Project Proposal 11/08/2023 GVS COURTq°
o: A Kevin Madok, CPA
-
�o ........ � Clerk of the Circuit Court& Comptroller Monroe County, Florida
�z cooN
DATE: November 29, 2023
TO: William DeSantis, Director
Facilities Maintenance
Chrissy Collins
Executive Administrator
Alice Steryou
Contract Monitor
FROM: Liz Yongue, Deputy Clerk
SUBJECT: November 8, 2023 BOCC Meeting
The following item has been executed and added to the record:
F16 Project Proposal with Siemens Industry, Inc., as a Sole Source provider for
testing, certification, and maintenance of Fire Alarm, Smoke Control, and Building Automation
Systems in Monroe County facilities, to perform under its current contract to provide Fire Alarm
Control Unit Upgrades on certain equipment at the Monroe County Detention Center in Key
West. American Rescue Plan Act Funding (ARPA) will be utilized for these upgrades in the
anticipated amount of$319,627.33.
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
500 Whitehead Street 3117 Overseas Highway 88770 Overseas Highway
Key West, Florida 33040 Marathon, Florida 33050 Plantation Key, Florida 33070
SIEMENS
PROPOSAL
MONROE DET FACILITY FA UPGRADE "�
PREPARED BY �...,...._...................
Siemens Industry, Inc.("Siemens")
PREPARED FOR
MONROE COUNTY
DELIVERED ON
October 23,2023
SMART BUILDINGS
Transforming the Everyday
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Table of Contents
SIEMENSPR()POSAL —...----- .......... —.. .......----...........— ........---...... —'' 3
Contact Information ---- ........—.-- ......... — ...... ---- ........----~—'' 3
Scope ofWork .-----..----._........---- — ...... _^.—`--_ ...........—. 4
Advantages of Modernizing with Desigo Fire Safety Mndu|ar..— ........---...........
7
EquipmentList ..................................................................................... --.---- 9
Commodity Price Clause ............_--- .............-- ...... .....—......_.-.—_- 1O
SellPrice.....................------------------....... ......... ......—.-- 11
PaymentTenns._.... ...---........... ......... —_--._.......— ........... — ......... 1Z
Terms and Conditions.............. --_---_ .......... —~— ........... -----.._--- 13
Terms & Conditions ..............—................----_—_--~---_—............— 13
Signature Page 13
-----_--—---—.----..-.----------.----._—
Signature Page ......... _....... — ........---....................--.^--- ...... ... —. 13
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Contact Information
Proposal 7885009
Date: October23'ZO23
Sales Executive: Jose Gonzalez
Branch Address: 3021 North Commerce PkwY
K4|ramarFL' 33025
Telephone: 1-954-329-7048
Email Address: gmnza|ezjose@siemenscmm
Customer Contact: D4N8ENSLEY
Customer: K40NNOE[OUNTY
Address: 55Ol COLLEGE RD
KEY WEST FL33O4O'43O7
Services shall be provided at: MONKOE[OUNTY
55O1 COLLEGE RD KEY WEST FL33O4O-4]O7
Page 3of13
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Scope ofWork
This is Project Proposal providing the fire alarm material, installation along with the engineering, project
management and technical support for the upgrade of the Fire alarm control unit and Field initiating
devices. Upon acceptance of this proposal, Siemens will assign a dedicated project manager who will be your
main point of contact for the duration on this project.
A project schedule was not available at the time of the bid and so this scope is based on an assumed project
duration time of approximately ZJOdays.
^ Siemens will provide shop drawings that indicate the devices|ieind in plans specified.
~ Siemens will provide parts and technical labor as detailed below for the fire alarm system at this
facility.
^ Siemens will update the Firmware/hardware on the CPU to the latest Design K8uduior
~ Siemens will replace the loop controller cards to latest XDLC loop controllers
^ Siemens will replace initiating field devices
^ Siemens will set the addresses of initiating devices prior Uoinstallation.
~ Siemens will provide labor to certify the functionality of the devices after job is completed.
^ Siemens will provide tech labor for AHJ final acceptance test(Not to exceed 10 days = 80 hours)
Page 4of13
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Exceptions and/or Clarifications:
~ Siemens is not responsible for the design of this project.Additional devices may be deemed
necessary and could result inadditional cost.
` Any AHJ required additional equipment or system upgrades are not included in this proposal and
will come atan additional charge.
