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Agreements/Contracts - Public Works
K19-082 CONTRACT THIS AGREEMENT, between the Board of County Commissioners of Grant County, State of Washington, acting under and by virtue of Chapter 36.77 of the Revised Code of Washington, as amended, hereinafter called the County, and Central Washington Asphalt, Inc. for itself, its heirs, executors, administrators, successors and assigns, hereinafter called the Contractor. WITNESSETH: That in consideration of the payments, covenants, and agreements, hereinafter mentioned, and attached and made a part of this agreement, to be made and performed by the parties hereto, and the parties hereto covenant and agree as follows: DESCRIPTION OF WORK: 1. The Contractor shall do all work and furnish all tools, materials, and equipment necessary to improve and complete Road 3 -NE Reconstruction Project, Phase 1, CRP 17-04, located in Grant County, Washington, as proposed in a bid opened 1:30 P.M., Tuesday, May 14, 2019 in accordance with and as described in the herein attached plans and standard specifications, and in full compliance with the terms, conditions, and stipulations herein set forth and attached, now referred to any by such reference incorporated herein and made part hereof as fully for all purposes as if here set forth at length, and shall perform any alterations in or additions to the work covered by this contract and every part thereof and any force account work may be ordered as provided in this contract and every part thereof. 2. The Contractor shall provide and be at the expense of all materials, labor, carriage, tools, implements and conveniences and things of every description that may be requisite for the transfer of materials and for constructing and completing the work provided for in this contract and every part thereof. 3. The County hereby promises and agrees with the Contractor to employ, and does employ the Contractor to provide the materials and to do and cause to be done the above described work and to complete and finish the same according to the attached plans and specifications and the terms and conditions herein contained, and hereby contracts to pay for the same according to the attached specifications and the schedule of unit or itemized prices hereto attached, at the time and in the manner and upon the conditions provided for in this contract and every part thereof. The County further agrees to employ the Contractor to perform any alterations in or additions to the work covered by this contract and every part thereof and any force account work that may be ordered and pay for same under the terms of this contract and the attached plans and specifications. 4. The Contractor for himself, and for his heirs, executors, administrators and assigns, and successors and assigns, does hereby agree to the full performance of all the covenants herein contained upon the part of the Contractor. S. It is further provided that no liability shall attach to the County by reason of entering into this contract, except as expressly provided herein. ntract — IN WITNESS WHEREOF, the said Contractor has executed this instrument, and the said Board of County Commissioners of Grant County has caused this instrument to be executed by and in the name of said Board by its Members, duly attested by its Clerk, the day and year below written, and the seal of said Board to be hereunto affixed on said date. Board APPROVED AS TO FORM: �ihday of k Ay 2019 Deputy Prose, ing Attorney n Project, CRP 17-04 5th day of Turia iZ-9 .2019 Signature Pamp Maiers, President Print Name Central. Washington. Asphalt, Inc. Firm Name P.O. Box 939 Address Moses Lake WA 98837 City state Zip ( 509) 765-5757 Phone BOARD OF COUNTY COMMISSIONERS OF GRANT COUNTY, WASHINGTON Done this day of '2019 T CONTRACT BOND #023210636 KNOW ALL MEN BY THESE PRESENTS: That we, the undersigned, Central Washington Asphalt, Inc. as principal, and Liberty Mutual Insurance Company a corporation organized and existing under the laws of the State of Massachusetts , as surety corporation, and qualified under the laws of the State of Washington to become surety upon bonds of contractors with municipal corporations, as surety, are jointly and severally held and firmly bound to Grant County, Washington, in the penal sum of One Million Eight Hundred Eighty Eight Thousand Eight Hundred Eighty Eight & 88/100ths ($ 1,888,888.88 ) for the payment of which sum on demand we bind ourselves and our successors, heirs, administrators or personal representatives, as the case may be. This obligation is entered into in pursuance of the statutes of the State of Washington, the Ordinances of Grant County, Washington. Dated at Seattle , Washington, this 31st day of May 2019. The conditions of the above obligation are such that: WHEREAS, on May 14, 2019, the Board of County Commissioners of said Grant County has let or is about to let to the Principal, a certain contract, the said contract providing for the improvement of Road 3 -NE Reconstruction Project, Phase 1, CRP 17-04, located in Grant County, Washington, (which contract is referred to herein and is made a part hereof as though attached hereto), and WHEREAS, the said Principal has accepted, or is about to accept, the said contract, and undertake to perform the work therein provided for in the manner and within the time set forth; NOW, THEREFORE, if the said Principal shall faithfully perform all of the provisions of said contract in the manner and within the time therein set forth or within such extensions of time as may be granted under said contract, and shall pay all laborers, mechanics, subcontractors and material men, and all persons who shall supply said Principal or subcontractors with provisions and supplies for the carrying on of said work, and shall hold said Grant County harmless from any loss or damage occasioned to any person or property by reason of any carelessness or negligence on the part of said Principal, or any subcontractor in the performance of said work and shall indemnify and hold Grant County harmless from any damage or expense by reason of failure of performance as specified in said contract or from defects appearing or developing in the material or workmanship provided or performed under said contract, and until the same is accepted, then and in that event this obligation shall be void but otherwise it shall be and remain in full force and effect. /� Countersigned: Central ion A I alt Ilic. N/A Licensed Agent/Surety Co. Propel Insurance 601 Union Street, Suite 3400, Seattle, WA 98101 ( 206 ) 676-4200 Firm, Street Address (No P O. Box), Phone of Local Office of Agent s-Nt Kecon on Project, m l ars `-rr s i l e n t Principal ibe ufual nsUance � mpany Surety Cynthia L. Jay Attorn Fact, Surety Approved as to form: )AKe. � t 201 eputy Proses ting Attorney eputv�y Prosecuting Attorney Contract — Page Liberty Mutual. SURETY This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8200930-023049 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Holli Albers. Heather L. Allen, James B Binder, Brandon K. Bush. Carley Espiritu- Jacob T. Haddock, Diane M. Harding, Brent E. Heilesen, Kyle Joseph Hov at, Cynthia L. Jay, Aliceon A. Keltner, Christopher Kinyon, Michael S. Mansfield, Jamie L. Marques, Erica E. Mosley, Annelies M. Richie, Sara Sophie Sellin, Donald Percell Shanklin, Jr., Karen C. Swanson, Misti M. Webb, Eric A. Zimmerman all of the city of Tacoma state of Washington each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 17tH day of April , 2019 . O N c CU State of PENNSYLVANIA 5 County of MONTGOMERY ss Liberty Mutual Insurance Company %Nsu,q qtr INS& � %Nsuq The Ohio Casualty Insurance Company ,LJPC, j" Rqr 0 yJPGOv'Yoo, ? VP 4°5, OR, C, West American Insurance Company 3 Fo F 3 Fo m W 3 Fo m 1 1912 0 1919 1991 : o a o 9& AIC '1 .aa yQ R�NAMPS� ,dD� 'ls �NOIANp' ,dam By. David M. Carey, Assistant Secretary L) to On this 17th day of April , 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance o 2 Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes N > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. .. — IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. C.