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HomeMy WebLinkAboutC20-223 JviationEGE LOC 20-01 / 2020.EGE.02 Airfield Asphalt Pavement Maintenance – Construction Coordination Page 1 of 2 AMENDMENT NO. SIX (6) TO CONTRACT DATED DECEMBER 6, 2018 BETWEEN JVIATION, INC. AND EAGLE COUNTY, COLORADO The Sponsor and the Engineer agree to amend their contract for improvements to the Eagle County Reg ional Airport, Gypsum, Colorado dated December 6, 2018 to add the additional services and associated fees identified in the Scope of Work for Eagle County Regional Airport dated, April 15, 2020, attached hereto as Exhibit A-6 and incorporated herein by this reference. NOW THEREFORE, in consideration of the foregoing and the mutual rights and obligations as set forth below, the parties agree as follows: The Original Contract shall be amended to include the following provisions: FEES: The Sponsor agrees to pay the Engineer for the services relating to Airfield Asphalt Pavement Maintenance –Construction Coordination (the “Project”) according to the schedule under Exhibit A-6 in the following manner: PART B - SPECIAL SERVICES The maximum estimated SPECIAL SERVICES engineering is as follows: CONSTRUCTION ADMINISTRATION Construction Administration .................................................................................. Lump Sum of $12,429.50 Post Constr uction Coordination ............................................................................... Lump Sum of $6,938.50 On-Site Construction Coordination ....................................................................... Lump Sum of $40,474.25 TOTAL CONSTRUCTION ADMINISTRATION ........................................... Lump sum of $59,842.25 [Signature Page Follows] DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 C20-223 Page 2 of 2 All other terms and conditions of the original contract shall remain in effect. IN WITNESS WHEREOF, the parties hereto have affixed their signatures this ___________________ . SPONSOR: ENGINEER: Eagle County, Colorado Jviation, Inc. By: By: Name: Name: Jason Virzi, PE Title: Title: Office Manager DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 County Manager 6/18/2020 Jeff Shroll Eagle County Regional Airport Jviation Project No. EGE LOC 20-01 Airfield Asphalt Pavement Maintenance – Construction Coordination April 15, 2020 Page 1 of 6 REV 2020.02 SCOPE OF WORK FOR EAGLE COUNT REGIONAL AIRPORT Gypsum, Colorado Jviation Project No. EGE LOC 20-01 Airfield Asphalt Pavement Maintenance – Construction Coordination This is an Appendix attached to, made a part of and incorporated by reference with the Consulting Contract dated December 6, 2018 between Eagle County, Colorado and Jviation, Inc. for providing professional services. For the remainder of this scope the Eagle County Regional Airport is indicated as “Sponsor” and Jviation, Inc. is indicated as “Engineer”. The as-bid construction cost of this project is $545,045.00. This project shall consist of Construction Administration, Post Construction and On-Site Construction Coordination for the Airfield Asphalt Pavement Maintenance Project. This scope of work is for the consulting services provided by the Engineer for the Sponsor. See Exhibit No. 1 below for the project location. EXHIBIT NO. 1 DESCRIPTION This project was bid under Colorado Department of Transportation (CDOT) Division of Aeronautics Project No. 19-EGE-01 and shall consist of asphalt pavement maintenance activities on Runway 7/25, connector taxiways, and blast pads. The proposed maintenance for theses asphalt pavements includes, but not necessarily limited to, the removal of rubber deposits from the surface of the pavement, predominately at the approach end of Runway 7/25, the routing and sealing of cracks, the application of GSB 78 pavement preservation surface treatment, and reapplying the existing pavement markings. The engineering fees for this project will be Part B-Special Services, which includes; 5) Construction Administration Phase, 6) Post Construction Phase, 7) On-Site Construction Coordination Phase or Field Engineering, and reimbursable costs during Construction. There is no Quality Assurance (QA) testing verification during construction anticipated for this project. PART B - SPECIAL SERVICES consists of construction administration phase, post-construction coordination phase, and on-site construction coordination phase (invoiced on a lump sum basis). DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 Eagle County Regional Airport Jviation Project No. EGE LOC 20-01 Airfield Asphalt Pavement Maintenance – Construction Coordination April 15, 2020 Page 2 of 6 REV 2020.02 5.0 Construction Administration Phase 5.1 Prepare Project Scope of Work and Contract. This task includes establishing the scope of work. Fees shall be negotiated with the Sponsor and may be subject to an independent fee estimate conducted by a third party hired by the Sponsor. This task also includes drafting the contract for the work to be completed by the Engineer for the Sponsor once negotiations are complete. 5.2 Prepare Construction Contract and Documents. In agreement with the County, the Engineer shall prepare the Notice of Award, Notice to Proceed and Contract Agreements, including bonds and insurance documents, which will be updated to include all addenda items issued during bidding, for the Sponsor's approval and signatures. Approximately five copies will be submitted to the successful Contractor for their signatures. The Engineer will ensure the construction contracts are in order, the bonds have been completed, and the Contractor has been provided with adequate copies of the Construction Plans, Specifications and Contract Documents, which will be updated to include all addenda items issued during bidding. 5.3 Provide Project Coordination. The Engineer shall provide project management and coordination services to ensure the completion of the construction. These duties include tasks such as:  Time the Engineer spends planning, organizing, securing and scheduling resources, and providing instruction to staff to meet project objectives as defined in the approved scope of work.  Additional items to be accomplished include compiling and sending additional information requested from the office to related parties, maintaining project files as necessary and other items necessary in day to day project coordination.  The Project Manager will review progress reports weekly and monthly.  Assist with change orders and supplemental agreements as necessary. All change orders and supplemental agreements will be coordinated with the Sponsor prior to execution. All change orders and supplemental agreements will be prepared in accordance with the FAA Standard Operating Procedure (SOP) 7.0, Airport Improvement Program Construction Project Change Orders.  Clerical staff shall prepare the quantity sheets, testing sheets, construction report format, etc.  Office engineering staff, CAD personnel and clerical staff shall be required to assist the Field Personnel as necessary during construction. Specific tasks to be accomplished include providing secondary engineering opinions on issues arising during construction, maintaining project files as necessary and various other tasks necessary in the day-to-day operations.  