15-044 JJR Construction Inc. Project No. 2014-15 2014 Sidewalk Accessibility ImprovementsOFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
TELEPHONE:(408)777-3223•FAX: (408)777-3366
C O P E RT I N O WEBSITE:www.cupertino.org
April 27, 2015
JJR Construction Inc.
1120 Ninth Ave.
San Mateo, CA 94402
Re: Bid Award, Project Number 2014-15 2014 Sidewalk Accessibility Improvements.
Your bid bond and contract for the above stated project is enclosed. If you have any questions or
need additional information,please contact the Public Works Department at(408) 777-3354.
Sincerely,
Andrea Sanders
City Clerk's Office
cc: Public Works
Enclosure
OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
TELEPHONE:(408)777-3223•FAX: (408)777-3366
C U P E RT I N O WEBSITE:www.cupertino.org
April 27, 2015
Sposeto Engineering Inc.
4558 Contractors Place
Livermore, CA 94551
Re: Bid Award,Project Number 2014-15 2014 Sidewalk Accessibility Improvements.
Thank you for your participation in the City of Cupertino's bid process for the above-stated
project. The contract was awarded to JJR Construction Inc. Your bid bond and statement of
qualifications envelope are enclosed.
If you have any questions or need additional information,please contact the Public Works
Department at(408) 777-3354.
Sincerely,
Andrea anders
City Clerk's Office
cc: Public Works
Enclosure
OFFICE OF THE CITY CLERK
CITY HALL
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255LMTELEPHONE:(408)777-3223• FAX: (408)777-3366
C U P E RT I N O WEBSITE:www.cupertino.org
April 27, 2015
SpenCon Construction Inc.
P.O. BOX 1220
Danville, CA 94526
Re: Bid Award, Project Number 2014-15 2014 Sidewalk Accessibility Improvements.
Thank you for your participation in the City of Cupertino's bid process for the above-stated
project. The contract was awarded to JJR Construction, Inc. Your bid bond and statement of
qualifications envelope are enclosed.
If you have any questions or need additional information, please contact the Public Works
Department at(408) 777-3354.
Sincerely,
r
Andrea Sanders
City Clerk's Office
cc: Public Works
Enclosure
u
Project No.2014-15
DOCUMENT 00520
CONTRACT
THIS CONTRACT, dated this23
l
day of cit , 2015, by and between JJR CONSTRUCTION,INC.,
whose place of business is located at 1120 Ninth Ave, San Mateo, CA 94402 ("Contractor"), and the CITY OF
CUPERTINO, a Municipal Corporation of the State of California ("City") acting under and by virtue of the authority
vested in the City by the laws ofthe State ofCalifornia.
WHEREAS,City,on the 7+`' day of pi\ ,2015 awarded to Contractor the following Project:
PROJECT NUMBER 2014-15
2014 Sidewalk Accessibility Improvements
NOW,THEREFORE, in consideration of the mutual covenants hereinafter set forth, Contractor and City agree
as follows:
Article 1. Work
1.1 Contractor shall complete all Work specified in the Contract Documents, in accordance with the Specifications,
Drawings,and all other terms and conditions of the Contract Documents.
Article 2. Agency and Notices to City
2.1 City has designated Roger Lee,Assistant Director of Public Works,to act as City's Authorized Representative(s),
who will represent City in performing City's duties and responsibilities and exercising City's rights and authorities
in Contract Documents. City may change the individual(s) acting as City's Authorized Representative(s), or
delegate one or more specific functions to one or more specific City's Representatives,including without limitation
engineering, architectural, inspection and general administrative functions, at any time with notice and without
liability to Contractor. Each City's Representative is the beneficiary of all Contractor obligations to City,
including without limitation,all releases and indemnities.
2.2 All notices or demands to City under the Contract Documents shall be to City's Authorized Representative at:
10300 Torre Avenue,Cupertino,California 95014 or to such other person(s)and address(es)as City shall
provide to Contractor.
Article 3. Contract Time and Liquidated Damages
3.1 Contract Time.
The Contract Time will commence to run on the date indicated in the Notice to Proceed. City may give a
Notice to Proceed at any time within 30 Days after the Notice ofAward. Contractor shall not do any Work at
the Site prior to the date on which the Contract Time commences to run.
Contractor shall achieve Final Completion ofthe entire Work and be ready for Final Payment in accordance
with Section 00700(General Provisions)within 110 working days as provided in Document 00700(General
Provisions)
3.2 Liquidated Damages.
City and Contractor recognize that time is of the essence of this Contract and that City will suffer financial loss
in the form of contract administration expenses(such as project management and consultant expenses), if all or
any part of the Work is not completed within the times specified above,plus any extensions thereof allowed in
City of Cupertino 00520- 1 Contract
2014 Sidewalk Accessibility Improvements
Addendum 1
Project No.2014-15
accordance with the Contract Documents. Consistent with Document 00700 (General Provisions), Contractor
and City agree that because of the nature of the Project,it would be impractical or extremely difficult to fix the
amount of actual damages incurred by City because of a delay in completion of all or any part of the Work.
Accordingly,City and Contractor agree that as liquidated damages for delay Contractor shall pay City:
3.2.1 $500 for each Calendar Day that expires after the time specified herein for Contractor to achieve Final
Completion of the entire Work as specified above.
3.2.2 $75 per Calendar Day per location for failure to replace concrete within the same calendar week.
3.2.3 $75 per Calendar Day per location for failure to replace asphalt to finish grade within 30 calendar days.
Liquidated damages shall apply cumulatively and, except as provided below, shall be presumed to be the
damages suffered by City resulting from delay in completion of the Work.
3.3 Liquidated damages for delay shall only cover administrative, overhead, interest on bonds, and general loss of
public use damages suffered by City as a result of delay. Liquidated damages shall not cover the cost of
completion of the Work, damages resulting from defective Work, lost revenues or costs of substitute facilities,
or damages suffered by others who then seek to recover their damages from City (for example, delay claims of
other contractors,subcontractors,tenants,or other third-parties),and defense costs thereof.
Article 4. Contract Sum
4.1 City shall pay Contractor the Contract Sum for completion of Work in accordance with Contract Documents as
set forth in Contractor's Bid,attached hereto:See Exhibit"A"attached
Article 5. Contractor's Representations
In order to induce City to enter into this Contract,Contractor makes the following representations and warranties:
5.1 Contractor has visited the Site and has examined thoroughly and understood the nature and extent of the
Contract Documents, Work, Site, locality, actual conditions, as-built conditions, and all local conditions, and
federal, state and local laws and regulations that in any manner may affect cost, progress, performance or
furnishing of Work or which relate to any aspect of the means,methods,techniques,sequences or procedures of
construction to be employed by Contractor and safety precautions and programs incident thereto.
5.2 Contractor has examined thoroughly and understood all reports of exploration and tests of subsurface
conditions, as-built drawings, drawings, products specifications or reports, available for Bidding purposes, of
physical conditions, including Underground Facilities, or which may appear in the Drawings. Contractor
accepts the determination set forth in these Documents and Document 00700(General Provisions)ofthe limited
extent of the information contained in such materials upon which Contractor may be entitled to rely. Contractor
agrees that except for the information so identified, Contractor does not and shall not rely on any other
information contained in such reports and drawings.
5.3 Contractor has conducted or obtained and has understood all such examinations, investigations, explorations,
tests, reports and studies (in addition to or to supplement those referred to in Section 5.2 of this Document
00520) that pertain to the subsurface conditions, as-built conditions, underground facilities, and all other
physical conditions at or contiguous to the Site or otherwise that may affect the cost, progress, performance or
furnishing of Work,as Contractor considers necessary for the performance or furnishing ofWork at the Contract
Sum, within the Contract Time and in accordance with the other terms and conditions of the Contract
Documents, including specifically the provisions of Document 00700 (General Provisions); and no additional
examinations, investigations, explorations, tests, reports, studies or similar information or data are or will be
required by Contractor for such purposes.
City of Cupertino 00520-2 Contract
2014 Sidewalk Accessibility Improvements
Addendum 1
Project No.2014-15
5.4 Contractor has correlated its knowledge and the results of all such observations, examinations, investigations,
explorations,tests,reports and studies with the terms and conditions ofthe Contract Documents.
5.5 Contractor has given City prompt written notice of all conflicts, errors, ambiguities, or discrepancies that it has
discovered in or among the Contract Documents and as-built drawings and actual conditions and the written
resolution thereof through Addenda issued by City is acceptable to Contractor.
5.6 Contractor is duly organized, existing and in good standing under applicable state law, and is duly qualified to
conduct business in the State of California.
5.7 Contractor has duly authorized the execution, delivery and performance of this Contract, the other Contract
Documents and the Work to be performed herein. The Contract Documents do not violate or create a default
under any instrument,contract,order or decree binding on Contractor.
5.8 Contractor has listed Subcontractors pursuant to the Subcontractor Listing Law, California Public Contracting
Code§4100 et seq.in document 00340(Subcontractors List)
Article 6. Contract Documents
6.1 Contract Documents consist of the following documents,including all changes, addenda,and modifications
thereto:
Document 00002 Signature Page
Document 00003 Project Directory
Document 00012 Caltrans/City Cross-Reference Table
Document 00100 Advertisement For Bids
Document 00200 Instructions to Bidders
Document 00210 Indemnity and Release Agreement
Document 00400 Bid Form
Document 00411 Bond Accompanying Bid
Document 00430 Subcontractors List
Document 00450 Statement of Qualifications
Document 00481 Non-Collusion Affidavit
Document 00482 Bidder Certifications
Document 00520 Contract
Document 00530 Insurance Forms
Document 00610 Construction Performance Bond
Document 00620 Construction Labor and Material Payment Bond
Document 00630 Guaranty
Document 00650 Agreement and Release ofAny and All Claims
Document 00660 Substitution Request Form
Document 00700 General Conditions
Document 00800 Special Conditions
Document 00820 Traffic Control Requirements
Document 00821 Insurance
Document 00822 Apprenticeship Program
Technical Specifications
Addenda(s)
Drawings/Plans
6.2 There are no Contract Documents other than those listed in this Document 00520, Article 6. The Contract
Documents may only be amended, modified or supplemented as provided in Document 00700 (General
Provisions).
City of Cupertino 00520-3 Contract
2014 Sidewalk Accessibility Improvements
Addendum I
Project No.2014-15
Article 7. Miscellaneous
7.1 Terms used in this Contract are defined in Document 00700 (General Provisions) and will have the meaning
indicated therein.
7.2 It is understood and agreed that in no instance are the persons signing this Contract for or on behalf of City or
acting as an employee, agent, or representative of City, liable on this Contract or any of the Contract
Documents, or upon any warranty of authority, or otherwise, and it is further understood and agreed that
liability of the City is limited and confined to such liability as authorized or imposed by the Contract
Documents or applicable law.
7.3 Contractor shall not assign any portion of the Contract Documents, and may subcontract portions of the
Contract Documents only in compliance with the Subcontractor Listing Law, California Public Contracting
Code§4100 et seg.
