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HomeMy WebLinkAboutMinturn, Inc. FY18 Bridge & Culvert Cont. 950 - 5/14/2018FORM OF CONTRACT CONTRACT FOR THE CONSTRUCTION OF F.Y. 2018 BRIDGE AND CULVERT REPAIRS CITY OF WATERLOO, IOWA CONTRACT N0. 950 This contract made and entered into this day of , 20�a, by and between the City of Waterloo, Iowa, a Municipal Corporation, (hereinafter referred to as City), and MINTURN, INC. of Brooklyn. Iowa, (hereinafter referred to as Contractor), WITNESSETH: PAR. 1 Contractor agrees to build and construct the FY 2018 BRIDGE AND CULVERT REPAIRS, Contract 950 .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. FORM OF CONTRACT PAGE 1 OF 5 PAGES PARA The Contractor agrees to perform 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 complete it on or before August 31, 2018, 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 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 construction 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 FORM OF CONTRACT PAGE 2 OF 5 PAGES 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. 10 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 furnish 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 FORM OF CONTRACT PAGE 3 OF 5 PAGES 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 100/0 surety bond is required is $124.676.00. 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 "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 FORM OF CONTRACT PAGE 4 OF 5 PAGES 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 4UJ4 Ci Clerk MINTURN. INC. Contractor BY: Title:(SIG�EYIf Approved by the City Council of the City of Waterloo, Iowa, this l� day of '"A , 20 L� ATTEST: City Clerk Waterloo, Iowa FORM OF CONTRACT PAGE 5 OF 5 PAGES Bond No. NIA2293 PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS: That we,Minturn, Inc. of 144 W. Front St. Brooklyn, IA 52211 (the "Principal"), and Merchants National Bonding, Inc. of P. 0. Box 14498, Des Moines, IA 50306 (the "Surety"), are held and firmly bound unto the City of Waterloo, Iowa (the "Obligee"), In the penal sum of One Hundred Twenty -Four Thousand Six Hundred Seventy -Six and no/100 Dollars ($ 1243676.00 ), lawful money of the United States, for the payment of said sum in connection with a contract (the "Contract") dated on or about S/ 4 t fS for the purpose of F.Y. 2018 Bridge and Culvert Repairs - Contract No. 950 . 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: 1. 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 price. 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 Performance Bond Page 1 of 2 notwithstanding, to consent to each and all of the following matters, without notice: Performance Bond Page 1 of 2 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 from 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. Terms used herein shall include, as appropriate, the singular or plural number, or the masculine, feminine or neuter gender. IN WITNESS WHEREOF, the undersigned Principal and Surety have executed this Performance Bond as of May 14, 2018 PRINCIPAL Minturn, Inc. Name By: Title: �YOSI C�Q,VI+ SURETY Merchants National Bonding, Inc. Name W(I&h A, By: Title: Abigail R. M hr, 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 Page 2 of 2 PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS: that Inc. 144 W. Front St. Brooklyn. IA 52211 (Name of Contractor) (Address of Contractor) Bond No. NIA2293 a Corporation ,hereinafter called Principal, (Corporation, Partnership or Individual) and, Merchants National Bonding, Inc. (Name of Surety) P. O. Box 14498, Des Moines, IA 50306 (Address of Surety) hereinafter called Surety, are held and firmly bound unto City of Waterloo 715 Mulberry Street, Waterloo, IA 50703 (Address of Owner) One Hundred Twenty -Four hereinafter called OWNER, in the penal sum of Thousand Six Hundred Seventy-sx Dollars,($ 124,676.00 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 1 Hll+` day of May 2018 , a copy of which is hereto attached and made a part hereof for the construction of: F Y 2018 Bridge and Culvert Repairs -Contract No. 950 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 terms of the contract or to the WORK to be performed thereunder or the SPECIFICATIONS accompanying the same 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. 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) counterparts, each one of (number) which shall be deemed an original, this the day of 20 18 ATTEST: Minturn, Inc. Principal (SEAL) NOSGPrC� Witnes a o Principal 144 Front St. (Address) 144 W. Front St. (Address) Brooklyn, IA 52211 Inc. P. O. Box 1449$ '✓ (Address) es Moines, IA 50306 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. P. O. Box 14498 D (Address) Des Moines, IA 50306 NOTE: Date of BOND must not be prior to date of Contract. If CONTRACTOR is Partnership, all partners should execute BOND. 