1st Amendment 09/16/2020 lPAC-A3 Kevin Madok, CPA
i
`... r_= Clerk of the Circuit Court&Comptroller—Monroe County, Florida
.` _
DATE: September 17, 2020
TO: Breanne Erickson, Contract Administrator
Project Management
FROM: PanelaG. H:unc ''���i.C.
SUBJECT: September 16th BOCC Meeting
Attached is an electronic copy of die following item for your handling:
C13 1st Amendment to Task Order lbr T.Y. l.in International in die amount of
$76,570.00 for the monitoring specialists and an additional survey of the Clarence Hiss Beach
Sand Replenishment Project to be paid by Tourist Development Council Grant#1759.
Should you have any questions please feel free to contact me at(305) 292-3550.
cc: County Attorney
Finance
File
KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING
500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road
Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Honda 33070 Plantation Key,Fladda 33070
305-294-4641 305-289-6027 305-852-7145 305-852-7145
FIRST AMENDMENT TO TASK ORDER FOR
ON CALL PROFESSIONAL ENGINEERING SERVICES
BETWEEN MONROE COUNTY
AND
T.Y. LIN INTERNATIONAL
FOR
HIGGS BEACH RE-NOURISHMENTABOVE AND BELOW MHW
In accordance with the Agreement for On Call Professional Engineering Services, made
and entered into on January 17,2018,between MONROE COUNTY,hereinafter referred
to as the "County" and T.Y. LIN INTERNATIONAL hereinafter referred to as
"Consultant"/"T.Y. Lin", where professional services are allowed if construction costs do
not exceed $2,000,000.00 or if the fee for professional services for each individual study
under the contract does not exceed $200,000.00, hereinafter referred to as "Agreement",
the parties enter into this First Amendment to the Task Order with an effective date of June
19, 2020 ("Task Order").
All terms and conditions of the Agreement apply to this Amendment, unless this
Amendment amends, adds, or modifies a provision or an Article of the Agreement or Task
Order of which will be specifically referenced in this Amendment and the amendment,
addition, or modification shall be precisely described.
This First Amendment is effective on the 16th day of September, 2020.
WHEREAS, an Agreement with the Consultant for On-Call Professional Engineering
Services was entered into on January 17, 2018, between the Consultant and the County;
and
WHEREAS,a Task Order with the Consultant for the Higgs Beach Re-Nourishment Above
and Below MHW project was entered into on June 19, 2020, between the Consultant and
the County; and
WHEREAS, additions to the original scope of work have been made necessary by the
Florida Department of Environmental Protection (FDEP), a state permitting agency,
specifically requiring a qualified On-Site Representative for the County and the conducting
of one (1) additional pre-construction survey.
NOW, THEREFORE,the Task Order for Higgs Beach Re-Nourishment, shall be amended
to include the additional required scope of services and in consideration of the mutual
promises and covenants set forth below, the parties agree as follows:
1. In accordance with Article II, paragraph 2.1, of the Professional Services
Agreement, Consultant will secure the services of a qualified On-Site
Representative for the County and secure the services of a licensed professional
surveyor and mapping consultant to conduct one (1) additional pre-construction
survey at Higgs Beach,Key West in Monroe County, Florida. The additional scope
of services will include the following tasks:
Higgs Beach Sand Re-Nourishment Above and Below MHW Task Order Amendment I
1
2.1 Pre-Construction Baseline Biological Monitoring
• Prior to conducting habitat edge mapping in the field and location of
permanent monitoring transects, a visual analysis of recent(as close as
possible and available to the date of the pending nourishment) aerial
imagery in GIS software as per the BMP will be conducted. This analysis
will be overlaid with the edge mapping conducted in the field and
included in the report.
