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HomeMy WebLinkAboutC18-376 Vail Honeywagon EnterprisesAGREEMENT FOR SERVICES
BETWEEN EAGLE COUNTY, COLORADO
AND
VAIL HONEYWAGON ENTERPRISES, LLC
THIS AGREEMENT (“Agreement”) is effective as of _________________ by and between Vail Honeywagon
Enterprises, LLC a Colorado limited liability company (hereinafter “Contractor”) and Eagle County, Colorado, a
body corporate and politic (hereinafter “County”).
RECITALS
WHEREAS, the County issued a request for proposals ("RFP") on September 24, 2018, seeking the services of a
vendor to transport collected material from drop-off collection sites situated throughout greater Eagle County to the
Eagle County Materials Recovery Facility (MRF) located at 605 Ute Creek Road Wolcott, Colorado (the
“Property”). A copy of the RFP is attached hereto as Exhibit A and incorporated herein by reference; and
WHEREAS, as a result of the RFP process, Contractor was selected as the successful respondent to provide the
Services. A copy of Contractor's proposal is attached hereto as Exhibit B and incorporated herein by reference.
Contractor is authorized to do business in the State of Colorado and has the time, skill, expertise, and experience
necessary to provide the Services as defined below in paragraph 1 hereof; and
WHEREAS, this Agreement shall govern the relationship between Contractor and County in connection with the
Services.
AGREEMENT
NOW, THEREFORE, in consideration of the foregoing and the following promises Contractor and County agree as
follows:
1. Services or Work. Contractor agrees to diligently provide all services, labor, personnel and materials
necessary to perform and complete the services or work described in Exhibit C (“Services” or “Work”) which is
attached hereto and incorporated herein by reference. The Services shall be performed in accordance with the
provisions and conditions of this Agreement.
a. Contractor agrees to furnish the Services in accordance with the Hauling Frequency Schedule
established in Exhibit C. Contractor agrees to furnish the Services in a timely and expeditious manner consistent
with the applicable standard of care. By signing below Contractor represents that it has the expertise and personnel
necessary to properly and timely perform the Services.
b. In the event of any conflict or inconsistency between the terms and conditions set forth in Exhibit
C and the terms and conditions set forth in this Agreement, the terms and conditions set forth in this Agreement shall
prevail.
c. Contractor agrees to provide the necessary vehicles and drivers to haul recycle collection
containers to the Eagle County MRF from various drop-off collection sites located throughout greater Eagle County.
The collection sites are identified in Exhibit C (collectively “sites” and each a “site”).
d. County owns and will provide roll-off containers at the sites for the collection of commingled
containers (“commingle”), newspaper, and cardboard. The County will provide a total of 14 roll-off containers: four
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(4) 30 cubic yard containers for Avon, four (4) 30 cubic yard containers for Edwards, three (3) 40 cubic yard
containers for Eagle, and three (3) 40 cubic yard containers for Gypsum sites for collection of commingle,
newspaper, and cardboard. The County will provide swap containers as needed for the sites.
e. Contractor shall be responsible for providing a cardboard collection container at the site in Red
Cliff. The Red Cliff site requires one (1) container for cardboard. Cardboard container must be eight (8) cubic yard
frontload dumpster with lid. Containers are required to be in good condition with operable slotted cardboard lids.
Contractor shall be responsible, at its sole expense, for the repair and maintenance of all cardboard collection
containers supplied pursuant to this Agreement. On cardboard collection days (excluding Saturdays) the drop-site
cardboard will need to be collected separate from any commercial or non-drop site cardboard and delivered to the
Eagle County Recycle MRF the next business morning. Cardboard collection on Saturday will require the delivery
of the material to the Eagle County MRF the next business day. Contractor shall provide the one (1) container at the
Red Cliff site. Reloads will be at no additional expense to the County.
f. The Contractor may not place any signage on the County containers unless prior approval is
obtained from the Eagle County Solid Waste & Recycling Department.
g. Contractor is responsible, at its sole expense, for repairs to any damaged roll-off containers when
the damage is caused by Contractor’s or its employee’s negligence.
h. Contractor is required to haul all collected material to the Eagle County MRF. There will be no
tipping fees assessed to the Contractor.
1. Collection site cleanup will be provided by the County.
j. The County may provide or request that Contractor provide, additional open-top 30 cubic yard
roll-off containers at the collection sites set forth in Exhibit C during holiday seasons, and Contractor will be
compensated at $200.00 per haul.
k. County will have the option at its discretion to change to eight (8) cubic yard frontload dumpsters
with lids at Avon and Edwards if they deem necessary.
2. County’s Representative. The Solid Waste and Recycling Department’s designee shall be Contractor’s
contact with respect to this Agreement and performance of the Services.
3. Term of the Agreement. This Agreement shall commence upon the date first written above, and subject to
the provisions of paragraph 11 hereof, shall continue in full force and effect through the 31st day of December, 2019.
4. Extension or Modification. This Agreement may be extended for up to three additional one year terms
upon written agreement of the parties. Any amendments or modifications shall be in writing signed by both parties.
No additional services or work performed by Contractor shall be the basis for additional compensation unless and
until Contractor has obtained written authorization and acknowledgement by County for such additional services in
accordance with County’s internal policies. Accordingly, no course of conduct or dealings between the parties, nor
verbal change orders, express or implied acceptance of alterations or additions to the Services, and no claim that
County has been unjustly enriched by any additional services, whether or not there is in fact any such unjust
enrichment, shall be the basis of any increase in the compensation payable hereunder. In the event that written
authorization and acknowledgment by County for such additional services is not timely executed and issued in strict
accordance with this Agreement, Contractor’s rights with respect to such additional services shall be deemed waived
and such failure shall result in non-payment for such additional services or work performed.
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5. Compensation. County shall compensate Contractor for the performance of the Services in a sum
computed and payable as set forth in Exhibit C. The performance of the Services under this Agreement shall not
exceed $250,000.00. Contractor shall not be entitled to bill at overtime and/or double time rates for work done
outside of normal business hours unless specifically authorized in writing by County.
a. Payment will be made for Services satisfactorily performed within thirty (30) days of receipt of a
proper and accurate invoice from Contractor. All invoices shall include detail regarding the hours spent, tasks
performed, who performed each task and such other detail as County may request.
b. If, at any time during the term or after termination or expiration of this Agreement, County
reasonably determines that any payment made by County to Contractor was improper because the Services for
which payment was made were not performed as set forth in this Agreement, then upon written notice of such
determination and request for reimbursement from County, Contractor shall forthwith return such payment(s) to
County. Upon termination or expiration of this Agreement, unexpended funds advanced by County, if any, shall
forthwith be returned to County.
c. County will not withhold any taxes from monies paid to the Contractor hereunder and Contractor
agrees to be solely responsible for the accurate reporting and payment of any taxes related to payments made
pursuant to the terms of this Agreement.
d. Notwithstanding anything to the contrary contained in this Agreement, County shall have no
obligations under this Agreement after, nor shall any payments be made to Contractor in respect of any period after
December 31 of any year, without an appropriation therefor by County in accordance with a budget adopted by the
Board of County Commissioners in compliance with Article 25, title 30 of the Colorado Revised Statutes, the Local
Government Budget Law (C.R.S. 29-1-101 et. seq.) and the TABOR Amendment (Colorado Constitution, Article X,
Sec. 20).
e. Contractor's fees for Services, set forth in Exhibit C, shall be subject to a 3% increase for each
term that this Agreement is extended.
6. Subcontractors. Contractor acknowledges that County has entered into this Agreement in reliance upon the
particular reputation and expertise of Contractor. Contractor shall not enter into any subcontractor agreements for
the performance of any of the Services or additional services without County’s prior written consent, which may be
withheld in County’s sole discretion. County shall have the right in its reasonable discretion to approve all
personnel assigned to the subject Project during the performance of this Agreement and no personnel to whom
County has an objection, in its reasonable discretion, shall be assigned to the Project. Contractor shall require each
subcontractor, as approved by County and to the extent of the Services to be performed by the subcontractor, to be
bound to Contractor by the terms of this Agreement, and to assume toward Contractor all the obligations and
responsibilities which Contractor, by this Agreement, assumes toward County. County shall have the right (but not
the obligation) to enforce the provisions of this Agreement against any subcontractor hired by Contractor and
Contractor shall cooperate in such process. The Contractor shall be responsible for the acts and omissions of its
agents, employees and subcontractors.
7. Insurance. Contractor agrees to provide and maintain at Contractor’s sole cost and expense, the following
insurance coverage with limits of liability not less than those stated below:
a. Types of Insurance.
