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Backup Documents 07/11/2017 Item #16C 3 (Coastal Concrete Products) ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 6 C THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATUI Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the Cou ' ®y Office at the time the item is placed on the agenda. All completed routing slips and original documents must VIE Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the documercl iH alrladr cgate to with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward`llo`tfe County Attorney 0 ice. Route to Addressee(s) (List in routing order) Off ce •� sOia" Date j �.�/ 1. Risk Risk Management �_ 2. County Attorney Office County Attorney Office 7/rr) 4. BCC Office Board of County Commissioners 4/ ' ( 6\ 4. Minutes and Records Clerk of Court's Office ` ( ( q' 3'.04P M 5. Procurement Services Procurement Services PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,may need to contact staff for additional or missing information. Name of Primary Staff Barbara Lance for Swain Hall Contact Information 239-252-8998 Contact/ Department Agenda Date Item was July 11,2017 / Agenda Item Number 16.C.3 Approved by the BCC V / Type of Document Contract / Number of Original �Y ri Attached ✓✓✓ Documents Attached PO number or account N/A 17-7021 Hammerhead Bradanna c,Coa al number if document is &Designated Driveway "oncrete Produc to be recorded Construction : +' I ers, Mitchell&Stark Construction,SW Division INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Appli abJj) 1. Does the document require the chairman's original signature STAMP OK $L� i r r`�1— 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be BL signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's BL signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 07/11/2017 and all changes made during the meeting have been incorporated in the attached document. The County �yn�► Attorney's Office has reviewed the changes,if applicable. 'ly 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for the Chairman's signature. 16C3 MEMORANDUM Date: July 19, 2017 To: Barbara Lance for Swain Hall Procurement Services From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Contract #17-7021 "Hammerhead & Designated Driveway Construction" Contractor: Coastal Concrete Products Attached for your records is one (1) original of the referenced contract above, (Item #16C3) adopted by the Board of County Commissioners on Tuesday, July 11, 2017. The Board's Minutes & Records Department has kept an original as part of the Board's Official Records. If you have any questions, please feel free to contact me at 252-7240. Thank you. Attachment 16C3 AGREEMENT 16-7021 for Hammerhead and Designated Driveway Construction THIS AGREEMENT is made and entered into this l i day of , 2017, by and between the Board of County Commissioners for Collier County, Florida, a politi I subdivision of the State of Florida (hereinafter referred to as the "County" or "Owner") and Coastal Concrete Products, LLC dba Coastal Site Development., authorized to do business in the State of Florida, whose business address is 7742 Alico Road, Fort Myers, Florida 33912 (hereinafter referred to as the "Contractor"). WITNESSETH: 1. TERM AND COMMENCEMENT. The Agreement shall be for a two (2) year period, commencing on the date of Board approval and terminating two (2) years from that date or until such time as all outstanding Work Orders issued prior to the expiration of the Agreement period have been completed or terminated. The Contractor shall commence the Work upon issuance of a Notice to Proceed or as specified in a Work Order. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all the terms and conditions contained in this Agreement for an additional, two (2) year period. The County shall give the Contractor written notice of the County's intention to renew the Agreement term prior to the end of the Agreement term then in effect. The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred eighty (180) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term prior to the end of the Agreement term then in effect. 2. STATEMENT OF WORK. The Board of County Commissioners deemed five (5) firms to be qualified and awarded an Agreement to each firm. Each awardee will enter into an Agreement to provide complete services for hammerheads or designated driveways on an as-needed basis as may be required by the Owner in accordance with the terms and conditions of Invitation to Bid (ITB) #16-7021 and the Contractor's proposal, which is incorporated by reference and made an integral part of this Agreement. Category I: Hammerheads Category II: Designated Driveways Bradanna, Inc. Bradanna, Inc. Southwest Division, Inc. Southwest Division, Inc. Mitchell & Stark Construction Co., Inc. Mitchell & Stark Construction Co., Inc. Coastal Concrete Products, LLC dba Coastal Site Coastal Concrete Products, LLC dba Coastal Site Development Development Heritage Builders N/A Page-1- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Develo nt. 16C 3 2.1 The execution of this Agreement shall not be a commitment to the Contractor that any Work will be awarded to the Contractor. Rather, this Agreement governs the rights and obligation of the procedure to obtain Work and all Work undertaken by Contractor for Owner pursuant to this Agreement during the term and any extension of the term of this Agreement. Any County Agency may utilize the services offered under this Agreement, provided sufficient funds are included in the budget(s). 2.2 Price Quote Procedures: The Contractor will provide a price quote and project schedule for each project within ten (10) business days of receiving the information about the services from the County's Project Manager. The price quote procedure to be followed will be determined by the value of the project. Procedures for projects with a value of$250,000 or less are as follows: • Quotations shall be solicited from all of the Contractors. • Contractor shall respond with the information and/or proposal sought within ten (10) business days. • For projects over$200,000 - Payment and Performance Bonds will be required and shall be provided within ten (10) business days after notification of award. • Issuance by Owner of a numbered Work Order, approval by the Division Director is required. Procedures for projects with a value of$250,000 to $750,000 are as follows: • Quotations shall be solicited from all of the Contractors. Completion time and the collection of liquidated damages may be specified in the Quotations. • Payment and Performance Bonds will be required and shall be provided within ten (10) business days after notification of award. • Contractor(s) shall respond with the information and/or proposal sought within ten (10) business days. • Issuance by Owner of a numbered Work Order; approval is required by the Department Head, County Attorney, and Board of County Commissioners. The Project Manager will award the Work to the Contractor that submits the lowest responsive quote and the successful firm will receive a Work Order for the Work. This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Contractor and the County Project Manager or his designee, in compliance with the Procurement Ordinance, as amended and Procurement Procedures in effect at the time such services are authorized. 3. THE AGREEMENT SUM. The Owner shall pay the Contractor for the performance of the Work pursuant to the quoted price offered by the Contractor in the response to a specific Request for Quotation and pursuant to the Price Methodology in Section 3.1. Page-2- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16C 3 3.1 Price Methodology: Lump Sum (Fixed Price): A firm fixed total price offering for a project; the risks are transferred from the County to the contractor; and, as a business practice there are no hourly or material invoices presented, rather, the contractor must perform to the satisfaction of the County's project manager before payment for the fixed price contract is authorized. 4. NOTICES. All notices required or made pursuant to this Agreement to be given by the County to the Contractor shall be made in writing and shall be delivered by hand, by fax, e-mail, or by the United States Postal Service Department, first class mail service, postage prepaid, addressed to the following Contractor's address of record: Coastal Concrete Products, LLC dba Coastal Site Development 7742 Alico Road Fort Myers, Florida 33912 Phone: 239-208-4079; Fax: 239-334-1399 Attn: David E. Torres, Manager Email: dtorres@coastalconcreteprod.com All notices required or made pursuant to this Agreement to be given by the Contractor to the County shall be in writing and shall be delivered by hand, by fax, e-mail, or by United States Postal Service Department, first class mail service, postage prepaid, addressed to the following County's address of record: Board of County Commissioners for Collier County, Florida c/o Public Utilities Solid & Hazardous Waste Management Division 3339 Tamiami Trail East, Suite 302 Naples, Florida 34112 Telephone: 239-252-5337 Attention: Dayne Atkinson, Project Manager Email: DayneAtkinson(a�colliergov.net The Contractor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Service Agreement must be in writing. 5. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. 6. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, Florida Statutes, all permits necessary for the prosecution of the Work shall be obtained by the Contractor. Payment for all such permits issued by the County shall be processed internally by the County. Contractor is not responsible for paying for permits issued by Collier County, but is responsible for acquiring all permits. Owner may require the Contractor to deliver internal budget transfer documents to applicable Collier county agencies when the Contractor is acquiring permits. All permits, fees and licenses necessary for the prosecution of the Work which are not issued by Collier County shall be acquired and paid for by the Contractor. Owner will not be obligated to pay Page-3- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16C 3 for any permits obtained by Subcontractors. Contractor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. 7. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to use in any manner whatsoever, county facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the Agreement of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. 8. TERMINATION. With respect to this Agreement, should the Contractor be found to have failed to perform Contractor services in a manner satisfactory to the County and requirements of this Agreement, the County may terminate said Agreement for cause; further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be sole judge of non-performance. 9. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 10. INSURANCE. The Contractor shall provide insurance as follows: A. Commercial General Liability: Coverage shall have minimum limits of $1,000,000 Per Occurrence, $2,000,000 aggregate, for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent contractors; Products and Completed Operations and Contractual Liability. B. Business Auto Liability: Coverage shall have minimum limits of $1,000,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include Owned Vehicles, Hired and Non-Owned Vehicles and Employee Non- Ownership. C. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of$1,000,000 for each accident. Special Requirements: Collier County Board of County Commissioners, Board of County Commissioners in Collier County, or Collier County Government shall be listed as the Certificate Holder and included as an Additional Insured on the Comprehensive General Liability. Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. Renewal certificates shall be sent to the County ten (10) days prior to any expiration date. There shall be a thirty (30) day notification Page-4- #16-7021 "Hammerhead and Designated Driveway Construction' Contractor:Coastal Concrete dba Coastal Site Development. 0 16C 3 to the County in the event of cancellation or modification of any stipulated insurance coverage. All insurance coverages of the Contractor shall be primary to any insurance or self-insurance program carried by the County, and the "Other Insurance" provisions of any policies obtained by the Contractor shall not apply to any insurance or self-insurance program carried by the County. Contractor shall ensure that all subcontractors comply with the same insurance requirements that Contractor is required to meet. The ame Contractor shall provide County with certificates of insurance meeting the required insurance provisions. 11. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Contractor shall defend, indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Contractor or anyone employed or utilized by the Contractor in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 11.1 The duty to defend under this Article 11 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Contractor, Owner and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Contractor. Contractor's obligation to indemnify and defend under this Article 11 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the Owner or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. 