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15-086 ELCOR Electric to relocate 400 Amp Breaker Feeding Chiller C I.TY OE -AGREEMENT CITY OF CUPERTINO 10300 Torre Avenue . Cupertino, CA 95014 . r 408-777-3200 NO. o I CUPERTINO . (� THIS AGREEMENT, made and entered into this 24th day of June is:by.and between thei.CITY OF CU.PERTINO (Hereinafter "CITY") and ELCOR Electric. 33-10 Bassett Street.: Santa Clara, CA 95054 (408)986-1320 Hereinafter'CONTRACTOR"), :in consideration of their mutual covenants, the parties :agree as follows:: i CONTRACTOR shall provide or furnish the following specified services:ar�d/or materials: Relocate 400Am_ . p Breaker Feeding Chiller ... Check box if services are further described.in an Exhibit. j EXHIBITS: The following attached exhibits hereby are made part of this Agreement: A=1:. TERM: The services and/or materials furnished under this Agreement shall commence on July P- 2015 and shall be completed no later than 90 Days COMPENSATION: For:the full performance of this Agreement, CITY shall pay CONTRACTOR:.: . $ 4,590:00 . . .. California Labor Code; Section 1771 requires the payment of prevailing wages to.all workers i employed on a Public Works.contract in excess of$1,000,00.. j . qq GENERAL TERMS AND CONDITIONS ... Hold Harmless. Contractor shall, to the fullest extent allowed by law, indemnify, defend;.and hold Harmless the City and its officers; officials, agents, employees and volunteers against any and all liability; :claims, stop notices, actions, causes:of action or demands whatsoever from and against j any of them, including any injury to or death.of any person or:damage to property-.or other liability of any nature,.arising out of, ,pertaining to, or related to the performance of this Agreement by Contractor- or Contractor's .employees, officers, officials, agents or independent contractors. Contractor shall not be :obligated under this Agreement to indemnify City to the extent that the damage is caused, by the sole or active negligence: or willful misconduct of City, its agents or employees. Such costs and expenses shall include reasonable attorneys' fees of counsel of City's .. choice, expert fees and all:other costs and.fees of litigation. i Subcontracting.: Contractor has been retained due.to-their unique:skills and Contractor.niay not is substitute another, assign or transfer any rights or obligations-under this Agreement.- Unless prior F written,:consent from City is obtained, only those people whose names are listed this Agreement j shall be' used,in the:performance of this Agreement. Assignment. Contractor may not assign or transfer this Agreement, without prior written consent f of CITY.:. Page 1 of 3 Short Form Agreement i i. Insurance. Contractor shall fife with City a Certificate of Insurance consistent with the following requirements Coverage: Contractor shall maintain the following insurance coverage: (1) Workers' Compensation: Statutory coverage as required by the State of Califainia. (2) Liabili Commercial general liability coverage in the following minimum limits: Bodily Injury: $500,000 each occurrence $1,000,000 aggregate-all other Property Damage: $100,000 each occurrence $250,000 aggregate If submitted, combined single limit policy with aggregate limits in the amounts of $1,000,000 will be considered equivalent to the required minimum limits shown above. (3) Automotive: Comprehensive automotive liability coverage in the following minimum limits: Bodily Injury: $500,000 each occurrence Property Damage: $100,000 each occurrence or Combined Single Limit: $500,000 each occurrence (4) Professional Liability: Professional liability insurance which includes coverage for the professional acts, errors and omissions of Consultant in the amount of at least$1,000,000. Subrogation Waiver. Contractor agrees that in the event of loss due to any of the perils for which it has agreed to provide comprehensive general and automotive liability insurance, Contractor shall look solely to its insurance for recovery. Contractor hereby grants.to City, on behalf of any insurer providing comprehensive general and automotive liability insurance to either Contractor or City with respect to the services of Contractor herein, a waiver of any right to subrogation which any such insurer of