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#18-7443 Assumption Agreement (Reladyne Florida, LLC)
ASSUMPTION AGREEMENT This Assumption Agreement is made and entered into on this g + of "Tune. 2022 by and between RELADYNE FLORIDA, LLC ("Reladyne") and COLLIER COUNTY, a political subdivision of the State of Florida ("County"), (collectively the"Parties"). WHEREAS, on December 11, 2018 (Agenda Item 16E2) the County awarded a RFQ No. 18-7443, "Motor Oils, Lubricants and Fluids" as a PO Driven Agreement to Flamingo Oil Corporation ("Flamingo"), and attached hereto as Exhibit"A" is a copy of the Award Letter; and WHEREAS, on February 1, 2021, Reladyne, a Delaware limited liability company registered to do business in Florida, and merged with Flamingo, with Reladyne as the surviving entity which is memorialized in the attached Exhibit"B;" and WHEREAS, Reladyne, hereby represents to Collier County that by virtue of the merger, it is the successor in interest in relation to the Agreement; and WHEREAS,the Parties wish to formalize Reladyne's assumption of rights and obligations under the Agreement effective as of the date first above written. NOW THEREFORE, IN CONSIDERATION of the mutual promises in this Assumption Agreement, and for other good and valuable consideration, the receipt and sufficiency of which are acknowledged by the Parties, it is agreed as follows: 1. Reladyne accepts and assumes all rights, duties, benefits, and obligations of Flamingo under the PO Driven Agreement,including all existing and future obligations to pay and perform under the Agreement. 2. Reladyne will promptly deliver to County evidence of insurance consistent with the Agreement. 3. Further supplements to, or modifications of, the Agreement shall be approved in writing by both parties. 4. Notice required under the Agreement to be sent to Reladyne shall be directed to: VENDOR: Reladyne Florida, LLC 205 NE 179th Street, Miami, FL 33162 Phone: (904) 386-1099 Attention: Jon Sistrunk 5. The County hereby consents to Reladyne's assumption of the PO Driven Agreement in order to continue the services provided under Agreement No. 18-7443. No waivers of perfonnance or extensions of time to perform are granted or authorized. The County will treat Page 1 of 2 Reladyne as it would have Flamingo for all purposes under the Agreement. Except as provided herein, all other terms and conditions of the Agreement remain in full force and effect. IN WITNESS WHEREOF,the undersigned have executed and delivered this Assumption Agreement effective as of the date first above written. ATTEST: BOARD OF COUNTY COMMISSIONERS Crystal K. Kjitize:l, Clerk COLLIER COUNTY, FLORIDA & ComptrYrpqr eiffff r By: _.r By: Wil;f m L. McDaniel, Jr., Chair eputyTk vtApproved to Form and Leg : By: 614-4-k ssistant County Attorney Reladyne's Witnesses: Reladyne Florida, LLC ?Iv c5'bitizefra By: r .ram First Witness Signature.' `, Jon Sistrunk Larry Stoddard, President & CEO TType/print signature and titleT TType/print witness nameT P �7V -47_ Second Witness Patrick Hennessey TType/print witness nameT Page 2 of 2 J/ ap EXHIBIT A From: VannODal To: "FLA.orders.Miami(areladvne,com";"achOoinkbird.com" Cc: BurksMichael;Renewals Subject: Award of Bid# 18-7443"Motor Oils,Lubricants and Fluids" Date: Tuesday,December 11,2018 12:52:00 PM Attachments: imaae001.ioq Dear Mr. Moseley: This email serves as notification that you have been awarded the above Bid # 18-7443 "Motor Oils, Lubricants and Fluids" in accordance with the terms, conditions and the specifications of the solicitation. A formal contract for this service will not be necessary. The Collier County department will forward a purchase order which will serve as the County's agreement to your proposal. Thank you for your interest in Collier County, and congratulations on the award of this solicitation. If there are any questions, please do not hesitate to contact Michael Burks, Project Manager, at 239-252-4135. Respectfully, dtaB mil. Twat Procurement Technician New Logo Version email dec92017 Collier County Procurement Services NOTE:Email Address Has Changed 3295 Tamiami Trail East Naples, FL 34112 (239) 252-6020 Opal.Vann(colliercountyfl.gov Collier County Procurement Services is pleased to announce, it has partnered with BidSync to provide Free web-based Bidding services to its vendors, suppliers and contractors. We are now"live on the new bidding platform. Register today at www.bidsync.com. For Registration Assistance, please contact BidSync customer service at 800-990-9339 Or email: support@bidsync.com co EXHIBIT B (Requestors Name) (Address) ' 700358545987 (Address) (City/State/Zip/Phone#) El PICK-UP WAIT MAIL (Business Entity Name) (Document Number) Certified Copies Certificates of Status • Special Instructions to Filing Officer ' Office Use Only • -t tr t jg - r-� 4-11 r,: c&) Sunshine State Corporate Compliance Company 3458 taks%o'e D,iue, T 11a/assee, fopicia 32372 (850) 656-4724 DATE 02/01/2021 "WALK IN*' ENTITY NAME RELADYNE FLORIDA, LLC DOCUMENT NUMBER ••P1MSEF/IE7WEA77 401/0 ANTI kf77eRN** Plop( Coly XXXXXX Cert0eal C% Ccr*atc of status **PCEASEIIBTA/N 77/EFOI1O4//NQ foe 7WEA50VEEN7779*** Cert/pd Coly of/1,4 & ,AreKd. & Ce4cat6 al Oad YearcO0 * o:PaE/NOrooz CEpfrc rrON** COGINT,w Of OES704770N N6!,if f OFCF°77F/C47Ef,et-gaESTE0 TOTAL OWED$195.00 ACCOUNT #: 120160000072 Please cal 77ra at t/e a6aue /ramie,- for. a/rg /saes o,' ca e'Ks. 7ri 01 boa so maci./ • txk r • t-41rY15 FLORIDA DEPARTMENT OF STATE Division of Corporations February 2, 2021 SUNSHINE STATE CO fa RECTED Please Allow For Same File Date SUBJECT: FLAMINGO OIL CORPORATION Ref. Number: P99000005737 We have received your document for FLAMINGO OIL CORPORATION and the authorization to debit your account in the amount of $195.00. However, the document has not been filed and is being returned for the following: As a condition of a merger, pursuant to s.605.0212(8) and/or s.607.1622 (8), Florida Statutes, each party to the merger must be active and current in filing its annual reports with the Department of State through December 31 of the calendar year in which the articles of merger are submitted for filing. Please return your document, along with a copy of this letter, within 60 days or your filing will be considered abandoned. If you have any questions concerning the filing of your document, please call (850) 245-6050. Yasemin Y Sulker Regulatory Specialist III Letter Number: 021A00002335 Y• •I www.sunbiz.org • • COVER LETTER '1'O: Amendment Section Division of Corporations SUBJECT: RelaDyne Florida, LLC Name of Surviving Party The enclosed Certificate of Merger and fee(s)arc submitted for filing. Please return all correspondence concerning this matter to: Julie A. Taylor Contact Person c/o Fredrikson & Byron, PA • Firm/Company 200 S. 6th Street, Suite 4000 Address Minneapolis, MN 55402 City, State and Zip Code jtaylor@fredlaw.com E-mail address: (to be used for future annual report notification) For further information concerning this matter, please call: Julie A. Taylor at (612 )492-7716 Name of Contact Person Area Code Daytime Telephone Number Cl Certified copy(optional) $30.00 STREET ADDRESS: MAILING ADDRESS: Amendment Section Amendment Section Division of Corporations Division of Corporations Clifton Building P. O. Box 6327 2661 Executive Center Circle Tallahassee, FL 32314 Tallahassee, FL 32301 CR2E0S0 (2/14) G�,0 • Articles of Merger For Florida Limited Liability Company The following Articles of Merger is submitted to merge the following Florida Limited Liability Company(ics) in accordance with s. 605.1025. Florida Statutes. FIRST: The exact name. form/entity type. and jurisdiction for each mers;ing party are as follows: Name Jurisdiction Form/Entity Type Flamingo Oil Corporation Florida corporation Flamingo Shop Scry Corp. Florida corporation Jack Becker Distributors, Inc. Florida corporation