12. BONDS. A. When a construction project is in excess of $200,000, the Contractor shall be required to provide Payment and Performance Bonds. B. When required by Owner, the Contractor shall furnish a Performance and/or Payment Bond prior to commencing performance, for the full amount of the Work, which shall act as a security guaranteeing the performance of the Contractor's work and the payment by the Contractor to any other party (ies) providing labor and/or materials in connection with each construction or renovation project performed by the Contractor. The bonds shall be furnished using the forms prescribed in Exhibit "A". C. If the surety for any bond furnished by Contractor is declared bankrupt, becomes insolvent, its right to do business in the State of Florida, or it ceases to meet the requirements imposed by the Contract Documents, the Contractor shall, within five (5) calendar days thereafter, substitute another bond and surety, both of which shall be subject to the Owner's approval. Page-5- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 0 16C 3 13. PAYMENTS. Generally, the Contractor will be paid upon completion; however, for Work in excess of thirty (30) days, the Contractor may indicate on the response to the Request for Quotation wishes to receive Progress Payments. Subsequent to the first payment, Contractor must provide Owner with a fully executed Release and Affidavit in the form attached hereto as Exhibit "B" as a condition precedent to release of each progress payment. All applications for payment, whether for full payment or a progress payment shall be in writing, and in substantially the form attached hereto as Exhibit "C." 14. PAYMENTS WITHHELD. Owner may decline to approve any Application for Payment, or portions thereof, because of defective or incomplete work, outstanding punchlist items, subsequently discovered evidence or subsequent inspections. The Owner may nullify the whole or any part of any approval for payment previously issued and Owner may withhold any payments otherwise due Contractor under this Agreement or any other Agreement between Owner and Contractor, to such extent as may be necessary in the Owner's opinion to protect it from loss because of: (a) defective Work not remedied; (b) third party claims failed or reasonable evidence indicating probable fling of such claims; (c) failure of Contractor to make payment properly to subcontractors or for labor, materials or equipment; (d) reasonable doubt that the Work can be completed for the unpaid balance of the Contract Amount; (e) reasonable indication that the Work will not be completed within the Contract Time; (f) unsatisfactory prosecution of the Work by the Contractor; or (g) any other material breach of the Contract Documents. If any conditions described above are not remedied or removed, Owner may, after three (3) days written notice, rectify the same at Contractor's expense. Owner also may offset against any sums due Contractor the amount of any liquidated or unliquidated obligations of Contractor to Owner, whether relating to or arising out of this Agreement or any other Agreement between Contractor and Owner. 15. SUBMITTALS AND SUBSTITUTIONS. Any substitution of products/materials from specifications shall be approved in writing by Owner in advance. 16. CONTRACT TIME AND TIME EXTENSIONS. A. Time is of the essence in the performance of any Work under this Agreement and Contractor shall diligently pursue the completion of the Work and coordinate the Work being done on the Project by its subcontractors and materialmen, as well as coordinating its Work with all work of others at the Project Site, so that its Work or the work of others shall not be delayed or impaired by any act or omission by Contractor. Contractor shall be solely responsible for all construction means, methods, techniques, sequences, and procedures as well as coordination of all portions of the Work under the Contract Documents, and the coordination of Owner's supplies and contractors. B. Should Contractor be obstructed or delayed in the prosecution of or completion of the Work as a result of unforeseeable causes beyond the control of Contractor, and not due to its fault or neglect, including but not restricted to acts of Nature or of the public enemy, acts of Government, fires, floods, epidemics, quarantine regulation, strikes or lockouts, Contractor shall notify the Owner in writing within forty-eight (48) hours after the commencement of such delay, stating the cause or causes thereof, or be deemed to have waived any right which Contractor may have had to request a time extension. C. No interruption, interference, inefficiency, suspension or delay in the commencement or progress of the Work from any cause whatever, including those for which Owner may Page-6- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 0 16 C 3 be responsible, in whole or in part, shall relieve Contractor of his duty to perform or give rise to any right to damages or additional compensation from Owner. Contractor expressly acknowledges and agrees that it shall receive no damages for delay. Contractor's sole remedy, if any, against Owner will be the right to seek an extension to the Contract Time; provided, however, the granting of any such time extension shall not be a condition precedent to the aforementioned "No Damage for Delay" provision. This paragraph shall expressly apply to claims for early completion, as well as to claims based on late completion. 17. CHANGES IN THE WORK. Owner shall have the right at any time during the progress of the Work to increase or decrease the Work. Promptly after being notified of a change, Contractor shall submit an estimate of any cost or time increases or savings it foresees as a result of the change. Except in an emergency endangering life or property, or as expressly set forth herein, no addition or changes to the Work shall be made except upon written order of Owner, and Owner shall not be liable to the Contractor for any increased compensation without such written order. No officer, employee or agent of Owner is authorized to direct any extra or changed work orally. Any modifications to this Agreement shall be in compliance with the County's Procurement Ordinance and Procurement Procedures in effect at the time such modifications are authorized. A Change Order in the form attached as Exhibit "D" to this Agreement, shall be issued and executed promptly after an Agreement is reached between Contractor and Owner concerning the requested changes. Contractor shall promptly perform changes authorized by duly executed Change Orders. The Contract Amount and Contract Time shall be adjusted in the Change Order in the manner as Owner and Contractor shall mutually agree. 18. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to this contract in accordance with the Procurement Ordinance, as amended, and Procurement Procedures. 19. COMPLIANCE WITH LAWS. The Contractor agrees to comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements applicable to the Project, including but not limited to those dealing with taxation, workers' compensation, equal employment and safety (including, but not limited to, the Trench Safety Act, Chapter 553, Florida Statutes, and the Florida Public Records Law Chapter 119, including specifically those contractual requirements in F.S. § 119.0701(2)(a)-(b) as stated as follows: IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Communication and Customer Relations Division 3299 Tamiami Trail East, Suite 102 Naples, FL 34112-5746 Telephone: (239) 252-8383 Page-7- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. ioc 3 The Contractor must specifically comply with the Florida Public Records Law: 1. Keep and maintain public records required by the public agency to perform the service. 2. Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by laW for the duration of the contract term and following completion of the contract if the Contractor does not transfer the records to the public agency. 4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the Contractor or keep and maintain public records required by the public agency to perform the service. If the Contractor transfers all public records to the public agency upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. If Contractor observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Contractor to comply with the laws referenced herein shall constitute a breach of this Agreement and the County shall have the discretion to unilaterally terminate this Agreement immediately. 20. CLEAN UP. Contractor agrees to keep the Project site clean at all times of debris, rubbish and waste materials arising out of the Work. At the completion of the Work, Contractor shall remove all debris, rubbish and waste materials from and about the Project site, as well as all tools, appliances, construction equipment and machinery and surplus materials, and shall leave the Project site clean and ready for occupancy by Owner. 21. ASSIGNMENT. Contractor shall not assign this Agreement or any part thereof, without the prior consent in writing of Owner. If Contractor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Contractor all of the obligations and responsibilities that Contractor has assumed toward Owner. 22. ORDER OF PRECEDENCE. In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the ITB, the Contractor's Proposal, and/or the County's Board approved Executive Summary, the Contract Documents shall take precedence. 23. WARRANTY. Contractor shall obtain and assign to Owner all express warranties given to Contractor or any subcontractors by any materialmen supplying materials, equipment or fixtures to be incorporated into the Project. Contractor warrants to Owner that any materials and equipment furnished under the Contract Documents shall be new unless otherwise Page-8- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 0 16C 3 specified, and that all Work shall be of good quality, free from all defects and in conformance with the Contract Documents. Contractor further warrants to Owner that all materials and equipment furnished under the Contract Documents shall be applied, installed, connected, erected, used, cleaned and conditioned in accordance with the instructions of the applicable manufacturers, fabricators, suppliers or processors except as otherwise provided for in the Contract Documents. If, within one (1) year after final completion, any Work is found to be defective or not in conformance with the Contract Documents, Contractor shall correct it promptly after receipt of written notice from Owner. Contractor shall also be responsible for and pay for replacement or repair of adjacent materials or Work which may be damaged as a result of such replacement or repair. These warranties are in addition to those implied warranties to which Owner is entitled as a matter of law. 24. STANDARDS OF CONDUCT: PROJECT MANAGER, SUPERVISOR, EMPLOYEES. The Contractor shall employ people to work on County projects who are neat, clean, well-groomed and courteous. Subject to the American with Disabilities Act, Contractor shall supply competent employees who are physically capable of performing their employment duties. The County may require the Contractor to remove an employee it deems careless, incompetent, insubordinate or otherwise objectionable and whose continued employment on Collier County projects is not in the best interest of the County. 25. TESTS AND INSPECTIONS. If the Contract Documents or any codes, laws, ordinances, rules or regulations of any public authority having jurisdiction over the Project requires any portion of the Work to be specifically inspected, tested or approved, Contractor shall assume full responsibility therefore, pay all costs in connection therewith and furnish to the Owner the required certificates of inspection, testing or approval. All inspections, tests or approvals shall be performed in a manner and by organizations acceptable to the Owner. This will include any and all tests and inspections required by local, county or state permitting agencies, and those specifically required for hammerheads and designated driveways, such as, but not limited to, densities, core samples, sump tests, etc. 26. PROTECTION OF WORK. A. Contractor shall fully protect the Work from loss or damage and shall bear the cost of any such loss or damage until final payment has been made. If Contractor or anyone for whom Contractor is legally liable is responsible for any loss or damage to the Work, or other work or materials of Owner or Owner's separate contractors, Contractor shall be charged with the same, and any monies necessary to replace such loss or damage shall be deducted from any amounts due Contractor. B. Contractor shall not load nor permit any part of any structure to be loaded in any manner that will endanger the structure, nor shall Contractor subject any part of the Work or adjacent property to stresses or pressures that will endanger it. C. Contractor shall not disturb any benchmark established by the Owner with respect to the Project. If Contractor, or its subcontractors, agents or anyone, for whom Contractor is legally liable, disturbs the Owner's benchmarks, Contractor shall immediately notify Owner. The Owner shall re-establish the benchmarks and Contractor shall be liable for all costs incurred by Owner associated therewith. Page-9- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 0 16 C 3 ' 27. EMERGENCIES. In the event of any emergency affecting the safety or protection of persons or the Work or property at the Project site or adjacent thereto, Contractor, without special instruction or authorization from Owner is obligated to act to prevent threatened damage, injury or loss. Contractor shall give the Owner written notice within forty-eight (48) hours after the occurrence of the emergency, if Contractor believes that any significant changes in the Work or variations from the Contract Documents have been caused thereby. If the Owner determines that a change in the Contract Documents is required because of the action taken in response to an emergency, a Change Order shall be issued to document the consequences of the changes or variations. If Contractor fails to provide the forty-eight (48) hour written notice noted above, the Contractor shall