) $1,481,128 Vehicle Replacements - OCS ($12,443) - Project# 51032 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Alternative Financing $35,000 $0 $35,000 Transfer from General Fund $220,000 $12,443 $232,443 Total Project Funding $255,000 $12,443 $267,443 7 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $255,000 $12,443 $267,443 Total Costs $255,000 $12,443 $267,443 Property Acquisition - OCS ($4,026) - Project# 51034 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Bond Proceeds $3,100,000 $0 $3,100,000 Transfer from General Fund $0 $4,026 $4,026 Total Project Funding $3,100,000 $4,026 $3,104,026 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $3,100,000 $4,026 $3,104,026 Total Costs $3,100,000 $4,026 $3,104,026 Roofing- OCS ($1,367,660) - Project# 51010 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Alternative Financing $4,497,067 $0 $4,497,067 2/3rds Net Debt Bonds $1,056,702 $0 $1,056,702 Transfer from General Fund $1,093,240 $1,367,660 $2,460,900 Qualified School Construction Bonds $1,600,000 $0 $1,600,000 Total Project Funding $8,247,009 $1,367,660 $9,614,669 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $8,247,009 $1,367,660 $9,614,669 Total Costs $8,247,009 $1,367,660 $9,614,669 Efland Cheeks Elementary- OCS ($4,590,085) - Project# 50003 Revenues for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Alternative Financing $0 $2,439,308 $2,439,308 Transfer from General Fund $448,423 $2,150,777 $2,599,200 Total Project Funding $448,423 1 $4,590,085 $5,038,508 8 Appropriated for this project: Current FY 2023-24 FY 2023-24 FY 2023-24 Amendment Revised Project Expenditures $448,423 $4,590,085 $5,038,508 Total Costs $448,423 $4,590,085 $5,038,508 FINANCIAL IMPACT: Funds are already allocated in the School Capital Fund. This amendment reallocates existing project funding to fund roofing work at Orange High, a roof replacement at New Hope Elementary, and interior renovations at Efland Cheeks Elementary. SOCIAL JUSTICE IMPACT: There are no Orange County Social Justice Goals associated with this item. ENVIRONMENTAL IMPACT: There are no Orange County Environmental Responsibility Goal impacts associated with this item. RECOMMENDATION(S): The Manager recommends that the Board consider approval of Budget Amendment #9-A for Orange County Schools to reallocate capital funds from a variety of existing capital projects to fund roofing work at Orange High, a roof replacement at New Hope Elementary, and interior renovations at Efland Cheeks Elementary. 9 OWNER-CONTRACTOR AGREEMENT PROJECT NUMBER:OCS Contract 00627 SCHOOL NAME: Efland Cheeks Elementary School—General Renovations THIS AGREEMENT, in four (4) copies, made.this loth day of April,Two Thousand and Twenty Four by and between Orange County Board of Education (herein referred to as the "Owner`%.whose mailing address is 200 East line Street`Hilisborough,NC 27278 and Lornax Construction, Incorporated (herein referred to as the "Contractor"), whose mailing address is P.O. Box 35169, Greensboro, NC 27425-5169. Correspondence, submittals, and notices relating to or required under this Contract shall be sent in writing to the above addresses; unless either party is notified in writing by the other, of a change in address_ WITNESSECH: WHEREAS, it is the intent of the Owner to obtain the services of the Contractor in connection with the new construction of Efland Cheeks Elements School-General Renovations (hereinafter referred to as the"Project" or the "Work");and WHEREAS, the Contractor desires to perform such construction in accordance with the terms and conditions of this Agreement, NOW,THEREFORE, in consideration of the promises made herein and other good and valuable consideration, the following terms and conditions are hereby mutually agreed to, by and between the Owner and Contractor: Article I DEFINITIONS 1.1 All terms in this Agreement which are defined in the Information for Bidders and the General Conditions shall have the meanings designated therein. 5aetion C,Owner-ContractorAgmernent C`Z 10 1.2 The Contract Documents are as defined in the General Conditions. Such documents form the Contract, and all are as fully a part thereof as if attached to this Agreement or repeated herein. The Contract Documents consist of the Owner-Contractor Agreement, the General and Supplemental Conditions of the Contract, the Drawings, the Specifications, all Addenda issued prior to bidding, and all Modifications and Change Orders issued after execution of the Contract_ Article 2 STATEMENT OF THE WORK 2.1 The Project is the Work identified in the plans and specifications prepared by Sud.Associates. 'P.A. dated FebruaEy 26 2024 for Orange County Board of Education, 200 East Icing Street, Hillsborou h NC27278 including the following addenda: Z-6 A listing of the plans and specifications included in the Contract Documents is attached as Exhibit A. 2.2 The Parties agree that the Project shall include the following alternates: {see Attached Sid Evaluation Form-Owner Preferred&Alternates(Exhibit B) OP-G1 OP-PI .GI G2 2.3 The Parties agree to the following modifications to the Project's plans and specifications, including the noted value engineering items: None—N/A Section C,Ovvner-Contractor Agreement G2 11 2.4 The Parties agree that the following allowances are included in the Contract Sum in Section 5.1 below: Allowances 1-5 (See Attached Bid Evaluation Form Allowances (Exhibit B) 2.5 The Contractor shall provide and pay for all materials,toots, equipment, labor and professional and non-professional services; and shall perform all other acts and supply all other things necessary, to fully and properly perform and complete the Work, as required by the Contract Documents. 2.6 The Contractor shall further provide and pay for all related facilities described in any of the Contract Documents, including all work expressly specified therein and such additionalwork as may be reasonably inferred therefrom, saving and excepting only such items of work as are specifically stated in the Contract Documents not to be the obligation of the Contractor. The totality of the obligations imposed upon the contractor by this Article and by all other provisions of the Contract Documents, as well as the structures to be built and the labor to be performed,is herein referred to as the"Work". Article 3 DESIGN CONSULTANT 3.1 The Design Consultant (as defined in the General Conditions) shall be Sud Associates P.A. whose address is 1813 Chapel Hill Road, Durham, NC 27707 however, that the .Owner may, without liability to the Contractor, unilaterally amend this Article from time to time by designating a different person or organization to act as its Design Consultant and so advising the Contractor in writing, at which time the person or organization so designated shall be the Design Consultant for purposes of this Contract. Article 4 TIME OF COMMENCEMENT AND COMPLETION 4,1 The Contractor shall commence the Work promptly upon the date established in the Notice to Proceed. if there is no Notice to Proceed,the date of commencement of the Work shall be the date of this Agreement or such other date as may be established herein. Section C,Owner-Contractor Agreement C 3 12 4.2 Time is of the essence. The Contractor shall achieve Final Completion,as defined in the General Conditions on or before the date established for Final Completion in the. Supplemental Conditions. 4.3 The Supplemental Conditions contains certain specific dates that shall be adhered to and are the last acceptable dates unless modified in writing by mutual agreement between the Contractor and the Owner. All dates indicate midnight unless otherwise stipglated. The only exceptions to this schedule are defined in the General Conditions under 8.3 DELAYS AND EXTENSIONS OFTIME. 4.4 Should the Contractor fail to complete the Work on or before the dates stipulated for Substantial Completion and/or Final Completion, or such later date as may result from an extensions of time granted by the Owner, he shall pay the Owner, as liquidated damages the sums setforth in the General and Supplemental Conditions. Article 5 CONTRACT SUM 5.1 Provided that the Contractor shall strictly and completely perform all of its obligations under the Contract Documents, and subject only to additions and deductions by Modification or as otherwise provided in the. Contract Documents, the Owner shall pay to the Contractor, in current funds and at the time and in the installments hereinafter specified, the sum of Four Million Seven Hundred Ninety-Five Thousand Dollars ($4,795,000.00)herein referred to as the "Contract Sum". This amount includes the base bid and the Alternates in Section 2.2 5.2 The Contract Sum includes the value engineering items and other contract modifications noted in Section 2 3'above that total S4,795,000.00. 