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HomeMy WebLinkAboutINTERNATIONAL LINE BUILDERS, INC.-2011N- 2011.163 NON - EXCLUSIVE LICENSE AGREEMENT THIS LICENSE AGREEMENT ( "Agreement ") is made and entered into this day of «.,oels , 2011, by and between the City of Santa Ana, a charter city and municipal corporation, herein referred to as "Licensor", and International Line Builders, Inc., a California Corporation, herein collectively referred to as "Licensee ". 1. ACKNOWLEDGEMENTS A. Licensor owns the vacant lot located northwest corner of Warner Avenue and Magnolia Avenue, (Exhibit "A"), Santa Ana, California (APN #015 - 194 -37) [ "the License Area"]. Licensor desires to license use of said Area to Licensee. B. Licensee represents that it desires a License in order to use said License Area as a storage area. 2. GRANT OF LICENSE a. Licensor grants to Licensee a personal, non- exclusive, revocable license ( "License ") to encroach upon the License Area as hereinabove described and shown in general in Exhibit "A," attached hereto and incorporated herein by reference, for its use as a storage area for construction material and equipment, hereafter referred to as "storage area." b. Licensee may not encroach upon the License Area for any other purpose or business, other than using it as a storage area, without obtaining Licensor's prior written consent. c. Licensor will not be held responsible for loss of or damage to, any personal property left on the License Area, or improvements made by Licensee in the License Area. d. This License is made subject and subordinate to the prior and continuing right of Licensor to use the property or the use of the public right of way. 3. DUTIES OF LICENSEE a. In exercising these rights, Licensee must use reasonable care and may not unreasonably increase the burden on the License Area. Licensee agrees that any use it makes of the License Area as specified herein shall be affected with all reasonable diligence and precaution to avoid damage to the land, property or personnel. b. Licensee agrees to conform to any reasonable requirements related to the use of the License Area as a storage area set forth by the Licensor during the course of this License. c. Licensee will install green screening on the chain link fence and sandbags around the property. Ingress and Egress must be off Civic Center Drive. Supplies cannot be stacked above 6 -feet high. Licensee shall make no other improvements or installation to the License Area without the written approval of the Licensor. Licensee agrees to pay all the costs of the installation, operation, maintenance, repair and removal of any improvements in the License Area. d. Licensee shall, at its expense and to the satisfaction of Licensor, maintain the License Area in a neat, clean, sanitary and safe condition, in a manner consistent with community standards which will uphold the value of the Property, in accordance with this Agreement, the Santa Ana Municipal Code and all other applicable local, state and federal rules, regulations and standards. e. Licensee shall be responsible for the payment of all charges in connection with utility services provided to the License Area. "Utility services" shall include natural gas, water, electricity and sewer. f. Licensee shall not record, hypothecate, assign or attempt to record, hypothecate or assign this personal License. Any attempt by Licensee to record, hypothecate or assign this License shall automatically terminate this License Agreement and render this License void and invalid for all purposes. 4. MONTHLY COMPENSATION Licensee shall pay to Licensor monthly compensation in the amount of Seven Hundred and Fifty Dollars ($750.00) per month ( "Compensation ") for use of the License Area. Compensation will be due on the above said date, payable to "The City of Santa Ana" and remitted to the address listed herein below in Section 6 - "Notices ". All payments requiring prorating shall be prorated on the basis of a 30 -day month. A late charge of ten percent (10 %) shall be applied after any payment hereunder is due but unpaid. In addition, one and a half percent (1 %%) interest per month shall be added for each month that payment hereunder is due but unpaid. 5. REVOCATION Licensor may revoke this License, at will, upon fifteen (15) days notice in writing to the Licensee. 