Loading...
HomeMy WebLinkAboutAgr 2020-08-20 (DC Electric Group)TOWN OF TIBURON 1505 Tiburon Boulevard, Tiburon CA 94920 CONSTRUCTION SERVICES AGREEMENT TIBURON BOULEVARD TRAFFIC SIGNAL BACKUP GENERATOR INSTALLATION Agreement No. 20 -ST -06 DATE: August 20, 2020 1. IDENTIFICATION OF CONTRACTOR: CONTRACTOR: DC Electric Group, Inc. LICENSE NO: 949934 2. SCOPE OF THE WORK Furnish and install externally mounted generator transfer switch assemblies, conduit, and associated outlets to provide backup power at (8) signalized intersections along Tiburon Boulevard from Bay Vista Drive to Beach Road. Town of Tiburon to provide backup generators, wiring pigtails, concrete slabs, and protective cages. See Full Scope of Work attached as Appendix A. 3. COMPENSATION FOR WORK. Contractor's total compensation for the Work performed under this Agreement (Contract Sum) is $44,800.00, to be paid as (check one): (1) X lump sum; (2) ❑ lump sum with progress payments; (3) ❑ per attached schedule of rates and charges, up to a guaranteed not -to -exceed amount of $ . All payments (check one): ❑ shall X shall not be subject to a five percent (5%) retention. 4. SCHEDULE OF PERFORMANCE FOR THE WORK Contractor shall commence and complete the Work by the following dates: Commencement Date shall be on the date established in the Notice to Proceed. Owner reserves the right to modify or alter the Commencement Date of the Work. Final Completion Date: Within 30 calendar days of Notice to Proceed date. 5. TERMS AND CONDITIONS. 5.01 Contractor shall perform the Work in accordance with the terms and conditions of this Agreement and the following attachments (together, Contract Documents): A. Appendix A — Scope of Work B. Appendix B — General Conditions C. Appendix C -- Insurance 5.02 The Contract Documents are the sole and exclusive provisions that govern the Work described herein. Any provision contained in any purchase order issued in connection with this Agreement or the Work described herein shall be null and void and shall have no force or effect. 5.03 Agreement number must appear on all invoices and correspondence. Send invoices in duplicate immediately upon performance of Work ordered hereon to: Town of Tiburon, Department of Public Works, 1505 Tiburon Boulevard, Tiburon, CA 94920 Construction Services Agreement Project No.: 20 -ST -06 005205-1 NTR dc Group, Inc. SignAture Signature 0 241"r Print Name & Title Printklame &Title Date Date T07WN-A"70RNEY: (A ,pproved As To Form) Signature OHM Name & Title Date Construction Services Agreement Project No.: 20 -ST -06 005205-2 Appendix A to Construction Services Agreement Scope of Work Per Location (Refer to `Tiburon Signal Backup Power Diagrams', attached hereto: • Obtain Caltrans Double Permit ($492.00 Pass-through cost is included in this price). • Furnish and install a new externally mounted TESCO Enclosure with Generator Transfer Switch (Model #T- 51097, per cutsheet provided) to the back of existing service pedestal. • Drill hole and install chase nipple as necessary to enter pedestal for connections. • Hand -trench and furnish install new V Sch. 40 PVC conduit from bottom of new TESCO enclosure to the new Town -furnished concrete pad; backfill trench as required. • Install new riser conduit with bell box and 30A receptacle with weather-proof locking cover at concrete pad. • Furnish and install new conductors between TESCO Enclosure and said 30A receptacle. • Notify Caltrans/Town/P.D. to coordinate temporary signal shutdown to complete wiring for the new generator transfer switch assembly. • Set the intersection to flash with stop -signs (with assistance Town of Tiburon/P.D.), then cut power. • Make the necessary connections and test for proper operation with LINE power and GENERATOR power. Construction Services Agreement Project No.: 20 -ST -06 005205-3 Appendix B to Construction Services Agreement GENERAL CONDITIONS ARTICLE 1 TERMS OF PERFORMANCE 1.01 Construction Services Agreement (Agreement) Force and Effect. The provisions of the Agreement and other Contract Documents constitute the entire agreement between the Contractor and Owner regarding the Work described herein. No representation, term or covenant not expressly specified in the Contract Documents shall, whether oral or written, be a part of this agreement. The Agreement and other Contract Documents shall govern the Work described herein (whenever performed), and shall supersede all other purchase orders and agreements between Contractor and Owner, and any proposal, with respect to the Work described herein. 1.02 No Modification or Waiver. The Contract Documents may not be modified, nor may compliance with any of its terms be waived, except by written instrument executed and approved by fully authorized representatives of Owner and Contractor. Contract Documents headings are for convenience only and do not affect the construction of the Contract Documents. 1.03 Performance of Work/No Assignment. Time is of the essence in the performance of the Work. Contractor will perform the Work in a skillful and workmanlike manner; comply fully with criteria established by Owner, and with applicable laws, codes, and all applicable industry standards. Contractor shall maintain its work area in a clean and sanitary condition, clear debris and trash at the end of each work day, and shall not damage or disrupt any property unless specifically part of the scope of the Agreement. Contractor shall not contract any portion of the Work or otherwise assign the Agreement without prior written approval of Owner. (Contractor shall remain responsible for compliance with all terms of the Contract Documents, regardless of the terms of any such assignment.) The Contractor shall permit Owner (or its designees) access to the work area, Contractor's shop, or any other facility, to permit inspection of the Work at all times during construction and/or manufacture and fabrication. The granting of any progress payment, and any inspections, reviews, approvals or oral statements by any Owner representative, or certification by any governmental entity, shall in no way limit Contractor's obligations under the Contract Documents. Either party's waiver of any breach, or the omission or failure of either party, at any time, to enforce any right reserved to it, or to require strict performance of any provision of the Contract Documents, shall not be a waiver of any other right to which any party is entitled, and shall not in any way affect, limit, modify or waive that party's right thereafter to enforce or compel strict compliance with every provision hereof. Owner shall have, at all times, set-off rights with respect to any payment and Contractor's failure to perform the terms of the Contract Documents. ARTICLE 2 LEGAL AND MISCELLANEOUS 2.01 Records and Payment Requests. Contractor shall submit all billings with all necessary invoices or other appropriate evidence of proper performance, after which Owner shall make payment within thirty (30) days. Upon Owner's written request, Contractor shall make available to Owner, its authorized agents, officers, or employees, any and all ledgers, books of accounts, invoices, vouchers, cancelled checks, and other records or documents evidencing or relating to the Work or the expenditures and disbursement charged to Owner, and all correspondence, internal memoranda, calculations, books and accounts, records documenting its Work under the Agreement, and invoices, payrolls, timecards, records and all other data related to matters covered by the Agreement. Contractor shall furnish to Owner, its authorized agents, officers, or employees, such other evidence or information as Owner may require with regard to the Work or any such expenditure or disbursement charged by Contractor. Contractor shall maintain all such documents and records prepared by or furnished to Contractor during the course of performing the Work for at least five years following completion of the Work, except that all such items pertaining to hazardous materials shall be maintained for at least thirty (30) years. Contractor shall permit Owner to audit, examine and make copies, excerpts and transcripts from such records. The State of California or any federal agency having an interest in the subject of the Agreement shall have the same rights conferred to Owner by this section. Such rights shall be specifically enforceable. 