• Perform the field survey tasks as required per the BMP, specifically:
o Habitat edge mapping (in situ)
o Transect establishment(4 hardbottom, 5 SAV transects)
o Transect monitoring (20 m, 8 1-m2 BEAMR quadrats each,
lineintercept, interval sediment depth)
o SAV Patch delineation and rapid assessment
o Coral colony tagging and condition monitoring (all ESA-listed
coral species, and all scleractinian coral species at least 10 cm in
diameter)
• Baseline data collected prior to the renourishment event will be submitted
to the FDEP JCP Compliance Officer and Monroe County, as per the
BMP at least thirty (30) days prior to construction (unless the survey is
conducted within thirty (30) days of construction commencement, in
which case the data will be submitted within thirty (30) days of survey
completion). Data will be submitted electronically and will include:
o Video and photographic data
o Raw transect survey data
o Habitat(nearshore edge and SAV patches) mapping data
o Coral colony condition data
o Scanned copies of field datasheets
• In addition to the data deliverables to the FDEP, a written monitoring
report will be submitted to Florida Keys National Marine Sanctuary
("FKNMS")that analyzes the above-listed data within sixty (60) days of
survey completion.
• T.Y. Lin will be assisted in this task by its sub-consultant, Cummins
Cederberg
2.2 Sediment QC/QA On-Site Representation
T.Y. Lin will enforce the construction contract and regulatory permits related to
sediment quality, including the FDEP-approved December 2019 Sediment
Quality Control/Quality Assurance Plan. It is anticipated that construction
activities associated with the sand placement will be conducted over a period of
four(4)weeks.
• On-Site Representative. On-site observation will be conducted by
individuals with training and experience in beach nourishment and
Higgs Beach Sand Re-Nourishment Above and Below MHW Task Order Amendment I
2
construction inspection and testing, and knowledgeable of the project
design and permit conditions. T.Y. Lin will provide approximately ten
(10) hours per week for on-site observations to be supplemented by
County staff. T.Y. Lin's Project Engineer will actively coordinate with
the On-Site Representatives. Communications will take place between the
T.Y. Lin's Engineer and On-Site Representatives on a weekly basis.
• Pre-Construction Meeting. The project QC/QA Plan will be discussed as a
matter of importance at the pre-construction meeting. The Contractor will
be required to acknowledge the goals and intent of the above described
QC/QA Plan, in writing, prior to commencement of construction.
• Contractor's Daily Reports. T.Y. Lin's On-Site Representative will review
the Contractor's Daily Reports which will characterize the nature of the
sediments encountered at the upland sand source and placed along the
project shoreline with specific reference to moist sand color and the
occurrence of rock, rubble, shell, silt or debris.
• On Call. T.Y. Lin will be continuously on call during the period of
construction for the purpose of making decisions regarding issues that
involve QC/QA Plan compliance.
• Addendums. Any addendum or change order to the Contract between the
County and the Contractor will be evaluated to determine whether or not
the change in scope will potentially affect the QC\QA Plan.
• Post-Construction Sampling for Laboratory Testing. To assure that the fill
material placed on the beach was adequately assessed by the borrow area
investigation and design, T.Y.Lin will conduct assessments of the
sediment as detailed in the Plan.
Post-construction sampling of each acceptance section and testing of the
fill material will be conducted to verify that the sediment placed on the
beach meets the expected criteria/characteristics provided from the
geotechnical investigation and borrow area design process. Upon
completion of an acceptance section of constructed beach, the T.Y. Lin
will collect two (2) duplicate sand samples at each FDEP reference
monument profile line to quantitatively assess the grain size distribution,
moist Munsell color, shell content, and silt content for compliance.
T.Y. Lin will collect the sediment samples of a minimum of 1 U.S. pint(at
least 200 grams) each from the bottom of a test hole a minimum of 18
inches deep within the limits of the constructed berm. T.Y. Lin will
visually assess grain size, Munsell color, shell content, and silt content of
the material by handling the fill material to ensure that it is predominantly
sand, and further to note the physical characteristics. T.Y. Lin will note the
existence of any layering or rocks within the test hole. One (1) sample will
be sent for laboratory analysis while the other sample will be archived by
the County. All samples and laboratory test results will be labeled with the
Project name, FDEP Reference Monument Profile Line designation, date
sample was obtained, and "Construction Berm Sample."