Seaboard Distribution. Inc. Florida corporation SECOND: The exact name, form/entity type. and jurisdiction of the surviving party are as follows: Name Jurisdiction Form/Entity Type RelaDvnc Florida, Ll_C Delaware limited liability company THIRD: The merger was approved by each domestic merging entity that is a limited liability company in accordance with ss.605.1021-605.1026; by each other merging entity in accordance with the laws of its jurisdiction; and by each member of such limited liability company who as a result of the merger will have interest holder liability under s.605.I023(1)(b). co • FOURTH: Please check one of the boxes that apply to surviving entity:(if applicable) NOT APPLICABLE This entity exists before the merger and is a domestic filing entity, the amendment, if any to its public organic record are attached. ❑ This entity is created by the merger and is a domestic filing entity, the public organic record is attached. • ❑ This entity is created by the merger and is a domestic limited liability limited partnership or a domestic limited liability partnership, its statement of qualification is attached. ❑ This entity is a foreign entity that does not have a certificate of authority to transact business in this state.The mailing address to which the department may send any process served pursuant to s.605.0117 and Chapter 48, Florida Statutes is: FIFTH: This entity agrees to pay any members with appraisal rights the amount, to which members are entitled under ss.605.1006 and 605.1061-605.1072. F.S. SIXTH: If other than the date of filing, the delayed effective date of the merger, which cannot be prior to nor more than 90 days after the date this document is filed by the Florida Department of State: Note: Ville date inserted in this block does not meet the applicable statutory filing requirements, this date, ll not be listed as the document's effective date on the Department of State's records. SEVENTH: Signature(s) for Each Party: �. t Typed:or'i'rinted Name of Entity/Organization: Si'Oahu s: Name of u ^- Flamingo Oil Corporation Larry 1fStoddarsl;: t"r i rn` Q .� Flamingo Shop Scry Corp. Larry 1:Stoddard•• Jack Becker Distributors,Inc. — Larry 1.Stallard Seaboard Distribution,Inc. Larry J.Stoddard Corporations: Chairman, Vice Chairman, President or Officer qua directors selected, signature rf incorporator.) General partnerships: Signature of a general partner or authorized person Florida Limited Partnerships: Signatures of all general partners Non-Florida Limited Partnerships: Signature of a general partner limited Liability Companies: Signature of an authorized person Fees: For each Limited Liability Company: $25.00 For each Corporation: $35.00 For each Limited Partnership: $52.50 For each General Partnership: $25.00 For each Other Business Entity: $25.00 Certified Copy(optional): S30.00 Co per County Administrative Services Department Procurement Services Division NEW BUSINESS/VENDOR FORM For all Board approved contracts, the Board of County Commissioners shall approve all assignments of contracts requested by the predecessor contracting party, per(Procurement Ordinance (19) (8)).Upon receipt of all proper documentation, Collier County Procurement will draft an Assumption Agreement which will be presented at the next available board meeting for Board approval and execution. Concerning Collier County Agreement#/Title: #18-7443 "Motor Oil, Lubricants and Fluids" with Flamingo Oil Corporation (current vendor) Please select one of the following: Q Merger ❑Acquisition ❑ Change in Business Organization (i.e.Corporation to LLC,Sole Proprietor to Partnership, Etc.) ❑ Other ADDITIONAL Documentation cannot be in the names of affilates,subsidiaries or parent companies.You will be notified if any REQUIRED additional information is needed based on the particulars of your firm's merger or acquisition. DOCUMENTS 1. Formal documentation of the acquisition/merger, signed by the Corporate Officer(s),showing the effective date of purchase, and/or a detailed Asset Purchase Agreement. 2. Company W-9 3. Current Certification from the Florida Department of State, Division of Corporations showing firm's name 4. Certificates of insurance meeting contractual insurance requirements 5. Department of Homeland Security's E-Verify MOU or profile page 6. Corporate resolution listing the signatory as authorized to sign 7. Business License 8. Required licenses/certifications to perform duties/tasks under Agreement(if applicable) Email this completed form along with the above listed documents to: PurOps@colliercountyfl.gov or Priscilla.Doria@colliercountyfl.gov NEW BUSINESS INFORMATION Legal Name(as registered with the IRS) RELADYNE FLORIDA, LLC Assumed Name(doing business as) FEIN-TAX ID Principal Address Mailing/Remittance Address (if different from above) Point of Contact Name/Title: Phone Number: Email: By submitting this form,you certify that: (a)you are authorized to represent the business listed above;and(b)all the information you have provided above is true and correct; Your Name(Print Name)&Title Signature Date Phone/Email New Business/Vendor Form(Version 3)1/8/20,u is>ot e49 Roq uoct for Taxpayer Gave form to the lfaev.tVh,hpi:o,al identification Nutntier and Certificaltion rr,lowilier, of,not Detwtm«tt o,the rreaszin Rind to the IRS. retiree Reserve Sevsv ► On te,►ww.bte.ytlr/FermW9 for trraln,cllorta rind the lei*at Information, it Nrese far meow.oo xxxxx ii;C;bne+tax tit;rnl Nen,►is twni*vea un Pile I,nr+,,to siit tent.*ri ii inns hlnnk. I Rai.ADYNE Ft t»It1A,i-l_C i t t't.rs,• s narwitiervatemwt entity owes it ANtweet Nrnm Above.. 3 LOw*.eporeeriete bos kr' i4vwl tax iiessitkehoo of the larerxi whnee riwne to mrtwwi e)r,fine 1 ChApck r,r4y one Iii the i 4 Frerhpines tr4riry apr y rrdy,n relkv irk, er,w*,boxes t rertee etr!ntos,,•,r Mrasrsvr,da'"A*e maftsfel ere per(0'9A f S ClTMhs: e1-,0M pnvpreetis,Of i r G(0,1+rrntirv, [1 8 t;retxnelir>r, ( .l Pertt+erxtdn L.) rnx,vestete eirioNer+xnvtesi Lle Exr+r pl p,yrr r vole tI rr=' f 1e"! l'rn'�tw7 weer,,nriywnv.Enter the tax<ineun.;'ntiun(L.-' t;cexprxaik>,1,S-S corporation,P Farfner- 1pl► .,_C,_, r Notre xties•k.the aporvicioate boa in the hoe nine fix the lax clawANicatiwl of pie xinpte.inMmtsv owner. T o not cMr:Y Fxampiton hers nercir reorient) I f Lt. ,,,„,...,,, ..Inex,Mc7 as a xingl+h mamae.LL C itra1 le deeper di!t from the owrie +Mice,the owner of the LL<;tic i anc4 w ILO that is not cM irthlw w1 horn the owner for U.S.ledfeei tax txnposes,Otherwise,A si i'le..mMnhre t1.0 that ram'f� j� is tfkevgsen..?Kt from the owner should check the Appropriate bow for the tax clasaihcwtion of its owner llNfer(lYM in9.lrtJty\`tMSl► {f An",r ec Leh.sies.'.f.ors*4* 4 !S .Address overtire.street.line apt..r suite not Sew instructionx. —iMrn,rat.,r'x Warne sod acSdres+wC* ^+�) j 1PO BOX 645857 II Cers, state.and 7..1P ix0e — ... 'cINCINNATT,OH 45264-5857 7 i ist ac.r.oxmt n;r,bertal here(options) Part i Taxpayer Identification Number(TIN) _ __________ E-rle,your TIN in the appropriate box.The TIN provided must match the name given on line"' to avoid 1 social "r ^"^'be'_ baywri withholdrn For indrviduals,this is generally7 i g your social security number(SSN).However,fora �) i resident elren,sole proprietor,or disregarded entity,see the Instructions for Part I,later.For other _ i entities,it is your employer identification number(EIN).If you do not have a number,see How to get a ..... TN,latex. or Note:tr:the account is in more than one name,see the instructions for line 1,Also see What Name and [E^'Plotor 1440 ,x se°^ ambar �, Nurnber To Give the Requester for guidelines on whose number to enter. ' j 1 i 8 2 - 4 3 411I0l8 0i 1 Certification _.,_...,_ Under penalties of perjury,I certify that: 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me):and 2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all Interest or dividends,or(c)the IRS has notified me that a am rio longer subject to backup withholding;and 3.I am a U.S citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Corttficatton instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup wentloi©iny aea;ause you have tailed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured property.cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other tree)interest and dividends,you are not required to sign the certification,but you must provide your correct TiN.See the instructions for Fart II,tatty. _ Sign aignattire et i I4ere U S.person► Date I. a,1\.. ... 