HomeMy WebLinkAboutI.C.E. BUILDERS, INC. 1B-2005
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WORK i,li" PROCEED
UNfIL "ISURAtJCE EXPIRES
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CLERK ')F COUNCIL
DATE; '" 'Ii -0'')
SECOND AMENDMENT TO
CONSULTANT AGREEMENT
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THIS SECOND AMENDMENT TO CONSULTANT AGREEMENT is entered
into on June 15, 2005, by and between I.C,E. Builders, Inc., a California corporation
("Consultant") and the City of Santa Ana, a charter city and municipal corporation of the
State of California ("City").
Recitals:
A. The parties entered into Agreement #N-2003-098, dated July 1,2003, (hereinafter
"said Agreement") by which Consultant has provided building renovation services.
B. In accordance with the terms and conditions of said Agreement, the parties wish to
extend the term for an additional one-year period and to increase compensation to pay
for services during the extended term.
Wherefore, in consideration ofthe covenants contained in said Agreement, and subject
to all the terms and conditions of said Agreement, except those amended in this Second
Amendment to Consultant Agreement, the parties agree as follows:
1. Section 2.a., COMPENSATION, shall be deleted in its entirety and replaced with the
following:
"City agrees to pay, and Consultant agrees to accept as total payment for its services,
the rates and charges identified in each accepted Proposal. The total sum to be
expended under this Agreement shall not exceed $10,000.00 during the City's 2005-
2006 fiscal year."
2. Section 3, TERM, shall be amended to extend the term from June 30, 2005 to June
30, 2006.
3. Except as hereinabove amended, all terms and conditions of said Agreement shall
remain in full force and effect.
II
II
II
II
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.
IN WITNESS WHEREOF, the parties hereto have executed this Second Amendment to
Consultant Agreement on the date and year first written above.
CITY OF SANTA ANA
ATTEST:
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o PATRICIA E. HEALY
Clerk of the Council
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DAVID N. REAM
City Manager
~
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
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By: !~>.o :,.-U,.jjL(/
Laur~ Sheedy . . /
Assistant City Attorney
APP 'Y ~ D AS TO CONTENT:
CONSULTANT
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DANIEL~OSA ~
(Title) t..G~bS/~J
PATRICIA C. WHITAKER
Executive Director of the
Community Development Agency
10/26/2004 TlΠ10:50 FAX 714+565 4020 CITY OF SANTA ANA ~~~ CITY ATTORNEY
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!41 002/006
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ACaBQ. CERTIFICATE OF LIABILITY INSURANCE DAn; ~Drnw
10/25/2004
""i/OUQ;" (Z70)'Sl-IU7 FAX (270)651-1127 THIS CeA.TlFICATE IS I$$UEC AS A M IoTTEI' OF 'NFORtIIATIOH
Pedigo-Lessenb8rry 7ns. Agençy. Inc. ONLY AND CONFEAS NO RIGHTS UPON THE CERTIFICATE
~~.}j:=R. TH~el=I!FICAT~ð~ES NOT ~MEND. EW~L~R
101 Pin Oak Lane A THE C GE A" D~D BY THE POLICI OW.
P. O. lox 1899
Glasgow. kY 4Z14Z-1199 INSURERS AFFORDING COW~OE NAIC .
"SURED :I.C-E. lUirde,.s, ¡n~. n"SURER II: Travelers Property casuAlty Co. If Amal"'Ìca
421 E. Ce,.ritos Ave. tJ -- 7.;:5>'3 - oqb--a \ UOISUIUill II'
Anahein. CA !JUGS 'NalJII.~RC.
U\l!UREJI D.
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Tlte POLICIES OF INSURANCE LISTED 8i~OW HA\I1:: BUN ISSUEr;) TO THE INiUIŒD NAM&O A80VE fOR THE POLICY PERIOD INDICATED. NOlWlTiotSTAM)]NC
~ REQUIAE"'ENT. TERM °" CONDITION 0' ANY CONTRACT °" OT o ~R DOCUMENT WITH RESPECT '1'0 WHICH THIS CE ¡TIFICATE MAY BE 15SUED OA
MAY' PERTAIN. THE INSURANCE AFFORDED BV TiE POLICIES DESCRIBED IiERelN IS sUaJ¡CT TO AU. THE TfRMS. EXClUSION5 AND CONDITION$ OF SUCH
POLICIES. AGGlREG4TE LlNITS SHOWN w..,. HAVE aSEN REOUCED BY PAlO CLAM!
