Hatch Mott MacDonald - 2016 Agreement - Amendment No. 1•
AMENDMENT TO THE AGREEMENT FOR SERVICES BETWEEN
CITY OF GILROY AND Hatch Mott MacDonald FOR Professional Engineering Services
DATED 5 -26-16
AMENDMENT NO.1
This Amendment shall become effective when it has been signed by the City Administrator, Project Manager,
and Consultant. Consultant shall sign two (2) original copies provided by the City. All copies forwarded to the
Consultant for signature shall be returned to the City of Gilroy properly filled out. Upon acceptance by the
City, the Consultant's copy will be returned as authorization to proceed with the work.
This amendment if for Hatch Mott Macdonald to provide professional engineering services for Luchessa
Avenue and Tenth Street conceptual grade crossing concept plans. Hatch Mott MacDonald proposal dated 5 -24-
16 detailing the work associated with this amendment is attached.
This Amendment extends the terms of the Agreement for Services between the City of Gilroy and Hatch Mott
MacDonald, dated May 25, 2016 to May 26, 2019
The total compensation for this agreement is $10,300
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.
Mott MacDonald hereby agrees to perform the work as described in the attached Mott MacDonald proposal
dated 5 -24 -16 to the terms of this Amendment for the Tenth Street and Luchessa Avenue grade crossing
concept plans.
Consultant: I0oV)4cDonalV 11300 -B First Street —Gilroy, CA 95020
Keith Higgin —Vic Pfe f dent
Date 3 l�
ACCEPTED:
David h r ngeles- Project Manager QDate %
ACCEPTED: a /20/1
Head
ACCEPTED: /v�
Gabriel Gonzalez —Ci 5 ' _ for Date
M
MOTT M
MACDONALD
May 24, 2016
Henry Servin
City of Gilroy
Engineering Division
7351 Rosanna St.
Gilroy, CA 95020
1300 -8 First Street
Gilroy, CA 95020
T408 -848 -3122
www.mottmac.com /americas
Re: 101i Street and Luchessa Ave Grade Crossing Concept Plans - Gilroy, CA
Proposal to Provide Professional Engineering Services
Dear Henry:
Mott MacDonald (MM) is pleased to submit this proposal to provide professional, traffic / civil
engineering services for the preparation of conceptual grade crossing design at 10th Street and
Luchessa Ave in Gilroy, CA.
Based on previous correspondence with you, our proposed scope of work includes the following
assumptions:
1. MM will prepare a base using Google imagery for the grade crossing at Luchessa Ave. The
Google imagery will be field verified at several cross section locations 'to confirm existing lane
widths and overall street width. Measurement will be taken outside of UPRR ROW so that an
encroachment permit will not be required.
2. MM will use existing topo from previous work at 10th Street for the base map for the grade
crossing at 10th Street. The Information will be field verified at several cross section locations
to confirm existing lane widths and overall street width. Measurement will be taken outside
of UPRR ROW so that an encroachment permit will not be required
3. The conceptual design will only include conceptual design of the grade crossings of two
existing UPRR tracks and one proposed commuter rail track at 10th Street and Luchessa Ave.
4. The conceptual design will include design of lane widths, medians, sidewalks, bike lanes, and
roadway striping. We will coordinate with you and /or other city staff to ensure that our
concept design incorporates all roadway features pertaining to ultimate roadway conditions.
5. MM's scope of work will be limited to the preparation of a base map, a conceptual layout plan
at each grade crossing, and two (2) roadway cross sections at each grade crossings.
The following scope of work is proposed for this project:
16-EF Kid=
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MOTT M
MACDONALD
A. SCOPE OF WORK
Task 1— General Coordination /Project Management
Coordination with the City of Gilroy staff, which includes phone calls, emails, short meetings, and
other miscellaneous items.
Task 2 - Prepare Base Map
MM will prepare a base map of Luchessa Ave using Google imagery to trace existing lane
configuration. Existing,topo from previous work at 10th Street will be used to create a base map of
10th Street. The plans will be prepared using AutoCAD 2013 with English units.
Task 3 – Site Visit
MM will conduct a site visit to verify lane dimensions obtained from Google imagery for Luchessa Ave
and the previous base map for 10th Street. Measurement will be taken at several locations along the
streets, outside of UPRR ROW.
Task 4 – Prepare Draft Conceptual Plans
Prepare a set of conceptual plans for the grade crossing improvements. The conceptual plans will
include a ,layout plan and two (2) roadway cross sections at each intersection. The plans will be
prepared using AutoCAD 2013 with English units. The plans will be submitted to the City for review
and comment.
