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HomeMy WebLinkAbout24B257 - PB Loader CorporationCONTRACT ABSTRACT Contract/Amendment Name of Contract: Company Name: Company Contact: Email: Summary of Services: Contract Price: Contract Term: Public Integrity/ Business Disclosure Forms: Contract Administration Lead Department: Contract Administrator/ Ext: Contract Approvals Council/City Manager Approval Date: Agreement Number: Amendment Number: Contract Compliance Exhibits: Insurance: Routed By: Bonds: Business License: Sole Source Co-Op CoOp Agmt #: Sole Source Documents: CoOp Name: CoOp Pricing: By: Submitted on: Contract Abstract Form Rev 8.16.23 Authorized Signers: Name, Email (Corporations require 2 signatures) Pothole Patch Truck PB Loader Corporation Michael Flaherty mflaherty@pbloader.com Purchase of one (1) Pothole Patch Truck $227,521.13 October 28, 2024 to October 27, 2027 Yes Jason Thompson - jthompson@aghpbl.com Chuck Stephenson - chuckstephenson@comcast.net Maintenance & Facilities Daniel Martinez 11/21/2024 24B257 N/A Yes Yes Yes Procurement N/A No IFB 24-29 N/A N/A N/A 11/14/2024 Anil Cholakkara Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 1 CITY OF PALM SPRINGS GOODS PURCHASE AGREEMENT 24B257 POTHOLE PATCH TRUCK This Goods Purchase Agreement (“Agreement”) is entered into this 21st day of November 2024, by and between the City of Palm Springs, a California charter city and municipal corporation (“City”), and PB Loader Corporation, a California Corporation (“Supplier”). City and Supplier are sometimes individually referred to as “Party” and collectively as “Parties” in this Agreement. 1. DEFINITIONS. A. “Goods” means all machinery, equipment, supplies, items, parts, materials, labor or other services, including design, engineering and installation services, provided by Supplier as specified in Exhibit “A,” attached hereto and incorporated herein by reference. B. “Delivery Date(s)” means that date or dates upon which the Goods is to be delivered to City, ready for approval, testing and/or use as specified in Exhibit “A,” attached hereto and incorporated herein by reference. 2. PRICES. Unless expressly provided otherwise, all prices and fees specified in Exhibit “B”, attached hereto and incorporated herein by reference, are firm and shall not be subject to change without the written approval of City. No extra charges of any kind will be allowed unless specifically agreed to in writing by City’s authorized representative. The total price shall include (i) all federal, state and local sales, use, excise, privilege, payroll, occupational and other taxes applicable to the Goods furnished to City hereunder; and (ii) all charges for packing, freight and transportation to destination. The total amount of Compensation shall not exceed $227,521.13 3. TERM. Unless earlier terminated in accordance with Section 15 of this Agreement, this Agreement shall continue in full force and effect for a period of three years, commencing on November 25, 2024, and ending on November 24, 2027, unless extended by mutual written agreement of the Parties. 4. INSPECTIONS AND TESTS. City shall have the right to inspect and/or test the Goods prior to acceptance. If upon inspection or testing the Goods or any portion thereof are found to be nonconforming, unsatisfactory, defective, of inferior quality or workmanship, or fail to meet any requirements or specifications contained in Exhibit “A,” then without prejudice to any other rights or remedies, City may reject the Goods or exercise any of its rights under this Agreement. The inspection, failure to make inspection, acceptance of goods, or payment for goods shall not impair City’s right to reject nonconforming goods, irrespective of City’s failure to notify Supplier of a rejection of nonconforming goods or revocation of acceptance thereof or to specify with particularity any defect in nonconforming goods after rejection or acceptance thereof. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 2 5. WARRANTY. A. Supplier warrants that the Goods will be of merchantable quality and free from defects in design, engineering, material, and workmanship for a period of Three (3) years on mechanical or such longer period as provided by a manufacturer’s warranty or as agreed to by Supplier and City, from the date of final written acceptance of the Goods by City as required for final payment under this Agreement. Supplier further warrants that any services provided in connection with the Goods will be performed in a professional and workmanlike manner and in accordance with the highest industry standards. B. Supplier further warrants that all machinery, equipment, or process included in the Goods will meet the performance requirements and specifications specified in Exhibit “A” and shall be fit for the purpose intended. City’s inspection, testing, approval, or acceptance of any such machinery, equipment, or process will not relieve Supplier of its obligations under this paragraph. C. For any breach of the warranties contained in this Section, Supplier will, immediately after receiving notice from City, at the option of City, and at Supplier’s own expense and without cost to City: 1. Repair the defective Goods; 2. Replace the defective Goods with conforming Goods, F.O.B. City’s plant, office or other location of City where the Goods was originally performed or delivered; or 3. Repay to City the purchase price of the defective Goods. If City selects repair or replacement, any defects will be remedied without cost to City, including but not limited to, the costs of removal, repair, and replacement of the defective Goods, and reinstallation of new Goods. All such defective Goods that is so remedied will be similarly warranted as stated above. In addition, Supplier will repair or replace other items of the Goods which may have been damaged by such defects or the repairing of the same, all at its own expense and without cost to City. D. Supplier also warrants that the Goods is free and clear of all liens and encumbrances whatsoever, that Supplier has a good and marketable title to same, and that Supplier owns or has a valid license for all of the proprietary technology and intellectual property incorporated within the Goods. Supplier agrees to indemnify, defend, and hold City harmless against any and all third party claims resulting from the breach or inaccuracy of any of the foregoing warranties. E. In the event of a breach by Supplier of its obligations under this Section, City will not be limited to the remedies set forth in this Section, but will have all the rights and remedies permitted by applicable law, including without limitation, all of the rights and remedies afforded to City under the California Commercial Code. 6. CHANGES. City, at any time, by a written order, and without notice to any surety, may make changes in the Goods, including but not limited to, City’s requirements and specifications. If such changes affect the cost of the Goods or time required for its performance, an equitable adjustment will be Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 3 made in the price or time for performance or both. Any change in the price necessitated by such change will be agreed upon between City and Supplier and such change will be authorized by a change order document signed by City and accepted by Supplier. 7. PAYMENTS. A. Terms of payment, are net thirty (30) days, less any applicable retention, after receipt of invoice, or completion of applicable Progress Milestones. Final payment shall be made by City after Supplier has satisfied all contractual requirements. Payment of invoices shall not constitute acceptance of Goods. B. If Progress Milestones have been specified in Exhibit “A,” then payments for the Goods will be made as the requirements of such Progress Milestones are met. Progress payments for the Goods will be made by City upon proper application by Supplier during the progress of the Goods and according to the terms of payment as specified in Exhibit “A.” Supplier’s progress billing invoice will include progress payments due for the original scope of work and changes. Each “Item for Payment” shown in Exhibit “A” and each change order will be itemized on the invoice. Invoices for cost plus work, whether part of Exhibit “A” or a change order, must have subcontractor and/or supplier invoices attached to Supplier’s invoice. Other format and support documents for invoices will be determined by City in advance of the first invoice cycle. C. Payments otherwise due may be withheld by City on account of defective Goods not remedied, liens or other claims filed, reasonable evidence indicating probable filing of liens or other claims, failure of Supplier to make payments properly to its subcontractors or for material or labor, the failure of Supplier to perform any of its other obligations under the Agreement, or to protect City against any liability arising out of Supplier’s failure to pay or discharge taxes or other obligations. If the causes for which payment is withheld are removed, the withheld payments will be made promptly. If the said causes are not removed within a reasonable period after written notice, City may remove them at Supplier’s expense. D. Payment of the final Progress Milestone payment or any retention will be made by City upon: 1. Submission of an invoice for satisfactory completion of the requirements of a Progress Milestone as defined in Exhibit “A” and in the amount associated with the Progress Milestone; 2. Written acceptance of the Goods by City; 3. Delivery of all drawings and specifications, if required by City; 4. Delivery of executed full releases of any and all liens arising out of this Agreement; and 5. Delivery of an affidavit listing all persons who might otherwise be entitled to file, claim, or maintain a lien of any kind or character, and containing an averment that all of the said persons have been paid in full. If any person refuses to furnish an actual release or receipt in full, Supplier may furnish a bond satisfactory to City to indemnify City against any claim or lien at no cost to City. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 4 E. Acceptance by Supplier of payment of the final Progress Milestone payment pursuant to Section will constitute a waiver, release and discharge of any and all claims and demands of any kind or character which Supplier then has, or can subsequently acquire against City, its successors and assigns, for or on account of any matter or thing arising out of, or in any manner connected with, the performance of this Agreement. However, payment for the final Progress Milestone by City will not constitute a waiver, release or discharge of any claims or demands which City then has, or can subsequently acquire, against Supplier, its successors and assigns, for or on account of any matter or thing arising out of, or in any manner connected with, the performance of this Agreement. 8. SCHEDULE FOR DELIVERY. The time of Supplier’s performance is of the essence for this Agreement. The Goods will be delivered in accordance with the schedule set forth in Exhibit “A.” Supplier must immediately notify City in writing any time delivery is behind schedule or may not be completed on schedule. In addition to any other rights City may have under this Agreement or at law, Supplier shall pay City the sum of $ 0.00 per item of Goods for each calendar day for which the item of Goods is unavailable beyond the scheduled delivery date(s) specified in Exhibit “A.” In the event that the Goods is part of a larger project or projects that require the coordination of multiple contractors or suppliers, then Supplier will fully cooperate in scheduling the delivery so that City can maximize the efficient completion of such project(s). 