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lanket A~ditjonll Insureds apply ~o Genera' L1abilitY an4 ^wtoøob;lc L1abi'ity if required by cantra~t
er forms CCTIXX(lO!OZ) and Ccr8XX(lU/02).
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City gf San~a A~
20 Ciw;c Center Pla~a
Santa Ana. CA 92101
ACORD 15 ,20D11011
10/26/2004 TUE 10:51 FAX 714+565 4020 CITY OF SANTA ANA ~~~ CITY ATTORNEY
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IMPORTANT
If the cer1ifale holder is an ADDITIONAL. INSURED, the pollcy(les) must be erldorseli. A slatemenl
on \hIs cenlfIcate dOe& no\ confer rlghls 10 the cer1ificate hold" in lieu of such endQrument(s).
If SUBROGATION IS WAIVED, Subjlld 10 Ihølll1Tfl5 and conditions mtlle policy. certain policies may
reQuire an endorsement A sUnemenl 01'1 Ihls c;ertificate does not cDnfør rights 10 ¡he œrtificale
holder in liøu of 5Ucl\ endors8I11enl(Iõ),
DISCLAIMER
The Cenificale or Insurance on the leller..e side of Itjs rorm does not constiLute a conlract between
the issuing jn$ur8r($), auU\orí:¡,ed represenla\Ï\le or producer, and ttle cel1inc.ale hOlder, oor does II
affirmatively or negatIVeI)' amend, e)(tenCl or aller the coverage affonied by lhe policies lisled Itlllreon.
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ACORD 25 C2DG1JOII
10/28/2004 TlΠ10:51 FAX 714+585 4020 CITY OF SANTA ANA ~~~ CITY ATTORNEY
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COMMERCrAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POJ..lCY. PLEASE READ IT CAREFULLY
BLANKET ADDITIONAL INSURED
(CONTRACTORS)
This e11.dorscment modilie.s insurance provided under tbe foLlowing:
COMMERCiAl.. GENERAL LIABTL1TY COVERACE PART
1.
WHO 15 AN INSURED - (Secrion 11) is amef\ded to include:
a) any person or orga\1ization )Iou arc required tn include as iln additional
insured en this pobcy by a written contr.act or writtcn agreement signed
and executed by you prior 1:0 the loss for which coverage is soughl; and
any pe~on or organization wbo is Lhe owner or property managcr of a
mall while you o,rç required to add a tenant of such mall as an additional
insured on this policy by u wriucn contract or writtcn agreement signed
iUld executed by you prior to the loss for which covernge is sought.
The person or organization does nO( qualitY as an additional insured with respect
to the independent act5 or omissions of such person or organization. The person
or ot¡õ\nizadon is 01ÙY an additional insured with respect to liability caused by
lIyour work" for the additional insured spcciiied jn plll1lgrapb (a) above.
b)
2.