7.4 The Contract Sum includes all allowances(ifany).
7.5 In entering into a public works contract or a subcontract to supply goods, services or materials pursuant to a
public works contract, Contractor or Subcontractor offers and agrees to assign to the awarding body all rights,
title and interest in and to all causes of action it may have under Section 4 ofthe Clayton Act(15 U.S.C. §15)or
under the Cartwright Act(Chapter 2(commencing with Section 16700)of Part 2 of Division 7 ofthe Business
and Professions Code), arising from purchases of goods, services or materials pursuant to the public works
contract or the subcontract. This assignment shall be made and become effective at the time City tenders final
payment to Contractor,without further acknowledgment by the parties.
7.6 Copies of the general prevailing rates of per diem wages for each craft,classification,or type ofworker needed
to execute the Contract,as determined by Director ofthe State ofCalifornia Department ofIndustrial Relations,
are deemed included in the Contract Documents and on file at City's office,or may be obtained of the State of
California web site http://www.dir.ca.gov/DLSR/PWD/Northem.html and shall be made available to any
interested party on request. Pursuant to Section 1861 of the Labor Code, Contractor represents that it is aware
of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability
for workers' compensation or to undertake self-insurance in accordance with the provisions of that Code, and
Contractor shall comply with such provisions before commencing the performance of the Work of the Contract
Documents.
7.7 Should any part,term or provision ofthis Contract or any ofthe Contract Documents,or any document required
herein or therein to be executed or delivered, be declared invalid, void or unenforceable, all remaining parts,
terms and provisions shall remain in full force and effect and shall in no way be invalidated, impaired or
affected thereby. If the provisions of any law causing such invalidity, illegality or unenforceability may be
waived,they are hereby waived to the end that this Contract and the Contract Documents may be deemed valid
and binding contracts, enforceable in accordance with their terms to the greatest extent pennitted by applicable
law. In the event any provision not otherwise included in the Contract Documents is required to be included by
any applicable law,that provision is deemed included herein by this reference(or, if such provision is required
to be included in any particular portion of the Contract Documents, that provision is deemed included in that
portion).
7.8 This Contract and the Contract Documents shall be deemed to have been entered into in the County of Santa
Clara, State of California, and governed in all respects by California law(excluding choice of law rules). The
exclusive venue for all disputes or litigation hereunder shall be in Santa Clara County. Both parties hereby
waive their rights under California Code of Civil Procedure Section 394 to file a motion to transfer any action
or proceeding arising out of the Contract Documents to another venue. Contractor accepts the Claims
Procedure in Document 00700,Article 12,established under the California Government Code,Title 1,Division
3.6,Part 3,Chapter 5.
City of Cupertino 00520-4 Contract
2014 Sidewalk Accessibility Improvements
Addendum 1
Po
4357
Project No.2014-15
IN WITNESS WHEREOF the parties have executed this Contract in triplicate the day and year first above written.
2014 SIDEWALK ACCESSIBILITY IMPROVEMENTS
CITY: CONTRACTOR: J.1 R ConS yuc{w
CITY OF CUPERTINO,a Municipal Corporation of the
State of California
By:
Signature]
Attest:
Coy\o5 Ra C)so
Please print name liere]
City Clerk:Grace Schmidt
Approved as to form by City Attorney: Title:
If Corporation: Chairman,President,or Vice President]
City Attorney: Carol Korade By:
Signature]
I hereby certify,under penalty of perjury,that Timm Borden,Please print name here]
Director of Public Works ofthe City of Cupertino was duly
authorized to execute this document. Title:
If Corporation: Secretary,Assistant Secretary,
ChiefFinancial Officer,or Assistant Treasurer]
Dated: P 23 nb5(o'-1
State Contractor's License No. Classification
Y/jp.,2 A410 k.
fmo
ii,,
uvlL,B' 31 3I I I q
David Brandt,City anage f the City of Cupertino,a Expiration Date
Municipal Corporation ofthe State of California
Designated Representative: Taxpayer ID No.
Name:Roger Lee Name:
Title:Assistant Director of Public Works Title: %ce Fre---48e.nt
Address: 10300 Torre Ave., Cupertino, CA 95014 Address: llaO WA-h lw.n Hat M, CA 9440a
Phone:408-777-3269 Phone: f050^Z54 6-G 109
Facsimile:408-777-3354 Facsimile: 1050-31-3`(oa0l
NOTARY ACKNOLEDGEMENT IS REQUIRED. IF A
AMOUNT: 1,035,646.00CORPORATION, CORPORATE SEAL AND CORPORATE
O
ACCOUNT NUMBER: 2 D- 86_gZq-too-RZZ W )DoD NOTARY AREQUIREDCIFNOTA CORPORATION SOCIAL
X IDARE
TY
ACCOUNT NUMBER: 0-70" 5S-ZI- 21 1$,b
NO.IS REQUIRED
FILE NO.: 50,354.00
END OF DOCUMENT
City of Cupertino 00520-5 Contract
2014 Sidewalk Accessibility Improvements
Addendum 1
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT C9V9L CODE§ 1189
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A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document.
State of Californiaifc
County of Is,
On ®before me, Alexis Garzota.Roman, Notary;.Publio
Date f c f ere Insert Name and Title of the Officer
personally appeared LJOIr AP S U
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who proved to me on 'the basis of satisfactory evidence to be the person(s) whose name;(} is/afe
subscribed to the within instrument and acknowledged to me that he/sWe/t[Ay executed the same in
his/or/their authorized capacity(iV6),and that by his/ter/tbsir signature)on the instrument the person(§),
or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
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is true and correct.
ALEXIS GARZOTA ROMAN a WITNESS my hand and official seal.COMM.#2080720 ,
NOTARY PUBLIC-CALIFORNIA y
ALAMEDA:.000NTY
My Comm.Exp.Sept.05,2018 = Signature
imunmiuinnuniuumnmunummimijiiumuiuuuiiuuuunwnmw Signature of Notary Public
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
Corporate Officer — Title(s): Corporate Officer — Title(s):
Partner — Limited General Partner — -El Limited General
Ij- Individual Attorney in Fact Individual Attorney in FactTrusteeGuardianorConservatorTrusteeGuardianorConservatorOther: Other:
Signer Is Representing: Signer Is Representing:
02014 National Notary Association e www.NationaiNotary.org o 1-800-US NOTARY(1-800-876-6827) Item#5907
I
EXECUTED IN TRIPLICATE Bond No: 3954571
Premium: $13,180.00
Project No.2014-15
DOCUMENT 00610
CONSTRUCTION PERFORMANCE BOND
THIS CONSTRUCTION PERFORMANCE BOND (`Bond") is dated April 17, 2015 , is in the penal sum of One
Million, Thirtv-Five Thousand. Six Hundred Fortv-Six Dollars and Zero Cents [which is one hundred percent of the
Contract Price], and is entered into by and between the parties listed below to ensure the faithful performance of the
Construction Contract listed below. This Bond consists of this page and the Bond Terms and Conditions, paragraphs 1
through 12, attached to this page. Any singular reference to JJR Construction, Inc.
Contractor''), Great American Insurance Company Surety"), the City of Cupertino, a Municipal
Corporation of the State of California(`City")or other party shall be considered plural where applicable.
CONTRACTOR: SURETY:
JJR Construction.Inc. Great American Insurance Company
Name Name
1120 Ninth Avenue 301 E. Fourth Street
Address Principal Place ofBusiness
San Mateo,CA 94402 Cincinnati,Ohio 45202
City/State/Zip City/State/Zip
CONSTRUCTION CONTRACT:
2014 SIDEWALK ACCESSIBILITY IMPROVEMENTS
PROJECT NUMBER 2011-15
at Cupertino,California.
DATED April 13 2015 in the Amount of S 1,035,646.00 the"Penal Sum")
CONTRACTOR AS PRINCIPAL SURETY
Company: (Corp. Seal) JJR Construction, Inc. Company: (Corp. eal e t Am.i s ante Company
Signature: Signature:
Name and Title: Carlos Raposo . Name and Title: - Mark C. Johnson
Vice Presid@nt Attorney-in-Fact
BOND TERMS AND CONDITIONS
1. Contractor and Surety,jointly and severally,bind themselves, their heirs, executors, administrators, successors
and assigns to City for the complete and proper performance of the Construction Contract, which is
incorporated herein by reference.
2. If Contractor completely and properly performs all of its obligations under the Construction Contract, Surety
and Contractor shall have no obligation under this Bond.
3. If there is no City Default, Surety's obligation under this Bond shall arise after:
3.1 City has declared a Contractor Default under the Construction Contract pursuant to the terms of the
Construction Contract;and
3.2 City has agreed to pay the Balance of the Contract Sum:
3.2.1 To Surety in accordance with the terms of this Bond and the Construction Contract;or
3.2.2 To a contractor selected to perform the Construction Contract in accordance with the terms of this
Bond and the Construction Contract.
City ofCupertino Construction Performance Bond
2014 Sidewalk Accessibility Improvements 00610- 1
I
Project No.2014-15
4. When City has satisfied the conditions of paragraph 3, Surety shall promptly(within 30 days) and at Surety's
expense elect to take one of the following actions:
4.1 Arrange for Contractor, with consent of City, to perform and complete the Construction Contract(but
City may withhold consent, in which case the Surety must elect an option described in paragraphs 4.2,
4.3 or 4.4,below);or
4.2 Undertake to perfonu and complete the Construction Contract itself, through its agents or through
independent contractors; provided, that Surety may not select Contractor as its agent or independent
contractor without City's consent;or
4.3 Undertake to perform and complete the Construction Contract by obtaining bids from qualified
contractors acceptable to City for a contract for performance and completion of the Construction
Contract, and, upon determination by City of the lowest responsible bidder, arrange for a contract to be
prepared for execution by City and the contractor selected with City's concurrence, to be secured with
performance and payment bonds executed by a qualified surety equivalent to the bonds issued on the
Construction Contract;and, if Surety's obligations defined in paragraph 6,below,exceed the Balance of
the Contract Sum,then Surety shall pay to City the amount of such excess;or
4.4 Waive its right to perform and complete, arrange for completion, or obtain a new contractor and with
reasonable promptness under the circumstances, and, after investigation and consultation with City,
determine in good faith its monetary obligation to City under paragraph 6, below, for the performance
and completion of the Construction Contract and, as soon as practicable after the amount is determined,
tender payment therefor to City with full explanation of the payment's calculation. If City accepts
Surety's tender under this paragraph 4.4, City may still hold Surety liable for future damages then
unknown or unliquidated resulting from the Contractor Default. If City disputes the amount of Surety's
tender under this paragraph 4.4,City may exercise all remedies available to it at law to enforce Surety's
liability under paragraph 6,below.
5. If Surety does not proceed as provided in paragraph 4, above, then Surety shall be deemed to be in default on
this Bond ten days after receipt of an additional written notice from City to Surety demanding that Surety
perform its obligations under this Bond. At all times City shall be entitled to enforce any remedy available to
City at law or under the Construction Contract including,without limitation,and by way of example only,rights
to perform work, protect work, mitigate damages, advance critical work to mitigate schedule delay, or
coordinate work with other consultants or contractors.