9. TAXES. Supplier agrees to timely pay all sales and use tax (including any value added or gross receipts tax imposed similar to a sales and use tax) imposed by any federal, state or local taxing authority on the ultimate purchase price of the Goods provided under this Agreement. Supplier will withhold, and require its subcontractors, where applicable, to withhold all required taxes and contributions of any federal, state or local taxing authority which is measured by wages, salaries or other remuneration of its employees or the employees of its subcontractors. Supplier will deposit, or cause to be deposited, in a timely manner with the appropriate taxing authorities all amounts required to be withheld. All other taxes, however denominated or measured, imposed upon the price of the Goods provided hereunder, will be the responsibility of Supplier. In addition, all taxes assessed by any taxing jurisdiction based on Supplier property used or consumed in the provision of the Goods such as and including ad valorem, use, personal property and inventory taxes will be the responsibility of Supplier. Supplier will, upon written request, submit to City written evidence of any filings or payments of all taxes required to be paid by Supplier hereunder. 10. INDEPENDENT CONTRACTOR. Supplier enters into this Agreement as an independent contractor and not as an employee of City. Supplier shall have no power or authority by this Agreement to bind City in any respect. Nothing in this Agreement shall be construed to be inconsistent with this relationship or status. All employees, agents, contractors or subcontractors hired or retained by the Supplier are employees, agents, contractors or subcontractors of the Supplier and not of City. City shall not be obligated in any way to pay any wage claims or other claims made against Supplier by any such employees, agents, contractors or subcontractors or any other person resulting from performance of this Agreement. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 5 11. TITLE AND RISK OF LOSS. Unless otherwise agreed, City will have title to, and risk of loss of, all completed and partially completed portions of the Goods upon delivery, as well as materials delivered to and stored on City property which are intended to become a part of the Goods. However, Supplier will be liable for any loss or damage to the Goods and/or the materials caused by Supplier or its subcontractors, their agents or employees, and Supplier will replace or repair said Goods or materials at its own cost to the complete satisfaction of City. Notwithstanding the foregoing, in the event that the City has paid Supplier for all or a portion of the Goods which remains in the possession of Supplier, then City shall have title to, and the right to take possession of, such Goods at any time following payment therefor. Risk of loss for any Goods which remains in the possession of Supplier shall remain with Supplier until such Goods has been delivered or City has taken possession thereof. Supplier will have risk of loss or damage to Supplier’s property used in the construction of the Goods but which does not become a part of the Goods. 12. INDEMNIFICATION. A. To extent permitted by law, Supplier shall defend, indemnify and hold the City, its officials, officers, employees, volunteers and agents free and harmless from any and all claims, demands, causes of action, costs, expenses, liability, loss, damage or injury, in law or equity, to property or persons, including wrongful death, in any manner arising out of or incident to any alleged acts, omissions, negligence or willful misconduct of Supplier, its officials, officers, employees, agents, subcontractors and subconsultants arising out of or in connection with the Goods or the performance of this Agreement, including without limitation the payment of damages, attorneys’ fees and other related costs and expenses except such loss or damage which was caused by the sole negligence or willful misconduct of the City. Supplier’s obligation to indemnify shall not be restricted to insurance proceeds, if any, received by the City, its officials, officers, employees, agents or volunteers. B. Supplier’s defense obligation for any and all such aforesaid suits, actions or other legal proceedings of every kind that may be brought or instituted against the City, its officials, officers, employees, agents, or volunteers shall be at Supplier’s own cost, expense, and risk. Supplier shall pay and satisfy any judgment, award, or decree that may be rendered against City or its officials, officers, employees, agents, or volunteers, in any such suit, action, or other legal proceeding. Supplier shall reimburse City and its officials, officers, employees, agents, and/or volunteers, for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided. 13. INSURANCE. A. General. Supplier shall take out and maintain: 1. Commercial General Liability Insurance, of at least $1,000,000 per occurrence/ $2,000,000 aggregate for bodily injury, personal injury and property damage, at least as broad as Insurance Services Office Commercial General Liability most recent Occurrence Form CG 00 01; 2. Automobile Liability Insurance for bodily injury and property damage including coverage for owned, non-owned and hired vehicles, of at least $1,000,000 per accident for bodily injury and property damage, at least as broad as most recent Insurance Services Office Form Number CA 00 01 covering automobile liability, Code 1 (any auto); Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 6 3. Workers’ Compensation in compliance with applicable statutory requirements and Employer's Liability Coverage of at least $1,000,000 per occurrence; and 4. Pollution Liability Insurance of at least $1,000,000 per occurrence and $2,000,000 aggregate shall be provided by the Supplier if transporting hazardous materials. 5. If Supplier is also the manufacturer of any equipment included in the Goods, Supplier shall carry Product Liability and/or Errors and Omissions Insurance which covers said equipment with limits of not less than $1,000,000. B. Additional Insured; Primary; Waiver of Subrogation; No Limitation on Coverage. The policies required under this Section shall give City, its officials, officers, employees, agents or volunteers additional insured status. Such policies shall contain a provision stating that Supplier’s policy is primary insurance and that any insurance, self-insurance or other coverage maintained by the City or any additional insureds shall not be called upon to contribute to any loss, and shall contain or be endorsed with a waiver of subrogation in favor of the City, its officials, officers, employees, agents, and volunteers. The limits set forth herein shall apply separately to each insured against whom claims are made or suits are brought, except with respect to the limits of liability. Requirements of specific coverage or limits contained in this section are not intended as a limitation on coverage, limits, or other requirement, or a waiver of any coverage normally provided by any insurance. Any available coverage shall be provided to the parties required to be named as additional insured pursuant to this Agreement. C. Insurance Carrier. All insurance required under this Section is to be placed with insurers with a current A.M. Best’s rating no less than A-:VII, licensed to do business in California, and satisfactory to the City. D. Evidence of Insurance. Supplier shall furnish City with original certificates of insurance and endorsements effecting coverage required by the Agreement. The certificates and endorsements for each insurance policy shall be signed by a person authorized by that insurer to bind coverage on its behalf, and shall be on forms supplied or approved by the City. All certificates and endorsements must be received and approved by the City before delivery commences. The City reserves the right to require complete, certified copies of all required insurance policies, at any time. E. Subcontractors. All subcontractors shall meet the requirements of this Section before commencing work. In addition, Supplier shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the requirements stated herein. F. Freight. Supplier shall ensure that third party shippers contracted by Supplier have adequate insurance coverage for the shipped Goods. 14. LIENS. Supplier, subcontractors and suppliers will not make, file or maintain a mechanic’s or other lien or claim of any kind or character against the Goods, for or on account of any labor, materials, fixtures, tools, machinery, equipment, or any other things furnished, or any other work done or performance given under, arising out of, or in any manner connected with the Agreement (such liens or claims referred to as “Claims”); and Supplier, subcontractor and suppliers expressly waive and relinquish any and all rights which they now have, or may subsequently acquire, to Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 7 file or maintain any Claim and Supplier, subcontractor and suppliers agree that this provision waiving the right of Claims will be an independent covenant. Supplier will save and hold City harmless from and against any and all Claims that may be filed by a subcontractor, supplier or any other person or entity and Supplier will, at its own expense, defend any and all actions based upon such Claims and will pay all charges of attorneys and all costs and other expenses arising from such Claims. 15. TERMINATION OF AGREEMENT BY CITY. A. Should Supplier at any time refuse or fail to deliver the Goods with promptness and diligence, or to perform any of its other obligations under the Agreement, City may terminate Supplier’s right to proceed with the delivery of the Goods by written notice to Supplier. In such event City may obtain the Goods by whatever method it may deem expedient, including the hiring of another contractor or other contractors and, for that purpose, may take possession of all materials, machinery, equipment, tools and appliances and exercise all rights, options and privileges of Supplier. In such case Supplier will not be entitled to receive any further payments until the Goods is delivered. If City’s cost of obtaining the Goods, including compensation for additional managerial and administrative services, will exceed the unpaid balance of the Agreement, Supplier will be liable for and will pay the difference to City. B. City may, for its own convenience, terminate Supplier’s right to proceed with the delivery of any portion or all of the Goods by written notice to Supplier. Such termination will be effective in the manner specified in such notice, will be without prejudice to any claims which City may have against Supplier, and will not affect the obligations and duties of Supplier under the Agreement with respect to portions of the Goods not terminated. C. On receipt of notice under this Section, Supplier will, with respect to the portion of the Goods terminated, unless the notice states otherwise, 1. Immediately discontinue such portion of the Goods and the placing of orders for materials, facilities, and supplies in connection with the Goods, 2. Unless otherwise directed by City, make every reasonable effort to procure cancellation of all existing orders or contracts upon terms satisfactory to City; and 3. Deliver only such portions of the Goods which City deems necessary to preserve and protect those portions of the Goods already in progress and to protect material, plant and equipment at the Goods site or in transit to the Goods site. D. Upon termination pursuant to this Section, Supplier will be paid a pro rata portion of the compensation in the Agreement for any portion of the terminated Goods already delivered, including material and services for which it has made firm contracts which are not canceled, it being understood that City will be entitled to such material and services. Upon determination of the amount of said pro rata compensation, City will promptly pay such amount to Supplier upon delivery by Supplier of the releases of liens and affidavit, pursuant to this Section. 16. FORCE MAJEURE Supplier shall not be held responsible for failure or delay in shipping nor City for failure or delay in accepting Goods described herein if such failure or delay is due to a Force Majeure Event. A Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 8 Force Majeure Event shall mean an event that materially affects a Party’s performance and is one or more of the following: (1) Acts of God or other natural disasters; (2) terrorism or other acts of a public enemy; (3) orders of governmental authorities (including, without limitation, unreasonable and unforeseeable delay in the issuance of permits or approvals by governmental authorities that are required for the Goods); (4) pandemics, epidemics or quarantine restrictions; and (5) strikes and other organized labor action, only to the extent such strikes and other organized labor action are beyond the control of Supplier and its subcontractors, of every tier, and to the extent the effects thereof cannot be avoided by use of replacement workers. For purposes of this section, “orders of governmental authorities,” includes ordinances, emergency proclamations and orders, rules to protect the public health, welfare and safety, and other actions of the City in its capacity as a municipal authority. In the event of any such excused interference with shipments, City shall have the option either to reduce the quantity provided for in the order accordingly or to exercise its right of cancellation as set forth in this Agreement. 