Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutC20-324 Umbrella RoofingAGREEMENT FOR PROCUREMENT
AND INSTALLATION SERVICES BETWEEN
EAGLE COUNTY, COLORADO
AND
UMBRELLA ROOFING, INC.
THIS AGREEMENT (“Agreement”) is effective as of _________________________________ by and between
Umbrella Roofing, Inc., a Colorado corporation (hereinafter “Contractor”) and Eagle County, Colorado, a body
corporate and politic (hereinafter “County”).
RECITALS
WHEREAS, County desires to utilize Contractor to install new TPO roofing (the “Project”) for the Eagle County
Justice Center Annex Building at 955 Chambers Avenue, Eagle Colorado (the “Property”); and
WHEREAS, Contractor is authorized to do business in the State of Colorado and has the time, skill, expertise, and
experience necessary to provide the equipment, materials and installation services as set forth below in paragraph 1
hereof; and
WHEREAS, this Agreement shall govern the relationship between Contractor and County in connection with the
procurement of equipment, materials and 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 procure the materials, equipment and/or products (“Equipment”)
necessary for the Project and agrees to diligently provide all services, labor, personnel and materials necessary to
perform and complete the procurement and installation services described in Exhibit A (“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 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
A and the terms and conditions set forth in this Agreement, the terms and conditions set forth in this Agreement
shall prevail.
c.County shall have the right to inspect all Equipment. Inspection and acceptance shall not be
unreasonably delayed or refused. In the event County does not accept the Equipment for any reason in its sole
discretion, then Contractor shall upon County’s request and at no charge to County:
i.take the Equipment back;
ii.exchange the Equipment; or
iii.repair the Equipment.
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
9/1/2020
C20-324
2
2. County’s Representative. The Project Management 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 until the work is satisfactorily
completed and accepted by the Project Management Department designee.
4. Extension or Modification. 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.
5. Compensation. County shall compensate Contractor for the Equipment and performance of the Services in
a sum computed and payable as set forth in Exhibit A. The Equipment and performance of the Services under this
Agreement shall not exceed One Hundred Thousand, Eight Hundred and Thirty Four Dollars ($100,834). In
the event Contractor and County agree upon the need for additional services beyond those described in Exhibit A,
Contractor shall first provide County with a written estimate which shall include an estimate of the labor, materials
without any mark up and any additional costs necessary to perform the Services at a particular Property or
Properties. Each estimate must be approved by County’s Representative prior to commencement of the Services by
Contractor. Total compensation under this Agreement shall not exceed One Hundred Twenty Thousand, Eight
Hundred and Thirty Four Dollars ($120,834) without a written amendment to this Agreement. 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 Equipment and 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 the County may request. County agrees to
pay contractor for stockpiled materials prior to start of work, with submittal of appropriate and applicable paid
invoices for said materials.
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 Equipment or
Services for which payment was made were not provided or 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
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
3
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).
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.
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
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
4
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 unemployment 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 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.
Further, Contractor shall execute any bill of sale or other documents required by County to transfer title of the
Equipment to County. Contractor shall provide copies of any instruction or operations or care manuals and shall
further provide copies of any manufacturers warranties associated with the Equipment.
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: Project Management Department
Post Office Box 850
Eagle, CO 81631
3289 Cooley Mesa Road
Gypsum, CO 81637
Telephone: 970-328-3532
Facsimile: 970-328-3539
E-mail: josh.miller@eaglecounty.us
With a copy to:
Eagle County Attorney
500 Broadway
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
5
Post Office Box 850
Eagle, Co 81631
Telephone: 970-328-8685
Facsimile: 970-328-8699
E-Mail: atty@eaglecounty.us
CONTRACTOR:
Umbrella Roofing, Inc
PO Box 1717
Carbondale, CO 81623
Telephone: (970) 471-9966
E-Mail: jake@umbrella-roofing.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
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 intended purpose and use of the Equipment, 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 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
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
6
accepted or approved the Equipment and/or 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 hereby represents and warrants that the Equipment will be new and will perform the
Services in a good and workmanlike manner and guarantees all Work against defects in materials or workmanship
for a period of one (1) year from the date the Work is accepted by County, or such longer period as may be provided
by the law or as otherwise agreed to by the parties.
g. All guarantees and warranties of Equipment furnished to Contractor or any subcontractor by any
manufacturer or supplier are for the benefit of County. If any manufacturer or supplier of any Equipment furnishes
a guarantee or warrantee for a period longer than one (1) year, then Contractor’s guarantee or warrantee shall extend
for a like period as to such Equipment.
h. Contractor warrants that title to all Work and Equipment shall pass to County either by
incorporation into the Property or upon receipt by Contractor of payment from County (whichever occurs first) free
and clear of all liens, claims, security interests or encumbrances. Contractor further warrants that Contractor (or any
other person performing Work) purchased all Equipment free and clear of all liens, claims, security interests or
encumbrances. Notwithstanding the foregoing, Contractor assumes all risk of loss with respect to the Equipment
until the Equipment is installed and County has inspected and approved the same.
i. Within a reasonable time after receipt of written notice, Contractor shall correct at its own
expense, without cost to County, and without interruption to County:
i. Any defects in materials or workmanship which existed prior to or during the period of
any guarantee or warranty provided in this Agreement; and
ii. Any damage to any other Work or property caused by such defects or the repairing of
such defects.
j. Guarantees and warranties shall not be construed to modify or limit any rights or actions County
may otherwise have against Contractor in law or in equity.
k. 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.
l. 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.
m. 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.