5.3 Unit Prices are established as follows for the Project: (See Attached Sid Evaluation Form-Unit Prices(Exhibit B) Unit Price No.1 General Construction $57.00 Per CuYd Unit Price No.2 Plumbing A $50.00 Per Ft Section C,O veer-Gr3ntzactorAgreement C-4 13 Unit Price No.3 Plumbing B $58.00 Per Ft Unit Price No.4 Plumbing C $66.00 Per Ft Unit Price No.S Plumbing D $72.00 Per Ft Unit Price No.6 Plumbing E $77.00 Per Ft Article 6 PROGRESS PAYMENTS 6.1 The Contractor hereby agrees that on or about the First day of the month for'every month during the performance of the Work he will deliver to the Owners Project Manager an Application for Payment in accordance with the provisions of Article 9 of the General Conditions. This date may be changed upon mutual agreement,stated.in writing, between the Owner and Contractor. Payment under this Contract shall be made as provided in the General Conditions. Payments due and unpaid underthe Contract Documentsshal€ not bearinterest. Article 7 OTHER REQUIREMENTS 7.1 The Contractor shall submit the Performance Bond, Labor and Material Payment Bond and Certification of Insurance as required by the Contract Documents. 7.2 The Owner shall furnish to the Contractor one (1) set of drawings and one (1) set of specifications, at no extra cost, for use in the Construction of the Work. Additional sets of drawings or specifications may be obtained by the Contractor by paying the Owner for the costs of reproduction,handling and mailing. 7.3 The Contractor shall make a good faith effort to utilize Historically Underutilized Businesses (HUB's) per N.C.Gen.Stat.143-128.2,and as described in the construction documents. 7.4 The General Conditions, Supplemental Conditions and the plans and specifications, including any addenda,are incorporated herein by reference. Section C,Ownar-CcntractorAgreement C'5 14 1N WETNESS WHEREOF, Orange County Board of Education (hereinbefore called the "Owner") has caused these presents to be signed and its corporate seal to be hereunto affixed, attested by its Chairperson and Secretary, and Lomax Construction, Incorporated (hereinbefore called "Contractor") has caused these presents to be signed by its President and its Corporate seal to be hereunto affixed, as hereinafter attested,all as of the day and year first above written. ORANGE COUNTY BOARD OF EDUCATION ,4nK--M. _Pcc�ceCG__ Anne M,Purcell(Apr M,202:20:2D EVIL Anne Purcell Board Chairperson ATTEST: 4 %, �an'selle 23,?024 zG I ED7)-- Dr.Danielle Jones Superintendent Section C,Owner-Contractor Agreement G6 15 [Corporate Seal] B : Y Travis Langley , President or Vice-President. Partner 1 VP of Pre-Construction (Print Name) ATTEST. Eric Lomax �i/�A LJ�Tf�"V r''r Corporate Secretary 99 [Corporate Seal] p! ;y CARS y . � 4 'llrf€iF[St�t�`t This instrument has been preaudited in the manner required by the School Budget and Fiscal Control Act. 41 Rhonda Rath Apr23,2024 I inance Officer Date Section C,Owner-Gontraator Agreement G7 16 µ y U Lr� � O O � 11 � p p ._• }5l'�Irlrldllf Rl oo a © o o � c+ U � a q n .ten' �mn' •`�a .� � a '� � �gg a �gg P � L.�+ Z 1//nff$41151p11""` o 1= o �i U o o e e a o $ "•' �' � � o O� �NCJ w H w��e .'^ Cl I+ N 1n a H h » of rn H C C!i [0 MT c a d d "•' m � ate. � � N o � m •`4 a ¢ �n 7 +� Z N 'C •U H .1 0 A m h a a °� h � U a O 1/3 .a �+ � � z, o Q Q G © O o O iJ Q U � �+�( o E-t ,•+ Rl n Is l] .12 Ic Q ra q m e� to 1 o V h OQr M� w1:a 0 y .. o wb P4 v 0 ,5 -o :v (�U � �`' o � � •d 4R A LG Al c4 r- � V] .o;q a � g v sa .� � A A A A W � U $ U � U `a• U � y Pam• �O R C-� i3 6 � Al Cz� � � 'si. s�, c 17 N O Q 4 Q of Vi ° © ❑ � A O o 0 0 6 4 •% a % a q It � I! 11 :a vs W v+ S� N ir. F. vi � e a Q ro o PZ PZ -tl b'�g Pam. h sk y Avi h RV. Gs Pa'. i rn o e o a o 0 0 � o II n � a E€ � w ,.; w <,; w ❑; w ,�; F= - a N c� o ri h � �, o �+ o o ca � `❑ e a n o 0 �f H o o a © a o a o ❑ o ❑ o b 0 0 00" o •�` o" o" `� _ a ea c a a o O � O t� � Gq ❑ O tl b b a O C a 0 0 0 L. 6 2 a W 6 o O o 0 4 •`� c o �p6-r H N T N T O O © R © C? D G] O C •O p 'CS O VI Vi G9 n � A C� p o o O ❑ C1 O tl 1n rq � O �� .mra. U � �� w� �u �i•��S 8 � p � 0 8 0 5 0 � o O O V•i " ' o U , oC7 p, u b` p' o Lh cya ci•e� �•o c!-a av og outo a e a U o .� ❑ ❑ gz El �i o � .r�nt o S� � Q �'� yy 4 � oE"❑ 7 v� � b � b � 'J' � kaf � 17 �' �..yRr�4��� ❑ � u � �..� ��•t,�U 6 ° � N � N P i+1 C `f O W C �p A yS.� aF a edi � � � �a a v e� �� d p•C �U�vv � e0 °� y�C7 �© �Rq S ep7 �Ct�7 ao aa� aao a ro any 54AU a Feria x o 18 •.© a a o v � oo�m 1 W Cam! C d C ^� p p O i¢n N v - '• M M �6 YS V) Q h M�'M A g o o G O O O G s Q © iJ � tl tl P GS P� p P » A O • o o � a o � a o00 C C 4 Si b C N ti O o 4 G Q Q q 0 R EA C 4 O C vbi ti w N U' a. W Cj Cj cw a + + b ID k 19 Exhibit C Sexual Offender Registry Check Certification Form PLEASE SUBMIT T,F.LIS FORM TO YO UR SCHOOL SYSTEM'S REPRESENTATIVE Project Name: Efland Cheeks Elementary School Contract Single Prime GC Renovations Check the appropriate box to indicate the type of check: X Initial Supplemental Annual I, Kacie Loye (insert name), Controller (insert title) of Lomax Construction Inc. (insert company name) hereby certify that I have performed all of the required sexual offender registry checks required under this Agreement for all contractual personnel (employees, agents, ownership personnel, or contractors ) who may be used to deliver goods or provide services under this Agreement, including the North Carolina Sex Offender and Public Protection Registration Program, the North Carolina Sexually Violent Predator Registration Program, and the National Sex Offender Registry (Note: all of the required registry checks may be completed at no cost by accessing the United States Department of Justice Sex Offender Public Website at http;//www.nsuw.zovn_I finther certify that none of the individuals listed below appears on any of the above-named registries and that I will not assign any individual to deliver goods or perform services under this Agreement if said individual appears on any of the sex offender registries_ I agree to maintain all records and documents associated with these registry checks, and that I will provide such records and documents to the school system upon request. I specifically acknowledge that the school system retains the right to audit these records to ensure compliance with this section at any time in the school system's sole discretion. I acknowledge that I am required to perform these checks and provide this certification form before any work is performed under the Agreement (initial check), any time additional contractual personnel may perform work under the Agreement(supplemental check),axed at each anniversary date of the Agreement(annual check). Contractual Personnel Names Job Title I. Bobby Weaver Project Manager 2. Josh Carter Superintendent 3. Kevin Lewis VP of Operations 4. Brian Evans Superintendent 5. 6. I attest that the forgoing information is true and accurate to the best of my knowledge_ T Kacie Love (print name) 4 1 1 2 0 2 4 _ (sianature/date) 2101264 20 Bond No. 108005982 PERFORMANCE BOND FT IS HEREBY AGREED that tlr vnrulIna=and addr= FCon==,) Lomax, Incorporated P.O, Box 35169 Greensboro, NC 27425 as Principal, hereinafter called Contractor, and, (Inxcr MIiamrs and addrezOrSLWCF,) Travelers Casualty and Surety Company of America One Tower Square Hartford, CT 06183 as Surety, hereinafter called Surety, are held and firmly bound unto the Orange County Board of Education 200 East King St_ Hillborough, NC 27278 as Obligee,hereinafter called Ovmer, in the amount of Four Million Seven Hundred Ninety Five Thousand and 00/1 OD Dollars ($4,795,000.00 ) for the payment whereof Contractor and Surety bind themselves. their heirs; executors, administrators, successors and assigns,jointly and severally, firmly by these obligations. WHEREAS. Contractor has by written agreement dated April 10 2024 , entered into a contract With Owner for the construction of [nscr nc name nl the Prgccl Elfand CHeeks Elementary School -General Renovations in accordance with Drawings and Specifications prepared by ilr3tn roll name ar,d addresorA ehiresx•Ere in rr, Sud Associates, P.A. 1813 Chapel Hill Rd Durham, NC 27707 which contract is by reference made a part hereof.. and is hereinafter referred to as the Contract_ NOW. THEREFORE. THE CONDITION OF THIS OBLIGATION is such that. if Contractor shall promptly and faithfully perform said Contract, then this obligation shall be null and void; otherwise it shall remain in full force and effect. The Surety hereby waives notice of any alteration or extension of time made by the Owner. Whenever Contractor shall be, and declared by Owner to be in default. under the Contract, the Owner having performed Owner's obligations thereunder, the Surety may promptly remedy the default, or shall promptly: 1) Complete the Contract in accordance with its terms and conditions,or 2) Obtain a bid or bids for completing the Contract in accordance with its terms and conditions. and upon determination by Surety of the lowest responsible bidder, or. if the Owner elects, upon determination by the Owner and the Surety jointly of the