HomeMy WebLinkAboutLARGE SCREEN DISPLAY 1A - 2006
.
INSURANIJE 1iQI ON FIL~
WORK MAY N.O.l PROCEED
CLERK OF COUNCIL
DATE: 'f-17-0f.,
A-2006-075
0: fD
risU+-L
FIRST AMENDMENT TO
CONSUL T ANT AGREEMENT
THIS FIRST AMENDMENT TO CONSULTANT AGREEMENT is entered into
on April 3, 2006, by and between Large Screen Displays ("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-2005-138, dated November 28,2005,
(hereinafter "said Agreement") by which Consultant has provided multimedia system
design consultation and installation management services.
B. In accordance with the terms and conditions of said Agreement, the parties wish to
amend said Agreement to include.
Wherefore, in consideration of the covenants contained in said Agreement, and subject
to all the terms and conditions of said Agreement, except those amended in this First
Amendment to Consultant Agreement, the parties agree as follows:
I. Section I, SCOPE OF SERVICES, shall be deleted in its entirety and replaced with
the following:
"Consultant shall perform those multimedia design consultation and installation
management services as set forth in Exhibit A to said Agreement and Exhibit B,
attached hereto and incorporated by reference."
2. Section 2.a., COPENSATION, shall be amended to add a flat fee of$8,500.00 for
Police Facility multimedia design and installation management, which will be earned
at the completion of the following milestones:
· Thirty percent (30%) upon City's acceptance of the drawings and equipment list
· Thirty-five percent (35%) upon completion of site visits
· Thirty-five percent (35%) upon final inspection of installed systems.
The total amount of compensation for services provided pursuant to said Agreement
shall not exceed $15,000.00 during the term of said Agreement.
3. Except as herein amended, all terms and conditions of said Agreement shall remain in
full force and effect.
II
II
.
IN WITNESS WHEREOF, the parties hereto have executed this First Amendment to
Consultant Agreement on the date and year first written above.
ATTEST:
CITY OF SANTA ANA
PATRICIA E. HEALY
Clerk of the Council
a~
DAVID N. RE M
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
City Attorney
By:
Laura Sheedy
Assistant City Attorney
LARGE SCREEN DISPLAYS
~~
(NAME) /
(Title) V p
.
EXHIBIT B
Multimedia System Consultant Scope of Work
Consultant shall conduct one site visit at the Santa Ana Police Department's Roll Call
Room, Community Center, and primary Training Classroom to assess the unique
multimedia needs of each location. Consultant shall design and provide a detailed
specification of proposed multi-media equipment to be utilized for each location and
review them with SAPD personnel. Consultant shall attend pre-bid meeting to provide
bidders with information on proposed multi-media equipment. Consultant shall also
provide evaluation of submitted bids. Consultant will assist City personnel in monitoring
the installation process to ensure proper installation of multi-media equipment by
conducting four progress site visits per location during the installation period. Consultant
shall assist City personnel in conducting a final inspection of the multi-media systems at
each location to ensure the equipment has been properly installed and functions correctly.
Ma~ 04 2006 11:16AM
LARGE SCREEN DISPLAYS
7145468383
p.2
From: {\merah Halt At: JSU~ The R~r ston. Agency FalC.lD: ISU InSJrance S~ic To: K1,..,; Hausman
Dale: 5/.:j.l20Q6 09:21 AM Paget: 2 of:3
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID :d.- DATE IMM..ti!rrYvv)
LAllGIl-2 05/0./0.
PRO,:,",.._ER THIS CERTIfiCATE IS ISSUEOAS A MATTER O~INFORMAnON
ISU ID:s~ance Sezvicea- ONLY AH_D C'ONFEI\S NO RIGHTS UPON THE CERTIFICATE
~~e Roge~ stone Agency HOL!lER. THIS CERTIFICATe Does NOT AMEND, EXTEND OR
5015 Bireb street ALTER Ttfe COVERAGE AFFO'RDED BY THE POUCIES BELOW.
Nnport: Ileael:l CA 92660
Pho~e:S4S.7S7-0270 raxI94S-757-0375 INSURERS AFFORIllNG COVE'RAGE NAIl: .