Task 5 – Prepare Final Conceptual Plans
Based on comments received from the City, MM will make revisions and prepare final conceptual
plans for the improvements.
NOT INCLUDED
Not Included in the above Scope of Work are the collection of any traffic count data, any sub -
consultant services, any environmental investigations and /or technical studies, preparation of design
plans beyond the conceptual stage, the preparation of traffic control /management plans, or the
design of additional grade crossings.
Any work required in addition to that described under the Scope of Work will be considered extra
work, including but not limited to design changes requiring significant redesign work, the attendance
at any project development meetings, and /or any other tasks which are not specifically included in
16-EF P01doa
M
MOTT ' - -
MACDONALD
this proposal. Receipt of written authorization for any additional work beyond our Scope of Work will
be required prior to performing any additional work beyond what is specifically described in this
proposal.
B. BUDGET
The "not - to-exceed" fee for this proposal is $10,330. We are prepared to start work on this project
upon authorization to proceed. A detailed breakdown of the Individual costs associated with each
task Is Included as Attachment A. The attached Fee Schedule (Attachment B) and corresponding
project fee may also be adjusted, if extensive delays outside of the Consultant's control are incurred in
the commencement or during the execution of the project.
C. TERMS OF AGREEMENT
Terms of this agreement are subject to the provisions of the on -call agreement between Mott
MacDonald and City of Gilroy.
D. CONCLUSION
If you have any questions regarding the contents of this proposal or need additional information,
please do not hesitate to contact me at your convenience. Thank you for the opportunity to assist
you with this project.
Very truly yours,
Mott MacDonald
I . ,
Leo Trujillo, PE, TE
Principal Engineer
T 408.848.5263 F 408.848.2202
leo.trujillb@mottmac.com
16 -EF P01.docx
ATTACHMENT A
10th Street and Luchessa Ave Grade Crossing Study
Gilroy, California
Fee Estimate
Submitted by
Mott MacDonald
May 24, 2016
-
- - Pro Tasks
Personnel and Hourly Blllirtg Rates
Total
Hours
Total
Fee
Project
Manager
240
Engineer
IV
161
Engineer
II
107
-Admin -
Assistant
$93
1 General Coordination/Project Management
8
8
$L920
2 Pre re Base Ma -
8
$1,288
3 Site Visit
4
4
- -
$1,072
3 Prepare Draft Conceptual Plans
-
. A. Layout Plan 1 per location - 2 total)
2
12
14
VAT
- B. Roe Cross Sections (4 Total}
2
.8 _
30
1 SL769
4 Prepare Final Conceptual Plans
_
_
A. layout Plan (1 per location - 2 total)
1
4
5
_ _ _ $884
B. Roadway Cross Sections 4 Total
1
4
5
$884
LABOR SUBTOTAL
14
40 -
4
0
.42
$10,228
Travel (Including mileage)
$0
Printing (Including shipping costs)
- .S302
TOTAL•
-$10,330
Notes:
1. This fee estimate Is based on hourly rates effective until December 2016.
16-EF B01AISX
M
MOTT ' - -
MACDONALD
FEE SCHEDULE (ATTACHMENT B)
Effective through December 2016
PERSONNEL
Classification Rate /Hour
Vice President
$302
Principal Engineer
$240
Senior Consultant
$240
Senior'Project Engineer
$227
Senior Planner / Senior Traffic Modeler
$227
Project, Engineer
$191
Senior Planner
$176
Associate Planner
$161
Engineer
$161
Specialist IV —Assistant Planner
$141
Specialist M — Senior CAD Technician
$141
CAD Technician, Designer
$141
Planner III
$110
EngineerII — Assistant CAD Technician
$107
Planner II
$93
Administrative Assistant III
$93
Specialist II— Traffic Count Supervisor, Field Technician
$79
Technician I — Traffic Counter
$62
Minimum Consultation Fee
$556
Expert Witness (Rates Available on Request)
SUB - CONSULTANTS
Profession& Service by Others Cost + 10%
EXPENSES
Materials, External Copying & Printing, Phone, Fax
Cost + 15%
Internal Copying - Letter Size (per single -sided page + labor)
$0.10
Internal Copying - Ledger Size (per single -sided page + labor)
$0.21
Large Sheet Prints - Bond or Blueline (per D size sheet + labor)
$2.08
Large Sheet Plots - Vellum (per D size sheet + labor)
$4.16
Large Sheet Plots - Mylar (per D size sheet + labor)
$6.24
Delivery/Courier Service
Cost + 15%
Auto Expenses (per mile)
$0.575
Travel Expenses
Cost + 10%
2016 Fee Schedule
EXHIBIT "C"