6.Surety's monetary obligation under this Bond is limited by the Amount of this Bond identified herein as the
Penal Sum. This monetary obligation shall augment the Balance of the Contract Sum. Subject to these limits,
Surety's obligations under this Bond are commensurate with the obligations of Contractor under the
Construction Contract. Surety's obligations shall include,but are not limited to:
6.1 The responsibilities of Contractor under the Construction Contract for completion of the Construction
Contract and correction of defective work;
6.2 The responsibilities of Contractor under the Construction Contract to pay liquidated damages, and for
damages for which no liquidated damages are specified in the Construction Contract, actual damages
caused by non-performance of the Construction Contract including, but not limited to, all valid and
proper backcharges, offsets,payments, indemnities,or other damages;
6.3 Additional legal, design professional and delay costs resulting from Contractor Default or resulting from
the actions or failure to act of the Suretv under paragraph 4,above(but excluding attorney's fees incurred
to enforce this Bond).
7. No right of action shall accrue on this Bond to any person or entity other than City or its successors or assigns.
City of Cupertino Construction Performance Bond
2014 Sidewalk Accessibility Improvements 00610-2
Project No.2014-15
8. Surety hereby waives notice of any change, alteration or addition to the Construction Contract or to related
subcontracts,purchase orders and other obligations, including changes of time. Surety consents to all terms of
the Construction Contract, including provisions on changes to the Contract. No extension of time, change,
alteration, modification, deletion, or addition to the Contract Documents, or of the work required thereunder,
shall release or exonerate Surety on this Bond or in any way affect the obligations of Surety on this Bond.
9. Any proceeding, legal or equitable, under this Bond shall be instituted in any court of competent jurisdiction
where a proceeding is pending between City and Contractor regarding the Construction Contract, or in the
courts of the County of Santa Clara, or in a court of competent jurisdiction in the location in which the work is
Iocated. Communications from City to Surety under paragraph 3.1 of this Bond shall be deemed to include the
necessary contracts under paragraph 3.2 of this Bond unless expressly stated otherwise.
10. All notices to Surety or Contractor shall be mailed or delivered(at the address set forth on the signature page of
this Bond), and all notices to City shall be mailed or delivered as provided in Document 00520 (Contract).
Actual receipt of notice by Surety,City or Contractor,however accomplished,shall be sufficient compliance as
ofthe date received at the foregoing addresses.
11. Any provision in this Bond conflicting with any statutory or regulatory requirement shall be deemed deleted
herefrom and provisions conforming to such statutory requirement shall be deemed incorporated herein.
12. Definitions.
12.1 Balance of the Contract Sum:The total amount payable by City to Contractor pursuant to the terms of the
Construction Contract after all proper adjustments have been made under the Construction Contract,for
example, deductions for progress payments made, and increases/decreases for approved modifications to
the Construction Contract.
12.2 Construction Contract: The contract between City and Contractor identified on the signature page of this
Bond,including all Contract Documents and changes thereto.
12.3 Contractor Default: Material failure of Contractor, which has neither been remedied nor waived, to
perform or otherwise to comply with the terms of the Construction Contract including,but not limited to,
default" or any other condition allowing a termination for cause as provided in Document 00700
General Conditions).
12.4 City Default: Material failure of City, which has neither been remedied nor waived, to pay Contractor
progress payments due under the Construction Contract or to perform other material terms of the
Construction Contract, if such failure is the cause of the asserted Contractor Default and is sufficient to
justify Contractor termination of the Construction Contract.
END OF DOCUMENT
City of Cupertino Construction Performance Bond
2014 Sidewalk Accessibility Improvements 00610-3
Bond No.: 3954571
EXECUTED IN TRIPLICATE Premium: Included in Performance Bond
Project No.2014-15
DOCUNvIENT 00620
CONSTRUCTION LABOR AND MATERIAL PAYMENT BOND
THIS CONSTRUCTION LABOR AND MATERIAL PAYivMNT BOND("Bond")is dated April 17, 2015 ,is in the
penal sum One Million,Thirty-five Thousand,Six Hundred Forty-Six dollars and Zero Cents. [one hundred percent
of the Contract Price], and is entered into by and between the parties listed below to ensure the payment of claimants
under the Construction Contract listed below. This Bond consists of this page and the Bond Terms and Conditions,
paragraphs 1 through 14, attached to this page. Any singular reference to
JJR Construction,Inc. Contractor"), Great American Insurance Company
Surety"), the City of Cupertino, a Municipal Corporation of the State of California ("City") or other party shall be
considered plural where applicable.
CONTRACTOR: SURETY:
AR Construction, Inc. Great American Insurance Company
Name Name
1120 Ninth Avenue 301 E. Fourth Streer
Address Principal Place of Business
San Mateo, CA 94402 Cincinnati Ohio 45202
City/State/Zip City/State/Zip
CONSTRUCTION CONTRACT:
2014 SIDEWALK ACCESSIBILITY IMPROVEMENTS-
PROJECT NUMBER 2014-15
at Cupertino,California.
DATED April 13 2015 in the Amount of$ 1,035,646.00 the"Penal Sum")
CONTRACTOR AS PRINCIPAL SURETY
Company:Corp. Seal) JJR Construction,Inc.Company: (Co e 1 Great Ameri surance Company
Signature: wee Signature:
f
Name and Title: Carlos Raposo, Name and Title: Mark C.Johnson
Vice President Attorney-in-Fact
BOND TERMS AND CONDITIONS
1. Contractor and Surety,jointly and severally,bind themselves, their heirs, executors,administrators, suscessbrs
and assigns to City and to Claimants, to pay for labor, materials and equipment furnished for use in the
perfonnance of the Construction Contract,which is incorporated herein by reference.
2. With respect to City,this obligation shall be null and void if Contractor:
2.1 Promptly makes payment,directly or indirectly,for all sums due Claimants-,and
2.2 Defends,indemnifies and holds harmless City from all claims,demands,liens or suits by any person or
entity who furnished labor, materials or equipment for use in the performance of the Construction
Contact, provided City has promptly notified Contractor and Surety (at the address set forth on the
signature page of this Bond) of any claims, demands, liens or suits and tendered defense of such
claims,demands, liens or suits to Contractor and Surety,and provided there is no City Default.
City of Cupertino Construction Labor and Material Payment Bond
2014 Sidewalk Accessibility Improvements 00620- 1
Project No. 2014-15
3. With respect to Claimants,this obligation shall be null and void if Contractor promptly makes payment,directly
or indirectly through its Subcontractors, for all sums due Claimants. If Contractor or its Subcontractors,
however, fail to pay any of the persons named in Section 3181 of the California Civil Code, or amounts due
under the Unemployment Insurance Code with respect to Work or labor performed under the Contract, or for
any amounts required to be deducted, withheld, and paid over to the Employment Development Department
from the wages of employees of Contractor or Subcontractors pursuant to Section 13020 of the Unemployment
Insurance Code, with respect to such Work and labor,then Surety shall pay for the same,and also, in case suit
is brought upon this Bond,a reasonable attorney's fee,to be fixed by the court.
4.Consistent with the California Mechanic's Lien Law, Civil Code§3082, et seq., Surety shall have no obligation
to Claimants under this Bond unless the Claimant has satisfied all applicable notice requirements.
5.Surety's total obligation shall not exceed the amount of this Bond,and the amount ofthis Bond shall be credited
for any payments made in good faith by Surety under this Bond.
6. Amounts due Contractor under the Construction Contract shall be applied first to satisfy claims, if any, under
any Construction Performance Bond and second, to satisfy obligations of Contractor and Surety under this
Bond.
7.City shall not be liable for payment of any costs, expenses, or attorney's fees of any Claimant under this Bond,
and shall have under this Bond no obligations to make payments to,give notices on behalf of,or otherwise have
obligations to Claimants under this Bond.
8.Surety hereby waives notice of any change,including changes of time,to the Construction Contract or to related
subcontracts,purchase orders and other obligations. Surety further hereby stipulates and agrees that no change,
extension of time, alteration or addition to the terms of the Construction Contract, or to the Work to be
performed thereunder, or materials or equipment to be furnished thereunder or the Specifications accompanying
the same, shall in any way affect its obligations under this Bond, and it does hereby waive any requirement of
notice or any such change, extension of time, alteration or addition to the terms of the Construction Contract or
to the Work or to the Specifications or any other changes.
9.Suit against Surety on this Bond may be brought by any Claimant, or its assigns,at any time after the Claimant
has furnished the last of the labor or materials, or both,but,per Civil Code §3249,must be commenced before
the expiration of six months after the period in which stop notices may be filed as provided in Civil Code
3184.
10. All notices to Surety or Contractor shall be mailed or delivered(at the address set forth on the signature page of
this Bond), and all notices to City shall be mailed or delivered as provided in Document 00520 (Contract).
Actual receipt of notice by Surety, City or Contractor,however accomplished,shall be sufficient compliance as
of the date received at the foregoing addresses.
11. This Bond has been furnished to comply with the California Mechanic's Lien Law including,but not limited to,
Civil Code §§3247, 3248, et seq. Any provision in this Bond conflicting with said statutory requirements shall
be deemed deleted herefrom and provisions conforming to such statutory or other legal requirements shall be
deemed incorporated herein. The intent is that this Bond shall be construed as a statutory bond and not as a
common law bond.
12. Upon request by any person or entity appearing to be a potential beneficiary of this Bond, Contractor shall
promptly furnish a copy of this Bond or shall permit a copy to be made.
13. Contractor shall pay to persons performing labor in and about Work provided for in the Contract Documents an
amount equal to or more than the general prevailing rate of per diem wages for(1)work of a similar character
in the locality in which the Work is performed and(2)legal holiday and overtime work in said locality. The per
diem wages shall be an amount equal to or more than the stipulated rates contained in a schedule that has been
ascertained and determined by the Director of the State Department of Industrial Relations and City to be the
City of'Cupertino Construction Labor and Material Payment Bond
2014 Sidewalk Accessibility Improvements 00620-2
Project No.2014-15
general prevailing rate of per diem wages for each craft or type of workman or mechanic needed to execute this
Contract. Contractor shall also cause a copy of this determination of the prevailing rate of per diem wages to be
posted at each Site.
14. Definitions.
14.1 Claimant: An individual or entity having a direct contract with Contractor or with a Subcontractor of
Contractor to furnish labor, materials or equipment for use in the performance of the Contract, as
further defined in California Civil Code §3181. The intent of this Bond shall be to include without
limitation in the terms "labor, materials or equipment" that part of water, gas, power, light, heat, oil,
Qasohne, telephone service or rental equipment used in the Construction Contract, architectural and
engineering services required for performance of the Work of Contractor and Contractor's
Subcontractors, and all other items for which a stop notice might be asserted. The term Claimant shall
also include the Unemployment Development Department as referred to in Civil Code§3248(b)-
14.2 Construction Contract: The contract between City and Contractor identified on the signature page of
this Bond,including all Contract Documents and changes thereto.
14.3 City Default: Material failure of City, which has neither been remedied nor waived, to pay the
Contractor as required by the Construction Contract,provided that failure is the cause of the failure of
Contractor to pay the Claimants and is sufficient to justify-termination of the Construction Contract.
