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HomeMy WebLinkAbout2024-430-E-AMS-Air Cleaning Specialists-Efland EMS SafeAir Control Panel InstallationRevised 01/24 1 [Departmental Use Only] TITLE Efland Safe Air Control FY 2024-2025 NORTH CAROLINA CONSTRUCTION AGREEMENT UNDER $250,000.00 ORANGE COUNTY THIS CONSTRUCTION AGREEMENT (hereinafter called “Agreement”), made as of the 15th day of July, 2024, by and between Air Cleaning Specialists, Inc., (hereinafter called the “Contractor”), and Orange County, a political subdivision of the State of North Carolina, (hereinafter called the “County,” “Orange County,” or “Owner”). W I T N E S S E T H: That the Contractor and the Owner, for the consideration herein named, agree as follows: 1. CONTRACT DOCUMENTS; PRIORITY The Contract Documents consist of this Agreement, the Request for Proposals, Proposal, Construction Drawings, and Written Specifications. The Contract Documents form the Contract. In the event of any inconsistency between or among the Contract Documents the Contract Documents shall be interpreted in the following order of priority: a. This Agreement. b. Designer Approved Bulletins and Field Orders. c. Request for Proposals and addenda thereto. d. Proposal. 2. SCOPE OF WORK The Contractor shall furnish and deliver all of the materials, and perform all of the work required by this Agreement within the time period stipulated in a written Notice-to-Proceed to be executed by the Contractor and Owner and in accordance with the following enumerated documents, which are made a part hereof as if fully contained herein: a. Construction Drawings prepared by NA (Sheet dated ) b. Written specifications prepared by the project engineer. c. Air Cleaning Specialists, Inc proposal dated June 21, 2024 which fully describes the work to be performed. Such work will hereafter be called the “Work”. d. Related documents listed under Section 1 above. 3. TERM AND SCHEDULING a. The Contractor agrees to commence work pursuant to the written Notice to Proceed. b. The Contractor agrees to complete substantially all Work by September 30, 2024. Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Revised 01/24 2 c. Time is of the essence with respect to all dates specified in the Contract Documents as Completion Dates. d. The Contractor shall perform the Work in the time, manner, and form required by the Contract Documents and as stipulated in a written Notice-to-Proceed to be executed by the Contractor and Owner. e. It is expressly understood that the Owner will employ other contractors to perform work as a part of the Project whose work will be performed simultaneously and sequentially with the performance of the Work by the Contractor. It shall be necessary for the Contractor to coordinate its activities with such other contractors, particularly with respect to access to work areas, storage of materials and other common facilities. f. Should the Owner determine that the Contractor is behind schedule Owner may require, at no additional cost to the Owner, the Contractor to expedite and accelerate its efforts, including providing additional resources and working overtime, as necessary, to perform the Work in accordance with the approved project schedule. 4. STANDARD OF CARE a. The Contractor shall exercise reasonable care and diligence in performing the Work in accordance with the highest generally accepted standards of this type of Contractor practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Contractor is solely responsible for the professional quality, accuracy and timely completion and submission of all work. b. The Contractor shall not load or permit any part of the Work to be loaded with a weight that will endanger its safety, intended performance or configuration. c. Contractor shall be responsible for all errors or omissions caused by its employees, agents, contractors, or assigns in the performance of the Agreement. Contractor shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the Owner. d. Contractor is an independent contractor of Owner. Any and all employees of the Contractor engaged by the Contractor in the performance of any work or services required of the Contractor under this Agreement, shall be considered employees or agents of the Contractor only and not of the Owner, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Contractor. e. If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Contractor represents that it or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Revised 01/24 3 f. The Contractor is responsible for all physical damage to owned or rented machinery, tools, equipment, forms, and other items owned, rented or used by the Contractor and Subcontractor(s) in the performance of the Work including all of Owner’s property in Contractor’s care, custody, or control, and all such property while it is in transit. g. The Contractor is solely responsible for obtaining all permits necessary to complete the Work in compliance with all local, state, and federal laws. 5. PAYMENT & TAXES a. The Owner hereby agrees to pay to the Contractor for the faithful performance of this Agreement and the Contractor hereby agrees to perform all of the Work for a sum not-to- exceed Eight Thousand Six Hundred Forty-Nine Dollars ($8,649.00). Not later than the fifth (5th) day of each calendar month the Contractor shall submit to the Owner’s Representative, generally the architect if an architect is retained on the Work, a Request for Payment for work done during the previous calendar month. i. The Request for Payment shall be in form of a standardized invoice or AIA Document G702-703 appropriately addressed to Owner’s Representative at PO Box 8181, Hillsborough, NC 27278 and shall show substantially the value of work done during the previous calendar month. ii. The amount due for payment shall be ninety-five percent (95%) of the value of work completed since the last Request for Payment and this amount shall be paid by the Owner on or before the last business day of the month. Owner shall retain five percent (5%). 1. Upon Owner’s Representative’s certification that ninety percent (90%) of the Work has been satisfactorily completed retainage may be discontinued. Retainage may be discontinued, at Owner’s Discretion, so long as work continues to be completed satisfactorily and on schedule. iii. Final payment shall not be due to the Contractor until thirty (30) days after one hundred percent (100%) of the Work, including punch list work, has been satisfactorily (as determined by the County) completed and an appropriate affidavit as required in Section 7(c) below has been received by Owner. b. Should Owner reasonably determine that Contractor has failed to perform the Work related to a Request for Payment, Owner, at its discretion may provide the Contractor ten (10) days to cure the breach. Owner may withhold the accompanying payment without penalty until such time as Contractor cures the breach. i. Should Contractor or its representatives fail to cure the breach within ten (10) days, or fail to reasonably agree to such modified schedule, Owner may immediately terminate this Agreement in writing, without penalty or incurring further obligation to Contractor. ii. This section shall not be interpreted to limit the definition of breach to the failure to perform the Work related to a Request for Payment. c. The Contractor has included in the Contract Price and shall pay all taxes assessed by any authority on the Work or the labor and materials used therein. It shall be the Contractor's responsibility to furnish the Owner documentary evidence showing the materials used and sales and use tax paid by the Contractor and each of its subcontractors. Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Revised 01/24 4 6. INSURANCE AND BONDS a. Minimum requirements – Contractor shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any additional insurance as may be required by Owner’s Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). If Owner’s Risk Manager determines additional insurance coverage is required such additional insurance shall be designated here NA (if no additional insurance required mark N/A as being not applicable). Contractor shall not commence construction work until such insurance is in effect and certification thereof has been received by the Owner's Risk Manager. b. Performance Bonds – Contractor shall furnish bonds covering the faithful performance of the Contract and payment of all obligations arising under any of the Contract Documents or related in any way to the Work. Contractor shall immediately furnish a copy of such bonds to any requesting person who appears to be a potential beneficiary of bonds covering payment obligations arising under any of the Contract Documents. This subsection 6(b) applies only to Contracts of fifty thousand dollars ($50,000.00) or more where the total cost for the project is three hundred thousand dollars ($300,000.00) or more. 7. INDEMNITY a. To the extent authorized by North Carolina law the Contractor shall indemnify, without limitation, and hold harmless to the maximum extent permitted by law the Owner and its agents and employees from and against any and all claims, damages, losses and expenses, including attorney's fees, arising out of or resulting from the performance or nonperformance of the Work, provided that any such claim, damages, loss or expense (A) is attributable to bodily injury, sickness, disease or death or injury to, or destruction of, property, including the loss of use resulting therefrom; and (B) is caused in whole or in part by any breach of any provision of the Agreement or by any negligent or wrongful act or omission of the Contractor, any Subcontractor, or supplier of the Contractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The indemnification obligation under this paragraph shall not be limited in any way by any limitation of the amount or type of damages, compensation or benefits payable by or for the Contractor or any subcontractor under workers' compensation acts, disability benefits acts or other employee benefit acts. It is the intent of this section that the Contractor shall indemnify the County to the maximum extent allowed by law. b. The Contractor shall indemnify and hold harmless Owner from any lien of whatever type through the purchase of appropriate bonds and insurance as designated in Section 6 above. In the event any such lien is filed against Owner’s property Contractor shall, through such bonds and insurance or at Contractors expense, defend Owner against all such claims of lien. c. Upon completion of the Work the Contractor shall execute an affidavit stating there are no unpaid debts for any work that has been done or materials that have been furnished to the Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Revised 01/24 5 project prior to and as of the date of substantial completion and further stating that Contractor shall indemnify, save and protect Owner and Owner’s lender, if any, harmless from and against any and all claims, liabilities, losses, damages, causes of action, and expenses (including court costs and reasonable attorney’s fees related thereto) arising out of, in connection with, or resulting from any such debts and liens. Such indemnification shall be in a form and substance acceptable to Owner. d. By executing this Agreement Contractor agrees to abide by and be bound by the indemnification provisions herein. 