17. CITY OFFICERS AND EMPLOYEES: NON-DISCRIMINATION A. Non-Liability of City Officers and Employees. No officer or employee of City shall be personally liable to the Supplier, or any successor-in-interest, in the event of any default or breach by City or for any amount which may become due to the Supplier or its successor, or for breach of any obligation of the terms of this Agreement. B. Conflict of Interest. Supplier acknowledges that no officer or employee of the City has or shall have any direct or indirect financial interest in this Agreement nor shall Supplier enter into any agreement of any kind with any such officer or employee during the term of this Agreement and for one (1) year thereafter. Supplier warrants that Supplier has not paid or given, and will not pay or give, any third party any money or other consideration in exchange for obtaining this Agreement. C. Covenant Against Discrimination. In connection with its performance under this Agreement, Supplier shall not discriminate against any employee or applicant for employment because of actual or perceived race, religion, color, sex, age, marital status, ancestry, national origin ( i.e., place of origin, immigration status, cultural or linguistic characteristics, or ethnicity), sexual orientation, gender identity, gender expression, physical or mental disability, or medical condition (each a “prohibited basis”). Supplier shall ensure that applicants are employed, and that employees are treated during their employment, without regard to any prohibited basis. As a condition precedent to City’s lawful capacity to enter this Agreement, and in executing this Agreement, Supplier certifies that its actions and omissions hereunder shall not incorporate any discrimination arising from or related to any prohibited basis in any Supplier activity, including but not limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship; and further, that Supplier is in full compliance with the provisions of Palm Springs Municipal Code Section 7.09.040, including without limitation the provision of benefits, relating to non-discrimination in city contracting. 18. MISCELLANEOUS PROVISIONS. A. Delivery of Notices. All notices permitted or required under this Agreement shall be given to the respective parties at the following address or at such other address as the respective parties may provide in writing for this purpose: Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 9 CITY: City of Palm Springs 3200 E. Tahquitz Canyon Way Palm Springs, CA 92262 Attn: City Manager SUPPLIER: PB Loader Corporation 5778 West Barstow Avenue Fresno, CA, 93722 Attn: Michael Flaherty Such notice shall be deemed made when personally delivered or when mailed, forty- eight (48) hours after deposit in the U.S. Mail, first class postage prepaid and addressed to the party at its applicable address. Actual notice shall be deemed adequate notice on the date actual notice occurred, regardless of the method of service. B. Assignment or Transfer. Supplier shall not assign or transfer any interest in this Agreement whether by assignment or novation, without the prior written consent of the City, which will not be unreasonably withheld. Provided, however, that claims for money due or to become due Supplier from the City under this Agreement may be assigned to a financial institution or to a trustee in bankruptcy, without such approval. Notice of any assignment or transfer, whether voluntary or involuntary, shall be furnished promptly to the City. C. Successors and Assigns. This Agreement shall be binding on the successors and assigns of the Parties. D. Amendment; Modification. No supplement, modification, or amendment of this Agreement shall be binding unless executed in writing and signed by both Parties. E. Waiver. No waiver of any default shall constitute a waiver of any other default or breach, whether of the same or other covenant or condition. No waiver, benefit, privilege, or service voluntarily given or performed by a Party shall give the other Party any contractual rights by custom, estoppel or otherwise. F. Governing Law. This Agreement shall be governed by the laws of the State of California. Venue shall be in Riverside County. G. Attorneys’ Fees and Costs. If any action in law or equity, including an action for declaratory relief, is brought to enforce or interpret the provisions of this Agreement, each Party shall pay its own attorneys’ fees. H. Interpretation. Since the Parties or their agents have participated fully in the preparation of this Agreement, the language of this Agreement shall be construed simply, according to its fair meaning, and not strictly for or against any Party. I. No Third Party Beneficiaries. There are no intended third party beneficiaries of any right or obligation assumed by the Parties. J. Authority to Enter Agreement. Each Party warrants that the individuals who have signed this Agreement have the legal power, right and authority to make this Agreement and bind each respective Party. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 10 K. Invalidity; Severability. If any portion of this Agreement is declared invalid, illegal, or otherwise unenforceable by a court of competent jurisdiction, the remaining provisions shall continue in full force and effect. L. Counterparts. This Agreement may be signed in counterparts, each of which shall constitute an original. M. City’s Right to Employ Other Suppliers. City reserves its right to employ other contractors in connection with the Goods. N. Entire Agreement. This Agreement constitutes the entire agreement between the Parties relative to the Goods specified herein. There are no understandings, agreements, conditions, representations, warranties or promises with respect to this Agreement, except those contained in or referred to in the writing. O. Electronic Signature. Each Party acknowledges and agrees that this Agreement may be executed by electronic or digital signature, which shall be considered as an original signature for all purposes and shall have the same force and effect as an original signature. 19. COMPLIANCE WITH ECONOMIC SANCTIONS IN RESPONSE TO RUSSIA'S ACTIONS IN UKRAINE. When funding for the services is provided, in whole or in part, by an agency controlled of the State of California, Consultant shall fully and adequately comply with California Executive Order N-6-22 (“Russian Sanctions Program”). As part of this compliance process, Consultant shall also certify compliance with the Russian Sanctions Program by completing the form located in Exhibit “C” (Russian Sanctions Certification), attached hereto and incorporated herein by reference. Consultant shall also require any subconsultants to comply with the Russian Sanctions Program and certify compliance pursuant to this Section. [SIGNATURES ON FOLLOWING PAGE] Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 11 SIGNATURE PAGE TO GOODS PURCHASE AGREEMENT BETWEEN THE CITY OF PALM SPRINGS AND PB LOADER CORPORATION IN WITNESS WHEREOF, the Parties have executed this Agreement as of the dates stated below. CONTRACTOR: By: _____________________________ By: _____________________________ Signature Signature (2nd signature required for Corporation) Date: ___________________________ Date: ___________________________ CITY OF PALM SPRINGS: APPROVED BY CITY COUNCIL: Date: _________________ Item No. _________________ APPROVED AS TO FORM: ATTEST: By: _____________________________ By: _____________________________ City Attorney City Clerk APPROVED: By: _____________________________ Date: ___________________________ City Manager – over $50,000 Deputy/Assistant City Manager – up to $50,000 Director – up to $25,000 Manager – up to $5,000 Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 11/14/2024 11/19/2024 11/21/24 1J 11/21/2024 12 Exhibit A Goods Specifications And Delivery Schedule [ATTACHED] Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 13 Background: The City of Palm Springs Street Maintenance division has a need for one Hot Pothole Truck/Patch Truck to meet the increasing demands for pothole repairs and street maintenance throughout the City. Scope: A. The Contractor must supply One (1) Hot Pothole Truck/Patch Truck per specifications below. 1. Patcher: Asphalt patcher (1.5 cubic yard capacity) equipped with radiant heater, thermostatically controlled LPG burner, hydraulic top lids and doors, Kevlar chain conveyor, hand torch, shovel apron, 25-gallon LPG tank, installation, and painted black. 2. Emulsion System: Emulsion spray unit heated by truck cooling system, Y strainer, fill basket, hydraulically powered, 10-gallon solvent tank, 35-gallon emulsion, wand with 25’ hose, 10-gallon waste tank, thermometer, auxiliary electric heat system, installation, and painted black. 3. Emulsion System Options: 12V Electric compressor 4. Compaction Tools: a. Compactor Lift Platform, Hydraulic b. Compactor Plate – Wacker WP1550AW Honda c. 8-gallon poly water tank with 10’ hose and spigot 5. Hose Reels a. Hose Reel – ½” x 25’ for emulsion. b. Hose Reel – 3/8” x 25’ for torch. c. Hose Reel – 3/8” x 25’ for solvent. d. Hose Reel – Dual ½” x 25’ for HYD Hammer 6. Hitch Plate and Pintle a. Hitch Plate with D-rings with 7 and 6 wire plugs. b. Premier Model 150 Combo Pintle and 2” ball 7. Heating a. LPG Tank 20-gallon horizontal with quick fill and level gauge 8. Wands a. Air blow gun with 25’ hose (Req. compressor option or truck air) b. Solvent pump and wand with 25-foot hose Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 14 9. Spoil Bins a. Cap guard with PB logo and perforated window. b. 18” Small spoils bin 10. Work Platforms a. 12” work platform/catwalk with handrails and ladders 11. Storage a. 24” Toolbox b. Holder – Spring asphalt lute – Stainless Steel c. Holder – Spring shovel – Stainless Steel d. Small lockable side tool basket 12. Hammer Systems a. Hydraulic tool circuit with flow meter, PSI gauge, and fan oil cooler b. Hydraulic hammer BR-67 with asphalt cutter and tamper pad c. Lockable hammer hanger 13. Discharge Systems a. Pivotal asphalt chute 14. Warning Systems a. Strobe – Whelen Microns MCRNSA LED (Set of 2) b. Strobe – Whelen 500 series LED (Set of 2) c. Traffic Advisory – Able (Show Me) 10 light LED. d. Arrow board – WANCO model WFP180B6-LSAC 36”x72”, 25 lamp LED with 180 degrees power tilt, cab controls. 15. Safety Accessories a. Dual front bumper cone holder (Male) b. Fire Extinguisher 5# c. Triangle Kit d. Water Igloo (5-gallon) with bracket assembly e. PA system f. Equipped with city radio. g. White in color to include PS Logo. h. Two (2) sets of Operation/Maintenance manuals shall be provided. i. A complete set of drawings shall be submitted. Descriptive literature, technical data and photographs shall be included with the bid. j. Delivery to Palm Springs Fleet Operation yard costs shall be included in the bid. k. A preconstruction meeting and final inspection meeting will be held with vendor. The bid shall include any necessary cost to host requested meeting to include flights and lodging for three (3) City Fleet Operations personnel. l. Warranty: Manufacturer’s warranty 3 years or more 16. Cab and Chassis 2024 F-600 4X2 Regular cab chassis with 7.3 L V-8 335HP gas-powered engine, 10-speed automatic transmission with PTO provision, 26.5-gallon mid-ship fuel Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 15 tank, air conditioning, power windows, payload package, cruise control, auxiliary switches, running boards, 4 keys with FOB, steel wheels, painted white. AQMD, CARB compliant. B. Delivery: Delivery to City of Palm Springs Fleet Operations no later than one-hundred fifty (150) days after placement of an order and the costs shall be included in the bid. C. Training for City of Palm Springs Staff: Factory maintenance and operation training to be conducted for five (5) City Fleet Operations personnel. Compensation: Work will be compensated on a lump sum basis that is inclusive of all costs related to the specifications and requirements. No additional compensation will be due by the City unless the contract is modified for additional work requested by the City. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 16 Exhibit B Fee Schedule [ATTACHED] Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 17 Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 18 Exhibit C Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A CITY OF PALM SPRINGS 3200 E TAHQUITZ CANYON WAY, PALM SPRINGS, CA 92262 (760) 322-8328 BUSINESS LICENSE CERTIFICATE Fees Paid:$174.00 ISSUANCE OF THIS LICENSE DOES NOT ENTITLE THE LICENSEE TO OPERATE OR MAINTAIN A BUSINESS IN VIOLATION OF ANY OTHER LAW OR ORDINANCE. THIS IS NOT AN ENDORSEMENT OF THE ACTIVITY NOR OF THE APPLICANT'S QUALIFICATIONS. Business Name:PB LOADER CORPORATION DBA: Owner:CHRISTOPHER DRAKE Mailing Address:5778 W BARSTOW AVE FRESNO, CA 93722 License Number:OC-007318-2024 Expiration Date:09/16/2025 PLEASE NOTE THAT IT IS YOUR RESPONSIBILITY TO RENEW AND UPDATE THIS LICENSE ANNUALLY. Business Location:5778 W BARSTOW AVE, FRESNO, CA 92722 Business Description:TRUCK DEALERSHIP TO BE POSTED IN A CONSPICUOUS PLACE Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 10/11/2024 Arthur J.Gallagher Risk Management Services,LLC 45 E.River Place West Suite 605 Fresno CA 93720 Melisa Resner 559-256-6570 559-256-6590 melisa_resner@ajg.com License#:0D69293 Zurich American Insurance Company 16535 Trumbull Insurance Company 27120AmericanGrapeHarvesters,Inc. PB Loader Corporation 5778 W.Barstow Avenue Fresno CA 93722 1289597755 A X 2,000,000 X 1,000,000 10,000 2,000,000 4,000,000 X X Y Y GLO 0187945-08 7/1/2024 7/1/2025 4,000,000 Employee benefit 1,000,000 B 1,000,000 X X X Y Y 51UENBC4812 7/1/2024 7/1/2025 A XYWC0380745-09 7/1/2024 7/1/2025 1,000,000 1,000,000 1,000,000 B GKLL Primary 51UENBC4812 7/1/2024 7/1/2025 Limit $2,500 Ded per Car $3,500,000 $10,000 per Event Certificate holder is listed as additional insured when required by contract as respect to General Liability and Auto Liability.Waiver of Subrogation Applies. Coverage is Primary and Non-Contributory.30 Day Notice of Cancelation Applies (10 Day for Non-Payment)per attached policy forms. Workers'Compensation:Waiver of Subrogation Applies.30 Day Notice of Cancelation Applies (10 Day for Non-Payment)per attached policy forms.. The City of Palms Springs,its officials,employees,and agents,are included as Additional Insured with respect to the agreement with City and the services to be provided thereunder.RE:PB Loader Contract Awarded. City of Palm Springs 3200 E.Tahquitz Canyon Way Palm Springs CA 92262 USA Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO 0187945-08 Effective Date: 07/01/2024 T i t l e o f f o r m m u s t n o t b e p l a c e d a b o v e t h e l o g o . ↑ T o p M a r g i n 3 / 4 " Additional Insured – Automatic – Owners, Lessees Or Contractors U-GL-2162-A CW (02/19) Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A.Section II – Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured under a written contract or written agreement executed by you, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" and subject to the following: 1.If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a.The Insurance Services Office (ISO) ISO CG 20 10 (10/01 edition); or b.The ISO CG 20 37 (10/01 edition), such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" arises out of: (1)Your ongoing operations, with respect to Paragraph 1.a. above; or (2)"Your work", with respect to Paragraph 1.b. above, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 1., insurance afforded to such additional insured: (a)Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (b)Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. 2.If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a.The Insurance Services Office (ISO) ISO CG 20 10 (07/04 edition); or b.The ISO CG 20 37 (07/04 edition), such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is caused, in whole or in part, by: (1)Your acts or omissions; or (2)The acts or omissions of those acting on your behalf, Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-2162-A CW (02/19) Page 2 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. in the performance of: (a)Your ongoing operations, with respect to Paragraph 2.a. above; or (b)"Your work" and included in the "products-completed operations hazard", with respect to Paragraph 2.b. above, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 2., insurance afforded to such additional insured: (i)Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (ii)Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. 3.If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that you provide that the person or organization be named as an additional insured: a.Under the ISO CG 20 10 (04/13 edition, any subsequent edition or if no edition date is specified); or b.With respect to ongoing operations (if no form is specified), such person or organization is then an additional insured only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is caused, in whole or in part by: (1)Your acts or omissions; or (2)The acts or omissions of those acting on your behalf, in the performance of your ongoing operations, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 3., insurance afforded to such additional insured: (a)Only applies to the extent permitted by law; (b)Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured; and (c)Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement. 4.If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that you provide that the person or organization be named as an additional insured: a.Under the ISO CG 20 37 (04/13 edition, any subsequent edition or if no edition date is specified); or b.With respect to the "products-completed operations hazard" (if no form is specified), such person or organization is then an additional insured only to the extent that "bodily injury" or "property damage" is caused, in whole or in part by "your work" and included in the "products-completed operations hazard", which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 4., insurance afforded to such additional insured: (1)Only applies to the extent permitted by law; (2)Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured; (3)Only applies if the "bodily injury" or "property damage" occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (4)Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-2162-A CW (02/19) Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. B.Solely with respect to the insurance afforded to any additional insured referenced in Section A. of this endorsement, 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 failure to render, any professional architectural, engineering or surveying services including: 1.The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2.Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C.Solely with respect to the coverage provided by this endorsement, the following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV – Commercial General Liability Conditions: The additional insured must see to it that: (1)We are notified as soon as practicable of an "occurrence" or offense that may result in a claim; (2)We receive written notice of a claim or "suit" as soon as practicable; and (3)A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D.Solely with respect to the coverage provided by this endorsement: 1.The following is added to the Other Insurance Condition of Section IV – Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a.The additional insured is a Named Insured under such other insurance; and b.You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2.The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition under Section IV – Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non- contributory basis. E.This endorsement does not apply to an additional insured which has been added to this Coverage Part by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F.Solely with respect to the insurance afforded to an additional insured under Paragraph A.3. or Paragraph A.4. of this endorsement, the following is added to Section III – Limits Of Insurance: Additional Insured – Automatic – Owners, Lessees Or Contractors Limit The most we will pay on behalf of the additional insured is the amount of insurance: Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-2162-A CW (02/19) Page 4 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 1.Required by the written contract or written agreement referenced in Section A. of this endorsement; or 2.Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms, conditions, provisions and exclusions of this policy remain the same. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO 0187945-08 Effective Date: 07/01/2024 T i t l e o f f o r m m u s t n o t b e p l a c e d a b o v e t h e l o g o . ↑ T o p M a r g i n 3 / 4 " U-GL-1345-C CW (03/20) Page 1 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. General Liability Supplemental Coverage Endorsement This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part The following changes apply to this Coverage Part. However, endorsements attached to this Coverage Part will supersede any provisions to the contrary in this General Liability Supplemental Coverage Endorsement. A. Broadened Named Insured 1.The following is added to Section II – Who Is An Insured: Any organization of yours, other than a partnership or joint venture, which is not shown in the Declarations, and over which you maintain an ownership interest of more than 50% of such organization as of the effective date of this Coverage Part, will qualify as a Named Insured. However, such organization will not qualify as a Named Insured under this provision if it: a.Is newly acquired or formed during the policy period; b.Is also an insured under another policy, other than a policy written to apply specifically in excess of this Coverage Part; or c.Would be an insured under another policy but for its termination or the exhaustion of its limits of insurance. Each such organization remains qualified as a Named Insured only while you maintain an ownership interest of more than 50% in the organization during the policy period. 2.The last paragraph of Section II – Who Is An Insured does not apply to this provision to the extent that such paragraph would conflict with this provision. B. Newly Acquired or Formed Organizations as Named Insureds 1.Paragraph 3. of Section II – Who Is An Insured is replaced by the following: 3.Any organization you newly acquire or form during the policy period, other than a partnership or joint venture, and over which you maintain an ownership interest of more than 50% of such organization, 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 only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier; b.Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and c.Coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. An additional premium will apply in accordance with our rules and rates in effect on the date you acquired or formed the organization. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 2 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2.The last paragraph of Section II – Who Is An Insured does not apply to this provision to the extent that such paragraph would conflict with this provision. C. Insured Status – Employees Paragraph 2.a.(1) of Section II – Who Is An Insured is replaced by the following: 2.Each of the following is also an insured: a.