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Maier and Dougherty - 2011 Agreement - Amendment No. 1
AMENDMENT TO THE AGREEMENT FOR SERVICES BETWEEN CITY OF GILROY AND MAIER AND DOUGHERTY FOR PUMP REPAIR WORK DATED JULY 1, 2011 AMENDMENT NO.1 This Amendment shall become effective when it has been signed by the City Administrator, Project Manager, and Contractor. All copies forwarded to Contractor for signature shall be returned to the City of Gilroy properly filled out. Upon acceptance by the City, the Contractor's copy will be returned to him as his authorily to proceed with the work. This Amendment extends the term of the Agreement for Services between the City of Gilroy and Maier and Dougherty, dated July 1, 2014 to JUNE 30, 2016. All requirements of the original Agreement Documents shall apply to the above work except as specifically modified by this Amendment. The contract time shall not extend unless expressly provided for in this Amendment. Maier and Dougherty hereby agrees to make the above changes subject to the terms of this Amendment for ongoing acquisition/relocati rvices. Maier By Randy Doughe Date 5-- )Z— /t ACCEPTED CA :f 61 P_ P" Ac ®R" CERTIFICATE OF LIABILITY INSURANCE Al. DATE(MMIDD /YYYY) 11/25/2013 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 The Liberty Company Ins Brks CA License No. OD79653 4 Rossi Circle, Suite 101 Salinas CA 93907 CAMEACT Shelly Werfelmann PHONE (831)233 -7199 FAX (866) 855 -8636 E- MAIL .swerfelmann @libertycompany.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Travelers Property Casualty- Co 25674 INSURED MAIER DOUGHERTY PUMP SERVICE PO BOX 1519 SAN MARTIN CA 95046 1 INSURER B: INSURER C: INSURER D INSURER E : - - - $_ INSURER F: X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE r_x_1 OCCUR COVERAGES CERTIFICATE NUMBER- CL1383010970 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 UBR POLICY NUMBER POLICY EFF MPW DIYYYY LIMITS GENERAL LIABILITY EACHOCCURRENCE. _ - - - $_ A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE r_x_1 OCCUR 6802697M138 /23/2013 /23/2014 DAMA PREM 'E TO RENTED ' P EMI E -a occurrence $ 360,660 MED EXP (Any one person) $ s,066 PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 X POLICY 7 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAR EACH OCCURRENCE $ HOCCUR AGGREGATE $ EXCESS LIAR CLAIMS -MADE' DED I RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE I OFFICER /MEMBER EXCLUDE D9 N 1 A E.L. EACH ACCIDENT', $ E.L. DISEASE -EA EMPLOYE $ (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Certificate holder is named as additional insured as per attached endorsment ult�•11.1��1 City of Gilroy It's Officers and Water Department 613 Old Gilroy St Gilroy, CA 95020 ACORD 25(2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Employees AUTHORIZED REPRESENTATIVE Werfelmann/SWERF ©1988 -2010 ACORD CORPORATION- All riahts reserved INSn7; rminn51 M Tho A Y`Y10r1 namo and Innn oru ronieforori m2r1re of Ar:r1Rr1 TRAVELERS One Tower Square, Hartford, Connecticut 06183 OTHER INTEREST CHANGE ENDORSEMENT INSURING COMPANY: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Named Insured: MAIER DOUGHERTY PUMP SERVICE Policy Number: Policy Effective Date: Policy Expiration Date: Issue Date: ADDITIONAL Premium $ 680- 2697M138 -14 -42 07/23/2014 07/23/2015 06/02/2014 125.00 Effective from 07/23/14 at the time of day the policy becomes effective. THIS INSURANCE IS AMENDED AS FOLLOWS: Under the Commercial General Liability Coverage Part, Who Is An Insured is changed to include scheduled contractors Additional Insureds as provided under the attached endorsement. The following forms and /or endorsements, is /are included with this change. These forms are added to the policy or replace forms already existing on the policy: IL TO 07 09 87 CG D2 47 08 05 Rates and /or premiums have been changed to reflect a change in the exposure and /or rating procedure NAME AND ADDRESS OF AGENT OR BROKER LIBERTY CO INS BROKERS 111 PACIFICA STE 125 IRVINE Countersigned by Authorized Representative CA 92618 DATE: 06/02/2014 IL TO 07 09 87 (Page 1 of 1 ) Office: WALNUT CREEK CA POLICY