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Municipal Pipe Tool - FY17 CIP Pipelining Ph IIIA, Cont. 919-3/6/2017
FORM OF CONTRACT CONTRACT FOR THE CONSTRUCTION OF FY 2017 CLP PIPELINING PHASE IIIA CITY OF WATERLOO, IOWA CONTRACT NO. 919 This contract made and entered into this 6th day of March, 2017 by and between the City of Waterloo, Iowa, a Municipal Corporation, (hereinafter referred to as City), and Municipal Pipe Tool Company, LLC. WITNESSETH: PAR. 1 Contractor agrees to build and construct the FY 2017 CIP Pipelining Phase IIIA, City Contract No. 919 and furnish all necessary tools, equipment, materials, and labor necessary to do all the work called for in the plans and specifications in a workmanshiplike manner and for the prices set forth in Contractor's proposal, which was accepted by the City, and which is understood and agreed to be a part of this contract. PAR. 2 It is understood and agreed that the resolution adopted by the City Council ordering the construction of the improvement, the Notice to Contractors as published, the Instruction to Bidders, the Form of Proposal, the Construction and Maintenance Bonds, the Council Proceedings relating to this matter, and the Plans and Specifications shall all be considered as forming a part of the contract the same as though they were each set out in said contract. PAR. 3 The Contractor agrees to furnish at its own cost and expense, all necessary materials and labor for said work and to construct said improvements in a thorough, substantial, and workmanlike manner, and in strict accordance with the requirements of this contract, and of the plans and specifications made a part hereof by reference, and to the satisfaction and approval of the City and its engineer. PAR. 4 The Contractor agrees to perforin said work and install said improvements on the terms set out in bid or proposal to the City which has been accepted by the City and which is by reference made a part of this contract. PAR. 5 The Contractor agrees to commence said work within ten (10) working days after receipt of "Notice to Proceed" and with a final completion date of October 27, 2017 unless an extension of time is granted in writing by the Council of the City. PAR. 6 Should the Contractor fail to complete said improvements in strict accordance with the terms and conditions of this contract, or the plans and specifications therefor promptly by the date herein specified, the City may pay such additional sums as it may be required to pay by reason of the failure of said contractor and deduct any and all such sums from any amount then due the Contractor. PAR. 7 The Contractor agrees to comply with and obey all ordinances of the City of Waterloo, Iowa, relating to the obstruction of streets and alleys, keeping open passage ways for water, traffic, and protecting any excavations in any street or alley, and maintaining proper and sufficient barricades with lights and signals during all hours of darkness, to see that the backfilling is properly done, and agrees to keep the City whole and defend any and all suits that may be brought against the City by reason of any injuries that may be sustained by any person or property allegedly caused by the Contractor, or his agents, while work is done pursuant to this agreement. PAR. 8 The Contractor agrees that in the event a law suit is brought against the City for damages allegedly sustained by reason of any act, omission or negligence of the Contractor or its agents, or on account of any injuries allegedly sustained by reason of any obstruction, hole, depression or barrier placed or dug by the defendant or its agents, in the doing of the work herein contracted for, that it will defend said suit and save the City harmless therein, and in case judgment is rendered against the City, the Contractor agrees to pay the same promptly. The Contractor agrees FORM OF CONTRACT 60504645 CONTRACT NO. 919 C -I of 3 to carry public liability insurance in a solvent company in a sufficient amount to protect the City and those who use the streets of the City. PAR. 9 The City shall have the right to appoint one or more consbuetion reviewers who shall review the progress of the work in detail; also, to make any test or any material to be used in such work. No material shall be used in any work until the same has first been approved by the construction reviewer. Such construction reviewer shall have full authority to pass judgment upon all materials and upon the manner of doing the work, and their judgment on rejecting any materials, substance, or manner of work shall be final unless it is revoked or modified by the City Engineer. PAR. 1O Any material, which has been rejected by the construction reviewer, shall be at once removed from the line of work and shall not be again taken thereon or placed with the material proposed to be used without the written consent of the City Engineer. PAR. 11 The Contractor shall maintain no cause of action against the City on account of delays and prosecution of work, but if said work is delayed by the City, the Contractor shall have such extra time for completion of the job as was lost by reason of the delay caused by the City. PAR. 12 The Contractor agrees to pay punctually all just claims of labor, material, men, or subcontractors who shall perform labor or famish materials entering into this improvement. It is agreed that the City need not pay the Contractor until all such claims are paid by the Contractor. It is agreed that the City shall not be liable for said labor, material, or men under this contract. PAR. 13 The Contractor agrees to furnish the City, simultaneously with this contract, a bond on a form to be provided by the City in the amount provided by law as stated in the Notice to Bidders, which shall be for the benefit of the City, and any and all persons injured by the breach of any of the terms of this contract. Said bond shall be filed with the City Clerk and shall be subject to the approval of the City Council, and is by reference made a part of this contract. PAR. 14 The Contractor agrees that should it abandon work under this contract or cease the prosecution thereof for a period of thirty (30) consecutive days without reasonable cause, and should it fail to proceed with said work within ten (10) days after a notice to continue or carry it on has been mailed to it at the address given herein by the City, or after such notice has been served on it, then the City may proceed to complete said work, using any material, tools, or machinery found along said line of work, doing the work either by contract or as it may elect, and the Contractor and the sureties on its bond shall be liable to the City for the costs and expenses so paid out. Said costs shall be retained by the City from any compensation due, or to become due the Contractor, and may be recovered by the City in an action upon Contractor's bond. PAR. 15 In consideration of the full compliance on the part of the Contractor with all the provisions, stipulations, and conditions hereof, or contained in the various instruments made a part of this contract by reference, and upon completion and acceptance of said work, the City agrees to pay to the Contractor, in the manner set out in the Notice to Contractors, the amount of money due the Contractor for work performed and accepted, at the unit prices set out in the Contractor's proposal, which has been accepted by the City. PAR. 16 The total amount of the contract, based on the Engineer's estimates of quantities and the Contractor's unit bid prices, and for which 100% surety bond is required is $1,465 634.00. PAR. 17 After the completion of said work, the Contractor agrees to remove all debris and clean-up said streets, and to save the City harmless from any damage allegedly resulting from a failure to clean up and remove the debris or put the street back in a proper condition for travel. PAR. 18 This contract is not divisible, but in the event of a conflict between this contract and the various instruments incorporated by reference, this contract shall govern. PAR. 19 Before the Contractor shall be entitled to receive final payment for work done under this contract, it shall execute and file a bond in the penal sum of not less than 100% of the total amount of the contract, same to be known as FORM OF CONTRACT 60504645 CONTRACT NO. 919 C-2 of 3 "Maintenance Bond," and which bond must be approved by the City Council, and which bond is in addition to the bond given by the Contractor to guarantee the