END OF DOCUMENT
City of Cupertino Construction Labor and\Material Payment Bond
2014 Sidewalk Accessibility Improvements 00620-3
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
County of Contra Costa
On April 17, 2015 before me, Cathy A. Shapard Notary Public,
Date Insert Name of Notary exactly as it appears on the official seal
personally appeared Mark C. Johnson
Name(s)of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person(po whose name(V is/are-subscribed to thewithininstrumentandacknowledgedtomethathe/a4efthey
executed the same in his/hegthek authorized capacity(x)
CATHY A. SHAPARD and that by his/hed1baic signature( on the instrument the
commission# 1960470
z
person( or the entity upon behalfof which the person%
Notary Public-California v acted, exe uted the instrument.
Z . ' IZContraCostaCounty
My Comm.Expires Dec 14,2015 1 certify under PENALTY OF PERJURY under the laws of
the State of California that the foregoing paragraph is true
and correct.
Witness my hand and official seal.
Signature Ae"&a,ZP
Place Notary Seal Above Sig ture of eryPublic
OPTIONAL
Though the information below is not required by law it may prove valuable to persons relying on the document
and could prevent fraudulent removal ana reattachment of the form to another document.
Description of Attached Document
Title or Type of Document: Construction Performance and Construction Labor& Material Bonds
Document Date: April 17, 2015 Number of Pages: 6
Signer(s) Other Than Named Above: JJR Construction, Inc.
Capacity(ies) Claimed by Signer(s)
Signer's Name: Mark C. Johnson Signer's Name:
Individual Individual
Corporate Officer—Title(s): Corporate Officer —Title(s):
Partner Limited General Partner Limited General
w Attorney in FactRIGHT THUMBPRINT Attorney in FactRIGHTTHUMBPRINT
Trustee Trustee OF
Guardian or Conservator Top of thumb here Guardian or Conservator Top of thumb here
Other: Other:
Signer is Representing: Signer is Representing:
Great American
Insurance Company
GREAT AMERICAN INSURANCE COMPANY®
Administrative Office: 301 E 4TH STREET • CINCINNATI,OHIO 45202 • 513-369-5000 • FAX 513-723-2740
The number of persons authorized by
this power of attorney is not more than FOUR
No.0 14752
POWER OFATTORNEY
KNOW ALLMEN BY THESE PRESENTS: That the GREATAMERICAN INSURANCE COMPANY,a corporation organized and existing under
and by virtue of the laws of the State ofOhio,does hereby nominate,constitute and appoint the person or persons named below,each individually if more than
one is named,its true and lawful attomey-in-fact,for it and in its name,place and stead to execute on behalfof the said Company,as surety,any and all bonds,
undertakings and contracts of suretyship,or other written obligations in the nature thereof,provided that the liability of the said Company on any such bond,
undertaking or contract of suretyship executed under this authority shall not exceed the limit stated below.
Name Address Limit ofPower
JOHN F.ARENTS CECIL A.COLLINS III ALL OF ALL
MARK C.JOHNSON PATRICK MARTIN CONCORD, 100,000,000.00
CALIFORNIA
This Power ofAttorney revokes all previous powers issued on behalf ofthe attomey(s)-in-fact named above.
IN WITNESS WHEREOF the GREATAMERICAN INSURANCE COMPANY has caused these presents to be signed and attested by its appropriate
officers and its corporate seal hereunto affixed this 4TH day of FEBRUARY 2015
Attest GREAT AMERICAN INSURANCE COMPANY
Assistant Secretary Dtvisiona!Senior rice President
STATE OF OHIO,COUNTY OF HAMILTON-ss:DAVID C.KITCHw(877-377-2405)
On this 4TH day of FEBRUARY 2015 , before me personally appeared DAVID C. KITCHIN, to me
known,being duly swom,deposes and says that he resides in Cincinnati,Ohio,that he is a Divisional Senior Vice President of the Bond Division of Great
American Insurance Company,the Company described in and which executed the above instrument;that he knows the seal of the said Company;that the seal
affixed to the said instrument is such corporate seal;that it was so affixed by authority of his office under the By-Laws ofsaid Company,and that he signed his
name thereto by like authority.
JENNIFER MARIE RIPPYv. .a NOTARY PUBLIC,STATE OF OHIO
MY CIMIIIIWW ExIP 6M-i9
This Power ofAttorney is granted by authority ofthe following resolutions adopted by the Board of Directors ofGreatAmerican Insurance Company
by unanimous written consent dated June 9,2008.
RESOLVED: That the DivisionalPresident,the several Divisional Senior Vice Presidents,Divisional Vice Presidents and Divisonal Assistant Vice
Presidents,or any one ofthem,be and hereby is authorized,from time to time,to appoint one or more Attorneys-in-Fact to execute on behalf ofthe Company,
as surety,any andall bonds,undertakings andcontracts ofsuretyship,or other written obligations in the nature thereof;to prescribe their respective duties and
the respective limits oftheir authority;and to revoke any such appointment at any time.
RESOLVED FURTHER: That the Company seal and the signature ofany of the aforesaid officers and any Secretary or Assistant Secretary ofthe
Company may be affixed byfacsimile to any power ofattorney or certificate ofeither givenfor the execution ofany bond, undertaking,contract ofsuretyship,
or other written obligation in the nature thereof,such signature and seal when so used being hereby adoptedby the Company as the original signature ofsuch
officer and the original seal ofthe Company,to be valid and binding upon the Company with the sameforce and effect as though manually affixed.
CERTIFICATION
I,STEPHEN C.BERAHA,Assistant Secretary ofGreatAmerican Insurance Company,do hereby certify that the foregoing Power ofAttorney andtheResolutionsoftheBoardofDirectorsofJune9,2008 have not been revoked and are now in full force and effect.
Signed and sealed this 17th day of April 1 2015
V„in5flgk
tai
Assistant Secretary
S1029AE{^1/15)
a
Client#:307587 JJRCONST
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 4/16/
2015DATE(
MMIDDNM/DD/YYYY)
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 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:
John Arents PHONE 925-609-6500 FAX 925-609-6550AICNoExt): A/C,No:
HUB Int'I Insurance Serv.Inc. E-MAIL
ADDRESS:
P.O.Box 4047 INSURER(S)AFFORDING COVERAGE NAIC#
Concord,CA 94524-4047 INSURER A:National Fire Ins Co of Hartfor 20478
INSURED INSURER B:Continental Casualty Company 20443
JJR Construction,Inc.
INSURERC:Everest National Insurance Co 10120
1120 9th Avenue INSURER D
San Mateo,CA 94402
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER: AIGLAWU 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 LIMITSLTRINSRWVDPOLICYNUMBERMM/DD MM/DD
A GENERAL LIABILITY 4034980658 1/01/2015 01/01/2016 EACHOCCURRENCE 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES Eao'curr0ence $100 000
CLAIMS-MADE OCCUR MED EXP(Any one person) $5,000
X PD Ded:1,000 PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,00
GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
F—IPOLICYF—X]PECa LOC
B AUTOMOBILELIABILITY 5090802572 cd. sINGLELIMITa., nl1,000,000
X ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $AUTOS AUTOS
NON-OWNEDXHIREDAUTOSXAUTOS PerraccidentDAMAGE
B X UMBRELLA LIAB X OCCUR 5090802586 1/01/2015 01/01/2016 EACH OCCURRENCE 5,000,000
EXCESS LIAR CLAIMS-MADE AGGREGATE s5,000,000
DED I X RETENTION$10000
C WORKERS COMPENSATION 7600014187151 1/01/2015 01/01/201 X WCSTATU- OTH-
AND EMPLOYERS'LIABILITY IER
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N
E.L.EACH ACCIDENT $1,000,000
OFFICER/MEMBER EXCLUDED? El N/AMandatoryInNH) E.L.DISEASE-EA EMPLOYEE $1,000,000
Ifyes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,Ifmore space Is required)
Re: Project#2014-15,2014 Sidewalk Accessibility Improvements.
City of Cupertino(City),its directors,officers,engineers,agents,employees,all public
agencies from whom permits will be obtained,their directors,officers,engineers,agents and employees,
the State of California,its officers,agents and employees,as additional insured including Primary
wording,Per project aggregate applies to General Liability per attached G18652J-0712 and additional
See Attached Descriptions)
CERTIFICATE HOLDER CANCELLATION
Cit f Cupertino SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City op THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
10300 Torre Ave. ACCORDANCE WITH THE POLICY PROVISIONS.
Cupertino,CA 95014
AUTHORIZED REPRESENTATIVE
1988-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD
S3458809/M3298799 GS41
a
DESCRIPTIONS (Continued from Page 1)
insured including Primary wording applies to Auto Liability per attached CNA63359XX-0412.Waiver of
Subrogation applies to Workers Compensation per attached WC040306,all as required by written contract.
SAGITTA 25.3(2010/05) 2 of 2
S3458809/M3298799
l
Policy#4034980658 G-1 8652-J
CNA Ed. 07-12)
CONTRACTORS'GENERAL LIABILITY EXTENSION ENDORSEMENT
It is understood and agreed that this endorsement amends the COMMERCIAL GENERAL LIABILITY COVERAGE
PART as follows. The changes this endorsement makes do not apply with respect to any coverage that has been
excluded or amended by another endorsement attached to this policy.
SCHEDULE
Coverage is summarized below. For particulars and limitations affecting each coverage, please refer to the
corresponding policy provisions in the body of this endorsement.
1. Additional Insureds
Seven additional insured extensions.
2: Bodily Injury—Expanded Definition
3. Broad Knowledge of Occurrence/Notice of Occurrence
4. Broad Named Insured
5. Broadened Liability Coverage For Damage To"Your Product"And"Your Work"
Limit:$100,000.
6. Contractual Liability—Railroads
Expanded definition of"insured contract."
7. Contractual Liability For Personal And Advertising Injury
8. Electronic Data Liability
Loss of Electronic Data Limit:$100,000.
9. Expanded Personal And Advertising Injury-Discrimination Or Humiliation
10. Expected Or Intended Injury
Reasonable force—"bodily injury"or"property damage."
11. General.Aggregate Limits Of Insurance-Per Project
12. In Rem Actions
13. Incidental Health Care Malpractice Coverage
14. Joint Ventures/Partnership/Limited Liability'Companies
Coverage for your interest in such terminated or ended organizations.
15. Legal Liability/Alienated Premises/Borrowed Equipment Coverage
Extended perils.
Default limit increased to$500,000 for Damage to Premises Rented To You.
25,000 limit for"property damage"to borrowed tools or equipment at a jobsite.
16. Liberalization Clause
17. Liquor Liability.Coverage Extension
18. Medical Payments
Limits increased to$15,000.
Reporting increased to three years from the date of accident.
10. Non-owned Aircraft Coverage
20. Non-owned Watercraft
Increased to 75 feet.
21. Primary And Non-Contributory To Other Insurance
22. Property Damage-Elevators
23. Supplementary Payments
Cost of bail bonds increased to$5,000.
Daily loss of earnings increased to$1,000.
24. Unintentional Failure To Disclose Hazards
25. Waiver of Subrogation -Blanket
Waiver of subrogationwhere required by written contract or written agreement.
26. Wrap-Up Extension
G-18652-J (Ed. 07-12)
Page 1 of 12
Copyright,CNA All Rights Reserved.