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
7
n. 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.
o. 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.
p. 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.
q. 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.
r. The invalidity, illegality or unenforceability of any provision of this Agreement shall not affect the
validity or enforceability of any other provision hereof.
s. 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.
t. 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:
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
8
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.
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.
IN WITNESS WHEREOF, the parties have executed this Agreement the day and year first set forth above.
COUNTY OF EAGLE, STATE OF
COLORADO, By and Through Its
BOARD OF COUNTY COMMISSIONERS
ATTEST:
____________________________ By:______________________________
Clerk to the Board of Kathy Chandler-Henry
County Commissioners County Commissioners Chair
CONTRACTOR:
Umbrella Roofing, Inc.
By:________________________________
Print Name: _________________________
Title: ______________________________
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
President
Trevor Cannon
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
08/19/2020
Martin Insurance Group
995 Cowen Dr Unit 202
Carbondale CO 81623
Marlane Zettlemoyer
(970) 963-6161 (970) 963-4331
marlane@martininsurancegrp.com
Umbrella Roofing
PO Box 1717
Carbondale CO 81623
Pinnacol Assurance 41190
CL206123725
A 4093141 06/01/2020 06/01/2021 1,000,000
1,000,000
1,000,000
Blanket Waiver of Subrogation for Workers Compensation exists to any person or organization when agreed to under a written contract or agreement which
is in effect and executed prior to any loss.
Eagle County
PO Box 850
Eagle CO 81631
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: A598FF5E-BE61-4818-A03E-4486C66F9233
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
8/19/2020
(970) 945-9111 (970) 945-2350
13037
Umbrella Roofing Inc.
PO Box 1717
Carbondale, CO 81623
10677
19445
10172
A 1,000,000
X CSU0080434 3/8/2020 3/8/2021 100,000
2,000
1,000,000
2,000,000
2,000,000
EE BENEFITS AGG 3,000,000
1,000,000B
X ENP0479173/EBA0479173 3/8/2020 3/8/2021
2,000,000C
BE016392611 3/8/2020 3/8/2021 2,000,000
0
D Pollution Liability G46875680003 3/8/2020 Per Occurenece 1,000,000
B Equipment Floater ENP0479173/EBA0479173 3/8/2020 3/8/2021 Scheduled Equipment 18,000
Certificate Holder: Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and volunteers, are