completion of the work. PAR. 20 The Contractor shall maintain all work done hereunder in good order for the period of two (2) years from and after the date it is accepted by the Council of the City of Waterloo, Iowa. Said maintenance shall be made without expense to the City or the abutting property. In the event of the failure or default of the Contractor to remedy any or all defects appearing in said work within a period of two (2) years from the date of its acceptance by said Council, and after having been given ten (10) days notice so to do by registered letter deposited in the United States Post Office in said town, addressed to said contractor at the address herein given, then the City may proceed to remedy such defects. The costs and expenses thereof to be recovered from the Contractor and the sureties on its maintenance bond by an action brought in any court of competent jurisdiction. PAR 21 The Contractor shall give notice to said City by registered letter directed to the Mayor or City Clerk/Auditor thereof not more than four (4) and not less than three (3) months prior to the expiration of the term during which the Contractor is required to maintain said improvements, in good repair by the terms of its Contract. The liability of the Contractor and of the sureties on its bond for maintenance of the said improvements shall continue until three (3) months after such notice has been given to the City, and, in any event, until two (2) years after the acceptance of the work. CITY OF WATERLOO, IOWA Mayor MUNICIPAL PIPE TOOL COMPANY. LLC. Contractor 13Y:"(x4 C t -e' Title: Approved by the City Council of the City of Waterloo, Iowa, this LT day of kph , 2017. ATTEST: FORM OF CONTRACT 60504645 , City Clerk Waterloo, Iowa CONTRACT NO. 919 C-3 of 3 Bond No. IAC586712 PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS: That we, Municipal Pipe Tool Co., LLC of Hudson, Iowa (the "Principal"), and Merchants Bonding Company (Mutual) pf West Des Moines, Iowa (the "Surety"), are held and firmly bound unto the City of Waterloo, Iowa (the "Obligee'), in the penal sum of One Minion Four Hundred Sixty Five Thousand Six Hundred Thirty Four & no/100 DOI lace ($ 1,465,634.00 ) lawful money of the United States, for the payment of said suns in connection with a contract (the "Contract") dated on or about March 6, 2017 for the purpose of FY 2017 CIP Pipelining Phase IIIA The Contract is incorporated herein by reference as though fully set forth herein. Whenever the Principal shall be and is declared by the Obligee to be in default under the Contract, with the Obligee having performed its obligations in the Contract, then the Surety, acknowledging that time is of the essence, may promptly remedy the default, or shall promptly undertake to: . Complete the Contract in accordance with its terms and conditions; or 2. Obtain one or more bids for completing the Contract in accordance with its terms and conditions, and upon determination by the Surety of the lowest responsible bidder, or negotiated proposal, or, if the Obligee elects, upon determination by the Obligee and the Surety jointly of the lowest responsible bidder, or negotiated proposal, arrange for a contract between such party and the Obligee. The Surety will make available as work progresses sufficient funds to pay the cost of completion less the balance of the Contract mice. The cost of completion includes responsibilities of the Principal for correction of defective work and completion of the Contract, the Obligee's legal and design professional costs resulting directly from the Principal's default, and liquidated damages or actual damages if no liquidated damages are specified in the Contract. The term "balance of the Contract price" means the total amount payable by the Obligee to the Principal under the Contract and any amendments thereto, less the amount properly paid by the Obligee to the Principal; or 3. Determine the amount for which it is liable to the Obligee and pay the Obligee that amount as soon as practicable. In the event this bond is enforced, Principal and Surety agree to indemnify Obligee and hold Obligee harmless from and against any and all costs of enforcement, including but not limited to reasonable attorneys' fees and expenses. Every Surety on this bond shall be deemed and held, any contract to the contrary notwithstanding, to consent to each and all of the following matters, without notice: To any extension of time to the Contract in which to perform the Contract. 2. To any change in the plans, specifications, or Contract when such change does not involve an increase of more than twenty percent (20%) of the total Contract price, and shall then be released only as to such excess increase. 3. That no provision of this bond or of any other contract shall be valid which limits to less than one (1) year front the time of the acceptance of the work the right to sue on this bond for defect in workmanship or material not discovered or known to the Obligee at the time such work was accepted. If the Principal performs the Contract, then this bond shall be null and void; otherwise it shall remain in full force and effect. In no event shall the Surety's total obligation exceed the penal amount of this bond. Ternis used herein shall include, as appropriate, the singular or plural number, or the masculine, feminine or neuter gender. PERFORMANCE BOND 06504645 CONTRACT NO. 919 PEB-I of IN WITNESS WHEREOF, the undersigned Principal and Surety have executed this Performance Bond as of March 8, 2017 PRINCIPAL SURETY Municipal Pipe Tool Co., LLC Merchants Bonding Company (Mutual) Name Name By: (/0a0t',�/ �." Title: C/a -1 ;LA.-) Title: Dione R. Young, Attorney -in -Fact [attach Power of Attorney] NOTE: Date of BOND must not be prior to date of Contract. If CONTRACTOR is Partnership, all partners should execute BOND. If this project includes Federal Funds, the following applies to the payment bond: IMPORTANT: Surety companies executing bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the project is located. PERFORMANCE BOND 06504645 CONTRACT NO. 919 I'FB-2 of 2 Bond No. IAC566712 KNOW ALL MEN BY THESE PRESENTS: that a Corporation PAYMENT BOND MUNICIPAL PIPE TOOL COMPANY LLC (Name of Contractor) 515 - 5TH Street P.O. Box 398, Hudson Iowa 50643 (Address of Contractor) (Corporation, Partnership or Individual) and Merchants Bonding Company (Mutual) hereinafter called Principal, (Name of Surety) 6700 Westown Parkway, West Des Moines, IA 50266-7754 (Address of Surety) hereinafter called Surety, are held and firmly bound unto CITY OE WATERLOO, IOWA (Nance of Owner) 715 MULBERRY STREET, WATERLOO, I OWA 50703 (Address of Owner) hereinafter called OWNER, in the penal sum of One Million Four Hundred Sixty Five Thousand Six Hundred Thirty Four & no/100 Dollars,($1,465,634.00 ) in lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, successors, and assigns, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that whereas. the Principal entered into a certain contract with the OWNER, dated the 6th day of March, 2017 , a copy of which is hereto attached and made a part hereof for the construction of: FY 2017 CIP Pipelining Phase IIIA CITY CONTRACT NO. 919 CITY OF WATERLOO IOWA NOW, THEREFORE, if the Principal shall promptly make payment to all persons, firms, SUBCONTRACTORS, and corporations furnishing materials for or performing labor in the prosecution of the WORK provided for in such contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, coal and coke, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such WORK, and all insurance premiums on said WORK, and for all labor, performed in such WORK whether by SUBCONTRACTOR or otherwise, then this obligation shall be void; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety for value received hereby stipulates and agrees that no change, extension of time, alteration or addition to the terns of the contract or to the WORK to be performed thereunder or the SPECIFICATIONS accompanying the sante shall in any wise affect its obligation on this BOND, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the WORK or to the SPECIFICATIONS. PAYMENT BOND 60504645 CONTRACT NO. 919 PB -1 of 2 PROVIDED, FURTHER, that no final settlement. between the OWNER and the CONTRACTOR shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. IN WITNESS HEREOF, this instrument is executed in three (3) an original, this the 8th ATTEST: day of March iejaZiLey. (77/ tea(. -e (Principal) Secretary (SEAL) Witness as t Principal 515 6th Street, Hudson, IA 50643 (Address) (number) counterparts, each one of which shall be deemed 2017 Municipal Pipe Tool Co., LLC Principal By 9/1-8-44)77 (A.