8. DISPUTE RESOLUTION AND GOVERNING LAW a. Any dispute with respect to any provision of, or the performance or non-performance of, this Agreement shall be subject to the Dispute Resolution Rules and Procedures for Orange County Design, Building Construction, Renovation, and Repair Projects. The policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). b. The laws of the State of North Carolina shall apply to the interpretation and enforcement of this Agreement. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or nonperformance of, this Agreement or the Contract shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina and it is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. c. Notice of any claim by Owner or Contractor must be initiated by written notice to the other Party within thirty (30) days of the occurrence of the event giving rise to the claim or within thirty (30) days of the discovery of the event or condition giving rise to the claim, whichever is later. i. Should any claim be made, regardless of whether such claim is made by Owner or Contractor, Contractor shall continue to faithfully and diligently perform the Work in such a manner as to meet all scheduled timelines. Any failure to faithfully and diligently perform the Work may be deemed, by the Owner, a breach of the Contract. ii. If a claim is made such claim shall be made to the initial decision maker, if applicable, who may request more supporting data, reject the claim in whole or in part, approve the claim in whole or in part or advise the parties the claim is unable to be resolved. iii. If a claim is made by the Owner the Owner may, but is not obligated to, notify the surety. 9. NON–APPROPRIATION a. Contractor acknowledges that Owner is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. b. In the event that public funds are unavailable or not appropriated for the performance of Owner’s obligations under this Agreement, then this Agreement shall automatically expire without penalty to Owner immediately upon written notice to Contractor of the Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Revised 01/24 6 unavailability or non-appropriation of public funds. It is expressly agreed that Owner shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement. c. In the event of a change in the Owner’s statutory authority, mandate or mandated functions, by state or federal legislative or regulatory action, which adversely affects Owner’s authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to Owner upon written notice to Contractor of such limitation or change in Owner’s legal authority. 10. NOTICES Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Owner: Contractor: Orange County Air Cleaning Specialists, Inc. Attn: A. Barnes Attn: Rick Childs P.O. Box 8181 3701 Bastion Lane Hillsborough, NC 27278 Raleigh, NC 27604 11. MISCELLANEOUS a. Duties and Obligations imposed by the Contract Documents shall be in addition to any Duties and Obligations imposed by state, federal or local law, rules, regulations and ordinances. b. No act or failure to act by the Owner or Contractor shall constitute a waiver of any right or duty granted them under the Contract Documents, nor shall any act or failure to act constitute any approval except as specifically agreed in writing. c. The Work shall be tested and inspected as required by the Contract Documents and as required by law. Unless prohibited by law the costs of all such tests and inspections related to state and federal codes such as ADA, Administrative, Electrical, Plumbing, Mechanical and Building Codes shall be borne by the Contractor. The costs for material and structural testing shall be conducted by an independent third party at the expense of the Owner. Delays related to any of the aforementioned tests and inspections shall not be grounds for delaying the completion of the work. If any such tests and inspections reveal deficiencies in the Work such that the Work does not comply with terms or requirements of the Contract Documents and the requirements of any code or law the Contractor is solely responsible for the cost of bringing such deficiencies into compliance with the terms of the Contract Documents and any code or law. d. Should the Architect, if an architect is retained for the project involving the Work, or Owner reject any portion of the Work for failing to comply with the Contract Documents Contractor shall immediately, at Contractor’s expense, correct the Work. Any such rejection may be made before or after substantial completion. If applicable, any additional expense borne by the Architect under this section shall be paid at Contractor’s expense. e. The Contractor shall not assign any portion of this Agreement nor subcontract the Work in Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Revised 01/24 7 its entirety without the prior written consent of the Owner. f. By executing this Agreement Contractor affirms that Contractor and any subcontractors of Contractor are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. g. By executing this Agreement Contractor certifies that Contractor has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. h. By executing this Agreement Contractor certifies that Contractor has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. i. The County has designated (Angel Barnes) to act as the County's representative with respect to the Work and shall have the authority to render decisions within guidelines established by the County Manager or the County Board of Commissioners and shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. j. Contractor shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal non- discrimination laws, policies, rules, and regulations and the Orange County Non- Discrimination Policy and Orange County Living Wage Policy (each Orange County policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). Any violation of the Orange County Non-Discrimination Policy is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. k. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. l. In the event of a breach by Contractor Owner has sole authority to determine the reasonableness of Contractor’s actions to remedy such breach or complete the performance of its obligations. m. Upon request of the Owner, the Contractor shall submit to County all relevant documentation, including but not limited to, job cost records, to support its claims for final compensation and if such request is made final compensation shall not be due until all relevant documentation is received, reviewed, and approved by Owner. n. There are no third-party beneficiaries of this Agreement and nothing in this Agreement, express or implied, is intended to confer on any person other than the parties hereto (and their respective successors, heirs and permitted assigns), any rights, remedies, or Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Revised 01/24 8 obligations. 12. CONSEQUENTIAL AND LIQUIDATED DAMAGES a. Owner and Contractor mutually waive any claim against each other for consequential damages. Consequential Damages include: i. Damages incurred by Owner for loss of use, income, financing, or business. ii. Damages incurred by Contractor for office expenses, including personnel, loss of financing, profit, income, business, damage to reputation, or any other non-direct damages. b. Liquidated damages shall be in accord with the Contract Documents. If the Contract Documents do not otherwise address liquidated damages, such damages shall be in the amount of five hundred dollars ($500.00) per day. 13. TERMINATION OR SUSPENSION a. The Owner may, without cause, order the Contractor to terminate, suspend, delay or interrupt the Work in whole or in part for such period of time as the Owner may determine. i. If Owner issues a written order to delay, suspend, or interrupt the Work, and such order is not due to or as a result of any fault on the part of the Contractor or any subcontractor, the Contractor may recover a per diem amount of five hundred dollars ($500.00) per day with a not-to-exceed limit of ten thousand dollars ($10,000.00). ii. In the event of termination by the Owner under this Agreement, the Contractor shall be entitled to receive its reasonable and documented direct costs incurred prior to the date Owner mails the notice of termination, including the cost of materials purchased for the Work, but only if such purchases cannot be canceled, or materials returned, or which material cannot reasonably be used by the Contractor on other work, and the cost of closing down the work in a safe and efficient manner. iii. If Owner elects to suspend or terminate the contract pursuant to subparagraphs 13.a.i. or 13 a.ii. the sole remedy available to the Contractor are those listed in said subparagraphs and Contractor is not entitled to any right to further claims for any amount owed or disputed or for payment of damages alleged to have been sustained as a result of Owner’s order to delay, suspend, or interrupt the Work. b. The Owner may, with cause, order the Contractor to suspend, delay or interrupt the Work in whole or in part for such period of time as the cause remains. i. If Owner issues a written order to delay, suspend, or interrupt the Work, and such order is due to or as a result of any fault on the part of the Contractor or any subcontractor, the Owner may reduce payment at a per diem amount of five hundred dollars ($500.00) per day for the full duration of the delay, suspension, or interruption. Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Revised 01/24 9 c. Contractor may terminate the Contract if, at the Owner’s written direction, the Work is stopped for thirty (30) consecutive days through no act or fault of the Contractor, their agents or employees, or a subcontractor or their agents or employees or any other person performing work pursuant to the Contract Documents. Contractor may terminate the Contract if a Court or other Public authority having jurisdiction enters a lawful order that requires all work to be stopped and such stoppage lasts for thirty (30) consecutive days. d. Either party may terminate this Agreement upon notice to the other party that obligations pursuant to this Agreement are made impossible due to declarations of emergency by Orange County or by North Carolina due to events directly impacting Orange County. Both parties shall remain responsible for all payment and performance due up to the receipt of such notice, but shall have no further obligation or responsibility beyond that date provided the terminating party has taken all reasonable steps to complete the performance of its obligations. 