2.02 Independent Contractor. Contractor is an independent Contractor and does not act as Owner's agent in any capacity, whatsoever. Contractor is not entitled to any benefits that Owner provides to Owner employees including, without limitation, insurance, worker's compensation benefits or payments, pension benefits, health benefits or insurance benefits. Terms within the Contract Documents regarding directives apply to and concern the result of the Contractor's provision of Work not the means, methods, or scheduling of the Contractor's Work. Contractor shall be solely responsible for the means, methods, techniques, sequences and procedures with respect to its provision of Work under the Contract Documents. Contractor shall pay all payroll taxes imposed by any governmental entity and will pay all other taxes not specifically identified in the Contract Documents as Owner's responsibility. Construction Services Agreement Project No.: 20 -ST -06 005205-4 2.03 Indemnity/Liability. Contractor shall defend, indemnify, and save harmless, to the fullest extent permitted by law, the Owner and each of its Council Members, officers, directors, representatives, agents and employees ("Indemnitees"), against all claims, suits, actions, loss, cost, damage, expense, and liability directly or indirectly arising out of, connected with, resulting from, or related to bodily injury to or death of any person or damage to any property, or resulting from performance of the Work, failure to perform the Work, or condition of the Work that is caused in whole or part by any act or omission of Contractor, Subcontractors, anyone directly or indirectly employed by any of them, or anyone for whose acts any of them may be liable, resulting from any cause whatsoever except the Indemnitees' sole negligence, willful misconduct, or active negligence. Notwithstanding any provision of the Contract Documents, Owner shall not be liable to Contractor or anyone claiming under it, in contract or tort, for any special, consequential, indirect or incidental damages arising out of or in connection with the Contract Documents or the Work. Owner's rights and remedies, whether under the Agreement or other applicable law, shall be cumulative and not subject to limitation. 2.04 Defective Work; Warranties. Contractor warrants that all construction services shall be performed in accordance with generally accepted professional standards of good and sound construction practices, all Contract Documents requirements, and all laws, codes, standards, licenses, and permits. Contractor warrants that all materials and equipment shall be new, of suitable grade of their respective kinds for their intended uses, and free from defects. Contractor hereby grants to Owner for a period of one year following the date of completion its unconditional warranty of the quality and adequacy of all of the Work including, without limitation, all labor, materials and equipment provided by Contractor and its Subcontractors of all tiers. If either prior to completion of the Work, or within one year after completion, any Work (completed or incomplete) is found to violate any of the foregoing warranties (Defective Work), Contractor shall promptly, without cost to Owner and in accordance with Owner's written instructions, correct, remove and replace the Defective Work with conforming Work, and correct, remove and replace any damage to other Work or other property resulting therefrom. If Contractor fails to do so, Contractor shall pay all of the Owner's resulting claims, costs, losses and damages. Where Contractor fails to correct Defective Work, or defects are discovered outside the. correction period, Owner shall have all rights and remedies granted by law. 2.05 Compliance with Laws; Conflict of Interests. Contractor agrees to comply with all applicable federal and state laws, regulations and policies, as amended, including those regarding discrimination, unfair labor practices, anti -kick -back, collusion, and the provisions of the Americans with Disability Act. Contractor, its officer, partners, associates, agents, and employees, shall not make, participate in making, or in anyway attempt to use the position afforded them by the Contract Documents to influence any governmental decision in which he or she knows or has reason to know that he or she has a financial interest under applicable state, federal and local conflict of interest regulations. Contractor warrants that no person or agency has been employed or retained to solicit or obtain the Agreement upon an agreement or understanding for a contingent fee, except a bona fide employee or agency. 2.06 Termination; Suspension; Disputes. Owner may direct Contractor to terminate, suspend, delay, interrupt or accelerate Work, in whole or in part, for such periods of time as Owner may determine in its sole discretion. Owner will issue such directives in writing, and may do so, in whole or in part, for its convenience or due to Contractor's fault. Owner will compensate Contractor for extra costs resulting from such directives only to the extent that Owner issues such directives for its convenience and not due to Contractor's fault (but Owner shall not compensate Contractor for costs, profit or overhead anticipated to be earned or incurred on Work terminated for Owner's convenience.) Contractor shall continue its Work throughout the course of any dispute, and Contractor's failure to continue Work during a dispute shall be a material breach of the Contract Documents. All claims by Contractor against Owner shall be submitted in writing to Owner, and shall be governed by Public Contract Code Sections 20104 — 20104.6, after which time the one year time period in Government Code Section 911.2 shall be, pursuant to Government Code Section 930.2, reduced to 90 days. Should Contractor be terminated for default, and such termination is subsequently determined to be wrongful, such termination will be converted to a termination for convenience as provided herein. 2.07 Execution; Venue; Limitations. The Agreement shall be deemed to have been executed in Marin County, California. Enforcement of the Contract Documents shall be governed by the laws of the State of California, excluding its conflict of laws rules. Except as expressly provided in the Contract Documents, nothing in the Contract Documents shall operate to confer rights or benefits on persons or entities not party to the Agreement. As between the parties to the Agreement, any applicable statute of limitations for any act or failure to act shall commence to run on the date of Owner's issuance of the final Certificate for Payment, or termination of the Contract Documents, whichever is earlier, except for latent defects, for which the statute of limitation shall begin running upon discovery of the defect and its cause. Construction Services Agreement Project No.: 20 -ST -06 005205-5 2.08 Employee Wages; Records; Apprentices. Contractor shall pay prevailing wages to its employees on any contract in excess of $1,000.00 (one thousand dollars). Copies of the prevailing rate of per diem wages are on file at Owner's principal office. Contractor shall comply with the 8 -hours per day/40 hours per week/overtime/working hours restrictions for all employees, pursuant to the California Labor Code. Contractor and all subcontractors shall keep and maintain accurate employee payroll records for Work performed under the Agreement. The payroll records shall be certified and submitted as required by law, including Labor Code Section 1771.4 (if applicable) and 1776, including (if the Agreement is awarded on or after April 1, 2015 or continues on or after January 1, 2016) to the Labor Commissioner no less frequently than monthly. Contractor shall comply fully with Labor Code Section 1777.5 in the hiring of apprentices for work relating to the Agreement. If the Agreement exceeds $2,000 and is funded with federal funds, then Contractor shall pay federal Davis Bacon wages and comply with applicable federal requirements. 2.09 Mandatory Contractor and Subcontractor Registration. Pursuant to Labor Code Section 1771(a), Contractor represents that it and all of its Subcontractors are currently registered and qualified to perform public work pursuant to Labor Code Section 1725.5. Contractor covenants that any additional or substitute Subcontractors will be similarly registered and qualified. 