^ Existing Notification devices and power boosters will boreused
^ All conduit, J boxes, pull boxeo, and raceways to be nauoad
~ In applications where the existing system is being modified, new strobes may not sync with the
existing strobes. If synchronization with existing strobes this will come with an additional uoaL
~ Any additional device required, will be quoted otan additional cost.
~ Please note the turnaround time for drawing is usually 4 to 8 weeks at a minimum.
^ P|uoe* note customer to provide us with CAD files and pdf drawing with exact location of devices
if none could be sourced internally.
~ This proposal assumes a project timeline start date of 01/01/2024 and completion date of 11/15/
2024, any delays outside of included project scope will be handled and billed separately or
processed via proposed change order
~ All contracts with e total value of less than $25.000wi|| be invoiced per the following schedule.
o2O% mobilization
o 55% Upon receipt ufmaterial to local Siemens Office
o25%final payment upon project completion
All projects between $25,O0O and $25O.00O will have o2O96 mobilization invoice and then
progress invoices.
All projects over$250,000 will have a mobilization invoice of 10%and then monthly progress
invoices.
Page 5of13
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THIS PROPOSAL|S BASED UPON ONLY THOSE THIS QUOTATION INCLUDES ONLY THOSE ITEMS
" i«]^:
n�n8S ��NO��� BY [��� oswoTsu�v^
D Specification sectiomNONE [x] Equipment a,listed
[XI Information from plans dated 0Z125120L13 and prepared by [XI Removal nf existing initiating devices being replaced
Fire Line
O Freight(pua shipping point)
(x)wn typical drawings nr references where used vnthis [XI Shop Drawings
proposal.Project Referenced 440p129619 [XI Submittal Data Sheets
Oupm and including addendum:NONE [XI Operation u Maintenance Manuals
UCustomer provided bill ofmaterial [x]ps Sealed Drawings
Verbal request [XI Panel/Device(inivadng)terminations
Value engineering [x)pemnk
Design Build O Inspection Fees
[lTime and Material OpaymendpemzmanceBonds
[XI1 functional system certification test
[XI lO days ufAn/acceptance testing
O1 10%mcrest
[XI 2 Hours o,operation and maintenance training
O Close out documentation
O Interface to non-Siemens provided equipment ie,:nvAc
and elevator
[XI One year standard warranty new parts only
OMonitoring
OxHcxmspccunn
OuL Certification
THIS QUOTATION DOES NOT INCLUDE THE FOLLOWING:
~ Phased Checkout ~ No asbestos abatement isidentified,
, Raceway or standard electric boxes expected or included in this contract.All
^ 120vacpowcr policies and procedures referenced inthe
~ Fire protection switches o/gas solenoids specification will be followed asrequired.
~ Phone lines ° No Lead paint abatement isidentified,
~ Remote station monitoring contract(available expected or included in this contract.All
upon request) policies and procedures referenced in the
~ Knox box specification will be followed as required.
^ Cutting, drilling, patching, fire caulking or ^ Cost for CAD files
painting ~ Terminations of]vd Party equipment
~ |ntedacetonon-Siemenspnovdedequipment ~ Overtime
ie.: HVA[and elevator ~ BDA
~ Fire watch ~ Cl Cable
~ Ethernet or|Pdrops ~ Cloud App Subscription service fee
~ Weatherproof and conditioned control ~ Smoke Control Testing/RecertiDcation
equipment housing
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it is Siemens understanding that these drawings and specifications represent the work to be accomplished in
its entirety and no additional work or materials is expected or required.This quote covers direct costs only
and vve reserve the right to claim for impact and consequential costs.
ADDITIONAL NOTES:
|f Siemens iu awarded this project me will need.
~ A complete set of bid documents including specifications and any addendums
~ An electronic CAD file in AutoCAD shall be sent to us or mailed to the branch address on this quote.
~ For all part please contact [your PM]
~ For programming and testing please contact[your PK8]
^ A complete schedule
~ A copy of the"Notice ofCommitment"
~ Your P.O. ur contract will need to reference this proposal #and amount.This proposal and its terms
and condition shall take precedence.You/Purchase Order o/contact is subject to review and must be
mutually agreeable.
~ Siemens reserves the right to change any of the equipment as required to meet the intent of the
project and the requirements nf the owner.