14. ENTIRE AGREEMENT All of the documents listed, referenced or described in this Agreement, the written Notice-to- Proceed, together with Modifications made or issued in accordance herewith are the Contract Documents, and the work, labor, materials and completed construction required by the Contract Documents and all parts thereof is the Work. The Contract Documents constitute the entire agreement between Owner and Contractor. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. If any provision of the Agreement shall be declared invalid or unenforceable, the remainder of the Agreement shall continue in full force and effect. IN WITNESS WHEREOF, the Parties hereto have executed this Agreement as of the day and date first above written wholly or in a number of counterparts each of which shall, without proof or accounting for other counterparts, be deemed an original contract. ORANGE COUNTY CONTRACTOR ____________________________________ ________________________________________ Signature Signature County Manager ________________________________________ Printed Name and Title Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Vice President 7/19/2024 Bill LeFavor 7/24/2024 Revised 01/24 10 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Air Cleaning Specialists, Inc Vendor Contact Person: Rick Childs (rchilds@acscarolinas.com Phone: 919.636.1338 Address: 3701 Bastion Lane City Raleigh State: NC Zip: 27604 Department: AMS Amount: $8,649.00 Purpose: Efland EMS SafeAir Control Panel Installation Budget Code(s): 61750035-801000-17000 Vendor # 65133 Vendor Status with NCSOS: Current - Active Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date 07/15/2024 End Date 09/30/2024 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by AMS 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: 17000) 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; OR This agreement is approved as to technical form and content. 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: Received for record retention: Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 7/19/2024 7/22/2024 7/22/2024 7/22/2024 Revised 01/24 11 Office of the Clerk to the Board __________________________________________Date:_________ Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 DATE:6/21/24 TO:Orange County EMS 306 Revere Road | A102 Hillsborough, NC 27278 PHONE:9196361338 FAX: E-MAIL abarnes@orangecountync.gov ATTN:Angel Burns PROPOSED BY: Rick Childs rchilds@acscarolinas.com ACCEPTED BY: PO# TERMS DELIVERY:TBD PAYMENT:DUE UPON RECEIPT OF INVOICE SafeAir Installation Only Estimate INSTALLATION AS DESCRIBED ABOVE DELIVERED PRICE , NO TAX*$8,045.00 ORANGE COUNTY TAX RATE @ 7.5%*$603.37 TOTAL EQUIPMENT COST WITH OPTION WITH TAX*$8,648.37 *Price does not include any electrical wiring (high voltage, and control wiring), any seismic restraining or seismic engineering (where identified), any TAB testing, any permitting, any sealed engineered drawings for permitting (if required), any bonding, or any painting. DUE TO THE VOLATILITY IN THE STEEL MARKET, PRICE IS VALID FOR 30 DAYS FROM THE DATE OF THE ESTIMATE PROVIDING AIR POLLUTION CONTROL SOLUTIONS FOR THE WORKPLACE Location: Orange County EMS Station #4 •Acs, Inc shall install the following SafeAir Equipment: *One (1) SafeAir Central Ventilation Controller (CVC) with thru the door disconnect 115V-1Ph *Two (2) SafeAir EFRS relay switch for F-1 And F-2 Ventilation Exhaust Fans *One (1) Combination CO/NO2 sensor. •Acs, Inc. shall provide all labor, installation, installation material, hardware, freight, and rental equipment (Scissor Lift) to install the SafeAir Toxic Gas system. •Acs, Inc’s Installation Scope of Work: •Install one (1) SafeAir control panel (panel cannot be recessed, can only be surface mounted) •Install two (2) SafeAir EFRS relay switch for F-1 And F-2 Ventilation Exhaust Fans •Install one (1) Combination CO/NO2 sensor. (Mounted 5’ AFF) •Acs, Inc to make final control wire termination inside SafeAir panel only. •All freight and installation material •Acs, Inc rent a provide scissor lift. •Acs, Inc. shall perform system startup of Plymovent exhaust system and SafeAir system, which includes Co/ No2 calibration and gas bump testing. •Exclusions: TO BE PROVIDED BY OTHERS •Acs, Inc. does NOT include the following: •Any conduit for the SafeAir panel, OLD(s), EFRS, or Co/No2 systems •Any control wire or pulling of control wire for SafeAir panel, OLD(s), EFRS, and Co/No2 sensors •Any electrical disconnect switches for Plymovent motor(s), SafeAir panel(s), EFRS, or OLD(s). •Acs, Inc. is not providing or installing ventilation fans or Louver. •Any 120/208v electrical wiring for the SafeAir panel, OLD(s), EFRS, Plymovent fan, or Co/No2 systems •Any Cat 5 communication wire for the ethernet connection inside of SafeAir panel (to be provided by others) •Any Non VOIP router for SafeAir communication integration (to be provided by others) •TAB testing •Permitting 3701 BASTION LANE • RALEIGH, NC 27604 • 919.255.9344 in NC 800.344.7751 • FAX 919.255.9634 Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 04/22/2024 Pelnik Insurance 100 Ridgeview Drive Suite 100 Cary NC 27511 Steven Stacy (919) 459-8000 (866) 714-3576 Steve.Stacy@Pelnik.com Air Cleaning Specialists, Inc. 3701 Bastion Lane Raleigh NC 27604 Donegal Companies 0250 Donegal Mutual Insurance Company 13692 CL23121925069 A Y Y CPP9259856 12/31/2023 12/31/2024 1,000,000 100,000 15,000 1,000,000 2,000,000 2,000,000 Employee Benefits 1,000,000 B Y Y CA9259856 12/31/2023 12/31/2024 1,000,000 A 10,000 Y Y CXS9259856 12/31/2023 12/31/2024 5,000,000 5,000,000 B Y 1000013056 12/31/2023 12/31/2024 1,000,000 1,000,000 1,000,000 A Leased/Rented Equipment Installation Floater CPP9259856 12/31/2023 12/31/2024 Leased/Rented 100,000 Installation 100,000 Deductible 500 Orange County, its officers, official agents and employees are additional insured with respect to the General Liability, Auto Liability and Umbrella Liability when required by contract. Waiver of Subrogation applies in favor of the additional insured with respect to the Workers Compensation when required by contract. 30 day notice of cancellation except 10 day notice for non payment of premium. Orange County 300 West Tryon Street PO Box 8181 Hillsborough NC 27278 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 COMMERCIAL LIABILITY UMBRELLA CUD 90 39 07 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CUD 90 39 07 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission Donegal Insurance Group Page 1 of 1 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US WHEN REQUIRED IN A WRITTEN CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE PART The Transfer Of Rights Of Recovery Against Others To Us Condition under Section IV - Conditions is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" included in the "products-completed operations hazard", subject to the following: a.You are required under a written contract to waive your rights to recover from that person or organization; and b.The written contract was executed and in effect before any injury or damage that would give rise to a claim under this Commercial Liability Umbrella Coverage Part. This waiver does not apply to any person who is an engineer or architect, or to any organization with respect to an engineer or architect employed by such organization, unless agreed to in writing by us. POLICY NUMBER: CXS9259856 Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Page 4 of 4 POLICY NUMBER:1000013056 LA 12/23/2022 07:39:33 REQUIREMENTS Supplemental Schedules WC 00 03 13 (04 84) Waiver of Our Right to Recover from Others Endorsement Specific Waiver: NC Name of Person or Organization: ANY PERSON WITH WHOM OR AN ORGANIZATION WITH WHICH YOU HAVE AGREED IN WRITING TO WAIVER YOUR RIGHTS TO RECOVER Premium:$100 WC 00 04 06 (08 84) Premium Discount Endorsement State: SC Estimated Eligible Premium First $5,000 0.0% Next $95,000 10.90% Next $400,000 12.60% Over $500,000 14.40% WC 00 04 06 A (08 95) Premium Discount Endorsement State: NC Estimated Eligible Premium First $5,000 0.0% Next $95,000 10.90% Next $400,000 12.60% Over $500,000 14.40% WC 00 04 24 (01 17) Audit Noncompliance Charge Endorsement State Basis of Audit Noncompliance Charge Maximum Audit Noncompliance Charge Multiplier Any State listed in Item 3.A. of the information page Estimated Annual Premium Up to two times WCD 90 02 (05 12) Notice of Cancellation to Third Party Name of Person or Organization and Mailing Address: CHOATE CONSTRUCTION COMPANY 8200 ROBERTS DR STE 600, ATLANTA, GA 30350 Number of Days Advanced Notice for cancellation for any reason other than non-payment of premium or for non-renewal: 30 Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 04 49 11 16 Copyright, Insurance Services Office, Inc., 2016 Page 1 of 1 PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A.The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance - Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1.Such "insured" is a Named Insured under such other insurance; and 2.You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". B.The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1.Such "insured" is a Named Insured under such other insurance; and 2.You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". POLICY NUMBER: CA9259856 Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 COMMERCIAL AUTO CAD 09 04 07 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CAD 09 04 07 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services Office, Inc., 2000 Donegal Insurance Group Page 1 of 6 SILVER SERIES PLUS BUSINESS AUTO COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM SCHEDULE* Coverage Limit(s) of Insurance Page Airbag Accidental Discharge Coverage Included in applicable Limit of Insurance 4 Audio, Visual And Data Electronic Equipment Coverage Included in applicable Limit of Insurance 5 Auto Loan/Lease Gap Coverage Included in applicable Limit of Insurance 4 Blanket Waiver Of Subrogation Included in applicable Limit of Insurance 5 Broad Form Named Insured And Newly Acquired Or Formed Organizations Coverage Included in applicable Limit of Insurance 2 Broadened Loss Of Use Expenses Loss Of Use Expenses Per Day Loss Of Use Expenses Maximum $65 $750 3 Broadened