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 organization other than a partnership, joint 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 insureds for: (1)"Bodily injury" or "personal and advertising injury": (a)To you, to your partners or members (if you are a partnership or joint venture), to your members (if you are a limited liability company), to a co-"employee" while in the course of his or her employment or performing 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; (c)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)Arising out of his or her providing or failing to provide professional health care services. However: Paragraphs (1)(a) and (1)(d) do not apply to your "employees" or "volunteer workers", who are not employed by you or volunteering for you as health care professionals, for "bodily injury" arising out of "Good Samaritan Acts" while the "employee" or "volunteer worker" is performing duties related to the conduct of your business. "Good Samaritan Acts" mean any assistance of a medical nature rendered or provided in an emergency situation for which no remuneration is demanded or received. Paragraphs (1)(a), (b) and (c) do not apply to any "employee" designated as a supervisor or higher in rank, with respect to "bodily injury" to co-"employees". As used in this provision, "employees" designated as a supervisor or higher in rank means only "employees" who are authorized by you to exercise direct or indirect supervision or control over "employees" or "volunteer workers" and the manner in which work is performed. D. Additional Insureds – Lessees of Premises 1.Section II – Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) who leases or rents a part of the premises you own or manage who you are required to add as an additional insured on this policy under a written contract or written agreement, but only with respect to liability arising out of your ownership, maintenance or repair of that part of the premises which is not reserved for the exclusive use or occupancy of such person or organization or any other tenant or lessee. This provision does not apply after the person or organization ceases to lease or rent premises from you. However, the insurance afforded to such additional insured: a.Only applies to the extent permitted by law; and b.Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. 2.With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 3 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. a.Required by the written contract or written agreement referenced in Subparagraph D.1. above (of this endorsement); or b.Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This Paragraph D. shall not increase the applicable Limits of Insurance shown in the Declarations. E. Additional Insured – Vendors 1.The following change applies if this Coverage Part provides insurance to you for "bodily injury" and "property damage" included in the "products-completed operations hazard": Section II – Who Is An Insured is amended to include as an additional insured any person or organization (referred to throughout this Paragraph E. as vendor) who you have agreed in a written contract or written agreement, prior to loss, to name as an additional insured, but 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 to such vendor: a.Only applies to the extent permitted by law; and b.Will not be broader than that which you are required by the written contract or written agreement to provide for such vendor. 2.With respect to the insurance afforded to these vendors, the following additional exclusions apply: a.The insurance afforded the vendor does not apply to: (1)"Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (2)Any express warranty unauthorized by you; (3)Any physical or chemical change in the product made intentionally by the vendor; (4)Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (5)Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (6)Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; (7)Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or (8)"Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (a)The exceptions contained in Subparagraphs (4) or (6); or (b)Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. b.This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. c.This insurance does not apply to any of "your products" for which coverage is excluded under this Coverage Part. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 4 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 3.With respect to the insurance afforded to the vendor under this endorsement, the following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the vendor is the amount of insurance: a.Required by the written contract or written agreement referenced in Subparagraph E.1. above (of this endorsement); or b.Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This Paragraph E. shall not increase the applicable Limits of Insurance shown in the Declarations. F. Additional Insured – Managers, Lessors or Governmental Entity 1.Section II – Who Is An Insured is amended to include as an insured any person or organization who is a manager, lessor or governmental entity who you are required to add as an additional insured on this policy under a written contract, written agreement or permit, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: a.Your acts or omissions; or b.The acts or omission of those acting on your behalf; and resulting directly from: a.Operations performed by you or on your behalf for which the state or political subdivision has issued a permit; b.Ownership, maintenance, occupancy or use of premises by you; or c.Maintenance, operation or use by you of equipment leased to you by such person or organization. However, the insurance afforded to such additional insured: a.Only applies to the extent permitted by law; and b.Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. 2.This provision does not apply: a.Unless the written contract or written agreement has been executed, or the permit has been issued, prior to the "bodily injury", "property damage" or offense that caused "personal and advertising injury"; b.To any person or organization included as an insured under Paragraph 3. of Section II – Who Is An Insured; c.To any lessor of equipment if the "occurrence" or offense takes place after the equipment lease expires; d.To any: (1)Owners or other interests from whom land has been leased by you; or (2)Managers or lessors of premises, if: (a)The "occurrence" or offense takes place after the expiration of the lease or you cease to be a tenant in that premises; (b)The "bodily injury", "property damage" or "personal and advertising injury" arises out of the structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor; or (c)The premises are excluded under this Coverage Part. 3.With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to Section III – Limits Of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: a.Required by the written contract or written agreement referenced in Subparagraph F.1. above (of this endorsement); or Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 5 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. b.Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This Paragraph F. shall not increase the applicable Limits of Insurance shown in the Declarations. G. Damage to Premises Rented or Occupied by You 1.The last paragraph under Paragraph 2. Exclusions of Section I – Coverage A – Bodily Injury And Property Damage Liability is replaced by the following: Exclusions c. through n. do not apply to damage by "specific perils" to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Damage To Premises Rented To You Limit of Insurance applies to this coverage as described in Section III – Limits Of Insurance. 2.Paragraph 6. of Section III – Limits Of Insurance is replaced by the following: 6.Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is 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 by one or more "specific perils" to any one premises, while rented to you or temporarily occupied by you with permission of the owner. H. Broadened Contractual Liability The "insured contract" definition under the Definitions Section is replaced by the following: "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 organization for damage by "specific perils" to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; b.A sidetrack agreement; c.Any easement or license agreement; d.An obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a 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 party to pay for "bodily injury", "property damage", or "personal and advertising injury" arising out of the offenses of false arrest, detention or imprisonment, to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1)That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a)Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b)Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage; or (2)Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured's rendering or failure to render professional services, including those listed in Paragraph (1) above and supervisory, inspection, architectural or engineering activities. I. Definition – Specific Perils The following definition is added to the Definitions Section: "Specific perils" means: a.Fire; b.Lightning; Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 6 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. c.Explosion; d.Windstorm or hail; e.Smoke; f.Aircraft or vehicles; g.Vandalism; h.Weight of snow, ice or sleet; i.Leakage from fire extinguishing equipment, including sprinklers; or j.Accidental discharge or leakage of water or steam from any part of a system or appliance containing water or steam. J. Limited Contractual Liability Coverage – Personal and Advertising Injury 1.Exclusion e. of Section I – Coverage B – Personal And Advertising Injury Liability is replaced by the following: 2. Exclusions This insurance does not apply to: e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to: (1)Liability for damages that the insured would have in the absence of the contract or agreement; or (2)Liability for "personal and advertising injury" if: (a)The "personal and advertising injury" arises out of the offenses of false arrest, detention or imprisonment; (b)The liability pertains to your business and is assumed in a written contract or written agreement in which you assume the tort liability of another. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement; and (c)The "personal and advertising injury" occurs subsequent to the execution of the written contract or written agreement. Solely for purposes of liability so assumed in such written contract or written agreement, reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "personal and advertising injury" described in Paragraph (a) above, provided: (i)Liability to such party for, or for the cost of, that party's defense has also been assumed in the same written contract or written agreement; and (ii)Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. 2.Paragraph 2.d. of Section I – Supplementary Payments – Coverages A and B is replaced by the following: d.The allegations in the "suit" and the information we know about the "occurrence" or offense are such that no conflict appears to exist between the interests of the insured and the interests of the indemnitee; 3.The following is added to the paragraph directly following Paragraph 2.f. of Section I – Supplementary Payments – Coverages A and B: Notwithstanding the provisions of Paragraph 2.e.(2) of Section I – Coverage B – Personal And Advertising Injury Liability, such payments will not be deemed to be damages for "personal and advertising injury" and will not reduce the limits of insurance. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 7 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. K. Supplementary Payments The following changes apply to Supplementary Payments – Coverages A and B: Paragraphs 1.b. and 1.d. are replaced by the following: b.Up to $2,500 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 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 $500 a day because of time off from work. L. Broadened Property Damage 1. Property Damage to Contents of Premises Rented Short-Term The paragraph directly following Paragraph (6) in Exclusion j. of Section I – Coverage A – Bodily Injury And Property Damage Liability is replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to premises (other than damage by "specific perils"), including "property damage" to the contents of such premises, rented to you under a rental agreement for a period of 14 or fewer consecutive days. A separate Limit of Insurance applies to Damage to Premises Rented to You as described in Section III – Limits Of Insurance. 