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COI - Oldcastle Infrastructure, Inc. - Expires 2024-09-01
ACORD® 8/14/2023 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). CERTIFICATE OF LIABILITY INSURANCE PRODUCER LibertyMutual Insurance Co. National Insurance East 500 N3rd St, Suite 300 Wausau, WI 54403 www.LibertyMutual.com INSURED Oldcastle Infrastructure, Inc. - 030 (PR820306) One Live Oak Avenue Morgan Hill CA 95037 CONTACT NAME: PHONE (Ng. No. Extl: E-MAIL ADDRESS: Valerie Reece 513-867-3822 MC. Nol: Oldcastle.certsra�LibertvMutual.com INSURER(S) AFFORDING COVERAGE INSURER A : Liberty Mutual Fire Insurance Company INSURER B ; Liberty Insurance Corporation INSURER C I INSURER D I INSURER E INSURER F : DATE (MMIDDIYYYY) NAIC # 23035 42404 COVERAGES CERTIFICATE NUMBER: 75747043 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 'AID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE Ira WVD POLICY NUMBER IMM/DD/YYYY1 (MMIDDIYYYY) A / COMMERCIAL GENERAL LIABILITY i / TB2-C81-004095-113 9/1/2023 9/1/2024 CLAIMS -MADE ✓ OCCUR ✓ Primary/Non-Contributory / Separation of Insured GEN'L AGGREGATE LIMIT APPLIES PER: PRO- JECT POLICY OTHER: A AUTOMOBILE LIABII.ITY A LOC ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB EXCESS LIAB DED I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY A N YP R O P R I ETO R/PARTNER/ E XE C U T I V E OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below OCCUR CLAIMS -MADE Y/N XCU Coverage Included ✓ ✓ AS2-C81-004095-123 N/A AS2-C81-054502-523 Physical Damage only: Comprehensive Ded $10,000 Collision Ded $10.000 ✓ WA7-C8D-004095-023 All except OH, ND, WA, WY 9/1/2023 9/1/2024 9/1/2023 9/1/2024 9/1/2023 9/1/2024 WC7-C81-004095-013 9/1/2023 WI, MN 9/1/2024 EACH OCCURRENCE LIMITS $2,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ 300,000 $ 50,000 $ 2,000,000 $ 2,000,000 $ 2,000,000 (EaSINGLE LIMIT accident) $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PPer aROPccidERTYent) DAMAGE ( $ EACH OCCURRENCE AGGREGATE ✓ I STATUTE I EERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1 .000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The City of Gilroy, its officers, officials and employees are listed as additional insured with regards to the general liability and automobile liability policies, where required by written contract. Waiver of subrogation is included in favor of the additional insured, where required by written contract, and where applicable by law. 30-day Notice of Cancellation. CERTIFICATE HOLDER The City of Gilroy 7351 Rosanna Street Gilroy CA 95020 ACORD 25 (2016/03) 75747043 15-004095 1 09.23-09.24 Standard 10-2 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 4 Valerie Reece c4ze /n © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Excess $13M AUTO I Erin Celing 18/14/2023 7:31:26 PM (CST) I Page 1 of 12 Policy Number: AS2-C81-004095-123, 1-054502-523 Issued by: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ [TCAREFULLY. DESIGNATED INSURED 'NONCONTRIBUTING This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIERS COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage form. Schedule Name ofPersonh8 or Organizations(s): Any person or organization where the Named Insured has agreed by written contract to include such. person or organization Regarding Designated Contract or Project: Any Each person or organization shown in the Schedule of this endorsement is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as on "insured" under the Who Is An Insured Provision contained inSection Ucfthe Coverage Form. The following ioadded tothe Other Insurance Condition: If you have ognaod in a written agreement that this policy will be primary and without right of contribution hnm any insurance in force for an Additional Insured for liability arising out of your opambono, and the agreement was executed prior to the "bodily injury" or"property damage". then this insurance will be primary and omwill not seek contribution from such insurance. @2U10.Liberty Mutual Group ofCompanies. All rights reserved. Includes copyrighted material ufInsurance Services Office, |nc.. with its permission, Page 1 of 1 75747043 1 ,*040* 1 09.23-09.24 Standard 10-2 Excess $13M^UTv / Erin oelmv 1 o/mum, 7.31.2" PM (CST) / Page 2 of 12 POLICY NUMBER: AS2-C81-004095-123, AS2-C81-054502-523 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) 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. SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization for whom you