The insurance provided to the additionaJ insured is limiTed as follows:
a) In the event that the limits of liability Stated in the policy exceed the limjts
of liability required by a written conrract or written agreement signed and
e)(ecuted by you prior to tbe loss for wh.içb coverage is sought, the
innlrance provided by this endorsement ghaJl be limited to the limits of
linbiEty required by such c;ontract or agraemcnt. This endorsement sball
not increase the: limits stated in Section III - LCMITS OF INSURANCE-
The insurance provided to tbe additionaJ insured does not apply to "bodily
injury", "property damnje". "penonal injury" or "advertising injury"
arising o~t of an architect's, eng;neer's or SlJtVcyor's n::ndt..ring of or failure
to render any professional scrvic~s including:
L The prepatÎog. approving or failing [0 prepare or approve maps,
shop drawings, opinioQS, repo11s, surveys, fieJd orders, change
orders, or drawings and 5pccifieasions; and
Supervisory OT inspcctjon activities pcrfo1]lled as pan of any
related archÜectural or engineering activities,
This insurance does nol appJy (0 "bodily injury'Þ or "property dámagc"
caused by "your work"included in the "products-completed operations
hazard" unless you are required to provide such coverage for rhe
additional insured by ¡¡, written coTttra.ct or written àgreement signed and
executed by you prior to the loss for which coverage is sought and then
uJ)ly for the period oftimc required by such contract. or agreement and Ïtl
no event beyond the expiration dale uCthe policy,
b)
11,
c)
CO TR XX 1002
Copyrithr, 1l'IC Travelers ~.~. M2 TO F()RMp~ge 1 0(2
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c. ~>I~c¿. ( .:J /. ~
Laura Stitt heedy
Aiiiitant City Attorney
141 0041008
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10/26/2004 T1Π10:51 FAX 714+565 4020 CITY OF SANTA ANA ~~~ CITY ATTORNEY
DCT-25-2ØØ~ 11:~0 FRrn~:PEDIGD LE55ENBERRY 27Ø 651 8127 TO: 17145&52693
COMM~RCIAL GENERAL LtABILTT"t
3-
Subpart (O(a) of tbe PollutÌon exclusion under Paragraph 2" Exclusions of13odi1y
Injury à1'1.d Proper.tY Damage Lhlbility Coverage (ScctiOl] 1 - Coverages) does noL
apply to you if the "bodily injury" Ot "property damage" arises OUt or "your workH
performed on premises wbich are owned or rented by the additional insured at the
fime "your work" is performed,
4,
Any coverage provided by tlús cndorsement to an ;¡ddÜiol1al inS'ured shall be
excess nver any other valid and collectible insurance aV8jlélble to the additional
insured whether primary, excess, contingt!nt or on any other basis unless a written
contract OT written agreement signed and executed by you prior to the loss for
which coverage i.s sougl1t specifically requires that this insurance apply an a
prí:r:nary or 1'Jonocontributory basis. When this insurance ís primary and there is
other insurançe available to U\e additional insW'ed from any source, we win share
with thitt other insurance by the method described in the policy.
s.
As a condition of coverage, each additional insured mUsf:
a.)
Give us .prompt wrilten not1c~ of any .'occurrencc" or often5e which may
result in a claim and prompt written notice of "suit",
Immediately fOTWard ¡¡,lIlegal papers to us. cooperate in the jnvestisarion
or settlement oftbe claim or defense against thc "suit," and otherwis~
cOluply with policy conditìons.
Tender rhe dc;fcose and indemnity of any cI.,jrn or "suit" to any orher
iO!iurc::r which also in¡urcs againSt Ii loss we çovcr under this endúJ'Semenl.
This includes, but is not limited to, any insuTcr which has issued 3 policy
of insurance ill which the :1dditional insured qualifies as an insured. For
purposes of this requirement, the tenn "insures against" rçfers to any self-
insuTaIlcc and to any insurer which issued a policy of insurance thal may
provide covcTilge for the loss, regardless ofwheLher the additional insured
has actually requested [bar the insurer provide the additional insured with
a defense and/or indemnify Utlder that policy of iusurance.
Agree to make available any other insurance that the additional insured
has for a loss we cover under this endorscmeQt.
b.)
c.)
d.)
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CGT8 xx 1002
Copyrighf, The Tr/i,¡clers1ndc:n\'1Í1Y CDmpany, 1002
p;,.gc 2 c(2
141 005/006
P.5/6
10/26/2004 TUE 10:52 FAX 714+565 4020 CITY OF SANTA ANA ~~~ ~J~~~~;¿~~;;
u..i-~pc:1Qll; 'i ~J.;'1t; "''''UI' ;r-t;.LJJ.1,:8U l..t;.:;.~Nt:lt;.r< o(' ¡;:{IQ C;)J. tI,l.I::::r
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLlCY. PL~ASE READ IT CAREFULLY
ADDITIONAL INSURED
This endorsement modifies insur:mce provided under the foHowing:
BUSINESS AUTO COVERAGE FORM
Paragraph c. of the WHO IS AN INSu:R..ED provision inc1ude..'I the person or organiz2;tion
indicated be]ow, bUt only for his, ha or itS liability because of acts or omissions of an
"insuTl~d" under parngraphs a. or b. of that provision, subject to the followiDg additional
proviS;OÐS;
1, No liabilir:y is assumed by that person or organization for the payment of any
premiums stated in the polioy or eamed under the policy,
2. In the event of cancellation of the policy, written notice of cancella.tion will be maned
by us to that persol'l or organjza'åon.