The Engineer will prepare and submit monthly invoicing. The Engineer will complete the following tasks:  Provide the Sponsor with a monthly Project Status Report (PSR), in writing, reporting on Engineer’s progress and any problems that may arise while performing the work. The PSR must include an update of the project schedule, as described in this section, when schedule changes are expected. 5.4 Prepare/Conduct Pre-Construction Meeting. The Engineer will conduct a pre-construction meeting to review Project requirements in general accordance with FAA AC 150/5370-12 (Current Edition), Quality Management for Federally Funded Airport Construction Projects, prior to the commencement of DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 Eagle County Regional Airport Jviation Project No. EGE LOC 20-01 Airfield Asphalt Pavement Maintenance – Construction Coordination April 15, 2020 Page 3 of 6 REV 2020.02 construction. The meeting will be held at the airport and will include the Sponsor, FAA (if possible), Contractor, subcontractors and airport tenants affected by the project. 5.5 Review Contractor’s Safety Plan Compliance Document. This task includes the review and to comment on the Contractor’s Safety Plan Compliance Document (SPCD) as required per FAA AC 150/5370- 2 (Current Edition), Operation Safety on Airports during Construction. The Engineer shall review to ensure that all applicable construction safety items are addressed and meet the requirements of AC 150/5370-2 (Current Edition) and the Contract’s Construction Safety and Phasing Plan (CSPP). The intent of the SPCD is to detail how the Contractor will comply with the CSPP. Following award of the project to the successful Contractor and prior to the issuance of the Notice to Proceed, the Engineer will review the SPCD, provide comments and ultimately approval of the document. It is anticipated that the document will require at least one re-submittal by the Contractor to address any missing information. The SPCD will be submitted to the Engineer for approval at least 14 days prior to the issuance of the Notice to Proceed to the Contractor. An approved copy of the SPCD shall be provided to the FAA. 5.6 Perform Site Visits During Construction. The Project Manager shall make on-site visits, as required, throughout the duration of the project. As of now, it is estimated that the Project Manager will be required to make a minimum of one site visit to the project. TASK 5 DELIVERABLES TO STATE TO SPONSOR 5.1 Construction SOW and Contract   5.2 Notice of Award, Notice to Proceed and Contract Agreement   5.2 Issue Construction Plans, Specifications and Contract Documents   5.3 Monthly Invoice and Monthly PSR   5.3 Pay Request Review Documentation   5.3 Weekly/Monthly Reports   5.3 Change Orders/Supplemental Agreements   5.4 Pre-Construction Agenda and Meeting Minutes  5.5 Review and Approval of SPCD and Final SPCD  TASK 5 MEETINGS/SITE VISITS LOCATION/ATTENDEES/DURATION 5.4 Conduct Pre-Construction Meeting · Gypsum, CO One (1) Project Manager and One (1) Construction Manager Assume full day site visit (1 site visit) Assume travel to/from Denver, CO to Gypsum, CO 5.6 Perform Site Visits During Construction · Gypsum, CO One (1) Project Manager Assume full day site visit (1 site visit) Assume travel to/from Denver, CO to Gypsum, CO 6.0 Post Construction Coordination Phase 6.1 Prepare Clean-up Item List. The Engineer will ensure the Contractor has removed all construction equipment and construction debris from the airport, that all access points have been re-secured (fences repaired, gates closed and locked, keys returned, etc.) and the site is clean. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 Eagle County Regional Airport Jviation Project No. EGE LOC 20-01 Airfield Asphalt Pavement Maintenance – Construction Coordination April 15, 2020 Page 4 of 6 REV 2020.02 6.2 Conduct Final Inspection. The Engineer, along with the Sponsor and CDOT (if available), shall conduct the final inspection. 6.3 Prepare Engineering Record Drawings. The Engineer will prepare the record drawings indicating modifications made during construction. An electronic and paper copy of the record drawings will be sent to the CDOT. 6.4 Summarize Project Costs. The Engineer will be required to obtain all administrative expenses, engineering fees and costs, testing costs and construction costs associated with the project and assemble a total project summary. The summary will be analyzed with the associated project funding. TASK 6 DELIVERABLES TO STATE TO SPONSOR 6.1 Clean-up List  6.2 Punch Lists  6.3 Record Drawings   6.4 Project Cost Summary   TASK 6 MEETINGS/SITE VISITS LOCATION/ATTENDEES/DURATION 6.2 Conduct Final Inspection · Gypsum, CO One (1) Project Manager and One (1) Construction Manager Assume full day site visit (1 site visit) Assume travel to/from Denver, CO to Gypsum, CO 7.0 On-Site Construction Coordination Phase This phase will consist of providing one full time Construction Manager. It shall be the responsibility of the Construction Manager to facilitate sufficient on-site construction coordination to ensure that the project is completed according to good construction practice and the Project Manager’s direction. It is estimated that it will take 23 calendar days to complete construction of the project. Incidental travel costs, including vehicle usage, mileage, lodging, per diem, etc., are in addition to the engineering hours expended. 7.1 Provide Resident Engineering. The Construction Manager will work approximately 12 hours per day. It is assumed that the Construction Manager will be able to complete all daily project documentation in the course of their shift and that total inspection on-site time is anticipated to be 23 calendar days. It is assumed that the Contractor will work seven (7) days a week during the construction period resulting in 23 working days. The following tasks will be performed during the course of a typical day’s shift during construction:  Reviewing and approving construction submittals, consisting of the plans and material submittal data received from the Contractor.  Review copies of the survey data and other construction tasks for general compliance with the construction documents.  Coordinate, review and provide a response to construction and general project Request for Information (RFI’s).  Prepare and process change orders and/or supplemental agreements.  Maintain record of the progress of construction and review the quantity records with the Contractor on a periodic basis. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 Eagle County Regional Airport Jviation Project No. EGE LOC 20-01 Airfield Asphalt Pavement Maintenance – Construction Coordination April 15, 2020 Page 5 of 6 REV 2020.02  Prepare the periodic cost estimates and review the quantities with the Contractor. The Engineer, Sponsor and Contractor will resolve discrepancies or disagreements with the Contractor’s records. The periodic cost estimate will also include all other costs associated with the project (administrative costs, engineering, any miscellaneous costs). After compiling all costs, the Engineer will then submit the periodic cost estimate to the Sponsor for payment.  Maintain daily logs of the construction activities for the duration of time on site which includes the Construction Project Daily Inspection Checklist as required by the Construction Safety and Phasing Plan and SPCD.  