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i. Workers’ Compensation insurance as required by law.
ii. Auto coverage with limits of liability not less than $1,000,000 each accident combined
bodily injury and property damage liability insurance, including coverage for owned, hired, and non-owned
vehicles.
iii. Commercial General Liability coverage to include premises and operations,
personal/advertising injury, products/completed operations, broad form property damage with limits of liability not
less than $1,000,000 per occurrence and $1,000,000 aggregate limits.
b. Other Requirements.
i. The automobile and commercial general liability coverage shall be endorsed to include
Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and
volunteers as additional insureds. A certificate of insurance consistent with the foregoing requirements is attached
hereto as Exhibit B.
ii. Contractor’s certificates of insurance shall include subcontractors, if any as additional
insureds under its policies or Contractor shall furnish to County separate certificates and endorsements for each
subcontractor.
iii. The insurance provisions of this Agreement shall survive expiration or
termination hereof.
iv. The parties hereto understand and agree that the County is relying on, and does
not waive or intend to waive by any provision of this Agreement, the monetary limitations or rights, immunities and
protections provided by the Colorado Governmental Immunity Act, as from time to time amended, or otherwise
available to County, its affiliated entities, successors or assigns, its elected officials, employees, agents and
volunteers.
v. Contractor is not entitled to workers’ compensation benefits except as
provided by the Contractor, nor to unemployment insurance benefits unless unemplo yment compensation coverage
is provided by Contractor or some other entity. The Contractor is obligated to pay all federal and state income tax
on any moneys paid pursuant to this Agreement.
8. Indemnification. The Contractor shall indemnify and hold harmless County, and any of its officers, agents
and employees against any losses, claims, damages or liabilities for which County may become subject to insofar as
any such losses, claims, damages or liabilities arise out of, directly or indirectly, this Agreement, or are based upon
any performance or nonperformance by Contractor its employees, agents or any of its subcontractors hereunder; and
Contractor shall reimburse County for reasonable attorney fees and costs, legal and other expenses incurred by
County in connection with investigating or defending any such loss, claim, damage, liability or action. This
indemnification shall not apply to claims by third parties against the County to the extent that County is liable to
such third party for such claims without regard to the involvement of the Contractor. This paragraph shall survive
expiration or termination hereof.
9. Ownership of Documents. All documents (including electronic files) and materials obtained during,
purchased or prepared in the performance of the Services shall remain the property of the County and are to be
delivered to County before final payment is made to Contractor or upon earlier termination of this Agreement.
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10. Notice. Any notice required by this Agreement shall be deemed properly delivered when (i) personally
delivered, or (ii) when mailed in the United States mail, first class postage prepaid, or (iii) when delivered by FedEx
or other comparable courier service, charges prepaid, to the parties at their respective addresses listed below, or (iv)
when sent via facsimile so long as the sending party can provide facsimile machine or other confirmation showing
the date, time and receiving facsimile number for the transmission, or (v) when transmitted via e-mail with
confirmation of receipt. Either party may change its address for purposes of this paragraph by giving five (5) days
prior written notice of such change to the other party.
COUNTY:
Eagle County, Colorado
Attention: Jesse Masten
815 Ute Creek Road
Post Office Box 473
Wolcott, CO 81655
Telephone: 970-328-3472
Facsimile: 970-328-3466
E-Mail: jesse.masten@eaglecounty.us
With a copy to:
Eagle County Attorney
500 Broadway
Post Office Box 850
Eagle, Co 81631
Telephone: 970-328-8685
Facsimile: 970-328-8699
E-Mail: atty@eaglecounty.us
CONTRACTOR:
Vail Honeywagon Enterprises, LLC
Post Office Box 4330
Edwards, CO 81632
Telephone: 970-476-3511
Facsimile: 970-926-3712
E-Mail: requests@vailhoneywagon.com
11. Termination. County may terminate this Agreement, in whole or in part, at any time and for any reason,
with or without cause, and without penalty therefor with seven (7) calendar days’ prior written notice to the
Contractor. Upon termination of this Agreement, Contractor shall immediately provide County with all documents
as defined in paragraph 9 hereof, in such format as County shall direct and shall return all County owned materials
and documents. County shall pay Contractor for Services satisfactorily performed to the date of termination.
12. Venue, Jurisdiction and Applicable Law. Any and all claims, disputes or controversies related to this
Agreement, or breach thereof, shall be litigated in the District Court for Eagle County, Colorado, which shall be the
sole and exclusive forum for such litigation. This Agreement shall be construed and interpreted under and shall be
governed by the laws of the State of Colorado.
13. Execution by Counterparts; Electronic Signatures. This Agreement may be executed in two or more
counterparts, each of which shall be deemed an original, but all of which shall constitute one and the same
instrument. The parties approve the use of electronic signatures for execution of this Agreement. Only the following
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two forms of electronic signatures shall be permitted to bind the parties to this Agreement: (i) Electronic or
facsimile delivery of a fully executed copy of the signature page; (ii) the image of the signature of an authorized
signer inserted onto PDF format documents. All documents must be properly notarized, if applicable. All use of
electronic signatures shall be governed by the Uniform Electronic Transactions Act, C.R.S. 24-71.3-101 to 121.
14. Other Contract Requirements and Contractor Representations.
a. Contractor has familiarized itself with the nature and extent of the Services to be provided
hereunder and the Property, and with all local conditions, federal, state and local laws, ordinances, rules and
regulations that in any manner affect cost, progress, or performance of the Services.
b. Contractor will make, or cause to be made, examinations, investigations, and tests as he deems
necessary for the performance of the Services.
c. To the extent possible, Contractor has correlated the results of such observations, examinations,
investigations, tests, reports, and data with the terms and conditions of this Agreement.
d. To the extent possible, Contractor has given County written notice of all conflicts, errors, or
discrepancies.
e. Contractor shall be responsible for the completeness and accuracy of the Services and shall
correct, at its sole expense, all significant errors and omissions in performance of the Services. The fact that the
County has accepted or approved the Services shall not relieve Contractor of any of its responsibilities. Contractor
shall perform the Services in a skillful, professional and competent manner and in accordance with the standard of
care, skill and diligence applicable to contractors performing similar services. Contractor represents and warrants
that it has the expertise and personnel necessary to properly perform the Services and shall comply with the highest
standards of customer service to the public. Contractor shall provide appropriate supervision to its employees to
ensure the Services are performed in accordance with this Agreement. This paragraph shall survive termination of
this Agreement.
f. Contractor agrees to work in an expeditious manner, within the sound exercise of its judgment and
professional standards, in the performance of this Agreement. Time is of the essence with respect to this
Agreement.
g. This Agreement constitutes an agreement for performance of the Services by Contractor as an
independent contractor and not as an employee of County. Nothing contained in this Agreement shall be deemed to
create a relationship of employer-employee, master-servant, partnership, joint venture or any other relationship
between County and Contractor except that of independent contractor. Contractor shall have no authority to bind
County.
h. Contractor represents and warrants that at all times in the performance of the Services, Contractor
shall comply with any and all applicable laws, codes, rules and regulations.
i. This Agreement contains the entire agreement between the parties with respect to the subject
matter hereof and supersedes all other agreements or understanding between the parties with respect thereto.
j. Contractor shall not assign any portion of this Agreement without the prior written consent of the
County. Any attempt to assign this Agreement without such consent shall be void.
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k. This Agreement shall be binding upon and shall inure to the benefit of the parties hereto and their
respective permitted assigns and successors in interest. Enforcement of this Agreement and all rights and obligations
hereunder are reserved solely for the parties, and not to any third party.
l. No failure or delay by either party in the exercise of any right hereunder shall constitute a waiver
thereof. No waiver of any breach shall be deemed a waiver of any preceding or succeeding breach.
m. The invalidity, illegality or unenforceability of any provision of this Agreement shall not affect the
validity or enforceability of any other provision hereof.
n. The signatories to this Agreement aver to their knowledge no employee of the County has any
personal or beneficial interest whatsoever in the Services or Property described in this Agreement. The Contractor
has no beneficial interest, direct or indirect, that would conflict in any manner or degree with the performance of the
Services and Contractor shall not employ any person having such known interests.
o. The Contractor, if a natural person eighteen (18) years of age or older, hereby swears and affirms
under penalty of perjury that he or she (i) is a citizen or otherwise lawfully present in the United States pursuant to
federal law, (ii) to the extent applicable shall comply with C.R.S. 24-76.5-103 prior to the effective date of this
Agreement.