� p PAS 00 CU eQ,y �oNwE TF! COMMONWEALTH OF PENNSYLVANIA /.� 0 °� Notarial Seal // O O ~ U s Teresa PasteWa, Notary Public v 00 OF Upper Menon Twp.. Montgomery County By: /a&gu C (B `JP�3 My Commission Expoes March 28, 2021 eresa Pastella, Notary Public N 4Py%0�� Member. Pennsylvania Association of Notaries 1�y Co aD This Power of Attomey is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual o .�_ Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: E a; ARTICLE IV – OFFICERS: Section 12. Power of Attorney. o ru Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the 'a >, President may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety Cany and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such Z� instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII – Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys -in -fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attomeys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation – The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys -in - fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization – By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 31 st day of May 2019 . \Nst/ %" INS& %NSIR �JP`O OR4 yC+ yJP4°aPol? Pqy VP G°RPoCJ tyr qyc ZI r Fo F 3 Fo m W 3 Fo F 1912 0 0 1919 0 f 1991 By- d�9s`T4CH�1`'.da yO y�hNA MPSaa le �NDIAptP aaS� Renee C. Llewellyn, Assistant Secretary ��� : �� Hyl • 1-t, �M * td LMS -12873 LMIC OCIC WAIC Multi Co_062018 C 0 H W oco co _ � ;i O� C (U CO O t0 2- p rn O �a) C o to �0 a (D to Q >o a) v CV 00 M `c 0O 0 0- 0 —0 Co PROPOSAL To; Board of County Commissioners Grant County, Washington Date:_ May 14 2019 This certifies that the undersigned has examined the location of Road 3 -NE Reconstruction Project, Phase 1, CRP 17-04, in Grant County, Washington, and that the pians, specifications and contract governing the work embraced In the improvement, and the method by which payment will be made for said work is understood. The undersigned hereby proposes to undertake and complete the work embraced in this improvement, or as much thereof as can be completed with the money available in accordance with said plans, specifications and contract and at the following schedule of rates and prices. Road 3 -NE Reconstruction Project, Phase 1 Note: Unit prices for all items, all extensions, and total amount must be shown. Please type or use ink_ Please initial all chanpps_ Item Plan Item Description Unit* Total AmountNo. Quantity Haul nPriceper rs . Cents Dollars . Cents 1:1A4LhI.Iit91COJ 1 1 Mobilization At Lump Sum Haul //J///J//.////J 59,054.43 Per Lump Sum 2 1 Clearing and Grubbing At Lump Sum Haul //J///J//.////J 5,000.00 Per Lump Sum GRADING 3 31,375 Rotomilling Bituminous Pavement At S.Y. Haul 0.95 29,806.25 Per Sci uare Yard 4 8,566 Roadway Excavation Including At C.Y. Haul 7.50 64,245.00 Per Cubic Yard 5 4,664 Embankment Compaction At C.Y. —12" Diameter 4.00 18, 65 6.00 Per Cubic Yard DRAINAGE 6 60 Plain Steel Culvert Pipe 0.064" Th. At L.F. —12" Diameter 65-00 3,900 .00 Per Linear Foot 7 260 Plain Steel Culvert Pipe 0.064" Th. At LF. —18" Diameter 60.00 15,600.00 Per Linear Foot Item Plan Item Descrip tion Price er unit' p Total Amount No. Quantity Pipe 0.064" Th. — 24" Diameter Dollars . Cents Dollars . Cents 8 60 Extend Existing Plain Steel Culvert At t.F. Pipe 0.064" Th. — 24" Diameter 85.00 5,100.00 Posts Per Linear Foot I 9 70 Extend Existing Plain Steel Culvert At L.F. Pipe -- 30" Diameter 125.00 8,750.00 Posts Per Linear Foot I % IRFACING 10 25,000 Crushed Surfacing Base Course At Ton Approaches 16.50 412,500.00 Posts Per Ton I 11 208 Crushed Surfacing Top Course For At Ton Approaches 3500 7,280.00 Posts Per Ton I WnT MIX ASPHALT 12 7,000 HMA Class 1/2" Incl. PG64-28 At Ton Paving Asphalt 68-00 476,000.00 Posts Per Ton 13 1 Calculated Job Mix Compliance Price At 1 Adjustment -1.00 -$1.00 Calculated 14 Calculated Compaction Price Adjustment At 1 Flared Terminal 50'-0" W/Steel -1.00 -$1.00 Posts Calculated Taeccar 15 500 Beam Guardrail Type 31 At L F. Flared Terminal 50'-0" W/Steel 26.00 13,000.00 Posts Per Linear Foot 16 4 Beam Guardrail Type 31— Non- At Each Flared Terminal 50'-0" W/Steel 3,500.00 14,000.00 Posts Per Each 17 10,100 Temporary Pavement Marking At L. F. 0.30 3,030.00 Per Linear Foot 18 29,404 Paint tine At L. F. 0.30 8,821.20 Per linear Foot Item I Plan C Item Description Price per Unit" I Totat Amount` No, Quantity ' Dollars. Cents I Dollars . Cents 1 19 1.91 Centerline Rumble Strip At _^f�+'�� `- a Mile 1,500.00 j 2,865.00 I Per Mile i 20 3.82 Shoulder Rumble Strip Type 3 At 15,000.00 i Mile 1,200.00 4,584.00 Per Mile 21 1 Lump Sum Project Temporary Traffic Control At 11111/IINH11 Per Lump Sum 15,000.00 i OTHER ITEMS 22 1 SPCC Plan At�"� Lump Sum 1,000 ,00 Per Lump Sum 13 1 Monument At Each —81,500.00 6,000.00 I Each 24 1—Trimming and Cleanup At � f Lump Sum I HIIIIIII.11111 7,500.00 Per Lump Sum 25�'- 4 Seeding, Fertilizing and Mulching, At —�-- Acre With Roadside Mix 1,800.00 7,200.00 `Acre 26 1 Minor Change At Est. -1.00 t -$1.00 1 Est. Contract Total i$1,188,888.88 Certification of Compliance with Wage Payment Statutes The bidder hereby certifies that, within the three-year period immediately preceding the bid solicitation date (5/7/2019), the bidder is not a "willful" violator, as defined in RCW 49.48.082, of any provision of chapters 49.46, 49.48, or 49.52 RCW, as determined by a final and binding citation and notice of assessment issued by the Department of Labor and Industries or through a civil judgment entered by a court of limited or general jurisdiction. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Central Washington Asphalt, Inc. Bidder's Busin Xnatu of Authorized Official* Pamp Maiers Printed Name President Title 5/14/19 Date Moses Lake City WA State Check One: Sole Proprietorship ❑ Partnership ❑ Joint Venture ❑ Corporation KI State of Incorporation, or if not a corporation, State where business entity was formed: Washington If a co -partnership, give firm name under which business is transacted: N/A * if a corporation, proposal must be executed in the corporate name by the president or vice-president (or any other corporate officer accompanied by evidence of authority to sign). If a co -partnership, proposal must be executed by a partner. n Failure to return this Declaration as part of the bid proposal package will make the bid nonresponsive and ineligible for award. NON -COLLUSION DECLARATION I, by signing the proposal, hereby declare, under penalty of perjury under the laws of the United States that the following statements are true and correct: 1. That the undersigned person(s), firm, association, or corporation has (have) not, either directly or indirectly, entered into any agreement, participated in any collusion, or otherwise taken any action in restraint of free competitive bidding in connection with the project for which this proposal is submitted. 