INBURIiiiP I\J ::!U05'-13g INSLNERA o;:atlQy IQRty ~an.. e.
Large Screen Display P.ei:1tals A - ).oDf.R-d15 INSLM:R B:
Kirstez Hau~man INSl.H':RC
3401-3403 . Ha~tbur Blvd INSI)RER D:
sant.a .Ana 0A92101
NSlJRfR E;
COVERAGES
THE POLICIES ao ~.&SI~ LISTED EELOWHAVE EEEN ISWED TO THE rlolSllREO ~oAaOVE FOR THE POLICY PERJOD It>DICAlED, IKlTYVlTHSrANOING
IWY.J;fOiJlRE...-eNf, TWA QR CQf:J/T[Ct<! OF '*II' CONJRACT O,!l ,OTHER. OOCUM~WtTH REGPECTTOWHICH THIS CE~nFlCAT~, Molly ee: ISSUED OR
Mol.Y PER1^~. THe lNSLifW'CE HFCROED BY THE POlla(E~ DESCRIBEO'fERE IN ts s:.a..ECT TO /tL~ THE TE~. EXCLUSlClNS ANDCO'JDmONs Of SlICH
POUC1~ .-.oGREGATE l.,uTS SHaWN MAY HAVE BEEN-REOUCEO'8Y P).JD ctAl~,
~ ,lWEi OF INSUIU,.CE PQll;YNUMaER ilATEMINO~ DATIii ,("'~DNYI Llrn
C;~RAl..LIABllfTY EACti OCQRREta , 1,000,000
A X X 3~ER<"'G€"'''''LlAI3L1lY GCU70.06 OS/1S/05 09/1S/05 PR~M'i~s lEe Q(:(:tJJ'erte~) .50,000
- Q,AIIIIISwoe: [RJ' oca..R h1:D ~ (Any ~11i -Pf(VJJ'l) I 2~ 000
- PfRSON">l & N)V lNJ~Y 11,000 000
GENEM AGGRE:GA~ 12,000,000
C~MGREGATE llt.1lT APPl.IESPE:R PRODUCTS. COMPIQP AGG 11,00D,00_0
GCCJCY n,'!:&- DLOC
AU'{CM~n..eI..lWl.ITV COMBINED SINGLe LIMIT
r- MolY AUTO (Ee.ccJd.nQ .
r-- }l,lL GlNNErJAUTOS 8000..1( NJURY ,
,]" SOiEOULED)lUTOS (PjrplO:ltl)
- HIRED AUTOS
- IilDOI. '( NJURY .
~.OWNE()AUTOS (PlftledlMrt)
-
p~ry OMIJWE I
-'u lP!faecl'dert)
GARAGE UlBlLrrv />JJTOON"Y.EAACCIOfNT ,
1NJYAlJrO OTHERlHAN EAN:C ,
AUTO O/ll.Y: N;G ,
EXCESS~eRau. LlAlilIUTY EAD! OCCURRe:t>CE .
=:Jooo..o 0' ClAJM:;: NAOE AGGREGAte; .
.
Boeoucntle ,
RETENTION I . .
WORKERS COMPENSAnor"l ANQ -.lIORY lIMmi! I' ER
BlPLOYe/Ui' UABl,;rrt
~y PROPR1ETORl?AATN~.llEOJ1lve: E.L. CACK AOCtOE;tJf .
OfFICEM.EMBER 5.XC\.UDE01 EL D1$&SE .E).EMDlO'fEE .
~",(li$<<lbt~OOI'
CIA:. PROVISK)NS bel_ EL D1SfASE. PQ..ICYLlMlr .
O'THiR .
.
.
OESC._ .:'.... .Of" tJI'EJU'TlONS-' L...CA'TION$' VeHleLJE'$1 ,,^CLu:"I;IN~''''OOEO fTfENDuRSIEMEW r_,_ECIAl-, nDVl5JQNS
U: Audio ,& Visual. consu.ltin_, a.t 60 C1.vi-c Ceutu Plaza..- S;anta. ArIa, CA
Certi~ieate hQlde~ b namf:!:d add:ltional. insure~ pe~ fO%m C~2fil010Dl.