3' uL'( General instructions •Form 1099-DIV(dividends,including those Al stocks or mutua funds) Section reterenuss are;to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross noted. proceeds) Future developments,For the latest information about developments •Form 1009-H(stock or mutual fund sales aaid certain other related to Form W-9 and its instructions,such as legislation enacted transactions by brokers) after they were published,go to www.irs.gov/ForrrrW9. •Form 1099-S(proceeds from real estate transa.rtiots) Purpose of Form •Form 1099-K(merchant card arid third party iietwurk trana:li°tiol,sy An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1088-E(student loan interest), information return with the IRS roust obtain your correct taxpayer 1098-T(tuition) identification number(TIN)which rosy be your social security number •Form 1099-C(canceled debt) (SSN),in dividual taxpayer identrtication number(ITIN),adoption •Form 1099-A(acquisition or aba i dorun eat of.secured property) taxpayer identification number(ATIN),or employer identification number (EIN),to report on an information return the amount plaid to you,or ether Use Fotrri W-9 only h you are a U.S.plaint rt(ifhaltrdeitl a resider amount reportable on an lrtiornatiort return.Lxtunpfes of information alien),to provide goon correct TIN. retrxris include,but are not limited to,the following. If you tin riot return Fornt W-9 to the requester with a TIN,you rnisgnt •Form 1tI99-INT(interest earned or paid) tie subject fo backup wanhOkflaif" Sew vVttai is backup withholding, later. _ _. Cat.No.10Y31x _ _ _ .. Font W_01Hvv,tO.2oldl C0Q, C.- 0 Z. 2 ‹C `c X S. 0 -c n. Q X a o c o a c u, c Q 4 z c 0 cc n c. c c c to c cc E Q C_ Fe C LL LL 2 y %* ' L ".7 Q '...... a 1 C t_t '* E E • -li z �Z " 1 a c E a LiM' (6 ._ 0 F ~; Z T u `-.' U--- a W 12 T ..c a 9 -C R C 'D LL •., oii a 0) C • , (,,,,. CCc0 c 2 N ``' N CDa0 C 00 N > O CO C c Q> ›. co co co .- .- 'o p 00 O H N a ca N M W U W W L? o MI E 2 00 0 0 Q H H 10 o O O U) U1 < a Z a ot UDES Et CID f (0a Q o } Cr) } N E U O 4IM Q O L W Lo Ct Lf) ca 5 C ca E a) WW W Zcl 6 W J O = - L to = 2 = c c -0 _Ia, a) cE .— tZ cs H i ,F- w E W 0 A-' -C Q Z Q 73 Z Q 'C c •° aai Z Q) O Z O Z o tt E Z ii n. Z a) Z °; a) - < an = w w __ t en — v o U —_ o U r = v _ CO CO C oo Z • CO Z 0) i 0 W — 0 W MI .. ' 1... .� N t4 N d �. m l.L U. 0 U. 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N N U C) cv CO o C Z N J CO + ,� N C O O O 0 L U W < Z H (I) CO U < Ce N N N C] a o o CD I Zi Page 1 of 2 �"'� DATE(MMIDD/YYYY) .AC'C>>R'l7 CERTIFICATE OF LIABILITY INSURANCE 03/22/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Willis Towers Watson Certificate Center NAME: Willis Towers Watson Northeast, Inc. PHONE FAX c/o 26 Century Blvd (A/C.No.Ext): 1-877-945-7378 (A/C,No): 1-688-467 2378 P.O. Box 305191 ADDRESS: certificates@willis.com Nashville, TN 372305191 USA INSURER(S)AFFORDINGCOVERAGE NAIC# INSURERA: Nationwide Agribusiness Insurance Company 28223 INSURED INSURER B: Westchester Fire Insurance Company 10030 RelaDyne Florida LLC 205 NE 179th Street INSURERC: Allied World Assurance Company Limited D1571 Miami, FL 33162 INSURERD: Illinois Union Insurance Company 27960 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:w24194165 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. INSR TYPE OF INSURANCE AWL SUBR POLICY EFF POLICY EXP W LIMITS LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE CLAIMS-MADE X OCCUR PREMISES(Ea occur ence) $ 100,000 A MED EXP(Any one person) $ 5,000 Y CPP143237A 11/01/2021 11/01/2022 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X .IECOT- X I LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y CPP143237A 11/01/2021 11/01/2022 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIREDA NON-OWNED PROPERTY DAMAGE $ (NM ONLY kaqS ONLY (Per accident) X X ; X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 A ,-- EXCESS LIAB CLAIMS-MADE CU143237A 11/01/2021 11/01/2022 AGGREGATE $ 4,000,000 - DED RETENTION$ $ WORKERS COMPENSATION X PTATUTE OTH- ER AND EMPLOYERS'LIABILITY A ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? No N/A WCC143237B 04/01/2022 04/01/2023 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Excess Liability G46836224005 11/01/2021 11/01/2022 Each Occurrence $5,000,000 General Aggregate $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: For any and all work performed on behalf of Collier County. Commercial Umbrella/Excess is following form. SEE ATTACHED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE_ Collier County 3295 Tamiami Trail East, Bldg. C2 A , Naples, FL 34112 / ` S �� ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD O SR m: 22358277 BATCH: 2455879 C. AGENCY CUSTOMER ID: LOC#: ACGRD® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Willis Towers Watson Northeast, Inc. RelaDyne Florida LLC 205 NE 179th Street POLICY NUMBER Miami, FL 33162 See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Collier County is included as an Additional Insured as respects to General Liability and Auto Liability. General Liability and Auto Liability policies shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Additional Insured. INSURER AFFORDING COVERAGE: Allied World Assurance Company Limited NAIC#: D1571 POLICY NUMBER: 03131211 EFF DATE: 11/01/2021 EXP DATE: 11/01/2022 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Excess Liability Each Occurrence $5,000,000 Aggregate $5,000,000 INSURER AFFORDING COVERAGE: Illinois Union Insurance Company NAIC#: 27960 POLICY NUMBER: PPL G28167945 002 EFF DATE: 09/28/2021 EXP DATE: 09/28/2024 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Pollution Legal Liability Per Incident $10,000,000 SIR $100,000 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 0 SR ID: 22358277 BATCH: 2455879 CERT: W24194165 C‘N' CPP143237A COMMERCIAL GENERAL LIABILITY CG 20 43 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to 4. Engineering services, including related include as an additional insured any person(s) or supervisory or inspection services; organization(s) for whom you have agreed in 5. Medical, surgical, dental, X-ray or nursing writing in a contract or agreement that such services treatment, advice or instruction; person(s) or organization(s) be added as an additional insured on your policy. Such person(s) 6. Any health or therapeutic service treatment, or organization(s) is an additional insured only with advice or instruction; respect to liability for: 7. Any service, treatment, advice or instruction for 1. "Bodily injury" or "property damage" not the purpose of appearance or skin included in the "products-completed operations enhancement, hair removal or replacement, or hazard"; or personal grooming or therapy; 2. "Personal and advertising injury"; 8. Any service, treatment, advice or instruction relating to physical fitness, including service, caused by, in whole or in part, your acts or treatment, advice or instruction in connection omissions or the acts or omissions of those acting onyour behalf in theperformance ofyour with diet, cardiovascular fitness, bodybuilding or physical training programs; operations. 