2. That by signing the signature page of this proposal, I am deemed to have signed and to have agreed to the provisions of this declaration. To report rigging activities call: Notice to All Bidders 1-800-424-9071 The U.S. Department of Transportation (USDOT) operates the above toll-free "hotline" Monday through Friday, 8:00 a.m. to S:00 p.m., Eastern Time. Anyone with knowledge of possible bid rigging, bidder collusion, or other fraudulent activities should use the "hotline" to report such activities. The "hotline" is part of USDOT's continuing effort to identify and investigate highway construction contract fraud and abuse and is operated under the direction of the USDOT Inspector General. All information will be treated confidentially and caller anonymity will be respected. nstruction Project, CRP 11-U4 Page Proposal — Signature Page The bidder is hereby advised that by signature of this proposal he/she is deemed to have acknowledged all requirements and signed all certificates contained herein. A proposal guaranty in an amount of five percent (5%) of the total bid, based upon the approximate estimate of quantities at the above prices and in the form as indicated below, is attached hereto: Cash Cashier's Check Certified Check ❑ In the Amount of 0 Dollars ($ ) Payable to the Grant County Treasurer Proposal Bond M In the Amount of 5% Qo�ff the Bid Receipt is hereby acknowledged of addendum(s) No.(s r'*, & Signature of Authorized Official(s) Proposal Must Be Signed Pamp Maiers, President Please Print Name of Authorized Official Firm Name Central Washington Asphalt Inc. Address P.O. Box 939 Moses Lake, WA 98837 (509) 765-5757 State of Washington Contractor's License No. CENTRWA181PG Federal ID No. 91-1178142 Note: (1) This proposal form is not transferable and any alteration entered hereon without prior permission from the County Engineer will be cause for considering the proposal irregular and subsequent rejection of bid. (2) Please refer to section 1-02.6 of the standard specifications, re:" Preparation of Proposal" or "Article 4" of the instructions to bidders for building construction Jobs. (3) Should it be necessary to modify this proposal either n w sting or by electronic means, please make reference to the following proposal number in your communication: _ Revised 8/95 Statement of Contractor Qualifications To: Board of County Commissioners Date: May 14 .2019 Grant County, Washington RE: Road 3 -NE Reconstruction Project, Phase 1, CRP 17-D4 I hereby maintain that I am a responsible bidder as contemplated by the policies of the State of Washington and Chapter 36.77 of the Revised Code of Washington. 1. My permanent business name and address is P.O. Box 939 - Moses Lake WA 98837 which I have maintained for 37 years. My phone is (.5-09-)-2_65-5757 Fax5j_09 )_.165-8(1S2 2. 7 - 2. 1 have adequate plant equipment to expeditiously and properly perform the work contemplated for Grant County,Washington. Description of work: This contract provides for the reconstruction of 1.91 miles of two lane county road in Grant County, WA, and includes roadway excavation, embankment compaction, crushed surfacing base course, HMA surfacing, guardrail, seeding and fertilizing, and other work all In accordance with the attached Contract Plans. these Contract Provisions and the Standard Specifications. (Please list equipment to be used on this project. Attach list If necessary.) Paver; Screed; Roller; Backhoe; Water Truck; Various Trucks and pups Excavator; Scraper; Blade; DdRer I have adequate funds to promptly meet obligations incident to this work. (Provide bank, contact & phone.) a) Washington Trust Bank b) Attn: Chera Andersen c) (509) 766-5361 1 have adequate experience in this class of work and I am thoroughly familiar with the specifications used to this project. I have constructed the following similar Improvements: (Provide project name, contact & phone.) a) See attachment "A" b) _ cl 5. 1 have submitted and maintain annually a "Standard Questionnaire and Financial Statement" to the Washington State Department of Transportation (WSDOT): Yes )$i No ❑ Region: WSDOT has determined: a) I am prequalified to work classes 1. 2, 3, 4,15,19 and 34 in the amount of 5154.218.525.00 b) I have failed to be prequalified for the following reasons: The Contracting Agency may determine a prospective Bidder who is not prequalified to perform certain types of work within the financial and experience constraints determined by WSDOT to be not responsible and refuse to award a contract. The Board of County Commissioners shall proceed to award the contract to the lowest and best bidder but may reject any or all bids If in its opinion good cause exathCW36.77.040) 1 hereby certify that the above statements are true and accurate. By:(Print Name P Company Name: Central Washington Asphalt, Inc. Address: P.O. Box 939 City, State, Zip: _Moses Lake. WA 98837 Washington State Contractor's License No.:. rFNTRWA1RtPG Revised 4/02 Road 3 -NE Reconstruction Project, CRP 17-04 Page 7 11 Bid Bond ALL MEN BY THESE PRESENTS: That as Principal, a d as Surety, are hel nd firmly bound unto Grant County, Washi on, as Obligee, in the penal sum of Dollars ($ r the payment of which the P incipal and Surety bind themselves, their heirs, executors, admin trators, successors a assigns, jointly and severally, by these presents. The condition of the obligatio is suc hat if the Obligee shall make any award to the Principal for Road 3 -NE Reconstruction Pr 'ect, Phase 1, CRP 17-04, located in Grant County, Washington, according to the terms of he pr osal or bid made by the Principal therefor, and the Principal shall duly make and a er into a cont ct with the Obligee in accordance with the terms of said proposal or bid an award and shall give nd for the faithful performance thereof, with the Surety or S eties approved by the Oblig • or if the principal shall, in case of failure so to do, pay and f feit to the Obligee the penal amou of the deposit specified in the call for bids, then this ligation shall be null and void; otherwise i hall be and remain in full force and effect an he Surety shall forthwith pay and forfeit to the O ' ee, as penalty and liquidated dama es, the amount of this bond. SIGNED, SEALED AND DATED THIS DAY OF Principal Surety Attorney -in -Fact on ,2019 KNOW ALL MEN BY THESE PRESENTS: That we, _ Central Washington Asphalt, Inc. as Principal, and Liberty Mutual Insurance Company , as Surety, are held and firmly bound unto Grant County, Washington, as Obligee, in the penal sum of Five Percent (5%) of Bid Amount Dollars ($ 5% of Bid Amount ) for the payment of which the Principal and Surety bind themselves, their heirs, executors, administrators, successors and assigns, jointly and severally, by these presents. The condition of the obligation is such that if the Obligee shall make any award to the Principal for Road 3 -NE Reconstruction Project, Phase 1, CRP 17-04, located in Grant County, Washington, according to the terms of the proposal or bid made by the Principal therefor, and the Principal shall duly make and enter into a contract with the Obligee in accordance with the terms of said proposal or bid and award and shall give bond for the faithful performance thereof, with the Surety or Sureties approved by the Obligee; or if the principal shall, in case of failure so to do, pay and forfeit to the Obligee the penal amount of the deposit specified in the call for bids, then this obligation shall be null and void; otherwise it shall be and remain in full force and effect and the Surety shall forthwith pay and forfeit to the Obligee, as penalty and liquidated damages, the amount of this bond. SIGNED, SEALED AND DATED THI Central Princip Sure Attorney -in -Fa n Project, CRP 17-04 Page -9 Liberty Mutual. SURETY This Power of Attorney limits the acts of those nam:d herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. Liberty Mutual Insurance Company The Ohio Casualty Insurance Company West American