Higgs Beach Sand Re-Nourishment Above and Below MHW Task Order Amendment I
3
It is estimated that ten (10) sand samples will be collected. Geotechnical
laboratory analysis will include:
o Gradation analyses (ASTM D 422)to include the following
standard sieves: 3/4", 5/8", 3.5, 4, 5, 7, 10, 14, 18, 25, 35, 45,
60, 80, 120, 170, and 230. The following will be included in
tabular form:
i. Sieve number
ii. Diameter in mm,
iii. Diameter in phi units,
iv. Weight retained on sieve,
V. Weight percent retained on sieve,
vi. Cumulative weight retained on sieve and
vii. Cumulative weight percent retained on sieve.
All weights and percentages will be recorded to the nearest
0.01 gm.
o A table of moment statistics (mean, median (d50), standard
deviation (sorting), moist Munsell color, silt percent, visual
estimate of shell content, and carbonate content will be
included. Frequency and cumulative frequency plots of each
sample will also be provided.
In the event that a section of beach contains fill material that is not in
compliance with the sediment compliance specifications, then the County
will be notified and proposed remediation strategies discussed. FDEP
notification will indicate the volume, aerial extent and location of any
unacceptable beach areas and remediation planned.
• T.Y. Lin will be assisted in this task by its sub-consultants, Terramar
Environmental Services and NV5.
COUNTY RESPONSIBILITY
The County's Responsibility is outlined in Article IV of the Professional Services
Agreement. County shall provide historical property records and deeds if required.
2. In accordance with Article VII of the Professional Services Agreement, the
County shall pay the Consultant a lump sum fee of Seventy-Six Thousand Five
Hundred Seventy and 00/100 Dollars ($76,570.00)paid on a percent complete
basis for each task, as described above in the Scope of Work, for the following
phases:
Task Preconstruction Baseline Biological
2.1 Monitoring $47 923.00
Task Construction Sediment QC/QA On-Site
2.2 Representation $28 647.00
Total Project Fees $76,570.00
Higgs Beach Sand Re-Nourishment Above and Below MHW Task Order Amendment I
4
The total cost of this Task Order, including the First Amendment, is$126,508.00.
All other terms and conditions of this First Amendment shall be in accordance with the
Task Order and Agreement.
IN WITNESS WHEREOF, each party caused this Amendment to be executed by its duly
eriMr, ionized representative.
J/ r
1 11 BOARD OF C•UNTY COMMISSIONERS
'� . inMadoo , Clerk OF MONROE •U. • , FLORIDA
�� By: As
As Deputy Clerk ay sr airman
AtirtDate: -•^^e^�I� �"0 �""
CONSULTANT: A WITNESS TO CONSULTANT
T.Y. LIN IN
By: Francisco - • By: O"
Title: Vice President Date: 8-31-20
Date: 8-31-20
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Higgs Beach Sand Re-Nourishment Above and Below MHW Task Order Amendment I
5
DATE(MM/DDYYY)
A�" CERTIFICATE OF LIABILITY INSURANCE /Y
3/1/2020
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 CONTACT
NAME: Nancy Ferrlck
Dealey, Renton &Associates PHONE FAX
License#0020739 A/C No Ext: 510-465-3090 vc,No):510-452-2193
E-MP. O. Box 12675 ADDRESS: nferrick@dealeyrenton.com
Oakland CA 94604-2675 INSURER(S)AFFORDING COVERAGE NAIC#
INSURERA: National Fire Insurance of Hartford 20478
INSURED TYLININTE1 INSURERB: Continental Insurance Company 35289
T. Y. Lin International
345 California Street, Ste. 2300 INsuRERc:Valley Forge Insurance Company 20508
San Francisco CA 94104 INSURERD:American Casualty Company of Reading, 20427
INSURERS:Aspen Specialty Insurance Company 10717
INSURER F
COVERAGES CERTIFICATE NUMBER:32887588 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICY NUMBER MM/DD MM/DD
A X COMMERCIAL GENERAL LIABILITY Y Y 6056538518 3/1/2020 3/1/2021 EACH OCCURRENCE $1,000,000
F7�vl TO
CLAIMS-MADE OCCUR PREMI ES( RENTED
PREMISES Ea occurrence)
ccurrence) $1,000,000
X Contractual Liab MED EXP(Any one person) $15,000
X Cross Liab. PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
Fy] PRO-
POLICY JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
OTHER: $
C AUTOMOBILE LIABILITY Y Y 6045854867 3/1/2020 3/1/2021 C Ea OMaccidentBINED SINGLE LIMIT $1,000,000
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
X HIRED X NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
B UMBRELLA LAB X OCCUR Y Y 6056538549 3/1/2020 3/1/2021 EACH OCCURRENCE $5,000,000
X EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000
DED RETENTION$ $
D WORKERS COMPENSATION Y 6056808508 3/1/2020 3/1/2021 X PER OTH-
A AND EMPLOYERS'LIABILITY Y/N 6056809061 3/1/2020 3/1/2021 STATUTE ER
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
OFFICER/MEMBER EXCLUDED? FN] N/A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
E Professional Liability LRA9P0120 3/1/2020 3/1/2021 $5,000,000 per Claim
$5,000,000 Annual Aggregate
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Re:All Operations of the Named Insured. Monroe County Board of County Commissioners and the State of Florida Department of Transportation are named as
Additional Insured for General and Automobile Liability as required by written contract or agreement. Insurance is primary and non-contributory per policy form.