lowest 1 21 responsible bidder, arrange for a contract between such bidder and Owner, and nuke available as Work progresses (even though there should be a default or:a succession of defauLts under the contract or contracts of completion arranged under this paragraph) sufficient Bands to pay the cost of completion less the balance of the contract price; but not exceeding, including other costs and damages for which the Surety may be liable hereunder. the amount set forth in the first paragraph hereof. The terra "balance of the contract price," as used in this paragraph, shall mean the total amount payable by Owner to Contractor under the Contract and any amendments thereto; less the amount properly paid by Owner to Contractor. Any suit under this bond must be instituted before the expiration of any applicable statute of limitations under the Contract. No right of action shall accrue on this bond to or. for the use of any person or corporation other than the Owner named herein or the heirs, executors, administrators or successors of the Owner. Sianed and sealed this IOth day of April 2024 G7'/ fi prate{CpP 1T p _• cQno, Lomax., In orated LAffix corporate seal] > �ccaRQZ y�` Firr s4 Q��k� (�famey Travis atagley Partner 1 VP of Pre-Construction �r�tG�x (%Vi,ncis) Eric Lomax Corporate Secretary SURETY Travelers Casualty and Surety Company of America w r Hf'M414. "x �Atfix corporate seal] Jennife Gullett Attorney-in-Fact Donna K_ Ashley 2 22 Bond No. 108005982 LAE30R AND MATERIAL PAYMENT BOND THIS 501,14D IS ISSUED SIMULTANEOUSL'� «TTlf PERFORUMANCE BOND IN FAVOR OF THE ON4NFR CONDITIONED ON THE Ftf".�No F:tI7EIFUL PERFQRhLANcF of THE CONMA CT IT IS HEREBY AGREED that (Insert full name and address of Contractor) Lomax, Incorporated P.O. Box 35169 Greensboro, NC 27425 as Principal,hereinafter called"Principal,"and, (Insert full name and address of Surety) Travelers Casualty and Surety Company of America One Tower Square Hartford, CT 061.83 as Surety,hereinafter called"Surety,"are held and firmly bound unto the Orange County Board of Education 200 East King St. Hillborough, NC 27278 Four Million Seven Hundred Ninety Five Thousand & 00/100 Dollars as Obligee,hereinafter called Owner,for the use and benefit of claimants as hereinbelow defined,in the amount of $4,795,000.00 ror the payment whereof Principal and Surety bind themselves, their heirs, executors, administrators, successors and assigns,jointly and severally, firmly by these obligations. WHEREAS.Principal has by written agreement dated April 10 -)0 24 entered into a contract with Owner for the construction of (Insert the name of the Project) Eifand Cheeks Elementary School -General Renovations in accordance with Drawings and Specifications prepared by (Insert fitll name and address of Architect Engineer) Sud Associates, P.A" 1813 Chapel Hill Rd Durham, NC 27707 which contract is by reference trade a part hereof,and is hereinafter referred to as the"Contract." NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that, if Principal shall promptly make payment to all claimants as hereinafter defined, for all labor and material used or reasonably required for use in the performance of the Contract,then this obligation shall be void; otherwise it shall remain in full force and effect,subject, however,to the following conditions: 1. A claimant is defined as one having a direct.contract with die principal or with a. Subcontractor of the Principal for labor, material, or both, used or reasonably required for use in the performance of the Contract, labor and material being construed to include that part of water,gas.power,light,heat, oil,gasoline,telephone service or rental of equipment directly applicable to the Contract. 3. The above named .Principal and Surety hereby jointly and severally agree with die Owner that every claimant as herein defined, who has not been paid in full before the expiration of period ofninety (90) days after the date on which the last of such claimants wort: or labor was done or performed, or materials were furnished by such claimant,may sue on this bond for the use of such claimanL prosecute the suit to final judgment forsuch sum or sums as may be justly due claimant, and have execution thereon" The Owner shall not be liable for the payment of any cosrs or expenses of any such suit. 3" No suitor action sliall be commenced hereunder by any claimant: a) Unless claimant, other than one havirig a direct contract with the Principal. shall have given written notice to any two of the following:the Principal,the Owner, or the Surety above named,within ninety(90)days,after such claimant did or performed the last of the work-or labor,or furnished the last of the materials for which said claitrt is 4 23 made, stating with substantial accuracy the amount claimed and the name of the party to whom the materials were fumished, or for whom the work or labor was done or performed. Such notice shall be served by mailing the same by registered mail or certified mail; postage prepaid, in an envelope addressed to the Principal, Owner or Surety, at any place where an office is regularly maintained for the transaction of business, or served rn any manner in which legal process may be served in the state in which the aforesaid project is located,save that such service need not be made by a public officer. b) after the e%piration of one (1) year following the date on which Principal ceased Work on said Contract, it being understood, however, that if any limitation embodied in this bond is prohibited by any law controlling the construction hereof such limitation shall be deemed to be amended so as to be equal to the minimum period of limitation permitted by such law. c) Other than in a state court of competent jurisdiction in and for the county or other political subdivision of the state in which the Project, or any part thereof is situated, or in the United States District Court for the district in which the Project,or any pan thereof is situated,and not elsewhere. 4. The amount of this bond shall be reduced by and to the extent of any payment or payments made in good faith hereunder, inclusive of the payment by Surety of mechanics' Hems which may be filed bf record against said improvement,whether or not claim for tie amount of such lien be presented under and against this.bond, Sinned and sealed this 1 Oth day of April. ,0 24 MiNCIPAL Jm^'o ± sy6 -�= Lomax, orafed o2: �0 " Q [Affix corporate sea]] RO��•'. A (Name) Travis Lan le ������✓✓✓✓ (.Title) Partner 1 VIP of Pre-Constructiou �r r (Witness) Eric Lomax Corporate Secretary 3:T,3sLa`r`�s SURETY Travelers Casualty and Surety Company of America [Affix corporate seal] (Dame)Dent' er B. Gul[ett `wJr,:rrdElryr',5 (Title)Atto rn ey-i n-i=act (witness) Donna K. Ashley FtS�_bl.S'3 5 24 Travelers Casualty-.and Surety Company of America Travelers Casualty and Surety Company TRAVELERS J St.Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the"Companies'},and that the Companies do hereby make.constitute and'appoint JENNIFER 13 GULLETT of CHARLOTTE , North Carolina , their true and IawfLI Attorneys)-in-Fact to sign, execute, seal and acknowledge any and all bonds, recognizances, conditional undertakings and other writings obligatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. IN WITNESS WHEREOF, the Companies have caused this instrument to be signed,and.their corporate seals to be hereto affixed,this list day of April, 2021. 1c State of Connecticut By. City of Hartford ss. Robert L..Rare , enior Vice President On this the 21st day of April, 2021, before me personally appeared Robert 1_ Raney, who acknowledged himself to be the Senior Vice President of each of the Companies, and that he, as such, being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing on behalf of said Companies by himself as a duly authorized officer- IN WITNESS WHEREOF,I hereunto set my hand and official seal.My Commission expires the 30th day of June,2026 s Anna P.Nawik,Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of each of the Companies,which resolutions are now in full force and effect,reading as follows; RESOLVED, that the Chairman, the President, any Vice Chairman, any ;executive Vice President, any Senior Vice President, any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Company's seal bonds, recognizances,.contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her;and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate all or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in writing and a copy thereof Is filed in the office of the Secretary;and it is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman, any Executve Vice President, any Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary; or (b) duly executed (under seal, if required) by one or more Attorneys-in-Fact and Agents pursuant to. the power prescribed in his or her certificate or their certificates of authority or by one or more Company officers pursuant to a wrtten delegation of authority;and it is FURTHER RESOLVED, that the signature of each of the followfng offioers: President, any Executive Vice President, any Senior Vice President, any Vice President, any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys-in- Fact for purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof, and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shalt be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. 