Prepare a weekly status report using the FAA's standard form. The report will be submitted to the Sponsor, CDOT and the office following the week of actual construction activities performed. TASK 7 DELIVERABLES TO STATE TO SPONSOR 7.1 Coordinate Submittal Reviews  7.1 Coordinate RFIs  7.1 Change Orders   7.1 Periodic Cost Estimates   7.1 Weekly Reports   EX Reimbursable Costs during Construction This section includes reimbursable items such as auto rental, mileage, lodging, per diem, travel and other miscellaneous costs incurred in order to complete Part B – Special Services. Sections 5, 6, and 7 Reimbursables are invoiced on a lump sum basis. Assumptions The scope of services described previously is based on the following assumptions of responsibilities by the Engineer and Sponsor. 1. It is anticipated there will be a minimum number of trips and site visits to the airport to facilitate the completion of the various phases listed in this scope. Each trip is anticipated to be a one-day trip and the number of trips for each phase are included at the end of each phase above. 2. The Sponsor will coordinate with tenants as required to facilitate field evaluations and construction. 3. All engineering work will be performed using accepted engineering principles and practices and provide quality products that meet or exceed industry standards. Dimensional criteria will be in accordance with FAA AC 150/5300-13 (Current Edition), Airport Design and related circulars. Construction specifications will be in accordance with FAA AC 150/5370-10 (Current Edition), Standard Specifications for Construction of Airports and the Northwest Mountain Region’s Regional Updates for Specifying Construction of Airports and related circulars. Project planning, design and construction will further conform to all applicable standards, including all applicable current FAA Advisory Circulars and Orders required for use in AIP- funded projects and other national, state, or local regulations and standards, as identified and relevant to an airfield design and construction project. 4. The Engineer must maintain records of design analyses and calculations consistent with typical industry standards, as required by the FAA, for a period of three years after the project is closed. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 Eagle County Regional Airport Jviation Project No. EGE LOC 20-01 Airfield Asphalt Pavement Maintenance – Construction Coordination April 15, 2020 Page 6 of 6 REV 2020.02 5. Because the Engineer has no control over the cost of construction-related labor, materials, or equipment, the Engineer's opinions of probable construction costs will be made on the basis of experience and qualifications as a practitioner of his/her profession. The Engineer does not guarantee that proposals for construction, construction bids, or actual project construction costs will not vary from Engineer's estimates of construction cost. 6. It is assumed that a project audit will not be performed. If a project audit occurs, the Engineer is prepared to assist the Sponsor in gathering and preparing the required materials for the audit. This work will be negotiated with the Sponsor, should the need occur and payment will be on a time and material basis. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 AIRPORT:JVIATION PROJECT NUMBER: EGE LOC 20-01PROJECT NAME: Airfield Asphalt Pavement MaintenanceDATE: April 15, 2020FEE BREAKDOWNLABOR HOUR BREAKDOWNLabor CategoryTotal CostPrincipal Project Manager IIIConstruction Manager IVAssociate Engineer IProject Coordinator IISupport IIPhase Item Costs5.0 Construction Administration Phase (Lump Sum)5.0 Construction Administration Phase (Lump Sum)4 hrs. x 275.00$ /hr = 1,100.00$ 5.1 Prepare Project Scope of Work and Contract2 2 822,780.00$ 30 hrs. x 195.00$ /hr = 5,850.00$ 5.2 Prepare Construction Contract and Documents24790.00$ 20 hrs. x 200.00$ /hr = 4,000.00$ 5.3Provide Project Coordination2 842,430.00$ 4 hrs. x 100.00$ /hr = 400.00$ 5.4 Prepare/Conduct Pre-Construction Meeting8 83,160.00$ 2 hrs. x 120.00$ /hr = 240.00$ 5.5 Review Contractor's Safety Plan Compliance Document2 41,190.00$ 4 hrs. x 80.00$ /hr = 320.00$ 5.6 Perform Site Visits During Construction81,560.00$ -$ -$ -$ SUBTOTAL 64hrs.11,910.00$ Reimbursables2 Day x 70.00$ /Day= 140.00$ 660 Mi x 0.575$ /Mi= 379.50$ 0 Day x 205.00$ /Day= -$ Per Diem 0 Day x 76.00$ /Day= -$ Travel & Airline Costs 0 Trip x 500.00$ /Trip= -$ 519.50$ 12,429.50$ 430204240000000011,910.00$ Labor CategoryTotal CostPrincipal Project Manager IIIConstruction Manager IVConstruction Manager ICADD Tech IIPhase Item Costs6.0 Post Construction Coordination Phase (Lump Sum)6.0 Post Construction Coordination Phase (Lump Sum)2 hrs. x 275.00$ /hr = 550.00$ 6.1 Prepare Clean-up Item List2 4860.00$ 12 hrs. x 195.00$ /hr = 2,340.00$ 6.2 Conduct Final Inspection8 4 83,280.00$ 6 hrs. x 200.00$ /hr = 1,200.00$ 6.3 Prepare Engineering Record Drawings1 24 41,545.00$ 18 hrs. x 115.00$ /hr = 2,070.00$ 6.4 Summarize Project Costs1 22895.00$ 4 hrs. x 105.00$ /hr = 420.00$ -$ -$ -$ -$ -$ -$ -$ SUBTOTAL 42hrs.6,580.00$ Reimbursables2 Day x 70.00$ /Day= 140.00$ 380 Mi x 0.575$ /Mi= 218.50$ 0 Day x 205.00$ /Day= -$ Per Diem 0 Day x 76.00$ /Day= -$ Travel & Airline Costs 0 Trip x 500.00$ /Trip= -$ 358.50$ 6,938.50$ 21261840000000006,580.00$ Labor CategoryTotal CostConstruction Manager IPhase Item Costs7.0 On-Site Construction Coordination Phase (Lump Sum)7.0 On-Site Construction Coordination Phase (Lump Sum)276 hrs. x 115.00$ /hr = 31,740.00$ Estimated Calendar Days from Scope of Work23Estimated Working Days/Week from Scope of Work 7Total Days Scoped for Resident Engineering23Estimated Hours/Day from Scope of Work127.1 Provide Resident Engineering27631,740.00$ SUBTOTAL 276hrs.31,740.00$ Reimbursables23 Day x 70.00$ /Day= 1,610.00$ 1150 Mi x 0.575$ /Mi= 661.25$ 23 Day x 205.00$ /Day= 4,715.00$ Per Diem 23 Day x 76.00$ /Day= 1,748.00$ Travel & Airline Costs 0 Trip x 500.00$ /Trip= -$ 8,734.25$ 40,474.25$ 276000000000000031,740.00$ Phase Fee Reimbursable Costs Total CostPART B - SPECIAL SERVICES (LUMP SUM)5.0 Construction Administration Phase (Lump Sum)11,910.00$ 519.50$ 12,429.50$ 6.0 Post Construction Coordination Phase (Lump Sum)6,580.00$ 358.50$ 6,938.50$ 7.0 On-Site Construction Coordination Phase (Lump Sum)31,740.00$ 8,734.25$ 40,474.25$ SUBTOTAL50,230.00$ 9,612.25$ 59,842.25$ 50,230.00$ 9,612.25$ 59,842.25$ TOTALSTOTALSAuto RentalConstruction Manager IMileageLodging + Tax & FeesLABOR CATEGORYLABOR CATEGORYTASKTASKTOTALSSUBTOTALTASKLABOR CATEGORYBilling RateSUBTOTALTotal HoursSUBTOTALSUBTOTALSUBTOTALConstruction Manager IVPrincipalTotal HoursMileageProject Manager IIIAuto RentalEagle County Regional AirportSUBTOTALSUBTOTALBilling RateBilling RatePrincipalProject Manager IIIAssociate Engineer IProject Coordinator IISupport IITotal HoursLodging + Tax & FeesTOTALSUBTOTALConstruction Manager IVConstruction Manager IAuto RentalCADD Tech IIMileageLodging + Tax & FeesSUBTOTALPage 1 of 1REV 2020.01DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 12/20/2019 Moody Insurance Agency, Inc. 8055 East Tufts Avenue Suite 1000 Denver CO 80237 Leigh Pullen (303) 824-6600 (303) 370-0118 leigh.pullen@moodyins.com Jviation, Inc. 900 S. Broadway Suite 350 Denver CO 80209 Travelers Indemnity of America 25666 Travelers Indemnity Company 25658 Lexington Insurance Co 19437 20/21 Master A Y 6803K605697 01/01/2020 01/01/2021 1,000,000 1,000,000 5,000 1,000,000 2,000,000 2,000,000 B BA3K607433 01/01/2020 01/01/2021 1,000,000 B 10,000 CUP3K612467 01/01/2020 01/01/2021 9,000,000 9,000,000 B N UB3K609703 01/01/2020 01/01/2021 1,000,000 1,000,000 1,000,000 C Primary Professional 031711172 01/01/2020 