15. Prohibitions on Government Contracts.
As used in this Section 15, the term undocumented individual will refer to those individuals from foreign countries
not legally within the United States as set forth in C.R.S. 8-17.5-101, et. seq. If Contractor has any employees or
subcontractors, Contractor shall comply with C.R.S. 8-17.5-101, et. seq., and this Agreement. By execution of this
Agreement, Contractor certifies that it does not knowingly employ or contract with an undocumented individual
who will perform under this Agreement and that Contractor will participate in the E-verify Program or other
Department of Labor and Employment program (“Department Program”) in order to confirm the eligibility of all
employees who are newly hired for employment to perform Services under this Agreement.
a. Contractor shall not:
i. Knowingly employ or contract with an undocumented individual to perform Services
under this Agreement; or
ii. Enter into a subcontract that fails to certify to Contractor that the subcontractor shall not
knowingly employ or contract with an undocumented individual to perform work under the public contract for
services.
b. Contractor has confirmed the employment eligibility of all employees who are newly hired for
employment to perform Services under this Agreement through participation in the E-Verify Program or Department
Program, as administered by the United States Department of Homeland Security. Information on applying for the
E-verify program can be found at:
https://www.uscis.gov/e-verify
c. Contractor shall not use either the E-verify program or other Department Program procedures to
undertake pre-employment screening of job applicants while the public contract for services is being performed.
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d. If Contractor obtains actual knowledge that a subcontractor performing work under the public
contract for services knowingly employs or contracts with an undocumented individual, Contractor shall be required
to:
i. Notify the subcontractor and County within three (3) days that Contractor has actual
knowledge that the subcontractor is employing or contracting with an undocumented individual; and
ii. Terminate the subcontract with the subcontractor if within three days of receiving the
notice required pursuant to subparagraph (i) of the paragraph (d) the subcontractor does not stop employing or
contracting with the undocumented individual; except that Contractor shall not terminate the contract with the
subcontractor if during such three (3) days the subcontractor provides information to establish that the subcontractor
has not knowingly employed or contracted with an undocumented individual.
e. Contractor shall comply with any reasonable request by the Department of Labor and Employment
made in the course of an investigation that the department is undertaking pursuant to its authority established in
C.R.S. 8-17.5-102(5).
f. If Contractor violates these prohibitions, County may terminate the Agreement for breach of
contract. If the Agreement is so terminated specifically for breach of this provision of this Agreement, Contractor
shall be liable for actual and consequential damages to County as required by law.
g. County will notify the Colorado Secretary of State if Contractor violates this provision of this
Agreement and County terminates the Agreement for such breach.
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EXHIBIT A
REQUEST FOR PROPOSALS
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EXHIBIT B
CONTRACTOR'S PROPOSAL
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EXHIBIT C
SCOPE OF SERVICES, SCHEDULE, FEES
County shall compensate Contractor for the satisfactory performance of the Services as follows:
1. Roll-off container hauling: County will pay Contractor $200.00 per haul.
2. Red Cliff cardboard hauling: County will pay Contractor $300.00 per haul.
3. Monthly pricing for front load cardboard collection, yellow slotted-locking bars (8-yard containers, 6
total at Edwards and Avon: County will pay Contractor $7,794.00 per month.
Drop-Off Collection Centers:
1. Avon: 375 Yoder Ave Town of Avon Public Works
2. Edwards: CDOT Rest Area near I-70 exit 163
3. Eagle: 1050 Chamber Ave. Town of Eagle Public Works Facility
4. Gypsum: Ridley’s Market Parking Lot Northwest Corner
5. Red Cliff: 400 Pine St. Community Center
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EXHIBIT D
INSURANCE CERTIFICATE
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ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
INSR ADDL SUBR
LTR INSD WVD
PRODUCER CONTACT
NAME:
FAXPHONE
(A/C, No):(A/C, No, Ext):
E-MAIL
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY)
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
EACH OCCURRENCE $
DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)
MED EXP (Any one person)$
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $
PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT
OTHER:$
COMBINED SINGLE LIMIT
$(Ea accident)
ANY AUTO BODILY INJURY (Per person)$
OWNED SCHEDULED
BODILY INJURY (Per accident)$AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE
$AUTOS ONLY AUTOS ONLY (Per accident)
$
OCCUR EACH OCCURRENCE
CLAIMS-MADE AGGREGATE $
DED RETENTION $
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below
INSURER(S) AFFORDING COVERAGE NAIC #
COMMERCIAL GENERAL LIABILITY
Y / N
N / A
(Mandatory in NH)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
$
$
$
$
$
The ACORD name and logo are registered marks of ACORD
12/22/2017
License # 0757776
(303) 893-0300 (866) 243-0727
13021
Vail Honeywagon Enterprises, LLC
955 Ute Creek Road
Wolcott, CO 81655
28053
41190
A 1,000,000
X X 60488166 01/01/2018 01/01/2019 100,000
5,000
1,000,000
2,000,000
2,000,000
1,000,000A
X X 60488166 01/01/2018 01/01/2019
2,000,000B
FF02167300 01/01/2018 01/01/2019 2,000,000
0
C
X 4133726 01/01/2018 01/01/2019 1,000,000
1,000,000
1,000,000
Eagle County is included as additional insured under General Liability and Automobile Liability on a primary and non-contributory basis.
Eagle County
P.O. Box 473
Wolcott, CO 81655
MOUNWAS-01 AWILLIAMSON1
HUB International Insurance Services (COL)
1125 17th Street, Suite 900
Denver, CO 80202
Jessica Roscoe
jessica.roscoe@hubinternational.com
United Fire & Casualty
Rockhill Insurance
Pinnacol Assurance Company
X
X
X
X X
X
X
X
X
DocuSign Envelope ID: CCA23F11-F9F8-47A2-B9A2-3B9D83926945
CG 71 03 07 17
ULTRA LIABILITY PLUS ENDORSEMENT
COMMERCIAL GENERAL LIABILITY EXTENSION ENDORSEMENT SUMMARY OF COVERAGES
This is a summary of the various additional coverages and coverage modifications provided by this
endorsement. No coverage is provided by this summary.
• Extended Property Damage
• Expanded Fire Legal Liability to include Explosion. Lightning and Sprinkler Leakage
• Coverage for non-owned watercraft is extended to 5 t feet in length
• Property Damage · Borrowed Equipment
• Property Damage Liability -Elevators
• Coverage D -Voluntary Property Damage Coverage
S5.000 Occurrence with a $10,000 Aggregate
• Coverage E -Care, Custody and Control Property Damage Coverage
S25,000 Occurrence with a $100,000 Aggregate -$500 Deductible
• Coverage F -Electronic Data Liability Coverage -$50,000
• Coverage G -Product Recall Expense
$25,000 Each Recall Limit with a $50,000 Aggregate -$1,000 Deductible
• Coverage H -Water Damage Legal Liability -$25,000
• Increase in Supplementary Payments: Bail Bonds to $1,000
• Increase in Supplementary Payments: Loss of Earnings lo $500
• For newly formed or acquired organizations -extend the reporting requirement to 180 days
• Broadened Named Insured
• Automatic Additional Insured -Owners, Lessees or Contractors -Automatic Status When Required in Construction
Agreement With You -Including Upstream Parties
• Automatic Additional Insured -Vendors
• Automatic Additional Insured -Lessor of Leased Equipment Automatic Status When Required in Lease Agreement With
You
• Automatic Additional Insured -Managers or Lessor of Premises
• Additional Insured -Engineers, Architects or Surveyors Not Engaged by the Named Insured
• Additional Insured -Employee Injury to Another Employee
• Automatically included -Aggregate Limits of Insurance (per location)
• Automatically included -Aggregate Limits of Insurance (per project)
• Knowledge of occurrence -Knowledge of an "occurrence'', "claim or suit"' by your agent, servant or employee shall not in
itself constitute knowledge of the named insured unless an olficer of the named insured has received such notice from
the agent, servant or employee
• Blanket Waiver of Subrogation
• Liberalization Condition
• Unintentional failure to disclose all hazards. If you unintentionally fail to disclose any hazards existing at the inception
date of your policy, we will not deny coverage under this Coverage Form because of such failure. However, this
provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal.
• Mobile equipment to include snow removal, road maintenance and street cleaning equipment less than 1,000 lbs GVW
• Bodily Injury Redefined
REFER TO THE ACTUAL ENDORSEMENT FOLLOWING ON PAGES 2 THROUGH 12 FOR CHANGES AFFECTING
YOUR INSURANCE PROTECTION
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Policy #60488166
DocuSign Envelope ID: CCA23F11-F9F8-47A2-B9A2-3B9D83926945
CG 71 03 07 17
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ULTRA LIABILITY PLUS ENDORSEMENT
This endorsement mod1f1es insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SECTION I -COVERAGES
A. The following changes are made at COVERAGE A -BODILY INJURY AND PROPERTY DAMAGE LIABILITY
1. Extended Property Damage
At 2. Exclusions exclusion a. Expected or Intended Injury is replaced with the following:
"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.