-'-/C"/:)6"tf)'(-"(-- 515 5th Street, P. O. Box 398 (Address) Hudson, IA 50643-0398 Merchant Bonding Compapyj Iutual) By ft Sure Attorney -its -Fac tlibione R. Young Holmes, Murphy and Associates, LLC i Surety Anne Crowner (Address) P. O. Box 9207, Des Moines, IA 50306-9207 (Address) P. O. Box 9207, Des Moines, IA 60306-9207 NOTE: Date of BOND must not be prior to date of Contract. If CONTRACTOR is Partnership, all partners should execute BOND. If this project includes Federal Funds, the following applies to the payment bond: IMPORTANT: Surety companies executing bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State where the project is located. PAYMENT BOND 60504645 CONTRACT NO. 919 PB -2 of 2 MERCHANTS BONDING COMPANY,, POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations duly organized under the laws of the State of Iowa (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint, individually, Anne Crowner; Brian M Deimerly; Cindy Bennett; Craig E Hansen; Dione R Young; Jay D Freiermuth; Jody Decker; Kathleen Brewer; Kevin J Knutson; Lacey Cramblit; Michelle R Gruis; Shirley S Bartenhagen; Stacy Venn; Tim McCulloh of Des Moines and State of Iowa their true and lawful Attorney -in -Fact, with full power and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surely any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject lo the limitation that any such instrument shall not exceed the amount of: TWEN'T'Y MILLION ($20,000,000.00) DOLLARS and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers of the Companies, and all the acts of said Attorney -in -Fact, pursuant to the authority herein given, are hereby ratified and confirmed. This Power -of -Attorney is made and executed pursuant to and by authority of the following By -Laws adopted by the Board of Directors of the Merchants Bonding Company (Mutual) on April 23, 2011 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 24, 2011. "The President, Secretary, Treasurer, or any Assistant Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof. The signature of any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 8th day of unf,,,,..... -• m —0- ,u ,: G'. :H - c)f3 := -0 'ai= •z: • ;t, 2003 :,,:-I .4t 1933 . :,� .ted.(1A..*o. By STATE OF IOWA r1; ";;;,•••��C,c�� ..�(y•. April , 2015. MERCHANTS BONDING COMPANY (MUTUAL) MERCHANTS NATIONAL BONDING, INC. COUNTY OF POLK ss. President On this 8th day of April , 2015, before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument is the Corporate Seals of the Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. In Testimony Whereof, I have hereunto set my hand and affixed my Official Seal at the City of Des Moines, Iowa, the day and year first above written. I'k Commission Number NDY WOODY 4654 My Commission Expires /owP June 20, 2017 STATE OF IOWA COUNTY OF POLK ss. Notary Public, Polk County. Iowa I, William Warner, Jr., Secretary of the MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER-OF-ATTORNEY executed by said Companies, which is still in full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on This Btfl day of March 2017 . . SPO 9•. -0- ti : : t. - t;: 3 Secretary 2003 r,�> y',,' 1933 iy • ac: t• eek.. • •\ POA 0014 (7/14) ACORODATE CO T ® CERTIFICATE OF LIABILITY INSURANCE (MW 3/7/2017 mDm YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: The Horton Group (NC No E.U:748-845-3000 FAX IA/C, No): 10320 Orland Parkway E-MAIL Orland Park IL 60467 ADDREss:constructioncedS 8/3/2017 EACH OCCURRENCE _thehortongroup.com INSURER(S) AFFORDING COVERAGE MAGE TO RENTED PREMSES(Ea occurrence) $300,000 NAIC # $5,000 INSURER A :Berkley Fire & Marine 3$.911 INSURED MUNIC-5 INSURER B:Amerisure Mutual Insurance Co. 23396 Municipal Pipe Tool INSURER C:IIli nois Union Insurance Oompaay 27960 Co., LLC INSURER D:Crim & Forster Insurance Company 42471 515 Fifth Street GEN'L AGGREGATE POLICY LIMIT APPLIES X PRO Hudson IA 50643 INSURER E: INSURER F : B AUTOMOBILE _ X COVERAGES CERTIFICATE NUMBER: 1216749183 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRINSR TYPE OFINSURANCE ADDL SUBR WVD POLICY NUMBER POLICY EFF IMM/DD/YYYY) POLICY EXP (MMIDDNYYY) LIMITS El GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY Y Y 0L21023070001 8/3/2016 8/3/2017 EACH OCCURRENCE $1,000,000 MAGE TO RENTED PREMSES(Ea occurrence) $300,000 MED EXP (Any one person) $5,000 CLAIMS -MADE X j OCCUR PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGO $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES X PRO PER: LOC $ B AUTOMOBILE _ X LIABILITY ANY AUTO ALL OWNED AUTOX HIRED AUTOS X SCHEDULED AUTOS AUTOS Y Y CA21023080002 8/3/2016 8/3/2017 COMBING SINGLELIMII (Ea accident) $1,000 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Peri acEcidenDAMAGE (Per $ D X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y 5811072651 8/3/2016 8/3/2017 EACH OCCURRENCE $8,000,000 AGGREGATE 516,000,000 $ DED X RETENT ON $0$ g WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AANY NYIPROPRIE BER PARTNE E ECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N N/A y WC2102310001 8/3/2016 8/3/2017 X 1JWCSTATU I IoFI E.L. EACH ACCIDENT 51,000,000 E.L. DISEASE- EA EMPLOYEE $1,000,000 E.L. DISEASE- POLICY LIMIT $1,000,000 C 8 Contractors Pollution Leased/Rented Equip Garagekeepers Y Y CPYG28116871001 MPK100202352 CA212023090002 8/3/2016 8/3/2016 8/3/2016 8/3/2017 8/3/2017 8/3/2017 51,000,000 Occ. $1,000,000 Agg. 5200,000 Per Item $1,000 Ded. $800,000 Comp 5800,000 Collision DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedul , if more space is required) RE: FY 2017 CIP Pipelining Phase IIIA City of Waterloo, Iowa City Contract No. 919 AECOM #60504645 Additional insured on a primary and non-contributory basis with respect to general liability and auto liability only when required by written contract: See Attached; Waivers of subrogation applies to the general liability, auto liability and workers compensation in favor of the stated See Attached... CERTIFICATE HOLDER CANCELLATION City of Waterloo 715 Mulberry St WAterloo IA 50703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE M�C�u fly ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORO® AGENCY CUSTOMER ID: MUNIC-5 LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY The Horton Group NAMED INSURED Municipal Pipe Tool Co., LLC 515 Fifth Street Hudson IA 50643 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE; ADDITIONAL REMARKS THIS ADDITIONAL. REMARKS FORM ISA SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE. CERTIFICATE OF LIABILITY INSURANCE additional insureds only when required by written contract. Additional Insureds: City of Waterloo ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADVANTAGE COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. The premium for this endorsement is $ INCLUDED 1. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS • CANCELLATION, Paragraph A.2. is replaced by the following: 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or b. 60 days before the effective date of cancellation if we cancel for any other reason. 2. BROAD FORM INSURED SECTION 11 - LIABILITY COVERAGE A.1. WHO 15 AN INSURED is amended by the addition of the following: d. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or a majority interest, will qualify as a Named Insured. However, (1) Coverage under this provision is afforded only until the end of the policy period; (2) Coverage does not apply to "accidents" or "loss" that occurred before you acquired or formed the organization; and (3) Coverage does not apply to an organization that is an "insured" under any other policy or would be an "insured" but for its termination or the exhausting of its limit of insurance. e. Any"employee" of yours using: (1) A covered "auto" you do not own, hire or borrow, or a covered "auto" not owned by the "employee" or a member of his or her household, while performing duties related to the conduct of your business or your personal affairs; or (2) An "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. However, your "employee" does not qualify as an insured under this paragraph (2) while using a covered "auto" rented from you or from any member of the "employee's" household. f. Your members, if you are a limited liability company, while using a covered "auto" you do not own, hire, or borrow, while performing duties related to the conduct of your business or your personal affairs. Any person or organization with whom you agree in a written contract, written agreement or permit, to provide Insurance such as is afforded under this policy, but only with respect to your covered "autos". This provision does not apply: (1) Unless the written contract or agreement is executed or the permit is issued prior to the "bodily injury" or "property damage': 9. Includes copyrighted material of Insurance Services Office, Inc. CA 71 15 11 09 - Page 1 of 5 (2) To any person or organization included as an insured by an endorsement or in the Declarations; or (3) To any lessor of "autos" unless: (a) The lease agreement requires you to provide direct primary insurance for the lessor; (b) The "auto" is leased without a driver; and (c) The lease had not expired. Leased "autos" covered under this provision will be considered covered "autos" you own and not covered "autos" you hire. h. Any legally Incorporated organization or subsidiary in which you own more than 50% of the voting stock on the effective date of this endorsement. This provision does not apply to "bodily injury" or "property damage" for which an "insured" is also an insured under any other automobile policy or would be an insured under such a policy, but for its termination or the exhaustion of Its limits of insurance, unless such policy was written to apply specifically in excess of this policy. 3. COVERAGE EXTENSIONS - SUPPLEMENTARY PAYMENTS Under. SECTION 11- LIABILITY COVERAGE, A,2.a. Supplementary Payments, paragraphs (2) and (4) are deleted and replaced with the following: (2) Up to $2500 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. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. 4. AMENDED FELLOW EMPLOYEE EXCLUSION SECTION II • LIABILITY COVERAGE, B. EXCLUSIONS, paragraph 5. Fellow Employee is deleted and replaced by the following: 5, -- Fellow Employee "Bodily Injury' to: a. Any fellow "employee" of the "insured" arising out of and in the course of the fellow "employee's" employment or while performing duties related to the conduct of your business, However, this exclusion does not apply to your "employees" that are officers, managers, supervisors or above. Coverage is excess over any other collectible insurance.. b, . The spouse, child, parent, brother or sister of that fellow "employee" as a consequence of paragraph a. above. 5. HIRED AUTO PHYSICAL DAMAGE COVERAGE AND LOSS OF USE EXPENSE A. Under SECTION III - PHYSICAL DAMAGE COVERAGE, A. COVERAGE, the following is added: If any of your owned covered "autos" are covered for Physical Damage, we will provide Physical Damage coverage to "autos" that you or your "employees" hire or borrow, under your name or the "employee's" name, for the purpose of doing your work. We will provide coverage equal to the broadest physical damage coverage applicable to any covered "auto" shown in the Declarations, Item Three, Schedule of Covered Autos You Own, or on any endorsements amending this schedule. B. Under SECTION III - PHYSICAL DAMAGE COVERAGE, A.4. COVERAGE EXTENSIONS, paragraph b. Loss of Use Expenses is deleted and replaced with 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: Includes copyrighted material of insurance Services Office, Inc. Page 2of5 CA71151109 (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 $30 per day, to a maximum of $2,000. C, Under SECTION IV — BUSINESS AUTO CONDITIONS. paragraph 5.b. Other Insurance is deleted and replaced by the following: b. For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: 1. Any covered "auto" you lease, hire, rent or borrow; and 2. Any covered "auto" hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto", nor is any "auto" you hire from any of your "employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. 6. LOAN OR LEASE GAP COVERAGE Under SECTION 111- PHYSICAL DAMAGE COVERAGE, A. COVERAGE, the following is added: If a covered "auto" is owned or leased and if we provide Physical Damage Coverage on it, we will pay, in the event of a covered total "loss", 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 or loan payments including penalties, interest or other charges resulting from overdue 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) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; (4) Security deposits riot refunded by a lessor: and (5) Carry-over balances from previous loans or leases. 7. RENTAL REIMBURSEMENT SECTION 111- PHYSICAL DAMAGE COVERAGE, A. COVERAGE, paragraph 4. Coverage Extensions is deleted and replaced by the following: 4. Coverage Extensions (a) We will pay up to $75 per day to a maximum of $2000 for transportation expense incurred by you because of covered "loss". We will pay only for those covered "autos" for which you carry Collision Coverage or either Comprehensive Coverage or Specified Causes of Loss Coverage. We will pay for transportation expenses incurred during the period beginning 24 hours after the covered "loss" and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". This coverage is in addition to the otherwise applicable coverage you have on a covered "auto". No deductibles apply to this coverage. (b) This coverage does not apply while there Is a spare or reserve "auto" available to you for your operation. Includes copyrighted material of Insurance Services Office, Inc. CA 71 15 11 09 Page 3 of 5 8. AIRBAG COVERAGE SECTION 111- PHYSICAL DAMAGE, B. EXCLUSIONS, Paragraph 3. is deleted and replaced by the following: We will not pay for "loss" caused by or resulting from any of the following unless caused by other "loss" that is covered by this insurance: a. Wear and tear, freezing, mechanical or electrical breakdown. However, this exclusion does not include the discharge of an airbag. b. Blowouts, punctures or other road dainage to tires. 9. GLASS REPAIR - WAIVER OF DEDUCTIBLE SECTION ID - PHYSICAL DAMAGE COVERAGE, D. DEDUCTIBLE is amended to add the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 10. COLLISION COVERAGE — WAIVER OF DEDUCTIBLE SECTION III - PHYSICAL DAMAGE COVERAGE, D. DEDUCTIBLE is amended to add the following: When there is a "loss" to your covered "auto" insured for Collision Coverage, no deductible will apply if the "loss" was caused by a collision with another "auto" insured by us. 11. KNOWLEDGE OF ACCIDENT SECTION IV - BUSINESS AUTO CONDITIONS, A. LOSS CONDITIONS, 2. DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS, paragraph a. is deleted and replaced by the following: a. You must see to it that we are notified as soon as practicable of an "accident", claim, "suit" or "loss". Knowledge of an "accident", claim, "suit" or "loss" by your "employees" shall not, in itself, constitute knowledge to you unless one of your partners, executive officers, directors, managers, or members (if you are a limited liability company) has knowledge of the "accident', claim, "suit" or "loss". Notice should include: (1) How, when and where the "accident" or "loss" occurred; (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. 12. TRANSFER OF RIGHTS (BLANKET WAIVER OF SUBROGATION) SECTION IV - BUSINESS AUTO CONDITIONS A.S. TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is deleted and replaced by the following: If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. However, if the insured has waived rights to recover through a written contract, or if your work was commenced under a letter of intent or work order, subject to a subsequent reduction in writing with customers whose customary contracts require a waiver, we waive any right of recovery we may have under this Coverage Form. 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV - BUSINESS AUTO CONDITIONS, B. GENERAL CONDITIONS, 2, CONCEALMENT, MISREPRESENTATION OR FRAUD is amended by the addition of the following: We will not deny coverage under this Coverage Form if you unintentionally fail to disclose all hazards existing as of the inception date of this policy. You must report to us any knowledge of an error or omission in your representations as soon as practicable after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non -renewal. Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 5 CA 71 15 11 09 14. BLANKET COVERAGE FOR CERTAIN OPERATIONS IN CONNECTION WITH RAILROADS When required by written contract or written agreement, the definition of "insured contract' is amended as follows: The exception contained in paragraph H.3, relating to construction or demolition operations on or within 50 feet of a railroad; and — Paragraph H.a. are deleted with respect to the use of a covered "auto" in operations for, or affecting, a railroad. Includes copyrighted material of Insurance Services Office, Inc. CA 71 15 11 09 Page 5 of 5 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT — FORM A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy Number GL21023070001 Agency Number Policy Effective Date 08/03/16 Policy Expiration Date 08/03/17 Date Account Number Named Insured Municipal Pipe Tool Co., LLC Agency Issuing Company Amerisure Mutual Ins. Co. 1. a. SECTION II - WHO IS AN INSURED is amended to add as an additional insured any person or organization: (1) Whom you are required to add as an additional insured on this policy under a written contract or written agreement relating to your business; or (2) Who is named as an additional insured under this policy on a certificate of insurance. b. The written contract, written agreement, or certificate of insurance must: (1) Require additional insured status for a time period during the term of this policy; and (2) Be executed prior to the "bodily injury", "property damage", or "personal and advertising injury" leading to a claim under this policy. c. If, however: (1) "Your work" began under a letter of intent or work order; and (2) The letter of intent or work order led to a written contract or written agreement within 30 days of beginning such work; and (3) Your customer's customary contracts require persons or organizations to be named as additional insureds; we will provide additional insured status as specified in this endorsement. 2. The insurance provided under this endorsement is limited as follows: a. That person or organization is an additional insured only with respect to liability caused, in whole or in part, by: (1) Premises you: (a) Own; (b) Rent; (c) Lease; or (d) Occupy; (2) Ongoing operations performed by you or on your behalf. Ongoing operations does not apply to "bodily injury" or "property damage" occurring after: Includes copyrighted material of Insurance Services Office, Inc. CG 70 48 10 15 Pages 1 of 4 (3) (a) All work to be performed by you or on your behalf for the additional insured(s) at the site of the covered operations is complete, including related materials, parts or equipment (other than service, maintenance or repairs); or (b) That portion of "your work" out of which the injury or damage arises is put to its intended use by any person or organization other than another contractor working for a principal as a part of the same project. Completed operations coverage, but only if: (a) The written contract, written agreement, or certificate of insurance requires completed operations coverage or "your work" coverage; and (b) This coverage part provides coverage for "bodily injury' or "property damage" included within the "products -completed operations hazard". However, the insurance afforded to such additional insured only applies to the extent permitted by law. b. If the written contract, written agreement, or certificate of insurance: (1) Requires "arising out of" language; or (2) Requires you to provide additional insured coverage to that person or organization by the use of either or both of the following: (a) Additional Insured — Owners, Lessees or Contractors — Scheduled Person Or Organization endorsement CG 20 10 10 01; or (b) Additional Insured — Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 10 01; then the phrase "caused, in whole or in part, by" in paragraph 2.a. above is replaced by "arising out of". c. If the written contract, written agreement, or certificate of insurance requires you to provide additional insured coverage to that person or organization by the use of: (1) Additional Insured — Owners, Lessees or Contractors — Scheduled Person Or Organization endorsement CG 20 10 07 04 or CG 20 10 04 13; or (2) Additional Insured — Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 07 04 or CG 20 37 04 13; or (3) Both those endorsements with either of those edition dates; or (4) Either or both of the following: (a) Additional Insured — Owners, Lessees or Contractors — Scheduled Person Or Organization endorsement CG 20 10 without an edition date specified; or (b) Additional Insured — Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 without an edition date specified; then paragraph 2.a. above applies. d. Premises, as respects paragraph 2.a.(1) above, include common or public areas about such premises if so required in the written contract or written agreement. e. Additional insured status provided under paragraphs 2.a.(1)(b) or 2.a.(1)(c) above does not extend beyond the end of a premises lease or rental agreement. f. The limits of insurance that apply to the additional insured are the least of those specified in the: (1) Written contract; (2) Written agreement; (3) Certificate of insurance; or (4) Declarations of this policy. The limits of insurance are inclusive of and not in addition to the limits of insurance shown in the Declarations. Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 4 CG 70 4810 15 g. The insurance provided to the additional insured does not apply to "bodily injury", "property damage", or "personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of, or failure to render, any professional services, including but not limited to: (1) The preparing, approving, or failing to prepare or approve: (a) Maps; (b) Drawings; (c) Opinions; (d) Reports; (e) Surveys; (f) Change orders; (g) Design specifications; and (2) Supervisory, inspection, or engineering services. h. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4. Other Insurance is deleted and replaced with the following: 4. Other Insurance. Coverage provided by this endorsement is excess over any other valid and collectible insurance available to the additional insured whether: a. Primary; b. Excess; c. Contingent; or d. On any other basis; but if the written contract, written agreement, or certificate of insurance requires primary and non- contributory coverage, this insurance will be primary and non-contributory relative to other insurance available to the additional insured which covers that person or organization as a Named Insured, and we will not share with that other insurance. i. If the written contract, written agreement, or certificate of insurance as outlined above requires additional insured status by use of CG 20 10 11 85, then the coverage provided under this CG 70 48 endorsement does not apply except for paragraph 2.h. Other Insurance. Additional insured status is limited to that provided by CG 20 10 11 85 shown below and paragraph 2.h. Other Insurance shown above, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Blanket Where Required by Written Contract, Agreement, or Certificate of Insurance that the terms of CG 20 10 11 85 apply (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Includes copyrighted material of Insurance Services Office, Inc. CG 70 48 10 15 Pages 3 of 4 The insurance provided by this endorsement does not apply to any premises or work for which the person or organization is specifically listed as an additional insured on another endorsement attached to this policy. Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 4 CG 70 48 10 15 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS GENERAL LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Under SECTION I -COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, paragraph 2. EXCLUSIONS, provisions 1. Through 6. of this endorsement amend the policy 6e follows. 1. LIQUOR LIABILITY Exclusion c. Liquor Liability is deleted. 2. NONOWNED WATERCRAFT AND NONOWNED AIRCRAFT (HIRED, RENTED OR LOANED WITH PAID CREW) Exclusion g. Aircraft, Auto or Watercraft, paragraph (2) is deleted and replaced with the following: (2) A watercraft you do not own that is: (a) Less than 51 feel long: and (b) Not being used to carry persons or properly fora charge; Exclusion g. Aircraft, Auto or Watercraft, paragraph (6) is added as follows: (6) An aircraft that you do not own that is: (a) Hired: (b) Rented: or (c) Loaned to you; with paid crew for a period of five (5) consecutive days or less. Paragraph (6) does not apply if the insured has any other Insurance for"bodily injury or "property damage" liability for suds aircraft, whether such other insurance Is primary. excess, contingent or on any other basis. 3. PREMISES ALIENATED A. Exclusion ). Damage to Property, paragraph (2) Is deleted B. The following paragraph is also deleted from Exclusion j. Damage to Property: 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. 