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 of the State of Iowa (herein collectively called the "Companies") do hereby make, constitute and appoint, individually, Abigail R Mohr; John R Fay; Kent M Rosenberg; Mat DeGroote; Matthew R Fay; Michael L McCoy their true and lawful Attorneys) -in -Fact, to sign its name as surety(ies) and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power -of -Attorney is granted and is signed and sealed by facsimile under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 and amended August 14, 2015 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16, 2015. 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 connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and out hority hereby given to the Attorney -in -Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond. In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney -in -Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 13th day of March , 2018 to P(10Nq�\NG,CphA MERCHANTS BONDING COMPANY MUTUAL ?lyGQVpORqi°2 o060(Zi 099J11A, MERCHANTS NATIONALBONDING,(INC. ) co 2003 O : y; 1933 :•y : By =d'•. ';may• ao. • i��.`' •,dk, \'\,� President tookSTATE OF IOWA " COUNTY OF DALLAS as. On this this 13th day of March 2018 , before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that he is President of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument are 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. aP�tAt S ALICIA K. GRAM o v Commission Number 767430 z My Commission Expires April 1, 2020 Notary Public (Expiration of notary 's commission does not invalidate this instrument) ,William Warner, Jr., Secretary of 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 14th day of May 12018 c:';•C,O�POgq e�: '•�0,�0(\POy9i)9yc: fr/��%Cel Sr6J 2003 1933 : ti ; Secretary to POA 0018 (3/17) CERTIFICATE OF LIABILITY INSURANCE DATE (MMGD/YYYY) 5/8/2018 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(les) 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 riahts to the certificate holder in lieu of such endorsement(s). PRODUCER TrueNorth Companies, L.C. 500 tat St SE Cedar Rapids IA 52401 INSURED Minturn Inc. 144 W Front St. Brooklyn IA 52211 MINTING -01 Selective Ins Co of COVERAGES CERTIFICATE NUMBER: 159065874 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE Aisiso DDLE n POLICY NUMBER MMIODY= MMI O%YY%YY LIMITS AUTHORIZED REPRESENTATIVE A X COMMERCIAL GENERAL LIABILITY Y S 2271005 4115/1018 4/15/2019 EACH OCCURRENCE $1,0000000 CLAIMS -MAGE OCCUR DAMAGE TO RENTED PREMISES (Ea occurs nce) _ _ $500,000 EXP (Any one person) $15,000 _MED PERSONAL B ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 GEN'L PRODUCTS_ COMP/OP AGG $2,000,000 POLICY [X] JECT [X ] LOC OTHER: A AUTOMOBILE LIABILITY 5 2271005 4/152018 4/15/2019 SINGLE LIMIT EO a accent) $11000,000 - BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE X Per accident)—, -11 $ $ A X-1 UMBRELLALIAB LX] OCCUR S 2271005 4/1512018 4/15/2019 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $5,000,000 OED X RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANYPROPRIETOR/PARTNEWEXECUTIVE f --N] OFFICEMMEMBEREXCLUDED7 (Mandatory In NH) NIA VJC 9052158 4/152018 4115/2019 X PER STATUTE OTH- ER _ E.L. EACH ACCIDENT _ E.L. DISEASE - EA EMPLOYEE _$500,000 $500,000 If yes, describe under DESCRIPTION OF OPERATIONS below EL.DISEASE - POLICY LIMIT $500,000 A tinted on FPmentosier S 2271005 41IM018 4/15/2019 Limit Limit 500,000 200,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is requiredl If Yes is indicated above for add'I insd forms Gen Liab #(CG7300) (premises), #(CG7988) (completed operations), Auto Liab #(CA7809) applies. If Yes is indicated above for waiver of subrogation forms Gen Liab #(CG7300), Auto Liab #(CA7809) and WC #WC000313 04184 applies. Coverage Is extended for work performed and required under written contract with the above named insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ©1908-2015 ACORD CORPORATION. All rights reserved. DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Waterloo ACCORDANCE WITH THE POLICY PROVISIONS, Engineering Dept 715 Mulberry St Waterloo IA 50703 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD ElitePac® General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 00 01 16 SUMMARY OF COVERAGES (including index) This is a summary of the various additional coverages and coverage modifications provided by this endorsement. No coverage is provided by this summary. Refer to the actual endorsement (Pages 3 -through -8) for changes affecting your insurance protection. DESCRIPTION