J
Policy#4034980658 G-18652-J
CNA Ed. 07-12)
1. ADDITIONAL INSURED 2. With respect to the insurance afforded to
these additional insureds, this insurance
SECTION II—WHO IS AN INSURED is amended to does not apply to any "occurrence" which
include as an insured any person or organization takes place after the equipment lease
called additional insured)described in paragraphs expires.
A.through G. below whom you are required to add
as an additional insured on this policy under a D. Lessor-Land
written contract or written agreement, provided the An owner or other interest from whom land has
written contract or written agreement: been leased by you but only with respect to
i. Is currently in effect or becomes effective liability arising out of the ownership,
during the term of this policy; and maintenance or use of that specific part of the
land leased to you and subject to the following
ii. Was executed prior to the "bodily injury," additional exclusions:
property damage" or "personal injury and
advertising injury" for which the additional This insurance does not apply to:
insured seeks coverage. 1. Any "occurrence" which takes place after
However, we will not provide the additional you cease to lease that land; or
insured any broader coverage or any higher 2. Structural alterations, new construction or
limit of insurance than the least that is: demolition operations performed by or on
a. The maximum permitted by law; behalf of such additional insured.
b. Required in the written contract or written E. Lessor-Premises
agreement; A manager or lessor of premises but only with
c. Afforded to you under this policy; or respect to liability arising out of the ownership,
maintenance or use of that specific part of the
d. Described in the applicable paragraphs A. premises leased to you and subject to the
through G. below. following additional exclusions:
A. Controlling Interest This insurance does not apply to:
Any persons or organizations with a controlling 1. Any."occurrence" which takes place after
interest in you but only with respect to their you cease to be a tenant in that premises;
liability arising out of: or
1. Their financial control of you; or 2. Structural alterations, new construction or
2. Premises they own, maintain or control demolition operations performed by or on
while you lease or occupy these premises. behalf of such additional insured.
This insurance does not apply to structural F. Mortgagee,Assignee or Receiver
alterations, new construction and demolition A mortgagee, assignee or receiver but only with
operations performed by or for such additional respect to their liability as mortgagee, assignee,
insured. or receiver and arising out of the ownership,
B. Co-owner of Insured Premises maintenance, or use of a premises by you.
A co-owner of a premises co-owned by you and This insurance does not apply to structural
covered under this insurance but only with alterations, new construction or demolition
respect to the co-owner's liability as co-owner operations performed by or for such additional
of such premises. insured.
C. Lessor-Equipment G. State or Governmental Agency or
Subdivision or Political Subdivisions
1. Any person or organization from whom you
lease equipment, but only with respect to A state or governmental agency or subdivision
liability for "bodily injury," "property or political subdivision subject to the following
damage" or "personal and advertising provisions:
injury" caused, in whole or in part, by your 1. This insurance applies only with respect to
maintenance, operation or use of the following hazards for which the state or
equipment leased to you by such person or governmental agency or subdivision or
organization. political subdivision has issued a permit or
authorization in connection with premises
G-18652-J (Ed. 07-12)
Page 2 of 12
Copyright,CNA All Rights Reserved.
5
CNA
Policy#4034980658 G-18652-J
Ed. 07-12)
you own, rent, or control and to which this You must give us or our authorized
insurance applies: representative notice of an "occurrence,"
offense, claim, or "suit" only when the
a. The existence, maintenance, repair,occurrence, offense, claim or "suit" is known
construction, erection, or removal of to:
advertising signs, awnings, canopies,
cellar entrances, coal holes, driveways, 1) You, if you are an individual;
manholes, marquees, hoistaway
openings, sidewalk vaults, street 2) A partner, if you are a partnership;
banners, or decorations and similar 3) An executive officer or the employee
exposures; or designated by you to give such notice, if
b. The construction, erection, or removal you are a corporation; or
of elevators; or 4) A manager, if you are a limited liability
c. The ownership, maintenance or use of company.
any elevators covered by this B. NOTICE OF OCCURRENCE
insurance.
Your rights under this Coverage Part will not be
2. This insurance applies only with respect to prejudiced if you fail to give us notice of an
operations performed by you or on your occurrence,"offense, claim or"suit"and that
behalf for which the state or governmental failure is solely due to your reasonable belief
agency or subdivision or political that the"bodily injury"or"property damage" is
subdivision has issued a permit or not covered under this Coverage Part.
authorization. However, you shall give written notice of this
3. This insurance does not apply to: occurrence,"offense, claim or"suit"to us as
soon as you are aware that this insurance may
a. "Bodily injury," "property damage" or apply to such "occurrence,"offense claim or
personal and advertising injury" arising suit."
out of operations performed for the 4. BROAD NAMED INSUREDfederalgovernment, state or
municipality; or A. Any subsidiary or affiliate organization, other
b. "Bodily injury" or "property damage" than a partnership, joint venture or limited
included within the"products-completed liability company, in which a Named Insured
operations hazard." specifically shown in the Declarations has
management control, directly or through one or
A governmental permit which requires you to more subsidiary organizations, at the time of
add the governmental entity as an additional loss will qualify as a Named Insured but only if
insured will trigger this Provision 1.as if the there is no other similar insurance available to
permit were a written contract. such organization, nor similar insurance which
2. BODILY INJURY—EXPANDED DEFINITION
would be available but for exhaustion of its
limits. For the purpose of this provision, similar
SECTION V—DEFINITIONS,the definition of insurance means general liability or equivalent
bodily injury"is changed to read: insurance, no matter whether its coverage is
Bodily injury"means bodily injury, sickness or
broader or narrower than that provided by this
insurance. But if the only other similar
disease sustained by a person, including death,insurance is for a "consolidated (wrap-up)humiliation, shock, mental anguish or mental injury program," then a subsidiary that qualifies as a
by that person at any time which results as a Named Insured on such project-specific
consequence of the bodily injury, sickness or insurance can still qualify as a Named Insureddisease. on this insurance, but not for projects covered
3. BROAD KNOWLEDGE OF OCCURRENCE/ by the"consolidated (wrap-up)program."
NOTICE OF OCCURRENCE Please see Item 26.C.of this endorsement for
Condition 2. Duties in The Event of Occurrence, the definition of"consolidated (wrap-up)
Offense, Claim or Suit of SECTION IV— program."]
COMMERCIAL GENERAL LIABILITY B. This endorsement does not apply to anyCONDITIONSisamendedtoaddthefollowingorganizationforwhichcoverageisexcludedby
provisions: another endorsement attached to this policy.
A. BROAD KNOWLEDGE OF OCCURRENCE C. Only for the purpose of this endorsement:
G-18652-J (Ed. 07-12)
Page 3 of 12
Copyright,CNA All Rights Reserved.
Policy#4034980658 G-1 8652-J
CNA Ed. 07-12)
1. Management control means: I. Damage to Your Work
a. Ownership interest representing more Property damage"to "your work"arising out of
than 50% of the voting, appointment, or it, or any part of it and included in the"products-
designation power for the subsidiary completed operations hazard."
organization's governing body; or This exclusion does notaapply:Y:
b. Having the right, pursuant to a written 1) If the damaged work or the work out ofcontract, or pursuant to the by-laws,
which the damage arises wascharter, operating agreement, or similar
performed on your behalf by adocumentofaspecificallyshown
subcontractor; orNamedInsuredorcontrolledsubsidiary
organization to select, appoint, or 2) If the cause of loss to the damaged
designate a majority of the subsidiary work arises as a result of:
organization's governing body. Such
contract or document must have been a) Fire;
created prior to the time of loss; or b) Smoke;
c. Having the right, pursuant to a written c) Collapse; or
trust agreement, to protect, control the
use of, encumber or transfer and sell d) Explosion.
property held by a trust. B. The following paragraph is added to SECTION
2. Governing body means the Board of III—LIMITS OF INSURANCE:
Directors of a corporation. Subject to 5. above, $100,000 is the most we
3. Loss means: will pay under Coverage A for the sum of
damages arising out of any one"occurrence"
a. The occurring of the "bodily injury" or because of"property damage"to"your product"
property damage'; or and "your work"that is caused by fire, smoke,
b. The committing of the offense that collapse or explosion and is included within the
caused the "personal and advertising product-completed operations hazard." This
injury." sublimit does not apply to"property damage"to
your work"if the damaged work or the work out
D. The insurance provided by this policy applies to of which the damage arises was performed on
Named Insureds when trading under their own your behalf by a subcontractor.
names, or under such trading names or doing-
business-as (DBA) names as any should C. This Provision 5. Broadened Liability
choose to employ. Coverage For Damage To "Your Product"
And "Your Work" does not apply if an
5. BROADENED LIABILITY COVERAGE FOR endorsement of the same name is attached to
DAMAGE TO "YOUR PRODUCT" AND "YOUR this policy.
WORK" 6. CONTRACTUAL LIABILITY—RAILROADS
A. Under SECTION I — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE With respect to operations performed within 50 feet
LIABILITY, Paragraph 2. Exclusions is of railroad property, the definition of"insured
amended to delete exclusions k. and I. and contract" in SECTION V—DEFINITIONS is
replace them with the following: replaced by the following:
This insurance does not apply to:] Insured Contract" means:
k. Damage to Your Product a. A contract for a lease of premises. However,
that portion of the contract for a lease of
Property damage"to"your product"arising premises that indemnifies any person or
out of it, or any part of it except when organization for damage by fire to premises
caused by or resulting from: while rented to you or temporarily occupied by
you with permission of the owner is not an1) Fire; insured contract";
2) Smoke; b. A sidetrack agreement;
3) Collapse; or
c. Any easement or license agreement;
4) Explosion.