4. PROPERTY DAMAGE LIABILITY - ELEVATORS AND SIDETRACK AGREEMENTS A. Exclusion j. Damage to Property, paragraphs (3), (4), and (6) do not apply to the use of elevators. 8. Exclusion k. Damage to Your Product does not apply to: 1. The use of elevators; or 2. Liability assumed under a sidetrack agreement. 5. PROPERTY DAMAGE LIABILITY - BORROWED EQUIPMENT A. Exclusion j. Damage to Property, paragraph (4) does not apply to "property damage" to borrowed equipment while et a jobsite and not being used to perform operations. B. With respect to any one borrowed equipment item, provision 5.A. above does not apply to "property damage" that exceeds 525,000 per occurrence or 525,000 annual aggregate. 6. PRODUCT RECALL EXPENSE A. Exclusion n. Recall Of Products, Work Or Impaired Property does not apply to "product recall expenses' that you incur for the "covered recall" of "your produce. This exception to the exclusion does not apply to' product recall expenses' resulting from: 1. Failure of any products to accomplish their intended purpose; 2. Breach of warranties of fitness, quality, durability or performance; 3. Loss of customer approval or any cost Incurred to regain customer approval; 4. Redistribution or replacement of your product", which hes been recalled, by like products or substitutes; 5. Caprice or whim at the insured; 6. A condition likely to cause lass, about which any insured knew or had reason to know at the inception of this insurance: 7. Asbestos, including loss, damage or clean up resulting from asbestos or asbestos containing materials; 8. Recall of "your product(s)" that have no known ar suspected defect solely because a known or suspected defect in another of "your produces)" has been found. B. Under SECTION III — LIMITS OF INSURANCE, paragraph 3. is replaced to Rs entirety as follows and paragraph 0. is added 3. The Products -Completed Operations Aggregate limit is the most we will pay for the sum of: a. Damages under COVERAGE A BODILY INJURY A310 PROPERTY DAMAGE LIABILITY because of "bodily injury:and "property damage" included in the "products - completed operations hazard" and b. 'Product recall expenses". B. Subject to paragraph 5. above, 525,0001s the most we will pay for all "product recall expenses' arising out of the same defect or deficiency. The insurance afforded by provisions 1. through 6. of TMs endorsement is excess over any valid and collectible insurance (including any deductible) available to the insured whether primary, excess or contingent, and SECTION IV., paragraph 4. Other insurance is changed accordingly. 7. BLANKET CONTRACTUAL LIABILITY —RAILROADS When a written contract or written agreement requires Contractual Liability - Railroads, the definition of "insured contract' in Section V - Definitions is replaced by the following with respect to operations performed lar, or affecting, a railroad: Insured Contract" means: a. A contract for a lease of premises_ However, that portion of the contract for a lease of premises that Indemnifies any person or orgenaa(ion for 5 while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract': b. A sidetrack agreement; damage by fire to premise c. Any easement or license agreement: dAn obligation, as required by ordinance, to Indemnify a municipality, except in connection with work fora municipality; e. An elevator maintenance agreement; f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another pally to pay for "bodily injury" or"property damage' to a third person ororganizallon Tod liability means a liability That would be imposed by law in the absence of any contract or agreement. Paragraph f, does not include that pad of any contract or agreement: (1) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Prepadng, approving or failing to prepare or approve maps. shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications: or (b) Cluing directions or instructions, or failing to give them; (2) Under which the Insured, If an architect, engineer or surveyor. assumes liability for an injury or damage arising out of the insureds rendering or failure to render professional services, including those listed In Paragraph (1) above and supervisory, inspection, architectural or engineering activities. B. CONTRACTUAL LIABILITY • PERSONAL AND ADVERTISING INJURY Under SECTION 1 -COVERAGE B., paragraph 2. Exclusions. paragraph e. Contractual Liability is deleted. 9. SUPPLEMENTARY PAYMENTS Under SECTION I -SUPPLEMENTARY PAYMENTS • COVERAGES A AND B, paragraphs 1.b. and 1,d, are deleted and replaced with the fallowing: b. Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle N which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at aur request to assist us in the investigation or defense of the claim or "suit', including actual loss of earnings up to 5500 a day because of time off from work. 10. BROADENED WHO IS AN INSURED SECTION 11 - WHO 15 AN INSURED is deleted and replaced with the following: If you are designated in the Declarations as: a. An individual, you and your spouse are insureds, but only with respect to the conduct of a business of which you are the sale owner. b. A partnership or joint venture. you are an insured Your members, your partners, and their spouses are also insureds, but only with respect to the conduct of your business. 0. A limited liability company, you are an insured Your members are also insureds, but only with respect to the conduct of your business. Your managers are insureds, but only with respect to their duties as your managers. 0. An organ¢ation other Nana partnership, joint venture or limited liability company, you are an insured. Your "executive officers' and directors are insureds, but only with respect to their duties as your officers or directors. Your stockholders are also insureds, but only with respect lo their liability as stockholders. e. A trust, you are an insured Your trustees are also insureds, but only with respect N their duties as trustees. Each of the following is also an insured: Your "volunteer workers" only while performing duties related to the conduct of your business, or your "employees,' other than either your 'executive officers.' (if you are an organtzalion other than a partnership, join) venture or limited liability company) or your managers (if you are a limited liability company). but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, none of these "employees" or "volunteer workers" are insured for: (1) "Bodily injury' or "personal and advertising injury": (a) To you, to your partners or members (if you we a partnership or pint venture), to your members (if you are a limited liability company), to a co -"employee" while to the course or his or her employment or pedomsing duties related to the conduct of your business. or to your other "volunteer workers" while performing duties related to the conduct of your business; (b) To the spouse,child, parent, brother or sister of that co"employee"or"volunteer worker" as a consequence of paragraph (1)(a) above; (0) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraphs (1)(a) or (b) above; or (d) Poising out of his or her providing or failing to provide professional health care services except as provided in provision 11. of this ervdolsement. Paragraphs (1)(a), (1)(b) and (1)(c) above do nal apply to your 'employees" who are: (1) Managers; (if) Supervisors: (111) Directors; or (Iv) Officers; with respect to "bodily injury" to a co -"employee". (2) "Property damage" to property (a) Owned, occupied or used by: (b) Rented to, in the care. custody or control of, or over which physical control is being exercised for any purpose by you, any of your "employees," "volunteer workers", any partner or member (if you area partnership or joint venture), or any member (if you are a limited liability company). b. Any person (other Than your "employee" r "volunteer worker'), or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die, but only; (1) With respect to liability arising out of the maintenance or use of that property: and (2) Until your legal representative has been appointed. d. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Form. e. Your subsidiaries if: (1) They are legally incorporated enti0es; and (2) You own more than 50% of the voting stock in such subsidiaries as of the effective date of its policy. If such subsitlianes are not shown in the Declarations, you must report them to us within (80 days of the inception of your original policy. f. (1) Any person or organization, other than an architect, engineer or surveyor, required to be named as an additional insured in a cork contract", letter of intent or work order. However, such person or organization shall be an additional insured only with respect to covered "bodily injury," "properly damage,' and "personal and advertising injury" arising out of "your work' under that "work contrary, letter of intent or work order. (2) We will provide additional insured coverage to such person or organization only; (a) for a period of 30 days after the effective date of the applicable "work contract', leiter f intent or work order; or (0) until the end of the policy term in effect at the inception of the applicable "work contract", leper of intent or work order: whichever is earlier. (3) Coverage provided under This paragraph f. is excess over any other valid and collectible insurance available to the additional insured whether primary, excess. contingent, or on any other basis unless the "work contract", letter of intent or work order requires this insurance be primary, in which case this insurance will be primary without contribution from such other insurance available to the additional insured. (4) This paragraph f. does not apply if fomr CG 7048, Contractors Blanket Additional Insured Endorsement, is attached to the policy. g. My person or organization to whom you are obligated by virtue of a wniten contract to provide insurance such as Is afforded by This policy, but only with respect to liability arising out of the maintenance or use of that pad of any premises leased to you, including common or public areas about such premises If so required in the contract. However. no such person or organization is an insured with respect lo: (1) My "occurrence' that takes place after you cease to occupy those premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. h. Any stale or political subdivision but only as respects legal liability Incurred by the stale or political subdrvision solely because It has issued a permit with respect to operations perfomted by you or on your behalf. However. no stale or political subdivision is an insured with respect to: (1) "Bodily injury". "property damage", and "personal and advertising injury" arising out of operations performed for the state or municipality; or (2) 'Bodily injury' or "property damage" included within the "products -completed operations hazard" 1. Any person or organization who is the lessor of equipment leased to you to whom you are obligated by virtue of a written contact to provide insurance such as is afforded by this policy. but only with respect to Weir liability arising out of the maintenance, operation or use of such equipment by you or a subcontractor on your behalf with your permission and antler your supervision. However. no such person Or organization Ie an insured with respect to any "occurrence" that takes place after the equipment lease expires_ j. Any architect, engineer. or surveyor engaged by you but only with respect to liability arising out of your premises or "your work.' However, no architect, engineer, or surveyor is an insured with respect to "bodily injury"' "property damage.' or "personal and advertising injury" arising out of the rendering of or the failure to render any professional services by or for you, including: (1) The preparing. approving, or failing to prepare or approve maps, drawings, opinions, reports. surveys. change orders, designs or specifications: or (2) Supervisory, inspection, or engineering services. This paragraph J. does not apply it form CG 704t,. Contractors Blanket Additional' insured Endorsement, is attached to the policy. k. Any manager, owner, lessor, mortgagee. assignee or receiver of premises, including land leased to you. but only with respect to liability arising out of the owners maintenance or use of that pad of the eternises or land teased to you. However, no such person or organization is an insured with respect to: (1) My "occurrence" that takes place after you cease to occupy that premises. or cease to lease the landor (2) Structural alteration. new construction or demolition operations performed by or on behalf of That person or organization. 3. My organization you newly acquire or form, other than a partnership, joint venture or limited liability company and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to That organization. However: a. Coverage under this provision is afforded until the end of the policy period. b. Coverage A does nal apply to "bodily injury" or "property damage' that occurred before you acquired or formed the organization. c. Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organhalion. d. Coverage A does not apply to 'product recall expense" arising out of any withdrawal or recall that occurred before you acquired ortormed the organization. 4. My person or organization (referred to below as vendor) with whom you agreed, because of a wnllen contract or agreement lo provide insurance is an Insured, but only with respect to "bodily injury" or "properly damage" arising out of ryour products" that are distributed or sold in the regular course of the vendors business. However, no such person or organization is an insured with respect lo: a. "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 contact or agreement. b. Any express warranty unauthorized by you: c. Any physical or chemical change in "your product' made intentionally by the vendor; 4. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of pads under instructions from the manufacturer, and Then repackaged in the anginal container; e. Any failure to make such inspections. adjustments, tests or servicing as the vendor has agreed to make or normally undertakes 10 make in the usual course of business. in connection with the distribution or sale of "your products"; f. Demonstration, installation, servicing or repair operations, except such operations performed al the vendors premises in connection with the sale of "your product; g. "Your 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. p h. "Bodily injury" or "properly damage" arising out of the sole negligence of the vendor for its awn acts or omissions or those of its employees or anyone else acting on its behalf. However, This exclusion does not apply lo: (1) The exceptions contained in subparagraphs d. or f.; or (2) 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. This insurance does not apply to any insured person or organization from which you have acquired "your products", or any ingredient, part, or container, entering into, accompanying or containing "your products". No person or organization is an insured with respect to the conduct of any current or past partnership. joint venture or limited liability company that is not shown as a Named Insured in the Declarations. 11. INCIDENTAL MALPRACTICE LIABILITY As respects provision 10., SECTION II - WHO IS AN INSURED, paragraph 2.a.(1)(d) does not apply to any nurse, emergency medical technician or paramedic employed by you to provide medical or paramedical services, provided That you are not engaged in the business or occupation of providing such services, and your "employee" does not have any other insurance that would also cover claims arising under this provision. whether the other insurance is primary. excess, contingent or on any other basis. Under SECTION III • LIMITS OF INSURANCE, provisions 12. through 14. of this endorsement amend the policy as follows: 12. AGGREGATE LIMITS PER PROJECT The General Aggregate Limit applies separately to each of your construction projects away from premises owned by or rented to you. 13. INCREASED MEDICAL PAYMENTS LIMIT AND REPORTING PERIOD A. The requirement under SECTION I - COVERAGE C MEDICAL PAYMENTS That expenses be incurred and reported to us within one year of the date of the accident le changed to three years 6. SECTION III -LIMITS OF INSURANCE, paragraph 7., the Medical Expense Limit, is subject to all of the terms of SECTION III -LIMITS OF INSURANCE and Is the greater of: 1, 510,000; or 2. The amount shown in the Declarations for Medical Expense Limit. C. This provision 13. does not apply if COVERAGE C MEDICAL PAYMENTS is excluded either by the provisions of the Coverage Form or by endorsement. 