said Contractor may acquire against City by virtue of the payment of any loss under such insurance. Termination of Agreement. The City reserves the right to terminate this Agreement with or without cause with a seven (7)-day notice. The Contractor may terminate this Agreement with or without cause with a seven (7)-day written notice. Non-Discrim!nation. No discrimination shall be made in the employment of persons under this Agreement because of the race, color, national origin, ancestry, religion, gender or sexual orientation of such person Interest of Contractor. It is understood and agreed that this Agreement is not a contract of employment in the sense that the relationship of master and servant exists between City and undersigned. At all times, Contractor shall be deemed to be an independent contractor and Contractor is not authorized to bind the City to any contracts or other obligations in executing this Agreement. Contractor certifies that no one who has or will have any financial interest under this Page 2 of 3 Short Form Agreement i Agreement is an officer or employee of City. City shall have no right of control as to the manner Contractor performs the services to be performed. Nevertheless, City may, at any time, observe the manner in which such services are being performed by the contractor. The Contractor shall comply with all applicable Federal, State, and local laws and ordinances including, but not limited to, unemployment insurance benefits, FICA laws, and the City business license ordinance. Changes. No changes or variations of any kind are authorized without the written consent of the City. CONTRACT CO-ORDINATOR and representative for CITY shall be: NAME: Chris Orr DEPARTMENT: Facilities Davison This Agreement shall become effective upon its execution by CITY, in witness thereof; the parties have executed this Agreement the day and year first written above. CONTRACTOR: CITY OF CU By B tQ-A!!S?W% - ,— Z. Title Qv® jenp 71 4neetv, Title: APPROVALS EXPENDITURE DISTRIBUTION DATE ACCOUN NUMBER AMOUNT *7 -2 7 -7o©--7©.z 'q,S 10 CITY-MTORNEY APPROVED AS TO,FORM 'DATE CIT ff CLEZRK.-,A�1-1-w DATE 7.�� ItI Page 3 of 3 Short Form Agreement r e L C0 0 L a E is E C T R R C June 25,2015 Mr. Chris Orr City of Cupertino 21251 Stevens Creek Boulevard Cupertino,CA 95014 RE: Relocate 400A Breaker 10300 Torre, Cupertino,CA 95014 Electrical Proposal Dear Sir, We are pleased to submit our proposal to perform electrical work for the above referenced project.This proposal was developed from requirements provided by the City of Cupertino and a review of the site conducted by Elcor Electric. Our proposal,with qualifications, is as follows: Scope of Work © Relocate existing 3-pole 400 amp breaker and hardware feeding chiller. o Extend existing 4500 MCM feeder wire to new breaker location. o This proposal includes an(8)hour full building shutdown to perform scope of work. o This proposal assumes all work shall be performed on a weekend at double time rates. o We are excluding drawings,design,permit, any other special systems, fire alarm system, liquidated damages, temporary power/lighting,overtime, any paint and/or patch. Our total bid price for this project is S 4,590.00 The above price is good for twenty(20)days. If you have any questions regarding this proposal,please contact the undersigned at your convenience. Sincerely, Troy�Wartinez Troy Martinez ELCOR ELECTRIC Proposal/City of Cupertino/Relocate 400A Breaker 6.25.15 DATE(MM/DDIYY) CORD CERTIFICATE OF LIABILITY INSURANCE 1 6/25/2015 THIS CERTIFICATE IS ISSUED ASA 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(les)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 endorsements. Producer License P,,Tumniner: OA91339 CONTACT NAME: Julie Lon wello A/PHONExt: C 866-966-8928 A FA7No): 405-271-1502 Asetro Insurance Services E-MAIL 200 N.Almaden Bind.,3'd Floor ADDRESS: Sam.Bose,CA 95110 [NSURER(S)AFFORDING COVERAGE NAIIC# INSURED INSURER A: Travelers Property and Casualty 1E➢co>r Electric,Inc. CompanyofAmedca Attn: Clint Woodley INSURER B: Lloyds of London 3310 Bassett Street INSURER C: Santa Clara,CA 95051 INSURER D: INSURER E: COVERAGES CERTIFICATE NUMBER: REVISION No. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM/DD MMIDD EACH OCCURRENCE $ 1,000,000 ®COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000 ❑❑CLAIMS-MADE ®OCCUR PREMISES Ea occurrence) ❑ x DT22-520OR796.14 07.25.2014 07.25.2015 MED EXP(Any on person) $ 5,000 A ❑ PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 ❑POLICY ® PROJECT ❑ LOC $ ❑OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ®ANY AUTO (Ea accident) $ 1,000,000 ❑ALL OWNED AUTOS DT-810.5200R-796.14 07.25.2014 07.25.2015 BODILY INJURY(Per Person) $ A ❑SCHEDULED AUTOS BODILY INJURY(Per Accident) $ ®HIRED AUTOS PROPERTY DAMAGE $ ®NON-OWNED AUTOS (Per accident) ®UMBRELLA LIAB ® OCCUR EACH OCCURRENCE $ 5,000,000 ❑EXCESS LIAR ❑ CLAIMS-MADE AGGREGATE $ 5,000,000 DTSL-KUP-520OR796- 07-25-2014 07.25.2015 A 14 ❑DEDUCTIBLE ®RETENTION $ 10,000 WORKERS COMPENSATION 0 PER STATUTE OTH- AND EMPLOYERS'LIABILITY ER ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 A OFFICERIMEMBERIEXCLUDED7 ❑ N/A DTJUB520OR79614 07-25.2014 07.25.2015 (Mandatory in NH) E.L.DISEASE—EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATION below EL DISEASE—POLICY LIMIT $ 1,000,000 13 Professional Liability-Primary AE141795 10-27-14 10.27-15 LIMIT: $ 2,000,000 AGG: $ 2,000,000 DEDUCTIBLE: Per Claim $ 10,000 13 Professional Liability-Excess AE14024 10-27-14 10.27.15 Limit. $ 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE: Relocate 400A Breaker City of Cupertino is named as Additional Insured per endorsement attached. Insurance is Primary.Waiver of Subrogation applies to General]Liability and Auto per endorsements attached. NOTE:30 DAYS NOTICE OF CANCELLATION INILL BE GIVEN EXCEPT 10 DAYS FOR NON-PAYMENT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS Cit,of Cupertino 10300 Torre Avenue AUTHORIZED REPRESENTATIVE Cupertino,CA 95011 ACORD 25 2014101 The ACORD name and loo are T2istered marcs of ACORD ©1988-2014 ACORD CORPORATION.All rights reserved. INSURED: Elcor Electric COMMERCIAL GENERAL LIABILITY POLICY# DT22-CO5200R796- 14 CG D2 46 08 05 2005 The St Paul Travelers Companies,Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED--(Section II) is amended to include any c) The insurance provided to the additional insured does person or organization that you agree in a "written contract not apply to "bodily injury" or "property damage" requiring insurance"to include as an additional insured on this caused by"your work"and included in the"products- Coverage Part,but: completed operations hazard" unless the "written contract requiring insurance"specifically requires you a) Only with respect to liability for "bodily injury', to provide such coverage for that additional insured, property damage"or"personal injury"; and and then the insurance provided to the additional insured applies only to such"bodily injury"or"property b) If, and only to the extent that, the injury or damage is damage"that occurs before the end of the period of caused by acts or omissions of you or your time for which the "written contract requiring subcontractor in the performance of "your work" to insurance" requires you to provide such coverage or which the "written contract requiring insurance" the end of the policy period,whichever is earlier. applies. The person or organization does not qualify as an additional insured with respect to the 3. The insurance provided to the additional insured by this independent acts or omissions of such person or endorsement is excess over any valid and collectible"other organization. insurance", whether primary, excess, contingent or on any other basis,that is available to the additional insured for a 2. The insurance provided to the additional insured by this loss we cover under this endorsement. However, if the endorsement is limited as follows: "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary a) In the event that the Limits of Insurance of this Coverage and non-contributory basis, this insurance is primary to Part shown in the Declarations exceed the limits of "other insurance"available to the additional insured which liability required by the 'written contract requiring covers that person or organization as a named insured for insurance", the insurance provided to the additional such loss,and we will not share with that"other insurance". insured shall be limited to the limits of liability required But the insurance provided to that additional insured