G-18652-J (Ed. 07-12)
Page 4 of 12
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Policy#4034980658 G-18652-J
C A Ed. 07-12)
d. An obligation, as required by ordinance, to Damages arising out of the loss of, loss of use
indemnify a municipality, except in connection of, damage to, corruption of, inability to access,
with work for a municipality;or inability to manipulate "electronic data" that
e. An elevator maintenance agreement; does not result from physical injury to tangible
property.
f. That part of any other contract or agreement However, this exclusion does not apply to
pertaining to your business (including an liability for damages because of"bodily injury."indemnification of a municipality in connection
with work performed for a municipality) under B. The following paragraph is added to SECTION
which you assume the tort liability of another III—LIMITS OF INSURANCE:
party to pay for "bodily injury" or "property Subject to 5. above, $100,000 is the most wedamage" to a third person or organization. Tort will pay under Coverage A for all damagesliabilitymeansaliabilitythatwouldbeimposedarisingoutofanyone"occurrence"because ofbylawintheabsenceofanycontractorpropertydamage"that results from physicalagreement. injury to tangible property and arises out of
Paragraph f.does not include that part of any electronic data."
contract or agreement: C. The following definition is added to the
1) That indemnifies an architect, engineer or SECTION V—DEFINITIONS:
surveyor for*injury or damage arising out of: Electronic data" means information, facts or
a) Preparing, approving or failing to programs stored as or on, created or used on,
prepare or approve maps, shop or transmitted to or from computer software
drawings, opinions, reports, surveys, including systems and applications software),
field orders, change orders or drawings hard or floppy disks, CD-ROMS, tapes, drives,
and specifications; or cells, data processing devices or any other
b) Giving directions or instructions, or media which are used with electronically
failing to give them, if that is the primary
controlled equipment.
cause of the injury or damage; D. For the purposes of the coverage provided by
2) Under which the insured, if an architect, this endorsement, the definition of "property
engineer or surveyor, assumes liability for damage" in SECTION V — DEFINITIONS is
an injury or damage arising out of the replaced by the following:
insured's rendering or failure to render 17. "Property damage"means:
professional services, including those listed a. Physical injury to tangible property,in (1) above and supervisory, inspection,
architectural or engineering activities. including all resulting loss of use of that
property. All such loss of use shall be
7. CONTRACTUAL LIABILITY FOR PERSONAL deemed to occur at the time of the
AND ADVERTISING INJURY physical injury that caused it;
Under SECTION I—COVERAGE B—PERSONAL b. Loss of use of tangible property that is
AND ADVERTISING INJURY LIABILITY, not physically injured. All such loss of
Paragraph 2. Exclusions is amended to delete use shall be deemed to occur at the
exclusion e. Contractual Liability. time of the "occurrence" that caused it;
This provision 7. does not apply to any person or
or
organization who otherwise qualifies as an c. Loss of, loss of use of, damage to,
additional insured on this Coverage Part. corruption of, inability to access, or
8. ELECTRONIC DATA LIABILITY inability to properly manipulate
electronic data," resulting from
A. Under SECTION I — COVERAGE A — BODILY physical injury to tangible property. All
INJURY AND PROPERTY DAMAGE, such loss of "electronic data" shall be
Paragraph 2. Exclusions is amended to delete deemed to occur at the time of the
exclusion p. Electronic Data and replace it with occurrence"that caused it.
the following: For the purposes of this insurance,
This insurance does not apply to:] electronic data" is not tangible property.
p. Electronic Data E. If Electronic Data Liability is provided at a
higher limit by another endorsement attached to
G-18652-J (Ed. 07-12)
Page 5 of 12
Copyright,CNA All Rights Reserved.
i
Policy#4034980658 G-1 8652-J
CIA Ed. 07-12)
this policy, then the $100,000 limit provided by amended to delete exclusion a. Expected or
this Provision 8. Electronic Data Liability is Intended Injury and replace it with the
part of, and not in addition to,that higher limit. following:
9. EXPANDED PERSONAL AND ADVERTISING This insurance does not apply to:]
INJURY-DISCRIMINATION OR HUMILIATION
a. Expected or Intended Injury
A. SECTION V — DEFINITIONS is amended to Bodily injury"or"property damage"add the following to the definition of "Personal
expected orandadvertisinginjury": the insured.This exclusion does
nnded
from the standpoint
tapply f
h. Discrimination or humiliation that results in to"bodily injury"or"property damage"
injury to the feelings or reputation of a resulting from the use of reasonable force
natural person, but only if such to protect persons or property.
discrimination or humiliation is: 11. GENERAL AGGREGATE LIMITS OF
1) Not done intentionally by or at the INSURANCE-PER PROJECT
direction of: A. For each construction project away from
a) The insured; or premises you own or rent, a separate
b) Any "executive officer," director, Construction Project General Aggregate
stockholder, partner, member or
Limit, equal to the amount of the General
manager (if you are a limited Aggregate Limit, is the most we will pay for
liability company) of the insured;the sum of:
and 1. All damages under Coverage A, except
2) Not directly or indirectly related to the damages because of "bodily injury" or
11
employment, prospective employment, property damage included in the
past employment or termination of
products-completed operations
hazard"; and
employment of any person or persons
by any insured. 2. All medical expenses under Coverage
B. Under SECTION I — COVERAGE B -C'
PERSONAL AND ADVERTISING INJURY that arise from "occurrences" or
LIABILITY, Paragraph 2. Exclusions is accidents which can be attributed solely
amended to add the following additional to ongoing operations at that
exclusions: construction project. Such payments
This insurance does not apply to:] shall not reduce the General Aggregate
Limit shown in the Declarations, nor the
Discrimination Relating To Room, Construction Project Aggregate Limit of
Dwelling or Premises any other construction project.
Personal or advertising injury"caused by B. All:
discrimination directly or indirectly related to 1. Damages under Coverage B, regardless ofthesale, rental, lease or sub-lease or the number of locations or construction
prospective sale, rental, lease or sub-lease projects involved;of any room, dwelling or premises by or at
the direction of any insured. 2. Damages under Coverage A, caused by
Fines Or Penalties
occurrences" which cannot be attributed
solely to ongoing operations at a single
Fines or penalties levied or imposed by a construction project, except damages
governmental entity because of because of "bodily injury" or "property
discrimination. damage" included in the "products-
This provision 9.does not apply to any person
completed operations hazard'; and
or organization who otherwise qualifies as an 3. Medical expenses under Coverage C
additional insured on this Coverage Part. caused by accidents which cannot be
10. EXPECTED OR INTENDED INJURY attributed solely to ongoing operations at a
single construction project,
Under SECTION I—COVERAGE A—BODILY will reduce the General Aggregate Limit shown
INJURY AND PROPERTY DAMAGE in the Declarations.
LIABILITY, Paragraph 2. Exclusions is
G-18652-J (Ed. 07-12)
Page 6of12
Copyright,CNA All Rights Reserved.
Policy#4034980658 G-18652-J
Ed. 07-12)
C. The limits shown in the Declarations for Each a) "Bodily injury" caused by a "health
Occurrence, for Damage To Premises Rented care incident" will be considered
To You and for Medical Expense continue to caused by an "occurrence"; and
apply, but will be subject to either the
Construction Project Aggregate Limit or the b) All acts, errors or omissions that
General Aggregate. Limit, depending on are .logically connected by any
whether the "occurrence" can be attributed common fact, circumstance,
solely to ongoing operations at a particular
situation, transaction, event, advice
construction project. or decision will be considered to
constitute a single"occurrence';
D. When coverage for liability arising out of the 2) The "bodily injury" occurs during theproducts-completed operations hazard" is
injury" arisingjprovided, any payments for damages because from an "occurrence"will
policy period. All "bodily inbe deemed toofbodilyinjuryorpropertydamageIncluded
in the "products-completed operations hazard,"have occurred at the time of the first
regardless of the number of locations involved act, error, or omission that is part of the
will reduce the Products-Completed Operations occurrence'; and
Aggregate Limit shown in the Declarations.B. With respect only to the insurance provided by
E. If a single construction project away from this Provision 13., Exclusion 2.e. Employer's
premises owned by or rented to the insured has Liability of SECTION I — COVERAGE A —
been abandoned and then restarted, or if the BODILY INJURY AND PROPERTY DAMAGE,
authorized contracting parties deviate from is amended to append the following:
plans, blueprints, designs, specifications or Only for "bodily injury" not covered by other
timetables, the project will still be deemed to be liability insurance. (including state-sanctioned
the same construction project. self insurance) available to the insured (or
F. The provisions of SECTION III — LIMITS OF which would be available but for exhaustion of
its limits),. this exclusion does not apply toINSURANCEnototherwisemodifiedbythisbodilyinjury" that arises out of a "health careendorsementshallcontinuetoapplyasincident."
stipulated.
12. IN REM ACTIONS C. SECTION V — DEFINITIONS is amended to
add the following new definition:
Any action in rem against any vessel owned or Health care incident" means a negligent act,operated by or for you, or chartered by or for you
error or omission by your "employees" or
will be treated in the same manner as though the volunteer workers" working on your behalf inactionwereinpersonamagainstyou.the rendering of or failure to render professional
In rem is a term used to designate actions instituted health care services in any of the following
against the thing, as distinct from actions against capacities, or the related furnishing of food,
the person,which ate said to be in personam. beverages, medical supplies or appliances:
13. INCIDENTAL HEALTH CARE MALPRACTICE a. Physician;
COVERAGE b. Nurse;
A. With respect only to "bodily injury" that arises
out of a "health care incident," COVERAGE A— c. Emergency medical technician;
BODILY INJURY AND PROPERTY DAMAGE d. Paramedic;
LIABILITY OF SECTION I — COVERAGES is
amended to replace Insuring Agreement e. Chiropractor;
Paragraphs 1.b.(1) and 1.b.(2) with the f. Dentist; .
following:
9• Athletic trainer;
b. This insurance applies to"bodily injury"only h. Audiologist;if you are not in the business of providing g
professional health care services, and only i. Physical therapist;
if:
j. Psychologist;
1) The bodily injuryis caused by an
st;thera Ieechk. Soccurrence" that takes place in the p pi
coverage territory." For the purpose of I. Other allied health professional; or
this insurance:
G-18652-J (Ed. 07-12)
Page 7 of 12
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CNA
Policy#4034980658 G
Ed.d. 07-107-12)
m. Provider of first aid or Good Samaritan a. "bodily injury" to a co-"volunteer
services rendered in an emergency and for worker" while performing duties related
which no payment is demanded or to the conduct of your business; and
received.b. "bodily injury"to an "employee"while in
D. SECTION I — COVERAGE A — BODILY the course of the "employee's"
INJURY AND PROPERTY DAMAGE,employment by you or while performing
Paragraph 2. Exclusions is amended to add the duties related to the conduct of your
following additional exclusions. These new business;
exclusions apply only to this Incidental Health
Care Malpractice Coverage: when such "bodily injury"arises out of a
health care incident.'
This insurance does not apply to:] 3. Paragraphs 2.a. (1)(a), (b) and (c) of
Dishonesty or Crime SECTION II — WHO IS AN INSURED do
Any dishonest, criminal or malicious act, error
not apply to "bodily injury" for which
or omission.
insurance is provided this Provision 13.
Clinical Trials/Product Testing 4. Paragraph 2.a.(1)(d) of SECTION II—WHO
IS AN INSURED is deleted.
Acts, errors or omissions that occur in the G. With respect to the insurance provided by thiscourseofhumanclinicaltrialsorproductProvision13., the following is added to
testing.Paragraph 4.b.(1) of SECTION IV —
Medicare/Medicaid Fraud COMMERCIAL GENERAL LIABILITY
Medicare or Medicaid fraud or abuse.
CONDITIONS:
Services Excluded by Endorsement
To the extent this insurance applies, it is excess
over any of the other insurance (including
Any"health care incident"for which coverage is qualified self insurance), whether iprimary,
excluded by endorsement. excess, contingent or on any other basis,
E. SECTION V — DEFINITIONS is amended to except for insurance purchased specifically by
you to be excess of this policy.add the following subparagraph to Paragraph f.
of the definition of"insured contract": 14. JOINT VENTURES / PARTNERSHIP / LIMITED
LIABILITY COMPANIES
Paragraph f. does not include that part of any
contract or agreement:A. The following is added to SECTION II — WHO
IS AN INSURED:
4) Under which you assume another's tort
liability for "bodily injury" arising out of the 4. You are an insured when you had an
rendering of or failure to render interest in a joint venture, partnership or
professional health care services.limited liability company which terminated
F. SECTION II — WHO IS AN INSURED is or ended prior to or during this policy
period, but only to the extent of your
amended to add the following provisions: interest in such joint venture, partnership or
1. Your"employees"are insureds with respect limited liability company. This coverage
to: does not apply:
a. "bodily injury" to a co-"employee" while a. Prior to the termination date of any joint
in the course of the co-"employee's"venture, partnership or limited liability
employment by you or while performing company;
duties related to the conduct of your b. If there is other valid and collectible
business; and insurance purchased specifically to
b. "bodily injury" to a "volunteer worker"insure the partnership, joint venture or
while performing duties related to the limited liability company; or
conduct of your business; c. To a joint venture, partnership or limited
when such "bodily injury"arises out of a liability company which is or was
health care incident." insured under a "consolidated (wrap-
up)insurance program." .