NUMBER: 680- 2697MI38 -14 -42 EFFECTIVE DATE: 07/23/2014 ISSUE DATE: 06/02/2014. LISTING OF FORMS, ENDORSEMENTS AND SCHEDULE NUMBERS THIS LISTING SHOWS THE NUMBER OF FORMS, SCHEDULES AND ENDORSEMENTS BY LINE OF BUSINESS * IL TO 07 09 87 CHANGE ENDORSEMENT IL TO 19 02 05 COMMON POLICY DECLARATIONS MP TO 01.02 02 05 BUSINESSOWNERS COVERAGE PART DECLARATIONS * IL T8 01 01 01 FORMS ENDORSEMENTS AND SCHEDULE NUMBERS IL T3 15 09 07 COMMON POLICY CONDITIONS BUSINESSOWNERS MP T1 30 02 05 TABLE OF CONTENTS - BUSINESSOWNERS COVERAGE PART - CG TO 08 07 86 DELUXE PLAN MP Tl 02 02 05 BUSINESSOWNERS PROPERTY COVERAGE SPECIAL FORM MP T1 78 02 05 AMENDATORY PROVISIONS - CONTRACTORS CP 02 99 11 85 CANCELLATION CHANGES MP T4 89 08 06 FUNGUS, ROT, BACTERIA AND OTHER CAUSES OF LOSS CHANGES CG 21 70 01 08 - CALIFORNIA MP T5 22 08 07 CALIFORNIA AMENDATORY PROVISIONS MP T3 25 01 08 TERRORISM RISK INSURANCE ACT OF 2002 DISCLOSURE MP T3 50 11 06 EQUIPMENT BREAKDOWN - SERVICE INTERRUPTION LIMITATION MP T3 56 02 08 AMENDATORY PROVISIONS - GREEN BUILDING AND BUSINESS PERSONAL PROP COV ENHANCEMENTS MP T1 71 04 09 BUILDING OWNERS ENDORSEMENT MP T9 70 03 06 POWER PAC ENDORSEMENT MP T4 90 05 10 LIMIT OF INS /OCCURRENCE ENDT - CALIFORNIA MP T5 08 01 06 CALIFORNIA CHANGES - REPLACEMENT COST COMMERCIAL GENERAL LIABILITY CG TO 07 04 09 DECLARATIONS PREMIUM SCHEDULE CG TO 08 07 86 KEY TO DECLARATIONS PREMIUM SCHEDULE CG TO 34 11 03 TABLE OF CONTENTS - COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG 00 01 10 01 CG 00 01 10 01 COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG M1 04 02 05 AMENDATORY LIABILITY PROVISIONS - CONTRACTORS CG 21 70 01 08 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM CG 22 92 12 07 SNOW PLOW OPERATIONS COVERAGE CG D2 55 11 03 AMENDMENT OF COVERAGE - POLLUTION CG D3 09 11 03 AMENDATORY ENDR- PRODUCTS- COMPLETED OPERATIONSJHAZARD CG D4 71 02 09 AMENDMENT OF COVERAGE B - PERSONAL AND ADVERTISING INJURY LIABILITY CG DO 37 04 05 OTHER INSURANCE —ADDITIONAL INSUREDS CG D2 03 12 97 AMEND - NON CUMULATION OF EACH OCC CG D2 46 08 05 BLANKET ADDITIONAL INSURED (CONTRACTORS) * TEXT IN THIS FORM HAS CHANGED, OR THE FORM WAS NOT ON POLICY BEFORE. IL T8 01 01 01 PAGE: 1 OF 2 POLICY NUMBER: 680- 2697M138 -14 -42 EFFECTIVE DATE: 07/23/2014 ISSUE DATE: 06/02/2014 COMMERCIAL GENERAL LIABILITY (CONTINUED) * CG D2 47 08 05 ADDITIONAL INSURED (CONTRACTORS) CG D4 13 04 08 AMEND COVG - POLLUTION -EQUIP EXCEPTION CG D2 43 01 02 FUNGI OR BACTERIA EXCLUSION CG D2 56 11 03 AMENDMENT OF COVERAGE - PROPERTY DAMAGE CG D2 88 11 03 EMPLOYMENT- RELATED PRACTICES EXCLUSION CG D3 26 10 11 EXCLUSION - UNSOLICITED COMMUNICATION CG D3 56 05 14 MOBILE EQUIPMENT REDEFINED - EXCLUSION OF VEHICLES SUBJECT TO MOTOR VEHICLE LAWS CG D3 96 08 13 EXCL - ALL PROJECTS SUBJECT TO WRAP UP INS PROGRAM WITH LIMITED EXCEPTIONS CG D4 21 07 08 AMEND CONTRAL LIAB EXCL - EXC TO NAMED INS CG D6 18 10 11 EXCLUSION - VIOLATION OF CONSUMER FINANCIAL PROTECTION LAWS CG DO 76 06 93 EXCLUSION - LEAD CG D1 42 01 99 EXCLUSION - DISCRIMINATION CG D2 04 06 01 EXCLUSION - EXTERIOR INSULATION AND FINISH SYSTEM CG D2 40 06 01 EXCLUSION - SILICA CG D2 42 01 02 EXCLUSION - WAR CG T4 78 02 90 EXCLUSION - ASBESTOS MULTIPLE SUBLINE ENDORSEMENTS CG T3 33 11 03 LIMITATION WHEN TWO OR MORE POLICIES APPLY CG 32 34 01 05 CALIFORNIA CHANGES COMMERCIAL INLAND MARINE CM TO 09 01 88 INSTALLATION COVERAGE - SPECIAL - DECLARATIONS CM TO 11 08 05 COMMERCIAL INLAND MARINE COVERAGE PART - TABLE OF 08 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD CONTENTS CM 00 01 09 04 COMMERCIAL INLAND MARINE CONDITIONS CM T1 07 01 98 INSTALLATION COVERAGE SPECIAL FORM INTERLINE ENDORSEMENTS IL T3 82 05 13 EXCLUSION OF LOSS DUE TO VIRUS OR BACTERIA IL 00 21 09 08 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD FORM) IL 01 04 09 07 CALIFORNIA CHANGES IL 02 70 09 12 CALIFORNIA CHANGES - CANCELLATION AND NONRENEWAL IL T3 79 01 08 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM * TEXT IN THIS FORM HAS CHANGED, OR THE FORM WAS NOT ON POLICY BEFORE. IL T8 61 01 01 PAGE: 2 OF 2 POLICY NUMBER: 680- 2697M138 -14 -42 COMMERCIAL GENERAL LIABILITY