be deemed to have waived any right it otherwise may have had to seek an adjustment to the Contract Amount or an extension to the Contract Time. 28. COMPLETION. When the entire Work (or any portion thereof designated in writing by Owner) is ready for its intended use, Contractor shall notify Owner in writing that the entire Work (or such designated portion) is substantially complete and request that Owner issue a Certificate of Substantial Completion. Within a reasonable time thereafter, Owner and Contractor shall make an inspection of the Work (or designated portion thereof) to determine the status of completion. If Owner does not consider the Work (or designated portion) substantially complete, the Owner shall notify Contractor in writing giving the reasons therefor. If Owner considers the Work (or designated portion) substantially complete, Owner shall prepare and deliver to Contractor a Certificate of Substantial Completion, Exhibit E, which shall fix the date of Substantial Completion for the entire Work (or designated portion thereof) and include a tentative punchlist of items to be completed or corrected by Contractor before final payment. Owner shall have the right to exclude Contractor from the Work and Project site (or designated portions thereof) after the date of Substantial Completion, but Owner shall allow Contractor reasonable access to complete or correct items on the tentative punchlist. Upon receipt of written certification by Contractor that the Work is completed in accordance with the Contract Documents and is ready for final inspection and acceptance, Owner will make such inspection and, if Owner finds the Work acceptable and fully performed under the Contract Documents, Owner shall promptly issue a Certificate of Final Completion, Exhibit F, recommending that on the basis of Owner's observations and inspections, and the Contractor's certification that the Work has been completed in accordance with the terms and conditions of the Contract Documents, that the entire balance found to be due Contractor is due and payable. Final payment shall not become due and payable until Contractor submits: (1) The Release and Affidavit in the form attached as Exhibit B. (2) Consent of Surety (if applicable) to final payment. (3) If required by Owner, other data establishing payment or satisfaction of all obligations, such as receipt, releases and waivers of liens, arising out of the Contract Documents, to the extent and in such form as may be designated by Owner. (4) The Warranty in the form attached as Exhibit G. Page-10- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 0 16C 3 Owner reserves the right to inspect the Work and make an independent determination as to the acceptability of the Work. Unless and until the Owner is completely satisfied, the final payment shall not become due and payable. 29. LIQUIDATED DAMAGES. The "Commencement Date" shall be established in the Notice to Proceed to be issued by the Owner. Contractor shall commence the work within five (5) calendar days from the Commencement Date. No Work shall be performed at the Project site prior to the Commencement Date. Any Work performed by Contractor prior to the Commencement Date shall be at the sole risk of Contractor. The Work shall be substantially completed within the time specified in the Request for Quotation. The date of substantial completion of the Work (or designated portions thereof) is the date certified by the Owner when construction is sufficiently complete, in accordance with the Contract Documents, so Owner can occupy or utilize the Work (or designated portions thereof) for the use for which it is intended. The Work shall reach final completion and be ready for final acceptance by Owner within the time specified in the Request for Quotation. Owner and Contractor recognize that since time is of the essence for any work under this Agreement, Owner will suffer financial loss if the Work is not substantially completed within the time specified in the Request for Quotation. Should Contractor fail to substantially complete the Work within the specified time period, Owner shall be entitled to assess as liquidated damages, but not as a penalty, the amount specified in the Request for Quotation for each calendar day thereafter until substantial completion is achieved. The Project shall be deemed to be substantially completed on the date the Owner issues a Certificate of Substantial Completion pursuant to the terms hereof. Contractor hereby expressly waives and relinquishes any right which it may have to seek characterize the above noted liquidated damages as a penalty, which the parties agree represents a fair and reasonable estimate of the Owner's actual damages at the time of contracting if Contractor fails to substantially complete the Work in a timely manner. When any period of time is referenced by days herein, it shall be computed to exclude the first day and include the last day of such period. If the last day of any such period falls on a Saturday or Sunday or on a day made a legal holiday by the law of the applicable jurisdiction, such day shall be omitted from the computation, and the last day shall become the next succeeding day which is not a Saturday, Sunday or legal holiday. 30. AGREEMENT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Solid & Hazardous Waste Management Division. 31. COMPONENT PARTS OF THIS AGREEMENT. This Agreement consists of the attached or referenced component parts, all of which are as fully a part of the Agreement as if herein set out verbatim, including: Contractor's Proposal, Insurance Certificate(s), ITB No. 16-7021, any addenda, any Quotation/Work Order made or issued pursuant to this Agreement, and any related plans or specifications for any such Quotations or Work Orders. Page-11- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 0 16C3 32. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, as amended, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any contract held by the individual and/or firm for cause. 33. SUBJECT TO APPROPRIATION. It is further understood and agreed, by and between the parties herein that this Agreement is subject to appropriation by the Board of County Commissioners. 34. SALES TAX. Contractor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. No markup shall be applied to sales tax. 35. IMMIGRATION LAW COMPLIANCE. By executing and entering into this Agreement, the Contractor is formally acknowledging without exception or stipulation that it is fully responsible for complying with the provisions of the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended. Failure by the Contractor to comply with the laws referenced herein shall constitute a breach of this Agreement and the County shall have the discretion to unilaterally terminate this Agreement immediately. 36. VENUE. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters. 37. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful proposer extending the pricing, terms and conditions of this solicitation or resultant Agreement to other governmental entities at the discretion of the successful proposer. 38. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall remain in effect. 39. SECURITY. The Contractor is required to comply with County Ordinance 2004-52, as amended. Background checks are valid for five (5) years and the Contractor shall be responsible for all associated costs. If required, Contractor shall be responsible for the costs of providing background checks by the Collier County Facilities Management Division for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence and employment Page-12- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 0 ioC3 verifications and other related records. Contractor shall be required to maintain records on each employee and make them available to the County for at least four(4) years. All of Contractor's employees and subcontractors must wear Collier County Government Identification badges at all times while performing services on County facilities and properties. Contractor ID badges are valid for one (1) year from the date of issuance and can be renewed each year at no cost to the Contractor during the time period in which their background check is valid, as discussed below. All technicians shall have on their shirts the name of the contractor's business. The Contractor shall immediately notify the Collier County Facilities Management Division via e-mail (DL-FMOPS@colliergov.net) whenever an employee assigned to Collier County separates from their employment. This notification is critical to ensure the continued security of Collier County facilities and systems. Failure to notify within four (4) hours of separation may result in a deduction of$500 per incident. 40. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. The negotiation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached during negotiations to County for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by representatives of Contractor with full decision- making authority and by County's staff person who would make the presentation of any settlement reached at mediation to County's board for approval. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. 41. SAFETY. All contractors and subcontractors performing service for Collier County are required and shall comply with all Occupational Safety and Health Administration (OSHA), State and County Safety and Occupational Health Standards and any other applicable rules and regulations. Also all Contractors and subcontractors shall be responsible for the safety of their employees and any unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site. Collier County Government has authorized the Occupational Safety and Health Administration (OSHA) to enter any Collier County Facility, property and/or right-of-way for the purpose of inspection of any Contractor's work operations. This provision is non-negotiable by any department/division and/or Contractor. All applicable OSHA inspection criteria apply as well as all Contractor rights, with one exception. Contractors do not have the right to refuse to allow OSHA onto a project that is being performed on Collier County Property. Collier County, as the owner of the property where the project is taking place shall be the only entity allowed to refuse access to the project. However, this decision shall only be made by Collier County's Risk Management Division Safety Manager and/or Safety Engineer. Page-13- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 0 1 C 3 IN WITNESS WHEREOF, the Contractor and the County, have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date and year first above written. BOARD OF COUNTY COMMISSIONERS ATTEST: . COLLIE'. C # Y, FLORIDA . , ,. Dwight EBrock, Clerl<ofourts is; l -" By: AL EV ... _1141.4 By: /141 ....._ Q—#—A.....- Penny Taylor airman Dated: 1)1 , 1 ,../ __........ , (4-- al) Attest as to Chairman's S ! attire , y. Coastal Concrete Products, LLC dba Coastal Site Developme r------ ContractorA/ illi / ..... By: —....se —....— First Witness Sign iv ' 4244 .4 ,t,i 42_ Dxv:`() C . ie S . Print Name an. 'We Print Name and Title i. / ,do . ..e.,...." '..,4l4:..4/ Second Witness j/7. e'74; /--4 /7-W.40 2 Print Name and Title At). ., ed a ° Fr ad Legality: • - t Cou ty Attorney 442'tk#46 Page-14- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development 47Fi*N 0 16C 3 EXHIBIT A PUBLIC PAYMENT BOND Bond No. Contract No. 16-7021 KNOW ALL MEN BY THESE PRESENTS: That , as Principal, and , as Surety, located at (Business Address) are held and firmly bound to as Oblige in the sum of ($ ) for the payment whereof we bind ourselves, our heirs, executors, personal representatives, successors and assigns, jointly and severally. WHEREAS, Principal has entered into a contract dated as of the day of , 20_, with Oblige for in accordance with drawings and specifications, which contract is incorporated by reference and made a part hereof, and is referred to as the Contract. THE CONDITION OF THIS BOND is that if Principal: Promptly makes payment to all claimants as defined in Section 255.05(1), Florida Statutes, supplying Principal with labor, materials or supplies, used directly or indirectly by Principal in the prosecution of the work provided for in the contract, then this bond is void; otherwise it remains in full force. Any changes in or under the Contract and compliance or noncompliance with any formalities connected with the Contract or the changes do not affect sureties obligation under this Bond. The provisions of this bond are subject to the time limitations of Section 255.0592. In no event will the Surety be liable in the aggregate to claimants for more than the penal sum of this Payment Bond, regardless of the number of suits that may be filed by claimants. IN WITNESS WHEREOF, the above parties have executed this instrument this day of , 20 , the name of under-signed representative, pursuant to authority of its governing body. Page-15- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 0 16C3 Signed, sealed and delivered in the presence of: PRINCIPAL: By: Witnesses as to Principal Name: Its: STATE OF COUNTY OF The foregoing instrument was acknowledged before me this of 20 , by , as of , a corporation, on behalf of the corporation. He/she is personally known to me OR has produced as identification and did (did not) take an oath. My Commission Expires: (Signature of Notary) Name: (Legibly Printed) (AFFIX OFFICIAL SEAL) Notary Public, State of Commission No.: ATTEST: SURETY: (Printed Name) (Business Address) (Authorized Signature) Witness as to Surety (Printed Name) OR Page-16- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16C 3 As Attorney in Fact (Attach Power of Attorney) Witnesses (Business Address) (Printed Name) (Telephone Number) STATE OF COUNTY OF The foregoing instrument was acknowledged before me this day of 20_, by , as of , Surety, on behalf of Surety. He/She is personally known to me OR has produced as identification and who did (did not)take an oath. My Commission Expires: (Signature of Notary) Name: (Legibly Printed) (AFFIX OFFICIAL SEAL) Notary Public, State of Commission No.: Page-17- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal S' - Development. 