"10 day. DoticeQ,f ~cella.tioD. fQr non"'pape~t (.'If pr_emi.um.
..
CERTIFICATE "OLOER
CITYSA6
CANCELLATION
SHOU.O ANY OF 'nie! ABOVE 06$CAIeED I"CLIClil B!:CANC:ELLED BEl"OfleTHE EXPIIUTlON
D4T&~o" ~It "$UING IN8UR&JtWIL~ ENJEAYOR'TO MAil t: 30 ELlVI WRITTeN
NO'TlCl!!TO THi ClfRl1FlCA'TE H(lLD~ ~MEDTOTHELEI'T, BUT'ALUIIlI!TO DO IO,'mL
WO.&NO oaLIG.\TlON OR LIABIUTY 0." JNf ~IHD UPOtll THE 1H9UREFl:, In AOEtIT'S OR
N;f'ftese"T~Trva;
_z;EO Rff'RlSE A
NaD4 . ela.i~a PH. 9t~~2G5-4175
SlACQRO "PO"A
1S88
city t:4 Santa Ana PoUce Dept.
60 ctv~c Cen~or P~a:a
Santa Ana GA 92701
AC.ORD U (2001108)
/~-j~/: /./-2
!
Ma~ 04 2006 11:16AM LARGE SCREEN DISPLAYS
7145468383
p.3.._
From: .Amerat! HaJIAt: ISu;. tn. Roger Sto~ Arienr::y FilxlD:. ISUln&Ur~nPfJ Servlc:To: KJrsteriHaUsniiil'\
Date: 5/412006 09:21 AM P~ge; 3013
,
COMMERCIAL GENERAL UAB.IUlY
CO 20 10 1001
THIS ENDORSEMENT CHANGES THE POLICY, PI.EASE READ ,IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATIO",
Tl1isendorsernent modifies IntlurancB provided- tJnde, the foilowing:
COMMERCIAL GENERAL lIABluTY COVERAGE PART
SCHEDULE
Nomool Perich or OrgonlJllllon: ..
8~ ADDlTIONlUo IlfStlRSD S!ll\U. BE liNYPEJUiOll (9) OR ORGlIlfIZAttOll (S) lfJ:Tll lflIOM YOU
AGREE HI IlRI'XTllN COIll'l'RII.CT TO !lAME JIB )\II II.IlDITIONAt. INSURED AS RBC:ORDED. ON FJ:LE WITH
COMP1lNY.
A. Soctlon JI - Who 10 An In..,.d 10 amondod 10
include o. iI/l inoUlad lhe parson or organiza.
tion .hown In tho SChodu'e. but only with re-
.POIC! to liability arl.ing out of your ongoing
operationo parformed fur thot insured.
B. With reopeel ID tho insurance afforded to
the..e odditiona' ....ureds, the following exclu-
elOfl i. Bdded: .
2. eo"'....i.""
This insurance dD.. not .,,~Iy 10 'bodily
injury" or "property damage., occurring
after:
III All work. including metoriol..
parts or equipment furnished in
cooneotlon -with such wm.on
!h. project lother tlten .......Ic..
meinte:nance or "'pairt) to b. pttr-
formed bv Dr on behalf of the
additional. in,uredl.' at the Bile of
111. cov.red o~ration. he. been
cornr:t.lltBdior
121 ThIll pol1il>n of 'your work' OUI of
which tho injury or d.mage arise,
hao been put to 11, Intended u..
~y onv parBOIl. or orgonizotion
alttar than another conttactDr or
IUbcontra.clor enIJlIged in- perfoim-
ing op.",1lon. for a pmelpel e. a
parfc.fthe same-pt'oject.
'. ik;5:./ ..( ,7/'7
/ /--;(/' --"---- ~--:'
,
ca 20 101001
· ISO Prop.rtie',lne.. 2000
Pll!lalofl [J
.