3. Any coverage provided by this endorsement to an addjtionB.I io.sured shalt be excess
over 3J1Y other vaJid and çollectib]c insurance available to the adddional iDSlU'ed whether
primary, ex.cess, t".Ontingent or on any other hasis unle$s a written contnct or written
agreement signed and executed by you prior to the loss forwhi¡;;b coverage is sought
specifically requires that this insurance apply OD a primary or non-contcibu.tory basis.
When this insurance is primary, and there is other in.surance available to the additional
insuted ftom any source. we Mil share with Ihat other insuratlcc by the O'Iethod described
in dùs policy.
P~on or Organization:
Any person or OtgæJÌZltidn you are tequ!rcli to incJude as an :adclirion:a1 insured 00 rhìs policy by a written
contncr fit. written 3greernent sipcd aDd cXCQ¡ted by you prior to the toss íor wblcb coverage Í5 sought.
API'ROVED AS TO FORM
CG TR XX 1() 02
CopyrighT, "lÃc Î..favclers IlIdmmity CDmpany, 2002
P;¡se 1 of 1
141006/006
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Feb 28 06 11:42a T11ac;l p. 1
Feb 23 06 OS:51a Tll ac; 1 p.2
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A~OBQ. CERTIFICATE OF LIABILITY INSURANCE
I'IfQI'1UCIIt (llO)6S1- au AX < OJ651...11l7
ped1ga-tessenberry In5. Agency, InC.
lOJ Pin OIl\. Line
p, ~. Box 1899
Clasgow, XV ~l142-1'99
.,iiultf"O 1.C.E. Blll1der.... Inc.
421 E. C.~ri'u~ A~.
L....im. CA ,nos
OIroTE(t.IMD/Y"m'I
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nIS CERTIRCATE IS lllUeu Ai" MATTER OF lNf!ORMATiON
ON'L Y ANP COWPSUI NO RlGHn uPON THE' cERTtFICATE
H01DEk.. 'I'M'S CI!'ImFrCATE DOES NOT AMe."O. EXTE:N'D OR
TER CO\! E AFFoRD Y POLICIES SEI..Cl
"SURElIS AFFORDINO C~VERAGE
""iI,lll(II.A Tr&~lers Property Casualty (0.
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ltiE POlIClr::S Of INSURANCe usm BElOW HAVl:. BfEN.I$SUit) TO TH~ INSUReD NAMEC A80Vf FOR THE POUC;Y ~IQD INDICATED. NOiWTHSTANDltlO
ANY HEOlllREkENT, TERrA OR CONDITION OF Nt'" CONTRACT OR OTHti.R OOCUMeNT 'MTH RESPECT TO WIlItH nus CERTF.cATi I{lAY BE ISSUEO OR
WJ\V Pf.R!TAlN. TlI.t lel$URANCEAFPORomBY TH!: PQLIctES O~5eRIII!,f]N!AEIN IS SUBJECT TO ALL THfi TERMS, txClLlSIONSAND COM)ITlOHS elF SUCH
. FOLlCIES AGGRl:GJl.TELI>'TfSIiHO,^,NMAYHAVEeli~NREOUC:EDB'I'~AlOCI.AlW:_ ~ __
~~_QQ.1! T'lP'~aflltllL.lflllM;~ _ POLIC't"UIallElIl Y .. uwn;
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lanket Additional nlsuNCI!; lIpply to Gen.ra.l tiall'tlhy and Auto l1abUity pAr form nu.rs CCTllftn
Qi/On and (~Z041 COlj") luechecL Certifiaw holder will QqaHfy as art'Ac1d1t1artal Insured 1f'
~"u-;N!:d in a "ritt,!" Contrilct yjith out" inwred.