6. NOTICES Any notice to be given by either party shall be deemed to be properly served if deposited with the United States Postal Service, or other acceptable mailing service, postage prepaid, to the addresses below: TO LICENSOR: City of Santa Ana Public Works Agency Attn: Souri Amirani 20 Civic Center Plaza P.O. Box 1988 (M -36) Santa Ana, CA 92702 TO LICENSEE: International Line Builders, Inc. Attn: Guillermo Vera 2520 Rubidoux Boulevard Riverside, CA 92509 1) 7. TERMINATION OF OCCUPANCY a. Notwithstanding paragraph 5, this agreement will automatically terminate on December 31, 2012. b. Licensee accepts the License Area in an "as is" condition and upon termination or revocation of this License, Licensee shall, at its own cost and expense, remove any improvements installed by Licensee and surrender possession of the License Area to the Licensor in good order and repair and as nearly practicable to the state and condition in which it existed prior to the grant of this License, to the satisfaction of Licensor. c. In the event Licensee fails, neglects or refuses to remove said improvements and restore the License Area, such removal and restoration may be performed by Licensor, at the expense of Licensee, which expense Licensee agrees to pay to Licensor upon demand. d. Occupancy may be terminated by either party with thirty days written notice to the other party. 8. INSURANCE a. Licensee shall maintain commercial general liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence covering the License Area. Such insurance shall: (1) name the City of Santa Ana, its officers, agents, employees and volunteers as additional insureds; (2) be primary and not contributory with respect to insurance or self- insurance programs maintained by the Licensor, and (3) contain standard separation of insured's provisions. b. Licensee shall, prior to and as a condition of exercising any rights under this License Agreement, (i) furnish properly executed certificates of insurance and endorsement to the Licensor prior to exercising its rights under this License, which certificates shall clearly evidence all coverage's required above and provide that such insurance shall not be materially changed or terminated except with 30 days prior written notice to the Licensor; (ii) maintain such insurance during the entire term of this License Agreement; and (iii) replace such certificates for policies expiring prior to the termination of this License. -i�► 111 Licensee shall indemnify, defend and hold harmless Licensor, its officers, agents, employees and volunteers from and against any and all loss or damage, expenses, injuries, death to any person or damage to property, including property and employees, volunteers, officers or agents of Licensor or Licensee, and shall indemnify, defend and hold harmless Licensor, its officers, agents, employees and volunteers from all claims, demands, suits, actions or proceedings of any kind, and all costs and expenses, including but not limited to reasonable attorneys' fees, settlements or judgment, arising out of the construction, reconstruction, maintenance, presence, operation, use, removal or state of repair, of the License Area. 3 10. GOVERNING LAW This License shall be governed by and construed in accordance with the laws of the State of California. 11. ENTIRE AGREEMENT This License, together with all attachments hereto, constitutes the entire understanding and agreement of the parties. It supersedes any and all other agreements either oral or in writing between the parties hereto with respect to the terms set forth in this License and contains all the covenants and agreements between the parties with respect thereto. Each party to this License acknowledges that no representation, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, with respect to such services, which are not embodied herein, and that no amendment hereto shall be effective unless set forth in writing, approved by the Licensor and Licensee. 12. INDEPENDENT CONTRACTOR It is understood and agreed that Licensee, in the performance of this License, will be acting in a wholly independent capacity and not as agent, employee, partner, or joint venture of the Licensor. This License does not create a tenancy of any nature whatsoever between the Licensor and Licensee. 13. ASSIGNMENT BY LICENSEE PROHIBITED In no event shall Licensee assign or transfer any of the rights conferred herein without the prior express written consent of the Licensor. 