1, Kevin E. Hughes, the undersigned. Assistant Secretary of each of the Companies, do hereby certify that the. above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies,which remains in full force and effecL Dated this i 0th day of April 2024 r w*i%urr.�t qy>tT aytr s9 � &� , A�•..r � y uaiprsortc, � �' LWVMI.. Kevin E.Hughes,AssiEtantSecretary To verify the authenticity of this Power ofAttorney,please call usatl-800-421 3880. Please referto the above-named Aftorney(s)-in-Fac#and the detviis of the band to which this PoweroFAtitorney is attached. _ 25 DATE(N}MlDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE FDATE 024 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($). PRODUCER CONTACT NAME: Denise Reynolds,CBIA Marsh&McLennan Agency LLC PHONE FAx 3625 N.Elm Street A N E •704-973-2175 A c No:336 348-1397 Suite 200 n-DO EMAIL Denise.Reynolds@MarshMMA.com Greensboro NC 27455 INSURERS AFFORDING COVERAGE NAIL F INSURER A;Selective Insurance Company of America 12572 INSURED LOMAXCONS-INSURER B.-Evanston Insurance Company 35378 Lomax Construction, Inc. P.O. Box 35169 INSURER C; Greensboro NC 27455 INSURERD: INSURER E- INSURER F; COVERAGES CERTIFICATE NUMBER:2058030384 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 70 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AOAL FU5R POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVID POLICY NUMBER MM/Do MMfo LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y S2407234 1/1/2024 1012025 EACHOCCURRENCE 51,000,000 CLAIM&MADE �OCCUR PREMISES .occurrence) S 5D0,000 MEO EXP(Anyone person) $15,000 PERSONAL&ADVINJURY $1,000,000 GEN-LAGGREGATEJMIT APPLIES PER: GENERALAGGREGATE $3,000,000 POLICY❑ PRO LOC JECT PRODUCTS-COMPIOPAGG $3,000,000 OTHER: $ A AUTOMOBILELIABILnY Y Y S2407234 1/1/2024 1I112025 CDMBTNEDS€NGLELIMIT $1,000,000 Ea aecfdent X ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULE➢ BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Pera��dent Is A X UMBRELLALIAB HX OCCUR Y Y $2407234 1/1/2024 1/1/2025 EACHOCCURRENCE S10,000,000 EXCESS LIA6 CLAIMS-MADE AGGREGATE $10,000,000 DED X RETENTION$0 1 1 S A WORKERS COMPENSATION Y WC9070977 ' 11,12024 1/1,2025 X 3 ATL71'E 11RH- AND EMPLOYERS'LIABILITY Y 1 N ^^^^ ANYPROPRIETC)WPARTNERIEXECUTNE E.LEACHACCIDENT $1,000,000 OFFICER/MEMBEREXCLUAED7 MIA (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under OESCRIPTIONOF OPERATIONS below E.L DISEASE-POLICY LIMIT s1,000,00D A Builders Risk S2407233 V112024 1/1/2025 Single Location $5,000,000 A LeasedrRented Equipment 52407234 111l202Q 1/1/2025 LIMI $100,000 B Prof/Poll Liability MMAENV003822 7/8/2023 7/8/2025 Per Oourrence S3M!$3M DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(AGORA 101,Additional Remarks Schedule,may be attached if more space is required) Project: Efiand Cheeks Elementary School-General Renovations Orange County Board of Education is included as additional insured on a primary and non-contributory basis with respect to General Liability,Automobile Liability and Umbrella Liability as required by written contract Waiver of subrogation in favor of Orange County Board of Education with respect to General Liability,Automobile Liability,Umbrella Liability and Workers Compensation as required by written contract-Waiver of subrogation in favor of Orange County Board of Education applies toward builders Risk when required by written contract.30 day notice of cancellation to be provided to certificate holder,exceptfor non-payment of premium which is 10 days. CERTIFICATE HOLDER CANCEI- ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Orange County Board of Education 2Do East King Street AUTHOR€ZEDREPRESSEEN�TAA,TIVE Hillsborough NC 27278 � ,,, O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD 26 ElitePae Commercial Automobile Extension COMMERCIAL AUTO CA 78 09NC 1117 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 11 - LIABILITY EMPLOYEE INDEMNIFICATION AND EMPLOYER'S COVERAGE LIABILITY AMENDMENT A. If this policy provides Auto Liability coverage for The following is added to SECTION 11, 6.4. - Owned Autos, the following extensions are Exclusions applicable accordingly_ This exclusion does not apply to a "volunteer worker" NEWLY ACQUIRED OR FORMED who is not entitled to workers compensation, disability or ORGANIZATIONS unemployment compensation benefits. N The following is added to SECTION 11, A.1. - Who FELLOW EMPLOYEE COVERAGE 1s An insured: The Fellow Employee Exclusion, SECTION 11, B.5. -is co cli Any organization you newly acquire or form, other deleted in its entirety. N than a partnership, joint venture or limited liability CARE, CUSTODY OR CONTROL AMENDMENT company over which you maintain ownership or The following is adder[ to SECTION II, 5.6. - o majority interest, will qualify as a Named Insured if Exclusions o there is no similar insurance available to that organization, However: This exclusion does not apply to property owned by 1. Coverage under this provision is afforded only anyone otherthan an"insured",subject to the following: until the 180th day after you acquire or form the I. The most we will pay under this exception for any organization or the end of the policy period, one"accident" is the Limit of Insurance stated in the whichever is earner; ElitePac Schedule;and 2. Coverage does not apply to "bodily injury" or 2. A per"accident" deductible as stated in the ElitePac "property damage" resulting from an "accident" Schedule applies to this exception. that occurred before you acquired or formed the B. if this policy provides Auto Liability coverage for organization. Owned Autos or Non-Owned Autos, the following No person or organization is an "insured" with extension is applicable accordingly: respect to the conduct of any current or past LIMITED LIABILITY COMPANIES partnership, joint venture or limited liability company The following is added to SECTION 11, AA -Who that is not shown as a Named Insured in the Is An Insured: Declarations. if you are a limited liability company, your members EXPENSES FOR BAIL 'BONDS AND LOSS OF and managers are "insureds" while using a covered EARNINGS "auto" you don't own, hire or borrow during the Paragraphs (2) and (4) of SECTION 11, A22.a. - course of their duties for you. Supplementary Payments are deleted in their entirety BLANKET ADDITIONAL INSUREDS - As and replaced with the following: Required By Contract (2) Up to the Limit of Insurance shown on the ElitePac The following is added to SECTION 11, A.I. - Who Schedule for the cost of ball bonds(including bonds Is An Insured: 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. 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 INSURED'S COPY 27 Any person or organization whom you have agreed For labor charges to be eligible for reimbursement the in a written contract, written agreement or written labor must be performed at the place of disablement. permit that such person or organization be added as This coverage extension does not apply to Emergency an additional "insured" on your policy. Such person Services Organizations and Governmental Entities. or organization is an additional "insured" only with GLASS BREAKAGE DEDUCTIBLE to liabllity for "bodily injury" or "property damage" caused, in whole or in part, by your The following is added to SECTION 111, A.3. - GIass ownership, maintenance or use of a covered "auto". Breakage-Hitting A Bird Or Animal -Failing Objects This coverage shall be primary and non-contributory or Missiles: with respect to the additional "insured". This If damaged glass is repaired rather than replaced, no prevision only applies if: deductible will apply for such repair.This extension does 1. It is required in the written contract, written not apply to Emergency Services Organizations and agreement or written permit identified in this Governmental Entities. section; ADDITIONAL TRANSPORTATION EXPENSES 2, It is permitted by law, and SECTION III, AA.a. - Transportation Expenses is 3. The written contract or written agreement has deleted in its entirety and replaced with the following: been executed (executed means signed by a We will pay up to the maximum Limit of Insurance named insured) or written permit issued prior to the "bodily injury"or"property damage". shown on the ElitePac Schedule for temporary transportation expenses that you incur because of any C. If this policy provides Auto Liability coverage for "loss"to a covered "auto", but only if the covered "auto" Non-Owned Autos, the following extension is carries the coverages and meets the requirements applicable accordingly: described in 1.or 2.below: EMPLOYEES AS INSUREDS 1. We will pay temporary transportation expenses for If this policy provides Auto Liability coverage for total theft of a covered "auto". We will only pay for Non-Owned Autos, the following is added to such expenses incurred during the period beginning SECTION 11,A.1.