16C3 EXHIBIT A-2 PUBLIC PERFORMANCE BOND Bond No. Contract No. 16-7021 KNOW ALL MEN BY THESE PRESENTS: That , as Principal, and , as Surety, located at (Business Address) are held and firmly bound to as Oblige in the sum of ($ ) for the payment whereof we bond ourselves, our heirs, executors, personal representatives, successors and assigns,jointly and severally. WHEREAS, Principal has entered into a contract dated as of the day of 20_, with Oblige for in accordance with drawings and specifications, which contractor is incorporated by reference and made a pat hereof, and is referred to as the Contract. THE CONDITION OF THIS BOND is that if Principal: 1. Performs the Contract at the times and in the manner prescribed in the Contract, and 2. Pays Oblige any and all losses, damages, costs and attorneys' fees that Oblige sustains because of any default by Principal under the Contract, including, but not limited to, all delay damages, whether liquidated or actual, incurred by Oblige; and 3. Performs the guarantee of all work and materials furnished under the Contract for the time specified in the Contract, then this bond is void; otherwise it remains in full force. Any changes in or under the Contract and compliance or noncompliance with any formalities connected with the Contract or the changes do not affect Sureties obligation under this bond. The Surety, for value received, hereby stipulates and agrees that no changes, extensions of time, alterations or additions to the terms of the Contract or other work to be performed hereunder, or the specifications referred to therein shall in anywise affect its obligations under this bond, and it does hereby waive notice of any such changes, extensions of time, alternations or additions to the terms of the Contract or to work or to the specifications. Page-18- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 0 16C3 This instrument shall be construed in all respects as a common law bond. It is expressly understood that the time provisions and statute of limitations under Section 255.05, Florida Statutes, shall not apply to this bond. In no event will the Surety be liable in the aggregate to Oblige for more than the penal sum of this Performance bond regardless of the number of suits that may be filed by Oblige. IN WITNESS WHEREOF, the above parties have executed this instrument this day of , 20 , the name of each party being affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body. Signed, sealed and delivered in the presence of : PRINCIPAL: By: Witnesses as to Principal Name: Its: STATE OF COUNTY OF The foregoing instrument was acknowledged before me this day of 201_, by , as of a corporation, on behalf of the corporation. He/She is personally known to me OR has produced as identification and did (did not) take an oath. My Commission Expires: (Signature of Notary) Name: (Legibly Printed) (AFFIX OFFICIAL SEAL) Notary Public, State of Commission No.: Page-19- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16C 3 ATTEST: SURETY: (Printed Name) (Business Address) (Authorized Signature) Witness as to Surety (Printed Name) OR As Attorney in Fact (Attach Power of Attorney) Witnesses (Business Address) (Printed Name) (Telephone Number) STATE OF COUNTY OF The foregoing instrument was acknowledged before me this day of , 20 , by_ , as of , Surety, on behalf of Surety. He/She is personally known to me OR has produced as identification and who did (did not) take an oath. My Commission Expires: (Signature of Notary) Name: (Legibly Printed) (AFFIX OFFICIAL SEAL) Notary Public, State of Commission No.: Page-20- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16C 3 EXHIBIT B RELEASE AND AFFIDAVIT FORM COUNTY OF COLLIER ) STATE OF FLORIDA ) Before me, the undersigned authority, personally appeared who after being duly sworn, deposes and says: (1) In accordance with the Contract Documents and in consideration of $ paid, ("Contractor") releases and waives for itself and it's subcontractors, material-men, successors and assigns, all claims demands, damages, costs and expenses, whether in contract or in tort, against the Board of County Commissioners of Collier County, Florida, relating in any way to the performance of the Agreement between Contractor and Owner, dated 20 for the period from to (2) Contractor certifies for itself and its subcontractors, material-men, successors and assigns, that all charges for labor, materials, supplies, lands, licenses and other expenses for which Owner might be sued or for which a lien or a demand against any payment bond might be filed, have been fully satisfied and paid. (3) Contractor agrees to indemnify, defend and save harmless Owner from all demands or suits, actions, claims of liens or other charges filed or asserted against the Owner arising out of the performance by Contractor of the Work covered by this Release and Affidavit. (4) This Release and Affidavit is given in connection with Contractor's [monthly/final] Application for Payment No. CONTRACTOR BY: ITS: President DATE: Witnesses [Corporate Seal] STATE OF COUNTY OF The foregoing instrument was acknowledged before me this day of 20 , by , as of , a corporation, on behalf of the corporation. He/she is personally known to me or has produced as identification and did (did not) take an oath. My Commission Expires: (Signature of Notary) NAME: (Legibly Printed) (AFFIX OFFICIAL SEAL) Notary Public, State of Commissioner No.: Page-21- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16C 3 EXHIBIT C FORM OF CONTRACT APPLICATION FOR PAYMENT (County Project Manager) Bid No. 16-7021 (County Department) Project No. Collier County Board of County Commissioners(the OWNER)or Collier County Water-Sewer District(the OWNER) Application Date FROM: (Contractor's Representative) Payment Application No. (Contractor's Name) for Work accomplished through the Date: (Contractor's Address) RE: (Project Name) Original Contract Time: Original Contract Amount: $ Revised Contract Time: Total Change Orders to Date $ Revised Contract Amount $ Total value of Work Completed Retainage @ 10% thru[insert date] $ and stored to Date $ Retainage @ _%after [insert date] $ Less previous payment(s) $ Percent Work completed to Date: % AMOUNT DUE THIS Percent Contract Time completed to Date % APPLICATION: $ Liquidated Damages to be Accrued $ ATTACH SCHEDULE OF VALUES AND ACCOMPANYING DOCUMENTATION TO THIS APPLICATION CONTRACTOR'S CERTIFICATION: The undersigned CONTRACTOR certifies that: (1) all previous progress payments received from OWNER on account of Work done under the Contract referred to above have been applied to discharge in full all obligations of CONTRACTOR incurred in connection with Work covered by prior Applications for Payment numbered 1 through inclusive; (2) title to all materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at time of payment free and clear of all liens, claims, security interests and encumbrances (except such as covered by Bond acceptable to OWNER); (3) all amounts have been paid for work which previous payments were issued and received from the OWNER and that current payment is now due; (4) and CONTRACTOR agrees that all overruns as shown on the monthly estimate summary shall, in fact, be added to the revised contract and shall be incorporated into a future Change Order: By CONTRACTOR: (Contractor's Name) (Signature) DATE: (Type Name&Title) (shall be signed by a duly authorized representative of CONTRACTOR) Payment to the CONTRACTOR for the above AMOUNT DUE THIS APPLICATION is recommended: By Design Professional : (DP's Name) (Signature) DATE: (Type Name&Title) Payment to the CONTRACTOR for the above AMOUNT DUE THIS APPLICATION is approved: By OWNER'S Project Manager: (Signature) DATE: (Type Name and Title) Page-22- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16C 3 EXHIBIT D CHANGE ORDER ❑Contract Modification 0 Work Order Modification 0 Amendment Contract#: Change#: Purchase Order#: Project#: Contractor/Firm Name: Project Name: Project Manager Name: Department: Original Contract/Work Order Amount Original BCC Approval Date Agenda Item # Current BCC Approved Amount Last BCC Approval Date; Agenda Item# Current Contract/Work Order Amount SAP Contract Expiration Date(Master) Dollar Amount of this Change #DIV/0! Total Change from Original Amount Revised Contract/Work Order Total $ 0.00 #DIV/0! Change from Current BCC Approved Amount Cumulative Changes $ 0.00 #DIV/0! Change from Current Amount Completion Date,Description of the Task(s)Change,and Rationale for the Change Notice to Proceed Original (Approved id Date Date "ompletion Date __„J es this change) #of Days Added Select Tasks 0 Add new task(s) 0 Delete task(s) 0 Change task(s) ❑ Other(see below) Provide a response to the following: 1.) detailed and specific explanation/rationale of the requested change(s)to the task(s) and / or the additional days added (if requested); 2.) why this change was not included in the original contract; and, 3.) describe the impact if this change is not processed. Attach additional information from the Design Professional and/or Contractor if needed. Prepared by: Date: (Project Manager Name and Division) Acceptance of this Change Order shall constitute a modification to contract/work order identified above and will be subject to all the same terms and conditions as contained in the contract / work order indicated above, as fully as if the same were stated in this acceptance. The adjustment, if any, to the Contract shall constitute a full and final settlement of any and all claims of the Contractor/ Vendor/Consultant/ Design Professional arising out of or related to the change set forth herein, including claims for impact and delay costs. Accepted by: Date: (Contractor/Vendor/Consultant/Design Professional and Name of Firm, if project applicable) Approved by: Date: (Design Professional and Name of Firm, if project applicable) Approved by: Date: (Procurement Professional Page-23- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16 C 3 EXHIBIT E CERTIFICATE OF SUBSTANTIAL COMPLETION OWNER'S Project No. ENGINEER'S Project No. PROJECT: CONTRACTOR Contract For Contract Date This Certificate of Substantial completion applies to all Work under the Contract documents or to the following specified parts thereof: To OWNER And To The Work to which this Certificate applies has been inspected by authorized representatives of OWNER, CONTRACTOR AND DESIGN PROFESSIONAL, and that Work is hereby declared to be substantially complete in accordance with the contract documents on: DATE OF SUBSTANTIAL COMPLETION A tentative list of items to be completed or corrected is attached hereto. This list may not be all- inclusive, and the failure to include an item in it does not alter the responsibility of CONTRACTOR to complete all the Work in accordance with the Contract Documents. The items in the tentative list shall be completed or corrected by CONTRACTOR within days of the above date of Substantial Completion. Page-24- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Developm • 16 C 3 The responsibilities between OWNER and CONTRACTOR for security, operation, safety, maintenance, heat, utilities, insurance and warranties shall be as follows: RESPONSIBILITIES: OWNER: CONTRACTOR: The following documents are attached to and made a part of this Certificate: This certificate does not constitute an acceptance of Work not in accordance with the Contract Documents nor is it a release of CONTRACTOR'S obligation to complete the Work in accordance with the Contract Documents. Executed by Design Professional on , 20_ Design Professional By: Type Name and Title CONTRACTOR accepts this Certificate of Substantial Completion on , 20 CONTRACTOR By: Type Name and Title OWNER accepts this Certificate of Substantial Completion on , 20_ OWNER By: Type Name and Title Page-25- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16 C 3 EXHIBIT F CERTIFICATE OF FINAL COMPLETION OWNER'S Project No. ENGINEER'S Project No. PROJECT: CONTRACTOR Contract For Contract Date This Certificate of Final completion applies to all Work under the Contract documents. To OWNER And To The Work to which this Certificate applies has been inspected by authorized representatives of OWNER, CONTRACTOR AND DESIGN PROFESSIONAL, and that Work is hereby declared to be finally complete in accordance with the contract documents on: DATE OF FINAL COMPLETION Page-26- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16C3 The warranty in Exhibit G is attached to and made a part of this Certificate: Executed by Design Professional on , 20_ Design Professional By: Type Name and Title CONTRACTOR accepts this Certificate of Final Completion on 20 CONTRACTOR By: Type Name and Title OWNER accepts this Certificate of Final Completion on 20 OWNER By: Type Name and Title Page-27- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. 