14. ATTORNEY FEES AND COSTS In the event that any action is instituted to enforce payment or performance under this Agreement, or otherwise in connection with this Agreement, the parties agree that the prevailing party shall be reimbursed by the other party for all costs and attorneys' fees incurred by the prevailing party in such action. 15. CONFLICT OF INTEREST No member, official or employee of the City shall have any personal interest, direct or indirect, in this Agreement, nor shall any member, official or employee participate in any decision relating to this Agreement which affects his /her personal interests or the interests of any corporation, partnership or association in which he /she is directly or indirectly interested. > The parties have executed this personal, non - exclusive, revocable License Agreement as of the date and year first written above. 4 LICENSOR: PUBLIC WORKS AGENCY OFT C Tl( OF 4NTA NA By: _ Raul Go nez II Executive Director APPROVED AS TO FORM: Joseph Straka Interim City Attorney Laura Sheedy Assistant City Attorney LICENSEE: International Lin Builders, Inc. By: Xj J Title: 4jff =t tit I nW4.fir" L- NRO °® CERTIFICATE OF LIABILITY INSURANCE DATE ,21311 "riYl L -= O�OSi231 t THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER (:UN I At; I Marsh •JSA Inc. NAME: 333 South 7th Street. Suite 16(X) PHONE FAX IAlC, NQ. EIA): (Alt:, No): Minneapolis MN 55402 -2400 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 0 J43750-INT- GAVdX -11 -12 2010 2037 2048 A P Y INSURER A: Liberty Mutual Fie ins Co 23035 INSURED INSURER 8: WA N:A Inlemationai Line Builders - 2520 Rubici Blvd INSURER C: Liberty Mutual Insurance Company 23043 Riverside CA 92519 INSURER D INSURER E: INSURER F: COVERAGES CFRTIFII^_ATF 1d11W11APP. rl4i!`d1d97AAr5A -i1 ccvlclnu ulIuQCO. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIYYri MMIDOlYYYY LIMITS A GENERAL LIABILITY TB2641005097 -ik11 01•,01,Kl l 01 ,0112012 EACH CCCURRENCE S 2 X14 000 X COMMERCLAL GENERAL LIABILITY DAMAGE TO RENtED PREMISES IEa occurrence) 5 560,E CLAIMS MADE X OCCUR MED EXP IAny one person...... 5... ,�. X PER PROJECT AGGREGATE 2,090,(100 PERSONAL & ADV iNJLIRY g ._ GENERAL. AGGREGATE S 4,(yJi;.'J00 SF NI L AGGREGATE JWT APPLIES PER PRODUCTS - COMPIOP AGG S PR.'3- POLICV - I lOC S A AUTOMOBILE LIABILITY AS2 641 1+)5097 61 (i', 112011 0''f 1i201 12 C M8lNE0 SINGLE LIMIT 2,00C 0�,� Ea acpderw.; S X ANY AUTO BODILY INJURY (Per person) S ALL 0V`iNEO SCHEDULED AUTOS AUTOS BODILY INJURY IPer aceu7enti S X ,. HIRED AUTOS X AUNSV,fvF is iPera ciaeolI GE S S UMBRELLA LIAR Ck. CUR EACH OCCURRENCE EXCESS LAB CLAIMS - MADE.. AGGREGATE S - DED ! RETENTIONS g WORKERS COMPENSATION WC7-641 06509 021 (('ajar cos ;) 0110'.'rO1 t O1 01'2012 X 1RK STATU- OTH- AND EMPLOYERS' LIABILITY Y. N .'CRY LIMITS_ ER ..... _ rC W.A7 14�,W -5CA .011 (AOSi (11,;2011 01 Or'2012 YEC.UTS'vE r'' 1 G009C E EACH ACCIDENT 5 OFFICER'MEMBER EXRTNCE[ NIA C (Mandatory in NH) W03-64, 001569/ 031 f.CR.W+) 01,�) 1%201) 01101 ., 2012 _ E L DISEASE - EA EMPLOYEE S 1000,000 if yes describe under r DESCRIPTION OF OPERATIONS NS below .n6udeS'S!o;o Gaj.`' _.... E L. DISEASE - POLICY LIMIT S 7,fXJ0 C}'JU DESCRIPTION OF OPERATIONS r LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) e'. Coba;t 12Kv ' f amden S ;ibstation @ Warner Ave and Bristol Street The Gry of Santa -n-3 d'r, e ?ejM Cffiicial., officers. agents employees and volunteers is,are nciuded as additroral insured per the attached CG 2010 and CG 2137 endorserlents and does riot iri&,de p,,,fes ;iooal ability coverage. Blanket Additional insured for Automobile Liability is included per attached designated Insured Endorsement CA 20 48 Primary and Non Contribution, applies for General Lability per LN 20 Ot attached %,MF'1%,II I IUIV City of Santa Ana ?uci•c'dticrks A.cency SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Sour. Amlr: ;nll THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2u Gvic Center' °iaza ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 9,172 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashl Mukherlee _MaLtinpa�: .1+4� e.c_a�a�.a e L n 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 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 EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF - INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCT&COMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART 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, orthe number of days listed below, 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 overage 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)1 Organ ization s : Email Address or mailing address: Number Days Notice: Per Schedule on file with the company 90 All other terms and conditions of this policy remain unchanged. Policy No: AS2- 641 - 005097 -051 Issued By: Liberty Mutual Fire Insurance Company Effective Date: 01/01/2011 Expiration Date: 01/01/2012 sales Office: 465 LA 99 224 09 10 Page 1 of 1 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 EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART SELF - INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART 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 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. SCHEDULE Name of Other Person(s)1 Organ Ization s : Email Address or mailing address: Number Days Notice: Per Schedule on file with the company 90 All other terms and conditions of this policy remain unchanged. Policy No: T82- 641- CO5097 -041 Issued By: Liberty Mutual Fire Insurance Company Effective Date: 01/0112011 Expiration Date: 01/0112012 Sales Office: 465 LA 99 224 09 10 Page 1 of 1 Pr) ?7r_y Number: WA7 -64D- 005097 -011 Issued bv: LIBERTY BtUTUAL FIRE INSURANCE COMPANY Endorsernent Effective Date: 011 ©l!?ilt 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 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 email 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) I Organ Ization s : Email Address or mailing address: Number Days Notice: Per Schedule on file with the company 90 i All other terms and conditions of this policy remain unchanged. WM 90 18 09 10 2010 Iaberty Mutual Group of Companies Page 1 of 1 Ed_ [1)101;,2010 All Rights Reserved Policy Number. WC-/-641-00509?-021 Issued by: LIBERTY MUTUAL FIRE INSURANCE COMPANY Endorsement Effective Date: 01 /01 /2011 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 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 email 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) / Organ Izatlon(s) Email Address or mailing address: _ Number Days Notice: Per Schedule on file with the company -- -_._ ____ -9-0_____.___ Ali other terms and conditions of this policy remain unchanged. WM g0 18 Og 10 2010 Liberty Mutual Group of Compatnes Page I of 1 FA. e1) /U1 1'-,010 All Rights Reserved Policy Number. W(,7-()41-005(197-0 " "I Issued by: LIBERTY'- %fUTUA� FIRE INSURANCE COMPANY Endorseme-ntEffective Dre: 01/01/' 11 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. 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 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 email 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) ! Per Schedule on file with the company Email Address or mailing address: Number Days Notice: ' -90 - - -~- --------------- __� All other terms and conditions of this policy remain unchanged. WNt 90 is 09 10 2010 Liberty Mutual Groin of C'omPanies Fag'- 1 of I Ed. (N/01/2010 All Rights Reserved THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modified insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER 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 after coverage provided in the Coverage Form, SCHEDULE Name of Person(s) or Organization(s): Any person or organization whom you have agreed in writing to add as an additional insured, but only to coverage and minirnim hirruts of insurance required by the written a;:eer Pent and in no event to exceed either the scope of c:ovelsge or the linuts of insurance provided in this polity. Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. Policy Igo: AS2 -64 - 0k 097-0351 I", ued Fay: Lbe t f v'u :a Firer lnsur nc e (a):nranp Eff ective Date: 01/01/2011 Expiration Date: 01/01/2012 Sales Office: 0465 CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 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 SCHEDULE Name of Person or Organization: Any Owner, Lessee or Contractor from whom you have agreed in writing prior to a lose to provide liability insurance (If no entry appears above, information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) A. Section II — Who Is An Insured is amended to include as an insured the person