2. Expanded Fire Legal Liability
At 2. Exclusions the last paragraph is deleted and replaced by the following:
Exclusions c. through n. do not apply to damage by fire, explosion, lightning, smoke resulting from such fire,
explosion, or lightning or sprinkler leakage to premises while rented to you or temporarily occupied by you with
permission of the owner. A separate limit of insurance applies to this coverage as described in SECTION Ill -
LIMITS OF INSURANCE .
3. Non-Owned Watercraft
At 2. Exclusions exclusion g. Aircraft, Auto Or Watercraft (2) (a) is deleted and replaced by the following:
(a) Less than 51 feet long;
4. Property Damage -Borrowed Equipment
At 2. Exclusions the following is added to paragraph (4) of exclusion j. Damage To Property:
This exclusion does not apply to "property damage" to borrowed equipment while at a jobsite and while not being
used to perform operations. The most we will pay for "property damage"' to any one piece of borrowed equipment
under this coverage is $25,000 per occurrence. The insurance afforded under this provision is excess over any
valid and collectible property insurance (including deductible) available to the insured, whether primary, excess,
contingent or on any other basis.
5. Property Damage Liability -Elevators
At 2. Exclusions the following is added to paragraphs (3), (4) and (6) of exclusion j. Damage To Property:
This exclusion does not apply to "property damage"' resulting from the use of elevators. However. any insurance
provided for such "'property damage" is excess over any valid and collectible property insurance (including
deductible) available to the insured, whether primary, excess, contingent or on any other basis.
B. The following coverages are added:
1. COVERAGE D -VOLUNTARY PROPERTY DAMAGE COVERAGE
"Property damage" to property of others caused by the insured:
a. While in your possession; or
b. Arising out of "your work"'.
Coverage applies at lhe request of the insured, whether or not the insured is legally obligated lo pay.
For the purposes of this Voluntary Property Damage Coverage only:
Exclusion j. Damage to Property is deleted and replaced by the following:
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j. Damage to Property
"Property damage" to:
CG 71 03 07 17
(1) Property held by the insured for servicing, repair, storage or sale at premises you own, rent, lease,
operate or use;
(2) Property transported by or damage caused by any "automobile', "watercraft" or "aircraft' you own, hire or
lease;
(3) Property you own, rent, lease, borrow or use.
The amount we will pay is limited as described below in SECTION Ill -LIMITS OF INSURANCE
For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when
we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted
discretion in making payments under this coverage.
2. COVERAGE E -CARE, CUSTODY AND CONTROL PROPERTY DAMAGE COVERAGE
For the purpose of this Care, Custody and Control Property Damage Coverage only:
a. Item (4) of exclusion j. does not apply.
The amount we will pay is limited as described below in SECTION Ill -LIMITS OF INSURANCE
For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to
defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we
are granted discretion in making payments under this coverage.
3. COVERAGE F -ELECTRONIC DATA LIABILITY COVERAGE
For the purposes of this Electronic Data Liability Coverage only:
a. Exclusion p. of Coverage A -Bodily Injury And Property Damage Liability in Section I -Coverages is
replaced by the following:
2. Exclusions
This insurance does not apply to:
p. Electronic data
Damages arising out of the loss of, loss of use of, damage to, corruption of, inability to access, or
inability to manipulate "electronic data" that does not result from physical injury to tangible property.
However, this exclusion does not apply to liability for damages because of "bodily injury"
b. "Property damage" means:
(1) Physical injury to tangible property, including all resulting loss of use of that property. All such loss of use
shall be deemed to occur at the time of the physical injury that caused it; or
(2) Loss of use of tangible property that is not physically injured. All such loss of use shall be deemed to
occur at the time of the "occurrence" that caused it; or
(3) Loss of, loss of use of, damage to, corruption of, inability to access or inability to properly manipulate
"electronic data", resulting from physical injury to tangible property. All such loss of "electronic data" shall
be deemed to occur at the time of the "occurrence" that caused it.
For the purposes of this Electronic Data Liability Coverage, "electronic data" is not tangible property.
The amount we will pay is limited as described below in SECTION Ill -LIMITS OF INSURANCE
4. COVERAGE G -PRODUCT RECALL EXPENSE
a. Insuring Agreement
(1) We will pay 90% of "product recall expense" you incur as a result of a "product recall" you initiate during
the coverage period.
(2) We will only pay for "product recall expense" arising out of "your products" which have been physically
relinquished to others.
The amount we will pay is limited as described below in SECTION Ill -LIMITS OF INSURANCE
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CG 71 03 07 17
b. Exclusions
This insurance does not apply to "product recall expense" arising out of:
(1) Any fact, circumstance or situation which existed at the inception date of the policy and which you were
aware of, or could reasonably have foreseen that would have resulted in a "'product recall".
(2) Deterioration, decomposition or transformation of a chemical nature, except if caused by an error in the
manufacture, design, processing, storage, or transportation of "your product".
(3) The withdrawal of similar products or batches that are not defective, when a defect in another product or
batch has been found.
(4) Acts, errors or omissions of any of your employees, done with prior knowledge of any of your officers or
directors.
(5) Inherent vice, meaning a natural condition of property that causes it to deteriorate or become damaged.
(6) "Bodily injury" or "property damage".
(7) Failure of "your product" to accomplish its intended purpose. including any breach of warranty of fitness,
quality, efficacy or efficiency, whether written or implied.
(8) Loss of reputation. customer faith or approval. or any costs incurred to regain customer market. or any
other consequential damages.
(9) Legal fees or expenses.
(10) Damages claimed for any loss, cost or expense incurred by you or others for the loss of use of "your
product".
(11) "Product recall expense" arising from the "product recall" of any of "your products" for which coverage is
excluded by endorsement.
(12) Any "product recall" initiated due to the expiration of the designated shelf life of "your product".
5. COVERAGE H -WATER DAMAGE LEGAL LIABILITY
The Insurance provided under Coverage H (Section I) applies to "property damage" arising out of water damage
to premises that are both rented to and occupied by you.
The Limit under this coverage shall not be in addition to the Damage To Premises Rented To You Limit.
The amount we will pay is limited as described below in SECTION Ill -LIMITS OF INSURANCE
C. SUPPLEMENTARY PAYMENTS -COVERAGES A AND Bis amended:
1. To read SUPPLEMENTARY PAYMENTS
2. Bail Bonds
Item 1.b. is amended as follows:
b. Up to $1,000 for cost of bail bonds required because of accidents or traffic law violations arising out of the
use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these
bonds.
3. Loss of Earnings
Item 1.d. is amended as follows:
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.
4. The following language is added to Item 1.
However, we shall have none of the duties set forth above when this insurance applies only for Voluntary
Property Damage Coverage and/or Care, Custody or Control Property Damage Coverage and we have paid
the Limit of Liability or the Aggregate Limit for these coverages.
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CG 71 03 07 17
SECTION II -WHO IS AN INSURED
A. The following change is made:
Extended Reporting Requirements
Item 3.a. is deleted and replaced by the following :
a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or
the end of the policy period. whichever is earlier.
B. The following provisions are added:
4. BROAD FORM NAMED INSURED
Item 1.1. is added as follows:
I. Any legally incorporated entity of which you own more than 50 percent of the voting stock during the policy
period only if there is no other similar insurance available to that entity. However:
(1) Coverage A does nol apply lo "bodily injury" or "properly damage" lhal occurred before you acquired
more than 50 percent of the voting stock; and
(2) Coverage B does not apply to "personal and advertising injury" arising out of an offense committed
before you acquired more than 50 percent of the voting stock.
5. Additional Insured -Owners, Lessees or Contractors-Automatic Status When Required in Construction
or Service Agreement With You -Including Upstream Parties
a. Any person or organization for whom you are performing operations when you and such person or
organization have agreed in writing in a contract or agreement that such person or organization be added as
an additional insured on your policy;
b. Any other person or organization you are required to add as an additional insured under the contract or
agreement described in Paragraph a. above.
Such person(s) or organ1zation(s) 1s an add1t1onal insured only with respect to liability for "bodily 1niury",
"property damage" or "personal and advertising injury" which may be imputed to that person or organization
directly arising out of:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured.