~ Should you have any questions with this quotation,or you desire a different scope of work please
contact me.
^ Quotation is valid for a period of 60 days only unless modified in writing by Siemens
~ All work is to be performed during normal Siemens hours of 8arn to 5pm Monday through Friday with
the exception of company sponsored holidays unless specifically noted otherwise.
~ We reserve the right to correct this quote for errors and omissions.
~ As stated above,Siemens will perform the work pursuant to the attached Terms and Conditions.
Should the parties fail to execute a mutually agreeable definitive agreement, all work performed by
Siemens on or related to the above captioned project(with the exception of any monitoring services
anticipated,which will only be performed pursuant to the unaltered terms and conditions of Siemens
standard Monitoring Agreement)will be performed pursuant to the attached Terms and Conditions.
Advantages ofModernizing with Desigo Fire Safety Modular
The Desigo Fire Safety Modular family gives you everything you need to ensure code compliance, continuity
of communications, and a smart investment.With more power, more flexibility,greater capacities, and a
high performance full-color user interface--the fastest, most intelligent fire safetysystem available offers
premium features and options that address the needs of today while remaining ready for the future.
Facilities of all sizes can take advantage of faster processor speeds and state-of-the-art features which define
the Desigo Fire Safety Modular. The Desigo Fire Safety Modular head-end features a large, hi-resolution 6^
Color LED screen and intelligence programmed into the system.With larger text, intuitive prompts, and clear
graphics, both first responders and maintenance personnel will find it easy to read and operate.
Page 7of13
SIEMENS
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The Desigo Fire Safety Modular interface includes:
• Premier panel for complex applications such as a campus or high-rise
• Fast processing speed enables voice smoke control and fire alarm in a single node
• Compatible with a wide range of detectors and devices including Siemens high performance
ASAtechnologyr"'with or without CO as well as traditional cost-competitive detectors and 1/0 modules
with built-in isolation
• High-level interface fully integrates with intelligent VESDA detectors offering a competitive detection
solution for datacenters and clean rooms
• Sophisticated Operator Interface with color-coded events provides at-a-glance insight to the nature of
the alarm
• 8-Channel audio system supporting 300 digital messages that exceeds government and Mass
Notification System (MNS)specifications
• Practical migration path from MXL creates cost-effective solution for modernizing older nodes
• True ring topology for survivability and reduced wiring cost
Page 8 of 13
SIEMENS
Equipment List
Qt
1 500-033240 NETWORK INTERFACE CARD-H-NET,OR X-NET,AND CAN ONE CARD SLOT CC-51
CC-2
2 500-033420 REMOTE NETWORK INTERFACE(REQUIRED FOR REMOTE, LVM,FMT SCMILCMI
FCM APPLICATIONS)MOUNTS IN REMBOX'S
SMALL REMOTE LOBBY ENCLOSURE PROVIDES MOUNTING SPACE FOR,LVM OR
2 500-633772 FMT OR REMOTE SWITCH AND LED OR FMT OR REMOTE SWITCH AND LED FIELD
MOUNTED
44 554320-F5-A1 Heat detector
345 554320-F7-A1 Multi-Crit. Fire Det.
76 554370-B1-A1 RELAY VERSION
36 554370-132-A1 DUAL INPUT MON MOD WITH ISOLATOR
29 554370-134-A1 MINI INPUT MON MOD,BLT-IN ISOLTR FOR PULL STATIONS
195 554370-134-A1 MINI INPUT MON MOD,BLT-IN ISOLTR FOR HEAT DET
4 554430-138-A1 FIELD DEVICE INTERFACE CARD
3 554430-C17-A1 DESIGO OPERATOR INTERFACE
1 554430-C26-A1 12A at 24VDC Pwr Supp w Charger
1 554811-13104-A1 CLOUD GATEWAY KIT
Page 9 of 13
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Commodity Price Clause
Availability and Cost of Steel, Plastics and Other Commodities
This contract includes a price for the purchase of steel products or products made from plastics orother
commodities. Customer hereby agrees and acknowledges that the price and availability ofsteel, plastics and
other commodities is particularly volatile and unpredictable and that because of factors beyond the control of
Siemens, it may be difficult or nearly impossible for to acquire steel products and products made from
plastics or other commodities.Therefore, Customer agrees that Siemens shall not be responsible for failure to
provide services,deliver products,or otherwise perform on the contract due to the lack of available steel
products o/products made from plastics or other commodities.