MILESTONE SCHEDULE
4835 - 2267 -0361v1 _1
LAC104706083
ATTACHMENT C
10th Street and Luchessa Ave Grade Crossing Study
Gilroy, California
Tentative Schedule
Submitted by
Mott MacDonald
May 25, 2016
Project Task
Estimated Duration
_ 1-General-Coordination/Project Management
Throughout the project
2 Prepare Base Map
1 Week
3 Site Visit
3 Prepare Draft Conceptual Plans
2 Week
A. Layout Plan (1 per location - 2 total)
B. Roadway Cross Sections (4 Total)
4 Prepare Final Conceptual Plans
1 Week
A. Layout Plan (1 per location - 2 total)
B. Roadway Cross Sections (4 Total)
Total
4 Weeks
Notes.,
1. This tentative schedule does not show / include City review time.
16 -EF B01- Copy.xlsx
�C11: 1
PAYMENT SCHEDULE
4835. 2267 -0361v1
LAC104706083
ATTACHMENT A
10th Street and Luchessa Ave Grade Crossing Study
Gilroy, California
Fee Estimate
Submitted by
Mott MacDonald
May 24, 2016
Project Taste
Personnel and Hourly Billing Rates
Total
Hours
Total
Fee
Project
Manager
240
Engineer
IV
161
Engineer
11
$107
Admin
Assistant
$93
1 General Coordinatlon/Pro ect Management
8
8
$1,920
2 Pre are Base Map
8
$1,288
3 Site Visit
4
4
_$1,072
3 Prepare Draft Conceptual Plans
A.Layou t Plan 1 Per location - 2total)
2
12
14
$2412
S. Roadway Cross Sections (4 Total)
_ 2
a
10
$1,768
-4 Pre re Final Conceptual Plans
A. Layout Plan 1 per location - 2 total)
1
4
5
5894
B. Roadway Cross Sections 4 Total)
1
4
5
$884
--- - - LABOR SUBTOTAL
14
40
4
0-
42
$10,228
Travel pndudin miles e)
$p
Printing (including shipping costs)
$102
TOTAL:
$10,330
Notes:
1. This fee estimate is based on hourly rates effective until December 2016.
16-EF B01AM
MOTT
MACDONALD
FEE SCHEDULE (ATTACHMENT B)
Effective through December 2016
PERSONNEL
Classification Rate /Hour
Vice President
$302
Principal Engineer
$240
Senior Consultant
$240
Senior Project Engineer
$227
Senior Planner/ Senior Traffic Modeler
$227
Project Engineer
$191
Senior Planner
$176
Associate Planner
$161
Engineer III
$161
Specialist IV — Assistant Planner
$141
Specialist III — Senior CAD Technician
$141
CAD Technician, Designer
$141
Planner III
$110
Engineer II — Assistant CAD Technician
$107
Planner II
$93
Administrative Assistant III
$93
Specialist II — Traffic Count Supervisor, Field Technician
$79
Technician I — Traffic Counter
$62
Minimum Consultation Fee
$SS6
Expert Witness (Rates Available on Request)
SUB - CONSULTANTS
Professional Service by Others Cost + 10%
EXPENSES
Materials, External Copying & Printing, Phone, Fax
Cost + 15%
Internal Copying - Letter Size (per single -sided page + labor)
$0.10
Internal Copying - Ledger Size (per single -sided page + labor)
$0.21
Large Sheet Prints - Bond or Blueline (per D size sheet + labor)
$2.08
Large Sheet Plots - Vellum (per D size sheet + labor)
$4.16
Large Sheet Plots - Mylar (per_ D size sheet + labor)
$6.24
Delivery/Courier Service
Cost + 15%
Auto Expenses (per mile)
$0.575
Travel Expenses
Cost + 10%
2016 Fee Schedule
Hourly Rate Schedule
Kim
.
,
Chris Metzger _
PrincipoWn-Charge
$295
Keith Higgins
Principal Project Manager
$285
Raj Murthy _ _
--
Principal Project Manager
285
Richard Davies
_ _
Principal Project Manager
$2$5 1
Chwen Sirtpocanont
Principal Project Manager
_
(QA/QC)
_ L $285
LMike Canepa _
_
Principal Project Manager
- - -_- - i -'
j $250
Leo Trujillo
Principal Engineer
215 1
Scott Hensler
Moe Amini
Senior Project Manager (Quality)
Principal Project Manager (Structural)_ __
270
$263
Bob Wtison
Principal Engineer (Systems)
$23—'6 i
I --
Brian Hughes
- -- _- --
Senior Specialist (Estimating)
i Senior Traffic Engineer (Specialist) __ __
--
235 _ i
- 230 -'
Dan Takaes
Jon Elson
.