Insurance Company POWER OF ATTORNEY Certificate No: 8200930-023049 KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the 'Companies'), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Holli Albers. Heather L. Allen. James B. Binder, Brandon K. Bush, Carley Espiritu, Jacob T. Haddock, Diane M. Harding, Brent E. Heilesen, Kyle Joseph Howat, Cynthia L. Jav_ Aliceon A. Kellner. Christooher Kinvon, Michael S. Mansfield, Jamie L. Marques, Erica E. Mosley, Annelies M. Richie, Sara Sophie Sellin, Donald Percell Shanklin, Jr., Karen C. Swanson, Mish M. Webb, Eric A. Zimmerman all of the city of Tacoma state of Washington each individually if there be more than one named, its true and lawful attomey-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duty signed by the president and attested by the secretary of the Companies in their own proper persons. IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 17th day of April , 2019 . @ State of PENNSYLVANIA 73 County of MONTGOMERY ss Liberty Mutual Insurance Company 1NSUR ox INS& t, %NSUR The Ohio Casualty Insurance Company `JPGoaP°FyrgLc y`�P°,,vtpo >�y �P�oaPORorgjn West American Insurance Company J3 FoF Q3 Foy �3 Foto 1912 0 1919 '0 U, d 1991 s Z O C 0 rJ1'`T4 CNUS�fida3' y0� NAMP`'�,da� 'is1 A1oIAN0- .aa B David M. Carey, Assistant Secretary On this 17th day of April 2019 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes > therein contained by signing on behalf of the corporations by himself as a duly authorized officer. G N 9? =3 1 IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written EL3N P PAS T' M N ` aj O Qty �,oNwF ru a� 9<a Ir }. � OF % 7r COIN1ONYYEALTH OF PENNSYWAIWA Notarial Seal Tea Paste W. NotaryPuhFc res ~O d upper M—Twp.. M«iogaaery County By: Et`e z Commission Mardi 28.2021 "''y E"P Teresa Pastella, Notary Public (D ^�svdp� � ��,� Merrier. Penri"Warm Amomidon of Not— N rn a`) This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual o ,5 Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: E 6 ARTICLE N — OFFICERS: Section 12. Power of Attorney. o m Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the V > President may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety to C: any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such 16 Z � instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attomey-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority. ARTICLE XIII — Execution of Contracts: Section 5. Surety Bonds and Undertakings. Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attomeys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys -in -fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. Certificate of Designation — The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attomeys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Authorization — By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed. I, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this 14th day of May , 2019 . 1NSOR SSV INS& 1NSUrq orLr4tiC+ yJP4oaPo�yr �yy VP'GopvoR�r'44.c Fo to g 1912 0 1919 `, i 1991 0 ' �,�e�jr�-�. 0 0 Y,61 DJAIA as Renee C. Llewellyn, Assistant Secretary LMS -12873 LMIC OCIC WAIC Multi Co 062018 AGL WsshIngton state Underufilized Disadvantaged Business o!/ Department of Transportation Enterprise (UDBE) Written Confirmation Document See l:ontract provisions: CiDBk'perument S:rbsni:nARayaircrtents 141adamitaged Buainess —Pnierprrse Porticipanar .THIS FORM SHALL ONr Y RL SUBMITTED TOA LTDRL' THAT IS I1ST£D ON THE CONTRACft)R'S LNDFRtTf►I.ILEJ) DISADVAN'C4GED BUSINESS ENTERPRISE tiTILI'LATiON C RTIP'I ATION, THE CONTRACTOR SHALL COMPLETE PART PRIOR TO SFNDIIJG TO 111E t IDSE. PART A: To be completed_py irtd Tlrc entries below shall be consistent with tivh.0 is shown on the Bidder's UndrrutitiLad Disadvantaged Business L•'nterpriW U:ill"inn Certification, failure to do so will,milr in Bid rejection. Contract Tulle: Road 3 -NE Reconstruction Project, Phase 1 Hiddrrs Businzm Name:_. Central Washingon Asphalt UDBE's Business Name: Scout Lake Construction, Inc. Description of Ul7RE's Work nuMR.ICU,k — -- DollarAmount to be Applied TowaAb UDBE Ona%_, 60,000.00_._ Dollar Amount to be Subcontracted to UDBF`: )'ART B: To he completed by ! e IluderutilLcd Disadvantage. d Husinrss Fntrr As an aulhorized rep =n=ative of the UnderuuNwed Disadvantaged Business Enterprise, I eon6rm thaw have been contacted by the Bidder will. regard to the referenc io project for the prpose of P::rtotming the Work described above. If the Bidder :s awarded the Contract, we will enter into en agteernent w:th rite Bidder to participate in the project consistent wifn the information provi led in Par+. A of this fan—P.. 1Varpe(printcd): Signature: Tide Address_. }�V Das:___sl�._ll.�q__.�. 00YF-422-031(1 R-602nOM tttrertt ?tartapwwon Underutilized Disadvantaged Business Enterprise Utilization Certification To be eligible for Award of this Contract the Bidder shall fill out and submit, as a supplement to its sealed Bid Proposal, an Underutilized Disadvantaged Business Enterprise (UDBE) Utilization Certification. The Contracting Agency shall consider as non-responsive and shall reject any Bid Proposal that does not contain a UDBE Utilization Certification which properly demonstrates that the Bidder will meet the UDBE participation requirements in one of the manners provided for in the proposed Contract. Refer to the instructions on Page 2 when filling out this form or the Bid may be rejected. An example form has been provided on Page 3. The successful Bidder's UDBE Utilization Certification shall be deemed a part of the resulting Contract. Box 1: Central Washington Asphalt, Inc. certifies that the UDBE firms listed below have been contacted regarding participation on this project. If this Bidder is successful on this project and is awarded the Contract, it shall assure that subcontracts or supp!y agreements are executed with named UDBEs. (If necessary, use additional sheets.) Box 2: Road 3 -NE Reconstruction Project, Phase 1 Column 1 Name of UDBE (See instructions) Cout aT2 Constr� uCtion Inc. Column 2 Project Role (See instructions) Subcontractor Column 3 Description of Work (See instructions) Dump Trucking Column 4 Dollar Amount Subcontracted to UDBE (See instructions) $60,000.00 Column 5 i Dollar Amount to be Applied Towards Goal (See Instructions) $ 60,000.00 VLIUC1UpnLGU umtaacvamnyvu ous111ess 10t8l UtJtSt commitment Dollar Amount $60,000.00 Enterprise Condition of Award Contract Goal sox 3 Sox 4 5 n By checking Box 5 the Bidder is stating that their attempts to solicit sufficient UDBE participation to meet the COA Contract goal has been unsuccessful and good faith effort will be submitted in accordance with Section 1-02.9 of the Contract DOT Form 272-056U Revised 0212018 Client#: 148076 CENT WASH31 DATE (MMJDDIYYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 1 6/0312019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: ,IOy Arakaki Propel Insurance PHONE 800 499-0933 rAM Np, 866 577-1326 AIC, No, Ext Seattle Commercial Insurance EMAIL o kaki ro Ilnsurance.com 601 Union St, Suite 3400 ADDRESS: I yara@PPeINSURER(S)AFFORDINGCOVERAGE MAIC# Seattle, WA 98101 INSURER A: Zurich American Insurance Company 16535 INSURED INSURER B: American Guarantee and Liability Ins.Co 26247 Central Washington Asphalt, Inc. PO Box 939 Moses Lake, WA 98837 INSURER 0: INSURER E: INSURER F: nnvoowr_cc !