16 C 3 EXHIBIT G WARRANTY In consideration of ten dollars, ($10.00), receipt of which is hereby acknowledged, the undersigned CONTRACTOR does hereby provide, warrant and guarantee all work done and executed under the contract either directly performed by the CONTRACTOR or at the express request of the CONTRACTOR by a SUBCONTRACTOR or CONSULTANT. Project Name: Date of Final Completion: Name and Address of CONTRACTOR: CONTRACTOR warrants and guarantees the work performed pursuant to the contract shall be free of all defects of materials and workmanship for a period of one year from the DATE OF FINAL COMPLETION. The undersigned party further agrees that it will, at its own expense, replace and/or repair all defective work and materials and all other work damaged by any defective work upon written demand by the COUNTY. It is further understood that further consideration for this warranty and guaranty is the consideration given for the requirement pursuant to the general conditions and specifications under which the contract was let that such warranty and guaranty would be given. This warranty and guaranty is in addition to any other warranties or guaranties for the work performed under the contract and does not constitute a waiver of any rights provided pursuant to Florida Statutes, Chapter 95, et seq. DATE: CONTRACTOR BY: Attest: Page-28- #16-7021 "Hammerhead and Designated Driveway Construction" Contractor:Coastal Concrete dba Coastal Site Development. .7; Client#: 67237 COACO6 I, C /YYYY) ACORD, CERTIFICATE OF LIABILITY INSURANCE 6/20/2017DATE(MM/DDDD7 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 Emma Blanco,CPSR NAME: Gulfshore Insurance -SWFL PHONE 239 659-8873 FAX 239 213-2803 (A/C No,Ext): (A/C,No): 4100 Goodlette Road N E-MAIL SS: Eblanco@gulfshoreinsurance.com ulfshoreinsurance.com ADDRE Naples, FL 34103 INSURER(S)AFFORDING COVERAGE NAIC# 239 261-3646 INSURER A Amerisure Mutual Insurance INSURED INSURER B:Amerisure Insurance Company Coastal Concrete Products LLC INSURER C: 7742 Alico Rd INSURER D: Fort Myers, FL 33912-3713 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MM/DD/YYYY) A GENERAL LIABILITY X X GL20732670602 11/17/2016 11/17/2017 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISESO(Ea occurrence) $1,000,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 X BI/PD Ded:1,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO n LOC _ $ JECT A AUTOMOBILE LIABILITY X X CA20732650602 11/17/2016 11/17/2017Ea COMBINaccident)SI $ED NGLE LIMIT 1e s 000 000 ( X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) A X UMBRELLA LIAB X OCCUR X X CU20732680602 11/17/2016 11/17/2017 EACH OCCURRENCE $4,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED X RETENTION$O $ B WORKERS COMPENSATION X WC20732690601 11/17/2016 11/17/2017 X TO STATU- OTH- ERAND EMPLOYERS'LIABILITY TORY LIMITS Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? y N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 A Leased/Rented IM20991750002 11/17/2016 11/17/2017 $400,000 Limit Equipment $2,500 Deductible DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Collier County Board of County Commissioners are included as Additional Insured for any and all work performed in Collier County on a primary and noncontributory basis with regards to General Liability only as required by written contract per form CG7048 0913,includes ongoing and completed operations,Waiver of Subrogation in favor of Additional Insured(s)per form CG7049 1109.Additional Insured in regards to Auto Liability only as required by written contract per form CA7171 0508,including Waiver of Subrogation. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Collier CountyBoard of CountySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 3327 Tamiami Trail E. Naples, FL 34112 AUTHORIZED REPRESENTATIVE ".46f ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1170312/M1163977 BNC 16C 3 DESCRIPTIDNS (Con from Page 1) Waiver of Subrogation in regards to Workers Compensation only as required by written contract per form WC000313 0484.30 Days Notice of Cancellation,except 10 days for non-payment*" SAGITTA 25.3(2010/05) 2 of 2 #S1170312/M1163977 16C3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS GENERAL LIABILITY EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Under SECTION I-COVERAGE A.BODILY INJURY AND PROPERTY DAMAGE LIABILITY,paragraph 2. EXCLUSIONS, provisions 1.through 6.of this endorsement amend the policy as follows: 1. LIQUOR LIABILITY Exclusion c.Liquor Liability is deleted. 2. NONOWNED WATERCRAFT AND NONOWNED AIRCRAFT(HIRED,RENTED OR LOANED WITH PAID CREW) Exclusion g.Aircraft,Auto or Watercraft,paragraph (2)is deleted and replaced with the following: (2) A watercraft you do not own that is: (a) Less than 51 feet long;and (b) Not being used to carry persons or property for a charge; Exclusion g.Aircraft,Auto or Watercraft,paragraph (6)is added as follows: (6) An aircraft that you do not own that is: (a) Hired; (b) Rented;or (c) Loaned to you; with paid crew fora period of five(5)consecutive days or less_ Paragraph(6)does not apply if the insured has any other insurance for"bodily injury or"property damage"liability for such aircraft,whether such other insurance is primary,excess,contingent or on any other basis. 3. PREMISES ALIENATED A. Exclusion j.Damage to Property,paragraph(2)is deleted. B. The following paragraph is also deleted from Exclusion).Damage to Property: Paragraph(2)of this exclusion does not apply if the premises are"your work"and were never occupied, rented or held for rental by you. 4. PROPERTY DAMAGE LIABILITY-ELEVATORS AND SIDETRACK AGREEMENTS A. Exclusion j.Damage to Property, paragraphs(3),(4),and(6)do not apply to the use of elevators. B. Exclusion k.Damage to Your Product does not apply to: 1. The use of elevators;or 2. Liability assumed under a sidetrack agreement 5. PROPERTY DAMAGE LIABILITY-BORROWED EQUIPMENT A. Exclusion j.Damage to Property,paragraph(4)does not apply to"property damage"to borrowed equipment while at a jobsite and not being used to perform operations. includes copyrighted material of Insurance Services Office, Inc_ CG 70 49 11 09 Page 1 of 10 16C 3 B. VYrth respect to any one borrowed equipment item,provision 5.A.above does not apply to"property damage"that exceeds$25,000 per occurrence or$25,000 annual aggregate. 6_ PRODUCT RECALL EXPENSE A. Exclusion n.Recall Of Products,Work Or Impaired Property does not apply to"product recall expenses"that you incur for the"covered recall"of"your product". This exception to the exclusion does not apply to"product recall expenses"resulting from: 1. Failure of any products to accomplish their intended purpose; 2. Breach of warranties of fitness,quality,durability or performance; 3. Loss of customer approval or any cost incurred to regain customer approval; 4_ Redistribution or replacement of"your product',which has been recalled, by like products or substitutes; 5. Caprice or whim of the insured; 6. A condition likely to cause loss,about which any insured knew or had reason to know at the inception of this insurance; 7. Asbestos,including loss, damage or clean up resulting from asbestos or asbestos containing materials; 8. Recall of"your product(s)"that have no known or suspected defect solely because a known or suspected defect in another of"your product(s)"has been found. B. Under SECTION HI—LIMITS OF INSURANCE,paragraph 3.is replaced in its entirety as follows and paragraph 8.is added: 3. The Products-Completed Operations Aggregate Limit is the most we will pay for the sum of: a. Damages under COVERAGE A BODILY INJURY AND PROPERTY DAMAGE LIABILITY because of"bodily injury„and"property damage" included in the"products-completed operations hazard"and b. "Product recall expenses". 8. Subject to paragraph 5..above;$25,000 is the most we will pay for all"product recall expenses" arising out of the same defector deficiency. The insurance afforded by provisions 1.through 6.of this endorsement is excess over any valid and collectible insurance(including any deductible)available to the insured whether prirnery,excess or contingent,and SECTION IV.,paragraph 4.Other Insurance is changed accordingly., 7. BLANKET CONTRACTUAL LIABILITY—RAILROADS When a written contract or written agreement requires Contractual Liability-Railroads,the definition of "insured contract"in Section V Definitions is replaced by the following with respect to operations performed for,or affecting,a railroad: 9. "Insured Contract"means: a. A contract for a lease of premises. However,that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you or temporarily occupied by you with permission of the owner is not an"insured contract"; b. A sidetrack agreement; C. Any easement or license agreement; d. An obligation,as required by ordinance,to indemnify a municipality,except in connection with work for a municipality; Includes copyrighted material of Insurance Services Office,inc_ Page 2 of 10 CG 70 49 11 09 16C 3 e. An elevator maintenance agreement; f. That part of any other contractor agreement pertaining to your business(including an indemnification of a municipality in connection with work performed for a municipality)under which you assume the tort liability of another party to pay for"bodily injury"or"property damage"to a third person or organization.Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f.does not include that part of any contract or agreement: (1) That indemnifies an architect,engineer or surveyor for injury or damage arising out of: (a) Preparing,approving or failing to prepare or approve maps,shop drawings,opinions, reports,surveys,field orders,change orders or drawings and specifications;or (b) Giving directions or instructions,or failing to give them; (2) Under which the insured,if an architect,engineer or surveyor,assumes liability for an injury or damage arising out of the insureds rendenng or failure to render professional services, including those listed in Paragraph(1)above and supervisory,inspection,architectural or engineering activities. 8. CONTRACTUAL LIABILITY-PERSONAL AND ADVERTISING INJURY Under SECTION 1 -COVERAGE B.,paragraph 2.Exclusions,paragraph e.Contractual Liability is deleted. 9. SUPPLEMENTARY PAYMENTS Under SECTION I-SUPPLEMENTARY PAYMENTS-COVERAGES AAND 8,paragraphs 1,.b.and td.are deleted and replaced with the following: b. Up to$2,500 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. d. All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or"suit°, including actual loss of earnings up to$500 a day because of time off from work. 10. BROADENED WHO IS AN INSURED SECTION II WHO IS AN INSURED is deleted and replaced with the following: 1. If you are designated in the Declarations as: a. An individual,you and your spouse are insureds,but only with respect to the conduct of a business of which you are the sole owner. b. A partnership or joint venture,you are an insured. Your members, your partners,and their spouses are also insureds,but only with respect to the conduct of your business. c. A limited liability company,you are an insured. Your members are also insureds,but only with respect to the conduct of your business. Your managers are insureds,but only with respect to their duties as your managers. d. An organization other than a partnership,joint venture or limited liability company,you are an insured Your"executive officers"and directors are insureds, but only with respect to their duties as your officers or directors: Your stockholders are also insureds,'but only with respect to their liability as stockholders. e. A trust,you are an insured. Your trustees are also insureds,but only with respect to their,duties as trustees. Includes copyrighted material of Insurance Services Office, Inc_ CG 70 49 11 09 Page 3 of 10 16C3 2. Each of the following is also an insured: a. Your"volunteer workers"only while performing duties related to the conduct of your business,or your"employees,"other than either your'executive officers,"(if you are an organization other than a partnership,joint venture or limited liability company)or your managers(if you are a limited liability company),but only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However,none of these"employees"or"volunteer workers" are insured for: (1) "Bodily injury"or"personal and advertising injury": (a) To you,to your partnersor members(if you are a partnership or joint venture),to your members(if you are a limited liability company),to a co-"employee"while in the course of his or her employment or performing duties related to the conduct of your business,or to your other"volunteer workers"while performing duties related to the conduct of your business; (b) To the spouse,child, parent,brother or sister of that co-"employee"or"volunteer worker as a consequence of paragraph(1)(a)above; (c) For which there is any obligation to share damages with or repay someone else who must pay damages because of the injury described in paragraphs(1)(a)or(b)above;or (d) Arising out of his or her providing or failing to provide professional health care services except as provided in provision 11.of this endorsement Paragraphs(1)(a),(1)(b)and(1)(c)above do not apply to your"employees"who are: (i) Managers; (ii) Supervisors; (iii) Directors;or (iv) Officers; with respect to"bodily injury"to a co-"employee". (2) "Property damage"to property: (a) Owned, occupied or used by; (b) Rented to,in the care,custody or control of,or over which physical control is being exercised for any purpose by you,any of your"employees,""volunteer workers",any partner or member(if you are a partnership or joint venture),or any member(if you are a limited liability company), b. Any person(other than your"employee"or"volunteer worker'),or any organization while acting as your real estate manager. c. Any person or organization having proper temporary custody of your property if you die,but only; (1) VIth respect to liability arising out of the maintenance or use of that property;and (2) Until your legal representative has been appointed. d. Your legal representative if you die,but only with respect to duties as such. That representative will have all your rights and duties under this Coverage Form. e. Your subsidiaries if: (1) They are legally incorporated entities;and (2) You own more than 50% of the voting stock in such subsidiaries as of the effective date of this policy. Includes copyrighted material of Insurance Services