However, the insurance afforded to such additional insured:
1. Only applies to the extent permitted by law; and
2. Will not be broader than that which you are required by the contract or agreement to provide for such
additional insured.
c. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to:
1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or
the failure to render. any professional architectural, engineering or surveying services, including:
a. The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports,
surveys, field orders, change orders or drawings and specifications; or
b. 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 in1ury" 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.
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2. "Bodily injury" or "property damage" occurring after:
a. All work, including materials, parts or equipment furnished in connection with such work, on the
project (other than service, maintenance or repairs) to be performed by or on behalf of the additional
insured(s) at the location of the covered operations has been completed; or
b. That portion of "your work" out of which the injury or damage arises has been put to its intended use
by any person or organization other than another contractor or subcontractor engaged in performing
operations for a principal as a part of the same project.
6. Additional Insured · Vendors
a. Any person(s) or organization(s) (referred to throughout this additional coverage as vendor), but only with
respect to "bodily injury" or "property damage", which may be imputed to that person(s) or organization(s)
arising out of "your products" shown with the Schedule which are distributed or sold in the regular course of
the vendor's business is an insured.
However:
(1) The insurance afforded to such vendor only applies to the extent permitted by law; and
(2) If coverage provided to the vendor is required by a contract or agreement, the insurance afforded to such
vendor will not be broader than that which you are required by the contract or agreement to provide for
such vendor.
b. With respect to the insurance afforded to these vendors, the following additional exclusions apply:
(1) This insurance afforded the vendor does not apply to:
(a) "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of
the assumption of liability in a contract or agreement. This exclusion does not apply to liability for
damages that the vendor would have in the absence of the contract or agreement;
(b) Any express warranty unauthorized by you;
(c) Any physical or chemical change in the product made intentionally by the vendor;
(d) Repackaging, 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.
(e) 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 products.
(f) Demonstration, installation, servicing or repair operations, except such operations performed at the
vendor's premises in connection with the sale of the product.
(g) 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.
(h) "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts
or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion
does not apply to:
i. The exceptions contained in Sub-paragraphs d. or f.; or
ii. Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally
undertakes to make in the usual course of business, in connection with the distribution or sale of
the products.
(2) 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.
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7. Additional Insured -Lessor of Leased Equipment -Automatic Status When Required in Lease
Agreement With You
a. Any person(s) or organization(s) from whom you lease equipment when you and such person(s) or
organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be
added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with
respect to your liability for "bodily injury", "property damage" or "personal and advertising injury" directly
arising out al the maintenance, operation or use of equipment leased to you, which may be imputed to such
person or organization as the lessor of equipment.
However, the insurance afforded to such additional insured:
(1) Only applies to the extent permitted by law; and
(2) Will not be broader than that which you are required by the contract or agreement to provide for such
additional insured.
A person's or organization's status as an additional insured under this endorsement ends when their contract
or agreement with you for such leased equipment ends.
b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any
"occurrence" which takes place after the equipment lease expires.
8. Additional Insured -Managers or Lessors of Premises
a. Any person(s) or organization(s), but only with respect to liability arising out of the ownership, maintenance or
use of that part of the premises leased to you and subject to the following additional exclusions:
This insurance does not apply lo:
(1) Any "occurrence" which takes place after you cease to be a tenant in that premises.
(2) Structural alterations, new construction or demolition operations performed by or on behalf of the
person(s) or organization(s) shown in lhe Schedule.
However:
(1) The insurance afforded to such additional insured only applies to the extent permitted by law; and
(2) If coverage provided to the additional insured is required by a contract or agreement, the insurance
afforded to such additional insured will not be broader than that which you are required by the contract or
agreement to provide for such additional insured.
9. Additional Insured · Engineers, Architects or Surveyors Not Engaged by the Named Insured
a. Any architects, engineers or surveyors who are not engaged by you are insureds, but only with respect to
liability for "bodily injury" or "property damage" or "personal and advertising injury" which may be imputed to
that architect, engineer or surveyor arising out of:
(1) Your acts or omissions; or
(2) Your acts or omissions of those acting on your behalf;
in the performance of your ongoing operations performed by you or on your behalf.
But only if such architects, engineers or surveyors, while not engaged by you, are contractually required to be
added as an additional insured to your policy.
However, the insurance afforded to such additional insured:
(1) Only applies to the extent permitted by law; and
(2) Will not be broader than that which you are required by the contract or agreement to provide for such
additional insured.
b. With respect to the insurance afforded to these additional insureds, the following additional exclusion applies:
This insurance does not apply to "bodily injury". "property damage" or "personal and advertising injury"
arising out of the rendering of or failure to render any professional services, including:
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(1) The preparing, approving, or failing to prepare or approve, maps, drawings, opinions, reports, surveys,
change orders, designs or specificalions; or
(2) Supervisory, inspection or engineering services.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the
supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which
caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising
injury", involved the rendering of or the failure to render any professional services.
10. Additional Insured-Employee Injury to Another Employee
With respect to your "employees" who occupy positions which are supervisory in nature:
Paragraph 2.a.(1) of SECTION II -WHO IS AN INSURED is amended to read:
a. "Bodily injury" or "personal and advertising injury"
(1) To you, to your partners or members (if you are a partnership or joint venture), or to your members (if
you are a limited liability company);
(2) For which there is any obligation to share damages with or repay someone else who must pay damages
because of the injury described in paragraph (1)(a) above; or
(3) Arising out of his or her providing or failing to provide professional healthcare services. Paragraph 3.a. is
deleted.
For the purpose of this Item 10 only, a position is deemed to be supervisory in nature if that person pertorms
principle work which is substantially different from that of his or her subordinates and has authority to hire,
direct, discipline or discharge.
SECTION Ill -LIMITS OF INSURANCE
A. The following Items are deleted and replaced by the following:
2. The General Aggregate Limit is the most we will pay for the sum of:
a. Medical expenses under Coverage C;
b. Damages under Coverage A, except damages because of "bodily injury" or "property damage" included in
the "products-completed operations hazard"; and
c. Damages under Coverage B; and
d. Damages under Coverage H.
3. The Products-Completed Operations Aggregate Limit is the most we will pay under Coverage A for damages
because of "bodily injury" and "property damage" included in the "products-completed operations hazard" and
Coverage G.
6. Subject to 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
fire, explosion, lightning, smoke resulting from such fire, explosion, or lightning or sprinkler leakage while rented
to you or temporarily occupied by you with permission of the owner.
B. The following are added:
8. Subject to Paragraph 5. of SECTION Ill -LIMITS OF INSURANCE $25,000 is the most we will pay under
Coverage H for Water Damage Legal Liability.
Coverage G -Product Recall Expense
9. Aggregate Limit $50,000
Each Product Recall Limit $25,000
a. The Aggregate Limit shown above is the most we will pay for the sum of all "product recall expense" you
incur as a result of all "product recalls" you initiate during the endorsement period.
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b. The Each Product Recall Limit shown above is the most we will pay, subject to the Aggregate and $1,000
deductible. for "product recall expense" you incur for any one "product recall" you initiate during the
endorsement period.
We will only pay for the amount of "product recall expenses" which are in excess of the deductible amount. The
deductible applies separately to each "product recall". The limits of insurance will not be reduced by the amount
of this deductible.
We may, or will if required by law, pay all or any part of any deductible amount. Upon notice of our payment of a
deductible amount, you shall promptly reimburse us for the part of the deductible amount we paid.
10. Aggregate Limits of Insurance (Per Location)
The General Aggregate Limit applies separately to each of your "locations" owned by or rented to you or
temporarily occupied by you with the permission of the owner.
"Location" means premises 1nvolv1ng the same or connecting lots, or premises whose connection is interrupted
only by a street, roadway, waterway or right-of-way of a railroad.
11. Aggregate Limits of Insurance (Per Project)
The General Aggregate Limit applies separately to each of your projects away from premises owned by or rented
to you.
12. With respects to the insurance afforded to additional insureds afforded coverage by items 5 through 10 of
SECTION II -WHO IS AN INSURED above, the following is added:
The most we will pay on behalf of the additional insured is the amount of insurance:
a. Required by the contract or agreement:
b. 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.
13 Subject to 5. of SECTION Ill -LIMITS OF INSURANCE, a $5,000 "occurrence" limit and a $10,000 "aggregate"
limit is the most we will pay under Coverage A for damages because of "property damage" covered under
Coverage D -Voluntary Property Damage Coverage.
For the purposes of this Voluntary Property Damage Coverage, our right and duty to defend ends when
we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we are granted
discretion in making payments under this coverage.