-Who Is An Insured: 24 hours after the theft and ending, regardless of Any "employee" of yours is an "insured"while using the policy's expiration, when the covered "auto" is a covered "auto" you don't own, hire or borrow in returned to use or we pay for its"loss". your business or your personal affairs. 2. For "ICSS,, other than total theft of a covered "auto" An "employee" of yours is an "insured" while under Comprehensive or Specified Causes of Lass operating an "auto" hired or rented under a contract Coverage, or for any "loss under Collision or agreement in that "employee's" name with your Coverage to a covered "auto", we will only pay for permission, while performing duties related to the those temporary transportation expenses incurred conduct of your business_ during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's AMENDMENTS TO SECTION III - PHYSICAL expiration, with the lesser of the number of days DAMAGE COVERAGE reasonably required to repair or replace the covered If this policy provides Comprehensive, Specified Causes "auto"or30 days. of Loss or Collision coverage, the following extensions Paragraph 2. of this extension does not apply while are applicable for those "autos" for which there are spare or reserve "autos" available to you Comprehensive, Specified Causes of Loss or Collision for your operations. coverage is purchased: This coverage extension does not apply to Emergency TOWING AND LABOR Services Organizations and Governmental Entities. SECTION Ill, 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 Passenger Auto, "Social Service Van or Sus" 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. 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 INSUREWS COPY 28 HIRED AUTO PHYSICAL DAMAGE COVERAGE HIRED AUTO LOSS OF USE COVERAGE The following is added to SECTION III, AA, -Coverage The following is added to SECTION 111,AA. -Coverage Extensions: Extensions: Physical Damage coverage is hereby extended to apply We ,will pay expenses for which you are legally to Physical Damage "loss" to "autos" [eased, hired, responsible to pay up to the Limit of Insurance shown on rented or borrowed without a driver. We will provide the ElitePac Schedule per"accident" for loss of use of a coverage equal to the broadest coverage available to leased, hired, rented or borrowed "auto"if it results from any covered "auto" shown in the Declarations. But: the an "accident". most we will pay for "loss" to each "auto" under this This coverage extensioh does not apply to Emergency coverage extension is the lesser of: Services Organizations, Governmental Entities, and 1. The Limit of Insurance stated in the ElitePac Schools. Schedule;or AUTO LOANILEASE GAP COVERAGE(Not Available 2. The actual cash value of the damaged or stolen in New York) property as of the time of the"loss';or The following is added to SECTION 111,A4. -Coverage 3. The actual cost of repairing or replacing the Extensions: damaged or stolen properly with other property of In the event of a total "loss"to a covered "auto" we will like kind and quality.A part is of like kind and quality pay any unpaid amount due on the lease or loan for a when it is of equal or better condition than the covered"auto",less: pre-accident part. We will use the original 1. The amount paid under the Physical Damage co equipment from the manufacturer when: Coverage Section of the policy; and (a) The operational safety of the vehicle might 2 Any otherwise be impaired; a. Overdue leasefloan payments at the time of (b) Reasonable and diligent efforts to locate the loss"; N appropriate rebuilt, aftermarket or used part a have been unsuccessful,or b. Financial penalties imposed under a lease for excessive use, abnormal wear and tear, high a (c) A new original equipment part of like kind mileage or similar charges; and quality is available and will result in the lowest overall repair cost. c. Security deposits not refunded by the lessor or For each leased, hired, rented or borrowed "auto" our financial institution; obligation to pay"losses"will be reduced by a deductible d. Costs for extended warranties,credit life, health, equal to the highest deductible applicable to any owned accident, or disability insurance purchased with "auto"for that coverage. No deductible will be applied to the loan or lease;and "losses" caused by fire or lightning. e. Carry-over balances from previous leases or SECTION IV, B. 5. Other Insurance Condition, loans. Paragraph 5.b. is deleted in its entirety and replaced by You are responsible for the deductible applicable to the the following'. "loss"for the covered"auto". For Hired Auto Physical Damage Coverage, the PERSONAL EFFECTS following are deemed to be covered"autos'"you own: The following is added to SECTION III,A.4. -Coverage 1. Any covered "auto" you lease, hire, rent, or borrow; Extensions: and if this policy provides Comprehensive Coverage for a 2. Any covered "auto" hired or rented by your covered "auto" you own and that covered "auto" is "employee" under a contract or agreement in that stolen,we will pay up to the Limit of Insurance shown on "employee's" name, with your permission, while the ElitePac Schedule, without application of a performing duties related to the conduct of your deductible, for lost personal effects that were in the business_ covered "auto" at the time of theft. Personal effects do However, any "auto" that is [eased, hired, rented or not include jewelry, tools, money, securities or valuable borrowed with a driver is not a covered"auto". papers. This coverage is excess over any other This coverage extension does not apply to Emergency collectible insurance. Services Organizations and Governmental Entities. AIRBAG COVERAGE The following is added to SECTION III, 13.3.a. - Exclusions: Mechanical breakdown does not include the accidental discharge of an airbag. This coverage extension does not apply to Emergency Serv[ees 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 INSUREDS COPY 29 EXPANDED AUDIO, VISUAL, AND DATA The following is added to SECTION IV, A2.a. - Duties ELECTRONIC EQUIPMENT COVERAGE In The Event Of Accident,Claire,Suit Or Loss: SECTION III, B.4. -Exclusions The notice requirements for reporting "accident" claim, This exclusion does not apply to the following: "suit" or "loss" information to us, including provisions related to the subsequent investigation of such 1. Global positioning systems; "accident", claim, "suit" or "lass" do not apply until the 2. "Telematic devices";or "accident",claim,"suit"or"loss"is known to: 3. Electronic equipment that reproduces, receives or 1. You,if you are an individual; transmits visual or data signals and accessories 2. A partner,if you are a partnership; used with such equipment, provided such equipment is: 3. An executive officer or insurance manager, if you a. Permanently installed in or upon the covered are a corporation; "auto"at the time of the"loss"; 4. Your members, managers or insurance manager, if b. Removable from a housing unit that is you are a limited liability company; permanently installed in the covered "auto" at 5. Your elected or appointed officials, trustees, board the time of the"loss"; members or your insurance manager, if you are an c. Designed to be solely operated by use of power organization other than a partnership, joint venture or limited liability company. from the"auta's"electrical system, or But, this section does not amend the provisions relating d. Designed to be used solely in or upon the to notification of police or protection or examination of covered"auto". the property that was subject to the"loss". For each covered "loss"to such equipment, a deductible WAIVER OF SUBROGATION of $50 shall apply, unless the deductible otherwise applicable to such equipment is less than $50, at which SECTION IV, A.S. -Transfer Of Rights Of Recovery point the lower deductible, if any,will apply_ Against Others To Us is deleted in its entirety and COMPREHENSIVE DEDUCTIBLE - LOCATION replaced with the fallowing: TRACKING DEVICE We waive any right of recovery we may have against The following is added to SECTION III,D.