2. Your "volunteer workers" are insureds with
respect to:
G-18652-J (Ed.07-12)
Page 8 of 12
Copyright,CNA All Rights Reserved.
Policy#4034980658 G-1 8652-J
Ed. 07-12)
Please see Item 26.C. of this endorsement Paragraphs (1), (3) and (4) of this exclusion
for the definition of"consolidated (wrap-up) do not apply to "property damage" (other
program."] than damage by fire) to premises rented to
B. The last paragraph of SECTION 11 — WHO IS you or temporarily occupied by you with the
AN INSURED is deleted and replaced by the permission of the owner, or to the contents
following:
of premises rented to you for a period of 7
or fewer consecutive days. A separate limit
Except as provided under the Contractors' of insurance applies to Damage To
General Liability Extension Endorsement or by Premises Rented To You as described in
the attachment of another endorsement(if any), SECTION III—LIMITS OF INSURANCE.
no person or organization is an insured with Paragraphs (3), (4), (5) and (6) of this
respect to the conduct of any current or past exclusion do not apply to liability assumed
partnership, joint venture or limited liability under a sidetrack agreement.company that is not shown as a Named Insured
in the Declarations. Paragraph (6) of this exclusion does not
15. LEGAL LIABILITY/ALIENATED PREMISES/ apply to "property damage" included in the
BORROWED EQUIPMENT
products-completed operations hazard."
A. Under SECTION I — COVERAGE A — BODILY B. Under SECTION I — COVERAGE A — BODILY
INJURY AND PROPERTY DAMAGE, INJURY AND PROPERTY DAMAGE the last.
Paragraph 2. Exclusions is amended to delete paragraph of Paragraph 2. Exclusions is
exclusion j. Damage to Property in its entirety deleted and replaced by the following.
and replace it with the following: Exclusions c. through n. do not apply to
This insurance does not apply to:] damage by fire to premises while rented to you
or temporarily occupied by you with permission
j. Damage to Property of the owner nor to the contents of premises
Property damage"to:
rented to you for a_ period of 7 or fewer
p y g consecutive days.
1) Property you own, rent, or occupy; A separate limit of insurance applies to this
2) Premises you sell, give away or coverage as described in SECTION III —
abandon, if the "property damage" LIMITS OF INSURANCE.
arises out of any part of those C. The following paragraph is added to SECTION
premises; III-LIMITS OF INSURANCE:
3) Property loaned to you; Subject to 5.above, $25,000 is the most we will
4) Personal property in the care, custody pay under Coverage A for damages arising out
or control of the insured; of any one "occurrence" because of "property
damage"to tools or equipment loaned to you by5) That particular part of real property on others that occurs while the equipment is being
which you or any contractors or used to perform operations.
subcontractors working directly or
indirectly on your behalf are performing D. Paragraph 6. Damage To Premises Rented To
operations, if the "property damage" You Limit of SECTION III — LIMITS OF
arises out of those operations; or INSURANCE is replaced by the following:
6) That particular part of any property that 6. Subject to Paragraph 5. above, (the Each
must be restored, repaired or replaced Occurrence Limit), the Damage To
because "your work" was incorrectly Premises Rented To You Limit is the most
performed on it. we will pay under SECTION — I —
COVERAGE A for damages because of
Paragraph (2) of this exclusion does not property damage" to any one premises
apply if the premises are"your work." while rented to you or temporarily occupied
Paragraphs (3) and (4) of this exclusion do by you with the permission of the owner,
not apply to "property damage" to tools or including contents of such premises rented
equipment loaned to you. A separate limit to you for a period of 7 or fewer consecutive
of insurance applies to such tools or days. The Damage To Premises Rented To
equipment that are damaged while being You Limit is the greater of:
used in your operations. a. $500,000; or
G-18652-J (Ed. 07-12)
Page 9 of 12
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CNA
Policy#4034980658 G-18652-J
Ed. 07-12)
b. The Damage To Premises Rented To This paragraph B. does not apply to medical
You Limit shown in the Declarations. expenses incurred in the state of Missouri.
E. Paragraph 4.b.(1)(a)(ii) of SECTION IV — 19. NON-OWNED AIRCRAFT
COMMERCIAL GENERAL LIABILITY Under SECTION I—COVERAGE A—BODILYCONDITIONSisdeletedandreplacedbytheINJURYANDPROPERTYDAMAGELIABILITY.following: Paragraph 2. Exclusions is amended such that
ii) That is property insurance for premises exclusion g.Aircraft,Auto or Watercraft does not
rented to you, for premises temporarily apply to an aircraft you do not own, provided that:
occupied by you with the permission of the 1. The pilot in command holds a currently effectiveowner; or for personal property of others in
certificate issued by the duly constitutedyourcare, custody or control; authority of the United States of America or
F. This Provision 15. does not apply if Damage To Canada, designating that person as a
Premises Rented To You Liability under commercial or airline transport pilot;
SECTION — I — COVERAGE A is excluded by 2. The aircraft is rented to you with a trained, paid
endorsement.crew;and
16. LIBERALIZATION CLAUSE 3. The aircraft does not transport persons or cargo
If we adopt a change in our forms or rules which for a charge.
would broaden coverage for contractors under this 20. NON-OWNED WATERCRAFTendorsementwithoutanadditionalpremiumcharge,
your policy will automatically provide the additional Under SECTION I—COVERAGE A-BODILY
coverage as of the date the revision is effective in INJURY AND PROPERTY DAMAGE LIABILITY,
your state. Paragraph 2. Exclusions is amended to delete
17. LIQUOR LIABILITY subparagraph (2)of exclusion g.Aircraft,Auto or
Watercraft and replace it with the following.
Under SECTION I—COVERAGE A—BODILY
This exclusion does not apply to:]INJURY AND PROPERTY DAMAGE, Paragraph 2.
Exclusions is amended to delete exclusion c. 2) A watercraft you do not own that is:
Liquor Liability.a) Less than 75 feet long; and
This provision 17.does not apply to any person or
organization who otherwise qualifies as an b) Not being used to carry persons or property
additional insured on this Coverage Part. for a charge.
18. MEDICAL PAYMENTS 21. PRIMARY AND NON-CONTRIBUTORY TO
OTHERINSURANCE
A. Paragraph 7. Medical Expense Limit, of
SECTION III — LIMITS OF INSURANCE is With respect to any person or organization that is
deleted and replaced by the following: an additional insured under this Coverage Part,the
following is added to Paragraph 4.of SECTION IV—
7. Subject to Paragraph S. above (the Each COMMERCIAL GENERAL LIABILITY
Occurrence Limit), the Medical Expense CONDITIONS:
Limit is the most we will pay under
SECTION — I — COVERAGE C for all If you have agreed in writing in a contract or
medical expenses because of"bodily injury" agreement that this insurance is primary and non-
sustained by any one person. The Medical contributory relative to an additional insured's own
Expense Limit is the greater of: insurance, then this insurance is primary and we
will not seek contribution from that other insurance.
1) $15,000; or For the purpose of this Provision 21.,the additional
2) The amount shown in the Declarations insured's own insurance means insurance on which
for Medical Expense Limit. the additional insured is a Named Insured. .
B. Paragraph 1.a.(3)(b) of SECTION I — This Provision 21. does not apply in situations
COVERAGE C MEDICAL PAYMENTS, is where the endorsement on this policy affording
replaced by the following: coverage to the additional insured specifies that this
insurance is excess over any other insurance
b) The expenses are incurred and reported to available to that additional insured.
us within three years of the date of the 22 PROPERTY DAMAGE—ELEVATORS
accident; and
G-1 8652-J (Ed. 07-12)
Page 10 of 12
Copyright,CNA All Rights Reserved.
Policy#4034980658 G-1 8652-J
CNA Ed. 07-12)
A. Under SECTION I — COVERAGE A — BODILY However, this waiver applies only when you have
INJURY AND PROPERTY DAMAGE, agreed in writing to waive such rights of recovery in
Paragraph 2. Exclusions is amended such that a contract or agreement, and only if the contract or
exclusion k. Damage to Your Product, and agreement:
subparagraph (3), (4) and (6) of exclusion j. 1. Is in effect or becomes effective during the termDamagetoPropertydonotapply "property of this policy; anddamagethatresultsfromtheuseofelevators.
B. With respect only to the coverage provided by 2. Was executed prior to loss.
this endorsement, Condition 4. Other 26. WRAP-UP EXTENSION: OWNER CONTROLLED
Insurance in SECTION IV — COMMERCIAL INSURANCE . PROGRAM, CONTRACTOR
GENERAL LIABILITY CONDITIONS is CONTROLLED INSURANCE PROGRAM OR
amended to add the following subparagraph CONSOLIDATED (WRAP-UP) INSURANCE
b.(1)(a)(v): PROGRAMS
4. Other Insurance Note: The following provision does not apply to any
b. Excess Insurance public construction project in the state of Oklahoma,
nor to any construction project in the state of
1) This insurance is excess over:Alaska,that is not permitted to be insured under a
a) Any of the other insurance, consolidated (wrap-up)insurance program" by
whether primary, excess,
applicable state statute or regulation:
contingent or on any other If the endorsement EXCLUSION—
basis- CONSTRUCTION WRAP-UP or another
v) That is Property insurance exclusionary endorsement pertaining to Owner
covering property of others
Controlled Insurance Programs (O.C.I.P:)or
damaged from the use of
Contractor Controlled Insurance Programs
elevators.C.C.I.P.)is attached to this policy,then the
following changes apply:
23. SUPPLEMENTARY PAYMENTS A. The following wording is added to the
A. Under Section I — Supplementary Payments endorsement:
Coverages A and B, Paragraph 1.b.,the limit With respect to a"consolidated (wrap-up)
of $250 shown for the cost of bail bonds is insurance program" project in which you are or
replaced by$5,000, were involved,this exclusion does not apply to
B. In Paragraph 1.d., the limit of $250 shown for those sums you become legally obligated to
daily loss of earnings is replaced by$1,000. pay as damages because of:
24. UNINTENTIONAL FAILURE TO DISCLOSE 1. 'Bodily injury," "property damage," or
HAZARDS personal or advertising injury" that occurs
If unintentional) should fail to disclose all during your ongoing operations at the
y you project, or during such operations of
existing hazards at the inception date of your policy, anyone acting on your behalf; norwewillnotdenycoverageunderthisCoveragePart
because of such failure. 2. 'Bodily injury" or "property damage"
25. WAIVER OF SUBGROGATION -BLANKET
included within the "products-completed
operations hazard" that arises out of those
Under SECTION IV—COMMERCIAL GENERAL portions of the project that are not
LIABILITY CONDITIONS, The Transfer Of Rights residential structures."