14. DAMAGE TO PREMISES RENTED TO YOU - SPECIFIC PERILS A. The word fire is changed to"specific perils" where it appears in: 1. The last paragraph of SECTION I - COVERAGE A, paragraph 2. Exclusions; 2. SECTION IV, paragraph 4.b. Excess Insurance. B. The Limits of Insurance shown in the Declarations will apply to all damage proximately caused by the same event, whether such damage results from a "specific peril" or any combination of "specific perils" C. The Damage To Premises Rented To You Limit described in SECTION III -LIMITS OF INSURANCE, paragraph 6., is replaced by a new limit, which is the greater of: 1. $1.000,000; or 2. The amount shown in the Declarations for Damage To Premises Rented To You Limit. D. This provision 14. does not apply if the Damage To Premises Rented To You Limit of SECTION I - COVERAGE A is excluded either by the provisions of the Coverage Form or by endorsement. Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, provisions 15. through 17. of This endorsement amend the policy as follows: 15. KNOWLEDGE OF OCCURRENCE Under 2. Duties In The Event Of Occurrence, Offense, Claim, Or Suit, paragraph a. is deleted and replaced and paragraphs e. and 1 are added as follows: You Must see to it that we are notified as soon as practicable of an "occurrence" or an offense, regardless of the amount. which may result in a claim. Knowledge of an "occurrence" or an offense by your 'employee(s)" shall not. in itself, constitute knowledge 10 you unless one of your partners, members. "executive officers". directors, or managers has knowledge of the "occurrence' or offense. To the extent possible, notice should include: (1) How, when and where the "occurrence' or offense look 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. If you repod an "occurrence" to your workers compensation carrier that develops into a liability claim for which coverage is provided by the Coverage Form, failure to repod such an 'occurrence to us at the time of the "occurrence" shall not be deemed a violation of paragraphs a., b., and c. above. However, you shall give written notice of this "occurrence" to us as soon you become aware that this "occurrence" may be a liabiiily claim rather than a workers compensation claim. You must see 10 It That the following are done in the even) of an actual or anticipated "covered recall" that may result in "product recall expense (1) Give us prompt notice of any discovery or notification that "your product" must be withdrawn or recalled. Include a description of "your product" and the reason for the withdrawal or recall; (2) Cease any further release, shipment, consignment or any other method of distribution of like or similar products unlit 11 has been determined that all such products are free from defects that could be a cause of loss under the insurance. 16. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Paragraph 6. Representations is deleted and replaced with the following: Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete: b. Those statements are based upon representations you made to us: c. We have issued This policy in reliance upon your representations: and d. This policy is void in any case of fraud by you as 4 relates to this policy or any claim under this policy. We will not deny coverage under This coverage pad if you unintentionally fail to disclose all hazards existing as of the inception date of this pollcy. You must repod to us any knowledge of an error or omission in the description of any premises or operations intended to be covered by the Coverage Form as soon as practicable after its discovery. However, this provision does not affect our right to collect additional premium or exercise our right of cancellation or nonrenewal. 17. TRANSFER OF RIGHTS (BLANKET WAIVER OF SUBROGATION) Paragraph 8. Transfer of Rights Of Recovery Against Others To Us is deleted and replacedwilh the following: 8. If the insured has rights Io recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair Nem. Al our request, the insured wilt bring 'sell" or transfer (hose rights to us and help us enforce Mem. However, if the insured has waived rights to recover through a written contract, or i1 "your work" was commenced under a letter of intent or work order, subject to a subsequent reduction to writing with customers whose customary contracts require a waiver. we waive any right of recovery we may have under this Coverage Form. 18. EXTENDED NOTICE OF CANCELLATION AND NONRENEWAL Paragraph 2.b. of A. Cancellation of the COMMON POLICY CONDITIONS is deleted and replaced with the following: b. 60 days before the effective date of the cancellation if we cancel for any other reason. Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 9. When We Do Not Renew is deleted and replaced with the following: 9. When We Do Not Renew f we decide not to renew this Coverage Pad, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less Than 60 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. 19. MOBILE EQUIPMENT REDEFINED Under SECTION V - DEFINITIONS, paragraph 12. "Mobile equipment", paragraph 1. (1) does not apply to s'elfpropelled vehicles of Fess than 1.000 pounds gross vehicle weigh. 20. DEFINITIONS SECTION V - DEFINITIONS, paragraph 4. "Coverage territory" is replaced by the following definition: "Coverage territory" means anywhere in the world with respect to liability arising out of 'bodily injury," 'property damage;' or "personal and advertising injury,' including "personal and advertising injury" offenses that take place Through the Internet or similar electronic means of communication provided the insured's responsibility to pay damages is determined in a settlement to which we agree or in a "suit" on the merits, in the United States of America (including its territories and possessions). Puerto Rico and Canada. SECTION V -DEFINITIONS is amended by the addition of the following definitions: 'Covered recall" means a recall made necessary because you or a government body has determined that a knarn or suspected defect, deficiency. inadequacy, or dangerous condition in "your product" has resulted or will result in 'bodily injury" or "property damage". "Product Recall expenses" mean only reasonable and necessary extra costs, which result from or are related to the recall or withdrawal of 'your product' for: a. Telephone and telegraphic communication, radio or television announcements. computer time and newspaper advehisingl b. Stationery. envelopes, production of announcements and postage or facsimiles; c. Remuneration pald to regular employees for necessary overtime or authorized travel expense; d. Temporary hiring by you or by agents designated by you of persons, other than your regular employees, to perform necessary tasks: e. Rental of necessary additional warehouse or storage space; f. Packaging of or transportation or shipping of defective products to the location you designate: and g. Disposal of "your products" That cannot be reused. Disposal expenses do not include: (1) Expenses that exceed the original cost of the materials incurred to manufacture or process such product: and (2) Expenses that exceed the cast of normal trash discarding or disposal. except as are necessary to avoid "bodily injury" or "property damage "Specific Perils" means fire', lightning: explosion; windstorm or hail; smoke: aircraft or vehicles: dot or civil commotion; vandalism; leakage from fire extinguishing equipment; weight of snow, ice or sleet; or "wafer damage". Water dalnage" means accidental discharge or leakage of water or steam as the direct result of the breaking or cracking of any part of a system or appliance containing wafer or steam Work contact' means a written agreement between you and ane or more parties for work to be performed by you or on your behalf. Includes copyrighted material of Insurance Services Office, Inc. CG 70 49 11 09 Cernsrlsuce Companies Pages1-10 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule "Any person or organization required by written contract or certificate of insurance." "This endorsement is not applicable in California, Kentucky, New Hampshire, New Jersey, Texas and Utah." "This endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6) of the Missouri Statues, a contractual provision purporting to waive subrogation rights is against public policy and void where one party to the contract is an employer in the construction group of code classifications." This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 08/03/16 Policy No. WC2102310001 Endorsement No. Insured Municipal Pipe Tool Co., LLC Premium $ Insurance Company Amerisure Mutual Ins. Co. Countersigned by WC 00 03 13 (Ed. 4-84) Copyright 1983 National Council on Compensation Insurance. Hart Forms & Services Reorder No. 144888