Office, Inc.. Page 4 of 10 CG 70 49 1109 16C 3 If such subsidiaries are not shown in the Declarations, you must report them to'uswithin 180 days of the inception of your original policy. f. (1) Any person or organization,other than an architect,engineer or surveyor,required to be named as an additional insured in a'work contract",letter of intent or work order. However,such person or organization shall be an additional insured only with respect to covered'bodily injury," "property damage,".and"personal and advertising injury"arising out of your work"under that "work contract",letter of intent or work order. (2) We will provide additional insured coverage to such person or organization only: (a) for a period of 30 days after the effective date of the applicable'work contract",letter of intent or work order;or (b) until the end of the policy term in effect at the inception of the applicable"work contract", letter of intent or work order; whichever is earlier. (3) Coverage provided under this paragraph f.is excess over any other valid and collectible insurance available to the additional insured whether primary,excess,contingent, or on any other basis unless the"work contract",letter of intent or work order requires this insurance be primary, in which case this insurance will be primary without contribution from such other insurance available to the additional insured. (4) This paragraph f.does not apply if form CG 70 48,Contractors Blanket Additional Insured Endorsement, is attached to the policy. g. Any person or organization to whom you are obligated by virtue of a written contract to provide insurance such as,is afforded by this policy, but only with respect to liability arising out of the maintenance or use of that part of any premises leased to you,including common or public areas about such premises if so required in the contract However,no such persorior organization is an insured with respect to: (1) Any"occurrence"that takes place after you cease,to occupy those premises;or (2) Structural alterations, new construction or demolition operations performed by or on behalf of such person or organization. h. Any state or political subdivision but only as respects legal liability incurred by the state or political subdivision solely because it has issued a permit with respect to operations performed by you or on your behalf. However,no state or political subdivision is an insured with respect to: (1) "Bodily injury","property damage", and"personal and advertising injury"arising out of operations performed for the state or municipality;or (2) "Bodily injury"or"property damage"included within the"products-completed operations hazard." i. Any person or organization who is the lessor of equipment leased to you to whom you are obligated by virtue of a written contact to provide insurance such as is afforded by this policy, but only with respect to their liability arising out of the maintenance, operation or use of such equipment by you or a subcontractor on your behalf with your permission and under your supervision. However,no such person or organization is an insured with respect to any"occurrence"that takes place after the equipment lease expires. j. Any architect,engineer,or surveyor engaged by you but only with respectto,,liability arising out of your premises or"your work." Includes copyrighted material of Insurance Services Office,Inc. CG70491109 Page 5of10 16C 3 However, no architect,engineer,or surveyor is an insured with respect to"bodily injury,""property damage,"or"personal and advertising injury"arising out of the rendering of or the failure to render any professional services by or for you, including: (1) The preparing,approving,or failing to prepare or approve maps,drawings, opinions, reports, surveys,change orders,designs or specifications;or (2) Supervisory,inspection,;or engineering services. This paragraph j.does not apply if form CG 70 48,Contractors Blanket Additional Insured Endorsement,is attached to the policy. k. Any manager,owner, lessor, mortgagee, assignee or receiver of premises, including land leased to you,but only with respect to liability arising out of the ownership maintenance or use of that part of the premises or land leased to you_ However, no such person or organization is an insured with respect to: (1) Any"occurrence"that takes place after you cease to occupy that premises,or cease to lease the land;or (2) Structural alteration,new construction or demolition operations performed by or on behalf of that person or organization. 3. Any organization you newly acquire or form,other than a partnership,joint venture or limited liability company and over which you maintain ownership or majority interest,will qualify asa Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded until the end of the policy period. b. Coverage A does not apply to"bodily injury"or"property damage"that occurred before you acquired or formed the organization. c. Coverage B does not apply to"personal and advertising injury"arising out of an offense committed before you acquired or formed the organization. d. Coverage A does not apply to"product recall expense"arising out of any withdrawal or recall that occurred before you acquired or formed the organization. 4. Any person or organization(referred to below as vendor)with whom you agreed,because of a written contract or agreement to provide insurance is an insured,but only with respect to"bodily injury"or "property damage"arising out of"your products"that are distributed or sold in the regular course of the vendor's business. However,no such person or organization is an insured with respect to: a. "Bodily injury"or"property damage"for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement. b. Any express warranty unauthorized by you, c. Any physical or chemical change in"your'product"made intentionally by the vendor; d. Repackaging,except when unpacked solely for the purpose of inspection, demonstration,testing,or the substitution of parts under instructions from the manufacturer,and then repackaged in the original container; e. Any failure to make such inspections,adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of"your products"; f. Demonstration, installation,servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of"your product% Includes copyrighted material of Insurance Services Office, Inc. Page 6at) CG70491109 ióC3 g. "Your products"which,after distribution or sale by you, have been labeled or relabeled or used as a container,part or ingredient of any other thing or substance by or for the vendor. h. "Bodily injury"or"property damage"arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However,this exclusion does not apply to: (1), The exceptions contained in subparagraphs d.or.1.;or (2) Such inspections,adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business,in connection with the distribution or sale of the products. This insurance does not apply to any insured person or organization from which you have acquired"your products",or any ingredient,part,or container,entering into,accompanying or containing"your products". No person or organization is an insured with respect to the conduct of any current or past partnership,joint venture or limited liability company that is not shown as a Named Insured in the Declarations. 11. INCIDENTAL MALPRACTICE LIABILITY As respects provision 10.,SECTION II-WHO IS AN INSURED,paragraph 2.a.(1)(d)does not apply to any nurse,emergency medical technician or paramedic employed by you to provide medical or paramedical services, provided that you are not engaged in the business or occupation of providing such services, and your "employee"does not have any other insurance that would also cover claims arising under this provision, whether the other insurance is primary,excess,contingent or on any other basis. Under SECTION III-LIMITS OF INSURANCE,provisions 12.through 14.of this endorsement amend the policy as follows: 12. AGGREGATE LIMITS PER PROJECT The General Aggregate Limit applies separately to each of your construction projects away from premises owned by or rented to you. 13. INCREASED MEDICAL PAYMENTS LIMIT AND REPORTING PERIOD A. The requirement under SECTION 1-COVERAGE C MEDICAL PAYMENTS that expenses be incurred and reported to us within one year of the date of the accident is changed to three years. B. SECTION III-LIMITS OF INSURANCE,paragraph 7.,the Medical Expense Limit, is subject to all of the terms of SECTION III-LIMITS OF INSURANCE and is the greater of: 1. $10,000;or 2. The amount shown in,the Declarations for Medical Expense Limit. C. This provision 13.does not apply if COVERAGE C MEDICAL PAYMENTS is excluded either by the provisions of the Coverage Form or by endorsement. 14. DAMAGE TO PREMISES RENTED TO YOU-SPECIFIC PERILS A. The word fire is changed to"specific perils"where it appears in: 1. The last paragraph of SECTION I—COVERAGE A,paragraph 2.Exclusions; 2. SECTION IV,paragraph 4.b.Excess Insurance. B. The Limits of Insurance shown in the Declarations will apply to all damage proximately caused by the same event,whether such damage results from a"specific peril"or any combination of"specific perils" C. The Damage To Premises Rented To You Limit described in SECTION III-LIMITS OF INSURANCE, paragraph 6.,is replaced by a new limit,which is the greater of: 1. $1,000,000;or Includes copyrighted material of Insurance Services Office, Inc. CG70491109 Page 7of10 16C 3 2. The amount shown in the Declarations for Damage To Premises Rented To You Limit D. This provision 14.does not apply if the Damage To Premises Rented To You Limit of SECTION I- COVERAGE A is excluded either by the provisions of the Coverage Form or by endorsement Under SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS,provisions 15.through 17 of this endorsement amend the policy as follows: 15. KNOWLEDGE OF OCCURRENCE Under 2.Duties In The Event Of Occurrence,Offense,Claim,Or Suit,paragraph a.is deleted and replaced and paragraphs e.and f.are added as follows: a. You must see to it that we are notified as soon as practicable of an"occurrence"or an offense,regardless of the amount,which may result in a claim. Knowledge of an"occurrence"or an offense by your "employee(s)"shall not,in itself,constitute knowledge to you unless one of your partners; members, "executive officers",directors,or managers has knowledge of the"occurrence"or offense. To the extent possible, notice should include: (1) How,when and where the"occurrence"or offense took place; (2) The names and addresses of any injured persons and witnesses;and (3) The nature and location of any injury or damage arising out of the"occurrence"or offense. e_ If you report an"occurrence"to your workers compensation carrier that develops into a liability claim for which coverage is provided by the Coverage Form,failure to report such an"occurrence"to us at the time of the"occurrence"shall not be deemed a violation of paragraphs a.,b.,and c.above. However,you shall give written notice of this"occurrence"to us as soon you become aware that this"occurrence"may be a liability claim rather than a workers compensation claim. f. You must see to itthat the following are done in the event of an actual or anticipated"covered recall"that may result in"product recall expense": (1) Give us prompt notice of any discovery or notification that"your product"must be withdrawn or recalled., Include a description of"your product"and the reason for the withdrawal or recall; (2) Cease any further release,shipment,consignment or any other method of distribution of like or similar products until it has been determined that all such products are free from defects that could be a cause of loss under the insurance. 16. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS Paragraph 6.Representations is deleted and replaced with the following: 6. Representations • By accepting this policy,you agree: a. The statements in the Declarations are accurate and complete; b. Those statements are based upon representations you made to us; c. We have issued this policy in reliance upon your representations;and d. This policy is void in any case of fraud by you as it relates to this policy or any claim under this policy. We will not deny coverage under this coverage part if you unintentionally fail to disclose all hazards existing as of the inception date of this policy.You must report to us any knowledge of an error or omission in the description of any premises or operations intended to be covered by the Coverage Form as soon as practicable after its discovery. However,this provision does riot affect our right to collect additional premium or exercise our right of cancellation or nonrenewal. Includes copyrighted material of Insurance Services Offiice, Inc. Page 8 of 10 CG 70 49 11 09 16C 3 17. TRANSFER OF RIGHTS(BLANKET WAIVER OF SUBROGATION) Paragraph 8.Transfer of Rights Of Recovery Against Others To Us is deleted and replaced with the following: 8. If the insured has rights to recover all,or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring"suit"or transfer those rights tows and help us enforce them. However,if the insured has waived rights to recover through a written contract,or if'your work"was commenced under a letter of intent or work order,subject to a subsequent reduction to writing with customers whose customary contracts require a waiver,we waive any right of recovery we may have under this Coverage Form. 18. EXTENDED NOTICE OF CANCELLATION AND NONRENEWAL Paragraph 2.b.of A.Cancellation of the COMMON POLICY CONDITIONS is deleted and replaced with the following: b. 60 days before the effective date of the cancellation if we cancel for any other reason. Under SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS,Paragraph 9.When We Do Not Renew is deleted and replaced with the following: 9. When We Do Not Renew If we decide not to renew this Coverage Part,we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less than 60 days before the expiration date. If notice is mailed, proof of mailing will be sufficient proof of notice. 