01/01/2021 Each Claim Limit 5,000,000 Aggregate Limit 5,000,000 RE: Any and All Projects Eagle County Regional Airport Attn Josh Miller Construction Manager 219 Eldon Wilson Road Gypsum CO 81637 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 Jviation, Inc.Moody Insurance Agency, Inc. 25 Certificate of Liability Insurance: Notes Other Coverage Lines: Aviation Insurance Policy/Unmanned Aircraft Policy Number: 9008387. Policy Effective Dates: 01/01/2020- 01/01/2021. Insurer: American Alternative Insurance Corp. Limits of Insurance: Each Occurrence Limit $3,000,000. Passenger War Liability Included. Medical Limit $5,000. Pollution Liability Policy: Policy Number: 031711172 Policy Effective Dates: 01/01/2020 – 01/01/2021 Insurer: Lexington Insurance Co. Pollution Liability Limit: $5,000,000 Each Pollution Condition Cyber Liability Policy: Policy Number: EVOPNZ490793 Policy Effective Dates: 01/01/2020 – 01/01/2021 Insurer: Evolve MGA Cyber Liability Limit: $1,000,000 Deductible: $10,000 General Liability CG D3 81 09 15 - Blanket Additional Insured Status When Required by Written Contract CG D3 81 09 15 – Blanket Waiver of Subrogation Status When Required by Written Contract CG D3 79 01 16 - Architects, Engineers and Surveyors Coverage Xtended Endorsement - Blanket Additional Insured, Blanket Waiver of Subrogation CG D4 69 07 14 - Per Project and Location Aggregate Limit Drone Liability UASA121 10/18 Additional Insured Endorsement Automobile Liability CA T420 0215 - Blanket Additional Insured & Waiver of Subrogation Umbrella Liability UM 04 88 07 08 – Blanket Waiver of Subrogation Status When Required by Written Contract Workers Compensation WC 00 03 13 00 001 Form Attached Includes: Blanket Waiver of Subrogation status applies when required by written contract. IMPORTANT: The policy forms referenced will be sent via email only. To obtain copies, please send your request with the email address to certrequest@moodyins.com. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 UMBRELLA UM 04 88 07 08 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement modifies insurance provided under the following: COMMERCIAL EXCESS LIABILITY (UMBRELLA) INSURANCE Page 1 of 1© 2008 The Travelers Companies, Inc. Includes the copyrighted material of Insurance Services Office, Inc. with its permission. The following is added to Paragraph 11., OUR RIGHT TO RECOVER FROM OTHERS., of SECTION IV – CONDITIONS.: If the insured has agreed in a contract or agreement to waive that insured's right of recovery against any person or organization, we waive our right of recovery against such person or organization, but only for payments we make because of: a."Bodily injury" or "property damage" caused by an "occurrence" that takes place; or b."Personal injury" or "advertising injury" caused by an "offense" that is committed; subsequent to the execution of the contract or agree- ment. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. This endorsement is effective: February 13, 2019 Endorsement Premium: Included Attached to and made part of Policy No.: 9008387 Issued to: JVIATION, INC. Global Aerospace, Inc. BY: UASA121 (October 1, 2018) Endorsement No. 1 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ADDITIONAL INSURED In consideration of the payment of the premium for this policy, it is agreed that solely as respects an occurrence arising out of the ownership, maintenance or use of a scheduled aircraft and solely to the extent required in an agreement with you for the use of a scheduled aircraft, the following provisions shall apply: 1.Subject to the policy exclusions and Paragraph 2 below, and to no greater extent than the scope of the insurance afforded by this policy, as respects the insurance afforded by Coverage A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY, policy SECTION III – WHO IS AN INSURED is extended to include any person or organization, but only as respects your use of a scheduled aircraft, and only as respects his, her, or its liability because of your acts or omissions. 2.No person or organization described in paragraph 1 above, or agent or employee thereof, is an Insured if engaged in the manufacture, maintenance, repair, or sale of aircraft, aircraft engines, components or accessories, or in the operation of any airport, hangar, flying school, flight service, or aircraft or piloting service, as respects any occurrence arising out of such activity. 3.The insurance afforded by this endorsement shall be primary without right of contribution by any other valid and collectible insurance available to any person or organization described in paragraph 1 above. 4.Unless otherwise indicated in the policy, we waive any right of recovery we may have against any person or organization described in paragraph 1 above because of payments we make for physical damage in accordance with Coverage B - PHYSICAL DAMAGE TO SCHEDULED AIRCRAFT, but only to the same extent that you have waived your right of recovery for such physical damage against such person or organization. 5.If we cancel this policy we will give written notice to each person or organization described in paragraph 1 above at least: (a)ten (10) days before the effective date of cancellation if we cancel for non-payment of premium; or (b)thirty (30) days before the effective date of cancellation if we cancel for any other reason. 6.If we require any material change that is adverse to the interest of any person or organization described in paragraph 1 above, we will give thirty (30) days written notice to each person or organization described in paragraph 1 above. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 6803K6056971847DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ARCHITECTS, ENGINEERS AND SURVEYORS COVERAGE XTEND ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CG D3 79 01 16 © 2016 The Travelers Indemnity Company. All rights reserved.Page 1 of 6 GENERAL DESCRIPTION OF COVERAGE This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this endorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. C.Reasonable Force – Bodily Injury Or Property Damage D.Non-Owned Watercraft – Increased To Up To 75 feet E.Aircraft Chartered With Crew F.Damage To Premises Rented To You G.Malicious Prosecution – Exception To Knowing Violation Of Rights Of Another Exclusion H.Medical Payments – Increased Limit I.Increased Supplementary Payments J.Additional Insured – Owner, Manager Or Lessor Of Premises A.Broadened Named Insured B.Incidental Medical Malpractice K.Additional Insured – Lessor Of Leased Equipment L.Additional Insured – State Or Political Subdivisions – Permits Relating To Premises M.Additional Insured – State Or Political Subdivisions – Permits Relating To Operations N.Who Is An Insured – Newly Acquired Or Formed Organizations O.Knowledge And Notice Of Occurrence Or Offense P.Unintentional Omission Q.Waiver Of Transfer Of Rights Of Recovery Against Others To Us When Required By Written Contract R.Amended Insured Contract Definition – Railroad Easement PROVISIONS A.BROADENED NAMED INSURED 1.The following is added to SECTION II – WHO IS AN INSURED: Any organization, other than a partnership or joint venture, over which you maintain ownership or majority interest on the effective date of the policy qualifies as a Named Insured. However, coverage for any such additional organization will cease as of the date during the policy period that you no longer maintain ownership of, or majority interest in, such organization. B.INCIDENTAL MEDICAL MALPRACTICE 1.The following is added to the definition of "occurrence" in the DEFINITIONS Section: Unless you are in the business or occupation of providing professional health care services, "occurrence" also means an act or omission committed in providing or failing to provide first aid or "Good Samaritan services" to a person. 