-Deductible: any person or organization because of payments we make for "bodily injury" or "property damage" resulting Any Comprehensive Coverage Deductible shown in the from the ownership, maintenance or use of a covered Declarations will be reduced by 50% for any "loss" "auto" but only when you have assumed liability for such caused by theft if the covered "auto" is equipped with a "bodily injury" or "property damage" in an "insured location tracking device and that device was the sole contract". In all other circumstances, if a person or method used to recoverthe"auto". organization to or for whom we make payment under PHYSICAL DAMAGE LIMIT OF INSURANCE this Coverage Form has rights to recover damages from SECTION ill, C. - Limit Of insurance is deleted in its another,those rights are transferred to us. entirety and replaced with the following: MULTIPLE DEDUCTIBLES The most we will pay for a "loss"in any one"accident" is The following is added to SECTION IV, A. - Loss the lesser of: Conditions: 1. The actual cash value of the damaged or stolen If a "loss"from one event involves two or more covered property as of the time of the"loss";or "autos" and coverage under Comprehensive or 2. The cost of repairing or replacing the damaged or Specified Causes of Loss applies, only the highest stolen property with other property of like kind and applicable deductible will be applied. quality. CONCEALMENT,MISREPRESENTATION OR FRAUD This coverage extension does not apply to Emergency The following is added to SECTION IV, B.2. - Services Organizations and Governmental Entities_ Concealment, Misrepresentation Or Fraud: AMENDMENTS TO SECTION IV - BUSINESS AUTO If you should unintentionally fail to disclose any existing CONDITIONS hazards in your representations to us prior to the DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT inception date of the policy or during the policy period in OR LOSS connection with any newly discovered hazards, we will not deny coverage under this Coverage Form based upon such failure. Copyright, 2017 Seiective 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 INSURER'S COPY 30 POLICY PERIOD,COVERAGE TERRITORY if we are prevented by law, or otherwise,from defending SECTION IV, 13.7. -Policy Period, Coverage Territory the "Insured'in a"suit"brought in a location described in is deleted in its entirety and replaced with the following: Paragraph 2. above, the insured will conduct a defense Under this Coverage Form, we cover accidents and of that "suit". We will reimburse the "insured" for the g reasonable and necessary expenses incurred for the "losses"occurring: defense of any such "suit" seeking damages to which a. During the policy period shown in the Declarations; this insurance applies, and that we would have paid had and we been able to exercise our right and duty to defend. b. Within the"Coverage Territory" EXTRA HEAVY TRUCK We also cover "loss" to or "accidents" involving a "Extra Heavy Truck" means a truck with a gross vehicle covered "auto" while being transported between any of weight rating of 45,001 pounds or more. these places. HEAVY TRUCK TWO OR MORE COVERAGE FORMS OR POLICIES 'Heavy Truck" means a truck with a gross vehicle ISSUED BY US-DEDUCTIBLES weight rating of 20,001 pounds to 45,000 pounds. The following is added to SECTION IV, B,8. - Two Or LIGHT TRUCK More Coverage Forms Or Policies Issued By Us. "Light Truck" means a truck with a grass vehicle weight If a "loss" covered under this Coverage Form also rating of 10,000 pounds or less. involves a "loss' to other property resulting from the same 'accident' that is covered under this policy or MEDIUM TRUCK another policy issued by us or any member company of "Medium Truck" means a truck with a gross vehicle ours, only the highest applicable deductible will be weight rating of 10,001 pounds to 20,000 pounds. a applied. SOCIAL SERVICE VAN OR BUS N AMENDMENTS TO SECTION V-DEFINITIONS "Social Service Van or Bus" means a van or bus used co BODILY INJURY INCLUDING MENTAL ANGUISH by a government entity, civic, charitable or social 0 8 (Not Applicable in New York) service organization to provide transportation to clients The definition of bodily injury is deleted in its entirety incidental to the social services sponsored by the and replaced by the following: organization,including special trips and outings. "Bodily injury" means bodily injury, sickness, or disease TELEMATIC DEVICE sustained by a person, including death resulting from "Telematic Device" includes devices designed for the any of these. "Bodily injury" includes mental anguish collection and dissemination of data for the purpose of resulting from bodily injury, sickness or disease monitoring vehicle and/or driver performance. This sustained by a person. includes Global Positioning System technology,wireless ADDITIONS TO SECTION V-DEFINITIONS safety communications and automatic driving assistance systems, all integrated with computers and mobile COVERAGE TERRITORY communications technology in automotive navigation „Coverage Territory" means: systems, 1. The United States of America (including its VOLUNTEER WORKER territories and possessions), Canada and Puerto "Volunteer worker" means a person who performs Rico;and business duties for you, for no financial or other 2. Anywhere in the world, except for any country or compensation. 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 "damages" 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. 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 INSURED'S COPY 31 RESULTING DAMAGE TO YOUR WORK ENDORSEMENT COMMERCIAL GENERAL LIABILITY CG 79 45 07 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: COMMERCIAL GENERAL LIABILITY COVERAGE PART The Definition of "occurrence" is deleted in its entirety and replaced by the following: 13. "Occurrence" means an accident, including continuous or repeated exposure to substantially the same general harmful conditions and includes: a. "Property damage" to property that is not "your work" but is caused by"your work`; and b. 'dour work" if the damaged work or the work out cc of which the damage arises was performed on your behalf by a subcontractor and the"property damage" to "your work" is included in the ti "products-completed operations hazard." 0 X All other terms, conditions, provisions, and exclusions of 2 the policy not changed by this endorsement shall o continue to apply as written. 0 N Copyright, 2014 Selective Insurance Company of America. All rights reserved. CG 79 45 0714 Includes copyrighted material of Insurance Services Office: Inc., with its permission. Page 1 of 1 INSURED'S COPY 32 (3) Materials used in repair, construction, a. Additional interest payments on money renovation or remodeling; or borrowed to finance construction, (4) Maintenance; remodeling, renovation, or repair including increased interest payments due to a rise in of part or all of any property wherever interest rates; located. b. Additional insurance premiums, real estate d. Settling, cracking, shrinkage, bulging or and property taxes, and assessments which expansion. you incur for the period of time covered by e. Wear and tear. this endorsement that construction extends f. Any quality in the property that causes it to beyond the estimated completion date; damage or destroy itself, hidden or latent c. Additional construction permit, architect, defect, gradual deterioration. engineering and consulting fees which g. Mechanical breakdown, become necessary due to the direct physical loss or damage; h, Insects,vermin, rodents, animals. d. Additional legal, lease administration or L Rust or other corrosion, dampness, accounting fees; and extremes of temperature. e. Additional advertising and promotional C. LIMITS OF INSURANCE expenses which become necessary due to The most we will pay for loss or damage in any one the direct physical loss or damage. m occurrence is the applicable Limit of Insurance f. The additional cost to extend leases for shown in the Declarations. construction equipment and temporary o D. DEDUCTIBLE office space. N 1. We will not pay for loss or damage in any one If the part of the covered property that sustains ti 0 occurrence until the amount of the adjusted loss direct physical loss or damage is repaired or 0 or damage before applying the applicable Limits replaced, the payment will not exceed the N of Insurance exceeds the Deductible shown in amount you spend to repair or replace the the Declarations. We will then pay the amount damaged or destroyed property. of the adjusted loss or damage in excess of the 2. TRANSFER OF RIGHTS OF RECOVERY Deductible, up to the applicable Limit of AGAINST OTHERS TO US Insurance. The fallowing Paragraph is added to General 2. If loss or damage covered under this Coverage Condition K. Transfer Of Rights Of Recovery Form also involves loss or damage under any Against Others To Us in the Commercial Inland other coverage form issued by us or any Marine Conditions: company affiliated with us, the most we will deduct from the payment for loss or damage to We will waive any rights of recovery we may Covered Properly is the single largest have against a person or organization because deductible involved. Furthermore, each of payments we make for loss or damage to deductible will only be applied against its Covered Properly if you have agreed to waive applicable coverage and any deductible any right of recovery against that person or amount(s) actually taken will be