14. Subject to 5. of SECTION Ill -LIMITS OF INSURANCE, a $25,000 "occurrence" limit and a $100,000
"aggregate" limit is the most we will pay under Coverage E · Care, Custody and Control Coverage regardless
of the number of:
a. Insureds:
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or bringing "suits".
Deductible -Our obligation to pay damages on your behalf applies only to the amount of damages in excess of
$500.
This deductible applies to all damages because of "property damage" as the result of any one "occurrence"
regardless of the number of persons or organizations who sustain damages because of that "occurrence".
We may pay any part or all of the deductible amount to effect settlement of any claim or "suit" and upon
notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has
been paid by us.
As respects this coverage "aggregate" is the maximum amount we will pay tor all covered "occurrences" during
one policy period.
For the purposes of this Care, Custody and Control Property Damage Coverage, our right and duty to
defend ends when we have paid the Limit of Liability or the Aggregate Limit for each coverage, and we
are granted discretion in making payments under this coverage.
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15. Subject to 5. of SECTION Ill -LIMITS OF INSURANCE. the most we will pay for "property damage" under
Coverage F -Electronic Data Liability Coverage for loss of "electronic data" is $50,000 without regard to the
number of "occurrences".
SECTION IV -COMMERCIAL GENERAL LIABILITY CONDITIONS
A. The following conditions are amended:
1. Knowledge of Occurrence
a. Condition 2., Items a. and b. are deleted and replaced by the following:
(1) Duties In The Event Of Occurrence, Offense, Claim Or Suit
(a) You must see to it that we are notified as soon as practicable of an "occurrence" or an offense which
may result in a claim. Knowledge of an "occurrence" by your agent, servant or employee shall not in
itself constitute knowledge of the named insured unless an officer of the named insured has received
such notice from the agent, servant or employee. To the extent possible, notice should include:
i. How, when and where the "occurrence" took place;
ii. The names and addresses of any injured persons and witnesses, and
iii. The nalure and localion of any injury or damage arising out of the "occurrence" or offense.
(b) If a claim is made or "suit" is brought against any insured, you must:
i. Immediately record the specifics of the claim or "suit" and the date received; and
ii. Notify us as soon as practicable.
You must see to it that we receive written notice of the claim or "suit" as soon as practicable. Knowledge
of a claim or "suit" by your agent, servant or employee shall not in itself constitute knowledge of the
named insured unless an officer of the named insured has received such notice from the agent, servant
or employee.
2. Where Broad Form Named Insured is added in SECTION II -WHO IS AN INSURED of this endorsement,
Condition 4. Other Insurance b. Excess Insurance (1).(a) is replaced by the following:
(a) Any of the other insurance, whether primary, excess, contingent or on any other basis, that is available to an
insured solely by reason of ownership by you of more than 50 percent of the voting stock, and not
withstanding any other language in any other policy. This provision does not apply to a policy written to apply
specifically in excess of this policy.
B. The following are added:
10. Condition (5) of 2. "Duties in the event Occurrence, Offense, Claim or Suit" c. You or any other involved
insured must:
(5) Upon our request, replace or repair the property covered under Voluntary Property Damage Coverage at
your actual cost, excluding profit or overhead.
11. Blanket Waiver Of Subrogation
We waive any right of recovery we may have against any person or organization because of payments we make
for injury or damage arising out of: premises owned or occupied by or rented or loaned to you, ongoing
operations performed by you or on your behalf, done under a contract with that person or organization, "your
work", or "your products". We waive this right where you have agreed to do so as part of a written contract,
executed by you before the "bodily injury" or "property damage" occurs or the "personal and advertising injury"
offense is committed.
12. Liberalization
If a revision to this Coverage Part, which would provide more coverage with no additional premium becomes
effective during the policy period in the state designated for the first Named Insured shown in the Declarations,
your policy will automatically provide this additional coverage on the effective date of the revision.
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13. Unintentional Failure to Disclose All Hazards
Based on our reliance on your representations as to existing hazards, if you unintentionally should fall to disclose
all such hazards at the inception date of your policy, we will not deny coverage under this Coverage Part
because of such failure. However. this provision does not affect our right to collect additional premium or
exercise our right of cancellation or non-renewal.
14. The following conditions are added in regard to Coverage G -Product Recall Expense
In event of a "product recall", you must
a. See to it that we are notified as soon as practicable of a "product recall". To the extent possible, notice
should include how, when and where the "product recall" took place and estimated "product recall expense".
b. Take all reasonable steps to minimize "product recall expense". This will not increase the limits of insurance.
c. If requested, permit us to question you under oath at such times as may be reasonably required about any
matter relating to this insurance or your claim, including your books and records. Your answers must be
signed.
d. Permit us to inspect and obtain other information proving the loss. You must send us a signed, sworn
statement of loss containing the information we request to investigate the claim. You must do this within 60
days after our request.
e. Cooperate with us in the investigation or settlement of any claim.
f. Assist us upon our request, in the enforcement of any rights against any person or organization which may be
liable to you because of loss to which this insurance applies.
SECTION V -DEFINITIONS
A. Al item 12. "Mobile equipment" the wording al 1.(1) is deleted and replaced by the following:
f.(1) Equipment designed primarily for:
(a) Snow removal;
(b) Road maintenance, but not construction or resurfacing; or
(c) Street cleaning;
except for such vehicles that have a gross vehicle weight less than 1,000 lbs which are not designed for highway
use.
B. Item 3. "bodily injury" is deleted and replaced with the following:
3. "Bodily injury" means physical injury, sickness or disease sustained by a person. This includes mental anguish,
mental injury, shock, fright or death that results from such physical injury, sickness or disease.
C. The following definitions are added for this endorsement only:
23. "Electronic data" means information, facts or programs stored as or on, created or used on, or transmitted to or
from computer software, including systems and applications software, hard or floppy disks, CD-ROMS, tape
drives, cells, data processing devices or any other media which are used with electronically controlled
equipment.
24. "Product recall" means a withdrawal or removal from the market of "your product" based on the determination by
you or any regulatory or governmental agency lhal:
a. The use or consumption of "your product" has caused or will cause actual or alleged "bodily injury" or
"property damage"; and
b. Such determination requires you to recover possession or control of "your product" from any distributor,
purchaser or user, to repair or replace "your product", but only if "your product" is unfit for use or
consumption, or is hazardous as a result of:
(1) An error or omission by an insured in the design, manufacturing, processing, labeling, storage, or
transportation of "your product"; or
(2) Actual or alleged intentional, malicious or wrongful alteration or contamination of "your product" by
someone other than you.
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25. "Product recall expense" means reasonable and necessary expenses for:
a. Telephone. radio and television communication and printed advertisements. including stationery. envelopes
and postage.
b. Transporting recalled products from any purchaser, distributor or user, to locations designated by you.
c. Remuneration paid to your employees for overtime, as well as remuneration paid to additional employees or
independent contractors you hire.
d. Transportation and accommodation expense incurred by your employees.
e. Rental expense incurred for temporary locations used to store recalled products.
I. Expense incurred to properly dispose of recalled products, including packaging that cannot be reused.
g. Transportation expenses incurred to replace recalled products.
h. Repairing, redistributing or replacing covered recalled products with like products or substitutes, not to
exceed your original cost of manufacturing, processing, acquisition and/or distribution.
These expenses must be incurred as a result of a "product recall".
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Policy # 60485230
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
COMMERCIAL UMBRELLA COVERAGE PART
The following is added to the Other Insurance Condition and supersedes any provision to the contrary:
Primary And Noncontributory Insurance
IL 71 05 10 14
This insurance is primary to and will not seek contribution from any other insurance available to an additional insured
under your policy provided that:
(1) The additional insured is a Named Insured under such other insurance;
(2) You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek
contribution from any other insurance available to the additional insured;
(3) The additional insured gives us prompt written notice of any "occurrence" which may result in a claim and prompt
written notice of "suit";
(4) The additional insured immediately forwards all legal papers to us, cooperates in the investigation or settlement of
the claim or defense against the "suit", and otherwise complies with policy conditions.
(5) The additional insured must tender the defense and indemnity of any claim or "suit" to any other insurer which also
insures against a loss we cover under this policy. This includes, but is not limited to, any insurer which has issued a
policy of insurance in which the additional insured qualifies as an insured. For the purpose of this requirement, the
term "insures against" refers to any self-insurance and to any insurer which issued a policy of insurance that may
provide coverage for the loss, regardless of whether the additional insured has actually requested that the insurer
provide the additional insured with a defense and/or indemnity under that policy of insurance.
(6) The additional insured agrees to make available any other insurance that the additional insured has for a loss we
cover under this policy.