9. Optometry or optical or hearing aid services B. The insurance afforded to such additional insured including the prescribing, preparation, fitting, described in Paragraph A. of this endorsement: demonstration or distribution of ophthalmic 1. Only applies to the extent permitted by law; lenses and similar products or hearing aid and devices; 2. Will not be broader than that which you are 10. Body piercing services; required by the contract or agreement to 11. Services in the practice of pharmacy; provide for such additional insured. C. With respect to insurance afforded to these 12. Law enforcement or firefighting services; and additional insureds, the following additional 13. Handling, embalming, disposal, burial, exclusion applies: cremation or disinterment of dead bodies. This insurance does not apply to "bodily injury", This exclusion applies even if the claims against "property damage" or "personal and advertising any insured allege negligence or other wrongdoing injury" due to rendering of or failure to render any in the supervision, hiring, employment, training or professional service. This includes but is not monitoring of others by that insured, if the limited to: "occurrence" which caused the "bodily injury" or • "property damage", or the offense which caused 1. Legal, accounting or advertising services; the "personal and advertising injury", involved the 2. Preparing, approving, or failing to prepare or rendering of or failure to render any professional approve, maps, shop drawings, opinions, service. reports, surveys, field orders, change orders or drawings or specifications; 3. Inspection, supervision, quality control, architectural or engineering activities done by or for you on a project on which you serve as construction manager; CG 20 43 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2 G�,0 D. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III—Limits Of Insurance: whichever is less. The most we will pay on behalf of the additional This endorsement shall not increase the insured is the amount of insurance: applicable limits of insurance. 1. Required by the contract or agreement described in Paragraph A.; or Page 2 of 2 © Insurance Services Office, Inc., 2018 CG 20 43 12 19 G4,0 POLICY NUMBER: CPP143237A COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person(s)or organization(s)with whom you have agreed to such notice, in a valid written contract or written agreement As required by contract that has been executed prior to the loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III— Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included 1. Required bythe contract or agreement; or in the"products-completed operations hazard". q g However: 2. Available under the applicable limits of 1. The insurance afforded to such additional insurance, insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the 2. If coverage provided to the additional insured is applicable limits of insurance. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 0 CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 C4' CPP143237A COMMERCIAL GENERAL LIABILITY CG20011219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 G4,0 Policy No. CPP143237A, CU143237A, WCC143237B THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURER CANCELLATION TERMS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL LIABILITY UMBRELLA COVERAGE FORM WORKERS COMPENSATION COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. Should any of the above described policies be cancelled before the expiration date thereof, the insurer will send 30 days' notice of cancellation to the certificate holder, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. MLCC491 1118 Page 1 of 1 co CPP143237A COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance B. The following is added to the Other Insurance Condition in the Business Auto Coverage Form Condition in the Auto Dealers Coverage Form and and the Other Insurance - Primary And Excess supersedes any provision to the contrary: Insurance Provisions in the Motor Carrier This Coverage Form's Covered Autos Liability Coverage Form and supersedes any provision to Coverage and General Liability Coverages are the contrary: primary to and will not seek contribution from any This Coverage Form's Covered Autos Liability other insurance available to an "insured" under Coverage is primary to and will not seek your policy provided that: contribution from any other insurance available to 1. Such "insured" is a Named Insured under such an "insured" under your policy provided that: other insurance; and 1. Such "insured" is a Named Insured under such 2. You have agreed in writing in a contract or other insurance; and agreement that this insurance would be 2. You have agreed in writing in a contract or primary and would not seek contribution from agreement that this insurance would be any other insurance available to such primary and would not seek contribution from "insured". any other insurance available to such "insured". CA 04 49 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 1 CPO Policy CPP143237A COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The BUSINESS AUTO COVERAGE FORM is amended to include the following additions and extensions of coverage: A. NEWLY ACQUIRED OR FORMED ENTITIES B. TEMPORARY SUBSTITUTE AUTOS - PHYSICAL DAMAGE COVERAGE C. BLANKET ADDITIONAL INSURED - REQUIRED BY CONTRACT D. EMPLOYEES AS INSUREDS - NONOWNED AUTOS E. EMPLOYEE HIRED AUTOS F. SUPPLEMENTARY PAYMENTS- BAIL BONDS G. SUPPLEMENTARY PAYMENTS- LOSS OF EARNINGS H. FELLOW EMPLOYEE COVERAGE I. PROPERTY OF OTHERS J. PERSONAL EFFECTS COVERAGE K. AUTO MEDICAL PAYMENTS COVERAGE- INCREASED LIMITS L. EXPANDED TOWING COVERAGE M. AUTO LOAN OR LEASE COVERAGE N. RENTAL REIMBURSEMENT COVERAGE O. EXPANDED TRANSPORTATION EXPENSE P. EXPENSE YOU INCUR TO RECOVER A STOLEN AUTO Q. ACCIDENTAL AIRBAG DISCHARGE COVERAGE R. PHYSICAL DAMAGE-TWO OR MORE DEDUCTIBLES S. BLANKET WAIVER OF SUBROGATION T. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS U. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS A. NEWLY ACQUIRED OR FORMED ENTITIES The Named Insured shown in the Declarations is amended to include 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 (more than 50%) interest; if there is no other similar insurance available to that organization. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization, or the end of the policy period, whichever comes first. B. TEMPORARY SUBSTITUTE AUTOS - PHYSICAL DAMAGE COVERAGE The following is added to Paragraph C. Certain Trailers, Mobile Equipment And Temporary Substitute Autos of SECTION I - COVERED AUTOS: If Physical Damage Coverage is provided on a covered "auto" you own that is out of service because of its breakdown, repair, servicing, "loss", or destruction, then you have coverage for any "auto" you do not own, while used with the permission of its owner as a temporary substitute for the covered out of service "auto". The deductible for the temporary substitute "auto" will be the same as the applicable deductible for the covered "auto" it replaces. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 1 of 6 co COMMERCIAL AUTO C. BLANKET ADDITIONAL INSURED — REQUIRED BY CONTRACT The following is added to Paragraph A.1. Who Is An Insured of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person(s) or organization(s) is an additional "insured" with whom you have agreed in a valid written contract or agreement, executed prior to any "accident" or "loss", that such person(s) or organization(s) be added as an additional "insured" on your policy. Such persons or organizations are additional "insureds", but only with respect to liability for "bodily injury" or "property damage" caused by an "accident" that is, in whole or in part, caused by your acts or omissions or the acts or omissions of those acting on your behalf and resulting from the ownership, maintenance or use of a covered "auto". D. EMPLOYEES AS INSUREDS — NONOWNED AUTOS The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. EMPLOYEE HIRED AUTOS 1. Changes In Covered Autos Liability Coverage The following is added to the Who Is An Insured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes In General Conditions Paragraph 5.b. of the Other Insurance Condition in the BUSINESS AUTO COVERAGE FORM is replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: a. Any covered "auto" you lease, hire, rent or borrow; and b. Any covered "auto" hired or rented by your "employee" under a contract in an "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". F. SUPPLEMENTARY PAYMENTS — BAIL BONDS The following replaces Paragraph A.2.a. (2) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (2) Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 2 of 6 G�,O COMMERCIAL AUTO G. SUPPLEMENTARY PAYMENTS — LOSS OF EARNINGS The following replaces Paragraph A.2.a. (4) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (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. H. FELLOW EMPLOYEE COVERAGE The Fellow Employee Exclusion contained under the COVERED AUTOS LIABILITY COVERAGE does not apply. I. PROPERTY OF OTHERS The Care, Custody Or Control Exclusion in SECTION II — COVERED AUTOS LIABILITY COVERAGE does not apply to "property damage" to property, other than your property, up to an amount not exceeding $3,000 in any one "accident". This coverage applies as a result of a covered "loss", without applying a deductible. Coverage is excess over any other valid and collectible insurance. J. PERSONAL EFFECTS COVERAGE The following is added to Paragraph A.4. Coverage Extensions of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $1,000 for the "loss" to personal effects which are: (1) Owned by an "insured"; and (2) In or on your covered "auto". This coverage applies as a result of a covered "loss", without applying a deductible. Coverage is excess over any other valid and collectible insurance. K. AUTO MEDICAL PAYMENTS COVERAGE — INCREASED LIMITS In the event of a covered "loss" where Auto Medical Payments Coverage applies, we will double the Limit Of Insurance for Medical Payments shown in the Declarations for each "insured" who was wearing a seat belt at the time of the "accident". This limit is the most we will pay for all covered medical expenses regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident". L. EXPANDED TOWING COVERAGE The following replaces Paragraph A.2. of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to: 1. $100 for a covered "auto" you own of the private passenger type; or 2. $500 for a covered "auto" you own that is not of the private passenger type; for towing and labor costs incurred each time the covered "auto" is disabled. However, the labor must be performed at the place of disablement. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 3 of 6 COMMERCIAL AUTO M. AUTO LOAN OR LEASE COVERAGE Physical Damage Coverage is amended by the addition of the following: 1. In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan, including up to a maximum of $500 for early termination fees or penalties, for a covered "auto", less: a. The amount paid under the policy's Physical Damage Coverage; and b. Any: (1) Overdue lease/loan 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) Security deposits not returned by the lessor; (4) Costs of extended warranties, Credit Life insurance, Health, Accident, or Disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous loans or leases. 2. This coverage only applies to a "loss" which is also covered under this policy for Comprehensive, Specified Causes Of Loss, or Collision Coverage. 3. Coverage does not apply to any unpaid amount due on a loan for which the covered "auto" is not the sole collateral. 4. This endorsement does not apply to any covered "auto" for which broader coverage is provided by any other endorsement form on this policy. N. RENTAL REIMBURSEMENT COVERAGE 1. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of "loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. 2. This coverage applies only to a covered "auto" for which Physical Damage Coverage is provided on this policy. 3. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: a. The number of days reasonably required to repair or replace the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. b. 30 days. 4. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses incurred. b. $75 for any one day or for a maximum of 30 days. 5. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 6. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Expanded Transportation Expense Coverage Extension in this form. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 4 of 6 Gp0 COMMERCIAL AUTO 7. This endorsement does not apply to any covered "auto" for which broader coverage is provided by any other endorsement form on this policy. O. EXPANDED TRANSPORTATION EXPENSE Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE is replaced by the following: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes Of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". P. EXPENSE YOU INCUR TO RECOVER A STOLEN AUTO The following is added to Paragraph A.4. of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $5,000 for the expense of recovering a stolen covered "auto" to you. We will pay only for those covered "autos" for which you carry Comprehensive or Specified Causes Of Loss Coverage. Q. ACCIDENTAL AIRBAG DISCHARGE COVERAGE The following is added to Paragraph B.3.a. of SECTION III — PHYSICAL DAMAGE COVERAGE: Mechanical breakdown does not include the accidental discharge of an airbag. R. PHYSICAL DAMAGE — TWO OR MORE DEDUCTIBLES The following is added to Paragraph D. Deductible of SECTION III — PHYSICAL DAMAGE COVERAGE: When two or more covered "autos" sustain "loss" in the same collision, the "loss" will be reduced by the largest single deductible that applies. For purposes of this coverage, an "auto" and its attached "trailer" are two separate "autos". S. BLANKET WAIVER OF SUBROGATION The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply, but only when the Named Insured agrees that subrogation is waived prior to the "accident" or the "loss" under the terms of a written contract entered into between the Named Insured and an entity that is part of that contract. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 5 of 6 COMMERCIAL AUTO T. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following replaces Paragraph A.2.a. Duties In The Event Of Accident, Claim, Suit Or Loss of SECTION IV— BUSINESS AUTO CONDITIONS: We have no duty to provide coverage under this policy unless there has been full compliance with the following duties: a. In the event of "accident", claim, "suit", or "loss", your insurance manager or any other person you designate as responsible for insurance-related matters must notify us promptly of an "accident" or a "loss", regardless of the amount, which may result in a claim. 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. Paragraph A.2.b.(2) Duties In The Event Of Accident, Claim, Suit Or Loss of SECTION IV — BUSINESS AUTO CONDITIONS is amended as follows: b. Additionally, you and any other involved "insured" must: (2) Notify us and send us copies of any request, demand, order, notice, summons or legal papers received concerning the claim or "suit" as soon as practicable. For the purposes of this coverage provided, you are presumed to have knowledge of the "accident" or "loss" when it has been reported to the insurance manager or any other person you designate as responsible for insurance-related matters. U. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following Condition is added to SECTION IV— BUSINESS AUTO CONDITIONS: Unintentional Failure To Disclose Hazards Failure by you to disclose to us all hazards existing as of the inception date of this policy shall not prejudice us with respect to the coverage afforded by this policy, provided such error or omission is not intentional. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 6 of 6 Page 1 of 2 Cr) DATE(MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 03/22/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Willis Towers Watson Certificate Center NAME: Willis Towers Watson Northeast, Inc. PHONE FAX c/o 26 Century Blvd INC No,Estl: 1-8 77-945-737B (A/C,No): 1-888 467-2378 P.O. Box 305191 ADDRESS: certificates@willis.com Nashville, TN 372305191 USA INSURER(S)AFFORDINGCOVERAGE NAIC# INSURERA: Nationwide Agribusiness Insurance Company 28223 INSURED INSURER B: Westchester Fire Insurance Company 10030 RelaDyne Florida LLC 205 NE 179th Street INSURER C: Allied World Assurance Company Limited D1571 Miami, FL 33162 INSURER D: Illinois Union Insurance Company _ 27960 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:W24194165 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MMIDD/YYYY) (MMIDDIYYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAlvt -J CLAIMS-MADE ( X I OCCUR PREMISES(a o cur ence) $ 100,000 A MED EXP(Any one person) $ 5,000 I CPP143237A 11/01/2021 11/01/2022 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO POLICY X JECT- I X I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) - X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED Y CPP143237A 11/01/2021 11/01/2022 BODILY INJURY(Per accident) $ __ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ __Cr ci ONLY —_ N aS ONLY (Per accident) _ X X $ X UMBRELLALIAB X I OCCUR EACH OCCURRENCE $ 4,000,000 A -1EXCESSLIAB CLAIMS-MADE CU143237A 11/01/2021 11/01/2022 AGGREGATE $ 4,000,000 DEI) I RETENTION$ $ WORKERS COMPENSATION X STA PER OTH- TUTE ,ER AND EMPLOYERS'LIABILITY Y/N 1,000,000 A ANYPROPRIETOWPARTNER/EXECUTIVE No NIA WCC143237B 04/01/2022 04/01/2023 E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED7 1,000,000 — (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Excess Liability G46836224005 11/01/2021 11/01/2022 Each Occurrence $5,000,000 General Aggregate $5,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: For any and all work performed on behalf of Collier County. Commercial Umbrella/Excess is following form. SEE ATTACHED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Collier County 3295 Tamiami Trail East, Bldg. C2 `1 tb,S l\I--,lr,>YC Naples, FL 34112 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD -t‘P SR m: 22358277 snzcn: 2455879 F AGENCY CUSTOMER ID: LOC#: ACCORD ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Willis Towers Watson Northeast, Inc. RelaDyne Florida LLC 205 NE 179th Street POLICY NUMBER Miami, FL 33162 See Page 1 CARRIER NAIC CODE See Page 1 See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Collier County is included as an Additional Insured as respects to General Liability and Auto Liability. General Liability and Auto Liability policies shall be Primary and Non-contributory with any other insurance in force for or which may be purchased by Additional Insured. INSURER AFFORDING COVERAGE: Allied World Assurance Company Limited NAIC#: D1571 POLICY NUMBER: 03131211 EFF DATE: 11/01/2021 EXP DATE: 11/01/2022 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Excess Liability Each Occurrence $5,000,000 Aggregate $5,000,000 INSURER AFFORDING COVERAGE: Illinois Union Insurance Company NAIC#: 27960 POLICY NUMBER: PPL G28167945 002 EFF DATE: 09/28/2021 EXP DATE: 09/28/2024 TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: Pollution Legal Liability Per Incident $10,000,000 SIR $100,000 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 22358277 BATCH: 2455879 CERT: W24194165 CPP143237A COMMERCIAL GENERAL LIABILITY CG 20 43 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN CONTRACT OR AGREEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to 4. Engineering services, including related include as an additional insured any person(s) or supervisory or inspection services; organization(s) for whom you have agreed in 5. Medical, surgical, dental, X-ray or nursing writing in a contract or agreement that such services treatment, advice or instruction; person(s) or organization(s) be added as an additional insured on your policy. Such person(s) 6. Any health or therapeutic service treatment, or organization(s) is an additional insured only with advice or instruction; respect to liability for: 7. Any service, treatment, advice or instruction for 1. "Bodily injury" or "property damage" not the purpose of appearance or skin included in the "products-completed operations enhancement, hair removal or replacement, or hazard"; or personal grooming or therapy; 2. "Personal and advertising injury"; 8. Any service, treatment, advice or instruction relating to physical fitness, including service, caused by, in whole or in part, your acts or treatment, advice or instruction in connection omissions or the acts or omissions of those acting with diet, cardiovascular fitness, bodybuilding on your behalf in the performance of your or physical training programs; operations. 9. Optometry or optical or hearing aid services B. The insurance afforded to such additional insured including the prescribing, preparation, fitting, described in Paragraph A. of this endorsement: demonstration or distribution of ophthalmic 1. Only applies to the extent permitted by law; lenses and similar products or hearing aid and devices; 2. Will not be broader than that which you are 10. Body piercing services; required by the contract or agreement to 11. Services in the practice of pharmacy; provide for such additional insured. C. With respect to insurance afforded to these 12. Law enforcement or firefighting services; and additional insureds, the following additional 13. Handling, embalming, disposal, burial, exclusion applies: cremation or disinterment of dead bodies. This insurance does not apply to "bodily injury", This exclusion applies even if the claims against "property damage" or "personal and advertising any insured allege negligence or other wrongdoing injury" due to rendering of or failure to render any in the supervision, hiring, employment, training or professional service. This includes but is not monitoring of others by that insured, if the limited to: "occurrence" which caused the "bodily injury" or • "property damage", or the offense which caused 1. Legal, accounting or advertising services; the "personal and advertising injury", involved the 2. Preparing, approving, or failing to prepare or rendering of or failure to render any professional approve, maps, shop drawings, opinions, service. reports, surveys, field orders, change orders or drawings or specifications; 3. Inspection, supervision, quality control, architectural or engineering activities done by or for you on a project on which you serve as construction manager; CG 20 43 12 19 ©Insurance Services Office, Inc., 2018 Page 1 of 2 �Q,0 D. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III—Limits Of Insurance: whichever is less. The most we will pay on behalf of the additional This endorsement shall not increase the insured is the amount of insurance: applicable limits of insurance. 1. Required by the contract or agreement described in Paragraph A.; or Page 2 of 2 ©Insurance Services Office, Inc., 2018 CG 20 43 12 19 G40 POLICY NUMBER: CPP143237A COMMERCIAL GENERAL LIABILITY CG 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations Any person(s)or organization(s)with whom you have agreed to such notice,in a valid written contract or written agreement As required by contract that has been executed prior to the loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is "property damage" caused, in whole or in part, by required by a contract or agreement, the most we "your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the"products-completed operations hazard". 