In the event Siemens is unable,after reasonable commercial efforts,to acquire and provide steel or steel
products, or products made from plastics or other commodities, if required for this project,the Customer
hereby agrees that Siemens may terminate the agreement, or the relevant portion of the Agreement, at no
additional cost and without penalty. Customer agrees to pay Siemens in full for all work performed up to the
time of any such termination.
If Siemens is able toobtain the steel products or products made from plastics nr other commodities, but the
price of any of the products has increased by more than 1O%from the date of the bid, proposal o/the date
Siemens signed the contract,whichever occurred first, then Siemens may pass through that increase under
the contract through a reasonable price increase to reflect the increased cost of material.
MONRDEDET
FACILITY FA
UPGRADE
Page 1Oof13
SIEMENS
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Sell Price
Total Quote Price $319'637.33
(2r Full day psSpecialist $2.20O per o
Labor $127.954.56 hr full workday,9ynorB PM,zueHo
Engineer)
Material $1e1'672./7 Siemens Material zozs Fire Price book
Labor&material rates per Appendix^B^Siemens Hourly Labor And Markup Rates on Service agreement
between Monroe County And Siemens industy. Inc.
This price is firm for 6O days from the date of this proposal.
Page 11of13
SIEMENS
Payment Terms
Payment Terms Acceptance Agreement
The total price of: $319,627.33 and the estimated return on investment are based on the items outlined in
this proposal.ANY STATEMENTS MADE HEREIN REGARDING SAVINGS THAT MAY BE ACHIEVED BY
IMPLEMENTING THE SERVICES OFFERED IN THIS PROPOSAL ARE ESTIMATES ONLY. NO WARRANTY, EITHER
EXPRESSED OR IMPLIED, SHALL BE CONSTRUED TO ARISE FROM SUCH STATEMENTS, NOR SHALL SUCH
STATEMENTS BE CONSTRUED AS CONSTITUTING A GUARANTEE BY SIEMENS THAT SUCH SAVINGS WILL
OCCUR IF THE SERVICES ARE IMPLEMENTED.
The Buyer acknowledges that when accepted by the Buyer as proposed by Siemens Industry, Inc.,this
Proposal and the Siemens RAM Projects Business Standard Terms and Conditions, (together with any other
documents, including any applicable Rider(s), incorporated herein)shall constitute the entire agreement of
the parties with respect to its subject matter. BY EXECUTION HEREOF,THE SIGNER CERTIFIES THAT(S)HE HAS
READ ALL OF THE TERMS AND CONDITIONS AND DOCUMENTS,THAT SIEMENS OR ITS REPRESENTATIVES
HAVE MADE NO AGREEMENTS OR REPRESENTATIONS EXCEPT AS SET FORTH THEREIN, AND THAT(S)HE IS
DULY AUTHORIZED TO EXECUTE THE SIGNATURE PAGE ON BEHALF OF THE BUYER.
Proposal is valid for thirty(60)days from the delivery date of October 23, 2023. Payment is due within 30
days of invoice date.
Payment Terms;See mobilization terms on clarifications page
Total:$319,627.33
Page 12 of 13
... . ,
SIEMENS
Terms & Conditions
The Terms and Conditions of this proposal are those in the Master Agreement between Monroe
County,Florida and Siemens Industry,Inc.,and are considered part of the proposal.
Signature Page
Proposed by: Accepted by:
Siemens Industry,Inc. MONROE COUNTY
Company Company
Jose Gonzalez Holly Merrill Raschein
Name Name(P 'A f T
7885009 �w. .,..r., � �.
°'r ..�i #j S, Y. .
Proposal# Signat re
$319,627.33 Mayor
Proposal Amount Title
October 23,2023 t 1 IQ)! 00 2 j
Date •
Date
,;..=9 :1zn;-#?urchase Order#
Electronically signed by: /_t ;/ 4,,
Sergio Victores Sergio Victores ''A -A�c. �s
Date:Nov 20.2023 1.4:f, , T 1�-:4 f l 9. `. —.—
y stir" 1^ Atte i evin Madok,Clerk = wF`�lv ?..7F?I W4 41�Sergio Victoresjct r f ) _ :, �'
cm,Miami Branch Sales Manager - _,`',�k•�• 0 c
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�� �fi a{As Deputy Clerk __'`— 4 :��
L ✓�.e !{,yam" .y_.i.�
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v. Mr..