included as Additional Insured with respect to General Liability, including Ongoing and Completed Operations coverage, if required by written contract.
Certificate Holder: Eagle County, its associated or affiliated entities, its successors and assigns, elected officials, employees, agents and volunteers, is
included as Additional Insured with respect to Auto Liability, if required by written contract.
Eagle County
PO Box 850
Eagle, CO 81631
UMBRROO-01 RACHAELS
Mountain West Insurance - Glenwood
201 Centennial St 4th Floor
Glenwood Springs, CO 81601
Thomas Reece, CIC
The Cincinnati Specialty Underwriters Insurance Company
Cincinnati Insurance Company
National Union Fire Insurance Company of Pittsburgh, Pa.
Westchester Surplus Lines Insurance Company
1
3/8/2021
X
X
X
X
X
X
X
X
X
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
†‰·«…»›‰–§fi•„‚‹»…‡¿‹»fi•¿· –”˝
Ł Ł Œ —fi–»fi‹•»›†‰'•‹‚•‹›»fi‡•››•–†—¿„»–”
˝ ˛˝˝—˙ —˝˛˛¸˙
•†‰•—·«›r
¸˝˝˝¸¨ı r
ł¨—˚˛—¸˝
˛˝
‚•›»†…–fi›»‡»†‹‡–…•”•»›•†›«fi¿†‰»fi–“•…»… § ‹‚» ”–··–'•†„
¸˝˝˝ ¸˚˛˛
•‹‚fi»›»‰‹ ‹–‹‚»‰–“»fi¿„»fi –“•…»…§‹‚•›»†…–fi›»‡»†‹‹‚»fi–“•›•–†›–” ‹‚»–“»fi¿„» –fi‡¿·§«†·»››
‡–…•”•»…§ ‹‚•› »†…–fi›»‡»†‹
·¿†»‹ ¿•“»fi –” ˝«fi–„¿‹•–†
˝˚¸˝˝˝¸
˝–››–†…•‹•–†› º fi¿†›”»fi –”
˛•„‚‹› –”˛»‰–“»fi§ „¿•†›‹‹‚»fi›‹–¸›•›
¿‡»†…»…§ ‹‚» ¿……•‹•–† –” ‹‚»”–··–'•†„
» '¿•“» ¿†§fi•„‚‹–”fi»‰–“»fi§'»‡¿§‚¿“»
¿„¿•†›‹¿†§ »fi›–† –fi –fi„¿†•ƒ¿‹•–†»‰¿«›»–”
¿§‡»†‹›'»‡¿» ”–fi –…•·§•†¶«fi§–fi
fi–»fi‹§…¿‡¿„»¿fi•›•†„–«‹–”‹‚»–»fi¿‹•–†
–”¿‰–“»fi»…¿«‹–'‚»†§–« ‚¿“»¿››«‡»…
·•¿•·•‹§”–fi ›«‰‚–…•·§•†¶«fi§–fi fi–»fi‹§
…¿‡¿„»«†…»fi ¿†•†›«fi»…‰–†‹fi¿‰‹fi–“•…
»…‹‚»–…•·§•†¶«fi§–fi fi–»fi‹§…¿‡¿„»–‰
‰«fi››«›»fl«»†‹‹–‹‚»»¤»‰«‹•–†–fi ‹‚»•†
›«fi»…‰–†‹fi¿‰‹
–†‰–†‹fi•«‹–fi §†›«fi ¿†‰»
˝˚¸˝˝˝¸
˝»†»fi¿·–†…•‹•–†›º‹‚»fi †
›«fi¿†‰» ‰•› fi»·¿‰»… § ‹‚»”–··–'•†„
‰˛»„¿fi…·»››–” ‹‚»fi–“•›•–†›–” —¿fi
¿„fi¿‚¿¿–“»‹‚•› –“»fi¿„»
–fi‡ø›•¿•·•‹§–“»fi¿„» •›fi•‡¿fi§
¿†…'»'•··†–‹ ›»»‰–†‹fi•«‹•–†
”fi–‡¿†§–‹‚»fi •†›«fi¿†‰»”–fi ¿†§·•¿
•·•‹§¿››«‡»…«†…»fi ¿†•†›«fi»…
‰–†‹fi¿‰‹‹‚¿‹fi»fl«•fi»›·•¿•·•‹§ ‹–»
¿››«‡»…–† ¿fi •‡¿fi§†–†‰–†‹fi•«‹–
fi§ ¿›•›
……•‹•–†¿·†›«fi »… § –†‹fi¿‰‹
˝˙˚˛
–“»fi¿„»‚–•›¿††›«fi»…•›¿‡»†…»…
‹–•†‰·«…»¿›¿†•†›«fi»…¿†§»fi›–†–fi –fi„¿†•
ƒ¿‹•–† '•‹‚'‚•‰‚§–« ‚¿“»¿„fi»»… •†¿“¿·•…
'fi•‹‹»†‰–†‹fi¿‰‹ ‹–fi–“•…»•†›«fi¿†‰»¿›•›¿”
”–fi…»… §‹‚•›–·•‰§
‚•›fi–“•›•–†•›·•‡•‹»… ‹–‹‚»›‰–»–”‹‚»
“¿·•… 'fi•‹‹»†‰–†‹fi¿‰‹
‚•›fi–“•›•–†…–»›†–‹¿·§«†·»››‹‚»“¿·•…
'fi•‹‹»†‰–†‹fi¿‰‹‚¿›»»†
¤»‰«‹»…fi •–fi ‹–‹‚»¿‰‰•…»†‹‰¿«›•†„
–…•·§•†¶«fi§–fi fi–»fi ‹§ …¿‡¿„»¿†…
› ›‹•··•† ”–fi‰»¿‹‹‚»‹•‡» –”‹‚»¿‰‰•…»†‹
‰¿«›•†„–…•·§•†¶«fi§–fi fi–»fi ‹§…¿‡
¿„»
‡·–§»»•fi»…«‹–
‚¿†„»› •†•¿•·•‹§ –“»fi¿„»
‚» ”–··–'•†„ •› ¿……»… ‹– ‹‚»˝»‰‹•–†
•¿•·•‹§–“»fi¿„» –“»fi¿„»
‚– •› ¿††›«fi»…
†»‡·–§»»–”§–«fi›•› ¿†•†›«fi»…