`c0TIPI1`ATF wIMnI=R• REVISION NUMBER: 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 CONTRACTOR 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 INSR SUB WVD POLICY NUMBER POLICY EFF MWDD/YYY POLICY EXP MWDDNYM OMITS A X COMMERCIAL GENERAL LIABILITY GLA039838102 17J31120111 1113112020 EDAACCHq�OECTCURRENCE $110001000 PREMISES EaEenw $1,000,000 CLAIMS -MADE OCCUR MED EXP (Any one person) $10,000 X PD Ded• $5,000 PERSONAL & ADV INJURY $1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,000,000 PRODUCTS -COMP/OPAGG $2,000,000 POLICY � J CT LOC $ OTHER: A AUTOMOBILE LIABILITY GLA039838102 12/31/2018 03/31/202 EeMB ED SINGLE LIMIT 2,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULEDpD AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY Ded: $10000 , PROPERTY DAMAGE $ Per accident S B X UMBRELLA LIAR X OCCUR AUC039848402 2/31/2018 03/31/2020 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 EXCESS LIAS CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICEMMEMBER EXCLUDED? F (Mandatory in NH) N I A GLA039838102 (WA Stop Gap) 2/31/2018 03131120 PER X OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEEI $1,000,000 E.L. DISEASE -POLICY LIMIT 1 $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101. Additional Remarks Schedule. may be attached if more space is required) The General Liability, Auto Liability and Umbrella Liability policies include a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. RE: CRP 17-04 / Road 3 -NE Reconstruction Project, Phase 1, TA -6596, STPR-HPR-P130. (See Attached Descriptions) Grant County Public Works 124 Enterprise St SE Ephrata, WA 98823 Lli l\�.Gt-LM I 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 V l`JtSB-LUI� xV VRv �.vrtrvr�i+l Ivl\. r.0 nyllw Ic�c..�.+. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S3669215/M3556237 JYA00 DESCRIPTIONS (Continued from Page 1) Grant County PUD and its officers, elected officials, employees, agents, and volunteers is additional insured per the attached endorsement. SAGITTA 25.3 (2016/03) 2 of 2 #S3669215/M3556237 Additional Insured — Automatic — Owners, Lessees Or Contractors This endorsement modifies insurance provided under the. Commercial General Liability Coverage Part A. Section If — Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured under a written contract or written agreement executed by you, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" and subject to the following: 1. if such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a. The Insurance Services Office (ISO) ISO CG 20 10 (10101 edition); or b. The ISO CG 20 37 (10/01 edition), such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" arises out of: (1) Your ongoing operations, with respect to Paragraph I.e. above, or (2) "Your work", with respect to Paragraph t.b. above, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 1., insurance afforded to such additional insured: (a) Only applies if the "bodily injury", "property damage" or "personal and advertising injury' offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (b) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products -completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. Solely with respect to this Paragraph (b), if the written contract or written agreement provides a minimum time period for providing such coverage, and such minimum time period ends prior to the end of the policy period, this insurance shall not apply to "bodily injury', "property damage" or a "personal and advertising injury" offense which occurs during the policy period and after the end of that minimum tine period 2. If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a. The Insurance Services Office (ISO) ISO CG 20 10 (07/04 edition); or b. The ISO CG 20 37 (07/04 edition), U -GL -1114 Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its pennission. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLA039838102 Effective Date: 12/31/2018 This endorsement modifies insurance provided under the. Commercial General Liability Coverage Part A. Section If — Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured under a written contract or written agreement executed by you, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" and subject to the following: 1. if such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a. The Insurance Services Office (ISO) ISO CG 20 10 (10101 edition); or b. The ISO CG 20 37 (10/01 edition), such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" arises out of: (1) Your ongoing operations, with respect to Paragraph I.e. above, or (2) "Your work", with respect to Paragraph t.b. above, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 1., insurance afforded to such additional insured: (a) Only applies if the "bodily injury", "property damage" or "personal and advertising injury' offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (b) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products -completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. Solely with respect to this Paragraph (b), if the written contract or written agreement provides a minimum time period for providing such coverage, and such minimum time period ends prior to the end of the policy period, this insurance shall not apply to "bodily injury', "property damage" or a "personal and advertising injury" offense which occurs during the policy period and after the end of that minimum tine period 2. If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a. The Insurance Services Office (ISO) ISO CG 20 10 (07/04 edition); or b. The ISO CG 20 37 (07/04 edition), U -GL -1114 Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its pennission. such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on ycur behalf, in the performance of: (a) Your ongoing operations, with respect to Paragraph 2.a. above; or (b) "Your work" and included in the "products -completed operations hazard", with respect to Paragraph 2.b, above, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 2., insurance afforded to such additional insured: (i) Only applies if the "bodily injury„ "property damage' or "personal and advertising injury„ offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (h) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products -completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. Solely with respect to this Paragraph (ii), if the written contract or written agreement provides a minimum time period for providing such coverage, and such minimum time period ends prior to the end of the policy period. this insurance shall not apply to "bodily injury", "property damage' or a "personal and advertising injury" offense which occurs dur;ng the policy period and after the end of that minimum time period. 3. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that you provide that the person or organization be named as an additional insured.- a. nsured:a. Under the ISO CG 20 10 (04/13 edition, any subsequent edition or if no edition date is specified); or b. With respect to ongoing operations (if no form is specified), such person or organization is then an additional insured only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is caused, in whole or in part by: (1) Your acts or omissions. or (2) The acts or omissions of those acting on your behalf, in the performance of your ongoing operations, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 3., insurance afforded to such additional insured: (a) Only applies to the extent permitted by law; (b) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured; and (c) Only applies if the "bodily injury" "property damage' or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement. 4. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that you provide that the person or organization be named as an additional insured: a. Under the ISO CG 20 37 (04113 edition, any subsequent edition or if no edition date is specified); or b. With respect to the "products -completed operations hazard" (if no form is specified), U -GL -1114 Page 2 or 4 Includes copyrighted material of Insurance Services Office Inc., with its permission. such person or organization is then an additional insured only to the extent that "bodily injury" or "property damage" is caused, in whole or in part by "your work" and included in the "products -completed operations hazard", which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 4., insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; (2) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured, (3) Only applies if the "bodily injury" or "property damage" occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (4) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products -completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. Solely with respect to this Paragraph (4), if the written contract or written agreement provides a minimum time period for providing such coverage, and such minimum time period ends prior to the end of the policy period, this insurance shall not apply to "bodily injury" or "property damage" which occurs during the policy period and after the end of that minimum time period, B. Solely with respect to the insurance afforded to any additional insured referenced in Section A. of this endorsement, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including: 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C. Solely with respect to the coverage provided by this endorsement, the following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV — Commercial General Liability Conditions: The additional insured must see to it that: (1) We are notified as soon as practicable of an "occurrence" or offense that may result in a claim; (2) We receive written notice of a claim or "suit" as soon as practicable; and (3) A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. Solely with respect to the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. u-GL_1114 Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition under Section IV — Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non-contributory basis. E. This endorsement does not apply to an additional insured which has been added to this Coverage Part by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies spec'fically to that identified additional insured. F. Solely with respect to the insurance afforded to an add'tional insured under this endorsement, the following is added to Section III — Limits Of Insurance: Additional Insured — Automatic — Owners, Lessees Or Contractors Limit The most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the written contract or written agreement referenced in Section A. of this endorsement; or 2. Available under the applicable Limits of Insurance shown in the Declarations, whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. All other terms, conditions, provisions and exclusions of this policy remain the same. U -G1-1114 Page 4 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. POLICY NUMBER- GtA039838102 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Projecgsj: A GENERAL AGGREGA'T'E LIMIT APPLIES TO EACH CONSTRUCTION PROJECT WHERE THE NAMED INSURED IS PERFORMING OPERATIONS HOWEVER, A GENERAL AGGREGATE LIMIT DOES NOT APPLY TO ANY CONSTRUCTION PROJECT WHERE THE NAMED INSURED IS PERFORMING OPERATIONS THAT ARE INSURED UNDER A WRAP UP OR ANY OTHER CONSOLIDATED OR SIMILAR INSURANCE PROGRAM. Information required to complete this Schedule if not shown above will be shown in the Declarations. A For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I —Coverage A, and for all medical expenses caused by accidents under Section I —Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above; 1. A separate Designated Construction Project General Aggregate Limit applies to each designated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations. 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, except damages because of "bodily injury„ or "property damage" included in the 'products - completed operations hazard", and for medical expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Construction Project General Aggregate Limit for that designated construction project_ Such payments shall not reduce the General Aggregate Limit shown in the Declarations nor shall they reduce any other Designated Construction Project General Aggregate Limit for any other designated construction project shown in the Schedule above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. However, instead of being subject to the General Aggregate Limit shown in the Declarations, such limits will be subject to the applicable Designated Construction Project General Aggregate Limit. CG 2503 05 09 © insurance Services Office, Inc., 2008 Page 1 of 2 CI Anne rnry GLA039838101 B. For ail sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I —Coverage A, and for all medical expenses caused by accidents under Section I —Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule above - 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -completed Operations Aggregate Limit, whichever is applicable; and 2 Such payments shall not reduce any Designated Construction Project General Aggregate Lima. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" Included in the "products -completed operations hazard" will reduce the Products -completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or If the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will sUII be deemed to be the same construction project. E. The provisions of Section III Limits Of Insurance not otherwise modified by this endorsement shall continue to apply as stipulated. Page 2 of 2 0 Insurance Services Office, Inc., 2008 CG 25 03 05 09 0 Waiver Of Subrogation (Blanket) Endorsement 9 ZURICH Policy Ao Eff. Date of Pol Exp Date of Pol Eff. Date of Fnd Producer Addl Prem Retum Prem. GLA039838102 12/3112018 Propel Insurance $ $ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: If you are required by a written contract or agreement, which is executed before a loss, to waive your rights of recovery from oth- ers, we agree to waive our rights of recovery. This waiver of rights shall not be construed to be a waiver with respect to any other operations in which the insured has no contractual interest. U -Cit. -925-B CW (12/01) Page I of I Coverage Extension Endorsement 0 ZURICH Policy No, Eff. Date of Pot. Exp Date of Pot. Eff Date of End. Producer No. Add'I Prem Return Prem. GLA039838102 12/31/2018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the: Business Auto Coverage Form Motor Carrier Coverage Form A. Amended Who Is An Insured 1. The following is added to the Who Is An Insured Provision in Section 11— Covered Autos Liability Coverage: The following are also "insureds": a. Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow for acts performed within the scope of employment by you. Any "employee" of yours is also 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 business. b. Anyone volunteering services to you is an "insured" while using a covered "auto" you don't own, hire or borrow to transport your clients or other persons in activities necessary to your business. c. Anyone else who furnishes an "auto" referenced in Paragraphs A.1.a. and A.1.b. in this endorsement. d. Where and to the extent permitted by law, any person(s) or organization(s) where required by written contract or written agreement with you executed prior to any "accident", including those person(s) or organization(s) directing your work pursuant to such written contract or written agreement with you, provided the "accident" arises out of operations governed by such contract or agreement and only up to the limits required in the written contract or written agreement, or the Limits of Insurance shown in the Declarations, whichever is less. 2. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance — Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form: Coverage for any person(s) or organization(s), where required by written contract or written agreement with you executed prior to any "accident', will apply on a primary and non-contributory basis and any insurance maintained by the additional "insured" will apply on an excess basis. However, in no event will this coverage extend beyond the terms and conditions of the Coverage Form. B. Amendment —Supplementary Payments Paragraphs a.(2) and a.(4) of the Coverage Extensions Provision in Section II — Covered Autos Liability Coverage are replaced by the following: (2) Up to $5,000 for the cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the "insured" at our request, including actual loss of earnings up to $500 a day because of time off from work. U -CA -424-F CW (04-14) Page 1 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. C. Fellow Employee Coverage The Fellow Employee Exclusion contained in Section 11— Covered Autos Liability Coverage does not apply. D. Driver Safety Program Liability and Physical Damage Coverage 1. The following is added to the Racing Exclusion in Section 11— Covered Autos Liability Coverage: This exclusion does not apply to covered "autos' participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations. 2. The following is added to Paragraph 2. in the Exclusions of Section III — Physical Damage Coverage of the Business Auto Coverage Form and Paragraph 2.b. in the Exclusions of Section IV — Physical Damage Coverage of the Motor Carrier Coverage Form: This exclusion does not apply to covered "autos' participating in a driver safety program event, such as, but not limited to, auto or truck rodeos and other auto or truck agility demonstrations E. Lease or Loan Gap Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Lease Or Loan Gap Coverage In the event of a total "loss" to a covered "auto', we will pay any unpaid amount due on the lease or loan for a covered "auto", less: a. Any amount paid under the Physical Damage Coverage Section of the Coverage Form, and b. Any: (1) Overdue lease or loan payments at the time of the "loss (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Security deposits not returned by the lessor; (4) Costs for extended warranties, credit life insurance, health, accident or disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous leases or loans. F. Towing and Labor Paragraph A.2. of the Physical Damage Coverage Section is replaced by the following: We will pay up to $75 for towing and labor costs incurred each time a covered "auto' of the private passenger type is disabled. However, the labor must be performed at the place of disablement. G. Extended Glass Coverage The following is added to Paragraph A.3.a. of the Physical Damage Coverage Section: If glass must be replaced, the deductible shown in the Declarations will apply. However, if glass can be repaired and is actually repaired rather than replaced, the deductible will be waived. You have the option of having the glass repaired rather than replaced. H. Hired Auto Physical Damage — Increased Loss of Use Expenses The Coverage Extension for Loss Of Use Expenses in the Physical Damage Coverage Section is replaced by the following: Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an "insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver under a written rental contract or written rental agreement. We will pay for loss of use expenses if caused by: U -CA -424-F CW (04-14) Page 2 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. (1) Other than collision only if the Declarations indicate that Comprehensive Coverage is provided for any covered "auto'; (2) Specified Causes Of Loss only if the declarations indicate that Specified Causes Of Loss Coverage is provided for any covered "auto", or (3) Collision only If the Declarations indicate that Collision Coverage is provided for any covered "auto". However, the most we will pay for any expenses for loss of use is $100 per day, to a maximum of $3000. 1. Personal Effects Coverage The following is added to the Coverage Provision of the Physical Damage Coverage Section: Personal Effects Coverage a. We will pay up to $750 for "loss" to personal effects which are: (1) Personal property owned by an "insured"; and (2) In or on a covered "auto". b. Subject to Paragraph a. above, the amount to be paid for "loss" to personal effects will be based on the lesser of: (1) The reasonable cost to replace; or (2) The actual cash value. c. The coverage provided in Paragraphs a. and b. above, only applies in the event of a total theft of a covered '"auto". No deductible applies to this coverage. However, we will not pay for "loss" to personal effects of any of the following: (1) Accounts, bills, currency, deeds, evidence of debt, money, notes, securities, or commercial paper or other documents of value. (2) Bullion, gold, silver, platinum, or other precious alloys or metals; furs or fur garments; jewelry, watches, precious or semi-precious stones. (3) Paintings, statuary and other works of art. (4) Contraband or property in the course of illegal transportation or trade. (5) Tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. Any coverage provided by this Provision is excess over any other insurance coverage available for the same "loss", J. Tapes, Records and Discs Coverage 1. The Exclusion in Paragraph 8,4.a. of Section III — Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B.2.c. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage Form does not apply. 2. The following is added to Paragraph 1.a. Comprehensive Coverage under the Coverage Provision of the Physical Damage Coverage Section: We will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: (a) Are the property of an "insured" and (b) Are in a covered "auto" at the time of "loss". The most we will pay for such "loss" to tapes, records, discs or other similar devices is 5500. The Physical Damage Coverage Deductible Provision does not apply to such "loss". U -CA -424-F CW (04-14) Page 3 of 6 includes copyrighted material of Insurance Services Office, Inc., with its permission K. Airbag Coverage The Exclusion in Paragraph B.3.a. of Section III — Physical Damage Coverage in the Business Auto Coverage Form and the Exclusion in Paragraph B,4.a. of Section IV — Physical Damage Coverage in the Motor Carrier Coverage Form does not apply to the accidental discharge of an airbag. L. Two or More Deductibles The following is added to the Deductible Provision of the Physical Damage Coverage Section: If an accident is covered both by this policy or Coverage Form and by another policy or Coverage Form issued to you by us, the following applies for each covered "auto" on a per vehicle basis: 1. If the deductible on this policy or Coverage Form is the smaller (or smallest) deductible it will be waived, or 2. If the deductible on this policy or Coverage Form is not the smaller (or smallest) deductible, it will be reduced by the amount of the smaller (or smallest) deductible. M. Physical Damage — Comprehensive Coverage — Deductible The following is added to the Deductible Provision of the Physical Damage Coverage Section: Regardless of the number of covered "autos" damaged or stolen, the maximum deductible that will be applied to Comprehensive Coverage for all "loss" from any one cause is $5:000 or the deductible shown in the Declarations, whichever is greater. N. Temporary Substitute Autos — Physical Damage 1. The following is added to Section I — Covered Autos: Temporary Substitute Autos — Physical Damage If Physical Damage Coverage is provided by this Coverage Form on your owned covered "autos", the following types of vehicles are also covered "autos" for Physical Damage Coverage: Any "auto" you do not own when used with the permission of its owner as a temporary substitute for a covered "auto" you do own but is out of service because of its 1. Breakdown; 2. Repair; 3. Servicing; 4. "Loss"; or 5. Destruction. 