PAGE FOUND Additional Insureds -Primary and Non -Contributory Provision Page 7 Blanket Additional Insureds - As Required By Contract Page 6 Broad Form Vendors Coverage Page 6 Damage To Premises Rented To You (Including Fire, Lightning or Explosion) Page 3 Electronic Data Liability ($100,000) Page 4 Employee Definition Amended Page 8 Employees As Insureds Modified Page 5 Employer's Liability Exclusion Amended (Not applicable in New York) Page 3 Incidental Malpractice Exclusion modified Page 7 Knowledge of Occurrence, Claim, Suit or Loss Page 7 Liberalization Clause Page 7 Mental Anguish Amendment (Not applicable to New York) Page 8 Newly Formed or Acquired Organizations Page 5 Non -Accumulation Of Limits (Not applicable in New York or Wisconsin) Page 7 Non -Owned Aircraft Page 3 Non -Owned Watercraft (under 60 feet) Page 3 Not-for-profit Members - as additional insureds Page 5 Personal And Advertising Injury - Discrimination Amendment (Not applicable in New York) Page 8 Products Amendment (Medical Payments) Page 4 Supplementary Payments Amended - Bail Bonds ($5,000) and Loss of Earnings ($1,000) Page 4 Unintentional Failure to Disclose Hazards Page 7 Waiver of Transfer of Rights of Recovery (subrogation) Page 7 When Two or More Coverage Parts of this Policy Apply to a Loss Page 3 Copyright, 2015 Selective Insurance Company of America. All rights reserved. CG 73 00 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 6 INSURED'S COPY THIS PAGE IS INTENTIONALLY LEFT BLANK. Copyright, 2015 Selective Insurance Company of America. All rights reserved. CG 73 00 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 8 INSURED'a COPY ElitePac® General Liability Extension Endorsement COMMERCIAL GENERAL LIABILITY CG 73 00 01 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies the insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART The SECTIONS of the Commercial General Liability Coverage Form identified in this endorsement will be amended as shown below. However, if (a) two or more Coverage Parts of this policy, or (b) two or more forms or endorsements within the same Coverage Part apply to a loss, only the broadest coverage of this policy will apply, unless specifically stated otherwise within the particular amendment covering that loss. With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. COVERAGES -Amendments B. The following is added to Exclusion g. Aircraft, Auto Or Watercraft under COVERAGE A BODILY SECTION 1 - COVERAGE A BODILY INJURY AND INJURY AND PROPERTY DAMAGE LIABILITY, 2. PROPERTY DAMAGE LIABILITY Exclusions: EXCLUSIONS Employer's Liability Amendment (This provision is not applicable in the State of New York). The following is added to Exclusion e. Employer's Liability under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions: This exclusion also does not apply to any "temporary worker". Non -Owned Aircraft, Auto or Watercraft A. Paragraph (2) of Exclusion g. Aircraft, Auto Or Watercraft under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclus- ions is deleted in its entirety and replaced with the following: (2) A watercraft you do not own that is: (a) Less than 26 feet long and not being used to carry persons or property for a charge; or (b) At least 26 feet, but less than 60 feet long, and not being used to carry persons or property for a charge. Any person is an insured who uses or is responsible for the use of such watercraft with your expressed or implied consent. However, if the insured has any other valid and collectible insurance for "bodily injur)1' or "property damage" that would be covered under this provision, or on any other basis, this coverage is then excess, and subject to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS. This exclusion does not apply to: (6) Any aircraft, not owned or operated by any insured, which is hired, chartered or loaned with a paid crew. However, if the insured has any other valid and collectible insurance for "bodily injur)r' or "property damage" that would be covered under this provision, or on any other basis, this coverage is then excess, and subject to Condition 4. Other Insurance, b. Excess Insurance under SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS. Damage To Premises Rented to You A. The last paragraph of Paragraph 2. Exclusions under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE is deleted in its entirety and replaced with the following: Exclusions c. through n. do not apply to damage by fire, lightning or explosion to premises rented to you or temporarily occupied by you with the permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION III -LIMITS OF INSURANCE. Copyright, 2015 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 16 Page 3 of 8 