1. Required by the contract or agreement; or However: 2. Available under the applicable limits of 1. The insurance afforded to such additional insurance; insured only applies to the extent permitted by whichever is less. law; and This endorsement shall not increase the 2. If coverage provided to the additional insured is applicable limits of insurance. required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 12 19 ©Insurance Services Office, Inc., 2018 Page 1 of 1 4! CPP143237A COMMERCIAL GENERAL LIABILITY CG20011219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance (2) You have agreed in writing in a contract or Condition and supersedes any provision to the agreement that this insurance would be contrary: primary and would not seek contribution Primary And Noncontributory Insurance from any other insurance available to the additional insured. This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) The additional insured is a Named Insured under such other insurance; and CG 20 01 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1 CV% Policy No. CPP143237A, CU143237A,WCC143237B THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURER CANCELLATION TERMS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM COMMERCIAL GENERAL LIABILITY COVERAGE FORM COMMERCIAL LIABILITY UMBRELLA COVERAGE FORM WORKERS COMPENSATION COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. Should any of the above described policies be cancelled before the expiration date thereof, the insurer will send 30 days' notice of cancellation to the certificate holder, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. MLCC491 1118 Page 1 of 1 €, ref CPP143237A COMMERCIAL AUTO CA 04 49 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance B. The following is added to the Other Insurance Condition in the Business Auto Coverage Form Condition in the Auto Dealers Coverage Form and and the Other Insurance - Primary And Excess supersedes any provision to the contrary: Insurance Provisions in the Motor Carrier This Coverage Form's Covered Autos Liability Coverage Form and supersedes any provision to Coverage and General Liability Coverages are the contrary: primary to and will not seek contribution from any This Coverage Form's Covered Autos Liability other insurance available to an "insured" under Coverage is primary to and will not seek your policy provided that: contribution from any other insurance available to 1. Such "insured" is a Named Insured under such an "insured" under your policy provided that: other insurance; and 1. Such "insured" is a Named Insured under such 2. You have agreed in writing in a contract or other insurance; and agreement that this insurance would be 2. You have agreed in writing in a contract or primary and would not seek contribution from agreement that this insurance would be any other insurance available to such primary and would not seek contribution from "insured". any other insurance available to such "insured". CA 04 49 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 1 Policy CPP143237A COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM The BUSINESS AUTO COVERAGE FORM is amended to include the following additions and extensions of coverage: A. NEWLY ACQUIRED OR FORMED ENTITIES B. TEMPORARY SUBSTITUTE AUTOS - PHYSICAL DAMAGE COVERAGE C. BLANKET ADDITIONAL INSURED- REQUIRED BY CONTRACT D. EMPLOYEES AS INSUREDS- NONOWNED AUTOS E. EMPLOYEE HIRED AUTOS F. SUPPLEMENTARY PAYMENTS-BAIL BONDS G. SUPPLEMENTARY PAYMENTS-LOSS OF EARNINGS H. FELLOW EMPLOYEE COVERAGE I. PROPERTY OF OTHERS J. PERSONAL EFFECTS COVERAGE K. AUTO MEDICAL PAYMENTS COVERAGE- INCREASED LIMITS L. EXPANDED TOWING COVERAGE M. AUTO LOAN OR LEASE COVERAGE N. RENTAL REIMBURSEMENT COVERAGE O. EXPANDED TRANSPORTATION EXPENSE P. EXPENSE YOU INCUR TO RECOVER A STOLEN AUTO Q. ACCIDENTAL AIRBAG DISCHARGE COVERAGE R. PHYSICAL DAMAGE-TWO OR MORE DEDUCTIBLES S. BLANKET WAIVER OF SUBROGATION T. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS U. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS A. NEWLY ACQUIRED OR FORMED ENTITIES The Named Insured shown in the Declarations is amended to include 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 (more than 50%) interest; if there is no other similar insurance available to that organization. Coverage under this provision is afforded only until the 90th day after you acquire or form the organization, or the end of the policy period, whichever comes first. B. TEMPORARY SUBSTITUTE AUTOS - PHYSICAL DAMAGE COVERAGE The following is added to Paragraph C. Certain Trailers, Mobile Equipment And Temporary Substitute Autos of SECTION I - COVERED AUTOS: If Physical Damage Coverage is provided on a covered "auto" you own that is out of service because of its breakdown, repair, servicing, "loss", or destruction, then you have coverage for any "auto' you do not own, while used with the permission of its owner as a temporary substitute for the covered out of service "auto". The deductible for the temporary substitute "auto" will be the same as the applicable deductible for the covered "auto" it replaces. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 1 of 6 COMMERCIAL AUTO C. BLANKET ADDITIONAL INSURED — REQUIRED BY CONTRACT The following is added to Paragraph A.1. Who Is An Insured of SECTION II — COVERED AUTOS LIABILITY COVERAGE: Any person(s) or organization(s) is an additional "insured" with whom you have agreed in a valid written contract or agreement, executed prior to any 'accident" or "loss", that such person(s) or organization(s) be added as an additional "insured" on your policy. Such persons or organizations are additional "insureds", but only with respect to liability for "bodily injury" or "property damage" caused by an "accident" that is, in whole or in part, caused by your acts or omissions or the acts or omissions of those acting on your behalf and resulting from the ownership, maintenance or use of a covered "auto". D. EMPLOYEES AS INSUREDS — NONOWNED AUTOS The following is added to the SECTION II — COVERED AUTOS LIABILITY COVERAGE, Paragraph A.1. Who Is An Insured provision: Any "employee" of yours is an "insured" while using a covered "auto" you don't own, hire or borrow in your business or your personal affairs. E. EMPLOYEE HIRED AUTOS 1. Changes In Covered Autos Liability Coverage The following is added to the Who Is An Insured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in an "employee's" name, with your permission, while performing duties related to the conduct of your business. 2. Changes In General Conditions Paragraph 5.b. of the Other Insurance Condition in the BUSINESS AUTO COVERAGE FORM is replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos" you own: a. Any covered "auto" you lease, hire, rent or borrow; and b. Any covered "auto" hired or rented by your "employee" under a contract in an "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". F. SUPPLEMENTARY PAYMENTS — BAIL BONDS The following replaces Paragraph A.2.a. (2) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (2) Up to $5,000 for cost of bail bonds (including bonds for related traffic law violations) required because of an "accident" we cover. We do not have to furnish these bonds. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 2 of 6 . i , COMMERCIAL AUTO G. SUPPLEMENTARY PAYMENTS — LOSS OF EARNINGS The following replaces Paragraph A.2.a. (4) of SECTION II — COVERED AUTOS LIABILITY COVERAGE: (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. H. FELLOW EMPLOYEE COVERAGE The Fellow Employee Exclusion contained under the COVERED AUTOS LIABILITY COVERAGE does not apply. I. PROPERTY OF OTHERS The Care, Custody Or Control Exclusion in SECTION II —COVERED AUTOS LIABILITY COVERAGE does not apply to "property damage" to property, other than your property, up to an amount not exceeding $3,000 in any one "accident". This coverage applies as a result of a covered "loss", without applying a deductible. Coverage is excess over any other valid and collectible insurance. J. PERSONAL EFFECTS COVERAGE The following is added to Paragraph A.4. Coverage Extensions of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $1,000 for the "loss" to personal effects which are: (1) Owned by an "insured"; and (2) In or on your covered "auto". This coverage applies as a result of a covered "loss", without applying a deductible. Coverage is excess over any other valid and collectible insurance. K. AUTO MEDICAL PAYMENTS COVERAGE — INCREASED LIMITS In the event of a covered "loss" where Auto Medical Payments Coverage applies, we will double the Limit Of Insurance for Medical Payments shown in the Declarations for each "insured" who was wearing a seat belt at the time of the "accident". This limit is the most we will pay for all covered medical expenses regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident". L. EXPANDED TOWING COVERAGE The following replaces Paragraph A.2. of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to: 1. $100 for a covered "auto" you own of the private passenger type; or 2. $500 for a covered "auto" you own that is not of the private passenger type; for towing and labor costs incurred each time the covered "auto" is disabled. However, the labor must be performed at the place of disablement. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 3 of 6 COMMERCIAL AUTO M. AUTO LOAN OR LEASE COVERAGE Physical Damage Coverage is amended by the addition of the following: 1. In the event of a total "loss" to a covered "auto", we will pay any unpaid amount due on the lease or loan, including up to a maximum of$500 for early termination fees or penalties, for a covered "auto", less: a. The amount paid under the policy's Physical Damage Coverage; and b. Any: (1) Overdue lease/loan 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) Security deposits not returned by the lessor; (4) Costs of extended warranties, Credit Life insurance, Health, Accident, or Disability insurance purchased with the loan or lease; and (5) Carry-over balances from previous loans or leases. 2. This coverage only applies to a "loss" which is also covered under this policy for Comprehensive, Specified Causes Of Loss, or Collision Coverage. 3. Coverage does not apply to any unpaid amount due on a loan for which the covered "auto" is not the sole collateral. 4. This endorsement does not apply to any covered "auto" for which broader coverage is provided by any other endorsement form on this policy. N. RENTAL REIMBURSEMENT COVERAGE 1. We will pay for rental reimbursement expenses incurred by you for the rental of an "auto" because of"loss" to a covered "auto". Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto". No deductibles apply to this coverage. 2. This coverage applies only to a covered "auto" for which Physical Damage Coverage is provided on this policy. 3. We will pay only for those expenses incurred during the policy period beginning 24 hours after the "loss" and ending, regardless of the policy's expiration, with the lesser of the following number of days: a. The number of days reasonably required to repair or replace the covered "auto". If "loss" is caused by theft, this number of days is added to the number of days it takes to locate the covered "auto" and return it to you. b. 30 days. 4. Our payment is limited to the lesser of the following amounts: a. Necessary and actual expenses incurred. b. $75 for any one day or for a maximum of 30 days. 5. This coverage does not apply while there are spare or reserve "autos" available to you for your operations. 6. If "loss" results from the total theft of a covered "auto" of the private passenger type, we will pay under this coverage only that amount of your rental reimbursement expenses which is not already provided for under the Expanded Transportation Expense Coverage Extension in this form. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 4 of 6 COMMERCIAL AUTO 7. This endorsement does not apply to any covered "auto" for which broader coverage is provided by any other endorsement form on this policy. O. EXPANDED TRANSPORTATION EXPENSE Paragraph A.4.a. of SECTION III - PHYSICAL DAMAGE is replaced by the following: We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense incurred by you because of the total theft of a covered "auto" of the private passenger type. We will pay only for those covered "autos" for which you carry either Comprehensive or Specified Causes Of Loss Coverage. We will pay for temporary transportation expenses incurred during the period beginning 48 hours after the theft and ending, regardless of the policy's expiration, when the covered "auto" is returned to use or we pay for its "loss". P. EXPENSE YOU INCUR TO RECOVER A STOLEN AUTO The following is added to Paragraph A.4. of SECTION III — PHYSICAL DAMAGE COVERAGE: We will pay up to $5,000 for the expense of recovering a stolen covered "auto" to you. We will pay only for those covered "autos" for which you carry Comprehensive or Specified Causes Of Loss Coverage. Q. ACCIDENTAL AIRBAG DISCHARGE COVERAGE The following is added to Paragraph B.3.a. of SECTION III — PHYSICAL DAMAGE COVERAGE: Mechanical breakdown does not include the accidental discharge of an airbag. R. PHYSICAL DAMAGE —TWO OR MORE DEDUCTIBLES The following is added to Paragraph D. Deductible of SECTION III — PHYSICAL DAMAGE COVERAGE: When two or more covered "autos" sustain "loss" in the same collision, the "loss" will be reduced by the largest single deductible that applies. For purposes of this coverage, an "auto" and its attached "trailer" are two separate "autos". S. BLANKET WAIVER OF SUBROGATION The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply, but only when the Named Insured agrees that subrogation is waived prior to the "accident" or the "loss" under the terms of a written contract entered into between the Named Insured and an entity that is part of that contract. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 5 of 6 COMMERCIAL AUTO T. AMENDED DUTIES IN THE EVENT OF ACCIDENT, CLAIM, SUIT OR LOSS The following replaces Paragraph A.2.a. Duties In The Event Of Accident, Claim, Suit Or Loss of SECTION IV— BUSINESS AUTO CONDITIONS: We have no duty to provide coverage under this policy unless there has been full compliance with the following duties: a. In the event of "accident", claim, "suit", or "loss", your insurance manager or any other person you designate as responsible for insurance-related matters must notify us promptly of an "accident" or a "loss", regardless of the amount, which may result in a claim. 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. Paragraph A.2.b.(2) Duties In The Event Of Accident, Claim, Suit Or Loss of SECTION IV — BUSINESS AUTO CONDITIONS is amended as follows: b. Additionally, you and any other involved "insured" must: (2) Notify us and send us copies of any request, demand, order, notice, summons or legal papers received concerning the claim or "suit" as soon as practicable. For the purposes of this coverage provided, you are presumed to have knowledge of the "accident" or "loss" when it has been reported to the insurance manager or any other person you designate as responsible for insurance-related matters. U. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS The following Condition is added to SECTION IV— BUSINESS AUTO CONDITIONS: Unintentional Failure To Disclose Hazards Failure by you to disclose to us all hazards existing as of the inception date of this policy shall not prejudice us with respect to the coverage afforded by this policy, provided such error or omission is not intentional. ALL OTHER CONDITIONS AND PROVISIONS OF THE POLICY REMAIN UNCHANGED BY THIS ENDORSEMENT. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CCAB191 1013 Page 6 of 6 0 GQ,