(1 ty Of' 5af'U Al"li
20 Civir; CtntQr ri'hl-il
SDnta AnI.. C" 92701
_ CORPORATION 19,8
ACORD 25 (::!ClDtIDII
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Feb 28 OS 11:42a
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Feb 23 OS OS:52a
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IMPORTANT
If Ihe certtf1Ca4e ttoIder i'S an ADDITIONAL INSURED, the policy(ie&J ml.Jst be endoraed. A lila1ement
ollltds certificaht does: 1101 confer right$ to lhe certificate hvlder in Ikfl,j 01 ~ r:ndor5!!ment(s)
I
If SUBROGATION tS WAIVED. sOOjecl to the fam'lli al'd CCN:lilionl Of 1.,. policy. cert3in politi" may
require in end~t. A stal9mWlt on this certificate does not ConfSf rilJhf!i.lo the certiticsle
t\oI.oer in liet,I Qf $ucft endorl;E'ment{s).
DISCLAIMER
TM Ce,liflCite of Inlllrence onllle reve~ side or Ibis form dries nol constitute a contract between
1nll' (ssuing in9Urer(s), authorlZlld llIp1Blienl8tive a~ ProdUcer,.end the oel'tirlCalt! hoteler. nOT doCll il
aff'mlativety or negaUvely amend, extent:l or aller tile couera9l' IIJfar~ by the pClJicies lis1ed thereon.
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ACO"D 2$ (2001ro",
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F@b 28 06 11:42a
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F@b,,23 06 D9:52a
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COMMERCI"l GCNCR.'\llIABllITY
~HIS ENOORSEME NT CHANGES ,HE POLICY. PLEAse READ IT CAREFUlL Y
6LANK~T AOOITlONAllNSURED
ICONTRACTORS)
ThIS endOrsement nlodifies i(tSljlaft<;e prOVlced under the tollOVllng:
COMMERCIAL GENERAL liABILITY CQVERAGE PART
I" WHO IS AN INSURED" (Section II) IS amended to inCllKle any pe!;on or
orgClnization that you agree in ,) ~wri1tetl ~ontf,act. requinng insuranc.e" to indude
as an addilionallnsured on this Coverage Part, but:
a) Only wIth re$pecl to liaDllily for "bodily inlUry", "properly damoge" or
~personaJ lnjl.lry~: and
b) II, and only to lI1e extenllha!. the injury or damage is cau~ed by acts or
omis~l(')ns of you or your 5ubeor'ltractor in the performance of ~your work"
to which the 'written conlr~ct requiring insu(ance" applies The person o(
orge.niz81io!"l does hot q.ualify a~ an additional inl)ured with respect to the
independenl acts or omissions ot such person ororganizolion.
2. WHO IS AN INSUREO ' (Seclion II) is also amended 10 include any perJion or
o(ganizatlon that IS Ih. owner or Pfoperty manager 01 a man while you ale
reqUired in .a "written contract requirin9 ins.Ul'1Ince~ \0 inctude B tena'" of slJch
mall.. an add,t,onal insu,"d on Ihls Co<<rage Part. but:
a) Only with respect to liability fO( "bodily injury'" "property damage" 01
~personal injury"; and
b) If, and only to the exlenl that. Ihe injUry or damage IS caused by aclS or
omt:5MJns of you or- your subcontractor in the perfurn1 311"ce of ~'fQLJr W<)r~~
10 which the 'written cO(1tracl requiring iMllrsnre" applies. The person or
orgamation does not qualdy .a on addilionalli1sured WllIl r..pecI to 1M
independent a!;ls or omissions of such per~on .r organi;:aDon.