2. Elevator Property Damage a.The following is added to Exclusion j. of Section I – Coverage A – Bodily Injury And Property Damage Liability: Paragraphs (3) and (4) of this exclusion do not apply to "property damage" arising out of the use of an elevator at premises you own, rent or occupy. b.The following is added to Section III – Limits Of Insurance: Subject to Paragraph 5. above, the most we will pay under Coverage A for damages because of "property damage" to property loaned to you or personal property in the care, custody or control of the insured arising out of the use of an elevator at premises you own, rent or occupy is $25,000 per "occurrence". 3. Property Damage to Borrowed Equipment a.The following is added to Exclusion j. of Section I – Coverage A – Bodily Injury And Property Damage Liability: Paragraph (4) of this exclusion does not apply to "property damage" to equipment you borrow from others at a jobsite. b.The following is added to Section III – Limits Of Insurance: Subject to Paragraph 5. above, the most we will pay under Coverage A for damages because of "property damage" to equipment you borrow from others is $25,000 per "occurrence". M. Expected or Intended Injury or Damage Exclusion a. of Section I – Coverage A – Bodily Injury And Property Damage Liability is replaced by the following: a. Expected Or Intended Injury Or Damage "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. N. Definitions – Bodily Injury The "bodily injury" definition under the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish, mental injury, shock, fright or death sustained by that person which results from that bodily injury, sickness or disease. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 8 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. O. Insured Status – Amateur Athletic Participants Section II – Who Is An Insured is amended to include as an insured any person you sponsor while participating in amateur athletic activities. However, no such person is an insured for: a."Bodily injury" to: (1)Your "employee", "volunteer worker" or any person you sponsor while participating in such amateur athletic activities; or (2)You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company) while participating in such amateur athletic activities; or b."Property damage" to property owned by, occupied or used by, rented to, in the care, custody or control of, or over which the physical control is being exercised for any purpose by: (1)Your "employee", "volunteer worker" or any person you sponsor; or (2)You, any partner or member (if you are a partnership or joint venture), or any member (if you are a limited liability company). P. Non-Owned Aircraft, Auto and Watercraft Exclusion g. of Section I – Coverage A – Bodily Injury And Property Damage Liability is replaced by the following: g. Aircraft, Auto Or Watercraft "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft owned or operated by or rented or loaned to any insured. Use includes operation and "loading or unloading". This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage" involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto" or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: (1)A watercraft while ashore on premises you own or rent; (2)A watercraft you do not own that is: (a)Less than 51 feet long; and (b)Not being used to carry persons for a charge; (3)Parking an "auto" on, or on the ways next to, premises you own or rent, provided the "auto" is not owned by or rented or loaned to you or the insured; (4)Liability assumed under any "insured contract" for the ownership, maintenance or use of aircraft or watercraft; (5)An aircraft that is hired or chartered by you or loaned to you, with a paid and licensed crew, and is not owned in whole or in part by an insured; or (6)"Bodily injury" or "property damage" arising out of: (a)The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment" if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or (b)The operation of any of the machinery or equipment listed in Paragraph f.(2) or f.(3) of the definition of "mobile equipment". Q. Definitions – Leased Worker, Temporary Worker and Labor Leasing Firm 1.The "leased worker" and "temporary worker" definitions under the Definitions Section are replaced by the following: Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 9 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. "Leased worker" means a person leased to you by a "labor leasing firm" under a written agreement between you and the "labor leasing firm", to perform duties related to the conduct of your business. "Leased worker" does not include a "temporary worker". "Temporary worker" means a person who is furnished to you to support or supplement your work force during "employee" absences, temporary skill shortages, upturns or downturns in business or to meet seasonal or short- term workload conditions. "Temporary worker" does not include a "leased worker". 2.The following definition is added to the Definitions Section: "Labor leasing firm" means any person or organization who hires out workers to others, including any: a.Employment agency, contractor or services; b.Professional employer organization; or c.Temporary help service. R. Definition – Mobile Equipment Paragraph f. of the "mobile equipment" definition under the Definitions Section is replaced by the following: f.Vehicles not described in Paragraph a., b., c. or d. above maintained primarily for purposes other than the transportation of persons or cargo. However, self-propelled vehicles with the following types of permanently attached equipment, exceeding a combined gross vehicle weight of 1000 pounds, are not "mobile equipment" but will be considered "autos": (1)Equipment designed primarily for: (a)Snow removal; (b)Road maintenance, but not construction or resurfacing; or (c)Street cleaning; (2)Cherry pickers and similar devices mounted on automobile or truck chassis and used to raise or lower workers; and (3)Air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment. S. Definitions – Your Product and Your Work The "your product" and "your work" definitions under the Definitions Section are replaced by the following: "Your product": a.Means: (1)Any goods or products, other than real property, manufactured, sold, handled, distributed or disposed of by: (a)You; (b)Others trading under your name; or (c)A person or organization whose business or assets you have acquired; and (2)Containers (other than vehicles), materials, parts or equipment furnished in connection with such goods or products. b.Includes: (1)Warranties or representations made at any time with respect to the fitness, quality, durability, performance, use, handling, maintenance, operation or safety of "your product"; and (2)The providing of or failure to provide warnings or instructions. c.Does not include vending machines or other property rented to or located for the use of others but not sold. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 10 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. "Your work": a.Means: (1)Work, services or operations performed by you or on your behalf; and (2)Materials, parts or equipment furnished in connection with such work, services or operations. b.Includes: (1)Warranties or representations made at any time with respect to the fitness, quality, durability, performance, use, handling, maintenance, operation or safety of "your work"; and (2)The providing of or failure to provide warnings or instructions. T. Duties in the Event of Occurrence, Offense, Claim or Suit Condition The following paragraphs are added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV – Commercial General Liability Conditions: Notice of an "occurrence" or of an offense which may result in a claim under this insurance or notice of a claim or "suit" shall be given to us as soon as practicable after knowledge of the "occurrence", offense, claim or "suit" has been reported to any insured listed under Paragraph 1. of Section II – Who Is An Insured or an "employee" authorized by you to give or receive such notice. Knowledge by other "employees" of an "occurrence", offense, claim or "suit" does not imply that you also have such knowledge. In the event that an insured reports an "occurrence" to the workers compensation carrier of the Named Insured and this "occurrence" later develops into a General Liability claim, covered by this Coverage Part, the insured's failure to report such "occurrence" to us at the time of the "occurrence" shall not be deemed to be a violation of this Condition. You must, however, give us notice as soon as practicable after being made aware that the particular claim is a General Liability rather than a Workers Compensation claim. U. Other Insurance Condition Paragraphs 4.a. and 4.b.(1) of the Other Insurance Condition of Section IV – Commercial General Liability Conditions are replaced by the following: 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph c. below. However, this insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: (1)The additional insured is a Named Insured under such other insurance; and (2)You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. Other insurance includes any type of self insurance or other mechanism by which an insured arranges for funding of its legal liabilities. b. Excess Insurance (1)This insurance is excess over: (a)Any of the other insurance, whether primary, excess, contingent or on any other basis: (i)That is property insurance, Builder's Risk, Installation Risk or similar coverage for "your work"; (ii)That is property insurance purchased by you (including any deductible or self insurance portion thereof) to cover premises rented to you or temporarily occupied by you with permission of the owner; Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 11 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. (iii)That is insurance purchased by you (including any deductible or self insurance portion thereof) to cover your liability as a tenant for "property damage" to premises rented to you or temporarily occupied by you with permission of the owner; (iv)If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of Section I – Coverage A – Bodily Injury And Property Damage Liability; or (v)That is property insurance (including any deductible or self insurance portion thereof) purchased by you to cover damage to: Equipment you borrow from others; or Property loaned to you or personal property in the care, custody or control of the insured arising out of the use of an elevator at premises you own, rent or occupy. (b)Any other primary insurance (including any deductible or self insurance portion thereof) available to the insured covering liability for damages arising out of the premises, operations, products, work or services for which the insured has been granted additional insured status either by policy provision or attachment of any endorsement. Other primary insurance includes any type of self insurance or other mechanism by which an insured arranges for funding of its legal liabilities. (c)Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis. V. Unintentional Failure to Disclose All Hazards Paragraph 6. Representations of Section IV – Commercial General Liability Conditions is replaced by the following: 6. 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; and c.We have issued this policy in reliance upon your representations. Coverage will continue to apply if you unintentionally: a.Fail to disclose all hazards existing at the inception of this policy; or b.Make an error, omission or improper description of premises or other statement of information stated in this policy. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to inception of this Coverage Part. W. Waiver of Right of Subrogation Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Commercial General Liability Conditions is replaced by the following: 8. Transfer Of Rights Of Recovery Against Others To Us a.If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. b.If the insured waives its right to recover payments for injury or damage from another person or organization in a written contract executed prior to a loss, we waive any right of recovery we may have against such person or organization because of any payment we have made under this Coverage Part. The written contract will Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1345-C CW (03/20) Page 12 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. be considered executed when the insured's performance begins, or when it is signed, whichever happens first. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. X. Liberalization Condition The following condition is added to Section IV – Commercial General Liability Conditions: Liberalization Clause If we revise this Coverage Part to broaden coverage without an additional premium charge, your policy will automatically provide the additional coverage as of the day the revision is effective in the state shown in the mailing address of your policy. All other terms, conditions, provisions and exclusions of this policy remain the same. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO 0187945-08 Effective Date: 07/01/2024 T i t l e o f f o r m m u s t n o t b e p l a c e d a b o v e t h e l o g o . ↑ T o p M a r g i n 3 / 4 " U-GL-1521-B CW (01/19) Page 1 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Blanket Notification to Others of Cancellation or Non-Renewal This endorsement applies to insurance provided under the: Commercial General Liability Coverage Part A.If we cancel or non-renew this Coverage Part by written notice to the first Named Insured, we will mail or deliver notification that such Coverage Part has been cancelled or non-renewed to each person or organization shown in a list provided to us by the first Named Insured if you are required by written contact or written agreement to provide such notification. Such list: 1.Must be provided to us prior to cancellation or non-renewal; 2.Must contain the names and addresses of only the persons or organizations requiring notification that such Coverage Part has been cancelled or non-renewed; and 3.Must be in an electronic format that is acceptable to us. B.Our notification as described in Paragraph A. of this endorsement will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to the first Named Insured. We will mail or deliver such notification to each person or organization shown in the list: 1.Within 10 days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or 2.At least 30 days prior to the effective date of: a.Cancellation, if cancelled for any reason other than nonpayment of premium; or b.Non-renewal, but not including conditional notice of renewal, unless a greater number of days is shown in the Schedule of this endorsement for the mailing or delivering of such notification with respect to Paragraph B.1. or Paragraph B.2. above. C.Our mailing or delivery of notification described in Paragraphs A. and B. of this endorsement is intended as a courtesy only. Our failure to provide such mailing or delivery will not: 1.Extend the Coverage Part cancellation or non-renewal date; 2.Negate the cancellation or non-renewal; or 3.Provide any additional insurance that would not have been provided in the absence of this endorsement. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A U-GL-1521-B CW (01/19) Page 2 of 2 Includes copyrighted material of Insurance Services Office, Inc., with its permission. D.We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs A. and B. of this endorsement. SCHEDULE The total number of days for mailing or delivering with respect to Paragraph B.1. of this endorsement is amended to indicate the following number of days:7* The total number of days for mailing or delivering with respect to Paragraph B.2. of this endorsement is amended to indicate the following number of days:30** *If a number is not shown here, 10 days continues to apply. ** If a number is not shown here, 30 days continues to apply. All other terms and conditions of this policy remain unchanged. Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A COMMERCIAL AUTOMOBILE HA 99 16 03 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED d. Any "employee" of yours while using a covered "auto" you don't own, hire orA. Subsidiaries and Newly Acquired or borrow in your business or yourFormed Organizations personal affairs.The Named Insured shown in the C. Lessors as InsuredsDeclarations is amended to include: Paragraph A.1. - WHO IS AN INSURED - of(1) Any legal business entity other than a Section II - Liability Coverage is amended topartnership or joint venture, formed as a add:subsidiary in which you have an ownership interest of more than 50% on e. The lessor of a covered "auto" while the the effective date of the Coverage Form."auto" is leased to you under a written However, the Named Insured does not agreement if: include any subsidiary that is an (1) The agreement requires you to"insured" under any other automobile provide direct primary insurance forpolicy or would be an "insured" under the lessor andsuch a policy but for its termination or (2) The "auto" is leased without a driver.the exhaustion of its Limit of Insurance. Such a leased "auto" will be considered a (2) Any organization that is acquired or covered "auto" you own and not a covered formed by you and over which you "auto" you hire.maintain majority ownership. However, the Named Insured does not include any D. Additional Insured if Required by Contract newly formed or acquired organization:(1) Paragraph A.1. - WHO IS AN INSURED (a) That is a partnership or joint - of Section II - Liability Coverage is venture,amended to add: (b) That is an "insured" under any other f. When you have agreed, in a written policy,contract or written agreement, that a (c) That has exhausted its Limit of person or organization be added as Insurance under any other policy, or an additional insured on your business auto policy, such person or(d) 180 days or more after its organization is an "insured", but onlyacquisition or formation by you, to the extent such person orunless you have given us notice of organization is liable for "bodilythe acquisition or formation. injury" or "property damage" causedCoverage does not apply to "bodily by the conduct of an "insured" underinjury" or "property damage" that results paragraphs a. or b. of Who Is Anfrom an "accident" that occurred before Insured with regard to theyou formed or acquired the organization. ownership, maintenance or use of aB. Employees as Insureds covered "auto." Paragraph A.1. - WHO IS AN INSURED - of SECTION II - LIABILITY COVERAGE is amended to add: © 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 Page 1 of 5of ISO Properties, Inc., with its permission.) Policy Number: 51UENBC4812Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A E. Primary and Non-Contributory ifThe insurance afforded to any such Required by Contractadditional insured applies only if the "bodily injury" or "property damage"Only with respect to insurance provided to occurs:an additional insured in 1.D. - Additional (1) During the policy period, and Insured If Required by Contract, the following provisions apply:(2)Subsequent to the execution of such written contract, and (3) Primary Insurance When Required By Contract(3) Prior to the expiration of the period of time that the written contract This insurance is primary if you have requires such insurance be provided agreed in a written contract or written to the additional insured.agreement that this insurance be primary. If other insurance is also(2) How Limits Apply primary, we will share with all that otherIf you have agreed in a written contract insurance by the method described inor written agreement that another Other Insurance 5.d.person or organization be added as an (4) Primary And Non-Contributory To Otheradditional insured on your policy, the Insurance When Required By Contractmost we will pay on behalf of such additional insured is the lesser of:If you have agreed in a written contract or written agreement that this insurance(a) The limits of insurance specified in is primary and non-contributory with thethe written contract or written additional insured's own insurance, thisagreement; or insurance is primary and we will not(b) The Limits of Insurance shown in seek contribution from that otherthe Declarations.insurance. Such amount shall be a part of and not (3) (4)Paragraphs and do not apply to other in addition to Limits of Insurance shown insurance to which the additional insuredin the Declarations and described in this has been added as an additional insured.Section. When this insurance is excess, we will have no (3) Additional Insureds Other Insurance duty to defend the insured against any "suit" if If we cover a claim or "suit" under this any other insurer has a duty to defend the Coverage Part that may also be covered insured against that "suit". If no other insurer by other insurance available to an defends, we will undertake to do so, but we will additional insured, such additional be entitled to the insured's rights against all insured must submit such claim or "suit"those other insurers. to the other insurer for defense and When this insurance is excess over otherindemnity.insurance, we will pay only our share of the However, this provision does not apply amount of the loss, if any, that exceeds the sum to the extent that you have agreed in a of: written contract or written agreement (1) The total amount that all such otherthat this insurance is primary and non-insurance would pay for the loss in thecontributory with the additional insured's absence of this insurance; andown insurance. (2) The total of all deductible and self-insured(4) Duties in The Event Of Accident, Claim,amounts under all that other insurance.Suit or Loss We will share the remaining loss, if any, by the If you have agreed in a written contract method described in Other Insurance 5.d.or written agreement that another 2. AUTOS RENTED BY EMPLOYEESperson or organization be added as an additional insured on your policy, the Any "auto" hired or rented by your "employee" additional insured shall be required to on your behalf and at your direction will be comply with the provisions in LOSS considered an "auto" you hire. CONDITIONS 2. - DUTIES IN THE The OTHER INSURANCE Condition is amended EVENT OF ACCIDENT, CLAIM , SUIT by adding the following: OR LOSS – OF SECTION IV – BUSINESS AUTO CONDITIONS, in the same manner as the Named Insured. © 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 Page 2 of 5of ISO Properties, Inc., with its permission.) Policy Number: 51UENBC4812Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A 5 PHYSICAL DAMAGE - ADDITIONALIf an "employee’s" personal insurance also . TEMPORARY TRANSPORTATION EXPENSE applies on an excess basis to a covered "auto" COVERAGEhired or rented by your "employee" on your behalf and at your direction, this insurance will Paragraph A.4.a. of SECTION III - PHYSICAL be primary to the "employee’s" personal DAMAGE COVERAGE is amended to provide a insurance.limit of $50 per day and a maximum limit of 3. AMENDED FELLOW EMPLOYEE EXCLUSION $1,000. 6. LOAN/LEASE GAP COVERAGEEXCLUSION 5. - FELLOW EMPLOYEE - of SECTION II - LIABILITY COVERAGE does not Under SECTION III - PHYSICAL DAMAGE apply if you have workers' compensation COVERAGE, in the event of a total "loss" to a insurance in-force covering all of your covered "auto", we will pay your additional legal "employees".obligation for any difference between the actual Coverage is excess over any other collectible cash value of the "auto" at the time of the "loss" insurance.and the "outstanding balance" of the loan/lease. 