//�'y Electronically signed by V•`�u'"'- `��`:
��V W ��� O�G'•roc '•�J4'i�`f�k� �,;N _ , 7 '1
Debbie Russel "°��•��•=,�„�� ,»..,,
Date:Nov 20.2023 18:27 EST
Debbie Russel s
Branch FBA Manager Page 13 of 13
MONROE CQUNTY ATTORNEYS:OFFICE
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PATRICIA EAGLES
ASSISTANT COUNTY ATTORNEY
DATE, J 1/29/71
A��" CERTIFICATE OF LIABILITY INSURANCE °;ppg1 23°"r"`
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
MARSH USA.L-C. NAME:
445 SOUTH STREET PHONE A Ne
MORRiSTOWN,NJ 07960-6454 E4AaL
ADDRESSi
INSURERS AFFORDING COVERAGE NAIC 0
CN102147003•RAM-23R4 4433 MANGO NOC60 INSURER A:HDI Global Insurance Company 41343
INSURED SIEMENS INDUSTRY,INC. INSURERS Travelers Prope5y Casua Co of America 25674
1000 DEERFIELD PARKWAY INSURER C:Travelers CaskiaiN d SurSty ComQanX 19038
BUFFALO GROVE,IL 9-4513 INSURER D s
INSURER E:
INSURER F;
COVERAGES CERTIFICATE NUMBER: NYC-011722700.01 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IITR ADDTYPE OF INSURANCE L S B POLICY NUMBER MMI°D_12606Y EFF- PM�EXP �EACH
LIMITS
LTR
A X COMMERCIAL GENERAL LIABILITY IGLW110115 10101)2023 ;:1010112024 OCCURRENCE $ 1,000„00O
CL4IMS-MADE ...,, OCCUR MED EXP(Any one Person) __... ,
x_ .�.._ L .. $ .. 1,0110 0d�
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x1,,000,000
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POLICY AGGREGATE LIMIT APPLIES PER: 1 GENERALAGG N'L.AGGREGA���� �..,_ G $ INCL
X LOD PRODUCTS-COMPIOP AG
OTHER: $
AUTOMOBILE LIABILITY TC2J-CRP-7440L34A-TIL-23 %Q112023 10101I2024 COMBINED SINGLE LIMIT 0
B Au TO BODILY
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AUTOS ONLY ALTOS de 19 $ NIA
AAUTOS ONLY X AUTOS ONLD II p CYPERTY�aMAfaE $ NIA
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UMBRELLALIAR11 CUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
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B WORKERS COMPENSATION LIB-8P839 -23.51-K(ADS) 110101,7023 10101024 X PER ITH-
ANDEMPLOYERS'LIABILITY ,STATUTE . „ER w,,,,,,,,,,,,, ,,,,�_.
C YIN UB-6P79233A-23-51-RQAZ,MA,WI) 10�1P2023 10r01c2024 EACH ACCIDENT $ �_ ,000000
OFFICERIMEMBE1
Mandatory in NHREXCLUDED7 N N r A E.L. „„....
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® TWXJ-UB7440L33823(OH 10r012023 10J()192024 DISEASE-EA EMPLOYE $ 1„000,000
IIyam.daaraiba under k, __._..._.m ..................................................„.........................
DE RIPTION OF OPERATIONS Wrawr $500K LIMIT 1$50DK 51R °"" E.L.DISEASE-POLICY LIMIT $ 1„000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached H mote space is required)
RE:006MZ000DD6M2KXAS tl BFL2 BAU ES MONROE COUNTY SA RENEWAL
144P RISK=i6,,
SEE ATTACHED ..,,�i1,„
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CERTIFICATE HOLDER CANCELLATION
MONROE COUNTY BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
1100 SIMONTON STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
KEY WEST,FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA LLC
1988 2016 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
1016
AGENCY CUSTOMER ID: CN102147003
LOC#: Morristown
ACCM0 ADDITIONAL REMARKS SCHEDULE Page 2 of 2
III.,
AGENCY NAMED INSURED
MARSH USA,LLC- SIEMENS INDUSTRY,INC.