2.The following is added to the DEFINITIONS Section: "Good Samaritan services" means any emergency medical services for which no compensation is demanded or received. 3.The following is added to Paragraph 2.a.(1) of SECTION II – WHO IS AN INSURED: Unless you are in the business or occupation of providing professional health care services, Paragraphs (1)(a), (b), (c) and (d) above DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 COMMERCIAL GENERAL LIABILITY Page 2 of 6 © 2016 The Travelers Indemnity Company. All rights reserved.CG D3 79 01 16 does not apply to any "bodily injury" arising out of any providing or failing to provide first aid or "Good Samaritan services" by any of your "employees", other than an employed doctor. Any such "employees" providing or failing to provide first aid or "Good Samaritan services" during their work hours for you will be deemed to be acting within the scope of their employment by you or performing duties related to the conduct of your business. 4.The following exclusion is added to Paragraph 2., Exclusions, of SECTION I – COVERAGES – COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY in COVERAGES: Sale of Pharmaceuticals "Bodily injury" or "property damage" arising out of the willful violation of a penal statute or ordinance relating to the sale of pharmaceuticals committed by, or with the knowledge or consent of, the insured. 5.The following is added to Paragraph 5. of SECTION III – LIMITS OF INSURANCE: For the purposes of determining the applicable Each Occurrence Limit, all related acts or omissions committed in the providing or failing to provide first aid or "Good Samaritan services" to any one person will be considered one "occurrence". 6.The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to any of your "employees" for "bodily injury" that arises out of providing or failing to provide first aid or "Good Samaritan services" to any person to the extent not subject to Paragraph 2.a.(1) of Section II – Who Is An Insured. C.REASONABLE FORCE – BODILY INJURY OR PROPERTY DAMAGE The following replaces Exclusion a., Expected Or Intended Injury, in Paragraph 2. of SECTION I – COVERAGES – COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: 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 any person or property. D.NON-OWNED WATERCRAFT – INCREASED TO UP TO 75 FEET 1.The following replaces Paragraph (2) of Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I – COVERAGES – COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY: (2)A watercraft you do not own that is: (a)Less than 75 feet long; and (b)Not being used to carry any person or property for a charge; 2. The following is added to Paragraph 2. of SECTION II – WHO IS AN INSURED: Any person or organization that, with your express or implied consent, either uses or is responsible for the use of a watercraft that you do not own that is: (a)Less than 75 feet long; and (b)Not being used to carry any person or property for a charge; 3.The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured for "bodily injury" that arises out of the use of a watercraft that you do not own that is: (a)Less than 75 feet long; and (b)Not being used to carry any person or property for a charge. E.AIRCRAFT CHARTERED WITH CREW 1.The following is added to Exclusion g., Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I – COVERAGES – COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY in COVERAGES: This exclusion does not apply to an aircraft that is: (a)Chartered with crew to any insured; DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 COMMERCIAL GENERAL LIABILITY CG D3 79 01 16 © 2016 The Travelers Indemnity Company. All rights reserved.Page 3 of 6 (b)Not owned by any insured; and (c)Not being used to carry any person or property for a charge. 2.The following is added to Paragraph 4.b., Excess Insurance, of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: This insurance is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured for use of an aircraft that is: (a)Chartered with crew to any insured; (b)Not owned by any insured; and (c)Not being used to carry any person or property for a charge. F.DAMAGE TO PREMISES RENTED TO YOU 1.The following replaces the last paragraph of Paragraph 2., Exclusions, of SECTION I – COVERAGES – COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY in COVERAGES: Exclusions c. through n. do not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a.Fire; b.Explosion; c.Lightning; d.Smoke resulting from such fire, explosion, or lightning; or e.Water. A separate limit of insurance applies to such damage to premises as described in Paragraph 6. of Section III – Limits Of Insurance. This insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: a.Rupture, bursting, or operation of pressure relief devices; b.Rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from water; or c.Explosion of steam boilers, steam pipes, steam engines, or steam turbines. 2.The following replaces Paragraph 6. of SECTION III – LIMITS OF INSURANCE: 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 temporarily occupied by you with permission of the owner, caused by fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water. The Damage To Premises Rented To You Limit will apply to all damage proximately caused by the same "occurrence", whether such damage results from: fire; explosion; lightning; smoke resulting from such fire, explosion, or lightning; or water; or any combination of any of these. The Damage To Premises Rented To You Limit will be the higher of: a.$1,000,000; or b.The amount shown on the Declarations of this Coverage Part for Damage To Premises Rented To You Limit. 3.The following replaces Paragraph a. of the definition of "insured contract" in the DEFINITIONS Section: 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 to premises while rented to you, or temporarily occupied by you with permission of the owner, caused by: (1)Fire; (2)Explosion; (3)Lightning; (4)Smoke resulting from such fire, explosion, or lightning; or (5)Water, is not an "insured contract"; 4.The following replaces Paragraph 4.b.