3. TM Inaurance llfovided to Ihe additional insu,.,d by lI1.s endorsement, whether
under paragraph 1" '" parag"'ph 2, above, Islirniled as tollows:
_) In rhe evenllhat 1M limits olios"""",,, ollhis Coverage Pan shoWfl in
the ERc:larations exceed tne. kmits of 'iabilit~ re<<:luired by the "wrKtel1
contract requiring insurancew. the insurance proVided to the additional
insured shall be limited to thll limits Qt liability required by Ural .wmt.n
contract requiring inlllJrance'" ThIS endorsement shall not ,ncrease the
limits of insUranci described jn Section ftl ~ Umi.t:s Of !nsW';.nce.
b) The insural1ce provided to the additlonal insvred does not apply to "bornly
injury'l. "proper1V damage" or "persOMI injury" arIsing out of thG rendering
CO:8 fl.n O~ \):0
Copyfie:hl. The Tr.1...=ellill"!llmJelnnilY COl111)IlRY, ~002
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COi\';F'\fER.CIALGf.Nr:.RAL LIAB1UiY
of. or failllre tll rend~r. any prcfeSSlo:"lal arc;hitecRm:'IJ, engIneering or
surveying services, Inch.id'lng:
i.
The preparing, apP~O\Jing, or failing to prepare or approye. maps,
Shc~ drawings, opinions, reports, surveys. fieJd orders Of change
orders. 0( the prep~uing. approving, or railing to prepare or
approve, drawings and specificalio"s; and
il.
Supervisory, iC'lspection, archItectural or engineenng activities.
c) The Insurance provided to th~ addll(onal ins.ured does not .-tpply 10 "bodily
mjLlrY"Q( "property damage" caused by "yoU( work" and illf..iuded;o the
"products-completed apelstiOne l1..lJzQrdOl unless \he ''written ~OnlrClCl
requiring IIlsuraf'lce" speCifically require6 you \0 prc\llde suCh coverage for
tt1~t addiflon;;a./ insured under paragl"a,,1l1, abQ\'e, or tor the tenant of such
",all under paragraph 2. abol/e. and then Ihe Insurance provide. \0 \he
additional insured applies Ollly 10 sucl, 'bodily InjUry" Of 'ploperiy
damage" that occurs belore the end 01 the period 01lim8 fa. which Ihe
-written eontract requiring insurance"' requires you to provide such
coverege or the Qnd of 1Me policy perj~, whichever lS earlier,
4. The i.l'\$\Jrance provide~ to tilt: add'Rlcmat insured by rnls el1dorsement is excess
01/.1' any \laid and roilecUble 'other ins.rarn:e". whelherpOm.rl. excess,
cOf1bngent or On any olher naSls, ~at is a\/lliteble to ,he .ddilional insured for a
loss we ~OVe( under this e-ndorsemenl. However, it the "written contract ra.qUJrlr'tg
iosulance" specifICally "'quI'''' that mi. insllrance apply on a p"llary basis or .
.onmary and non..contributQCY b8Si$, this insurance i;; primary to "olher insurance'
available to tt'te additionsl insured. WhIch 'COV~HS 1hat person or organization as a
named jnsu~d for such 105S, and we will IiQt share with tha1 "othet Insurance",
But tne insuranee provide; 10 the addition.. in.ure<! by lhia en;orsemenl sbIJ ;.
excess over any valid and cone-ciible ~otrter tnSUr.ance", whether primary, &)teass,
contingent Or on any othsr basis, that it> available- to lMe additional Itlaul"ed wh~1"I
lhat person or orgaftlZaticm is an addihonal insured under such .other insurance"
5. As. condrtlon of cOl/erage prol/medlc Ihe addiiionalln....e; by this
endolsem@nt
". The llddrtionallnslU'e</ must gll/e us wnlten notice as soon as p'acticaiJle
of;n "occurrence" Of en offeflse whictl may resuft in a claim, To (he
elttent possib<l. aul:l1 notice should include:
i. How, when and where the ~occurrence~ or OffStl66 fool< place;
ii. The names and. addresses of any injured persons and witnesses;
and
IIi. The nature and 10G.bon of any inJV,,! 01 damage aJi$lng out of the
"occ:urrenc:eu or offense,
h) It a claim )$ made or "suif is brQught against the additional insured. the
addltionslll'\sured must
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CO~1MEI\C1.'L GENEllA!. LIABILITY
i. lrnlnediatery record lhe specifics of the c!alm Of "suit" arvj' the date
receIved: and
ii. Nolifju:. liS soon as praclicabfe.