ITS/Technology
_
230
Brian Wledmann
Senior Project Engineer (StructuraVConstrucdon)
225
Bill Baker
Senior Project Engineer _
$212 j
Yvonne Use _
Senior Project Engineer
192 ,
Margaret Parkhill
Senior Project Engineer v
- ! $192
Men Nle _
__
j Senior Traffic Engineer (Modeler)_ _
- - -�
$215 J
Shrut!( Malik
j Senior Traffic Engineer
$205
Christoffer Brodbask _
Senior Project Manager (Geotechnical)
_
$205 1
j Ravi Narayanan
Traffic Modeler
-
$200
AllShahabl
j Senior Design, Engineer
$195 j
_
Lori Weiss J
_ _ _
j Surveying/Base Mapping -__ __ -
_ _ _ - - $175 j
Russell Thompson
-- -
_ -_
; Senior Project Engineer
-
$igg
CelinF a Lee
j Design Engineer - -- -- - - — —
- - - -- $165
j Renee Crawford
I Design Engineer
165
Katie Chou
Design Engineer
_
-� $165
Jeff Waller - -- - -
I Traffic Engineer - -- - - -- - - - -- - —_
-- - $155 - +
Jasou.Nesdahl _
1 Traffic Engineer
—$155
Julie
_ --
Oates - --
-- -- --
i Traffic Engineer
_- _J
$155
i Amy Henschke
Civil Engineer - - -- -- - - - - --
- •-- - - - - -- 105 1
Kirk Meyer — —
Civil Engineer -- - - - - --
-- -- -$105
e • • e
Terri WlaslerAdam
j Erwironmental
j $210
e
Janet Kan
j Geotechnical
--
j $220
e e:
I, John Brunetti
j Land Surveyor
$im
•e o
•
Reza Hosseini ITS/Technology Lead
Daniel Cossack -- - 17S/Technology (Software /Systems) — — - -- - -- $180
Mehran pou
Hadlr ITS/Technology (Hardware/Comm) $155
Allison Daniels Right-of- -Way $1,51
RIVAC EIiciNEERING Gc51GtU i) G'rEF ?Fs'veb`'�i7 L!ci s: Pf.Qce :S"tr.`!'CIES J10kIPrRFP P.44 -35G'x , "...z`..ti '
Bob Van Boening Two-Hour Intersection Turning Mc
_ Bicycles and Pedestrians
Bob Van Boening j 24-Hour Pneumatic Hose Volume
Michelle Wandler Parking Studies
- Vehicles, S1T5
J
• Hourly rates are effective through December 31, 2016 and are subject to annual Increases that are generally In line with CPI Increases
•'Additional subconsu Rant support staff maybe "IIzed depending on each task/ project need. Those hourly rates can be provided upon
request
iWMR'C ORMIMEEKING DESIMANDOPERATIOIW :ST001ESSUPPORTSERV=- t10164HFP.M3ss
HATCMOT -01 DUBEAA
CERTIFICATE OF LIABILITY INSURANCE
DATE
7/1/2016
THIS CERTIFICATE IS 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement A statement on this Certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
Willis of Now Jerssy, Inc.