1
Y ,
I
a 3/24/2020 ,.,
CERTIFICATE HOLDER WAMF
� - LLATION 30 Days Notice of Cancellation
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Monroe County ACCORDANCE WITH THE POLICY PROVISIONS.
Board of County Commissioners
1100 Simonton Street#2-216 AUTHORIZED REPRESENTATIVE
Key West FL 33040-3110 �U�iktk
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
AdWAIA
Blanket Additional Insured - Owners, Lessees or
Operations Coverage Endorsement_
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Itia understood and agreed aefollows:
|. The VVHQ IS AN INSURED section is amended to add as an Insured any person or organization whom the
Named Insured is required by written contract to add as an additional insured on this coverage part, including
any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement.
However, such person or organization in an Insured only with respect to such person or orQanization'a liability
for:
A. unless paragraph B.below applies,
Y. bodily injury, property damage, or personal and advertising injury caused in whole or in part by the
acts or omissions by or on behalf of the Named Insured and in the performance of such Named
lnmured's ongoing operations ea specified in such written contract; or
2. bodily injury or property damage caused in whole or in part by your work and included in the
prod uoba-comnp|eted operations hazard, and only if
o. the written contract requires the Named Insured to provide the additional insured such coverage;
and �
|
b` this coverage part provides such coverage. �
B. bodily injury, property damage, or personal and advertising injury arising out of your work described in �
such written contract, but only if:
� |
1, this coverage part provides coverage for bodily injury or property damage included within the
products completed operations hazard; and |
2. the written contract specifically requires the Named Insured to provide additional insured coverage �
under the 11-85or1O-U1 edition ufCG2O10or the 1O-01 edition ofCG2U37 �
U. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not
provide such additional insured with:
A. coverage broader than required by the written contract; or
B. a higher limit of insurance than required by the written contract.
|||. The insurance granted by this endorsement tothe additional insured does not apply to bodily irjury, property
damage,or personal and advertising injury arising out of:
A. the rendering of, or the failure to render, any professional anohiteutura|, engineering, or surveying oen/inen.
including:
1. the pnaporing, opprnxng, or failing to prepare or approve nzapn, shop drawingo, opinione, reports,
surveys, field orders, change orders or drawings and specifications; and
3. supervisory, inspection, architectural or engineering activities; nr
B. any premises or work for which the additional insured is specifically listed as an additional insured on another
endorsement attached to this coverage part.
Ky' Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY
CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available
to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance
CNA75079>0((1-15) Policy No: 605e53e518
Page 1nf2 Endorsement No:
Effective Dute:O3/O1/2O2O
Insured Name'. r.v.Lin International
WAWA
WAWL
Blanket Additional Insured - Owners, Lessees or
Operations Coverage Endorsement_
is required by written contract to be primary and non-contributory, this insurance will be primary and non-
contributory relative solely to insurance on which the additional insured isanamed insured.