by this by that "written contract requiring insurance". This endorsement still is excess over any valid and collectible endorsement shall not increase the limits of insurance "other insurance", whether primary, excess, contingent or described in Section III—Limits of Insurance. on any other basis, that is available to the additional insured when that person or organization is an additional b) The insurance provided to the additional insured does insured under such"other insurance". not apply to "bodily injury", "property damage" or "personal injury" arising out of the rendering of, or 4. As a condition of coverage provided to the additional failure to render, any professional architectural, insured by this endorsement: engineering or surveying services,including: a) The additional insured must give us written notice as soon i. The preparing, approving, or failing to prepare or as practicable of an "occurrence" or an offense which approve, maps, shop drawings, opinions, reports, may result in a claim. To the extent possible, such surveys, field orders or change orders, or the notice should include: preparing, approving, or failing to prepare or approve,drawings and specifications;and ii. Supervisory, inspection, architectural or engineering activities. COMMERCIAL GENERAL LIBILITY L How, when and where the "occurrence" or offense took place; insured for a loss we cover under this endorsement. ii. The names and addresses of any injured However, this condition does not affect whether the persons and witnesses;and insurance provided to the additional insured by this ili. The nature and location of any injury or endorsement is primary to"other insurance"available damage arising out of the "occurrence" or to the additional insured which covers that person or offense. organization as a named insured as described in paragraph 3.above. b) If a claim is made or"suit"is brought against the additional insured,the additional insured must: 5. The following definition is added to SECTION V. - DEFINITIONS: I. Immediately record the specifics of the claim or"suit"and the date received;and "Written contract requiring insurance"means that part fl. Notify us as soon as practicable. of any written contract or agreement under which you are required to include a person or organization as an c) The additional insured must immediately send us additional insured on this Coverage Part, provided that copies of all legal papers received in connection the "bodily injury" and "property damage" occurs and with the claim or"suit" cooperate with us in the the "personal injury" is caused by an offense investigation or settlement of the claim or committed: defense against the "suit"and otherwise comply with all policy conditions. a. After the signing and execution of the contract or agreement by you, d) The additional insured must tender the defense b. While that part of the contract or and indemnity of any claim or "suit" to any agreement is in effect;and provider of other insurance"which would cover c. Before the end of the policy period. the additional Policy No:DT-8i 0-520OR-796-14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ 17 CAREFULLY. BUSINESS ALTFO EXTENSION ENDORSEMENT This ondorc,,onment mzd�.ifijez insu munce pravided undor the fullo-wing, BU&NESS AUTO COVERAGE FORM pect to =h,0rQgcj1UAyId0d b)j the jplu&iLwx�uf Itie. Puran apply ufilcsi mondi- fied bj,+tfic undar-serricul- OENERAL DESCRIPT ION OF COVERACE-This enifor,-,erman't hrcmdenz cvir-.m-j!;e_ cowerage for a-ire injuri., damage or medicall expanses desmbed in any of, the pny4zions of th5iz, my be ewcludad or V""Trikbad bre{avicfte,-endcinserrant to *ate Grivewage Fa;t,and these ccvemq_e tmadening ppLivisions do not apply,to the a7dan't thatcovera-ga,is,excluded or If-mited tysuch azi andomserm-wit, The fcI[vAirjr;j Visling is a geznerall cvw- a0e desuiption only. Lirmnifatmns and excfuSiQRZMil y 3P.PIV rEJ th'55E,, wmragea_Ruad af;1 khe pro,.4sjons of this hPan- �rf,u rsam-pn"4 and Je m�st of yi;jA;.pulicy mvOury tzlde-Zimr mn,I ne vfqh'Us,dutleg, snag wha.I � k i5 and,is ric.irm?vF-TFz1% A. BROAD FORM NAMED INSURED H, HIORE13 AU70 PHYSICAL DAMAGE - LOSS OF USIF-MIREASED LI&99T 9. SLAN KET A01331110NJAL IN-SURS-D J. PHYSICAL DAMAO- 15 - TRAN$F0RT,9ff1ON EXPENSES-P1 fR ASIED LIMIT