'‚•·»–»fi ¿‹•†„ ¿†¿«‹–‚•fi»…–fi fi»†‹»…
«†…»fi ¿‰–†‹fi¿‰‹–fi ¿„fi»»‡»†‹ •†‹‚¿‹
»‡·–§»»ø›†¿‡»'•‹‚ §–«fi »fi‡•››•–†
'‚•·»»fi ”–fi‡•†„…«‹•»›fi»·¿‹»…‹–‹‚»
‰–†…«‰‹ –”§–«fi «›•†»››
‚¿†„»› •†»†»fi¿·–†…•‹•–†›
˝˚¸˝˝˝¸
˝»†»fi¿·–†…•‹•–†› º
‹‚»fi †›«fi¿†‰»•›¿‡»†…»…§fi»·¿‰
•†„—¿fi¿„fi¿‚º'•‹‚‹‚» ”–··–'•†„
–fi •fi»…«‹–—‚§›•‰¿·¿‡¿„»
–“»fi¿„»‹‚»”–··–'•†„ ¿fi»…»»‡»…
‹– »‰–“»fi»…¿«‹–›§–« –'†
ł †§‰–“»fi»…¿«‹–§–«·»¿›»
‚•fi» fi»†‹ –fi –fifi–'¿†…
ł †§‰–“»fi»…¿«‹–‚•fi»… –fi
fi»†‹»…§ §–«fi »‡·–§»»«†…»fi
¿‰–†‹fi¿‰‹•†‹‚¿‹ •†…•“•…«¿· »‡
·–§»»ø›†¿‡»'•‹‚§–«fi »fi
‡•››•–†'‚•·»»fi”–fi‡•†„…«‹•»›
fi»·¿‹»…‹–‹‚»‰–†…«‰‹–”§–«fi
«›•†»››
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
†‰·«…»›‰–§fi•„‚‹»…‡¿‹»fi•¿· –”˝
Ł Ł Œ —fi–»fi‹•»›†‰'•‹‚•‹›»fi‡•››•–†—¿„»–”
–'»“»fi ¿†§¿«‹–‹‚¿‹ •›·»¿›»…
‚•fi»…fi»†‹»…–fi –fifi–'»…'•‹‚¿…fi•“»fi
•›†–‹ ¿ ‰–“»fi»…¿«‹–
«…•–˚•›«¿·¿†… ¿‹¿·»‰‹fi–†•‰fl«•
‡»†‹
˝—˙˝ ˚
˛•‡•‹–”†›«fi¿†‰»•›¿‡»†…»…
§ ¿……•†„‹‚»”–··–'•†„
‚»‡–›‹'» '•··¿§”–fi ¿···–››‹–¿«
…•–“•›«¿·–fi …¿‹¿ »·»‰‹fi–†•‰ »fl«•‡»†‹
¿†…¿†§ ¿‰‰»››–fi•»›«›»… '•‹‚ ‹‚•›
»fl«•‡»†‹¿›¿fi»›«·‹–”¿†§–†»¿‰‰•
…»†‹•›‹‚»·»››»fi –”
¿‚»¿‰‹«¿·‰¿›‚“¿·«» –” ‹‚»…¿‡
¿„»…–fi ›‹–·»†fi–»fi‹§ ¿›–”‹‚»‹•‡»
–” ‹‚»¿‰‰•…»†‹
‚»‰–›‹–”fi»¿•fi•†„–fi fi»·¿‰•†„‹‚»
…¿‡¿„»… –fi ›‹–·»†fi–»fi‹§'•‹‚–‹‚
»fi fi–»fi‹§–” ·•» •†… ¿†…fl«¿·•‹§–fi
‰º
—fi–“•…»…‹‚» »fl«•‡»†‹¿‹‹‚»‹•‡» –”‹‚»
·–››•›
¿—»fi‡¿†»†‹·§•†›‹¿··»…•†–fi «–†‹‚»
‰–“»fi»…¿«‹–•†¿ ‚–«›•†„–»†•†„
–fi –‹‚»fi ·–‰¿‹•–† ‹‚¿‹•›†–‹†–fi‡¿··§
«›»…§‹‚»¿«‹–‡¿†«”¿‰‹«fi»fi ”–fi
‹‚»•†›‹¿··¿‹•–† –”›«‰‚ »fl«•‡»†‹
˛»‡–“¿·»”fi–‡¿»fi‡¿†»†‹·§•†
›‹¿··»…‚–«›•†„«†•‹¿›…»›‰fi•»…•†
—¿fi¿„fi¿‚¿¿–“» –fi
‰†•†‹»„fi¿·¿fi‹ –”›«‰‚»fl«•‡»†‹
‚– •› ¿††›«fi»…‡»†…»…
˝˙˚˛
–“»fi¿„» ‚–•›¿† †›«fi»…•›¿‡»†…»…
§ ¿……•†„‹‚»”–··–'•†„
‚» ”–··–'•†„ ¿fi»•†›«fi»…›
†§ ›«›•…•¿fi§'‚•‰‚•› ¿·»„¿··§•†‰–fi–
fi¿‹»…»†‹•‹§–” '‚•‰‚§–« –'†¿”•†¿†‰•¿·
•†‹»fi»›‹–” ‡–fi»‹‚¿†ºß –” ‹‚»“–‹•†„
›‹–‰–†‹‚»»””»‰‹•“»…¿‹»–” ‹‚•›‰–“»fi
¿„»”–fi‡
–'»“»fi ‹‚» •†›«fi¿†‰»¿””–fi…»…§‹‚•›
fi–“•›•–† …–»›†–‹ ¿·§‹– ¿†§ ›«›•…•¿fi§
‹‚¿‹ •›¿†•†›«fi»…«†…»fi ¿†§–‹‚»fi ¿«
‹–‡–•·» ·•¿•·•‹§–·•‰§–fi '–«·…» ¿†
•†›«fi»…«†…»fi ›«‰‚–·•‰§«‹”–fi ‹»fi‡•
†¿‹•–† –”›«‰‚ –·•‰§–fi ‹‚» »¤‚¿«›‹•–† –”
›«‰‚ –·•‰§ø›·•‡•‹›–” •†›«fi¿†‰»
†§–fi„¿†•ƒ¿‹•–†‹‚¿‹•›†»'·§¿‰fl«•fi»… –fi
”–fi‡»…§§–«¿†…–“»fi '‚•‰‚§–« ‡¿•†
‹¿•†‡¿¶–fi•‹§–'†»fi›‚•‚» •†›«fi¿†‰»
fi–“•…»… § ‹‚•› fi –“•›•–†
¿› »””»‰‹•“»–† ‹‚»…¿‹»–”¿‰fl«•›•‹•–†
–fi ”–fi‡¿‹•–†¿†…•›¿””–fi…»…”–fi Ł
…¿§›¿”‹»fi ›«‰‚…¿‹»
–»›†–‹¿·§‹––…•·§•†¶«fi§–fi
fi–»fi‹§…¿‡¿„»fi»›«·‹•†„”fi–‡¿†
¿‰‰•…»†‹‹‚¿‹–‰‰«fifi»…»”–fi» §–«
¿‰fl«•fi»… –fi ”–fi‡»… ‹‚» –fi„¿†•ƒ¿‹•–†
‰–»›†–‹ ¿·§ ‹– ¿†§†»'·§¿‰fl«•fi»…
–fi ”–fi‡»… –fi„¿†•ƒ¿‹•–†‹‚¿‹•›¿¶–•†‹
“»†‹«fi» –fi ¿fi‹†»fi›‚•¿†…
…–»›†–‹¿·§ ‹–¿†•†›«fi»…«†…»fi
¿†§–‹‚»fi ¿«‹–‡–•·» ·•¿•·•‹§–·•‰§