Towing And Labor Costs Coverage - All Vehicle Types Broadened Towing And Labor Costs Each Disablement Broadened Towing And Labor Costs Aggregate Limit $75 $600 2 Broadened Transportation Expenses Coverage Extension - All Vehicle Types Broadened Transportation Expenses Increased Limit Per Day Broadened Transportation Expenses Maximum Limit $60 $1,800 3 Glass Repair Deductible Waiver Included in applicable Limit of Insurance 5 Hired Auto Physical Damage Coverage - Any One Accident Or Loss $50,000 3 Knowledge Of An Accident, Claim, Suit Or Loss Included in applicable Limit of Insurance 5 Worldwide Hired Auto Coverage Included in applicable Limit of Insurance 6 Parked Auto Collision Deductible Included in applicable Limit of Insurance 5 Personal Effects Coverage $400 4 Rental Reimbursement Coverage $600 4 Supplementary Payments Increased Limits Supplementary Payments - Bail Bonds Increased Limit Supplementary Payments - Loss of Earnings Increased Limit $3,000 $300 per day 2 Unintentional Failure To Disclose Hazards Included in applicable Limit of Insurance 6 *Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations. The following Coverages apply only if they are shown in the Schedule above. Each of the Coverages is subject to the limit of insurance associated with such Coverage in the Schedule. POLICY NUMBER: CA9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CAD 09 04 07 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services Office, Inc., 2000 Donegal Insurance Group Page 2 of 6 The following provisions apply only with respect to the insurance provided by the Business Auto Coverage Form. I.BROAD FORM NAMED INSURED AND NEWLY ACQUIRED OR FORMED ORGANIZATIONS COVERAGE The following provisions are added to subparagraph 1. Who Is An Insured under paragraph A. Coverage as found in SECTION II - LIABILITY COVERAGE: d.Any organization, or any subsidiary of such organization, which is a legally incorporated entity of which you own a financial interest of more than 50 percent of the voting stock on the effective date of this endorsement with respect to any covered "auto". However, this paragraph A.1.d. does not apply to "accident" or "loss" with respect to which an "insured" under this policy is also an "insured" under another policy, or would be an "insured" under such other policy but for its termination or upon the exhaustion of its limits of insurance, unless such other policy was written to apply specifically in excess of this policy. e.Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as an insured if there is no other similar insurance available to that organization. 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 under this provision does not apply to "bodily injury" or "property damage" that results from an "accident" that occurred before you acquired or formed the organization. All provisions, exclusions and conditions applicable to you, except those pertaining to notice of cancellation or refusal to renew, as provided in this policy, including any endorsement attached to and made a part of this policy, apply with respect to the insurance provided to such newly acquired or formed organizations. II.SUPPLEMENTARY PAYMENTS INCREASED LIMITS A.Subparagraph a.(2) under paragraph 2. Coverage Extensions as found in paragraph A. Coverage (SECTION II - LIABILITY COVERAGE) is deleted and replaced by the following: (2)Up to the limit of insurance shown in the Schedule above for Supplementary Payments - Bail Bonds Increased Limit for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. B.Subparagraph a.(4) under paragraph 2. Coverage Extensions as found in paragraph A. Coverage (SECTION II - LIABILITY COVERAGE) is deleted and replaced by the following: (4)All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to the limit of insurance shown in the Schedule above for Supplementary Payments - Loss of Earnings Increased Limit, because of time off from work. III.BROADENED TOWING AND LABOR COSTS COVERAGE - ALL VEHICLE TYPES Subparagraph 2. Towing under paragraph A. Coverage as found in SECTION III - PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following: 2.Towing And Labor Costs We will pay up to the limit of insurance shown in the Schedule above for Broadened Towing And Labor Costs Each Disablement for towing and labor costs incurred each time a covered "auto" is disabled. However, the labor must be performed at the place of disablement. With respect to disablement of covered "autos" other than of the private passenger type, the most we will pay for the total of all towing and labor costs during the policy period shown in the Declarations is the limit of insurance shown in the Schedule above for Broadened Towing And Labor Costs Aggregate Limit. POLICY NUMBER: CA9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CAD 09 04 07 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services Office, Inc., 2000 Donegal Insurance Group Page 3 of 6 IV. BROADENED TRANSPORTATION EXPENSES COVERAGE EXTENSION - ALL VEHICLE TYPES Subparagraph a. Transportation Expenses under paragraph 4. Coverage Extensions as found in paragraph A. Coverage (SECTION III - PHYSICAL DAMAGE COVERAGE) is deleted and replaced by the following: a.Transportation Expenses We will pay per day up to the limit of insurance shown in the Schedule above for Broadened Transportation Expenses Increased Limits Per Day, subject to the maximum limit of insurance shown in the Schedule above for Broadened Transportation Expenses Maximum Limit, for temporary transportation expense incurred by you because of the total theft of a covered "auto". We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". V.BROADENED LOSS OF USE EXPENSES COVERAGE EXTENSION Subparagraph b. Loss Of Use Expenses under paragraph 4. Coverage Extensions as found in paragraph A. Coverage (SECTION III - PHYSICAL DAMAGE COVERAGE) is deleted and replaced by the following: b.Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use expenses if caused by: (1)Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto"; (2)Specified Causes Of Loss only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto"; or (3)Collision only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is the limit of insurance shown in the Schedule above for Loss Of Use Expenses Per Day, subject to the maximum limit of insurance shown in the Schedule above for Loss Of Use Expenses Maximum Limit. VI.The following is added to paragraph A. COVERAGE (SECTION III - PHYSICAL DAMAGE COVERAGE): 5.Hired Auto Physical Damage If hired "autos" are covered "autos" for Liability Coverage under this policy and if Physical Damage Comprehensive Coverage, Physical Damage Specified Causes Of Loss Coverage, or Physical Damage Collision Coverage is provided under this policy for any "auto" you own, then such Physical Damage Coverages are extended to apply to "autos" you hire without a driver, subject to the following provisions: a.The most we will pay for any "accident" or "loss" under this Hired Auto Physical Damage Coverage is the lesser of: (1)The limit of insurance shown in the Schedule above for Hired Auto Physical Damage Coverage - Any One Accident Or Loss; (2)The actual cash value, including an adjustment for depreciation and physical condition in the event of a total "loss"; or (3)The cost of repairing or replacing the damaged or stolen hired "auto" with other property of like kind and quality, minus a $500 deductible. No deductible applies to "loss" caused by fire or lightning. b.Subject to the limit of insurance and deductible provisions provided in paragraph 5.a. above, we will provide coverage equal to the broadest Physical Damage Coverage applicable to any covered "auto" shown in the Declarations. c.This Hired Auto Physical Damage Coverage does not apply to any "auto" you lease, hire, rent or borrow from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. d.This Hired Auto Physical Damage Coverage is excess over all other collectible insurance. POLICY NUMBER: CA9259856 Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CAD 09 04 07 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services Office, Inc., 2000 Donegal Insurance Group Page 4 of 6 6.Rental Reimbursement Expenses We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss", other than total theft, to a covered "auto". We will pay rental reimbursement expenses only for those covered "autos": a.For which you carry either Comprehensive or Specified Causes of Loss Coverage if the "loss" arises from such coverage; or b.For which you carry either Collision Coverage if the "loss" arises from such coverage. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, when the covered "auto" is repaired or replaced or we pay for its "loss". This coverage does not apply while there are spare or reserve "autos" available to you for your operations. The most we will pay for rental reimbursement expenses under this Coverage Extension because of "loss" to a covered "auto" is the limit of insurance shown in the Schedule above for Rental Reimbursement Coverage. No deductibles apply to this coverage. If the Rental Reimbursement Coverage endorsement is also attached to and made a part of this policy, then the coverage provided under this Rental Reimbursement Expenses Coverage Extension will be excess over the insurance provided by the Rental Reimbursement Coverage endorsement. 7.Personal Effects Coverage We will pay up to the limit of insurance shown in the Schedule above for Personal Effects Coverage for loss to wearing apparel and other personal effects which are: a.Owned by an "insured"; and b.In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this coverage. The insurance provided by this Personal Effects Coverage provision is excess over any other collectible insurance covering such property. 