-~ DATE (MM/DDNYVY)
ACORDM CERTIFICATE OF LIABILITY INSURANCE OP 10 J1!
LAR.GE-2 10/05/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ISU Insurance Services- ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Roger stone Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5015 Birch street AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Newport Beach CA 92660
Phone: 949-757-0270 Fax:949-757-0375 INSURERS AFFORDING COVERAGE NAIC#
INSURED -
A-&. 00 ~ ~ O';() INSURER A Hartford Fire Ins CO
INSURER B
L~rge Screen Display Rentals INSURER C
K~rsten Hausman
3401-3403 W. MacArthur Blvd INSURER D
Santa Ana CA 92704
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED ~WAED ABOVE FOR THE POLICY PERIOD INDICATE:> NOTWITHSTANDING
MY REQUIREMENT, TERM OR CONDITION OF MY CONT~i\CT OR 01HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, TH= INSlJ1MCE !"=FORDED BY THE POc,CIES DESCRIBED HEREIN IS SUBJECT ,0 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDLX:EO BY PAID CLAII'.'S,
LTR NSRC TYPE OF INSURANCE POUCY NUMBER I PD'M'{MMfDOmt DATE (MMIODIYY) UMITS
GENERAL LIABILITY EACH OCCURRENCE $J ,.QQ.Q,09()
f-- .... .. ., " '."'" . .'. -~~'-- -. - - .'~ .. .
A X X COMMERCIAL GENERAL LIABILITY 72CESOl!'0047 09/19/07 09/19!-08 PREMISES (E~':~~~';.';MCe) iMO,OOO ,)
f-- :=J CLAIMS MADE o OCCUR , . ,~
f-- MED EXP (Any'one person) n.O ~ 900' '..~ .
,. PER"'O~ &ADV INJu~l' .;d..,:ooo,ooo
f--
GENERALAGGflEGA'TE; : $2, QO,O, 000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. cbwlOP AGG $2t,MO,000
Xl n PRO- nLOC
X POLICY JECT
AUTOMOBILE LIABILITY ;,- ". ;;. ",' C6MBINED SINGLE LIMIT "-i, j'" )
I-- $
ANY AUTO -- :(Eaacci.d~t) .:\'
~
- ALL OWNEDAUTOS BOOIL Y INJURY $
SCHEDULED AUTOS (Per person) ,
- .. .
HIRED AUTOS BOD 1 Y INJUR Y
f-- $
NON-OWt;EJ AUTOS (Per accident)
f-- .' ,.. ... .',.. _......._...r.~.~'_...._. """"'d ~ -- ...~. - ..",-,.., 0'_''" ...__.'
.'. . RROPERTY- DAMAGE. ,.. $ ,- ..... '-, .._..",~
Iper accident)
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
~ MY AUTO OTHER THAN EAACC $
AVTD ONLY: /lI3G $
EXCESSJUMBRELLA LIABILITY EACH OCCURRENCE $
..J OCCUR LJ CLAIMS MADE ~ ------ --
AGGREGATE $
$ .
==1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND APPRO' E:) (:" l,.J t'u IVI ITO~\ t:~I% I IV~~
EMPLOYERS' LIABILITY
!>N'I PROPRIETOR/PARTNER/EXECUTIVE ~h~~ EL EACH ACGJDENT $
OFFICERlMEMBER EXCLUJED? f~II~- ." $
.EL DISEASE - EA EMPLOYEE
If.yes, cescribe under .-
SPECAL PROVISIONS below ---,P . . E:L. DISEASE - POLICY LIMIT $
.. . "
OTHER , ~... .~.',. ,.
A ~si ~ t:', It .'-or -" .,
, j
'"
,
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE: Audio & visual conSUlting for the Santa Police .. .. -- .... .
Ana Dept.
Certificate Holder is named Addi tional Insured. .. ..
*10 day notice of cancellation for non-payment of premiwn. .