B. Paragraph 6. under SECTION III -LIMITS OF INSURANCE is deleted in its entirety and replaced with the following: 6. Subject to Paragraph 5. above, the most we will pay under COVERAGE A for damages because of "property damage" to any one premises, while rented to you, or in the case of damage caused by fire, lightning or explosion, while rented to you or temporarily occupied by you with permission of the owner, for all such damage caused by fire, lightning or explosion proximately caused by the same event, whether such damage results from fire, lightning or explosion or any combination of the three, is the amount shown in the Declarations for the Damage To Premises Rented To You Limit. C. Paragraph a. of Definition 9. "Insured contract" under SECTION V -DEFINITIONS is deleted in its entirety and replaced with the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning or explosion to prem- ises while rented to you or temporarily occupied by you with the permission of the owner is not an "insured contract"; Electronic Data Liability A. Exclusion p. Access or Disclosure Of Confidential Or Personal Information And Date -related Liability under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclus- ions is deleted in its entirety and replaced by the following: p. Access or Disclosure Of Confidential Or Personal Information And Date -related Liability Damages arising out of: (1) Any access to or disclosure of any person's or organization's confidential or personal information, including patents, trade secrets, processing methods, customer lists, finan- cial information, credit card information or any other type of nonpublic information; or (2) The loss of, loss of use of, damage to, corruption of, inability to access, 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, credit monitoring expenses, forensic 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 most we will pay under COVERAGE A for "property damage' because of all loss of "electronic data' arising out of any one "occurrence' is a sub -limit of $100,000. SECTION I - COVERAGE C MEDICAL PAYMENTS EXCLUSIONS Any Insured Amendment Exclusion a. Any Insured under COVERAGE C MEDICAL PAYMENTS, 2. Exclusions is deleted in its entirety and replaced with the following: a. Any Insured To any insured. This exclusion does not apply to: (1) "Not-for-profit members"; (2) "Golfing facility" members who are not paid a fee, salary, or other compensation; or (3) "Volunteer workers'. This exclusion exception does not apply if COVERAGE C MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part. Product Amendment Exclusion f. Products -Completed Operations Hazard under COVERAGE C MEDICAL PAYMENTS, 2. Exclusions is deleted in its entirety and replaced with the following: f. Products -Completed Operations Hazard Included within the "products -completed operations hazard". This exclusion does not apply to "your products' sold for use or consumption an your premises, while such products are still on your premises. This exclusion exception, does not apply if COVERAGE C MEDICAL PAYMENTS is excluded by another endorsement to this Coverage Part. SECTION 1 - SUPPLEMENTARY PAYMENTS - COVERAGES AAND B Expenses For Bail Bonds And Loss Of Earnings A. Subparagraph 1.b. under SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is deleted in its entirety and replaced with the following: b. Up to $5,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. Copyright, 2015 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURGD'S COPY CG 73000116 Page 4 of 8 B. Subparagraph 1.d. under SUPPLEMENTARY PAYMENTS - COVERAGES A AND B is deleted in its entirety and replaced with 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", including actual loss of earnings up to $1,000 a day because of time off from work. SECTION II -WHO IS AN INSURED -Amendments Not -for -Profit Organization Members The following paragraph is added to SECTION II -WHO IS AN INSURED: If you are an organization other than a partnership, joint venture, or a limited liability company, and you are anot- for-profit organization, the following are included as additional insureds: 1. Your officials; 2. Your trustees; 3. Your members; 4. Your board members; 5. Your commission members; 6. Your agency members; 7. Your insurance managers; 8. Your elective or appointed officers; and 9. Your "not-for-profit members". However only with respect to their liability for your activities or activities they perform on your behalf. Employees As Insureds Modified A. Subparagraph 2.a.(1)(a) under SECTION II -WHO IS AN INSURED does not apply to "bodily injury" to a "temporary worker' caused by a co -"employee" who is nota "temporary worker". B. Subparagraph 2.a.