–fi '–«·…»¿†•†›«fi»… «†…»fi ›«‰‚ ¿
–·•‰§«‹”–fi ‹‚» ‹»fi‡•†¿‹•–†–”›«‰‚
–·•‰§–fi ‹‚»»¤‚¿«›‹•–†–” ›«‰‚–·•
‰§ø›·•‡•‹›–” •†›«fi¿†‰»
†§–” §–«fi »‡·–§»»›'‚•·»«›•†„¿
‰–“»fi»…¿«‹–•† §–«fi «›•†»››–fi §–«fi
»fi ›–†¿·¿””¿•fi›fi–“•…»…§–« …– †–‹–'†
‚•fi»–fi –fifi–' ‹‚¿‹¿«‹–
•¿•·•‹§–“»fi¿„»¤‹»†›•–†›˝«·»
‡»†‹¿fi§ —¿§‡»†‹›•„‚»fi •‡•‹›
˝˙˚˛
–“»fi¿„»–“»fi¿„» ¤‹»†›•–†›¿˝«
·»‡»†‹¿fi§ —¿§‡»†‹›•› ¿‡»†…»… §
˛»·¿‰•†„‹‚»•‡•‹–” †›«fi¿†‰»
”–fi ¿•· –†…›'•‹‚ •†ł ¿†…
˛»·¿‰•†„‹‚»º•‡•‹–”†›«fi¿†‰»”–fi
fi»¿›–†¿·»»¤»†›»›'•‹‚º •†ł
‡»†…»… »··–' ‡·–§»»¤‰·«›•–†
˝˙ ˚˛¤
‰·«›•–†›º»··–'‡·–§»»•›‡–…•”•»…¿›
”–··–'›
¤‰·«›•–†º »··–' ‡·–§»»•›…»·»‹»…
•fi »…«‹–—‚§›•‰¿·¿‡¿„»
”‚•fi»…¿«‹–›¿fi»‰–“»fi»…¿«‹–›”–fi •¿•·•‹§
–“»fi¿„»‹‚»†–‡fi»‚»†›•“»¿†…–··•›•–†
—‚§›•‰¿·¿‡¿„» –“»fi¿„»›¿›fi–“•…»…«†
…»fi ˝—˙˝
˚˛–” ‹‚•› –“»fi¿„» —¿fi‹¿fi»»¤
‹»†…»… ‹–¿«‹–›§–«‚•fi»›«¶»‰‹‹–‹‚»”–·
·–'•†„
‚» ‡–›‹'» '•··¿§ ”–fi ·–››‹–¿†§
‚•fi»…¿«‹–•›º–fi ‹‚»¿‰‹«¿·‰¿›‚
“¿·«»–fi ‰–›‹‹–fi»¿•fi –fi fi»·¿‰»'‚•‰‚
»“»fi •› ‹‚»·»¿›‹ ‡•†«›¿ …»…«‰‹•·»
‚»…»…«‰‹•·» '•··» »fl«¿· ‹–‹‚»·¿fi„»›‹
…»…«‰‹•·»¿·•‰¿·» ‹– ¿†§–'†»…¿«‹–
”–fi ‹‚¿‹‰–“»fi¿„»–fi '‚•‰‚»“»fi •›
·»››
•fi»…«‹–—‚§›•‰¿·¿‡¿„»‰–“»fi¿„»
•›»¤‰»››–“»fi ¿†§–‹‚»fi ‰–··»‰‹•·» •†›«fi
¿†‰»
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
†‰·«…»›‰–§fi•„‚‹»…‡¿‹»fi•¿· –”˝
Ł Ł Œ —fi–»fi‹•»›†‰'•‹‚•‹›»fi‡•››•–†—¿„»–”
˝«¶»‰‹ ‹–‹‚» ¿–“»·•‡•‹…»…«‰‹•·»¿†…
»¤‰»››fi–“•›•–†›'»'•··fi –“•…»‰–“»fi
¿„»»fl«¿·‹– ‹‚»fi –¿…»›‹‰–“»fi¿„»¿·•
‰¿·»‹–¿†§‰–“»fi»…¿«‹–§–«–'†•†
›«fi»… «†…»fi ‹‚•›–·•‰§
–“»fi¿„»•†‰·«…»›·–››–” «›»–”‹‚¿‹‚•fi»…¿«
‹–fi–“•…»…•‹fi»›«·‹›”fi–‡¿†¿‰‰•…»†‹”–fi
'‚•‰‚§–«¿fi» ·»„¿··§·•¿·» ¿†…¿›¿fi»›«·‹–”
'‚•‰‚ ¿‡–†»‹¿fi§·–›› •› ›«›‹¿•†»…§‹‚»
·»¿›•†„ –fi fi»†‹¿·‰–†‰»fi†‚» ‡–›‹'»'•··
¿§”–fi ¿†§ –†»¿‰‰•…»†‹•›
”¿·•‡•‹ ”–fi •fi»…«‹–—‚§›•‰¿· ¿‡¿„»•›
›‚–'†•†‹‚» ˝‰‚»…«·»‹‚»† ‹‚¿‹·•‡•‹fi»·¿‰
»›¿†…•› †–‹¿……»… ‹–‹‚»º·•‡•‹•†…•
‰¿‹»…¿–“»
˛»†‹¿· ˛»•‡«fi›»‡»†‹
˝—˙˝•›
¿‡»†…»…§ ¿……•†„‹‚» ”–··–'•†„
» '•··¿§”–fi fi»†‹¿·fi»•‡«fi›»‡»†‹»¤
»†›»›•†‰«fifi»…§§–«”–fi ‹‚»fi»†‹¿·–”
¿†¿«‹–»‰¿«›»–”¿·–››‹–¿‰–“»fi»…
¿«‹–—¿§‡»†‹¿·•»›•† ¿……•‹•–† ‹–‹‚»
–‹‚»fi'•›»¿·•‰¿·»¿‡–«†‹–” »¿‰‚‰–“
»fi¿„»§–« ‚¿“» –†¿‰–“»fi»…¿«‹––
…»…«‰‹•·» ¿·•»›‹– ‹‚•›‰–“»fi¿„»
» '•··¿§–†·§”–fi ‹‚–›»»¤»†›»›•†
‰«fifi»……«fi•†„‹‚»–·•‰§»fi•–…»„•††•†„
‚–«fi›¿”‹»fi ‹‚»·–››¿†…»†…•†„fi»
„¿fi…·»››–”‹‚»–·•‰§ø›»¤•fi¿‹•–†'•‹‚
‹‚»·»››»fi –”‹‚»”–··–'•†„†«‡»fi –”
…¿§›
¿‚»†«‡»fi –”…¿§›fi»¿›–†¿·§fi»
fl«•fi»… ‹–fi»¿•fi ‹‚»‰–“»fi»…¿«‹–”
·–››•›‰¿«›»…§‹‚»”‹‹‚•›†«‡»fi
–”…¿§› •›¿……»…‹–‹‚»†«‡»fi –”
…¿§›•‹‹¿»› ‹–·–‰¿‹» ‹‚»‰–“»fi»…
¿«‹–¿†… fi»‹«fi†•‹‹– §–«–fi
…¿§›
«fi ¿§‡»†‹•›·•‡•‹»…‹–‹‚» ·»››»fi –”‹‚»
”–··–'•†„¿‡–«†‹›
¿»‰»››¿fi§¿†…¿‰‹«¿·»¤»†›»›•†
‰«fifi»… –fi
º»fi …¿§
‚•›‰–“»fi¿„»…–»›†–‹¿·§'‚•·»‹‚»fi»
¿fi»›¿fi»–fi fi»›»fi“»¿«‹–›¿“¿•·¿·» ‹–