2. The following is added to the Paragraph A. Coverage Provision of the Physical Damage Coverage Section: Temporary Substitute Autos — Physical Damage We will pay the owner for "loss" to the temporary substitute "auto' unless the "loss" results from fraudulent acts or omissions on your part. If we make any payment to the owner, we will obtain the owner's rights against any other party. The deductible for the temporary substitute "auto" will be the same as the deductible for the covered "auto" it replaces. O. Amended Duties In The Event Of Accident, Claim, Suit Or Loss Paragraph a. of the Duties In The Event Of Accident, Claim, Suit Or Loss Condition is replaced by the following: a. In the event of "accident", claim, "suit" or "loss", you must give us or our authorized representative prompt notice of the "accident", claim, "suit" or "loss". However, these duties only apply when the "accident", claim, "suit" or "loss" is known to you (if you are an individual), a partner (if you are a partnership), a member (if you are a limited liability company) or an executive officer or insurance manager (if you are a corporation). The failure of any U -CA -424-F CW (04-14) Page 4 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission. agent, servant or employee of the "insured" to notify us of any "accident", claim, "suit" or "loss" shall not invalidate the insurance afforded by this policy. Include, as soon as practicable - (1) How, when and where the "accident" or "loss" occurred and if a claim is made or "suit" is brought, written notice of the claim or "suit" including, but not limited to, the date and details of such claim or "suit' (2) The "insured's" name and address; and (3) To the extent possible, the names and addresses of any injured persons and witnesses. If you report an "accident", claim, "suit" or "loss" to another insurer when you should have reported to us, your failure to report to us will not be seen as a violation of these amended duties provided you give us notice as soon as practicable after the fact of the delay becomes known to you. P. Waiver of Transfer Of Rights Of Recovery Against Others To Us The following is added to the Transfer Of Rights Of Recovery Against Others To Us Condition: This Condition does not apply to the extent required of you by a written contract, executed prior to any "accident" or "loss", provided that the "accident" or "loss" arises out of operations contemplated by such contract. This waiver only applies to the person or organization designated in the contract. Q. Employee Hired Autos — Physical Damage Paragraph b. of the Other Insurance Condition in the Business Auto Coverage Form and Paragraph f. of the Other Insurance — Primary and Excess Insurance Provisions Condition in the Motor Carrier Coverage Form are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: (1) Any covered "auto" you lease, hire, rent or borrow; and (2) Any covered "auto" hired or rented under a written contract or written agreement entered into by an "employee" or elected or appointed official with your permission while being operated within the course and scope of that "employee's" employment by you or that elected or appointed official's duties as respect their obligations to you. However, any "auto" that is leased, hired, rented or borrowed with a driver is not a covered "auto". R. Unintentional Failure to Disclose Hazards The following is added to the Concealment, Misrepresentation Or Fraud Condition: However, we will not deny coverage under this Coverage Form if you unintentionally: (1) Fail to disclose any hazards existing at the inception date of this Coverage Form; or (2) Make an error, omission, improper description of "autos" or other misstatement of information. You must notify us as soon as possible after the discovery of any hazards or any other information that was not provided to us prior to the acceptance of this policy. S. Hired Auto —World Wide Coverage Paragraph 7a.(5) of the Policy Period, Coverage Territory Condition is replaced by the following: (5) Anywhere in the world if a covered "auto" is leased, hired, rented or borrowed for a period of 60 days or less, T. Bodily Injury Redefined The definition of "bodily injury" in the Definitions Section is replaced by the following: "Bodily injury" means bodily injury, sickness or disease, sustained by a person including death or mental anguish, resulting from any of these at any time. Mental anguish means any type of mental or emotional illness or disease. U -CA -424-F CW (04-14) Page 5 of 6 Includes copyrighted material of Insurance Services Office, Inc., with its permission.. U. Expected Or Intended Injury The Expected Or Intended Injury Exclusion in Paragraph B. Exclusions under Section 11 — Covered Auto Liability Coverage is replaced by the following: Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the "insured". This exclusion does not apply to "bodily injury" or "property damage" resulting from the use of reasonable force to protect persons or property. V. Physical Damage —Additional Temporary Transportation Expense Coverage Paragraph A.4.a. of Section III — Physical Damage Coverage is replaced by the following: 4. Coverage Extensions a. Transportation Expenses We will pay up to $50 per day to a maximum of $1,000 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". W. Replacement of a Private Passenger Auto with a Hybrid or Alternative Fuel Source Auto The following is added to Paragraph A. Coverage of the Physical Damage Coverage Section: In the event of a total "loss" to a covered "auto" of the private passenger type that is replaced with a hybrid "auto" or "auto" powered by an alternative fuel source of the private passenger type, we will pay an additional 10% of the cost of the replacement "auto", excluding tax, title, license, other fees and any aftermarket vehicle upgrades, up to a maximum of $2500. The covered "auto" must be replaced by a hybrid "auto" or an "auto" powered by an alternative fuel source within 60 calendar days of the payment of the "loss" and evidenced by a bill of sale or new vehicle lease agreement. To qualify as a hybrid "auto", the "auto" must be powered by a conventional gasoline engine and another source of propulsion power. The other source of propulsion power must be electric, hydrogen, propane, solar or natural gas, either compressed or liquefied. To qualify as an "auto" powered by an alternative fuel source, the "auto" must be powered by a source of propulsion power other than a conventional gasoline engine. An "auto" solely propelled by biofuel, gasoline or diesel fuel or any blend thereof is not an "auto" powered by an alternative fuel source. X. Return of Stolen Automobile The following is added to the Coverage Extension Provision of the Physical Damage Coverage Sectior: If a covered "auto" is stolen and recovered, we will pay the cost of transport to return the "auto' to you. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes of Loss Coverage. All other terms, conditions, provisions and exclusions of this policy remain the same. U -CA -424-F CW (04 14) Page 6 of 6 Includes copyrighted material of Insurance Services Office, Inc.. with its permission.