(1)(b) of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: (b)That is insurance for premises rented to you, or temporarily occupied by you with the permission of the owner; DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 COMMERCIAL GENERAL LIABILITY Page 4 of 6 © 2016 The Travelers Indemnity Company. All rights reserved.CG D3 79 01 16 G.MALICIOUS PROSECUTION – EXCEPTION TO KNOWING VIOLATION OF RIGHTS OF ANOTHER EXCLUSION The following is added to Exclusion a., Knowing Violation Of Rights Of Another, in Paragraph 2. of SECTION I – COVERAGES – COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY: This exclusion does not apply to "personal injury" caused by malicious prosecution. H.MEDICAL PAYMENTS – INCREASED LIMIT The following replaces Paragraph 7. of SECTION III – LIMITS OF INSURANCE: 7.Subject to 5. above, the Medical Expense Limit is the most we will pay under Coverage C. for all medical expenses because of "bodily injury" sustained by any one person, and will be the higher of: (a)$10,000; or (b)The amount shown on the Declarations of this Coverage Part for Medical Expense Limit. I.INCREASED SUPPLEMENTARY PAYMENTS 1.The following replaces Paragraph 1.b. of SUPPLEMENTARY PAYMENTS – COVERAGES A AND B of SECTION I – COVERAGES: b.Up to $2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2.The following replaces Paragraph 1.d. of SUPPLEMENTARY PAYMENTS – COVERAGES A AND B of SECTION I – COVERAGES: 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. J.ADDITIONAL INSURED – OWNER, MANAGER OR LESSOR OF PREMISES The following is added to SECTION II – WHO IS AN INSURED: Any person or organization that is a premises owner, manager or lessor and that you have agreed in a written contract to name as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a.Is "bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" caused by an offense that is committed, after you have signed that contract; and b.Arises out of the ownership, maintenance or use of that part of any premises leased to you under that written contract. The insurance provided to such premises owner, manager or lessor is subject to the following provisions: a.The limits of insurance provided to such premises owner, manager or lessor will be the limits which you agreed to provide in the written contract, or the limits shown on the Declarations of this Coverage Part, whichever are less. b.The insurance provided to such premises owner, manager or lessor does not apply to: (1)"Bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" caused by an offense that is committed, after you cease to be a tenant in that premises; or (2)Structural alterations, new construction or demolition operations performed by or on behalf of such premises owner, manager or lessor. c.The insurance provided to such premises owner, manager or lessor is excess over any valid and collectible other insurance available to such premises owner, manager or lessor, unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. K.ADDITIONAL INSURED – LESSOR OF LEASED EQUIPMENT The following is added to SECTION II – WHO IS AN INSURED: Any person or organization that is an equipment lessor and that you have agreed in a written contract to name as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage", "personal injury" or "advertising injury" that: a.Is "bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" caused by an offense that is DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 COMMERCIAL GENERAL LIABILITY CG D3 79 01 16 © 2016 The Travelers Indemnity Company. All rights reserved.Page 5 of 6 committed, after you have signed that written contract; and b.Is caused, in whole or in part, by acts or omissions of you or any person or organization performing operations on your behalf, in the maintenance, operation or use of equipment leased to you by such equipment lessor. The insurance provided to such equipment lessor is subject to the following provisions: a.The limits of insurance provided to such equipment lessor will be the limits which you agreed to provide in the written contract, or the limits shown on the Declarations of this Coverage Part, whichever are less; and b.The insurance provided to such equipment lessor does not apply: (1)To any "bodily injury" or "property damage" caused by an "occurrence" that takes place, or "personal injury" caused by an offense that is committed, after the equipment lease expires; or (2)If the equipment is leased with an operator. c.The insurance provided to such equipment lessor is excess over any valid and collectible other insurance available to such equipment lessor, unless you have agreed in a written contract for this insurance to apply on a primary or contributory basis. L.ADDITIONAL INSURED – STATE OR POLITICAL SUBDIVISIONS – PERMITS RELATING T O PREMISES The following is added to Paragraph 2. of SECTION II – WHO IS AN INSURED: Any state or political subdivision that has issued a permit in connection with premises owned or occupied by, or rented or loaned to, you, is an insured, but only with respect to "bodily injury", "property damage", "personal injury" or "advertising injury" arising out of the existence, ownership, use, maintenance, repair, construction, erection or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, elevators, street banners or decorations for which that state or political subdivision has issued such permit. M.ADDITIONAL INSURED – STATE OR POLITICAL SUBDIVISIONS – PERMITS RELATING TO OPERATIONS The following is added to Paragraph 2. of SECTION II – WHO IS AN INSURED: Any state or political subdivision that has issued a permit with respect to operations performed by you or on your behalf is an insured, but only with respect to "bodily injury", "property damage", "personal injury" or "advertising injury" arising out of operations performed by you or on your behalf for which that state or political subdivision has issued such permit. However, no such state or political subdivision is an insured for: (1)"Bodily injury", "property damage", "personal injury" or "advertising injury" arising out of operations performed for that state or political subdivision; or (2)"Bodily injury" or "property damage" included within the "products – completed operations hazard". N.WHO IS AN INSURED – NEWLY ACQUIRED OR FORMED ORGANIZATIONS The following replaces Paragraph 4.a. of SECTION II – WHO IS AN INSURED: a.Coverage under this provision is afforded only: (1)Until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier, if you do not report such organization in writing to us within 180 days after you acquire or form it; or (2)Until the end of the policy period, when that date is later than 180 days after you acquire or form such organizations, if you report such organization in writing to us within 180 days after you acquire or form it. O.KNOWLEDGE AND NOTICE OF OCCURRENCE OR OFFENSE The following is added to Paragraph 2., Duties In The Event of Occurrence, Offense, Claim Or Suit, of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: e.The following provisions apply to Paragraph a. above, but only for the purposes of the insurance provided under this Coverage Part to you or any insured listed in Paragraph 1. or 2. of Section II – Who Is An Insured: DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 Page 6 of 6 © 2016 The Travelers Indemnity Company. All rights reserved.CG D3 79 01 16 COMMERCIAL GENERAL LIABILITY (1)Notice to us of such "occurrence" or of an offense must be given as soon as practicable only after the "occurrence" or offense is known to you (if you are an individual), any of your partners or members who is an individual (if you are a partnership or joint venture), any of your managers who is an individual (if you are a limited liability company), any of your trustees who is an individual (if you are a trust), any of your "executive officers" or directors (if you are an organization other than a partnership, joint venture, limited liability company or trust), or any "employee" (such as an insurance, loss control or risk manager or administrator) authorized by you to give notice of an "occurrence" or offense. Knowledge by any other "employee" of an "occurrence" or offense does not imply that you also have such knowledge. (2)If you are a partnership, joint venture, limited liability company or trust, and none of your partners, joint venture members, managers or trustees are individuals, notice to us of such "occurrence" or offense must be