applied toward organization in a written contract or written any remaining larger deductible(s). agreement, but only if the foss or damage occurs subsequent to the execution of the E. ADDITIONAL CONDITIONS written contract or written agreement. However, 1. VALUATION this does not apply to: The Valuation Conditions under the General a. Any architect, engineer or other party or Conditions section, in the Commercial Inland entity responsible for any design, Marine Conditions is replaced by the following: specification or plans for the fabrication, The value of Covered Property will be based on erection or completion of the property insured with respect to any loss or damage "replacement cost". that may be caused by: "Replacement cost" is limited to the cost of (1) Fault, defect, error or omission in such repair or replacement with similar materials on design, specifications or plans; or the same 'job site" and used for the same purpose. It does not include costs you incur over and above the costs you would have incurred had there been no loss, including: Copyright, 2013 Selective Insurance Company of America. All rights reserved. CM 7105 0713 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 11 of 15 INSURED'S COPY 33 (2) Performance of, or failure to perform, (a) Pays any premium due under this supervisory or management functions Coverage Form at our request if related to the construction project(s)_ you have failed to do so; lb. Any contractor, manufacturer or supplier of (b) Submits a signed, sworn statement Covered Property that has agreed to make of loss or damage within 60 days good any loss or damage under a guarantee after receiving notice from us of or warranty. your failure to do so; and 3. The following conditions apply in addition to the (c) Has notified us of any change in Commercial Inland Marine Conditions and the ownership, occupancy or substantial Common Policy Conditions: change in risk known to the a. COVERAGE TERRITORY mortgage holder. We cover property wherever located within: All terms of this Coverage Form will then apply directly to the mortgage (1) The United States of America (including holder. its territories and possessions); (5) if we pay the mortgage holder for any (2) Puerto Rico; and loss or damage and deny payment to (3) Canada. you because of your acts or because b. COINSURANCE you have failed to comply with the terms of this Coverage Form: All Covered Property, except property in (a) The mortgage holders rights under transit, must be insured for its total the mortgage will be transferred to "completed value" as of the time of loss or us to the extent of the amount we damage or you will incur a penalty_ pay; and The penalty is that we will pay only the (b) The mortgage holder's right to proportion of any loss or damage that the recover the full amount of the limit of insurance at the "job site" bears to mortgage holder's claim will not be the "completed value" of all property at that impaired. "job site". This penalty will not apply to property in transit. At our option, we may pay to the c. MORTGAGE HOLDERS mortgage holder the whole principal on the mortgage plus any accrued interest. (1) The term mortgage holder includes In this event, your mortgage and note trustee. will be transferred to us and you will pay (2) We will pay for covered loss or damage your remaining mortgage debt to us. to Covered Property to each mortgage (6) If we cancel this policy, we will give holder shown in the Declarations in their written notice to the mortgage holder at order of precedence, as interests may least: appear. (a) 10 days before the effective date of (3) The mortgage holder has the right to cancellation if we cancel for your receive loss or damage payment even if nonpayment of premium; or the mortgage holder has started (b) 30 days before the effective date of foreclosure or similar action on the cancellation if we cancel for any Covered Property. other reason. (4) If we deny your claim because of your (7) If we elect not to renew this policy, we acts or because you have failed to will give written notice to the mortgage comply with the terms of this Coverage holder at least 10 days before the Form, the mortgage holder will still have expiration date of this policy the right to receive loss or damage payment if the mortgage holder: Copyright, 2013 Selective Insurance Company of America. All rights reserved. CM 7105 07 13 Includes copyrighted material of Insurance Services Office, Inc„with its permission. Page 12 of 15 INSURED'S COPY 34 B. Subparagraph 1.d. under SUPPLEMENTARY a. Coverage under this provision is afforded only PAYMENTS - COVERAGES A AND B is deleted in until the 180th day after you acquire or form the its entirety and replaced with the following: organization or the end of the policy period, d. All reasonable expenses incurred by the insured whichever is earlier. However, COVERAGE A at our request to assist us in the investigation or does not apply to 'bodily injury' or "property defense of the claim or "suit", including actual damage" that occurred before you acquired or loss of earnings up to $1,000 a day because of formed the organization. time off from work. B. The following paragraph is added to SECTION 11 SECTION 11-WHO IS AN INSURED-Amendments -WHO IS AN INSURED, Paragraph 3: Not-for-Profit Organization Members If you are engaged in the business of con- struction of dwellings three stories or less in The following paragraph is added to SECTION 11 -WHO height, or other buildings three stories or less in IS AN INSURED: height and less than 25,000 square feet in area, If you are an organization other than a partnership,joint you will also be an insured with respect to "your venture,or a limited liability company, and you are a not- work" only, for the period of time described for-profit organization, the following are included as above,for your liability arising out of the conduct additional insureds: of any partnership or joint venture of which you 1. Your officials; are or were a member, even if that partnership or joint venture is not shown as a Named 2. Your trustees; Insured. However, this provision only applies if 3. Your members; you maintain or maintained an interest of at least 4. Your board members; fifty percent in that partnership or joint venture for the period of that partnership or joint venture. 5. Your commission members; This provision does not apply to any partnership or joint 5. Your agency members; venture that has been dissolved or otherwise ceased to 7. Your insurance managers; function for more than thirty-six months. 8. Your elective or appointed officers,and With respect to the insurance provided by this provision, Newly Formed or Acquired Organizations, the 9. Your"not-for-profit members'. following is added to SECTION IV - COMMERCIAL However only with respect to their liability for your GENERAL LIABILITY, Paragraph 4. Other Insurance, activities or activities they perform on your behalf. Subparagraph b. Excess Insurance: Employees As Insureds Modified The insurance provided by this provision, Newly Formed A. Subparagraph 2.a.(1)(a) under SECTION II - WHO or Acquired Organizations, is excess over any other IS AN INSURED does not apply to "bodily injury" to insurance available to the insured, whether primary, a "temporary worker" caused by a co-"employee" excess, contingent or on any other basis. who is not a"temporary worker . (All other provisions of this section remain unchanged) S. Subparagraph 2.a.(2) under SECTION 11 - WHO IS Blanket Additional Insureds - As Required By AN INSURED does not apply to "property damage" Contract to the property of a"temporary worker"or"volunteer Subject to the Primary and Non-Contributory provision worker" caused by a cc-"employee" who is not a set forth in this endorsement, SECTION 11 -WHO IS AN "temporary worker"or"volunteer worker". INSURED is amended to include as an additional C. Subparagraph 2.a.(1)(d) under SECTION 11 - WHO insured: IS AN INSURED does not apply to "bodily injury" A. Owners, Lessees or Contractors/Architects, caused by oardia-pulmonary resuscitation or first aid Engineers and Surveyors services administered by a co-"employee". 