V. Solely with respect to the insurance granted by this endorsement,the section entitled COMMERCIAL GENERAL
LIABILITY CONDITIONS is amended aufollows:
The Condition entitled Duties In The Event of Occurrence, Offense, Claim orSuit in emended with the
addition of the following:
Any additional insured pursuant to this endorsement will as soon as practicable:
1. give the Insurer written notice of any claim, or any occurrence or offense which may result inaclaim;
2, except as provided in Paragraph |V, of this endorsement, agree to make available any other insurance
the additional insured has for any loss covered under this coverage part;
3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the
inveotigmtiun, defenae, or settlement of the claim; and U
4. tender the defense and indemnity of any claim to any other insurer urself insurer whose policy or �
program applies to e |oon that the Insurer covers under this coverage part. Hovw*var, if the written
contract requires this insurance tobo primary and non-uonthbutory.this paragraph (4)does not apply to �
insurance nn which the additional insured iva named insured. �
�
The Insurer has no duty to defend or indemnify an additional insured under this endorsementuntil the Insurer �
receives written notice ofa claim from the additional insured. �
�
\A. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended
to add the following definition: `
Written contract means awritten contract or written agreement that requires the Munned Insured to make a �
person or organization an additional insured on this coverage part, provided the contract or agreement:
A. io currently in effect orbecomes effective during the term of this policy; and i
B. was executed prior to:
�
1' the bodily injury or property damage; or '
2. the offense that caused the personal and advertising injury
for which the additional insured seeks coverage.
Any coverage granted by this endorsement shall apply solely to the extent permissible bylaw.
All other terms and conditions of the Policy remain unchanged.
This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes
effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown
below, and expires concurrently with said Policy.
CNA75879XX(1-15) Policy No:
Page 2of2 Endorsement No:
Effective Date:
Insured Name-
Copyright nmxm/mootseenawau. Includes copyrighted material m Insurance Services Office,|mc,.Wm its permission,
CNA CNA PARAMOUNT
Waiver of Transfer of Rights of Recovery Against
Others to the Insurer Endorsement
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Person Or Organization:
Any person or organization whom the Named Insured has agreed in writing in a
contract or agreement to waive such rights of recovery, but only if such
contract or agreement:
1. is in effect or becomes effective during the term of this Coverage
Part; and 2. was executed prior to the bodily injury, property damage
or personal and advertising injury giving rise to the claim.
Information required to complete this Schedule, if not shown above,will be shown in the Declarations.
It is understood and agreed that the condition entitled Transfer Of Rights Of Recovery Against Others To The Insurer
is amended by the addition of the following:
Solely with respect to the person or organization shown in the Schedule above, the Insurer waives any right of recovery
the Insurer may have against such person or organization because of payments the Insurer makes for injury or damage
arising out of the Named Insured's ongoing operations or your work done under a contract with that person or
organization and included in the products-completed operations hazard.
All other terms and conditions of the Policy remain unchanged.
This endorsement,which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect
on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and
expires concurrently with said Policy.
CNA75008XX (1-15) Policy No: 6056538518
National Fire Insurance Co of H Effective Date: 03/01/2020
Insured Name: T.Y.Lin International
Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission.
A
CN
6045854867 CNA6335(Ed. 04/12)12)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CONTRACTORS EXTENDED COVERAGE ENDORSEMENT
- BUSINESS AUTO PLUS -
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
I. LIABILITY COVERAGE 4. An "employee" of yours is an "insured" while
A. Who Is An Insured operating an "auto" hired or rented under a
contract or agreement in that "employee's"
The following is added to Section II, Paragraph name, with your permission, while performing
A.1., Who Is An Insured: duties related to the conduct of your
1. a. Any incorporated entity of which the business.
Named Insured owns a majority of the "Policy," as used in this provision A. Who Is An
voting stock on the date of inception of Insured, includes those policies that were in
this Coverage Form; provided that, force on the inception date of this Coverage Form
b. The insurance afforded by this provision but:
A.1. does not apply to any such entity 1. Which are no longer in force; or
that is an "insured" under any other liability "policy" providing "auto" 2. Whose limits have been exhausted.
coverage. B. Bail Bonds and Loss of Earnings
2. Any organization you newly acquire or form, Section II, Paragraphs A.2. (2) and A.2. (4)
other than a limited liability company, are revised as follows:
partnership or joint venture, and over which 1. In a.(2), the limit for the cost of bail bonds is
you maintain majority ownership interest. changed from $2,000 to $5,000; and
The insurance afforded by this provision A.2.: 2. In a.(4), the limit for the loss of earnings is
a. Is effective on the acquisition or changed from $250 to $500 a day.
formation date, and is afforded only until C. Fellow Employee
the end of the policy period of this
Coverage Form, or the next anniversary Section II, Paragraph B.5 does not apply.
of its inception date, whichever is earlier.