Of Recovery Against Others To Us Condition is B. SECTION IV — COMMERCIAL GENERAL
amended by the addition of the following: LIABILITY CONDITIONS is amended to add
We waive any right of recovery we may have the following subparagraph 4.b.(1)(c) to
against any person or organization because of Condition 4.Other Insurance:
payments we make for injury or damage arising out This insurance is excess over:]
of:
1. Your ongoing operations; or c) Any of the other insurance whether primary,
excess, contingent or any other basis that is
2. "Your work"' included in the "products insurance available to you as a result of
completed operations hazard." your being a participant in a "consolidated
wrap-up) insurance program," but only as
G-18652-J (Ed. 07-12)
Page 11 of 12
Copyright,CNA All Rights Reserved.
Policy#4034980658 G-18652-J
CNA Ed. 07-12)
respects your involvement in that residency including but not limited to single or
consolidated (wrap-up) insurance multifamily housing, apartments,
program."condominiums,townhouses, co-operatives or
C. SECTION V — DEFINITIONS is amended to planned unit developments and also includes
add the following definition:their common areas and/or appurtenant
structures (including pools, hot tubs, detached
Consolidated (wrap-up) insurance program" garages, guest houses or any similar
means a construction, erection or demolition structures). When there is no individual
project for which the prime contractor/project ownership of units, residential structure does
manager or owner of the construction project not include military housing, college/university
has secured general liability insurance covering housing or dormitories, long term care facilities,
some or all of the contractors or subcontractors hotels, or motels. Residential structure also
involved in the project, such as an'Owner does not include hospitals or prisons.
Controlled Insurance Program (O.C.I.P.)or This provision 26.does not apply to any personContractorControlledInsuranceProgramororganizationwhootherwisequalifiesasanC.C.I.P.). additional insured on this Coverage Part.
Residential structure" means any structure
where 30%or more of the square foot area is
used or is intended to be used for human
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.
Material used with permission of ISO Properties, Inc
G-18652-J (Ed. 07-12)
Page 12 of 12
Copyright,CNA All Rights Reserved.
5090802572
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
A. Who Is An Insured
The following is added to Section II, Paragraph A.1.,Who Is An Insured:
1. a. Any incorporated entity of which the Named Insured owns a majority of the voting stock on the date
of inception of this Coverage Form; provided that,
b. The insurance afforded by this provision A.1. does not apply to any such entity that is an "insured"
under any other liability"policy"providing "auto"coverage.
2. Any organization you newly acquire or form, other than a limited liability company, partnership or joint
venture, and over which you maintain majority ownership interest.
The insurance afforded by this provision A.2.:
a. Is effective on the acquisition or formation date, and is afforded only until the end of the policy period
of this Coverage Form, or the next anniversary of its inception date,whichever is earlier.
b. Does not apply to:
1) "Bodily injury" or"property damage" caused by an "accident"that occurred before you acquired
or formed the organization; or
2) Any such organization that is an "insured" under any other liability "policy" providing "auto"
coverage.
3. Any person or organization that you are required by a written contract to name as an additional insured
is an "insured"but only with respect to their legal liability for acts or omissions of a person, who qualifies
as an "insured" under Section II —Who Is An Insured and for whom Liability Coverage is afforded under
this policy. If required by written contract, this insurance will be primary and non-contributory to
insurance on which the additional insured is a Named Insured.
4. An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or
agreement in that "employee's" name, with your permission, while performing duties related to the
conduct of your business.
Policy", as used in this provision A. Who Is An Insured, includes those policies that were in force on the
inception date of this Coverage Form but:
1. Which are no longer in force; or
2. Whose limits have been exhausted.
B. Bail Bonds and Loss of Earnings
Section II, Paragraphs A.2.(2) and A.2. (4)are revised as follows:
1. In a.(2),the limit for the cost of bail bonds is changed from$2,000 to$5,000; and
2. In a.(4),the limit for the loss of earnings is changed from$250 to$500 a day.
C. Fellow Employee
Section II, Paragraph B.5 does not apply.
Such coverage as is afforded by this provision C. is excess over any other collectible insurance.
II. PHYSICAL DAMAGE COVERAGE
A. Glass Breakage—Hitting A Bird Or Animal—Falling Objects Or Missiles
The following is added to Section III, Paragraph A.3.:
With respect to any covered "auto", any deductible shown in the Declarations will not apply to glass
breakage if such glass is repaired, in a manner acceptable to us, rather than replaced.
B. Transportation Expenses
Section III, Paragraph A.4.a. is revised,with respect to transportation expense incurred by you, to provide:
a. $60 per day, in lieu of$20; subject to
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b. $1,800 maximum, in lieu of$600.
C. Loss of Use Expenses
Section III, Paragraph AA.b. is revised, with respect to loss of use expenses incurred by you,to provide:
a. $1,000 maximum, in lieu of$600.
D. Hired "Autos"
The following is added to Section III. Paragraph A.:
5. Hired "Autos"
If Physical Damage coverage is provided under this policy, and such coverage does not extend to Hired
Autos, then Physical Damage coverage is extended to:
a. Any covered "auto"you lease, hire, rent or borrow without a driver; and
b. Any covered "auto" hired or rented by your "employee" without a driver, under a contract in that
individual "employee's" name, with your permission, while performing duties related to the conduct
of your business.
c. The most we will pay for any one "accident" or"loss" is the actual cash value, cost of repair, cost of
replacement or $75,000, whichever is less, minus a $500 deductible for each covered auto. No
deductible applies to "loss"caused by fire or lightning.
d. The physical damage coverage as is provided by this provision is equal to the physical damage
coverage(s)provided on your owned "autos".
e. Such physical damage coverage for hired "autos"will:
1) Include loss of use, provided it is the consequence of an "accident" for which the Named
Insured is legally liable, and as a result of which a monetary loss is sustained by the leasing or
rental concern.
2)Such coverage as is provided by this provision will be subject to a limit of$750 per"accident."
E. Airbag Coverage
The following is added to Section III, Paragraph B.3.:
The accidental discharge of an airbag shall not be considered mechanical breakdown.
F. Electronic Equipment
Section III, Paragraphs B.4.c and B.4.d.are deleted and replaced by the following:
c. Physical Damage Coverage on a covered "auto" also applies to "loss" to any permanently installed
electronic equipment including its antennas and other accessories
d. A$100 per occurrence deductible applies to the coverage provided by this provision.
G. Diminution In Value
The following is added to Section III, Paragraph B.6.:
Subject to the following, the"diminution in value"exclusion does not apply to:
a. Any covered "auto"of the private passenger type you lease, hire, rent or borrow, without a driver for
a period of 30 days or less,while performing duties related to the conduct of your business; and
b. Any covered "auto"of the private passenger type hired or rented by your"employee"without a driver
for a period of 30 days or less, under a contract in that individual "employee's" name, with your
permission, while performing duties related to the conduct of your business.
c. Such coverage as is provided by this provision is limited to a "diminution in value" loss arising
directly out of accidental damage and not as a result of the failure to make repairs; faulty or
incomplete maintenance or repairs; or the installation of substandard parts.
d. The most we will pay for"loss"to a covered "auto" in any one accident is the lesser of:
1) $5,000; or
2) 20% of the"auto's"actual cash value (ACV).
III. Drive Other Car Coverage—Executive Officers
The following is added to Sections II and III:
1. Any "auto" you don't own, hire or borrow is a covered "auto"for Liability Coverage while being used by, and
for Physical Damage Coverage while in the care, custody or control of, any of your "executive officers,"
except:
a. An "auto"owned by that"executive officer"or a member of that person's household; or
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b. An "auto" used by that "executive officer" while working in a business of selling, servicing, repairing or
parking "autos."
Such Liability and/or Physical Damage Coverage as is afforded by this provision.
1) Equal to the greatest of those coverages afforded any covered "auto'; and
2) Excess over any other collectible insurance.
2. For purposes of this provision, "executive officer" means a person holding any of the officer positions
created by your charter, constitution, by-laws or any other similar governing document, and,while a resident
of the same household, includes that person's spouse.
Such "executive officers"are"insureds"while using a covered "auto"described in this provision.
IV. BUSINESS AUTO CONDITIONS
A. Duties In The Event Of Accident, Claim, Suit Or Loss
The following is added to Section IV, Paragraph A.2.a.:
4) Your "employees" may know of an "accident" or "loss." This will not mean that you have such
knowledge, unless such "accident" or"loss" is known to you or if you are not an individual, to any of
your executive officers or partners or your insurance manager.
The following is added to Section IV, Paragraph A.2.b.:
6) Your"employees" may know of documents received concerning a claim or"suit." This will not mean
that you have such knowledge, unless receipt of such documents is known to you or if you are not
an individual,to any of your executive officers or partners or your insurance manager.
B. Transfer Of Rights Of Recovery Against Others To Us
The following is added to Section IV, Paragraph A.5.Transfer Of Rights Of Recovery Against Others To
Us:
We waive any right of recovery we may have, because of payments we make for injury or damage, against
any person or organization for whom or which you are required by written contract or agreement to obtain
this waiver from us.
This injury or damage must arise out of your activities under a contract with that person or organization.
You must agree to that requirement prior to an"accident"or"loss".
C. Concealment, Misrepresentation or Fraud
The following is added to Section IV, Paragraph B.2.:
Your failure to disclose all hazards existing on the date of inception of this Coverage Form shall not
prejudice you with respect to the coverage afforded provided such failure or omission is not intentional.
D. Other Insurance
The following is added to Section IV, Paragraph B.5.:
Regardless of the provisions of Paragraphs 5.a. and 5.d. above, the coverage provided by this policy shall
be on a primary non-contributory basis.This provision is applicable only when required by a written contract.
That written contract must have been entered into prior to"Accident"or"Loss".
E. Policy Period, Coverage Territory
Section IV, Paragraph B.7.(5).(a). is revised to provide:
a. 45 days of coverage in lieu of 30 days.
V. DEFINITIONS
Section V. paragraph C. is deleted and replaced by the following:
Bodily injury" means bodily injury, sickness or disease sustained by a person, including mental anguish, mental
injury or death resulting from any of these.
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5
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -
CALIFORNIA
We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not
enforce our right against the person or organization named in the Schedule. (This agreement applies only to the
extent that you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration ofyour employees while engaged in
the work described in the Schedule.
The additional premium for this endorsement shall be 2%of the California workers'compensation premium
otherwise due on such remuneration.
SCHEDULE
PERSON OR ORGANIZATION JOB DESCRIPTION
ANY PERSON OR ORGANIZATION FOR WHOM THE BLANKET WAIVER OF SUBROGATION
NAMED INSURED HAS AGREED BY WRITTEN
CONTRACT TO FURNISH THIS WAIVER
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective: 01/01/2015 Policy No.7600014187151 Endorsement No. 001
Insured: JJR Construction,Inc.
Premium$ INCL.
Insurance Company: Everest National Insurance Company
Countersigned By:
1998 by the Workers'Compensation Insurance Rating Bureau of California.All rights reserved.
From the WCIRB's California Workers'Compensation Insurance Forms Manual-1999.