8.Auto Loan/Lease Gap Coverage In the event of a total "loss" to a covered "auto" shown on the Declarations in the Schedule Of Covered Autos You Own, we will pay any unpaid amount due on the lease or loan for a covered "auto", less: a.The amount paid under the Physical Damage Coverage Section of the policy; and b.Any: (1)Overdue lease/loan payments at the time of the "loss"; (2)Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage. (3)Security deposits not returned by the lessor; (4)Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and (5)Carry-over balances from previous loans or leases. We will pay the unpaid amount due on the lease or loan only for those covered "autos": a.For which you carry either Comprehensive or Specified Causes of Loss Coverage if the "loss" arises from such coverage; or b.For which you carry either Collision Coverage if the "loss" arises from such coverage. VII. AIRBAG ACCIDENTAL DISCHARGE COVERAGE The following is added to subparagraph 3. under paragraph B. Exclusions as found in SECTION III - PHYSICAL DAMAGE COVERAGE: The exclusion for "loss" caused by or resulting from mechanical breakdown, as described in paragraph B.3.a. above, does not apply with respect to the accidental discharge of an airbag in a covered "auto" if the airbag is repaired or replaced in a manner acceptable to us. No deductible will apply to such "loss". POLICY NUMBER: CA9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CAD 09 04 07 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services Office, Inc., 2000 Donegal Insurance Group Page 5 of 6 VIII. AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE Subparagraph a. under the exception to paragraphs 4.c. and 4.d. as found in paragraph B. Exclusions as contained in SECTION III - PHYSICAL DAMAGE COVERAGE is deleted and replaced by the following: Exclusions 4.c. and 4.d. do not apply to: a.Equipment, that receives or transmits audio, visual or data signals, and accessories used with such equipment, except tapes, records or discs, provided such equipment is permanently installed in the covered "auto" at the time of the "loss" or the equipment is removable from a housing unit which is permanently installed in the covered "auto" at the time of the "loss", and such equipment is designed to be solely operated by use of the power from the "auto's" electrical system, in or upon the covered "auto". IX. GLASS REPAIR DEDUCTIBLE WAIVER The following is added to paragraph D. Deductible as found in SECTION III - PHYSICAL DAMAGE COVERAGE: However, no deductible applies to glass damage if the glass is repaired in a manner acceptable to us instead of replaced. X.PARKED AUTO COLLISION DEDUCTIBLE A.The following is added to paragraph D. Deductible as found in SECTION III - PHYSICAL DAMAGE COVERAGE: However, in the event of "loss" caused by collision to a covered "auto" while such "auto" is in the care, custody or control of an "insured" and legally parked, the Collision Coverage deductible amount that will be applied to the "loss" will be $100, regardless of any deductible amount shown in the Declarations as applicable to such covered "auto". This Parked Auto Collision Deductible provision does not apply to the "loss" if: 1.The covered "auto" is occupied at the time of the "loss"; or 2.The covered "auto" is in the care, custody or control of any person or organization engaged in the business of selling, servicing, repairing or parking "autos". B.If the Exclusions section of any Uninsured Motorists Coverage endorsement or Underinsured Motorists endorsement attached to and made a part of this policy includes a provision excluding a stated dollar amount from the total amount of "property damage" as the result of any one "accident", such stated dollar amount is revised to be $100. XI. KNOWLEDGE OF AN ACCIDENT, CLAIM, SUIT OR LOSS The following provisions are added to subparagraph 2. Duties In The Event Of Accident, Claim, Suit Or Loss under paragraph A. Loss Conditions as found in SECTION IV - BUSINESS AUTO CONDITIONS: d.Knowledge of an "accident", claim, "suit" or "loss" by an agent, servant or "employee" of an "insured" (other than an officer or insurance manager if you are a corporation, a partner if you are a partnership, or a manager if you are a limited liability company) does not imply knowledge of the "insured" unless the "insured" has received notice from the agent, servant or "employee". e.Failure by an agent, servant or "employee" of an "insured" (other than an officer or insurance manager if you are a corporation, a partner if you are a partnership, or a manager if you are a limited liability company) to notify us of an "accident", claim, "suit" or "loss" will not jeopardize your coverage. XII. BLANKET WAIVER OF SUBROGATION The following is added to paragraph A. Loss Conditions 5. Transfer Of Rights Of Recovery Against Others To Us as found in SECTION IV - BUSINESS AUTO CONDITIONS: With respect to the insurance provided under SECTION II - LIABILITY COVERAGE only, 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" caused by an "accident" and resulting from the ownership, maintenance or use of a covered "auto" if such ownership, maintenance or use of a covered "auto" is related to work or ongoing operations performed by you or on your behalf. This provision is also subject to the following: POLICY NUMBER: CA9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CAD 09 04 07 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services Office, Inc., 2000 Donegal Insurance Group Page 6 of 6 A.The work or ongoing operations performed by you or on your behalf have not yet been completed or abandoned and are being performed away from premises you own or rent; B.You are required under a written contract to waive your rights to recover from that person or organization; and C.The written contract was executed and in effect before any "accident", injury, loss or demand that would give rise to a claim under this Business Auto Policy. Under paragraph A. above, your work will be deemed completed at the earliest of when all the work called for in your contract has been completed, when all of the work to be done at a job site has been completed if your contract calls for work at more than one job site, or when that part of the work done at a job site has been put to its intended use by any person or organization other than another contractor or subcontractor working on the same project. Work that may need service, maintenance, correction, repair or replacement, but which is otherwise complete, will be treated as completed. XIII. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following provision is added to paragraph A. Loss Conditions as found in SECTION IV - BUSINESS AUTO CONDITIONS: 6.Unintentional Failure To Disclose Hazards We will not deny coverage under this policy because of an unintentional failure to disclose all exposures or hazards existing on the effective date of the Business Auto Policy or because of an unintentional error or omission in any of the information provided by you and relied upon by us in the issuance of this policy. However: a.You must report the undisclosed exposure or hazard, or unintentional error or omission, to us as soon as practicable after its discovery; b.This provision does not affect our right to collect any additional premium associated with such unintentional failure or our right to cancel or non-renew this policy. XIV. WORLDWIDE HIRED AUTO COVERAGE Subparagraph e.(1) under paragraph B. General Conditions 7. Policy Period, Coverage Territory as found in SECTION IV - BUSINESS AUTO CONDITIONS is deleted and replaced by the following: (1)A covered "auto" is leased, hired, rented or borrowed without a driver for a period of 30 days or less; and POLICY NUMBER: CA9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 COMMERCIAL GENERAL LIABILITY CGD 90 36 01 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGD 90 36 01 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 1 of 2 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS - AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN CONSTRUCTION CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A.SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization whom you are required under a written contract or agreement to provide insurance such as is afforded under this policy, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" performed at the site or location designated in the written contract or agreement. However: 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.The insurance afforded to such additional insured will not be broader than: a.The coverage you have agreed to provide in the written contract or agreement; or b.The coverage provided by this endorsement. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 1.This does not apply to "bodily injury" or "property damage" occurring prior to the date the written contract or agreement was executed and in effect. 2."Bodily injury" or "property damage" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services for you, for such person or organization, or for others, including: a.The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs, drawings or specifications; and b.Supervisory, inspection, or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the rendering of or the failure to render any professional services. 3.Any "bodily injury" or "property damage" for which valid and collectible insurance is available under an Owners and Contractors Protective Liability policy that you have purchased. C.With respect to the Insurance provided by this endorsement, the following is added to SECTION III - LIMITS OF INSURANCE: 8.The most we will pay under the insurance provided by this endorsement is: a.The applicable limit of insurance to which you have agreed in the written contract or agreement to provide; or b.The applicable Limit of Insurance shown in the Declarations, whichever is less. D.With respect to the Insurance provided by this endorsement, Paragraph 4. Other Insurance as found under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4.Other Insurance This insurance is excess over any other valid and collectible insurance, whether primary, excess, contingent or on any other basis, unless you have agreed in a written contract or agreement for this insurance to apply either on a: (1)Primary and non-contributory; or (2)Contributory basis. When this insurance is excess, we will have no duty under Coverage A to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CGD 90 36 01 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 2 of 2 When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1)The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2)The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 COMMERCIAL GENERAL LIABILITY CGD 20 33 05 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGD 20 33 05 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 1 of 2 ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A.SECTION II - WHO IS AN INSURED is amended to include as an insured any person or organization whom you are required under a written contract or agreement to provide insurance such as is afforded under this policy, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by: 1.Your acts or omissions; or 2.The acts or omissions of those acting on your behalf; in the performance of your ongoing operations at the site or location designated in the written contract or agreement. However, 1.The insurance afforded to such additional insured only applies to the extent permitted by law; and 2.The insurance afforded to such additional insured will not be broader than: a.The coverage you have agreed to provide in the written contract or agreement; or b.The coverage provided by this endorsement. B.With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 1.This does not apply to "Bodily injury" or "property damage" occurring: a.Prior to the date the written contract or agreement was executed and in effect; b.After all work on the project (other than service, maintenance or repairs) to be performed at the site or location of the covered operations has been completed; or c.After that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. 