(2) under SECTION II -WHO IS AN INSURED does not apply to "property damage" to the property of a "temporary worker" or "volunteer worker" caused by a co -"employee" who is not a "temporary worker" or "volunteer worker". C. Subparagraph 2.a.(1)(d) under SECTION II -WHO IS AN INSURED does not apply to "bodily injury" caused by cardio -pulmonary resuscitation or first aid services administered by a co -"employee". With respect to this provision only, Subparagraph (1) of Exclusion 2. e. Employer's Liability under SECTION I - COVERAGES, COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY does not apply. Newly Formed Or Acquired Organizations A. Subparagraph 3.a. under SECTION II -WHO IS AN INSURED is deleted in its entirety and replaced with 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. However, COVERAGE A does not apply to "bodily injury' or "property damage' that occurred before you acquired or formed the organization. B. The following paragraph is added to SECTION 11 -WHO IS AN INSURED, Paragraph 3: If you are engaged in the business of con- struction of dwellings three stories or less in height, or other buildings three stories or less in height and less than 25,000 square feet in area, you will also be an insured with respect to "your work" only, for the period of time described above, for your liability arising out of the conduct of any partnership or joint venture of which you are or were a member, even if that partnership or joint venture is not shown as a Named Insured. However, this provision only applies if you maintain or maintained an interest of at least fifty percent in that partnership or joint venture for the period of that partnership or joint venture. This provision does not apply to any partnership or joint venture that has been dissolved or otherwise ceased to function for more than thirty-six months. With respect to the insurance provided by this provision, Newly Formed or Acquired Organizations, the following is added to SECTION IV -COMMERCIAL GENERAL LIABILITY, Paragraph 4. Other Insurance, Subparagraph b. Excess Insurance: The insurance provided by this provision, Newly Formed or Acquired Organizations, is excess over any other insurance available to the insured, whether primary, excess, contingent or on any other basis. (All other provisions of this section remain unchanged). Copyright, 2015 Selective Insurance Company of America. All rights reserved. CG 73 00 01 16 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 8 INSURED'S COPY Blanket Additional Insureds - As Required By Contract A. Subject to the Primary and Non-contributory provision set forth in this endorsement, SECTION II - WHO IS AN INSURED is amended to include as an additional insured any person or organization whom you have agreed in a written contract, written agreement or written permit that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury" or "property damage' or "personal and advertising injury" caused, in whole or in part, by: Your ongoing operations, "your product", or premises owned or used by you; With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to: "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any profes- sional architectural, engineering or surveying services by or for you, including: a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifi- cations; and b. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrong- doing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage', or the offense which caused the "personal and advertising injury", involved the rendering of, or failure to render, any professional architectural, engineering or surveying services. 2. Your maintenance, operation or use of equip- ment, other than aircraft, "auto' or watercraft, rented or leased to you by such person or organization. A person or organization's status as an additional insured under this endorsement ends when their contract, or agreement with you for such rented or leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the rental agreement or equipment lease expires. The provisions of this coverage extension do not apply unless the written contract or written agreement has been executed (executed means signed by the named insured) or written permit issued prior to the "bodily injury" or "property damage" or "personal and advertising injury". Broad Form Vendors Coverage Subject to the Primary and Non -Contributory provision set forth in this endorsement, SECTION II -WHO IS AN INSURED is amended to include as an additional insured any person or organization (referred to below as vendor) whom you have agreed in a written contract or written agreement to add as an additional insured on your policy. Such person or organization is an additional insured only with respect to "bodily injury" or "property damage' arising out of "your products" which are distributed or sold in the regular course of the vendor's business, however the insurance afforded the vendor does not apply to: 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; however this exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. 