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HomeMy WebLinkAboutLD24-1680Permit Number: LD24-1680 LD - Utilities/ Excavation - Parallel Issued: 06/19/2024 Expired: 12/16/2024 Job Address: 44535 Bedford Ct Legal Description: City of Temecula - Land Development Division 41000 Main Street - Temecula, CA 92590 Mailing Address: P.O. Box 9033 Temecula, CA 92589-9033 Phone: (951) 308-6395 Fax: (951) 694-6475 Tracey Farmer 555 W 5Th Street Los Angeles, CA 90013 Applicant: Contractor: Utility Work Order Number: Description: Pothole WORK HOURS SHALL BE SUNDAY – THURSDAY, NO HOLIDAYS, 9:00pm – 5:00am Location: Various City Wide Proposed work: Pothole to verify Southern California gas pipeline as shown on exhibit "GSTR-24" LINE 1028 HYDROTEST, LD24-1680" All facilities shall be installed in accordance with City Standard Drawing 117. Traffic Control shall be in accordance with approved Traffic Control Plan LD24-1680 Permittee shall comply with all applicable Traffic Control General Notes. Safe pedestrian/bicycle traffic and driveway access shall be maintained at all times. Concrete repair shall be in accordance with City Standards and the Greenbook. Trench repair shall be in accordance with City Standard Drawing 407. Final compaction test results shall be provided by a soils engineer. Concrete curbs, walks, gutters, cross gutters and driveway approaches damaged during construction shall be removed from joint to joint and reconstructed in accordance with City Standards and the Greenbook. All disturbed landscaping and other improvements shall be removed/repaired and replaced to the satisfaction of Public Works Inspector. Permittee shall contact LDInspections@temeculaca.gov a minimum of two (2) business days prior to any work. Page 1 of 3*****See Page 2 of this Permit for Permittee Responsibilities***** Permit Number: LD24-1680 LD - Utilities/ Excavation - Parallel Permittee must also request a final inspection, via LDInspections@temeculaca.gov, to verify completion of project. Permittee Responsibilities This Permittee agrees to indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Trench repair shall be pursuant to City of Temecula Standard Drawing No. 407. 3.Traffic control devices shall be utilized to protect and control pedestrian and vehicular traffic in the construction area in accordance with the latest revision of the “Manual of Uniform Traffic Control Devices for Streets and Highways” (MUTCD). The contractor shall submit a specific traffic control plan for review and approval by the City in accordance with City “Traffic Control Plan Guidelines” for all work within Major Circulation Element streets. 2.BEFORE YOU DIG - CALL (TOLL FREE) 800-422-4133 A pre-construction meeting is required two (2) business days prior to any scheduled work. Permittee shall contact LDInspections@TemeculaCA.gov to schedule a meeting. 1. 4. Water Quality: Contractor shall remain in compliance with the City Water Pollution Control Ordinance. Contractor is required to provide protection of the City storm drain system. 5. Work hours shall be limited between 7:30 AM and 4:30 PM, Monday through Friday, unless otherwise noted. No work shall be allowed during City-recognized holidays." 6. THIS PERMIT IS ISSUED AND ACCEPTED SUBJECT TO THE FOLLOWING CONDITIONS AND ANY ATTACHED PROVISIONS: All U.S.A. mark outs shall be removed prior to completion of project.7. 8.All contractors and subcontractors shall have a valid City of Temecula business license and valid Certificate of Liability prior to start of work. 9.Should there be any claim against the City and the property owner with the encroachment being the proximate cause, the property owner shall be notified in writing to remove the encroachment within 30 days or the City will remove and bill the owner. 10.Permission is hereby requested to encroach into public right of way to perform work as set forth above. It is understood that this permit is limited to the work described herein and that all work is to be done in compliance with the provisions attached to this permit and with all other applicable rules. Permittee shall be responsible for said compliance, for acceptability of the work, for repair or replacement thereof if defective, and for repair or replacement of any existing improvement damaged by the doing of the work I hereby certify and agree on behalf of the Permittee that all laws, regulations and ordinances of the City of Temecula and the State of California and the terms and conditions of the Permit shall be complied with whether herein stated or not. 11. 