2."Property damage" to: a.Property owned, occupied or used by; b.Property rented to, in the care, custody, or control of, or over which physical control is being exercised for any purpose by; or c."Your work" for, such person or organization. 3."Bodily injury" or "property damage" arising out of an architect's, engineer's, or surveyor's rendering of or failure to render any professional services for you, for such person or organization, or for others, including: a.The preparing, approving, or failure to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, designs, drawings or specifications; and b.Supervisory, inspection, or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the rendering of or the failure to render any professional services. 4.Any "bodily injury" or "property damage" for which valid and collectible insurance is available under an Owners and Contractors Protective Liability policy that you have purchased. C.With respect to the Insurance provided by this endorsement, the following is added to SECTION III - LIMITS OF INSURANCE: 8.The most we will pay under the insurance provided by this endorsement is: a.The applicable limit of insurance to which you have agreed in the written contract or agreement to provide; or b.The applicable Limit of Insurance shown in the Declarations, whichever is less. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CGD 20 33 05 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 2 of 2 D.With respect to the Insurance provided by this endorsement, Paragraph 4. Other Insurance as found under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4.Other Insurance This insurance is excess over any other valid and collectible insurance, whether primary, excess, contingent or on any other basis, unless you have agreed in a written contract or agreement for this insurance to apply on either a: (1)Primary and non-contributory basis; or (2)Contributory basis. When this insurance is excess, we will have no duty under Coverage A to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (1)The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (2)The total of all deductible and self-insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 COMMERCIAL GENERAL LIABILITY CGD 09 08 05 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 1 of 8 CONTRACTORS SILVER SERIES GENERAL LIABILITY COVERAGE ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE* Coverage Limit(s) of Insurance Page *Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 2 of 8 The following Coverages apply only if they are shown in the Schedule above. Each of the Coverages is subject to the limit of insurance associated with such Coverage in the Schedule. I.NON-OWNED WATERCRAFT COVERAGE A.Subparagraph g.(2) under paragraph 2. Exclusions as found in COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I - COVERAGES) is deleted and replaced by the following: (2)A watercraft you do not own that is: (a)Less than 51 feet long; and (b)Not being used to carry persons or property for a charge; B.With respect to COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY only, the following provision is added to SECTION II - WHO IS AN INSURED: 4.Any person is an insured with respect to a watercraft you do not own that is less than 51 feet long and is not being used to carry persons or property for a charge, while using such watercraft with your permission. Any other person or organization responsible for the conduct of such person is also an insured, but only with respect to liability arising out of the operation of the watercraft. However, no person or organization is an insured: a.With respect to "bodily injury" to a co- "employee" of the person operating the watercraft; b.With respect to "property damage" to property owned by, rented to, loaned to, occupied by, or otherwise in the care, custody or control of, you or the employer of any person who is insured under this provision; or c.If other insurance of any kind is available to that person or organization for this liability, unless such insurance was written to apply specifically in excess of this policy. II.BROADENED DAMAGE TO PREMISES RENTED TO YOU COVERAGE The following provisions apply only if a Limit of Insurance is shown in the Declarations for Damage To Premises Rented To You. If no Limit of Insurance is shown in the Declarations for Damage To Premises Rented To You, or if Damage To Premises Rented To You is shown as excluded, the following provisions do not apply. A.Subparagraph j. Damage To Property under paragraph 2. Exclusions as found in COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I - COVERAGES) is deleted and replaced by the following: j.Damage To Property "Property damage" to: (1)Property you own, rent, or occupy, including any costs or expenses incurred by you, or any other person, organization or entity, for repair, replacement, enhancement, restoration or maintenance of such property for any reason, including prevention of injury to a person or damage to another's property; (2)Premises you sell, give away or abandon, if the "property damage" arises out of any part of those premises; (3)Property loaned to you; (4)Personal property in the care, custody or control of the insured; (5)That particular part of real property on which you or any contractors or subcontractors working directly or indirectly on your behalf are performing operations, if the "property damage" arises out of those operations; or (6)That particular part of any property that must be restored, repaired or replaced because "your work" was incorrectly performed on it. Paragraph (2) of this exclusion does not apply if the premises are "your work" and were never occupied, rented or held for rental by you. Paragraphs (3), (4), (5) and (6) of this exclusion do not apply to liability assumed under a sidetrack agreement. Paragraph (6) of this exclusion does not apply to "property damage" included in the "products-completed operations hazard". POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 3 of 8 B.The last subparagraph under paragraph 2. Exclusions as found in COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I - COVERAGES) is deleted and replaced by the following: Exclusions c. through e. and g. through n. do not apply to "property damage" to premises while rented to you or temporarily occupied by you with permission of the owner. Exclusion f. does not apply to damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner. A separate limit of insurance applies to this coverage as described in Section III - Limits Of Insurance and as provided under the Broadened Damage To Premises Rented To You Coverage. C.Subject to the Each Occurrence Limit Shown in the Declarations, the Limit of Insurance shown in the Schedule above for Broadened Damage To Premises Rented To You Coverage is the most we will pay under Coverage A for damages because of "property damage" to any one premises, while rented to you or temporarily occupied by you with permission of the owner. The Limit of Insurance for Broadened Damage To Premises Rented To You Coverage shown in the Schedule above is in addition to any Limit of Insurance shown in the Declarations for Damage To Premises Rented To You. III.ELECTRONIC DATA LIABILITY A.Subparagraph p. Electronic Data under paragraph 2. Exclusions as found in COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I -COVERAGES) is deleted and replaced by the following: p.Access Or Disclosure Of Confidential Or Personal Information And Data-related Liability Damages arising out of: (1)Any access to, or disclosure or theft of, any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, financial information, an individual's name, social security number, driver's license number, state identification number, credit card information, debit card information, account number, account histories, passwords, health information, medical information, or any other type of nonpublic information; or (2)The loss of, loss of use of, damage to, corruption of, inability to access, inability to transmit or receive, or inability to manipulate "electronic data" that does not result from physical injury to tangible property. This exclusion applies even if damages are claimed for notification costs, monitoring expenses, forensic or investigation expenses, public relations expenses or any other loss, cost or expense incurred by you or others arising out of that which is described in Paragraph (1) or (2) above. B.The following paragraph is added to SECTION III - LIMITS OF INSURANCE: Subject to 5. above, the Electronic Data Liability Limit shown in the Schedule above is the most we will pay under COVERAGE A for "property damage" because of all loss of "electronic data" arising out of any one "occurrence". C.With respect to the insurance provided by this endorsement, the definition of "Property Damage" in the Definitions Section is replaced by the following: 17."Property damage" means: a.Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use shall be deemed to occur at the time of the physical injury that caused it; b.Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to occur at the time of the "occurrence" that caused it; or c.Loss of, loss of use of, damage to, corruption of, inability to access, or inability to properly manipulate "electronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall be deemed to occur at the time of the "occurrence" that caused it. "Property damage" does not include any loss, cost or expense to correct any defective, faulty or incorrect work performed by you or by any contractors or subcontractors working directly or indirectly on your behalf. For the purposes of this insurance, "electronic data" is not tangible property. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 4 of 8 D.With respect to the insurance provided by this endorsement, the following Definition is added to SECTION V - DEFINITIONS: "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or from computer software (including systems and applications software), hard or floppy disks, CD-ROMS, tapes, drives, cells, data processing devices or any other media which are used with electronically controlled equipment. IV.SUPPLEMENTARY PAYMENTS - COVERAGES A AND B INCREASED LIMITS A.Subparagraph b. under paragraph 1. as found in SUPPLEMENTARY PAYMENTS - COVERAGES A AND B (SECTION I - COVERAGES) is deleted and replaced by the following: b.Up to the Limit of Insurance shown in the Schedule above for Supplementary Payments - Coverages A and B - Bail Bonds Increased Limit for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. B.Subparagraph d. under paragraph 1. as found in SUPPLEMENTARY PAYMENTS - COVERAGES A AND B (SECTION I - COVERAGES) is deleted and replaced by the following: d.All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit". Expenses paid under this provision includes actual loss of earnings, up to the Limit of Insurance shown in the Schedule above for Supplementary Payments - Coverages A and B - Loss of Earnings Increased Limit, because of time off from work. V.BROAD FORM NAMED INSURED COVERAGE With respect to COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY and COVERAGE B. PERSONAL AND ADVERTISING INJURY LIABILITY, the following provision is added to paragraph 1. as found in SECTION II - WHO IS AN INSURED: f.An organization other than a partnership, joint venture or limited liability company, your legally incorporated subsidiaries are insureds if you own a financial interest of more than 50 percent of the voting stock on the effective date of this endorsement. However, coverage under this provision does not apply to "bodily injury", "property damage", or "personal and advertising injury" with respect to which an insured under this policy, including any endorsement attached to and made a part of this policy, is also an insured under another policy, or would be an insured under such policy but for its termination or the exhaustion of the applicable limits of insurance, unless such policy was written to apply specifically in excess of this policy. VI.INCIDENTAL MALPR ACTICE LIABILITY - NURSE, EMT OR PARAMEDIC COVERAGE Paragraph 2.a.(1)(d) as found in SECTION II - WHO IS AN INSURED is deleted and replaced by the following: (d)Arising out of his or her providing or failing to provide professional health care services. This paragraph 2.a.(1)(d) does not apply to a nurse, emergency medical technician (EMT) or paramedic employed by you. VII.BROADENED NEWLY FORMED OR ACQUIRED ORGANIZATIONS COVERAGE Paragraph 3.a. as found in SECTION II - WHO IS AN INSURED is deleted and replaced by the following: a.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; VIII. BROADENED WHO IS AN INSURED The following is added to SECTION II - WHO IS AN INSURED: The following is an additional insured: A. 1.Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an insured only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. A person's or organization's status as an insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 5 of 8 However, such person or organization is not an insured with respect to any "occurrence" which takes place after the equipment lease expires. 2.Any person or organization (referred to below as vendor) with whom you agree in a written contract or agreement to provide insurance such as is afforded under this policy, but only with respect to "bodily injury" or "property damage" caused, in whole or in part, by "your products" which are distributed or sold in the regular course of the vendor 's business, subject to the following additional exclusions: (a)The insurance afforded the vendor does not apply to: (1)"Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (2)Any express warranty unauthorized by you; (3)Any physical or chemical change in the product made intentionally by the vendor; (4)Repackaging, unless unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (5)Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (6)Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (7)Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. (8)"Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i)The exceptions contained in Subparagraphs (4) or (6) above; or (ii)Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (b)This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 3.Any person or organization but only with respect to their liability for "bodily injury" or "property damage" caused, in whole or in part, by your ongoing operations due to: (a)Their financial control of you; or (b)Premises they own, maintain or control while you lease or occupy these premises. However, the insurance afforded to such person or organization does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. 4.Any person or organization but only with respect to liability for "bodily injury" or "property damage" as co-owner of a Described Premises shown in the declarations. 5.Any person or organization but only with respect to liability for "bodily injury" or "property damage" as grantor of a franchise or license to you. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 6 of 8 6.Any person or organization but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by your ongoing operations on that part of the land leased to you and shown in the Schedule. However, the insurance afforded to such person or organization does not apply to: (a)Any "occurrence" which takes place after you cease to lease that land; (b)Structural alterations, new construction or demolition operations performed by or for that person or organization. 7.Any person or organization but only with respect to liability for "bodily injury" or "property damage" as a mortgagee, assignee, or receiver and arising out of the ownership, maintenance, or use of a Described Premises shown in the declarations. However, the insurance afforded to such person or organization does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. 8.Any person or organization but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by your ongoing operations performed in that part of the premises leased to you and shown as a Described Premises in the declarations. However, the insurance afforded to such person or organization does not apply to (a)Any "occurrence" which takes place after you cease to be a tenant in that premises. (b)Structural alterations, new construction or demolition operations performed by or for that person or organization. 9.Any state or political subdivision, but only with respect to liability for "bodily injury" or "property damage". This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with premises you own, rent, or control and to which this insurance applies: (a)The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures; or (b)The construction, erection, or removal of elevators; or (c)The ownership, maintenance, or use of any elevators covered by this insurance. B.The insurance afforded to such person or organization described in paragraph A. above only applies to the extent permitted by law. C.The insurance afforded to such person or organization described in paragraph A. above will not be broader than: 1.The coverage you have agreed to provide in the written contract or agreement; or 2.The coverage provided by this endorsement. D.A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you ends. E.The insurance provided to such person or organization described in paragraph A. above does not apply to "bodily injury" or "property damage" occurring: 1.Prior to the date the written contract or agreement was executed and in effect; 2.After your contract or agreement with such additional insured ends; or 3.After the requirement in the written contract or agreement to add such person or organization as an additional insured on your policy ends. F.The insurance afforded to any additional insured is excess over any other valid and collectible insurance, whether primary, excess, contingent or on any other basis, unless you have agreed in a written contract or agreement for this insurance to apply on either a: 1.Primary and non-contributory basis; or 2.Contributory basis. IX.MEDICAL EXPENSE INCREASED LIMIT The following provision applies only if a Limit of Insurance is shown in the Declarations for Medical Expense. If no Limit of Insurance is shown in the Declarations for Medical Expense, or if Medical Expense is shown as excluded, the following provision does not apply. Subject to the Each Occurrence Limit Shown in the Declarations, the Limit of Insurance shown in the Schedule above for Medical Expense Increased Limit is the most we will pay under Coverage C for all medical expenses because of "bodily injury" sustained by any one person. The Limit of Insurance for Medical Expense Increased Limit shown in the Schedule above is in addition to any Limit of Insurance shown in the Declarations for Medical Expense. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 7 of 8 X.AMENDMENT OF GENERAL AGGREGATE LIMIT OF INSURANCE - PER PROJECT AND PER LOCATION A.With respect to COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY and COVERAGE C. MEDICAL PAYMENTS only, the following provision is added to SECTION III - LIMITS OF INSURANCE: The General Aggregate as described in paragraph 2. under SECTION III - LIMITS OF INSURANCE applies separately to each of your projects away from premises owned by or rented to you and separately to each of your "locations" owned by or rented to you. However: 1.This Amendment of General Aggregate Limit of Insurance - Per Project and Per Location provision does not apply if a single "occurrence" under Coverage A, or a single accident under Coverage C, can be attributed to multiple projects or "locations". The General Aggregate Limit of Insurance shown in the Declarations will apply to the sum of all damages under Coverage A arising out of such "occurrence" and all medical expenses under Coverage C arising out of such accident; 2.This Amendment of General Aggregate Limit of Insurance - Per Project and Per Location does not apply to damages under Coverage B. The General Aggregate Limit of Insurance shown in the Declarations continues to apply to the sum of all damages under Coverage B, regardless of the number of projects or "locations"; B.With respect to the insurance provided by this endorsement, the following Definition is added to SECTION V - DEFINITIONS: "Locations" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. XI.KNOWLEDGE OF AN OCCURRENCE, OFFENSE, CLAIM OR SUIT Subparagraphs a. and b. under paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit as found in SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS are deleted and replaced by the following: a.You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, notice should include: (1)How, when and where the "occurrence" or offense took place; (2)The names and addresses of any injured persons and witnesses; and (3)The nature and location of any injury or damage arising out of the "occurrence" or offense. This Condition only applies when the "occurrence", offense, claim or "suit" is known to you (if you are an individual), to a partner (if you are a partnership), a manager (if you