19. MOBILE EQUIPMENT REDEFINED Under SECTION V-DEFINITIONS,paragraph 12"Mobile equipment',paragraph f.(1)does not apply to self- propelled vehicles of less than 1,000 pounds gross vehicle weight. 20. DEFINITIONS 1. SECTION V—DEFINITIONS,paragraph 4."Coverage territory"is replaced by the following definition: "Coverage territory"means anywhere in the world with respect to liability arising out of"bodily injury," "property damage,"or"personal and advertising injury,"including"personal and advertising injury offenses that take place through the Internet or similar electronic means of communication provided the insured's responsibility to pay damages is determined in a settlement to which we agree or in a'suit"on the merits, in the United States of America(including its territories and possessions),Puerto Rico and Canada. 2. SECTION V—DEFINITIONS is amended by the addition of the following definitions "Covered recall"means a recall made necessary because you or a government body has determined that a known or suspected defect deficiency,inadequacy,or dangerous condition in your product"has resulted or will result in"bodily injury"or"property damage". "Product Recall expenses"mean only reasonable and necessary extra costs,which result from or are related to the recall or withdrawal of"your product"for: a Telephone and telegraphic communication,radio or television announcements, computer time and newspaper advertising; b. Stationery,envelopes,production of announcements and postage or facsimiles; c. Remuneration paid to regular employees for necessary overtime or authorized travel expense; d. Temporary hiring by you or by agents designated by you of persons, other than your regular employees,to perform necessary tasks; Includes copyrighted material of Insurance Services Office, Inc. CG70491109 Page 9of10 16C 3 e. Rental of necessary additional warehouse or storage space; If. Packaging of or transportation or shipping of defective products to the location you designate;and g. Disposal of"your products"that cannot be reused. Disposal expenses do not include: (1) Expenses that exceed the original cost of the materials incurred to manufacture or process such product:and (2) Expenses that exceed the cost of normal trash discarding or disposal,except as are necessary to avoid"bodily injury"or"property damage". "Specific Perils"means fire;lightning; explosion;windstorm or hail;smoke;aircraft or vehicles;riot or civil commotion;vandalism;leakage from fire extinguishing equipment weight of snow, ice or sleet,or'Water damage". "Water damage"means accidental discharge or leakage of water or steam as the direct result of the breaking or cracking of any part of a system or appliance containing water or steam. 'Work contract"means a written agreement between you and one or more parties for work to be performed by you or on your behalf. Includes copyrighted material of Insurance Services Office, Inc. Page 10 of 10 CG 70 49 11 09 16C3 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POUCY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule "Any person or organization required by written contract or certificate of insurance." 'This endorsement is not applicable in California,Kentucky, New Hampshire, New Jersey, Texas and Utah." "This endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6)of the Missouri Statues,a contractual provision purporting to waive subrogation rights is against public policy and void where one party to the contract is an employer in the construction group of code classifications!' 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 Policy No. Endorsement No. Insured Premium Insurance Company Countersigned by WC 00 03 13 Hart Forms&Ssrvkas< (Ed. 4_81) Copyright 1983 National Council on Compensation Insurance, Reorder N .14-4808 16C 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. FLORIDA ADVANTAGE COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. The premium for this endorsement is$$350.on 1. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS-CANCELLATION,Paragraph A.2.is replaced by the following: 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: a 10 days before the effective date of cancellation if we cancel for nonpayment of premium;or b. 60 days before the effective date of cancellation if we cancel for any other reason. 2. BROAD FORM INSURED SECTION II-LIABILITY COVERAGE A.1.WHO IS AN INSURED is amended by the addition of the following: d. Any organization you newly acquire or form,other than a partnership,joint venture or limited liability company,and over which you maintain ownership or a majority interest,will qualify as a Named Insured. However, (1) Coverage under this provision is afforded only until the end of the policy period; (2) Coverage does not apply to"accidents"or loss"that occurred before you acquired or formed the organization;and (3) Coverage does not apply to an organization that is an"insured"under any other policy or would be an "insured"but for its termination or the exhausting of its limit of insurance. e. Any"employee"of yours using: (1) A covered"auto"you do not own,hire or borrow,or a covered"auto"not owned by the"employee"or a member of his or her household,while performing duties related to the conduct of your business or your personal affairs;or (2) 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. However,your "employee"does not qualify as an insured under this paragraph(2)while using a covered"auto" rented from you or from any member of the"employee's"household. f Your members,if you are a limited liability company,while using a covered"auto"you do not own,hire,or borrow,while performing duties related to the conduct of your business or your personal affairs. g. Any person or organization with whom you agree in a written contract,written agreement or permit,to provide insurance such as is afforded under this policy,but only with respect to your covered"autos", This provision does not apply: (1) Unless the written contractor agreement is executed or the permit is issued prior to the"bodily injury" or"property damage"; Includes copyrighted material of Insurance Services Office,inc. CA 71 71 05 08 Page 1 of 6 16C 3 (2) To any person or organization included as an insured by an endorsement or in the Declarations;or (3) To any lessor of"autos"unless: (a) Thelease agreement requires you to provide direct primary insurance for the lessor; (b) The"auto"is leased without a driver;and (c) The lease had not expired. Leased"autos"covered under this provision will be considered covered"autos"you own and not covered `autos"you hire. h. Any legally incorporated organization or subsidiary in which you own more than 50%of the voting stock on the effective date of this endorsement. This provision does not apply to"bodily injury"or"property damage"for which an"insured"is also an insured under any other automobile policy or would be an insured under such a policy,but for its termination or the exhaustion of its limits of insurance,unless such policywas written to apply specifically in excess of this policy. 3. COVERAGE EXTENSIONS SUPPLEMENTARY PAYMENTS Under SECTION II-LIABILITY COVERAGE,A.2.a.Supplementary Payments,paragraphs(2)and(4)are deleted and replaced with the following: (2) Up to$2500 for the cost of bail bands(including bonds for related traffic law violations)required because of an"accident"we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the"insured"at our request,including actual loss of earnings up to $500 a day because of time off from work. 4. AMENDED FELLOW EMPLOYEE EXCLUSION SECTION II-LIABILITY COVERAGE,B.EXCLUSIONS,paragraph 5.FELLOW EMPLOYEE is deleted and replaced bythe following: "Bodily injury"to any fellow"employee"of the"insured"arising out of and in the course of the fellow "employee's"employment or while performing duties related to the conduct of your business.However,this exclusion does not apply to your"employees"that are officers or managers if the"bodily injury"results from the use of a covered"auto"you own,hire or borrow. Coverage is excess over any other collectible insurance. 5. HIRED AUTO PHYSICAL DAMAGE COVERAGE AND LOSS OF USE EXPENSE A. Under SECTION III-PHYSICAL DAMAGE COVERAGE,A.COVERAGE,the following is added: If any of your owned covered"autos"are covered for Physical Damage,we will provide Physical Damage coverage to"autos"that you or your"employees"hire or borrow,under your name or the"employee's" name,for the purpose of doing your work. We will provide coverage equal to the broadest physical damage coverage applicable to any covered"auto"shown in the Declarations,Item Three,Schedule of Covered Autos You Own,or on any endorsements amending this schedule. B. Under SECTION III-PHYSICAL DAMAGE COVERAGE,A.4.COVERAGE EXTENSIONS,paragraph b. Loss of Use Expenses is deleted and replaced with the following: b. Loss Of Use Expenses For Hired Auto Physical Damage,we will pay expenses for which an"insured"becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver,under a written rental contractor agreement. We will pay for loss of use expenses if caused by: (1) Other than collision,only if the Declarations indicate that Comprehensive Coverage is provided for any covered"auto"; (2) Specified Causes of Loss,only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered"auto";or Includes copyrighted material of Insurance Services Office,Inc. Page2of6 CA71710508 16C 3 (3) Collision,only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However,the most we will pay for any expenses for loss of use is$30 per day,to a maximum of $2,000. C. Under SECTION IV—BUSINESS AUTO CONDITIONS,paragraph 5.b.Other Insurance is deleted and replaced bythe following: b. For Hired Auto Physical Damage Coverage,the following are deemed to be covered"autos"you own: 1. Any covered"auto"you lease,hire,rent or borrow;and 2. Any covered"auto"hired or rented by your"employee"under a contract in that individual "employee's"name,with your permission,while performing duties related to the conduct of your business, However,any"auto"that is leased,hired, rented or borrowed with a driver is not a covered"auto",nor is any"auto"you hire from any of your"employees",partners(if you are a partnership),members(if you are a limited liability company),or members of their households. 6. LOAN OR LEASE GAP COVERAGE Under SECTION III-PHYSICAL DAMAGE COVERAGE,A.COVERAGE,the following is added: If a covered"auto"is owned or leased and if we provide Physical Damage Coverage on it,we will pay,in the event of a covered total"loss",any unpaid amount due on the lease or loan for a covered"auto", less: (a) The amount paid under the Physical Damage Coverage Section of the policy;and (b) Any: (1) Overdue lease or loan payments including penalties,interest or other charges resulting from overdue payments at the time of the"loss"; (2) Financial penalties imposed under a lease for excessive use,abnormal wear and tear or high mileage; (3) Costs for extended warranties,Credit Life Insurance,Health,Accident or Disability Insurance purchased with the loan or lease; (4) Securitydeposits not refunded by a lessor;and (5) Carry-over balances from previous loans or leases. 7. RENTAL REIMBURSEMENT SECTION III-PHYSICAL DAMAGE COVERAGE,A.COVERAGE,paragraph 4.Coverage Extensions is deleted and replaced by the following: 4. Coverage Extensions (a) We will pay up to$75 per day to a maximum of$2000 for transportation expense incurred by you because of covered"loss". We will pay only for those covered"autos"for which you carry Collision Coverage or either Comprehensive Coverage or Specified Causes of Loss Coverage. We will pay for transportation expenses incurred during the period beginning 24 hours after the covered"loss" and ending, regardless of the policy's expiration,when the covered"auto"is returned to use or we pay for its"loss". This coverage is in addition to the otherwise applicable coverage you have on a covered"auto". No deductibles apply to this coverage. (b) This coverage does not apply while there is a spare or reserve"auto"available to you for your operation. Includes copyrighted material of Insurance Services Office, Inc. CA71710508 Page 3of6 16C3 8. AIRBAG COVERAGE SECTION III-PHYSICAL DAMAGE,B.EXCLUSIONS,Paragraph 3. is deleted and replaced by the following: We will not pay for loss"caused by or,resulting from any of the following unless caused by other"toss"that is covered by this insurance: a. Wear and tear,freezing,mechanical or electrical breakdown. However,this exclusion does not include the discharge of an airbag. b. Blowouts,punctures or other road damage to tires. 9. GLASS REPAIR-WAIVER OF DEDUCTIBLE SECTION III-PHYSICAL DAMAGE COVERAGE,D.DEDUCTIBLE is amended to add the following: No deductible applies to glass damage. 10. COLLISION COVERAGE—WAIVER OF DEDUCTIBLE SECTION III-PHYSICAL DAMAGE COVERAGE,D.DEDUCTIBLE is amended to add the following: When there is a"loss"to your covered`auto"insured for Collision Coverage,no deductible will apply if the "loss"was caused by collision with another"auto"insured by us. 11. KNOWLEDGE OF ACCIDENT SECTION IV-BUSINESS AUTO CONDITIONS,A.LOSS CONDITIONS,2.DUTIES IN THE EVENT OF ACCIDENT,CLAIM,SUIT OR LOSS,paragraph a is deleted and replaced by the following a You must see to it that we are notified as soon as practicable of an"accident",claim,"suit"or"loss". Knowledge of an"accident",claim,"suit"or"loss"by your"employees"shall not,in itself,constitute knowledge to you unless one of your partners,executive officers,directors,managers,or members(if you are a limited liability company)has knowledge of the"accident",claim,"suit"or"loss".Notice should include: (1) How,when and where the"accident"or"loss"occurred; (2) The"insured's"name and address;and (3) To the extent possible,the names and addresses of any injured persons and witnesses. 