2.10 Worker's Compensation. Pursuant to Labor Code Sections 1860 and 1861, in accordance with the provisions of Section 3700 of the Labor Code, every contractor will be required to secure the payment of compensation to his employees. Contractor represents that it is aware of the provisions of Labor Code Section 3700 that require every employer to be insured against liability for workers' compensation or to undertake self-insurance in accordance with the provisions of that Code, and Contractor shall comply with such provisions before commencing the performance of the Work. 2.11 Construction Performance Bond; Construction Labor and Materials Payment Bond; Securities in Lieu of Retention Escrow Account. A. If Contract Sum under the Agreement exceeds (or is expected to exceed) $25,000, Contractor shall provide a construction performance bond in form attached hereto as Appendix D — Construction Performance Bond, and a construction labor and material payment bond, in accordance with Civil Code Section 9550 and in form attached here to Appendix E — Construction Labor and Materials Payment Bond. Contractor may not substitute cash in lieu of the required bond(s). B. If the Agreement specifies performance retention, Contractor may elect to substitute securities or direct payment to an escrow account, pursuant to Public Contract Code Section 22300 (incorporated herein by this reference). 2.12 Earthwork and Underground Facilities. If the Work involves digging trenches or other excavations that extend deeper than four feet below the surface, Contractor shall notify Owner in writing of any material that Contractor believes may be hazardous waste that is required to be removed in accordance law, subsurface or latent physical conditions at the site differing from those indicated by information about the site made available to bidders prior to the deadline for submitting bids, or unknown physical conditions at the site of any unusual nature, different materially from those ordinarily encountered and generally recognized as inherent in work of the character provided for in the Contract Documents, pursuant to Section 7104 of the Public Contract Code. For any Work involving trench shoring that costs in excess of $25,000, Contractor shall submit and Owner (or a registered civil or structural engineer employed by Owner) must accept, in advance of excavation, a detailed plan showing the design of shoring, bracing, sloping, or other provisions to be made for worker protection from the hazard of caving ground during the excavation of such trench or trenches, pursuant to Labor Code Section 6705. If such plan varies from the shoring system standards, the plan shall be prepared by a registered civil or structural engineer. Consistent with Government Code Section 4215, as between Owner and Contractor, Owner will be responsible for the timely removal, relocation, or protection of existing main or trunk line utility facilities located on the Site only if such utilities are not identified in the Contract Documents or information made available for bidding, Construction Services Agreement Project No.: 20 -ST -06 005205-6 Appendix C to Construction Services Agreement INSURANCE 1. Commercial General Liability Insurance, written on an "occurrence" basis, which shall provide coverage for bodily injury, death and property damage resulting from operations, liability for slander, false arrest and invasion of privacy, blanket contractual liability, broad form endorsement, and completed operations, personal and advertising liability, with limits of not less than [$1,000,000] general aggregate and [$1,000,000] each occurrence, subject to a deductible of not more than [$1,000] payable by Contractor. 2. Business Automobile Liability Insurance with limits not less than [$1,000,000] each occurrence including coverage for owned, non -owned and hired vehicles, subject to a deductible of not more than [$1,000] payable by Contractor. 3. Workers' Compensation Employers' Liability limits not less than [$1,000,000] each accident, [$1,000,000] per disease and [$1,000,000] aggregate. Contractor's Workers' Compensation Insurance policy shall contain a Waiver of Subrogation against the Town of Tiburon, its officers, directors, officials, agents, employees and volunteers. In the event Contractor is self-insured, it shall furnish Certificate of Permission to Self -Insure signed by Department of Industrial Relations Administration of Self -Insurance, State of California. Builder's Risk Insurance including, without limitation, coverage against loss or damage to the Work by fire, lightening, wind, hail, aircraft, riot, vehicle damage, explosion, smoke, falling objects, vandalism, malicious mischief, collapse, and other such hazards as are normally covered by such coverage. Such insurance shall be in amount equal to the replacement cost (without deduction for depreciation and subject to stipulated value in lieu of average clause) of all construction constituting any part of the Work, excluding the cost of excavations, of grading and filling of the land, and except that such insurance may be subject to deductible clauses not to exceed [$10,000] for any one loss. Such insurance will not cover loss or damage to Contractor's equipment, scaffolding or other materials not to be consumed in the construction of the Work. The insurer shall waive all rights of subrogation against Owner. 5. Insurance policies in Appendix C shall contain an endorsement containing the following terms: 5.01 Town of Tiburon, its officers, directors, officials, agents, employees, and volunteers, shall be named as additional insureds, but only with respect to liability arising out of the activities of the named insured, and there shall be a waiver of subrogation as to each named and additional insured. 5.02 The policies shall apply separately to each insured against whom claim is made or suit is brought except with respect to the limits of the company's liability. 5.03 Written notice of cancellation, non -renewal or of any material change in the policies shall be mailed to Owner thirty (30) days in advance of the effective date thereof. 5.04 Insurance shall be primary insurance and no other insurance or self-insured retention carried or held by any named or additional insureds other than Contractor shall be called upon to contribute to a loss covered by insurance for the named insured. 6. Certificates of Insurance and Endorsements shall have clearly typed thereon the Project Name, shall clearly describe the coverage and shall contain a provision requiring the mailing of written notices of cancellation described in clause 5.03 above. 7. All policies of insurance shall be placed with insurers acceptable to Owner. The insurance underwriter(s) must be duly licensed to do business in the State of California. Required minimum amounts of insurance may be increased should conditions of Work, in the opinion of Owner, warrant such increase. Contractor shall increase required insurance amounts upon direction by Owner. Construction Services Agreement Project No.: 20 -ST -06 005205-7 ACR 7 0 �_. CERTIFICATE OF LIABILITY INSURANCE ATE (MMIDDIYYYY) r9/4/2020 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). PRODUCER Woodruff -Sawyer & CO. 50 California Street, Floor 12 San Francisco CA 94111 CONTACT NAME: Megan Montano PHONE FAX (mac a E • 415-402-6507 A/c, Nor 415-989-9923 ADDRESS: mmontano@woodruffsawyer.com INSURER(S) AFFORDING COVERAGE NAIC9 Y _ INsuRERA: Travelers Indemnity Comps of CT 25682 CO2JI11435 INSURED OCELECT-01 DC Electric Group, Inc. P.O. Box 7525 INSURER B_XL Specialtv Insurance Company 37885 _ INSURER c : Travelers 25674 Prop Casualty Co of America — -- INSURER D: Cotati CA 94931 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 389282227 RF_VISICIN NIIMRFR! 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. INSR LTR TYPE OF INSURANCE ADDL JUM SUBR WVD POLICYNUMBER POLICY EFF MM/DD POLICY EXP MMID IYYYYI LIMITS A X COMMERCIALGENERALLIABILITY Y Y CO2JI11435 3/1/2020 3/1/2021 EACH OCCURRENCE $1,000,_000 CLAIMS -MADE L. -J OCCUR DAMAGE TO RE TED PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY I •' J PROJECT ❑ LOC _ PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: C AUTOMOBILE LIABILITY Y Y 81081590848 3/1/2020 3/1/2021 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO —._._ OWNED SCHEDULED AUTOS ONLY_ AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ - $ -- UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE __ $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN Y U82J107920 3/1/2020 3/1/2021 X PER OTH- STATUTE ER E.L. EACH ACCIDENT S 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under —� -- — DESCRIPTION OF OPERATIONS below E,L. DISEASE - POLICY LIMIT $ 1,000,000 B Installation Floater (Builders Risk) UM00055255MA20A 3/1/2020 3/1/2021 Per Location Limit Temp. Loc./Transit Deductible $500,000 $500,000 $2,500 DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Job #20 -ST -06 - Tiburon Blvd. Traffic Signal Backup Generator Installation. Town of Tiburon is additional insured, on a primary, non-contributory basis, per the attached endorsements. Waiver of Subrogation, in favor of a additional insured is applicable, per the attached endorsements, Policies contain a 30 -day notice of cancellation, 10 -day notice of cancellation for non-payment of premium. Town of Tiburon Department of Public Works 1505 Tiburon Blvd. Tiburon CA 94920 GANGtLLA 1 ILIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Policy No. 8108L590848 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COV- ERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION II -- COVERED AUTOS LIABILITY COVERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL INSURED The following is added to Paragraph c. in A.1., Who Is An Insured, of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person or organization who is required under a written contract or agreement between you and that person or organization, that is signed and executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Covered Autos Liability Coverage, but only for damages to which H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT 1. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL PROPERTY K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS this insurance applies and only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Section 11. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — COW ERED AUTOS LIABILITY COVERAGE: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your busi- ness. 2. The following replaces Paragraph b. in B.S., Other Insurance, of SECTION IV — BUSI- NESS AUTO CONDITIONS: b. For Hired Auto Physical Damage Cover- age, the following are deemed to be cov- ered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow: and (2) Any covered "auto" hired or rented by your "employee" under a contract in an "employee's" name, with your CA T3 53 02 15 © 2015 The Travelers Indemnity Company. All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc, with its permission. COMMERCIAL AUTO permission, while performing duties related to the conduct of your busi- ness. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". D. EMPLOYEES AS INSURED The following is added to Paragraph A.1„ Who Is An Insured, of SECTION 11 — COVERED AUTOS LIABILITY COVERAGE: Any "employee" of yours is an "insured" while us- ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs, (a) With respect to any claim made or "suit" brought outside the United States of America, the territories and possessions of the United States of America, Puerto Rico and Canada: (i) You must arrange to defend the "in- sured" against, and investigate or set- tle any such claim or "suit" and keep us advised of all proceedings and ac- tions. (ii) Neither you nor any other involved "insured" will make any settlement without our consent. E. SUPPLEMENTARY PAYMENTS — INCREASED (iii) We may, at our discretion, participate LIMITS in defending the "insured" against, or in the settlement of, any claim or 1. The following replaces Paragraph A,2,a.(2), "suit". of SECTION II — COVERED AUTOS LIABIL- (iv) We will reimburse the "insured" for ITY COVERAGE: sums that the "insured" legally must (2) Up to,$3,000 for cost of bail bonds (in- pay as damages because of "bodily cluding bonds for related traffic law viola- injury" or "property damage" to which tions) required because of an "accident" this insurance applies, that the "in - we cover. We do not have to furnish sured" pays with our consent, but these bonds. only up to the limit described in Para - 2. The following replaces Paragraph A.2.a.(4), graph C., Limits Of Insurance, of of SECTION 11 -- COVERED AUTOS LIABIL- SECTION II — COVERED AUTOS ITY COVERAGE: LIABILITY COVERAGE, (4) All reasonable expenses incurred by the (v) We will reimburse the "insured" for "insured" at our request, including actual the reasonable expenses incurred loss of earnings up to $500 a day be- with our consent for your investiga- cause of time off from work, tion of such claims and your defense of the "insured" against any such F. HIRED AUTO — LIMITED WORLDWIDE COV- "suit", but only up to and included ERAGE — INDEMNITY BASIS within the limit described in Para - The following replaces Subparagraph (5) in Para- graph C., Limits Of Insurance, of graph B.7., Policy Period, Coverage Territory, SECTION II — COVERED AUTOS of SECTION IV — BUSINESS AUTO CONDI- LIABILITY COVERAGE, and not in TIONS: addition to such limit. Our duty to make such payments ends when we (5) Anywhere in the world, except any country or have used up the applicable limit of jurisdiction while any trade sanction, em- insurance in payments for damages, bargo, or similar regulation imposed by the settlements or defense expenses. United States of America applies to and pro- hibits the transaction of business with or (b) This insurance is excess over any valid within such country or jurisdiction, for Cov- and collectible other insurance available ered Autos Liability Coverage for any covered to the "insured" whether primary, excess, "auto" that you lease, hire, rent or borrow contingent or on any other basis, without a driver for a period of 30 days or less (c) This insurance is not a substitute for re - and that is not an "auto" you lease, hire, rent quired or compulsory insurance in any or borrow from any of your "employees", country outside the United States, its ter - partners (if you are a partnership), members ritories and possessions, Puerto Rico and (if you are a limited liability company) or Canada, members of their households, Page 2 of 4 © 2015 The Travelers Indemnity Company. All rights reserved. CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc. with Its permission, You agree to maintain all required or compulsory insurance in any such coun- try up to the minimum limits required by local law. Your failure to comply with compulsory insurance requirements will not invalidate the coverage afforded by this policy, but we will only be liable to the same extent we would have been liable had you complied with the compulsory in- surance requirements. (d) It is understood that we are not an admit- ted or authorized insurer outside the United States of America, its territories and possessions, Puerto Rico and Can- ada. We assume no responsibility for the furnishing of certificates of insurance, or for compliance in any way with the laws of other countries relating to insurance. G. WAIVER OF DEDUCTIBLE — GLASS The following is added to Paragraph D., Deducti- ble, of SECTION 111 — PHYSICAL DAMAGE COVERAGE: No deductible for a covered "auto" will apply to glass damage if the glass is repaired rather than replaced. H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT The following replaces the last sentence of Para- graph AA.b., Loss Of Use Expenses, of SEC- TION III — PHYSICAL DAMAGE COVERAGE: However, the most we will pay for any expenses for loss of use is $65 per day, to a maximum of $750 for any one "accident". I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT The following replaces the first sentence in Para- graph A.4.a., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- curred by you because of the total theft of a cov- ered "auto" of the private passenger type. J. PERSONAL PROPERTY The following is added to Paragraph A.4., Cover- age Extensions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Personal Property We will pay up to $400 for 'loss" to wearing ap- parel and other personal property which is: (1) Owned by an "insured"; and COMMERCIAL AUTO (2) In or on your covered "auto". This coverage applies only in the event of a total theft of your covered "auto". No deductibles apply to this Personal Property coverage. K. AIRBAGS The following is added to Paragraph 8.3., Exclu- sions, of SECTION 111 — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does not apply to "loss" to one or more airbags in a covered "auto" you own that in- flate due to a cause other than a cause of "loss" set forth in Paragraphs A.1.b. and A.1.c., but only: a. If that "auto" is a covered "auto" for Compre- hensive Coverage under this policy; b. The airbags are not covered under any war- ranty; and c. The airbags were not intentionally inflated. We will pay up to a maximum of $1,000 for any one "loss". L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS The following is added to Paragraph A.2.a., of SECTION IV — BUSINESS AUTO CONDITIONS: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- plies only when the "accident" or 'loss" is known to: (a) You (if you are an individual); (b) A partner (if you are a partnership); (c) A member (if you are a limited liability com- pany); (d) An executive officer, director or insurance manager (if you are a corporation or other or- ganization); or (e) Any "employee" authorized by you to give no- tice of the "accident" or "loss". M. BLANKET WAIVER OF SUBROGATION The following replaces Paragraph A.S., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS AUTO CONDI- TIONS : S. Transfer Of Rights Of Recovery Against Others To Us We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract signed and executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by CA T3 53 02 15 0 2015 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with Its permission. COMMERCIAL AUTO such contract. The waiver applies only to the The unintentional omission of, or unintentional person or organization designated in such error in, any information given by you shall not contract. prejudice your rights under this insurance, How - N. UNINTENTIONAL E=RRORS OR OMISSIONS ever this provision does not affect our right to col - The following is added to Paragraph B.Z., Con- lect additional premium or exercise our right of cealment, Misrepresentation, Or Fraud, of cancellation or non -renewal. SECTION IV — BUSINESS AUTO CONDITIONS: Page 4 of 4 0 2015 The Travelers Indemnity Compa ny. All rights reserved . CA T3 53 02 15 Includes copyrighted material of Insurance Services Office, Inc, with its permission. Policy No, 810BL590848 4. Loss Payment — Physical Damage Cover- ages At our option, we may: a. Pay for, repair or replace damaged or sto- len property; b. Return the stolen property, at our ex- pense. We will pay for any damage that results to the "auto" from the theft; or c. Take all or any part of the damaged or stolen property at an agreed or appraised value. If we pay for the "loss", our payment will in- clude the applicable sales tax for the dam- aged or stolen property. 5. Transfer Of Rights Of Recovery Against Others To Us If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another, those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after "accident" or "loss" to impair them. B. General Conditions 1. Bankruptcy Bankruptcy or Insolvency of the "insured" or the "insured's" estate will not relieve us of any obligations under this Coverage Form. 2. Concealment, Misrepresentation Or Fraud This Coverage Form is void in any case of fraud by you at any time as it relates to this Coverage Form. It is also void if you or any other "insured", at any time, intentionally con- ceals or misrepresents a material fact con- cealing: a. This Coverage Form; b. The covered "auto"; c. Your interest in the covered "auto"; or d. A claim under this Coverage Form. 3. Liberalization If we revise this Coverage Form to provide more coverage without additional premium charge, your policy will automatically provide the additional coverage as of the day the re- vision is effective in your state. 4. No Benefit To Bailee — Physical damage Coverages We will not recognize any assignment or grant any coverage for the benefit of any per- COMMERCIAL AUTO son or organization holding, storing or trans- porting property for a fee regardless of any other provision of this Coverage Form. 5. Other Insurance a. For any covered "auto" you own, this Coverage Form provides primary insur- ance. For any covered "auto" you don't own, the insurance provided by this Cov- erage Form is excess over any other col- lectible insurance. However, while a cov- ered "auto" which is a "trailer" is con- nected to another vehicle, the Covered Autos Liability Coverage this Coverage Form provides for the "trailer" is: (1) Excess while it is connected to a mo- tor vehicle you do not own; or (2) Primary while it is connected to a covered "auto" you own. b. For Hired Auto Physical Damage Cover- age, any covered "auto" you lease, hire, rent or borrow is deemed to be a covered "auto" you own. However, any "auto" that is teased, hired, rented or borrowed with a driver is not a covered "auto". c. Regardless of the provisions of Para- graph a. above, this Coverage Form's Covered Autos Liability Coverage is pri- mary for any liability assumed under an "insured contract". d. When this Coverage Form and any other Coverage Form or policy covers on the same basis, either excess or primary, we will pay only our share. Our share is the proportion that the Limit of Insurance of our Coverage Form bears to the total of the limits of all the Coverage Forms and policies covering on the same basis. 6. Premium Audit The estimated premium for this Coverage Form is based on the exposures you told us you would have when this policy be- gan. We will compute the final premium due when we determine your actual ex- posures. The estimated total premium will be credited against the final premium due and the first Named Insured will be billed for the balance, if any. The due date for the final premium or retrospective pre- mium is the date shown as the due date on the bill. If the estimated total premium exceeds the final premium due, the first Named Insured will get a refund. CA 00 01 10 13 0 Insurance Services Office, Inc., 2011 Page 9 of 12 Policy No. CO2J 111435 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (Includes Products -Completed Operations If Required By Contract) This endorsement modifies insurance provided underthe following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS The following is added to SECTION II — WHO IS AN INSURED: Any person or organization that you agree in a written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only: a. With respect to liability for "bodily injury' or "property damage" that occurs, or for "personal injury" caused by an offense that is committed, subsequent to the signing of that contract or agreement and while that part of the contract or agreement is in effect; and b. If, and only to the extent that, such 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 or agreement applies. Such person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The insurance provided to such additional insured is subject to the following provisions: a. If the Limits of Insurance of this Coverage Part shown in the Declarations exceed the minimum limits required by the written contract or agreement, the insurance provided to the additional insured will be limited to such minimum required limits. For the purposes of determining whether this limitation applies, the minimum limits required by the written contract or agreement will be considered to include the minimum limits of any Umbrella or Excess liability coverage required for the additional insured by that written contract or agreement. This provision will not increase the limits of insurance described in Section III — Limits Of Insurance. (1) Any "bodily injury", "property damage" or "personal injury" arising out of the providing, or failure to provide, any professional architectural, engineering or surveying services, including: (a) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders or change orders, or the preparing, approving, or failing to prepare or approve, drawings and specifications; and (b) Supervisory, inspection, architectural or engineering activities. (2) Any "bodily injury" or "property damage" caused by "your work" and included in the "products -completed operations hazard" unless the written contract or agreement specifically requires you to provide such coverage for that additional insured during the policy period. c. The additional insured must comply with the following duties: (1) Give us written notice as soon as practicable of an "occurrence" or an offense which may result in a claim. To the extent possible, such notice should include: (a) How, when and where the "occurrence" or offense took place; (b) The names and addresses of any injured persons and witnesses; and (c) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. The insurance provided to such additional (2) If a claim is made or "suit" is brought against insured does not apply to: the additional insured: CG D2 46 0419 0 20118 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 COMMERCIAL GENERAL LIABILITY (a) Immediately record the specifics of the claim or "suit" and the date received; and (b) Notify us as soon as practicable and see to it that we receive written notice of the claim or "suit" as soon as practicable. (3) Immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions. (4) Tender the defense and indemnity of any claim or "suit" to any provider of other insurance which would cover such additional insured for a loss we cover. However, this condition does not affect whether the insurance provided to such additional insured is primary to other insurance available to such additional insured which covers that person or organization as a named insured as described in Paragraph 4., Other Insurance, of Section IV — Commercial General Liability Conditions. Page 2 of 2 © 2018 The Travelers Indemnity Company. All rights reserved. CG D2 46 04 19 Policy No, CO2J111435 COMMERCIAL GENERAL LIABILITY c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. d. Primary And Non -Contributory Insurance If Required By Written Contract If you specifically agree in a written contract or agreement that the insurance afforded to an 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 that is available to such insured which covers such insured as a named insured, and we will not share with that other insurance, provided that: (1) The "bodily injury' or "property damage" for which coverage is sought occurs; and (2) The "personal and advertising injury" for which coverage is sought is caused by an offense that is committed; subsequent to the signing of that contract or agreement by you. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the earned premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will return the excess to the first Named Insured. c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; and c. We have issued this policy in reliance upon your representations. 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. 7. Separation Of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this Coverage Part to the first Named Insured, this insurance applies: a. As if each Named Insured were the only Named Insured; and b. Separately to each insured against whom claim is made or "suit" is brought. 8. Transfer Of Rights Of Recovery Against Others To Us If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring "suit" or transfer those rights to us and help us enforce them. 9. When We Do Not Renew If we decide not to renew this Coverage Part, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 30 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. SECTION V — DEFINITIONS 1. "Advertisement" means a notice that is broadcast or published to the general public or specific market segments about your goods, products or services for the purpose of attracting customers or supporters. For the purposes of this definition: a. Notices that are published include material placed on the Internet or on similar electronic means of communication; and b. Regarding websites, only that part of a website that is about your goods, products or services for the purposes of attracting customers or supporters is considered an advertisement. Page 16 of 21 © 2017 The Travelers Indemnity Company. All rights reserved. CG T1 00 02 19 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Policy No. CO2J 111435 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 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. 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. A. Who Is An Insured — Unnamed Subsidiaries B. Blanket Additional Insured — Governmental Entities — Permits Or Authorizations Relating To Operations PROVISIONS A. WHO IS AN INSURED — UNNAMED SUBSIDIARIES C. Incidental Medical Malpractice D. Blanket Waiver Of Subrogation E. Contractual Liability — Railroads F. Damage To Premises Rented To You The following is added to SECTION II — WHO IS AN INSURED: Any of your subsidiaries, other than a partnership, B. joint venture or limited liability company, that is not shown as a Named Insured in the Declarations is a Named Insured if: a. You are the sole owner of, or maintain an ownership interest of more than 50% in, such subsidiary on the first day of the policy period; and b. Such subsidiary is not an insured under similar other insurance. No such subsidiary is an insured for "bodily injury" or "property damage" that occurred, or "personal and advertising injury" caused by an offense committed: a. Before you maintained an ownership interest of more than 50% in such subsidiary; or a. An organization other than a partnership, joint venture or limited liability company; or b. A trust; as indicated in its name or the documents that govern its structure. BLANKET ADDITIONAL INSURED — GOVERNMENTAL ENTITIES — PERMITS OR AUTHORIZATIONS RELATING TO OPERATIONS The following is added to SECTION II — WHO IS AN INSURED: Any govemmental entity that has issued a permit or authorization with respect to operations performed by you or on your behalf and that you are required by any ordinance, law, building code or written contract or agreement to include as an additional insured on this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" arising out of such operations. The insurance provided to such governmental entity does not apply to: b. After the date, if any, during the policy period a. Any "bodily injury", "property damage" or that you no longer maintain an ownership "personal and advertising injury" arising out of interest of more than 50% in such subsidiary. operations performed for the governmental For purposes of Paragraph 1. of Section II — Who entity; or Is An Insured, each such subsidiary will be b. Any "bodily injury" or "property damage" deemed to be designated in the Declarations as: included in the 1. deemed operations hazard". CG D3 16 02 19 © 2017 The Travelers Indemnity Company. All rights reserved. Page 1 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. COMMERCIAL GENERAL LIABILITY C. INCIDENTAL MEDICAL MALPRACTICE 1. The following replaces Paragraph b. of the definition of "occurrence" in the DEFINITIONS Section: b. An act or omission committed in providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to a person, unless you are in the business or occupation of providing professional health care services. 2. The following replaces the last paragraph of Paragraph 2.a.(1) of SECTION 11 — 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 do not apply to "bodily injury" arising out of providing or failing to provide: (a) "Incidental medical services" by any of your "employees" who is a nurse, nurse assistant, emergency medical technician or paramedic; or (b) First aid or "Good Samaritan services" by any of your "employees" or "volunteer workers", other than an employed or volunteer doctor. Any such "employees" or "volunteer workers" 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. 3. The following replaces the last sentence of 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 providing or failing to provide "incidental medical services", first aid or "Good Samaritan services" to any one person will be deemed to be one "occurrence". pharmaceuticals committed by, or with the knowledge or consent of, the insured. 5. The following is added to the DEFINITIONS Section: "Incidental medical services" means: a. Medical, surgical, dental, laboratory, x-ray or nursing service or treatment, advice or instruction, or the related furnishing of food or beverages; or b. The furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances, 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 "incidental medical services" to any person to the extent not subject to Paragraph 2.a.(1) of Section 11 — Who Is An Insured. D. BLANKET WAIVER OF SUBROGATION The following is added to Paragraph 8., Transfer Of Rights Of Recovery Against Others To Us, of SECTION IV — COMMERCIAL GENERAL LIABILITY 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" that occurs; or b. "Personal and advertising injury" caused by an offense that is committed; 4. The following exclusion is added to subsequent to the execution of the contract or Paragraph 2., Exclusions, of SECTION I — agreement. COVERAGES — COVERAGE A — BODILY E CONTRACTUAL LIABILITY — RAILROADS INJURY AND PROPERTY DAMAGE LIABILITY: 1. The following replaces Paragraph c. of the Sale Of Pharmaceuticals definition of "insured contract" in the "Bodily injury" or "property damage" arising DEFINITIONS Section: out of the violation of a penal statute or c. Any easement or license agreement; ordinance relating to the sale of Page 2 of 3 © 2017 The Travelers Indemnity Company. All rights reserved. CG D3 16 02 19 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is deleted. F. DAMAGE TO PREMISES RENTED TO YOU The following replaces the definition of "premises damage" in the DEFINITIONS Section: "Premises damage" means "property damage" to: COMMERCIAL GENERAL LIABILITY a. Any premises while rented to you or temporarily occupied by you with permission of the owner; or b. The contents of any premises while such premises is rented to you, if you rent such premises for a period of seven or fewer consecutive days. CG D3 16 02 19 © 2017 The Travelers Indemnity Company. All rights reserved, Page 3 of 3 Includes copyrighted material of Insurance Services Office, Inc., with its permission. TRAVELERS ONE TOWER SQUARE HARTFORD CT 06163 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 76 ( A) - 001 POLICY NUMBER: UB -2J107920 -20 -2S -G WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be 2.00 % of the California workers' compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR ELECTRICAL CONTRACTORS AND OTHER WIRING WHICH THE INSURED HAS AGREED INSTALLATION CONTRACTORS ELECTRICAL BY WRITTEN CONTRACT EXECUTED WORK PRIOR TO LOSS TO FURNISH THIS WAIVER. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No, Endorsement No. Insured Premium Insurance Company Countersigned by DATE OF ISSUE: 03-04-20 ST ASSIGN: Page 1 of 1 PERFORMANCI� 13OND KNOW A I, t?)' '1'I Il?SEs PR1's.il N'CS, Ilial Svc, DC Electric Group, Inc. Premium: $529 F1011d 57BCSIJ6881 (Hereinafter Called tate Principal j; as Prilieipatl, acrd Hartford Fire Insurance Company a Corporation duly organized under the lavys of the State of Connecticut (hereinafter called the Sur.tv), as Surety, are held and firmly bound unto Town of Tiburon (he.reirmiler called the. Oblince), ill the sail of Forty Four Thousand Eight Hundred Eighty & 001100 -- _ 0; _44,880.00 ) D(Ah rs, fOr the INIVIUent crf Whieh sum Well and truly to be. imine, Nie, the said Principal and the said Sum.ty, bind ourselves, our Heirs, exce:utors, athninisirators, successors and assig ns.. Jointly and sevc ally, firml3l., by these presents. Signed Rill scalett this - ' _ 3rd Clay of September 2020 Wl )FRBAS, said Principal has entered info a Britten Contract xvith said Oblipee, dated August 27th, 2020 for Tiburon Boulevard Traffic Signal Backup Generator Installation, Agreement No. 20 -ST -06 in accordance; with the terms and conditions of said Contraet, which is hercby I-Cfe red to and made a part hereof as if fully set forth herein' NOW, '1'HERl?FORT','fli1 CONDITION OF THIS 013I-RIATION IS SUCH, That if the above bounden Principal shall well and truly keep, do and perform each alld every, all and singular, the matters anis things in said coutract set Porth and specified to be by said Principal kept, done alid performed, at the. tinier and in the nn tauel in said contract. specified, or sliall pay over, make good ")nil Wintburac to tile above named Oblifrec, all loss and damage which said Obligee nla}sustain bV reason of failure or default ort the part of said Principal so Lo do, then this Obligation shall be 111111 and. void: otherwise shall remain in dill force and of lcc.t. NO SUYT, ACTION OR P1,Z0Cl%l I3INt3 by (lie; Obligee to recover on Lhis bond shall be sustained unless (lee, s;urte be conrnrenced within two (2) yews following the date on which Principal ceased work on said Contract. S-0757/GE 10(99 DC Elec c Gro �, Inc. Principal Hartford Fire Insurance Company Kelly Holtemann Attirney in f ai t XDP CALWORMA AQP.-PUMPOSE ACKHOMMOOMMY CIVIL. CODE lag A notary public or other officer (,oniplPtIng this certificate verifios only the identity of the individi.cal who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that docuryiont, State of California County of Marin On �)A- -2,;), 2 Z' before rne, J. DeLuca, Notary Public Here Insert Name .and Title of the Officer personally appeared Kelly Holterriann Name(.,) of Signer(s) who proved to me on the basis of satisfactory evidence, to be the person(4) whose naryie(e) in/are- subscribed to the within instrument and acknowlodged to me that he/she/" executed thea carne in l,*Mer/V,ie4r authorized capacity(if,*, and that by tWher/tt eh, signature(a) on the instrument the person(s), or the entity upon beNalf of which the personal acted, tMOCUted the instrument. I cortify under PENALTY OF PERJURY under [lie laws of the State of California that the oregoing paragraph is true an(] correct, VVITNE,13S my hand and official seal. JNotary Polic California .... .. ..... Marin cotility �ignaturEa 00mmisslon # P166061 Signature of Notary Public, f y Comm, Wires Oct 24, 202 Place, Alotaill Seal Above OPTICIVAL -1hoogli thi"', Section is optional, cornpletirng this; information can deter alteration of the document or fraudulent rnAttachrnont of this form to an unintended (Jocument. Doscriptuan of Attached Document 'I"Ifle or Type of Document: Document Number of Pages, U3qner(s) Other Thain NRrned Above: caipacjty(ieu) Claimed by signer(s) Signer's Marro: I �oi i,-ws Narne: 'I.-! Corporate Officer — Title(s): H Corporate Officer Title(s): i, - Par',ner - -- 1 Liaftod ;-.1 Partner Limited L.] Gioneral 1 -1 Individual /Mlor-ficy ;- 7CrI Individual F.1 Attorney in Fact F- I!,an or Conservator 1 Trustee oorGonseRator ('1 Trustee* G :Iiinrc LJ Other: U Other: Signer 1--. Signer Is Representing: CO2014 National Notary Association - www,N,,atioti,ilNotaty.org 1.800 -US 1,40'FARY (1-800-876.-6827) ItornMWI Direct fnquiriesJClairrrs to: THE HARTFORD BOND, T-11 One Hartford Plaza -VUW*--ER(.-DF ATTORNE"y Hartford, Connecticut 06155 P;c+itct,GlainS s�ttte har tfgr<!. cgti} calf.' 888.266.3488 orfox: 860-757.5835 KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: WOODRUFF SAWYER & COMPANY Agency Code: 5 L' _r1 Hartford Fife Insurance Company, a oorporntion duly organized under tha km'l of fbo Stale of Connecticut = Hartford Casualty Insurance Company, it cortwratiou dulyorganized under the la\cs of the Stato of Indiana �J Hartford Accident and Indemnity Company, a corporation duty organized under the laws of the State of Conne.cticnt Hartford Underwriters Insurance Company, a corporation duly organized tinder the ta\Ns of the State. of Connecticul Twin City Fire Insurance Company, a corporzuion duty organized tinder the lave, of the State of Indiana Hartford insurance Company of Illinois, a corlwration duly organized under the [miss ofthe State of ftlinois Hartford insurance Company of the Midwest, it corporation duly organized under the lat}'s of the State of ludiana C I Hartford Insurance Company of the Southeast, a corporation dole organized under the Imus of the State of Florida having their home office in Hartford, ConneCtlCUL (hereinafter collectively referred to as the "Companies") do hereby make, constitute and appoint, up to the amount of Unlimited Nerissa S. Bartolome, Christina Burton, Alicia Dass, Joan DeLuca, Roger C. Dickinson, Patrick R Diebel, Valerie Garcia, Kelly Holtemann, Thomas E. Hughes, Stanley D. Loar, Mark M. Munekawa, Sara Ridge, Yvonne Roncagliolo, Charles R. Shoemaker of SAN FRANCISCO, California their true and lawful Attorney(s)-fn-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as delineated above by 0, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by laud. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 23, 2018 the Companies have caused these presents to be signed by its Assistant Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney. u r • ::�raa.,r erne f tdAt ��r�+<ett% o � IyraNce-Q � Sjy' r�, o< �'.,rwF �. a al t86� • • >1', n t a31 y i� ( k �4lr>V'�� �\F�s�". r^ s�rax,r,i,ca f" �•ar�+t�' � �'..4 i� yg��g bk 4°}79'' 4?c Xrq� \\��3 aY/i.. N � ° may.. _ .. �tla' *�' y=•,u...+'l; F q.F':,. w,.r�4� •.t� � ?• '. )v�A�'' N rA'o'rY • o, riilaal•.a`�.N G,ynie` - +1-xxa Shelby Wiggins, Assistant Secretary Joelle L. LaPierre, Assistant Vice President S`FATE OF FLORIDA 5S, Lake Mary COUNT'YOFSEMINOt.E On this 13th day of February, 2020, before me personally came Joelle LaPierre, to me known, who being by me duly sworn, did depose and say: that (s)he resides in Seminole County, State of Florida; that (s)I've is the Assistant Vice President of the Companies, the corporations described in and Wiich exectrted the above instrument; that (s)he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that (s)he signed his/her name thereto by like authority. -:�lyT}� : les>ica � iccllo � 7ica:>nu r,`,thl' rl} �s'• fr t: onUnissirn hi ldr, J702 flxvires ]into 20' ?ti^r I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the Powder of Attorney executed by said Companies, which is still in full force effective as of September 3 rd, 2`020 Signed and sealed in Lake Mary, Florida. tae u •F` r.�-. - i'Uat.rirrlrri� 4 40Ai � �`6coaC&�-a� 3q'YI �a°t, �n �� ��Y,aF°"59k^Y y yp rnr.era, �as1Aa1► 'iwtEF7� =z d97�Rrr`> ''� ,f • ' � r �i,�.r' , ytA ;._10a, • `'"v°.s`uaal, .