12.I hereby warrant and represent to the City that I am authorized to execute this Permit Application on behalf of the Permittee and bind the Permittee to the agreements contained herein and any conditions of the Permit. ******Contractor and all subcontractors shall be present at the pre-construction meeting; otherwise, the meeting will be rescheduled to a later date****** Any work commencing within the City right-of-way before permit issuance or a pre-construction meeting shall be subject to a 72-Hour suspension of said work and an assessment of double permit fees.13. Permitee Date Page 2 of 3 Permit Number: LD24-1680 LD - Utilities/ Excavation - Parallel City Engineer or Authorized Representative Date 06/19/2024 Page 3 of 3 PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 END ROAD WORK G20-2 W20-1 WORKROAD AHEAD C30(CA) CLOSEDLANE W20-4 ROADONE LANE AHEAD C9A(CA)W3-4 PREPAREDBE TO STOP END ROAD WORK G20-2 W20-1 WORKROAD AHEAD C30(CA) CLOSEDLANE PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 W20-4 ROADONE LANE AHEAD C9A(CA)W3-4 PREPAREDBE TO STOP END ROAD WORK G20-2 W20-1 WORKROAD AHEAD C30(CA) CLOSEDLANE PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 W20-4 ROADONE LANE AHEAD C9A(CA)W3-4 PREPAREDBE TO STOP R3-5(LT) ONLY R3-5 (RT) ONLY R3-2 ROAD CLOSED THRU TRAFFIC R11-4 TO PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 END ROAD WORK G20-2 W20-1 WORKROAD AHEAD W20-2 DETOUR AHEAD R5-1 DO NOT ENTER ROAD CLOSED R11-2 W20-3 CLOSEDROAD AHEAD R3-2 R3-1 C30(CA) CLOSEDLANE R3-5(LT) ONLY R3-5 (RT) ONLY C27(CA) TRENCHOPEN W3-4 PREPARED BE TO STOP W1-6(LT) C9A(CA)R3-7(RT) MUST RIGHT LANE TURN RIGHT PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 END ROAD WORK G20-2 W20-1 WORKROAD AHEAD W20-4 ROADONE LANE AHEAD C9A(CA)W3-4 PREPAREDBE TO STOP W4-2(RT) AHEAD RIGHT LANECLOSED C20(RT) W1-6(LT) END ROAD WORK G20-2 W20-1 WORKROAD AHEAD C30(CA) CLOSEDLANE PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 AHEAD RIGHT LANECLOSED C20(2RT)W4-2(RT) W1-6(LT) W6-4 W1-3(RT)W1-3(LT) 2 PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 END ROAD WORK G20-2 W20-1 WORKROAD AHEAD C30(CA) CLOSEDLANE W3-4 PREPAREDBE TO STOP C9A(CA)W20-4 ROADONE LANE AHEAD W1-3(LT) PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning 03/26/2024 W20-1 WORKROAD AHEAD END ROAD WORK G20-2 C9A(CA)C30(CA) CLOSEDLANE W3-4 PREPAREDBE TO STOP W20-4 ROADONE LANE AHEAD END ROAD WORK G20-2 W20-1 WORKROAD AHEAD C30(CA) CLOSEDLANE PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 AHEAD RIGHT LANECLOSED C20(RT)W4-2(RT) PREPARED BY: 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location 03/26/2024 END ROAD WORK G20-2 W20-1 WORKROAD AHEAD C30(CA) CLOSEDLANE AHEAD RIGHT LANECLOSED C20(RT)W4-2(RT) END ROAD WORK G20-2 W20-1 WORKROAD AHEAD C30(CA) CLOSEDLANE PREPARED BY: C. RAMIREZ 05/17/2024 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location AHEAD BIKE LANECLOSED C20(BIKE) SHARE THE ROAD W16-1 W11-1 W1-6(LT) BIKE LANE CLOSED SC11(MOD) W4-2(RT) AHEAD RIGHT LANECLOSED W20-5(RIGHT( 6/12/20 24 06/17/24 END ROAD WORK G20-2 W20-1 WORKROAD AHEAD C30(CA) CLOSEDLANE PREPARED BY: C. RAMIREZ 05/17/2024 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location W3-4 PREPAREDBE TO STOP W20-4 ROADONE LANE AHEAD C9A(CA) SAN DIEGO A Q U E D U C T END ROAD WORK G20-2 W20-1 WORKROAD AHEAD C30(CA) CLOSEDLANE PREPARED BY: C. RAMIREZ 05/17/2024 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location W3-4 PREPAREDBE TO STOP W20-4 ROADONE LANE AHEAD C9A(CA) END ROAD WORK G20-2 W20-1 WORKROAD AHEAD PREPARED BY: C. RAMIREZ 05/17/2024 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location C30A(CA) CLOSEDSHOULDER W21-5 SHOULDER WORK END ROAD WORK G20-2 W20-1 WORKROAD AHEAD PREPARED BY: C. RAMIREZ 05/17/2024 4150 CONCOURS STREET, SUITE 100, ONTARIO, CA 91764 PHONE: (909) 989-9789 FAX: (909) 989-9660 Engineering | Geospatial | Land Planning | Utility Location C30A(CA) CLOSEDSHOULDER W21-5 SHOULDER WORK Land Development Utility Plan General Notes 41000 Main Street Temecula, CA 92590 Phone: 951-694-6444 www.temeculaca.gov Utility Construction/Site plans shall be submitted for review and include the following, but not be limited to: 1. The City Engineer or their representative has the authority to initiate field changes to assure public safety. 2. BEFORE YOU DIG – CALL (TOLL FREE) (800)422-4133 3. Where there is conflict with the permit language and approved plans, the approved plans shall govern. 4. Trench repair shall be in accordance with City Standard Drawing 407. 5. All facilities shall be installed in accordance with City Standard Drawing 117. 6. Concrete curbs, walks, gutters, cross gutters and driveway approaches damaged during construction shall be removed from joint to joint and reconstructed in accordance with City Standards and the Greenbook. 7. All disturbed landscaping and other improvements shall be removed or repaired and replaced to the satisfaction of Public Works. 8. Access ramps shall be removed joint to joint and reconstructed in accordance with City Standard Drawing 402 and meet current ADA Standards. 9. Any survey monuments damaged or destroyed shall be reset per City Standards by a qualified professional pursuant to the California Business and Professions Code Section 8771. 