C. ENT-PLOYEE HIRED AUTO J. PERSONAL EFFECTS 0, EMPLOYEES AS J USURED AgREAGS E. SUPPO [EMENTARY PAYMENTS - INCREASED L KOTItE AND, KNOWLEDOE OF ACCIDENT LjmqTS OR LOSS -F. HIRED AUTO - RJEVED 'kNORLDWIDE M. SLM49ET WAWE OFSU,BRUCTATION COVERAGE-INDEL9NffV'9A31Z 10. VVAIVER OF iDEDUCTISLE-04A 55 N. UNINTENTIONAL Ir 11 OR 0MUSSIGNS A, BROAD FORM NAMED INSURED expeute.d by to b0avp, !the `boOl ly lrjjry" or Tho fellop4mg is added to Par-agraph A.1-, Who [Is "pmpz�:tty d".gen otmirs and €imat fts Jn 0114EA- dv�ngfhmq pqEcy �n be namt,9das n An Insured, o�SECTION It ­LIABIM COV- . a add�- ERAGE, 0-mal irwspured is an 'imumd' lbrr Uabflty Ccvg­ Any otgardz2tiun ga� but Only fcjr darnZ3�',l Ir,whichtbi�s imuran,rz you nvaity ar;qg4re or form dur- applies and Only to 1 , exterd of.al pomon or or- Ing the poficy pariod] veer whl&i p,ou miidntain ganization qualiffes as an oimuredl' undes ffilp 50% or mr oru vonersair} intereal iniad lharriG mal &qho i13 pin Iriwmd pTavition cznWned in Se lion separrilely Irmved far Susimess ALL0 C-twerage. fl. Caverago, undur Mi8 piowr2lon is arfutdud only un- III tha 1801 h day after wju =quirz, ar roran the or- g; r- C. EUPLOYEE WREID AUTO glanizaL�,cn or 6m,arid of ft pol_'r pQfj0d �Qhje. 1. TIhe t611ovihg Is added to Pamgra-ph A.1- evar IV,eerbor. 'Who Is An Rmumd. of SECT[OVA [II - Li!- S_ BLANKET A0313910DIAL IN SURD ABNUITY;CV%vERAGE-. The fanovofnq i� added in Paragraph u, in AA, An Imployce.-L" of yotkrs is an "Insured' while Who Its An Inswed, of SECTM 11- LIARILWY operating an eau to" faired -or rented under a COVEIRAGE: wratact Or ,Vg u -mart in; thal rt,uma,'Odlh your 00=1&2 lon, while Pw"ar mr Ing Arty pa-mon or orprimfion P,0*Es mqiVrad under duS2s Mated lo 111he conduclof ytmm bmtl- u%wiztmn cn,ntract or agrictunnool betv"mi yuu and MSS. Mat parson or oNganizwtion., that, Is sirgrtcd and CA T3 53 0310 (9 Zjlct rho lnjorrmll,,p7 CoInpry, MIL!ENO sir�nwlzftww wilt i b COMMERCIAL AUTO M. BLANKET WAIVER OF SUBROGATION such contract. The waiver applies only to the The following replaces Paragraph A.S., Transfer person or organization designated in such Of Rights Of Recovery Against Others To Us, contract. of SECTION IV - BUSINESS AUTO CONDI- N. UNINTENTIONAL ERRORS OR OMISSIONS TIONS: The following is added to Paragraph E.2., Con- s. Transfer Of Rights Of Recovery Against cealement, Misrepresentation, Or f=raud, of Others To Us SECTION IV-BUSINESS AUTO CONDITIONS: We waive any right of recovery we may have The unintentional omission of, or unintentional against any person or organization to the ex- error in, any information given by you shall not tent required of you by a written contract prejudice your rights under this insurance. How- signed and executed prior to any "accident" or ever this provision does not affect our right to col- "loss", provided that the "accident" or 'loss" lect additional premium or exercise our right of arises out of operations contemplated by cancellation or non-renewal. ©2010 The Travelers Indemnity Company. CA T3 53 03 10 Includes copyrighted material of Insurance Services Office,Inc.with its permission. INSURED: Elcor Electric,Inc. POLICY 9 DT22-CO5200R795.14 by any ordinance, law or building code to include (11)A manager of any limited liability as an additional insured on this Coverage Part is company; or an insured, but only with respect to liability for (iii)An executive officer or director of "bodily injury""property damage""personal in- any other organization; jury"or that is your partner, joint venture member or manager;or The insurance provided to such state or political (b)Any"employee"authorized by such subdivision does not apply to: partnership, joint venture, limited li- s.Any"bodily injury, ability company or other organization sonal injury" or"advertising injury" arising out to give notice of an "occurrence" or of operations performed for that state or po- offense. (3)Notice to us of such"occurrence"or of an b.Any"bodily injury" or"property damage" in- offense will be deemed to be given as cluded in the"products-completed operations soon as practicable if it is given in good faith as soon as practicable to your work- J. KNOWLEDGE AND NOTICE OF OCCUR-RENCE ers' compensation insurer. This applies OR OFFENSE only if you subsequently give notice to us