§–«”–fi §–«fi –»fi¿‹•–†›
º» '•··¿§«†…»fi ‹‚•›‰–“»fi¿„»–†·§‹‚¿‹
¿‡–«†‹–”§–«fi fi»†‹¿·fi»•‡«fi›»‡»†‹»¤
»†›»›'‚•‰‚•›†–‹¿·fi»¿…§fi–“•…»…”–fi
«†…»fi ˝—˙˝
˚˛–“»fi¿„»
–“»fi¿„»¤‹»†›•–†›
fi ¿†›–fi ‹¿‹•–† ¤»†›»•„‚»fi •‡•‹›
˝—˙˝ ˚
˛–“»fi¿„»–“»fi¿„»¤‹»†
›•–†›•›¿‡»†…»…§fi»·¿‰•†„»fi …¿§
'•‹‚º»fi …¿§¿†…Œ ‡¿¤•‡«‡ '•‹‚
º‡¿¤•‡«‡ •†¤‹»†›•–†¿ fi¿†›–fi
‹¿‹•–† ¤»†›»›
•fi¿„ –“»fi¿„»
˝—˙˝ ˚
˛¤‰·«›•–†›¿•›¿‡»†…»…§
¿……•†„‹‚» ”–··–'•†„
–'»“»fi ‹‚» ‡»‰‚¿†•‰¿·¿†… »·»‰‹fi•‰¿·
fi»¿…–'† –fi‹•–†–”‹‚•›»¤‰·«›•–†…–»›†–‹
¿·§ ‹–‹‚»¿‰‰•…»†‹¿·…•›‰‚¿fi„»–”¿†¿•fi¿„
‚•›‰–“»fi¿„»”–fi ¿•fi¿„›•›»¤‰»››–“»fi ¿†§
–‹‚»fi ‰–··»‰‹•·»•†›«fi¿†‰»–fi '¿fifi¿†‹§
–¿† –fi »¿›» ¿ –“»fi¿„»
˝—˙˝
˚˛•‡•‹–”†›«fi¿†‰»•›
…»·»‹»… •†•‹›»†‹•fi»‹§¿†…fi»·¿‰»…§‹‚»
”–··–'•†„«‹–†·§”–fi fi•“¿‹»¿››»†„»fi
‹§»¿«‹–›'•‹‚¿†–fi•„•†¿· ·–¿†–fi ·»¿›»
¿†…–†·§•† ‹‚»»“»†‹–”¿‹–‹¿··–››‹–
›«‰‚ ¿ fi•“¿‹» ¿››»†„»fi ‹§»¿«‹–
¿‚»‡–›‹'»'•··¿§”–fi ·–››•† ¿†§
–†»¿‰‰•…»†‹•›‹‚»„fi»¿‹»fi –”
ł ‚»¿‡–«†‹…«» «†…»fi ‹‚»‹»fi‡›
–”‹‚»·»¿›» –fi ·–¿†‹– '‚•‰‚
§–«fi ‰–“»fi»… fi•“¿‹»¿››»†„»fi
‹§»¿«‹–•››«¶»‰‹«‹'•··†–‹
•†‰·«…»
ł¿“»fi…«» ·»¿›» –fi ·–¿†¿§
‡»†‹›
ł •†¿†‰•¿·»†¿·‹•»›•‡–›»…
«†…»fi ‹‚» ·»¿›»…«»‹–‚•„‚
‡•·»¿„» »¤‰»››•“»«›»–fi
¿†–fi‡¿·'»¿fi ¿†…‹»¿fi
ł‰˝»‰«fi•‹§…»–›•‹›†–‹fi»
”«†…»… § ‹‚»·»››–fi
ł…–›‹›”–fi »¤‹»†…»…'¿fifi¿†
‹•»›fi»…•‹•”» †›«fi¿†‰»
»¿·‹‚‰‰•…»†‹–fi •›¿•·
•‹§ †›«fi¿†‰» «fi‰‚¿›»…
'•‹‚ ‹‚» ·–¿†–fi ·»¿›» ¿†…
ł»¿fifi §–“»fi ¿·¿†‰»›”fi–‡
fi»“•–«›·–¿†›–fi ·»¿›»› –fi
ł ‰‹«¿· ‰¿›‚“¿·«»–” ‹‚»›‹–·»†
–fi …¿‡¿„»… fi–»fi‹§
†¿…¶«›‹‡»†‹”–fi …»fi»‰•¿‹•–† ¿†…
‚§›•‰¿·‰–†…•‹•–† '•··»‡¿…»•†…»
‹»fi‡•†•†„¿‰‹«¿· ‰¿›‚“¿·«»¿‹‹‚»
‹•‡»–”·–››
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
†‰·«…»›‰–§fi•„‚‹»…‡¿‹»fi•¿· –”˝
Ł Ł Œ —fi–»fi‹•»›†‰'•‹‚•‹›»fi‡•››•–†—¿„»–”
˝˚˝•›¿‡»†…»…
§ ¿……•†„ ‹‚» ”–··–'•†„«‹–†·§”–fi ‹‚»
«fi –›»›–” ‹‚•›–¿†–fi »¿›»¿
–“»fi¿„»
–‹¿··–››‡»¿†›¿·–››•†'‚•‰‚‹‚»
‰–›‹–”fi»¿•fi›·«›‹‚»›¿·“¿„»“¿·«»»¤
‰»»…›‹‚»¿‰‹«¿· ‰¿›‚“¿·«»
·¿›› ˛»¿•fi ¿•“»fi –”»…«‰‹•·»
˝—˙˝ ˚
˛»…«‰‹•·»•›¿‡»†…»…§¿……•†„
‹‚»”–··–'•†„
–…»…«‰‹•·»¿·•»›‹–„·¿››…¿‡¿„»•”‹‚»
„·¿››•›fi»¿•fi»…•†¿‡¿††»fi ¿‰‰»‹¿·»‹–«›
fi¿‹‚»fi ‹‚¿† fi»·¿‰»…
«‹•»›•† ‹‚»“»†‹–”¿†‰‰•…»†‹·¿•‡
˝«•‹ –fi –››‡»†…»…
˝˚¸˝˝˝¸
˝–››–†…•‹•–†›«‹•»›•† ‹‚»
“»†‹–”‰‰•…»†‹·¿•‡˝«•‹–fi –››¿•›
¿‡»†…»…§ ¿……•†„ ‹‚»”–··–'•†„
‚•›‰–†…•‹•–†¿·•»›–†·§'‚»† ‹‚»¿‰‰•
…»†‹–fi ·–››•›†–'† ‹–
˙–«•”§–« ¿fi»¿†•†…•“•…«¿·
¿fi‹†»fi •”§–« ¿fi» ¿¿fi‹†»fi›‚•
†»¤»‰«‹•“» –””•‰»fi –fi •†›«fi¿†‰»‡¿†¿„
»fi •” §–« ¿fi» ¿‰–fi–fi¿‹•–† –fi
‡»‡»fi –fi ‡¿†¿„»fi •”§–«¿fi»¿·•‡
•‹»…·•¿•·•‹§ ‰–‡¿†§
—¸†•†‹»†‹•–†¿·¿•·«fi »‹–•›‰·–›» ¿ƒ¿fi…›
˝˚¸˝˝˝¸
˝»†»fi¿·–†…•‹•–†›–†‰»¿·
‡»†‹•›fi»fi»›»†‹¿‹•–† –fi fi¿«…•›
¿‡»†…»…§ ¿……•†„ ‹‚»”–··–'•†„
–'»“»fi•”§–««†•†‹»†‹•–†¿··§”¿•·‹– …•›‰·–›»
¿†§‚¿ƒ¿fi…›»¤•›‹•†„–† ‹‚» »””»‰‹•“» …¿‹»–”