10. Final compaction test results shall be provided by a soils engineer. 11. A pre-construction meeting is required two (2) business days prior to any scheduled work. Permittee shall contact LDInspections@temeculaca.gov to schedule a meeting. 12. All U.S.A. mark outs shall be removed prior to completion of project. 13. A final inspection is required for all projects. Permittee must contact LDInspections@temeculaca.gov to verify completion of project. 14. Standard Inspection Request shall include: ➢ Permit Number: ➢ Requested Date (of work proposed): ➢ Requested Time (am, pm, or specific time): ➢ Inspection Type (Pre-construction, Repair, Restorations, Traffic Control, Final, etc.): ➢ Inspection Location: ➢ Requestor Name/Company: ➢ Field Contact Name/Number: CLEARED BY CITY OF TEMECULA PUBLIC WORKS Tricia.ortega 06/12/2024 06/12/2024 06/12/2024 06/12/20 LEGEND: POTHOLE ACCESS ROAD PROPERTY LINE PIPELINE-EXISTING NOT A PART OF LD24-1680 THIS LOCATION LIES OUTSIDE CITY OF TEMECULA JURISDICTION LEGEND: POTHOLE ACCESS ROAD PROPERTY LINE PIPELINE-EXISTING NOT A PART OF LD24-1680 THIS LOCATION LIES OUTSIDE CITY OF TEMECULA JURISDICTION LEGEND: POTHOLE ACCESS ROAD PROPERTY LINE PIPELINE-EXISTING NOT A PART OF LD24-1680 THIS LOCATION LIES OUTSIDE CITY OF TEMECULA JURISDICTION LEGEND: POTHOLE ACCESS ROAD PROPERTY LINE PIPELINE-EXISTING LEGEND: POTHOLE ACCESS ROAD PROPERTY LINE PIPELINE-EXISTING LEGEND: POTHOLE ACCESS ROAD PROPERTY LINE PIPELINE-EXISTING LEGEND: POTHOLE ACCESS ROAD PROPERTY LINE PIPELINE-EXISTING SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 5/23/2024 Alliant Insurance Services,Inc. 18100 Von Karman Ave 10th Fl Irvine CA 92612 Nick Parizino 949 -260-5055 Nick.Parizino@alliant.com Zurich American Insurance Comp 16535 Amer Guarantee &Liab Ins Co 26247KanaSubsurfaceEngineering 12620 Magnolia Ave. Riverside CA 92503 Pacific Insurance Company,Lim 10046 1459846805 A X 1,000,000 X 100,000 5,000 1,000,000 2,000,000 X Y Y GLO 0478441 -00 8/1/2023 8/1/2024 2,000,000 Deductible 5,000 A 1,000,000 X Y Y BAP 0478439 -00 8/1/2023 8/1/2024 B X 10,000,000 X Y SXS 0673825-00 8/1/2023Y 8/1/2024 10,000,000 Products -Comp/Op Agg 10,000,000 A X N Y WC 0686374 -00 8/1/2023 8/1/2024 1,000,000 1,000,000 1,000,000 C Contractors Professional Liab Pollution Liability 13 CPI GC8660 8/1/2023 8/1/2024 $3,000,000 $2,000,000 $5,000,000 SIR $25,000 SIR $10,000 Policy Aggregate Re:SoCal Gas L1028 potholing. City of Temecula and The Owner/Developer are named as Additional Insured per attached endorsements.Per Project Aggregate applies per attached endorsements. 30 City of Temecula 41000 Main Street Temecula CA 92590 U-GL-2162-A CW (02/19) Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. INTERNAL USE ONLY Additional Insured – Automatic – Owners, Lessees Or Contractors THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO-0478441-00 Effective Date: 08/01/2023 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part A. Section II – Who Is An Insured is amended to include as an additional insured any person or organization whom you are required to add as an additional insured under a written contract or written agreement executed by you , but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" and subject to the following: 1. If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a. The Insurance Services Office (ISO) ISO CG 20 10 (10/01 edition); or b. The ISO CG 20 37 (10/01 edition), such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" arises out of : (1) Your ongoing operations, with respect to Paragraph 1.a. above; or (2) "Your work", with respect to Paragraph 1.b. above, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 1., insurance afforded to such additional insured: (a) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (b) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. 2. If such written contract or written agreement specifically requires that you provide that the person or organization be named as an additional insured under one or both of the following endorsements: a. The Insurance Services Office (ISO) ISO CG 20 10 (07/04 edition); or b. The ISO CG 20 37 (07/04 edition), such person or organization is then an additional insured with respect to such endorsement(s), but only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf, POLICY NUMBER: GLO-0478441-00 U-GL-2162-A CW (02/19) Page 2 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. INTERNAL USE ONLY in the performance of: (a) Your ongoing operations, with respect to Paragraph 2.a. above; or (b) "Your work" and included in the "products-completed operations hazard", with respect to Paragraph 2.b. above, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 2., insurance afforded to such additional insured: (i) Only applies if the "bodily injury", "property damage" or "personal and adve rtising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (ii) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. 3. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that you provide that the person or organization be named as an additional insured : a. Under the ISO CG 20 10 (04/13 edition, any subsequent edition or if no edition date is specified); or b. With respect to ongoing operations (if no form is specified), such person or organization is then an additional insured only to the extent that "bodily injury", "property damage" or "personal and advertising injury" is 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, which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 3., insurance afforded to such additional insured: (a) Only applies to the extent permitted by law; (b) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured; and (c) Only applies if the "bodily injury", "property damage" or "personal and advertising injury" offense occurs during the policy period and subsequent to your execution of the written contract or written agreement. 4. If neither Paragraph 1. nor Paragraph 2. above apply and such written contract or written agreement requires that you provide that the person or organization be named as an additional insured: a. Under the ISO CG 20 37 (04/13 edition, any subsequent edition or if no edition date is specified); or b. With respect to the "products-completed operations hazard" (if no form is specified), such person or organization is then an additional insured only to the extent that "bodily injury" or "property damage" is caused, in whole or in part by "your work" and included in the "products-completed operations hazard", which is the subject of the written contract or written agreement. However, solely with respect to this Paragraph 4., insurance afforded to such additional insured: (1) Only applies to the extent permitted by law; (2) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured; (3) Only applies if the "bodily injury" or "property damage" occurs during the policy period and subsequent to your execution of the written contract or written agreement; and (4) Does not apply to "bodily injury" or "property damage" caused by "your work" and included within the "products-completed operations hazard" unless the written contract or written agreement specifically requires that you provide such coverage to such additional insured. POLICY NUMBER: GLO-0478441-00 U-GL-2162-A CW (02/19) Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. INTERNAL USE ONLY B. Solely with respect to the insurance afforded to any additional insured referenced in Section A. of this endorsement, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services including: 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional architectural, engineering or surveying services. C. Solely with respect to the coverage provided by this endorsement, the following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV – Commercial General Liability Conditions: The additional insured must see to it that: (1) We are notified as soon as practicable of an "occurrence" or offense that may result in a claim; (2) We receive written notice of a claim or "suit" as soon as practicable; and (3) A request for defense and indemnity of the claim or "suit" will promptly be brought against any policy issued by another insurer under which the additional insured may be an insured in any capacity. This provision does not apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement requires that this coverage be primary and non-contributory. D. Solely with respect to the coverage provided by this endorsement: 1. The following is added to the Other Insurance Condition of Section IV – Commercial General Liability Conditions: Primary and Noncontributory insurance This insurance is primary to and will not seek contribution from any other insurance available to an additional insured provided that: a. The additional insured is a Named Insured under such other insurance; and b. You are required by written contract or written agreement that this insurance be primary and not seek contribution from any other insurance available to the additional insured. 