**Revised**
CERTIFICATE HOLDER CANCELLATION
CITYSA6 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 6E CANCELLED 6EFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL E~AJL * 3 0 DAYS WRITTEN
Ci ty of Santa Ana Police Dept. ----
60 Civic Center Plaza
P.O. Box 19B1
Santa Ana CA 92702
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT F~JllX>1!XXmlliHALL
HW~~'AIljI\lIQ""WIi~~vqNQ~~tl~WW~
~~~V.V\ijiS,
~REt::.Xr.E
@ACORD CORPORATION 1988
ACORD 25 (2001108)
..
ADDITIONAL INSURED ENDORSEMENT
FOR COMMERCIAL GENERAL LIABILITY POLICY
Insurance Company 1-1 jJrlLif1Jf1..-f)
This endorsement modifies such insurance as is afforded by the provisions of Policy
# '7 2CL=S of ().J"17 relating to the following:
1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its
officers, employees, agents, volunteers and representatives are named as additional insureds
("additional insureds") with regard to liability and defense of suits arising from the operations
and uses performed by or on behalf of the named insured.
2. With respect to claims arising out of the operations and uses performed by or on
behalf of the named insured, such insurance as is afforded by this policy is primary and is not
additional to or contributing with any other insurance carried by or for the benefit of the
additional insureds.
3. This insurance applies separately to each insured against whom claim is made or
suit is brought except with respect to the company's limits of liability. The inclusion of any
person or organization as an insured shall not affect any right which such person or organization
would have as a claimant if not so included.
4. With respect to the additional insureds, this insurance shall not be cancelled, or
materially reduced in coverage or limits except after thirty (30) days written notice has been
given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701.
(Completion of the following, including countersignature, is required to make this endorsement
effective.)
Effective
Policy #
Issued to
o/z!ifg;OO~7
C /N o? ...f~1J- t9V-;9
, this endorsement form as a part of
po
Named Insured
Countersigned by
.Q
AEzed Representative -
ACORD.' CERTIFICATE OF LIABILITY INSURANCE OP 10 J11 DATE (MMJDOJYYVV)
LAM!-2 09/27/07
PRODUCEFf A -';).00"'-0-75 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ISU Insurance Services- ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Roger stone Agency I'J - ;;loo5-1'? 8 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5015 Birch Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
Newport Beach CA 92660
Phone: 949-757-0270 Fax:949-757-0375 INSURERS AFFORDING COVERAGE NAlC #
INSURED INSJRER A Hartford Casualty
INSURER B
Large Screen Display Rentals INSURER C
Kirsten Hausman
3401-3403 W. MacArthur Blvd INSURER 0
Santa Ana CA 92704
INSURER E
COVERAGES
THE POLl:IES OF INSURANCE LISTED BELOW I-<AVE BEEN ISSUED TO n-E INS:.JRED NAMED ABOVE FOR H-IE POLICY PERIOD I~DICATED NOTWITHSTAJlJDING
.~y RECUIREMENT. TERM OR CONDITION OF IWY CONTRACT OR OTHER DOCl"MENTWITH RES;>ECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, Tf-IE INSURPNCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TON-L THE TERMS. EXCLUSIONSAI\JJ CONDITIONS OF SUCH
PCLlCIES AGGREGATE LIMITS SHOYVN MAY HAVE BEEN REDUCEC BY PAID CLAIMS