‹‚•›–“»fi¿„» –fi‡ '» '•··†–‹…»†§‰–“»fi
¿„»«†…»fi ‹‚•› –“»fi¿„» –fi‡ »‰¿«›»–”
›«‰‚ ”¿•·«fi»
ˇ»†‹¿· †„«•›‚ ˛»›«·‹•†„”fi–‡–…•·§†¶«
fi§
˝˚˝–…•·§•†¶«
fi§•› …»·»‹»…•†•‹›»†‹•fi»‹§¿†… fi»·¿‰»…§
‹‚»”–··–'•†„
–…•·§ •†¶«fi§‡»¿†›–…•·§ •†¶«fi§›•‰†»››–fi
…•›»¿›»›«›‹¿•†»…§¿ »fi›–†•†‰·«…•†„‡»†
‹¿· ¿†„«•›‚ ¿†……»¿‹‚›«›‹¿•†»…§‹‚»›¿‡»
»fi ›–† ‹‚¿‹fi»›«·‹›”fi–‡›«‰‚–…•·§•†¶«fi§
›•‰†»››–fi …•›»¿›»–…•·§•†¶«fi§…–»›†–‹
•†‰·«…»‡»†‹¿·¿†„«•›‚ –fi …»¿‹‚ ‹‚¿‹…–»›†–‹
fi»›«·‹ ”fi–‡–…•·§ •†¶«fi§ ›•‰†»››–fi …•›»¿›»
˛–“»fi¿„»”–fi »fi‹¿•†»fi¿‹•–†›•†–†
†»‰‹•–† '•‹‚˛¿•·fi–¿…›
•‹‚fi»›»‰‹‹–‹‚»«›» –” ¿‰–“»fi»…¿«‹–•†
–»fi¿‹•–†›”–fi –fi ¿””»‰‹•†„¿fi¿•·fi–¿…
˝»‰‹•–†˚»”•†•‹•–†›†›«fi»…‰–†
‹fi¿‰‹‰•› ¿‡»†…»…‹–fi»¿…
‰† »¿›»‡»†‹ –fi ·•‰»†›»¿„fi»»‡»†‹
˝»‰‹•–†˚»”•†•‹•–†› †›«fi»…‰–†
‹fi¿‰‹¿•›…»·»‹»…
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
Includes copyrighted material of ISO
CSGA 437 12 13 Properties, Inc., with its permission.Page 1 of 2
COMMERCIAL GENERAL LIABILITY
CSGA 437 12 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -OWNERS,LESSEES OR
CONTRACTORS - AUTOMATIC STATUS WH EN
REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU -
OPERATIONS AND COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A.SECTION II -WHO IS AN INSURED is
amended to include as an additional insured
any person or organization 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,but only with respect to "bodily
injury","property damage"or "personal and
advertising injury"caused,in whole or in part,
by:
1.Your acts or omissions in the perform-
ance of your ongoing operations for the
additional insured;
2.The acts or omissions of those acting on
your behalf in the performance of your
ongoing operations for the additional in-
sured; or
3."Your work"performed for the additional
insured and included in the "products-
completed operations hazard".
If not specified otherwise in the written con-
tract or agreement,a person's or organiza-
tion's status as an additional insured under this
endorsement ends one year after your opera-
tionsfor that additional insured are completed.
The written contract or agreement must be
currently in effect or become effective during
the term of this Coverage Part.The contract or
agreement must be executed prior to the "bod-
ily injury","property damage"or "personal and
advertising injury"to which this endorsement
pertains.
However:
1.The insurance afforded to such additional
insured only applies to the extent permit-
ted by law;and
2.If coverage provided to the additional in-
sured is required by a contract or agree-
ment,the insurance afforded to such ad-
ditional insured will not be broader than
that which you are required by the con-