1000 DEERFIELD PARKWAY
POLICY NUMBER BUFFALO GROVE,IL M9-4513
CARRIER NAIC CODE
EFFECTIVE
DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: --25- FORM TITLE: Certificate of Liability Insurance
RE W6MZ0000D6M2KKJAS ,BFL2 BAU ES MONROE COUNTY SA RENEWAL
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS,1100 SIMONTON STREET,KEY WEST,FL 3304015 HEREBY ADDITIONAL INSURED AS OBLIGATED UNDER CONTRACT UNDER THE
REFERENCED GENERAL LIABILITY AND AUTOMOBILE IJABILITY INSURANCE POIUC;ES
SUCH INSURANCE AS IS AFFORDED BY THE ADDITIONAL INSURED ENDORSEMENT SHALL APPLY AS PRIMARY fNSURANCE&OTHER INSURANCE MAiNTAINED BY THE CERTIFICATE HOLDER
SHALL BE EXCESS ONLY&NOT CONTRIBUTING WITH INSURANCE PROVIDED UNDER THIS POLICY.
WAIVER OF S,RROGATION fS EFFECTUA,WHERE REQUIRED BY WRITTEN CONTRACT
COMPLETED OPERATIONS COVERAGE PS INCLUDED IN THE GENERAL LIABILITY POLICY
IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NONPAYMENT OF PREMIUM,THE INSPJRER WILL DELIVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER UP
TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQU,,,RED BY WRITTEN CONTRACT,WHICHEVER TS tESS
aw
ACORD 101 (2008101) 0 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
1017
COMMERCIAL AUTO
POLICY NUMBER: ISSUE DATE: - -
TC2J-CAP-7440L34A-TIL-23 09 29 23
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi.
fied by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds"for Covered Autos Liability Coverage
under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage pro-
vided in the Coverage Form.
SCHEDULE
Name Of Person(s)Or Organization(s):
ANY PERSON OR ORGANIZATION WHOM YOU HAVE AGREED TO ADD AS
ADDITIONAL INSURED, BUT ONLY TO COVERAGE AND MINIMUM LIMITS
REQUIRED IN A WRITTEN CONTRACT
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is ered Autos Liability Coverage in the Business Auto
an "insured"for Covered Autos Liability Coverage, but and Motor Carrier Coverage Forms and Paragraph
only to the extent that person or organization qualifies D.2. of Section I - Covered Autos Coverages of the
as an "insured" under the Who is An Insured provi- Auto Dealers Coverage Form.
sion contained in Paragraph A.1. of Section 11 - Cov-
CA 20 48 10 13 Insurance Services Office, Inc., 201 1I Page 1 of 1
1018
COMMERDAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET WAIVER OF SUBROGATION
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorse- required of you by a written contract executed
meni, the provisions of the Coverage Form apply prior to any "accident" or "loss", provided that the
unless modified by the endorsement. "accident" or "loss" arises out of the operations
Paragraph 5. Transfer of Rights Of Recovery contemplated by such contract. The waiver ap-
Against Others To Us of the COND@TIONS section plies only to the person or organization desig-
is replaced by the following. Hated in such contract.
5. Transfer Of Rights Of Recovery Against Oth-
ers To Us
We waive any right of recovery we may have
against any person or organization to the extent
CA T3 40 08 08 ®2008 The Travelers Companies,Inc. Page 1 of 1
1019
HDI GLOBAL INSURANCE COMPANY
ENDORSEMENT#31
PolllcyNwrtber Nm ardirtsured
CAD1110115 SIENENSCORPORA"I ON
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This modifies Ir�arece I underthe foNawing:
CenmwddGsrsarai Llisbiity/CaysnW Fw..r
Who Is an Insured Is amended to Include as an adMonal insured any person whom you are required to add as an
addlllonal InsunWI on this policy under a wrben agreement,but only with respect 1>D liability for INW4 Injury', property
damage'or"personal and advertising lnjury caused.In whole or in part, by:1.Your ads or omissions;or 2.The ads
oromissions of those acing on your behalf.The Insurance coverage provided to such addidonel insured applies only to
the efxi ant required wMdn the wrlden agreenserst.
The Insuranoscoverege pvAded to the addidonal Insured person shall not provide any broader cover4e thanyou are
taqukedl pmvldeto the addlMonal Insured pennon in the written agreamentoW shall nut provide Ilmllss of InsuranostM
exceed the lower of the IUnft of Insurerm pry dedl to you in this po6cy,orthe limits of Insurance you are reqLdred to
provide in ttowritten gIreement.