perform work under a written contract if the contract requires you to obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. Premium: $ INCL Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 75747043 I 0-004095 1 09.23-09.24 Standard 10-2 Excess $13M AUTO I Erin Celing 1 8/14/2023 7:31:26 PM (CST) 1 Page 3 of 12 Policy Number: AS2-C81-004095-123, AS2-C81-054502-523, TB2-C81-004095-113 Issued By: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. NOTICE OF CANCELLATION TO THIRD PARTIES This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Other Person(s)/ Email Address or mailing Number Organization(s): address: Days Notice: Where required by written contract Where required by written contract 90 A. If we cancel this policy for any reason other than nonpayment of premium, we'will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 01 0511 O 2011, Liberty Mutual Group of Companies. All rights reserved. Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 1 75747043 I 0-004095 109.23-09.24 Standard 10-2 Excess $13M AUTO I Erin Celing 10/14/2023 7:31:26 PM (CST) I Page 4 of 12 POLICY NUMBER: TB2'C81'0O4095-i13 nw COMMERCIAL GENERAL LIABILITY [G2SO386OQ THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |TCAREFULLY. DESIGNATED ���~~�n��x�x��o �~�� ����o�~�nn����°nn��n� nn���~x�~�~o(S) ��������K���U ������������J�~��� LIMIT . ����o��~n���nu~�n�������~�u�no u~ u~oo�non This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" medical expenses caused by accidents under Section I - Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule below: t A separate Designated Construction roj General Aggregate Limit applies to each des- ignated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations, 2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A ex- cept damages because of "bodily injury" or "property damage" included in the !'products - completed operations hozard", and for medi- cal expenses under Coverage Cregend|eyo of the number of: a Insureds; b. Claims made or "suits" brought; or c Persons or organizations making dahno or bringing "suits". -' Any payments~ ^~~^ underCoverage " = damages or under Coverage C for medical expenses shall reduce the Designated Con- struction Project General Aggregate Lirnit for that designated construction project. Such payments shall not reduce the General Ag- gregate Limit shown in the Declarations nor shall they reduce any other Designated Con- struction Project General Aggregate Limit for any other designated construction project shown in the Schedule below. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply. Hmwe*er, instead of being subject to the General Aggregate Limit shown in the Decla- rations, such limits will be subject \othe appli- cable Designated Construction Project General Aggregate Lit -nit. - B. For all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under Section I - Coverage A, and for all medical expenses caused by accidents under Section I - Coverage C, which cannot be attributed only to ongoing operations at a single designated construction project shown in the Schedule below: 1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not educe any Designated Construction Project General Aggregate Limit, C. When coverage for liability "prod ucts-completed operations hazard" is prov- ided, any payments for darnages because of "bodily injury' or "property damage" included in the "prod ucts-completed operations hazard" will reduce the Products -completed Operations Agg- regate Limit, and not reduce the General Agg- regate Limit nor the Designated Construction Project General Aggregate Limit. D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Section |U-Lhnits Of Insurance not otherwise modified by this endorsement shall continue hoapply asstipulated. CG2503O50$ (DInsurance Services Office, |m,20O8 Page 1 of 2 SCHEDULE Designated Construction Project(s): All Projects. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 25 03 05 09 © Insurance Services Office, Inc., 2008 75747043 18-004095 109.23-09.24 Standard 10-2 Excess $13M AUTO 1 Erin Celing 18/14/2023 7:31:26 PM (CST) I Page 6 of 12 745 Page 2 of 2 POLICY NUMBER: TB2-C81-004095-113 COMMERCIAL GENERAL LIABILITY CG 2010 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 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", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 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 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 additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: Name Of Additional Insured Person(s) Or Organization(s): Any owner, lessee, or contractor for whom you have agreed in writing prior to a loss to provide liability insurance 1. 