IL71051014 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
*42037200*
I llllll lllll lllll 111111111111111111111111111111111
Policy # 60488166
DocuSign Envelope ID: CCA23F11-F9F8-47A2-B9A2-3B9D83926945
CA 71 09 01 06
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL Y.
BUSINESS AUTO ULTRA ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
COVERAGE INDEX
Descriptio n Page
TEMPORARY SUBSTITUTE AUTO PHYSICAL DAMAGE
BROAD FORM INSURED
EMPLOYEES AS INSUREDS
ADDITIONAL INSURED STATUS BY CONTRACT, AGREEMENT OR PERMIT
AMENDED FELLOW EMPLOYEE EXCLUSION
TOWING AND LABOR
PHYSICAL DAMAGE ADDITIONAL TRANSPORTATION EXPENSE COVERAGE
EXTRA EXPENSE - THEFT
RENTAL REIMBURSEMENT AND ADDITIONAL TRANSPORTATION EXPENSE
PERSONAL EFFECTS COVERAGE
AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE
AIRBAG ACCIDENTAL DISCHARGE
AUTO LOAN/LEASE TOTAL LOSS PROTECTION ENDORSEMENT
GLASS REPAIR – DEDUCTIBLE AMENDMENT
AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS
WAIVER OF SUBROGATION REQUIRED BY CONTRACT
UNINTENTIONAL FAILURE TO DISCLOSE
HIRED, LEASED, RENTED OR BORROWED AUTO PHYSICAL DAMAGE
EXTENDED CANCELLATION CONDITION
1
1
2
2
2
2
3
3
3
4
4
4
4
5
5
5
5
5
6
The COVERAGE INDEX set forth above is informational only and grants no coverage.
Terms set forth in are likewise for information only and by themselves shall be deemed to grant no
coverage.
B. BROADENED LIABILITY COVERAGESA. TEMPORARY SUBSTITUTE AUTO PHYSICAL
DAMAGE
SECTION II – LIABILITY COVERAGE in Paragraph A.
Coverage at 1. Who Is An Insured is amended to
include the following:
SECTION I – COVERED AUTOS , paragraph C. Certain
Trailers, Mobile Equipment and Temporary
Substitute Autos is amended by adding the following at
the end of the existing language:
d.Any legally incorporated subsidiary in which you
own more than 50% of the voting stock on the
effective date of the Coverage Form. However, the
Named Insured does not include any subsidiary that
is an “insured” under any other automobile policy or
would be an “insured” under such a policy but
for its termination or the exhaustion of its Limit
of Insurance.
If Physical Damage Coverage is provided under this
Coverage form for an “auto” you own, the Physical
Damage coverages provided for that owned “auto” are
extended to any “auto” you do not own while used with
the permission of its owner as a temporary substitute for
the covered “auto” you own that is out of service
because of its breakdown, repair, servicing, “loss”, or
destruction.
CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission.Page 1 of 6
Policy #60485230Policy # 60488166
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CA 71 09 01 06
e.Any organization that is acquired or formed by you,
during the term of this policy and over which you
maintain majority ownership. However, the Named
Insured does not include any newly formed or
acquired organization:
C. AMENDED FELLOW EMPLOYEE EXCLUSION
Only with respect to your “employees” who occupy
positions which are supervisory in nature,SECTION II.
LIABILITY B. Exclusion 5. Fellow Employee is
replaced by:(1)That is a joint venture or partnership,
5. Fellow Employee(2)That is an “insured” under any other policy,
“Bodily Injury”:(3)That has exhausted its Limit of Insurance under
any other policy, or (a)To you, or your partners or members (if you
are a partnership or joint venture), or to your
members (if you are a limited liability
company);
(4)180 days or more after its acquisition or
formation by you, unless you have given us
notice of the acquisition or formation.
(b)To your “executive officers” and directors (if
you are an organization other than a
partnership, joint venture, or limited liability
company) but only with respect to
performance of their duties as your officers
or directors;
Coverage does not apply to “bodily injury” or
“property damage” that results from an accident that
occurred before you formed or acquired the
organization.
(c)For which there is an obligation to share
damages with or repay someone else who
must pay damages because of the injury
described in paragraph a and b above; or
f.Any employee of yours while acting in the course of
your business or your personal affairs while using a
covered “auto” you do not own, hire or borrow.
(d)Arising out of his or her providing or failing
to provide professional health care services.
g.Any person or organization whom you are required
to add as an additional insured on this policy under
a written contract or agreement; but the written
contract or agreement must be:
For purposes of this endorsement, a position is deemed
to be supervisory in nature if that person performs
principle work which is substantially different from that
of his or her subordinates and has authority to hire,
transfer, direct, discipline or discharge.(1)Currently in effect or becoming effective during
the term of this policy; and D. BROADENED PHYSICAL DAMAGE COVERAGES
(2)Executed prior to the “bodily injury” or “property
damage”.SECTION III – PHYSICAL DAMAGE COVERAGE
Coverage is amended as follows:The additional insured status will apply only with respect
to your liability for “bodily injury” or “property damage”
which may be imputed to that person(s) or
organization(s) directly arising out of the ownership,
maintenance or use of the covered “autos” at the
location(s) designated, if any.
2. Towing and Labor
We will pay towing and labor costs incurred, up to the
limits shown below, each time a covered “auto”
classified and rated as a private passenger type, “light
truck” or “medium truck” is disabled:
Coverage provided by this endorsement will not exceed
the limits of liability required by the written contract or
written agreement even if the limits of liability stated in
the policy exceed those limits. This endorsement shall
not increase the limits stated in Section II. C. Limits of
Insurance.
(a)For private passenger type vehicles or “light
trucks” we will pay up to $75 per
disablement. “Light trucks” have a gross
vehicle weight (GVW) of 10,000 pounds or
less.For any covered “auto” you own this Coverage Form
provides primary coverage.
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CA 71 09 01 06
(b)For “medium trucks” we will pay up to $150
per disablement. “Medium trucks” have a
gross vehicle weight (GVW) of 10,001 lbs.
to 20,000 pounds.
(2)We will pay only for expenses incurred
during the policy period and beginning 24
hours after the “loss” and ending, regardless
of the policy's expiration, with the lesser of
the following number of days:
However, the labor must be performed at the place of
disablement.(a)The number of days reasonably
required to repair or replace the covered
“auto.” If “loss” is caused by theft, this
number of days is added to the number
of days it takes to locate the covered
“auto” and return it to you, or4. Coverage Extensions
(b)30 days.a. Transportation Expense is amended to
provide the following limits:(3)Our payment is limited to the lesser of the
following amounts:We will pay up to $50 per day to a maximum of
$1,000. All other terms and provisions of this
section remain applicable.
(a)Necessary and actual expenses
incurred; or
(b)$35 per day.
The following language is added to 4. Coverage
Extensions:(c)This coverage does not apply while
there are spare or reserve “autos”
available to you for your operations.c. Theft Recovery Expense
(d)If “loss” results from the total theft of a
covered “auto” of the private passenger
or light truck type, we will pay under this
coverage only that amount of your
rental reimbursement expense which
is not already provided for under the
SECTION III – PHYSICAL DAMAGE
COVERAGE, A. Coverage, 4.
Coverage Extensions, a.
Transportation Expenses.
If you have purchased Comprehensive
Coverage on an “auto” that is stolen, we will pay
the expense of returning that stolen auto to you.
The limit for this coverage extension is $5,000.
d. Rental Reimbursement
We will provide Rental Reimbursement and
Additional Expense coverage only for those
Physical Damage coverages for which a
premium is shown in the Declarations or
schedule pages. Coverage applies only to a
covered “auto” of the private passenger or light
truck (10,000 lbs. or less gross vehicle weight)
type for which Physical Damage coverages
apply.
(
e. Personal Effects
If you have purchased Comprehensive
Coverage on this policy for an “auto” you own
and that “auto” is stolen, we will pay, without
application of a deductible, up to $500 for
Personal Effects stolen with the “auto”. The
insurance provided under this provision is
excess over any other collectible insurance. For
this coverage extension, Personal Effects
means tangible property that is worn or carried
by an “insured”. Personal Effects does not
include tools, jewelry, guns, musical
instruments, money, or securities.
(1)We will pay for auto rental expense and the
expense incurred by you because of “loss”
to remove and transfer your materials and
equipment from a covered “auto” to a
covered “auto.” Payment applies in addition
to the otherwise applicable coverage you
have on a covered “auto.” No deductible
applies to this coverage.