c/o 28 Century BNd
P.O. Box 305191
CNAONTAME: CT Willis Towers Watson Certificate Center
PHONe E.I: 945 -7378 An: Na: 888 467 -2378
ADDRESS: Certificates@willis.com
Nashville, TN 37230.5191
INSURER(S) AFFORDING COVERAGE
NAIC e
INSURER A: Fireman's Fund Insurance Company
21873
INSURED
INSURER 8: American Insurance Company
21857
Mott MacDonald, LLC
INSURER C: Underwriters at Lloyd's London
15792
Hatch Mott MacDonald, LLC
111 Wood Avenue South
INSURER D:
OW3012016
0613012017
Iselin, NJ 09830.4112
INSURER E
INSURER F:
$ 5,00
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INeURANCE
POLICY NUMBER
MWDDNYW
MOO Y
LIMBS
A
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
7COMMERCIAL
CLAIMS-MAOE 7 OCCUR
X
MZX 80971387
OW3012016
0613012017
PREMISES Es ooanrence
S 1,000,00
MED EXP(Any one person )
$ 5,00
PERSONAL$ADV INJURY
$ 1,000,00
GENL AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
S 2,000,00
POLICY [X] jE`CT T LOC
PRODUCTS - COMPIOP AGG
$ 2,000,00
S
OTHER
AUTOMOBILE LIABILITY
COMBINED .0 SINGLE L M
Ea
$ 1,000,00
BODILY INJURY (Per Person)
$
A
X' ANY AUTO
X
MZX 80971387
0 63012018
06/3012017
ALLOWNED SCHEDULED
AUTOS
BODILY INJURY(Per acddenl)
$
PROPERTY DAMAGE
Par acddem
$
NON-OWNED
HIRED AUTOS AUTOS
S
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LAB
CIAIMS -MADE
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RETENTION$
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WORKERS COMP'NU17 N
WORKERS COMPENSATION
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�( STATUTE ER
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06130/2017
Per Occurrence /Agg: 1,000,00
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101. Addmond Rem s Sche_ dula, may be aaeched N mme specs Is r ulred)
Division #WSCIBSA.
Re: HMM Project No. 372692 Gilroy AWSC Warrants 2018.
City of Gilroy, Its employees, officers, officials, and volunteers are Included as Additional Insureds as respects to General Liability and Auto Liability as per
written contract or agreement
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
SEE ATTACHED ACORD 101
City of Gilroy
7351 Rosanna Street
ACORD 25 (2014/01)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORISED REPRESENTATIVE
X*L—>
The ACORD name and logo are registered marks of ACORD
7
ACORO'
llo.�
AGENCY CUSTOMER ID: HATCMOT -01 DUBEAA
LOC III: 1
ADDITIONAL REMARKS SCHEDULE
Page 1 of 1
AGENCY
NAMED INSURED
Willis of New Jersey, Inc.
Mott MacDonald, LLC
Hatch Mott MacDonald, LLC
POLICY NUMBER
111 Wood Avenue South
EE PAGE 1
Iselin, NJ 08830 -4112
CARRIER -
NAIC CODE
EE PAGE 1
SEE P 1
EFFECTIVE DATE: SEE PAGE I
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: Certificate of UnbNRy insum"
Description of Operations /Locations/Vehicles:
Additional Insureds as agreed to by written contract.
Waiver of Subrogation applies in favor of Additional Insureds with respects to Worker's Compensation as agreed to by written
contract for all states and as permitted by law.
ACORD 101 (2008/011
The ACORD name and logo are registered marks of ACORD
;Ke7 d -Se7:731 P7: �_1I riTA T6Tl�Td.171
Additional Insured - Owners Lessees or Contractors - Completed
Operations - CG 20 37 04 b
Policy Amendment(s) Commercial General Liability
Insured; Mott MacDonald Group, Inc.
Producer: Willis of New Jersey, Inc.
Policy Number: MZX80971367
Effective Date: 06/30/2016
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) Location And Description Of
Or Organizations) Completed Operations
City of Gilroy, kits employees, officers, officials, All Projects
and volunteers
7351 Rosanna Street
Gilroy, CA 95020
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
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for bodily injury or
property damage caused, in whole or in part, by
your work at the location designated and described
in the Schedule of this endorsement performed for
that additional insured and included in the
products - completed operations hazard.
However
1. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
2. If coverage provided to the additional insured
is 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.
B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III - Limits Of Insurance:
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
This Form must be attached to Change Endorsement when issued after the policy is written.
One of the Fireman's Fund Insurance Companies as named in the policy
Secretary
CG2037 4 -13
+ Insurance Services Office, Inc., 2012
President
Additional Insured - Owners, Lessees or Contractors - Scheduled
Person or Organization - CG 20 10 04 13
Policy Amendment(s) Commercial General Liability
Insured: Mott MacDonald Group, Inc.
Producer: Willis of New Jersey, Inc.
Policy Number: MZX80971387
Effective Date: 06/3012016
This endorsement modifies insurance provided under the following:
Commercial General Liability Coverage Part
Schedule
Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations
City of Gilroy, its employees, officers, officials, All Projects
and volunteers
7351 Rosanna Street
Gilroy, CA 95020
Information required to complete this Schedule, if not shown above, will be shown in the Declarations
A. Section H - Who Is An Insured is amended to 2. If coverage provided to the additional insured
include as an additional insured the person(s) or is required by a contract or agreement, the
organization(s) shown in the Schedule, but only insurance afforded to such additional insured
with respect to liability for bodily injury, property will not be broader than that which you are
damage or personal and advertising injury caused, required by the contract or agreement to
in whole or in part, by: provide for such additional insured.