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 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: 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. SCHEDULE Location(s) Of Covered Operations Any location listed in such agreement Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 75747043 I 0-004095 109.23-09,24 Standard 10-2 Excess $13M AUTO I Erin Celi.ng 18/14/2023 7:31:26 PM (CST) I Page 7 of 12 POLICY NUMBER: TB2-C81-004095-113 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 owner, lessee, or contractor for whom you have agreed in writing prior to a loss to provided liability insurance Any location listed in such agreement 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. CG 20 37 04 13 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. © Insurance Services Office, Inc., 2012 Page 1 of 1 75747043 1 8-004095 109.23-09,24 Standard 10-2 Excess $13M AUTO I Erin Celing 18/14/2023 7:31:26 PM (CST) I Page 8 of 12 Policy Number: TB2-C81-004095-113 Issued By: Liberty Mutual Fire Insurance Co. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. OTHER INSURANCE AMENDMENT — SCHEDULED ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART Schedule Name of Person(s) or Organization(s): Any person or organization for which such coverage is required by written contract prior to a loss If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for any person(s) or organization(s) shown in the Schedule of this endorsement that qualifies as an additional insured on this Policy, this Policy will apply solely on the basis required by such written agreement and Paragraph 4. Other Insurance of Section IV — Conditions will not apply. Where the applicable written agreement does not specify on what basis the liability insurance will apply, the provisions of Paragraph 4. Other Insurance of Section IV — Conditions will apply. However, this insurance is excess over any other insurance available to the additional insured for which it is also covered as an additional insured for the same "occurrence, claim or "suit". LC 24 2011 18 © 2018 Liberty Mutual Insurance Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. 75747043 I 0-004095 1 09.23-09.24 Standard 10-2 Excess $13M AUTO I Erin Celi.ng 18/14/2023 7:31)26 PM (CST) I Page 9 of 12 POLICY NUMBER: TB2-C81-004095-113 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV — Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products - completed operations hazard". This waiver applies only to the person or organization shown in the Schedule below. SCHEDULE Name Of Person Or Organization: As required by written contract or agreement entered into prior to loss. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG 24 04 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 1 75747043 18-001095 109.23-09.24 Standard 10-2 Excess $13M AUTO 1 Erin Celing 10/14/2023 7:31:26 PM (CST) I Page 10 of 12 NOTICE OF CANCELLATION TO THIRD PARTIES A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured. B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy. Schedule Name of Other Person(s) / Email Address or mailing address: Number Days Notice: Organization(s): Schedule on file with the Schedule on file with the 90 Company Company All other terms and conditions of this policy remain unchanged. Issued by Liberty Insurance Corporation 21814 For attachment to Policy No. WA7-C8D-004095-023 Effective Date Premium $ Issued to CRH Americas, Inc. WC 99 20 75 Ed. 12/01/2016 © 2016 Liberty Mutual Insurance Page 1 of 1 75747043 18-004095 109.23-09.24 Standard 10-2 Excess $13M AUTO I Erin Celing 18/14/2023 7:31:26 PM (CST) I Page 11 of 12 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy, We will not enforce our right against the person or organization named in the Schedule, (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of $250 per policy. Person or Organization Where required by contract or written agreement prior to loss and allowed by law Job Description All CA Locations Issued by Liberty Insurance Corporation 21814 For attachment to Policy No. WA7-C8D-004095-023 Effective Date Premium $ Issued to CRH Americas, Inc. Endorsement No. WC 04 03 06 R1 Page 1 of 1 Ed. 08/01/2013 75747043 I 8-004095 1 09.23-09.24 Standard 10-2 Excess $13M AUTO I Grin Celing 18/14/2023 7:31:26 PM (CST) I Page 12 of 12