4. HIRED AUTO PHYSICAL DAMAGE COVERAGE "Outstanding balance" means the amount you owe on the loan/lease at the time of "loss" lessIf hired "autos" are covered "autos" for Liability any amounts representing taxes; overdueCoverage and if Comprehensive, Specified payments; penalties, interest or chargesCauses of Loss, or Collision coverages are resulting from overdue payments; additionalprovided under this Coverage Form for any mileage charges; excess wear and tear charges;"auto" you own, then the Physical Damage lease termination fees; security deposits notCoverages provided are extended to "autos" you returned by the lessor; costs for extendedhire or borrow, subject to the following limit. warranties, credit life Insurance, health, accidentThe most we will pay for "loss" to any hired or disability insurance purchased with the loan or"auto" is:lease; and carry-over balances from previous (1) $100,000;loans or leases. (2) The actual cash value of the damaged or 7. AIRBAG COVERAGE stolen property at the time of the "loss"; or Under Paragraph B. EXCLUSIONS - of (3) The cost of repairing or replacing the SECTION III - PHYSICAL DAMAGE damaged or stolen property,COVERAGE, the following is added: whichever is smallest, minus a deductible. The The exclusion relating to mechanical breakdown deductible will be equal to the largest deductible does not apply to the accidental discharge of an applicable to any owned "auto" for that airbag. coverage. No deductible applies to "loss" caused 8. ELECTRONIC EQUIPMENT - BROADENED by fire or lightning. Hired Auto Physical Damage COVERAGE coverage is excess over any other collectible a. The exceptions to Paragraphs B.4 -insurance. Subject to the above limit, deductible EXCLUSIONS - of SECTION III - PHYSICALand excess provisions, we will provide coverage DAMAGE COVERAGE are replaced by theequal to the broadest coverage applicable to any following:covered "auto" you own. 4.c. 4.d.Exclusions and do not apply to We will also cover loss of use of the hired "auto" equipment designed to be operated solelyif it results from an "accident", you are legally by use of the power from the "auto's"liable and the lessor incurs an actual financial electrical system that, at the time of "loss", loss, subject to a maximum of $1000 per is:"accident". (1) Permanently installed in or uponThis extension of coverage does not apply to the covered "auto";any "auto" you hire or borrow from any of your "employees", partners (if you are a partnership),(2) Removable from a housing unit members (if you are a limited liability company),which is permanently installed in or members of their households.or upon the covered "auto"; (3) An integral part of the same unit housing any electronic equipment described in Paragraphs (1) and (2) above; or © 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 Page 3 of 5of ISO Properties, Inc., with its permission.) Policy Number: 51UENBC4812Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A (4) Necessary for the normal If another Hartford Financial Services Group, operation of the covered "auto" or Inc. company policy or coverage form that is not the monitoring of the covered an automobile policy or coverage form applies to "auto's" operating system.the same "accident", the following applies: b.Section III – Version CA 00 01 03 10 of the (1) If the deductible under this Business Auto Business Auto Coverage Form, Physical Coverage Form is the smaller (or smallest) Damage Coverage, Limit of Insurance,deductible, it will be waived; Paragraph C.2 and Version CA 00 01 10 01 of (2) If the deductible under this Business Auto the Business Auto Coverage Form, Physical Coverage Form is not the smaller (or Damage Coverage, Limit of Insurance,smallest) deductible, it will be reduced by Paragraph C are each amended to add the the amount of the smaller (or smallest) following:deductible. $1,500 is the most we will pay for "loss" in 12. AMENDED DUTIES IN THE EVENT OF any one "accident" to all electronic ACCIDENT, CLAIM, SUIT OR LOSS equipment (other than equipment designed The requirement in LOSS CONDITIONS 2.a. -solely for the reproduction of sound, and DUTIES IN THE EVENT OF ACCIDENT,CLAIM,accessories used with such equipment)SUIT OR LOSS - of SECTION IV - BUSINESSthat reproduces, receives or transmits AUTO CONDITIONS that you must notify us ofaudio, visual or data signals which, at the an "accident" applies only when the "accident" istime of "loss", is:known to: (1) Permanently installed in or upon (1) You, if you are an individual;the covered "auto" in a housing, (2) A partner, if you are a partnership;opening or other location that is not normally used by the "auto"(3) A member, if you are a limited liability manufacturer for the installation of company; or such equipment;(4) An executive officer or insurance manager, if (2) Removable from a permanently you are a corporation. installed housing unit as described 13. UNINTENTIONAL FAILURE TO DISCLOSEin Paragraph 2.a. above or is an HAZARDSintegral part of that equipment; or If you unintentionally fail to disclose any hazards(3) An integral part of such equipment.existing at the inception date of your policy, we c.For each covered "auto", should loss be limited will not deny coverage under this Coverage to electronic equipment only, our obligation to Form because of such failure. pay for, repair, return or replace damaged or 14. HIRED AUTO - COVERAGE TERRITORYstolen electronic equipment will be reduced by Paragraph e. of GENERAL CONDITIONS 7. -the applicable deductible shown in the POLICY PERIOD, COVERAGE TERRITORY -Declarations, or $250, whichever deductible is of SECTION IV - BUSINESS AUTOless. CONDITIONS is replaced by the following:9. EXTRA EXPENSE - BROADENED e. For short-term hired "autos", the coverageCOVERAGE territory with respect to Liability Coverage isUnder Paragraph A. - COVERAGE - of SECTION anywhere in the world provided that if theIII - PHYSICAL DAMAGE COVERAGE, we will "insured's" responsibility to pay damages forpay for the expense of returning a stolen covered "bodily injury" or "property damage" is"auto" to you.determined in a "suit," the "suit" is brought in 10. GLASS REPAIR - WAIVER OF DEDUCTIBLE the United States of America, the territories and possessions of the United States ofUnder Paragraph D. - DEDUCTIBLE - of SECTION America, Puerto Rico or Canada or in aIII - PHYSICAL DAMAGE COVERAGE, the settlement we agree to.following is added: 15. WAIVER OF SUBROGATIONNo deductible applies to glass damage if the glass is repaired rather than replaced.TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - of SECTION IV -11. TWO OR MORE DEDUCTIBLES BUSINESS AUTO CONDITIONS is amended byUnder Paragraph D. - DEDUCTIBLE - of SECTION adding the following:III - PHYSICAL DAMAGE COVERAGE, the following is added: © 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 Page 4 of 5of ISO Properties, Inc., with its permission.) Policy Number: 51UENBC4812Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A We waive any right of recovery we may have c.Regardless of the number of autos deemed a against any person or organization with whom total loss, the most we will pay under this you have a written contract that requires such Hybrid, Electric, or Natural Gas Vehicle waiver because of payments we make for Payment Coverage provision for any one damages under this Coverage Form."loss" is $10,000. 16. RESULTANT MENTAL ANGUISH COVERAGE For the purposes of the coverage provision, The definition of "bodily injury" in SECTION V-a.A "non-hybrid" auto is defined as an auto that DEFINITIONS is replaced by the following:uses only an internal combustion engine to move the auto but does not include autos"Bodily injury" means bodily injury, sickness or powered solely by electricity or natural gas.disease sustained by any person, including mental anguish or death resulting from any of b.A "hybrid" auto is defined as an auto with an these.internal combustion engine and one or more electric motors; and that uses the internal17.EXTENDED CANCELLATION CONDITION combustion engine and one or more electricParagraph 2. of the COMMON POLICY motors to move the auto, or the internalCONDITIONS - CANCELLATION - applies combustion engine to charge one or moreexcept as follows:electric motors, which move the auto. If we cancel for any reason other than 19. VEHICLE WRAP COVERAGE nonpayment of premium, we will mail or deliver In the event of a total loss to an "auto" for whichto the first Named Insured written notice of Comprehensive, Specified Causes of Loss, orcancellation at least 60 days before the effective Collision coverages are provided under thisdate of cancellation. Coverage Form, then such Physical Damage18. HYBRID, ELECTRIC, OR NATURAL GAS Coverages are amended to add the following:VEHICLE PAYMENT COVERAGE In addition to the actual cash value of the "auto",In the event of a total loss to a "non-hybrid" auto we will pay up to $1,000 for vinyl vehicle wrapsfor which Comprehensive, Specified Causes of which are displayed on the covered "auto" at theLoss, or Collision coverages are provided under time of total loss. Regardless of the number ofthis Coverage Form, then such Physical autos deemed a total loss, the most we will payDamage Coverages are amended as follows:under this Vehicle Wrap Coverage provision for a.If the auto is replaced with a "hybrid" auto or any one "loss" is $5,000. For purposes of this an auto powered solely by electricity or natural coverage provision, signs or other graphics gas, we will pay an additional 10%, to a painted or magnetically affixed to the vehicle are maximum of $2,500, of the "non-hybrid" auto’s not considered vehicle wraps. actual cash value or replacement cost, whichever is less, b.The auto must be replaced and a copy of a bill of sale or new lease agreement received by us within 60 calendar days of the date of "loss," © 2011, The Hartford (Includes copyrighted material Form HA 99 16 03 12 Page 5 of 5of ISO Properties, Inc., with its permission.) Policy Number: 51UENBC4812Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A WC 252 (4-84) WC 04 03 06 (Ed. 4-84)Page 1 of 1 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be of the California workers' compensation pre-mium otherwise due on such remuneration. Schedule Person or Organization Job Description ANY PERSON AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION Policy Number: WC 0380745-09 Effective Date: 7-1-2024 Policy Number: WC 0380745-09Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A WC 99 06 43 Page 1 of 1 (Ed. 01-13) Includes copyright material of the National Council on Compensation Insurance, Inc. used with its permission. 2012 Copyright National Council on Compensation Insurance, Inc. All Rights Reserved. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 43 BLANKET NOTIFICATION TO OTHERS OF CANCELLATION OR NONRENEWAL ENDORSEMENT This endorsement adds the following to Part Six of the policy. PART SIX CONDITIONS Blanket Notification to Others of Cancellation or Nonrenewal 1. If we cancel or non-renew this policy by written notice to you, we will mail or deliver notification that such policy has been cancelled or non-renewed to each person or organization shown in a list provided to us by you if you are required by written contract or written agreement to provide such notification. However, such notification will not be mailed or delivered if a conditional notice of renewal has been sent to you. Such list: a. Must be provided to us prior to cancellation or non-renewal; b. Must contain the names and addresses of only the persons or organizations requiring notification that such policy has been cancelled or non-renewed; and c. Must be in an electronic format that is acceptable to us. 2. Our notification as described in Paragraph 1. above will be based on the most recent list in our records as of the date the notice of cancellation or non-renewal is mailed or delivered to you. We will mail or deliver such notification to each person or organization shown in the list: a. Within seven days of the effective date of the notice of cancellation, if we cancel for non-payment of premium; or b. At least 30 days prior to the effective date of: (1) Cancellation, if cancelled for any reason other than nonpayment of premium; or (2) Non-renewal, but not including conditional notice of renewal. 3. Our mailing or delivery of notification described in Paragraphs 1. and 2. above is intended as a courtesy only. Our failure to provide such mailing or delivery will not: a. Extend the policy cancellation or non-renewal date; b. Negate the cancellation or non-renewal; or c. Provide any additional insurance that would not have been provided in the absence of this endorsement. 4. We are not responsible for the accuracy, integrity, timeliness and validity of information contained in the list provided to us as described in Paragraphs 1. and 2. above. All other terms and conditions of this policy remain unchanged. 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 Policy No. Endorsement No. Insured Premium $ Insurance Company Policy Number: WC 0380745-09 7-1-2024 WC 0380745-09 American Grape Harvesters, Inc. PB Loader Corporation Docusign Envelope ID: F951718E-F03B-4BD0-AE4D-BD13852BE35A