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; e. Any failure to make such inspections, adjust- ments, 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 sale of the product; or f. Products which, after distribution or sale by you, have been labeled or re -labeled or used as a container, part of ingredient of any other thing or substance by or for the vendor; however this insurance does not apply to any insured person or organization, from who you have acquired such products, or any ingredient, part or con- tainer, entering into, accompanying or containing such products. The provisions of this coverage extension do not apply unless the written contract or written agreement has been executed (executed means signed by the named insured) prior to the "bodily injury" or "property damage'. Copyright, 2015 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73000116 Page 6 of 8 Incidental Malpractice Subparagraph 2.a.(1)(d) under SECTION II -WHO IS AN INSURED is deleted in its entirety and replaced with the following: (d) Arising out of his or her providing or failing to provide professional health care services. This does not apply to nurses, emergency medical technicians or paramedics if you are not in the business or occupation of providing any such professional services. This provision does not apply if you are a Social Service or Senior Living risk. SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS -Amendments Knowledge Of Occurrence, Claim, Suit Or Loss The following is added to Paragraph 2. Duties in the Event of Occurrence, Offense, Claim or Suit under SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS: The requirements under this paragraph do not apply until after the "occurrence" or offense is known to: 1. You, if you are an individual; 2. A partner, if you are a partnership; 3. An "executive officer" or insurance manager, if you are a corporation; 4. Your members, managers or insurance manager, if you are a limited liability company; or 5. Your elected or appointed officials, officers, mem- bers, trustees, board members, commission mem- bers, agency members, or your administrator or your insurance manager if you are an organization other than a partnership, joint venture, or limited liability company. Primary and Non -Contributory Provision The following is added to Paragraph 4. Other Insur- ance, b. Excess Insurance under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance shall be excess with respect to any person or organization included as an additional insured under this policy, any other insurance that person or organization has shall be primary with respect to this insurance, unless: (1) The additional insured is a Named Insured under such other insurance; (2) You have agreed in a written contract, written agreement or written permit to include that additional insured on your General Liability policy on a primary and/or non-contributory basis; and (3) The written contract or written agreement has been executed (executed means signed by the named insured) or written permit issued prior to the "bodily injury" or "property damage' or "personal and adver- tising injur)r'. Unintentional Failure To Disclose Hazards The following is added to Paragraph 6. Representations under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: However, if you should unintentionally fail to disclose any existing hazards in your representations to us at the inception date of the policy, or during the policy period in connection with any additional hazards, we shall not deny coverage under this Coverage Part based upon such failure to disclose hazards. Waiver Of Transfer Of Rights Of Recovery The following is added to Paragraph 8. Transfer of Rights Of Recovery Against Others To Us under SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS: We will waive any right of recovery we may have against a person or organization because of payments we make for "bodily injur�J' or "property damage' arising out of your ongoing operations or "your work" done under a written contract or written agreement and included in the "products -completed operations hazard", if: 1. You have agreed to waive any right of recovery against that person or organization in a written con- tract or written agreement; 2. Such person or organization is an additional insured on your policy; or 3. You have assumed the liability of that person or organization in that same