Such coverage as is afforded by this provision C.
b. Does not apply to: is excess over any other collectible insurance.
(1) "Bodily injury" or "property damage" II. PHYSICAL DAMAGE COVERAGE
caused by an "accident" that
occurred before you acquired or A. Glass Breakage — Hitting A Bird Or Animal —
formed the organization; or Falling Objects Or Missiles
(2) Any such organization that is an The following is added to Section III,
"insured" under any other liability Paragraph A.3.:
"policy" providing "auto" coverage. With respect to any covered "auto," any
3. Any person or organization that you are deductible shown in the Declarations will not
required by a written contract to name as an apply to glass breakage if such glass is repaired,
additional insured is an "insured" but only in a manner acceptable to us, rather than
with respect to their legal liability for acts or replaced.
omissions of a person, who qualifies as an B. Transportation Expenses
"insured" under Section II — Who Is An
Insured and for whom Liability Coverage is Section III, Paragraph AA.a. is revised, with
afforded under this policy. If required by respect to transportation expense incurred by
written contract, this insurance will be you, to provide:
primary and non-contributory to insurance on a. $60 per day, in lieu of$20; subject to
which the additional insured is a Named
Insured. b. $1,800 maximum, in lieu of$600.
CNA63359XX Copyright,CNA Corporation,2000. Page 1 of 3
(Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission.
CNA63359XX
CNA (Ed. 04/12)
C. Loss of Use Expenses Section III, Paragraphs B.4.c and B.4.d. are
Section III, Paragraph A.4.16. is revised, with deleted and replaced by the following:
respect to loss of use expenses incurred by you, c. Physical Damage Coverage on a covered
to provide: "auto" also applies to "loss" to any
a. $1,000 maximum, in lieu of$600. permanently installed electronic equipment
including its antennas and other
D. Hired "Autos" accessories.
The following is added to Section III. d. A $100 per occurrence deductible applies to
Paragraph A.: the coverage provided by this provision.
5. Hired "Autos" G. Diminution In Value
If Physical Damage coverage is provided under The following is added to Section III,
this policy, and such coverage does not extend Paragraph B.6.:
to Hired Autos, then Physical Damage coverage Subject to the following, the "diminution in value"
is extended to: exclusion does not apply to:
a. Any covered "auto" you lease, hire, rent a. Any covered "auto" of the private
or borrow without a driver; and passenger type you lease, hire, rent or
b. Any covered "auto" hired or rented by borrow, without a driver for a period of 30
your"employee" without a driver, under a days or less, while performing duties
contract in that individual "employee's" related to the conduct of your business;
name, with your permission, while and
performing duties related to the conduct b. Any covered "auto" of the private
of your business. passenger type hired or rented by your
c. The most we will pay for any one "employee" without a driver for a period
"accident" or "loss" is the actual cash of 30 days or less, under a contract in
value, cost of repair, cost of replacement that individual "employee's" name, with
or $75,000, whichever is less, minus a your permission, while performing duties
$500 deductible for each covered auto. related to the conduct of your business.
No deductible applies to "loss" caused c. Such coverage as is provided by this
by fire or lightning. provision is limited to a "diminution in
d. The physical damage coverage as is value" loss arising directly out of
provided by this provision is equal to the accidental damage and not as a result of
physical damage coverage(s) provided the failure to make repairs; faulty or
on your owned "autos." incomplete maintenance or repairs; or
e. Such physical damage coverage for
the installation of substandard parts.
hired "autos" will: d. The most we will pay for "loss" to a
(1) Include loss of use, provided it is the covered "auto" in any one accident is the
consequence of an "accident" for lesser of:
which the Named Insured is legally (1) $5,000; or
liable, and as a result of which a (2) 20% of the "auto's" actual cash
monetary loss is sustained by the value (ACV).
leasing or rental concern.