The following is added to Paragraph 2., Duties In of the "occurrence" or offense as soon as The Event of Occurrence, Offense, Claim or practicable after any of the persons de- Suit, of SECTION IV — COMMERCIAL GEN- scribed in Paragraphs e. (1) or(2) above ERAL LIABILITY CONDITIONS: discovers that the "occurrence" or offense may result in sums to which the insurance a. above, but only for the purposes of the in- provided under this Coverage Part may apply. surance provided under this Coverage Part to you or any insured listed in Paragraph 1.or 2. However, if this Coverage Part includes en- you tor that provides coverage for of Section II—Who Is An Insured: "property damage"or pollution"bodily injury"or (1) Notice to us of such "occurrence" or of- costs arising out of a discharge, release or es- fense must be given as soon as practica- cape of"pollutants"which contains a requirement ble only after the "occurrence" or offense that the discharge, release or escape of "pollut- is known by you (if you are an individual), ants" must be reported to us within a specific any of your partners or members who is number of days after its abrupt commencement, an individual (if you are a partnership or this Paragraph e. does not affect that require- joint venture), any of your managers who ment. is an individual (if you are a limited liability K UNINTENTIONAL OMISSIONcompany), any of your"executive officers" or directors (if you are an organiza-tion The following is added to Paragraph 6., Repre- other than a partnership, joint venture or limited liability company) or any "em- GENERAL LIABILITY CONDITIONS: ployee" authorized by you to give notice of The unintentional omission of, or unintentional an"occurrence"or offense. error in, any information provided by you which we (2) If you are a partnership,joint venture or relied upon in issuing this policy will not prejudice limited liability company, and none of your your rights under this insurance. However, this partners, joint venture members or man- provision does not affect our right to collect agers are individuals, notice to us of such additional premium or to exercise our rights of "occurrence" or offense must be given as cancellation or nonrenewal in accordance with soon as practicable only after the "occur- applicable insurance laws or regulations. rence"or offense is known by: L. BLANKET WAIVER OF SUBROGATION (a)Any individual who is: The following is added to Paragraph 9., Transfer (I)A partner or member of any part- Of Rights Of Recovery Against Others To Us, nership or joint venture; of SECTION IV — COMMERCIAL GENERAL LI- ABILITY CONDITIONS: If the insured has agreed in a contract or agree- 3. "Bodily injury" means bodily injury, mental ment to waive that insured's right of recovery anguish, mental injury, shock,'fright, disability, against any person or organization, we waive our humiliation, sickness or disease sustained by right of recovery against such person or organiza- a person, including death resulting from any of tion, but only for payments we make because of: these at any time. a. "Bodily injury" or N.CONTRACTUAL LIABILITY—RAILROADS 1. The following replaces Paragraph c. of the b. "Personal injury" or definition of"insured contract" in the DEFINI- caused by an offense that is committed; TIONS Section: subsequent to the execution of that contract or c.Any easement or license agreement; agreement. 2. Paragraph f.(1) of the definition of"insured M.AMENDED BODILY INJURY DEFINITION contract"in the DEFINITIONS Section is de- The following replaces the definition of "bodily leted. injury"in the DEFINITIONS Section: WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03.76(A)— POLICY NUMBER: DT-J-UB-5200R79-6-14 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA (BLANKET WAIVER) . We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. The additional premium for this endorsement shall be%.300 of the California workers'compensation pre- mium. Schedule Person or Organization Job Description ANY PERSON OR ORGANIZATION FROM WHOM BLANKET WAIVER OF SUBROGATION THE NAME® INSURE® HAS AGREE® 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 07/25/2014 Policy No DT-J-UB-52001x79-6-14. Endorsement No. Insured Premium Insurance Company: Travelers Property&Casualty Countersigned by