LTR INSR TYPE OF INSURANCE POLICY NUMBER t"D"i~~[MMIDDNY) DATE (MWODiYY) LIMITS
I ~NERAL LIABILITY EACH OCCURRENCE 11,000,000
A X X COMMERCiAL GENERAL LIABILITY 72CESOF0047 09/19/07 09/19/08 PREMISES (EaocclXence) 1300,000
I CLAIMS MADE ~ OCCUR MED EXP (Any ane person) 110,000
- PERSCNAL & PDV INJURY 11,000,000
I
i GENERAL AGGREGA.TE 12,000,000
il'~ AGGR,EA L~rMIT AP;:>L1ES PER PRODUCTS - COMP/OP AGG 12,000,000
X POLICY j~g- n LOC
~TOMOBILE LIABILITY ,
COMBINED SINGLE L,MIT $
ANY AUTO (Eaaccldant)
-
- A..L OVVNED AUTOS BODILY INJURY
(Per person) I
- SC:i-,EDUlED AUTOS
HIRED ALfTCS BODIL Y INJU~Y
- I
NON-OWNED AUTJ::; (Peraccldenl)
-
PROPERTY DAMAGE I
(Per accident)
GARAGE LIABILITY I AUTO ONLY - EAACCIDENT I
R ANYAUTO OT1-lERTI-lAN EAACC I
AUTO ONLY AGO I
D~SSJUMBRELLA LIABLllY EACH OCCURRENCE I
OCCUR 0 CLAiMS MADE AGGREGATE $
I
~ DEDUCTIBLE I
RETENTION I I
WORKERS COMPENSATION AND ITI,1,\t:~:T'!, I lu/it
EMPLOYERS' liABILITY
!>NY PROPRIETOO/PAATNERIEXECUTIVE EL EACH p,.cCIDENT I
OFFICER/MEMBER EXCLUDED? H DISEASE - EA EMPLOYEE I
If yes, dascnbe under E.L DISEASE - POliCY LIMIT I
9"ECIAL PROVISIONS below
OTHER
DESCRf'TlON Of OPERATlONS J LOCATlONS I VEHICLES I EXCLUSIONS ADDeO BY ENDORSEMENT I SPECIAL PROVISIONS
RE: Audio & visual consulting for the Santa Ana Police Dept. ?:!yc.a-ReC (
Certificate Holder is named Additional Insured. //<.
*10 day notice of cancellation for non-payment of premium.
CERTIFICATE HOLDER
City of Santa Ana Police Dept.
60 Civic Center Plaza
P.O. Box 1981
Santa A,n,~ CA ~2702
, !~ I .,~"t .,' ~ '-'
CANCELLATION
CITYSA6 SHOUL.C Am OF THe ABOVE CeSCRlBI J POL.ICIES BE CANCE:L.L.EC BEFORE: THE EXPlRATlON
CATE THEREOF, THE: ISSUING INSURER V1LL. E~IL * 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER "VIlE[) TO THE LEFT, SlIT F~Il:XIHAll
~~1Iil(l9E!R~!ltW~!JI!n!\fl(-XlOOlX'X'Xltllllla!~~
-jl'il'WWWY,
~REt:)T~ (l~~
ACORD 25(20011081
~
III ACORD CORPORATION 198B
,
,.
~
COMMERaAL GENERAL UABlUTY
CG20101001
THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS. SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL L1ABIUTY COVERAGE PART
SCHEDULE
Nama of PellOll 01 Organlzlllon:
BLANKET ADDITIONAL INSURED SHALL BE ANY PERSON(S) OR ORGANIZATIOB(SI KITH WHOM YOU
AGREE IN WRI'l'rEN CONTRACT TO !lAME AS AN ADDITIONAL INSURED AS RECORDED ON FILE WITH
COMPANY.
A. Sactlon II - Who Ie An Inaurecl ie amandad to
include as an ineured the pe/Sal or organiza-
tion shown in the Schedule, but only with ra-
spect to liability erising out of your ongoing
oparotions parfonmed for thet insU'ed.
B. With respect to the insurance afforded to
thesa additional insureds. the following exclu-
sion is edded:
2. Exclueions
This insurance does not epply to 'bodily
injU'y" or 'property damage' occurring
after:
(1) All work, including materials,
parts or eou ipment Furnished in
connection with such work, on
tha project (othar than service.
maintenance or repoirs) to be per-
formed by or on behalf of the
additional insuredls) at the site of
the covered operstlons has been
completed; or
(21 That portion of 'your work' out of
which the injury or damega arises
has baen put to ~s intended use
by any parson or organization
other then another contractor or
subcontractor e~gagad in perform-
ing opera1ione for a principal ae a
part of the 88me 1lI'0ject.
CG20 10 1001
s ISO Properties, Inc., :WOO
PageloflD