2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition under Section IV – Commercial General Liability Conditions: This insurance is excess over: Any of the other insurance, whether primary, excess, contingent or on any other basis, available to an additional insured, in which the additional insured on our policy is also covered as an additional insured on another policy providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any policy in which the additional insured is a Named Insured on such other policy and where our policy is required by a written contract or written agreement to provide coverage to the additional insured on a primary and non - contributory basis. E. This endorsement does not apply to an additional insured which has been added to this Coverage Pa rt by an endorsement showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to that identified additional insured. F. Solely with respect to the insurance afforded to an additional insured under Paragraph A.3. or Paragraph A.4. of this endorsement, the following is added to Section III – Limits Of Insurance: Additional Insured – Automatic – Owners, Lessees Or Contractors Limit The most we will pay on behalf of the additional insured is the amount of insurance: POLICY NUMBER: GLO-0478441-00 U-GL-2162-A CW (02/19) Page 4 of 4 Includes copyrighted material of Insurance Services Office, Inc., with its permission. INTERNAL USE ONLY 1. Required by the written contract or written agreement referenced in Section A. of this endorsement; 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. All other terms, conditions, provisions and exclusions of this policy remain the same. POLICY NUMBER: GLO-0478441-00 COMMERCIAL GENERAL LIABILITY CG 25 03 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2 Wolters Kluwer Financial Services | Uniform FormsTM INTERNAL USE ONLY DESIGNATED CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Designated Construction Project(s): Any construction project except a construction project for which a consolidated (wrap-up) or similar insurance program has been provided. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section I – Coverage A, and for all 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 above: 1. A separate Designated Construction Project 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 hazard", and for medi- cal expenses under Coverage C regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Con- struction Project General Aggregate Limit 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 above. 4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to appl y. However, instead of being subject to the General Aggregate Limit shown in the Decla- rations, such limits will be subject to the appli- cable Designated Construction Project Gen- eral Aggregate Limit. POLICY NUMBER: GLO-0478441-00 Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09 B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur- rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which cannot be at- tributed only to ongoing operations at a single designated construction project shown in the Schedule above: 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 reduce any Desi g- nated Construction Project General Aggre- gate Limit. C. When coverage for liability arising out of the "products-completed operations hazard" is pro- vided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-completed Operations Ag- gregate Limit, and not reduce the General Ag- gregate 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 contract- ing parties deviate from plans, blueprints, de- signs, specifications or timetables, the project will still be deemed to be the same construction pro- ject. E. The provisions of Section III – Limits Of Insur- ance not otherwise modified by this endorsement shall continue to apply as stipulated. U-GL-1060-F CW (05/22) Page 1 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Contractors Liability Supplemental Coverages and Conditions THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy No. GLO-0478441-00 Effective Date: 08/01/2023 This endorsement modifies insurance provided under the: Commercial General Liability Coverage Part NON-OWNED WATERCRAFT SCHEDULE Watercraft Length: feet (If no amount is shown above, 51 feet applies.) A. Non-owned Watercraft Liability Extended Coverage Paragraph (2) of Exclusion 2.g. Aircraft, Auto Or Watercraft under Section I – Coverage A – Bodily Injury And Property Damage Liability is replaced by the following: (2) A watercraft you do not own that is: (a) Less than the length shown in the Non-Owned Watercraft Schedule of this endorsement; and (b) Not being used to carry persons or property for a charge; B. Damage To Premises Rented Or Occupied By You 1. The last paragraph under Paragraph 2. Exclusions of Section I – Coverage A – Bodily Injury And Property Damage Liability is replaced by the following: Exclusions c. through n. do not apply to damage by "specific perils" to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Damage to Premises Rented To You Limit of Insurance applies to this coverage as described in Section III – Limits Of Insurance. 2. The paragraph directly following Paragraph (6) in Exclusion j. of Section I – Coverage A – Bodily Injury And Property Damage Liability is replaced by the following: Paragraphs (1), (3) and (4) of this exclusion do not apply to "property damage" to premises (other than damage by "specific perils"), including "property damage" to the contents of such premises, rented to you under a rental agreement for a period of 14 or fewer consecutive days. A separate Limit of Insurance applies to Damage to Premises Rented to You as described in Section III – Limits Of Insurance. 