�' +tl,ai '�Z--vi��s`S Keith D. Dozois, Assistant Vice President ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Sonoma On September 8th, 2020 before me, Angelo A. Cortes (insert name and title of the officer) personally appeared Don Caramagno who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ANQLO A. CORTES COMM. #2176365 z x Notary public • California o _.._ Sonoma County Comm, Egres Dec. 19,2020t Signature (Seal) Premium: Included PAYAAGN f 1:9(YND BOND NO. 57BCSIJ6881 I NOW ALI. )3Y'I'I{1:41; pRf.SF. ITS, That we. DC Electric Group, Inc., P.O. Box 7525, Cotati, CA 94931 ( Here. inscr(the name and address or lecal title of Contatctor) as Principal.. hcrcinrtlter called I'tincipal, and Hartford Fire Insurance Company if Connecticut t '" poral1on, a iurely. hereinafter called Surely. are held and tirill, hound unto Town of Tiburon, Dept of Public Works, 1505 Tiburon Boulevard, Tiburon, CA 94920 (![ere insert the name and addressor logal title of Owner) as Obfipee.. hereinafter called Owat(a. lbr the use: and benefit of (Aainuantti as herein defined. ill the amount of Forty Four Thousand Eight Hundred Eighty & 001100 -- Dollars (h 44,880.00 ): (here insert a sunt equal to at least one -hallo the contract price) for the paynncnt whoreof t'rineipa) and Surety bind thenlsch es, their heir., oxeeutor:5. administaitocs, Niuecessor:s and assigns, jointly and severally, thinly by these presents. Wl IEREAS. Principal has by written agreement dined _ _August 27th _ 2020enlewd into a co]]bncl. with Owner for _ Tiburon Boulevard Traffic Signal Backup Generator Installation, Agreement No. 20 -ST -06 in accordance with the terms and Conditions of said oonhact, which is hereby referred to and rmulc if part hereof NOW, T111,UZE 'ORE, Tit E CONDITION OF TIIIS OBLIGATION 1S SUCi-1. That if tyle Principal Shall promptly makc paynwnt to all Claimants as bereinatter defined, for all labor fund numerial used or reasunabl\ required for use in life p erlbrn]ance. of the Contract, then this obligation shall be void-. olherwise it Shall rellmin ill 1lrH force and cl'i�.el. subject, howcvcr, to (he tb)lowing ci]nditions: I . A Claimant is defined is one having a direct Contract with the PrinCipat or with a Subconttac-lotof the Principal for labor, material, or both; used or rcasonabiy required for [INC in life performance of the Contract. 2. The above named Principal and Surely hereby jointly and severally agree will] the owner that avM, Claimant as herein defined. who has not been paid in Pull before the expiration of., period of ninety (90) days alter lite date on which the hist of such Clain]aut's Work or labor was clone or pertimned. or nmtcrials were furni.slied by such Claimant, n]av suo on this bond ('(if- tllc use of such Claimant, prosecute tine suit to final judgment for such suis or awns a. may bejustly duc Claimant, and have cNecution thereon. 3. No suit or action shall bC conm]enced liercunder by ally Claimant. aj Unless ClailuanC other than one having a direct Contract %\-fill the Principal, shall have givell notice to ally" ]lav orthe. following: The Principal. the Owner, or the Surely above canted. within ninety (90) days atter such Claimant dict or Performed the last of the wort: (if- labor, or furnished the last of the materials lin' which Said chaiel is niade. b) After the cxpuation of one (1) Year JbIlotving the date nc Which principal ceased work on said Contract. I f the provisions of this pertt raPh me void or prohibited by law, tilc minimmr] period of limitation alcaifable to safeties as a defense in the-. jurisdiction o1 the suit shall be applicable. 0 Other than in a state coull ofcon]peient jurisdiction in and for the courtly or other political subdivision of the state in which the ('reject, or any part dtere-of, is Situated, or in the United Slate:; District Court Ibr life district in Which lite- Prgjecl. or any part thereof. is situated, and not elsewhere. 4. The fucount of this bond shall he reduced by and to the extent of ally payment or payments made in ,oaf firth hereunder. Signed and sealed this lard_ day of __ September — _ 2020 _ _ DC Electric Gr p sine. _ __��----._—_--Principal Hartford Fire Insurance Company Kelly Ho temann Attorney -in -!'fret S-4174/GE 2/98 CAUFORMA CIVIL CODE § I 180 . � this certificate vodKexvnlythe Identify o!the individual who signed the | / docurnerit. to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document, � Statnof California County of Marin On -'t)ofoxeme._J. DeLuca, Notary Public ` Date Here Insert iVammand TWO ofthe officer pamonnUh/ uppPu/nd KoUyHNtemamn _ Nxnm(s)ofSig/mns) who proved to me an the basis of sati,,:ifactory evidence to be the person(e) whose riarrie(s) lsmf�e- suh,,cribed to tho within instrument and acknowliqdged to ry)e that Wshe/" execu-ced the same, in oapaoity(6,s�, arid that by IWher/t�eifslgnature(s) on the instrument the pemonH, orthe entity Upon behalf of which the person(s) acted, executed the instrument, I (;ertIfy under PENALTY OFPERJURY under Umlawm ofthe State ofCalifornia that dmforogoingparagraph |otrue and correct, VV[FNE88myhand and official uooL J. DEL CA Notary Public Ca ornia if Marin County ` Signauornmis MY Comro, Expires Oct 24, 2020 SignettireofNotary Public Mace Alotary Seal Above ----~~ --- — -- ------ - —OP0IOMAL.'--------'-- '--- ----- - '-- 7hough this section boptional, comp(eting this information can deter alteration of the document or 8agadtilentmattachtnonto/this form Manunintended duuurnenL Oeeor*t&wvofAttached Doowmment TI -de or Type of Document: _ _ _ - - - _ Document |)n.� Number ofPoyas,: 'ENgner(s) Other Than Named Above: Cmpacky(ies)Claimed bySigner(m) Signers Name: _ _ _ _' - ��/"o'�'«Nnme: Corporate Officer — Title(s); _-- - , . �- OCorpo/atoOfficmr —Thle(,->)� Partner -- 1 Um8od U'�xpn� '� !IPortnorLimited OGonond |]Individual |/m/ i!+r | [,Individual []Attorney hnFact /]Trustee ,tioo"rCunopwmtor OTnuuhe i](3uardlaoorCmnnor/mho fOthmr _~. - _ ____� ��_-- '-_ O Other: Signer 1,.; Signer IsRepresenting: __ ((,)2014 National Notary Association `v�,Nationaft\lotaty.org^1��t�iai-ARY(1-800-876-6827) Item #590'1 Direct InquirieslClaims to: THE HARTFORD VvTR t BOND, T-11 Y" One Hartford Plaza ATTORNET Hartford, Connecticut 06156 i�,oild,Ealairlts a.ttuehrrtforct.cnrtt call: 888.266.3488 or fax: 060-757.5836 KNOW ALL. PERSONS BY THESE PRESENTS THAT: Agency Name: WOODRUFF SAWYER & COMPANY Agency Code: 57-554795 = Hartford Fire Insurance Company, n oo>Iroration duh, org;uti-Zed ruder the IMUS of the St<ue of Connecticut l._.._-1 Hartford Casualty Insurance Company, a corporation duly organirod under the lints of the. Stato. of Indiwia !a^Hartford Accident and Indemnity Company, a corporation duly organized under the Laws ol'rlte Slaty of Connecticut Hartford Underwriters insurance Company, a corporation dull organized under the laws of the Slaic of Connecticut Twin City Fire Insurance Company, it corporatioti duly orDiiiized under tho lawtr of the State of Indiana Hartford Insurance Company of Illinois, a corporation ditty Organized undo the laws of tlic State of Illinois Hartford insurance Company of the Midwest, a corporation duly ort_anized under the law- of the State of htdiana Hartford Insurance Company of the Southeast, a corporation dui.' organized under the late, of the State of Florida having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the "Companies') do hereby make, constitute and appoint, up to the amount of Unlimited : Nerissa S. Bartolome, Christina Burton, Alicia Dass, Joan DeLuca, Roger C. Dickinson, Patrick R Diebel, Valerie Garcia, Kelly Holtemann, Thomas E. Hughes, Stanley D. Loar, Mark M. Munekawa, Sara Ridge, Yvonne Roncagliolo, Charles R. Shoemaker of SAN FRANCISCO, California their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as delineated above by ®, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by lava. In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 23, 2016 the Companies have caused these presents to be signed by its Assistant Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney. 9•7 W+A+* ba - •"� o+`r.net:cei /sat�Np j,�w;Yg%t! F� �" S9� Sgw g<igq S) � h �t���il�% hAtA'(N a I.i • hyo:t 1301E �� tiClFSes •:.1}p'i•;�,fl. Shelby Wiggins, Assistant Secretary Joeile L. LaPierre, Assistant Vice President STATE OF FLORIDA 5S, Lake Mary COUNTY OF SEMINOLE On This '13th day of February, 2020, before me personally carne Joelle LaRerre, to me (mown, who being by me duly sworn, did depose and say: that (s)he resides in Seminole County, State of Florida; that (s)he is the Assistant Vice President of the Companies, the corporations described in and which executed the above instrument; that (s)he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations and that (s)he signed his!her nanme thereto by like authority. X�a� leczioa ioefle. ('iec;.tn;: M." Cbnunitmru. ra'I tr 9i0^ F,arna" lute =0, i, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which is still in full force effective as of September 3rd, 2020 Signed and sealed inn take Mary, Florida. .... ......� • � ^"e i�eoiti �,an �ky`' �ter��� 'Y �'a{?r� Keith D. Dozois, Assistant Vice President ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Sonoma On September 8th, 2020 before me, Angelo A. Cortes (insert name and title of the officer) personally appeared Don Caramagno who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. ANSELO A. CORTH COMM. o#217665 �-- ° Nota publIt - Calltornla o nama Cqunty -� Signature (Seal)