ISSUE DATE: 06/02/2014 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART NAME OF PERSON(S) OR ORGANIZATION(S): CITY OF GILROY WATER DEPARTMENT 613 OLD GILROY STREET GILROY CA 95020 SCHEDULE PROJECT /LOCATION OF COVERED OPERATIONS: REHAB & REPAIR OF CITY WELLS & BOOSTER STATIONS 1. WHO IS AN INSURED — (Section II) is amended b) The insurance provided to the additional in- to include the person or organization shown in the sured does not apply to "bodily injury", "prop - Schedule above, but: erty damage" or "personal injury" arising out a) Only with respect to liability for "bodily injury", of the rendering of, or failure to render, any "property damage" or "personal injury'; and professional architectural, engineering or sur- veying services, g: b) If, and only to the extent that, the injury or damage is caused by acts or omissions of i, The preparing, approving, or failing to you or your subcontractor in the performance prepare or approve, maps, shop draw - of "your work" on or for the project, or at the ings, opinions, reports, surveys, _field or- location, shown in the Schedule. The person ders or change orders, or the preparing, or organization does not qualify as an addi- approving, or failing to prepare or ap- tional insured with respect to the independent prove, drawings and specifications; and acts or omissions of such person or organiza- ii. Supervisory, inspection, architectural or tion. engineering activities. 2. The insurance provided to the additional insured c) The insurance provided to the additional in- by this endorsement is limited as follows: sured does not apply to "bodily injury" or a) In the event that the Limits of Insurance of "property damage" caused by "your work" this Coverage Part shown in the Declarations and included in the "products- completed op- exceed the limits of liability required by a erations hazard" unless a "written contract "written contract requiring insurance" for that requiring insurance" specifically requires you additional insured, the insurance provided to to provide such coverage for that additional the additional insured shall be limited to the insured, and then the insurance provided to. limits of liability required by that "written con- the additional insured applies only to such tract requiring ,insurance ". This endorsement "bodily injury" or "property damage" that oc- shall not increase the limits of insurance de- curs before the end of the period of time .for scribed in Section III — Limits Of Insurance. which the "written contract requiring insur- ance requires you to provide such coverage CG D2 47 08 05 C 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance ", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if a "written contract requiring insurance" for that ad- ditional insured specifically requires that this in- surance apply on a primary basis or a primary and non- contributory basis, this insurance is pri- mary to "other insurance" available to the addi- tional insured which covers that person or organi- zation as a named insured for such loss, and we will not share with that "other insurance But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other insurance ", whether pri- mary, excess, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional in- sured under such "other insurance ". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: L How, when and where the "occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense. b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: L Immediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. The additional insured must see to it that we receive written notice of the claim or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit ", cooperate with us in the investigation or settlement of the claim or defense against the "suit ", and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. S. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed: a. After the signing and execution of the contract or agreement by you; b. While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 © 2005 The St. Paul Travelers Companies, Inc. CG D2 47 08 05