contract, and it is an "insured contract". The section above only applies to that person or organization identified above, and only if the "bodily injury" or "property damage' occurs subsequent to the execution of the written contract or written agreement. Liberalization The following condition is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS: If we revise this Coverage Part to provide more coverage without additional premium charge, subject to our filed company rules, your policy will automatically provide the additional coverage as of the day the revision is effective in your state. Non -Accumulation Of Limits (This provision is not Applicable in the state of New York or Wisconsin). The following condition is added to SECTION IV - COMMERCIALGENERAL LIABILITY CONDITIONS: If you have other insurance provided by us or one of our affiliates that will respond to a claim or "suit" also covered under this coverage, the maximum limit of insurance under all collectible insurance shall not exceed the highest applicable limit under any one of the other coverage part(s), forms) or policy(ies). Copyright, 2015 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S CORY CG 73 00 01 16 Page 7 of 8 SECTION V -DEFINITIONS Discrimination (This provision does not apply in New York). A. The following is added to Definition 14. "Personal and advertising injury': "Personal and advertising injury' also means "discrimination' that results in injury to the feelings or reputation of a natural person, however only if such "discrimination' or humiliation is: 1. Not done by or at the direction of: a. The insured; or b. Anyone considered an insured under SECTION II - WHO IS AN INSURED; 2. Not done intentionally to cause harm to another person. 3. Not directly or indirectly related to the employ- ment, prospective employment or termination of employment of any person or persons by any insured. 4. Not arising out of any "advertisement" by the insured. B. The following definition is added to SECTION V - DEFINITIONS: "Discrimination' means: a. Any act or conduct that would be considered discrimination under any applicable federal, state, or local statute, ordinance or law; b. Any act or conduct that results in disparate treatment of, or has disparate impact on, a per- son, because of that person's race, religion, gender, sexual orientation, age, disability or physical impairment; or c. Any act or conduct characterized or interpreted as discrimination by a person based on that person's race, religion, gender, sexual orienta- tion, age, disability or physical impairment. It does not include acts or conduct characterized or interpreted as sexual intimidation or sexual harass- ment, or intimidation or harassment based on a person's gender. Electronic Data 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 applica- tions software, hard or floppy disks, CD-ROMs, tapes, drives, cell, data processing devices or any other media which are used with electronically controlled equipment. For the purpose of the Electronic Data Liability coverage provided by this endorsement, Definition 17. "Property damage' is deleted in its entirety and 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; or b. 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. For the purpose of the Electronic Data Liability coverage provided by this endorsement, "electronic data" is not tangible property. Employee Amendment Definition 5. "Employee" under SECTION V - DEFINI- TIONS is deleted in its entirety and replaced by the following: 5. "Employee' includes a "leased worker", ora "tempo- rary worker". If you are a School, "Employee' also includes a student teacher. Golfing Facility The following definition is added to SECTION V - DEFINITIONS: "Golfing facility' means a golf course, golf club, driving range, or miniature golf course. Mental Anguish Amendment (This provision does not apply in New York). Definition 3. "Bodily injury" under SECTION V - DEFINITIONS is deleted in its entirety and replaced with the following: 3. "Bodily injury" means bodily injury, sickness or disease sustained by a person, including death resulting from any of these at any time. This includes mental anguish resulting from any bodily injury, sickness or disease sustained by a person. (In New York, mental anguish has been determined to be "bodily injury"). Not-for-profit Member The following definition is added to SECTION V - DEFINITIONS: "Not-for-profit member" means a person who is a member of anot-for-profit organization, including clubs and churches, who receives no financial or other compensation. Copyright, 2015 Selective Insurance Company of America. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. INSURED'S COPY CG 73 00 01 16 Page 8 of 8