1. Any person or organization for wham you are With respect to this provision only, Subparagraph (1) of performing operations when you and such Exclusion 2.e. Employer's Liability under SECTION I - person or organization have agreed in a written COVERAGES, COVERAGE A BODILY INJURY AND contract,written agreement or written permit that PROPERTY DAMAGE LIABILITY does not apply. such person or organization be added as an Newly Formed Or Acquired Organizations additional insured on your commercial general A. Subparagraph 3.a. under SECTION II-WHO IS AN liability policy,and INSURED is deleted in its entirety and replaced with the following, Copyright, 2018 Selective Insurance Company of America.All rights reserved. GG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 5 of 9 =SAD'S COPY 35 3. An "executive officer" or insurance manager, if you 3. You have assumed the liability of that person or are a corporation; organization in that same contract, and it is an 4. Your members, managers or insurance manager. if "insured contract". you are a limited liability company;or The section above only applies to that person or 5. Your elected or appointed officials, officers, organization identified above, and only if the "bodily members, trustees, board members, commission injury' or "property damage" occurs subsequent to the members, agency members,or your administrator or execution of the written contract or written agreement. your insurance manager if you are an organization Liberalization other than a partnership, joint venture, or limited The following condition is added to SECTION IV- liability company. COMMERCIAL GENERAL LIABILITY CONDITIONS: Primary and Nan-Contributory Provision if we revise this Coverage Part to provide more coverage The following is added to Paragraph 4. Other Insur- Without additional premium charge, subject to our filed ance, b. Excess Insurance under SECTION IV- company rules, your policy will automatically provide the COMMERCIAL GENERAL LIABILITY CONDITIONS: additional coverage as of the day the revision is effective This insurance is primary to and we will not seek in your state. contribution from any other insurance available to an Two or More Coverage Parts or Policies Issued By additional insured under this policy provided that: Lis (1) The additional insured is a Named Insured under (This provision is not Applicable in the state of New York such other insurance;and or Wisconsin). (2) You have agreed in a written contract, written The following condition is added to SECTION IV - agreement or written permit that this insurance COMMERCIAL GENERAL LIABILITY CONDITIONS: would be primary and would not seek contrlbution It is our intention that the various coverage parts or from any other insurance available to the additional policies issued to you by us, or any company affiliated insured. with us, do not provide any duplication or overlap of Unintentional Failure To Disclose Hazards coverage. We have exercised diligence to draft our The following is added to Paragraph 6. Representations coverage parts and policies to reflect this intention. under SECTION IV - COMMERCIAL GENERAL however, if the facts and circumstances that will respond LIABILITY CONDITIONS: to any claim or "suit give rise to actual or claimed duplication or overlap of coverage between the various However, if you should unintentionally fail to disclose any coverage parts or policies issued to you by us or any existing hazards in your representations to us at the company affiliated with us, the limit of insurance under inception date of the policy, or during the policy period in all such coverage parts or policies combined shall not connection with any additional hazards, we shall not exceed the highest applicable limit under this coverage, deny coverage under this Coverage Part based upon or any one of the other coverage forms or policies. such failure to disclose hazards. This condition does riot apply to any Excess or Umbrella Waiver Of Transfer Of Rights Of Recovery policy issued by us specifically to apply as excess The following is added to Paragraph S. Transfer of insurance over this coverage part or policy to which this Rights Of Recovery Against Others To Us under coverage part is attached. SECTION IV - COMMERCIAL GENERAL LIABILITY SECTION V-DEFINITIONS CONDITIONS: Discrimination We will waive any right of recovery we may have against a person or organization because of payments we make (This provision does not apply in New York). for"bodily injury"or"property damage"arising out of your A. The following is added to Definition 14. "Personal ongoing operations or "your work" done under a written and advertising injury": contract or written agreement and included in the "Personal and advertising injury" also means "products-completed operations hazard", if: discrimination"that results in injury to the feelings or 1. You have agreed to waive any right of recovery reputation of a natural person, however only if such against that person or organization in a written "discrimination"or humiliation is: contract or written agreement; 1. Not done by or at the direction of: 2. Such person or Organization is an additional insured a. The insured;or on your policy;or Copyright, 2018 Selective Insurance Company of America.All rights reserved. CG 73 00 01 19 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Rage 8 of 9 =strsan Is COPY 36 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - BLANKET BASIS COMMERCIAL UMBRELLA LIABILITY CXL 456 03 20 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA LIABILITY COVERAGE FORM A. The following is added to Paragraph M.Transfer Of d. An obligation, as required by ordinance, to Rights Of Recovery Against Others To Us under indemnify a municipality, except in connection SECTION IV-CONDITIONS: with work for a municipality; We will waive any right of recovery we may have e. An elevator maintenance agreement; against a person or organization because of f. That part of any other contract or agreement payments we make for "bodily injury" or "property pertaining to your business (including an damage" arising out of your ongoing operations or indemnification of a municipality in connection "your work" done under a written contract or written with work performed for a municipality) under agreement and included in the "products-completed which you assume the tort liability of another operations hazard". This waiver applies only if, in party to pay for "bodily injury" or "property that same written contract or agreement, you have damage" to a third person or organization. Tort agreed, liability means a liability that would be imposed 'l. To waive any right of recovery against that by law in the absence of any contract or person or organization; agreement. 2. To include such person or organization as an Paragraph f. does not include that part of any additional insured on an "underlying policy ;or contract or agreement: 3. To assume the liabif€ty of that person or organi- (t) That indemnifies a railroad for "bodily injury" or zation and that written contract or agreement "property damage" arising out of construction or qualifies as an`insured contract";and demolition operations, within 50 feet of any 4. The "underlying insurance" contains a substan- railroad property and affecting any railroad tially similar waiver of recovery rights. bridge or trestle, tracks, roadbeds, tunnel, underpass or crossing; This endorsement applies only if the"bodily injury"or (2) That indemnifies an architect, engineer or "property damage" occurs subsequent to all parties` execution of the written contract or written surveyor for injury or damage arising out of: agreement. (a) Preparing, approving, or failing to prepare or B. The following Definition is added to SECTION V - approve, maps, shop drawings, opinions, DEFINITIONS- reports, surveys,field orders, change orders or drawings and specifications;or "insured contract"means: (b) Giving directions or instructions, or falling to a. A contract for a lease of premises. However, give them, if that is the primary cause of the that portion of the contract for a lease of prem- injury or damage;or ises that indemnifies any person or organization (3) Under which the insured, if an architect, for damage by fire to premises while rented to you or temporarily occupied by you with permis- engineer or surveyor, assumes liability for an injury sion of the owner is not an "insured contract"; damage arising out of the insured' renderinn g or failure to render professional sor- b. A sidetrack agreement; vices, including those listed in (2) above and c. Any easement or license agreement, except in supervisory, inspection, architectural or connection with construction or demolition engineering activities. operations on or within 50 feet of a railroad; Copyright,2019 Selective Insurance Company of America. All rights reserved. CXL 456 03 20 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Page 1 of 1 xxsuA=,s copy 37 WC000313 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following"attaching clause"need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement,effective on at 12:01 A.M.,standard time,forms a part of (DATE) Policy No.we s070977 Endorsement No. Premium (if any)$ of the (NAME OF INSURANCE COMPANY) issued to rn c ti n rn 0 ti can Authorized Representative U 0 0 a E We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us. This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. Schedule Any party for whom you have agreed via written contract to waive subrogation prior to any loss_ This waiver is not applicable in any jurisdiction where prohibited by statute or regulation. Copyright 1983 National Council on Compensation Insurance_ WC UO 03 13 (04184) INSUREDS COPY