tract or agreement to provide for such ad-
ditional linsured.
B.W ith respect to the insurance afforded to
these additional insureds,the following addi-
tional exclusions apply:
This insurance does not apply to:
1."Bodily injury","property damage"or "per-
sonal and advertising injury"arising out of
the rendering of,or the failure to render,
any professional architectural,engineer-
ing 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 draw-
ings and specifications; or
b.Supervisory,inspection,architectural
or engineering activities.
2."Bodily injury"or "property damage"aris-
ing out of "your work"for which a consoli-
dated (wrap-up)insurance program has
been provided by the prime contrac-
tor/project manager or owner of the con-
struction project in which you are involved.
3."Bodily injury","property damage"or "per-
sonal and advertising injury"to any em-
ployee of you or to any obligation of the
additional insured to indemnity another
because of damages arising out of such
injury.
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233
Includes copyrighted material of ISO
CSGA 437 12 13 Properties, Inc., with its permission.Page 2 of 2
4."Bodily injury","property damage"or "per-
sonal and advertising injury"for which the
Named Insured is afforded no coverage
under this policy of insurance.
C.W ith respect to the insurance afforded to
these additional insureds,SECTION III -LIM-
ITS OF INSURANCE is amended to include:
The limits applicable to the additional insured
are those specified in the written contract or
agreement or in the Declarations of this Cov-
erage Part,whichever is less. If no limits are
specified in the written contract or agreement,
the limits applicable to the additional insured
are those specified in the Declarations of this
Coverage Part.The limits of insurance are in-
clusive of and not in addition to the limits of in-
surance shown in the Declarations.
D.With respect to the insurance afforded to
these additional insureds,SECTION IV -
COMMERCIAL GENERAL LIABILITY CON-
DITIONS,4.Other Insurance is amended to
include:
Any coverage provided herein will be excess
over any other valid and collectible insurance
available to the additional insured whether
primary,excess, contingent or on any other
basis unless you have agreed in a written con-
tract or written agreement executed prior to
any loss that this insurance will be primary.
This insurance will be noncontributory only if
you have so agreed in a written contract or
written agreement executed prior to any loss
and this coverage is determined to be primary.
DocuSign Envelope ID: A598FF5E-BE61-4818-A03E-4486C66F9233