3. Paragraph 6. of Section III – Limits Of Insurance is replaced by the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A for damages because of "property damage" to any one premises while rented to you, or in the case of damage by one or more "specific perils" to any one premises, while rented to you or temporarily occupied by you with permission of the owner. 4. Paragraph a. of the "insured contract" definition under the Definitions Section is replaced by the following: a. A contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by "specific perils" to premises while rented to you or temporarily occupied by you with permission of the owner is not an "insured contract"; POLICY NUMBER: GLO-0478441-00 U-GL-1060-F CW (05/22) Page 2 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 5. Paragraph (ii) under Paragraph 4.b.(1) of the Other Insurance Condition under Section IV – Commercial General Liability Conditions is replaced by the following: (ii) That is property insurance providing coverage for "specific perils" for premises rented to you or temporarily occupied by you with permission of the owner; 6. The following definitions are added to the Definitions Section: "Specific perils" means fire, lightning, explosion, windstorm or hail, smoke, aircraft or vehicles, riot or civil commotion, vandalism, leakage from fire extinguishing equipment, weight of snow, ice or sleet or "water damage". "Water damage" means accidental discharge or leakage of water or steam as the direct result of the breaking or cracking of any part of a system or appliance containing water or steam. C. Additional Insured – Lessor Of Leased Equipment – Automatic Status When Required In Lease Agreement With You 1. Section II – Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in a written contract or written agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s). However, the insurance afforded to such additional insured: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. A person’s or organization’s status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. 2. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 3. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the written contract or written agreement you have entered into with the additional insured; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. The insurance provided by this Paragraph C. shall not increase the applicable Limits of Insurance shown in the Declarations. D. Additional Insured – Managers Or Lessors Of Premises 1. Section II – Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) that you have agreed in a written contract or written agreement to name as an additional insured, but only with respect to liability arising out of the ownership, maintenance or use of that part of premises leased to you and subject to the following additional exclusions: This insurance does not apply to: a. Any "occurrence" which takes place after you cease to be a tenant in that premises. b. Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured manager or lessor of the premises leased to you. However, the insurance afforded to such additional insured: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. POLICY NUMBER: GLO-0478441-00 U-GL-1060-F CW (05/22) Page 3 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission. 2. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the written contract or written agreement you have entered into with the additional insured; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. The insurance provided by this Paragraph D. shall not increase the applicable Limits of Insurance shown in the Declarations. E. Additional Insured – State Or Governmental Agency Or Subdivision Or Political Subdivision – Permits Or Authorizations 1. Section II – Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision that you have agreed in a written contract or written agreement or that you are required by statute, ordinance or regulation to name as an additional insured, subject to the following provisions: a. This insurance applies only with respect to operations performed by you or on your behalf for wh ich the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. b. This insurance does not apply to: (1) "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or (2) "Bodily injury" or "property damage included within the "products-completed operations hazard". However, the insurance afforded to such additional insured: a. Only applies to the extent permitted by law; and b. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits of Insurance: The most we will pay on behalf of the additional insured is the amount of insurance: a. Required by the written contract or written agreement you have entered into with the additional insured; or b. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. The insurance provided by this Paragraph E. shall not increase the applicable Limits of Insurance shown in the Declarations. F. Personal And Advertising Injury Coverage – Assumed Under Contract Or Agreement 1. Exclusion e. of Section I – Coverage B – Personal And Advertising Injury Liability is replaced by the following: 2. Exclusions This insurance does not apply to: e. Contractual Liability "Personal and advertising injury" for which the insured has assumed liability in a contract or agreement. This exclusion does not apply to: (1) Liability for damages that the insured would have in the absence of the contract or agreement; or (2) Liability for "personal and advertising injury" if: (a) The liability pertains to your business and is assumed in a contract or agreement that is an "insured contract"; and (b) The "personal and advertising injury" occurs subsequent to the execution of the contract or agreement. POLICY NUMBER: GLO-0478441-00 U-GL-1060-F CW (05/22) Page 4 of 6 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Solely for the purposes of liability so assumed in such "insured contract", reasonable attorney fees and necessary litigation expenses incurred by or for a party other than an insured are deemed to be damages because of "personal and advertising injury", provided: (i) Liability to such party for, or for the cost of, that party’s defense has also been assumed in the same contract or agreement; and (ii) Such attorney fees and litigation expenses are for defense of that party against a civil or alternative dispute resolution proceeding in which damages to which this insurance applies are alleged. 2. For purposes of this "personal and advertising injury" coverage only: Paragraph d. and the second to last paragraph under Paragraph 2. of Supplementary Payments – Coverages A and B are replaced by the following: d. The allegations in the "suit" and the information we know about the "occurrence" or offense are such that no conflict appears to exist between the interests of the insured and the interest of the indemnitee; So long as the above conditions are met, attorne ys’ fees incurred by us in the defense of that indemnitee, necessary litigation expenses incurred by us and necessary litigation expenses incurred by the indemnitee at our request will be paid as Supplementary Payments. Such payments will not be deemed to be damages for "bodily injury", "property damage" or "personal and advertising injury" and will not reduce the limits of insurance. G. Insured Contract Amendment Paragraph f. and f.(1) through f.(3) of the "insured contract" definition under the Definitions Section is replaced by the following: f. That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the t ort liability of another to pay for "bodily injury", "property damage" or "personal and advertising injury" to a third person or organization. Tort liability means a liability that would be imposed by law in the absence of any contract or agreement. Paragraph f. does not include that part of any contract or agreement: (1) That indemnifies a railroad for "bodily injury", "property damage" or "personal and advertising injury" arising out of construction or demolition operations within 50 feet of any railroad pro perty and affecting any railroad bridge or trestle, tracks, road-beds, tunnel, underpass or crossing; (2) That indemnifies an architect, engineer or surveyor for injury or damage arising out of: (a) Preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (b) Giving directions or instructions, or failing to give them, if that is the primary cause of the injury or damage ; (3) Under which the insured, if an architect, engineer or surveyor, assumes liability for an injury or damage arising out of the insured’s rendering or failure to render professional services, including those listed in (2) above and supervisory, inspection, architectural or engineering activities; (4) That indemnifies a person or organization for "personal and advertising injury": (a) Arising out of advertising, publishing, broadcasting or telecasting done for you or on your behalf; or (b) To an "employee" of such person or organization that does advertising, publishing, broadcasting or telecasting for you or on your behalf; or (5) That indemnifies a labor leasing firm for "bodily injury" to "leased workers". H. Medical Payments – Increased Reporting Period Paragraph a. of Section I – Coverage C – Medical Payments is replaced by the following: a. We will pay medical expenses as described below for "bodily injury" caused by an accident: (1) On premises you own or rent; (2) On ways next to premises you own or rent; or (3) Because of your operations;