(2) Such coverage as is provided by this III. Drive Other Car Coverage — Executive Officers
provision will be subject to a limit of The following is added to Sections II and III:
$750 per"accident." 1. Any "auto" you don't own, hire or borrow is a
E. Airbag Coverage covered "auto" for Liability Coverage while being
The following is added to Section III, used by, and for Physical Damage Coverage
Paragraph B.3.: while in the care, custody or control of, any of
your"executive officers," except:
The accidental discharge of an airbag shall not a. An "auto" owned by that "executive officer"
be considered mechanical breakdown. or a member of that person's household; or
F. Electronic Equipment
CNA63359XX Copyright,CNA Corporation,2000. Page 2 of 3
(Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission.
CNA63359XX
CNA (Ed. 04/12)
b. An "auto" used by that "executive officer" The following is added to Section IV,
while working in a business of selling, Paragraph A.5. Transfer Of Rights Of
servicing, repairing or parking "autos." Recovery Against Others To Us:
Such Liability and/or Physical Damage Coverage We waive any right of recovery we may have,
as is afforded by this provision. because of payments we make for injury or
(1) Equal to the greatest of those coverages damage, against any person or organization for
afforded any covered "auto"; and whom or which you are required by written
contract or agreement to obtain this waiver from
(2) Excess over any other collectible us.
insurance. This injury or damage must arise out of your
2. For purposes of this provision, "executive officer" activities under a contract with that person or
means a person holding any of the officer organization.
positions created by your charter, constitution, You must agree to that requirement prior to an
by-laws or any other similar governing document, "accident" or"loss."
and, while a resident of the same household,
includes that person's spouse. C. Concealment, Misrepresentation or Fraud
Such "executive officers" are "insureds" while The following is added to Section IV,
using a covered "auto" described in this Paragraph B.2.:
provision. Your failure to disclose all hazards existing on the
IV. BUSINESS AUTO CONDITIONS date of inception of this Coverage Form shall not
A. Duties In The Event Of Accident, Claim, Suit prejudice you with respect to the coverage afforded
Or Loss provided such failure or omission is not intentional.
The following is added to Section IV,
D. Other Insurance
Paragraph A.2.a.: The following is added to Section IV,
(4) Your "employees" may know of an Paragraph B.5.:
"accident" or "loss." This will not mean Regardless of the provisions of Paragraphs 5.a.
that you have such knowledge, unless and 5.d. above, the coverage provided by this
such "accident" or "loss" is known to policy shall be on a primary non-contributory
you or if you are not an individual, to any basis. This provision is applicable only when
of your executive officers or partners or required by a written contract. That written
your insurance manager. contract must have been entered into prior to
The following is added to Section IV,
"Accident" or"Loss."
Paragraph A.2.b.: E. Policy Period, Coverage Territory
(6) Your "employees" may know of Section IV, Paragraph B. 7.(5).(a). is revised to
documents received concerning a claim provide:
or "suit." This will not mean that you a. 45 days of coverage in lieu of 30 days.
have such knowledge, unless receipt of
such documents is known to you or if V. DEFINITIONS
you are not an individual, to any of your
executive officers or partners or your Section V. Paragraph C. is deleted and replaced
insurance manager. by the following:
B. Transfer Of Rights Of Recovery Against "Bodily injury" means bodily injury, sickness or
Others To Us disease sustained by a person, including mental
anguish, mental injury or death resulting from any of
these.
CNA63359XX Copyright,CNA Corporation,2000. Page 3 of 3
(Ed. 04/12) Includes copyrighted material of the Insurance Services Office used with its permission.
CNA POLICY NUMBERS: 6056808508 AND 6056809061 G-19160-B
(Ed. 11/97)
WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY
BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
This endorsement changes the policy to which it is attached.
It is agreed that Part One Workers' Compensation Insurance G. Recovery From Others and Part Two Employers'
Liability Insurance H. Recovery From Others are amended by adding the following:
We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that
you perform work under a written contract that requires you to obtain this agreement from us.)
PREMIUM CHARGE -
The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California
exposure. The amount is
G-19160-B Page 1 of 1
(Ed. 11/97)