or organi- zation shown in the Schedule, but only with re- spect to liability arising out of your ongoing op- erations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodity in- jury" or "property damage" occurring after: (1) All work, including materials, parts or equipment fumished 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 site of the covered operations has been completed; or CG 20 10 10 01 Cr7 ISO Properties, Inc., 2000 Page 1 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 pro- ject. This endorsement is executed by the LIBERTY MUTUAL FIRE fNSURANCF COMPANY Premium $ Effective Date 01/0112011 Expiration Date 0110112012 Far attachment to Policy No, 1 B2- 641 - 0050974)41 Audit Basis 'SSI.;ed I7 Page 2 of 2 Oc ISO Properties, Inc., 2000 CG 20 10 10 01 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 SCHEDULE Name of Person or Organization: Any person or organization for whom you have agreed in writing prior to a loss to provide Liability Insurance Location And Description of Completed Operations: Additional Premium: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section II — Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule. but only with respect to liability arising out of 'your work" at the location designated and described in the schedule of this endorsement performed for that insured and included in the "products - completed operations hazard ". This endorsement is execuleti by the LIBERTY MUTUAL F'RE.. INSURANCE COMPANY Premium $ Effective Date 0110112011 Expiration Date 01/01/2012 For atlacbment to Policy No 182- W- 00507 -041 Audit Basis ssued To CG 20 37 10 01 (J ISO Properties, Inc., 2000 Page 1 of 1 1'l-IIS ENDORSI.:MF,N "I' CHANGES THE POLICY. I'Li:ASE RL-AD I'I' CARL,FUL.LY'. BLANKET ADDITIONAL. INSURED Tn• ,s endotsernent modifies assurance prctvAed under the following; COWN4Lt tC:IAL c �NL:itAL LiAB I-ITY (UVL L''tc, FORM SECTION II WHO IS AN INSUREL) is amended to include as an insured any person cu organization. for whom you have agreed in wriung to provide liability insurance. But: 'Tip,° insurance provided by this amendment: 1. Applies only to "bodily injury" or "property dama�" arising out of lal "your work" or (b) premises of other property owned by Of rented to you-, Applies only to coverage and minimum lirn ;t, of insurance required by t!it written agreement, but in no event exceeds either the Scrip- of coverage or the 'imttc of insurance provided by this policy; and 3. Does not apply to any person or otganiza or. f.-,r whom you have procured separate liability insurance while such insurance is in effect, regardless of whether the scope of coverage or limits of insurance of this policy exceed -hose of such other insurance or whether such other assurance is valid and collectible. The fol owing pr wisio-as also apply: I. Where the applicable written agreement requires the insured to provide liability insurance on a pr.mary, excess, contingent, or any other basis, th s policy will apply solely on the basis required by such written agreement and Item -I. Other Insurance of SEC ION IV of this policy will not apply, where the applicable written Agreernrrir does no* specify on what basis :r' abi t,, nsurance. will apply, the ptovisions of Item 4. Other Insurance of Sp;C;T7ON IV of this poLcy wnli govern. 3 This endorsement shall not apply to any person or organization for any "bodily injury" or "property damage" if any other additional insured endofsemetrt ,n this policy applies r.o that perc;on or organization with regard to the "bodily injury" or "property damage ". 4. If any other addiuonal insured endorsement app'ies to any person or organizanc,n and you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any other basis for that additional insured, this policy will apply so`ely on the basis required by such written agreement and Item 4. Other Insurance of SECTION IV of this policy will not apply, regardless of whether the person or organization has available other valid and collectible insurance. If the applicable written agreement does not sperfy cn what basis the liability ins uance will apply, the provisoons o£Item =. Other Insurance of S .Ci"ICl\: I1,' :if this } >olicy will ?pverr.. This emdommi- tit is exrcutedb,1 the LIBERTY MUTUAL FIRE INSURANCE COMPANY P'trniurn f ).Ercclve Dair - EXPi2tien1-Date For ittachrr,er,t to Policy No, lssucd To LN 20 0106 05