given as soon as practicable only after the "occurrence" or offense is known by: (a)Any individual who is: (i)A partner or member of any partnership or joint venture; (ii)A manager of any limited liability company; (iii)A trustee of any trust; or (iv)An executive officer or director of any other organization; that is your partner, joint venture member, manager or trustee; or (b)Any "employee" authorized by such partnership, joint venture, limited liability company, trust or other organization to give notice of an "occurrence" or offense. (3)Notice to us of such "occurrence" or offense will be deemed to be given as soon as practicable if it is given in good faith as soon as practicable to your workers' compensation, accident, or health insurer. This applies only if you subsequently give notice to us of the "occurrence" or offense as soon as practicable after any of the persons described in Paragraphs e. (1) or (2) above discovers that the "occurrence" or offense may result in sums to which the insurance provided under the Coverage Part may apply. P.UNINTENTIONAL OMISSION The following is added to Paragraph 6., Representations, of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: The unintentional omission of, or unintentional error in, any information provided by you which we relied upon in issuing this policy will not prejudice your rights under this insurance. However, this provision does not affect our right to collect additional premium or to exercise our rights of cancellation or nonrenewal in accordance with applicable insurance laws or regulations. Q.WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US WHEN REQUIRED BY WRITTEN CONTRACT The following is added to Paragraph 8., Transfer of Rights of Recovery Against Others to Us, of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of premises owned or occupied by or rented or loaned to you; ongoing operations performed by you or on your behalf, done under a written 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 signed by you prior to loss. R.AMENDED INSURED CONTRACT DEFINITION – RAILROAD EASEMENT 1.The following replaces Paragraph c. of the definition of "insured contract" in the DEFINITIONS Section: c.Any easement or license agreement; 2.Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is deleted. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GENERAL DESCRIPTION OF COVERAGE This endorsement broadens coverage.However,coverage for any injury,damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part,and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement.The following listing is a general cover- age description only.Limitations and exclusions may apply to these coverages.Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights,duties,and what is and is not covered. A.BLANKET ADDITIONAL INSURED H.AUDIO,VISUAL AND DATA ELECTRONIC EQUIPMENT INCREASED LIMITB.EMPLOYEE HIRED AUTO I.WAIVER OF DEDUCTIBLE GLASSC.EMPLOYEES AS INSURED J.PERSONAL PROPERTYD.SUPPLEMENTARY PAYMENTS INCREASED LIMITS K.AIRBAGS E.TRAILERS INCREASED LOAD CAPACITY L.AUTO LOAN LEASE GAP F.HIRED AUTO PHYSICAL DAMAGE M.BLANKET WAIVER OF SUBROGATION G.PHYSICAL DAMAGE TRANSPORTATION EXPENSES INCREASED LIMIT A.BLANKET ADDITIONAL INSURED performing duties related to the conduct of your business.The following is added to Paragraph A.1.,Who Is An Insured,of SECTION II COVERED AUTOS 2.The following replaces Paragraph b.in B.5., LIABILITY COVERAGE:Other Insurance,of SECTION IV BUSI- NESS AUTO CONDITIONS:Any person or organization who is required under a written contract or agreement between you and b.For Hired Auto Physical Damage Cover- that person or organization,that is signed and age,the following are deemed to be cov- executed by you before the "bodily injury"or ered "autos"you own: "property damage"occurs and that is in effect (1)Any covered "auto"you lease,hire,during the policy period,to be named as an addi-rent or borrow;andtionalinsuredisan"insured"for Covered Autos (2)Any covered "auto"hired or rented byLiabilityCoverage,but only for damages to which your "employee"under a contract inthisinsuranceappliesandonlytotheextentthat an "employee's"name,with yourpersonororganizationqualifiesasan"insured" permission,while performing dutiesundertheWhoIsAnInsuredprovisioncontained related to the conduct of your busi-in Section II. ness.B.EMPLOYEE HIRED AUTO However,any "auto"that is leased,hired,1.The following is added to Paragraph A.1.,rented or borrowed with a driver is not aWhoIsAnInsured,of SECTION II COV-covered "auto".ERED AUTOS LIABILITY COVERAGE: C.EMPLOYEES AS INSUREDAn"employee"of yours is an "insured"while The following is added to Paragraph A.1.,Who Isoperatingacovered"auto"hired or rented An Insured,of SECTION II COVERED AUTOSunderacontractoragreementinan"em- LIABILITY COVERAGE:ployee's"name,with your permission,while CA T4 20 02 15 ©2015 The Travelers Indemnity Company.All rights reserved.Page 1 of 3 Includes copyrighted material of Insurance Services Office,Inc.with its permission. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 COMMERCIAL AUTO (2)An adjustment for depreciation and physicalAny"employee"of yours is an "insured"while us- ing a covered "auto"you don't own,hire or borrow condition will be made in determining actual in your business or your personal affairs.cash value in the event of a total "loss". D.SUPPLEMENTARY PAYMENTS INCREASED (3)If a repair or replacement results in better LIMITS than like kind or quality,we will not pay for the amount of betterment.1.The following replaces Paragraph A.2.a.(2)of SECTION II COVERED AUTOS LIABILITY (4)A deductible equal to the highest Physical COVERAGE:Damage deductible applicable to any owned covered "auto".(2)Up to $3,000 for cost of bail bonds (in- (5)This Coverage Extension does not apply to:cluding bonds for related traffic law viola- tions)required because of an "accident"(a)Any "auto"that is hired,rented or bor- we cover.We do not have to furnish rowed with a driver;orthesebonds. (b)Any "auto"that is hired,rented or bor-2.The following replaces Paragraph A.2.a.(4)of rowed from your "employee".SECTION II COVERED AUTOS LIABILITY G.PHYSICAL DAMAGE TRANSPORTATIONCOVERAGE: EXPENSES INCREASED LIMIT(4)All reasonable expenses incurred by the The following replaces the first sentence in Para-"insured"at our request,including actual graph A.4.a.,Transportation Expenses,oflossofearningsupto$500 a day be-SECTION III PHYSICAL DAMAGE COVER-cause of time off from work. AGE:E.TRAILERS INCREASED LOAD CAPACITY We will pay up to $50 per day to a maximum ofThefollowingreplacesParagraphC.1.of SEC-$1,500 for temporary transportation expense in-TION I COVERED AUTOS:curred by you because of the total theft of a cov- 1."Trailers"with a load capacity of 3,000 ered "auto"of the pri ate passenger type.v pounds or less designed primarily for travel H.AUDIO,VISUAL AND DATA ELECTRONIC on public roads.EQUIPMENT INCREASED LIMIT F.HIRED AUTO PHYSICAL DAMAGE Paragraph C.1.b.of SECTION III PHYSICAL The following is added to Paragraph A.4.,Cover-DAMAGE COVERAGE is deleted. age Extensions,of SECTION III PHYSICAL I.WAIVER OF DEDUCTIBLE GLASSDAMAGECOVERAGE: The following is added to Paragraph D.,Deducti- Hired Auto Physical Damage Coverage ble,of SECTION III PHYSICAL DAMAGE COVERAGE:If hired "autos"are covered "autos"for Covered Autos Liability Coverage but not covered "autos"No deductible for a covered "auto"will apply to for Physical Damage Coverage,and this policy glass damage