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CA 71 09 01 06
(4)With respect to this coverage, the most we
will pay for all “loss” of audio, visual or data
electronic equipment and any accessories
used with this equipment as a result of any
one “accident” is the lesser of:f. Audio, Visual and Data Electronic
Equipment Coverage.
(a)The actual cash value of the damaged
or stolen property as of the time of the
“loss”;We will pay for “loss” to any electronic
equipment that receives or transmits audio,
visual or data signals and that is not designed
solely for the reproduction of sound. This
coverage applies only if the equipment is
permanently installed in a covered “auto” at the
time of the “loss” or the equipment is removable
from a housing unit which is permanently
installed in a covered “auto” at the time of the
“loss”, and such equipment is designed to be
solely operated by use of the power from the
”auto's” electrical system, in or upon the
covered “auto.”
(b)The cost of repairing or replacing the
damaged or stolen property with other
property of like kind and quality; or
$1,000;
minus a deductible of $100.
An adjustment for depreciation and physical
condition will be made in determining actual
cash value at the time of loss. If a repair or
replacement results in better than like kind
or quality, we will not pay for the amount of
the betterment.
(1)We will pay with respect to a covered “auto”
for “loss” to any accessories used with the
electronic equipment described above.
However, this does not include tapes,
records or discs.
If there is other coverage provided for audio,
visual and data electronic equipment, the
coverage provided herein is excess over any
other collectible insurance.
(2)In addition to the exclusions that apply to
Physical Damage Coverage with exception
of the exclusion relating to audio, visual and
data electronic equipment, the following
exclusions also apply:
D. SECTION III – PHYSICAL DAMAGE COVERAGE,
B. Exclusions is amended as follows:
The following language is added to Exclusion 3.:
If you have purchased Comprehensive or Collision
Coverage under this policy, this exclusion does not
apply to mechanical breakdown relating to the
accidental discharge of an air bag. This coverage
applies only to a covered auto you own and is
excess of any other collectible insurance or warranty.
No deductible applies to this coverage.
(3)We will not pay for any electronic
equipment or accessories used with such
electronic equipment that are:
(a)Necessary for the normal operation of
the covered “auto” for the monitoring of
the covered “auto's” operating system;
or
E. AUTO LOAN/LEASE TOTAL LOSS PROTECTION(b)Both:
An integral part of the same unit
housing any sound reproducing
equipment designed solely for the
reproducing of sound if the sound
reproducing equipment is permanently
installed in the covered “auto”; and
SECTION III – PHYSICAL DAMAGE COVERAGE – C.
Limit of Insurance is amended by adding the following
language:
4.In the event of a total “loss” to a covered “auto”
shown in the Schedule pages, subject at the time of
the “loss” to a loan or lease, we will pay any unpaid
amount due on the lease or loan for a covered
“auto” less:
Permanently installed in the opening of
the dash or console normally used by
the manufacturer for the installation of a
radio.
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CA 71 09 01 06
a.The amount paid under the Physical Damage
Coverage Section of the policy; and
(4)Your members, managers or insurance
manager, if you are a limited liability
company; orb.Any:
(5)Your officials, trustees, board members or
insurance manager, if you are a
not-for-profit organization.
(1)Overdue lease / loan payments at the time
of the “loss’’;
(2)Financial penalties imposed under a lease
for excessive use, abnormal wear and tear
or high mileage;
G. WAIVER OF SUBROGATION REQUIRED BY
CONTRACT
Under SECTION IV ,BUSINESS AUTO
CONDITIONS, A. Loss Conditions 5. Transfer
of Rights of Recovery Against Others to Us
the following language is added:
(3)Security deposits not returned by the lessor;
(4)Costs for extended warranties, Credit Life
Insurance, Health, Accident or Disability
Insurance purchased with the loan or lease;
and However, we waive any rights of recovery we may
have against the person or organization with whom
you have agreed in writing in a contract, agreement
or permit, to provide insurance such as is afforded
under the policy to which this endorsement is
attached. This provision does not apply unless the
written contract or written agreement has been
executed, or permit has been issued, prior to the
“bodily injury” or “property damage.”
(5)Carry-over balances from previous loans or
leases.
(GLASS REPAIR – DEDUCTIBLE AMENDMENT)
Under D., Deductible is amended by adding the
following:
Any deductible shown in the Declarations as
applicable to the covered “auto” will not apply to
glass breakage if the damaged glass is repaired,
rather than replaced.
H. UNINTENTIONAL FAILURE TO DISCLOSE
Under SECTION IV – BUSINESS AUTO
CONDITIONS, Subsection B. General Conditions ,
the following is added to 2. Concealment,
Misrepresentation Or Fraud :F. AMENDED DUTIES IN THE EVENT OF
ACCIDENT, CLAIM, SUIT OR LOSS Your unintentional error in disclosing, or failing to
disclose, any material fact existing at the effective
date of this Coverage Form, or during the policy
period in connection with any additional hazards, will
not prejudice your rights under this Coverage Form.
Under SECTION IV – BUSINESS AUTO CONDITIONS,
Subsection A., Loss Conditions , the following is
added to paragraph 2. Duties In The Event of
Accident, Suit or Loss:
I. HIRED, LEASED, RENTED OR BORROWED
AUTO PHYSICAL DAMAGE
d.Knowledge of any “accident,” “claim,” “suit” or
“loss” will be deemed knowledge by you when
notice of such “accident,” “claim,” “suit” or “loss”
has been received by:
Under SECTION IV – BUSINESS AUTO CONDITIONS
B. General Conditions 5. Other Insurance
Paragraph 5.b.is replaced by the following:(1 ) You, if you are an individual;
b. (1)For “Comprehensive” and “Collision” Auto
Physical Damage provided by this endorsement,
the following are deemed to be covered “autos”
you own:
(2)Any partner or insurance manager if you are
a partnership;
(3)An executive officer or insurance manager,
if you are a corporation;(a)Any Covered “auto” you lease, hire, rent or
borrow; and
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(b)Any Covered “auto” hired or rented by your
“employee” under a contract in that
individual “employee's” name, with your
permission, while performing duties related
to the conduct of your business.
(3)This Hired Auto Physical Damage coverage is
excess over any other collectible insurance.
(4)Definitions For This Section
(a)Comprehensive Coverage: from any cause
except the covered “auto's” collision with
another object or the covered “auto's”
overturn. We will pay glass breakage, “loss”
caused by hitting a bird or animal and, “loss”
caused by falling objects or missiles.
However, any “auto” that is leased, hired, rented or
borrowed with a driver is not a covered “auto”
(2)Limit of Insurance For This Section
The most we will pay for any one “loss” is the
lesser of the following:(b)Collision Coverage: caused by the covered
“auto's” collision with another object or by
the covered “auto's” overturn.
(a)$50,000 per accident, or
(b)actual cash value at the time of loss, or J. EXTENDED CANCELLATI ON CONDITION
(c)cost of repair.A.Under CANCELLATION,of the COMMON POLICY
CONDITIONS form, item 2.b . is replaced by the
following:minus a $500 deductible. An adjustment for
depreciation and physical condition will be made
in determining actual cash value in the event of
a total loss. No deductible applies to “loss”
caused by fire or lightning.
b.60 days before the effective date of cancellation
if we cancel for any other reason
CA 71 09 01 06 Includes Copyrighted material of Insurance Services Office, Inc., with its permission .Page 6 of 6
DocuSign Envelope ID: CCA23F11-F9F8-47A2-B9A2-3B9D83926945
Policy # 60488166
DocuSign Envelope ID: CCA23F11-F9F8-47A2-B9A2-3B9D83926945
7501 E. Lowry Blvd.
Denver, CO 80230-7006
303.361.4000 / 800.873.7242
Pinnacol.com
Mountain Waste and Recycling, Inc.
10100 E 102nd Ave
Henderson, CO 80640
Hub International Insurance Service
1125 17th Street
Ste. 900
Denver, CO 80202-4364
(888) 795-0300
7501 E. Lowry Blvd Denver, CO 80230-7006
Page 1 of 1 P MARTINAK - Underwriter 12/18/2017 07:56:04 4133726 50594167 359-B
NCCI #: WC000313B
Policy #: 4133726
ENDORSEMENT:Blanket Waiver of Subrogation
Effective Date:January 1, 2018 Expires on: January 1, 2019
Pinnacol Assurance has issued this endorsement December 18, 2017
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not
enforce our right against the person or organization named in the Schedule. This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
SCHEDULE
To any person or organization when agreed to under a written contract or agreement, as defined above
and with the insured, which is in effect and executed prior to any loss.
DocuSign Envelope ID: CCA23F11-F9F8-47A2-B9A2-3B9D83926945