12. TRANSFER OF RIGHTS(BLANKET WAIVER OF SUBROGATION) SECTION IV-BUSINESS AUTO CONDITIONS A.5.TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is deleted and replaced by the following: If any person or organization to or forwhom we make payment underthis Coverage Form has rights to recover damages from another,those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after"accident"or loss"to impair them. However,if the insured has waived rights to recover through a written contract,or if your work was commenced under a letter of intent or work order,subject to a subsequent reduction in writing with customers whose customary contracts require a waiver,we waive any right of recovery we may have under this Coverage Form. 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV-BUSINESS AUTO CONDITIONS,B.GENERAL CONDITIONS,2.CONCEALMENT, MISREPRESENTATION OR FRAUD is amended by the addition of the following: We will not deny coverage under this Coverage Form if you unintentionally fail to disclose all hazards existing as of the inception date of this policy. You must report to us any knowledge of an error or omission in your representations as soon as practicable after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. Includes copyrighted material of Insurance Services Office, Inc. • Page4offi CA71710508 i6C3 14. AUDIO,VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE SCHEDULE Description of Covered "Auto": Limit of Insurance Deductible $500 $250 A. Coverage 1. We will pay,with respect to a covered"auto"described in the above Schedule,for"loss"to any electronic equipment that receives or transmits audio,visual or data signals and that is not designed solelyfor the reproduction of sound. This coverage applies only if the equipment is permanently installed in the covered"auto"at the time of the"loss"or the equipment is removable from a housing unit that is permanently installed in the covered"auto"at the time of"loss',and such equipment is designed to be solely operated by use of the power from the"auto's"electrical system,in or upon the covered"auto". 2. We will pay,with respect to a covered"auto"described in the above Schedule,for"loss"to any accessories used with the electronic equipment described in paragraph A.1.above. However,this does not include tapes,records or discs. B. Exclusions For purposes of this provision 14,the exclusions that apply to Physical Damage Coverage,except forthe exclusion relating to Audio,Visual and Data Electronic Equipment,also apply to coverage provided by this endorsement. In addition,the following exclusions apply: We will not pay,under this endorsement,for either any electronic equipment or accessories used with such electronic equipment that is: 1. Necessary for the normal operation of the covered"auto"or the monitoring of the covered"auto's" operating system;or 2. Both: a. An integral part of the same unit housing any sound reproducing equipment designed solely for the reproduction of sound if the sound reproducing equipment is permanently installed in the covered"auto";and b. Permanently installed in the opening of the dash or console normally used by the manufacturer for the installation of a radio. 3. A device designed or used to detect speed measuring equipment such as radar or laser detectors or a jamming apparatus intended to elude or disrupt speed measurement equipment,whether permanently installed or temporarily mounted in or on the covered"auto". C. Limit of Insurance With respect to coverage under provision 14.of this endorsement,the Limit of Insurance provision of Physical Damage Coverage is replaced by the following: 1. The most we will pay for all"loss"to audio,visual or data electronic equipment and any accessories used with this equipment, as described in paragraph A.above,as a result of any one"accident',is the lesser of: a. The actual cash value of the damaged or stolen property as of the time of the'loss";or b. The cost of repairing or replacing the damaged or stolen property with other property of like kind and quality;or c. The amount shown in the Schedule. includes copyrighted material of Insurance Services Office, Inc. CA 7171 05 08 Page 5 of 6 16C3 3 2, An adjustment for depreciation and physical condition will be made in determining actual cash value at the time of the loss". 3. If a repair or replacement results in betterthan like kind or quality,we will not pay for the amount of betterment., D. Deductible 1. If lossto the audio,visual or data electronic equipment or accessories used with this equipment,as described in paragraph A.above,is the result of a"loss'to the covered"auto"under this Coverage Form's Comprehensive or Collision Coverage,then for each covered"auto"our obligation to pay for, repair,return or replace damaged or stolen property will be reduced bythe applicable deductible shown in the Declarations. Any Comprehensive Coverage deductible shown in the Declarations does not apply to"loss'to audio,visual or data electronic equipment caused by fire or lightning. 2. !floss"to the audio,visual or data electronic equipment or accessories used with this equipment,as described in paragraph A.above,is the result of a"loss"to the covered"auto"under this Coverage Form's Specified Causes of Loss Coverage,then for each covered"auto"our obligation to pay for, repair, return or replace damaged or stolen property will be reduced bythe applicable deductible shown in the Schedule of this endorsement. 3. If"loss"occurs solely to the audio,visual or data electronic equipment or accessories used with this equipment,as described in paragraph A.above,then for each covered"auto'our obligation to pay for,repair,return or replace damaged or stolen property will be reduced by the applicable deductible shown in the Schedule of this endorsement. 4. In the event thatthere is more than one applicable deductible,only the highest deductible will apply. In no event will more than one deductible apply. E. When This Provision Becomes Void This provision,AUDIO,VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE,is void if CA 99 60,Audio,Visual And Data Electronic Equipment Coverage,is attached to the policy. Includes copyrighted material of Insurance Services Office, Inc. Page 6 of 6 CA 71 71 05 08 16C 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S BLANKET ADDDITiONAL INSURED ENDORSEMENT FORM A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy Number Agency Number Policy Effective Date GL 20732670602 0825463 11/17/2016 Policy Expiration Date Date Account Number 11/17/2017 11/28/2016 20048469 Named Insured Agency Issuing Company COASTAL CONCRETE PRODUCTS LLC Gt7LFSHORE INSURANCE, INC. AMERISUR.E MUTUAL INSURANCE COMPANY 1. a. SECTION 11-WHO IS AN INSURED is amended to add as an additional insured any person or organization: (1) Whom you are required to add as an additional insured on this policy under a written contract or written agreement relating to your business;or (2) Who is named as an additional insured under this policy on a certificate of insurance. b. The written contract,written agreement,or certificate of insurance must (1) Require additional insured status for a time period during the term of this policy,and (2) Be executed prior to the"bodily injury","property damage",or"personal and advertising injury" leading to a claim under this policy. C. If,however: (1) "Your work" began under a letter of intent or work order,and (2) The letter of intent or work order led to a written contractor written agreement within 30 days of beginning such work;and (3) Your customer's customary contracts require persons or organizations to be named as additional insureds; we will provide additional insured status as specifiedin this endorsement. 2. The insurance provided under this endorsement is limited as follows: a That person or organization is an additional insured only with respect to liability caused, in whole or in part, by: (1) Premises you: (a)Own; (b)Rent; (c)Lease;or (d)Occupy; (2) Ongoing operations performed by you or on your behalf. Ongoing operations does not apply to "bodily Injury"or"property damage'occurring after: Includes copyrighted material of Insurance Services Office, Inc. CG 70 48 10 15 Pages 1 of 4 16C3 (a) All work to be performed by you or on your behalf for the additional insured(s)at the site of the covered operations is complete,including related materials, parts or equipment(other than service, maintenance or repairs);or (b) That portion of"your work'out of which the injury or damage arises is put to its intended use by any person or organization other than another contractor working fora principal as a part of the same project. (3) Completed operations coverage,but only it (a) The written contract,written agreement,or certificate of insurance requires completed operations coverage or"your work"coverage;and (b) This coverage part provides coverage for"bodily injury"or"property damage"included within the"products-completed operations hazard". However,the insurance afforded to such additional insured only applies to the extent permitted by law. b. If the written contract,written agreement,or certificate of insurance: (1) Requires"arising out of language;or (2) Requires you to provide additional insured coverage to that person or organization by the use of either or both of the following: (a) Additional Insured—Owners,Lessees or Contractors—Scheduled Person Or Organization. endorsement CG 201010 01;or (b) Additional Insured—Owners,Lessees or Contractors-Completed Operations endorsement CG 20371001; then the phrase"caused, in whole or in part, by'in paragraph 2.a.above is replaced by"arising out of. c. lf the written contract,written agreement,or certificate of insurance requires you to provide additional insured coverage to that person or organization by the use of: (1) Additional Insured—Owners,Lessees or Contractors—Scheduled Person Or Organization endorsement CG 2010 07 04 or CG 2010 0413;or (2) Additional Insured—Owners,Lessees or Contractors—Completed Operations endorsement CG 20 37 0704 or CG 2037 0413;or (3) Both those endorsements with either of those edition dates;or (4) Either or both of the following (a) Additional Insured—Owners,Lessees or Contractors—Scheduled Person Or Organization endorsement CG 2010 without an edition date specified;or (b) Additional Insured—Owners,Lessees or Contractors—Completed Operations endorsement CG 20 37 without an edition date specified; then paragraph 2.a.above applies. d. Premises,as respects paragraph 2.a.(1)above,include common or public areas about such premises if so required in the written contract or written agreement. e. Additional insured status provided under paragraphs 2.a.(1)(b)or 2.a.(1)(c)above does not extend beyond the end of a premises lease or rental agreement. f. The limits of insurance that apply to the additional insured are the least of those specified in the: (1) Written contract (2) Written agreement; (3) Certificate of insurance;or (4) Declarations of this policy. The limits of insurance are inclusive of and not in addition to the limits of insurance shown in the Declarations. Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 4 CG 7048'1015 16C3 g. The insurance provided to the additional insured does not apply to"bodily injury", "property damage", or "personal and advertising injury"arising out of an architect's,engineer's,or surveyors rendering of,or failure to render,any professional services, including but not limited to: (1) The preparing,approving, or failing to prepare or approve: (a)Maps; (b)Drawings; (c)Opinions; (d)Reports; (e)Surveys; (f)Change orders; (g)Design specifications;and (2) Supervisory,inspection,or engineering services. h. SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS,paragraph 4.Other Insurance is deleted and replaced with the following: 4. Other Insurance. Coverage provided by this endorsement is excess over any other valid and collectible insurance available to the additional insured whether a.Primary; b.Excess; c.Contingent;or d.On any other bas is;µ but if the written contract,written agreement,or certificate of insurance requires primary and non- contributory coverage,this insurance will be primary and non-contributory relative to other insurance available to the additional insured which covers that person or organization as a Named Insured,and we will not share with that other insurance. i. If the written contract,written agreement,or certificate of insurance as outlined above requires additional insured status by use of CG 20 1011 85,then the coverage provided under this CG 70 48 endorsement does not apply except for paragraph 2.h.Other Insurance. Additional insured status is limited to that provided by CG 20 10 11 85 shown below and paragraph 2.h.Other Insurance shown above. ADDITIONAL INSURED-OWNERS,LESSEES OR CONTRACTORS(FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Blanket Where Required by Written Contract,Agreement,or Certificate of Insurance that the terms of CG 2010 11 85 apply (If no entry appears above,information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement) WHO IS AN INSURED(Section II)is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of"your work"for that insured by or for you. CG 20:101185 Copyright, insurance Services Office. Inc., 1984 Includes copyrighted material of Insurance Services Office, inc. CG 70481013 Pages 3 of 4 16C 3 j. The insurance provided by this endorsement does not apply to any premises or work for which the person or organization is specifically listed as an additional insured on another endorsement attached to this policy. Includes copyrighted material of Insurance Services Office, Inc. Page4of4 CG70481015