The Insuramw provided to the additional insured by this endorsement Is wtcess over any valid and colledlble other
insurance,whether .eowess,amlinpK or an anyatherbasis,that Is avellableto the addi&md Insured for a loss
we cover under this enclareernent However,If to writ m agreerserd speciftelly requires the#this Insurance apply on a
primary basis,this Insurance is primary.If the rrr[t en agreement specilkaly requires ft Inaumnce apply on a primary
and r4rHxwdftj1wy basis this hssuranceIs prlmaryto other insurance available b the additional Insured and we will not
share with thatother Insurance.
This endorsementshall prevall over additional Insured endorsernerds do may apply underthis policy unless required
otherwise In thewrittennmernent.
Auuxdwd I' eser>ks i ve
All terms and conditlor►s of the policy remain unchmWed.
THIS ENDORSEMENT MUST BE ATTACHED TO A CHANGE ENDORSEMENT WHEN ISSUED AFTER THE POLICY
IS WRITTEN.
1020
POLICY NUMBER GLDI IIO115 COMMERCIAL.GENERALLIABRITY
CG 24 04 0509
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US
This endorsement modifies insurance pro u irisd under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTSICOMPLETED OPERATIONS LIABILITYCOVERAGE PART
SCHEDULE
Nara Of Pera m OrOrganta®tion:
ANY PERSON OR ORGANIZATION TO THE EXTENT REQUIRED BY WRITTEN CONTRACT
Irdiormafion nmulred to co eta this Schedule,If not shown above will be shown In,the Declarations.
The following Is added to &17 an I r Of
Rlghft Of Rimmery Against To Us of
Secllon IV—Condillons:
We waive any right of recovery we may have against
the person or organbMm shown in the Schedule
above because of payment we make for Injury or
damage arising out of your ongoing operations or
'your woW done under a contract with Mat person or
organization and included in the Wuc ts-completed
operations hazarT. This waiver applies any to the
person or or+gani¢allon shown In the Schedule above.
CO 24 04 00 09 0 Insurance Services Office, Ina,2= Pop 1 *(I 0
1021
NAMED INS D: SIFUMNS CORPORATION
POLICY EFFECTIVE: 10/01/2023 TO 10/01/2024
TRAVELERS J� WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 00 03 13 (00)-
POLICY NUMBER: Us-SP83929A-23-51-K
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy_ We will not
enforce our right against the person or organization named iin the Schedule. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.
SCHEDULE
DESIGNATED PERSON:
DESIGNATED ORGANIZATION:
ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED BY
WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS WAIVER.
DATE OF ISSUE: 08-03 23 ST ASSIGN:
1022
POLICY NUMBEk GLD1110115 IL SU 41I04(1a1Dy
HDI GLOBAL INSURANCE COMPANY
THIS PENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
NOTICE OF CANCELLATION AMENDMENT
SCHEDULE
Name,Address and EaNall Address ofOther
gan Number of Days Notice:
s)t Or - - 1(s):
Par schedule on file with the Company. 60 Days.or as required by contrack
whiclw4w is lass
(lf no entry appears above,the inforrnatlon required to complete this endorsement wll be shown In the Declarations as
applicable to thiserKicmnrent:)
I. If we cancel this policy by notice to you for any sWh t dy permitted reason other than nonpayment of premium,we
shall endeavor to mall,email or deliver a copy of such written notice of canoella Lion to the person(s)or
organization(s)shown in the Schedvieabove.
IL A copy of the notice,per paragraph I.above,wig be mailed,e-malled or delivered:
1. To the appropriate addresses corresponding to the person(s)or orgsnhatlon(s)shown in the Schedulsabove;
and
2. The number of days required for notice of canoeliation,as provided in paragraph AZ of the Common Policy
Condbone or as amended by an applicable state cancellation endonwnent or by the data as shown in the
Schedule above
III. Our failure to provide such advance notiflcatlon to the pwson(s)or organizations)shown in the Schedule ofthis
endorsement will not odend any policy cancellation date nor negate any cancellation of the policy.
All curer berms and conditions of this policy remain unchanged.
Page 1 of 1 IL SU 4004(10.10)
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