The addItional insured mus1 SIfie Ie it that we receive written IiOtice of the
etaim Q( "suif as soan as praC\icabl9
0)
The additionallnsureo must immedialely send US copIes of a!llegal
papef::i received in connecti.on with the claim Or "surf. cooperare witf1 us
in the rnvestigatiQn Or s&ttlement af the claim or c::tefcnse aQainst the .suir,
and otherwise comply with 311 policy l;onditions.
d} The addition.-I insured mU3t 1ender the defense at'ld ind-emmty of any
claim or "suW to any providli.W of ftother insurance" which would cover the
additional insured to( a loss we cover under thIs endorsement. Howe\ler,
this conditiorl does not affect ,..vhelher the instJran<:e fJifo'lided tQ the
additional <l$ured by this endorsement 15 primary to "other insurance"
available to the additiQ,," inslJrecl whiCh cavetS that person or
Ofg.nizatlon as a named insured as described in paragraph 4. abo",,_
5. The (ollowlng definition is added to SECTION V_ - DEFINITIONS:
"Written contract reQUiTinD inl;uranOl~ mean; that pert of W1y lMitten conrract or
agreement U!1<ler wI1Ich you are I\'!quiled 10 Include. P""O<l or organizal/Of1 as
an additiclMalln;'lJ~ on thS$ Coveragl!' Part, provlaed th_t tl'ie "bodily i1jury" and
"property damage' occurs aod 1t1<l "persona' injUly'. is csused by an off""se
committed:
a. After Ihe signing and eKecuhoo of the contOO or agreement by you;
b. While Ihat port of lhe conlract or agreement IS in effecl; and
c. Before the end of the policy period.
CGT8MOSQS
Pa:ge }afi
Copyrighl. Tfl.t Trilveleu hlemolly Comp!ll1}1, 2002
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peLlCY 'UM5~1'\:
c~MMERClAL AUTO
ISS~E DATE,
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED
Hie -a!ldOl'Sement mcdfflea]t\S....IInC9 J)(ovided unaer U1e fOllOwing:
SUSIJ>lESS AUTO COVERAGE FORM
GARAGE COVERAGE FOAM
MOTOR CARRIER COVE1W3E FOR~
TRUCKERS COVER.':GE FOAM
Wilt! resQecr fQ coverage "..Ide" DY ihtC "ncfotsametJr. rtle prtlvlSklns of ttt9 CeviIf'igM r~ 1lP~ urn.. madl-
fied b)' rhiE, endorsement. '
This &ndMiiumt'r\t id8CUifieS pMlon(&) oc ~tlatlDn(5) MlQ lire "insurEds- under the Wile Ju An lns.~ P~i.
siOn of rtJC Cov'r.l9' Foftl1. ntl's lWldorsamenl dOltS net alter coverage proVided in Ehe Covl!ragi FQI'ft1_
SCHeDULE
Nom. of ".n;an(!ll or olllo.l..lIon(o),
"Any penon or org.mization that you a.re required to include as an additional
insured on this coverage form in. a written contract 01" agreement that is signed
and eX6Guted by you h8furd the "bodily injury" or Ilproperty damage" OCCllrs
and that Is In effect durin II the ~Qlicy period."
tlf no lintl"j ~~ft, ~., infOftnQtloft requir8cl '0 aamplota ~ cndOl'$lImcnt will be ~n in Ol& Oll5cllJ'al:iQna
.. ~Ppl1<Obl8:C Iho ."d.....mtnt.)
EIIGt1 ptnan Ql" Qrglil~;Jlkln 'Shawn in 1M: :SC!\eCSUla ($ ~ "lm\I"",, for UBbi.l\t'j cmraoe. U of'bt to fle e:tIem
that pll1cn or QfQaI1IDlXln Qualirtes as an "lnsured'l under the WM.1I An Inljl"l'BCI PrOvIsion CDRtIWl!!ld 1ft SldOlt
n of the eo.e_ ""1111.
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