1. Your acts or omissions; or
2. The acts or omissions of those acting on your
behalf,
in the performance of your ongoing operations for
the additional insured(s) at the location(s)
designated above.
However
1. The insurance afforded to such additional
insured only applies to the extent permitted
by law; and
B. With respect to the insurance afforded to these
additional insureds, the following additional
exclusions apply:
This insurance does not apply to bodily injury or
property damage occurring after:
All work, including materials, parts or
equipment furnished in connection with such
work, on the project (other than service,
maintenance or repairs) to be performed by
or on behalf of the additional insured(s) at the
location, of the covered operations has been
completed; or
This Form most be attached to Change Endorsement when issued after the policy is written.
One of the Fireman's Fund Insurance Companies as named in the policy
Secretary
J
President
CO2010 4.13
+ Insurance services Office, Inc., 2012 Page I. of 2
2. That portion of your work out of which the
injury or damage arises has been put to its
intended use by any person or organization
other than another contractor or
subcontractor engaged in performing
operations for a principal as a part of the same
project.
C. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III - Limits Of Insurance:
CG2010 413
+ Insurance Services Office, Inc., 2012
If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable Limits of
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the applicable
Limits of Insurance shown in the Declarations.
Page 2 of 2
Policy Number #B080120388P16
Effective: 6/30/2016
Endorsement No 6
CANCELLATION
If the Company cancel this policy prior to its expiry date by notice to the Insured for any reason, the
Company will send written notice of cancellation to the persons or organisations listed In the
schedule to be created and maintained by the Insured (the 'Cancellation Notice Schedule') at least
30 days prior to the cancellation date applicable to the policy. This notice will be in addition to any
notice to the Insured.
The Insured will provide an updated copy of the Cancellation Notice Schedule to the Company on a
monthly basis.
The notice referenced in this endorsement Is intended only to be a courtesy notificatlon to the
person(s) or organsaton(s) named in the Cancellation Notice Schedule In the event of a pending
cancellation of coverage. The Company has no legal obligation of any kind to any such person(s) or
organisation(s). Any failure to provide advance notice of cancellation to the person(s) or
organisation(s) named in the Cancellation Notice Schedule will impose no obligation or liability of any
kind upon the Company, will not extend any policy cancellation date and will not negate any
cancellation of the policy.
The Company are not responsible for verifying any information in any Cancellation Notice Schedule,
nor is the Company responsible for any incorrect information that the Insured may use.
Section 11 - HMM 2016 wording
Courtesy Notice of Cancellation for Other Than
Nonpayment of Premium to Designated Entities - 145977 01 11
Policy Amendment Policy Number: MZX 80971387; WZC81035277 Effective Date: 06/30/2016
General Liability; Auto Liability, Workers Compensation
Schedule
Name and Address of Person(s) or Organizations Number of Days Notice If other than 10 days:
On File with Carrier, as required by written contract Canacellation Number of Days Notice- 60
When we don't Renew (Non - Renewal)- 30
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
This policy is amended as follows:
A. If We cancel this policy prior to expiration for any reason other than non payment of premium or
at Your request, and we have been notified that You are required under a current contractual
obligation to notify a certificate of insurance holder or holders when this policy is canceled, then
We will endeavor to mall or deliver a copy of such written notice of cancellation to the certificate
holder(s) shown in the Schedule above, as follows:
1. To the name and address corresponding to each certificate of insurance holder indicated in
the Schedule above; and
2. At least 10 days prior to the effective date of the cancellation, as shown in our notice to the
first Named insured, or, if indicated, the longer number of days notice shown in the Schedule
above.
B. Notwithstanding the foregoing, such notice of cancellation is provided on an informational basis
and solely to assist You in informing, the certificate of insurance holder(s) in advance of pending
cancellation in coverage to assist you in meeting Your contractual notice requirements to such
parties. Our failure to provide such advance notification to the certificate of insurance holder(s)
shown in the Schedule of this endorsement will not extend any policy cancellation date, negate
any cancellation of the policy, or grant, after or extend any rights or obligations under this policy
and we shall have no liability for any failure to provide the notice(s) as provided herein.
All other terms and conditions of this policy remain unchanged
1459771 -11
+ 2010 Fireman's Fund Insurance Company, Novato, CA All rights reserved.