are a limited liability company), or an officer or insurance manager of a corporation (if you are a corporation). Knowledge of an "occurrence", offense, claim or "suit" by an agent, servant or "employee" of an insured (other than a partner, manager, officer, or insurance manager) does not imply knowledge by the insured unless the insured has received notice from the agent, servant or "employee". b.If a claim is made or "suit" is brought against any insured, you must: (1)Immediately record the specifics of the claim or "suit" and the date received; and (2)Notify us as soon as practicable. You must see to it that we receive written notice of the claim or "suit" as soon as practicable. Failure by an agent, servant or "employee" of an insured (other than a partner, manager, officer, or insurance manager) to notify us of an "occurrence", offense, claim or "suit" will not jeopardize your coverage. XII.WAIVER OF TRANSFER OF RIGHTS OF RECOVERY The following is added to the paragraph 8. Transfer Of Rights Of Recovery Against Others To Us as found in SECTION IV - COMMERCIAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of "your work" included in the "products-completed operations hazard" or your ongoing operations, subject to the following: a.You are required under a written contract to waive your rights to recover from that person or organization; and b.The written contract was executed and in effect before any injury or damage that would give rise to a claim under this Commercial General Liability Coverage Part. This waiver does not apply to any person who is an engineer or architect, or to any organization with respect to an engineer or architect employed by such organization, unless agreed to in writing by us. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CGD 09 08 05 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Donegal Insurance Group Page 8 of 8 XIII. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following Condition is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: 10.Unintentional Failure To Disclose Hazards Any unintentional error or omission in the description of, or failure to completely describe, any premises or operations intended to be covered by this Coverage Part will not invalidate or affect coverage for those premises or operations. Such unintentional error or omission must be reported to us as soon as practicable after its discovery. This Condition does not affect our right to collect any additional premium associated with such unintentional error or omission or our right to cancel or non-renew this policy. XIV.CONTRACTUAL LIABILITY - RAILROADS Subparagraph f.(1) under the definition of "insured contract" as found in SECTION V - DEFINITIONS or as found in endorsement CG 24 26 AMENDMENT OF INSURED CONTRACT DEFINITION is deleted. XV. MOBILE EQUIPMENT REDEFINED Subparagraph f.(1) under the definition of "mobile equipment" as found in SECTION V - DEFINITIONS is deleted and replaced by the following: (1)Equipment with a gross vehicle weight of 1000 pounds or more and designed primarily for: (a)Snow removal; (b)Road maintenance, but not construction or resurfacing; or (c)Street cleaning. POLICY NUMBER: CPP9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 COMMERCIAL LIABILITY UMBRELLA CUD 90 05 03 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CUD 90 05 03 06 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 2 Copyright, Insurance Services Office, Inc., 2001, 2000 Donegal Insurance Group CONTRACTOR'S LIABILITY FOLLOWING FORM ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY UMBRELLA COVERAGE PART A.This insurance does not apply to any sums the insured becomes legally obligated to pay as damages, or any loss, cost or expense, including costs or expenses for defense, arising out of, traceable to, or relating in any way to: 1.Either your ongoing operations or operations included within the "products-completed operations hazard", at any site, location or construction project, if any insured under this policy entered into contracts or agreements commonly referred to as consolidated insurance programs or wrap-up programs providing general liability coverage at that site, location or construction project. This exclusion applies whether or not the consolidated insurance program or wrap-up program: a.Provides coverage identical to that provided by this policy; b.Has limits adequate to cover all claims; or c.Remains in effect. 2. Any joint venture. B.The following exclusion is added to paragraph 2. Exclusions as found under COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I - COVERAGES) and paragraph 2. Exclusions as found under COVERAGE B - PERSONAL AND ADVERTISING INJURY LIABILITY (SECTION I - COVERAGES): This insurance does not apply to "bodily injury", "property damage", or "personal and advertising injury", for which the insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement, including an "insured contract". This exclusion does not apply to the extent that valid "underlying insurance" for the liability assumed under such contract or agreement, including an "insured contract", exists or would have existed but for the exhaustion of underlying limits for "bodily injury" "property damage", or "personal and advertising injury". Coverage provided will follow the provisions, exclusions and limitations of the "underlying insurance" unless otherwise directed by this insurance. C.The following exclusions are added to paragraph 2. Exclusions as found under COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY (SECTION I - COVERAGES): This insurance does not apply to: 1.Any sums the insured becomes legally obligated to pay as damages, or any loss, cost or expense, including costs or expenses for defense, arising out of, contributed to, aggravated by, traceable to, or relating in any way to, "earth movement" caused by or resulting from any ongoing operation performed by or on behalf of an insured, or from the "products-completed operations hazard". This exclusion applies regardless of whether such damages, loss, cost or expense arises solely from "earth movement" or from "earth movement" in combination with one or more other causes, and regardless of whether such other causes are naturally occurring phenomena or man-made. 2."Property damage" included within the "explosion hazard", the "collapse hazard" or the "underground property damage hazard". This exclusion does not apply to: a.Operations performed for you by others; b."Property damage" included within the "products-completed operations hazard"; or c.The extent that valid "underlying insurance" for "property damage" included within the "explosion hazard", the "collapse hazard" or the "underground property damage hazard" exists or would have existed but for the exhaustion of underlying limits for such "property damage". Coverage provided will follow the provisions, exclusions and limitations of the "underlying insurance" unless otherwise directed by this insurance. POLICY NUMBER: CXS9259856 Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991 CUD 90 05 03 06 Includes copyrighted material of Insurance Services Office, Inc., with its permission Page 2 of 2 Copyright, Insurance Services Office, Inc., 2001, 2000 Donegal Insurance Group 3."Property damage" to any property, whether real or personal, occupied, leased or used by, rented or loaned to, in the care, custody or control of, or over which physical control is being exercised for any purpose, by any insured or any person or organization for whom you may be legally responsible. 4."Bodily injury" or "property damage" arising out of, traceable to, or relating in any way to: a.Equipment or machinery of any type owned by, leased, rented, or loaned to, or in the care, custody and control of, any insured while leased, rented or loaned to others; or b.Equipment or machinery of any type for which an insured is acting as an agent for the equipment or machinery owner or lessee while the equipment or machinery is leased, rented or loaned to others. D.With respect to the provisions of this endorsement, the following Definitions are added to SECTION V - DEFINITIONS: 1."Collapse hazard" includes "structural property damage" and any resulting "property damage" to any other property at any time. "Collapse hazard" does not include "property damage": a.Arising out of operations performed for you by independent contractors; or b.Included within the "products-completed operations hazard" or the "underground property damage hazard". 2."Earth movement" means any form of earth movement, regardless of whether a naturally occurring phenomena or man-made, including but not limited to the following: a.Landslide; b.Mudflow or mudslide; c.Earth settling, sinking, caving in, or subsidence (including mine subsidence); d.Earth rising or expanding; e.Earth slipping, falling away, shrinking, eroding, tilting, flowing, or shifting in a horizontal or sideways direction; f.Collapse or movement of landfill; g.Earth compaction or consolidation; h.Earthquake; i.Any instability of land or earth; or j.Any other movement of land, earth or mud. 3. "Explosion hazard" includes "property damage" arising out of blasting or explosion. The "explosion hazard" does not include "property damage": a.Arising out of the explosion of air or steam vessels, piping under pressure, prime movers, machinery or power transmitting equipment; b.Arising out of operations performed for you by independent contractors; or c.Included within the "products-completed operations hazard" or the "underground property damage hazard". 4."Structural property damage" means the collapse of or structural injury to any building or structure due to: a.Grading of land, excavating, borrowing, filling, back-filling, tunneling, pile driving, cofferdam work or caisson work; or b.Moving, shoring, underpinning, raising or demolition of any building or structure or removal or rebuilding of any structural support of that building or structure. 5."Underground property damage hazard" includes "underground property damage" and any resulting "property damage" to any other property at any time. "Underground property damage hazard" does not include "property damage": a.Arising out of operations performed for you by independent contractors; or b.Included within the "products-completed operations hazard". 6."Underground property damage" means "property damage" to wires, conduits, pipes, mains, sewers, tanks, tunnels, any similar property, and any apparatus used with them beneath the surface of the ground or water, caused by and occurring during the use of mechanical equipment for the purpose of grading land, paving, excavating, drilling, borrowing, filling, back-filling, or pile driving. POLICY NUMBER: CXS9259856Docusign Envelope ID: 55889BA8-C67F-4754-881E-630DCDB08991