if the glass is repaired rather than replaced.also provides Physical Damage Coverage for an owned "auto",then the Physical Damage Cover-J.PERSONAL PROPERTY age is extended to "autos"that you hire,rent or The following is added to Paragraph A.4.,Cover-borrow subject to the following:age Extensions,of SECTION III PHYSICAL DAMAGE COVERAGE:(1)The most we will pay for "loss"to any one "auto"that you hire,rent or borrow is the Personal Property Coverage lesser of:We will pay up to $400 for "loss"to wearing ap- (a)$50,000;parel and other personal property which is: (1)Owned by an "insured";and(b)The actual cash value of the damaged or stolen property as of the time of the (2)In or on your covered "auto". "loss";or This coverage only applies in the event of a total (c)The cost of repairing or replacing the theft of your covered "auto". damaged or stolen property with other No deductibles apply to Personal Property cover- property of like kind and quality.age. Page 2 of 3 ©2015 The Travelers Indemnity Company.All rights reserved.CA T4 20 02 15 Includes copyrighted material of Insurance Services Office,Inc.with its permission. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 COMMERCIAL AUTO K.AIRBAGS (2)Any: The following is added to Paragraph B.3.,Exclu-(a)Overdue lease or loan payments at the sions,of SECTION III PHYSICAL DAMAGE time of the "loss"; COVERAGE:(b)Financial penalties imposed under a Exclusion 3.a.does not apply to "loss"to one or lease for excessive use,abnormal wear more airbags in a covered "auto"you own that in-and tear or high mileage; flate due to a cause other than a cause of "loss"(c)Security deposits not returned by the les-set forth in Paragraphs A.1.b.and A.1.c.,but sor;only: (d)Costs for extended warranties,Credit Lifea.If that "auto"is a covered "auto"for Compre- Insurance,Health,Accident or DisabilityhensiveCoverageunderthispolicy; Insurance purchased with the loan orb.The airbags are not covered under any war-lease;andranty;and (e)Carry-over balances from previous loansc.The airbags were not intentionally inflated.or leases. We will pay up to a maximum of $1,000 for any M.BLANKET WAIVER OF SUBROGATIONone"loss". The following replaces Paragraph A.5.,TransferL.AUTO LOAN LEASE GAP Of Rights Of Recovery Against Others To Us, The following is added to Paragraph A.4.,Cover-of SECTION IV BUSINESS AUTO CONDI- age Extensions,of SECTION III PHYSICAL TIONS:DAMAGE COVERAGE: 5.Transfer Of Rights Of Recovery AgainstAutoLoanLeaseGapCoverageforPrivateOthersToUsPassengerTypeVehicles We waive any right of recovery we may haveIntheeventofatotal"loss"to a covered "auto"of against any person or organization to the ex-the private passenger type shown in the Schedule tent required of you by a written contract exe-or Declarations for which Physical Damage Cov- cuted prior to any "accident"or "loss",pro-erage is provided,we will pay any unpaid amount vided that the "accident"or "loss"arises out ofdueontheleaseorloanforsuchcovered"auto" the operations contemplated by such con-less the following: tract.The waiver applies only to the person or(1)The amount paid under the Physical Damage organization designated in such contract.Coverage Section of the policy for that "auto"; and CA T4 20 02 15 ©2015 The Travelers Indemnity Company.All rights reserved.Page 3 of 3 Includes copyrighted material of Insurance Services Office,Inc.with its permission. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL GENERAL LIABILITY BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CG D3 81 09 15 © 2015 The Travelers Indemnity Company. All rights reserved. Includes the copyrighted material of Insurance Services Office, Inc., with its permission Page 1 of 2 1.The following is added to SECTION II – WHO IS AN INSURED: Any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Coverage Part, but: a.Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b.If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies, or in connection with premises owned by or rented to you. The person or organization does not qualify as an additional insured: c.With respect to the independent acts or omissions of such person or organization; or d.For "bodily injury", "property damage" or "personal injury" for which such person or organization has assumed liability in a contract or agreement. The insurance provided to such additional insured is limited as follows: e.This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. f.This insurance does not apply to the rendering of or failure to render any "professional services". g.In the event that the Limits of Insurance of the Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the insurance provided to the additional insured shall be limited to the limits of liability required by that "written contract requiring insurance". This endorsement does not increase the limits of insurance described in Section III – Limits Of Insurance. h.This insurance does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products- completed operations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that occurs before the end of the period of time for which the "written contract requiring insurance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 2.The following is added to Paragraph 4.a. of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: The insurance provided to the additional insured is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover. However, if you specifically agree in the "written contract requiring insurance" that this insurance provided to the additional insured under this Coverage Part must apply on a primary basis or a primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person or organizations as a named insured for such loss, and we will not share with the other insurance, provided that: (1)The "bodily injury" or "property damage" for which coverage is sought occurs; and (2)The "personal injury" for which coverage is sought arises out of an offense committed; after you have signed that "written contract requiring insurance". But this insurance provided to the additional insured still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any other insurance. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 COMMERCIAL GENERAL LIABILITY Page 2 of 2 CG D3 81 09 15© 2015 The Travelers Indemnity Company. All rights reserved. Includes the copyrighted material of Insurance Services Office, Inc., with its permission 3.The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your work" performed by you, or on your behalf, done under a "written contract requiring insurance" with that person or organization. We waive this right only where you have agreed to do so as part of the "written contract requiring insurance" with such person or organization signed by you before, and in effect when, the "bodily injury" or "property damage" occurs, or the "personal injury" offense is committed. 4.The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part of any written contract under which you are required to include a person or organization as an additional insured on this Coverage Part, provided that the "bodily injury" and "property damage" occurs and the "personal injury" is caused by an offense committed: a.After you have signed that written contract; b.While that part of the written contract is in effect; and c.Before the end of the policy period. DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526 DocuSign Envelope ID: 6059B71B-84B1-43B5-9EAB-98A7B9A75526